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Biomedical subjects

F Kunz

Publications and source records attributed to F Kunz.

At least 19 recordsLinked to original sources

Increased lipid binding to thrombi in coronary artery disease. Findings in patients without premedication in native (not anticoagulated) test systems.

Thrombi and clots were produced from native (i.e., not anticoagulated) platelet-rich and platelet-poor plasma from patients with coronary artery disease and control subjects who had not taken any medication known to influence plasma lipids, coagulation, or platelet aggregation. The clotting times were recorded, and the lipid content of clots, thrombi, platelets, plasma, and high density lipoprotein was analyzed. Thrombi produced from native platelet-rich plasma were 46% heavier in coronary artery disease patients and contained about 20% more phospholipids and free cholesterol and about twice the amount of triglycerides and esterified cholesterol in both absolute and relative amounts with respect to the corresponding lipids of plasma plus platelets. The elevated content of lipids not only increases the size of the thrombi but also changes their quality because of an increased content in plasmatic lipids, as platelets contain only trace amounts of triglycerides and cholesterol esters. In agreement herewith, fibrinogen and maximal amplitude on the thrombelastogram were increased in coronary artery disease patients, whereas the thrombus-forming time and clotting times of platelet-poor and platelet-rich plasma were shortened, indicating accelerated coagulation and activation of platelets. Analysis of these results suggests a disturbed interrelation in coronary artery disease between lipids and hemostasis, in which platelets, high density lipoprotein, and lipoproteins rich in triglycerides and cholesterol esters may play a role.

Blood Coagulation

[An idiopathic floating left-ventricular thrombus].

Four weeks after appendicectomy a 28-year-old man developed dragging pains in the left calf. Left popliteal, posterior tibial and dorsalis pedis arteries could not be palpated. Angiography revealed an embolic occlusion of the left superior femoral artery at the level of the adductor canal. Echocardiography demonstrated a pedunculated left ventricular thrombus, 3.5 x 2.0 cm, as a possible source of the embolus. After successful trifurcation embolectomy and saphenous vein patch-plasty acenocoumarol, 4 mg/d and heparin, 3 x 7500 IU/d were administered. Because the thrombus failed to shrink, systemic thrombolysis, initially 750,000 IU streptokinase and 3000 IU heparin i.v., was begun. After five days the thrombus diameter had decreased to 0.7 cm. But because thrombus movement had increased, streptokinase was replaced by 70 IU/d ancrod i.v. The thrombus completely disappeared within two weeks. The patient was symptom-free during the period of anticoagulation with acenocoumarol. Six months later echocardiography confirmed the absence of thrombus in the left ventricle.

Acenocoumarol

Influence of oral contraceptives on coagulation tests in native blood and plasma.

Routine coagulation laboratory tests, clotting times in native (not anticoagulated) whole blood, platelet-rich and platelet-poor plasma, and recalcification times in citrated whole blood, platelet-rich and platelet-poor plasma were performed in 14 healthy premenopausal women. Blood was taken before and after one or two cycles of low-dose oral contraceptives. After oral contraceptives a reduction in clotting time in native platelet-rich plasma and activated partial thromboplastin time were observed. Recalcification times in whole blood and platelet-rich plasma were shorter than clotting times in their native counterparts. The observed changes are compatible with a procoagulant effect seen soon after the start of oral contraceptive use. The absence of these changes in the recalcification times in citrate systems suggests a masking effect of citrate. The reduction in clotting times in native platelet-rich but not in platelet-poor plasma indicates that the hypercoagulability in oral contraceptives users is mainly related to platelets.

Blood Coagulation

[Comparison of various methods of cryopreservation of human pre-embryos].

A human egg and embryo freezing program for non-fertilized eggs and spare embryos has been established in our in vitro fertilization clinic. In the following we report on our first experience with different methods of human pre-embryo cryopreservation. In a simple evaluation we have compared different conventional freezing techniques using cryoprotectant substances such as glycerol, DMSO and 1.2 propanediol and an "ultrarapid" technique. So far we have achieved 6 normal ongoing and 2 biochemical pregnancies out of a total number of 61 embryo transfers. This equals 9.8% pregnancy rate per embryo transfer. Two methods seem preferable, i.e. sucrose and 1.2 propandiol which has the highest success rate and the ultrarapid method which gives a good rate of embryo survival on the one hand and a simple handling on the other.

Embryo Transfer

Sex-related differences in platelet aggregation in native whole blood.

To clarify discrepant reports about sex-related differences platelet aggregation (PA) was tested by a new impedance method in native whole blood (NWB) and compared to the results of citrated whole blood (CWB) and the turbidometric method (TM). In NWB collagen or ADP-induced PA was stronger in women than men similar to the TM indicating that this is not or not only caused by citrate. With collagen this difference persisted after ingestion of 125 mg acetylsalicylic acid (ASA) which might in part explain the greater therapeutic benefit of ASA for men. The results exclude haematocrit or platelet count as a cause of the differences of PA between women and men. Sodium arachidonate (NaAA)-induced PA was inhibited by 125 mg ASA in all tested methods; since inhibition of ADP-induced PA was not observed in NWB or CWB and the impedance methods failed to show a second wave of ADP-induced PA the significance of the second wave appears doubtful. The impedance method of NWB was found to be more sensitive to collagen, ADP or NaAA than the impedance method of CWB and to collagen or NaAA more sensitive than the TM. The impedance methods in NWB or CWB are not suited to test epinephrine-induced PA.

Adenosine Diphosphate

A method of testing platelet aggregation in native whole blood.

A method of testing collagen induced platelet aggregation and ATP release in native (= non anticoagulated) whole blood by monitoring the electrical impedance in the Chrono Log Whole Blood Aggregometer is reported. It is the first simple method by which aggregation of human platelets can be measured in their natural environment. In normal individuals lower threshold collagen concentrations could induce platelet aggregation as determined with this method than in the other tested methods (impedance method with citrated blood, optical method in platelet rich plasma). The aggregation response was not inhibited by hirudin or heparin in therapeutic dose. The luminescence channel of the Whole Blood Aggregometer permits measurements of ATP release in native whole blood.

Adult

[Retinal vascular occlusion in antithrombin III deficiency].

Deficiency of Antithrombin III (AT III), which is one of the main inhibitors of blood coagulation, may lead to severe thrombosis and embolism. The authors detected AT III deficiency in two patients with retinal vessel occlusion. Both patients were otherwise healthy. One had recurrent retinal vein thrombosis, the other cilioretinal occlusion. To the authors' knowledge, only one case of retinal vessel occlusion with AT III deficiency has been reported in literature. Furthermore, in the patients reported here retinal vessel occlusion may have been caused by AT III deficiency, which has considerable therapeutic and prophylactic consequences for patients with this disorder. AT III should therefore be determined in retinal vessel occlusion of unknown cause.

Aged

[Acute fatty liver in pregnancy with consumption coagulopathy].

Acute idiopathic fatty liver of pregnancy was observed in a 34-year-old patient. Mother and child survived this complication which has happened in only 10% of the 69 histologically verified cases. On the basis of coagulation studies it may be assumed that consumption coagulopathy had been present initially. This could be pathogenetically relevant in the development of fatty liver of pregnancy.

Acute Disease

Studies in a case of Bernard-Soulier syndrome.

In two siblings, brother and sister, with a history of bleeding Bernard-Soulier syndrome was diagnosed: The stronger affected sister showed a high percentage of giant blood platelets, an abnormal platelet spreading test and a defect in ristocetin and bovine fibrinogen-induced platelet aggregation. In addition, the content of platelet ATP, ADP and AMP was increased. As leucocyte counts were consistently decreased in the more seriously affected anaemic sister, repeated cytochemical examinations of the haemopoietic cells were carried out, revealing maturational defects in the whole haemopoietic system. Therapy with tranexamic acid reduced bleeding in the sister and she has not been anaemic since.

Adenine Nucleotides

[Postoperative fructose infusion in a case of presumed hereditary fructose intolerance (author's transl)].

Hereditary fructose intolerance (HFI) was diagnosed in a 61 year-old male patient on account of liver dysfunction followed by prolonged shock immediately after the administration of a fructose and lactose infusion postoperatively. The diagnosis of HFI was based on an increased value of fructose, hypoglycaemia, lactic acidosis and diminution of the phosphate level in combination with the typical family history. The patient's children showed a normal reaction to fructose administration. The therapy included glucose, insulin and heparin administration, balance of acidosis and partial exchange of blood, which resulted in improvement in the glucose level, coagulation factors and acidosis, but could not prevent further liver damage and uraemia with a fatal outcome.

Acidosis

Plasma lipids, coagulation factors, and fibrin formation after severe multiple trauma, and in adult respiratory distress syndrome.

Following severe multiple trauma, decreases were observed in a) Free cholesterol, b) Cholesteryl esters, c) Total phospholipids, and d) Lysolecithin. Comparatively slight changes in coagulation parameters did not differ regardless of whether pulmonary complications developed. In contrast, increased fibrin lipid complexing was more closely correlated with clinical data, because: a) Plasmatic lipids, particularly triglycerides complexed with fibrins, were elevated severalfold in patients with adult respiratory distress and fat embolism syndromes when compared with multiple trauma patients without pulmonary complications. This was independent of plasma lipid levels. b) Plasmatic triglycerides complexed with fibrins were significantly higher in patients who died than in those who survived. The considerable changes in the plasma lipid pattern following severe trauma suggest the presence of an abnormal lipoprotein with increased affinity to fibrin, thereby inhibiting fibrinolysis. This might well be one pathogenic mechanism in the development of post-traumatic respiratory distress syndrome.

Adult

[Phospholipids].

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Animals