• International Journal of Advanced Culture Technology
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• v.10 no.4
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• pp.316-321
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• 2022

Since 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread rapidly, infecting millions of people worldwide. On March 11, 2020, the World Health Organization declared coronavirus disease (COVID-19) a pandemic owing to the worldwide spread of SARS-CoV-2, which created an unprecedented burden on the global healthcare system. In this context, there are increasing concerns regarding co-infections with other respiratory viruses, such as the influenza virus. In this study, clinical data of patients infected with SARS-CoV-2 and other respiratory viruses were compared with patients infected with SARS-CoV-2 alone. The hematology and blood biochemistry results of 178 patients infected with SARS-CoV-2 , who were tested on admission, were retrospectively reviewed. In patients with SARS-CoV-2 and adenovirus co-infection, C-reactive protein levels were elevated on admission, whereas lactate dehydrogenase (LDH), prothrombin time, international normalized ratio, activated partial thromboplastin clotting time, and bilirubin values were all within the normal range. Moreover, patients with SARS-CoV-2 and human bocavirus co-infection had low LDH and high bilirubin levels on admission. These findings reveal the clinical features of respiratory virus and SARS-CoV-2 co-infections and support the development of appropriate approaches for treating patients with SARS-CoV-2 and other respiratory virus co-infections.

• Journal of Veterinary Clinics
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• v.39 no.6
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• pp.373-377
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• 2022

Hypercoagulability is the most common coagulopathy seen in dogs with neoplasia, whereas a hypocoagulable state is relatively rare. A 16-year-old spayed female miniature Schnauzer presented with bilateral epistaxis, bilateral hindlimb swelling, and lameness. Previously, the dog was diagnosed with intermediate grade solid carcinoma after mastectomy, and then showed generalized ecchymoses on the abdomen and bilateral hindlimbs on presentation. Laboratory tests revealed a hypocoagulable state, including thrombocytopenia, hypofibrinogenemia, and delayed prothrombin and activated partial thromboplastin time. Thromboelastography demonstrated a prolonged K time with a decreased alpha angle and low maximal amplitude, reflecting a decrease in clot strength. The hypocoagulable state of disseminated intravascular coagulopathy was speculated based on the presence of an underlying tumor, clinical symptoms, and laboratory results of the hypocoagulable state. This case shows the incidence of hemostatic dysfunction as a paraneoplastic syndrome in a dog with mammary gland carcinoma.

• Childhood Kidney Diseases
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• v.28 no.2
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• pp.80-85
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• 2024

Lupus anticoagulant hypoprothrombinemia syndrome (LAHPS) is a rare entity characterized by the presence of lupus anticoagulant (LA) and prothrombin (factor II) deficiency. It may cause severe bleeding contrary to classical antiphospholipid syndrome. Here, we report a case of LAHPS presenting with a hemorrhagic ovarian cyst in a 17-year-old girl with systemic lupus erythematosus (SLE) nephritis. She had been followed up for 8 years. Her first manifestation of SLE was prolonged gingival bleeding after tooth extraction at 9 years of age. During the follow-up period, she had neither severe bleeding nor thrombotic complications despite a positive LA and a prolonged activated partial thromboplastin time (aPTT). At this visit, the patient presented with colicky abdominal pain, a hemorrhagic ovarian cyst, a prolonged prothrombin time, a prolonged aPTT, a low factor II level, and a positive LA, leading to the diagnosis of LAHPS. While a hemorrhagic ovarian cyst resolved completely in 3 months, she received oral pill, transfusions of red blood cells and plasma, and intravenous cyclophosphamide pulse therapy in combination with glucocorticoids due to persistent menorrhagia, anemia, prolonged aPTT, and lupus flaring. Thus, LAHPS needs to be considered in SLE patients with positive LA and prolonged aPTT.

• Korean Journal of Fisheries and Aquatic Sciences
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• v.34 no.5
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• pp.515-520
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• 2001

The anticoagulant activities of fucoidan fractions extracted from Sporophylls of Undaria pinnatifida, Laminaria religiosa, Hizikia fusiforme and Sargassum fulvellum were studied to assess the relationship between chemical characteristics and the activities. Crude fucoidans extracted with diluted HCl solution (pH 2.0) at $65^{\circ}C$ were precipitated with cetylpyridinum chloride and then fractionated by dissolving the precipitated complex with increasing $CaCl_2$, concentrations (1.0 M, 1.5 M, 3.0 M). The anticoagulant activities of the fractions with respect to activated partial thromboplastin (APTT) increased with increase in their sulfate content and Undaria finnatifida Fr-3.0 fraction, prepared by dissolving with 3.0 M $CaCl_2$ solution, exhibited the highest activity. The Undaria finnatifida Fr-3.0 fraction was further modified with pronase and laminase. The pronase and laminase treatment decreased protein and glucose content and the APTT activity was higher than that or parent Undaria finnatifida Fr-3.0 fraction. The pronase and laminase modified Undaria finnatifida Fr-3.0 was composed of fucose, galactose, mannose, sulfate, uronic acid in the approximately molar ratio of 1.00 : 1.30: 0.03 : 2.70 : 0.08.

• Journal of The Korean Society of Clinical Toxicology
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• v.12 no.2
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• pp.92-96
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• 2014

Dabigatran is the first oral direct thrombin inhibitor approved by the US Food and Drug Administration (FDA) for prevention of stroke and systemic embolism in patients with nonvalvular atrial fibrillation. Because dabigatran is excreted mainly by the kidneys, serum levels of dabigatran can be elevated to a supratherapeutic range in patients with renal failure, predisposing to emergent bleeding. We describe the case of a 66-year-old man taking dabigatran 150 mg twice daily for atrial fibrillation and cerebral infarction who presented with hematochezia and disseminated intravascular coagulation. Laboratory evaluation showed a hemoglobin level of 6.3 g/dL, platelets of $138,000/mm^3$, activated partial thromboplastin time (aPTT) of 10 s, and an international normalized ratio (INR) of 8.17. Colonoscopy showed a bleeding anal fissure. Hemostasis was provided by hemoclips and packed red blood cells and fresh frozen plasma were transfused. Since then, there was no further hematochezia, however, bleeding including oral mucosal bleeding, hematuria, and intravenous site bleeding persisted. At presentation, his serum creatinine was 4.96 mg/dL (baseline creatinine, 0.9 mg/dL). Dabigatran toxicity secondary to acute kidney injury was presumed. Because acute kidney injury of unknown cause was progressing after admission, he was treated with hemodialysis. Fresh frozen plasma transfusion was provided with hemodialysis. At 15 days from admission, there was no further bleeding, and laboratory values, including hemoglobin, partial thromboplastin time, and prothrombin time were normalized. He was discharged without bleeding. After 2 months, he undergoes dialysis three times per week and no recurrence of bleeding has been observed.

• Journal of Applied Biological Chemistry
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• v.53 no.3
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• pp.170-173
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• 2010

Antioxidant and anticoagulant activities of water extract and 70% ethanol extract of Phyllostachys pubescence leaf (PPL) produced in Geoje were investigated. Total polyphenol contents of PPL-water extract and PPL-70%, EtOH extract were measured as $80.6{\pm}3.2$ and $71.3{\pm}2.7$ mg/g, respectively. DPPH radical scavenging activity of PPL-water extract and PPL-70% EtOH extract were 50% and 90%, respectively. The anticoagulant activity, in intrinsic pathway of activated partial thromboplastin time (APTT) showed a concentration-dependency. This results showed that PPL-water extract and PPL-70% EtOH extract have high antioxidant and anticoagulant activities.

• BMB Reports
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• v.30 no.1
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• pp.37-40
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• 1997

Earthworm extracts are known for anti-inflammatory, analgesic. antipyretic, and anticancer effects but can also influence blood circulation. It was previously shown that an earthworm, Lumbricus rubelius. contained a water-extractable anticoagulant which was a heat- and acid-stable molecule with hydrophilic property. In order to uncover the biochemical nature of this molecule, the anticoagulant was processed with various hydrolases such as trypsin, DNase, RNase. and lysozome. When the digested samples were analyzed with an in vitro coagulation test measuring activated partial thromboplastin time (APTT) and agarose gel electrophoresis, the anticoagulant proved to be a relatively homogeneous DNA fragment with relative molecular size around 72 base pairs. Interestingly, the activity was further stimulated with a trypsin digestion. RNA. on the other hand, did not prolong the APTT. It was also demonstrated that the DNA accelerated the antithrombin III (AT-III) inhibition of thrombin from $IC_{50}$ of 0.34 to 0.16 unit determined with S-2238 as a substrate, whereas heparin, a popular anticoagulant. shifted the value to 0.05. Therefore, it is suggested that the DNA could be considered as an alternative antithrombotic agent to heparin, which would exhibits bleeding side effects.

• Journal of Trauma and Injury
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• v.30 no.3
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• pp.91-97
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• 2017

Purpose: Purpose: The prognostic factors of non-operative management (NOM) in high-grade spleen injuries have been extensively studied, but factors that would help treatment decisions are lacking. We compared the characteristics of the patients to identify the factors affecting treatment choices. Methods: This is a review of 207 blunt spleen injury patients from January 2004 to December 2013. We compared clinical features and mortality between surgery and NOM, and used multivariate regression analysis to find the factor most strongly associated with prognosis. Results: Of the 207 patients, 107 had high-grade spleen injury patents (grade III or above). Of these, 42 patients underwent surgery and 65 patients underwent NOM. The mortality was 7% following surgery, 3% with NOM. The amount of packed red blood cells transfused in the first 24 hours and spleen injury grade were associated with management type, and mortality was highly associated with activated partial thromboplastin time (aPTT) and spleen injury grade. Conclusions: The grade of spleen injury was associated with management and mortality, so correctly assessing the spleen injury grade is important.

• Molecules and Cells
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• v.19 no.3
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• pp.350-355
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• 2005

Selectins are carbohydrate-binding cell adhesion molecules that play a major role in the initiation of inflammatory responses. Heparin can bind to P-selectin, and its anti-inflammatory property is mainly due to inhibition of P-selectin. However, the strong anticoagulant activity of heparin limits its clinical use. We prepared periodate-oxidized, borohydride-reduced heparin (RO-heparin) by chemical modification and tested its anticoagulant and anti-inflammatory activities. Activated partial thromboplastin time (aPTT) assays showed that, compared with heparin, RO-heparin had greatly reduced anticoagulant activity. Intravenous administration of this compound led to reduction in the peritoneal infiltration of neutrophils in a mouse acute inflammation model. In vitro cell adhesion experiments demonstrated that the effect of RO-heparin on inflammatory responses was mainly due to inhibiting the interaction of P-selectin with its ligands. These results indicate that RO-heparin may be a safer treatment for inflammation than heparin, especially when selectin is targeted.

• Journal of Yeungnam Medical Science
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• v.40 no.3
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• pp.276-282
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• 2023

Background: Bleeding and thrombosis are major complications associated with high mortality in extracorporeal membrane oxygenation (ECMO) management. Anticoagulant therapy should be adequate to reduce thrombosis. However, related studies are limited. Methods: We retrospectively reviewed all patients supported with ECMO at a single institution between January 2014 and July 2022 and included those on all types of ECMO using the Permanent Life Support System. Patients were classified into two groups according to their measured mean activated partial thromboplastin time (aPTT) during ECMO management: a high-anticoagulation (AC) group (aPTT, ≥55 seconds; n=52) and a low-AC group (aPTT, <55 seconds; n=79). The primary outcome was thrombotic or bleeding events during ECMO. Results: We identified 10 patients with bleeding; significantly more of these patients were in the high-AC group (n=8) than in the low-AC group (15.4% vs. 2.5%, p=0.01). However, thrombus events and oxygenator change-free times were not significantly different between the two groups. Four patients in the high-AC group died of bleeding complications (brain hemorrhage, two; hemopericardium, one; and gastrointestinal bleeding, one). One patient in the low-AC group developed a thrombus and died of ECMO dysfunction due to circuit thrombosis. Conclusion: Heparin did not significantly improve thrombotic outcomes. However, maintaining an aPTT of ≥55 seconds was a significant risk factor for bleeding events, especially those associated with mortality.