• Title/Summary/Keyword: Thromboembolism

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Successful Arterial Thromboembolism Therapy in a Cat with Recombinant Tissue Plasminogen Activator Using an Accelerated Dosing Protocol

  • Cho, Yoo-Ra;Seo, Do-Hyun;Choi, Ho-Jung;Song, Kun-Ho;Seo, Kyoung-Won
    • Journal of Veterinary Clinics
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    • v.34 no.4
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    • pp.275-278
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    • 2017
  • An 8-year old female Korean Short Hair cat with a history of paralysis of both hind limbs less than 1 hour before admission was referred. On physical examination, the left hind limb was cold and there was no pulsation or mobility. On abdominal ultrasound examination, a thrombus 8 mm in length was found at the aortic bifurcation. The patient was diagnosed with hypertrophic cardiomyopathy (HCM) and cardiogenic pulmonary edema through radiologic evaluation and echocardiography. A tissue plasminogen activator (tPA) was applied intravenously using an accelerated dosing protocol (1 mg administered intravenously [IV] bolus, 2.5 mg IV over 30 min, 1.5 mg IV over 1 h) to treat the feline arterial thromboembolism. Within 12 h after administration of tPA, pulsation and mobility of both hind limbs were normal, without any noticeable complications. Clopidogrel was prescribed to prevent additional thrombus formation, and pimobendan, benazepril, and furosemide were prescribed for administration at home. The patient was discharged and survived 377 days.

Life-Threatening Acute on Chronic Pulmonary Thromboembolism Requiring Extracorporeal Membrane Oxygenation

  • Lee, Heemoon;Kim, Min Soo;Kim, Wook Sung;Kim, Yong Han;Cho, Sung Ho;Lee, Jae Jin
    • Journal of Chest Surgery
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    • v.51 no.3
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    • pp.205-208
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    • 2018
  • A 71-year-old female patient was admitted to the emergency department with sudden aggravation of chest pain and severe dyspnea. Computed tomography showed extensive pulmonary thromboembolism. Venoarterial extracorporeal membrane oxygenation (ECMO) was instituted due to sudden bradycardia and hypotension. An emergency operation was performed. However, chronic pulmonary thromboembolism combined with an acute pulmonary embolism was detected in the operating room. Embolectomy and endarterectomy were performed. ECMO was then discontinued. The patient was discharged on postoperative day 13 with warfarin for anticoagulation. The patient was followed up for 46 months as an outpatient without further thromboembolic events.

Anticoagulation Therapy, Thrombolytic Therapy, and Use of Blood Products in Neonates (신생아에서의 항응고요법, 혈전용해요법 및 혈액제제 사용)

  • Choi, Chang-Won
    • Neonatal Medicine
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    • v.18 no.1
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    • pp.34-41
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    • 2011
  • Neonatal coagulation disorders and thromboembolism require timely management. Failure to treat these conditions at the appropriate time may lead to death or the development of significant long-term sequelae. However, most current guidelines for managing neonatal coagulation disorders and thromboembolism are empiric and not based on randomized clinical trials. Thus, it is not easy to choose an appropriate management strategy for these conditions in clinical settings. In this review, therapeutic guidelines currently utilized in clinics and novel therapeutic options still under investigation are presented and reviewed.

Experimental Studies on the Efficiency of Insamyunpye-Hwan (인삼윤폐환(人蔘潤肺丸)의 효능(效能)에 관(關)한 실험적(實驗的) 연구(硏究))

  • Rhee, Hyung-Koo
    • Korean Journal of Oriental Medicine
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    • v.2 no.1
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    • pp.314-326
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    • 1996
  • Experimental studies were done to research the clinical effect of Insamyunpye-H wan on viscousity of mucin solution, pulmonary thromboembolism, oxygen consumption in $O_3$-exposed and Lung TBA in rats and mice. The result was obtained as follows : 1. In the effect of viscosity sampled from mucin, Insamyunpye-Hwan was revealed to have a significant effect of decrease in the rate of viscousity (p<0.01). 2. In the effect of sodium aracdonic acid induced pulmonary thromboembolism, I samyunpye-Hwan was revealed to have an effect of increasing the number of survival, but were not significant 3. In the effect of ADP induced pulmonary thrornboembolism, Insamyunpye-Hw an was revealed to have an effect of increasing the number of survival, but were not significant 4. In the effect of oxygen cansumption values in rats exposed-$O_3$, Insarnyunpye-Hwan was revealed to have a significant effect (p<0.05). 5. In the effect of the lung TBA values in rats exposed-$O_3$, Isamyunpye-Hwan was revealed to have a significant effect (p<0.05). In connection with the results of the studies, Insamyunpye-Hwan is concluded to be effective on the treatment of cough and lung and respiratory organ damages.

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Short-term and Intermediate-term Follow-up After Valve Replacement with the St.Jude Medical Prosthesis (St. Jude 기계판막의 단기및 중기 성적)

  • 조범구
    • Journal of Chest Surgery
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    • v.25 no.1
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    • pp.57-65
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    • 1992
  • St.Jude Medical cardiac valve replacement was performed in 322 patients: 191 had mitral, 58 had aortic, 72 had double valve and 3 had tricuspid valve replacement. Motality rate in early period was 2.8%[9 patients]. The most common cause of early death was low cardic output syndrome. Follow up extended from 1 to 90 months[mean: 34 months] in 292 patients among 313 in all surviving patients [93.6%]. There were thrombolic complications in eighteen patients. The probability of free from thromboembolism at 5 yerars in MVR, AVR and DVR were 84.7%, 91.8% and 90.2% respectively. And also, actuarial event free rate at 5 years in MVR, AVR and DVR were 80.1%, 82.2%, and 81.4% respectively. There were fourteen late death during follow up period: six from thromboembolism, one from hemorrhage and the others from non valve related -or unknown complications. The acturial survival rate at 5 years were 93.1% in mitral, 92.1% in aortic and 97.1% in double valve replacement. In conclusion, the performance of the St. Jude Mecanical valve compares most favorably with other artificial valves. But it remains still hazards of mechanical prosthesis such as thromboembolism and anticoagulant related hemorrhage.

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Assessment of Systemic Arterial Thromboembolism with Multi-Slice Spiral CT in a Dog (개에서 다중나선형 CT촬영에 의한 동맥혈전색전증의 평가)

  • Shin, Seung-Ho;Lee, Ki-Chang
    • Journal of Veterinary Clinics
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    • v.24 no.2
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    • pp.208-213
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    • 2007
  • A 15 kg 6-year-old intact male Jindo dog with a history of a respiratory distress, hindlimb paralysis with necrosed skin of dorsal digit for three weeks was referred to Animal Medical Center, Chonbuk National University. Heartworm infection was identified by kit examination. In plain thoracic radiographs, dilated pulmonary arteries reverse D sign and focal interstitial pattern was compatible with heartworm infection and possible pulmonary thromboembolism. Abdominal radiographs showed poor serosal detail indicating fluid accumulation within peritoneal cavity. No evidence of musculoskeletal abnormalities was found. Ultrasonography presented focal wedge-shaped hyperechogenecity on the both poles of left kidney, weak or absent pulse on the distal to the external iliac artery as well as ascites and irregular liver margin. Multi-organ failure was strongly supposed by blood profile including leukocytosis, anemia, hemoglobinuria bililubinemia, hypoalbuminemia, imbalance of electrolytes, and increased hepatic and renal function values. Interestingly, the glucose level is remarkably lower in pelvic limb compared to thoracic limb. Suspected pulmonary thromboembolism, renal infarction and femoral arterial embolization causing hindlimb paralysis and dermatic necrosis were confirmed by 3D reconstructed CT imaging. Prior to taking a consideration of euthanasia, interventional radiology was experimentally attempted but failed due to not recovered from general anesthesia. Early and accurate diagnosis of thromboembolism is valuable and 3D reconstructed CT images might be very useful to show the correct way to treat effectively.

The Prognostic Role of B-type Natriuretic Peptide in Acute Pulmonary Thromboembolism (급성 폐혈전색전증 환자에서 예후 인자로서 혈중 BNP의 의의)

  • Lee, Su Jin;Lee, Jae Hyung;Park, Ji Young;Jo, Woo Sung;Kim, Ji Eun;Kim, Ki Uk;Park, Hye Kyung;Kim, Yun Seong;Lee, Min Ki;Park, Soon Kew
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.5
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    • pp.540-547
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    • 2006
  • Background : Vital stability and right side heart failure are major prognostic factors of acute pulmonary thromboembolism. While it is important to recognize right side heart failure, it is often difficult in real practice. Recently, several studies have described early diagnostic tools for detecting right side heart failure including echocardiography and biochemical markers. This study, we evaluated the prognostic role of the B-type natriuretic peptide (BNP) in an acute pulmonary thromboembolism. Methods : Thirty-four patients with a diagnosis of acute pulmonary thromboembolism were enrolled in the study. The BNP levels were measured and echocardiography was performed at the Emergency Department. Data on the prognostic factors including ventilatory support, vital stability, pulmonary artery pressure, degree of tricuspid valve regurgitation, complications and death was collected from the patients' medical records. The patients with an acute pulmonary thromboembolism were divided into two groups based on the vital stability and the BNP level and the cutoff values and prognostic factors of the two groups were compared. Results : The predictors of the vital stability that influence the prognosis of patients with acute pulmonary thromboembolism were the BNP level, ventilatory support and death. The plasma BNP levels showed a strong correlation with the vital stability, ventilatory support, thrombolytic therapy and death. When the BNP cutoff level was set to 377.5 pg/dl in a ROC curve, the sensitivity and the specificity for differentiating between the groups with stable or unstable vital signs was 100% and 90%, respectively. Conclusion : This study indicates that a measurement of the plasma BNP levels may be a useful prognostic marker in patients with an acute pulmonary thrombo-embolism.

Experimental Studies on Efficiency of Imoyongsutang and Imoyongsutang Plus Maduryong (이모영수탕(二母寧嗽湯) 및 이모영수탕가마두령방(二母寧嗽湯加馬兜鈴方)의 효능(效能)에 관(關)한 실험적 연구(實驗的 硏究))

  • Chai, Jung-Won
    • The Journal of Pediatrics of Korean Medicine
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    • v.21 no.2
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    • pp.69-88
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    • 2007
  • Objectives In this study, we investigated the clinical effect of Imoyongsutang and Imoyongsutang plus Maduryong on the viscosity of mucin solution, the instantly type allergy, the delayed type allergy, the carbon clearance, the pulmonary thromboembolism for the lung damaged rats and mice. Methods The gastric mucin and incubation time, pulmonary thromboembolism induced by sodium arachidonic acid, the pulmonary thromboembolism induced by ADP, vascular permeability response, non inhibitory effects, the delayed type hypersensitivity response to picryl chloride, serum $Na^+$ level, $K^+$ and $Cl^-$ level, ${\alpha}-index$ in phagocytic activity were measured. Results 1. Both the solid extracts of Imoyongsutang and Imoyongsutang plus Maduryong gave some high significance results on the gastric mucin and incubation time on the viscosity of mucin solution in rats, and both groups had similar result. 2. Both the solid extracts of Imoyongsutang and Imoyongsutang plus Maduryong were revealed feeble effect on the pulmonary thromboembolism induced by sodium arachidonic acid in mice, and both groups had similar result. 3. Both the solid extracts of Imoyongsutang and Imoyongsutang plus Maduryong were revealed feeble effect on the pulmonary thromboembolism induced by ADP in mice, and after medication, the value was increased than the before one. 4. Both the solid extracts of Imoyongsutang and Imoyongsutang plus Maduryong were recognized. significance on vascular permeability response induced by histamine in rats. And the significance of the Imoyongsutang plus Maduryong is rather higher than that of Imoyongsutang. 5. The extract of Imoyongsutang recognized no significance symptoms on vascular permeability response induced by serotonin in rats, but the solid extract of Imoyongsutang plus Maduryong resulted recognized significance. 6. Both the solid extracts of Imoyongsutang and Imoyongsutang plus Maduryong were revealed non inhibitory effects on the 48 hour homologous PCA in rats provoked by the IgE-like antibody against the egg albumin. 7. Both the solid extracts of Imoyongsutang and Imoyongsutang plus Maduryong were remarkably revealed inhibitory effect on the delayed type hypersensitivity response to picryl chloride in mice. And the significance of the latter is rather higher than that of the former. 8. The solid extract of Imoyongsutang was revealed inhibitory eects on the delayed type hypersensitivity response to SRBC in mice, but thffe solid extract of Imoyongsutang plus Maduryong recognized significance. 9. The solid extract of Imoyongsutang was recognized significance on the lung TBA value of $O_3$ intoxicated rats, but the solid extract of Imoyongsutang plus Maduryong recognized no significance. 10. Both the solid extracts of Imoyongsutang and Imoyongsutang plus Maduryong was recognized significance on serum $Na^+$ level in $O_{3}-intoxicated$ rats. And the significance of the latter is rather higher than that of the former. 11. Both the solid extracts of Imoyongsutang and Imoyongsutang plus Maduryong were revealed non inhibitory effects on serum $K^+$ and $CL^-$ level $O_{3}-intoxicated$ Rats 12. The solid extracts Imoyongsutang was recognized significance on K-index in phagocytic activity in mice, but the solid extract of Imoymgsutang plus Maduryong recognized no significance. 13. The solid extract Imoyongsutang was recognized on significance on ${\alpha}-index$ in phagocytic activity in mice. but the solid extract of Imoyongsutang plus Maduryong recognized significance. Conclusions According to the above findings, it is suggested that the sold extract of Imoyongsutang and Imoyongsutang plus Maduryong were revealed effects on asthma cough or dyspnea caused by the abnormal rising of lung-allergy and throat discomfort so that they retain effectiveness on the instantly and delayed type allergy, the pulmonary thromboembolism and the lung damages in rats and mice.

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Comparative Study of Compliance for Venous Thromboembolism Prophylaxis (American College of Chest Physicians Guideline and American College of Orthopedic Surgeons Guideline) in High Risk Patients with a Venous Thromboembolism (정맥혈전 색전증 고위험군에서 시행한 혈전색전 예방요법(American College of Chest Physicians 지침 및 American College of Orthopedic Surgeons 지침)의 준수율 비교 연구)

  • Suh, You-Sung;Nho, Jae-Hwi;Jang, Byung-Woong;Kang, Deokwon;Won, Sung-Hun
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.4
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    • pp.317-326
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    • 2019
  • Purpose: To compare and analyze the rate of prevention of two venous thromboembolism prophylaxis guidelines in patients with artificial joint arthroplasty and hip joint fracture. Proper prophylaxis for preventing thromboembolism in orthopedic surgery is significant because of this fetal complication. Materials and Methods: This study compared and retrospective analyzed the rate of prevention using the medical records and radiographs of patients who underwent orthopedic surgery from March 2009 to February 2011 according to the American College of Chest Physicians (ACCP) guidelines and from March 2012 to February 2014 according to the American Academy of Orthopedic Surgeons (AAOS) guidelines. Results: The guidelines for venous thromboembolism prophylaxis have been applied to patients with artificial joint replacement and hip joint fracture, the compliance rate of the ACCP guidelines was 56.0% before surgery, 67.0% after surgery with chemical prophylaxis, and 80.5% with mechanical prophylaxis. In addition, the compliance rate of the AAOS guidelines was 74.1% with chemical prophylaxis, and 88.3% with mechanical prophylaxis, which was higher than the ACCP guidelines. The compliance rates of mechanical and chemical prophylaxis before and after surgery of the ACCP guidelines, and the compliance rate of mechanical and chemical prophylaxis of the AAOS guidelines were compared and analyzed. The results revealed statistical significance (p<0.05) before and after total knee replacement arthroplasty and hip joint fracture internal fixation and total high risk orthopedic surgery. Conclusion: Raising the compliance rate of prophylaxis of venous thromboembolism in high risk orthopedic surgery is necessary and people should follow the guidelines for a unified direction depending on which situation they are in.