Gastric tubes in children with caustic esophageal injury: a 32-year review

By means of ischemic coagulation of the hepatic artery and portal vein in a microwave coagulation experiment of in vivo swine [correction of bovine] liver, we confirmed approximate doubling of the coagulation diameter compared to the usual coagulation. Based on this fact, for treatment of patients with metastatic liver tumor, we developed an ischemic percutaneous microwave tumor coagulation method using IVR method and applied it in one case, and performed laparotomy microwave tumor coagulation in three cases. We performed the ischemic percutaneous microwave tumor coagulation method on one of the cases. Coagulation was performed for one minute at a dose of 100 W for treatment of metastatic liver tumor of 2 cm in diameter via laparotomy. The postoperative CT showed an extensive coagulation larger than 3 cm. A 2 cm liver tumor was coagulated under balloon ischemia of the hepatic vein and hepatic artery for 13 minutes at a dose of 60 W. The maximum coagulation diameter was 5 cm. Extensive coagulation was possible with percutaneous microwave tumor coagulation through ischemia.     

M33, a mammalian homologue of Drosophila Polycomb localises to euchromatin within interphase nuclei but is enriched within the centromeric heterochromatin of metaphase chromosomes

Both experimental and clinical data have shown that coagulation disorders are common in patients with cancer although clinical symptoms occur rarely. A prethrombotic state is probably involved in the mechanism of metastatic spread. Anticoagulant treatment, with either warfarin or heparin, has been shown to have a positive influence in small cell lung cancer. The purpose of this study was to evaluate the prethrombotic state as a possible marker of the outcome of lung cancer. Pretreatment prothrombin time (PT), partial thromboplastin time (PTT), antithrombin III (AT-III), platelet blood count (P), fibrinogen (F) and D-dimer (DD) were prospectively recorded in a series of 286 consecutive patients with a new primary lung cancer. Other recorded variables (32 in all) consisted of a set of anthropometric, clinical, physical, laboratory, radiological and pathological data. All patients were carefully followed up, and their subsequent clinical course recorded. Spearman rank correlation tests between coagulation factors were weakly significant, or more often non-significant. The best correlation index was that between PT and PTT (ra = -0.25). Univariate analyses of survival showed that a prolonged value of PT (P = 0.00167) and higher values of F (P = 0.00143) and DD (P = 0.0005) were associated with a poor prognosis. A few, weak relationships between well-known prognostic variables and coagulation abnormalities were also found. Because of the weakness of this correlation pattern, coagulation factors emerged in all the Cox's regression analyses as important predictors of survival, regardless of the number and type of cofactors used. A prethrombotic state (depicted by a prolongation of PT and increase of DD) is confirmed in this study as an aggravating condition in lung cancer. Studies attempting to reverse possible haemostatic abnormalities with the use of anticoagulants are justified by the present data.     

Influence of soft tissue on density and relative contrast between gutta-percha and dentin images. An in vitro study

Factor XII initiates the intrinsic coagulation cascade and may affect the fibrinolytic system. Routine coagulation tests used during cardiopulmonary bypass (CPB) are abnormal in factor-XII-deficient patients and are useless for monitoring anticoagulation in these patients. A factor-XII-deficient patient requiring CPB is described. The baseline celite activated clotting time (ACT) was greater than 1400 seconds and the thrombin time was 12.4 seconds (control, 11.9 seconds). Two units of plasma were given resulting in an ACT of 173 seconds. Following 300 units/kg of heparin and during CPB, the ACT ranged from 670-596 seconds with the thrombin time greater than 200 seconds. Plasma provides exogenous factor XII allowing an endpoint on the ACT test and may protect against possible postoperative hypofibrinolytic complications. A commercially available modified thrombin time may also be useful and provide an endpoint during high-dose heparinization.     

Hemostatic disorders in septicemia. Apropos of 65 cases

In the course of a restrospective study, some hemostatic parameters were studied in connection with 65 cases of septicaemia. From this study, it follows that coagulation troubles are more frequent in septicaemiae induced by negative Gram germs, but that this frequency is actually linked with circulatory troubles. Besides, as for the biological diagnosis of the disseminated intravascular coagulation syndrome in this instance, it is not possible to take strictly into account the fibrinogen values or the rate of thrombocytes.     

A case of the successful treatment of a patient with severe craniocerebral trauma combined with hemophilia

The described case with a severe craniocerebral injury in a patient with hemophilia A demonstrated that the initial hypocoagulation does not preclude the development of intravascular blood coagulation. Therefore, in patients with severe brain injury, a more rapid reduction of antihemophilic globulin A is possible, in comparison with that occurring during planned surgery, and, hence, higher doses of cryoprecipitate and longer duration of its infusion are needed. Moreover, this case demonstrated that even in patients with a slight form of hemophilia A the treatment with cryoprecipitate should be continued till the levels of thrombinemia markers are reduced and the concentration of antihemophilic globulin A in the blood stabilized at a level of at least 10%; the dose of infused cryoprecipitate should be reduced gradually.     

钢铁过程细微颗粒物凝并性能研究

为寻求一种收集钢铁冶炼过程中产生的气溶胶颗粒的方法,研究了EAF粉尘颗粒物的性质.采用Zn蒸汽氧化产生的ZnO模拟气溶胶颗粒进行凝并实验研究,另采用熏香烟雾在不同的搅拌速度下进行气溶胶凝并实验,并将实验结果与理论计算进行比较.同时,采用一种考虑颗粒间相互作用的气溶胶凝并模型估算反应范德华力作用的Hamaker常数.实验结果表明,在搅拌条件下,对于气溶胶的凝并应考虑微细颗粒间的相互作用.     

Staged Coagulation for Treatment of Refractory Organics

Seasonal periods of high rainfall have been shown to cause elevated natural organic matter (NOM) loadings at treatment works. These high levels lead to difficulties in removing sufficient NOM to meet trihalomethane standards, and hence better alternative treatments are required. Here the removal of NOM was investigated by conventional coagulation treatment using both bulk and fractionated NOM. Initial experiments showed that over 70% removal of the hydrophobic and hydrophilic acid fractions was achieved at the works, while only 16% of the hydrophilic nonacid fraction was being removed. Bench scale jar testing of the isolated NOM fractions demonstrated that high removals of the hydrophobic fractions were achieved and that optimized conditions increased removal of the hydrophilic fractions, indicating that staged coagulation could be of benefit in the removal of the recalcitrant fractions. Experiments using optimized staged coagulation indicated that a small increase in the removal of the total NOM of this water was possible when compared to conventional treatment.     

Recognition of hemophilia A in an elderly patient

Hemophilia A (classic hemophilia) is an hereditary coagulation disorder characterized by the absence, severe deficiency, or defective functioning of plasma coagulation factor VIII. It is inherited in an X-linked recessive manner and occurs almost exclusively in males. The first manifestations of bleeding are usually first noted as a young child since most of the patients with hemophilia A have a profound deficiency of factor VIII (less than 1% of normal value). However, in mild hemophilia (5-25% of normal level of factor VIII) the condition may escape detection with many of the patients developing bleeding only after trauma or surgery. Hemophilia A is the result of a recent genetic mutation in approximately one third of patients, for whom often there is no family history of a bleeding disorder. Here we present an elderly male patient with spontaneous bleeding in an extremity that has coagulation studies consistent with the diagnosis of hemophilia A. Physicians must be aware that mild hemophilia can present in this unusual manner and should consider this possibility in patients that have unexplained bleeding even if there is no clear personal or family history of an hereditary coagulation disorder.     

Experience with the trans-uterine tubal coagulation with high frequency current and the thermo method under hysteroscopic control (author''s transl)

With the aid of the carbon dioxide hysteroscope, 152 patients underwent transuterine tubal sterilization. 106 women had high frequency current coagulations of the tubes. At follow-up examinations 62 tubes were occluded and 30 showed a unilateral tubal occlusion. These results did not improve by using the thermo coagulation method since only 10 out of 24 patients showed bilateral tubal occlusion and two unilateral tubal occlusions. Up to 20 months following the transuterine tubal sterilization, 28 of the 152 women became pregnant. Of these, 16 became pregnant in spite of hysterosalpingographic evidence of bilateral tubal occlusion. Two patients required emegency laparotomies because of small bowel injuries. Within the coagulation times and temperature ranges used in this series, the results of trans-uterine tubal sterilization are unsatisfactory. It is possible that other types of hysteroscopic tubal sterilizations which are now being developed will be more successful.     

Marketing innovations to nurses, Part 2: Marketing''s role in the adoption of innovations

A mathematical model for the prothrombin time test is proposed. The time course of clotting factor activation during coagulation was calculated, and the sensitivity of the test to a decrease in the concentrations of coagulation proteins or their activities was studied. The model predicts that only severe coagulation disorders connected with a more than five-fold decrease in the concentrations or activities of the blood coagulation factors can be revealed by the test.     

Extracorporeal lithotripsy in patients with acquired or congenital coagulopathies

Post ESWL haemorragic complications are frequent and most patients experience temporary haematuria and focal intrarenal bleeding or perirenal haematoma are detected by NMR or US imaging. By tradition coagulation troubles have been a contraindication for ESWL but literature describes cases of coagulopathic patients treated with ESWL. From January 1992 to July 1993, 4 of our patients with severe haemostatis troubles (severe haemophilia A in two cases, acquired deficit of coagulation factors and mild thrombocytopenia secondary to post-necrotic hepatitis in 1 case and Glanzmann's thrombasthenia in 1 case) underwent ESWL using Dornier HM3 mod. or MPL 9000. An extensive haematological and clinical evaluation pre and post-ESWL with an adequate haematological prophylaxis (transfusion of blood derivatives) has been performed depending on the coagulation disorder. In our patients we did not observe any haemorragic complication and we propose a reappraisal of the contraindications of ESWL in subjects with coagulation disorders: careful evaluation of haemorragic risk factors, by suitable correction measures and close clinical and instrumental monitoring, allows a reduction of the risk of haemorragic complications in coagulopathic patients who undergo ESWL treatment.     

Partial portal vein and mesenteric vein thrombosis in familial protein S deficiency

Protein S, a vitamin-K dependent glycoprotein is a cofactor of protein-C system, which acts as an inhibitor of the plasmatic coagulation. Protein-S congenital deficiency results in recurrent venous thromboses, atypical locations in portal and mesenteric veins are possible. In our patient the partial thrombosis of the portal vein was diagnosed by computed tomography and angiography. Small bowel ischaemia due to mesenteric vein thrombosis required segmental resection. Post-operatively the patient was heparinized and later phenprocoumon was applied to a long-term therapy.     

Role of eicosanoids in biosynthesis and secretion of insulin

A new technique of unipolar laparoscopic coagulation is particularly useful for the treatment of pelvic or abdominal bleeding during laparoscopic procedures. Blood present at the coagulation site is blown clear with a stream of argon gas prior to tissue coagulation. Of particular importance is the virtual absence of smoke, and because the procedure involves a nontouch technique, eschar is not removed inadvertently. The speed of tissue coagulation is faster than that of conventional bipolar and unipolar techniques.     

Postmenopausal hormone replacement therapy and cardiovascular disease

Cardiovascular disease is the leading cause of mortality in postmenopausal women in developed countries. A possible cardioprotective role of hormone replacement therapy (HRT) is suggested by epidemiologic studies of HRT and reduced risk of coronary heart disease, as well as by randomized trials of HRT and lipid subfractions. Estrogen has beneficial effects on the lipid profile, raising high-density lipoprotein cholesterol levels and reducing low-density lipoprotein cholesterol levels each by approximately 10%. Other possible biologic mechanisms include beneficial effects on vascular function, oxidative status, endothelial-dependent vasodilation, intimal hyperplasia and insulin sensitivity. Estrogen's net effects on coagulation and fibrinolysis are less clear. Estrogen replacement therapy is associated with decreased atherosclerosis in several animal models. However, most of the available data on HRT derive from observational studies or small randomized trials assessing biologic intermediates rather than clinical events. Further research, including large-scale randomized clinical trials, are required to evaluate definitively the role of estrogen replacement therapy, especially given uncertainties about the effects of combined estrogen-progestin therapy and the balance of benefits and risk of this common intervention in postmenopausal women.     

Sucrose: is it not only sweet, but also an analgesic?

Case reports about vasopressin-induced cutaneous necrosis are not frequent. Here we report a further case, of which skin manifestations included not only mottling, cyanosis, ecchymosis, bullae and gangrene, but also amber-like change in focal areas. Besides, intermittent paling of the skin with or without deep pain sensation of the limbs over non-injection sites was observed that might be a warning sign of impending skin necrosis. Based on the literature about vasopressin-induced skin necrosis we discuss the possible role of coagulation enhancement of this molecule.     

The effect of endocrine disturbances on hemodynamic stability of brain dead organ donors. I. Thyroid function

The effect of oxidized starch (OS) which contained 15% of COOH groups and its nitroether (NOS) with 4% of nitrogen on coagulation properties of rat blood was studied in vitro and in vivo. The results of the study in vitro showed that OS did not affect the function of the coagulation system. In contrast to OS, a dose-dependent increase in prothrombin-, thrombin time, and activated partial thromboplastin time was observed for NOS. The activity of the components of the internal coagulation pathway changed when the NOS concentration reached 0.1 mg/ml. At a concentration of 0.6 mg/ml and higher this compound affect the external pathway and final stage of coagulation. According to the efficiency (in vitro) of the influence on the thrombine time I mg/ml NOS corresponded to 0.2 U/ml of heparine. The anticoagulant effect of NOS was also observed in vivo along with reliable changes in thromboplastin and thrombin time. Antithrombin activity of plasma remained the same. Standard test was negative and indicated to the absence of fibrin monomers. The pronounced anticoagulant effect of NOS in the experiments in vitro and quick response in the experiments in vivo make it possible to consider this compound as anticoagulant of direct action.     

Fasting (acute energy deprivation) in man: effect on blood coagulation and fibrinolysis

Blood coagulation and fibrinolysis parameters were studied during 10 days of total fasting in healthy, normal weight males. A reduction of plasma levels of factor VIII activity with a concomitant decrease in factor VIII antigen was found, without other laboratory evidence for a disseminated intravascular coagulation. The effect of 10 days' starvation on blood coagulation appears to be small but the effect of more prolonged starvation might implicate impaired hemostasis.     

Comparison of Quick/INR values of whole capillary blood (CoaguChek Plus) and venous citrate plasma in patients with and without oral anticoagulation

BACKGROUND: The prothrombin time, also called thromboplastin time ("Quick"), is usually measured by using citrated plasma from venous blood. Recently, portable coagulation monitors have been developed which measure prothrombin time using non-anticoagulated capillary whole blood from a finger-stick. In the present study we evaluated the CoaguChek Plus coagulation monitor in comparison with a standard laboratory method in various patient groups: patients on oral anticoagulation with or without heparinisation, patients receiving heparin without oral anticoagulation, patients with a deficiency of one of the coagulation factors of the extrinsic or common pathway, and patients with liver disease. Furthermore, we studied the influence of the haemoglobin concentration on the test results. METHOD: Capillary prothrombin time was measured by using the portable coagulation monitor CoaguChek Plus and venous prothrombin time was assessed by using Thromborel S. RESULTS: We found a correlation coefficient of 0.94 between capillary and venous INR values in 216 determinations from 167 patients. The slope of the regression line was 1.03, and the y-intercept 0.05, 93.5% of the results were within 0.9, 90.7% within 0.7, and 83.8% within 0.5 INR units. Similar results were obtained in patients on oral anticoagulation, patients with a deficiency of a factor of the extrinsic system and in patients with liver disease. Correlation and agreement were somewhat lower among patients on oral anticoagulation and simultaneous heparinisation (40 patients): correlation coefficient was 0.83, slope of the regression line was 0.87 and y-intercept was 0.27 INR units. No influence of the haemoglobin concentration on INR results could be demonstrated. CONCLUSION: Our results show the CoaguChek Plus coagulation monitor to be a valuable tool for measuring prothrombin time in patients on oral anticoagulation, in patients with liver disease to estimate the capacity of protein synthesis, and to screen for possible deficiencies of one of the coagulation factors of the extrinsic or common pathway. However, based on our preliminary data we cannot recommend the use of the CoaguChek Plus coagulation monitor in heparinised patients.     

Non-bacterial thrombotic endocarditis: clinicopathologic correlations

Sixty-five cases of nonbacterial thrombotic endocarditis (NBTE) were discovered at autopsy during a 10 year period--an incidence of 1.6 per cent in the adult autopsy population. In 51 cases, one or more malignant neoplasms were associated; adenocarcinoma represented the most frequent histologic type of related neoplasm. Coagulation abnormalities suggestive of disseminated intravascular coagulation (DIC) were present in 18.5 per cent of the cases. It is possible that both the valvular and peripheral intravascular thromboses in at least some cases of NBTE represent the abnormal coagulation of DIC. Arterial thrombosis with infarction occurred in many peripheral organs. Splenic and renal were most frequent, but cerebral and cardiac consequences were the most significant.     

The Stokes coagulation model

The coagulation problem related to the kinetic theory of motion of particles according to the Boltzmann equation. The coagulation equation brought from the infinite space to the limited one. A real boundary condition for the Stokes coagulation limiting the purified zones without the nonmetallic inclusions. The equivalent relative boundary conditions. The Stokes coagulation as function of time.