bluuebunny/crossref_metadata_2025_split huggingface dataset:
Contrast Venography, the Gold Standard for the Diagnosis of Deep-Vein Thrombosis: lmprovement in Observer Agreement
Authors: Lensing Anthonie W A , Büller Harry R , prandoni Paolo , Batchelor David , Molenaar Andre H M , Cogo Alberto , Vigo Mario , Huisman Peter M , ten Cate Jan Woutert 
Published: July 2018

SummaryTo determine whether the Rabinov-Paulin or the long-leg venography technique should be preferred in the diagnostic management of patients with clinically suspected deep-vein thrombosis, two independent experienced radiologists blindly assessed two different series of venograms of consecutive outpatients with clinically suspected deep-vein thrombosis. Venograms were obtained from two outpatient clinics of primary referral centres. In one centre the venograms were performed according to the technique of Rabinov and Paulin with the use of 100 ml of radiographic material and spot films of the calf, popliteal and more proximal veins. In the other centre, long-leg films were obtained after the administration of 150 ml of contrast material. The percentage venograms adjudicated as inadequate by at least one radiologist and inter-observer disagreement for both series were used as the main study outcome measures. Prior to the study, both radiologists agreed on the standardized criteria for a normal, abnormal and inadequate test result using a separate set of films.An inadequacy rate of 20% was found for the Rabinov-Paulin venography series (n = 123), whereas only 2% of the L26long-leg films were inadequate for interpretation (p <0.001). The interobserver disagreement for inadequacy, presence or absence of deep-vein thrombosis was 2I% for the Rabinov and Paulin venograms and 4o/" for the long-leg films (kappa, 0.65 and 0.92; 95% confidence intervals: 0.53 to 0.77 and 0.84 to 0.99, respectively; p <0.002).We conclude that the long-leg method is superior to the Rabinov-Paulin method in the venographic diagnosis of deep-vein thrombosis in symptomatic outpatients since noninterpretable test results are rarely observed and it reduces both unnecessary treatment of patients without deep-vein thrombosis and limits the undertreatment of patients with the disease.
No Evidence of HIV-1 Infection in Seronegative Hemophiliacs and in Seronegative Partners of Seropositive Hemophiliacs through Polymerase Chain Reaction (PCR) and Anti-NEF Serology
Authors: Ferrer-Le-Coeur Françoise , Mariotti Martine , Hivert Philippe , Satre Eric Pascal , Bouchardeau Françoise , Couroucé Anne-Marie , Rouger Philippe , Lefrère Jean-Jacques 
Published: July 2018

SummaryWe prospectively studied a well-characterized cohort including 60 seronegative hemophiliacs or von Willebrand’s disease patients, 6 seronegative female sexual partners of seropositive hemophiliacs, 59 seropositive hemophiliacs or von Willebrand’s disease patients and 2 seropositive partners of seropositive hemophiliacs (used as positive controls), and 117 seronegative low risk individuals (used as negative controls). PCR assay, performed in peripheral blood mononuclear cells using three primer pairs in the gag, pol, LTR regions, showed no positive results in the 60 seronegative patients, in the 6 seronegative partners of seropositive patients and in the 117 seronegative low risk individuals, while PCR was positive with at least one primer pair in 53 (87%) of 61 seropositive patients. Anti-nef serology (Westem-blot) was negative in seronegative patients, in seronegative partners of seropositive patients and positive in 58% out of the seropositive individuals. These results strongly suggest an absence of HIV-1 infection in individuals with a lastingly negative HIV serology.
Studies on the Contact System of Coagulation during Therapy with High Doses of Recombinant IL-2: Implications for Septic Shock
Authors: Hack C Erik , Wagstaff John , Strack Van Schijndel Robert J M , Eerenberg Anke J M , Pinedo Herbert M , Thijs Lambertus G , Nuijens Jan H 
Published: July 2018

SummaryPatients treated with high doses of interleukin-2 (IL-2) because of cancer, develop hemodynamic and vasopermeability changes, that resemble those observed in sepsis. These patients thus provide a unique opportunity to study the early events in the development of septic shock. We analysed the changes that occurred in the contact system of coagulation in plasma from 4 patients, who together received seven 12-day cycles of high doses of IL-2. Levels of factor XII and prekallikrein during the cycles progressively fell to 50 and 30% of their initial levels, respectively, whereas significant increases in plasma factor XIIa-and kallikrein-C1-inhibitor complexes were not observed (in 3 out of 211 samples slightly increased levels of both complexes were found). The reductions in factor XII and prekallikrein were only in part due to protein leakage, since levels were still significantly lower, i. e., 80 and 50%, respectively, when corrected for albumin decreases. Levels of high molecular weight kininogen (HMWK) also decreased during IL-2 therapy, however, this decrease paralleled that of albumin. SDS-PAGE analysis of plasma HMWK did not reveal increased cleavage of this protein. The reduction of factor XII and prekallikrein, corrected for protein leakage, significantly correlated with albumin levels and inversely with daily cumulative weight gain in the patients.Thus, we demonstrate that factor XII and prekallikrein decrease during IL-2 therapy. As these decreases, already observed after 1 day treatment, were disproportional to that of albumin, a negative acute phase reactant, and correlated with signs of the vascular leak syndrome, we favor the explanation that they reflected activation rather than a decreased synthesis of the contact system proteins. Further studies are needed to substantiate this hypothesis.
Evaluation of Pulmonary Accumulation of 51Chromium-Labelled Rat Platelets following Intravenous Application of ADP and Collagen
Authors: Klee Andreas , Seiffge Dirk 
Published: July 2018

SummaryWe examined the effects of ADP- and collagen-induced pulmonary platelet embolism in the rat. Homologous 51Chromium-labelled platelets were used to monitor extracorporally the distribution of platelets in the circulation. For that purpose, collimated iodide scintillation detectors were placed above thorax (C1) and abdomen (C2). A dose-dependent increase in thoracic radioactivity, paralleled by a decrease in the abdomen, was observed after intravenous injection of ADP and collagen. This resulted in a shift of C1/C2, so that the effect of collagen was more pronounced (maximal increase of C1/C2 = 134%) than ADP (maximal increase of C1/C2 = 79%). The increase in thoracic radioactivity was caused by the uptake of platelets in the lung as was shown after administration of collagen (6-fold enrichment of labelled platelets). Lung platelet sequestration resulted in a dose-dependent thrombocytopenia. The ADP-and collagen-induced pulmonary platelet embolism reversibly provoked cardiovascular symptoms of shock: hypotension and bradycardia. Impaired gas exchange during platelet accumulation manifested itself in a reversible arterial hypoxaemia and hyper-capnia, followed by a weak acidosis. We were able to inhibit ADP-dependent thoracic platelet accumulation by ticlopidine in a dose-related manner as well as collagen-induced thoracic platelet accumulation by acetylsalicylic acid. The results indicate that behaviour of homologous labelled rat platelets in vivo can easily be monitored, thus offering the opportunity to investigate the effects of antiaggregatory drugs on platelets in their natural environment.
Soluble Thrombomodulin Antigen in Conditioned Medium Is Increased by Damage of Endothelial Cells
Authors: Ishii Hidemi , Uchiyama Hiroyuki , Kazama Mutsuyoshi 
Published: July 2018

SummaryThrombomodulin (TM) exists not only in endothelial cells but also in circulating plasma as soluble heterogeneous fragments. A release mechanism of soluble TM antigen from endothelial cells was investigated. Cultured human umbilical vein endothelial cells released about 0.6% of total cellular TM antigen into conditioned medium during 24 h. The release of TM antigen was not influenced by addition of various concentrations (0.01-5.0 μM) of monensin, which inhibits intracellular transport of secretory proteins, though the secretion of plasminogen activator inhibitor-1 from the cells was inhibited. The release of TM antigen was not increased when total cellular TM level increased 1.3- or 1.4-fold relative to control cells after stimulation with 0.1-1.0 U/ml thrombin or 3 mM dibutyryl cAMP, respectively. Exposure of endothelial cells for 6 h to mixture of 1 μM N-formyl-methionyl-leucyl-phenylalanine (FMLP) and 100 ng/ml lipopolysaccharide (LPS) decreased cellular TM level by 30% relative to control cells without increase in the TM release. The FMLP and LPS-stimulated leukocyte treatment of the cells increased the release of TM antigens into the medium in a time-dependent manner and the increased release of TM antigen paralleled the extent of cell damage as measured by 51Cr release. Hydrogen peroxide treatment of the cells increased the release of TM antigens into the medium in a time- and concentration-dependent manner. The increased release of TM antigen by hydrogen peroxide also paralleled the extent of cell damage. Soluble TM antigen in conditioned medium from the untreated control cells was composed of six heterogeneous fragments of 105, 56, 48, 33, 31 and 28 kDa observed on Western blots after sodium dodecyl sulfatepolyacrylamide gel electrophoresis under reducing conditions, and the soluble TM antigen from the hydrogen peroxide-treat-ment cells was composed of five heterogeneous fragments of 80, 56, 33, 31 and 28 kDa. These compositions were quite similar to that observed for soluble TM fragments in human plasma. It is suggested that soluble TM antigen is not secreted from endothelial cells, but results from cellular damage.
Carcinoma del uraco: una extraña entidad
Authors: Gómez San Martín Maria , Gil Guerra Ana , Sanchez Lite Israel , Herreros Rodriguez José 
Published: July 2018

Objetivo Revisar la patología tumoral del uraco, haciendo énfasis en su clínica, los métodos diagnósticos empleados y el manejo terapéutico.
Métodos Presentamos el caso de un varón de 39 años con carcinoma del uraco que simuló clínicamente un absceso umbilical.
Resultados Los hallazgos en la TC fueron sospechosos de patología del uraco. El examen anatomopatológico reveló células atípicas y la PET-TC demostró extensión a pared abdominal y epiplón, requiriéndose la resección completa.
Conclusiones El carcinoma del uraco es una neoplasia muy poco frecuente, que tiene su origen en el epitelio que recubre la luz del uraco, un vestigio de la alantoides que conecta la vejiga con el ombligo y normalmente involuciona en la etapa embrionaria. La clínica insidiosa hace que el diagnóstico sea tardío y el pronóstico pobre. Las pruebas de imagen tienen un papel fundamental en su sospecha, así como en la definición de la relación con la pared vesical y posible extensión local o a distancia. Una vez confirmado el diagnóstico histológicamente, está indicada la resección quirúrgica completa.
Prostatectomía radical y calidad de vida: resultados en un centro de alta complejidad
Authors: Sánchez Basto Catalina , Cataño Cataño Juan , Lizcano Herrera Ana , Chavarriaga Soto Julián , Orrego Rojas Paola , Monrroy Feijóo Eliana , Fakih García Nayib , Silva Herrera Jose 
Published: July 2018

Introducción La prostatectomía radical (PR) es el patrón de oro para el manejo quirúrgico con intención curativa del cáncer de próstata. Sin embargo, tiene secuelas importantes como la incontinencia urinaria y la disfunción eréctil. El objetivo de este estudio es describir la prevalencia de las secuelas y el compromiso de calidad de vida de los pacientes llevados a PR abierta en un centro de alta complejidad.
Materiales y Métodos Se revisaron los datos de los pacientes llevados a prostatectomía radical en el Hospital Universitario San Ignacio desde el año 2005 hasta el año 2015. Se seleccionaron aquellos que tuvieran más de 12 meses de postoperatorio, previo consentimiento informado verbal por vía telefónica se aplicó el cuestionario UCLA PCI. La información fue organizada para su análisis en una base de datos construida con ese fin para posterior aplicación de las estadísticas descriptivas que permitieran resumir y describir los resultados.
Resultados Durante los años analizados, se realizaron 231 prostatectomías radicales. Se logró tener contacto con 112 de ellos a los cuales se les aplicó el cuestionario UCLA PCI. En el dominio de función urinaria, 57% de los pacientes reportan tener “control total de la orina,” 53% nunca tienen escape involuntario de la orina, 82% no requieren el uso de protectores y 62% presentan goteo de orina menos de 1 vez por semana. En cuanto a la función sexual, 69,3% califican su habilidad para tener una erección como pobre o muy pobre, 25% regular y 7% buena o muy buena. Para 20% la erección es suficiente para lograr el coito. Y para 52% esa función implica un problema en su vida. El impacto en la calidad de vida mostró que un 91,8% de los pacientes consideran que su salud es en general buena muy buena o excelente y un 70% no tienen ningún tipo de limitación física.
Conclusiones La prostatectomía radical tiene un impacto importante no despreciable en la calidad de vida de los pacientes, especialmente en lo referente a la función urinaria y sexual. Su impacto en la calidad de vida debe ser considerado al momento de realizar la consejería previa a la toma de decisiones en el manejo definitivo del cáncer de próstata con el fin de que el paciente tenga unas expectativas claras en ese sentido.
On the Fibrinolytic System in Aged Rats, and Its Reactivity to Endotoxin and Cytokines
Authors: Emeis J J , Brouwer A , Barelds R J , Horan M A , Durham S K , Kooistra T 
Published: July 2018

SummaryAged rats are more susceptible to endotoxin-induced effects, including microthrombosis and platelet aggregation, than are young rats. To investigate whether changes in the fibrinolytic system might be involved, we investigated the fibrinolytic activity in plasma euglobulin fractions and tissues (lung and heart) of young (6-months old) and aged (24-months old) rats under baseline conditions and after challenge with endotoxin. Aged rats had lower plasma levels of tissue-type plasminogen activator (t-PA) and of urokinase-type PA (u-PA) activity. PA inhibitor (PAI) activity was higher in the plasma of aged rats, as was t-PA activity in lung and heart.Rats were treated with either a low dose (1 μg/kg) or a high dose (10 mg/kg) of endotoxin. Both treatments induced a transient phase of increased blood fibrinolytic activity, as evidenced by higher levels of tissue-type plasminogen activator (t-PA) activity and decreased levels of PA inhibitor (PAI) activity. Over time, the fibrinolytic activity decreased, probably due to increased levels of PA inhibitor.Both the early increase in t-PA activity, and the subsequent increase in PAI activity, were more pronounced in the aged rats, as compared with the younger rats, after the high dose of endotoxin. The aged rats also responded to an injection of interleukin-1β or tumor necrosis factor-α with a larger increase of PAI activity than did the younger rats.Together the data suggest that, compared to young rats, aged rats have a decreased base-line plasma fibrinolytic activity, while their fibrinolytic system is more responsive to challenge by endotoxin and cytokines.
Characterization of Partial Gene Deletions in Type III von Willebrand Disease with Alloantibody Inhibitors
Authors: Mancuso David J , Tuley Elodee A , Castillo Ricardo , de Bosch Norma , Mannucci Pler M , Evan Sadler J 
Published: July 2018

Summaryvon Willebrand factor gene deletions were characterized in four patients with severe type III von Willebrand disease and alloantibodies to von Willebrand factor. A PCR-based strategy was used to characterize the boundaries of the deletions. Identical 30 kb von Willebrand factor gene deletions which include exons 33 through 38 were identified in two siblings of one family by this method. A small 5 base pair insertion (CCTGG) was sequenced at the deletion breakpoint. PCR analysis was used to detect the deletion in three generations of the family, including two family members who are heterozygous for the deletion. In a second family, two type III vWD patients, who are distant cousins, share an -56 kb deletion of exons 22 through 43. The identification and characterization of large vWF gene deletions in these type III vWD patients provides further support for the association between large deletions in both von Willebrand factor alleles and the development of inhibitory alloantibodies.
Comparison of Once-Daily Subcutaneous Fragmin® with Continuous Intravenous Unfractionated Heparin in the Treatment of Deep Vein Thrombosis
Authors: Lindmarker Per , Holmström Margareta , Granqvist Staffan , Johnsson Hans , Lockner Dieter 
Published: July 2018

SummaryTwo hundred and four consecutive patients with venographically confirmed deep vein thrombosis (DVT) were randomised either to a low molecular weight heparin, Fragmin®, administered subcutaneously (s.c.) once daily as a fixed dose of 200IU anti-factor Xa/kg or to continuous intravenous infusion of unfractionated heparin (UFH). The UFH dose was adjusted to maintain the activated partial thromboplastin time between 1.5 and 3.0 times the upper limit of the reference value at each centre. Fragmin® or UFH was given for a minimum of 5 days until anticoagulation with warfarin, given from day 1, was established (i. e. an International Normalised Ratio, of 2.0−3.0). A second venogram was obtained after Fragmin® or UFH treatment. There were no significant differences in the change in mean Marder score before and after treatment between the two treatment groups, irrespective of thrombus localisation. No major bleeding events, symptomatic pulmonary embolism, symptomatic thrombosis progression or death occurred during hospitalisation. Eight documented venous thromboembolic events occurred before the follow-up visit 6 months after randomisation: 5 in patients treated with Fragmin® and 3 in those treated with UFH. Six of these events occurred after cessation of warfarin treatment. In conclusion Fragmin® given s.c. once daily in a fixed dose adjusted for body weight, is no less effective or safe than a continuous infusion of UFH in the initial treatment of acute DVT.
Prevalence, Follow-Up and Clinical Significance of the Anticardiolipin Antibodies in Normal Subjects
Authors: Vila P , Hernández M C , López-Fernández M F , Batlle J 
Published: July 2018

SummaryTo date very few studies that analyze the prevalence of anticardiolipin antibodies (ACA) in healthy subjects have been reported. No data based on a systematic analysis of normal subjects with positive ACA is available. The aim of the present study was to evaluate the prevalance of ACA, its clinical significance and relationship to the lupus anticoagulant (LA) and other autoimmune parameters in an apparently healthy population. 552 normal blood donors from a blood bank were randomly selected. ACA positive donors who consented were monitored over a period of twelve months and tested every three months. ACA (IgG and IgM isotypes) were quantitated by enzyme linked immunoassay (ELISA). The prevalance for IgG ACA in our donor population was estimated to be 6.5%, and 9.4% for IgM ACA, which is similar to the one previously reported for IgG and slightly higher for IgM. It is worth noting that in our study ACA positive donors exhibited a progressive negativization. Eight donors with IgG ACA and seven with IgM ACA remained positive for nine months. Five donors with IgG ACA and four with IgM ACA had family history of thromboembolic disease. One donor with IgG ACA and two with IgM ACA had had unexplained miscarriages in the past. We did not find any relationship between ACA and LA, nor between ACA positivity and the clinical and laboratory data studied. Pseudopositivity for lues was not found. No thrombotic event occurred in donors that were positive for ACA during the 12-month follow-up.
Characterisation of Persistent Anti-Xa Activity Following Administration of the Low Molecular Weight Heparin Enoxaparin Sodium (Clexane)
Authors: Brieger David , Dawes Joan 
Published: July 2018

SummaryIt is widely reported that persistent anti-Xa activity follows administration of low molecular weight heparins. To identify the effectors of this activity we have injected 125I-labelled Enoxaparin sodium into rabbits and subsequently analysed the circulating radiolabelled material and anti-Xa activity by affinity and size exclusion chromatography. Antithrombin III-binding material derived from the injected drug was responsible for all the anti-Xa amidolytic activity. At early times after injection additional anticoagulant activity which was largely attributable to tissue factor pathway inhibitor was measured by the Heptest clotting assay after removal of glycosaminoglycans from plasma samples. Small radiolabelled fragments, including penta/hexasaccharide with affinity for antithrombin III, were detectable in the circulation 1 week later, and sulphated oligosaccharides persisted for 3-4 weeks. Significant quantities of radiolabel remained in the liver and kidney several weeks post-injection; these organs may sequester some of the injected drug and give rise to circulating biologically active material by degradation and secretion of catabolic products into the plasma.
The Effects of Bedrest on Circadian Changes in Hemostasis
Authors: Rosenfeld Brian A , Faraday Nauder , Campbell David , Sakima Neal , Bell William 
Published: July 2018

SummaryVenous stasis occurs when people are at bedrest, because of altered venous flow characteristics. This is commonly believed to be one etiology behind the development of deep venous thrombosis (DVT). The hemostatic effects of bedrest and their possible role in DVT development have not been fully examined. We hypothesized that bedrest would lead to increases in hemostatic function and that these increases could be important in the development of DVT.Twelve non-smoking volunteers were studied during supine positioning for 36 hours. Platelet reactivity and plasma concentrations of fibrinogen, a2-antiplasmin, plasminogen, thromboxane (32, plasminogen activator inhibitor-1, tissue plasminogen activator and neuroendocrine hormones (cortisol, epinephrine and norepinephrine) were measured at 8:00 a.m., 10:00 a.m., 4:00 p.m. and 8:00 a.m.Cortisol demonstrated an early morning increase while catecholamines were unchanged throughout. Fibrinogen, a2-antiplasmin, plasminogen and platelet reactivity were no different at any time point. Fibrinolytic proteins changed over time, manifested by decreased PAI-1 antigen and activity levels at 24 h.Based upon the parameters measured, bedrest causes no increase in hemostatic function. In fact, bedrest causes the potential for enhanced fibrinolysis, that differs from that previously reported for normal activity over 24 h. This may represent a protective mechanism to counter the effects of stasis from bedrest.