• Title/Summary/Keyword: Coagulation therapy

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Provocative Discography Following Focal Selective Coagulation in a Patient with Chronic Lumbar Discogenic Pain (만성 요추간판성 통증 환자에서 선택적 조직 응고술 후 유발성 추간판조영술의 진단적 소견 변화)

  • Kim, Dahn;Kim, Nackhwan;Lee, Sang-Heon
    • Clinical Pain
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    • v.18 no.2
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    • pp.142-146
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    • 2019
  • This is a case report of the provocative discographic findings before and after focal selective coagulation of the major annular fissure using intradiscal navigable catheter. A 46-year-old woman had a 30-month history of axial low back pain and magnetic resonance imaging findings suspicious for painful L4/5 disc. The provocative discography confirmed painful disc before coagulation. The final electrode tip position in the coagulation procedure was at the largest fissure within the outer annular margin identified through the discography. Six months after the successful coagulation therapy, inadvertently performed discography resulted in decreased pressure rise over time. Neither evoked pain nor change in the integrity of outer annulus as compared with the previous results was reported. Such an interventional method has not been reported previously, and the analytic results suggest that it may be possible to relocate the pressure of the entire nucleus pulposus only by focal selective coagulation of the fissure.

A Micorowave Tissue Coagulation Therapy in the Restenosis of the Tracheal Reconstruction -A Case of Report- (기관 재건술후 발생한 협착증에 대한 Microwave 조직응고법을 이용한 치료 -1례 보고-)

  • 김남혁
    • Journal of Chest Surgery
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    • v.28 no.4
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    • pp.416-418
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    • 1995
  • The microwave tissue coagulation therapy was originally used for hemostasis in the hepatic surgery, which is effectively applied in the endoscopic surgery such as the hemostasis of gastric ulcer or tumor bleeding, stenosis relieving of esophageal or rectal stenosis and tumor reduction in inoperable early cancer cases.We experienced one case of the restenosis after the tracheal reconstruction. The patient, who was 42 year-old male, had severe dyspnea due to the tracheal stenosis for 4 years. The resection of tracheal stenosis and tracheal reconstruction was done. But the restenosis occurred at the tracheal anastomosis site because of the protrusive granulation at one month after operation. The patient was successfully treated by the microwave tissue coagulation therapy.

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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.

An Experience of The Microwave Tissue Coagulation Therapy in The Restenosis of The Esophagogastrostomy (식도위 문합술후 재협착증에 대한 microwave 조직응고법적 치험 례)

  • Nam, Chung-Hui;An, Uk-Su;Lee, Gil-No
    • Journal of Chest Surgery
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    • v.20 no.4
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    • pp.859-864
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    • 1987
  • The microwave tissue coagulator was originally used for hemostasis in the hepatic surgery, which is effectively applied in the endoscopic surgery such as the hemostasis of gastric ulcer or tumor bleeding, stenosis relieving of esophageal or rectal stenosis and tumor reduction in inoperable early cancer cases. We experienced the good result of the microwave tissue coagulation therapy in the patient with the restenosis of esophagogastrostomy. The patient was 67 year-old female, who was admitted due to the lye stricture of esophagus for 40 years. We made the lower esophagectomy and the esophagogastrostomy with the upper intact esophagus in the right thorax. But the restenosis occurred at the esophagogastrostomy site because of the polypoid mucosal protrusion at one month after operation. We applied the microwave tissue coagulator 3 times with 6 day interval under esophagoscopy and the good symptomatic and endoscopic relief was alleviated. We think that the microwave tissue coagulation is a very convenient and advisable method in the case of restenosis after esophageal surgery.

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Early-stage Diagnosis of Bladder Carcinoma by a Clinical Pharmacist's Effective Anti-coagulation Service in a Patient with Anticoagulation Therapy: a Clinical Case Report (항응고제 투여 환자에서 약사의 효과적인 ACS를 통한 방광암 조기발견 사례)

  • An, Sung-Shim;Bang, Joon-Seok;La, Hyen-Oh
    • Korean Journal of Clinical Pharmacy
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    • v.20 no.1
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    • pp.85-87
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    • 2010
  • Recently, the prevalence of bladder cancer is increasing in the Korean society. As the risk factors of bladder carcinoma are variable, the early-stage diagnosis is regarded the best preventive practice. Hematuria is a specific sign of the malignancy as well as a kind of various medication-related adverse reactions. Some anti-coagulation therapy can cause bleedings including hematuria to the patients with cardiovascular diseases such as paroxysmal atrial fibrillation (PAF). Therefore, to the clinical pharmacists working in the anti-coagulation services (ACS), a closer monitoring of patients can give an opportunity to find certain ailments unexpectedly. In this case, a patient with PAF had episodes of sporadic hematuria in the course of warfarin therapy even though with its low levels of INR. An ACS pharmacist found a discrepancy between the bleeding symptoms and INR values, and recommended properly the patient to refer urologist. Fortunately, an early-stage of bladder carcinoma was found then followed by an excision performed to the lesion. Therefore, alert-minded and precise monitoring done by ACS pharmacist could optimize the therapeutic outcomes as well as increase the quality of life of the patient.

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.

Two Cases of Disseminated Intravascular Coagulation (DIC) Following Pit Viper Envenomation (살모사 교상 후 발생한 범발성 혈관내 응고장애 2례)

  • Kim, Suk-Hwan;Choi, Se-Min;Oh, Young-Min;Park, Kyu-Nam;Lee, Won-Jae;Choi, Kyung-Ho
    • Journal of The Korean Society of Clinical Toxicology
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    • v.4 no.2
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    • pp.137-142
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    • 2006
  • Our records include two cases of DIC in snakebite patients. One patient, who was 48-years old, was bitten in his left ankle 3 days before admission to our hospital. Initial symptoms were painful swelling, extensive ecchymosis, and persistent bleeding at the bite site. He visited and was admitted to a local hospital, but his condition did not improve with supportive care that included a single dose of antivenin. He was transferred to our hospital. His condition was compatible with DIC. We tried multi-dose antivenin therapy and blood product transfusion. At the seventh hospital day, the patient's symptoms were completely resolved. The other patient, who was 75 years old, was bitten in his right thumb. Initial symptoms were painful swelling of the right arm and persistent bleeding at the bite site, and within minutes of hospital admission, the patient experienced massive hematochezia. We peformed laboratory tests, the results of which were compatible with DIC, and the next day a sigmoidscopic examination showed ischemic colitis. We administered multi-dose antivenin therapy and blood product tranfusion. At the third hospital day mild anemia still existed, but the patient's clinical condition was improved. No signs or symptoms of gastrointestinal bleeding were observed. In these two cases, multi-dose antivenin therapy and transfusion effectively resolved symptoms of DIC. Platelet concentrate transfusion was required only for acute thrombocytopenia. After resolution of DIC, platelet counts were returned to normal ranges within a few days. The authors propose that multidose antivenin therapy and coagulation factor transfusion might be useful for improving coagulopathy in snakebite patients.

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Herbal Medicines Effect on Coagulation System of Ischemic Patients (한약 투여가 허혈성 질환 환자의 혈액 응고계에 미치는 영향)

  • Lee Seoung Geun;Ryu Hyun Hee
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.18 no.4
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    • pp.1213-1217
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    • 2004
  • Many ischemic disease patients have been taking herbal medicine and there are some papers that prescription of herbal medicine to ischemic disease patients are useful. Mechanism of herbal medicines on ischmeic disease have been investigated in many ways, but anticougulation or anti platelet effect of herbal medicines is not known obviously. And recently patients receiving anticougulation therapy are discouraged from taking herbal medicines. In this study, we investigate PT, INR, platelet of patients receiving herbal medicine therapy to study whether herbal medicines effect coagulation system of ischemic patients. In PT, INR, platelet values obtained from the patients, before and after administering herbal medicine, there were no significant changes.

Advanced Gastric Cancer Associated with Disseminated Intravascular Coagulation Successfully Treated with 5-fluorouracil and Oxaliplatin

  • Lee, Dong Seok;Yoo, Seung Jin;Oh, Ho Suk;Kim, Eun Jung;Oh, Kwang Hoon;Lee, Sang Jin;Park, Jong Kyu;Ahn, Yong Chel;Eom, Dae-Woon;Ahn, Heui June
    • Journal of Gastric Cancer
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    • v.13 no.2
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    • pp.121-125
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    • 2013
  • Gastric cancer patients with acute disseminated intravascular coagulation experiences a rare but severe complication resulting in a dismal prognosis. We report a case of advanced gastric cancer complicated with disseminated intravascular coagulation with intractable tumor bleeding which was successfully treated with chemotherapy consisting of 5-fluorouracil and oxaliplatin. The patient was a 63-yearold man who complained of abdominal pain, melena, and dyspnea on 24 November 2010. We diagnosed stage IV gastric cancer complicated by disseminated intravascular coagulation. Gastric tumor bleeding was not controlled after procedures were repeated three times using gastrofiberscopy. With the patient's consent, we selected the 5-fluorouracil and oxaliplatin combination chemotherapy for treatment. After one cycle of 5-fluorouracil and oxaliplatin therapy, symptoms of bleeding improved and the disseminated intravascular coagulation process was successfully controlled. The primary tumor and multiple metastatic bone lesions were remarkably shrunken and metabolically remitted after eight cycles of chemotherapy. In spite of progression, systemic chemotherapy is effective in disease control; further, the patient gained the longest survival time among cases of gastric cancer with disseminated intravascular coagulation.