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)

Thrombolytic therapy has been used for treating patients suffering from a variety of clinical disorders including patients suffering from extensive venous and arterial thrombosis. This paper describes a combined approach to lytic therapy consisting of administration of small doses of streptokinase in combination with the infusion of plasminogen. The rationale for this approach is based on recent observations that additional plasminogen will be absorbed into preformed thrombi, rendering them more susceptible to lysis in the presence of activators. Forty-four patients who presented with symptoms and signs of acute or sub-acute deep vein thrombosis (DVT) confirmed by phlebography, were included in this study. Group I: 15 consecutive patients received an infusion of 600,000 units of SK dissolved in 50 ml of physiological saline over a period of half and hour. On the subsequent 4 days, a dose of 300,000 units was given twice daily. Group II: 29 consecutive patients received 60 to 90 mg of pretreated plasminogen dissolved in 50 ml of saline given intravenously over 30 min. and followed by same dosage regimen of SK. Blood samples were taken at varying intervals to assess changes in the haemostatic parameters. These were analysed for levels of alpha 2-antiplasmin, antithrombin III, fibrinogen, plasminogen, fibrinogen and degradation products, fibrinolytic activity and levels of activator complex. Findings observed will be presented. Phlebograms were performed before starting treatment and were repeated at the end of 5 days when the treatment had finished. In Group I--(15 patients)--thrombi remained virtually unchanged in 12 out of 15 patients receiving streptokinase infusion; in 3 (20%) there was partial but extensive lysis. In contrast, in Group II--(29 patients)--in 16 (55%) of 29 patients receiving plasminogen and streptokinase infusion, complete lysis of thrombi was obtained. Seven (24%) showed extensive clearance of venous tree while in remaining 6, thrombi virtually remained unchanged.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Intermittent plasminogen-streptokinase treatment of deep vein thrombosis. 335 Mar 94

Preventive effect of intermittent sequential pneumatic compression of the legs (ISPC) on the postoperative deep venous thrombosis (DVT) was studied by 125I-fibrinogen uptake test in 64 surgical patients. Furthermore the mechanism of preventive effect by ISPC was analysed from the point of view of coagulation and fibrinolytic activity in 78 patients. Following results were obtained. 1) The incidence of DVT in control group was 18.0 percent, while it was 6.3 percent in ISPC group (p less than 0.01). 2) The euglobulin lysis time in ISPC group was significantly shorter than that of control group on the first postoperative day (p less than 0.01). 3) There were no definite changes in plasminogen and B beta 15-42 peptide between control group and ISPC group. 4) There were no complications in using of ISPC. This study demonstrates that ISPC has a dual action; (1) mechanical prevention of venous stasis and (2) fibrinolytic acceleration. ISPC are effective for prevention of postoperative DVT.
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PMID:[Study on postoperative deep venous thrombosis with reference to prevention]. 336 30

Familial hypercoagulable states are a collection of syndromes characterized by an inherited deficiency of various proteins involved in the control of coagulation and include antithrombin III, plasminogen, protein C, and protein S. Affected patients usually develop venous thrombosis as adults. During a 15-month interval, we identified five patients with venous thrombosis accompanied by protein C deficiency. Four patients presented with deep venous thrombosis, which was recurrent in two, and one patient developed mesenteric venous thrombosis. The kindred of this last patient suggested an autosomal dominant genetic transmission of protein C deficiency. Patients' ages at the time of diagnosis of disease ranged from 28 to 41 years. All patients had low levels of protein C (range, 34 to 67 U/dL; normal, 70 to 130 U/dL). All patients were treated with heparin sodium immediately and then given long-term oral anticoagulation therapy with warfarin sodium. Protein C deficiency is a predisposing factor to the development of venous thrombosis that has only recently been recognized. Treatment of symptomatic protein C deficiency requires short-term heparin therapy followed by long-term oral anticoagulation therapy with warfarin. Oral anticoagulation treatment must be initiated slowly with no loading dose to avoid warfarin-associated skin necrosis. Patients with unexplained or unusual thrombosis, especially if it occurs at an early age, and patients with recurrent episodes of lower limb venous thrombosis should have their protein C levels measured. If a deficiency is documented, long-term warfarin anticoagulation therapy is recommended.
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PMID:Protein C deficiency. A cause of unusual or unexplained thrombosis. 338 55

In a patient with deep venous thrombosis, plasma concentrations of coagulant and inhibitor proteins were normal except for moderate deficiency of plasminogen. Family studies revealed a similar deficiency in the mother and sister of the propositus. Evaluation of purified plasminogen demonstrated that it functioned normally. The patient represents our only example of plasminogen deficiency in 435 German individuals evaluated with a history of thromboembolism.
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PMID:Congenital deficiency of plasminogen and its relationship to venous thrombosis. 338 98

In 1933 Streptokinase (SK) was isolated from bacterial strains of haemolytic Streptococci. Since then it has become the widest spread drug for fibrinolysis. SK, a protein, consists of 415 aminoacids and has a molecular weight of 47,000u. Together with the plasminogen (PLG) of the blood it forms activator complexes, which then convert other PLG molecules of the blood to plasmin. Plasmin attacks and dissolves fibrin deposits. As a substance produced by bacteria SK stimulates antibody formation in the body, the titer will increase during therapy, and SK lysis should be terminated after 6 days of treatment. Usually SK is administered intravascularly to treat a wide range of diseases, associated with pathological activation of hemostasis, like deep vein thrombosis, pulmonary embolism, myocardial infarction etc.. Contraindications can be traced back to the effects of SK on coagulation and the immune system. Bleeding is the most common side effect, but also a few anaphylactic reactions, caused by massive antigen-antibody precipitation have been observed. The rate of lethality of the treatment was established at 0.7% of the cases. To reduce the incidence of side effects modifications of the drug have been proposed, such as activator complex, light B chain SK, and acylated activator therapy. Compared with Urokinase, SK shows a higher rate of side effects, especially in the field of the immune system. Therapy with Urokinase can be controlled more easily. Nevertheless because of considerable price differences and logistics, SK is preferred in Europe and the USA. If strict guidelines in therapeutic use are followed, the rate of side effects of the drug can be curtailed and will be comparable to those of Urokinase.
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PMID:Review and current status of thrombolytic therapy with streptokinase. 354 44

Twenty-one patients with deep vein thrombosis were treated for six hours per day in accordance with an "ultrahigh" dose scheme with 1,500,000 units/hour streptokinase. A maximum of two such cycles were administered in the first ten patients, and the subsequent patients received up to five cycles as required. In terms of clinical chemical parameters, a pronounced lowering of fibrinogen with corresponding elevation of fibrin(ogen) cleavage products regularly occurred during the first cycle. There were great differences in the individual times for which these alterations persisted (12-72 hours). The alterations during the subsequent cycles were very much less, probably because of the pronounced lowering of the plasminogen concentration. The clinical tolerance (including hemorrhagic complications) was roughly comparable with that of a streptokinase treatment with conventional doses. Phlebographic checking of the result of treatment showed that the ultrahigh dosed intermittent dosage scheme is a highly effective treatment procedure with which the duration of treatment can be appreciably shortened compared to conventional dosage schemata: in four cases, a full recanalization could already be attained after a single cycle.
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PMID:[Fibrinolytic treatment of deep venous thromboses with streptokinase at an ultrahigh dosage]. 356 60

Plasminogen, fibrinogen, antithrombin III, euglobulin lysis time, tissue plasminogen activator (t-PA) and fast-acting t-PA inhibitor were measured in 21 patients receiving either stanozolol (10 mg orally given for 14 days preoperatively) or subcutaneous heparin, during a continuing comparative trial in the prevention of postoperative deep vein thrombosis. Stanozolol treatment resulted in significant (p less than 0.01) increases between the 14th and 1st preoperative days in the plasma concentrations of plasminogen (3.4 to 4.9 Cu/ml) and antithrombin III (107% to 132%); t-PA levels did not increase significantly (6.0 to 16.0 mU/ml; p greater than 0.1). There were significant (p less than 0.02) falls in fast-acting t-PA inhibitor (132% to 75%) and fibrinogen (2.4 to 1.8 g/l). Surgery reversed the changes in fibrinolytic activity seen preoperatively in the stanozolol-treated patients, and similar changes were seen in the heparin-treated group. In this dosage, stanozolol does not appear to prevent the fibrinolytic shutdown which occurs after elective major surgery.
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PMID:Effects of oral stanozolol used in the prevention of postoperative deep vein thrombosis on fibrinolytic activity. 387 18

Thirty-nine patients with symptomatic, venographically verified deep vein thrombosis (DVT) were studied during treatment with heparin in order to investigate the correlation between the venographic changes and parameters of heparin therapy or fibrinolytic components. Venograms were scored with a 40-grade scale, and after one week a significant improvement with an average reduction of the thrombi of 17% was observed. No statistically significant correlation was found between reduction of thrombus size and duration of heparin treatment, total amount of heparin administered, mean levels of APTT, plasmin-alpha 2-antiplasmin complex (PAP), tissue plasminogen activator (t-PA) antigen or t-PA-inhibitor. Only a short history of the thrombus was significantly correlated to thrombolysis. The concentrations of PAP and t-PA-inhibitor were not influenced, while that of t-PA antigen showed a significant increase during heparin infusion. Even if statistically significant correlations were not obtained, the patients with pronounced thrombolytic effect had high PAP-levels. Furthermore, patients with high t-PA-inhibitor levels had no lysis. The results suggest, that also other factors than plasminogen dependent fibrinolysis are of importance for the thrombolytic effect.
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PMID:Thrombolysis and fibrinolytic parameters during heparin treatment of deep vein thrombosis. 408 3

The existence of a system in the human body capable of inducing the dissolution of endogenous pathologically formed thrombi was appreciated in ancient times. Considered in detail in this article are the data that have elucidated the physiologic regulation of which plasmin formation is dependent on, the plasma concentration of plasminogen, availability of activators of plasminogen in the plasma and surrounding tissue environment, the concentration of naturally present inhibitors, and the existence of fibrin in the circulation. Important in this rapidly progressive scientific discipline is consideration of the factors which control the synthesis of the components of this proteolytic enzyme system. Recently abundant information has indicated that this plasminogen-plasmin proteolytic enzyme system can be utilized therapeutically. Knowledge of the mechanisms of this system has permitted identification of agents that can be exogenously administered to releave thrombotic obstruction to blood flow in the venous (pulmonary emboli, deep vein thrombosis) and arterial (peripheral and central vessels) circulatory systems. Particularly important is the demonstration that thrombolytic agents can directly attack and alleviate the immediate cause of acute myocardial infarction. As a result of the innovations in the present decade, it is evident that the plasminogen system can be advantageously employed to reverse the pathologic effects of all thrombotic diseases.
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PMID:The fibrinolytic system in man. 608 39

Patients undergoing total hip replacement surgery were given 500 ml of 6% dextran 70 or 5% albumin by intravenous infusion on the third postoperative day when the post-traumatic fibrinolysis inhibition has reached its maximum. The large increase in the fibrinolysis inhibition activity measured by a clot-lysis system was counteracted by the infusion of dextran, whereas the albumin infusion had no such effect. The plasma concentration of antiplasmin (chromogenic substrate assay) and the immunologically determined plasma levels of the primary fibrinolysis inhibitor (alpha2-antiplasmin), alpha2-macroglobulin, alpha2-antitrypsin and plasminogen were not changed after the infusion of dextran. It is hypothesized that dextran exerts its effects partly by interfering with the interaction between the primary fibrinolysis inhibitor, fibrin and plasmin(ogen) and by enhancing the activation rate of plasminogen. This observed effect of dextran may be of importance in the prevention of deep venous thrombosis and pulmonary embolic complications, as well as pulmonary microembolism.
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PMID:Effect of dextran on fibrinolysis inhibition activity in the blood after major surgery. 616 53


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