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Dextran

Dextran is a branched polysaccharide made of many glucose molecules joined into chains of varying lengths. The straight chain consists of α1->6 glycosidic linkages between glucose molecules, while branches begin from α1->3 linkages (and in some cases, α1->2 and α1->4 linkages as well). (For information on the numbering of carbon atoms in glucose, see the glucose article.) Dextran is synthesized from sucrose by Leuconostoc mesenteroides streptococcus, and are also produced by bacteria and yeast. Dental plaque is rich in dextrans. more...

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Uses

Microsurgery uses

These agents are used commonly by microsurgeons to decrease vascular thrombosis. The antithrombotic effect of dextran is mediated through its binding of erythrocytes, platelets, and vascular endothelium, increasing their electronegativity and thus reducing erythrocyte aggregation and platelet adhesiveness. Dextrans also reduce factor VIII-Ag Von Willebrand factor, thereby decreasing platelet function. Clots formed after administration of dextrans are more easily lysed due to an altered thrombus structure (more evenly distributed platelets with coarser fibrin). By inhibiting α-2 antiplasmin, dextran serves as a plasminogen activator and therefore possesses thrombolytic features. Outside from these features, larger dextrans, which do not pass out of the vessels, are potent osmotic agents, and thus have been used urgently to treat hypovolemia. The hemodilution caused by volume expansion with dextran use improves blood flow, thus further improving patency of microanastomoses and reducing thrombosis. Still, no difference has been detected in antithrombotic effectiveness in comparison of intraaterial and intravenous administration of dextran. Dextrans are available in multiple molecular weights ranging from 10,000 Da to 150,000 Da. The larger dextrans are excreted poorly from the kidney and therefore remain in the blood for as long as weeks until they are metabolized. Subsequently, they have prolonged antithrombotic and colloidal effects. In this family, dextran-40 (MW: 40,000 Da), has been the most popular member for anticoagulation therapy. Close to 70% of dextran-40 is excreted in urine within the first 24 hours after intravenous infusion while the remaining 30% will be retained for several more days. Although there are relatively few side-effects associated with dextran use, these side-effects can be very serious. These include anaphylaxis, volume overload, pulmonary edema, cerebral edema, or platelet dysfunction. An uncommon but significant complication of dextran osmotic effect is acute renal failure. The pathogenesis of this renal failure is the subject of many debates with direct toxic effect on tubules and glomerulus versus intraluminal hyperviscosity being some of the proposed mechanisms. Patients with history of diabetes mellitus, renal insufficiency, or vascular disorders are most at risk. Brooks and others recommend the avoidance of dextran therapy in patients with chronic renal insufficiency and CrCl<40 cc per minute.

Other medical uses

It is used in some eye drops as a lubricant, and in certain intravenous fluids. Dextran in intravenous solution provides an osmotically neutral fluid that once in the body is digested by cells into glucose and free water. It is occasionally used to replace lost blood in emergency situations, when replacement blood is not available, but must be used with caution as it does not provide necessary electrolytes and can cause hyponatremia or other electrolyte disturbances. It also increases blood sugar levels.

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Detection of gastric and colonic sentinel nodes through endoscopic administration of ^sup 99m^Tc-DTPA-mannosyl-dext ran in pigs : An article from: The Journal of Nuclear Medicine $20.00 Dietary nucleotides augment dextran sulfate sodium-induced distal colitis in rats : An article from: The Journal of Nutrition $20.00
Epidural hematoma associated with dextran infusion.(Case Report) : An article from: Southern Medical Journal $5.95

Agarose-dextran gels as synthetic analogs of glomerular basement membrane: Water permeability
ABSTRACT Novel agarose-dextran hydrogels were synthesized and their suitability as experimental models of glomerular basement membrane was examined by ...
Early resuscitation with hypertonic saline/dextran in uncontrolled intra-abdominal bleeding in swine combined with a soft tissue gunshot wound
The effects of hypertonic saline/dextran (HSD) on hemodynamics and on rebleeding were studied during an uncontrolled intra-abdominal hemorrhage combined ...
Magnetic resonance of a dextran-coated magnetic fluid intravenously administered in mice
ABSTRACT Magnetic resonance was used to investigate the kinetic disposition of magnetite nanoparticles (9.4 nm core diameter) from the blood circulation ...
Dextran syndrome: acute hypotension, noncardiogenic pulmonary edema, anemia, and coagulopathy following hysteroscopic surgery using 32% dextran 70
Dextran solutions are favored distending media for many hysteroscopic procedures because they are easy to administer, distribute uniformly within the uterine cavity, and are relatively nontoxic. We p
Dextran 70 embolization: another cause of pulmonary hemorrhage, coagulopathy, and rhabdomyolysis
Thirty-two percent dextran 70 is a highly viscous polysacharide liquid used for uterine distention during hysteroscopy. Although generally safe, this ...
Investigation of phospholipid area compression induced by calcium-mediated dextran sulfate interaction
ABSTRACT The association of anionic polyelectrolytes such as dextran sulfate (DS) to zwitterionic phospholipid surfaces via Ca2+ bridges results in a perturbation of lipid packing at physiologically
Anomalous Diffusion of Proteins Due to Molecular Crowding
ABSTRACT We have studied the diffusion of tracer proteins in highly concentrated random-coil polymer and globular protein solutions imitating the crowded ...
Effect of Aloe vera on nitric oxide production by macrophages during inflammation
Byline: D. Sarkar, A. Dutta, M. Das, K. Sarkar, C. Mandal, M. Chatterjee OBJECTIVE : To demonstrate the mechanism of action mediating the acute and ...

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