• 제목/요약/키워드: Anticoagulation

검색결과 273건 처리시간 0.024초

Giant Arachnoid Granulation Misdiagnosed as Transverse Sinus Thrombosis

  • Choi, Hyuk-Jin;Cho, Chang-Won;Kim, Yoon-Suk;Cha, Jae-Hun
    • Journal of Korean Neurosurgical Society
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    • 제43권1호
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    • pp.48-50
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    • 2008
  • We experienced a case of giant arachnoid granulation misdiagnosed as dural sinus thrombosis. A 66-year-old woman presented with a one month history of progressive occipital headache. Computed tomography angiography and cerebral angiography showed a round filling defect at the transverse sinus which was speculated as a transverse sinus thrombosis. Anticoagulation therapy was performed to prevent worsening of thrombosis for 2 weeks and then a Gadolinium-enhanced magnetic resonance imaging scan was performed. The filling defect lesion at the transverse sinus revealed a non-enhancing granule with central linear enhancement, which was compatible with giant arachnoid granulation. We checked the intrasinus pressure difference across the lesion the through the dural sinus in order to exclude the lesion as the cause of headache. Normal venous pressure with no significant differential pressure across the lesion was noted. Headache was treated with medical therapy.

플라즈마 중합 처리된 중공사 막의 혈액 적합성 (Blood Compatibility of Hollow Fiber Membranes Treated with Plasma Polymerization)

  • 권오성;이삼철
    • 한국재료학회지
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    • 제15권8호
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    • pp.521-527
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    • 2005
  • Surface modification of polypropylene hollow fiber membranes was peformed in order to develop blood-compatible biomaterials for use in the blood contacting and oxygenation membranes of a lung-assist device(LAD). Blood compatibility was determined by using anticoagulation blood and evaluating formation of blood clots on their surfaces as well as activation of plasma coagulation cascade, platelet adhesion, and aggregation. It was verified that the number of platelets on the silicone coated fibers was significantly lower than those on polypropylene. It was also found that the polypropylene hollow fiber membranes using plasma treatment exhibited suppression of complement activation in blood compatibility test.

A long duration of anticoagulant activity of acharan sulfate in vivo

  • Li, Da-Wei;Lee, In-Sun;Toshihiko Toida;Kim, Yeong-Shik
    • 대한약학회:학술대회논문집
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    • 대한약학회 2003년도 Proceedings of the Convention of the Pharmaceutical Society of Korea Vol.2-2
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    • pp.98.2-99
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    • 2003
  • Introduction: We previously reported that a new glycosaminoglycan, acharan sulfate (AS) from the African giant snail Achatina fulica showed anticoagulation activity in vitro, but it was much less than that of heparin. In the present study, the anticoagulant activity of AS was investigated in vivo. Methods: AS and heparin were administered to rats in various concentrations and anticoagulant activities were measured. Both were also compared in thrombin-induced Results: Intravenous administration of acharan sulfate prolonged the coltting time (APTT) in mice and rats in a dose-dependent manner. (omitted)

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Successful treatment of fungal central thrombophlebitis by surgical thrombectomy in Korea: a case report

  • Eun Ji Lee;Jihoon T. Kim
    • Journal of Trauma and Injury
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    • 제36권3호
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    • pp.276-280
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    • 2023
  • Fungal thrombophlebitis of the central vein is a rare, life-threatening disease associated with significant morbidity and mortality. It requires immediate central venous catheter removal and intravenous antifungal therapy, combined in some cases with either anticoagulation or aggressive surgical debridement. A 70-year-old male patient injured by a falling object weighing 1,000 kg was transferred to our hospital. A contained rupture of the abdominal aorta with retroperitoneal hematoma was treated with primary aortic repair, and a small bowel perforation with mesenteric laceration was treated with resection and anastomosis. After a computed tomography scan, the patient was diagnosed with thrombophlebitis of the left internal jugular vein and brachiocephalic vein. Despite antifungal treatment, fever and candidemia persisted. Therefore, emergency debridement and thrombectomy were performed. After the operation, the patient was treated with an oral antifungal agent and direct oral anticoagulants. During a 1-year follow-up, no signs of candidemia relapse were observed. There is no optimal timing of surgical treatment for relapsed fungal central thrombophlebitis. Surgical treatment should be considered for early recovery.

Treatment of Internal Carotid Artery Dissections with Endovascular Stent Placement: Report of Two Cases

  • Deok Hee Lee;Seung Ho Hur;Hyeon Gak Kim;Seung Mun Jung;Dae Sik Ryu;Man Soo Park
    • Korean Journal of Radiology
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    • 제2권1호
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    • pp.52-56
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    • 2001
  • Extracranial carotid artery dissection may manifest as arterial stenosis or occlusion, or as dissecting aneurysm formation. Anticoagulation and/or antiplatelet therapy is the first-line treatment, but because it is effective and less invasive than other procedures, endovascular treatment of carotid artery dissection has recently attracted interest. We encountered two consecutive cases of trauma-related extracranial internal carotid artery dissection, one in the suprabulbar portion and one in the subpetrosal portion. We managed the patient with suprabulbar dissection using a self-expandable metallic stent and managed the patient with subpetrosal dissection using a balloon-expandable metallic stent. In both patients the dissecting aneurysm disappeared, and at follow-up improved luminal patency was observed.

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Optimal Rhythm Control Strategy in Patients With Atrial Fibrillation

  • Daehoon Kim;Pil-Sung Yang;Boyoung Joung
    • Korean Circulation Journal
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    • 제52권7호
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    • pp.496-512
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    • 2022
  • For almost 20 years, data regarding the effect of rhythm control therapy for atrial fibrillation (AF) on cardiovascular prognosis in comparison with rate control therapy has not been conclusive. The safety of rhythm control and anticoagulation therapy has generally improved. Recently, it was revealed that a rhythm-control strategy reduced the risk of adverse cardiovascular events than usual rate control in patients with recent AF (diagnosed within 1 year). Within 1 year after the AF diagnosis, early initiation of rhythm control led to more favorable cardiovascular outcomes than rate control. Early rhythm control reduced the risks of stroke and heart failure-related admission than rate control. Moreover, rhythm control was associated with lower dementia risk than rate control. Finally, early rhythm control treatment was also effective in patients with asymptomatic AF but less effective in older adults. Therefore, in patients with AF, rhythm control should be considered at earlier stages, regardless of symptom.

와파린-리팜핀 병용 시 용량 조절 (Dosage Adjustment before and after Warfarin - Rifampin Combination Therapy)

  • 김동현;김경환;최경희;이광자;이혜숙;손인자;김기봉;이재웅;안혁
    • Journal of Chest Surgery
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    • 제41권3호
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    • pp.354-359
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    • 2008
  • 배경: 와파린은 항응고제로 쓰이는 약물로서 주로 간 대사에 의해 배설되는 약물이다. 리팜핀은 결핵 혹은 심내막염 등에 쓰이는 항생제로 2C9과 3A4를 포함한 CYP계열 효소 유도를 일으키는 대표적인 약물이다. 따라서 두 약물을 병용할 경우 리팜핀의 효소 유도에 의한 와파린 대사율 증가로 와파린의 항응고 효과는 감소한다. 이에 따라 와파린의 적절한 용량 조절이 요구되나 정확한 증량과 감량 정도는 제시되지 못하고 있는 실정이다. 이에 본 연구에서는 와파린 복용 환자 중 리팜핀을 병용하게 된 환자를 대상으로 두 약물의 병용 전후, 상호작용의 정도를 시간 경과에 따라 평가하고, 상호작용에 영향을 미치는 요인을 분석하고 또한 이를 토대로 두 약물의 병용 전후, 임상에서 활용할 수 있는 와파린 용량 결정 방법을 설정하고자 하였다. 대상 및 방법: OO병원 항응고 치료 상담 팀의 상담기록지를 1998년 1월부터 2006년 9월까지 후향적으로 검토하여 리팜핀을 병용하게 된 환자를 대상으로 하였다(n=15). 결과: 리팜핀 병용 전 전체 환자의 평균 INR은 $2.25{\pm}0.52$이며 병용 초기 100일간의 평균 INR은 $1.98{\pm}0.28$이었다. 이 경우 병용 전과 병용 초기의 평균 INR은 유의한 차이가 없었다(paired t-test, p>0.05). 리팜핀 병용 중단 직전 2회 측정한 INR의 평균은 $2.19{\pm}0.34$이고 병용 중단 이후 INR의 평균은 $2.49{\pm}0.43$으로 병용 중단 전과 후의 INR 평균은 유의한 차이를 보였으나(paired t-test, p<0.05)모두 치료유효역 범위 내에 있었다. 결론: 항응고 치료 상담 팀의 용량 조절이 적절하다고 판단하여 항응고 치료 상담 팀의 조절을 근거로 병용 시작 시와 병용 중단시의 와파린 용량조절 수식을 도출해냈다

기계 판막을 이용한 라스텔리 수술의 장기 성적 (Long Term Results of Rastelli Operation with a Mechanical Valve)

  • 최세훈;김관창;곽재건;김창영;이정렬;김용진;노준량;김웅한
    • Journal of Chest Surgery
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    • 제39권12호
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    • pp.900-905
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    • 2006
  • 배경: 선천성 심장병에서 라스텔리 수술은 일반적으로 동종 혹은 이종의 조직판막을 이용하게 되며 이 경우 장기적으로 재수술이 요구된다. 반면 기계판막을 이용하여 라스텔리 수술은 보고가 많지 않으며 이번 연구는 이들 환자에서의 장기 성적을 알아보고자 하였다. 대상 및 방법: 1990년 1월부터 1992년 7월까지 기계판막을 이용한 라스텔리 수술을 받은 20명의 환자 중 조기 사망 1명을 제외한 19명의 환자를 대상으로 하였다. 기저질환으로는 교정된 대혈관전위증 4예, 대혈관전위증 2예, 심실중격결손을 동반한 폐동맥폐쇄증 9예, 총동맥간 2예, 양대혈관우심실기시증에 동반된 폐동맥협착증 2예였다. 수술 당시의 평균 연령은 $4.6{\pm}3.4$년이며, 남녀비는 1.11:1이었다. 사용한 판막으로는 Carbomedics 16예, Bjork-Shiley 3예였으며 평균 크기는 $17{\pm}2mm$였다. 평균 추적관찰 기간은 $12.8{\pm}2.7$년이었다. 결과: 19명 중 15명은 판막 도관에 대한 재수술을 받았으며, 재수술까지의 평균 기간은 $5.3{\pm}4.7$년이었다. 재수술 시에는 전부 조직판막을 사용하였다. 5 yr freedom from reoperation은 53%, 10 yr freedom from reoperation은 37%였다. 항응고 치료는 와파린과 아스피린, 다이피리다몰을 사용하였으며 PT INR수준은 1.5에서 2.0으로 유지하였고, 심각한 수준의 출혈성 부작용이나 색전에 의한 부작용은 발생하지 않았다. 술 후 3년을 기준으로 이전과 이후의 판막도관의 실패원인에서 차이를 보였다. 3년 이전에 재수술을 받은 환자군(총 6예)을 분석하였을 때, 전부에서 판막 자체의 움직임에 제한이 있었으며, 그 중 3예에서는 혈전에 의한 움직임 장애, 3예에서는 pannus 또는 fibromyxoid plaque에 의한 움직임 장애였다. 반면, 3년 이후에 재수술을 시행받은 9예에서는 1예를 제외하고 전부에서 도관 협착이 있었으며 판막 움직임은 정상이었다. 결론: 기계판막을 이용하여 라스텔리 수술의 경우 장기 성적을 좋게 하기 위해서 초기에는 엄격한 항응고 치료가 요구되며 장기적으로는 도관재질의 개선을 요구된다. 일부 환자에서는 10년 이상 특별한 문제없이 사용이 가능하였다.

함초 씨의 항균, 항산화 및 항혈전 활성 (Antimicrobial, Antioxidant, and Anticoagulation Activities of Salicornia europaea seeds)

  • 김미선;김득회;손호용
    • 한국미생물·생명공학회지
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    • 제44권4호
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    • pp.452-460
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    • 2016
  • 함초를 이용한 고부가가치 식의약 소재 개발 연구의 일환으로, 성숙 함초로부터 씨를 회수하고 이의 성분분석 및 유용 생리활성을 평가하였다. 함초 씨의 열수 추출효율은 29.6% 이었으며, 추출물의 total polyphenol (TP) 및 total flavonoid (TF) 함량은 각각 25.7 및 11.5 mg/g을 나타내어 성숙기 함초와 유사한 함량을 보였다. Hexane, ethylacetate (EA), butanol을 이용한 순차적 유기용매 분획물 중 EA 분획이 158.3 및 136.2 mg/g의 가장 높은 TP 및 TF 함량을 보였으며, 특이하게 물 잔류물 및 butanol 분획물보다 높은 총당 함량(228.3 mg/g)을 나타내었다. 함초 씨 시료의 항균 활성 평가 결과, EA 분획에서 그람양성 세균에 대한 광범위한 항세균 활성이 나타났으며, butanol 분획에서도 Staphylococcus epidermidis에 대한 강력한 항균활성을 확인하였다. 한편, 함초 씨 열수 추출물은 우수한 radical 소거능과 환원력을 나타내었으며, 가장 강력한 항산화 활성은 EA 분획에서 나타났다. EA 분획의 DPPH 음이온 소거능, ABTS 양이온 소거능 및 Nitrite 소거능에 대한 $RC_{50}$은 각각 57.0, 29.0 및 $28.9{\mu}g/ml$로 확인되어, vitamin C의 10.7, 4.0 및 $18.0{\mu}g/ml$보다 약하지만 우수한 항산화능을 확인하였다. 항혈전 활성 평가결과, EA 분획은 5 mg/ml 농도에서 thrombin time을 무첨가구에 비해 15배 이상, 7 mg/ml 농도에서 activated partial thromboplastin time을 15배 이상 연장시켜 아스피린에 필적하는 강력한 항응고 활성을 나타내었다. 반면 함초씨 추출물과 분획물(0.25 mg/ml)은 모두 혈소판 응집저해 활성은 나타나지 않았으며, 1 mg/ml 농도까지 인간 적혈구 용혈활성도 나타나지 않았다. 상기의 연구결과는 함초 씨 추출물의 EA 분획의 활성물질을 정제하여 항세균 및 항혈전제 개발이 가능함을 제시하고 있다.

기초간호자연과학의 인체구조와 기능 내용별 필요도에 대한 연구 (A Study on the Degree of Need of Human Structure and Function Knowledge in Clinical Nurses)

  • 최명애;변영순;서영숙;황애란;김희승;홍해숙;박미정;최스미;이경숙;서화숙;신기수
    • Journal of Korean Biological Nursing Science
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    • 제1권1호
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    • pp.1-24
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    • 1999
  • The purpose of this study was to define the content of requisite human structure and function knowledge needed for clinical knowledge of nursing practice. Subjects of human structure and function were divided into 10 units, and each unit was further divided into 21 subunits, resulting in a total of 90 items. Contents of knowledge of human structure and function were constructed from syllabus of basic nursing subjects in 4 college of nursing, and textbooks published by nurse scholars prepared with basic nursing sciences. The degree of need of 90 items was measured with a 4 point scale. The subjects of this study were college graduated 136 nurses from seven university hospitals in Seoul and three university hospitals located in Chonnam Province, Kyungbook Province, and Inchon. They have been working at internal medicine ward, surgical ward, intensive care unit, obstetrics and gynecology ward, pediatrics ward, opthalmology ward, ear, nose, and throat ward, emergency room, rehabilitation ward, cancer ward, hospice ward, and their working period was mostly under 5 years. The results were as follows: 1. The highest scored items of human structure and function knowledge necessary for nursing practice were electrolyte balance, blood clotting mechanism and anticoagulation mechanism, hematopoietic function, body fluid balance, function of plasma, and anatomical terminology in the order of importance. The lowest scored items of human structure and function knowledge necessary for nursing practice was sexual factors of genetic mutation. 2. The highest order of need according to unit was membrane transport in the living unit, anatomical terminology in movement and exercise unit, mechanism of hormone function in regulation and integration unit, component and function of blood in oxygenation function unit, structure and function of digestive system in digestive and energy metabolism unit, temperature regulation in temperature regulation unit electrolyte balance in body fluid and electrolyte unit, concept of immunity in body resistance unit, and genetics terminology in genetics unit. The highest order of importance according to subunit was membrane transportation in cell subunit, classification of tissues in tissue unit, function of skin and skin in skin subunit, anatomical derivatives of the skeleton subunit, classification of joints in joint subunit, an effect of exercise on muscles in muscle subunit, function of brain in nervous system subunit, special sense in sensory subunit mechanism of hormone function in endocrine subunit, structure and function of female reproductive system in reproductive system unit, structure and function of blood in blood unit, structure of heart, electrical and mechanical function in cardiovascular system unit, structure of respiratory system in respiratory system subunit, structure and function of digestive system in digestive system subunit, hormonal regulation of metabolism in nutrition and metabolism subunit, function of kidney in urologic system subunit, electolyte balance in body fluid, electolyte and acid-base balance subunit. 3. The common content of human structure and function knowledge need for all clinical areas in nursing was structure and function of blood, hematopoietic function, function of plasm, coagulation mechanism and anticoagulation mechanism, body fluid, electrolyte balance, and acid-base balance. However, the degree of need of each human structure and function knowledge was different depending on clinical areas. 4. Significant differences in human structure and function knowledge necessary for nursing practice such as skin and derivatives of the skin, growth and development of bone, classification of joint, classification of muscle, structure of muscle, function of muscle, function of spinal cord, peripheral nerve, structure and function of pancrease, component and function of blood, function of plasma, structure and function of blood, hemodynamics, respiratory dynamics, gas transport, regulation of respiration, chemical digestion of foods, absorption of foods, characteristics of nutrients, metabolism and hormonal regulation, body energy balance were demonstrated according to the duration of work. 5. Significant differences in human structure and function knowledge necessary for nursing practice such as classification of tissue, classification of muscles, function of muscles, muscle metabolism, classification of skeletal muscles, classification of nervous system, neurotransmitters, mechanism of hormone function, pituitary and pituitary hormone, structure and function of male reproductive organ, structure and function of female reproductive organ, component and function of blood, function of plasma, coagulation mechanism and anticoagulation mechanism, gas exchange, gas transport, regulation of respiration, characteristics of nutrients, energy balance, function of kidney, concept of immunity, classification and function of immunity were shown according to the work area. Based on these findings, all the 90 items constructed by Korean Academic Society of Basic Nursing Science should be included as contents of human structure and function knowledge.

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