• Journal of Pharmaceutical Investigation
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• 제18권4호
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• pp.169-174
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• 1988

The release of heparin from monolithic devices composed of different ratios of polyethylene oxide-polypropylene oxide (PEO-PPO) and hydrophobic polyurethane was investigated. The release rate of heparin could be controlled by varying the PEO-PPO content. The heparin release rate from the devices increased as the content of PEO-PPO in the devices increased. The release mechanism may be associated with creation of micro-channels and pores through the devices following the change in the physical structure of the polymer network. Hydrophobic polyurethane containing PEO-PPO can provide an antithrombogenic material for prolonged release of heparin from a heparin blended system.

• 약학회지
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• 제29권2호
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• pp.70-75
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• 1985

The influence of polyethylene glycol derivatives on heparin release from cylindrical monolithic type silicone segment devices was examined in physical saline solution. This water-soluble carrier caused the devices to absorb the water in aqueous media. The release rate of heparin from the devices was increased as molecular weight of polyethylene glycol was increased. Water soluble carrier incorporated into silitone segment devices permits controlled release of heparin that otherwise would be released extremly slowly from the polymer. Heparin released from the silicone segment containing polyethylene glycol showed the first-order kinetics. Without changing the release-pattern, the release rate of heparin could be controlled by varing molecular weight of polyethylene glycol, the water-soluble carrier and depleting polyethylene glycol on the outlayer of devices. The mechanism of release probably showed the creation of pore or microdomine through the devices secondary to the swelling.

• Journal of Chest Surgery
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• 제32권1호
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• pp.70-74
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• 1999

승모판의 기계판막치환술 후 판막이나 좌심방 내 혈전증은 판막 기능장애나 혈전색전증을 일으킨다. 조기 진단과 적절한 치료는 중요하지만 임상에서 쉽지 않다. 혈전용해 치료는 혈전증으로 인한 재수술의 위험성을 줄일 수 있어 혈전증 치료에 적절한 한 방법이 될 수 있다. 본 보고는 저분자량 헤파린과 와파린으로 혈전용해 치료를 한 3명의 환자를 보고하고자 하였다. 한 명의 임산부를 포함한 2명의 환자는 판막 혈전증으로 인한 판막폐쇄와 개폐운동 장애가 있었고 다른 한 명은 내원 5일전 혈전색전증으로 뇌경색이 발생한 좌심방내 혈전증 환자였다. 환자들은 프락시파린 0.3cc (7,500 ICU AXa)을 하루에 2∼3번씩 피하로 투여하여 치료를 받았다. 퇴원 당시 판막과 좌심방 내 혈전은 완전히 혹은 거의 완전히 용해되었고 판막의 개폐운동은 정상이었다. 혈전용해 때부터 외래 추적 기간동안 특별한 부작용은 없었다.

• Journal of Trauma and Injury
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• 제24권2호
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• pp.164-167
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• 2011

Trauma is an important risk factor for a pulmonary thromboembolism, and anticoagulation is essential to prevent deep vein thrombosis (DVT) in patients with trauma. Low-molecular-weight heparin (LMWH) is excreted in the kidney; therefore, using LMWH in patients with renal insufficiency may increase the risk of bleeding complication. The following case describes a 55-year-old traffic accident victim who had massive bleeding and underwent a laparotomy for bleeding control. The patient had acute renal failure, and enoxaparin was administered for the prophylaxis of DVT. Although the patient suffered from serious complications such as pericardial hematoma, the patient recovered without sequellae and was discharged at day 84.

• Journal of Chest Surgery
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• 제38권3호
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• pp.245-248
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• 2005

에르고타민이 포함된 약물은 편두통의 치료에 널리 사용되고 있다. 경련성의 혈관수축은 가장 심각한 약물 부작용 중의 하나로 이는 허용된 약물 투여량의 복용에서도 일어날 수 있다. 저자는 15년간 편두통으로 인해 꾸준히 에르고타민이 포함된 약물을 복용한 과거력이 있는 63세 남자환자에 나타난 혈관경축에 의한 상지의 심한 허혈상태를 인조혈관 우회로 이식술, 교감신경 차단술, 그리고 헤파린과 프로스타글란딘 El으로 치료하였으나 결국 에르고타민이 포함된 약물을 중단하고서야 극적인 임상 호전을 경험하였기에 보고하는 바이다.

• Archives of Reconstructive Microsurgery
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• 제2권1호
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• pp.77-81
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• 1993

Free tissue transplantation is commonly performed with the brilliant achievement in microsurgery and anticoagulants and antithrombotic agents have been prescribed in the procedures. However, there is no clean-cut indication as to which agents would be more effective in every steps and final consequences. Low molecular weight heparins inhibiting coagulation in plateletrich plasma and acting on the vascular endothelium have antithrombotic and fibrinolysis action. The experiment with rat groin free flap transplantation after 6-hour ischemia and injection of the low molecular weight heparin was performed and the results between the injection and non-injection group were analysed as follows, 1. Both of the 24-hour groups, vessel patency was not proportional to color change of the groin flap. 2. On the second day after anastomois, heparin-injection group showed intact intima, patent lumen without thrombus, and mild granulomatous inflammation around the suture material and control group with doubtful patency revealed intimal loss and thrombus formation. 3. On the 5th, 7th, and 9th postoperative day, heparin group was patent in anastomosis and showed acute inflammatory cells. 4. The 7th-week period, heparin-injection group showed intact flap color, patent lumen with intact intima and persistent foreign body granuloma.

• Clinical and Experimental Pediatrics
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• 제48권6호
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• pp.675-677
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• 2005

가성혈소판감소증은 항응고제인 ethylenediaminetetraacetic acid (EDTA)를 사용 시 주로 발생한다. 이 때 관찰되는 혈소판 응고는 헤파린이나 구연산나트륨 같은 항응고제를 EDTA 대신 사용하면 일어나지 않기도 하여 가성혈소판감소증과 진성혈소판 감소증을 감별할 수 있다. 저자들은 이러한 감별을 위하여 6세된 EDTA 의존성 가성혈소판감소증 남아에서 아미노글리코사이드 계열의 약물인 가나마이신을 채혈 전에 EDTA 용기에 미리 넣거나, EDTA 용기에 이미 채혈된 혈액에 첨가한 후 각각 혈소판수와 혈소판 응고 양상을 조사하여 보았다. 그 결과 가나마이신 채혈 전 혹은 후에 처리한 경우 모두 혈소판응고 없이 정상적인 혈소판수를 나타내어 소아에서도 임상적으로 쉽게 검사 할 수 있는 방법으로 생각되어 보고하는 바이다.

• Journal of Chest Surgery
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• 제24권3호
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• pp.253-260
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• 1991

The adequacy of anticoagulation with heparin during cardiopulmonary bypass, and precise neutralization with protamine at the conclusion of cardiopulmonary bypass, were important. In sixty children undergoing cardiopulmonary bypass, ACT and heparin dose-response curve were studied. Total dose of heparin before bypass were 2.80$\pm$0.74 mg/kg and the amount of protamine administered after bypass were 3.0$\pm$1.23 mg/kg. So protamine: heparin ratio was 1.07: l.c After administration of protamine which dose is calculated with heparin dose-response curve, ACTs were returned to normal range[mean 114.8 $\pm$13 second]. The heparin sensitivity and its half-life do not have relationship with age, weight, height, surface area and urine amount during operation. And there are too much individual variations in heparin sensitivity and its half-life. So conventional heparin protocols can overestimate or underestimate the amount of heparin and protamine. Heparin dose-response curve makes it possible to maintain anticoagulation in a safe range during bypass with adequate amount of heparin individually. At the conclusion of bypass, this curve can be used to predict the precise amount of protamine amount of protamine needed for neutralization of the heparin. But heparin dose-response curve to be used clinically, further studies will be needed about relationship between ACT and heparin level in the high range, influence of hemodilution and hypothermia to ACT and discrepancy between true adequate amount of protamine and calculated amount by heparin dose-response curve.

• 대한수의학회지
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• 제44권3호
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• pp.469-473
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• 2004

This study was performed to investigate the effects of calcium administration on the blood coagulation mechanism through APTT in the calf. Five male calves (70~90 kg) were used in this experiment. In the control group, heparinized normal saline (1 IU/kg/min) had been infusing into the jugular vein for 100 minutes. For the analysis of calcium effects on the APTT, the same solutions had been infusing during the first 40 minutes, subsequently the solution including calcium gluconate (3.3 mg/ml/min) had been infusing for 60 minutes. Blood samples were serially collected every 10 minutes for the APTT and platelets count and every 20 minutes for the calicum level during the infusion. In the calcium-treated group, after 70 minutes the APTT ratio (APTT heparin/APTT baseline) was higher than the therapeutic range. APTT was significantly increased at 50, 60 and 70 minutes in the calcium-treated group as compared to the control group (p<0.01). In the control group, calcium level was decreased significantly after heparin infusion (p<0.01). The platelet count was gradually decreased without significant variation in the both control and calcium-treated groups. These results suggested that APTT is slightly increased in combined heparin and calcium administration.

• Journal of Chest Surgery
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• 제19권1호
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• pp.12-17
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• 1986

The pericardial adhesions following the first open heart surgery pose a major problem that can increase the morbidity and mortality in cases of reoperation because of the danger of damaging the heart, great vessels or grafts. The purpose of this study was to determine the effect of intrapericardial infusion of 5% dextrose solution and heparin on experimental pericardial adhesions. The 15 white rabbits were divided into three treatment groups of 5 animals each: group 1 [control group], group 2[5% dextrose group] and group 3 [heparin group]. At 4 weeks, all animals were sacrificed and the pericardial adhesions were graded as follows: 1[none], ll[mild], Ill[moderate] and IV[severe]. Histological examination was performed on a subset of each group. The difference of adhesion between control and heparin group was evaluated by Chi-square analysis. The results were as follows: 1. Pericardial adhesions developed in 80% of animals in group 1 and 2. 2. Only 40%> of animals in group 3 had mild to moderate pericardial adhesions. This was significantly different from the control group [P=0.01]. 3. Histological examination showed that the pericardium with adhesion was thickened with fibrosis, while that without adhesion was thin, normal appearance. 4. In group 3, there was no evidence of hemorrhage or hemorrhagic tendency in the pericardium.