Arterial graft maturation: the duration of thrombotic activity in Dacron aortobifemoral grafts measured by platelet and fibrinogen kinetics

Dacron is thrombogenic, hence small arterial grafts of this material frequently thrombose in the period prior to graft maturation. Anti-thrombotic therapy may therefore be indicated to preserve patency during this risk period. To evaluate the thrombogencity of immature Dacron grafts, platelet and fibrinogen kinetics using 51Cr and 125I respectively were measured before operation and at 3, 6 and 9 months in 10 patients following aortobifemoral bypass and in 6 age-matched volunteers. Platelet survival was reduced from 8.8 +/- 0.2 d before surgery to 7.4 +/- 0.24 d at 3 months. This was accompanied by an increase in platelet turnover from 39 +/- 2.4 X 10(9)l-1d-1 to 46.9 +/- 2.9 X 10(9)l-1d-1. Fibrinogen t1/2 fell from 3.72 +/- 0.13 d preoperatively to 3.36 +/- 0.11 d at 3 months, while fibrinogen fractional catabolic rate rose from 0.27 +/- 0.014 to 0.34 +/- 0.014. These changes were all significant (P less than 0.01). Fibrinogen consumption had returned to normal by 6 months following surgery but platelet kinetics only equated to preoperative levels at 9 months. We suggest that Dacron grafts are thrombogenically active for about 9 months. When anti-thrombotic therapy is indicated it should be continued throughout this period.     

Analysis of antibody reactivities toward self antigens of IgM of patients with Waldenstrom's macroglobulinemia

By using a quantitative immunoblotting technique, we have analyzed the repertoires of antibody reactivities of IgM directed toward self antigens in the serum of patients with Waldenstrom's macroglobulinemia (WM) and in the serum of healthy adults. Monoclonal IgM of patients with WM expressed various degrees of polyreactivity and a high degree of heterogeneity with regard to the number and the nature of the protein bands that were recognized in homologous tissue extracts. Heterogeneous patterns of reactivity of WM IgM contrasted with the conserved profiles of reactivity of IgM in the serum of healthy blood donors. Protein bands that were recognized by WM IgM belonged to the restricted set of self antigens recognized in homologous tissues by normal polyclonal IgM, indicating the absence of a disease-specific reactivity profile of monoclonal WM IgM. Thus, monoclonal IgM that is present in large amounts in WM distorts the homogeneous pattern of reactivity of natural antibodies with self antigens which characterizes the natural antibody repertoire of healthy individuals.      

Multifocal supratentorial diffuse glioma in a young patient with Ollier disease

Ollier disease is a rare disorder characterised by the development of multiple enchondromas in long bones. Here we present a 19-year-old man with Ollier disease who also developed three synchronous brain tumours. Craniotomy, biopsy and debulking was performed for one lesion followed by a period of observation, and 9 months later he underwent a second craniotomy and debulking for symptomatic progression. Histopathological examination revealed a diagnosis of multifocal diffuse glioma (World Health Organization grade II). This report highlights the increased incidence of primary brain tumours in patients with Ollier disease and identifies the importance of screening patients with Ollier disease for primary neoplasms.     

Asymmetric lenticulostriate arteries in patients with moyamoya disease presenting with movement disorder: three new cases

ABSTRACT

Objective

Unilateral movement disorder associated with moyamoya disease is a rare finding and the mechanism remains to be fully elucidated. Theories postulated include contralateral cerebral ischemic or hemorrhagic lesions, and/or hypoperfusion. However, few studies have reported such patients without contralateral lesions nor hypoperfusion. This study aimed to explore the potential mechanism of those who had neither contralateral cerebral lesions nor hypoperfusion.     

The effects on in-vitro fertilization of autoantibodies to spermatozoa in subfertile men

Thirty-six infertile couples underwent treatment by in-vitrofertilization. In 16 couples (group 1) the male partner waspositive for antisperm antibodies measured by direct mixed antiglobulinreaction, direct immunobead test, and serum and/or seminal plasmatray agglutination test. In 20 couples (group 2) the men hadno such antibodies. Men with poor sperm motility were excluded.The female partners had no antisperm antibodies, and in thecontrols (group 2) infertility was due to a known female factor.The fertilization rate in couples without antisperm antibodies(group 2) was 72.7% compared to 50.5% when the men had antibodies.However, the pregnancy rate per embryo transfer was not significantlydifferent in the two groups (46.1% in group 1, 33.3% in group2). This indicates that antisperm antibodies in the male interferewith sperm —egg fusion and subsequent fertilization butonce fertilization has occurred, the pregnancy rate remainsthe same.     

Childhood seroprevalence of hepatitis A in the United Arab Emirates

The seroprevalence of hepatitis A in Emirati children less than 12 years was 20.1% (95% CI 16.4-24.6%) in 2004.