• Journal of Korean Biological Nursing Science
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• v.16 no.3
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• pp.251-257
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• 2014

Purpose: Little is known about appropriate interval periods between the heparin flushing of implanted ports after completion of chemotherapy. The purpose of this study was to describe the current status of interval of heparin flushing for maintenance of an implanted port in solid tumor patients. Methods: We performed a retrospective review of all patients who had undergone implanted port removal in 2012 at the Seoul St. Mary's Hospital. The subjects were 90 patients who, after completion of chemotherapy, retained their ports for extended periods of time. Results: The mean number of flushes of heparin was 4. Compliance with visits for implanted port maintenance varied with the individual, and the mean accession times were in the range between 13 days and 243 days. The overall mean time between flushes was 66 days. One patient showed resistance during flushing. Conclusion: Our results demonstrate that extending the flushing interval to a maximum of 8 weeks remains medically safe. Less frequent heparin flushing of an implanted port decreases medical expenditure and the workload of medical professionals; it also improves the patient's satisfaction.

• Journal of Chest Surgery
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• v.43 no.1
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• pp.96-99
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• 2010

Artificial lung support may be necessary in various conditions during the performance of bilateral lung transplantation, and cardiopulmonary bypass (CPB) has usually been used. Yet using the conventional CPB techniques may increase risk of bleeding and early allograft dysfunction due to the large dosages of heparin and the complement activation. Extracorporeal membrane oxygenation (ECMO) is able to support gas exchange and maintain the hemodynamics without administering high-dose heparin for anticoagulation. We performed sequential bilateral lung transplantation with ECMO support. ECMO is a valuable tool when performing lung transplantation and it has the potential to replace CPB.

• Polymer(Korea)
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• v.27 no.6
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• pp.583-588
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• 2003

Sulfated chitosan and sulfated sodium alginate were synthesized by sulfating reaction of low molecular chitosan and low molecular sodium alginate with SO$_3$-pyridine complex. When the weight ratio of SO$_3$-pyridine complex to polysaccharide was 1:5, the degrees of sulfation were the highest at 2.75 and 2.53 respectively. The anticoagulation effect was the highest when the molecular weight was 8.0${\times}$10$^3$ Da, and the anticoagulation activity was the highest at 91% of that of heparin when sulfated chitosan and sulfated sodium alginate were mixed at a weight ratio of 1:1. The anticoagulation activity was highest at 84% of that of heparin in the active plastin trombo test (aPTT) when sulfated chitosan and sulfated sodium alginate were mixed at a weight ratio of 1:1.

• Journal of Chest Surgery
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• v.32 no.3
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• pp.307-309
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• 1999

Warfarin-induced skin necrosis is a rare complication caused by transient hypercoagulable state. This state is a result of rapid decline of the protein C activity relative to that of coagulation factor II, IX, and X during initiation of oral anticoagulant therapy. We experienced a case of warfarin-induced skin necrosis involving both breasts in a patient who underwent double valve replacement 1 month before. Warfarin was replaced to a low- molecular weight heparin and the necrotic breast lesion was healed spontaneously. Low-dose warfarin was restarted and gradually increased, after which a low molecular weight heparin discontinued..

• The Journal of Korean Academy of Prosthodontics
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• v.51 no.4
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• pp.307-314
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• 2013

Purpose: The aim of this study was to evaluate the effect of immobilization of the recombinant human bone morphogenetic protein 2 (rhBMP-2) on anodized titaum implants coated with heparin to enhance the vertical alveolar ridge augmentation in the supraalveolar peri-implant defect region. Materials and methods: 18 pure titanium implants (7.0 mm in length, 3.5 mm in diameter) were manufactured for this study. All implants were anodized and designed insertion reference line marked with laser at the apical 2.5 mm from the fixture platform. Implantation of 6 noncoated anodized implants (Control group), 6 anodized implants physically adsorbed with rhBMP-2 by dip and dry method (BMP group) and 6 anodized implants chemically immobilized 3,4-dihydroxyphenylalanine (DOPA)-heparin/ rhBMP-2 (Hep-BMP group) was performed in the both mandibular of three male adult beagle dogs using split-mouth design. Radiologic examinations were performed immediately after implant placement and 4 and 8 weeks after implant placement. The amount of mesio-distal bone augmentation was evaluated by measuring the vertical distance from the platform to the marginal bone. Statistical analysis was performed using one-way analysis of variance (SPSS version 18.0) and multiple comparison analysis of The Kruskal-Wallis test and the Mann-Whitney U test. Statistical significance was established at the 5% significant level. Results: At the 4 weeks vertical alveolar ridge augmentation of Control group, BMP group and Hep-BMP group is $0.09{\pm}0.22mm$, $1.02{\pm}0.72mm$, and $1.29{\pm}0.51mm$, At the 8 weeks $0.11{\pm}1.26mm$, $1.11{\pm}0.58mm$, $1.59{\pm}0.79mm$ according to radiographic observations. The two experimental groups showed a significantly increasing in vertical bone height compared with the control group (P<.05). However, there is no significant difference between the BMP group and Hep-BMP group (P>.05). Conclusion: The rhBMP-2 coated implants were enhanced the vertical bone growth in the supraalveolar peri-implant defect area. However, there is no significant difference between chemically and physically coating method.

• Journal of Chest Surgery
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• v.35 no.3
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• pp.171-176
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• 2002

Background: Blood-foreign interaction cause activation of coagulation and inflammatory process that may lead to multiorgan dysfunction and determine the surgical outcomes. Of the methods for assessing the biocompatibility, the platelet adhesion study is considered as the most valuable evaluation step in blood-foreign interaction. As the most studies have used in-vitro or ex-vivo conditions, we have developed a technique of quantification for platelet adhesion on the blood contact surface by using in-vivo injection of radioactive platelets. Material and Method: A coupled bypass circuit was designed to connect the proximal and descending thoracic aorta in 6 piglets(20∼25 Kg). One side of the circuit tube was consisted of a heparin coated PVC tube(10mm in ID, n=6, Experimental group), and the other, a non-heparin coated PVC tube(10mm in ID, n=6, Control group). After cannulation, the blood was circulated through the circuit for 2 hours. Platelet concentrate was prepared from homologous pig blood 24 hours before the experiment. The platelet concentrate was incubated with Tc-99m-HMPAO for 30 min and then centrifuged for 10 min. The supernatant was discarded and the radio-labeling efficacy was measured. The radio-labeled platelet concentrate was mixed with the autologous plasma to make the volume 5 ml, and the mixture was injected intravenously into the experimental animal. After 2 hour circulation, 5 pieces of the specimen(10mm in length each) were obtained from each PVC tube. The radioisotopes were counted with a gamma counter(Cobra ll, Packard, USA), and the ratio of radioisotope count was compared between the control and experimental group. Result: The radioisotope count number was 537.3221.1 Ci/min in the control group and 311.1 184.5 Ci/min in the experimental group(p=0.0104). The ratio between the groups was 1 to 0.58 (p=0.004). Conclusion: In vivo quantification using technetium-99m-HMPAO labeled platelets is simple and reproducible in evaluating platelet adhesion on a foreign surface. We suggest this technique to be a useful tool for blood compatibility test.

• Journal of Biomedical Engineering Research
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• v.16 no.4
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• pp.463-470
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• 1995

Complete prelining of artificial vascular grafts with autologous endothelial cells may be one of the ideal solutions to obtain a nonthrombogenlc blood-contacting surface. To establish an intact endothelial cell monolayer on a prosthetic surface at the time of implantation,a sufficient number of endothelial cells and adequate propagation condition In cell culture are prerequisites. In this experimental study, endothelial cells from microvessels of adult human oriental adipose tissue were enzymatically harvested, and optimal culture conditions for proliferation of the endothelial cells in cell culture were examined. Human oriental adipose tissue was digested with collagenase and endothelial cells were separated from other stromal elements by mesh filtration method. Cultured cells were identified as endothelial cells by immunofluorescent staining for factor VIII-related antigen. Proliferation in usual 20% fetal bovine serum (FBS) medium or medium containing endothelial cell growth factor (ECGF)(5 ng/ml) and heparin (HEP)(1,000 units/ml) were compared,and the effects of adding compounds that increase intracellular cyclic adenosine monophosphate levels, that is,cholera toxin (CT)(1 $\mu\textrm{g}$/ml) and isobutylmethylxanthine (IBMX)(0.2 ml),were also analyzed. In total,following eight media groups were examined. 1) FBS medium + ECGF + HEP, 2) FBS medium + ECGF + HEP+CT, 3) FBS medium+ECGF+HEP+lBMX, 4) FBS medium+ECGF+HEP+CT+ IBMX, 5) FBSmedium, 6) FBS medium +CT, 7) FBS medium + IBMX, 8) FBS medium + CT + IBMX. It was shown that the medium containing ECGF + HEP with or without cholera toxin was most efficient in Stimulating cell proliferation. IBMX was considered to have antagonistic effect to ECGF. Among experimental groups without ECGF and HEP, the addition of cholera toxin and IBMX was shown to significantly potentiate cell proliferation. This results could provide a practical method for use of cultured human endothelial cells for endothelial cell seeding of cardiovascular prosthetic device, particularly in small-diameter vascular grafts.

• Journal of Pharmaceutical Investigation
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• v.17 no.2
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• pp.75-78
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• 1987

The release rate of heparin from monolithic devices composed of raffinose, ${\beta}-cyclodextrin$, polyethylene oxide (Mw 20,000, PEO), and hydrophobic polyether urethane (biomer) was investigated. Water soluble raffinose, ${\beta}-cyclodextrin$, and PEO blended into the biomer provided a controlled release of heparin. The release rate of heparin could be controlled by the content of raffinose, ${\beta}-cyclodextrin$, and PEO in the devices. The mechanism of release rate increased by the raffinose, ${\beta}-cyclodextrin$, and PEO may result from the formation of channels and pores in the biomer matrices following the swelling and the change in the physical structure of polymer net work. Hydrophobic polyurethane containing raffinose, ${\beta}-cyclodextrin$, and PEO can provide a hydrophilic antithrombogenic material for prolonged release of heparin.

• Journal of Chest Surgery
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• v.29 no.3
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• pp.326-330
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• 1996

Despite anticoagulation, systemic embolization and anticoagulant-related hemorrhage are the major drawbacks of heart valve replacement with mechanical prostheses. Among many predisposing factors, inadequacy of anticoagulation is the most important one. Surgery can be reserved for patients who do not response to thrombolytic therapy, We have experienced 3 cases of prosthetic valve thrombosis treated by thrombolytic therapy by use of urokinase and heparin. Two patients fully recovered and returned to their employments and active lives but 1 patient,died of intracerebral hemorrhage and infarction. We report prosthetic valve thrombosis thrombolytic therapy with urokinase and heparin which was detected and serially followed by 2-dimensional echocardiography, cinefluoro copy, and monitoring of Swan-Ganz catherterized pressures.

• Proceedings of the Korean Society of Applied Pharmacology
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• 1993.04a
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• pp.76-76
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• 1993

헤파린은 혈액응고계에서 antithrombin III 존재하에서 thrombin과 factor Xa의 작용을 억제함으로써 항응고제로서 작용을 한다. 심정맥혈전증 등 임상에 응용성이 높지만 장기적 사용시 혈소판 감소효과, 출혈, 골다공증 등의 부작용이 나타나고 있다. 본연구는 식물성 생약으로부터 당을 분리 정제하여 화학적으로 sulfation시켜 in vitro와 ex vivo에서 항응고활성을 비교하였다. 우선적으로 aPTT를 측정하여 응고시간의 연장을 시키는 다섯종류의 식물생약을 선택하였고 이 중에서 청호(Artemisiae apiaceae)로부터 산성당을 분리하여 pyridine과 chlorosulfonic산으로 sulfation 시켰율 때 in vitro상에서 항응고활성은 sulfation전에 비해 두드러지게 증가하였다. 농도를 달리 하여 실험동물에 투여시 응고시간의 연장 역시 비슷한 양상을 보여주었다. Thrombin 억제는 발견되지 않았지만 sulfate기와 항응고 활성과는 관계가 있는 것처럼 보였다.