• Journal of Chest Surgery
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• 제47권1호
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• pp.43-46
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• 2014

Phlegmasia cerulea dolens (PCD) is one of the most critical disorders of acute deep vein thrombosis in that it can cause permanent disability secondary to the compartment syndrome. Although several etiological factors have been proposed, PCD after coronary artery bypass surgery is extremely rare and its definitive pathophysiology is still under debate. We herein present a case of PCD that resulted in the compartment syndrome after coronary artery bypass surgery. Early recognition and decompression of PCD are crucial for saving the affected limbs.

• Macromolecular Research
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• 제17권2호
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• pp.79-83
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• 2009

The oral delivery of heparin is the preferred therapy in the treatment of patients with a high risk of deep vein thrombosis and pulmonary embolism. New conjugates of heparin and sodium deoxycholate were synthesized in order to enhance the heparin absorption in the GI tract. After oral administration of DOC-heparin, the concentration in anti-FXa assay was increased with increasing amount of coupled DOC. The maximum concentration of DOC-heparin VIII conjugate was $3.3{\pm}0.5\;IU/mL$ at an oral dose of 10 mg/kg, which was 3-fold higher than the baseline level. Finally, DOC coupled to heparin greatly enhanced the absorption of heparin in the GI tract, and this enhancing effect was not induced by changing the tissue structure of the GI wall.

• Journal of Chest Surgery
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• 제18권4호
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• pp.673-678
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• 1985

A 21 year-old male patient had a diagnosis of Budd-Chiari syndrome caused by inferior vena caval obstruction. Conservative medical therapy failed to control the symptoms of both portal hypertension and inferior vena caval stasis. Portocaval or mesocaval shunts may relive the symptoms of chronic forms of Budd-Chiari syndrome. But when inferior vena caval stenosis is severe, another procedure has to be used. Cavoatrial or portoatrial shunt has been suggested. Therefore, a long Dacron graft was placed from the inferior vena cava just below the left renal vein to the right atrium. He exhibited almost complete relief of symptoms for 1.5 year postoperatively. And there was angiographic proof of patency of the graft. This simple procedure should be encouraged in treatment of these patients.

• Journal of Hospice and Palliative Care
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• 제25권3호
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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.

• 대한영상의학회지
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• 제84권4호
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• pp.941-945
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• 2023

메이-터너 증후군은 심부정맥혈전증을 유발할 수 있는 흔하지 않은 원인으로 알려져 있다. 다양한 원인에 의한 메이-터너 증후군 사례가 보고되고 있지만 우리가 아는한, 미만성 골격 과골증 환자에서 뼈곁돌기에 의한 메이-터너 증후군 사례는 영어 논문으로 보고된 바가 없다. 저자들은 특발성 골격 과골증 환자에서 발생한 메이-터너 증후군의 컴퓨터단층촬영 소견을 제시하고자 한다.

• Radiation Oncology Journal
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• 제25권3호
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• pp.170-176
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• 2007

목적: 치료방법이 정립되지 않은 진행된 간세포암에서의 간문맥 혈전증에 대한 방사선치료의 효과와 간독성을 측정함으로써 향후 방사선치료의 효용성에 대하여 알아보고자 한다. 대상 및 방법: 2000년 5월부터 2005년 12월까지 서울아산병원에서 원발성 간세포암으로 진단받은 환자 중 간문맥 혈전증이 동반된 70명의 환자를 대상으로 후향적 분석을 하였다. 대상 환자들의 나이는 $24{\sim}74$세(중앙값 51세)였으며, 대부분이 Child-Pugh's class A, B였고 Eastern Cooperative Oncology Group (ECOG) 2 이하였다. 방사선치료는 3차원입체조형치료를 시행하였으며, 1회 선량은 $2{\sim}4$ Gy로 총방사선량은 $40{\sim}60$ Gy (중앙값 48 Gy)였으며, 생물학적 유효선량(biologic effective dose)은 $31.3{\sim}78.0\;Gy_{10}$ (중앙값 61.6 $Gy_{10}$)였다. 결과: 치료 반응평가는 치료 전과 치료 종료 후 최소 1개월 이상 경과 후 컴퓨터 단층촬영(CT)을 시행하여 평가하였으며, 대상 환자들의 추적관찰기간은 $2{\sim}24$개월(중앙값 9개월)이었다. 방사선치료 후 완전반응인 경우가 2명(2.9%), 부분반응 31명(44.3%), 무반응 35명(50.0%), 진행병변 2명(2.9%)이었다. 1년 무진행 생존율(progression-free survival)은 60%였으며, 중앙 무진행 생존기간은 17개월이었다. 전체 환자의 중앙 생존기간(overall survival)은 11개월이었으며, 치료반응 유무에 따라 부분 반응 이상을 보인 환자군의 중앙 생존기간은 15개월, 무반응이거나 진행병변을 보인 환자군은 8개월로 통계학적 차이를 보였다(p=0.032). 치료 중 일시적인 간기능 저하가 4명(5.7%), 방사선 간염은 1명(1.4%)에서 발생하였다. 결론: 진행된 간세포암에서의 간문맥 혈전에 대해 방사선치료를 시행한 경우 비교적 유용하며 안전한 치료법이며, 앞으로의 연구에서는 방사선치료가 생존율을 향상시킬 수 있는지 여부와 적절한 방사선량을 결정하기 위한 연구가 필요할 것으로 생각된다.

• Tuberculosis and Respiratory Diseases
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• 제47권1호
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• pp.103-110
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• 1999

저자 등은 폐색전증이 확인된 환자에서 지속적인 경구 warfarin 항응고 치료에도 불구하고 색전에 의한 호흡곤란 증상이 악화하여 시행한 색전제거술 후 혈전에서 원발 미상의 미분화 편평 상피 세포암이 확인된 1예를 경험하여 보고하는 바이다.

• Journal of Chest Surgery
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• 제37권12호
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• pp.1010-1014
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• 2004

급성 폐동맥 혈전색전증은 대부분 혈전용해제나 항응고제 등을 이용하여 내과적으로 치료하나, 폐동맥 혈전색전증에 의한 급성 우심실 부전이 발생하는 경우에는 신속히 수술을 하지 않으면, 단시간 내에 치명적인 결과를 가져올 수 있으며, 우심혈전이 동반되어 있는 경우 그 사망률은 훨씬 높아지고, 개방형 난원공을 통한 역리성 색전증(paradoxical embolism)이 보고되고 있다. 그러나 본 증례에서와 같이 우심방의 혈전이 심방중격결손을 통해 좌심방으로 유입되는 것이 관찰되는 예는 극히 드물다. 직장암으로 저위전방절제술을 받은 63세 남자 환자에서 수술 직후 심부정맥혈전증에 의해 생긴 우심실부전을 동반한 급성 페동맥 혈전색전증을 응급개심술을 통해 좋은 결과를 얻었기에 보고하는 바이다.

• 대한한의학방제학회지
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• 제6권1호
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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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• 제60권6호
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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.