• Journal of Korean Neurosurgical Society
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• 제57권2호
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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.

• Journal of Chest Surgery
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• 제39권5호
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• pp.403-406
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• 2006

폐경색은 폐동맥의 폐색으로 인해 발생하며 기관지내 세균오염에 의해 폐감염이 흔하게 속발하며 이는 폐농양, 농흉 그리고 기관지 흉막루 등을 일으켜 결국 패혈증에 이르게 할 수 있다. 이러한 이유로 조기 진단이 중요하며 감염 조절을 위해 폐절제 등을 조기에 고려해야 한다. 67세 남자가 호흡곤란을 주소로 응급실에 내원하였다. 흉부 전산화 단층 촬영에서 좌하엽에 침윤성 병변과 소량의 흉수 그리고 늑막 비후가 관찰되었다. 폐색전은 하엽 폐동맥에서 상엽 폐동맥까지 자라나 있었다. 출혈성 경색이 완연한 좌하엽은 절제되었고 좌주폐동맥을 열어 나머지 폐색전을 제거하였다. 수술 후 15개월간 추적 관찰하고 있으며 폐색전이나 폐경색의 재발은 보이지 않았다.

• Journal of Korean Neurosurgical Society
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• 제60권6호
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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.

• Journal of Chest Surgery
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• 제37권7호
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• pp.597-600
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• 2004

57세 남자 환자로 약 2개월 전부터 호흡곤란이 있어오다 1주일 전부터 악화되어 폐동맥 혈전색전증으로 오인된 폐동백 육종을 치험하여 보고하는 바이다. 환자는 지방병원에서 흉부전산화 단층촬영을 시행하였고 급성 폐동맥 색전증 진단 하에 본원으로 전원 되었다. 흉부전산화 단층촬영 및 폐동맥 혈관 조영술, 폐 관류 검사를 시행하였고 체외순환을 이용하여 수술적 치료를 시행하였다. 환자는 폐동맥 육종으로 최종 진단되었으며 이에 문헌과 함께 보고하는 바이다.

• Tuberculosis and Respiratory Diseases
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• 제47권2호
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• pp.239-246
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• 1999

저자등은 우하지 동통 및 객혈을 주소로 내원하여 우하지 심부정맥혈전증, 폐색전증 및 뇌정맥혈전증으로 환자에서 과호모시틴혈증이 다발성 혈전증의 원인이었던 1예를 경험 하였기에 문헌고찰과 함께 보고하는 바이다.

• 대한한방내과학회지
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• 제16권1호
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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.

• 한국임상약학회지
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• 제26권3호
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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.

• 대한한의학회지
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• 제17권2호
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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.

• Journal of Korean Neurosurgical Society
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• 제60권2호
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• pp.146-154
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• 2017

Objective : The semi-jailing technique (SJT) provides stent-assisted remodeling of the aneurysm neck during coil embolization without grasping the coil delivery microcatheter. We retrospectively evaluated the efficacy and safety of SJT using a Neuroform3 stent for coiling of wide-necked intracranial aneurysms. Methods : We collected the clinical and radiological data between January 2009 and June 2015 of the wide-necked aneurysms treated with SJT using a Neuroform3 stent. Results : SJT using a Neuroform3 stent was attempted in 70 wide-necked aneurysms (68 patients). There were 56 unruptured and 14 ruptured aneurysms. The size of aneurysm ranged from 1.7 to 28.1 mm (mean 6.1 mm). The immediate angiographic results were complete occlusion in 55 aneurysms (78.6%), neck remnant in 7 (10.0%), and aneurysm remnant in 8 (11.4%). Overall, periprocedural complications occurred in 13 patients (19.1%), including asymptomatic thromboembolism in 7 (10.3%), symptomatic thromboembolism in 4 (5.9%), and symptomatic hemorrhagic complications in 2 (2.9%). Conventional angiography follow-up was obtained in 55 (78.6%) of 70 aneurysms (mean, 10.9 months). The result showed progressive occlusion in 7 aneurysms (12.7%) and recanalization in 1 aneurysm (1.8%). At the end of the observation period (mean, 17.5 months), all 54 patients without subarachnoid hemorrhage showed excellent clinical outcomes (modified Rankin Scale [mRS] 0), except two (mRS 1 or 2) and seven of 14 patients with subarachnoid hemorrhage remained symptom-free (mRS 0). Conclusion : In this report of 70 aneurysms, SJT using a Neuroform3 stent for coiling of wide-necked intracranial aneurysms showed good technical safety, as well as favorable clinical and angiographic outcomes.

• Archives of Plastic Surgery
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• 제43권4호
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• pp.360-364
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• 2016

Background Venous thromboembolism, a spectrum of diseases ranging from deep venous thrombosis to pulmonary embolism, is a major source of morbidity and mortality. The majority of cases described in plastic surgery involve abdominoplasty. Risk assessment and prophylaxis are paramount in such patients. General recommendations were recently developed, but the evidence in the literature was insufficient to prepare exhaustive guidelines regarding the medication, dosage, timing, or length of the prophylaxis. Methods A thromboprophylaxis protocol was developed for patients undergoing abdominoplasty. The protocol consisted of preoperative, intraoperative, and postoperative measures. Enoxaparin was administered as chemoprophylaxis in selected patients. The study involved 253 patients. The patients were analyzed for age, body mass index, enoxaparin dosage, risk factors, and complications. Results Deep venous thrombosis was documented in two cases (0.8%). No pulmonary embolism occurred. Three patients (1.2%) presented mild subcutaneous abdominal hematoma within the first postoperative week that spontaneously resorbed with neither aesthetic nor functional complications. Two patients (0.8%) presented severe hematoma requiring surgical re-intervention for drainage and hemostasis revision. Statistical analysis showed no significant correlation between enoxaparin dosage and hematoma (P=0.18) or deep venous thrombosis (P=0.61). Conclusions The described thromboprophylaxis protocol proved to be effective in the prevention of thrombotic events, with an acceptable risk of hemorrhagic complications. Furthermore, it provides new evidence regarding the currently debated variables of chemoprophylaxis, namely type, dosage, timing, and length.