fibrin and Genital-Diseases--Female

The pathophysiology of adhesion formation continues to be perplexing. A delicate balance appears to exist between those wound factors that would initiate the physiologic process of peritoneal wound healing and those factors necessary for the lysis of fibrin, a major component of adhesions. Research continues to elucidate the roles of leukotrienes, prostaglandins, protein kinase-C, and transforming growth factors in adhesiogenesis. The ability to enhance plasmin's fibrinolytic activity or to impede plasminogen activator inhibitor factor may have important clinical ramifications in adhesiolysis. Clinical studies continue to address the effectiveness of intraperitoneal additives (dextran, lactated Ringer's solution, heparin) and barriers to adhesion formation (Interceed, TC7, Johnson & Johnson, New Brunswick, NJ; Gore-Tex, polytetrafluoroethylene, Gore & Assoc, Flagstaff, AZ). Surgical technique with attention to hemostasis, minimal trauma, proper suture selection, and peritoneal irrigation continues to be the mainstay in adhesion prevention.

Topics: Anti-Inflammatory Agents, Non-Steroidal; Calcium; Female; Fibrin; Genital Diseases, Female; Humans; Inflammation; Poloxalene; Polytetrafluoroethylene; Tissue Adhesions

1. The purpose of fluid administration is not only the restoration of blood volume but also the normalization of impaired nutritive flow. 2. Plasma oncotic (colloid osmotic) pressure is the only force which can draw water into the circulation. In shock the infusion of colloid solutions is able to normalize nutritive flow and peripheral resistance almost at once. 3. Five per cent solutions of pasteurized plasma protein or albumin and 6 per cent dextran 70 yield a volume expansion corresponding to the amount infused. 4. The decrease in hematocrit produced by the infusion of these three colloidal solutions is accompanied by a decrease in whole blood viscosity resulting in a rise in cardiac output as well as in nutritional tissue flow. 5. Hemodilution improves oxygen supply as long as the hematocrit does not fall below 30 per cent, although normovolemia is the critical requirement. 6. Transmission of viral hepatitis is still the greatest danger of blood transfusion. 7. The use of large amounts of Ringer's lactate is not advised, as this solution does not reduce the total number of units of blood which need to be given. Pulmonary edema may become a problem. 8. Dextrans are best suited to initial volume replacement in shock. They increase plasma volume, improve blood flow, have antithrombotic properties, and are easily available and relatively cheap. Anaphylactoid reactions are rare. 9. Every third patient undergoing general surgery and every other patient having hip surgery develops a deep venous thrombosis. Widespread prophylaxis to prevent thromboembolic complications is mandatory. 10. The antithrombotic properties of dextran are due to a reduction in platelet adhesiveness, a change in fibrin clot structure, and the increased lysability of thrombi and the improvement of blood flow. 11. In a personal controlled, prospective, randomezed trial comparing subcutaneous heparin and intravenous dextran 40, 35.8 per cent of the controls (n=95), 13.2 per cent of the 83 patients in the heparin group, and 20.5 per cent in the dextran group (n=83) developed deep venous thrombosis. The difference between dextran and heparin is not significant; however, both treatment groups show a statistically significant effect compared to the controls.

Topics: Blood Coagulation Tests; Blood Transfusion; Bone and Bones; Coumarins; Dextrans; Female; Fibrin; Genital Diseases, Female; Heparin; Humans; Microscopy, Electron, Scanning; Molecular Weight; Phlebography; Postoperative Complications; Prospective Studies; Pulmonary Embolism; Thromboembolism

Serum concentrations of fibrin degradation products were found to be higher during menstruation than in the intermenstrual phase. Higher concentrations were present in cases of menorrhagia as compared with healthy women and women with various gynaecological disorders but with normal menstrual function. Higher serum concentrations of fibrin degradation products in cases of menorrhagia may indicate increased local fibrinolytic activity in the uterus.

Topics: Adolescent; Adult; Female; Fibrin; Fibrinolysis; Genital Diseases, Female; Humans; Menorrhagia; Menstruation; Middle Aged; Uterus

Topics: Aminocaproates; Antifibrinolytic Agents; Aprotinin; Culture Techniques; Decidua; Endometrium; Female; Fibrin; Fibrinolysis; Genital Diseases, Female; Genital Neoplasms, Female; Hemorrhage; Humans; Methods; Placenta; Pregnancy; Thrombelastography; Uterine Cervical Neoplasms; Uterine Neoplasms; Uterus

The fibrinolytic components of uterine arterial and venous blood were studied in 14 patients undergoing various obstetrical and gynaecological procedures. There was a highly significant higher concentration of plasminogen activator, as measured by the euglobulin lysis time, and fibrin degradation products in the uterine venous blood.

Topics: Adult; Arteries; Blood Coagulation Tests; Female; Fibrin; Fibrinogen; Fibrinolysis; Fibrinolytic Agents; Genital Diseases, Female; Hemagglutination Inhibition Tests; Humans; Middle Aged; Models, Biological; Plasminogen; Pregnancy; Uterus; Veins

Topics: Abortion, Induced; Afibrinogenemia; Blood Transfusion; Curettage; Female; Fibrin; Genital Diseases, Female; Gynecology; Hemorrhage; Humans; Postpartum Hemorrhage; Postpartum Period; Pregnancy; Thrombin; Uterine Hemorrhage

Topics: Abortion, Induced; Abortion, Spontaneous; Blood; Female; Fibrin; Fibrinolysis; Genital Diseases, Female; Gynecology; Humans; Neoplasms; Obstetrics; Pregnancy; Uterine Neoplasms; Uterus