Tumours are capable of activating blood coagulation through the expression of procoagulant molecules such as tissue factor, cancer procoagulant and hepsin. Initiation of the clotting cascade results in the generation of the activated serine proteases factor VIIa, factor Xa and thrombin. These proteases act via protease-activated receptors and tissue factor to alter gene expression, thereby modu...

Preclinical studies in animals and ex vivo human blood have provided a solid rationale for conducting prospective randomized trials in trauma patients. Small animal models have been utilized to study the efficacy of recombinant activated factor VII (rFVIIa; NovoSeven) in treating thrombocytopenic rabbits and for the reversal of anticoagulation. Safety models in the rabbit also exist to test for...

Coagulation proteases are involved in a highly orchestrated proteolytic cascade which is essential for haemostasis and blood clotting. In particular, the initiator of the coagulation cascade, Factor VIIa, binds to its cofactor, tissue factor, and its substrate, Factor X, via exosite interactions to form a ternary catalytic complex named extrinsic Xase. These exosite interactions have also been ...

been detected in small fractions of uncommitted and lineage-committed hematopoietic progenitor cells, but the functional role of WT1 in the development and regulation of the normal hematopoiesis is currently not well characterized. Further, constitutive expression of wild-type or mutant WT1 has been demonstrated in a variety of hematologic malignancies and, particularly, in blasts of nearly all...

As described in detail in other chapters of this volume, conditions with excessive bleeding, as are seen with uterine rupture, placenta accreta, abruption and uterine atony, often require intensive resuscitation with blood components and coagulation factors. In such circumstances, blood transfusion may be life-saving, but on occasion involves exposing the patient to additional risks. Over the y...

Blood function defines bleeding and clotting risks and dictates approaches for clinical intervention. Independent of adding exogenous tissue factor (TF), human blood treated in vitro with corn trypsin inhibitor (CTI, to block Factor XIIa) will generate thrombin after an initiation time (T(i)) of 1 to 2 hours (depending on donor), while activation of platelets with the GPVI-activator convulxin r...

Recombinant factor VIIa (rFVIIa) has become available for treating people with hemophilia with inhibitors who experience bleeding or require surgery. It has become apparent that rFVIIa is useful in controlling bleeding in a variety of clinical situations. This review attempts to collate and summarize the nonhemophilia applications of rFVIIa. The theoretical mechanism for the coagulation and hem...

the severity of hypertensive attacks. The other recommended agent phentolamine, a short-acting alpha blocker, could not be used due to unavailability in our institution during this case. Magnesium sulphate is routinely used to control arrhythmias and hypertension in patients undergoing cardiovascular surgery and in the Caesarean section of preeclamptic patients or ICU patients. However, magnesi...