A pilot trial of microplasmin in patients with long-term venous access catheter thrombosis

Background Microplasmin, a truncated form of plasmin, degrades fibrin and reacts with the circulating inhibitor α₂-antiplasmin. We investigated the safety and efficacy of intra-catheter microplasmin bolus administration for the restoration of catheter function in long-term venous access catheter thrombosis. Methods This open-label, ascending-dose, pilot study enrolled 31 subjects. Two doses of microplasmin were evaluated, (5 mg and 8 mg) administered via a 2 ml intra-catheter bolus injection in 10 and 21 patients respectively. Catheter function was evaluated 30 min after the first bolus administration. In case of incomplete catheter function restoration, a second bolus was administered with reassessment of catheter function 30 min thereafter. Results After the first bolus, complete restoration of catheter withdrawal function was observed in 5 out of 10 (50%) and 14 of out 21 (66%) subjects treated with 5 mg and 8 mg respectively and in 8 out of 10 (80%) and 18 out of 21 (86%) subjects after a second administration of microplasmin. No bleeding complications nor other adverse events were related to microplasmin. Conclusions In this pilot trial, microplasmin restored catheter function in a safe and effective way.     

Fetomaternal hemorrhage in relation to chorionic villus sampling revisited

OBJECTIVE: To investigate whether chorionic villus sampling (CVS) results in a proportional increase of alpha-fetoprotein (AFP) and fetal red cells in maternal blood. METHODS: Blood samples were collected before and after CVS. The AFP concentration was measured and supervised automated microscopy of Kleihauer-Betke slides was applied to quantify fetal red cells. RESULTS: AFP analysis was performed in 53 paired samples and automated microscopic scanning in 59 paired samples. Median AFP concentrations before and after CVS were 12.0 microg/L (range 6.4-36.4) and 18.7 microg/L (range 8.2-668.9), respectively, indicating a significant increase (p < 0.0001). Median numbers of fetal red cells detected before and after CVS were 0 (range 0-36) and 0 (range 0-31), respectively. No significant increase of fetal cells was observed (p = 0.72). The delta (Delta) fetal red cells and the Delta AFP correlated poorly (rho = -0.22, p = 0.11). The amount of villi correlated moderately with the Delta AFP (rho = 0.32, p = 0.02) and did not correlate with the Delta fetal red cells (rho = -0.11, p = 0.43). CONCLUSIONS: Although the AFP concentration after CVS increased, no increase of fetal red cells was detected. These findings suggest that CVS results in a leakage of proteins due to placental tissue damage, rather than increased trafficking of fetal cells.     

Tracking of physical fitness and physical activity from youth to adulthood in females

PURPOSE: To evaluate stability of physical fitness and physical activity from adolescence into middle adulthood in Flemish females. METHODS: Within the scope of the Leuven Longitudinal Study on Lifestyle, Fitness and Health, 138 females (mean age=16.6+/-1.1 yr) from the Leuven Growth Study of Flemish Girls were seen in adulthood (mean age=40.5+/-1.1 yr). Several body dimensions and motor fitness tests were taken. Physical activity was assessed by means of a sports participation inventory. Inter-age correlations were calculated between adolescent and adult values. Cross-tabulation was used to identify the percentage of subjects remaining in the same BMI and physical activity group or shifting from one group to another from adolescence to adulthood. Odds ratios for less activity and overweight in adulthood according to adolescent activity or weight status were calculated. RESULTS: Except for flamingo balance, plate tapping, leg lifts, and arm pull, all anthropometric and physical fitness characteristics were stable from adolescence to adulthood (r ranging from 0.49 to 0.96). Sports participation was not a stable characteristic (r=0.13). From adolescence to adulthood, 84.5 and 63.6%, respectively, remained in the normal-weight and overweight group, whereas 62.5 and 54.4%, respectively, remained in the less active and active group. The odds of being overweight in adulthood was 9.53 (95% CI: 3.1-29.8) times greater in overweight compared with normal-weight adolescent girls. CONCLUSION: In Flemish females, anthropometric and fitness characteristics demonstrate higher levels of stability from adolescence to middle adulthood than physical activity. Weight status during adolescence is indicative of adult weight status, and a pattern of less activity rather than activity tends to continue from youth to adulthood.     

Establishment of reference values for immunoglobulins in the cryoprecipitate

Cryoglobulins are often estimated by determining cryocrit or total protein content in the cryoprecipitate, but these are only indirect measures. Direct quantification of immunoglobulins in combination with agarose gel electrophoresis, to appreciate the presence of other proteins in the cryoprecipitate, offers a more sensitive and specific tool for confirming the diagnosis of cryoglobulinemia. Using such strategy, we established reference values for immunoglobulins in cryoprecipitate in diseased controls and applied them to 214 consecutive patients. The 97.5th percentile for IgA, IgG and IgM in diseased controls was 2, 11 and 26 mg/L serum, respectively. The distribution of the 49 positive patients (23%) was 10% type I, 33% type IIa, 16% type IIb, and 41% type III. Complement C4 was decreased in 61% and 55% of the patients classified as type II and type III compared to 16% of the patients that were negative for cryoglobulins and 9% of the diseased controls.     

An improved method for whole-mount in situ hybridization of Heterodera schachtii juveniles

An optimized protocol is presented to visualize gene expression in the sedentary beet cyst nematode, Heterodera schachtii, by whole-mount in situ hybridization. Two different probes were used for genes with known expression pattern in other nematodes. Vacuum infiltration of the fixative significantly increased its efficiency and resulted in a nicely preserved morphology. Additional modifications were introduced to simplify and standardize the process.