• Asian Pacific Journal of Cancer Prevention
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• 제14권11호
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• pp.6681-6686
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• 2013

Background: Fatal adverse events (FAEs) have been reported with sorafenib, a vascular endothelial growth factor receptor kinase inhibitor (VEGFR TKI). We here performed an up-to-date and detailed meta-analysis to determine the overall risk of FAEs associated with sorafenib. Methods: Databases, including PubMed, Embase and Web of Science, and abstracts presented at the American Society of Clinical Oncology annual meetings were searched to identify relevant studies. Eligible studies included randomized controlled trials evaluating sorafenib effects in patients with all malignancies. Summary incidence rates, relative risks (RRs), and 95% confidence intervals (CIs) were calculated for FAEs. In addition, subgroup analyses were performed according to tumor type and therapy regimen. Results: 13 trials recruiting 5,546 patients were included in our analysis. The overall incidence of FAEs with sorafenib was 1.99% (95%CI, 0.98-4.02%). Patients treated with sorafenib had a significantly increased risk of FAEs compared with patients treated with control medication, with an RR of 1.77 (95%CI 1.25-2.52, P=0.001). Risk varied with tumour type, but appeared independent of therapy regimen. A significantly increased risk of FAEs was observed in patients with lung cancer (RR 2.26; 95% CI 1.03-4.99; P= 0.043) and renal cancer (RR 1.84; 95% CI 1.15-2.94; P= 0.011). The most common causes of FAEs were hemorrhage (8.6%) and thrombus or embolism (4.9%). Conclusions: It is important for health care practitioners to be aware of the risks of FAEs associated with sorafenib, especially in patients with renal and lung cancer.

• 대한한방부인과학회지
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• 제21권2호
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• pp.125-151
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• 2008

Purpose: In this study, we investigated the anti-thrombotic efficacy of "Eungapbang-gagam(EGB)" currently used in clinical treatment of PID Methods: We studied inhibitory effect of platelet cohesion, suppressive effect of GPIIb/IIIa activity, inhibitory effect of $TXB_2$ and $PGE_2$ biosynthesis, and oxidative damage suppression effects of "EGB" in vitro. Also, suppression of pulmonary embolism and changes of related factors in dextran coagulation condition model were studied in vivo. Results: In this study, EGB extract showed dose-dependent inhibitory effect on platelet coagulation induced by ADP, epinephrine, collagen, arachidonic acid. Also it showed dose-dependent inhibition effect on GPIIb/IIIa activities compared to the control group. EGB extract significantly suppressed the decrease of speed of bloodstream caused by blood coagulation in dextran coagulation condition model and increased the number of platelets and amount of fibrinogen, and decreased the APTT in dextran coagulation condition model compared to the control group. EGB extract showed dose-dependent decrease of oxidative damages caused by DPPH and superoxide anion radicals, whereas dose-dependent increase of superoxide dismutase like activity was observed compared to the control group. Conclusion: We confirmed the anti-thrombosis and anti-oxidative efficacy of "Eungapbang-gagam". Various clinical applications of "Eungapbang-gagam" as well as use of data for the construction of EBM is anticipated.

• 동의생리병리학회지
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• 제26권5호
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• pp.732-737
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• 2012

The aim of this study is examine the protection effect for artery and antithrombotic effect of Sokmyong-tang(SMT; xuming-tang) on carotid artery thrombosis in a rat model. Thirty minutes before $FeCl_3$ treatment, SD rats were intraperitoneal injected with SMT. We tested the effects of SMT on time to occlusion (TTO) in thrombosis model by induced $FeCl_3$ using the laser Doppler flow meter and accessed thrombus weight (TW) inhibition and measured collagen fibers in the vessel after injury using Masson's trichrome stain. SMT(100 mg/kg, i.p.) showed significantly delayed TTO ($13.17{\pm}1.33$ min, P < 0.001) compared to vehicle control group ($8.63{\pm}0.92$ min) and inhibiting effect on TW with $0.72{\pm}0.02$ mg/mm (P < 0.05). In addition, SMT prevented collagen fibres damage in injured vessel ($22.24{\pm}4.48%$, P < 0.001). These results provide experimental evidence for SMT can be used to prevent vascular injury and thrombosis such as hypertension, arteriosclerosis, and so on.

• Journal of Chest Surgery
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• 제40권4호
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• pp.297-300
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• 2007

특발성 과호산구 증후군은 호산구 매개에 의한 조직 손상으로 인해 다발성 장기부전, 특히 심장을 침범하는 드문 전신성, 백혈구증식성 질환이다. 심장침범은 특발성 과호산구 증후군 환자의 75% 이상에서 일어난다. 심장증상은 심내막 하 섬유증, 제한성 심근병증, 판막부전, 그리고 말초동맥 혈전증을 유발하는 혈전이다. 이 질환은 남자에서 여자보다 9 : 1로 호발하고, $20{\sim}50$대에서 주로 발현하는 경향이 있으며 소아에서는 매우 드물다. 인공 대동맥판막부전을 나타낸 특발성 과호산구 증후군 환자(58세, 남자)를 인공판막 재치환 수술 후 부신피질호르몬제와 hydroxyurea 투여로 성공적으로 치료하였기에 보고하는 바이다.

• Journal of Chest Surgery
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• 제42권5호
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• pp.649-652
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• 2009

75세 남자 환자가 한 달 동안 점점 심해지는 호흡곤란 및 간헐적인 연하곤란을 주소로 내원하였다. 단순 흉부 사진상 기관이 우측 종격동 종괴에 심하게 눌려 있는 소견이 보였으며, 흉부 컴퓨터 촬영상 우측 쇄골하동맥 근위부 낭성 동맥류로 확진되었다. 정중흉골절개 및 쇄골상부 절개하에 동맥류 절제술 및 혈관재건술을 시행하였다. 동맥류 벽과 혈전의 균 배양 검사는 음성이었고, 병리 검사는 동맥경화성 동맥류 소견이었다. 수술 후 호흡곤란과 연하곤란은 호전되었으나, 술 후 8개월에 진행된 위암에 의해 사망하였다.

• Journal of Chest Surgery
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• 제51권3호
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• pp.180-186
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• 2018

Background: Endovascular aortic repair (EVAR) is widely performed to treat infrarenal abdominal aortic aneurysms (AAAs), and related techniques and devices continue to be developed. Although continuous attempts have been made to perform EVAR in patients with unfavorable aortic anatomy, the outcomes are still controversial. This study examined the short-term outcomes of EVAR for the treatment of infrarenal AAAs in patients with a 'hostile' neck and unfavorable iliac anatomy. Methods: Thirty-eight patients who underwent EVAR from January 2012 to December 2017 were enrolled in this study. A hostile neck was defined based on neck length, angulation, the presence of an associated thrombus, or a conical shape. Unfavorable iliac anatomy was considered to be present in patients with a short common iliac artery (<15 mm) or the presence of aneurysmal changes. Results: No perioperative mortality was recorded. No significant differences were found depending on the presence of a hostile neck, but aneurysmal sac shrinkage was significantly less common in the group with unfavorable iliac anatomy (p=0.04). A multivariate analysis performed to analyze the risk factors for aneurysmal progression revealed only unfavorable iliac anatomy to be a risk factor (p=0.02). Conclusion: Patients with unfavorable aortic anatomy showed relatively satisfactory short-term outcomes after EVAR. No difference in the surgical outcomes was observed in patients with a hostile neck. However, unfavorable iliac anatomy was found to inhibit the shrinkage of the aneurysmal sac.

• Asian Pacific Journal of Cancer Prevention
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• 제13권5호
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• pp.1873-1875
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• 2012

Objective: To compare the complications of peripherally inserted central catheters (PICC) by a modified Seldinger technique under ultrasound guidance or the conventional (peel-away cannula) technique. Methods: From February to December of 2010, cancer patients who received PICC at the Department of Chemotherapy in Jiangsu Cancer Hospital were recruited into this study, and designated UPICC if their PICC lines were inserted under ultrasound guidance, otherwise CPICC if were performed by peel-away cannula technique. The rates of successful placement, hemorrhage around the insertion area, phlebitis, comfort of the insertion arm, infection and thrombus related to catheterization were analyzed and compared on days 1, 5 and 6 after PICC and thereafter. Results: A total of 180 cancer patients were recruited, 90 in each group. The rates of successful catheter placement between two groups differed with statistical significance (P <0.05), favoring UPICC. More phlebitis and finger swelling were detected in the CPICC group (P <0.05). From day 6 to the date the catheter was removed and thereafter, more venous thrombosis and a higher rate of discomfort of insertion arms were also observed in the CPICC group. Conclusion: Compared with CPICC, UPICC could improve the rate of successful insertion, reduce catheter related complications and increase comfort of the involved arm, thus deserving to be further investigated in randomized clinical studies.

• Journal of Korean Neurosurgical Society
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• 제59권5호
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• pp.518-520
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• 2016

Cerebral venous sinus thrombosisis an uncommon entity and its clinical presentations are highly variable. We present the case of superior sagittal sinus thrombosis. Although it was medical refractory, successfully treated with mechanical thrombectomy using the Solitaire FR device. A 27-year-old man who presented with venous infarction accompanied by petechial hemorrhage secondary to the superior sagittal sinus (SSS) thrombosis. Due to rapid deterioration despite of anticoagulation therapy, the patient was taken for endovascular treatment. We deployed the Solitaire FR device ($4{\times}20mm$) in the anterior portion of the thrombosed SSS, and it was left for ten minutes before the retraction. Thus, we removed a small amount of thrombus. But the sinus remained occluded. We therefore performed the thrombectomy using the same methods using the Solitaire FR ($6{\times}20mm$). Thus, we were successful in removing larger clots. Our case highlights not only that the mechanical thrombectomy using the Solitaire FR is effective in achieving revascularization both rapidly and efficiently available, but also that it might be another option in patients with cerebral venous sinus thrombosis who concurrently had rapid clinical deterioration with devastating consequences.

• 대한한의학회지
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• 제23권2호
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• pp.164-179
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• 2002

Object: Death rate due to hypertension, atherosclerosis, ischemic heart disease and cerebral infarction induced by Westernized diet and increased average life span is on the rise. Decrease in blood circulation, activation of thrombus generation and intravascular lipid accumulation, cited as the principal causes of the above mentioned diseases in recent studies, result in circulatory disturbance and blood vessel obstruction leading to ischemic cell death of heart, brain and peripheral vessels. Method: We investigated the biochemical changes in microvascular permeability, aggregation of platelet and the intravascular lipid accumulation in induced-diabetic rat using Streptozotocin. We also studied the effects of Woohwangcheongsirn-won after oral administration on blood circulation, platelet function and lipid metabolism. The results are as follows: I. Woohwangcheongsim-won increased blood circulation in microvessels. 2. Woohwangcheongsim-won increased the reduced erythrocyte deformability in diabetes. 3. Woohwangcheongsim-won induced the reduction of contents of 2, 3-DPG, but failed to affect the reduced contents of ATP in erythrocyte in diabetes. 4. Woohwangcheongsim-won reduced the activity of Ca/sup 2+/-ATPase in the membrane of erythrocyte. 5. Woohwangcheongsim-won reduced the platelet aggregation evoked by platelet agglutinin factor. 6. Woohwangcheongsim-won reduced the production of platelet-derived granules. 7. Woohwangcheongsim-won reduced the production of metabolites of arachidonic acid in diabetes, and also reduced the production of increased thromboxane B2. 8. Woohwangcheongsim-won reduced the synthesis of oxidized LDL-cholesterol. In conclusion, Woohwangcheongsim-won enhanced blood circulation in microvesseles, erythrocyte deformability and inhibited the increased platelet aggregation and the synthesis of oxidized LDL-cholesterol in diabetes. Therefore Woohwangcheongsim-won is believed to positively affect blood circulation (J Korean Oriental Med 2002;23(2):164-179)

• Archives of Plastic Surgery
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• 제36권4호
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• pp.489-492
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• 2009

Purpose: Autologous fat injection is ideal for patients who wish to add contour, projection and gross volumization of the aging, atrophic face and is claimed to be a safe procedure. However, there are several case reports in the literature where patients have suffered from acute visual loss and cerebral infarction after facial fat injection. This paper will explore a rare case of vessel related complication, an arteriovenous fistula that occurs after fat injection on forehead. Method: A 28 - year - old female who showed a non - tender, soft $1.0{\times}2.5cm$ sized mass on forehead for 3 weeks. A thrill could be detected on the totuous dilatated vessel - like structure around the mass. She had a fat injection on forehead for soft tissue augmentation 3 months prior to developing the mass. 3 - dimensional brain CT angiography showed arteriovenous fistula. Results: The fistula is totally excised with ligation of feeding vessels. Pathology report showed an atypical vessel which had intimal thickening, myxoid degeneration and thrombus formation. There were no evidences of recurrence at least for 2 months of follow - up. Conclusion: An occurrence of arteriovenous fistula after autologous fat injection is very rare. After perforation of artery and vein by coincidence, blood extravasates with the formation of a hematoma capsule and a pseudocapsule around it. The hematoma capsule would expand and clot would reabsorb resulting in a cavity leading to fistula formation. Other vessel related complications like acute visual loss or cerebral infarction are very severe. Therefore, surgeons should be cautious during facial fat injection to avoid vessel injuries.