• 제목/요약/키워드: thrombolytic

검색결과 104건 처리시간 0.038초

Types of Thromboembolic Complications in Coil Embolization for Intracerebral Aneurysms and Management

  • Kim, Hong-Ki;Hwang, Sung-Kyun;Kim, Sung-Hak
    • Journal of Korean Neurosurgical Society
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    • 제46권3호
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    • pp.226-231
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    • 2009
  • Objective : We describe our clinical experiences and outcomes in patients who had thromboembolic complications occurring during endovascular treatment of intracerebral aneurysms with a review of the literature. The types of thromboembolic complications were divided and the treatment modalities for each type were described. Methods : Between August 2004 and March 2009 we performed endovascular embolization with Guglielmi detachable coils for 173 patients with 189 cerebral aneurysms, including ruptured and unruptured aneurysms at our hospital. Sixty-eight patients were males and 105 patients were females. The age of patients ranged from 22-82 years (average, 58.8 years). We retrospectively evaluated this group with regard to complication rates and outcomes. The types of thromboembolic complications were classified into the following three categories: mechanical obstruction, distal embolic stroke, and stent-induced complications, which corresponded to types I, II, and III, respectively. A comparison of the clinical results was made for each type of complication. Results : Only eight patients had a thromboembolic complication during or after a procedure (4.6%). Of the eight patients, two had a mechanical obstruction as the causative factor; the other three patients had distal embolic stroke as the causative factor. The remaining three patients had stent-induced complications. In cases of mechanical obstruction, recanalization occurred due to the use of intra-arterial thrombolytic agents in one of two patients. Nevertheless, a poor prognosis was seen. In the cases of stent-induced complications, in one of three patients in whom a thrombus developed following stent insertion, a middle cerebral artery territory infarct developed with a poor prognosis despite the use of wiring and an intra-arterial thrombolytic agent. In the cases of distal embolic stroke, all three patients achieved good results following the use of antiplatelet agents. Conclusion : Treatment for thromboemboic complications due to mechanical obstruction and stent-induced complications include antiplatelet and intra-arterial thrombolytic agents; however, this cannot guarantee a sufficient extent of effectiveness. Therefore, active treatments, such as balloon angioplasty, stent insertion, and clot extraction, are helpful.

Lower limb ischemia after bee sting

  • Ryu, Hee Yun;Yoo, Min Seok;Park, Ji Young;Choi, Jae Woong;Ryu, Sung Kee;Kim, Seunghwan;Lee, Se Jin;Kim, Young Bin
    • Journal of Yeungnam Medical Science
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    • 제33권2호
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    • pp.134-137
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    • 2016
  • Bee sting causes mild symptoms such as urticaria and localized pain, and severe symptoms including anaphylaxis, cardiovascular collapse, and death. We reported on a patient with arterial thrombotic occlusion and severe ischemia in the lower limb after multiple bee stings. The patient was stung 5 times and complained of pallor, pain, and coldness in the left toe, and did not have dorsalis pedis pulsation. Computed tomography angiography showed multiple thrombotic occlusion of the anterior and posterial tibial artery below the knee. Local thrombolytic therapy using urokinase was administered and the occluded arteries were successfully recanalized.

임신과 연관된 헤파린 항응고요법 중 반복적으로 발생한 인공판막 혈전증의 혈전용해치료 (Thrombolytic Therapy for Repeated Prosthetic Valvular Thrombosis That's Associated with Pregnancy under Heparin Anticoagulation)

  • 최주원;김용인
    • Journal of Chest Surgery
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    • 제41권4호
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    • pp.484-488
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    • 2008
  • 기계판막을 이용한 승모판치환술을 시행 받은 환자가 임신과 연관되어 장기간의 헤파린 피하주사를 이용한 항응고 치료를 받는 중에, 반복적인 인공판막 혈전증을 포함하는 항응고제로 인한 다양한 합병증이 관찰되었다. 이는 안티트롬빈 III의 결핍으로 인한 헤파린 저항성에 의한 것으로 판단되었고, 유로키나아제 또는 조직플라즈미노겐활성제(tissue plasminogen activator, tPA)를 이용한 혈전용해치료를 통하여 산모와 태아 모두 안전하게 치료할 수 있었다.

A Numerical Study on the Effects of Drug Ejection Velocity on Endovascular Thrombolysis

  • Jeong Woo Won;Rhee Kyehan
    • 대한의용생체공학회:의공학회지
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    • 제26권3호
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    • pp.157-161
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    • 2005
  • Direct injection of a fibrinolytic agent to the intraarterial thrombosis may increase the effectiveness of thrombolysis by enhancing the permeation of thrombolytic agents into the blood clot. Permeation of fibrinolytic agents into a clot is influenced by the surface pressure, which is determined by the injection velocity of fibrinolytic agents. In order to calculate the pressure distribution on the clot surface for different jet velocities (1, 3, 5 m/sec) and nozzle arrangements (1, 9, 17 nozzles), computational fluid dynamic methods were used. Thrombolysis of a clot was mathematically modeled based on the pressure and lysis front velocity relationship. Direct injection of a thrombolytic agent increased the speed of thrombolysis significantly and the effectiveness was increased as the ejecting velocity increased. The nine nozzles model showed about $20\%$ increase of the lysed volume, and the one and seventeen nozzles models did not show significant differences. The wall shear stress decreased as the number of nozzles increased, and the wall shear stress in most vessel wall was lower than 25 Pa. The results implied that thrombolysis could be accelerated by direct injection of a drug with the moderate velocity without damaging the blood vessel wall.

발효쑥의 생리활성 및 흰쥐의 지질대사에 미치는 영향 (Biological Activities of Fermented Mugworts and Their Effects on Lipid Metabolism in Rats)

  • 정순모;송효남
    • 동아시아식생활학회지
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    • 제19권3호
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    • pp.356-362
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    • 2009
  • The objective of this study was to investigate the biological activities of fermented mugworts and their effects on the lipid metabolism in hyperlipidemia-induced rats. The proximate compositions of two kinds of mugwort, Artemisia capillaris Thumberg and Artemisiae asiaticae Nakai, were compared before and after fermentation. In both types of mugwort crude protein and amino nitrogen contents markedly increased with fermentation. Thrombolytic activity determined from the size of the clear zone on a fibrin plate was higher for the Artemisiae asiaticae Nakai, especially in the fermented sample. Antioxidative activity according to DPPH(1,1-diphenyl-2-picrylhydrazyl) radical scavenging effects was higher for Artemisia capillaris Thumberg but no significant differences were found between the samples after fermentation. The body weights of hyperlipidemia-induced rats that were fed the mugworts for 4 weeks were lower than those of the control group. In all the mugwort-fed rats serum total cholesterol and LDL-cholesterol levels remarkably decreased. Furthermore the fermented mugworts were found to be more effective at decreasing triglyceride (TG) levels. It is also noteworthy that the highest HDL-cholesterol levels were observed in the rats treated with the fermented Artemisiae asiaticae Nakai. And fatty liver weights were higher in the rats fed Artemisia capillaris Thumberg. In conclusion the feeding of fermented Artemisiae asiaticae Nakai was effective for increasing thrombolytic activity and HDL-cholesterol levels as well as reducing TG levels in rats.

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출혈을 동반한 급성기 허혈성 뇌중풍 환자에 대한 한방치료 증례 보고 1례 (A Case Report of Korean Medicine Treatment for Acute Cerebral Infarction with Cerebral Hemorrhage)

  • 전상우;이기향;강세영
    • 대한한방내과학회지
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    • 제40권5호
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    • pp.999-1006
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    • 2019
  • Objectives: The purpose of this study was to report the improvement of symptoms by Korean medicine in acute hemorrhagic infarction. Method: The patient was diagnosed with a cerebral infarction of the right temporal lobe accompanied by cerebral hemorrhage of the left basal ganglia. He did not receive intravenous thrombolytic treatment. Sunghyangjungi-san-gamibang was initially administered, and Gami-daebo-tang was administered during the recovery phase, together with Uhwangchungsim-won, Simjeok-hwan, and acupuncture. The prognostic observation was conducted using the manual muscle test (MMT), the Korean version of the modified Bathel index (K-MBI), and subjective assessment. Results: After Korean medicine treatment, the K-MBI score was improved from 52 to 93. The MMT score and subjective assessment also showed improvement. Conclusions: For patients who cannot be treated with intravenous thrombolytic treatment, Korean medicine treatment is effective during the early and recovery stages of stroke.

인공 승모판막에 생긴 혈전의 혈전용해 치료 - 1례 보고 - (Thrombolytic Therapy for Thrombosis of Prosthetic Mitral Valve - A Case Report -)

  • 강신광;김시욱;원태희;구관우;나명훈;유재현;임승평;이영;정진옥
    • Journal of Chest Surgery
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    • 제35권11호
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    • pp.826-830
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    • 2002
  • 인공판막 혈전증은 인공판막 치환술 후 발생할 수 있는 치명적인 합병증으로 즉각적인 처치를 요한다. 저자들은 인공 승모판막 혈전에 대해 혈전용해 치료를 시행하였기에 보고하는 바이다. 47세 남자 환자가 갑자기 시작된 호흡곤란으로 응급실로 내원하였다. 환자는 승모판막협착증으로 8 개월 전에 승모판막 치환술(On-X valve, 29 mm)을 시행받았으며, 내원 시 INR은 1.09였다. 청진 상 기계판막음이 잘 들리지 않았으며, 양측폐야에서 수포음이 들렸다. 경식도 심초음파에서 판막 혈전이 보였으며, 경판막 압력차는 34 mmHg로 증가되어 있었다. 환자는 상태 악화되어 기관 삽관과 기계호흡을 하였으나 경제적인 이유로 수술을 거부하였다. 환자를 심장 집중치료실로 옳기고 혈전용해 치료를 시작하였다. 유로키나제 1,500,000 IU를 정맥주사하고 이어서 1,500,000 IU를 점적하였다. 환자 상태가 호전이 없어 t-PA 100 mg을 2 시간에 걸쳐 점적하였다. 그동안 기계 판막음이 들리기 시작하였으며, 환자의 활력징후는 점차 회복되었다. 혈전용해 치료 6시간 후에 경식도 심초음파에서 판막 혈전은 사라졌고 경판막 압력차는 1.7 mmHg로 호전되었다. 환자는 신경학적 이상 없이 회복되었으며 경구 항응고제로 적정 INR을 유지하고 퇴원하였다.

제주전통된장으로부터 세포외효소 분비능이 우수한 미생물의 분리 및 특성 (Isolation and Characteristics of Microorganisms Producing Extracellular Enzymes from Jeju Traditional Fermented Soybean Paste (Doenjang))

  • 오유성;박지은;오현정;김정현;오명철;오창경;오영주;임상빈
    • 한국식품영양과학회지
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    • 제39권1호
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    • pp.47-53
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    • 2010
  • 제주 전통된장으로부터 세포외효소(protease, fibrinolytic enzyme, amylase, cellulase, lipase) 분비능이 우수한 세균을 분리한 후 16S rRNA 유전자 분석과 생리적 특성을 분석하여 균주를 확인하고자 하였다. Protease 분비능은 JR14, JR19, JR25, JR32, JR38, JR47과 JR64가 표준균주인 Bacillus subtilis KCCM12027보다 활성이 높았다. Amylase 분비능은 JR6, JR25, JR38, JR56, JR81에서 나타난 반면 표준균주인 KCCM12027에서는 나타나지 않았다. Cellulase 분비능은 JR6, JR14, JR48과 JR65가 다른 분리균주 또는 표준균주보다 높았으며, lipase 분비능은 JR14와 JR48이 높았다. 혈전용해 활성은 positive control인 plasmin의 용해 영역에 비하여 JR19가 192%로 가장 높았고, hemolysis 활성도 높았다. 혈전용해능이 있는 균주인 JR19, JR32, JR47, JR64의 배양액을 zymography한 결과, 25~75 kDa 사이에서 4~5개의 밴드가 확인되었다. 된장으로부터 분리한 균주들의 16s rRNA 유전자 염기서열을 분석한 결과 모두 Bacillus species와 99%의 상동성을 나타내었으며, 혈전용해능이 가장 우수한 JR19는 B. stratosphericus $41KF2a^T$와 거의 일치하였다.