• Journal of Chest Surgery
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• v.30 no.7
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• pp.677-685
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• 1997

Thromboelastography(TEG) is the unique measure that gives rapid information about the whole clotting process. Simplifying the diagnosis of coagulopathy during operations, TEG can provide an adequate therapy for postoperative bleeding. Remarkable improvement in hemostasis after cardiopulmonary bypass(CPB) has been achieved by the treatment with proteinase inhibitor aprotinin, but the hemostatic mechanism of aprotinin during CPB is still unclear. This study was designed to evaluate the effects of aprotinin on coagulation system during CPB by using TEG. Forty patients who underwent CPB were divided into two groups: aprotinin(2u 106 kallikrein inhibition units, as a single dose into the cardiopulmonary bypass priming solution) treatment group(male 14, female 8, mean age=50.Byears) and no aprotinin treatment(control) group(male 10, female 8, mean age=53.4 years). TEG, activated clotting time, prothrombin time, activated partial thromboplastin time, platelet counts, fibrinogen an (ibrinogen degradation product(FDP) concentrations were checked before and after CPB(30 minutes after neutralization of heparin effect by protamine sulfate). There was no significant difference in other conventional coagulation tests of two groups except postcardiopulmonary bypass FDP concentration in control group, which was significantly increased compared to that in aprotinin group(p<0.05). In TEG variables of both groups, clot formation time(K) and alpha $angle(\alpha^{\circ})$ were significantly increased and decreased, respectively, after CPB(p<0.05), but fibrinolytic index(LYS60) was not changed during CPB. In aprotinin group, reaction time(R) was decreased significantly after CPB(p<0.05) but maximum amplitude(MA) was not changed(p>0.05). On the contrary, R was not changed markedly but MA was decreased significantly in control group after CPB(p<0.05). This result shows that main change in coagulation system during CPB is not hyperfibrinolysis but cecrease in clot strength by platelet dys unction, and the main effect of aprotinin during cardiopulmonary bypass is the maintenance of clot strength to the pre-CPB level by the preservation of platelet function.

• Childhood Kidney Diseases
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• v.8 no.1
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• pp.26-32
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• 2004

Purpose : Hypercoagulability is present in patients with nephrotic syndrome. Plasminogen activator inhibitor type 1(PAI-1) is a major inhibitor of plasminogen activators. PAI-1 inactivates both tissue plasminogen activator(tPA) and urokinase plasminogen activator(uPA) by rapid formation of inactive 1:1 stoichiometric complexes. Recently some studies showed that the enhanced PAI-1 expression may be involved in the intraglomerular fibrinogen/fibrinrelated antigen deposition seen in nephrotic syndrome. Methods : PAI-1 gene promoter -844(G/A) polymorphism was evaluated in 146 children with minimal change nephrotic syndrome(MCNS) and 230 control subjects. The patients with MCNS were subdivided into 85 infrequent-relapser(IR) group and 61 frequent relapser(FR) group. PCR of PAI-1 gene promoter region including -844(G/A) and RFLP using the restriction enzyme Xhol were performed for each DNA samples extracted from the groups. Results : The distribution of PAI-1 genotype in the control group was G/G 81(32.5%), A/A 42(16.9%), and G/A 126(50.6%). The distribution of PAI-1 genotypes in the IR group of MCNS was G/G 29(34.1%), A/A 15(17.7%), and G/A 41(48.2%). The distribution of PAI-1 genotype in the FR group of MCNS was G/G 17(27.9%), A/A 18(29.5%), and G/A 26(42.6%). There was a significantly increased frequency of A/A genotype(P=0.0251) in the FR group of MCNS. Conclusion : Our results indicate that the PAI-1 gene promoter A/A genotype may be associated with the FR in MCNS.

• Journal of Veterinary Clinics
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• v.26 no.6
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• pp.547-555
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• 2009

This study was performed to determine the minimum dose of Poloxamer/Sodium alginate (PX/SA) mixture on preventing intraperitoneal adhesions to evaluate organ toxicity. Twenty five healthy adult mongrel dogs (weighing 4.68${\pm}$1.67 kg) were divided into five experimental groups composed of five dogs respectively; negative control group (NC, non-treated), positive control group (PC, 2% carboxymethyl chitosan solution treated), and experiment 1 group (E1, 0.25 ml PX/SA mixture of abraded area), experiment 2 group (E2, 0.5 ml PX/SA mixture of abraded area), experiment 3 group (E3, 1.0 ml PX/SA mixture of abraded area). Venous blood specimens were collected from all experimental animals for hematologic and biochemical analysis: WBC, fibrinogen, AST, ALT, ALP, BUN and creatinine. The anti-adhesion effect was evaluated using a serosa abrasion model. The denuded ileum was coated with PX/SA mixture, carboxymethyl chitosan solution or neither. The tensile strength of the adhesion site was evaluated with a tensiometer. For histopathological examination, tissue samples of the liver and kidney were collected from all dogs. According to the results, the frequency and tensile strength values for adhesion separation in PX/SA group were significantly lower than those in negative control group (p < 0.05). In E2 group, the tensile strength was significantly decreased in consideration of PX/SA dose. The values of AST, ALT, ALP, BUN and creatinine of the control and the experimental groups showed no statistical differences. No obvious microscopic differences were noted among tissue sections obtained from all groups. The results suggest that PX/SA mixture may be effective on reducing peritoneal adhesion formation in dog and that 0.5 ml PX/SA mixture of abraded area is most effective dose. Moreover, PX/SA mixture was considered not to have toxicity for the liver and the kidney.

• Journal of Veterinary Clinics
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• v.20 no.1
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• pp.42-48
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• 2003

This study was performed to compare the effect of hyaluronic acid(HA), vitamin I and their combinations for the prevention of postoperative intraperitioneal adhesion in dogs. Twelve mongrel dogs were divided into four groups; HA- (HA Group), vitamin E 800IU- (E8 Group), HA + vitamin E 800IU- (HA+E8 Group) and HA + vitamin E 1600IU-treated group(HA+E16 Group) with three dogs in each group. After celiotomy, five abrasions of 1$\times$1 cm area were made on the antimesenteric serosal surface of the anterior ileocecum with a No. 10 scalpel blade. The five abrasions and peritoneal cavity were coated with 25 of 0.l% HA. Oral supplements of vitamin E were given from the fifth day before the operation to the fourteenth day after the operation. Hematologic values were evaluated before the operation and on the 1st, 4th, 7th and 14th day after the operation. The locations and scores of adhesion were assessed through the second operation on the 21st day after the first operation. The adhesions were located on serosa to mesentary(43.3%)), serosa to serosa(20%), serosa to omentum(5%) and serosa to parietal peritoneum(1.7%). The incidences of adhesion in HA, E8, HA+E8 and HA+E16 groups were 80%, 100%, 47% and 53%, respectively. The scores of adhesion in HA+E8 group(p < 0.05) were lower than those in other groups. This study showed that the combination of HA and vitamin E 800IU was significantly effective in reducing the intraperitoneal adhesion in dogs.

• Tuberculosis and Respiratory Diseases
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• v.45 no.6
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• pp.1214-1222
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• 1998

Background : The intrapleural hypofibrinolysis is caused by mainly excessive concentration of pleural plasminogen activator inhibitor-1 antigen(PAI-1 Ag), which binds tissue type plasminogen activator. In pleural inflammation induced by sclerosing agents for pleurodesis, levels of pleural PAI-1 antigen increase in relation to decreasing D-dimer levels. It has been known that the pleural mesothelial cells have the capability of secreting PAI-1 Ag in response to inflammation in vivo. Therefore, we estimated whether pleural inflammation changes the balance between fibrinolytic and coagulative properties in exudative pleural effusions. Method : The thirty cases was included in our study. We determined the pleural levels of glucose, lactic dehydrogenase(LDH), pH and the counts of white blood cell(WBC), polymorpho leukocyte(PMN), lymphocyte as the parameters of pleural inflammation and cellular components of pleural fluid. The plasma level of fibrinogen in fluid and the neutrophil count in blood were determined. The levels of D-dimer, PAI-1 Ag and thrombinantithrombin III complex(TAT) were determined by ELISA(Behring, Marburg, Germany). Result : The causes of pleural effusion were as following : tuberculous in 14 cases, malignant in 10 cases and parapneumonic in 6 cases. The levels of pleural D-dimer, PAI-1 Ag and TAT was significantly higher than that of plasma(p<0..001). The severity of pleural inflammation did not correlated with pleural D-dimer, PAI-1 Ag, TAT and their plasma levels. But the level of pleural TAT correlated with pleural WBC and lymphocyte count. Conclusion : We found that the severity of pleural inflammations did not correlated with pleural D-dimer, PAI-1 Ag, TAT and the possibility of local production of PAI-1 antigen is present.

• Journal of Life Science
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• v.15 no.6 s.73
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• pp.987-993
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• 2005

A bacterium, producing a fibrinolytic enzyme, was screened from a decaying rice plant. The bacterium was identified as Bacillus subtilis by morphological, biochemical, and physiological properties and named Bacillus subtilis BK-17. The fibrinolytic enzyme (BK) was purified from supernatant of Bacillus subtilis BK-17 culture broth. The molecular weight was 31 kDa as determined by SDS-PAGE. The effect of temperature, pH, and plasminogen on the activity of the bacillokinase (BK) was analysed and the activity was compared with urokinase. The optimal temperature and pH were $50^{circ}C$ and pH 7, pH 8, respectively. The BK activity was inhibited to $45\%$, $35\%$, and $23\%$ with 1mM EDTA, $Zn^{2+}$, and $Ca^{2+}$, respectively. However, $Mg^{2+}$, $Mn^{2+}$, and $Co^{2+}$ ions did not have any significant effect on the enzyme activity The BK showed the artivity in the both plates, plasminogen-free fibrin plate and plasminogen-rich fibrin plate. The result indicates that the BK can directly act the fibrin. In comparison of fibrinolytic activity with urokinase on the fibrin plate, the BK shows about 20 folds higher activity than that of the urokinase.