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C Kluft, C J M van Leuven
BACK GROUND: It has recently been reported that factor XIa can activate factor X directly and can bypass factors VIII-IX. We evaluated the consequences for factor analysis with the one-stage APTT. METHODS: APTT was performed with the Actin FS reagent with ellagic acid as the standard. Silica, high lipid (PTT-A) or low lipid (PTT-LA) were also tested. Factor depleted and deficient plasma's were obtained from commercial sources. RESULTS: The APTT clotting times in factor XII, XI, High Molecular Weight Kininogen, factor X and factor V deficient plasma's were all significantly longer (>100s) than the clotting times of factor VIII- and IX-depleted or deficient plasma's (<100s)...
January 2015: Thrombosis Research
R S Mangus, S B Kinsella, J A Fridell, C A Kubal, P Lahsaei, L O Mark, A J Tector
INTRODUCTION: This study compared clinical outcomes for a large number of liver transplant patients receiving intraoperative epsilon-aminocaproic acid (EACA), aprotinin, or no antifibrinolytic agent over an 8-year period. PATIENTS AND METHODS: Records for deceased donor liver transplants were reviewed. Data included antifibrinolytic agent, blood loss, early graft function, and postoperative complications. Study groups included low-dose aprotinin, high-dose aprotinin, EACA (25 mg/kg, 1-hour infusion), or no antifibrinolytic agent...
June 2014: Transplantation Proceedings
Ajai R Singh, Shakuntala A Singh
Private investment in biomedical research has increased over the last few decades. At most places it has been welcomed as the next best thing to technology itself. Much of the intellectual talent from academic institutions is getting absorbed in lucrative positions in industry. Applied research finds willing collaborators in venture capital funded industry, so a symbiotic growth is ensured for both.There are significant costs involved too. As academia interacts with industry, major areas of conflict of interest especially applicable to biomedical research have arisen...
January 2007: Mens Sana Monographs
F Fleischmann, C Matuschek, K Orth, P A Gerber, R Mota, W T Knoefel, M Peiper, M Schick, M van Griensven, Edwin Bölke, W Fleischmann
BACKGROUND: Classic wound drainage is still common in hip replacement but its benefit is doubtful. The role of systemic administration of proteinase inhibitors like aprotinin to avoid perioperative blood loss is still unclear. PATIENTS AND METHODS: In a prospective randomized trial, the perioperative blood loss in alloplastic hip replacement under the influence of proteinase inhibitor (aprotinin, Trasylol®) using wound drainage as well as compression treatment alone were compared...
January 27, 2011: European Journal of Medical Research
Chikodili C Nduaguibe, Kwamina Bentsi-Barnes, Yoko Mullen, Fouad Kandeel, Ismail Al-Abdullah
Pefabloc, Trasylol and Urinary Trypsin Inhibitor (UTI) have been reported to be effective serine protease inhibitors that impair pancreatic endogenous proteases resulting in improved islet yield. Here we evaluated the effect of these inhibitors on endogenous proteases (trypsin, chymotrypsin and elastase), bacterial neutral proteases (thermolysin and neutral protease) and islet isolation digestion samples. Protease activity was measured using a fluorimetric assay and islet function was assessed by dynamic perifusion...
May 2010: Islets
A C Shisheva, M P Printz, K Herman, D Ganten
The present study shows that rat brain contains a kinin-forming activity which is distinguishable from plasma kallikrein. Kinin-forming activity was found in an acetone powder of frozen brain tissue (between 27 and 175.5 ng generated bradykinin/g fresh brain tissue/h). Analysis by high pressure liquid chromatography (HPLC) indicated that the kinin formed chromatographed like true bradykinin (BK). After subcellular fractionation using differential centrifugation of homogenized fresh brain tissue the kinin-forming activity was found mainly in a microsomal (P-3) fraction after preincubation with 2 ?M melittin...
1985: Neurochemistry International
Eivind Øvrum, Geir Tangen, Stein Tølløfsrud, Mari-Anne L Ringdal, Rolf Øystese, Reidar Istad
Clopidogrel (Plavix) given before the operation increases bleeding complications following coronary artery bypass grafting (CABG). High perioperative doses of aprotinin (Trasylol) are known to reduce bleeding and transfusions after cardiac surgery, but may increase the risk of thrombosis, renal impairment, and mortality. The aim of the study was to evaluate the clinical effects of aprotinin given in high doses intra- and postoperatively vs. a low postoperative dose in patients on clopidogrel. Patients admitted for first-time CABG and receiving clopidogrel with or without aspirin, were prospectively randomized either to receive a total of 75,000 kallikrein inhibitor unit (KIU)/kg aprotinin given intra- and postoperatively or 25,000 KIU/kg aprotinin after the operation...
April 2010: Interactive Cardiovascular and Thoracic Surgery
Jeremiah R Brown, Andrew W J Toler, Robert S Kramer, R Clive Landis
It is important to define the extent, and any limitations, of potential anti-inflammatory regimens used in cardiac surgery to guide the rational combination of drugs to suppress the systemic inflammatory response. Aprotinin (Trasylol) is an anti-fibrinolytic agent with reported anti-inflammatory properties. In this study, we investigated the published data on aprotinin's effect on acute phase protein and cytokine levels in cardiac surgery patients. Randomized placebo-controlled trials of aprotinin published between 1985 and 2007, in adult cardiac surgery using cardiopulmonary bypass, reporting tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6), IL-8, and IL-10 levels were included for review...
June 2009: Journal of Extra-corporeal Technology
Emma-Karin I Millers, Manuela Trabi, Paul P Masci, Martin F Lavin, John de Jersey, Luke W Guddat
Textilinin-1 is a Kunitz-type serine protease inhibitor isolated from the venom of the Australian common brown snake, Pseudonaja textilis. This molecule binds to and blocks the activity of a range of serine proteases, including plasmin and trypsin. Textilinin-1's ability to inhibit plasmin, a protease involved in fibrinolysis, has raised the possibility that it could be used as an alternative to aprotinin (Trasylol) as a systemic antibleeding agent in surgery. Here, the crystal structure of free recombinant textilinin-1 has been determined to 1...
June 2009: FEBS Journal
Abe DeAnda, John A Elefteriades, Nahidh W Hasaniya, Omar M Lattouf, Robert R Lazzara
The continued need to minimize blood product usage both during and after cardiac surgical procedures has been challenged by a changing patient population, and most recently by the withdrawal of the antifibrinolytic aprotinin (Trasylol, Bayer Pharmaceuticals, West Haven, CT, USA) from the market. To meet these challenges, a variety of topical hemostatic tools have continued to emerge in the surgical armamentarium. These include hemostatic agents, adhesives, and sealants designed to control perioperative bleeding and decrease blood product utilization...
May 2009: Journal of Cardiac Surgery
P Hebborn, B Shaw
The effects of sodium salicylate and of aspirin on the actions of pancreatic, salivary and serum kallikreins have been investigated. Kinin production by the three enzymes was assessed using a guinea-pig isolated ileum preparation. The esterolytic activity of pancreatic and salivary kallikreins was measured by determining acid release from the synthetic substrate toluene-p-sulphonyl-L-arginine methyl ester. Sodium salicylate (up to 20 mM) or aspirin (up to 5 mM) failed to inhibit kinin production by each of the three enzymes...
April 1963: British Journal of Pharmacology and Chemotherapy
K Burger, M Pékli
A simple potentiometric procedure based on the determination of the primary amino groups in macromolecular polypeptides is presented. The method was found suitable for the detection of decomposition processes involving splitting of the peptide chain (liberation of primary amino groups) and deamination. The method has been applied to analysis of corticotropin fragments (ACTH(1-28) and ACTH(1-32)), Angiotensin II, and the basic trypsin inhibitor Kunitz base (Trasylol).
November 1979: Talanta
Stepan Kasimian, David L Skaggs, Wudbhav N Sankar, Joseph Farlo, Mashallah Goodarzi, Vernon T Tolo
Reduction of blood transfusions in patients with neuromuscular scoliosis can decrease potential complications such as immune suppression, infection, hemolytic reaction and viral transmission. Aprotinin (Trasylol), Bayer), an antifibrinolytic, has proven to be effective in reducing blood loss in cardiac and liver surgery, but little data exists in patients undergoing spinal fusion for neuromuscular scoliosis. The purpose of this study was to evaluate the safety and efficacy of aprotinin in pediatric neuromuscular scoliosis patients undergoing spinal fusion...
December 2008: European Spine Journal
Benjamin J Kober, Albertus M Scheule, Vladimir Voth, Norbert Deschner, Eckhard Schmid, Gerhard Ziemer
We report a 67-yr-old male after multiple surgical procedures for treatment of arterial occlusive disease who suffered an anaphylactic reaction after administration of aprotinin (Trasylol) prior to urgent coronary artery bypass surgery. The patient had been treated with aprotinin-containing fibrin sealant in 2004 and in 2007, 2 wk before coronary artery bypass surgery. The postoperative serologic screening revealed positive results for qualitative aprotinin-specific IgG, highly elevated quantitative aprotinin-specific IgG and moderately elevated aprotinin-specific IgE antibodies...
August 2008: Anesthesia and Analgesia
C Umeadi, K Bentsi-Barnes, F Kandeel, I H Al-Abdullah
Pefabloc and Trasylol are serine protease inhibitors that have been used during islet isolation to inhibit endogenous proteases (trypsin, chymotrypsin, and elastase) and improve islet yields. Using in vitro studies, we evaluated the effects of Pefabloc and Trasylol on the activities of these proteases and the effect of Pefabloc on islet function. In addition, it has been reported that Protector Solution (PS) enhances the efficiency of Pefabloc. Thus, we evaluated the efficacy of Pefabloc in the presence or absence of PS...
March 2008: Transplantation Proceedings
Sebastian Schneeweiss, John D Seeger, Joan Landon, Alexander M Walker
BACKGROUND: Aprotinin (Trasylol) is used to mitigate bleeding during coronary-artery bypass grafting (CABG). Accumulating evidence suggests that this practice increases mortality. METHODS: Using electronic administrative records of the Premier Perspective Comparative Database, we studied hospitalized patients with operating-room charges for the use of aprotinin (33,517 patients) or aminocaproic acid (44,682 patients) on the day CABG was performed. We tabulated the numbers of patients with a hospital-discharge status of death and performed three types of analyses: a multivariable logistic-regression analysis (primary analysis); propensity-score matching in the highly selected subcohort of patients who received full amounts of the study drug, who underwent CABG by surgeons who performed 50 or more CABG surgeries during the study period, and for whom information on 10 additional covariates was available because the surgery occurred on hospital day 3 or later; and an instrumental-variable analysis of data from patients whose surgeons showed a strong preference for one of the two study drugs...
February 21, 2008: New England Journal of Medicine
John Aker, Chuck Biddle
Complex biological systems are often shaped and maintained by opposing forces. A relevant biological example is the delicate balance between proteases and their inhibitors. Serine proteases contain a serine residue in the active site of the molecule that is essential to the activity of the enzyme. Protease inhibitors limit the activity of proteases in the body. As examples, aprotinin (Trasylol), a serine protease inhibitor, and aminocaproic acid (Amicar), a lysine protease inhibitor, are used to decrease the rate of fibrinolysis and have recently been the subject of considerable controversy in the literature regarding safety and efficacy...
October 2007: AANA Journal
R Clive Landis
The protease-activated receptors (PARs) are a unique family of vascular receptors that confer on cells an ability to sense, and respond to, local changes in the proteolytic environment. They are activated by serine proteases of the blood coagulation cascade, notably thrombin, and are linked to thrombotic and inflammatory effector pathways. In surgery with cardiopulmonary bypass (CPB), thrombin is generated in large quantities in the extracorporeal circuit and can exert systemic effects by way of platelet and endothelial PAR1...
February 2007: Hematology/oncology Clinics of North America
P F Maness, G M Edelman
Mating factor alpha isolated from yeast culture filtrates was radiolabeled by lactoperoxidase-catalyzed iodination, with full retention of biological activity. The (125)I-labeled alpha factor bound at low levels to cells of both mating types (a and alpha) but not to spheroplasts. Despite the low level of binding, large quantities of alpha factor activity were lost by incubation with a cells and a spheroplasts, but not with alpha or a/alpha diploid cells. The amount of activity removed from the culture medium was much larger than the amount of (125)I-labeled alpha factor bound to the cells and was correlated with the appearance of radiolabeled derivatives separable by thin-layer chromatography...
March 1978: Proceedings of the National Academy of Sciences of the United States of America
Adrienne P Williams, Andrew Gettinger
PURPOSE OF REVIEW: Transfusion therapy in the intensive care unit is an ever-growing field, with new understanding of potential complications, new drug therapies to reduce the need for transfusion, and new additions in component therapy. In addition to the risks of sepsis, ABO blood group mismatch, and other complications associated with transfusion, the intensivist needs to be familiar with alternative therapies to minimize transfusion. RECENT FINDINGS: Transfusion-related acute lung injury and immunosuppression are two newly recognized complications in transfusion...
April 2006: Current Opinion in Anaesthesiology
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