• Title/Summary/Keyword: Blood coagulation disorders

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Viscoelastic Coagulation Test Guided Therapy for a Strategy to Reduce Transfusions (수혈 감소 전략을 위한 점탄성 응고 검사법의 유용성)

  • Park, Sun Young
    • The Korean Journal of Blood Transfusion
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    • v.29 no.3
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    • pp.240-252
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    • 2018
  • Viscoelastic coagulation tests provide simultaneous measurements of multiple aspects of whole-blood coagulation, including interactions between the plasma components and cellular components of the coagulation cascade. This can be carried out immediately using a point of care technique. Viscoelastic tests could predict the patient's outcome, including mortality, and detect coagulopathy more sensitively, resulted in reduced blood loss. The transfusion strategy based on the viscoelastic parameters rather than a conventional coagulation test has been shown to reduce the transfusion requirements. Although there are concerns about the reliability and accuracy of this method, viscoelastic tests, including ROTEM, would be a useful method to guide patient blood management strategies.

Light Scattering Analysis on Coagulation Detection with Magnetic Particles

  • Nahm, Kie B.
    • Current Optics and Photonics
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    • v.2 no.6
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    • pp.623-628
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    • 2018
  • Clotting properties of human blood are important clinical information to monitor for patients with platelet and coagulation disorders. Most devices used to diagnose these disorders utilize blood plasma together with tissue factors and $Ca^{{+}{+}}$ additives. In some instruments, magnetic particles were mixed with blood samples and a rotating magnetic field was applied, resulting in the rotation of magnetic particles, which was probed by impinging light. The working principle seems obvious yet had not been investigated in depth. We modeled the collective behavior of light propagating through magnetic needles, aligned in the direction of the rotating external magnetic field, with scattering light analysis software. Simulation results indicated that the scattering pattern undergoes periodic undulations with respect to the slant angle of the magnetic needles. Also provided is a means of extracting meaningful information from the scattering measurement.

A Case of Heel Reconstruction with a Reverse Sural Artery Flap in a Hemophilia B Patient

  • Lee, Byung-Kwon;Shim, Jeong-Su
    • Archives of Plastic Surgery
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    • v.39 no.2
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    • pp.150-153
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    • 2012
  • Hemophilia B is a rare blood coagulation disorder. Complications such as bleeding and hematoma can cause necrosis of flaps, wound disruption, and the disturbance of wound healing. In particular, guidelines for flap operations in hemophilia B patients have still not been defined, and case reports are rare. We reconstructed the heel of a 41-year-old male hemophilia B patient using a reverse sural artery flap operation. The patient presented with mild hemophilia, having 27% of the normal value of coagulation factor IX. Coagulation and the changing value of the coagulation factor were regularly measured, and 70% of the normal value of coagulation factor IX was maintained through the injection of recombinant coagulation factors and antihemorrhagics. Hematoma developed twice (postoperative day [POD] 5 and POD 7) and in each case the hematoma was removed. Injections of recombinant coagulation factors and antihemorrhagics were continuously administered until postoperative week 2. When the coagulation factors were within normal ranges. In this article, a hemophilia B patient underwent reverse sural artery flap surgery and the healing progress was analyzed. We conclude that higher than baseline levels of coagulation factors are needed for successful healing in reverse sural artery flap surgery.

A Case of Hemophilia A Diagnosed in a Premature Infant (미숙아에서 진단된 혈우병 A 1례)

  • Oh, Ki-Won;Lee, Kyung-Yeon;Kim, Ja-Hyeong;Rhee, Kang-Won;Jeong, Jin-Young;Park, Sang-Kyu
    • Neonatal Medicine
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    • v.17 no.1
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    • pp.132-135
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    • 2010
  • Although the majority of abnormal bleeding during the neonatal period results from acquired coagulation disorders, inherited coagulation disorders can also manifest at this time. Hemophilia is the most common of inherited coagulation disorder. Although 40-70% of cases with hemophilia are diagnosed in the neonatal period, few cases have been reported in premature infants. We report a case of a premature infant born at 31 weeks of gestation, diagnosed with hemophilia A by blood coagulation test, coagulation factor assay and study of the F8 gene. The baby was treated with recombinant factor VIII (Recombinate$^{(R)}$, USA) because of repeated seizures and intramuscular hematoma.

Anticoagulation Therapy, Thrombolytic Therapy, and Use of Blood Products in Neonates (신생아에서의 항응고요법, 혈전용해요법 및 혈액제제 사용)

  • Choi, Chang-Won
    • Neonatal Medicine
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    • v.18 no.1
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    • pp.34-41
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    • 2011
  • Neonatal coagulation disorders and thromboembolism require timely management. Failure to treat these conditions at the appropriate time may lead to death or the development of significant long-term sequelae. However, most current guidelines for managing neonatal coagulation disorders and thromboembolism are empiric and not based on randomized clinical trials. Thus, it is not easy to choose an appropriate management strategy for these conditions in clinical settings. In this review, therapeutic guidelines currently utilized in clinics and novel therapeutic options still under investigation are presented and reviewed.

Successful Surgical Treatment for Thoracoabdominal Aortic Aneurysm with Leriche Syndrome

  • Chong, Byung Kwon;Kim, Joon Bum
    • Journal of Chest Surgery
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    • v.48 no.2
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    • pp.134-138
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    • 2015
  • Thoracoabdominal aortic aneurysm accompanied by Leriche syndrome is an extremely rare combination of aortic diseases, the surgical management of which has not been described to date. We report the successful treatment of one such case through open surgical repair of the thoracoabdominal aorta.

Neonatal Coagulation Disorder: Diagnostic Approaches for Bleeding Neonates (신생아 혈액 응고질환: 출혈 경향을 보이는 신생아에 대한 진단적 접근)

  • Kim, Chun-Soo
    • Neonatal Medicine
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    • v.18 no.1
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    • pp.6-13
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    • 2011
  • All newborn infants with clinically significant bleeding should be evaluated for a hemostatic deficit. Medical history should include the following data: familial bleeding disorders, maternal illness and medication, age of bleeding onset, and prophylactic administration of vitamin K. The first essential step for evaluating bleeding neonates is determining whether the baby is sick or well. The physician should also evaluate the extent of the bleeding, features of bleeding lesions, and other abnormal findings from the physical examination. Skeletal anomalies may provide diagnostic clues. Depending on the clinical features and results of screening tests, other tests including coagulation factors may be useful for determining the diagnosis. All laboratory results must be considered in the context of age-related reference values. The platelet function analyzer provides a promising alternative to bleeding time. Fibrin degradation products and D-dimers are used for screening and specially testing fibrinolytic activity, respectively. The Apt test may help to rule out factors derived from maternal blood. Radiologic imaging studies are important because asymptomatic intracranial hemorrhages are common in neonates.

Anti-coagulation and Anti-platelet Aggregation Activities of Black Ginger (Kaempferia parviflora) (흑생강(Kaempferia parviflora)의 항응고 및 혈소판 응집저해 활성)

  • Lee, Man-Hyo;Sung, Hwa-Jung;Kwon, Chong Suk;Sohn, Ho-Yong
    • Journal of Life Science
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    • v.28 no.9
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    • pp.1068-1075
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    • 2018
  • Kaempferia parviflora, an herbaceous plant in the family Zingiberaceae, is popular in many tropical regions. It is called as black ginger or krachaidum in Thailand and Laos, and its raw or dried root have been used as spices and teas. The rhizomes also have been traditionally used to treat gastrointestinal disorders, ulcers, gout, dysentery, allergies and to improve physical work capacity. Recently, its anti-obesity, anti-oxidant, anti-inflammatory and blood clot-lysis activities were reported. In this study, the anti-thrombosis activity of black ginger was investigated, since improvement in blood fluidity leads to the prevention of various lifestyle-related diseases. The hot water and ethanol extract and their subsequent solvent fractions (hexane, ethylacetate, butanol fractions and water residue) were prepared, and their anti-coagulation and platelet aggregation inhibitory activities were determined, respectively. Among the black ginger extracts and their fractions, the ethylacetate fraction (EAF) of ethanol extract only showed significant extensions of blood coagulation time determined by thrombin time (TT), prothrombin time (PT), and activated partial thromboplastin time (aPTT). At 5 mg/ml concentration, TT, PT and aPTT were extended to 1.22, 1.49 and >15-folds compared to non-treatment. The EAFs of ethanol and hot water extract showed strong inhibitions against collagen-induced platelet aggregations, which are comparable to inhibitions of aspirin. Also the EAFs from black ginger did not show any hemolysis activity against human RBC up to 0.5 mg/ml. Our results suggest that the EAF of black ginger has a potential as novel anti-coagulation and ant-platelet aggregation agent. This report provides the first evidence of anti-coagulation activity of black ginger.

A Case Report of Palatoplasty in a Patient with Clotting Factor Ⅹ Deficiency (선천성 혈액 응고 인자 Ⅹ(10번) 결핍증 환아에서 구개성형술의 증례보고)

  • Kim, Suk Wha;Jeong, Eui Cheol;Yun, Byung Min;Choi, Tae Hyun;Kang, Hyoung Jin
    • Archives of Plastic Surgery
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    • v.36 no.6
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    • pp.792-794
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    • 2009
  • Purpose: Clotting factor X deficiency is one of the most uncommon coagulation disorders. The authors describe a case of cleft palate in a patient with a congenital clotting factor X deficiency. Methods: In pediatric patients with a cleft palate, the coagulation problem is more worrisome, because they are more sensitive to blood than adults, and because postoperative bleeding can cause blood ingestion with subsequent vomiting, aspiration, and airway obstruction. To prevent hemorrhagic complications in the described case, fresh frozen plasma (FFP) was administered every 24 hrs from the day before surgery to the second postoperative day. Results: Good hemostasis, normal healing, and no complications was shown postoperatively. Conclusion: The replacement of fresh frozen plasma was useful in the case of congenital clotting factor deficiency for bleeding prophylaxis in cleft palate operation.

DENTAL MANAGEMENT OF CHILDREN WITH HEMOPHILIA UNDER THE GENERAL ANESTHESIA : A CASE REPORT (혈우병 B 환아의 전신마취 하 치과치료 : 증례보고)

  • Kim, Soo-Kyoung;Park, Jea-Hong;Lee, Keung-Ho;Kim, Kwang-Chul;Choi, Sung-Chul
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.4 no.1
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    • pp.7-11
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    • 2008
  • Hemophilia is a group of gender-linkage inherited bleeding disorders that impair the body's ability to control blood clotting or coagulation. This sex-linked disorder is transmitted on the X chromosome. These genetic disorders have lower blood plasma clotting factor level of coagulation factor. Most common form is Hemophilia A and B. Restorative dental care and simple surgery for the hemophiliac patient are quite often neglected for fear of bleeding during procedures. Even dental specialist avoid these patients and make them severe problem patients. On the dental treatment especially, invasive procedure, special considerations of bleeding control are required. Inter-consultation with the hematologist will provide orientation on the best approach to dental treatment, such as the need of replacement therapy, the modification of antifibrinolytic therapy, the application of local hemostatic methods. In this case reports, we successfully treat early childhood caries of patient with hemophilia B under the general anesthesia.

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