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Query: UMLS:C0012739 (
disseminated intravascular coagulation
)
8,673
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Protein S, an important cofactor of
activated protein C
, and C4b-binding protein were purified from human plasma. Specific antibodies against the purified proteins were raised in rabbits and used for the development of immunologic assays for these proteins in plasma: an immunoradiometric assay for protein S (which measures both free protein S and protein S complexed with C4b-binding protein) and an electroimmunoassay for C4b-binding protein. Ranges for the concentrations of these proteins were established in healthy volunteers and patients using oral anticoagulant therapy. A slight decrease in protein S antigen was observed in patients with liver disease (0.78 +/- 0.25 U/ml); no significant decrease in protein S was observed in patients with
DIC
(0.95 +/- 0.25 U/ml). Criteria were developed for the laboratory diagnosis of an isolated protein S deficiency.
...
PMID:Determination of plasma protein S--the protein cofactor of activated protein C. 316 Dec 6
This rapid, simple amidolytic assay of
protein C
activity in whole plasma involves activation by
protein C
activator from the venom of Agkistrodon contortrix contortrix (Protac) and use of a Cobas Fara spectrophotometer programmed for kinetic assay. Plasma is incubated with activator venom in the presence or absence of antibody to human
protein C
in the instrument, chromogenic substrate (S-2366) is added, and the absorbance is measured at 405 nm. The difference between the absorbance of the sample plasma with and without antibody to human
protein C
correlated well with
protein C
antigen as assayed by enzyme-linked immunosorbent assay (ELISA) and the Laurell rocket technique in normal subjects, patients being treated with warfarin, and patients with liver cirrhosis or
disseminated intravascular coagulation
. Our mean value for
protein C
in normal subjects is 115.9 (SD 16.7)% for amidolytic activity, 103.0 (SD 17.4)% for ELISA, and 97.2 (SD 18.1)% for the rocket technique. The high value for normal subjects presumably includes some nonspecific amidolytic activity activated by the activator venom, as indicated by measurable activity in immuno-depleted
protein C
-deficient plasma. Within-run and between-run CVs were less than 5% at low, normal, and high concentrations of
protein C
amidolytic activity.
...
PMID:Amidolytic kinetic assay of protein C by selective spectrophotometry in a centrifugal analyzer. 318 Apr 21
Using a new rapid coagulant method,
protein C
activity (PC act) was determined in liver cirrhosis and malignancies and compared with PC antigen and AT III values. PC was decreased in a more pronounced manner than AT III in liver cirrhosis, mainly due to impaired synthesis. This is of special clinical interest because PC proved to be a high sensible indicator of liver cell dysfunction. Decreased levels of PC act (PC ratio act/ag less than 1) in decompensated liver cirrhosis may be caused by the synthesis of dysfunctional PC and/or vitamin K deficiency with production of undercarboxylated PC most sensitively registered by this coagulant assay. An increased clearance of in vivo activated PC induced by
DIC
may play an insignificant role. In patients with liver metastases, PC act (but not AT III and immunological parameters) was significantly reduced, supporting the conclusion that in these patients liver dysfunction concomitant with synthesis of dysfunctional PC must be discussed as the main cause of this alteration.
...
PMID:Immunological and functional determination of the protease inhibitors, protein C and antithrombin III, in liver cirrhosis and in neoplasia. 320 4
Protein C
(PC) activities measured by two thrombin-based assays have been compared with those obtained by two assays based on snake venom activation of plasma PC followed by measurement of both the amidolytic and anticoagulant activities of activated PC. This study indicates that snake venom assays gave results similar to those of the thrombin assays in 20 healthy subjects, in 16 patients with
DIC
and in 15 patients with congenital PC deficiency. There was, however, some degree of misclassification of normals and congenitally-deficient patients, with only the clotting snake venom assay resulting in no misclassifications. In 15 patients stabilized on warfarin treatment and in 17 with liver disease, the clotting snake venom assay gave significantly lower values than the other assays, so that it might prove to be more sensitive than the other assays to these defects.
...
PMID:Functional assays of protein C: comparison of two snake-venom assays with two thrombin assays. 321 14
Protein S is a vitamin K-dependent plasma protein which serves as the cofactor for
activated protein C
. Protein S circulates in both an active, free form and in an inactive complex with C4b-binding protein. To elucidate the role of protein S in disease states and during oral anticoagulation, we developed a functional assay for protein S that permits evaluation of the distribution of protein S between free and bound forms and permits determination of the specific activity of the free protein S. In liver disease, free protein S antigen is moderately reduced and the free protein S has significantly reduced specific activity. In
disseminated intravascular coagulation
, reduced protein S activity occurs due to a redistribution of protein S to the inactive bound form. During warfarin anticoagulation, reduction of free protein S antigen and the appearance of forms with abnormal electrophoretic mobility significantly decrease protein S activity. After the initiation of warfarin, the apparent half-life of protein S is 42.5 h. In patients with thromboembolic disease, transient protein S deficiency occurs due to redistribution to the complexed form. Caution should be exercised in diagnosing protein S deficiency in such patients by use of functional assays.
...
PMID:Acquired deficiencies of protein S. Protein S activity during oral anticoagulation, in liver disease, and in disseminated intravascular coagulation. 328 13
Protein C
and protein S serve as natural anticoagulants. Deficiencies of these proteins are often associated with recurrent deep vein thrombosis and coumarin induced skin necrosis. These two proteins function by selectively inactivating factors Va and VIIIa, two of the "cofactors" of blood coagulation. Hence, inhibition of coagulation by this pathway complements the better known inhibition mediated by the antithrombin III-heparin system. These observations suggest that
protein C
and/or
activated protein C
may prove useful in controlling thrombosis and/or
DIC
. We have developed a Ca2+ dependent monoclonal antibody which allows the rapid isolation of human
protein C
. This rapid isolation has allowed us to demonstrate that
activated protein C
can protect baboons from the lethal effects of E. coli/endotoxin and that
protein C
supplementation can minimize fibrinogen consumption following tissue factor infusion into dogs.
...
PMID:Protein C, isolation and potential use in prevention of thrombosis. 330 68
In eighteen patients with fulminant hepatic failure (FHF), in grade III or IV coma, both
protein C
antigen and activity were significantly decreased (0.35 +/- 0.03 u/ml and 0.35 +/- 0.03 u/ml respectively). There was a significant correlation between
protein C
antigen and activity (r = 0.61, p less than 0.01).
Protein C
antigen levels were inversely correlated with prothrombin time (r = -0.57, p less than 0.05) as were
protein C
activity levels (r = -0.57, p less than 0.05). There was also significant correlations between fibrinogen and
protein C
antigen (r = 0.69, p less than 0.01) and
protein C
activity (r = 0.61, p less than 0.01). These results demonstrate that the naturally occurring inhibitor of coagulation,
protein C
, is present at low levels in FHF and this is probably due to the lack of synthesis of the protein in the damaged liver. The low levels of
protein C
may make these patients more susceptible to the
disseminated intravascular coagulation
which is known to occur in FHF and this in turn will lead to a further reduction in
protein C
levels.
...
PMID:The effect of fulminant hepatic failure on protein C antigen and activity. 338
Hemostatic abnormalities are common in patients with metastatic malignancy and are attributed, in part, to materials secreted by tumor cells. Tumor stimulation might therefore cause further perturbation of hemostasis. This article reports observations on the effects of androgen stimulation on multiple hemostatic parameters in patients with metastatic prostate cancer. Testosterone was given before chemotherapy in an experimental protocol designed to increase tumor sensitivity to cytotoxic agents. The following parameters were measured on day 0 (before) and days 2 and 4 of fluoxymesterone administration: PT, APTT, platelet count, plasma betathromboglobulin (BTG), platelet factor 4 (PF4), fibrinogen, fibrin(ogen) split products (FSP), factor VIII coagulant activity (VIII C), von Willebrand factor antigen (vWF Ag), fibrinopeptide A (FPA), antithrombin III (AT III), and
protein C
antigen (PC). Ten patients were studied during 17 cycles of hormonal stimulation. Baseline levels of BTG, PF4, fibrinogen, FSP, factor VIII C, vWF Ag, and FPA were significantly elevated compared with normal control. Although androgen stimulation resulted in elevation of BTG, FPA, and FSP levels by day 4 in many patients, the changes for the entire group were not statistically significant. Other parameters remained unchanged or were only slightly elevated. Two patients developed laboratory evidence of
disseminated intravascular coagulation
(
DIC
) but were clinically unaffected. Our data suggest that most patients with metastatic prostate cancer show evidence of ongoing activation of platelets, coagulation, and fibrinolysis. In a few individual patients, androgen stimulation of this hormonally dependent tumor may cause further activation of platelets, coagulation, and fibrinolysis.
...
PMID:Hemostatic effects of hormonal stimulation in patients with metastatic prostate cancer. 340 35
Patients who are severely envenomed by Russell's viper develop
DIC
which is frequently associated with spontaneous bleeding and incoagulable blood. These haemostatic disturbances may be responsible for death or organ/tissue damage both through haemorrhage and microvascular occlusion by fibrin thrombi. The most striking laboratory features of the coagulopathy developing after Russell's viper bite in the 42 patients studied were depletion of fibrinogen (mean 0.09 g/l, range 0-0.6), factor V (6.5 u/dl, range 0-17), factor X (35 u/dl, range 1-85), factor XIIIa (57 u/dl, range 15-82), plasminogen (61 u/dl, range 10-92), antiplasmin (36 u/dl, range 14-62).
Protein C
(49 u/dl, range 15-100) and platelets (104 x 10(9)/l, range 25-197). Intense fibrinolytic activity was detected in all cases with marked elevation of FDPs (1614 micrograms/ml, range 350-3000), a large proportion of which were cross-linked (1058 micrograms/ml, range 38-3000). The monospecific Burmese antivenom appeared to be very effective in neutralizing the venom procoagulants and in restoring blood coagulability. Moreover, the unexpectedly normal level of AT III provides a theoretical basis for the use of heparin to enhance the inactivation of those serine proteases present before antivenom administration.
...
PMID:Haemostatic disturbances in patients bitten by Russell's viper (Vipera russelli siamensis) in Burma. 340 87
Both anticoagulant and amidolytic activities of
protein C
(PC) were measured using a snake venom activator in 4 patients with hereditary PC deficiency, 37 with
disseminated intravascular coagulation
(
DIC
), and 30 under stabilized warfarin therapy. The results were compared with those obtained by an immunological assay (ELISA). PC levels measured by different functional and immunological assays were very close in patients with hereditary PC deficiency and
DIC
. In patients under stable oral anticoagulant therapy, there was no detectable difference between amidolytic activity and antigen levels of PC in each patient plasma, whereas a decrease in anticoagulant activity was much more pronounced. These results indicate that the present activity assays measure PC specifically, and that the snake venom activator is capable of activating both carboxylated and hypocarboxylated forms of PC, but only anticoagulant assay can evaluate the physiological PC function in vitamin K-deficient states.
...
PMID:Fast functional assay of protein C in whole plasma using a snake venom activator: evaluation in patients with congenital and acquired protein C deficiencies. 341 83
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