• Journal of Chest Surgery
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• v.30 no.5
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• pp.501-505
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• 1997

It was reported that use of aprotinin in elderly patients undergoing hypothermic circulatory arrest was associated with an increased risk of renal dysfunction, and myocardial infarction as a result of intravascular coagulation. We reviewed 20 patients who received high-dose aprotinin under deep hypothermic circulatory arrest with(NP group, n= 11) or without selective cerebral perfusion(SP group, n=9). The activated clotting time was exceeded 750 seconds in all but 1 patient. After opening aortic arch, retrograde low flow perfusion was maintained through femoral artery to prevent air embolization to the visceral arteries. Four patients among 20 died during hospitalization'due to bleeding, coronary artery dissection pulmonary hemorrhage and multiple cerebral infarction. Postoperatively, cerebrovascular accidents occurred in two patients; one with preoperative carotid artery dissection and the other with unknown multiple cerebral infarction. In conclusion, use of aprotinin in young patients undergoing hypothermic circulatory arrest did not increase the risk of renal dysfunction or intravascular coagulation if ACT during circulatory arrest is maintained to exceed 750 seconds with low-flow perfusion.

• Journal of Chest Surgery
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• v.39 no.5 s.262
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• pp.366-375
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• 2006

Background: Hypomagnesemia is a common complication after cardiac surgery with cardiopulmonary bypass. The purpose of this study was to assess the clinical beneficial effect of administration of magnesium sulfate in cardiac surgery. Material and Method: Thirty five patients scheduled for elective cardiac surgery were randomly assigned to magnesium group (n=20) which received magnesium sulfate in priming solution (1 g) and cardioplegic solution (1 g) or control group (n=15) which did not receive it. Arterial blood samples were drawn for measuring $Mg^{++}$ and electrolytes contents, blood gas analysis, CBC, total protein, albumin, blood urea nitrogen (BUN), creatinine, alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin, tumor necrosis factor-${\alpha}$ $(TNF-{\alpha})$, interleukin-6 (IL-6), interleukin-10 (IL-10), creatine phosphokinase (CpK), creatine kinase-MB (CK-MB), lactate dehydrogenase(LDH), troponin-1 (TNI), prothrombin time (PT) and activated pratial thromboplastin time level (aPTT). Venous blood samples were drawn before and after the operation for measuring activated clotting time level (ACT). Result: $Mg^{++}$ levels in magensium group were higher than those of control group at intraoperative and post-operative periods (p<0.05). dysrhythmias were lower in magnesium group (8 cases out of 17 patients, 46.4%) than in control group (10 cases out of 10, 100%, p=0.050). Conclusion: These results showed that administration of low dose magnesium sulfate during cardiac surgery prevented hypomagnesemia and lowered incidence of dysrhythmia.

• Natural Product Sciences
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• v.13 no.3
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• pp.220-224
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• 2007

To search of more selective vasculogenic relaxation activity, the antioxidant activity of silkworm male pupae was determined by measuring its radical scavenging effect on 1, 1-diphenyl-2-picrylhydrazyl (DPPH) radicals, and anticoagulant activity of them was measured clotting time in both activated partial thromboplastin time (aPTT). Because, most of cGMP-enhancing agent such as, sildenafil, promotes thrombin-induced platelet aggregation, developed unexplained thrombic conditions including heart attack. To search more suitable and safe drug for vasculogenic relaxation, we purified silkworm pupae male extract. The ethyl acetate extract of silkworm male pupae showed strong scavenging activity in both DPPH and aPTT anticoagulant activity. The antioxidant activity potential of the individual fraction was in order of ethyl acetate > n-butanol > chloroform > n-hexane. The ethyl acetate soluble fraction exhibiting strong anti-oxidant and anticoagulant activity was further purified by repeated silica gel and Sephadex LH-20 column chromatography. Cholesterol was isolated as one of the active principles from ethyl acetate fraction, together with, minor portion, ${\beta}-sitosterol$.

• Biomolecules & Therapeutics
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• v.22 no.3
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• pp.254-259
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• 2014

The pentacyclic triterpenoid ursolic acid (UA) and its isomer oleanolic acid (OA) are ubiquitous in food and plant medicine, and thus are easily exposed to the population through natural contact or intentional use. Although they have diverse health benefits, reported cardiovascular protective activity is contentious. In this study, the effect of UA and OA on platelet aggregation was examined on the basis that alteration of platelet activity is a potential process contributing to cardiovascular events. Treatment of UA enhanced platelet aggregation induced by thrombin or ADP, which was concentration-dependent in a range of $5-50{\mu}M$. Quite comparable results were obtained with OA, in which OA-treated platelets also exhibited an exaggerated response to either thrombin or ADP. UA treatment potentiated aggregation of whole blood, while OA failed to increase aggregation by thrombin. UA and OA did not affect plasma coagulation assessed by measuring prothrombin time and activated partial thromboplastin time. These results indicate that both UA and OA are capable of making platelets susceptible to aggregatory stimuli, and platelets rather than clotting factors are the primary target of them in proaggregatory activity. These compounds need to be used with caution, especially in the population with a predisposition to cardiovascular events.

• Archives of Pharmacal Research
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• v.25 no.5
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• pp.669-674
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• 2002

Glycosaminoglycans (GAGs) were isolated from the porcine testis, and their immuno-modulating and anticoagulant activity was investigated. From anion exchange chromatography (Dowex Macropolous Resin) used for further isolation of porcine testis GAGs (PT-GAGs), two fractions (PT-GAG-1.5 and PT-GAG-16) eluted by different salt concentration were obtained. In immunomodulating activity test, PT-GAG-1.5, but not PT-GAG-16, significantly enhanced the growth of murine peritoneal macrophages. In addition, treatment with PT-GAG-1.5 induced the production of cytokines, interleukin-1$\beta$ (IL-1$\beta$), interferon-${\gamma}$ (IFN-${\gamma}$) and tumor necrosis factor-$\alpha$ (TNF-$\alpha$), from murine microphages. Unexpectedly, both of PT-GAGs had no effect on the growth of murine splenocytes. The anticoagulant activity of PT-GAG-1.5 and PT-GAG-16 was examined by activated partial thromboplastin time (aPTT) assay and thrombin time (TT) assay. Both of PT-kGAGs significantly increased the clotting times of aPTT and TT in a dose-dependent manner. The anticoagulant activity of PT-GAG-16 was found to be higher than that of PT-GAG-1.5. These results suggest that PT-GAGs possess biological activities such as immunomodulating activity and anticoagulant activity.

• International Journal of Advanced Culture Technology
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• v.10 no.4
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• pp.316-321
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• 2022

Since 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread rapidly, infecting millions of people worldwide. On March 11, 2020, the World Health Organization declared coronavirus disease (COVID-19) a pandemic owing to the worldwide spread of SARS-CoV-2, which created an unprecedented burden on the global healthcare system. In this context, there are increasing concerns regarding co-infections with other respiratory viruses, such as the influenza virus. In this study, clinical data of patients infected with SARS-CoV-2 and other respiratory viruses were compared with patients infected with SARS-CoV-2 alone. The hematology and blood biochemistry results of 178 patients infected with SARS-CoV-2 , who were tested on admission, were retrospectively reviewed. In patients with SARS-CoV-2 and adenovirus co-infection, C-reactive protein levels were elevated on admission, whereas lactate dehydrogenase (LDH), prothrombin time, international normalized ratio, activated partial thromboplastin clotting time, and bilirubin values were all within the normal range. Moreover, patients with SARS-CoV-2 and human bocavirus co-infection had low LDH and high bilirubin levels on admission. These findings reveal the clinical features of respiratory virus and SARS-CoV-2 co-infections and support the development of appropriate approaches for treating patients with SARS-CoV-2 and other respiratory virus co-infections.

• Journal of Life Science
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• v.24 no.5
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• pp.515-521
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• 2014

The oriental traditional medicine, Aruncus dioicus var kamtschaticus (ADK) is used for hemostasis (blood stopping) and the promotion of blood circulation. Recently, the demands of the aerial part of ADK as edible mountain herbs are rapidly increased due to its unique fragrance and bioactivity. In this study, to evaluate the anti-thrombosis activity of ADK, ethanol extract and organic solvent fractions were prepared from aerial parts of ADK, and their anticoagulation and anti-platelet aggregation activities were determined. In an anticoagulation activity assay, the ethanol extract of ADK increased the thrombin time, prothrombin time, and activated partial thromboplastin time (aPTT) 1.4-2.3 times at a concentration of 5 mg/ml. Among the fractions, the ethylacetate fraction showed strong inhibitory effects against blood clotting factors, as shown in an extension of the aPTT. In contrast, the butanol fraction strongly promoted blood clotting. In an anti-platelet aggregation assay, the activity of the ethanol extract was comparable to that of aspirin, a commercial anti-platelet aggregation agent, and the butanol fraction showed 2-fold higher aggregation inhibitory activity than aspirin. The aforementioned ethanol extract and active fractions have ignorable hemolytic activity against human red blood cells up to a concentration of 0.5 mg/ml. Considering the high content of total polyphenol, total flavonoid, and total sugar of the ethylacetate and butanol fractions, the purified active substances have potential as safe and novel anti-thrombosis agents. This report provides the first evidence of anti-thrombosis activity of ADK.

• Journal of Chest Surgery
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• v.33 no.12
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• pp.954-958
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• 2000

배경: 헤파린표면처리 도관(Heparin-coated circuit: HCC)이 도관과 혈액사이의 반응(Blood-marterial reaction)을 줄여주어서 보체활성화(complement activation), 백혈구활성화(leukocyte activation)와 사이토킨 분비(cytokinerelease)등을 감소시켜 준다. 그러나 HCC가 수술 후에 출혈 양을 줄여주고 헌혈 필요량을 감소시켜 준다는 임상적 효과에 대해서는 인정된 부분이 많으나 아직까지 그 기전은 대부분은 미지의 상태로 남아있는 것이 사실이다. 본 연구는 HCC를 사용한 군(Group H)과 사용하지 않은 군(Group C)간에 심폐기 사용기간(Pumptime), 활성화 응고시간(activated clotting time: ACT)과 헤파린 사용량을 비교 분석해 봄으로서 두 군간에 존재할 수 있는 헤파린 사용량을 비교 분석해 본으로서 두 군간에 존재할 수 있는 헤파린 사용량 차이에 대하여 알아보려고 하게되었다. 대상 및 방법: 본원에서 1999년 5월 1일부터 동년 12월 31일 사이에 연령이 16세 이상인 환자에서 HCC를 사용했던 16명(Group H)과 사용하지 않았던 19명(Group C)을 대상으로 하였다. 모든 환자에서 수술 전 체중, 신장, 체표면적, 심폐기 사용시간(pumptime), 수술 중 최저체온, 대동맥 차단시간(Aortic cross clamping time. ACC time), ACT, 헤파린 및 프로타민 사용 양 등을 조사하였다. 결과: 연구대상 환자의 연령, 체중, 신장, 체표면적, 대동맥차단 시간, 체온 등은 HCC를 사용한 군(H 군)과 사용하지 않은 군(C군)간에 의미 있는 차이가 없었다(p<0.05). 헤파린 공급 전, 공급 후 20분, 40분, 60분과 프로타민 공급 후 20분에 측정한 ACT는 두 군간에 의미 있는 차이가 없었다. 두 군간의 처음에 공급한 헤파린 양과 총 프로타민 사용량은 차이가 없었으나(p>0.05), 추가 공급한 헤파린 양(11$\pm$30 versus 67$\pm$49mg, p<0.05)과 총 헤파린 사용량(176$\pm$44 versus 239$\pm$70mg, p<0.05)은 H군에서 의미 있게 적게 나왔다. 두 군간에서 심폐기 사용시간에는 차이가 없었으면서 H군에서 약 38%정도의 헤파린을 적게 사용하였다. 결론: 결론적으로 HCC의 사용으로 심폐기 사용 시간과 상관없이 추가하는 헤파린 양을 줄임으로서 총 헤파린 사용량을 줄여 줄 수 있었으며 이것이 HCC의 임상적 효과를 나타나게 하는 하나의 요소로 작용할 수 있다고 생각된다.

• Journal of Chest Surgery
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• v.32 no.2
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• pp.97-107
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• 1999

Background: This study was designed to develop a Korean version of the heparin-coated vascular bypass shunt by using a physical dispersing technique. The safety and effectiveness of the thrombo-resistant shunt were tested in experimental animals. Material and Method: A bypass shunt model was constructed on the descending thoracic aorta of 21 adult mongrel dogs(17.5-25 kg). The animals were divided into groups of no-treatment(CONTROL group; n=3), no-treatment with systemic heparinization(HEPARIN group; n=6), Gott heparin shunt (GOTT group; n=6), or Korean heparin shunt(KIST group; n=6). Parameters observed were complete blood cell counts, coagulation profiles, kidney and liver function(BUN/Cr and AST/ ALT), and surface scanning electron microscope(SSEM) findings. Blood was sampled from the aortic blood distal to the shunt and was compared before the bypass and at 2 hours after the bypass. Result: There were no differences between the groups before the bypass. At bypass 2 hours, platelet level increased in the HEPARIN and GOTT groups(p<0.05), but there were no differences between the groups. Changes in other blood cell counts were insignificant between the groups. Activated clotting time, activated partial thromboplastin time, and thrombin time were prolonged in the HEPARIN group(p<0.05) and differences between the groups were significant(p<0.005). Prothrombin time increased in the GOTT group(p<0.05) without having any differences between the groups. Changes in fibrinogen level were insignificant between the groups. Antithrombin III levels were increased in the HEPARIN and KIST groups(p<0.05), and the inter-group differences were also significant(p<0.05). Protein C level decreased in the HEPARIN group(p<0.05) without having any differences between the groups. BUN levels increased in all groups, especially in the HEPARIN and KIST groups(p<0.05), but there were no differences between the groups. Changes of Cr, AST, and ALT levels were insignificant between the groups. SSEM findings revealed severe aggregation of platelets and other cellular elements in the CONTROL group, and the HEPARIN group showed more adherence of the cellular elements than the GOTT or KIST group. Conclusion: Above results show that the heparin-coated bypass shunts(either GOTT or KIST) can suppress thrombus formation on the surface without inducing bleeding tendencies, while systemic heparinization(HEPARIN) may not be able to block activation of the coagulation system on the surface in contact with foreign materials but increases the bleeding tendencies. We also conclude that the thrombo-resistant effects of the Korean version of heparin shunt(KIST) are similar to those of the commercialized heparin shunt(GOTT).

• Journal of Chest Surgery
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• v.30 no.7
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• pp.677-685
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• 1997

Thromboelastography(TEG) is the unique measure that gives rapid information about the whole clotting process. Simplifying the diagnosis of coagulopathy during operations, TEG can provide an adequate therapy for postoperative bleeding. Remarkable improvement in hemostasis after cardiopulmonary bypass(CPB) has been achieved by the treatment with proteinase inhibitor aprotinin, but the hemostatic mechanism of aprotinin during CPB is still unclear. This study was designed to evaluate the effects of aprotinin on coagulation system during CPB by using TEG. Forty patients who underwent CPB were divided into two groups: aprotinin(2u 106 kallikrein inhibition units, as a single dose into the cardiopulmonary bypass priming solution) treatment group(male 14, female 8, mean age=50.Byears) and no aprotinin treatment(control) group(male 10, female 8, mean age=53.4 years). TEG, activated clotting time, prothrombin time, activated partial thromboplastin time, platelet counts, fibrinogen an (ibrinogen degradation product(FDP) concentrations were checked before and after CPB(30 minutes after neutralization of heparin effect by protamine sulfate). There was no significant difference in other conventional coagulation tests of two groups except postcardiopulmonary bypass FDP concentration in control group, which was significantly increased compared to that in aprotinin group(p<0.05). In TEG variables of both groups, clot formation time(K) and alpha $angle(\alpha^{\circ})$ were significantly increased and decreased, respectively, after CPB(p<0.05), but fibrinolytic index(LYS60) was not changed during CPB. In aprotinin group, reaction time(R) was decreased significantly after CPB(p<0.05) but maximum amplitude(MA) was not changed(p>0.05). On the contrary, R was not changed markedly but MA was decreased significantly in control group after CPB(p<0.05). This result shows that main change in coagulation system during CPB is not hyperfibrinolysis but cecrease in clot strength by platelet dys unction, and the main effect of aprotinin during cardiopulmonary bypass is the maintenance of clot strength to the pre-CPB level by the preservation of platelet function.