• Tuberculosis and Respiratory Diseases
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• v.62 no.3
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• pp.211-216
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• 2007

Hyperhomocysteinemia is an independent risk factor for cardiovascular, cerebrovascular and peripheral vascular diseases that are complicated by atherosclerosis and a thromboembolism. An increased level of plasma homocysteine develops from a genetic defect in the of enzyme for the homocysteine metabolism or a vitamin deficiency. Hyperhomocysteinemia has direct toxic effect on the vascular endothelium and causes damages to the antithrombotic action of vascular endothelial cells. Most cases of hyperhomocysteinemia are asymptomatic, but cardiopulmonary or cerebrovascular incidents developin rare cases. In the case of a thromboembolism with an unknown cause, hyperhomocysteinemia should be considered in a differential diagnosis. The authors report a case of pulmonary thromboembolism in a patient with hyperhomocysteinemia with a review of the relevant literature.

• Tuberculosis and Respiratory Diseases
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• v.63 no.4
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• pp.362-367
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• 2007

Hormonal replacement therapy (HRT) has been proven for treatment of postmenopausal symptoms such as hot flushes, night sweats and urologic symptoms. HRT became very popular in the 1990's, when there were several reports showing that it also helped with other menopausal complications such as osteoporosis and cardiovascular disease. Recent studies report that the incidence of breast cancer, endometrial cancer, cerebral infarction, coronary artery diseases, deep vein thrombosis and pulmonary thrombembolism could rise after HRT. Among these side effects of HRT, the risk of pulmonary thromboembolism increases 2 to 4 fold after HRT, but can vary with the use of different doses and preparations. Here, we summarize the risk factors and clinical courses for 5 patients who developed pulmonary thromboembolism after postmenopausal HRT.

• The Journal of Internal Korean Medicine
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• v.30 no.2
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• pp.438-449
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• 2009

Objectives: Deep vein thrombosis (DVT) is a common complication among stroke patients. The implication of DVT progressing into a fatal pulmonary embolism is one of the main reasons treatment cannot be delayed. However, when there is a contradiction for anticoagulants, such intracranial hemorrhage (ICH), it is difficult to determine the course of treatment. Our team reports a case with both acute DVT and ICH who improved with herbal medicine Hyulbuchuko-tang. Methods : A patient with a variety of thrombosis risk factors (atrial fibrillation, DVT, Cb-inf with intracranial hemorrhage due to thrombolytic complications) showed classic symptoms of DVT (pain, edema, discoloration), disorientation and chest discomfort. The patient was administered Hyulbuchuko-tang three times a day for 24 days without any anticoagulants. Conservative therapy including elastic stocking and leg elevation was co-administered. Laboratory tests and extremity vascular Doppler sonography were carried out 3 times during the treatment period. Results : After our treatment period, both popliteal vein DVT and calf vein DVT were not discovered by sonography, and thrombosis derived factors (eg. D-dimer, fibrinogen) decreased. There was no sign of edema or discoloration after treatment, and the patient no longer complained of leg pain, disorientation or chest discomfort. Conclusion : From these results, we suggest that there is a positive effect of Hyulbuchuko-tang on DVT. Hyulbuchuko-tang should be considered as a treatment option when western medical procedures are unavailable.

• Journal of Trauma and Injury
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• v.25 no.4
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• pp.109-114
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• 2012

Purpose: Deep vein thrombosis and pulmonary thromboembolism are major causes of death after severe multiple trauma. Although various means of prevention have been presented and utilized, still, there are no standard guidelines for anticoagulation of multiple trauma because of some contraindications. Methods: A retrospective study of adult major trauma patients whose injury severity scores (ISSs) were over 16 and who had visited one university hospital in Daegu city was performed. We compared some features of patients diagnosed DVT or PTE with those of patients without DVT by computed tomography or ultra sonography. Those features included accompanying various kinds of intracranial hemorrhages, possibility of ambulation, emergent operation, early transfusion, and suspicious symptoms. Results: The mean age of the 58 subjects included in this study was $50.9{\pm}17.2years$, the mean ISS was $22.7{\pm}6.0$, and the mean hospital stay was $55.2{\pm}37.9days$. Ten(17.2%) patients had emergent surgery, and 44(75.9%) experienced delayed surgery. Early transfusion was needed in 34(58.6%) patients. Among the 18 patients diagnosed with DVT, accompanying intracranial hemorrhages were noted in 8(44.4%) patients; one of the 8 also had PTE. Among the same 18 patients, early transfusions were required in 11(61.1%) patients; one of the 11 also had PTE. Conclusion: The risk of DVT is increased in cases of severe multiple trauma, and many difficulties in applying anticoagulants are experienced. Though we need additional studies to decide proper prophylaxis for DVT and PTE, if the patient's general condition permits, a screening test for DVT as soon as possible could be an effective method to reduce the possibility of a bad outcome.

• Journal of Physiology & Pathology in Korean Medicine
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• v.29 no.6
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• pp.503-509
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• 2015

This is a case report on a deep vein thrombosis(DVT) patient whose pain, numbness, and swelling in the left leg have been decreased with Korean Medicine. The 59 year-old male patient who was diagnosed with DVT and showed the classic symptoms of DVT(pain, numbness and swelling in the left leg). Although he was treated with medication(100mg of aspirin, 20mg of rivaroxaban) for five weeks, his symptoms did not improved. Then, he was gaven Sunkihwalhyul-tang three times a day and Jungsongouhyul pharmacopuncture once a day for two months. Conservative therapy including leg elevation and an elastic stocking was co-administered. During our treatment period, the size of the thrombus in the left external iliac vein was decreased according to sonography compared with the pre-hospital's sonography, and the patient felt his symptoms had improved. This case report suggests Korean Medicine may play a role in improving the deep vein thrombosis symptoms.

• Archives of Plastic Surgery
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• v.38 no.5
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• pp.703-706
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• 2011

Purpose: Augmentation mammoplasty by cohesive silicone gel implant is becoming more popular nowadays. Many types of complications have been reported, such as hematoma, seroma, infection, capsular contracture and etc. But there were no report of deep vein thrombosis(DVT) after augmentation mammoplasty in Korea. The authors experienced one case of DVT after augmentation mammoplasty using a cohesive silicone gel implant. Methods: A 38-year-old woman with breast cancer underwent reconstruction by tissue expander and augmentation mammoplasty by cohesive silicone gel implant, and exchange of expander to cohesive silicone gel implant. The operation was finished without any complicating event. On 4th day after the operation, the patient complained of intermittent right lower leg pain. By doppler ultrasonography, the patient was diagnosed with acute venous thrombosis of the popliteal vein, posterior tibial vein and peroneal vein. Results: Intravenous heparinization and oral warfarin were started immediately and elastic compression stocking was applied. Intravenous heparinization was continued until INR (blood coagulation unit) reached to target levels. The patient was discharged on 11th day of operation with oral warfarin. Other complication has not been reported after 10 weeks of operation. Conclusion: To our knowledge, this is the first report of DVT after silicone implant based breast augmentation.

• The Journal of Korean Medicine
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• v.42 no.2
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• pp.107-119
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• 2021

Objectives: This study was aimed to report changes in clinical symptoms and signs after treatment with Korean medicine in patients who suffered from calf edema due to deep vein thrombosis (DVT). Methods: A 46-year-old male patient, who discharged home after receiving standardized treatment for acute DVT in the right leg, suffered pain and heat sense due to edema of the affected calf. Oral administration of herbal medicine (Gyejibongnyeong-hwan 4 g, twice daily) and acupuncture therapy were given to him for 6 weeks. The change in chief complaints, Villalta score, the right and left side difference of the circumference and the skin surface temperature of both calves, and blood level of D-dimer were observed before and after treatment. Results: The patient's chief complaints began to significantly improve from 2 weeks after treatment, and disappeared completely within 4 weeks. At the end of the treatment, a substantial decrease in the difference between the right and left calves in the circumference and skin surface temperature was observed. This effect was maintained even at the time of follow-up 3 months after the end of treatment, and the patient completely recovered indoor and outdoor life to the level before onset. Conclusions: This case suggests that Korean medicine treatment, including Gyejibongnyeong-hwan administration and acupuncture therapy, can be a viable option to improve edema and related clinical problems in the affected limbs due to DVT.

• The Journal of Internal Korean Medicine
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• v.44 no.5
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• pp.999-1010
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• 2023

This case report shows the effect of Korean medicine treatment in a patient with deep vein thrombosis (DVT) after cerebral infarction who is suspected of having post-thrombotic syndrome (PTS) due to the loss of thrombus after receiving new oral anticoagulant (NOAC) treatment. The patient was treated with Korean medicine (Boyanghwano-tang and Hyulbuchuko-tang) three times a day. Acupuncture, moxibustion, infrared, and extra-physical therapy were given to the patient for 24 days. Clinical assessment - grading of edema and circumference of the left lower extremity were observed twice a week until the end of the treatment. NOAC treatment was continued for 24 days. After treatment, the patient's edema grade and circumference of the extremity improved. On the 24th day, the patient's chief complaints improved, and she requested termination of treatment. The results suggest that Korean medicine treatments, including Boyanghwano-tang, Hyulbuchuko-tang, and acupuncture therapy, can be effective in improving the clinical symptoms of DVT and PTS.

• Tuberculosis and Respiratory Diseases
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• v.59 no.6
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• pp.651-655
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• 2005

Background : Diagnosing a pulmonary embolism is difficult because its presenting symptoms are nonspecific and there are limitations with all of the objective tests. The D-dimer is known to be a marker of the lysis of intravascular cross-linked fibrin as a result of the activation of the endogenous fibrinolytic pathways, and the D-dimer assay is these an objective method for diagnosing a pulmonary embolism. This study assessed the benefits of the D-dimer test for diagnosing a pulmonary embolism using semiquantitative latex agglutination. Methods : The latex agglutination results of 185 patients were retrospectively reviewed. The D-dimer test was performed at the time a pulmonary embolism was suspected. Ninety patients(group I) were diagnosis with PE through spiral chest CT or a chest CT angiogram, perfusion/ventilation scans, and/or pulmonary angiogram. Ninety-five patients (group II) were found not to have a pulmonary embolism through the above tests. Results : The male to female ratio and mean age in groups I and II was 37:55, and 57 years old to 50:45 and 52 years old, respectively. When the cut off value for a positive D-dimer assay was set to $500{\mu}g$, the sensitivity, positive predictive value, negative predictive value and specificity was 86.7%, 61.4%, 79.3%, and 48.4%, respectively. Conclusion : The semiquantitative latex agglutination method in the D-dimer test has a lower sensitivity and negative predictive value than the well known ELISA test particularly for small emboli. Therefore, this test is not a suitable screening test for excluding a pulmonary embolism.

• The Journal of Internal Korean Medicine
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• v.39 no.2
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• pp.165-175
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• 2018

Purpose: To report on a patient with subarachnoid hemorrhage and deep vein thrombosis treated with a combination of Korean and Western medicine. Methods: A patient diagnosed with subarachnoid hemorrhage and deep vein thrombosis was treated with herbal medicine (加減淸熱瀉濕湯 (Gagam-cheongyeolsaseub-tang)), acupuncture (GV2, GB20, LI11, LI4, TE5, GB34, ST36, SP9, ST38, GB39, SP6, LR3), moxibustion (CV6, CV9), and Western medicine for deep vein thrombosis and subarachnoid hemorrhage. To evaluate edema, one of the classic symptoms of deep vein thrombosis, we measured leg circumference at a specified time. Results: After taking Gagam-cheongyeolsaseub-tang and being treated with acupuncture, moxibustion, and Western medicine, the patient showed improvement in leg edema. The left calf circumference decreased from 37.5 cm to 34.5 cm. Conclusions: Korean medicine, acupuncture, moxibustion, and Western medicine may provide effective treatment for deep vein thrombosis in patients with subarachnoid hemorrhage, but further study is needed.