• International Journal of Advanced Culture Technology
• /
• v.10 no.1
• /
• pp.108-115
• /
• 2022

The purpose of this study is to investigate the actual status of antithrombotic management before and after the procedure or surgery, the difference between the duration of medication suspension by clinical and demographic characteristics, and the patient's understanding and satisfaction after medication management by a dedicated nurse. The results were as follows. The most commonly used antithrombotic agents were aspirin and flavitol. The drug discontinuation period according to antithrombotic, procedures, and underlying diseases, there was a significant difference in duration for each variables(p<.000). In the case of antiplatelet drugs, 5-day suspension was the most frequent, and anticoagulants 2-day suspension was the most frequent. Depending on the procedure,colonoscope,nucleoplasty,rotator cuff repair,and total knee arthroplasty commonly showed more than 80% of 5-day discontinuation. The differences according to underlying diseases are as follows. 64.7% of all diseases discontinued on the 5th. The patient's understanding of the nurse's medication management performed before and after the procedure was found to be lower in Angina patients than those with other diseases. In terms of age, those in their 50s showed higher understanding than other age groups. There were no differences in understanding and satisfaction with the remaining characteristics.

• Journal of Yeungnam Medical Science
• /
• v.37 no.4
• /
• pp.321-328
• /
• 2020

Background: This study aimed to investigate the incidences of and risk factors for perioperative events following anticoagulant discontinuation in patients with non-valvular atrial fibrillation (NVAF) undergoing non-cardiac surgery. Methods: A total of 216 consecutive patients who underwent cardiac consultation for suspending perioperative anticoagulants were enrolled. A perioperative event was defined as a composite of thromboembolism and major bleeding. Results: The mean anticoagulant discontinuation duration was 5.7 (±4.2) days and was significantly longer in the warfarin group (p<0.001). Four perioperative thromboembolic (1.9%; three strokes and one systemic embolization) and three major bleeding events (1.4%) were observed. The high CHA₂DS₂-VASc and HAS-BLED scores and a prolonged preoperative anticoagulant discontinuation duration (4.4±2.1 vs. 2.9±1.8 days; p=0.028) were associated with perioperative events, whereas the anticoagulant type (non-vitamin K antagonist oral anticoagulants or warfarin) was not. The best cut-off levels of the HAS-BLED and CHA₂DS₂-VASc scores were 3.5 and 2.5, respectively, and the preoperative anticoagulant discontinuation duration for predicting perioperative events was 2.5 days. Significant differences in the perioperative event rates were observed among the four risk groups categorized according to the sum of these values: risk 0, 0%; risk 1, 0%; risk 2, 5.9%; and risk 3, 50.0% (p<0.001). Multivariate logistic regression analysis showed that the HAS-BLED score was an independent predictor for perioperative events. Conclusion: Thromboembolic events and major bleeding are not uncommon during perioperative anticoagulant discontinuation in patients with NVAF, and interrupted anticoagulation strategies are needed to minimize these.

• Journal of Chest Surgery
• /
• v.48 no.6
• /
• pp.432-434
• /
• 2015

Anticoagulation therapy is essential after cardiac valve surgery. However, spontaneous bleeding remains a major concern during anticoagulation therapy. Spontaneous gallbladder (GB) hemorrhage (hemobilia) is a rare occurrence during standard anticoagulation therapy. This report presents a case of GB hemorrhage that occurred shortly after initiating oral anticoagulant therapy in a patient who had undergone mitral valve replacement surgery.

• Archives of Pharmacal Research
• /
• v.16 no.2
• /
• pp.168-174
• /
• 1993

The michael adducts 2a, b were obtained from the reaction of the phenylacelyl derivative 1 with benzadehyde and p-anisaldehyde and p-anisaldehyde respectively. 2a and 2b were subjected to react with cyanoethanoic acid hydrazide, malononitrile, cyanothioacetamide, cyanoacetamide and 1, 1, 3-tricyano-2-amino propene to yield 4a-h and 5a, b respecitively. Hydrogen peroxide oxidation of 2a, b gave the aurone derivative 6a, b. The pyone derivatives 8a, b were obtained from 2a, b by addition of chioroacetyl chioride followed by dehydrochlorination.

• The Journal of Internal Korean Medicine
• /
• v.30 no.2
• /
• pp.438-449
• /
• 2009

Objectives: Deep vein thrombosis (DVT) is a common complication among stroke patients. The implication of DVT progressing into a fatal pulmonary embolism is one of the main reasons treatment cannot be delayed. However, when there is a contradiction for anticoagulants, such intracranial hemorrhage (ICH), it is difficult to determine the course of treatment. Our team reports a case with both acute DVT and ICH who improved with herbal medicine Hyulbuchuko-tang. Methods : A patient with a variety of thrombosis risk factors (atrial fibrillation, DVT, Cb-inf with intracranial hemorrhage due to thrombolytic complications) showed classic symptoms of DVT (pain, edema, discoloration), disorientation and chest discomfort. The patient was administered Hyulbuchuko-tang three times a day for 24 days without any anticoagulants. Conservative therapy including elastic stocking and leg elevation was co-administered. Laboratory tests and extremity vascular Doppler sonography were carried out 3 times during the treatment period. Results : After our treatment period, both popliteal vein DVT and calf vein DVT were not discovered by sonography, and thrombosis derived factors (eg. D-dimer, fibrinogen) decreased. There was no sign of edema or discoloration after treatment, and the patient no longer complained of leg pain, disorientation or chest discomfort. Conclusion : From these results, we suggest that there is a positive effect of Hyulbuchuko-tang on DVT. Hyulbuchuko-tang should be considered as a treatment option when western medical procedures are unavailable.

• Journal of Korean Neurosurgical Society
• /
• v.52 no.3
• /
• pp.234-239
• /
• 2012

Objective : Chronic subdural hematoma (CSDH) is a typical disease that is encountered frequently in neurosurgical practice. The medications which could cause coagulopathies were known as one of the risk factors of CSDH, such as anticoagulants (ACs) and antiplatelet agents (APs). Recently, the number of patients who are treated with ACs/APs is increasing, especially in the elderly population. With widespread use of these drugs, there is a need to study the changes in risk factors of CSDH patients. Methods : We retrospectively reviewed 290 CSDH patients who underwent surgery at our institute between 1996 and 2010. We classified them into three groups according to the time of presentation (Group A : the remote period group, 1996-2000, Group B : the past period group, 2001-2005, and Group C : the recent period group, 2006-2010). Also, we performed the comparative analysis of independent risk factors between three groups. Results : Among the 290 patients, Group A included 71 patients (24.5%), Group B included 98 patients (33.8%) and Group C included 121 patients (41.7%). Three patients (4.2%) in Group A had a history of receiving ACs/APs, 8 patients (8.2%) in Group B, and 19 patients (15.7%) in Group C. Other factors such as head trauma, alcoholism, epilepsy, previous neurosurgery and underlying disease having bleeding tendency were also evaluated. In ACs/APs related cause of CSDH in Group C, significantly less proportion of the patients are associated with trauma or alcohol compared to the non-medication group. Conclusion : In this study, the authors concluded that ACs/APs have more importance as a risk factor of CSDH in the recent period compared to the past. Therefore, doctors should prescribe these medications carefully balancing the potential risk and benefit.

• The Journal of Korean Medicine
• /
• v.42 no.3
• /
• pp.165-175
• /
• 2021

Background: Many herbal medications have been used to treat various liver diseases. But the concerns of herbal medicine induced liver injury also existed. In this respect, we would like to report several cases with imporved elevated liver aminotransferase after treating herbal medicine including Artemisia capillaris. Case Reports: We report four patients with elevated aminotransferase levels (ATLs), which indicate hepatocellular damages. After receiving herbal medicines therapy containing Artemisia capillaris as principal component (HMA), the patients' ATLs were improved. In the first case, the patient's ATLs decreased into normal range after administration of HMA, although they have not been improved with hepatotonics for a long period. In the second case, the patient's ATLs have been elevated after taking anticoagulants. The ATLs were improved with HMA without stopping anticoagulants. In the other two cases, the patients' ATLs were also improved after taking HMA. In addition, there were no changes of previous drugs for treating the corresponding underlying diseases and no adverse events during HMA applications. Result and Conclusion: The four patients received the herbal medicine containing Artemisia capillaris as principal component and showed improvement of ATLs. These cases suggest that HMA can be considered as alternative or complementary remedies to improve various liver diseases.

• Journal of Mechanical Science and Technology
• /
• v.16 no.12
• /
• pp.1719-1724
• /
• 2002

A previously designed capillary viscometer with measuring differential pressure was modified to measure the viscosity of non-Newtonian fluids including unadulterated blood continuously over numerous shear rates in a single measurement. Because of unavoidable experimental noise and a limited number of data, the previous capillary viscometer experienced an inaccuracy and could not directly determine a viscosity without an iterative calculation. However, in the present measurement there are numerous data available near the point of interest so that the numeric value of the derivative, d(In Q)/d(In Q$\sub$w/), is no longer sensitive to the method of differentiation. In addition, relatively low and wide shear rate viscosity measurements were possible because of the present precision pressure-scanning method with respect to time. For aqueous polymer solutions, excellent agreement was found between the results from the pressure-scanning capillary viscometer and those from a commercially available rotating viscometer. In addition, the pressure-scanning capillary viscometer measured the viscosity of unadulterated whole blood without adding any anticoagulants.

• CELLMED
• /
• v.4 no.3
• /
• pp.17.1-17.8
• /
• 2014

Herbal remedies are commonly used by patients worldwide. Because these herbal preparations share the same metabolic and transport proteins with prescribed medicines, the potential for a drug-herb interaction is substantial and is an issue of significant concern. This review paper summarizes drug-herb interactions involving inhibition or induction of cytochrome P450 enzymes, drug transporters as well as modulation of drug pharmacodynamics. An increasing number of in vitro and animal studies, case reports and clinical trials evaluating such interactions have been reported, and implications of these studies are discussed in this review. The most commonly implicated drugs in the interaction include anticoagulants, antiplatelets, immunosuppressants, anti-neoplastics, protease inhibitors, and some antidepressants. Pharmacokinetic and/or pharmacodynamic interactions of five commonly used herbal remedies (danshen, garlic, Ginkgo biloba, ginseng, and St John's wort) with these drugs are presented, with focus of discussion being the potentials for interaction, their mechanisms and clinical implications. There is a necessity for adequate pharmacovigilance to be carried out in minimizing unanticipated but often preventable drug-herb interactions.

• Journal of Korean Neurosurgical Society
• /
• v.40 no.1
• /
• pp.28-30
• /
• 2006

Two patients presented with amaurosis fugax[AMF]. despite treatment with antiplatelet drugs and anticoagulants due to previous transient ischemic attacks. Angiography demonstrated severe stenosis in the cavernous and petrous internal carotid artery[ICA] respectively, with reduced flow in the ophthalmic artery[OA]. Endovascular stent placement in both patients resulted in normalization of the vessel lumen of the stenotic vessel segments. In addition, complete restoration of OA flow was noted immediately after stenting. Both patients showed no further episode of AMF over a follow-up period of 38 and 23 months respectively. Our clinical and angiographic findings suggest that hemodynamic Insufficiency in retinal vasculature caused by a stenosis of the cavernous or petrous ICA can be treated successfully by endovascular stent.