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Biomedical subjects

H Vinazzer

Publications and source records attributed to H Vinazzer.

At least 55 records · Page 3Linked to original sources
PubMed1984

[Substitution of antithrombin III in shock and consumption coagulopathy].

A considerable diminution of the activity of antithrombin III (AT III) is found in the majority of patients in shock with signs of DIC. This results in further propagation of the mechanism of consumption coagulopathy and in a diminished effect of heparin. AT III was substituted in 16 patients who were admitted in shock. When acute consumption coagulopathy was present a greatly increased rate of inactivation of AT III was found. In spite of this fact, a comparison with a similar group of patients in whom substitution was not undertaken demonstrated a highly significant shortening of the duration of DIC and a clinically impressive, but not statistically significant, diminution of the mortality rate.

Antithrombin III↗
PubMed1984

[Antithrombin III substitution in patients in shock].

In a trial involving 61 patients suffering from shock and DIC, the relations between the concentration of heparin, the effect of heparin on coagulation and the activity of AT III were studied. The effect of heparin decreased to one-half when the activity of AT III was 75 per cent of the average normal level. At 50 per cent AT III, the effect of heparin was negligible. When AT III was substituted the disappearance rate of the AT III activity from circulation was considerably increased in the case of acute DIC, while the concentration of AT III when measured immunologically, did not show an increased disappearance. This difference suggests increased consumption of AT III by active serine proteases of coagulation. In patients substituted with AT III, the duration of acute DIC was between 16 h and 19 h, while it was 3.3 days in patients who received heparin. The survival rate of most severe cases of DIC showed a distinct trend towards improvement, but significance was lacking, probably due to the small number of comparable cases. When AT III and heparin were given simultaneously, there was no further shortening of the duration of DIC; however, severe bleeding complications occurred in some cases. The substitution of AT III was calculated on the following basis: In acute DIC an increase in AT III activity of 1 per cent can be expected when 1 unit/kg body weight is given. The same dose of AT III increases the plasma level by 1.8 per cent when the clotting system is unaffected.

Antithrombin III↗
PubMed1983

Double-blind cross-over study of the effect of sultosilic acid piperazine salt (A-585) and bezafibrate in primary hyperlipoproteinemia.

Sultosilic acid piperazine salt (A-585), a new lipid lowering drug, was compared with the action of bezafibrate. In 20 patients suffering from primary hyperlipoproteinemia a double-blind cross-over study was carried out. A series of parameters of the lipoprotein metabolism, as well as of fibrinolysis and platelet function, was compared before and after administration of the drugs. There was a statistically significant diminution of total cholesterol, triglycerides, beta- and pre-beta-cholesterol and an increase of alpha-cholesterol by both drugs. Furthermore, both drugs caused a significant shortening of the euglobulin lysis time and a significant diminution of platelet adhesiveness. In patients who were under oral anticoagulants the thrombotest levels were not influenced by A-585 but were frequently below the therapeutic range during bezafibrate therapy. The difference in the thrombotest during treatment with the 2 drugs was significant. A slightly elevated gamma-GT activity normalized during bezafibrate therapy but was not influenced by A-585. Other parameters did not show significant differences between the 2 drugs.

Aged↗
PubMed1982

Substitution therapy with an antithrombin III concentrate in shock and DIC.

In 15 patients admitted to the Intensive Care Unit for shock and with signs of DIC, Antithrombin III (AT III) was substituted. Immediately after the first blood sampling, 1,000 units of AT III was given. This was followed by 500 units AT III after 24 h and after 48 h. A continuous dose of heparin of between 250 and 500 I.U./h was simultaneously given. The following results were obtained: The activity of AT III on admission of 63 +/- 19% increased to 83 +/- 17% 30 min after the initial substitution. There was a clear difference between the recovery of the substituted AT III in acute DIC and in patients in a steady state. AT III recovered in circulation was 47 +/- 15% in the former group but 83 +/- 16% in the latter cases. One unit of AT III per kg body weight increased AT III activity in circulation by 1% in acute DIC but by 1.8% in a steady state. The average half life of the substituted AT III was 4.4 +/- 1.6 h in acute DIC and was 20.2 +/- 4.1 h when the patients were in a steady state.

Adult↗
PubMed1982

Influence of heparin; of different heparin fractions and of a low molecular weight heparin-like substance on the mechanism of fibrinolysis.

The influence of different heparin fractions and of a synthetic polysulfated polysaccharide (SP54) on the fibrinolytic mechanism was examined. In vitro, a significant shortening of the euglobulin lysis time (ELT) was found after addition of standard mucosa heparin, of high MW heparin and of SP 54 respectively. Low MW heparin fractions had no influence on the ELT. Simultaneously with the shortening of the ELT an activation of factor XII and of kallikrein was observed. A similar effect was found in groups of volunteers after i.v. or s.c. injections and even after oral administration of SP 54. The effect of venous occlusion on the ELT and on the activation of factor XII was considerably increased when heparin or SP 54 was injected 2 h prior to the test. When a comparable concentration of the test substances was added to plasma samples before and after venous occlusion, the effect on the ELT was much less pronounced than after injection whilst the effect on factor XII was comparable in both tests. From these results the conclusion was drawn that activation of fibrinolysis by polysulfated polysaccharides is achieved by an endogenous pathway as well as by an increased availability of the vascular activator. The magnitude of the activation of fibrinolysis partly depends on the MW of the substance but apparently also on the degree of sulfation since a low MW substance with a high number of sulfate bonds such as SP 54 was considerably more active than the low MW fraction of standard heparin.

Adult↗
PubMed1982

Comparison between two concentrates with factor VIII inhibitor bypassing activity.

Clotting activities as well as thrombogenicity in rabbits of two activated prothrombin complex concentrates, Feiba (Immuno) and Autoplex (Travenol) were compared. When total activities of clotting factors were measured, factor VII was considerably higher in Autoplex than in Feiba. Likewise, a higher concentration of the activated serine proteases VIIa and IXa was found in Autoplex. On incubation with calcium chloride low activities of Xa and IIa appeared in both concentrates. When factor VIII was also added, the increase of these activities was higher in Autoplex but not in Feiba. On addition of phospholipid, the activities of Xa and IIa considerably increased in Autoplex but not in Feiba. There was a rapid diminution of these activities when antithrombin III was in the test system. Factor IXa however, on incubation of the concentrates with antithrombin III disappeared slower from Autoplex than from Feiba. Thrombogenicity in rabbits assayed by the Wessler test varied between different batches of the concentrate but was higher in Autoplex than in Feiba by an average factor of between 12.8 and 17.8.

Animals↗
PubMed1982

[Diagnosis of increased thrombotic tendency with chromogenic substrates].

In 185 patients suffering from increased thrombotic tendency and in 40 healthy individuals, the following parameters were assayed by the aid of chromogenic substrates: antithrombin III, plasminogen, immediate and total antiplasmin. Furthermore, the vascular activator of plasminogen and the spontaneous aggregation of platelets were examined by other methods. Alterations of plasmatic parameters which are likely to cause an increased thrombotic tendency were detected in 10% of all cases. In patients suffering from arterial thrombotic manifestations hyperactive platelets were found in 42%.

Antithrombin III↗
PubMed1982

[Substitution of antithrombin III in shock patients].

In 15 patients admitted to the operative intensive care unit of the Institute of Anesthesiology for shock and with signs of DIC, antithrombin III (AT III) was substituted together with a continuous infusion of heparin. 1,000 units AT III were given after the first blood sampling. This was followed by 500 units after 24 h and after 48 h. 14 out of the 15 cases could be evaluated. The activity of AT III prior to substitution was below 75% in 10 cases and above 75% in 4 cases. The mean increase after substitution was 16%. The recovery was below 50% in cases with acute DIC whilst it was 90% in cases in a comparatively steady state. One unit AT III per kg body weight increased the activity of AT III in circulation by an average of 1% in acute DIC whilst the increase was 2% in cases without signs of acute DIC. The average half disappearance of the increase of AT III in circulation was 4.25 h in acute DIC but was 19.0 h when acute DIC was not detectable.

Adult↗
PubMed1980

[Prophylaxis of consumption coagulopathy in shock. Dependence of the effect of heparin on the activity of antithrombin III (author's transl)].

In 16 patients admitted in shock, heparin prophylaxis for DIC was carried out. The effect of heparin was monitored by a series of coagulation tests. A distinct relation was found between the effect of heparin on the aPTT and on the thrombin clotting time and the activity of antithrombin III. Even a comparatively slight diminution of this activity resulted in a considerable decrease of the heparin effect on coagulation. Since this effect is of primary importance for the efficacy of prophylaxis of DIC, regular assays of antithrombin III are proposed in shock patients receiving heparin.

Adolescent↗