Ethanol extract of the mixture of Ligusticum wallichii and Angelica acutiloba exerts significant anticoagulant effect on human blood in in vitro experiments. At concentration of 1:25 in the serum, the extract prolongs the prothrombin, thromboplastin and thrombin times, thus inhibits all the three steps of the coagulation process, i.e, the exogenous, the endogenous precoagulation steps and the formation of fibrins. Finally, at concentration of 1:50 in the serum, the mixture significantly reduces theplatelet aggregation blocking the clotting process.
Anticoagulants ; Blood ; Biochemistry

We inserted the 0.6 mm caliber graft-heparin (in inner wall) conduits into the tailarteries of 14 mice. The results showed that the graft conduit could be used repeatedly with no blood oozing out in the wound, no massive internal hemorrhage, and no additional coagulative reagent given during the whole experiment. On the other hand, the graft-heparin conduits of variant caliber were inserted into the femur arteries of 4 rabbits and 4 dogs for blood pressure experiment and femur arterio-venous bypass tests. The results showed that the anticoagulative effect of these conduits was markedly improved, but there was a strip of thrombus. There was no thrombus track in the wall of the conduit. The strip of thrombus was formed first in the cone of conduit where caliber changed. The results indicate that the blood flow resistance is in inverse proportion to 4 power of the conduit radius. So the thinner the conduit is, the more sensitive to conduit radius variation the conduit resistance will be. In studying and making the arfificial conduit, one must take notice of the conduit caliber, which should be equal to the caliber of the blood vessel.
Animals ; Anticoagulants ; administration & dosage ; Blood Vessel Prosthesis ; Dogs ; Heparin ; administration & dosage ; Mice ; Rabbits ; Regional Blood Flow

PURPOSE: To assess the efficacy and safety of autologous transfusion of filtered shed blood in total knee arthroplasty (TKA). MATERIALS AND METHODS: A total of 42 patients with TKA (group A; without autologous transfusion in 15 patients, group B; with autologous transfusion in 27 patients) were evaluated retrospectively. The influence of autologous reinfusion of filtered blood, bleeding tendency, amount of blood drainage, rate of allogenic transfusion, and the postoperative changes of hemoglobin were analyzed. RESULTS: Allogenic transfusion was needed in 26.7% (4/15) of group A and none of group B till postoperative 48 hours. Till postoperative 14 days, 46.7% (7/15) of group A needed allogenic transfusion while 7.4% (2/27) in group B. The average drained blood volume was 1,197+/-400 mL in group A and 975+/-422 mL in group B. The average decrease of hemoglobin at postoperative 1, 7, and 14 days was 2.9+/-1.5, 2.9+/-1.6, and 2.3+/-1.5 g/dL respectively in group A and 2.7+/-0.8, 4.0+/-1.0, and 2.9+/-1.3 g/dL respectively in group B. CONCLUSIONS: An autotransfusion system lowered the allogenic transfusion rate, while anticoagulants did not increase the amount of drained blood. An autotransfusion system with anticoagulants was effective and safe to save the shed blood in TKA.
Anticoagulants ; Arthroplasty ; Blood Transfusion, Autologous ; Blood Volume ; Drainage ; Hemoglobins ; Hemorrhage ; Humans ; Knee ; Retrospective Studies

OBJECTIVE: To discuss blood collection tubes with different additives and their effects on the testing results of alcohol concentration in blood samples. METHODS: Blood samples from 10 volunteers were collected 2 hours after drinking with seven different types of disposable vacuum blood collection tubes, including ordinary tube without anticoagulant, coagulant tube, separating gel-coagulant tube, sodium citrate (1:4) tube, sodium citrate (1:9) tube, sodium citrate (9:1) tube and EDTA-K2 tube. The alcohol concentrations in these blood samples were analyzed by headspace gas chromatography. RESULTS: The concentration testing results of the same blood samples in different types of tubes were different from one to another. The sequence was as follows: separating gel-coagulant tube > coagulant tube > ordi- nary tube without anticoagulant > EDTA-K2 tube> sodium citrate (1:9) tube> sodium citrate (1:4) tube, whereas the results of the same blood sample in sodium citrate (1:9) tube and sodium citrate (9:1) tube showed no obvious difference. CONCLUSION It is better to collect a suspicious drunk driver's blood sam- ple using a disposable vacuum blood collection tube, with the EDTA-K2 tube being preferred.
Anticoagulants ; Blood Specimen Collection/methods* ; Citrates ; Ethanol/blood* ; Humans ; Sodium Citrate

Thalassemia is the most common human hereditary hemolytic anemia. Due to splenomegaly and hypersp-lenism, splenectomy can be used as a means of treatment for thalassemia. Various complications following splenectomy, however, especially thromboembolic complications are remarkable. This review summarizes the incidence, clinical manifestations and development time of thromboembolism. The pathogenesis of thromboembolism after splenectomy in thalassemia, such as abnormal platelet number and function, changes in red cell membrane, endothelial cell damage, dysfunction of other procoagulant and anticoagulant factors, and local factors associated with splenectomy are elaborated and the trategies to prevent and treat the thromboembolic events in thalassemia after splenectomy, including the attention to risk factors associated with splenectomy, a reassessment of splenectomy, regular blood transfusion to reduce the ratio of abnormal red blood cells, treatment with anticoagulant and antiplatelet drugs, application of hydroxyurea and stem cell transplantation are discussed.
Anticoagulants ; therapeutic use ; Blood Transfusion ; Humans ; Risk Factors ; Splenectomy ; Thalassemia ; pathology ; Thromboembolism ; pathology ; prevention & control ; therapy

Spontaneous non-traumatic intracerebral hemorrhage (ICH) remains a significant cause of mortality and morbidity throughout the world. To improve the devastating course of ICH, various clinical trials for medical and surgical interventions have been conducted in the last 10 years. Recent large-scale clinical trials have reported that early intensive blood pressure reduction can be a safe and feasible strategy for ICH, and have suggested a safe target range for systolic blood pressure. While new medical therapies associated with warfarin and non-vitamin K antagonist oral anticoagulants have been developed to treat ICH, recent trials have not been able to demonstrate the overall beneficial effects of surgical intervention on mortality and functional outcomes. However, some patients with ICH may benefit from surgical management in specific clinical contexts and/or at specific times. Furthermore, clinical trials for minimally invasive surgical evacuation methods are ongoing and may provide positive evidence. Upon understanding the current guidelines for the management of ICH, clinicians can administer appropriate treatment and attempt to improve the clinical outcome of ICH. The purpose of this review is to help in the decision-making of the medical and surgical management of ICH.
Anticoagulants ; Blood Pressure ; Cerebral Hemorrhage* ; Cerebrovascular Disorders ; Humans ; Intracranial Hemorrhages ; Mortality ; Stroke ; Warfarin

As, until now, many studies have failed to establish the clinical effect of numerous neuroprotectives, antithrombotic therapy must be emphasized as one of critical options among limited treatment strategies in acute ischemic stroke. Based on the accumulating evidences that platelets and coagulating proteins play an important role in the thrombus formation, antiplatelets and anticoagulants are served as antithrombotics. Recently, major advances have been made in understanding the effects of antiplatelets and anticoagulants. Large randomized clinical trials have highlighted the effectiveness and safety of early and continuous antiplatelet therapy in reducing atherothrombotic stroke recurrence. Urgent anticoagulation has been used often to prevent early recurrent stroke and to improve neurological outcomes, however, its formal use in acute stroke has been the subject of debate even in cardioembolic stroke. That's because anticoagulants also increase the risk of fatal or disabling intracranial hemorrhage and it is difficult to monitor proper anticoagulation. Although early administration of anticoagulants should be considered to prevent the secondary injury and the propagation of thrombosis in patients with atherothrombotic stroke, more evidences are needed especially in patients with infractions secondary to large artery thrombosis or cardioembolism. This review discusses recent advances related to antithrombotic strategies and putative neuroprotectives.
Anticoagulants ; Arteries ; Blood Platelets ; Humans ; Intracranial Hemorrhages ; Organothiophosphorus Compounds ; Proteins ; Recurrence ; Stroke ; Thrombosis

BACKGROUND: The identification of in vitro hemolysis (IVH) using a hematology analyzer is challenging because centrifugation of the specimens cannot be performed for cell counts. In the present study, we aimed to develop a scoring system to help identify the presence of hemolysis in anticoagulated blood specimens. METHODS: Thirty-seven potassium EDTA anticoagulated blood specimens were obtained, and each specimen was divided into 3 aliquots (A, B, and C). Aliquots B and C were mechanically hemolyzed by aspirating 2 and 5 times, respectively, using a 27-gauge needle and then tested; aliquot A was analyzed immediately without any hemolysis. After the cells were counted, aliquots B and C were centrifuged and the supernatants were tested for the hemolytic index and lactate dehydrogenase levels. RESULTS: The 4 hematologic parameters were selected and scored from 0 to 3 as follows:< 34.0, 34.0-36.2, 36.3-38.4, and > or =38.5 for mean cell hemoglobin concentration (MCHC, g/dL); <0.02, 0.02, 0.03, and > or =0.04 for red blood cell ghosts (10(12)/L); <0.13, 0.13-0.38, 0.39-1.30, and > or =1.31 for difference value (g/dL) of measured hemoglobin and calculated hemoglobin; and <0.26, 0.26-0.95, 0.96-3.34, and > or =3.35 for difference value (g/dL) of MCHC and cell hemoglobin concentration mean. The hemolysis score was calculated by adding all the scores from the 4 parameters. At the cutoff hemolysis score of 3, the IVH of aliquots B and C were detected as 64.9% and 91.9%, respectively. CONCLUSIONS: The scoring system might provide effective screening for detecting spurious IVH.
Anticoagulants/*pharmacology ; *Blood Specimen Collection ; Edetic Acid/pharmacology ; Hemoglobins/analysis ; Hemolysis/drug effects ; Humans

The causes of ischemic stroke are widely diverse, ranging from large artery atherosclerosis to cardioembolism, and it is important to use preventive therapy toward the goal reducing the future risk of recurrent ischemic stroke, myocardial infarction, and vascular death. Antithrombotic therapy is one of the fundamental medical approaches for secondary prevention of ischemic stroke, which is broadly divided into two general categories, those that exert their effect via platelet inhibition (antiplatelet agents), and those that influence various factors in the clotting cascade (anticoagulants). In general, the clinical guidelines recommend antiplatelet agents for patients with non-cardioembolic stroke, while anticoagulants is indicated for patients with presumed or proven cardioembolic stroke. Many clinical trials have attempted to test the efficacy and safety of antithrombotics in ischemic stroke. This review will discuss on currently available antithrombotic agents that have demonstrated efficacy for secondary prevention of ischemic stroke.
Anticoagulants ; Arteries ; Atherosclerosis ; Blood Platelets ; Fibrinolytic Agents ; Humans ; Myocardial Infarction ; Platelet Aggregation Inhibitors ; Secondary Prevention* ; Stroke*

PURPOSE: We underwent this study to evaluate the factors which influence labeling efifciency when modified in vivo erythrocyte labeling technique was used. MATERIALS AND METHODS: Thirty healthy volunteers (M: F=19: 11, age: 25 +/- 2 yrs) were enrolled in this study. Totally, two hundred ten samples were obtained from them. The 1 mg of stannous pyrophosphate was injected intravenously at the beginning of labeling. After suitable tinning time (5 min, 20 min, 35 min) passed by, blood (5 mL, 3 mL or 1 mL) was withdrawn into 10 mL syringe previously containing Tc-99m (740 MBq) and anticoagulant (heparin, ACD or CPDA) through 19-gauged scalp needle. The generator ingrowth time of Tc-99m was within 24 hrs in each case. The blood samples were placed on rotating invertor during incubation (10 min, 25 min, 40 min) but some of them were not. Immediately after the conclusion of incubation, the labeled blood specimens to analyze were centrifuged. and then %Unbound Tc-99m was calculated. Statical analysis was used paired T-test and one way ANOVA with SPSS 10.0. RESULTS: The binding efficiency at 1 mL of blood volume was 73 +/- 32%, 91 +/- 10% at 3 mL and 96 +/- 7% at 5 mL (p< 0.01). The binding efficiency at 5 min of tinning time was 45 +/- 23%, 98 +/- 6% at 20 min and 97 +/- 8% at 35 min (p< 0.001). The binding efficiency at 10 min of incubation time was 96 +/- 7%, 95 +/- 12% at 25 min and 98 +/- 3% at 40 min (p> 0.05). The binding efficiency in case of using rotating invertor was 96 +/- 7% and the binding efficiency in case of not using it was 87 +/- 18% (p> 0.05). There was no significant difference between them. In binding efficiency according to kinds of anticoagulants, ACD was 98 +/- 4%, CPDA was 97 +/- 6% and heparin was 89 +/- 20% (p< 0.001). CONCLUSION: When modified in vivo erythrocyte labeling technique is used with Tc-99m, the methods to obtain the highest labeling efficiency are as follow. The withdrawing blood volume should be over 3 mL, tinning time should be kept between 20 min and 35 min, and incubation time should be kept between 10 min and 40 min. ACD or CPDA have to be used as a anticoagulant except heparin and the blood samples should be placed on rotating invertor during incubation.
Anticoagulants ; Blood Volume ; Erythrocytes* ; Healthy Volunteers ; Heparin ; Needles ; Scalp ; Syringes ; Tin