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  • 1
    ISSN: 1436-2813
    Keywords: prostaglandin ; aspirin ; renal insuffiency ; endotoxin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The effects of the anticoagulants, heparin and low molecular weight heparin (LMWH), and the antiplatelet agents, prostaglandin E1 (PGE1) and aspirin, on endotoxin-induced renal insufficiency not induced by prerenal factors, were investigated using rabbits to evaluate the clinical usefulness of these drugs and their possible involvement in the activation of hemostasis in renal insufficiency. The intravenous administration of PEG1, at 0.4 μg/kg/min, or aspirin, at 5 mg/kg, significantly restored all the parameters of renal function measured in the present study, namely, effective renal plasma flow, glomerular filtration rate and urine N-acetyl-β-D-glucosaminidase, as well as histological renal ischemic changes. On the other hand, neither heparin nor LMWH, even at a high dose, improved any parameter. As the antiplatelet effect is the common property of PGE1 and aspirin, it is suggested that the activation of platelets may be prerequisite to the occurrence of renal insufficiency induced by endotoxin. The results of this study thus show that PGE1 or aspirin may be applied in clinical use for renal insufficiency complicated by sepsis or endotoxemia.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1436-2813
    Keywords: dysplasminogenemia ; varicose veins ; deep vein thrombosis ; hemostasis activation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Sclerotherapy combined with ligation has become a widely accepted treatment for varicose veins; however, it is associated with some risk of the serous complications of deep vein thrombosis (DVT). We investigated the incidence of thrombophilia in 164 consecutive patients undergoing treatment for varicose veins and determined the activities of antithrombin-III, protein C, and plasminogen. Of the 164 patients, 10 were diagnosed as having dysplasminogenemia (DPG), showing an incidence of 6.1%, in accordance with previous reports. DVT was not found to be caused by DPG in any patient, and no difference was found between patients with and those without DPG, suggesting that DPG is not a risk factor for varicose veins. We also investigated the activation of coagulation by measuring the thrombin-antithrombin III complex (TAT). The activation of coagulation after sclerotherapy was inhibited when ligation was performed 1 month prior to sclerotherapy, whereas it was increased when sclerotherapy and ligation were performed simultaneously. Of the 10 patients with DPG, 5 were treated uneventfully, and their TAT level increased to 4.0 μg/l, which was comparable to the level after sclerotherapy and ligation. These findings indicate that sclerotherapy can be performed safely in the majority of patients with DPG, and that the temporal separation of sclerotherapy and surgery is an alternative for these patients to prevent the activation of coagulation.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1436-2813
    Keywords: pseudointimal hyperplasia ; fibril length ; PTFE ; animal model
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In addition to the polytetrafluoroethylene (PTFE) vascular graft (G) with its conventionally smooth surface, a unique PTFE graft with a ridged outer wall (T) is now also currently available for clinical use. Although an excellent antikinking property is provided by this unique outer structure, the possible influence of the structure on the formation of pseudointima has not yet been investigated in detail. Four kinds of T grafts (3 mm inner diameter, 3 cm long) with various fibril lengths (FL, T-15, T-30, T-60, T-90) and a G graft with 30 μm FL (G-30) were implanted into the inferior vena cava of rabbits. The patency of the grafts at 4 weeks were as follows: 6/8(T-15), 6/8(T-30), 5/8(T-60), 0/8(T-90) and 4/6 (G-30). Pseudointimal hyperplasia (PH) of the T grafts advanced as the FL increased, judging by the thickness of the pseudointima, cellular density, and maturity of fibroblasts. In addition, the maturity of endothelial-like cells on the luminal surface increased as the FL increased. The degree of pseudomintimal hyperplasia in G-30 was comparable to that of T-15, although the maturity of the endothelial-like cells was similar to that of T-60. Microscopically, there was a microheterogeneity of cellular density in T grafts probably due to the uneven outer structure. In conclusion, not only FL but also the outer structure of PTFE may thus influence the formation of the pseudointima.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1436-2813
    Keywords: Key Words: aortocaval fistula ; omentum ; aortic exclusion
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1436-2813
    Keywords: portal vein calcification ; superior mesenteric vein thrombosis ; dysplasminogenemia ; abnormal plasminogen ; idiopathic portal hypertension
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report herein a case of a 68-year-old Japanese woman in whom calcification of the portal vein was recognized by plain abdominal X-ray radiograph and computed tomography (CT) scan when she presented with repeated thrombosis of the portal system. Following emergency small bowel resection for intestinal necrosis caused by superior mesenteric vein thrombosis, hematological studies revealed the association of dysplasminogenemia. A review of 21 cases of portal vein calcification reported between 1940 and 1990 revealed the average age to be 53.7±10.2 years and the male/female ratio 17:4. Although the majority of cases suffered from portal hypertension (81%), only 38% had any evidence of liver cirrhosis, while 52% had normal liver function, being comparable to idiopathic portal hypertension. The calcified lesions were located in the portal vein in 100% of cases, the splenic vein in 62%, the superior mesenteric vein in 33%, and the inferior mesenteric vein in 0%. The precise etiology of the calcification was not elucidated in any of the reviewed cases. The patient reported herein is the first reported case of portal vein calcification due to repeated thrombosis of the portal system caused by dysplasminogenemia, which could be accounted as a cause of idiopathic portal hypertension.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1436-2813
    Keywords: prostacyclin analogue ; pseudointimal hyperplasia ; venous prosthesis ; animal model ; smooth muscle cell
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The aim of this study was to evaluate the effect of a novel prostaglandin I2 analogue, beraprost (BPT), on the pseudointimal hyperplasia (PIH) of polytetrafluoroethylene (PTFE) prostheses. A total of 12 rabbits were equally divided into three groups. The control group was given a placebo daily, group 1 was given BPT orally 2 mg/kg per day, and group 2 was given BPT orally 4 mg/kg b.i.d. Exactly 1 cm of the inferior vena cava was resected and replaced by a 3-cm PTFE tube graft. All the grafts were patent when harvested 4 weeks after implantation, but the lumens were narrowed to various extents by PIH. PIH, determined by the dry weight of the intraluminal tissue deposit, was significantly (P〈0.01) suppressed in groups 1 and 2 compared with the control group. High-magnification light microscopy with various staining methods revealed the PIH to be composed mainly of smooth muscle cells (SMCs) and collagen fibrils in all three groups. Transmission electron microscopy revealed that the majority of SMCs in groups 1 and 2 were contractile in form, in contrast with the synthetic form seen in the control group. In conclusion, BPT attenuated the PIH of PTFE grafts by inhibiting the phenotype change in the SMCs.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1436-2813
    Keywords: primary varicose veins ; thrombin antithrombin-III complex ; D-dimer ; hypercoagulability ; thrombophlebitis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The relationship between a local hypercoagulable state and primary varicose veins of the lower legs was investigated by measuring the plasma levels of D-dimer (DD) and the thrombin-antithrombin-III complex (TAT) in 122 consecutive patients before treatment, and in 46 patients after surgical intervention and compression sclerotherapy. Elevated levels of DD and TAT were found in 25% and 20%, respectively, of the 122 patients, being significantly elevated in the patients with thrombophlebitis compared to the patients with no dermal symptoms, pigmentation, or stasis dermatitis. There was no significant difference in either parameter among eight groups of patients classified according to their valvular incompetence. The levels of DD and TAT were elevated before treatment in 25% and 20%, respectively, of 45 treated patients, but became significantly reduced after treatment. These results indicate that even though the local hypercoagulable state in varicose veins without thrombophlebitis is too subtle to be detected by systemic parameters such as DD and TAT, a local hypercoagulable state can be detected in a certain proportion of patients with venous stasis by these parameters.
    Type of Medium: Electronic Resource
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  • 8
    ISSN: 1436-2813
    Keywords: sepsis ; systemic inflammatory response syndrome (SIRS) ; hepatocyte growth factor (HGF) ; endotoxin ; beta-glucan
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Interleukin-1 (IL-1), a cytokine released from macrophages by endotoxin stimulation, has been shown to upregulate the genetic expression of the hepatocyte growth factor (HGF). The present study was conducted to determine whether plasma HGF is increased in patients with systemic inflammatory response syndrome (SIRS). The plasma levels of HGF, endotoxin, and beta-glucan were measured in 41 surgical patients without hepatic diseases, 18 of whom had been diagnosed with sepsis, and 33, with nonseptic SIRS. The plasma HGF was found to be significantly increased in the 18 patients with sepsis, at 0.69±0.47 ng/ml (mean ± SD), and in the 23 patients with nonseptic SIRS, at 0.49±0.37 ng/ml, compared to values in 40 normal controls, at 0.10±0.03 ng/ml (P〈0.001). No significant correlations were observed between the plasma levels of HGF and endotoxin (r=0.02) or beta-glucan (r=−0.05) in any of the patients; however, plasma HGF was significantly correlated with the WBC count (r=0.34, P〈0.05) and with total bilirubin (r=0.45, P〈0.01). Plasma HGF was also strongly correlated with alanine transaminase (ALT) in 8 patients with ALT levels higher than 50 U/I (r=0.70), but there was no such correlation in 33 patients with ALT levels of 50 U/I or less (r=0.30). Thus, although the clinicopathologic significance of HGF is not well understood, the present findings indicate that plasma HGF increases in response to infection or inflammation.
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  • 9
    ISSN: 0730-2312
    Keywords: platelets ; morphological change ; [Ca2+]i ; confocal laser scanning microscopy ; surface contact activation ; Life and Medical Sciences ; Cell & Developmental Biology
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Biology , Chemistry and Pharmacology , Medicine
    Notes: The dynamic change of cytoplasmic Ca2+ concentration ([Ca2+]i) and morphological change were investigated simultaneously by confocal laser scanning microscopy using fluo-3 and by differential interference contrast optics in platelets activated by contact with the following types of surfaces: native glass and glass treated with poly-L-lysine (PLL), fibrinogen (Fg), or von Willebrand factor (vWF). The initial [Ca2+]i values just after the surface contact were comparable (approximately 100 nM) among platelets deposited on the four surface types. On the PLL-surface, no morphological change or [Ca2+]i elevation was observed. Glass-, Fg-, and vWF-surface adhered platelets showed pseudopod formation and spreading associated with the inhomogeneous [Ca2+]i rise. The platelets on the Fg-surface were the most active in terms of [Ca2+]i rise and morphological change. During pseudopod formation, the mean [Ca2+]i value was maximal and localized high [Ca2+]i zones were observed inside pseudopods, as well as in the center of the platelets. After spreading, high [Ca2+]i zones still remained in the center of the cell. This new technique enabled simultaneous observation of [Ca2+]i and cell shape and we clearly demonstrated a close relationship between [Ca2+]i and morphological alterations. © 1996 Wiley-Liss, Inc.
    Additional Material: 4 Ill.
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  • 10
    ISSN: 0730-2312
    Keywords: [Ca2+]i and [Ca2+]n ; Ca2+ gradients ; confocal laser scanning microscopy ; Fluo-3 ; heterogeneity ; Life and Medical Sciences ; Cell & Developmental Biology
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Biology , Chemistry and Pharmacology , Medicine
    Notes: Ca2+ concentration inside human umbilical vein endothelial cells was studied separately in cytosol and nucleus by a confocal laser scanning microscopy using fluo-3. The in vivo calibration curve for cytosol and nucleus showed good linearity between fluorescence intensity and Ca2+ concentration in cytosol ([Ca2+]i) and nuclei ([Ca2+]n). After calibration, [Ca2+]n was constantly higher than [Ca2+]i before and after the chelation of extracellular Ca2+ suggesting an active Ca2+ accumulation system on nuclear membrane. [Ca2+]n was also constantly higher than [Ca2+]i after the stimulation of thrombin (0.05 U/ml), FCS (10%), and thapsigargin (Tsg, 1μM). The temporal change of [Ca2+]n and [Ca2+]i was identical, and [Ca2+]i gradient towards the nucleus and peripheral or central [Ca2+]n rise was observed after these stimulations. From these results, [Ca2+]n is not only regulated by the active Ca2+ accumulation system on nuclear membrane at rest but also the generation of Inositol-triphosphate. FCS caused heterogeneous [Ca2+]n or [Ca2+]i rise from cell to cell; single spike or oscillatory change of [Ca2+]n and [Ca2+]i was observed in about 56% of cells, which were completely abolished by the chelation of extracellular Ca2+, suggesting that FCS stimulated [Ca2+]n and [Ca2+]i rise solely depending on Ca2+ influx from extracellular medium. The higher concentration of [Ca2+]n and heterogeneous [Ca2+]n rise may have important roles in nuclear-specific cellular responses. © 1996 Wiley-Liss, Inc.
    Additional Material: 5 Ill.
    Type of Medium: Electronic Resource
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