• Title/Summary/Keyword: 혈소판 감소증

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Multiple Mandibular Idiopathic Bone Cavities in a Patient with Immune Thrombocytopenia : A Case Report (면역성혈소판감소증 환자의 하악골에 발생한 다발성 특발성골강 : 증례보고)

  • Baek, Young-Jae;Geum, Dong-Ho;Lee, Jung-Han;Kim, Sung-Hee;Ahn, Kyung-Yong;Kim, Uk-Kyu
    • The Journal of the Korean dental association
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    • v.51 no.1
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    • pp.25-32
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    • 2013
  • The immune thrombocytopenia(ITP) is defined as a platelet count of less than $100,000/{\mu}L$. It is gene rally known as characterized by the bleeding manifestations of skin and/or mucosa like ecchymosis due to low platelet count, but reports of the related intraosseous lesions are not common. The idiopathic bone cavity(IBC) is an empty space of the bone, which occurs mainly in the long bones. It is found predominantly in the mandible in case of the maxillofacial area. In general, it appears as an isolated unilocular lesion without the correlation of the teeth. Although the cause of the IBC is supposed to be associated with hemostatic problems, the etiology is unclear and it was not disclosed the relevance of specific systemic disease. In this present case, IBCs that occurred in mandible of patient who has IPT was treated by curettage with platelet transfusion.

Valvuloplasy in Mitral Regurgitation : available option in Young rheumatic mitral regurgitation patients (승모판막 폐쇄부전증에서 판막 성형술의 임상 분석: 젊은 류마티스성 승모판막 폐쇄부전증 환자에서의 판막 성형술)

  • 이재원;송태승;주석중;김종욱;송명근
    • Journal of Chest Surgery
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    • v.32 no.12
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    • pp.1093-1099
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    • 1999
  • 배경 : 류마티스성 승모판막 폐쇄부전증과 퇴행성 승모판막 폐쇄부전증에서 승모판막 성형술의 결과와 비교하여 류마티스성 승모판막 폐쇄부전증에서도 승모팍막성형술이 적합한 치료방법이 될 수 있는지를 알아보았다. 대상 및 방법 : 95년 1월부터 98년 12월 까지 승모판막 성형술을 시행받은 184명의 환자중에서 류마티스성 승모판막 폐쇄부전증 49례(1군)의 퇴행성 승모판막 폐쇄부전증 78례(2군)를 대상으로 하였다. 평균연령은 1군이 36.3$\pm$14.6(16-74세) 2군은 52.5$\pm$13.4(14-77)세였다 총 추적 관찰기간은 1군이 72.2인년 2군이77.2인년이었다 두군에서 수술후와 수술후 6개월 1년 및 이후 1년 단위로 주기적인 심초음파를 시행하였고 이를 통계적 검정하였다. 결과 : 두 군간에 수술전 혈류역학적인 차이를 보이지 않았고 수술전 평균 승모판막 폐쇄 부전의 정도는 1군이 3.0$\pm$0.4, 2군이 3.9$\pm$0.3였으나 수술후 추적 관찰에서 각각 0.9$\pm$0.9와 0.8$\pm$0.7정도의 양호한 판막 성형술의 결과를 보였고 승모판막 면적의 변화나 승모판막에서의 평균압력차이 등 혈류역학적인 결과에도 차이를 보이고 있지 않았다 수술조기 사망과 후기 사망은 없었으며 재수술율은 1군이 인년대비 1.4% 2군이 인년대비 2.6%였고 색전발생율은 1군이 인년대비 2.8% 2군이 1.3%였다. 심내막염발생은 1군에서만 1례있었으며 상기 결과들에서 두군간에 의미있는 차이를 보이고 있지는 않았다 결론 : 향후 장기적인 추적 관찰이 필요하나 중기 성적에서 승모판막 성형술이 류마티스성 승모판막 폐쇄 부전증에서도 효과적인 치료방법임을 알수 있었다.다 출생후 폐포막의 FN의 활성은 출생후 5일 및 7일에 최고주에 달했다. 출생직후 1-2일경에 혈관의 조직내 FN의 활성이 양성을 나타내지만 3일이후 활성이감소되었다. 폐포대식세포내 FN의 활성은 출생후 증가되었다. 폐조직내 소기관지의 FN의 활성은 출생후 완만하게 상승되었다. 큰 폐포세포는 출생 1-3일에 일정량의 FN 반응이 세포질과 미세융모내에 관찰되었다. 결론 : 이상과 같은 결과로 흰쥐의 폐포의 분화과정이 계속되는 출생후 폐에서 FN의 분비는 7일이내에 성숙흰쥐의 폐포내 반응과 비슷한 반응으르 보이며 이때 폐의 실질조직은 분화가 거의 완료되었을 것으로 사료되었고 큰 폐포세포에서도 FN이 분비되는 것으로 결론지울수 있다.X>에서 $1,332.75{\mu}g/mL$으로 최 대값을 나타내었으며, 추출시간 4.24시간 및 시료에 대한 용매비 9.71 mL/g에서 가장 높게 나타났다. 추출온도가 높고, 추출시간이 증가할수록 총 polyphenol 함량이 증가하는 경향을 나타내었다. Gallic acid 함량은 $65.84^{\circ}C$에서 $30.51{\mu}g/mL$으로 최대값을 나타내 었으며, 추출시간 1.65시간 및 시료에 대한 용매비 17.17mL/g에서 가장 높은 추출율을 보였다. Gallic acid 함량에 대한 추출조건의 영향은 추출시간과 용매비에 영향을 받는 것으로 나타났으며, 설정된 범위 내에서 온도에 대한 영향은 거의 나타나지 않는 것으로 나타났다. 실험연구가 더 필요하리라 본다. 혈액학적 변화를 유도하고 환자의 연령, 혈소판 수, 대동맥 차단 시간, 체외 순환 시간, 술후 PT 및 aPTT와 같은 다인적 상황들이 술후 출혈에 영향을 미친다는 점들을 시사하고

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Fixed Dose Regimen of Heparin Administration with Activated Coagulation Time During Cardiopulmonary Bypass (심폐바이패스시 활성응고시간을 이용한 헤파린 고정용량법)

  • 김원곤;박성식
    • Journal of Chest Surgery
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    • v.31 no.9
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    • pp.867-872
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    • 1998
  • Background: The fixed dose regimen with activated coagulation time(ACT) is the most commonly employed method for determining the required dosage of heparin and protamine during cardiopulmonary bypass(CPB). Material and Method: We performed a prospective study on a fixed dose regimen for analyzing adequate dosages of heparin and protamine, the incidence of heparin resistance and heparin-induced thrombocyt openia, factors affecting ACT during CPB, and changes of ACT during aprotinin usage. 300 units/kg of heparin were administered to patients, and ACTs were measured after 5 mins. ACTs were checked at 10 mins and 30 mins after the onset of CPB, and then at 30 min intervals thereafter. If the measured ACT was under 400 secs, we added 100 units/kg of heparin. The heparin was reversed with 1 mg of protamine for each 100 units administered. If the measured ACT was longer than 130 secs 30 mins after protamine administration or if there was definitive evidence of a coagulation defect, we administered a further 0.5 mg/kg of protamine. Result: We studied 80 patients(50 adults and 30 children) who underwent open heart surgery(OHS) at Seoul National University Hospital. Preoperative ACT was 114.3${\pm}$19.3 secs in adults, and 119.5${\pm}$18.2 secs in children. There were no differences in preoperative ACT due to age, body weight, body surface area, or sex. The preoperative ACT was not influenced by a positive past history of OHS. Ten adults(20%) and 3 pediatric patients(10%) needed additional doses of heparin to maintain the ACT above 400 secs. Additional protamine administration was needed in 9 adults(18%) and 10 children(33%). Heparin resistance was found in only two adults. Heparin-induced thrombocytopenia was detected in 2 adults and 1 child. During CPB, ACT was prolonged. 12 adult patients received a low dose of aprotinin and showed longer celite activated ACT compared to the control group.The kaolin activated ACT showed a lower tendency than the celite activated ACT in aprotinin users. Conclusion: In conclusion, fixed dose regimen of heparin and protamine can be used without significant problems, but the incidence of need of additional dosage remains unsatisfactory.

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High VPP Combination Chemotherapy for Advanced Non-Small Cell Lung Cancer (진행된 비소세포 폐암에 대한 High-VPP 복합화학요법의 효과)

  • Hong, Seok-Cheol;Han, Pyo-Seong;Lee, Jong-Jin;Cho, Hai-Jeong;Kim, Ju-Ock;Kim, Sun-Young
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.4
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    • pp.367-377
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    • 1993
  • Background: The benefits of combination chemotherapy in unresectable non-small cell lung cancer remain uncertain. But, according to the recent reports, the response rates of cisplatin-based polychemotherapy regimens are higher than those of single agent. Also, the response rates of high-dose cisplatin group are higher than those of low-dose cisplatin group. In attemp to answer the question whether treatments, combination chemotherapy (high VPP) and combination chemotherapy with radiation therapy, improve survival in advanced non-small cell lung cancer, we begin to study. Method: Thirty-five patients above stage III, diagnosed histologically as non-small cell lung cancer, were enrolled. Among them, nineteen received a combination chemotherapy consisting of VP-16 & high-dose cisplatin (100 $mg/m^2$) and/or radiation therapy. The other group (16 subjects) received no therapy. To investigate the differences of survival and response rates between two groups and the side effects related to therapy, we reviewed patients' records. Results: 1) The overall objective response rate was 47%(9/19) with one complete remission. 2) In patients who received polychemotherapy and radiation therapy, the response rate was 60%(6/10) with one complete remission and survival rates of 3 months, 6 months and 12 months were 100%, 70% and 40%. 3) In patients who received polychemotherapy, the response rate was 33% (3/9) with no complete remission and survival rates of 3 months, 6 months and 12 months were 78%, 67% and 33%. 4) Overall, treated patients survived significantly longer (p<0.05) than non-treated patients (median survival 307 days versus 95 days). 5) Analysis of the various prognostic factors disclosed that good performance status, stage III and squamous cell type showed the good response rates. 6) The toxicities were nausea and/or vomiting (100%), alopecia (90%), anemia (79%), leukopenia (69%), thrombocytopenia (2%), increased creatinine (16%) and neurotoxicity (5%). Conclusion: According to above results, there are relatively good results that high VPP combination chemotherapy in advanced non-small cell lung cancer improves survival in the treated group than in the non-treated group. Thus, it is considerd that we select the patients with proper indications and treat them with effective chemotherpy and radiation therapy. But, because improvement related to high VPP ploychemotherapy is not marked in this study, it is necessary that we should investigate follow-up studies in many cases.

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Disorders in Hemostasis

  • Sung, Tae-Jung
    • Neonatal Medicine
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    • v.18 no.1
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    • pp.14-22
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    • 2011
  • Neonatal bleeding is a common problem encountered in nursery rooms or neonatal intensive care units, especially among premature infants. Furthermore, owing to recent remarkable improvement of neonatology, survival rates of preterm neonates have increased; hence, neonatal bleeding cannot be emphasized enough. Since the total blood volume of neonates is small, bleeding can be one of the causes of morbidities and mortalities. Therefore, rapid diagnosis and immediate therapy is urgently needed. The patient's medical history including a familial history of a bleeding disorder or of a previously affected infant who suffered from bleeding along with maternal and neonatal drugs can provide important diagnostic clues. Presence of bleeding with or without petechiae and ecchymoses in a healthy term or late preterm infant with thrombocytopenia but normal prothrombin time and activated partial thromboplastin time strongly suggests a congenital bleeding disorder. For a sick infant who is bleeding from multiple sites, an acquired disorder such as disseminated intravascular coagulation is suspected. Intracranial hemorrhage in term or late preterm infants without a history of birth trauma is highly suggestive of coagulation disorders. The purpose of this review is to summarize recent advances in diagnostic methods is as well as basic concepts of neonatal hemostatic disorders. First, an outline of background information will be presented followed by a discussion of primary and secondary hemostatic disorders as well as inherited and acquired disorders.

Pharmacological Effect of Decursin, Decursinol Angelate, and Decursinol Derived from Angelica gigas Nakai (참당귀(Angelica gigas Nakai) 유래 decursin, decursinol 그리고 decursinol angelate의 약리 효과)

  • Kang, Jae Seon
    • Journal of Life Science
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    • v.31 no.12
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    • pp.1128-1141
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    • 2021
  • 'Angelica' is one of the most traditionally consumed medicinal herbs around Northeast Asia including Korea for treatments of various diseases or health care purposes like hematopoiesis, blood circulation for women, sedative, analgesic, and a tonic medicine etc. Angelica gigas Nakai, a Korean native species of Angelica, is clearly different from the others in containing a high concentration of active ingredients like pyranocoumarines including decursin, decursinol, and decursinol angelate. These compounds have various kinds of positive effects such as anti-tumor activity including the precaution of neutropenia occurred during anticancer drug administration, improvements of metabolic disorders, menstrual irregularity, impairment of renal function, respiration improvement, cognition-enhancement, anti-inflammatory effect, anti-oxidative effect, enhancing fertility and so forth. Thus it implies incredible potentialities in future development for foods and drugs. However, certain purity-related qualities and/or overdose in food products can cause side effects like toxicities; therefore, their safety profiles should also be considered. This review focuses on the positive and negative effects of three pyranocoumarines in Angelica gigas Nakai and some possibilities and considerations for future food and drug products development.

Effect of Ketanserin and Positive End Expiratory Pressure Ventilation on Hemodynamics and Gas Exchange in Experimental Acute Pulmonary Embolism (실험적 급성 폐동맥색전증에서 Ketanserin과 Positive End Expiratory Pressure Ventilation이 혈류역학 및 환기에 미치는 영향)

  • Lee, Sang-Do;Lee, Young-Hyun;Han, Sung-Koo;Shim, Young-Soo;Kim, Keun-Youl;Han, Yong-Chol
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.2
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    • pp.135-146
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    • 1993
  • Background: In acute pulmonary embolism it has been postulated that the constriction of bronchi and pulmonary artery secondary to neurohumoral response plays an important role in cardiopulmonary dysfunction in addition to the mechanical obstruction of pulmonary artery. Serotonin is considered as the most important mediator. Positive end expiratory pressure (PEEP) stimulates $PGI_2$ secretion from the vascular endothelium, but its role in acute pulmonary embolism is still in controversy. Methods: To study the cardiopulmonary effect and therapeutic role of Ketanserin, selective antagonist of 5-HT2 receptor, and PEEP in acute pulmonary embolism experimental acute pulmonary embolism was induced in dogs with autologous blood clot. The experimental animals were divided into 3 groups, that is control group, Ketanserin injection group and PEEP application group. Results: Thirty minutes after embolization, mean pulmonary arterial pressure and pulmonary vascular resistance increased and cardiac output decreased. $PaO_2,\;P\bar{v}O_2$ and oxygen transport decreased and physiological shunt and $PaCO_2$ increased. After injection of Ketanserin, comparing with control group, mean pulmonary arterial pressure, pulmonary vascular resistance and physiological shunt decreased, while cardiac output, $PaO_2$ and oxygen transport increased. All these changes sustained till 4 hours after embolization. After PEEP application pulmonary vascular resistance, $PaO_2$ and $PaCO_2$ increased, while physiological shunt, cardiac output and oxygen transport decreased. After discontinuation of PEEP, mean pulmonary arterial pressure and pulmonary vascular resistance decreased and were lower than control group, while $PaO_2$ and cardiac output increased and higher than control group. $PaCO_2$ decreased but showed no significant difference comparing with control group. Conclusion: It can be concluded that Ketanserin is effective for the treatment of acute pulmonary embolism. With PEEP hemodynamic status deteriorated, but improved better than control group after discontinuation of PEEP. Thus PEEP may be applied carefully for short period in acute pulmonary embolism if the hemodynamic status is tolerable.

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Effect of Ginseng Saponin on LDL Receptor Biosynthesis (인삼사포닌의 저밀도지질단백질(LDL)수용체에 미치는 영향)

  • Joo Chung No;Lee Hee Bong;Lee Yong Woo;Kang In Chul
    • Proceedings of the Ginseng society Conference
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    • 1988.08a
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    • pp.47-54
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    • 1988
  • Cholesterol a component of all eucaryotic plasma membranes. is essential for the growth and viability of cells in higher organisms. However. too much cholesterol can be lethal because of atherosclerosis resulting from the deposition of cholesterol ester plaques. It was attempted in this study to understand the preventive effect of ginseng saponin. one of the major components of the roots of Panax ginseng C.A. Meyer. against hypercholesterolemia induced by high cholesterol diet. $^{125}I-LDL$ was injected intravenously to rabbits and rats. which were fed a high cholesterol diet with and/or without ginseng saponin for 12 days. The disappearance of the radioactivity occurred faster in the test group than the control. The effect of saponin fraction from Panax ginseng C.A. Meyer and the purified ginsenosilks. $Rb_1,\;Rb_2,\;Re\;and\;Rg_1,$ on LDL receptor biosynthesis in high cholesterol fed rat has been investigated. Analysis of LDL receptors from various organs such as liver. kidney. adrenal cortex and testis showed that the population of LDL receptors of test group significantly higher than that of the control. It was also found that liver homogenate containing ginsenosides $(10^{-3}-10^{-4}\%)$ stimulated the biosynthesis of bile acid form cholesterol. From the above results. it seemed that ginsenosides lower the cholesterol level by stimulating cholesterol metabolism. which result in the suppression of the inhibitory action of cholesterol on LDL receptor biosynthesis.

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Gemcitabine/Cisplatin Combination Chemotherapy in Advanced non-Small Cell lung Cancer (진행된 비소세포폐암환자에서 Gemcitabine, Cisplatin 복합화학요법의 치료효과)

  • Shin, Ho-Sik;Yook, Dong-Seung;Kim, Hee-Kyoo;Choi, Paul;Lim, Hyun-Jeung;Park, Chan-Bog;Ha, Seung-In;Ok, Chul-Ho;Jang, Tae-Won;Jung, Maan-Hong
    • Tuberculosis and Respiratory Diseases
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    • v.55 no.1
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    • pp.98-106
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    • 2003
  • Background : To evaluate the efficacy and safety of gemcitabine and cisplatin chemotherapy in advanced non-small cell lung cancer (NSCLC). Materials and Methods : Forty patients (21 men, 19 women ; age range, 37 to 73 years; median, 63 years) with unresectable stage IIIB to IV NSCLC were evaluated. Patients received cisplatin $60mg/m^2$ (Day 1), gemcitabine $1200mg/m^2$ (Day 1 and 8) every 21 days. Eighteen patients had stage IIIB disease and 22 had stage IV. There were 28 patients of adenocarcinoma (70.0%), 11 of squamous cell carcinoma (27.5%), and one of large cell carcinoma (2.5%). Results : Of 40 patients, no patients showed complete response while 15(37.5%) showed partial response, 7(17.5%) had stable diseases, 18(45%) had progressive diseases. During a total of 195 courses of chemotherapy, grade 3 or more granulocytopenia and thrombocytopenia occured in 12.5% and 2.5% of patients respectively. Non-hematologic toxicity was mild and easily controlled. There was one case of treatment-related death by pneumomia. The median survival was 55 weeks (95% CI, 34~75weeks), and the time to progression was 19 weeks (95% CI, 16~23weeks). One year survival rate was 55% and 2 year survival rate was 10%. Conclusion : The efficacy of cisplatin and gemcitabine combination chemotherapy was acceptable in the treatment of advanced NSCLC.

A Case of a 2-year-old Girl with Type I Gaucher Disease Presenting with Growth Retardation and Leg Pain (2세 여아에서 성장 부진과 다리 통증을 동반한 1형 고셔병 증례)

  • Park, Yesul;Hwang, Jae-Yeon;Hwang, Eun Ha;Cheon, Chong Kun;Lee, Beom Hee;Yoo, Han-Wook;Kim, Yoo-Mi
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.17 no.2
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    • pp.63-68
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    • 2017
  • Gaucher disease (GD) is caused by the deficiency of glucocerebrosidase. In pediatric patients with GD, especially Type I GD, enzyme replacement therapy (ERT) can reduce the hepatosplenomegaly and improve the hematologic finding and growth velocity. Herein, we report a 2-year-old girl with Type I GD presented with hepatosplenomegaly, bone pain and growth retardation. A 2 year-old-girl was referred to our hospital due to severe hepatosplenomegaly and growth retardation. She suffered from both leg pain and chronic fatigue. Simple x-ray showed widened distal long bones like that of an 'Erlenmeyer flask' which is associated with GD. The laboratory test showed anemia and thrombocytopenia. The enzyme activity was markedly reduced and the direct sequencing of the GBA gene showed the compound heterozygous mutations, p.G46E and p.L444P. As the G46E have been considered as the protective gene against neuronopathic genotype, we could assess the Type I GD in this patient. After one year of ERT, the growth velocity became 11 cm per year. Bone pain and fatigue disappeared. The volume of liver and spleen was reduced from $683cm^3$ and $703cm^3$ to $590cm^3$ and $235cm^3$, respectively. Although GD is an extremely rare disease in Korea, growth retardation and bone pain in children are the important signs which lead to early detection of GD and a simple radiologic finding is helpful to assess the GD at outpatient clinic. We highlight that the early diagnosis and early ERT is important for good growth and outcome for pediatric patients with GD.

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