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1.
This paper presents the first attempt to model the blood coagulation reactions in flowing blood. The model focuses on the
common pathway and includes activation of factor X and prothrombin, including feedback activation of cofactors VIII and V
by thrombin, and plasma inhibition of factor Xa and thrombin. In this paper, the first of two, the sparsely covered membrane
(SCM) case is presented. This considers the limiting situation where platelet membrane binding sites are in excess, such that
no membrane saturation or binding competition occurs. Under these conditions, the model predicts that the two positive feedback
loops lead to multiple steady-state behavior in the range of intermediate mass transfer rates. It will be shown that this
results in three parameter regions exhibiting very different thrombin production patterns. The model predicts the effect of
flow on steady-state and dynamic thrombin production and attempts to explain the difference between venous and arterial thrombi.
The reliance of thrombin production on precursor procoagulant protein concentrations is also assessed. 相似文献
2.
Diran Basmadjian 《Annals of biomedical engineering》1990,18(6):685-709
The paper presents a mathematical analysis of the contributions of flow and mass transport to a single reactive event at a
blood vessel wall. The intent is to prepare the ground for a comprehensive study of the intertwining of these contributions
with the reaction network of the coagulation cascade. We show that in all vessels with local mural activity, or in “large”
vessels (d>0.1 mm) with global reactivity, events at the tubular wall can be rigorously described by algebraic equations under
steady conditions, or by ordinary differential forms (ODEs) during transient conditions. this opens up important ways for
analyzing the combined roles of flow, transport, and coagulation reactions in thrombosis, a task hitherto considered to be
completely intractable.
We report extensively on the dependence of transport coefficient kL and mural coagulant concentration Cw on flow, vessel geometry, and reaction kinetics. It is shown that for protein transport, kL varies only weakly with shear rate
in large vessels, and not at all in the smaller tubes (d<10−2 mm). For a typical protein, kL∼10−3 cm s−1 within a factor of 3 in most geometries, irrespective of the mural reaction kinetics. Significant reductions in kL (1/10–1/1,000) leading to high-coagulant accumulation are seen mainly in stagnant zones vicinal to abrupt expansions and
in small elliptical tubules. This is in accord with known physical observations. More unexpected are the dramatic increases
in accumulation which can come about through the intervention of an autocatalytic reaction step, with Cw rising sharply toward infinity as the ratio of reaction to transport coefficient approaches unity. Such self-catalyzed reactions
have the ability to act as powerful amplifiers of an otherwise modest influence of flow and transport on coagulant concentration.
The paper considers as well the effect on mass transport of transient conditions occasioned by coagulation initiation or pulsatile
flow. During initiation, instantaneous flux varies with diffusivity and bulk concentration, favouring the early adsorption/consumption
of proteins with the highest abundance and mobility. This is akin to the ‘Vroman effect’ seen in narrow, stagnant spaces.
The effect of flow pulsatility on kL has the potential, after prolonged cycling, of bringing about segregation or accumulation of proteins, with consequences
for the coagulation process. 相似文献
3.
Osteomas of the nose and paranasal sinuses are rather common benign tumors arising in the head and neck area. The sphenoid sinus is involved in various inflammatory and neoplastic conditions; however, an osteoma arising from the sphenoid sinus proper has not been reported in the available literature. This paper reviews, in detail, osteomas of the paranasal sinuses and their incidence, and a case of a sphenoid sinus osteoma is presented with radiological and pathological findings. 相似文献
4.
Thimm E Richter-Werkle R Kamp G Molke B Herebian D Klee D Mayatepek E Spiekerkoetter U 《Journal of inherited metabolic disease》2012,35(2):263-268
Objective
The implementation of NTBC into treatment of hypertyrosinemia type I (HT I) greatly improved survival by prevention of acute liver failure and hepatocellular carcinoma. However, there are first reports of cognitive impairment in patients with elevated plasma tyrosine concentrations. 相似文献5.
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8.
A rare case of intrarenal pheochromocytoma associated with a renal artery stenosis is reported. The association between phenochromocytoma and renal artery stenosis is discussed. 相似文献
9.
苗族,布依族和汉族躁狂症的跨文化研究 总被引:2,自引:0,他引:2
对符合CCMD-2-R躁狂发作诊断标准的苗族,布依族112例和汉族220例躁狂症患者的临床变量进行变化研究,两组患者在平均起病年龄,平均入院年龄,就诊早晚,求助巫医,妄想内容等方面存在显著性差异,提示与民族社会文化背景,宗教信仰和生活习俗等因素有关。 相似文献
10.