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Biomedical subjects

J A Zeller

Publications and source records attributed to J A Zeller.

13 recordsLinked to original sources
PubMed1991

Urinary fibrinopeptide A in evaluation of patients with suspected acute pulmonary embolism. A prospective pilot study.

This pilot study assessed the urinary fibrinopeptide A (uFPA) levels and the combination of uFPA test plus ventilation/perfusion (V/Q) scan in the diagnostic evaluation of acute pulmonary embolism (PE). One hundred consecutive patients were studied prospectively. Twenty-nine patients fulfilled diagnostic criteria defined in this study (seven with and 22 without PE). The uFPA concentration was significantly higher in patients with than without PE (41.1 +/- 2.6 vs 4.8 +/- 2.5 ng/mg of creatinine, p less than 0.0001). In all patients with PE, the uFPA levels were higher than threshold value derived by adding 2 standard deviations to the mean uFPA concentration of patients without PE. In patients without PE, the V/Q scan was negative in 16, the uFPA test was negative in 18, and at least one of the tests was negative in 21. These preliminary data suggest that a negative uFPA test may be helpful in excluding PE and that uFPA in combination with V/Q lung scans may correctly exclude PE in more patients than either test alone. Further studies in a large unselected population are needed to confirm these results.

Acute Disease↗
PubMed1989

Urinary fibrinopeptide A levels in ischemic heart disease.

Because acute coronary thrombosis can cause unstable coronary artery disease, fibrinopeptide A, a reliable marker of coagulation activity, may play a role in the evaluation of unstable ischemic syndromes. A new method of fibrinopeptide A sampling, spot urine normalized to urinary creatinine, was evaluated in patients with stable and unstable angina pectoris and acute myocardial infarction. Serial samples were obtained to characterize the changes in urinary fibrinopeptide A levels over time in patients with ischemic heart disease. Admission values (mean +/- SD) were similar in the control group (3.3 +/- 1.4 ng/mg creatinine) and the stable angina group (3.2 +/- 1.1 ng/mg creatinine) (p = NS). Values in the unstable angina group (5.7 +/- 2.6 ng/mg creatinine) were higher than those in the control (p = 0.008) and stable angina (p less than 0.001) groups. Myocardial infarction admission values (8.4 +/- 10.0 ng/mg creatinine) were higher than those in the control (p = 0.005) and stable angina (p less than 0.001) groups, but not higher than those in the unstable angina group. Peak values (the highest of multiple samples) were higher in the unstable angina group (7.6 +/- 5.9 ng/mg creatinine) than in the stable angina group (4.0 +/- 1.0 ng/mg creatinine) (p = 0.04), but not in the control group (4.5 +/- 1.9 ng/mg creatinine) (p = 0.056). The two patients with unstable angina with the highest peak values subsequently exhibited infarction. Peak values in patients with infarction (44.5 +/- 60.0 ng/mg creatinine) were significantly higher than those in patients with unstable (p = 0.03) or stable (p = 0.002) angina and control patients (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Angina Pectoris↗
PubMed1984

Circulating heparan sulfate anticoagulant in a patient with a fatal bleeding disorder.

We have identified a circulating, heparin-like anticoagulant in a patient with multiple myeloma (IgG4 lambda) who had serious clinically evident bleeding that contributed to his death. Purification of the patient's circulating coagulation inhibitor was accomplished by ammonium sulfate concentration, anion exchange chromatography, and affinity chromatography on protamine sulfate. Analysis of the purified inhibitor showed that it was a proteoglycan that comigrated with heparan sulfate on lithium acetate-agarose-gel electrophoresis and that it contained 39 per cent L-iduronic acid. Control samples of heparan sulfate and heparin contained 29 and 68 per cent L-iduronic acid, respectively. Functional coagulation studies revealed that the purified inhibitor had cofactor activity with antithrombin III that could be abolished by prior incubation with protamine sulfate or platelet factor 4. Recognition of the existence of this or of other similar inhibitors in bleeding patients is important because of the potential for treatment with agents such as protamine sulfate and platelet factor 4, which neutralize the anticoagulant effects of proteoglycans.

Blood Coagulation↗
PubMed1984

Aldehyde-induced platelet aggregation.

Formaldehyde, acetaldehyde, malondialdehyde, glutaraldehyde and paraldehyde, when added in vitro to platelet-rich plasma, generate a similar distinct platelet aggregation response which is dose dependent when measured with a manual visual microscopic technique and by computerized image analysis, 'computerized platelet aggregation analysis'. Light transmission aggregometry did not measure this aggregation in a reliable manner. The aggregating reaction was specific to the aldehyde group and was not seen when the aldehyde was replaced by an alcohol, ketone, or acetate group in the case of acetaldehyde. The maximal aggregating effect of these aldehydes was directly proportional to the number of aldehyde groups per molecule. Aggregation was found to require the presence of plasma, but not von Willebrand's factor.

Acetaldehyde↗
PubMed1981

Consultation in the coagulation laboratory. A conceptual analysis.

Physicians can play an important role as consultants in the utilization of laboratory data by providing interpretation, recommending action, and presenting rationale. These activities have been quantitated in 382 consecutive consultations provided by pathologists in the coagulation laboratory, and their statistical interrelationships have been analyzed. Quantitative characterization of the consultation is important, since the pathologist's professional role in patient care may no longer remain informal and undocumented. However, analogous evaluations can be applied to expose, evaluate, and improve the properties of clinical consultation in general.

Blood Coagulation Tests↗
PubMed1976

Elevated plasmz zinc: a heritable anomaly.

An extremely high concentration of zinc in the plasma (hyperzincemia) was found in five out of seven members of one family and in two out of three second generation indiviuals, an indication that the condition is heritable. The excess zinc in the plasma appears to be bound to serum proteins, with no apparent clinical symptoms or abnormalities.

Black People↗
PubMed1972

Ultrastructural identification of spirochetes and flagellated microbes at the brush border of the large intestinal epithelium of the rhesus monkey.

Spiral-shaped organisms exclusively and intimately populate the brush border of the cecal and colonic epithelium of healthy monkeys (Macaca mulatta). These organisms replace the glycocalyx, destroy most microvilli, and attenuate the terminal web of the brush border. Despite these remarkable alterations, the remaining host cellular structure is unchanged. Two structurally distinct microbes, a spirochete and a flagellate, were recognized by electron microscopy. These spirochetes share the general characteristics of other known spirochetes: they are 3 to 6 mum long and 0.2 to 0.4 mum wide, spiral 2 to 6 times, and have axial fibrils of 6-12-6 and 4-8-4 arrangements. Flagellated microbes are 4 to 6 mum long and 0.2 to 0.4 mum wide, spiral 2 to 4 times, and are characterized by a polar flagellum which originates from the terminal button at each end of the cytoplasmic body. This in vivo ultrastructural study of anaerobic spiral-shaped organisms bypasses the difficulties of in vitro culture techniques and provides a detailed description and identification of these organisms in their host environment.

Animals↗