• Journal of Chest Surgery
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• v.19 no.1
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• pp.35-42
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• 1986

Prevention of thrombombolism after rosthetic cardiac valve replacement is essential for the patients. About 90% of patients are free of major and minor thromboembolic complications 5 year after replacement of cardiac valves with prosthetic devices when they are under control of anticoagulant therapy. Ticlopidine is a drug that alter platelet function to have an antithrombotic effect. It is an antiaggregating agent which inhibits primary platelet function to have an antithrombotic effect. It is an antiaggregating agent which inhibits primary platelet aggregation induced by ADP and increases the production of prostaglandin $D_{2}$. Aspirin in small doses inhibits platelet synthesis of prostaglandins by irreversibly blocking the enzyme cyclo-oxygenase. Platelet secretion and aggregation are impaired with Ticlopidine and Aspirin. the thromboembolic event sof 54 patient s who were treated with Ticlopidine and Aspirin after cardiac valve replacement were evaluated and compared with that of 79 patients who were treated with Wafarin and Aspirin after the same type of operation. The follow-up period ranged from 4 to 110 months (mean of 48 months). there were 11 major thromboembolic episodes including three deaths in the warfarin goup during mean follow-up period of 56 months. two cases of CVA and one hemoarthrosis were noted due to overdose of Warfarin. Inticlopidine group, there was only one fatal thromboembolic epdisode three month after mitral valve replacement during mean follow-up period of 18 months. Two episodes of hypermenorrhea resulting anemia ere noted in the ticlopidine group. We measured the parameters of platelet function in aggreagation curve of platelet with platelet aggregometer (chrono-log Aggregometer, Model No. 430) Aggregation test was performed with three final concentrations of epinephrine in 10 uM/L, ADP in 5uM/L. 28 patients with prosthetic cardiac valves and 35 healthy volunteers were subgrouped as follows to analyze the effect of antithrombotic drugs used. Group I ; 11 patients treated with 250-500 mg of ticlopidine and 0.5gm of Aspirin as a daily single dose after cardiac valve replacement (14 St. Jude Medical and 1 Carpentier-Edwards, 9 patients with atrial fibrillation among them) Group II ; 10 patients treated with 3-5 mg of Warfarin and 0.75 gm of Aspirin daily to prolong prothrombin time around 20 seconds for more than 6 months and single Aspirin dose was maintained afterward as a life-long regimes(3 St. Jude Medical, 1 Hall-Kaster and 7 Carpentier-Edwards valve, 9 patients in atrial fibrilation). Group III ; 7 patients who quit anticoagulant treatment (Warfarin + Aspirin) 6-12 months after the regime as group II (3 St. Jude Medical. 1 bjork-Shiley, 1 Hall-Kaster, 3 Carpentier-Edwards valve, 2 of them are with atrial fibrillation). Group IV ; 35 healthy vounteers (28 males and 7 females). The following results were obtained. 1. The mean maximal platelet aggregability in Group I induced by 10uM/L epinephrine was 15.6%, and 17.5 and 18.7% in BM in proportion to the induction by 5 and 10 uM/L ADP. 2. The mean maximal platelet aggregability in Group II induced by 10uM/L epinephrine was 16.5%, and 27.4 and 44.7% in BM in proportion to the induction by 5 and 10uM/L ADP. 3. The mean maximal platelet aggregability in group III induced by 10uM/L epinephrine was 65%, and 56.5 and 51.8% in BM in proportion to the induction by 5 and 10 uM/L ADP. 4. The mean maximal platelet aggregability in the normal subjects induced by 10 uM/L epinephrine was 64%, and 65 and 69% in Bm inproportion to the induction by 5 and 10 uM/L ADP. 5. Reversible change of platelet aggregation curve induced by 5 and 10uM/L was noted all of the patients in Group I. conclusion : Ticlopidine is an antiaggregating agent which inhibits primary platelet aggregation induced by ADP, and increases the production of prostaglandin $D_{2}$. Ticlopidine and Aspirin produced a significant inhibition of platelet in the presence of ADP and epinephrine in our study. Acccording to our brief experience, 250 mg of ticlopidine and low dose of Aspirin resulted synergistic superior effect to each drug alone in prevention of thromboembolism after prosthetic cardiac valve replacement.

• The Journal of Korean Philosophical History
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• no.43
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• pp.9-32
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• 2014

Until now, the studies researching the Taoism theories of Joseon Dynasty have mainly dealt around the latter half of Joseon Dynasty. The reason for that was because the 5 cribs of a book Lao Tzu and the 2 crib of a book Changzi were produced after the Imjin-Year Korean-Japanese War(壬辰倭亂,Imjin Waeran). Therefore this thesis extracted the mentions about Taoism from about 200-year history records from Jeong Do-Jeon's Theory, which was the theoretical foundation for early days of Joseon's foundation and the history book King Taejong's Annals(太宗實錄) contained in The Annals of Joseon Dynasty(朝鮮王朝實 錄) and analyzed the extracted historic data as the first work contemplating how the Taoism theories were developed during the first half of Joseon Dynasty. From the analysis, this study drew out the findings as follows. Jeong Do-Jeon and Gwon Geun sharply criticized the Taoism for that it pursued for the techniques of longevity for oneself without moral. They tried to establish the identity of neo-Confucianism on the foundation criticizing the Taoism and the Buddhism. Since then, the Taoism was transformed through the 3 stages in The Annals of Joseon Dynasty. The first stage was the stage transformed 'Lao Tzu' as the witchcraft master of long-live, the technique of the taoist hermit and the super god in Taoism, and regarded the Taoism as heresy and excluded the Taoism. Second stage was the stage trying to see the book Lao Tzu as the core of Taoism theory separately from the 'Hermit Witchcraft' and the 'Taoist gods' the target of fortune-pursue religion beyond from the primary discussion of exclusion. Third stage was revealed as the respects on the art of politics and the art of living described in the book Lao Tzu. That is, the Taoism theories in the first half of Joseon Dynasty was developed with various spectrums from the early days of Joseon's foundation to 15~16 centuries beyond Joseon's strong suppression against the Taoism and the Buddhism in early days. That is the point that the Taoism in the first half of Joseon Dynasty can't be simply interpreted in the neo-Confucianism. During the firs half of Joseon Dynasty, the warm attitude toward the Taoism was created differently from the attitude against suppressing it as a cult, which had been created in the early days of Josen's foundation, and there appeared the changes accepting the art of living and the art of politics theoretically integrating with the Confucianism theories. That is, the book 'Lao Tus' became accepted as the Confucian country's arts of living and politics from a cult book pursuing for immoral log and immortal life. Such acception is revealed as the appearance actively interpreting the books about Laoism in the latter half o Joseon Dynasty.