In the urological field, the fibrin-clot included blood-clot in the urine is one of the important problems in a sense of obtaining good urine output through the urinary tract.
Recently, as fibrinolytic preparations advanced, these have been administered to the treatment of vascular occlusive diseases such as thrombosis.
In urine, there is a fibrinolytic enzyme i. e. urokinase (U. K.), and uropepsin, trypsin-inhibitory substance and a thromboplastin-like substance are pointed out as substances associated with this enzyme.
This paper reviews my experience about clotting and dissolution of the blood in urine reacted with these preparations in vitro.
1. The experiments of 1ml of these preparations to 10g of blood-clot in 30ml of urine:
1) Urokinase: A solution of 5, 000 and 2, 500u/ml dissolved the blood-clot initially incompletely, but thereafter clotted total urine with blood, and then redissolved the urine and the blood-clot.
The solution of 1, 250, 625 and 312.5u/ml did not clot it temporarily, but dissolved it completely. The solution of 625u/ml to the blood-clot in urine dissolved extremely.
2) Plasmin: The dissolution of the solution of 62.5u/ml to the blood-clot in urine was extreme, also that of 31.25u/ml.
The dissolution of the higher concentrated solutions was later and incomplete than that of 62.5u/ml.
3) Streptokinase: The dissolved curve of the solutions ranging from 3, 125 to 50, 000u/ml to the hood-clot were almost parallel to the concentration of the solution, but that of 6, 250u/ml was most rapidly.
2. The clotting and dissolution of 2.5ml of the venous blood and 0.5ml of U. K.—solutions in 7.5ml of urine:
1) The clotting time; The clotting of the total urine with the blood was observed. The control without U. K. clotted after 46 minutes. When the U. K.—solution of 1, 350u/ml was added the sample added the purified U. K. and the commercial U. K. clotted after 51 and 61.5 minutes respectively.
2) The dissolution: The dissolution of the clot added to purified U. K. was most rapidly up to 170 minutes, but equivalent dissolution of the clot added to purified U. K. and of the control was at 170 minutes.
In general, the dissolution of the clot added to commercial U. K. was latest.
3. The clotting and dissolution of 0.25ml of U. K.—Solution on 2.5ml of the fresh venous blood involved 0.5g of the same patient's fresh blood-clot. The concentration of U. K.—solution was 1, 350u/ml.
1) The clotting time: The clotting time of the control without U. K., that added the purified U. K. and the commercial U. K. were 21 minutes and 5 seconds, 14 minutes and 30 seconds, and 20 seconds respectively.
2) The clot added to purified U. K. and commercial U. K. dissolved much more rapidly than the control.
4. The clotting time of 10ml of the urine with 2ml of the same patient's venous blood added 0.1ml of Trostin (Chugai)—solution and 0.1ml of Thrombokinase (Geigy)—solution was shorter than the control without these thromboplastin agents.
Thereafter, the dissolution time of the U. K.—solution (1.0ml) ranged from 100 to 500u/ml to total clotting was from 180 to 900 minutes, but that of the control without U. K. could not be observed at 1, 800 minutes.
The dissolution time of the PL-solution (1ml) of 250u/ml was 146 minutes, and 125u/ml 165 minrutes, 25u/ml ranged from 180 to 900 minutes.
5. In series of 15ml of urine added to 0.5ml of U. K.—solution of 312.5u/ml, PL-Solution of 62.5u/ml, SK-solution of 3, 125u/ml respectively, the control without thromboplastin agent, and the sample added Trostin-solution, Thrombokinase-solution and Trostin-solution plus Thrombokinase-solution were prepared respectively.
Thereafter, 5ml of banked blood, 0.1ml of CaCl₂ and 0.1ml of thrombin were added to these samples.