• Title/Summary/Keyword: 혈전증

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DENTAL TREATMENT OF A PEDIATRIC PATIENT WITH HOMOZYGOUS PROTEIN C DEFICIENCY: A CASE REPORT (동형접합성 단백 C 결핍 환아의 치과적 치험례)

  • Yoon, Mi;Kim, Seung-Oh;Kim, Jong-Soo;Yoo, Seung-Hoon
    • Journal of the korean academy of Pediatric Dentistry
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    • v.37 no.2
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    • pp.207-212
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    • 2010
  • Protein C deficiency increases the risk of thrombosis due to the lack of anticoagulant factor protein C. Among the numerous congenital protein C deficiencies, homozygous protein C deficiency has an especially low protein C activity level, that it is almost undetectable. It is a rare disease with a probability of 1:250000~500000. The signs and symptoms of homozygous protein C deficiency include purpuric, necrotic dermatosis, ecchymosis, blindness, and thrombosis in central nervous system. A 4-year-old girl was brought to the clinic with a chief complaint of extensive caries. The child was under warfarin medication in order to prevent possible complications during dental treatment. We consulted the pediatric department. Without warfarin intake, serious complications may occur due to thrombosis during dental treatment. Therefore, certain warfarin dosage (INR 3~5) and fresh frozen plasma as a backup for excessive hemorrhage were recommended. This child was a severely disabled child with the loss of vision, and it was difficult to manage her behavior effectively. Thus, dental treatment was carried out under general anesthesia, where bleeding control would be also easier to achieve.This report presents the case of a 4-year-old girl with protein C deficiency, who has received dental treatment for extensive caries under general anesthesia.

Percutaneous Cardiopulmonary Bypass Support in a Patient with Acute Myocardial Infarction by Stent Thrombosis Complicated with Ventricular Tachycardia (스텐트 혈전에 의한 재발성 심실성 빈맥을 동반한 급성 심근경색에 경피적 심폐순환보조)

  • Kim Sang-Pil;Lee Jun-Wan
    • Journal of Chest Surgery
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    • v.39 no.5 s.262
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    • pp.399-402
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    • 2006
  • Stent thrombosis is a rare complication after percutaneous coronary intervention (PCI), but it might be related to fatal outcomes. We report a case of patient who suffered from acute myocardial infarction complicated with cardiogenic shock and ventricular tachycardia caused by stent thrombosis and successfully resuscitated by percutaneous cardiopulmonary bypass support.

Mechanical Valve Thrombosis -3 Cases- (기계 판막 혈전증 치험 3례 보고)

  • 김경훈;박성동
    • 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.

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Portal Vein Thrombosis in a Dog with Dirofilariasis (심장사상충에 감염된 개에서 발생한 문정맥혈전증)

  • Yun, Seok-Ju;Cheon, Haeng-Bok;Han, Jae-Ik;Kang, Ji-Houn;Chang, Jin-Hwa;Na, Ki-Jeong;Chang, Dong-Woo
    • Journal of Veterinary Clinics
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    • v.27 no.5
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    • pp.600-604
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    • 2010
  • A ten-year-old female mongrel dog was presented to Veterinary Medical Center, Chungbuk National University with the signs of anorexia, weakness, and hemoglobinuria. Patient had been diagnosed as dirofilariasis based on heartworm antigen test and treated with adulticide (melarsomine) at local hospital one day before admission. On laboratory examinations, there were hypochromic and microcytic regenerative anemia, thrombocytopenia, moderate neutrophilia, and increase ALT, AST, and ALP. Radiographic exam showed main pulmonary artery bulging, pulmonary infiltration and hypervascularity, reduced abdominal serosal detail and mild hepatomegaly. Abdominal ultrasonographic exam showed mild peritoneal effusion and large hyperechoic thrombi at trifurcation of the porta hepatica and the splenic vein. In addition, intraluminal low density area and intravascular filling defect were confirmed on contrast enhanced CT scanning at the same anatomic locations. Patient was treated with anticoagulant and thrombolytic therapy. On day 42 after treatment, complete resolution of thrombi was confirmed via ultrasonography and improvement of clinical signs was observed.

Interventional Approaches for Treatment of Saddle Embolus in Two Cats with Hypertrophic Cardiomyopathy (고양이 심근비대증에 병발한 안장색전증의 중재치료 증례)

  • Kang, Min-Hee;Park, Hee-Myung
    • Journal of Veterinary Clinics
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    • v.31 no.4
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    • pp.298-302
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    • 2014
  • An 8-year-old castrated male domestic shorthair cat (Case 1) and 3-year-old castrated male Siamese cat (Case 2) was presented with acute paresis of the hindlimbs, constant open-mouth breathing, and hemoptysis. Heart murmur (Case 1) and gallop sound (Case 2) was ausculated on the left heart base. Radiographs revealed alveolar infiltration of the caudodorsal lung lobes with aerophagea in Case 1 and prominent cardiomegaly in Case 2. Marked concentric hypertrophy of the ventricular septum and free wall, and left atrial enlargement was detected through echocardiography in both cats. Based on the examinations including echocardiography, those cats were diagnosed as hypertropic cardiomyopathy. Abdominal ultrasound revealed echogenic material in the aortic trifurcation region, aortic thromboembolism (ATE). Although prognosis of those animals was guarded, interventional therapeutic approach through direct endovascular thrombolytic therapy was attempted. ATE was visualized through angiography; however dissolving the embolus using interventional thrombolytic approach was not successful due to the extensive thrombus.

Early and Mid-term Results of Operation for Acute Limb Ischemia (급성 사지 허혈증의 증단기 수술 성적)

  • 김대환;최창석;황상원;김한용;유병하;김종석
    • Journal of Chest Surgery
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    • v.37 no.9
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    • pp.787-792
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    • 2004
  • Even though there well developments in various treatment techniques for acute limb ischemia, this disease is both life threatening and limb threatening. We investigated early and mid-term results of operation for acute limb ischemia with symptoms, the combined diseases, location of occlusion, complication in our patients. Material and Method: A retrospective review was conducted in 54 patients (43 men, 11 women, mean age 67.2 years) presenting with acute limb ischemia due to arterial thrombosis or embolism between Jan. 1996 and Dec. 2003, initially underwent thromboembolectomy. Result: In 33 patients (61.1%) the timeinterval from the onset of symptom to admission was within 24 hours. Causes of acute limb ischemia were embolic occlusion (27.8%), native arterial thrombosis (66.7%), and bypass graft thrombosis (5.6%). The distribution of arterial occlusion location was at 8 aortoiliac (14.8%) and 43 distal to femoral (79.6%) and brachial (5.6%). Clinical categories were grade I in 64.8%, IIa in 24.1%, IIb in 7.4%, and III in 3.7%, All the patients were received embolectomy. Underlying diseases were heart disease (72.2%), hypertension (33.3%), cerebrovascular accident (16.7%) and diabetes (18.5%). History of smoking was noted in 96,3% of the cases. Mortality rate was 5.6% and overall amputation rate was 9.3% (5/54). The 1-year limb salvage rate was 93.62%. Postoperative complications were 1 wound infection, 1 G1 bleeding, 3 acute renal failure, and 1 compartment syndromes. The functional outcomes of the salvaged limb according to the recommended scale for gauging changes in clinical status, revised version in 1997 were +3 in 68.5%, +2 in 9.3%, +1 in 7.4%, -1 in 5.6%, -2 in 3.7%, and -3 in 5.6%. Conclusion: This study revealed 5.6% mortality and the amputation rate was 9.3%. We have retrospectively shown good results from early diagnosis & early operation. To improve outcome, early diagnosis and understand the underlying diseases, prompt treatment and operation would be appreciated.

Current Status and Application Prospects of Anti-Atherosclerotic Active Biomaterials (항동맥경화 활성 바이오소재 개발 연구 동향 및 활용 전망)

  • Seunghee Kim;Jeongho Lee;Hah Young Yoo
    • Korean Chemical Engineering Research
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    • v.62 no.2
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    • pp.133-141
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    • 2024
  • Atherosclerosis, a disease with high morbidity and mortality worldwide, is a chronic inflammatory disease that is a major cause of cardiovascular diseases such as stroke and myocardial infarction. Atherosclerosis is characterized by the accumulation of lipid deposits in the arteries, forming atheromas. This leads to the narrowing of the arteries and thrombosis. Recently, the need to develop bio-derived anti-atherosclerotic materials has been highlighted with concerns about the side effects of synthetic therapeutics. Accordingly, related research (such as the discovery of biomaterials for the improvement and treatment of atherosclerosis and the identification of mechanisms) has been actively conducted. Biomaterials including polysaccharides, polyphenols, and coenzyme Q10 have been reported to inhibit or delay symptoms by modulating factors involved in the development of atherosclerosis. For biomaterials with superior activity, in vivo anti-atherosclerotic activity has been confirmed. In this review, the pathogenesis of atherosclerosis was investigated, and the current status and application prospects of biomaterials with anti-atherosclerotic activity were proposed.

Thrombolytic Therapy for Thrombosis of Prosthetic Mitral Valve - A Case Report - (인공 승모판막에 생긴 혈전의 혈전용해 치료 - 1례 보고 -)

  • Kang, Shin-Kwang;Kim, Si-Wook;Won, Tae-Hee;Ku, Kwan-Woo;Na, Myung-Hoon;Yu, Jae-Hyun;Lim, Seung-Pyung;Lee, Young;Jeong, Jin-Ok
    • Journal of Chest Surgery
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    • v.35 no.11
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    • pp.826-830
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    • 2002
  • Prosthetic valve thrombosis(PVT) may be a life-threatening complication requiring prompt intervention. This is a case report of thrombolytic therapy for thrombosis of prosthetic mitral valve. A 47 year-old male admitted to the emergency room for abrupt onset of dyspnea. He had undergone mitral valve replacement(On-Ⅹ valve, 29mm) for mitral stenosis 8 months ago. The patient's international normalized ratio(INR) on admission was 1.09. The mechanical clicks were muffled and rales were heard in both lung fields. A transesophageal echocardiography(TEE) revealed prosthetic valve thrombosis with increased transvalvular pressure gradient(34 mmHg). The patient's condition needed to intubation for mechanical ventilation due to hemodynamic compromise, however his wife and relatives refused the surgical intervention due to financial problems. The patient was transferred to the cardiac care unit and we decided to perform thrombolytic therapy. A bolus of 1,500,000 IU of urokinase was given, followed by a drip of 1,500,000 IU for 1 hour. The patient did not improved hemodynamically; therefore, we gave 100 mg of tissue plasminogen activator(t-PA) for over 2 hours. During that time mechanical clicks were audible and hemodynamics of the patient improved progressively. A TEE showed disappearance of thrombus and decreased pressure gradient(1.7 mmHg) after 6 hours of thrombolytic therapy. The patient was recovered without any neurologic sequale and was discharged with administration of warfarin.

지혜 깊어지는 건강 - 활기찬 실버 세대 - 골절 예방하면 빙판길도 두렵지 않다

  • Son, Ju-Seok
    • 건강소식
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    • v.35 no.12
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    • pp.24-25
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    • 2011
  • 겨울철에는 낙상사고가 다른 계절보다 3배 이상 높게 나타난다. 추운 날씨 주머니에 손을 넣고 걷다 빙판길에서 미끄러지는 일이 빈번하다. 문제는 노인들의 골절이다. 손목, 척추, 고관절(엉덩이뼈) 골절을 입은 환자는 독립적 보행이 불가능해지며 일상생활에 큰 어려움을 겪게 된다. 특히 고관절(엉덩이뼈) 골절의 경우 1년 내에 사망할 확률이 무려 20%다. 고령 환자의 경우 고관절 골절을 입고 병상에 누워 지내는 기간이 길어지면 심폐 및 방광기능이 저하될 수 있으며, 욕창이나 혈전증 등이 발생할 수 있다. 골절이 노인에게 치명적인 이유다.

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The Role of Radiotherapy in the Treatment of Portal Vein Thrombosis from Advanced Hepatocellular Carcinoma (진행된 간세포암에서의 간문맥 혈전증에 대한 방사선치료 효과)

  • Kim, Jung-Hoon;Choi, Eun-Kyung;Ahn, Seung-Do;Lee, Sang-Wook;Shin, Seong-Soo;Choi, Won-Sik;Lim, Young-Suk;Kim, Kang-Mo;Suh, Dong-Jin;Chung, Young-Wha;Lee, Young-Sang;Won, Hyung-Jin;Kim, Jong-Hoon
    • Radiation Oncology Journal
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    • v.25 no.3
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    • pp.170-176
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    • 2007
  • Purpose: To determine the role of radiotherapy for the treatment of portal vein thrombosis (PVT) from hepatocellular carcinoma (HCC). Material and Methods: A retrospective analysis was performed on 70 patients that had been diagnosed with HCC and were treated with three-dimensional conformal radiotherapy (3D-CRT) for the PVT. The radiation dose ranged from 40 Gy to 60 Gy (median dose: 48 Gy) and the biological effective dose (BED) ranged from 31.3 Gy to 78.0 $Gy_{10}$ (median dose: 61.6 $Gy_{10}$). Response was determined by measuring the extent of the PVT on a CT image at 0, 1 and 3 months after completion of the radiotherapy. The median follow-up period was 9 months. Results: The response rate was 47.1% (33 patients), with two patients (2.9%) showing a complete response, 31 patients (44.3%) showing a partial response, and 35 patients (50%) showing stable disease or no response. The 1-year progression-free survival rate was 60%, and the median progression-free survival time was 17 months. The median overall survival time was 11 months, the median survival time in the responders was 15 months and in the nonresponders was 8 months (p=0.032). Four patients (5.7%) had transient liver function impairment during treatment. Radiation induced liver disease (RILD) was observed in only one patient (1.4%). Conclusion: Three-dimensional conformal radiotherapy for the treatment of PVT from advanced HCC was a relatively effective and safe method.