• Journal of Korean Neurosurgical Society
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• v.62 no.1
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• pp.27-34
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• 2019

Objective : Stent-assisted coil embolization of intracranial wide-necked aneurysm requires long-term postoperative antiplatelet therapy to prevent in-stent thrombosis. This study aimed to demonstrate results of temporary stent placement for coiling wide necked small intracranial aneurysms, which eliminated need for antiplatelet agents, and to discuss its feasibility and safety. Methods : Data of 156 patients who underwent stent-assisted coil embolization between 2011 and 2014 were retrospectively analyzed. Thirteen cases of temporary stent-assisted coil embolization were included, and their clinical and radiological results were evaluated. Results : The aneurysms treated were all unruptured except one case. All of them had wide neck with mean dome-to-neck ratio of 0.96 and were small-sized aneurysms with mean maximal diameter of 4.2 mm. There was no technical failure in retrieval of stent after completion of embolization of the target aneurysm. Immediate angiography revealed 11 complete and two partial embolization (one residual neck and one residual aneurysm). Two cases encountered thrombosis complication, and they were managed without neurological sequelae. The mean follow-up period was 43 months, angiographic follow-up revealed two cases with minor recurrence, and clinical outcome was good with modified Rankin scale score of 0. Conclusion : Temporary stent-assisted coil embolization of small wide-necked intracranial aneurysm using fully retrievable stent appears safe and effective. Further application and evaluation of this technique in more cases with larger size aneurysm is warranted.

• Biomolecules & Therapeutics
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• v.30 no.3
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• pp.284-290
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• 2022

Oral squamous cell carcinoma (OSCC) is mostly diagnosed at an advanced stage, with local and/or distal metastasis. Thus, locoregional and/or local control of the primary tumor is crucial for a better prognosis in patients with OSCC. Platelets have long been considered major players in cancer metastasis. Traditional antiplatelet agents, such as aspirin, are thought to be potential chemotherapeutics, but they need to be used with caution because of the increased bleeding risk. Podoplanin (PDPN)-expressing cancer cells can activate platelets and promote OSCC metastasis. However, the reciprocal effect of platelets on PDPN expression in OSCC has not been investigated. In this study, we found that direct contact with platelets upregulated PDPN and integrin β1 at the protein level and promoted invasiveness of human OSCC Ca9.22 cells that express low levels of PDPN. In another human OSCC HSC3 cell line that express PDPN at an abundant level, silencing of the PDPN gene reduced cell invasiveness. Analysis of the public database further supported the co-expression of PDPN and integrin β1 and their increased expression in metastatic tissues compared to normal and tumor tissues of the oral cavity. Taken together, these data suggest that PDPN is a potential target to regulate platelet-tumor interaction and metastasis for OSCC treatment, which can overcome the limitations of traditional antiplatelet drugs.

• The Journal of the Convergence on Culture Technology
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• v.6 no.2
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• pp.567-572
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• 2020

The purpose of this study was to investigate the effects of Anti-Thrombotic Activities and Cardiovascular Improvement of Fermented Garlic Extracts. The incidence of cardiovascular diseases (CVDs) is increasing rapidly in developed countries, with CVDs now representing the leading cause of morbidity and mortality. Natural products and ethnomedicines have been shown to reduce the risk of CVDs. Garlic is a medicinal plant used throughout the world for its anti-inflammatory, antioxidant, and antiplatelet activities. We hypothesized that fermented preparations of these products may possess stronger antiplatelet effects than the non-fermented forms owing to the increased bioavailability of the bioactive compounds produced during fermentation. Therefore, we compared these compounds via in vitro and ex vivo platelet aggregation assays by using standard light transmission aggregometry and ex vivo granule secretions from rat platelets. We found that fermented preparations exerted more potent and significant inhibition of platelet aggregation both in vitro and ex vivo. Likewise, ATP release from dense granules of platelets was also significantly inhibited in fermented preparation-treated rat platelets compared to that in non-fermented preparation-treated ones. We concluded that fermented preparations exerted more potent effects on platelet function both in vitro and ex vivo, possibly as a result of the increased bioavailability of active compounds produced during fermentation. We therefore suggest that fermented products may be potent therapeutics against platelet-related CVDs and can be used as antiplatelet and antithrombotic agents.

• Journal of Life Science
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• v.21 no.10
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• pp.1422-1427
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• 2011

This study was performed to develop effective antithrombotic agents from traditional herb extracts. Prunella vulgaris L. has been used traditionally as a medical resource in cancer therapy, as well as treatment of hypertension and inflammation, and as a diuretic. However, the effects of Prunella vulgaris on thrombosis and platelet activation have not been clearly understood. Antithrombotic and antiplatelet activities of oriental medicinal herbs were investigated by evaluating the effect of the aqueous extract from Prunella vulgaris on the blood coagulation, platelet aggregation and fibrinolysis. Prunella vulgaris extracts showed effective anticoagulant activity in coagulation times such as activated partial thromboplastin time (APTT) and prothrombin time (PT). Prunella vulgaris also inhibited adenosine diphosphate (ADP)- and collagen-induced platelet aggregation. In addition, evaluation of fibrinolytic activity showed that the Prunella vulgaris extracts have high solubility. From these results, it is suggested that Prunella vulgaris can be a potential candidate for anticoagulants and antiplatelets, as well as fibrinolytic agents.

• Journal of Nutrition and Health
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• v.36 no.2
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• pp.101-108
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• 2003

Antiplatelet aggregation, anticoagulant and lipid-lowering drugs are clinically widely used for secondary preventive purpose in the cardiovascular patients, but there is no primary preventive agents to prevent these diseases. With the aim of developing effective primary agents for cardiovascular diseases, we tried to formulate an optimized mixture of natural plants extract containing Theae sinensis, Camelliae sinensis, Vitis vinifera, Gingko folium and curcuminoids from Curcuma longa and to evaluate its anti-thrombotic and anti-hypercholesterolemic effects in vivo. The inhibitory effect of curcuminoids on vascular smooth muscle cell proliferation and migration were also investigated in vitro. in the animal experiments treated with hyperlipidemic diet, oral treatment of curcuminoids and natural plants extracts mixture (100 mg/kg) into male Sprague Dawley rats for 7 week simultaneously inhibited platelet aggregation as well as improved lipid profile in the blood. Compared to control group, both of curcuminoids-treated and mixture-treated groups revealed significantly decrease of total cholesterol (24.4%, 28.6%), free cholesterol (25.1%, 24.0%), cholesterol ester (14.6%, 29.0%), LDL-cholesterol (27.0%, 32.0%) and triglyceride (15.0%, 31.0%), respectively. However, both groups showed increase of HDL-cholesterol (46.6% and 51.5%) . In particular, atherogenic index of curcuminoids and mixture treatment group was significantly decreased to 47.0% and 56.0%, respectively. Furthermore, oral treatment of curcuminoids and mixture significantly inhibited collagen-induced platelet aggregation (21.1% and 29.1%, respectively), compared to control group. The anti-thrombotic values of mixture was almost similar to that of aspirin treatment (100 mg/kg) group. These results suggest that the oral treatment of curcuminoids-based natural plant extract mixture improved cardiovascular conditions in hyperlipidemic rats.

• BMB Reports
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• v.31 no.5
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• pp.515-518
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• 1998

Adhesive interaction of the platelet glycoprotien IIb-IIIa (GP IIb-IIIa) with a plasma protein, such as fibrinogen, plays an important role in thrombosis and hemostasis. The specific sequence Arg-Gly-Asp (RGD) is critical for the binding of fibrinogen to platelet. To examine and characterize the GP IIb-IIIa antagonist from natural sources, we have developed a simple enzyme-linked immunosorbant assay (ELISA) system. The GP IIb-IIIa complex was purified to homogeneity from platelet Iysates by the combination of two affinity chromatographic methods using the synthetic RGD peptide (GRGDSPK)-immobilized Sepharose and wheat germ lectin-Sepharose. The synthetic peptide GRGDSP inhibits GP IIb-IIIa binding to immobilized fibrinogen with an $IC_{50}$ of $1.5\;{\mu}M$. Venoms of three different snake species and a Korean scolopendra extract have strong antagonistic activities for the binding of human fibrinogen to the platelet GP IIb-IIIa complex. The $IC_{50}$ values of the snake venom s and scolopendra were in the range of $5.5\;{\mu}g$ to $60\;{\mu}g$. These results provide meaningful information for developing antiplatelet agents.

• BMB Reports
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• v.46 no.10
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• pp.484-489
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• 2013

Piperlonguminine (PL), an important component of Piper longum fruits, is known to exhibit anti-hyperlipidemic, antiplatelet and anti-melanogenic activities. Here, the anticoagulant activities of PL were examined by monitoring activated-partial-thromboplastin-time (aPTT), prothrombin-time (PT), and the activities of thrombin and activated factor X (FXa). The effects of PL on the expressions of plasminogen activator inhibitor type 1 (PAI-1) and tissue-type plasminogen activator (t-PA) were also tested in tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$) activated HUVECs. The results showed that PL prolonged aPTT and PT significantly and inhibited the activities of thrombin and FXa. PL inhibited the generation of thrombin and FXa in HUVECs. In accordance with these anticoagulant activities, PL prolonged in vivo bleeding time and inhibited TNF-${\alpha}$ induced PAI-1 production. Furthermore, PAI-1/t-PA ratio was significantly decreased by PL. Collectively, our results suggest that PL possesses antithrombotic activities and that the current study could provide bases for the development of new anticoagulant agents.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.39 no.6
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• pp.289-291
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• 2013

Moyamoya disease is a rare neurovascular disorder that involves constriction of certain arteries in the brain. In patients with moyamoya disease, it is very important to prevent cerebral ischemic attacks and intracerebral bleeding caused by fluctuating blood pressure and increased respiration. A 40-year-old woman with moyamoya disease was scheduled for extraction of her right upper and lower impacted wisdom teeth. Her lower impacted wisdom tooth was situated close to the inferior alveolar nerve. We decided to continue her oral antiplatelet therapy and planned intravenous sedation with analgesic agents administered approximately five minutes prior to extraction of the root of the mandibular wisdom tooth. Oral analgesic medications were regularly administered postoperatively to alleviate pain and anxiety. During the perioperative period, no cerebrovascular event occurred, and the wisdom teeth were successfully extracted as per the planned procedure. It is thought that the perioperative risks of wisdom tooth extraction in patients with moyamoya disease can be minimized with the use of our protocols.

• The Journal of Internal Korean Medicine
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• v.22 no.3
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• pp.393-396
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• 2001

Objectives: We were to assess the effectiveness of combined therapy of Oriental Medicine and Western Medicine on acute stroke. Methods: We selected acute middle cerebral artery territory infarction subjects, within 3 days after stroke onset, who had never have any type of stroke history before. The subjects, admitted to department of Oriental Medicine, received combination therapy of western medical treatment including thrombolytic, anticoagulant, or antiplatelet agents and oriental medical treatment including acupuncture and herbs medication. The other subjects, admitted to department of Neurology, received only modern western medical treatment. The National Institute of Health Stroke Scale (NIHSS) was checked at admission, 1 week and 2 weeks later to assess neurologic improvement. The Modified Barthel Index (MBI) was checked 1 week and 2 weeks after admission to motor function recovery. Results: Comparing the NIHSS between baseline and 1 week later, the combination therapy group showed more improvement than the single-treated with anticoagulants group. However, there was no significant difference between the two groups, comparing 1 week and 2 weeks later with the NIHSS and the MBI. Conclusions: Combination therapy have more beneficial effect on acute stage of stroke.

• Journal of Korean Neurosurgical Society
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• v.41 no.6
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• pp.414-417
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• 2007

A 52-year-old woman with hypertension and moyamoya disease presented with chronic subdural hematoma [CSDH]. The presumed cause of bleeding was ascribed to administrated antiplatelet agents. She responded slowy and clumsily to verbal commands and had right arm weakness. After surgery, her clinical condition improved. But two days after surgery, her symptoms became aggravated and a convulsive seizure was noted within 24 hours. Brain magnetic resonance imaging showed no organic lesion except a small amount of residual CSDH. In addition, there was no laboratory evidence of metabolic brain disease. Moreover, after the administration of an antiepileptic drug [phenytoin], her manifestations disappeared. Therefore, the authors presume that her symptoms were resulted from nonconvulsive status epilepticus [NCSE], despite a lack of ictal period electroencephalographic findings. The authors were unable to find a single case report on postoperative NCSE in Korea. Therefore, the authors report this case of nonconvulsive status epilepticus after drainage of a CSDH in a patient with moyamoya disease.