Analysis of hemostasis alterations in sepsis.

This laboratory study tested new methods to analyze hemostasis alterations in septic patients. Samples of ethylenediamine tetraacetic acid (EDTA) plasma and citrated plasma were collected from 62 patients with clinical diagnosis of sepsis. Additionally, a subset of EDTA-plasma samples from each patient was stabilized 1 + 1 with 2.5 mol/l arginine, pH 8.6, to conserve the real hemostasis activation state. EDTA-arginine plasma, EDTA plasma and citrated plasma samples were tested in duplicate. The patients at admission to the intensive care unit had 36 +/- 26 (normal, 0.8 +/- 0.2) ng/ml global endotoxin reactivity, 188 +/- 66% (normal, 100 +/- 20%) fibrinogen function, 179 +/- 66% (normal, 100 +/- 20%) fibrinogen antigen, 4.0 +/- 3.6 (normal, 0.049 +/- 0.025) microg/ml D-dimer, 313 +/- 307% (normal, 100 +/- 30%) plasmin-antiplasmin complex, 8.7 +/- 11.4 (normal, 1.1 +/- 0.7) U/ml plasminogen activator inhibitor-1, 12.1 +/- 10.5 (normal, 1.3 +/- 0.4) ng/ml thrombin-antithrombin III complex, 173 +/- 62% (normal, 100 +/- 20%) thrombin, 568 +/- 225 (normal, 140 +/- 42) pg/ml tissue factor, and 2.56 +/- 2.48 (normal, 0.19 +/- 0.04) microg/ml soluble intercellular adhesion molecule-1. Endotoxin (lipopolysaccharide and/or beta-glucan) reactivity (EDTA plasma), fibrinogen function + antigen + ratio and plasminogen activator inhibitor-1 (citrated plasma), and D-dimer, soluble intercellular adhesion molecule-1, thrombin activity (EDTA-arginine-stabilized plasma) presented large aberrations in septic patients when compared with normal values and may therefore be particularly interesting as markers of hemostasis alteration. Whether the observed alterations are of clinical significance has to be determined in well defined patient groups.     

Über Dermatoskopie bei Finsendruckbestrahlung der normalen Haut des Menschen

Ohne ZusammenfassungMit 5 Textabbildungen     

Zur Kritik der Tuberculose-Frage I

Ohne ZusammenfassungHierzu Taf. III.     

Liver transplantation in children with sickle-cell disease.

Severe liver disease is an unusual but potentially fatal complication of sickle-cell disease (SCD). Liver transplantation has been complicated by ongoing SCD and thrombosis. We reviewed 214 pediatric transplants done at our institution from 1990 to 2005. Three patients were transplanted for complications of SCD, including intrahepatic cholestasis and viral hepatitis. Overall patient and graft survival was 66%. One patient died after 6 years from a subdural hematoma. There were not any incidences of graft loss, primary nonfunction, or thrombosis. All 3 patients required between 1 and 4 postoperative transfusions to keep hemoglobin (Hgb) >9 g/dL with an S fraction of less than 25%. One patient required a preoperative transfusion for a hemoglobin S (HbS) fraction of 30%. Mean follow-up has been 4.2 years (range, 2.6-5.4 years). All 3 children continued to suffer sequelae from their SCD. One child suffered from recurrent sickle-cell hepatopathy and chronic graft failure. In conclusion, children with SCD can in rare instances develop acute and chronic liver failure. These children can be successfully transplanted with good outcomes. Careful attention must be paid to HbS fraction and hemoglobin level to prevent sickling and vascular thrombosis. Unfortunately, liver transplant cannot alter the natural course of the disease.     

Messende Untersuchungen über die Gegenrollung der Augen und die Lokalisation der scheinbaren Vertikalen bei seitlicher Neigung (des Kopfes,des Stammes und des Gesamtkörpers)

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"Chemical fingerprints" of pumice from Cappadocia (Turkey) and Kos (Greece) for archaeological applications.

Pumice has been used as a serviceable abrasive or religious artefact since antiquity and has therefore been an object of trade. It can be found in excavations of ancient workshops all over the Mediterranean.Pumice lumps from the major pumice-bearing rhyolitic tephra units in Cappadocia—the Central Anatolian Volcanic Province, Turkey (in particular the ignimbrites Kavak, Çemilköy, Tahar, Gördeles, and the volcanic complexes of Acıgöl and Hasan Dağı), were sampled and analyzed for major and trace element concentrations using instrumental neutron activation analysis (INAA). Elements determined were Na, K, Sc, Cr, Fe, Co, Zn, As, Rb, Zr, Sb, Cs, Ba, La, Ce, Nd, Sm, Eu, Tb, Yb, Lu, Hf, Ta, Th, and U.Since the distribution of those elements is characteristic of the products of a certain eruption, this “chemical fingerprint” can be used to establish the origin of an unknown pumice sample by comparison with samples of known origin. In the course of this study, it could be shown that one pumice finding from the excavation in Miletos (Turkey) probably originates from the Hasan Dağı volcanic complex in Cappadocia. Since it is known that the population in Miletos focused their trade connections on the Mediterranean, this result is somewhat surprising.Two other samples from Miletos show a very high similarity to the chemical fingerprint of pumice from the Kos Plateau Tuff (KPT; Greece): In one case, the identification is doubtless, in the other case identification as KPT seems quite probable.     

Besprechungen

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Beitrag zur Aetiologie und Pathologie des Harnröhrentrippers

Ohne Zusammenfassung