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排序方式: 共有228条查询结果,搜索用时 31 毫秒
1.
Individualized anticoagulation with dermatan sulphate for haemodialysis in chronic renal failure 总被引:1,自引:0,他引:1
Boccardo P; Melacini D; Rota S; Mecca G; Boletta A; Casiraghi F; Gianese F 《Nephrology, dialysis, transplantation》1997,12(11):2349-2354
Background: Dermatan sulphate (DS) is a selective
thrombin inhibitor with antithrombotic properties and low bleeding
potential. In preliminary studies it was reported to be effective for
preventing clot formation in the haemodialysis circuit.
Methods: Ten patients on maintenance haemodialysis for
chronic renal failure underwent three consecutive investigation phases. In
phase 1 (individual dose titration), repeated dialyses were preformed with
increasing doses of DS until successful dialysis was obtained in two
sessions at the same dose. In phase 2, individualized DS doses were
validated by a randomized crossover comparison with the individual heparin
dose of each patient. In phase 3, each patient underwent 24 consecutive
dialyses with DS over 8 weeks. Successful dialysis was defined as
completion of the procedure without visible clot formation in the bubble
traps and lines or a greater than 20% decrease in dialyser capacity.
Dialysis efficiency (decrease in serum urea and creatinine, Kt/V), APTT
prolongation, bleeding time, and DS plasma concentrations were also
assessed. Results: Phase 1: successful dialysis was
achieved in nine patients with 4 mg/kg DS as a predialysis intravenous
bolus followed by continuous infusion of 0.65 mg/kg/h. One patient required
5 mg/kg plus 1.3 mg/kg/h. Phase 2: no statistically significant differences
were found between DS and heparin in any of the investigated variables.
Residual dialyser capacity and dialysis efficiency indexes indicated
equivalent efficacy. Phase 3: residual dialyser capacity and dialysis
efficiency did not change with time. There was no accumulation of DS in
plasma. No bleeding or thrombocytopenia were observed.
Conclusions: The dose of DS can be individually
titrated to suppress clot formation during haemodialysis as efficiently as
with individualized heparin. Such an individualized DS regimen maintains
its anticoagulant efficacy and is safe in prolonged use. Key
words: anticoagulation; clinical trial; dermatan sulphate;
haemodialysis; heparin
相似文献
2.
Severe glomerular epithelial cell damage does not prevent passive Heyman nephritis in rats.
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T Bertani G Remuzzi A Poggi F Delaini G Sacchi L Morassi P Verroust G Mecca M B Donati 《Clinical and experimental immunology》1983,51(1):38-44
Analysis of the local cell-mediated immunity within the central nervous system is limited by the small amount of material available. In the present report we describe that T lymphocyte clones can be expanded directly from the cerebrospinal fluid (CSF) using T cell growth factor and irradiated feeder cells. Without in vitro restimulation such clones can reproducibly be generated from fresh or cryopreserved CSF lymphocytes. From a patient with tuberculous meningitis, T lymphocyte clones were obtained that showed tuberculin (PPD) specific proliferative responses restricted by a single HLA-DR antigen. One of these clones was restricted by an antigen different from the serologically defined HLA-DR since this clone recognized PPD only on autologous but not on HLA-DR matched monocytes. These experiments show that T lymphocytes involved in the in situ immune response can be cloned directly from the site of inflammation. 相似文献
3.
Ten patients with juvenile rheumatoid arthritis and age- and sex-matched healthy controls were investigated in pairs. The patients were found to have both normal proportions and normal absolute numbers of T lymphocytes, B lymphocytes, and the Fc-receptor-bearing lymphoid cells in peripheral blood. No abnormality of mitogen-induced lymphocyte transformation was observed. Lymphocyte-mediated cytotoxicity induced by phytohemagglutinin (PHA) or anti-target cell antibodies was also found to be normal. As in an earlier study, impaired delayed hyper-sensitivity by skin testing was observed in the patient group, thus indicating a dissociation between in vivo and in vitro parameters of lympboid cell function. 相似文献
4.
Inhibition of Antibody-Dependent Human Lymphocyte-Mediated Cytotoxicity by Immunoglobulin Classes, IgG Subclasses, and IgG Fragments 总被引:11,自引:0,他引:11
The cytotoxicity of human peripheral blood lymphocytes against chicken erythrocytes sensitized by rabbit antibodies was inhibited by human immunoglobulin and immunoglobulin fragments. Myeloma proteins isolated in dimeric state or aggregated by heat treatment inhibited better than the corresponding monomeric proteins. Strong inhibition was observed with IgG1 and IgG3, and with IgG2 after aggregation, while IgG4 inhibited very little. No inhibition was found with IgM, IgA. IgD and IgE. The F(ab')2 . and Fab fragments of IgG inhibited poorly or not at all. While- considerable inhibition was observed with the Fc fragment, the pFc' fragment, which roughly corresponds to the C-terminal half of the Fc portion, showed little inhibitory capacity. A fragment isolated from IgG3, containing an extension of the N-terminal part of Fc (the Fch fragment), was an even better inhibitor than tin Fc fragment. The inhibitory capacity of the Fch and Fc fragments was greatly diminished following partial reduction and alkylation On the basis of the inhibitory pattern of IgG fragments, it is suggested that the region on the immunoglobulin molecule involved in binding to the Fc receptor of the effector lymphocytic cell may be located within the CH2 domain. 相似文献
5.
Striated intramural gallbladder lucencies on US studies: predictors of acute cholecystitis 总被引:1,自引:0,他引:1
Ultrasound scans of 51 consecutive patients with gallbladder wall thickening were reviewed, and specific sonographic features were correlated with surgical and clinical follow-up. Two patterns of thickening were identified as specific indicators of the presence or absence of acute cholecystitis. "Striated" wall thickening, consisting of several alternating, irregular, discontinuous, lucent and echogenic bands, was seen in eight of 13 patients (62%) with acute cholecystitis. This pattern was not encountered in any of the patients who did not have acute cholecystitis. Conversely, "three-layer" thickening, consisting of a single circumferential lucent zone between two relatively uniform echogenic layers, was seen in only one of 13 patients (8%) with acute cholecystitis but in 11 of 38 patients (29%) with other diagnoses. Other abnormalities, including the presence of intramural echogenic foci and wall irregularities, were more frequently seen in patients with acute cholecystitis but were not as helpful. Use of these features may suggest or help exclude a diagnosis of acute cholecystitis in those patients in whom the cause of gallbladder wall thickening is otherwise not apparent. 相似文献
6.
C Camenzuli AN DiMarco KE Isaacs Y Grant J Jackson A Alsafi C Harvey TD Barwick N Tolley FF Palazzo 《Annals of the Royal College of Surgeons of England》2021,103(1):29
IntroductionReoperative parathyroidectomy for persistent and recurrent primary hyperparathyroidism is dependent on radiology. This study aimed to compare outcomes in reoperative parathyroidectomy at a single centre using a combination of traditional and newer imaging studies.Materials and methodsRetrospective case note review of all reoperative parathyroidectomies for persistent and recurrent primary hyperparathyroidism over five years (June 2014 to June 2019; group A). Imaging modalities used and their positive predictive value, complications and cure rates were compared with a published dataset spanning the preceding nine years (group B).ResultsFrom over 2000 parathyroidectomies, 147 were reoperations (101 in group A and 46 in group B). Age and sex ratios were similar (56 vs 62 years; 77% vs 72% female). Ultrasound use remains high and shows better positive predictive value (76% vs 57 %). 99mTc-sestamibi use has declined (79% vs 91%) but the positive predictive value has improved (74% vs 53%). 4DCT use has almost doubled (61% vs 37%) with better positive predictive value (88% vs 75%). 18F-fluorocholine positron emission tomography-computed tomography and ultrasound-guided fine-needle aspiration for parathyroid hormone are novel modalities only available for group A. Both carried a positive predictive value of 100%. Venous sampling with or without angiography use has decreased (35% vs 39%) but maintains a high positive predictive value (86% vs 91%). Cure rates were similar (96% vs 100%). Group A had 5% permanent hypoparathyroidism, 1% permanent vocal cord palsy and 1% haematoma requiring reoperation. No complications for group B.ConclusionOptimal imaging is key to good cure rates in reoperative parathyroidectomy. High-quality, non-interventional imaging techniques have produced a shift in the preoperative algorithm without compromising outcomes. 相似文献
7.
8.
Arruda VR; Pieneman WC; Reitsma PH; Deutz-Terlouw PP; Annichino-Bizzacchi JM; Briet E; Costa FF 《Blood》1995,86(8):3015-3020
The molecular characterization of the mutations in hemophilia A patients is hampered by the large size of the factor VIII gene and the great heterogeneity of mutations. In this study, we have performed a protocol involving multiplex polymerase chain reaction in which 19 exons were amplified in four different combinations followed by nonradioactive single-strand conformational polymorphism (SSCP) to screen for mutations. Southern blotting was used to detect inversion of the factor VIII gene resulting from recombination between copies of the gene A (F8A) located in intron 22 of the factor VIII gene and two copies close telomeric region of X chromosome. Forty-two hemophilia A patients (21 with severe and 21 with mild-to-moderate disease) were studied. The inversion of factor VIII occurred in 13 of 21 patients affected by severe hemophilia A. One patient showed a large extra band in addition to the three bands observed after Southern blotting with the F8A probe. An abnormal electrophoretic pattern of SSCP was detected in 85% and 50% of the patients affected by mild-to-moderate and severe disease, respectively. Sixteen different mutations were identified. Eleven mutations were novel and comprised 9 point mutations and 2 small deletions. This study shows that the methodology used is safe and rapid and has potential for detecting almost all of the genetic defects of the studied hemophilia A patients. 相似文献
9.
The color complementation assay (CCA) is a method of allele-specific DNA amplification by which competitive priming and extension of fluorescently labeled oligonucleotide primers determine the color of DNA amplification product. This diagnostic method precludes the need for radioisotopes, electrophoresis, and multiple high-stringency reaction conditions. The multiplicity of mutant globin genes present in Southeast Asians complicates clinical diagnosis and underscores the importance of DNA-based diagnostic methods. We have applied CCA to distinguish beta A and beta E alleles. Competing 15mer primers were a fluorescein-labeled complement to beta A and a rhodamine-labeled complement to beta E, identical except for their central nucleotides. A common unlabeled primer was used to amplify DNA product, the color of which was determined by the perfectly complementary primer. Color photography and spectrofluorometry, as well as a method of black-white photography that we developed to distinguish fluorescein- and rhodamine- labeled DNA, were used to record results. We applied CCA to define the complex genotype of a Thai woman with thalassemia intermedia, 96% HbE, and 4% HbF whose possible genotypes included several permutations of alpha-thalassemia, beta-thalassemia, and beta E genes. zeta-Globin gene mapping of DNA doubly digested with Bg/II and Asp 718 showed the -alpha 3.7/--SEA genotype, and CCA confirmed homozygous beta E/beta E. The CCA is useful for diagnosing the compound hemoglobin genotypes of Southeast Asians and could be applied also to prenatal diagnosis in this population. 相似文献
10.