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G De Nucci - One of the best experts on this subject based on the ideXlab platform.
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AnaLysis of five streptokinase formulations using the Euglobulin Lysis Test and the plasminogen activation assay
Associação Brasileira de Divulgação Científica, 2015Co-Authors: Couto L.t., Donato J.l., G De NucciAbstract:Streptokinase, a 47-kDa protein isolated and secreted by most group A, C and G ß-hemolytic streptococci, interacts with and activates human protein plasminogen to form an active complex capable of converting other plasminogen molecules to plasmin. Our objective was to compare five streptokinase formulations commercially available in Brazil in terms of their activity in the in vitro Tests of Euglobulin clot formation and of the hydroLysis of the plasmin-specific substrate S-2251™. Euglobulin Lysis time was determined using a 96-well microtiter plate. Initially, human thrombin (10 IU/ml) and streptokinase were placed in individual wells, clot formation was initiated by the addition of plasma Euglobulin, and turbidity was measured at 340 nm every 30 s. In the second assay, plasminogen activation was measured using the plasmin-specific substrate S-2251™. Streptase™ was used as the reference formulation because it presented the strongest fibrinolytic activity in the Euglobulin Lysis Test. The Unitinase™ and Solustrep™ formulations were the weakest, showing about 50% activity compared to the reference formulation. All streptokinases Tested activated plasminogen but significant differences were observed. In terms of total S-2251™ activity per vial, Streptase™ (75.7 ± 5.0 units) and Streptonase™ (94.7 ± 4.6 units) had the highest activity, while Unitinase™ (31.0 ± 2.4 units) and Strek™ (32.9 ± 3.3 units) had the weakest activity. Solustrep™ (53.3 ± 2.7 units) presented intermediate activity. The variations among the different formulations for both Euglobulin Lysis Test and chromogenic substrate hydroLysis correlated with the SDS-PAGE densitometric results for the amount of 47-kDa protein. These data show that the commercially available clinical streptokinase formulations vary significantly in their in vitro activity. Whether these differences have clinical implications needs to be investigated
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anaLysis of five streptokinase formulations using the Euglobulin Lysis Test and the plasminogen activation assay
Brazilian Journal of Medical and Biological Research, 2004Co-Authors: L T Couto, J L Donato, G De NucciAbstract:Streptokinase, a 47-kDa protein isolated and secreted by most group A, C and G s-hemolytic streptococci, interacts with and activates human protein plasminogen to form an active complex capable of converting other plasminogen molecules to plasmin. Our objective was to compare five streptokinase formulations commercially available in Brazil in terms of their activity in the in vitro Tests of Euglobulin clot formation and of the hydroLysis of the plasmin-specific substrate S-2251™. Euglobulin Lysis time was determined using a 96-well microtiter plate. Initially, human thrombin (10 IU/ml) and streptokinase were placed in individual wells, clot formation was initiated by the addition of plasma Euglobulin, and turbidity was measured at 340 nm every 30 s. In the second assay, plasminogen activation was measured using the plasmin-specific substrate S-2251™. Streptase™ was used as the reference formulation because it presented the strongest fibrinolytic activity in the Euglobulin Lysis Test. The Unitinase™ and Solustrep™ formulations were the weakest, showing about 50% activity compared to the reference formulation. All streptokinases Tested activated plasminogen but significant differences were observed. In terms of total S-2251™ activity per vial, Streptase™ (75.7 ± 5.0 units) and Streptonase™ (94.7 ± 4.6 units) had the highest activity, while Unitinase™ (31.0 ± 2.4 units) and Strek™ (32.9 ± 3.3 units) had the weakest activity. Solustrep™ (53.3 ± 2.7 units) presented intermediate activity. The variations among the different formulations for both Euglobulin Lysis Test and chromogenic substrate hydroLysis correlated with the SDS-PAGE densitometric results for the amount of 47-kDa protein. These data show that the commercially available clinical streptokinase formulations vary significantly in their in vitro activity. Whether these differences have clinical implications needs to be investigated.
Shou-dong Lee - One of the best experts on this subject based on the ideXlab platform.
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Hemostatic changes in patients with liver cirrhosis.
Zhonghua yi xue za zhi = Chinese medical journal; Free China ed, 1999Co-Authors: Shou-dong LeeAbstract:BACKGROUND Hemostatic changes in liver disease are complicated. An overall evaluation of the main hemostatic parameters in patients with different degrees of cirrhosis of the liver has not been reported in Taiwan. METHODS A series of hemostatic Tests and parameters including activated partial thromboplastin time, prothrombin time, thrombin time, bleeding time, factor VIII assay, antithrombin activity, fibrinogen, plasminogen, protamine sulfate Test, fibrin(ogen) degradation products, D-dimer, thrombin-antithrombin complex (measured by modified antithrombin), tissue plasminogen activator (tPA), plasminogen activator inhibitor-1, Euglobulin Lysis Test and venous occlusion Test were performed in 51 patients with cirrhosis of the liver and 33 healthy controls. Among the cirrhotics, 18 were classified as Child-Pugh group A, 16 were B and 17 were C. RESULTS Plasminogen, antithrombin and platelet count decreased progressively, starting with group A, then B and then C, relative to the controls. Factor VIII, activated partial thromboplastin time, prothrombin time, bleeding time, D-dimer and fibrin(ogen) degradation products increased progressively starting with group A, to B and then C, relative to controls. Severity of cirrhosis correlated with hemostatic changes. No significant change in the fibrinolytic response after challenge with the venous occlusion Test was found in either Child-Pugh groups A, B, C or the controls, though progressive increases in tPA were found starting with group A, to B and then C, relative to controls. CONCLUSIONS Our study proved a close relationship between the severity of cirrhosis and hemostatic changes. Activated partial thromboplastin time was better than bleeding time or thrombin time to demonstrate the severity of liver damage and hemostatic change in cirrhosis. Because the deterioration of coagulation function and increased fibrinolytic activity paralleled the severity of liver cirrhosis, adequate treatment for cirrhotic bleeding should not only correct the coagulation defects, but should also lower the increasing fibrinolytic activity.
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Can advanced hemostatic parameters detect disseminated intravascular coagulation more accurately in patients with cirrhosis of the liver
Zhonghua yi xue za zhi = Chinese medical journal; Free China ed, 1998Co-Authors: Shou-dong LeeAbstract:Laboratory diagnosis of disseminated intravascular coagulation (DIC) is difficult in patients with cirrhosis of the liver due to the complicated hemostatic changes of DIC. More recently, newer molecular hemostatic markers have been used to improve the diagnosis of DIC. This study evaluated the ability of the more advanced hemostatic Tests to diagnose DIC in patients with cirrhosis of the liver. A series of hemostatic Tests and parameters including activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT), factor VIII assay, antithrombin (AT) activity, fibrinogen, plasminogen, protamine sulfate Test (PST), fibrin (ogen) degradation product (FDP), D-dimer, thrombin-antithrombin complex (TAT) (measured by modified antithrombin, ATM), Euglobulin Lysis Test (ELT) and platelet count were performed in 51 patients with cirrhosis of the liver. A diagnosis of DIC was made according to the following parameters and criteria: a) platelets less than 80 x 10(9)/l; b) PT greater than 1.5, c) APTT greater than 1.3; d) TT greater than 24 sec; e) AT less than 60%; f) ATM greater than 14.7 ng/ml (normal, mean +/- 3 SD); g) fibrinogen less than 1.50 g/l; h) positive PST; i) D-dimer greater than 1.0 microgram/ml; j) FDP greater than 20 micrograms/ml; k) ELT less than 150 min; l) plasminogen less than 50%. DIC was diagnosed if six or more of the above items were present, and at least two of them were item (a) to (h), and at least two were item (g) to (l). Although eight patients had results that fitted the diagnostic criteria of DIC by using the more advanced Tests, only two of them were diagnosed with DIC by conventional Testing. The concentration of factor VIII in these eight patients did not markedly decrease. New Tests are not necessary to improve the diagnosis of DIC in patients with cirrhosis of the liver.
I. Filin - One of the best experts on this subject based on the ideXlab platform.
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Study of fibrinolytic parameters in different types of polycythemia.
American journal of hematology, 1999Co-Authors: Gilles Lugassy, I. FilinAbstract:Polycythemia vera (PV) is a myeloproliferative disorder characterized by thrombotic and, less often, bleeding complications. Many mechanisms have been advanced to explain the occurrence of these complications, none of them satisfactory. We examined a cohort of 27 patients with PV, secondary erythrocytosis, and essential thrombocythemia for coagulation and fibrinolytic parameters, including Euglobulin Lysis Test, D-dimer, and alpha2 antiplasmin. Ten of the 27 patients developed one or more thrombotic complications during the study. We found no clinical correlation between the studied parameters and the complications. Three patients, one of each group, with elevated serum alpha2 antiplasmin levels, developed severe arterial or venous thromboses.
Vesna Libek - One of the best experts on this subject based on the ideXlab platform.
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Primary hyperfibrinoLysis as the presenting sign of prostate cancer: A case report.
Vojnosanitetski pregled, 2016Co-Authors: Andrijana Đ. Kulić, Zorica Cvetković, Vesna LibekAbstract:Introduction A bleeding syndrome in the setting of primary hyperfibrinoLysis in a prostate cancer patient is only 0.40– 1.65% of cases. The laboratory diagnosis of primary hyperfibrinoLysis is based on the increase of biomarkers like D-dimer, fibrinogen split products, plasminogen, and Euglobulin Lysis Test. These Tests are not specific for primary hyperfibrinoLysis. We reported a rare case of hemorrhagic syndrome caused by primary hyperfibrinoLysis as the first clinical symptom of metastatic prostate cancer. Case report A 64-year-old male was admitted to our hospital with large hematomas in the right pectoral and axillary areas (20 x 7 cm), right hemiabdomen (30 x 30 cm) and the left lumbal area, (25 x 5 cm). The patient had no subjective symptoms nor used any medication. Initial coagulation Testing, prothrombin time (PT), and activated partial thromboplastin time (APTT) were within the normal range, while fibrinogen level was extremely low (1.068 g/L) (normal range 2.0–5.0) and the D-dimer assay result was high 1.122 mg/L (normal range < 0.23). The results obtained by rotation thrombelastometry pointed to primary fibrinoLysis. Further clinical and laboratory examination indicated progressive malignant prostate disease. First line treatment for the patient was a combined administration of tranexamic acid (3 x 500 mg iv) and transfusion of ten units of cryoprecipitate (400 mL). Next day, fibrinolytic function measurements by rotation thrombelastometry were within the normal ranges. Fibrinogen level was normalized within two days (2.4 g/L). There were no newly developed hematomas. Conclusion This case report shows primary hyperfibrinoLysis with bleeding symptoms, which is an uncommon paraneoplastic phenomenon within expanded prostate malignancy. Rotation thrombelastometry in this severe complication helped to achieve the prompt and proper diagnosis and treatment.
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Primary hyperfibrinoLysis as the presenting sign of prostate cancer - A case report Primarna hiperfibrinoliza kao prezentujući znak karcinoma prostate
2016Co-Authors: Vesna LibekAbstract:Introduction. A bleeding syndrome in the setting of primary hyperfibrinoLysis in a prostate cancer patient is only 0.40- 1.65% of cases. The laboratory diagnosis of primary hyperfi- brinoLysis is based on the increase of biomarkers like D-dimer, fibrinogen split products, plasminogen, and Euglobulin Lysis Test. These Tests are not specific for primary hyperfibrinoLysis. We reported a rare case of hemorrhagic syndrome caused by primary hyperfibrinoLysis as the first clinical symptom of metas- tatic prostate cancer. Case report. A 64-year-old male was ad- mitted to our hospital with large hematomas in the right pecto- ral and axillary areas (20 7 cm), right hemiabdomen (30 30 cm) and the left lumbal area, (25 5 cm). The patient had no subjective symptoms nor used any medication. Initial coagula- tion Testing, prothrombin time (PT), and activated partial thromboplastin time (APTT) were within the normal range, while fibrinogen level was extremely low (1.068 g/L) (normal range 2.0-5.0) and the D-dimer assay result was high 1.122 mg/L (normal range < 0.23). The results obtained by rotation thrombelastometry pointed to primary fibrinoLysis. Further clinical and laboratory examination indicated progressive ma- lignant prostate disease. First line treatment for the patient was a combined administration of tranexamic acid (3 500 mg iv) and transfusion of ten units of cryoprecipitate (400 mL). Next day, fibrinolytic function measurements by rotation thrombe- lastometry were within the normal ranges. Fibrinogen level was normalized within two days (2.4 g/L). There were no newly developed hematomas. Conclusion. This case report shows primary hyperfibrinoLysis with bleeding symptoms, which is an uncommon paraneoplastic phenomenon within expanded prostate malignancy. Rotation thrombelastometry in this severe complication helped to achieve the prompt and proper diagno- sis and treatment.
Gilles Lugassy - One of the best experts on this subject based on the ideXlab platform.
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Study of fibrinolytic parameters in different types of polycythemia.
American journal of hematology, 1999Co-Authors: Gilles Lugassy, I. FilinAbstract:Polycythemia vera (PV) is a myeloproliferative disorder characterized by thrombotic and, less often, bleeding complications. Many mechanisms have been advanced to explain the occurrence of these complications, none of them satisfactory. We examined a cohort of 27 patients with PV, secondary erythrocytosis, and essential thrombocythemia for coagulation and fibrinolytic parameters, including Euglobulin Lysis Test, D-dimer, and alpha2 antiplasmin. Ten of the 27 patients developed one or more thrombotic complications during the study. We found no clinical correlation between the studied parameters and the complications. Three patients, one of each group, with elevated serum alpha2 antiplasmin levels, developed severe arterial or venous thromboses.