• Journal of Chest Surgery
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• 제49권5호
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• pp.401-404
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• 2016

The formation of aortic thrombi is an extremely rare complication of acute pancreatitis. Here we report a case of acute pancreatitis complicated by a paraesophageal pseudocyst, necrotizing mediastinitis, and the formation of multiple thrombi in the ascending aorta. The patient was successfully treated by surgical therapy, which included extensive debridement of the mediastinum and removal of the aortic thrombi under cardiopulmonary bypass. Although esophageal resection was not carried out concomitantly, the lesions were resolved and the patient remained free of complications over 2 years of follow-up care.

• Journal of Ginseng Research
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• 제46권2호
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• pp.175-182
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• 2022

Coronavirus disease 2019 (COVID-19) not only targets the respiratory system but also triggers a cytokine storm and a series of complications, such as gastrointestinal problems, acute kidney injury, and myocardial ischemia. The use of natural products has been utilized to ease the symptoms of COVID-19, and in some cases, to strengthen the immune system against COVID-19. Natural products are readily available and have been regularly consumed for various health benefits. COVID-19 has been reported to be associated with the risk of thromboembolism and deep vein thrombosis. These thrombotic complications often affects mortality and morbidity. Panax ginseng, which has been widely consumed for its various health benefits has also been reported for its therapeutic effects against cardiovascular disease, thrombosis and platelet aggregation. In this review, we propose that P. ginseng can be consumed as a supplementation against the various associated complications of COVID-19, especially against thrombosis. We utilized the network pharmacology approach to validate the potential therapeutic properties of P. ginseng against COVID-19 mediated thrombosis, the coagulation pathway and platelet aggregation. Additionally, we aimed to investigate the roles of P. ginseng against COVID-19 with the involvement of platelet-leukocyte aggregates in relation to immunity-related responses in COVID-19.

• Journal of Chest Surgery
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• 제22권4호
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• pp.677-679
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• 1989

Recently, we have experienced a case of acute thrombotic obstruction of the St. Jude Medical cardiac valve in the mitral position of the Heart. We will discuss about the incidence, recognition and preventive measurement of the thrombotic St. Jude Medical valve with the review of literatures.

• 한국콘텐츠학회논문지
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• 제12권7호
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• pp.273-283
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• 2012

급성심근경색증 환자에서 약물 용출 스텐트(drug-eluting stents, DES)는 일반 금속 스텐트(bare-metal stents, BMS)에 비해 재협착은 감소하지만 구조적인 특성으로 스텐트 혈전증(stent thrombosis, ST)이 증가한다고 알려져 있다. 이에 본 연구에서는 ST의 발생빈도, 임상양상, 그리고 1년간 예후를 알아보고자 하였다. 대학병원 심혈관센터에서 급성심근경색증으로 관상동맥 중재술을 받은 2,667명에서 스텐트 혈전증이 발생한 환자 80명을 대상으로 DES-ST를 I군(n=57), BMS-ST(n=23)를 II군으로 분류하여 양군 간의 특징을 분석하였다. 양군간의 ST는 I군에서 57명(2.7%)과 II군에서 23명(4.3%)로 양군 간에 유의한 차이는 없었다(p>0.064). ST의 유형으로는 acute ST는 I군5(8.8%), II군3(2.3%), subacute ST는 I군 29(50.9%), II군14(60.9%), late ST 는 I군11(19.3%), II군2(8.7%), very late ST는 I군12(21.1%), II군 4(17.4%)로 양군간의 차이는 없었다(p>0.605). DES와 BMS를 삽입 후 1년 예후에 미치는 인자로는 ST(OR 8.166 95% CI 2.825-23.608 p<0.001), 좌심실구혈율(<40) (OR 6.409 95% CI 2.422-16.955 p<0.001), 나이(${\geq}$75세) (OR 4.979 95% CI 1.946-12.744 p=0.001) 이었다. ST의 발생율은 양군 사이에 차이가 없었고, 1년 예후에 미치는 인자로는 ST의 발생, 좌심실 구혈률의 저하 및 환자의 연령 등 이었다.

• Journal of Chest Surgery
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• 제42권6호
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• pp.757-762
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• 2009

배경: May-Thurner 증후군은 좌측장골정맥이 우측장골동맥에 의해 눌리어 정맥 환류장해에 의해 혈전증을 일으키는 것을 말한다. 저자들은 심부 정맥혈전중의 치료를 위해 시행한 혈전 제거-용해술 및 스탠트 삽입술의 결과를 분석하고자 한다. 대상 및 방법: May-Thurner 증후군과 동반된 하지 심부정맥혈전증으로 진단받고 좌측 장골정맥에 스탠트를 삽입한 34명(평균연령 $64.6{\pm}13.7$세, 여자 25(74%)명)을 대상으로 하였다. 시술은 흡인성 혈전제거와 혈전용해 후 분지성 협착이 있는 곳에 Wall stent를 삽입하고 풍선 확장을 하였다. Multi side hole 카테타를 혈전이 있는 부위에 위치시키고 Urokinase를 시간당 8만에서 12만 International Unit을 1일 또는 2일 동안 주입하였다. 시술 중 폐동맥혈전색전증을 방지 하기 위하여 대부분 환자에서 시술 전 일시적 하대정맥 여과기(IVC Filter)를 삽입하였다. 퇴원 후 3개월간 경구용 와파린을 투여 하였으며 퇴원 전과 퇴원 후 6개월에 Multi Detector Computerized Tomography (MDCT) 혈관촬영을 이용하여 혈전의 유무를 판단하였다. 결과: 시술 48시간 이내 부종과 동통이 완전하게 소실된 환자가 2 (6%)명이었으며 증상의 완화가 있는 환자가 28 (82%)명, 증상의 호전이 없는 환자가 4 (12%)명이었다. 퇴원 시 MDCT혈관촬영에서 9 (26%)명에서 혈전없음, 21 (62%)명에서 부분 혈전, 그리고 4명(12%)에서 폐쇄소견을 보였다. 퇴원 6개월 후에 2명을 제외한 32명이 추적 MDCT혈관촬영을 하였는데 23 (72%)명에서 혈전없음을 9 (26%)명에서는 부분혈전이 관찰 되었다. 평균 5.6개월 관찰기간 동안 2 (6%)명에서 심부정맥혈전이 재발되어 재입원하였으며 하지 부종과 통증을 동반한 혈전 후 증후군은 9예(26%)에서 발생하였다. 결론: May-Thurner 증후군과 동반된 하지 심부정맥혈전환자에서 심부정맥혈전의 제거와 혈전용해술과 함께 시술된 스탠트 삽입은 효과적인 치료 방법으로 생각된다.

• 대한신경집중치료학회지
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• 제11권2호
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• pp.102-109
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• 2018

Background: A sians were known to have a relatively lower incidence of venous thromboembolism (VTE), and there is insufficient evidence to suggest a specific D-dimer threshold level for screening VTE in patients with acute stroke. Methods: We prospectively enrolled patients with acute ischemic stroke admitted to Jeju National University Hospital. The inclusion criteria were: 1) aged ${\geq}18$ years, 2) admission within seven days of symptom onset, and 3) an initial National Institute of Health Stroke Scale (NIHSS) score >1 for the affected lower limb. Ultrasound scans of the lower limbs and plasma D-dimer assays were performed on days 7-14 and 15-28 after stroke onset. Results: Of 285 patients admitted during the study period, 52 patients met inclusion criteria (mean age 74.5, male 40.4%, median initial NIHSS score 12, and unable to walk unassisted at discharge 76.9%). During 7-14 days, 23 of 52 patients (44.2%) had a D-dimer level above 1.57 mg/L, and 9.6% had a level above 5.50 mg/L. Proximal deep vein thrombosis (DVT) was detected in 3 patients (5.8%, 95% confidence Interval 1.2-16.0%) on ultrasound examination. All DVTs were found in elderly female patients with severe leg weakness. No patient was diagnosed with pulmonary embolism during the study period. Conclusion: The incidence of VTE seems to be very low among Korean patients with acute ischemic stroke. Advanced age, female sex, and severe leg weakness were important risk factors for developing DVT in this study.

• Journal of Korean Neurosurgical Society
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• 제66권6호
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• pp.735-742
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• 2023

Nephrotic syndrome (NS) is associated with cerebral venous sinus thrombosis (CVST), which is a rare cerebrovascular disorder in children. Systemic anticoagulation with heparin is the standard therapy for CVST, and mechanical thrombectomy (MT) has been described as a salvage treatment for adult anticoagulant refractory CVST, However, it has never been reported in children. We describe a case of MT for refractory CVST in a child with NS. A 13-year-old boy with newly diagnosed NS presented to an emergency department with acute headache. A head computed tomography showed acute thrombus in the superior sagittal sinus, straight sinus and transverse sinus. The child was started on heparin therapy, but clinically deteriorated and became unresponsive. In view of the rapid deterioration of the condition after anticoagulation treatment, the patient received intravascular treatment. Several endovascular technologies, such as stent retriever and large bore suction catheter have been adopted. After endovascular treatment, the patient's neurological condition was improved within 24 hours, and magnetic resonance venography of the head demonstrated that the CVST was reduced. The child recovered with normal neurological function at discharge. This case highlights the importance of considering MT for refractory CVST, and we suggest that MT may be considered for refractory CVST with NS in children.

• 대한한방내과학회지
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• 제30권2호
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• pp.438-449
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• 2009

Objectives: Deep vein thrombosis (DVT) is a common complication among stroke patients. The implication of DVT progressing into a fatal pulmonary embolism is one of the main reasons treatment cannot be delayed. However, when there is a contradiction for anticoagulants, such intracranial hemorrhage (ICH), it is difficult to determine the course of treatment. Our team reports a case with both acute DVT and ICH who improved with herbal medicine Hyulbuchuko-tang. Methods : A patient with a variety of thrombosis risk factors (atrial fibrillation, DVT, Cb-inf with intracranial hemorrhage due to thrombolytic complications) showed classic symptoms of DVT (pain, edema, discoloration), disorientation and chest discomfort. The patient was administered Hyulbuchuko-tang three times a day for 24 days without any anticoagulants. Conservative therapy including elastic stocking and leg elevation was co-administered. Laboratory tests and extremity vascular Doppler sonography were carried out 3 times during the treatment period. Results : After our treatment period, both popliteal vein DVT and calf vein DVT were not discovered by sonography, and thrombosis derived factors (eg. D-dimer, fibrinogen) decreased. There was no sign of edema or discoloration after treatment, and the patient no longer complained of leg pain, disorientation or chest discomfort. Conclusion : From these results, we suggest that there is a positive effect of Hyulbuchuko-tang on DVT. Hyulbuchuko-tang should be considered as a treatment option when western medical procedures are unavailable.

• 동의생리병리학회지
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• 제16권2호
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• pp.245-256
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• 2002

This studt was investigated to prove the effect of SPBST on the hypertension, the thrombosis and the brain damage. The results were as follows; 1. SPBST affected the htpertension as adepressant, but insignificant. 2. SPBST decreased significantly dopamine, aldosterone but ineffective on the epinephrine, norepinephrine and renin activity. 3. SPBST increased the NO product but insignificant. 4. SPBST had a death suppression effect by 50% in pulmonary thrombosis inducement experiment and activated slightly on the fibrinolytic activity. 5. SPBST suppressed significantly platelet diminution and prolonged insignificantly PT and APTT. 6. On the measure of the blood flow rate induced by the thrombus, in vivo SPBST accelerated the blood flow rate, in vitro insignificant. 7. SPBST had no toxicity on the PC12 cell and B103 cell induced by amyloid β protein (-35) and a protective effect, in proportion to the density. 8. SPBST decreased significantly coma duration time in a Infatal dose of KCN and showed 50% of survival rate in a fatal dose. 9. SPBST decreased significantly ischemic area and edema incited by the MCA blood flow block. These results indicate that SPBST can be used in hypertension, the thrombosis, the brain damage, the ischemic cerebral infarction and the acute stage of the brain damage. Further study will be needed about the functional mechanism and etc.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제17권4호
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• pp.447-455
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• 1995

Cavernous sinus thrombosis is one of the major complications of abscesses of the maxillofacial region. The initial symptoms of CST are usually pain in the eye and tenderness to pressure. this is associated with high fluctuating fever, chills, rapid pulse, and sweating. Venous obstruction subsequently causes edema of the eyelids, lacrimation, proptosis, chemosis and retinal hemorrhages. Blindness is sometimes an accompaniment of cavernous sinus thrombosis when the infection also involves the orbit. There is also cranial nerve involvement (oculomotor, troclear, abducence) and ophthalmoplegia, diminished or absent corneal reflex, ptosis, and dilation of the pupil occur. The terminal stages bring signs of advanced toxemia and meningitis. Infections of the face can cause a septic thrombosis of the cavernous sinus. Furunculosis and infected hair follicles in the nose are frequent causes. Extractions of maxillary anterior teeth in the presence of acute infection and especially curettage of the sockets under such circumstances can cause this condition. The infection is usually staphylococcal. The inflection may spread directly through the pterygoid plexus of veins and the pterygomaxillary space and then ascend into the sinus or it may spread directly from the pterygopalatine space to the orbit. This is possible because of the absence of valves in the angular, facial, and ophthalmic veins. The treatment is empirical antibiotic therapy followed by specific anbibiotic therapy based on blood or pus culture. The inflection usually involves one side, however, it may easily spread to the opposite side through the circulus sinus. Unless it is treated early, the prognosis is poor even in this doses. Occasionally the antibiotics will not adequately resolve the septic thrombus, and death ensues. the use of anticoagulants to prevent venous thrombosis has been recommended, but the efficacy of such therapy has not been substantiated. Surgical access through eye enucleation has been suggested. We report a case which demonstrates cavernous sinus thrombosis by the infection after the functional neck dissection and the intraoral reconstruction with auriculomastoid fascio-cutaneous island flap.