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ARTICLE |

ROLE OF FIBRINOLYTIC AGENTS IN THROMBOTIC DISEASES FREE

R. V. Chapple, M.D.; H. O. Singher, Ph.D.
[+] Author Affiliations

Presented at the World Conference of Angiology, Atlantic City, June 5-7, 1959.


Raritan, N. J.


JAMA. 1960;173(3):221-225. doi:10.1001/jama.1960.03020210001001
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Critical analysis of existing data demonstrates that fibrinolysin in conjunction with anticoagulant therapy decreases the morbidity in patients with thrombophlebitis. This conclusion was the result of comparison of data from hospital charts of 20 patients in a fibrinolysin-treated series and a control group of 22 patients. The comparison was made after outlining the necessary criteria for the arbitrary selection of patients and setting up rules to be followed in the interpretation and grading of the clinical information. The author also reviews the theories of clot lysis that have been put forward, with the realization that a final answer has not yet been determined.

REFERENCES

Sherry, S.; Fletcher, A. P.; and Alkjaersig, N.:  Fibrinolysin and Fibrinolytic Activity in Man , Physiol. Rev. 39:343-382 ( (April) ) 1959;.
Astrup, T.:  Fibrinolysis in Organism , Blood 11:781-806 ( (Sept.) ) 1956;.
Fearnley, G. R., and Tweed, J. M.:  Evidence of Active Fibrinolytic Enzyme in Plasma of Normal People with Observations on Inhibition Associated with Presence of Calcium , Clin. Sc. 12:81-89 ( (Feb.) ) 1953;.
Sherry, S.; Fletcher, A. P.; and Alkjaersig, N.:  Developments in Fibrinolytic Therapy for Thrombo-embolic Disease , Ann. Int. Med. 50:560-570 ( (March) ) 1959;.
Ambrus, J. L., and others:  Fate of I 131 Labelled Component of Fibrinolysin System , Fed. Proc. 18:364 ( (March) ) 1959;.
Coon, W. W., and Duff, I. V.:  Effects of Intravenous Human Plasmin on Blood Clotting Mechanism of Dog , J. Lab. & Clin. Med. 51:381-385 ( (March) ) 1958;.
Johnson, A. J., and McCarty, W. R.:  Lysis of Artificially Induced Intravascular Clots in Man by Intravenous Infusions of Streptokinase , J. Clin. Invest. 37:905 ( (June) ) 1958;.
Innerfield, I.:  Intramuscular Trypsin-in-Oil in Acute Thrombophlebitis, Diabetic Cellulitis, and Leg Ulcer , Surgery 36:1090-1100 ( (Dec.) ) 1954;.
 Proteolytic Enzymes and Their Clinical Application, Symposium , Ann. New York Acad. Sc. 68:1-244 ( (Aug.) ) 1957;.
Cliffton, E. E., and Downie, G. R.:  Variations in Proteolytic Activity of Serum of Animals Including Man , Proc. Soc. Exper. Biol. & Med. 73:559-562 ( (April) ) 1950;.
Ambrus, J. L.; Back, N.; Mihalyi, E.; and Ambrus, C. M.:  Quantitative Method for in vivo testing of Fibrinolytic Agents: Effect of Intravenous Trypsin on Radioactive Thrombi and Emboli , Circulation Res. 4:430-439 ( (July) ) 1956;.
Warren, R., and Villavicencio, J. L.:  Experience with Use of Human Fibrinolysin , Angiology 10:263-267 ( (Aug.) ) 1959;.
DeBakey, M. E.:  Critical Evaluation of Problem of Thromboembolism , Internat. Abstr. Surg. 98:1-27 ( (Jan.) ) 1954;.
Evans, J. A., and Smedal, M. I.:  Clinical Experiences with Fibrinolysin Therapy , Angiology 10:311-318 ( (Aug.) ) 1959;.
Sokal, J. E.; Ambrus, J. L.; and Ambrus, C. M.:  Treatment of Thrombosis with Fibrinolysin (Plasmin) , J. A. M. A. 168:1314-1328 ( (Nov. 8) ) 1958;.
Moser, K. M.; Personal communication to the authors.
Cosgriff, S. W.:  Thromboembolic Complications Associated with ACTH and Cortisone Therapy , J. A. M. A. 147:924-926 ( (Nov. 3) ) 1951;.
Robin, E. D.; Julian, D. G.; Travis, D. M.; and Crump, C. H.:  Physiologic Approach to Diagnosis of Acute Pulmonary Embolism , New England J. Med. 260:586-591 ( (March 19) ) 1959;.

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Sherry, S.; Fletcher, A. P.; and Alkjaersig, N.:  Fibrinolysin and Fibrinolytic Activity in Man , Physiol. Rev. 39:343-382 ( (April) ) 1959;.
Astrup, T.:  Fibrinolysis in Organism , Blood 11:781-806 ( (Sept.) ) 1956;.
Fearnley, G. R., and Tweed, J. M.:  Evidence of Active Fibrinolytic Enzyme in Plasma of Normal People with Observations on Inhibition Associated with Presence of Calcium , Clin. Sc. 12:81-89 ( (Feb.) ) 1953;.
Sherry, S.; Fletcher, A. P.; and Alkjaersig, N.:  Developments in Fibrinolytic Therapy for Thrombo-embolic Disease , Ann. Int. Med. 50:560-570 ( (March) ) 1959;.
Ambrus, J. L., and others:  Fate of I 131 Labelled Component of Fibrinolysin System , Fed. Proc. 18:364 ( (March) ) 1959;.
Coon, W. W., and Duff, I. V.:  Effects of Intravenous Human Plasmin on Blood Clotting Mechanism of Dog , J. Lab. & Clin. Med. 51:381-385 ( (March) ) 1958;.
Johnson, A. J., and McCarty, W. R.:  Lysis of Artificially Induced Intravascular Clots in Man by Intravenous Infusions of Streptokinase , J. Clin. Invest. 37:905 ( (June) ) 1958;.
Innerfield, I.:  Intramuscular Trypsin-in-Oil in Acute Thrombophlebitis, Diabetic Cellulitis, and Leg Ulcer , Surgery 36:1090-1100 ( (Dec.) ) 1954;.
 Proteolytic Enzymes and Their Clinical Application, Symposium , Ann. New York Acad. Sc. 68:1-244 ( (Aug.) ) 1957;.
Cliffton, E. E., and Downie, G. R.:  Variations in Proteolytic Activity of Serum of Animals Including Man , Proc. Soc. Exper. Biol. & Med. 73:559-562 ( (April) ) 1950;.
Ambrus, J. L.; Back, N.; Mihalyi, E.; and Ambrus, C. M.:  Quantitative Method for in vivo testing of Fibrinolytic Agents: Effect of Intravenous Trypsin on Radioactive Thrombi and Emboli , Circulation Res. 4:430-439 ( (July) ) 1956;.
Warren, R., and Villavicencio, J. L.:  Experience with Use of Human Fibrinolysin , Angiology 10:263-267 ( (Aug.) ) 1959;.
DeBakey, M. E.:  Critical Evaluation of Problem of Thromboembolism , Internat. Abstr. Surg. 98:1-27 ( (Jan.) ) 1954;.
Evans, J. A., and Smedal, M. I.:  Clinical Experiences with Fibrinolysin Therapy , Angiology 10:311-318 ( (Aug.) ) 1959;.
Sokal, J. E.; Ambrus, J. L.; and Ambrus, C. M.:  Treatment of Thrombosis with Fibrinolysin (Plasmin) , J. A. M. A. 168:1314-1328 ( (Nov. 8) ) 1958;.
Moser, K. M.; Personal communication to the authors.
Cosgriff, S. W.:  Thromboembolic Complications Associated with ACTH and Cortisone Therapy , J. A. M. A. 147:924-926 ( (Nov. 3) ) 1951;.
Robin, E. D.; Julian, D. G.; Travis, D. M.; and Crump, C. H.:  Physiologic Approach to Diagnosis of Acute Pulmonary Embolism , New England J. Med. 260:586-591 ( (March 19) ) 1959;.
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