• Clinical and Experimental Pediatrics
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• v.49 no.8
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• pp.821-829
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• 2006

Hemophilia is the most common coagulation disorder. It has a long history. Hemophilia A is caused by FVIII gene mutation, and hemophilia B by FIX gene mutation. Those genes are located on X chromosome long arm. Bleedings in hemophiliacs predominantly occur in joints and muscles. Because those site are insufficient in tissue factor to induce hemostasis. Among joints knee, ankle and elbow are most frequently affected because their synovial structure is vulnerable to injury compared to other joints. Hemophilia is diagnosed with factor assay. Severe hemophilia is below 1% of FVIII : C, moderate between 1% and 5%, mild over 5%. Carrier detection and prenatal diagnosis have been conducted with RFLP-based linkage analysis and DNA sequencing. Mainstay of treatment is factor replacement therapy so far. Bleedings can be controlled by infusion of factor concentrates. Hemophilc arthropathy and muscle contracture are representative sequelae. Complications of facotor replacement therapy are inhibitor development and infections. Hemophiliacs with inhibitor should be managed with large dose factor concentrate, bypassing agent, ITI and immunosuppression. Ultimately, hemophilia could be cured by gene therapy.

• Journal of the korean academy of Pediatric Dentistry
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• v.23 no.3
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• pp.575-581
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• 1996

Hemophilia is a hereditary condition in which one of the normal blood clotting factors is absent. This sex-linked, recessive disease, transmitted by the female and expressed in some of her male offspring, is characterized by significantly delayed coagulation times and by the tendency to hemorrhage. On the dental treatment especially, surgical procedure, appropriate methods of hemorrhage control are required. These methods are replacement therapy, antifibrinolytic agents, and local hemostatic methods. In this case, we successfully extract residual roots of hemophiliac patient without eccessive post operative bleeding using replacement therapy and surgical splint.

• 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.

• The Korea Journal of Herbology
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• v.25 no.4
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• pp.1-6
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• 2010

Objective : The purpose of this study is to compare anti-thrombotic activities of 4 Rhubarb species. Methods : Rhubarb has been used as medical and edible resources worldwide for the therapy of cancer, constipation and inflammation, etc. To compare the anti-thrombotic activities among the species within rhubarb, we investigated and compared the inhibitory properties of water extracts from R. palmatum(RPE), R. officinale(ROE), R. nobile(RNE), and R. franzenbachii (RFE) on the fibrinolysis, blood coagulation and platelet aggregation. APTT and PT, blood coagulation time, were measured by apparatus of auto blood coagulation analysis that called ACL-7000. The measurement of fibrinolysis was measured and compares with the width of clear zone from melted fibrin plate. The platelet aggregation was measured and compared with inhibition rate of aggregation. Results : We found out the best species from rhubarb showing the significant fibrinolytic, anti-coagulant and anti-platelet aggregation activity. Our results show that Rheum nobile (RNE) has the most effective anti-thrombotic activity among 4 tested rhubarb. Conclusions : This study, therefore, RNE will be able to be used the development of drug which is thrombosis treatment.

• 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.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.6 no.2
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• pp.192-196
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• 2003

Angiodysplasia is the most common vascular abnormality of the gastrointestinal tract and probably the most frequent cause of recurrent lower intestinal bleeding in otherwise healthy elderly patients. Also, it is an important cause of hemorrhage in chronic renal failure observed in up to 19~32% of patients. Bleeding due to gastric angiodysplasia is treated by various endoscopic approaches, including argon and Nd : YAG laser photocoagulation, monopolar or bipolar electrocoagulation, heater probe, injection sclerotherapy, band ligation or hemoclipping. A 15-year-old boy, who had undergone hemodialysis for chronic renal failure for about 10 years, was admitted due to melena and progressive anemia. A gastroduodenoscopy revealed a cherry red and fern-like lesion with oozing on the posterior wall at junction of gastric body and fundus. Endoscopic hemoclipping therapy was performed. However, melena recurred four days later. Argon plasma coagulation and hemoclipping therapy were performed again. Since then, no recurrence of bleeding has been observed.

• The Korean Journal of Pain
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• v.9 no.1
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• pp.271-274
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• 1996

Epidural hematoma during anticoagulant therapy is a rare complication of central neural blockade, but it may result in serious neurologic sequelae. A 61-year-old male receiving warfarin due to heart failure was referred to the pain clinic for control of severe herpetic neuralgia. Epidural catheterization was done at $T_{8-9}$ interspace. At that time, PT and aPTT were extremely prolonged. The next morning, severe back pain, motor paralysis and urinary difficulty developed. On spine MRI, epidural hematoma was detected at $T_{8-9}$ interspace. Four days later, he died due to underlying diseases. Central neural blockade in patient with anticoagulant therapy is contraindicated in most cases. If is undertaken, close observation of patients's neurologic functions and monitoring of coagulation profiles(PT, aPTT, etc) are necessary. If epidural hematoma develops, early surgical decompression is mandatory.

• Journal of Chest Surgery
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• v.25 no.3
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• pp.232-239
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• 1992

Acute renal failure is a well known serious complication following open heart surgery and is associated with a significant increase in morbidity and mortality rate. From 1984 to 1990, 33 patients who had acute renal failure following cardiopulmonary bypass received renal replacement therapy. PD[Peritonial dialysis] was employed in 11 patients and CAVH[continous arteriovenous hemofiltration] was employed in 22 patients. Their age ranged from 3 months to 64 years[mean 25.5$\pm$7.8 years]. The disease entities included congenital cardiac anomaly in 18, valvular heart disease in 15 and aorta disease in 2 cases. Low cardiac output was thought as a primary cause of ARF except two redo valve cases who showed severe Aemolysis k depressed renal function preoperatively. Mean serum BUN and creatinine level at the onset renal replacement therapy were 65$\pm$8 mg/dl and 3.5$\pm$0.4 mg/dl respectively, declining only after reaching peak level 7&10 days following the onset of therapy. Overall hospital mortality was 72.7%[24/33]; 81%[9/11] in PD group and 68.2% [15/22] in CAVH group respectively. The primary cause of death was low cardiac output & hemodynamic depression in all the cases. The fatal complications included multiorgan failure in 7, disseminated intravascular coagulation and sepsis in 6, neurologic damage in 4 and mediastinitis in 3 cases. No measurable differences were observed between CAVH and PD group upon consequence of acute renal failure and disease per se. The age at operation, BUN/Cr level at the onset of bypass and highest BUN/Cr level and the consequence of low output status were regarded as important risk factors, determining outcome of ARF and success of renal replacement therapy. Thus, we concluded that althoght the prognosis is largely determined by severity of low cardiac output status and other organ complication, early institution of renal replacement therapy with other intensive supportive measures could improve salvage rate in established ARF patients following CPB.

• Journal of The Korean Dental Society of Anesthesiology
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• v.12 no.2
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• pp.99-104
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• 2012

Anticoagulation therapy with warfarin sodium is used to reduce the risk of thromboembolic events in patients with valvular heart disease, prosthetic heart valve, recurrent myocardiac infarction, etc. To keep anticoagulation state and minimize bleeding risk, patients with high risk of thromboembolism have been usually hospitalized for heparinization before oral surgery like extraction. However, this protocol requires time and high expense because of the long period of hospitalization and this is why low-molecular-weight heparin (LMWH) therapy is receiving attention in medical field as well as dentistry. LMWH has several advantages over unfractionated heparin (UFH) including predictable anticoagulant response which makes coagulation monitoring unnecessary in most patients and longer half-life than heparin which enables the patients to give themselves a subcutaneous injection once or twice daily. These advantages of LMWH make patients get oral surgery on an outpatient basis so that they can save time and cost. This case report introduces the use of LMWH in dental surgery and suggests proper use of LMWH. Though LMWH bridging therapy is widely used most of the previous studies are observational studies. Therefore randomized controlled trials are necessary to evaluate the safety and efficacy of LMWH bridging therapy.

• Tuberculosis and Respiratory Diseases
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• v.65 no.2
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• pp.137-141
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• 2008

We treated synchronous double primary lung cancers, where one site resulted from CIS disease, with lobectomy and argon plasma coagulation (APC) in a patient who couldn't tolerate pneumonectomy, which resulted in a reduction of the extent of surgery. APC could be a reasonable alternative for CIS disease of lung in inoperable patients.