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Biotech / Medical : Biotime-Nasdaq's best kept secret? -- Ignore unavailable to you. Want to Upgrade?

To: Jim Roof who wrote (830)	4/12/1998 5:44:00 PM
From: Stephen How	Respond to of 1432

I finally reviewed the medical literature on coagulopathy of hydroxyethyl starch (HES) plasma expanders. I found the material very readable and relevant to the controversy of Hextend's improved coagulation properties over hetastarch. The issue of HES coagulation has been researched for over 30 years. Several good tutorial review papers were published in the last few years. Although the issue remains unresolved, the consensus seems to be that the high weight hetastarch molecules (MW = 480 kD) interferes with clotting factors, especially for repeated administrations. The trend seems to be the use of lower MW HES solutions as pentastarch (280 kD) in Canada, and 200 kD HES in Europe. It seems the US is behind the trend in it's continued use of hetastarch (480 kD). I've written a summary of what I learned at btim.dyn.ml.org Again, I'm skeptical that any simple addition of Ca solves this long and actively studied, not-completely-understood mechanism. Anecdotally, I found a study that administered 5 l of hetastarch to 4 trauma patients in 1983. Steve

To: Jim Roof who wrote (830)	4/12/1998 6:00:00 PM
From: Stephen How	Respond to of 1432

I found some data on the annual U.S. hetastarch usage while reading about coagulopathy. I interpreted a US hetastarch sales figure of $50M/year based on a $46/liter cost from [1]. I didn't do any calculation, but just translated from their context of a savings calculation of hetastarch relative to albumin. [1] Warren BB, Durieux ME. Hydroxyethl starch: safe or not? Anesth Analg 1997; 84: 206-12. Steve btim.dyn.ml.org

To: Jim Roof who wrote (830)	4/15/1998 1:49:00 AM
From: Stephen How	Read Replies (1) \| Respond to of 1432

Reference #3 in the Phase III Trial Poster Presentation (16th Annual Symposium Clinical Update in Anesthesiology, San Juan, Puerto Rico; siliconinvestor.com is invalid. The reference reads: "3. Bick RL. Evaluation of a new hydroxyethyl starch preparation (Hextend) on selected coagulation parameters. Clin Appl Thrombosis/Hemostasis 1995; 1:215-29." I couldn't find the reference either on Medline, or at the local UC medical library. There are quite a few related papers by Bick RL, but I couldn't find the journal "Clinical Applications of Thrombosis ..." in the medical library. Neither was there any paper with a similar title by Dr. Bick. Here's the Medline search I used: ncbi.nlm.nih.gov (Or, go to ncbi.nlm.nih.gov and enter Bick [AU] AND coagulation or Bick [AU] AND hydroxyethyl or just Hextend ) I'll try to contact the authors, and Dr. Bick at the University of Texas Southwestern Medical Center and Dallas Thrombosis Hemostasis Clinical Center. Steve btim.dyn.ml.org