PubMed Health⌕ Search

Biomedical subjects

D Ville

Publications and source records attributed to D Ville.

At least 37 records · Page 2Linked to original sources

Increased plasma tissue-type plasminogen activator levels in patients with chronic thrombocytopenia.

Plasma fibrinolytic factors were measured in 14 patients with chronic idiopathic thrombocytopenic purpura (ITP), in 5 patients with chronic central thrombocytopenia and in 16 healthy volunteers. The von Willebrand factor (vWF), tissue-type plasminogen activator (t-PA) and D-dimer (DD) antigens were found to be significantly higher in both patient groups than in the control group. No difference appeared in euglobulin fibrinolytic activity and plasminogen activator inhibitor activity. The increases in both t-PA and vWF suggest the occurrence of an endothelial cell stimulation, associated with the reduction of circulating platelet number. The correlation of increased DD and t-PA levels during ITP can be the proof of a fibrinolysis activation and suggest an antifibrinolytic role of platelets at physiological concentrations. These results can justify antifibrinolytic therapy in bleeding thrombocytopenic patients.

Adult↗

Aggregation to thrombin and collagen of platelets from a Glanzmann thrombasthenic patient lacking glycoproteins IIb and IIIa.

The aim of this study was to investigate the platelets of a Glanzmann thrombasthenic patient, which in citrated PRP failed to respond to various agonists, but aggregated and secreted to high concentrations of thrombin (0.36, 0.72 and 1 U/ml) and collagen (4, 10 and 20 micrograms/ml) when washed and resuspended in a Tyrode-albumin solution (containing 2 mM Ca2+). Aggregation of the patient platelets was not affected by anti-IIb/IIIa monoclonal antibody (P18) which strongly inhibits thrombin or collagen induced aggregation of normal platelets. Washed platelets of this patient did not aggregate to ADP (10-100 microM) in the presence of added fibrinogen (2 mg/ml) nor bind 125I-labelled fibrinogen (40 to 320 micrograms/ml) when thrombin-stimulated. Different anti-IIb/IIIa monoclonal antibodies (P2, P18) when used in binding or crossed immunoelectrophoretic studies showed a complete absence of the IIb-IIIa glycoprotein complex on the patient platelets. Moreover, glycoproteins IIb or IIIa were absent on silver-stained two-dimensional (non-reduced/reduced) polyacrylamide gel separations of the patient platelets and were not detected by Western blots used in combination with anti-PLA1 (antigen present on IIIa), anti-Leka (antigen present on IIb). This study shows that platelets lacking glycoproteins IIb or IIIa can aggregate in response to high concentrations of collagen or thrombin when resuspended in the presence of physiological concentrations of calcium. Results obtained in this study could indicate the existence of other mechanisms (other than the IIb-IIIa glycoprotein complex) involving glycolipids, heparans, proteoglycans, and/or unknown membrane glycoproteins to mediate platelet aggregation of stimulated thrombasthenic platelets.

Adult↗

Randomized trial of a low-molecular-weight heparin (Kabi 2165) versus adjusted-dose subcutaneous standard heparin in the prophylaxis of deep-vein thrombosis after elective hip surgery.

124 patients undergoing total hip replacement were randomly allocated to receive Kabi 2165, 2,500 anti-Xa units twice a day (group A); Kabi 2165, 2,500 anti-Xa units twice a day during the first 48 h postoperatively and then 5,000 anti-Xa units once a day (group B), or adjusted-dose standard heparin, monitored by activated partial thromboplastin time (group C). The first dose was given 2 h before surgery in the three groups. Deep-vein thrombosis (DVT) was detected by radiolabelled fibrinogen uptake and bilateral venography was performed in patients who had a positive scan. In patients who had a negative scan, bilateral venography was performed routinely the day before discharge from hospital. The frequency of DVT demonstrated by venography was 4.9% in group A, 7.3% in group B and 10% in group C. The difference between the three groups was not statistically significant. The incidence of proximal DVT was 2.4, 2.4 and 7.5%, respectively, for the three groups. There was no significant difference between the three groups with respect to mean estimated blood loss, the number of blood units transfused, wound hematoma formation, or hemoglobin and hematocrit levels.

Drug Evaluation↗

Thromboresistance of bulk heparinized catheters in human.

Bulk heparinized catheters (1 mm internal diameter) containing 10% heparin ionically bound, were tested in four human volunteers. Catheters containing 0% and 10% heparin were compared in each individual using ultrasound microflow velocimetry, permeability test, sequential determinations of activated partial thromboplastin time, heparin levels and generation of Fibrinopeptide A, beta thromboglobulin and Platelet factor 4. Although the release of heparin expressed by its anti-IIa activity is of similar range in the four individuals the release of anti-Xa activity is variable and generally of greater magnitude, suggesting a privileged migration of low molecular weight components of heparin. These antiproteasic activities of heparin are sufficient to inhibit fibrin formation and blood coagulation despite their relative inability to prevent platelet activation.

Catheters, Indwelling↗

Atracurium in patients with renal failure. Clinical trial of a new neuromuscular blocker.

Atracurium was given to 30 patients with terminal chronic renal insufficiency, in two regimens. Group I (20 patients) received a single dose of 0.6 mg kg-1 and group II (10 patients), received one or several injections of 0.2 mg kg-1. Tracheal intubation was performed with ease in all patients 3 min after the injection of atracurium. A supramaximal stimulus was applied to the ulnar nerve at wrist level, and thumb adduction force was recorded. Muscular blockade was 100% in 29/30 patients and 95% in one. Mean time between atracurium injection and reappearance of 25% of the initial muscular power (HT25) was 49 min. The recovery time index (IR25-75) was 12 min and did not increase after re-injection. No side-effects were observed and no significant differences in any of the measurements made were seen between the two groups.

Adult↗

Plasma thrombospondin in patients with chronic renal failure, liver disease and splenectomy.

Thrombospondin (TSP), is a major constituent of human blood platelet alpha-granules. Stimulation of platelets causes the release of TSP in parallel with other alpha-granule constituents such as beta-thromboglobulin (beta-TG) and platelet factor 4 (PF4) but the thrombospondin plasma in vivo half life is significantly greater than beta-TG and PF4. The aim of this study was to assay TSP levels in plasma of patients with chronic renal failure (CRF), liver disease (LD) and following splenectomy. The TSP values were then compared to the patients plasma levels of two traditional markers of platelet activation, beta-TG and PF4, and to fibronectin (FN) and von Willebrand factor (VIII:vWF). Plasma TSP levels (67.6 +/- 16.9 ng/ml) assayed in 14 CRF patients were significantly higher (p less than 0.05) than those measured in 28 donors (55.5 +/- 11.7 ng/ml). No correlation was observed, in CRF patients, between the TSP level and PF4 (2.5 +/- 1.5 ng/ml), beta-TG (131.1 +/- 21 ng/ml), FVIII:vWF (252 +/- 85%), or FN (102 +/- 33%) plasma levels. The TSP plasma level in CRF patients was significantly correlated (p less than 0.02) with that of fibrinopeptide A (4.1 +/- 1.9 ng/ml). Although the beta-TG (23.5 +/- 6.9 ng/ml) and PF4 (2.9 +/- 2 ng/ml) plasma levels in six LD patients were normal, the TSP levels (82.5 +/- 39.1 ng/ml) were significantly increased (p less than 0.01). Thrombospondin plasma levels (77.1 +/- 20.1 ng/ml) in 14 patients having undergone splenectomy were significantly increased (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[Evaluation of erythrocyte survival by the determination of glycosylated hemoglobin. Clinical value].

In normoglycaemic subjects the haemoglobin glycosylation rate primarily depends on duration of erythrocyte life. Measurements of glycosylated haemoglobin therefore can be used to evaluate erythrocyte life. Indeed, glycosylated haemoglobin is significantly reduced (p less than 0.001) in patients with autoimmune haemolytic anaemia or Minkowski-Chauffard syndrome as compared with patients with non-haemolytic anaemia. In addition, there is a strong correlation (r = 0.92) in non-diabetic subjects between the level of glycosylated haemoglobin and the percentage of daily haemolysis, as determined by a method using 51 Cr-labelled antologous red cells.

Anemia↗

[Ineffective cortico-sensitive erythropoiesis in 2 young adults].

A 21 year-old man and a 17 year-old woman presented with severe anemia of unknown etiology. The bone marrow aspiration showed many erythroblasts which were morphologically normal, but there was no reticulocytosis; the 59Fe kinetics were typical of a major ineffective erythropoiesis. A rapid and total improvement occurred following steroid treatment. In the first case, there was a transient and cortico-responsive thrombocytopenia before and after the anemia and in the second case, the antiglobulin test was sometimes weakly positive. An immunological disturbance against the late erythroblasts is likely. Perhaps these case are not very different from those reported as "hemolytic anemia with reticulocytopenia".

Adolescent↗

Drugs effect on platelet survival time: comparison of two pyrimido-pyrimidine derivatives in patients with aortic or mitral replacement.

A prospective randomized trial of the effects of 2 antiplatelet aggregating drugs, dipyridamole (375 mg/d), a related substance RA 233 (1500 mg/d) and placebo, concomitantly with oral anticoagulants, was carried out in patients with prior valvular replacement. The study was aimed to determine effect on platelet survival time (PST) of these 2 agents. The trial sample consisted of 40 males and 15 females aged 40-70 years (average 53 years). 32 received Björk-Shiley valve in aortic position, 23 underwent mitral valve replacement: 3 with Cooley-Cutter, 11 with Lillehei-Kaster 500 and 9 with Starr-Edwards 6120 prostheses; 28 patients had aortic stenosis, 21 aortic insufficiency. All the PST measured after 3 months of treatment were within normal ranges and not different between placebo, dipyridamole or RA 233 treated subjects: averages in days were, respectively, 7.49, 7.11 and 6.88. The present study did not support the claim that modern valve prosthesis could lead to a shortened PST.

Adult↗

Serum beta 2 microglobulin in adult myeloid acute leukemias.

Serum beta 2 microglobulin levels, measured by radioimmunoassay (Phadebas test), were found increased in acute myeloid leukemias at diagnosis. Serum beta 2 microglobulin levels were significantly higher in patients with monocytic leukemias (13 patients, M4-M5 FAB classification) than in those with other cytological types (18 patients). Beta 2 microglobulin levels at diagnosis were correlated with serum lysozyme levels, but they were not correlated with blood blast counts, serum LDH and ferritin levels. 195 serum beta 2 microglobulin measurements were made serially in 30 patients with acute myeloid leukemias in first remission. Compared to values at diagnosis, beta 2 microglobulin levels in remission were significantly decreased. Out of 30 patients in remission 12 had increased serum beta 2 microglobulin levels (greater than 3 mg/l). Serial measurements were not predictive for relapses.

Adolescent↗

Clearance mediated by splenic macrophage membrane receptors for immune complexes in cutaneous vasculitis.

This study concerns 11 patients with immune complex associated cutaneous vasculitis (5 leukocytoclastic vasculitis or Gougerot Ruiter's disease, 3 essential mixed cryoglobulinaemia, 2 Henoch-Schönlein purpura and 1 Waldenström's hypergammaglobulinaemic purpura). By determining the clearance of 51Cr-labeled IgG sensitized erythrocytes we showed a slight modification in the splenic mononuclear phagocyte system. In patients with Gougerot-Ruiter's disease the clearance of the autologous IgG-coated erythrocytes was delayed in 1 patient, and normal in 2 patients. In contact, the 8 other patients showed accelerated rates of IgG-mediated clearance. There was no statistically significant correlation between clearance rate, serum complement component levels and composition and/or levels of circulating immune complexes. Thus, the accelerated clearance rate suggests an enhanced activity of the mononuclear phagocyte system IgG-Fc receptors.

Adolescent↗

[Pure red cell aplasia and chronic leukemia. Usefulness of ferrokinetic measurements (author's transl)].

Erythroblastopenia is probably not rare in chronic lymphocytic leukemia (CLL) but the diagnosis could be difficult. It produces a severe and rapidly developing anemia, without evidence of hemolysis. The chief differential diagnosis is the common bone marrow insufficiency of end-stage CLL. Iron kinetics measurements are typical, showing a total erythropoietic insufficiency, and a red cell utilization of radio-iron that is practically zero. Erythroblastopenia could be cured with corticosteroid or sometimes with immunosuppressive treatment.

Adult↗

[The radioimmunological assay of fibrinogen breakdown products with E antigen during postoperative venous thromboses. Study in 46 cases of arthroplasty for osteoarthrosis of the hip (author's transl)].

Twenty six patients (without thrombosis) had a normal 125I-fibrinogen test, among whom 15 had a normal phlebography; 18 patients (with thrombosis) had a positive 125I-fibrinogen test among whom 11 had a positive phlebography. There was a discrepancy between phlebography and 125I-fibrinogen test in 2 patients. In patients with thrombosis, there is a significantly increase of FgE levels for several days after the intervention. However the measurement of FgE is not a reliable test (4% of false positive and 38% of false negative); but it is always elevated in femoral and popliteal thrombosis.

Adult↗

Controlled trial of platelet anti-aggregating agents and subcutaneous heparin in prevention of postoperative deep vein thrombosis in high risk patients.

In a prospective randomised trial, three groups of 20 patients each were compared. A first group served as a control, a second group received dipyridamole and acetylsalicylic acid and a third group received low doses of heparin. The incidence of deep vein thrombosis determined by the 125I-fibrinogen test was 40% in the first group, 50% in the second group, and 5% in the third group. The differences between the heparin group and the two other groups are statistically significant. No wound complication and no haematoma at the injection site occurred.

Aged↗