• Journal of Animal Science and Technology
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• v.62 no.6
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• pp.933-947
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• 2020

This study was conducted to develop an effective heparin extraction method by using low-cost and highly effective enzymes from six pig by-products (liver, lung, heart, stomach, small intestine, and large intestine), and analyze their bioavailability. Low-cost and highly effective enzymes (alkaline-AK and papain) and a common enzyme (trypsin) were used for the heparin extraction. The angiotensin I- converting enzyme (ACE) inhibitory activity and the antimicrobial activity of extracted heparin were analyzed to verify their bioavailability. The average amount of heparin extracted per kilogram of pig by-products was 439 mg from the liver, 127 mg from the lung, 398 mg from the heart, 261 mg from the stomach, 197 mg from the small intestine, and 239 mg from the large intestine. Various enzymes were used to extract heparin, and the amount of extracted heparin was similar. Based on 1 g of pig by-product, the enzymes trypsin, papain, and alkaline-AK could extract 1,718 mg, 1,697 mg, and 1,905 mg of heparin, respectively. Heparin extracted from pig by-products showed antihypertensive activity and antimicrobial activity against Staphylococcus aureus at low populations. These results indicated that heparin can be obtained from pig by-products at a low cost.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.46 no.4
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• pp.228-234
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• 2020

Objectives: The number of patients undergoing oral anticoagulant therapy for cardiovascular and cerebrovascular disease is increasing. However, the risk of bleeding after tooth extraction in patients receiving warfarin is unclear. Here, we assess the risk of bleeding after tooth extraction in patients on warfarin. Materials and Methods: The study included 260 patients taking warfarin who underwent tooth extraction (694 teeth). The patients were divided into those whose teeth were extracted while they were taking warfarin, those who discontinued warfarin before extraction, and those who underwent extraction while receiving heparin bridging therapy. Bleeding complications in the two groups were compared. Results: Of the 260 patients, 156 underwent extraction while taking warfarin, 70 stopped taking warfarin before extractions, and 34 received heparin bridging therapy and stopped taking either medication before extractions. Bleeding complications occurred in 9 patients (3.5%) and 9 tooth sites (1.3%). Among the 9 patients with bleeding complications, 6 underwent extraction while taking warfarin, 2 stopped warfarin before extraction, and 1 underwent extraction after receiving heparin bridging therapy. No significant difference was seen between patient groups regarding bleeding after extractions (P=0.917). Conclusion: Warfarin use does not increase the risk of post-extraction bleeding and can therefore be continued during tooth extraction.

• 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.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.8 no.1
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• pp.15-21
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• 2012

Extraction of all nonrestorable teeth prior to bone marrow transplantation is the major dental management of the patient being prepared for the transplantation. But, there are four principal causes for excessive bleeding in the immediate postextraction phase ; (1) Vascular wall alteration (wound infection, scurvy, chemicals, allergy) (2) Disorders of platelet function (3) Thrombocytopenic purpuras (4) Disorders of coagulation (liver disease, anticoagulation drug-heparin, coumarin, aspirin, plavix) If the hemorrhage from postextraction wound is unusually aggressive, the socket must be packed with local hemostatic agent and wound closure & pressure dressing are applied. But, in dental alveoli, local hemostatic agent (gelfoam, surgcel etc) may absorb oral microorganisms and cause alveolar osteitis (infection). This is a case report of bleeding and infection control by suture, pressure packing and iodoform gauze drainage on infected active bleeding extraction socket under sedation and local anesthesia in a 57-years-old multiple disabled patient with anticoagulation drug.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.43 no.5
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• pp.351-355
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• 2017

Prior to the advent of efficacious antimicrobial agents, the mortality rate from cavernous sinus thrombosis (CST) was effectively 100%. There have been very few reports of CST associated with tooth extraction. A 40-year-old female presented to the emergency room with swelling over the right side of the face and history of extraction in the upper right region by an unregistered dental practitioner. The patient presented with diplopia, periorbital ecchymosis, and chemosis of the right eye. A computed tomography scan revealed venous dilatation of the right superior ophthalmic vein. The patient was immediately treated with incision and drainage, intravenous antibiotics, and heparin (low molecular weight). Unfortunately, the patient died two days after surgery due to complications from the disease. CST is a rare disease with a high mortality rate. Therefore, dental health education in rural areas, legal action against unregistered dental practitioners, early diagnosis, and aggressive antibiotic treatment can prevent future mortality resulting from CST.

• Journal of The Korean Dental Society of Anesthesiology
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• v.11 no.2
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• pp.177-182
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• 2011

There are five principal causes for excessive bleeding in the immediate postextraction phase ; (1) Vascular wall alteration (wound infection, scurvy, chemicals, allergy) (2) Disorders of platelet function (genetic defect, drug-aspirin, autoimmune disease) (3) Thrombocytopenic purpuras (radiation, leukemia), (4) Inherited disorders of coagulation (hemophilia, Christmas disease, vitamin deficiency, anticoagulation drug-heparin, coumarin, aspirin, plavix). If the hemorrhage from postextraction wound is unusually aggressive, and then dehydration and airway problem are occurred, the socket must be packed with gelatine sponge(Gelfoam) that was moistened with thrombin and wound closure & pressure dressing are applied. The thrombin clots fibrinogen to produce rapid hemostasis. Gelatine sponges moistened with thrombin provide effective coagulation of hemorrhage from small veins and capillaries. But, in dental alveoli, gelatine sponges may absorb oral microorganisms and cause alveolar osteitis (infection). This is a case report of bleeding and infection control by the circumferential suture and iodoform gauze drainage on infected active bleeding extraction socket under sedation and local anesthesia in a 71-years-old male patient with anticoagulation drug.

• Korean Journal of Pharmacognosy
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• v.42 no.1
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• pp.68-75
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• 2011

A new lectin was purified from Bombyx mori (BML) by physiological saline extraction, ammonium sulfate precipitants, anion exchange column chromatography on DEAE Sephadex A-50 and gel filtration column chromatography on Sephadex G-200. BML agglutinated trypsinized and glutaraldehyde-fixed erythrocytes, and was observed the most high activity with rabbit, chicken erythrocytes and rat splenic lymphocytes. Agglutinability was markedly affected at highly acidic pH, but was relatively stable with high temperature. The effect of metal ions was observed and BML was affected by bivalaent cations, especially depending on $Ca^{2+}$, $Fe^{2+}$, $Mn^{2+}$, whereas, inhibited by $Mg^{2+}$. Agglutination was strongly inhibited by heparin and glucuronic acid. BML was proved to be a glycoprotein which contains 17.16% of sugars. By mass spectrometry analysis, we found 2 bands that were considered as lectin subunits.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.35 no.6
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• pp.431-436
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• 2009

There are five principal causes for excessive bleeding in the immediate postextraction phase ; (1) Vascular wall alteration (wound infection, scurvy, chemicals, allergy) (2) Disorders of platelet function (genetic defect, drug-aspirin, autoimmune disease) (3) Thrombocytopenic purpuras (radiation, leukemia), (4) Inherited disorders of coagulation (hemophilia, Christmas disease, vitamin deficiency, anticoagulation drug-heparin, coumarin). If the hemorrhage from postextraction wound is unusually aggressive, and then dehydration and airway problem are occurred, the socket must be packed with gelatine sponge(Gelfoam) that was moistened with thrombin and wound closure & pressure dressing are applied. The thrombin clots fibrinogen to produce rapid hemostasis. Gelatine sponges moistened with thrombin provide effective coagulation of hemorrhage from small veins and capillaries. But, in dental alveoli, gelatine sponges may absorb oral microorganisms and cause alveolar osteitis (infection). This is a case report of bleeding control by continuous rubber strip & iodoform gauze drainage (without gelfoam packing) of active bleeding infection sites of three teeth extraction wounds in a 46-years-old female patient with advanced liver cirrhosis.

• Journal of the Korean Society of Food Science and Nutrition
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• v.29 no.4
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• pp.712-718
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• 2000

The alkali extraction of anticoagulant from a clove revealed 3-to 6-fold more effective than hot-water extraction. The highest anticoagulant activity was found with 0.1 N NaOH at 7$0^{\circ}C$. The anticoagulant fractions from a clove, EC-2B and EC-2C were separated by alkali extraction, ethanol precipitation, cetavlon treatment, and ultrafiltration. The anticoagulant activities of these two fractions were, respectively, 6.57 and 8.63 times higher than those extracted with hot-water. As of the sensory evaluation, boiled pork added with EC-2B fraction revealed similar sensory acceptability to raw clove material, while EC-2C fraction had low sensory acceptability due to a mild chemical odor. Antibacterial characteristics against pathogenic microorganism of both fractions were confirmed in the control strain. The inhibitory effect of growth by EC-2B was noticed above 0.016% in S. aureus. Also, EC-2C showed the inhibitory effect at 0.004% in both E. cole and S. aureus control strains.

• Journal of Ginseng Research
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• v.23 no.4
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• pp.217-221
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• 1999

We have isolated an antithrombin active polysaccharide in red ginseng by procedures comprising three major steps involving alkaline extraction, anion exchange and gel permeation chromatography. Active polysaccharide behaved as a single band on cellulose acetate membrane electrophoresis. The average molecular mass was estimated to be about 177 kDa by gel filtration. This polysaccharide was found to be an acidic heteropolysaccharide that contains uronic acid moiety $(40.2\%)$, sulfate group $(9.2\%)$ and protein $(1.5\%)$ in addition to neutral sugar consisted of rhamnose, mannose, galactose, arabinose, glucose, fucose and xylose in a molar ratio of 1.00 : 0.88 : 0.86 : 0.78: 0.70 : 0.33 : 0.22. This polysaccharide inhibited blood coagulation via the intrinsic pathway like heparin in a dose-dependent manner. The clotting of fibrinogen by thrombin was also mitigated by the presence of this polysaccharide.