Search PubMed⌕ Search

Biomedical subjects

S Wessler

Publications and source records attributed to S Wessler.

At least 37 records · Page 2Linked to original sources

Antiheparin antibodies: their preparation and use in a heparin immunoassay.

Antibodies that recognize unmodified heparin bound to positively charged macromolecules have been obtained by immunizing rabbits with a methylated bovine serum albumin-heparin precipitate. These antibodies have been used to develop an immunoassay that can quantitate heparin at a concentration of 5 ng/ml in buffer solutions, and at a concentration of 25 ng/ml in plasma without pretreatment of the sample. The specificity of the antibodies is such that they do not recognize other glycosaminoglycans and are able to distinguish among different commercial heparin samples that are otherwise indistinguishable by specific anticoagulant activity or molecular weight distribution.

Animals↗

What's the dose?

Explore the source record for details and available documents.

Humans↗

Prophylactic anticoagulants in managing embolic stroke.

The primary risk of anticoagulant therapy in cardiac embolic stroke is hemorrhage--particularly cerebral hemorrhage in the elderly. Improving the benefit/risk ratio for indicated anticoagulation involves consideration of the following: hemostatic competence, blood pressure, drug interactions, falls, interval surgery, diet, aspirin and last but not least, the intensity of anticoagulant prophylaxis. For the present it would be prudent to limit heparin administration to a low-dose regimen not exceeding 20,000 units/24 hours and warfarin maintenance to a low-dose prothrombin time ratio of 1.5.

Accidental Falls↗

Pharmacology of heparin and warfarin.

Thromboembolic obstruction to three major components of the circulation--arterial, venous and intravascular foreign surfaces--contributes to premature death and disability in Western society. In many, but not all, of these conditions associated with thromboembolism, heparin and warfarin are the drugs of choice. It is the purpose of this presentation to provide some common ground in the area of anticoagulant prophylaxis that will be of intrinsic value for decision making in cardiac, cerebral and peripheral vascular disease. Only those aspects of the hemostatic mechanism most relevant to the antithrombotic action of heparin and warfarin are discussed. Assays for both drugs as well as some practical guidelines for their use in low, medium and high dose regimens are outlined. Techniques for improving the benefit/risk ratio for each drug are specifically detailed.

Antithrombin III↗

Preparation and identification of a population of antibodies that recognize carbodiimide-modified heparin.

Protein-heparin complexes, prepared by a water-soluble carbodiimide coupling technique, were used to produce anti-heparin antibodies in rabbits. Antiserums that recognized carbodiimide-treated heparin, but not untreated heparin, were obtained. Carbodiimide-treated heparan sulfate exhibited 10% to 20% cross-reactivity compared with a similarly treated heparin, whereas there was no cross-reactivity with five other carbodiimide-treated mucopolysaccharides. 3H-1-ethyl-3-(3-trimethylammoniumpropyl) carbodiimide iodide was used to demonstrate that carbodiimide forms a stable adduct with heparin and other mucopolysaccharides. Using an antibody fraction that eluted from 1-ethyl-3-(3-trimethylammoniumpropyl) carbodiimide iodide-treated heparin-Sepharose with 2 mol/L KI, it was demonstrated that, for the antibody population studied, the addition of one carbodiimide per heparin molecule resulted in complete epitope expression without loss of anticoagulant activity. The addition of up to eight additional carbodiimide molecules to heparin did not increase the extent of epitope formation, although anticoagulant activity was lost. Except for heparan sulfate, the addition of radiolabeled carbodiimide to other mucopolysaccharides did not result in epitope formation. These data demonstrate that antibodies to an epitope derived from heparin can be formed, that the epitope is fully expressed while anticoagulant activity is present, and that the antibody is specifically directed against an altered portion of the polysaccharide.

Animals↗

Inhibition of human activated Factor X by antithrombin III and alpha 1-proteinase inhibitor in human plasma.

The inhibition of activated human Factor X by human plasma protease inhibitors was investigated in both purified and plasma systems. In the former, antithrombin III, alpha 1-proteinase inhibitor, and alpha 2-macroglobulin, at normal plasma concentrations, markedly inhibited activated Factor X. Significant inhibition by alpha 2-antiplasmin, however, was only achieved when present at 40 times its plasma concentration. The relative rates of inhibition of activated Factor X coagulant activity in normal human plasma, antithrombin III-deficient plasma, and alpha 1-proteinase inhibitor-deficient plasma were 1.0, 0.63, and 0.75, respectively. From these relative rates of inhibition and their measured concentrations in the 3 plasmas, it was calculated that antithrombin III, alpha 1-proteinase inhibitor, and alpha 2-macroglobulin contribute 53, 35, and 12%, respectively, to the inhibition of activated Factor X in normal human plasma. Using 125I-labeled activated Factor X and a combination of sodium dodecyl sulfate disc gel electrophoresis and immunoadsorption, it was then demonstrated that antithrombin III accounted for 45-55%, alpha 1-proteinase inhibitor, 35-40%, and alpha 2-macroglobulin, 10-15% of the inhibition of the labeled protease in normal human plasma. The values obtained with the deficient plasmas are consistent with the distribution of activated Factor X-inhibitor complexes in normal human plasma. These data show by two independent techniques, one measuring coagulant activity and the other 125I-labeled activated Factor X-inhibitor complexes, that both antithrombin III and alpha 1-proteinase inhibitor are the major inhibitors of activated Factor X in normal human plasma.

Antithrombin III↗

Molecular identification and isolation of the Waxy locus in maize.

The Waxy (Wx) locus in maize determines the amylose content of pollen and endosperm tissue. There are several mutant alleles of the locus caused by insertion of transposable controlling elements. In the present study, we have used the properties of controlling element alleles to identify the Wx locus and its gene product, with the subsequent objective of isolating the elements causing the mutations. We present evidence that the Wx locus encodes a starch granule-bound 58 kd polypeptide that is synthesized in vitro as a 65 kd precursor. We describe the isolation of recombinant plasmids containing cDNA inserts homologous to Wx mRNA and a recombinant lambda phage containing a genomic Eco RI fragment encompassing most or all of the Wx transcription unit. We show that a mutation caused by the controlling element Dissociation (Ds) is attributable to an insertion of approximately 2.4 kb at the Wx locus.

Alleles↗

Isolation of the transposable maize controlling elements Ac and Ds.

Restriction endonuclease fragments containing part of the Waxy (Wx) locus have been cloned from strains with insertion mutations at the locus caused by the controlling elements Activator (Ac) and Dissociation (Ds). Evidence is presented that the genetically defined Ac element corresponds to a 4.3 kb insertion, while the two Ds elements correspond to 4.1 kb and 2.0 kb insertions, all near the 3' end of the Wx transcription unit. The 4.1 kb Ds is almost completely homologous to the Ac element, differing by a central deletion of less than 0.2 kb. The 2.0 kb Ds element is homologous to the ends of the Ac element. Sequences homologous to the ends of the Ac element are present in many copies in the genomes examined, while there are ten or fewer copies of a sequence with homology to the center of the cloned Ac element. The Ac element at the Wx locus can be distinguished structurally from the other Ac-like sequences in the genome.

Alleles↗

Dose-dependent antithrombotic effect of warfarin in rabbits.

One-hundred and fifty-one rabbits, divided into controls and animals treated with varying daily doses of warfarin, were subjected to the stasis assay, and the amount of thrombosis quantitated after intravascular coagulation was initiated either by activated factor X or tissue thromboplastin. Following 8-10 days of warfarin administration, there was a significant dose-dependent decrease in the vitamin-K-dependent coagulation factors paralleled by an increase in the prothrombin time ratio. Whether thrombosis was initiated by activated factor X or tissue thromboplastin, there was, with increasing drug dose, a progressive increase in the inhibition of stasis thrombosis. This significant antithrombotic effect occurred even when the vitamin-K-dependent coagulation activities were at a mean value of 50%.

Animals↗

Drug prophylaxis for arterial thromboembolism--1981.

Recent multicenter clinical trials using platelet-suppressive agents for the secondary prevention of myocardial infarction have yielded inconclusive results, although some of the data suggest possible benefits. For transient ischemic attacks, after carotid artery surgery has been eliminated as an option, aspirin is the drug of choice for men; for women, and for men in whom aspirin fails, warfarin sodium should be considered. Warfarin is indicated after insertion of cardiac prosthetic disk valves, and if systemic emboli occur, dipyridamole should be added. Patients with atrial fibrillation should be treated prophylactically with coumarin agents, but only if underlying organic heart disease is demonstrable.

Aspirin↗

Lack of correlation between activated clotting time and plasma heparin during cardiopulmonary bypass.

The activated clotting time (ACT) with a Hemochron system for determining heparin requirements during cardiopulmonary bypass surgery, (CPB) accompanied by hemodilution and hypothermia was evaluated using plasma heparin levels as a standard. In 28 patients who were administered a standard heparin regimen (300 units/kg prebypass, 8000 units in the pump prime and 100 units/kg hourly during CPB) mean prebypass plasma heparin was 4 units/ml, and ACT was 493 seconds. During CPB mean plasma heparin decreased significantly (p < 0.001) to 3.1 units/ml, whereas mean ACT increased significantly (p < 0.001) to 674 seconds. The mean protamine requirement predicted from ACT was significantly higher (43%) than predicted from plasma heparin levels or actual protamine administered. The ACT neither accurately reflected plasma heparin during CPB nor predicted protamine requirements. The fixed-dose regimen employed, however, prevented both intraoperative thrombosis, assessed clinically in all patients, and clotting on six arterial line filters, as determined by scanning EM, despite wide variations in ACT and plasma heparin levels during surgery.

Adult↗

Thrombosis: the relationship of hemostatic mechanisms to drug therapy.

The mechanism of action and present clinical role of drugs affecting hemostasis in the therapy of spontaneous, postoperative, and posttraumatic arterial thrombosis, arterial embolism, venous thrombosis, pulmonary embolism, and intracranial aneurysm have been reviewed. Both the management of neurosurgical problems and the development of antithrombotic regimens are improving. In regard to the use of drug therapy, discussed herein, each surgeon will reach his own decision based on his findings in the individual patient, and may wisely elect in specific situations not to employ drug therapy. The comments offered in ths analysis are to be construed as suggestions not mandates, as they will undoubtedly undergo modification with time. In closing, it is appropriate to recall a famous Chinese curse: "May you live," it reads, "in a time of transition."

Anticoagulants↗

Heparin and warfarin therapy. Recommendations concerning efficacy and safety.

Heparin and warfarin are antithrombotic agents effective against venous thrombosis as well as pulmonic and systemic emboli. They can exert a favorable effect on mortality and morbidity in a diverse group of illnesses associated with thrombosis. Proper use of these agents will increase their efficacy and diminish the risk of serious hemorrhage.

Coumarins↗