• Journal of Gastric Cancer
• /
• v.13 no.2
• /
• pp.121-125
• /
• 2013

Gastric cancer patients with acute disseminated intravascular coagulation experiences a rare but severe complication resulting in a dismal prognosis. We report a case of advanced gastric cancer complicated with disseminated intravascular coagulation with intractable tumor bleeding which was successfully treated with chemotherapy consisting of 5-fluorouracil and oxaliplatin. The patient was a 63-yearold man who complained of abdominal pain, melena, and dyspnea on 24 November 2010. We diagnosed stage IV gastric cancer complicated by disseminated intravascular coagulation. Gastric tumor bleeding was not controlled after procedures were repeated three times using gastrofiberscopy. With the patient's consent, we selected the 5-fluorouracil and oxaliplatin combination chemotherapy for treatment. After one cycle of 5-fluorouracil and oxaliplatin therapy, symptoms of bleeding improved and the disseminated intravascular coagulation process was successfully controlled. The primary tumor and multiple metastatic bone lesions were remarkably shrunken and metabolically remitted after eight cycles of chemotherapy. In spite of progression, systemic chemotherapy is effective in disease control; further, the patient gained the longest survival time among cases of gastric cancer with disseminated intravascular coagulation.

• Journal of Pharmacopuncture
• /
• v.17 no.1
• /
• pp.20-26
• /
• 2014

Objectives: The study aimed to determine changes in laboratory data for cancer patients receiving Korean medicine (KM) care, with a focus on patients' functional status, cancer-coagulation factors and cancer immunity. Methods: We conducted an observational study of various cancer patients in all stages admitted to the East-West Cancer Center (EWCC), Dunsan Korean Hospital of Daejeon University, from Mar. 2011 to Aug. 2011. All patients were under the center's multi-modality Korean-medicine-based inpatient cancer care program. The hospitalization stay at EWCC ranged from 9 to 34 days. A total of 80 patients were followed in their routine hematologic laboratory screenings performed before and after hospitalization. Patients were divided into three groups depending on the status of their treatment: prevention of recurrence and metastasis group, KM treatment only group, and combination of conventional and KM treatment group. The lab reports included natural killer cell count (CD16 + CD56), fibrinogen, white blood cell (WBC), lymphocytes, monocytes, neutrophil, red blood cell (RBC), hemoglobin, platelet, Erythrocyte Sedimentation Rate (ESR), and Eastern Cooperative Oncology Group (ECOG) performance status. Results: With a Focus on patients' functional status, cancer-coagulation factors and cancer immunity, emphasis was placed on the NK cell count, fibrinogen count, and ECOG scores. Data generally revealed decreased fibrinogen count, fluctuating NK cell count and decreased ECOG, meaning improved performance status in all groups. The KM treatment only group showed the largest decrease in mean fibrinogen count and the largest increase in mean NK cell count. However, the group's ECOG score showed the smallest decrease, which may be due to the concentration of late-cancer-stage patients in that particular group. Conclusions: Multi-modality KM inpatient care may have positive effect on lowering the cancer coagulation factor fibrinogen, but its correlation with the change in the NK cell count is not clear.

• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.14
• /
• pp.5799-5804
• /
• 2014

Background: Radiofrequency ablation (RFA) is the most widely used and studied method internationally for the local treatment of liver tumors. However, the extension of coagulation necrosis in one RFA procedure is limited and incomplete coverage of the damaged area can lead to a high local recurrence rate. Objective: In this study, we compared the effects of different solutions in enhancing hepatic radiofrequency by establishing a rabbit VX2 liver cancer model. We also determined the optimal solution to maximise effects on the extent of RFA-induced coagulation necrosis. Methods: Thirty VX2 tumor rabbits were randomly assigned to five groups: group A, RFA alone; group B, RFA with anhydrous ethanol injection; group C, RFA with 5% hypertonic saline injection; group D, RFA with lidocaine injection; and group E, RFA with a mixed solution. Routine ultrasound examinations and contrast-enhanced ultrasound (CEUS) of the ablation areas were performed after RFA. Then, we measured the major axis and transverse diameter and compared the areas of coagulation necrosis induced by RFA. Results: The mean ablation area range increased in groups B, C and especially E, and the scopes were greater compared with group A. Preoperative application of anhydrous ethanol, hypertonic saline, lidocaine and the mixed solution (groups B, C, D and E, respectively) resulted in larger coagulation necrosis areas than in group A (p<0.05). Among the groups, the coagulation necrosis areas in group E was largest, and the difference was statistically significant compared with other groups (p<0.05). Pathological findings were consistent with imaging results. Conclusions: A mixture of dehydrated alcohol, hypertonic saline and lidocaine injected with RFA increases the extent of coagulation necrosis in the liver with a single application, and the mixed solution is more effective than any other injection alone.

• Asian Pacific Journal of Cancer Prevention
• /
• v.14 no.7
• /
• pp.4459-4459
• /
• 2013

• Korean Journal of Clinical Laboratory Science
• /
• v.39 no.3
• /
• pp.156-160
• /
• 2007

We evaluated the newly developed plastic sodium citrate tubes for routine coagulation test by direct comparison with glass citrate theophylline adenosine dipyridamole (CTAD) tubes. Blood was drawn from 100 patients into glass CTAD tubes and plastic sodium citrate tubes. After collection, samples were centrifuged at 1500 ${\times}$g for 15 min at $22^{\circ}C$. Prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen were measured by using the Coagrex-800 (IRC, Japan). We used comparison plot by linear regression model and difference plot graphs to compare the results of the independent measurements of PT, aPTT, fibrinogen between glass CTAD tubes and plastic sodium citrate tubes. On the comparison study between glass CTAD tubes and plastic sodium citrate tubes, the correlation coefficients (R) were 0.99 for PT, 0.97 for aPTT and 0.97 for fibrinogen. This results implicated good correlation of each parameter between two tubes. Although the difference plot graph analysis showed statistically significant differences between glass and plastic tubes for PT, aPTT and fibrinogen, the range of difference was acceptable according to the CLSI/NCCLS guideline. The plastic sodium citrate tubes showed good correlation with the glass CTAD tubes, so it can substitute glass citrate tube for routine coagulation tests.

• Journal of Gastric Cancer
• /
• v.6 no.3
• /
• pp.189-192
• /
• 2006

Acute disseminated intravascular coagulation (DIC) associated with gastric cancer is not common and has short survival of 1 to 3 weeks. Systemic chemotherapy in spite of hematologic unstability for gastric cancer may prolong survival time. A 47-year-old woman who complained of dyspnea, vaginal bleeding and easy bruisibility was diagnosed to stage IV gastric cancer with acute disseminated intravascular coagulation based on the laboratory data. She also had multiple bone metastases and bone marrow involvement. This is the first case treated with combination chemotherapy of irinotecan and cisplatin for advanced gastric cancer complicated by disseminated intravascular coagulation at the time of diagnosis, With systemic chemotherapy, some of the bleeding symptoms and the DIC process improved, even not completely recovered. However the patient died of disease progression and survival time was 12 weeks.

• Asian Pacific Journal of Cancer Prevention
• /
• v.14 no.8
• /
• pp.4529-4532
• /
• 2013

Background: Acute normovolemic hemodilution (ANH) has been widely used to prevent the massive blood loss during hepatic carcinoma. The influences of ANH on coagulation function are still controversy, especially in elderly patients. The study observed ANH effects on coagulation function and fibrinolysis in elderly patients undergoing the disease. Materials and Methods: Thirty elderly patients (aged 60-70 yr) with liver cancer (ASA I or II) taken hepatic carcinectomy from February 2007 to February 2008 were randomly divided into ANH group (n=15) and control group (n=15). After tracheal intubation, patients in ANH group and control group were infused with 6% hydroxyethyl starch (130/0.4) and Ringer's solution, respectively. Blood samples were drawn from patients in both groups at five different time points: before anesthesia induction (T1), 30 min after ANH (T2), 1 h after start of operation (T3), immediately after operation (T4), and 24 h after operation (T5). Then coagulation function, soluble fibrin monomer complex (SFMC), prothrombin fragment (F1+2), and platelet membrane glycoprotein (CD62P and activated GP IIb/GP IIIa) were measured. Results: The perioperative blood loss and allogeneic blood transfusion were recorded during the surgery. The perioperative blood loss was not significantly different between two groups (p>0.05), but the volume of allogeneic blood transfusion in ANH group was significantly less than in control group ($350.0{\pm}70.7$) mL vs. ($457.0{\pm}181.3$) mL (p<0.01). Compared with the data of T1, the prothrombin time (PT) and activated partial thromboplastin time (APTT) measured after T3 were significantly longer (p<0.05) in both groups, but within normal range. There were no significant changes of thrombin time (TT) and D-dimer between two groups at different time points (p>0.05). SFMC and F1+2 increased in both groups, but were not statistically significant. PAC-1-positive cells and CD62P expressions in patients of ANH group were significantly lower than those at T1 (p<0.05) and T2-T5 (p>0.05). Conclusions: ANH has no obvious impact on fibrinolysis and coagulation function in elderly patients undergoing resection of liver cancer. The study suggested that ANH is safe to use in elderly patients and it could reduce allogeneic blood transfusion.

• Journal of Haehwa Medicine
• /
• v.9 no.2
• /
• pp.241-250
• /
• 2001

A study on relation of angiogenesis and blood stagnation in cancer was done, and the results were as follows. 1. Angiogenesis is a sequence of vascular proliferation and accomplished by regulation of anti-angiogenesis factor and indicating factor. These factors are secreted in the course of blood coagulation, inflammation, and regeneration. 2. Angiogenesis in cancer is a important action in growth of tumor and metastasis because it supply oxygen and nutrition. 3. The complicated processes, for example, platelet coagulation, action of coagulator factor & dissolution factor and interaction of variety factors are related to blood stasis and promoting blood circulation to remove blood stasis in oriental medicine. 4. Promoting blood circulation to remove blood stasis is expected to suppress angiogenesis, and we expect advanced study will be accomplished in future.

• Tuberculosis and Respiratory Diseases
• /
• v.42 no.6
• /
• pp.941-946
• /
• 1995

The association between hypercoagulability and malignant disease was first described by Armand Trousseau in 1865. According to Trousseau, the thrombophlebitis was usually/migratory and recurrent and involved both venous and arterial system. Thrombosis remains the hallmark of Trousseau's syndrome, although a wide variety of coagulation disorders including disseminated intravascular coagulation(DIC), pulmonary embolism, thrombotic endocarditis, and bleeding have been associated with the syndrome. Since then, abnormalities of the coagulation system have been repeatedly demonstrated in patients with cancer. Pancreatic carcinoma is thought to carry the highest risk of Trousseau's syndrome although the number of cases of Trousseau's syndrome is actually higher in patients with lung cancer because of the greater prevalence of this tumor. We report a thirty-five year old male patient with Trousseau's syndrome associated with lung cancer initially presenting deep vein thrombosis.

• Biomedical Science Letters
• /
• v.22 no.1
• /
• pp.9-17
• /
• 2016

Unfortunately, the five-year survival rate of lung cancer is relatively low compared with other cancers. Therefore, better predictors are need for prognosis, therapeutic strategy, risk stratification and predicting long-term mortality of lung cancer. Recently, increasing data suggest that Glasgow Prognostic Score (GPS) and procalcitonin levels are useful predictor cancer prognosis. In this study, we retrospectively investigated the correlation of GPS or procalcitonin to clinical variables in patients with pretreatment lung cancer. In 135 patients with pretreatment lung cancer, GPS, procalcitonin, demographic characteristics, hematological, coagulation, biochemical, inflammatory and cardiac markers were measured. Monocyte, eosinophil, basophil, neutrophil to lymphocyte ratio, red cell distribution width (RDW), platelet to lymphocyte ratio, mean platelet volume to platecrit ratio, D-dimer and prothrombin time (PT) levels were higher, whereas mean platelet volume was lower than their normal ranges. Glucose and sodium levels were low, whereas gamma glutamyl transferase (GGT), total bilirubin, creatinine and inorganic phosphorus concentrations were increase compared their normal ranges. Procalcitonin, high sensitivity C-reactive protein and troponin-I concentrations were elevated compared with their normal ranges. GPS had significantly positive or negative relations to cancer stage, hematological, coagulation, biochemical, inflammatory and troponin-I. Based on the data, we suggest that GPS may be a potent and useful predictor for prognosis, therapeutic strategy, risk stratification and predicting long-term mortality of lung cancer.