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PubMed2004

[Hemostatic and analgesic effect of Gonghuan Zhixue Tablet on mice].

OBJECTIVE: To explore the hemostatic and analgesic effect of Gonghuan Zhixue Tablet (GHZXT) on mice and to produce experimental evidence for exploiting new drug for endometrorrhagia caused by Cu-intrauterine contraceptive device (Cu-IUD). METHODS: Compared with 6-aminocaproic acid and notoginseng, the effects of GHZXT on clotting and bleeding time of mice with capillary method and severed tail were investigated; and compared with aspirin, the analgesic effects of GHZXT on mice were investigated with hot plate and torsive body method. RESULTS: The clotting time of mice was remarkably shortened with a rising of the dosage of GHZXT and the difference between each therapeutic group and distilled water group was remarkable. As compared with distilled water group, the bleeding time of each dosage group of GHZXT was obviously shortened; and each dosage of GHZXT could prolong the time of pain reaction to hot plate and decrease the degree of torsive body of the mice. CONCLUSION: Pharmacological experiment has proved that GHZXT has evident hemostatic and analgesic function.

Analgesics↗
PubMedDate not supplied

Traumatic total hyphema in a patient with severe hemophilia.

A 12-year-old hemophilic boy suffered from secondary glaucoma in his right eye due to total hyphema following trauma. An emergency operation was performed to evacuate the hyphema under a tight anti-hemophilic treatment. A careful postoperative treatment with factor VIII concentrate, antiglaucomatous drugs and aminocaproic acid was administered. Intraocular pressure returned to normal and remained so during the four months follow-up period. Visual acuity returned to 6/9 and there was no rebleeding into the anterior chamber. To the best of our knowledge, this is the first reported case of traumatic hyphema and of an operation to wash this hyphema in a hemophiliac. The dilemma of management of such a case is discussed.

Child↗
PubMed2002

Enhancement of fibrinolytic activity of U937 cells by malformin A1.

We have found that malformin A1, a cyclopentapeptide metabolite of Aspergillus niger, enhanced 2.0- to 3.2-fold the 125I-fibrin clot lysis when incubated at 1 to approximately 10 microM with both U937 cells and blood plasma, both of which were essential to the malformin A1 action. The effect was inhibited by epsilon-aminocaproic acid and anti-urokinase serum, but not by anti-tissue-type plasminogen activator IgG, showing that the enhancement was mediated by urokinase-catalyzed plasminogen activation. However, malformin A1 affected neither cellular urokinase activity nor cell-free reactions involved in the fibrinolytic pathway. Malformin-treated, washed cell had an increased capacity to degrade fibrin in the presence of plasma. These results suggest that malformin A1 enhances fibrinolytic activity by affecting cell-mediated response to initiate and/or propagate fibrinolytic activity.

Fibrinolysis↗
PubMed1999

Acute normovolemic hemodilution (ANH) in surgery of the thoraco-abdominal aorta. A cohort study to evaluate coagulation parameters and blood products utilization.

OBJECTIVE: To assess whether a modified technique of acute normovolemic hemodilution (ANH) reduces the utilization of blood products and donor exposures, and/or improves hemostasis in surgery of the thoracoabdominal aorta. METHODS EXPERIMENTAL DESIGN: cohort study comparing fifteen control patients and seven treated with the adjunct of ANH. Mean follow-up 23 (SD=15.4) months. SETTING: community hospital acting as a referral centre for vascular diseases. Patients' selection: Thirty patients between 1990 and 1995 were entered into the study, eight were excluded because of rupture. INTERVENTIONS: the ANH technique used the withdrawal of up to 3000 ml blood during the time between induction of anesthesia and clamping of the thoracic aorta. Colloids were preferentially used for replacement together with up to three units of packed red blood cells (PRC). The autologous blood was retransfused during the final phases of the procedure. MEASURES: Parameters measured included pre- and postoperative PTT, INR, and platelets; the quantity of stored blood products and total donor exposures. RESULTS: Blood losses, PRC transfused, and postoperative hemoglobin concentration were not statistically different in the two groups. Repeated measures Analysis of variance on coagulation parameters showed lower PTT values (F1,20=4.2, p=0.05) and higher platelet concentration (F1,20=8.2, p=0.01) after surgery in the ANH group. In the latter, the reduction in fresh frozen plasma (FFP) utilization did not reach statistical significance (T19.5=1.79, p=0.08). This group, however, required fewer transfusions of platelets (T20=4.27, p=0.0004), and cryoprecipitate (T20=2.52, p=0.02), and no coagulation adjuncts (dDAVP, epsilon-aminocaproic acid), (Fisher's test=0.04). Total donor exposures was also significantly lower in the ANH group (T20=3.28, p=0.003). CONCLUSIONS: The ANH technique reduces homologous transfusions and donor exposures, and has a beneficial effect on hemostasis. Moreover, the technique may be useful in the management of cross clamping hypertension.

Adult↗
PubMed1999

Medical and hormonal therapy in occult gastrointestinal bleeding.

In this age of modern technology and aggressive but noninvasive therapies, the idea of treating an identifiable but discrete bleeding lesion with systemic medical therapy seems an anachronism. But medical therapy can be the treatment of choice for some bleeding vascular lesions of the gut. Though most vascular lesions appear similar endoscopically and are a cause of gastrointestinal bleeding, they consist of various pathologic identities. These different lesions have not only different pathologic appearances, but also different prognoses. The natural history of many of these lesions remains largely unknown. Long-term success in controlling bleeding must be measured in the context of the responsible lesion's frequency of occurrence and recurrence. Medical therapy can include hopeful watchful waiting, routine blood transfusions, or specific medications. Medical therapy has been pursued along two lines. The most common form of medical therapy has been simple supportive care. This may include iron therapy and avoidance of aspirin and other anticoagulants. Transfusions may be necessary, occasionally or on a regular basis. The second form of medical therapy has been the use of estrogens. There have been other medical attempts to control bleeding from intestinal vascular lesions. Somatostatin has been used in an uncontrolled fashion, as has aminocaproic acid. Vascular lesions of the bowel are not all the same. Medical therapy of vascular lesions is contrary to general present practice. Endoscopic or surgical therapy is presently considered best because of its ease, relatively good long-term results, and the lack of a clearly effective, well-tolerated medical therapy. Medical therapy is usually reserved for diffuse vascular diseases of the bowel, for vascular lesions located in relatively inaccessible locations, for patients with continued bleeding despite endoscopic or surgical management, and for patients who are not candidates for either endoscopic or surgical therapy.

Aged↗
PubMedDate not supplied

[Antifibrinolytic and antimycotic properties of 2-thiontetrahydro-1,3,5-thiadiazine].

A series of tetrahydro-1,3,5-thiadiazine-2-thiones have been tested for their fungistatic and antifibrinolytic effects. The fungistatic activity depends upon the substitution of nitrogen in positions 3 and 5 of the ring system. But it is, however, only the derivatives that are able to split off the antifibrinolytically active w-amino acids by solvolysis which produces antifibrinolytic effect in vivo.

4-Aminobenzoic Acid↗
PubMed2000

Traumatic hyphema: a comprehensive review of the past half century yields 8076 cases for which specific medical treatment reduces rebleeding 62%, from 13% to 5% (P<.0001).

PURPOSE: To eliminate the continuing so-called "controversy" regarding, and opposition to, the specific medical management of traumatic hyphema (TH) with systemic antifibrinolytic agents including aminocaproic acid (ACA) and tranexamic acid (TXA) and steroids (prednisone); to illuminate the role of topical steroids. METHOD: Review of all (English language) studies since 1950 of these medical treatments of TH, and contemporary no specific medical treatment controls. RESULTS: The difference between the average rebleeding rate in the specifically medically treated group, 4.89%, and that rate in the untreated group, 13.02%, was statistically a true difference due not to chance but to the difference in therapy with a probability of <0.0001 by Chi Square Test, Yates Corrected Chi Square Test and Fisher's Exact Test. This was also true individually respectively and with identical probabilities of p=<0.0001 for systemic steroids, topical steroids, ACA and TXA. Combined topical steroids and systemic ACA or TXA did not further improve results. CONCLUSION: Preventing rebleeding episodes remains a major treatment objective in the clinical management of TH. This is best accomplished by the Yasuna systemic steroid No Touch or No Touch PLUS treatment protocol, the only treatment protocols consistently yielding zero rebleed rates in non-Scandinavian populations.

Anterior Eye Segment↗
PubMed2000

[Angioedema is caused by a defect in C1-inhibitor synthesis].

Deficit of the first component of complement inhibitor (C1-inhibitor, C1-inh) may clinically be manifested as angioedema. The disease is characterized by episodic swellings of mucosa and subcutaneous tissue at different locations of the body. Laryngeal swelling can be life-threatening. The major mediators of edema are discussed to be bradykinin and C2b derived peptides. These mediators increase capillary permeability. Antifibrinolytic agents (aminocaproic acid, tranexamic acid) and attenuated androgens (danazol or stanazolol) are used for prophylaxis. Prolonged use both of them might result in more or less severe side effects. In experiments in vitro it has been shown that IFN-gamma, IL-1, IL-6 have a stimulatory effect on C1-inh synthesis. We want to verify the practical use of probiotics as natural inductors of IFN-gamma synthesis for elevating C1-inh level.

Adolescent↗
PubMed2000

Effects of acute normovolaemic haemodilution and partial exchange transfusion on blood product utilization, haemostasis and haemodynamics in surgery of the thoracoabdominal aorta. A cohort study in consecutive patients.

BACKGROUND: This paper outlines the technique of acute normovolaemic haemodilution with partial exchange transfusion (ANHPET) in surgery of the thoracic and thoracoabdominal aorta. Perioperative coagulation parameters and patterns of blood product utilization observed with this technique are described and compared with results for historical controls treated without ANHPET. METHODS: During thoracoabdominal aneurysm repair, acute normovolaemic haemodilution with partial exchange transfusion (ANHPET) was used to withdraw of up to 3 L of blood. This was returned to the patient at the end of the reconstruction. Albumin 5% and stored packed red cells (PRC) were used for replacement. Seven patients underwent surgery with ANHPET, and fifteen without. Univariate and multivariate analysis of variance was used to examine differences between these groups. RESULTS: No differences were observed between the two groups for estimated blood loss, PRC transfused, and postoperative haemoglobin concentration. The ANHPET group received fewer platelets (8 vs 22 units, p = 0.0004), cryoprecipitate (0 vs 13 units, p = 0.02), and desmopressin or epsilon-aminocaproic acid (0 of 7 vs 4 of 15 patients, p = 0.04). FFP use was not significantly different (11 vs 17 units). Postoperatively, PTT values were less prolonged (26 vs 34 sec, p = 0.05) and platelet concentration higher (218 vs 169 x 109/L, p = 0.01) in the ANHPET group. A significant reduction in the total of blood products transfused was observed in the ANHPET group (30 vs 68 units, p = 0.003). Control of hypertension was facilitated by phlebotomy so that nitroglycerine was necessary in low doses only (0.25-1.0 microgram/kg/min). CONCLUSIONS: ANHPET reduced blood product transfusion, improved postoperative haemostatic parameters and simplified the management of cross-clamping hypertension.

Aged↗
PubMed1975

Separation and evaluation of the covalent and noncovalent interactions which contribute to the binding of pyridoxal 5'-phosphate to D-serine apodehydratase.

The equilibrium constant (KX) for the reaction D-serine dehydratase + pyridoxamine-P in equilibrium KX D-serine apodehydratase: pyridoxamine-P + pyridoxal-P was determined. At 25 degreees, pH 7.80, KX increases from 5.4 times 10-minus 5 to 21 times 10-minus 5 as T/2 is increased from 0.33 to 0.66. A value of 1.3 times 10-minus 4 M at 25 degrees, pH 7.80, T/2 0.33 for the equilibrium constant (KPMP) for dissociation of pyridoxamine-P from D-serine apodehydratase was determined from the ratio of the equilibrium constant for dissociation of pyridoxal-P from holoenzyme to KX. Pyridoxamine-P and the thiazolidine, formed from pyridoxal-P and cysteine, were found to have similar affinities for D-serine apodehydratase. Using the affinities of these derivatives as a measure of the noncovalent interactions between cofactor and protein, it was possible to estimate the contribution of the Schiff base linkage to the stability of the complex formed between pyridoxal-P and protein. The covalent Schiff base linkage in the holoenzyme was found to be no more stable than the Schiff base linkage formed between 6-aminocaproic acid and pyridoxal-P. The contribution of noncovalent interactions to the stability of the cofactor-protein complex was shown to be at least 20 to 40 times greater than the contribution of the covalent Schiff base linkage.

Chromatography, Gel↗
PubMed2002

Lipoprotein-complexed C-reactive protein and the biphasic transmittance waveform in critically ill patients.

The 'biphasic transmittance waveform' (BTW) refers to a decrease in light transmittance that often occurs prior to clotting in coagulation assays of critically ill patient plasmas. It correlates with disseminated intravascular coagulation and mortality. The present work shows that the BTW is due to the rapid formation of a precipitate and a coincident change in turbidity in re-calcified plasma. The precipitate was isolated from patient plasma and contained lipids typical of very low density lipoprotein (VLDL), plus the proteins apolipoprotein B-100 and C-reactive protein (CRP). Precipitation also occurred in normal plasma supplemented with CRP. In addition, CRP precipitated with VLDL and intermediate density lipoprotein, but not low density lipoprotein or high density lipoprotein. The Kd value for the CRP/VLDL interaction is 340 nM. The IC50 value of Ca2+ for complex formation is 5.0 mM, and epsilon-aminocaproic acid inhibits the process. In 15 plasmas with the BTW from critically ill patients, CRP was highly elevated (77-398 microg/mL) and VLDL cholesterol ranged from 0.082 to 1.32 mM. The magnitude of the turbidity change on re-calcification correlated well with the calculated level of the CRP/VLDL complex. Thus, the Ca2+-dependent formation of a complex between CRP and VLDL accounts for the BTW.

C-Reactive Protein↗
PubMed1976

Isolation and characterization of the affinity chromatography forms of human Glu- and Lys-plasminogens and plasmins.

Affinity chromatography forms, 1 and 2, were each isolated from human Glu- and Lys-plasminogens by gradient elution from a L-lysine-substituted Sepharose column with a linear gradient of epsilon-aminocaproic acid. Although each of the two zymogen forms contains two affinity chromatography forms, the relative concentrattions of these forms in each of the zymogen preparations depended upon the plasma sample or enriched plasma fraction used for the preparation of the zymogen. Specific analytical acrylamide gel electrophoretic systems were used for the characterization of the zymogen and enzyme forms, and their component affinity chromatography forms, 1 and 2. The four zymogen affinity chromatography forms, Glu-1-plasminogen, Glu-2-plasminogen, Lys-1-plasminogen, and Lys-2-plasmingoen, show distinct stepwise differences in their molecular size and charge. The Glu-1-form is the largest in molecular size and the most acidic, and the Lys-2-form is the smallest in molecular size and the most basic. The proteolytically altered Lys-1- and Lys-2- forms appear to be specifically df the zymogen affinity chromatography forms showed a different distribution of isoelectric forms. The major isoelectric forms isolated from Glu-plasminogen with pI values of 6.2, 6.3, 6.4, and 6.6, and the major isoelectric forms isolated from Lys-plasminogen with pI values of 6.7, 7.2, 7.5, 7.8, and 8.1, (Summaria, L., Arzadon, L., Bernabe, P., Robbins, K. C., and Barlow, G. H. (1973) J. Biol. Chem. 248, 2984-2991) were shown to be mixtures of the Glu-1- and Glu-2- forms, or the Lys-1- and Lys-2- forms, respectively. Although the sialic acid contents of the Glu- and Lys- forms appear to be similar, the isolated affinity chromatography forms show distinct differences. The sialic acid contents of the Glu-1- and Lys-1- forms are identical, and are substantially higher than the sialic acid contents of the Glu-2- and Lys-2- forms which are also identical to each other. It is possible that the charge difference between the zymogen-1- and -2- forms may be related to the differences in their sialic acid content. Each of the four zymogen affinity chromatography forms, when activated by urokinase in the presence of the plasmin inhibitor, Trasylol, was converted to an apparently unique and different enzyme form. The four enzyme forms show distinct stepwise differences in molecular size; Glu-1-plasmin is the largest in size whereas Lys-2-plasmin is the smallest in size. Each plasmin-derived carboxymethyl heavy(A) chain was found to be different in molecular size, but the two carboxymethyl light(B) chains found in each of the four enzyme forms appeared to be identical and of the same molecular sizes. The four heavy(A) chains show a stepwise difference in molecular size; the Glu-1-heavy(A) chain is the largest in size whereas the Lys-2-heavy(A) chain is the smallest in size...

Chromatography, Affinity↗