• Title/Summary/Keyword: thromboembolism

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A comparative study on anticoagulants following valve replacement surgery - a retrospective study with warfarin anticoagulation comparing with antiplatelet therapy in patients with bioprosthetic heart valve replacement (판막 이식수술후의 각종 항응고제 사용에 관한 비교적 연구 - 조직판막 이식수술후 Warfarin 사용군과 antiplatelet 사용군과의 비교 -)

  • Chae, Hurn;Park, Young-Kwan;Suh, Kyung-Phill
    • Journal of Chest Surgery
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    • v.20 no.1
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    • pp.13-21
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    • 1987
  • To clarify the difference between the outcome of warfarin anticoagulation and the antiplatelet [Aspirin, Dipyridamole] therapy after bioprosthetic heart valve replacement, we compared the following two groups. Group I [Warfarin group] consisted of 557 patients undergone lonescu - Shiley valve replacement between January, 1979 and December, 1985, and treated with scheduled warfarin therapy at Seoul National University Hospital. Group II [Antiplatelet group] consisted of 128 patients undergone lonescu - Shiley, Carpentier - Edwards or Wessex bioprosthetic valve replacement between March, 1983 and December, 1986, and treated primarily with antiplatelet therapy [Aspirin plus Dipyridamole] at SeJong General Hospital. The two groups were similar with respect to age, number of valves utilized per patient, type of operation and risk factors of thromboembolism. In group I, 522 patients excluding 35 hospital death [hospital mortality 6.3%], and in group II, 119 survivors excluding 9 hospital death [hospital mortality 7.0%] were followed. In group I, there were 13 fatal complications, of which seven were thromboembolic [0.6% / pt-yr] and six hemorrhagic [0.5%/pt-yr] during the period of four years. In group II, there were 3 fatal thromboembolic complications [2.3%/pt-yr] during the period of four years. This showed no statistically significant difference. Apart from fatal complications, there were lots of warfarin related minor complications in group I comparing with those of group II. The actuarial probability of the freedom from thromboembolism and of the freedom from fatal complications were very similar at each corresponding years postoperatively. As a result, warfarin anticoagulation in patients with bioprosthetic valve replacement did not reveal any significant advantages over antiplatelet therapy.

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Effect of Sambutang on the Serum Cholesterol Levels and the Cardiovascular System in Experimental Animals (삼부탕(蔘附湯)이 실험동물(實驗動物)의 혈장지질함량(血漿脂質含量) 및 심혈관계(心血管系)에 미치는 영향(影響))

  • Choi, Cheol-Won;Shin, Sun-Ho;Moon, Byung-Soon
    • The Journal of Internal Korean Medicine
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    • v.18 no.1
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    • pp.97-113
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    • 1997
  • The present experiment was designed to investigate the effects of Sambutang water extracts on the serum cholesterol levels and the cardiovascular system in the experimental animals. Thus, the changes of blood pressure and heart rate were measured after oral administration. Measurment of Mortality rate was observed for measuring the effect of Sambutang water extract. Sambutang water extract against pulmonary thromboembolism induced by collagen the mixture(0.1 ml/10 g, 2 mg/kg) plus serotonin(5 mg/kg) in mouse. The effect of Sambutang water extract was examined by observing the change of collagen-induced platelet aggregation, coagulation activity, ex vivo and in vitro fibrinolytic activity of euglobulin fraction in rats. The results were summarized as follows. 1. Sambutang decreased the serum cholesterol levels in rats. 2. Sambutang dropped the blood pressure in spontaneous hypertensive rat. 3. The drug increased the auricular blood flow in rabbit. 4. The drug relaxed the artery contraction by pretreated norepinephrine in rat. 5. The drug inhibited the death rate of mouse which was led to thromboembolism by serotonin and collagen. 6. The drug inhibited the platelet aggregation in rat. 7. The drug prolonged the prothrombin time and activated partial thromboplastin time on the test of plasma coagulation factor activity in rat, but was not valuable. 8. The drug increased the antithrombin activity in rat and the fibrinogen lysis time was reduced and lysis area was increased. 9. Sambutang reduced fibrinogen lysis time of rat in vitro assay. According to the above mentioned results. Sambutang increased the blood flow and dropped the blood pressure by the dilation of blood vessel. And the drug presented the antithrombin activity, inhibited the platelet aggregation.

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Incidence of Venous Thromboembolic Complications in Instrumental Spinal Surgeries with Preoperative Chemoprophylaxis

  • Hamidi, Saeed;Riazi, Mahdieh
    • Journal of Korean Neurosurgical Society
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    • v.57 no.2
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    • pp.114-118
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    • 2015
  • Objective : Venous thromboembolism (VTE) after spinal surgery affects a patients' postoperative recovery and also carries a mortality risk. Some studies recommended chemical prophylaxis for high-risk patients and for those after complex spinal surgeries. However, chemoprophylaxis for VTE in spinal surgery is underemployed and there is no agreement on the use of VTE prophylaxis in spinal surgery. The aim of this study was to document the incidence of VTE after an elective instrumental spinal surgery, among those receiving preoperative chemoprophylaxis as compared with patients who did not receive it. Methods : This study was carried out on eighty-nine patients allocated randomly to receive either low molecular weight heparin (LMWH) or no prophylaxis before elective instrumental spinal surgery. All patients received postoperative compression stockings. A compression Doppler ultrasonography was performed for all patients to detect postoperative deep vein thrombosis. In addition, further imaging studies were performed for patients suspected of VTE. Results : Three (3.3%) patients were diagnosed with VTE. One of them had received preoperative chemoprophylaxis. There were no significant difference in incidence of VTE between the two groups (p>0.95; 95% confidence interval, 0.06-8.7). Laterality of gender and postsurgical recumbence duration were all independent predictors of VTE (p=0.01 and p<0.001, respectively). Conclusion : The difference in the incidence of thromboembolic complications between the two groups was not significant. Moreover, we found that preoperative prophylactic LMWH injection has no major bleeding complications altering postoperative course; still, the issue concerning the initiation time of chemoprophylaxis in spinal surgery remains unclear.

Pulmonary Infarction due to Chronic Pulmonary Thromboembolism -Surgical Experience of One Case- (폐경색이 발생한 만성 폐색전증 -수술적 치험 1예-)

  • Kim Min-Ho;Seo Yeon-Ho
    • Journal of Chest Surgery
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    • v.39 no.5 s.262
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    • pp.403-406
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    • 2006
  • Infarction of the lung usually results from pulmonary arterial obstruction. Pulmonary infarcts often become infected from bronchial contamination and may become lung abscesses, empyema, or bronchopleural fistula causing sepsis. Diagnosis is important for intensive therapy, since infection is prone to spread. Resection of the infarcted lung should be considered early in an attempt to control infection. A sixty-seven-year-old man was hospitalized with dyspnea. A computed tomographic scan of the chest showed left lower lobe infiltration and mild pleural effusion with pleural thickening. There was a thrombus in the left pulmonary artery leading from the lower lobe to the upper lobe artery. At operation, the left lower lobe was found to have complete hemorrhagic infarction. The left lower lobectomy was performed. The remaining thrombus was removed after the left main pulmonary arteriotomy. He has been followed up for 15 months and has done well with no recurrence of thrombus and infarction of the lung.

Elevated Blood Urea Nitrogen/Creatinine Ratio Is Associated with Venous Thromboembolism in Patients with Acute Ischemic Stroke

  • Kim, Hoon;Lee, Kiwon;Choi, Huimahn A.;Samuel, Sophie;Park, Jung Hyn;Jo, Kwang Wook
    • Journal of Korean Neurosurgical Society
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    • v.60 no.6
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    • pp.620-626
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    • 2017
  • Objective : Although venous thromboembolism (VTE) is frequently related to dehydration, the impact of dehydration on VTE in acute ischemic stroke (AIS) is not clear. This study investigated whether dehydration, as measured by blood urea nitrogen (BUN)/creatinine (Cr) ratio, influences the occurrence of VTE in patients with AIS. Methods : This is a retrospective study of patients with AIS between January 2012 and December 2013. Patients with newly diagnosed AIS who experienced prolonged hospitalization for at least 4 weeks were included in this study. Results : Of 182 patients included in this study, 17 (9.3%) suffered VTE during the follow-up period; in two cases, VTE was accompanied by deep vein thrombosis and pulmonary embolism. Patients with VTE were more frequently female and had higher National Institutes of Health Stroke Scale (NIHSS) score, more lower limb weakness, and elevated blood urea nitrogen BUN/Cr ratio on admission. In a multivariate analysis, BUN/Cr ratio >15 (odds ratio [OR] 8.75) and severe lower limb weakness (OR 4.38) were independent risk factors for VTE. Conclusion : Dehydration on admission in cases of AIS might be a significant independent risk factor for VTE.

Surgical Treatment of Pulmonary Artery Sarcoma -One case report- (급성 폐동맥 색전증으로 오인된 폐동맥 육종 -1예 보고-)

  • Park, Kuhn;Kwon, Jong-Bum;Lee, Jong-Ho;Kang, Jae-Kul;Kim, Hwan-Ook;Jo, Keon-Hyon;Wang, Young-Pil
    • Journal of Chest Surgery
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    • v.37 no.7
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    • pp.597-600
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    • 2004
  • We report a rare case of pulmonary artery sarcoma mimicking pulmonary artery thromboembolism in a 57-year-old man who suffered with 2-month dyspnea and exacerbated for 1 week. He was transferred from private clinic and he was diagnosed as acute pulmonary artery thromboembolism on the basis of chest CT. Chest CT, pulmonary artery angiogram, and perfusion scan were examined. We performed surgical excision with aid of CPB. The final pathologic report was that the mass was a pulmonary artery sarcoma. We experienced one case of pulmonary artery sarcoma and reported it with reference.

A Case of Multiple Thromboembolisms in Hyperhomocysteinemia (과호모시스턴혈증에서 발생된 다발성 혈전증 1예)

  • Park, Jae-Sun;Bae, Won-Ki;Lee, Sang-Jun;Chung, Rae-In;Jin, Seong-Lim;Lee, Hyuk-Pyo;Kim, Joo-In;Choi, Soo-Jeon;Yum, Ho-Kee
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.2
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    • pp.239-246
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    • 1999
  • Hyperhomocysteinemia is an independent risk factor for cardiovascular, cerebrovascular and peripheral vascular diseases complicated with atherosclerosis and thromboembolism. Increased plasma homocystein level develops from genetic defect of enzyme for homocystein metabolism or vitamine deficiency, has direct toxic effect for vascular endothelium and makes damages to antithrombotic action of vascular endothelial cell. Most of hyperhomocysteinemia is asymptomatic, but rarely develops cardiopulmonary or cerebrovascular accidents. In case of thromboembolism with unknown cause, the hyperhomocysteinemia should be considered as one of the many etiologies. The authors, first in korea, report a case of multiple thromboembolisms of deep vein of lower extremity, pulmonary vessels, superior sagittal and transverse sinus of brain in a patient with the hyperhomocysteinemia with a review of literature.

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Effects of Sopoongtang on the Cardiovascular System in the Experimental Animals (소풍탕(疎風湯)이 실험동물(實驗動物)의 심혈관계(心血管系)에 미치는 영향(影響))

  • Jeong, Jang-Gyun;Mun, Byeong-Sun
    • The Journal of Internal Korean Medicine
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    • v.16 no.1
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    • pp.197-213
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    • 1995
  • The present experiment was desinged to investigate the effects of Sopungtang water extracts on the Cardiovascular System in the Experimental Animals. Thus, the changes of blood pressure and heart rate were measured after oral administration. Measurments of Mortality rate were observed for measuring the effect of Sopungtang water extract. Sopungtang water extract against pulmonary thromboembolism induced by collagen the mixture(0.1ml/10g, 2mg/kg B.W) plus serotonin(5mg/kg B.W) in mouse. The effects of Sopungtang water extract were examined by observing the change of collagen-induced platelet aggregation, coagulation activity, ex vivo and in vitro fibrinolytic activity of euglobulin fraction in rats. The results were summarized as followings. 1. Sopungtang dropped the blood pressure in spontaneous hypertensive rat. 2. The drug increased the auricular blood flow in rabbit. 3. The drug relaxed the artery contraction by pretreated norepinephrine in rat. 4. The drug inhibited the death rate of mouse which was led to thromboembolism by serotonin and collagen. 5. The drug inhibited the platelet aggregation in rat. 6. The drug prolonged the prothrombin time and activated partial thromboplastin time on the test of plasma coagulation factor activity in rat, but was not valuable. 7. The drug increased the antithrombin activity in rat and the fibrinogen lyses time was reduced and lyses area was increased. 8. Sopungtang reduced fibrinogen lyses time of rat in vitro assay. According to the above mentioned results, Sopungtang increased the blood flow and dropped the blood pressure by the dilation of blood vessel. And the drug presented the antithrombin acivity, inhibited the platelet aggregation.

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Comparisons of Bleeding Risks between Rivaroxaban and Dalteparin for Treatment of Venous Thromboembolism in Cancer Patients (암환자의 정맥혈전색전증 치료에서 rivaroxaban과 dalteparin의 출혈 부작용 비교)

  • Kim, Yoon Kyung;An, Sook Hee;Kim, Jae Yeon;Chung, Jee Eun;Gwak, Hye Sun
    • Korean Journal of Clinical Pharmacy
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    • v.26 no.3
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    • pp.195-200
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    • 2016
  • Background: Venous thromboembolism (VTE) is a common and life-threating condition in cancer patients. Low molecular weight heparins (LMWH), such as dalteparin, are recommended in the treatment of VTE. Also, rivaroxaban, an orally administered direct factor Xa inhibitor, was approved for the treatment of VTE. It showed similar efficacy to standard therapy (LMWH or warfarin) and was associated with significantly lower rates of major bleedings. However, in the real world, bleeding has been reported to occur frequently in cancer patient receiving rivaroxaban. The goal of this research was to analyze bleeding risks between rivaroxaban and dalteparin for treatment of VTE in cancer patients. Methods: Medical records of oncology patients who were treated with rivaroxaban or dalteparin for VTE from July 2012 to June 2014 were retrospectively reviewed. Data collected were as follows: age, sex, weight, height, cancer types and stages, ECOG (eastern cooperative oncology group) PS (performance score), VTE types, concurrently used medications, study drug information (dose and duration of therapy), INR (international normalized ratio), PT (prothrombin time), and platelet counts. Bleeding was classified into major bleedings, clinically relevant non-major bleedings, and minor bleedings. Results: A total of 399 patients were included in the study. Of these patients, 246 were treated with rivaroxaban and 153 with dalteparin. Bleeding rates were significantly higher in the rivaroxaban group than in the dalteparin group (adjusted odds ratio (AOR) 2.09, 95% CI 1.22-3.60) after adjusting for confounders. In addition, rivaroxaban remained independently associated with 1.78-fold (95% CI 1.14-2.76) shorter time to bleeding compared to dalteparin after adjusting other factors known to be associated with poor outcomes. Conclusion: This study suggested that rivaroxaban was associated with an increased risk of bleedings in cancer patients.

Experimental Studies on the Efficiency of Insamyounpaesan and Insamyounpaesangamibang (인삼윤폐산(人蔘潤肺散) 및 인삼윤폐산가미방(人蔘潤肺散加味方)의 효능(效能)에 관(關)한 실험적(實驗的) 연구(硏究))

  • Lee, Jeong-U;Jeong, Hui-Jae;Jeong, Seung-Gi;Lee, Hyeong-Gu
    • The Journal of Korean Medicine
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    • v.17 no.2 s.32
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    • pp.203-213
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    • 1996
  • Experimental studies were done to research the clinical effect of Insamyounpaesan and Insamyounpaesangamibang on viscousity of mucin solution, pulmonary thromboembolism, oxygen consumption in $O_3$ - exposed and Lung TBA in rats and mice. The result was obtained as follows: 1. In the effect of Insamyounpaesan and I nsamyounpaesangami-bang on the rate of viscousity sampled from mucin, Insam-younpaesan and Insamyounpaesangamibang were revealed to have a significant effect of decreasinf the rate of viscousity (p<0.05). 2. In the effect of Insamyounpaesan and Insamyounpaesangami-bang on sodium arachidonic acid induced pulmonary thrombo-embolism, Insamyounpaesan and Insamyounpaesangarnibang were revealed to have an effect of increasing the number of survival(p<0,05), but were not significant. 3. In the effect of Insamyounpaesan and Insamyounpaesangami-bang on ADP induced pulmonary thromboembolism, Insam-younpaesangamibang were revealed to have an effect of increasing the number of survival(p<0.05), but were not significant. 4. In the effect of Insamyounpaesan and Insamyounpaesangami-bang on oxygen cansumption values in rats exposed, Insamyounpaesan and Insamyounpaesangamibang were revealed to have a significant effect on the care of lung damages (p<0.05), but were not significant by Duncan's multiple comparision test. 5. In the effect of Insamyounpaesan and Insamyounpaesangami-bang on the lung TBA values in rats exposed $-O_3$, Insam-younpaesangamibang were revealed to have a significant effect (p<0.05) on the care of lung damages. In connection with the results of the studies, Insamyounpaesan and Insamyounpaesangamibang are concluded to be effective on the treatment of cough and lung and respiratory organ damages.

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