• The Journal of Korean Obstetrics and Gynecology
• /
• v.18 no.1
• /
• pp.1-14
• /
• 2005

This study was performed to evaluate antithrombotic activities of Saegeumsan (瑞金散, SGS) which has effects of activating blood, removing thrombus. This study is designed to measure the effect which was given to blood flow rate through the regular volume of glass tube after the blood was diluted five times with ACD solution. Antithrombotic effect was calculated as a percentage of the experimental animal figure protected from the paralysis of hind legs or death of the mouse that is caused from the administration of platelet aggregation regent. We standardized the time when the experimental animals were incapable of functioning the hind legs more than 20 minutes or maintained trembling. Being classified one group of eight mice, each of them was divided into Normal, Control, and SGS. The normal group supplied a saline solution and the control group brought the dextran extravasated blood after an hour of administering the saline solution. Also, SGS was dissolved in $2m{\ell}$ saline solution and then we dosed it to the experimental mice with Oral Zonde one day before the experiment. After that, the mice were abstained from food. And then we gave a measured amount of it before an hour. Finally, it gave rise to dextran extravasated blood in the same way as the Control group. The results were obtained as follows, SGS significantly inhibited platelet aggregation induced by ADP and epinephrine when analyzed by the Sigmoid $E_{max}$ model in WinNonlin. $EC_{50}$ values of SGS were 4.61 mg/ml and 12.41 mg/ml for ADP and epinephrine respectively. SGS showed fibrinolytic activity insignificantly as compared with the control group. SGS increased blood flow rate significantly as compared with the control group in vitro. SGS inhibited pulmonary embolism induced by collagen and epinephrine(inhibitive rate is 37.5 %). SGS increased number of platelet and fibrinogen amount significantly, and shortened PT and APTT as compared with the control group in thrombus model induced by dextran. According to, SGS is effective antithrombotic activity from experimental result.

• The Journal of Korean Obstetrics and Gynecology
• /
• v.22 no.3
• /
• pp.99-116
• /
• 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.

• Journal of Digestive Cancer Research
• /
• v.1 no.2
• /
• pp.104-107
• /
• 2013

Gallbladder (GB) cancer is highly malignant neoplasm found in advanced stage and chemotherapy commonly plays a palliative role in GB cancer. We report a case of unresectable GB cancer treated with chemotherapy followed by extended cholecystectomy. Fifty-six-year-old male visited our hospital with weight loss and dyspnea on exertion. Computed tomography detected pulmonary embolism and diffuse GB wall thickening with para-aortic lymph node enlargement. The length of common channel was 23mm at magnetic resonance cholangiopancreatography which stands for anomalous union of the pancreaticobiliary duct. Anticoagulation was started for pulmonary embolism. GB wall mass was regarded as unresectable GB cancer with distant lymph node metastasis. Gemcitabine and cisplatin combination chemotherapy was carried out for 6 cycles. Primary tumor was stationary but multiple enlarged lymphnodes were almost completely disappeared. Extended cholecystectomy with hepaticojejunostomy was performed. Post-operative tumor stage was T3N1 (stage IIIB) and R0 resection was achieved. After operation he has no evidence of disease recurrence for 6 months.

• Journal of the Korean Society of Radiology
• /
• v.84 no.4
• /
• pp.891-899
• /
• 2023

Purpose To survey perceptions of certified physicians on the protocol of chest CT in patients with coronavirus (COVID-19) using a negative pressure isolation stretcher (NPIS). Materials and Methods This study collected questionnaire responses from a total of 27 certified physicians who had previously performed chest CT with NPIS in COVID-19 isolation hospitals. Results The nine surveyed hospitals performed an average of 116 chest CT examinations with NPIS each year. Of these, an average of 24 cases (21%) were contrast chest CT. Of the 9 pulmonologists we surveyed, 5 (56%) agreed that patients who showed abnormalities in serum D-dimer required contrast chest CT. All 9 surveyed radiologists agreed that the image quality of the chest CT with NPIS was sufficient for CT image interpretation regarding pneumonia or pulmonary embolism. Furthermore, in our 9 surveyed infectionologists, 5 (56%) agreed that a risk of secondary infection in the CT room after temporary opening of NPIS could be prevented through a process of disinfection. Conclusion Experienced physicians considered that the effects of NIPS on chest CT image quality was minimal in patients with COVID-19, and the risk of CT room contamination was easily controlled.

• Journal of Chest Surgery
• /
• v.41 no.5
• /
• pp.591-597
• /
• 2008

Background: Pulmonary endarterectomy is widely accepted as a treatment for chronic thromboembolic pulmonary hypertension. Based on our experiences, we sought to find ways to reduce perioperative complications and to improve surgical outcomes in patients undergoing pulmonary endarterectomy. Material and Method: This study was designed as a retrospective analysis of 20 patients with pulmonary hypertension who underwent pulmonary endarterectomy between January 1998 and March 2008. All patients presented with chronic dyspnea. Deep vein thrombosis (DVT) was the major cause of chronic pulmonary thromboembolism (55%). Seventeen patients (85%) underwent inferior vena cava (IVC) filter placement. Thirteen patients underwent surgery under total circulatory arrest, while the others underwent surgery while on low flow cardiopulmonary bypass. Concomitant tricuspid annuloplasty was done in 6 patients (66%) whose tricuspid regurgitation was as severe as grade IV/IV. The mean follow-up duration was $45{\pm}32$ months. Result: Using of University of California, San Diego (UCSD), thromboembolism classification, 4 patients (20%) were type 1, 8 patients (40%) were type II, and 8 patients (40%) were type III. Right ventricular systolic pressure was reduced significantly from $77{\pm}29$ mmHg to $37{\pm}19$ mmHg after pulmonary endarterectomy (p<0.001). The degree of tricuspid regurgitation and the NYHA functional class were all improved postoperatively. Reperfusion edema occurred in 7 cases (35%). The incidence of reperfusion edema was higher in the UCSD type III group than in the other group (25% vs 50%, p=0.25) and the length of postoperative intensive care unit stay was longer in type III group ($5{\pm}2$ days vs $9{\pm}7$ days, p=0.07). The early mortality rate was 10%, and the late mortality rate was 15% (n=3); one death was due to progression of underlying non-Hodgkin's lymphoma, and the other deaths were related to recurrent thromboembolism and persistent pulmonary hypertension, respectively. Conclusion: Pulmonary endarterectomy, as a curative surgical method for treating chronic thromboernbolic pulmonary hypertension, should be performed aggressively in patients diagnosed with chronic thromboembolic pulmonary hypertension, and an effort should be made to reduce the frequency of perioperative complications and to improve surgical outcomes.

• Tuberculosis and Respiratory Diseases
• /
• v.54 no.1
• /
• pp.5-14
• /
• 2003

Background : According to the study in ICOPER (International Cooperative Pulmonary Embolism Registry), the overall mortality rate of acute pulmonary thromboembolism (APTE) at 3 months is 17.4%. According to the study for current status of APTE in Japan, the hospital mortality rate is 14%. Although the incidence and mortality rate of APTE has been increasing, patient characteristics, management strategies, and outcome of APTE in the Korean population have not yet been assessed in large series. We therefore performed the national survey for the current status of APTE in the Korean population. Methods : 808 registry patients with APTE were analyzed with respect to clinical characteristics, risk factors, diagnostic procedures, treatment, and clinical outcome. Results : Main risk factors were immobilization, recent major surgery, and cancer. Common symptoms were dyspnea and chest pain. Common signs were tachypnea and tachycardia. The majority of registry patients underwent lung perfusion scanning. Spiral CT was used in 309 patients(42.9%), and angiography in 48 patients(7.9%). Heparin was the most widely used treatment. On multivariate logistic regression analysis, onset in hospital (odds ratio 1.88, p=0.0385), lung cancer (odds ratio 9.20, p=0.0050), tachypnea (odds ratio 3.50, p=0.0001), shock (odds ratio 6.74, p=0.0001), and cyanosis (odds ratio 3.45, p=0.0153) were identified as significant prognostic factors. The overall mortality rate was 16.9% and mortality associated with APTE was 9.0%. Conclusions : The present registry demonstrated the clinical characteristics, diagnostic strategies, management and outcome of patient with APTE in Korea. The mortality rate was 9.0%, and the predictors of mortality were onset in hospital, lung cancer, tachypnea, shock, and cyanosis. These results may be important for risk stratification as well as for the identification of potential candidates for more aggressive treatment.

• The Korean Journal of Nuclear Medicine
• /
• v.20 no.2
• /
• pp.73-78
• /
• 1986

Of 18 patients with Takayasu's arteritis who underwent $^{99m}Tc-MAA$ (macroaggregated albumin) perfusion luing scanning, 9 (50%) showed perfusion defects. Chest X-rays of them were nonspecific. One patient underwent $^{99m}Tc-DTPA$ radio aerosol inhalation lung scanning simultaneously, which revealed normal. So routine screening radioisotope perfusion lung scanning is helpful to evaluate pulmonary arterial involnmement in Takayasu's arteritis patients. And Takayasu's arteritis should be included in differential diagnosis of pulmonary embolism.

• Journal of Chest Surgery
• /
• v.22 no.6
• /
• pp.1025-1035
• /
• 1989

Since we first performed open heart surgery on December 30, 1986, 126 cases were operated on up to August 31, 1989. Among the 126 cases, 65 cases were congenital heart disease of which 63 were acyanotic disease, and 61 cases were acquired heart disease, most of which were valvular heart disease. The age distribution of congenital heart disease was from 1 years 2 months to 48 years, and males had a slightly higher incidence. The age of acquired heart disease was from a minimum of 15 years to a maximum of 68 years, and the male to female ratio was 1;1.5. Midsternotomy was performed in all cases, and the aortic cannula was inserted through ascending aorta and the venous cannula inserted into the SVC and IVC through the right atrium. Vent was inserted through the right superior pulmonary vein. Cardioplegia solution was used in all cases; it was composed of sodium bicarbonate 3.5 ampule, KCL 14 mEq, 2% lidocaine 2.5 ml, 20 % albumin 50 ml and heparin 1000 units mixed to 950 ml with Hartman solution, and was made to 4oC and infused 10 ml per Kg every 20 minutes. The congenital heart disease had a variety of VSD in 32 cases, ASD 23 cases, PS 6 cases, PDA 2 cases, and one case each of Ebsteins anomaly and tricuspid atresia. The operations performed for acquired heart disease were 4 cases of OMC, 33 cases of MVR, and 5 cases of AVR, and 1 case of AVR with CABG. DVR was perfomed in 13 cases, and triple valve replacement was done in 1 case. Other than these, excision of LA myxoma was 2 cases, and repair of traumatic VSD and removal of a pulmonary embolism were one case each. The surgical mortality was 5 cases[4%], all of which occurred in valve replacement cases. Follow-up study revealed 2 late deaths. One died after a traffic accident and one died due to sepsis after he had received a gastrectomy for ulcer bleeding. The remaining patients were in good condition.

• Journal of Digestive Cancer Research
• /
• v.1 no.2
• /
• pp.108-110
• /
• 2013

The relationship between malignancy and venous thromboembolism(VTE) has been well established. About 20% of all VTE cases are associated with cancer and thrombotic events are the second leading cause of death in cancer patients after death from cancer itself. Effective prophylaxis and treatment will reduce morbidity and may decrease overall mortality. We report a case of VTE in a patient with advanced gastric cancer who treated with low-molecular weighted heparin (LMWH). A 49-year-old man with heartburn was admitted to our hospital. On the endoscopic and radiologic imaging, the patient was diagnosed as an advanced gastric cancer with perigastric infiltration and liver metastasis. During the combination chemotherapy, he had pain and swelling of left lower leg. Doppler ultrasonography showed left posterior tibial venous thrombosis and pulmonary embolism CT showed thromboembolism in subsegmental pulmonary artery branch in right lower lobe. He was treated with LMWH, Dalteparin once daily via subcutaneous injection, and his symptoms was subsided.

• Tuberculosis and Respiratory Diseases
• /
• v.47 no.1
• /
• pp.103-110
• /
• 1999

A thromboembolic event in patients later given a diagnosis of cancer is the result rather than the cause of the cancer. The risk of hidden cancer is significantly higher for patients with recurrent idiopathic thromboembolism compared to those with secondary deep vein thrombosis. Microemboli from hepatic or adrenal metastases and large-sized emboli from the great veins invaded by the tumor are the sources of tumor embolization The intraarterial tumor emboli less likely invade the arterial wall. Thrombus formation and organization may be capable of destroying tumor cells within pulmorlary blood vessels. Therefore, all tumor emboli are not true metastases. The treatment of deep vein thrombosis and pulmonary embolism in patients with cancer consists of anticoagulation with heparin and warfarin, venacaval filters, appropriate anti-neoplastic agents, and surgical methods(embolectomy, thromboendarterectomy). However, considerable literatures suggest that oral anticoagulant such as warfarin is ineffective in the treatment of those. We report a case of primary unknown squamous cell carcinoma incidentally found in the thrombus after pulmonary embolectomy.