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Successful reconstruction of an ankle defect with free tissue transfer in a hemophilia A patient with repetitive hemoarthrosis:A case report

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World Journal of Clinical Cases 2023年第17期11卷 4079-4083页

作者： Dong Yun Lee SooA Lim SuRak Eo Jung Soo Yoon Department of Plastic and Reconstructive Surgery DongGuk University Medical CenterGoYang 10326South Korea

BACKGROUND Hemophilia, an uncommon yet consequential hereditary bleeding disorder, manifests as two clinically indistinguishable forms that hinder the normal functioning of the coagulation cascade. This impairment renders individuals more susceptible to excessive bleeding during significant surgical interventions. Moreover, individuals with severe hemophilia frequently encounter recurring hemarthrosis, resulting in progressive joint destruction and, subsequently, the need for hip and knee replacement *** SUMMARY The patient was a 53-year-old man with hemophilia A as the underlying disease and had self-injected factor Ⅷ twice weekly for several decades. He had undergone ankle fusion surgery for recurrent hemarthrosis at the Department of Orthopedic Surgery 1 mo prior and was referred to our department because of skin necrosis after a hematoma at the surgical site. An anterolateral thigh perforator free flap was created after three cycles of factor Ⅷ administration in addition to the concomitant administration of tranexamic acid(TXA)(Transamin 250 mg cap, 1 cap tid, q8h). After the operation, from postoperative days(PODs) 1-5, the factor Ⅷ dose and interval were maintained, and q12h administration was tapered to q24h administration after POD 6. Because the patient’s flap was stable 12 d after the operation, factor Ⅷ administration was tapered to twice a week. At 6 mo follow-up, the patient recovered well without any *** To the best of our knowledge, there are very few reports of successful free flaps in patients with hemophilia, and none have been reported in patients with hemophilia A. Moreover, there are several reports on the efficacy of TXA in free flaps in general patients;however, there are no case reports of combining factor Ⅷ and TXA in patients with hemophilia. Therefore, we report this case to contribute to future academic research.

关键词： Free tissue transfer Anterolateral thigh free flap Hemophilia A Hemoarthrosis Factor VIII tranexamic acid Case report

Photo-Initiated Coagulation Activation and Fibrinolysis Inhibition for Synergetic Tumor Vascular Infarction via a Gold Nanorods-Based Nanosystem

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CCS Chemistry 2022年第5期4卷 1770-1787页

作者： Sheng Hong Qian-Xiao Huang Zhenlin Zhong Lei Rong Xian-Zheng Zhang Key Laboratory of Biomedical Polymers of Ministry of Education Department of ChemistryWuhan UniversityWuhan 430072 Institute of Pharmaceutical Sciences China Pharmaceutical UniversityNanjing 210009

Tumor vascular infarction has been regarded as a promising therapy in tumor ***,due to the limited activity of designed coagulation agents,resulting from the challenges of inducing sustained and complete thrombosis and associated selectivity issues,the traditional vascular infarction strategy consequently results in treatment ***,we report a photo-initiated coagulation activation and fibrinolysis inhibition approach to achieve synergetic tumor vascular infarction via gold nanorods(AuNRs)-based nanosystem for the co-delivery of coagulation initiator thrombin and fibrinolysis inhibitor tranexamic *** a photo-initiated cascade reaction,thrombin and tranexamic acid could be released from the nanosystem to activate coagulation and inhibit the fibrinolysis within tumor *** integrating these two physiological reactions,fortified clots were formed,and tumor vessels were occluded steadily,affecting the metabolism of the tumor cells,thereby inhibiting tumor *** strategy might open an alternative path for the advancement of the current tumor vascular infarction strategy.

关键词： vascular infarction coagulation fibrinolysis gold nanorod thrombin tranexamic acid

4-((4-Chlorophenylsulfonamido)methyl)cyclohexanecarboxylic acid： Synthesis, Crystal Structure and Biological Activities

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Chinese Journal of Structural Chemistry 2017年第8期36卷 1307-1314页

作者： MUHAMMAD Danish RABIA Ayub Butt MUHAMMAD Nawaz Tahir MUHAMMAD Ashfaq SYEDA Tahira Hafeez MUHAMMAD Naeem Ahmed HALEEMA Qureshi Department of Chemistry University of Gujrat Gujrat 50700 Pakistan Department of Physics University of Sargodha Sargodha Pakistan Department of Chemistry University of Azad Jammu and Kashmir Muzaffarabad 13100 Pakistan

In this study, a novel 4-（（4-chlorophenylsulfonamido）methyl）cyclohexanecarboxylic acid（C（14）H（18）ClNO4S） was synthesized by the reaction of tranexamic acid and 4-chlororbenzene sulfonyl chloride in basic medium at room temperature. The molecular structure was determined by FT-IR, NMR, elemental analysis and single-crystal X-ray analysis. The compound crystallizes in the monoclinic system, space group P21/c with a = 12.3120（11）, b = 16.5987（19）, c = 7.6873（7）？, β = 90.495（6）o, Z = 4 and V = 1570.9（3）？~3, crystal size（mm） = 0.38 × 0.16 × 0.14 and Rint = 0.045. In this compound, the carboxylic acid A（O（1）/C（1）/C（2）） and the sulfonyl B（O（3）/S（1）/O（4）） moieties are of course planar. The molecules are dimerized due to the O–H…O type of H-bonding with the R22（8） ring motifs. The dimmers are interlinked through C–H…O and N–H…O types of H-bonding. The synthesized compound was screened against four bacterial and two fungal strains and inactive against all strains. Antioxidant activity was checked against DPPH. Enzyme inhibition activity was carried out using three different enzymes and the title compound was more potent α-chymotrypsin inhibitor.

关键词： sulfonamide tranexamic acid 4-chlorobenzenesulfonyl chloride XRD biological applications

UV Assisted Preliminary DNA Binding Studies and Single-crystal X-ray Structure of 4-{(4-Nitrophenyl-sulfonamido)methyl}cyclohexanecarboxylic acid

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Chinese Journal of Structural Chemistry 2017年第5期36卷 745-750页

作者： MUHAMMAD Danish RABIA Ayub Butt MUHAMMAD Nawaz Tahir MUHAMMAD Ashfaq SYEDA Tahira Hafeez Department of Chemistry University of GujratGujrat 50700Pakistan Department of Physics University of SargodhaSargodhaPakistan

A new sulfonamide, 4-{（4-nitrophenylsulfonamido）methyl}cyclohexanecarboxylic acid（C14H18N2O6S）, has been synthesized by the reaction of tranexamic acid and 4-nitrobenzenesulfonyl chloride in basic medium at room temperature. The molecular structure was determined by FT-IR, NMR, elemental analysis and single-crystal X-ray technique. X-ray diffraction shows that the compound crystallizes in the monoclinic system, space group P21/c with a = 13.5980（7）, b = 4.9877（2）, c = 23.3878（13） A, β = 93.254（3）°, Z = 4, V = 1583.67（14） A3, μ = 0.237 mm-1, F（000） = 720, R = 0.0471 and w R = 0.1182. The molecules are related by inversion and paired into dimers via C–H…O interactions. The dimmers are interlinked due to strong N–H…O bonds, where O-atoms are of sulfonyl groups. The molecules are stabilized in the form of infinite two-dimensional network with base vectors [0 1 0] and [0 0 –1] in the plane（1 0 2）. The existence of good intermolecular interactions suggests the biological importance of the synthesized molecule. The compound was screened for its interaction with FS-DNA using UV-visible spectroscopy. UV-visible spectroscopic results depict that the compound interacts with DNA by mixed binding mode intercalation along with hydrogen bonding. Negative values of ΔG（–23.34, –17.79 k J·mol-1） indicate spontaneity of the compound-DNA adduct formation.

关键词： sulfonamide tranexamic acid 4-nitrobenzenesulfonyl chloride XRD FS-DNA,intercalation

Using antifibrinolytics to tackle neuroinflammation

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Neural Regeneration Research 2020年第12期15卷 2203-2206页

作者： Stanimir Atsev Nikola Tomov Faculty of Medicine Trakia UniversityStara ZagoraBulgaria Institute of Anatomy University of BernBernSwitzerland

Plasmin is generally known as a promotor of *** advancement suggests that it has a complex role as immunity *** inhibition of plasmin production and activity has been proven to improve neurological outcomes in traumatic brain injury and subarachnoid hemorrhage,most probably by preventing *** immune-modulatory properties of antifibrinolytics,however,suggest that they probably have effects unrelated to fibrinolysis inhibition,which are currently not adequately *** present work aims to give an account of the existing data regarding antifibrinolytics as agents influencing *** and clinical studies on the possible influence of antifibrinolytics on neuroinflammation are ***,the emerging evidence suggests that inhibition of plasmin(ogen)activity can ameliorate neuroinflammation to some *** data demonstrate that plasmin(ogen)is not exclusively involved in fibrinolysis,but also has other substrates and can precipitate in inflammatory *** on the role of plasmin as the factor for the development of neuroinflammation shows the significant potential of antifibrinolytics as pharmacotherapy of neuroinflammationm,which is worthy of further exploration.

关键词： antifibrionolytics fibrin fibrinogen neuroinflammation plasmin plasminogen tranexamic acid

Cost Effective Trend in Epistaxis Management

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International Journal of Otolaryngology and Head & Neck Surgery 2023年第3期12卷 85-91页

作者： Roman Sereda Whitney Hall Department of Physician Assistant Medicine University of Tampa Tampa Florida USA

Background: Epistaxis affects much of the population and is a common medical complaint seen across a variety of medical settings. Current standard of care treatment includes a range of options from topical therapy to invasive intranasal device insertion in the absence of on-demand specialist involvement. Aim: The aim of this article is to not only highlight superior outcomes in patients with acute nontraumatic epistaxis that are treated with noninvasive nebulized tranexamic acid instead of more invasive options, but also monetary benefit to the community through reduced costs. Case Presentation: this case report highlights a successful epistaxis resolution with use of tranexamic acid in a 64-year-old female after she was subjected to intranasal device insertion that did not resolve bleeding. Conclusion: Nebulized tranexamic acid is a cost-effective medication that not only reduces rates of recurrence, but it also increases patient satisfaction while minimizing overall healthcare costs, and therefore should be the first choice therapy in uncomplicated epistaxis management.

关键词： Epistaxis TXA tranexamic acid Rhinorocket Nasal Packing