Biomedical subjects
Publications and source records attributed to G W Farrell.
A method is described for distinguishing coagulation from fibrinolysis by three estimates of fibrinogen. This "fibrinogen series" together with plasma antithrombin and urinary urokinase have been compared in pregnant patients with venous thrombosis and pre-eclampsia. Evidence is presented for active coagulation during deterioration of the pre-eclampsia state and for enhanced fibrinolysis during improvement.
A method for estimating thrombin clottable fibrinogen in a large number of plasma samples is described. This method is based on measuring the optical density difference of a diluted plasma and its corresponding serum after incubation at 59 degrees C in the presence of 10% NaCl. The method gave excellent correlation with previously described thrombin clottable estimates, but was easier to perform and more accurate when estimating friable thrombin clots. The method is compared with measurements of heat-coagulable plasma protein described by Thorp (1967) and by Millar, Simpson, and Stalker (1971), and direct optical density measurement of plasma after thrombin treatment (Burmester, Aulton, and Horsfield, 1970). The feasibility of automating the proposed technique together with immunoreactive fibrinogen estimates is discussed.
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In individuals in a steady state of fibrinogen metabolism, immunoreactive and clottable fibrinogen estimates of plasma fibrinogen show close agreement. These estimates also detect any increase of plasma fibrinogen (due to increased synthesis) following metabolic stresses but in certain circumstances discrepancies between immunoreactive and clottable fibrinogen values occur which are of diagnostic assistance.During extensive thrombosis, circulating ;cryoprofibrin' (fibrin intermediates) may be formed. These fail to give full quantitative immunodiffusion reactions with antifibrinogen. Values for immunoreactive are therefore lower than for clottable fibrinogen. When intravascular catabolism (due to plasmin action) accompanies increased synthesis, since some of the molecular breakdown products of fibrin or fibrinogen react with antifibrinogen but are not clottable, immunoreactive values exceed those for clottable fibrinogen. This discrepancy is therefore an indicator of thrombolysis. Each discrepancy in turn may be encountered during the alternating predominance of thrombosis or thrombolysis in vivo: (a) physiologically, in association with the menstrual cycle; (b) pathologically, following surgical operations or extensive intravascular thrombosis.
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