Tissue and urokinase plasminogen activators in the environs of venous and ischaemic leg ulcers

SummaryEnhancement of thrombolysis with combinations of tissue-type and single chain urokinase plasminogen activators (t-PA and scu-PA) has been demonstrated in vivo but has not been seen consistently in vitro. This study was designed to characterize interactions between t-PA and scu-PA with respect to rate of and extent of thrombolysis in vitro and to delineate mechanisms responsible. Combinations of t-PA and scu-PA at selected concentrations synergistically enhanced thrombolysis in vitro compared with thrombolysis induced by either activator alone. Enhanced thrombolysis did not occur at the expense of fibrin specificity since the extent of fibrinogenolysis and consumption of α2-antiplasmin were significantly less with synergistic combinations of t-PA and scu-PA compared with equi-effective concentrations of either activator alone. Attenuation of complex formation of t-PA and two chain u-PA (tcu-PA), formed from scu-PA, with plasma proteins did not appear to contribute to enhancement of thrombolysis as assessed by fibrin autography. Binding of 125I-t-PA to thrombi was increased by 27% at 1 hr and by 21% at 2 hr in the presence of scu-PA (p <0,001 for both). Conversion of scu-PA to tcu-PA was enhanced when thrombi were exposed to scu-PA in the presence of t-PA. Results of this study indicate that t-PA and scu-PA at selected concentrations enhance thrombolysis in vitro synergistically without compromising fibrin specificity. Enhanced binding of t-PA to thrombi in the presence of scu-PA and enhanced conversion of scu-PA to tcu-PA appear to contribute to synergy between t-PA and scu-PA for thrombolysis.

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Separation of Plasminogen Activators from Human Plasma and a Comparison with Activators from Human Uterine Tissue and Urine

Thrombosis and Haemostasis ◽

10.1055/s-0038-1646833 ◽

1979 ◽

Vol 41 (04) ◽

pp. 734-744 ◽

Cited By ~ 15

Author(s):

Preben Kok

Keyword(s):

Human Plasma ◽

Gel Filtration ◽

Plasminogen Activators ◽

Particle Sizes ◽

Uterine Tissue ◽

Porcine Tissue ◽

Normal Human ◽

Molecular Sizes ◽

Urokinase Plasminogen Activators ◽

Acid Stable

SummaryNormal human plasma contains acid-stable as well as labile plasminogen activators. The activity of activators in plasma euglobulins was inhibited by EACA in an uniform pattern, similar to that obtained with the major activators in human uterine tissue or with the purified porcine tissue activator, but different from the patterns obtained with plasmin or with urokinase.Gel filtration at high ionic strength separated activators corresponding to particle sizes of 60,000 dalton and about 10,000 dalton, corresponding to two activators similarly obtained from human tissue. The 60,000 dalton activator was precipitated in the euglobulin fraction. Its concentration increased in plasma after exercise. The 10,000 dalton activator was found mainly in the supernatant. Gel filtration in 0.15 M solutions yielded activators in fractions of molecular sizes of 100-140,000 dalton and 200,000 dalton or larger.The activity of normal and exercise euglobulins was inhibited by antiserum to a plasminogen activator prepared from porcine tissue, but it was not inhibited by antiserum to urokinase. Plasminogen activators in human plasma euglobulins resembled immunochemi- cally the activators in human uterine tissue.

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Difficult Wounds: Pressure Ulcerations and Leg Ulcers

Clinics in Plastic Surgery ◽

10.1016/s0094-1298(20)32015-0 ◽

1979 ◽

Vol 6 (4) ◽

pp. 537-540

Author(s):

Martin C. Robson

Keyword(s):

Leg Ulcers

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Treatment of venous leg ulcers with sulodexide

Phlebologie ◽

10.1055/s-0037-1621458 ◽

2003 ◽

Vol 32 (05) ◽

pp. 115-120 ◽

Cited By ~ 15

Author(s):

A. Franek ◽

H. Koziolek ◽

M. Kucharzewski

Keyword(s):

Pharmacological Treatment ◽

Healing Process ◽

Leg Ulcers ◽

Venous Ulceration ◽

Venous Leg Ulcers ◽

Group I ◽

Group Ii

SummaryAim: The study of the influence of sulodexide in the treatment of venous leg ulcers. Patients and method: 44 patients with chronic venous ulceration were randomly divided into two groups. Group I: 21 patients (ulceration area: 12.7-18.9 cm2), Group II: 23 patients (ulceration size: 12.1-20.3 cm2). Both groups were treated by using Unna’s boot. This dressing was changed every seven days until the ulcer had healed. Additionally, the patients in group II received the systemic pharmacological treatment with sulodexide. Results: After 7 weeks of treatment ulcers of seven patients (35%) from group I had healed, and 3 weeks later the ulceration of two more patients had healed completely. After further 7 weeks the ulcers of 12 patients had healed completely. Whereas in group II after 7 weeks of treatment ulceration of 16 (70%, p <0.05) patient had healed completely and after further 3 weeks the ulcers of the remaining 7 patients had healed, too. Conclusion: The use of sulodexide in patients with chronic venous leg ulcers accelerates the healing process.

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The treatment of venous leg ulcers with a specifically designed compression stocking kit

Phlebologie ◽

10.1055/s-0037-1622230 ◽

2008 ◽

Vol 37 (04) ◽

pp. 191-197 ◽

Cited By ~ 13

Author(s):

V. Mattaliano ◽

G. Mosti ◽

V. Gasbarro ◽

M. Bucalossi ◽

W. Blättler ◽

...

Keyword(s):

Patient Characteristics ◽

Compression Stocking ◽

Leg Ulcers ◽

Compression Stockings ◽

Venous Leg Ulcers ◽

Venous Ulcers ◽

Time To Completion ◽

Validated Questionnaire ◽

First Choice ◽

Ankle Movement

SummaryTraditionally, venous leg ulcers are treated with firm nonelastic bandages. Medical compression stockings are not the first choice although comparative studies found them equally effective or superior to bandages. Patients, methods: We report on a multi-center randomized trial with 60 patients treated with either short stretch multi-layer bandages or a two-stocking system (Sigvaris® Ulcer X® kit). Three patients have been excluded because their ankle movement was restricted to the extent that they could not put on the stockings and 1 patient withdrew consent. Patient characteristics and ulcer features were evenly distributed. The proportion of ulcers healed within 4 months and the time to completion of healing were recorded. Subjective appraisal was assessed with a validated questionnaire. Results: Complete wound closure was achieved in 70.0% (21 of 30) with bandages and in 96.2% (25 of 26) with the ulcer X kit (p = 0.011). Ulcers with a diameter of up to about 4cm healed twice as rapidly, the larger ones as fast with the stocking kit as with bandages. The sum of problems encountered with bandages was significantly greater than that observed with the stocking kit (p < 0.0001). Pain at night and in the morning was absent with stockings but reported by 40% and 20% in the bandage group, respectively. The cardinal features associated with delayed or absent healing were ulcer size and pain. Conclusions: Common venous ulcers can readily be treated with the ulcer X compression kit provided the ankle movement allow its painless donning. Bandages, even when applied by the most experienced staff are less effective and cause more problems.

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