In the study, using the kinetic method for the examination of the dependence between the specific activity of the enzyme and the concentration of the enzyme itself in the combined reaction, the researchers have proved that the Ribonuclease (R.Nase) molecule of the black cobra (Naja naja) venom exits at least in two interconvertible forms with the difference in specific activity of almost one grade. These two forms are probably the different oligomers or configurations, temporarily named as the kinetic forms of R.Nase found in the black cobra venom.
Snake Venoms ; Ribonucleases ; Polymorphism, Genetic

Some species of venomous snakes spit venom in human eyes as a defence mechanism when threatened. If not detected and treated appropriately early, this can result in severe toxic ocular injury leading to potential blindness (snake venom ophthalmia). Not much is known of the clinical course and treatment guidelines due to the rarity of such occurrences. We present a case of isolated severe toxic ocular injury in one eye who reported to us with very poor vision following venom spit, which was promptly treated leading to a successful visual recovery. This is the first documented case of snake venom ophthalmia from Kuala Belait, Brunei Darussalam.
Elapidae ; Snake Venoms ; Corneal Opacity ; Blindness

Among the enzymes found in snake venom, ribonuclease (RNase) has been known to have the potential effect against cancer and HIV. In a previous report, the author and his colleague have demonstrated that RNase from Vietnamese black cobra (Naja naja) venom differed from all the other identified RNase for its extremely low optimal value of pH. The results in this study showed that it also differed in nonlinear activity dependence on the enzyme concentrations and a sigmoidal curve of saturation with the substrate. This enzyme expressed the maximal activity at the ionic strength of 10 mM of the reaction buffers. Ammonium sulfate entirely suppressed the enzyme activity at the concentration over 70 mM, and sodium chloride reduced the activity by 70% at the level over 100 mM. No magnesium ion was needed for the activation of this RNase.
Snake Venoms ; Snakes ; Animals, Poisonous ; Black Cobra Venom

PURPOSE: Snake venom induced coagulopathy is a major cause of both morbidity and mortality among affected patients. The effects of venomous factors to coagulation cascade and fibrinolysis were verified by analyzing the hematological data and clinical features of envenomed patients, and the efficacy of blood products transfusion and antivenin against a Korean snakebite clarified. METHODS: A retrospective study was conducted on 57 patients, admitted to the Department of Surgery of Chuncheon Sacred Hospital, between July 2002 and October 2005. According to the guidelines for assessing the severity of North American envenomination, the patients were divided into three groups according to severity, and the clinical course, DIC profile and usages of blood products and antivenin then analyzed. RESULTS: Of the 15 patients in the severe group (26.3%), 9 (60.0%) developed severe coagulation abnormalities, similar to DIC. No substantial bleeding or thrombic event manifested. All the patients with initial hypofibrinogenemia (33.3%) and unmeasured PT/aPTT during the 2nd to 4th hospital days (46.7%) progressed to severe coagulopathy. On average, these patients received transfusions of 18.4 +/- 6.1 pints of FFP and 14.4 +/- 14.9 pints of platelet product. The average amounts of antivenin applied were 1.2 +/- 0.4, 1.7 +/- 0.5 and 2.8 +/- 0.8 vials for the Minimal, Moderate and Severe groups, respectively. There was no death due to a Korean snakebite during this period. CONCLUSION: Korean snake venom is assumed to be a complex mixture of anticoagulant, platelet active and fibrinolytic venom. The discrepancy between abnormal coagulopathy and the clinical course explains venom induced DIC-like syndrome. Hypofibrinogenemia is the most reasonable predictor of DIC-like syndrome. Abrupt prolongation of PT/aPTT during the 2nd to 4th hospital days must weigh against thrombocytopenia. An early antivenin injection, along with the proper use of blood products, could improve the clinical course of envenomed patients.
Blood Platelets ; Dacarbazine ; Fibrinolysis ; Gangwon-do ; Hemorrhage ; Humans ; Mortality ; Retrospective Studies ; Snake Bites* ; Snake Venoms ; Thrombocytopenia ; Venoms

Animals ; China ; Elapidae ; Humans ; Male ; Snake Bites ; Snake Venoms ; poisoning ; Young Adult

BACKGROUND AND PURPOSE: Arginine esterase(Ancrod), a thrombin-like enzyme, purified from the venoms of Agkistrodon halys, has known to cleave fibrinopeptide A from the fibrinogen and lead to circulation of soluble noncross-linked "ancrodfibrin', which stimulates endogenous T-PA release.Many authors have suggested clinical applicability of this enzyme,but clinical studies on its fibrinolytic action has been insufficient.Thus we studied the influence of this enzyme on fibrinolytic activity in cerebral infarction. METHOD: We observed the change of euglobulin fibrinolytic activity, t-PA antigen, t-PA activity, fibrinopeptide A, fibrinogen, FDP and D-dimer, during 12 hours after a bolus intravenous administration of 0.25 unit of the arginine esterase to the 9 patients with cerebral infarction. RESULT:There was no change of the euglobulin fibrinolytic activity, fibrinopeptide A and t-PA Ag but there was significant increase in both t-PA activity and FDP, D-dimer and significant decrease in fibrinogen. CONCLUSION: Our result suggest that arginine esterase converts fibrinogen to a fibrin polymer which has a increased susceptibility to lysis by plasmirl This enzyme seems to amplify T-PA activity through the consequent increase in FT)P, because there is no increase in the euglobulin fibrinolytic activity, fibr'mopeptide A and t-PA Ag suggesting direct T-PA release. Arginine esterase, having action of effective defibrinogenation and safe fibrinolysis,could be used for the thrombus related disease.
Administration, Intravenous ; Agkistrodon ; Arginine ; Cerebral Infarction ; Fibrin ; Fibrinogen ; Fibrinopeptide A ; Humans ; Polymers ; Snake Venoms* ; Snakes* ; Thrombosis ; Venoms

Agkistrodon acutus is a traditional Chinese herb medicine which has immunological regulation,anti-tumor,anti-inflammatory and analgesic effects,which is mainly used for the treatment of rheumatoid arthritis,ankylosing spondylitis,sjogren's syndrome and tumors. In order to excavate more important functional genes from A. acutus,the transcriptome of the venom gland was sequenced by the Illumina Hi Seq 4000,and 32 862 unigenes were assembled. Among them,26 589 unigenes were mapped to least one public database. 2 695 unigenes were annotated and assigned to 62 TF families,and 5 920 SSR loci were identified. The majority of mapped unigenes was from Protobothrops mucrosquamatus in the NR database,which revealed their closest homology. Three secretory phospholipase A_2 with different amino acid sequences showed similar spatial structures and all had well-conserved active sites. The 3 D structural models of C-type lectin showed conserved glycosylation binding sites( Asn45). This study will lay the foundation for the further study of the function of snake venom protein,and promoting the development and utilization of genome resources from A. acutus.
Agkistrodon/genetics* ; Animals ; Crotalid Venoms ; Gene Expression Profiling ; Snake Venoms/genetics* ; Snakes ; Transcriptome

PURPOSE: The aim of this study was to evaluate the feasibility and safety of our antivenin treatment protocol for patients with Korean Viperidae envenomation. METHODS: We developed an antivenin treatment protocol for Korean Viperidae envenomation, based on previous data, and applied this treatment to the enrolled patients. In brief, antivenin was not used for patients with grade 0. Patients with grade I and II received one vial of antivenin. Those with grade III and IV received two and three vials of antivenin, respectively. Adult patients who visited the emergency department (ED) after receiving a snakebite between July 2008 to August 2010 were included. Follow ups were performed at 24 hours, 7 days, and 28 days after the snakebite. RESULTS: A total of 62 patients were enrolled. At the initial evaluation, 6 patients (9.7%) were grade 0, 47 patients (75.8%) were grade I, and 9 patients (14.5%) were grade II. Upon the follow-up evaluation, 14 patients (29.8%) progressed from grade I to grade II and 2 patients (22.2%) progressed from grade II to III. Coagulopathy developed in 5 patients (8.0%) and rhabdomyolysis in 5 patients (8.0%). Urticaria developed in 2 patients (3.2%) and cellulitis in 3 patients (4.8%) as delayed complications. As an antivenin-related complication, serum sickness developed in only 1 patient (1.6%). There were no severe complications and all clinical and laboratory abnormalities disappeared within 28 days. CONCLUSION: Our antivenin treatment protocol was feasible and safe. To confirm our data, multicenter validation studies are needed.
Adult ; Antivenins ; Cellulitis ; Clinical Protocols ; Emergencies ; Follow-Up Studies ; Humans ; Rhabdomyolysis ; Serum Sickness ; Snake Bites ; Snake Venoms ; Urticaria ; Viperidae

In Korea, there are four types of snakes, Glyoidius brevicaudus, G. intermedius (formerly named, saxatilis), G. ussuriensis, Rhabdophis tigrinus. The case-fatality rate in snake bite envenomation is very low. Snake venom is a heterogeneous mixture of pharmacologically active enzymatic, non-enzymatic protein, peptide toxins, other organic and inorganic substances. The pathophysiology evokes a complex series of events that depend on the combined and synergistic action of toxic and non-toxic components. The manifestation includes local and systemic effects. Local tissue effects includes of tissue pain, redness, swelling, tenderness, bullae formation, and necrosis. The major systemic manifestations of snake bite include neurotoxicity, myotoxicity, cytotoxicity, hemolytic, procoagulant, hemorrhagic, and hypotensive effects and interfere in platelet function. General care includes parenteral analgesia, antivenom administration, and serial assessments of limb swelling and laboratory tests. Despite the presence of soft tissue inflammation, prophylactic antibiotics are rarely required, and most patients achieve good outcomes with supportive care and antivenom alone. In the case of mild poisoning do not need to be treated with antivenom. In moderate to severe envenomation, antivenom should be administered. When administered antivenom, adverse reactions are monitored closely and treated early with epinephrine and anti-histamine. In future, we should establish algorithm provides guidance about clinical and laboratory observations, indications for and dosing of antivenom, adjunctive therapies, post-stabilization care, and management of complications from envenomation and therapy.
Analgesia ; Anti-Bacterial Agents ; Blood Platelets ; Epinephrine ; Extremities ; Humans ; Inflammation ; Korea* ; Necrosis ; Nociceptive Pain ; Poisoning ; Snake Bites* ; Snake Venoms ; Snakes* ; Venoms

PURPOSE: The aim of this study was to help set the domestic guidelines for administration of antivenom to envenomated patients with snake. METHODS: This retrospective observation case series comprised 128 patients with a snake envenomation. The patients were divided into two groups according to the need for additional antivenom after the initial treatment strategy based on the traditional snakebite severity grading scale; one group recovered successfully with the initial treatment decision and did not require an additional antivenom (N=85) and the other group required an additional administration of antivenom later (N=43). RESULTS: The group requiring additional administration of antivenom showed a higher local effect score and traditional snakebite severity grading at presentation, a shorter prothrombin and activated partial prothrombin time, a higher frequency of rhabdomyolysis and disseminated intravascular coagulopathy, and longer hospitalization than the group that did not require an antivenom later. The most common cause of additional administration was the progression of local symptoms. The independent factor associated with the need for additional antivenom administration was a local effect scoring of pain score (odds ratio, 2.477; 95% confidence interval, 1.309 to 4.689). The optimal cut off value of local effect scoring of pain was 1.5 with 62.8% sensitivity and 71.8% specificity. CONCLUSION: The local effect scoring of pain should be considered when treating patients who are envenomated with a snake using the traditional snakebite severity scale. If the local effect scoring of pain is more than 2, an increase of antivenom should be considered and the patients should be assessed frequently.
Antivenins ; Hospitalization ; Humans ; Prothrombin ; Prothrombin Time ; Retrospective Studies ; Rhabdomyolysis ; Sensitivity and Specificity ; Snake Bites* ; Snakes* ; Venoms