Fibrinolysis Following Electrically Induced Convulsions

Abstract

The application in this hospital of alternating current for electro-convulsive therapy (E.C.T.) and electronarcbsis in certain mental disturhances afforded the opportunity of investigating the effects of this form of therapy on some of the components of the hlood. Schiitz (1942) ohserved in vitro a delayed coagulation of blood following application of a weak direct current.Brecht and Kummer (1943) noted a leucocytosis immediately after electrical shock; there was no alteration of hlood sugar or protein.Spiegel-Adolf, Spiegel et al. (1945) reported that following the application of a 60 cycle current at 30 volts for 1-2 seconds there were changes in cerehrospinal fluid suggesting the hreakdown of nuclear substances. This statement, however, has since heen contradicted by M. Ii. Hack (1947). Huddleson (1946) observed haemorrhages in the central nervous system in rats following electrical shock. Trojaniello (1947) indicated that dogs subjected to electrical shock by alternating current at 120 volts for a fraction of a second, showed no changes in blood lipase and diastase, but that phosphatase aetivity decreased for about 12 hours. Delay and Soulairac (1943) observed, following E.C.T. in human subjects, a transient inerease in blood albumin, and oeeasionally a slight increase in the globulin fraetion. There was a concomitant increase of blood calcium and inorganic phosphate. Purther, hyperglycemia, leucocytosis, and a decrease in the alkali reserve were demonstrable. EXPERIMENTAL.Electrical convulsions were induced in suitable patients by alternating current (50 cycles) at 120 volts. Three to eight shocks, each of a duration of 0-1 seconds, were given. Blood samples were obtained by venepuncture before and after application of the current and mixed with one-ninth volume of 0-1 M sodium, oxalate solution. The ratio of plasma: cell volume was determined in tubes of uniform size and shape and centrifugation was carried out under identical conditions, which should ensure compai'able results, if not absolute values.

Studies on a Proteolytic Enzyme in Human Plasma. Ix. Fibrinogen and Fibrin as Substrates for the Proteolytic Enzyme of Plasma 1

“…The various experiments which have been described would appear to reconcile the contradictory reports of Christensen (1) and of Fantl and his associates (2,3). The digestion of both fibrinogen and fibrin by the plasma proteolytic enzyme results principally in the breakdown of the molecule whose molecular weight is approximately 400,000 to 700,000 to molecules whose molecular weight is approximately 100,000 (7).…”

“…When either plasma or serum mixed with fibrinogen was diluted with buffer, and optimal amounts of streptokinase were added, the proteolytic enzyme was activated whether or not the fibrinogen had been clotted by thrombin. (3) The time required for the spontaneous digestion of fibrinogen and fibrin in oxalated plasma Fantl and Simon (2) reported that the clotted plasma of patients who had been given electric shock therapy underwent fibrinolysis before appreciable digestion of fibrinogen was noted. If this were the case, then one might infer that the spontaneous activation of the plasma proteolytic The relative effect of streptokinase upon the digestion of fibrinogen and fibrin in human serum Time required for digestion of (a) fibrin, in a mixture of 0.1 ml.…”

“…This observation has been challenged by Fantl, Simon, and Fitzpatrick (2,3) who claimed that fibrin is a more suitable substrate for this enzyme than fibrinogen.…”

Studies on a Proteolytic Enzyme in Human Plasma. Vii. A Fatal Hemorrhagic State Associated With Excessive Plasma Proteolytic Activity in a Patient Undergoing Surgery for Carcinoma of the Head of the Pancreas 1

“…The inhibitory activity of plasma against the plasma proteolytic enzyme was tested against purified bovine plasma proteolytic enzyme. 4 The enzyme was dissolved in buffer and standardized in the following manner: The enzyme solution was serially diluted with buffer, 0.3 ml. of each dilution was pipetted into pyrex tubes (internal diameter, 8 mm.)…”

“…Abnormally rapid fibrinolysis has been observed in blood drawn from patients with a wide variety of diseases (1)(2)(3). Rapid fibrinolysis has also been seen in the blood of patients undergoing electric shock therapy (4), and in patients with shock as the result of burns or hemorrhage (5).…”