• Journal of Life Science
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• v.29 no.3
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• pp.382-393
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• 2019

Wound care is a health industry concern affecting millions worldwide. Recent increase in metabolic disorders such as diabetes comes with elevated risk of wound-based complications. Treatment and management of wounds are difficult practices due to complexity of the wound healing process. Conventional wound dressings and treatment applications only provide limited benefits which are mainly aimed to keep wound protected from external factors. To improve wound care, recent developments make biopolymers to be of high interest and importance to researchers and medical practitioners. Biopolymers are polymers or natural origin produced by living organisms. They are credited to be highly biocompatible and biodegradable. Currently, studies reported biopolymers to exhibit various health beneficial properties such as antimicrobial, anti-inflammatory, hemostatic, cell proliferative and angiogenic activities which are crucial for effective wound management. Several biopolymers, namely chitosan, cellulose, collagen, hyaluronic acid and alginic acid have been already investigated and applied as wound dressing agents. Different derivatives of biopolymers have also been developed by cross-linking with other molecules, grafting with other polymers, and loading with bioactive agents or drugs which showed promising results towards wound healing without any undesired outcome such as scarring and physiological abnormalities. In this review, current applications of common biopolymers in wound treatment industry are highlighted to be a guide for further applications and studies.

• Korean Journal of Clinical Laboratory Science
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• v.51 no.1
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• pp.34-41
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• 2019

Platelet aggregation is essential for the formation of a hemostatic plug in the case of blood vessel damage. On the other hand, excessive platelet aggregation may cause cardiovascular disorders, such as thrombosis, atherosclerosis, and myocardial infarction. Scopoletin, which found in the root of plants in the genus Scopolia or Artemisia, has anti-coagulation and anti-malaria effects. This study examined the effects of scopoletin on human platelet aggregation induced by collagen. Scopoletin had anti-platelet effects via the down-regulation of thromboxane $A_2$ ($TXA_2$) production and intracellular $Ca^{2+}$ mobilization ($[Ca^{2+}]_i$), which are aggregation-inducing molecules produced in activated platelets. On the other hand, scopoletin increased both the cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP) levels, which are known as intracellular $Ca^{2+}$-antagonists and aggregation-inhibiting molecules. In particular, scopoletin increased the potently cAMP level more than cGMP, which led to suppressed fibrinogen binding to ${\alpha}IIb/{\beta}_3$ in collagen-induced human platelet aggregation. In addition, scopoletin inhibited collagen-elevated adenosine triphosphate (ATP) release in a dose-dependent manner. The results suggest that aggregation amplification through granule secretion is inhibited by scopoletin. Therefore, scopoletin has potent anti-platelet effects and may have potential for the prevention of platelet-derived vascular diseases.

• Journal of Rhinology
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• v.25 no.2
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• pp.86-90
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• 2018

Background and Objectives: Although polyvinyl acetate ($Merocel^{(R)}$) has been widely used as a packing material after septoplasty, removable nasal packing can increase patient discomfort, local pain, and pressure. Furthermore, the removal of nasal packing has been described as the most uncomfortable and distressing feature associated with septoplasty. The purpose of this study was to investigate the efficacy of polyvinyl acetate with carboxymethyl cellulose sheet ($Rhinocel^{(R)}$) nasal packing on patient subjective symptoms, degree of bleeding, hemostasis, and wound healing following septoplasty. Subjects and Method: Forty patients with nasal septum deviation requiring septoplasty were included. Following surgery, one nasal cavity was packed with $Rhinocel^{(R)}$ and the other one with $Merocel^{(R)}$. Patient subjective symptoms while the packing was in situ, hemostatic properties, pain on removal, degree of bleeding on removal, duration of hemostasis after removal, postoperative wound healing, and the cost of the pack were evaluated. Results: Although the two types of packing materials were equally effective in controlling postoperative bleeding after septoplasty, $Rhinocel^{(R)}$ was significantly more comfortable while in situ and less painful on removal than $Merocel^{(R)}$, which was associated with significantly more bleeding on removal and so more time was needed to control hemorrhage. There was no significant difference in postoperative wound healing or pack cost. Conclusion: The use of $Rhinocel^{(R)}$ after septoplasty has less discomfort, greater patient satisfaction, and less bleeding on removal with no adverse reactions compared to $Merocel^{(R)}$ packing. Therefore, $Rhinocel^{(R)}$ may be a useful packing material after septoplasty.

• Journal of Chest Surgery
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• v.30 no.7
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• pp.677-685
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• 1997

Thromboelastography(TEG) is the unique measure that gives rapid information about the whole clotting process. Simplifying the diagnosis of coagulopathy during operations, TEG can provide an adequate therapy for postoperative bleeding. Remarkable improvement in hemostasis after cardiopulmonary bypass(CPB) has been achieved by the treatment with proteinase inhibitor aprotinin, but the hemostatic mechanism of aprotinin during CPB is still unclear. This study was designed to evaluate the effects of aprotinin on coagulation system during CPB by using TEG. Forty patients who underwent CPB were divided into two groups: aprotinin(2u 106 kallikrein inhibition units, as a single dose into the cardiopulmonary bypass priming solution) treatment group(male 14, female 8, mean age=50.Byears) and no aprotinin treatment(control) group(male 10, female 8, mean age=53.4 years). TEG, activated clotting time, prothrombin time, activated partial thromboplastin time, platelet counts, fibrinogen an (ibrinogen degradation product(FDP) concentrations were checked before and after CPB(30 minutes after neutralization of heparin effect by protamine sulfate). There was no significant difference in other conventional coagulation tests of two groups except postcardiopulmonary bypass FDP concentration in control group, which was significantly increased compared to that in aprotinin group(p<0.05). In TEG variables of both groups, clot formation time(K) and alpha $angle(\alpha^{\circ})$ were significantly increased and decreased, respectively, after CPB(p<0.05), but fibrinolytic index(LYS60) was not changed during CPB. In aprotinin group, reaction time(R) was decreased significantly after CPB(p<0.05) but maximum amplitude(MA) was not changed(p>0.05). On the contrary, R was not changed markedly but MA was decreased significantly in control group after CPB(p<0.05). This result shows that main change in coagulation system during CPB is not hyperfibrinolysis but cecrease in clot strength by platelet dys unction, and the main effect of aprotinin during cardiopulmonary bypass is the maintenance of clot strength to the pre-CPB level by the preservation of platelet function.

• Journal of Chest Surgery
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• v.32 no.4
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• pp.333-340
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• 1999

Background: Plasminogen activator inhibitor-1(PAI-1) is known as the primary physiological inhibitor of tissue-type plasminogen activator(t-PA) in the plasma, and is present within the atherosclerotic vessels. Increased plasma levels of PAI-1 are one of the major disturbances of the hemostatic system in patients with diabetes and/or hypertension, and may have multiple interrelations with the important risk factors in the development of atherosclerosis. This study was performed to determine whether altered gene expression of PAI-1 occurs within the arterial wall, and thereby potentially contributing to the increase of cardiovascular risks associated with diabetes and/or hypertension. Material and Method: The aortic vascular smooth muscle cells of the rat were exposed to 22 mM glucose, angiotensin II, and insulin increased PAI-1 mRNA expression with the use of Northern blotting were examined. Also examined were the effects of 22 mM glucose, angiotensin II and insulin on the growth of the rat's aortic smooth muscle cells by using MTT assay. Result: Twenty-two mM glucose treatment increased the PAI-1 mRNA expression in a time- and dose-dependent manner. Aniotensin II treatment synergistically increased the glucose-induced PAI-1 mRNA expression. In contrast, addition of insulin attenuated the increase of 22 mM glucose and angiotensin II induced PAI-1 mRNA expression. Furthermore, treatment of 22 mM glucose, angiotensin II and insulin resulted in a significant increase in cell numbers. This study demonstrated that 22 mM glucose and angiotensin II have a synergistic effect in stimulating the PAI-1 mRNA expression and in the cell growth of the rat's aortic smooth muscle cells. Conclusion: Elevation of glucose and angiotensin II may be important risk factors in impairing fibrinolysis and developing atherosclerosis in diabetic patients.

• Journal of radiological science and technology
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• v.39 no.4
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• pp.615-622
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• 2016

The 18~20G needle is used to computer tomography (CT) contrast examination. Therefore, a patient has to apply a self-administering hemostasis (conventional method: CM) and often experience bleeding in the course. Thus, we developed the new disposable transparent tourniquet (TT) for reducing. This study was to compare the usefulness between the proposed transparent tourniquet and the existing hemostatic methods. A Satisfaction survey was conducted by 50 patients and 25nurses. The survey contained the satisfaction of the convenience, safety, sanitation, and wearing sensation of transparent tourniquet. We employed face-to-face interview on 5 points likert scales. And Chi-square, paired T-test were used for the statistics verification. As for the patients, the satisfaction levels were measured for each category with the gender, age. Patients evaluation, overall satisfaction high average sore used TT and there were statistical significance by paired T-test(p<0.05). The following is the average satisfaction level for each category: $4.4{\pm}0.53$ in; $4.28{\pm}0.57$ in safety; $4.52{\pm}0.54$ in sanitation; $4.16{\pm}0.54$ in wearing sensation. So the overall satisfaction level is measured at $4.34{\pm}0.51$. As for the nurses, CT work experience and the current satisfaction with tourniquet were counted as variables. The satisfaction level for each category is: $3.8{\pm}0.7$ in; $3.6{\pm}0.68$ in safety; $3.4{\pm}0.5$ in sanitation; $3.9{\pm}0.49$ in hemostasis. The overall satisfaction level is $3.8{\pm}0.3$. Patients' satisfaction levels were very high with little difference among variables. Nurses' satisfaction levels were different with the TT depending on their work experience but their overall satisfaction was high. This TT will be a starting point to minimizing patient's inconvenience and more studies are necessary to enhance their satisfaction.

• Journal of Chest Surgery
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• v.37 no.10
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• pp.817-826
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• 2004

Background: Several studies have demonstrated that conventional hypothermic cardiopulmonary bypass (CPB) causes cellular injury, abnormal responses in peripheral vascular beds and increased postoperative bleeding, whereas normothermic CPB provides protection of the hypothermic-induced effects and better cardiac recovery. The present study was prospectively performed to compare the effects of normothermic CPB to those of hypothermic CPB on the inflammatory and hematologic responses during cardiac surgery. Material and Method: Thirty-four adult patients scheduled for elective cardiac surgery were randomly assigned to hypothermic CPB (nasopharyngeal temperature $26～28^{\circ}C,$ n=17) or normothermic CPB (nasopharyngeal $temperature>35.5^{\circ}C,$ n=17) group. In both groups, cold $(4^{\circ}C)$ crystalloid cardioplegia was applied for myocardial protection. Blood samples were drawn from radial artery before (Pre-CPB), 10 minutes after starting (CPB-10) and immediately after ending (CPB-OFF) CPB. Total leukocyte and platelet counts, interleukin-6 (IL-6) level(expressed as percent to the baseline of Pre-CPB), D-dimer level, protein C and protein S activity were measured with the blood samples. The amount of bleeding for postoperative 24 hours and blood transfusion after operation were also assessed. All parameters were compared between the two groups. Result: The total leukocyte counts $(10,032\pm65/mm^3)$ and the increased ratio of IL-6 $(353\pm7.0%)$ at CPB-OFF in the normothermic group were higher than that $(7,254\pm48/mm^3$ and $298\pm7.3%)$ of the hypothermic group(p=0.02 and p=0.03). In the normothermic group, protein C activity $(32\pm3.8%)$ and protein S activity $(35\pm4.1%)$ at CPB-OFF were significantly lower than that $(45\pm4.3%$ and $51\pm3.8%)$ of the hypothermic group (p=0.04 and p=0.009). However, there were no differences in platelet counts and D-dimer concentration. In the normothermic group, the amount of bleeding for postoperative 24 hours $(850\pm23.2$ mL) and requirements for blood transfusion after operation such as packed cell $(1,402\pm20.5$ mL), fresh frozen plasma $(970\pm20.8$ mL) and platelet $(252\pm6.4$ mL) were higher than that $(530\pm21.5$ mL, $696\pm15.7$ mL, $603\pm18.2$ mL and $50\pm0.0$ mL) of the hypothermic group. Conclusion: These results indicate that normothermic CPB with cold crystalloid cardioplegia was associated with higher increase in inflammatory response, hemostatic abnormalities and postoperative bleeding problem than moderate hypothermic CPB.