• Journal of Chest Surgery
• /
• 제50권3호
• /
• pp.224-227
• /
• 2017

A 20-year-old man presented with a femur fracture and epidural hemorrhage (EDH) following a fall. One month after fracture surgery, swelling developed in both legs, and he was diagnosed as having a deep-vein thrombosis and pulmonary embolism. A retrievable inferior vena cava filter (IVCF) was inserted, because EDH is a contraindication to anticoagulants. Four months later, he complained of abdominal pain, and a computed tomography scan showed a fractured IVCF strut. After percutaneous removal failed 3 times, the IVCF was surgically removed by orthopedists using a portable image intensifier without cardiopulmonary bypass.

• Clinical and Experimental Pediatrics
• /
• 제48권6호
• /
• pp.675-677
• /
• 2005

가성혈소판감소증은 항응고제인 ethylenediaminetetraacetic acid (EDTA)를 사용 시 주로 발생한다. 이 때 관찰되는 혈소판 응고는 헤파린이나 구연산나트륨 같은 항응고제를 EDTA 대신 사용하면 일어나지 않기도 하여 가성혈소판감소증과 진성혈소판 감소증을 감별할 수 있다. 저자들은 이러한 감별을 위하여 6세된 EDTA 의존성 가성혈소판감소증 남아에서 아미노글리코사이드 계열의 약물인 가나마이신을 채혈 전에 EDTA 용기에 미리 넣거나, EDTA 용기에 이미 채혈된 혈액에 첨가한 후 각각 혈소판수와 혈소판 응고 양상을 조사하여 보았다. 그 결과 가나마이신 채혈 전 혹은 후에 처리한 경우 모두 혈소판응고 없이 정상적인 혈소판수를 나타내어 소아에서도 임상적으로 쉽게 검사 할 수 있는 방법으로 생각되어 보고하는 바이다.

• Clinical and Experimental Reproductive Medicine
• /
• 제25권3호
• /
• pp.277-280
• /
• 1998

Antiphospholipid antibody is an immunoglobulin which may be of any class and which reacts with any phospholipid. For clinical use the definition of the term anti-phospholipid antibody is usually restricted to IgG and/or IgM antibody directed against the negatively charged phopholipids, cardiolipin, phosphatidyl inositol, phosphatidyl serine, or phosphatidic acid. The antigen of the serological test for syphilis is cardiolipin; negatively charged phopholipids are understood to be antigens to which lupus anticoagulants are directed. The term 'anticardiolipin' antibody syndrome, 'antiphospholipid' antibody syndrome, and 'lupus anticoagulant' syndrome are often, imprecisely, used interchangeably. We have experienced a case of recurrent spontaneous abortion with antiphospholipid antibody. So we report this case with a brief review of literatures.

• Journal of Korean Neurosurgical Society
• /
• 제55권1호
• /
• pp.51-53
• /
• 2014

Mild traumatic brain injury is common in elderly patients, many of whom are on anticoagulant. The common practice is to discharge these patients from the emergency room if the computed tomography (CT) of the brain is normal. However, a very small proportion of these patients may develop a life threatening intracranial haematoma in the following days. We present here a case of a 66-year-old male on anticoagulant therapy that developed a subdural haematoma 48 hours after a mild head injury, with a normal initial CT scan of the brain. The patient underwent a craniotomy with evacuation of a large subdural clot. Postoperatively he had progressively improved and six months later has a Glasgow Outcome Score of three. This case is characterized by the delayed onset of a subdural haematoma in a patient on anticoagulation and we discuss here the possible pathogenesis related to this phenomenon. We also briefly review the pertinent literature and the current guidelines for the management of this type of head injuries.

• Journal of Korean Neurosurgical Society
• /
• 제29권9호
• /
• pp.1184-1187
• /
• 2000

Spontaneous spinal epidural hematoma is rare disease and usually presents with a progressive neurological syndrome for which surgical decompression is usually indicated. The cause of bleeding in epidural hematoma remains unknown in most of the cases. The most frequently identified risk factor is coagulopathy or treatment with anticoagulants. Recently, authors experienced a case of spontaneous spinal epidural hematoma with intraoperative profuse bleeding at the cervicothoracic location. Laboratory examination showed no evidence of coagulopathy or hepatic disease. On neurologic examination, left hemiparesis(Grade : II) and left side sensory change were noted. On MRI scan, there was a mass of high signal intensity in T2WI and isosignal intensity in T1WI compressing the cord to left side. The patients had good surgical outcome after decompressive laminectomy and hematoma removal.

• Bulletin of the Korean Chemical Society
• /
• 제35권6호
• /
• pp.1763-1768
• /
• 2014

In the course of our program to search for antithrombotic and anti-inflammatory agents from plants, twelve phenolics (1-12) were isolated from the stems of Parthenocissus tricuspidata. Their structures were elucidated on the basis of spectroscopic (1D and 2D NMR, and MS) data analyses, and comparison with published data. At the concentration of $100{\mu}g/ml$, compounds 2, 4, 6 and 10 possessed potential effects on anti-blood coagulation, with inhibitory percentage of 216, 174, 148 and 225%, respectively; while aspirin used as positive control showed 181% inhibition at the same concentration. Furthermore, the anti-inflammatory activity of isolated compounds (1-12) was investigated on lipopolysaccharide (LPS)-induced murine macrophage cells (RAW264.7). Compounds 2, 4 and 6 also potential inhibited the production of nitric oxide, with $IC_{50}$ values of $11.9{\pm}0.3$, $2.9{\pm}0.2$ and $29.0{\pm}0.6{\mu}M$, respectively. Celastrol, the positive control used, gave an $IC_{50}$ value of $1.0{\pm}0.1{\mu}M$.

• Journal of Chest Surgery
• /
• 제41권4호
• /
• pp.484-488
• /
• 2008

기계판막을 이용한 승모판치환술을 시행 받은 환자가 임신과 연관되어 장기간의 헤파린 피하주사를 이용한 항응고 치료를 받는 중에, 반복적인 인공판막 혈전증을 포함하는 항응고제로 인한 다양한 합병증이 관찰되었다. 이는 안티트롬빈 III의 결핍으로 인한 헤파린 저항성에 의한 것으로 판단되었고, 유로키나아제 또는 조직플라즈미노겐활성제(tissue plasminogen activator, tPA)를 이용한 혈전용해치료를 통하여 산모와 태아 모두 안전하게 치료할 수 있었다.

• Journal of Korean Neurosurgical Society
• /
• 제39권2호
• /
• pp.109-113
• /
• 2006

Objective : Meningioma is a benign tumor which has a high occurrence rate of postoperative hematomas. The purpose of this study is to analyze risk factors for postoperative hemorrhages after meningioma surgery. Methods : One hundred and fifty three patients with intracranial meningiomas, operated at the Department of Neurosurgery, National Medical Center, between January 1995 and December 2003 were included in this retrospective study. Risk factors considered to be related with postoperative hematomas were age, sex, preoperative pharmacological anticoagulants for medical co-morbidity, tumor location, histological type of the meningioma, infiltration of dural sinus and arachnoid, removal range of tumors, and the perioperative coagulation status including prothrombin time, partial thromboplastin time, and platelet count. Results : Patients' aged more than 70 years with a platelet count of less than $150{\times}10^9{\ell}^{-1}$ after surgery had statistically significant relations to the occurrence rate of postoperative hematomas. The other factors had no statistical significance. Conclusion : Various and intensive preoperative examinations for coagulation factors of patients, especially of older age, and proper transfusion before meningioma surgery are necessary for preventing postoperative hematoma.

• Clinical and Experimental Pediatrics
• /
• 제48권2호
• /
• pp.216-220
• /
• 2005

폐동정맥루는 폐동맥 고혈압의 유무에 따라 치료가 달라진다. 따라서 폐동정맥루 치료 전 반드시 폐동맥압을 측정하여야 한다. 이에 저자들은 폐동맥 고혈압이 없어 폐동맥 색전술로 치료한 1례와 폐동맥 고혈압이 동반되어 항응고제를 투여하면서 관찰 중인 1례를 보고하는 바이다.

• Journal of Chest Surgery
• /
• 제26권12호
• /
• pp.920-925
• /
• 1993

Extra-anatomic bypass was proposed by Freeman in 1952 and has been used for patient with lower extremity arterial occlusion who had very high operative risk, especially elderly or severly illed patient.We had performed 14 cases of extra-anatomic bypasses from Jan. 1991 till July 1993 and having been following up them. Their results were summarized as follow. Among total 14 patients, 13 was male. Their mean age was 64.8 years old, ranged from 48 to 80. The most common complaint was pain on lower limb and they visited hospital 6.1 months in average after onset of symptom. Frequently, they were associated with systemic diseases such as generalized atherosclersis, hypertension, diabetes mellius, etc. Axillary artery was used as donor artery in 8 cases and crossover femoro-femoral or femoro-popliteal bypass was performed in 6 cases. Postoperative complications were notedd in 8 cases so their morbidity rate was 42.8%. Except for two contraindicated cases, one or more anticoagulants were used routinely . Among them, combined use of aspirin and persantine was most commonly applied.After bypass graft, nine cases were occluded beteween 10 and 53 months. So their average duration of freedom from reocclusion was 35.7 months and 3-year patency rate was 63%.