Expectant management of deep cerebral venous thrombosis with intraventricular hemorrhage

Limited randomized clinical trial data favor the use of anticoagulation in patients with cerebral venous thrombosis. We present a patient with deep cerebral venous thrombosis in whom anticoagulation was withheld because of coexistent intraventricular hemorrhage. She had a benign clinical course without anticoagulation, suggesting that close observation may be a management option in these patients.     

Unique variant of partial anomalous pulmonary venous connection with intact atrial septum

Summary Partial anomalous pulmonary venous connections (PAPVCs) are rare in association with an intact atrial septum. However, the diagnosis should be considered in patients with otherwise unexplained findings of left-to-right shunt and right heart enlargement. An unusual variant is presented, which we considered unsuitable for operative repair, based on findings at catheterization. Developmental, hemodynamic, and surgical considerations are discussed.     

Thrombosis triggered by severe arterial lesions is inhibited by oral administration of a glycoprotein IIb/IIIa antagonist

Platelet aggregation and thrombosis play an important role in the onset of acute coronary events. Regardless of the stimulus for activation, platelet thrombus formation is ultimately regulated through the IIb/IIIa receptor complex. The effects of oral administration of xemilofiban, a non-peptide mimetic of the RGDF sequence of the IIb/IIIa receptor complex, on thrombus formation were evaluated in a canine model. Xemilofiban significantly reduced platelet deposition on severely damaged arterial wall. Platelet deposition was reduced at both low (13 ± 1 from 56 ± 18 × 10⁶ platelets cm⁻²; P  < 0.05) and high (23 ± 2 from 111 ± 21 × 10⁶ platelets cm⁻²; P  < 0.01) shear rates. Platelet deposition was reduced to a monolayer as seen by electron microscopy (platelet–vessel wall interaction). Therefore, the availability of an orally active IIb/IIIa antagonist for chronic use may have significant value in preventing thrombus formation in those clinical situations associated with severe arterial injury, such as atherosclerotic plaque disruption.     

Protein C concentrate prevents peripartum thrombosis.

A protein C deficient woman, with a past history of recurrent thrombosis and purpura fulminans, was successfully treated with protein C concentrate in the peripartum period. © 1992 Wiley-Liss, Inc.     

Postmenopausal HRT is not independent risk factor for dural sinus thrombosis

While a dural sinus thrombosis (DST), is a well-known consequence of the use of oral contraceptives, the role of hormone replacement therapy (HRT) in DST was not previously evaluated. We report two postmenopausal women, presenting with DST under HRT. Antiphospholipid antibodies in one case and borderline protein S deficiency in another were diagnosed. Only five cases of DST under HRT were previously reported and in two of them additional prothrombotic risk factors were found. According to these and previous cases, HRT is not an independent risk factor for DST.     

同型半胱氨酸及抗磷脂抗体与深静脉血栓形成和复发关系的研究

目的通过检测深静脉血栓形成（DVT）患者血浆中的同型半胱氨酸（Hey）和抗磷脂抗体（APLA）水平，探讨DVT形成和复发的因素，并寻找DVT复发的预报因子。方法选取2001年1月至2003年4月期间哈尔滨医科大学附属第二医院血管外科收治的60例DVT患者，其中初发组和复发组各30例，另随机选取门诊就诊经证实无DVT的下肢静脉曲张或深静脉功能不全的30例患者作为对照组，同时选取复发DVT的一级亲属组30例。用荧光偏振免疫法测定Hey，用酶联免疫吸附试验（ELISA）检测APLA中的抗心磷脂抗体（AcLA）水平（IgG、IgM型）并测定狼疮抗体（LA）阳性率。结果初发与复发DVT组患者血浆中的Hey和ACLA-IgG及ACLA-IgM水平均高于对照组和复发DVT一级亲属组，差异有统计学意义（P〈0．01）。复发DVT的一级亲属组的血浆中的Hey水平高于对照组（P〈0．05）。各组的LA阳性率差异无统计学意义（P〉0．05）。结论DVT患者血浆中Hey和APLA均升高，Hey和APLA与深静脉血栓形成有密切关系。Hey升高与DVT复发有关，可能是DVT复发的预报因子。     

胰头静脉弓的16层CT研究

目的探讨16层CT的各种血管成像方法对胰头静脉弓的正常表现及显示率方法对40例非腹部疾病患者行胰腺静脉期扫描,使用轴位图像、薄层最大密度投影(TSMIP)和容积再现(VR)图像分别评价胰头静脉弓的表现及显示率结果轴位图像、TSMIP和VR显示胃网膜右静脉均为100%,胃结肠干均为80%,右结肠上静脉分别为100%、87.5%、80%;胰十二指肠上后静脉分别为92.5%、65%、40%;胰十二指肠上前静脉分别为92.5%、62.5%、45%结论使用16层CT,联合轴位、TSMIP和VR图像可以清楚显示胰头静脉弓     

Cerebrovascular deaths before and after the appearance of oral contraceptives

The mortality of cerebrovascular diseases in Denmark was analysed for men and women 15-44 years of age, in a 14-year period before and after the appearance of oral contraceptives (OC) in 1966. 1,670 deaths were registered over 28 years, during which the female incidence of cerebrovascular deaths increased by 19% (P less than 0.025), while the male mortality was unchanged. Women showed a percentage increase in deaths from cerebral thromboembolic attacks (CTA) of 33%, men a fall of 14%. The increase of female CTA deaths was most pronounced in the young fertile group, the age group with a high OC use. A relative risk of CTA of 3.3-4.5 for OC users compared with non-users could explain the CTA trend difference between women and men. No other single risk factor responsible for the observed trends could be identified. Both women and men had a significant increase in the mortality of subarachnoidal hemorrhages, and a significant fall in the mortality of intracerebral hemorrhages.     

多糖硫酸脂(PSS)治疗缺血性脑血管病临床观察和实验室研究

应用PSS治疗270例缺血性脑血管病并进行了临床、实验室以及动物试验的观察.总有效率为92.27%;显效率65.24%,与对照组相比较有显著性差异(P<0.005).实验室观察发现PSS有显著的抗凝血、降低血粘度,降低血脂及血管扩张作用.动物实验也说明了这一点.