• Journal of Hospice and Palliative Care
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• v.25 no.3
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• pp.133-137
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• 2022

A 72-year-old woman with metastatic lung cancer to bone and brain and with left external iliac vein thrombosis was under the care of a community palliative care provider. She experienced an acute pain crisis due to acute limb ischemia of the left lower limb. Goals-of-care discussions were held with the patient and her family; she prioritized symptom control and end-of-life care at home. The family and patient were aware of her short prognosis. Her complex pain was managed by the community palliative team, and her family was empowered to give subcutaneous injections. We illustrate a case showing the importance of community health services with palliative care support in providing symptom management and support to patient and family caregivers throughout the course of a life-limiting illness. It also highlights family caregivers' potential psychological distress in delivering subcutaneous injections in terminal care for a patient at home.

• Journal of the Korean Society of Radiology
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• v.84 no.4
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• pp.941-945
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• 2023

May-Thurner syndrome (MTS) is a rare cause of deep vein thrombosis. Several cases of MTS because of various causes have been reported. However, MTS due to osteophytes in patients with underlying diffuse idiopathic skeletal hyperostosis (DISH) has not been reported in English literature, to the best of our knowledge. Here, we present the CT findings of MTS in patient with DISH.

• Radiation Oncology Journal
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• v.25 no.3
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• pp.170-176
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• 2007

Purpose: To determine the role of radiotherapy for the treatment of portal vein thrombosis (PVT) from hepatocellular carcinoma (HCC). Material and Methods: A retrospective analysis was performed on 70 patients that had been diagnosed with HCC and were treated with three-dimensional conformal radiotherapy (3D-CRT) for the PVT. The radiation dose ranged from 40 Gy to 60 Gy (median dose: 48 Gy) and the biological effective dose (BED) ranged from 31.3 Gy to 78.0 $Gy_{10}$ (median dose: 61.6 $Gy_{10}$). Response was determined by measuring the extent of the PVT on a CT image at 0, 1 and 3 months after completion of the radiotherapy. The median follow-up period was 9 months. Results: The response rate was 47.1% (33 patients), with two patients (2.9%) showing a complete response, 31 patients (44.3%) showing a partial response, and 35 patients (50%) showing stable disease or no response. The 1-year progression-free survival rate was 60%, and the median progression-free survival time was 17 months. The median overall survival time was 11 months, the median survival time in the responders was 15 months and in the nonresponders was 8 months (p=0.032). Four patients (5.7%) had transient liver function impairment during treatment. Radiation induced liver disease (RILD) was observed in only one patient (1.4%). Conclusion: Three-dimensional conformal radiotherapy for the treatment of PVT from advanced HCC was a relatively effective and safe method.

• 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.

• Journal of Chest Surgery
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• v.37 no.12
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• pp.1010-1014
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• 2004

Though acute pulmonary thromboembolism is usually managed medically with the use of thrombolytics or anticoagulants, an emergent life-saving surgery would be required. In a case of acute pulmonary thromboembolism with acute severe right heart failure and deferment of it could result in fatal outcomes in a short time. In addition, the mortality is raised considerably if it is combined with right heart thrombi. Despite paradoxical thromboembolism via patent foramen ovale was reported, few report might be presented, in which showed the thrombus in right atrium has traversed atrial septal defect into left atrium and left ventricle like this case as the evidence of paradoxical thromboembolism. We report a case of acute pulmonary thromboembolism with acute right heart failure arising from deep vein thrombosis, developed immediately after low anterior resection for colon cancer in a 63-year-old male, who was managed successfully by emergent thromboembolectomy with cardiopulmonary bypass.

• Herbal Formula Science
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• v.6 no.1
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• pp.199-214
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• 1998

This study was performed to prove the antithrombotic effects of DoHongYeum fluid by way of experimental methods. The thrombosis was induced by injection of collagen the mixture (0.1ml/10g, 2mg/kg B.W)plus serotonin (5mg/kg B.W) into the caudal vein of rat, 2 hours after liquid extract of DoHongYeum was oral administration. The effect of the fluid of DoHongYeum was rxamined by the number of RBC and platelets, bleeding time, blood clotting time, death rate, platelet aggregation, plasmacoagulation factor activity, exvivo and fibrinolytic activity of englobulin fracture in the rats. The results were summerized as followings. 1. The number of RBC and platelets was significantly increased in DoHomeYeum group incomparison with the control group. 2. Bleeding time was significantly shortened in DHY group in comparison with the controlgroup. 3. Blood clotting time was significantly prolonged in DHY group in comparison with the control group. 4. The death rate of mouse was inhibited in DHY group in comparison with the control group. 5. The platelet aggregation was inhibited in DHY group in comparison with the control group. 6. The prothrombin time and activated partial thromboplastin time on the test of plasmacoagulation factor activity was prolonged but was not valuable in DHY group. 7. Fibrinogen lyses time of rat was reduced and lyses area was increased in DHY group incomparison with the control group. 8. Fibrinogen lyses time of rat in vitro assay was reduced in DHY group. From the above results, it was thought that the DoHongYeum could be applied effectively in the thrombosis.

• Journal of Korean Neurosurgical Society
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• v.60 no.6
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• pp.620-626
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• 2017

Objective : Although venous thromboembolism (VTE) is frequently related to dehydration, the impact of dehydration on VTE in acute ischemic stroke (AIS) is not clear. This study investigated whether dehydration, as measured by blood urea nitrogen (BUN)/creatinine (Cr) ratio, influences the occurrence of VTE in patients with AIS. Methods : This is a retrospective study of patients with AIS between January 2012 and December 2013. Patients with newly diagnosed AIS who experienced prolonged hospitalization for at least 4 weeks were included in this study. Results : Of 182 patients included in this study, 17 (9.3%) suffered VTE during the follow-up period; in two cases, VTE was accompanied by deep vein thrombosis and pulmonary embolism. Patients with VTE were more frequently female and had higher National Institutes of Health Stroke Scale (NIHSS) score, more lower limb weakness, and elevated blood urea nitrogen BUN/Cr ratio on admission. In a multivariate analysis, BUN/Cr ratio >15 (odds ratio [OR] 8.75) and severe lower limb weakness (OR 4.38) were independent risk factors for VTE. Conclusion : Dehydration on admission in cases of AIS might be a significant independent risk factor for VTE.

• Journal of Chest Surgery
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• v.34 no.9
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• pp.711-715
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• 2001

Background: Deep venous thrombosis(DVT) is a curable disease when it is appropriately treated in the early stages of onset. The long term follow up of chronic DVT shows poor prognosis with serious complications such as venous valvular insufficiency, venous claudication, venous ulcer and leg swelling. Thrombolytic therapy is a very active treatment that delivers thrombolytic agents via catheter to the target thrombi. The aim of this study is to evaluate the effect of catheter directed thrombolysis using urokinase to acute DVT. Material and Method: We studied 5 patients, who were diagnosed as acute DVT and had no contraindication for selective hemolysis using urokinase. Result: All the patients were successfully recanalized. Total infusion time of urokinase was 2.0$\pm$0.6 days, and the amount was 5.9$\pm$2.45 million IU. In 4 patients, who were diagnosed as May-Therner syndrome, we performed the balloon angioplasty and inserted the stent at the stenotic portion. There were minor complications such as hematuria, hematoma at puncture site, and all of them are self limited. Conclusion: Catheter induced thrombolysis is an effective treatment in acute DVT.

• Journal of Yeungnam Medical Science
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• v.34 no.2
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• pp.279-284
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• 2017

Pulmonary artery sarcoma (PAS) is a rare and fatal disease that often mimics chronic thromboembolic pulmonary hypertension (CTEPH); therefore, diagnosis of PAS is often delayed. Herein, a healthy 74-year-old man was presented with a 4-month history of dyspnea. Chest computed tomography showed wall thickening and stenosis in the main pulmonary artery as well as in both proximal pulmonary arteries. In order to differentiate between unusual CTEPH, vasculitis, and PAS, we performed right heart catheterization and pulmonary angiography. The mean pulmonary arterial pressure was 21 mmHg, and there was severe pulmonary artery stenosis. Thrombi on the pulmonary arterial wall lesions were observed in intravascular ultrasound and optical coherence tomography. Furthermore, the patient had a history of deep vein thrombosis. Therefore, we diagnosed unusual CTEPH. After 6 months of rivaroxaban anticoagulation therapy, a chest X-ray revealed a left lower lobe lung mass, and a positron emission tomography later showed hypermetabolic lesions in the main pulmonary artery wall, in both pulmonary arteries walls, in the lung parenchyma, and in the bones. A biopsy of the right proximal humerus lesion revealed undifferentiated intimal sarcoma. Pulmonary sarcoma is rare, but should be considered when differentially diagnosing main pulmonary artery wall thickening and stenosis. A positron emission tomography may aid in this diagnosis.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.10 no.1
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• pp.1-38
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• 1997

This study was performed to investigate the effects of Kamigyemyoungsan and each compositive herbs on the intravascular coagulation and subcutaneous hematoma. The intravascular coagulation was induced by the injection of endotoxin into the caudal vein of the rats. These rats were treated with endotoxin after administering orally extracts of Kamigyemyoungsan and each compositive herbs. Then the number of platelet, prothrombin time, the concentration of fibrinogen and FDP(fibrinogen degration product), hematocrit and RBC and WBC were measured. The subcutaneous hematoma was induced by the subcutaneous injection of the autologous whole blood to produce clotting in situ in rats. Then the extracts of Kamigyemyoungsan and each compositive herbs were administered orally. The lesions were then dissected and observed. The results were obtained as follows ; 1. The number of platelets of the trial groups was increased as compared with the control group, and revealed significance in sample Ⅰ. 2. The concentration of fibrinogen of the trial groups was increased as compared with the control group, and revealed significance in sample Ⅰ, sampleⅡ and sample Ⅴ. 3. The prothrombin time was shortened significantly in the trial groups, except sampleⅡ and sampleⅣ as compared with the control group. 4. The concentration of FDP decreased in the trial groups, and revealed significance in sample Ⅰ and sample Ⅵ as compared with the control group. 5. The hematocrit significantly increased in sample Ⅰ, sampleⅢ and sample Ⅵ as compared with the control group. 6. The number of RBC significantly increased in sample Ⅵ only as compared with the control group. 7. The number of WBC significantly increased in the trial groups, except sampleⅣ and sample Ⅵ as compared with the control group. 8. Histologically, the lesions in the trial groups showed significantly thinner fibroblastic neomembrane than the control group, except sampleⅢ. According to the above results, it is considered that Kamigyemyoungsan and each compositive herbs have inhibitive effects on the thrombosis and the fibroblastic neomembrane development. Therefore, it seems to be applicable to the diseases related to thrombosis and hematoma.