[Simultaneous quantification of soluble fibrin and D-dimer in blood plasma for the assessment of the threat of thrombosis].

Soluble fibrin and D-dimer are the most specific markers of blood coagulation cascade and the threat of thrombosis. Two immunoassay test systems were designed using the fibrin-specific and D-dimer-specific monoclonal antibodies. The clinical trials of the test systems were carried out in Ukraine. The high informative value of soluble fibrin quantification as a prognostic indicator of the threat of thrombosis associated with hip replacement and endoprosthetics of the abdominal aorta was shown. Independent D-dimer quantification is less informative. Simultaneous quantification of soluble fibrin and D-dimer before operation and at different time intervals after it is required for the prediction of postoperative thrombotic complications and monitoring the efficiency of antithrombotic therapy. Only in this case it is possible to get information about the state of the balance between blood coagulation and fibrinolytic systems, and determine the degree of the threat of thrombosis.

Level of overall hemostasis potential in donor and patient plasma in pathology.

Coagulation potential (CP), overall hemostasis potential (OHP) and fibrinolysis potential (FP) in plasma of donors and patients with myocardial infarction (MI), stroke (St) and hip joint diseases (HJD) have been investigated using M. Blomback's global hemostasis assay. Plasma samples of the patients were analyzed with APTT reagent in the presence or absence of t-PA. It was found that the ratio of values of СP, OHP and FP in plasma of patients to those of donors plasma were 78, 60 and 123% at MI; 157, 155 and 162% at St; 128, 131 and 124% at HJD. CP to FP ratio that indicated balance between coagulation and fibrinolytic systems activities were 4.13, 2.5, 4.0 and 4.26 in plasma of donors and MI, St and HJD patients, respectively. These results are evidence of increased fibrinolytic activity in plasma of MI patients. Lag-periods of plasma clotting of MI, St and HJD patients were prolonged by 2.3, 7.2 and 1.5-fold, respectively. Pearson's correlation analysis between parameters, obtained in vitro studies using global hemostasis assay, and concentrations of the molecular markers (soluble fibrin and D-dimer), which formed in vivo in plasma of MI, St and HJD patients, did not reveal any relationship between them.

The cleavage of beta-chain in bovine fibrinogen DH fragment (95 kDa) leads to a significant increase in its anticlotting activity.

It is shown that in the presence of Ca2+ plasmin converts bovine fibrinogen fragment DH (95 kDa) into DLA fragment by the cleavage of its beta-chain Arg372-Thr373 bond. DLA fragment consists of two components (82 and 12 kDa) held together by non-covalent bonds and has 3.5-fold higher anticlotting activity than DH fragment. The DH to DLA fragment conversion leads to the destabilization of thermolabile domains of the latter without the loss of their compact structure. The results obtained show that the activation of DH fragment by the cleavage of its Arg372-Thr373 bond bears some resemblance to the general activation of proenzyme into enzyme.

[Application of the phase transition theory to the description of fibrinogen-fibrin transition]. / Primenenie teorii fazovykh perekhodov dlia opisaniia prevrashcheniia fibrinogena v fibrin.

A physical model of the kinetics of the fibrinogen--fibrin transition was constructed using the theory of phase transitions. It was shown that the model is consistent with the experimental data.

[Differences between the complexes formed by monomeric fibrin with fragment D and dimer D]. / Razlichie mezhdu kompleksami, obrazuemymi monomernym fibrinom s fragmentom D i dimerom D.

The paper is concerned with studies in formation of monomeric fibrin (fm) complexes with fragment D (D) of fibrinogen and dimer D (DD) of stabilized fibrin. The complexes are shown to be essentially different. The fm-D complexes are unstable, their composition is a function of D concentration in the mixture, the ultimate molar D/fm ratio is equal to 3. The fm-DD complexes are quite stable, their composition is constant: the molar DD/fm ratio is equal to 1. In mixtures containing fm, DD and different amounts of D complexes of different composition are formed but the total number of D-units in them approaches 3. A model is suggested showing interaction of fm molecules in protofibril formation with allowance for the retention of binding centres which provide the lateral link between protofibrils.

[Hemostasis in patients operated on for abdominal hemorrhage. 4. Conception of hemostasis changes]. / Gemostaz u bol'nykh, operirovannykh po povodu abdominal'nykh krovotechenii. 4. Kontseptsiia izmenenii gemostaza.

Studies of haemostasis changes in the dynamics of early post-operational period permitted revealing the tendency to the growth of fibrinogen concentration, decrease in the fibrinogen self-assembling rate, weakening of thrombinemia, disturbances in fibrinogen degradation products (FDP) elimination, increase of inhibitors activity and/or weakening of blood coagulation factors activity, intensification thrombocytes aggregation. Hypercoagulation has been registered under acute haemorrhage and the haemorrhage time exceeding 24 h before the operation, the weakening of hypercoagulation response was observed, notwithstanding the possibility of haemorrhage continuation. The letter is underlined by the changes in the balance between the coagulation factors and inhibitors up to the absence of typical hypercoagulation response to surgical interference.

[Determination of the general prothrombin level and detection of its functionally inactive forms using the enzyme ecamulin purified from Echis multisquamatus venom]. / Opredelenie obshchego urovnia protrombina i vyiavlenie ego funktsional'no neaktivnykh form s pomoshch'iu fermenta ékamulina, vydelennogo iz iada éfy mnogocheshuichatoi.

The method for determination of the general prothrombin level and detection of its inactive forms (prothrombin-1, decarboxylated prothrombin, etc.) has been worked out. Enzyme ecamulin was purified from the venom of Echis multisquamatus. Ecamulin test was used for plasma of practically healthy people and patients with hypertension. The results obtained proved that this test is informative and precise. Comparison of two tests, prothrombin and ecamulin ones, permits characterizing the state of blood coagulation and finding functionally inactive prothrombin forms which are the markers of some pathological states.

[Comprehensive laboratory diagnosis of intravascular blood coagulation syndrome in late gestosis]. / Kompleksnaia laboratornaia diagnostika sindroma vnutrisosudistogo svertyvaniia krovi pri pozdnykh gestozakh.

A chronic form of intravascular blood coagulation (the DIC syndrome) is an obligatory pathogenetic mechanism in the organism of pregnant women with late gestoses. In order to find the DIC-syndrome and to provide urgent protective measures comprehensive laboratory diagnostics of the hemostatic pathologies is necessary. Analysis of clinician data has shown an optimal quantity and sequence of tests, among which some are traditional and several have been worked out by the authors. This approach can be recommended for corresponding medical institutions as such that provides obtaining exact and informative data about the state of blood coagulation with minimal amounts of human plasma.

[Hemostasis in patients operated for abdominal bleeding. I. Estimation of the relationship of hemostasis parameters according to data of the correlation coefficient and factor analysis]. / Gemostaz u bol'nykh, operirovannykh po povodu abdominal'nykh krovotechenii. I. Otsenka sviazi pokazatelei gemostaza po dannym koéffitsienta korreliatsii i faktornogo analiza.

The work was aimed to estimate the interrelation and indexes which define the main alterations of hemostatic deviations in the patients with abdominal bleeding. For this reason the authors have analysed interrelations between 31 hemostasis indexes in 30 patients after operations. Fourteen groups of interrelated indications have been revealed. They are as follows: 1. Prothrombin index, activated partial thromboplastin index; 2. Prothrombin's inactive forms (prethrombin-1, decarboxylated prethrombin etc.), ecamulin index; 3. Velocity bend of distraction of fibrin clot, velocity bend of forming of fibrin clot, height of clot using turbidimetric method; 4. Half-lysis time, lysis time, time of fibrin clot using turbidimetric method; 5. Velocity, Intensity, remainder of platelet aggregation induced by ADP 10 mcg/ml, 2.5 mcg/ml, 1.9 mcg/ml; 6. Thrombin time; 7. Protein C; 8. Fibrinogen; 9. Platelet count; 10. Soluble fibrin; 11. Ancystron time; 12. X factor; 13. Antithrombin-III; 14. Fibrin(ogen) degradation products. It was shown how different groups affect hemostasis. The authors have suggested to use the data of mathematical analysis and laboratory tests for the estimation of hemostatic deviations.

[Hemostasis in patients operated on for abdominal hemorrhage. 2. Characterization of the process of activation of blood coagulation system factors. Coagulation inhibitors]. / Gemostaz u bol'nykh, operirovannykh po povodu abdominal'nykh krovotechenii. 2. Kharakteristika protsessa aktivatsii faktorov sistemy svertyvaniia krovi. Ingibitory svertyvaniia.

Haemostasis indexes were estimated in four groups of patients which were isolated by the cluster analysis and operated for abdominal haemorrhages. A tendency or explicit hyperfibrinogenemia have been fixed which are connected with the syndrome of the system inflammation response of the patient in the critical state. The correlation between the indexes of the prothrombin time, activated partial prothrombin time and protein C activity is shown. An analysis of anticoagulants effect suggests it possible to consider the antithrombin III to be the main, stable blood anticoagulant, while protein C is responsible for the operational response of the organism on the part of haemostasis. The decrease of ancystron and thrombin time was recorded in 50% of patients notwithstanding the hyperfibrinogenemia and presence of fibrin fibrinogen degradation products. It is supposed that the acceleration of fibrin polymerization in the examined groups of patients is the mechanism of the organism protection from the blood loss under the given pathology.

[Hemostasis in patients operated on for abdominal hemorrhage. 3. Boundary deviations of hemostasis]. / Gemostaz u bol'nykh, operirovannykh po povodu abdominal'nykh krovotechenii. 3. Krainie varianty otkloneniia gemostaza.

The fibrinolytic process in the plasma of patients operated for abdominal haemorrhages have been investigated. The results allowed to conclude that the blockade of fibrinolysis did not effect on the course of the disease. The high level of the inhibitors and of the platelets hypoaggregation can be considered as a cause increased of the recurring gastrointestinal haemorrhages. It was demonstrated that the probability of DIC-syndrome development increased at the aggravation of the patient's state after the operation.

[Antithrombin III. Functional role and methods of determination (review)]. / Antitrombin III. Funktsional'naia rol' i metody opredeleniia (obzor).

Antithrombin III (AT III) is the most important inhibitor of thrombin and other serine proteinases in the system of blood coagulation. AT III not only removes the excess of thrombin from blood but it inhibits the enzyme synthesis. AT III became functionally active in presence of heparin, which operates as a catalyst and accelerates significantly the formation of inactive complexes between AT III and proteinases, which usually developed slowly in absence of the activator. AT III and heparin cofactor are synonyms and designate the same substance. Modern procedures for estimation of AT III in blood plasma are reviewed.

[Determination of fibrinogen content in human blood plasma using thrombin-like enzyme of ancistron N and analysis of hemostasis under presence of blood coagulation inhibitors]. / Vyznachennia vmistu fibrynogenu v plazmi krovi liudyny za dopomogoiu trombinopodibnogo fermentu antsystronu-H ta analiz stanu gemostazu pry naiavnosti ingibitoriv zsidannia krovi.

The cases of non-coagulation or only partial coagulation of blood plasma fibrinogen under the effect of thrombin have been revealed while examining the homeostasis-state in practically healthy elderly and old people and those with hypertonic disease. These cases have been analyzed. It is shown that the suggested method of fibrinogen determination in blood plasma using thrombin-like enzyme ancistrone-H extracted from venom of snakes (Agkistrodon halys halys) permits determining the fibrinogen content in blood plasma even in the cases connected with the presence of circulating coagulation inhibitors in plasma. The determination is not hindered by the introduction of exogenous heparin, including low-molecular heparins of the fraxiparin type.

[The prevention of HIV infection in the army and navy]. / Profilaktika VICh-infektsii v armii i na flote.

In the course of 5 years 121 foreign and 13 Soviet military servicemen showed HIV infection; seven of them (officers and warrant officers) are still in service. As distinct from WHO requirements symptomless virus carriers are also registered. Infected servicemen constitute 1.5% from the total number of infected in the country.

[The determination of fibrinogen in the blood plasma during heparin therapy]. / Opredelenie fibrinogena v plazme krovi pri geparinoterapii.

A new method is suggested for blood plasma fibrinogen measurements, making use of ancystron-N thrombin-like enzyme, isolated from common viper venom. Comparative studies have demonstrated the possibility of using the new test for plasma fibrinogen determination in heparin-containing or intact blood.