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Biomedical subjects

U Hedner

Publications and source records attributed to U Hedner.

At least 145 records · Page 8Linked to original sources

Deep venous thrombosis of the arm: a study of coagulation and fibrinolysis.

Sixty consecutive patients with phlebographically verified deep venous thrombosis of the upper arm were studied for disorders of coagulation and fibrinolysis. No appreciable increase in abnormalities of the factor VIII complex, antithrombin III, or inhibitors of activators of fibrinolysis were found. A decreased fibrinolytic defence mechanism, evident either as a deficient release capacity of fibrinolytic activators from the vein during stasis or as decreased fibrinolytic activity in the vein wall as determined histochemically, was found in 26 out of 53 patients studied (49%). It is concluded that deep venous thrombosis of the upper arm is a multifactorial disease. An impaired fibrinolytic defence mechanism is one of the factors that may be of pathogenetic importance.

Adolescent↗

delta 4-ethylestrenol in recurrent deep venous thrombosis.

In a study of 21 patients with recurrent venous thrombosis and/or thrombophlebitis, fibrinolytic activity measured after venous occlusion was significantly improved after treatment with 6 mg delta 4-ethylestrenol (Orgabolin) daily. Seven of the 21 patients had abnormally low vessel wall plasminogen activator content, which normalised during treatment. No tendency to develop resistance to the drug was observed during treatment for periods up to 56 months. This improvement was shown to be combined with a significant lower (p less than 0.001) incidence of thrombosis.

Adult↗

Coagulation studies in children and young adults with cerebral ischemic episodes.

One hundred and one patients below 45 years and showing objective signs of cerebral ischemia were studied retrospectively for pathogenic factors. Twelve were below 15 years; the male to female ratio was 1:1. Factors known as predisposing (heart disease, hypertension, hyperlipemia, diabetes mellitus or infectious diseases) and other possible factors (e.g. trauma, abuse) were found in 41 patients. Among women using contraceptive pills there might be an increased risk of development of cerebral thrombosis, but the material was not large enough to warrant statistical analysis. In 64 patients one or more abnormal coagulation values were found, the most frequent being a deficient vessel wall fibrinolysis, which was noted in 38%. We therefore consider it worthwhile to investigate the fibrinolytic defence mechanism of the vessel wall in patients with cerebral thrombosis, since it is possible to treat this condition with specific fibrinolytic stimulating agents.

Adolescent↗

Radiologic evaluation of prophylaxis in severe haemophilia.

The effect of prophylactic treatment of severe haemophilia A and B was evaluated with a recently described radiologic score system for assessing the severity of arthropathy. The severity of the arthropathy was assessed in 50 patients with severe haemophilia receiving prophylaxis with factor VIII or IX (25--30 units factor VIII or IX/kg bodyweight at 4--7 day intervals), and in 9 in whom the condition was complicated by inhibitors and who were thus not receiving prophylaxis. The score values found in a recent investigation of the natural course of haemophilia served as controls in the evaluation of the effect of the prophylaxis. In the group with severe haemophilia receiving prophylaxis changes appeared only exceptionally in joints not affected already before the prophylaxis, and the course of the arthropathy and its severity according to age did not vary to any noteworthy extent from that in the control group with moderate haemophilia. In the cases complicated by inhibitors the joints were most often worse than those in the control group with severe haemophilia. It is concluded that prophylaxis has a considerable effect on the course of the arthropathy and the prophylaxis should be instituted at an early stage of the disease, when the joints are still unaffected.

Adolescent↗

Binding of fibrinogen degradation products to S. aureus and to beta-hemolytic streptococci group A, C and G.

Binding of fibrinogen degradation products was measured to Gram-positive cocci known to carry receptors for human fibrinogen. Forty-one strains of S. aureus and group A, C and G streptococci were studied. The largest plasmin produced fragment (X-fragment, HMWDP) showed higher binding levels to the bacterial receptors in all four species as compared to intact fibrinogens. The enzymatically produced C-terminal fragment D was strongly reactive, whereas the N-terminal fragment E was non-reactive. Inhibition experiments showed that reactive fragments were bound to the same receptors as fibrinogen. Three chemically-produced and well-characterized fragments from the terminal and the middle portions of the fibrinogen molecule were all negative in binding assays. The binding patterns for fibrinogen and the fragments tested were identical in the four bacterial species tested, S. aureus and group A, C and G streptococci. The results confirm and extend earlier data on similarities between fibrinogen receptors on these Gram-positive bacterial species.

Binding Sites↗

Effect of dextran on factor VIII (antihemophilic factor) and platelet function.

Three different properties of factor VIII (antihemophilic globulin) were studied after infusion of 500 ml of six per cent Dextran 70 to healthy volunteers. This dose caused no change in the factor VIII coagulant activity while there was a significant but temporary decrease of factor VIII related antigen. The Ristocetin induced platelet aggregation analysed with native as well as with formalin-fixed platelets, also decreased significantly. The maximal decrease was found a few hours after the infusion. The decrease was seen only if Dextran was infused in vivo and not if Dextran was added to blood in vitro. The dysfunction of factor VIII caused by Dextran resembles that found in one variant of von Willebrand's disease. This finding probably explains the platelet function inhibiting properties of Dextran, and may be of significance for its antithrombotic effects.

Adolescent↗

Umbilical artery catheterization in newborns. III. Thrombosis--a study of some predisposing factors.

Thrombosis following umbilical artery catheterization is a relatively frequent complication. Low fibrinolytic activity in the vessel walls, high factor VIII and low antithrombin III (AT III, Heparin cofactor activity) in blood are factors known to favour the formation of thrombosis. In 30 newborns who died and in 2 foetuses the fibrinolytic activity determined in the aorta and the femoral vessels was in the normal 'adult' range except for a few very immature infants and the foetuses. The five cases with arterial thrombosis were not associated with low fibrinolytic activity. The various factor VIII activities (VIII:C, VIIIR:Ag, and VIIIR:RCF) ant AT III were studied in 30 sick newborns and in 20 healthy newborns. The sick exhibited increased levels of various factor VIII activities (VIIIR:Ag and VIIIR:RCF mainly) and markedly reduced levels of AT III. The high factor VIII activities and the low AT III found will add to the existing risk of thrombosis due to the presence of a foreign material. AT III substitution is suggested as a possible prophylactic.

Antithrombin III↗