Download Molecular Basis of Thrombosis and Hemostasis by Katherine A. High PDF

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By Katherine A. High

This certain, single-source reference offers accomplished insurance of the molecular biology and genetics of the standards eager about blood clotting and fibrinolytic structures in addition to the antiproteases that regulate these reactions.

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The systemic release of necrotic tumor tissue and/or enzymes with procoagulant or phospholipoprotein-like activity may activate the early phases of coagulation and/or platelet release. Also, many tumors undergo neovascularization; this process may produce abnormal endothelial cell lining which may either cause a platelet release or generation of Factor XIIa and XIa with subsequent procoagulant activation and the development of a fulminant, subacute, or low-grade DIC process. Another trigger for disseminated intravascular coagulation in the patient with malignancy is the use of LeVeen or Denver shunts for malignant ascites, commonly utilized in gynecological malignancies.

5 Elms and co-workers have done D-Dimer assays in DIC patients and found elevated D-Dimer levels in 28 Rodger L. P. 5 Formation of prothrombin fragment 1 þ 2. 5. In some instances, FDP titers and paracoagulation reactions may be negative in DIC. 201 When these thrombin clot-tubes are used, not only is fibrinogen removed from the system but also Fragment X and Fragment Y. 6 The formation of D-Dimer. only be degradation to the X fragment stage or some intermediate between fibrin(ogen) and Fragment X.

The prothrombin time depends upon ultimate conversion of fibrinogen to fibrin and in DIC there is usually 26 Rodger L. Bick and Deborah Hoppensteadt hypofibrinogenemia, and FDP and thrombin interference with fibrin monomer polymerization. Also, plasmin-induced lysis of Factors V and IX should prolong the prothrombin time. The prothrombin time is prolonged in about 50% to 75% of patients with DIC and in up to 50% of patients is normal or short. 1,2,3,4,5,12,62,163 The activated partial thromboplastin time (aPTT) should also be prolonged in fulminant disseminated intravascular coagulation for a variety of reasons, but is more unreliable than is the prothrombin time.

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