Korean hemorrhagic fever is a disease with an acute onset of severe hemorrhagic tendency and acute renal failure. Acute renal failure may be produced by inducing intravascular coagulation in experimental animals, and also, coagulation mechanisms may play a pathogenetic role in certain human renal diseases. One of the clinical consequences of DIC is serious ischemic tissue damage due to capillary flow blocking by fibrin deposits. The kidney is particularly vulnerable to ischemic effects. For the detection of intravascular coagulation, FDP assay is known as a more sensitive and reliable test than are other coagulation studies. Therefore, from September, 1973 to January, l974, the serum and the urine of the selected patients with Korean hemorrhagic fever who had a typical clinical course were subjected to study. The alterations of the serum and urinary FDP concentrations, and the other hematologic, blood chemistry, and urinary examinations were studied in a total of 177 examples of each febrile, hypotensive, oliguric, diuretic, and convalescent phase. Both the serum and urinary FDP concentrations were significantly higher than normal. This data indicates that DIC is detected in Korean hemorrhagic fever, where it may play a major pathogenetic role. And the urinary FDP concentration more closely reflects the severity of renal lesions in this disease than does the serum FDP concentration and the blood urea nitrogen level. It can be assumed that the concentration of urinary FDP can be used as a therapeutic criteria, and is correlated to the intensity and the prognosis of the disease. Also the possibility of improvement following anticoagulant treatment may be proposed. It appears that acute renal failure in this disease has a close relationship to DIC. In its pathogenesis it can be assumed that disruption of the renal cortical perfusion plays a major role in this Korean hemorrhagic fever.
Blood Urea Nitrogen ; Disseminated Intravascular Coagulation/etiology* ; Disseminated Intravascular Coagulation/metabolism ; Female ; Fibrin Fibrinogen Degradation Products/metabolism* ; Hemorrhagic Fevers, Viral/blood* ; Hemorrhagic Fevers, Viral/urine ; Human ; Kidney Failure, Acute/etiology* ; Korea ; Male

This study was aimed to prepare the polypeptide of N-terminal heparin-binding domain of fibronectin(rhFNHN-29 polypeptide) with pichia expression system, to detect biological activity of recombinant polypeptide and investigate its effect on disseminated intravascular coagulation (DIC) in rats. The sequence of N-terminal heparin-binding domain of fibronectin was amplified from FNcDNA by PCR. The aim gene was cloned into T vector for selection. Then it was cloned into pAo815SM and pPIC9K vectors.Lined pPIC9K vectors were transformed into GS115 Pichia cells so as to express the aim polypeptide in Pichia expression system. The fermentation liquid were precipitated by 80% ammonium sulfate, and the further dissolved sediment were purified using S-100 column and SP column. Its activity of binding with heparin were detected by Western-blot. The established DIC rats (40 rats) were randomly divided into two groups. One group was treated with rhFNHN-29 polypeptide, and the other was treated with normal saline. The rats in the former group were injected with rhFNHN-29 polypeptide (10 mg/kg) through tail vein at 0.5 hour before, 2 hours and 4 hours after injection of LPS respectively. The rats in latter group were injected with equal volume saline. In addition, 20 normal rats injected with normal saline were as normal controls. 500 microl blood was taken from the rat vein, at 6 hours after the injection of LPS. White blood cell (WBC), hemoglobin (Hb) and platelets were tested from 50 microl blood. The rest 450 microl blood was used to isolate plasma for detecting TNFa level and coagulogram. The rats were killed at 24 hours after injection with LPS. Their livers, lungs, hearts, kidneys, and brain tissues were taken for histopathologic examination. The results showed that the aim polypeptide was successfully expressed in Pichia expression system. The expression level reached approximately 30 mg/L. The polypeptide had activity of binding with heparin antibody. In the experiment study of polypeptide effect on DIC in rats, the plasma TNFa level in polypeptide-treated group was lower than that in saline control group, the hemogram, coagulogram and histopathology were more obviously improved in polypeptide-treated group as compared with saline control group. It is concluded that the rhFNHN-29 polypeptide is successfully prepared, this polypeptide can antagonize DIC induced by endotoxin in rats.
Animals ; Disseminated Intravascular Coagulation ; therapy ; Endotoxins ; Female ; Fibronectins ; genetics ; immunology ; therapeutic use ; Heparin ; metabolism ; Male ; Peptides ; genetics ; therapeutic use ; Pichia ; metabolism ; Rats ; Rats, Sprague-Dawley

Anesthesia in post-thyroidectomy patients carries the risk of potential complications such as the depression of myocardial function, decreased spontaneous ventilation, abnormal baroreceptor function, reduced plasma volume, anemia, hypoglycemia, hyponatremia, and impaired hepatic drug metabolism. In addition, these patients may be complicated by pigment induced acute renal failure such as rhabdomyolysis. Rhabdomyolysis is a common syndrome in which injury to skeletal muscle results in the leakage of intracellular contents from myocytes into plasma. Moreover, massive rhabdomyolysis can produce life-threatening disseminated intravascular coagulation, myoglobinuric renal failure, acute cardiomyopathy, and various other complications. We experienced a case of acute renal failure caused by rhabdomyolysis during emergence from anesthesia in a post-thyroidectomy patient.
Acute Kidney Injury* ; Anemia ; Anesthesia ; Cardiomyopathies ; Cholecystectomy, Laparoscopic* ; Depression ; Disseminated Intravascular Coagulation ; Humans ; Hypoglycemia ; Hyponatremia ; Metabolism ; Muscle Cells ; Muscle, Skeletal ; Plasma ; Plasma Volume ; Pressoreceptors ; Rhabdomyolysis* ; Ventilation

Traumatic brain injury (TBI) is a leading cause of death and disability worldwide. The finding that cellular microparticles (MPs) generated by injured cells profoundly impact on pathological courses of TBI has paved the way for new diagnostic and therapeutic strategies. MPs are subcellular fragments or organelles that serve as carriers of lipids, adhesive receptors, cytokines, nucleic acids, and tissue-degrading enzymes that are unique to the parental cells. Their sub-micron sizes allow MPs to travel to areas that parental cells are unable to reach to exercise diverse biological functions. In this review, we summarize recent developments in identifying a casual role of MPs in the pathologies of TBI and suggest that MPs serve as a new class of therapeutic targets for the prevention and treatment of TBI and associated systemic complications.
Animals ; Astrocytes ; metabolism ; pathology ; Biological Transport ; Blood Coagulation Factors ; genetics ; metabolism ; Brain ; metabolism ; pathology ; physiopathology ; Brain Injuries, Traumatic ; genetics ; metabolism ; pathology ; physiopathology ; Cell-Derived Microparticles ; chemistry ; metabolism ; pathology ; Cytokines ; blood ; genetics ; Disease Models, Animal ; Disseminated Intravascular Coagulation ; genetics ; metabolism ; pathology ; physiopathology ; Gene Expression Regulation ; Humans ; Microglia ; metabolism ; pathology ; Neurons ; metabolism ; pathology ; Signal Transduction

In order to discover the mechanism of Xuebijing oral effervescent tablet (XBJOET) to treat infectious diseases, the effect of XBJOET on endotoxin induced rabbit fever and disseminated intravascular coagulation (DIC) was investigated. Auricle microcirculation in rabbit was detected by laser speckle blood perfusion imager system; coagulation function was measured by coagulation analyzer, fibrinolytic system was quantified by Elisa assay and micro thrombosis in tissues was observed with HE staining under light microscope. The results demonstrated that the body temperature of rabbit decreased significantly at 1-3 h after administration with 4.8, 2.4 and 1.2 g x kg(-1) XBJOET to endotoxin induced DIC rabbit model, the auricle microcirculation blood flow in model group (54.45 +/- 14.53) PU was lower than that in control group (77.18 +/- 12.32) PU. The auricle microcirculation blood flow increased markedly and there was significant difference between model group and 1.2 g x kg(-1) XBJOET group. There was significant difference between model group and control group in the content of PAI1 and FIB. The PAI1 levels in model and control groups were (30.48 +/- 2.46) ng x mL(-1) and (20.93 +/- 3.25) ng x mL(-1), respectively. The FIB levels in model and control group were (3.34 +/- 1.09) g x L(-1) and (4.84 +/- 1.10) g x L(-1), respectively. The content of PAI1 in rabbit plasma decreased notably, there were significant differences between model group and 4.8, 2.4 g x kg(-1) XBJOET groups. On the contrary the content of FIB increased. XBJOET possessed pharmacological activities of curing infectious fever and DIC, the mechanism of which is related to amelioration of microcirculation disturbance, inhibition of fibrinolytic system activation and coagulation and micro thrombosis elimination.
Administration, Oral ; Animals ; Blood Coagulation ; drug effects ; Body Temperature ; drug effects ; Disseminated Intravascular Coagulation ; blood ; chemically induced ; Drugs, Chinese Herbal ; administration & dosage ; pharmacology ; Ear Auricle ; blood supply ; Endotoxins ; Female ; Fever ; chemically induced ; drug therapy ; physiopathology ; Fibrinogen ; metabolism ; Male ; Microcirculation ; Partial Thromboplastin Time ; Plasminogen Activator Inhibitor 1 ; blood ; Prothrombin Time ; Rabbits ; Tablets ; Thrombosis ; pathology

Higenamine (HG) is a potent cardioactive benzylisoquinoline alkaloid isolated from Aconiti tuber which has long been used as a cardiotonic in traditional Chinese medicine. HG exerts various effects on the cardio-circulatory system inotropic and chronotropic in isolated rat atria. It also relaxes isolated rat aorta. It inhibits epinephrine, ADP or collagen-induced platelet aggregation in platelet rich plasma. HG inhibits LPS-induced nitrate accumulation and the expression of iNOS mRNA in RAW 264.7 cells. HG lowers blood pressure in rats and increases the recovery rates in acute thrombosis model of mice, and lower the weight of thrombus formed in the arterio-venous shunt model of rats. Higenamine also has ameliorative effects in the LPS-induced DIC model.
Aconitum ; chemistry ; Alkaloids ; isolation & purification ; pharmacology ; therapeutic use ; Animals ; Blood Pressure ; drug effects ; Cardiotonic Agents ; pharmacology ; therapeutic use ; Disseminated Intravascular Coagulation ; drug therapy ; metabolism ; Fibrinolytic Agents ; pharmacology ; therapeutic use ; Humans ; Nitric Oxide Synthase ; biosynthesis ; genetics ; Nitric Oxide Synthase Type II ; Plants, Medicinal ; chemistry ; Platelet Aggregation ; drug effects ; RNA, Messenger ; biosynthesis ; genetics ; Tetrahydroisoquinolines ; isolation & purification ; pharmacology ; therapeutic use

OBJECTIVETo explore the expression of CD34 in patients with acute promyelocytic leukemia (APL) and investigate the clinical and laboratory features of CD34(+) APL patients.

METHODS262 APL patients diagnosed by chromosome analysis and/or fusion gene examination in the last five years were retrospectively analyzed in this study. To survey the expression of CD34 in those patients, all the cases were divided into two groups (CD34(+) APL vs. CD34(-) APL). The clinical features including age, gender, abnormal values of the peripheral hemogram before treatment, the complete remission (CR) rate and the incidence of DIC and laboratory data such as the results of morphology, immunology, cytogenetics and molecular biology (MICM) between those two groups were compared.

RESULTSOf the 262 APL patients, 38 (14.5%) cases were positive for CD34 expression. There were no statistically significant differences between CD34(+) APL and CD34(-) APL groups in gender and age (P > 0.05). Before treatment, the median level of WBC in CD34(+) APL was 25.92 x 10(9)/L, which was significantly higher than that of CD34(-) APL (5.3 x 10(9)/L, P < 0.05). CD34(+) APL by morphology classification were mostly of the subtypes M3b and M3v (65.8%), while these subtypes in CD34(-) APL (40.3%) were significantly less (P < 0.01). There were no statistically significant differences between the two groups compared in respect of complete remission (CR) rate and the incidence of DIC (P > 0.05). The expression level of CD34 in APL had correlation to the expression level of CD2, CD7 and CD117; the latter three phenotypes in CD34(+) APL were significantly higher than those in CD34(-) APL (P < 0.01). No significant difference was found between those two groups by chromosome analysis, but there was more PML-RAR-alpha transcript short form in CD34(+) APL than that in CD34(-) APL (P < 0.05).

CONCLUSIONCD34(+) acute promyelocytic leukemia is a unique subtype of APL with different biological characteristics.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antigens, CD34 ; blood ; Antigens, CD7 ; blood ; Antineoplastic Agents ; therapeutic use ; CD2 Antigens ; blood ; Child ; Disseminated Intravascular Coagulation ; etiology ; Female ; Humans ; Immunophenotyping ; Leukemia, Promyelocytic, Acute ; complications ; drug therapy ; genetics ; immunology ; Male ; Middle Aged ; Nuclear Proteins ; metabolism ; Phenotype ; Promyelocytic Leukemia Protein ; Proto-Oncogene Proteins c-kit ; blood ; Receptors, Retinoic Acid ; metabolism ; Remission Induction ; Retinoic Acid Receptor alpha ; Retrospective Studies ; Transcription Factors ; metabolism ; Translocation, Genetic ; Tretinoin ; therapeutic use ; Tumor Suppressor Proteins ; metabolism ; Young Adult