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Biomedical subjects

S N Gitel

Publications and source records attributed to S N Gitel.

29 records · Page 2Linked to original sources
PubMed1979

The effect of total hip replacement and general surgery on antithrombin III in relation to venous thrombosis.

This investigation was undertaken to identify and correlate one factor that makes patients undergoing total hip replacement more susceptible to venous thrombosis and pulmonary embolism than those who have almost any other elective orthopaedic procedure, and to determine why the operation of total hip replacement has proved to be relatively resistant to antithrombotic prophylaxis compared with general surgical procedures. Using the depletion of antithrombin III as a marker of activation of the coagulation system, two groups of patients were compared: twenty-one who were subjected to hip arthroplasty and fourteen who underwent general surgical procedures. Both during and after operation the decrease in the quantity of antithrombin III in hip-arthroplasty patients was significantly greater (p less than 0.05) than the decrease in general surgical patients. Seventy-three per cent of hip-replacement patients had venographic evidence of recent thrombosis, 60 per cent of which were discontinuous femoral-vein thrombi. Femoral-vein thrombosis occurs frequently in hip-arthroplasty patients and is relatively resistant to current antithrombotic prophylaxis. The data presented suggest that during hip surgery there is a strong systemic activation of the clotting cascade that is associated with local vessel injury and local stasis in the femoral vein, an association not found in most general surgical procedures.

Abdomen↗
PubMed1979

The antithrombotic effects of warfarin and heparin following infusions of tissue thromboplastin in rabbits: clinical implications.

An animal model for the production of stasis thrombi was employed to obtain the data reported in this study. Rabbits treated with warfarin (1.5 mg/kg/day) exhibited a maximal increase in prothrombin time and decreases in factor VII, factor X, and prothrombin within 48 hr with no additional changes occurring after 10 days of drug administration. In contrast, Xa inhibitory activity was unchanged after 48 hr of warfarin treatment but was significantly increased by the tenth day. When thrombosis was induced by infusions of 60 micrograms of tissue thromboplastin, the warfarin regimen produced an antithrombotic effect by the sixth hour, which increased to significance by day 2 and was further significantly increased by day 10. These three stages correspond to the initial depletion of the vitamin K-dependent clotting factors, the maximal depletion of these proteins, and the maximal increase in Xa inhibitory activity, respectively. Thus these experiments separate the antithrombotic potential of warfarin into two components: an early effect related to the decrease in factor VII and a delayed augmentation of Xa inhibitory acticity. Intravenous heparin alone (5 U/kg) did not protect against infusions of 60 micrograms of tissue thromboplastin but did provide an antithrombotic effect against 45 micrograms of the same infusate. Higher doses of heparin, however, did protect against infusion of 60 micrograms of tissue thromboplastin. After 48 hr of warfarin treatment, 5 U/kg heparin increased protection against 60 micrograms of tissue thromboplastin to a degree equivalent to that provided after 10 days of warfarin therapy alone.

Animals↗
PubMed1978

The activated factor X-antithrombin III reaction rate: a measure of the increased thrombotic tendency induced by estrogen-containing oral contraceptives in rabbits.

Estrogen-containing compounds are thrombogenic in man. The extent of thrombosis is dose-related, but a measure of this thrombogenicity is not currently available. Evidence is presented, using an animal model of venous thrombosis, that impaired Xa inhibitory activity (the rate of reaction between Xa and antithrombin III) correlates with the development of thrombosis initiated by thrombin in rabbits receiving an oral contraceptive compound. The responses in the clotting assay and in the extent of thrombosis are dose-related. The hypercoagulable state induced by oral contraceptives can be completely reversed by trace amounts of heparin.

Animals↗
PubMed1977

In vitro and in vivo correlation of clotting protease activity: effect of heparin.

The thrombogenicity of three highly purified proteases (thrombin, activated Factor X, and activated Factor IX) was determined quantitatively in an animal model. The minimal amounts required to produce a standard score 4 thrombus were 1.1 nmol for thrombin, 0.12 nmol for activated Factor X, and 0.018 nmol for activated Factor IX. After the administration of heparin at 5, 10, and 20 units/kg in rabbits, the thrombogenicity of each of these proteases decreased progressively. The heparin-induced inhibition of thrombosis decreased in the order, activated Factor IX > activated Factor X > thrombin at each heparin concentration. These differences were statistically significant. These in vivo data provide support for the following hypotheses originally developed from in vitro experiments: (i) activation of the blood coagulation system, which proceeds through a cascade mechanism, incorporates biochemical amplification; (ii) the inhibition of activated Factor IX by antithrombin III in the presence of heparin is an important reaction in the prevention of thrombosis; (iii) less heparin is required to inhibit thrombosis prior to thrombin generation than afterward; (iv) an increase in the reactivity of antithrombin III reflects a decreased tendency to thrombosis while a decrease in this reactivity reflects an increased tendency to thrombosis.

Animals↗
PubMed1977

The rabbit as an animal model for the activated factor X-antithrombin III-heparin reaction.

When activated factor X (Xa) inhibitory activity of serially diluted human and rabbit plasma is determined in a low salt assay, a lineare plot is obtained for human, but not for rabbit plasma. When a high salt assay is used, the dilution curves for both human and rabbit plasma are linear, and qualititive as well as quantitative differences are essentially eliminated. On Sephadex G-200 chromatography Xa inhibitory activity of human and rabbit plasma appears in two peaks. With the low salt assay the first and second peaks for human plasma contain respectively 30%, and 70% of the activity; whereas with rabbit plasma these values are greater than 95% and less than 5% of the activity. With the high salt assay the figures for human plasma are less than 5% and greater than 95%, and with rabbit plasma 65 +/- 3% and 35 +/- 3%, respectively. With the high salt system, rabbit plasma shows a continuous increase in Xa inhibitory activity with increasing heparin concentrations, similar to that obtained with human plasma. In the high salt system the relative contributions of antithrombin III to Xa neutralization in human and rabbit plasma are different. However, in experiments in which Xa inhibitory activity of antithrombin III is altered by heparin, a simple formula, Total activity (%) = 65% + 0.35 x human plasma (%), permits translation of rabbit data on the Xa-antithrombin III-heparin reaction to man. On the basis of these findings, the rabbit model can effectively be used to study the Xa-antithrombin III reaction.

Animals↗
PubMed1976

Estrogen-containing oral contraceptive agents. A basis for their thrombogenicity.

The mechanism whereby estrogen-containing contraceptives facilitate thrombosis is obscure, and published data concerning their effect on antithrombin III are conflicting. Plasma samples were examined for the quantity of antithrombin III and activated factor X (Xa) inhibitory activity among 57 women receiving oral contraceptives and 48 controls. The quantity of antithrombin III in both groups was normal. In contrast, Xa inhibitory activity was significantly reduced (P less than .001) among patients taking oral contraceptives, compared to controls. Heparin sodium added to plasma from patients taking contraceptives raised Xa inhibitory activity toward or above normal without changing the quantity of antithrombin III. The effect of estrogen is not to decrease the quantity of plasma antithrombin III, but rather to diminish plasma Xa inhibitory activity, an effect that can be abolished by heparin.

Adolescent↗
PubMed1973

A polypeptide region of bovine prothrombin specific for binding to phospholipids.

The blood-clotting protein prothrombin can be converted to thrombin in free solution by the proteolytic enzyme, activated factor X. When prothrombin is bound to the surface of phospholipid vesicles, the rate of thrombin generation is increased more than 30-fold over the rate of unbound prothrombin. If the prothrombin activation process is terminated after a time interval in which less than 10% of the expected thrombin has been produced, two major products are found in the activation mixture. These products have been termed intermediate 1, a precursor of thrombin, and fragment 1. The conversion of intermediate 1 to thrombin is not accelerated by phospholipid nor can binding of this intermediate to phospholipid particles be demonstrated. In contrast, fragment 1, the other activation product derived from prothrombin, binds to phospholipid particles under the same conditions as prothrombin. On the basis of these observations, we propose that the prothrombin molecule contains a specific region of polypeptide chain for binding to phospholipid particles. This specific polypeptide region or lipid interaction site is part of the nonthrombin-forming activation fragment.

Animals↗