Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0012739 (disseminated intravascular coagulation)
 8,673 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 22-month-old female infant with an accidental methanol poisoning is presented. Her serum methanol level was 25 mg/dl. The clinical and biochemical features were as follows: coma, hyperventilation, metabolic acidosis, paralytic mydriasis, hypoglycemia, increased anion and osmolal gap, DIC, elevated CPK and LDH, anemia and abnormal EEG. She was treated with bicarbonated solutions and continuous infusion of ethanol. The pathophysiology, diagnosis and treatment of this poisoning is herein revised. DIC and enzymatic alterations are specially remarked.
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PMID:[Accidental methanol poisoning in an infant girl. Physiopathology, diagnosis and treatment]. 380 Jan 75

In vitro effects of S-2441, H-D-Pro-Phe-Arg-NH-Heptyl, include potent anti-bradykinin activity and broad-spectrum inhibition of serine proteases involved in the coagulation cascade. In this study, rats infused with 7.8 X 10(8) viable Escherichia coli were treated either with saline (group A) or with intravenous (0.1 mg) and intraperitoneal (0.4 mg) doses of S-2441 (group B). Survival rates for groups A and B were 68% and 98%, at 12 hours (P less than 0.001), and 37% and 73% at 24 hours (P less than 0.001), respectively. Hematologic studies revealed that S-2441 significantly inhibited E. coli-induced prolongation of prothrombin time and partial thromboplastin time as well as a rapid decrease in the values of factor X, anti-thrombin III, and fibrinogen. In addition, S-2441 attenuated E. coli-induced hypoglycemia and a marked reduction of serum complement level. Ultrastructural evaluation of the liver demonstrated that S-2441 prevented the development of extensive sinusosoidal microthrombosis and hepatocellular necrosis. The results indicate that S-2441 affords protection in lethal gram-negative bacteremia owing in part to attenuation of disseminated intravascular coagulation and complement-mediated reactions. The findings are consistent with the concept that S-2441 and related oligopeptides modulate serine protease-mediated responses involving inhibition of active enzymes with competitive antagonism of pharmcologically active products formed during the activation of coagulation, fibrinolytic, kallikrein, and complement systems.
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PMID:Efficacy of S-2441, a synthetic oligopeptide, in a rat model for gram-negative bacteremia. 388 74

1 The effects of pretreatment with the thromboxane synthetase inhibitor UK 37248 (dazoxiben) administered 30 min before intravenous endotoxin (S. enteriditis) in the rat was investigated 2 Plasma prostaglandins and thromboxanes were determined via radioimmunoassay. Endotoxaemia was associated with significant elevations above control values (less than 200 pg/ml) in plasma thromboxane B2 (TXB2), prostaglandin E (PGE) and 6-keto-prostaglandin F1 alpha (6-keto-PGF1 alpha). Within 30 min after endotoxin administration plasma immunoreactive (i) iTXB2 was 875 +/- 90 pg/ml (n = 9), iPGE was 1670 +/- 271 (n = 9) and i6-keto-PGF1 alpha was 1191 +/- 209 pg/ml (n = 10). By 4 h plasma iTXB2 was 1743 +/- 328 pg/ml (n = 5), iPGE was 2589 +/- 494 pg/ml (n = 9) and i6-keto-PGF1 alpha was 4251 +/- 984 pg/ml (n = 10). UK 37248 pretreatment resulted in a significant (P less than 0.001) decrease in plasma iTXB2 at 30 min and 4 h to 193 +/- 28 pg/ml (n = 5) and 421 +/- 57 pg/ml (n = 5), respectively. Unexpectedly UK 37248 also significantly decreased plasma i6-keto PGF1 alpha at 30 min and 4 h to 360 +/- 75 pg/ml (n = 10) (P less than 0.005) and 1920 +/- 513 pg/ml (n = 10) (P less than 0.05), respectively, iPGE plasma levels were not significantly changed in the UK 37248-pretreated rats 30 min (2210 +/- 370 pg/ml (n = 9) or 4 h 3529 +/- 1093 pg/ml (n = 13) after endotoxin compared to the vehicle-treated rats. 3 UK 37248 significantly (P less than 0.05) reduced the endotoxin mortality rate at 24 h from 69% (n = 13) to 30% (n = 13), UK 37248 also reduced splanchnic infarction from 90% (n = 20) to 6% (n = 16). 4 UK 37248 significantly improved the endotoxin-induced thrombocytopaenia, disseminated intravascular coagulation, hypoglycaemia and lysosomal labilization. 5 We conclude that UK 37248 provides significant beneficial effects in experimental endotoxic shock in the rat.
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PMID:Beneficial effects of UK 37248, a thromboxane synthetase inhibitor, in experimental endotoxic shock in the rat. 633 4

Four cases of fulminant pneumococcal septicemia in splenectomized patients are reported. Three had undergone splenectomy for trauma 42, 28 and 14 years prior to the septicemia. The fourth had been splenectomized for suspected lymphoma 3 years earlier. In 3 out of 4 patients the symptomatology was so rapidly progressive that a physician was consulted within 12 hours. Two patients hospitalized after a second consultation and 20 hours after the first symptoms had evidence of septic shock, disseminated intravascular coagulation and hypoglycemia, and died within a few hours despite early antibiotherapy. Diplococci were seen in peripheral smears of these 2 patients and in the buffy coat of the 3 cases in which this was carried out. These four cases reemphasize the fact that during their entire life splenectomized patients are at risk for development of overwhelming septicemia even when the splenectomy was performed because of trauma. Therefore, such patients should be aware of this risk, should be treated promptly with antibiotics in the event of a febrile episode, and should be vaccinated against pneumococci and possibly other encapsulated bacteria such as Haemophilus influenzae and Neisseria meningitidis.
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PMID:[Fulminant pneumococcal septicemia in splenectomized patients]. 731 55

The recent increase in the occurrence of pulmonary yellow hyaline membranes correlates with improved therapy for premature infants with the respiratory distress syndrome and with their prolonged survival. We compared the clinicopathologic features in 54 cases with pulmonary yellow hyaline membranes with those in 56 cases with conventional hyaline membranes seen during the same interval at Magee-Womens Hospital. Kernicterus, intraventricular hemorrhage, intrahepatic bile stasis, pulmonary hemorrhages, and disseminated intravascular coagulation were significantly frequent in the yellow hyaline membrane group. Clinical problems of hypoglycemia, hypocalcemia, jaundice, and endotracheal hemorrhages and also treatment with endotracheal intubation, ventilatory assistance, and phototherapy were much more common in the yellow hyaline membrane cases. The yellow pigment was identified as unconjugated bilirubin by histochemical and biochemical techniques. A plausible hypothesis for the pathogenesis is presented wherein intrapulmonary hemorrhages lay an important role. The frequent association of yellow membranes and kernicterus in premature infants at relatively low serum levels of bilirubin is significant.
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PMID:Pulmonary yellow hyaline membranes in neonates. 742 2

Proteolytic enzymes, lipase, kinins, and other active peptides liberated from the inflamed pancreas convert inflammation of the pancreas, a single-organ disease of the retroperitoneum, to a multisystem disease. Adult respiratory distress syndrome, in addition to being secondary to microvascular thrombosis, may be the result of active phospholipase A (lecithinase), which digests lecithin, a major component of surfactant. Myocardial depression and shock are suspected to be secondary to vasoactive peptides and a myocardial depressant factor. Coagulation abnormalities may range from scattered intravascular thrombosis to severe disseminated intravascular coagulation. Acute renal failure has been explained on the basis of hypovolemia and hypotension. The renin-angiotensin alterations in acute pancreatitis (AP) as mediators of renal failure need to be studied. Metabolic complications include hypocalcemia, hyperlipemia, hyperglycemia, hypoglycemia, and diabetic ketoacidosis, of which hypocalcemia has been long recognized as an indicator of poor prognosis. The pathogenesis of hypocalcemia is multifactorial and includes calcium-soap formation, hormonal imbalances (e.g., parathyroid hormone, calcitonin, glucagon), binding of calcium by free fatty acid-albumin complexes, and intracellular translocation of calcium. Subcutaneous fat necrosis, arthritis, and Purtscher's retinopathy are rare. The various prognostic criteria of AP and other associated laboratory abnormalities are manifestations of systemic effects. Early recognition and appropriated management of these complications have resulted in improved prognosis of severe AP.
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PMID:Acute pancreatitis: a multisystem disease. 804 85

1. Injection of lipopolysaccharides (LPS) or endotoxin into mice and rats induces a prolonged increase in serotonin (5-hydroxytryptamine: 5HT), predominantly in the liver. 2. The 5HT increase reflects the accumulation of platelets in the sinusoidal and perisinusoidal Disse spaces (spaces between endothelial cells and hepatocytes) in the liver. 3. Most of the platelets which accumulated in these spaces still retained their intact structure and a large amount of 5HT. 4. Interleukin-1 and/or tumor necrosis factor also induce the platelet response. 5. Kupffer's cells play a key role in this platelet response. 6. Anti-platelet drugs currently used, except for anti-inflammatory steroids, were ineffective in preventing the platelet response. 7. This platelet response is different from the well known platelet aggregation. 8. The possible involvement of this platelet response in insulin-independent hypoglycaemia, disseminated intravascular coagulation, septic shock, hepatitis, Shwartzman type reactions or self-defense mechanisms is discussed.
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PMID:Active translocation of platelets into sinusoidal and Disse spaces in the liver in response to lipopolysaccharides, interleukin-1 and tumor necrosis factor. 827 Jan 61

We report on a 3-day-old newborn with critical coarctation of the aorta, coexisting adrenal and intracranial hemorrhages and acute renal failure requiring dialysis. Severe hypoglycemia, hyperbilirubinemia, mounting anemia and thrombocytopenia, clotting disturbances suggesting DIC, pneumonia, hypertension, increasing circulatory failure and repeated intracranial hemorrhage were observed and were the reason for postponing heart surgery. The child was operated on during the third week of hospitalisation on an emergency basis. The cardiac surgery procedure was performed successfully.
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PMID:[Diagnostic and therapeutic problems in a newborn with aortic coarctation, adrenal and intracranial hemorrhages and renal failure]. 864 47

Reported is a case of hemorrhagic shock and encephalopathy syndrome (HSE) with extensive white matter involvement. A three year old, previously healthy boy was presented with an acute onset of fever, loss of consciousness and convulsions. He had disseminated intravascular coagulation, metabolic acidosis, non-ketotic hypoglycemia and hepatorenal dysfunction. The computed tomography (CT) scan of his head on the second day of illness demonstrated symmetric, extensive low-density areas in the cerebral and cerebellar white matter. The child died on the 13th hospital day. A post-mortem histopathological examination of the liver revealed centrilobular necrosis and infiltration of fatty acid droplets. The concentrations of serum 2',5'-oligoadenylate synthetase and urinary neopterin were markedly elevated, indicating excessively activated cell-mediated immunity. This overproduction of inflammatory cytokines might play an important role in the pathogenesis of the brain lesion as well as in other clinical and laboratory manifestations. The patient had a decreased serum level of alpha l-antitrypsin, which may have been associated with the development of uncontrolled inflammation and coagulation disorder.
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PMID:Extensive white matter involvement in hemorrhagic shock and encephalopathy syndrome. 874 21

Many complications are frequently associated in patients with cancer which require immediate treatment. Oncologic emergencies are widely varying, which include superior vena cava syndrome, intracranial hypertension, spinal cord compression, metabolic emergencies, surgical emergencies, urologic emergencies, etc. In the treatment of these emergencies, the decision is most difficult because the usual responses and criteria for decision making are altered, and specific expertise is necessary. In patient with cancer, a situation in which complex problems are frequent, and the use of more sophisticated studies may be critical in defining and following acute, emergent problems. Furthermore, poor host "reserve" may make earlier decision-making essential, even though apparent risks are greater and diagnosis may be less certain. In this review, pathogenesis, manifestation, diagnosis, and treatment of principal oncologic emergencies (hypercalcemia, hyponatremia, tumor hypoglycemia, DIC, and cardiac tamponade) were evaluated from the view point of medical oncology.
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PMID:[Oncologic emergencies]. 905 Nov 26


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