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Sample records for factor viii rfviii

  1. Immunogenicity and pharmacokinetic studies of recombinant Factor VIII containing lipid cochleates

    OpenAIRE

    Kosloski, Matthew P.; Peng, Aaron; Varma, Prashant R.; Fathallah, Anas M.; MICLEA, RAZVAN D.; Mager, Donald E.; Balu-Iyer, Sathy V.

    2010-01-01

    Replacement therapy using recombinant factor VIII (rFVIII) is currently the most common therapy for hemophilia A, a bleeding disorder caused by the deficiency of FVIII. However, 15–30% of patients develop inhibitory antibodies against administered rFVIII which complicates the therapy. Encapsulation or association of protein with lipidic structures can reduce this immune response. Previously, we developed and characterized rFVIII-containing phosphatidylserine (PS) cochleate cylinders using bio...

  2. Immunogenicity and pharmacokinetic studies of recombinant factor VIII containing lipid cochleates.

    Science.gov (United States)

    Kosloski, Matthew P; Peng, Aaron; Varma, Prashant R; Fathallah, Anas M; Miclea, Razvan D; Mager, Donald E; Balu-iyer, Sathy V

    2011-05-01

    Replacement therapy using recombinant factor VIII (rFVIII) is currently the most common therapy for hemophilia A, a bleeding disorder caused by the deficiency of FVIII. However, 15-30% of patients develop inhibitory antibodies against administered rFVIII, which complicates the therapy. Encapsulation or association of protein with lipidic structures can reduce this immune response. Previous studies developed and characterized rFVIII-containing phosphatidylserine (PS) cochleate cylinders using biophysical techniques. It was hypothesized that these structures may provide a reduction in immunogenicity while avoiding the rapid clearance by the reticuloendothelial system (RES) previously observed with liposomal vesicles of similar composition. This study investigated in vivo behavior of the cochleates containing rFVIII including immunogenicity and pharmacokinetics in hemophilia A mice. The rFVIII-cochleate complex significantly reduced the level of inhibitory antibody developed against rFVIII following intravenous (i.v.) administration. Pharmacokinetic modeling allowed assessment of in vivo release kinetics. Cochleates acted as a delayed release delivery vehicle with an input peak of cochleates showed limited RES uptake and associated rFVIII displayed a similar disposition to the free protein upon release from the structure. Incomplete disassociation from the complex limits systemic availability of the protein. Further formulation efforts are warranted to regulate the rate and extent of release of rFVIII from cochleate complexes.

  3. Reduction of Factor VIII Inhibitor Titers During Immune Tolerance Induction With Recombinant Factor VIII-Fc Fusion Protein.

    Science.gov (United States)

    Groomes, Charles L; Gianferante, David M; Crouch, Gary D; Parekh, Dina S; Scott, David W; Lieuw, Kenneth

    2016-05-01

    The development of inhibitors toward factor VIII (FVIII) is a common and serious complication of hemophilia A (HA) therapy. Patients with hemophilia who develop inhibitors often undergo time- and resource-intensive immune tolerance induction (ITI) protocols. We report a 15-month-old male with severe HA and a high-titer inhibitor that occurred while receiving prophylactic treatment with recombinant FVIII (rFVIII), in whom significant inhibitor titer reduction was achieved with thrice weekly infusions of a new, prolonged half-life rFVIII-Fc fusion protein product (trade name Eloctate). Further studies are warranted to explore the potential of Eloctate in ITI protocols.

  4. Tranexamic acid combined with recombinant factor VIII increases clot resistance to accelerated fibrinolysis in severe hemophilia A

    DEFF Research Database (Denmark)

    Hvas, Anne-Mette; Sørensen, Hanne Thykjær; Norengaard, Lisbeth

    2007-01-01

    BACKGROUND: Most patients with severe hemophilia A suffer from a profoundly compromised hemostatic response. In addition to both the delayed and slow development of a clot, previous studies have documented that severe hemophilia A is also associated with reduced clot stability. OBJECTIVES: We...... examined whether the clot stability in hemophiliacs could be improved by treatment with tranexamic acid (TXA) in combination with recombinant factor VIII (rFVIII). PATIENTS/METHODS: Baseline blood samples were obtained from eight males with severe hemophilia A. Thereafter, a bolus injection of r...... the elasticity curve increased 5-fold after rFVIII and 24-fold after addition of TXA. CONCLUSIONS: The study demonstrates that simultaneous treatment with TXA and rFVIII significantly improves the clot stability in patients with hemophilia A. Udgivelsesdato: December...

  5. Efficacy and safety of rVIII-Singlechain : Results of a phase 1/3 multicenter clinical trial in severe hemophilia A

    NARCIS (Netherlands)

    Mahlangu, Johnny; Kuliczkowski, Kazimierz; Karim, Faraizah Abdul; Stasyshyn, Oleksandra; Kosinova, Marina V.; Lepatan, Lynda Mae; Skotnicki, Aleksander; Boggio, Lisa N.; Klamroth, Robert; Oldenburg, Johannes; Hellmann, Andrzej; Santagostino, Elena; Baker, Ross I.; Fischer, Kathelijn; Gill, Joan C.; P'Ng, Stephanie; Chowdary, Pratima; Escobar, Miguel A.; Khayat, Claudia Djambas; Rusen, Luminita; Bensen-Kennedy, Debra; Blackman, Nicole; Limsakun, Tharin; Veldman, Alex; Ledger, Katie St; Pabinger, Ingrid

    2016-01-01

    Recombinant VIII (rVIII)-SingleChain is a novel B-domain–truncated recombinant factor VIII (rFVIII), comprised of covalently bonded factor VIII (FVIII) heavy and light chains. It was designed to have a higher binding affinity for von Willebrand factor (VWF). This phase 1/3 study investigated the eff

  6. Development and characterization of lipidic cochleate containing recombinant factor VIII

    Science.gov (United States)

    Miclea, Razvan D.; Varma, Prashant R.; Peng, Aaron; Balu-Iyer, Sathy V.

    2007-01-01

    Hemophilia A, a life threatening bleeding disorder is caused by deficiency of Factor VIII (FVIII). Replacement therapy using rFVIII is the first line therapy for hemophilia A. However, 15-30% of patients develop neutralizing antibody, mainly against the C2, A3 and A2 domains. It has been reported that PS-FVIII complex reduced total and neutralizing anti-rFVIII antibody titers in hemophilia A murine models. Here, we developed FVIII – containing cochleate cylinders, utilizing PS-Ca2+ interactions and characterized these particles for optimal in vivo properties using biophysical and biochemical techniques. Approximately 75% of the protein was associated with cochleate cylinders. Sandwich ELISA, acrylamide quenching and enzymatic digestion studies established that rFVIII was shielded from the bulk aqueous phase by the lipidic structures, possibly leading to improved in vivo stability. Freeze – thawing and rate limiting diffusion studies revealed that small cochleate cylinders with a particles size of 500 nm or less could be generated. The release kinetics and in vivo experiments suggested that there is slow and sustained release of FVIII from the complex upon systemic exposure. In vivo studies using tail clip method indicated that FVIII-cochleate complex is effective and protects hemophilic mice from bleeding. Based on these studies, we speculate that the molecular interaction between FVIII and PS may provide a basis for the design of novel FVIII lipidic structures for delivery applications. PMID:17936245

  7. Recombinant factor VIII Fc (rFVIIIFc) fusion protein reduces immunogenicity and induces tolerance in hemophilia A mice.

    Science.gov (United States)

    Krishnamoorthy, Sriram; Liu, Tongyao; Drager, Douglas; Patarroyo-White, Susannah; Chhabra, Ekta Seth; Peters, Robert; Josephson, Neil; Lillicrap, David; Blumberg, Richard S; Pierce, Glenn F; Jiang, Haiyan

    2016-03-01

    Anti-factor VIII (FVIII) antibodies is a major complication of FVIII replacement therapy for hemophilia A. We investigated the immune response to recombinant human factor VIII Fc (rFVIIIFc) in comparison to BDD-rFVIII and full-length rFVIII (FL-rFVIII) in hemophilia A mice. Repeated administration of therapeutically relevant doses of rFVIIIFc in these mice resulted in significantly lower antibody responses to rFVIII compared to BDD-rFVIII and FL-rFVIII and reduced antibody production upon subsequent challenge with high doses of rFVIIIFc. The induction of a tolerogenic response by rFVIIIFc was associated with higher percentage of regulatory T-cells, a lower percentage of pro-inflammatory splenic T-cells, and up-regulation of tolerogenic cytokines and markers. Disruption of Fc interactions with either FcRn or Fcγ receptors diminished tolerance induction, suggesting the involvement of these pathways. These results indicate that rFVIIIFc reduces immunogenicity and imparts tolerance to rFVIII demonstrating that recombinant therapeutic proteins may be modified to influence immunogenicity and facilitate tolerance.

  8. Factor VIII brand and the incidence of factor VIII inhibitors in previously untreated UK children with severe hemophilia A, 2000-2011.

    Science.gov (United States)

    Collins, Peter W; Palmer, Benedict P; Chalmers, Elizabeth A; Hart, Daniel P; Liesner, Ri; Rangarajan, Savita; Talks, Katherine; Williams, Michael; Hay, Charles R M

    2014-11-27

    The effect of recombinant factor VIII (rFVIII) brand on inhibitor development was investigated in all 407 severe hemophilia A previously untreated patients born in the United Kingdom (UK) between 1 January 2000 and 31 December 2011. Eighty-eight (22%) had been in the RODIN study. Information was extracted from the National Haemophilia Database. Because exposure days (EDs) were not known for some patients, time from first treatment was used as a surrogate for rFVIII exposure. An inhibitor developed in 118 (29%) patients, 60 high and 58 low titer, after a median (interquartile range) of 7.8 (3.3-13.5) months from first exposure and 16 (9-30) EDs. Of 128 patients treated with Kogenate Bayer/Helixate NexGen, 45 (35.2%, 95% confidence interval [CI] 27.4-43.8) developed an inhibitor compared with 42/172 (24.4%, 95% CI 18.6% to 31.4%) with Advate (P = .04). The adjusted hazard ratio (HR) (95% CI) for Kogenate Bayer/Helixate NexGen compared with Advate was 2.14 (1.12-4.10) (P = .02) for high titer and 1.75 (1.11-2.76) (P = .02) for all inhibitors. When excluding UK-RODIN patients, the adjusted HR (95% CI) for high-titer inhibitors was 2.00 (0.93-4.34) (P = .08). ReFacto AF was associated with a higher incidence of all, but not high-titer, inhibitors than Advate. These results will help inform debate around the relative immunogenicity and use of rFVIII brands.

  9. Optimisation of the Factor VIII yield in mammalian cell cultures by reducing the membrane bound fraction

    DEFF Research Database (Denmark)

    Kolind, Mille Petersen; Nørby, Peder Lisby; Berchtold, Martin Werner

    2011-01-01

    and forms the tenase complex together with clotting Factor IX. In vitro, during serum free production of recombinant FVIII (rFVIII), production cells also expose PS, and since vWF is not present to hinder interaction of secreted rFVIII with PS, rFVIII is partly associated with the cell membrane...... of active membrane bound rFVIII to the culture medium. Moreover, the attachment of rFVIII to cell membranes of un-transfected HEK293 cells was studied in the presence of compounds that competes for interactions between rFVIII and PS. Competitive assays between iodinated rFVIII (¹²5I-rFVIII) and annexin V...... or ortho-phospho-L-serine (OPLS) demonstrated that annexin V and OPLS were able to reduce the membrane bound fraction of rFVIII by 70% and 30%, respectively. Finally, adding OPLS to CHO cells stably expressing FVIII increased the yield by 50%. Using this new knowledge, the recovery of rFVIII could...

  10. Molecular design and downstream processing of turoctocog alfa (NovoEight), a B-domain truncated factor VIII molecule.

    Science.gov (United States)

    Ahmadian, Haleh; Hansen, Ernst B; Faber, Johan H; Sejergaard, Lars; Karlsson, Johan; Bolt, Gert; Hansen, Jens J; Thim, Lars

    2016-07-01

    Turoctocog alfa (NovoEight) is a third-generation recombinant factor VIII (rFVIII) with a truncated B-domain that is manufactured in Chinese hamster ovary cells. No human or animal-derived materials are used in the process. The aim of this study is to describe the molecular design and purification process for turoctocog alfa. A five-step purification process is applied to turoctocog alfa: protein capture on mixed-mode resin; immunoaffinity chromatography using a unique, recombinantly produced anti-FVIII mAb; anion exchange chromatography; nanofiltration and size exclusion chromatography. This process enabled reduction of impurities such as host cell proteins (HCPs) and high molecular weight proteins (HMWPs) to a very low level. The immunoaffinity step is very important for the removal of FVIII-related degradation products. Manufacturing scale data shown in this article confirmed the robustness of the purification process and a reliable and consistent reduction of the impurities. The contribution of each step to the final product purity is described and shown for three manufacturing batches. Turoctocog alfa, a third-generation B-domain truncated rFVIII product is manufactured in Chinese hamster ovary cells without the use of animal or human-derived proteins. The five-step purification process results in a homogenous, highly purified rFVIII product.

  11. Coagulation factor VIII activity in diabetic patients

    Directory of Open Access Journals (Sweden)

    Nermina Babić

    2011-02-01

    Full Text Available Aim To examine coagulation factor VIII activity in plasma, as a risk factor for thrombosis, in the patients with diabetes mellitus (DM. Also, to assess its relationship with ibrinogen and fasting blood glucose concentrations and with body mass index. Methods The plasma coagulation factor VIII activity, plasma levels of ibrinogen and blood glucose concentrations were measured in 30 patients with DM type 1, 30 patients with DM type 2 and in 30 healthy subjects. Body weight and body height were also measured and BMI was calculated.Results The plasma factor VIII activity in patients with DM type 1 and patients with DM type 2 was signiicantly higher than the values measured in healthy subjects. There was no signiicant difference in the factor VIII activity between patients with DM type 1 and type 2. The concentrations of ibrinogen and blood glucose in both groups of patients were signiicantly higher than in the group of healthy subjects. Patients with DM type 2 had a signiicantly higher BMI compared to healthy subjects, as well as compared to patients with DM type 1. There was a signiicant positive correlation between plasma factor VIII activity and plasma level of ibrinogen and a signiicant negative correlation between factor VIII activity and BMI in patients with DM type 2. Conclusion Diabetic patients have the elevated plasma coagulation factor VIII activity and increased ibrinogen concentration thus an increased risk of thrombosis and vascular diseases.

  12. The B-domain of factor VIII reduces cell membrane attachement to host cells in serum free conditions

    DEFF Research Database (Denmark)

    Kolind, Mille Petersen; Nørby, Peder Lisby; Flintegaard, Thomas Veje

    2010-01-01

    engineered extensively throughout the years to increase the low production yields that initially were obtained from mammalian cell cultures. The scope of this work was to investigate the interaction of rFVIII with the cell membrane surface of the producing cells in serum free medium. We wondered whether...... binding of rFVIII to the cell membrane could be a factor diminishing the production yield. We studied the contribution of the rFVIII B-domain to membrane attachment by transfecting several constructs containing increasing lengths of the B-domain into cells under serum free conditions. We found that 90......% of rFVIII is attached to the cell membrane of the producing cell when the rFVIII variant contains a short B-domain (21 aa). By increasing the length of the B-domain the membrane attached fraction can be reduced to 50% of the total expressed rFVIII. Further, our studies show that the N...

  13. Status and trend analysis of prophylactic usage of recombinant factor VIII in Chinese pediatric patients with hemophilia A: ReCare - a retrospective, phase IV, non-interventional study.

    Science.gov (United States)

    Li, Changgang; Zhang, Xinsheng; Zhao, Yongqiang; Wu, Runhui; Hu, Qun; Xu, Vicky; Sun, Jing; Yang, Renchi; Li, Xiaojing; Zhou, Rongfu; Lian, Shinmei; Gu, Jian; Wu, Junde; Hou, Qingsong

    2017-09-01

    No study has reported the status and chronological trend of prophylactic recombinant factor VIII (rFVIII) use in Chinese pediatric patients with hemophilia A (HA). We aimed to analyze the status and trend of rFVIII-containing prophylaxis in Chinese pediatric patients with HA. ReCARE (Retrospective study in Chinese pediatric hemophilia A patients with rFVIII contained REgular prophylaxis) was a retrospective study conducted in 12 hemophilia treatment centers across China. The trend of prophylaxis was evaluated by determining the mean duration of prophylaxis, mean injection frequency (per week), mean dose of each injection (IU/kg), mean total dose injected/week (IU) and proportion of rFVIII consumption relative to factor VIII (FVIII) consumption over the study period. We analyzed 183 male pediatric patients with HA (mean age, 7.1 ± 4.23 years), who received intermittent prophylaxis between 1 November 2007 and 31 May 2013. The mean duration of prophylaxis with rFVIII increased from 16.72 weeks in 2008 to 32.77 in 2012. Per injection dose of rFVIII increased significantly from 2008 to 2013 (25.89 to 28.31 IU/kg, p < .001). An increase was also reported in the mean total FVIII consumed (699.97 ± 173.25 IU in 2008 and 891.30 ± 730.341 in 2013) and mean proportion of rFVIII used (33.33 ± 57.73% in 2008 to 85.50 ± 29.077% in 2013). Our data revealed an overall improvement in treatment dosage and duration with an increase in the number of patients receiving prophylaxis. The total proportion of rFVIII also increased gradually indicating the development of economy and safety awareness. The trial is registered at ClinicalTrials.gov (CT.gov identifier: NCT02263066).

  14. Blood coagulation factor VIII: An overview

    Indian Academy of Sciences (India)

    G M Bhopale; R K Nanda

    2003-12-01

    Factor VIII (FVIII) functions as a co-factor in the blood coagulation cascade for the proteolytic activation of factor X by factor IXa. Deficiency of FVIII causes hemophilia A, the most commonly inherited bleeding disorder. This review highlights current knowledge on selected aspects of FVIII in which both the scientist and the clinician should be interested.

  15. Game, set, match for factor VIII mismatch?

    Science.gov (United States)

    Miller, Connie H

    2015-08-13

    In this issue of Blood, Gunasekera et al provide evidence that the high rate of factor VIII (FVIII) inhibitors seen in black hemophilia A (HA) patients is not due to a mismatch between the structure of treatment products and FVIII genotypes common in blacks.

  16. BAY 81-8973, a full-length recombinant factor VIII: manufacturing processes and product characteristics.

    Science.gov (United States)

    Garger, S; Severs, J; Regan, L; Hesslein, A; Ignowski, J; Wu, P; Long, E; Gupta, S; Liu, S; Wang, W

    2017-03-01

    BAY 81-8973 (Kovaltry(®) , Bayer, Berkeley, CA, USA) is an unmodified, full-length recombinant human factor VIII (FVIII) approved for prophylaxis and on-demand treatment of bleeding episodes in patients with haemophilia A. The BAY 81-8973 manufacturing process is based on the process used for sucrose-formulated recombinant FVIII (rFVIII-FS), with changes and enhancements made to improve production efficiency, further augment pathogen safety, and eliminate animal- and human-derived raw materials from the production processes. The baby hamster kidney cell line used for BAY 81-8973 was developed by introducing the gene for human heat shock protein 70 into the rFVIII-FS cell line, a change that improved cell line robustness and productivity. Pathogen safety was enhanced by including a 20-nm filtration step, which can remove viruses, transmissible spongiform encephalopathy agents and potential protein aggregates. No human- or animal-derived proteins are added to the cell culture process, purification or final formulation. The BAY 81-8973 manufacturing process results in a product of enhanced purity with a consistently high degree of sialylation of N-linked glycans on the molecular surface. The innovative manufacturing techniques used for BAY 81-8973 yield an effective rFVIII product with a favourable safety profile for treatment of haemophilia A. © 2016 Bayer. Haemophilia Published by John Wiley & Sons Ltd.

  17. Acquired Factor VIII Inhibitors: Three Cases

    Directory of Open Access Journals (Sweden)

    Tay Za Kyaw

    2013-03-01

    Full Text Available Acquired hemophilia A is a rare, but devastating bleeding disorder caused by spontaneous development of autoantibodies directed against coagulation factor VIII. In 40%-50% of patients it is associated with such conditions as the postpartum period, malignancy, use of medications, and autoimmune diseases; however, its cause is unknown in most cases. Acquired hemophilia A should be suspected in patients that present with a coagulation abnormality, and a negative personal and family history of bleeding. Herein we report 3 patients with acquired hemophilia A that had different underlying pathologies, clinical presentations, and therapeutic responses. Factor VIII inhibitor formation in case 1 occurred 6 months after giving birth; underlying disorders were not identified in cases 2 or 3. The bleeding phenotype in these patients’ ranged from no bleeding tendency with isolated prolongation of APTT (activated partial thromboplastin time to severe intramuscular hematoma and hemarthrosis necessitating recombinant activated factor VII infusion and blood components transfusion. Variable responses to immunosuppressive treatment were also observed.

  18. Patient preference for needleless factor VIII reconstitution device: the Italian experience

    Directory of Open Access Journals (Sweden)

    Roberto Musso

    2010-07-01

    Full Text Available Roberto Musso1, Rita Santoro2, Antonio Coppola3, Maura Marcucci4, Gianluca Sottilotta5, Roberto Targhetta6, Ezio Zanon7, Massimo Franchini81Centro Emofilia, Istituto di Ematologia Università degli Studi di Catania, Ospedale Ferrarotto, Catania, Italy; 2Haemophilia Centre, Hemostasis and Thrombosis Service, Department of Haematology and Oncology, Azienda Ospedaliera “Pugliese-Ciaccio”, Catanzaro, Italy; 3Regional Reference Centre for Coagulation Disorders, Federico II University, Naples, Italy; 4Internal and Vascular Medicine, University of Perugia, Perugia, Italy; 5Hemophilia Centre, Hemostasis and Thrombosis Service, Azienda Ospedaliera “Bianchi-Melacrino-Morelli”, Reggio Calabria, Italy; 6Centro Emofilia Struttura Semplice Patologie della Coagulazione, Ospedale Microcitemico, Cagliari, Italy; 7Centro Emofilia, Clinica Medica II, Azienda Ospedaliera di Padova, Padova, Italy; 8Immunohaematology and Transfusion Centre, Department of Pathology and Laboratory Medicine, University Hospital of Parma, Parma, ItalyBackground: Needlestick injuries, mostly due to unsafe needle devices, are a frequent adverse event among health care workers and patients on chronic treatment, such as hemophiliacs. To improve the safety of these procedures, a needleless reconstitution system, Bio-Set® has been implemented for the sucrose-formulated recombinant factor VIII (rFVIII-FS Kogenate® Bayer (Bayer Healthcare, Berlin, Germany. The aim of this study was to collect patients’ satisfaction and safety data regarding the administration of rFVIII-FS with this new device.Methods: This was a multicenter, prospective, postmarketing surveillance study collecting data from seven Italian Haemophilia Centers within the framework of an international project involving patients from nine European countries. The patients were asked to fill out two preference questionnaires (one assessing the old method and one assessing the new method directly after the training and two

  19. Development and characterization of recombinant ovine coagulation factor VIII.

    Science.gov (United States)

    Zakas, Philip M; Gangadharan, Bagirath; Almeida-Porada, Graca; Porada, Christopher D; Spencer, H Trent; Doering, Christopher B

    2012-01-01

    Animal models of the bleeding disorder, hemophilia A, have been an integral component of the biopharmaceutical development process and have facilitated the development of recombinant coagulation factor VIII (fVIII) products capable of restoring median survival of persons with hemophilia A to that of the general population. However, there remain several limitations to recombinant fVIII as a biotherapeutic, including invasiveness of intravenous infusion, short half-life, immunogenicity, and lack of availability to the majority of the world's population. The recently described ovine model of hemophilia A is the largest and most accurate phenocopy. Affected sheep die prematurely due to bleeding-related pathogenesis and display robust adaptive humoral immunity to non-ovine fVIII. Herein, we describe the development and characterization of recombinant ovine fVIII (ofVIII) to support further the utility of the ovine hemophilia A model. Full-length and B-domain deleted (BDD) ofVIII cDNAs were generated and demonstrated to facilitate greater biosynthetic rates than their human fVIII counterparts while both BDD constructs showed greater expression rates than the same-species full-length versions. A top recombinant BDD ofVIII producing baby hamster kidney clone was identified and used to biosynthesize raw material for purification and biochemical characterization. Highly purified recombinant BDD ofVIII preparations possess a specific activity nearly 2-fold higher than recombinant BDD human fVIII and display a differential glycosylation pattern. However, binding to the carrier protein, von Willebrand factor, which is critical for stability of fVIII in circulation, is indistinguishable. Decay of thrombin-activated ofVIIIa is 2-fold slower than human fVIII indicating greater intrinsic stability. Furthermore, intravenous administration of ofVIII effectively reverses the bleeding phenotype in the murine model of hemophilia A. Recombinant ofVIII should facilitate the maintenance of

  20. Development and characterization of recombinant ovine coagulation factor VIII.

    Directory of Open Access Journals (Sweden)

    Philip M Zakas

    Full Text Available Animal models of the bleeding disorder, hemophilia A, have been an integral component of the biopharmaceutical development process and have facilitated the development of recombinant coagulation factor VIII (fVIII products capable of restoring median survival of persons with hemophilia A to that of the general population. However, there remain several limitations to recombinant fVIII as a biotherapeutic, including invasiveness of intravenous infusion, short half-life, immunogenicity, and lack of availability to the majority of the world's population. The recently described ovine model of hemophilia A is the largest and most accurate phenocopy. Affected sheep die prematurely due to bleeding-related pathogenesis and display robust adaptive humoral immunity to non-ovine fVIII. Herein, we describe the development and characterization of recombinant ovine fVIII (ofVIII to support further the utility of the ovine hemophilia A model. Full-length and B-domain deleted (BDD ofVIII cDNAs were generated and demonstrated to facilitate greater biosynthetic rates than their human fVIII counterparts while both BDD constructs showed greater expression rates than the same-species full-length versions. A top recombinant BDD ofVIII producing baby hamster kidney clone was identified and used to biosynthesize raw material for purification and biochemical characterization. Highly purified recombinant BDD ofVIII preparations possess a specific activity nearly 2-fold higher than recombinant BDD human fVIII and display a differential glycosylation pattern. However, binding to the carrier protein, von Willebrand factor, which is critical for stability of fVIII in circulation, is indistinguishable. Decay of thrombin-activated ofVIIIa is 2-fold slower than human fVIII indicating greater intrinsic stability. Furthermore, intravenous administration of ofVIII effectively reverses the bleeding phenotype in the murine model of hemophilia A. Recombinant ofVIII should facilitate

  1. Continuous infusion of factor VIII for surgery and major bleeding.

    Science.gov (United States)

    Hay, C R; Doughty, H I; Savidge, G F

    1996-03-01

    In a clinical trial, 24 patients with haemophilia A who needed surgery or had suffered severe bleeding were treated by continuous infusion of Monoclate P, a factor VIII concentrate that is immunopurified by monoclonal antibodies. Continuous infusion of Monoclate P began with a dose of 2 U/kg per h that was adjusted according to the results of factor VIII assays to achieve a factor VIII target level of 100 IU/dl for 2 days and then 80 IU/dl for 5 days. The safety, efficacy, and economics of this approach were assessed. No haemorrhagic episodes were observed. The continuous infusion was convenient and had the advantage of producing steady-state levels of factor VIII. With a single-compartment model, we found median factor VIII clearance values of 3.11 (range 1.79-7.78) x 10(3) litres/kg per h, elimination rates of 5.0-19.4 x 10(-2)/h and a median half-life of 9.9 h (range 4.8-20.0 h). Clearance and the elimination rate appeared to decline over the infusion period, as judged by the decreasing infusion rate required to maintain the target concentration of factor VIII. An economic comparison with bolus therapy, using theoretically derived bolus dosages, indicated that the potential saving was related inversely to the factor VIII half-life. Potential savings of 75% were predicted on the first postoperative day, averaging 35% over the full course of therapy.

  2. Idiopathic Acquired Hemophilia A with Undetectable Factor VIII Inhibitor

    Directory of Open Access Journals (Sweden)

    Nicholas B. Abt

    2014-01-01

    Full Text Available Objective. We present the case of a 73-year-old female, with no family or personal history of a bleeding disorder, who had a classic presentation for acquired hemophilia A. Factor VIII activity was low but detectable and a factor VIII inhibitor was undetectable. Methods. The patient’s plasma was comprehensively studied to determine the cause of the acquired coagulopathy. Using the Nijmegen modification of the Bethesda assay, no factor VIII autoantibody was measureable despite varying the incubation time from 1 to 3 hours. Results. The aPTT was prolonged at 46.8 seconds, which did not correct in the 4 : 1 mix but did with 1 : 1 mix. Using a one stage factor VIII activity assay, the FVIII activity was 16% and chromogenic FVIII activity was also 16%. The patient was treated with recombinant FVII and transfusion, significantly reducing bleeding. Long-term therapy was initiated with cyclophosphamide and prednisone with normalization of FVIII activity. Conclusions. Physicians can be presented with the challenging clinical picture of an acquired factor VIII inhibitor without a detectable inhibitor by the Bethesda assay. Standard therapy for an acquired hemophilia A should be considered.

  3. Functional regions in coagulation factor VIII explored by mass spectrometry

    NARCIS (Netherlands)

    Bloem, E.

    2013-01-01

    The molecular mechanisms behind the function of factor VIII (FVIII) have remained poorly understood. FVIII acts in the blood coagulation cascade as cofactor for activated factor IX (FIXa) in the membrane bound activated factor X generating (FXase) complex. A functional absence in FVIII leads to the

  4. Collagen-bound von Willebrand factor has reduced affinity for factor VIII.

    Science.gov (United States)

    Bendetowicz, A V; Wise, R J; Gilbert, G E

    1999-04-30

    von Willebrand factor (vWf) is a multimeric adhesive glycoprotein that serves as a carrier for factor VIII in plasma. Although each vWf subunit displays a high affinity binding site for factor VIII in vitro, in plasma, only 2% of the vWf sites for factor VIII are occupied. We investigated whether interaction of plasma proteins with vWf or adhesion of vWf to collagen may alter the affinity or availability of factor VIII-binding sites on vWf. When vWf was immobilized on agarose-linked monoclonal antibody, factor VIII bound to vWf with high affinity, and neither the affinity nor binding site availability was influenced by the presence of 50% plasma. Therefore, plasma proteins do not alter the affinity or availability of factor VIII-binding sites. In contrast, when vWf was immobilized on agarose-linked collagen, its affinity for factor VIII was reduced 4-fold, with KD increasing from 0.9 to 3.8 nM. However, one factor VIII-binding site remained available on each vWf subunit. A comparable reduction in affinity for factor VIII was observed when vWf was a constituent of the subendothelial cell matrix and when it was bound to purified type VI collagen. In parallel with the decreased affinity for factor VIII, collagen-bound vWf displayed a 6-fold lower affinity for monoclonal antibody W5-6A, with an epitope composed of residues 78-96 within the factor VIII-binding motif of vWf. We conclude that collagen induces a conformational change within the factor VIII-binding motif of vWf that lowers the affinity for factor VIII.

  5. Low risk of inhibitor formation in haemophilia A patients following en masse switch in treatment to a third generation full length plasma and albumin-free recombinant factor VIII product (ADVATE®).

    LENUS (Irish Health Repository)

    Bacon, C L

    2011-05-01

    Previous studies have suggested that development of inhibitors in previously treated patients (PTPs) may be attributable to a switch in factor VIII (FVIII) therapeutic product. Consequently, it is widely recognized that inhibitor development must be assessed in PTPs following the introduction of any new FVIII product. Following a national tender process in 2006, all patients with haemophilia A in Ireland changed their FVIII treatment product en masse to a plasma and albumin-free recombinant full-length FVIII product (ADVATE(®)). In this study, we retrospectively reviewed the case records of Irish PTPs to evaluate risk of inhibitor formation following this treatment switch. One hundred and thirteen patients participated in the study. Most patients (89%) had severe haemophilia. Only one of 96 patients with no inhibitor history developed an inhibitor. Prior to the switch in his recombinant FVIII (rFVIII) treatment of choice, this child had only experienced three exposure days (EDs). Consequently, in total he had only received 6 EDs when his inhibitor was first diagnosed. In keeping with this lack of de novo inhibitor development, we observed no evidence of any recurrent inhibitor formation in any of 16 patients with previously documented inhibitors. Similarly, following a previous en masse switch, we have previously reported that changing from a Chinese hamster ovary cell-produced to a baby hamster kidney cell-produced rFVIII was also associated with a low risk of inhibitor formation in PTPs. Our cumulative findings from these two studies clearly emphasizes that the risk of inhibitor development for PTPs following changes in commercial rFVIII product is low, at least in the Irish population.

  6. Isolation, subunit structure, and proteolytic modification of bovine factor VIII.

    Science.gov (United States)

    Legaz, M E; Weinstein, M J; Heldebrant, C M; Davie, E W

    1975-01-20

    A new method has been described for the isolation of factor VIII. The method results in a high yield of factor VIII that is homogeneous by several different criteria. The purified protein is very stable and is not dissociated in the presence of 1 M NaCl or 0.25 M CaCl2. The highly purified protein is readily activated and inactivated by various proteolytic enzymes, such as thrombin, plasmin, and trypsin. The molecular events that lead to the activation reaction, however, have not been established.

  7. BAY 81-8973, a full-length recombinant factor VIII: Human heat shock protein 70 improves the manufacturing process without affecting clinical safety.

    Science.gov (United States)

    Maas Enriquez, Monika; Thrift, John; Garger, Stephen; Katterle, Yvonne

    2016-11-01

    BAY 81-8973 is a full-length, unmodified recombinant human factor VIII (FVIII) approved for the treatment of hemophilia A. BAY 81-8973 has the same amino acid sequence as the currently marketed sucrose-formulated recombinant FVIII (rFVIII-FS) product and is produced using additional advanced manufacturing technologies. One of the key manufacturing advances for BAY 81-8973 is introduction of the gene for human heat shock protein 70 (HSP70) into the rFVIII-FS cell line. HSP70 facilitates proper folding of proteins, enhances cell survival by inhibiting apoptosis, and potentially impacts rFVIII glycosylation. HSP70 expression in the BAY 81-8973 cell line along with other manufacturing advances resulted in a higher-producing cell line and improvements in the pharmacokinetics of the final product as determined in clinical studies. HSP70 protein is not detected in the harvest or in the final BAY 81-8973 product. However, because this is a new process, clinical trial safety assessments included monitoring for anti-HSP70 antibodies. Most patients, across all age groups, had low levels of anti-HSP70 antibodies before exposure to the investigational product. During BAY 81-8973 treatment, 5% of patients had sporadic increases in anti-HSP70 antibody levels above a predefined threshold (cutoff value, 239 ng/mL). No clinical symptoms related to anti-HSP70 antibody development occurred. In conclusion, addition of HSP70 to the BAY 81-8973 cell line is an innovative technology for manufacturing rFVIII aimed at improving protein folding and expression. Improved pharmacokinetics and no effect on safety of BAY 81-8973 were observed in clinical trials in patients with hemophilia A. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  8. Presentation and management of a stage Ia lung cancer patient with a paraneoplastic factor VIII inhibitor.

    Science.gov (United States)

    Laselle, Brooks T; Boggio, Lisa N; Blum, Matthew G

    2006-01-01

    Acquired inhibitors to clotting factors most commonly involve factor VIII and are associated with autoimmune disease. Factor VIII inhibitors can cause severe spontaneous and iatrogenic bleeding that is difficult to manage. Factor VIII inhibitors are rarely associated with solid tumors and only three cases of adenocarcinoma of the lung have been reported. This report describes the multidisciplinary management of a factor VIII inhibitor-producing stage Ia lung adenocarcinoma that ultimately resulted in complete resectability.

  9. Factor VIII/V C-domain swaps reveal discrete C-domain roles in factor VIII function and intracellular trafficking.

    Science.gov (United States)

    Ebberink, Eduard H T M; Bouwens, Eveline A M; Bloem, Esther; Boon-Spijker, Mariëtte; van den Biggelaar, Maartje; Voorberg, Jan; Meijer, Alexander B; Mertens, Koen

    2017-04-01

    Factor VIII C-domains are believed to have specific functions in cofactor activity and in interactions with von Willebrand factor. We have previously shown that factor VIII is co-targeted with von Willebrand factor to the Weibel-Palade bodies in blood outgrowth endothelial cells, even when factor VIII carries mutations in the light chain that are associated with defective von Willebrand factor binding. In this study, we addressed the contribution of individual factor VIII C-domains in intracellular targeting, von Willebrand factor binding and cofactor activity by factor VIII/V C-domain swapping. Blood outgrowth endothelial cells were transduced with lentivirus encoding factor V, factor VIII or YFP-tagged C-domain chimeras, and examined by confocal microscopy. The same chimeras were produced in HEK293-cells for in vitro characterization and chemical foot-printing by mass spectrometry. In contrast to factor VIII, factor V did not target to Weibel-Palade bodies. The chimeras showed reduced Weibel-Palade body targeting, suggesting that this requires the factor VIII C1-C2 region. The factor VIII/V-C1 chimera did not bind von Willebrand factor and had reduced affinity for activated factor IX, whereas the factor VIII/V-C2 chimera showed a minor reduction in von Willebrand factor binding and normal interaction with activated factor IX. This suggests that mainly the C1-domain carries factor VIII-specific features in assembly with von Willebrand factor and activated factor IX. Foot-printing analysis of the chimeras revealed increased exposure of lysine residues in the A1/C2- and C1/C2-domain interface, suggesting increased C2-domain mobility and disruption of the natural C-domain tandem pair orientation. Apparently, this affects intracellular trafficking, but not extracellular function. Copyright© Ferrata Storti Foundation.

  10. Evaluation of Factor VIII as a Risk Factor in Indian Patients with DVT.

    Science.gov (United States)

    Hazra, Darpanarayan; Sen, Indrani; Stephen, Edwin; Agarwal, Sunil; Nair, Sukesh Chandran; Mammen, Joy

    2015-01-01

    Introduction. Elevated factor VIII population in the Indian population has not been studied as a possible risk factor for deep vein thrombosis (DVT). High factor VIII level is considered a predisposing factor for DVT and its recurrence. However it is known to vary between populations and its exact role in the etiopathogenesis of thrombophilia remains unknown. Material and Methods. Factor VIII levels of patients with DVT who had undergone a prothrombotic workup as a part of their workup was compared to normal age matched controls in a 1 : 3 ratio. Results. There were 75 patients with DVT who had undergone a prothrombotic workup in the course of their treatment for lower limb DVT. In these, 64% had levels of factor VIII more than 150 as compared to 63% of normal controls (p > 0.05, not significant). Conclusion. Elevated factor VIII in the Indians may not be associated with the same thrombotic risk as seen in the West. We find a variation in the levels of factor VIII with a different "normal" than what is reported in other populations. This needs further study to elucidate the role of factor VIII in the evaluation and treatment of thrombophilia.

  11. The effect of factor VIII deficiencies and replacement and bypass therapies on thrombus formation under venous flow conditions in microfluidic and computational models.

    Directory of Open Access Journals (Sweden)

    Abimbola A Onasoga-Jarvis

    Full Text Available Clinical evidence suggests that individuals with factor VIII (FVIII deficiency (hemophilia A are protected against venous thrombosis, but treatment with recombinant proteins can increase their risk for thrombosis. In this study we examined the dynamics of thrombus formation in individuals with hemophilia A and their response to replacement and bypass therapies under venous flow conditions. Fibrin and platelet accumulation were measured in microfluidic flow assays on a TF-rich surface at a shear rate of 100 s⁻¹. Thrombin generation was calculated with a computational spatial-temporal model of thrombus formation. Mild FVIII deficiencies (5-30% normal levels could support fibrin fiber formation, while severe (1 nM, but too low to support fibrin formation (<10 nM. In the absence of platelets, fibrin formation was not supported even at normal FVIII levels, suggesting platelet adhesion is necessary for fibrin formation. Individuals treated by replacement therapy, recombinant FVIII, showed normalized fibrin formation. Individuals treated with bypass therapy, recombinant FVIIa, had a reduced lag time in fibrin formation, as well as elevated fibrin accumulation compared to healthy controls. Treatment of rFVIIa, but not rFVIII, resulted in significant changes in fibrin dynamics that could lead to a prothrombotic state.

  12. Factor VIII therapy for hemophilia A: current and future issues.

    Science.gov (United States)

    Aledort, Louis; Ljung, Rolf; Mann, Kenneth; Pipe, Steven

    2014-06-01

    Hemophilia A is a congenital, recessive, X-linked bleeding disorder that is managed with infusions of plasma-derived or recombinant factor (F) VIII. The primary considerations in FVIII replacement therapy today are the: 1) immunogenicity of FVIII concentrates, 2) role of longer-acting FVIII products, 3) prophylactic use of FVIII in children and adults with severe hemophilia A, and 4) affordability and availability of FVIII products. Improving patient outcomes by increasing the use of FVIII prophylaxis, preventing or eliminating FVIII inhibitors, and expanding access to FVIII concentrates in developing countries are the major challenges confronting clinicians who care for patients with hemophilia A.

  13. Comparison of factor VIII transgenes bioengineered for improved expression in gene therapy of hemophilia A.

    Science.gov (United States)

    Dooriss, Kerry L; Denning, Gabriela; Gangadharan, Bagirath; Javazon, Elisabeth H; McCarty, David A; Spencer, H Trent; Doering, Christopher B

    2009-05-01

    Successful gene therapy of hemophilia A depends on the sustained expression of therapeutic levels of factor VIII (fVIII). Because of mRNA instability, interactions with resident endoplasmic reticulum (ER) chaperones, and the requirement for carbohydrate-facilitated transport from the ER to the Golgi apparatus, fVIII is expressed at much lower levels from mammalian cells than other proteins of similar size and complexity. A number of bioengineered forms of B domain-deleted (BDD) human fVIII have been generated and shown to have enhanced expression. Previously, we demonstrated that recombinant BDD porcine fVIII exhibits high-level expression due to specific sequence elements that increase biosynthesis via enhanced posttranslational transit through the secretory pathway. In the current study, high-expression recombinant fVIII constructs were compared directly in order to determine the relative expression of the various bioengineered fVIII transgenes. The data demonstrate that BDD porcine fVIII expression is superior to that of any of the human fVIII variant constructs tested. Mean fVIII expression of 18 units/10(6) cells/24 hr was observed from HEK-293 cells expressing a single copy of the porcine fVIII transgene, which was 36- to 225-fold greater than that of any human fVIII transgene tested. Furthermore, greater than 10-fold higher expression was observed in human cells transduced with BDD porcine fVIII versus BDD human fVIII-encoding lentiviral vectors, even at low proviral copy numbers, supporting its use over other human fVIII variants in future hemophilia A gene therapy clinical trials.

  14. Efficacy and safety of rVIII-SingleChain: results of a phase 1/3 multicenter clinical trial in severe hemophilia A

    Science.gov (United States)

    Mahlangu, Johnny; Kuliczkowski, Kazimierz; Karim, Faraizah Abdul; Stasyshyn, Oleksandra; Kosinova, Marina V.; Lepatan, Lynda Mae; Skotnicki, Aleksander; Boggio, Lisa N.; Klamroth, Robert; Oldenburg, Johannes; Hellmann, Andrzej; Santagostino, Elena; Baker, Ross I.; Fischer, Kathelijn; Gill, Joan C.; P’Ng, Stephanie; Chowdary, Pratima; Escobar, Miguel A.; Khayat, Claudia Djambas; Rusen, Luminita; Bensen-Kennedy, Debra; Blackman, Nicole; Limsakun, Tharin; Veldman, Alex; St. Ledger, Katie

    2016-01-01

    Recombinant VIII (rVIII)-SingleChain is a novel B-domain–truncated recombinant factor VIII (rFVIII), comprised of covalently bonded factor VIII (FVIII) heavy and light chains. It was designed to have a higher binding affinity for von Willebrand factor (VWF). This phase 1/3 study investigated the efficacy and safety of rVIII-SingleChain in the treatment of bleeding episodes, routine prophylaxis, and surgical prophylaxis. Participants were ≥12 years of age, with severe hemophilia A (endogenous FVIII <1%). The participants were allocated by the investigator to receive rVIII-SingleChain in either an on-demand or prophylaxis regimen. Of the 175 patients meeting study eligibility criteria, 173 were treated with rVIII-SingleChain, prophylactically (N = 146) or on-demand (N = 27). The total cumulative exposure was 14 306 exposure days (EDs), with 120 participants reaching ≥50 EDs and 52 participants having ≥100 EDs. Hemostatic efficacy was rated by the investigator as excellent or good in 93.8% of the 835 bleeds treated and assessed. Across all prophylaxis regimens, the median annualized spontaneous bleeding rate was 0.00 (Q1, Q3: 0.0, 2.4) and the median overall annualized bleeding rate (ABR) was 1.14 (Q1, Q3: 0.0, 4.2). Surgical hemostasis was rated as excellent/good in 100% of major surgeries by the investigator. No participant developed FVIII inhibitors. In conclusion, rVIII-SingleChain is a novel rFVIII molecule showing excellent hemostatic efficacy in surgery and in the control of bleeding events, low ABR in patients on prophylaxis, and a favorable safety profile in this large clinical study. This trial was registered at www.clinicaltrials.gov as #NCT01486927. PMID:27330001

  15. Efficacy and safety of rVIII-SingleChain: results of a phase 1/3 multicenter clinical trial in severe hemophilia A.

    Science.gov (United States)

    Mahlangu, Johnny; Kuliczkowski, Kazimierz; Karim, Faraizah Abdul; Stasyshyn, Oleksandra; Kosinova, Marina V; Lepatan, Lynda Mae; Skotnicki, Aleksander; Boggio, Lisa N; Klamroth, Robert; Oldenburg, Johannes; Hellmann, Andrzej; Santagostino, Elena; Baker, Ross I; Fischer, Kathelijn; Gill, Joan C; P'Ng, Stephanie; Chowdary, Pratima; Escobar, Miguel A; Khayat, Claudia Djambas; Rusen, Luminita; Bensen-Kennedy, Debra; Blackman, Nicole; Limsakun, Tharin; Veldman, Alex; St Ledger, Katie; Pabinger, Ingrid

    2016-08-04

    Recombinant VIII (rVIII)-SingleChain is a novel B-domain-truncated recombinant factor VIII (rFVIII), comprised of covalently bonded factor VIII (FVIII) heavy and light chains. It was designed to have a higher binding affinity for von Willebrand factor (VWF). This phase 1/3 study investigated the efficacy and safety of rVIII-SingleChain in the treatment of bleeding episodes, routine prophylaxis, and surgical prophylaxis. Participants were ≥12 years of age, with severe hemophilia A (endogenous FVIII <1%). The participants were allocated by the investigator to receive rVIII-SingleChain in either an on-demand or prophylaxis regimen. Of the 175 patients meeting study eligibility criteria, 173 were treated with rVIII-SingleChain, prophylactically (N = 146) or on-demand (N = 27). The total cumulative exposure was 14 306 exposure days (EDs), with 120 participants reaching ≥50 EDs and 52 participants having ≥100 EDs. Hemostatic efficacy was rated by the investigator as excellent or good in 93.8% of the 835 bleeds treated and assessed. Across all prophylaxis regimens, the median annualized spontaneous bleeding rate was 0.00 (Q1, Q3: 0.0, 2.4) and the median overall annualized bleeding rate (ABR) was 1.14 (Q1, Q3: 0.0, 4.2). Surgical hemostasis was rated as excellent/good in 100% of major surgeries by the investigator. No participant developed FVIII inhibitors. In conclusion, rVIII-SingleChain is a novel rFVIII molecule showing excellent hemostatic efficacy in surgery and in the control of bleeding events, low ABR in patients on prophylaxis, and a favorable safety profile in this large clinical study. This trial was registered at www.clinicaltrials.gov as #NCT01486927.

  16. von Willebrand factor binds to the surface of dendritic cells and modulates peptide presentation of factor VIII.

    Science.gov (United States)

    Sorvillo, Nicoletta; Hartholt, Robin B; Bloem, Esther; Sedek, Magdalena; ten Brinke, Anja; van der Zwaan, Carmen; van Alphen, Floris P; Meijer, Alexander B; Voorberg, Jan

    2016-03-01

    It has been proposed that von Willebrand factor might affect factor VIII immunogenicity by reducing factor VIII uptake by antigen presenting cells. Here we investigate the interaction of recombinant von Willebrand factor with immature monocyte-derived dendritic cells using flow cytometry and confocal microscopy. Surprisingly, von Willebrand factor was not internalized by immature dendritic cells, but remained bound to the cell surface. As von Willebrand factor reduces the uptake of factor VIII, we investigated the repertoire of factor VIII presented peptides when in complex with von Willebrand factor. Interestingly, factor VIII-derived peptides were still abundantly presented on major histocompatibility complex class II molecules, even though a reduction of factor VIII uptake by immature dendritic cells was observed. Inspection of peptide profiles from 5 different donors showed that different core factor VIII peptide sequences were presented upon incubation with factor VIII/von Willebrand factor complex when compared to factor VIII alone. No von Willebrand factor peptides were detected when immature dendritic cells were pulsed with different concentrations of von Willebrand factor, confirming lack of von Willebrand factor endocytosis. Several von Willebrand factor derived peptides were recovered when cells were pulsed with von Willebrand factor/factor VIII complex, suggesting that factor VIII promotes endocytosis of small amounts of von Willebrand factor by immature dendritic cells. Taken together, our results establish that von Willebrand factor is poorly internalized by immature dendritic cells. We also show that von Willebrand factor modulates the internalization and presentation of factor VIII-derived peptides on major histocompatibility complex class II.

  17. The C1 and C2 domains of blood coagulation factor VIII mediate its endocytosis by dendritic cells

    Science.gov (United States)

    Gangadharan, Bagirath; Ing, Mathieu; Delignat, Sandrine; Peyron, Ivan; Teyssandier, Maud; Kaveri, Srinivas V.; Lacroix-Desmazes, Sébastien

    2017-01-01

    The development of inhibitory antibodies to therapeutic factor VIII is the major complication of replacement therapy in patients with hemophilia A. The first step in the initiation of the anti-factor VIII immune response is factor VIII interaction with receptor(s) on antigen-presenting cells, followed by endocytosis and presentation to naïve CD4+ T cells. Recent studies indicate a role for the C1 domain in factor VIII uptake. We investigated whether charged residues in the C2 domain participate in immunogenic factor VIII uptake. Co-incubation of factor VIII with BO2C11, a monoclonal C2-specific immunoglobulin G, reduced factor VIII endocytosis by dendritic cells and presentation to CD4+ T cells, and diminished factor VIII immunogenicity in factor VIII-deficient mice. The mutation of basic residues within the BO2C11 epitope of C2 replicated reduced in vitro immunogenic uptake, but failed to prevent factor VIII immunogenicity in mice. BO2C11 prevents factor VIII binding to von Willebrand factor, thus potentially biasing factor VIII immunogenicity by perturbing its half-life. Interestingly, a factor VIIIY1680C mutant, that does not bind von Willebrand factor, demonstrated unaltered endocytosis by dendritic cells as well as immunogenicity in factor VIII-deficient mice. Co-incubation of factor VIIIY1680C with BO2C11, however, resulted in decreased factor VIII immunogenicity in vivo. In addition, a previously described triple C1 mutant showed decreased uptake in vitro, and reduced immunogenicity in vivo, but only in the absence of endogenous von Willebrand factor. Taken together, the results indicate that residues in the C1 and/or C2 domains of factor VIII are implicated in immunogenic factor VIII uptake, at least in vitro. Conversely, in vivo, the binding to endogenous von Willebrand factor masks the reducing effect of mutations in the C domains on factor VIII immunogenicity. PMID:27758819

  18. Clinical evaluation of recombinant factor VIII preparation (Kogenate) in previously treated patients with hemophilia A: descriptive meta-analysis of post-marketing study data.

    Science.gov (United States)

    Yoshioka, A; Fukutake, K; Takamatsu, J; Shirahata, A

    2006-08-01

    The safety and efficacy of Kogenate, a recombinant factor VIII (rFVIII) preparation for the treatment of bleeding episodes, were studied in a 123-patient meta-analysis population of previously treated patients (PTPs), including 15 enrolled in the registration Phase III trial (PTP-I group), 93 from the post-marketing special investigation (PTP-II group), and 15 from short-term special investigations in surgery or tooth extraction (SI group). These patients (82 severe, 31 moderate, 9 mild, and 1 unknown), aged 11 months to 72 years, were enrolled in 28 centers in Japan. Blood samples taken at the baseline and at 3, 6, 9, 12, 18, and 24 months after the introduction of Kogenate were evaluated for FVIII inhibitor antibodies, antibodies formed against trace proteins derived from the rFVIII production process, and for general changes in laboratory test results. Mean exposure to Kogenate was 1103 days in PTP-I, 86 days in PTP-II, 27 days in patients in surgery, and 2 days in patients with tooth extraction. Assessment of FVIII inhibitor activity was conducted in 115 of the 123 patients by means of the Bethesda assay. Twelve patients were found to have a low titer of FVIII inhibitor (0.5-3.0 BU/mL) prior to any administration of Kogenate, and 103 were inhibitor-negative at the baseline. Among this latter group, 3 patients (2.9%) tested inhibitor-positive, with titers ranging from 1.2 to 2.1 BU/mL, with 4 patients below 1.0 BU/mL. One patient in the 11 PTPs investigated (PTP-I) developed antibodies against baby hamster kidney protein and mouse immunoglobulin G, but these findings were transient and asymptomatic. Hemostasis was achieved (markedly effective or effective) in 3666 of the 3855 bleeding episodes (95.1%) observed in 108 patients. Only 1 infusion was necessary in 3790 (98.3%) of these episodes. These data indicate that Kogenate is safe and very effective for the treatment of bleeding in PTPs with hemophilia A.

  19. Acquired factor VIII inhibitor syndrome: A rare cause of hematuria

    Directory of Open Access Journals (Sweden)

    Muthuvel Seral Kannan

    2015-01-01

    Full Text Available A 50-year-old woman presented with gross hematuria for 1 month. Clinical examinations, laboratory investigations, ultrasound and contrast computed tomography were normal, except anemia. Cystoscopy revealed bloody efflux from the right side. Retrograde pyelogram showed filling defect in the renal pelvis and biopsy was inconclusive. Renal angiogram was normal. She developed ecchymosis on the right thigh and arm with elevated activated partial thromboplastin time. The partial thromboplastin time correction study and Bethesda study confirmed the presence of acquired factor VIII inhibitor (acquired hemophilia. With flexible ureterorenoscopy, the mass in the renal pelvis was removed and its histopathology revealed clotted blood. The patient was subsequently managed with steroids and Factor eight inhibitor bypass activity.

  20. Factor VIII and von Willebrand factor changes during normal pregnancy and puerperium.

    Science.gov (United States)

    Sánchez-Luceros, Analía; Meschengieser, Susana S; Marchese, Carlos; Votta, Roberto; Casais, Patricia; Woods, Adriana I; Nadal, María V; Salviú, María J; Lazzari, María A

    2003-10-01

    Gestation is a challenge to haemostasis and it is associated with significant haemostatic changes. Several studies have evaluated von Willebrand factor in normal pregnancy, but none considered the personal history of bleeding. We studied a group of healthy non-bleeding women (184 pregnant, 64 puerperium, 37 non-pregnant) to evaluate normal ranges and their relationship to blood group and parity. The von Willebrand factor increased markedly from non-pregnant values up to the end of early puerperium (P < 0.0001), while factor VIII only showed a slight increase. Factor VIII and von Willebrand factor activity remained within the normal range for non-pregnant women. The return to non-pregnant factor levels occurred in late puerperium, later than previously reported. Only factor VIII was significantly lower in the O blood group (P = 0.035). As regards parity, there were no differences in factor VIII, von Willebrand factor antigen and von Willebrand factor ristocetin cofactor between primigravidae and multigravidae for any period studied (P = 0.888, 0.999, and 0.237, respectively). Our results provide reference ranges that may help to design a study in von Willebrand factor disease in pregnancy.

  1. Purification of coagulation factor VIII by immobilized metal affinity chromatography.

    Science.gov (United States)

    Rodrigues, Estela S; Verinaud, Claudia I; Oliveira, Douglas S; Raw, Isaías; Lopes, Alexandre P Y; Martins, Elizabeth A L; Cheng, Elisabeth

    2015-01-01

    Factor VIII (FVIII) is a glycoprotein that plays an essential role in blood coagulation cascade. Purification of plasma-derived coagulation FVIII by direct application of plasma to a chromatographic column is a method of choice. Anion exchange column is a very powerful method because FVIII is strongly adsorbed, resulting in good activity recovery and high purification factor. However, vitamin-K-dependent coagulation factors coelute with FVIII. In the present study, we report the separation of vitamin-K-dependent coagulation proteins from FVIII using immobilized metal affinity chromatography (IMAC) with Cu(2+) as the metal ligand. Plasma was directly loaded to a Q Sepharose Big Beads column, and FVIII was recovered with 65% activity and a purification factor of approximately 50 times. Then, the Q Sepharose eluate was applied to the IMAC-Cu(2+) column, and FVIII was eluted with 200 mM imidazole, with up to 85% recovery of activity. The mass recovery in this fraction was less than 10% of the applied mass of protein. Vitamin-K-dependent proteins elute with imidazole concentrations of lower than 60 mM. Because of the difference in affinity, FVIII could be completely separated from the vitamin-K-dependent proteins in the IMAC column.

  2. Factor VIII and von Willebrand factor co-delivery by endothelial cells

    NARCIS (Netherlands)

    Bouwens, E.A.M.|info:eu-repo/dai/nl/314061894

    2011-01-01

    A defect in coagulation factor VIII (FVIII) results in the inherited bleeding disorder hemophilia A. Current treatment of hemophilia A is hampered by the need of frequent administration of costly FVIII products. Therefore gene therapy is an attractive alternative for protein replacement to treat

  3. Factor VIII and von Willebrand factor co-delivery by endothelial cells

    NARCIS (Netherlands)

    Bouwens, E.A.M.

    2011-01-01

    A defect in coagulation factor VIII (FVIII) results in the inherited bleeding disorder hemophilia A. Current treatment of hemophilia A is hampered by the need of frequent administration of costly FVIII products. Therefore gene therapy is an attractive alternative for protein replacement to treat hem

  4. piggyBac-mediated phenotypic correction of factor VIII deficiency

    Directory of Open Access Journals (Sweden)

    Janice M Staber

    2014-01-01

    Full Text Available Hemophilia A, caused by a deficiency in factor VIII (FVIII, is the most severe inherited bleeding disorder. Hemophilia A is an attractive gene therapy candidate because even small increases in FVIII levels will positively alter the phenotype. While several vectors are under investigation, gene addition from an integrated transgene offers the possibility of long term expression. We engineered the DNA transposon-based vector, piggyBac (PB, to carry a codon-optimized B-domain deleted human FVIII cDNA. Evaluation of gene transfer efficiency in FVIII null mice demonstrated that PB containing the FVIII cDNA, delivered via hydrodynamic injection to immunocompetent hemophilia mice, conferred persistent gene expression, attaining mean FVIII activity of approximately 60% with 3/19 developing inhibitors. In addition to efficacious expression, a goal of gene transfer-based therapies is to develop vectors with low toxicity. To assess endoplasmic reticulum stress in hepatocytes stably expressing the transgene, we evaluated levels of ER stress markers via qPCR and found no evidence of cell stress. To evaluate phenotypic correction, a tail clip assay performed at the end of the study revealed reduced blood loss. These data demonstrate that PB can be used to achieve sustained FVIII expression and long-term therapeutic benefit in a mouse model.

  5. A study of reported factor VIII use around the world.

    Science.gov (United States)

    Stonebraker, J S; Brooker, M; Amand, R E; Farrugia, A; Srivastava, A

    2010-01-01

    The effect of replacement therapy has significantly improved the morbidity and mortality of people with haemophilia A in high income countries, a recent socio-economic development as the availability of safe concentrates has been matched by a willingness for their provision through reimbursement. In the developing world, however, this state has not been achieved, primarily because of the low visibility of haemophilia coupled with its expense, leading to inadequate treatment with its sequelae of severe pain, joint deformities, arthropathy, disabilities, and even death in childhood or early adult life. The objective of this paper was to study the reported factor VIII (FVIII) use on a country-by-country basis. Data on the reported FVIII use for 104 countries were obtained from the Marketing Research Bureau, Inc. and the World Federation of Hemophilia. The results show that FVIII use varies considerably among countries, even among the wealthiest of countries. The use of FVIII concentrate increases as economic capacity increases; in addition, consumption of FVIII has been increasing at a greater rate in high income countries. Given these trends, there probably will be a global increase in FVIII concentrates usage. Such information is critical for national healthcare agencies to determine realistic budget priorities in planning for an increased allocation of resources required to improve the treatment of patients with haemophilia A. This information is also important for pharmaceutical manufacturers to adequately plan for increased production of FVIII concentrates.

  6. [Structure and function of the factor VIII/von Willebrand factor complex].

    Science.gov (United States)

    Müller, G

    1990-03-01

    In the blood plasma factor VIII is bound to the von Willebrand factor. The primary structure of the two proteins were clarified by gene clonation. Factor VIII descends from a precursor protein with 2,351 amino acids by splitting of 19 amino acid residues and is activated by partial proteolysis. In the blood coagulation factor VIII acts as co-factor for the activation of factor X by factor IX in the presence of phospholipids and Ca++ within the intrinsic coagulation system. The formation of the von Willebrand factor takes place by splitting of 22 and 741 amino acid residues, respectively, from pre-pro-von Willebrand factor via pro-von Willebrand factor. The subunits of the von Willebrand factor consist od 2,050 amino acid residues. In the blood plasma the von Willebrand factor is existing as a mixture of multimeres. Receptors of the von Willebrand factor on the thrombocytic membrane are the glycoproteins GPIb and GPIIb/GPIIIa, by means of which the adhesion of thrombocytes at the subendoethelium of the vascular wall and the aggregation of thrombocytes are mediated.

  7. Case of acquired hemophilia with factor VIII inhibitor in a mother and newborn.

    Science.gov (United States)

    Kotani, Yasushi; Shiota, Mitsuru; Umemoto, Masahiko; Koike, Eiji; Tsuritani, Mitsuhiro; Hoshiai, Hiroshi

    2011-08-01

    We report a mother and newborn in the puerperium with hemorrhage secondary to factor VIII inhibitor. A 31-year-old gravida 1 para 1 delivered at a local clinic with a massive postpartum hemorrhage. The activated partial thromboplastin time was prolonged and factor VIII inhibitor was detected. The persistent hemorrhage improved following treatment, including transfusion, steroid therapy, and bypass therapy with factor VII formulations. After hysteroscopic removal of the retained placenta, the hemorrhage decreased. The newborn developed significant swelling of the hands after routine blood sampling and factor VIII inhibitor was detected. The inhibitor disappeared without any special treatment in the 5th month postpartum in the mother and the 4th month postpartum in the newborn. Factor VIII inhibitor may be transferred via the placenta from the mother to the fetus. Therefore, the newborn should also be carefully observed in a case of massive hemorrhage after delivery.

  8. A case of renal infarction associated with elevated factor VIII level.

    Science.gov (United States)

    Siddiqui, O Asif; Al-Absi, A; Showkat, A

    2011-09-01

    Elevated factor VIII level has recently been shown to be associated with increased risk of thrombosis. We report here a case of renal infarction in association with elevated factor VIII level. The patient presented with a three-day history of flank pain. Laboratory studies on presentation showed an elevated serum creatinine concentration and microscopic hematuria. He was found to have bilateral pulmonary emboli and left common femoral vein thrombosis; imaging studies showed evidence of renal arterial thrombosis with infarction. Hypercoagulability assessment showed an elevated factor VIII level. He was treated with heparin and warfarin with significant improvement in his renal function. Consideration should be given to measurement of factor VIII level as a part of the workup of unexplained thrombo-embolic events.

  9. Novel, human cell line-derived recombinant factor VIII (Human-cl rhFVIII, Nuwiq(®) ) in children with severe haemophilia A: efficacy, safety and pharmacokinetics.

    Science.gov (United States)

    Klukowska, A; Szczepański, T; Vdovin, V; Knaub, S; Jansen, M; Liesner, R

    2015-09-14

    Nuwiq(®) (Human-cl rhFVIII) is a new-generation recombinant factor VIII (rFVIII) protein, without chemical modification or fusion to any other protein, produced in a human cell line. This prospective, open-label, multinational phase III study assessed the efficacy and safety of Human-cl rhFVIII in 59 previously treated patients (PTPs) with severe haemophilia A aged 2-12 years (2-5 [N = 29]; 6-12 [N = 30]) during standard prophylaxis (≥50 exposure days and ≥6 months). Efficacy in treating breakthrough bleeds and during surgical prophylaxis was also assessed. An initial pharmacokinetic assessment (N = 13 per age subgroup) demonstrated comparable results with the one-stage and chromogenic assays. Mean (SD) half-life was 11.9 (5.4) and 13.1 (2.6) hours in children aged 2-5 years and 6-12 years respectively (one-stage assay). Prophylactic efficacy, based on mean monthly bleeding rate, was 'excellent' or 'good' in 91.5% of children for all bleeds and in 96.6% of children for spontaneous bleeds. Mean (SD) annualized bleeding rate was 4.12 (5.22) [median 1.9] for all bleeds, 1.50 (3.32) [median 0] for spontaneous bleeds and 2.34 (3.54) [median 1.57] for traumatic bleeds. There were no major, life-threatening bleeds. Efficacy was 'excellent' or 'good' in the treatment of 82.4% of breakthrough bleeds. Overall efficacy during five major surgeries was rated as 'excellent'. There were no FVIII inhibitors or treatment-related serious adverse events. These results in paediatric PTPs indicate that Human-cl rhFVIII is effective for the prevention and treatment of bleeds. © 2015 The Authors. Haemophilia Published by John Wiley & Sons Ltd.

  10. Crystal Structure of Human Factor VIII: Implications for the Formation of the Factor IXa-Factor VIIIa Complex

    Energy Technology Data Exchange (ETDEWEB)

    Ngo, J.C.; Huang, M.; Roth, D.A.; Furie, B.C.; Furie, B. (Wyeth); (MBL)

    2008-06-03

    Factor VIII is a procofactor that plays a critical role in blood coagulation, and is missing or defective in hemophilia A. We determined the X-ray crystal structure of B domain-deleted human factor VIII. This protein is composed of five globular domains and contains one Ca{sup 2+} and two Cu{sup 2+} ions. The three homologous A domains form a triangular heterotrimer where the A1 and A3 domains serve as the base and interact with the C2 and C1 domains, respectively. The structurally homologous C1 and C2 domains reveal membrane binding features. Based on biochemical studies, a model of the factor IXa-factor VIIIa complex was constructed by in silico docking. Factor IXa wraps across the side of factor VIII, and an extended interface spans the factor VIII heavy and light chains. This model provides insight into the activation of factor VIII and the interaction of factor VIIIa with factor IXa on the membrane surface.

  11. Crystal Structure of Human Factor VIII: Implications for the Formation of the Factor IXa-Factor VIIIa Complex

    Energy Technology Data Exchange (ETDEWEB)

    Chi Ki Ngo,J.; Huang, M.; Roth, D.; Furie, B.; Furie, B.

    2008-01-01

    Factor VIII is a procofactor that plays a critical role in blood coagulation, and is missing or defective in hemophilia A. We determined the X-ray crystal structure of B domain-deleted human factor VIII. This protein is composed of five globular domains and contains one Ca(2+) and two Cu(2+) ions. The three homologous A domains form a triangular heterotrimer where the A1 and A3 domains serve as the base and interact with the C2 and C1 domains, respectively. The structurally homologous C1 and C2 domains reveal membrane binding features. Based on biochemical studies, a model of the factor IXa-factor VIIIa complex was constructed by in silico docking. Factor IXa wraps across the side of factor VIII, and an extended interface spans the factor VIII heavy and light chains. This model provides insight into the activation of factor VIII and the interaction of factor VIIIa with factor IXa on the membrane surface.

  12. Extrahepatic sources of factor VIII potentially contribute to the coagulation cascade correcting the bleeding phenotype of mice with hemophilia A.

    Science.gov (United States)

    Zanolini, Diego; Merlin, Simone; Feola, Maria; Ranaldo, Gabriella; Amoruso, Angela; Gaidano, Gianluca; Zaffaroni, Mauro; Ferrero, Alessandro; Brunelleschi, Sandra; Valente, Guido; Gupta, Sanjeev; Prat, Maria; Follenzi, Antonia

    2015-07-01

    A large fraction of factor VIII in blood originates from liver sinusoidal endothelial cells although extrahepatic sources also contribute to plasma factor VIII levels. Identification of cell-types other than endothelial cells with the capacity to synthesize and release factor VIII will be helpful for therapeutic approaches in hemophilia A. Recent cell therapy and bone marrow transplantation studies indicated that Küpffer cells, monocytes and mesenchymal stromal cells could synthesize factor VIII in sufficient amount to ameliorate the bleeding phenotype in hemophilic mice. To further establish the role of blood cells in expressing factor VIII, we studied various types of mouse and human hematopoietic cells. We identified factor VIII in cells isolated from peripheral and cord blood, as well as bone marrow. Co-staining for cell type-specific markers verified that factor VIII was expressed in monocytes, macrophages and megakaryocytes. We additionally verified that factor VIII was expressed in liver sinusoidal endothelial cells and endothelial cells elsewhere, e.g., in the spleen, lungs and kidneys. Factor VIII was well expressed in sinusoidal endothelial cells and Küpffer cells isolated from human liver, whereas by comparison isolated human hepatocytes expressed factor VIII at very low levels. After transplantation of CD34(+) human cord blood cells into NOD/SCIDγNull-hemophilia A mice, fluorescence activated cell sorting of peripheral blood showed >40% donor cells engrafted in the majority of mice. In these animals, plasma factor VIII activity 12 weeks after cell transplantation was up to 5% and nine of 12 mice survived after a tail clip-assay. In conclusion, hematopoietic cells, in addition to endothelial cells, express and secrete factor VIII: this information should offer further opportunities for understanding mechanisms of factor VIII synthesis and replenishment.

  13. The F309S mutation increases factor VIII secretion in human cell line

    Directory of Open Access Journals (Sweden)

    Daianne Maciely Carvalho Fantacini

    2016-06-01

    Full Text Available ABSTRACT OBJECTIVES: The capacity of a human cell line to secrete recombinant factor VIII with a F309S point mutation was investigated, as was the effect of the addition of chemical chaperones (betaine and sodium-4-phenylbutyrate on the secretion of factor VIII. METHODS: This work used a vector with a F309S mutation in the A1 domain to investigate FVIII production in the HEK 293 human cell line. Factor VIII activity was measured by chromogenic assay. Furthermore, the effects of chemical drugs on the culture were evaluated. RESULTS: The addition of the F309S mutation to a previously described FVIII variant increased FVIII secretion by 4.5 fold. Moreover, the addition of betaine or sodium-4-phenylbutyrate increased the secretion rate of FVIIIΔB proteins in HEK 293 cells, but the same effect was not seen for FVIIIΔB-F309S indicating that all the recombinant protein produced had been efficiently secreted. CONCLUSION: Bioengineering factor VIII expressed in human cells may lead to an efficient production of recombinant factor VIII and contribute toward low-cost coagulation factor replacement therapy for hemophilia A. FVIII-F309S produced in human cells can be effective in vivo.

  14. Recombinant factor VIII in the management of hemophilia A: current use and future promise

    Directory of Open Access Journals (Sweden)

    Jerry S Powell

    2009-05-01

    Full Text Available Jerry S PowellDivision of Hematology and Oncology, University of California Davis Cancer Center, Sacramento, CA, USAAbstract: Hemophilia A is a rare inherited bleeding disorder due to mutation of the gene that encodes the coagulation protein factor VIII. Historically, prior to the availability of treatment with factor VIII preparations, most boys died from uncontrolled bleeding, either spontaneous bleeding or after injury, before reaching 20 years of age. One of the most impressive triumphs of modern medicine is that with current recombinant factor VIII replacement therapy, a boy born in the 21st century with severe hemophilia A can anticipate a normal life expectancy with essentially no permanent complications from bleeding. For severe hemophilia A, current optimal treatment should have two goals: first, to provide sufficient factor VIII to prevent spontaneous bleeding, and second, to provide sufficient factor VIII to have normal coagulation function after any trauma. However, the replacement therapy requires tremendous resources for effective use, and remains extraordinarily expensive. Thus there are opportunities for further advances in therapy for hemophilia A. Two major concerns continue to trouble current optimal treatment approaches: some patients will develop neutralizing antibodies during the first 50 infusions of therapeutic factor VIII, and second, to administer therapeutic factor VIII every other day in young boys often requires placement of a central venous access device, and such use carries the life-threatening risks of infection and thrombosis. Because of the effectiveness of current therapy, any new developments in treatment will require significant concerns for safety, both immediate and in the long term. A number of research groups seek to prolong the biological efficacy of infused recombinant factor VIII. Currently, one such promising development is in the advanced stages of clinical trial. The goals will be to improve

  15. Hemodialysis in a patient with severe hemophilia A and factor VIII inhibitor.

    Science.gov (United States)

    Gopalakrishnan, Natarajan; Usha, Thiruvengadam; Thopalan, Balasubramaniyan; Dhanapriya, Jeyachandran; Dineshkumar, Thanigachalam; Thirumalvalavan, Kaliaperumal; Sakthirajan, Ramanathan

    2016-10-01

    Hemophilia A is a hereditary X-linked recessive disease caused by mutations in the gene encoding factor VIII (FVIII), occurring in 1 out of 10,000 persons. Life expectancy and quality of life have dramatically improved recently in patients with hemophilia. Chronic kidney disease and need for renal replacement therapy in these patients are rare. The development of inhibitors to FVIII is the most serious complication of hemophilia and makes treatment of bleeds very challenging. We describe here a 28-year-old male patient with severe hemophilia A with presence of factor VIII inhibitor, who had end stage renal disease. Central venous access device was inserted along with infusion of factor eight inhibitor bypass activity before and after the procedure. He is currently on thrice weekly hemodialysis and doing well for 6 months without bleeding episodes. To our knowledge, hemophilia A with factor VIII inhibitor managed with hemodialysis has not been reported so far. © 2016 International Society for Hemodialysis.

  16. Immunological abnormalities in haemophilia: are they caused by American factor VIII concentrate?

    Science.gov (United States)

    Froebel, K S; Madhok, R; Forbes, C D; Lennie, S E; Lowe, G D; Sturrock, R D

    1983-10-15

    Scottish patients with haemophilia, most of whom had received no American factor VIII concentrate for over two years, were found to have immunological abnormalities similar to those in their American counterparts--that is, a reduced proportion of T helper cells, an increased proportion of T suppressor cells, and a reduced response to concanavilin A. Factor VIII from both the United States and Scotland severely inhibited the in vitro lymphocyte response to mitogens in patients and controls. The American and Scottish concentrates could not be distinguished in terms of either patient usage or their effect in vitro. These results argue against a disease vector specific to American blood products.

  17. Storage and regulated secretion of factor VIII in blood outgrowth endothelial cells

    NARCIS (Netherlands)

    van den Biggelaar, M.; Bouwens, E.A.M.; Kootstra, N.A.; Hebbel, R.P.; Voorberg, J.; Mertens, K.

    2009-01-01

    Background Gene therapy provides an attractive alternative for protein replacement therapy in hemophilia A patients. Recent studies have shown the potential benefit of directing factor (F)VIII gene delivery to cells that also express its natural carrier protein von Willebrand factor (VWF). In this

  18. Storage and regulated secretion of factor VIII in blood outgrowth endothelial cells

    NARCIS (Netherlands)

    van den Biggelaar, M.; Bouwens, E.A.M.; Kootstra, N.A.; Hebbel, R.P.; Voorberg, J.; Mertens, K.

    2009-01-01

    Background Gene therapy provides an attractive alternative for protein replacement therapy in hemophilia A patients. Recent studies have shown the potential benefit of directing factor (F)VIII gene delivery to cells that also express its natural carrier protein von Willebrand factor (VWF). In this s

  19. Storage and regulated secretion of factor VIII in blood outgrowth endothelial cells

    NARCIS (Netherlands)

    van den Biggelaar, M.; Bouwens, E.A.M.; Kootstra, N.A.; Hebbel, R.P.; Voorberg, J.; Mertens, K.

    2009-01-01

    Background Gene therapy provides an attractive alternative for protein replacement therapy in hemophilia A patients. Recent studies have shown the potential benefit of directing factor (F)VIII gene delivery to cells that also express its natural carrier protein von Willebrand factor (VWF). In this s

  20. Safety and Efficacy of BAY 94-9027, a Prolonged-Half-Life Factor VIII

    DEFF Research Database (Denmark)

    Reding, M T; Ng, H J; Poulsen, Lone Hvitfeldt

    2016-01-01

    BACKGROUND: BAY 94-9027 is a B-domain-deleted prolonged-half-life recombinant factor VIII (FVIII) conjugates in a site-specific manner with polyethylene glycol. OBJECTIVE: Assess efficacy and safety of BAY 94-9027 for prophylaxis and treatment of bleeds in patients with severe hemophilia A PATIEN...

  1. Immune recognition and processing of blood coagulation factor VIII by antigen-presenting cells

    NARCIS (Netherlands)

    van Haren, S.D.

    2011-01-01

    Hemophilia A is an X chromosome-linked bleeding disorder caused by a reduction or com­plete absence of coagulation factor VIII (FVIII). The bleeding tendency in patients suffering from hemophilia A can be treated by regular intravenous administrations of FVIII. A severe complication that occurs in

  2. Analysis of mutations in the entire coding sequence of the factor VIII gene

    Energy Technology Data Exchange (ETDEWEB)

    Bidichadani, S.I.; Lanyon, W.G.; Connor, J.M. [Glascow Univ. (United Kingdom)] [and others

    1994-09-01

    Hemophilia A is a common X-linked recessive disorder of bleeding caused by deleterious mutations in the gene for clotting factor VIII. The large size of the factor VIII gene, the high frequency of de novo mutations and its tissue-specific expression complicate the detection of mutations. We have used a combination of RT-PCR of ectopic factor VIII transcripts and genomic DNA-PCRs to amplify the entire essential sequence of the factor VIII gene. This is followed by chemical mismatch cleavage analysis and direct sequencing in order to facilitate a comprehensive search for mutations. We describe the characterization of nine potentially pathogenic mutations, six of which are novel. In each case, a correlation of the genotype with the observed phenotype is presented. In order to evaluate the pathogenicity of the five missense mutations detected, we have analyzed them for evolutionary sequence conservation and for their involvement of sequence motifs catalogued in the PROSITE database of protein sites and patterns.

  3. Binding of factor VIII to von willebrand factor is enabled by cleavage of the von Willebrand factor propeptide and enhanced by formation of disulfide-linked multimers.

    Science.gov (United States)

    Bendetowicz, A V; Morris, J A; Wise, R J; Gilbert, G E; Kaufman, R J

    1998-07-15

    von Willebrand factor (vWF) is a multimeric adhesive glycoprotein with one factor VIII binding site/subunit. Prior reports suggest that posttranslational modifications of vWF, including formation of N-terminal intersubunit disulfide bonds and subsequent cleavage of the propeptide, influence availability and/or affinity of factor VIII binding sites. We found that deletion of the vWF propeptide produced a dimeric vWF molecule lacking N-terminal intersubunit disulfide bonds. This molecule bound fluorescein-labeled factor VIII with sixfold lower affinity than multimeric vWF in an equilibrium flow cytometry assay (approximate KDs, 5 nmol/L v 0.9 nmol/L). Coexpression of propeptide-deleted vWF with the vWF propeptide in trans yielded multimeric vWF that displayed increased affinity for factor VIII. Insertion of an alanine residue at the N-terminus of the mature vWF subunit destroyed binding to factor VIII, indicating that the native mature N-terminus is required for factor VIII binding. The requirement for vWF propeptide cleavage was shown by (1) a point mutation of the vWF propeptide cleavage site yielding pro-vWF that was defective in factor VIII binding and (2) correlation between efficiency of intracellular propeptide cleavage and factor VIII binding. Furthermore, in a cell-free system, addition of the propeptide-cleaving enzyme PACE/furin enabled factor VIII binding in parallel with propeptide cleavage. Our results indicate that high-affinity factor VIII binding sites are located on N-terminal disulfide-linked vWF subunits from which the propeptide has been cleaved.

  4. Potentiation of thrombin generation in hemophilia A plasma by coagulation factor VIII and characterization of antibody-specific inhibition.

    Directory of Open Access Journals (Sweden)

    Bhavya S Doshi

    Full Text Available Development of inhibitory antibodies to coagulation factor VIII (fVIII is the primary obstacle to the treatment of hemophilia A in the developed world. This adverse reaction occurs in 20-30% of persons with severe hemophilia A treated with fVIII-replacement products and is characterized by the development of a humoral and neutralizing immune response to fVIII. Patients with inhibitory anti-fVIII antibodies are treated with bypassing agents including recombinant factor VIIa (rfVIIa. However, some patients display poor hemostatic response to bypass therapy and improved treatment options are needed. Recently, we demonstrated that fVIII inhibitors display widely variable kinetics of inhibition that correlate with their respective target epitopes. Thus, it was hypothesized that for antibodies that display slow rates of inhibition, supplementation of rfVIIa with fVIII would result in improved thrombin generation and be predictive of clinical responses to this novel treatment regimen. In order to test this hypothesis, 10 murine monoclonal antibodies (MAbs with non-overlapping epitopes spanning fVIII, differential inhibition titers, and inhibition kinetics were studied using a thrombin generation assay. Of the 3 MAbs with high inhibitory titers, only the one with fast and complete (classically defined as "type I" kinetics displayed significant inhibition of thrombin generation with no improvement upon supplementation of rfVIIa with fVIII. The other two MAbs that displayed incomplete (classically defined as "type II" inhibition did not suppress the potentiation of thrombin generation by fVIII. All antibodies that did not completely inhibit fVIII activity demonstrated potentiation of thrombin generation by the addition of fVIII as compared to rfVIIa alone. In conclusion, fVIII alone or in combination with rfVIIa corrects the thrombin generation defect produced by the majority of anti-fVIII MAbs better than single agent rfVIIa. Therefore, combined fVIII

  5. Variation in baseline factor VIII concentration in a retrospective cohort of mild/moderate hemophilia A patients carrying identical F8 mutations

    NARCIS (Netherlands)

    Loomans, J.I.; Velzen, A.S. van; Eckhardt, C.L.; Peters, M.; Makipernaa, A.; Holmstrom, M.; Brons, P.P.T.; Dors, N.; Haya, S.; Voorberg, J.; Bom, J.G. Van Der; Fijnvandraat, K.

    2017-01-01

    Essentials Factor VIII levels vary in mild and moderate hemophilia A (MHA) patients with the same mutation. We aimed to estimate the variation and determinants of factor VIII levels among MHA patients. Age and genotype explain 59% of the observed inter-individual variation in factor VIII levels.

  6. Desenvolvimento de inibidores do fator VIII na hemofilia A Development of factor VIII inhibitors in hemophilia A

    Directory of Open Access Journals (Sweden)

    Daniel G. Chaves

    2009-01-01

    Full Text Available A hemofilia A é uma coagulopatia genética com herança recessiva ligada ao cromossomo X que afeta 1-2 a cada 10 mil indivíduos do sexo masculino nascidos vivos. Estes indivíduos têm baixas concentrações ou ausência do fator VIII (FVIII da coagulação no plasma e apresentam quadros hemorrágicos leves, moderados e graves, dependendo da atividade de FVIII circulante. Estes pacientes necessitam de constante reposição proteica e aproximadamente 30% deles desenvolvem aloanticorpos contra a proteína exógena. A síntese dos anticorpos anti-FVIII é iniciada quando o FVIII exógeno é endocitado por células apresentadoras de antígeno, degradado e apresentado às células T CD4+ na forma de peptídeos ligados a moléculas do complexo maior de histocompatibilidade (MHC de classe II. Alguns fatores de risco (paciente/tratamento podem ser relacionados ao desenvolvimento desta resposta imune. Neste contexto, as mutações no gene do FVIII e polimorfismos em genes envolvidos na resposta imune são candidatos moleculares como determinantes imunogenéticos na predisposição para o desenvolvimento de inibidores. Por não ser completamente entendido e controlado, o desenvolvimento desta resposta imune contra o FVIII constitui o maior problema decorrente do tratamento de indivíduos portadores de hemofilia A e faz-se necessária busca de opções que visem minimizar suas ações deletérias. Algumas alternativas de tratamento têm se mostrado eficazes no tratamento (anti-CD20, plasmaférese, concentrado de complexo protrombínico (PCCs, concentrado de complexo protrombínico ativado (APCCs, fator VII humano ativado, mas a retirada ou neutralização específica dos inibidores de FVIII ainda não foram alcançadas.Hemophilia A, which affects 1-2:10,000 live-born male neonates, is a genetic coagulopathy with recessive inheritance linked to the X chromosome. These individuals have low concentrations or no coagulation factor VIII (FVIII in the plasma

  7. Generation of an optimized lentiviral vector encoding a high-expression factor VIII transgene for gene therapy of hemophilia A.

    Science.gov (United States)

    Johnston, J M; Denning, G; Doering, C B; Spencer, H T

    2013-06-01

    We previously compared the expression of several human factor VIII (fVIII) transgene variants and demonstrated the superior expression properties of B domain-deleted porcine fVIII. Subsequently, a hybrid human/porcine fVIII molecule (HP-fVIII) comprising 91% human amino-acid sequence was engineered to maintain the high-expression characteristics of porcine fVIII. The bioengineered construct then was used effectively to treat knockout mice with hemophilia A. In the current study, we focused on optimizing self-inactivating (SIN) lentiviral vector systems by analyzing the efficacy of various lentiviral components in terms of virus production, transduction efficiency and transgene expression. Specifically, three parameters were evaluated: (1) the woodchuck hepatitis post-transcriptional regulatory element (WPRE), (2) HIV versus SIV viral vector systems and (3) various internal promoters. The inclusion of a WPRE sequence had negligible effects on viral production and HP-fVIII expression. HIV and SIV vectors were compared and found to be similar with respect to transduction efficiency in both K562s and HEK-293T cells. However, there was an enhanced expression of HP-fVIII by the SIV system, which was evident in both K562 and BHK-M cell lines. To further compare expression of HP-fVIII from an SIV-based lentiviral system, we constructed expression vectors containing the high expression transgene and a human elongation factor-1 alpha, cytomegalovirus (CMV) or phosphoglycerate kinase promoter. Expression was significantly greater from the CMV promoter, which also yielded therapeutic levels of HP-fVIII in hemophilia A mice. Based on these studies, an optimized vector contains the HP-fVIII transgene driven by a CMV internal promoter within a SIV-based lentiviral backbone lacking a WPRE.

  8. A population pharmacokinetic model for perioperative dosing of factor VIII in hemophilia A patients

    Science.gov (United States)

    Hazendonk, Hendrika; Fijnvandraat, Karin; Lock, Janske; Driessens, Mariëtte; van der Meer, Felix; Meijer, Karina; Kruip, Marieke; Gorkom, Britta Laros-van; Peters, Marjolein; de Wildt, Saskia; Leebeek, Frank; Cnossen, Marjon; Mathôt, Ron

    2016-01-01

    The role of pharmacokinetic-guided dosing of factor concentrates in hemophilia is currently a subject of debate and focuses on long-term prophylactic treatment. Few data are available on its impact in the perioperative period. In this study, a population pharmacokinetic model for currently registered factor VIII concentrates was developed for severe and moderate adult and pediatric hemophilia A patients (FVIII levels hemophilia A patients by Bayesian adaptive dosing. PMID:27390359

  9. EFFECT OF ORAL CONTRACEPTIVES (LD AND CILEST ON CLOTTING FACTORS VIII AND IX

    Directory of Open Access Journals (Sweden)

    H.R. Sadeghipour Roudsari

    1997-10-01

    Full Text Available Based on epidemiologic data, women who take oral contraceptives seem to have an increased risk of developing thromboembollic disease. The thrombotic effects of oral contraceptive (OC are probably mediated, at least partly through their effects on the coagulation system. Plasma levels of several clotting factors have been shown to be elevated in OC users, and this increase is graduated according to the dose of estrogen. In this study, fifty healthy and non smoking women, aged 18-35 years, were randomly assigned to treatment with 2 different OCs: a monophasic pill containing 30 pg of ethinyl estradiol plus 150µg levonorgestrel (LD and a monophasic pill containing 35µg ethinylestradiol plus 250pg norgestimate (Cilest. Factor VIII plasma values were significantly decreased (P<0.05 only in women treated with the preparation LD, but the levels of factor VIII were not significantly different in the group treated with Cilest. Factor IX plasma values were significantly increased (P<0.05 only in women treated with the preparation Cilest, but the levels of factor Ix were not significantly different in the group treated with LD. In LD and cilest users factors VIII and IX were not significantly changed (P<0.05 in overweight and obese subjects in comparison to normal weight.

  10. Effect of transmembrane pressure on Factor VIII yield in ATF perfusion culture for the production of recombinant human Factor VIII co-expressed with von Willebrand factor.

    Science.gov (United States)

    Kim, Seung-Chul; An, Sora; Kim, Hyun-Ki; Park, Beom-Soo; Na, Kyu-Heum; Kim, Byung-Gee

    2016-10-01

    In this study, we evaluated three cell retention devices, an alternating tangential flow (ATF) system, a spin-filter, and a Centritech Lab III centrifuge, for the production of recombinant human Factor VIII co-expressed with von Willebrand factor. From the results, it was found that the FVIII activity in bioreactor was significantly higher in the ATF perfusion culture than two other perfusion cultures. Moreover, the FVIII activity yield was unexpectedly low in the ATF perfusion culture. We have, therefore, studied the reasons for this low FVIII activity yield. It was revealed that the inactivation and the surface adsorption of FVIII onto the harvest bag were not the main reasons for the low yield in the ATF perfusion culture. The FVIII activity yield was not increased by the use of a hollow fiber filter with 0.5 μm pore size instead of 0.2 μm pore size. Additionally, the retention of FVIII molecules by the hollow fiber filter was a dominant factor in the low FVIII activity yield in the ATF perfusion culture. We demonstrated that FVIII yield was significantly improved by controlling transmembrane pressure (TMP) across the hollow fiber filter membrane. Taken together, these results suggest that TMP control could be an efficient method for the enhancement of FVIII yield in an ATF perfusion culture.

  11. Molecular Analysis of Factor VIII and Factor IX Genes in Hemophilia Patients: Identification of Novel Mutations and Molecular Dynamics Studies

    Science.gov (United States)

    Al-Allaf, Faisal A.; Taher, Mohiuddin M.; Abduljaleel, Zainularifeen; Bouazzaoui, Abdellatif; Athar, Mohammed; Bogari, Neda M.; Abalkhail, Halah A.; Owaidah, Tarek MA.

    2017-01-01

    Background Hemophilias A and B are X-linked bleeding disorders caused by mutations in the factor VIII and factor IX genes, respectively. Our objective was to identify the spectrum of mutations of the factor VIII and factor IX genes in Saudi Arabian population and determine the genotype and phenotype correlations by molecular dynamics (MD) simulation. Methods For genotyping, blood samples from Saudi Arabian patients were collected, and the genomic DNA was amplified, and then sequenced by Sanger method. For molecular simulations, we have used softwares such as CHARMM (Chemistry at Harvard Macromolecular Mechanics; http://www.charmm-gui.org) and GROMACS. In addition, the secondary structure was determined based on the solvent accessibility for the confirmation of the protein stability at the site of mutation. Results Six mutations (three novel and three known) were identified in factor VIII gene, and six mutations (one novel and five known) were identified in factor IX gene. The factor VIII novel mutations identified were c.99G>T, p. (W33C) in exon 1, c.2138 DelA, p. (N713Tfs*9) in eon14, also a novel mutation at splicing acceptor site of exon 23 c.6430 - 1G>A. In factor IX, we found a novel mutation c.855G>C, p. (E285D) in exon 8. These novel mutations were not reported in any factor VIII or factor IX databases previously. The deleterious effects of these novel mutations were confirmed by PolyPhen2 and SIFT programs. Conclusion The protein functional and structural studies and the models built in this work would be appropriate for predicting the effects of deleterious amino acid substitutions causing these genetic disorders. These findings are useful for genetic counseling in the case of consanguineous marriages which is more common in the Saudi Arabia. PMID:28270892

  12. Treatment of radiation osteomyelitis of the mandible in a patient with acquired factor VIII inhibitor

    Energy Technology Data Exchange (ETDEWEB)

    Arimoto, Takamasa; Kishimoto, Hiromitsu; Matsumoto, Suwako; Kawanaka, Masao; Urabe, Masahiro; Yoshioka, Wataru [Hyogo Coll. of Medicine, Nishinomiya (Japan)

    1996-07-01

    A case of radiation osteomyelitis of mandible in a 56-year-old man with acquired factor VIII inhibitor is presented. He had undergone radiation therapy for malignant lymphoma of the tonsilar region seven years earlier, and also had received steroids to treat acquired factor VIII inhibitor for a year. On initial examination, he was given a diagnosis of phlegmon of the cheek caused by pericoronitis of the left lower wisdom tooth. To prevent the recurrence of inflammation, the wisdom tooth was extracted carefully, but radiation osteomyelitis occurred in association with a pathological fracture of the condylar head. After mini-pulse therapy with methylpredonisolone, segmental mandibulectomy and reconstruction with a titanium metal plate were performed. The postoperative course was satisfactory with no complications such as bleeding or infection. (author)

  13. Detection of Intracellular Factor VIII Protein in Peripheral Blood Mononuclear Cells by Flow Cytometry

    Directory of Open Access Journals (Sweden)

    Gouri Shankar Pandey

    2013-01-01

    Full Text Available Flow cytometry is widely used in cancer research for diagnosis, detection of minimal residual disease, as well as immune monitoring and profiling following immunotherapy. Detection of specific host proteins for diagnosis predominantly uses quantitative PCR and western blotting assays. In this study, we optimized a flow cytometry-based detection assay for Factor VIII protein in peripheral blood mononuclear cells (PBMCs. An indirect intracellular staining (ICS method was standardized using monoclonal antibodies to different domains of human Factor VIII protein. The FVIII protein expression level was estimated by calculating the mean and median fluorescence intensities (MFI values for each monoclonal antibody. ICS staining of transiently transfected cell lines supported the method's specificity. Intracellular FVIII protein expression was also detected by the monoclonal antibodies used in the study in PBMCs of five blood donors. In summary, our data suggest that intracellular FVIII detection in PBMCs of hemophilia A patients can be a rapid and reliable method to detect intracellular FVIII levels.

  14. Construction of a mouse model of factor VIII deficiency by gene targeting

    Energy Technology Data Exchange (ETDEWEB)

    Bi, L.; Lawler, A.; Gearhart, J. [Univ. of Pennsylvania School of Medicine, Philadelphia, PA (United States)] [and others

    1994-09-01

    To develop a small animal model of hemophilia A for gene therapy experiments, we set out to construct a mouse model for factor VIII deficiency by gene targeting. First, we screened a mouse liver cDNA library using a human FVIII cDNA probe. We cloned a 2.6 Kb partial mouse factor VIII cDNA which extends from 800 base pairs of the 3{prime} end of exon 14 to the 5{prime} end of exon 26. A mouse genomic library made from strain 129 was then screened to obtain genomic fragments covering the exons desired for homologous recombination. Two genomic clones were obtained, and one covering exon 15 through 22 was used for gene targeting. To make gene targeting constructs, a 5.8 Kb genomic DNA fragment covering exons 15 to 19 of the mouse FVIII gene was subcloned, and the neo expression cassette was inserted into exons 16 and 17 separately by different strategies. These two constructs were named MFVIIIC-16 and MFVIIIC-17. The constructs were linearized and transfected into strain 129 mouse ES cells by electroporation. Factor VIII gene-knockout ES cell lines were selected by G-418 and screened by genomic Southern blots. Eight exon 16 targeted cell lines and five exon 17 targeted cell lines were obtained. Three cell lines from each construct were injected into blastocysts and surgically transferred into foster mothers. Multiple chimeric mice with 70-90% hair color derived from the ES-cell genotype were seen with both constructs. Germ line transmission of the ES-cell genotype has been obtained for the MFVIIIC-16 construct, and multiple hemophilia A carrier females have been identified. Factor VIII-deficient males will be conceived soon.

  15. Potential role of a new PEGylated recombinant factor VIII for hemophilia A

    OpenAIRE

    2016-01-01

    Tung Thanh Wynn,1 Burak Gumuscu,2,3 1Department of Pediatrics, Division of Pediatric Hematology/Oncology, University of Florida, Gainesville, FL, 2Pediatric Hematology-Oncology, Bon Secours Health System, St. Mary’s Hospital, Richmond, VA, 3Department of Pediatrics, Division of Pediatric Hematology/Oncology, University of Virginia, Charlottesville, VA, USA Abstract: Hemophilia A, a deficiency in the activity of coagulation factor (F) VIII, is an X-linked bleeding disorder with an ap...

  16. HTLV-III seropositivity in European haemophiliacs exposed to Factor VIII concentrate imported from the USA.

    Science.gov (United States)

    Melbye, M; Froebel, K S; Madhok, R; Biggar, R J; Sarin, P S; Stenbjerg, S; Lowe, G D; Forbes, C D; Goedert, J J; Gallo, R C

    1984-12-22

    77 Scottish haemophiliacs and 22 Danish haemophiliacs were serologically tested for antibodies to human T-cell leukaemia virus III (HTLV-III). Since 1979 the Scottish patients had been treated largely with factor VIII concentrate produced in Scotland, whereas all but 2 of the Danish patients had received both locally prepared concentrate and commercial concentrate made from US donor material. 15.6% of Scottish and 59.1% of Danish haemophiliacs were antibody positive (p less than 0.001). None of 11 haemophiliacs not treated in the period 1979-84 was seropositive. 2 (6.7%) of 30 subjects who had been treated with locally produced concentrate only were antibody positive, compared with 23 (39.7%) of 58 subjects who had been treated with commercial concentrate. Among 52 users of both commercially and locally produced factor VIII concentrate, seropositivity was directly correlated with the consumption of commercial concentrate (p less than 0.001) but not locally produced material. These data indicate that European haemophiliacs were exposed to HTLV-III via some factor VIII concentrates obtained from the USA.

  17. Renal Vein Thrombosis in a Newborn With Abnormal Factor VIII Level: Clinical Case Report.

    Science.gov (United States)

    Szafranska, Agnieszka; Pajak, Agata; Kilis-Pstrusinska, Katarzyna; Królak-Olejnik, Barbara

    2015-08-01

    Renal vein thrombosis (RVT) in neonates is a rare condition of low mortality but significant morbidity due to renal impairment.We report the case of a male term newborn with left RVT and elevated serum factor VIII (FVIII).The main symptoms of the patient and the important clinical findings: prompt diagnosis of RVT was possible because the classic clinical presentation of macroscopic hematuria, thrombocytopenia, and palpable flank mass were present in this newborn infant.The main diagnoses: finally, the reason of RVT was established when the infant was 3 months of age: the increased level of FVIII was confirmed. We discuss the diagnosis, therapy, and outcome of the patient and compare with the literature.Therapeutics interventions: however, despite anticoagulant therapy the left kidney developed areas of scarring and then atrophy.Conclusions and outcomes: Prothrombotic defects should be considered in all patients with perinatal RVT. Elevated factor VIII as a reason of RVT in neonatal period is particularly rare. Given a poor renal outcome in children associated with elevated levels of factor VIII, consideration could be given to more aggressive antithrombotic therapy in such cases.

  18. Elevated factor VIII level and stroke in patients without traditional risk factors associated with cardiovascular diseases

    Directory of Open Access Journals (Sweden)

    Lasek-Bal A

    2013-06-01

    Full Text Available Anetta Lasek-Bal, Przemyslaw Puz, Zofia KazibutowskaStroke Unit, Department of Neurology, Medical University of Silesia, Professor Leszek Giec Upper Silesian Medical Centre, Katowice, PolandIntroduction: Hemostasis is affected by interactions between physiological processes, including those connected with the coagulation system, whose essence is converting fibrinogen into fibrin. The role of factor VIII (FVIII consists in activating factor X, which directly participates in the generation of thrombin, which is able to produce stable fibrin, which in turn forms blood clots. There are divergent opinions regarding the significance of high levels of FVIII in stroke pathogenesis.Aim: The aim of our study was to evaluate FVIII activity in individuals with cryptogenic stroke in order to determine a potential relationship between it and cerebral ischemia.Material and methods: Nine patients suffering with stroke were used in this study: six women and three men aged 49–63 years. In all of the patients, the presence of known and potential risk factors for stroke had been excluded during previous diagnostic procedures. These patients accounted for 1.2% of the 719 people who suffered a stroke and were hospitalized in 2011 at the Stroke Unit. FVIII activity was examined in each of the nine qualified subjects within 1–2 months of the occurrence of stroke (the first test and repeated (the second test in five patients with abnormal results obtained from the first examination.Results: Increased activity of FVIII was found in 5 out of 9 patients. In patients with abnormal results, elevated FVIII was found in follow-up examinations in the 8th–10th month following stroke. Hemodynamic abnormalities in carotid or cerebral artery (presence of thrombus were found in 3 of the 5 patients with increased FVIII levels. In the first 24 hours following stroke the neurological state of patients with abnormal FVIII was worse than individuals with normal FVIII activity. The

  19. Neonatal helper-dependent adenoviral vector gene therapy mediates correction of hemophilia A and tolerance to human factor VIII.

    Science.gov (United States)

    Hu, Chuhong; Cela, Racel G; Suzuki, Masataka; Lee, Brendan; Lipshutz, Gerald S

    2011-02-01

    Neonatal gene therapy is a promising strategy for treating a number of congenital diseases diagnosed shortly after birth as expression of therapeutic proteins during postnatal life may limit the pathologic consequences and result in a potential "cure." Hemophilia A is often complicated by the development of antibodies to recombinant protein resulting in treatment failure. Neonatal administration of vectors may avoid inhibitory antibody formation to factor VIII (FVIII) by taking advantage of immune immaturity. A helper-dependent adenoviral vector expressing human factor VIII was administered i.v. to neonatal hemophilia A knockout mice. Three days later, mice produced high levels of FVIII. Levels declined rapidly with animal growth to 5 wk of age with stable factor VIII expression thereafter to >1 y of age. Decline in factor VIII expression was not related to cell-mediated or humoral responses with lack of development of antibodies to capsid or human factor VIII proteins. Subsequent readministration and augmentation of expression was possible as operational tolerance was established to factor VIII without development of inhibitors; however, protective immunity to adenovirus remained.

  20. Refreezing previously thawed fresh-frozen plasma. Stability of coagulation factors V and VIII:C.

    Science.gov (United States)

    Dzik, W H; Riibner, M A; Linehan, S K

    1989-09-01

    With the growth in autologous blood programs and the increased scrutiny of the indications for transfusion of fresh-frozen plasma (FFP), an increase has been seen in the number of occasions on which FFP was requested and thawed but then not transfused. The coagulation properties of FFP units that were refrozen and then rethawed were therefore studied. Fifty-eight units of plasma were studied, with each experimental unit of FFP paired with an identical control unit. Experimental units were frozen, stored at -65 degrees C, thawed, stored at 1 to 6 degrees C for various periods of time up to 24 hours, and then refrozen, stored at -65 degrees C, rethawed, and stored again in the refrigerator for up to 24 hours. Control units were frozen once at the time the experimental units were first frozen and thawed once at the time of the second thaw of the experimental units. Aliquots of plasma were sampled periodically and were later batch-tested for prothrombin time (PT), activated partial thromboplastin time (aPTT), and factor V and VIII:C activity. The results of coagulation testing of the twice-frozen plasmas were always within the normal range. There was a slight but statistically valid prolongation of the PT and aPTT and a decrease in the factor V and VIII:C levels for twice-frozen plasma compared with control plasma. The greatest decline occurred in the level of factor VIII:C. The measured deterioration in coagulation of twice-frozen FFP is unlikely to be of clinical importance. Refreezing FFP may eventually prove useful for rare donor, autologous, and massive transfusion programs.

  1. Analysis of inversions in the factor VIII gene in Spanish hemophilia A patients and families

    Energy Technology Data Exchange (ETDEWEB)

    Domenech, M.; Tizzano, E.; Baiget, M. [Hospital de Sant Pau, Barcelona (Spain); Altisent, C. [Hospital Vall d`Hebron, Barcelona (Spain)

    1994-09-01

    Intron 22 is the largest intron of the factor VIII gene and contains a CpG island from which two additional transcripts originate. One of these transcripts corresponds to the F8A gene which have telomeric extragenic copies in the X chromosome. An inversion involving homologous recombination between the intragenic and the distal or proximal copies of the F8A gene has been recently described as a common cause of severe hemophilia A (HA). We analyzed intron 22 rearrangements in 195 HA patients (123 familial and 72 sporadic cases). According to factor VIII levels, our sample was classified as severe in 114 cases, moderate in 29 cases and mild in 52 cases. An intron 22 (F8A) probe was hybridized to Southern blots of BcII digested DNA obtained from peripheral blood. A clear pattern of altered bands identifies distal or proximal inversions. We detected an abnormal pattern identifying an inversion in 49 (25%) of the analyzed cases. 43% of severe HA patients (49 cases) showed an inversion. As expected, no inversion was found in the moderate and mild group of patients. We found a high proportion (78%) of the distal rearrangement. From 49 identified inversions, 33 were found in familial cases (27%), while the remaining 15 were detected in sporadic patients (22%) in support that this mutational event occurs with a similar frequency in familial or sporadic cases. In addition, we detected a significant tendency of distal inversion to occur more frequently in familial cases than in sporadic cases. Inhibitor development to factor VIII was documented in approximately 1/3 of the patients with inversion. The identification of such a frequent molecular event in severe hemophilia A patients has been applied in our families to carrier and prenatal diagnosis, to determine the origin of the mutation in the sporadic cases and to detect the presence of germinal mosaicism.

  2. Characterization of Chinese Hamster Ovary Cells Producing Coagulation Factor VIII Using Multi-omics Tools

    DEFF Research Database (Denmark)

    Kaas, Christian Schrøder

    ,000 fold over the last couple of years due to the revolution of next-generation sequencing (NGS), has dramatically accelerated CHO-omics from virtually non-existent to a vibrant growing field. The aim of this thesis was to investigate the impact of coagulation factor VIII (FVIII) production in CHO cells...... for analysis and engineering of industrially relevant CHO cells. Full implementation of such tools for generating specifically engineered CHO production cell lines may allow significant cost-reductions in production of complex biopharmaceuticals such as FVIII....

  3. ADAMTS13 content in plasma-derived factor VIII/von Willebrand factor concentrates.

    Science.gov (United States)

    Peyvandi, Flora; Mannucci, Pier M; Valsecchi, Carla; Pontiggia, Silvia; Farina, Claudio; Retzios, Anastassios D

    2013-10-01

    Thrombotic thrombocytopenic purpura (TTP) is a microangiopathy syndrome caused by a congenital or acquired deficiency of ADAMTS13, a plasma metalloprotease that cleaves von Willebrand factor (VWF) and thus prevents the formation of platelet-rich thrombi in the microcirculation. TTP can be fatal if not appropriately and timely treated with the infusion of fresh frozen plasma (FFP) or exchange plasmapheresis, that reverse the process of microangiopathy by removing anti-ADAMTS13 autoantibodies and replacing functional ADAMTS13. The treatment of TTP with FFP is not free from risks and must be administered in hospitals or clinics, owing to the substantial amount of plasma volume infused or exchanged and the frequent need of catheter application. Moreover, most FFPs are not subjected to treatments to remove or inactivate blood-borne infectious agents. A number of recent reports indicate that certain plasma-derived VWF-factor VIII (FVIII) concentrates are clinically effective in the treatment of congenital TTP. In this study, we measured ADAMTS13 levels in various plasma-derived VWF-FVIII concentrates, showing that Koate(®) -DVI (Grifols), contained relatively high amounts of ADAMTS13 and that Alphanate(®) (Grifols) was the closest other product in terms of protease content. Koate(®) -DVI contains, on average (five lots tested), 0.091 ± 0.007 Units of ADAMTS13 activity per IU of FVIII. On the basis of this analysis and other reports of VWF-FVIII concentrate utilization in congenital TTP, potential dosing, and future clinical developments are discussed.

  4. The impact of von Willebrand factor on factor VIII memory immune responses.

    Science.gov (United States)

    Chen, Juan; Schroeder, Jocelyn A; Luo, Xiaofeng; Shi, Qizhen

    2017-08-22

    Immune tolerance induction (ITI) with aggressive infusion of factor VIII (FVIII) is the current strategy used to eradicate FVIII inhibitors and restore normal FVIII pharmacokinetics in inhibitor patients. Whether the use of FVIII products containing von Willebrand factor (VWF) will affect the efficacy of ITI is still controversial. In this study, we explored the impact of VWF on FVIII memory immune responses in hemophilia A (HA) mice. A T-cell proliferation assay and cytokine profile analysis were used to study FVIII-primed CD4(+) T cells. When CD4(+) T cells from primed FVIII(null) mice were restimulated with recombinant human FVIII (rhF8) plus recombinant human VWF (rhVWF) in vitro, the percentages of daughter CD4(+) T cells were significantly decreased compared with the groups cultured with rhF8 only. Levels of interferon-γ and interleukin 10 were significantly lower in the rhF8 plus rhVWF groups than in the rhF8 groups. When memory B-cell pools from primed FVIII(null) mice were cultured with rhF8 with or without rhVWF to induce differentiation of memory B cells into antibody-secreting cells (ASCs), the number of ASCs was significantly lower in the rhF8 plus VWF group than in the rhF8 group. When memory B-cell pools were transferred into NSGF8KO mice followed by rhF8 immunization with or without rhVWF, the titers of anti-F8 inhibitors and total immunoglobulin G were significantly higher in the rhF8 group than in the rhF8 plus rhVWF group, with an average difference of 2.23- and 2.04-fold. Together, our data demonstrate that VWF attenuates FVIII memory immune responses in HA mice.

  5. Many factor VIII products available in the treatment of hemophilia A: an embarrassment of riches?

    Science.gov (United States)

    Lieuw, Kenneth

    2017-01-01

    Hemophilia A (HA) is a common bleeding disorder caused by the deficiency of factor VIII (FVIII) with an incidence of ~1 in 5000 male births. Replacement of FVIII is necessary to prevent and treat bleeding episodes. However, with multiple new drugs in addition to old standards, choosing among the different FVIII treatment options is harder than ever. There are FVIII products that are plasma derived or recombinant, FVIII products designed to extend the half-life of FVIII, and the first single-chain FVIII product, recombinant factor VIII single chain (rFVIII-SC). As development of inhibitors to FVIII continues to be a major problem in the care of HA patients, recent studies showing lower rates of inhibitor development with plasma-derived FVIIII products versus recombinant FVIII products have made choosing among the many options now available even more complex. Although still unproven, extended half-life (EHL) products may provide the hope of decreased immunogenicity but need further testing in previously untreated patients (PUPs). This review highlights some of the differences between FVIII products currently available and hopefully assists the clinician to decide which FVIII product to choose for their patients.

  6. Factor V and VIII combined deficiency: clinical perioperative management for tonsillectomy in a child.

    Science.gov (United States)

    Lanchon, R; Robin, F; Brissaud, O; Marro, M; Nouette-Gaulain, K

    2014-03-01

    Combined factors V (FV) and VIII (FVIII) deficiency is a rarely seen hereditary coagulation disease. Experience of its management in surgery with a high-risk of bleeding is rare. The interest of this case report is to propose a strategy of perioperative management for such a deficit, but also to recall that a careful preoperative anesthetic evaluation with questioning and physical examination permits to detect unsuspected coagulation disorders and to schedule the preventive treatment. The protocol for the perioperative period consisted of the administration of desmopressin and fresh frozen plasma one hour before surgery. The administration of desmopressin was continued for 48hours. Fresh frozen plasma and tranexamic acid were administered during the first 9 postoperative days. A local bleeding occurred at 8 days (scab coming off) and required systematically a surgical hemostasis and an intensification of the therapeutic protocol. Recombinant plasmatic factor VIII was administered for 7 days together with a daily perfusion of fresh frozen plasma for a total treatment period of 14 days.

  7. A new recombinant factor VIII: from genetics to clinical use

    Directory of Open Access Journals (Sweden)

    Santagostino E

    2014-12-01

    Full Text Available Elena Santagostino Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy Abstract: Advances in recombinant technology and knowledge about coagulation factor VIII (FVIII are building a platform for new therapeutic options in patients with hemophilia A. The development of turoctocog alfa, a novel, high-purity, third-generation, B-domain truncated recombinant FVIII, has been produced and formulated without the use of animal-derived or human serum-derived components, in the wake of understanding of the new biochemical characteristics of FVIII, namely its protein structure, and glycosylation and sulfating patterns. Culture conditions and a five-step purification process have been developed to optimize the safety of turoctocog alfa. The results of two pilot clinical trials using turoctocog alfa confirmed high safety levels, with no patient developing inhibitors during the period of observation. The purpose of this review is to describe briefly the molecular and biological properties of turoctocog alfa, together with details of its clinical development, with emphasis on the needs of patients with hemophilia A. Keywords: hemophilia A, recombinant factor VIII, turoctocog alfa, purification, inhibitor, safety

  8. Anti-CD3 antibodies modulate anti-factor VIII immune responses in hemophilia A mice after factor VIII plasmid-mediated gene therapy.

    Science.gov (United States)

    Peng, Baowei; Ye, Peiqing; Rawlings, David J; Ochs, Hans D; Miao, Carol H

    2009-11-12

    One major obstacle in gene therapy is the generation of immune responses directed against transgene product. Five consecutive anti-CD3 treatments concomitant with factor VIII (FVIII) plasmid injection prevented the formation of inhibitory antibodies against FVIII and achieved persistent, therapeutic levels of FVIII gene expression in treated hemophilia A mice. Repeated plasmid gene transfer is applicable in tolerized mice without eliciting immune responses. Anti-CD3 treatment significantly depleted both CD4+ and CD8+ T cells, whereas increased transforming growth factor-beta levels in plasma and the frequency of both CD4+CD25+FoxP3+ and CD4+CD25-Foxp3+ regulatory T cells in the initial few weeks after treatment. Although prior depletion of CD4+CD25+ cells did not abrogate tolerance induction, adoptive transfer of CD4+ cells from tolerized mice at 6 weeks after treatment protected recipient mice from anti-FVIII immune responses. Anti-CD3-treated mice mounted immune responses against both T-dependent and T-independent neo-antigens, indicating that anti-CD3 did not hamper the immune systems in the long term. Concomitant FVIII plasmid + anti-CD3 treatment induced long-term tolerance specific to FVIII via a mechanism involving the increase in transforming growth factor-beta levels and the generation of adaptive FVIII-specific CD4+Foxp3+ regulatory T cells at the periphery. Furthermore, anti-CD3 can reduce the titers of preexisting anti-FVIII inhibitory antibodies in hemophilia A mice.

  9. Structural investigation of zymogenic and activated forms of human blood coagulation factor VIII: a computational molecular dynamics study

    Directory of Open Access Journals (Sweden)

    Venkateswarlu Divi

    2010-02-01

    Full Text Available Abstract Background Human blood coagulation factor VIII (fVIII is a large plasma glycoprotein with sequential domain arrangement in the order A1-a1-A2-a2-B-a3-A3-C1-C2. The A1, A2 and A3 domains are interconnected by long linker peptides (a1, a2 and a3 that possess the activation sites. Proteolysis of fVIII zymogen by thrombin or factor Xa results in the generation of the activated form (fVIIIa which serves as a critical co-factor for factor IXa (fIXa enzyme in the intrinsic coagulation pathway. Results In our efforts to elucidate the structural differences between fVIII and fVIIIa, we developed the solution structural models of both forms, starting from an incomplete 3.7 Å X-ray crystal structure of fVIII zymogen, using explicit solvent MD simulations. The full assembly of B-domainless single-chain fVIII was built between the A1-A2 (Ala1-Arg740 and A3-C1-C2 (Ser1669-Tyr2332 domains. The structural dynamics of fVIII and fVIIIa, simulated for over 70 ns of time scale, enabled us to evaluate the integral motions of the multi-domain assembly of the co-factor and the possible coordination pattern of the functionally important calcium and copper ion binding in the protein. Conclusions MD simulations predicted that the acidic linker peptide (a1 between the A1 and A2 domains is largely flexible and appears to mask the exposure of putative fIXa enzyme binding loop (Tyr555-Asp569 region in the A2 domain. The simulation of fVIIIa, generated from the zymogen structure, predicted that the linker peptide (a1 undergoes significant conformational reorganization upon activation by relocating completely to the A1-domain. The conformational transition led to the exposure of the Tyr555-Asp569 loop and the surrounding region in the A2 domain. While the proposed linker peptide conformation is predictive in nature and warrants further experimental validation, the observed conformational differences between the zymogen and activated forms may explain and support the

  10. Hemophilia A gene therapy via intraosseous delivery of factor VIII-lentiviral vectors.

    Science.gov (United States)

    Miao, Carol H

    2016-01-01

    Current treatment of hemophilia A (HemA) patients with repeated infusions of factor VIII (FVIII; abbreviated as F8 in constructs) is costly, inconvenient, and incompletely effective. In addition, approximately 25 % of treated patients develop anti-factor VIII immune responses. Gene therapy that can achieve long-term phenotypic correction without the complication of anti-factor VIII antibody formation is highly desired. Lentiviral vector (LV)-mediated gene transfer into hematopoietic stem cells (HSCs) results in stable integration of FVIII gene into the host genome, leading to persistent therapeutic effect. However, ex vivo HSC gene therapy requires pre-conditioning which is highly undesirable for hemophilia patients. The recently developed novel methodology of direct intraosseous (IO) delivery of LVs can efficiently transduce bone marrow cells, generating high levels of transgene expression in HSCs. IO delivery of E-F8-LV utilizing a ubiquitous EF1α promoter generated initially therapeutic levels of FVIII, however, robust anti-FVIII antibody responses ensued neutralized functional FVIII activity in the circulation. In contrast, a single IO delivery of G-FVIII-LV utilizing a megakaryocytic-specific GP1bα promoter achieved platelet-specific FVIII expression, leading to persistent, partial correction of HemA in treated animals. Most interestingly, comparable therapeutic benefit with G-F8-LV was obtained in HemA mice with pre-existing anti-FVIII inhibitors. Platelets is an ideal IO delivery vehicle since FVIII stored in α-granules of platelets is protected from high-titer anti-FVIII antibodies; and that even relatively small numbers of activated platelets that locally excrete FVIII may be sufficient to promote efficient clot formation during bleeding. Additionally, combination of pharmacological agents improved transduction of LVs and persistence of transduced cells and transgene expression. Overall, a single IO infusion of G-F8-LV can generate long-term stable

  11. The course of preexistent immune abnormalities in HIV-negative hemophiliacs treated for 2 years with a monoclonal purified factor-VIII concentrate

    NARCIS (Netherlands)

    Smid, W. M.; van der Meer, J.; Smit, J. W.; Halie, M. R.

    1993-01-01

    The administration of factor VIII concentrates has been associated with immune abnormalities in patients with severe haemophilia A, even in the absence of HIV infection. The effects of a monoclonal purified factor VIII concentrate, Hemofil M (Baxter), on preexistent immune abnormalities were

  12. Evaluation of B&W UO2/ThO2 VIII experimental core: criticality and thermal disadvantage factor analysis

    Energy Technology Data Exchange (ETDEWEB)

    Carlo Parisi; Emanuele Negrenti

    2017-02-01

    In the framework of the OECD/NEA International Reactor Physics Experiment (IRPHE) Project, an evaluation of core VIII of the Babcock & Wilcox (B&W) Spectral Shift Control Reactor (SSCR) critical experiment program was performed. The SSCR concept, moderated and cooled by a variable mixture of heavy and light water, envisaged changing of the thermal neutron spectrum during the operation to encourage breeding and to sustain the core criticality. Core VIII contained 2188 fuel rods with 93% enriched UO2-ThO2 fuel in a moderator mixture of heavy and light water. The criticality experiment and measurements of the thermal disadvantage factor were evaluated.

  13. Half-life extended factor VIII for the treatment of hemophilia A.

    Science.gov (United States)

    Tiede, A

    2015-06-01

    Prophylactic infusion of factor VIII (FVIII) prevents joint bleeding and other hemorrhages in patients with hemophilia A. Conventional FVIII concentrates have a short half-life, with an average of about 12 h in adults, ranging in individual patients between 6 and 24 h, and even shorter in younger children. Therefore, effective prophylaxis requires frequent intravenous injection, usually three times per week or every other day. Several technologies are currently under investigation to extend the half-life of FVIII, including Fc fusion (Eloctate, Elocta, efmoroctocog alfa), addition of polyethylene glycol (turoctocog alfa pegol [N8-GP], BAY 94-9027, BAX 855), and a single-chain construct (CSL627). This review summarizes characteristics of products in clinical development and discusses their potential benefits.

  14. Development of a peptidomimetic ligand for efficient isolation and purification of factor VIII via affinity chromatography.

    Science.gov (United States)

    Knör, Sebastian; Khrenov, Alexey V; Laufer, Burkhardt; Saenko, Evgueni L; Hauser, Charlotte A E; Kessler, Horst

    2007-09-06

    Hemophilia A, one of the most severe bleeding disorders, results from an inherited deficiency of factor VIII (FVIII) function. Treatment by injection of FVIII has been a common procedure for decades. Nevertheless, the production and purification of FVIII remains a challenging task. Current procedures using immunoaffinity chromatography are expensive and suffer from the instability of the applied antibody ligands, which elute along with the product and contaminate it. Recently, FVIII was purified by use of octapeptide ligands, but their low protease-resistance limits their application. We here report the systematic rational and combinatorial optimization procedure that allowed us to transfer the octapeptide ligands into a small peptidomimetic. This compound is the smallest ligand known for separation of such a large protein (330 kDa). It not only binds and purifies FVIII with high efficiency but also is stable, protease-resistant, and cheap to produce in preparative scale. Hence it offers a valuable alternative to antibody-based purification procedures.

  15. Pharmacokinetics and dose requirements of factor VIII over the age range 3-74 years

    DEFF Research Database (Denmark)

    Björkman, Sven; Folkesson, Anna; Jönsson, Siv

    2009-01-01

    PURPOSE: The three aims of this investigation were (1) to develop a population pharmacokinetic (PK) model for factor VIII (FVIII) in haemophilia A patients, with estimates of inter-occasion and inter-individual variance, (2) to investigate whether appropriate dosing of FVIII for regular prophylaxis...... can be calculated according to patient characteristics, and (3) to present dosing recommendations for initiating prophylactic treatment. METHODS: A population PK model was developed using data from four PK studies on patients aged 7-74 years. The model was tested on sparse FVIII data from 42...... outpatient visits by haemophilia prophylaxis patients aged 3-66 years. Dose requirements for prophylaxis were calculated both according to the population model and from empirical Bayesian estimates of FVIII PK in the individual patients. RESULTS: The study data were well characterised by a two-compartment PK...

  16. Assessing patients' and caregivers' perspectives on stability of factor VIII products for haemophilia A

    DEFF Research Database (Denmark)

    DiBenedetti, D B; Coles, T M; Sharma, T

    2014-01-01

    Haemophilia A is a rare inherited bleeding disorder characterized by an inability of the blood to clot normally. Patients can experience spontaneous or trauma-induced joint and soft tissue bleeding and must keep coagulation factor VIII (FVIII) accessible at all times; thus, FVIII product storage ...... convenient and accessible FVIII products for patients in daily life and while travelling. In addition, the use of social media has potential value in recruiting this population....... and stability are critical. Our primary objective was to assess haemophilia A patients' and caregivers' experiences and preferences with FVIII product storage and stability. A secondary objective was to evaluate the use of the social media site Facebook in recruitment. In this cross-sectional study, 145 English...

  17. Analysis of factor VIII gene inversions in 164 unrelated hemophilia A families

    Energy Technology Data Exchange (ETDEWEB)

    Vnencak-Jones, L.; Phillips, J.A. III; Janco, R.L. [Vanderbilt Univ. School of Medicine, Nashville, TN (United States)] [and others

    1994-09-01

    Hemophilia A is an X-linked recessive disease with variable phenotype and both heterogeneous and wide spread mutations in the factor VIII (F8) gene. As a result, diagnostic carrier or prenatal testing often relies upon laborious DNA linkage analysis. Recently, inversion mutations resulting from an intrachromosomal recombination between DNA sequences in one of two A genes {approximately}500 kb upstream from the F8 gene and a homologous A gene in intron 22 of the F8 gene were identified and found in 45% of severe hemophiliacs. We have analyzed banked DNA collected since 1986 from affected males or obligate carrier females representing 164 unrelated hemophilia A families. The disease was sporadic in 37%, familial in 54% and in 10% of families incomplete information was given. A unique deletion was identified in 1/164, a normal pattern was observed in 110/164 (67%), and 53/164 (32%) families had inversion mutations with 43/53 (81%) involving the distal A gene (R3 pattern) and 10/53 (19%) involving the proximal A gene (R2 pattern). While 19% of all rearrangements were R2, in 35 families with severe disease (< 1% VIII:C activity) all 16 rearrangements seen were R3. In 18 families with the R3 pattern and known activities, 16 (89%) had levels < 1%, with the remaining 2 families having {le} 2.4% activity. Further, 18 referrals specifically noted the production of inhibitors and 8/18 (45%) had the R3 pattern. Our findings demonstrate that the R3 inversion mutation patterns is (1) only seen with VIII:C activity levels of {le} 2.4%, (2) seen in 46% of families with severe hemophilia, (3) seen in 45% of hemophiliacs known to have inhibitors, (4) not correlated with sporadic or familial disease and (5) not in disequilibrium with the Bcl I or Taq I intron 18 or ST14 polymorphisms. Finally, in families positive for an inversion mutation, direct testing offers a highly accurate and less expensive alternative to DNA linkage analysis.

  18. Antidote strategies to reverse anticoagulation with TB-402, a long-acting partial inhibitor of factor VIII

    NARCIS (Netherlands)

    Tangelder, M.; Long, C.; Emmerechts, J.; Jacquemin, M.; Peerlinck, K.; Vanassche, T.; Glazer, S.; Giesen, P.; Hoylaerts, M.; Verhamme, P.

    2012-01-01

    . Background: TB-402 is a partially inhibiting antibody of factor VIII that is under development as a long-acting anticoagulant. Patients and Methods: The reversibility of FVIII inhibition by TB-402 was evaluated in vitro after spiking with recombinant human FVIII (rhFVIII), human plasma-derived FVI

  19. Evaluation of the biological differences of canine and human factor VIII in gene delivery: Implications in human hemophilia treatment

    Science.gov (United States)

    The canine is the most important large animal model for testing novel hemophilia A(HA) treatment. It is often necessary to use canine factor VIII (cFIII) gene or protein for the evaluation of HA treatment in the canine model. However, the different biological properties between cFVIII and human FVII...

  20. [Ssp DnaB intein-mediated ligation of heavy and light chains of coagulation factor VIII in Escherichia coli].

    Science.gov (United States)

    Zhu, Fuxiang; Liu, Zelong; Qu, Huige; Xin, Xiaolin; Dong, Hongxin; Liu, Xiangqin

    2009-07-01

    We studied the ligation of coagulation factor VIII heavy and light chains in Escherichia coli by utilizing the intein-mediated protein trans-splicing. A B-domain deleted factor VIII (BDD-FVIII) gene was broken into two halves of heavy and light chains before Ser1657 which meets the splicing required conserved residue and then fused to 106 and 48 amino acid-containing N-part termed Int-N and C-part termed Int-C coding sequences of split mini Ssp DnaB intein respectively. These two fusion genes were constructed into a prokaryotic expression vector pBV220. Through induction for expression of recombinant protein it displayed an obvious protein band as predicted size of BDD-FVIII protein on SDS-PAGE gel. Western blotting using factor VIII specific antibodies confirmed that this protein band is BDD-FVIII produced by protein trans-splicing. It demonstrated that the heavy and light chains of BDD-FVIII can be efficiently ligated with the Ssp DnaB intein-mediated protein trans-splicing. These results provided evidence for encouraging our ongoing investigation with intein as a means in dual AAV vectors carrying the factor VIII gene to overcome the packaging size limitation of a single AAV vector in hemophilia A gene therapy.

  1. Potential role of a new PEGylated recombinant factor VIII for hemophilia A

    Directory of Open Access Journals (Sweden)

    Wynn TT

    2016-06-01

    Full Text Available Tung Thanh Wynn,1 Burak Gumuscu,2,3 1Department of Pediatrics, Division of Pediatric Hematology/Oncology, University of Florida, Gainesville, FL, 2Pediatric Hematology-Oncology, Bon Secours Health System, St. Mary’s Hospital, Richmond, VA, 3Department of Pediatrics, Division of Pediatric Hematology/Oncology, University of Virginia, Charlottesville, VA, USA Abstract: Hemophilia A, a deficiency in the activity of coagulation factor (F VIII, is an X-linked bleeding disorder with an approximate incidence of one in 5,000 male infants. Bleeding-related complications often result in greater severity of disease, poor quality of life, surgical interventions for severe joint destruction, and shortened life span. With the availability of plasma-derived and recombinant FVIII products, the benefits of primary prophylaxis were demonstrated and is now the standard of care for patients with severe factor deficiencies. Current hemophilia research is focusing on the creation of new factor replacement therapies with longer half-lives; accessing alternative mechanisms to achieve desired hemostasis and enhance bypassing ­activity; and limiting the immunogenicity of the protein. PEGylation involves the covalent attachment of polyethylene glycol (PEG to a protein, peptide, or a small molecule drug. PEG effectively increases the molecular weight and size of the protein by creating a hydrophilic cloud around the molecule. This molecular change may reduce susceptibility of the molecule to proteolytic activity and degradation. It is also believed that PEGylation changes the surface charge of the protein that ultimately interferes with some receptor-mediated clearance processes. The half-life of PEGylated factor is more prolonged when compared to non-PEGylated full-length recombinant FVIII. The dawn of a new era in the care of hemophilia patients is upon us with the release of recombinant FVIII products with extended half-lives, and products with even more extended half

  2. Successful immune tolerance induction consisting of high-dose factor VIII rich in von Willebrand factor and pulsed intravenous immunoglobulin: a case report

    Directory of Open Access Journals (Sweden)

    Kubisz Peter

    2012-10-01

    Full Text Available Abstract Introduction The development of factor VIII inhibitors is a serious complication of replacement therapy in patients with congenital hemophilia A. Immune tolerance induction has been accepted as the only clinically proven treatment allowing antigen-specific tolerance to factor VIII. However, some of its issues, such as patient selection, timing, factor VIII dosing, use of immunosuppressive or immunomodulatory procedures, still remain the subject of debate. Case presentation A case of a 3-year-old Caucasian boy with severe congenital hemophilia A, intron 22 inversion of the F8 gene and high-titer inhibitor, who underwent an immune tolerance induction according to the modified Bonn regimen (high doses of plasma-derived factor VIII rich in von Willebrand factor and pulsed intravenous immunoglobulin is presented. The treatment lasted for 13 months and led to the eradication of inhibitor. Conclusion Addition of intravenous immunoglobulin did not negatively affect the course of immune tolerance induction and led to the rapid eradication of factor VIII inhibitor.

  3. Potential for cellular stress response to hepatic factor VIII expression from AAV vector

    Directory of Open Access Journals (Sweden)

    Irene Zolotukhin

    2016-01-01

    Full Text Available Hemophilia A and B are coagulation disorders resulting from the loss of functional coagulation factor VIII (FVIII or factor IX proteins, respectively. Gene therapy for hemophilia with adeno-associated virus vectors has shown efficacy in hemophilia B patients. Although hemophilia A patients are more prevalent, the development of therapeutic adeno-associated virus vectors has been impeded by the size of the F8 cDNA and impaired secretion of FVIII protein. Further, it has been reported that over-expression of the FVIII protein induces endoplasmic reticulum stress and activates the unfolded protein response pathway both in vitro and in hepatocytes in vivo, presumably due to retention of misfolded FVIII protein within the endoplasmic reticulum. Engineering of the F8 transgene, including removal of the B domain (BDD-FVIII and codon optimization, now allows for the generation of adeno-associated virus vectors capable of expressing therapeutic levels of FVIII. Here we sought to determine if the risks of inducing the unfolded protein response in murine hepatocytes extend to adeno-associated virus gene transfer. Although our data show a mild activation of unfolded protein response markers following F8 gene delivery at a certain vector dose in C57BL/6 mice, it was not augmented upon further elevated dosing, did not induce liver pathology or apoptosis, and did not impact FVIII immunogenicity.

  4. Potential for cellular stress response to hepatic factor VIII expression from AAV vector

    Science.gov (United States)

    Zolotukhin, Irene; Markusic, David M; Palaschak, Brett; Hoffman, Brad E; Srikanthan, Meera A; Herzog, Roland W

    2016-01-01

    Hemophilia A and B are coagulation disorders resulting from the loss of functional coagulation factor VIII (FVIII) or factor IX proteins, respectively. Gene therapy for hemophilia with adeno-associated virus vectors has shown efficacy in hemophilia B patients. Although hemophilia A patients are more prevalent, the development of therapeutic adeno-associated virus vectors has been impeded by the size of the F8 cDNA and impaired secretion of FVIII protein. Further, it has been reported that over-expression of the FVIII protein induces endoplasmic reticulum stress and activates the unfolded protein response pathway both in vitro and in hepatocytes in vivo, presumably due to retention of misfolded FVIII protein within the endoplasmic reticulum. Engineering of the F8 transgene, including removal of the B domain (BDD-FVIII) and codon optimization, now allows for the generation of adeno-associated virus vectors capable of expressing therapeutic levels of FVIII. Here we sought to determine if the risks of inducing the unfolded protein response in murine hepatocytes extend to adeno-associated virus gene transfer. Although our data show a mild activation of unfolded protein response markers following F8 gene delivery at a certain vector dose in C57BL/6 mice, it was not augmented upon further elevated dosing, did not induce liver pathology or apoptosis, and did not impact FVIII immunogenicity. PMID:27738644

  5. Continuous infusion of porcine factor VIII: stability, microbiological safety and clinical experience.

    Science.gov (United States)

    DiMichele, D M; Gorman, P O; Kasper, C K; Mannucci, P M; Santagostino, E; Hay, C R M

    2002-01-01

    Porcine factor VIII (pFVIII) is an effective haemostatic treatment for bleeding in selected patients with FVIII inhibitors. Its use is sometimes associated with a transient fall in platelet count and transfusion reactions, the risk of which may be related to the rate of administration. Theoretical considerations suggest that the administration of pFVIII by continuous infusion should be effective, and could have pharmacokinetic advantages that lead to an improvement in the side-effect profile. The results of a retrospective survey of continuous infusion of pFVIII with respect to clinical safety and efficacy are reported. Porcine FVIII stability and microbiological studies are included. It is concluded that pFVIII given by continuous infusion is safe and effective. The risk of transfusion reactions and fall in platelet count appears to be reduced, compared with bolus administration. Stability studies showed that pFVIII activity declined at room temperature, most rapidly in the dilute solution (5-10 U mL(-1)). More concentrated mixtures showed acceptable stability for up to 24 h using a variety of infusion devices. Various concentrations of pFVIII did not support the growth of Escherichia coli or Staphylococcus aureus. These observations suggest that the porcine factor is suitable for continuous infusion (CI).

  6. A population pharmacokinetic model for perioperative dosing of factor VIII in hemophilia A patients.

    Science.gov (United States)

    Hazendonk, Hendrika; Fijnvandraat, Karin; Lock, Janske; Driessens, Mariëtte; van der Meer, Felix; Meijer, Karina; Kruip, Marieke; Gorkom, Britta Laros-van; Peters, Marjolein; de Wildt, Saskia; Leebeek, Frank; Cnossen, Marjon; Mathôt, Ron

    2016-10-01

    The role of pharmacokinetic-guided dosing of factor concentrates in hemophilia is currently a subject of debate and focuses on long-term prophylactic treatment. Few data are available on its impact in the perioperative period. In this study, a population pharmacokinetic model for currently registered factor VIII concentrates was developed for severe and moderate adult and pediatric hemophilia A patients (FVIII levels modeling was performed using non-linear mixed-effects modeling. Population pharmacokinetic parameters were estimated in 75 adults undergoing 140 surgeries (median age: 48 years; median weight: 80 kg) and 44 children undergoing 58 surgeries (median age: 4.3 years; median weight: 18.5 kg). Pharmacokinetic profiles were best described by a two-compartment model. Typical values for clearance, intercompartment clearance, central and peripheral volume were 0.15 L/h/68 kg, 0.16 L/h/68 kg, 2.81 L/68 kg and 1.90 L/68 kg. Interpatient variability in clearance and central volume was 37% and 27%. Clearance decreased with increasing age (Pmodel describes the perioperative pharmacokinetics of various FVIII concentrates, allowing individualization of perioperative FVIII therapy for severe and moderate hemophilia A patients by Bayesian adaptive dosing. Copyright© Ferrata Storti Foundation.

  7. Circumventing furin enhances factor VIII biological activity and ameliorates bleeding phenotypes in hemophilia models

    Science.gov (United States)

    Siner, Joshua I.; Samelson-Jones, Benjamin J.; Crudele, Julie M.; French, Robert A.; Lee, Benjamin J.; Zhou, Shanzhen; Merricks, Elizabeth; Raymer, Robin; Camire, Rodney M.; Arruda, Valder R.

    2016-01-01

    Processing by the proprotein convertase furin is believed to be critical for the biological activity of multiple proteins involved in hemostasis, including coagulation factor VIII (FVIII). This belief prompted the retention of the furin recognition motif (amino acids 1645–1648) in the design of B-domain–deleted FVIII (FVIII-BDD) products in current clinical use and in the drug development pipeline, as well as in experimental FVIII gene therapy strategies. Here, we report that processing by furin is in fact deleterious to FVIII-BDD secretion and procoagulant activity. Inhibition of furin increases the secretion and decreases the intracellular retention of FVIII-BDD protein in mammalian cells. Our new variant (FVIII-ΔF), in which this recognition motif is removed, efficiently circumvents furin. FVIII-ΔF demonstrates increased recombinant protein yields, enhanced clotting activity, and higher circulating FVIII levels after adeno-associated viral vector–based liver gene therapy in a murine model of severe hemophilia A (HA) compared with FVIII-BDD. Moreover, we observed an amelioration of the bleeding phenotype in severe HA dogs with sustained therapeutic FVIII levels after FVIII-ΔF gene therapy at a lower vector dose than previously employed in this model. The immunogenicity of FVIII-ΔF did not differ from that of FVIII-BDD as a protein or a gene therapeutic. Thus, contrary to previous suppositions, FVIII variants that can avoid furin processing are likely to have enhanced translational potential for HA therapy. PMID:27734034

  8. Eradication of neutralizing antibodies to factor VIII in canine hemophilia A after liver gene therapy.

    Science.gov (United States)

    Finn, Jonathan D; Ozelo, Margareth C; Sabatino, Denise E; Franck, Helen W G; Merricks, Elizabeth P; Crudele, Julie M; Zhou, Shangzhen; Kazazian, Haig H; Lillicrap, David; Nichols, Timothy C; Arruda, Valder R

    2010-12-23

    Inhibitory antibodies to factor VIII (FVIII) are a major complication in the treatment of hemophilia A, affecting approximately 20% to 30% of patients. Current treatment for inhibitors is based on long-term, daily injections of large amounts of FVIII protein. Liver-directed gene therapy has been used to induce antigen-specific tolerance, but there are no data in hemophilic animals with pre-existing inhibitors. To determine whether sustained endogenous expression of FVIII could eradicate inhibitors, we injected adeno-associated viral vectors encoding canine FVIII (cFVIII) in 2 strains of inhibitor hemophilia A dogs. In 3 dogs, a transient increase in inhibitor titers (up to 7 Bethesda Units [BU]) at 2 weeks was followed by continuous decline to complete disappearance within 4-5 weeks. Subsequently, an increase in cFVIII levels (1.5%-8%), a shortening of clotting times, and a reduction (> 90%) of bleeding episodes were observed. Immune tolerance was confirmed by lack of antibody formation after repeated challenges with cFVIII protein and normal protein half-life. A fourth dog exhibited a strong early anamnestic response (216 BU), with slow decline to 0.8 BU and cFVIII antigen detection by 18 months after vector delivery. These data suggest that liver gene therapy has the potential to eradicate inhibitors and could improve the outcomes of hemophilia A patients.

  9. Improvement of fibrin clot structure after factor VIII injection in haemophilia A patients treated on demand.

    Science.gov (United States)

    Antovic, Aleksandra; Mikovic, Danijela; Elezovic, Ivo; Zabczyk, Michael; Hutenby, Kjell; Antovic, Jovan P

    2014-04-01

    Patients with haemophilia A have seriously impaired thrombin generation due to an inherited deficiency of factor (F)VIII, making them form unstable fibrin clots that are unable to maintain haemostasis. Data on fibrin structure in haemophilia patients remain limited. Fibrin permeability, assessed by a flow measurement technique, was investigated in plasma from 20 patients with severe haemophilia A treated on demand, before and 30 minutes after FVIII injection. The results were correlated with concentrations of fibrinogen, FVIII and thrombin-activatable fibrinolysis inhibitor (TAFI), and global haemostatic markers: endogenous thrombin potential (ETP) and overall haemostatic potential (OHP). Fibrin structure was visualised using scanning electron microscopy (SEM). The permeability coefficient Ks decreased significantly after FVIII treatment. Ks correlated significantly with FVIII levels and dosage, and with ETP, OHP and levels of TAFI. SEM images revealed irregular, porous fibrin clots composed of thick and short fibers before FVIII treatment. The clots had recovered after FVIII replacement almost to levels in control samples, revealing compact fibrin with smaller intrinsic pores. To the best of our knowledge, this is the first description of fibrin porosity and structure before and after FVIII treatment of selected haemophilia patients. It seems that thrombin generation is the main determinant of fibrin structure in haemophilic plasma.

  10. Evolution of recombinant factor VIII safety: KOGENATE and Kogenate FS/Bayer.

    Science.gov (United States)

    Lusher, Jeanne M; Scharrer, Inge

    2009-11-01

    The use of factor VIII (FVIII) concentrates in the treatment of hemophilia A has raised important safety issues, historically of pathogen transmission and increasingly of inhibitor development to FVIII treatment. While manufacturing processes of current recombinant FVIII products have been shaped entirely around preventing pathogen transmission, the same modifications that afford a greater margin of safety could affect immunogenicity of the product, consequences of which could only be seen through long-term clinical experience. This review summarizes pathogen safety and inhibitor reports from clinical trials, post-marketing surveillance studies, and study reports on KOGENATE and its successor, Kogenate FS/Bayer. Although KOGENATE and Kogenate FS/Bayer are nearly identical products, subtle manufacturing improvements to address the need for greater margins of safety from a pathogen transmission perspective have also led to a potentially improved immunogenicity profile (15% in previously untreated/minimally treated patients with severe hemophilia A for Kogenate FS/Bayer). Notably, there has been no occurrence of pathogen contamination, and minimal de novo inhibitor formation in previously treated patients throughout the use of both products. Overall, KOGENATE and Kogenate FS/Bayer have a long history of safety in a variety of clinical settings, including treatment of bleeding, surgical management, and prophylaxis therapy.

  11. In vitro differentiation of mouse ES cells into hepatocytes with coagulation factors VIII and IX expression profiles

    Institute of Scientific and Technical Information of China (English)

    MENG; Ying; HUANG; Shaoliang; MIN; Jun; GUO; Zhongmin

    2006-01-01

    Coagulation factors II, V, VII, VIII, IX and X are produced by hepatocytes. So factors VIII and IX deficiencies, which result in hemophilia A and B, have the potential to respond to cellular re- placement therapy. Embryonic stem (ES) cells provide a unique source for therapeutic applications. Here, E14 mouse ES cells have been induced into hepatocytes in vitro. Morphology revealed that ES-derived hepatic-like cells were round or polyhedral shaped with distinct boundary of individual cells, and some arranged in trabeculae. These cells expressed endodermal- or liver-specific mRNA --transthyretin (TTR), α1-anti-trypsin (AAT), α-fetoprotein (AFP), albumin (ALB), glucose-6- phoshpatase (G6P) and tyrosine aminotransferase (TAT). Approximately (85.1(0.5)% of the ES-de- rived cells was stained positive green with ICG uptake. These cells were also stained magenta as a result of PAS reaction. In this paper, expression of coagulation factors VIII and IX mRNA in the ES-derived cells is documented. Therefore, ES cells might be developed as substitute donor cells for the therapy of coagulation factor deficiencies.

  12. Recombinant B domain deleted porcine factor VIII for the treatment of bleeding episodes in adults with acquired hemophilia A.

    Science.gov (United States)

    Gomperts, Edward

    2015-08-01

    Hemophilia A is an inherited deficiency of clotting factor VIII (FVIII) often complicated by inhibitor development (CHAWI) in which neutralizing antibodies block the therapeutic benefit of replacement therapy. Inhibitors to FVIII can also be seen in an auto-immune disease known as acquired hemophilia A (AHA). 'Bypassing' therapies have been shown to provide hemostasis but dosing must be done empirically because current assays cannot measure objective markers of treatment efficacy and safety. A recombinant porcine sequence factor VIII (r-pFVIII) has been developed for the management of AHA. Preclinical, Phase I and Phase II clinical research studies in CHAWI subjects showed therapeutic potential and safety of this agent. A Phase II/III study in AHA with serious bleeding episodes shows a positive response in all subjects after administration. Based on current preclinical and clinical trial data, r-pFVIII should become the first line of treatment in the management of hemorrhage in patients with AHA.

  13. [Detection of alloantibodies against Factor VIII in plasma of patients with hemophilia A and its relationship with Factor VIIIC domain].

    Science.gov (United States)

    Zhang, Lu-Lu; Yu, Zi-Qiang; Wan, Chu-Cheng; Zhang, Wei; Zhang, Zheng-Hua; Ruan, Chang-Geng

    2013-10-01

    This study was purposed to detect the alloantibodies against Factor VIII (FVIII) by ELISA for estimating the incidence of the alloantibodies against Factor VIII (FVIII) in patients with hemophilia A, and to investigate the relationship between factor VIIIC domain and alloantibodies. Total of 140 patients with hemophilia A and 80 normal controls were enrolled in this study, among them plasma FVIII level of 84 patients was less than 1%, plasma FVIII level of 34 patients was between 1% and 5%, and plasma FVIII level of 22 patients was more than 5%. All patients were treated with plasma-derived FVIII concentrate or plasma before. The ELISA plate was coated with McAb (SZ-132) against FVIII prepared in our laboratory, then human recombinant FVIII concentrates were applied. After incubation in room temperature for 2 hours, diluted plasma samples and HRP-conjugated goat anti-human IgG were added successively, finally A490 was recorded. The threshold of alloantibody of patient plasma was set as mean value>3 SD more than control. The plate was coated with antibody against His, then human recombinant FVIII-C1C2 prepared in our laboratory was added. After incubation in room temperature for 2 hours, diluted plasma samples and HRP-conjugated goat anti-human IgG were added successively, finally A490 were recorded. The threshold was set as the mean value>3 SD more than control. The results showed that the alloantibodies against FVIII were found in 56 patients (40%) by ELISA, and 82.1% (46/56) of this kind of alloantibody could interact with the C domain of FVIII. It is concluded that C domain of FVIII is one of the primary binding sites for the alloantibodies against FVIII in Chinese patients with hemophilia A.

  14. Danger signal-dependent activation of human dendritic cells by plasma-derived factor VIII products.

    Science.gov (United States)

    Miller, L; Weissmüller, S; Ringler, E; Crauwels, P; van Zandbergen, G; Seitz, R; Waibler, Z

    2015-08-01

    Treatment of haemophilia A by infusions of the clotting factor VIII (FVIII) results in the development of inhibitors/anti-drug antibodies in up to 25 % of patients. Mechanisms leading to immunogenicity of FVIII products are not yet fully understood. Amongst other factors, danger signals as elicited upon infection or surgery have been proposed to play a role. In the present study, we focused on effects of danger signals on maturation and activation of dendritic cells (DC) in the context of FVIII application. Human monocyte-derived DC were treated with FVIII alone, with a danger signal alone or a combination of both. By testing more than 60 different healthy donors, we show that FVIII and the bacterial danger signal lipopolysaccharide synergise in increasing DC activation, as characterised by increased expression of co-stimulatory molecules and secretion of pro-inflammatory cytokines. The degree and frequency of this synergistic activation correlate with CD86 expression levels on immature DC prior to stimulation. In our assay system, plasma-derived but not recombinant FVIII products activate human DC in a danger signal-dependent manner. Further tested danger signals, such as R848 also induced DC activation in combination with FVIII, albeit not in every tested donor. In our hands, human DC but not human B cells or macrophages could be activated by FVIII in a danger signal-dependent manner. Our results suggest that immunogenicity of FVIII is a result of multiple factors including the presence of danger, predisposition of the patient, and the choice of a FVIII product for treatment.

  15. Partial correction of a severe molecular defect in hemophilia A, because of errors during expression of the factor VIII gene

    Energy Technology Data Exchange (ETDEWEB)

    Young, M.; Antonarakis, S.E. [Univ. of Geneva (Switzerland); Inaba, Hiroshi [Tokyo Medical College (Japan)] [and others

    1997-03-01

    Although the molecular defect in patients in a Japanese family with mild to moderately severe hemophilia A was a deletion of a single nucleotide T within an A{sub 8}TA{sub 2} sequence of exon 14 of the factor VIII gene, the severity of the clinical phenotype did not correspond to that expected of a frameshift mutation. A small amount of functional factor VIII protein was detected in the patient`s plasma. Analysis of DNA and RNA molecules from normal and affected individuals and in vitro transcription/translation suggested a partial correction of the molecular defect, because of the following: (i) DNA replication/RNA transcription errors resulting in restoration of the reading frame and/or (ii) {open_quotes}ribosomal frameshifting{close_quotes} resulting in the production of normal factor VIII polypeptide and, thus, in a milder than expected hemophilia A. All of these mechanisms probably were promoted by the longer run of adenines, A{sub 10} instead of A{sub 8}TA{sub 2}, after the delT. Errors in the complex steps of gene expression therefore may partially correct a severe frameshift defect and ameliorate an expected severe phenotype. 36 refs., 6 figs.

  16. Factor VIII gene variants and inhibitor risk in African American hemophilia A patients.

    Science.gov (United States)

    Gunasekera, Devi; Ettinger, Ruth A; Nakaya Fletcher, Shelley; James, Eddie A; Liu, Maochang; Barrett, John C; Withycombe, Janice; Matthews, Dana C; Epstein, Melinda S; Hughes, Richard J; Pratt, Kathleen P

    2015-08-13

    African American hemophilia A (HA) patients experience a higher incidence of neutralizing anti-factor VIII (FVIII) antibodies ("inhibitors") vis-à-vis white patients. Nonsynonymous single-nucleotide polymorphisms (ns-SNPs) in the F8 gene encoding FVIII-H484, FVIII-E1241, and FVIII-V2238 are more prevalent in African Americans. This study tested the hypothesis that immune responses to these sites provoke inhibitors. Blood samples were obtained from 174 African American and 198 white HA subjects and their F8 gene sequences determined. Major histocompatibility complex class II binding and T-cell recognition of polymorphic sequences were evaluated using quantitative binding assays and HLA-DRB1 tetramers. Peptides corresponding to 4 common ns-SNPs showed limited binding to 11 HLA-DRB1 proteins. CD4 T cells from 22 subjects treated with FVIII products having sequences at residues FVIII-484, 1241, and 2238 differing from those of putative proteins encoded by their F8 genes did not show high-avidity tetramer binding, whereas positive-control staining of tetanus-specific CD4 T cells was routinely successful. African Americans with an intron-22 inversion mutation showed a 2-3 times-higher inhibitor incidence than whites with the same mutation (odds ratio = 2.3 [1.1-5.0, P = .04]), but this did not correlate with any of the ns-SNPs. We conclude that immune responses to "sequence-mismatched" FVIII products are unlikely to contribute appreciably to the inhibitor incidence in African Americans.

  17. Application of a novel affinity adsorbent for the capture and purification of recombinant factor VIII compounds.

    Science.gov (United States)

    McCue, Justin T; Selvitelli, Keith; Walker, Joshua

    2009-11-06

    Recombinant Factor VIII (FVIII) therapies have been created to provide treatment for Hemophilia A, an inherited bleeding disorder caused by mutation in the FVIII gene. A major challenge in the purification of recombinant FVIII molecules is the development of an affinity chromatography step. Such a step must be highly specific and selective for the FVIII molecule, but also must be designed appropriately to ensure the FVIII molecule can be effectively recovered without resorting to harsh elution conditions which may be harmful to the product. Additionally, it is desirable to have affinity adsorbents designed to be reusable over a large number of column cycles while maintaining consistent purification performance. In this work, we describe the use of VIIISelect, a commercially available affinity adsorbent designed specifically for the purification of FVIII compounds. The VIIISelect adsorbent consists of a 13kDa recombinant protein ligand attached to a cross-linked agarose base matrix. The structure of the recombinant ligand is based upon Camelid-derived single domain antibody fragments. The VIIISelect adsorbent is produced using a process free of animal-derived raw materials, which is a highly desirable attribute for adsorbents used in the purification processes of recombinant protein therapeutics. The VIIISelect adsorbent was used as the initial capture column to purify a FVIII compound directly from clarified cell culture fluid prior to further downstream purification. The purification performance of the VIIISelect was evaluated, which included measurement of the static binding capacity, dynamic binding capacity, product recovery, impurity clearance, and adsorbent reuse. Following laboratory-scale process development, the VIIISelect adsorbent was scaled up and used in the large scale manufacturing of a FVIII compound.

  18. Intraosseous delivery of lentiviral vectors targeting factor VIII expression in platelets corrects murine hemophilia A.

    Science.gov (United States)

    Wang, Xuefeng; Shin, Simon C; Chiang, Andy F J; Khan, Iram; Pan, Dao; Rawlings, David J; Miao, Carol H

    2015-04-01

    Intraosseous (IO) infusion of lentiviral vectors (LVs) for in situ gene transfer into bone marrow may avoid specific challenges posed by ex vivo gene delivery, including, in particular, the requirement of preconditioning. We utilized IO delivery of LVs encoding a GFP or factor VIII (FVIII) transgene directed by ubiquitous promoters (a MND or EF-1α-short element; M-GFP-LV, E-F8-LV) or a platelet-specific, glycoprotein-1bα promoter (G-GFP-LV, G-F8-LV). A single IO infusion of M-GFP-LV or G-GFP-LV achieved long-term and efficient GFP expression in Lineage(-)Sca1(+)c-Kit(+) hematopoietic stem cells and platelets, respectively. While E-F8-LV produced initially high-level FVIII expression, robust anti-FVIII immune responses eliminated functional FVIII in circulation. In contrast, IO delivery of G-F8-LV achieved long-term platelet-specific expression of FVIII, resulting in partial correction of hemophilia A. Furthermore, similar clinical benefit with G-F8-LV was achieved in animals with pre-existing anti-FVIII inhibitors. These findings further support platelets as an ideal FVIII delivery vehicle, as FVIII, stored in α-granules, is protected from neutralizing antibodies and, during bleeding, activated platelets locally excrete FVIII to promote clot formation. Overall, a single IO infusion of G-F8-LV was sufficient to correct hemophilia phenotype for long term, indicating that this approach may provide an effective means to permanently treat FVIII deficiency.

  19. Enhanced factor VIII heavy chain for gene therapy of hemophilia A.

    Science.gov (United States)

    Chen, Lingxia; Lu, Hui; Wang, Jinhui; Sarkar, Rita; Yang, Xiao; Wang, Hongli; High, Katherine A; Xiao, Weidong

    2009-03-01

    Hemophilia A gene therapy using recombinant adenovirus-associated virus (AAV) vectors has been hampered by the size of the factor VIII (FVIII) cDNA. Previously, splitting the FVIII coding sequence into a heavy-chain (HC) fragment and a light-chain (LC) fragment for dual recombinant AAV vector delivery has been successfully explored. However, the main disadvantage of this approach is a "chain imbalance" problem in which LC secretion is approximately 1-2 logs higher than that of HC, and therefore, the majority of protein synthesized is nonfunctional. To improve HC secretion, we constructed alternate FVIII HCs based on our observation that LC facilitates HC secretion. To our surprise, most of the new HC molecules exhibited enhanced expression over the traditional HC molecule (HC(745)). The optimized HC mutein, HC(HL), including additional acidic-region-3 (ar3) sequences, exhibited three- to fivefold higher activity in both enzyme-linked immunosorbent assay (ELISA) and activated partial thromboplastin time (aPTT) assay in in vitro testing. Further characterization suggested ar3 sequences increased HC secretion, rather than promoting HC synthesis. Intravenous delivery of AAV8-HC(HL)+AAV8-LC or AAV8-HC(745)+AAV8-LC achieved phenotypic correction in hemophilia A mice. Mice receiving AAV8-HC(HL)+AAV8-LC achieved three- to fourfold higher HC expression than AAV8-HC(745)+AAV8-LC, consistent with the FVIII functional assays. HC(HL) should be substituted for HC(745) in a dual AAV vector strategy due to its enhanced expression.

  20. The factor VIII Structure and Mutation Resource Site: HAMSTeRS version 4.

    Science.gov (United States)

    Kemball-Cook, G; Tuddenham, E G; Wacey, A I

    1998-01-01

    Since 1996 the HAMSTeRS (Haemophilia A Mutation, Search, Test and Resource Site) WWW site has provided an online resource for access to data on the molecular pathology of haemophilia A, replacing previous text editions of the Haemophilia A Database published in Nucleic Acids Research . This report describes the continued development of the site (version 4), and in particular the expansion of factor VIII (FVIII) structure-related features. Access to the mutation database itself, both for searching the listings and for submission of new mutations, is via custom-designed forms: more powerful Boolean searches of the point mutations in the database are also available. During 1997 a total of 22 novel missense mutations were reported, increasing the total number of unique variants now described to 252 (238 in exonic sequences and 14 at intronic splice junctions). Currently, a total of 586 individual reports with associated phenotypic data are available for searching by any category including phenotype. The FVIII structure section now includes a download of a FVIII A domain homology model in Protein Data Bank format and a multiple alignment of the FVIII amino-acid sequencies from four species (human, murine, porcine and canine) in addition to the virtual reality simulations, secondary structural data and FVIII animation already available. Finally, to aid navigation across this site, a clickable roadmap of the main features provides easy access to the page desired. Our intention is that continued development and updating of the site shall provide workers in the fields of molecular and structural biology with a one-stop resource site to facilitate FVIII research and education. The HAMSTeRS URL is http://europium.mrc.rpms.ac.uk

  1. Frequencies of VNTR and RFLP polymorphisms associated with factor VIII gene in Singapore

    Energy Technology Data Exchange (ETDEWEB)

    Fong, I.; Lai, P.S.; Ouah, T.C. [National Univ. of Singapore (Malaysia)] [and others

    1994-09-01

    The allelic frequency of any polymorphism within a population determines its usefulness for genetic counselling. This is important in populations of non-Caucasian origin as RFLPs may significantly differ among ethnic groups. We report a study of five intragenic polymorphisms in factor VIII gene carried out in Singapore. The three PCR-based RFLP markers studied were Intron 18/Bcl I, Intron 19/Hind III and Intron 22/Xba I. In an analysis of 148 unrelated normal X chromosomes, the allele frequencies were found to be A1 = 0.18, A2 = 0.82 (Bcl I RFLP), A1 = 0.80, A2 = 0.20 (Hind III RFLP) and A1 = 0.58, and A2 = 0.42 (Xba I RFLP). The heterozygosity rates of 74 females analyzed separately were 31%, 32% and 84.2%, respectively. Linkage disequilibrium was also observed to some degree between Bcl I and Hind III polymorphism in our population. We have also analyzed a sequence polymorphism in Intron 7 using hybridization with radioactive-labelled {sup 32}P allele-specific oligonucleotide probes. This polymorphism was not very polymorphic in our population with only 2% of 117 individuals analyzed being informative. However, the use of a hypervariable dinucleotide repeat sequence (VNTR) in Intron 13 showed that 25 of our of 27 (93%) females were heterozygous. Allele frequencies ranged from 1 to 55 %. We conclude that a viable strategy for molecular analysis of Hemophilia A families in our population should include the use of Intron 18/Bcl I and Intron 22/Xba I RFLP markers and the Intron 13 VNTR marker.

  2. Pharmacokinetic properties of BAY 81-8973, a full-length recombinant factor VIII.

    Science.gov (United States)

    Shah, A; Delesen, H; Garger, S; Lalezari, S

    2015-11-01

    BAY 81-8973 is a full-length recombinant factor VIII (FVIII) with the same primary amino acid sequence as sucrose-formulated recombinant FVIII (rFVIII-FS) but is produced with advanced manufacturing technologies. To analyse the pharmacokinetics (PK) of BAY 81-8973 after single and multiple dosing across different age and ethnic groups in the LEOPOLD clinical trial programme. The LEOPOLD trials enrolled patients with severe haemophilia A aged 12-65 years (LEOPOLD I and II) or ≤12 years (LEOPOLD Kids) with ≥150 (LEOPOLD I and II) or ≥50 (LEOPOLD Kids) exposure days to any FVIII product and no history of FVIII inhibitors. PK were assessed using chromogenic and one-stage assays (only chromogenic assay for LEOPOLD Kids) after a single 50-IU kg(-1) dose of BAY 81-8973 and, in a subset of patients in LEOPOLD I, after repeated dosing. Pharmacokinetic analyses were also performed based on age (18 to 65, 12 to <18, 6 to <12 and <6 years) and ethnicity (Asian and non-Asian). Pharmacokinetic assessments in the LEOPOLD I trial showed non-inferiority of BAY 81-8973 vs. rFVIII-FS. The PK of BAY 81-8973 were comparable after single and multiple dosing. Age-based analysis in the three trials showed that plasma concentrations were slightly lower for children, but similar for adolescents compared with adults. Pharmacokinetic results were similar in the different ethnic groups. Results of the LEOPOLD trials show that the BAY 81-8973 pharmacokinetic profile is non-inferior to rFVIII-FS. Similar BAY 81-8973 pharmacokinetic values were observed following single and repeated dosing and across ethnic groups. © 2015 John Wiley & Sons Ltd.

  3. Bioengineered coagulation factor VIII enables long-term correction of murine hemophilia A following liver-directed adeno-associated viral vector delivery

    Directory of Open Access Journals (Sweden)

    Harrison C Brown

    2014-01-01

    Full Text Available Clinical data support the feasibility and safety of adeno-associated viral (AAV vectors in gene therapy applications. Despite several clinical trials of AAV-based gene transfer for hemophilia B, a unique set of obstacles impede the development of a similar approach for hemophilia A. These include (i the size of the factor VIII (fVIII transgene, (ii humoral immune responses to fVIII, (iii inefficient biosynthesis of human fVIII, and (iv AAV vector immunity. Through bioengineering approaches, a novel fVIII molecule, designated ET3, was developed and shown to improve biosynthetic efficiency 10- to 100-fold. In this study, the utility of ET3 was assessed in the context of liver-directed, AAV-mediated gene transfer into hemophilia A mice. Due to the large size of the expression cassette, AAV-ET3 genomes packaged into viral particles as partial genome fragments. Despite this potential limitation, a single peripheral vein administration of AAV-ET3 into immune-competent hemophilia A mice resulted in correction of the fVIII deficiency at lower vector doses than previously reported for similarly oversized AAV-fVIII vectors. Therefore, ET3 appears to improve vector potency and mitigate at least one of the critical barriers to AAV-based clinical gene therapy for hemophilia A.

  4. Von Willebrand factor and coagulation factor VIII in Moyamoya disease associated with Graves' disease: A case report

    Science.gov (United States)

    Ren, Shou-Chen; Gao, Bao-Qin; Yang, Wei-Li; Feng, Wei-Xin; Xu, Jian; Li, Shao-Wu; Wang, Yong-Jun

    2016-01-01

    The present study reported the case of a Chinese boy who was diagnosed with Moyamoya disease (MMD) associated with Graves' disease (GD). An overactivation of von Willebrand factor (vWF) and coagulation factor VIII (FVIII) was identified in the plasma of the patient. Thiamazole and metoprolol treatment was thus administrated. After 2 months of treatment, the patient's thyroid function returned to normal and the neurological symptoms improved gradually. At the same time, the activities of vWF and FVIII were depressed. During the 20-month follow-up, information regarding the neurological symptoms, cerebrovascular imaging, thyroid function, thyroid autoantibodies and coagulation parameters was collected. High levels of thyroid autoantibodies persisted throughout the follow-up period, while other coagulation parameters remained in the normal range. In conclusion, considering the vital role of vWF and FVIII in vascular diseases, it is hypothesized that these two factors may serve an important role in the occurrence of GD associated with MMD. PMID:27882137

  5. Severe Hemophilia A in a Male Old English Sheep Dog with a C→T Transition that Created a Premature Stop Codon in Factor VIII

    Science.gov (United States)

    Lozier, Jay N; Kloos, Mark T; Merricks, Elizabeth P; Lemoine, Nathaly; Whitford, Margaret H; Raymer, Robin A; Bellinger, Dwight A; Nichols, Timothy C

    2016-01-01

    Animals with hemophilia are models for gene therapy, factor replacement, and inhibitor development in humans. We have actively sought dogs with severe hemophilia A that have novel factor VIII mutations unlike the previously described factor VIII intron 22 inversion. A male Old English Sheepdog with recurrent soft-tissue hemorrhage and hemarthrosis was diagnosed with severe hemophilia A (factor VIII activity less than 1% of normal). We purified genomic DNA from this dog and ruled out the common intron 22 inversion; we then sequenced all 26 exons. Comparing the results with the normal canine factor VIII sequence revealed a C→T transition in exon 12 of the factor VIII gene that created a premature stop codon at amino acid 577 in the A2 domain of the protein. In addition, 2 previously described polymorphisms that do not cause hemophilia were present at amino acids 909 and 1184. The hemophilia mutation creates a new TaqI site that facilitates rapid genotyping of affected offspring by PCR and restriction endonuclease analyses. This mutation is analogous to the previously described human factor VIII mutation at Arg583, which likewise is a CpG dinucleotide transition causing a premature stop codon in exon 12. Thus far, despite extensive treatment with factor VIII, this dog has not developed neutralizing antibodies (‘inhibitors’) to the protein. This novel mutation in a dog gives rise to severe hemophilia A analogous to a mutation seen in humans. This model will be useful for studies of the treatment of hemophilia. PMID:27780008

  6. Therapeutic and routine prophylactic properties of rFactor VIII Fc (efraloctocog alfa, Eloctate®) in hemophilia A

    Science.gov (United States)

    Chowdary, Pratima; Fosbury, Emma; Riddell, Anne; Mathias, Mary

    2016-01-01

    rFVIIIFc (efraloctocog alfa, Eloctate®) is an extended half-life (EHL) factor VIII licensed for use in patients with hemophilia A for prophylaxis and treatment of bleeding and surgical episodes. Pharmacokinetic studies in adults have shown a mean 1.5-fold increase in half-life compared to full-length factor VIII. When compared to adults, the half-life is decreased by 8% in adolescents between 12 and 17 years, by 18% in children 6 to <12 years, and by 33% in children between the ages of 2 and <6 years. There is a considerable interindividual variation in the prolongation of the half-life particularly in children and across the age groups, the range extending from no increase to a 2.5-fold increase. In addition to age, von willebrand factor (VWF) antigen level has demonstrated a significant impact on rFVIIIFc half-life, with higher VWF levels associated with greater prolongation of half-life. The pivotal and pediatric clinical trials have demonstrated the efficacy and safety of rFVIIIFc for use in regular prophylaxis and in management of bleeds and surgery. In these studies, just under half the participants showed a zero annualized bleed rate (ABR), and the median ABR (1.6 in the pivotal study for the individualized prophylaxis arm) showed a further decrease in the extension study. On average, the patients required fewer infusions (reduced by at least a third), and the mean weekly consumption seems to be in keeping with standard recombinant factor VIII. EHL rFVIIIFc has made decreased infusion frequency a possibility. However, the interindividual variability in dose and infusion frequency highlights the need for a personalized approach based on individual patient’s half-life and/or response to treatment. PMID:27695377

  7. Factor VIII alters tubular organization and functional properties of von Willebrand factor stored in Weibel-Palade bodies.

    Science.gov (United States)

    Bouwens, Eveline A M; Mourik, Marjon J; van den Biggelaar, Maartje; Eikenboom, Jeroen C J; Voorberg, Jan; Valentijn, Karine M; Mertens, Koen

    2011-11-24

    In endothelial cells, von Willebrand factor (VWF) multimers are packaged into tubules that direct biogenesis of elongated Weibel-Palade bodies (WPBs). WPB release results in unfurling of VWF tubules and assembly into strings that serve to recruit platelets. By confocal microscopy, we have previously observed a rounded morphology of WPBs in blood outgrowth endothelial cells transduced to express factor VIII (FVIII). Using correlative light-electron microscopy and tomography, we now demonstrate that FVIII-containing WPBs have disorganized, short VWF tubules. Whereas normal FVIII and FVIII Y1680F interfered with formation of ultra-large VWF multimers, release of the WPBs resulted in VWF strings of equal length as those from nontransduced blood outgrowth endothelial cells. After release, both WPB-derived FVIII and FVIII Y1680F remained bound to VWF strings, which however had largely lost their ability to recruit platelets. Strings from nontransduced cells, however, were capable of simultaneously recruiting exogenous FVIII and platelets. These findings suggest that the interaction of FVIII with VWF during WPB formation is independent of Y1680, is maintained after WPB release in FVIII-covered VWF strings, and impairs recruitment of platelets. Apparently, intra-cellular and extracellular assembly of FVIII-VWF complex involves distinct mechanisms, which differ with regard to their implications for platelet binding to released VWF strings.

  8. Combined deficiency of factor V and factor VIII is due to mutations in either LMAN1 or MCFD2

    Science.gov (United States)

    Zhang, Bin; McGee, Beth; Yamaoka, Jennifer S.; Guglielmone, Hugo; Downes, Katharine A.; Minoldo, Salvador; Jarchum, Gustavo; Peyvandi, Flora; de Bosch, Norma B.; Ruiz-Saez, Arlette; Chatelain, Bernard; Olpinski, Marian; Bockenstedt, Paula; Sperl, Wolfgang; Kaufman, Randal J.; Nichols, William C.; Tuddenham, Edward G. D.; Ginsburg, David

    2006-01-01

    Mutations in LMAN1 (ERGIC-53) or MCFD2 cause combined deficiency of factor V and factor VIII (F5F8D). LMAN1 and MCFD2 form a protein complex that functions as a cargo receptor ferrying FV and FVIII from the endoplasmic reticulum to the Golgi. In this study, we analyzed 10 previously reported and 10 new F5F8D families. Mutations in the LMAN1 or MCFD2 genes accounted for 15 of these families, including 3 alleles resulting in no LMAN1 mRNA accumulation. Combined with our previous reports, we have identified LMAN1 or MCFD2 mutations as the causes of F5F8D in 71 of 76 families. Among the 5 families in which no mutations were identified, 3 were due to misdiagnosis, with the remaining 2 likely carrying LMAN1 or MCFD2 mutations that were missed by direct sequencing. Our results suggest that mutations in LMAN1 and MCFD2 may account for all cases of F5F8D. Immunoprecipitation and Western blot analysis detected a low level of LMAN1-MCFD2 complex in lymphoblasts derived from patients with missense mutations in LMAN1 (C475R) or MCFD2 (I136T), suggesting that complete loss of the complex may not be required for clinically significant reduction in FV and FVIII. PMID:16304051

  9. Human von Willebrand factor/factor VIII concentrates in the management of pediatric patients with von Willebrand disease/hemophilia A

    OpenAIRE

    Castaman G; Linari S

    2016-01-01

    Giancarlo Castaman, Silvia Linari Department of Oncology, Center for Bleeding Disorders, Careggi University Hospital, Florence, ItalyAbstract: Several plasma-derived intermediate and high-purity concentrates containing von Willebrand factor (VWF) and factor VIII (FVIII) are currently available. The main role of these products in the management of pediatric the population is represented by the replacement therapy in patients with severe or intermediate forms of von Willebrand disease, in whom ...

  10. Expression, purification, and partial in vitro characterization of biologically active human coagulation factor VIII light chain (A3-C1-C2) in Pichia pastoris.

    Science.gov (United States)

    A R, Sudheer Reddy; Satheeshkumar, Padikara Kutty; Vijayalakshmi, Mookambeswaran A

    2013-09-01

    Recombinant coagulation factor VIII (FVIII) expressed in mammalian expression systems is used extensively in the treatment of hemophilia A. It is reported that the heavy (A1-A2) and light chains (A3-C1-C2) of factor VIII purified from plasma regained the coagulation activity by dimerization in vitro. In this work, cDNA coding for the light chain of human coagulation factor VIII (FVIII-LC) was cloned into pPICZα-A expression vector downstream of alcohol oxidase promoter and α-mating signal sequence from Saccharomyces cerevisiae in order to express the protein with a native N-terminus. The methylotrophic yeast, Pichia pastoris X-33, was transformed with this cassette, and transformants were selected for production of human factor VIII light chain into culture media. SDS-PAGE and Western blot analysis confirmed the expression of factor VIII light chain protein. The expressed protein was purified to near homogeneity using histidine ligand affinity chromatography (2.342 mg/L). The biological activity of FVIII-LC was confirmed by analyzing the interaction between FVIII-LC and phospholipid vesicles. The data presented here indicate the possibilities of exploring cost-effective systems to express complex proteins of therapeutic value.

  11. Storage of factor VIII variants with impaired von Willebrand factor binding in Weibel-Palade bodies in endothelial cells.

    Directory of Open Access Journals (Sweden)

    Maartje van den Biggelaar

    Full Text Available BACKGROUND: Point mutations resulting in reduced factor VIII (FVIII binding to von Willebrand factor (VWF are an important cause of mild/moderate hemophilia A. Treatment includes desmopressin infusion, which concomitantly increases VWF and FVIII plasma levels, apparently from storage pools containing both proteins. The source of these VWF/FVIII co-storage pools and the mechanism of granule biogenesis are not fully understood. METHODOLOGY/PRINCIPAL FINDINGS: We studied intracellular trafficking of FVIII variants implicated in mild/moderate hemophilia A together with VWF in HEK293 cells and primary endothelial cells. The role of VWF binding was addressed using FVIII variants displaying reduced VWF interaction. Binding studies using purified FVIII proteins revealed moderate (Arg2150His, Del2201, Pro2300Ser to severe (Tyr1680Phe, Ser2119Tyr VWF binding defects. Expression studies in HEK293 cells and primary endothelial cells revealed that all FVIII variants were present within VWF-containing organelles. Quantitative studies showed that the relative amount of FVIII storage was independent of various mutations. Substantial amounts of FVIII variants are co-stored in VWF-containing storage organelles, presumably by virtue of their ability to interact with VWF at low pH. CONCLUSIONS: Our data suggest that the potential of FVIII co-storage with VWF is not affected in mild/moderate hemophilia A caused by reduced FVIII/VWF interaction in the circulation. These data support the hypothesis that Weibel-Palade bodies comprise the desmopressin-releasable FVIII storage pool in vivo.

  12. Recurrent myocardial infarctions in a young football player secondary to thrombophilia, associated with elevated factor VIII activity

    Directory of Open Access Journals (Sweden)

    Vacek TP

    2014-10-01

    Full Text Available Thomas P Vacek, Shipeng Yu, Shahnaz Rehman, Blair P Grubb, Daniel Kosinski, Cherian Verghese, Ehab A Eltahawy, Shafiq Qaiser Department of Medicine, University of Toledo Medical Center, Toledo, OH, USAAbstract: Myocardial infarction (MI due to coronary atherosclerosis in young adults is uncommon; rare causes such as cocaine abuse, arterial dissection, and thromboembolism should be considered. A 21-year-old football player, and otherwise healthy African American man, developed chest pain during exercise while bench-pressing 400 lbs. Acute MI was diagnosed based on physical examination, electrocardiography findings, and elevated cardiac enzymes. Coronary arteriography showed a thrombus occluding the proximal left anterior descending artery (LAD. Aggressive antiplatelet therapy with aspirin, clopidogrel, and eptifibatide was pursued, in addition to standard post-MI care. This led to the successful resolution of symptoms and dissolution of the thrombus, demonstrated by repeat coronary arteriography. Five months later, he presented with similar symptoms during exercise after lifting heavy weights, and was found to have another acute MI. Coronary arteriography again showed a thrombus occluding the LAD. No evidence of coronary artery dissection or vasospasm was found. Only mild atherosclerotic plaque burden was observed on both occasions by intravascular ultrasound. A bare metal stent was placed at the site as it was thought this site had acted as a nidus for small plaque rupture and thrombus formation. Elevated serum factor VIII activity at 205% (reference range 60%–140% was found, a rare cause of hypercoagulability. Further workup revealed a patent foramen ovale during a Valsalva maneuver by transesophageal echocardiography. Both events occurred during weight lifting, which can transiently increase right heart pressure in a similar way to the Valsalva maneuver. In light of all the findings, we concluded that an exercise-related increase in factor

  13. Production of factor VIII by human liver sinusoidal endothelial cells transplanted in immunodeficient uPA mice.

    Directory of Open Access Journals (Sweden)

    Marina E Fomin

    Full Text Available Liver sinusoidal endothelial cells (LSECs form a semi-permeable barrier between parenchymal hepatocytes and the blood. LSECs participate in liver metabolism, clearance of pathological agents, immunological responses, architectural maintenance of the liver and synthesis of growth factors and cytokines. LSECs also play an important role in coagulation through the synthesis of Factor VIII (FVIII. Herein, we phenotypically define human LSECs isolated from fetal liver using flow cytometry and immunofluorescence microscopy. Isolated LSECs were cultured and shown to express endothelial markers and markers specific for the LSEC lineage. LSECs were also shown to engraft the liver when human fetal liver cells were transplanted into immunodeficient mice with liver specific expression of the urokinase-type plasminogen activator (uPA transgene (uPA-NOG mice. Engrafted cells expressed human Factor VIII at levels approaching those found in human plasma. We also demonstrate engraftment of adult LSECs, as well as hepatocytes, transplanted into uPA-NOG mice. We propose that overexpression of uPA provides beneficial conditions for LSEC engraftment due to elevated expression of the angiogenic cytokine, vascular endothelial growth factor. This work provides a detailed characterization of human midgestation LSECs, thereby providing the means for their purification and culture based on their expression of CD14 and CD32 as well as a lack of CD45 expression. The uPA-NOG mouse is shown to be a permissive host for human LSECs and adult hepatocytes, but not fetal hepatoblasts. Thus, these mice provide a useful model system to study these cell types in vivo. Demonstration of human FVIII production by transplanted LSECs encourages further pursuit of LSEC transplantation as a cellular therapy for the treatment of hemophilia A.

  14. Recurrent myocardial infarctions in a young football player secondary to thrombophilia, associated with elevated factor VIII activity.

    Science.gov (United States)

    Vacek, Thomas P; Yu, Shipeng; Rehman, Shahnaz; Grubb, Blair P; Kosinski, Daniel; Verghese, Cherian; Eltahawy, Ehab A; Shafiq, Qaiser

    2014-01-01

    Myocardial infarction (MI) due to coronary atherosclerosis in young adults is uncommon; rare causes such as cocaine abuse, arterial dissection, and thromboembolism should be considered. A 21-year-old football player, and otherwise healthy African American man, developed chest pain during exercise while bench-pressing 400 lbs. Acute MI was diagnosed based on physical examination, electrocardiography findings, and elevated cardiac enzymes. Coronary arteriography showed a thrombus occluding the proximal left anterior descending artery (LAD). Aggressive antiplatelet therapy with aspirin, clopidogrel, and eptifibatide was pursued, in addition to standard post-MI care. This led to the successful resolution of symptoms and dissolution of the thrombus, demonstrated by repeat coronary arteriography. Five months later, he presented with similar symptoms during exercise after lifting heavy weights, and was found to have another acute MI. Coronary arteriography again showed a thrombus occluding the LAD. No evidence of coronary artery dissection or vasospasm was found. Only mild atherosclerotic plaque burden was observed on both occasions by intravascular ultrasound. A bare metal stent was placed at the site as it was thought this site had acted as a nidus for small plaque rupture and thrombus formation. Elevated serum factor VIII activity at 205% (reference range 60%-140%) was found, a rare cause of hypercoagulability. Further workup revealed a patent foramen ovale during a Valsalva maneuver by transesophageal echocardiography. Both events occurred during weight lifting, which can transiently increase right heart pressure in a similar way to the Valsalva maneuver. In light of all the findings, we concluded that an exercise-related increase in factor VIII activity led to coronary arterial thrombosis in the presence of a small ruptured plaque. Alternatively, venous clots may have traversed the patent foramen ovale and occluded the LAD. In addition to continuing aggressive risk

  15. Targeting factor VIII expression to platelets for hemophilia A gene therapy does not induce an apparent thrombotic risk in mice.

    Science.gov (United States)

    Baumgartner, C K; Mattson, J G; Weiler, H; Shi, Q; Montgomery, R R

    2017-01-01

    Essentials Platelet-Factor (F) VIII gene therapy is a promising treatment in hemophilia A. This study aims to evaluate if platelet-FVIII expression would increase the risk for thrombosis. Targeting FVIII expression to platelets does not induce or elevate thrombosis risk. Platelets expressing FVIII are neither hyper-activated nor hyper-responsive. Background Targeting factor (F) VIII expression to platelets is a promising gene therapy approach for hemophilia A, and is successful even in the presence of inhibitors. It is well known that platelets play important roles not only in hemostasis, but also in thrombosis and inflammation. Objective To evaluate whether platelet-FVIII expression might increase thrombotic risk and thereby compromise the safety of this approach. Methods In this study, platelet-FVIII-expressing transgenic mice were examined either in steady-state conditions or under prothrombotic conditions induced by inflammation or the FV Leiden mutation. Native whole blood thrombin generation assay, rotational thromboelastometry analysis and ferric chloride-induced vessel injury were used to evaluate the hemostatic properties. Various parameters associated with thrombosis risk, including D-dimer, thrombin-antithrombin complexes, fibrinogen, tissue fibrin deposition, platelet activation status and activatability, and platelet-leukocyte aggregates, were assessed. Results We generated a new line of transgenic mice that expressed 30-fold higher levels of platelet-expressed FVIII than are therapeutically required to restore hemostasis in hemophilic mice. Under both steady-state conditions and prothrombotic conditions induced by lipopolysaccharide-mediated inflammation or the FV Leiden mutation, supratherapeutic levels of platelet-expressed FVIII did not appear to be thrombogenic. Furthermore, FVIII-expressing platelets were neither hyperactivated nor hyperactivatable upon agonist activation. Conclusion We conclude that, in mice, more than 30-fold higher levels of

  16. Continuous infusion of porcine factor VIII in patients with haemophilia A and high-responding inhibitors: stability and clinical experience.

    Science.gov (United States)

    O'Gorman, P; Dimichele, D M; Kasper, C K; Mannucci, P M; Santagostini, E; Hay, C R

    2001-11-01

    A multicentre retrospective survey was conducted to assess the efficacy and side-effect profile of porcine factor VIII (pFVIII:C) given by continuous infusion (CI) to patients with congenital haemophilia A and inhibitors. Twenty-nine episodes in 18 patients were treated by CI of pFVIII:C. Efficacy was graded as good in 79% of infusions and fair in 17%. There was a failed response in only one episode. Fourteen percent of patients experienced transfusion reactions with bolus doses, but no reactions were observed in patients given CI. There were no severe reactions. All the reactions resolved following interruption of the infusion and administration of steroids. Premedication did not prevent reactions. In this series the median decrease in platelet count after bolus injection of pFVIII:C was -67 X 10(9) L(-1) compared with a median decrease of -2 x 109 L(-1) during the course of CI, thus, continuous infusion of pFVIII:C appears to have less effect on platelet count than bolus injection. An anamnestic response was associated with 77% of infusions. This high rate of anamnesis reflects patient selection, in that they were all known to have high-level high-responding FVIII inhibitors with cross-reactivity to pFVIII. After reconstitution, the pFVIII:C showed little loss in factor VIII activity in solution over a 24-h period. We conclude that pFVIII:C may be effectively administered by CI to patients with haemophilia A and high-responding FVIII inhibitors. CI is the probably the mode of administration of choice for intensive replacement therapy with pFVIII.

  17. Impact of quality control matrix effect: application to the calculation of uncertainty of measurement in one-stage clotting factor VIII assay.

    Science.gov (United States)

    Sobas, Frédéric; Benattar, Norbert; Bellisario, Audrey; Marin, Sylvie; Nougier, Christophe; Lienhart, Anne; Négrier, Claude

    2010-07-01

    In Europe, the ISO 15 189 standard requires uncertainty of measurement to be calculated for all measurands. We calculated the analytical imprecision and bias of our factor VIII coagulometric assay method between 5 and 80 U/dl, using plasmas expected to be at 5, 30 and 80 U/dl of factor VIII. We implemented Meijer et al.'s [Clin Chem 2002; 48:1011-1015] long-term coefficient of variance, bias and also uncertainty of measurement calculations. Assessments used reference plasma diluted in severe haemophilic plasma, in immunodepleted factor VIII-deficient plasma and in bovine serum albumin. With plasmas diluted in severe haemophilic and immunodepleted factor VIII-deficient plasma, calculated uncertainty of measurement was 10% compared with 15% (i.e., 50% greater) for plasma diluted in albumin buffer or as calculated from European Concerted Action on Thrombosis consensus values. It is thus important to approximate the patient sample matrix to obtain as precise an estimation as possible of assay method uncertainty of measurement.

  18. EFFICACY AND SAFETY OF A MONOCLONAL PURIFIED FACTOR-VIII CONCENTRATE - 5-YEAR FOLLOW-UP IN PREVIOUSLY TREATED HIV-NEGATIVE HEMOPHILIACS

    NARCIS (Netherlands)

    SMID, WM; VANDERMEER, J; HALIE, MR

    1995-01-01

    The efficacy and safety of a monoclonal purified factor VIII concentrate (Hemofil M) were assessed in a historically controlled study in 22 HIV-negative patients with haemophilia A, previously treated with various concentrates. Data from 5 years of follow-up were compared with those from the precedi

  19. Efficacy and safety of a monoclonal purified factor-VIII concentrate - 5-year follow-up in previously treated HIV-negative hemophiliacs

    NARCIS (Netherlands)

    Smid, W. M.; van der Meer, J.; Halie, M. R.

    1995-01-01

    The efficacy and safety of a monoclonal purified factor VIII concentrate (Hemofil M) were assessed in a historically controlled study in 22 HIV-negative patients with haemophilia A, previously treated with various concentrates. Data from 5 years of follow-up were compared with those from the

  20. Novel factor VIII variants with a modified furin cleavage site improve the efficacy of gene therapy for hemophilia A.

    Science.gov (United States)

    Nguyen, G N; George, L A; Siner, J I; Davidson, R J; Zander, C B; Zheng, X L; Arruda, V R; Camire, R M; Sabatino, D E

    2017-01-01

    Essentials Factor (F) VIII is an inefficiently expressed protein. Furin deletion FVIII variants were purified and characterized using in vitro and in vivo assays. These minimally modified novel FVIII variants have enhanced function. These variants provide a strategy for increasing FVIII expression in hemophilia A gene therapy. Background The major challenge for developing gene-based therapies for hemophilia A is that human factor VIII (hFVIII) has intrinsic properties that result in inefficient biosynthesis. During intracellular processing, hFVIII is predominantly cleaved at a paired basic amino acid cleaving enzyme (PACE) or furin cleavage site to yield a heterodimer that is the major form of secreted protein. Previous studies with B-domain-deleted (BDD) canine FVIII and hFVIII-R1645H, both differing from hFVIII by a single amino acid at this site, suggested that these proteins are secreted mainly in a single polypeptide chain (SC) form and exhibit enhanced function. Objective We hypothesized that deletion(s) of the furin site modulates FVIII biology and may enhance its function. Methods A series of recombinant hFVIII-furin deletion variants were introduced into hFVIII-BDD [Δ1645, 1645-46(Δ2), 1645-47(Δ3), 1645-48(Δ4), or Δ1648] and characterized. Results In vitro, recombinant purified Δ3 and Δ4 were primarily SC and, interestingly, had 2-fold higher procoagulant activity compared with FVIII-BDD. In vivo, the variants also have improved hemostatic function. After adeno-associated viral (AAV) vector delivery, the expression of these variants is 2-4-fold higher than hFVIII-BDD. Protein challenges of each variant in mice tolerant to hFVIII-BDD showed no anti-FVIII immune response. Conclusions These data suggest that the furin deletion hFVIII variants are superior to hFVIII-BDD without increased immunogenicity. In the setting of gene-based therapeutics, these novel variants provide a unique strategy to increase FVIII expression, thus lowering the vector dose, a

  1. Factors Associated with the Time of Admission among Notified Dengue Fever Cases in Region VIII Philippines from 2008 to 2014.

    Directory of Open Access Journals (Sweden)

    Jason Echavez Abello

    2016-10-01

    Full Text Available In cases of Dengue fever, late hospital admission can lead to treatment delay and even death. In order to improve early disease notification and management, it is essential to investigate the factors affecting the time of admission of Dengue cases. This study determined the factors associated with the time of admission among notified Dengue cases. The study covered the period between 2008 and 2014 in Region VIII, Philippines. The factors assessed were age, sex, hospital sector, hospital level, disease severity based on the 1997 WHO Dengue classification, and period of admission (distinguishing between the 2010 Dengue epidemic and non-epidemic time. We analysed secondary data from the surveillance of notified Dengue cases. We calculated the association through chi-square test, ordinal logistic regression and linear regression at p value < 0.05. The study included 16,357 admitted Dengue cases. The reported cases included a majority of children (70.09%, mild cases of the disease (64.00%, patients from the public sector (69.82%, and non-tertiary hospitals (62.76%. Only 1.40% of cases had a laboratory confirmation. The epidemic period in 2010 comprised 48.68% of all the admitted cases during this period. Late admission was more likely among adults than children (p<0.05. The severe type of the disease was more likely to be admitted late than the mild type (p<0.05. Late admission was also more likely in public hospitals than in private hospitals (p<0.05; and within tertiary level hospitals than non-tertiary hospitals (p<0.05. Late admission was more likely during the non-epidemic period than the 2010 epidemic period (p<0.05. A case fatality rate of 1 or greater was significantly associated with children, severe diseases, tertiary hospitals and public hospitals when admitted late (p<0.05. Data suggests that early admission among child cases was common in Region VIII. This behavior is encouraging, and should be continued. However, further study is needed

  2. Limit of detection and threshold for positivity of the Centers for Disease Control and Prevention assay for factor VIII inhibitors.

    Science.gov (United States)

    Miller, C H; Boylan, B; Shapiro, A D; Lentz, S R; Wicklund, B M

    2017-08-10

    Essentials Immunologic methods detect factor VIII (FVIII) antibodies in some inhibitor-negative specimens. Specimens were tested by modified Nijmegen-Bethesda assay (NBA) and fluorescence immunoassay. The NBA with preanalytical heat inactivation detects FVIII inhibitors down to 0.2 NBU. IgG4 frequency validates the established threshold for positivity of ≥ 0.5 NBU for this NBA. Background The Bethesda assay for measurement of factor VIII inhibitors called for quantification of positive inhibitors by using dilutions producing 25-75% residual activity (RA), corresponding to 0.4-2.0 Bethesda units, with the use of 'more sensitive methods' for samples with RA closer to 100% being recommended. The Nijmegen modification (Nijmegen-Bethesda assay [NBA]) changed the reagents used but not these calculations. Some specimens negative by the NBA have been shown to have FVIII antibodies detectable with sensitive immunologic methods. Objective To examine the performance at very low inhibitor titers of the Centers for Disease Control and Prevention (CDC)-modified NBA (CDC-NBA), which includes preanalytic heat inactivation to liberate bound anti-FVIII antibodies. Methods Specimens with known inhibitors were tested with the CDC-NBA. IgG4 anti-FVIII antibodies were measured by fluorescence immunoassay (FLI). Results Diluted inhibitors showed linearity below 0.4 Nijmegen-Bethesda units (NBU). With four statistical methods, the limit of detection of the CDC-NBA was determined to be 0.2 NBU. IgG4 anti-FVIII antibodies, which correlate most strongly with functional inhibitors, were present at rates above the background rate of healthy controls in specimens with titers ≥ 0.2 NBU and showed an increase in frequency from 14.3% at 0.4 NBU to 67% at the established threshold for positivity of 0.5 NBU. Conclusions The CDC-NBA can detect inhibitors down to 0.2 NBU. The FLI, which is more sensitive, demonstrates anti-FVIII IgG4 in some patients with negative (NBA, supporting the need for

  3. Phenotypic correction and stable expression of factor VIII in hemophilia A mice by embryonic stem cell therapy.

    Science.gov (United States)

    Wang, J J; Kuang, Y; Zhang, L L; Shen, C L; Wang, L; Lu, S Y; Lu, X B; Fei, J; Gu, M M; Wang, Z G

    2013-05-13

    Hereditary deficiency of factor VIII (FVIII) leads to hemophilia A, a severe X-linked bleeding disorder. Current therapies include fixed-dose FVIII prophylaxis, factor replacement therapy, and most recently, gene therapy. Prophylaxis and FVIII replacement therapies are limited by incomplete efficacy, high cost, restricted availability, and development of neutralizing antibodies in chronically treated individuals. Limited success has been obtained in preclinical trials using gene therapy for the treatment of hemophilia. Therefore, new options for therapy for hemophilia A are needed. We evaluated the potential of embryonic stem cells for correcting hemophilia A in mice. FVIII-deficient mouse blastocysts were collected and injected with mouse embryonic stem cells stably expressing green-fluorescent protein (GFP) and transferred to pseudopregnant recipient mice. Expression of FVIII was measured in the liver and plasma of the 5 chimeric mice that were produced. Three of these mice were GFP-positive at the age of 6 months. The plasma FVIII activity levels were equal to those of wild-type mice. These data demonstrate that embryonic stem cell transplantation at an early embryonic stage has potential as therapy for this progressively debilitating, life-threatening bleeding disorder.

  4. In vivo expansion of regulatory T cells with IL-2/IL-2 mAb complexes prevents anti-factor VIII immune responses in hemophilia A mice treated with factor VIII plasmid-mediated gene therapy.

    Science.gov (United States)

    Liu, Chao-Lien; Ye, Peiqing; Yen, Benjamin C; Miao, Carol H

    2011-08-01

    Generation of transgene-specific immune responses can constitute a major complication following gene therapy treatment. An in vivo approach to inducing selective expansion of Regulatory T (Treg) cells by injecting interleukin-2 (IL-2) mixed with a specific IL-2 monoclonal antibody (JES6-1) was adopted to modulate anti-factor VIII (anti-FVIII) immune responses. Three consecutive IL-2 complexes treatments combined with FVIII plasmid injection prevented anti-FVIII formation and achieved persistent, therapeutic-level of FVIII expression in hemophilia A (HemA) mice. The IL-2 complexes treatment expanded CD4(+)CD25(+)Foxp3(+) Treg cells five- to sevenfold on peak day, and they gradually returned to normal levels within 7-14 days without changing other lymphocyte populations. The transiently expanded Treg cells are highly activated and display suppressive function in vitro. Adoptive transfer of the expanded Treg cells protected recipient mice from generation of high-titer antibodies following FVIII plasmid challenge. Repeated plasmid transfer is applicable in tolerized mice without eliciting immune responses. Mice treated with IL-2 complexes mounted immune responses against both T-dependent and T-independent neoantigens, indicating that IL-2 complexes did not hamper the immune system for long. These results demonstrate the important role of Treg cells in suppressing anti-FVIII immune responses and the potential of developing Treg cell expansion therapies that induce long-term tolerance to FVIII.

  5. Evaluation of the expression of VIII factor and VEGF in the regeneration of non-vital teeth in dogs using propolis

    Directory of Open Access Journals (Sweden)

    Mina Zarei

    2017-02-01

    Full Text Available Objective(s: The purpose of the present study was the immunohistochemical evaluation of VEGF and VII factors in dog’s teeth pulp revascularized with MTA and propolis. Materials and Methods: 144 mature and immature two rooted dog’s premolar canals were selected.  Pulp necrosis and infection were established after 2 weeks and the disinfection of the canals was done with copious NaOCl irrigation and triantibiotic mixture (ciprofloxacin, metronidazole, and minocycline for 3 weeks. Subsequently, the blood clot was evoked in the canal by periapical tissue irritation with a k-file. The samples were randomly divided into 6 experimental groups: propolis (groups 1, 2, MTA (groups 3, 4, and parafilm (groups 5, 6 in immature and mature teeth. The animals were sacrificed and samples were prepared for immunohistochemical evaluation of VEGF and the VIII factor. Results: Tissue regeneration was seen in 64.5% of MTA, 38% of propolis, and 0% of parafilm group samples. Expression of VEGF and VIII factor in the propolis group was more than the MTA group and it showed a reduction after 3 months in comparison to 1 month. VEGF and VIII factor were seen in stromal cells in addition to endothelial vessel cells. Overall, expression of angiogenic factors was more in the open apex teeth compared to close apex ones. Conclusion: According to the results of this study, propolis can induce the expression of VEGF and VIII factor in infected mature and immature dog’s teeth and is a suitable biomaterial for the revascularization technique.

  6. Evaluation of the expression of VIII factor and VEGF in the regeneration of non-vital teeth in dogs using propolis

    Science.gov (United States)

    Zarei, Mina; Jafarian, Amir Hossein; Harandi, Azadeh; Javidi, Maryam; Gharechahi, Maryam

    2017-01-01

    Objective(s): The purpose of the present study was the immunohistochemical evaluation of VEGF and VII factors in dog’s teeth pulp revascularized with MTA and propolis. Materials and Methods: 144 mature and immature two rooted dog’s premolar canals were selected. Pulp necrosis and infection were established after 2 weeks and the disinfection of the canals was done with copious NaOCl irrigation and triantibiotic mixture (ciprofloxacin, metronidazole, and minocycline) for 3 weeks. Subsequently, the blood clot was evoked in the canal by periapical tissue irritation with a k-file. The samples were randomly divided into 6 experimental groups: propolis (groups 1, 2), MTA (groups 3, 4), and parafilm (groups 5, 6) in immature and mature teeth. The animals were sacrificed and samples were prepared for immunohistochemical evaluation of VEGF and the VIII factor. Results: Tissue regeneration was seen in 64.5% of MTA, 38% of propolis, and 0% of parafilm group samples. Expression of VEGF and VIII factor in the propolis group was more than the MTA group and it showed a reduction after 3 months in comparison to 1 month. VEGF and VIII factor were seen in stromal cells in addition to endothelial vessel cells. Overall, expression of angiogenic factors was more in the open apex teeth compared to close apex ones. Conclusion: According to the results of this study, propolis can induce the expression of VEGF and VIII factor in infected mature and immature dog’s teeth and is a suitable biomaterial for the revascularization technique. PMID:28293394

  7. Overexpression of factor VIII after AAV delivery is transiently associated with cellular stress in hemophilia A mice

    Directory of Open Access Journals (Sweden)

    Amy M Lange

    2016-01-01

    Full Text Available Factor VIII (FVIII is a large glycoprotein that is challenging to express both in vitro and in vivo. Several studies suggest that high levels of FVIII expression can lead to cellular stress. After gene transfer, transgene expression is restricted to a subset of cells and the increased FVIII load per cell may impact activation of the unfolded protein response. We sought to determine whether increased FVIII expression in mice after adeno-associated viral liver gene transfer would affect the unfolded protein response and/or immune response to the transgene. The FVIII gene was delivered as B-domain deleted single chain or two chain (light and heavy chains at a range of doses in hemophilia A mice. A correlation between FVIII expression and anti-FVIII antibody titers was observed. Analysis of key components of the unfolded protein response, binding immunoglobulin protein (BiP, and C/EBP homologous protein (CHOP, showed transient unfolded protein response activation in the single chain treated group expressing >200% of FVIII but not after two chain delivery. These studies suggest that supraphysiological single chain FVIII expression may increase the likelihood of a cellular stress response but does not alter liver function. These data are in agreement with the observed long-term expression of FVIII at therapeutic levels after adeno-associated viral delivery in hemophilia A dogs without evidence of cellular toxicity.

  8. A novel cell-sheet technology that achieves durable factor VIII delivery in a mouse model of hemophilia A.

    Science.gov (United States)

    Tatsumi, Kohei; Sugimoto, Mitsuhiko; Lillicrap, David; Shima, Midori; Ohashi, Kazuo; Okano, Teruo; Matsui, Hideto

    2013-01-01

    Gene- or cell-based therapies aimed at creating delivery systems for coagulation factor VIII (FVIII) protein have emerged as promising options for hemophilia A treatment. However, several issues remain to be addressed regarding the efficacies and adverse events of these new classes of therapies. To improve an existing cell-based therapy involving the subcutaneous transplantation of FVIII-transduced blood outgrowth endothelial cells (BOECs), we employed a novel cell-sheet technology that allows individual dispersed cells to form a thin and contiguous monolayer without traditional bioabsorbable scaffold matrices. Compared to the traditional methodology, our cell-sheet approach resulted in longer-term and 3-5-fold higher expression of FVIII (up to 11% of normal) in recipient hemophilia A mice that lacked a FVIII humoral immune response due to transient immunosuppression with cyclophosphamide. Histological studies revealed that the transplanted BOEC sheets were structured as flat clusters, supporting the long-term expression of therapeutic FVIII in plasma from an ectopic subcutaneous space. Our novel tissue-engineering approach using genetically modified BOEC sheets could aid in development of cell-based therapy that will allow safe and effective in vivo delivery of functional FVIII protein in patients with hemophilia A.

  9. A novel cell-sheet technology that achieves durable factor VIII delivery in a mouse model of hemophilia A.

    Directory of Open Access Journals (Sweden)

    Kohei Tatsumi

    Full Text Available Gene- or cell-based therapies aimed at creating delivery systems for coagulation factor VIII (FVIII protein have emerged as promising options for hemophilia A treatment. However, several issues remain to be addressed regarding the efficacies and adverse events of these new classes of therapies. To improve an existing cell-based therapy involving the subcutaneous transplantation of FVIII-transduced blood outgrowth endothelial cells (BOECs, we employed a novel cell-sheet technology that allows individual dispersed cells to form a thin and contiguous monolayer without traditional bioabsorbable scaffold matrices. Compared to the traditional methodology, our cell-sheet approach resulted in longer-term and 3-5-fold higher expression of FVIII (up to 11% of normal in recipient hemophilia A mice that lacked a FVIII humoral immune response due to transient immunosuppression with cyclophosphamide. Histological studies revealed that the transplanted BOEC sheets were structured as flat clusters, supporting the long-term expression of therapeutic FVIII in plasma from an ectopic subcutaneous space. Our novel tissue-engineering approach using genetically modified BOEC sheets could aid in development of cell-based therapy that will allow safe and effective in vivo delivery of functional FVIII protein in patients with hemophilia A.

  10. Nanocapsule-delivered Sleeping Beauty mediates therapeutic Factor VIII expression in liver sinusoidal endothelial cells of hemophilia A mice.

    Science.gov (United States)

    Kren, Betsy T; Unger, Gretchen M; Sjeklocha, Lucas; Trossen, Alycia A; Korman, Vicci; Diethelm-Okita, Brenda M; Reding, Mark T; Steer, Clifford J

    2009-07-01

    Liver sinusoidal endothelial cells are a major endogenous source of Factor VIII (FVIII), lack of which causes the human congenital bleeding disorder hemophilia A. Despite extensive efforts, gene therapy using viral vectors has shown little success in clinical hemophilia trials. Here we achieved cell type-specific gene targeting using hyaluronan- and asialoorosomucoid-coated nanocapsules, generated using dispersion atomization, to direct genes to liver sinusoidal endothelial cells and hepatocytes, respectively. To highlight the therapeutic potential of this approach, we encapsulated Sleeping Beauty transposon expressing the B domain-deleted canine FVIII in cis with Sleeping Beauty transposase in hyaluronan nanocapsules and injected them intravenously into hemophilia A mice. The treated mice exhibited activated partial thromboplastin times that were comparable to those of wild-type mice at 5 and 50 weeks and substantially shorter than those of untreated controls at the same time points. Further, plasma FVIII activity in the treated hemophilia A mice was nearly identical to that in wild-type mice through 50 weeks, while untreated hemophilia A mice exhibited no detectable FVIII activity. Thus, Sleeping Beauty transposon targeted to liver sinusoidal endothelial cells provided long-term expression of FVIII, without apparent antibody formation, and improved the phenotype of hemophilia A mice.

  11. An Acquired Factor VIII Inhibitor in a Patient with HIV and HCV: A Case Presentation and Literature Review

    Directory of Open Access Journals (Sweden)

    S. B. Zeichner

    2013-01-01

    Full Text Available Introduction. Despite its low incidence, acquired factor VIII inhibitor is the most common autoantibody affecting the clotting cascade. The exact mechanism of acquisition remains unclear, but postpartum patients, those with autoimmune conditions or malignancies, and those with exposure to particular drugs appear most susceptible. There have been several case reports describing acquired FVIII inhibitors in patients receiving interferon alpha for HCV treatment and in patients being treated for HIV. To our knowledge, this is the first case of a patient with HCV and HIV who was not actively receiving treatment for either condition. Case Presentation. A 57-year-old Caucasian male with a history of HIV and HCV was admitted to our hospital for a several day history of progressively worsening right thigh bruising and generalized weakness. CTA of the abdominal arteries revealed large bilateral retroperitoneal hematomas. Laboratory studies revealed the presence of a high titer FVIII inhibitor. Conclusion. Our case of a very rare condition highlights the importance of recognizing and understanding the diagnosis of acquired FVIII inhibitor. Laboratory research and clinical data on the role of newer agents are needed in order to better characterize disease pathogenesis, disease associations, genetic markers, and optimal disease management.

  12. Overexpression of factor VIII after AAV delivery is transiently associated with cellular stress in hemophilia A mice

    Science.gov (United States)

    Lange, Amy M; Altynova, Ekaterina S; Nguyen, Giang N; Sabatino, Denise E

    2016-01-01

    Factor VIII (FVIII) is a large glycoprotein that is challenging to express both in vitro and in vivo. Several studies suggest that high levels of FVIII expression can lead to cellular stress. After gene transfer, transgene expression is restricted to a subset of cells and the increased FVIII load per cell may impact activation of the unfolded protein response. We sought to determine whether increased FVIII expression in mice after adeno-associated viral liver gene transfer would affect the unfolded protein response and/or immune response to the transgene. The FVIII gene was delivered as B-domain deleted single chain or two chain (light and heavy chains) at a range of doses in hemophilia A mice. A correlation between FVIII expression and anti-FVIII antibody titers was observed. Analysis of key components of the unfolded protein response, binding immunoglobulin protein (BiP), and C/EBP homologous protein (CHOP), showed transient unfolded protein response activation in the single chain treated group expressing >200% of FVIII but not after two chain delivery. These studies suggest that supraphysiological single chain FVIII expression may increase the likelihood of a cellular stress response but does not alter liver function. These data are in agreement with the observed long-term expression of FVIII at therapeutic levels after adeno-associated viral delivery in hemophilia A dogs without evidence of cellular toxicity. PMID:27738645

  13. Enhancement of pig embryonic implants in factor VIII KO mice: a novel role for the coagulation cascade in organ size control.

    Directory of Open Access Journals (Sweden)

    Anna Aronovich

    Full Text Available Very little is known about the mechanisms that contribute to organ size differences between species. In the present study, we used a mouse model of embryonic pig tissue implantation to define the role of host Factor VIII in controlling the final size attained by the implant. We show here that pig embryonic spleen, pancreas, and liver all grow to an increased size in mice that are deficient in the Factor VIII clotting cascade. Similar results were obtained using the transplantation model after treatment with the low molecular weight heparin derivative Clexane which markedly enhanced transplant size. Likewise, enhanced size was found upon treatment with the direct thrombin inhibitor Dabigatran, suggesting that organ size regulation might be mediated by thrombin, downstream of Factor VIII. Considering that thrombin was shown to mediate various functions unrelated to blood clotting, either directly by cleavage of protease-activated receptors (PARs or indirectly by cleaving osteopontin (OPN on stroma cells, the role of PAR1 and PAR4 antagonists as well as treatment with cleaved form of OPN (tcOPN were tested. While the former was not found to have an impact on overgrowth of embryonic pig spleen implants, marked reduction of size was noted upon treatment with the (tcOPN. Collectively, our surprising set of observations suggests that factors of the coagulation cascade have a novel role in organ size control.

  14. Lineages of human T-cell clones, including T helper 17/T helper 1 cells, isolated at different stages of anti–factor VIII immune responses

    OpenAIRE

    Ettinger, Ruth A.; James, Eddie A.; Kwok, William W.; Arthur R Thompson; Pratt, Kathleen P.

    2009-01-01

    The development of neutralizing antibodies (inhibitors) after factor VIII (FVIII) infusions is a serious complication that affects approximately one-quarter of hemophilia A patients who have access to replacement therapy. To investigate the differentiation of naive T cells into FVIII-specific helper T cells that promote B-cell activation and antibody secretion, HLA-DRA-DRB1*0101-restricted T-cell clones that respond to a specific epitope in FVIII were isolated from a mild hemophilia A subject...

  15. Identification and multidimensional optimization of an asymmetric bispecific IgG antibody mimicking the function of factor VIII cofactor activity.

    Directory of Open Access Journals (Sweden)

    Zenjiro Sampei

    Full Text Available In hemophilia A, routine prophylaxis with exogenous factor VIII (FVIII requires frequent intravenous injections and can lead to the development of anti-FVIII alloantibodies (FVIII inhibitors. To overcome these drawbacks, we screened asymmetric bispecific IgG antibodies to factor IXa (FIXa and factor X (FX, mimicking the FVIII cofactor function. Since the therapeutic potential of the lead bispecific antibody was marginal, FVIII-mimetic activity was improved by modifying its binding properties to FIXa and FX, and the pharmacokinetics was improved by engineering the charge properties of the variable region. Difficulties in manufacturing the bispecific antibody were overcome by identifying a common light chain for the anti-FIXa and anti-FX heavy chains through framework/complementarity determining region shuffling, and by pI engineering of the two heavy chains to facilitate ion exchange chromatographic purification of the bispecific antibody from the mixture of byproducts. Engineering to overcome low solubility and deamidation was also performed. The multidimensionally optimized bispecific antibody hBS910 exhibited potent FVIII-mimetic activity in human FVIII-deficient plasma, and had a half-life of 3 weeks and high subcutaneous bioavailability in cynomolgus monkeys. Importantly, the activity of hBS910 was not affected by FVIII inhibitors, while anti-hBS910 antibodies did not inhibit FVIII activity, allowing the use of hBS910 without considering the development or presence of FVIII inhibitors. Furthermore, hBS910 could be purified on a large manufacturing scale and formulated into a subcutaneously injectable liquid formulation for clinical use. These features of hBS910 enable routine prophylaxis by subcutaneous delivery at a long dosing interval without considering the development or presence of FVIII inhibitors. We expect that hBS910 (investigational drug name: ACE910 will provide significant benefit for severe hemophilia A patients.

  16. Factor VIII Is Synthesized in Human Endothelial Cells, Packaged in Weibel-Palade Bodies and Secreted Bound to ULVWF Strings.

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    Nancy A Turner

    Full Text Available The cellular synthesis site and ensuing storage location for human factor VIII (FVIII, the coagulation protein deficient in hemophilia A, has been elusive. FVIII stability and half-life is dependent on non-covalent complex formation with von Willebrand factor (VWF to avoid proteolysis and clearance. VWF is synthesized in megakaryocytes and endothelial cells, and is stored and secreted from platelet alpha granules and Weibel-Palade bodies of endothelial cells. In this paper we provide direct evidence for FVIII synthesis in 2 types of primary human endothelial cells: glomerular microvascular endothelial cells (GMVECs and umbilical vein endothelial cells (HUVECs. Gene expression quantified by real time PCR revealed that levels of F8 and VWF are similar in GMVECs and HUVECs. Previous clinical studies have shown that stimulation of vasopressin V2 receptors causes parallel secretion of both proteins. In this study, we found that both endothelial cell types express AVPR2 (vasopressin V2 receptor gene and that AVPR2 mRNA levels are 5-fold higher in GMVECs than HUVECs. FVIII and VWF proteins were detected by fluorescent microscopy in Weibel-Palade bodies within GMVECs and HUVECs using antibodies proven to be target specific. Visual presence of FVIII and VWF in Weibel-Palade bodies was confirmed by correlation measurements. The high extent of correlation was compared with negative correlation values obtained from FVIII detection with cytoplasmic proteins, β-actin and Factor H. FVIII activity was positive in GMVEC and HUVEC cell lysates. Stimulated GMVECs and HUVECs were found to secrete cell-anchored ultra-large VWF strings covered with bound FVIII.

  17. Factor VIII Is Synthesized in Human Endothelial Cells, Packaged in Weibel-Palade Bodies and Secreted Bound to ULVWF Strings.

    Science.gov (United States)

    Turner, Nancy A; Moake, Joel L

    2015-01-01

    The cellular synthesis site and ensuing storage location for human factor VIII (FVIII), the coagulation protein deficient in hemophilia A, has been elusive. FVIII stability and half-life is dependent on non-covalent complex formation with von Willebrand factor (VWF) to avoid proteolysis and clearance. VWF is synthesized in megakaryocytes and endothelial cells, and is stored and secreted from platelet alpha granules and Weibel-Palade bodies of endothelial cells. In this paper we provide direct evidence for FVIII synthesis in 2 types of primary human endothelial cells: glomerular microvascular endothelial cells (GMVECs) and umbilical vein endothelial cells (HUVECs). Gene expression quantified by real time PCR revealed that levels of F8 and VWF are similar in GMVECs and HUVECs. Previous clinical studies have shown that stimulation of vasopressin V2 receptors causes parallel secretion of both proteins. In this study, we found that both endothelial cell types express AVPR2 (vasopressin V2 receptor gene) and that AVPR2 mRNA levels are 5-fold higher in GMVECs than HUVECs. FVIII and VWF proteins were detected by fluorescent microscopy in Weibel-Palade bodies within GMVECs and HUVECs using antibodies proven to be target specific. Visual presence of FVIII and VWF in Weibel-Palade bodies was confirmed by correlation measurements. The high extent of correlation was compared with negative correlation values obtained from FVIII detection with cytoplasmic proteins, β-actin and Factor H. FVIII activity was positive in GMVEC and HUVEC cell lysates. Stimulated GMVECs and HUVECs were found to secrete cell-anchored ultra-large VWF strings covered with bound FVIII.

  18. The prevalence of latex sensitisation and allergy and associated risk factors among healthcare workers using hypoallergenic latex gloves at King Edward VIII Hospital, KwaZulu-Natal South Africa: a cross-sectional study

    National Research Council Canada - National Science Library

    Phaswana, Shumani Makwarela; Naidoo, Saloshni

    2013-01-01

    The present study describes latex sensitisation and allergy prevalence and associated factors among healthcare workers using hypoallergenic latex gloves at King Edward VIII Hospital in KwaZulu-Natal, South Africa...

  19. Therapeutic levels of human factor VIII in mice implanted with encapsulated cells: potential for gene therapy of haemophilia A.

    Science.gov (United States)

    García-Martín, Carmen; Chuah, Marinee K L; Van Damme, An; Robinson, Kelly E; Vanzieleghem, Beatrijs; Saint-Remy, Jean-Marie; Gallardo, Dominique; Ofosu, Frederick A; Vandendriessche, Thierry; Hortelano, Gonzalo

    2002-01-01

    A gene therapy delivery system based on microcapsules enclosing recombinant cells engineered to secrete a therapeutic protein has been evaluated. The microcapsules are implanted intraperitoneally. In order to prevent cell immune rejection, cells are enclosed in non-antigenic biocompatible alginate microcapsules prior to their implantation into mice. It has been shown that encapsulated myoblasts can deliver therapeutic levels of Factor IX (FIX) in mice. The delivery of human Factor VIII (hFVIII) in mice using microcapsules was evaluated in this study. Mouse C2C12 myoblasts and canine MDCK epithelial kidney cells were transduced with MFG-FVIII (B-domain deleted) vector. Selected recombinant clones were enclosed in alginate microcapsules. Encapsulated recombinant clones were subsequently implanted intraperitoneally into C57BL/6 and immunodeficient SCID mice. Plasma of mice receiving C2C12 and encapsulated MDCK cells had transient therapeutic levels of FVIII in immunocompetent C57BL/6 mice (up to 20% and 7% of physiological levels, respectively). In addition, FVIII delivery in SCID mice was also transient, suggesting that a non-immune mechanism must have contributed to the decline of hFVIII in plasma. Quantitative RT-PCR analysis confirmed directly that the decline of hFVIII is due to a reduction in steady-state hFVIII mRNA, consistent with transcriptional repression. Furthermore, encapsulated cells retrieved from implanted mice were viable, but secreted FVIII ex vivo at three-fold lower levels than the pre-implantation levels. In addition, antibodies to hFVIII were detected in immunocompetent C57BL/6 mice. Implantable microcapsules can deliver therapeutic levels of FVIII in mice, suggesting the potential of this gene therapy approach for haemophilia A. The findings suggest vector down-regulation in vivo. Copyright 2002 John Wiley & Sons, Ltd.

  20. Endothelial cell processing and alternatively spliced transcripts of factor VIII: potential implications for coagulation cascades and pulmonary hypertension.

    Directory of Open Access Journals (Sweden)

    Claire L Shovlin

    Full Text Available BACKGROUND: Coagulation factor VIII (FVIII deficiency leads to haemophilia A. Conversely, elevated plasma levels are a strong predictor of recurrent venous thromboemboli and pulmonary hypertension phenotypes in which in situ thromboses are implicated. Extrahepatic sources of plasma FVIII are implicated, but have remained elusive. METHODOLOGY/PRINCIPAL FINDINGS: Immunohistochemistry of normal human lung tissue, and confocal microscopy, flow cytometry, and ELISA quantification of conditioned media from normal primary endothelial cells were used to examine endothelial expression of FVIII and coexpression with von Willebrand Factor (vWF, which protects secreted FVIII heavy chain from rapid proteloysis. FVIII transcripts predicted from database mining were identified by RT-PCR and sequencing. FVIII mAb-reactive material was demonstrated in CD31+ endothelial cells in normal human lung tissue, and in primary pulmonary artery, pulmonary microvascular, and dermal microvascular endothelial cells. In pulmonary endothelial cells, this protein occasionally colocalized with vWF, centered on Weibel Palade bodies. Pulmonary artery and pulmonary microvascular endothelial cells secreted low levels of FVIII and vWF to conditioned media, and demonstrated cell surface expression of FVIII and vWF Ab-reacting proteins compared to an isotype control. Four endothelial splice isoforms were identified. Two utilize transcription start sites in alternate 5' exons within the int22h-1 repeat responsible for intron 22 inversions in 40% of severe haemophiliacs. A reciprocal relationship between the presence of short isoforms and full-length FVIII transcript suggested potential splice-switching mechanisms. CONCLUSIONS/SIGNIFICANCE: The pulmonary endothelium is confirmed as a site of FVIII secretion, with evidence of synthesis, cell surface expression, and coexpression with vWF. There is complex alternate transcription initiation from the FVIII gene. These findings provide a

  1. A population pharmacokinetic model for perioperative dosing of factor VIII in hemophilia A patients

    NARCIS (Netherlands)

    Hazendonk, Hendrika; Fijnvandraat, Karin; Lock, Janske; Driessens, Mariette; van der Meer, Felix; Meijer, Karina; Kruip, Marieke; Laros-van Gorkom, Britta; Peters, Marjolein; de Wildt, Saskia; Leebeek, Frank; Cnossen, Marjon; Mathot, Ron

    2016-01-01

    The role of pharmacokinetic-guided dosing of factor concentrates in hemophilia is currently a subject of debate and focuses on long-term prophylactic treatment. Few data are available on its impact in the perioperative period. In this study, a population pharmacokinetic model for currently registere

  2. A population pharmacokinetic model for perioperative dosing of factor VIII in hemophilia A patients

    NARCIS (Netherlands)

    Hazendonk, Hendrika; Fijnvandraat, Karin; Lock, Janske; Driessens, Mariette; van der Meer, Felix; Meijer, Karina; Kruip, Marieke; Laros-van Gorkom, Britta; Peters, Marjolein; de Wildt, Saskia; Leebeek, Frank; Cnossen, Marjon; Mathot, Ron

    2016-01-01

    The role of pharmacokinetic-guided dosing of factor concentrates in hemophilia is currently a subject of debate and focuses on long-term prophylactic treatment. Few data are available on its impact in the perioperative period. In this study, a population pharmacokinetic model for currently

  3. Associations between high factor VIII and low free protein S levels with traditional arterial thrombotic risk factors and their risk on arterial thrombosis : Results from a retrospective family cohort study

    NARCIS (Netherlands)

    Mulder, Rene; van Schouwenburg, Inge M.; Mahmoodi, Bakhtawar K.; Veeger, Nic J. G. M.; Mulder, Andre B.; Middeldorp, Saskia; Kluin-Nelemans, Hanneke C.; Lijfering, Willem M.

    2010-01-01

    Introduction: Whether high factor (F)VIII and low free protein S levels are risk factors for arterial thrombosis is unclarified. Material and Methods: In a post-hoc analysis of a single-centre retrospective family cohort, we determined if these two proteins could increase the risk of arterial

  4. Factor VIII delivery devices in haemophilia A. Barriers and drivers for treatment adherence.

    Science.gov (United States)

    Fernández-Arias, Isabel; Kim, Hae Kyung

    2016-11-01

    Introducción y objetivo: Recabar la experiencia de pacientes con hemofilia A con sus dispositivos de reconstitucion de factor de coagulacion, barreras para la adherencia y determinar sus preferencias, presentando una nueva jeringa de doble camara (JDC). Método: Investigacion transversal mediante encuesta dirigida y sesion de prueba de la JDC. Resultados: Participaron 74 pacientes, el 50% en tratamiento con profilaxis, y 7 anos (mediana) con su tratamiento habitual (RIC 17,25). En la encuesta, la JDC recibio la mayor puntuacion (75/100, p probabilidad de uso en profilaxis (p probabilidad de favorecer la profilaxis.

  5. Transient B cell depletion or improved transgene expression by codon optimization promote tolerance to factor VIII in gene therapy.

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    Brandon K Sack

    Full Text Available The major complication in the treatment of hemophilia A is the development of neutralizing antibodies (inhibitors against factor VIII (FVIII. The current method for eradicating inhibitors, termed immune tolerance induction (ITI, is costly and protracted. Clinical protocols that prevent rather than treat inhibitors are not yet established. Liver-directed gene therapy hopes to achieve long-term correction of the disease while also inducing immune tolerance. We sought to investigate the use of adeno-associated viral (serotype 8 gene transfer to induce tolerance to human B domain deleted FVIII in hemophilia A mice. We administered an AAV8 vector with either human B domain deleted FVIII or a codon-optimized transgene, both under a liver-specific promoter to two strains of hemophilia A mice. Protein therapy or gene therapy was given either alone or in conjunction with anti-CD20 antibody-mediated B cell depletion. Gene therapy with a low-expressing vector resulted in sustained near-therapeutic expression. However, supplementary protein therapy revealed that gene transfer had sensitized mice to hFVIII in a high-responder strain but not in mice of a low-responding strain. This heightened response was ameliorated when gene therapy was delivered with anti-murine CD20 treatment. Transient B cell depletion prevented inhibitor formation in protein therapy, but failed to achieve a sustained hypo-responsiveness. Importantly, use of a codon-optimized hFVIII transgene resulted in sustained therapeutic expression and tolerance without a need for B cell depletion. Therefore, anti-CD20 may be beneficial in preventing vector-induced immune priming to FVIII, but higher levels of liver-restricted expression are preferred for tolerance.

  6. Characterization of Adeno-Associated Viral Vector-Mediated Human Factor VIII Gene Therapy in Hemophilia A Mice.

    Science.gov (United States)

    Greig, Jenny A; Wang, Qiang; Reicherter, Amanda L; Chen, Shu-Jen; Hanlon, Alexandra L; Tipper, Christopher H; Clark, K Reed; Wadsworth, Samuel; Wang, Lili; Wilson, James M

    2017-05-01

    Adeno-associated viral (AAV) vectors are promising vehicles for hemophilia gene therapy, with favorable clinical trial data seen in the treatment of hemophilia B. In an effort to optimize the expression of human coagulation factor VIII (hFVIII) for the treatment of hemophilia A, an extensive study was performed with numerous combinations of liver-specific promoter and enhancer elements with a codon-optimized hFVIII transgene. After generating 42 variants of three reduced-size promoters and three small enhancers, transgene cassettes were packaged within a single AAV capsid, AAVrh10, to eliminate performance differences due to the capsid type. Each hFVIII vector was administered to FVIII knockout (KO) mice at a dose of 10(10) genome copies (GC) per mouse. Criteria for distinguishing the performance of the different enhancer/promoter combinations were established prior to the initiation of the studies. These criteria included prominently the level of hFVIII activity (0.12-2.12 IU/mL) and the pattern of development of anti-hFVIII antibodies. In order to evaluate the impact of capsid on hFVIII expression and antibody formation, one of the enhancer and promoter combinations that exhibited high hFVIII immunogenicity was evaluated using AAV8, AAV9, AAVrh10, AAVhu37, and AAVrh64R1 capsids. The capsids subdivided into two groups: those that generated anti-hFVIII antibodies in ≤20% of mice (AAV8 and AAV9), and those that generated anti-hFVIII antibodies in >20% of mice (AAVrh10, AAVhu37, and AAVrh64R1). The results of this study, which entailed extensive vector optimization and in vivo testing, demonstrate the significant impact that transcriptional control elements and capsid can have on vector performance.

  7. The mesenchymal stem cells derived from transgenic mice carrying human coagulation factor VIII can correct phenotype in hemophilia A mice.

    Science.gov (United States)

    Wang, Qing; Gong, Xiuli; Gong, Zhijuan; Ren, Xiaoyie; Ren, Zhaorui; Huang, Shuzhen; Zeng, Yitao

    2013-12-20

    Hemophilia A (HA) is an inherited X-linked recessive bleeding disorder caused by coagulant factor VIII (FVIII) deficiency. Previous studies showed that introduction of mesenchymal stem cells (MSCs) modified by FVIII-expressing retrovirus may result in phenotypic correction of HA animals. This study aimed at the investigation of an alternative gene therapy strategy that may lead to sustained FVIII transgene expression in HA mice. B-domain-deleted human FVIII (hFVIIIBD) vector was microinjected into single-cell embryos of wild-type mice to generate a transgenic mouse line, from which hFVIIIBD-MSCs were isolated, followed by transplantation into HA mice. RT-PCR and real-time PCR analysis demonstrated the expression of hFVIIIBD in multi-organs of recipient HA mice. Immunohistochemistry showed the presence of hFVIIIBD positive staining in multi-organs of recipient HA mice. ELISA indicated that plasma hFVIIIBD level in recipient mice reached its peak (77 ng/mL) at the 3rd week after implantation, and achieved sustained expression during the 5-week observation period. Plasma FVIII activities of recipient HA mice increased from 0% to 32% after hFVIIIBD-MSCs transplantation. APTT (activated partial thromboplastin time) value decreased in hFVIIIBD-MSCs transplanted HA mice compared with untreated HA mice (45.5 s vs. 91.3 s). Our study demonstrated an effective phenotypic correction in HA mice using genetically modified MSCs from hFVIIIBD transgenic mice. Copyright © 2013. Published by Elsevier Ltd.

  8. A sequence variation scan of the coagulation factor VIII (FVIII) structural gene and associations with plasma FVIII activity levels.

    Science.gov (United States)

    Viel, Kevin R; Machiah, Deepa K; Warren, Diane M; Khachidze, Manana; Buil, Alfonso; Fernstrom, Karl; Souto, Juan C; Peralta, Juan M; Smith, Todd; Blangero, John; Porter, Sandra; Warren, Stephen T; Fontcuberta, Jordi; Soria, Jose M; Flanders, W Dana; Almasy, Laura; Howard, Tom E

    2007-05-01

    Plasma factor VIII coagulant activity (FVIII:C) level is a highly heritable quantitative trait that is strongly correlated with thrombosis risk. Polymorphisms within only 1 gene, the ABO blood-group locus, have been unequivocally demonstrated to contribute to the broad population variability observed for this trait. Because less than 2.5% of the structural FVIII gene (F8) has been examined previously, we resequenced all known functional regions in 222 potentially distinct alleles from 137 unrelated nonhemophilic individuals representing 7 racial groups. Eighteen of the 47 variants identified, including 17 single-nucleotide polymorphisms (SNPs), were previously unknown. As the degree of linkage disequilibrium across F8 was weak overall, we used measured-genotype association analysis to evaluate the influence of each polymorphism on the FVIII:C levels in 398 subjects from 21 pedigrees known as the Genetic Analysis of Idiopathic Thrombophilia project (GAIT). Our results suggested that 92714C>G, a nonsynonymous SNP encoding the B-domain substitution D1241E, was significantly associated with FVIII:C level. After accounting for important covariates, including age and ABO genotype, the association persisted with each C-allele additively increasing the FVIII:C level by 14.3 IU dL(-1) (P = .016). Nevertheless, because the alleles of 56010G>A, a SNP within the 3' splice junction of intron 7, are strongly associated with 92714C>G in GAIT, additional studies are required to determine whether D1241E is itself a functional variant.

  9. Factor VIII (F8) inversions in severe hemophilia A: Male germ cell origin and diagnosis with RT-PCR

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    Antonarakis, S.E. [Geneva Medical School (Switzerland)]|[Johns Hopkins School of Medicine, Baltimore, MD (United States); Rossiter, J.P. [Johns Hopkins School of Medicine, Baltimore, MD (United States); Young, M. [Geneva Medical School (Switzerland)] [and others

    1994-09-01

    The Factor VIII (F8) gene, which is defective in hemophilia A, is located in the most telomeric megabase of Xq. Inversions due to intrachromosomal homologous recombination between mispaired copies of gene A located within intron 22 of the gene and about 500 kb telomeric to it account for nearly half of the cases of severe hemophilia A. We hypothesized that pairing of Xq with its homolog inhibits the inversion process, and that therefore the event originates predominantly in male germ cells. In all 21 informative cases in which the inversion originated in a maternal grandparent, DNA polymorphism analysis using markers within or very closely linked to F8, determined that it occurred in the male germline. In addition, all but one of 56 mothers of sporadic cases due to inversions were carriers. The data indicate that the F8 gene inversions leading to severe hemophilia A occur almost exclusively in male germ cells. The mean age of maternal grandfathers at the birth of their carrier daughters was 29.9 years (13 cases), i.e. not different from the mean paternal age in the general population, supporting the hypothesis that the inversions occur in meiosis. The inversions can be diagnosed by Southern blot analysis. For more rapid diagnosis we have used RT-PCR of RNA ectopically expressed in blood. Oligonucleotides were used to PCR amplify, after the initial RT reaction of RNA samples using random hexamers, either the normal transcript (F8 exons 21 to 24;312 bp product) or the novel abnormal transcript that is generated after the inversion. Both type 1 and 2 inversions can be recognized in affecteds and carriers by the presence of the diagnostic PcR product of 248 bp. Correct diagnoses were made in samples from 6 patients and 2 carriers with type 1 inversions, 2 patients and 2 carriers with type 2 inversions and 5 normal controls.

  10. Severe hemophilia A in a female by cryptic translocation: Order and orientation of factor VIII within Xq28

    Energy Technology Data Exchange (ETDEWEB)

    Migeon, B.R.; McGinniss, M.J.; Antonarakis, S.E.; Axelman, J.; Stasiowski, B.A.; Youssoufian, H.; Kearns, W.G.; Chung, A.; Pearson, P.L.; Kazazian, H.H. Jr. (Johns Hopkins Univ., Baltimore, MD (United States)); Muneer, R.S. (Univ. of Oklahoma, Norman (United States))

    1993-04-01

    The authors report studies of a female with severe hemophilia A resulting from a complex de novo translocation of chromosomes X and 17 (46,X,t(X; 17)). Somatic cell hybrids containing the normal X, the der(X), or the der(17) were analyzed for coagulation factor VIII (F8C) sequences using Southern blots and polymerase chain reaction. The normal X, always late replicating, contains a normal F8C gene, whereas the der(X) has no F8C sequences. The der(17) chromosome containing Xq24-Xq28 carries a functional G6PD locus and a deleted F8C allele that lacks exons 1--15. Also, it lacks the DXYS64-X locus, situated between the F8C locus and the Xq telomere. These results indicate that a cryptic breakpoint within Xq28 deleted the 5[prime] end of F8C, but left the more proximal G6PD locus intact on the der(17)chromosome. As the deleted segment includes the 5[prime] half of F8C as well as the subtelomeric DXYS64 locus, F8C must be oriented on the chromosome with its 5[prime] region closest to the telomere. Therefore, the order of these loci is Xcen-G6PD-3[prime]F8C-5[prime]F8C-DXYS64-Xqtel. The analysis of somatic cell hybrids has elucidated the true nature of the F8C mutation in the pro-band, revealing a more complex rearrangement (three chromosomes involved) than that expected from cytogenetic analysis, chromosome painting, and Southern blots. A 900-kb segment within Xq28 has been translocated to another autosome. Hemophilia A in this heterozygous female is due to the decapitation of the F8C gene on the der(17) and inactivation of the intact allele on the normal X. 27 refs., 5 figs., 1 tab.

  11. Joint bleeds increase the inhibitor response to human factor VIII in a rat model of severe haemophilia A.

    Science.gov (United States)

    Lövgren, K M; Søndergaard, H; Skov, S; Wiinberg, B

    2016-09-01

    The most serious complication in haemophilia A (HA) replacement therapy with coagulation factor VIII (FVIII) is neutralizing antibodies, i.e. inhibitors. It has been hypothesized that danger signals generated during a bleed might have an adjuvant effect on the immune response to FVIII in on-demand treatment, increasing the inhibitor risk. To compare the antibody response to treatment with recombinant human FVIII (rhFVIII) in relation to induced knee joint bleeds and treatment without concurrent bleeds in a HA rat model. HA rats were divided into two groups: one group (n = 10) receiving three needle induced knee joint bleeds 14 days apart and a control group (n = 9) receiving three sham procedures. Three hours after each injury/sham 50 IU kg(-1) rhFVIII was administrated intravenously. Subsequently, both groups continued rhFVIII treatment for another 9 weeks. Binding antibodies were analysed using an enzyme-linked immunosorbent assay and neutralizing antibodies using a Bethesda-like assay. Rats in the knee-bleed group developed a significantly faster inhibitor response and reached significantly higher inhibitor levels. In the knee-bleed group, 80% developed inhibitors vs. 33% in the control group, demonstrating a 2.4 times higher inhibitor risk when treating concurrent with bleeds. FVIII treatment in relation to a bleed potentiates inhibitor development compared to FVIII treatment alone in this HA rat, indicating that bleeding is a potential danger signal. Our results support the theory that FVIII replacement therapy concurrent with a bleeding episode increases the inhibitor risk, which to the best of our knowledge, has not been confirmed in an animal model before. © 2016 John Wiley & Sons Ltd.

  12. Antibody response to recombinant human coagulation factor VIII in a new rat model of severe hemophilia A.

    Science.gov (United States)

    Lövgren, K M; Søndergaard, H; Skov, S; Weldingh, K N; Tranholm, M; Wiinberg, B

    2016-04-01

    Neutralizing antibodies toward FVIII replacement therapy (inhibitors) are the most serious treatment-related complication in hemophilia A (HA). A rat model of severe HA (F8(-/-) ) has recently been developed, but an immunological characterization is needed to determine the value of using the model for research into inhibitor development. Characterize the antibody response towards recombinant human coagulation factor VIII (rhFVIII) in the HA rat, following a human prophylactic dosing regimen. Two identical studies were performed, which included a total of 17 homozygous HA rats (F8(-/-) , 0% FVIII activity), 12 heterozygous rats (F8(+/-) ), and 12 wild-type (F8(+/+) ) rats. All rats received intravenous injections of rhFVIII at 50 IU kg(-1) twice weekly for 4 weeks. Predosing blood samples were analyzed for binding and neutralizing anti-rhFVIII antibodies at weeks 1-7. In both studies, antibodies developed after 4-6 administrations of rhFVIII, and neutralizing antibodies reached levels similar to human patients (range 1-111 BU, median 6.0 BU) at the end of the study. There was no significant difference between the two studies or between genotypes in time to response or levels reached for binding and neutralizing antibodies. Interestingly, early spontaneous bleeds were associated with a faster antibody response. Following intravenous administration of human FVIII, according to a clinical prophylaxis regimen, a robust and reproducible antibody response is seen in this HA rat model, suggesting that the model is useful for intervention studies with the aim of suppressing, delaying, or preventing the inhibitor response. Also, bleeds seem to have an adjuvant effect on the immune response. © 2016 International Society on Thrombosis and Haemostasis.

  13. Plasma levels of plasminogen activator inhibitor type 1, factor VIII, prothrombin activation fragment 1+2, anticardiolipin, and antiprothrombin antibodies are risk factors for thrombosis in hemodialysis patients.

    Science.gov (United States)

    Molino, Daniela; De Santo, Natale G; Marotta, Rosa; Anastasio, Pietro; Mosavat, Mahrokh; De Lucia, Domenico

    2004-09-01

    Patients with end-stage renal disease are prone to hemorrhagic complications and simultaneously are at risk for a variety of thrombotic complications such as thrombosis of dialysis blood access, the subclavian vein, coronary arteries, cerebral vessel, and retinal veins, as well as priapism. The study was devised for the following purposes: (1) to identify the markers of thrombophilia in hemodialyzed patients, (2) to establish a role for antiphospholipid antibodies in thrombosis of the vascular access, (3) to characterize phospholipid antibodies in hemodialysis patients, and (4) to study the effects of dialysis on coagulation cascade. A group of 20 hemodialysis patients with no thrombotic complications (NTC) and 20 hemodialysis patients with thrombotic complications (TC) were studied along with 400 volunteer blood donors. Patients with systemic lupus erythematosus and those with nephrotic syndrome were excluded. All patients underwent a screening prothrombin time, activated partial thromboplastin time, fibrinogen (Fg), coagulation factors of the intrinsic and extrinsic pathways, antithrombin III (AT-III), protein C (PC), protein S (PS), resistance to activated protein C, prothrombin activation fragment 1+2 (F1+2), plasminogen, tissue type plasminogen activator (t-PA), plasminogen tissue activator inhibitor type-1 (PAI-1), anticardiolipin antibodies type M and G (ACA-IgM and ACA-IgG), lupus anticoagulant antibodies, and antiprothrombin antibodies type M and G (aPT-IgM and aPT-IgG). The study showed that PAI-1, F 1+2, factor VIII, ACA-IgM, and aPT-IgM levels were increased significantly over controls both in TC and NTC, however, they could distinguish patients with thrombotic complications from those without, being increased maximally in the former group. The novelty of the study is represented by the significant aPT increase that was observed in non-systemic lupus erythematosus hemodialysis patients, and particularly in those with thrombotic events. In addition

  14. The 1.7 A X-ray crystal structure of the porcine factor VIII C2 domain and binding analysis to anti-human C2 domain antibodies and phospholipid surfaces.

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    Caileen M Brison

    Full Text Available The factor VIII C2 domain is essential for binding to activated platelet surfaces as well as the cofactor activity of factor VIII in blood coagulation. Inhibitory antibodies against the C2 domain commonly develop following factor VIII replacement therapy for hemophilia A patients, or they may spontaneously arise in cases of acquired hemophilia. Porcine factor VIII is an effective therapeutic for hemophilia patients with inhibitor due to its low cross-reactivity; however, the molecular basis for this behavior is poorly understood. In this study, the X-ray crystal structure of the porcine factor VIII C2 domain was determined, and superposition of the human and porcine C2 domains demonstrates that most surface-exposed differences cluster on the face harboring the "non-classical" antibody epitopes. Furthermore, antibody-binding results illustrate that the "classical" 3E6 antibody can bind both the human and porcine C2 domains, although the inhibitory titer to human factor VIII is 41 Bethesda Units (BU/mg IgG versus 0.8 BU/mg IgG to porcine factor VIII, while the non-classical G99 antibody does not bind to the porcine C2 domain nor inhibit porcine factor VIII activity. Further structural analysis of differences between the electrostatic surface potentials suggest that the C2 domain binds to the negatively charged phospholipid surfaces of activated platelets primarily through the 3E6 epitope region. In contrast, the G99 face, which contains residue 2227, should be distal to the membrane surface. Phospholipid binding assays indicate that both porcine and human factor VIII C2 domains bind with comparable affinities, and the human K2227A and K2227E mutants bind to phospholipid surfaces with similar affinities as well. Lastly, the G99 IgG bound to PS-immobilized factor VIII C2 domain with an apparent dissociation constant of 15.5 nM, whereas 3E6 antibody binding to PS-bound C2 domain was not observed.

  15. BAY 81-8973, a full-length recombinant factor VIII: results from an International comparative laboratory field study.

    Science.gov (United States)

    Kitchen, S; Beckmann, H; Katterle, Y; Bruns, S; Tseneklidou-Stoeter, D; Maas Enriquez, M

    2016-05-01

    BAY 81-8973 is a full-length, unmodified, recombinant human factor VIII (FVIII) with the same primary amino acid sequence as sucrose-formulated recombinant FVIII but produced with certain more advanced manufacturing technologies. This global laboratory study evaluated variability in measurement of BAY 81-8973 using one-stage and chromogenic assays compared with antihaemophilic factor (recombinant) plasma/albumin-free method (rAHF-PFM; Advate(®) ) under assay conditions routinely used in clinical laboratories. BAY 81-8973 or rAHF-PFM was spiked into FVIII-deficient plasma at 0.043 (low), 0.375 (medium) and 0.865 (normal) IU mL(-1) . Participating laboratories analysed blinded samples and normal plasma in triplicate using their routine assay, reagents and standards. Results were analysed for intra- and interlaboratory variability. Forty-one laboratories in 11 countries participated in the study. One-stage assay and chromogenic assays were used by 40 and 10 laboratories, respectively; 9 laboratories used both assays. Intralaboratory variability was <11% for both assays and both products at all concentrations. Interlaboratory variability was highest at the low concentration in the chromogenic and one-stage assay for BAY 81-8973 (60.0% and 33.7%, respectively) and rAHF-PFM (51.0% and 30.8%) and was lowest at the normal concentration (BAY 81-8973, 5.4% and 14.0%; rAHF-PFM, 5.8% and 12.4%), which was similar to the plasma control (6.6% and 10.3%). The chromogenic:one-stage assay ratio ranged from 0.95 (low concentration) to 1.10 (normal concentration) for BAY 81-8973 and 0.96-1.18 for rAHF-PFM. BAY 81-8973 can be accurately measured in plasma using the one-stage and chromogenic assays routinely used in clinical laboratories without a product-specific standard. © 2016 The Authors. Haemophilia Published by John Wiley & Sons Ltd.

  16. Pathogen inactivation in fresh frozen plasma using riboflavin and ultraviolet light: Effects on plasma proteins and coagulation factor VIII

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    Stanojković Zoran

    2011-01-01

    Full Text Available Background/Aim. Riboflavin (vitamin B2 activated by ultraviolet (UV light, produces active oxygen which damages cell membrane and prevents replication of the carrier of diseases (viruses, bacteria, protozoa in all blood products. The aim of this study was to establish the influence of the process of photo inactivation in pathogens using riboflavin and UV rays on the concentration of coagulation factor VIII:C (FVIII:C and proteins in plasma that were treated before freezing. Methods. The examination included 20 units of plasma, separated from whole blood donated by voluntary blood donors around 6 hours from the moment of collection. The units were pooled and separated in to two groups: one consisted of 10 control units and the other of 10 experimental units. Experimental units of the plasma were treated by riboflavin (35 mL and UV rays (6.24 J/mL, 265-370 nm on Mirasol aparature (Caridian BCT Biotechnologies, USA in approximate duration of 6 minutes. Furthermore, 35 mL of saline solution was added to the control plasma. One sample for examining was taken from the control plasma (KG and two residual were taken from experimental plasma after the addition of riboflavin either before (EG1 or post illumination (EG2. Results. Comparing the mean values of FVIII:C (% we noticed statistically significantly higher level in the EG1 group than in the EG2 group (65.00 ± 4.52 vs 63.20 ± 4.73; t = 4.323, p = 0.002, while between the KG and experimental groups (EG1 and EG2 there was no statistically significant difference in the concentration of FVIII:C. There was a statistically significant decrease of albumin concentration (g/L in the EG2 group comparing to the KG (33.35 ± 0.94 vs 31.94 ± 0.84; t = 3.534, p = 0.002, but there was no mentioned difference in albumin concentration between the KG and the EG1, so as between the EG1 and the EG2. Conclusion. Plasma inactivated by riboflavin and UV rays (Mirasol PRT sistem, Caridian BCT, USA keeps all the

  17. Sustaining expression of B domain-deleted human factor VIII mediated by using lentiviral vectors in NOD/SCID mouse.

    Science.gov (United States)

    Li, Yan-Jie; Chen, Chong; Zeng, Ling-Yu; Cao, Jiang; Xu, Kai-Lin

    2012-06-01

    Recently, gene therapy has been become a promising approach to cure hemophilia A, a most common recessive bleeding disease. The aim of this study was to determine the perspective of lentiviral vector in hemophilia A gene therapy in vitro and in NOD/SCID mice. Lentivirus transfer vector pXZ9/BDDFVIII containing human B-domain-deleted Factor VIII-IRES-eGFP coding sequence and mock control pXZ9 were constructed. Lentivirus was prepared by co-transfecting 3 plasmids into 293FT cells. 293FT, HLF, human bone marrow mesenchymal stem cells and Chang-liver cells were transfected with the prepared virus. Coagulant activity of human FVIII, human FVIII antigen, human FVIII mRNA transcription and genomic integration were assayed by ELISA, one-step method, RT-PCR and PCR after infection. Lentiviral particles were concentrated by ultracentrifugation and NOD/SCID mice were transfected via portal vein injection. Human FVIII antigen in mouse blood plasma was analyzed by ELISA. eGFP expression was observed by fluorescent microscopy and human FVIII transcription in mouse liver was analyzed by RT-PCR at one month after transduction. The results showed that the high titer of recombinant virus was prepared and used to efficiently transduce the target cells in vitro. At 72 h after transfection, high levels of FVIII activity and FVIII antigen were detected. Human FVIII gene transcription could be detected in the liver of NOD/SCID mice received lentiviral particles carrying FVIII gene. Mouse hepatocytes were transfected with recombinant lentivirus efficiently in vivo. Human FVIII level in mouse blood plasma reached to (49 ± 6) mU, (54 ± 8) mU and (23 ± 4) mU at 72 h, one week and one month after transfection respectively. It is concluded that the lentiviral particles carrying BDDhFVIII gene can high efficiently transfect the target cells both in vitro and in vivo, and the transfected target cells can secrete hFVIII efficiently. The sustained expression of human FVIII in NOD/SCID mice is

  18. Stable high-level expression of factor VIII in Chinese hamster ovary cells in improved elongation factor-1 alpha-based system.

    Science.gov (United States)

    Orlova, Nadezhda A; Kovnir, Sergey V; Gabibov, Alexandre G; Vorobiev, Ivan I

    2017-03-24

    Recombinant factor VIII (FVIII), used for haemophilia A therapy, is one of the most challenging among the therapeutic proteins produced in heterologous expression systems. Deletion variant of FVIII, in which the entire domain B is replaced by a short linker peptide, was approved for medical use. Efficacy and safety of this FVIII deletion variant are similar to full-length FVIII preparations while the level of production in CHO cells is substantially higher. Typical levels of productivity for CHO cell lines producing deletion variant FVIII-BDD SQ, described elsewhere, are 0.5-2 IU/ml, corresponding to the concentration of FVIII of about 0.2 μg/ml. Using standard vectors based on the cytomegalovirus promoter (CMV) and the dihydrofolate reductase cDNA we have previously obtained the cell line secreting 0.5 IU/ml of FVIII-BDD, which roughly corresponds to the previously published data. An expression system based on CHO genomic sequences including CHO-EEF1A promoter and Epstein-Barr virus terminal repeat fragment allowed us to achieve 80-fold increase in the production level as compared with the conventional expression system based on the CMV promoter. Immediately after the primary selection FVIII -producing cells secreted 5-10 IU/ml of FVIII-BDD, and after multi-stage methotrexate-driven amplification a stable clonal line 11A4H was selected, secreting 39 IU/ml of FVIII-BDD in the simple batch culturing conditions, which considerably exceeds known indicators for industrial producers of this protein. In contrast to other FVIII-BDD producing lines 11A4H accumulates low proportion of the secreted FVIII on the membrane. Its productivity may be further increased approximately two-fold by adding sodium butyrate and butylated hydroxyanisol to the culture medium. A five-stage purification process for the factor VIII was employed. It allowed isolation of the intact FVIII-BDD as was confirmed by mass spectrometry. Purified FVIII-BDD has a specific activity of 11,000

  19. A computer-based model to assess costs associated with the use of factor VIII and factor IX one-stage and chromogenic activity assays.

    Science.gov (United States)

    Kitchen, S; Blakemore, J; Friedman, K D; Hart, D P; Ko, R H; Perry, D; Platton, S; Tan-Castillo, D; Young, G; Luddington, R J

    2016-04-01

    Measurement of coagulation factor factor VIII (FVIII) and factor IX (FIX) activity can be associated with a high level of variability using one-stage assays based on activated partial thromboplastin time (APTT). Chromogenic assays show less variability, but are less commonly used in clinical laboratories. In addition, one-stage assay accuracy using certain reagent and instrument combinations is compromised by some modified recombinant factor concentrates. Reluctance among some in the hematology laboratory community to adopt the use of chromogenic assays may be partly attributable to lack of familiarity and perceived higher associated costs. To identify and characterize key cost parameters associated with one-stage APTT and chromogenic assays for FVIII and FIX activity using a computer-based cost analysis model. A cost model for FVIII and FIX chromogenic assays relative to APTT assays was generated using assumptions derived from interviews with hematologists and laboratory scientists, common clinical laboratory practise, manufacturer list prices and assay kit configurations. Key factors that contribute to costs are factor-deficient plasma and kit reagents for one-stage and chromogenic assays, respectively. The stability of chromogenic assay kit reagents also limits the cost efficiency compared with APTT testing. Costs for chromogenic assays might be reduced by 50-75% using batch testing, aliquoting and freezing of kit reagents. Both batch testing and aliquoting of chromogenic kit reagents might improve cost efficiency for FVIII and FIX chromogenic assays, but would require validation. Laboratory validation and regulatory approval as well as education and training in the use of chromogenic assays might facilitate wider adoption by clinical laboratories. © 2016 The Authors. Journal of Thrombosis and Haemostasis published by Wiley Periodicals, Inc. on behalf of International Society on Thrombosis and Haemostasis.

  20. Estudo citofotométrico da expressão do marcador tumoral Fator VIII e fatores prognósticos no adenocarcinoma gástrico Cytophotometric study of the expression of the tumoral marker Factor VIII and prognostic factors in gastrci adenocarcinoma

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    Mary Tossa Nakamura

    2007-12-01

    ção III ou IV apresentaram índice de marcagem maiores do que aqueles com Bormann I ou II, porém sem correlação com a profundidade de invasão tumoral, grau de diferenciação, envolvimento nodal e padrão histológico. CONCLUSÕES: O presente estudo identificou e marcou 95,24% das amostras para o Fator VIII. Em relação aos fatores prognósticos não houve correlação significativa exceto entre o Fator VIII e a classificação de Bormann no qual o tipo III ou IV foi maior que o tipo I ou II.INTRODUCTION: Regarding gastric cancer, the incidence, diagnosis and therapeutic options showed improvement in the last decades, but prognosis remains gloomy, specially due the fact that most patients, already diagnosed present advanced tumors, metastatic and not liable to be surgically resected. Molecular biology is an area in science, which can give the answer to many questions and current scientific facts show that the this should be through detection of tumoral markers. The great advances in informatics refined cell image analysis by image cytophotometry makes it possible to study cell proliferation and angiogenesis in various tumor processes using immunohistochemistry and several markers. At present, studies are conducted to demonstrate the prognostic value of their expressions, however, in gastric adenocarcinoma the results have been divergent and studies are scarce. AIM: To identify and quantify the expression of cell proliferation markers using Ki-67 and of angiogenesis with Factor VIII in gastric adenocarcinoma using cytophotometry, and compare their expressions with factors such as Bormanns´ classification, tumor invasion depth, degree of differentiation, nodal involvement, histologic pattern and age. METHODS: Twenty-one patients with gastric adenocarcinoma identified between 1998 and 2006 were studied. Ki-67 and Factor VIII expressions were performed using immunohistochemistry with clone MIB-1 primary antibodies, monoclonal for Ki-67 and policlonal for Factor VIII

  1. Immune regulatory gene polymorphisms as predisposing risk factors for the development of factor VIII inhibitors in Indian severe haemophilia A patients.

    Science.gov (United States)

    Pinto, P; Ghosh, K; Shetty, S

    2012-09-01

    Development of inhibitors to factor VIII, a serious complication of replacement therapy in haemophilia A patients, leads to increased bleeding, morbidity and mortality. There is no data on the risk factors for inhibitor development in Indian patients with severe haemophilia A. Our aim was to study the role of immune regulatory gene polymorphisms in the development of inhibitors. Fourteen immune regulatory gene polymorphisms (IL1β, IL4, IL10, TNFA and CTLA4) were analysed in 120 patients with severe haemophilia A, i.e. 50 inhibitor positive patients, and 70 inhibitor negative control patients, by PCR-RFLP, DNA sequencing and allele-specific PCRs. The IL10 promoter 'GCC' haplotypes overall (P: 0.002, OR: 3.452, 95% CI: 1.607-7.416), and 'GCC/ATA' (P: 0.011, OR: 3.492, 95% CI: 1.402-8.696) haplotype, associated with high and intermediate IL10 production, respectively, were significantly higher in inhibitor positive patients, whereas the 'non-GCC' haplotypes overall (P: 0.002,OR: 0.290, 95% CI 0.135-0.622) and 'ATA/ATA' haplotype (P: 0.025, OR: 0.278, 95% CI: 0.096-0.802), associated with low IL10 synthesis, were significantly higher among inhibitor negative patients. The TNFA rs1799724 C/T heterozygote prevalence was significantly higher in the inhibitor positive group (P: 0.021, OR: 3.190, 95% CI: 1.273-7.990), whereas the other polymorphisms showed no statistically significant association with the presence of inhibitors. Different immune regulatory gene polymorphisms play a significant role as possible risk factors for the development of inhibitors in severe haemophilia A patients. © 2012 Blackwell Publishing Ltd.

  2. Challenges of the management of severe hemophilia A with inhibitors: two case reports emphasizing the potential interest of a high-purity human Factor VIII/von Willebrand factor concentrate and individually tailored prophylaxis guided by thrombin-generation test.

    Science.gov (United States)

    Mathieu, Sophie; Crampe, Carine; Dargaud, Yesim; Lavigne-Lissalde, Géraldine; Escuriola-Ettingshausen, Carmen; Tardy, Brigitte; Meley, Roland; Thouvenin, Sandrine; Stephan, Jean L; Berger, Claire

    2015-12-01

    Severe hemophilia A is an X-linked bleeding disorder. Immune tolerance induction (ITI) is the best strategy of treatment when patients develop inhibitors. The objective is to illustrate the benefit of a high-purity human factor VIII/von Willebrand factor (VWF) concentrate (Octanate) in the management of ITI. We also wanted to raise the potential interest of laboratory assays such as thrombin-generation test (TGT) and epitope mapping. Two patients were treated during ITI, first with a recombinant FVIII and then with plasma-derived factor VIII without success, and, finally, with Octanate. Bypassing agents were used based on the results of TGT. Epitope mapping was performed during ITI therapy. These observations suggest the potential contribution of Octanate in the management of ITI in difficult cases. The use of bypassing agents can be necessary in prophylaxis or to treat bleedings, and may be guided by TGT results. Epitope mapping is used to describe the inhibitor. This article shows a decrease of the inhibitor directed against the C2 domain after initiation of Octanate. A high-purity human factor VIII/von Willebrand factor concentrate (Octanate) may be a valuable therapeutical option for ITI therapy. TGT and epitope mapping could be of help in the management of ITI.

  3. Distinct roles of Ser-764 and Lys-773 at the N terminus of von Willebrand factor in complex assembly with coagulation factor VIII.

    Science.gov (United States)

    Castro-Núñez, Lydia; Bloem, Esther; Boon-Spijker, Mariëtte G; van der Zwaan, Carmen; van den Biggelaar, Maartje; Mertens, Koen; Meijer, Alexander B

    2013-01-04

    Complex formation between coagulation factor VIII (FVIII) and von Willebrand factor (VWF) is of critical importance to protect FVIII from rapid in vivo clearance and degradation. We have now employed a chemical footprinting approach to identify regions on VWF involved in FVIII binding. To this end, lysine amino acid residues of VWF were chemically modified in the presence of FVIII or activated FVIII, which does not bind VWF. Nano-LC-MS analysis showed that the lysine residues of almost all identified VWF peptides were not differentially modified upon incubation of VWF with FVIII or activated FVIII. However, Lys-773 of peptide Ser-766-Leu-774 was protected from chemical modification in the presence of FVIII. In addition, peptide Ser-764-Arg-782, which comprises the first 19 amino acid residues of mature VWF, showed a differential modification of both Lys-773 and the α-amino group of Ser-764. To verify the role of Lys-773 and the N-terminal Ser-764 in FVIII binding, we employed VWF variants in which either Lys-773 or Ser-764 was replaced with Ala. Surface plasmon resonance analysis and competition studies revealed that VWF(K773A) exhibited reduced binding to FVIII and the FVIII light chain, which harbors the VWF-binding site. In contrast, VWF(S764A) revealed more effective binding to FVIII and the FVIII light chain compared with WT VWF. The results of our study show that the N terminus of VWF is critical for the interaction with FVIII and that Ser-764 and Lys-773 have opposite roles in the binding mechanism.

  4. Patient preference and ease of use for different coagulation factor VIII reconstitution device scenarios: a cross-sectional survey in five European countries

    Directory of Open Access Journals (Sweden)

    Cimino E

    2014-12-01

    Full Text Available Ernesto Cimino,1 Silvia Linari,2 Mara Malerba,3 Susan Halimeh,4 Francesca Biondo,5 Martina Westfeld5 1Dipartimento Medicina Clinica e Sperimentale, Universita’ degli Studi di Napoli Federico II, Naples, Italy; 2Agenzia per l’ Emofilia, AOU Careggi di Firenze, Florence, Italy; 3Fondazione Cà Granda Ospedale Maggiore Policlinico, Centro Emofilia e Trombosi “A Bianchi Bonomi”, Milan, Italy; 4CRC Coagulation Research Centre GmbH, Duisburg, Germany; 5Pfizer Italia, Rome, Italy Introduction: Hemophilia A treatment involves replacing the deficient coagulation factor VIII. This process may involve multiple steps that might create a barrier to adherence. A new dual-chamber syringe (DCS; FuseNGo® was recently introduced with the aim of simplifying reconstitution. Aim: This study aimed to identify factors associated with adult patients’ preferences for different coagulation factor VIII reconstitution systems and to test ease of use and patient preference for the DCS. Methods: A cross-sectional survey of adults with hemophilia A in five European countries was conducted; a subset of subjects also participated in a practical testing session of the DCS. Results: Among the 299 survey participants, the device scenario requiring the least equipment and reconstitution steps (the DCS received a median preference rating of 71 out of 100 (0 being “the least desirable” and 100 “the most desirable” rating. This was significantly higher than the other scenarios (the next highest achieved a median of 50 points; P<0.001. Participants would be more likely to use this device prophylactically (P<0.001. Among the 98 participants who tested the DCS, 57% preferred this device over their current device, 26% preferred their current device, and 17% had no preference. The DCS was rated as easier to use than current treatment devices (median score 9/10 versus 7/10 for current treatment, P=0.001. Conclusion: The survey indicates that the prefilled DCS, Fuse

  5. Murine leukemia virus-derived retroviral vector has differential integration patterns in human cell lines used to produce recombinant factor VIII

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    Marcela Cristina Correa de Freitas

    2014-06-01

    Full Text Available OBJECTIVE: Nowadays recombinant factor VIII is produced in murine cells including in Chinese hamster ovary (CHO and baby hamster kidney cells (BHK. Previous studies, using the murine leukemia virus-derived retroviral vector pMFG-FVIII-P140K, modified two recombinant human cell lines, HepG2 and Hek293 to produce recombinant factor VIII. In order to characterize these cells, the present study aimed to analyze the integration pattern of retroviral vector pMFG-FVIII-P140K.METHODS: This study used ligation-mediated polymerase chain reaction to locate the site of viral vector integration by sequencing polymerase chain reaction products. The sequences were compared to genomic databases to characterize respective clones.RESULTS: The retroviral vector presented different and non-random profiles of integration between cells lines. A preference of integration for chromosomes 19, 17 and 11 was observed for HepG2FVIIIdB/P140K and chromosome 9 for Hek293FVIIIdB/P140K. In genomic regions such as CpG islands and transcription factor binding sites, there was no difference in the integration profiles for both cell lines. Integration in intronic regions of encoding protein genes (RefSeq genes was also observed in both cell lines. Twenty percent of integrations occurred at fragile sites in the genome of the HepG2 cell line and 17% in Hek293.CONCLUSION: The results suggest that the cell type can affect the profile of chromosomal integration of the retroviral vector used; these differences may interfere in the level of expression of recombinant proteins.

  6. The intron-22-inverted F8 locus permits factor VIII synthesis: explanation for low inhibitor risk and a role for pharmacogenomics.

    Science.gov (United States)

    Sauna, Zuben E; Lozier, Jay N; Kasper, Carol K; Yanover, Chen; Nichols, Timothy; Howard, Tom E

    2015-01-01

    Intron-22-inversion patients express the entire Factor VIII (FVIII)-amino-acid sequence intracellularly as 2 non-secreted polypeptides and have a positive "intracellular (I)-FVIII-CRM" status. Mutations conferring a positive I-FVIII-CRM status are associated with low inhibitor risk and are pharmacogenetically relevant because inhibitor risk may be affected by the nature of the therapeutic FVIII-protein (tFVIII), the affinity of any tFVIII-derived foreign peptide (tFVIII-fp) for any HLA class-II isomer (HLA-II) comprising individual major histocompatibility complex (MHC) repertoires, and the stability of any tFVIII-fp/HLA-II complex. We hypothesize that mutations conferring a completely or substantially negative I-FVIII-CRM status are pharmacogenetically irrelevant because inhibitor risk is high with any tFVIII and individual MHC repertoire.

  7. A novel mutation (4040-4045 nt. delA in exon 14 of the factor VIII gene causing severe hemophilia A

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    Habib Onsori

    2011-01-01

    Full Text Available Hemophilia A is an X-linked congenital bleeding disorder caused by Factor VIII deficiency. Different mutations including point mutations, deletions, insertions and inversions have been reported in the FVIII gene, which cause hemophilia A. In the current study, with the use of conformational sensitive gel electrophoresis (CSGE analysis, we report a novel 1-nt deletion in the A6 sequence at codons 1328-1330 (4040-4045 nt delA occurring in exon 14 of the FVIII gene in a seven-year-old Iranian boy with severe hemophilia A. This mutation that causes frameshift and premature stop-codon at 1331 has not previously been reported in the F8 Hemophilia A Mutation, Structure, Test and Resource Site (HAMSTeRS database.

  8. Transient blockade of the inducible costimulator pathway generates long-term tolerance to factor VIII after nonviral gene transfer into hemophilia A mice.

    Science.gov (United States)

    Peng, Baowei; Ye, Peiqing; Blazar, Bruce R; Freeman, Gordon J; Rawlings, David J; Ochs, Hans D; Miao, Carol H

    2008-09-01

    Formation of inhibitory antibodies is a common problem encountered in clinical treatment for hemophilia. Human factor VIII (hFVIII) plasmid gene therapy in hemophilia A mice also leads to strong humoral responses. We demonstrate that short-term therapy with an anti-ICOS monoclonal antibody to transiently block the inducible costimulator/inducible costimulator ligand (ICOS/ICOSL) signaling pathway led to sustained tolerance to hFVIII in hFVIII plasmid-treated hemophilia A mice and allowed persistent, high-level FVIII functional activity (100%-300% of normal). Anti-ICOS treatment resulted in depletion of ICOS(+)CD4(+) T cells and activation of CD25(+)Foxp3(+) Tregs in the peripheral blood, spleen, and lymph nodes. CD4(+) T cells from anti-ICOS-treated mice did not proliferate in response to hFVIII stimulation and produced high levels of regulatory cytokines, including interleukin-10 and transforming growth factor-beta. Moreover, CD4(+)CD25(+) Tregs from tolerized mice adoptively transferred dominant tolerance in syngeneic hFVIII plasmid-treated hemophilia A mice and reduced the production of antibodies against FVIII. Anti-ICOS-treated mice tolerized to hFVIII generated normal primary and secondary antibody responses after immunization with the T-dependent antigen, bacteriophage Phix 174, indicating maintenance of immune competency. Our data indicate that transient anti-ICOS monoclonal antibody treatment represents a novel single-agent immunomodulatory strategy to overcome the immune responses against transgene product after gene therapy.

  9. Successful immune tolerance induction with low-dose coagulation factor VIII in a patient with hemophilia A from a developing country.

    Science.gov (United States)

    Ay, Yilmaz; Ersin, Toret; Yesim, Oymak; Hilkay, Karapinar Tuba; Dilek, Ince; Gulcihan, Ozek; Ahmet, Koc

    2016-09-01

    Inhibitor development is the most frequent and serious complication of the treatment in patients with hemophilia. Immune tolerance induction (ITI) is the only option of treatment for the eradication of factor VIII (FVIII) inhibitor. We would like to present our case with hemophilia whose FVIII inhibitor eradication was done by a low-dose ITI regimen. Our patient has been applied on-demand therapy until 8 years of age. Secondary prophylaxis was began because of having hemophilic arthropathy. A low titer of FVIII inhibitor (4.2 BU/ml) was detected in the fifth month of the prophylaxis. The peak inhibitor titer of patient was 4.6 BU/ml, and there was no decrease in inhibitor titer in the follow-up duration. The low-dose ITI (50 IU/kg, 3 days a week) was started. His inhibitor level was detected negative and the recovery test was ameliorated in the 15th of the ITI therapy. High-dose regimen ITI could not be given particularly in developing countries such as Turkey in view of the high cost of treatment. Patients who had good risk factors might be successfully treated by using low-dose ITI regimen as effective as high-dose ITI regimen.

  10. Impact of a product-specific reference standard for the measurement of a PEGylated rFVIII activity: the Swiss Multicentre Field Study.

    Science.gov (United States)

    Bulla, O; Poncet, A; Alberio, L; Asmis, L M; Gähler, A; Graf, L; Nagler, M; Studt, J-D; Tsakiris, D A; Fontana, P

    2017-07-01

    Measuring factor VIII (FVIII) activity can be challenging when it has been modified, such as when FVIII is pegylated to increase its circulating half-life. Use of a product-specific reference standard may help avoid this issue. Evaluate the impact of using a product-specific reference standard for measuring the FVIII activity of BAX 855 - a pegylated FVIII - in eight of Switzerland's main laboratories. Factor VIII-deficient plasma, spiked with five different concentrations of BAX 855, plus a control FVIII sample, was sent to the participating laboratories. They measured FVIII activity by using either with a one-stage (OSA) or the chromogenic assay (CA) against their local or a product-specific reference standard. When using a local reference standard, there was an overestimation of BAX 855 activity compared to the target concentrations, both with the OSA and CA. The use of a product-specific reference standard reduced this effect: mean recovery ranged from 127.7% to 213.5% using the OSA with local reference standards, compared to 110% to 183.8% with a product-specific reference standard, and from 146.3% to 182.4% using the CA with local reference standards compared to 72.7% to 103.7% with a product-specific reference standard. In this in vitro study, the type of reference standard had a major impact on the measurement of BAX 855 activity. Evaluation was more accurate and precise when using a product-specific reference standard. © 2017 John Wiley & Sons Ltd.

  11. Delivery of full-length factor VIII using a piggyBac transposon vector to correct a mouse model of hemophilia A.

    Directory of Open Access Journals (Sweden)

    Hideto Matsui

    Full Text Available Viral vectors have been used for hemophilia A gene therapy. However, due to its large size, full-length Factor VIII (FVIII cDNA has not been successfully delivered using conventional viral vectors. Moreover, viral vectors may pose safety risks, e.g., adverse immunological reactions or virus-mediated cytotoxicity. Here, we took advantages of the non-viral vector gene delivery system based on piggyBac DNA transposon to transfer the full-length FVIII cDNA, for the purpose of treating hemophilia A. We tested the efficiency of this new vector system in human 293T cells and iPS cells, and confirmed the expression of the full-length FVIII in culture media using activity-sensitive coagulation assays. Hydrodynamic injection of the piggyBac vectors into hemophilia A mice temporally treated with an immunosuppressant resulted in stable production of circulating FVIII for over 300 days without development of anti-FVIII antibodies. Furthermore, tail-clip assay revealed significant improvement of blood coagulation time in the treated mice. piggyBac transposon vectors can facilitate the long-term expression of therapeutic transgenes in vitro and in vivo. This novel gene transfer strategy should provide safe and efficient delivery of FVIII.

  12. Endogenous factor VIII synthesis from the intron 22-inverted F8 locus may modulate the immunogenicity of replacement therapy for hemophilia A.

    Science.gov (United States)

    Pandey, Gouri Shankar; Yanover, Chen; Miller-Jenkins, Lisa M; Garfield, Susan; Cole, Shelley A; Curran, Joanne E; Moses, Eric K; Rydz, Natalia; Simhadri, Vijaya; Kimchi-Sarfaty, Chava; Lillicrap, David; Viel, Kevin R; Przytycka, Teresa M; Pierce, Glenn F; Howard, Tom E; Sauna, Zuben E

    2013-10-01

    Neutralizing antibodies (inhibitors) to replacement factor VIII (FVIII, either plasma derived or recombinant) impair the effective management of hemophilia A. Individuals with hemophilia A due to major deletions of the FVIII gene (F8) lack antigenically cross-reactive material in their plasma ("CRM-negative"), and the prevalence of inhibitors in these individuals may be as high as 90%. Conversely, individuals with hemophilia A caused by F8 missense mutations are CRM-positive, and their overall prevalence of inhibitors is hemophilia A) have been grouped with the former on the basis of their genetic defect and CRM-negative status. However, only ∼20% of these individuals develop inhibitors. Here we demonstrate that the levels of F8 mRNA and intracellular FVIII protein in B lymphoblastoid cells and liver biopsies from individuals with the intron 22 inversion are comparable to those in healthy controls. These results support the hypothesis that most individuals with the intron 22 inversion are tolerized to FVIII and thus do not develop inhibitors. Furthermore, we developed a new pharmacogenetic algorithm that permits the stratification of inhibitor risk for individuals and subpopulations by predicting the immunogenicity of replacement FVIII using, as input, the number of putative T cell epitopes in the infused protein and the competence of major histocompatibility complex class II molecules to present such epitopes. This algorithm showed statistically significant accuracy in predicting the presence of inhibitors in 25 unrelated individuals with the intron 22 inversion.

  13. Delivery of full-length factor VIII using a piggyBac transposon vector to correct a mouse model of hemophilia A.

    Science.gov (United States)

    Matsui, Hideto; Fujimoto, Naoko; Sasakawa, Noriko; Ohinata, Yasuhide; Shima, Midori; Yamanaka, Shinya; Sugimoto, Mitsuhiko; Hotta, Akitsu

    2014-01-01

    Viral vectors have been used for hemophilia A gene therapy. However, due to its large size, full-length Factor VIII (FVIII) cDNA has not been successfully delivered using conventional viral vectors. Moreover, viral vectors may pose safety risks, e.g., adverse immunological reactions or virus-mediated cytotoxicity. Here, we took advantages of the non-viral vector gene delivery system based on piggyBac DNA transposon to transfer the full-length FVIII cDNA, for the purpose of treating hemophilia A. We tested the efficiency of this new vector system in human 293T cells and iPS cells, and confirmed the expression of the full-length FVIII in culture media using activity-sensitive coagulation assays. Hydrodynamic injection of the piggyBac vectors into hemophilia A mice temporally treated with an immunosuppressant resulted in stable production of circulating FVIII for over 300 days without development of anti-FVIII antibodies. Furthermore, tail-clip assay revealed significant improvement of blood coagulation time in the treated mice. piggyBac transposon vectors can facilitate the long-term expression of therapeutic transgenes in vitro and in vivo. This novel gene transfer strategy should provide safe and efficient delivery of FVIII.

  14. Early eradication of factor VIII inhibitor in patients with congenital hemophilia A by immune tolerance induction with a high dose of immunoglobulin.

    Science.gov (United States)

    Mizoguchi, Yoko; Furue, Aya; Kagawa, Reiko; Chijimatsu, Ikue; Tomioka, Keita; Shimomura, Maiko; Imanaka, Yusuke; Nishimura, Shiho; Saito, Satoshi; Miki, Mizuka; Ono, Atsushi; Konishi, Nakao; Kawaguchi, Hiroshi; Kobayashi, Masao

    2016-04-01

    The production of factor VIII (FVIII) inhibitory antibodies is a serious problem in patients with hemophilia A. Immune tolerance induction (ITI) is the only strategy proven to eradicate persistent inhibitors and has been shown to be successful in 70 % of patients with hemophilia A. However, a minority of hemophilia patients present life-long inhibitors. To eliminate such inhibitors, we designed an intravenous immunoglobulin (IVIG) strategy in combination with high dose recombinant FVIII for ITI in hemophilia A children with inhibitors. Four previously untreated patients produced inhibitors within 16 exposures to FVIII. The peak inhibitor titers in these patients ranged from 3 to 14 BU/mL. The patients received ITI combined with IVIG within 1.5 months after the inhibitors were detected. All patients showed a negative titer for inhibitors by 28 days, with no anamnestic responses. The recovery of FVIII in the plasma concentration was normalized within three months after initiation of ITI. An additional course of IVIG administration led to induction of complete tolerance by 20 months after initiation of ITI therapy in all patients. ITI treatment with high-dose FVIII combined with IVIG may be effective for the early elimination of inhibitors.

  15. The Factor VIII Mutation Database on the World Wide Web: the haemophilia A mutation, search, test and resource site. HAMSTeRS update (version 3.0).

    Science.gov (United States)

    Kemball-Cook, G; Tuddenham, E G

    1997-01-01

    The HAMSTeRS WWW site was set up in 1996 in order to facilitate easy access to, and aid understanding of, the causes of haemophilia A at the molecular level; previously, the first and second text editions of the database have been published in Nucleic Acids Research. This report describes the facilities originally available at the site and the recent additions which we have made to increase its usefulness to clinicians, the molecular genetics community and structural biologists interested in factor VIII. The database (version 3.0) has been completely updated with easy submission of point mutations, deletions and insertions via e-mail of custom-designed forms. The searching of point mutations in the database has been made simpler and more robust, with a concomitantly expanded real-time bioinformatic analysis of the database. A methods section devoted to mutation detection has been added, highlighting issues such as choice of technique and PCR primer sequences. Finally, a FVIII structure section gives access to 3D VRML (Virtual Reality Modelling Language) files for any user-definable residue in a FVIII A domain homology model based on the crystal structure of human caeruloplasmin, together with secondary structural data and a sound+video animation of the model. It is intended that the general availability of this model will assist both in interpretation of causative mutations and selection of candidate residues forin vitromutagenesis. The HAMSTeRS URL is http://europium.mrc.rpms.ac.uk.

  16. Elective surgery on factor VIII inhibitor patients using continuous infusion of recombinant activated factor VII: plasma factor VII activity of 10 IU/ml is associated with an increased incidence of bleeding.

    Science.gov (United States)

    Smith, M P; Ludlam, C A; Collins, P W; Hay, C R; Wilde, J T; Grigeri, A; Melsen, T; Savidge, G F

    2001-10-01

    We examined recombinant activated factor VII (rVIIa) administered by continuous infusion to eight patients with inhibitors to factor VIII, undergoing elective surgery. rVIIa was infused at a fixed rate of 16.5 microg/kg/h for a median of 13.5 days (range 1-26). There was effective haemostasis at this infusion rate in only one of two minor procedures and two of six major operations. Three patients experienced excessive bleeding despite plasma factor VII activity around 10 IU/ml. Serious bleeding occurred in two other patients caused by procedural errors unrelated to rVIIa and required re-operation. The median rVIIa clearance on day 1 was 57 ml/h/kg (range 18-100) and on day 3 was 100 ml/h/kg (range 61-200). Clearance on the final infusion day was not significantly different from day 3. The infusion did not induce pathological activation of the coagulation mechanism. The only thrombotic adverse events were two episodes of superficial thrombophlebitis of the infused vein in one subject. In conclusion, the 16.5 microg/kg/h infusion rate reliably achieves plasma factor VII activity levels of 10 IU/ml, but this level does not provide reliable haemostasis.

  17. Efficacy and safety of BAY 81-8973, a full-length recombinant factor VIII: results from the LEOPOLD I trial.

    Science.gov (United States)

    Saxena, K; Lalezari, S; Oldenburg, J; Tseneklidou-Stoeter, D; Beckmann, H; Yoon, M; Maas Enriquez, M

    2016-09-01

    BAY 81-8973 (Kovaltry(®) ) is a full-length, unmodified recombinant human factor VIII (FVIII) with the same amino acid sequence as sucrose-formulated recombinant FVIII and is produced using additional advanced manufacturing technologies. To demonstrate efficacy and safety of BAY 81-8973 for treatment of bleeds and as prophylaxis based on two different potency assignments. In LEOPOLD I (ClinicalTrials.gov identifier, NCT01029340), males aged 12-65 years with severe haemophilia A and ≥150 exposure days received BAY 81-8973 20-50 IU kg(-1) two or three times per week for 12 months. Potency was based on chromogenic substrate assay per European Pharmacopoeia and label adjusted to mimic one-stage assay potency. Patients were randomized for potency sequence and crossed over potency groups after 6 months, followed by an optional 12-month extension. Primary efficacy endpoint was annualized bleeding rate (ABR). Patients also received BAY 81-8973 during major surgeries. Sixty-two patients received BAY 81-8973 prophylaxis and were included in the analysis. Median ABR was 1.0 (quartile 1, 0; quartile 3, 5.1) without clinically relevant differences between potency periods. Median ABR was similar for twice-weekly vs. three times-weekly dosing (1.0 vs. 2.0). Haemostasis was maintained during 12 major surgeries. Treatment-related adverse event (AE) incidence was ≤7% overall; no patient developed inhibitors. One patient with risk factors for cardiovascular disease developed a myocardial infarction. BAY 81-8973 was efficacious in preventing and treating bleeding episodes, irrespective of the potency assignment method, with few treatment-related AEs. Caution should be used when treating older patients with cardiovascular risk factors. © 2016 Bayer. Haemophilia Published by John Wiley & Sons Ltd.

  18. Photoionization of Ar VIII

    Science.gov (United States)

    Liang, Liang; Jiang, Wen-xian; Zhou, Chao

    2017-01-01

    The photoionization cross section, energy levels and widths of 22 Rydberg series (in the autoionization region) for Na-like Ar VIII were investigated by using of R-matrix method. The relativistic distorted-wave method is used to calculate the radial functions, and QB method of Quigly-Berrington [Quigley et al. 1998] is employed to calculate the resonance levels and widths. We have identified the formant in the figure of the photoionization cross section.

  19. Spotlight on the human factor: building a foundation for the future of haemophilia A management: report from a symposium on human recombinant FVIII at the World Federation of Hemophilia World Congress, Melbourne, Australia on 12 May 2014.

    Science.gov (United States)

    Kessler, C; Oldenburg, J; Ettingshausen, C Escuriola; Tiede, A; Khair, K; Négrier, C; Klamroth, R

    2015-01-01

    Inhibitor development is the most serious and challenging complication in the treatment of severe haemophilia A. Up to 38% of such patients develop inhibitors with current recombinant factor VIII (rFVIII) products produced in hamster cell lines. Human-cl rhFVIII is a new generation fully sulfated B-domain-deleted FVIII coagulant glycoprotein, which is generated from a human cell line. Thus, there are no non-human epitopes which would be potentially immunogenic. This molecule has significantly higher VWF-binding affinity compared with existing full-length rFVIII produced in hamster cell lines. The development aim of Human-cl rhFVIII is to address the challenges of FVIII inhibitors and frequent infusions during prophylaxis. Human-cl rhFVIII's mean half-life is very comparable to some of the newer products which involve modification of the FVIII molecule to extend the circulating half-life. There are promising data concerning the use of a personalized prophylaxis regimen with Human-cl rhFVIII. Preliminary data indicate a median dosing interval of 3.5 days with 66.7% of the patients on a twice per week or fewer infusions schedule combined with a low bleeding rate and no increased FVIII consumption when compared to standard prophylaxis. No product-specific laboratory assay is required to monitor the coagulation activity for Human-cl rhFVIII. The results of registration clinical trials with Human-cl rhFVIII as well as the ongoing studies in previously untreated patients (NuProtect) and personalized prophylaxis study in previously treated patients (NuPreviq), will be discussed. The manufacturer has received marketing authorization for Human-cl rhFVIII in Europe and Canada under the name Nuwiq(®) and plans to launch it in the USA and globally in 2015.

  20. Influence of factor VIII level and its inhibitor titer on the therapeutic response to corticosteroids alone in the management of acquired hemophilia

    Science.gov (United States)

    Vautier, Mathieu; de Boysson, Hubert; Creveuil, Christian; Repesse, Yohan; Borel-Derlon, Annie; Troussard, Xavier; Damaj, Gandhi L.; Bienvenu, Boris; Gautier, Philippe; Aouba, Achille

    2016-01-01

    Abstract The treatment of acquired hemophilia (AH) involves discussing whether corticosteroids should be administered alone or combined with immunosuppressant drugs, which increase the risk of infection especially in elderly patients and/or those with autoimmunity or neoplastic diseases, who represent the target population of the disease. Prognostic factors highlighting adequate responses to corticosteroids alone must be identified for satisfactory clinical response and lower infectious risk. We aimed to evaluating the efficacy of corticosteroids alone in the management of AH depending on factor VIII (FVIII, ≥ or 20 Bethesda units per milliliter [BU/mL]) titer. We conducted a retrospective single-center study including 24 patients treated for AH with corticosteroids alone. Time to achieve partial remission (PR: absence of hemorrhage and FVIII levels >50 IU/dL) was significantly shorter in the FVIII ≥ 1 IU/dL group than in the FVIII  20 BU/mL group (15 [11–35] vs 41 [20–207] days, P = 0.003). In both subgroups, time to achieve complete remission (CR: negative INH and corticosteroids below 10 mg/d) was also significantly shorter than that observed in the opposite subgroups. INH titer, considered alone, did not affect the length of time to onset of PR or CR. CR and PR rates did not differ significantly depending on these variables. Our study suggests that in AH, patients with FVIII levels ≥1 IU/dL considered alone or combined with INH titer ≤20 BU/mL could be treated by corticosteroids alone, given that this subgroup of patients displayed faster therapeutic responses to this strategy. PMID:27902587

  1. [Relationship between factor VIII inhibitor development and polymorphisms of TNFα and CTLA-4 gene in Chinese Han patients with hemophilia A].

    Science.gov (United States)

    Zhang, Lu-lu; Yu, Zi-qiang; Zhang, Wei; Cao, Li-juan; Su, Jian; Bai, Xia; Ruan, Chang-geng

    2011-03-01

    To investigate the potential association between factor VIII inhibitor development and polymorphisms of tumor necrosis factor-α (TNF-α)-308 and cytotoxic T-lymphocyte associated protein-4 gene in Chinese Han patients with hemophilia A (HA). The single base change polymorphism in TNF-α and CTLA-4 gene was analyzed in 140 Chinese Han patients with hemophilia A who have been treated with plasma-derived FVIII concentrates and 108 normal controls by using PCR-restrictive fragment length polymorphism (RFLP). All of the HA patients' plasma samples were measured by modified-Nijmegen assay simultaneously. In HA patients, G/G genotype, G/A genotype and A/A genotype were detected in 118 (84.3%), 18 (12.8%) and 4 cases (2.9%) respectively; C/C genotype, C/T genotype and T/T genotype were detected in 108 (77.2%), 30 (21.4%) and 2 cases (1.4%) respectively. The difference in the genotype frequencies between HA patients and controls was nonsignificant (P > 0.05). Patients who were carriers of homozygotes for A allele had a higher risk of inhibitor development compared with those who were not (OR = 7.519, 95% CI = 3.168 - 17.844). Severe HA patients who were carriers of homozygotes for A allele had a higher risk of inhibitor development compared with those who were not (OR = 8.163, 95% CI = 2.521 - 26.434). There was no statistical difference in the risk of inhibitor development between the patients who were carriers or not (OR = 1.586, 95% CI = 0.729 - 3.450). TNF-α-308 gene polymorphism is significantly associated with inhibitor development in Chinese Han patients with severe hemophilia A. TNF-α gene may be a useful marker and potential modulator of the immune response to replacement therapy for hemophilia A patients.

  2. Six amino acid residues in a 1200 A2 interface mediate binding of factor VIII to an IgG4κ inhibitory antibody.

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    Jasper C Lin

    Full Text Available The development of neutralizing anti-factor VIII (FVIII antibodies complicates the treatment of many hemophilia A patients. The C-terminal C2 domain is a particularly antigenic FVIII region. A crystal structure of recombinant FVIII-C2 bound to an Fab fragment of the patient-derived monoclonal antibody BO2C11, which recognizes an immunodominant inhibitor epitope on FVIII and blocks its ability to bind von Willebrand factor (VWF and phospholipids, revealed that 15 amino acids in FVIII contact this antibody. Forty-three recombinant FVIII-C2 proteins, each with a surface-exposed side chain mutated to alanine or another residue, were generated, and surface plasmon resonance studies were carried out to evaluate effects of these substitutions on BO2C11/FVIII-C2 binding affinity. Thermodynamic analysis of experiments carried out at three temperatures indicated that one beta hairpin turn at the antigen-antibody interface (FVIII-F2196, N2198, M2199 and F2200 plus two non-contiguous arginines (FVIII-R2215 and R2220, contributed appreciably to the affinity. B-domain-deleted (BDD FVIII-F2196A, FVIII-F2196K and FVIII-M2199A were generated and characterized. Their pro-coagulant activities and binding to VWF were similar to those of WT-BDD-FVIII, and FVIII-F2196K avoided neutralization by BO2C11 and murine inhibitory mAb 1B5. This study suggests specific sites for amino acid substitutions to rationally design FVIII variants capable of evading immunodominant neutralizing anti-FVIII antibodies.

  3. A single chain variant of factor VIII Fc fusion protein retains normal in vivo efficacy but exhibits altered in vitro activity.

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    Yang Buyue

    Full Text Available Recombinant factor VIII Fc (rFVIIIFc is a fusion protein consisting of a single B-domain-deleted (BDD FVIII linked recombinantly to the Fc domain of human IgG1 to extend half-life. To determine if rFVIIIFc could be further improved by maintaining the heavy and light chains within a contiguous single chain (SC, we evaluated the activity and function of SC rFVIIIFc, an isoform that is not processed at residue R1648. SC rFVIIIFc showed equivalent activity in a chromogenic assay compared to rFVIIIFc, but approximately 40% activity by the one-stage clotting assay in the presence of von Willebrand Factor (VWF, with full activity in the absence of VWF. Moreover, SC rFVIIIFc demonstrated markedly delayed thrombin-mediated release from VWF, but an activity similar to that of rFVIIIFc upon activation in FXa generation assays. Therefore, the apparent reduction in specific activity in the aPTT assay appears to be primarily due to delayed release of FVIII from VWF. To assess whether stability and activity of SC rFVIIIFc were affected in vivo, a tail vein transection model in Hemophilia A mice was utilized. The results demonstrated similar pharmacokinetic profiles and comparable efficacy for SC rFVIIIFc and rFVIIIFc. Thus, while the single chain configuration did not promote enhanced half-life, it reduced the rate of release of FVIII from VWF required for activation. This impaired release may underlie the observed reduction in the one-stage clotting assay, but does not appear to affect the physiological activity of SC rFVIIIFc.

  4. Assessment of the frequency of regulatory T cells (CD4+CD25+CD127-) in children with hemophilia A: relation to factor VIII inhibitors and disease severity.

    Science.gov (United States)

    El-Asrar, Mohamed Abo; Hamed, Ahmed El-Saeed; Darwish, Yasser Wagih; Ismail, Eman Abdel Rahman; Ismail, Noha Ali

    2016-01-01

    A rapidly growing evidence showed that regulatory T cells (Tregs) play a crucial role in tolerance to coagulation factors and may be involved in the pathogenesis of inhibitor formation in patients with hemophilia. We determined the percentage of Tregs (CD4CD25CD127) in 45 children with hemophilia A compared with 45 healthy controls, and assessed their relation to the clinical characteristics of patients and factor VIII (FVIII) inhibitors. Patients were studied stressing on frequency of bleeding attacks, joint pain, history of viral hepatitis, and the received therapy (FVIII precipitate/cryotherapy). FVIII activity and FVIII inhibitors were assessed with flow cytometric analysis of CD4CD25CD127 Tregs. According to residual FVIII activity levels, 30 patients (66.7%) had mild/moderate hemophilia A, whereas 15 (33.3%) patients had severe hemophilia A. The frequency of Tregs was significantly lower among all patients with hemophilia A compared with controls (2.59 ± 1.1 versus 3.73 ± 1.12%; P = 0.002). Tregs were significantly decreased among patients with FVIII inhibitors compared with the inhibitor-negative group (P hemophilia A had lower Tregs levels than those without (P = 0.34 and P = 0.011, respectively). A significant positive correlation was found between the percentage of Tregs and FVIII among hemophilia A patients. ROC curve analysis revealed that the cut-off value of Tregs at 1.91% could differentiate patients with and without FVIII inhibitors, with a sensitivity of 100% and a specificity of 91.3%. We suggest that alteration in the frequency of Tregs in young patients with hemophilia A may contribute to inhibitor formation and disease severity.

  5. Coronary artery calcification in hemophilia A: No evidence for a protective effect of factor VIII deficiency on atherosclerosis

    NARCIS (Netherlands)

    Tuinenburg, A.; Rutten, A.; Kavousi, M.; Leebeek, F.W.G.; Ypma, P.F.; Laros-Van Gorkom, B.A.P.; Nijziel, M.R.; Kamphuisen, P.W.; Mauser-Bunschoten, E.P.; Roosendaal, G.; Biesma, D.H.; Van Der Lugt A., [No Value; Hofman, A.; Witteman, J.C.M.; Bots, M.L.; Schutgens, R.E.G.

    2011-01-01

    Mortality due to ischemic heart disease is lower in hemophilia patients when compared to the general male population. As coagulation plays a role in the inflammatory pathways involved in atherogenesis, we investigated whether the clotting factor deficiency protects hemophilia patients from developin

  6. Plasmin-induced procoagulant effects in the blood coagulation: a crucial role of coagulation factors V and VIII.

    Science.gov (United States)

    Ogiwara, Kenichi; Nogami, Keiji; Nishiya, Katsumi; Shima, Midori

    2010-09-01

    Plasminogen activators provide effective treatment for patients with acute myocardial infarction. However, paradoxical elevation of thrombin activity associated with failure of clot lysis and recurrent thrombosis has been reported. Generation of thrombin in these circumstances appears to be owing to plasmin (Plm)-induced activation of factor (F) XII. Plm catalyzes proteolysis of several coagulant factors, but the roles of these factors on Plm-mediated procoagulant activity remain to be determined. Recently developed global coagulation assays were used in this investigation. Rotational thromboelastometry using whole blood, clot waveform analysis and thrombin generation tests using plasma, showed that Plm (> or =125 nmol/l) shortened the clotting times in similar dose-dependent manners. In particular, the thrombin generation test, which was unaffected by products of fibrinolysis, revealed the enhanced coagulation with an approximately two-fold increase of peak level of thrombin generation. Studies using alpha2-antiplasmin-deficient plasma revealed that much lower dose of Plm (> or =16 nmol/l) actually contributed to enhancing thrombin generation. The shortening of clotting time could be observed even in the presence of corn trypsin inhibitor, supporting that Plm exerted the procoagulant activity independently of FXII. In addition, using specific coagulation-deficient plasmas, the clot waveform analysis showed that Plm did not shorten the clotting time in only FV-deficient or FVIII-deficient plasma in prothrombin time-based or activated partial thromboplastin time-based assay, respectively. Our results indicated that Plm did possess procoagulant activity in the blood coagulation, and this effect was likely attributed by multicoagulation factors, dependent on FV and/or FVIII.

  7. Anti-CD20 as the B cells targeting agent in the combined therapy to modulate anti-factor VIII immune responses in hemophilia A inhibitor mice

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    Chao Lien eLiu

    2014-01-01

    Full Text Available Neutralizing antibody formation against transgene products can represent a major complication following gene therapy with treatment of genetic diseases, such as hemophilia A. Although successful approaches have been developed to prevent the formation of anti-factor VIII (FVIII antibodies, innovative strategies to overcome pre-existing anti-FVIII immune responses in FVIII-primed subjects are still lacking. Anti-FVIII neutralizing antibodies circulate for long periods in part due to persistence of memory B cells. Anti-CD20 targets a variety of B cells (pre-B cells to mature/memory cells; therefore, we investigated the impact of B cell depletion on anti-FVIII immune responses in hemophilia A mice using anti-CD20 combined with regulatory T (Treg cell expansion using IL-2/IL-2mAb complexes plus rapamycin. We found that anti-CD20 alone can partially modulate anti-FVIII immune responses in both unprimed and FVIII-primed hemophilia A mice. Moreover, in mice treated with anti-CD20 + IL-2/IL-2mAb complexes + rapamycin + FVIII, anti-FVIII antibody titers were significantly reduced in comparison to mice treated with regimens targeting only B or T cells. In addition, titers remained low after a second challenge with FVIII plasmid . Treg cells and activation markers were transiently and significantly increased in the groups treated with IL-2/IL-2mAb complexes ; however,significant B cell depletion was obtained in anti-CD20-treated groups. Importantly, both FVIII-specific antibody-secreting cells and memory B cells were significantly reduced in mice treated with combination therapy. This study demonstrates that a combination regimen is highly promising as a treatment option for modulating anti-FVIII antibodies and facilitating induction of long-term tolerance to FVIII in hemophilia A mice.

  8. Lentivirus-mediated platelet gene therapy of murine hemophilia A with pre-existing anti-factor VIII immunity.

    Science.gov (United States)

    Kuether, E L; Schroeder, J A; Fahs, S A; Cooley, B C; Chen, Y; Montgomery, R R; Wilcox, D A; Shi, Q

    2012-08-01

    The development of inhibitory antibodies, referred to as inhibitors, against exogenous factor VIII in a significant subset of patients with hemophilia A remains a persistent challenge to the efficacy of protein replacement therapy. Our previous studies using the transgenic approach provided proof-of-principle that platelet-specific expression could be successful in treating hemophilia A in the presence of inhibitory antibodies. To investigate a clinically translatable approach for platelet gene therapy of hemophilia A with pre-existing inhibitors. Platelet FVIII expression in preimmunized FVIII(null) mice was introduced by transplantation of lentivirus-transduced bone marrow or enriched hematopoietic stem cells. FVIII expression was determined with a chromogenic assay. The transgene copy number per cell was quantitated with real-time PCR. Inhibitor titer was measured with the Bethesda assay. Phenotypic correction was assessed by the tail clipping assay and an electrolytically induced venous injury model. Integration sites were analyzed with linear amplification-mediated PCR. Therapeutic levels of platelet FVIII expression were sustained in the long term without evoking an anti-FVIII memory response in the transduced preimmunized recipients. The tail clip survival test and the electrolytic injury model confirmed that hemostasis was improved in the treated animals. Sequential bone marrow transplants showed sustained platelet FVIII expression resulting in phenotypic correction in preimmunized secondary and tertiary recipients. Lentivirus-mediated platelet-specific gene transfer improves hemostasis in mice with hemophilia A with pre-existing inhibitors, indicating that this approach may be a promising strategy for gene therapy of hemophilia A even in the high-risk setting of pre-existing inhibitory antibodies. © 2012 International Society on Thrombosis and Haemostasis.

  9. Genotyping of intron 22 inversion of factor VIII gene for diagnosis of hemophilia A by inverse-shifting polymerase chain reaction and capillary electrophoresis.

    Science.gov (United States)

    Pan, Tzu-Yu; Wang, Chun-Chi; Shih, Chi-Jen; Wu, Hui-Fen; Chiou, Shyh-Shin; Wu, Shou-Mei

    2014-09-01

    This is the first capillary electrophoresis (CE) analysis for diagnosis of hemophilia A (HA). The intron 22 inversion of factor VIII gene (F8) causes 40-50 % of severe bleeding disorder of HA in all human populations. Consequently, identification of the disease-causing mutations is becoming increasingly important for accurate genetic counseling and prenatal diagnosis. In this study, the key steps of inverse-shifting polymerase chain reaction (IS-PCR) and of short-end injection capillary electrophoresis were used for more specific and rapid genotyping of intron 22 inversion of F8. In IS-PCR, three specific primers were used to amplify 512-bp amplicon for wild type and 584-bp amplicon for patients with intron 22 inversion. The capillary gel electrophoresis (CGE) system was performed using 1× Tris-borate-EDTA (TBE) buffer containing 0.3 % (w/v) polyethylene oxide (PEO). The PCR amplicons were electrokinetically injected at 10 kV for 10 s at a temperature of 25 °C. The optimal short-end injection CGE was applied to detect the F8 gene of HA patients and carriers within 5 min. Intron 22 inversion was indeed found on some HA patients (13/35, 37.1 %). All genotyping results showed good agreement with DNA sequencing method and long-distance polymerase chain reaction (LD-PCR). The IS-PCR combined with short-end injection CGE method was feasible and efficient for intron 22 inversion screening of F8 in the HA populations.

  10. Characterization of the anti-factor VIII immunoglobulin profile in patients with hemophilia A by use of a fluorescence-based immunoassay

    Science.gov (United States)

    Boylan, Brian; Rice, Anne S.; Dunn, Amy L.; Tarantino, Michael D.; Brettler, Doreen B.; Barrett, John C.; Miller, Connie H.

    2015-01-01

    Summary Background The development of neutralizing antibodies, referred to as inhibitors, against factor VIII (FVIII) is a major complication associated with FVIII infusion therapy for the treatment of hemophilia A (HA). Previous studies have shown that a subset of HA patients and a low percentage of healthy individuals harbor non-neutralizing anti-FVIII antibodies that do not elicit the clinical manifestations associated with inhibitor development. Objective Assess HA patients' anti-FVIII antibody profiles as potential predictors of clinical outcomes. Methods A fluorescence immunoassay (FLI) was used to detect anti-FVIII antibodies in 491 samples from 371 HA patients. Results Assessments of antibody profiles showed that the presence of anti-FVIII IgG1, IgG2, or IgG4 correlated qualitatively and quantitatively with the presence of a FVIII inhibitor as reported by the Nijmegen-Bethesda assay (NBA). Forty-eight patients with a negative inhibitor history contributed serial samples to the study, including seven patients who had negative NBA titers initially and later converted to NBA-positive. The FLI detected anti-FVIII IgG1 in five of those seven patients prior to their conversion to NBA-positive. Five of 15 serial-sample patients who had a negative inhibitor history and a positive anti-FVIII IgG1 later developed an inhibitor, compared to 2 of 33 patients with a negative inhibitor history without anti-FVIII IgG1. Conclusions These data provide a rationale for future studies designed both to monitor the dynamics of anti-FVIII antibody profiles in HA patients as a potential predictor of future inhibitor development and to assess the value of the anti-FVIII FLI as a supplement to traditional inhibitor testing. PMID:25354263

  11. Obtenção e caracterização de anticorpo monoclonal murino anti-fator VIII da coagulação sangüínea Attainment and characterization of murine monoclonal anti-factor VIII antibodies

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    Rosana Rossi-Ferreira

    2006-06-01

    Full Text Available Entre os avanços da engenharia celular e biotecnologia nas últimas décadas, destaca-se a produção de anticorpos monoclonais murinos (AcMm utilizados no aprimoramento diagnóstico nas rotinas laboratoriais. A produção de fator VIII de alta pureza sempre foi o desejo e a preocupação das indústrias de hemoderivados para tratamento de pacientes portadores de hemofilia A, porém este produto inexiste no Brasil, sendo necessária sua obtenção no mercado internacional a custos elevados. O trabalho tem por objetivo a produção de AcMm anti-fator VIII humano (FVIII H através da expansão dos clones e caracterização imunoquímica do anticorpo. Camundongos Balb/c foram imunizados com FVIII H purificado como também proveniente de crioprecipitado e as células esplênicas dos animais foram fusionadas com células mielomatosas murinas segundo o método descrito por Kohler e Milstein para produção de híbridos em cultura. Foram testados 1.983 híbridos dos quais 105 foram submetidos à clonagem. Destes, 39 obtiveram monoclonalidade e 7 destes clones foram caracterizados através de técnicas de immunoblotting. Foram submetidas à purificação por cromatografia três imunoglobulinas de diferentes classes pertencentes aos clones LAMB1-10A1A4, LAMB1-17A1A1 e LAMB1-24A2A1. A imunoglobulina purificada pertencente ao clone LAMB1-10A1A4 foi adsorvida em coluna de imunoafinidade para purificação de concentrado de FVIII proveniente de crioprecipitado plasmático.Among the advances in cellular engineering and biotechnology over the last decades, the production of murine monoclonal antibodies (AcMm, used to improve laboratory diagnoses, stands out. The production of very pure factor VIII has always been a concern of suppliers of blood products to treat patients with hemophilia A and this product is still not produced in Brazil. Hence, it can only be attained on the international market at a high cost. The aim of this work was to produce AcMm anti-factor

  12. Immune tolerance induced by platelet-targeted factor VIII gene therapy in hemophilia A mice is CD4 T cell mediated.

    Science.gov (United States)

    Chen, Y; Luo, X; Schroeder, J A; Chen, J; Baumgartner, C K; Hu, J; Shi, Q

    2017-10-01

    Essentials The immune response is a significant concern in gene therapy. Platelet-targeted gene therapy can restore hemostasis and induce immune tolerance. CD4 T cell compartment is tolerized after platelet gene therapy. Preconditioning regimen affects immune tolerance induction in platelet gene therapy. Background Immune responses are a major concern in gene therapy. Our previous studies demonstrated that platelet-targeted factor VIII (FVIII) (2bF8) gene therapy together with in vivo drug selection of transduced cells can rescue the bleeding diathesis and induce immune tolerance in FVIII(null) mice. Objective To investigate whether non-selectable 2bF8 lentiviral vector (LV) for the induction of platelet-FVIII expression is sufficient to induce immune tolerance and how immune tolerance is induced after 2bF8LV gene therapy. Methods Platelet-FVIII expression was introduced by 2bF8LV transduction and transplantation. FVIII assays and tail bleeding tests were used to confirm the success of platelet gene therapy. Animals were challenged with rhF8 to explore if immune tolerance was induced after gene therapy. Treg cell analysis, T-cell proliferation assay and memory B-cell-mediated ELISPOT assay were used to investigate the potential mechanisms of immune tolerance. Results We showed that platelet-FVIII expression was sustained and the bleeding diathesis was restored in FVIII(null) mice after 2bF8LV gene therapy. None of the transduced recipients developed anti-FVIII inhibitory antibodies in the groups preconditioned with 660 cGy irradiation or busulfan plus ATG treatment even after rhF8 challenge. Treg cells significantly increased in 2bF8LV-transduced recipients and the immune tolerance developed was transferable. CD4(+) T cells from treated animals failed to proliferate in response to rhF8 re-stimulation, but memory B cells could differentiate into antibody secreting cells in 2bF8LV-transduced recipients. Conclusion 2bF8LV gene transfer without in vivo selection of

  13. Characterization of the factor VIII defect in 147 patients with sporadic hemophilia A: Family studies indicate a mutation type-dependent sex ratio of mutation frequencies

    Energy Technology Data Exchange (ETDEWEB)

    Becker, J.; Schmidt, W.; Olek, K. [Univ. of Bonn (Germany)] [and others

    1996-04-01

    The clinical manifestation of hemophilia A is caused by a wide range of different mutations. In this study the factor VIII genes of 147 severe hemophilia A patients-all exclusively from sporadic families-were screened for mutations by use of the complete panel of modern DNA techniques. The pathogenous defect could be characterized in 126 patients (85.7%). Fifty-five patients (37.4%) showed a F8A-gene inversion, 47 (32.0%) a point mutation, 14 (9.5%) a small deletion, 8 (5.4%) a large deletion, and 2 (1.4%) a small insertion. Further, four (2.7%) mutations were localized but could not be sequenced yet. No mutation could be identified in 17 patients (11.6%). Sixteen (10.9%) of the P identified mutations occurred in the B domain. Four of these were located in an adenosine nucleotide stretch at codon 1192, indicating a mutation hotspot. Somatic mosaicisms were detected in 3 (3.9%) of 76 patients` mothers, comprising 3 of 16 de novo mutations in the patients` mothers. Investigation of family relatives allowed detection of a de novo mutation in 16 of 76 two-generation and 28 of 34 three-generation families. On the basis of these data, the male:female ratio of mutation frequencies (k) was estimated as k = 3.6. By use of the quotients of mutation origin in maternal grandfather to patient`s mother or to maternal grandmother, k was directly estimated as k = 15 and k = 7.5, respectively. Considering each mutation type separately, we revealed a mutation type-specific sex ratio of mutation frequencies. Point mutations showed a 5-to-10-fold-higher and inversions a >10-fold- higher mutation rate in male germ cells, whereas deletions showed a >5-fold-higher mutation rate in female germ cells. Consequently, and in accordance with the data of other diseases like Duchenne muscular dystrophy, our results indicate that at least for X-chromosomal disorders the male:female mutation rate of a disease is determined by its proportion of the different mutation types. 68 refs., 1 fig., 5 tabs.

  14. Comparison of Clot-based, Chromogenic, and Fluorescence Assays for Measurement of Factor VIII Inhibitors in the U.S. Hemophilia Inhibitor Research Study

    Science.gov (United States)

    Miller, Connie H.; Rice, Anne S.; Boylan, Brian; Shapiro, Amy D.; Lentz, Steven R.; Wicklund, Brian M.; Kelly, Fiona M.; Soucie, J. Michael

    2015-01-01

    Summary Background Detection and validation of inhibitors (antibodies) to hemophilia treatment products are important for clinical care, evaluation of product safety, and assessment of population trends. Methods Centralized monitoring for factor VIII (FVIII) inhibitors was conducted for patients in the Hemophilia Inhibitor Research Study using a previously reported modified Nijmegen-Bethesda clotting assay (NBA), a chromogenic Bethesda assay (CBA), and a novel fluorescence immunoassay (FLI). Results NBA and CBA were performed on 1005 specimens and FLI on 272 specimens. CBA was negative on 880/883 specimens (99.7%) with Nijmegen-Bethesda units (NBU)<0.5 and positive on 42/42 specimens (100%) with NBU≥2.0 and 43/80 specimens (53.8%) with NBU 0.5–1.9. Among specimens with positive NBA and negative CBA, 58.1% were FLI-negative, 12.9% had evidence of lupus anticoagulant, and 35.5% had non-time-dependent inhibition. CBA and FLI were positive on 72.4% and 100% of 1.0–1.9 NBU specimens and 43.1% and 50.0% of 0.5–0.9 NBU specimens. FLI detected antibodies in 98.0% of CBA-positive and 81.6% of NBA-positive specimens (P=0.004). Among 21 new inhibitors detected by NBA, 5 (23.8%) with 0.7–1.3 NBU did not react in CBA or FLI. Among previously positive patients with 0.5–1.9 NBU, 7/25 (28%) were not CBA or FLI positive. FLI was positive on 36/169 NBU-negative specimens (21.3%). Conclusions FVIII specificity could not be demonstrated by CBA or FLI for 26% of inhibitors of 0.5–1.9 NBU; such results must be interpreted with caution. Low titer inhibitors detected in clot-based assays should always be repeated, with consideration given to evaluating their reactivity with FVIII using more specific assays. PMID:23601690

  15. First prospective report on immune tolerance in poor risk haemophilia A inhibitor patients with a single factor VIII/von Willebrand factor concentrate in an observational immune tolerance induction study.

    Science.gov (United States)

    Kreuz, W; Escuriola Ettingshausen, C; Vdovin, V; Zozulya, N; Plyushch, O; Svirin, P; Andreeva, T; Bubanská, E; Campos, M; Benedik-Dolničar, M; Jiménez-Yuste, V; Kitanovski, L; Klukowska, A; Momot, A; Osmulskaya, N; Prieto, M; Šalek, S Z; Velasco, F; Pavlova, A; Oldenburg, J; Knaub, S; Jansen, M; Belyanskaya, L; Walter, O

    2016-01-01

    Development of neutralizing inhibitors against factor VIII (FVIII) is a major complication of haemophilia A treatment. The ongoing, international, open-label, uncontrolled, observational immune tolerance induction (ObsITI) study evaluates ITI, the standard of care in patients with inhibitors. Forty-eight prospective patients in this interim analysis received a single plasma-derived, von Willebrand factor-stabilized, FVIII concentrate (pdFVIII/VWF) for ITI. According to recommended Bonn protocol, 'low responders' at ITI start (2 years since inhibitor diagnosis, inhibitor titre ≥10 BU at the start of ITI, or prior ITI failure). Nonetheless, 34 patients (70.8%) achieved complete success, 3 (6.3%) partial success, 1 (2.1%) partial response; ITI failed in 10 patients (20.8%), all with poor prognosis factors. All six low responders achieved complete success. ITI outcome was significantly associated with inhibitor titre level at ITI start (P = 0.0068), number of poor prognosis factors for ITI success (P = 0.0187), monthly bleeding rate during ITI (P = 0.0005) and peak inhibitor titre during ITI (P = 0.0007). Twenty-two of 35 high responder patients (62.9%) with ≥1 poor prognosis factor achieved complete success. Treatment with a single pdFVIII/VWF concentrate, mainly according to the Bonn protocol, resulted in a high ITI success rate in haemophilia A patients with inhibitors and poor prognosis for ITI success. © 2015 The Authors. Haemophilia Published by John Wiley & Sons Ltd.

  16. Risk Factors for High-Titer Inhibitor Development in Children with Hemophilia A: Results of a Cohort Study

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    Susan Halimeh

    2013-01-01

    Full Text Available Among the discussed risk factors for high-titre inhibitor (HRI development in patients with hemophilia A (HA are high dose FVIII replacement therapy and use of recombinant FVIII concentrates (rFVIII. The aim of this study was to evaluate the aforementioned risk factors for HRI development in children with hemophilia A ≤2%. About 288 ascertained PUPs (Israel and Germany were followed after initial HA diagnosis over 200 exposure days. Inhibitor-free survival, hazard ratios (HR, and 95% confidence intervals (CIs were calculated. Adjustment was performed for factor VIII concentrates, median single dose over the first three months of treatment, first FVIII administration before the age of three months, presence of risk HA gene mutations, “intensive treatment moments” and “year of birth” (proxy for different treatment periods. HRI occurred in 71/288 children (24.7%. In multivariate analysis adjusted for “year of birth”, underlying risk gene mutations (HR/CI: 2.37/1.40–3.99, FVIII dose, measured per one IU increase per kgbw (HR/CI: 1.05/1.04–1.07, and first FVIII administration before the age of three months showed a significant impact on HR development. The risk of HRI development was similar for recombinant or plasmatic FVIII products. Children at risk should be treated with carefully calculated lower dose regimens, adapted to individual bleeding situations.

  17. Risk factors for high-titer inhibitor development in children with hemophilia A: results of a cohort study.

    Science.gov (United States)

    Halimeh, Susan; Bidlingmaier, Christoph; Heller, Christine; Gutsche, Sven; Holzhauer, Susanne; Kenet, Gili; Kurnik, Karin; Manner, Daniela; Iorio, Alfonso; Nowak-Göttl, Ulrike

    2013-01-01

    Among the discussed risk factors for high-titre inhibitor (HRI) development in patients with hemophilia A (HA) are high dose FVIII replacement therapy and use of recombinant FVIII concentrates (rFVIII). The aim of this study was to evaluate the aforementioned risk factors for HRI development in children with hemophilia A ≤2%. About 288 ascertained PUPs (Israel and Germany) were followed after initial HA diagnosis over 200 exposure days. Inhibitor-free survival, hazard ratios (HR), and 95% confidence intervals (CIs) were calculated. Adjustment was performed for factor VIII concentrates, median single dose over the first three months of treatment, first FVIII administration before the age of three months, presence of risk HA gene mutations, "intensive treatment moments" and "year of birth" (proxy for different treatment periods). HRI occurred in 71/288 children (24.7%). In multivariate analysis adjusted for "year of birth", underlying risk gene mutations (HR/CI: 2.37/1.40-3.99), FVIII dose, measured per one IU increase per kgbw (HR/CI: 1.05/1.04-1.07), and first FVIII administration before the age of three months showed a significant impact on HR development. The risk of HRI development was similar for recombinant or plasmatic FVIII products. Children at risk should be treated with carefully calculated lower dose regimens, adapted to individual bleeding situations.

  18. Polymorphisms in the F8 gene and MHC-II variants as risk factors for the development of inhibitory anti-factor VIII antibodies during the treatment of hemophilia a: a computational assessment.

    Directory of Open Access Journals (Sweden)

    Gouri Shankar Pandey

    Full Text Available The development of neutralizing anti-drug-antibodies to the Factor VIII protein-therapeutic is currently the most significant impediment to the effective management of hemophilia A. Common non-synonymous single nucleotide polymorphisms (ns-SNPs in the F8 gene occur as six haplotypes in the human population (denoted H1 to H6 of which H3 and H4 have been associated with an increased risk of developing anti-drug antibodies. There is evidence that CD4+ T-cell response is essential for the development of anti-drug antibodies and such a response requires the presentation of the peptides by the MHC-class-II (MHC-II molecules of the patient. We measured the binding and half-life of peptide-MHC-II complexes using synthetic peptides from regions of the Factor VIII protein where ns-SNPs occur and showed that these wild type peptides form stable complexes with six common MHC-II alleles, representing 46.5% of the North American population. Next, we compared the affinities computed by NetMHCIIpan, a neural network-based algorithm for MHC-II peptide binding prediction, to the experimentally measured values and concluded that these are in good agreement (area under the ROC-curve of 0.778 to 0.972 for the six MHC-II variants. Using a computational binding predictor, we were able to expand our analysis to (a include all wild type peptides spanning each polymorphic position; and (b consider more MHC-II variants, thus allowing for a better estimation of the risk for clinical manifestation of anti-drug antibodies in the entire population (or a specific sub-population. Analysis of these computational data confirmed that peptides which have the wild type sequence at positions where the polymorphisms associated with haplotypes H3, H4 and H5 occur bind MHC-II proteins significantly more than a negative control. Taken together, the experimental and computational results suggest that wild type peptides from polymorphic regions of FVIII constitute potential T-cell epitopes

  19. [Intein-mediated F309SfVIII ligation with enhanced secretion of its heavy chain.].

    Science.gov (United States)

    Zhu, Fu-Xiang; Liu, Ze-Long; Qu, Hui-Ge; Chi, Xiao-Yan

    2009-12-25

    Coagulation factor VIII (fVIII) is a secretion protein and plays a crucial role in the coagulation cascade. Hemophilia A resulted from deficiency of fVIII is the most common X-linked recessive bleeding disorder. Gene therapy is recognized as an attractive strategy for the eventual cure of this disease. However, the gene therapy is hampered by the big size of fVIII gene when using the most promising gene vectors, adeno-associated virus (AAV) vectors. In this study we explored the intein-mediated protein trans-splicing to deliver a Phe(309)-->Ser mutant full-length fVIII (F309SfVIII) gene by using a dual-vector system. An intein is a protein sequence embedded within a precursor protein and can excise itself through protein splicing. The F309SfVIII is proven to be beneficial to its secretion. The F309SfVIII gene was broken into heavy and light chains before Ser(1239) in B domain and fused with the coding sequences of Ssp DnaB intein respectively to construct a pair of plasmid vectors by inserting them into the pcDNA3.1 vectors. Forty-eight hours after co- or separate transfection of 293 cells, the co-transfected cell lysate showed an obvious ligated F309SfVIII protein band by Western blot with a polyclonal antibody against fVIII. The amounts of secreted F309SfVIII protein in culture supernatants and their bioactivities were (71+/-9) ng/mL and (0.38+/-0.09) IU/mL determined by ELISA and Coatest assay respectively. The supernatant from combined cells with separate transfections also displayed lower levels of F309SfVIII antigen and fVIII activity [(25+/-6) ng/mL and (0.12+/-0.05) IU/mL], indicating the F309SfVIII could be formed by splicing both before and after secretion. The content of F309SfVIII heavy chain protein from co-transfected cell supernatant was higher than that of intein-fused heavy chain transfection alone [(135+/-10) ng/mL vs (37+/-7) ng/mL, Pintein could be used as a technical strategy in a dual-vector system delivering F309SfVIII gene with improved

  20. Process development for human factor VIII purification by chromatography, the use of specific antibodies against fragments of the protein for evaluation of purity and stability during purification processes.

    OpenAIRE

    Daniela Jinzenji

    2008-01-01

    O fator VIII de coagulação (FVIII), recombinante ou purificado de plasma, é o biofármaco necessário para o tratamento da hemofília A, a doença hemorrágica mais freqüente em humanos. O método tradicional para a purificação de FVIII parte de crioprecipitado de plasma e precipitação alcoólica. No Instituto Butantan, foi proposto um método alternativo, utilizando somente cromatografia para esta purificação. Este projeto teve por objetivo comparar dois métodos cromatográficos de purificação do FVI...

  1. A Serotype VIII Strain among Colonizing Group B Streptococcal Isolates in Boston, Massachusetts

    OpenAIRE

    Paoletti, Leanne J.; Bradford, Jessica; Paoletti, Lawrence C.

    1999-01-01

    Maternal colonization with group B Streptococcus (GBS) is a risk factor for neonatal GBS disease. Whereas serotypes Ia, Ib, II, III, and V are prevalent in the United States, types VI and VIII predominate in Japan. Recently, a serotype VIII strain was detected among 114 clinical GBS isolates from a Boston, Mass., hospital.

  2. A factor VIII-derived peptide enables von Willebrand factor (VWF)-binding of artificial platelet nanoconstructs without interfering with VWF-adhesion of natural platelets.

    Science.gov (United States)

    Haji-Valizadeh, Hassan; Modery-Pawlowski, Christa L; Sen Gupta, Anirban

    2014-05-01

    There is substantial clinical interest in synthetic platelet analogs for potential application in transfusion medicine. To this end, our research is focused on self-assembled peptide-lipid nanoconstructs that can undergo injury site-selective adhesion and subsequently promote site-directed active platelet aggregation, thus mimicking platelet's primary hemostatic actions. For injury site-selective adhesion, we have utilized a coagulation factor FVIII-derived VWF-binding peptide (VBP). FVIII binds to VWF's D'-D3 domain while natural platelet GPIbα binds to VWF's A1 domain. Therefore, we hypothesized that the VBP-decorated nanoconstructs will adhere to VWF without mutual competition with natural platelets. We further hypothesized that the adherent VBP-decorated constructs can enhance platelet aggregation when co-decorated with a fibrinogen-mimetic peptide (FMP). To test these hypotheses, we used glycocalicin to selectively block VWF's A1 domain and, using fluorescence microscopy, studied the binding of fluorescently labeled VBP-decorated nanoconstructs versus platelets to ristocetin-treated VWF. Subsequently, we co-decorated the nanoconstructs with VBP and FMP and incubated them with human platelets to study construct-mediated enhancement of platelet aggregation. Decoration with VBP resulted in substantial construct adhesion to ristocetin-treated VWF even if the A1-domain was blocked by glycocalicin. In comparison, such A1-blocking resulted in significant reduction of platelet adhesion. Without A1-blocking, the VBP-decorated constructs and natural platelets could adhere to VWF concomitantly. Furthermore, the constructs co-decorated with VBP and FMP enhanced active platelet aggregation. The results indicate significant promise in utilizing the FVIII-derived VBP in developing synthetic platelet analogs that do not interfere with VWF-binding of natural platelets but allow site-directed enhancement of platelet aggregation when combined with FMP.

  3. Trp[superscript 2313]-His[superscript 2315] of Factor VIII C2 Domain Is Involved in Membrane Binding Structure of a Complex Between the C[subscript 2] Domain and an Inhibitor of Membrane Binding

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Zhuo; Lin, Lin; Yuan, Cai; Nicolaes, Gerry A.F.; Chen, Liqing; Meehan, Edward J.; Furie, Bruce; Furie, Barbara; Huang, Mingdong (Harvard-Med); (UAH); (Maastricht); (Chinese Aca. Sci.)

    2010-11-03

    Factor VIII (FVIII) plays a critical role in blood coagulation by forming the tenase complex with factor IXa and calcium ions on a membrane surface containing negatively charged phospholipids. The tenase complex activates factor X during blood coagulation. The carboxyl-terminal C2 domain of FVIII is the main membrane-binding and von Willebrand factor-binding region of the protein. Mutations of FVIII cause hemophilia A, whereas elevation of FVIII activity is a risk factor for thromboembolic diseases. The C2 domain-membrane interaction has been proposed as a target of intervention for regulation of blood coagulation. A number of molecules that interrupt FVIII or factor V (FV) binding to cell membranes have been identified through high throughput screening or structure-based design. We report crystal structures of the FVIII C2 domain under three new crystallization conditions, and a high resolution (1.15 {angstrom}) crystal structure of the FVIII C2 domain bound to a small molecular inhibitor. The latter structure shows that the inhibitor binds to the surface of an exposed {beta}-strand of the C2 domain, Trp{sup 2313}-His{sup 2315}. This result indicates that the Trp{sup 2313}-His{sup 2315} segment is an important constituent of the membrane-binding motif and provides a model to understand the molecular mechanism of the C2 domain membrane interaction.

  4. Alfonso VIII, Cruzada y Cristiandad = Alfonso VIII, Crusade and Christendom

    Directory of Open Access Journals (Sweden)

    Carlos de Ayala Martínez

    2016-06-01

    Full Text Available Lacruzada fue el cauce más directo para la integración de la Península Ibérica en el conjunto de la Cristiandad. Este hecho se pone especialmente de relieve cuando nos acercamos al reinado de Alfonso VIII de Castilla. El monarca, que casó con la hija del rey de Inglaterra, comprometió el matrimonio de su primogénita con el heredero del emperador alemán y casó a otra de sus hijas con el futuro rey de Francia, representa esa plena integración cuyo seguimiento es posible a través de diversos indicadores –políticos, ideológicos, culturales…-, que, en todo caso, refuerzan la imagen propagandística de un rey al servicio de la defensa de la Cristiandad.Crusading was the most effective method of integrating the Iberian Peninsula within Christendom. This fact is most evident when we consider the reign of Alfonso VIII of Castile. This monarch married the daughter of the king of England, arranged the marriage of his eldest daughter with the heir of the German Emperor and married another of his daughters with the future king of France. These actions convey the need for maximum integration which can be traced using several indicators –political, ideological, cultural...– that moreover reinforce the propaganda image of a king at the service and in defence of Christianity.

  5. Functional Role of Milk Fat Globule-Epidermal Growth Factor VIII in Macrophage-Mediated Inflammatory Responses and Inflammatory/Autoimmune Diseases

    OpenAIRE

    Young-Su Yi

    2016-01-01

    Inflammation involves a series of complex biological processes mediated by innate immunity for host defense against pathogen infection. Chronic inflammation is considered to be one of the major causes of serious diseases, including a number of autoimmune/inflammatory diseases, cancers, cardiovascular diseases, and neurological diseases. Milk fat globule-epidermal growth factor 8 (MFG-E8) is a secreted protein found in vertebrates and was initially discovered as a critical component of the mil...

  6. 12 CFR 611.1137 - Title VIII service corporations.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Title VIII service corporations. 611.1137... Organizations § 611.1137 Title VIII service corporations. (a) What is a title VIII service corporation? A title VIII service corporation is a service corporation organized for the purpose of exercising...

  7. Prospective surveillance study of haemophilia A patients switching from moroctocog alfa or other factor VIII products to moroctocog alfa albumin-free cell culture (AF-CC) in usual care settings.

    Science.gov (United States)

    Parra Lopez, Rafael; Nemes, Laszlo; Jimenez-Yuste, Victor; Rusen, Luminita; Cid, Ana R; Charnigo, Robert J; Baumann, James A; Smith, Lynne; Korth-Bradley, Joan M; Rendo, Pablo

    2015-10-01

    This prospective, open-label, postauthorisation safety surveillance study assessed clinically significant inhibitor development in patients with severe haemophilia A transitioning from moroctocog alfa or other factor VIII (FVIII) replacement products to reformulated moroctocog alfa (AF-CC). Males aged ≥ 12 years with severe haemophilia A (FVIII:C) 150 exposure days (EDs) to recombinant or plasma-derived FVIII products, and no detectable inhibitor at screening were enrolled. Primary end point was the incidence of clinically significant FVIII inhibitor development. Secondary end points included annualised bleeding rate (ABR), less-than-expected therapeutic effect (LETE), and FVIII recovery. Patients were assigned to one of two cohorts based on whether they were transitioning to moroctocog alfa (AF-CC) from moroctocog alfa (cohort 1; n=146) or from another recombinant or plasma-derived FVIII product (cohort 2; n=62). Mean number of EDs on study was 94 (range, 1-139). Six positive FVIII inhibitor results, as determined by local laboratories, were reported in four patients; none were confirmed by a central laboratory, no inhibitor-related clinical manifestations were reported, and all anti-FVIII antibody assays were negative. Median ABRs were 23.4 and 3.4 in patients categorised at baseline as following on-demand and prophylactic regimens, respectively; 86.5% of bleeding episodes resolved after one infusion. LETE incidence was 0.06% and 0.19% in the on-demand and prophylaxis settings, respectively. FVIII recovery remained constant throughout the study. No new safety concerns were identified. This study found no increased risk of clinically significant FVIII inhibitor development in patients transitioning from moroctocog alfa or other FVIII replacement products to moroctocog alfa (AF-CC).

  8. F8 gene mutation profile in Indian hemophilia A patients: Identification of 23 novel mutations and factor VIII inhibitor risk association.

    Science.gov (United States)

    Pinto, Patricia; Ghosh, Kanjaksha; Shetty, Shrimati

    2016-04-01

    'FVIII inhibitors', especially in severe hemophilia A (HA) patients, is a serious adverse effect that complicates their clinical management. Many genetic and non-genetic risk factors have been proposed for FVIII inhibitor development, diverse in different population groups. This is the first study in Indian hemophiliacs that analyzes inhibitor risk in relation to the complete F8 mutation profile, in a case-control study that included 145 Indian severe HA patients, i.e. 69 inhibitor positive (with 18 inhibitor concordant/discordant family members), and 58 inhibitor negative patients, after informed consent. While 53.54% (68/127) index cases were positive for intron 22 or intron 1 inversions, 55 causative F8 mutations were detected in the 59 inversion negative patients, of which 23 were novel mutations (in 24 patients) and 32 were reported earlier (in 35 patients). A higher incidence of mutations, in the C1 and C2 domains in inhibitor positive patients, and in the A1 domain in inhibitor negative patients was observed, though not significantly different. The study suggests that large F8 rearrangements (significantly higher in the inhibitor positive patients) pose the highest risk, while missense mutations (significantly higher in the inhibitor negative patients) pose the lowest risk of inhibitor development in Indian hemophilia A patients.

  9. Functional Role of Milk Fat Globule-Epidermal Growth Factor VIII in Macrophage-Mediated Inflammatory Responses and Inflammatory/Autoimmune Diseases

    Directory of Open Access Journals (Sweden)

    Young-Su Yi

    2016-01-01

    Full Text Available Inflammation involves a series of complex biological processes mediated by innate immunity for host defense against pathogen infection. Chronic inflammation is considered to be one of the major causes of serious diseases, including a number of autoimmune/inflammatory diseases, cancers, cardiovascular diseases, and neurological diseases. Milk fat globule-epidermal growth factor 8 (MFG-E8 is a secreted protein found in vertebrates and was initially discovered as a critical component of the milk fat globule. Previously, a number of studies have reported that MFG-E8 contributes to various biological functions including the phagocytic removal of damaged and apoptotic cells from tissues, the induction of VEGF-mediated neovascularization, the maintenance of intestinal epithelial homeostasis, and the promotion of mucosal healing. Recently, emerging studies have reported that MFG-E8 plays a role in inflammatory responses and inflammatory/autoimmune diseases. This review describes the characteristics of MFG-E8-mediated signaling pathways, summarizes recent findings supporting the roles of MFG-E8 in inflammatory responses and inflammatory/autoimmune diseases, and discusses MFG-E8 targeting as a potential therapeutic strategy for the development of anti-inflammatory/autoimmune disease drugs.

  10. Functional Role of Milk Fat Globule-Epidermal Growth Factor VIII in Macrophage-Mediated Inflammatory Responses and Inflammatory/Autoimmune Diseases.

    Science.gov (United States)

    Yi, Young-Su

    2016-01-01

    Inflammation involves a series of complex biological processes mediated by innate immunity for host defense against pathogen infection. Chronic inflammation is considered to be one of the major causes of serious diseases, including a number of autoimmune/inflammatory diseases, cancers, cardiovascular diseases, and neurological diseases. Milk fat globule-epidermal growth factor 8 (MFG-E8) is a secreted protein found in vertebrates and was initially discovered as a critical component of the milk fat globule. Previously, a number of studies have reported that MFG-E8 contributes to various biological functions including the phagocytic removal of damaged and apoptotic cells from tissues, the induction of VEGF-mediated neovascularization, the maintenance of intestinal epithelial homeostasis, and the promotion of mucosal healing. Recently, emerging studies have reported that MFG-E8 plays a role in inflammatory responses and inflammatory/autoimmune diseases. This review describes the characteristics of MFG-E8-mediated signaling pathways, summarizes recent findings supporting the roles of MFG-E8 in inflammatory responses and inflammatory/autoimmune diseases, and discusses MFG-E8 targeting as a potential therapeutic strategy for the development of anti-inflammatory/autoimmune disease drugs.

  11. Co-segregation of thrombophilic disorders in factor V Leiden carriers; the contributions of factor VIII, factor XI, thrombin activatable fibrinolysis inhibitor and lipoprotein(a) to the absolute risk of venous thromboembolism

    NARCIS (Netherlands)

    Libourel, EJ; Bank, [No Value; Meinardi, [No Value; Balje-Volkers, CP; Hamulyak, K; Middeldorp, S; Koopman, MMW; van Pampus, ECM; Prins, MH; Buller, HR; van der Meer, J

    2002-01-01

    Background and Objectives. The clinical expression of factor V Leiden varies widely within and between families and only a minority of carriers will ever develop venous thromboembolism. Co-segregation of thrombophilic disorders is a possible explanation, Our aim was to assess the contributions of

  12. Igor Zabel 14. VIII 1958 - 23. VII 2005

    Index Scriptorium Estoniae

    2005-01-01

    Igor Zabel oli Ida-Euroopa tuntumaid kunstiteoreetikuid ja kuraatoreid. Töötas 1986. aastast Ljubljana moodsa kunsti muuseumi kuraatorina. 9. VIII avatakse seal viimane I. Zabeli kureeritud näitus "Territories, Identities, Nets-Slovene Art 1995-2005"

  13. Factor VIII deficiency does not protect against atherosclerosis

    NARCIS (Netherlands)

    Biere-Rafi, S.; Tuinenburg, A.; Haak, B.W.; Peters, M.; Huijgen, R.; de Groot, E.; Verhamme, P.; Peerlinck, K.; Visseren, F.L.J.; Kruip, M.J.H.A.; Laros-van Gorkom, B.A.P.; Gerdes, V.E.A.; Buller, H.R.; Schutgens, R.E.G.; Kamphuisen, P.W.

    2012-01-01

    Summary. Background: Hemophilia A patients have a lower cardiovascular mortality rate than the general population. Whether this protection is caused by hypocoagulability or decreased atherogenesis is unclear. Objectives: To evaluate atherosclerosis and endothelial function in hemophilia A patients w

  14. New study on the XeVIII spectrum

    Energy Technology Data Exchange (ETDEWEB)

    Gallardo, M. [Centro de Investigaciones Opticas (CIOp) Casilla de Correo 124, 1900 La Plata (Argentina)]. E-mail: gallardom@ciop.unlp.edu.ar; Raineri, M. [Centro de Investigaciones Opticas (CIOp) Casilla de Correo 124, 1900 La Plata (Argentina)]. E-mail: monicar@ciop.unlp.edu.ar; Giuliani, M. [Dto. de Fisica, Fac. de C. Exactas y Naturales, Universidad Nacional de Mar del Plata Funes 3350 (7600) Mar del Plata (Argentina); Lagorio, C. [Dto. de Fisica, Fac. de C. Exactas y Naturales, Universidad Nacional de Mar del Plata Funes 3350 (7600) Mar del Plata (Argentina); Padilla, S. [Dto. de Fisica, Fac. de C. Exactas y Naturales, Universidad Nacional de Mar del Plata Funes 3350 (7600) Mar del Plata (Argentina); Sarmiento, R. [Dto. De Fisica, Universidad del Atlantico, A.A 1890 Barranquilla (Colombia); Reyna Almandos, J.G. [Centro de Investigaciones Opticas (CIOp) Casilla de Correo 124, 1900 La Plata (Argentina)]. E-mail: jreyna@ciop.unlp.edu.ar

    2005-10-15

    Capillary light sources were used to observe the spectrum of seven-times-ionized xenon, XeVIII, in the 300-6000 A wavelength range. Twenty-eight energy levels belonging to the 5s-9s, 5d-9d, 5g-9g, 7i-10i, 9l, 5p-9p, 4f-9f, 6h-9h and 8k-10k configurations were adjusted and 38 new spectral lines were classified. The XeVIII ionization energy was determined with improved accuracy using the polarization model. The analysis was supported by Hartree-Fock calculations. The weighted oscillator strengths for all the observed spectral lines were also calculated considering the fitted values for the energy parameters.

  15. Zwitterionic Group VIII transition metal initiators supported by olefin ligands

    Science.gov (United States)

    Bazan, Guillermo C.; Chen, Yaofeng

    2011-10-25

    A zwitterionic Group VIII transition metal complex containing the simple and relatively small 3-(arylimino)-but-1-en-2-olato ligand that catalyzes the formation of polypropylene and high molecular weight polyethylene. A novel feature of this catalyst is that the active species is stabilized by a chelated olefin adduct. The present invention also provides methods of polymerizing olefin monomers using zwitterionic catalysts, particularly polypropylene and high molecular weight polyethylene.

  16. Ehlers-Danlos Syndrome Type VIII: A Rare Cause of Leg Ulcers in Young Patients

    Science.gov (United States)

    Lucas, Antoine; Piérard, Gérald E.; Hermanns-Lê, Trinh; De Paepe, Anne; Dupuy, Alain

    2013-01-01

    Ehlers-Danlos syndrome type VIII (EDS-VIII) is a very rare autosomal dominant disease characterized by early-onset periodontitis associated with features of Ehlers-Danlos syndrome. We report a 32-year-old man whose chronic leg ulcer led to the diagnosis of EDS-VIII. He had severe periodontitis with complete loss of permanent teeth and skin fragility with thin skin, atrophic scars, and brownish atrophic pretibial plaques. Leg ulcer is not a prominent feature of EDS-VIII. We suggest adding EDS-VIII to the list of rare diseases accounting for chronic leg ulcers, if this case report prompts others to report leg ulcers associated with EDS-VIII. PMID:24198978

  17. 40 CFR Appendix Viii to Part 600 - Fuel Economy Label Formats

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 29 2010-07-01 2010-07-01 false Fuel Economy Label Formats VIII... POLICY FUEL ECONOMY AND CARBON-RELATED EXHAUST EMISSIONS OF MOTOR VEHICLES Pt. 600, App. VIII Appendix VIII to Part 600—Fuel Economy Label Formats EC01MY92.117 EC01MY92.118 EC01MY92.119 EC01MY92.120...

  18. Effectiveness of Mind Mapping in English Teaching among VIII Standard Students

    Science.gov (United States)

    Hallen, D.; Sangeetha, N.

    2015-01-01

    The aim of the study is to find out the effectiveness of mind mapping technique over conventional method in teaching English at high school level (VIII), in terms of Control and Experimental group. The sample of the study comprised, 60 VIII Standard students in Tiruchendur Taluk. Mind Maps and Achievement Test (Pretest & Posttest) were…

  19. Surgery as a risk factor for inhibitor development in haemophilia A : A systematic review

    NARCIS (Netherlands)

    Eckhardt, C.; Van Der Bom, J.; Van Der Naald, M.; Peters, M.; Kamphuisen, P.; Fijnvandraat, K.

    2010-01-01

    Introduction: Surgery is a risk factor for the development of factor VIII inhibiting antibodies (inhibitors) in haemophilia A. This may be due to the combination of danger signal release resulting from tissue damage and intensive exposure to factor VIII (FVIII) concentrate. The purpose of this syste

  20. Surgery as a risk factor for inhibitor development in haemophilia A : A systematic review

    NARCIS (Netherlands)

    Eckhardt, C.; Van Der Bom, J.; Van Der Naald, M.; Peters, M.; Kamphuisen, P.; Fijnvandraat, K.

    2010-01-01

    Introduction: Surgery is a risk factor for the development of factor VIII inhibiting antibodies (inhibitors) in haemophilia A. This may be due to the combination of danger signal release resulting from tissue damage and intensive exposure to factor VIII (FVIII) concentrate. The purpose of this syste

  1. Solar Wind Charge Exchange and O VIII emission toward MBM 12

    Science.gov (United States)

    Edgar, Richard J.; Wargelin, B. J.; Raymond, J. C.; Slavin, J. D.; Smith, R. K.; Kharchenko, V.

    2006-09-01

    A Chandra observation toward MBM-12, a nearby (MBM 12 during the Chandra observation. The Solar Wind Charge Exchange mechanism can account for essentially all of the O VIII emission seen in this observation.

  2. INSIGHT in risk factors and treatment of inhibitors in nonsevere hemophilia A

    NARCIS (Netherlands)

    van Velzen, A.S.

    2016-01-01

    Hemophilia A is an inherited X-linked bleeding disorder that occurs in male offspring of carrier females. In these individuals a mutation in the F8 gene, located on the X-chromosome, causes a deficiency of the factor VIII protein, clotting factor VIII. The worldwide prevalence of hemophilia is 1 in

  3. Implications of an updated ultraviolet background for the ionization mechanisms of intervening Ne VIII absorbers

    Science.gov (United States)

    Hussain, Tanvir; Khaire, Vikram; Srianand, Raghunathan; Muzahid, Sowgat; Pathak, Amit

    2017-04-01

    Ne VIII absorbers seen in QSO spectra are useful tracers of warm ionized gas, when collisional ionization is the dominant ionization process. While photoionization by the ultraviolet background (UVB) is a viable option, it tends to predict large line-of-sight thickness for the absorbing gas. Here, we study the implications of the recently updated UVB at low z to understand the ionization mechanisms of intervening Ne VIII absorbers. With the updated UVB, one typically needs higher density and metallicity to reproduce the observed ionic column densities under photoionization. Both reduce the inferred line-of-sight thicknesses of the absorbers. We find a critical density of ≥5 × 10-5 cm-3 above which the observed N({Ne VIII})/N({O VI}) can be reproduced by pure collisional processes. If the gas is of near solar metallicity (as measured for the low ions) then the cooling time-scales will be small (<108 yrs). Therefore, a continuous injection of heat is required in order to enhance the detectability of the collisionally ionized gas. Using photoionization models we find that in almost all Ne VIII systems the inferred low ion metallicity is near solar or supersolar. If we assume the Ne VIII phase to have similar metallicities then photoionization can reproduce the observed N({Ne VIII})/N({O VI}) without the line-of-sight thickness being unreasonably large and avoids cooling issues related to the collisional ionization at these metallicities. However, the indication of broad Lyα absorption in a couple of systems, if true, suggests that the Ne VIII phase is distinct from the low ion phase having much lower metallicity.

  4. Understanding FVIII/VWF complex--report from a symposium of XXIX WFH meeting 2010.

    Science.gov (United States)

    Gringeri, A; Ofosu, F A; Grancha, S; Oldenburg, J; Ewing, N P; Federici, A B

    2012-05-01

    von Willebrand factor (VWF) has the capacity to form a complex with factor VIII (FVIII) which may modulate the immunogenicity of FVIII. It has been proposed that a significant fraction of recombinant FVIII (rFVIII) is unable to bind VWF. In an experimental model studied at the McMaster University in Canada, this VWF-unbound rFVIII fraction showed no coagulant function. Sulphation of FVIII tyrosine (Tyr) 1680 has been reported as essential for the interaction with VWF. In a study performed at the Grifols and CNS-CSIC in Spain, Tyr1680 sulphation was observed to be incomplete in rFVIII and complete in plasma-derived FVIII (pdFVIII). This could explain the incapability of some rFVIII molecules to bind VWF. Experience with immune tolerance induction (ITI) at the Bonn Haemophilia Centre indicates that only eradication of FVIII inhibitors allows safe haemostasis control and the option of prophylactic treatment. Various clinical trials were planned to evaluate the clinical role VWF-containing FVIII concentrates (FVIII/VWF). RES.I.ST (an acronym for REScue Immunotolerance STudy) is an international, prospective study aimed at assessing whether FVIII/VWF can induce ITI in high-risk haemophilia patients (RES.I.ST naïve) and whether patients who previously failed ITI with FVIII alone can be rescued with FVIII/VWF (RES.I.ST experienced). Enrolment started in November 2009. In the FAIReSt.Will (Fanhdi and Alphanate Italian Retrospective Study in Willebrand disease) study, 120 von Willebrand disease (VWD) patients treated with Fanhdi(®) or Alphanate(®) were retrospectively analysed. Efficacy was excellent and no side effects were reported. The ongoing PRO.Will study is a prospective, multicenter trial aimed at assessing the efficacy, safety and pharmacoeconomics of secondary long-term prophylaxis in patients with severe inherited VWD.

  5. Drevnerusskij pamflet na Mihaila VIII Paleologa v svete germenevtičeskogo analiza

    Directory of Open Access Journals (Sweden)

    Demincev Mihail

    2015-01-01

    Full Text Available In the article the perception of the image of Michael VIII Palaeologus by literate citizens of Tsardom of Russia is considered. The study is based on analysis of writings that date back to XVII century. The study focuses on identifying the symbols and latent ideas, that point to a semantic connection of the studied writings with The Old Testament, Apocalypse and some antique texts. In the end of the article the authjr makes a conclusion, that the perception of the image of Michael VIII Palaeologus in Tsardom of Russia was negative.

  6. Quark matter coupled to domain walls in Bianchi types II, VIII and IX Universes

    Indian Academy of Sciences (India)

    S D Katore; M M Sancheti; S P Hatkar

    2014-10-01

    In this study of Bianchi types II, VIII and IX Universes, quark matter coupled to domain walls in the context of general relativity are explored. To obtain deterministic solution of the Einstein’s field equations, various techniques are adopted. The features of the obtained solution are discussed.

  7. Challenges and Opportunities of Information Technology in the 90s. Track VIII: Managing Distributed Computing Services.

    Science.gov (United States)

    CAUSE, Boulder, CO.

    Six papers from the 1990 CAUSE Conference Track VIII: Managing Distributed Computing are presented. Authors discuss the challenges and opportunities involved in providing user managers with direct access to institutional databases to support their decision making and planning activities. Papers and their authors are as follows: "Rendering an…

  8. Aspectos literarios de la obra de don Joan de Castellanos : Capitulo VIII

    Directory of Open Access Journals (Sweden)

    Mario Germán Romero

    1966-03-01

    Full Text Available Capítulo VIII. Los discursos de Jiménez de Quesada. Toda historia de la literatura colombiana comienza con el nombre del licenciado don Gonzalo Jiménez de Quesada. Que era un letrado, no puede ponerse en duda. Los escritos que de él conocemos justifican plenamente el título.

  9. 7 CFR 1901.203 - Title VIII of the Civil Rights Act of 1968.

    Science.gov (United States)

    2010-01-01

    ..., rental, or financing of housing contained in title VIII apply to: (1) All dwellings financed by loans... equal housing opportunity throughout the nation. We encourage and support an affirmative advertising and... Public Law 103-354 programs and referral to the Department of Justice for suit by the United States...

  10. Detection of two intervening Ne viii absorbers probing warm gas at z ˜ 0.6

    Science.gov (United States)

    Pachat, Sachin; Narayanan, Anand; Khaire, Vikram; Savage, Blair D.; Muzahid, Sowgat; Wakker, Bart P.

    2017-10-01

    We report on the detection of two Ne viii absorbers, at z = 0.619 07 and 0.570 52 in the Hubble Space Telescope/Cosmic Origins Spectrograph spectrum of background quasars SDSS J080908.13 + 461925.6 and SBS 1122 + 594, respectively. The Ne viii 770 line is at ∼3σ significance. In both instances, the Ne viii is found to be tracing gas with T ≳ 105 K, predominantly collisionally ionized, with moderate densities of n_{H} ≲ 10^{-4} cm-3, sub-solar metallicities and total hydrogen column densities of N(H) ≳ 1019 cm-2. In the z = 0.619 07 absorber, the low, intermediate ions and O vi are consistent with origin in photoionized gas, with the O vi potentially having some contribution from the warm collisional phase traced by Ne viii. The z = 0.570 52 system has H I absorption in at least three kinematically distinct components, with one of them having b({H I}) = 49 {± } 11 km s-1. The intermediate-ionization lines, O vi and Ne viii, are coincident in velocity with this component. Their different line widths suggest warm temperatures of T = (0.5-1.5) × 105 K. Both absorbers are residing in regions where there are several luminous (≳L★) galaxies. The absorber at z = 0.570 52 is within the virial radius of a 2.6L★ galaxy, possibly associated with shock-heated circumgalactic material.

  11. VIII Olimpíada Brasileira de Astronomia e Astronáutica

    Science.gov (United States)

    Garcia Canalle, João Batista; Villas da Rocha, Jaime Fernando; Wuensche de Souza, Carlos Alexandre; Pereira Ortiz, Roberto; Aguilera, Nuricel Villalonga; Padilha, Maria De Fátima Catta Preta; Pessoa Filho, José Bezerra; Soares Rodrigues, Ivette Maria

    2007-07-01

    Neste trabalho apresentamos as motivações pelas quais organizamos, em conjunto, pela primeira vez, a Olimpíada Brasileira de Astronomia incluindo a Astronáutica, em colaboração com a Agência Espacial Brasileira. Esta ampliação contribuiu para atrair ainda mais alunos, professores, escolas e patrocinadores para participarem desta Olimpíada. Em 2005 participaram da VIII Olimpíada Brasileira de Astronomia e Astronáutica (VIII OBA) 187.726 alunos distribuídos por 3.229 escolas, pertencentes a todos os estados brasileiros, incluindo o Distrito Federal. O crescimento em número de alunos participantes foi 52,4% maior do que em 2004. Em abril de 2005 organizamos, em Itapecerica da Serra, SP, um curso para os 50 alunos previamente selecionados e participantes da VII OBA e ao final selecionamos, dentre eles, uma equipe de 5 alunos, os quais representaram o Brasil na X Olimpíada Internacional de Astronomia, na China, em outubro de 2005. Ganhamos, pela primeira vez, uma medalha de ouro naquele evento. Em Agosto de 2005, organizamos a VIII Escola de Agosto para 50 alunos e respectivos professores, em Águas de Lindóia, SP, juntamente com a XXXI reunião anual da Sociedade Astronômica Brasileira (SAB). Em novembro de 2005 realizamos a I Jornada Espacial, em São José dos Campos, com 22 alunos e 22 professores selecionados dentre os participantes que melhores resultados obtiveram nas questões de Astronáutica da VIII OBA. Neste trabalho detalhamos os resultados da VIII OBA bem como as ações subseqüentes.

  12. Bianchi VIII and IX vacuum cosmologies: Almost every solution forms particle horizons and converges to the Mixmaster attractor

    CERN Document Server

    Brehm, Bernhard

    2016-01-01

    Bianchi models are posited by the BKL picture to be essential building blocks towards an understanding of generic cosmological singularities. We study the behaviour of spatially homogeneous anisotropic vacuum spacetimes of Bianchi type VIII and IX, as they approach the big bang singularity. It is known since 2001 that generic Bianchi IX spacetimes converge towards the so-called Mixmaster attractor as time goes towards the singularity. We extend this result to the case of Bianchi VIII vacuum. The BKL picture suggests that particle horizons should form, i.e. spatially separate regions should causally decouple. We prove that this decoupling indeed occurs, for Lebesgue almost every Bianchi VIII and IX vacuum spacetime.

  13. Marcadores genéticos ligados al gen del factor VIII de coagulación : Su utilidad diagnóstica en hemofilia y en el estudio del mecanismo molecular de la recombinación homóloga en meiosis humanas

    OpenAIRE

    De Brasi, Carlos Daniel

    2001-01-01

    La hemofiliaA (HA)es una enfermedad hemorrágica hereditaria, ligada al sexo, causada por deficiencia del factor VIIIde coagulación (FVIII). La ruta preferida para la provisión de datos para diagnóstico molecular es la detección directa de mutaciones. Entre las mutaciones que afectan al gen del FVIII, la inversión del intrón 22 (inv22) constituye la causa de casi la mitad de las HA severas (SHA). Mediante análisis de Southern blot fueron estudiadas 47 familias Argentinas con SHA. En cercano ac...

  14. DAMPAK POSITIF DAN NEGATIF SOSIAL MEDIA TERHADAP PENDIDIKAN AKHLAK ANAK (Studi Kasus di SMP Negeri 2 Kelas VIII Banda Aceh)

    National Research Council Canada - National Science Library

    NISA KHAIRUNI

    2016-01-01

    The author examines the positive and negative effects of social media on the moral education of children in school SMPN 2 class VIII Banda Aceh, it is very interesting because of the many children who abuse social media...

  15. KEEFEKTIFAN PAIRED STORYTELLING DAN JIGSAW DALAM PENINGKATAN KOMPETENSI BERBICARA SISWA KELAS VIII SMP NEGERI 3 SLEMAN

    Directory of Open Access Journals (Sweden)

    Nurmiyati Nurmiyati

    2014-10-01

    Full Text Available Penelitian ini bertujuan untuk mengetahui: (1 apakah ada perbedaan keefektifan antara teknik paired storytelling, jigsaw, dan konvensional dalam meningkatkan kompetensi berbicara siswa, (2 teknik pembelajaran berbicara yang paling efektif antara ketiga teknik penelitian itu dalam meningkatkan kompetensi berbicara siswa kelas VIII SMP Negeri 3 Sleman. Penelitian ini menggunakan jenis penelitian eksperimen semu dengan nonequivalent control-group design. Hasil penelitian menunjukkan bahwa: (1 Ada perbedaan keefektifan antara teknik paired storytelling, jigsaw, and konvensional itu dalam meningkatkan kompetensi berbicara siswa dengan nilai F sebesar 3,532 dan signifikan dengan P < 0,05, yaitu sebesar 0,033, dan (2 teknik paired storytelling adalah teknik keterampilan berbicara yang paling efektif diantara ketiga teknik itu dalam meningkatkan kompetensi berbicara siswa kelas VIII SMP Negeri 3 Sleman dengan mean tertinggi sebesar 74,3492. Kata kunci: teknik paired storytelling, teknik jigsaw, teknik konvensional, kompetensi berbicara

  16. Compact invariant sets of the Bianchi VIII and Bianchi IX Hamiltonian systems

    Energy Technology Data Exchange (ETDEWEB)

    Starkov, Konstantin E., E-mail: konst@citedi.mx [CITEDI-IPN, Av. del Parque 1310, Mesa de Otay, Tijuana, BC (Mexico)

    2011-08-22

    In this Letter we prove that all compact invariant sets of the Bianchi VIII Hamiltonian system are contained in the set described by several simple linear equalities and inequalities. Moreover, we describe invariant domains in which the phase flow of this system has no recurrence property and show that there are no periodic orbits and neither homoclinic, nor heteroclinic orbits contained in the zero level set of its Hamiltonian. Similar results are obtained for the Bianchi IX Hamiltonian system. -- Highlights: → Zero level set of Hamiltonian of Bianchi VIII/IX systems contains no periodic orbits. → Similar conditions for homoclinic/heteroclinic orbits are given. → General nonexistence conditions of compact invariant sets are got.

  17. FUNDAMENTALS OF AMHARIC (REVISED EDITION), UNITS VIII-IX. DIALOGUES FOR CONVERSATION, AMHARIC SCRIPT.

    Science.gov (United States)

    BARTON, DONALD K.; AND OTHERS

    THIS IS THE THIRD AND FINAL VOLUME OF A NINE-UNIT COURSE IN BASIC AMHARIC. VOLUMES ONE AND TWO DEAL WITH THE PROBLEMS OF PRONUNCIATION AND THE ORAL-AURAL MASTERY OF BASIC GRAMMATICAL CONSTRUCTIONS. AT THE END OF EACH VOLUME ARE APPENDED ENGLISH-AMHARIC AND AMHARIC-ENGLISH GLOSSARIES. VOLUME THREE (UNITS VIII-IX) IS DIVIDED INTO TWO PARTS. PART I…

  18. Historical intensity VIII earthquakes along the Rhone valley (Valais, Switzerland): primary and secondary effects

    Energy Technology Data Exchange (ETDEWEB)

    Fritsche, S.; Faeh, D.; Schwarz-Zanetti, G.

    2012-06-15

    In recent years the upper Rhone Valley has been one of the most intensively investigated regions by the Swiss Seismological Service. The high seismicity in the region encourages research in the seismological field and one main focus has been historical seismology. This report presents the state of the art of our historical investigations by giving an overview of the effects of four damaging earthquakes with intensity larger than VII, for which a fairly large number of documents could be found and analyzed. The overview includes the events of 1584 (Aigle, epicentral intensity VIII), 1755 (Brig, epicentral intensity VIII), 1855 (Visp, epicentral intensity VIII), and 1946 (Sierre, epicentral intensity VIII for the main shock and intensity VII for the largest aftershock). The paper focuses mainly on primary and secondary effects in the epicentral region, providing the key data and a general characterization of the event. Generally, primary effects such as the reaction of the population and impact on buildings took more focus in the past. Thus building damage is more frequently described in historic documents. However, we also found a number of sources describing secondary effects such as landslides, snow avalanches, and liquefaction. Since the sources may be useful, we include citations of these documents. The 1584 Aigle event, for example, produced exceptional movements in the Lake of Geneva, which can be explained by an expanded sub aquatic slide with resultant tsunami and seiche. The strongest of the aftershocks of the 1584 event triggered a destructive landslide covering the villages Corbeyrier and Yvorne, Vaud. All macroseismic data on the discussed events are accessible through the web page of the Swiss Seismological Service (http://www.seismo.ethz.ch). (authors)

  19. Laparoscopic Liver Resection Using the Lateral Approach from Intercostal Ports in Segments VI, VII, and VIII.

    Science.gov (United States)

    Inoue, Yoshihiro; Suzuki, Yusuke; Fujii, Kensuke; Kawaguchi, Nao; Ishii, Masatsugu; Masubuchi, Shinsuke; Yamamoto, Masashi; Hirokawa, Fumitoshi; Hayashi, Michihiro; Uchiyama, Kazuhisa

    2017-07-31

    Laparoscopic liver resection (LLR) has been developed as a minimally invasive surgery. However, challenges such as difficulty securing visibility and limited control of forceps make it difficult to complete LLR in hepatic segments VI, VII, and VIII. To overcome these challenges, we devised a surgical technique using intercostal ports. We termed this approach the lateral approach. This work describes our experience performing LLR using this approach and discusses the safety and effectiveness of this approach. Between April 2011 and December 2016, data from 91 patients who underwent LLR with or without the intercostal port at a single institution were retrospectively analyzed regarding surgical outcomes, safety, and utility. LLR was performed for 32 patients with the intercostal port and for 59 patients without the intercostal port. The conversion rates to open surgery with and without intercostal ports were 3.1 and 25.4% (P = 0.008). In hepatic segments VII and VIII, the rates of conversion to open surgery were significantly lower for cases involving intercostal ports (6.7 vs. 42.9 and 0 vs. 38.9%; P = 0.035 and 0026, respectively); however, there were no differences in hepatic segment VI (0 vs. 7.4%; P = 0.563). There were no differences in operative time, blood loss volume, surgical margin, curative resection rate, or postoperative complication rate for LLR in all segments (VI, VII, and VIII). No adverse events due to placement of the intercostal port were observed in this set of patients. LLR using the lateral approach and intercostal ports for hepatic segments VII and VIII resulted in a significant decrease in conversion rates to open surgery.

  20. Structural characterization of the novel aminoglycoside phosphotransferase AphVIII from Streptomyces rimosus with enzymatic activity modulated by phosphorylation

    Energy Technology Data Exchange (ETDEWEB)

    Boyko, Konstantin M., E-mail: kmb@inbi.ras.ru [Bach Institute of Biochemistry, Federal Research Centre of Biotechnology of the Russian Academy of Sciences, Leninsky Prospekt. 33, Bld. 2, 119071, Moscow (Russian Federation); National Research Center “Kurchatov Institute”, Kurchatov Complex of NBICS-technologies, Akad. Kurchatova sqr., 1, Moscow, 123182 (Russian Federation); Gorbacheva, Marina A.; Korzhenevskiy, Dmitry A. [National Research Center “Kurchatov Institute”, Kurchatov Complex of NBICS-technologies, Akad. Kurchatova sqr., 1, Moscow, 123182 (Russian Federation); Alekseeva, Maria G.; Mavletova, Dilara A.; Zakharevich, Natalia V.; Elizarov, Sergey M.; Rudakova, Natalia N.; Danilenko, Valery N. [Vavilov Institute of General Genetics, Russian Academy of Sciences, Gubkina str. 3, Moscow, 119333 (Russian Federation); Popov, Vladimir O. [Bach Institute of Biochemistry, Federal Research Centre of Biotechnology of the Russian Academy of Sciences, Leninsky Prospekt. 33, Bld. 2, 119071, Moscow (Russian Federation); National Research Center “Kurchatov Institute”, Kurchatov Complex of NBICS-technologies, Akad. Kurchatova sqr., 1, Moscow, 123182 (Russian Federation)

    2016-09-02

    Aminoglycoside phosphotransferases represent a broad class of enzymes that promote bacterial resistance to aminoglycoside antibiotics via the phosphorylation of hydroxyl groups in the latter. Here we report the spatial structure of the 3′-aminoglycoside phosphotransferase of novel VIII class (AphVIII) solved by X-ray diffraction method with a resolution of 2.15 Å. Deep analysis of APHVIII structure and its comparison with known structures of aminoglycoside phosphotransferases of various types reveals that AphVIII has a typical two-domain fold and, however, possesses some unique characteristics that distinguish the enzyme from its known homologues. The most important difference is the presence of the activation loop with unique Ser146 residue. We demonstrate that in the apo-state of the enzyme the activation loop does not interact with other parts of the enzyme and seems to adopt catalytically competent state only after substrate binding. - Highlights: • 3D structure of the novel aminoglycoside phosphotransferase AphVIII was obtained. • AphVIII activation loop is clearly identified in the electron density. • AphVIII has some unique structural features in its substrate C-ring binding pocket.

  1. Pengembangan perangkat pembelajaran matematika SMP kelas VIII semester genap dengan model problem-based learning

    Directory of Open Access Journals (Sweden)

    Maria Trisna Sero Wondo

    2017-06-01

    Abstract This study aimed to produce mathematics learning kits using the problem based learning model oriented to the learning achievement, problem solving skill, and self-confidence for Grade VIII students of the junior high school (JHS in the even semester. This study was and development study used the development model by Plomp (preliminary study, development, evaluation. The research subjects were teachers and students of Grade VIII of Swasta Katolik Maria Goretti Ende. The analysis of the data was done by converting the quantitative data in the form scores as the results of the evaluation into qualitative data in the form of five-scale standard scores. This study produce mathematics learning kits in the form of lesson plans and student worksheets for Grade VIII students of the junior high school in the even semester. Of the results of expert validation, a teacher evaluation scores, a students evaluation scores, an observation for the implementation of learning activities, a learning achievement test, a problem solving skil test, and a self-confidence questionnaire show that lesson plans (RPP  and student worksheets (LKS is valid, practical, and effective. Keywords: learning kits, problem-based learning, learning achievement, problem solving, self-confidence

  2. Costs of treatment of haemophilia A in Italy: comparison of the use of plasma-derived and recombinant FVIII using a discrete event simulation (DES model

    Directory of Open Access Journals (Sweden)

    Mario Eandi

    2013-06-01

    Full Text Available OBJECTIVE: To simulate haemophilia A (HA real-life management and compare the cost of different treatment strategies, both with plasma-derived and recombinant factor VIII (pdFVIII and rFVIII, respectively, from the perspective of the Italian NHS.METHODS: A discrete event (micro-simulation (DES model was developed to reproduce every possible HA patient clinical pathway: on-demand (OD treatment of bleeding, continuous or discontinuous prophylaxis (PRO with FVIII, inhibitors-tolerance-induction treatment (ITI, surgery in case of severe disability. Patient characteristics, treatment indications and disease evolution were modeled basing on data available in clinical literature in order to represent the actual state of art of HA management. In addition to the baseline scenario, reproducing current HA management, alternative strategies were simulated to explore the impact on the cost borne by the Italian NHS for these patients. Only differential direct sanitary costs were considered in the simulation, with a 3.5% discount rate.RESULTS: Baseline scenario results show difference between patients treated with pdFVIII and those treated with rFVIII: mean lifetime HA patient management cost was estimated at € 1,332,373 with pdFVIII treatment, compared with € 2,013,222 for rFVIII. The saving is due mainly to the lower acquisition cost of pdFVIII. Total medical costs are strongly and positively correlated with HA severity: cost per patient increases from € 86,269 (mild HA to € 1,509,231 (severe HA for patients treated with pdFVIII and from € 147,900 to € 2,621,540 in patients treated with rFVIII. All analyses conducted in the study lead to the conclusion that the use of pdFVIII is much less expensive than rFVIII, but therapeutically equivalent.CONCLUSION: Management of HA patients is complex and difficult to optimize; although involving a limited number of patients, lifetime management costs for the Italian NHS are extremely high. The main

  3. PENINGKATAN PEMBELAJARAN MENULIS PUISI BEBAS MELALUI MEDIA LAGU MEDLEY SISWA KELAS VIII SMP SINTANG

    Directory of Open Access Journals (Sweden)

    Rohanawati Silalahi

    2015-05-01

    Full Text Available Penelitian ini bertujuan untuk meningkatkan pembelajaran menulis puisi bebas melalui media lagu medley siswa kelas VIII B SMP Sintang. Subjek penelitian adalah siswa kelas VIII B SMP Sintang. Penelitian ini merupakan Penelitian Tindakan Kelas (PTK. Prosedur pelaksanaan dan implementasi penelitian dilaksanakan dalam dua siklus. Teknik pengumpulan data berupa obsevasi, wawancara, catatan lapangan, angket, evaluasi dan dokumentasi. Instrumen pengumpulan data meliputi lembar wawancara, lembar catatan lapangan, lembar angket, lembar tes hasil belajar dan lembar portofolio serta dokumentasi foto kegiatan. Teknik analisis data yang digunakan adalah analisis data kuantitatif dan kualitatif. Hasil penelitian ini menunjukkan bahwa penggunaan media lagu medley dapat meningkatkan pembelajaran menulis puisi bebas. Peningkatan hasil atau produk dapat dilihat dari perbandingan skor rata-rata keterampilan menulis puisi bebas siswa pada setiap siklus. Nilai rata-rata siswa pada tahap pratindakan adalah 55,23, pada saat siklus I meningkat menjadi 71,18, dan pada siklus II meningkat menjadi 73,4. ___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ DEVELOPING THE TEACHING OF FREE VERSE WRITING THROUGH MEDLEY SONG MEDIA TO GRADE VIII STUDENTS OF SMP SINTANG   Abstract This study aims to improve the teaching of free verse writing through medley song media to Grade VIII B students of SMP Sintang. The research subjects were Grade VIII B students of SMP Sintang,. This was a classroom action research (CAR. The research procedure and implementation were conducted in two cycles. The data were collected through observations, field notes, questionnaires, evaluations, and documentations. The data collecting instruments included interview sheets, field note sheets

  4. Characterization of Chinese Hamster Ovary Cells Producing Coagulation Factor VIII Using Multi-omics Tools

    DEFF Research Database (Denmark)

    Kaas, Christian Schrøder

    The first public draft of a genome from Chinese hamster ovary (CHO) cells was published in 2011, an entire decade after the first draft of the human genome. This publication of a relevant CHO reference genome, in combination with the fact that the cost for DNA sequencing has dropped more than 10,...

  5. Minimal modification in the factor VIII B-domain sequence ameliorates the murine hemophilia A phenotype

    OpenAIRE

    Siner, Joshua I.; Iacobelli, Nicholas P.; Sabatino, Denise E.; Ivanciu, Lacramiora; Zhou, Shangzhen; Poncz, Mortimer; Camire, Rodney M.; Arruda, Valder R.

    2013-01-01

    The novel FVIII variant (FVIII-RH) has enhanced stability and procoagulant activity in both in vitro and in vivo models.FVIII-RH is efficacious and safe; thus, it is an attractive molecule for protein replacement and as a transgene in gene-therapy strategies.

  6. Characteristics of hemophilia patients with factor VIII inhibitors detected by prospective screening

    Science.gov (United States)

    Miller, Connie H.; Rice, Anne S.; Boylan, Brian; Payne, Amanda B.; Kelly, Fiona M.; Escobar, Miguel A.; Gill, Joan; Leissinger, Cindy; Soucie, J. Michael

    2015-01-01

    Characteristics of inhibitors identified by prospective screening may differ from those detected clinically. In a prospective study at 17 hemophilia centers with central inhibitor measurement by Nijmegen-Bethesda assay, 23 (2.8%) of 824 hemophilia A patients had new inhibitors detected: nine high-titer inhibitors (HTI: 7 ≥5.0 NBU plus 2 of 2.6 and 3.4 NBU at immune tolerance induction initiation) and 14 low-titer inhibitors (LTI: 0.5–1.9 NBU). HTI occurred at an earlier age (median 2 years, range 1–18, vs. median 11 years, range 2–61, P = 0.016). Both HTI (22%) and LTI (43%) occurred in non-severe patients. All HTI, but only 64% of LTI, were found to be FVIII-specific by chromogenic Bethesda assay or fluorescence immunoassay (FLI), indicating a high rate of false-positive LTI. Repeat specimens confirmed all HTI, 7/9 LTI, and 7/7 FVIII-specific LTI. FLI results were similar between HTI and FVIII-specific LTI; all included IgG1 and IgG4 subclasses. A comparable prospective study conducted from 1975 to 1979 at 13 U.S. centers found 31 (2.4%) new inhibitors among 1,306 patients. In both studies, one-third of inhibitors occurred in non-severe patients and one-quarter after 150 exposure days (ED). Significant differences were seen in the age at which inhibitors occurred (median 16 years in the older study vs. 5 years currently, P = 0.024) and in ED before inhibitor development, 10% in the older study and 43% currently study occurring within 20 ED, suggesting a temporal change in inhibitor development. Prospective screening detects inhibitors in patients of all severities, ages, and ED. Some LTI, however, are false positives. PMID:26147783

  7. AKTIVITAS FISIK, ASUPAN ENERGI DAN STATUS GIZI WANITA PEMETIK TEH DI PTPN VIII BANDUNG, JAWA BARAT

    Directory of Open Access Journals (Sweden)

    Venny Agustiani Mahardikawati

    2012-03-01

    Full Text Available 800x600 Normal 0 false false false IN X-NONE X-NONE MicrosoftInternetExplorer4 Quality of human resources is very important to improve productivity. The worker productivity is correlated with nutritional status and health status. The objective of the research is to analyze physical activity, energy intake, nutritional status, of women workers at Tea Plantation PTPN VIII Bandung, West Java. The cross sectional design was used in this study to elaborate physical activity, nutritional status, and productivity of tea picker’s women. The criteria of study sample were tea picker’s women at cluster area of Malabar tea plantation of PTPN VIII Bandung, having infant and they were willing to be interviewed. The total number of 92 women sample was chosen randomly. Primary data consisted of physical activity recall (2x24 hours, food consumption recall (2x24 hours, anthropometry data (weight and height, and productivity (passage of tea sprout. Secondary data were included data of PT Perkebunan Nusantara VIII Bandung, West Java. The result showed that more than a half of samples having active or moderate physical activity level (PAL. The physical activity level of samples during work day (average PAL=1.87 was higher than holiday (average PAL=1.69 (p2362 kcal and 2134 kcal. The average energy adequacy level during workday and day off according to Schofield and Oxford equation were not significantly different, respectively 97,2% and 103,3%. The majority of samples had normal nutritional status, and 30.4% of the sample was overweight. The energy adequacy level according to Schofield and Oxford equation are related to nutritional status of women workers. Keywords: physical activity, energy expenditure, nutritional status, plantation women

  8. Precise Calculations of Astrophysically Important Allowed and Forbidden Transitions of Xe VIII

    Science.gov (United States)

    Bhowmik, Anal; Nath Dutta, Narendra; Roy, Sourav

    2017-02-01

    The present work reports transition line parameters for Xe viii, which are potentially important for astrophysics in view of recent observations of multiply ionized xenon in hot white dwarfs. The relativistic coupled-cluster method is employed here to calculate the E1, E2, and M1 transition line parameters with high accuracy. The E1 oscillator strengths and probabilities of E2 and M1 transitions are determined using theoretical amplitudes and experimental energy values. The calculated branching ratios and the lifetimes are supplemented to the transition parameters. The accurate presentation of these calculated data is crucial for density estimation in several stellar and interstellar media.

  9. Precise calculations of astrophysically important allowed and forbidden transitions of Xe VIII

    CERN Document Server

    Bhowmik, Anal; Roy, Sourav

    2016-01-01

    The present work reports astrophysically important transition line parameters for Xe VIII. The relativistic coupled-cluster method is employed here to calculate the E1, E2, and M1 transition line parameters with a high accuracy. The E1 oscillator strengths and probabilities of E2 and M1 transitions are determined using theoretical amplitudes and experimental energy values. The calculated branching ratios and the lifetimes are supplement to the transition parameters. The accurate presentations of these calculated data are crucial for the density estimations in several stellar and inter-stellar mediums.

  10. Isidore of Seville and comici ueteres. Ad Isid., Orig. VIII 7.7

    Directory of Open Access Journals (Sweden)

    Krzysztof Rzepkowski

    2012-12-01

    Full Text Available In chapter 7 of book VIII of Etymologies dedicated to Roman poets (De poetis, Isidore draws a dividing line between the so-called ueteres and noui comici. Among ueteres he counts Plautus, Accius, Terentius, although Accius, according to our knowledge, composed only tragedies and can hardly be considered a comic playwright. In this paper I try to prove that all the palaeographic, phonetic, historical, and literary arguments speak in favour of emending in the discussed passage the peculiar «Accius» to the expected «Caecilius» (i.e. Caecilius Statius.

  11. Underground Test Area Subproject Phase I Data Analysis Task. Volume VIII - Risk Assessment Documentation Package

    Energy Technology Data Exchange (ETDEWEB)

    None

    1996-12-01

    Volume VIII of the documentation for the Phase I Data Analysis Task performed in support of the current Regional Flow Model, Transport Model, and Risk Assessment for the Nevada Test Site Underground Test Area Subproject contains the risk assessment documentation. Because of the size and complexity of the model area, a considerable quantity of data was collected and analyzed in support of the modeling efforts. The data analysis task was consequently broken into eight subtasks, and descriptions of each subtask's activities are contained in one of the eight volumes that comprise the Phase I Data Analysis Documentation.

  12. QSO ABSORPTION SYSTEMS DETECTED IN Ne VIII: HIGH-METALLICITY CLOUDS WITH A LARGE EFFECTIVE CROSS SECTION

    Energy Technology Data Exchange (ETDEWEB)

    Meiring, J. D.; Tripp, T. M. [Department of Astronomy, University of Massachusetts, Amherst, MA 01003 (United States); Werk, J. K.; Prochaska, J. X. [University of California Observatories-Lick Observatory, UC Santa Cruz, CA 95064 (United States); Howk, J. C. [Department of Physics, University of Notre Dame, 225 Nieuwland Science Hall, Notre Dame, IN 46556 (United States); Jenkins, E. B. [Princeton University Observatory, Peyton Hall, Ivy Lane, Princeton, NJ 08544 (United States); Lehner, N.; Sembach, K. R. [Space Telescope Science Institute, 3700 San Martin Drive, Baltimore, MD 21218 (United States)

    2013-04-10

    Using high-resolution, high signal-to-noise ultraviolet spectra of the z{sub em} = 0.9754 quasar PG1148+549 obtained with the Cosmic Origins Spectrograph (COS) on the Hubble Space Telescope, we study the physical conditions and abundances of Ne VIII+O VI absorption line systems at z{sub abs} = 0.68381, 0.70152, 0.72478. In addition to Ne VIII and O VI, absorption lines from multiple ionization stages of oxygen (O II, O III, O IV) are detected and are well aligned with the more highly ionized species. We show that these absorbers are multiphase systems including hot gas (T Almost-Equal-To 10{sup 5.7} K) that produces Ne VIII and O VI, and the gas metallicity of the cool phase ranges from Z = 0.3 Z{sub Sun} to supersolar. The cool ( Almost-Equal-To 10{sup 4} K) phases have densities n{sub H} Almost-Equal-To 10{sup -4} cm{sup -3} and small sizes (<4 kpc); these cool clouds are likely to expand and dissipate, and the Ne VIII may be within a transition layer between the cool gas and a surrounding, much hotter medium. The Ne VIII redshift density, dN/dz{approx}7{sup +7}{sub -3}, requires a large number of these clouds for every L > 0.1 L* galaxy and a large effective absorption cross section ({approx}> 100 kpc), and indeed, we find a star-forming {approx}L {sup *} galaxy at the redshift of the z{sub abs} = 0.72478 system, at an impact parameter of 217 kpc. Multiphase absorbers like these Ne VIII systems are likely to be an important reservoir of baryons and metals in the circumgalactic media of galaxies.

  13. KEANEKARAGAMAN HYMENOPTERA PARASITOID PADA PERKEBUNAN KELAPA SAWIT PTPN VIII CINDALI, BOGOR

    Directory of Open Access Journals (Sweden)

    Ichsan Luqmana Indra Putra

    2016-09-01

    Full Text Available Diversity of parasitic Hymenoptera in PTPN VIII oil palm plantation Cindali, Bogor. One group of important natural enemies in oil palm plantation is parasitic Hymenoptera. The purpose of this research is to know the diversity and fluctuation of parasitic Hymenoptera PTPN VIII Cindali oil palm plantation. This research was conducted in 6 blocks of oil palm in September 2014 – June 2015. There were 5 plots in every observation blocks 39.2 x 39.2 m in size, and used direct and indirect method. Direct method done by 5 plants in every plots was taken randomized to observed and taken the herbivore insects to reared until the parasitic Hymenoptera came out. Observation of cover crops conducted by 3 subplots determined diagonally in every plots 9.8 x 9.8 m in size and herbivore insects was observed and collected. Indirect methods used sweep net and yellow pan trap. The result of this research, 26 parasitic Hymenoptera families was found, with the Braconidae was the most morphospecies found and the most individual amount was Scelionidae. The abundance of parasitoid in every month fluctuated.

  14. Atmospheric Imaging Assembly Response Functions: Solving the Fe VIII Problems with Hinode EIS Bright Point Data

    CERN Document Server

    Schmelz, Joan T; Kimble, Jason A; 10.1007/s11207-012-0208-1

    2013-01-01

    The Atmospheric Imaging Assembly (AIA) onboard the Solar Dynamics Observatory is a state-of-the-art imager with the potential to do unprecedented time-dependent multi-thermal analysis at every pixel on scales short compared to the radiative and conductive cooling times. Recent results, however, have identified missing spectral lines in the CHIANTI atomic physics data base, which is used to construct the instrument response functions. We have done differential emission measure analysis using simultaneous AIA and Hinode/EIS observations of six X-ray bright points. Our results not only support the conclusion that CHIANTI is incomplete near 131 angstroms, but more importantly, suggest that the peak temperature of the Fe VIII emissivity/response is likely to be closer to log T = 5.8 than to the current value of log T = 5.7. Using a revised emissivity/response calculation for Fe VIII, we find that the observed AIA 131-angstrom flux can be underestimated by about 1.25, which is smaller than previous comparisons.

  15. Experimentally Derived Dielectronic Recombination Rate Coefficients for Heliumlike C V and Hydrogenic O VIII

    CERN Document Server

    Savin, D W

    1999-01-01

    Using published measurements of dielectronic recombination (DR) resonance strengths and energies for C V to C IV and O VIII to O VII, we have calculated the DR rate coefficient for these ions. Our derived rates are in good agreement with multiconfiguration, intermediate-coupling and multiconfiguration, fully-relativistic calculations as well as with most LS coupling calculations. Our results are not in agreement with the recommended DR rates commonly used for modeling cosmic plasmas. We have used theoretical radiative recombination (RR) rates in conjunction with our derived DR rates to produce a total recombination rate for comparison with unified RR+DR calculations in LS coupling. Our results are not in agreement with undamped, unified calculations for C V but are in reasonable agreement with damped, unified calculations for O VIII. For C V, the Burgess general formula (GF) yields a rate which is in very poor agreement with our derived rate. The Burgess & Tworkowski modification of the GF yields a rate w...

  16. 46 CFR 54.01-2 - Adoption of division 1 of section VIII of the ASME Boiler and Pressure Vessel Code.

    Science.gov (United States)

    2010-10-01

    ... Boiler and Pressure Vessel Code. 54.01-2 Section 54.01-2 Shipping COAST GUARD, DEPARTMENT OF HOMELAND... division 1 of section VIII of the ASME Boiler and Pressure Vessel Code. (a) Pressure vessels shall be designed, constructed, and inspected in accordance with section VIII of the ASME Boiler and Pressure...

  17. Pandangan Hakim Pengadilan Agama Palembang Terhadap Putusan Mahkamah Konstitusi Nomor 46/PUU-VIII/2010 Tentang Status Anak di Luar Nikah

    Directory of Open Access Journals (Sweden)

    Arne Huzaimah

    2016-03-01

    Full Text Available Penelitian ini mengkaji tentang status anak di luar nikah perpektif hukum Islam. Pertimbangan Hukum Majelis Hakim Mahkamah Konstitusi Nomor: 46/PUU-VIII/201. Pandangan Hakim Pengadilan Agama Kelas 1A Palembang terhadap Putusan Mahkamah Konstitusi Nomor: 46/PUU-VIII/2010 adalah: Putusan uji materi pasal 43 ayat 1 UUP, sesungguhnya ditujukan untuk anak yang lahir di luar perkawinan akibat nikah sirri atau kumpul kebo. Berdasarkan penetapan pengadilan agama yang berkaitan dengan pengesahan perkawinan/itsbat nikah dan penetapan asal usul anak, maka anak yang dilahirkan dari perkawinan sirri dapat dinyatakan sebagai anak yang sah. Dengan status anak sah, maka anak tersebut mempunyai hubungan perdata dengan ayah biologisnya. Hubungan perdata yang timbul akibat dari adanya hubungan darah ini meliputi hubungan hukum, hak dan kewajiban antara anak dengan ayah dan ibunya yang dapat berupa:  (1  hubungan  nasab;  (2  hubungan mahram; (3 hubungan hak dan kewajiban; (4 hubungan pewarisan (saling mewarisi  yang  merupakan  pelanjutan  hubungan  hak  dan  kewajiban karena  nasab  ketika mereka  sama-sama masih  hidup;  dan  (5  hubungan wali nikah antara ayah dengan anak perempuannya. This paper examined the status of children outside wedlock in perspective of Islamic law. Consideration of the judges of the Constitutional Court Law No. 46 / PUU-VIII / 2010: included: the right to obtain legal status of the child; registration of marriage was not a factor in determining the legal of the marriage and registration of marriages was an administrative obligations required by legislation. The factors that determined the legal of a marriage was the conditions prescribed by the religion of each pair bride; problems concerned children born out of wedlock should receive law protection and law certainty to the status of a child born and rights available to him, including toward children born though the legal of the marriage still disputed. While the

  18. The scorpion toxin Amm VIII induces pain hypersensitivity through gain-of-function of TTX-sensitive Na⁺ channels.

    Science.gov (United States)

    Abbas, Najwa; Gaudioso-Tyzra, Christelle; Bonnet, Caroline; Gabriac, Mélanie; Amsalem, Muriel; Lonigro, Aurélie; Padilla, Françoise; Crest, Marcel; Martin-Eauclaire, Marie-France; Delmas, Patrick

    2013-08-01

    Voltage-gated Na(+) channels (Nav) are the targets of a variety of scorpion toxins. Here, we investigated the effects of Amm VIII, a toxin isolated from the venom of the scorpion Androctonus mauretanicus mauretanicus, on pain-related behaviours in mice. The effects of Amm VIII were compared with the classic scorpion α-toxin AaH II from Androctonus australis. Contrary to AaH II, intraplantar injection of Amm VIII at relatively high concentrations caused little nocifensive behaviours. However, Amm VIII induced rapid mechanical and thermal pain hypersensitivities. We evaluated the toxins' effects on Nav currents in nociceptive dorsal root ganglion (DRG) neurons and immortalized DRG neuron-derived F11 cells. Amm VIII and AaH II enhanced tetrodotoxin-sensitive (TTX-S) Nav currents in DRG and F11 cells. Both toxins impaired fast inactivation and negatively shifted activation. AaH II was more potent than Amm VIII at modulating TTX-S Nav currents with EC50 of 5 nM and 1 μM, respectively. AaH II and Amm VIII also impaired fast inactivation of Nav1.7, with EC50 of 6.8 nM and 1.76 μM, respectively. Neither Nav1.8 nor Nav1.9 was affected by the toxins. AaH II and Amm VIII reduced first spike latency and lowered action potential threshold. Amm VIII was less efficient than AaH II in increasing the gain of the firing frequency-stimulation relationship. In conclusion, our data show that Amm VIII, although less potent than AaH II, acts as a gating-modifier peptide reminiscent of classic α-toxins, and suggest that its hyperalgesic effects can be ascribed to gain-of-function of TTX-S Na(+) channels in nociceptors. Copyright © 2013 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  19. Epidemiological study on Buccal Health in the 12 years old population of Health Care Area VIII in Cienfuegos.

    Directory of Open Access Journals (Sweden)

    Yumaidi Colina Sánchez

    2007-08-01

    Full Text Available Background: The 12 years-old children population is worldwide taken as a reference age to compare the buccal health condition of different countries, by means of various indicators that measure the presence of the main buccal diseases. The knowledge of these epidemiological profiles generates information to guide the services planning policies of the Primary Health Care. Objective: To characterize 12 years-old population's buccal health condition. Methods: Cross- sectional descriptive correlative study with a stratified probabilistic sample of 90 children starting from a universe conformed by the 269 adolescents that constitute the total of the 12 years old population of the Health Care Area VIII in Cienfuegos municipality. Pearson’s chi-square and Mantel-Haenszel lineal tendency tests were used with the determination of the relative risk and reliance intervals of 95%. Results: The decay prevalence reached 54, 4%. The COP-D index was 2, 45 being the decayed component the major percentage with 4.6%. The periodontal disease was more frequent in boys than in girls, with 54, 9% and 30, 8% respectively. 80,9% of the segments is healthy. In those affected, the calculation prevailed in 11,7%. It was determined that faulty obturations, inheritance and faulty buccal hygiene were the most affecting risk factors for children with decays, while in the periodontal disease it was faulty buccal hygiene. Malocclusions presented a prevalence rate of 40%. Out of which, 55,6% required secondary level attention. Those with habits present a risk 2 times superior of making sick. The sick epidemiological category was present in 77,8% of the total. Conclusions: We emphasize the prevention need as core issue of the primary medical care in the world today; being the General-Integral Dentist a transforming agent that according to his/her formation is capable to assume the existent health problem and to modify it positively, acting from the earliest ages.

  20. Keefektifan Experiential Learning Berbantuan Origami Terhadap Kemampuan Keruangan Siswa Kelas VIII

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    Isnaeni Umi Machromah

    2014-11-01

    Full Text Available AbstrakPenelitian eksperimen ini bertujuan untuk mengetahui keefektifan pembelajaran Experiential Learning berbantuan origami terhadap kemampuan keruangan siswa dengan kualifikasi keefektifan yang telah ditentukan. Populasi yaitu siswa kelas VIII SMP Negeri 3 Colomadu tahun pelajaran 2012/2013. Sampel diambil secara simple random sampling. Hasil penelitian ini yaitu: (1 Uji proporsi ketuntasan belajar menunjukkan siswa kelompok eksperimen telah mencapai ketuntasan belajar; (2 Uji perbedaan dua rata-rata menghasilkan simpulan bahwa rata-rata hasil post-test kemam-puan keruangan siswa kelompok eksperimen lebih dari kelompok kontrol; (3 Analisis re-gresi menunjukkan bahwa motivasi belajar siswa memberikan pengaruh positif sebesar 49,3% terhadap kemampuan keruangan siswa; (4 Uji gain ternormalisasi menunjukkan terdapat peningkatan kemampuan keruangan siswa secara signifikan pada kategaori sedang untuk kelompok eksperimen dan kategori rendah untuk kelompok kontrol. Simpulan yang diperoleh yaitu Experiential Learning berbantuan origami efektif terhadap kemampuan keruangan siswa kelas VIII. AbstractThis experiment research aims to determine the effectiveness of Experiential Learning with Origami to the students’s spatial abilities by the criteria of effectiveness. The population of this research is students of grade VIII of SMP Negeri 3 Colomadu 2012/2013 academic year. Independent variables used in this research are learning by Experiential Learning with origami and student’s motivation. While the dependent variable is the student’s spatial abilities. This research is using documentation, spatial abilities’s test, dan motivation’s scale for collecting data method. Result of this research are: (1 proportion test show that the experiment group has reached mastering of learning clasically and personally; (2 result of spatial ablities’s post test in experiment group better than control group; (3 result of regretion shows that student

  1. 77 FR 10740 - Lock+ Hydro Friends Fund VIII, FFP Project 92, LLC, Riverbank Hydro No. 24, LLC; Notice...

    Science.gov (United States)

    2012-02-23

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Lock+ Hydro Friends Fund VIII, FFP Project 92, LLC, Riverbank Hydro No. 24.... 14262-000, FFP Project 92, LLC for Project No. 14276-000, and Riverbank Hydro No. 24, LLC for Project...

  2. Fifteen Questions on the Rules Regarding the Acquisition of Movables in Book VIII Draft Common Frame of Reference

    NARCIS (Netherlands)

    Salomons, A.F.

    2009-01-01

    ABSTRACT: This contribution focuses on Book VIII Draft Common Frame of Reference (DCFR) regarding acquisition and loss of ownership of movable property and consists of fifteen questions encountered when studying the rules of this book. The aim is to provide an ‘internal’ assessment of the provisions

  3. Comparison of kaolin and tissue factor activated thromboelastography in haemophilia.

    Science.gov (United States)

    Young, G; Zhang, R; Miller, R; Yassin, D; Nugent, D J

    2010-05-01

    A limitation of bypassing agent therapy for haemophilia patients with inhibitors is the absence of a laboratory assay, which predicts the clinical response to treatment. Recent investigations have demonstrated the potential for thromboelastography to assess the effects of bypassing agent therapy in this patient population. While tissue factor activation has been used in several prior studies, a recent multicentre study failed to demonstrate an expected concentration-response effect of rFVIIa and called into question the tissue factor activation methods that have been employed. A comparison of kaolin to two concentrations of tissue factor as the activation method for thromboelastography was investigated in patients with haemophilia. We performed kaolin and tissue factor activated thromboelastography on blood from inhibitor and non-inhibitor patients with and without addition of rFVIIa and rFVIII. The results demonstrate that kaolin leads to a longer R, K and angle than the higher dilution of tissue factor (1:17 000) at baseline (no factor) and after addition of rFVIIa for both the inhibitor and non-inhibitor patients. Kaolin led to a longer R and K in comparison to a low dilution of tissue factor (1:42 000) following the addition of rFVIIa in the inhibitor patients. The longer R and K allows for better discrimination of the effects of rFVIIa thus making kaolin the most sensitive activation method in this setting. Thus kaolin activated thromboelastography should be considered an effective, perhaps the most effective, activator when utilizing thromboelastography to assess the effects of rFVIIa in haemophilia patients with inhibitors.

  4. ANALISIS KESALAHAN SISWA SMP KELAS VIII DALAM MENYELESAIKAN MASALAH SOAL CERITA MATEMATIKA

    Directory of Open Access Journals (Sweden)

    Nurul Farida

    2015-12-01

    Full Text Available The aims of the research is to know mistakes and cause of mistakes mengetahui were done by students in in troubleshoot mathematics story problem. The research was a descrptive  qualitative. The subjects of the research was students of class VIII SMP Negeri 2 Karang Anyar. The result of the research are: 1 the mistakes made by students are: student incorrecting to change information that is given into mathematics expression, students can't determine formula, the students incorrectly concept, errors in interpreting the solution , do not make conclusions , errors in calculation;  2 cause students make mistakes  are : do not pay attention to a matter of intent , forget the formula , less familiar to a material , less given the questions varied, in a hurry, and less conscientious in performing the calculations Keywords: analysis, mathematics story problem, mistake

  5. PENERAPAN PENDEKATAN CINEMATHERAPY UNTUK MENINGKATKAN PERILAKU PROSOSIAL PADA SISWA KELAS VIII DI BOSOWA INTERNATIONAL SCHOOL MAKASSAR

    Directory of Open Access Journals (Sweden)

    Haeruddin Niva

    2016-06-01

    Full Text Available The objectives of the research are: (i to know the prosocial behavioral level of the students in Bosowa International School Makassar before and after giving cinematography approach, and (ii to know whether or not the approach is able to enhance the prosocial behavior of the students in Bosowa International School Makassar. The research is a quantitative research using experimental method. The research design used is quasi experimental design with non-equivalent control group design. The data collection technique applied is scale and FGD (Focus Group Discussion. The findings shows that (i the prosocial behavioral level of the students was low in pretest while after giving treatment there were significant increase to the prosocial behavior in the experimental group, and (ii the cinematography approach was able to increase the prosocial behavior of the Grade VIII students in Bosowa Internatinal School Makassar. 

  6. Symposium by NATO Defense Research Group Panel VIII on Computer-Based Instruction in Military Environments

    CERN Document Server

    Weddle, Peter

    1987-01-01

    This collection of papers is the result of a symposium sponsored by NATO's Defense Research Group Panel VIII in the Spring of 1985. The symposium came into being when it became obvious to the NATO countries that research, development and utilization of advanced technologies for training was the best means of increasing both training effectiveness and efficiency. This symposium was the second in a series of three devoted to training. The series was structured to cover all aspects of training. The first series addressed the value of training, the second one dealt with the application of training technologies and the third and last of the series focused on academic issues concerned with the effect of prior learning on subsequent learning. The fact that a major American publisher has determined that computer based instruction is the technology of greatest interest to the NATO community is not surprising. Advances in microprocessor technology have revolutionized both how and where we train. During this symposium t...

  7. PENGARUH MODEL KOOPERATIF TIPE NHT TERHADAP HASIL BELAJAR SISWA KELAS VIII SMP NEGERI 18 MEDAN

    Directory of Open Access Journals (Sweden)

    Faridah Anum Siregar

    2012-06-01

    Full Text Available Penelitian ini bertujuan untuk mengetahui pengaruh model Kooperatif Tipe NHT terhadap hasil belajar siswa semester genap pada sub materi pokok Tekanan Pada Zat Padat dan Zat Cair di SMP Negeri 18 Medan T.P 2009/2010. Jenis penelitian ini adalah eksperimen two group pretest postest. Populasi dalam penelitian adalah seluruh siswa kelas VIII Semester Genap SMP Negeri 18 Medan yang terdiri dari 8 kelas berjumlah 320 orang. Pengambilan sampel dilakukan dengan cara cluster random sampling yaitu dengan mengambil 2 kelas dari 8 kelas secara acak. Dari hasil uji t-test diperoleh thitung sebesar 2,458 dengan probabilitas 0,017 < 0,05. Ini berarti ada pengaruh yang signifikan penggunaan model kooperatif tipe NHT terhadap hasil belajar siswa pada sub materi pokok Tekanan Pada Zat Padat dan Zat Cair Semester Genap SMP Negeri 18 Medan T.P 2009/2010.

  8. The personality and health of King Henry VIII (1491-1547).

    Science.gov (United States)

    Keynes, Milo

    2005-08-01

    The projection of Henry VIII in the first half of his reign, which began in 1509, is of a magnificent and accomplished 'imperial prince', the possessor of superb physical health. In 1528, when aged 37, he showed a marked change in personality due, it is here argued, to depressive illness, from which he recovered by the mid-1530s. Such ill health has not been recognized previously and it engenders a need for a reassessment of his character and actions during these years of illness. He did not suffer from syphilis and the well-known leg ulcers were less incapacitating than has been described in the past. This truly enormous and overweight man was 55 years old when he died in 1547 in chronic heart failure.

  9. Characterization of a Novel Alkaline Family VIII Esterase with S-Enantiomer Preference from a Compost Metagenomic Library.

    Science.gov (United States)

    Lee, Hyun Woo; Jung, Won Kyeong; Kim, Yong Ho; Ryu, Bum Han; Kim, T Doohun; Kim, Jungho; Kim, Hoon

    2016-02-01

    A novel esterase gene, est7K, was isolated from a compost metagenomic library. The gene encoded a protein of 411 amino acids and the molecular mass of the Est7K was estimated to be 44,969 Da with no signal peptide. Est7K showed the highest identity of 57% to EstA3, which is an esterase from a drinking water metagenome, when compared with the enzymes with reported properties. Est7K had three motifs, SMTK, YSV, and WGG, which correspond to the typical motifs of family VIII esterases, SxxK, Yxx, and WGG, respectively. Est7K did not have the GxSxG motif in most lipolytic enzymes. Three additional motifs, LxxxPGxxW, PLGMxDTxF, and GGxG, were found to be conserved in family VIII enzymes. The results of the phylogenetic analysis and the alignment study suggest that family VIII enzymes could be classified into two subfamilies, VIII.1 and VIII.2. The purified Est7K was optimally active at 40°C and pH 10.0. It was activated to exhibit a 2.1-fold higher activity by the presence of 30% methanol. It preferred short-length p-nitrophenyl esters, particularly p-nitrophenyl butyrate, and efficiently hydrolyzed glyceryl tributyrate. It did not hydrolyze β-lactamase substrates, tertiary alcohol esters, glyceryl trioleate, fish oil, and olive oil. Est7K preferred an Senantiomer, such as (S)-methyl-3-hydroxy-2-methylpropionate, as the substrate. The tolerance to methanol and the substrate specificity may provide potential advantage in the use of the enzyme in pharmaceutical and other biotechnological processes.

  10. The Arabidopsis class VIII myosin ATM2 is involved in endocytosis.

    Science.gov (United States)

    Sattarzadeh, Amirali; Franzen, Rainer; Schmelzer, Elmon

    2008-06-01

    Members of the class XI of the myosin superfamily comprising higher plant, actin-based molecular motors have been shown to be involved in peroxisome and Golgi vesicle trafficking comparable to yeast and animal class V myosins. The tasks of the second class of myosins of higher plants, class VIII, are unclear. In this study the class VIII myosin ATM2 from the model plant Arabidopsis thaliana was selected for the examination of cargo specificity in vivo. Fluorescent protein-fusion plasmid constructs with fragments of the ATM2 cDNA were generated and used for Agrobacterium tumefaciens-based transient transformation of Nicotiana benthamiana leaves. The resulting subcellular localization patterns were recorded by live imaging with confocal laser scanning microscopy (CLSM) in epidermal leaf cells. Expression of a nearly full-length construct displayed labeling of filaments and vesicles, a head + neck fragment led to decoration of filaments only. However, expression of fluorescent protein-tagged C-terminal tail domain constructs labeled vesicular structures of different appearance. Most importantly, coexpression of different RFP/YFP-ATM2 tail fusion proteins showed colocalization and, hence, binding to the same type of vesicular target. Further coexpression experiments of RFP/YFP-ATM2 tail fusion proteins with the endosomal marker FYVE and the endosomal tracer FM4-64 demonstrated colocalization with endosomes. Colocalization was also detected by expression of the CFP-tagged membrane receptor BRI1 as marker, which is constantly recycled via endosomes. Occasionally the ATM2 tail targeted to sites at the plasma membrane closely resembling the pattern obtained upon expression of the YFP-ATM1 C-terminal tail. ATM1 is known for its localization at the plasma membrane at sites of plasmodesmata. Copyright 2008 Wiley-Liss, Inc.

  11. On the miscellaneous aspects of von Willebrand factor

    NARCIS (Netherlands)

    Groeneveld, Dafna Jordana

    2015-01-01

    Von Willebrand disease is the most common inherited bleeding disorder and is characterized by reduced plasma von Willebrand factor (VWF) levels or functionally abnormal VWF. VWF is best known for its three classical hemostatic functions: (i) as a carrier protein for coagulation factor VIII, (ii)

  12. Expression of von Willebrand factor Normandy: An autosomal mutation that mimics hemophilia A

    Energy Technology Data Exchange (ETDEWEB)

    Tuley, E.A.; Worrall, N.K.; Sadler, J.E. (Washington Univ. School of Medicine, St. Louis, MO (United States)); Gaucher, C.; Jorieux, S.; Mazurier, C. (Centre Regional de Transfusion Sanguine, Lille (France))

    1991-07-15

    von Willebrand disease Normandy (vWD Normandy) is a recently described phenotype in which a mutant von Willebrand factor (VWF) appears structurally and functionally normal except that is does not bind to blood coagulation factor VIII. This interaction is required for normal survival of factor VIII in the circulation; consequently, vWD Normandy can present as apparent hemophilia A but with autosomal recessive rather than X chromosome-linked inheritance. AvWF missense mutation, Thr{sup 28} {r arrow} Met, was identified in the propositus in or near the factor VIII binding site. The corresponding mutant recombinant vWF(T28M) formed normal multimers and had normal ristocetin cofactor activity. However, vWF(T28M) exhibited the same defect in factor VIII binding as natural vWF Normandy, confirming that this mutation causes the vWD Normandy phenotype. The distinction between hemophilia A and vWD Normandy is clinically important and should be considered in families affected by apparent mild hemophilia A that fail to show strict X chromosome-linked inheritance and, particularly, in potential female carriers with low factor VIII levels attributed to extreme lyonization.

  13. PENGEMBANGAN MODEL PEMBELAJARAN BERBASIS MASALAH YANG BERMUATAN NILAI-NILAI PENDIDIKAN KARAKTER DALAM PEMBELAJARAN MENULIS CERPEN PADA KELAS VIII SMP

    Directory of Open Access Journals (Sweden)

    Aditya Dwi Haryawan

    2014-08-01

    Full Text Available Menulis merupakan suatu keterampilan yang harus dimiliki peserta didik sekolah menengah pertama. Melaluitulisan, peserta didik dapat menyampaikan pengalaman, pikiran, perasaan, atau keinginan. Masalah penelitianini adalah (1 bagaimanakah kebutuhan pengembangan model pembelajaran berbasis masalah yang bermuatannilai-nilai pendidikan karakter dalam pembelajaran menulis cerpen berdasarkan persepsi guru dan pesertadidik kelas VIII SMP?; (2 bagaimanakah prinsip-prinsip pengembangan model pembelajaran berbasis masalahyang bermuatan nilai-nilai pendidikan karakter dalam pembelajaran menulis cerpen pada peserta didik kelasVIII SMP? (3 bagaimanakah pengembangan prototipe model pembelajaran berbasis masalah yang bermuatannilai-nilai pendidikan karakter dalam pembelajaran menulis cerpen pada kelas VIII SMP?; (4 bagaimanakahkeberterimaan penerapan pengembangan model pembelajaran berbasis masalah yang bermuatan nilai-nilaipendidikan karakter dalam pembelajaran menulis cerpen pada kelas VIII SMP. Dalam penelitian ini digunakandesain Research and Development. Tahapan yang dilakukan dalam penelitian ini adalah studi pustaka, analisiskebutuhan, pengembangan model yang dikembangkan, uji validasi, revisi, implementasi, revisi akhir,pengembangan model/produk akhir. Pengumpulan data dilakukan dengan observasi, angket, wawancara, tes,dan dokumentasi foto. Writing is a skill that must be owned by middle school students. Through writing, students canconvey experiences, thoughts, feelings, or desires. The research problem is (1 How can the needsof the development of PBL model that charged the values of character education in learning towrite short stories on the perceptions of teachers and students of class VIII?; (2 How do thecharacteristics of the development of PBL model value-laden -the value of character education inlearning to write short stories at the high school of learner assessment system class?; (3 How isthe development of a prototype model of PBL  charged

  14. Protein trans-splicing based dual-vector delivery of the coagulation factor Ⅷ gene

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    A dual-vector system was explored for the delivery of the coagulation factor VIII gene,using intein-mediated protein trans-splicing as a means to produce intact functional factor VIII post-translationally.A pair of eukaryotic expression vectors,expressing Ssp DnaB intein-fused heavy and light chain genes of B-domain deleted factor VIII (BDD-FVIII),was constructed.With transient co-transfection of the two vectors into 293 and COS-7 cells,the culture supernatants contained (137±23) and (109±22) ng mL–1 spliced BDD-FVIII antigen with an activity of (1.05±0.16) and (0.79±0.23) IU mL–1 for 293 and COS-7 cells,respectively.The spliced BDD-FVIII was also detected in supernatants from a mixture of cells transfected with inteinfused heavy and light chain genes.The spliced BDD-FVIII protein bands from cell lysates were visualized by Western blotting.The data demonstrated that intein could be used to transfer the split factor VIII gene and provided valuable information on factor VIII gene delivery by dual-adeno-associated virus in hemophilia A gene therapy.

  15. Defect-free zinc-blende structured InAs nanowires realized by in situ two V/III ratio growth in molecular beam epitaxy.

    Science.gov (United States)

    Zhang, Zhi; Lu, Zhen-Yu; Chen, Ping-Ping; Lu, Wei; Zou, Jin

    2015-08-07

    In this study, we devised a two-V/III-ratio procedure to control the Au-assisted growth of defect-free InAs nanowires in molecular beam epitaxy. The demonstrated two V/III ratio procedure consists of a first high V/III ratio growth step to prepare the nanowire foundation on the substrate surface, followed by a low V/III ratio step to induce the nanowire growth. By manipulating the V/III ratios in different steps, we have achieved the controlled growth of pure defect-free zinc-blende structured InAs nanowires on the GaAs {1̄1̄1̄} substrates. This study provides an approach to control not only the crystal structure of semiconductor nanowires, but also their structural qualities.

  16. 20 CFR 408.931 - How much will we withhold from your title II and title XVI benefits to recover a title VIII...

    Science.gov (United States)

    2010-04-01

    ... willfully misrepresented or concealed material information in connection with the overpayment. (c) In... withholding from title VIII benefits. (d) If you or your spouse willfully misrepresented or concealed material...

  17. Tecniche costruttive e forme di potere nella Toscana sud-occidentale (secc. VIII-XIV

    Directory of Open Access Journals (Sweden)

    Bianchi, Giovanna

    2005-12-01

    Full Text Available This paper tells about the analysis of the building techniques of elevations inferred from data obtained in extensive projects of archaeological research executed in western Tuscany's rural field from half '90s of last century to present. The text looks over the changes from wooden building trade related to the first high rise habitants in VIIth-VIIIth century, until the pattern settlements in the second half of VIIIth and XIth centuries, characterized by the first use of masonry and the presence of expert master builders. The more complex organization of the building workshops for castles of the XIth and XIIth centuries in relation with the liege lord's rising politic abusive authority is explained in the following part. The subsequent formation of new suburbs between the XIIIth and the XIV centuries is characterized by a different way of use of building techniques, often founded over pre-existing castles, linked to local council, up to the political and economical influence of Pisa in this territory.Nell’articolo si tratta l’analisi delle tecniche murarie desunta da dati provenienti da ampi progetti di indagine archeologica svolti in ambito rurale nella Toscana occidentale dalla metà degli anni Novanta dello scorso secolo ad oggi. Nel testo si esaminano i cambiamenti dei modi di edificare a partire dall’edilizia in legno dei primi abitati di altura di VII-VIII secolo, sino agli insediamenti più strutturati di seconda metà VIII e IX secolo, caratterizzati da un primo uso della pietra e dalla presenza di maestranze specializzate. In seguito si analizza la più complessa organizzazione del cantiere propria della costruzione dei castelli di XI e XII secolo in rapporto ai poteri politici ed economici delle nascenti signorie territoriali. Un differente uso delle tecniche costruttive caratterizza la successiva formazione di nuovi borghi tra XIII e XIV secolo, spesso impiantati sui preesistenti castelli, legati ai locali organismi comunali

  18. Kubas-type hydrogen storage in V(III) polymers using tri- and tetradentate bridging ligands.

    Science.gov (United States)

    Hoang, Tuan K A; Hamaed, Ahmad; Moula, Golam; Aroca, Ricardo; Trudeau, Michel; Antonelli, David M

    2011-04-01

    Oxalic acid, oxamide, glycolic acid, and glycolamide were employed as 2-carbon linkers to synthesize a series of one-dimensional V(III) polymers from trismesityl vanadium(III)·THF containing a high concentration of low-valent metal sites that can be exploited for Kubas binding in hydrogen storage. Synthesized materials were characterized by powder X-ray diffraction (PXRD), nitrogen adsorption (BET), X-ray photoelectron spectroscopy (XPS), infrared spectroscopy (IR), Raman spectroscopy, thermogravimetric analysis, and elemental analysis. Because each of these organic linkers possesses a different number of protons and coordinating atoms, the products in each case were expected to have different stoichiometries with respect to the number of mesityl groups eliminated and also a different geometry about the V(III) centers. For example, the oxalate and glycolate polymers contained residual mesityl groups; however, these could be exchanged with hydride via hydrogenolysis. The highest adsorption capacity was recorded on the product of trismesityl vanadium(III)·THF with oxamide (3.49 wt % at 77 K and 85 bar). As suggested by the high enthalpy of adsorption (17.9 kJ/mol H(2)), a substantial degree of performance of the vanadium metal centers was retained at room temperature (25%), corresponding to a gravimetric adsorption of 0.87 wt % at 85 bar, close to the performance of MOF-177 at this temperature and pressure. This is remarkable given the BET surface area of this material is only 9 m(2)/g. A calculation on the basis of thermogravimetric results provides 0.88 hydrogen molecule per vanadium center under these conditions. Raman studies with H(2) and D(2) showed the first unequivocal evidence for Kubas binding on a framework metal in an extended solid, and IR studies demonstrated H(D) exchange of the vanadium hydride with coordinated D(2). These spectroscopic observations are sufficient to assign the rising trends in isosteric heats of hydrogen adsorption observed

  19. IMPLEMENTASI MODEL PEMBELAJARAN ARIAS DALAM UPAYA MENINGKATKAN PARTISIPASI DAN HASIL BELAJAR EKONOMI SISWA KELAS VIII PADA SMP N 10 PADANG

    Directory of Open Access Journals (Sweden)

    nilma desri rosya

    2015-10-01

    Full Text Available This study aims to see increased participation and student learning outcomes by using model study on subjects ARIAS Economy class VIII.3 in SMP N 10 Padang. This research is a classroom action research with the hypothesis of action is the application of learning models ARIAS can increase participation and learning outcomes Economy class students VIII.3 SMP N 10 Padang. Data were collected through observation sheet that is used to view changes in participation and learning outcomes of students in the learning process cycle I and II. The results of the two cycles shows that participation and learning outcomes of students has increased since the first cycle and this improvement continued in the second cycle

  20. V/III ratio effects on high quality InAlAs for quantum cascade laser structures

    Science.gov (United States)

    Demir, Ilkay; Elagoz, Sezai

    2017-04-01

    In this study we report the V/III ratio effects on growth, structural, optical and doping characteristics of low growth rate (∼1 Å/s) heteroepitaxial Metal Organic Chemical Vapor Deposition (MOCVD) grown InxAl1-xAs layers, a part of Quantum Cascade Laser (QCL) structures, on InP substrate. Especially photoluminescence (PL) properties of InAlAs-InP interface show strong dependence on AsH3 overpressure. We have shown that the V/III ratio with fixed metalorganic precursor flow is a crucial parameter on InxAl1-xAs layers to have a good material quality in terms of crystallinity, optical and electrical characteristics with and without doping.

  1. PENGARUH KEMANDIRIAN BELAJAR DAN PENGGUNAAN UANG SAKU TERHADAP PRESTASI BELAJAR KOMPETENSI DASAR EKONOMI KELAS VII DAN VIII

    Directory of Open Access Journals (Sweden)

    Apri Dwi Astuti

    2012-10-01

    Full Text Available Kemandirian belajar membantu siswa untuk bertanggung jawab dan menumbuhkan kesadaran belajar. Penggunaan uang saku menumbuhkan jiwa mandiri, jujur dan komitmen. Adapun hasil observasi awal menunjukkan masih ada siswa kels VII dan VIII SMP Semesta untuk kompetensi dasar ekonomi dibawah KKM. Tujuan penelitian ini untuk mengetahui pengaruh kemandirian belajar dn penggunaan uang saku terhadap prestasi belajar kompetensi dasar ekonomi kelas VII dan VIII SMP Semesta. Populasi penelitian ini adalah semua siswa kelas VII dan VIII SMP Semesta Boarding School Semarang. Variabel penelitian ini adalah kemandirian belajar dan penggunaan uang saku sebagai variabel bebas, sedangkan untuk� variabel terikat adalah prestasi belajar kompetensi dasar ekonomi. Data diambil dengan metode wawancara, kuesioner dan dokumentasi guru. Analisis data menggunakan analisis regresi linear berganda.Berdasarkan penelitian secara simultan menunjukkan adanya pengaruh antara kemandirian belajar dan penggunaan uang saku terhadap prestasi belajar kompetensi dasar ekonomi sebesar 51,3%. Secara parsial, pengaruh kemandirian belajar terhadap prestasi belajar kompetensi dasar ekonomi sebesar 66,2% dan pengaruh penggunaan uang saku terhadap prestasi belajar kompetensi dasar ekonomi sebesar 62,5%.Berdasarkan hasil penelitian diatas disimpulkan bahwa kemandirian belajar dan penggunaan uang saku berpengaruh positif baik secara simultan maupun parsial terhadap prestasi belajar kompetensi dasar ekonomi kelas VII dan VIII SMP Semesta Boarding school semarang tahun pelajaran 2011/2012. Saran yang berkaitan dengan penelitian ini yaitu : 1 Sekolah disarankan untuk memberikan batasan siswa pulang ke rumah agar dapat membantu siswa beradaptasi dengan cepat dan mudah tinggal di asrama. 2 Orang tua disarankan untuk memberikan uang saku yang disesuaikan dengan kebutuhan siswa. 3 Siswa disarankan untuk meningkatkan kemandirian dalam aspek belajar terutama bagi mata pelajaran yang masih kurang dari

  2. Structure and stability of hexa-aqua V(III) cations in vanadium redox flow battery electrolytes.

    Science.gov (United States)

    Vijayakumar, M; Li, Liyu; Nie, Zimin; Yang, Zhenguo; Hu, JianZhi

    2012-08-01

    The vanadium(III) cation structure in mixed acid based electrolyte solution from vanadium redox flow batteries is studied by (17)O and (35/37)Cl nuclear magnetic resonance (NMR) spectroscopy, electronic spectroscopy and density functional theory (DFT) based computational modelling. Both computational and experimental results reveal that the V(III) species can complex with counter anions (sulfate/chlorine) depending on the composition of its solvation sphere. By analyzing the powder precipitate it was found that the formation of sulfate complexed V(III) species is the crucial process in the precipitation reaction. The precipitation occurs through nucleation of neutral species formed through deprotonation and ion-pair formation process. However, the powder precipitate shows a multiphase nature which warrants multiple reaction pathways for precipitation reaction.

  3. MX Siting Investigation. Geotechnical Evaluation. Volume VIII. Nevada - Utah Verification Studies, FY 79. Geotechnical Data Big Smoky CDP, Nevada.

    Science.gov (United States)

    1979-08-24

    Angular - particles have sharp edges and relatively plane sides with unpolished surfaces. wfl . AT#UNL, EWE. FN-TR-27-VIII 6-5 Subangular - particles... GEM ~GIC UNIT My ’All .’j GP T-3 C-33 St FACE ELEV TION: 492j * 1500m) SM jSIRFICIAL GE LOGIC UNIT: AMy A3 SW-SM F -6 C-34 SURFACE ELEVATION: 4938

  4. Neurotology findings in patients with diagnosis of vascular loop of cranial nerves VIII in magnetic resonance imaging

    Directory of Open Access Journals (Sweden)

    Grocoske, Francisco Luiz Busato

    Full Text Available Introduction: The vascular compression by redundant vessels under the VIII cranial nerves has been studied since the 80's, and many authors proposed correlations between the compression and the otoneurological findings (vertigo, tinnitus, hypoacusis, audiometry and electrophysiological findings. Objective: Analyze and correlate the different signs and otoneurological symptoms, the audiological findings and its incidence over individuals with Vascular Loop (VL diagnosis of VIII cranial nerves by magnetic resonance imaging (MRI. Method: Retrospective study through the analysis of medical records of 47 patients attended in the otoneurology clinic of Clinical Hospital of UFPR. All the patients have MRI exams with compatible pictures of VL of the VIII cranial nerves. Results: The tinnitus was the most frequent symptom, in 83% of the patients, followed by hypoacusis (60% and vertigo (36%. The audiometry presented alterations in 89%, the brainstem evoked auditory potential in 33% and the vecto-electronystagmography in 17% of the patients. Was not found statistically significant relation between the buzz or hypoacusis, and the presence of VL in MRI. Only 36% of patients had complaints of vertigo, the main symptom described in theory of vascular compression of the VIII pair of nerve. As in the audiometry and in brainstem evoked auditory potential was not found a statistically significant relation between the exam and the presence of the VL in the RMI. Conclusion: The results show independence between the findings of the RMI, clinical picture and audiological results (p>0,05 suggesting that there are no exclusive and direct relation between the diagnosis of vascular loop in the MRI and the clinical picture matching.

  5. Development of Integrated Natural Science Teaching Materials Webbed Type with Applying Discourse Analysis on Students Grade VIII in Physics Class

    Science.gov (United States)

    Sukariasih, Luh

    2017-05-01

    This study aims to produce teaching materials integrated natural science (IPA) webbed type of handout types are eligible for use in integrated science teaching. This type of research IS a kind of research and development / Research and Development (R & D) with reference to the 4D development model that is (define, design, develop, and disseminate). Data analysis techniques used to process data from the results of the assessment by the validator expert, and the results of the assessment by teachers and learners while testing is limited (12 students of class VIII SMPN 10 Kendari) using quantitative descriptive data analysis techniques disclosed in the distribution of scores on the scale of five categories grading scale that has been determined. The results of due diligence material gain votes validator material in the category of “very good” and “good”, of the data generated in the feasibility test presentation obtained the category of “good” and “excellent”, from the data generated in the feasibility of graphic test obtained the category of “very good “and” good “, as well as of the data generated in the test the feasibility of using words and language obtained the category of“very good “and” good “, so with qualifications gained the teaching materials IPA integrated type webbed by applying discourse analysis on the theme of energy and food for Junior High School (SMP) grade VIII suitable as teaching materials. In limited testing, data generated in response to a science teacher at SMPN 10 Kendari to product instructional materials as “excellent”, and from the data generated while testing is limited by the 12 students of class VIII SMPN 10 Kendari are more students who score indicates category “very good”, so that the qualification obtained by the natural science (IPA) teaching material integrated type webbed by applying discourse analysis on the theme of energy and food for SMP / class VIII fit for use as teaching material.

  6. The Funnel Geometry of Open Flux Tubes in the Low Solar Corona Constrained by O VI and Ne VIII Outflow

    Science.gov (United States)

    Byhring, Hanne S.; Esser, Ruth; Lie-Svendsen, Oystein

    2008-01-01

    Model calculations show that observed outflow velocities of order 7-10 km/s of C IV and O VI ions, and 15-20 km/s of Ne VIII ions, are not only consistent with models of the solar wind from coronas holes, but also place unique constraints on the degree of flow tube expansion as well as the location of the expansion in the transition region/lower corona.

  7. MENINGKATKAN PEMBELAJARAN HOCKEY MELALUI PERMAINAN 4 GAWANG KECIL PADA SISWA KELAS VIII 3 SMP MUHAMMADIYAH 4 SEMARANG TAHUN 2015

    Directory of Open Access Journals (Sweden)

    Muhammad Taufiq

    2016-02-01

    Full Text Available The purpose of this result the study learning of hockey games through the 4 Small Wicket Game in Grade VIII 3 students of Smp Muhammadiyah 4 Semarang. In this case the right is 4 semarang. research method. In practice consists of two cycles. Based on the results of the research, it showed the percentage of passing students study result in the first cycle, students who got pass score are 58.33% (21 students and who did not pass are 41.66% (15 students. In the second cycle students who got pass score are 88.88% (34 students and students who did not pass are 11.11% (4 students. It indicates an increase completeness of student study result is 30.55%.Based on the research’s result, it can be concluded that the use of 4 Small Wicket Game in Grade VIII 3 students is right to improve the study result of grade VIII 3 students of SMP Muhammadiyah 4 Semarang in learning hockey.

  8. EFEKTIFITAS METODE MIND MAPPING UNTUK MENINGKATKAN PRESTASI BELAJAR FISIKA PADA SISWA KELAS VIII

    Directory of Open Access Journals (Sweden)

    Unggul Haryanto Nur Utomo

    2012-03-01

    Full Text Available This study aimed to determine the effectiveness of mind mappingmethod to improve the learning achievements of physics. The subjects ofthis study were students in grade VIII of SMP Muhammadiyah 8 Yogyakartawhich have average score of physics subjects below 6.5, and have theability to see and hear well. Data collection methods used in this study wasthe academic score on the physics subject of optical tools, documentation,observation and interview. This study used the experimental method ofpretest-posttest with control group design and used the t-test analysis.The results of paired sample t-test analysis in experimental group obtainedthat mind mapping method has highly significant positive effect in enhancingachievement of physics learning (t = -11.006, p = 0.000. The results ofthe paired sample t-test analysis in control group showed that conventionalmethod has insignificant influence on achievement enhancement of physicslearning (t = -1.941, p = 0.070 and the independent sample t-test in bothgroup found that there are significant difference of average (mean posttestscore between the experimental group and control group (t = 2.144, p =0.020. The results demonstrate mind mapping method is very effective inimproving the learning achievements of physics.

  9. PENINGKATAN KUALITAS BERMAIN PERAN SISWA KELAS VIII SMP 1 TEPUS DENGAN TEKNIK LEARNING GAME

    Directory of Open Access Journals (Sweden)

    Sutrisno Sutrisno

    2014-05-01

    Full Text Available Penelitian ini bertujuan untuk mendeskripsikan peningkatan kualitas proses dan hasil pembelajaran bermain peran siswa kelas VIII SMP dengan menggunakan teknik Learning Game. Game yang digunakan adalah permainan Joko Tingkir dan permainan Tebak Peran. Penelitian ini merupakan penelitian tindakan kelas (PTK. Guru bertindak sebagai peneliti yang bekerja sama dengan kolaborator, yakni guru Bahasa Indonesia dan Kepala Sekolah SMP 1 Tepus. Subjek penelitian yang dikenai tindakan adalah siswa kelas VIIIA SMP 1 Tepus Gunungkidul, DIY, tahun ajaran 2011/2012 yang berjumlah 34 siswa. Penelitian ini terdiri atas dua siklus. Setiap siklus dibagi menjadi tiga kali pertemuan. Prosedur pelaksanaan setiap siklus terdiri atas empat tahap, yakni perencanaan, pelaksanaan tindakan, pengamatan, dan refleksi. Teknik pengumpulan data yang digunakan adalah angket, wawan-cara, pengamatan, dan pencermatan dokumen. Analisis dilakukan dengan teknik deskriptif kualitatif yang didukung oleh data kuantitatif.  Hasil penelitian menunjukkan bahwa dengan teknik Learning Game dalam pembelajaran bermain peran, kualitas proses dan hasil pembelajaran meningkat. Peningkatan kualitas proses pembelajaran meliputi aspek interaksi dan komunikasi dalam pembelajaran, kerja sama dalam kelompok, dan keseriusan dalam mengikuti pembelajaran. Adapun peningkatan kualitas hasil pembelajaran meliputi kemampuan vokal, intonasi, ekspresi, dan gestur. Keempat kemampuan tersebut masing-masing mengalami peningkatan nilai rata-rata lebih dari 25%. Hal ini sesuai dengan kriteria keberhasilan tindakan yang ditetapkan. Kata Kunci: bermain peran, teknik Learning Game

  10. Phonon dynamics in type-VIII silicon clathrates: Beyond the rattler concept

    Science.gov (United States)

    Norouzzadeh, Payam; Myles, Charles W.; Vashaee, Daryoosh

    2017-05-01

    Clathrates can form a type of guest-host solid structures that, unlike most crystalline solids, have very low thermal conductivity. It is generally thought that the guest atoms caged inside the host framework act as "rattlers" and induce lattice dynamics disorders responsible for the small thermal conductivity. We performed a systematic study of the lattice dynamical properties of type-VIII clathrates with alkali and alkaline-earth guests, i.e., X8S i46 (X =Na , K, Rb, Cs, Ca, Sr, and Ba). The energy dependent participation ratio (PR) and the atomic participation ratio of phonon modes extracted from density functional theory calculations revealed that the rattler concept is not adequate to describe the effect of fillers as they manifest strong hybridization with the framework. For the case of heavy fillers, such as Rb, Sr, Cs, and Ba, a phonon band gap was formed between the acoustic and optical branches. The calculated PR indicated that the fillers suppress the acoustic phonon modes and change the energy transport mechanism from propagative to diffusive or localized resulting in "phonon-glass" characteristics. This effect is stronger for the heavy fillers. Furthermore, in all cases, the guest insertion depressed the phonon bandwidth, reduced the Debye temperature, and reduced the phonon group velocity, all of which should lead to reduction of the thermal conductivity.

  11. Results from a large multinational clinical trial (guardian™3) using prophylactic treatment with turoctocog alfa in paediatric patients with severe haemophilia A: safety, efficacy and pharmacokinetics.

    Science.gov (United States)

    Kulkarni, R; Karim, F A; Glamocanin, S; Janic, D; Vdovin, V; Ozelo, M; Rageliene, L; Carboni, E; Laguna, P; Dobaczewski, G; Seremetis, S; Lindblom, A; Santagostino, E

    2013-09-01

    Recombinant factor VIII (rFVIII) products provide a safe and efficacious replacement therapy for prophylaxis and treatment of bleeding episodes in patients with severe haemophilia A. This multinational, open-label, non-controlled trial investigated the safety, efficacy and pharmacokinetics (PK) of turoctocog alfa, a new rFVIII product, in a paediatric population. The primary objective was to evaluate safety. A total of 31 younger children (0-5 years) and 32 older children (6-11 years), with ≥ 50 exposure days to any factor VIII (FVIII) product and no history of inhibitors, received prophylaxis with turoctocog alfa (25-50 IU kg(-1) every second day or 25-60 IU kg(-1) three times weekly). PK assessments of turoctocog alfa and the patients' previous FVIII product were performed in 28 patients. Mean exposure to turoctocog alfa was 60 exposure days per patient. This corresponds to approximately 4.5 months in the trial. None of the patients developed inhibitors (≥ 0.6 BU) and no safety concerns were raised. A total of 120 bleeding episodes (95%) were controlled with 1-2 infusions of turoctocog alfa. Based on patient reports, the success rate (defined as 'excellent' or 'good' haemostatic response) for treatment of bleeding episodes was 92%. Overall, the median annualized bleeding rate was 3.0 (interquartile range: 8.5) bleeds patient(-1) year(-1) . PK parameters were comparable between the two age groups. In conclusion, the present large global clinical trial showed that turoctocog alfa was safe, effective in treatment of bleeding episodes and had a prophylactic effect in paediatric patients. © 2013 John Wiley & Sons Ltd.

  12. MENINGKATKAN AKTIVITAS BELAJAR SISWA DENGAN MENGGUNAKAN METODE GROUP INVESTIGATION (GI PADA POKOK BAHASAN PASAR DI KELAS VIII SMP 5 KUDUS

    Directory of Open Access Journals (Sweden)

    Mutthofiyah Mutthofiyah

    2016-03-01

    Full Text Available Penelitian ini bertujuan untukmeningkatkan aktivitas belajar siswa dengan menggunakan metode group investigation (GI pada pokok bahasan pasar pada penelitian ini menggunakan penelitian tindakan kelas (PTK. Dalam penelitian ini dirancang menggunakan siklus, masing-masing siklus dengan tahapan perencanaan, pelaksanaan tindakan, observasi dan refleksi. Teknik pengumpulan data pada penelitian ini adalah dokumentasi, observasi dan tes.Hasil penelitian menunjukkan melalui meningkatkan metode group investigation (GI aktivitas siswa SMP 5 Kudus ada peningkatan yang sigifikan, dari siklus I kelas VIII F 15,8 (41,62% meningkat di siklus II menjadi 24,8 (72,9%, sedangkan di kelas VIII G siklus I 18,5 (47,04% meningkat menjadi 26,2 (74,7%; melalui penerapan metode group investigation hasil belajar siswa SMP 5 kudus meningkat sangat signifkan, ketuntasan belajar secara klasikal dari kelas VIII F pra siklus sebesar 17,64% terjadi peningkatan 47% ke siklus I dan meningkat menjadi 82,35% di siklus II. Sedangkan di kelas VII G pra siklus sebesar 22,85% meningkat 54,28% di siklus I dan meningkat menjadi 94,28% di siklus II. Saran yang peneliti berikan adalah sebagai berikut:1Kepada para guru diharapkan dapat menerapkan pembelajaran kooperatif khususnya pembelajaran kooperatif tipe Group Investigation (GI dalam proses pembelajaran ekonomi dan mata pelajaran lainya dan mengembangkannya; 2 Kepada para peneliti selanjutnya diharapkan dapat melakukan penelitian tentang penerapan model pembelajaran yang dapat membangkitkan keaktifan siswa untuk belajar ekonomi. This study aims to improve students' learning activities using group investigation (GI on the subject of markets in class VIII SMP 5 Kudus. In this study is designed to use cycles, with each cycle stages of planning, action, observation and reflection. Data collection techniques in this study is documentation, observation and tests. Results showed through improved methods of group investigation (GI junior 5 high

  13. Seleucid, Demotic and Mediterranean mathematics versus Chapters VIII and IX of the Nine Chapters: accidental or significant similarities?

    DEFF Research Database (Denmark)

    Høyrup, Jens

    2016-01-01

    Similarities of geometrical diagrams and arithmetical structures of problems have often been taken as evidence of transmission of mathematical knowledge or techniques between China and “the West”. Confronting on one hand some problems from Chapter VIII of the Nine Chapters with comparable problems...... known from Ancient Greek sources, on the other a Seleucid collection of problems about rectangles with a subset of the triangle problems from Chapter IX, it is concluded, (1) that transmission of some arithmetical riddles without method – not “from Greece” but from a transnational community of traders...

  14. DAMPAK POSITIF DAN NEGATIF SOSIAL MEDIA TERHADAP PENDIDIKAN AKHLAK ANAK (Studi Kasus di SMP Negeri 2 Kelas VIII Banda Aceh)

    OpenAIRE

    NISA KHAIRUNI

    2016-01-01

    The author examines the positive and negative effects of social media on the moral education of children in school SMPN 2 class VIII Banda Aceh, it is very interesting because of the many children who abuse social media. This work analyzes about the use of social media that have an impact on the moral education of children. The data collected in this study through the work of other literature, researchers also interviewed principals and students as many as 16 students as well as the observati...

  15. EK(b)P Keskkomitee VIII pleenumi stenogramm / tõlk. Mart Arold, tõlk. Jaan Isotamm

    Index Scriptorium Estoniae

    1999-01-01

    EK(b)P Keskkomitee VIII pleenum, 21.-23. märts 1950. Sõnavõtud: N. Karotamm, P. Ponomarenko, I. Käbin, V. Kuusik, A. Jaanus, V. Hiznjakov, E. Ristimägi, I. Suija, H. Ajo, A. Meri, G. Abels, M. Assin, G. Latõshov, Rumjantsev, Müürisepp. Kommenteerinud Viktor Niitsoo. Algus: Akadeemia (1998) nr. 12, lk. 2655-2683 ; Järg nr.2;3;4;5;6;7;8;9;10 lk.415-446;639-670;863-894;1087-1118;1310-1342;1534-1566;1759-1790;2017-2048;2220-2256

  16. Changes of androgen receptor expression in stages VII-VIII seminiferous tubules of rat testis after exposure to methamphetamine

    OpenAIRE

    Sutita Nudmamud-Thanoi; Nareelak Tangsrisakda; Samur Thanoi

    2016-01-01

    Methamphetamine (METH) is toxic not only to the central nervous system but also to the reproductive system. This study aimed to investigate the effect of METH administration on androgen receptor (AR) expression in the seminiferous tubules (stages VII-VIII) and Leydig cells. 24 Sprague-Dawley rats were equally divided into 4 groups; control, acute doseMETH binge (AB-METH), escalating dose-METH (ED-METH) and escalating dose-METH binge (ED-METH binge) groups. The expressions of AR we...

  17. CONSTRAINING THE MILKY WAY'S HOT GAS HALO WITH O VII AND O VIII EMISSION LINES

    Energy Technology Data Exchange (ETDEWEB)

    Miller, Matthew J.; Bregman, Joel N., E-mail: mjmil@umich.edu, E-mail: jbregman@umich.edu [Department of Astronomy, University of Michigan, Ann Arbor, MI 48104 (United States)

    2015-02-10

    The Milky Way hosts a hot (≈2 × 10{sup 6} K), diffuse, gaseous halo based on detections of z = 0 O VII and O VIII absorption lines in quasar spectra and emission lines in blank-sky spectra. Here we improve constraints on the structure of the hot gas halo by fitting a radial model to a much larger sample of O VII and O VIII emission line measurements from XMM-Newton/EPIC-MOS spectra compared to previous studies (≈650 sightlines). We assume a modified β-model for the halo density distribution and a constant-density Local Bubble from which we calculate emission to compare with the observations. We find an acceptable fit to the O VIII emission line observations with χ{sub red}{sup 2} (dof) = 1.08 (644) for best-fit parameters of n{sub o}r{sub c}{sup 3β}=1.35±0.24 cm{sup –3} kpc{sup 3β} and β = 0.50 ± 0.03 for the hot gas halo and negligible Local Bubble contribution. The O VII observations yield an unacceptable χ{sub red}{sup 2} (dof) = 4.69 (645) for similar best-fit parameters, which is likely due to temperature or density variations in the Local Bubble. The O VIII fitting results imply hot gas masses of M(<50 kpc) = 3.8{sub −0.3}{sup +0.3}×10{sup 9} M{sub ⊙} and M(<250 kpc) = 4.3{sub −0.8}{sup +0.9}×10{sup 10} M{sub ⊙}, accounting for ≲50% of the Milky Way's missing baryons. We also explore our results in the context of optical depth effects in the halo gas, the halo gas cooling properties, temperature and entropy gradients in the halo gas, and the gas metallicity distribution. The combination of absorption and emission line analyses implies a sub-solar gas metallicity that decreases with radius, but that also must be ≥0.3 Z {sub ☉} to be consistent with the pulsar dispersion measure toward the Large Magellanic Cloud.

  18. EK(b)P Keskkomitee VIII pleenumi stenogramm / tõlk. Mart Arold, tõlk. Jaan Isotamm

    Index Scriptorium Estoniae

    1999-01-01

    EK(b)P Keskkomitee VIII pleenum, 21.-23. märts 1950. Sõnavõtud: N. Karotamm, P. Ponomarenko, I. Käbin, V. Kuusik, A. Jaanus, V. Hiznjakov, E. Ristimägi, I. Suija, H. Ajo, A. Meri, G. Abels, M. Assin, G. Latõshov, Rumjantsev, Müürisepp. Kommenteerinud Viktor Niitsoo. Algus: Akadeemia (1998) nr. 12, lk. 2655-2683 ; Järg nr.2;3;4;5;6;7;8;9;10 lk.415-446;639-670;863-894;1087-1118;1310-1342;1534-1566;1759-1790;2017-2048;2220-2256

  19. Love and/in psychoanalysis: a commentary on Lacan's reading of Plato's Symposium in Seminar VIII: Transference.

    Science.gov (United States)

    Fink, Bruce

    2015-02-01

    What is love and what part does it play in psychoanalysis? Where are the analyst and the analysand situated in relation to the roles defined as those of the "lover" and the "beloved"? Jacques Lacan explores these and other questions in his soon-to-be-published Seminar VIII: Transference by providing an extensive commentary on Plato's most famous dialogue on love, the Symposium. This paper outlines some of the major points about love that grow out of Lacan's reading of the dialogue and examines their relevance to the analytic setting. Can the analyst be characterized as a sort of modern-day Socrates?

  20. Conversaciones en el VIII Congreso Panamericano de Mecánica de Suelos e Ingeniería de Fundaciones

    OpenAIRE

    Ruiz Restrepo, Carlos Enrique

    1988-01-01

    En el mes de agosto de 1987 se cumplió, en Cartagena de Indias el "VIII Congreso Panamericano de Mecánica de Suelos", bajo la presidencia del geólogo colombiano Juan Montero Olarte, asistido por un Comité Organizador de todas las excelencias. Abrir canales para la comunicación permanente entre todos nuestros centros educativos, o entre los más representativos, es el método más simple para garantizar, como en simbólico vaso comunicante, que el nivel de enseñanza vibre en un clima de con...

  1. Functional characterisation of a metagenome derived family VIII esterase with a deacetylation activity on ß-lactam antibiotics

    CSIR Research Space (South Africa)

    Mokoena, N

    2013-08-01

    Full Text Available of a metagenome derived family VIII esterase with deacetylation activity on β-lactam antibiotics Nobalanda Mokoena1, Kgama Mathiba1, Tsepo Tsekoa1, Paul Steenkamp1,2 and Konanani Rashamuse1* 1CSIR Biosciences, Scientia campus, PO Box 395... of 0.3 U/L and the antibiotic (50 µg/mL Kanamycin). The culture was incubated at 16°C overnight and then booster tablet and additional enzyme mixture (0.6 U/L) were added to the culture. Est22 protein expression was induced with ITPG (1mM) followed...

  2. [The beneficial effect of mineral waters of Fiuggi on Pope Bonifacio VIII and Michelangelo: two prominent calculous patients].

    Science.gov (United States)

    Androutsos, Georges

    2005-09-01

    Going back to the dawn of time, we deal with two historical figures, that of Pope Bonifacio VIII, and that of the hierophant of art, Michelangelo Buonarroti. The texts and the codes of the British Museum (Department of Manuscripts), of the Biblioteca Medica Laurenziana (Archivio Buonarroti) of Florence, and the Biblioteca Apostolica of Vatican, convincing detalled evidence that both figures were urological patients. It concerns two clinical cases with especially pertain to the history of lithiasis of urinary tract. Even though, both of them--the first with nephrolithiasis or gravel, and the second with a bladder stone--were historically bound with the well-known cures of Fiuggi in Italy.

  3. Synthesis of dispersive iron or iron–silver nanoparticles on engineered capsid pVIII of M13 virus with electronegative terminal peptides

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Shuai; Nakano, Kazuhiko; Zhang, Shu-liang; Yu, Hui-min, E-mail: yuhm@tsinghua.edu.cn [Tsinghua University, Key Laboratory of Industrial Biocatalysis of the Ministry of Education, Department of Chemical Engineering (China)

    2015-10-15

    M13 is a filamentous Escherichia coli virus covered with five types of capsid proteins, in which pVIII with ∼2700 copies was around the cylindered surface and pIII with five copies located at one end of the phage particle. The pIII-engineered M13 phages with enhanced binding specificity toward Fe were screened after five rounds of biopanning, and the one containing ATPTVAMSLSPL peptide at pIII-terminus was selected for mediated synthesis of zero valent (ZV) Fe nanoparticles (NPs) with the wild M13 as control. Under a reducing environment, uniformly dispersed ZVFeNPs with diameter of 5–10 nm were both synthesized and the morphologies after annealing were confirmed to be face-centered cubic type. The synthesized FeNPs mediated by the two phages showed no significant difference, revealing that the pVIII capsid did dominant contribution to metal binding in comparison with the pIII. A novel pVIII-engineered M13 containing AAEEEDPAK at terminus, named as 4ED-pVIII-M13, was constructed and it carried one more negatively charged residue than the wild one (AEGDDPAK). Metal adsorption quantification showed that the binding affinity of the 4ED-pVIII-M13 toward Ag and Ni ions improved to 62 and 18 % from original 21 and 6 %, respectively. The binding affinity toward Fe remained constant (∼85 %). ZVFe–Ag bi-NPs were successfully synthesized through mediation of 4ED-pVIII-M13. Particularly, the Fe:Ag ratio in the bi-NPs was conveniently controlled through changing the molar concentration of FeCl{sub 2} and AgNO{sub 3} solution before reduction.

  4. Clinicopathological characterization of experimental infection in chickens with sub-genotype VIIi Newcastle disease virus isolated from peafowl.

    Science.gov (United States)

    Desingu, P A; Singh, S D; Dhama, K; Kumar, O R Vinodh; Malik, Y S; Singh, R

    2017-04-01

    Newcastle disease (ND) is an economically important viral disease distressing poultry industry across the globe. Herein, we report the clinicopathology of sub-genotype VIIi Newcastle disease virus (NDV) isolated from peafowl in chickens. The virus isolate produced systemic infection with prominent tropism in visceral organs in chicken, confirmed on the basis of gross and microscopic lesions, and immunohistochemistry findings. The experimentally infected chickens exhibited 100% mortality with severe hemorrhagic lesions in the proventriculus and intestine, especially marked lymphocytolysis in spleen and bursa. The virus could be re-isolated from the cloacal swabs of infected chickens during 4th to 6th dpi (on 6th dpi all birds died), and all were tested positive in conventional RT-PCR. This is the first report on clinicopathology of NDV isolated from peafowl and/or sub-genotype VIIi NDV in experimentally infected chickens. Explorative epidemiological and molecular studies are suggested to screen wild peafowls and poultry flocks of the country for establishing the occurrence of this sub-genotype and opting for appropriate prevention and control strategies. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Changes of androgen receptor expression in stages VII-VIII seminiferous tubules of rat testis after exposure to methamphetamine

    Directory of Open Access Journals (Sweden)

    Sutita Nudmamud-Thanoi

    2016-06-01

    Full Text Available Methamphetamine (METH is toxic not only to the central nervous system but also to the reproductive system. This study aimed to investigate the effect of METH administration on androgen receptor (AR expression in the seminiferous tubules (stages VII-VIII and Leydig cells. 24 Sprague-Dawley rats were equally divided into 4 groups; control, acute doseMETH binge (AB-METH, escalating dose-METH (ED-METH and escalating dose-METH binge (ED-METH binge groups. The expressions of AR were examined using immunohistochemical staining. AR expressions in round and elongated spermatids showed significant decreases in ED-METH binge and AB-METH groups. In Leydig’s cells, AR expressions were significantly decreased in both ED-METH and ED-METH binge groups. These results could reflect the effect of METH on the expressions of AR in both round and elongated spermatids of stages VII-VIII seminiferous tubule and Leydig’s cells. Decreases of AR expressions in those cells of METH-treated animals may interrupt spermatogenesis at these stages.

  6. Il manoscritto Chigiano L VIII 305 della Biblioteca Apostolica Vaticana e la «Vita nuova»

    Directory of Open Access Journals (Sweden)

    Donato Pirovano

    2015-07-01

    Full Text Available L’articolo nasce a margine della nuova edizione commentata, con testo criticamente rivisto, della Vita nuova di Dante nell’àmbito della «Nuova Edizione Commentata delle Opere di Dante» (vd. Roma, Salerno Editrice, 2015. Viene spiegato in che misura il codice Chigiano L VIII 305 della Biblioteca Apostolica Vaticana (siglato K è stato utilizzato come manoscritto di riferimento per le varianti di forma. A partire dal caso specifico viene poi proposta una riflessione sulla restituzione formale degli antichi testi a tradizione plurima e una discussione sui criteri editoriali, tra conservazione e leggibilità. The article comes on the sidelines of the new annotated edition with critically reviewed text of the Vita Nuova by Dante, in the scope of the «Nuova Edizione Commentata delle Opere di Dante» (see Roma, Salerno Editrice, 2015. The author explains how the code Chigiano L VIII 305 of the Biblioteca Apostolica Vaticana (signed K was used as a reference manuscript for the formal variants. From the specific example the author proposes a reflection on the formal restituition of the plural tradition ancient texts and a discussion on the editorial criteria, between conservation and readability. 

  7. Pisanello’s hat. The costume and weapons depicted in Pisanello’s medal for John VIII Palaeologus. A discussion of the saber and related weapons

    Directory of Open Access Journals (Sweden)

    Alexander, David

    2004-12-01

    Full Text Available A group of six drawings by the Veronese artist Antonio Pisano depicted the Bizantine Emperor John VIII Paleologus wearing costumes and weapons according to islamic types. This paper studies these objects in relation to other contemporary islamic weapons.

    Un grupo de seis dibujos del artista veronés Antonio Pisano representa al emperador bizantino Juan VIII Paleólogo vestido y armado según modelos islámicos. Este trabajo estudia dichos objetos en relación a otras armas islámicas contemporáneas.

  8. Joint bleeds increase the inhibitor response to human factor VIII in a rat model of severe haemophilia A

    DEFF Research Database (Denmark)

    Löfgren, Karin Maria; Søndergaard, H.; Skov, Søren

    2016-01-01

    = 10) receiving three needle induced knee joint bleeds 14 days apart and a control group (n = 9) receiving three sham procedures. Three hours after each injury/sham 50 IU kg−1 rhFVIII was administrated intravenously. Subsequently, both groups continued rhFVIII treatment for another 9 weeks. Binding...... antibodies were analysed using an enzyme-linked immunosorbent assay and neutralizing antibodies using a Bethesda-like assay. Results Rats in the knee-bleed group developed a significantly faster inhibitor response and reached significantly higher inhibitor levels. In the knee-bleed group, 80% developed...

  9. Antibody response to recombinant human coagulation factor VIII in a new rat model of severe hemophilia A

    DEFF Research Database (Denmark)

    Löfgren, Karin Maria; Sondergaard, H.; Skov, Søren

    2016-01-01

    studies,antibodies developed after 4–6 administrations ofrhFVIII, and neutralizing antibodies reached levels simi-lar to human patients (range 1–111 BU, median 6.0 BU)at the end of the study. There was no significant differ-ence between the two studies or between genotypes intime to response or levels...... reached for binding and neu-tralizing antibodies. Interestingly, early spontaneousbleeds were associated with a faster antibody response. Conclusions: Following intravenous administration ofhuman FVIII, according to a clinical prophylaxis regi-men, a robust and reproducible antibody response is seenin...

  10. Identification of intron 1 and intron 22 inversions of factor VIII gene in Serbian patients with hemophilia A

    Directory of Open Access Journals (Sweden)

    Ilić Nina

    2013-01-01

    Full Text Available Hemophilia A (HA is a common X-linked recessive bleeding disease caused by mutations of FVIII gene. Inversion of intron 1 (inv1 and intron 22 (inv22 are recurrent mutations in severe HA, causing 50% of cases. Inv1 has been reported to occur in 2-5% and inv 22 in 45% of severe HA patients. Our objective was to determine, for the first time in Serbia, the frequency of inv1 and inv22 in a group of severe HA patients and to compare these data with those from other countries. Study subjects were 50 HA patients, diagnosed and treated from April 2009 to June 2012 at Mother and Child Health Care Institute of Serbia “Dr Vukan Cupic” (IHS and Institute for Child and Youth Health Care of Vojvodina (IHV.The presence of inv1 and inv22 was analyzed using Inverse shifting PCR (IS-PCR. Our results revealed that the frequencies of inv1 and inv22 in the cohort of Serbian patients were 6 % and 42% (34% of inv22 type I and 8% of inv22 type II respectively . These frequencies were in line with those found in other populations. Carrier status analyses of 65 family members (mothers and sisters showed the de novo inversion of intron 22 in one patient. Genetic Counseling Units of IHS and IHV provide the adequate genetic advice to all HA affected patients and their family members. [Projekat Ministarstva nauke Republike Srbije, br. 173046 i br. 175056

  11. Off-label use of recombinant factor VIIa for treatment of haemorrhage: results from randomized clinical trials

    DEFF Research Database (Denmark)

    Johansson, Per Ingemar

    2008-01-01

    Background Recombinant factor VIIa (rFVIIa) is used for haemophilic patients with inhibitors against coagulation factor VIII or IX, but there is also an off-label use of rFVIIa for patients with massive bleeding. The aim of the present study was to review the randomized clinical trials (RCT...

  12. Incidence and risk factors of bleeding-related adverse events in patients with chronic lymphocytic leukemia treated with ibrutinib

    DEFF Research Database (Denmark)

    Lipsky, Andrew H; Farooqui, Mohammed Z H; Tian, Xin

    2015-01-01

    , suggesting that the risk of bleeding decreases with continued therapy. At baseline, von Willebrand factor and factor VIII levels were often high and normalized on treatment. Platelet function measured via the platelet function analyzer (PFA-100™) was impaired in 22 patients at baseline and in an additional...

  13. Angioma cavernoso do meato acústico interno envolvendo o complexo VII e VIII nervos cranianos: relato de caso Cavernous hemangioma of the internal auditory canal encasing the VII and VIII cranial nerve complex: case report

    Directory of Open Access Journals (Sweden)

    Roberto Leal Silveira

    2005-03-01

    Full Text Available Relata-se o caso de homem de 21 anos, leucoderma, portador de angioma cavernoso do meato acústico interno direito envolvendo o complexo VII e VIII nervos cranianos tratado cirurgicamente. Apenas 18 casos de angiomas cavernosos dessa localização foram relatados na literatura. São comentados os aspectos clínicos, o diagnóstico diferencial e o tratamento.We report the surgically treated case of a 21-year-old caucasian male harboring a cavernous hemangioma of the right internal auditory canal encasing the seventh and eighth cranial nerves complex. Only 18 cases of cavernous hemangiomas of this location have been previously reported. The clinical features, the differential diagnosis and the treatment are discussed.

  14. Retsensioon : Riigikogu VII, VIII ja IX koosseis. Statistikat ja kommentaare. Peatoimetaja Aaro Mõttus. Tallinn : Riigikogu Kantselei, Eesti Rahvusraamatukogu, 2004. 326 lk. / Mart Nutt

    Index Scriptorium Estoniae

    Nutt, Mart, 1962-

    2004-01-01

    Arvustus: Riigikogu VII, VIII ja IX koosseis. Statistikat ja kommentaare / peatoim. Aaro Mõttus. Tallinn : Riigikogu Kantselei, Eesti Rahvusraamatukogu, 2004. - Lisatud: Ott Heinapuu tutvustav sõnum retsenseeritud väljaande kohta lk. 193. - Vt. ka: http://www.riigikogu.ee/rito/index.php?id=11357

  15. Report on corrections and future considerations for Appendices II–VIII of the International Code of Nomenclature for Algae, Fungi, and Plants

    Science.gov (United States)

    For the first time, the main text and Appendices II–VIII of the International Code of Nomenclature were separately published following decisions of the Melbourne Nomenclature Section, which contributed to subsequent development of an online resource capable of producing the Appendices in real time. ...

  16. PENGARUH MODEL PEMBELAJARAN INQUIRY TRAINING TERHADAP HASIL BELAJAR SISWA PADA MATERI POKOK USAHA DAN ENERGI KELAS VIII MTS N-3 MEDAN

    Directory of Open Access Journals (Sweden)

    Ratni Sirait

    2012-06-01

    36 orang. Hasil analisis data melalui uji t menunjukkan bahwa diperoleh thitung = 1,71 dan ttabel = 1,67, sehingga thitung > ttabel, artinya Ha diterima. Dapat disimpulkan ada pengaruh terhadap hasil belajar siswa dengan menggunakan model pembelajaran inquiry training pada materi pokok usaha dan energi kelas VIII semester I MTs N 3 Medan.

  17. The Regularities of Phase and Structural Transformation in Binary Titanium Alloys with Metals of IV—VIII Groups of the Periodic Table

    National Research Council Canada - National Science Library

    Dobromyslov, A V

    2008-01-01

    Martensitic β→α′(α″) and β→ω transformation in a series of Ti-base alloys with transition metals of groups IV-VIII have been investigated using the techniques of X-ray diffraction, optical and transmission electron microscopy...

  18. Mechanistic aspects of Os(VIII) catalysed oxidation of loop diuretic drug furosemide by Ag(III) periodate complex in aqueous alkaline medium

    Indian Academy of Sciences (India)

    Shweta J Malode; Nagaraj P Shetti; Sharanappa T Nandibewoor

    2012-03-01

    The kinetics of oxidation of a loop diuretic drug furosemide (Fur) by diperiodatoargentate(III) (DPA) has been investigated in the presence of osmium(VIII) (Os(VIII)) used as homogeneous catalyst in alkaline medium at a constant ionic strength of 0.20mol dm-3 spectrophotometrically attached with HI-TECH SFA-12 stopped flow accessory. The stoichiometry was 1:2 (Fur:DPA). The order of the reaction with respect to [DPA] was unity while the order with respect to [Fur] was less than unity over the concentration range studied. The rate increased with an increase in [OH−] and decreased with an increase in [IO$^{−}_{4}$]. The order with respect to [Os(VIII)] was unity. The oxidation products were identified as 2-(4-carboxy-2-oxo-but-3-enylamino)-4-chloro-5-sulfamoyl-benzoic acid and Ag(I). A suitable mechanism was proposed. The reaction constants involved in the different steps of the reaction mechanism were calculated. Kinetic experiments suggest that [Ag(H2IO6)(H2O)2] is the reactive silver(III) species and [OsO4(OH)2]2− is the reactive Os(VIII) species.

  19. Is Octavalent Pu(VIII) Possible? Mapping the Plutonium Oxyfluoride Series PuO(n)F(8-2n) (n = 0-4).

    Science.gov (United States)

    Huang, Wei; Pyykkö, Pekka; Li, Jun

    2015-09-01

    While the oxidation state Pu(VIII) is shown to be less stable than Pu(V) in the PuO4 molecule, it is not clear if the more electronegative fluorine can help to stabilize Pu(VIII). Our calculations on PuO(n)F(8-2n) (n = 0-4) molecules notably confirm that PuO2F4 has both (1)D(4h) and (5)C(2v) minima with the oxidation states Pu(VIII) and Pu(V), respectively, with the latter having lower energy. The hybrid-DFT, CCSD(T), and CASSCF methods all give the same result. The results conform to a superoxide ligand when n ≥ 2. PuF8 in a (1)O(h) state can decompose to PuF6 and F2, and PuOF6 in a (1)C(2v) state also can break down to PuF6 and 1/2 O2. The Pu(VIII) anion PuO2F5(-) does have a D(5h) minimum, which also lies above a (5)C(2v) Pu(V) peroxide structure. However, the energy differences between the different minima are not large, indicating that metastable species with oxidation states higher than Pu(V) cannot be completely excluded.

  20. Retsensioon : Riigikogu VII, VIII ja IX koosseis. Statistikat ja kommentaare. Peatoimetaja Aaro Mõttus. Tallinn : Riigikogu Kantselei, Eesti Rahvusraamatukogu, 2004. 326 lk. / Mart Nutt

    Index Scriptorium Estoniae

    Nutt, Mart, 1962-

    2004-01-01

    Arvustus: Riigikogu VII, VIII ja IX koosseis. Statistikat ja kommentaare / peatoim. Aaro Mõttus. Tallinn : Riigikogu Kantselei, Eesti Rahvusraamatukogu, 2004. - Lisatud: Ott Heinapuu tutvustav sõnum retsenseeritud väljaande kohta lk. 193. - Vt. ka: http://www.riigikogu.ee/rito/index.php?id=11357

  1. Theoretical studies of the atomic transitions in boron-like ions: Mg VIII, Si X and S XII

    Energy Technology Data Exchange (ETDEWEB)

    Nataraj, H S [Non-Accelerator Particle Physics Group, Indian Institute of Astrophysics, Bangalore-34 (India); Sahoo, B K [Max Planck Institute for the Physics of Complex Systems, Noethnitzer Street 38, D-01187 Dresden (Germany); Das, B P [Non-Accelerator Particle Physics Group, Indian Institute of Astrophysics, Bangalore-34 (India); Chaudhuri, R K [Non-Accelerator Particle Physics Group, Indian Institute of Astrophysics, Bangalore-34 (India); Mukherjee, D [Department of Physical Chemistry, Indian Association for Cultivation of Science, Kolkata-700 032 (India)

    2007-08-14

    In this paper, we have carried out the calculations of the weighted oscillator strengths and the transition probabilities for a few low-lying transitions of boron-like ions: Mg VIII, Si X and S XII, which are astrophysically important, particularly in the atmosphere of the solar corona. We have employed an all-order relativistic many-body theory called the relativistic coupled-cluster theory to calculate very precisely these atomic quantities of astrophysical interest. We have reported for the first time the transition probabilities for some forbidden transitions which are unavailable in the literature, either theoretically or experimentally. We also discuss the physical effects associated with these transitions. Our data can be used for the identification of spectral lines arising from the coronal atmospheres of the Sun and Sun-like stars having an extended corona.

  2. The Effect Of Core Polarization On The Population Of The Rydberg States Of ArVIII Ions Escaping Solid Surfaces

    Science.gov (United States)

    Galijas, S. M. D.; Nedeljkovic, N. N.; Majkic, M. D.; Bunjac, A. B.

    2010-07-01

    The appearance of maxima at nA = nmax in the population distributions for the Rydberg states of multiply charged ions ArVIII escaping solid surfaces at intermediate velocities ( v ˜1 a.u.) is discussed. Within the framework of the time-symmetrized two-state vector model, in which the state of a single active electron is described by two wave functions 1 ? and 2 ? , the regular maxima appear as a consequence of the electron tunneling through the potential barrier created between the ionic core and the polarized solid. The pronounced peaks (resonances) in the population distributions are addressed to the electron tunneling in the vicinity of the potential barrier top. The appropriate etalon equation method is used in the calculation of the function 1 ? ; the effect of core polarization is expressed via the function ?2.

  3. PENGARUH FAKTOR INTERNAL DAN EKSTERNAL SISWA TERHADAP HASIL BELAJAR MATA PELAJARAN IPS KELAS VIII DI MTS N 02 SEMARANG

    Directory of Open Access Journals (Sweden)

    Erlina Indriasari

    2014-08-01

    Full Text Available Hasil belajar mempunyai fungsi sebagai indikator untuk mengetahui sejauh manakompetensi yang telah dikuasai oleh siswa. Tujuan dari penelitian ini adalah untukmengetahui, menganalisis dan mengkaji pengaruh motivasi, sikap, lingkungankeluarga dan lingkungan sekolah secara parsial dan secara simultan terhadap hasilbelajar mata pelajaran IPS. Penelitian ini menggunakan metode kuantitatif. Sampelpenelitian ini berjumlah 161 siswa kelas VIII. pengumpulan data melalui angketdan dokumentasi. Analisis data dengan menggunakan analisis Regresi LinierSederhana dan Berganda. Hasil penelitian menunjukkan (1 ada pengaruh yangsignifikan antara motivasi dan hasil belajar sebesar 8,47%, (2 ada pengaruh yangsignifikan antara sikap dan hasil belajar sebesar 18,57%, (3 ada pengaruh yang signifikanantara lingkungan keluarga dan hasil belajar sebesar 10,62%, (4 ada pengaruhyang signifikan antara lingkungan sekolah dan hasil belajar sebesar4,28%, dan(5 ada pengaruh yang signifikan antara motivasi, sikap, lingkungan keluarga, danlingkungan sekolah dan hasil belajar IPS kelas VIII di MTs N 02 Semarang secarabersama-sama sebesar 49,3%. Learning outcomes has the function as an indicator to determine the extent of competencethat has been mastered by the student. The purpose of this study is to investigate, analyzeand assess the influence of motivation, attitude, family environment and school environmentpartially and simultaneously to the learning outcomes of the eye social studies. This study usesquantitative methods. The study sample totaled 161 eighth grade students. collection of datathrough questionnaires and documentation. Analysis of the data using the Simple LinearRegression analysis and Regression. The results showed (1 no significant relationship betweenmotivation and learning outcomes of 8.47%, (2 no significant relationship between attitudesand learning outcomes of 18.57%, (3 no significant relationship between family environmentand learning outcomes of 10

  4. Alteration in lymphocyte responses, cytokine and chemokine profiles in chickens infected with genotype VII and VIII velogenic Newcastle disease virus.

    Science.gov (United States)

    Rasoli, Mehdi; Yeap, Swee Keong; Tan, Sheau Wei; Moeini, Hassan; Ideris, Aini; Bejo, Mohd Hair; Alitheen, Noorjahan Banu Mohamed; Kaiser, Pete; Omar, Abdul Rahman

    2014-01-01

    Newcastle disease (ND) is a highly contagious avian disease and one of the major causes of economic losses in the poultry industry. The emergence of virulent NDV genotypes and repeated outbreaks of NDV in vaccinated chickens have raised the need for fundamental studies on the virus-host interactions. In this study, the profiles of B and T lymphocytes and macrophages and differential expression of 26 immune-related genes in the spleen of specific-pathogen-free (SPF) chickens, infected with either the velogenic genotype VII NDV strain IBS002 or the genotype VIII NDV strain AF2240, were evaluated. A significant reduction in T lymphocyte population and an increase in the infiltration of IgM+ B cells and KUL01+ macrophages were detected in the infected spleens at 1, 3 and 4 days post-infection (dpi) (P<0.05). The gene expression profiles showed an up-regulation of CCLi3, CXCLi1, CXCLi2 (IL-8), IFN-γ, IL-12α, IL-18, IL-1β, IL-6, iNOS, TLR7, MHCI, IL-17F and TNFSF13B (P<0.05). However, these two genotypes showed different cytokine expression patterns and viral load. IBS002 showed higher viral load than AF2240 in spleen at 3 and 4dpi and caused a more rapid up-regulation of CXCLi2, IFN-γ, IL-12α, IL-18, IL-1β, iNOS and IL-10 at 3dpi. Meanwhile, the expression levels of CCLI3, CXCLi1, IFN-γ, IL-12α, IL-1β and iNOS genes were significantly higher in AF2240 at 4dpi. In addition, the expression levels of IL-10 were significantly higher in the IBS002-infected chickens at 3 and 4dpi. Hence, infection with velogenic genotype VII and VIII NDV induced different viral load and production of cytokines and chemokines associated with inflammatory reactions.

  5. PENINGKATAN AKTIVITAS DAN HASIL BELAJAR TERBENTUKNYA HARGA PASAR DENGAN PENERAPAN MODEL CORE PADA SISWA KELAS VIII SMP N 2 UNGARAN

    Directory of Open Access Journals (Sweden)

    Lala Sakuntala

    2013-11-01

    Full Text Available Permasalahan yang muncul dalam pembelajaran di SMP N 2 Ungaran berawal dari penggunan metode dan model pembelajaran yang digunakan guru pada saat pembelajaran. Dalam pembalajaran guru cenderung masih menggunakan ceramah, sehingga menyebabkan kurangnya interaksi dan motivasi siswa pada saat pembelajaran berlangsung. Berdasarkan hasil observasi awal di SMP N 2 Ungaran, diperoleh data bahwa 53,12% siswa belum tuntas dalam pembelajaran materi harga keseimbangan. Tujuan dari penelitian ini yaitu untuk mengetahui apakah ada peningkatan menggunakan model pembelajaran CORE terhadap aktivitas dan hasil belajar pokok bahasan pembentukan harga pasar siswa kelas VIII di SMP Negeri 2 Ungaran. Subjek penelitian ini adalah siswa kelas VIII D SMP N 2 Ungaran dengan menerapkan model pembelajaran CORE. Rancangan penelitian ini merupakan penelitian tindakan kelas yang terdiri dari dua siklus, setiap siklus meliputi perencanaan, pelaksanaan, pengamatan, dan refleksi. Hasil penelitian siklus I menunjukkan rata-rata hasil belajar siswa sebesar 74,2 dengan ketuntasn klasikal 72%. Untuk hasil penelitian siklus II menunjukkan rata-rata hasil belajar siswa sebesar 78.9 dengan ketuntasan klasikal 88%. Hasil aktivitas siswa dan guru meningkat dengan diterapkannya model pembelajaran CORE. Terlihat pada hasil aktivitas siswa siklus I sebesar 70% meningkat menjadi 87.5% pad siklus II. Sedangkan aktivitas guru pada siklus II sebesar 75% meningkat menjadi 95% pada siklus II. Berdasarkan hasil penelitian diatas dapat disimpulkan bahwa terjadi peningkatan aktivitas dan hasil belajar siswa dengan menggunakan model pembelajaran CORE pada materi harga keseimbangan. Saran yang berkaitan dengan hasil penelitian adalah perlu adanya kesiapan guru sebelum memulai pelajaran, guru hendaknya mampu menguasai kelas dengan baik, dan memilih metode yang tepat untuk diterapkan dalam proses belajar mengajar. The problems that arise in learning in SMP 2 Ungaran originated from the use of learning

  6. Temperature, salinity and other measurements found in dataset CTD taken from the BARUNA JAYA VIII (FRV; call sign YFZQ; built 08.1998; IMO9155171) in the Coastal Equatorial Pacific, South Indian and other locations in 2005 (NODC Accession 0044407)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Temperature, salinity and other measurements found in dataset CTD taken from the BARUNA JAYA VIII (FRV; call sign YFZQ; built 08.1998; IMO9155171) in the Coastal...

  7. In pursuit of clean air: a data book of problems and strategies at the state level. Volume 5. Federal Regions VIII, IX, and X

    Energy Technology Data Exchange (ETDEWEB)

    Garvey, D.B.; Streets, D.G.

    1980-02-01

    The following material is provided for each state in Federal Regions VIII, IX, and X: state title page (lists nonattainment areas for each pollutant, the number of monitors with valid readings for a particular averaging time for a pollutant, and the number of monitors that recorded a violation of the standard); revised State Implementation Plan (SIP) outline (covers sources of the problems, the proposed strategies for achieving attainment, and new state review procedures); maps of nonattainment areas, as designated; SAROAD (Storage and Retrieval of Aerometric Data) data; SAROAD data maps; power plant data; power plant maps; and county maps. States in Federal Region VIII are Colorado, Montana, North Dakota, South Dakota, Utah, and Wyoming. Federal Region IX includes Arizona, California, and Nevada. Federal Region X includes Idaho, Oregon, and Washington. (JGB)

  8. Peran Orang Tua Pada Remaja Yang Berperilaku Seks Pra-Nikah Remaja Di Dusun VIII Desa Bandar Klippa Kecamatan Percut Sei Tuan Kabupaten Deli Serdang Tahun 2015

    OpenAIRE

    Sagala, Justriana Feriaty

    2015-01-01

    Sexual abuse in the adolescent is increase. This condition is influenced by the advanced technology, misinterpretation of sex that causes the adolescent do the pre-marital sex behavior. In this sense, the parents has an important role in build the character and knowledge of adolescent. This research aims to study the influence of the role of parents to the adolescent with the premarital sex behavior at Dusun VIII Desa Bandar Klippa sub-district of Percut Sei Tuan regency of ...

  9. Protection of open-metal V(III) sites and their associated CO₂/CH₄/N₂/O₂/H₂O adsorption properties in mesoporous V-MOFs.

    Science.gov (United States)

    Yang, Jiangfeng; Wang, Yong; Li, Libo; Zhang, Zhuoming; Li, Jinping

    2015-10-15

    Metal-organic frameworks with open metal site are potential sorbents for the separation of gas mixtures; however, low valence metal will bind to oxygen in the open air causing a decrease in adsorption ability. We now report open-metal sites V(III) on both MIL-100V(III/IV) and MIL-101V(III/IV) that can be protected with water molecules, and which associated CO2/CH4/N2/O2 adsorption properties on these two mesoporous V-MOFs were investigated. The protective properties of water were investigated and evaluated using density functional theory simulations. The binding energy of single O2 on open-metal V(III) site was 93.278 kJ/mol, which decreased to 26.5 kJ/mol when H2O occupies the site. When the water coating is removed, the X-ray photoelectron spectroscopy pattern of V2p showed that the V-MOF changes to MIL-100V(IV) and MIL-101V(IV) at 298 K because of the action of O2. Under these conditions, O2 binds strongly on the open V site significantly reducing the BET (Brunauer-Emmett-Teller) surface and CH4 adsorption volume of the V-MOFs. From the ideal adsorbed solution theory calculated, the adsorption selectivity of CH4/N2 is higher before than after binding of O2 (with V(III) site). In contrast, the adsorption selectivity of CO2/CH4 is higher after than before O2 binding (with no more V(III) sites). Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Analysis of the influence of dabigatran on coagulation factors and inhibitors.

    Science.gov (United States)

    Tsutsumi, Y; Shimono, J; Ohhigashi, H; Ito, S; Shiratori, S; Teshima, T

    2015-04-01

    Dabigatran is an oral intake thrombin inhibitor for preventive administration against stroke accompanied by atrial fibrillation. Although dabigatran causes prolonged activated partial thromboplastin time (APTT), the effect of dabigatran on each coagulation factor and coagulation factor inhibitor remains to be investigated. Our aim was to analyze the influence of dabigatran on coagulation factors and coagulation factor inhibitors. We administered dabigatran to 40 patients. In 26 of these 40, we analyzed the activity of several coagulation factors and their inhibitors. We used Fisher's exact test to determine statistical significance. The activities of many coagulation factors changed during the dabigatran therapy. Factor II levels decreased in all patients showing prolongation of partial thromboplastin (PT) and APTT. The antifactor VIII inhibitor was positive in the majority of patients with prolonged PT and APTT, while activities of protein C, protein S, and antifactor IX inhibitor were not associated with PT and APTT prolongation. Dabigatran affects the activities of many coagulation factors, including factors II, V, VIII, and IX, as well as the antifactor VIII inhibitor. © 2014 John Wiley & Sons Ltd.

  11. 冷冻后切除第Ⅷ段肝癌%Resection of segment VIII of liver after cryotherapy for hepatocarcinoma

    Institute of Scientific and Technical Information of China (English)

    韦长元; 杨伟萍; 刘剑仑; 陈建思; 李挺; 杨南武

    2001-01-01

    Objective To study the applicable value of resection of segment VIII after cryotherapy for hepatocarcinoma. Methods As for 8 patients with hepatocarcinoma in segment VIII, the turnor was dealt with cryotherapy before resected. Results All the tumors were resected smoothly after cryotherapy with less bleeding (mean 430ml), less time (mean 138min) and without severe complications or postoperative death in this series. Conclusions Resection of segment VIII after cryotherapy for hepatocarcinoma is proved safe and feasible, whitch can decrease blood loss, save time, reduce tissue injury, and decrease postoperative recurrence.%目的评价冷冻后切除第Ⅷ段肝癌的应用价值。方法对8例第Ⅷ段肝癌先冷冻成冰球后,再作手术切除。结果冷冻后能顺利切除第Ⅷ段肝癌,术中出血平均430ml,手术时间平均138min,术后无严重并发症及手术死亡。结论冷冻后切除第Ⅷ段肝癌是安全可行的,且出血少、省时、损伤组织少和可降低复发。

  12. PENGARUH MODEL PEMBELAJARAN KOOPERATIF TIPE STAD BERBANTUAN PEMETAAN PIKIRAN (MIND MAPPING TERHADAP KEMAMPUAN MENULIS TEKS BERITA SISWA KELAS VIII SMP NEGERI 1 PANTI

    Directory of Open Access Journals (Sweden)

    Ricci Gemarni Tatalia, M.Pd

    2017-05-01

    Full Text Available This study was generated from the problem of students’ ability in writing news texts ini class VIII, SMPN 1 Panti. Some of the problem were (1 lack of the students’ response towards news writing teaching and learning process, (2 lack of teacher’s creativity in designing interesting news sriting learning model, (3 no appropriate creative techniques applied by the teacher which could train the students to develop their skill in writing news texts and (4 lack of the students’ motivation in participating in teaching and learning process because of their lack of understanding in the elements of news. Thus, this study was aimed at escribing the effect of the students’ ability ini writing news texts in class VIII SMP N 1 Panti. This was a quantitative research with factorial 2x2 experimental design. The population was the students in class VIII SMPN 1 Panti. Sampling technique was done by using random sampling and the data was collected through test. The result of the study revealed that cooperative learning model with STAD mind mapping type affected the students’ ability in writing news texts

  13. Long-term pathologic follow-up of obsolete design: Choyce Mark VIII anterior chamber intraocular lens.

    Science.gov (United States)

    Ollerton, Andrew; Stagg, Brian C; Leishman, Lisa; Bodnar, Zachary; Werner, Liliana; Mamalis, Nick

    2012-02-01

    We analyzed an enucleated eye that was blind and painful from a 66-year-old patient implanted with a Tennant modification of the Choyce Mark VIII anterior chamber intraocular lens (IOL) as a secondary procedure in 1978. The eye developed glaucoma, with implantation of an Ahmed valve in 2006. Gross and light microscopic analyses showed corneal decompensation and vascularization, peripheral anterior and posterior synechiae, iris thinning, significant changes in the iris pigmented layer, fibrous tissue on the anterior surface of the iris, and Soemmerring ring formation in the periphery of capsular bag remnants. In addition, there was severe attenuation of the nerve fiber layer and extensive cupping of the optic disc. The IOL surface was overall smooth and regular, without warping of the footplates, and was partially covered by clumps of various cell elements, including giant cells intermixed with pigment. This study represents the longest clinicopathologic correlation report on this IOL. Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  14. Direct observation of the M1 transition between the ground state fine structure splitting of W VIII

    CERN Document Server

    Mita, Momoe; Kato, Daiji; Murakami, Izumi; Nakamura, Nobuyuki

    2016-01-01

    We present direct observation of the M1 transition between the fine structure splitting in the 4f13 5s2 5p6 2F ground state of W VIII. The spectroscopic data of few-times ionized tungsten ions are important for the future ITER diagnostics, but there is a serious lack of data. The present study is part of an ongoing effort to solve this lack. Emission from the tungsten ions produced and trapped in a compact electron beam ion trap is observed with a Czerny-Turner visible spectrometer. Spectra in the EUV range are also observed at the same time to help the identification of the previously-unreported visible lines. The observed wavelength 574.47 pm 0.03 nm (air), which corresponds to the fine structure splitting of 17402.5 pm 0.9 cm-1, shows reasonable agreement with the previously reported value 17410 pm 5 cm-1 obtained indirectly through the analysis of EUV spectra [Ryabtsev et al., Atoms 3 (2015) 273].

  15. Population dynamics of the ions SVI, ClVII and ArVIII interacting with solid surfaces

    Energy Technology Data Exchange (ETDEWEB)

    Nedeljkovic, N.N. [Faculty of Physics, University of Belgrade, P.O. Box 368, Belgrade (Serbia)], E-mail: hekata@ff.bg.ac.yu; Majkic, M.D.; Galijas, S.M.D.; Mitrovic, S.B. [Faculty of Physics, University of Belgrade, P.O. Box 368, Belgrade (Serbia)

    2008-08-30

    We used the recently developed time-symmetrized, two-state vector model to investigate the intermediate stages of the electron capture into the Rydberg states (n{sub A}>>1,l{sub A}=0-3, m{sub A}=0) of multiply charged ions SVI, ClVII and ArVIII, with polarized core charges Z=6, 7 and 8, respectively, escaping solid surfaces at low velocities. Within the framework of the model, the two wave functions are used to describe the system at intermediate stages; the corresponding probabilities and rates are based on the calculation of the mixed flux. The simple analytical formulae derived for the neutralization rates enable us to analyze the localization of the process and to calculate the neutralization distances. In the pointlike core approximation, the rates are comparable with the available coupled-angular-mode results. The neutralization distances follow the classical predictions for all considered Rydberg states with exception of the states with critical quantum numbers n{sub A}=n{sub c}, mainly populated via tunneling mechanism; the corresponding values are larger than it is predicted by the classical overbarrier model. Inclusion of core polarization significantly reduces the neutralization distances.

  16. Inhibition of the intrinsic factor X activating complex by protein S: evidence for a specific binding of protein S to factor VIII

    NARCIS (Netherlands)

    Koppelman, S.J.

    1995-01-01

    Protein S is a vitamin K-dependent nonenzymatic anticoagulant protein that acts as a cofactor to activated protein C. Recently it was shown that protein S inhibits the prothrombinase reaction independent of activated protein C. In this study, we show that protein S can also inhibit the intrinsic

  17. Inhibition of the intrinsic factor X activating complex by protein S: evidence for a specific binding of protein S to factor VIII

    NARCIS (Netherlands)

    Koppelman, S.J.

    1995-01-01

    Protein S is a vitamin K-dependent nonenzymatic anticoagulant protein that acts as a cofactor to activated protein C. Recently it was shown that protein S inhibits the prothrombinase reaction independent of activated protein C. In this study, we show that protein S can also inhibit the intrinsic fac

  18. DAMPAK POSITIF DAN NEGATIF SOSIAL MEDIA TERHADAP PENDIDIKAN AKHLAK ANAK (Studi Kasus di SMP Negeri 2 Kelas VIII Banda Aceh

    Directory of Open Access Journals (Sweden)

    NISA KHAIRUNI

    2016-01-01

    Full Text Available The author examines the positive and negative effects of social media on the moral education of children in school SMPN 2 class VIII Banda Aceh, it is very interesting because of the many children who abuse social media. This work analyzes about the use of social media that have an impact on the moral education of children. The data collected in this study through the work of other literature, researchers also interviewed principals and students as many as 16 students as well as the observation at the school. Based on the analysis that has been done it can be seen the positive and negative impacts of the use of social media to the moral education of children. The positive impact on the social development of the media on moral education of children among children can adapt, socialize with the public and manage a network of friends, and make children easier to accomplish these tasks, while the negative impact of the development of social media to the moral education of children very much of them can make the omission in children so that children are less disciplined and be lazy, makes children easy to cheat the works of others, disrespectful both in dress and speech, often quarrel due to scenes that are as dangerous as scenes of pornography, violence, wars and so forth , as well as making children miss school because they feel more comfortable in the cafe of the study at the school, not only that social media also makes children spend pocket money a child so that the child took the money her parents secretly to access the internet cafe. Therefore, social media can lead education of children.

  19. AKTIVITAS FISIK, ASUPAN ENERGI, DAN PRODUKTIVITAS KERJA PRIA DEWASA: STUDI KASUS DI PERKEBUNAN TEH MALABAR PTPN VIII BANDUNG, JAWA BARAT

    Directory of Open Access Journals (Sweden)

    Noni Eka Jaya Wardani

    2012-03-01

    Full Text Available 800x600 Normal 0 false false false IN X-NONE X-NONE MicrosoftInternetExplorer4 The cross sectional design was used in this study to elaborate physical activity, energy consumption, and work productivity of men workers. The total number of sample is 72 men.  The inclusion criteria of  the sample is the head of household’s women tea pickers at Tea Plantation PTPN VIII Bandung, West Java who have children 0-72 month age and willing to be interviewed. The place of the research was chose purposively. Malabar Plantation was chosen from the other five plantations (clusters cause of its easier access and the homogenous characteristics inter cluster. Data collected was analyzed statistically. In general, more than a half of samples had  active or moderately physical activity  level (PAL=1.89. The physical activity level of samples during work day (average PAL=1.93 was higher than holiday (average PAL=1.77 (p87.2 - 121.2%.  Majority of samples (76.4% had wages per month below the regional minimum wages. The working hours of more than a half of samples were below seven hours per day and had wages per hour below standard regional minimum wage. Based on correlation analysis, there are significant correlation between 1 education level with physical activity level; 2 age, income per capita, and family size with wage per month; 3 age and physical activity level with working hours; and 4 age and  income per capita with wages per hour. Keywords:  physical activity, energy expenditure, energy   adequacy level, work productivity, tea picker’s household   head.

  20. Radiation effects on rat testes. VIII. Kinetic properties of hydrolases following partial body gamma irradiation of rats.

    Science.gov (United States)

    Gupta, G S; Bawa, S R

    1975-05-01

    Kinetic properties such as Michaelis constant (Km), maximum velocity (Vmax), temperature coefficient (Q10) and energy of activation (Ea) for hydrolysis of adenosine-5'-phosphate at pH 9.5 and sodium pyrophosphate at pH 8.35 by normal and radiated testes supernatants have been described. Kinetic parameters are related to respective phosphohydrolases (phosphatases). (1) Km values for 5'nucleotidase and inorganic pyrophosphatase of normal testis were determined as 1.25 X 10(-3)M and 0.81 X 10(-3)M respectively; (II) Vmax correspond to 318 mug P/15 min and 430 mug P/15 min for 100 mg tissue respectively; (III) Q10 for 5 nucleotidase is 1.7 and for inorganic pyrophosphatase is 4.2 at a temperature 10-30degreesC; (IV) Ea for hydrolysis of AMP and sodium pyrophosphate were calculated by Arrhenius plots as 17000 and 9000 cal/mol. (V) Km values for irradiated enzymes are similar to the control values suggesting that the binding capacities of these enzymes with their substrates remain unaffected after radiation; (VI) Vmax for radiated enzymes correspond to a value of 500 mug P/100 mg tissue/15 min for 5'nucleotidase and 118 mug P/100 mug tissue/15 min for inorganic pyrophosphatase; (VII) 110 for 5'nucleotidase is 2.2 and inorganic pyrophosphatase 1.16 at 10-30degreesC; (VIII) Ea for irradiated 5'nucleotidase is comparable to those of normal rats whereas for inorganic pyrophosphatase Ea is moderately declined. The observed changes have been related to the different types of metabolic activity in germinal and nongerminal cells of testes.

  1. The High Time Resolution Universe Pulsar Survey VIII: The Galactic millisecond pulsar population

    CERN Document Server

    Levin, L; Barsdell, B R; Bates, S D; Bhat, N D R; Burgay, M; Burke-Spolaor, S; Champion, D J; Coster, P; D'Amico, N; Jameson, A; Johnston, S; Keith, M J; Kramer, M; Milia, S; Ng, C; Possenti, A; Stappers, B; Thornton, D; van Straten, W

    2013-01-01

    We have used millisecond pulsars (MSPs) from the southern High Time Resolution Universe (HTRU) intermediate latitude survey area to simulate the distribution and total population of MSPs in the Galaxy. Our model makes use of the scale factor method, which estimates the ratio of the total number of MSPs in the Galaxy to the known sample. Using our best fit value for the z-height, z=500 pc, we find an underlying population of MSPs of 8.3(\\pm 4.2)*10^4 sources down to a limiting luminosity of L_min=0.1 mJy kpc^2 and a luminosity distribution with a steep slope of d\\log N/d\\log L = -1.45(\\pm 0.14). However, at the low end of the luminosity distribution, the uncertainties introduced by small number statistics are large. By omitting very low luminosity pulsars, we find a Galactic population above L_min=0.2 mJy kpc^2 of only 3.0(\\pm 0.7)*10^4 MSPs. We have also simulated pulsars with periods shorter than any known MSP, and estimate the maximum number of sub-MSPs in the Galaxy to be 7.8(\\pm 5.0)*10^4 pulsars at L=0.1...

  2. Characteristics of reading and understanding of hearing impaired students in classes VI-VIII

    Directory of Open Access Journals (Sweden)

    Mustaf Morina

    2015-03-01

    Full Text Available Good reading has a very important role in the development of children with hearing impaired; also reading in explicit way is one of the crucial factors which affect the oral language development of children with hearing impaired. The best form and possibility of improvement, development of oral language, development of communicating, receipt of information, knowledge, and ideas over the world, is reading. When the auditory perception is damaged reading is poor. Hearing impairment causes a lot of problems in the development of personality of children with hearing impairment in these fields: poor development of vocabulary, poor quality of lexica, poor quality of sentences, and disorder in articulation. The purpose of this research is to verify the following: 1-Speed of reading of hearing impaired children, 2-The number of errors, 3-The kind of errors, 4-To understand the text in the context of the degree of hearing impairment, age (class, success in school and gender. This theoretical-experimental study was made with students from two schools; special school “Mother Teresa” in Prizren and Primary School “Elena Gjika” in Prishtina (class attached. The research included a total of 32 students (respondent 27 students (respondent from special schools “Mother Teresa” in Prizren and 5 elementary school students “Elena Gjika” Prishtina, all these students are with hearing impairment. From 32 students involved in the research, 23 were male and 9 female. The research was done by applying a text fables “The fox and the raven” watched and analyzed in terms of three dimensions. The research results have shown that students with hearing impairments have considerable problems in many aspects; in terms of speed of reading, students with hearing impairment have stagnated compared with their peers in the ratio 8/1. In terms of reading errors have stagnated considered being incomparable. In terms of understanding the text students with hearing

  3. The specifics of reading to students with hearing and speech impairment in classes VI-VIII

    Directory of Open Access Journals (Sweden)

    Mustaf Morina

    2016-03-01

    Full Text Available Good reading has a very important role in the development of children with hearing impaired; also reading in explicit way is one of the crucial factors which affect the oral language development of children with hearing impaired. The best form and possibility of improvement, development of oral language, development of communicating, receipt of information, knowledge, and ideas over the world, is reading. When the auditory perception is damaged reading is poor. Hearing impairment causes a lot of problems in the development of personality of children with hearing impairment in these fields: poor development of vocabulary, poor quality of lexica, poor quality of sentences, and disorder in articulation. The purpose of this research is to verify the following: 1-Speed of reading of hearing impaired children, 2-The number of errors, 3-The kind of errors, 4-To understand the text in the context of the degree of hearing impairment, age (class, success in school and gender. This theoretical-experimental study was made with students from two schools; special school “Mother Teresa” in Prizren and Primary School “Elena Gjika” in Prishtina (class attached. The research included a total of 32 students (respondent 27 students (respondent from special schools “Mother Teresa” in Prizren and 5 elementary school students “Elena Gjika” Prishtina, all these students are with hearing impairment. From 32 students involved in the research, 23 were male and 9 female. The research was done by applying a text fables “The fox and the raven” watched and analyzed in terms of three dimensions. The research results have shown that students with hearing impairments have considerable problems in many aspects; in terms of speed of reading, students with hearing impairment have stagnated compared with their peers in the ratio 8/1. In terms of reading errors have stagnated considered being incomparable. In terms of understanding the text students with hearing

  4. Display of E. coli Alkaline Phosphatase pIII or pVIII Fusions on Phagemid Surfaces Reveals Monovalent Decoration with Active Molecules

    Science.gov (United States)

    Weichel, Michael; Jaussi, Rolf; Rhyner, Claudio; Crameri, Reto

    2008-01-01

    Active alkaline phosphatase of Escherichia coli (PhoA, EC 3.1.3.1) was displayed via the leucine zipper element of the Jun-Fos heterodimer on the surface of filamentous phage and the kinetic parameters Km and kcat were determined. The phoA gene was cloned downstream of fos while jun was inserted upstream of pIII or pVIII, alternatively, in the pJuFo phagemid vector. Both fusion genes are regulated by independent lacZ promoters. PhoA displayed on the phagemid pIII surface exhibited a Km of 11.2 µM with 4-nitrophenyl phosphate as substrate, which is consistent with data published for soluble PhoA. Based on these data we calculated the decoration of pJuFo phagemid with PhoA using the minor and major coat proteins pIII and pVIII as fusion partners under variable inducing conditions. We found that, even if the promoters are fully induced at a concentration of 1000 µM IPTG, the phagemids display maximally one copy of PhoA-Fos-Jun-coat protein fusion, irrespective of whether the protein is presented via pIII or pVIII. However, since PhoA is displayed in a native-like fashion, as deduced from the kinetic parameters of the enzymatic reaction, the pJuFo technology provides a versatile tool for the functional screening of complex cDNA libraries displayed on the phagemids' surface. PMID:18949073

  5. Plasma-derived versus recombinant factor concentrates in PUPs: a never ending debate?

    Science.gov (United States)

    Berntorp, Erik

    2017-01-31

    Inhibitor development in haemophilia is a serious complication to treatment with factor concentrates. Since the advent of more pure products, especially developed using recombinant DNA technology, some studies have shown an increased incidence of inhibitors in previously untreated patients (PUPs) receiving recombinant products whereas plasma-derived concentrates sometimes have been claimed to have a protective role, probably due to the content of von Willebrand factor (VWF). In fact, experiments indicate that the VWF may block uptake of factor VIII into macrophages for further processing to the immune system. Also, a competition between VWF and inhibitor binding to the C2 domain of factor VIII has been suggested. Recently, large cohort and surveillance studies have created a vigorous debate about the role of product class for inhibitor development as results have been conflicting. The only randomised prospective study, the SIPPET study, was published in 2016, and substantiated previous reports claiming that plasma derived concentrates give less inhibitors in patients with severe haemophilia A, previously not exposed to factor VIII. The debate will continue.

  6. Damage to urban buildings in zones of intensities VIII and VII during the Wenchuan earthquake and discussion on some typical damages

    Institute of Scientific and Technical Information of China (English)

    Jingjiang Sun; Yuhong Tang; Chao Zheng; Hongbin Shi; Lin Lin; Zhongxian Sun

    2009-01-01

    The outline and typical characteristics of damages to building in Jiangyou city and Anxian county (intensity VIII), Mianyang city and Deyang city (intensity VII) are introduced in the paper. The damage ratios, based on the sample statistics of multi-story brick buildings together with multi-story brick buildings with RC frame at first story (BBF), are presented. Then some typical damages, such as horizontal cricks of brick masonry buildings, X-shaped cricks on the walls under windows, the damages to columns, beams and infill walls of frame buildings and the damage to half circle-shaped masonry walls, are discussed.

  7. VIII Jornadas de trabajo AENTDE. El NOC en el proceso de cuidados. A Coruña, 20 y 21 de mayo de 2011

    OpenAIRE

    Asociación Española de Nomenclatura, Taxonomía y Diagnóstico de Enfermería

    2011-01-01

    Las VIII Jornadas de AENTDE pretenden profundizar en el uso del NOC (Clasificación de Resultados Enfermeros) desde la perspectiva de una de sus autoras, la profesora Elisabeth Swanson, y difundir las experiencias de las enfermeras españolas en el desarrollo funcional y la aplicación clínica de la NOC con los sistemas de información en España. Objetivos: • Profundizar en el conocimiento para la utilización clínica de la NOC. • Conocer las líneas de investigación del NOC que se están d...

  8. Micro-chemical and metallurgical study of Samnite bronze belts from ancient Abruzzo (central Italy, VIII-IV BC)

    Science.gov (United States)

    Riccucci, Cristina; Ingo, Gabriel Maria; Faustoferri, Amalia; Pierigè, Maria Isabella; Parisi, Erica Isabella; Di Carlo, Gabriella; De Caro, Tilde; Faraldi, Federica

    2013-12-01

    The Samnite bronze belts and the chest disk cuirasses (VIII-IV BC) are the distinctive defensive weapons of the Samnite warriors having likely also a symbolic relevance. These artefacts were mainly found during the archaeological excavations of warriors' graves from ancient Abruzzo (central Italy). Their chemical composition, metallurgical features and corrosion products formed during the long-term burial have been studied by means of the combined use of analytical techniques such as optical microscopy (OM), scanning electron microscopy coupled with energy-dispersive X-ray micro-analysis (SEM-EDS), X-ray photoelectron spectroscopy (XPS) and X-ray diffraction (XRD). The micro-chemical and structural results show that the bronze belts have often been produced by using unusual high-tin bronze alloys achieving a silver-like appearance and by performing tailored cycles of thermal treatments under reducing conditions and hot mechanical working aimed to shape the high-tin alloys in the form of a thin bronze sheet. Furthermore, the investigation has shown that the main alloying elements have been transformed during the burial into mineral species giving rise to the formation of stratified structures constituted by different mineral phases such as tin oxides, cuprous oxide (Cu2O) and copper carbonates (azurite (Cu3(CO3)2(OH)2 and malachite (CuCO3Cu(OH)2)) as well as dangerous chlorine-based compounds such as nantokite (CuCl) and atacamite (Cu2(OH)3Cl) polymorphs. This information evidences the strict interaction of the alloying elements with the soil components as well as the occurrence of the copper cyclic corrosion as a post-burial degradation phenomenon. The present study confirms that the combined micro-chemical and micro-structural investigation techniques such as SEM-EDS, XPS, XRD and OM can be successfully used to investigate the technological production processes of the ancient artefacts and to achieve the detailed micro-chemical and structural description of the

  9. The effect of different methods of leucoreduction on plasma coagulation factors.

    Science.gov (United States)

    Aboul Enein, Azza A; Abdel Rahman, Hala A; Abdel Maged, Mohamed M M; El Sissy, Maha H

    2017-03-01

    Removal of leucocytes from blood products, namely leucoreduction, improves the safety of blood transfusion by reducing adverse events associated with the incidental transfusion of leucocytes. Coagulation factors might be compromised during leucoreduction because of exposure of plasma to a variety of filter materials. The aim of the current study was to assess the effect of different methods of prestorage leucofiltration (apheresis and whole blood filters) on prothrombin time, international normalized ratio, partial thromboplastin time and factors V and VIII. There was a significant prolongation of prothrombin time as well as elevation of international normalized ratio in plasma after leucoreduction (14.5 ± 0.7 s vs. 13.9 ± 0.7 s, P = 0.008 and 1.14 ± 0.07 vs. 1.09 ± 0.07, P = 0.005, respectively). Also, there was a statistically significant prolongation of activated partial thromboplastin time in nonleucoreduced plasma (55.6 ± 9.9 s vs. 43.2 ± 12.8 s, P = 0.001). There was no significant filtration effect on factors V and VIII levels. Furthermore, there was no significant difference in factors V and VIII levels between plasma filtered by inline whole blood filters and apheresis machine. Leucodepleted plasma originating from both inline whole blood filter and apheresis machine maintained satisfactory levels of factors V and VIII.

  10. Venom Concentrations and Clotting Factor Levels in a Prospective Cohort of Russell's Viper Bites with Coagulopathy.

    Directory of Open Access Journals (Sweden)

    Geoffrey K Isbister

    Full Text Available Russell's viper envenoming is a major problem in South Asia and causes venom induced consumption coagulopathy. This study aimed to investigate the kinetics and dynamics of venom and clotting function in Russell's viper envenoming.In a prospective cohort of 146 patients with Russell's viper envenoming, we measured venom concentrations, international normalised ratio [INR], prothrombin time (PT, activated partial thromboplastin time (aPTT, coagulation factors I, II, V, VII, VIII, IX and X, and von Willebrand factor antigen. The median age was 39 y (16-82 y and 111 were male. The median peak INR was 6.8 (interquartile range [IQR]: 3.7 to >13, associated with low fibrinogen [median,3 at 6 h post-antivenom but had reduced to <2, by 24 h. The aPTT had also returned to close to normal (<50 sec at 24 h. Factor VII, VIII and IX levels were unusually high pre-antivenom, median peak concentrations of 393%, 307% and 468% respectively. Pre-antivenom venom concentrations and the INR (r = 0.20, p = 0.02 and aPTT (r = 0.19, p = 0.03 were correlated (non-parametric Spearman analysis.Russell's viper coagulopathy results in prolonged aPTT, INR, low fibrinogen, factors V, VIII and X which recover over 48 h. Severity of clotting abnormalities was associated with venom concentrations.

  11. Essays on Strategy VIII

    Science.gov (United States)

    1991-01-01

    perfectibility, also permit the easiest adaptation to change. NOTES 1. Daniel J. Boorstin , The Americans: The Colonial Experience (New York: Vantage Books, 1974...pp. 5-8. 2. Ibid., p. 66. 3. R. W. Van Alstyne, The Rising American Empire (Chicago: Quadran- gle Books, -965), p. 8. 4. Boorstin , The Colonial

  12. Targeted exome sequencing identifies novel compound heterozygous mutations in P3H1 in a fetus with osteogenesis imperfecta type VIII.

    Science.gov (United States)

    Huang, Yanru; Mei, Libin; Lv, Weigang; Li, Haoxian; Zhang, Rui; Pan, Qian; Tan, Hu; Guo, Jing; Luo, Xiaomei; Chen, Chen; Liang, Desheng; Wu, Lingqian

    2017-01-01

    Osteogenesis imperfecta (OI) is a highly clinically and genetically heterogeneous group of disorders. It is difficult to identify severe OI in the perinatal period. Here, a Chinese woman with a suspected history of fetal OI was referred to our institution at 19weeks of gestation, due to ultrasound inspection during antenatal screening, which revealed bulbous metaphyses, short humeri, and short thick bent femora in the fetus. Using targeted exome sequencing of 248 genes known to be involved in skeletal system diseases, we identified novel compound heterozygous mutation in the P3H1 gene in the fetus with OI type VIII: c.105_120del (p.D36Rfs*16) and c.2164C>T (p.Q722*). These two mutations were inherited from the father and mother, respectively. The mRNA level of P3H1 wasn't changed suggested that mRNA with this mutation escaped from nonsense-mediated RNA decay. Besides, the level of P3H1 was absence while the CRTAP was mildly decreased. In conclusion, our findings imply this novel compound heterozygous mutation as the molecular pathogenetic in a Chinese fetus with OI type VIII, and demonstrate that targeted next-generation sequencing (NGS) is an accurate, rapid, and cost-effective method in the genetic diagnosis of fetal skeletal dysplasia with genetic and clinical heterogeneity, especially for autosomal recessive skeletal disorders.

  13. Discovery of a broad O VIII Ly alpha line in the ultra-compact X-ray binary 4U 1543-624

    CERN Document Server

    Madej, O K

    2010-01-01

    We report the discovery of a broad emission feature at ~0.7 keV in the spectra of the ultra-compact X-ray binary 4U 1543-624, obtained with the high-resolution spectrographs of the XMM-Newton and Chandra satellites. We confirm the presence of the feature in the broad band MOS2 spectrum of the source. As suggested before in the literature, the donor star in this source is a CO or ONe white dwarf, which transfers oxygen-rich material to the accretor, conceivably a neutron star. The X-rays reprocessed in this oxygen-rich accretion disc could give a reflection spectrum with O VIII Ly alpha as the most prominent emission line. Apart from the feature at ~0.7 keV we confirm the possible presence of a weak emission feature at ~6.6 keV, which was reported in the literature for this data set. We interpret the feature at ~0.7 keV and ~6.6 keV as O VIII Ly alpha and Fe K alpha emission respectively, caused by X-rays reflected off the accretion disc in the strong gravitational field close to the accretor.

  14. EFEKTIVITAS METODE PEMBELAJARAN INKUIRI DENGAN METODE PEMBELAJARAN KONVENSIONAL UNTUK MENINGKATKAN HASIL BELAJAR MATA PELAJARAN IPS TERPADU POKOK BAHASAN PERMINTAAN, PENAWARAN DAN TERBENTUKNYA HARGA PASAR SISWA KELAS VIII SMP 2 BAE KUDUS

    Directory of Open Access Journals (Sweden)

    Nailul Hana

    2012-06-01

    Full Text Available Proses belajar mengajar di sekolah menentukan keberhasilan pembelajaran. Belajar mengajar merupakan dua konsep yang tidak bisa dipisahkan satu sama lain. Berdasarkan observasi awal guru pelajaran IPS masih menggunakan metode ceramah atau konvensional. Hasil belajar IPS Terpadu kelas VIII SMP 2 Bae Kudus menunjukan rendahnya pemahaman siswa terhadap konsep IPS dapat dilihat dari nilai rata-rata mata pelajaran IPS Terpadu kurang dari 75.Jenis penelitian ini adalah penelitian True ExperimentalDesign dengan menggunakan rancangan Control group pretest-posttest. Populasi dari penelitian ini adalah kelas VIII SMP 2 Bae Kudus.Sampelnya adalah kelas VIII F dan VIII G SMP 2 Bae Kudus Tahun Ajaran 2011/2012.Variabel bebas meliputi penerapan metode pembelajaran inkuiri dan metode pembelajaran konvensional.Dan variabel terikat meliputi peningkatan hasil belajar siswa kelas VIII SMP 2 Bae Kudus. Metode pengumpulan data menggunakan metode dokumentasi dan metode tes.Hasil penelitian ketuntasan hasil belajar siswa secara klasikal telah dicapai dengan metode pembelajaran inkuiri yaitu sebesar 86%. Sedangkan dengan metode pembelajaran konvensional sebesar 63%. Gain kelas ekperimen yaitu 0.55 dan gain kelas kontrol sebesar 0.37. dapat disimpulkan bahwa kelas eksperimen dan kelas kontrol mengalami peningkatan hasil belajar dengan kriteria sedang. The process of teaching and learning in schools to determine successful learning. Teaching and learning are two concepts that can not be separated from one another. Based on preliminary observations are social studies teachers use the lecture method or conventional. Integrated learning outcomes IPS eighth grade SMP 2 Bae Kudus shows lack of understanding of the concept of IPS students can be seen from the average value of integrated social studies less than 75. Type of research is a True Experimental Design using design Control group pretest-posttest. The population of this study was a class VIII SMP 2 Bae Kudus. The sample

  15. Epidemiological study on Buccal Health in the 12 years old population of Health Care Area VIII in Cienfuegos. Estudio epidemiológico de salud bucal en la población de 12 años del área VIII de salud de Cienfuegos.

    Directory of Open Access Journals (Sweden)

    Raúl López Fernández

    2007-01-01

    Full Text Available

    Background: The 12 years-old children population is worldwide taken as a reference age to compare the buccal health condition of different countries, by means of various indicators that measure the presence of the main buccal diseases. The knowledge of these epidemiological profiles generates information to guide the services planning policies of the Primary Health Care. Objective: To characterize 12 years-old population's buccal health condition. Methods: Cross- sectional descriptive correlative study with a stratified probabilistic sample of 90 children starting from a universe conformed by the 269 adolescents that constitute the total of the 12 years old population of the Health Care Area VIII in Cienfuegos municipality. Pearson’s chi-square and Mantel-Haenszel lineal tendency tests were used with the determination of the relative risk and reliance intervals of 95%. Results: The decay prevalence reached 54, 4%. The COP-D index was 2, 45 being the decayed component the major percentage with 4.6%. The periodontal disease was more frequent in boys than in girls, with 54, 9% and 30, 8% respectively. 80,9% of the segments is healthy. In those affected, the calculation prevailed in 11,7%. It was determined that faulty obturations, inheritance and faulty buccal hygiene were the most affecting risk factors for children with decays, while in the periodontal disease it was faulty buccal hygiene. Malocclusions presented a prevalence rate of 40%. Out of which, 55,6% required secondary level attention. Those with habits present a risk 2 times superior of making sick. The sick epidemiological category was present in 77,8% of the total. Conclusions: We emphasize the prevention need as core issue of the primary medical care in the world today; being the General-Integral Dentist a transforming agent that according to his/her formation is capable to assume the existent

  16. Diagnosis and classification of von Willebrand disease: a review of the differential utility of various functional von Willebrand factor assays.

    Science.gov (United States)

    Favaloro, Emmanuel J

    2011-10-01

    von Willebrand disease (VWD) is considered to be the most common inherited bleeding disorder. VWD is diagnosed following a clinical and physical review, with personal and familial evidence of (primarily mucocutaneous) bleeding, and confirmed by laboratory testing. The latter typically entails initial plasma testing of factor VIII coagulant, von Willebrand factor (VWF) protein ('antigen') and VWF function which has classically been assessed using the ristocetin cofactor (VWF:RCo) assay. More recent attention has focussed on other functional VWF assays, such as collagen binding and so-called 'VWF activity' assays, as possible replacements to the VWF:RCo, or as supplementary tests of VWF 'function'. Additional laboratory testing can comprise a battery of confirmatory and VWD-type assisting assays, including VWF:multimer and von Willebrand factor VIII binding. This review aims to update knowledge of current VWD diagnostics with a particular emphasis on 'functional' VWF assays.

  17. Type and intensity of FVIII exposure on inhibitor development in PUPs with haemophilia A. A patient-level meta-analysis.

    Science.gov (United States)

    Marcucci, Maura; Mancuso, Maria Elisa; Santagostino, Elena; Kenet, Gili; Elalfy, Mohssen; Holzhauer, Susanne; Bidlingmaier, Christoph; Escuriola Ettingshausen, Carmen; Iorio, Alfonso; Nowak-Göttl, Ulrike

    2015-05-01

    The impact of treatment-related factors on inhibitor development in previously untreated patients (PUPs) with haemophilia A is still debated. We present the results of a collaborative, individual patient data meta-analytic project. Eligible data sources were published cohorts of PUPs for which patient-level data were available. The exposures of interest were factor (F)VIII type (recombinant [rFVIII] vs plasma-derived [pdFVIII]) and treatment intensity (≥ vs intensity treatment (unadjusted HR 2.9, 95 % CI 2.0-4.2), respectively. In adjusted analyses, only treatment intensity remained an independent predictor; the effect of FVIII type was largely due to confounding, but with a significant interaction between FVIII type and treatment intensity. This patient-level meta-analysis confirms, across different statistical approaches, that high-intensity treatment is a strong risk factor for inhibitor development. The possible role of FVIII type in subgroups is suggested by the test for interactions but could not be proven because of the limited subgroups sample sizes.

  18. Sample Packet of Tex-SIS Questionnaires. DeVault VIII Expansion and the Vocational Education Data System (VEDS). Tex-SIS Student Information System Postsecondary Student Follow-Up.

    Science.gov (United States)

    Texas Coll. and Univ. System, Austin. Coordinating Board.

    This packet identifies and explains the questionnaires and coding used in DeVault VIII, a subsystem of the Texas Student Information System designed to generate data for local utilization and for fulfillment of the federally-mandated Vocational Education Data System (VEDS) student and employer follow-up requirements. The report first explains the…

  19. La cisma de Enrique VIII: ambición y dignidad. Catalina de Aragón y Ana Bolena en el imaginario de Calderón y Shakespeare

    OpenAIRE

    Vallejo Mateo, María Luisa

    2015-01-01

    El artículo tiene como finalidad comparar el tratamiento que dan Calderón y Shakespeare a sus personajes femeninos principales en La cisma de Ingalaterra y Enrique VIII, en torno a los conceptos de dignidad y ambición, que marcan su manera de ser y est

  20. The Development of Geometri Teaching Materials Based on Constructivism to Improve the Students' Mathematic Reasoning Ability through Cooperative Learing Jigsaw at the Class VIII of SMP Negeri 3 Padangsidimpuan

    Science.gov (United States)

    Dewi, Izwita; Harahap, Muhammad Syahri

    2016-01-01

    The purposes of this research were to know the validity, practicality, and effectivity of geometrical learning material based on the constructivism to Increase students' mathematic reasoning ability and increasing students' mathematic reasoning ability by using learning material at the grade VIII of SMP Negeri 3 Padangsidimpuan. Type of the…

  1. Asistencia técnica en el sector agropecuario en México: análisis del VIII censo agropecuario y forestal

    OpenAIRE

    2012-01-01

    El objetivo de esta investigación fue determinar a través de la información estadística obtenida por el VIII Censo Agrícola, Ganadero y Forestal del año 2007, la importancia que tiene la asistencia técnica en las unidades de producción en México para contar con elementos que sirvan en la toma de decisiones de éste servicio. Se realizó un análisis de la base de datos a nivel nacional y por zonas económicas a través de la obtención de frecuencias relativas. De acuerdo al Censo, en México, la co...

  2. Tartaglia’s science of weights and mechanics in the sixteenth century selections from quesiti et inventioni diverse books VII–VIII

    CERN Document Server

    Pisano, Raffaele

    2016-01-01

    This book presents a historical and scientific analysis as historical epistemology of the science of weights and mechanics in the sixteenth century, particularly as developed by Tartaglia in his Quesiti et inventioni diverse, Book VII and Book VIII (1546; 1554). In the early 16th century mechanics was concerned mainly with what is now called statics and was referred to as the Scientia de ponderibus, generally pursued by two very different approaches. The first was usually referred to as Aristotelian, where the equilibrium of bodies was set as a balance of opposite tendencies to motion. The second, usually referred to as Archimedean, identified statics with centrobarica, the theory of centres of gravity based on symmetry considerations. In between the two traditions the Italian scholar Niccolò Fontana, better known as Tartaglia (1500?–1557), wrote the treatise Quesiti et inventioni diverse (1546). This volume consists of three main parts. In the first, a historical excursus regarding Tartaglia’s lifetime,...

  3. Fundamentos geométricos, metrológicos y sistemas de proporción en la arquitectura altomedieval asturiana (siglos VIII y X

    Directory of Open Access Journals (Sweden)

    Arias Páramo, Lorenzo

    2001-12-01

    Full Text Available This paper aims to establish the criteria that ruled the proportions and order in early mediaeval Asturian architecture ( 8th-10th centuries. It includes the study of the metrological system and the module of proportions used in these buildings. As a result, these principles are used as a basis for establishing the forms and principles of proportion common to all Asturian architecture.Estudiamos los criterios de orden y proporción presentes en la arquitectura altomedieval asturiana (siglos VIII-X. El estudio abarca igualmente el sistema metrologico aplicado, estudiando asimismo el módulo de proporción presente en sus edificios. A partir de estos principios se establecen las formas tipológicas y los cánones de proporción comunes al conjunto de la arquitectura asturiana.

  4. Influence of the V/III ratio in the gas phase on thin epitaxial AlN layers grown on (0001) sapphire by high temperature hydride vapor phase epitaxy

    Energy Technology Data Exchange (ETDEWEB)

    Claudel, A., E-mail: arnaud.claudel@grenoble-inp.org [ACERDE, 354 Voie Magellan — Alpespace, 73800 Ste Hélène du Lac (France); Fellmann, V. [ACERDE, 354 Voie Magellan — Alpespace, 73800 Ste Hélène du Lac (France); Science et Ingénierie des Matériaux et des Procédés, Grenoble INP-CNRS-UJF, BP 75, 38402 Saint Martin d' Hères (France); Gélard, I. [ACERDE, 354 Voie Magellan — Alpespace, 73800 Ste Hélène du Lac (France); Coudurier, N. [ACERDE, 354 Voie Magellan — Alpespace, 73800 Ste Hélène du Lac (France); Science et Ingénierie des Matériaux et des Procédés, Grenoble INP-CNRS-UJF, BP 75, 38402 Saint Martin d' Hères (France); Sauvage, D. [ACERDE, 354 Voie Magellan — Alpespace, 73800 Ste Hélène du Lac (France); Balaji, M. [ACERDE, 354 Voie Magellan — Alpespace, 73800 Ste Hélène du Lac (France); Science et Ingénierie des Matériaux et des Procédés, Grenoble INP-CNRS-UJF, BP 75, 38402 Saint Martin d' Hères (France); Crystal Growth Center, Anna University, Chennai 600025 (India); and others

    2014-12-31

    Thin (0001) epitaxial aluminum nitride (AlN) layers were grown on c-plane sapphire using high temperature hydride vapor phase epitaxy. The experimental set-up consists of a vertical cold-wall quartz reactor working at low pressure in which the reactions take place on a susceptor heated by induction. The reactants used are ammonia and aluminum chlorides in situ formed via hydrogen chloride reaction with high purity aluminum pellets. As-grown AlN layers have been characterized by scanning electron microscopy, atomic force microscopy, X-ray diffraction, transmission electron microscopy, photoluminescence and Raman spectroscopies. The influence of the V/III ratio in the gas phase, from 1.5 to 15, on growth rate, surface morphology, roughness and crystalline quality is investigated in order to increase the quality of thin epitaxial AlN layers grown at high temperature. Typical growth rates of around 0.45 μm/h were obtained for such thin epitaxial AlN layers. The growth rate was unaffected by the V/III ratio. An optimum for roughness, crystalline quality and optical properties seems to exist at V/III = 7.5. As a matter of fact, for a V/III ratio of 7.5, best root mean square roughness and crystalline quality — measured on 0002 symmetric reflection — as low as 6.9 nm and 898 arcsec were obtained, respectively. - Highlights: • Growth of thin epitaxial AlN layers by high temperature hydride vapor phase epitaxy • Influence of V/III ratio on growth rate, morphology and crystalline quality • The effect of surface morphology on strain state and crystal quality is established.

  5. Invención y tradición en la cancillería real de Alfonso VIII de Castilla (1158-1214

    Directory of Open Access Journals (Sweden)

    Pablo Martín Prieto

    2013-11-01

    Full Text Available El estudio de la evolución de la cancillería real de Castilla bajo Alfonso VIII permite derivar ciertas conclusiones sobre el papel individual de los miembros de su personal en la redacción de los diplomas regios, concretamente por medio de un análisis detenido de los preámbulos, su formación y alteraciones a lo largo del tiempo en la mano de los distintos scriptores. Asimismo, esta base permite medir el equilibrio entre tradición e innovación en el trabajo de cancillería. La consideración de la imagen del monarca ideal, tal como se propone tanto en fuentes literarias como en los mismos documentos de la cancillería, conduce a una comprensión más clara del alcance de la propaganda política de la época en el más amplio contexto cultural de la corte castellana.The study of the Castilian royal Chancery’s evolution under King Alfonso VIII allows us to draw certain conclusions on the role of individual members of that office in the process of drafting royal documents. We will present a detailed description of preambles, their elaboration and evolution in time and by the hands of different scriptores. This will also allow us to gauge the balance between tradition and innovation within the Chancery. A more thorough grasp of the scope of political propaganda at the time can be determined through the image of the ideal king as depicted both in literary sources and in Chancery documents within the wider context of cultural developments in the Castilian court.

  6. Iconoclasmo e iconodulia entre oriente y occidente (siglos VIII-IX Iconoclasm and iconoduly between east and west (8th-9th centuries

    Directory of Open Access Journals (Sweden)

    Alfonso Hernández Rodríguez

    2011-10-01

    Full Text Available El siguiente artículo trata acerca de la recepción en el occidente carolingio de la crisis iconoclasta. Reflexiona sobre la forma en que ambas cristiandades trataron el problema que las imágenes representan para las prácticas religiosas y las consecuencias políticas del culto de los iconos. El escrito afirma también que durante los siglos VIII y IX la crisis iconoclasta permitió la aparición de una tradición cristiana latina consciente de sí misma. Por lo tanto, se trató del momento que puso en evidencia el nacimiento de dos formas divergentes de piedad cristiana y la alienación de una respecto de la otra. La cristiandad occidental centrada en el edificio eclesiástico y que privilegiaba la ubicación de lo sagrado en el rito eucarístico, y la oriental cuyo centro era la adoración de las imágenes, con la consecuente multiplicación de los espacios sagrados.The following paper deals with the reception in the Carolingian west of the Byzantine Iconoclast Crisis. It considers the way both Christianities dealed with the problem that images presented to religious practices and the political consequences of iconic worship. The paper also states that during the VIII and IX centuries the iconoclast crisis allowed the emergence of a self conscious Latin Christian tradition. Consequently it was the moment that showed the beginning of two differing ways of Christian piety and the alienation of one towards the other. Western Christianity focused its religion practice in church building and the idea of Sacrality in the Eucharistic Rite. The oriental church, moreovers, centered its practices and theology on icon worship.

  7. Advances in clotting factor treatment for congenital hemorrhagic disorders.

    Science.gov (United States)

    Tarantino, Michael D; Aledort, Louis M

    2004-06-01

    During the last 50 years, clotting factor replacement has evolved from the use of frozen plasma in the 1950s, through the serendipitous discovery of cryoprecipitate in the 1960s and the development of purified clotting factors in the 1970s and 1980s, to the era of recombinant clotting factors beginning in the 1990s. The dawn of the new millennium has seen the refinement of recombinant factor (rF) VIII with enhanced safety via the elimination of plasma-derived culture media or product stabilizers. During the last decade of the 20th century, a cure for hemophilia through gene therapy became a possibility. This was, in part, facilitated by availability of large (dogs) and small (mice) animal models for hemophilia A and B. Although this review will focus primarily on clotting factor replacement, the reader may refer to recent discourse on gene therapy for hemophilia.

  8. PENINGKATAN HASIL BELAJAR PELAKU-PELAKU KEGIATAN PEREKONOMIAN DI INDONESIA DENGAN MODEL PEMBELAJARAN THINK PAIR AND SHAREPADA SISWA KELAS VIII SMP PGRI BERGAS

    Directory of Open Access Journals (Sweden)

    Ani Sumaiyah

    2002-06-01

    Full Text Available Dalam proses belajar mengajar guru memegang peranan penting yaitu sebagai fasilitator dalam mengoptimalkan keaktifan siswa. Hasil� observasi awal menunjukkan bahwa kelas VIII� ada 17 siswa (65,3% belum tuntas pada nilai materi pelaku-pelaku kegiatan perekonomian di Indonesia. Hasil tersebut belum optimal karena perhatian siswa kurang, partisipasi anak kurang menyeluruh. Subyek penelitian ini adalah siswa kelas VIII. Prosedur penelitian ini merupakan siklus kegiatan yang terdiri dari dua siklus dimana setiap siklus meliputi perencanaan, pelaksanaan tindakan, pengamatan dan refleksi. Hasil baik pada siklus I maupun siklus II terlihat bahwa nilai rata-rata hasil belajar kognitif siswa meningkat yaitu dari skor awal yaitu dari rata-rata awal sebesar 66,9 menjadi 73,2pada siklus I dan 84,2 pada siklus II dan ketuntasan klasikal dari 34,6% menjadi 65,3% pada siklus I dan 92,3% pada siklus II. In teaching and learning education, teachers play an important role as a facilitator in optimizing the activity of students. Teachers are expected to use appropriate teaching methods to involve more students in the teaching-learning process. The results of preliminary observations suggest that class VIII (65,3% who have not completed the economic value of the material perpetrators of the economic activities in Indonesia.Results are not optimal because attention ofstudents are less, participation of children less comprehensive, students have a fairly good activity, but not channeled properly.The procedure of this research is a cyclical activity that consists of two cycles where each cycle includes planning, implementation of the action, observation and reflection.Good results in cycle I and cycle II shows that the average value of cognitive learning outcomes that students increased from the initial score from the initial average of 66.9 to 73.2 to 84.2 in cycle I and cycle II and classical completeness from 34,6% to 65.3% in cycle I and 92.3% in cycle II.

  9. 78 FR 19445 - Notice of Proposed New Fee Sites; Federal Lands Recreation Enhancement Act, (Title VIII, Pub. L...

    Science.gov (United States)

    2013-04-01

    ... campgrounds. Fees are assessed based on the level of amenities and services provided, cost of operation and maintenance, market assessment, and public comment. Funds from fees would be used for the continued operation... open area at Miller Flat has been an encouraging factor in the development of numerous unauthorized...

  10. LEGISLASI MAHKAMAH KONSTITUSI DALAM PUTUSAN MAHKAMAH KONSTITUSI NOMOR: 46/PUU-VIII/2010 DITINJAU DARI TEORI HUKUM HANS KELSEN TENTANG KONSTITUSI

    Directory of Open Access Journals (Sweden)

    Subroto Subroto

    2014-12-01

    Full Text Available ABSTRAK: Legeslasi kewenangan Mahkamah Konstitusi (disingkat MK adalah sebagai berikut : (1 menguji undang-undang terhadap UUD NRI Th.1945; (2 memutus sengketa kewenangan lembaga Negara yang kewenangannya diberikan oleh UUD NRI Th.1945; (3 memutus pembubaran partai politik; dan (4 memutus perselisihan tentang hasil pemilihan umum. Dari legislasi MK tersebut, penulis tertarik untuk melihat sejauh mana legislasi MK dalam membuat suatu putusan berdasarkan teori hukum yang dikemukakan oleh Hans Kelsen, mengenai konstitusi. Pemikiran Kelsen, mendorong dibentuknya suatu lembaga yang diberi nama Verfassungsgerichtshoft atau MK (Constitutional Court yang berdiri sendiri di luar Mahkamah Agung, sering disebut The Kelsenian Model. Adanya putusan MK No. 46/PUU-VIII/2010, merupakan suatu produk hukum yang dikeluarkan oleh Mahkamah Konstitusi. Dari putusan tersebut, akan dianalisis berkaitan dengan dasar hukum dan pertimbangan hukum yang digunakan MK dalam memutus perkara telah sesuai dengan teori hukum yang dikemukakan oleh Hans Kelsen dalam teori konstitusinya atau belum dan tentang legislasi MK dalam membuat putusan tersebut berdasarkan teori hukum Hans Kelsan. Kata kunci : konstitusi, Hans Kelsen,

  11. A probable case of gigantism/acromegaly in skeletal remains from the Jewish necropolis of "Ronda Sur" (Lucena, Córdoba, Spain; VIII-XII centuries CE).

    Science.gov (United States)

    Viciano, Joan; De Luca, Stefano; López-Lázaro, Sandra; Botella, Daniel; Diéguez-Ramírez, Juan Pablo

    2015-01-01

    Pituitary gigantism is a rare endocrine disorder caused by hypersecretion of growth hormone during growing period. Individuals with this disorder have an enormous growth in height and associated degenerative changes. The continued hypersecretion of growth hormone during adulthood leads to acromegaly, a condition related to the disproportionate bone growth of the skull, hands and feet. The skeletal remains studied belong to a young adult male from the Jewish necropolis of "Ronda Sur" in Lucena (Córdoba, Spain, VIII-XII centuries CE). The individual shows a very large and thick neurocranium, pronounced supraorbital ridges, an extremely prominent occipital protuberance, and an extremely large and massive mandible. Additional pathologies include enlargement of the vertebral bodies with degenerative changes, thickened ribs, and a slight increased length of the diaphysis with an increased cortical bone thickness of lower limbs. Comparative metric analysis of the mandible with other individuals from the same population and a contemporary Mediterranean population shows a trend toward acromegalic morphology. This case is an important contribution in paleopathological literature because it is a rare condition that has not been widely documented in ancient skeletal remains.

  12. ASME Section VIII Recertification of a 33,000 Gallon Vacuum-jacketed LH2 Storage Vessel for Densified Hydrogen Testing at NASA Kennedy Space Center

    Science.gov (United States)

    Swanger, Adam M.; Notardonato, William U.; Jumper, Kevin M.

    2015-01-01

    The Ground Operations Demonstration Unit for Liquid Hydrogen (GODU-LH2) has been developed at NASA Kennedy Space Center in Florida. GODU-LH2 has three main objectives: zero-loss storage and transfer, liquefaction, and densification of liquid hydrogen. A cryogenic refrigerator has been integrated into an existing, previously certified, 33,000 gallon vacuum-jacketed storage vessel built by Minnesota Valley Engineering in 1991 for the Titan program. The dewar has an inner diameter of 9.5 and a length of 71.5; original design temperature and pressure ranges are -423 F to 100 F and 0 to 95 psig respectively. During densification operations the liquid temperature will be decreased below the normal boiling point by the refrigerator, and consequently the pressure inside the inner vessel will be sub-atmospheric. These new operational conditions rendered the original certification invalid, so an effort was undertaken to recertify the tank to the new pressure and temperature requirements (-12.7 to 95 psig and -433 F to 100 F respectively) per ASME Boiler and Pressure Vessel Code, Section VIII, Division 1. This paper will discuss the unique design, analysis and implementation issues encountered during the vessel recertification process.

  13. PENINGKATAN AKTIVITAS DAN HASIL BELAJAR IPS MELALUI PENERAPAN METODE PEMBELAJARAN JIGSAW PADA SISWA KELAS VIII B SEMESTER II S M P NEGERI 9 SURAKARTA TAHUN PELAJARAN 2015 / 2016

    Directory of Open Access Journals (Sweden)

    Suparni Suparni

    2017-02-01

    Full Text Available The aim of this research was to improve the student’s activeness and learning outcome of social science subject in the understanding of Indonesian independence struggle through Jigsaw method implementation. The respondents were the students of grade VIII class B at SMP N 9 (State Junior High School 9 Surakarta. The data collection was conducted by interview, documentation, and questionnaire. The research used the interactive technique which was divided into three steps. The steps were, firstly data reduction, secondly data presentation, and thirdly concluding. Before the first cycle of this action research, there were 5 students with low learning activity and 10 students with low learning outcome. The result of the first cycle was the student’s activeness and learning outcome increase 15,62 % or 5 students improved their activeness and learning outcome. In the second cycle, almost all students had high activeness and learning outcome. Therefore, the implementation of Jig Saw method was successful to improve student’s activeness and learning outcome Keywords: Learning Outcome, Activity, Jigsaw

  14. A relativistically broadened O VIII Lyalpha line in the ultra-compact X-ray binary 4U 0614+091

    CERN Document Server

    Madej, O K; Fabian, A C; Pinto, C; Verbunt, F; de Plaa, J

    2010-01-01

    Ultra-compact X-ray binaries consist of a neutron star or black hole that accretes material from a white dwarf-donor star. The ultra-compact nature is expressed in very short orbital periods of less than 1 hour. In the case of 4U 0614+091 oxygen-rich material from a CO or ONe white dwarf is flowing to the neutron star. This oxygen-rich disc can reflect X-rays emitted by the neutron star giving a characteristic emission spectrum. We have analyzed high-resolution RGS and broad band EPIC spectra of 4U 0614+091 obtained by the XMM-Newton satellite. We detect a broad emission feature at ~0.7 keV in both instruments, which cannot be explained by unusual abundances of oxygen and neon in the line of sight, as proposed before in the literature. We interpret this feature as O VIII Lyalpha emission caused by reflection of X-rays off highly ionized oxygen, in the strong gravitational field close to the neutron star.

  15. Mapping Henry: Synchrotron-sourced X-ray fluorescence mapping and ultra-high-definition scanning of an early Tudor portrait of Henry VIII

    Energy Technology Data Exchange (ETDEWEB)

    Dredge, Paula; Ives, Simon [Art Gallery of New South Wales (AGNSW), Sydney, NSW (Australia); Howard, Daryl L.; Spiers, Kathryn M. [Australian Synchrotron, Clayton, VIC (Australia); Yip, Andrew [Art Gallery of New South Wales (AGNSW), Sydney, NSW (Australia); University of New South Wales, Laboratory for Innovation in Galleries, Libraries, Archives and Museums (iGLAM), National Institute for Experimental Arts, Sydney, NSW (Australia); Kenderdine, Sarah [University of New South Wales, Laboratory for Innovation in Galleries, Libraries, Archives and Museums (iGLAM), National Institute for Experimental Arts, Sydney, NSW (Australia)

    2015-11-15

    A portrait of Henry VIII on oak panel c. 1535 has recently undergone technical examination to inform questions regarding authorship and the painting's relationship to a group of similar works in the collections of the National Portrait Gallery, London, and the Society of Antiquaries. Due to previous conservation treatments of the painting, the conventional transmission X-radiograph image was difficult to interpret. As a result, the painting underwent high-definition X-ray fluorescence (XRF) elemental mapping on the X-ray fluorescence microscopy beamline of the Australian Synchrotron. Scans were conducted at 12.6 and 18.5 keV, below and above the lead (Pb) L edges, respectively. Typical scan parameters were 120 μm pixel size at 7 ms dwell time, with the largest scan covering an area 545 x 287 mm{sup 2} collected in 23 h (10.8 MP). XRF mapping of the panel has guided the conservation treatment of the painting and the revelation of previously obscured features. It has also provided insight into the process of making of the painting. The informative and detailed elemental maps, alongside ultra-high-definition scans of the painting undertaken before and after varnish and over-paint removal, have assisted in comparison of the finely painted details with the London paintings. The resolution offered by the combination of imaging techniques identifies pigment distribution at an extremely fine scale, enabling a new understanding of the artist's paint application. (orig.)

  16. The effect of color on the production of responses to Rorschach cards VIII, IX, and X in age groups of 11-12 and 15-16 years.

    Science.gov (United States)

    Silva, Danilo R; Ferreira, Ana Sousa

    2014-01-01

    The effect of color on the production of responses to the Rorschach task has been considered by investigators from 2 different positions: (a) that color has little effect on the production of responses, and (b) that color increases the number of responses. Some previous results found by the current investigators have supported the first position for the last 3 fully colored Rorschach cards (VIII, IX, and X), in children from 5 to 12 years old. Other studies of ours, however, have confirmed the second position for these same cards with a group of young adults 17 to 23 years old. As there was no increase of responses up to age 12, for this study we hypothesized a developmental effect in adolescence such that there would be an increase in the production of responses to the colored Rorschach cards at the age of 15 to 16 years, and this is what the results indicate. From a pragmatic standpoint, these results imply a revision of interpretive meaning for the Color and Affective Ratio variables in children's protocols. Our results also indicate that color cannot be regarded as a means of expression of affect at age 11 to 12 like it will be from age 15 to 16 and on.

  17. Diagnóstico de brucelosis bovina en leche por el Ring Test y ELISA en lecherías de la provincia de Ñuble (VIII Región Bovine brucellosis diagnosis in milk by Ring Test and ELISA in dairy farms of Ñuble (VIII Region, Chile

    Directory of Open Access Journals (Sweden)

    J. LOPEZ

    1998-01-01

    Full Text Available Se utilizaron los métodos de ELISA y Ring Test en leche para diagnosticar brucelosis bovina en estanques de recolección en frío a 60 predios lecheros de la provincia de Ñuble, VIII Región de Chile, durante los meses de noviembre y diciembre de 1995. Estos fueron estratificados en relación al número de vacas en producción de leche. Los resultados obtenidos por ambos métodos fueron similares,18 muestras positivas y 42 negativas. La diferencia se estableció en 5 muestras (8.3% que fueron clasificadas como positivas débiles al Ring Test y confirmadas como positivas por ELISA. Se determinó que la prevalencia predial de brucelosis bovina fue de un 30% en predios lecheros con estanque enfriador en la provincia de Ñuble. El métodode ELISA resultó ser una prueba confiable para diagnosticar brucelosis bovina en leches colectivas.ELISA and Ring Test were compared as diagnostic tests for bovine brucellosis in bulk tank refrigerated milk from 60 dairies in the Ñuble Province, VIII Region, Chile, from November to December. Samples were stratified according to the number of cows in the farm. Diagnosis obtained from both methods gave similar results: 18 positive and 42 negative. The difference was established in 5 samples (8.3% that were classified as weak positive to the Ring Test and confirmed as positives by ELISA. Furthermore, it was determined that there was 30% prevalence of bovine brucellosis in dairies with refrigerated tanks in the Ñuble province. The ELISA proved to be a reliable diagnostic test of bovine brucellosis in bulk milk

  18. Measurement of Blood Coagulation Factor Synthesis in Cultures of Human Hepatocytes.

    Science.gov (United States)

    Heinz, Stefan; Braspenning, Joris

    2015-01-01

    An important function of the liver is the synthesis and secretion of blood coagulation factors. Within the liver, hepatocytes are involved in the synthesis of most blood coagulation factors, such as fibrinogen, prothrombin, factor V, VII, IX, X, XI, XII, as well as protein C and S, and antithrombin, whereas liver sinusoidal endothelial cells produce factor VIII and von Willebrand factor. Here, we describe methods for the detection and quantification of most blood coagulation factors in hepatocytes in vitro. Hepatocyte cultures indeed provide a valuable tool to study blood coagulation factors. In addition, the generation and expansion of hepatocytes or hepatocyte-like cells may be used in future for cell-based therapies of liver diseases, including blood coagulation factor deficiencies.

  19. THE PANCHROMATIC HUBBLE ANDROMEDA TREASURY. VIII. A WIDE-AREA, HIGH-RESOLUTION MAP OF DUST EXTINCTION IN M31

    Energy Technology Data Exchange (ETDEWEB)

    Dalcanton, Julianne J.; Fouesneau, Morgan; Weisz, Daniel R.; Williams, Benjamin F. [Department of Astronomy, Box 351580, University of Washington, Seattle, WA 98195 (United States); Hogg, David W. [Center for Cosmology and Particle Physics, Department of Physics, New York University, 4 Washington Pl #424, New York, NY 10003 (United States); Lang, Dustin [McWilliams Center for Cosmology, Department of Physics, Carnegie Mellon University, 5000 Forbes Ave, Pittsburgh, PA 15213 (United States); Leroy, Adam K. [National Radio Astronomy Observatory, 520 Edgemont Road, Charlottesville, VA 22903 (United States); Gordon, Karl D.; Gilbert, Karoline M. [Space Telescope Science Institute, 3700 San Martin Drive, Baltimore, MD 21218 (United States); Sandstrom, Karin [Steward Observatory, University of Arizona, 933 N Cherry Ave, Tucson, AZ 85721 (United States); Bell, Eric F. [Department of Astronomy, University of Michigan, 500 Church St., Ann Arbor, MI 48109 (United States); Dong, Hui; Lauer, Tod R. [National Optical Astronomy Observatory, 950 North Cherry Avenue, Tucson, AZ 85719 (United States); Gouliermis, Dimitrios A. [Max Planck Institute für Astronomie, Königstuhl 17, D-69117, Heidelberg (Germany); Guhathakurta, Puragra [Department of Astronomy and Astrophysics, University of California Santa Cruz, 1156 High Street, Santa Cruz, CA 95064 (United States); Schruba, Andreas [California Institute of Technology, Cahill Center for Astrophysics, 1200 E. California Blvd, Pasadena, CA 91125 (United States); Seth, Anil C. [University of Utah, Salt Lake City, UT (United States); Skillman, Evan D., E-mail: jd@astro.washington.edu [Minnesota Institute for Astrophysics, University of Minnesota, 116 Church Street SE, Minneapolis, MN 55455 (United States)

    2015-11-20

    We map the distribution of dust in M31 at 25 pc resolution using stellar photometry from the Panchromatic Hubble Andromeda Treasury survey. The map is derived with a new technique that models the near-infrared color–magnitude diagram (CMD) of red giant branch (RGB) stars. The model CMDs combine an unreddened foreground of RGB stars with a reddened background population viewed through a log-normal column density distribution of dust. Fits to the model constrain the median extinction, the width of the extinction distribution, and the fraction of reddened stars in each 25 pc cell. The resulting extinction map has a factor of ≳4 times better resolution than maps of dust emission, while providing a more direct measurement of the dust column. There is superb morphological agreement between the new map and maps of the extinction inferred from dust emission by Draine et al. However, the widely used Draine and Li dust models overpredict the observed extinction by a factor of ∼2.5, suggesting that M31's true dust mass is lower and that dust grains are significantly more emissive than assumed in Draine et al. The observed factor of ∼2.5 discrepancy is consistent with similar findings in the Milky Way by the Plank Collaboration et al., but we find a more complex dependence on parameters from the Draine and Li dust models. We also show that the the discrepancy with the Draine et al. map is lowest where the current interstellar radiation field has a harder spectrum than average. We discuss possible improvements to the CMD dust mapping technique, and explore further applications in both M31 and other galaxies.

  20. Asistencia técnica en el sector agropecuario en México: análisis del VIII censo agropecuario y forestal Technical assistance in the farming sector in Mexico: analysis of the 8th farming and forestry census

    Directory of Open Access Journals (Sweden)

    Venancio Cuevas Reyes

    Full Text Available El objetivo de esta investigación fue determinar a través de la información estadística obtenida por el VIII Censo Agrícola, Ganadero y Forestal del año 2007, la importancia que tiene la asistencia técnica en las unidades de producción en México para contar con elementos que sirvan en la toma de decisiones de éste servicio. Se realizó un análisis de la base de datos a nivel nacional y por zonas económicas a través de la obtención de frecuencias relativas. De acuerdo al Censo, en México, la cobertura de la asistencia técnica es baja, 3% del total nacional de unidades de producción con actividad agropecuaria disponen de este servicio, y sólo 11.7% perciben como problema la falta de asistencia técnica y capacitación. La agricultura cuenta con 75.4% de la asistencia técnica, le sigue el sector pecuario 19.3%, sector forestal 3.2%. El 70.8% de éste servicio es otorgado por técnicos, 17.7% por productores, 2.8% por instituciones académicas o de investigación y en último lugar 1.5% a los despachos. Se concluye que los factores ambientales (pérdidas de la producción por cuestiones climáticas son los elementos que afectan en mayor medida las unidades de producción, en quinto lugar como factor crítico se encuentra la capacitación y asistencia técnica. Las políticas deben considerar la problemática desde el punto de vista del productor para lograr una mayor eficiencia de los recursos destinados a los programas de extensión.The aim of this investigation was to determine, using the statistical information, obtained from the 8th Agriculture, Livestock and Forestry Census 2007, the importance of technical assistance of production units in Mexico to have elements that help in decision-making regarding this service. Databases were analyzed countrywide and by economic areas by obtaining relative frequencies. According to the Census, in Mexico, coverage of technical assistance is low, since only 3% of the del total farming

  1. Dark-ages Reionization & Galaxy Formation Simulation VIII. Suppressed growth of dark matter halos during the Epoch of Reionization

    Science.gov (United States)

    Qin, Yuxiang; Duffy, Alan R.; Mutch, Simon J.; Poole, Gregory B.; Geil, Paul M.; Angel, Paul W.; Mesinger, Andrei; Wyithe, J. Stuart B.

    2017-01-01

    We investigate how the hydrostatic suppression of baryonic accretion affects the growth rate of dark matter halos during the Epoch of Reionization. By comparing halo properties in a simplistic hydrodynamic simulation in which gas only cools adiabatically, with its collisionless equivalent, we find that halo growth is slowed as hydrostatic forces prevent gas from collapsing. In our simulations, at the high redshifts relevant for reionization (between ˜6 and ˜11), halos that host dwarf galaxies (≲ 109M⊙) can be reduced by up to a factor of 2 in mass due to the hydrostatic pressure of baryons. Consequently, the inclusion of baryonic effects reduces the amplitude of the low mass tail of the halo mass function by factors of 2 to 4. In addition, we find that the fraction of baryons in dark matter halos hosting dwarf galaxies at high redshift never exceeds ˜90% of the cosmic baryon fraction. When implementing baryonic processes, including cooling, star formation, supernova feedback and reionization, the suppression effects become more significant with further reductions of ˜30% to 60%. Although convergence tests suggest that the suppression may become weaker in higher resolution simulations, this suppressed growth will be important for semi-analytic models of galaxy formation, in which the halo mass inherited from an underlying N-body simulation directly determines galaxy properties. Based on the adiabatic simulation, we provide tables to account for these effects in N-body simulations, and present a modification of the halo mass function along with explanatory analytic calculations.

  2. Cerebral Vein Thrombosis:Screening of Acquired and Hereditary Thrombophilic Risk Factors

    Directory of Open Access Journals (Sweden)

    Sarraf Payam

    2009-10-01

    Full Text Available Cerebral vein thrombosis (CVT is an infrequent condition with a large variety of causes that can lead to serious disabilities. However, in 20% to 35% of cases, no cause is found. In this study we evaluated the hereditary (P & C Proteins, antithrombin, mutation of prothrombin G20210A and factor V Leiden, other risk factors (hyperhomocycteinemia, factor VIII, ACL-ab, APL-ab, and OCP and clinical manifestations among a population of Iranian patients with CVT. 18 women and 10 men aged 16 to 50 years with CVT were screened for inherited and acquired coagulation risk factors. No one had an abnormal ACL-ab, APL-ab or antithrombin III deficiency. One had prothrombin G20210A mutation (heterozygot (3.6%. Hyperhomocycteinemia was observed in 5 patients (17.9%. APC-R was decreased in 3 (10.7%. 2 had positive factor V Leiden mutation (heterozygot (7.1%. 17 had an increased of factor VIII (60.7. PS and PC deficiencies were each detected in two cases (7.1%. Conclusion: Our study suggests that screening for inherited thrombophilia may be an integral part in the diagnostic workup and duration of treatment in patients with CVT.

  3. Dark-ages Reionization and Galaxy Formation Simulation - VIII. Suppressed growth of dark matter haloes during the Epoch of Reionization

    Science.gov (United States)

    Qin, Yuxiang; Duffy, Alan R.; Mutch, Simon J.; Poole, Gregory B.; Geil, Paul M.; Angel, Paul W.; Mesinger, Andrei; Wyithe, J. Stuart B.

    2017-05-01

    We investigate how the hydrostatic suppression of baryonic accretion affects the growth rate of dark matter haloes during the Epoch of Reionization. By comparing halo properties in a simplistic hydrodynamic simulation in which gas only cools adiabatically, with its collisionless equivalent, we find that halo growth is slowed as hydrostatic forces prevent gas from collapsing. In our simulations, at the high redshifts relevant for reionization (between ˜6 and ˜11), haloes that host dwarf galaxies (≲109 M⊙) can be reduced by up to a factor of 2 in mass due to the hydrostatic pressure of baryons. Consequently, the inclusion of baryonic effects reduces the amplitude of the low-mass tail of the halo mass function by factors of 2-4. In addition, we find that the fraction of baryons in dark matter haloes hosting dwarf galaxies at high redshift never exceeds ˜90 per cent of the cosmic baryon fraction. When implementing baryonic processes, including cooling, star formation, supernova feedback and reionization, the suppression effects become more significant with further reductions of 30-60 per cent. Although convergence tests suggest that the suppression may become weaker in higher resolution simulations, this suppressed growth will be important for semi-analytic models of galaxy formation, in which the halo mass inherited from an underlying N-body simulation directly determines galaxy properties. Based on the adiabatic simulation, we provide tables to account for these effects in N-body simulations and present a modification of the halo mass function along with explanatory analytic calculations.

  4. The Panchromatic Hubble Andromeda Treasury VIII: A Wide-Area, High-Resolution Map of Dust Extinction in M31

    CERN Document Server

    Dalcanton, Julianne J; Hogg, David W; Lang, Dustin; Leroy, Adam K; Gordon, Karl D; Sandstrom, Karin; Weisz, Daniel R; Williams, Benjamin F; Bell, Eric F; Dong, Hui; Gilbert, Karoline M; Gouliermis, Dimitrious A; Guhathakurta, Puragra; Lauer, Tod R; Schruba, Andreas; Seth, Anil C; Skillman, Evan D

    2015-01-01

    We map the distribution of dust in M31 at 25pc resolution, using stellar photometry from the Panchromatic Hubble Andromeda Treasury. We develop a new mapping technique that models the NIR color-magnitude diagram (CMD) of red giant branch (RGB) stars. The model CMDs combine an unreddened foreground of RGB stars with a reddened background population viewed through a log-normal column density distribution of dust. Fits to the model constrain the median extinction, the width of the extinction distribution, and the fraction of reddened stars. The resulting extinction map has >4 times better resolution than maps of dust emission, while providing a more direct measurement of the dust column. There is superb morphological agreement between the new map and maps of the extinction inferred from dust emission by Draine et al. 2014. However, the widely-used Draine & Li (2007) dust models overpredict the observed extinction by a factor of ~2.5, suggesting that M31's true dust mass is lower and that dust grains are sign...

  5. vbyCaHbeta CCD Photometry of Clusters. VIII. The Super-Metal Rich, Old Open Cluster NGC 6791

    CERN Document Server

    Anthony-Twarog, B J; Mayer, L

    2006-01-01

    CCD photometry on the intermediate-band vbyCaHbeta system is presented for the metal-rich, old open cluster, NGC 6791. Preliminary analysis led to [Fe/H] above +0.4 with an anomalously high reddening and an age below 5 Gyr. A revised calibration between (b-y)_0 and [Fe/H] at a given temperature shows that the traditional color-metallicity relations underestimate the color of the turnoff stars at high metallicity. With the revised relation, the metallicity from hk and the reddening for NGC 6791 become [Fe/H] = +0.45 +/- 0.04 and E(b-y) = 0.113 +/- 0.012 or E(B-V) = 0.155 +/- 0.016. Using the same technique, reanalysis of the photometry for NGC 6253 produces [Fe/H] = +0.58 +/-0.04 and E(b-y) = 0.120 +/- 0.018 or E(B-V) = 0.160 +/- 0.025. The errors quoted include both the internal and external errors. For NGC 6791, the metallicity from m_1 is a factor of two below that from hk, a result that may be coupled to the consistently low metal abundance from DDO photometry of the cluster and the C-deficiency found from...

  6. Evidence supporting the use of recombinant activated factor VII in congenital bleeding disorders

    Directory of Open Access Journals (Sweden)

    Pär I Johansson

    2010-06-01

    Full Text Available Pär I Johansson, Sisse R OstrowskiCapital Region Blood Bank, Section for Transfusion Medicine, Rigshospitalet, University of Copenhagen, Copenhagen, DenmarkBackground: Recombinant activated factor VII (rFVIIa, NovoSeven® was introduced in 1996 for the treatment of hemophilic patients with antibodies against coagulation factor VIII or IX.Objective: To review the evidence supporting the use of rFVIIa for the treatment of patients with congenital bleeding disorders.Patients and methods: English-language databases were searched in September 2009 for reports of randomized controlled trials (RCTs evaluating the ability of rFVIIa to restore hemostasis in patients with congenital bleeding disorders.Results: Eight RCTs involving 256 hemophilic patients with antibodies against coagulation factors, also known as inhibitors, were identified. The evidence supporting the use of rFVIIa in these patients was weak with regard to dose, clinical setting, mode of administration, efficacy, and adverse events, given the limited sample size of each RCT and the heterogeneity of the studies.Conclusion: The authors suggest that rFVIIa therapy in hemophilic patients with inhibitors should be based on the individual’s ability to generate thrombin and form a clot, and not on the patient’s weight alone. Therefore, assays for thrombin generation, such as whole-blood thromboelastography, have the potential to significantly improve the treatment of these patients.Keywords: hemophilia, inhibitors, coagulation factor VIII, coagulation factor IX, rFVIIa, NovoSeven, FEIBA, hemostasis, RCT

  7. Ionizing radiation and genetic risks. VIII. The concept of mutation component and its use in risk estimation for multifactorial diseases.

    Science.gov (United States)

    Denniston, C; Chakraborty, R; Sankaranarayanan, K

    1998-08-31

    Multifactorial diseases, which include the common congenital abnormalities (incidence: 6%) and chronic diseases with onset predominantly in adults (population prevalence: 65%), contribute substantially to human morbidity and mortality. Their transmission patterns do not conform to Mendelian expectations. The model most frequently used to explain their inheritance and to estimate risks to relatives is a Multifactorial Threshold Model (MTM) of disease liability. The MTM assumes that: (i) the disease is due to the joint action of a large number of genetic and environmental factors, each of which contributing a small amount of liability, (ii) the distribution of liability in the population is Gaussian and (iii) individuals whose liability exceeds a certain threshold value are affected by the disease. For most of these diseases, the number of genes involved or the environmental factors are not fully known. In the context of radiation exposures of the population, the question of the extent to which induced mutations will cause an increase in the frequencies of these diseases has remained unanswered. In this paper, we address this problem by using a modified version of MTM which incorporates mutation and selection as two additional parameters. The model assumes a finite number of gene loci and threshold of liability (hence, the designation, Finite-Locus Threshold Model or FLTM). The FLTM permits one to examine the relationship between broad-sense heritability of disease liability and mutation component (MC), the responsiveness of the disease to a change in mutation rate. Through the use of a computer program (in which mutation rate, selection, threshold, recombination rate and environmental variance are input parameters and MC and heritability of liability are output estimates), we studied the MC-heritability relationship for (i) a permanent increase in mutation rate (e.g., when the population sustains radiation exposure in every generation) and (ii) a one-time increase

  8. Photometric Properties for Selected Algol-type Binaries. VIII. The Triple Systems DI Peg and AF Gem Revisited

    Science.gov (United States)

    Yang, Yuan-Gui; Yang, Ying; Li, Shu-Zheng

    2014-06-01

    New extensive photometry for two triple binary stars, DI Peg and AF Gem, was performed from 2012 October to 2013 January, with two small telescopes at Xinglong station (XLs) of NAOC. From new multi-color observations and previously published ones in literature, the photometric models were (re)deduced using the updated Wilson-Devinney code. The results indicated that the low third lights exist in two classic Algol-type binaries, whose fill-out factors for the more massive components are fp = 78.2(± 0.4)% for DI Peg, and fp = 69.0(± 0.3)% for AF Gem, respectively. Through analyzing the O-C curves, the orbital periods for two binaries change in the complicated mode. The period of DI Peg possibly appears to show two light-time orbits, whose modulated periods are P 3 = 54.6(± 0.5) yr and P 4 = 23.0(± 0.6) yr, respectively. The inferred minimum masses for the inner and outer sub-stellar companions are M in = 0.095 M ⊙ and M out = 0.170 M ⊙, respectively. Therefore, DI Peg may be a quadruple star. The orbital period of AF Gem appears to show a continuous period decrease or a cyclic variation; the latter may be preferable. The cyclic oscillation, with a period of 120.3(± 2.5) yr, may be attributed to the light-time effect due to the third body. This kind of additional companion may extract angular momentum from the central system, which may play a key role in the evolution of the binary.

  9. Anatomy of the AGN in NGC 5548. VIII. XMM-Newton's EPIC detailed view of an unexpected variable multilayer absorber

    Science.gov (United States)

    Cappi, M.; De Marco, B.; Ponti, G.; Ursini, F.; Petrucci, P.-O.; Bianchi, S.; Kaastra, J. S.; Kriss, G. A.; Mehdipour, M.; Whewell, M.; Arav, N.; Behar, E.; Boissay, R.; Branduardi-Raymont, G.; Costantini, E.; Ebrero, J.; Di Gesu, L.; Harrison, F. A.; Kaspi, S.; Matt, G.; Paltani, S.; Peterson, B. M.; Steenbrugge, K. C.; Walton, D. J.

    2016-07-01

    In 2013, we conducted a large multi-wavelength campaign on the archetypical Seyfert 1 galaxy NGC 5548. Unexpectedly, this usually unobscured source appeared strongly absorbed in the soft X-rays during the entire campaign, and signatures of new and strong outflows were present in the almost simultaneous UV HST/COS data. Here we carry out a comprehensive spectral analysis of all available XMM-Newton observations of NGC 5548 (precisely 14 observations from our campaign plus three from the archive, for a total of ~763 ks) in combination with three simultaneous NuSTAR observations. We obtain a best-fit underlying continuum model composed by i) a weakly varying flat (Γ ~ 1.5-1.7) power-law component; ii) a constant, cold reflection (FeK + continuum) component; iii) a soft excess, possibly owing to thermal Comptonization; and iv) a constant, ionized scattered emission-line dominated component. Our main findings are that, during the 2013 campaign, the first three of these components appear to be partially covered by a heavy and variable obscurer that is located along the line of sight (LOS), which is consistent with a multilayer of cold and mildly ionized gas. We characterize in detail the short timescale (mostly ~ks-to-days) spectral variability of this new obscurer, and find it is mostly due to a combination of column density and covering factor variations, on top of intrinsic power-law (flux and slope) variations. In addition, our best-fit spectrum is left with several (but marginal) absorption features at rest-frame energies ~6.7-6.9 keV and ~8 keV, aswell as a weak broad emission line feature redwards of the 6.4 keV emission line. These could indicate a more complex underlying model, e.g. a P-Cygni-type emission profile if we allow for a large velocity and wide-angle outflow. These findings are consistent with a picture where the obscurer represents the manifestation along the LOS of a multilayer of gas, which is also in multiphase, and which is likely outflowing at

  10. Clinical chorioamnionitis at term VIII: a rapid MMP-8 test for the identification of intra-amniotic inflammation.

    Science.gov (United States)

    Chaiyasit, Noppadol; Romero, Roberto; Chaemsaithong, Piya; Docheva, Nikolina; Bhatti, Gaurav; Kusanovic, Juan Pedro; Dong, Zhong; Yeo, Lami; Pacora, Percy; Hassan, Sonia S; Erez, Offer

    2017-07-26

    Clinical chorioamnionitis is the most common infection/inflammatory process diagnosed in labor and delivery units worldwide. The condition is a syndrome that can be caused by (1) intra-amniotic infection, (2) intra-amniotic inflammation without demonstrable microorganisms (i.e. sterile intra-amniotic inflammation), and (3) maternal systemic inflammation that is not associated with intra-amniotic inflammation. The presence of intra-amniotic inflammation is a risk factor for adverse maternal and neonatal outcomes in a broad range of obstetrical syndromes that includes clinical chorioamnionitis at term. Although the diagnosis of intra-amniotic infection has relied on culture results, such information is not immediately available for patient management. Therefore, the diagnosis of intra-amniotic inflammation could be helpful as a proxy for intra-amniotic infection, while results of microbiologic studies are pending. A rapid test is now available for the diagnosis of intra-amniotic inflammation, based on the determination of neutrophil collagenase or matrix metalloproteinase-8 (MMP-8). The objectives of this study were (1) to evaluate the diagnostic indices of a rapid MMP-8 test for the identification of intra-amniotic inflammation/infection in patients with the diagnosis of clinical chorioamnionitis at term, and (2) to compare the diagnostic performance of a rapid MMP-8 test to that of a conventional enzyme-linked immunosorbent assay (ELISA) interleukin (IL)-6 test for patients with clinical chorioamnionitis at term. A retrospective cohort study was conducted. A transabdominal amniocentesis was performed in patients with clinical chorioamnionitis at term (n=44). Amniotic fluid was analyzed using cultivation techniques (for aerobic and anaerobic bacteria as well as genital Mycoplasmas) and broad-range polymerase chain reaction (PCR) coupled with electrospray ionization mass spectrometry (PCR/ESI-MS). Amniotic fluid IL-6 concentrations were determined by ELISA, and rapid

  11. Evolución trófica de Laguna Grande de San Pedro (VIII Región, Chile durante el último siglo, mediante el análisis de registros sedimentarios Trophic evolution of Laguna Grande de San Pedro (VIII Region, Chile during the last century, by means of the analysis of sedimentary records

    Directory of Open Access Journals (Sweden)

    FABIOLA CRUCES

    2001-06-01

    Full Text Available La presente investigación realizó una reconstrucción de la evolución trófica de Laguna Grande de San Pedro (VIII Región, Chile durante el último siglo, a través del análisis estratigráfico de diatomeas y registros geoquímicos preservados en un núcleo de sedimento obtenido en el lago. Los resultados obtenidos señalan que la comunidad de diatomeas ha variado su composición a través del tiempo, reconociéndose cuatro períodos distintos, que representan cada uno de ellos una condición trófica diferente. Por otra parte, los registros geoquímicos aumentan sus tasas de acumulación hacia los estratos superficiales del perfil, evidenciando un aumento de la productividad hacia la actualidad. De acuerdo a lo anterior, es posible concluir que la productividad de Laguna Grande ha experimentado importantes cambios, evolucionando desde un sistema oligo-mesotrófico (período más antiguo a uno eutrófico (período reciente. Los cambios más drásticos habrían sucedido en las últimas décadas, como respuesta al fuerte desarrollo de actividades forestales y de urbanización en la cuenca de este sistemaThis research reconstructs the trophic evolution of Laguna Grande de San Pedro (VIII Region, Chile during the last century, through both the stratigraphic analyses of diatom remains and geochemical parameters preserved in a sediment core obtained in this lake. The results obtained show that the community of diatoms has changed its composition throughout time, showing four different periods, representing each one a distinctive trophic condition. On the other hand, the geochemical records increase their accumulation rates to the profile surface layers, making evident an increase of the productivity to the present time. In this context, it is possible to conclude that the productivity at Laguna Grande has experienced significant changes, evolving from an oligo-mesotrophic system (earlier period to an eutrophic one (recent period. The most drastic

  12. PENGARUH PENGGUNAAN MODEL COOPERATIVE LEARNING TIPE GROUP INVESTIGATION (GI TERHADAP HASIL BELAJAR IPS TERPADU KELAS VIII SEMESTER GENAP SMPYPI 1 BANDAR MATARAM LAMPUNG TENGAH T.P 2015/2016

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    Desi Fatmawati Maryatun

    2016-05-01

    Full Text Available Metode cooperative learning tipe group investigation merupakan model pembelajaran kooperatif yang dapat melibatkan peserta didik secara aktif dalam kegiatan pembelajaran mulai dari merencanakan topik-topik yang akan dipelajari, bagaimana melaksanakan investigasinya, hingga melakukan presentasi kelompok dan evaluasi. Tujuan penelitian ini adalah untuk mengetahui adanya pengaruh penggunaan model pembelajaran cooperative learning tipe Group Investigation terhadap hasil belajar IPS Terpadu peserta didik kelas VIII semester genap SMP YPI 1 Bandar Mataram  Lampung Tengah tahun pelajaran 2015/2016. Hipotesis yang penulis ajukan adalah “Ada pengaruh yang positif pada model pembelajaran cooperative learning tipe Group Investigation terhadap hasil belajar IPS Terpadu peserta didik kelas VIII semester genap SMP YPI 1 Bandar Mataram  Lampung Tengah tahun pelajaran 2015/2016. Populasi dalam penelitian ini adalah siswa kelas VIII SMP YPI 1 Bandar Mataram Lampung Tengah Tahun Pelajaran 2015/2016 yaitu berjumlah 48 orang siswa dan diantaranya terdiri dari 2 kelas. Dan yang menjadi sampel dalam penelitian ini adalah kelas VIIIa dan VIIIb. Kelas VIIIa sebagai kelas eksperimen dan kelas VIIIb sebagai kelas control, sampel diambil menggunakan teknik purposive sampling, Eksperimen dilaksanakan pada siswa kelas VIIIa Semester Genap SMP YPI 1 Bandar Mataram Lampung Tengah Tahun Pelajaran 2015/2016 yang berjumlah 24 peserta didik. Data penelitian ini dikumpulkan dengan menggunakan  metode observasi, wawancara, dokumentasi, dan tes. Sedangkan untuk mengetahui tingkat validitas dan reliabilitas penulis menggunakan rumus K-R 20. Kemudian untuk menguji/membuktikan hipotesis digunakan rumus Regresi Linier Sederhana yaitu  Ŷ = a + bx. Nilai Ŷ = 73,33+ 0,5 X yang dilanjutkan dengan rumus thitung > ttabel.pada daftar signifikan 5% yaitu 4 > 1,72  dan pada taraf signifikan 1% yaitu 4 > 2,52. Dengan demikian hipotesisnya diterima karena ada pengaruh yang positif

  13. TIRO Y LAS FLUCTUACIONES DE LA ECONOMÍA FENICIA DURANTE EL SIGLO VIII ANTES DE NUESTRA ERA (Tyre and the Fluctuations of Phoenician Economy during the 8th Century BC

    Directory of Open Access Journals (Sweden)

    Pascual Izquierdo-Egea

    2014-12-01

    Full Text Available La aplicación del método de valoración contextual al análisis de los ajuares funerarios hasta ahora publicados de la necrópolis fenicia de Tiro-Al Bass, Líbano, permite aislar las fluctuaciones económicas y los cambios sociales experimentados por la población tiria durante el siglo VIII a. C. En concreto, se detecta una larga prosperidad desde mediados del siglo IX hasta mediados del VIII antes de nuestra era, con un máximo de bonanza a lo largo del periodo 775-750 a. C. En cambio, la segunda mitad del siglo VIII muestra una aguda crisis económica asociada a una elevada conflictividad social. Estos resultados coinciden plenamente con los acontecimientos históricos conocidos a través de las fuentes literarias antiguas, aportando evidencias que las complementan. En todo caso, con este nuevo ejemplo se confirma, una vez más, la universalidad de la metodología empleada y su irrefutable validez científica. ENGLISH: By applying the contextual valuation method to the analysis of grave goods from the Phoenician cemetery of Tyre-Al Bass, Lebanon, we can isolate the economic fluctuations and social changes experienced by the Tyrian population during the 8th century BC. Based on the evidence, the mid-9th to the mid-8th century BC was a period of prosperity, with the most pronounced economic boom between 775-750 BC. In contrast, the second half of the 8th century BC shows a sharp economic crisis associated with a high level of social conflict. These results are fully consistent with the historical events known through ancient literary sources. This new example confirms the universality of this methodology and its irrefutable scientific validity.

  14. Non-genetic risk factors and their influence on the management of patients in the clinic.

    Science.gov (United States)

    Álvarez, Teresa; Soto, Immaculada; Astermark, Jan

    2015-02-01

    The development of inhibitors is the most serious iatrogenic complication affecting patients with haemophilia. This complication is associated with impaired vital or functional prognosis, reduced quality of life and increased cost of treatment. The reasons why some patients develop antibodies to factor replacement and others do not remain unclear. It is however clear that inhibitor development results from a complex multifactorial interaction between genetic and non-genetic risk factors. Environmental influences implicated in increasing the risk of inhibitor formation can be viewed as modifiable risk factors. Therefore, identification of the non-genetic risk factors may offer the possibility of personalising haemophilia therapy by modifying treatment strategies in high-risk patients in the critical early phase of factor VIII exposure. In this article, we review the non-genetic factors reported as well as the potential impact of danger signals and the different scores for inhibitor development risk stratification.

  15. Dinàmiques socials en l'àmbit rural al nord de la Península Ibèrica (segles VI-VIII dne)un estat de la qüestió

    OpenAIRE

    Gonzalo Arango, Xavier

    2008-01-01

    L'Arqueologia Medieval, malauradament, no ha estat una realitat fins a temps relativament recents. Fins aleshores, aquesta havia estat més interessada - pel període de temps comprès entre els segles VI-VIII - en castells, necròpolis i esglésies, que en sistemes de producció i relacions socials. El que busquem amb aquest article és mostrar quins són els debats arqueològics actuals, per tal de determinar les possibilitats del registre la metodlogia i els objectius de l'arqueologia. Real Medi...

  16. «Ladinia», Sföi cultural dai Ladins dies Dolomites, numm.V. (1981- VIII (1984, Institut Ladin «Micurà de Rü”, San Martin de Tor, Piccolino (Val Badia.

    Directory of Open Access Journals (Sweden)

    Pavao Tekavčić

    1986-12-01

    Full Text Available La rivista «Ladinia», le cui prime quattro annate sono state recensite in «Linguistica» 21 (1981, pp. 325-331, continua ad uscire, conservando il suo profilo, Ia vastità degli argomenti che concernono il mondo ladino ed arricchendosi an­ che di rubriche nuove. Offriamo ai lettori Ia recensione delle annate 1981-1984, concentrandoci anche qui sui contributi linguistici (tanto piu che nei numeri V-VIII, e particolarmente negli ultimi due, i contributi di argomento linguistico occupano più spazio di prima.

  17. PENINGKATAN AKTIVITAS DAN HASIL BELAJAR BENTUK PASAR DENGAN METODE COURSE REVIEW HORAY (CRH BERBANTUAN MEDIA GAMBAR KELAS VIII SMP N 1 BULU KABUPATEN SUKOHARJO

    Directory of Open Access Journals (Sweden)

    Setyaningsih Setyaningsih

    2013-11-01

    Full Text Available Penelitian ini bertujuan untuk meningkatkan aktivitas dan hasil belajar siswa pada materi bentuk pasar dengan metode Course Review Horay (CRH berbantuan media gambar kelas VIII SMP N 1 Bulu Kabupaten Sukoharjo. Jenis penelitian ini adalah penelitian tindakan kelas yang terdiri dari dua siklus. Setiap siklus memiliki empat tahap yaitu perencanaan, pelaksanaan, pengamatan, dan refleksi. Subjek penelitian ini adalah siswa kelas VIIIA SMP N 1 Bulu. Data aktivitas siswa dan guru diperoleh dari lembar observasi. Data hasil belajar diperoleh dari soal evaluasi siklus I dan siklus II. Berdasarkan hasil penelitian diperoleh aktivitas siswa siklus I sebesar 70,83% meningkat menjadi 87,50% pada siklus II. Sedangkan aktivitas guru dalam siklus I sebesar 71,86% meningkat menjadi 90,6% pada siklus II. Rata-rata hasil belajar kognitif menunjukkan pada siklus I sebesar 72,67 meningkat menjadi 83,20 pada siklus II. Sedangkan ketuntasan klasikal pada siklus I sebesar 70% meningkat menjadi 83,33% pada siklus II. Dari hasil penelitian tersebut dapat disimpulkan bahwa terjadi peningkatan aktivitas dan hasil belajar siswa pada materi bentuk pasar dengan metode Course Review Horay (CRH berbantuan media gambar siswa kelas VIIIA SMP N 1 Bulu Kabupaten Sukoharjo. This research is aimed to increasing activity and student learning results in the subject matter of market forms material by using Course Review Horay (CRH method and image as media in VIIIA class of SMP N 1 Bulu. The design is Classroom Action Research (CAR consisting of two cycles, each cycle including planning, action, observation and reflection. The subjects of research were 30 students of the VIIIA class of SMP N 1 Bulu. Student and teacher activity data were obtained from observation sheet. Results learning data were obtained from test evaluation of the first cycle and second cycle. Based on the results research was obtained in the first cycle of student activities at 70,83% increased to 87,50 in the

  18. 31. VIII avati Vaala galeriis...

    Index Scriptorium Estoniae

    2004-01-01

    Näitus "Märkmed maalist. Eesti ja Leedu noor kunst". Kuraatorid Margaret Tali ja Milda Zvirblyte. Osalevad Maarit Murka, Tõnis Saadoja, Kristi Laanemäe, Vilius Vanagas, Agile Mazonaite, Jolanta Kyzikaite, Ieva Baranauskaite. Kõlab Taavi Laatsiti originaalmuusika

  19. 24. VIII avati Eesti meremuuseumis...

    Index Scriptorium Estoniae

    2005-01-01

    Mallorcal elava eesti kunstniku Erik Schmidti elu ja kirjandusliku loomingu näitus. Kunstnik andis Eesti Kaitsejõudude staabile üle admiral Pitka portree. Koos Vaal-galeriiga kavandatavasse 2006. a. Mallorcal toimuvasse E. Schmidti juhendatavasse eesti maalikunstnike laagrisse sõidavad Maarit Murka, Anna Litvinova, Lauri Sillak (Laurentsius), Karl Nagel ja Rait Rosin

  20. 31. VIII avati Vaala galeriis...

    Index Scriptorium Estoniae

    2004-01-01

    Näitus "Märkmed maalist. Eesti ja Leedu noor kunst". Kuraatorid Margaret Tali ja Milda Zvirblyte. Osalevad Maarit Murka, Tõnis Saadoja, Kristi Laanemäe, Vilius Vanagas, Agile Mazonaite, Jolanta Kyzikaite, Ieva Baranauskaite. Kõlab Taavi Laatsiti originaalmuusika

  1. VIII.- Bibliografía

    OpenAIRE

    2013-01-01

    AMAO MANRIQUEZ Jorge Luis. "Sonora y Baja California: la huelga de Cananea y su impacto en Santa Rosalía", en Memoria del Simposio de Historia y Antropología de Sonora, Instituto de Investigaciones Históricas. Hermosillo, Sonora; 1985. "La revolución en Baja California Sur. Memoria de la IX y X Semana de Información Histórica de Baja California Sur, La Paz, B.C. Sur; 1987. "Apuntes para formar la Estadística Minera de la República Mexicana". Anales del Ministerio de Fomento, Tomo V. 1880. BAJ...

  2. 《刑法修正案(八)》若干立法完善之建议%Suggestions on the Legislative Perfection of "Amendment VIII to the Criminal Law"

    Institute of Scientific and Technical Information of China (English)

    陈光明

    2012-01-01

    The passing and implementation of "Amendment VIII to the Criminal Law" promote the scientific and legislative construction, as well as the socialization, of modern prisons. It will produce an important impact on the punishment and reconstruction role of Chinese prisons. However, while we affirm the positive effects of "Amend- ment VIII to the Criminal Law", we should not neglect its defects on such legislative aspects as "major meritorious performance", "not less than", "pardon system", and "community correction" so as to perfect the amendment.%《刑法修正案(八)》的通过与实施,助推了现代监狱的行刑科学化、法制化和社会化的建设.对我国监狱的惩罚与改造将产生极其重要的影响。但是在肯定《刑法修正案(八)》积极作用的同时,其在“重大立功表现”、“不能少于”、“赦免制度”和“社区矫正”等若干立法方面,也存在着不可忽略的缺陷,祈望刑法的修正能更为完备。

  3. Stellar laboratories. VIII. New Zr IV - VII, Xe IV - V, and Xe VII oscillator strengths and the Al, Zr, and Xe abundances in the hot white dwarfs G191-B2B and RE0503-289

    CERN Document Server

    Rauch, T; Quinet, P; Loebling, L; Hoyer, D; Werner, K; Kruk, J W; Demleitner, M

    2016-01-01

    For the spectral analysis of high-resolution and high-signal-to-noise spectra of hot stars, state-of-the-art non-local thermodynamic equilibrium (NLTE) model atmospheres are mandatory. These are strongly dependent on the reliability of the atomic data that is used for their calculation. To search for Zr and Xe lines in the ultraviolet (UV) spectra of G191-B2B and RE0503-289, new Zr IV-VII, Xe IV-V, and Xe VIII oscillator strengths were calculated. This allows for the first time, determination of the Zr abundance in white dwarf (WD) stars and improvement of the Xe abundance determinations. We calculated Zr IV-VII, Xe IV-V, and Xe VIII oscillator strengths to consider radiative and collisional bound-bound transitions of Zr and Xe in our NLTE stellar-atmosphere models for the analysis of their lines exhibited in UV observations of the hot WDs G191-B2B and RE0503-289. We identified one new Zr IV, 14 new Zr V, and ten new Zr VI lines in the spectrum of RE0503-289. Zr was detected for the first time in a WD. We mea...

  4. COLONIZAÇÃO OU DIÁSPORAS? RESENHA C.-G. SCHWENTZEL (org., M. DANA, St.LEBRETON, Fr.PRÊTEUX, Les diásporas grecques VIII-III s. Paris, Atlande, 2012, 446 páginas, 25 euros. (Dossiê: O Mundo Antigo: Literatura e Historiografia

    Directory of Open Access Journals (Sweden)

    José Antonio Dabdab Trabulsi

    2015-09-01

    Full Text Available C.-G. SCHWENTZEL (org., M. DANA, St.LEBRETON, Fr.PRÊTEUX, Les diásporas grecques VIII-III s. Paris, Atlande, 2012, 446 páginas, 25 euros.C.-G. SCHWENTZEL (org., M. DANA, St.LEBRETON, Fr.PRÊTEUX, Les diásporas grecques VIII-III s. Paris, Atlande, 2012, 446 páginas, 25 euros. Recebido em: 02/04/2015  – Aceito em 13/05/2015

  5. Variabilidad espacial y temporal en la hidrografía invernal del sistema de bahías frente a la VIII región (Chile centro-sur Spatial and temporal variability of winter hydrography in the bay system off the VIII region (central-south Chile

    Directory of Open Access Journals (Sweden)

    PATRICIA FAÚNDEZ-BÁEZ

    2001-12-01

    Full Text Available En la zona centro-sur de Chile (VIII región existe un sistema de bahías (~ 36°30'-37° S, que incluye las bahías de Concepción (BC, San Vicente (BSV y Coronel en el sector oriental del Golfo de Arauco (SOGA, conocido como un importante centro de desove y reclutamiento de especies de peces durante el período invernal. En el presente estudio se analizó la variabilidad hidrográfica (temperatura, salinidad y estratificación, en la dimensión espacial (dentro y entre bahías y temporal (entre años de muestreo, así como su relación con las condiciones meteorológicas (viento y precipitaciones y aporte fluvial (caudal de ríos, durante el período invernal (julio-agosto entre 1993 y 1996. A nivel superficial (1 m y estrato 1-10 m las tres bahías mostraron heterogeneidad espacial en las distribuciones de temperatura y salinidad, especialmente entre las zonas del saco y la boca. A este nivel, además, los menores valores de temperatura y salinidad ocurrieron generalmente en SOGA, la que además presentó una mayor estratificación por efecto de la presencia de aguas de mayor dilución (The central-south area of Chile (VIII region presents a system of bays (~36°30'-37º S, including the bays of Concepcion (BC, San Vicente (BSV and Coronel in the eastern boundary of the Gulf of Arauco (SOGA. This system has been recognized as an important center for the spawning and recruitment of fish species during the winter. In the present study the hydrographic variability (temperature, salinity and density, both in space (inside and between the bays and time (between sampling years, during the winter period (July-August between 1993 and 1996, was analyzed. As well, its relationship to the meteorological conditions (wind and rainfall and fluvial contribution (river discharge was explored. At the surface level (1 m and 1-10 m depth stratum, the three bays showed spatial heterogeneity in temperature and salinity distributions, especially between the inner

  6. Factoring nonviral gene therapy into a cure for hemophilia A.

    Science.gov (United States)

    Gabrovsky, Vanessa; Calos, Michele P

    2008-10-01

    Gene therapy for hemophilia A has fallen short of success despite several clinical trials conducted over the past decade. Challenges to its success include vector immunogenicity, insufficient transgene expression levels of Factor VIII, and inhibitor antibody formation. Gene therapy has been dominated by the use of viral vectors, as well as the immunogenic and oncogenic concerns that accompany these strategies. Because of the complexity of viral vectors, the development of nonviral DNA delivery methods may provide an efficient and safe alternative for the treatment of hemophilia A. New types of nonviral strategies, such as DNA integrating vectors, and the success of several nonviral animal studies, suggest that nonviral gene therapy has curative potential and justifies its clinical development.

  7. Molecular defect in factor IXBm Lake Elsinore. Substitution of Ala390 by Val in the catalytic domain.

    Science.gov (United States)

    Spitzer, S G; Pendurthi, U R; Kasper, C K; Bajaj, S P

    1988-08-05

    Earlier studies with factor IXBm Lake Elsinore (IXBmLE), a nonfunctional variant of factor IX, suggested that the defect in this protein may reside in the catalytic domain of the molecule (Usharani, P., Warn-Cramer, B. J., Kasper, C. K., and Bajaj, S. P. (1985) J. Clin. Invest. 75, 76-83). In this report, genomic DNA fragments from normal IX and IXBmLE alleles were cloned into phage lambda EMBL3 and the recombinant phage identified using normal IX cDNA and synthetic oligonucleotides. Exons VI, VII, and VIII of normal IX and IXBmLE gene were also amplified using a newly developed primer-directed polymerase chain reaction method. All eight exons and flanking regions of the normal IX and IXBmLE gene were sequenced by the dideoxy chain termination method. Comparison of the normal IX and IXBmLE sequences revealed a single base substitution (C----T) in the exon VIII of the BmLE variant, which results in the replacement of Ala390 by Val in the variant molecule. Although this mutation is in the catalytic domain of the molecule, purified factor IXaBmLE is indistinguishable from normal IXa in its activity toward a small synthetic substrate, L-tosylarginine methyl ester. These data, coupled with the previous data, identify a region (around residue 390) in the normal factor IXa which appears to play a major role in the extended macromolecular substrate binding site.

  8. La inestabilidad política de los reyes visigodos de Toledo (s. VI-VIII: balance historiográfico y nueva propuesta de análisis

    Directory of Open Access Journals (Sweden)

    Sabrina Soledad Orlowski

    2012-03-01

    Full Text Available La inestabilidad política regia visigoda es un fenómeno tan constante en la documentación de los siglos VI-VIII que motiva una investigación para dar cuenta de sus principios estructurales. Se propone que la evolución política de la realeza visigoda corresponde a lógicas de funcionamiento de las aristocracias en sociedades de dominación incompleta, que expresan una dinámica general de la temprana Edad Media. Las opiniones de los autores sobre este fenómeno son tan variadas que se vuelve imperioso realizar un balance del estado de la investigación, detectar los problemas existentes y, lo más importante, delinear una línea de trabajo a seguir

  9. PENERAPAN METODE DISKUSI SYNDICATE GROUP UNTUK MENINGKATKAN AKTIVITAS DAN HASIL BELAJAR PADA POKOK BAHASAN MENDESKRIPSIKAN HUBUNGAN ANTARA KELANGKAAN SUMBER DAYA DENGAN KEBUTUHAN MANUSIA YANG TIDAK TERBATAS SISWA KELAS VIII B DI SMP NEGERI 2 BANYUBIRU

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    Meita Lusianti

    2013-11-01

    Full Text Available Aktivitas siswa dalam kegiatan belajar mengajar di SMP Negeri 2 Banyubiru belum terlihat optimal. Proses pembelajaran berpusat pada guru sehingga siswa belum terlibat langsung untuk aktif dalam pembelajaran. Kondisi tersebut mempengaruhi hasil penerimaan siswa terhadap materi pembelajaran yang berakibat rendahnya hasil ulangan harian siswa. Penelitian ini bertujuan untuk meningkatkan aktivitas dan hasil belajar siswa. Penelitian ini dilaksanakan dalam 2 (dua siklus. Kegiatan dalam setiap siklus meliputi kegiatan perencanaan, pelaksanaan, observasi, dan refleksi. Hasil penelitian diperoleh nilai rata-rata hasil belajar kognitif siswa pada siklus I sebesar 72,93 dengan ketuntasan klasikal 67%. Rata-rata hasil belajar pada siklus II sebesar 79,20 dengan ketuntasan klasikal 90%. Adapun hasil analisis aktivitas siswa pada siklus I mencapai 61% dan pada siklus II meningkat menjadi 81%. Berdasarkan hasil penelitian tersebut, dapat diambil kesimpulan bahwa penerapan metode diskusi Syndicate Group dapat peningkatan aktivitas dan hasil belajar siswa kelas VIII B SMP Negeri 2 Banyubiru tahun ajaran 2013/2014. Student activity in learning activities at SMP Negeri 2 Banyubiru seen optimum yet. Learning proces centre on teacher so the student not involve direct to active in the learning. That condition influential student outcome about learning material that come about student daily test outcome low. The research as a purpose to increase activity and student outcome learning. This research doing on two cycle. Activity in every cycle includes planning, implementation, observation, and reflection. Research result got average of cognitive learning outcome in cycle I is 72,93 with classical totally 67%. Average of learning outcome in cycle II is 79,20 with classical totally 90%. There is student activity analysis outcome on cycle I reach 61% and on cycle II rises become 81%. Grounded on research result that, be able take conclusion that implementation Syndicate

  10. Switching clotting factor concentrates: considerations in estimating the risk of immunogenicity.

    Science.gov (United States)

    Matino, D; Lillicrap, D; Astermark, J; Dolan, G; Kessler, C; Lambert, T; Makris, M; O'Donnell, J; Pipe, S; Santagostino, E; Saint-Remy, J-M; Schramm, W; Iorio, A

    2014-03-01

    The development of neutralizing antibodies to factor VIII (FVIII) is the most serious complication of therapy for haemophilia A. There is now excellent documentation that a large number of both genetic and environmental factors contribute to the risk of FVIII inhibitor incidence. One of the environmental factors that has been proposed as an influence on this complication is the occurrence of FVIII product switching. There are only a small number of clinical studies that have addressed this question, and thus, the amount of objective information available to assess this association is limited. In this review, in addition to summarizing past evidence pertinent to this subject, we present the results of a complementary strategy, a Delphi analysis, to add to the considerations of product switching and FVIII immunogenicity. With the imminent arrival in the clinic of several new FVIII products, the haemophilia community must be prepared to collect prospectively controlled data to better address this important management issue.

  11. Testosterone, anastrozole, factor V Leiden heterozygosity and osteonecrosis of the jaws.

    Science.gov (United States)

    Pandit, Ramesh S; Glueck, Charles J

    2014-04-01

    Our specific aim is to describe the development of thrombotic osteonecrosis of the jaws after testosterone-anastrozole therapy in a 55-year-old white man subsequently found to have previously undiagnosed factor V Leiden heterozygosity. Before the diagnosis of V Leiden heterozygosity, he was given testosterone gel, 50 mg/day, and on testosterone, serum testosterone (963 ng/dl) and estradiol were high (50 pg/ml). Anastrozole was started, and testosterone was continued. Six months later, osteonecrosis of the jaws was diagnosed. Exogenous testosterone is aromatized to estradiol and estradiol-induced thrombophilia, when superimposed on underlying familial thrombophilia, as in this case, may lead to thrombosis and osteonecrosis. We recommend that before giving testosterone, at a minimum, screening for the factor V Leiden and G20210A mutations, and factor VIII and XI activity be carried out, to avoid unanticipated thrombosis.

  12. Hypercortisolism and pregnancy upregulate von Willebrand factor through different mechanisms: report on a pregnant patient with Cushing's syndrome.

    Science.gov (United States)

    Casonato, Alessandra; Daidone, Viviana; Pontara, Elena; Albiger, Nora; Cattini, Maria G; Scaroni, Carla

    2010-07-01

    Von Willebrand factor (VWF) is reportedly increased in pregnancy and Cushing's syndrome, inducing a hypercoagulable state. In Cushing's syndrome, VWF gene promoter polymorphisms modulate cortisol-dependent VWF upregulation, haplotype 1 (GCAG) and short GT-repeats (GT)(S) being the susceptible, and haplotype 2 (CTGA) and long GT-repeats (GT)(L) the protective pattern. We report on a Cushing's syndrome patient who became pregnant under hypercortisolism, in whom we monitored the evolution of her hypercoagulable state. During the active phase of Cushing's syndrome, the patient's VWF and factor VIII concentrations were normal, despite high urinary-free cortisol levels consistent with the presence of haplotype 2 and (GT)(L) alleles in the VWF gene promoter. VWF and factor VIII increased significantly and progressively after she became pregnant and peaked just before delivery, returning to normal 5 months later, while her hypercortisolism persisted. Our data indicate that two different mechanisms upregulate VWF under hypercortisolism and pregnancy, the latter being independent of the VWF promoter haplotypes sensitive to cortisol excess.

  13. Meningkatkan Ketuntasan Hasil Belajar Peserta Didik Kelas VIII-F SMP Negeri 33 Surabaya Melalui Penerapan Model Pengajaran Langsung Dengan Kegiatan Laboratorium Mini Pada Materi Pembentukan Harga Pasar

    Directory of Open Access Journals (Sweden)

    Mudjianingsih .

    2017-01-01

    Full Text Available Penelitian ini dilaksanakan dengan latar belakang masih banyak kesulitan  yang ditemui peserta didik dalam mempelajari IPS. Berdasarkan observasi yang telah dilakukan, pembelajaran di kelas VIII-F SMPN 33 Surabaya menggunakan metode ceramah dan tanya jawab. Penerapan metode ini menjadikan peserta didik hanya sebagai obyek belajar, peserta didik yang duduk di belakang cenderung pasif dan kemungkinan hasil belajarnya tidak tuntas. Untuk mengatasi pemasalahan tersebut peneliti mengunakan model pengajaran langsung dengan kegiatan praktikum. Kegiatan praktikum ini merupakan bagian pengetahuan prosedural. Penelitian ini adalah penelitian tindakan kelas dengan tahapan  berupa rancangan, kegiatan dan pengamatan, refleksi dan revisi. Penelitian ini terdiri dari 3 putaran. Data penelitian diambil dengan menggunakan lembar observasi dan tes yang dilakukan pada bulan Maret s/d April 2013. Berdasarkan analisis data diperoleh informasi tentang keterampilan guru dalam pengelolaan model pengajaran langsung pada putaran I sampai putaran III mengalami peningkatan dari kriteria kurang baik menjadi baik. Keterampilan psikomotor peserta didik pada aspek transaksi pada putaran I mencapai skor 2,6 (kategori baik, sedangkan putaran II mencapai 2,4 (kategori kurang baik, hal ini peserta didik kurang serius pada saat melakukan kegiatan dan pengamatan, kemudian pada putaran III meningkat menjadi 3,8 (kategori sangat baik. Keterampilan afektif peserta didik dalam bertanya/ mengemukakan pendapat pada putaran I mencapai 2,8 (kategori baik, sedangkan putaran II menurun mencapai 2,4 (kategori kurang baik, dan putaran III mengalami peningkatan menjadi 3,3 (kategori sangat baik. Hasil belajar peserta didik sudah mencapai standar ketuntasan di sekolah. Pada putaran I ketuntasan belajar 70%, putaran II mencapai 91,06% sedangkan putaran III mencapai 88,62%. Dengan demikian dapat disimpulkan bahwa hasil belajar peserta didik sudah mencapai standar ketuntasan belajar di sekolah

  14. FAKTOR-FAKTOR YANG MEMPENGARUHI HASIL BELAJAR MATA PELAJARAN IPS EKONOMI SISWA KELAS VIII SMP NEGERI 5 BATANG (Tahun Ajaran 2015/2016

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    Rene Higuita

    2017-02-01

    Full Text Available The results of the economic study subjects are influenced by internal factors and external factors. The background of this research from the observation that shows there are students who obtain economic value of learning outcomes under KKM predetermined value is 67. Based on the results of the economic study odd semester grade students VIIISMP 5 Batang academic year 2014/2015, there were 122 students out of 244 (50% of students scored below the KKM. This study aims to identify and analyze the factors that influence student learning outcomes in accounting subjects eighth grade students of SMP 5 Rod. The results showed there were five (5 factors that affect student learning outcomes, namely (1 the factors psychology students consisting of: Talent, Readiness, Maturity, pehatian, intelligence, interest, and motivation. (2 environmental factors society consisting of: Student activities in the community, friends get along, Mass media. (3 factors of student learning conditions consist of: Methods of learning, teaching tool. (4 The school environment factors consist of: The state of the building, teachers' teaching methods, teacher relations with students, student relationships with students. (5 environmental factors family that consists of: How to educate parents, and the relationship between family members. And parents should not only meet the needs of the economy alone but rather to approach students with a more considered way so that students learning results increased. It is suggested that teachers are expected to take appropriate and timely policies so that student learning outcomes can be improved.

  15. Physiological levels of blood coagulation factors IX and X control coagulation kinetics in an in vitro model of circulating tissue factor

    Science.gov (United States)

    Tormoen, Garth W.; Khader, Ayesha; Gruber, András; McCarty, Owen J. T.

    2013-06-01

    Thrombosis significantly contributes to cancer morbidity and mortality. The mechanism behind thrombosis in cancer may be circulating tissue factor (TF), as levels of circulating TF are associated with thrombosis. However, circulating TF antigen level alone has failed to predict thrombosis in patients with cancer. We hypothesize that coagulation factor levels regulate the kinetics of circulating TF-induced thrombosis. Coagulation kinetics were measured as a function of individual coagulation factor levels and TF particle concentration. Clotting times increased when pooled plasma was mixed at or above a ratio of 4:6 with PBS. Clotting times increased when pooled plasma was mixed at or above a ratio of 8:2 with factor VII-depleted plasma, 7:3 with factor IX- or factor X-depleted plasmas, or 2:8 with factor II-, V- or VIII-depleted plasmas. Addition of coagulation factors VII, X, IX, V and II to depleted plasmas shortened clotting and enzyme initiation times, and increased enzyme generation rates in a concentration-dependent manner. Only additions of factors IX and X from low-normal to high-normal levels shortened clotting times and increased enzyme generation rates. Our results demonstrate that coagulation kinetics for TF particles are controlled by factor IX and X levels within the normal physiological range. We hypothesize that individual patient factor IX and X levels may be prognostic for susceptibility to circulating TF-induced thrombosis.

  16. Diagnosis and treatment strategies of thrombophilic risk factors

    Directory of Open Access Journals (Sweden)

    Murat Albayrak

    2010-09-01

    Full Text Available Thrombophilia is defined as the general name for a group of genetic and acquired situations, arising from defects of hemostasis mechanism and generating tendency to thrombosis. Examples of the acquired risk factors that increase the tendency to thrombosis are venous catheters, sepsis, surgery, hyperlipidemia, congestive heart disease, increased lipoprotein a, old age, antiphospholipid syndrome, nephrotic syndrome, hyperviscosity, chronic myeloproliferative neoplasms, paroxysmal nocturnal hemoglobinuria, heparin induced thrombocytopenia, vasculitis, immobility, obesity, major surgery, trauma, burns, malignancy, pregnancy and oral contraceptive usage. Genetic tendency to venous thromboembolism in early ages, even without any known cause, is named as thrombophilia. Factor V Leiden, prothrombin G20210A, methylenetetrahydrofolate reductase gene mutations, factor VIII elevation, protein C, protein S and antithrombin deficiency parameters are suggested for evaluation, in patient groups suspected of inherited thrombophilia. Detection of inherited thrombophilic factors in selected patient groups is a guide in developing treatment strategies and in establishing prognosis. Due to the genetic heterogeneities, each society should determine their thrombophilic risk pool. Thus, with the determination of the risk factors, unnecessary assessments will be prevented and a cost-effective approach can be developed.

  17. Effect of recombinant human basic fibroblast growth factor on angiogenesis during mandible fracture healing in rabbits

    Institute of Scientific and Technical Information of China (English)

    龚振宇; 周树夏; 顾晓明; 李涤尘; 孙明林

    2003-01-01

    Objective: To investigate the effect of recombinant human basic fibroblast growth factor (rhbFGF) on angiogenesis during mandible fracture healing in rabbit. Methods: Fifty adult white rabbits were used for animal model and randomly divided into a control group (25 rabbits) and an experimental group (25 rabbits). The membranous complex of rhbFGF and bovine type I collagen was prepared and implanted into the rabbit mandible fracture site under periosteum. The animals were sacrificed on 7, 14, 28, 56 and 84 days respectively after operation and the whole mandibles were harvested. The expression of factor VIII related antigen (F8-RA) in callus was examined with immunohistochemical staining. Results: The amounts of microvascular formation in calluses in the rhbFGF-treating group on days 7, 14, 28 and 56 were more than those of the control group (P<0.01).Conclusions: The results indicated that rhbFGF could stimulate microvascular formation during mandible fracture healing in rabbits.

  18. Failure of Recombinant Activated Factor VII in Treatment of Diffuse Alveolar Hemorrhage due to Cryoglobulinemic Vasculitis

    Directory of Open Access Journals (Sweden)

    Dania Khoulani

    2014-01-01

    Full Text Available Diffuse alveolar hemorrhage (DAH is a serious complication of the small vessel vasculitis syndromes and carries a high mortality. Recombinant activated factor VII (rFVIIa is used to treat bleeding in patients with hemophilia and antibodies to factor VIII or IX. It is increasingly being used in life-threatening hemorrhage in a variety of other settings in which conventional therapy is unsuccessful. Randomized controlled trials of rFVIIa in DAH are lacking. However, several case reports have described a complete or sustained control of DAH using rFVIIa after patients failed to respond to medical treatment. There are no case reports in the literature describing the use or the failure of rFVIIa in DAH associated with cryoglobulinemic vasculitis. We here report the failure of rFVIIa to control DAH in a patient with CD5+ B-cell non-Hodgkin’s lymphoma and cryoglobulinemic vasculitis.

  19. III. Mezquita de Córdoba. El trazado de la portada interior de la Bāb al-Wuzarā’. La Puerta de los Deanes (s. VIII, su trazado interior y exterior

    Directory of Open Access Journals (Sweden)

    Fernández-Puertas, Antonio

    2009-06-01

    Full Text Available The design of the inner façade of the Bāb al-Wuzarā’ is based on a square and its diagonal √2, with the use of a set-square of 90°, 45°, 45°, another of 90°, 60°, 30° and a compass. The ashlars alternate correctly in depth and width. The lintel space is carried by a horse-shoe arch with a merlon frieze. The intrados of the jambs reveals, by the differing ashlars, the consolidation of the Bāb al-Wuzarā’ undertaken in 855/856. The inner façade of the Puerta de los Deanes belongs to the eighth century, the outer façade was consolidated in the fourteenth. The steps are done with both set-squares and a compass. The left jamb on the N. side shows the larger ashlars of the eighth century and the smaller ones of the tenth century.

    El trazado de la portada interior de la Bāb al-Wuzarā’ obedece al cuadrado y su diagonal √2, y al uso de la escuadra, el cartabón y el compás. La cantería del muro está bien despiezada a soga y tizón. El hueco adintelado se descarga por arco enjarjado de herradura con alfiz y friso de almenas. En el intradós de las jambas del hueco se ve, en el despiece de la cantería, la obra de consolidación de la Bāb al-Wuzarā’ del 855/856. La Puerta de los Deanes en su fachada interior es obra del siglo VIII y la exterior fue consolidada en el siglo XIV. Su trazado se ha hecho con la escuadra, el cartabón y el compás. En la jamba izquierda, a N., se ve la unión de la cantería del siglo VIII con la de menor sección del siglo X.

  20. Inhibitor development in nonsevere hemophilia A

    OpenAIRE

    2014-01-01

    Hemophilia A is an X-linked inherited bleeding disorder that affects approximately 1 in 5000 male live births. It is caused by a deficient plasma level of clotting factor VIII and can be treated by the intravenous administration of factor VIII concentrates. A severe complication of the treatment with factor VIII concentrates is the development of inhibiting antibodies against factor VIII, also called inhibitors. Inhibitors challenge the treatment of hemophilia A as they inactivate factor VIII...

  1. Antihemophilic factor (recombinant plasma/albumin-free method for the management and prevention of bleeding episodes in patients with hemophilia A

    Directory of Open Access Journals (Sweden)

    Steven Pipe

    2009-02-01

    Full Text Available Steven PipeDepartment of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, MI, USAAbstract: Hemophilia is a rare genetic bleeding disorder that, if not adequately controlled, is associated with life-threatening bleeding events and serious and costly complications, primarily from joint damage. The advent of effective clotting factor replacement therapy for patients with hemophilia is considered one of the foremost medical advances of the 20th century. The last 3 decades of experience in hemophilia care have witnessed the effectiveness of the care of patients with hemophilia within specialized comprehensive care centers, advances in factor replacement therapies, the benefits of prophylaxis over on-demand replacement therapy, and the role of aggressive management of joint disease to prevent dysfunction. Ongoing challenges, including the management of inhibitors to factor therapies and the consequences of thousands of patients with hemophilia becoming infected with human immunodeficiency virus and hepatitis C virus in the 1980s from contaminated plasma-derived factor concentrates, have highlighted the need for vigilance with respect to clotting factor product safety, access to care, and a full complement of choice of factor replacement therapies. Advate® (antihemophilic factor [recombinant] plasma/albumin-free method [rAHF-PFM] is the first recombinant factor VIII therapy manufactured without human or animal protein additives to eliminate the risk of pathogen transmission that could be carried by these additives. Preclinical studies established bioequivalence with recombinant antihemophilic factor (Recombinate®, a product with 16 years of clinical experience. Currently licensed in 44 countries worldwide, rAHF-PFM has over 7 years of clinical research within 5 global studies supporting its safety and efficacy in the treatment of patients with hemophilia A.Keywords: factor VIII, hemophilia A, recombinant proteins, clinical

  2. Applying Cheerful Disco Learning for Improving of Motivation and Learning Result of PKn in Grade VIII C Students Junior High School 1 Kebumen in Second Semester 2013/2014 Academic Years

    Directory of Open Access Journals (Sweden)

    Siti Makmuroh

    2017-06-01

    Full Text Available The aim of this classroom action research is to improve students’ learning motivation, learning result of PKn on Basic Competence of Describing Indonesian Government System and the Roles of the State Institutions as the Sovereignty Executive and the characters of Grade VIII C Students of Junior High School 1 of Kebumen in Second Semester of Academic Year 2013/2014 by applying CHEERFUL DISCO learning method. The research is a classroom action research conducted in two cycles; each cycle of which includes planning, conducting, observation, and reflection. The result of the research shows that the learning method was able to improve the students’ learning motivation in learning activities from 62.37% in pre cycle to 73.74% in the first cycle, then from 78.91% in the second cycle, improved the PKn learning achievement in mastering concept of the ability to describe Indonesian Government System and the Roles of the State Institutions as the Sovereignty Executive, which can be seen that the students’ achievement test result is improving in average from 78.18 with 54.55% of mastery learning in pre cycle to 83.23 with 72.73% of mastery learning in the first cycle, then it was improved to 86.59 in average with 81.82% of mastery learning in the second cycle.

  3. LEGAL RELATIONSHIP BETWEEN ILLEGITIMATE CHILDREN AND THEIR BIOLOGICAL FATHER: The Analysis of Constitutional Court Decree No. 46/PUU-VIII/2010 in the Perspective of Civil and Islamic Law

    Directory of Open Access Journals (Sweden)

    Marilang Marilang

    2016-12-01

    Full Text Available In Indonesia, children born out of wedlock only have legal relationship or family lineage relationship with their mother and mother’s family, not with their biological father and biological father’s family. This provisions of law are arranged in Article 43 paragraph (1 of Marriage Law No. 1 of 1974 which is highly influenced by Shafi’ite School of Islamic jurisprudence. Through judicial review of Aisyah (Machica Mochtar and her son named M. Iqbal Ramadhan, Constitutional Court has agreed to waive the provisions by means of the Decree Number 46/PUU-VIII/2010 with legal consideration that the concerned article contravenes the Constitution, then it creates new legal norm which states those children have legal relationship and family lineage with their mother and mother’s family and also the man who is their father. The Decree sparks controversies concerning the term ‘children born out of wedlock’ and ‘legal relationship’ in the decree. Contrary to many law experts, the article argues that the term ‘children born out of wedlock’ simply means children born from zina (adultery or fornication. Thus, ‘legal relationship’ only refer to limited relationship between both parties.

  4. Robotic suture of a large caval injury caused by endo-GIA stapler malfunction during laparoscopic wedge resection of liver segments VII and VIII en-bloc with the right hepatic vein.

    Science.gov (United States)

    Boggi, Ugo; Moretto, Carlo; Vistoli, Fabio; D'Imporzano, Simone; Mosca, Franco

    2009-01-01

    Primary endo-GIA stapler malfunction occurred during robotic wedge resection of liver segments VII and VIII en-bloc with the right hepatic vein, in an obese woman diagnosed with single liver metastasis from a previous carcinoid tumour. Haemorrhage was soon controlled by clamping the vena cava below the injury using two wristed forceps angled at 90 degrees . With the two instruments locked in the holding position the ensuing operative strategy was discussed between surgeon and anaesthesia teams. Using the third robotic arm the caval injury was repaired laparoscopically with interrupted polypropylene sutures. The patient was transfused with two units of packed red blood cells, recovered uneventfully, and was discharged on post-operative day five. We conclude that even the most advanced technologies can fail and that surgeons should be fully aware of the consequences of these malfunctions and be prepared for repair. From this point of view, the da Vinci surgical system seems to have some advantages over classical laparoscopic methods including the ability to lock the wristed instruments in the holding position, the use of three arms by the same operating surgeon, and the extreme facilitation of intracorporeal suturing and knot-tying in deep and narrow spaces, extremely difficult if not impossible with conventional laparoscopic instruments.

  5. Solution of the Skyrme-Hartree–Fock–Bogolyubovequations in the Cartesian deformed harmonic-oscillator basis. (VIII) hfodd (v2.73y): A new version of the program

    Energy Technology Data Exchange (ETDEWEB)

    Schunck, N.; Dobaczewski, J.; Satuła, W.; Bączyk, P.; Dudek, J.; Gao, Y.; Konieczka, M.; Sato, K.; Shi, Y.; Wang, X. B.; Werner, T. R.

    2017-07-01

    We describe the new version (v2.73y) of the code hfodd which solves the nuclear Skyrme Hartree–Fock or Skyrme Hartree–Fock–Bogolyubov problem by using the Cartesian deformed harmonic-oscillator basis. In the new version, we have implemented the following new features: (i) full proton–neutron mixing in the particle–hole channel for Skyrme functionals, (ii) the Gogny force in both particle–hole and particle–particle channels, (iii) linear multi-constraint method at finite temperature, (iv) fission toolkit including the constraint on the number of particles in the neck between two fragments, calculation of the interaction energy between fragments, and calculation of the nuclear and Coulomb energy of each fragment, (v) the new version 200d of the code hfbtho, together with an enhanced interface between hfbtho and hfodd, (vi) parallel capabilities, significantly extended by adding several restart options for large-scale jobs, (vii) the Lipkin translational energy correction method with pairing, (viii) higher-order Lipkin particle-number corrections, (ix) interface to a program plotting single-particle energies or Routhians, (x) strong-force isospin-symmetry-breaking terms, and (xi) the Augmented Lagrangian Method for calculations with 3D constraints on angular momentum and isospin. Finally, an important bug related to the calculation of the entropy at finite temperature and several other little significant errors of the previous published version were corrected.

  6. Long-term results of International Breast Cancer Study Group Trial VIII: adjuvant chemotherapy plus goserelin compared with either therapy alone for premenopausal patients with node-negative breast cancer.

    Science.gov (United States)

    Karlsson, P; Sun, Z; Braun, D; Price, K N; Castiglione-Gertsch, M; Rabaglio, M; Gelber, R D; Crivellari, D; Collins, J; Murray, E; Zaman, K; Colleoni, M; Gusterson, B A; Viale, G; Regan, M M; Coates, A S; Goldhirsch, A

    2011-10-01

    The International Breast Cancer Study Group Trial VIII compared long-term efficacy of endocrine therapy (goserelin), chemotherapy [cyclophosphamide, methotrexate and fluorouracil (CMF)], and chemoendocrine therapy (CMF followed by goserelin) for pre/perimenopausal women with lymph-node-negative breast cancer. From 1990 to 1999, 1063 patients were randomized to receive (i) goserelin for 24 months (n = 346), (ii) six courses of 'classical' CMF (cyclophosphamide, methotrexate, 5-fluorouracil) chemotherapy (n = 360), or (iii) six courses of CMF plus 18 months goserelin (CMF→ goserelin; n = 357). Tumors were classified as estrogen receptor (ER) negative (19%), ER positive (80%), or ER unknown (1%); 19% of patients were younger than 40. Median follow-up was 12.1 years. For the ER-positive cohort, sequential therapy provided a statistically significant benefit in disease-free survival (DFS) (12-year DFS = 77%) compared with CMF alone (69%) and goserelin alone (68%) (P = 0.04 for each comparison), due largely to the effect in younger patients. Patients with ER-negative tumors whose treatment included CMF had similar DFS (12-year DFS CMF = 67%; 12-year DFS CMF→ goserelin = 69%) compared with goserelin alone (12-year DFS = 61%, P= NS). For pre/perimenopausal women with lymph-node-negative ER-positive breast cancer, CMF followed by goserelin improved DFS in comparison with either modality alone. The improvement was the most pronounced in those aged below 40, suggesting an endocrine effect of prolonged CMF-induced amenorrhea.

  7. Vasculite isolada do sistema nervoso central e acometimento do VIII nervo craniano manifestações raras da síndrome de imunodeficiência adquirida: an uncommon manifestation of AIDS

    Directory of Open Access Journals (Sweden)

    Valentina Van Boekel

    1992-03-01

    Full Text Available O objetivo de nosso estudo é enfatizar a exuberante anarquia dos mecanismos imunológicos na síndrome de imunodeficiência adquirida. Tal anarquia propicia a eclosão de manifestações clínicas atípicas e, por vezes, bizarras, de difícil diagnóstico. No estudo em questão, chamamos a atenção para duas raras manifestações da doença: vasculite isolada do sistema nervoso central (SNC e acometimento do> VIII nervo craniano, que exigem amplo diagnóstico diferencial, o que significa dizer intervenção de especialistas de diversas áreas. Após revisão da literatura, identificamos apenas dois casos de vasculite isolada do SNC induzida pelo vírus da imunodeficiência, humana e um caso de surdez neurossensorial comprovadamente ocasionada pelo retrovírus mencionado. Em passado longínquo, os médicos de boa formação clínica diziam ser necessário raciocinar «sifiliticamente» e hoje, diante de doença tão complexa e multissistêmica, nos parece necessário raciocinar «aideticamente».

  8. Long-term health experience of jet engine manufacturing workers: VIII. glioblastoma incidence in relation to workplace experiences with parts and processes.

    Science.gov (United States)

    Marsh, Gary M; Youk, Ada O; Buchanich, Jeanine M; Downing, Sarah; Kennedy, Kathleen J; Esmen, Nurtan A; Hancock, Roger P; Lacey, Steven E; Pierce, Jennifer S; Fleissner, Mary Lou

    2013-06-01

    To determine whether glioblastoma (GB) incidence rates among jet engine manufacturing workers were associated with workplace experiences with specific parts produced and processes performed. Subjects were 210,784 workers employed between 1952 and 2001. We conducted nested case-control and cohort incidence studies with focus on 277 GB cases. We estimated time experienced with 16 part families, 4 process categories, and 32 concurrent part-process combinations with 20 or more GB cases. In both the cohort and case-control studies, none of the part families, process categories, or both considered was associated with increased GB risk. If not due to chance alone, the not statistically significantly elevated GB rates in the North Haven plant may reflect external occupational factors or nonoccupational factors unmeasured in the current evaluation.

  9. Hypoperfusion in severely injured trauma patients is associated with reduced coagulation factor activity.

    Science.gov (United States)

    Jansen, Jan O; Scarpelini, Sandro; Pinto, Ruxandra; Tien, Homer C; Callum, Jeannie; Rizoli, Sandro B

    2011-11-01

    Recent studies have shown that acute traumatic coagulopathy is associated with hypoperfusion, increased plasma levels of soluble thrombomodulin, and decreased levels of protein C but with no change in factor VII activity. These findings led to the hypothesis that acute traumatic coagulopathy is primarily due to systemic anticoagulation, by activated protein C, rather than decreases in serine protease activity. This study was designed to examine the effect of hypoperfusion secondary to traumatic injury on the activity of coagulation factors. Post hoc analysis of prospectively collected data on severely injured adult trauma patients presenting to a single trauma center within 120 minutes of injury. Venous blood was analyzed for activity of factors II, V, VII, VIII, IX, X, and XI. Base deficit from arterial blood samples was used as a marker of hypoperfusion. Seventy-one patients were identified. The activity of factors II, V, VII, IX, X, and XI correlated negatively with base deficit, and after stratification into three groups, based on the severity of hypoperfusion, a statistically significant dose-related reduction in the activity of factors II, VII, IX, X, and XI was observed. Hypoperfusion is also associated with marked reductions in factor V activity levels, but these appear to be relatively independent of the degree of hypoperfusion. The activity of factor VIII did not correlate with base deficit. Hypoperfusion in trauma patients is associated with a moderate, dose-dependent reduction in the activity of coagulation factors II, VII, IX, X, and XI, and a more marked reduction in factor V activity, which is relatively independent of the severity of shock. These findings suggest that the mechanisms underlying decreased factor V activity--which could be due to activated protein C mediated cleavage, thus providing a possible link between the proposed thrombomodulin/thrombin-APC pathway and the serine proteases of the coagulation cascade--and the reductions in factors

  10. Factor analysis of the Neuropsychological Screening Battery for Hispanics (NeSBHIS).

    Science.gov (United States)

    Pontón, M O; Gonzalez, J J; Hernandez, I; Herrera, L; Higareda, I

    2000-01-01

    The Neuropsychological Screening Battery for Hispanics (NeSBHIS; Pontón et al., 1996) was developed to provide clinicians and researchers with appropriate tests and norms to assess the Latino population. However, the construct validity of the NeSBHIS is unclear, and its clinical utility is untested. This study provides data on the construct validity of this battery via factor analytic methodology. Five factors were identified: (a) a language factor, which included the Controlled Oral Word Association Test, the Pontón-Satz Boston Naming Test, and the Escala de Inteligencia Wechsler para Adultos (EIWA; Wechsler, Green, & Martinez, 1968) Digit Span; (b) a verbal learning factor, which included all the World Health Organization--University of California, Los Angeles Auditory Verbal Learning Test scores (Trials V, VII, and VIII); (c) an attentional-mental control factor, which included the EIWA Digit Symbol, Color Trails 1 and 2, and the EIWA Block Design; (d) a visuospatial factor, made up of the Rey-Osterrieth Complex Figure Test Copy and Memory and the Raven's Standard Progressive Matrices total score; and (e) a psychomotor factor, the Pin Test. This was a stable factor structure, suggesting that the NeSBHIS has a robust construct validity.

  11. Corruption Factors

    OpenAIRE

    Polterovich, Victor

    1998-01-01

    Among the factors that give rise to corruption, it is suggested that three groups be distinguished: fundamental factors rooted in the imperfection of economic institutions and economic policy, organizational factors ("weakness of the government"), and societal factors that depend on the prehistory and are connected with the mass culture and norms of bureaucratic behavior. A model in which corruption equilibrium is supported by non-optimum tax policy or by slow technical progress is compared w...

  12. Functional variation in the arginine vasopressin 2 receptor as a modifier of human plasma von Willebrand factor levels

    DEFF Research Database (Denmark)

    Nossent, Anne Yaël; Robben, J H; Deen, P M T

    2010-01-01

    SUMMARY OBJECTIVES: Stimulation of arginine vasopressin 2 receptor (V2R) with arginine vasopressin (AVP) results in a rise in von Willebrand factor (VWF) and factor VIII plasma levels. We hypothesized that gain-of-function variations in the V2R gene (AVPR2) would lead to higher plasma levels of VWF....... The functionality of the G12E variant was studied in stably transfected MDCKII cells, expressing constructs of either 12G-V2R or 12E-V2R. Both V2R variants were fully glycosylated and expressed on the basolateral membrane. The binding affinity of V2R for AVP was increased three-fold in 12E-V2R-green fluorescent...

  13. Non-genetic risk factors in haemophilia A inhibitor management

    DEFF Research Database (Denmark)

    Löfgren, Karin Maria; Søndergaard, H.; Skov, Søren;

    2016-01-01

    In haemophilia A (HA) management, antidrug antibodies, or inhibitors, are a serious complication that renders factor VIII (FVIII) replacement therapy ineffective, increases morbidity and reduces quality of life for affected patients. Inhibitor development aetiology is multifactorial and covers bo...... with a suspected danger signal aetiology; on-demand treatment, treatment during major bleeds or surgery, and treatment during infection or vaccination. Clinical studies as well as animal experiments addressing these factors will be reviewed......., and explanations for this association are being investigated. A potential explanation is the danger signal effect, where the immune response is activated by endogenous or exogenous danger or damage signals present at the time and site of FVIII administration. The danger theory explains how alarm signals from...... stressed, injured or dying cells can activate an immune reaction, without the involvement of foreign antigens. Bleeds, trauma, surgery or concomitant infection could be events initiating danger signalling in HA patients, resulting in an immune reaction towards administered FVIII that otherwise would pass...

  14. 聚四氟乙烯棉片置入治疗Ⅶ、Ⅷ颅神经微血管压迫症状%Teflon cotton sheet implantation for treatment of microvascular compression symptoms of VII, VIII cranial nerves

    Institute of Scientific and Technical Information of China (English)

    冯兆海; 石鑫; 姜磊; 郝玉军

    2015-01-01

    背景:聚四氟乙烯棉片具有良好的生物学特性和组织相容性,置入颅内不会导致严重排异反应,目前在微血管减压中得到了广泛应用。目的:探讨颅神经Ⅶ、Ⅷ显微血管聚四氟乙烯棉片置入减压治疗面肌痉挛合并眩晕及耳鸣的疗效。方法:纳入10例第Ⅶ、Ⅷ脑神经压迫综合征患者,其中6例面肌痉挛合并耳鸣,2例面肌痉挛合并眩晕,2例面肌痉挛合并耳鸣及眩晕,均采用乙状窦后入路聚四氟乙烯棉片置入减压治疗,其中5例以圈套式置入,另5例以絮状式置入。随访观察棉片置入后的生物相容性及面部抽搐、耳鸣、眩晕改善情况,以及并发症情况。结果与结论:聚四氟乙烯棉片具有良好的生物学特性和组织相容性,置入颅内未导致严重排异反应,未随时间的推移而吸收变形。棉片置入后,10例面部抽搐患者中,7例面部抽搐症状完全消失,3例症状减轻,置入后1周所有患者面部抽搐症状消失;伴有耳鸣症状8例患者中,5例患者自觉耳鸣消失,2例自觉耳鸣减轻2级,1例症状无改善;4例合并眩晕患者中,眩晕症状减轻2例,2例症状无改善。随访6-48个月,面部抽搐症状无复发;6例耳鸣症状消失,1例减轻,1例无改善;3例眩晕症状消失,1例无改善。表明聚四氟乙烯棉片置入减压治疗颅神经Ⅶ、Ⅷ显微血管压迫安全有效。%BACKGROUND:Teflon cotton sheets have good biological characteristics and histocompatibility, and the intracranial implantation of teflon cotton sheets cannot lead to severe rejection, which, at present, has been widely applied in the microvascular decompression. OBJECTIVE:To explore the therapeutic efficacy of the intracranial implantation of teflon cotton sheetsvia VII, VIII cranial nerves in the microvascular decompression treatment of hemifacial spasm combined with vertigo and tinnitus. METHODS:Ten patients

  15. Differential haemostatic risk factors for pregnancy-related deep-vein thrombosis and pulmonary embolism: a population-based case-control study.

    Science.gov (United States)

    Bergrem, Astrid; Dahm, Anders E A; Jacobsen, Anne Flem; Sandvik, Leiv; Sandset, Per Morten

    2012-12-01

    Limited data exist on thrombophilia and the risk of venous thrombosis (VT) during pregnancy and postpartum. The objectives of the present study were to investigate the role of haemostatic risk factors for pregnancy-related VT and their phenotypic expression in deep-vein thrombosis (DVT) and pulmonary embolism (PE). Total 313 cases with objectively verified first time VT and 353 controls were selected from a source population of 377,155 women with 613,232 pregnancies. The adjusted odds ratio (aOR) for pregnancy-related VT was 1.7 (95% confidence interval [CI] 1.1-2.8) for women with factor VIII >90th percentile. The aOR for VT for endogenous thrombin potential and D-dimer values >90th percentiles were 1.8 (95% CI 1.1-3.0) and 2.1 (95% CI 1.3-3.3), respectively. Factor IX >90th percentile or free protein S ≤the 5th percentile increased the risk for PE, and the aORs were 2.4 (95% CI 1.1-5.0) and 3.1 (95% CI 1.3-7.2), respectively. Women carrying the factor V Leiden (F5 rs6025) polymorphism, or who had reduced sensitivity to activated protein C (aPC) in the absence of F5 rs6025, had increased risk for DVT, with unadjusted ORs 7.7 (95% CI 4.7-12.7) and 3.5 (95% CI 2.2-5.4), respectively. Women with a history of pregnancy-related VT showed activation of coagulation and had elevated factor VIII. Furthermore, high levels of factor IX and low levels of free protein S were associated with increased risk for PE, whereas aPC resistance and F5 rs6025 were risk factors for DVT and not PE.

  16. Ionizing radiation and genetic risks. Part VIII. The concept of mutation component and its use in risk estimation for multifactorial diseases

    Energy Technology Data Exchange (ETDEWEB)

    Denniston, C. [Laboratory of Genetics, University of Wisconsin-Madison, Madison (United States); Chakraborty, R. [Human Genetics Center, University of Texas School of Public Health, P.O. Box 20334, Houston, TX (United States); Sankaranarayanan, K. [Department of Radiation Genetics and Chemical Mutagenesis, Sylvius Laboratories, Leiden University Medical Centre, Wassenaarseweg 72, 2333 AL Leiden (Netherlands)

    1998-08-31

    Multifactorial diseases, which include the common congenital abnormalities (incidence: 6%) and chronic diseases with onset predominantly in adults (population prevalence: 65%), contribute substantially to human morbidity and mortality. Their transmission patterns do not conform to Mendelian expectations. The model most frequently used to explain their inheritance and to estimate risks to relatives is a Multifactorial Threshold Model (MTM) of disease liability. The MTM assumes that: (1) the disease is due to the joint action of a large number of genetic and environmental factors, each of which contributing a small amount of liability, (2) the distribution of liability in the population is Gaussian and (3) individuals whose liability exceeds a certain threshold value are affected by the disease. For most of these diseases, the number of genes involved or the environmental factors are not fully known. In the context of radiation exposures of the population, the question of the extent to which induced mutations will cause an increase in the frequencies of these diseases has remained unanswered. In this paper, we address this problem by using a modified version of MTM which incorporates mutation and selection as two additional parameters. The model assumes a finite number of gene loci and threshold of liability (hence, the designation, Finite-Locus Threshold Model or FLTM). The FLTM permits one to examine the relationship between broad-sense heritability of disease liability and mutation component (MC), the responsiveness of the disease to a change in mutation rate. Through the use of a computer program (in which mutation rate, selection, threshold, recombination rate and environmental variance are input parameters and MC and heritability of liability are output estimates), we studied the MC-heritability relationship for (1) a permanent increase in mutation rate (e.g., when the population sustains radiation exposure in every generation) and (2) a one-time increase in

  17. Non-random temporary emigration and the robust design: Conditions for bias at the end of a time series: Section VIII

    Science.gov (United States)

    Langtimm, Catherine A.

    2008-01-01

    Deviations from model assumptions in the application of capture–recapture models to real life situations can introduce unknown bias. Understanding the type and magnitude of bias under these conditions is important to interpreting model results. In a robust design analysis of long-term photo-documented sighting histories of the endangered Florida manatee, I found high survival rates, high rates of non-random temporary emigration, significant time-dependence, and a diversity of factors affecting temporary emigration that made it difficult to model emigration in any meaningful fashion. Examination of the time-dependent survival estimates indicated a suspicious drop in survival rates near the end of the time series that persisted when the original capture histories were truncated and reanalyzed under a shorter time frame. Given the wide swings in manatee emigration estimates from year to year, a likely source of bias in survival was the convention to resolve confounding of the last survival probability in a time-dependent model with the last emigration probabilities by setting the last unmeasurable emigration probability equal to the previous year’s probability when the equality was actually false. Results of a series of simulations demonstrated that if the unmeasurable temporary emigration probabilities in the last time period were not accurately modeled, an estimation model with significant annual variation in survival probabilities and emigration probabilities produced bias in survival estimates at the end of the study or time series being explored. Furthermore, the bias propagated back in time beyond the last two time periods and the number of years affected varied positively with survival and emigration probabilities. Truncating the data to a shorter time frame and reanalyzing demonstrated that with additional years of data surviving temporary emigrants eventually return and are detected, thus in subsequent analysis unbiased estimates are eventually realized.

  18. Clásicos de la Psiquiatría Española del Siglo XIX (VIII: Mariano Cubí y Soler (1801-1875.

    Directory of Open Access Journals (Sweden)

    Antonio M Rey González

    1984-01-01

    Full Text Available La frenología se inicia a fines del siglo XVIII con los trabajos del médico F.J GALl. Tiene su época de máxima difusión en el primer tercio del siglo XIX, al final del cual inicia su declive. A España llega como movimiento tardío, alcanzando su máximo desarrollo entre los años 1843 y 1857. El rechazo de la medicina oficial, el desinterés del gran público, la condena de la Iglesia Católica y el período que le tocó vivir, t de signo político netamente absolutista, fueron los factores que influyeron en su escasa difusión. La frenología en nuestro país se centró en la figura y en la actividad de Mariano CUBI, propagador o apostol de la "ciencia" en España, a donde llega en 1842, tras permanecer veinte años en tierras americanas. Desde su llegada emprendió la tarea de su divulgación; publicó varios libros y fundó una revista sobre la nueva doctrina. Aunque seguidor de la ortodoxia de GALL y SPURZHEIM, hizo, sin embargo, algunas aportaciones originales, sobre todo en su intento de conjugar la frenología, el magnetismo animal de MESMER y la fisionomía de LAVATER.

  19. An ideal preparation for dermal regeneration: skin renewal growth factors, the growth factor composites from porcine platelets.

    Science.gov (United States)

    Wang, Kuo-Hsien; Wu, Yo-Ping Greg; Lo, Wen-Cheng

    2012-12-01

    The use of growth factor composites from platelets has been introduced to many areas of clinical applications and studies. With the richest source of growth factors (GFs), beneficial effects have been shown on tissue regeneration and wound healing. However, animal and clinical studies have revealed inconsistent outcomes with the use of platelet-derived growth factors (PDGFs), which were likely due to variations in the presence and concentrations of GFs between various sources. Autologous PDGFs are considered to be safer, but they are limited by the feasibility of large-scale production to be used extensively in the acute phase, greater surface area, or general cosmetic applications. This study employed a simple process to obtain growth factor composites from activated platelets of porcine origin, namely skin renewal growth factors (SRGF). The functions of SRGF were subsequently evaluated on cultured human fibroblasts, keratinocytes, and melanocytes. Our data revealed that SRGF significantly promoted the proliferation of fibroblasts, accompanied by increased expression of collagens (types I, III, IV, and VIII) and proteoglycans. Diminished proliferation and arrested differentiation of keratinocytes were evidenced by the attenuated expression of laminin V and keratin 10. In addition, SRGF also suppressed the growth of melanocytes and reduced the expression of microphthalmia-associated transcription factor (MITF), tyrosinase, and paired box 3 (PAX3), which mediates melanogensis. Our results suggest that SRGF possesses beneficial properties and is a promising and cost-effective composition for the development of a safe cosmetic agent or topical products for skin regeneration. The development of SRGF may also provide an alternative strategy for tissue engineering.

  20. El factoring

    Directory of Open Access Journals (Sweden)

    Alberto Rosenthal

    1988-04-01

    Full Text Available RESUMEN El artículo  presenta, una conceptualización general de lo que es el factoring, el origen del mismo, su evolución y hace una clasificación de los distintos tipos de factoring.

  1. Robust factorization

    DEFF Research Database (Denmark)

    Aanæs, Henrik; Fisker, Rune; Åström, Kalle;

    2002-01-01

    Factorization algorithms for recovering structure and motion from an image stream have many advantages, but they usually require a set of well-tracked features. Such a set is in generally not available in practical applications. There is thus a need for making factorization algorithms deal...... effectively with errors in the tracked features. We propose a new and computationally efficient algorithm for applying an arbitrary error function in the factorization scheme. This algorithm enables the use of robust statistical techniques and arbitrary noise models for the individual features....... These techniques and models enable the factorization scheme to deal effectively with mismatched features, missing features, and noise on the individual features. The proposed approach further includes a new method for Euclidean reconstruction that significantly improves convergence of the factorization algorithms...

  2. Sequencing of a 9.9 kb segment on the right arm of yeast chromosome VII reveals four open reading frames, including PFK1, the gene coding for succinyl-CoA synthetase (beta-chain) and two ORFs sharing homology with ORFs of the yeast chromosome VIII.

    Science.gov (United States)

    Guerreiro, P; Azevedo, D; Barreiros, T; Rodrigues-Pousada, C

    1997-03-15

    A 9.9 kb DNA fragment from the right arm of chromosome VII of Saccharomyces cerevisiae has been sequenced and analysed. The sequence contains four open reading frames (ORFs) longer than 100 amino acids. One gene, PFK1, has already been cloned and sequenced and the other one is the probable yeast gene coding for the beta-subunit of the succinyl-CoA synthetase. The two remaining ORFs share homology with the deduced amino acid sequence (and their physical arrangement is similar to that) of the YHR161c and YHR162w ORFs from chromosome VIII.

  3. EFEKTIFITAS MODEL PEMBELAJARAN NUMBERED HEAD TOGETHER (NHT TERHADAP HASIL BELAJAR MATERI PAJAK DALAM PEREKONOMIAN NASIONAL SISWA KELAS VIII SMP N 39 SEMARANG

    Directory of Open Access Journals (Sweden)

    Julia Ratma Wardani

    2012-06-01

    siklusnya terlihat dari aktivitas siswa pada siklus I sebesar 68,18% keaktifan sedang dan aktivitas siswa pada siklus II sebesar 78,6% keaktifan sangat tinggi. Berdasarkan hasil penelitian disimpulkan bahwa kegiatan pembelajaran Pajak dalam perekonomian nasional dengan metode pembelajaran NHT dapat meningkatkan keaktifan dan hasil belajar siswa. � Education is a very influential media to create quality human, The success of the learning process in learning can be seen from the success of students who follow these activities. But in fact in SMP N 39 Semarang learning outcomes have not been optimal economic subjects. Some classes are still many students who do not complete the study. The average number of students who completed amounted to 56.27%, while the average number of students who have not completed amounted to 43.73%, so there needs to be improved to maximize learning outcomes. To overcome the problem of learning is one of them by applying a learning model that aims to improve the quality of learning, the learning model is applied NHT (Numbered Head Together. The purpose of this study was to determine the application of learning models Numbered Head Together can improve learning outcomes subject IPS Economics of Taxation in the National Economy �than the lecture method. The learning process a factor that very important in the success results learning, but the learning process is still dominated by the teacher with the methods lectures one direction that positioning learners just as listeners without involved in interaction of learning, and so students not interested in the learning. Therefore needed solution methods of instruction interesting and will raise motivation students learn so liveliness and study result of the could increase. Research results showed the students learning up on each cycle as: the students on learning cycle I 77,1 % and results in learning cycle II 91,4 %. Ketuntsan learning cycle in cycles I has not yet reached performance indicators

  4. El factoring

    Directory of Open Access Journals (Sweden)

    Alberto Rosenthal

    2015-04-01

    Full Text Available RESUMEN Se presenta la segunda parte del artículo aparecido en  el número 6 de la revista EAN. Su contenido es complementario a lo expuesto en dicho número, en está aparecen las ventajas del factoring, conveniencias, limitaciones así como la forma  de efectuar un factor en Colombia,  su necesidad, incidencia económica, etc.

  5. Biological and analytical variations of 16 parameters related to coagulation screening tests and the activity of coagulation factors.

    Science.gov (United States)

    Chen, Qian; Shou, Weiling; Wu, Wei; Guo, Ye; Zhang, Yujuan; Huang, Chunmei; Cui, Wei

    2015-04-01

    To accurately estimate longitudinal changes in individuals, it is important to take into consideration the biological variability of the measurement. The few studies available on the biological variations of coagulation parameters are mostly outdated. We confirmed the published results using modern, fully automated methods. Furthermore, we added data for additional coagulation parameters. At 8:00 am, 12:00 pm, and 4:00 pm on days 1, 3, and 5, venous blood was collected from 31 healthy volunteers. A total of 16 parameters related to coagulation screening tests as well as the activity of coagulation factors were analyzed; these included prothrombin time, fibrinogen (Fbg), activated partial thromboplastin time, thrombin time, international normalized ratio, prothrombin time activity, activated partial thromboplastin time ratio, fibrin(-ogen) degradation products, as well as the activity of factor II, factor V, factor VII, factor VIII, factor IX, and factor X. All intraindividual coefficients of variation (CVI) values for the parameters of the screening tests (except Fbg) were less than 5%. Conversely, the CVI values for the activity of coagulation factors were all greater than 5%. In addition, we calculated the reference change value to determine whether a significant difference exists between two test results from the same individual.

  6. Aegyptio-afroasiatica VIII : first Version

    Directory of Open Access Journals (Sweden)

    Gabor Takacs

    1996-12-01

    Full Text Available The present paper represents the eighth part of a series of contributions to com­ parative Afroasiatic lexicology primarily from the viewpoint of Egyptian. This series is the first fruit of the work on a newly begun greater project for the Comparative-Etymo­ logical Vocabulary of Egyptian pursued by the author at the Egyptological Department of Eotvos Lorand University, Budapest, Hungary.

  7. Progress in Ultrafast Intense Laser Science VIII

    CERN Document Server

    Nisoli, Mauro; Hill, Wendell; III, III

    2012-01-01

    The PUILS series delivers up-to-date reviews of progress in Ultrafast Intense Laser Science, a newly emerging interdisciplinary research field spanning atomic and molecular physics, molecular science and optical science which has been stimulated by the recent developments in ultrafast laser technologies. Each volume compiles peer-reviewed articles authored by researchers at the forefront of each their own subfields of UILS. Every chapter opens with an overview of the topics to be discussed, so that researchers unfamiliar to the subfield as well as graduate students can grasp the importance and attractions of the research topic at hand. These are followed by reports of cutting-edge discoveries. This eighth volume covers a broad range of topics from this interdisciplinary research field, focusing on molecules interacting with ultrashort and intense laser fields, advanced technologies for the characterization of ultrashort laser pulses and their applications, laser plasma formation and laser acceleration.

  8. Journal of Undergraduate Research, Volume VIII, 2008

    Energy Technology Data Exchange (ETDEWEB)

    Stiner, K. S.; Graham, S.; Khan, M.; Dilks, J.; Mayer, D.

    2008-01-01

    Th e Journal of Undergraduate Research (JUR) provides undergraduate interns the opportunity to publish their scientific innovation and to share their passion for education and research with fellow students and scientists. Fields in which these students worked include: Biology; Chemistry; Computer Science; Engineering; Environmental Science; General Sciences; Materials Sciences; Medical and Health Sciences; Nuclear Sciences; Physics; Science Policy; and Waste Management.

  9. The makings of meteor astronomy: Part VIII.

    Science.gov (United States)

    Beech, M.

    1994-12-01

    Ernst Chladni (1756 - 1827) is often considered to be the father of modern meteor astronomy. While his thesis of 1794 offered no essentially new or innovative ideas it did break important ground in showing the clear inadequacies of the then accepted model of fireball origins.

  10. Division Viii: Galaxies and the Universe

    Science.gov (United States)

    Sadler, Elaine M.; Combes, Françoise; Okamura, Sadanori; Davies, Roger L.; Gallagher, John S.; Padmanabhan, Thanu; Schmidt, Brian P.

    2012-04-01

    The fields of extragalactic research and cosmology have continued to progress rapidly over the past three years, as detailed in the reports of the Commission Presidents, and we are pleased to acknowledge the award of the 2011 Nobel Prize in Physics to Saul Perlmutter, Brian P. Schmidt and Adam G. Riess for ``the discovery of the accelerating expansion of the Universe through observations of distant supernovae''. The Gruber Cosmology Prize was awarded in 2009 to Wendy L. Freedman, Robert C. Kennicutt and Jeremy Mould for their leadership of the Hubble Space Telescope Key Project on the Extragalactic Distance Scale, in 2010 to Charles Steidel for the identification and study of galaxies in the very distant universe, and in 2011 to Marc Davis, George Efstathiou, Carlos Frenk and Simon D.M. White for pioneering the use of numerical simulations as a tool to model and interpret the large-scale distribution of galaxies and dark matter.

  11. VIII. Formación y familia

    OpenAIRE

    2015-01-01

    (Rosaldina Villasante de Benites). De toda la familia, yo he sido quizás la hija que más tiempo ha vivido con su padre. Me he casado ya profesional, todo por acompañar a mis padres. En un primer movimiento, pensaba hacerles compañía hasta el final de sus días, puesto que va mis cuatro hermanos se habían casado e ido a vivir a diferentes lugares. He tenido la suerte de que mis padres fallecieron acá, en mi hogar. Todo esto me da la oportunidad de hablar con propiedad y con veracidad de las inq...

  12. New genera of Fungi—VIII

    NARCIS (Netherlands)

    Singer, Rolf

    1962-01-01

    The genus Pseudohiatula, based on hymeniform structure of epicutis with interspersed dermatocystidia or trichodermial-palisadic structure without dermatocystidia, contains species, all belonging in the same tribus (Marasmieae), but does not seem to be sufficiently homogeneous to be maintained sensu

  13. MAPPING THE GALACTIC HALO. VIII. QUANTIFYING SUBSTRUCTURE

    NARCIS (Netherlands)

    Starkenburg, Else; Helmi, Amina; Morrison, Heather L.; Harding, Paul; van Woerden, Hugo; Mateo, Mario; Olszewski, Edward W.; Sivarani, Thirupathi; Norris, John E.; Freeman, Kenneth C.; Shectman, Stephen A.; Dohm-Palmer, R. C.; Frey, Lucy; Oravetz, Dan

    2009-01-01

    We have measured the amount of kinematic substructure in the Galactic halo using the final data set from the Spaghetti project, a pencil-beam high-latitude sky survey. Our sample contains 101 photometrically selected and spectroscopically confirmed giants with accurate distance, radial velocity, and

  14. Project ACT VIII Wrap-Up Report.

    Science.gov (United States)

    Colorado State Univ., Ft. Collins. Dept. of Education.

    Project ACT (Adult Competency Training) was a United States Office of Education staff development project in Region 8 from 1972 to 1975, implementing a self-generating and self-supporting staff system to help adult educators become better prepared to serve their clients. The project served Colorado, Montana, North Dakota, South Dakota, Utah, and…

  15. Measurement and interpretation of threshold stress intensity factors for steels in high-pressure hydrogen gas.

    Energy Technology Data Exchange (ETDEWEB)

    Dadfarnia, Mohsen (University of Illinois at Urbana-Champaign, Urbana, IL); Nibur, Kevin A.; San Marchi, Christopher W.; Sofronis, Petros (University of Illinois at Urbana-Champaign, Urbana, IL); Somerday, Brian P.; Foulk, James W., III; Hayden, Gary A. (CP Industries, McKeesport, PA)

    2010-07-01

    Threshold stress intensity factors were measured in high-pressure hydrogen gas for a variety of low alloy ferritic steels using both constant crack opening displacement and rising crack opening displacement procedures. The sustained load cracking procedures are generally consistent with those in ASME Article KD-10 of Section VIII Division 3 of the Boiler and Pressure Vessel Code, which was recently published to guide design of high-pressure hydrogen vessels. Three definitions of threshold were established for the two test methods: K{sub THi}* is the maximum applied stress intensity factor for which no crack extension was observed under constant displacement; K{sub THa} is the stress intensity factor at the arrest position for a crack that extended under constant displacement; and K{sub JH} is the stress intensity factor at the onset of crack extension under rising displacement. The apparent crack initiation threshold under constant displacement, K{sub THi}*, and the crack arrest threshold, K{sub THa}, were both found to be non-conservative due to the hydrogen exposure and crack-tip deformation histories associated with typical procedures for sustained-load cracking tests under constant displacement. In contrast, K{sub JH}, which is measured under concurrent rising displacement and hydrogen gas exposure, provides a more conservative hydrogen-assisted fracture threshold that is relevant to structural components in which sub-critical crack extension is driven by internal hydrogen gas pressure.

  16. Risk Factors for Portal Vein Thrombosis in Patients With Cirrhosis Awaiting Liver Transplantation in Shiraz, Iran

    Directory of Open Access Journals (Sweden)

    Bagheri Lankarani

    2015-12-01

    Full Text Available Background Portal vein thrombosis is a fairly common and potentially life-threatening complication in patients with liver cirrhosis. The risk factors for portal vein thrombosis in these patients are still not fully understood. Objectives This study aimed to investigate the associations between various risk factors in cirrhotic patients and the development of portal vein thrombosis. Patients and Methods In this case-control study performed at the Shiraz organ transplantation center, Iran, we studied 219 patients (> 18 years old with liver cirrhosis, who were awaiting liver transplants in our unit, from November 2010 to May 2011. The patients were evaluated by history, physical examination, and laboratory tests, including factor V Leiden, prothrombin gene mutation, Janus Kinase 2 (JAK2 mutation, and serum levels of protein C, protein S, antithrombin III, homocysteine, factor VIII, and anticardiolipin antibodies. Results There was no statistically significant difference in the assessed hypercoagulable states between patients with or without portal vein thrombosis. A history of previous variceal bleeding with subsequent endoscopic treatment in patients with portal vein thrombosis was significantly higher than in those without it (P = 0.013, OR: 2.526, 95% CI: 1.200 - 5.317. Conclusions In our population of cirrhotic patients, treatment of variceal bleeding predisposed the patients to portal vein thrombosis, but hypercoagulable disorders by themselves were not associated with portal vein thrombosis.

  17. Factor 8 (F8) gene mutation profile of Turkish hemophilia A patients with inhibitors.

    Science.gov (United States)

    Fidanci, Inanç D; Kavakli, Kaan; Uçar, Canan; Timur, Cetin; Meral, Adalet; Kilinç, Yurdanur; Sayilan, Hülya; Kazanci, Elif; Cağlayan, S Hande

    2008-07-01

    Factor VIII (FVIII) replacement therapy is ineffective in hemophilia A patients who develop alloantibodies (inhibitors) against FVIII. The type of factor 8 (F8) gene mutation, genes in the major histocompatibility complex loci, and also polymorphisms in IL-10 and tumor necrosis factor-alpha are the major predisposing factors for inhibitor formation. The present study was initiated to reveal the F8 gene mutation profile of 30 severely affected high-responder patients with inhibitor levels of more than 5 Bethesda U (BU)/ml and four low-responder patients with inhibitors less than 5 BU/ml. Southern blot and PCR analysis were performed to detect intron 22 and intron 1 inversions, respectively. Point mutations were screened by DNA sequence analysis of all coding regions, intron/exon boundaries, promoter and 3' UTR regions of the F8 gene. The prevalent mutation was the intron 22 inversion among the high-responder patients followed by large deletions, small deletions, and nonsense mutations. Only one missense and one splicing error mutation was seen. Among the low-responder patients, three single nucleotide deletions and one intron 22 inversion were found. All mutation types detected were in agreement with the severe hemophilia A phenotype, most likely leading to a deficiency of and predisposition to the development of alloantibodies against FVIII. It is seen that Turkish hemophilia A patients with major molecular defects have a higher possibility of developing inhibitors.

  18. Is ABO blood group truly a risk factor for thrombosis and adverse outcomes?

    Science.gov (United States)

    Zhou, Shan; Welsby, Ian

    2014-01-01

    ABO blood type is one of the most readily available laboratory tests, and serves as a vital determinant in blood transfusion and organ transplantation. The ABO antigens are expressed not only on red blood cell membranes, determining the compatibility of transfusion, but also on the surface of other human cells, including epithelium, platelet and vascular endothelium, therefore extending the research into other involvements of cardiovascular disease and postoperative outcomes. ABO blood group has been recognized as a risk factor of venous thrombosis embolism since the 1960’s, effects now understood to be related to ABO dependent variations are procoagulant factor VIII (FVIII) and von Willebrand factor (vWF) levels. Levels of vWF, mostly genetically determined, are strongly associated with venous thromboembolism (VTE). It mediates platelet adhesion aggregation and stabilizes FVIII in plasma. Moreover, many studies have tried to identify the relationship between ABO blood types and ischemic heart disease. Unlike the clear and convincing associations between VTE and ABO blood type, the link between ABO blood type and ischemic heart disease is less consistent and may be confusing. Other than genetic factors, ischemic heart disease is strongly related to diet, race, lipid metabolism and economic status. In this review, we’ll summarize the data relating race and genetics, including ABO blood type, to VTE, ischemic heart disease and postoperative bleeding after cardiac surgery. PMID:25276299

  19. Diagnostic difficulties of factor XI deficiencies: interferences' assay or real deficit?

    Science.gov (United States)

    Gaymard, Alexandre; Nougier, Christophe

    2016-06-01

    Madam P, 77 years old, consulted in the hemostasis department after a coagulation anomaly was discovered during her preoperative test for a total hip prosthesis. After confirmation of a persistent and increased aPTT, additional tests were performed and showed the presence of antiphospholipid antibodies. Factor VIII level could be corrected after the plasma dilution to 1/40(th). But successive dilutions were not enough to obtain a correct factor IX (FIX) and factor XI (FXI) level. FIX level was obtained by chromogenic method in order to avoid the interferences caused by the antibodies. Finally, despite the change of reagents and dilutions up to 1/160(th), the FXI level couldn't be determined. Despite these results and those of the thrombin generation assay, the surgery was successfully done without specific treatment thanks to the absence of hemorrhagic history. This observation highlights the diagnostic and monitoring difficulties for uncommon clotting factor deficit. The development of interference free test could increase the support for these patients.

  20. Behavioral factors.

    Science.gov (United States)

    Zero, D T; Lussi, A

    2006-01-01

    During and after an erosive challenge, behavioral factors play a role in modifying the extent of erosive tooth wear. The manner that dietary acids are introduced into the mouth (gulping, sipping, use of a straw) will affect how long the teeth are in contact with the erosive challenge. The frequency and duration of exposure to an erosive agent is of paramount importance. Night-time exposure (e.g. baby bottle-feeding) to erosive agents may be particularly destructive because of the absence of salivary flow. Health-conscious individuals tend to ingest acidic drinks and juices more frequently and tend to have higher than average oral hygiene. While good oral hygiene is of proven value in the prevention of periodontal disease and dental caries, frequent toothbrushing with abrasive oral hygiene products may enhance erosive tooth wear. Unhealthy lifestyles such as consumption of designer drugs, alcopops and alcohol abuse are other important behavioral factors.

  1. Factor analysis

    CERN Document Server

    Gorsuch, Richard L

    2013-01-01

    Comprehensive and comprehensible, this classic covers the basic and advanced topics essential for using factor analysis as a scientific tool in psychology, education, sociology, and related areas. Emphasizing the usefulness of the techniques, it presents sufficient mathematical background for understanding and sufficient discussion of applications for effective use. This includes not only theory but also the empirical evaluations of the importance of mathematical distinctions for applied scientific analysis.

  2. Non-genetic risk factors in haemophilia A inhibitor management - the danger theory and the use of animal models.

    Science.gov (United States)

    Lövgren, K M; Søndergaard, H; Skov, S; Wiinberg, B

    2016-09-01

    In haemophilia A (HA) management, antidrug antibodies, or inhibitors, are a serious complication that renders factor VIII (FVIII) replacement therapy ineffective, increases morbidity and reduces quality of life for affected patients. Inhibitor development aetiology is multifactorial and covers both genetic and therapy related risk factors. Many therapy-related risk factors have proven difficult to confirm due to several confounding factors and the small study populations available. However, clinical studies indicate that e.g. on-demand treatment and surgery affect inhibitor development, and explanations for this association are being investigated. A potential explanation is the danger signal effect, where the immune response is activated by endogenous or exogenous danger or damage signals present at the time and site of FVIII administration. The danger theory explains how alarm signals from stressed, injured or dying cells can activate an immune reaction, without the involvement of foreign antigens. Bleeds, trauma, surgery or concomitant infection could be events initiating danger signalling in HA patients, resulting in an immune reaction towards administered FVIII that otherwise would pass unnoticed. This role of danger in HA inhibitor formation has previously been suggested, but a thorough discussion of this subject is lacking. The present review will discuss the potential role of danger signals in haemophilia and inhibitor development, with focus on treatment related risk factors with a suspected danger signal aetiology; on-demand treatment, treatment during major bleeds or surgery, and treatment during infection or vaccination. Clinical studies as well as animal experiments addressing these factors will be reviewed.

  3. Bone marrow-derived cells mobilized by granulocyte-colony stimulating factor facilitate vascular regeneration in mouse kidney after ischemia/reperfusion injury.

    Science.gov (United States)

    Akihama, Susumu; Sato, Kazunari; Satoh, Shigeru; Tsuchiya, Norihiko; Kato, Tetsuro; Komatsuda, Atsushi; Hirokawa, Makoto; Sawada, Kenichi; Nanjo, Hiroshi; Habuchi, Tomonori

    2007-12-01

    Bone marrow-derived cells (BMDC) play crucial roles in tissue regeneration. Granulocyte-colony stimulating factor (G-CSF) mobilizes BMDC and may facilitate the repair of kidney tissues after ischemia/reperfusion (I/R) injury. The tissue protective action of resveratrol, an antioxidant, might modify the regenerating potential of BMDC in I/R renal injury. This study examined whether G-CSF and/or resveratrol affect the recruitment of BMDC into vascular endothelial cells and renal tubular cells and the kidney function after I/R injury. I/R renal injury was induced in female mice that had been lethally irradiated and transplanted with male bone marrow cells. The mice were given saline, resveratrol or G-CSF, daily for 7 days. Non-irradiated and non-bone-marrow-transplanted female mice, which underwent the same kidney injury, were included as control. White blood cell (WBC) count and serum creatinine were monitored. Immunohistologic evaluation for renal tubular cells (cytokeratin) and endothelial cells (factor VIII-related antigen), and fluorescence in situ hybridization for mouse Y chromosome were performed. Although WBC was significantly higher in the G-CSF group, there was no significant difference in creatinine levels among all groups. Factor VIII-related antigen-positive cells with a Y-chromosome signal were identified in the capillary wall between renal tubuli and most frequently seen in the G-CSF group (p cells having a Y-chromosome signal were identified. In conclusion, BMDC are recruited into endothelial cell in I/R renal injury without apparent renal tubular cell regeneration, and G-CSF facilitates the endothelial cell regeneration.