• Title/Summary/Keyword: Warfarin

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The Evaluation of Therapeutic Control with Warfarin in Patients with Mechanical Heart Valve Prostheses (인공심장판막 환자를 대상으로 한 Warfarin 치료의 적정성 평가)

  • Im, Young Sun;Chang, Byung Chul;Suh, Ok Kyung;Lee, Suk Hyang;Shin, Hyun Taek
    • Korean Journal of Clinical Pharmacy
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    • v.9 no.1
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    • pp.27-34
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    • 1999
  • The goal of oral anticoagulation therapy with warfarin is to maintain INR values within the therapeutic range in order to prevent complications such as bleeding and thrombosis. The purposes of this study were to investigate the current level of anticoagulation control using INR values, to investigate the incidences of thromboembolism and bleeding complications, and to compare the effect of low intensity INR regimen with therapeutic range recommended by ACCP (American College of Chest Physician). Two hundred three patients with mechanical heart valve replacement done at Yonsei University Cardiovascular Center between January 1994 and December 1996 were selected and reviewed retrospectively. The target INR ranges of $2.5\sim3.5$ (ACCP standard) and low intensity INR of $2.0\sim3.5$ were used for evaluation. According to ACCP standard, $51.2\%$ of patients and $31.1\%$ of INR values were within the therapeutic range when average INR and cumulative INR were used, respectively. Applying low intensity INR values of $2.0\sim3.5$, the therapeutic control was achieved in $57.4\%\;and\;90.1\%$, using average INR and total INR, respectively. The incidences of major and minor bleedings were $0.5\%\;and\;26.6\%$, respectively. The incidence of thromboembolism was $0.5\%$. There was no significant difference in terms of complication incidences between INR $2.0\sim2.5\;and\;INR\;2.5\sim3.5$ groups. However, INR values at the time of bleeding were generally high. In conclusion, the evaluation of patients with mechanical heart valve replacement showed low level of therapeutic control with warfarin therapy. This is partially explained by the fact that the physicians at Yonsei University Cardiovascular Center were using lower intensity INR values as a goal than recommended INR. Also, in the near future, systematic anticoagulation service should be implemented at various hospitals in Korea so that patients on anticoagulant therapy can be more closely monitored to be within the recommended INR by ACCP.

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An Experimental Study on the Effects of Aebaegeum Applicable to the Treatment of Epistaxis (鼻出血에 應用되는 艾柏飮의 效能에 關한 實驗的 硏究)

  • Hong, Ik-Pyo;Chae, Byeong-Yun
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.3 no.1
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    • pp.1-15
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    • 1990
  • Aebaegeum has been widely used in the treatment of epistaxis, as based on Oriental Medical 1iteratures. In order to investigate experimentally the clinical effects of Aebaegeum, hemostatic time, plasma recalcification time and prothrombin time of hypoprothrombinemia induced by warfarin injection, action on isolated ileum, action on blood vessel, action on blood pressure and respiration and action on heart were observed. The result of the studies were obtained as follows: 1. Hemostatic time of vein ruptured mice was significantly shortened. 2. Plasma recalification time and prothrombin time of hypoprothrombinemic rats induced by warfarin injection were significantly shortened. 3. Spontaneous mobilities in the isolated ileum of mice were significantly suppressed, and contraction by acetylcholine chloride and barium chloride were inhibited. 4. Dilatation of blood vessel and downing of blood pressure of rabbit were noted. 5. Contraction of heart in the original position and isolated heart of frog were significantly shortened. According to the above result, it is expected that Aebaegeum can be widely applicable to the treatment of epistaxis.

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Femoral Neuropathy due to Iliacus Muscle Hematoma in a Patient on Warfarin Therapy

  • Kong, Woo-Keun;Cho, Keun-Tae;Lee, Ho-Jun;Choi, Jae-Sung
    • Journal of Korean Neurosurgical Society
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    • v.51 no.1
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    • pp.51-53
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    • 2012
  • Spontaneous hematomas of the iliacus muscle are rare lesions and these are seen in individuals receiving anticoagulation therapy or patients with blood dyscrasias such as hemophilia. It can cause femoral neuropathy and resultant pain and paralysis. Although there is no clear consensus for the treatment of femoral neuropathy from iliacus muscle hematomas, delays in the surgical evacuation of hematoma for decompression of the femoral nerve can lead to a prolonged or permanent disability. We report here on a rare case of a spontaneous iliacus muscle hematoma that caused femoral neuropathy in a patient who was taking warfarin for occlusive vascular disease and we discuss the treatment.

Anticoagulant Therapy in Pregnant Women with Mechanical Cardiac valve Prostheses (기계판막을 갖고있는 임산부에서 항응고요법)

  • 최순호;고광표;한재오;최종범;김경호
    • Journal of Chest Surgery
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    • v.33 no.6
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    • pp.502-506
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    • 2000
  • Background: Anticoagulant therapy can be required during pregnancy with prosthetic heart valves. Warfarin and heparin provide real protection against thromboembolic phenomena, but they also carry serious risks for the fetus and the mother. In an attempt to identify the best treatment for pregnant women with cardiac valve prostheses who are receiving anticoagulant, we studied 19 pregnancies, the warfarin was discontinued and heparin was administered every 12 hours by subcutaneous injection in doses adjusted to keep the midinterval aPTT in the therapeutic range(at least 2-2.5 control) from the conception to the 12th week of gestation and oral antiocagulant was then administered until the middle of the third trimester in the therapeutic range(at least 2 INR), and heparin therapy was restared until delivery. Also in order to avoid an anticoagulant effect during delivery, it has been our practice to instruct women to either discontinue their heparin injections with the onset of labur or to stop heparin injections 12 hours prior to the elective induction of labour. Result: The outcome of 19 pregnancies managed with above protocol was spontaneous abortion in 3 cases, voluntary termination in 2 cases, premature delivery at 35 weeks in 1 case and delivery at full-term in 14 cases. There was no maternal morbidity and moratality and fetopathy. Conclusion: We conclude that in the second and third trimester of pregnancy, warfarin provide effective protection against thromboembolism, Oral antiocagulant therapy should be avoided in 2 weeks before delivery because of the risk of serious perinatal bleeding caused by the trauma of delivery to the anticoagulated fetus. However, the substitution of heparin at first trimester and 2 weeks before delivery reduce the incidence of complications.

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Comparative Evaluation of North American Symptomatic Carotid Endarterectomy Trial and Warfarin-Aspirin Symptomatic Intracranial Disease Methods for Measurement of Middle Cerebral Artery Stenosis in Digital Subtraction Angiography and Magnetic Resonance Angiography (디지털 감산 혈관조영술과 자기 공명 혈관조영술에서 중대뇌동맥의 협착 측정을 위한 North American Symptomatic Carotid Endarterectomy Trial 및 Warfarin-Aspirin Symptomatic Intracranial Disease 방법의 비교 평가)

  • Lee, Jung-Hoon;Kim, Sang-Hyun
    • Journal of radiological science and technology
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    • v.42 no.5
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    • pp.351-356
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    • 2019
  • This study aimed to determine whether there was a difference in measurements between North American Symptomatic Carotid Endarterectomy Trial(NASCET) and Warfarin-Aspirin Symptomatic Intracranial Disease(WASID) methods that measure the middle cerebral artery stenosis in Digital Subtraction Angiography (DSA) and Magnetic Resonance Angiography (MRA). It involved 24 patients who had completed both DSA and MRA among patients with Middle Cerebral Artery (MCA) stenosis. The Middle Cerebral Artery (MCA) stenosis was measured using the NASCET and WASID methods through a retrospective analysis. For the NASCET and WASID methods, they performed measurements on normal blood vessels located far from and close to the stenosis, respectively. The mean value and standard deviation of the Digital Subtraction Angiography (DSA) measured by the NASCET method were 59.23% and 13.27%. On the other hand, those of the Digital Subtraction Angiography (DSA) measured by the WASID method were 66.64% and 12.47%. And, the mean value and standard deviation of the Magnetic Resonance Angiography (MRA) measured by the NASCET method were 49.82% and 12.06%. By contrast, those of the Magnetic Resonance Angiography (MRA) measured by the WASID method were 56.63% and 10.67%. All the p-values obtained by the Pearson and Spearman correlation tests in the Digital Subtraction Angiography (DSA) and the Magnetic Resonance Angiography (MRA) were <0.01. In conclusion, this study suggests that both the NASCET and WASID methods to measure the middle cerebral artery stenosis in the Digital Subtraction Angiography (DSA) and the Magnetic Resonance Angiography (MRA) can be used if they are not used interchangeably.

An Evaluation of Rat Control Methods (驅鼠法의 評價)

  • Tyson, Edwin L.
    • The Korean Journal of Zoology
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    • v.11 no.3
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    • pp.92-98
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    • 1968
  • 著者는 네가지 驅鼠法 즉 쥐덫, pyval, raticate, shoxin 및 warfarin을 比較 評價하였다. 이들 方法은 각기 特有의 長點을 갖고 있어서 優劣을 가리기 어려웠다. 네 개의 마을을 대상으로 採集한 쥐의 數는 平均 14.63마리 (1人當 2.01 마리) 였으며 이들 마을에서 大部分의 집쥐類의 驅除에 따른 他齧齒類의 侵入은 볼수 없었다.

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