Background: Thrombosis will occur due to contact of blood with unepithelialized surfaces after vascular clamping and also blood stasis during vascular surgery. Heparin is administered to prevent thrombosis. The aPTT test is used for assurance of the anticoagulative effect of heparin. At the end of the operation heparin is neutralized by Protamine sulfate in some centers. In this study we assessed the necessity of aPTT and the use of Protamine during vascular surgery.Methods: In this case-control survey 154 cases of vascular surgery were divided in to two groups, while the groups were matched regarding age, underlying disease and for vascular complications during the first postoperative 24 hours. In group A (62 cases), aPTT was determined after 2 minutes of heparin administration but heparin was not neutralized by Protamine at the end of the operation.In group B (92 cases), aPTT was not determined after heparin administration but heparin was neutralized by an appropriate dose of Protamine at the end of the operation.Results: Complications were seen in 4 cases of vascular surgery (2.6 %): right leg embolus in 1 case (0.65 %), spinal ischemia in 1 case (0.65 %), neuropathy in 1 case (0.6%) and hypotension due to Protamine in 1 case (0.65 %). 3 cases were from group Aand 1 case was from group B, but differences were not statistically significant although the power is high enough (power=70%). Conclusion: According to our findings it seems with appropriate techniques and accomplishing surgical principles, there is no need for aPTT assessment and Protamine administration. This can reduce the cost and duration of operation, its complications, and prevent adverse reactions to Protamine.

Background & Objective: Bleeding is a common complication during heart surgery, and management of heparin and Protamine consumption during operation affects hemeostasis. The dosage of Protamine sulfate is variable based on the amount of heparin used and studies have reported different results. The aim of this study was to evaluate the effect of Protamine sulfate administration after cardiac surgery on the drainage of the patient's blood secretions. Methods: In this retrospective cross-sectional study, required data from 120 medical records patients, from 2011 to 2020 undergoing heart surgery, for example CABG, was extracted and examined. Patients were grouped (60 people in each group) and compared based on Protamine sulfate intake and not receiving it, in the intensive care unit and body mass index, age, sex, ACT values and blood drainage rate. Results: 76 (63. 37%) patients were male and 44 (36. 66%) patients were female. Most patients were in the age range of 50-70 years and most patients were overweight. Blood drainage in the Protamine group was significantly lower than the control group. There was no statistically significant difference between the two groups in terms of ACT values. Blood drainage in the Protamine group was significantly lower in normal BMI and overweight individuals than in the control group. The amount of blood drained in the Protamine group in women and in people over 70 years was significantly lower than the control group. Conclusion: despite previous studies, our study showed a reduction in the amount of postoperative bleeding following re-prescribing of Protamine sulfate in the intensive care unit, which eliminated the effect of heparin and the coagulation disorder caused by heparin. The limitations of the present study included patients under 12 years of age, patients weighing more than 120 kg, and patients requiring hypothermia treatment less than 28 Cº, .

Background and purpose: The optimization of an effective non-viral gene delivery method for genetic manipulation of primary human T cells has been a major challenge in immunotherapy researches. Due to the poor transfection efficiency of conventional methods in T cells, there has been an effort to increase the transfection rate in these cells. Protamine is an FDA-approved compound with a documented safety profile that enhances DNA condensation for gene delivery. Experimental approach: In this study, the effect of Protamine sulfate on the transfection efficiency of standard transfection reagents, was evaluated to transfect primary human T cells. In this regard, pre-condensation of DNA was applied using Protamine, and the value of the zeta potential of DNA/Protamine/cargo complexes was determined. T cells were transfected with DNA/Protamine/cargo complexes. The transfection efficiency rate was evaluated by flow cytometry. Also, the green fluorescent protein expression level and cytotoxicity of each complex were identified using real-time polymerase chain reaction and MTT assay, respectively. Findings/Results: Our results demonstrated that Protamine efficiently increases the positive charge of DNA/cargo complex without any cytotoxic effect on the primary human T cells. We observed that the transfection efficiency in DNA/Protamine/ Lipofectamine ® 2000 and DNA/Protamine/TurboFect TM was 87. 2% and 78. 9%, respectively, while transfection of T cells by Lipofectamine ® 2000 and TurboFect TM would not result in sufficient transfection. Conclusion and implications: Protamine sulfate enhanced the transfection rate of T cells; and could be a promising non-viral gene delivery method to achieve a safe, rapid, cost-effective, and efficient system which will be further applied in gene therapy and T cells manipulation methods.

During spermiogenesis, histones are replaced by Protamines (P1 and P2), resulting in sperm chromatin condensation followed by a halt in gene expression of haploid spermatids and spermatozoa. As a consequence, Protamine deficiency and aberrant P1/P2 ratio have a profound effect on both fertilization and embryo development. However, reports on the effect of the P1/P2 ratio on fertilization and embryo development after intracytoplasmic sperm injection (ICSI) are contradictory among human and animal studies. The question yet to be answered is which type of Protamine deficiency is most common among Protamine deficient samples. The main aim of this study was to investigate the possible correlations of the P1/P2 ratio with Protamine deficiency, fertilization, embryo quality, and embryo development in ICSI patients. It was carried out in 71 patients. Chromomycin A3 (CMA3) staining was used to determine Protamine deficiency. Since this procedure does not indicate the type of Protamine deficiency, the P1/P2 ratio was evaluated by nuclear protein extraction, acetic acid urea polyacrylamide gel electrophoresis, and analysis of protein bands with software. Polyclonal anti-P1 and anti-P2 antibodies were used to confirm P1 and P2 presence. Our results showed a statistically significant negative correlation of fertilization rate with Protamine deficiency and P1/P2 ratio. However, no significant correlation was observed between Protamine deficiency and P1/P2 ratio. Therefore, it can be concluded that altered P1/P2 ratio effects fertilization rate and embryo quality which subsequently may affect implantation and pregnancy outcome

Background: Administration of Protamine sulfate for heparin neutralization after cardiopulmonary bypass may be associated with adverse reactions such as transient hypotension to cardiovascular collapse. Although catastrophic events are rare and occur only in 2.6% of cardiac surgeries, it is associated with adverse postoperative outcome. The aim of this study is to investigate whether bolus administration of calcium gluconate can minimize the adverse hemodynamic effects of Protamine.Patients and Methods: This randomized clinical trial (RCT) prospective study was conducted between Feb. 2006 to Dec. 2008. The patients were randomly allocated into three groups including group A (42 patients) who received only Protamine after weaning from cardiopulmonary, group B (44 patients) concomitantly treated with Protamine sulfate and calcium gluconate, and group C (40 patients) receiving calcium gluconate 5 minutes before administration of Protamine. Hemodynamic variables such as systolic and diastolic blood pressures, mean of arterial pressure, central venous pressure and heart rate were obtained 0, 2, 4, 6, 8 and 10 minutes after Protamine administration from each group.Results: Systolic blood pressure in groups A (control) and C (calcium administration before Protamine) 0,2,4,6,8 and 10 minutes after Protamine administration initially decreased and increased subsequently (P=0.228). Also no statistically significant difference was found in diastolic blood pressure (DBP), mean arterial pressure (MAP), central venous pressure (CVP), and heart rate (HR) in 0,2,4,6,8, and 10 minutes in any of the three groups. Conclusion: In our study, hemodynamic changes in 10 minutes after Protamine administration for heparin neutralization in patients with good left ventricular systolic function after coronary artery bypass grafting surgery were mild, and prophylactic calcium gluconate administration concurrent with or before Protamine injection was not recommended.

Background: Although aberrant Protamine (PRM) ratios have been observed in infertile men, the mechanisms that implicit the uncoupling of PRM1 and PRM2 expression remain unclear. To uncover these mechanisms, in this observational study we have compared the PRM1/PRM2 mRNA ratio and mRNA contents of two regulatory factors of these genes. Materials and Methods: In this experimental study, sampling was performed by a multi-step method from 50 non-obstructive azoospermic and 12 normal men. After RNA extraction and cDNA synthesis, real-time quantitative polymerase chain reaction (RTQPCR) was used to analyze the PRM1, PRM2, Y box binding protein 2 (YBX2) and JmjC-containing histone demethylase 2a (JHDM2A) genes in testicular biopsies of the studied samples.Results: The PRM1/PRM2 mRNA ratio differed significantly among studied groups, namely 0.21±0.13 in azoospermic samples and -0.8±0.22 in fertile samples. The amount of PRM2 mRNA, significantly reduced in azoospermic patients. Azoospermic men exhibited significant under expression of YBX2 gene compared to controls (P<0.001). mRNA content of this gene showed a positive correlation with PRM mRNA ratio (R=0.6, P=0.007). JHDM2A gene expression ratio did not show any significant difference between the studied groups (P=0.3). We also observed no correlation between JHDM2A mRNA content and the PRM mRNA ratio (R=0.2, P=0.3).Conclusion: We found significant correlation between the aberrant PRM ratio (PRM2 under expression) and lower YBX2 mRNA content in testicular biopsies of azoospermic men compared to controls, which suggested that downregulation of the YBX2 gene might be involved in PRM2 under expression. These molecules could be useful biomarkers for predicting male infertility.