• Title/Summary/Keyword: 항혈소판

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The Clinical Significance of Antiphospholipid Antibodies in Korean Children with Henoch-$Sch{\ddot{o}}nlein$ Purpura (Henoch-$Sch{\ddot{o}}nlein$ 자반증에서 항인지질 항체의 임상적 의의)

  • Park, Eun-Jung;Baek, Ji-Young;Shin, Jae-Il;Lee, Jae-Seung;Kim, Hyon-Suk
    • Childhood Kidney Diseases
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    • v.13 no.2
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    • pp.146-152
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    • 2009
  • Purpose : We performed this study to evaluate the incidence and clinical significance of antiphospholipid antibodies (aPL Ab) in Korean children with Henoch-$Sch{\ddot{o}}nlein$ purpura (HSP). Methods : The medical records of 62 patients (31 boys and 31 girls) aged $46.0{\pm}3.1$ (1-16) years with a clinical diagnosis of HSP based on the EULAR/PReS criteria were reviewed retrospectively. From the years 2007 to 2009, the sera from children with acute HSP were tested for aPL Ab such as LA, anti-cardiolipin antibody and anti-${\beta}_2$ glycoprotein I antibody. Results : LA was positive in 18 (29%) of the 62 patients with HSP and We divided the patients into the two groups LA positive group (N=18) and LA negative group (N=44). There were no significant differences between the two groups with regard to abdominal pain, arthralgia and renal involvement, but LA positive group had significantly higher C-reactive protein ($4.3{\pm}7.2$ mg/dL vs. $1.3{\pm}1.8$ mg/dL, P=0.035), erythrocyte sedimentation rate ($37.5{\pm}26.2$ mm/hr vs. $25.1{\pm}22.6$ mm/hr, P= 0.039), IgM ($148.1{\pm}48.4$ mg/dL vs. $114.9{\pm}41.5$ mg/dL, P=0.024), C3 ($143.1{\pm}21.9$ mg/dL vs. $129.7{\pm}24.5$ mg/dL, P=0.048) and C4 levels ($30.9{\pm}6.3$ mg/dL vs. $24.9{\pm}7.8$ mg/dL, P=0.002) compared with LA negative group. Conclusion : We found that the incidence of positive aPL Ab tests was relatively higher in Korean children with HSP and the presence of aPL Ab was associated with acute inflammatory process of HSP. These results suggest that the aPL Ab are involved in the pathogenesis of HSP in children.

Evaluation of in-vitro Anti-thrombosis and Anti-oxidation Activity of Lees of Takju (Wookukseng) (우국생 탁주 주박의 항혈전 및 항산화 활성)

  • Kim, Mi-Sun;Lee, Ye-Seul;Kim, Jong Sik;Shin, Woo-Chang;Sohn, Ho-Yong
    • Journal of Life Science
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    • v.25 no.4
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    • pp.425-432
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    • 2015
  • This study was performed to develop high-value-added biomaterials for health and beauty products. Extracts of ethanol and hot water and their subsequent organic solvent fractions were prepared from Lees of Wookukseng (LW), a commercialized Korean traditional rice wine. We investigated their activities on blood coagulation, platelet aggregation, hemolysis against human red blood cells (hRBCs), and anti-oxidation. The water content, pH and brix of the LW were 80.3%, 3.94 and 13.0°, respectively. The yield of ethanol extraction (6.62%) was 3.15 times higher than that of hot-water extraction (2.1%), and the ethyacetate fraction (EAF) of ethanol extract showed the highest content of total polyphenol (128 mg/g) among the various fractions. In anticoagulation activity assay, the EAF of ethanol extract showed a 15-fold extension in TT, PT, and aPTT, indicating that the EAFs contain various inhibitory substances against thrombin, prothrombin and coagulation factors. In anti-platelet aggregation activity assay, the butanol fraction and water residue of ethanol extract showed significant inhibition activity. The activities were comparable to aspirin, a commercial anti-thrombosis agent. The above extracts and fractions did not show hemolysis activity against hRBC up to 5 mg/ml, and had radical scavenging activity against DPPH anion, ABTS cation and nitrite. Our results suggest that the active fractions prepared from LW, which has no specific usage until now, have a high potential as novel resources for anti-thrombosis agents.

Blood-compatible Bio-inspired Surface of Poly(L-lactide-co-ε-caprolactone) Films Prepared Using Poor Co-solvent Casting (비용매 휘발법을 이용한 생체모사 혈액친화성 폴리락티드-카프로락톤 공중합체 필름의 제조)

  • Lim, Jin Ik;Kim, Soo Hyun
    • Polymer(Korea)
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    • v.39 no.1
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    • pp.40-45
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    • 2015
  • Simple poor-cosolvent casting was used to surface treat biodegradable elastic poly(L-lactide-co-${\varepsilon}$-caprolactone) (PLCL; 50:50) copolymer films that presented lotus-leaf-like structures. We evaluated whether the lotus-leaflike-structured PLCL (L-PLCL) films could be used as a biomaterial for artificial vascular grafts. The surface morphology, hydrophobicity, and antithrombotic efficiency of the films were examined while immersed in platelet-rich plasma (PRP) using scanning electron microscopy (SEM) and a contact angle meter. The recovery and crystallinity of the films were measured using a tensile-strength testing machine and an X-ray diffractometer, respectively. The solvent containing acetic acid, as a poor co-solvent, and methylene chloride mixed in a 1:2 ratio produced an optimal PLCL film with a water contact angle of approximately $124^{\circ}$. Furthermore, the surface of the L-PLCL films immersed in PRP showed a lower rate of platelet adhesion (<10%) than that of the surface of an untreated PLCL film immersed in PRP.

PROPOSAL FOR PRETREATMENT OF PATIENTS IN ANTIPLATELET THERAPY REQUIRING MINOR ORAL SURGERY (항혈소판제 복용 환자의 구강 내 소수술 전 처치에 대한 제안)

  • Choi, Ji-Wook;Choi, Se-Kyung;Kim, Nam-Kyun;Choi, Eui-Young;Cha, In-Ho;Kim, Hyung-Jun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.35 no.6
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    • pp.426-430
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    • 2009
  • Purpose: Many patients in anti-platelet therapy have been consulted for bleeding risks before minor oral surgery. However, there has not been an established pretreatment protocol for treating these patients. The purpose of this study is to make a protocol for the preoperative management for patients in anti-platelet therapy. Patients and Methods: The existed consultation pattern of patients was examined in the Department of Oral and Maxillofacial Surgery, Yonsei Dental Hospital. Based on the observation, a protocol including classification of medical status of patients and the type of oral surgery in need was introduced. This protocol had been performed for 6 months. Result: Following this protocol, the frequency of consultation for bleeding risk was decreased. The number of minor oral surgeries with concurrent anti-platelet therapy was increased. There was no severe bleeding event observed among minor oral surgeries that were performed while maintaining anti-platelet therapy. Conclusion: This protocol can be used as a guideline for clinical practice of patients in anti-platelet therapy requiring minor oral surgery.

Effect of Triple Compared to Dual Antiplatelet Therapy After Drug-Eluting Stent Implantation in Percutaneous Coronary Intervention (관상동맥 약물 용출 스텐트 삽입 후 항혈소판제제 3제요법과 2제요법의 임상적 효과 비교)

  • Ye, Kyong-Nam;Kim, Jeong-Tae;Lee, Suk-Hyang
    • Korean Journal of Clinical Pharmacy
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    • v.22 no.2
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    • pp.113-122
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    • 2012
  • ACC/AHA/SCAI Guideline recommends for administration dual antiplatelet therapy after drug-eluting stent (DES) to prevent restenosis and stent thrombosis in patients with percutaneous coronary intervention (PCI). Recently triple antiplatelet therapy including cilostazol is known to reduce restenosis and stent thrombosis significantly after DES implantation. However, there is lack of data providing the efficacy of triple antiplatelet therapy. The purpose of this study is to evaluate the clinical effects of the triple therapy after DES implantation compared with the dual therapy. This retrospective study collected data from medical charts of 251 patients who received DES implantation between Jul 2006 and Jun 2008. They received either dual antiplatelet therapy (N = 154 clopidogrel and aspirin; Dual group) or triple antiplatelet therapy (N = 97 cliostazol, clopidogrel and aspirin; Triple group). Major adverse cardiac event rates (MACE, included total death, myocardial infarction, target lesion revascularization) at 12 months, 24 months, stent thrombosis, rates of bleeding complications and adverse drug reactions were compared between these two groups. Compared with the dual group, the triple group had a similar incidence of the MACE rates at 24months (12.3% vs. 12.4%, p = 0.99). There is no difference in overall stent thrombosis between two groups (Dual group 2.6% vs. Triple group 4.1%, p = 0.5). Subgroup analysis showed that diabetic patients got more benefit in reducing MACE rates but, there is no statistical difference. Bleeding complications and adverse drug effects were not different significantly. As compared with dual antiplatelet therapy, triple antiplatelet therapy did not reduce the 12-months, 24-months MACE rates and stent thrombosis. Bleeding complications and adverse drug effects were not different.

Effects of Combined Antiplatelets on Bleeding in Off-Pump Coronary-Artery Bypass Surgery (술 전 항혈소판제 복합투여가 무심폐기하 관상동맥우회술 후 출혈에 미치는 영향)

  • Lee, Su-Kyeong;Kim, Tae-Jin;Song, Yun-Seok;Jung, Sun-Ho;Yang, Kyung-Ho;Choi, Kang-Joo;Kim, Young-Bok
    • Journal of Yeungnam Medical Science
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    • v.28 no.2
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    • pp.124-132
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    • 2011
  • Background: Antiplatelet agent administration is critical in managing coronary-artery disease, but there is a concern regarding operation-related bleeding and an increase in blood transfusion in such, especially when delivering combined antiplatelet agents. This study was conducted to evaluate the effect of the administration of antiplatelet agents on off-pump coronary-artery bypass surgery (OPCAB). Methods: From March 2003 to December 2009, 49 patients who had undergone OPCAB were collected retrospectively. The patients were divided into three groups according to the administration of antiplatelet agents before the OPCAB operation: 21 patients were given an aspirin agent (group 1), 19 patients were given combined agents (aspirin+clopidogrel) (group 2), and nine patients were not given any antiplatelet agent (group 3). The three groups' perioperative hematologic and coagulation profiles, including their platelet counts, hemoglobin levels, hematocrit, prothrombin times, and aPTTs (activated partial thromboplastin times), and their postoperative bleeding, related complications, transfusion requirements, and operation times, were compared. Results: The operation time in group 2 was 4.3 hours, longer than those in the two other groups, and urgent operation was significantly most frequent in group 2 (63%). The amount of blood loss and the number of patients who received blood transfusion were not different in the three groups. The perioperative hemoglobin level, hematocrit, platelet count, prothrombin time, and aPTT were also not significantly different among the three groups. Conclusion: The continuous administration of antiplatelet agents to the patients in this study did not increase their postoperative bleeding or operation-related complications. Therefore, OPCAB may well be considered even if combined antiplatelet agents are being administered.

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Bleeding after Taking Dual Antiplatelets and NSAID Concurrently (항혈소판제와 비스테로이드성소염진통제의 동시 투약으로 인한 출혈 사례)

  • Seo, Jeongmin;Choi, Joonghyuk;Son, Pyoungwoo;Lee, Seungmin;Chae, Hyunwoo;Kang, Geunhyung;Ji, Eunhee
    • Korean Journal of Clinical Pharmacy
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    • v.28 no.3
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    • pp.250-253
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    • 2018
  • When stenting is applied to treat myocardial infarction, antiplatelet agents are administered to prevent thrombosis, which increases the risk of bleeding. Patients with myocardial infarction are also more likely to have osteoarthritis simultaneously, because both diseases occur frequently in elderly patients. Patients with osteoarthritis often use analgesics, especially nonsteroidal anti-inflammatory drugs (NSAIDs); hence, patients with both diseases use analgesics and antiplatelet agents simultaneously. The risk of bleeding increases with the use of antiplatelet agents and this is further increased when NSAIDs are added. We would like to report a case that reflects this situation. A 60-year-old man underwent stenting after ST-elevation myocardial infarction, and was treated with aspirin and clopidogrel. This patient also received a pelubiprofen prescription from another physician to treat osteoarthritis. After the patient took pelubiprofen twice, he found a bruise on his wrist and reported it to the pharmacist. It is unlikely that this is rare in community pharmacies, so pharmacists should pay careful attention to the concomitant administration of analgesics to patients receiving antiplatelet agents and should provide appropriate education to patients.

A Case Report of dcrease of hypodense region on CT images in ischemic cerebrovascular disease patient treated with Antiplatelet agent and Cheonghyulgangki-tang (항혈소판제제와 청혈강기탕(淸血降氣湯)을 병용 투여하여 CT영상에서 저음영부위의 감소를 보인 허혈성 뇌혈관질환 환자의 증례 보고)

  • Shin, Woo-Jae;Cha, Ji-Hye;Kim, Tae-Yeon;Park, Yu-Jin;Ko, Heung;Kim, Gi-Tae;Sin, Sun-Mi
    • The Journal of Internal Korean Medicine
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    • v.31 no.2
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    • pp.380-387
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    • 2010
  • The ischemic penumbra represents part of the hypoperfused region associated with focal brain ischemia. A practical approach is to define this region as that portion of the ischemic territory that can potentially be salvaged by timely intervention. For the prevention and treatment of ischemic stroke, antithrombotic therapy is prescribed. But medication of antiplatelet agent is only validated as prevention effect. Cheonghyulgangki-tang has been used for cerebral apoplexy, hypertension, etc. In this case report, an acute ischemic stroke patient was treated with an antiplatelet agent named Plavix and Cheonghyulgangki-tang and remarkable reduction of ischemic portion in the brain CT was observed. The result of this case suggests that oriental medical therapy could be a safe and effective intervention in acute ischemic stroke.

중의치료소아효천임상관찰(中醫治療小兒哮喘臨床觀察) -소아천식에 대한 중약치료의 임상관찰-

  • Yun Hye-Min;Yang Yeon;Jang Ryeo-Yeong
    • The Journal of Pediatrics of Korean Medicine
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    • v.15 no.1
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    • pp.267-270
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    • 2001
  • 소아천식은 기도의 만성 염증 및 과민반응을 특징으로 나타내고 있어 염증을 일으키거나 알레르기 반응을 일으키는 물질로부터 차단하는 방법이 효과적임을 현대의학에서 이미 밝히고 있다. 한의학에서는 천증(喘證)에 본디 뿌리 깊은 근원(천유숙근(喘有夙根))이 있다고 간주하여 허약한 체질은 내적인 요인이고, 풍한침습(風寒侵襲)은 유발요인이며, 담음복폐(痰飮伏肺)와 신기휴허(腎氣虧虛)는 재발의 근본이라고 하였다. 본 연구에서는 소아 천식에 구마황(灸麻黃), 은행(銀杏), 건강(乾薑), 오미자(五味子), 백전(白前), 구백부(灸百部), 소자(蘇子) 등을 사용하였고, 경우에 따라 황기(黃?) 혹은 선령비(仙靈脾)를 추가하여 正氣(正氣)를 강화시키는 목적으로 사용하였다. 약리학적 연구에 따르면 마황과 건강, 오미자 등은 모두 기도의 염증세포 침윤(浸潤)를 억제하고 항알레르기 효과가 있으며, 건강과 오미자는 또한 히스타민에 대한 길항효과(拮抗效果)도 있는 것으로 알려져 있다. 은행 추출물은 혈소판 활성화 수용체에 대한 길항작용을 갖고 있으므로 이러한 물질들로 인한 기관지의 경련을 방지하여 천식증상을 왕화시킨다. 구백부(灸百部)는 지해(止咳)효과가 뛰어나다. 소아천식에 대한 치료는 표본동치(標本同治)의 원칙을 지키며, 증상이 완화된 단계에서도 중약 투여를 1-2개월 지속시키는 것이 중요하다. 소아에게 있어서 천식증상이 완화된 후 어혈(瘀血) 상태가 성인에 비해 심하지는 않지만, "구병필어(久病必瘀)"의 결과에 유의할 필요가 있다. 천식이 장기간 지속되면 필히 혈액순환 장애가 수반되므로 천궁(川芎)이나 단삼(丹蔘) 등의 활혈제(活血劑)를 가미하여 사용하면 효과를 높일 수 있다. 결론적으로 소아의 천식은 항염증, 평천(平喘), 화담(火痰), 지해(止咳)와 더불어 보신익기화어(補腎益氣化瘀)의 약물을 병행하여 사용하는 것이 바람직하며, 단순한 중약 투여는 일부 양약에 의한 소아성장에 미치는 영향을 피할 수 있어 더 많은 임상연구가 이어져야 한다.

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A Case of Antiphospholipid Syndrome Associated with Autoimmune Thrombocytopenic Purpura (자가면역 혈소판감소성 자반병과 관련된 항인지질 증후군 1례)

  • Nam, Y.S.;Lee, W.S.;Park, C.;Yoon, T.K.;Cha, K.Y.
    • Clinical and Experimental Reproductive Medicine
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    • v.26 no.2
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    • pp.265-269
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    • 1999
  • Thrombocytopenic patients without detectable bound antiplatelet antibody should be diagnosed with idiopathic thrombocytopenic purpura (ITP) if no other cause of their decreased platelet count could be found. More recently the term "autoimmune thrombocytopenic purpura (ATP) has supplanted ITP since the disease is related to the production of autoantibodies against one's own platelets. This entity should not be confused with isoimmune thrombocytopenic purpura (also called alloimmune thrombocytopenic purpura). In this cases maternal antiplatelet antibodies directed against the PLA 1 antigen on the fetal platelets causes severe fetal and neonatal thrombocytopenia in a situation analogous to Rheusus disease. Antibodies to the negatively charged phospholipids, lupus anticoagulant, and anticardiolipin have been linked to adverse pregnancy events. Pregnant women possessing these antibodies have an increased risk of spontaneous abortion, stillbirths, intrauterine fetal growth retardation, preterm birth, and arterial and venous thrombosis. Antiphospholipid antibodies decrease or may even disappear between pregnancies only to recur with increased activity in a subsequent pregnancy and lead to loss. We have experienced a case of antiphospholipid syndrome associated with autoimmune thrombocytopenic purpura in patient with recurrent spontaneous abortion. So we report this case with a brief review of literatures.

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