• Title/Summary/Keyword: Embolism and thrombosis

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Mid term experience with CarboMedics Medical Valve (CarboMedics 기계판막의 임상경험)

  • 김기출
    • Journal of Chest Surgery
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    • v.26 no.10
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    • pp.753-760
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    • 1993
  • The CarboMedics valve is a bileaflet prosthesis with excellent hemodynamic characteristics, but the long term surgical experience with this valve, its durability and its biocompatibility are unknown. During a 5 year period from october 1988 to July 1993, 748 prostheses [402 mitral, 261 aortic, 58 tricuspid, 27 pulmonic] were inserted in 552 patients [mean age 40.2 years]. The operative mortality was 6.6% [37/560, 13.2% in age group below 15 years and 5.7% above 15 years]. and the main causes of death were complex congenital malformation and left ventricular failure. Follow up was totaled 1182 patient- years and mean follow up was 28.3 months/patient. No structural failure has been observed. Hemorrhage was the most frequent valve related complication[1.78% / Patient-year]. Embolism occurred at a rate of 0.93% / Patient-year. There were 5 cases of valve thrombosis [0.42% / Patient-year, two fatal]. There occurred 11 late deaths[6 valve related] and 42 valve related complications. Actuarial survival at 5 years is 97.18 0.94% and actuarial complication free survival at 5 years is 89.07 1.54%. In summary, the CarboMedics valve stands for a durable valve substitute, with low valve related complications.

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Hemothorax after Central Venous Catherization Failure through the Subclavian Vein (쇄골하정맥을 통하여 중심정맥도관 삽입 실패 후 나타난 혈흉 1예)

  • Kim, Dae-Young;Kim, Dae-Woo;Son, Hee-Won;Park, Sang-Jin;Lee, Deok-Hee
    • Journal of Yeungnam Medical Science
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    • v.25 no.2
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    • pp.175-181
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    • 2008
  • Central venous catheterization via an internal jugular vein or subclavian vein has become a common procedure in monitoring CVP and managing severely ill patients. However, there have beennumerous reports of complications associated with central venous catheterization. These include vessel injury, pneumothorax, hemothorax, nerve injury, arrhythmias, arteriovenous thrombosis, pulmonary embolism, and infection at the insertion site. We report a case of hemothorax after subclavian vein catheterization failure, along with successful treatment.

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Experiences of Abdominoplasty without Undermining (박리없는 복부성형술의 경험)

  • Sim, Hyung Bo;Yoon, Sang Yup
    • Archives of Plastic Surgery
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    • v.33 no.3
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    • pp.303-307
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    • 2006
  • No one technique provides an optimal outcome for all body contouring patients. There are many surgical options for abdominoplasty. Among these, this abdominoplasty without undermining consists of liposuction around abdominal subcutaneous fatty tissue, excision of lower abdominal flap. The procedure allows aggressive thinning and sculpting of abdominal flap. This operation minimizes the dead space, which often leads to postoperative complications, and preserves neurovascular supply to the abdominal skin. From 1999 to 2004, 18 patients underwent the abdominoplasty without undermining, resulting in high satisfaction rates with no significant complications, such as, pulmonary embolism and deep vein thrombosis. Patients could return to normal activity within a week. This abdominoplasty without undermining is an effective and safe alternative with low complication rate and enhances aesthetic results compared to traditional abdominal surgery.

Arterial Complication of Percutaneous Transluminal Angioplasty - A Report of Case - (경피 경관 혈관 성형술후 발생한 동맥내 합병증의 치험 1례)

  • 김상익
    • Journal of Chest Surgery
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    • v.25 no.11
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    • pp.1273-1277
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    • 1992
  • Percutaneous Transluminal Angioplasty[PTA] was introduced by Dotter and JudKins [1964], using coaxial catheters of increasing diameter. The remarkable advances in vascular catheter technology over the past several decades have permitted the development. But the application of the balloon catheters carries with it the risk of arterial injury, thrombosis, embolism, and loss of life or limb. A 53-year-old man was admitted to other hospital due to a intermittent claudication in his right leg for 10 years. and PTA was performed at that hospital. Thereafter he was transferred to our hospital because of coldness, pulselessness, rest pain, ischemic ulcer, and progressing gangrene at the anterior aspect of left lower leg. The left lower extremity was salvaged by left ilio-femoral bypass and later saphenous in situ femoro-popliteal bypass.

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Normothermic Cardiac Surgery with Warm Blood Cardioplegia in Patient with Cold Agglutinins

  • Cho, Sang-Ho;Kim, Dae Hyun;Kwak, Young Tae
    • Journal of Chest Surgery
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    • v.47 no.2
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    • pp.133-136
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    • 2014
  • Cold agglutinins are predominately immunoglobulin M autoantibodies that react at cold temperatures with surface antigens on the red blood cell. This can lead to hemagglutination at low temperatures, followed by complement fixation and subsequent hemolysis on rewarming. Development of hemagglutination or hemolysis in patients with cold agglutinins is a risk of cardiac surgery under hypothermia. In addition, there is the potential for intracoronary hemagglutination with inadequate distribution of cardioplegic solutions, thrombosis, embolism, ischemia, or infarction. We report a patient with incidentally detected cold agglutinin who underwent normothermic cardiac surgery with warm blood cardioplegia.

Evaluation of the Oral Absorption of Heparin Conjugated with Sodium Deoxycholate as a Facilitating Agent in GI Tract

  • Moon, Hyun-Tae;Jeon, Ok-Chul;Byun, Young-Ro;Kim, Yu-Jin;Lee, Yong-Kyu
    • Macromolecular Research
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    • v.17 no.2
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    • pp.79-83
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    • 2009
  • The oral delivery of heparin is the preferred therapy in the treatment of patients with a high risk of deep vein thrombosis and pulmonary embolism. New conjugates of heparin and sodium deoxycholate were synthesized in order to enhance the heparin absorption in the GI tract. After oral administration of DOC-heparin, the concentration in anti-FXa assay was increased with increasing amount of coupled DOC. The maximum concentration of DOC-heparin VIII conjugate was $3.3{\pm}0.5\;IU/mL$ at an oral dose of 10 mg/kg, which was 3-fold higher than the baseline level. Finally, DOC coupled to heparin greatly enhanced the absorption of heparin in the GI tract, and this enhancing effect was not induced by changing the tissue structure of the GI wall.

Comparative Study on Anti-thrombotic Effects of Gamihyunbooleekyungtang with Decoction Method (탕전기의 추출방법(抽出方法)에 따른 가미현부이경탕(加味玄附理經湯)의 항혈전(抗血栓) 효능(效能) 비교(比較) 연구(硏究))

  • Jeong, Ji-Hye;Lee, Soon-Yee;Jang, Yun-Jeong;Choe, Chang-Min;Cho, Han-Baek;Kim, Song-Baeg
    • The Journal of Korean Obstetrics and Gynecology
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    • v.22 no.3
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    • pp.99-116
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    • 2009
  • Purpose: In this study, we investigated anti-thrombotic effects of Gamihyunbooleekyungtang currently used clinical treatment of dysmenorrhea and compared effects by decoction methods. Methods: Gamihyunbooleekyungtang was extracted by pressure extractor (GHYT) and nonpressure extractor(GHYT-1). Inhibitory effect of platelet cohesion, suppression effect of GPIIb/IIIa activity, inhibitory effect of $TXB_2$ and $PEG_2$ biosynthesis, and oxidative damage suppression effect were tested in vitro. Also suppression of pulmonary embolism was studied in vivo. Results: In this study, both GHYT and GHYT-1 extract showed a safety in cytotoxicity of hFCs. Both showed dose-dependent inhibitory effect on platelet coagulation. GHYT-1 extract is usually higher than GHYT, especially for $E_{max}$. GHYT and GHYT-1 extract showed dose-dependent inhibitory effect on GPIIb/IIIa activities. GHYT extract suppressed significantly $TXB_2$ biosynthesis at 1000, $500{\mu}g/m{\ell}$ and also suppressed significantly $PEG_2$ biosynthesis at $1000{\mu}g/m{\ell}$ as compared with the control group. GHYT-1 suppressed significantly $TXB_2$ biosynthesis at $1000{\mu}g/m{\ell}$ as compared with the control group. Also it suppressed pulmonary embolism triggered by collagen and epinephrine by respectively 50%, 75% as compared with the control group. Both GHYT and GHYT-1 extract showed dose-dependent decrease of oxidative damages caused by DPPH, whereas dose-dependent increase of superoxide dismutase like activity was observed. Conclusion: These results suggest that Gamihyunbooleekyungtang can be used for treating dysmenorrhea caused by thrombosis. Nonpressure decoction method is a little more effective, but more detailed studies would be needed.

Transcranial Doppler Ultrasonography(TCD) in diagnosis of Cerebrovascular Accident (CVA) (뇌졸중의 진단에 대한 TCD의 활용 (Brain CT, Brain MRI와 Transcranial Doppler Ultrasonography 비교를 통한 뇌졸중 진단의 상호 보완에 관한 연구))

  • Park, Se-Gi;Kang, Myeong-Seog;Jun, Chan-Yong;Park, Chong-Hyeong
    • The Journal of Korean Medicine
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    • v.17 no.1 s.31
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    • pp.171-189
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    • 1996
  • Background and Purpose: The greater part of patients to visit Hospital of Oriental Medicine suffer from cerebrovascular accident(CVA). There is transcranial Doppler(TCD) in the diagnostic method to confirm cerebrovascular accident(CVA). Transcranial Doppler(TCD) is an accurate method of monitoring the blood flow velocities of the cerebral vessels and have been generally used to prevent symptomatic vasospasm and confirm cerebral infarction. So we studied, in the crebrovascular accident(CVA), to estimate whether transcranial Doppler(TCD) is useful to. Methods: Using transcranial doppler(Multigon Model 500M Transcranial Doppler System), we measured the mean and peak velocity and the direction of blood flow in 10 cerebrovascular accident(CVA)'s subjects who had been examined by Computed Tomography(CT) or Magnetic Resonance Imaging (MRI). Results : As an anticipation, in cerebrovascular accident(CVA)'s subject with Cb-infarction, the mean and peak velocity of blood flow fell down remarkably and the direction of blood flow was change or irritable. But didn't find out any signal in lacunar infarction. Also, in case with spontaneous hemorrhage, the velocity and direction of blood flow was change but this signal was short of diagnosis for Cb-hemorrhage. Besides, we found signals about embolism, stenosis, thrombosis and occlusion in cerebrovascular accident(CVA)'s subjects. Conclusion: In Cb-infarction, the result of TCD was equal to diagnosis with Computed Tomography(CT) or Magnetic Resonance Imaging (MRI). But about lacunar infarction or spontaneous hemorrhage, signals of TCD couldn't be found out or was insufficient more than Computed Tomography(CT) or Magnetic Resonance Imaging(MRI). In cerebrovascular accident(CVA)'s subject with embolism, stenosis, thrombosis or occlusion, signals of TCD were found out more than Computed Tomography(CT) or Magnetic Resonance Imaging(MRI). Therefore transcranial doppler(TCD) is necessary method which makes a diagnosis of cerebrovascular accident(CVA), with Computed Tomography(CT) or Magnetic Resonance Imaging(MRI).

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The Study on Antithrombosis and Inflammation according to The Broth Preparation Method of Gamijoukyungtang (가미조경탕(加味調經湯)의 전탕(煎湯) 방법에 따른 항혈전 및 염증에 관한 연구)

  • Ahn, Kyu-Hwan;Choe, Chang-Min;Kim, Song-Baeg;Cho, Han-Baek
    • The Journal of Korean Obstetrics and Gynecology
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    • v.22 no.1
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    • pp.53-78
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    • 2009
  • Purpose: In this study, we investigated the anti-thrombotic and antiinflammatory efficacy of "Gamijoukyungtang(GJKT)". Methods: We studied inhibitory effects of platelet aggregation, FXa activation, $TXB_2$ and $PGE_2$ biosynthesis and suppressive effects of GPIIb/IIIa activity and oxidative damage, pro-inflammatory cytokine reduction effects of 'GJKT(by press extractor)/GJKT-1(by pressless extractor)' in vitro. Also, we studied suppression of pulmonary embolism, AV shunt model in rats and shortening of Rat tail bleeding time in vivo. Results: GJKT/GJKT-1 extract showed inhibitory effects on GPIIb/IIIaactivities and platelet aggregation induced by ADP, epinephrine, collagen and arachidonic acid. They suppressed biosynthesis of $PGE_2$ but GJKT-1 only supressed biosynthesis of $TXB_2$. In FXa assay, they inhibited activation of FXa. they suppressed pulmonary embolism triggered by collagen and epinephrine. In AV shunt model, they decreased the weights of AV shunt thrombus. they inhibited pro-inflammatory cytokines and decreased oxidative damages caused by DPPH. Conclusion: We confirmed the anti-thrombosis, and ant-inflammatory efficacy of 'GJKT(by press extractor)/GJKT-1(by pressless extractor)'.