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[en] To determine the regular changes of blood coagulation indices in twin pregnancy complicated with preeclampsia (PE). Study Design: Descriptive study. Place and Duration of Study: Fujian Provincial Maternity and Children Hospital from January 2014 to December 2017. Methodology: A total of 180 twin pregnancies were enrolled in this study, including 40 diagnosed as PE, 50 as severe PE (SPE), and 90 as normal twin pregnancies. The changes of coagulation parameters of twin pregnant women in different gestational states and periods were retrospectively analysed. Results: During the middle and late pregnancies in all groups, the PT (prothrombin time) decreased, and D-Di (D-dimers) increased gradually compared to early pregnancy (p <0.05). When D-Di increased abnormally, adverse pregnancy outcomes increased. APTT (activated partial thromboplastin time) and TT (thromoplastin time) were shortened first and then significantly prolonged (p <0.05). In the normal twin group, FIB was increased gradually from early pregnancy to midlate pregnancy; in the PE group, FIB was increased and then decreased, especially in the sPE group (p <0.05). There was no significant difference in coagulation function in early pregnancy (p >0.05). FIB in sPE group was lower than that in other two groups in late pregnancy. TT in sPE group was higher than that in other two groups. D-Di and APTT in PE group and sPE group were higher than those in normal group (p <0.05). The TT sensitivity was 68.8% with specificity 72.4%, at cut-off value of 13.48 s (p <0.01). Conclusion: The regular changes of blood coagulation indices in twin pregnancy complicated with PE had great predictive and diagnostic value of preeclampsia. (author)
[en] To determine correlation between the Prothrombin time obtained by Prothrombin time meter with Prothrombin time estimation by clinical laboratory in neonates. Study Design: Cross sectional study. Place and Duration of Study: Study was conducted in the department of Paediatrics, Combined Military Hospital Lahore, from Feb 2014 to Aug 2014. Methodology: One hundred cases, comprising of infants between the age from 0 to 28 days of both genders fulfilling the inclusion and exclusion criteria, were included in the study after seeking written informed consent. Blood samples from all selected neonates were obtained from a peripheral vein under strict aseptic conditions. The samples were analyzed on Sysmex Coagulation Analyzer CA-500 from the Pathology Department. Simultaneously a drop of blood was obtained by heel prick and spot checked by Roche Coaguchek Prothrombin Time Meter. SPSS version 17 was used for data analysis. Percentage and frequency were calculated for the qualitative variables; while mean and standard deviation were calculated for the quantitative variables. Data was analyzed by using Pearson’s correlation between the values obtained with the meter and the laboratory. Results: The mean (SD) INR values measured from PT meter was 2.176 (0.94557), while that from laboratory was 2.1467 (0.91013). A useful correlation with a correlation coefficient of 0.984 (r =0.984) was found between the two values. Conclusion: PT values obtained by PT meter did not differ significantly from the PT estimation by clinical laboratory in neonates. (author)
[en] To compare the rates of central venous stenosis in patients undergoing hemodialysis who underwent disruption of fibrin sheath with percutaneous transluminal angioplasty balloons and those who underwent over-the-wire catheter exchange. This study is a retrospective review of 209 percutaneous transluminal angioplasty balloon disruption and 1304 over-the-wire catheter exchange procedures performed in 753 patients. Approval from the Human Investigations Committee was obtained for this study. Up to 10-year follow-up was performed. A χ2 test was used to compare the rates of central venous stenosis after balloon disruption versus catheter exchange. A t-test was used to compare time to central venous stenosis development. Of the 753 patients in the study, 127 patients underwent balloon disruption of fibrin sheath and 626 had catheter exchange. Within the balloon disruption group, 18 (14.2%) of 127 patients subsequently developed central venous stenosis, compared with 44 (7.0%) of 626 in the catheter exchange group (P < 0.01, χ2 test). Time to central venous stenosis development was approximately 3 years in both groups and not significantly different (1371 and 1010 days, P = 0.20). A total of 25.2% of patients in the balloon disruption group had four or more subsequent catheter exchanges, versus 12.6% in the catheter exchange group (P < 0.01, χ2 test). In conclusions, there is a possible association between percutaneous transluminal angioplasty balloon disruption of fibrin sheath and late-onset central venous stenosis. Because venography was not routinely performed in catheter exchange patients, future randomized studies are necessary to confirm these findings.
[en] Purpose: Central venous catheters (CVC) may fail for many reasons, though 'fibrin sheaths' blocking catheter ports are usually implicated. We examined the sheaths removed from dialysis catheters to determine their histopathology.Methods: Ten catheter strippings were performed and the removed material was studied grossly and microscopically.Results: The histologic specimens showed thrombus both with and without a proteinaceous sheath.Conclusion: Dialysis catheters fail because of thrombus formation. This can occur in either the absence or presence of a protein coating on the catheter, the so-called 'fibrin sheath.'
[en] To date, a large number of literature have focused on the mechanisms of fibronectin (FN) fibril initiation and elongation, discovering many binding sites on FN molecules that are required for FN fibril growth. However, it is still poorly understood how FN fibrils widen while elongating. Here, single molecules and polymers, FN fibrillogenesis, and FN fibril bundles around cells have all been investigated visually using atomic force microscopy. We found that the formation of ring-shaped and beaded-filament-like FN aggregates may be two early intermediate stages of FN fibrillogenesis within the fibrils away from cells, perhaps involving in the FN fibril widening/bundling
[en] The next step beyond conventional scaffold-based tissue engineering is cell-based direct biofabrication techniques. In industrial processes, various three-dimensional (3D) prototype models have been fabricated using several different rapid prototyping methods, such as stereo-lithography, 3D printing and laser sintering, as well as others, in which a variety of chemical materials are utilized. However, with direct cell-based biofabrication, only biocompatible materials can be used, and the manufacturing process must be performed under biocompatible and physiological conditions. We have developed a direct 3D cell printing system using inkjet and gelation techniques with inkjet droplets, and found that it had good potential to construct 3D structures with multiple types of cells. With this system, we have used alginate and fibrin hydrogel materials, each of which has advantages and disadvantages. Herein, we discuss the roles of hydrogel for biofabrication and show that further developments in biofabrication technology with biomatrices will play a major part, as will developments in manufacturing technology. It is important to explore suitable biomatrices as the next key step in biofabrication techniques.
[en] Background: Detection of protein C and S deficiency forms a major investigation in the laboratory evaluation of thrombophilia screening. It has key role in the diagnosis of protein C and S deficiency. The objective of this study is to determine the utility of ProC Global as a screening test for identifying the defects of protein C and S anticoagulant pathways. Methods: Two Hundred patients with venous thromboembolism were studied at the Department of Haematology, Armed Forces Institute of Pathology, Rawalpindi, from October 2004 to March 2006. ProC Global test (Dade Behring Diagnostics) was performed and was followed up by protein C and S assays. ProC Global is an activated partial thromboplastin time based assay in which Protac (snake venom from Aghistroden contortrix) is used for activation of the endogenous protein C of the plasma sample. The protein C activation time in the presence of the activator was set in relation to a parallel determination of PCAT/O with addition of a buffer instead of activator reagent. The ratio PCAT: PCAT/O was transformed in normalized ratio by relating them to a calibrator. Control plasma for normal range and ProC control plasma for pathological range (Dade Behring Diagnostics) were assayed in each run for quality control. Results: A total of 200 patients, 132 (66%) males and 68 (34%) females with age ranging from 1 to 68 years were studied. ProC Global was positive in 29/200 (14.5%) patients. ProC Global was found to be 86% sensitive, 94% specific and its overall efficiency turned out to be 94%. Conclusion: Pro-C Global can be used effectively as a screening test to detect abnormalities in protein C and S anticoagulant pathways. (author)
[en] We present a rare case of a pleural loose body, thought to be a pedunculated pleural tumor, found incidentally in a 58-year-old female. Computed tomography showed a non-enhancing mass, which migrated along the mediastinum and paravertebral area. Thoracoscopic surgery revealed a 4 cm, soap-like mass that was found to be a fibrin body consisting of hyalinized collagen histopathologically. Mobility and the lack of contrast enhancement of a pleural mass are important clues to diagnosing this benign condition
[en] Objective: To comparatively evaluate peri-implant tissue changes around the nano-pore implant surface with or without platelet rich fibrin (PRF). Material and methods: For the present study, a total of 17 patients was initially enrolled (6 females, 11 males), and 38 sites (19 control and 19 experimental sites) were randomly assigned to either group 1 (control), i.e. extraction site received immediate implants without any PRF, and group 2 (experimental), i.e. extraction sites received immediate implants with PRF. Clinical and radiographic parameters were recorded for 9 months after the implant-loading phase. Results: Clinically, there was a significant (p < 0.001) increase in the peri-implant probing depth from the prosthetic phase up to 9 months in both the groups, and the increase was greater in the control group. However, the mean difference in the changes between the two groups was non-significant. The modified gingiva index for group 2 was significantly lower than that for group 1 in the prosthetic phase. Radiographically, in the control group and experimental group, there was a significant increase (<0.01) in bone loss (BL) in the mesial and distal aspect of the implant from the surgical to prosthetic phase, surgical up to 9 months and from the prosthetic phase up to 9 months. There was greater BL in the control group than in the experimental group in both the mesial and distal aspect of the implant; however the difference in BL was non-significant (<0.01). There was greater BL in the distal aspect than in the mesial aspect in both groups; however, the difference in BL was non-significant. Conclusion: PRF treatment may provide a way to prevent BL during the surgical-to-prosthetic phase. These results were based on a short-term, low sample randomized clinical study, therefore a long-term study with more sites and homogenous sampling is recommended. (paper)
[en] For immunochemical purposes, a cyclic 12 peptide was synthesized to model the γ-γ-chain cross-link site in human fibrin. The model was based upon the structure proposed by Chen and Doolittle which is characterized by two reciprocating epsilon-(γ-Glu)Lys bonds between adjacent fibrin γ-chains oriented in an antiparallel manner. To achieve the antiparallel orientation of the peptide backbone, Pro and Gly were inserted at positions 6 and 7 of the linear 12-peptide: acetyl-Gly-Glu-Gln-His-His-Pro-Gly-Gly-Gly-Ala-Lys-Gly-amide. The insertions were made to facilitate a reverse turn of the peptide during the last synthetic step, which was formation of the epsilon-(γ-Glu)Lys bond between Glu at position 2 and Lys at position 11 with diphenylphosphorylazide. The resulting cyclic peptide represented half of the symmetrical cross-linked region in clotted fibrin. Following purification by HPLC, both linear and cyclic 12-peptides were analyzed by fast atom bombardment mass spectrometry. Abundant molecular protonated ions were observed for both peptides. In addition, the amino acid sequence of the linear peptide and the location of the epsilon-(γ-Glu)Lys bond in the cyclized peptide could be verified. (author)