• Title/Summary/Keyword: coagulation factor

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Stability Evaluation of National Reference Standards for Blood Products in Korea

  • Park, Tae Jun;Choi, Chan Woong;Oh, Ho Kyung;Kim, Jae Ok;Kim, Byung Kuk;Kang, Hyun Kyung;Kwon, Eun Jeong;Gweon, Eun Jeong;Park, Sang Jin;Kang, Ho Il;Jung, Ki Kyung;Park, Sang Mi;Kim, Ji Hye;Han, Ki Won;Jeong, Ja Young
    • Toxicological Research
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    • v.33 no.3
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    • pp.225-231
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    • 2017
  • National reference standards (NRSs) for biologics are established through potency estimation by a multi-center joint study of standard materials used in the approval process for national lot release and quality control of vaccines, blood products, and other biologics. In this study, a stability evaluation was conducted to determine whether the potency of NRSs for six blood products was being maintained at a consistent level in Korea. The present study conducted real-time stability tests via in-vivo/in-vitro bioassay on NRSs for blood coagulation factor VIII concentrate (2nd standard), antithrombin concentrate, prekallikrein activator, anti-hepatitis B immunoglobulin, blood coagulation factor IX concentrate, and anti-tetanus human immunoglobulin, as well as a trend analysis using cumulative annual results. The real-time stability test results showed that the mean potency of six NRSs was all within the control limit. In the trend analysis, the potency of NRS for blood coagulation factor VIII concentrate (2nd standard) showed a decreasing trend, while the potency of all other products had been stably maintained. The present study confirmed that the mean potency of NRSs for six blood products had been stably maintained in Korea. The findings of the present study establish a foundation that can ensure the quality of NRSs for biologics in Korea, and it is expected to make a major contribution to the supply of high-quality biologics.

A Case of Congenital Factor VII Deficiency Presented with Subacute Subdural Hematoma

  • Kim, Min-Kyoung;Shin, Sang-Jun;Kim, Kyung-Ok;Lee, Kyung-Hee;Hyun, Myung-Soo;Cho, Hee-Soon
    • Journal of Yeungnam Medical Science
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    • v.21 no.2
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    • pp.231-236
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    • 2004
  • A congenital factor VII deficiency is a rare disorder with an estimated incidence in the western contries of one in 500,000. Because factor VII is important in initiation the coagulation cascade, a factor VII deficiency can result in significant bleeding with prolongation of the prothrombin time. We present a case of a factor VII deficiency with a subdural hematoma in an 18-year-old boy whose plasma activity of factor VII was ${\leq}10%$. Previously, he did not have any symptoms, such as hemarthrosis, easy bruising or bleeding after a minor trauma. He was administered fresh frozen plasma and a trephination was performed. His sister also had 51% lower level of factor VII.

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Anticoagulant Activity of Ilexoside D, a Triterpenoid Saponin from ilex pubescens

  • Han, Yong-Nam;Song, Jae-Ihn;Rhee, In-Kyung
    • Archives of Pharmacal Research
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    • v.16 no.3
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    • pp.209-212
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    • 1993
  • The anti-coagulant activity of ilexoside D isolated from the roots of ilex pubescens Hook. et Am. was investigated in in vivo models of blood coagulation in rats. On oral administration, ilexoside D prolonged the bleeding time and the whole blood recalcified clotting time, but not the plasma recalcified clotting time. In vitor, ilexoside D did not affect the recalciffed clotting times of whole blood, platelet-rich plasma(PRP), and platelet-poor plasma(PPP), while in the presence of tissue factor the compound prologed the reduced proth-rombin times of whole blood, PRP and PPP in the dose-dependent manner. These results indicate that ilexoside D has the anit-tissue factor activity as well as the antithromobotic activity.

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Two Cases of Disseminated Intravascular Coagulation (DIC) Following Pit Viper Envenomation (살모사 교상 후 발생한 범발성 혈관내 응고장애 2례)

  • Kim, Suk-Hwan;Choi, Se-Min;Oh, Young-Min;Park, Kyu-Nam;Lee, Won-Jae;Choi, Kyung-Ho
    • Journal of The Korean Society of Clinical Toxicology
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    • v.4 no.2
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    • pp.137-142
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    • 2006
  • Our records include two cases of DIC in snakebite patients. One patient, who was 48-years old, was bitten in his left ankle 3 days before admission to our hospital. Initial symptoms were painful swelling, extensive ecchymosis, and persistent bleeding at the bite site. He visited and was admitted to a local hospital, but his condition did not improve with supportive care that included a single dose of antivenin. He was transferred to our hospital. His condition was compatible with DIC. We tried multi-dose antivenin therapy and blood product transfusion. At the seventh hospital day, the patient's symptoms were completely resolved. The other patient, who was 75 years old, was bitten in his right thumb. Initial symptoms were painful swelling of the right arm and persistent bleeding at the bite site, and within minutes of hospital admission, the patient experienced massive hematochezia. We peformed laboratory tests, the results of which were compatible with DIC, and the next day a sigmoidscopic examination showed ischemic colitis. We administered multi-dose antivenin therapy and blood product tranfusion. At the third hospital day mild anemia still existed, but the patient's clinical condition was improved. No signs or symptoms of gastrointestinal bleeding were observed. In these two cases, multi-dose antivenin therapy and transfusion effectively resolved symptoms of DIC. Platelet concentrate transfusion was required only for acute thrombocytopenia. After resolution of DIC, platelet counts were returned to normal ranges within a few days. The authors propose that multidose antivenin therapy and coagulation factor transfusion might be useful for improving coagulopathy in snakebite patients.

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Effectiveness of High-Volume Therapeutic Plasma Exchange for Acute and Acute-on-Chronic Liver Failure in Korean Pediatric Patients

  • Lim, Hyeji;Kang, Yunkoo;Park, Sowon;Koh, Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.25 no.6
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    • pp.481-488
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    • 2022
  • Purpose: Liver transplantation (LT) is the only curative treatment for acute liver failure (ALF) and acute-on-chronic liver failure (ACLF). In high-volume therapeutic plasma exchange (HV-TPE), extracorporeal liver support filters accumulate toxins and improve the coagulation factor by replacing them. In this study, we aimed to evaluate the effectiveness of HV-TPE in pediatric patients with ALF and ACLF. Methods: We reviewed the records of children waiting for LT at Severance Hospital who underwent HV-TPE between 2017 and 2021. Aspartate aminotransferase (AST), alanine aminotransferase (ALT), total and direct bilirubin (TB and DB), gamma-glutamyl transferase (GGT), ammonia, and coagulation parameter-international normalized ratio (INR) were all measured before and after HV-TPE to analyze the liver function. The statistical analysis was performed using IBM SPSS Statistics for Windows, version 26.0 (IBM Co., Armonk, NY, USA). Results: Nine patients underwent HV-TPE with standard medical therapy while waiting for LT. One had neonatal hemochromatosis, four had biliary atresia, and the other four had ALF of unknown etiology. Significant decreases in AST, ALT, TB, DB, GGT, and INR were noted after performing HV-TPE (930.38-331.75 IU/L, 282.62-63.00 IU/L, 11.75-5.59 mg/dL, 8.10-3.66 mg/dL, 205.62-51.75 IU/L, and 3.57-1.50, respectively, p<0.05). All patients underwent LT, and two expired due to acute complications. Conclusion: HV-TPE could remove accumulated toxins and improve coagulation. Therefore, we conclude that HV-TPE can be regarded as a representative bridging therapy before LT.

A Case of Factor XII Deficiency Which was Found in Recurrent Spontaneous Abortion (반복자연유산 환자에서 발견된 응고인자 12 부족증 1례)

  • Nam, Y.S;Kim, I.H.;Yoon, T.K.;Lee, C.N.;Cha, K.Y.
    • Clinical and Experimental Reproductive Medicine
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    • v.26 no.2
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    • pp.271-274
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    • 1999
  • Activated factor XII (FXIIc: Hageman factor) is a central component of the contact activation system of blood coagulation, fibrinolysis, and kinin formation. Although patients deficient in FXIIc (up to 50% of normal) do not show increased bleeding tendency, thrombotic complications were reported in 8% to 10% among these patients. The reduced generation of bradykinin resulting in diminished release of tissue plasminogen activator is proposed as a cause of thrombosis in factor XII (FXII)-deficient patients. Similarly, in patients with elevated levels of circulating antiphospholipid antibodies, hemostasis may be impaired resulting in excessive thrombophilia. Both vascular and placental thromboses because of antiphospholipid antibodies or FXIIc deficiency have been reported to be associated with recurrent fetal loss. We have experienced a case of factor XII deficiency in woman with recurrent spontaneous abortion. So we report this case with a brief review of literatures.

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Effects of Tetrandrine and Fangchinoline on Human Platelet Aggregation, Thromboxane B$_2$ Formation and Blood coagulation.

  • Zhang, Yong-He;Kim, Hack-Seang;Yun, Yeo-Pyo;Lee, Hyung-Kyu
    • Proceedings of the Korean Society of Applied Pharmacology
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    • 1998.11a
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    • pp.177-177
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    • 1998
  • In the previous report, tetrandrine (TET) and fangchinoline (FAN) showed antithrombotic and antiplatelet aggregation activities. The present study was undertaken to investigate the effects of tetrandrine and fangchinoline on human platelet aggregation, formation of thromboxane B$_2$ and coagulation of platelet poor plasma. TET and FAN inhibited platelet activating factor (PAF) induced human platelet aggregation, but didn't inhibit the specific binding of PAF to its receptor. Meanwhile, TET and FAN also inhibited PAF, thrombin and arachidonic acid induced thromboxane B$_2$ formation in human washed platelets. In addition, neither TET nor FAN showed any anticoagulation activities in the measurement of the activated partial thromboplastin time (APTT), prothrombin time (PT) and thrombin time (TT) using human platelet poor plasma. These results suggest that antithrombotic effects of TET and FAN in mice may be mainly related to the antiplatelet aggregation activities, and the antiplatelet aggregation effects may be related to the intracellular messenger system such as TXA$_2$ formation etc., but not to the binding of PAF to PAF-receptor on the platelet membrane directly.

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Purification and Characterization of Anticoagulant Protein from Ark Shell, Scapharca broughtonii

  • Jung, Won-Kyo;Park, Pyo-Jam;Kim, Se-Kwon
    • Proceedings of the Korean Society of Fisheries Technology Conference
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    • 2000.05a
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    • pp.90-91
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    • 2000
  • The physiological systems that control blood fluidity are both complex and elegant. Blood must remain fluid within the vasculature and yet clot quickly when exposed to nonendothelial surfaces at sites of vascular injury. There are two principle mechanisms to control a delicate balance in higher organisms (Davie & Ratnoff, 1964). Present evidence suggests that the intrinsic pathway play an important role in the growth and maintenance of fibrin formation in the coagulation cascade while a second overlapping mechanism, called the extrinsic pathway, is critical in the initiation of fibrin formation. Coagulation factors is in two mechanisms, and in order to clot blood, they are activated by a cooperation with $Ca^{2+}$, phospholipid and vitamin K etc. For example, the human placental anticoagulant protein (PAP of PAP- I), which is a $Ca^{2+}$ -dependent phospholipid binding protein (Funakoshi et al., 1987) inhibited the activity of factor Xa, so that it prolonged fibrin formation. We wondered whether any other protein was involved in regulation of the coagulant system as an anticoagulant protein from natural organisms. Natural agents would have not harmful side-effects in comparision with chemically synthesized materials such as warfarin, aspirin, phenindione, etc.. But anticoagulant agents from natural, especially marine organisms have hardly been researched except for polysaccharides from marine algae. (omitted)

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DENTAL MANAGEMENT OF CHILDREN WITH HEMOPHILIA UNDER THE GENERAL ANESTHESIA : A CASE REPORT (혈우병 B 환아의 전신마취 하 치과치료 : 증례보고)

  • Kim, Soo-Kyoung;Park, Jea-Hong;Lee, Keung-Ho;Kim, Kwang-Chul;Choi, Sung-Chul
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.4 no.1
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    • pp.7-11
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    • 2008
  • Hemophilia is a group of gender-linkage inherited bleeding disorders that impair the body's ability to control blood clotting or coagulation. This sex-linked disorder is transmitted on the X chromosome. These genetic disorders have lower blood plasma clotting factor level of coagulation factor. Most common form is Hemophilia A and B. Restorative dental care and simple surgery for the hemophiliac patient are quite often neglected for fear of bleeding during procedures. Even dental specialist avoid these patients and make them severe problem patients. On the dental treatment especially, invasive procedure, special considerations of bleeding control are required. Inter-consultation with the hematologist will provide orientation on the best approach to dental treatment, such as the need of replacement therapy, the modification of antifibrinolytic therapy, the application of local hemostatic methods. In this case reports, we successfully treat early childhood caries of patient with hemophilia B under the general anesthesia.

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Purification and Characterization of Anticoagulant Protein from the Tabanus, Tabanus bivittatus

  • Ahn Mi-Young;Hahn Bum-Soo;Lee Pyeong-Jae;Wu Song-Ji;Kim Yeong-Shik
    • Archives of Pharmacal Research
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    • v.29 no.5
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    • pp.418-423
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    • 2006
  • Tabanus anticoagulant protein (TAP) was isolated from the whole body of the tabanus, Tabanus bivittatus, using three purification steps (ammonium sulfate fractionation, gel filtration on Bio-Gel P-60, and ion exchange chromatography on DEAE Sephadex gel). The purified TAP, with a molecular weight of 65 kDa, was assessed to be homogeneous by SDS-polyacrylamide gel electrophoresis, and an isoelectric point of 7.9 was determined by isoelectric focusing. The internal amino acid sequence of the purified protein was composed of Ser-Leu-Asn-Asn-Gln-Phe-Ala-Ser-Phe-lle-Asp-Lys-Val-Arg. The protein was activated by $Cu^{2+}\;and\;Zn^{2+}$, and the optimal conditions were found to be at pH $3\sim6\;and\;40\sim70^{\circ}C$. Standard coagulation screen assays were used to determine thrombin time and activated partial thromboplastin time. Chromogenic substrate assays were performed for thrombin and factor Xa activity. TAP considerably prolonged human plasma clotting time, especially activated partial thromboplastin time in a dose-dependent manner; it showed potent and specific antithrombin activity in the chromogenic substrate assay. Specific anti-factor Xa activity in TAP was not detected. Overall, this result suggested that TAP has significant anticoagulant activity on blood coagulation system.