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Biomedical subjects

C T Kisker

Publications and source records attributed to C T Kisker.

11 recordsLinked to original sources

Blood coagulation following vasectomy.

Concern that men may have an increased risk of the development of thrombophlebitis following vasectomy prompted the study of 58 vasectomized men and 37 age-matched controls. Eight patients undergoing total hip replacement also were studied, since they are known to have an increased risk of thrombotic complications. There were no changes in coagulation suggestive of a thrombotic tendency in the vasectomized population, though an increase in fibrinogen concentration was present preoperatively, and transient increases in factor V concentration, prothrombin time, and fibrinogen concentration were seen postoperatively in some cases. None of the vasectomized patients had clinical evidence suggestive of thrombosis.

Blood Coagulation

An intrinsic coagulation pathway inhibitor in a 3-year-old child.

An intrinsic coagulation pathway inhibitor with acitivty against factor XI was detected in the plasma of a 3-year-old child, following a respiratory infection. The inhibitor was present transiently, but it was clinically significant and was manifiested by extensive bruises. Abnormalities of clotting and the bruising tendency disappeared simultaneously without treatment before the inhibitor could be definitively characterized. It was possibly the consequence of an adenovirus infection, as an elevated adenovirus titer was demonstrated in the patient's blood. It is possible that inhibitors of this type are more common sequelae of viral infections than realized, and perhaps a systematic effort should be made to detect them and to define their etiology and mechanism of action.

Adenovirus Infections, Human

Detection of fibrin monomer. Comparison of the immune precipitate method with the serial-dilution protamine sulfate test and the ethanol gel test.

In a previous publication, a method for measuring fibrin monomer in plasma with the use of an immune precipitate of fibrinogen was described. The method was found to be more sensitive to unstabilized fibrin monomer than the serial-dilution protamine sulfate test, or the ethanol gel test, and detected fibrin in a mixture of the plasmin digestion products of fibrin. In the present study the sensitivity of the immune precipitate method for detecting specific plasmin digestion products of fibrin X, Y, D, and E, its sensitivity for stabilized fibrin monomer complexes, and its sensitivity for fibrin retaining B-peptide were measured and compared with the corresponding sensitivities of the serial-dilution protamine sulfate test and the ethanol gel test for detecting these same products. The immune precipitate method was found to be highly sensitive to stabilized fibrin monomer complexes and to fibrin retaining B-peptide; to be significantly less sensitive to the plasmin digestion fragments X, Y, and E; and to be insensitive to fragment D. The serial-dilution protamine sulfate test and the ethanol gel test were found to be insensitive to all of the plasmin digestion products of fibrin and less sensitive to the other fibrin complexes.

Batroxobin

Intrauterine fetal transfusion, 1965-1976, with an assessment of the surviving children.

The need for IUT in the management of Rh hemolytic disease is likely to continue in the foreseeable future. Recent reports have been skeptical about the success of this procedure and the quality of the surviving infants. Of 84 fetuses who received 134 IUT's, over all, 35.7 per cent survived; 48.3 per cent of the nonhydropic group survived. Fifteen of the 23 survivors between 3 and 11 years of age received intellectual, academic, behavioral, health, and developmental evaluations. When compared to sibling and high-risk control groups, the study children showed no significant differences in intelligence quotients, arithmetic achievements, or reading achievements; their school performance is acceptable and none is presenting significant behavioral problems. Except for an excessive number of umbilical and inguinal hernias, there were no physical abnormalities that could be directly related to IUT.

Amniocentesis

Adequate anticoagulation during cardiopulmonary bypass determined by activated clotting time and the appearance of fibrin monomer.

The adequacy of anticoagulation during 2 hours of cardiopulmonary bypass at 30 degrees C in 9 rhesus monkeys was determined by measuring the whole-blood activated clotting time (ACT) and by noting the appearance of thrombin-altered fibrin (fibrin monomer) and the relative consumption of clotting factors. Factor V and VIII, the heparin cofactor, antithrombin III, prothrombin time, partial thromboplastin time, ACT, platelets, hematocrit, fibrinogen, and fibrin monomer were determined prior to heparinization and after protamine. In 6 of 9 experiments, fibrin monomer became positive in the plasma during cardiopulmonary bypass (CPB), indicating that active coagulation was occurring. In 5 of the 6 animals, initial ACT was less than 400 seconds, and fibrin monomer appeared within the first 30 minutes of bypass. In 1 animal with an initial ACT of 439 seconds, fibrin monomer appeared after 60 minutes of bypass, at which time the ACT was less than 400 seconds. An abnormal level of fibrin monomer was not detected in 5 pediatric patients with an ACT greater than 450 seconds during CPB. Our experimental study and clinical data suggest that the lower limit, as measured by the ACT, for anticoagulant effect to provide coagulation-free CPB is at least 400 seconds.

Animals

Coagulation changes following vasectomy: a study in primates.

Thirty vasectomized rhesus monkeys were tested for changes in coagulation factors that might reflect an increased incidence of thrombosis. The results of tests on these monkeys were compared with results of tests on 18 control rhesus monkeys; there were no significant differences between control and vasectomized animals for any of the parameters tested. One vasectomized animal had increased levels of fibrin monomer in his plasma on repeated samples, but no evidence of thrombosis on postmortem examination.

Animals

A method for measurement of fibrin monomer with the use of an immune precipitate of fibrinogen.

A semiquantitative test for measuring fibrin monomer in human plasma is described. The test is based upon the ability of fibrin monomer to form a complex with an immune precipitate of fibrinogen. The test is not sensitive to the plasmin digestion products of fibrinogen and relatively insensitive to plasmin digestion products of fibrin. The test is easily performed on small quantities of plasma in approximately 2 hours.

Adolescent

Absence of intravascular coagulation in the hemolytic-uremic syndrome.

Four patients had clinical manifestations of the hemolytic-uremic syndrome. No evidence of active intravascular coagulation was found during the acute phase of the illness, using a sensitive assay to measure soluble circulating fibrin in the plasma of these patients, three of whom developed the clinical syndrome while hospitalized for gastro-enteritis. These findings, coupled with the findings of others, suggest that either the episode of intravascular coagulation precedes the development of the clinical manifestations, or that platelet thrombosis is occurring in the absence of activation of plasma clotting factors. In any case, heparin anticoagulant therapy does not seem indicated.

Anuria

The effects of combined platelet and leukapheresis on the blood coagulation system.

Analysis of blood coagulation was done on samples of blood collected from ten donors undergoing combined platelet and leukapheresis using the Haemonetics Model 30 Blood Processor. Blood samples were obtained from the donors prior to, during, and following pheresis. Blood was also obtained from the blood-return line after the first collection of leukocytes and platelets, but before it was returned to the donor. Although the citrate anticoagulant was returned to the donor and there were some decreases in the concentrations of fibrinogen, platelets, and factors V and VIII, there were no changes of sufficient degree to suggest that development of a potential bleeding disorder. In addition there was no evidence to suggest that any activation of blood coagulation occurred during the pheresis or that thrombogenic substances were returned to the donors. Combined platelet and leukapheresis using the Haemonetics Model 30 Blood Processor, therefore, do not appear to subject the donor to risks for either bleeding or thrombotic complications.

Blood Coagulation