• Title/Summary/Keyword: anti-platelet therapy

Search Result 27, Processing Time 0.025 seconds

A Case of Gastric Wall Hematoma and Ischemic Necrosis After Endoscopic Biopsy (상부 위장관 내시경조직검사 후 위벽에 발생한 출혈을 동반한 혈종 및 점막 괴사 1예)

  • Kim, You-Min;Lee, Jin-Sung;Kim, Dong-Hee;Sung, Young-Ho;Choi, Sun-Taek;Kim, Hyun-Tae;Lee, Hyun-Wook;Kim, Keung-Ok
    • Journal of Yeungnam Medical Science
    • /
    • v.27 no.2
    • /
    • pp.159-164
    • /
    • 2010
  • Hematoma of gastric wall is very rare, and occasionally associated with coagulopathy, trauma, peptic ulcer disease, and therapeutic endoscopy. Ischemic gastric necrosis is also rare because of the abundant anastomotic supply to the stomach, and it is usually associated with surgery and disruption of the major vessels. Endoscopic submucosal injection of hypertonic saline-epinephrine (HS-E) is a safe, cost-effective, and widely used therapy for hemostasis but it may cause tissue necrosis and perforation. We describe a case of gastric wall hematoma with oozing bleeding after endoscopic gastric mucosa biopsy in 71-year old woman with chronic renal failure and angina pectoris undergoing anti-platelet medication. We injected a small dose of HS-E (7ml) for controlling oozing bleeding. Two days later, endoscopy showed huge ulcer with necrotic tissue at the site of previously hematoma. Therefore we should pay particular attention for hematoma and mucosal necrosis when performing endoscopic procedure in a patients with high bleeding and atherosclerotic risk.

  • PDF

One Case of Systemic Lupus Erythematosus treated by Integrated Therapy of Western Medicine with Oriental Differential Diagnosis of Symptoms and Signs (한방 변증과 양방 협진에 의한 전신성 홍반성 낭창(Systemic Lupus Erythematosus) 치료 1예)

  • Jung, Dae-Young;Baek, Dong-Gi;Hwang, Sang-Il;Shin, Sun-Ho;Kim, Dong-Woung;Han, Myoung-Ah
    • The Journal of Internal Korean Medicine
    • /
    • v.23 no.2
    • /
    • pp.306-312
    • /
    • 2002
  • Systemic Lupus Erythematosus(SLE) is a autoimmune disease characterized by combined symtoms of malar rash, discoid rash, neuropsychiatric disorder, renal disorder, hematologic disorder, photosensitivity immunologic disorder, oral ulcer, anti-nuclear antibody, arthritis, pleuritis and pericarditis, etc. Multiple genetic or environmental causes are supposed to facilitate antiboby production to autoantigen such as ds-DNA, histone, phospholipid, red blood cell, platelet, etc. And defective complementary system fail to remove autoantigen-antibody complex, which deposit in multiple organs and result in inflammatory damages. SLE does not correctly correspond to any specific category of oriental medicine. But, accoring to previous reports, it can be controlled by herb medications used differently patients-to-patients. So we are to report this one SLE case being successfully controlled by classic corticosteroids with herb medications based on oriental diffrential diagnosis of symptoms and signs.

  • PDF

Which Emphasizing Factors Are Most Predictive of Hematoma Expansion in Spot Sign Positive Intracerebral Hemorrhage?

  • Kim, So Hyun;Jung, Hyun Ho;Whang, Kum;Kim, Jong Yun;Pyen, Jin Su;Oh, Ji Woong
    • Journal of Korean Neurosurgical Society
    • /
    • v.56 no.2
    • /
    • pp.86-90
    • /
    • 2014
  • Objective : The spot sign is related with the risk of hematoma expansion in spontaneous intracerebral hemorrhage (ICH). However, not all spot sign positive patients undergo hematoma expansion. Thus, the present study investigates the specific factors enhancing the spot sign positivity in predicting hematoma expansion. Methods : We retrospectively studied 316 consecutive patients who presented between March 2009 to March 2011 with primary ICH and whose initial computed tomography brain angiography (CTA) was performed at our Emergency Department. Of these patients, 47 primary ICH patients presented spot signs in their CTA. We classified these 47 patients into two groups based on the presence of hematoma expansion then analyzed them with the following factors : gender, age, initial systolic blood pressure, history of anti-platelet therapy, volume and location of hematoma, time interval from symptom onset to initial CTA, spot sign number, axial dimension, and Hounsfield Unit (HU) of spot signs. Results : Of the 47 spot sign positive patients, hematoma expansion occurred in 26 patients (55.3%) while the remaining 21 (44.7%) showed no expansion. The time intervals from symptom onset to initial CTA were $2.42{\pm}1.24$ hours and $3.69{\pm}2.57$ hours for expansion and no expansion, respectively (p=0.031). The HU of spot signs were $192.12{\pm}45.97$ and $151.10{\pm}25.14$ for expansion and no expansion, respectively (p=0.001). Conclusions : The conditions of shorter time from symptom onset to initial CTA and higher HU of spot signs are the emphasizing factors for predicting hematoma expansion in spot sign positive patients.

DENTAL TREATMENT OF THE PATIENT WITH AUTISM AND HEMOPHILIA A UNDER GENERAL ANESTHESIA A CASE REPORT (자폐증상이 있는 혈우병 A 환아의 전신 마취를 통한 치과적 치험례)

  • Park, Kyeong-Sun;Lee, Keung-Ho
    • Journal of the korean academy of Pediatric Dentistry
    • /
    • v.23 no.3
    • /
    • pp.593-600
    • /
    • 1996
  • This case report is a treatment of patient with hemophilia A and autism. The patient's chief complaint was treatment of dental caries on entire dentition and he has an impacted mesiodens located on the apex of the upper right primary central incisor. The patient was consulted with pediatrician and anesthetist about the detailed discussion of the complexities of hemorrhagic disorder. Because he had some problems of behavior management and bleeding, the treatment was done under the gerneral anesthesia. The following results were obtained. 1. Consult with the patient's physician and hematologist about the replacement therapy and bleeding tendency. 2. For the severe hemophiliac child who requires extensive or surgical treatment, general anesthesia may be indicated for the comprehensive care. 3. For the hemophiliac child who has a behavior management problem due to autism and other defects, general anesthesia may be considerable. 4. Care must be taken during dental procedures not to causing a bleeding. 5. Local hemostatic methods must be acquired for the emergency state. 6. Neve prescribe aspirin or non-steroidal anti-inflammatory drugs such as ibuprofen, indomethacin, and phenylbutazone. These drugs affect platelet aggregation and exaggerate the bleeding defect. 7. Do not be afraid of hemophiliac patient, and never compromise quality of dental care.

  • PDF

The current status of the combination therapy of frequently used herbal extracts and anti-platelet drug, anti-coagulant drug in ischemic stroke patients hospitalized in oriental medical hospital (한방병원 입원 허혈성 뇌경색 환자에서 한방 의료보험용 엑스산제와 항혈소판제 및 항응고제의 병용투여 현황)

  • Han, Su-Ryun;Park, Sung-Hwan;Ahn, Young-Min;Ahn, Se-Young;Lee, Byung-Cheol
    • The Journal of Korean Medicine
    • /
    • v.32 no.2
    • /
    • pp.14-22
    • /
    • 2011
  • Objective: Nowadays the combined use of herbal extracts and western medicines has been prevalent, but concern about its risk is also increasing. Even though the importance of clinical trials is well recognized, there have been only a few studies on the combined use of herbal extracts and western medicines. This study was aimed to examine which herbal extracts and antiplatelets or anticoagulants are most commonly prescribed together to inpatient ischemicstroke patients and investigate the combined prescription rate. Methods: We investigated the most frequently prescribed herbal extracts from two different sources. First, we chose herbal medicine extracts from 2008 Traditional Korean Medicine Utilization Status. Then, among patients who were admitted to Kyung-Hee Oriental Medical Center diagnosed with ischemic stroke, we found patients who were administered with these herbal medicine extracts and among these patients, we investigated how many were concomitantly administered with antiplatelets or anticoagulants. Second, we chose other herbal medicine extracts that were most often prescribed within Kyung-Hee Oriental Medical Center and found patients who were administered with these herbal medicine extracts, then investigated how many of them were concomitantly administered with specific antiplatelets or anticoagulants. Results: The most commonly prescribed herbal medicine extracts among ischemic stroke patients were Ojeok-san, Bojungikgi-tang, Sochungryong-tang and Samsoeum. About 46 to 69 percent were concomitantly administered with either specific antiplatelets or anticoagulants. Conclusions: The most often prescribed herbal medicine extracts in inpatient ischemic stroke patients are Ojeok-san, Bojungikgi-tang, Sochungryong-tang, and Samsoeum. Among patients who were prescribed with Ojeok-san, Bojungikgi-tang, Sochungryong-tang, Samsoeum, patients who were concomitantly administered with either antiplatelets or anticoagulants were about 46% to 69%.

The Effect of Eisenia bicyclis Extracts on Antioxidant Activity and Serum Lipid Level in Ovariectomized Rats (대황 추출물의 in vitro 항산화 활성 및 난소를 절제한 흰쥐의 혈중 지질함량에 미치는 영향)

  • Park, Yong Soo;Kim, Mihyang
    • Journal of Life Science
    • /
    • v.22 no.10
    • /
    • pp.1407-1414
    • /
    • 2012
  • Hormone replacement therapy (HRT) is an effective regimen that has been found to prevent these diseases in postmenopausal women. However, HRT is accompanied by an increased risk of unfavorable outcomes. This study was conducted to evaluate the effects of Eisenia Bicyclis extract on lipids in ovariectomized rats. Fifty 7-week-old female Sprague-Dawley rats were randomly assigned to four groups: sham-operated rats (SHAM), ovariectomized rats (OVX-CON), and ovariectomized rats that were treated with Eisenia bicyclis extracts. The extract-treated diets were fed to the rats for 6 weeks after operation. Antioxidant effects were measured by DPPH free radical scavenging activity. Antioxidant activity of the ethanol extract increased in a dose-dependent manner and was about 55.9% in a concentration of 100 ${\mu}g/ml$. We measured the total cholesterol content, triglyceride content, HDL-cholesterol content, LDL-cholesterol content, atherosclerotic index, cardiac risk factor in serum, and anti-platelet aggregation and blood rheology. The total cholesterol and triglyceride concentration in serum increased for the OVX-control group, but supplementation with the E. bicyclis extract caused these factors to decrease. Notably, the serum LDL-cholesterol concentration in the OVX-EB200 group was significantly lower than the OVX-CON group. In addition, the blood passage times in rats that received the E. bicyclis extract were more rapid than the times in the untreated group (OVX-CON). Microscopic evaluation revealed that whole blood passed more smoothly through the microchannels in rats in the E. bicyclis extract supplement groups. Our results clarified the effects of E. bicyclis extract on serum lipid content in ovariectomized rats, and consequently we expect positive effects from providing E. bicyclis extract to postmenopausal women with cardiovascular disease.

The Ability of Anti-tumor Necrosis Factor Alpha(TNF-${\alpha}$) Antibodies Produced in Sheep Colostrums

  • Yun, Sung-Seob
    • 한국유가공학회:학술대회논문집
    • /
    • 2007.09a
    • /
    • pp.49-58
    • /
    • 2007
  • Inflammatory process leads to the well-known mucosal damage and therefore a further disturbance of the epithelial barrier function, resulting abnormal intestinal wall function, even further accelerating the inflammatory process[1]. Despite of the records, etiology and pathogenesis of IBD remain rather unclear. There are many studies over the past couple of years have led to great advanced in understanding the inflammatory bowel disease(IBD) and their underlying pathophysiologic mechanisms. From the current understanding, it is likely that chronic inflammation in IBD is due to aggressive cellular immune responses including increased serum concentrations of different cytokines. Therefore, targeted molecules can be specifically eliminated in their expression directly on the transcriptional level. Interesting therapeutic trials are expected against adhesion molecules and pro-inflammatory cytokines such as TNF-${\alpha}$. The future development of immune therapies in IBD therefore holds great promises for better treatment modalities of IBD but will also open important new insights into a further understanding of inflammation pathophysiology. Treatment of cytokine inhibitors such as Immunex(Enbrel) and J&J/Centocor(Remicade) which are mouse-derived monoclonal antibodies have been shown in several studies to modulate the symptoms of patients, however, theses TNF inhibitors also have an adverse effect immune-related problems and also are costly and must be administered by injection. Because of the eventual development of unwanted side effects, these two products are used in only a select patient population. The present study was performed to elucidate the ability of TNF-${\alpha}$ antibodies produced in sheep colostrums to neutralize TNF-${\alpha}$ action in a cell-based bioassay and in a small animal model of intestinal inflammation. In vitro study, inhibitory effect of anti-TNF-${\alpha}$ antibody from the sheep was determined by cell bioassay. The antibody from the sheep at 1 in 10,000 dilution was able to completely inhibit TNF-${\alpha}$ activity in the cell bioassay. The antibodies from the same sheep, but different milkings, exhibited some variability in inhibition of TNF-${\alpha}$ activity, but were all greater than the control sample. In vivo study, the degree of inflammation was severe to experiment, despite of the initial pilot trial, main trial 1 was unable to figure out of any effect of antibody to reduce the impact of PAF and LPS. Main rat trial 2 resulted no significant symptoms like characteristic acute diarrhea and weight loss of colitis. This study suggested that colostrums from sheep immunized against TNF-${\alpha}$ significantly inhibited TNF-${\alpha}$ bioactivity in the cell based assay. And the higher than anticipated variability in the two animal models precluded assessment of the ability of antibody to prevent TNF-${\alpha}$ induced intestinal damage in the intact animal. Further study will require to find out an alternative animal model, which is more acceptable to test anti-TNF-${\alpha}$ IgA therapy for reducing the impact of inflammation on gut dysfunction. And subsequent pre-clinical and clinical testing also need generation of more antibody as current supplies are low.

  • PDF