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  • 1
    ISSN: 1432-1238
    Keywords: Key words Thiopental ; Endothelial cells ; Neutrophils ; Migration ; In vitro assay ; PMNL
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objectives: The interactions between blood and vascular wall cells are essential for the understanding of pathophysiologic processes, e. g. inflammation. The influence of the anesthetic drug thiopental on leukocyte function is well documented. Recently, an inhibitory effect of thiopental on leukocyte chemotaxis in a Boyden chamber assay (i. e. endothelial cells were not included) was demonstrated. In vivo, leukocytes have to interact with endothelial cell monolayers to invade the tissue. The influence of thiopental on a monolayer of endothelial cells has not yet been investigated. The aim of the current study was to investigate the influence of thiopental on the migration of leukocytes through endothelial cell monolayers (ECM). Material and methods: Human umbilical vein endothelial cells (HUVEC) were isolated and cultured on microporous membrane filters to achieve a monolayer. Isolated polymorphonuclear leukocytes (PMNL) as well as ECM were preincubated with different concentrations of thiopental. The rate of leukocyte migration against the chemotactic protein formyl-methyl-leucyl-phenylalanine was measured (n = 7). Thiopental was able to reduce the amount of leukocyte migration through ECM significantly. Conclusion: In conclusion, we could show that thiopental is able to reduce the migration of PMNL through ECM significantly.
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  • 2
    ISSN: 1432-0584
    Keywords: Transient lupus anticoagulant ; Adenovirus ; Factor II and XII deficiency
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A potent lupus anticoagulant (LA) was detected in four children, 1 week after the clinical onset of an adenovirus infection. The adenovirus infection was documented by direct virus detection in the stool of one patient and serologically in the others. None of the children had elevated titers of IgM- and only one of IgG-anticardiolipin antibodies (ACA). All patients had a marked reduction of prothrombin activity as well as antigen. Prothrombin-antibody complexes were demonstrated in the patients' plasma or mixtures of patient and normal plasma. Factor XII activity was moderately reduced in three of the patients. All coagulation abnormalities returned to normal within 4–12 weeks. Localized bleeding was observed in two cases, but there was no generalized bleeding tendency or evidence of thrombosis.
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  • 3
    ISSN: 1432-0584
    Keywords: Key words Factor V inhibitor ; Coagulation inhibitors ; Blood coagulation disorders ; Immunoadsorption ; Blood component removal
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  We report on the rapid elimination of a potent spontaneous factor V antibody of undetermined etiology by extracorporeal immunoadsorption on sepharose-bound polyclonal sheep antibodies to human immunoglobulins (Ig-Therasorb, Baxter) in combination with immunosuppressive treatment. A 68-year-old woman presented with severe hematuria. Severe factor V deficiency (〈1%) caused by an antibody to factor V (26 BU/ml) was found. Extracorporeal immunoadsorption (8.245±553 ml plasma processed per session) led to an average reduction of the antibody titer by 75% per session. The procedure was well tolerated without any side effects. Hematuria ceased after three immunoadsorptions and complete elimination of the antibody was achieved after seven sessions (day 15), followed by a rapid increase of the factor V activity to normal levels. Treatment with cyclophosphamide and prednisone was started on day 6 and continued for 2 months. The patient remains in remission at 6 months. Extracorporeal immunoadsorption is a highly effective method for eliminating antibodies to factor V (or other clotting factors) in selected cases, i.e., in patients with severe bleeding tendency, high antibody titer, and low probability of a rapid spontaneous remission.
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  • 4
    ISSN: 1432-0584
    Keywords: Drug-induced agranulocytosis ; G-CSF
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Five patients with drug-induced agranulocytosis received 300μg recombinant human granulocyte colony-stimulating factor (rh G-CSF) subcutaneously twice daily for 2–5 days. G-CSF therapy resulted in a steep increase of the neutrophil count, which was faster than that in patients with spontaneous recovery reported in the literature. In all four patients with infectious complications fever rapidly declined with the increase of granulocytes. G-CSF may be useful in the management of drug-induced agranulocytosis.
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  • 5
    ISSN: 1432-0584
    Keywords: Oral contraceptives ; Blood coagulation ; Fibrinolysis ; Endothelial cells
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Blood coagulation (fibrinogen, thrombinantithrombin III complexes, TAT, and prothrombin fragment F1+2) and fibrinolytic parameters [fibrin split-product D-dimer, tissue plasminogen activator (t-PA) activity, plasminogen activator inhibitor-1 activity (PAI-1), and plasmin-antiplasmin-complexes (PAP)] were evaluated in 16 women on low estrogen (EE) oral contraceptive (OC) therapy. Blood samples were taken before and between days 18 and 22 of the first, third, and sixth treatment cycle. Fibrinogen levels were found significantly elevated during OC treatment compared with pretreatment values, while TAT and also F1+2 levels remained unchanged. Treatment-induced activation of fibrinolysis was documented by elevated D-dimer [pretreatment (pt): 172 ng/ml (range: 65–640 ng/ml), cycle 6 (c.6): 351 ng/ml (range: 93–960 ng/ ml),p〈0.05)] and PAP [(pt: 46.6 ng/ml (13–220 ng/ml), c.6: 66.4 ng/ml (21–200 ng/ml),p〈0.05] plasma levels. Among the fibrinolytic components a decrease in PAI-1 [pt: 10.8 ng/ml (2–56 ng/ml), c.6: 5.3 ng/ml (2.2–14.4 ng/ml),p〈0.05] and an increase in t-PA activity [pt: 0.23 U/ml (0.17–0.45 U/ml), c.6: 0.33 U/ml (0.2–0.9 U/ml),p〈0.05] were detected. Experiments with cultured human endothelial cells (EC) showed that EE influenced neither EC hemostatic regulatory activities (tissue factor, thrombomodulin) nor the secretion of the fibrinolytic components t-PA and PAI-1.
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  • 6
    ISSN: 1432-0584
    Keywords: Factor V inhibitor ; Coagulation inhibitors ; Blood coagulation disorders ; Immunoadsorption ; Blood component removal
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report on the rapid elimination of a potent spontaneous factor V antibody of undetermined etiology by extracorporeal immunoadsorption on sepharose-bound polyclonal sheep antibodies to human immunoglobulins (Ig-Therasorb, Baxter) in combination with immunosuppressive treatment. A 68-year-old woman presented with severe hematuria. Severe factor V deficiency (〈 1%) caused by an antibody to factor V (26 BU/ml) was found. Extracorporeal immunoadsorption (8.245 ±553 ml plasma processed per session) led to an average reduction of the antibody titer by 75% per session. The procedure was well tolerated without any side effects. Hematuria ceased after three immunoadsorptions and complete elimination of the antibody was achieved after seven sessions (day 15), followed by a rapid increase of the factor V activity to normal levels. Treatment with cyclophosphamide and prednisone was started on day 6 and continued for 2 months. The patient remains in remission at 6 months. Extracorporeal immunoadsorption is a highly effective method for eliminating antibodies to factor V (or other clotting factors) in selected cases, i.e., in patients with severe bleeding tendency, high antibody titer, and low probability of a rapid spontaneous remission.
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