Lack of interference by heparin with thrombolysis or binding of tissue- type plasminogen activator to thrombi

Coronary thrombolysis with t-PA is generally implemented with concomitant administration of heparin. However, results of studies in vitro suggest that heparin competes with fibrin for binding of tissue- type plasminogen activator (t-PA), augments activation of free plasminogen, decreases fibrin specificity, and impairs thrombolysis. To define the biological implications of these observations, we characterized effects of therapeutic concentrations of heparin on the binding of t-PA to thrombi formed in whole blood, effects of heparin on activation of plasminogen by t-PA in plasma, and effects of heparin on thrombolysis induced by t-PA in a clot lysis system designed to simulate conditions in vivo. The amount of t-PA bound to thrombi was not affected by heparin (0, 0.5, 1.0, and 5.0 U/mL). When t-PA activity was selectively and irreversibly inhibited by D-Phe-Pro-Arg- chloromethyl ketone (PPACK) the amount of t-PA-PPACK bound was similarly unaffected by heparin. Thrombolysis measured by 125I- fibrin(ogen) release and by reduction of mass of thrombi were not altered by heparin. Heparin did not affect plasminogen consumption induced by t-PA. Plasma concentrations of alpha-2-antiplasmin after exposure of blood to t-PA were less depressed with increasing concentrations of heparin. Thus, heparin in therapeutic concentrations does not interfere with binding of t-PA to thrombi, augment activation of free plasminogen, or inhibit thrombolysis. Accordingly, it appears likely that concomitant administration of heparin will not impair thrombolysis with t-PA implemented clinically.     

Evaluation by angiography of the lateral dominance of the drainage of the dural venous sinuses

Summary Venous drainage dominance of the dural venous sinuses may be defined as the drainage only or mainly into one of the transverse sinuses, as shown by bilateral carotid angiography. The aim of this study was to evaluate the venous drainage dominance in bilateral carotid angiograms of 189 cases retrospectively. Among these cases 41.3% showed drainage mainly to the right side, 37.6% showed equal drainage to each side, 18.5% showed drainage mainly to the left side, 2.1% showed drainage only to the right side and 0.53% showed drainage only to the left side. Cerebral venous drainage dominance is of great importance and should be considered before operations on patients for radical neck dissection, removal of tumors in the neck that invade the internal jugular vein or tumors of the glomus jugulare which may require ligation of the internal jugular vein.

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Evaluation angiographique de la prédominance du drainage veineux des sinus dure-mériens

Résumé La prédominance angiographique du drainage des sinus veineux dure-mériens se traduit par le drainage de la substance radioopaque essentiellement ou uniquement par l'un des sinus transverses au cours d'angiographies carotidiennes bilatérales. Le but de ce travail est d'évaluer la prédominance du drainage veineux sur 189 angiographies carotidiennes bilatérales. Dans 41,3% des cas, on note une prédominance à droite. Dans 37,6% des cas, le drainage veineux s'effectue de façon égale des deux côtés. Dans 18,5% des cas, il y a prédominance à gauche. Dans 2,1% des cas le drainage est limité à droite et dans 0,53% des cas il est limité à gauche. La connaissance de cette prédominance du drainage veineux cérébral est capitale pour le chirurgien lors de curage cervical radical, lors d'intervention pour des tumeurs du cou envahissant la veine jugulaire interne ou pour des tumeurs du glomus jugulaire nécessitant la ligature de la veine jugulaire interne.

     

The effect of periodontal therapy on serum TNF-α and HbA1c levels in type 2 diabetic patients

Background:  To determine the effect of non-surgical periodontal therapy on serum TNF-α and HbA1c levels in poorly and well-controlled type 2 diabetic patients.
Methods:  In total, 45 patients were enrolled in the study; 30 patients with type 2 diabetes mellitus with periodontitis (15 with poorly controlled diabetes, HbA1c ≥ 7%, group 1A and 15 with well-controlled diabetes, HbA1c < 7%, group 1B) and 15 patients that were systemically healthy with periodontitis (group 2). The plaque index, gingival index, probing depth, clinical attachment loss, gingival bleeding index, HbA1c value, and circulating TNF-α concentration were measured at baseline and three months after the non-surgical periodontal therapy.
Results:  All periodontal parameters and serum TNF-α levels were significantly decreased three months after the non-surgical periodontal therapy compared to the baseline values in all groups. The HbA1c values were significantly decreased only in well-controlled diabetic patients. We found no significant differences in the periodontal parameters or TNF-α levels at baseline and after three months between the two groups.
Conclusions:  Although non-surgical periodontal therapy eliminates local/systemic infection and inflammation via decreases in TNF-α, it is insufficient for significantly reducing HbA1c levels without strict glycaemic control in poorly controlled diabetic patients in a short time period.     

Noninvasive assessment of glycosaminoglycan production in injectable tissue-engineered cartilage constructs using magnetic resonance imaging

The glycosaminoglycan (GAG) content of engineered cartilage is a determinant of biochemical and mechanical quality. The ability to measure the degree to which GAG content is maintained or increases in an implant is therefore of importance in cartilage repair procedures. The gadolinium exclusion magnetic resonance imaging (MRI) method for estimating matrix fixed charge density (FCD) is ideally suited to this. One promising approach to cartilage repair is use of seeded injectable hydrogels. Accordingly, we assess the reliability of measuring GAG content in such a system ex vivo using MRI. Samples of the photopolymerizable hydrogel, poly(ethylene oxide) diacrylate, were seeded with bovine chondrocytes (approximately 2.4 million cells/sample). The FCD of the constructs was determined using MRI after 9, 16, 29, 36, 43, and 50 days of incubation. Values were correlated with the results of biochemical determination of GAG from the same samples. FCD and GAG were found to be statistically significantly correlated (R2 = 0.91, p < 0.01). We conclude that MRI-derived FCD measurements of FCD in injectable hydrogels reflect tissue GAG content and that this methodology therefore has potential for in vivo monitoring of such constructs.     

Perception and practice of contraception among male soldiers in Sobi barracks,Ilorin, Nigeria

Background

There is a popular belief among the general population that Nigerian soldiers tend to have large families but this has not been substantiated with evidence-based research. The Nigerian military health authority implements female-targetted contraception strategies, with less focus on their husbands; who are the dominant fertility determinants.

Objective

To determine the perception and practice of contraception among male soldiers of Sobi Cantonment, Ilorin, Nigeria, with a view to instituting male-targeted contraceptive/family planning strategies.

Methodology

A cross-sectional survey of 334 male soldiers using multistage sampling technique and pre-tested interviewer administered questionnaires.

Results

The respondents'' approval of contraception (73.6%) and willingness to discuss it with their spouses/partners (71.6%) were high. Fear of wives/partner''s sexual promiscuity (55.7%), cultural and religious beliefs (43.2%), fear of the side effects of contraceptives (29.5%) and the desire for more children (21.6%) were reported reasons for the non-approval of contraception. The prevalence of contraceptive use among the respondents was low (12.3%). There was a significant relationship between the respondents'' educational level and contraceptive use (p< 0.05).

Conclusion

The study revealed a high approval and willingness to discuss contraception with their spouses/partners but low contraceptive use.     

Echogenicity of prostate cancer correlated with histologic grade and stromal fibrosis: endorectal US studies

In this study an attempt was made to clarify some of the causes of the apparent differences in appearance on ultrasound (US) images of prostate cancer. These differences were correlated with histologic grade and the degree of stromal fibrosis present. Fifty-one cancers (diagnosed and evaluated by means of US-guided biopsy or evaluated by means of radical prostatectomy) were studied. There were 30 hypoechoic, ten echogenically mixed, six isoechoic, and five subtly hyperechoic cancers. The degree of stromal fibrosis was minimal in well-differentiated cancers and increased in poorly differentiated cancers. In addition, the more hypoechoic lesions were, in general, the better-differentiated cancers and had less fibrosis. There was a tendency for the isoechoic cancers and those with subtly hyperechoic areas to more often have poor cellular differentiation and a greater degree of stromal fibrosis, but considerable overlap among histologic types was seen.     

Sexual and Reproductive Health of Young Women With Cystic Fibrosis: A Concept Mapping Study

Objective

Adolescent and young adult (AYA) women with pediatric-onset chronic diseases, such as cystic fibrosis (CF), face disease-specific sexual and reproductive health (SRH) concerns. Using concept mapping (CM), this study aimed to identify the SRH topics and outcomes valued by AYA women with CF and their parents.