• Journal of Chest Surgery
• /
• v.29 no.5
• /
• pp.569-572
• /
• 1996

A sixty nine-year-old mate patient was admitted with a chief complaint of exertional dyspnea. Lung perfusion scan revealed total perfusion defect of the of left lung and CT anglography showed the ab- rupt cutoff left pulmonary artery. He denied of trauma history, previous lower leg symptom and sign, or any embolic history. With the impression of chronic pulmonary thromboembolism of unknown etiology, operation was done under the cardiopulmonary bypass through a median sternotomy. After main pulmonary artery clamping and pulmonary arteriotomy, thromboembolectomy was done. Postoperative lung perfusion scan and CT angiography showed near normal left pulmonary blood flow. The patient was discharged on the postoperative 9th day without any postoperative complication.

• Investigative Magnetic Resonance Imaging
• /
• v.20 no.2
• /
• pp.132-135
• /
• 2016

We report the case of a 43-year-old male with both giant left atrial appendage (LAA) aneurysm and drug-refractory atrial fibrillation (AF). The patient was treated with percutaneous electrical isolation of cardiac arrhythmogenic substrate, and has been free of AF symptom over one year. Although the surgical resection of giant LAA aneurysm is mostly used to prevent systemic thromboembolism, we have performed follow-up of the giant LAA aneurysm using cardiac magnetic resonance (CMR) imaging and transesophageal echocardiography (TEE) after the successful catheter ablation of refractory AF. At one-year follow-up CMR, the giant LAA aneurysm showed remarkable enlargement as well as decreased contractility. Additionally, one-year follow-up TEE showed spontaneous echo contrast as an indicator of blood stasis in the giant LAA aneurysm. Those findings of giant LAA aneurysm suggest that the risk of thromboembolism may be high despite termination of AF.

• Journal of Chest Surgery
• /
• v.28 no.7
• /
• pp.666-670
• /
• 1995

A total of and consecutive 87 patients underwent concomitant double mitral and aortic valve replacement with the St. Jude Medical prosthesis between January 1985 and December 1993. They were 44 males and 43 females with the ages ranging from 18 to 59 years[mean$\pm$SD: 40.9$\pm$9.5 years . Fifteen patients[17.2% had a history of previous cardiac valve replacement. There were 2 early deaths[2.3% , and 85 early survivors were followed up for a total of 352.6 patient-years[mean$\pm$SD: 4.1 $\pm$2.6 years . All were anticoagulated with coumadin keeping the target international normalized ratio within the range of 1.5 and 2.5. There was a single late death[late mortality of 0.284%/patient-year . Thromboembolism was the most frequent complication[1.985%/patient-year , and bleeding related to anticoagulation was experienced in one patient [0.284%/patient-year . The incidences of prosthetic valve endocarditis and of paravalvular leak were also low[0.284%/patient-year, respectively . The survival including operative mortality was 96.1%$\pm$2.2% at 10 years. The actuarial probabilities of freedom from thromboembolism and from all events were 77.9%$\pm$11.1% and 72.4%$\pm$10.7%, respectively, at 10 years. There was no structural failure of the prosthesis. Results from a series of clinical studies suggest strongly that the use of lower intensity of anticoagulation therapy lowers the thromboembolic as well as bleeding rates in patients with the ST. Jude Medical prosthesis.

• Restorative Dentistry and Endodontics
• /
• v.38 no.3
• /
• pp.113-118
• /
• 2013

Nowadays, oral anticoagulants are commonly prescribed to numerous patients for preventing cardiovascular accident such as thromboembolism. An important side effect of anticoagulant is anti-hemostasis. In a major surgery, the oral anticoagulant therapy (OAT) regimen must be changed before the surgery for proper post-operative bleeding control. However, in a minor dental surgery and endodontic surgery, the necessity for changing or discontinuing the OAT is open to debate. In this study, risks of the consequences were weighed and analyzed. In patients who stop the OAT, the occurrence of thromboembolic complication is rare but the result is fatal. In patients who continuing the OAT, post-operative bleeding can be controlled well with the local hemostatic measures. In the endodontic surgery, there are almost no studies about this issue. The intra-operative bleeding control is particularly important in the endodontic surgery because of its delicate and sensitive procedures such as inspection of resected root surface using dental microscope and retrograde filling. Further studies are necessary about this issue in the viewpoint of endodontic surgery.

• Journal of Yeungnam Medical Science
• /
• v.31 no.2
• /
• pp.99-102
• /
• 2014

Diabetic ketoacidosis (DKA), a fatal acute diabetic complication, is characterized by severe metabolic decompensation and intravascular volume depletion. These conditions may result in hypercoagulability and prothrombic state. Pulmonary thromboembolism (PTE) could be presented as an uncommon and life-threatening complication of DKA. Reported herein is a case involving a 54-year-old male patient who was admitted with DKA due to chronic alcohol consumption and stopping the intake of oral antidiabetic drugs. After low-molecular-weight heparin and warfarin treatment because of PTE during the DKA treatment, the patient's condition improved over the week that he was discharged on insulin and warfarin.

• Journal of Veterinary Clinics
• /
• v.36 no.1
• /
• pp.42-45
• /
• 2019

Thromboelastography (TEG) analysis consists of ${\alpha}$, G, K, MA, and R types of values and tests the effectiveness of blood clotting, which can be assessed for platelet function, clotting strength, and fibrinolysis. Canine heartworm diseases caused by Dirofilaria immitis, a vascular nematode, can lead to hyperfibrinolysis and hypercoagulation. In this study, G and MA values showed a statistically significant decrease over time after treatment of heartworm disease. Additionally, the ${\alpha}-value$ showed a high correlation with G, K, MA, and R values. The G value showed a high correlation with K and MA values, while The K value showed a high correlation with MA and R values. This study clearly found a gradual decrease in G and MA values in dogs with heartworm disease over time, both before and after treatment. This suggests that the clot formation time is longer and that the intensity of clot formation is lowered and may improve the risk of thromboembolism in dogs with heartworm disease.

• Tuberculosis and Respiratory Diseases
• /
• v.47 no.5
• /
• pp.669-680
• /
• 1999

Background: Pulmonary thromboembolism(PTE) is a life threatening disease that needs early diagnosis. Spiral CT angiography depict thromboemboli in the central pulmonary vessels with greater than 90% sensitivity and specificity, which approaches the results of pulmonary angiography in the Prospective Investigation of Pulmonary Embolism Diagnosis(PIOPED) study. This study was performed to evaluate the findings and the diagnostic value(clinical utility) of the spiral CT angiography with 2D image(multiplanar reformation) and 3D images(Shaded surface display, Minimal intensity projection) in the pulmonary thromboembolism. Methods: We retrospectively analysed spiral CT angiography and pulmonary angiography, lung scan and clinical recordings of 20 patients who had PTE diagnosed by spiral CT angiography(n=19 cases) or pulmonary angiography(n=l case) from September 1997 to August 1998. Among 20 patients who had underwent spiral CT angiography, 14 patients could be performed lung perfusion scan at the same time. We analyzed the vascular and parenchymal change in spiral CT angiogram. Results: Anatomical distribution of PTE was as follows: 1) left lung(n= 103)

• Tuberculosis and Respiratory Diseases
• /
• v.66 no.1
• /
• pp.6-12
• /
• 2009

Background: The efficacy of several thrombolytic agents for treating massive pulmonary thromboembolism (PTE) has been reported to be similar. However, the difference of the bleeding complications caused by two commonly used thrombolytic agents in PTE patients is not well known. The aim of this study was to compare the therapeutic efficacy and the bleeding complications between urokinase and recombinant tissue-type plasminogen activatior (rt-PA, alteplase) in a Korean medical center. Methods: We retrospectively reviewed the clinical data of the patients who were treated with thrombolytic agents (urokinase and alteplase) because of massive PTE. Results: A total of 40 patients were included: 16 (40%) treated with urokinase and 24 (60%) with alteplase. The patients treated with alteplase showed a shorter duration of using vasopressor agents than did the patients who were given urokinase, but the duration of mechanical ventilation, the length of the ICU stay and the hospital stay were not different between the thrombolytic agents. Five patients treated with urokinase and eight patients treated with alteplase died (p=0.565): One patient in the urokinase group and four patients in the alteplase group died due to pulmonary thromboembolism. Bleeding complications after thrombolysis were observed in 3 patients (7.5%) treated with urokinase and in 11 (27.5%) patients treated with alteplase (p=0.079). Major bleeding complication occurred in 2 patients who were treated with alteplase. Conclusion: Urokinase seems to have fewer bleeding complications with an equivalent efficacy, as compared to alteplase, in Korean patients who suffer with massive pulmonary thromboembolism.

• The Journal of Korean Medicine
• /
• v.17 no.1 s.31
• /
• pp.280-301
• /
• 1996

This thesis is on the effects of the Injections of Mokhyangsunkisan extract, Mokhyangsunkisan plus Rheum undulatum L. extract and Palmisunkisan extract clinical experiments wre done with medicines to research their analgesic and anti-convulsive action and their efficiency on $O_3$ and Xylene-poisoned lung damage and the pulmonary thromboembolism of rats and mice. The results are as follows; 1. As to the analgesic action, each Injection of Mokhyangsunkisan extract, Mokhyangsunkisan plus Rheum undulatum L. extract and Palmisunkisan extract had significant effects. Among them the Injection of Mokhyangsunkisan plus Rheum undulatum L. extract had the highest effect. 2. As to the anti-convulsive action, each Injections of Mokhyangsunkisan extract and Palmisunkisan extract had significant effects whereas that of the Injection of Mokhvangsunkisan plus Rheum undulatum L. extract had no effect. 3. In the frsearch of the Lung TBA values of $O_3$-poisoned rats. each Injection of Mokhyangsunkisan extract and Palmisunkisan extract had significant effects whereas that of the Injection of Mokhyangsunkisan plus Rheum undulatum L. extract had no effect. 4. None of the Injection of Mokhyangsunkisan extract, Mokhyangsunkisan plus Rheum undulatum L, extract and Palmisunkisan extract had significant effects in the experiments about the variation of the $Na^+$ contents and $K^+$ contents in the serum electrolytes of the $O_3$-poisoned rats. 5. In the research of the Lung TBA values of Xylene-poisoned rats all the three Injections had prominent effects. 6. In the research of the Lung weight in Xylene-poisoned rats each Injections of Mokhyangsunkisan extract and Palmisunkisan extract had significant effects whereas that of the Injection of Mokhyangsunkisan plus Rheum undulatum L. extract had no effect. 7. In the experiments about the variation of the $Na^+$ contents in the serum electrolytes of the Xylene-poisoned rats the Injection of Mokhyangsunkisan extract had a significant effect whereas those of the Injections of Mokhyangsunkisan plus Rheum undulatum L. extract and Palmisunkisan extract had no significant effects. 8. None of the Injection of Mokhyangsunkisan extract, Mokhyangsunkisan plus Rheum undulatum L. extract and Palmisunkisan extract had significant effects in the experiments about the variation of the $K^+$ contents in the serum electrolytes of the Xylene-poisoned rats. 9. All the three Injections had prominent death-repressive effects on the pulmonary thromboembolism induced by Sodium Arachidonate. 10. Each Injection of Mokhyangsunkisan extract and Palmisunkisan extract had death-repressive effects on the pulmonary thromboembolism induced by ADP, whereas the Injection of Mokhyangsunkisan plus Rheum undulatum L. extract had a feeble death-repressive effect By all results of the clinical experiments. the following conclusions are drown; Each Injection of Mokhyangsunkisan extract and Palmisunkisan extract has analgesic and anti-convulsive effects and is also effective for the $O_3$ and Xylene-poisoned Lung damage and pulmonary thromboembolism of rats and mice. The Injection of Mokhyangsunkisan plus Rheum undulatum L. extract has on analgesic effect and is also effective for the pulmonary thromboembolism. Especially its analgesic effect is prominent. Therefore, each Injection of Mokhyangsunkisan extract and Palmisunkisan extract can be used for injection to improve the pulmonary functions whereas the Injection of Mokhyangsunkisan plus Rheum undulatum L. extract is partly effective for the improvement of the pulmonary function. In view of the results so far achieved, fluid acupuncture therapy can be applied as well as traditional way of oral administration of the decoction.

• Journal of Veterinary Clinics
• /
• v.26 no.4
• /
• pp.362-366
• /
• 2009

Hypertrophic cardiomyopathy (HCM) is the most often seen type of cardiomyopathy in cats. The cause is unknown but a genetic basis is thought to underlie some cases. Thromboembolism (TE) is a troubling complication in cats with myocardial disease. Two cats referred to Seoul National University Hospital for Animals with the paralysis of bilateral hindlimbs after vomiting. The cats were depressed and the bilateral hindlimbs were cyanotic, cool and painful. Heart murmur sounds were auscultated in both cases. Through radiographic and echocardiographic evaluation, HCM was diagnosed. TE at the distal aortic trifurcation was also visualized on abdominal ultrasonography. Both cats were expired and HCM and saddle thrombus were confirmed by postmortem examination in one cat.