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Query: UMLS:C0027960 (mole)
 21,279 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Coagulation and fibrinolysis tests were performed in 14 patients with hydatidiform mole before any significant therapy was given and again, after evacuation of the mole, in eight instances. The results were compared with those found in a group of ten volunteers with normal pregnancies. The most frequent abnormalities in the problem cases were a shortening of the partial thromboplastin time and a prolongation of the thrombin time. From a total of seven cases with complete hematologic profiles before and shortly after evacuation of the mole, first showed important drops in platelets and fibrinogen. The most altered profiles occurred after expulsion of the mole in cases with important previous uterine activity. The findings suggested a latent state of hypercoagulability with higher turn over rate of fibrinogen and increased levels of fibrinogen-fibrin degradation products, that may exist even before the mechanism of expulsion begins. It was concluded that the alterations in coagulation and fibrinolysis seen in molar pregnancies most likely have a multifactorial pathogenesis, but the initiating causes must depend on several events taking place in the trophoblast itself and their consequences upon a very distorted intervillous blood circulation.
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PMID:Coagulation and fibrinolysis in molar pregnancy. 85 Nov 43

The activated partial thromboplastin time (aPTT) is the most popular test for monitoring of heparin therapy. The purpose of the present study was to show that an aPTT reagent with good response to heparin can be prepared from synthetic phosphoglycerides. Mixed liposomes were prepared from synthetic dioleoylphosphatidylserine (DOPS), dioleoylphosphatidylcholine (DOPC), and dioleoylphosphatidylethanolamine (DOPE). These liposomes were used in an aPTT test system with kaolin as activator, to evaluate their procoagulant activity in the absence and presence of heparin. For comparison, mixtures of purified non-synthetic phospholipids were prepared and tested with the same systems. The aPTT and its response to heparin were influenced by the phospholipid class composition and concentration. The presence of phosphatidylserine (PS) was required to reduce the aPTT of normal plasma to values between 30 and 40s. The presence of phosphatidylethanolamine (PE) in mixed liposomes could modulate the response to heparin. At low PE/PS liposome concentrations (approximately 40 microM), a relatively low response was observed. At high liposome concentrations (approximately 1 mM), the response to heparin increased with the mole fraction of phosphatidylethanolamine. The results obtained with non-synthetic phospholipid mixtures were similar to those obtained with the synthetic phosphoglycerides. Optimal concentrations of DOPS, DOPE and DOPC were found with which an almost linear response to heparin and to low molecular weight heparin (Fragmin) was observed. Using a mixed liposome consisting of 12 microM DOPS/12 microM DOPC/16 microM DOPE, a doubling of the base-line aPTT was achieved at approximately 0.2 IU/ml of heparin, and at approximately 1.0 IU/ml of Fragmin.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Effect of synthetic phospholipids on the response of the activated partial thromboplastin time to heparin. 814 82

Four direct thrombin inhibitors (DTIs), lepirudin, bivalirudin, argatroban, and melagatran, differ in their ability to prolong the prothrombin time (PT). Paradoxically, the DTI in clinical use with the lowest affinity for thrombin (argatroban) causes the greatest PT prolongation. We compared the effects of these DTIs on various clotting assays and on inhibition of human and bovine factor Xa (FXa). On a mole-for-mole basis, lepirudin was most able to prolong the PT, activated partial thromboplastin time (APTT), and thrombin clotting time (TCT), whereas argatroban had the least effect. At concentrations that doubled the APTT (argatroban, 1 micromol/l; melagatran, 0.5 micromol/l; bivalirudin, 0.25 micromol/l; lepirudin, 0.06 micromol/l), the rank order for PT prolongation was: argatroban > melagatran > bivalirudin > lepirudin. Although the Ki's associated with inhibition of human FXa by melagatran (1.4 micromol/l) and argatroban (3.2 micromol/l) approach their therapeutic concentrations, inhibition of FXa did not appear to be a major contributor to PT prolongation, since argatroban also prolonged the PT of bovine plasma (despite a Ki for bovine FXa of 2,600 micromol/l). Only melagatran inhibited prothrombinase-bound FXa. We conclude that the differing effects of the DTIs on PT prolongation are primarily driven by their respective molar plasma concentrations required for clinical effect. DTIs with a relatively low affinity for thrombin require high plasma concentrations to double the APTT; these higher plasma concentrations, in turn, quench more of the thrombin generated in the PT, thereby more greatly prolonging the PT.
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PMID:Differences in the clinically effective molar concentrations of four direct thrombin inhibitors explain their variable prothrombin time prolongation. 1636 36