• Title/Summary/Keyword: Pulmonary embolism

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A Case of Advanced Gastric Cancer with Deep Vein Thrombosis Treated with Low Molecular Weighted Heparin (전이성 위암환자의 심부정맥혈전증에 대한 저분자량 헤파린 투여 사례)

  • Su Jin Heo;Chan Hyuk Park;Sang Kil Lee
    • Journal of Digestive Cancer Research
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    • v.1 no.2
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    • pp.108-110
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    • 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.

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A Case of Primary Unknown Squamous Cell Carcinoma Incidentally Found in the Thrombus After Pulmonary Embolectomy (폐색전 제거술 후 혈전에서 우연히 확인된 원발 미상 편평 상피 세포암 1예)

  • Choi, Chang-Hwan;Park, Young-Soo;Ryu, Dong-Ryeol;Park, Sung-Ha;Ko, Won-Ki;Ahn, Kang-Hyun;Park, Jae-Min;Kim, Se-Kyu;Chang, Joon;Kim, Sung-Kyu;Lee, Won-Young
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.1
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    • pp.103-110
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    • 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.

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Periareolar Augmentation Mastopexy with Interlocking Gore-Tex Suture, Retrospective Review of 50 Consecutive Patients

  • Franco, Johnny;Kelly, Emma;Kelly, Michael
    • Archives of Plastic Surgery
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    • v.41 no.6
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    • pp.728-733
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    • 2014
  • Background Periareolar Augmentation Mastopexy is one of the most challenging operations in plastic surgery. Problems with scar quality, areolar widening, and distortion are frequent problems that interfere with a predictable result. Methods A retrospective review was performed on fifty consecutive patients who underwent a periareolar augmentation mastopexy with the interlocking approach. Of the 50 patients, 30 had both preoperative and postoperative photographs and were the basis of the study. Results The age of the patients ranged from 19 to 56 years with the average age being 39 years. The postoperative follow-up averaged 9.5 months and the implants averaged 316 mL. There were no deaths, pulmonary embolism, deep vein thrombosis, or infected implants. Four patients had complications following surgery for an overall complication rate of 13%. Two patients developed an infected Gore-Tex suture. Two of these complications were treated with revision surgery. Five patients required reoperation for an overall reoperative rate of 16% (one patient was converted to a full mastopexy). Conclusions As a result of this retrospective study, we have found the interlocking approach to periareolar augmentation/mastopexy to be a safe and reliable operation.

Hypotension during Percutaneous Vertebroplasty with PMMA (Polymethylmethacrylate) -A case report- (경피적 추체 성형술 중 발생한 저혈압 -증례 보고-)

  • Park, Jin-Woo;Kim, Haa-Soo;Lim, Se-Hun;Kim, Jeong-Hun;Jeong, Soon-Ho;Choe, Young-Kyun;Kim, Young-Jae;Shin, Chee-Mahn;Park, Ju-Yuel
    • The Korean Journal of Pain
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    • v.13 no.1
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    • pp.126-129
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    • 2000
  • Age-related osteoporotic compression fractures occur frequently in old aged group recently. Percutaneous vertebroplasty has recently been introduced as a therapeutic method for the treatment of pain associated with osteoporotic vertebral compression fracture. Percutaneous intravertebral injection of PMMA (polymethylmethacrylate) results in marked reduction in pain and morbidity. Among complications during vertebroplasty with PMMA, pulmonary embolism is repotred occasionally but the reports about hypotension are not common. This case is a report of a patient whom significant hypotension occured during percutaneous vertebroplasty.

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The Beau's Line Secondary to Acute Hand Injury (급성 수부 손상 후 발생한 보우선)

  • Kim, Tak Ho;Chung, Sung Mo;Lee, Nae Ho;Yang, Kyung Moo
    • Archives of Plastic Surgery
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    • v.33 no.5
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    • pp.652-654
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    • 2006
  • Beau first described transverse depressions of the fingernails after an acute febrile illness in 1846. It was the result of the temporary arrest of nail matrix formation. The transient interference of nail growth rate is usually induced by disability caused by severe systemic disease. Such as Raynaud disease, myocardial infarction, pulmonary embolism, acute renal failure, psoriasis and dysmenorrhea were reported to be the cause of Beau's line. The trauma caused either in a hand or in a forearm was also reported to be the cause of Beau's line. We experienced patients with Beau's line, two cases secondary to fingertip injury and one case due to fracture in radius. They had Beau's lines in all fingers of traumatized hand and nails of opposite hand were normal. During the follow-up, the growth rate of traumatized fingernails were normal and there was no complication.

Extravascular Migration of a Fractured Inferior Vena Cava Filter Strut

  • Lim, Jung Hyeon;Lee, Weon Yong;Ra, Yong Joon;Jeong, Jae Han;Park, Bong Suk;Ko, Ho Hyun
    • Journal of Chest Surgery
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    • v.50 no.3
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    • pp.224-227
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    • 2017
  • A 20-year-old man presented with a femur fracture and epidural hemorrhage (EDH) following a fall. One month after fracture surgery, swelling developed in both legs, and he was diagnosed as having a deep-vein thrombosis and pulmonary embolism. A retrievable inferior vena cava filter (IVCF) was inserted, because EDH is a contraindication to anticoagulants. Four months later, he complained of abdominal pain, and a computed tomography scan showed a fractured IVCF strut. After percutaneous removal failed 3 times, the IVCF was surgically removed by orthopedists using a portable image intensifier without cardiopulmonary bypass.

Surgical Treatment of Infective Endocarditis (감염성 심내막염에 대한 외과적치료)

  • Wang, Ok-Bo;Park, Ju-Cheol
    • Journal of Chest Surgery
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    • v.25 no.10
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    • pp.1055-1060
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    • 1992
  • Clinical experience of 21 patients with infective endocarditis was reviewed. Endocarditis involved the left-sided valve in 16 cases, the right-sided valve in 2, and PDA in the remaining 3 patients. Valve abnormalities included leaflet perforation in 9 patients, chordal rupture in 2,; annular abscess in 6; and aorticoleft atnal perforation in 2. Sixteen patients underwent valve replacement[aortic valve replacement in 7 patients, mitral replacement in 4 and double valve replacement in 5], two had VSD closure with pulmonary valve excision, three had ductus arteriousus closure. The patients were classified into two groups. I ] Healed endocarditis group: including the patients who had completed a planned cou-rseof antibiotic therapy[N=10], II ] Active endocarditis group: patients in which operations were performed prior to completetion of antibiotic treatment course[N=11]. The indications for operation included congestive heart failure, embolism, and persistent sepsis. Organisms were predominantly streptococcus[N=5] and staphylococcus [N=4] followed by candida, moraxella, and E-coli. By NYHA functional classification, all patients were in Class III or IV preoperatively. There was only one operative mortality in patient from group II. All patients substantially, improved postoperatively with NYHA classification in class I or II. This study shows that early surgical intervention in patients with active endocarditis has desirable outcome.

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Complications of nephrotic syndrome

  • Park, Se-Jin;Shin, Jae-Il
    • Clinical and Experimental Pediatrics
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    • v.54 no.8
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    • pp.322-328
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    • 2011
  • Nephrotic syndrome (NS) is one of the most common glomerular diseases that affect children. Renal histology reveals the presence of minimal change nephrotic syndrome (MCNS) in more than 80% of these patients. Most patients with MCNS have favorable outcomes without complications. However, a few of these children have lesions of focal segmental glomerulosclerosis, suffer from severe and prolonged proteinuria, and are at high risk for complications. Complications of NS are divided into two categories: disease-associated and drug-related complications. Disease-associated complications include infections (e.g., peritonitis, sepsis, cellulitis, and chicken pox), thromboembolism (e.g., venous thromboembolism and pulmonary embolism), hypovolemic crisis (e.g., abdominal pain, tachycardia, and hypotension), cardiovascular problems (e.g., hyperlipidemia), acute renal failure, anemia, and others (e.g., hypothyroidism, hypocalcemia, bone disease, and intussusception). The main pathomechanism of disease-associated complications originates from the large loss of plasma proteins in the urine of nephrotic children. The majority of children with MCNS who respond to treatment with corticosteroids or cytotoxic agents have smaller and milder complications than those with steroid-resistant NS. Corticosteroids, alkylating agents, cyclosporin A, and mycophenolate mofetil have often been used to treat NS, and these drugs have treatment-related complications. Early detection and appropriate treatment of these complications will improve outcomes for patients with NS.

Lemierre Syndrome in Adolescent with Active Ulcerative Colitis

  • Unic, Josipa;Kovacic, Matea;Jakovljevic, Gordana;Batos, Ana Tripalo;Grmoja, Tonci;Hojsak, Iva
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.21 no.3
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    • pp.214-217
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    • 2018
  • Inflammatory bowel disease (IBD) is a well-recognized risk factor for thrombotic events in adults but data on children are scarce. In the great majority of adult patients, thrombotic events are usually deep vein thrombosis and pulmonary embolism. Other sites such as jugular veins are extremely rare. We present a case of Lemierre syndrome in an adolescent girl with active ulcerative colitis and discuss possible risk factors. This is the first reported case of severe Lemierre syndrome with thrombus extension to cranial veins in a patient with ulcerative colitis. Early recognition of Lemierre syndrome in patients who present with rapidly worsening symptoms of neck pain, fever and signs of pharyngitis is imperative because it increases a chance of favorable prognosis. It is important for pediatricians treating IBD patients not to underestimate possible thrombotic events in children with IBD. Recognition of additional risk factors is crucial for prompt diagnosis and adequate treatment.

The Experimental Studies on Antithrombotic Effects of Hyunhosaiksan (현호색산의 항혈전작용에 대한 연구)

  • Lim Min Cheul;Kim Dong Hee
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.17 no.4
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    • pp.930-938
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    • 2003
  • The purpose of the present study was to investigate the effects of Hyunhosaiksan (HHS) on antithrombotic actions which include blood activation, thrombus removal, warming of circulating blood, and the control of pain on abdomen and lower and upper burning spaces. HHS significantly inhibited platelet aggregation induced by ADP and epinephrine in a HHS dose-dependent manner when analyzed by the Sigmoid Emax model in WinNonlin. EC50 values of HHS were 1.71 ㎍/ml and 0.004 ㎍/ml for ADP and epinephrine respectively. In the vivo study, HHS inhibited pulmonary embolism induced by collagen and epinephrine, which was however statistically insignificant. HHS increased number of platelets, APTT and volume of fibrinogen significantly as compared with the control group in dextran-induced thrombus model. Furthermore, HHS stimulated levels of blood flow in vivo though its effect was not observed in vitro. These results suggest that Hyunhosaiksan (HHS) can be used for treating numerous diseases related with blood aggregation and circulation problems. Further systematic investigations on the synergic effects among drugs used in the oriental medicine as well as in the western medicine in relation to thrombosis therapy would provide an important insight into the potential therapeutic applications.