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2 SK-euglobulin streptokinase-euglobulin activity= total plasmin) euglobulinstreptokinase SK) SP-euglobulin (spontaneous-euglobulin activity=free plasmin) free plasmin 3) anti plasmin =SK-euglobulin lysis time

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27 1) Duke, W. W. : JAMA, 55 : 1185, ) Lee, R. & White, P. D. : Am. J. Med. Sci,, 145 : 495, ) Quick, A. J. : Am. J. Med. Sci,, 190 : 501, ) Stefanini, M. Sr Crosby, W. H. Proc. Soc. Exp. Biol. Med., 73 : 301, ) Foliw, O. & Ciocatter, V. : 3. Biol. Chem., 73 : ) Quick, A. J. : Hemorrhagic Disease, P 436, Lea & Febiger, Philadelphia, ) Stefanini, M. & Paresheck, W. : The Hemorrhagic Disorder, A Clinical and Therapeutic Approach. Minophagen Medical Review, 10: 119, ) Astrup,T.& Mullertz, S. : Arch.Biochern. & Bioph)., 40 : 346, ) Downie, G. R. & Cliffton, E. E. : Proc. Soc, Exper. Med., 71 : 138, : Minophagen Medical Review, 10 : 125, ) Drabkin, D. L. et al, : Medical Physics. 2 : 1072, ) Simons & Gentzkow : Medical & Public Health Laboratory Method, P 141, ) Siggaard-Andersen, O_ et al, : Scand J. Clin. Lab. Invest., 12 : 177, ) Astrup, P. et al, : Lancet, 1 : 1035, ) Siggaard -Andersen, O, et al, : Scand. J. Clin, Lab. Invest., 14 : 598, ) von Kaulla, K. N. et al. : Blood, 13 : , 22) Remmert, L. R. & Cohen, P. P. et al. : J. Biol. Chem,, 181 : 431, ) Kunitz, M. et al. : J. Gen. Phisiol,, , ) Normann, P. S. et al. : J. Exper. Med., 108 : 53, ) Normann, P. S. et al. : J. Exper. Med., 108 : 639, 1958, 28) Osborn, J. et al. : Surg. Forum, 8 : 96, ) Nillson, I. M. et al. : Acta Chir. Scanidnay., 117 : 47, ) Gans, H. et al : Ann. Surg., 154 : 915, ) Tice, D. A et al. : J, Thoracic Cardiovas. Surg., 46 : 673, ) Andersen, M. N. et al. : Archives of Surg., 86 : 649, ) Kevy, S. V, et al, : Surg. Forum, 15 : 282,

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29 FIBRINOLYSIS DURING AND AFTER EXTRACORPOREAL PERFUSION TOSHIHIDE OKI The 2 nd Department of Surgery, Gunma University School of Medicine, Maebashi, Japan (Director: Prof. Masao Fujimori) Experimental studies were performed on 28 hybrid dogs in order to elucidate changes of fibrinolysis during extacorporeal perfusion. In clinical series of 43 cases undergoing open heart surgery, activations of the fibrinolytic enzyme system have been observed during and after extracorporeal perfusion. Every episode of excessive oozing or bleeding following open heart surgery seems practically to be related to a significant increase in activity of this enzyme system. In the treatment for this fibrinolysis were dosed several anti plasmin agents. Following results were obtained: 1) Fibrinolytic activity was advanced in more hypothermia than normothermia during the extracorporeal perfusion, and was not concerned to any kind of the diluent (Haemacel, Hartmann ph 8 ). 2) Free and total plasmin activity was elevated to the muximum in about 30 minutes to 60 minutes after the beginning of perfusion in most cases. Activation of plasmin was detected in the above under surgical procedure. 3) And this investigation was naturally undertaken to evaluate new method of determining anti plasmin activity with the tool of SP-Plasma after standard plate. 4) Again fibrinolytic activity was advanced twice relatively one and six hours from postperfusion. Heparin was neutralized with protamine sulfate 4 mg/kg, which was verified to be optimum volume, 5) Dosages of the anti plasmin agents (EACA, AMCHA, Trasylol) were used in 10 minutes and 6 hours postperfusionally. Fibrinolysis was chiefly inhibited by means of EACA 0.1g/kg, AMCHA 0. 04g `0. 06/kg. 6) Perfusuate combined heparinized blood with Ringer' solution { Haemacel { Mannitol was least hemolysic, 7) According to change the respiratory alkalosis, total plasmin activity was advanced. Negative correlation was found between fibrinolytic activity and a significant increase of the metabolic acidosis.

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