Thrombolytic therapy with tissue plasminogen activator or streptokinase induces transient thrombin activity

We have determined the plasma level of fibrinopeptide A as a specific index of thrombin activity during the infusion of a thrombolytic agent in patients with acute myocardial infarction. Peripheral venous plasma levels of fibrinopeptide A increased following the initiation of thrombolytic therapy from 2.7 nmol/L to a peak of 13.0 nmol/L at 30 minutes with streptokinase and from 1.1 nmol/L to a peak of 10.7 nmol/L at 90 minutes with tissue plasminogen activator. The amount of fibrinogen converted to fibrin I was determined by integration of the plasma level of fibrinopeptide A over time. The amount of fibrin I formed over the five-hour period from the start of drug infusion was approximately 10 mg/dL in response to either streptokinase or recombinant tissue plasminogen activator. We conclude that activation of coagulation occurs in response to thrombolytic therapy despite heparin administration. This thrombin action, though transient, would be sufficient to cause rethrombosis if localized and incompletely opposed by fibrinolytic activity.     

Intracerebral malignant melanoma: high-field-strength MR imaging

Thirteen patients with intracerebral malignant melanoma underwent high-field-strength (1.5-T) magnetic resonance (MR) imaging. The images were correlated with computed tomography (CT) scans (n = 7) and surgical specimens (n = 7). Most commonly, these lesions were hyperintense to normal white matter on T1-weighted images and hypointense to normal white matter on T2-weighted images. Hemorrhage in the lesion may have a greater influence on this unique appearance than does melanin. The increased tissue sensitivity of MR imaging allowed for 22% greater lesion detection than did CT.     

Human gingival keratinocytes express E-selectin (CD62E)

OBJECTIVES: E-selectin (CD62E) is an adhesion molecule that participates in the binding of leukocytes to activated blood vascular endothelium. The present study was undertaken to characterise the pattern of E-selectin expression on epithelial cells of the gingival crevice and oral epithelium.
METHODS: A panel of six anti-E-selectin monoclonal antibodies was reacted with cryosections of human gin-giva and cytospins of cultured gingival keratinocytes.
RESULTS Three antibodies raised against leukocyte binding epitopes of the molecule (H4/18, HI8/7, I.2B6) were reactive with gingival keratinocytes, three were negative (4DI0, BBAl, BBA2), while all six reacted with endothelial cells. Staining with H18/7 and 1.2B6 was weaker and more variable than with H4/18. In cell culture, levels of E-selectin expression reduced slowly, and were only modestly increased by treatment with exogenous TNFα, a known inducer of E-selectin on endothelium.
CONCLUSIONS: E-selectin epitopes are expressed on gingival keratinocytes. These binding epitopes may be involved in the traffic of leukocytes in this tissue compartment.     

Sucking habits and their relation to posterior cross-bite in 4-year-old children

Abstract – Sucking habits and their relationship to posterior cross-bite were studied in 4-year-old children (n = 588) living in the municipality of Huddinge on the outskirts of Stockholm. Previous or persisting sucking habits were registered for 88% of the children with dummy sucking as the dominating type (78%). At the age of 4 years 48% of all children still exhibited some form of sucking habit. The incidence of normal buccolingual occlusion steadily decreased in cases where sucking habits persisted. The increase in unilateral cross-bite occurreoce was most pronounced in cases where the children continued sucking after 2 years of age. The variable "intensity of sucking habit" was significantly correlated to the occurrence of unilateral cross-bite ( P <0.05). From a dental point of view these results indicate that sucking habits in children should be brought under control by 2 years of age.     

自体富血小板血浆对Stanford A型主动脉夹层手术中输血和短期转归的影响

目的观察自体富血小板血浆(autologous platelet-rich plasma,aPRP)对深低温停循环(deep hypothermic circulatory arrest,DHCA)下的Stanford A型主动脉夹层手术中输血量和术后短期转归的影响。方法选择2016年6月至2017年8月在本院接受手术治疗的急性Stanford A型主动脉夹层患者83例,男60例,女23例,年龄24～81岁,BMI 19.0～41.9kg/m2,ASAⅣ级。根据是否制备aPRP将患者分为观察组(n=35)和对照组(n=48)。两组患者于麻醉诱导插管后经右侧颈内静脉置入三腔中心静脉导管和Swan-Ganz导管外鞘。随后,观察组于手术开始前完成aPRP制备,对照组开始手术。记录麻醉、手术、心肺转流(cardiopulmonary bypass,CPB)、主动脉阻断和DCHA时间。记录血栓弹力图反应时间(R)、α角和最大振幅(MA);记录术中出血量和红细胞、血浆、冷沉淀和血小板用量;记录术后机械通气时间、ICU留观时间、30d内严重并发症(神经系统并发症、需要持续肾脏替代治疗的急性肾功能不全、二次插管或气管切开、胸骨后感染或胸骨愈合不良、开胸止血)发生率和死亡率。结果观察组手术时间明显短于对照组(P0.05)。麻醉、CPB、主动脉阻断时间差异无统计学意义。观察组DCHA时间明显短于对照组(P0.05)。观察组TEGα角和MA明显大于对照组(P0.05)。观察组术中红细胞、血浆和冷沉淀用量明显少于对照组(P0.05)。两组术后机械通气时间、ICU留观时间、术后30d严重并发症发生率和死亡率差异无统计学意义。结论在DCHA下的Stanford A型主动脉夹层手术,aPRP可减少术中红细胞、血浆和冷沉淀的用量,但对术后机械通气时间、ICU时间、术后30d内严重并发症发生率和死亡率无明显影响。     

脾功能亢进的介入放射学治疗——部分性脾动脉栓塞

目的研究部分性脾动脉栓塞对脾功能亢进的介入性放射学治疗,以致改善脾功能亢进的外周血象.材料与方法对14例临床诊断为脾功能亢进的患者,经股动脉穿刺行部分性脾动脉栓塞术,栓塞剂为0号医用丝线,剪成2cm～3cm长的线段,部分辅以明胶海绵条.结果14例患者PSE术后均有程度不同的发热、腹痛、恶心、呕吐等栓塞后综合症,经对症治疗后均缓解、消失,24小时～1周开始白细胞,血小板计数明显升高.结论栓塞面积控制在40%～70%之间可较好的改善脾功能亢进患者的外周血象,减少栓塞后严重并发症的发生,是脾功能亢进的首选治疗手段.     

A valid and reliable method for measuring the kicking accuracy of soccer players

Kicking accuracy is an important component of soccer performance. We constructed a plywood target measuring 243.5cm wide x 122cm high. Carbon paper applied to the surface of the target allowed measurement by 2 raters from a bull's-eye to 10 ball marks left by kicks. Intraclass correlation coefficients with 95% confidence intervals were used to determine the intra- and interrater reliability of the measurement to each ball mark. Mean and median distances from bulls-eye to ball mark were 89.9cm and 97.9cm, respectively (range, 25.7 to 150.75cm). The intraclass correlation coefficients for intra- and interrater reliability were 0.99. The root mean square error of measurement indicated that accuracy of measurement was within 0.15cm. These results suggest that our method of assessing kicking accuracy is a valid and reliable tool for analysing performance. Because this tool closely replicates kicking into a soccer goal, we feel that it also has validity. To our knowledge, no other tool or measure (e.g.. number of shots on goal or number of goals per game) has comparable validity and reliability. This method can be used as a training tool and for future investigations of kicking accuracy.