The Detection and Importance of Intravascular Platelet Aggregation in Surgical Shock

1979 ◽  
Author(s):  
C.N. McCollum
Keyword(s):  
Femoral Vein ◽  
Major Surgery ◽  
Minor Surgery ◽  
Post Operation ◽  
Femoral Blood ◽  
Shock Lung ◽  
Platelet Aggregates ◽  
Filtration Technique

Intravascular platelet aggregates (IPA) have as yet avoided detection in shocked patients hence their role in the aetiology of “shock lung” remains controversial. Screen filtration pressure (SFP) has only been shown to measure aggregates in vitro.A modified screen filtration technique was evaluated in 43 surgical patients. The characteristics (height,slope) of the pressure wave were compared with the number of aggregates seen to occlude filter pores on scanning electron microscopy (SEM). In 80 estimations on femoral vein blood the slope of the SFP curve was utilised improving SFP/ SEM correlation to r= .93. These aggregates arise in vivo as they were rarely detected in blood from the arm and IPA levels in femoral blood were not influenced by EDTA priming of the syringe. In 36 preoperative estimations mean SFP slope was identical to that in 14 patients after minor surgery (1.5 ± SD 1.6). After major surgery in 29 patients this value was elevated at 7.1 ± 6.1 (P<.001). Seventeen of these patients with SFP slope greater than 5 suffered a mean fall in arterial P2 at 5 days post operation of 1.85 KPa (13.9 mm Hg) which was significantly greater than that in the other major cases (0.85 KPa, 6.4 mm Hg)(P <.05). SFP also correlated closely with the fall in platelet count on day 1 post operation (r= .82, P< .001).Intravascular platelet aggregates arise in the veins of the lower limb immediately after major surgery. They can be measured by the screen filtration technique described and may be related to pulmonary dysfunction.

Human gallstones: Specimen preparation and light microscopy

1992 ◽  
Vol 50 (1) ◽  
pp. 734-735
Author(s):  
Ronald Sinicki ◽  
Christopher Viney
Keyword(s):  
Light Microscopy ◽  
Microstructural Characterization ◽  
Laser Lithotripsy ◽  
Major Surgery ◽  
Specimen Preparation ◽  
Thin Sections ◽  
Choice Of Procedure ◽  
Minor Surgery

Several methods for removing gallstones from the human body are in use or under investigation. They range from noninvasive techniques (dissolving; ultrasound lithotripsy), through minor surgery (use of wire basket lithotriptor; laser lithotripsy), to major surgery. The choice of procedure seeks to accomplish removal of stones while minimizing the cutting of patient tissue, the post-treatment rehabilitation time, and the overall cost. The effectiveness of a given procedure will vary, depending on the size and number of stones present, and especially on their composition and microstructure. Attempts have therefore been made to correlate gallstone structure (from computerized tomography studies or magnetic resonance imaging with the least severe procedure needed to break up and remove the stone. Such empirical correlations can be facilitated by additional in vitro microstructural characterization of stones, which attempt to relate the in vivo observations to likely fracture paths and mechanisms. It is convenient to distinguish between three broad categories of gallstone. Cholesterol gallstones are associated with cholesterol supersaturation, when the level of cholesterol in bile exceeds the amount that the bile salts can keep in solution; they contain more than 25 wt% cholesterol and are relatively rare. Pigment gallstones contain less than 25 wt% cholesterol, and result from the precipitation and agglomeration of bilirubin and other inorganic salts. Mixed stones are the most common, and form the subject of our present investigations. Viewed in cross-section, they contain radiating crystals of cholesterol, together with concentric layers of apparently amorphous pigment. There are few literature references to the study of gallstone structure by light microscopy. We found only one reference to the microscopy of thin sections; others described low resolution reflected light studies of surfaces generated by dividing stones with a sudden impact delivered to a sharp knife. The drought of high resolution light micrographs even extends to pathology atlases.

In Vivo Effect of Suloctidil as an Antiplatelet Agent

1979 ◽  
Vol 41 (03) ◽  
pp. 465-474 ◽  
Author(s):  
Marcia R Stelzer ◽  
Thomas S Burns ◽  
Robert N Saunders
Keyword(s):  
Ex Vivo ◽  
Antiplatelet Agent ◽  
Ratio Method ◽  
Platelet Aggregate ◽  
Permanent Effect ◽  
Platelet Aggregates ◽  
5 Ht Uptake ◽  
High Doses

SummaryThe relationship between the effects of suloctidil in vivo as an antiplatelet agent and in vitro as a modifier of platelet serotonin (5-HT) parameters was investigated. Suloctidil was found to be effective in reducing platelet aggregates formation in the retired breeder rat as determined using the platelet aggregate ratio method (PAR) with an ED50 of 16.1 mg/kg 24 hours post administration. In contrast to the hypothesis that 5-HT depletion is involved in the anti-aggregatory mechanism of suloctidil, no correlation was found between platelet 5- HT content and this antiplatelet activity. Reduction of platelet 5-HT content required multiple injections of high doses (100 mg/kg/day) of suloctidil. Suloctidil administration for 8 days at 100 mg/kg/day, which lowered platelet 5-HT content by 50%, resulted in no permanent effect on ex vivo platelet 5-HT uptake or thrombin-induced release, nor alteration in the plasma 5-HT level. However, these platelets exhibited a short-lived, significant increase in percent leakage of 5-HT after 30 minutes of incubation. Therefore, suloctidil treatment at high doses may with time result in platelet 5-HT depletion, however this effect is probably not related to the primary anti-aggregatory activity of the drug.

Accumulation of Macromolecular Particles in the Reticuloendothelial System (RES) Mediated by Platelet Aggregation and Disaggregation

1969 ◽  
Vol 22 (03) ◽  
pp. 496-507 ◽  
Author(s):  
W.G van Aken ◽  
J Vreeken
Keyword(s):  
Platelet Aggregation ◽  
Degradation Products ◽  
Reticuloendothelial System ◽  
Caproic Acid ◽  
Carbon Particles ◽  
Carbon Clearance ◽  
Aggregation And Disaggregation ◽  
Platelet Aggregates

SummaryCarbon particles cause platelet aggregation in vitro and in vivo. Prior studies established that substances which modify thrombocyte aggregation also influence the rate at which carbon is cleared from the blood.This study was performed in order to elucidate the mechanism by which the carbon-platelet aggregates specifically accumulate in the RES.Activation of fibrinolysis by urokinase or streptokinase reduced the carbon clearance rate, probably due to generated fibrinogen degradation products (FDP). Isolated FDP decreased the carbon clearance and caused disaggregation of platelets and particles in vitro. Inhibition of fibrinolysis by epsilon-amino-caproic acid (EACA), initially accelerated the disappearance of carbon and caused particle accumulation outside the RES, predominantly in the lungs. It is supposed that platelet aggregation and locally activated fibrinolysis act together in the clearance of particles. In the normal situation the RES with its well known low fibrinolytic activity, becomes the receptor of the particles.

scholarly journals Effects of chitosan-collagen dressing on wound healing in vitro and in vivo assays

2021 ◽  
Vol 19 ◽  
pp. 228080002198969
Author(s):  
Min-Xia Zhang ◽  
Wan-Yi Zhao ◽  
Qing-Qing Fang ◽  
Xiao-Feng Wang ◽  
Chun-Ye Chen ◽  
...  
Keyword(s):  
Wound Healing ◽  
Wound Dressing ◽  
Type I Collagen ◽  
Inhibition Zone ◽  
Negative Control ◽  
Type I ◽  
Nih3t3 Cells ◽  
Post Operation

The present study was designed to fabricate a new chitosan-collagen sponge (CCS) for potential wound dressing applications. CCS was fabricated by a 3.0% chitosan mixture with a 1.0% type I collagen (7:3(w/w)) through freeze-drying. Then the dressing was prepared to evaluate its properties through a series of tests. The new-made dressing demonstrated its safety toward NIH3T3 cells. Furthermore, the CCS showed the significant surround inhibition zone than empty controls inoculated by E. coli and S. aureus. Moreover, the moisture rates of CCS were increased more rapidly than the collagen and blank sponge groups. The results revealed that the CCS had the characteristics of nontoxicity, biocompatibility, good antibacterial activity, and water retention. We used a full-thickness excisional wound healing model to evaluate the in vivo efficacy of the new dressing. The results showed remarkable healing at 14th day post-operation compared with injuries treated with collagen only as a negative control in addition to chitosan only. Our results suggest that the chitosan-collagen wound dressing were identified as a new promising candidate for further wound application.

scholarly journals Therapeutic effects of EGF-modified curcumin/chitosan nano-spray on wound healing

2021 ◽  
Vol 8 (2) ◽  
Author(s):  
Yue Li ◽  
QingQing Leng ◽  
XianLun Pang ◽  
Huan Shi ◽  
YanLin Liu ◽  
...  
Keyword(s):  
Drug Delivery ◽  
Wound Healing ◽  
Chitosan Nanoparticles ◽  
Skin Lesions ◽  
In Vitro Assays ◽  
Therapeutic Effects ◽  
Skin Defects ◽  
Post Operation

Abstract Dermal injury, including trauma, surgical incisions, and burns, remain the most prevalent socio-economical health care issue in the clinic. Nanomedicine represents a reliable administration strategy that can promote the healing of skin lesions, but the lack of effective drug delivery methods can limit its effectiveness. In this study, we developed a novel nano-drug delivery system to treat skin defects through spraying. We prepared curcumin-loaded chitosan nanoparticles modified with epidermal growth factor (EGF) to develop an aqueous EGF-modified spray (EGF@CCN) for the treatment of dermal wounds. In vitro assays showed that the EGF@CCN displayed low cytotoxicity, and that curcumin was continuously and slowly released from the EGF@CCN. In vivo efficacy on wound healing was then evaluated using full-thickness dermal defect models in Wistar rats, showing that the EGF@CCN had significant advantages in promoting wound healing. On day 12 post-operation, skin defects in the rats of the EGF@CCN group were almost completely restored. These effects were related to the activity of curcumin and EGF on skin healing, and the high compatibility of the nano formulation. We therefore conclude that the prepared nano-scaled EGF@CCN spray represents a promising strategy for the treatment of dermal wounds.

STUDIES ON THE ANTICOAGULANT AND ANTITHROMBOTIC ACTIONS OF DERMATANS AND THEIR SULFATED DERIVATIVES

1987 ◽  
Author(s):  
D Hoppensteadt ◽  
A Kumar ◽  
J Fareed ◽  
J Mardigian
Keyword(s):  
Antithrombin Iii ◽  
Femoral Vein ◽  
In Vivo Studies ◽  
In Vitro Assays ◽  
Protease Inhibition ◽  
Thrombosis Model ◽  
Antithrombotic Effects ◽  
Activated Prothrombin Complex Concentrates

Non-antithrombin III mediated effects such as interaction with heparin cofactor II, modulation of endothelium and polymorphonuclear leukocytes contribute to the overall antithrombotic effects of glycosaminoglycans. In order to study the role of these dermatans, we investigated their in vitro anticoagulant effects using the clot based (PT, APTT, TT, and Heptest), antiprotease (anti IIa and anti Xa) and Thromboplastin C activated fibrinopeptide A generation test. The in vivo antithrombotic actions were investigated, against activated and non activated prothrombin complex concentrates, and in combination with Russells viper venom in jugular and femoral vein stasis thrombosis models (rabbit). The dermatans studied consisted of a standard dermatan of porcine intestinal origin and four sulfated dermatans with varying degrees of sulfation. All of the dermatans studied showed weak anticoagulant effects on the routinely performed clot based assays. Marked variability was seen on the protease inhibition (anti Xa and anti IIa) assays. In the in vivo studies all dermatans studied showed varying degrees of antithrombotic actions against various thrombogenic agents in a modified stasis thrombosis model. Sulfation appeared to produce stronger anticoagulant effects as determined by in vitro assays, whereas the intravenous antithrombotic actions of native dermatan were stronger than sulfated derivatives. This data suggests that dermatans produce their antithrombotic actions via non-antithrombin III mediated pathways. Furthermore, in vitro testing methods are of limited value in the evaluation of the biologic actions of dermatans and their derivatives.

An Experimental Model for the Study of Venous Thrombosis in Vivo

1975 ◽  
Author(s):  
T. K. Day ◽  
K. G. A. Glark ◽  
V. V. Kakkar
Keyword(s):  
Electron Microscopy ◽  
Scanning Electron Microscopy ◽  
Experimental Model ◽  
Femoral Vein ◽  
Total Charge ◽  
Small Current ◽  
Group I ◽  
Scanning Electron

The lack of a satisfactory in vivo experimental model has probably been responsible for the delay in the clinical application of recent advances in in vitro research on thrombosis. This paper describes a model in which thrombosis is initiated by an electrical stimulus. The thrombus produced has the histological and biochemical features of human deep vein thrombosis (DVT).The minimum stimulus necessary to induce thrombosis was first determined by passing a fixed current for timed intervals along the femoral veins of 10 rabbits. Thrombi were seen 24 hours later if the total charge passed exceeded a threshold value of 25 millicoulombes. With this small current, no endothelial changes were visible immediately after the passage of the charge on light or scanning electron microscopy. At 24 hours a mural thrombus formed, which had fully cross-linked fibrin and histological features resembling human DVT.In the second series of experiments, the sequence of changes occurring in thrombus production was investigated in 3 groups of 18 rabbits each. After passage of the critical charge along the femoral vein in each animal, veins were removed at fixed intervals, the contralateral vein acting as a control. The veins were examined by scanning electron-microscopy (Group I), transmission electron-microscopy (Group II) and light microscopy (Group III), The earliest changes were detectable at 5 minutes and consisted of the laying down of an organised structure of criss-crossing fibrin strands with small platelet clumps at fibrin intersections. Later the fibrin structure spread towards the lumen; platelet clumps fused and a coralline thrombus was formed by 24 hours. The significance of these changes will be discussed.

scholarly journals Do patients with thromboembolic disease have circulating platelet aggregates?

Blood ◽  
1984 ◽  
Vol 64 (1) ◽  
pp. 205-209 ◽  
Author(s):  
FH Kohanna ◽  
MH Smith ◽  
EW Salzman
Keyword(s):  
Platelet Rich Plasma ◽  
Venous Blood ◽  
Adenosine Diphosphate ◽  
Normal Subjects ◽  
Thromboembolic Disease ◽  
Circulating Platelet Aggregates ◽  
Platelet Aggregates ◽  
Lower Ratio

Reports of circulating platelet aggregates (ie, microemboli) in thromboembolism and other vascular disorders are based on a method (Wu and Hoak , 1974) in which venous blood is collected via scalp vein needle and tubing into either formaldehyde, which fixes aggregates, or EDTA, which disperses them. The ratio of platelet counts in platelet- rich plasma (PRP) from the two blood samples after centrifugation is interpreted as a measure of platelet aggregates in the circulation in vivo. We compared this standard Wu and Hoak technique with a modified one, in which blood was drawn directly into a syringe, and with a third method that avoided centrifugation by counting single platelets in whole blood. Both modified techniques could detect aggregates generated in vitro with adenosine diphosphate (ADP). In 12 normal subjects, the three methods were equivalent, but in 37 patients with thromboembolic disorders, the standard Wu and Hoak method gave a lower ratio than the other methods. Similar results were found in a subset of eight patients with myocardial infarction. Heparin treatment of patients did not influence the results. The data suggest that formation of platelet aggregates occurred during venipuncture. Platelets may be hyperactive in patients with thromboembolic disease and may form aggregates in vitro during collection, but the concept of chronic microembolism in such patients should be reassessed.

The Filtragometer: A New Device for Measuring Platelet Aggregation in Venous Blood of Man

1975 ◽  
Vol 34 (02) ◽  
pp. 531-544 ◽  
Author(s):  
G Hornstra ◽  
F ten Hoor
Keyword(s):  
Platelet Aggregation ◽  
Pressure Difference ◽  
Venous Blood ◽  
New Device ◽  
Platelet Aggregates ◽  
Spontaneous Platelet Aggregation ◽  
Short Time ◽  
Forearm Vein

SummaryA new device for the direct assessment of spontaneous platelet aggregation in human venous blood is described: the Filtragometer. The principle of the method is based on measurement of the pressure difference across a filter with pores of 20 μπι diameter through which blood from a forearm vein is drawn. Platelet aggregates, obstructing the filter, cause a change in the pressure difference which is proportional to the degree of platelet aggregation. The measurement takes only a short time and a small amount (5-10 ml) of blood.Platelet aggregation as measured with the Filtragometer depends on the type of anticoagulant used. The Filtragometer response decreases on inhibition of platelet stickiness in vitro by prostaglandin E1 and in vivo by aspirin ingestion. Moreover it appeared to be higher in a group with a high thrombosis tendency than in a group less susceptible to fatal arterial thrombosis.The Filtragometer seems especially useful in monitoring the results of diet and/or drug therapy.

Influence of Fibrinogen Split Products on Platelets

1967 ◽  
Vol 17 (01/02) ◽  
pp. 078-098 ◽  
Author(s):  
M. I Barnhart ◽  
D. C Cress ◽  
R. L Henry ◽  
J. M Riddle
Keyword(s):  
Platelet Aggregation ◽  
Plasma Concentration ◽  
Whole Blood ◽  
Platelet Rich Plasma ◽  
Platelet Response ◽  
Transient Nature ◽  
Platelet Morphology ◽  
Platelet Aggregates

SummaryBreakdown products of fibrinogen and fibrin can play a role in hemostasis and also may be of consequence in thrombosis. β2 fibrinogen derivative D is an electropositive terminal proteolysis product of fibrinolysis which has the ability to aggregate platelets. The normal plasma concentration of such nonclottable fibrinogen relatives is 0.2 mg/ml. During fibrinolysis this concentration may reach 5 mg/ml plasma. Addition of β 2 fibrinogen D (raising the plasma concentration 0.1 to 5 mg/ml) either in vivo or in vitro induced platelet aggregations. Moreover, alterations in platelet morphology occurred which were obvious by electron microscopy.Platelet depletion was a consistent response to the infusion of purified β2 fibrinogen D (8 to 55 mg/kg body weight) into dogs. Circulating platelets decreased as much as 85% but were only temporarily aggregated and reappeared in the circulation within 1 to 5 hrs. Small platelet aggregates circulated while large aggregates were trapped in the microcirculation. Thrombin was not responsible for the platelet aggregations as neither prothrombin nor clottable fibrinogen were changed significantly. The transient nature and morphological features of the platelet response according to microscopic criteria were prominent during and after infusion of β2 fibrinogen D.In vitro studies included 3 systems; washed platelets, platelet rich plasma and whole blood. Positive results were obtained with all, but platelets in whole blood were most responsive. The magnitude of platelet aggregation and morphology correlated with the concentration of β2 fibrinogen D. Platelet aggregation induced by ADP (10~5 mg/ml) was compared with that induced by β2 fibrinogen D (0.09 to 0.72 mg/ml). With either reagent aggregates were of dendritic forms. Combination of the 2 reagents was additive but did not further change the morphology. Additional factors seem necessary for development of viscous metamorphosis.

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