• Tuberculosis and Respiratory Diseases
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• v.42 no.5
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• pp.781-786
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• 1995

Transcatheter arterial chemoembolization(TACE) was performed in a 61 year old male patient with hepatocellular carcinoma with 10 cc of Lipiodol and 50 mg of doxorubicin. Three days later, he complained of dyspnea and dry cough. The arterial blood gas study revealed moderate hypoxemia and hypocarbia. The chest PA showed acute pulmonary edema with bilateral pleural effusion. To rule out the possibilities of acute respiratory failure caused by infection, pulmonary embolism or congestive heart failure, we performed several laboratory studies. The blood and sputum culture studies revealed negative results for bacterial growth. The echocardiogram was normal. The abdominal CT scan and MR imaging revealed no thrombus or mass lesion in the inferior vena cava. So we concluded pulmonary oil embolism induced by lipiodol as the cause of acute lung injury. Four weeks later, clinical symptoms and chest x-ray were markedly improved with conservative care. We report a case of acute lung injury after TACE with lipiodol and doxorubicin, with review of literatures.

• Microbiology and Biotechnology Letters
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• v.41 no.1
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• pp.33-43
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• 2013

A bacterium producing a fibrinolytic enzyme was isolated from Cheonggukjang. The bacterium was identified as a strain of Bacillus amyloliquefaciens by 16S rDNA analysis and designated as B. amyloliquefaciens HC188. The optimum culture medium appeared to be one containing 0.5% (w/v) maltose and 0.5% (w/v) soytone. Bacterial growth in the optimal medium at $37^{\circ}C$ reached the stationary phase after 27 h of incubation and the fibrinolytic enzyme showed optimum activity at 24 h. The enzyme was purified by 20-80% ammonium sulfate precipitation, CM Sepharose fast flow ion exchange chromatography, and Sephacryl S-200HR column chromatography. Its specific activity was 38359.3 units/mg protein and the yield was 5.5% of the total activity of the crude extracts. The molecular weight was 24.7 kDa and the amino acids of the N-terminal sequence were AQSVPYGVSQIKAPA. The fibrinolytic enzyme activity had an optimum temperature of $40^{\circ}C$ and an optimum pH of 8.0, and the enzyme was stable in the ranges $20-40^{\circ}C$ and pH 6.0-8.0. Enzyme activity was increased by $Ca^{2+}$ and $Co^{2+}$ but inhibited by $Cu^{2+}$, EDTA, and PMSF. It is suggested that the purified enzyme is a metallo-serine protease.

• Journal of Chest Surgery
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• v.42 no.3
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• pp.371-374
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• 2009

A 36-year-old woman with a history of spontaneous abortion and photosensitivity was admitted to our hospital with periumbilical pain and lower extremity edema. The preoperative CT scan revealed massive inferior vena cava thrombus, which extended from the suprarenal portion of the vena cava to the hepatic vein. The laboratory data showed an elevated level of anticardiolipin antibody, which suggested the diagnosis of antiphospholipid syndrome. After medical management, she underwent an operation for removal of an vena cava thrombus by performing cavectomy and thrombectomy. After the operation, she has been taking oral anticoagulation and she is doing quite well at 9 months after her operation.

• Proceedings of the Korean Society of Applied Pharmacology
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• 1995.04a
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• pp.114-114
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• 1995

이 연구에서는 혈전증 치료에 사용되는 혈전 응해제를 국내 독사독으로부터 개발하기 위한 실험을 실시하였다. 그 내용을 요약하면 다음과 같다. 국내에 서식하는 독사인 Agkistrodon blomoffi brevicaudus, Agkistrodon caliginosus와 Agkistrodon saxatilis에서 각각 사독을 채취하여 fibrin plate 방법으로 fibrin 분해능을 조사하여 Agkistrodon blomoffi brevicaudus의 독이 분해능이 가장 우수함을 밝혔다. 이와 같은 사실에 기초하여 A. blomoffi brevicaudus의 독으로부터 p-Aminobenzamidine affinity chromatography와 DEAE ion-exchange chromatography를 이용하여 분자량이 50.8 kDa인 황성 단백질을 정제하였다. 위에서와 같은 방법으로 정제한 단백질은 fibrin 분해능이 우수하고 fibrinogen의 ${\gamma}$ chain은 분해하지 않으나 B$\beta$ chain을 $A\alpha$ chain에 비하여 보다 선택적으로 분해하는 단백분해 효소임을 증명하였다. 이 정제 효소의 Fibrin에 대한 분해능은 266$\mu\textrm{g}$/${\mu}\ell$의 농도에서 Plasmin 1.0 unit (=3.0 WHO unit)보다 높게 나타났다. 정제된 효소는 chromogenic substrate인 N-Benzoyl-Phe-Val-Arg-pNA와 N-p-Tosyl- Gly-Pro-Arg-pNA의 arginine carboxyl side를 분해하고 pH 7.5에서 최대 활성을 보이며, Vmax는 5.46 umo1/1ㆍmin이고, Km 값은 0.20mM이며, 그리고 Cu$^{2+}$, $Zn^{2+}$, soybean trypsin inhibtor에 의해 25～50% 정도, serine proteinase inhibitor인 phenylmethylsulfonyl floride에 의해 80%정도 활성이 억제되는 특성이 있음을 규명하였다.

• The Journal of Dong Guk Oriental Medicine
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• v.8 no.1
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• pp.171-190
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• 1999

This following is effect of Buthus martensi Karsch(BMK) extract on dextran-thrombus model, KCN-induced coma, cytotoxicity of brain etc. BMK extract significantly increased number of platelet and fibrogen and significantly shortened the prothrombin time as compared with control group treated with dextran. BMK extract didn't affect the changes of hematocrit as compared with control group treated with dextran. BMK extract induced a significant inhibition of human platelet aggregation induced by thrombin and ADP but did not affect human platelet aggregation induced by collagen. BMK extract showed a protective effect on pulmonary thrombosis induced by collagen and epinephrine. BMK extract prolonged the duration of KCN-induced coma and showed a protective effect on cytotoxicity of PC12 cells induced by amyloid ${\beta}$ protein(25-35) in a dose dependent manner. These results suggested that BMK extract might be usefully applied for prevention and treatment of thrombosis and brain damage.

• Journal of the Korean Society of Radiology
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• v.85 no.1
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• pp.161-170
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• 2024

Purpose To assess the safety and feasibility of intentionally positioning the catheter tip in the right atrium (RA) without an abutment during implantation of a totally implantable venous access port (TIVAP). Materials and Methods We enrolled 330 patients who had undergone TIVAP implantation between January and December 2016 and postoperative chest CT. The TIVAP was placed using the single-incision technique to access the axillary vein directly from the incision line. To position the catheter tip in the RA without abutment, blood return was checked before cutting. Catheter length and complications were evaluated by retrospectively reviewing medical images and records. Results All patients achieved successful catheter tip positioning without abutment or dysfunction. The median tip position was 15.3 mm distal to the cavoatrial junction (CAJ) on fluoroscopy and 6 mm distal to the CAJ on CT. Catheter tips migrated a median of 10.4 mm cephalically on CT compared to fluoroscopy. Thromboses were detected in the RA and superior vena cava in one patient each. Conclusion Intentional catheter tip positioning in the RA without abutment is a safe and feasible technique with a low incidence of thrombosis and no observed dysfunction.

• Journal of Chest Surgery
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• v.42 no.4
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• pp.480-486
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• 2009

Background: The Fogarty thromboembolectomy catheter technique was devised to extract distal arterial emboli and it represents a milestone for the treatment of patients with acute arterial occlusion since the 1960s. The major causes of arterial occlusion have changed from emboli of a heart origin to atherosclerosis over the past 30 years. Accordingly, questions have been raised about the effectiveness of simple Fogarty thromboembolectomy. Material and Method: During the period from March 1990 through August 2008, 156 patients who requiring Fogarty thromboembolectomy were analyzed. The patients were divided into two groups: those with simple Fogarty thromboembolectomy (Group 1, 79 patients) and those with additional vascular bypass graft surgery (Group 2, 77 patients). The duration of symptoms, the cause of thrombi, admission via the emergency room, a history of acupuncture or misdiagnosis, combined diseases, the anatomic occlusion site and the cause of death were analyzed using T-tests, cross tab tests, Chi square tests and Kaplan-Meier tests, respectively. Result: The mean age was 64$\pm$10 years in the 2 groups. The duration of symptoms (pain) in Group 1 vs Group 2 was 12$\pm$4 days vs 71$\pm$14 days (p=0.001). 50 (63%) patients in Group 1 were admitted via the emergency room vs 18 (23%) patients in Group 2 (p=0.005). Misdiagnosis and the treatment for herniated intervertebral disc or acupuncture were given to, 20 (25%) patients in Group 1 vs 30 (39%) patients in Group 2. Anticoagulation treatment before admission was performed in 22 (28%) patients in Group 1 vs 11 (14%) patients in Group 2. The causes of thrombi were heart disease in, 24 (30%) patients in Group 1 vs 6 (8%) patients in Group 2 (p=0.001), atherosclerosis in 46 (58%) patients in Group 1 vs 67 (87%) patients in Group 2 (p=0.001) and trauma in 9 (11%) patients in Group 1 vs 6 (8%) patients in Group 2. The combined diseases were cerebrovascular accident, hypertension and diabetes mellitus in 22 $\sim$ 37% of the total patients. The occlusion sites were mainly in the iliac and femoral arteries. Endarterectomy was performed in 7 (9%) patients in Group 1 vs 18 (23%) patients in Group 2 (p=0.012). Treatment was successful in 27 (34%) patients in Group 1 and in 40 (52%) patients in Group 2 (p=0.019). Reocclusion occurred in 37(47%) patients in Group 1 vs 20 (26%) patients in Group 2 (p=0.000), Amputation was done in 4 (5%) patients in Group 1 vs 12 (16%) patients in Group 2 (p=0.012) and death occurred in 10 (13%) patients (Group 1) vs 3(4%) patients (Group 2) (p=0.044). Conclusion: The recent past has shown a decline in the effectiveness of simple Fogarty thromboembolectomy with a changing pattern of acute arterial occlusion from a rheumatic heart origin to atherosclerosis. Additional bypass procedures play a role for the treatment of arterial occlusion instead of always performing simple Fogarty thromboembolectomy.

• Proceedings of the KAIS Fall Conference
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• 2003.06a
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• pp.320-321
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• 2003

최근 천연물을 중심으로 한 학문이 발전하면서 천연물이 가지는 생리활성 물질에 대한 관심이 중대되고 있다. 또한 인공합성품의 일부가 안정성의 문제가 제기되면서 천연물의 이용분야는 더욱 확대되고 있다. 급속한 경제발전과 생활수준의 향상으로 식생활을 포함한 생활방식의 다양화로 인하여 과거 감염 위주의 질병이 감소하고 선진국형의 만성퇴행성 질환이 증가하는 추세이다. 혈소판은 혈전증(thrombosis)과 지혈증(haemstasis)에서 중요한 역할을 담당하고 있는 인자로서 현관 내 병적 이상으로 인한 과도한 혈전의 생성은 뇌 -심혈관계 질환의 중요한 유발인자로 작용하므로 뇌ㆍ심혈관계 질환이나 항고지혈증을 연구하는데 유용하게 이용되고 있다. 본 연구에서는 토끼 혈액에서 분리한 세정 혈소판 부유액을 이용하여 작약 MeOH 추출물에서 분리한 천연생리활성물질들을 대상으로 혈소판 응집억제활성에 대하여 연구하였다. 작약 MeOH 추출물의 혈소판 응집억제활성 측정에서 강한 혈소판 응집억제활성 작용을 보였다. 따라서 작약 MeOH 추출물을 크로마토그라피법을 이용하여 분리하였고, NMR을 이용한 분광학적 방법으로 지금까지의 분리한 자료와 비교ㆍ분석하였다. Monoterpene glycoside 계열의 성분들인 15개의 compound와 다수의 fraction들을 HPLC를 이용하여 분리하였으며, collagen으로 유도된 혈소판 응집억제활성측정 방법에서 뛰어난 응집억제활성을 보였다. 표준물질을 이용한 HPLC 분석과 ¹H-NMR 관련 자료의 검색을 통하여 최종적으로 compound 1b가 benzoyloxy-paeoniflorin(2.6％). compound 1d가 paeond(1.3％), compound 2c가 albiflorin(3.2％), compound 2e가 paeoniflorin(33.6％)임을 확인할 수 있었다. Compound 3a의 분석결과 benzoyloxypaeoniflorin과 구조적 유사성은 있으나 동일한 구조식으로 확인할 수 없었다. 그러나 collagen에서 응집억제활성이 90％ 이상으로 뛰어난 활성을 나타내므로 benzoyloxypaeoniflorin과 유사한 구조에서 benzoyl group이 다른 작용기로 치환되었거나 R₁ group이 다른 작용기로 치환된 형태로 추측하였다. Benzoyloxypaeoniflorin은 collagen＞thrombin＞U46616＞A.A(arachidonic acid)＞PAF의 순으로 활성을 보였다. 이는 paeoniflorin의 glycoside 5-carbon위치에 위치한 OH기 대신에 benzoyl기로 치환된 benzoyl 기가 혈소판 억제 산물로 작용한 것으로 추측했다. Paeoniflorin.은 U46619＞thrombin＞collagen＞A.A＞PAF순으로 억제를 보였다. Paeoniflorin이 collagen보다 thrombin에서 강한 억제를 보이는 것으로 Ca/sup 2＋/ chelate를 형성함으로 인해 calciu 대사를 저해하는 것으로 추축했다. Compound 3a는 U46619＞collagen＞A.A＞thrombin＞PAF순으로 억제율을 보이므로 이 화합물은 paeoniflorin의 benzoyl기에 OH기가 다른 치환기로 바뀌거나 paeoniflorin의 glycoside 5-carbon 위치의 OH기 대신에 다른 작용기로 치환된 것으로 추정하였다. 이러한 결과로 작약의 주성분인 paeoniflorin과 유사한 구조를 가진 다른 monoterpene glycoside 계열의 화합물들과 비교 분석하고 구조를 화인하고 이들 성분이 어떻게 혈소판 응집억제활성에 작용하는지를 연구하였다.

• Clinical and Experimental Pediatrics
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• v.53 no.3
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• pp.428-431
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• 2010

Thrombotic thrombocytopenic purpura (TTP) is a thrombotic microangiopathy characterized by endothelial cell damage, resulting in microangiopathic hemolytic anemia, thrombocytopenia, and various degrees of neurological and renal impairment caused by microvascular thrombi. It is rare in children and frequently follows a fatal course. TTP is divided into 2 types: one is inherited and associated with ADAMTS-13 gene mutations and the other is acquired and associated with anti-ADAMTS-13 autoantibodies. The measurement of ADAMTS-13 activity in plasma, identification of ADAMTS-13 circulating inhibitor, anti-ADAMTS-13 IgG, and ADAMTS-13 gene sequencing are crucial to the diagnosis of TTP. Plasma exchanges are the first-line treatment for acquired TTP, combined with steroids and immunosuppressive drugs. Here, we describe the case of an adolescent patient with TTP, confirmed by decreased level of ADAMTS-13 activity and an increased level of ADAMTS-13 inhibitor, who was successfully treated by plasma exchanges.

• The Korean Journal of Pharmacology
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• v.18 no.2
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• pp.15-25
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• 1982

It was undertake to investigate the factors involved in the micro thrombus formation in the plasma from the patients with cerebrovascular disease(CVD) and the in vitro actions of sodium nitroprusside on the platelet aggregate formation. 1) The microthrombus formation in the plasma from CVD was significantly enhanced, in comparison with that from the healthy volunteers. 2) Both lipid peroxide and cathepsin D in the plasma from CVD were higher than those levels from the healthy volunteers. 3) Whereas the platelets from healthy individuals showed less aggregation activity in response to ADP in the second phase those from CVD revealed the enhanced aggregating response to ADP. 4) When the bovine basilar artery, rabbit aorta and human umbilical artery were pretreated with $K^+-free$ PSS, ouabain, 13-hydroperoxylinoleic acid(13-HPLA) and cadmium they markedly enhanced the platelet aggregability respectively. 5) Platelet aggregation induced by $K^+-free$ PSS-treated bovine basilar artery was decreased by sodium nitroprusside in a dose-dependent manner, but not by either hydralazine. 6) Both dibutyryl cyclic AMP and 8-bromo cyclic GMP had the inhibitory action on the platelet aggregation. However, the latter had more prominent action than former. The antiaggregating effect by sodium nitroprusside was antagonized by pretreatment with methylene blue, but not by hemoglobin. These results provide the evidences for the therapeutic use of sodium nitroprusside in the emergency of cerebrovascular disease and in remains the further study of the clinical therapy with it.