Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0149871 (deep vein thrombosis)
 12,364 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Two thrombolytic agents are mainly used in patients: streptokinase (SK) and urokinase (UK). UK from human origin is an endopeptidase which is able to convert plasminogen into plasmin. UK is only secreted by the kidney and is only found in urine which is presently the only source of extraction. Studies in man have shown that UK produces a highly reproducible state of enhanced plasma thrombolytic activity with a high fibrinolysis/fibrnogenolysis ratio and a lack of toxicity and antigenicity. The half life in Animal is short as well as the duration of fibrinolytic activity in Man. In clinical experience, positive results have been reported in pulminary embolism while the issues in myocardial infarction are controversial. Suggestive results have been registered in deep vein thrombosis, in ophthalmologic field and in desobstruction of arterio-venious shunts. No evident benefit has been noted in cerebral vascular disease. Up to now, UK has been very well tolerated.
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PMID:[Urokinase. Biochemical therapeutical and therapeutical data (author's transl)]. 6 58

The fibrinolytic response of 12 patients receiving single daily infusions of 600,000 units of streptokinase (SK) and 90 mg of plasminogen for the treatment of DVT has been studied. The mean plasminogen concentration was maintained throughout the treatment period (4-6 days) at between 20-40% the initial value, while mean circulating plasmin concentration rose to only about twice initial plasma levels. The degradation of fibrinogen as indicated by a fall in clottable fibrinogen did not fall below 1 mg/ml and serum FDP rose to greater than 1 mg/ml. Limited fibrinogenolysis occurred in 2 patients, while in another patient who bled there was immediate and extensive depletion to below 0.5 mg/ml. The beneficial clinical results obtained with this regimen (Kakkar et al. 1975), which produces only limited systemic plasminaemia, suggest that thrombolysis may be facilitated by higher levels of plasminogen than those maintained during conventional SK treatment.
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PMID:Intermittent plasminogen-streptokinase treatment of deep vein thrombosis. 13 63

This review deals with aspects of fibrinolysis in which significant developments have taken place in the last few years. The structural changes of plasminogen during its activation are now identified precisely; the recent description of a thrombotic tendency in a kindred characterized by a defect of this protein emphasizes its important role in the homeostatic balance. Several activators of plasminogen are now identified; some of them, such as tissue and vascular activators, appear to have an important role in physiology and pathology. The recent characterizations of the alpha 2-antiplasmin and of antiactivators have widened our understanding of the inhibitors of fibrinolysis: a defect of the plasmin inhibitor seems to be associated with an haemorrhagic tendency, whereas high antiactivator levels were encountered in thrombotic conditions. The clinical use of fibrinolytic agents appears to be promising in conditions such as recurrent deep vein thrombosis and in the post-phlebitic syndrome. Thrombolytic therapy with urokinase or streptokinase appears to have elective indications in patients with acute deep vein thrombosis and massive life-threatening pulmonary embolism.
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PMID:Progress in fibrinolysis. 16 15

1. We describe a patient who developed deep vein thrombosis after commencing treatment with the synthetic androgen, mesterolone (Pro-Viron). 2. To investigate the potential thrombogenic action of this drug, a 21 day course of mesterolone (100 mg/day) was given to nine healthy male volunteers. 3. No significant change after treatment occurred in any of the blood tests performed (clotting times, Factor VIII coagulant activity, Factor VIII related antigen, antithrombin III activity, fibrinogen, fibrinogen-fibrin degradation products, plasminogen, euglobulin lysis time, urokinase sensitivity, platelet count, haematocrit, whole blood viscosity and plasma viscosity). 4. We conclude that in a conventional dose taken for 3 weeks mesterolone does not produce a consistent measurable prothrombotic state, nor does it enhance fibrinolysis.
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PMID:Mesterolone: thrombosis during treatment, and a study of its prothrombotic effects. 76 Jul 33

The properties of fibrinogen extracted by a precipitation method using glycine at ambient temperatures near neutral pH are described. The simple and reproducible method gives a 73% yield of high purity plasminogen-free fibrinogen in 45 minutes from small volumes of plasma. The protein extract was labelled with 125I using chloramine-T under conditions optimal for fibrinogen stability. The extraction procedure, radio-iodination, desalting, and sterilization take only 70 minutes for completion from the time donor blood is received in the laboratory. The methods, using a specially developed extraction vessel and desalting/sterilizing column, can be used in a small hospital laboratory. Autologous fibrinogen can thus be extracted from patients' blood, eliminating the risk of transmitting hepatitis when it is re-administered. The autologous material, which is 97% clottable and contains less than 0-05% free iodide, is being routinely used as a diagnostic tool in the detection of deep vein thrombosis. The high purity of the preparation facilitates metabolic studies and in vitro experimental work. In vivo results show a mean half-life in three normal volunteers of 3-95 days and a catabolic rate of 25-23% per day with the extravascular space estimated as 24-86%. In 30 surgical patients an expected reduced half-life in plasma was determined with a mean of 3-1 days.
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PMID:A rapidly produced 125I labelled autologous fibrinogen: in vitro properties and preliminary metabolic studies in man. 93 5

In fifteen patients with a cerebro-vascular accident resulting in an acute hemiplegia there was a subsequent rise in the platelet count and plasma fibrinogen level. There were no significant alterations in platelet adhesiveness, plasminogen activator, plasminogen, FR-antigen and haematocrit. Patients diagnosed as developing deep venous thrombosis with the 125I-fibrinogen technique had a significantly lower platelet adhesiveness and plasminogen level than those who were not.
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PMID:Platelet adhesiveness and fibrinolysis after recent cerebro-vascular accidents and their relationship with subsequent deep venous thrombosis of the legs. 103 1

Of 67 patients with acute deep vein thrombosis of the lower extremity (DVT), 43 patients were treated by venous thrombectomy and 24 patients were managed by conservative treatment. The clinical effect of thrombectomy was evaluated by analyzing follow-up results in the 2 groups. The cumulative incidences of pigmentation and stasis ulcer at the 5th year were 2.7% and 0% respectively in the thrombectomy group, and 24.3% and 10% respectively in the conservative treatment group. Pigmentation and stasis ulcer were significantly more frequent in the conservative treatment group (p < 0.01). It is concluded that venous thrombectomy is superior to conservative treatment to prevent late postthrombotic sequelae. Protein C, protein S and plasminogen were assayed in 40 DVT patients to determine the incidence of hypercoagulable state in DVT. Congenital deficiency or abnormality were found in 15 patients (37.5%). In such DVT patients with thrombophilia anticoagulant prophylaxis should be continued to decrease a risk of rethrombosis.
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PMID:[The treatment of choice in deep vein thrombosis of the lower extremity]. 147 Jan 17

The overall incidence per year of deep vein thrombosis is about one per thousand, but may be much higher in the presence of certain clinical risk factors such as advanced age, immobilization, surgical procedures, pregnancy, puerperium, use of oral contraceptive agents and malignancy. Moreover, homocystinuria, nephrotic syndrome, systemic lupus erythematosus and hematological disorders such as paroxysmal nocturnal hemoglobinuria or myeloproliferative syndromes predispose to thrombotic disease. Evaluation of the patient with thromboembolism should include detailed history, clinical examination and laboratory investigation to exclude these secondary thrombophilic states. Primary or hereditary thrombophilia is suspected mainly in patients suffering from (venous) thromboembolism at an early age (< 45 years), especially if recurrent and/or familial thrombosis is present. Hereditary thrombophilia may be due to deficiency of antithrombin III, protein C, protein S or plasminogen, some other defects being less well-established prethrombotic risk factors. These currently recognized primary prethrombotic molecular defects are found in 10 to 30% of patients with idiopathic thromboembolism. In the majority of cases the cause of thrombosis remains unknown.
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PMID:[Evaluating the origin of thrombophilia: indications and implementation]. 148 83

Thrombotic and thromboembolic occlusions of arteries and veins represent acute and often life threatening complications requiring immediate therapeutic intervention. The most important clinical manifestations of vascular occlusions are myocardial infarction, peripheral arterial occlusion, pulmonary embolism, deep vein thrombosis and ischemic stroke. The logical approach for the treatment in these indications is the early restoration of blood circulation in order to preserve the organ deprived from oxygen supply and to prevent chronic sequelae. Recanalization by surgical intervention is only possible in some indications and is restricted to special clinics. Thrombolysis induced by agents activating plasminogen imitates the physiologic way of dissolving an occlusive clot by shifting the balance of the hemostatic and fibrinolytic system towards fibrinolysis. Streptokinase was the first effective thrombolytic drug used in patients. In the first years of its usage the identification of the appropriate indication and the dosage and application regimens used were based on little pharmacological knowledge and lack of appropriate dose finding. This resulted in suboptimal therapeutic efficacy and severe bleeding. Development of advanced diagnostic methods, more appropriate dose and application regimens and the development of more specific fibrinolytic drugs like rt-PA led to a remarkable improvement of its benefit-risk ratio and made thrombolysis to a widely accepted form of therapy in thrombotic and thromboembolic diseases. Early restoration of blood flow however is only the starting point of a therapeutic strategy, aiming at minimizing the risk of recurrence.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Thrombolysis: the logical approach for the treatment of vascular occlusions. 152 9

Some haemostatic parameters (AT III, alpha 2-AP, C1-INH, kallikrein, F.XII, fibrinogen, plasminogen, euglobulin lysis time, FDP and ethanol test) were studied in patients with deep (DVT) and superficial (SVT) venous thrombosis. The patients with DVT revealed significantly decreased AT III activity, increased alpha 2-AP, C1-INH activity, fibrinogen and FDP concentrations and prolongation of euglobulin lysis time. Ethanol gelation test was positive in 61% in DVT group. Plasminogen level was unchanged in patients with DVT. No significant changes in these parameters were found in SVT group. Only the ethanol gelation test was positive in 21% in this group. These results show a markedly expressed phenomenon of hypercoagulability in the group of patients with DVT and suggest that in the treatment different therapeutic procedures should be considered which influence these specific changes in these coagulation parameters.
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PMID:Some haemostatic parameters in patients with deep and superficial venous thrombosis. 169 73


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