Thromb Haemostasis
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Basal t-PA antigen concentration, PAI-I activity and fibrinolytic capacity was studied in plasma from 20 healthy teenager girls (age 15.9 +/- 1.3 years) and two groups of older healthy volunteers, consisting of 17 women (age 32 +/- 8 years, group 1) and 35 men (age 34 +/- 8 years, group 2). Basal t-PA antigen concentrations in plasma were found to be highly age-dependent with higher values with increasing age. The teenager girls had significantly lower values compared with the two groups of elderly volunteers. ⋯ The coagulation parameters, factor VIII activity, AT III, Protein C and platelet counts were all within reference values before and on OC. The fibrinolytic activity in plasma after venous occlusion (15 min) increased significantly when the teenagers had used OC for 4 months. This phenomenon was explained by significantly decreased PAI levels and also by significantly increased t-PA antigen release from the vessel wall after venous occlusion.
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In order to investigate the bleeding tendency in clinically identified carriers of hemophilia, a self-administered questionnaire was held among 135 carriers of hemophilia A and B, 25 females with relatives with hemophilia and a matched group consisting of 60 females without relatives with hemophilia. Carriers of hemophilia appeared to suffer more often from bleeding than their relatives or the matched unrelated control group. ⋯ Obligatory carriers with normal factor VIII:C levels showed no bleeding tendency and were in this respect similar to a group of 25 females with relatives with hemophilia. This study shows that it is important to assay factor VIII:C or IX:C also in those women in whom the carrier status has already been established otherwise.
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We simultaneously evaluated platelet and fibrinolytic parameters to assess their individual and combined contributions to postoperative blood loss in cardiopulmonary (CP) bypass patients. Platelet count, platelet aggregability, hematocrit, plasminogen (PLG) concentration, alpha 2-antiplasmin (AP) concentration, free protease activity (fPA), and antithrombin-III (AT-III) were measured in nine patients undergoing surgery using cardiopulmonary bypass. Chest tube drainage was used as the measure of postoperative blood loss. ⋯ Chest tube drainage during the first four postoperative hours correlated positively (p less than 0.05) with the combination of increase in free protease activity and decrease in platelet count. The total chest tube drainage correlated significantly with the combination of decrease in platelet count and the decrease in platelet aggregability. These combinations of changes correlated significantly with postoperative blood loss whereas the individual changes did not.(ABSTRACT TRUNCATED AT 250 WORDS)
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Comparative Study
Plasma kallikrein-kinin system in patients with uncomplicated sepsis and septic shock--comparison with cardiogenic shock.
Alterations of the kallikrein-kinin system consistent with activation and increased consumption have been reported in septic patients and it has been suggested that this activation could contribute to the development of septic shock. The aim of this work was to confirm these alterations in septic patients and to investigate the possible existence of similar changes in subjects developing cardiogenic shock secondary to myocardial infarction as a model of non septic shock. ⋯ Components and inhibitors of the kallikrein-kinin system were within normal limits in patients with cardiogenic shock. Our findings support the idea of a contribution of the kallikrein-kinin system to the development of septic shock though this system does not seem to play a significant role in the pathogenesis of cardiogenic shock or seem to be altered as a consequence of it.
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A potential synergic effect of tissue-type plasminogen activator (t-PA), single-chain urokinase-type plasminogen activator (scu-PA) or urokinase on clot lysis was investigated in a whole human plasma system in vitro. The system consisted of a human plasma clot labeled with 125I-fibrinogen, immersed in citrated whole human plasma, to which the thrombolytic agents were added. Clot lysis was quantitated by measurement of released 125I, and activation of the fibrinolytic system in the surrounding plasma by measurements of fibrinogen and alpha 2-antiplasmin. t-PA, scu-PA and urokinase induced a dose-dependent and time-dependent clot lysis; 50 percent lysis after 2 h was obtained with 5 nM t-PA, 20 nM scu-PA and 12 nM urokinase. ⋯ The shape of the dose-response curves was different; t-PA and urokinase showed a log linear dose-response whereas that of scu-PA was sigmoidal. Combinations of t-PA and scu-PA, of t-PA and urokinase or of scu-PA and urokinase at thrombolytic doses of each showed no synergism for thrombolysis. Fifty percent clot lysis in 2 h was obtained at total concentrations of the combined agents of 5 to 15 nM with molar ratios ranging from 1:4 to 4:1.(ABSTRACT TRUNCATED AT 250 WORDS)