• The Korean Journal of Blood Transfusion
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• v.29 no.3
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• pp.253-261
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• 2018

Background: A massive blood transfusion (MT) requires significant efforts by the Blood Bank. This study examined blood product use in MT and emergency O Rh Positive red cells (O RBCs) available directly for emergency patients from the Trauma Center in Ajou University Hospital. Methods: MT was defined as a transfusion of 10 or more RBCs within 24 hours. The extracted data for the total RBCs, fresh frozen plasma (FFP), platelets (PLTs, single donor platelets (SDP) and random platelet concentrates (PC)) issued from Blood Bank between March 2016 and November 2017 from Hospital Information System were reviewed. SDP was considered equivalent to 6 units of PC. Results: A total of 345 MTs, and 6233/53268 (11.7%) RBCs, 4717/19376 (24.3%) FFP, and 4473/94166 (4.8%) PLTs were used in MT (P<0.001). For the RBC products in MT and non-MT transfusions, 28.0% and 34.1% were group A; 27.1% and 26.0% were group B; 37.3% and 29.7% were group O, and 7.5% and 10.2% were group AB (P<0.001). The ratios of RBC:FFP:PLT use were 1:0.76:0.72 in MT and 1:0.31:1.91 in non-MT (P<0.001). A total of 461 O RBCs were used in 36.2% (125/345) of MT cases and the number of O RBCs transfused per patient ranged from 1 to 18. Conclusion: RBCs with the O blood group are most used for MT. Ongoing education of clinicians to minimize the overuse of emergency O RBCs in MT is required. A procedure to have thawed plasma readily available in MT appears to be of importance because FFP was used frequently in MT.

• Clinical and Experimental Pediatrics
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• v.58 no.12
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• pp.505-508
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• 2015

It is uncommon for pediatric patients with rhabdomyosarcoma to present with clinical and/or laboratory features of disseminated intravascular coagulation (DIC). We report a case of metastatic alveolar rhabdomyosarcoma with severe bleeding because of DIC in a 13-year-old boy. He experienced persistent oozing at the site of a previous operation, gross hematuria, and massive epistaxis. Two weeks after initiating combination chemotherapy consisting of vincristine, doxorubicin, and cyclophosphamide, the patients' laboratory indications of DIC began to resolve. During this period, the patient received massive blood transfusion of a total of 311 units (26 units of red blood cells, 26 units of fresh frozen plasma, 74 units of platelet concentrates, 17 units of single donor platelets, and 168 units of cryoprecipitate), antithrombin-III and a synthetic protease inhibitor. Despite chemotherapy and radiation therapy, he died 1 year later because of disease progression. In children with metastatic rhabdomyosarcoma and massive DIC, prompt chemotherapy and aggressive supportive care is important to decrease malignancy-triggered procoagulant activities.

• The Journal of Internal Korean Medicine
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• v.25 no.3
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• pp.573-581
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• 2004

Evans syndrome, as originally described, refers to autoimmune hemolytic anemia accompanied by thrombocytopenia. The autoantibodies in Evans syndrome are directed specifically against red cells, platelets, or neutrophils and are not crossreacting. The incidence of autoimmune hemolytic anemia is estimated to be approximately 10 cases per million people. Many patients have associated disorders, such as lupus erythematosus and other autoimmune disease, chronic lymphadenopathy, or hypogammaglobulinemia. In Oriental Medicine, the approach to Evans syndrome is made in view of deficiency of blood. The ailment was treated through methods of Oriental Medicine. Acupucture and herbal medicine were administered to patients diagnosed with Evans Syndrome by ecchymosis at the lower limb after continued gingival bleeding. As a result significant improvement in RBC, Hb, Hct, and PLT were observed and complaints abated.

• Journal of Applied Biological Chemistry
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• v.63 no.2
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• pp.131-136
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• 2020

When blood vessels are damaged, a fast hemostatic response should occur to minimize blood loss and maintain normal circulation. Platelet activation and aggregation are essential in this process. However, excessive platelet aggregation or abnormal platelet aggregation may be the cause of cardiovascular diseases such as thrombosis, stroke, and atherosclerosis. Therefore, finding a substance capable of regulating platelet activation and suppressing agglutination reaction is important for the prevention and treatment of cardiovascular diseases. 6,7-Dimethoxy-2H-chromen-2-one (Scoparone), found primarily in the roots of Artemisia or Scopolia plants, has been reported to have a pharmacological effect on immunosuppression and vasodilation, but studies of platelet aggregation and its mechanisms are still insufficient. This study confirmed the effect of scoparone on collagen-induced human platelet aggregation, TXA₂ production, and major regulation of intracellular granule secretion (ATP and serotonin release). In addition, the effect of scoparone on the phosphorylation of the phosphoproteins PI3K/Akt and mitogen-activated protein kinases (MAPK) involved in signal transduction in platelet aggregation was studied. As a result, scoparone significantly inhibited the phosphorylation of PI3K/Akt and MAPK, which significantly inhibited platelet aggregation through TXA₂ production and intracellular granule secretion (ATP and serotonin release). Therefore, we suggest that scoparone is an antiplatelet substance that regulates the phosphorylation of phosphoproteins such as PI3K/Akt and MAPK and is of value as a preventive and therapeutic agent for platelet-derived cardiovascular disease.

• Toxicological Research
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• v.35 no.2
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• pp.201-207
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• 2019

Nanoxel-$PM^{TM}$ (Nanoxel) is a docetaxel-loaded methoxy-poly(ethylene glycol)-block-poly(D,L-lactide) (mPEG-PDLLA). This newly developed and marketed nanoformulation exhibits an improved pharmacokinetic profile, efficacy, and safety. Although the safety of Nanoxel to docetaxel as well as its bioequivalence must be clinically confirmed, all biological activities have not been examined in in vitro or in vivo studies. Here, the toxicity in a cultured cell system and the effects on blood cells were tested with Nanoxel and docetaxel. The in vitro cytotoxicity of Nanoxel was found to be comparable to or slightly lower than that of docetaxel depending on the concentrations tested or the cell types. Neither docetaxel nor Nanoxel induced erythrocytes hemolysis and produced reactive oxygen species up to $100{\mu}M$. However, Nanoxel was able to enhance the aggregatory response of platelets to collagen, whereas docetaxel attenuated such aggregation in a range of $50-100{\mu}M$, while thrombin-induced aggregation was not affected by either of them. Docetaxel or Nanoxel did not alter basal level of $Ca^{2+}$ and 5-hydroxytryptamine-evoked $Ca^{2+}$ transient in vascular smooth muscle cells. These results suggest that the mPEG-PDLLA micellar formulation alters the toxicological properties of docetaxel, and that extra cautions are needed when evaluating the safety of nanomedicine.

• Korean Journal of Pharmacognosy
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• v.53 no.2
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• pp.64-69
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• 2022

When blood vessels are damaged, a rapid hemostatic response should occur in order to lower blood loss and keep normal circulation, and platelet activation and aggregation are essential. Nevertheless, abnormal or excessive platelet aggregation can be a reason of cardiovascular diseases including thrombosis, atherosclerosis, and stroke. Therefore, the screening for a substance which can regulate platelet activation and suppress aggregation reaction is very important for treatment and prevention of cardiovascular diseases. Artemether is a methyl ether derivative of artemisinin, which is isolated from the antimalarial plant Artemisia annua, but research on platelet aggregation or its mechanisms is still insufficient. This study identified the effects of artemether on U46619-induced human platelet aggregation and their granule secretion (ATP and serotonin release). In addition, the effects of artemether on the phosphorylation of PI3K/Akt or MAPK, which are related to signal transduction in platelet aggregation, were studied. As the results, artemether significantly lowered PI3K/Akt and MAPK phosphorylation, which inhibited platelet aggregation through granule secretion (ATP and serotonin release) dose-dependently. Therefore, we suggest that artemether is an antiplatelet substance that regulates PI3K/Akt and MAPK pathway and is of value as a therapeutic and preventive agent for platelet-derived cardiovascular diseases.

• Journal of Physiology & Pathology in Korean Medicine
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• v.36 no.2
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• pp.54-58
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• 2022

This study aimed to investigate the anti-stress function of Aucklandiae Radix (AR) and Cyperi Rhizoma (CR). The essential oils used in the experiment were extracted from AR and CR using Steam Distillation Extraction and Super critical CO₂ extraction. To observe the effects of sample administration, we measured feed intake, leukocytes, red blood cells, hemoglobin, platelets, serum serotonin content, immobility time, climbing time, and swimming time in mice subjected to chronic restraint stress as behavioral changes. The average body weight of all experimental groups increased than the average body weight of the control group. The immobility and climbing times of experimental groups A and B administered with supercritical extraction samples were shorter than those of the other experimental groups and the control group, and the swimming time was longer. The serotonin content in the blood of all experimental groups decreased compared to the normal group, and the serotonin content of the control group was increased. The authors suggest that Korean herbal medicines AR and CR may be utilized as anti-stress flavoring agents based on the above results.

• Korean Journal of Clinical Pharmacy
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• v.21 no.2
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• pp.145-155
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• 2011

The objective of this study was to determine whether any pretreatment parameters were associated with pharmacological effect or toxicity parameters after vincristine administration and to describe a mathematical model, which explains the interpatient pharmacodynamic variability. The relationship between patient characteristics and vincristine dose and hematological toxicity were evaluated. 68 pediatric and adolescence patients and 107 adults with acute lymphoblastic leukemia were treated with vincristine $1.5mg/m^2/day$ IV and other anticancer drugs as scheduled. Complete blood counts and other blood test results were obtained. The input variables were age, gender, weight, lean body weight (LBW), height, body surface area, vincristine dose and total vincristine dose. The outcome measures were nadir values (white blood cells, absolute neutrophil counts, hemoglobin, and platelets); the absolute decrease, relative decrease, and survival fraction of blood cells. Polynomial regression analysis was carried out to determine the other significant covariates. The variability of $WBC_{nadir}$ was modeled with good precision and accuracy with a two-covariate model. This model should be validated and improved on with further clinical data. We believe that such pharmacodynamic modeling should be explored further to determine its performance and clinical relevance compared with modeling using pharmacokinetic parameter.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.12
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• pp.4905-4908
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• 2015

Background: Platelets are blood elements thought to play a role in the immune system and therefore tumor development and metastasis. Platelet activation parameters such as mean platelet volume (MPV), platelet distribution width (PDW), and plateletcrit (PCT) can be easily evaluated with the whole blood count and have been studied as markers of systemic inflammatory responses in various cancer types. Our aim in this study was to evaluate the correlation between endometrial pathologies and MPV, PDW and PCT. Materials and Methods: A total of 194 patients who presented to our clinic with abnormal vaginal bleeding were included in our study. The patients were divided into 3 groups (endometrial hyperplasia, endometrial cancer, control) according to their pathology results. The groups were compared for MPV, PDW, and PCT values obtained from the blood samples taken on endometrial biopsy day. Results: The endometrial cancer patients were the oldest group (p=0.04). There was no significant difference between the three groups in terms of white blood cell count (WBC), platelet count (PC), and hemoglobin (Hb) level. The highest MPV (p<0.001), PDW (p=0.002), and PCT (p<0.001) levels were in the endometrial cancer group, and the lowest levels were in the control group. Conclusions: The easy evaluation of platelet parameters in patients who are suspected of having endometrial pathology is a significant advantage. We found MPV, PDW, and PCT to be correlated with the severity of endometrial pathology with the highest values in endometrial cancer. Studies to be conducted together with different laboratory parameters will further help evaluate the diagnosis and severity of endometrial cancer and precursor lesions.

• Journal of Radiation Protection and Research
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• v.42 no.3
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• pp.146-153
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• 2017

Background: Acute radiation syndrome (ARS) primarily refers to damage to the hematopoietic system, myeloid system, and gastrointestinal (GI) system caused by radiation exposure. Such damage progresses to become life-threatening. In particular, as the syndrome develops very rapidly-within several hours from radiation exposure-prompt and accurate diagnosis and treatment are needed, as is further research into appropriate diagnostic and treatment modalities. Materials and Methods: Minipigs, which display human-like properties, underwent whole-body irradiation at 2 or 4 Gy (doses causing hematopoietic ARS) or at higher doses of 7 or 12 Gy. Changes in the blood cells and clinical symptoms were analyzed and we performed a necropsy when the animals succumbed to ARS. Results and Discussion: The minipig irradiated with 2 Gy showed a decrease in white blood cells, including neutrophils, lymphocytes, and platelets in the early stages. However, the blood cell counts gradually increased and returned to normal values. The minipig irradiated with 4 Gy succumbed due to hematopoietic ARS. In contrast, the minipigs irradiated with 7 or 12 Gy exhibited clinical symptoms of combined GI damage and hematopoietic syndrome. Moreover, a characteristic pattern of platelet changes was observed in the 7 and 12 Gy irradiated minipigs. Conclusion: The changes in the platelet count caused by radiation exposure observed in minipigs, which are hematologically and pathohistologically similar to humans, suggest that they can be used as a novel diagnostic criterion.