Hemostatic function is regarded to be preserved after an off-pump coronary artery bypass grafting (CABG), compared to conventional CABG, and the preserved hemostatic function may increase thrombotic occlusion of the graft. We studied the changes of hemostatic variables in patients undergoing off-pump CABG, and compared to those of on-pump CABG. We studied the changes of coagulation function in 11 patients who underwent off-pump CABG (group I), and compared them with those of 11 patients who underwent on-pump CABG and Dor procedure (group II). Coagulation status was evaluated by thromboelastography and blood coagulation test preoperatively, postoperative 1$^{st}$ day, 2$^{nd}$ day, 3$^{rd}$ day, and 5$^{th}$ day, respectively. Among the variables measured by thromboelastography (such as r time, k time, $\alpha$ angle, and MA value) and blood coagulation test (such as factor Ⅶ, protein S, protein C, antithrombin III, activated protein C resistance test, plasminogen, D-dimer, prothrombin time, activated partial thromboplastin time, platelet count, hemoglobin, and fibrinogen), there were significant differences in the MA value, $\alpha$ angle, and platelet counts between the two groups. MA values were 140$\pm$72% and 153$\pm$98% in group I, and 87$\pm$27% and 78$\pm$28% in group II, at postoperative 3$^{rd}$ and 5$^{th}$ days, respectively (p<0.05). $\alpha$ angle was 122$\pm$92% in group I and 69$\pm$23% in group II at postoperative 3$^{rd}$ day (p=0.09). Platelet count was 63$\pm$55% in group I and 33$\pm$13% in group II at postoperative 3$^{rd}$ day (p<0.05). Patients who underwent off-pump CABG showed increased coagulability during postoperative periods, compared to those who underwent on-pump CABG. Our data suggest that aggressive perioperative anticoagulation therapy is warranted in patients undergoing off-pump CABG. CABG.
Xenotransplantation in discordant species results in immediate and irreversible hyperacute rejection due to natural antibodies, IgM. With this, antibody depletion is one option to reduce hyperacute rejection, we investigated the effect of PCPP (postcentrifugal plasmapheresis) on the depletion of natural antibodies and the effect of antibody titer on xenograft survival. Material and Method: Outbred swines (n=4) weighing 10∼20 kg were used as donors and mongrel dogs (n=4) weighing 25∼30 kg were used as recipients. Recipient canines underwent plasmapheresis (COBE TPE Laboratories, Lakewood. CO, USA). Pre-transplantation PCPP was peformed on day -2 and day 0. There were three groups (Group 0: no PCPP, Group 1: 1 pla sma-volume (PV) at day -2 and 2 PV at day 0, Group 2: 2 PV at day -2 and 2 PV at day 0). A swine heart was heterotopically transplanted into a recipient's abdominal infrarenal aorta and inferior vena cava. Mean percent depletion of total IgM and IgG in plasma of the recipients was calculated. Serum albumin, electrolyte, complement activity and coagulation factors were measured. Histopathologic examination of heart specimens was performed. Result: Mean percent depletion of IgM and IgG were 95.7$\pm$1.2%, 80.5$\pm$2.4% in the group 2 at the end of PCPP. The percent depletion of serum albumin concentration was decreased from 2.8 to 1.4 g/㎗ in the group 1 and 3.0 to 1.5 g/㎗ in the group 2. Complement hemolytic activity was decreased in group 1 and 2, but returned to normal level within 24 hours. Complement hemolytic activity was reduced to 10% of pre-PCPP level in group 2. Serum fibrinogen decreased to 20% or less and was recovered within 24 hours in group 2. Antithrombin III decreased but less than fibrinogen. PT and aPTT were sometimes but not always prolonged during plasmapheresis. After plasmapheresis, PT and aPTT were prolonged beyond the measurable level. D-dimer was not found during PCPP, but appeared and maintained from 10 minutes after trasplantation. Graft Survival time was 5 min in group 0, and it was 90$\pm$0 min in the group 2. Histopathologic changes were more typically characterized by edema, hemorrhages, thrombosis in all groups at the end of experiment. Conclusion: PCPP effectively removed immuoglobulins and reduced the titer of natural antibodies, as a result, significantly prololonged swine heart xenograft survival.
Background: This study was designed to develop a Korean version of the heparin-coated vascular bypass shunt by using a physical dispersing technique. The safety and effectiveness of the thrombo-resistant shunt were tested in experimental animals. Material and Method: A bypass shunt model was constructed on the descending thoracic aorta of 21 adult mongrel dogs(17.5-25 kg). The animals were divided into groups of no-treatment(CONTROL group; n=3), no-treatment with systemic heparinization(HEPARIN group; n=6), Gott heparin shunt (GOTT group; n=6), or Korean heparin shunt(KIST group; n=6). Parameters observed were complete blood cell counts, coagulation profiles, kidney and liver function(BUN/Cr and AST/ ALT), and surface scanning electron microscope(SSEM) findings. Blood was sampled from the aortic blood distal to the shunt and was compared before the bypass and at 2 hours after the bypass. Result: There were no differences between the groups before the bypass. At bypass 2 hours, platelet level increased in the HEPARIN and GOTT groups(p<0.05), but there were no differences between the groups. Changes in other blood cell counts were insignificant between the groups. Activated clotting time, activated partial thromboplastin time, and thrombin time were prolonged in the HEPARIN group(p<0.05) and differences between the groups were significant(p<0.005). Prothrombin time increased in the GOTT group(p<0.05) without having any differences between the groups. Changes in fibrinogen level were insignificant between the groups. Antithrombin III levels were increased in the HEPARIN and KIST groups(p<0.05), and the inter-group differences were also significant(p<0.05). Protein C level decreased in the HEPARIN group(p<0.05) without having any differences between the groups. BUN levels increased in all groups, especially in the HEPARIN and KIST groups(p<0.05), but there were no differences between the groups. Changes of Cr, AST, and ALT levels were insignificant between the groups. SSEM findings revealed severe aggregation of platelets and other cellular elements in the CONTROL group, and the HEPARIN group showed more adherence of the cellular elements than the GOTT or KIST group. Conclusion: Above results show that the heparin-coated bypass shunts(either GOTT or KIST) can suppress thrombus formation on the surface without inducing bleeding tendencies, while systemic heparinization(HEPARIN) may not be able to block activation of the coagulation system on the surface in contact with foreign materials but increases the bleeding tendencies. We also conclude that the thrombo-resistant effects of the Korean version of heparin shunt(KIST) are similar to those of the commercialized heparin shunt(GOTT).
Journal of the Korean Society of Food Science and Nutrition
/
v.35
no.5
/
pp.606-612
/
2006
Obtaining powder form of seaweed is essential for the use of seaweed as a food additive. The deterioration of seaweed caused by high temperatures during homogenization and powder processing is a serious problem and limits the use of seaweed as a food or pharmaceutical ingredient. Furthermore, many powder particles are not fluidized very well because of the interaction between particles. In order to solve this problem, sea tangle was hydrolyzed to a level of single cell detritus (SCD) by Vibrio sp., isolated from Batillus cornutus. with strong hydrolytic activity. The crude protein and amino acid contents of sea tangle SCD were higher than those of the powder, whereas the reverse was true for ash content. Sea tangle powder contained more mineral than its SCD, whereas total amino acid content was 5 times more in SCD than in power. The anticancer activities of sea tangle SCD and powder were 31.20 and 29.07%, respectively, with no significant difference (p<0.05), but about 15% higher than that of the control. The ACE inhibitory activity of the sea tangle powder, 39.31%, was higher than the 26.07% of the SCD. The antithrombin activity of the sea tangle powder, 55.3 seconds, was higher than the 34.5 seconds of the SCD. Moreover, there was no antioxidative and ischemic activities in both tile sea tangle powder and SCD.
Wild-garlic (Allium victorialis L.) is a perennial plant found in worldwide and has been considered as a favorite vegetable due to its particular smell and taste. However, the study of biological activity of wild-garlic and the development of processed food are in rudimentary. In this study, we evaluated several biological activities, including antioxidant, antimicrobial, and inhibitory activities against human thrombin, $\alpha$-amylase and $\alpha$-glucosidase, of Ulrung wild-garlic. Analysis of the composition showed that Ulrung wild-garlic is nutritive although it is perishable. The color of fresh juice was stably maintained during 10 days-storage at $4^{\circ}C$, but rapidly discolored by heat treatment at $70^{\circ}C$ for 1 h. During heat treatment, the contents of total sugar and total polyphenol were decreased to 75% and 50%, respectively, and acidity was increased from 0.069% to 0.111%. In a while, the brix, reducing sugar, and total flavonoids showed minor changes. The fresh juice showed strong DPPH scavenging activity, reducing power and antibacterial and antifungal activity, but the heat-treated juice lost the antioxidant and antimicrobial activities. The inhibitory activities against human thrombin and $\alpha$-amylase and $\alpha$-glucosidase was negligible in both fresh juice and heat-treated juice. These results suggested that the antioxidant and antimicrobial components in wild-garlic are heat-liable and volatile. Based on our results, we propose non-heat treatment products for processed wild-garlic, for example, fresh juice-added beverage or fermented liquors using wild-garlic.
Park, Joon-Cheol;Lim, Su-Yeon;Bae, Jin-Gon;Kim, Jong-In;Rhee, Jeong-Ho
Clinical and Experimental Reproductive Medicine
/
v.35
no.1
/
pp.83-88
/
2008
Thromboembolic disease associated with assisted reproductive techniques is considered to be extremely rare but most serious complication. The reasons for this are thought to hypercoagulable state characteristic of OHSS due to high serum levels of estrogen, hemoconcentration and reduced circulating blood volume, but is still unclear. The risk is increased those with rare hypercoagulable conditions such as antiphospholipid antibody syndrome, protein C deficiency, protein S deficiency, antithrombin III deficiency, and those with a personal or family history of thromboembolic disease. The majority of thrombosis reported were venous site but arterial thrombosis mostly intracerebral was reported 5 cases in Korea so far. We present a case of basilar a. thrombosis at 11 days after hCG injection. The patient developed the right hemiparesis, and recovered after intraarterial thrombolysis and transluminal angioplasty. Protein S activity was decreased and vWF antigen was increased. Decreased protein S activity was also found in previous reported 4 cases, so we suggest screening test for protein S in OHSS patients.
Background; Aprotinin, which is a nonspecific serine protease inhibitor, has an antiinflammatory and thrombogenic effect. However, it has an antithrombogenic effect during the cardiopulmonary bypass. This study was performed to evaluated the effects of aprotinin on the activated clotting time(ACT) and the total amount of the heparin used during the cardiopulmonary bypass. Marterial and Method; From December 1998 to November 1999, 82 consecutive patients electively underwent open heart surgery at Gachon medical school. The patients were older than 18 years. Eighty two patients were classified into a control group(group C, n=36) and a aprotinin-treated group(group A, n=46). Body weight, height, body surface area(BSA), pump time(PT), aortic cross clamping time(ACCT), and body temperature(BT) were determined. Total amount of heparin and protamine during the CPB were also measured. ACT was determined before heparin administration, at 20, 40 and 60 minutes after heparin administration, and after protamine administration. Result; No significant differences were noted in either group in body weight, height, BSA, BT, and the total amoun of heparin and protamine. Group A demonstrated a significant(p <0.05) increase in age, PT, ACCT, and ACT at 20, 40, and 60 minutes after heparin administration. Conclusion; In summary, the use of aprotinin prime resulted in an increase in ACT. The total amount of heparin in aproinin-treated patient was similar to that of the control group in spite of having the prolonged pump time. Therefore aprotinin may reduce the requirement of heparin.
Park, Nam-Hee;Chun, Bae-Hyeock;Je, Hyung-Gon;Lee, Jun-Wan;Lee, Jae-Won
Journal of Chest Surgery
/
v.40
no.4
s.273
/
pp.273-279
/
2007
Background: We evaluate the efficacy of ultra-hydrophilic coated bypass circuits in comparison with uncoated bypass circuits in a porcine cardiopulmonary bypass model. Material and Method: Normothermic cardiopulmonary bypass was peformed in 10 anesthetized pigs via the left atrium and ascending aorta with a centrifugal biopump. Ultra-hydrophilic coated bypass circuits wore used in 5 pigs (the study group) and uncoated bypass circuits were used for the control group. Platelet counts and platelet aggregation tests were peformed. The thrombin-antithrombin(TAT) complex level and total protein level were evaluated. Result: There were no significant changes En the platelet counts and aggregation ability of both groups. The TAT complex levels were not different between the two groups. The total protein level was significantly lower in the control group after cessation of cardiopulmonary bypass. Conclusion: The clinical effects of ultra-hydrophilic coating circuits were not remarkable, in terms of reducing inflammatory reaction and protection of platelet function. However, the effect of protection for blood protein adsorption might be acceptable.
Park, Tae Jun;Choi, Chan Woong;Oh, Ho Kyung;Kim, Jae Ok;Kim, Byung Kuk;Kang, Hyun Kyung;Kwon, Eun Jeong;Gweon, Eun Jeong;Park, Sang Jin;Kang, Ho Il;Jung, Ki Kyung;Park, Sang Mi;Kim, Ji Hye;Han, Ki Won;Jeong, Ja Young
Toxicological Research
/
v.33
no.3
/
pp.225-231
/
2017
National reference standards (NRSs) for biologics are established through potency estimation by a multi-center joint study of standard materials used in the approval process for national lot release and quality control of vaccines, blood products, and other biologics. In this study, a stability evaluation was conducted to determine whether the potency of NRSs for six blood products was being maintained at a consistent level in Korea. The present study conducted real-time stability tests via in-vivo/in-vitro bioassay on NRSs for blood coagulation factor VIII concentrate (2nd standard), antithrombin concentrate, prekallikrein activator, anti-hepatitis B immunoglobulin, blood coagulation factor IX concentrate, and anti-tetanus human immunoglobulin, as well as a trend analysis using cumulative annual results. The real-time stability test results showed that the mean potency of six NRSs was all within the control limit. In the trend analysis, the potency of NRS for blood coagulation factor VIII concentrate (2nd standard) showed a decreasing trend, while the potency of all other products had been stably maintained. The present study confirmed that the mean potency of NRSs for six blood products had been stably maintained in Korea. The findings of the present study establish a foundation that can ensure the quality of NRSs for biologics in Korea, and it is expected to make a major contribution to the supply of high-quality biologics.
The fructus of Crataegus pinnatifida Bunge has been used as medicinal and food source in worldwide. In this study, a strong direct thrombin inhibition and antithrombosis activity were identified from the methanol extract of C. pinnatifida Bunge fructus. The solvent fractionation of fructus extract using hexane, ethylacetate, butanol revealed that the butanol fraction has a prominent antithrombin activity. Thrombin time(blood-clot formation time) and activated partial thromboplastin time(aPTT) extended to 835% and 315% by addition of the butanol fraction at concentration of 1.25 mg/mL, whereas thrombin time extended to 287% by addition of aspirin at concentration of 1,25 mg/mL. The butanol fraction showed anthrone-positive and weak ninhydrine-postive reaction. The thrombin inhibitory activity was not related to previously reported flavonoids or polyphenols. The activity was maintained against acid treatment(0.5 N HCl for 120 min), but rapidly lost by heat-treatment($100^{\circ}C$ for 30 min). Our results suggested that fructus of C. pinnatifida Bunge with non-heat treatment process could be developed as a natural source of antithrombosis.
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