No abstract available.
Korea ; Prekallikrein

No abstract available.
Bernard-Soulier Syndrome* ; Prekallikrein*

BACKGROUND: After multiple trauma, blood coagulation activity is enhanced and fibrinolytic activity is suppressed by overproduction of plasminogen activator inhibitor-1 (PAI-1). Intermittent sequential pneumatic compression (ISPC) is an effective method to prevent deep vein thrombosis. Its action is explained by the mechanical effect on blood flow, as well as by the enhancement of fibrinolysis by the reduction of PAI-1. The aim of this study was to determine the effects of ISPC on coagulation and fibrinolysis after multiple trauma. METHODS: Thirty-nine trauma patients were either treated with ISPC (ISPC group, 20 patients) or without ISPC (control group, 19 patients). We measured the plasma levels of the thrombin antithrombin III complex (TAT), the plasmin alpha 2 plasmin inhibitor complex (PIC), the tissue plasminogen activator (t-PA), and the plasminogen activator inhibitor-1 (PAI-1) on admission and at 1, 2, 3, 6, 12, and 24 hours after admission. RESULTS: The TAT was higher than normal in both groups, with no significant difference between the two groups throughout the study period. The PIC level of ISPC group was significantly higher than that of the control group. In the ISPC group, the PIC level increased gradually, reaching a peak at 3 hours and decreasing thereafter. In the control group, the PIC level increased to a peak level at 2 hours. The TAT/PIC ratio dropped in the first two hours and increased at 3 hours, dropping again thereafter. In the ISPC group, the ratio dropped gradually without an intermittent fluctuation. At 3 and 6 hours, the control group showed a significantly greater ratio compared to the ISPC group. PAI-1 was higher than normal in bothgroups, with a significantly lower level in the ISPC group from 2 hours to 24 hours. For the t-PA level, no difference was noted between the two groups, with the peak level occurring at 1 hour. The PAI-1/t-PA ratio was significantly greater in the control group from 2 hours to 12 hours than in the ISPC group, but the difference was not significant at 24 hours. CONCLUSIONS: In multiple trauma patients, ISPC does not seem to affect coagulation, but enhances fibrinolysis through suppressed PAI-1 production. This effect of ISPC may be maintained for 12 hours.
alpha-2-Antiplasmin ; Antithrombin III ; Blood Coagulation ; Fibrinolysin ; Fibrinolysis* ; Humans ; Multiple Trauma* ; Plasma ; Plasminogen Activator Inhibitor 1 ; Plasminogen Activators ; Thrombin ; Tissue Plasminogen Activator ; Venous Thrombosis

BACKGROUND: After multiple trauma, blood coagulation activity is enhanced and fibrinolytic activity is suppressed. Due to high tissue thromboplastin concentration in cerebral tissue, more serious coagulation and fibrinolytic abnormalities may occur when concomitant head trauma is present. The aim of this study was to determine the changes in coagulation and fibrinolysis after trauma and the effects of head trauma on coagulation and fibrinolysis. METHODS: This study includes 35 trauma patients: 16 patients with head trauma (group A) and 19 patients without head trauma (group B). We measured the plasma levels of functional protein C, antithrombin III (AT III), thrombin antithrombin III complex (TAT), plasmin alpha 2 plasmin inhibitor complex (PIC), tissue plasminogen activator antigen (t-PA), and plasminogen activator inhibitor-1 antigen (PAI-1) on admission and on days 1, 2, 4, and 6 after the trauma. RESULTS: The TAT and the TAT/PIC were significantly higher in group A than in group B on all days. PIC was significantly lower in group A than in group B on all days except the day of admission. Over the course of time, the TAT and the TAT/PIC decreased in both groups and PIC increased. On admission, the PAI-1 of both groups was increased, but it decreased over the course of time. The t-PA was increased on admission, was suppressed on the 1st day, and then increased again. The PAI-1 and the t-PA showed no significant difference between the two groups. CONCLUSIONS: After multiple trauma, coagulation was enhanced and fibrinolysis was suppressed. Enhanced coagulation and suppressed fibrinolysis were significantly greater in group A than in group B.
alpha-2-Antiplasmin ; Antithrombin III ; Blood Coagulation ; Craniocerebral Trauma ; Fibrinolysin ; Fibrinolysis* ; Humans ; Multiple Trauma* ; Plasma ; Plasminogen Activator Inhibitor 1 ; Plasminogen Activators ; Protein C ; Thrombin ; Thromboplastin ; Tissue Plasminogen Activator

<b>BACKGROUNDb>The present study was undertaken to replicate the associations of representative polymorphisms in three genes (complement factor H (CFH), complement factor B (BF) and HtrA serine peptidase 1 (HTRA1)) with exudative age-related macular degeneration (AMD) in a Han Chinese population, and to test if the modifiable environmental factors affect AMD susceptibility associated with different type of genotype in these genes.

<b>METHODSb>An age, gender and ethnicity matched case-control study was conducted to genotype the representative single neucleotide polymorphisms (SNPs) loci including rs1061170 and rs1410996 in CFH, rs641153 and rs4151667 in BF and rs11200638 in HTRA1 gene in 144 exudative AMD patients and 126 normal controls using PCR-RFLP and direct resequencing. The demographic characteristics and behavioral risk factors were also recorded. Allelic and genotypic associations for individual SNP and joint associations with two loci were performed. The gene-gene and gene-environment interactions were analyzed using multivariate non-conditional Logistic regression analysis.

<b>RESULTSb>The C risk allele frequencies for CFH Y402H (rs1061170) in cases and controls were 12.5% and 5.4% respectively, which were much lower than those in Caucasians (P < 0.001). Compared with TT homozygous genotype, the CT heterozygous genotype was positively associated with AMD with odds ratio (OR) of 3.23 (1.36 - 5.07). However, the population attributable risk (PAR) of C allele was only 3.3% (1.4% - 4.3%). rs1410996 was also associated with AMD independent of Y402H. The ORs of exudative AMD for individuals carrying one copy risk allele and two copy risk alleles were 2.57 (1.21 - 5.45) and 4.76 (2.15 - 10.55) respectively, with correspondent PARs of 28.3% (2.0% - 40.5%) and 38.2% (21.8% - 45.4%). rs11200638 in HTRA1 was another susceptible locus for AMD and the risk homozygotes were significantly susceptible for exudutive AMD (OR = 3.98, 1.88 - 8.43) with PAR of 38.9% (24.3% - 45.8%). Education status and cigarette smoking were also related to exudative AMD. After controlling for environmental risk factors, CFH and HTRA1 SNPs were independently associated with exudative AMD, with OR of 3.50 (1.45 - 8.45) for CT genotype in Y402H, 3.34 (1.33 - 8.36) for GG genotype in rs1410996 and 3.85 (1.58 - 9.42) for AA genotype in rs11200638 respectively. The interaction analysis between gene and environmental factors showed that smoking synergistically increased susceptibility of AMD for heterozygotes of rs1410996, with OR(interaction) of 7.33 (P(interaction) = 0.029).

<b>CONCLUSIONSb>In a Han Chinese population, CFH and HTRA1 polymorphisms appear to be independently and possibly additively hereditary contributors to exudative AMD. Y402H polymorphism conferred a significant but relatively lower contribution in Chinese than in Caucasians with a low frequency of risk allele. The gene-environment interaction may be a best way to encourage those with a high genetic risk to prevent AMD by avoiding modifiable factors until there is effective treatment for AMD.

Aged ; Asian Continental Ancestry Group ; Complement Factor B ; genetics ; Complement Factor H ; genetics ; Female ; Gene Frequency ; genetics ; Genetic Predisposition to Disease ; genetics ; Genotype ; High-Temperature Requirement A Serine Peptidase 1 ; Humans ; Macular Degeneration ; genetics ; Male ; Middle Aged ; Polymerase Chain Reaction ; Polymorphism, Single Nucleotide ; genetics ; Risk Factors ; Serine Endopeptidases ; genetics ; Smoking ; adverse effects

A novel serine protease with high purity was extracted from the venom of Agkistrodon hlays Pallas using monoclonal antibody affinity chromatography. This protease releases bradykinin and has arginine esterase activity without being activated. After purification, its hydrolytic activity exceeded 800 U/mg, far higher than its counterparts from mammalian sources. The purity of the kininogenase could exceed 95%. The acute toxicity and the long-term toxicity of this kallikrein was studied for its potential clinical application. The maximum tolerance dose in adult was 150,000 times greater than the maximum applied dose, and long-term administration at the dose 50 times of allowed clinical dose did not obviously after the animals' body weight, survival condition, liver function, renal function, or blood routines, suggesting the extremely low toxicity of the kallidrein.
Agkistrodon ; Animals ; Bradykinin ; metabolism ; Crotalid Venoms ; toxicity ; Kallikreins ; toxicity ; Maximum Tolerated Dose ; Mice ; Mice, Inbred BALB C ; Serine Endopeptidases ; toxicity ; Toxicity Tests, Acute

PURPOSE: The aim of this study was to evaluate the clinical significance of inflammatory biomarkers in acute infectious diarrhea among children. METHODS: Clinical parameters including fever, bacterial and viral etiology based on stool culture and multiplex polymerase chain reaction, and nine biomarkers including C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and leukocytes in blood and calprotectin, lactoferrin, myeloperoxidase, polymorphonuclear elastase, leukocytes, and occult blood in feces were evaluated in children who were hospitalized due to acute diarrhea without underlying disease. RESULTS: A total of 62 patients were included. Among these patients, 33 had fever, 18 showed bacterial infections, and 40 patients were infected with 43 viruses. Of all the biomarkers, CRP was significantly correlated with fever (p<0.001). CRP, ESR, calprotectin, lactoferrin, myeloperoxidase, fecal leukocytes, and occult blood were significantly associated with infection with bacterial pathogens (p<0.001, p=0.04, p=0.03, p=0.003, p=0.02, p=0.03, p=0.002, respectively). The combination of CRP and fecal lactoferrin at their best cut-off values (13.7 mg/L and 22.8 µg/mL, respectively) yielded a sensitivity of 72.2%, and a specificity of 95.5% for bacterial etiology compared with their individual use. CONCLUSION: Blood CRP is a useful diagnostic marker for both fever and bacterial etiology in acute pediatric diarrhea. The combination of CRP and fecal lactoferrin yields better diagnostic capability for bacterial etiology than their use alone for acute diarrhea in children without underlying gastrointestinal disease.
Bacterial Infections ; Biomarkers ; Blood Sedimentation ; C-Reactive Protein ; Child ; Diarrhea ; Feces ; Fever ; Gastrointestinal Diseases ; Humans ; Lactoferrin ; Leukocyte L1 Antigen Complex ; Leukocytes ; Multiplex Polymerase Chain Reaction ; Occult Blood ; Pancreatic Elastase ; Peroxidase ; Sensitivity and Specificity

PURPOSE:Vascular endothelial growth factor (VEGF) is known to play an important role in the process of angiogenesis and chronic inflammation. Plasminogen activator inhibitor (PAI)-1 and tissue plasminogen activator (tPA) are main regulators of the plasmin system. The functions of these components are shown to be closely associated and recent studies have reported their potential roles in the asthmatic airways. We determined plasma levels of soluble VEGF (sVEGF), PAI-1, tPA and endothelin (ET)-1 in children with recurrent early wheeze. Our purpose was to examine whether there would be any difference in these biomarkers in relation to the relapse rate of wheezing. METHODS:Fifty-eight children aged 2-6 years who were admitted with acute wheezing were enrolled. They were divided into two groups: patients with more than three relapses of wheezing (group 1, n=34) and those with less than one relapse (group 2, n=24). Plasma levels of sVEGF, PAI-1, ET-1 and tPA on admission were measured using ELISA in the two patient groups and controls (n=16). RESULTS:PAI-1, sVEGF and tPA significantly increased during acute wheezing episode. The levels of these biomarkers were significantly higher in group 1 than in group 2 (P<0.01). ET-1 showed no significant difference between the patient groups and controls. CONCLUSION:Our study showed significantly elevated plasma levels of sVEGF and plasmin system regulators in children with recurrent early wheeze, which was even higher in the group with more frequent relapses. Our results suggest that these biomarkers may be associated with airway inflammation and may contribute to the later development of asthma in these children.
Asthma ; Biomarkers ; Child ; Endothelial Growth Factors ; Endothelins ; Enzyme-Linked Immunosorbent Assay ; Fibrinolysin* ; Humans ; Inflammation ; Plasma* ; Plasminogen Activator Inhibitor 1 ; Plasminogen Activators ; Recurrence ; Respiratory Sounds ; Tissue Plasminogen Activator ; Vascular Endothelial Growth Factor A*

PURPOSE:Vascular endothelial growth factor (VEGF) is known to play an important role in the process of angiogenesis and chronic inflammation. Plasminogen activator inhibitor (PAI)-1 and tissue plasminogen activator (tPA) are main regulators of the plasmin system. The functions of these components are shown to be closely associated and recent studies have reported their potential roles in the asthmatic airways. We determined plasma levels of soluble VEGF (sVEGF), PAI-1, tPA and endothelin (ET)-1 in children with recurrent early wheeze. Our purpose was to examine whether there would be any difference in these biomarkers in relation to the relapse rate of wheezing. METHODS:Fifty-eight children aged 2-6 years who were admitted with acute wheezing were enrolled. They were divided into two groups: patients with more than three relapses of wheezing (group 1, n=34) and those with less than one relapse (group 2, n=24). Plasma levels of sVEGF, PAI-1, ET-1 and tPA on admission were measured using ELISA in the two patient groups and controls (n=16). RESULTS:PAI-1, sVEGF and tPA significantly increased during acute wheezing episode. The levels of these biomarkers were significantly higher in group 1 than in group 2 (P<0.01). ET-1 showed no significant difference between the patient groups and controls. CONCLUSION:Our study showed significantly elevated plasma levels of sVEGF and plasmin system regulators in children with recurrent early wheeze, which was even higher in the group with more frequent relapses. Our results suggest that these biomarkers may be associated with airway inflammation and may contribute to the later development of asthma in these children.
Asthma ; Biomarkers ; Child ; Endothelial Growth Factors ; Endothelins ; Enzyme-Linked Immunosorbent Assay ; Fibrinolysin* ; Humans ; Inflammation ; Plasma* ; Plasminogen Activator Inhibitor 1 ; Plasminogen Activators ; Recurrence ; Respiratory Sounds ; Tissue Plasminogen Activator ; Vascular Endothelial Growth Factor A*

No abstract available
Acute Lung Injury* ; Pancreatic Elastase*