bluuebunny/crossref_metadata_2025 huggingface dataset:
Aspirin Reduces Vascular Damage And Myointimal Proliferation In Canine Pulmonary Arteries Subjected To Chronic Injury
Authors: Schaub Robert G , Keith James C , Rawlings Clarence A
Published: July 2018

Scanning electron microscopy (SEM) was used to study pulmonary artery injury 4 days (10 dogs) and 30 days (8 dogs) after transplantation of 6-8 adult canine heartworms (HW) into the pulmonary arteries. Worms were introduced into the jugular vein and allowed to float into position in the main pulmonary artery, where HW are found in naturally occurring infections. One half the dogs in each group were given 323 mg aspirin (ASA)/day starting 3 days before infection. At the end of the 4 or 30 day period all dogs were given 1% Evan’s blue dye (2 ml/kg i.v.), heparin (3,000 units i.v.) and anesthetized. The lungs were perfused at 15 mmHg pressure with Tyrode’s solution followed by 1% glutaraldehyde. Evan’s blue stained areas of pulmonary arteries were dissected and processed for SEM. Dogs were compared for the percentage of surface with endothelial damage, white blood cell and platelet adhesion, and myointimal proliferation. All numerical values show treated dogs vs non-treated dogs (mean ± SE). After 4 days of HW infection the blood vessels of both ASA treated and non-treated dogs exhibited extensive endothelial damage (51 ± 8% vs 81 ± 6%), white blood cell adhesion (56 ± 15% vs 60 ± 12%) and platelet adhesion (36 ± 6% vs 51 ± 9%). Neither group exhibited formation of myointimal proliferation. After 30 days of HW infection blood vessels from ASA treated dogs had less endothelial cell damage (15 ± 6% vs 33 ± 14%), less white blood cell adhesion (13 ± 2% vs 45 ± 9%) and less platelet adhesion (0% vs 25 ± 9%) than non-treated dogs. Myointimal proliferation was observed in both groups (50 ± 16% vs 61 ± 14%), however, the lesions were smaller and less complex in ASA treated dogs. These results suggest that after 4 days of HW infection ASA was ineffective in preventing vascular damage and platelet-leukocyte adhesion. However, continuous ASA therapy during the chronic vascular injury produced by a 30 day HW infection reduced platelet-leukocyte adhesion and the severity of myointimal proliferation. These findings support the suggestion that aspirin protects against formation of atherosclerotic lesions.
Stress Of Unemployment As Risk Factors And Atherosclerosis
Authors: Saxena R P
Published: July 2018

Selye defined stress as the body's non-specific response to any demand on its resources. Unemployment is a stress which is equivalent to a bereavement in the family. In a period of one year, in a Health Centre, patients were screened for lipid profile studies, history of stress (ideas of intrusion and avoidance), hypertension, overweight and cigarette smoking, who were between the ages of 35 and 60 years, and of both sexes.

95% who had more than an 85 score on the scale of intrusion and avoidance, were found to have hypertension, they smoked more than 15 cigarettes, had raised triglycerides and total cholesterol. In thirteen patients there was raised IgA (only 27 patients were tested for immunoglobins). These findings suggest that during stress there could be more incidence of atheroma. There are a few behavioural techniques which can be taught e.g. change of behaviour from A to B; desensitization of stress; inoculation of stress and increased compliance to raise the aerobic power to face the stressor

So a hypothesis can be put forward that stress is the main factor to be emphasised in preventive cardiology, along with the other three factors; hypertension, lipid and smoking
Atherogenesis, Lipid Hypothesis And Clofibrate
Authors: Villaverde C A , Escolar G , Badimón J J , Badimón L , Valdecasas F G
Published: July 2018

A WHO cooperative trial in hypercholesterolemic patients treated with clofibrate (Cf) shows a higher index of mortality in treated patients (Lancet, 378, 1980). A previous hyperlipidic diet (HL) (butter, cholesterol, cholic acid, thiouracil) protects the rats against the atherosclerotic lesions induced by vit D2; contrarily, the administration of HL following to vit D2 impairs the lesions, reaching an optimal experimental model of atherosclerosis (AT) (Villaverde et al. Proc. X I.G. Angiology, 285, 1976).
We have studied the implication of the biochemical changes induced by HL, and the influence of Cf on the experimental model AT in rat. The HL, that did not produce vascular injury during the period of experiment, induced an increase in cholesterol, from 76 to 717 mg/dl, changing the total-cho/HDL-cho ratio (cho-R) from 1.1 to 8.7. The index of thrombodynamic potential increased from 48 to 66 and fibrinolytic activity in whole blood decreased significantly (2p<0.02). Cf, administrated at doses of 60, 120 and 240 mg/Kg/day during the 15 days of AT-model, produced a significant decrease in the seric lipid levels. Mortality reached an increase from 28.7%AT to 40% AT-Cf60, 45% AT-Cf120, and 55% AT-Cf240; vascular lesion degree in survive animals, evaluated by an arbitrarily index gave: AT 2.54; AT-Cf60 2.5; AT-Cf120 2, and AT-Cf240 1.77. The lipid hypothesis seems to have a relative value conditioned to other factors as the alteration produced by overdose of vit D2. The increase in cho-R induced by HL has not a predictive previous value in the development of this experimental atherosclerosis. The increase of mortality produced by Cf in hypercholesterolemic patients is corroborated in this experimental study in rats.
The Effects Of Age And Thrombotic Stroke Upon Plasma Concentrations Of Fibrinogen Derivatives And Platelet Release
Authors: Lane D A , Gawel M J , Wolff S , Ireland H , Clifford Rose F
Published: July 2018

An investigation has been made of the activation of coagulation and fibrinolytic systems and platelets in normal individuals and in patients who have had cerebral infarction probably caused by thromboembolism. Thrombin and plasmin activities and platelet releasing stimuli were measured using double antibody techniques directed towards fibrinopepti.de A (FpA), fibrinogen fragment Bβl-42 and β thromboglobulin (βTG), respectively. Normal healthy laboratory controls' (n = 20) of mean age 29 yr, range 18-46, had mean FpA, Bβ 1-42 and βTG plasma concentrations of 1.06, 1.59 and 0.80 pmol/ml respectively. 95% of these normal results were within the range 1.50, 3.50 and 1.30 pmol/ml, respectively. Patients (n = 47) who had had computer assisted tomographical demonstrable stroke at least 1 month, but mostly greater than 1 yr, prior to examination had mean FpA, B β l-42 and βTG levels of 2.81, 4.44 and 2.09 pmol/ml. Some of these patients (n = 15) received sulphinpyrazone (800 mg daily) and their plasma levels were not appreciably different, 3.17, 5.48 and 2.18 pmol/ml respectively. The age of all patients, mean 65 yr, range 53-83, was considerably higher than the laboratory controls and therefore apparently healthy age and sex matched controls (n = 14) were studied. Mean FpA, Bβ 1-42 and βTG of this older control group were 2.1, 3.0 and 1.48 pmol/ml, respectively. It is concluded that (a) in normal apparently healthy individuals plasma concentrations of FpA, Bβ 1-42 and βTG rise with age, suggesting increased activation of coagulation and fibrinolytic systems and platelets (b) following thrombotic stroke the three systems are further activated and remain so for many months (c) sulphinpyrazone does not alter this activation.
Clinical And Experimental Studies On FBG Heterogeneity And Fibrinogenolysis —Especially In DIC And UK Treatment
Authors: Yamauchi M , Takei H , Seya T , Oguma Y , Murakoshi T , Nagata H , Hasegawa H
Published: July 2018

ABy means of SDS-PAGE (3.3% gel), Fbg heterogeneity originated from partial degradation of Aα chain was studied. Comparison of electrophoretic patterns of plasma and corresponding serum made it possible to identify 2 major Fbg bands designated as high-molecular-weight Fbg (HMW, MW 350,000) and low-molecular-weight Fbg (LMW, MW 310,000). LMW comprised 28×2% (mean×S.D) of total Fbg (HMW+LMW) in healty subjects. The elevation of fibrinolytic activity did not accompany the increase of percentages of LMW in various diseases, even in cirrhotic patients whose levels of α2;PI were low. In DIC patients percentages of LMW were decreased extremely (12×6%, mean×SD). Samples from animal experimental models of DIC exhibited the same pattern of Fbg heterogeneity as that of DIC patients.

UK was added to the purified Fbg in vitro. On the earliest stage of the fibrinogenolysis. 2 bands appeared newly on SDS-PAGE, while the bands of HMW and LMW were decreased. One of these new bands (Band 1) corresponded with a major compornent of Fraction 1-9 of Mosesson. It was located in the slightly anodal position (MW 300,000) from LMW band. Another band (MW 270,000) migrated between Band 1 and the band of Frag X. The same pattern of Fbg heterogeneity was observed in patients recieving large dose of UK. After cessation of UK treatment these new bands disappeared, while the bands of HMW was increased extremel

These findings suggest that HMW is a freshly synthesized Fbg and that unknown mechanism without plasmin may present for the conversion HMW to LMW.
Thrombolytic Treatment During Pregnancy
Authors: Ludwig H , Genz H J
Published: July 2018

The treatment of occlusive deep vein thrombosis during pregnancy with fibrinolytic agents as streptokinase and urokinase is still controversial. The main points of controversy are retroplacental bleeding, fetal heart rate acceleration and malformations of the fetus. The main author conducted 122 therapeutic fibrinolytic treatments during pregnancy since 1961. The earliest beginning of treatment was the 14th week, the latest the 38th week of pregnancy. The indications to all treatments in these cases was an acute thrombotic occlusion of one or both ileofemoral veins in pregnant women. The diagnosis was established by clinical signs and, since 1975 by ultrasonography (n = 63). The treatment regimen was previously designed with the use of medium large doses of streptokinase in prolongation of an initially high dosage (1000,000 IU), later on 63 cases were treated by the following scheme: Initial dosage 1.5 - 1000,000 IU streptokinase within 30 minutes i.v. by monitored infusion, followed by an hourly dosage of not more than 250,000 IU streptokinase for 24 to 48 hours. An initial raise of body temperature occured in 28% of all cases. The fetal heart rate was watched by cardiotocography so far the pregnancy was beyond the 28th week. The success rate of all cases was 72%, indicating the complete restoration of the vessel's patency, 18% responded partially, 10% did not respond at all. 55% of all cases were examined by phlebography some days after delivery, the others were checked by clinical examination only or by ultrasonography respectively. The postfibrinolytic treatment in all cases consisted in the application of heparin in the dosage of 20,000 to 40,000 IU/24 hours for at least two weeks, approximately 60 percent of the cases received oral anticoagulants for further five weeks. Complications: One premature rupture of the membranes with healthy child, one premature separation of the well situated placenta with fatal fetal outcome, two severe bleedings during the treatment which made ar. emergency delivery by cesarean section necessary. Streptokinase was then neutralized by AM- CA. No fetal malformations were observed.
Reduction In Thrombus Formation In Hollow Fiber Artificial Kidney (HFAK) And Improvement Of Dialyser Reuse With Ticlopidine (TCP)
Authors: chong G , Nguyen Q V , Mion C
Published: July 2018

To determine whether TCP reduced thrombus formation in HFAK, 2 protocols were used in 20 patients on haemodialysis (HD) for more than 4 months (weekly schedule: 3 × 3-5 hours; Cordis HFAK IV, 1.3 m2; heparin: 25-30 units per kg body weight per hour).

In protocol I, the reduction in HFAK fiber bundle volume (ΔFBV) and residual blood volume (RBV) were compared after a single use during a non-treatment control period and while patients were receiving TCP 500 mg/day (9 dialyses in each period). Before TCP, AFBV and RBV were 21.4±14 ml (x±SD) and 21.5±16 ml respectively; on TCP, both parameters were reduced to 2.1±1.5 ml and 3.1±1.9 ml respectively (p<0.01).

In protocol II, HFAK Cordis IV was reused as long as the reduction in FBV (controlled before the first and at the end of each dialysis) was less than 20%; urea clearance (Cu) was also measured after each use. Before TCP, reuse frequency (RF) was 1.7±1 per dialyser and Cu dropped from 163±16 ml/mn to 118±23 ml/mn after first use (p<0.01); on TCP, RF was 5.5±1.2 per dialyser without significant Cu variation between first and third utilisation (160±15 Vs 152±16 ml/mn; p=NS).

No major side effect was observed and digestive blood loss (measured with 51Cr tagged red blood cells) did not increase significantly

In conclusion, TCP was shown to be a safe antiplatelet agent in HD patients and to maintain better dialysis performances in HFAK with single and/or multiple uses
Evolution Of β-Tg Level In Diabetic Patients Undergoing Artificial Pancreas Treatment
Authors: Voisin Ph , Rouselle D , Guimont C , Drouin P , Stoltz J F
Published: July 2018

Plasma β-thromboglobulin was measured at 0, 24 and 48 hours on 27 healthy subjects and 22 insulin-dependent diabetic patients undergoing a 48-hour artificial pancreas treatment (Biostator).

Before treatment all the diabetic patients revealed β-TG levels which were significantly higher than those measured in healthy subjects

On average, after 24 hours of blood glucose control, β-TG levels in the diabetic patients were not significantly reduced in comparison with the original β-TG levels. In contrast, after 48 hours of blood glucose control, plasma β-TG levels were significantly reduced.

As β-TG is a platelet-specific protein, which is considered to be an indicator of the cell’s release reaction, these results suggest that short-term control of blood glucose levels is likely to influence platelet activation in diabetic patients.
In Vitro Effects Of 5-Fluorouracil On Vascular Tissue Prostacyclin Release And Platelet Thromboxane Production
Authors: Caprino L , Antonetti F , Lagomarsino M , Morelli L
Published: July 2018

Severe chest pain (angina attacks) and myocardial infarction has been recorded during 5-Fluorouracil (5-F.U.) tre atment. The present study was undertaken to evaluate the "in vitro" activity of 5-F.U. on vascular prostacyclin (PGI ) release and platelet thromboxane A2(TXA2) formation, which play a role in the onset of cardiovascular disorders. Rat aortic rings (about 20 mg wet/weight) were incubated at 30*C for 15 mins in 300 pi tris buffer containing 5-F.U. (250-500-1000 yg). The aortic rings were removed and the supernatant was kept 4 hrs at room temperature and the RIA of 6-keto PGF1α was thereafter performed.

In 1 ml rabbit PRP containing 5-F.U. (50-100-500 yg) platelet aggregation was induced by Arachidonic acid (45 μg). Platelets were then removed by centrifugation and RIA of TXB2 was performed on supernatant.

At the dose levels of 250, 500, 1000 μg, 5-F.U. yielded a dose-dependent increase (20, 44 and 68 percent, respectively) in the 6-keto PGF2 released by rat aortic rings. Coil versely, the TXB2 production by platelets during aggregation was reduced of 19, 27, 36 percent at 5-F.U. concentrations of 50, 100, 500 μg/ml, respectively. 5-F.U. had no effect on platelet aggregation.

Considering the vasodilator and antithrombogenic effects of PGI2 and the vasoconstrictor effect of TXA2 the present results are not in agreement with the already described cardiotoxicity of 5-F.U. The “in vitro” results, however, if confirmed “in vivo”, show a new aspect of the mechanism of 5-F.U. cardiotoxicity.
Correlation Between Platelet Disaggregation And Arachidonic Acid Conversion To Prostacyclin And Thromboxane A2 In The Ex Vivo Cat Model
Authors: Nicholson N S , Smith S L , Saunders R N
Published: July 2018

Arachidonic Acid (AA) infusion in the ex vivo cat model was performed to determine the effects of the products produced from the metabolism of AA on the disaggregation of platelets accumulated on a rabbit Achilles tendon. Apparent peak blood levels of both prostacyclin (PGI2) and thromboxane (TXA2) were noted 4-8 minutes post initiation of AA infusion (1.0 mpk, i.v.). Plasma levels of PGI2 and TXA2 were determined by radioimmunoassay. Significant platelet disaggregation was noted 6-8 minutes post AA infusion with peak effects attained at 20-24 minutes. In other experiments no disaggregation occurred when AA was infused at 0.5 mg/kg. PGI2 infused in the same animal model at 14 μg/kg was detected in peak levels within 2 minutes after infusion and disappeared rapidly thereafter. Disaggregation of accumulated platelets following PGI2 infusion occurred immediately after the completion of infusion and continued over the 20 minute observation period. This data shows that AA infused into the cat can be converted to both PGI2 and TXA2 and that at 1.0 mg/kg AA, sufficient PGI2 is produced to result in platelet disaggregation even in the presence of elevated TXA2 levels.
Characteristics Of The Contractions Induced By Prostaglandin E2-Like Activity In The Rat Stomach Strip And By Thromboxane A2-Like Activity In The Rabbit Aorta And Mesenteric Artery
Authors: Zijlstra F J , Vincent J E
Published: July 2018

The dose-response curves obtained in the measurement of the prostaglandin E (PGE) and thromboxane-A2 (TxA2)-like activity using a cascade system cons isting of a rat stomach strip , a rabbit aorta strip and a mesenteric artery were determined. The following linear relat ionships were observed:log dose-activity for PGE2 and the stomach strip , do se-activity for angiotensin II (All) and the rabbit aorta, log dose-log activity for angiotensin II and the rabbit mesenteric artery.

The do se-activity curves for All and TxA2 are different when the rabbit aorta is used whereas the log dose-log activity curves are much more similar for the rabbit mesenteric artery. Therefore, AI I can only be used as a reference substance in the last case. A comparison was made of the TxA2 like activity measured by bioassay and the TxB2 determined by a radioimmunoassay in platelets after aggregation. The curves were parallel when the TxA2 like activity was measured with the mesenteric artery.

The different contractile characteristics of these organs should be taken into account in the determination of the PGE2 like and TxA2 like activity with these tests.
The Anturane Reinfarction Italian Study (Aris)
Authors: Polli E , Cortellaro M
Published: July 2018

ARIS, which closed on Dec. 31, 1980, was a multicenter (26 centers coordinated by Medical Clinic I, Milan University), randomized, double-blind, placebo-controlled trial designed to assess the efficacy of sulfinpyrazone (S) (200 mg × 2 twice a day, dose reached gradually during the 1st week) in reducing cardiac mortality, non-fatal reinfarction and other major thromboembolic events (endpoints selected to evidence S’s antithrombotic effect) in patients (≤ 70 yr) with a documented myocardial infarction (MI). Enrollment was at 15-25 days after MI during hospitalization and follow-up was 1-3 yr. The population required (700 patients;α = 0.05, 1 -β = 0.90) was based on the assumption that the rate of endpoints would be about 20% in the mean observation period (2 yr) and that S would reduce this to 10%, considering also dropouts. All events were classified according to predetermined criteria. Interim history, physical examinations, laboratory tests and EOT were performed at various fixed times. Trial enrollment closed on Dec. 31, 1979 with a total of 727 patients. Statistical analysis will be performed according to life tables methods. Response time (period of time until a critical event) analysis will be done by Gehan’s and log-rank procedures and by a regression-life table technique (Cox).

At Dec. 15, 1980, before the final blind revision, the following data are available: 41 total deaths; 37 deaths for cardiac causes; 42 non-fatal reinfarctions; 9 other thromboembolic events. This trial included a study of the trend of some hemostatic parameters.
Antiactivator (Antikinase) Activity of Human Plasma and Its Blocking by Parachloromercuribenzoate and Salicylate
Authors: Nanninga L. B , Guest M. M
Published: July 2018

A two-stage assay for fibrinolytic antiactivator (FAA), independent of the concentration of antifibrinolysin (AFL) in plasma, is based upon the essentially complete precipitation of profibrinolysin (PFL) in euglobulin precipitated at pH 5.6. In the first stage a standardized amount of urokinase converts part or all of the PFL to fibrinolysin (FL) depending upon the concentration of FAA in the test plasma. FL and AFL remain in the supernatant solution during precipitation of the euglobulins. In stage two PFL from the euglobulin precipitate is completely activated by urokinase and the generated fibrinolytic activity is estimated from turbidity measurements of the fibrinogen remaining after a standardized incubation period.

FAA is strongly blocked by parachloromercuribenzoate and more weakly blocked by salicylate. The dissociation constant of the UK-FAA complex is estimated to be 2 × 10∼9M. The FAA in plasma can block 5600 CTA units UK/ml plasma (1.1 x 10∼6M). For UK concentrations much lower than 9.5 U/ml (2 × 10-9 M), it was calculated that 590 u UK are bound per ml for every unit free UK/ml. At 37 ° C the kinetic constant of PFL activation by UK is 1.25 × 105 sec-1 M-1.
Virus Infection and Blood Coagulation
Authors: Gagel Ch , Linder M , Müller-Berghaus G , Lasch H. G
Published: July 2018

By means of a new model, the fowl plague of chickens, further evidence is given that viruses may trigger blood coagulation. Macroscopically, hemorrhages were observed, whereas microscopic studies revealed platelet and fibrin thrombi in the small vessels of various organs. Hematologic studies demonstrated an increase in the clotting time and a decrease in the activities of clotting factors I, II, VIII and X, and drop in platelet counts. Heparin could diminish the hemorrhages but did not influence the survival time of the animals.
Defective Collagen-Induced Platelet Aggregation in a Normal Population
Authors: ten Cate J. W , de Vries S. I , Sixma J. J , van Berkel W
Published: July 2018

Systemic studies on platelet functions of normal healthy individuals were carried out in two independent centres. Both samples of 40 volunteers comprised several individuals (Amsterdam 3 and Utrecht 5 individuals) with a syndrome consisting of an absent collagen-induced platelet aggregation, a reversible ADP-aggregation and frequently a decreased platelet retention in the glass bead column. Occasionally the platelet factor-3 availability was decreased.
Platelet Aggregation and Platelet Factor 3 Activity in Myeloproliferative Disorders
Authors: Tangün Y
Published: July 2018

33 patients with myeloproliferative disorder were studied and in 28 (84%) various anomalies of platelet function were observed. Single, or more commonly, multiple platelet aggregation defects and impaired release of platelet ADP and platelet factor 3 activity were the chief anomalies noted, whether thrombocytosis was present or not. The effect of myelosuppressive therapy upon the defects demonstrated varied from patient to patient, and from one anomaly to another. Reducing the high platelet count to normal levels does not seem to be sufficient to eradicate qualitative platelet defects.
An Experimental Obliterating Thromboangiitis Limited to the Posterior Part of the Body*
Authors: Selye H , Nielsen K , Tuchweber Beatriz
Published: July 2018

After a brief outline of the principles involved in the production of thrombo- hemorrhagic phenomena (THP) with special organotropic localizations, an experimental technique is described which permits the production of acrocyanosis and thrombohemorrhagic lesions largely limited to the posterior part of the body.

This phenomenon can be consistently produced by certain combinations of THP elicitors, anaphylactoid agents and noradrenaline (NA). The most effective combination among those tested is thorium dextrin (Th-Din) plus tannic acid plus NA.

Several drugs can decisively influence the course of this reaction. Most notable among these are Neo-Antergan (an antihistaminic) which sensitizes for the production of the aboral THP, while heparin (presumably through its anticoagulant effect) and Dibenamine (presumably through its antiadrenergic action) offer virtually complete protection.

When only Th-Din plus tannic acid is given, there develops an intense but reversible cyanosis in the hind paws and tail; additional treatment with NA induces obliterating thromboangiitis with hemorrhages and gangrene. None of these changes are produced by Th-Din, tannic acid or NA alone. Evidently, here, we are dealing with pluricausal experimental diseases whose possible relationship to Raynaud’s disease, thromboangiitis obliterans and anaphylactoid purpura is briefly discussed.
The Action on Blood Clotting of Different Lipoid Fractions of Beef Brain* (Methods of Fractionization and Chromatographic Isolation Procedure of a Phospholipid Anticoagulant)
Authors: Kahn M. J. P , Hans M , Bourgain R. H
Published: July 2018

A method of fractionation and isolation of a lipid anticoagulant from beef brain has been described. This method is based on chemical and chromatographic techniques. The lipid anticoagulant was found to be an inositol monophosphatide containing two different fatty acids. The anticoagulant activity has been evidenced in the Russell-viper-venom test and is believed to interfere with the formation of the early intermediate products involving factor X.
Über die Erhöhung des Antithrombin-Niveaus während Cumarin-Behandlung
Authors: Péter M
Published: July 2018

Die thrombininaktivierende Fähigkeit des Serums, die Aktivität des Antithrombin III und des endogenen Heparins wurden vom Autor bei 70 mit Cumarin (Syncumar) behandelten Patienten mit der Gerendâsschen Methode bestimmt. Bei sämtlichen Fällen wurde eine Erhöhung der Thrombininaktivie- rung sowie der Antithrombin-III- und der Heparinaktivität konstatiert; es wurde auf die Abnahme des Prothrombinniveaus und die Zunahme der Antithrombine hingewiesen, zwischen denen zweifellos eine Korrelation besteht. Die im Laufe der Cumarin-Behandlung beobachtete Erhöhung der Thrombininakti- vierung kann mittels Heparin auch in vitro erzielt werden. Nicht nur im Serum sondern auch im Plasma der Cumarin-Behandelten sind die Antithrombinwerte in signifikanter Weise erhöht. Der Autor ist der Meinung, daß bei der Erhöhung des Antithrombinniveaus auch die sich unter Einwirkung des Cumarins verlangsamende latente Blutgerinnung eine Rolle spiele.
The Effect of Warfarin Sodium on the Duration of Platelet Aggregation
Authors: Knieriem H. J , Chandler A. B
Published: July 2018

The effect of the administration of warfarin sodium (Coumadin®) on the duration of platelet aggregation in vitro was studied. Coumadin was given for 4 consecutive days to 10 healthy adults who were followed over a period of 9 days. The duration of adenosine diphosphate-induced platelet aggregation in platelet-rich plasma, the prothrombin time, and the platelet count of platelet-rich plasma were measured. Four other healthy adults received placebos and participated in a double-blind study with those receiving Coumadin.

Although administration of Coumadin caused a prolongation of the prothrombin time to 2 or 21/2 times the normal value, a decrease in the duration of platelet aggregation was not observed. In most individuals who received Coumadin an increase in the duration of platelet aggregation occurred. The effect of Coumadin on platelet aggregation was not consistently related to the prothrombin time or to the platelet count. In the placebo group there was a distinct relation between the duration of platelet aggregation and the platelet count in platelet-rich plasma.

The mean increase in the duration of platelet aggregation when compared to the control value before medication with Coumadin was 37.7%. In the placebo group there was a mean increase of 8.4%. The difference between the two groups is significant (p <0.001). Increased duration of platelet aggregation also occurred in two individuals who received Coumadin over a period of 10 and 16 days respectively.
Peptidase Activity in Human Platelets
Authors: Kocholaty Walter ,   with technical assistance of Miss S. M. Horn
Published: July 2018

Normal human platelets contain a variety of di- and tripeptidases. The hydrolytic action of platelet extracts on glycylglycine, glycyl-L-leucine and L-leucylglycine was investigated under a variety of conditions. The pH optima, heavy metal activation and some other properties of these enzymes were described and compared with that of serum and the other formed elements of the blood.
Prevalencia de disfunción eréctil en hombres del Quindío, y factores de riesgo asociados
Authors: De La Hoz Franklin José Espitia
Published: July 2018

Introducción La disfunción eréctil es la incapacidad persistente, de un hombre, para lograr o mantener una erección que le permita una relación sexual satisfactoria.

Objetivo Conocer la prevalencia de disfunción eréctil en una muestra de hombres del Quindío, y conocer los factores de riesgo relacionados con su aparición.

Materiales y Métodos Estudio descriptivo de corte transversal, en el período de enero de 2010 a diciembre de 2016. Muestra constituida por hombres de 18 a 87 años, los cuales asistieron como acompañantes de las mujeres que acudieron a la Clínica Sagrada Familia de Armenia. La disfunción eréctil se evaluó mediante el cuestionario: Índice Internacional de la Función Eréctil abreviado (IIEF-5).

Resultados Se encuestaron 1.902 hombres, con edad media de 48,6 ± 6,9 años. La media del puntaje en el IIFE-5 fue 17,58 ± 5,37 puntos (rango entre 6 y 25 puntos). La prevalencia de disfunción eréctil en la población general alcanzó un 47,63%, y en la edad o población productiva 39,1%. El 85,81% de los mayores de 50 años, tenían más disfunción eréctil, comparado con el 15,11% de los menores de 50 años (p < 0,0007). En cuanto a la intensidad de la disfunción eréctil, la más elevada es la severa (16,27%), la moderada 10,46%, y leve a moderada 12,79%. La prevalencia de la severa se incrementó en los mayores de 50 años (26,64%) en comparación con los menores de 50 años (1,92%), p = 0,0051. Entre las variables que aumentan el riesgo en este estudio, se destacan: enfermedades crónicas, prostatectomía, tabaquismo, obesidad, sedentarismo, edad superior a 50 años, etc.

Conclusiones Un significativo porcentaje de hombres del Quindío presenta un bajo puntaje en el IIFE-5, compatible con la disfunción eréctil; lo cual está asociado a múltiples factores de riesgo prevalentes en nuestra población.
Prostatitis: revisión de una patología enigmática y su relación con la fertilidad masculina
Authors: Puerta Suárez Jenniffer , Cardona Maya Walter
Published: July 2018

Introducción La prostatitis, término que involucra cuatro categorías de inflamación de la próstata, es considerada una patología enigmática por su complejidad en el diagnóstico e involucra el uso indiscriminado de antibióticos sin obtener evidencia de la infección. El objetivo de esta revisión es describir una patología de mal diagnóstico y de gran magnitud sobre la fertilidad masculina.

Materiales y Métodos Se realizó una revisión de la literatura científica a conveniencia en la base de datos PubMed, empleando los términos prostatitis, prevalencia, dolor pélvico crónico y diagnóstico.

Resultados La prevalencia de prostatitis varía entre 1,8% y 65% en los estudios evaluados, la prevalencia depende de la metodología empleada y del tipo de población evaluada.

Conclusión Se requiere determinar la prevalencia de prostatitis en la población en general, con el fin de mejorar las ayudas diagnósticas y el tratamiento para evitar la propagación de microorganismos.
Síndromes de neoplasia endocrina múltiple: revisión radiológica
Authors: García Ignacio Martín , Tocino Rosario Vidal , García Elisabeth Martín , Pérez Manuel Ángel Martín , Balbín José Martín Marín
Published: July 2018

Los síndromes de neoplasia endocrina múltiple (MEN), incluyen una serie de enfermedades con alteraciones genéticas que se caracterizan por la presencia de tumores que afectan a dos o más glándulas endocrinas. Son síndromes con una herencia autosómica dominante e incluyen tres patrones: MEN 1 (síndrome de Wermer), MEN 2 (que incluye MEN 2A o síndrome de Sipple y MEN 2B o síndrome de Wagenmann-Froboese) y MEN 4. Los adenomas paratiroideos y el carcinoma medular tiroideo, son los tumores más frecuentes del MEN tipo 1 y 2 respectivamente. Esos síndromes son más comunes en pacientes jóvenes, con patología de afectación bilateral, múltiple o multifocal y, sobre todo, en pacientes con antecedentes familiares. Es necesario el trabajo en equipo de endocrinólogos, cirujanos, oncólogos y radiólogos para optimizar el tratamiento de esos pacientes.
Laborkontrollen vor, während und nach einer Thrombolysetherapie im Kindesalter
Authors: Kehl H. G. , Vielhaber H. , Nowak-Göttl Ulrike
Published: July 2018

Thrombosen im Kindes- und Jugendalter sind ernst zu nehmende Ereignisse und erfordern neben einer Ursachenklärung eine adäquate Therapie. Bei den heute üblichen Lysetherapien im Kindesalter haben Laboranalysen neben der Überwachung der Antikoagulanzientherapie die wesentliche Aufgabe der Therapiesteuerung. Die Laboranalyse besteht vor Thrombolysetherapie in der Bestimmung von Thrombozytenzahl, Hämoglobin, TPZ, aPTT, Fibrinogen, Antithrombin, Plasminogen und D-Dimer. Während der Lysetherapie sollen zur Therapiesteuerung, zur Erfassung von möglichen Nebenwirkungen und Begleitantikoagulation Thrombozyten, Hämoglobin, aPTT, Antithrombin, Plasminogen und D-Dimer bestimmt werden. Zur Verhinderung einer Reokklusion unter voller Antikoagulation nach Thrombolyse besteht die Laborkontrolle in der Akutphase in der Analyse von aPTT, Antithrombin und D-Dimer.
Eröffnung von Verschlüssen der Arteria femoralis nach Herzkatheterisierung
Authors: Gildein P. , Mocellin R. , Sutor A. H. , Krüger M.
Published: July 2018

Die Thrombosierung der Arteria femoralis nach retrograder Katheterunter-suchung stellt im Kindesalter die häufigste Indikation für den Einsatz einer syste-mischen Lysetherapie dar. Hierbei kommen heute Urokinase oder rt-PA zum Einsatz. Wir untersuchten retrospektiv alle Patienten mit Thrombose der Femo-ralarterie nach Katheteruntersuchung in den letzten 42 Monaten, um die Sicherheit und Effektivität des verwendeten Schemas einer Urokinaselyse (Bolus 10000 E/kg, Dauerinfusion 2500 E/kg, parallel Heparininfusion) zu überprüfen. In 42 Monaten wurden 82 Patienten unter 15 kg Körpergewicht arteriell femoral punktiert. Bei sieben Patienten (8,5%) wurde eine systemische Lyse durchge-führt. Bei allen Patienten kam es nach 23-132 h zur Wiedereröffnung des Ge-fäßes. Bei drei dieser Patienten kam es zum deutlichen Hämoglobinabfall aufgrund einer lokalen Nachblutung, die durch Kompression gut beherrschbar war. Andere Blutungskomplikationen fanden sich nicht. In keinem Fall war eine Bluttransfusion notwendig. Während die Lysetherapie mit rt-PA auch im Kindesalter wegen der thrombinspezifischeren Wirksamkeit zunehmende Verbreitung findet, zeigen unsere Ergebnisse bei den sieben Patienten eine gute und sichere Wirksamkeit der Urokinasetherapie.
Incidencia de hidronefrosis transitoria en reimplante vesicouretral abierto con técnica de Lich Gregoir en niños con reflujo vesicoureteral
Authors: Bolaños Andrea Patrica , Larios Carlos Alberto , Rodriguez Pablo Gonzalez , Franco Diana Carolina , Mora Jorge Andres , Quiroz Madarriaga Yesica Yasmín
Published: July 2018

Introducción y Objetivo La técnica de Lich Gregoir es actualmente la de elección para la corrección del reflujo vesicoureteral (RVU) de alto grado, con complicaciones como la obstrucción ureteral. La literatura reporta tasas del 6% al 28% de hidronefrosis transitoria, las cuales, en su gran mayoría, corresponden a un hallazgo temporal sin repercusión clínica. El objetivo de este trabajo es establecer la incidencia de hidronefrosis transitoria y la asociación con factores de riesgo.

Materiales y Metodos Realizamos una cohorte descriptiva retrospectiva, analizando 119 unidades ureterales reimplantadas mediante técnica de Lich Gregoir (LG) en menores de 18 años, entre Septiembre del 2009 y abril del 2017. Se excluyeron pacientes con megauréter primario, RVU secundario y cirugía previa para corrección de RVU. El análisis estadístico se realizó con Stata 13.0

Resultados Evaluamos 85 pacientes, 34 de ellos reimplantados de manera bilateral, para un total de 119 unidades ureterales. El promedio de edad fue de 4,4 años y el 68% fueron mujeres. El RVU grado IV fue el más prevalente con el 42%. Las ecografías renales prequirúrgicas fueron normales en el 63% de los casos y el 14,2% presentó hidronefrosis transitoria con resolución a los 3 meses. No se reportaron casos de obstrucción ureteral. El grado de reflujo prequirúrgico no se asoció con hidronefrosis transitoria (p = 0,64) así como tampoco la lateralidad (p = 0,06).

Conclusión El reimplante vesicoureteral abierto con técnica de Lich Gregoir en nuestra institución, reporta tasas de hidronefrosis transitoria comparables a la literatura mundial. No se identificaron factores de asociación para hidronefrosis transitoria, diferentes a la técnica quirúrgica perse.
Refinements in Saddle Nose Reconstruction
Authors: Chen Yung Yuan , Jang Yong Ju
Published: July 2018

Saddle nose correction remains a challenging procedure for rhinoplasty surgeons due to both aesthetic and functional issues. The most common causes of saddle nose are nasal trauma and prior septal surgery, and a defective relationship between the caudal septum and the anterior septal spine is the principal postoperative pathology. The authors propose their own classification system for saddle nose with one new category and several approaches to deal with this condition in accordance with the level of severity. They strongly advocate major septal reconstruction for most cases of saddle nose, either by placing extended spreader grafts, caudal extension grafts, or a new extracorporeally made L strut. For extreme cases, integrated dorsal implant with columellar strut can successfully bypass the saddled nasal dorsum without dissecting the septal mucoperichondrial pocket and achieve adequate dorsal height. Further dorsal augmentation can be achieved by applying side/gap grafts or dorsal onlay grafts in different forms. In cases with retracted columella, a premaxillary plumping graft is another useful technique. Finally, in autoimmune-related saddling patients, the evidence indicates that their aesthetic problems can be managed safely with surgery as long as the disease is well under control.
The Emerging Importance of Liver Sinusoidal Endothelial Cells in Regulating Injury during Machine Perfusion of Deceased Liver Donors
Authors: Mergental Hynek , Mirza Darius , Afford Simon , Bhogal Ricky
Published: July 2018

While majority of liver transplants worldwide continue to be performed using deceased donor organs, the demands for donor livers continues to exceed the current supply. In an attempt to maximize the number of potentially usable donor livers and expand the current donor pool, there is intense global research by various groups exploring the role of machine perfusion in the liver transplantation, particularly with respect to the machine perfusion of extended-criteria liver donors. In this review, the authors summarize the current field of machine perfusion strategies as applied to deceased donor liver transplantation and how therapeutic targeting of the liver sinusoidal endothelial cell may improve the quality of donor livers.
Enhancement of Tissue Plasminogen Activator-Catalyzed Plasminogen Activation by Escherichia coii S Fimbriae Associated with Neonatal Septicaemia and Meningitis
Authors: Parkkinen Jaakko , Hacker Jörg , Korhonen Timo K
Published: July 2018

The effect of Escherichia coli strains isolated from blood and cerebrospinal fluid of septic infants on plasminogen activation was studied. These strains typically carry a filamentous surface protein, S fimbria, that has formerly been shown to bind to endothelial cells and interact with plasminogen. The bacteria effectively promoted plasminogen activation by tissue plasminogen activator (t-PA) which was inhibited by s-aminocaproic acid. A recombinant strain expressing S fimbriae accelerated t-PA-catalyzed plasminogen activation to a similar extent as did the wild-type strains whereas the nonfimbriate recipient strain had no effect. After incubation with t-PA and plasminogen, the S-fimbriate strain displayed bacterium-bound plasmin activity whereas the nonfimbriate strain did not. Bacterium-associated plasmin generation was also observed with a strain expressing mutagenized S fimbriae that lack the cell-binding subunit SfaS but not with a strain lacking the major subunit SfaA. Both t-PA and plasminogen bound to purified S fimbriae in a lysine-dependent manner and purified S fimbriae accelerated t-PA-catalyzed plasminogen activation. The results indicate that E. coli S fimbriae form a complex with t-PA and plasminogen which enhances the rate of plasminogen activation and generates bacterium-bound plasmin. This may promote bacterial invasion and persistence in tissues and contribute to the systemic activation of fibrinolysis in septicaemia.
Hepatocellular Carcinoma with Portal Vein Tumor Involvement: Best Management Strategies
Authors: Liu Po-Hong , Huo Teh-Ia , Miksad Rebecca
Published: July 2018

Portal vein tumor thrombosis (PVTT) commonly occurs in patients with hepatocellular carcinoma (HCC). Patients with PVTT usually have an aggressive disease course, decreased liver function reserve, limited treatment options, higher recurrence rates after treatment, and, therefore, worse overall survival. Among untreated HCC patients with PVTT, the median overall survival has been reported as low as 2 to 4 months. Historically, many aspects of PVTT have impacted the theoretical and practical safety and efficacy of treatment, for example, disordered blood flow and associated impairment of liver function, heat-sink effects of blood flow in the area of the PVTT, and risk of recurrence due to tumor location in the blood vessel. The current Barcelona Clinic Liver Cancer staging system categorizes HCC patients with PVTT as advanced stage, for which the standard of care is targeted therapy with sorafenib. However, sorafenib is associated with only marginal benefits among patients with PVTT. First-line lenvatinib, which was shown to be noninferior to sorafenib, excluded patients with main portal trunk invasion. Regorafenib and nivolumab, an immune-based therapy, were recently approved in the United States for second-line therapy after sorafenib. Preliminary results for cabozantinib suggest a benefit in the second-/third-line after sorafenib failure. In addition, rapid advances in many fields (surgery, interventional radiology, nuclear medicine, and immunotherapy) have increased the potential treatment options for the management of this complex disease entity. A large portion of the emerging evidence focuses on the broader category of advanced HCC of which PVTT is a subgroup. While many of these studies show promising results, the efficacy among PVTT patients requires validation in prospective studies. Real-world data may help fill the evidence gap for patients not eligible for clinical trials due to common hepatic function requirements. The variety of new treatment advances for the heterogeneous and complex disease entity of HCC with PVTT means that personalized, multidisciplinary management may be necessary to achieve optimal outcomes. In this narrative review, we summarize the evolving management strategies for patients with HCC and PVTT.
Potential Mechanisms Underlying the Role of Coffee in Liver Health
Authors: Alferink Louise , Kiefte-de Jong Jessica , Darwish Murad Sarwa
Published: July 2018

Coffee, the most consumed hot beverage worldwide, is composed of many substances, of which polyphenols, caffeine, and diterpenoids are well studied. Evidence on potential effects of coffee on human health has been accumulating over the past decades. Specifically, coffee has been postulated to be hepatoprotective in several epidemiological and clinical studies. Several underlying molecular mechanisms as to why coffee influences liver health have been proposed. In this review, the authors summarized the evidence on potential mechanisms by which coffee affects liver steatosis, fibrosis, and hepatic carcinogenesis. The experimental models reviewed almost unanimously supported the theorem that coffee indeed may benefit the liver. Either whole coffee or its specific compounds appeared to decrease fatty acid synthesis (involved in steatogenesis), hepatic stellate activation (involved in fibrogenesis), and hepatic inflammation. Moreover, coffee was found to induce apoptosis and increased hepatic antioxidant capacity, which are involved in carcinogenesis.
Abdominal Wall Reconstruction: An Integrated Approach
Authors: Boukovalas Stefanos , Sisk Geoffrey , Selber Jesse
Published: July 2018

Abdominal wall reconstruction has undergone substantial evolution over the last few decades. The optimal method of repair should be tailored to each patient's unique condition; however, a general approach that integrates four major factors can be applied as a conceptual framework to most clinical scenarios. Major factors to be considered include selection of mesh material, mesh inset position and technique, selective component separation, and management of soft tissue. These topics are inextricably intertwined in the sense that each can have specific implications, and in some cases, a determinative impact on the other decisions. When the relationship among these four factors is appreciated and applied to patient management, the reconstructive surgeon can achieve consistent outcomes that reflect skill, experience, and understanding.
Complicaciones vasculares durante la trombectomía mecánica en el ictus agudo, una experiencia multicéntrica en España
Authors: Meléndez Fernando , Tomasello Alejandro , Hernández David , Dinia Lavinia , Coscojuela Pilar , Ribó Marc
Published: July 2018

Objetivo Determinar la frecuencia de las complicaciones observadas durante la trombectomía en el ictus isquémico agudo.

Materiales y Métodos Se revisó de forma retrospectiva las trombectomías realizadas en nuestra institución cuando los ictus isquémicos tuvieron una indicación de tratamiento endovascular. Se registraron los diferentes dispositivos utilizados en ese periodo de tiempo y si presentaron relación con el desarrollo de las complicaciones inmediatas mediante arteriografía.

Resultados De un total de 228 casos, se registraron complicaciones en el 16,6% de los casos. Se identificaron embolias (n = 31), hemorragias subaracnoideas (n = 2), hemorragia gangliobasal (n = 1), vasoespasmo (n = 1), disección (n = 1) y peusoaneurismas (n = 2). La embolia a nuevos territorios se presentó solo en 5 casos.

Discusión El tratamiento endovascular ha demostrado ser efectivo para la recanalización en oclusión de gran vaso. El uso de dispositivos presume un riesgo por la manipulación de los vasos.

Conclusión La embolia fue la complicación más frecuente. El tratamiento endovascular en el ictus genera un desenlace clínico favorable de los pacientes, al mismo tiempo, el bajo porcentaje de complicaciones que encontramos no suponen una afectación negativa en el desenlace final.