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  • 1
    ISSN: 1520-4995
    Quelle: ACS Legacy Archives
    Thema: Biologie , Chemie und Pharmazie
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 2
    ISSN: 1365-2516
    Quelle: Blackwell Publishing Journal Backfiles 1879-2005
    Thema: Medizin
    Notizen: Summary.  In haemophilia patients with inhibitor, elective orthopaedic surgery is usually performed under recombinant activated factor VII (rFVIIa). We report here the case of a severe haemophilia A patient with a high inhibitor who needed a bilateral total knee arthroplasty. Recombinant FVIIa was previously shown to be ineffective for the treatment of muscle and joint bleedings, and he had a history of excessive postoperative bleeding under activated prothrombin complex concentrate (APCC). Thrombin generation test (TGT) was used to assess the efficacy of Factor Eight Inhibitor Bypassing Activity (FEIBATM). Insufficient correction of thrombin-generating capacity was observed after administration of 75 U kg−1 FEIBATM. In a multidisciplinary environment, a bilateral total knee arthroplasty was performed using a protocol combining immunoadsorption of inhibitors preoperatively associated with FVIII replacement during a first phase followed by FEIBATM when the inhibitor reappeared. To our knowledge this is the first direct application of TGT in the management of haemophilia patients with inhibitor, which indicated that a sequential use of immunoadsorption, FVIII and FEIBATM was the most appropriate treatment to perform this major elective surgery. This case demonstrates that this combined protocol can be safely used to cover major surgery in inhibitor patients. In addition, it also suggests that TGT may have a major contribution in the decision-making process of the most adapted therapy for the treatment of such high-risk patients.
    Materialart: Digitale Medien
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  • 3
    Digitale Medien
    Digitale Medien
    Oxford, UK : Blackwell Science Ltd
    Haemophilia 10 (2004), S. 0 
    ISSN: 1365-2516
    Quelle: Blackwell Publishing Journal Backfiles 1879-2005
    Thema: Medizin
    Notizen: Summary.  In patients with haemophilia, a close correlation is usually observed between the clinical expression of the disease and plasmatic factor VIII/factor IX clotting activity. However, some patients experience milder bleeding phenotypes than others, although they exhibit a similar biological profile. The high prevalence of some inherited thrombophilia risk factors offers the possibility of a co-inheritance in haemophilic patients which could influence the phenotypic expression of the disease. Rare thrombotic complications occurring in haemophiliacs could also be facilitated by the co-inheritance of modifier genes. The majority of thrombotic events occurring in haemophiliacs are in relation to clotting factor infusions or central venous catheters. Concerning surgical situations, in the absence of therapeutic recommendations, postoperative thromboprophylaxis is not systematically performed in haemophiliacs. However, substitutive treatment more or less completely corrects the coagulation defect and makes the venous thrombosis risk closer to the control population. It should be emphasized that haemophilia does not fully protect against venous thromboembolic disease. Patients with haemophilia very infrequently experience thrombotic events. Thus, the management of thrombotic complications occurring in haemophilic patients should be discussed in each case according to the precipitating risk factors, the clinical context and the thrombo-haemorrhagic balance of the patient with respect to a particular clinical situation.
    Materialart: Digitale Medien
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  • 4
    ISSN: 0167-4889
    Schlagwort(e): (Rat adrenal cell) ; Cholesterol uptake ; Corticosteroid synthesis ; HDL subfraction
    Quelle: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Thema: Biologie , Chemie und Pharmazie , Medizin , Physik
    Materialart: Digitale Medien
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  • 5
    Digitale Medien
    Digitale Medien
    Amsterdam : Elsevier
    Analytical Biochemistry 100 (1979), S. 254-259 
    ISSN: 0003-2697
    Quelle: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Thema: Biologie , Chemie und Pharmazie
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 6
    Digitale Medien
    Digitale Medien
    Springer
    Experimental brain research 76 (1989), S. 510-518 
    ISSN: 1432-1106
    Schlagwort(e): Heteronymous Ia facilitation ; Presynaptic inhibition ; Reciprocal inhibition ; Monosynaptic reflex ; Voluntary movement ; Human
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Summary Variations of presynaptic inhibition in heteronymous Ia fibres projecting to soleus motoneurones were studied during the first 250 ms of phasic voluntary isometric contractions of the antagonist tibialis anterior muscle in human subjects. During the first 60–80 ms of TA e.m.g activity, presynaptic inhibition was often more marked than at rest, but not in all experimental sessions. After 60–80 ms, presynaptic inhibition was always increased compared to rest and to the onset of TA e.m.g. activity. A “rebound” in femoral nerve induced Ia facilitation was often observed between 90–150 ms. The early increase in presynaptic inhibition was widespread and non specific since it was observed at the onset of extensor carpi radialis contractions of maximal strength. The “rebound” in heteronymous Ia facilitation was interpreted as a relative decrease in presynaptic inhibition to which nonspecific suprasegmental and cutaneous effects contributed. The late increase in presynaptic inhibition in Ia fibers to soleus motoneurones was considered as reciprocally inhibiting the Sol H-reflex, thus counteracting the phasic stretch of the antagonist muscle during TA contraction.
    Materialart: Digitale Medien
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  • 7
    ISSN: 1432-1106
    Schlagwort(e): Non-monosynaptic Ia excitation ; Spinal interneurones ; Voluntary movement ; Human quadriceps
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Summary The facilitation of the quadriceps (Q) H reflex evoked by stimulation of group I afferents from pretibial flexors exhibits biphasic changes during Q voluntary contraction. At short conditioning-test intervals the facilitation is increased, whereas it is decreased at longer intervals and/or at high conditioning stimulus intensities and/or when the contraction strength is increased. The spatial facilitation at a premotoneuronal level observed at rest on combined stimulation — common peroneal nerve (CPN) and femoral nerve (FN) — regularly disappeared during contraction. It is argued that the increase in facilitation at the onset of the weakest Q contraction reflects a descending facilitation of the interneurones mediating the CPN-induced excitation to Q MNs. An occlusion of descending and peripheral excitation in these interneurones can easily account for the depression of the facilitation when the conditioning stimulus intensity and/or the strength of the contraction is increased. However, occlusion cannot explain all the results and inhibition of the neurones mediating excitation of MNs, i.e. disfacilitation of the MNs, probably contributes to the decrease in facilitation observed during contraction.
    Materialart: Digitale Medien
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  • 8
    ISSN: 1432-1106
    Schlagwort(e): Key words Non-monosynaptic group I excitation ; Group II excitation ; Spinal reflexes ; Human
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract  Non-monosynaptic group I and group II excitation of human lower limb motoneurones was investigated. Changes in the firing probability of individual voluntarily activated motor units belonging to various muscles (soleus, gastrocnemius medialis, tibialis anterior, peroneus brevis, quadriceps and biceps femoris) were investigated after stimulation of various nerves (posterior tibial, common peroneal and femoral nerves) with weak (0.4–0.6×motor threshold) electrical stimuli. In all investigated motor nuclei, stimulation of the ”homonymous” nerve evoked a peak of increased firing probability with a latency that was 3–7 ms longer than the monosynaptic Ia latency. The more caudal the motor nucleus explored, the greater the central delay. This strongly suggests a transmission through neurones located above the lumbar enlargement. If one excepts the sural-induced excitation of peroneus brevis units, which seems to be mediated through a particular pathway, the main peripheral input to neurones mediating non-monosynaptic excitation evoked by these weak stimuli is group I in origin. The pattern of distribution of non-monosynaptic group I excitation was very diffuse, since stimulation of each nerve was able to evoke excitation in all investigated nuclei. In most cases, non-monosynaptic excitation evoked in a given motor unit by stimulation of one nerve was depressed on combined stimulation of two nerves, and evidence is presented that this lateral inhibition is exerted at a premotoneuronal level. By contrast, there was no evidence that increasing the afferent input in a given pathway evokes an ”autogenetic” inhibition in this pathway. The negative correlation found between non-monosynaptic group I-induced and late group II-induced facilitation of the quadriceps H-reflex when using high stimulus intensities applied on the common peroneal nerve suggests that these two effects could be mediated through common interneurones.
    Materialart: Digitale Medien
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  • 9
    Digitale Medien
    Digitale Medien
    Springer
    Experimental brain research 96 (1993), S. 534-544 
    ISSN: 1432-1106
    Schlagwort(e): Ia EPSP ; Monosynaptic Ia pathways ; Spinal reflexes ; Man
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Changes in the firing probability of single motor units in response to electrical stimulation of muscle nerves were used to derive the projections of muscle spindle Ia afferents to the motoneurones of various leg and thigh muscles. Discharges of units in soleus, gastrocnemius medialis, peroneus brevis, tibialis anterior, quadriceps, biceps femoris and semitendinosus were investigated after stimulation of inferior soleus, gastrocnemius medialis, superficial peroneal, deep peroneal and femoral nerves. Homonymous facilitation, occurring at the same latency as the H reflex and therefore attributed to monosynaptic Ia EPSPs, was found in virtually all the sampled units. In many motor nuclei an early facilitation was also evoked by heteronymous low-threshold afferents. The heteronymous facilitation was considered to be mediated through a monosynaptic pathway when the difference between the central latencies of heteronymous and homonymous peaks was not more than 0.2 ms. The heteronymous Ia connections were widely distributed. In particular, monosynaptic coupling between muscles operating at different joints appears to be the rule in humans, though it is rare between ankle and knee muscles in the cat and the baboon.
    Materialart: Digitale Medien
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  • 10
    Digitale Medien
    Digitale Medien
    Springer
    Experimental brain research 63 (1986), S. 436-438 
    ISSN: 1432-1106
    Schlagwort(e): Polysynaptic Ia excitation ; Spinal interneurones ; Voluntary movement ; Human quadriceps
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Summary Homonymous Ia facilitation of quadriceps (Q) motoneurones (MNs) was significantly larger during (and at the onset of) a very weak Q voluntary contraction than at rest. This increase in Ia facilitation only appeared with a conditioning-test interval within the narrow range of 5–9 ms, which fits the time course of the recently described polysynaptic Ia excitation to Q MNs. This suggests that interneurones mediating polysynaptic Ia excitatory effects to Q MNs receive a strong descending excitation during such a contraction. It is therefore argued that these interneurones might mediate part of the descending command to Q MNs during voluntary contraction.
    Materialart: Digitale Medien
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