Some properties of the cancer coagulative factor

1916-2016: a centenary of publications

Last year, the centenary of the 1916 Easter rising in Ireland was marked by a commemorative programme organised by the Irish government including both historical and cultural events. The main themes of these events were remembering the past, celebrating Irish achievements and imagining our future. Reviewing the medical literature offers an insight into a century of achievement and change in Irish medicine, captured from the unique perspective of Ireland's oldest medical journal. This manuscript examines papers published during the last 100 years of the Irish Journal of Medical Science, specifically examining the most cited paper from each year. The majority of top cited papers originate in Ireland (77%) with Trinity College Dublin the commonest institution (n = 12) and obstetrics the most common specialty (n = 9). The average number of citations per article was 20.56 (SD ± 22.36; range 1-118) and the article with most citations was 'Coagulative properties of cancers' published in 1958 by O'Meara et al. The mean number of citations for the top cited publication each year has increased over time. The journal continued to publish even amidst backgrounds of war and civil unrest and represents an important cultural artefact that deserves our ongoing support.

Treatment of advanced breast cancer with chemotherapeutics and inhibition of coagulation and fibrinolysis

A case of advanced breast cancer with cerebral metastasis and pleurisy is reported in which irradiation and cytostatics had failed to retard progressive growth and spread of the tumour. Adjuvant therapy with heparin combined with the fibrinolytic inhibitor tranexamic acid was followed by regression of the cerebral metastasis as well as the pleurisy. When last seen one year later, the patient was free from symptoms.

Cancer procoagulant

Cancer procoagulant is a unique cysteine proteinase. The enzyme has been purified by several procedures and many of its characteristics and enzymatic properties have been determined. Several sensitive and reproducible assays are now available. Many proteinase inhibitors have been evaluated for their effect on CP; most low molecular weight inhibitors work well in a reduced environment. In the foreseeable future, protein and gene sequence information, expression vectors, molecular probes, and highly specific antibodies and inhibitors should provide the research tools to delineate a functional understanding of CP at the molecular and cellular level.

Isolation and characterization of cancer procoagulant: a cysteine proteinase from malignant tissue

Cancer procoagulant, a proteolytic procoagulant enzyme, has been purified from rabbit V2 carcinoma extracts by two procedures. In the first, the protein was purified by benzamidine--Sepharose affinity chromatography, gel filtration chromatography, and phenyl-Sepharose hydrophobic chromatography. Antiserum was raised against the purified protein and was used to prepare an immunoadsorbent column. In the second, tumor extracts were purified by immunoaffinity chromatography followed by p-(chloromercuri)benzoate affinity chromatography. The second procedure was substantially quicker and easier. The final product of both procedures was homogeneous on the basis of analytical sodium dodecyl sulfate--polyacrylamide gel electrophoresis and isoelectric focusing. The molecular weight was 68 000 and the isoelectric point 4.8. The proteinase activity of cancer procoagulant directly activated factor X, in the absence of factor VII, and was inhibited by 1 mM iodoacetamide and 0.1 mM mercury which are classic cysteine proteinase inhibitors. A carbohydrate analysis showed less than 1 mol of hexose or sialic acid/mol of protein. The amino acid analysis showed that serine (19.1%), glycine (18.77%), and glutamic acid (12.5%) were the prevalent amino acids. The amino acid composition of cancer procoagulant was substantially different than other known factor X activating proteinases or other cysteine proteinases including cathepsin B.

Is the formation of fibrin a necessary event for the initiation of angiogenic responses in the chick chorioallantoic membrane?

Millipore filters belong to number of solid materials which interact with the chorioallantoic membrane (CAM) and frequently initiate local edemas sometimes accompanied by vascular responses. We observed that such reactions can completely be prevented by coating Millipore filter pieces with hydrophilic polymers (e.g. polyvinylpyrrolidone dextran) or by hydrophobic substances as liquid paraffin and vaseline. Protease inhibitors (Contrikal, epsilon-aminocaproic acid) did not prevent such reactions but increased the incidence of vascular responses. By assaying several blood components we found a relationship between the initiation of vascular responses in the CAM and the process of blood clotting. If small amounts (5 to 10 microliter) of citrated bovine or human plasma arae dropped on the CAM angiogenic responses occur as good as regularly. They are also initiated if the plasmas are recalified and small fibrin fragments are placed on the CAM. Chicken plasma, however, regularly induced such responses only in combination with bovine serum or following application of (or treatment with) fibrinolysis inhibitors. We conclude that the formation of a stable extravascular plasma clot with reduced susceptibility to fibrinolysis could be the most important precondition for the initiation of vascular responses, and that all materials, substances or biofactors capable of activating the clotting cascade should also have the capacity to induce angiogenic responses.

Clinical significance of "circulating fibrin monomers'

During the decade 1970-9 we investigated circulating fibrin monomers in 3293 patients. Fibrinaemia was determined by means of the ethanol gelation test (EGT). This was positive in 149 patients (4.5%) and was highly correlated with fibrogenal fibrin products. In many diseases the test was only transiently positive (1 or 2 days). However in patients with circulating fibrin monomers, demonstrable for more than 5 days (chronic fibrinaemia) malignant disease was associated in 63%. Chronic fibrinaemia occasionally preceded overt malignancy by a long period. Overall, only 10.8% of patients with malignant disease showed chronic fibrinaemia. The clinical symptoms most often associated with chronic fibrinaemia were those of venous thrombosis (42.8%) and abnormal bleeding (10.7%). Thromboembolism in the absence of malignant disease only occasionally showed short-term positive EGT and chronic fibrinaemia was never seen. Almost half (46.5%) of patients with chronic fibrinaemia had neither thromboembolic disease nor a haemorrhagic diathesis.

Invasion of veins by carcinoma of rectum: method of detection, histological features and significance

Histopathological material from operation specimens of rectal adenocarcinoma was reviewed and invasion of veins identified in 51.9% of 703 cases. The extent of venous invasion, thickness of the walls of invaded veins and various other histological features were examined in detail. By follow-up studies recurrence rates, incidence of distant metastases and corrected 5-year survival rates were obtained; correlation with the histopathological results showed that invasion of extramural and thick-walled veins is associated with a poor prognosis independent of the degree of differentiation of the adenocarcinoma. Prognosis is not significantly related to the presence of necrosis of intravenous tumour and a clearly defined stroma in the intravenous growth all appear to exert a protective influence on patient survival. Whereas permeation of capillaries in vein walls, the presence of loose clumps of tumour cells in veins and direct contact between tumour cells and venous blood appear to adversely affect survival. Venous invasion is shown to be related to local invasiveness of rectal carcinoma. Suggested modes of venous spread and interaction with host tissues are proposed, with implications for general attitudes to the spread of cancer and metastasis.

Thromboplastic and fibrinolytic activities of V2 and V7 carcinomas of rabbit, with special reference to fibrin deposition and thrombus formation in the tumors

Thromboplastic and fibrinolytic activities of V2 and V7 carcinomas, the two transplantable rabbit tumors of the same viral origin, were studied in relation to fibrin deposition and thrombus formation in the tumors. Thromboplastic activity of V7 carcinoma was comparatively high, while that of V2 carcinoma was as low as that of muscle tissue. More fibrin deposits in the stroma and more thrombi in the small vessels were found at the advancing border of V7 carcinoma than that of V2 carcinoma. These differences might be associated with higher thromboplastic activity of V7 carcinoma than that of V2 carcinoma. Fibrinolytic activity of both tumors was high and it was confirmed to be localized in the tumor cells by Todd's method. Fibrin deposits in the stroma were found more abundantly somewhat apart from the advancing border of the tumor nests of both tumors. It was suggested that plasmin activated by plasminogen activator released locally from the tumor cells might digest fibrin deposited in the stroma just close to the tumor nests.

Plasminogen-activator-producing tumour

In a patient with giant-cell carcinoma of the lung a secondary tumour deposit in the arm was incised and bled for three weeks. Investigations showed the tumour to be rich in plasminogen activator. Haemostasis in the tumour was achieved with aminocaproic acid therapy. For a period the plasminogen-activator properties were retained in cell culture of the tumour.