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Biomedical subjects

J J Corrigan

Publications and source records attributed to J J Corrigan.

At least 55 records · Page 3Linked to original sources
PubMed1983

Problems in the measurement of zinc using heparin as an anticoagulant.

Although several reports imply that anticoagulants and preservatives contain zinc, the quantity of zinc in heparin, if any, has not been documented. Zinc concentration was determined by flame atomic absorption spectroscopy in varying dilutions of multiple commercially obtained samples of purified sodium heparin N = 15 (microgram Zn/1000 Units heparin). Rubber stoppers of sterile heparin vials and of blood evacuation tubes were incubated in pre-analyzed water or saline on a mechanical shaker with fluid aliquots obtained up to 27 hours and analyzed for zinc content (microgram Zn/0.1 ml). Heparin, with contact or without contact with rubber stoppers, recorded identical zinc concentrations. Zinc concentrations varied from 0.222 +/- 0.01 (mean +/- SE) to 3.49 +/- 0.005 microgram Zn/1000 Units heparin. Leaching of zinc from rubber stoppers of vacutainer tubes (N = 9) was noted only with those containing known chelators of zinc. These results indicate that zinc is present in certain lots of sodium heparin and that caution must be exercised when reporting zinc concentrations of blood samples that contain sodium heparin as the anticoagulant.

Drug Contamination↗
PubMed1983

Ferrokinetic and hematologic studies in cystic fibrosis patients.

We investigated 28 cystic fibrosis (CF) patients to determine why hypoxia from their obstructive pulmonary disease does not produce polycythemia. Oxygen saturation was lower and erythropoietin levels were higher in CF patients than in 25 age-comparable reference subjects (90.8% and 47 mimu vs. 94.7% and 29 mimu, p less than 0.01). Hematocrit and red blood cell (RBC) indices were not different between groups. Serum vitamin and iron levels, ferrokinetics, RBC volume, and RBC survival were studied in 10 of the 28 CF patients. Total iron-binding capacity and vitamin E levels were low, and serum iron, ferritin, vitamin B12, and folate levels were normal in these patients. Red blood cell survival was minimally decreased in six patients although there was no other evidence for hemolysis. Ferrokinetics (59Fe) indicated a reduction in total erythropoiesis in only two patients. Plasma volume was high-normal in five and above normal in four CF patients; RBC mass was increased appropriately for each patient's degree of hypoxia, when compared to healthy individuals living at different altitudes. These results suggest that CF patients are able to compensate for hypoxia by increasing RBC mass; however, an expanded plasma volume prevents a detectable rise in hematocrit.

2,3-Diphosphoglycerate↗
PubMed1983

Idiopathic thrombocytopenic purpura during pregnancy. A pediatric viewpoint.

Thrombocytopenia in the fetus must be anticipated when the mother has or has had idiopathic thrombocytopenic purpura (ITP). Although maternal morbidity and mortality is extremely low, the overall fetal mortality is high and ranges from 13-25%. The mortality in almost all cases is due to intracranial hemorrhage and appears to be related to the events surrounding labor and delivery. At the present time, the only guide to possible fetal involvement is the activity of the ITP process in the mother. In this review the current state of the art is examined. A scheme for the management of these cases at the time of expected date of confinement is proposed and is based upon the maternal and fetal platelet counts, maternal response to corticosteroids, and obstetrical considerations. It is recommended that cesarean section be given strong consideration when significant fetal involvement is anticipated or demonstrated by fetal scalp blood platelet level.

Adult↗
PubMed1982

Acute polyarthritis associated with active Epstein-Barr virus infection.

Nine patients with an initial onset of symptoms of acute arthritis within the preceding four weeks were enrolled in a prospective serological study with clinical follow-up for six months to two years. Four adults with chronic rheumatoid arthritis and ten healthy adults were similarly studied. Serial titers measured included antibodies to Epstein-Barr virus (EBV) antigens, group B coxsackieviruses, rubella virus, cytomegalovirus, and herpes simplex virus. Serological evidence of active EBV infection was found in four of the patients with acute arthritis, none of the patients with chronic arthritis, and one of the ten healthy adults. There was no similar correlation between acute disease and presence of antibodies to the other viruses tested. We suggest that EBV may cause acute rheumatic illnesses more commonly than is currently appreciated but is probably not involved in the etiology of typical chronic rheumatoid arthritis.

Acute Disease↗
PubMed1982

Prothrombin antigen and coagulant activity in patients with liver disease.

Plasma levels of prothrombin immunoreactive protein (factor II antigen) (II-Ag) and coagulant activity (II-CA) were determined in eight patients with acute hepatitis and in 29 patients with chronic liver disease (cirrhosis). The II-CA was reduced in 23 (62%), II-Ag in 17 (46%), and both were reduced in 13 (36%) of the cases. A disproportionate reduction was noted in 21 (57%); ie, there was more II-Ag found in comparison to the corresponding level of II-Ca. Ninety-six percent (23) of 24 patients with moderate to severe hepatocellular disease showed reduced II-CA levels; 63% (15) showed reduced II-Ag levels, with a disproportionate reduction in II-CA in 67% (16). These data suggest that reduced synthesis as well as impaired carboxylation of prothrombin precursor protein are factors contributing to the coagulopathy in patients with moderate to severe liver disease and that measurement of circulating levels of II-Ag may provide an excellent indication of hepatic synthetic capacity.

Adolescent↗
PubMed1982

Envenomation by the northern blacktail rattlesnake (Crotalus molossus molossus): report of two cases and the in vitro effects of the venom on fibrinolysis and platelet aggregation.

In two cases of human envenomation by the northern blacktail rattlesnake (Crotalus molossus molossus) there was marked swelling and ecchymosis of the bitten extremity and thrombocytopenia and, in one case, hypofibrinogenemia. Treatment consisted of i.v. antivenin, crystalloid solution, fresh frozen plasma and cryoprecipitates, with recovery in each case. In vitro studies showed that the venom had fibrinolytic and platelet aggregating properties; a coagulant effect, although present, was much less marked.

Adult↗
PubMed1982

The effect of vitamin E on warfarin-induced vitamin K deficiency.

Vitamin K-deficient animals and humans developed a more severe coagulopathy when treated with vitamin E, which was due to further reduction in the vitamin K-dependent coagulation factors (II, VII, IX, and X). This phenomenon was not seen in normal vitamin K-sufficient animals or human subjects. The mechanism by which vitamin E causes this effect is not known. These coagulation factors are produced by the liver in precursor forms and are converted to functional proteins by a vitamin K-dependent reaction. Analysis of one of these coagulation factors, prothrombin (factor II), in plasma of vitamin K-deficient animals and humans treated with vitamin E was done in this study. The precursor of factor II is antigenically similar to biologically active factor II and can be activated to form thrombin by Echis carinatus venom. The data showed that functional factor II coagulant activity was reduced below base in warfarin-treated humans and animals given vitamin E. Factor II antigen as determined by electroimmunoassay in humans and factor II coagulant activity as measured using Echis venom in animals were unchanged and no different from untreated controls. The data suggest that vitamin E acts at the vitamin K-carboxylase step of carboxylation of precursor prothrombin and not in the synthesis of the precursor protein.

Animals↗
PubMed1982

Aortic thrombosis in a neonate: failure of urokinase thrombolytic therapy.

Complete aortic occlusion at L2-L3 occurred in an 11-day-old male with hypernatremic dehydration. Attempted thrombolytic therapy using intraarterial urokinase was unsuccessful in inducing either a systemic hyperfibrinolytic state or lysis of the clot. The infant's plasma plasminogen level was low (50-75% of adult levels) and neither fresh frozen plasma nor cryoprecipitate infusion provided adequate plasminogen replacement. Thrombolytic therapy failure was due in part to inadequate generation of plasmin. Alternative means of lytic therapy will need to be devised for this age group.

Aortic Diseases↗
PubMed1981

Rapid adrenocortical recovery after short-term glucocorticoid therapy.

The recovery time of adrenocortical function was studied in 13 children receiving intermittent high-dosage glucocorticoid therapy (prednisone, 2 mg/kg/day) for one month out of every four months as treatment for acute leukemia. The data indicate that the adrenal gland's ability to respond to stress recovers rapidly from such treatment. The results of our study clearly show that routine supplementation with glucocorticoid therapy in these patients during periods of clinical stress occurring later than nine days after glucocorticoid therapy is not warranted.

Adolescent↗
PubMed1981

Effect of vitamin E on prothrombin levels in warfarin-induced vitamin K deficiency.

Rats rendered lightly vitamin K deficient with warfarin (0.01 mg/100 g, IP) and given the equivalent of 1000 units of vitamin E/kg IM for 7 days, showed a marked reduction in functional factor II activity, but normal factor II levels using Echis venom on coagulation analysis. In 12 humans receiving warfarin, vitamin E was administered in doses of 100 or 400 units/day orally for 4 wk. The results in these patients showed no significant change in the prothrombin time, factor II coagulant activity, or factor II antigen (by electroimmunoassay). However, by using a ratio of factor II coagulant activity to immunoreactive protein, significant reduction was observed when compared to pretreatment ratios. These data suggest that vitamin E acts at the step mediated by vitamin K and not in the synthesis of the factor II precursor. Although the administration of high doses of vitamin E in animals, and possibly humans, with vitamin K deficiency potentiates the vitamin K deficiency, this effect is not clinically obvious with 400 IU/day or less.

Adult↗
PubMed1981

The vitamin K-dependent proteins.

A new class of proteins has emerged, the so-called vitamin K-dependent calcium binding proteins, which are uniquely characterized by the presence of alpha-carboxyglutamic acid residues. These proteins have been identified in a variety of tissues and body fluids. The specialized nature of calcium binding by Gla residues promotes protein phospholipid interaction, which is important not only in blood coagulation but in many tissue processes involving calcium metabolism. What role other than the blood coagulation mechanism the vitamin K reaction may play in diseases in children is still unclear.

Blood Coagulation Factors↗
PubMed1981

Diagnosis and therapy of coagulopathies in patients with liver disease.

Although the coagulopathies encountered in patients with liver disease can be multifactorial, the most common cause is underproduction of certain coagulation factors synthesized by the liver. Generally, vitamin K and replacement therapy are all that is necessary. In the rare instance in which the coagulopathy may be complicated by hyperfibrinolysis or disseminated intravascular coagulation, replacement therapy may not suffice and other means of correcting the defect may be necessary. The prothrombin time, partial thromboplastin time, platelet count, fibrinogen concentration, and a test for fibrinolysis are recommended as the initial workup for the bleeding patient with underlying liver disease. Other, more specific tests may be necessary to differentiate the various causes of the defects in the hemostatic mechanism in these patients.

Blood Coagulation Disorders↗