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Sample records for fibrin d-dimer levels

  1. Genetic predictors of fibrin D-dimer levels in healthy adults

    NARCIS (Netherlands)

    N.L. Smith (Nicholas); J.E. Huffman (Jennifer E.); D.P. Strachan (David); J. Huang (Jian); A. Dehghan (Abbas); S. Trompet (Stella); L.M. Lopez (Lorna M.); S.Y. Shin (So Youn); J. Baumert (Jens); V. Vitart (Veronique); J.C. Bis (Joshua); S.H. Wild (Sarah); A. Rumley (Ann); Q. Yang (Qiong Fang); A.G. Uitterlinden (André); D.J. Stott (David. J.); G. Davies (Gareth); A.M. Carter (Angela M.); B. Thorand (Barbara); O. Polašek (Ozren); B. McKnight (Barbara); H. Campbell (Harry); A.R. Rudnicka (Alicja); M.H. Chen (Min-hsin); B.M. Buckley (Brendan M.); S.E. Harris (Sarah); A. Peters (Annette); D. Pulanic (Drazen); T. Lumley (Thomas); A.J.M. de Craen (Anton J.M.); D.C. Liewald (David C.); C. Gieger (Christian); I. Ford (Ian); A.J. Gow (Alan J.); M. Luciano (Michelle); D.J. Porteous (David J.); X. Guo (Xiuqing); N. Sattar (Naveed); A. Tenesa (Albert); M. Cushman (Mary Ann); P.E. Slagboom (Eline); P.M. Visscher (Peter M.); T.D. Spector (Tim); T. Illig (Thomas); I. Rudan (Igor); E.G. Bovill (Edwin G.); A.F. Wright (Alan); W.L. McArdle (Wendy); G.H. Tofler (Geoffrey); A. Hofman (Albert); R.G.J. Westendorp (Rudi); J.M. Starr (John); P.J. Grant (Peter J.); M. Karakas (Mahir); N.D. Hastie (Nicholas D.); B.M. Psaty (Bruce); J.F. Wilson (James); G.D.O. Lowe (Gordon); C.J. O'Donnell (Christopher); J.C.M. Witteman (Jacqueline); J.W. Jukema (Jan Wouter); I.J. Deary (Ian); N. Soranzo (Nicole); W. Koenig (Wolfgang); C. Hayward (Caroline)

    2011-01-01

    textabstractBACKGROUND: Fibrin fragment D-dimer, one of several peptides produced when crosslinked fibrin is degraded by plasmin, is the most widely used clinical marker of activated blood coagulation. To identity genetic loci influencing D-dimer levels, we performed the first large-scale, genome-wi

  2. Genetic predictors of fibrin D-dimer levels in healthy adults

    NARCIS (Netherlands)

    N.L. Smith (Nicholas); J.E. Huffman (Jennifer E.); D.P. Strachan (David); J. Huang (Jian); A. Dehghan (Abbas); S. Trompet (Stella); L.M. Lopez (Lorna M.); S.Y. Shin (So Youn); J. Baumert (Jens); V. Vitart (Veronique); J.C. Bis (Joshua); S.H. Wild (Sarah); A. Rumley (Ann); Q. Yang (Qiong Fang); A.G. Uitterlinden (André); D.J. Stott (David. J.); G. Davies (Gareth); A.M. Carter (Angela M.); B. Thorand (Barbara); O. Polašek (Ozren); B. McKnight (Barbara); H. Campbell (Harry); A.R. Rudnicka (Alicja); M.H. Chen (Min-hsin); B.M. Buckley (Brendan M.); S.E. Harris (Sarah); A. Peters (Annette); D. Pulanic (Drazen); T. Lumley (Thomas); A.J.M. de Craen (Anton J.M.); D.C. Liewald (David C.); C. Gieger (Christian); I. Ford (Ian); A.J. Gow (Alan J.); M. Luciano (Michelle); D.J. Porteous (David J.); X. Guo (Xiuqing); N. Sattar (Naveed); A. Tenesa (Albert); M. Cushman (Mary Ann); P.E. Slagboom (Eline); P.M. Visscher (Peter M.); T.D. Spector (Tim); T. Illig (Thomas); I. Rudan (Igor); E.G. Bovill (Edwin G.); A.F. Wright (Alan); W.L. McArdle (Wendy); G.H. Tofler (Geoffrey); A. Hofman (Albert); R.G.J. Westendorp (Rudi); J.M. Starr (John); P.J. Grant (Peter J.); M. Karakas (Mahir); N.D. Hastie (Nicholas D.); B.M. Psaty (Bruce); J.F. Wilson (James); G.D.O. Lowe (Gordon); C.J. O'Donnell (Christopher); J.C.M. Witteman (Jacqueline); J.W. Jukema (Jan Wouter); I.J. Deary (Ian); N. Soranzo (Nicole); W. Koenig (Wolfgang); C. Hayward (Caroline)

    2011-01-01

    textabstractBACKGROUND: Fibrin fragment D-dimer, one of several peptides produced when crosslinked fibrin is degraded by plasmin, is the most widely used clinical marker of activated blood coagulation. To identity genetic loci influencing D-dimer levels, we performed the first large-scale, genome-wi

  3. Genetic predictors of fibrin D-dimer levels in healthy adults

    Science.gov (United States)

    Smith, Nicholas L.; Huffman, Jennifer E.; Strachan, David P.; Huang, Jie; Dehghan, Abbas; Trompet, Stella; Lopez, Lorna M.; Shin, So-Youn; Baumert, Jens; Vitart, Veronique; Bis, Joshua C.; Wild, Sarah H.; Rumley, Ann; Yang, Qiong; Uitterlinden, Andre G; Stott, David. J.; Davies, Gail; Carter, Angela M.; Thorand, Barbara; Polašek, Ozren; McKnight, Barbara; Campbell, Harry; Rudnicka, Alicja R.; Chen, Ming-Huei; Buckley, Brendan M.; Harris, Sarah E.; Williams, Frances M. K.; Peters, Annette; Pulanic, Drazen; Lumley, Thomas; de Craen, Anton J.M.; Liewald, David C.; Gieger, Christian; Campbell, Susan; Ford, Ian; Gow, Alan J.; Luciano, Michelle; Porteous, David J.; Guo, Xiuqing; Sattar, Naveed; Tenesa, Albert; Cushman, Mary; Slagboom, P. Eline; Visscher, Peter M.; Spector, Tim D.; Illig, Thomas; Rudan, Igor; Bovill, Edwin G.; Wright, Alan F.; McArdle, Wendy L.; Tofler, Geoffrey; Hofman, Albert; Westendorp, Rudi G.J.; Starr, John M.; Grant, Peter J.; Karakas, Mahir; Hastie, Nicholas D.; Psaty, Bruce M.; Wilson, James F.; Lowe, Gordon D. O.; O’Donnell, Christopher J; Witteman, Jacqueline CM; Jukema, J. Wouter; Deary, Ian J.; Soranzo, Nicole; Koenig, Wolfgang; Hayward, Caroline

    2011-01-01

    Background Fibrin fragment D-dimer is one of several peptides produced when cross-linked fibrin is degraded by plasmin, and is the most widely-used clinical marker of activated blood coagulation. To identity genetic loci influencing D-dimer levels, we performed the first large-scale, genome-wide association search. Methods and Results A genome-wide investigation of the genomic correlates of plasma D-dimer levels was conducted among 21,052 European-ancestry adults. Plasma levels of D-dimer were measured independently in each of 13 cohorts. Each study analyzed the association between ~2.6 million genotyped and imputed variants across the 22 autosomal chromosomes and natural-log transformed D-dimer levels using linear regression in additive genetic models adjusted for age and sex. Among all variants, 74 exceeded the genome-wide significance threshold and marked 3 regions. At 1p22, rs12029080 (p-value 6.4×10−52) was 46.0 kb upstream from F3, coagulation factor III (tissue factor). At 1q24, rs6687813 (p-value 2.4×10−14) was 79.7 kb downstream of F5, coagulation factor V. At 4q32, rs13109457 (p-value 2.9×10−18) was located between 2 fibrinogen genes: 10.4 kb downstream from FGG and 3.0 kb upstream from FGA. Variants were associated with a 0.099, 0.096, and 0.061 unit difference, respectively, in natural-log transformed D-dimer and together accounted for 1.8% of the total variance. When adjusted for non-synonymous substitutions in F5 and FGA loci known to be associated with D-dimer levels, there was no evidence of an additional association at either locus. Conclusions Three genes were associated with fibrin D-dimer levels, of which the F3 association was the strongest and has not been previously reported. PMID:21502573

  4. Cancer-associated ischemic stroke is associated with elevated D-dimer and fibrin degradation product levels in acute ischemic stroke with advanced cancer.

    Science.gov (United States)

    Kono, Tomoyuki; Ohtsuki, Toshiho; Hosomi, Naohisa; Takeda, Ikuko; Aoki, Shiro; Sueda, Yoshimasa; Ishihara, Kayoko; Nakamura, Takeshi; Yamawaki, Takemori; Matsumoto, Masayasu

    2012-07-01

    Although several studies have reported various causes of ischemic stroke in patients with cancer, only a few have evaluated the clinical relevance of ischemic stroke pathogenesis to cancer. The aim of the present study was to elucidate the clinical characteristics of cancer-associated ischemic stroke. We evaluated 154 ischemic stroke patients without cancer and 57 ischemic stroke patients with cancer who had either received continuous treatment for cancer within 5 years before to the onset of ischemic stroke, or who had been diagnosed with cancer within 1 year after the onset of ischemic stroke. Cancer patients were grouped into "cancer-associated ischemic stroke," the "conventional ischemic stroke," or "other." A total of 15 patients (26%) were classified into the cancer-associated ischemic stroke in cancer patients. In univariate analysis of the cancer-associated ischemic stroke and the others, there were significant differences in the prevalence of hypertension, hyperlipidemia and advanced cancer (clinical stage IV), and the levels of d-dimer, fibrin degradation product and hemoglobin. With multivariate regression analysis of those factors, the prevalence of hypertension, hyperlipidemia and advanced cancer (clinical stage IV), and the levels of D-dimer and fibrin degradation product remained as statistically independent factors, which were associated with cancer-associated ischemic stroke (n = 111, χ(2) =67.21, P acute ischemic stroke, the cancer-associated ischemic stroke is associated with elevated D-dimer and fibrin degradation products, even after controlling hypertension, hyperlipidemia and advanced cancer (clinical stage IV). © 2012 Japan Geriatrics Society.

  5. Diagnostic implication of fibrin degradation products and D-dimer in aortic dissection

    Science.gov (United States)

    Dong, Jian; Duan, Xianli; Feng, Rui; Zhao, Zhiqing; Feng, Xiang; Lu, Qingsheng; Jing, Qing; Zhou, Jian; Bao, Junmin; Jing, Zaiping

    2017-01-01

    Fibrin degradation products (FDP) and D-dimer have been considered to be involved in many vascular diseases. In this study we aimed to explore the diagnostic implication of FDP and D-dimer in aortic dissection patients. 202 aortic dissection patients were collected as the case group, 150 patients with other cardiovascular diseases, including myocardial infarction (MI, n = 45), pulmonary infarction (n = 51) and abdominal aortic aneurysm (n = 54) were collected as non-dissection group, and 27 healthy people were in the blank control group. The FDP and D-dimer levels were detected with immune nephelometry. Logist regression analysis was performed to evaluate the influence of FDP and D-dimer for the aortic dissection patients. ROC curve was used to determine the diagnostic value of FDP and D-dimer. The FDP and D-dimer levels were significantly higher in aortic dissection patients than in non-dissection patients and the healthy controls. FDP and D-dimer were both the risk factors for patients with aortic dissection. From the ROC analysis, diagnostic value of FDP and D-dimer were not high to distinguish aortic dissection patients from the non-dissection patients. However FDP and D-dimer could be valuable diagnostic marker to differentiate aortic dissection patients and healthy controls with both AUC 0.863. PMID:28262748

  6. Changes in fibrin D-dimer, fibrinogen, and protein S during pregnancy

    DEFF Research Database (Denmark)

    Hansen, Anette Tarp; Andreasen, Birgitte Horst; Salvig, Jannie Dalby

    2010-01-01

    Background. Pregnancy is a hypercoagulable state with a 5- to 10- fold higher risk of venous thromboembolism. Existing reference intervals for fibrin D-dimer (D-dimer), functional fibrinogen (fibrinogen) and protein S, free antigen (protein S) are based on non-pregnant patients and reference...... intervals for pregnant patients are warranted. Objectives. The aim of the present study was to contribute to the establishment of reference intervals for D-dimer, fibrinogen and protein S during pregnancy and to discuss the use of the analyses during pregnancy. Methods. We included 55 healthy pregnant women....... Changes during pregnancy in plasma D-dimer, protein S and fibrinogen were confirmed. Further clinical studies are needed to clarify a clinical useful cut-off point for D-dimer in pregnancy. We suggest careful attention to a low peripartum fibrinogen, since it indicates an increased bleeding risk. We...

  7. A neoantigenic determinant in the D-dimer fragment of fibrin

    NARCIS (Netherlands)

    Lugovskoy, E.V.; Kolesnikova, I.N.; Gritsenko, P.G.; Zolotareva, E.N.; Gaffney, P.; Nieuwenhuizen, W.; Komisarenko, S.V

    2002-01-01

    Monoclonal antibody (mAb) III-3b binds D-dimer with Kd = 1.4 × 10-10 M without cross-reaction with fibrin(ogen). The epitope for this mAb is in Bβ134-190, presumably in Bβ155-160. The latter site is buried in the coiled coil structure of fibrin(ogen) but it is exposed as a neoantigenic determinant i

  8. Immunohistochemical evaluation of tissue factor, fibrin/fibrinogen and D-dimers in canine gliomas.

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    de la Fuente, Cristian; Pumarola, Martí; Blasco, Ester; Fernández, Francisco; Viu, Judit; Añor, Sònia

    2014-06-01

    In human gliomas, tissue factor (TF) is overexpressed, associated with the grade of malignancy and influences tumour biology. Intra-tumoural fibrin/fibrinogen deposition and activation of the fibrinolytic system also play a role in tumour cell proliferation and angiogenesis. The first aim of the present study was to investigate TF expression and the presence of fibrin/fibrinogen and D-dimers in canine glioma biopsies, graded according to the World Health Organization (WHO) classification of tumours of the central nervous system. The second aim was to investigate the occurrence of intravascular thrombosis (IVT) in canine gliomas, as a potential histological marker of glioma type or grade of malignancy. An immunohistochemical study using antibodies against TF, fibrin/fibrinogen and D-dimers was performed with 24 glioma samples, including 15 oligodendrogliomas, 6 astrocytomas and 3 mixed gliomas. Immunohistochemical data were statistically analysed to determine whether there was any relationship between glioma type and grade of malignancy. All gliomas were moderate to strongly positive for TF and the staining score was significantly higher (P = 0.04) in high-grade (III or IV) than in low-grade (II) gliomas. Intra-tumoural fibrin/fibrinogen deposition was detected in all tumour biopsies assessed, and D-dimers were detected in 17/24 gliomas. IVT was a frequent finding, but was not linked to a specific glioma type or malignancy grade. TF expression, fibrin/fibrinogen deposition, extravascular fibrinolytic system activation and IVT occur in canine gliomas. Canine glioma might be a suitable model for studying coagulation and fibrinolysis as potential therapeutic targets for human gliomas.

  9. D-Dimer Plasma Levels Parallel the Clinical Response to Omalizumab in Patients with Severe Chronic Spontaneous Urticaria.

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    Asero, Riccardo; Marzano, Angelo V; Ferrucci, Silvia; Cugno, Massimo

    2017-01-01

    Omalizumab is very effective in the majority of patients with severe chronic spontaneous urticaria (CSU), but its mechanism of action is still unclear. In CSU the coagulation cascade is activated with an intensity that parallels the disease severity, and elevated plasma D-dimer levels are associated with a poor response to both antihistamines and cyclosporin. We measured D-dimer plasma levels before and after the first administration of omalizumab in 32 patients with severe CSU. A number of clinical and laboratory parameters were recorded, including the urticaria activity score, presence of angioedema, disease duration, C-reactive protein, anti-nuclear, and anti-thyroid antibodies. Baseline D-dimer levels were elevated in 19 (59%) cases. Omalizumab induced a complete response in 25 patients (78%), in most cases already after the first administration. At baseline, 14/25 responders had increased D-dimer plasma levels versus 5/7 non-responders. All responders showed a dramatic decrease of D-dimer plasma levels after the first administration of the drug (from 1,024 ± 248 [mean ± SE] to 251 ± 30 ng/mL; p = 0.003). In contrast, non-responders did not show any reduction in D-dimer levels after omalizumab administration (from 787 ± 206 to 1,230 ± 429 ng/mL; p = ns). In conclusion, plasma levels of D-dimer are frequently elevated in patients with severe CSU before omalizumab administration and decrease according to the clinical response of the disease to the drug, suggesting a possible effect of omalizumab on coagulation activation and fibrin degradation in a subset of CSU patients. © 2017 S. Karger AG, Basel.

  10. Correlation analysis between plasma D-dimer levels and orthopedic trauma severity

    Institute of Scientific and Technical Information of China (English)

    ZHANG Li-dan; LIU Hong-bo; LI Yu-neng; MA Hai-mei; LIU Ya-bo; WANG Man-yi

    2012-01-01

    Background The correlation between the plasma D-dimer level and deep vein thrombosis has not been conclusive in various studies.The aim of this research was to study the relationship between plasma D-dimer levels and the severity of orthopedic trauma by retrospective examination of orthopedic trauma cases.Methods Clinically acute trauma and non-acute trauma patients were selected and their plasma D-dimer levels were measured.Plasma D-dimer levels in patients of these two groups were compared.The relationship between the plasma D-dimer level and the severity of the trauma was also studied.Results There were 548 cases in the acute trauma group and 501 cases in the non-acute trauma group.The levels of plasma D-dimer were significantly higher in the acute trauma group than in the non-acute trauma group (P <0.01).In the acute trauma group,the correlation between the D-dimer level and the number of fractures was a positive linear correlation (r=0.9532).Conclusions Elevated plasma D-dimer is common in trauma patients.The D-dimer level and the number of fractures in the trauma patients are closely correlated.D-dimer is not only an indicator for the diagnosis of deep vein thrombosis and pulmonary embolus,but also an indicator of the severity of trauma in acute trauma patients.

  11. Factors associated with D-dimer levels in HIV-infected individuals

    DEFF Research Database (Denmark)

    Borges, Alvaro H; O'Connor, Jemma L; Phillips, Andrew N

    2014-01-01

    with measured D-dimer levels were included (N = 9,848). Factors associated with D-dimer were identified by linear regression. Covariates investigated were: age, gender, race, body mass index, nadir and baseline CD4+ count, plasma HIV RNA levels, markers of inflammation (C-reactive protein [CRP], interleukin-6...

  12. Evaluation of Serum D-dimer Levels in Children with Pneumonia

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    Nilgün Selçuk Duru

    2016-03-01

    Full Text Available Aim: The aim of this study was to investigate the relationship of plasma D-dimer levels with duration of hospitalization and radiological and laboratory findings in patients with pneumonia. Methods: Forty-seven patients with pneumonia (31 boys and 16 girls, mean age: 4.2±4.7 years were included in the study. The patients were divided into two groups according to duration of hospitalization and three groups according to radiological findings. D-dimer and other laboratory findings were compared between the groups. Results: The mean serum D-dimer level was 1333.5±1364.4 ng/L. There was no statistically significant difference in D-dimer, leukocyte, erythrocyte sedimentation rate (ESR and C-reactive protein (CRP between the groups divided according to duration of hospitalization. In addition, there was no statistically difference in D-dimer levels between the groups divided according to radiological findings. Age, percentage of neutrophils, ESR and fibrinogen levels were higher in patients with lobar pneumonia when compared with the other groups and CRP level was higher in lobar pneumonia group when compared to interstitial pneumonia group. D-dimer levels were negatively correlated with age and positively correlated with ESR, CRP, and fibrinogen. Conclusion: In our study, D-dimer levels were high in patient with pneumonia. Further studies with a larger number of patients are necessary to determine the role of D-dimer levels as an acutephase reactant in patients with pneumonia

  13. Factors associated with D-dimer levels in HIV-infected individuals

    DEFF Research Database (Denmark)

    Borges, Alvaro H; O'Connor, Jemma L; Phillips, Andrew N;

    2014-01-01

    [IL-6]), antiretroviral therapy (ART) use, ART regimens, co-morbidities (hepatitis B/C, diabetes mellitus, prior cardiovascular disease), smoking, renal function (estimated glomerular filtration rate [eGFR] and cystatin C) and cholesterol. RESULTS: Women from all age groups had higher D-dimer levels...... viruses, was positively correlated with D-dimer. Other factors independently associated with higher D-dimer levels were black race, higher plasma HIV RNA levels, being off ART at baseline, and increased levels of CRP, IL-6 and cystatin C. In contrast, higher baseline CD4+ counts and higher high...

  14. D-dimer levels and cerebral infarction in critically ill cancer patients.

    Science.gov (United States)

    Ryu, Jeong-Am; Bang, Oh Young; Lee, Geun-Ho

    2017-08-30

    D-dimer levels have been used in the diagnosis of a variety of thrombosis-related diseases. In this study, we evaluated whether measuring D-dimer levels can help to diagnose cerebral infarction (CI) in critically ill cancer patients. We retrospectively evaluated all cancer patients who underwent brain magnetic resonance imaging (MRI) between March 2010 and February 2014 at the medical oncology intensive care unit (ICU) of Samsung Medical Center. Brain MRI scanning was performed when CI was suspected due to acute neurological deficits. We compared D-dimer levels between patients ultimately diagnosed as having or not having CI and analyzed diffusion-weighted imaging (DWI) lesion patterns. A total of 88 patients underwent brain MRI scanning due to clinical suspicion of CI; altered mental status and unilateral hemiparesis were the most common neurological deficits. CI was ultimately diagnosed in 43 (49%) patients. According to the DWI patterns, multiple arterial infarctions (40%) were more common than single arterial infarctions (9%). Cryptogenic stroke etiologies were more common (63%) than determined etiologies. There was no significant difference in D-dimer levels between patients with and without CI (P = 0.319). Although D-dimer levels were not helpful in diagnosing CI, D-dimer levels were associated with cryptogenic etiologies in critically ill cancer patients; D-dimer levels were higher in the cryptogenic etiology group than in the determined etiology group or the non-infarction group (P = 0.001). In multivariate analysis, elevated D-dimer levels (> 8.89 μg/mL) were only associated with cryptogenic stroke (adjusted OR 5.46; 95% confidence interval, 1.876-15.857). Abnormal D-dimer levels may support the diagnosis of cryptogenic stroke in critically ill cancer patients.

  15. CT Findings of Disease with Elevated Serum D-Dimer Levels in an Emergency Room Setting

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    Choi, Ji Youn; Kwon, Woo Cheol; Kim, Young Ju [Dept. of Radiology, Wonju Christian Hospital, Yensei University Wonju College of Medicine, Wonju (Korea, Republic of)

    2012-01-15

    Pulmonary embolism and deep vein thrombosis are the leading causes of elevated serum D-dimer levels in the emergency room. Although D-dimer is a useful screening test because of its high sensitivity and negative predictive value, it has a low specificity. In addition, D-dimer can be elevated in various diseases. Therefore, information on the various diseases with elevated D-dimer levels and their radiologic findings may allow for accurate diagnosis and proper management. Herein, we report the CT findings of various diseases with elevated D-dimer levels in an emergency room setting, including an intravascular contrast filling defect with associated findings in a venous thromboembolism, fracture with soft tissue swelling and hematoma formation in a trauma patient, enlargement with contrast enhancement in the infected organ of a patient, coronary artery stenosis with a perfusion defect of the myocardium in a patient with acute myocardial infarction, high density of acute thrombus in a cerebral vessel with a low density of affected brain parenchyma in an acute cerebral infarction, intimal flap with two separated lumens in a case of aortic dissection, organ involvement of malignancy in a cancer patient, and atrophy of a liver with a dilated portal vein and associated findings.

  16. D-dimer levels and stroke progression in patients with acute ischemic stroke and atrial fibrillation

    DEFF Research Database (Denmark)

    Krarup, L-H; Sandset, E C; Sandset, P M

    2011-01-01

    Krarup L-H, Sandset EC, Sandset PM, Berge E. D-dimer levels and stroke progression in patients with acute ischemic stroke and atrial fibrillation. Acta Neurol Scand: 2011: 124: 40-44. © 2010 John Wiley & Sons A/S. Background -  Patients with acute ischemic stroke and atrial fibrillation...... in patients with acute ischemic stroke and atrial fibrillation....... are at increased risk of stroke progression and recurrence. We sought to assess whether D-dimer and other markers of hemostatic activation could predict these adverse events in such patients. Method -  Blood samples were obtained from patients included in the Heparin in Acute Embolic Stroke Trial. Stroke...

  17. Prognostic associations of preoperative plasma levels of fibrinogen and D-dimer after curative resection in patients with colorectal cancer

    Institute of Scientific and Technical Information of China (English)

    王俊锋

    2013-01-01

    Objective To explore the associations of preoperative plasma levels of fibrinogen and D-dimer with clinico-pathologic parameters and overall survival in colorectal cancer patients after curative resection.Methods From

  18. D-Dimer and Carcinoembryonic Antigen Levels: Useful Indicators for Predicting the Tumor Stage and Postoperative Survival

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    Kemal Tekeşin

    2016-01-01

    Full Text Available The purpose of this prospective study is to determine the preoperative plasma D-dimer and serum Carcinoembryonic Antigen (CEA levels of patients scheduled for curative surgical resection for colorectal cancer and to evaluate the significance of these levels on the prognosis and postoperative survival rate. One hundred sixty-five patients with colorectal cancer, who were scheduled to have elective resection between January 2008 and January 2011, were included in the study. A significant increase was observed in the D-dimer levels, particularly in poorly differentiated tumors. The distance covered by the tumor inside the walls of the colon and rectum (T-stage was significant for both D-dimer and CEA levels. As the T-stage increased, there was also a significant increase in the D-dimer and CEA levels. A high significance and correlation level was detected between the TNM staging and both D-dimer and CEA. A significant relationship was found between the advanced tumor stage and short postoperative survival rate of patients with colorectal cancer. Therefore, the analysis of preoperative D-dimer and CEA levels can be useful in predicting the stage and differentiation of the tumor and the postoperative survival rate.

  19. Evaluation of the Diagnostic Accuracy of Serum D-Dimer Levels in Pregnant Women with Adnexal Torsion

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    Hasan Onur Topçu

    2015-01-01

    Full Text Available We aimed to evaluate the diagnostic accuracy of serum D-dimer levels in pregnant women with adnexal torsion (AT. The pregnant women with ovarian cysts who suffered from pelvic pain were divided into two groups; the first group consisted of the cases with surgically proven as AT (n = 17 and the second group consisted of the cases whose pain were resolved in the course of follow-up period without required surgery (n = 34. The clinical characteristics and serum D-dimer levels were compared between the groups. Patients with AT had a higher rate of elevated serum white blood cell (WBC count (57% vs. 16%, p = 0.04 and serum D-dimer levels (77% vs. 21%, p < 0.01 on admission in the study group than in the control group. Elevated D-dimer and cyst diameter larger than 5 cm yielded highest sensitivity (82% for each; whereas the presence of nausea and vomiting and elevated CRP had the highest specificity (85% and 88%, respectively. This is the first study that evaluates the serum D-dimer levels in humans in the diagnosis of AT, and our findings supported the use of D-dimer for the early diagnosis of AT in pregnant women.

  20. HIGH D-DIMER LEVELS PREDICT A POOR OUTCOME IN PATIENTS WITH SEVERE TRAUMA, EVEN WITH HIGH FIBRINOGEN LEVELS ON ARRIVAL: A MULTICENTER RETROSPECTIVE STUDY.

    Science.gov (United States)

    Hayakawa, Mineji; Maekawa, Kunihiko; Kushimoto, Shigeki; Kato, Hiroshi; Sasaki, Junichi; Ogura, Hiroshi; Matauoka, Tetsuya; Uejima, Toshifumi; Morimura, Naoto; Ishikura, Hiroyasu; Hagiwara, Akiyoshi; Takeda, Munekazu; Kaneko, Naoyuki; Saitoh, Daizoh; Kudo, Daisuke; Kanemura, Takashi; Shibusawa, Takayuki; Furugori, Shintaro; Nakamura, Yoshihiko; Shiraishi, Atsushi; Murata, Kiyoshi; Mayama, Gou; Yaguchi, Arino; Kim, Shiei; Takasu, Osamu; Nishiyama, Kazutaka

    2016-03-01

    Elevated D-dimer level in trauma patients is associated with tissue damage severity and is an indicator of hyperfibrinolysis during the early phase of trauma. To investigate the interacting effects of fibrinogen and D-dimer levels on arrival at the emergency department for massive transfusion and mortality in severe trauma patients in a multicenter retrospective study. This study included 519 adult trauma patients with an injury severity score ≥16. Patients with ≥10 units of red cell concentrate transfusion and/or death during the first 24 h were classified as having a poor outcome. Receiver operating characteristic curve analysis for predicting poor outcome showed the optimal cut-off fibrinogen and D-dimer values to be 190 mg/dL and 38 mg/L, respectively. On the basis of these values, patients were divided into four groups: low D-dimer (high fibrinogen (>190 mg/dL), low D-dimer (low fibrinogen (≤190 mg/dL), high D-dimer (≥38 mg/L)/high fibrinogen (>190 mg/dL), and high D-dimer (≥38 mg/L)/low fibrinogen (≤190 mg/dL). The survival rate was lower in the high D-dimer/low fibrinogen group than in the other groups. Moreover, the survival rate was lower in the high D-dimer/high fibrinogen group than in the low D-dimer/high fibrinogen and low D-dimer/low fibrinogen groups. High D-dimer level on arrival is a strong predictor of early death or requirement for massive transfusion in severe trauma patients, even with high fibrinogen levels.

  1. The follow-up of patients of sixty-five years of age and younger with acute ischemic stroke and transient ischemic attacks, and elevated D-dimer levels in plasma

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    Magnus Vrethem

    2009-09-01

    Full Text Available D-dimer levels in plasma, a degradation product of fibrin, have been shown to correlate with the severity of ischemic stroke. In order to investigate the outcome of patients with elevated D-dimer we have carried out a follow-up study of patients of 65 years of age and younger with acute ischemic stroke or transient ischemic attacks (TIA admitted to our stroke unit from 1991 to 1992. Twenty-two of the 57 patients had elevated D-dimer levels in the plasma. High levels were associated with cardioembolic stroke. On follow-up after a mean of 12 years, 15 patients had died and six patients had suffered another stroke or TIA (three of whom were dead. Ten patients had suffered other cardiovascular events and seven of them were dead. We concluded that high levels of D-dimer in acute ischemic stroke patients on admission were associated with cardioembolic stroke and might have prognostic value for the development of further cardio- or cerebrovascular events. Advanced age was found to be an independent risk factor.

  2. Raised D-dimer levels in acute sickle cell crisis and their correlation with chest X-ray abnormalities

    Directory of Open Access Journals (Sweden)

    Hassan, Imad S. A.

    2010-01-01

    Full Text Available Objective: Quantitation of D-dimer level during a sickling crisis and its correlation with other clinical abnormalities. Design: Prospective longitudinal study. Setting: Armed Forces Hospital, Southern Region, Kingdom of Saudi Arabia. Patients: Adult patients (12 years and older admitted acutely with a sickle cell crisis who consent to taking part in the study. Candidates may re-participate if they are readmitted with a further acute painful crisis. Results: 36 patients with homozygous sickle cell disease consented to take part in the study. D-dimer levels were raised in 31 (68.9% of 45 episodes of painful crisis of whom 13 had an abnormal chest X-ray. Of those with a normal chest X-ray only one patient had a raised D-dimer level: sensitivity of 92.3%, specificity 40.6%, positive predictive value 38.7% and negative predictive value of 92.9% for an abnormal chest X-ray. Conclusion: D-dimer levels are frequently raised during an acute painful crisis. A normal level has a high negative predictive value for an abnormal chest X-ray.

  3. Plasma level of D-dimer accompanying different types of gynecologic surgery and effects of prophylactic subcutaneous injection of heparin calcium

    Directory of Open Access Journals (Sweden)

    Sakika Yanai

    2015-06-01

    Conclusions: Plasma levels of D-dimer on POD-1 were higher than those on the DPE in each type of gynecologic surgery. The D-dimer level remained high even on POD-6, and not changed by prophylactic subcutaneous injection of heparin calcium. [Int J Reprod Contracept Obstet Gynecol 2015; 4(3.000: 551-554

  4. D-D dimer levels in patients with sickle cell disease during bone pain crises and in the steady state

    Directory of Open Access Journals (Sweden)

    Fakunle EE

    2012-05-01

    Full Text Available Eyitayo Emmanuel Fakunle,1 Kapoona Iwara Ibiang Eteng,2 Wuraola Adebola Shokunbi21Department of Pathology, King Edward VII Memorial Hospital, Bermuda; 2Department of Hematology, University College Hospital, Ibadan, NigeriaObjective: To determine the presence of ongoing thrombosis by measuring the D-D dimer levels in bone pain crises (BPCs and in the steady state of patients with sickle cell disease, comparing these levels with those in individuals with normal hemoglobin (HbAA in southwest Nigeria.Study design, patients, and methods: The study design involved 38 patients with homozygous sickle cell anemia (HbSS and 78 adults with the HbAA phenotype, seen at the Hematology Day Care and Accident and Emergency units of the University College Hospital, Ibadan, Nigeria. The TintElize kit was used to quantitatively determine human D-D dimer levels in the plasma with enzyme immunoassay.Results: The mean D-D dimer level measured of the 78 individuals with HbAA was 73.59 ng/mL. The mean D-D dimer level of the patients with HbSS during BPCs was 4002.40 ng/mL, while the mean level in the same patients in the steady state measured 6 weeks after their BPCs, with no other painful crisis episode before the sample was collected, was 1320.00 ng/mL.Conclusion: This study demonstrated a significant increase in the D-D dimer levels of patients with HbSS in the steady state, when compared with those of individuals with HbAA of the same age and sex distribution. There was also an approximate threefold increase in the D-D dimer levels in the same patients with HbSS during BPCs. This confirms the activation of coagulation and fibrinolytic systems in patients with HbSS in the steady state, which is further escalated during BPCs. A multicenter study on the use of anticoagulants in BPCs in patients with sickle cell disease is required.Keywords: anticoagulant, dimer, sickle cell disease, BPC, Nigeria, chronic hemolytic anemia

  5. A Quantitative Trait Locus on Chromosome 5p Influences D-Dimer Levels in the San Antonio Family Heart Study

    Directory of Open Access Journals (Sweden)

    V. P. Diego

    2010-01-01

    D-dimer levels were normalized in our study. We found that D-dimer levels were heritable, at about 23% heritability (P≈.00001. In a linkage analysis employing 432 microsatellite markers, we found strong evidence of a QTL on chromosome 5p with a lod score of 3.32 at 21 centiMorgans (cM. We also found suggestive evidence of a QTL on chromosome 2q with a lod score of 2.33 at 207 cM. Conclusions. To our knowledge, the putative QTL on chromosome 5p is novel. The possible QTL on chromosome 2q is discussed in relation to a recent report of linkage of a related hemostatic factor to the same location. These results warrant further investigation.

  6. The role of serum D-dimer level in the diagnosis of patients admitted to the emergency department complaining of chest pain.

    Science.gov (United States)

    Orak, M; Ustündağ, M; Güloğlu, C; Alyan, O; Sayhan, M B

    2010-01-01

    This study investigated D-dimer levels in 241 patients admitted to the emergency department with sudden-onset chest pain. The patient group included those diagnosed with acute coronary syndrome (ACS; i.e., unstable angina pectoris [USAP], non-ST elevated myocardial infarction [NSTEMI], ST-elevated myocardial infarction [STEMI]); the control group included those diagnosed with non-cardiac chest pain. Mean serum levels of D-dimer, creatine kinase-MB (CK-MB) and troponin I (TPI) were compared between the groups. Levels of D-dimer, CK-MB and TPI in the patient group were significantly higher than in the control group. There were also significantly higher D-dimer, CK-MB and TPI levels in the STEMI and NSTEMI patient subgroups compared with the control group. Only the D-dimer level was significantly higher in the USAP subgroup versus the control group. The sensitivity and specificity of D-dimer for ACS were 83.7% and 95.4%, respectively, suggesting that evaluating D-dimer levels might be useful in the emergency room for diagnosing ACS and predicting mortality in patients presenting with acute chest pain.

  7. The relationship between level of plasma D-dimer and survival time in metastatic gastric cancer patients%血浆D-二聚体水平与转移性胃癌患者生存期的关系

    Institute of Scientific and Technical Information of China (English)

    Xiaodong Jiao; Jianxin Qian; Guanzhen Yu; Rui Li; Zhan Wang; Jin Wang; Xiaoqiang Gu; Jiejun Wang

    2011-01-01

    Objective: The principal purpose of this study was to determine the relationship between level of plasma D-dimer and survival time in metastatic gastric cancer patients. Methods: We retrospectively collected the data of plasma D-dimer in metastatic gastric cancer patients admitted in our Department (Department of Oncology, The Affiliated Changzheng Hospital, The Second Military Medical University, Shanghai, China) from October 2006 to October 2008 and analyzed the relationship between level of plasma D-dimer and survival time along with other clinicopathologic parameters. Results: A total of 82 patients were studied in our research, 52 were males and 30 females, and the mean age was 57 years. The 48 cases had a normal plasma D-dimer level (< 300 μg/L) and 34 had a high plasma D-dimer level (≥ 300 μg/L). In the normal and high plasma D-dimer level groups, the mean survival times were 10.9 (95% CI: 9.8-12.2) months and 6.8 (95% CI: 4.4-7.6) months respectively, and the difference was statistically significant. Conclusion: Metastatic gastric cancer patients with high plasma D-dimer level had significantly shorter survival time than those with normal plasma D-dimer level. Level of plasma D-dimer can be referred as a potential predictor in metastatic gastric cancer patients.

  8. Serum Potassium Levels Inversely Correlate with D-Dimer In Patients with Acute-Onset Atrial Fibrillation

    Energy Technology Data Exchange (ETDEWEB)

    Cervellin, Gianfranco, E-mail: gcervellin@ao.pr.it; Bonfanti, Laura; Picanza, Alessandra; Lippi, Giuseppe [1Academic Hospital of Parma (Italy)

    2015-03-15

    D-dimer values are frequently increased in patients with atrial fibrillation (AF) compared to subjects in sinus rhythm. Hypokalemia plays a role in several cardiovascular diseases, but little is known about the association with AF. D-dimer values are frequently increased in patients with atrial fibrillation (AF) compared with subjects in sinus rhythm. Hypokalemia plays a role in several cardiovascular diseases, but little is known about the association with AF. The aim of this study was to investigate correlations between D-dimer and serum potassium in acute-onset AF (AAF). To investigate the potential correlation between the values of serum potassium and D-dimer in patients with AAF, we retrospectively reviewed clinical and laboratory data of all emergency department visits for AAF in 2013. Among 271 consecutive AAF patients with D-dimer assessments, those with hypokalemia (n = 98) had significantly higher D-dimer values than normokalemic patients (139 versus 114 ng/mL, p = 0.004). The rate of patients with D-dimer values exceeding the diagnostic cut-off was higher in the group of patients with hypokalemia than in those with normal serum potassium (26.5% versus 16.2%; p = 0.029). An inverse and highly significant correlation was found between serum potassium and D-dimer (r = −0.21; p < 0.001), even after adjustments for age and sex (beta coefficient −94.8; p = 0.001). The relative risk for a positive D-dimer value attributed to hypokalemia was 1.64 (95% CI, 1.02 to 2.63; p = 0.040). The correlation remained statistically significant in patients free from antihypertensive drugs (r = −0.25; p = 0.018), but not in those taking angiotensin-receptor blockers, angiotensin-converting enzyme inhibitors, or diuretics. The inverse correlation between values of potassium and D-dimer in patients with AAF provides important and complementary information about the thromboembolic risk of these patients.

  9. D-二聚体的检测及临床应用%Detection and Application of D-dimer

    Institute of Scientific and Technical Information of China (English)

    张勇

    2011-01-01

    D-dimer is one of specific degradation products of cross-linked fibrin,D-dimer levels increase reflects the enhancement of secondary thrombolytic activity in vivo.In view of the formation principle of D-dimer has been widely used in clinical diagnosis and treatment,the clinical testing and application of D-dimer are emphatically reviewed.%D-二聚体是交联纤维蛋白的特异性降解产物之一,D-二聚体水平增高反映体内继发性纤溶活性增强.鉴于D-二聚体的形成原理已被广泛应用于临床诊断和治疗,现着重对D-二聚体的临床检测及应用作一综述.

  10. D-Dimer Levels before HIV Seroconversion Remain Elevated Even after Viral Suppression and Are Associated with an Increased Risk of Non-AIDS Events.

    Science.gov (United States)

    Freiberg, Matthew S; Bebu, Ionut; Tracy, Russell; So-Armah, Kaku; Okulicz, Jason; Ganesan, Anuradha; Armstrong, Adam; O'Bryan, Thomas; Rimland, David; Justice, Amy C; Agan, Brian K

    2016-01-01

    The mechanism underlying the excess risk of non-AIDS diseases among HIV infected people is unclear. HIV associated inflammation/hypercoagulability likely plays a role. While antiretroviral therapy (ART) may return this process to pre-HIV levels, this has not been directly demonstrated. We analyzed data/specimens on 249 HIV+ participants from the US Military HIV Natural History Study, a prospective, multicenter observational cohort of >5600 active duty military personnel and beneficiaries living with HIV. We used stored blood specimens to measure D-dimer and Interleukin-6 (IL-6) at three time points: pre-HIV seroconversion, ≥6 months post-HIV seroconversion but prior to ART initiation, and ≥6 months post-ART with documented HIV viral suppression on two successive evaluations. We evaluated the changes in biomarker levels between time points, and the association between these biomarker changes and future non-AIDS events. During a median follow-up of 3.7 years, there were 28 incident non-AIDS diseases. At ART initiation, the median CD4 count was 361cells/mm3; median duration of documented HIV infection 392 days; median time on ART was 354 days. Adjusted mean percent increase in D-dimer levels from pre-seroconversion to post-ART was 75.1% (95% confidence interval 24.6-148.0, p = 0.002). This increase in D-dimer was associated with a significant 22% increase risk of future non-AIDS events (p = 0.03). Changes in IL-6 levels across time points were small and not associated with future non-AIDS events. In conclusion, ART initiation and HIV viral suppression does not eliminate HIV associated elevation in D-dimer levels. This residual pathology is associated with an increased risk of future non-AIDS diseases.

  11. Dual energy CT pulmonary blood volume assessment in acute pulmonary embolism - correlation with D-dimer level, right heart strain and clinical outcome

    Energy Technology Data Exchange (ETDEWEB)

    Bauer, Ralf W.; Frellesen, Claudia; Schell, Boris; Lehnert, Thomas; Jacobi, Volkmar; Vogl, Thomas J.; Kerl, J.M. [Clinic of the Goethe University, Department of Diagnostic and Interventional Radiology, Frankfurt (Germany); Renker, Matthias [Clinic of the Goethe University, Department of Diagnostic and Interventional Radiology, Frankfurt (Germany); Medical University of South Carolina, Heart and Vascular Center, Ashley River Tower, Charleston, SC (United States); Ackermann, Hanns [Clinic of the Goethe University, Department of Biostatistics and Mathematical Modelling, Frankfurt (Germany); Schoepf, U.J. [Medical University of South Carolina, Heart and Vascular Center, Ashley River Tower, Charleston, SC (United States)

    2011-09-15

    To investigate the role of perfusion defect (PD) size on dual energy CT pulmonary blood volume assessment as predictor of right heart strain and patient outcome and its correlation with d-dimer levels in acute pulmonary embolism (PE). 53 patients with acute PE who underwent DECT pulmonary angiography were retrospectively analyzed. Pulmonary PD size caused by PE was measured on DE iodine maps and quantified absolutely (VolPD) and relatively to the total lung volume (RelPD). Signs of right heart strain (RHS) on CT were determined. Information on d-dimer levels and readmission for recurrent onset of PE and death was collected. D-dimer level was mildly (r = 0.43-0.47) correlated with PD size. Patients with RHS had significantly higher VolPD (215 vs. 73 ml) and RelPD (9.9 vs. 2.9%) than patients without RHS (p < 0.003). There were 2 deaths and 1 readmission due of PE in 18 patients with >5% RelPD, while no such events were found for patients with <5% RelPD. Pulmonary blood volume on DECT in acute PE correlates with RHS and appears to be a predictor of patient outcome in this pilot study. (orig.)

  12. Combined use of the National Early Warning Score and D-dimer levels to predict 30-day and 365-day mortality in medical patients

    DEFF Research Database (Denmark)

    Nickel, Christian H; Kellett, John; Cooksley, Tim;

    2016-01-01

    AIM: To investigate the combined use of NEWS and D-dimer levels to predict the 30-day and 365-day mortality rates of a cohort of Danish patients with complete follow-up. METHODS: Post-hoc retrospective observational study of acutely admitted medical patients aged 18 years or older who had D......-dimer measured within 6h after arrival to two medical admission units in Denmark. RESULTS: The final study population consisted of 1201 patients with a median age of 65.0 years (range 18.0-107.0 years), and 44.7% were of male sex. Four patients (0.3%) died within 24h of admission, 69 (5.7%) within 30 days...... and 198 (16.5%) within 365 days. On admission, 576 (48%) patients had a NEWS≥3 - of these 441 had a D-dimer≥0.50mgL(-1): 55 (12.5%) of these patients died within 30 days, compared with 5 (3.7%) of the 135 patients with a D-dimer

  13. Large D-Dimer Fluctuation in Normal Pregnancy

    DEFF Research Database (Denmark)

    Hedengran, Katrine K; Andersen, Malene R; Stender, Steen

    2016-01-01

    pregnancies were recruited. D-dimer was repeatedly measured during pregnancy, at active labor, and on the first and second postpartum days. Percentiles for each gestational week were calculated. Each individual D-dimer was normalized by transformation into percentiles for the relevant gestational age......Introduction. D-dimer levels increase throughout pregnancy, hampering the usefulness of the conventional threshold for dismissing thromboembolism. This study investigates the biological fluctuation of D-dimer in normal pregnancy. Methods. A total of 801 healthy women with expected normal...... normal pregnancy, repeated D-dimer measurements are of no clinical use in the evaluation of thromboembolic events during pregnancy....

  14. Von Willebrand Factor, ADAMTS13 and D-Dimer Are Correlated with Different Levels of Nephropathy in Type 1 Diabetes Mellitus.

    Directory of Open Access Journals (Sweden)

    Caroline Pereira Domingueti

    Full Text Available We have investigated whether von Willebrand factor, ADAMTS13 (a disintegrin and metalloproteinase with thrombospondin type 1 motif, member 13, and D-Dimer were associated with different levels of renal function in patients with type 1 diabetes. Patients were classified according to level of renal function through estimated glomerular filtration rate: ≥90 and <130mL/min/1,73m2, n=52 (control group, ≥60 and <90mL/min/1,73m2, n=29 (mild renal dysfunction group, <60mL/min/1,73m2, n=28 (severe renal dysfunction group; and through urinary albumin excretion: normoalbuminuria, microalbuminuria and macroalbuminuria. Von Willebrand factor, ADAMTS13, and D-Dimer plasma levels were determined by enzyme-linked immunosorbent assay. ADAMTS13 activity was determined by fluorescence resonance energy transfer assay. Von Willebrand factor levels were increased in patients with mild (P=0.001 and severe (P<0.001 renal dysfunction as compared to the control group. ADAMTS13 levels were also increased in mild (P=0.029 and severe (P=0.002 renal dysfunction groups in comparison to the control group, while ADAMTS13 activity was increased only in the severe renal dysfunction group as compared to the control group (P=0.006. No significant differences were observed among the groups regarding von Willebrand factor/ADAMTS13 ratio. ADAMTS13 activity/ADAMTS13 levels ratio was reduced in patients with mild (P=0.013 and severe (P=0.015 renal dysfunction as compared to the control group. D-Dimer levels were increased in patients with mild (P=0.006 and severe (P<0.001 renal dysfunction as compared to the control group; it was also higher in patients with severe renal dysfunction as compared to the mild renal dysfunction group (P=0.019. Similar results were found for albuminuria classification. Increased von Willebrand factor, ADAMTS13, and D-Dimer levels and decreased ADAMTS13 activity/ADAMTS13 levels ratio are associated with renal dysfunction in patients with type 1 diabetes

  15. Cumulative scores based onplasma D-dimer andserum albumin levels predict survival inesophageal squamous cell carcinoma patients treated withtransthoracic esophagectomy

    Institute of Scientific and Technical Information of China (English)

    DeQingLiu; FangFangLi; WeiHuaJia

    2016-01-01

    Background:Recently, studies have shown that plasma D‑dimer and serum albumin are prognostic markers for esophageal cancer. The purpose of this study was to evaluate a novel prognostic scoring system—DA score (combi‑nation of preoperative plasma D‑dimer and serum albumin levels)—and analyze the association between survival of patients with esophageal squamous cell carcinoma (ESCC) and their Glasgow prognostic score. Methods:In this retrospective study, preoperative biochemical markers and clinicopathologic factors in 260 ESCC patients treated with transthoracic esophagectomy were reviewed. According to receiver operating characteristic analysis, the cutoff values of D‑dimer and albumin were deifned as 0.5μg/mL and 43.8g/L, respectively. Patients with high D‑dimer levels (≥0.5μg/mL) and low albumin levels (<43.8g/L) were assigned a score of 2, those with only one of the two abnormalities were assigned a score of 1, and those with neither of the two abnormalities were assigned a score of 0. Results:ESCC patients with a DA score of 0, 1, and 2 numbered 55, 116, and 89, respectively. Survival analysis showed that patients with a DA score of 2 had lower overall survival (OS) rates than those with DA scores of 1 and 0 (37.1% vs. 52.6% and 76.4%,P<0.001); similar ifndings were observed for disease‑free survival (DFS) rates (32.6% vs. 44.8% and 67.3%,P<0.001). In addition, the predictive value of the DA score was also signiifcant in patients with stages I–IIA and stages IIB–IV ESCC. Multivariate Cox regression analyses indicated that hazard ratios (HRs) for predicting OS of patients with DA scores 1 and 2 were 2.25 (P=0.010) and 3.14 (P<0.001), respectively, compared with those with a DA score of 0, and HRs for predicting DFS of patients with DA scores of 1 and 2 were 1.86 (P=0.023) and 2.68 (P<0.001), respectively, compared with those with a DA scores of 0. Conclusions:Our study suggests that preoperative DA scores are notably associated with

  16. Predicting deep venous thrombosis using Wells scoring system combined with D-dimer and fibrin degradation product%复合骨折后下肢深静脉血栓形成Wells评分与D-二聚体及纤维蛋白降解产物的预测

    Institute of Scientific and Technical Information of China (English)

    沈明荃; 谢增如

    2014-01-01

    背景:文献报道各种对深静脉血栓形成的诊断方法,但是结合危险度预测评分系统及多种实验室指标对深静脉血栓形成的预测诊断率的提高尚不明确。  目的:使用Wel s评分系统并结合D-二聚体及纤维蛋白降解产物提高诊断创伤后下肢深静脉血栓敏感性。方法:下肢骨折及脊柱骨折患者82例,排除患病前合并深静脉血栓形成高危因素的患者及曾患有深静脉血栓形成的患者。入院后检测患者D-二聚体、纤维蛋白酶原降解产物、纤维蛋白酶原、凝血酶原时间、部分活化凝血酶原时间、血小板计数、C-反应蛋白及血沉相关指标,并做彩色多普勒下肢超声检测。根据下肢深静脉栓塞评分表(Wel s评分表)评分分为低危、中危及高危患者。  结果与结论:彩色多普勒下肢超声检测深静脉血栓形成组30例;非深静脉血栓形成组52例,两组患者 D-二聚体及纤维蛋白降解产物的峰值差异有显著性意义(P OBJECTIVE:To improve the diagnosis sensitivity of traumatic deep venous thrombosis of lower extremity using Wel s scoring system combined D-dimer and fibrin degradation product. METHODA total of 82 patients with low limb fractures and spine fracture were included in this study, those patients with high risk factors of deep venous thrombosis or with the history of deep venous thrombosis were excluded. After admission, the fol owing indicators of deep venous thrombosis were determined, including D-dimer, fibrin degradation product, fibrinogenase, prothrombin time, activated partial thrombokinase time, blood platelets count, C-reaction protein, and erythrocyte sedimentation rate. In addition, Doppler ultrasound detection of double lower limbs deep vein was performed, and the results were recorded. According to scoring system of deep venous thrombosis of lower extremity (Wel s scoring system), the patients were assigned into low-risk, middle

  17. Relationship between disseminated intravascular coagu-lation and levels of plasma thrombinogen segment 1+2,D-dimer, and thrombomodulin in patients with multiple injuries

    Institute of Scientific and Technical Information of China (English)

    ZHU Yu-jun; HUANG Xian-kai

    2009-01-01

    Objective: To explore the relationship between dis-seminated intravascular coagulation (DIC) and levels of plasma thrombinogen segment 1+2 (F1+2), D-dimer (D-D), and thrombomodulin (TM) in patients with severe multiple injuries.Methods: In this study, 66 patients (49 males and 17 females, aged 15-74 years, mean=38.4 years) with multiple injuries, who were admitted to our hospital within 24 hours after injury with no personal or family history of hematopathy or coagulopathy, were divided into a minor injury group (ISS≥16, n=45) according to the injury severity. The patients in the major injury group were divided into a subgroup complicated with DIC (DIC subgroup, n=12) and a subgroup compli-cated with no DIC (non-DIC subgroup, n=33). Ten healthy people (7 males and 3 females, aged 22-61 years, mean=36.5 years±9.0 years), who received somatoscopy and diagnosed as healthy, served as the control group. Venous blood samples were collected once in the control group and 1, 3 and 7 days after trauma in the injury groups. The F1+2 and TM concentrations were determined by enzyme linked immunosorbent assay (ELISA), and D-D concentrations were measured by automated latex enhanced immunoassay. Results: F1+2, D-D and TM levels were higher in the minor and major injury groups than in the control group.They were markedly higher in the major injury group than in the minor injury group. In the non-DIC subgroup, F1+2 levels declined gradually while D-D and TM levels declined continuously. In the DIC subgroup, F1+2 and D-D levels remained elevated while TM levels exhibited an early rise and subsequent decrease. Plasma F1+2, D-D and TM levels were higher in the DIC patients than in the non-DIC patients. Injury-induced increases in F1+2, D-D and TM plasma lev-els had significant positive correlation with each other at each time point.Conclusions: Besides being related to trauma severity, F1+2, D-D and TM levels correlate closely with the occur-rence of posttraumatic DIC. Therefore

  18. Fiber optic D dimer biosensor

    Science.gov (United States)

    Glass, Robert S.; Grant, Sheila A.

    1999-01-01

    A fiber optic sensor for D dimer (a fibrinolytic product) can be used in vivo (e.g., in catheter-based procedures) for the diagnosis and treatment of stroke-related conditions in humans. Stroke is the third leading cause of death in the United States. It has been estimated that strokes and stroke-related disorders cost Americans between $15-30 billion annually. Relatively recently, new medical procedures have been developed for the treatment of stroke. These endovascular procedures rely upon the use of microcatheters. These procedures could be facilitated with this sensor for D dimer integrated with a microcatheter for the diagnosis of clot type, and as an indicator of the effectiveness, or end-point of thrombolytic therapy.

  19. Analysis of D-dimer level of normal pregnancy and pregnancy hypertension syndrome pregnant woman%正常妊娠与妊娠高血压综合征孕妇D-二聚体水平分析

    Institute of Scientific and Technical Information of China (English)

    李明兰

    2014-01-01

    Objective:To analyze the difference of D-dimer level of normal pregnancy and pregnancy hypertension syndrome pregnant woman,and to explore the influence of hypertension on D-two dimer level of pregnant women.Methods:128 pregnant women were selected from March 2010 to October 2013.According to with hypertension or not,they were divided into the pregnancy induced hypertension syndrome group(60 cases) and the normal pregnancy group(68 cases),at the same time,70 healthy women were selected as the control group.We compared the plasma D-dimer level of the three groups.Results:The D-dimer level of pregnancy induced hypertension group and normal pregnancy group were significantly higher than those of the control group(P<0.05,P<0.01).The D-dimer level of pregnancy induced hypertension group were significantly higher than that of normal pregnancy group(P<0.05);between the different degree pregnancy induced hypertension,the plasma D-dimer level had significant difference(P<0.05).Conclusion:The plasma D-dimer content of normal pregnancy is increased,and the blood is become hypercoagulable state.Patients with hypertensive disorders in pregnancy have the pathological changes of the coagulation system,and the plasma D-dimer level is higher than that of normal pregnancy.We suggest that we should examine the plasma D-dimer level of patients with hypertension of pregnancy,and understand the existence of thrombotic diseases,to protect the health of mother and infant.%目的:分析正常妊娠与妊娠高血压综合征孕妇血浆D-二聚体水平差异,探讨高血压对妊娠期妇女D-二聚体水平的影响。方法:2010年3月-2013年10月收治妊娠期孕妇128例,按照是否合并高血压分为妊娠期高血压综合征组(60例)和正常妊娠组(68例),另选择同期健康女性70例作为对照组。对比3组血浆D-二聚体水平。结果:妊娠高血压组、正常妊娠组D-二聚体水平显著高于对照组(P<0.05,P<0.01)。妊娠高血压

  20. Elevated D-dimers in attacks of hereditary angioedema are not associated with increased thrombotic risk

    Science.gov (United States)

    Reshef, A; Zanichelli, A; Longhurst, H; Relan, A; Hack, C E

    2015-01-01

    Background Recommended management of attacks of hereditary angioedema (HAE) due to C1 esterase inhibitor (C1-INH) deficiency (C1-INH-HAE) includes therapy with exogenous C1INH. Thrombotic/thromboembolic events (TEE) have been reported with plasma-derived C1INH, but so far none with recombinant human C1INH (rhC1INH). This phase III, randomized, placebo (saline)-controlled study evaluated the safety of rhC1INH 50 IU/kg for the treatment of acute attacks in 74 patients with C1-INH-HAE. Methods Monitoring for TEE and assessment of risk of deep vein thrombosis (DVT) by the Wells prediction rule were performed, and levels of fibrin degradation products (plasma D-dimers) were assessed before study drug administration (baseline), 2 h, and 7 days posttreatment. Results Plasma D-dimer levels were elevated in 80% of the patients (median [25th–75th percentiles]: 2149 [480–5105] μg/l; normal ≤250 μg/l) and were higher in patients with submucosal (abdominal, oropharyngeal–laryngeal) attacks (3095 [890–10000] μg/l; n = 29) compared with subcutaneous (peripheral, facial) attacks (960 [450–4060] μg/l; n = 35). Median plasma D-dimer levels were comparable across treatment groups at baseline (1874 [475–4568] μg/l rhC1INH; 2259 [586–7533] μg/l saline) and 2 h postinfusion (2389 [760–4974] μg/l rhC1INH; 2550 [310–8410] μg/l saline); median plasma D-dimer levels were decreased by Day 7 in both groups (425 [232–3240] μg/l rhC1INH; 418 [246–2318] μg/l saline). No increased risk of DVT was identified, nor any TEE reported in rhC1INH treated or controls. Conclusion Elevated plasma D-dimer levels were associated with acute C1-INH-HAE attacks, particularly with submucosal involvement. However, rhC1INH therapy was not associated with thrombotic events. PMID:25640891

  1. Increased tissue factor, MMP-8, and D-dimer expression in diabetic patients with unstable advanced carotid atherosclerosis

    Directory of Open Access Journals (Sweden)

    Jerzy Krupinski

    2007-09-01

    Full Text Available Jerzy Krupinski1,2, Marta M Turu1,2, M Angels Font1, Nesser Ahmed3, Matthew Sullivan3, Ana Luque1,2, Francisco Rubio1, Lina Badimon2, Mark Slevin31Department of Neurology, Stroke Unit, University Hospital of Bellvitge (HUB, Fundacio IDIBELL, Barcelona, Spain; 2Cardiovascular Research Centre, IIBB/CSIC-HSCSP-UAB, Barcelona, Spain; 3School of Biology, Chemistry and Health Science, Manchester Metropolitan University, Manchester, United KingdomAbstract: Advanced atherogenesis is characterized by the presence of markers of enhanced prothrombotic capacity, attenuated fibrinolysis, and by clinical conditions associated with defective coagulation. Diabetes may be associated with enhanced lesion instability and atherosclerotic plaque rupture. Plaques obtained from 206 patients undergoing carotid endarterectomy were divided into diabetic (type 2 and nondiabetic and analyzed by Western blotting and immunohistochemistry to detect tissue factor (TF, metalloproteinases (MMP-2, -8, -9, and fibrin/fibrinogen related antigens, and in situ zymography to detect MMP activity. Plasma samples were quantified for TF procoagulant activity, C-reactive protein, fibrinogen and D-dimer. Diabetic and symptomatic patients with hypoechogenic plaques had increased plasma TF activity and D-dimer, compared with those with hyperechogenic plaques (p = 0.03, p = 0.007, respectively. Diabetic, symptomatic patients had higher plasma D-dimer levels than asymptomatic patients (p = 0.03. There was a significant correlation between intramural TF levels and D-dimer in diabetic patients with symptomatic disease (p = 0.001, r2 = 0.4. In diabetic patients, plasma fibrinogen levels were higher in patients with hypoechogenic plaques (p = 0.007. Diabetic patients with ulcerated plaques had higher plasma D-dimer and MMP-8 levels than those with fibrous plaques (p = 0.02, p = 0.01, respectively. This data suggests that currently available circulating markers may be clinically useful to select

  2. 急性脑梗死患者血浆D-二聚体水平变化%The significance of blood plasma D-Dimer level in diagnosing and treating the acute cerebral infarction patients in the community hospital

    Institute of Scientific and Technical Information of China (English)

    张惠光

    2009-01-01

    目的 观察急性脑梗死患者血浆D-二聚体水平的变化及临床意义.方法 对71例急性脑梗死患者急性期、恢复期和64例健康体检者采用双抗体夹心法检测血浆D-二聚体水平.结果 急性脑梗死患者急性期血浆D-二聚体水平:72 h(1.54±0.91)mg/L、第7天(1.32±0.86)mg/L,较恢复期第15天(0.49±0.31)mg/L、第30天(0.32±0.14)me/L和健康体检者(0.31±0.81)mg/L明显增高(t=2.576、t=2.807,P<0.01).结论 检测血浆D-二聚体可作为急性期脑梗死病情判定及疗效观察的有效指标.%Objective To throagh observing the change of plasma D-Dimer level in the acute cerebral infarction patients to provide the experimental foundation for further research of pathology,physiology pathological process judgment and observation of curative effect.Methods To measure the plasma D-Dimer level by ELISA in 71 cases of acute wrebral infarction patients and 64 healthy controls.Results The plasma D-Dimer level in the acute cerebral infarction patients in acute period was 72h(1.54 ±0.91)mg/L、7d(1.32 ±0.86)mg/L significantly higher than 15d (0.49±0.31)mg/L30d(0.32±0.14)mg/L at resume period patients and(0.31 ±0.81)mg/L at normal controls and dropped in resume period(t =2.576,t =2.807,P<0.01).They had significant difference.Conclusion The results indicate that acute cerebral infarction is in the manifestation of hyper coagulation,plasma D-Dimer measuring was valuable for pathological process judgment and observation of curative effect of acute cerebral infarction.

  3. 全髋关节置换术后血浆D-二聚体及纤维蛋白降解产物浓度变化特点的临床意义%Total hip arthroplasty plasma D- dimer and fibrin degradation product concentration changes of clinical significance

    Institute of Scientific and Technical Information of China (English)

    周胜虎; 甄平; 郑宁刚; 高明暄; 田琦; 常彦峰; 李旭升

    2013-01-01

    Objective To investigate the total hip arthroplasty D-dimer (DD) and fibrin degradation products (FDPS) concentration and its effect on the dynamic changes of the early diagnosis of deep venous thrombosis (DVT) value. Methods From July 2011 to May 2012 126 cases of hip replacement patients, their data were retrospectively analyzed, including 56 males and 70 females; aged 38 to 92 years, mean 75.6 years old. According to 7 days after lower extremity B-test results, patients were divided into thrombus group of 32 patients, 94 cases of non-thrombotic group . By immune nephelometry were measured on admission, postoperative 1d, 4d, 7d plasma D-dimer and fibrin degradation products (FDPS) concentration, the relevant test results OK statistical analysis, combined with B-test results, analysis comparison of plasma DD, FDPS two detection index and joint detection sensitivity of the results. Results 126 cases of arthroplasty patients with DD and FDPS values increased in varying degrees postoperatively . Different time points after DD and FDPS plasma concentrations were higher than those without DVT patients, the difference was statistically significant (P<0.05). FDPS after 4, 7 days significantly increased (P<0.01). Compared with baseline in both groups at each time point after DD were significantly increased, peaking at 1 day after surgery : no thrombus group (2469.9±508.3) μg/L, thrombosis group (3472.2 ± 690.7)μg/L (P<0.01);FDPS increased significantly after 4, 7 days and 7 days values increased significantly compared with the value of 4 days:Non-thrombosis group (3673.4±480.7)μg/L, thrombosis group.Conclusion Patients with total hip arthroplasty plasma D-dimer and fibrin degradation product concentration for dynamic monitoring of early diagnosis of DVT has important value.%目的:探讨全髋关节置换术后血浆D-二聚体(DD)及纤维蛋白降解产物(FDPs)浓度的动态变化特点及其对早期诊断下肢深静脉血栓

  4. Weight reduction is associated with increased plasma fibrin clot lysis.

    Science.gov (United States)

    Brzezińska-Kolarz, Beata; Kolarz, Marek; Wałach, Angelika; Undas, Anetta

    2014-11-01

    Obesity is associated with an increased risk of vascular thrombotic events. We sought to investigate how obesity and weight loss affect plasma fibrin clot properties. A total of 29 obese patients were studied before and after 3-month low-fat diet. Plasma fibrin clot parameters, including fibrin clot permeation coefficient (Ks), the lag phase of the turbidity curve, clot lysis time (t 50%), maximum rate of increase in D-dimer levels, and maximum D-dimer concentrations, were determined. Low-fat diet resulted in the reduction of body weight (P < .0001), body mass index (P < .0001), fat mass (P < .0001), total cholesterol (P < .0001), low-density lipoprotein cholesterol (P = .0005), triglycerides (P = .008), and plasminogen activator inhibitor 1 (P = .02), but not in fibrinogen or C-reactive protein. The only change in fibrin clot variables was shorter t 50% (P = .02). Baseline t 50%, but not posttreatment, correlated with waist circumference (r = .44, p = .02). This study demonstrates that weight loss in obese people can increase the efficiency of fibrin clot lysis.

  5. Fiber optic immunosensor for cross-linked fibrin concentration

    Science.gov (United States)

    Moskowitz, Samuel E.

    2000-08-01

    Working with calcium ions in the blood, platelets produce thromboplastin which transforms prothrombin into thrombin. Removing peptides, thrombin changes fibrinogen into fibrin. Cross-linked insoluble fibrin polymers are solubilized by enzyme plasmin found in blood plasma. Resulting D-dimers are elevated in patients with intravascular coagulation, deep venous thrombosis, pulmonary embolism, myocardial infarction, multiple trauma, cancer, impaired renal and liver functions, and sepsis. Consisting principally of a NIR 780 nm GaAlAs laser diode and a 800 nm avalanche photodiode (APD), the fiber-optic immunosensor can determined D-dimer concentration to levels detected by a second antibody which is labeled with NN 382 fluorescent dye. An evanescent wave traveling on an excitation optical fiber excites the antibody-antigen fluorophore complex. Concentration of cross-linked fibrin is directly proportional to the APD measured intensity of fluorescence. NIR fluorescence has advantages of low background interference, short fluorescence lifetime, and large difference between excitation and emission peaks. Competitive ELISA test for D-dimer concentration requires trained personnel performing a time consuming operation.

  6. Effects of neurofeedback on the level of D-dimer in patients with cerebral infarction%脑电生物反馈对脑梗死患者D-二聚体的影响

    Institute of Scientific and Technical Information of China (English)

    刘文杰; 胡义奎

    2013-01-01

    目的 探讨超脑电生物反馈对脑梗死患者的纤溶系统指标D-二聚体(D-dimer)的影响. 方法 共选取发病72 h内入院的急性脑梗死患者126例,运用随机数字表法分为脑电生物反馈治疗组(治疗组)62例及常规治疗组(对照组)64例,2组患者均接受神经内科常规药物治疗,治疗组在常规治疗基础上给予脑电生物反馈治疗.所有患者在入院时及治疗2周后进行血浆D-二-聚体的检测及美国国立卫生院卒中量表(NIHSS)评分.结果 经2周治疗后,治疗组有效率(88.7%)明显优于常规治疗组(68.7%,P<0.05);2组患者入院时D-二聚体水平高于阴性对照组(P<0.05),2周后2组D-二聚体水平较入院时降低(P<0.05),且治疗组变化幅度较对照组显著(P<0.05). 结论 脑电生物反馈治疗能下调D-二聚体,对脑梗死患者的神经功能有显著改善作用.%Objective To investigate the effects of neurofeedback on the level of D-dimer in the patients with acute cerebral infarction. Methods All 126 patients with cerebral infarction within the first 72 h from stroke onset were randomly divided into the control group(64 cases) and therapy group(62 cases). All patients received routine treatment, and the patients in therapy group were given additional neurofeedback. In both groups, the plasma level of D-dimer was measured by double antibodies sandwich enzyme linked immunosorbent assay (ELISA) at the time of admission and 2 weeks later. According to National Institute of Health Stroke Scale (NIHSS) ,the effect was evaluated at the time of admission and 2 weeks later. Results The score of NIHSS and the level of D-dimer were significantly decreased after therapy in both groups. The efficacy in therapy group was more significant than that in control group (88. 7% vs 68. 7% ,P < 0. 05). Conclusions Neurofeedbak is effective in treating the acute cerebral infarction by decreasing the level of D-dimer.

  7. D-dimer concentration outliers are not rare in at-term pregnant women.

    Science.gov (United States)

    Wang, Yu; Gao, Jie; Du, Juan

    2016-06-01

    To determine the D-dimer levels in pregnant women at term and the differences between pregnant women with different D-dimer levels. The plasma D-dimer concentrations in pregnant women at term were identified in a cross-sectional study. The clinical indicators that are potentially relevant to D-dimer levels were compared between the pregnant women with different D-dimer levels (i.e., normal, mildly increased, and severely increased). There were always some D-dimer concentration outliers in the pregnant women at term regardless of the presence or absence of complications, and there were no significant differences in maternal age, gestational age, gravidity, parity, blood count, blood coagulation, or liver function between the pregnant women with different D-dimer levels. D-dimer levels may vary significantly during pregnancy for unknown reasons. This variation, particularly in pregnant women at term, might lead to questionable diagnostic information regarding coagulation. Copyright © 2016 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  8. Influence of ACE I/D Polymorphism on Circulating Levels of Plasminogen Activator Inhibitor 1, D-Dimer, Ultrasensitive C-Reactive Protein and Transforming Growth Factor β1 in Patients Undergoing Hemodialysis.

    Directory of Open Access Journals (Sweden)

    Sara Santos de Carvalho

    Full Text Available There is substantial evidence that chronic renal and cardiovascular diseases are associated with coagulation disorders, endothelial dysfunction, inflammation and fibrosis. Angiotensin-Converting Enzyme Insertion/Deletion polymorphism (ACE I/D polymorphism has also be linked to cardiovascular diseases. Therefore, this study aimed to compare plasma levels of ultrassensible C-reactive protein (usCRP, PAI-1, D-dimer and TGF-β1 in patients undergoing HD with different ACE I/D polymorphisms.The study was performed in 138 patients at ESRD under hemodialysis therapy for more than six months. The patients were divided into three groups according to the genotype. Genomic DNA was extracted from blood cells (leukocytes. ACE I/D polymorphism was investigated by single polymerase chain reaction (PCR. Plasma levels of D-dimer, PAI-1 and TGF-β1 were measured by enzyme-linked immunosorbent assay (ELISA, and the determination of plasma levels of usCRP was performed by immunonephelometry. Data were analyzed by the software SigmaStat 2.03.Clinical characteristics were similar in patients with these three ACE I/D polymorphisms, except for interdialytic weight gain. I allele could be associated with higher interdialytic weight gain (P = 0.017. Patients genotyped as DD and as ID had significantly higher levels of PAI-1 than those with II genotype. Other laboratory parameters did not significantly differ among the three subgroups (P = 0.033. Despite not reaching statistical significance, plasma levels of usCRP were higher in patients carrying the D allele.ACE I/D polymorphisms could be associated with changes in the regulation of sodium, fibrinolytic system, and possibly, inflammation. Our data showed that high levels of PAI-1 are detected when D allele is present, whereas greater interdialytic gain is associated with the presence of I allele. However, further studies with different experimental designs are necessary to elucidate the mechanisms involved in these

  9. [Clinical use of D-dimer in patients with cancer].

    Science.gov (United States)

    Lecumberri, Ramón; Pegenaute, Carlota; Páramo, José A

    2011-10-15

    There is a well-known close relationship between cancer and the haemostatic system. Plasma D-dimer (DD) is a marker of fibrin generation and lysis. In the clinical practice, its main use is in the diagnostic algorithms of venous thromboembolism (VTE), and it is one of the diagnostic criteria of disseminated intravacular coagulation. In patients with cancer, the specificity of DD is lower than in the general population, reducing its usefulness. However, there is a growing evidence that points out a possible application of DD in the clinical management of cancer patients as a predictor of VTE, marker of hidden cancer in patients with idiopathic VTE, or even as an independent prognostic factor of response to chemotherapy and survival. In this review, the current evidence supporting the use of DD in cancer patients is critically exposed and discussed.

  10. Identification of quantitative trait loci for fibrin clot phenotypes: The EuroCLOT study

    Science.gov (United States)

    Williams, Frances MK; Carter, Angela M; Kato, Bernet; Falchi, Mario; Bathum, Lise; Surdulescu, Gabriela; Kyvik, Kirsten Ohm; Palotie, Aarno; Spector, Tim D; Grant, Peter J

    2012-01-01

    Objectives Fibrin makes up the structural basis of an occlusive arterial thrombus and variability in fibrin phenotype relates to cardiovascular risk. The aims of the current study from the EU consortium EuroCLOT were to 1) determine the heritability of fibrin phenotypes and 2) identify QTLs associated with fibrin phenotypes. Methods 447 dizygotic (DZ) and 460 monozygotic (MZ) pairs of healthy UK Caucasian female twins and 199 DZ twin pairs from Denmark were studied. D-dimer, an indicator of fibrin turnover, was measured by ELISA and measures of clot formation, morphology and lysis were determined by turbidimetric assays. Heritability estimates and genome-wide linkage analysis were performed. Results Estimates of heritability for d-dimer and turbidometric variables were in the range 17 - 46%, with highest levels for maximal absorbance which provides an estimate of clot density. Genome-wide linkage analysis revealed 6 significant regions with LOD>3 on 5 chromosomes (5, 6, 9, 16 and 17). Conclusions The results indicate a significant genetic contribution to variability in fibrin phenotypes and highlight regions in the human genome which warrant further investigation in relation to ischaemic cardiovascular disorders and their therapy. PMID:19150881

  11. Accuracy of D-Dimers to Rule Out Venous Thromboembolism Events across Age Categories

    Directory of Open Access Journals (Sweden)

    G. Der Sahakian

    2010-01-01

    Full Text Available Background. Strategies combining pretest clinical assessment and D-dimers measurement efficiently and safely rule out venous thromboembolism events (VTE in low- and intermediate-risk patients. Objectives. As process of ageing is associated with altered concentrations of coagulation markers including an increase in D-dimers levels, we investigated whether D-dimers could reliably rule out VTE across age categories. Method. We prospectively assessed the test performance in 1,004 patients visiting the emergency department during the 6-month period with low or intermediate risk of VTE who also received additional diagnostic procedures. Results. 67 patients had VTE with D-dimers levels above the threshold, and 3 patients displayed D-dimers levels below the threshold. We observed that specificity of D-dimers test decreased in an age-dependent manner. However, sensitivity and negative predictive value remained at very high level in each age category including older patients. Conclusion. We conclude that, even though D-dimers level could provide numerous false positive results in elderly patients, its high sensitivity could reliably help physicians to exclude the diagnosis of VTE in every low- and intermediate-risk patient.

  12. [Negative D-dimers and exclusion of venous thromboembolism--own experience].

    Science.gov (United States)

    Dworakowska, Dorota; Kazimierska, Ewa; Weyer-Hepka, Jolanta; Skibowska-Bielińska, Anna; Swiatkowska-Stodulska, Renata; Lubińska, Monika; Czestochowska, Eugenia

    2005-12-01

    The assessment of D-dimer concentration has become essential step during diagnostic algorithm of venous thromboembolism (VTE). This test characterizes high sensitivity but limited specificity. Negative D-dimer with high probability excludes VTE. The aim of this study was to assess the percentage of patients treated in Department of Internal Medicine, Endocrinology and Haemostatic Disorders, Medical University of Gdańisk, who in spite of clinical signs of VTE showed normal D-dimer level. Between 2000 and 2004 in our department 57 cases with recent deep vein thrombosis (DVT) were diagnosed, in 2 cases with co-existence of pulmonary embolism (PE). The D-dimer concentration was assessed in patients' plasma with the use of immunoturbidometry. Between 57 cases with VTE, 7 patients (12%) showed normal D-dimer level (<500 microg/ml). This group consisted of 4 men and 3 women, aged from 40 to 82 years (the mean age of 58 years). In all 7 cases DVT was diagnosed, in 2 patients with concomitent PE. The final diagnosis was confirmed by compression ultrasonography and pulmonary scintigraphy. Our analysis underlines the observation that occurrence of VTE and negative d-dimer concentration is possible and may probably be related to methodological limitations. However, the lack of increase of D-dimer could also be caused by fibrinolysis alteration.

  13. 死胎患者产前母体D-二聚体水平变化的相关性研究%Correlation Study of Antepartum D-dimer Levels in Stillbirth Patients

    Institute of Scientific and Technical Information of China (English)

    王欲; 杜鹃

    2011-01-01

    , international normalized ratio of prothrom-bin,activated partial thromboplastin time,fibrinogen.thrombin clotting time between the two groups (P> 0.05). In stillbirth pregnancy,D-dimer concentration was not correlated to maternal age,gravidity,parity,gestational weeks,platelet count,coagulation function and liver function (P > 0.05). Conclusion D-dimer level in stillbirth pregnant women was increased independently. Not only the antepartum maternal blood in stillbirth pregnancy was hypercoagulable,but also secondary fibrinolysis was enhanced.

  14. D-dimer is useful in assessing the vulnerable blood in elderly patients with coronary disease

    Institute of Scientific and Technical Information of China (English)

    Yansong Zheng; Qiang Zeng; Liping Zhang; Liufa Duan; Kunlun He; Qiufu Zheng

    2008-01-01

    Background and objective The value of D-dimer in the risk stratification of patients with coronary artery diseas(CAD)and the relationship between D-dimer and the diseased coronary arteries remains controversial or unclear.especially in the elderly.Thisstudy was to evaluate the usefulness of D-djmer as a biomarker in assessing the vuinerable blood in the elderly patients with coronarydisease.Methods Sixty elderly (≥60 years old)male patients with suspected CAD were enrolled in this prospective study.Patients were divided into CAD group(n=41,10 with stable angina and 31 with unstable angina)and control group(n=19)according to their coronary angiography Results Clinicalinformation including age,body mass index(BMI),smoking index,and thecomplications of Primary hypertension or diabetes.and CAD family history was collected.Venous blood was sampled serially for thedetermination of total cholesterol,HDL cholesterol,LDL cholesterol,triglycerides,apoAl,apoB,glucose,uric acid,homocysteine(Hey),hs-CRP,soluble thrombomodulin(sTM),and marker of fibrinolytic system and hypercoagulability,such as D-dimer,fibrinogen,etc.The extent of coronary atherosclerosis was assessed.using the Gensini scoring system on the basis of coronary angiography.Results Compared with the controls.the patients with CAD had significantly higher levels of D-dimer.D-dimer level wassignificantly correlated to age.hs-CR P.Hcy,and PAI-1.Patients with D-dimer levels in the top triplicate of D-dimer level hadsignificantly higher prevalence of unstable angina compared with patients in the lowest triplicate(OR=4.8,Z=3.28,P=0.001).In anordinal logistic regression.the OR value ofdeveloping more serious CAD augmented 3.1-foid with each increasing triplicate of D-dimer.Patients with unstable angina had a significantly higher level of D-dimer than the controls(P=0.005),and an increasing trend comparedwith patients with stable angina (P=0.059).whereas there was no difference between the patients with stable angina and

  15. Adapting the D-dimer cutoff for thrombosis detection in elderly outpatients.

    Science.gov (United States)

    Andro, Marion; Righini, Marc; Le Gal, Grégoire

    2013-06-01

    D-dimer measurement is an important step in diagnostic strategies for venous thromboembolism. It allows the safe ruling out of the diagnosis with no need for imaging tests in approximately 30% of outpatients. However, the usefulness of d-dimer is limited in elderly patients; the likelihood of a negative d-dimer strongly decreases with age, making physicians reluctant to order the test. Several attempts to improve the performance of D-dimer in elderly patients have been pursued. Recently, an age-adjusted cutoff was derived; the optimal cutoff value (in µg/l) appears to be equal to the patient's age (in years) multiplied by ten in patients over 50 years of age with a low pretest clinical risk of venous thromboembolism. This age-adjusted cutoff value has been extensively and externally validated in retrospective studies that included mostly outpatients with suspected deep vein thrombosis or pulmonary embolism and used various quantitative D-dimer assays. All available studies confirmed the increased usefulness and similar safety of the age-adjusted cutoff compared with the conventional cutoff, the most important benefit being obtained in elderly patients. However, before any recommendation for clinical practice can be made, a prospective diagnostic management outcome study is lacking, in which all low clinical risk patients with D-dimer levels below their age-adjusted cutoff would be left untreated with no further diagnostic testing.

  16. D-dimer for prediction of long-term outcome in cryptogenic stroke patients with patent foramen ovale.

    Science.gov (United States)

    Kim, Young Dae; Song, Dongbeom; Nam, Hyo Suk; Lee, Kijeong; Yoo, Joonsang; Hong, Geu-Ru; Lee, Hye Sun; Nam, Chung Mo; Heo, Ji Hoe

    2015-08-31

    Patent foramen ovale (PFO) is a potential cause of cryptogenic stroke, given the possibility of paradoxical embolism from venous to systemic circulation. D-dimer level is used to screen venous thrombosis. We investigated the risk of embolism and mortality according to the presence of PFO and D-dimer levels in cryptogenic stroke patients. A total of 570 first-ever cryptogenic stroke patients who underwent transesophageal echocardiography were included in this study. D-dimer was assessed using latex agglutination assay during admission. The association of long-term outcomes with the presence of PFO and D-dimer levels was investigated. PFO was detected in 241 patients (42.3 %). During a mean 34.0 ± 22.8 months of follow-up, all-cause death occurred in 58 (10.2 %) patients, ischaemic stroke in 33 (5.8 %), and pulmonary thromboembolism in 6 (1.1 %). Multivariate Cox regression analysis showed that a D-dimer level of > 1,000 ng/ml was an independent predictor for recurrent ischaemic stroke in patients with PFO (hazard ratio 5.341, 95 % confidence interval 1.648-17.309, p=0.005), but not in those without PFO. However, in patients without PFO, a D-dimer level of > 1,000 ng/ml was independently related with all-cause mortality. The risk of pulmonary thromboembolism tended to be high in patients with high D-dimer levels, regardless of PFO. Elevated D-dimer levels in cryptogenic stroke were predictive of the long-term outcome, which differed according to the presence of PFO. The coexistence of PFO and a high D-dimer level increased the risk of recurrent ischaemic stroke. The D-dimer test in cryptogenic stroke patients may be useful for predicting outcomes and deciding treatment strategy.

  17. Relationship of pneumonia severity index with serum levels of NT?proBNP and D?Dimer in elderly patients with community?acquired pneumonia%老年社区获得性肺炎患者PSI分级与NT-proBNP及血清D-二聚体的关系

    Institute of Scientific and Technical Information of China (English)

    邱建凯; 尹占良; 张芳芳; 李令娟; 姚海珍

    2016-01-01

    目的 探讨老年社区获得性肺炎(CAP)患者肺炎严重度指数(PSI)分级与血清N末端脑钠肽前体(NT-proBNP)和D-二聚体(D-Dimer)水平的关系.方法 选择本院收治的162例老年CAP患者为老年肺炎组,正常对照组为50例无基础疾病的健康体检人群.患者入院后24 h内进行临床数据收集,评估PSI,根据入院后28 d内是否死亡分为存活组与死亡组.同时检测老年肺炎组及正常对照组血清NT-proBNP与D-Dimer浓度,分析并比较CAP患者PSI分级与血清NT-proBNP及D-Dimer水平的关系.结果 (1)老年肺炎组血清NT-proBNP、D-Dimer水平明显高于正常对照组(P<0.05).(2)老年肺炎组患者血清NT-proBNP及D-Dimer水平随PSI分级增加而升高.不同PSI分级患者间NT-proBNP及D-Dimer水平比较,差异均有统计学意义(P<0.05).CAP患者死亡率随PSI分级增加而上升(P<0.05).(3)死亡组在入院时PSI评分、血清NT-proBNP及D-Dimer水平均明显高于存活组,差异有统计学意义(P<0.05).结论 NT-proBNP、D-Dimer不仅可作为诊断老年CAP的有效指标,而且与老年CAP患者PSI分级有一定的关系.%Objective To explore the relationship of pneumonia severity index(PSI) with serum levels of NT-proBNP and D-Dimer in elderly patients with community-acquired pneumonia ( CAP ) . Methods 162 elderly cases of CAP in our hospital were chosen as senile pneumonia group from March 2012 to July 2015. Fifty cases of healthy people without basic diseases were selected as normal control group. Clinical data of CAP patients were collected within 24 h after admission and PSI was assessed. All the patients were divided into survival group and death group within 28 d after admission. Serum levels of NT-proBNP and D-Dimer were detected in two groups. The relationship of PSI with serum levels of NT-proBNP, D-Dimer was analyzed. Results ( 1) Serum levels of NT-proBNP and D-Dimer in senile pneumonia group were significantly higher than those in normal control group( P

  18. D-dimer assay in Egyptian patients with Gaucher disease: correlation with bone and lung involvement.

    Science.gov (United States)

    Sherif, Eman M; Tantawy, Azza A G; Adly, Amira A M; Kader, Hossam A; Ismail, Eman A R

    2011-04-01

    Gaucher disease is the most frequent lysosomal storage disorder. Bone and lung involvement are two major causes of morbidity in this disease. D-dimer is a reliable indicator of active microvascular thrombosis, even in patients without overt hypercoagulation. This study aimed to assess D-dimer levels in Gaucher disease, correlating this marker to clinical characteristics and radiological parameters to investigate its role as a potential predictor for the occurrence and severity of skeletal and pulmonary manifestations. The study population consisted of 56 Egyptian patients with Gaucher disease, 36 had type 1 Gaucher disease (64.3%) and 20 had type 3 Gaucher disease (35.7%). Thirty healthy individuals were enrolled as a control group. D-dimer levels were significantly higher in all patients with Gaucher disease compared with controls (P < 0.001). Patients with type 3 showed significantly higher D-dimer concentrations compared with type 1 (P < 0.001). Pulmonary involvement was present in a significant proportion among type 3 Gaucher patients (P < 0.05), whereas bone changes were present in a higher percentage in type 1 compared with type 3 Gaucher patients. D-dimers were significantly higher in patients with abnormal MRI findings of the long bones and in those with ground glass appearance on high-resolution computerized tomography of the chest compared with patients with normal radiology (P < 0.001). Splenectomized patients displayed significantly higher D-dimer levels compared with nonsplenectomized patients (P < 0.001). Our results suggest that D-dimer is significantly elevated in Gaucher disease, particularly type 3, and may be considered as a potential marker of risk prediction of bone and lung involvement that could be used to monitor treatment response.

  19. Validation of an immunochromatographic D-dimer test to presumptively identify menstrual fluid in forensic exhibits.

    Science.gov (United States)

    Holtkötter, Hannah; Dierig, Lisa; Schürenkamp, Marianne; Sibbing, Ulla; Pfeiffer, Heidi; Vennemann, Marielle

    2015-01-01

    Identifying the biological source of a crime scene stain can be crucial for police investigations in many scenarios. Blood is one of the most common fluids found, and accurate differentiation between peripheral blood and menstrual fluid could provide valuable information regarding the issue of consent in sexual assault cases. For the detection of menstrual fluid, no easy-to-use presumptive test is available to date. Therefore, this study aimed to validate a simple immunochromatographic test for the indication of menstrual fluid, focusing on a D-dimer assay. The Clearview® rapid D-dimer test provides a diagnostic assay for the detection of fibrin degradation products. We validated the sensitivity and robustness of the assay using fresh and dried menstrual fluid samples, body fluid mixtures, diluted samples, and casework swabs. Cross reactivity was tested for saliva, semen, vaginal fluid, and blood. No false positive results were obtained; it was possible to successfully analyze mixtures, highly diluted samples, and casework swabs. The results of this study indicate that the D-dimer assay reliably detects menstrual fluid in forensic exhibits and is easy to implement into the current workflow of body fluid identification.

  20. 血浆D-二聚体及纤维蛋白原在非小细胞肺癌患者围术期监测中的应用价值%Value of plasma D-dimer,fibrinogen levels monitoring in non-small cell lung cancer patients in perioperative period

    Institute of Scientific and Technical Information of China (English)

    江吕泉; 高坤祥; 郑建; 陈建; 吴昊; 陈林松

    2013-01-01

    Objective Bleeding or thrombotic diseases are easily to be found in non - small cell lung cancer ( NSCLC ) patients, because the equilibrium of their coagulation system might be disturbed due to tumor burden or surgical injury. In the study, we studied the value of plasma D - dimer and fibrinogen levels monitoring in patients with non - small cell lung cancer before and after surgery. Methods The plasma D - dimer and fibrinogen levels were measured in 254 patients with non - small cell lung cancer and 52 patients with benign lung tumor, and then we followed up to record the D - dimer and fibrinogen levels change in postoperative patients. Results The plasma levels of D - dimer and fibrinogen in non - small cell lung cancer patients were found to be significantly higher than those in patients with benign lung tumor ( P < 0. 01). Significant differences in D - dimer and fibrinogen levels were found among different stages of non - small cell lung cancer ( P < 0. 01 ) , which suggested that coagulation and fibrinolysis dysfunction in patients with non - small cell lung cancer aggravated along with the progression of disease. The D - dimer and fibrinogen levels kept at a high level or rose suddenly after a transient decrease in 15 patients who had thrombotic diseases after operation. Conclusions Monitoring the plasma D - dimer and fibrinogen levels in patients with non - small cell lung cancer before and after operation helps find out those who have high risk of thrombotic diseases and preventing thrombtic disease after operation. It also helps us to strive for early prevention, early diagnosis,early treatment,nd to improve the prognosis of the patients.%目的 探讨血浆D-二聚体及纤维蛋白原(fibrinogen,FIB)在非小细胞肺癌患者手术前、后监测中的应用价值.方法 测定254例非小细胞肺癌患者和52例肺部良性肿瘤患者血浆D-二聚体及FIB水平,对其术后D-二聚体及FIB变化进行随访监测.结果 非小细胞肺癌组

  1. The plasma D-dimer levels and their clinical significance in liver cirrhosis patients with portal vein thrombosis%肝硬化门静脉血栓患者血浆D-二聚体水平及其临床意义

    Institute of Scientific and Technical Information of China (English)

    姜佳丽; 展玉涛; 李莉

    2012-01-01

    Objective To investigate the plasma D-dimer levels and their clinical significance in liver cirrhosis (LC) patients with portal vein thrombosis (PVT) .Methods 77 patients with LC were selected and 31 had PVT, and 46 had not.The PVT was diagnosed by CT scan and the D-dimer levels were detected.Results The plasma D-dimer levels in patients with PVT were significantly higher than that in without PVT (l.2±0.5 mg/1 vs. 0.6±0.4mg/l;P<0.0l) ;The plasma D-dimer level in PVT patients with severe esophageal varices group (l.3±0.5mg/l) was higher significantly than that in patients with mild esophageal varices group (0.9±0.5mg/l,P<0.05) ;The plasma D-dimer level in patients with gastrointestinal bleeding (1.5±0.5mg/l) was higher significantly than that in patients without gastrointestinal bleeding (0.8±0.4mg/LP<0.0l) ; The plasma D-dimer level in death group (l.318±0.512mg/l) was higher significantly than in survived group (1.0±0.4mg/l,P<0.01).Conclusion Plasma D-dimer level increases in patients with LC and might prompt the PVT formation.%目的 探讨肝硬化门静脉血栓(PVT)患者血浆D-二聚体水平及其临床意义.方法 在77例肝硬化患者中,PVT形成患者31例,无血栓形成患者46例,依据螺旋CT检查诊断PVT,采用乳胶凝集法检测血浆D-二聚体水平.结果 血栓组和无血栓组患者血浆D-二聚体水平分别为1.2±0.5 mg/l和0.6±0.4mg/l(P<0.01);血栓组伴中重度食管静脉曲张患者血浆D-二聚体水平(1.3±0.5mg/l)显著高于轻度食管静脉曲张患者(0.9±0.5mg/l,P<0.05);血栓形成伴消化道出血和死亡患者血浆D- 二聚体水平显著高于无出血和生存患者(P<0.01).结论 肝硬化患者血浆D-二聚体水平升高可能与PVT形成有关,并严重影响预后.

  2. Variation of D-dimer values as assessment of pulmonary thromboembolism during adulticide treatment of heartworm disease in dogs.

    Science.gov (United States)

    Carretón, E; Morchón, R; González-Miguel, J; Simón, F; Juste, M C; Montoya-Alonso, J A

    2013-07-01

    Dirofilaria immitis adult worms lodged in the pulmonary arteries are the causative agent of heartworm disease, characterized by endarteritis and obstruction of the blood flow. Dying worms form embolic fragments which trigger thrombosis. Thus, pulmonary thromboembolism is an inevitable consequence of successful adulticide therapy. Clinical signs of pulmonary thromboembolisms are highly variable and non-specific, and its diagnosis is often difficult to obtain. The D-dimer assay is considered the marker of choice for dogs with a suspicion of pulmonary thromboembolism. The aim of the present study was to evaluate the variation of D-dimer and platelets in 15 heartworm-infected dogs during the adulticide treatment with ivermectin, doxycycline and melarsomine. Nine dogs were considered to have a low parasite burden and 6 had a high burden. Measurements were carried out on days 0, 60, and afterwards weekly on days 67, 75, 82, 91, 98, 106, 113, 120, and finally on day 271 after treatment. 40% of dogs showed pathological concentrations of D-dimer and 40% showed slight or mild thrombocytopenia on day 0. The levels of D-dimer decreased by day 60, probably due to the joint action of the ivermectin, doxycycline and exercise restriction. All dogs with high parasite burden showed elevated values of D-dimer on several occasions during the treatment, reaching the highest values the first and second week after the injections of melarsomine. Only 33.3% of the dogs with low parasite burden showed elevated D-dimer levels at some point during the treatment, and all of them showed undetectable levels from the third week after the first injection of melarsomine. On day 271, all dogs showed undetectable levels of D-dimer. There was no correlation between thrombocytopenia and levels of D-dimer during the treatment. The evaluation of serum D-dimer appears to be a supportive test in the assessment and monitoring of pulmonary thromboembolism in dogs with heartworm disease during the adulticide

  3. Value of serum D-dimer levels to the elderly patients with pulmonary infection in the emergency%急诊80岁以上老年肺炎患者D-二聚体检测的意义

    Institute of Scientific and Technical Information of China (English)

    周卫华; 金东生; 朱旖; 李晓红

    2014-01-01

    Objective To investigate the relationship of serum D-dimer(D-D) levels with severity of pulmonary infection in the elderly patients over 80 years old in emergency.Methods The data of 143 cases (older than 80 years old) of pulmonary infection from December 2012 to December 2013 in emergency were retrospectively reviewed.The patients were assigned to the following pneumonia subgroups:segmental pneumonia,lobar pneumonia,and multilobar pneumonia,according to radiologic extension.They were divided into complication group and non-complication group.Results The serum D-D levels in the three subgroups were (295.24±49.11) ng/ml,(868.42 ± 941.11) ng/ml,(1706.67 ± 1210.44) ng/ml,respectively.There were significant difference between three groups(P<0.01).The serum level of D-D in segmental pneumonia group was significantly lower than that in lobar pneumonia group and multilobar pneumonia group (P<0.05).Serum D-D levels in complication group and non-complication group were (1226.78 ± 1173.83) ng/ml and (310.56± 361.30) ng/ml,and there was significant difference between the two groups (P<0.05).Conclusions The serum D-D level is associated with the severity of pneumonia in the elderly patients,and D-D could be used as an indicator for disease status of the elderly patients with pulmonary infection in emergency.%目的 研究≥80岁老年肺炎急诊患者血清D-二-聚体水平与病情严重程度的关系,探讨急诊检测D-二聚体的意义. 方法 回顾分析2012年12月至2013年12月我院急诊≥80岁老年肺炎患者血清D-二聚体水平,按照肺部影像改变范围分3组,单肺段肺炎组、单肺叶组和多肺叶肺炎组;按基础合并症分3组:无合并症组、单种合并症组、多种合并症组,在亚组内进行D-二聚体水平比较分析. 结果 单肺段肺炎组与单肺叶组和多肺叶组比较D-二聚体水平明显较低,差异有统计学意义(P<0.01);有基础合并症组较无合并症组D-二聚体水平增

  4. Elevation in D-dimer concentrations is positively correlated with gestation in normal uncomplicated pregnancy

    Directory of Open Access Journals (Sweden)

    Jeremiah ZA

    2012-08-01

    Full Text Available Zaccheaus A Jeremiah,1 Teddy C Adias,2 Margaret Opiah,3 Siyeoforiye P George,4 Osaro Mgbere,5 Ekere J Essien61Department of Medical Laboratory Sciences, Niger Delta University, Wilberforce Island, Nigeria; 2Bayelsa State College of Health Technology, Ogbia-Town, Nigeria; 3Department of Maternal and Child Health, Faculty of Nursing, Niger Delta University, Wilberforce Island, Nigeria; 4Postgraduate Hematology Unit, Rivers State University of Science and Technology, Port Harcourt, Nigeria; 5Houston Department of Health and Human Services, Houston, TX, USA; 6Institute of Community Health, University of Houston, Houston, TX, USABackground: D-dimer levels have been reported to increase progressively during pregnancy, but how this affects Nigerian women is not well known.Objective: This study aims to determine the D-dimer concentration and its relationship to other coagulation parameters among pregnant women in Port Harcourt, Nigeria.Method: In a cross-sectional observational study conducted in Port Harcourt, Nigeria, 120 pregnant women and 60 nonpregnant controls, drawn from a tertiary health institution in the Niger Delta, Nigeria, were assessed, using the standard procedures, for the following parameters: D-dimer concentration, prothrombin time, activated partial thromboplastin time, platelet count, hemoglobin, and packed cell volume.Results: The median D-dimer concentration of 153.1 ng/mL in the pregnant group was found to be significantly elevated when compared with the control value of 118.5 ng/mL (t = 2.348, P = 0.021. Conversely, there was a marked depression in the platelet count among pregnant women (193.5 × 109/L when compared with 229.0 × 109/L in the control group (t = 3.424; P = 0.001. There was no statistically significant difference in the values for the prothrombin time and the activated partial thromboplastin time between pregnant and nonpregnant women. D-dimer values correlated positively and significantly with gestation (r = 0

  5. How to use D-dimer in acute cardiovascular care

    DEFF Research Database (Denmark)

    Giannitsis, Evangelos; Mair, Johannes; Christersson, Christina

    2015-01-01

    D-dimer testing is important to aid in the exclusion of venous thromboembolic events (VTEs), including deep venous thrombosis and pulmonary embolism, and it may be used to evaluate suspected aortic dissection. D-dimer is produced upon activation of the coagulation system with the generation and s...... testing. For the exclusion of pulmonary embolism/deep vein thrombosis, age-adjusted cut-offs are recommend. Clinicians must be aware of the validated use of their hospital's D-dimer assay to avoid inappropriate use of this biomarker in routine care....

  6. Serum D-dimer concentrations in nephrotic syndrome track with albuminuria, not estimated glomerular filtration rate.

    LENUS (Irish Health Repository)

    Sexton, D J

    2012-01-01

    The nephrotic syndrome is associated with an increased risk of venous and arterial thrombosis. There are little published data on the distribution, interpretation or determinants of serum D-dimer levels in patients with the nephrotic syndrome. We aimed to describe this relationship.

  7. Identification of Quantitative Trait Loci for Fibrin Clot Phenotypes. The EuroCLOT Study

    DEFF Research Database (Denmark)

    Williams, Frances M K; Carter, Angela M; Kato, Bernet;

    2009-01-01

    associated with fibrin phenotypes. METHODS AND RESULTS: 447 dizygotic (DZ) and 460 monozygotic (MZ) pairs of healthy UK white female twins and 199 DZ twin pairs from Denmark were studied. D-dimer, an indicator of fibrin turnover, was measured by ELISA and measures of clot formation, morphology, and lysis...

  8. Complementarity of lung scintigraphy and D-dimer test in pulmonary embolism

    Energy Technology Data Exchange (ETDEWEB)

    Bonnin, F. [Department of Nuclear Medicine, Hopital Beaujon, Clichy (France); Hadjikostova, H. [Department of Nuclear Medicine, Hopital Beaujon, Clichy (France); Jebrak, G. [Department of Pneumology, Hopital Beaujon, Clichy (France); Denninger, M.H. [Laboratory of Hemobiology, Hopital Beaujon, Clichy (France); Vera, P. [Department of Nuclear Medicine, Hopital Beaujon, Clichy (France); Rufat, P. [Cellule MSI, Hopital Beaujon, Clichy (France); Seknadji, P. [Department of Cardiology, Hopital Beaujon, Clichy (France); Bok, B. [Department of Nuclear Medicine, Hopital Beaujon, Clichy (France)

    1997-04-01

    D-dimer assay (DDA), measuring fibrin degradation products, was compared with lung scintigraphy (LS) in a prospective unselected series of 83 consecutive patients referred owing to suspicion of pulmonary embolism (PE). This patient series was also used to compare several methods of performing and interpreting LS images. The final diagnosis was established independently by a separate panel with all available information except for the result of DDA. D-dimer was determined by ELISA (threshold value 500 ng/ml). LS, including perfusion (.Q) and pseudo-ventilation (Technegas) (.V), was classified according to PIOPED, (1) immediately by the physician on duty, and (2) retrospectively by a blinded panel. A positive (19) or negative (61) diagnosis of PE was achieved in 80 patients, the prevalence of PE being 24%. Only one false-negative was noted on DDA (sensitivity=95%) but there were 42 false-positives (specificity=31%), resulting in a positive predictive value of 30% and a negative predictive value of 95%. Emergency and retrospective interpretations of LS were close (kappa=0.4). In a minority of patients, PE may be excluded with reasonable certainty if DDA is normal, resulting in a significant saving in terms of time and money. (orig.). With 3 tabs.

  9. The Diagnostic Value of D-dimer, Procalcitonin and CRP in Acute Appendicitis

    Directory of Open Access Journals (Sweden)

    Bulent Kaya, Baris Sana, Cengiz Eris, Koray Karabulut, Orhan Bat, Riza Kutanis

    2012-01-01

    Full Text Available BACKGROUND: The early diagnosis of acute abdomen is of great importance. To date, several inflammatory markers have been used for the diagnosis of acute abdominal conditions, including acute appendicitis. The aim of this study was to evaluate the diagnostic utility of D-dimer, Procalcitonin (PCT and C-reactive protein (CRP measurements in the acute appendicitis.METHODS: This prospective study was conducted between March 1st, 2010 and July 1st, 2011. In this period, seventy-eight patients were operated with the diagnosis of acute appendicitis, and D-dimer, PCT and CRP levels of the patients were measured. The patients were grouped as phlegmonous appendicitis (Group 1, gangrenous appendicitis (Group 2, perforated appendicitis (Group 3 and negative appendectomy (Group 4 according to the surgical findings and histopathological results.RESULTS: Of 78 patients, 54 (69.2 % were male and 24 (30.8 % were female, and the mean age was 25.4 ± 11.1 years (range, 18 to 69 years. 66 (84.6 % patients had increased leukocyte count (white blood cell count. The PCT values were higher than the upper normal limit in 20 (25.6% patients, followed by D-dimer in 22 (28.2 % patients and CRP in 54 (69.2 % patients. The diagnostic value of leukocyte count and CRP in acute appendicitis was higher than that of the other markers, whereas leukocyte count showed very low specificity. CRP values were higher in perforated appendicitis when compared with the phlegmonous appendicitis (p<0.05. However, PCT and D-dimer showed lower diagnostic values (26% and 31%, respectively.CONCLUSION: An increase in CRP levels alone is not sufficient to make the diagnosis of acute appendicitis. However, CRP levels may differentiate between phlegmonous appendicitis and perforated appendicitis. Due to their low sensitivity and diagnostic value, PCT and D-dimer are not better markers than CRP for the diagnosis of acute appendicitis.

  10. 联合检测血清降钙素原、C反应蛋白、乳酸、D-二聚体水平在儿童脓毒症中的意义%Significance of combined detection of serum procalcitonin, C-reactive protein, lactic acid and D-dimer level in children with sepsis

    Institute of Scientific and Technical Information of China (English)

    陈晓锐; 彭俊旭; 郑华

    2016-01-01

    目的:探讨血清降钙素原、C反应蛋白、乳酸、D-二聚体水平在儿童脓毒症联合检测的意义。方法选取64例我院治疗的脓毒症,根据患儿病情情况,将脓毒症组分为一般脓毒症和重度脓毒症组,另选择32例健康儿童为正常对照组。于入院后1h内测定血清降钙素原、C反应蛋白、乳酸、D-二聚体水平。结果脓毒症患儿组血清降钙素原、C反应蛋白、乳酸、D-二聚体水平较正常儿童组明显升高,差异有统计学意义( P<0.01);重度脓毒组血清降钙素原、乳酸水平在诊断为脓毒症后的6 h、24 h、48 h比一般脓毒症组升高,差异有统计学意义(P<0.01),C反应蛋白水平在两组中比较差异无统计学意义(P>0.05);脓毒症组并发DIC者四项指标同时升高,且死亡组血清降钙素原、乳酸、D-二聚体水平比存活组更高,差异有统计学意义(P均<0.01)。结论在脓毒症患儿中联合检测血清降钙素原、C反应蛋白、乳酸、D-二聚体水平可能可以提高诊断早期脓毒症及判断病情严重程度及预后的水平。%Objective To explore the significance of combined detection of serum procalcitonin, C-reactive protein, lactic acid and D-dimer levels in children with sepsis.Methods 64 cases with sepsis according to their situation were divided into general sepsis and severe sepsis group, and 32 cases healthy children were selected as control group.Serum procalcitonin, C-reactive protein, lactic acid and D-dimer levels were detected within 1h after they were hospitalized.Results Serum procalcitonin, C-reactive protein, lactic acid and D-dimer levels in sepsis group were significantly higher (P0.05);All the four parameters in sepsis group complicated with DIC increased at the same time, and in death group, serum procalcitonin, lactic acid and D-dimer levels were significantly higher than the survival group ( P <0.01 ) . Conclusions

  11. Prognostic values of heart-type fatty acid-binding protein and D-dimer level in plasma in acute pulmonary embolism patients%心肌型脂肪酸结合蛋白联合血浆D-二聚体对肺栓塞预后评估的临床意义

    Institute of Scientific and Technical Information of China (English)

    陶琳; 杨毅

    2015-01-01

    ObjectiveTo evaluate the clinical value of heart-type fatty acid-binding protein (H-FABP) and D-dimer in assessing the prognosis of acute pulmonary embolism (APE). MethodsTotaly 120 APE patients were hospitalized from January 2011 to December 2014 and enroled in this study. The plasma H-FABP and D-dimer level were measured by enzyme-linked immunosorbent assay. The APE patients were divided three groups including low-risk, middle-risk and high-risk group by European heart association new guidelines. According to the clinical prognosis, the APE patients were divided into survival and death group. The H-FABP and D-dimer level in different groups and the relationship with the prognosis were assessed.ResultsWith the increased severity in patients, the H-FABP and D-dimer level were significantly elevated (P<0.05); the H-FABP and D-dimer level were significantly higher in death group as compared with survival group (P<0.05). The H-FABP and D-dimer level were positively correlated (r=0.693,P=0.000). ROC curves analysis results showed that the area under curve of H-FABP was 0.845 (95%CI: 0.752-0.918), and optimal operating point (OOP) was 8.65 µg/L, which had 81.24% sensitivity and 84.14% specificity; ACU of D-dimer was 0.832 (95%CI: 0.728-0.899), and OOP was 1.25 mg/L, which had 83.72% sensitivity and 82.65% specificity.Conclusion The H-FABP and D-dimer can effectively assess severity and prognosis of APE patients, meanwhile, it provide an objective basis for the clinical individual treatment and reducing the mortality rate of APE patients.%目的:探讨心肌型脂肪酸结合蛋白(H-FABP )联合血浆 D-二聚体在评价急性肺栓塞(APE)患者预后中的临床价值。方法选取本院2011年1月至2014年12月确诊的APE患者120例为研究对象,采用酶联免疫吸附法分别测定外周血H-FABP及D-二聚体浓度。根据病情严重程度将APE患者分为低危组、中危组及高危组;根据临床转归,分为存活组和死亡组

  12. 依达拉奉对急性脑梗死患者超敏C-反应蛋白及D-二聚体的影响%Effects of Edaravone on the levels of hs-CRP and D-dimer in Patients with Acute Cerebral infarction

    Institute of Scientific and Technical Information of China (English)

    杜金明; 闫宗廷

    2010-01-01

    目的 探讨依达拉奉对急性脑梗死患者血清超敏C-反应蛋白(hs-CRP)、D-二聚体的影响及临床疗效.方法 86例急性脑梗死患者随机分为两组,即常规治疗组和治疗组,治疗组在常规治疗基础上给予依达拉奉30 mg每天2次静脉点滴,连用14 d.治疗前后测定血清hs-CRP、D-二聚体的变化并用中国卒中量表(Chinese stroke scale,CSS)及巴氏指数(Barthel index,BI)评定.结果 两组患者hs-CRP和D-二聚体均下降,治疗组明显低于常规治疗组(P<0.05).治疗后两组CSS及BI评分指数较治疗前均明显增加,治疗组评分高于常规治疗组(P<0.05).结论 依达拉奉可降低急性脑梗死患者hs-CRP、D-二聚体的水平,有益于患者神经功能的恢复.%Objective To investigate the effects of edaravone on the levels of high sensitivity C-reactive protein(hs-CRP) and D-dimer in patients with acute ischemic cerebral infarction. Methods A total of 86 patients with acute ischemic cerebral infarction were randomly divided and assigned into therapy group and control group. The control group was given a routine treatment of acute ischemic stroke. The therapy group was treated with edaravone in addition to the routine treatment. hs-CRP and D-dimer were measured before and after treatment. Barthel index(BI) and Chinese stroke Scale(CSS) of two groups were assessed before treatment and after treatment. Results The levels of hs-CRP and D-dimer were deceased after treatment. After the start of edaravone ,the levels of hs-CRP and D-dimer of therapy group were significantly lower than those of control group(P <0.05). The scores of CSS and BI of two groups improved after treatment,and scores of CSS and BI of the therapy group were better than those of the control group(P< 0.05). Conclusion Edaravone could decrease the levels of hs-CRP and D-dimer and is beneficial to improve neurofunctional recovery.

  13. D-Dimer combined with glycated hemoglobin level of cerebral small vessel disease condition prediction effect%D - D 二聚体水平联合糖化血红蛋白对脑小血管疾病病情的预测效果

    Institute of Scientific and Technical Information of China (English)

    周绍英; 伍辉; 王真艳; 刘连琴

    2015-01-01

    three sets. The high standards for the PI group of patients in which PI ﹥ 1. 5,this group included 49 patients. The group of patients with PI standard 1. 2≤PI≤1. 5 included 66 patients. Low PI group standards for PI ﹤ 1. 2 included 50 patients. The healthy control group included 50 cases. D - D- dimer,glycosylated hemoglobin,PI,blood pressure,weight,height and other basic information of all patients were detected and compared a-mong the four groups. The other indexes included D - D dimer blood samples,the difference of glycohemoglobin. Multivariate Logistic regression was used to determine the risk of cerebral small vessel disease,and analyze the relationship between glycated hemoglobin and D - dimer and cere-bral small vessel disease condition. Results The difference D - dimer and glycated hemoglobin content of the four groups of the study were statis-tically significant. Pairwise comparisons between groups were statistically difference. D - dimer,glycosylated hemoglobin were small risk factors for vascular disease. Pesrson correlation analysis showed that glycated hemoglobin levels and severity of cerebral small vessel disease of the disease was positively correlated( r = 0. 669,P = 0. 013). D - Dimer and severity of cerebral small vessel disease condition had a positive correlation( r =0. 683,P = 0. 010). Conclusion The severity of D - dimer levels and glycosylated hemoglobin content of cerebral small vessel disease had a positive correlation between clinically by D - Dimer levels and glycated hemoglobin,which can predict disease cerebral small vessel disease to a certain extent.

  14. Correlation of plasma D-dimer, T lymphocyte subsets, CRP level with Apgar score of neonates in pregnant women with pregnancy-induced hypertension during perinatal period%妊高征孕妇围生期血浆D-二聚体、T细胞亚群及CRP水平与胎儿Apgar评分的相关性

    Institute of Scientific and Technical Information of China (English)

    钟晓红

    2014-01-01

    Objective It is to explore the correlation of plasma D -dimer ( D-D) , T lymphocyte subsets , CRP level with Apgar score of neonates in pregnant women with pregnancy-induced hypertension ( PIH) during perinatal period .Methods 120 pregnant women with PIH were selected as observation group , and 60 healthy pregnant women were selected as control group . Plasma D-D, CD4 +and CD8 +T cell lymphocyte subsets and CRP level of the two groups were detected before and 3d after delivery , and Apgar scores of neonates were recorded after delivery .By applying Pearson correlation analysis , the correlation of plasma D-dimer, T lymphocyte subsets proportion , CRP level and Apgar score of neonates was analyzed .Besides, the correlation of D-dimer, CD4+/CD8 +, CRP index, and Apgar score of neonates was analyzed by multiple logistic regression analysis.Results There was no statistical difference in plasma D -D, CD4+/CD8 +and CRP before and 3d after delivery in control group (P>0.05), while observation group’s plasma D-D and CRP decreased (P<0.05), and CD4 +/CD8 +in-creased (P<0.05).By comparison, D-dimer, CRP, and CD4 +/CD8 +before and 3d after delivery in observation group were all higher than those in control group (P<0.05).By Pearson correlation, it showed that D -dimer, CD4 +/CD8+, CRP and Apgar score of neonates were both negative correlation with each other (P<0.05).By multiple logistic regression a-nalysis, D-dimer and CD4 +/CD8 +are independent forecast factors for Apgar score of neonates (OR=0.673, P=0.032;OR=0.543, P=0.026).Conclusion Plasma D-dimer, T lymphocyte subsets and CRP in pregnant women with PIH during perinatal period have clinical value for assessment of Apgar score of neonates .%目的:探讨妊娠高血压综合征孕妇围生期血浆D-二聚体( D-dimer )、T细胞亚群、C反应蛋白( CRP)与胎儿Apgar评分的相关性。方法选取妊高征孕妇120例设为观察组;另选取同期孕检的健康孕妇60例设为对照组。检测2

  15. Prognostic role of D-dimer for in-hospital and 1-year mortality in exacerbations of COPD

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    Hu G

    2016-10-01

    Full Text Available Guoping Hu,1 Yankui Wu,2 Yumin Zhou,3 Zelong Wu,1 Liping Wei,1 Yuqun Li,1 GongYong Peng,3 Weiqiang Liang,1 Pixin Ran3 1Department of Respiratory Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 2Department of Respiratory Disease of People’s Hospital of Guangxi Zhuang Autonomous Region, Guangxi Zhuang Autonomous Region, 3Guangzhou Institute of Respiratory Disease, State Key Lab of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, People’s Republic of China Background and objective: Serum D-dimer is elevated in respiratory disease. The objective of our study was to investigate the effect of D-dimer on in-hospital and 1-year mortality after acute exacerbations of chronic obstructive pulmonary disease (AECOPD. Methods: Upon admission, we measured 343 AECOPD patients’ serum D-dimer levels and arterial blood gas analysis, and recorded their clinical characteristics. The level of D-dimer that discriminated survivors and non-survivors was determined using a receiver operator curve (ROC. The risk factors for in-hospital mortality were identified through univariate analysis and multiple logistic regression analyses. To evaluate the predictive role of D-dimer for 1-year mortality, univariate and multivariate Cox regression analyses were performed. Results: In all, 28 patients died, and 315 patients survived in the in-hospital period. The group of dead patients had lower pH levels (7.35±0.11 vs 7.39±0.05, P<0.0001, higher D-dimer, arterial carbon dioxide tension (PaCO2, C-reactive protein (CRP, and blood urea nitrogen (BUN levels (D-dimer 2,244.9±2,310.7 vs 768.2±1,078.4 µg/L, P<0.0001; PaCO2: 58.8±29.7 vs 46.1±27.0 mmHg, P=0.018; CRP: 81.5±66, P=0.001; BUN: 10.20±6.87 vs 6.15±3.15 mmol/L, P<0.0001, and lower hemoglobin levels (118.6±29.4 vs 128.3±18.2 g/L, P=0.001. The areas under the ROC curves of D-dimer for in-hospital death were 0

  16. Predictive value of D-dimer for portal vein thrombosis after portal hypertension surgery in hepatitis B virus-related cirrhosis

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    AIM: To evaluate the predictive value of D-dimer as a predictive indicator of portal vein thrombosis (PVT) after portal hypertension surgery in hepatitis B virus-related cirrhosis.METHODS: A prospective study was carried out in 52 patients who had undergone surgery for portal hypertension in hepatitis B virus-related cirrhosis.Changes in perioperative dynamic D-dimer were observed. The sensitivity, specificity, positive predictive values and negative predictive values of D-dimer were calculated, and ROC curves were analyzed.RESULTS: The D-dimer levels in the group developing postoperative PVT was significantly higher than those in the group not developing PVT (P = 0.001), and the ROC semi-quantitative and qualitative analysis of D-dimer showed a moderate predictive value in PVT (semiquantitative value Az = 0.794, P = 0.000; qualitative analysis: Az = 0.739, P = 0.001).CONCLUSION: Dynamic monitoring of D-dimer levels in patients with portal hypertension after surgery can help early diagnosis of PVT, as in cases where the D-dimer levels steadily increase and exceed 16 μg/mL, the possibility of PVT is very high.

  17. Plasma D-dimer concentration in patients with systemic sclerosis

    Directory of Open Access Journals (Sweden)

    Montagnana Martina

    2006-01-01

    Full Text Available Abstract Background Systemic sclerosis (SSc is an autoimmune disorder of the connective tissue characterized by widespread vascular lesions and fibrosis. Little is known so far on the activation of the hemostatic and fibrinolytic systems in SSc, and most preliminary evidences are discordant. Methods To verify whether SSc patients might display a prothrombotic condition, plasma D-dimer was assessed in 28 consecutive SSc patients and in 33 control subjects, matched for age, sex and environmental habit. Results and discussion When compared to healthy controls, geometric mean and 95% confidence interval (IC95% of plasma D-dimer were significantly increased in SSc patients (362 ng/mL, IC 95%: 361–363 ng/mL vs 229 ng/mL, IC95%: 228–231 ng/mL, p = 0.005. After stratifying SSc patients according to disease subset, no significant differences were observed between those with limited cutaneous pattern and controls, whereas patients with diffuse cutaneous pattern displayed substantially increased values. No correlation was found between plasma D-dimer concentration and age, sex, autoantibody pattern, serum creatinine, erythrosedimentation rate, nailfold videocapillaroscopic pattern and pulmonary involvement. Conclusion We demonstrated that SSc patients with diffuse subset are characterized by increased plasma D-dimer values, reflecting a potential activation of both the hemostatic and fibrinolytic cascades, which might finally predispose these patients to thrombotic complications.

  18. Four-Group Classification Based on Fibrinogen Level and Fibrin Polymerization Associated With Postoperative Bleeding in Cardiac Surgery.

    Science.gov (United States)

    Kawashima, Shingo; Suzuki, Yuji; Sato, Tsunehisa; Kikura, Mutsuhito; Katoh, Takasumi; Sato, Shigehito

    2016-10-01

    Fibrinogen and fibrin formation have a key role in perioperative hemostasis. The aim of this study is to examine the association of postoperative hemostasis with a combined evaluation of the fibrinogen level and fibrin polymerization in cardiac surgery. We retrospectively classified 215 consecutive cardiac surgery patients into 4 groups (Fuji-san classification) that were divided by fibrinogen level fibrinogen thromboelastometry value at 10 minutes with rotational thromboelastometry <6 mm (ie, low fibrin polymerization) at the warming of cardiopulmonary bypass. Four groups resulted; group I, the acceptable range (n = 85); group II, only hypofibrinogenemia (<150 mg/dL, ≥6 mm, n = 63); group III, hypofibrinogenemia and low fibrin polymerization (<150 mg/dL, <6 mm, n = 60); and group IV, only low fibrin polymerization (≥150 mg/dL, <6 mm, n = 7). The risk of chest tube drainage volume greater than 500 mL within the first 24 hours after surgery (with group I as the reference) was increased in group II (odds ratio [OR], 3.3; 95% confidence interval [CI], 1.5-7.4; P < .01) and group III (OR, 8.5; 95% CI, 3.5-21.7; P < .01), and the risk greater than 1000 mL (with group I as the reference) was increased in group III (OR, 4.0; 95% CI, 1.1-17.3; P = .03) and group IV (OR, 23.1; 95% CI, 3.2-201.0; P < .01). Intraoperative blood transfusions were decreased by 24.5%, after stratifying the starting amount of fresh frozen plasma by the 4-group classification in the recent consecutive 65 (30.2%) patients (P < .01). The 4-group classification is associated with postoperative bleeding and may improve the quality of perioperative blood transfusion in cardiac surgery.

  19. Increased von Willebrand factor, P-selectin and fibrin content in occlusive thrombus resistant to lytic therapy.

    Science.gov (United States)

    Sambola, Antonia; García Del Blanco, Bruno; Ruiz-Meana, Marisol; Francisco, Jaume; Barrabés, José A; Figueras, Jaume; Bañeras, Jordi; Otaegui, Imanol; Rojas, Angeles; Vilardosa, Úrsula; Montaner, Joan; García-Dorado, David

    2016-06-01

    Therapeutic fibrinolysis is ineffective in 40 % of ST-segment elevation acute myocardial infarction (STEMI) patients, but understanding of the mechanisms is incomplete. It was our aim to compare the composition of coronary thrombus in lysis-resistant STEMI patients with that of lysis-sensitive patients. Intracoronary thrombi (n=64) were obtained by aspiration in consecutive STEMI patients. Of them, 20 had received fibrinolysis and underwent rescue percutaneous coronary intervention (r-PCI, lysis-resistant patients) and 44 underwent primary PCI (p-PCI). Lysis-sensitivity was determined in vitro by clot permeability measurements and turbidimetric lysis in plasma of 44 patients undergoing p-PCI and 20 healthy donors. Clot-lysis sensitivity was defined as a clot-lysis time not greater than 1 SD over the mean of healthy donors. Coronary thrombus composition in 20 lysis-resistant and in 20 lysis-sensitive patients was analysed by immunofluorescence with confocal microscopy. Plasma biomarkers (P-selectin, VWF, PAI-1, t-PA, D-dimer, TF pathway markers, plasmin and CD34+) were measured simultaneously on peripheral blood. Lysis-resistant clots had higher levels of fibrin (p=0.02), P-selectin (p=0.03) and VWF (p=0.01) than lysis-sensitive clots. Among thrombi obtained ≤ 6 hours after onset of symptoms, those from lysis-resistant patients showed a higher content in fibrin than those from p-PCI patients (p=0.01). Plasma PAI-1 (p=0.02) and D-dimer levels were significantly higher (p=0.003) in lysis-resistant patients, whereas plasmin levels were lower (p=0.03). Multivariate analysis showed the content of fibrin and VWF within thrombus as predictors of thrombolysis resistance. In conclusion, coronary thrombi in STEMI patients resistant to fibrinolysis are characterised by higher fibrin, P-selectin and VWF content than lysis-sensitive thrombi.

  20. Preoperative plasma D-dimer is a predictor of one-year survival in colorectal cancer patients: a prospective clinical cohort study

    DEFF Research Database (Denmark)

    Stender, Mogens; Larsen, Torben Bjerregaard; Frøkjær, J.B.;

    PURPOSE: The study examined if preoperative plasma D-dimer level was associated with the postoperative cumulative incidence of deep venous thrombosis in patients with colorectal cancer admitted for intended curative surgery. METHODS: In 176 consecutive patients with newly-diagnosed colorectal...... cancer and absence of preoperative deep venous thrombosis, we measured the preoperative plasma D-dimer levels and performed compression ultrasonography for deep venous thrombosis prior to surgery, as well as one week, one month, and one year after surgery. RESULTS: The cumulative incidence of deep venous...... thrombosis up to one year after surgery was 20 percent (95 percent confidence interval, 12 to 31 percent) in the positive D-dimer group compared with 5 percent (95 percent confidence interval, 2 to 12 percent) in the negative D-dimer group. The adjusted hazard ratio of deep venous thrombosis in the positive...

  1. Age- and sex-dependent reference intervals for D-dimer

    DEFF Research Database (Denmark)

    Haase, Christine; Joergensen, Maja; Ellervik, Christina;

    2013-01-01

    A low D-dimer is commonly used to exclude venous thromboembolism in low risk patients. However, the reference intervals are poorly defined and D-dimer has been shown to increase by patient age. We aimed to establish age- and sex-dependent D-dimer reference intervals and to test the consequence...

  2. Altered fibrin clot structure/function in patients with antiphospholipid syndrome: association with thrombotic manifestation.

    Science.gov (United States)

    Celińska-Lowenhoff, M; Iwaniec, T; Padjas, A; Musiał, J; Undas, A

    2014-08-01

    We tested the hypothesis that plasma fibrin clot structure/function is unfavourably altered in patients with antiphospholipid syndrome (APS). Ex vivo plasma clot permeability, turbidity and susceptibility to lysis were determined in 126 consecutive patients with APS enrolled five months or more since thrombotic event vs 105 controls. Patients with both primary and secondary APS were characterised by 11% lower clot permeability (p<0.001), 4.8% shorter lag phase (p<0.001), 10% longer clot lysis time (p<0.001), and 4.7% higher maximum level of D-dimer released from clots (p=0.02) as compared to the controls. Scanning electron microscopy images confirmed denser fibrin networks composed of thinner fibres in APS. Clots from patients with "triple-antibody positivity" were formed after shorter lag phase (p=0.019) and were lysed at a slower rate (p=0.004) than in the remainder. Clots from APS patients who experienced stroke and/or myocardial infarction were 8% less permeable (p=0.01) and susceptible to lysis (10.4% longer clot lysis time [p=0.006] and 4.5% slower release of D-dimer from clots [p=0.01]) compared with those following venous thromboembolism alone. Multivariate analysis adjusted for potential confounders showed that in APS patients, lupus anticoagulant and "triple-positivity" were the independent predictors of clot permeability, while "triple-positivity" predicted lysis time. We conclude that APS is associated with prothrombotic plasma fibrin clot phenotype, with more pronounced abnormalities in arterial thrombosis. Molecular background for this novel prothrombotic mechanism in APS remains to be established.

  3. Preparation and Analysis of Lyophilization Characterization of Human D-dimer%人D-二聚体的制备及其冻干性质的分析

    Institute of Scientific and Technical Information of China (English)

    武建伟; 才蕾; 王继华; 唐时幸

    2014-01-01

    以人源纤维蛋白原为原材料制备D-二聚体,将其制成冻干品并分析其冻干性质。使用凝血酶、Factor XIIIa酶解纤维蛋白原,获得交联纤维蛋白。经纤溶酶降解交联纤维蛋白,生成纤维蛋白降解产物。超滤除去纤维蛋白降解产物中的小分子物质,可获得较高纯度的D-二聚体。通过筛选和优化冻干方案,将D-二聚体制备成冻干品。经检测可知,D-二聚体冻干品可在37℃稳定保存12 d;复溶后在25℃稳定保存8 d;复溶后在4℃稳定保存30 d;复溶时,常用复溶溶剂对其复溶后的活性检测无明显影响。%D-dimer is formed by sequential action of 3 enzymes from fibrinogen. After producing D-dimer, we did the research on its lyophilization process. To produce cross-linked fibrin, fibrinogen was digested by thrombin and Factor XIIa. Then, fibrin degradation products (FDP)was prepared from cross-linked fibrin being degraded by plasmin. D-dimer was purified from FDP through ultrafiltration and prepared into lyophilized powder. By optimizing the lyophilization program, lyophilized D-dimer was stable for at least 12 days at 37℃, stable for at least 8 days at 25℃ and 30 days at 4℃ after reconstitution, and not different when being dissolved by different solvent.The preparation system established in this research is feasible and efficient. Depend on its stability, lyophilized D-dimer could be provided as biological raw materials for further research.

  4. Changes in D-dimer and inflammatory biomarkers before ischemic events in patients with peripheral artery disease: The BRAVO Study.

    Science.gov (United States)

    McDermott, Mary McGrae; Liu, Kiang; Green, David; Greenland, Philip; Tian, Lu; Kibbe, Melina; Tracy, Russell; Shah, Sanjiv; Wilkins, John T; Huffman, Mark; Zhao, Lihui; Huang, Chiang-Ching; Auerbach, Amanda; Liao, Yihua; Skelly, Christopher L; McCarthy, Walter; Lloyd Jones, Donald

    2016-02-01

    Whether circulating biomarker levels increase shortly before an ischemic heart disease (IHD) event is unknown. We studied whether levels of D-dimer, C-reactive protein (CRP), and serum amyloid A (SAA) are higher within 2 months of an IHD event compared to time periods more than 2 months before the IHD event. We assembled 595 participants with peripheral artery disease (PAD) and followed them for up to 3 years. Blood samples were obtained every 2 months. The primary outcome was IHD events: myocardial infarctions, unstable angina, or IHD death. We used a nested case-control design. Fifty participants (cases) had events and were each matched by age, sex, duration in the study, and number of blood draws to two controls without events. Among cases, the mean D-dimer value of 1.105 obtained within 2 months of the event was higher than values obtained 10 months (0.68 mg/L, pevent. Compared to controls, median D-dimer levels in cases were higher 4 months (p=0.017), 6 months (p=0.005), and 8 months (p=0.028) before the event. Values of CRP and SAA obtained within two months of an IHD event not consistently higher than values obtained during the prior months. In PAD participants with an IHD event, D-dimer was higher within 2 months of the event, compared to most values obtained 10 to 32 months previously. D-dimer was also higher in cases as compared to controls during most visits within 8 months of the IHD event.

  5. The value of ischemia-modified albumin compared with d-dimer in the diagnosis of pulmonary embolism

    Directory of Open Access Journals (Sweden)

    Ucar Utku

    2008-05-01

    Full Text Available Abstract Study objective The primary aim of this study was to investigate whether IMA levels are helpful in the diagnosis of pulmonary embolism (PE. The secondary aim was to determine whether IMA was more effective alone or in combination with clinical probability scores in the diagnosis of PE. Thirdly, the sensitivity and specificity of IMA is compared with D-dimer both with and without clinical probability scores in patients with suspected PE. Methods Consecutive patients presenting to the emergency department with suspected PE were prospectively recruited, and healthy volunteers were also enrolled as controls. D-dimer and IMA levels were measured for the entire study group. Wells and Geneva scores were calculated and s-CTPA was performed on all suspected PE patients. Results The study population consisted of 130 patients with suspected PE and 59 healthy controls. Mean IMA levels were 0.362 ± 0.11 ABSU for Group A, the PE group (n = 75; 0.265 ± 0.07 ABSU for Group B, the non-PE group (n = 55; and 0.175 ± 0.05 ABSU for Group C, the healthy control group (p Conclusion IMA is a good alternative to D-dimer in PE diagnosis in terms of both cost and efficiency. Used in combination with clinical probability scores, it has a similar positive effect on NPV and sensitivity to that of D-dimer. The PPV of IMA is better than D-dimer, but it is still unable to confirm a diagnosis of PE without additional investigation.

  6. Evaluation of D-dimer serum levels among patients with chronic urticaria, psoriasis and urticarial vasculitis Avaliação dos níveis séricos de D-dímeros entre doentes com urticária crônica, psoríase e urticária vasculite

    Directory of Open Access Journals (Sweden)

    Paulo Ricardo Criado

    2013-06-01

    Full Text Available BACKGROUND: It has been demonstrated that neutrophils, eosinophils and monocytes, under appropriated stimulus, may express tissue factor and therefore, activate the extrinsic pathway of coagulation. We performed a transversal and case-control study of patients with chronic urticaria and patients with psoriasis, in our outpatient clinic to evaluate the production of D-dimer. OBJECTIVE: To evaluate D-dimer serum levels in patients with chronic urticaria and its possible correlation with disease activity. PATIENTS AND METHODS: The study was conducted from October 2010 until March 2011. We selected 37 consecutive patients from our Allergy Unit and Psoriasis Unit, and divided them into three groups for statistical analysis: (i 12 patients with active chronic urticaria (CU; (ii 10 patients with chronic urticaria under remission and (iii 15 patients with psoriasis (a disease with skin inflammatory infiltrate constituted by neutrophils, lymphocytes and monocytes. Another five patients with urticarial vasculitis were allocated in our study, but not included in statistical analysis. The serum levels of D-dimer were measured by Enzyme Linked Fluorescent Assay (ELFA, and the result units were given in ng/ml FEU. RESULTS: Patients with active chronic urticaria had the highest serum levels of D-dimer (p FUNDAMENTOS: Tem sido demonstrado que os neutrófilos, eosinófilos e monócitos, sob estímulo apropriado, podem expressar fator tecidual e, portanto, ativar a via extrínseca da coagulação. Realizamos um estudo transversal e caso-controle de pacientes com urticária crônica e pacientes com psoríase em nosso ambulatório para avaliar a produção de dímero-D. OBJETIVO: Avaliar níveis de dímero-D em pacientes com urticária crônica e sua possível correlação com a atividade da doença. PACIENTES E MÉTODOS: O estudo foi conduzido de outubro de 2010 até março de 2011. Nós selecionamos 37 pacientes consecutivos da Unidade de Alergia e Unidade de

  7. Efficacy of low molecular weight heparin on severe pneumonia in elderly patients with high level of D-dimer%低分子肝素钠辅助治疗D二聚体升高的老年重症肺炎疗效观察

    Institute of Scientific and Technical Information of China (English)

    倪军; 林宏; 孙嵘; 刘伟春; 郑海燕; 王倩

    2013-01-01

    Objective To evaluate the clinical effect and safety of low molecular weight heparin in the treatment of severe pneumonia in elderly patients with high D-dimer.Methods Eighty-nine cases of severe pneumonia with high level of D-dimer were randomly divided into two groups.The experiment group was given subcutaneous injection of low molecular weight heparin 5000 IU/d for 5 to 7 days.The control group was given conventional therapy.Artery Blood oxygen pressure(PaO2) in arterial blood and C-reactive protein concentration (CRP),D-dimer before and after treatment were measured.The fatality rate and adverse drug reactions were observed.Results After anticoagulant therapy,PaO2 in the experimental group had a more significant improvement than that in the control group [(77.4 ± 12.9) mmHg vs (62.8 ±12.3) mmHg,P <0.05].The level of D-dimer in the experiment group had a more significant decrease than that in the control group[(0.66 ±0.38) mg/L vs (1.19 ±0.55) mg/L,P <0.01].The experiment group had shorter hospital stay (days) and lower cost of hospitalization than the control group.There was no statistical difference in the fatality rate between two groups (9.09 % vs 20.45%,P > 0.05).The adverse drug reactions were few and mild in both groups.Conclusions Low molecular weight heparin is effective and safe to severe pneumonia in elderly patients.%目的 观察低分子肝素在老年重症肺炎患者中的治疗作用及不良反应. 方法 将2009年1月自2012年12月闸北区中心医院住院的D二聚体(D-D)升高的老年重症肺炎患者随机分为抗凝组和对照组.抗凝组予低分子肝素钠(法安明5000 IU/d,皮下注射)治疗;对照组仅给予常规治疗.观察2组治疗前后D-D、静脉血C反应蛋白浓度、动脉血氧分压(PaO2).比较2组平均住院天数及住院费用,观察2组病死率及不良反应. 结果 抗凝组治疗后D-D较对照组显著降低(P<0.01),为(0.66±0.38) mg/L和(1.19±0.55) mg/L.抗凝组治疗后PaO2

  8. Mesenchymal Stromal Cell-Derived PTX3 Promotes Wound Healing via Fibrin Remodeling.

    Science.gov (United States)

    Cappuzzello, Claudia; Doni, Andrea; Dander, Erica; Pasqualini, Fabio; Nebuloni, Manuela; Bottazzi, Barbara; Mantovani, Alberto; Biondi, Andrea; Garlanda, Cecilia; D'Amico, Giovanna

    2016-01-01

    Although mesenchymal stromal cells (MSCs) can promote wound healing in different clinical settings, the underlying mechanism of MSC-mediated tissue repair has yet to be determined. Because a nonredundant role of pentraxin 3 (PTX3) in tissue repair and remodeling has been recently described, here we sought to determine whether MSC-derived PTX3 might play a role in wound healing. Using a murine model of skin repair, we found that Ptx3-deficient (Ptx3(-/-)) MSCs delayed wound closure and reduced granulation tissue formation compared with wt MSCs. At day 2, confocal microscopy revealed a dramatic reduction in green fluorescent protein (GFP)-expressing Ptx3(-/-) MSCs recruited to the wound, where they appeared to be not only poorly organized in bundles but also scattered in the extracellular matrix. These findings were further confirmed by quantitative biochemical analysis of GFP content in wound extracts. Furthermore, Ptx3(-/-) MSC-treated skins displayed increased levels of fibrin and lower levels of D-dimer, suggesting delayed fibrin-rich matrix remodeling compared with control skins. Consistently, both pericellular fibrinolysis and migration through fibrin were found to be severely affected in Ptx3(-/-) MSCs. Overall, our findings identify an essential role of MSC-derived PTX3 in wound repair underscoring the beneficial potential of MSC-based therapy in the management of intractable wounds.

  9. Comparison of clinical probability-adjusted D-dimer and age-adjusted D-dimer interpretation to exclude venous thromboembolism.

    Science.gov (United States)

    Takach Lapner, Sarah; Julian, Jim A; Linkins, Lori-Ann; Bates, Shannon; Kearon, Clive

    2017-10-05

    Two new strategies for interpreting D-dimer results have been proposed: i) using a progressively higher D-dimer threshold with increasing age (age-adjusted strategy) and ii) using a D-dimer threshold in patients with low clinical probability that is twice the threshold used in patients with moderate clinical probability (clinical probability-adjusted strategy). Our objective was to compare the diagnostic accuracy of age-adjusted and clinical probability-adjusted D-dimer interpretation in patients with a low or moderate clinical probability of venous thromboembolism (VTE). We performed a retrospective analysis of clinical data and blood samples from two prospective studies. We compared the negative predictive value (NPV) for VTE, and the proportion of patients with a negative D-dimer result, using two D-dimer interpretation strategies: the age-adjusted strategy, which uses a progressively higher D-dimer threshold with increasing age over 50 years (age in years × 10 µg/L FEU); and the clinical probability-adjusted strategy which uses a D-dimer threshold of 1000 µg/L FEU in patients with low clinical probability and 500 µg/L FEU in patients with moderate clinical probability. A total of 1649 outpatients with low or moderate clinical probability for a first suspected deep vein thrombosis or pulmonary embolism were included. The NPV of both the clinical probability-adjusted strategy (99.7 %) and the age-adjusted strategy (99.6 %) were similar. However, the proportion of patients with a negative result was greater with the clinical probability-adjusted strategy (56.1 % vs, 50.9 %; difference 5.2 %; 95 % CI 3.5 % to 6.8 %). These findings suggest that clinical probability-adjusted D-dimer interpretation is a better way of interpreting D-dimer results compared to age-adjusted interpretation.

  10. Effect of low-level laser therapy (LLLT) on peripheral nerve regeneration using fibrin glue derived from snake venom.

    Science.gov (United States)

    Buchaim, Rogerio Leone; Andreo, Jesus Carlos; Barraviera, Benedito; Ferreira Junior, Rui Seabra; Buchaim, Daniela Vieira; Rosa Junior, Geraldo Marco; de Oliveira, Alexandre Leite Rodrigues; de Castro Rodrigues, Antonio

    2015-04-01

    The purpose of this study was to assess whether the adhesive permits the collateral repair of axons originating from a vagus nerve to the interior of a sural nerve graft, and whether low-level laser therapy (LLLT) assists in the regeneration process. Study sample consisted of 32 rats randomly separated into three groups: Control Group (CG; n=8), from which the intact sural nerve was collected; Experimental Group (EG; n=12), in which one of the ends of the sural nerve graft was coapted to the vagus nerve using the fibrin glue; and Experimental Group Laser (EGL; n=12), in which the animals underwent the same procedures as those in EG with the addition of LLLT. Ten weeks after surgery, the animals were euthanized. Morphological analysis by means of optical and electron microscopy, and morphometry of the regenerated fibers were employed to evaluate the results. Collateral regeneration of axons was observed from the vagus nerve to the interior of the autologous graft in EG and EGL, and in CG all dimensions measured were greater and presented a significant difference in relation to EG and EGL, except for the area and thickness of the myelin sheath, that showed significant difference only in relation to the EG. The present study demonstrated that the fibrin glue makes axonal regeneration feasible and is an efficient method to recover injured peripheral nerves, and the use of low-level laser therapy enhances nerve regeneration. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. Relevance of Interleukin-6 and D-Dimer for Serious Non-AIDS Morbidity and Death among HIV-Positive Adults on Suppressive Antiretroviral Therapy.

    Directory of Open Access Journals (Sweden)

    Birgit Grund

    Full Text Available Despite effective antiretroviral treatment (ART, HIV-positive individuals are at increased risk of serious non-AIDS conditions (cardiovascular, liver and renal disease, and cancers, perhaps due in part to ongoing inflammation and/or coagulation. To estimate the potential risk reduction in serious non-AIDS conditions or death from any cause that might be achieved with treatments that reduce inflammation and/or coagulation, we examined associations of interleukin-6 (IL-6, D-dimer, and high-sensitivity C-reactive protein (hsCRP levels with serious non-AIDS conditions or death in 3 large cohorts.In HIV-positive adults on suppressive ART, associations of IL-6, D-dimer, and hsCRP levels at study entry with serious non-AIDS conditions or death were studied using Cox regression. Hazard ratios (HR adjusted for age, gender, study, and regression dilution bias (due to within-person biomarker variability were used to predict risk reductions in serious non-AIDS conditions or death associated with lower "usual" levels of IL-6 and D-dimer.Over 4.9 years of mean follow-up, 260 of the 3766 participants experienced serious non-AIDS conditions or death. IL-6, D-dimer and hsCRP were each individually associated with risk of serious non-AIDS conditions or death, HR = 1.45 (95% CI: 1.30 to 1.63, 1.28 (95% CI: 1.14 to 1.44, and 1.17 (95% CI: 1.09 to 1.26 per 2x higher biomarker levels, respectively. In joint models, IL-6 and D-dimer were independently associated with serious non-AIDS conditions or death, with consistent results across the 3 cohorts and across serious non-AIDS event types. The association of IL-6 and D-dimer with serious non-AIDS conditions or death was graded and persisted throughout follow-up. For 25% lower "usual" IL-6 and D-dimer levels, the joint biomarker model estimates a 37% reduction (95% CI: 28 to 46% in the risk of serious non-AIDS conditions or death if the relationship is causal.Both IL-6 and D-dimer are independently associated with

  12. The role of d-dimer as first marker of thrombophilia in women affected by sterility: implications in pathophysiology and diagnosis of thrombophilia induced sterility

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    Di Micco Pierpaolo

    2004-11-01

    Full Text Available Abstract Background D-dimer is considered a marker of hypercoagulable state and of endogenous fibrinolysis, so increased d-dimer is detectable in patients affected by thrombosis. Yet, several studies showed that also infertility, in particular secondary infertility due to recurrent fetal losses, has been often related to thrombotic events, in particular in women carrying thrombotic risk factors such as inherited thrombophilia (MTHFRC677T, PTHRA20210G, Factor V Leiden polimorphisms and/or inhAfter this screening we selected 39erited protein C, protein S, AT III deficiency or acquired thrombophilia (primary antiphospholipid syndrome, acquired protein C, protein S, AT III deficiency, drugs induced thrombophilia. However, because its high predictive negative value in case of suspected thrombosis, increased d-dimer has been often associated to subclinical thrombophilia. The aim of this study is to investigate the role of d-dimer as first marker of thrombophilia in women affected by unexplained infertility and subsequently to search the cause of increased d-dimer, such as inherited and/or acquired thrombophilia. Patients and Methods We selected 79 patients with unexplained primary or secondary infertility. We excluded 40 patients affected by hydrosalpinx, uterine fibroids, uterine malformations, endocrinological and immunological diseases, luteal insufficiency, cytogenetical alterations. All remaining 39 patients were tested for d-dimer and divided in two groups: the patients of group A (25 patients showed increased plasma d-dimer, in group B were included 14 patients with normal plasma level of d-dimer. After this step all 39 patients were screened for MTHFRC677T, PTHRA20210G, Factor V Leiden polimorphisms, protein C, protein S, AT III, anticardiolipin IgM and IgG, lupus anticoagulant. In the control group were included 15 age matched women without sterility problems referred to our outpatient's section of vascular medicine for suspected deep venous

  13. Brug af D-dimer til at udelukke dyb venøs trombose i overekstremiteterne

    DEFF Research Database (Denmark)

    Ahler-Toftehøj, Hans-Ulrik; Mikkelsen, Peter

    2009-01-01

    D-dimer is often used to exclude deep venous thrombosis, primarily in the lower extremities. We describe a 38-year-old man who had deep venous thrombosis in the left vena subclavia in spite of a normal D-dimer. Only one inconclusive survey compares the value of D-dimer and upper extremity deep...... venous thrombosis. We conclude that where deep venous thrombosis of the upper extremities is suspected, you cannot rely on the D-dimer value, but should examine the patient using other modalities such as colour Doppler ultrasound. Udgivelsesdato: 2009-Sep...

  14. Age Adjusted D-Dimer for exclusion of Pulmonary Embolism: a retrospective cohort study.

    LENUS (Irish Health Repository)

    Monks, D

    2017-08-01

    D-Dimer (DD) will increase with age and recent studies have shown the upper limit of normal can be raised in those who are low risk and over 50. We studied age adjusted D-dimer (AADD) levels to assess whether pulmonary embolism (PE) could be safely excluded. This study analysed the Emergency Department (ED) Computed Tomographic Pulmonary Angiography (CTPA) requests. There were 756 requests. The parameters studied were; age, DD value, calculated AADD, CT result and Simplified Geneva Score (SGS). The primary outcome was the diagnostic performance of AADD. One hundred and eighty-five patients were included in the final cohort. Twenty-one patients had a negative DD after age adjustment. Of these one had a PE, corresponding to a failure rate of 4.76% (1 in 22). The sensitivity of AADD was 0.96 (95% CI 0.76 to 0.99) and its specificity was 0.12 (95% CI 0.08- 0.19). AADD demonstrated a reduction in false positives with one false negative, giving rise to a failure rate higher than that of other larger studies. Further study is indicated to accurately define the diagnostic characteristics for the Irish context.

  15. 血清肌酸激酶、C-反应蛋白和D-二聚体水平的测定在绞窄性肠梗阻早期诊断中的应用价值%Application value of level determination of serum creatine kinase, C-reactive protein and D-dimer in the early diagnosis of strangulated intestinal obstruction

    Institute of Scientific and Technical Information of China (English)

    张壮儒; 林楚怀; 杨永怀

    2016-01-01

    Objective: To analyze the value of level determination of serum creatine kinase, C-reactive protein and D-dimer in the early diagnosis of strangulated intestinal obstruction. Methods: 35 cases of strangulating intestinal obstruction patients admitted in our hospital from April 2013 to 2015 April were treated as observation group, and 35 patients admitted during the same period with simple obstruction were taken as the experimental group. Serum creatine kinase, C- reactive protein and D- dimer levels of 30 cases of healthy volunteers were examined as a control group. All patients received serum creatine kinase, C- reactive protein and D- dimer levels measured to compare their test results and analyze the correlation between the three indicators. Results: Compared with the control group, the levels of serum creatine kinase, C- reactive protein and D- dimer were not significantly different (P>0.05), while the serum creatine kinase, C- reactive protein and D- dimer levels of the observation group were significantly higher than those in the experimental group and the control group, the difference was statistically significant (P<0.05). The serum creatine kinase, C-reactive protein and D-dimer levels of the observation group among the three indexes were positively correlated. Conclusion: The detection of serum creatine kinase, C- reactive protein and D- dimer levels can effectively determine the level of strangulating intestinal obstruction, accurately determine the degree of injury patients and provide useful information for the treatment of late stage patients which is worthy of promotion.%目的:分析血清肌酸激酶、C-反应蛋白和 D-二聚体水平的测定在绞窄性肠梗阻早期诊断中的应用价值。方法:选择我院2013年4月—2015年4月收治的35例绞窄性肠梗阻患者作为观察组研究对象,和同期收治的35例单纯性肠梗阻患者作为实验组研究对象,同时,收集我院行血清肌酸激酶、C-反应蛋白

  16. Elevated d-dimer cut-off values for computed tomography pulmonary angiography—d-dimer correlates with location of embolism

    Science.gov (United States)

    Kubak, Mateuzs Piotr; Borthne, Arne; Ruud, Espen Asak; Ashraf, Haseem

    2016-01-01

    Background Acute pulmonary embolism (APE) is a potentially fatal condition, and making a timely diagnosis can be challenging. Computed tomography pulmonary angiography (CTPA) has become the modality of choice, and this contributes to the increasing load on emergency room CT scanners. Our purpose was to investigate whether an elevated d-dimer cut-off could reduce the demand for CTPA while maintaining a high sensitivity and negative predictive value (NPV). Methods We retrospectively reviewed all patients referred for CTPA with suspicion of APE in 2012, and collected d-dimer values and CTPA results. We investigated the diagnostic performance of d-dimer using a 0.5 mg/L cut-off and an age adjusted cut-off. We also evaluated a new and elevated cut-off. Cases were categorized according to their CTPA result into: no embolism, peripheral embolism, lobar embolism and central embolism. Finally we investigated a possible correlation between d-dimer values and location of embolism. Results We included 1,051 CTPAs, from which 216 (21%) showed pulmonary embolism. There were concomitant d-dimer analyses in 822 CTPA examinations. The current 0.5 mg/L cut-off achieved a sensitivity and NPV of 99%. The age-adjusted cut-off achieved a sensitivity and NPV of 98%, and our suggested cut-off of 0.9 mg/L achieved a sensitivity and NPV of 97%. Conclusions We conclude that the elevated d-dimer cut-off of 0.9 mg/L achieved a high sensitivity and NPV, while reducing the number of CTPA by 27%. The correlation between d-dimer values and location of embolisms supports the suggestion of an elevated d-dimer value. PMID:27386486

  17. The Sensitivity and Specificity of High Sensitive CRP, D-Dimer and IL-6 in Acute Coronary Syndrome

    Directory of Open Access Journals (Sweden)

    Özlem Yiğit

    2011-11-01

    Full Text Available Objective: ACS is the life threatening causes of chest pain. The aim of this study is to detect the sensitivity and specificity of CRP, IL-6 and D-dimer and identify their role in predicting adverse cardiac events. Material and Methods: All patients describing typical chest pain were enrolled in the study. Demographic features and final diagnosis were written and serum specimens were collected. All patients were telephoned after one month to determine if there were any adverse cardiac events. Results: There were 132 patients, (94 male, 38 female. The mean age was 60.92±10.78. 55 patients were diagnosed as AMI (37 STEMI and 18 NSTEMI 60 patients as unstable angina pectoris, 15 patients as stable angina pectoris and 2 patients as non cardiac chest pain. 6 patients died in the hospital. 15 patients had adverse cardiac events (12 recurrent AMI, 2 sudden cardiac death, 1 stroke. The levels of D-dimer, CRP and IL-6 at the presentation were not predictive for adverse events. Conclusion: D-dimer, CRP and IL-6 levels were high both in ACS and stable angina. Detecting the predictive value for adverse cardiac events requires larger patient numbers and longer follow up times.

  18. Predictive values of D-dimer assay, GRACE scores and TIMI scores for adverse outcome in patients with non-ST-segment elevation myocardial infarction

    Science.gov (United States)

    Satilmisoglu, Muhammet Hulusi; Ozyilmaz, Sinem Ozbay; Gul, Mehmet; Ak Yildirim, Hayriye; Kayapinar, Osman; Gokturk, Kadir; Aksu, Huseyin; Erkanli, Korhan; Eksik, Abdurrahman

    2017-01-01

    Purpose To determine the predictive values of D-dimer assay, Global Registry of Acute Coronary Events (GRACE) and Thrombolysis in Myocardial Infarction (TIMI) risk scores for adverse outcome in patients with non-ST-segment elevation myocardial infarction (NSTEMI). Patients and methods A total of 234 patients (mean age: 57.2±11.7 years, 75.2% were males) hospitalized with NSTEMI were included. Data on D-dimer assay, GRACE and TIMI risk scores were recorded. Logistic regression analysis was conducted to determine the risk factors predicting increased mortality. Results Median D-dimer levels were 349.5 (48.0–7,210.0) ng/mL, the average TIMI score was 3.2±1.2 and the GRACE score was 90.4±27.6 with high GRACE scores (>118) in 17.5% of patients. The GRACE score was correlated positively with both the D-dimer assay (r=0.215, P=0.01) and TIMI scores (r=0.504, P=0.000). Multivariate logistic regression analysis revealed that higher creatinine levels (odds ratio =18.465, 95% confidence interval: 1.059–322.084, P=0.046) constituted the only significant predictor of increased mortality risk with no predictive values for age, D-dimer assay, ejection fraction, glucose, hemoglobin A1c, sodium, albumin or total cholesterol levels for mortality. Conclusion Serum creatinine levels constituted the sole independent determinant of mortality risk, with no significant values for D-dimer assay, GRACE or TIMI scores for predicting the risk of mortality in NSTEMI patients.

  19. Unfavorably Altered Fibrin Clot Properties in Patients with Eosinophilic Granulomatosis with Polyangiitis (Churg-Strauss Syndrome: Association with Thrombin Generation and Eosinophilia.

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    Lucyna Mastalerz

    Full Text Available Given reports on the increased prevalence of thromboembolic incidents in patients with eosinophilic granulomatosis with polyangiitis (EGPA; Churg-Strauss syndrome, we investigated whether fibrin clot properties are unfavorably altered in EGPA.Ex vivo plasma fibrin clot characteristics, including clot permeability, turbidimetry and efficiency of fibrinolysis using two assays, were investigated in 34 consecutive patients with remission in EGPA according to the Birmingham Vasculitis Activity Score version 3 (23 female, 11 male, aged 48 (range, 21-80 years. The control group comprised 34 age- and sex- matched volunteers.Compared with controls, patients with EGPA were characterized by denser fiber clots (estimated pore size, Ks, 7.30±0.93 vs 10.14±1.07 10-9 cm2, faster fibrin polymerization (lag phase in a turbidimetric curve, 41.8±3.6 vs 47.4±2.9 s, thicker fibrin fibers (maximum absorbance, ΔAbs, 0.87±0.09 vs 0.72±0.07, higher maximum levels of D-dimer released from clots (DDmax 4.10±0.46 vs 3.54±0.35 mg/L, and prolonged clot lysis time (t50%; 9.50±1.45 vs 7.56±0.87 min; all p<0.0001. Scanning electron microscopy images confirmed denser plasma fibrin networks composed of thinner fibers formed in EGPA. Antineutrophil cytoplasmic antibody status and C-reactive protein did not affect clot variables. Multivariate analysis adjusted for fibrinogen showed that Ks was predicted by eosinophil count, peak thrombin generation, factor VIII, and soluble CD40 ligand, whereas eosinophil count, peak thrombin generation and antiplasmin predicted t50%.This study is the first to show that EGPA is associated with prothrombotic plasma fibrin clot phenotype, which may contribute to thromboembolic manifestations reported in this disease.

  20. Evaluation of D-dimer test in patients on chronic hemodialysis

    Directory of Open Access Journals (Sweden)

    Vurusic Branimir

    2013-07-01

    Full Text Available Determining the value of D-Dimer is a routine test in case of suspecting thromboembolic event. In patients on chronic dialysis, baseline concentrations for biomarkers have changed in widespread clinical use, which prompted us to measure the concentration of D-dimer, due to disorders of hemostasis in chronic kidney failure. From the evaluation of the findings of D-dimer in 67 patients and the available literature we can conclude that the value of the test in the diagnosis of thromboembolic events has significantly decreased.

  1. Qualitative point-of-care D-dimer testing compared with quantitative D-dimer testing in excluding pulmonary embolism in primary care.

    Science.gov (United States)

    Lucassen, W A M; Erkens, P M G; Geersing, G J; Büller, H R; Moons, K G M; Stoffers, H E J H; van Weert, H C P M

    2015-06-01

    General practitioners can safely exclude pulmonary embolism (PE) by using the Wells PE rule combined with D-dimer testing. To compare the accuracy of a strategy using the Wells rule combined with either a qualitative point-of-care (POC) D-dimer test performed in primary care or a quantitative laboratory-based D-dimer test. We used data from a prospective cohort study including 598 adults suspected of PE in primary care in the Netherlands. General practitioners scored the Wells rule and carried out a qualitative POC test. All patients were referred to hospital for reference testing. We obtained quantitative D-dimer test results as performed in hospital laboratories. The primary outcome was the prevalence of venous thromboembolism in low-risk patients. Prevalence of PE was 12.2%. POC D-dimer test results were available in 582 patients (97%). Quantitative test results were available in 401 patients (67%). We imputed results in 197 patients. The quantitative test and POC test missed one (0.4%) and four patients (1.5%), respectively, with a negative strategy (Wells ≤ 4 points and D-dimer test negative) (P = 0.20). The POC test could exclude 23 more patients (4%) (P = 0.05). The sensitivity and specificity of the Wells rule combined with a POC test were 94.5% and 51.0% and, combined with a quantitative test, 98.6% and 47.2%, respectively. Combined with the Wells PE rule, both tests are safe to use in excluding PE. The quantitative test seemed to be safer than the POC test, albeit not statistically significant. The specificity of the POC test was higher, resulting in more patients in whom PE could be excluded. © 2015 International Society on Thrombosis and Haemostasis.

  2. Diagnostic Accuracy of a New d-Dimer Assay (Sclavo Auto d-Dimer) for Exclusion of Deep Vein Thrombosis in Symptomatic Outpatients.

    Science.gov (United States)

    Legnani, Cristina; Cini, Michela; Frascaro, Mirella; Rodorigo, Giuseppina; Sartori, Michelangelo; Cosmi, Benilde

    2017-04-01

    In patients presenting non-high clinical pretest probability (PTP), a negative d-dimer can exclude venous thromboembolism without imaging tests. However, each d-dimer assay should be validated in prospective studies. We evaluated an automated d-dimer immunoassay using the Sclavo Auto d-dimer (Sclavo Diagnostics Int, Sovicille, Italy) provided by Dasit Diagnostica (Cornaredo, Milan, Italy). Three hundred two consecutive outpatients suspected of leg deep vein thrombosis (DVT) with non-high PTP were included. The Sclavo Auto d-dimer assay was evaluated on 2 analyzers (Sysmex CA-7000 and Sysmex CS-2100; Sysmex Corporation, Kobe, Japan, provided by Dasit). The cutoff value (200 ng/mL) was established a priori. Prevalence of DVT was 11.9%. Since no false-negative patients were detected, the sensitivity and negative predictive values (NPVs) were 100% (sensitivity = CA-7000: 100% [95% confidence interval, CI: 93.3-100], CS-2100: 100% [95% CI: 93.3-100]; NPV = CA-7000: 100% [95% CI: 97.9-100], CS-2100: 100% [95% CI: 98.0-100]). Specificity was 65.4% (95% CI: 59.4-71.1) and 69.2% (95% CI: 63.3-74.7) for CA-7000 and CS-2100, respectively. Specificity increased when a higher cutoff value (234 ng/mL) was used for patients aged ≥60 years without compromising the safety. Assay reproducibility was satisfactory at concentrations near the cutoff value (total coefficient of variations d-dimer assay was accurate when used for DVT diagnostic workup in outpatients with non-high PTP. Based on its high sensitivity and NPV, it can be used as a stand-alone test in outpatients with non-high PTP. Given its high specificity, the number of patients in whom further imaging techniques can be avoided increased, improving the yield of the test.

  3. Interleukin 6 Is a Stronger Predictor of Clinical Events Than High-Sensitivity C-Reactive Protein or D-Dimer During HIV Infection

    DEFF Research Database (Denmark)

    Borges, Alvaro Humberto Diniz; O'Connor, Jemma L; Phillips, Andrew N

    2016-01-01

    BACKGROUND: Interleukin 6 (IL-6), high-sensitivity C-reactive protein (hsCRP), and D-dimer levels are linked to adverse outcomes in human immunodeficiency virus (HIV) infection, but the strength of their associations with different clinical end points warrants investigation. METHODS: Participants...

  4. 肺挫伤患者早期超敏C反应蛋白、D-二聚体及肌钙蛋白I水平的临床意义%The clinical significance of hypersensitive C-reactive protein, D-dimer, and troponin I levels in patients with early-stage lung contusion

    Institute of Scientific and Technical Information of China (English)

    欧阳茴香; 刘彦宇; 李臻

    2015-01-01

    目的:观察超敏c反应蛋白(hs-crP)、d-二聚体(dd)及肌钙蛋白i(cTni)在肺挫伤后急性呼吸窘迫综合征(acute respiratory distress syndrome,ards)患者中的变化情况,探讨其临床意义。方法对128例急性肺挫伤患者入科24小时内测定hs-crP、dd、cTni水平,追踪观察1周内患者伤情变化,终点事件为ards。依据检测结果分为ards组和对照组。结果128例肺挫伤患者中1周内发生ards 29例。ards组hs-crP、dd和cTni值分别为(7.89±3.24)mg/l、(5.32±2.14)μg/ml和(2.34±1.04)ng/ml,均明显高于对照组的(6.08±2.46)mg/l、(4.26±2.08)μg/ml和(1.87±0.98)ng/ml(P<0.05)。结论hs-crP、dd及cTni水平可以作为肺挫伤后ards的病情评估指标。%Objective To observe the variation of hypersensitive c-reactive protein (hs-crP), d- dimer (dd) and troponin i (cTni) patients with acute respiratory distress syndromes(ards)after lung contusion and to explore its clinical significance.Method Hs-crP, dd, cTni levels of 128 patients with acute pulmonary contusion were measured within 24 hours after being enrolled into the department and their injury condition was followed up for a week with ards defined as the clinical endpoint. Based on the test results, they were divided into the ards and the normal group.Result 29 cases of ards occurred in 128 patients with pulmonary contusion within 1 week. Hs-crP value, dd value and cTni value in the ards group were (7.89 ±3.24)mg/l,(5.32±2.14)μg/ml,and(2.34±1.04)ng/ml,respectively,significantly higher than those of the control group which were(6.08±2.46)mg/l,(4.26±2.08)μg/ml,(1.87±0.98)ng/ml(P<0.05). Conclusion Hs-crP, dd and cTni levels can be used as indicators to assess the ards after lung contusion.

  5. Influence of mechanical hemolysis of blood on two D-dimer immunoassays.

    Science.gov (United States)

    Lippi, Giuseppe; Avanzini, Paola; Zobbi, Valentina; Ippolito, Luigi

    2012-07-01

    Although there is broad information about the influence of spurious hemolysis on several laboratory tests, less is known on the bias produced on D-dimer testing. Four different pools were obtained from primary blood tubes, and each of them was divided into four aliquots. The first nonhemolyzed was centrifuged, the plasma was separated and then tested for hemolysis index and D-dimer. The second (hemolyzed aliquot A), third (hemolyzed aliquot B) and fourth (hemolyzed aliquot C) aliquots were mechanically hemolyzed by aspirating whole blood one, two and three times through a fine needle. The plasma was then separated and tested for hemolysis index and D-dimer. D-dimer was quantified by HemosIL AcuStar D-dimer and HemosIL D-dimer HS for ACL TOP. Undetectable hemolysis was present in aliquot nonhemolyzed (hemolysis interference is more likely to be biological than analytical. The modest bias observed in samples with frank hemolysis (i.e. cell-free hemoglobin of 11.5 g/l) confirms that both methods are robust against this type of interference, so that test results might be released in the majority of mildly hemolyzed samples.

  6. Predictive values of D-dimer assay, GRACE scores and TIMI scores for adverse outcome in patients with non-ST-segment elevation myocardial infarction

    Directory of Open Access Journals (Sweden)

    Satilmisoglu MH

    2017-03-01

    Full Text Available Muhammet Hulusi Satilmisoglu,1 Sinem Ozbay Ozyilmaz,1 Mehmet Gul,1 Hayriye Ak Yildirim,2 Osman Kayapinar,3 Kadir Gokturk,4 Huseyin Aksu,1 Korhan Erkanli,5 Abdurrahman Eksik1 1Department of Cardiology, 2Department of Biochemistry, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, 3Department of Cardiology, Duzce University Faculty of Medicine, Duzce, 4Department of Infectious Diseases, 5Department of Thoracic and Cardiovascular Surgery, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey Purpose: To determine the predictive values of D-dimer assay, Global Registry of Acute Coronary Events (GRACE and Thrombolysis in Myocardial Infarction (TIMI risk scores for adverse outcome in patients with non-ST-segment elevation myocardial infarction (NSTEMI.Patients and methods: A total of 234 patients (mean age: 57.2±11.7 years, 75.2% were males hospitalized with NSTEMI were included. Data on D-dimer assay, GRACE and TIMI risk scores were recorded. Logistic regression analysis was conducted to determine the risk factors predicting increased mortality.Results: Median D-dimer levels were 349.5 (48.0–7,210.0 ng/mL, the average TIMI score was 3.2±1.2 and the GRACE score was 90.4±27.6 with high GRACE scores (>118 in 17.5% of patients. The GRACE score was correlated positively with both the D-dimer assay (r=0.215, P=0.01 and TIMI scores (r=0.504, P=0.000. Multivariate logistic regression analysis revealed that higher creatinine levels (odds ratio =18.465, 95% confidence interval: 1.059–322.084, P=0.046 constituted the only significant predictor of increased mortality risk with no predictive values for age, D-dimer assay, ejection fraction, glucose, hemoglobin A1c, sodium, albumin or total cholesterol levels for mortality.Conclusion: Serum creatinine levels constituted the sole independent determinant of mortality risk, with no significant values for D-dimer

  7. D-二聚体在急性心肌梗死中的应用%Application of D - dimer in Acute Myocardial Infarction

    Institute of Scientific and Technical Information of China (English)

    廖佩娟; 谢睿彬

    2014-01-01

    Objective To explore tje application of value of tje D-dimer in patients witj acute myocardial infarction,to guide tje D- dimer in tje diagnosis and differential diagnosis of acute myocardial infarction disease. Method Tje results in 203 patients witj acute myocardial infarction D-dimer were analyzed retrospectively from January 2010 to June 2013. Results 97. 0% of patients witj acute myo-cardial infarction D-dimer values <0. 5 ng/ml,wjile only 3. 0% of patients witj acute myocardial infarction values of D-dimer acuity≥0. 5 ng/ml. Conclusion D-dimer value in 97% of patients witj acute myocardial infarction< 0. 5 ng/ml level,it is advantageous to tje diagnosis of acute myocardial infarction patients witj cjest pain and D-dimer value jigjer diseases sucj as pulmonary embolism,and tje identification of aortic dissection.%目的:探讨D-二聚体在急性心肌梗死患者中的应用价值,指导D-二聚体在急性心肌梗死疾病中的诊断和鉴别诊断。方法:回顾性分析2010年~2013年6月203例冠心病,急性心肌梗死患者D-二聚体的结果。结果:97.0%的急性心肌梗死患者D-二聚体值<0.5 ng/ml,仅有3.0%的急性心肌梗死患者D-二聚体值≥0.5 ng/ml。结论:D-二聚体值在97%的急性心肌梗死患者中<0.5 ng/ml水平,有利于在胸痛患者诊断中急性心肌梗死与D-二聚体值较高的疾病如肺栓塞及主动脉夹层的鉴别。

  8. Clinical applicability of D-dimer assay in the diagnosis of pulmonary embolism reduces with aging

    Directory of Open Access Journals (Sweden)

    Luca Masotti

    2007-12-01

    Full Text Available Despite modern algorithms have been proposed for diagnosis of pulmonary embolism (PE, it remains understimed and often missed in clinical practice, especially in elderly patients, resulting in high morbidity and mortality when early and correctly untreated. One of the main controversial issue is represented by the role and applicability of D-dimer in the diagnostic work up of geriatric patients. Most recent guidelines in young-adult patients suggest to perform D-dimer assay by ELISA or immunoturbidimetric methods only in non high pre-test clinical probability (PTP patients; in these patients negative D-dimer can safely rule out the diagnosis of PE. This strategy is safe also in elderly patients; however the percentage of patients with non high PTP and negative D-dimer reduces progressively with age, making difficult its clinical applicability. The Authors, starting from two case reports, up date the diagnostic management of PE underling the limitations of D-dimer assay in elderly patients.

  9. D-dimer to guide the intensity of anticoagulation in Chinese patients after mechanical heart valve replacement: a randomized controlled trial.

    Science.gov (United States)

    Zhang, L; Zheng, X; Long, Y; Wu, M; Chen, Y; Yang, J; Liu, Z; Zhang, Z

    2017-08-01

    Essentials Low anticoagulation intensity reduces bleeding but increases thrombosis during warfarin therapy. Elevated D-dimer level is associated with increased thrombosis events. D-dimer can be used to find potential thrombosis in those receiving low intensity therapy. D-dimer-guided therapy may be the optimal strategy for those with mechanical heart valve replacement. Background Controversies remain regarding the optimal anticoagulation intensity for Chinese patients after mechanical heart valve replacement despite guidelines having recommended a standard anticoagulation intensity. Objectives To investigate whether D-dimer could be used to determine the optimal anticoagulation intensity in Chinese patients after mechanical heart valve replacement. Patients/Methods This was a prospective, randomized controlled clinical study. A total of 748 patients following mechanical heart valve replacement in Wuhan Asia Heart Hospital were randomized to three groups at a ratio of 1 : 1 : 1. Patients in two control groups received warfarin therapy based on constant standard intensity (international normalized ratio [INR], 2.5-3.5; n = 250) and low intensity (INR, 1.8-2.6; n = 248), respectively. In the experimental group (n = 250), warfarin therapy was initiated at low intensity, then those with elevated D-dimer levels were adjusted to standard intensity. All patients were followed-up for 24 months until the occurrence of endpoints, including bleeding events, thrombotic events and all-cause mortality. Results A total of 718 patients were included in the analysis. Fifty-three events occurred during follow-up. There was less hemorrhage (3/240 vs. 16/241; hazard ratio [HR], 0.18; 95% confidence interval [CI], 0.07-0.45) and all-cause mortality (4/240 vs. 12/241; HR, 0.33; 95% CI, 0.12-0.87) observed in the D-dimer-guided group than in the standard-intensity group. A lower incidence of thrombotic events was also observed in the D-dimer-guided group when compared with the

  10. ANP, BNP and D-dimer predict right ventricular dysfunction in patients with acute pulmonary embolism

    DEFF Research Database (Denmark)

    Mortensen, Jann; Jensen, Claus V; Von Der Recke, Peter;

    2010-01-01

    The aim of this study was to predict right ventricular dysfunction (RVD) using plasma concentration of D-dimer, pro-atrial natriuretic peptide (pro-ANP), brain natriuretic peptide (BNP), endothelin-1 (ET-1) and cardiac troponin I (TNI) in patients with pulmonary embolism (PE).......The aim of this study was to predict right ventricular dysfunction (RVD) using plasma concentration of D-dimer, pro-atrial natriuretic peptide (pro-ANP), brain natriuretic peptide (BNP), endothelin-1 (ET-1) and cardiac troponin I (TNI) in patients with pulmonary embolism (PE)....

  11. Relevance of Interleukin-6 and D-Dimer for Serious Non-AIDS Morbidity and Death among HIV-Positive Adults on Suppressive Antiretroviral Therapy

    DEFF Research Database (Denmark)

    Grund, Birgit; Baker, Jason V; Deeks, Steven G

    2016-01-01

    to within-person biomarker variability) were used to predict risk reductions in serious non-AIDS conditions or death associated with lower "usual" levels of IL-6 and D-dimer. RESULTS: Over 4.9 years of mean follow-up, 260 of the 3766 participants experienced serious non-AIDS conditions or death. IL-6, D......BACKGROUND: Despite effective antiretroviral treatment (ART), HIV-positive individuals are at increased risk of serious non-AIDS conditions (cardiovascular, liver and renal disease, and cancers), perhaps due in part to ongoing inflammation and/or coagulation. To estimate the potential risk...... in 3 large cohorts. METHODS: In HIV-positive adults on suppressive ART, associations of IL-6, D-dimer, and hsCRP levels at study entry with serious non-AIDS conditions or death were studied using Cox regression. Hazard ratios (HR) adjusted for age, gender, study, and regression dilution bias (due...

  12. Pulmoner emboli tanısında D-dimer düzeyleri ile ventilasyon/perfüzyon sintigrafisindeki bulgular arasındaki ilişki

    Directory of Open Access Journals (Sweden)

    Zekiye Hasbek

    2014-09-01

    Full Text Available Amaç. Pulmoner emboli (PE ölüm riskinin yüksek olması ve PE kuşkusu ile başlanan antikoagülan tedavinin yüksek kanama riski taşıması, tanının en kısa sürede doğrulanmasını ya da dışlanmasını gerektiren kardiovasküler hastalıktır. Ventilasyon/perfüzyon (V/P sintigrafisi PE şüphesinde yaygın kullanılan testlerden biridir. D-dimer fibrin yıkımının bir ürünüdür. Ancak akut trombozlar için spesifik değildir. Bu çalışmada amacımız, D-dimer düzeyleri ile ventilasyon/perfüzyon sintigrafisindeki perfüzyon defekt sayısı arasındaki ilişkiyi araştırmaktı. Yöntem. Çalışmamızda, PE ön tanısı ile takip edilen 100 olgunun D-dimer düzeyleri ile V/P sintigrafileri arasındaki ilişki araştırıldı. Hastaların sintigrafik bulguları perfüzyon defekti açısından; “perfüzyon defekti yok”, “subsegmenter tutulum”, “bir segment tutulum”, “iki segment tutulum”, “üç segment tutulum” ve “üçten fazla segment tutulum” şeklinde altı gruba; pulmoner emboli olasılığı açısından ise “pulmoner emboli yok”, “düşük olasılıklı”, “orta olasılıklı” ve “yüksek olasılıklı” şeklinde dört gruba ayrıldı. D-dimer düzeyi referans aralığı 0,00-0,50 µg/mL idi. Bulgular. Çalışmaya alınan 100 hastanın 52’si erkek 48’i kadındı. Pulmoner emboli olmayan 65 hastada D-dimer: 4,39 ± 9 µg/mL; düşük olasılıklı 20 hastada D-dimer: 4,57 ± 4 µg/mL; orta olasılıklı olan 9 hastada D-dimer: 6,38 ± 6 µg/mL; yüksek olasılıklı olan 6 hastada D-dimer: 8.0±8µg/mL olarak bulundu (p>0,05. Perfüzyon defekti izlenen segment sayısına göre; perfüzyon defekti olmayan 22 hastada D-dimer: 3,01 ± 4 µg/mL; subsegmenter defekti olan 8 hastada D-dimer: 3,62 ± 3 µg/mL; 1 segment defekti olan 14 hastada D-dimer: 10,7 ± 18 µg/mL; 2 segment defekti olan 11 hastada D-dimer: 3,16 ± 2 µg/mL; 3 segment defekti olan 10 hastada D-dimer: 3,86 ± 3

  13. Variable D-dimer thresholds for diagnosis of clinically suspected acute pulmonary embolism

    NARCIS (Netherlands)

    Van der Hulle, T.; Den Exter, P. L.; Erkens, P. G. M.; Van Es, J.; Mos, I. C. M.; Ten Cate, H.; Kamphuisen, P. W.; Hovens, M. M. C.; Buller, H. R.; Klok, F. A.; Huisman, M. V.

    2013-01-01

    Background Computed tomography pulmonary angiography (CTPA) is frequently requested using diagnostic algorithms for suspected pulmonary embolism (PE). For suspected deep vein thrombosis, it was recently shown that doubling the D-dimer threshold in patients with low pretest probability safely decreas

  14. D-dimer is useful in the diagnosis of cortical venous sinus thrombosis

    Directory of Open Access Journals (Sweden)

    Misra Usha

    2009-01-01

    Full Text Available Background: Estimations of D-dimer correlate with deep vein thrombosis and pulmonary thromboembolism and may serve as a marker of cortical venous sinus thrombosis (CVST. Aim: To study the usefulness of D-dimer in the diagnosis of CVST. Materials and Methods: A total of 26 patients with CVST were subjected to a detailed medical history and neurological evaluation. A cranial MRI was carried out on a 1.5T scanner using T1, T2, and DWI sequences and two-dimensional time of flight MR venography. D-dimer was estimated using a rapid latex agglutination slide test using monoclonal antibodies. Results: The age of patients ranged between 16 and 70 years old (median 31 years old; 8 were males and were examined after a mean duration of 22 days of symptoms. Cortical venous thrombosis was attributed to puerperium in 4 patients, infection in 5 patients, and pregnancy, dehydration, insect bite, and migraine in 1 patient each. Superior sagittal sinus was involved in 15 patients, transverse sinus in 16 patients, straight sinus in 3 patients, sigmoid sinus in 7 patients, and cavernous and deep system in 1 patient each. A total of 12 patients had more than one sinus involvement. D-dimer was positive in 20 patients and correlated with the duration of symptoms but not with the extent of sinus thrombosis and the outcome. Conclusion: D-dimer is useful in patients suspected of CVST and patients with positive test results should be urgently sent for MR imaging.

  15. Imaging of deep venous thrombosis in patients using a radiolabelled anti-D-dimer Fab' fragment ({sup 99m}Tc-DI-DD3B6/22-80B3): results of a phase I trial

    Energy Technology Data Exchange (ETDEWEB)

    Macfarlane, David [University of Queensland, School of Medicine, Brisbane (Australia); Socrates, Angelides; Larcos, George [University of Sydney, Department of Medicine, Sydney (Australia)]|[Westmead Hospital, Department of Nuclear Medicine and Ultrasound, Westmead (Australia)]|[Westmead Hospital, Centre for Biomedical Imaging and Research, Westmead (Australia); Eisenberg, Paul [Amgen Inc, Thousand Oaks, CA (United States); Roach, Paul [University of Sydney, Department of Medicine, Sydney (Australia)]|[Royal North Shore Hospital, Nuclear Medicine, St. Leonards (Australia); Gerometta, Michael [Agen Biomedical Pty Ltd, Brisbane (Australia); Smart, Richard; Tsui, Wendy [St. George Hospital, Nuclear Medicine Department, Sydney (Australia)]|[University of New South Wales, Department of Medicine, Sydney (Australia); Scott, Andrew M. [Austin Hospital, Centre for PET, Melbourne (Australia)]|[Ludwig Institute, Melbourne (Australia)

    2009-02-15

    {sup 99m}Tc-DI-DD3B6/22-80B3 (ThromboView registered, hereafter abbreviated to {sup 99m}Tc-DI-80B3 Fab') is a radiolabelled humanised monoclonal Fab' fragment with affinity and specificity for D-dimer domains of cross-linked fibrin. Detection of thromboembolic events has been demonstrated in canine models. The study objectives were evaluation of safety and characterisation of biodistribution, immunogenicity and pharmacokinetic profile of increasing doses of {sup 99m}Tc-DI-80B3 Fab' in subjects with acute lower-limb DVT. Twenty-six patients with acute lower limb DVT were enrolled. Of these, 21 received a single intravenous dose of 0.5 mg (n = 6), 1.0 mg (n = 9) or 2 mg (n = 6) {sup 99m}Tc-DI-80B3 Fab'. Blood and urine samples and gamma camera images were collected to 24 h after administration for pharmacokinetic and dosimetry analysis. Vital signs, electrocardiography, hematological and biochemical data and human anti-human antibody (HAHA) levels were monitored for up to 30 days following administration. Patients were assigned to either planar or single photon emission computed tomographic (SPECT) imaging of the thorax at 4 h following injection. Thirty-five adverse events were reported in 15 of the 21 subjects. Those deemed possibly related to administration of {sup 99m}Tc-DI-80B3 Fab' included mild hypertension, mild elevation of LD (lactate dehydrogenase) and moderate elevation of ALT (alanine transaminase). HAHA assays remained negative. Pharmacokinetics and organ dosimetry were comparable to prior normal volunteer data. Localisation of Thromboview registered to sites of known thrombus was evident as early as 30 min post-injection. In subjects with acute DVT, {sup 99m}Tc-DI-80B3 Fab' was well tolerated with favourable characteristics for the detection of acute venous thrombosis. (orig.)

  16. Imaging of deep venous thrombosis in patients using a radiolabelled anti-D-dimer Fab' fragment (99mTc-DI-DD3B6/22-80B3): results of a phase I trial.

    Science.gov (United States)

    Macfarlane, David; Socrates, Angelides; Eisenberg, Paul; Larcos, George; Roach, Paul; Gerometta, Michael; Smart, Richard; Tsui, Wendy; Scott, Andrew M

    2009-02-01

    (99m)Tc-DI-DD3B6/22-80B3 (ThromboView, hereafter abbreviated to (99m)Tc-DI-80B3 Fab') is a radiolabelled humanised monoclonal Fab' fragment with affinity and specificity for D-dimer domains of cross-linked fibrin. Detection of thromboembolic events has been demonstrated in canine models. The study objectives were evaluation of safety and characterisation of biodistribution, immunogenicity and pharmacokinetic profile of increasing doses of (99m)Tc-DI-80B3 Fab' in subjects with acute lower-limb DVT. Twenty-six patients with acute lower limb DVT were enrolled. Of these, 21 received a single intravenous dose of 0.5 mg (n = 6), 1.0 mg (n = 9) or 2 mg (n = 6) (99m)Tc-DI-80B3 Fab'. Blood and urine samples and gamma camera images were collected to 24 h after administration for pharmacokinetic and dosimetry analysis. Vital signs, electrocardiography, hematological and biochemical data and human anti-human antibody (HAHA) levels were monitored for up to 30 days following administration. Patients were assigned to either planar or single photon emission computed tomographic (SPECT) imaging of the thorax at 4 h following injection. Thirty-five adverse events were reported in 15 of the 21 subjects. Those deemed possibly related to administration of (99m)Tc-DI-80B3 Fab' included mild hypertension, mild elevation of LD (lactate dehydrogenase) and moderate elevation of ALT (alanine transaminase). HAHA assays remained negative. Pharmacokinetics and organ dosimetry were comparable to prior normal volunteer data. Localisation of Thromboview to sites of known thrombus was evident as early as 30 min post-injection. In subjects with acute DVT, (99m)Tc-DI-80B3 Fab' was well tolerated with favourable characteristics for the detection of acute venous thrombosis.

  17. Concentration of D-dimers in healthy cats and sick cats with and without disseminated intravascular coagulation (DIC).

    Science.gov (United States)

    Tholen, Inger; Weingart, Christiane; Kohn, Barbara

    2009-10-01

    The objective of this prospective study was to measure concentrations of D-dimers in 48 cats with various diseases and in 20 healthy cats to evaluate the sensitivity and specificity for D-dimers to diagnose disseminated intravascular coagulation (DIC). The cats were classified as having DIC if an underlying disease and at least three of the following criteria were present: thrombocytopenia, prolonged activated partial thromboplastin time, prothrombin time or thrombin time, schistocytes and/or a reduced antithrombin activity. D-dimer concentrations were measured using a semi-quantitative latex agglutination (LA) test (Accuclot D-Dimer, Sigma Diagnostics). The D-dimer test was positive for 8/12 cats with DIC and for 16/36 sick cats without DIC. D-dimers were negative for all healthy control cats. The comparison of the sick cats with DIC and those without DIC revealed a specificity and sensitivity of the D-dimer test of 56% and 67%; a comparison of the results for healthy cats and cats with DIC revealed a specificity and sensitivity of 100% and 67%, respectively. The D-dimer LA test is only of limited value for the diagnosis of DIC in cats.

  18. FIBRIN GLUE DAN APLIKASINYA

    Directory of Open Access Journals (Sweden)

    Agi Harliani S

    2015-08-01

    Full Text Available Fibrin Tissue Adhesive (FTA, Fibrin Sealant (FS or Fibrin Glue (FG are names given to a group of product that lead to the formation of fibrin clot at the site of application. Fibrin Glue represents a new revolution for local haemostatic, which produced by based on the understanding about blood coagulation process. The mechanism of FG mimics the last stage of blood coagulation process. Haemophilia, is a congenital inherited bleeding disorder, characterized by repeated bleeding episodes. The basic pathology is deficiency of factor VIII (hemophilia A or factor IX (hemophilia B. At bleeding episodes, hemophilia patients need replacement therapy. Hemophilia patients need transfusion of cryoprecipitate, Fresh Frozen Plasma (FFP or factor concentrate as replacement therapy. Oral surgery, dental extraction, circumcision, and orthopedic operations are the most important indications for fibrin glue in hemophilia care. As haemostatic local, FG minimizes bleeding, reducing the need of transfusion or factor concentrate, reducing the complication of transfusion, hospitalization and cost.

  19. Clinical Significance of Fibrinogen and D-dimer Detection in Esophageal Cancer%食管癌患者纤维蛋白原与D-二聚体检测的临床意义

    Institute of Scientific and Technical Information of China (English)

    刘瑜; 林晓铭; 池闯; 程德志

    2012-01-01

    目的 检测并研究食管癌患者血浆中纤维蛋白原(FIB)和D-二聚体(D-dimer,DD)的变化及其临床意义.方法 对60例食管癌患者和8例健康人血浆中FIB和D-二聚体进行检测并同临床指标间进行统计学分析.结果 食管癌组血浆中的FIB和D-二聚体水平明显高于正常对照组(P<0.01);同患者的淋巴结转移情况及P-TNM分期有关(P <0.05或P<0.01),而同性别及年龄不相关(P>0.05).结论 食管癌患者的FIB及D-二聚体高于正常,并同淋巴结转移及P-TNM分期相关且与患者的生存期呈明显的负相关.%Objective To explore the clinical significance of fibrinogen and D - dimer detection in esophageal squamous cell cancer. Methods The fibrinogen and D - dimer were detected in 60 esophageal cancer patients and 8 healthy adults, and the data were analyzed with clinical indexes by SPSS. Results Levdel of fibrinogen and D - dimer in esophageal cancer patients were higher than that in healthy group (P 0. 05 ). Conclusion Compared with healthy group, significantly higher serum fibrinogen and D - dimer levels were detected in esophageal cancer patients. There was closely relationship between fibrinogen and D - dimer levels in esophageal cancer patients and lymph node metastases, p - TNM stage,and they were negatively correlated with lifetime.

  20. Hyperprolactinemia during antipsychotics treatment increases the level of coagulation markers

    Directory of Open Access Journals (Sweden)

    Ishioka M

    2015-02-01

    Full Text Available Masamichi Ishioka, Norio Yasui-Furukori, Norio Sugawara, Hanako Furukori, Shuhei Kudo, Kazuhiko Nakamura Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki, Japan Objective: The strong association between psychiatric patients who receive antipsychotics and the incidence of venous thromboembolism (VTE is known. Although previous reports suggest that hyperprolactinemia often increases markers of activated coagulation, few studies have examined the direct relationship between the prolactin level elevated by antipsychotics and activated markers of activated coagulation.Method: The participants included 182 patients with schizophrenia (male =89, female =93 who received antipsychotic treatments for at least 3 months. Markers of VTE (D-dimer, fibrin/fibrinogen degradation products, and thrombin–antithrombin complex and serum prolactin concentrations were measured.Results: Prolactin levels were significantly correlated with the logarithmic transformation of the D-dimer (r=0.320, P=0.002 and fibrin/fibrinogen degradation product levels (r=0.236, P=0.026 but not of the thrombin–antithrombin complex level (r=0.117, ns among men. However, no correlations were found between the VTE markers and prolactin levels among women. These results were confirmed using multiple regression analyses that included demographic factors and antipsychotic dosages. Conclusion: The current study indicates that hyperprolactinemia is associated with an increase in markers of activated coagulation among men receiving antipsychotics. This finding clinically implies that monitoring and modulating prolactin levels among men are important to decrease the risk of VTE. Keywords: prolactin, antipsychotics, venous thromboembolism

  1. d-dimer testing as an adjunct to ultrasonography in patients with clinically suspected deep vein thrombosis: prospective cohort study

    Science.gov (United States)

    Bernardi, Enrico; Prandoni, Paolo; Lensing, Anthonie W A; Agnelli, Giancarlo; Guazzaloca, Giuliana; Scannapieco, Gianluigi; Piovella, Franco; Verlato, Fabio; Tomasi, Cristina; Moia, Marco; Scarano, Luigi; Girolami, Antonio

    1998-01-01

    Objective To investigate the efficacy of using a rapid plasma d-dimer test as an adjunct to compression ultrasound for diagnosing clinically suspected deep vein thrombosis. Design d-dimer concentrations were determined in all patients with a normal ultrasonogram at presentation. Repeat ultrasonography was performed 1 week later only in patients with abnormal d-dimer test results. Main outcome measure Patients with normal ultrasonograms were not treated with anticoagulants and were followed for 3 months for thromboembolic complications. Setting University research and affiliated centres. Subjects 946 patients with clinically suspected deep vein thrombosis. Results Ultrasonograms were abnormal at presentation in 260 (27.5%) patients. Of the remaining 686 patients tested for d-dimer, 88 (12.8%) had abnormal concentrations. During follow up venous thromboembolic complications occurred in one of the 598 patients who were not treated with anticoagulants and who had an initial normal ultrasonogram and d-dimer concentration, whereas thromboembolic complications occurred in two of the 83 untreated patients who had abnormal d-dimer concentrations but a normal repeat ultrasonogram. The cumulative incidence of venous thromboembolic complications during follow up was 0.4% (95% confidence interval 0% to 0.9%). The rapid plasma d-dimer test used as an adjunct to compression ultrasonography resulted in a reduction in the mean number of repeat ultrasound examinations and additional hospital visits from 0.7 to 0.1 per patient. Conclusions Testing for d-dimer as an adjunct to a normal baseline ultrasound examination decreased the number of subsequent ultrasound examinations considerably without any increased risk of venous thromboembolic complications in patients not receiving anticoagulants. The use of ultrasound and testing for d-dimer enabled treatment decisions to be made at the time of presentation in most patients. Key messagesPatients with clinically suspected deep vein

  2. Structural hierarchy governs fibrin gel mechanics.

    Science.gov (United States)

    Piechocka, Izabela K; Bacabac, Rommel G; Potters, Max; Mackintosh, Fred C; Koenderink, Gijsje H

    2010-05-19

    Fibrin gels are responsible for the mechanical strength of blood clots, which are among the most resilient protein materials in nature. Here we investigate the physical origin of this mechanical behavior by performing rheology measurements on reconstituted fibrin gels. We find that increasing levels of shear strain induce a succession of distinct elastic responses that reflect stretching processes on different length scales. We present a theoretical model that explains these observations in terms of the unique hierarchical architecture of the fibers. The fibers are bundles of semiflexible protofibrils that are loosely connected by flexible linker chains. This architecture makes the fibers 100-fold more flexible to bending than anticipated based on their large diameter. Moreover, in contrast with other biopolymers, fibrin fibers intrinsically stiffen when stretched. The resulting hierarchy of elastic regimes explains the incredible resilience of fibrin clots against large deformations.

  3. COPD患者D-二聚体和纤维蛋白原检测的临床价值%The clinical value of D-Dimer and plasma fibrinogen in patients with chronic obstructive pulmonary disease

    Institute of Scientific and Technical Information of China (English)

    周洋; 龚建化; 黄河; 张家洪

    2012-01-01

    目的 探讨COPD患者血浆D-二聚体和纤维蛋白原检测的临床意义.方法 分别检测122例按病情严重程度分期、分度的COPD患者和30例健康对照组血浆D-二聚体和纤维蛋白原含量,分析比较各组间血浆D-二聚体和纤维蛋白原含量的差异.结果 COPD患者血浆D-二聚体和纤维蛋白原含量明显高于健康对照组(P<0.05),且急性加重期明显高于稳定期(P<0.05).在75例急性加重期COPD患者中,轻、中、重、极重度患者其血浆D-二聚体和纤维蛋白原含量间相互比较(P<0.05).结论 COPD患者存在血液高凝状态,且随着病情的加重而加重,对其监测和预防性使用抗凝、溶栓剂是非常必要的.%Objective To investigate the clinical significance of the level of plasma D-dimer and plasma fibrinogen in patients with COPD. Methods According to severity stage, the plasma D-dimer and plasma fibrinogen level were measured in 122 patients with COPD. 30 healthy subjects were included as controls. All the measures of D-dimer and plasma fibrinogen were compared between the groups. Results The levels of D-dimer and fibrinogen in 122 patients were significantly higher than those in the control group (P < 0.05 ) , and the levels of D-dimer and fibrinogen in the acute exacerbation were significantly higher than those in the stable. In 75 patients with acute exacerbation of COPD patients, the levels of plasma D-dimer and fibrinogen in mild, moderate, severe and critical patients were compared, and the group differences were statistically significant (P < 0. 05 ). Conclusion The patients with COPD are in a state of hy-percoagulability, and the levels of plasma D-dimer and fibrinogen are related to the severity of COPD attack. To monitor and preventively use anticoagulant, the use of thrombolytic agent is necessary.

  4. Association of CRP and D-Dimer with secondary pulmonary hypertension in patients with AECOPD%CRP及D-Dimer在慢性阻塞性肺疾病急性加重期继发肺动脉高压中的相关性

    Institute of Scientific and Technical Information of China (English)

    金丛; 黄相增

    2014-01-01

    Objective To explore the clinical significance of C-reaction protein ( CRP ) and D-Dimer levels in patients with acute exacerbation of chronic obstructive pulmonary disease ( AECOPD ) complicated by pulmonary hypertension (PH) and their association with HP. Methods Arterial blood gas and levels of CRP and D-Dimer were detected in 150 patients with AECOPD. Results Levels of CRP, D-Dimer, and PaCO2 were higher but PO2 level was lower in patients with moderate to severe PH than those with mild PH and the control subjects. Levels of CRP and D-Dimer were higher in patients with mild PH than the control subjects. Levels of CRP, D-Dimer, and PCO2 levels had a linear relationship with PASP, while PO2 was negatively correlated with PASP. Levels of CRP and D-Dimer were positively related with PCO2, while were negatively correlated with PO2. Conclusions Levels of CRP and D-Dimer can be used as an indicator for estimating the severity of pulmonary hypertension in patients with AECOPD.%目的:探讨C反应蛋白(CRP)及D-二聚体(D-Dimer)在慢性阻塞性肺疾病急性加重期(AECOPD)合并肺动脉高压( PH )患者中的临床意义及相关性。方法:150例AECOPD患者进行CRP、D-Dimer及动脉血气检测。结果:AECOPD合并中重度PH组患者CRP、D-Dimer、PaCO2水平高于轻度PH组及对照组,(P<0.05),而PaO2水平低于轻度PH组及对照组(P<0.05)。AECOPD合并轻度PH组患者CRP、D-Dimer水平高于对照组(P<0.05)。 CRP、D-Dimer、PaCO2与肺动脉收缩压(PASP)呈正相关;PaO2与PASP呈负相关;CRP、D-Dimer 与 PaCO2呈正相关;CRP、D-Dimer 与 PaO2呈负相关。结论:CRP 及 D-Dimer 水平可作为AECOPD患者判断PH严重程度的指标。

  5. USAGE OF MONOCLONAL ANTIBODIES FOR DETERMINATION OF LOCALIZATION OF ANTIGENIC DETERMINANTS AND FIBRIN POLYMERIZATION SITES WITHIN FIBRINOGEN AND FIBRIN MOLECULES AND THEIR APPLICATION IN TEST--SYSTEMS FOR DIAGNOSTICS AND THE THREAT OF THROMBUS FORMATION

    Directory of Open Access Journals (Sweden)

    E. V. Lugovskoi

    2013-08-01

    Full Text Available It was shown by monoclonal antibodies that B?N-region of fibrin desA molecule (B?1-53 comprises the polymerization site including the peptide bond B?14-15. This site participates in the second stage of fibrin polymerization — lateral association of protofibrils. In the B?15-53 fragment was also found the site called «C», which together with the site «A» participate in the first stage of polymerization — the protofibrils formation. The model of the primary intermolecular interaction of fibrin was designed. It was found by monoclonal antibodies II-4d the site («c» in the N-terminal half of ? chain of the fibrin D-region. This site participates in the protofibrils formation and is complement to site «C» as we assume. We have discovered two neoantigenic determinants. One of these determinants exposes within the coiledcoil fragment B?126-135 of fibrin as a result of fibrinopeptide A splitting off from fibrinogen by thrombin. The structural rearrangements discovered in this site of the fibrin molecule are necessary for the following protofibrils lateral association. The second neoantigenic determinant is localized in the fragment B?134-190 of D-dimer formed after plasmin degradation of fibrin stabilized by FXIIIa. We have obtained the fibrin-specific monoclonal antibodie FnI-3C to the first determinant and D-dimer-specific mAb III-3b to the second one. Three monoclonal antibodies were obtained against the ?C-region of fibrin(ogen molecule. It has been experimentally shown by of one of them that ?C-domains is connected with the fibrinopeptides B in fibrinogen and fibrin desA molecules, but removes from the core of the molecules after fibrinopeptides B splitting off by thrombin. Two other monoclonal antibodies specifically inhibit the fibrin polymerization by blocking two unknown polymerization sites within the ?C-region. The test-systems for the soluble fibrin and D-dimer quantification in human blood plasma were designed on the basis of

  6. DIAGNOSTIC VALUE OF D-DIMER MEASUREMENT IN PATIENTS SUSPECTED TO HAVE CEREBRAL VENOUS THROMBOSIS

    Directory of Open Access Journals (Sweden)

    M Ghaffarpour

    2008-12-01

    Full Text Available "nAmong the causes of headache, cerebral venous and/or dural sinus thrombosis (CVT is an important challenge because of its variable clinical presentation, having negative brain CT in up to 30% of cases and unavailability of MRI in some situations. On the other hand as D-Dimer (DD test has been reported to be a sensitive test for the exclusion of venous thromboembolism, we sought whether it could be useful in the diagnosis of cerebral venous thrombosis. A prospective study of 104 consecutive patients with headache or unusual ischemic stroke (infarction in brain CT, but not compatible with any brunch of cerebral arteries, suggesting CVT was conducted between 2003 and 2005. D-Dimer test determined for all patients in the emergency ward before MRI or MRV was performed. Titers above 500 ng/ml were regarded as positive test. From a total 104 patients, 21 cases (20.2% were confirmed (by MRI and/or MRV to have CVT, 20/21 (95.7% of whom had positive DD test. In the remainder 83 (without CVT it was only positive in 16.8% (14/83, which was statistically meaningful (P < 0.001. Specificity, sensitivity, negative and positive predictive values of DD test were 83.1, 95.2, 98.6 and 58.8%, respectively, so application of this test would be useful in the diagnosis of CVT and values below 500 ng/ml make acute thrombosis unlikely.

  7. D-dimer testing for safe exclusion and risk stratification in patients with acute pulmonary embolism in primary care

    Directory of Open Access Journals (Sweden)

    Zhou Yin

    2015-01-01

    Full Text Available Background: Safe exclusion and risk stratification are currently recommended for the initial management of patients with acute pulmonary embolism (APE. The aim of this study was to assess the safe exclusion and risk stratification value of D-dimer (DD for APE when tested at the beginning of admission. Materials and Methods: All consecutive Chinese APE patients and controls were recruited from January 2010 to December 2012. All measurements of serum indexes were made in duplicate and blinded to the patients′ status. All the 40 patients with the first episode of APE were confirmed by multi-detector computed tomographic pulmonary angiography. The plasma prothrombin time (PT, activated partial thromboplastin time, thrombin time, fibrinogen, and DD levels were measured within 24 h of admission. We used the Mann-Whitney U-test to determine the differences between groups and drew receiver operator characteristic curve to evaluate the indexes′ value in the APE screening. Results: The PT and DD in the APE group were significantly higher than those in the disease control group (P 1820 μg/L as cut-off value, the sensitivity, specificity, positive and negative predictive value was 82.5%, 75.2%, 56.9%, and 91.6%, respectively. Conclusion: The patients with APE showed significant higher DD levels compared with disease controls, suggesting a negative qualitative DD test result can safely and efficiently exclude APE in primary care.

  8. D-二聚体水平在系统性红斑狼疮的临床意义%The clinical significance of D-dimer in systemic lupus erythematosus

    Institute of Scientific and Technical Information of China (English)

    李春; 穆荣; 任立敏; 范文强; 任长吉; 栗占国

    2010-01-01

    目的 了解系统性红斑狼疮(SLE)患者D-二聚体水平及其临床意义.方法 选北京大学人民医院住院的261例SLE患者,收集临床及实验室资料,分析D-二聚体水平及其与SLE患者临床特征及实验室检查指标的相关性.结果 (1)除外合并肾功能不全、严重感染、弥漫性血管内凝血(DIC)、肝功能异常、妊娠及外伤等可能影响D-二聚体水平的因素,261例SLE患者中入选205例,其中D-二聚体水平升高者达69.3%(142/205).(2)D-二聚体水平升高与SLE疾病活动指数(SLEDAI)评分呈正相关(r=0.598,P=0.000),并与抗双链DNA抗体阳性、C反应蛋白(GRP)升高、补体C3、补体C4降低等有一定相关性.(3)D-二聚体水平升高者脏器损伤比例增加,狼疮性肾炎(58.5%比38.1%)、神经精神性狼疮的发生率(18.3%比4.8%)明显高于D-二聚体水平正常者.(4)伴有血栓形成的SLE患者均有D-二聚体水平升高,但不合并血栓形成者D-二聚体水平升高或正常.结论 D-二聚体水平升高可见于SLE活动期及有重要脏器损伤者,并不必然提示血栓形成.但是,伴发血栓形成的SLE患者均有D-二聚体升高.%Objective To investigate the clinical significance of D-dimer in systemic lupus erythematosus (SLE). Methods The study group comprised 261 SLE patients who were admitted in ward from 2005 to 2008 in Peking University People's Hospital Collect the clinical data to investigate the clinical significance of D-dimer. Results ( 1 ) The D-dimer levels of 56 patients were increased due to coexist reduced renal function, infections, disseminated intravascular coagulation ( DIC), liver disorders, pregnancy and injury. With the exception of above patients, 142 ( 69. 3 ) patients were increased in total 205 patients. (2)The level of D-dimer was positively correlated with SLE disease activity index( SLEDAI ) score ( r =0. 598,P =0. 000), and was associated with anti-dsDNA antibody, ESR, C-reactive protein(CRP) and complement C3

  9. 肺癌患者血浆Fb、D-D和血清NSE检测的临床意义%Clinical Significance of Measurement of Changes on Plasma Fibrinogen(Fb) D-dimer(D-D) and Serum NSE Levels in Patients with Lung Cancer

    Institute of Scientific and Technical Information of China (English)

    李静; 姚加平; 伏开新; 柏丽丽

    2013-01-01

    Objective To explore the clinical significance of measurement of changes on plasmw Fb, D-D and serum NSE levels in patients with lung cancer. Methods Serum NSE(with RIA) , plasma Fb, D-D(with autoagglutination method)levels were determined in 34 patients with lung cancer and 35 normal health; controls. Results Plasma Fb, D-D and serum NSE levels were significantly higher than those in controls(P < 0. 01), serum NSE level showed positively correlated with Fb, D-D levels(r = 0. 6325, 0.5986, P<0.01). Conclusion Detection of plasma Fb, D-D and serum NSE levels can be useful for prediction of therapeutic efficacy and prognosis in patients with advanced lung cancer and hence provides definite clinical value.%目的:探讨了肺癌患者血浆纤维蛋白原(Fb)、D-二聚体(D-D)和血清NSE水平的变化及临床意义.方法:应用放射免疫分析和自动凝血仪测定法对34例肺癌患者进行了血浆Fb、D-D和血清NSE检测,并与35名正常健康人作比较.结果:肺癌患者血浆Fb、D-D和血清NSE水平均非常显著地高于正常人组(P<0.01),血清NSE水平与Fb、D-D水平呈正相关(r=0.6325、0.5986,P<0.01).结论:检测肺癌患者血浆Fb、D-D和血清NSE水平的变化有助于对疗效评价和预后判断,因而具有一定的临床价值.

  10. D-dimer is not elevated in asymptomatic high altitude climbers after descent to 5340 m: the Mount Everest Deep Venous Thrombosis Study (Ev-DVT).

    Science.gov (United States)

    Zafren, Ken; Feldman, Joanne; Becker, Robert J; Williams, Sarah R; Weiss, Eric A; Deloughery, Tom

    2011-01-01

    We performed this study to determine the prevalence of elevated D-dimer, a marker for deep venous thrombosis (DVT), in asymptomatic high altitude climbers. On-site personnel enrolled a convenience sample of climbers at Mt. Everest Base Camp (Nepal), elevation 5340 m (17,500 ft), during a single spring climbing season. Subjects were enrolled after descent to base camp from higher elevation. The subjects completed a questionnaire to evaluate their risk factors for DVT. We then performed a D-dimer test in asymptomatic individuals. If the D-dimer test was negative, DVT was considered ruled out. Ultrasound was available to perform lower-extremity compression ultrasounds to evaluate for DVT in case the D-dimer was positive. We enrolled 76 high altitude climbers. None had a positive D-dimer test. The absence of positive D-dimer tests suggests a low prevalence of DVT in asymptomatic high altitude climbers.

  11. The role of hs-CRP, D-dimer and fibrinogen in differentiating etiological subtypes of ischemic stroke.

    Science.gov (United States)

    Liu, Li-Bin; Li, Mu; Zhuo, Wen-Yan; Zhang, Yu-Sheng; Xu, An-Ding

    2015-01-01

    The aim of this study was to evaluate the diagnostic value of the serum biochemical markers high-sensitivity C-reactive protein (hs-CRP), D-dimer (DD) and fibrinogen (Fg) in differentiating etiological subtypes of ischemic stroke. This study was a retrospective case-only study, consecutively including patients with acute ischemic stroke. All patients were classified into subtypes using the TOAST classification system. A total of 317 patients were evaluated. Hs-CRP and DD levels were significantly different among the subtypes and were the highest in CE, followed by LAA and SAA; no significant difference between the subtypes was found for Fg. Hs-CRP > 6.96 mg/L was classified as the CE subtype, with a sensitivity of 41% and a specificity of 74%; DD > 791.30 ng/mL was classified as CE, with a sensitivity of 58% and a specificity of 78%. The combination of hs-CRP and DD classification as CE yielded a sensitivity of 65% and a specificity of 91%. DD > 791.30 ng/mL was considered an independent predictive factor of CE. Hs-CRP and DD could be useful for identifying the etiological subtypes of acute ischemic stroke, especially for predicting CE. The diagnostic value of DD was higher than that of hs-CRP.

  12. Evaluation of the innovance d-dimer assay for the diagnosis of disseminated intravascular coagulopathy in different clinical settings.

    Science.gov (United States)

    Khalafallah, Alhossain; Jarvis, Chris; Morse, Michael; Albarzan, Abdul-Majeed; Stewart, Phoebe; Bates, Gerald; Hayes, Robert; Robertson, Iain; Seaton, David; Brain, Terry

    2014-01-01

    Disseminated intravascular coagulopathy (DIC) is a serious disease with fatal consequences. We prospectively analyzed Innovance d-dimer immunoturbidimetric assay in 68 patients diagnosed with DIC on the background of malignancy (22), severe infection (20), or multitrauma (26) at a single institution between January 2010 and January 2011. Median age was 61 years (range 20-89). All patients were assessed according to the International Society of Thrombosis and Haemostasis (ISTH) DIC score. Applying a threshold of Innovance d-dimer of 10 mg/L fibrinogen equivalent unit (normal Innovance d-dimer is a useful and simple tool that enhances the ISTH DIC diagnostic criteria. Further studies to confirm these findings are warranted.

  13. Values of the Wells and Revised Geneva Scores Combined with D-dimer in Diagnosing Elderly Pulmonary Embolism Patients

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    Dan-Jie Guo

    2015-01-01

    Full Text Available Background: Pulmonary embolism (PE can be difficult to diagnose in elderly patients because of the coexistent diseases and the combination of drugs that they have taken. We aimed to compare the clinical diagnostic values of the Wells score, the revised Geneva score and each of them combined with D-dimer for suspected PE in elderly patients. Methods: Three hundred and thirty-six patients who were admitted for suspected PE were enrolled retrospectively and divided into two groups based on age (≥65 or <65 years old. The Wells and revised Geneva scores were applied to evaluate the clinical probability of PE, and the positive predictive values of both scores were calculated using computed tomography pulmonary arteriography as a gold standard; overall accuracy was evaluated by the area under the curve (AUC of receiver operator characteristic curve; the negative predictive values of D-dimer, the Wells score combined with D-dimer, and the revised Geneva score combined with D-dimer were calculated. Results: Ninety-six cases (28.6% were definitely diagnosed as PE among 336 cases, among them 56 cases (58.3% were ≥65 years old. The positive predictive values of Wells and revised Geneva scores were 65.8% and 32.4%, respectively (P < 0.05 in the elderly patients; the AUC for the Wells score and the revised Geneva score in elderly was 0.682 (95% confidence interval [CI]: 0.612-0.746 and 0.655 (95% CI: 0.584-0.722, respectively (P = 0.389. The negative predictive values of D-dimer, the Wells score combined with D-dimer, and the revised Geneva score combined with D-dimer were 93.7%, 100%, and 100% in the elderly, respectively. Conclusions: The diagnostic value of the Wells score was higher than the revised Geneva score for the elderly cases with suspected PE. The combination of either the Wells score or the revised Geneva score with a normal D-dimer concentration is a safe strategy to rule out PE.

  14. Normal D-dimer ved dyb venøs trombose i en overekstremitet hos to patienter med pacemaker

    DEFF Research Database (Denmark)

    Byrne, Christina; Abdulla, Jawdat; Christensen, Jan Kim

    2015-01-01

    Danish guidelines recommend the use of D-dimer to exclude deep venous thrombosis (DVT) in the lower extremities. However, guidelines are lacking for DVT in the upper extremities. We describe two young women with transvenous pacemaker electrodes and symptomatic DVT in related veins. Despite a normal...... D-dimer, DVT was verified by colour Doppler ultrasound in both cases. The guidelines of American College of Chest Physicians recommend initial evaluation using colour Doppler ultrasound as front-line examination. Accordingly, we suggest a similar revision of Danish guidelines incorporating upper...... extremity DVT as well....

  15. Values of the Wells and Revised Geneva Scores Combined with D-dimer in Diagnosing Elderly Pulmonary Embolism Patients

    Institute of Scientific and Technical Information of China (English)

    Dan-Jie Guo; Can Zhao; Ya-Dan Zou; Xu-Hang Huang; Jing-Min Hu; Lin Guo

    2015-01-01

    Background:Pulmonary embolism (PE) can be difficult to diagnose in elderly patients because of the coexistent diseases and the combination of drugs that they have taken.We aimed to compare the clinical diagnostic values of the Wells score,the revised Geneva score and each of them combined with D-dimer for suspected PE in elderly patients.Methods:Three hundred and thirty-six patients who were admitted for suspected PE were enrolled retrospectively and divided into two groups based on age (_>65 or <65 years old).The Wells and revised Geneva scores were applied to evaluate the clinical probability of PE,and the positive predictive values of both scores were calculated using computed tomography pulmonary arteriography as a gold standard;overall accuracy was evaluated by the area under the curve (AUC) of receiver operator characteristic curve;the negative predictive values of D-dimer,the Wells score combined with D-dimer,and the revised Geneva score combined with D-dimer were calculated.Results:Ninety-six cases (28.6%) were definitely diagnosed as PE among 336 cases,among them 56 cases (58.3%) were >65 years old.The positive predictive values of Wells and revised Geneva scores were 65.8% and 32.4%,respectively (P < 0.05) in the elderly patients;the AUC for the Wells score and the revised Geneva score in elderly was 0.682 (95% confidence interval [CI]:0.612-0.746) and 0.655 (95% CI:0.584-0.722),respectively (P =0.389).The negative predictive values of D-dimer,the Wells score combined with D-dimer,and the revised Geneva score combined with D-dimer were 93.7%,100%,and 100% in the elderly,respectively.Conclusions:The diagnostic value of the Wells score was higher than the revised Geneva score for the elderly cases with suspected PE.The combination of either the Wells score or the revised Geneva score with a normal D-dimer concentration is a safe strategy to rule out PE.

  16. Expression Level and Clinical Value of PAPP-A,Cystatin -C,and D- Dimer in Patients with Preg-nancy-Induced Hypertension%PAPP-A、Cys-C、D-D在妊娠期高血压孕妇中的表达及其意义

    Institute of Scientific and Technical Information of China (English)

    连李斌; 杜冬青

    2016-01-01

    Objective]To investigate the level of PAPP‐A ,Cystatin ‐C ,and D‐ dimer in patients with hypertensive disorders in pregnancy and their clinical value .[Methods]A total of 94 cases of progency induced hypertension patients were selected as the gestational hypertension group and further divided according to the classification standard of hyperten‐sive disorders in pregnancy (PIH) into three groups :a mild preeclampsia group ,severe preeclampsia group ,and eclamp‐sia group .At the same time ,41 normal pregnant women were selected as normal pregnancy control group .The levels of PAPP‐A ,Cystatin ‐C ,and D‐ dimer of patients in all groups were detected .[Results] The serum PAPP ‐A ,Cystatin C , and D ‐ dimer levels in the gestational hypertension group were significantly higher than that in the normal pregnancy group ( P < 0 .05) .The serum PAPP‐A ,Cys‐C ,and D‐Dimer levels in the mild preeclampsia group ,severe preeclampsia group ,and eclampsia group all rose ;the difference among the groups had statistical significance ( P < 0 .05) .The results of Pearson correlation analysis showed that serum PAPP‐A ,Cystatin C ,and D‐Dimer levels and the severity of hyperten‐sion were positively related ( r = 0 .604 ,P = 0 .013 ;r = 0 .618 ,P = 0 .007 ;r = 0 .583 ,P = 0 .013) .[Conclusion]PAPP‐A ,Cystatin C ,and D‐dimer levels in pregnancy induced hypertension in pregnant women are higher than in normal preg‐nancies ,and rise in correlation to the severity of the disease .They have a high clinical value for clinical diagnosis of preg‐nancy‐induced hypertension .%【目的】探讨 PAPP‐A 、胱抑素‐C(Cys ‐C)、D‐二聚体(D‐D)在妊娠高血压疾病(hypertensive disorders in pregnancy ,PIH)孕妇中的表达及其意义。【方法】选择 PIH 患者94例,根据分类标准分为子痫前期轻度、子痫前期重度和子痫,同时选择同期足月妊娠的正常孕妇41例。检测各

  17. Age-dependent D-dimer cut-off to avoid unnecessary CT-exams for ruling-out pulmonary embolism; Altersangepasste Anhebung des D-Dimer-Grenzwertes zur Vermeidung unnoetiger CT-Untersuchungen bei Verdacht auf Lungenarterienembolie

    Energy Technology Data Exchange (ETDEWEB)

    Altmann, M.M.; Hoehne, M.; Herold, T. [HELIOS Klinikum Berlin-Buch (Germany). Radiology; Wrede, C.E. [HELIOS Klinikum Berlin-Buch (Germany). Emergency Department; Peetz, D. [HELIOS Klinikum Berlin-Buch (Germany). Laboratory Medicine; Stroszczynski, C. [University Medical Center, Radiology, Regensburg (Germany)

    2015-09-15

    To evaluate the effect of an age-dependent D-Dimer cut-off in patients who underwent a computed tomography pulmonary angiogram (CTPA) for suspected pulmonary embolism (PE). Retrospective application of an age-dependent D-dimer cut-off (age/100 in patients aged over 50) in 530 consecutive patients, both in- and outpatients, aged over 18, who underwent CTPA for suspected PE according to the guidelines. The application of an age-dependent D-dimer cut-off showed a now negative test-result in 17 of 530 patients (3.2 %). The proportion was 4.1 % (17 of 418) in patients aged over 50. None of these 17 cases was diagnosed with PE in CTPA, the false-negative rate was 0 %. The effect could be seen in outpatients (14 of 377 [3.7 %]) as well as in inpatients(3 of 153 [2.0 %]) with no statistically significant difference (p > 0.05). The application of an age-dependent D-dimer cut-off as part of the guideline-based algorithm for suspected PE reduced the number of necessary CTPA in outpatients as well as in inpatients.

  18. Improving appropriate use of pulmonary computed tomography angiography by increasing the serum D-dimer threshold and assessing clinical probability.

    Science.gov (United States)

    Char, Sydney; Yoon, Hyo-Chun

    2014-01-01

    To determine whether the implementation of an increased D-dimer threshold value and clinical probability assessment increases the prevalence of pulmonary embolism (PE) in patients undergoing pulmonary computed tomography angiography (PCTA) in an Emergency Department setting. A retrospective review of all patients undergoing PCTA during 2 separate 12-month intervals, 1 before the implementation of an increased D-dimer threshold and recommendation for formal clinical probability assessment and the other after regional implementation. The primary outcome measure was the prevalence of acute PE in each of the samples. After the implementation of the increased D-dimer threshold and recommendation for formal clinical probability assessment, the prevalence of PE detected by PCTA increased from 4.7% to 11.7% (p probability assessment before ordering a PCTA, only 4% of patients had a formal clinical probability assessment recorded in their electronic medical record. The implementation of an increased D-dimer threshold value increased the prevalence of PE in patients undergoing PCTA in an Emergency Department setting, but more consistent application of clinical probability assessment remains an elusive target.

  19. Using an age-dependent D-dimer cut-off value increases the number of older patients in whom deep vein thrombosis can be safely excluded

    NARCIS (Netherlands)

    Douma, Renée A.; Tan, Melanie; Schutgens, Roger E.G.; Bates, Shannon M.; Perrier, Arnaud; Legnani, Cristina; Biesma, Douwe H.; Ginsberg, Jeffrey S.; Bounameaux, Henri; Palareti, Gualtiero; Carrier, Marc; Mol, Gerben C.; Le Gal, Grégoire; Kamphuisen, Pieter W.; Righini, Marc

    2012-01-01

    Background D-dimer testing to rule out deep vein thrombosis is less useful in older patients because of a lower specificity. An age-adjusted D-dimer cut-off value increased the proportion of older patients (>50 years) in whom pulmonary embolism could be excluded. We retrospectively validated the eff

  20. Diagnosis and prognosis of overt disseminated intravascular coagulation in a general hospital -- meaning of the ISTH score system, fibrin monomers, and lipoprotein-C-reactive protein complex formation.

    Science.gov (United States)

    Cauchie, Ph; Cauchie, Ch; Boudjeltia, K Zouaoui; Carlier, E; Deschepper, N; Govaerts, D; Migaud-Fressart, M; Woodhams, B; Brohée, D

    2006-06-01

    The meaning, the utility, and the prognostic significance of the International Society of Thrombosis and Hemostasis overt disseminated intravascular coagulation (DIC) score and other parameters of coagulation activation including soluble fibrin monomer complexes (SFMC), antithrombin and protein C consumption, and formation of lipoprotein-C-reactive protein (LP-CRP) complexes (MDA slope 1 and flag A2) were evaluated in 165 inpatients from a general hospital for whom DIC testing was required by the attending physicians. Of these 165 patients, 148 had an underlying disease that clearly justified the laboratory request from our systematic post hoc review of the clinical charts. Of these 148 patients, 28 had a positive overt DIC score, 19 had an A2 flag, and 4 had both. The DIC score was strongly related to several major markers of coagulation activation such as D-dimers, thrombin-antithrombin complexes, and soluble fibrin and was inversely related to antithrombin and protein C levels, which began to fall from DIC score 4 or higher. The formation of LP-CRP complexes was only related to Gram-negative sepsis and these patients had a strong inflammatory reaction. Independent risk factors for death were high creatininemia, positive overt DIC score, and/or presence of SFMC. In patients with positive DIC score, SFMC positivity and low levels of antithrombin and/or protein C were additional risk factors. The ISTH overt DIC score proves useful and adequate as a marker for clinically significant DIC. Illness severity is further defined by SFMC, antithrombin, and protein C levels. LP-CRP complexes are related to sepsis but not to actual overt DIC and lethal prognosis.

  1. D-二聚体定量检测在毛细支气管炎中的应用%Application of quantitative detection of D-dimer in bronchiolitis

    Institute of Scientific and Technical Information of China (English)

    陈学高

    2015-01-01

    Objective To investigate the clinical significance of D-dimer changes in children with bronchiol-itis. Methods 61 children with bronchiolitis were selected and divided into the normal group and the severe group based on their situation, and 11 healthy children were taken as the control group. The levels of D-dimer were detec-ted. Results The level of D-dimer was significantly higher in the study group than in the control group, and it was higher in the severe group than in the normal group (P<0. 01). After the treatment, the level of D-dimer decreased significantly in the severe group (P<0. 01). Conclusion The level of plasma D-dimer can be used to judge the se-verity of bronchiolitis.%目的:探讨毛细支气管炎患儿D-二聚体( D-D)水平变化及临床意义。方法随机选取61例毛细支气管炎住院患儿,根据病情程度分为普通组与重症组,同时选取11例同龄健康婴儿作为正常对照组。检测其血浆D-二聚体水平。结果毛细支气管炎患儿组血浆D-二聚体水平显著高于对照组,重症毛细支气管炎患儿血浆D-二聚体水平显著高于普通患儿组,差异具有统计学意义(P<0.01)。而且重症毛细支气管炎患儿治疗前后血浆D-二聚体水平差异显著,具有统计学意义( P<0.01)。结论血浆D-二聚体水平检测可用于毛细支气管炎病情严重程度的判定。

  2. 血浆D-二聚体测定在深静脉血栓形成中的意义%Measuring of D-dimer in patients with deep venous thrombosis

    Institute of Scientific and Technical Information of China (English)

    徐颖; 钱申贤

    2013-01-01

    目的:探讨血浆D-二聚体测定对深静脉血栓形成(DVT)诊断和疗效评估的意义及DVT患者临床危险因素。方法回顾性分析435例DVT患者的血浆D-二聚体水平,同时在体检人群中随机选择150例作为对照组,比较分析DVT患者中135例初诊时的危险因素。进一步监测其中的33例DVT患者治疗后1~3d、7~10d、15d的血浆D-二聚体变化情况。结果 DVT患者血浆D-二聚体水平与对照组相比有统计学差异(P=0.000),抗凝治疗的有效率为78.8%。治疗有效组DVT患者的血浆D-二聚体下降程度与无效组相比有统计学差异(P=0.005)。年龄<40岁的DVT患者中手术和外伤是主要危险因素,而年龄≥40岁患者中肿瘤、内科疾病、中心静脉置管及长期卧床是其主要危险因素。结论血浆D-二聚体是DVT诊断及疗效评估的重要指标,DVT危险因素是其一级预防的依据。%Objective To investigate plasma D- dimer levels in patients with deep venous thrombosis (DVT). Methods Plasma D- dimer levels were measured in 435 patients with DVT, and 150 healthy subjects (controls). The clinical data and plas-ma D- dimer levels were retrospectively analyzed in 135 DVT patients and the D- dimer levels were monitored in 33 DVT patients during the anticoagulation therapy at different time points (at 1~3d, 7~10d and 15d). Results Compared to healthy subjects, plasma D- dimer levels in DVT patients were significantly increased (P=0.000). The overal effective rate of treatment was 78.8%, D- dimer levels in effective patientws was significantly decreased after treatment (P=0.005). For patients aged<40, surgery and trauma were major risk factors of DVT;for those aged≥40, medical diseases, cancer, placement of central venous catheter and long- term bed rest were major risk factors. Conclusion Measurement of plasma D- dimer levels is of value in diagnosis and monotoring of therapeutic effect for patients with deep vein

  3. GDM患者D-二聚体、CRP和尿酸检测的临床意义%Clinical significance of D-Dimer, c-reactive protein and uric acid test in patients with gestational diabetes mellitus

    Institute of Scientific and Technical Information of China (English)

    聂艳华; 赵丽萍

    2014-01-01

    目的:探讨妊娠期糖尿病( GDM)患者血浆D-二聚体、C反应蛋白( CRP)和尿酸检测的临床意义。方法检测108例GDM孕妇血浆D-二聚体、CRP和尿酸的水平,同时选择108例健康孕妇作为对照,分析血浆D-二聚体、CRP和尿酸在GDM诊断中的临床意义。结果 GDM患者血浆D-二聚体、CRP和尿酸与健康孕妇相应参数比较,差异均有统计学意义( t值分别为2.33、8.61、7.73,均P<0.05)。结论 D-二聚体、CRP和尿酸的测定在GDM的诊断和预后判断中具有重要临床价值。%Objective To explore the clinical significance of D-dimer, c-reactive protein (CRP) and uric acid test in patients with gestational diabetes mellitus ( GDM) .Methods Plasma D-dimer, CRP and uric acid level of 108 cases of GDM were tested , and 108 healthy pregnant women were selected as controls .The clinical significance of D-dimer, CRP and uric acid level in the diagnosis of GDM was analyzed.Results Plasma D-dimer, CRP and uric acid level in patients with GDM were significantly different from those of the controls (t value was 2.33, 8.61 and 7.73, respectively, all P<0.05).Conclusion The determination of D-dimer, CRP and uric acid has important clinical value in the diagnosis and prognosis judgment of GDM .

  4. 检测D-二聚体对快速筛查主动脉夹层的临床意义%Clinical significance of D-dimer in rapid screening for acute aortic dissection

    Institute of Scientific and Technical Information of China (English)

    杨军; 王烁; 李春盛

    2010-01-01

    目的 探讨D-二聚体及其他易获得的实验室指标对筛查急性主动脉夹层的意义.方法 回顾性分析明确诊断为急性主动脉夹层及急性冠状动脉综合征患者的外周血白细胞、C反应蛋白、肌钙蛋白-Ⅰ以及D-二聚体的检测结果,结合临床症状,以logistic回归分析方法分析各项指标对急性主动脉夹层的临床诊断意义,并以受试者工作特征曲线评价诊断结果.结果 Ⅰ型急性主动脉夹层患者D-二聚体明显升高,与Ⅱ型、Ⅲ型患者比较差异有统计学意义(P值分别为0.011和0.002).D-二聚体、白细胞及C反应蛋白是Ⅰ型急性主动脉夹层的独立危险因素.可以建立logistic回归方程,以D-二聚体对方程式结果影响最大,受试者工作特征曲线亦支持此分析结果.结论 D-二聚体影响对Ⅰ型急性主动脉夹层有诊断意义,结合外周血白细胞和C反应蛋白等指标可以对急性主动脉夹层进行快速筛查.%Objective To investigate clinical significance of D-dimer and other easily-obtained laboratory parameters in rapid screening for acute aortic dissection ( AAD). Methods Data of general health, clinical symptoms, white blood cell (WBC) count, serum levels of C-reactive protein (CRP),cardiac troponin Ⅰ (cTn Ⅰ ) and D-dimer in patients with confirmed AAD and acute coronary syndrome (ACS) were retrospectively analyzed. Significance of varied parameters in clinical diagnosis for AAD was evaluated by logistic regression model and their diagnostic values were evaluated by receiver operating characteristics (ROC) curve. Results Serum level of D-dimer increased significantly in patients with type Ⅰ AAD, as compared with that in those with type Ⅱ and type Ⅲ (P = 0. 111 and 0. 002, respectively). D-dimer, WBC and CRP all were independent risk factors for type Ⅰ AAD by logistic regression model fitted,with the largest effect of D-dimer. Analysis by ROC curve with sensitivities and specificities of

  5. Combined use of clinical pre-test probability and D-dimer test in the diagnosis of preoperative deep venous thrombosis in colorectal cancer patients

    DEFF Research Database (Denmark)

    Stender, Mogens; Frøkjaer, Jens Brøndum; Hagedorn Nielsen, Tina Sandie

    2008-01-01

    The preoperative prevalence of deep venous thrombosis (DVT) in patients with colorectal cancer may be as high as 8%. In order to minimize the risk of pulmonary embolism, it is important to rule out preoperative DVT. A large study has confirmed that a negative D-dimer test in combination with a low...... clinical pre-test probability (PTP) can be safely used to rule out the tentative diagnosis of DVT in cancer patients. However, the accuracy in colorectal cancer patients is uncertain. This study assessed the diagnostic accuracy of a quantitative D-dimer assay in combination with the PTP score in ruling out...... preoperative DVT in colorectal cancer patients admitted for surgery. Preoperative D-dimer test and compression ultrasonography for DVT were performed in 193 consecutive patients with newly diagnosed colorectal cancer. Diagnostic accuracy indices of the D-dimer test were assessed according to the PTP score...

  6. Research Progress on the Relationship of Coronary Heart Disease and D-dimer,Lipoprotein(a),Fibrinogen%D-二聚体、脂蛋白(a)、纤维蛋白原和冠心病关系研究进展

    Institute of Scientific and Technical Information of China (English)

    龚小鹏

    2012-01-01

    冠心病(CHD)与D-二聚体、脂蛋白(a)、纤维蛋白原(FG)有着密切的关联,CHD患者中D-二聚体、脂蛋白(a)、FG较高,但它们之间相互作用的机制仍不明确.近年来的研究显示,D-二聚体、脂蛋白(a)和FG可能参与CHD的发病过程,因此通过测定D-二聚体、脂蛋白(a)和FG在不同危险程度的CHD患者中的含量,评估它们对于CHD的发生、发展具有重要意义.%Coronary heart disease( CHD)is closely associated with D-dimer,lipoprotein( a)and fibrino-gen( FG),CHD patients have higher levels of D-dimer,lipoprotein( a),fibrinogen while the mechanism of the interaction between them remains unclear. In recent years, studies have shown that D-dimer,lipoprotein ( a )and fibrinogen may be involved in the pathogenesis of coronary heart disease, so by measuring D-dimer, lipoprotein( a )and fibrinogen level in patients with coronary heart disease is of great significance for assessing the genesis and development of CHD.

  7. Thrombin antithrombin complex and IL-18 serum levels in stroke patients

    Science.gov (United States)

    Piazza, Ornella; Scarpati, Giuliana; Cotena, Simona; Lonardo, Maria; Tufano, Rosalba

    2010-01-01

    The complex picture of inflammation and coagulation alterations comes to life in acute stroke phases. Increasing evidence points to a strong interaction and extensive crosstalk between the inflammation and coagulation systems: the interest towards this relationship has increased since recent experimental research showed that the early administration of antithrombin III (ATIII) decreases the volume of ischemia in mice and might be neuroprotective, playing an antiinflammatory role. We aimed to establish the extent of the relationship among markers of inflammation (S100B and IL-18) and procoagulant and fibrinolytic markers (ATIII, thrombin-antithrombin III complex (TAT), Fibrin Degradation Products (FDP), D-dimer) in 13 comatose patients affected by focal cerebral ischemia. Plasma levels of TAT, D-dimer and FDP, IL18 and S100B were increased. IL-18 and S100B high serum levels in ischemic patients suggest an early activation of the inflammatory cascade in acute ischemic injury. The basic principles of the interaction between inflammatory and coagulation systems are revised, from the perspective that simultaneous modulation of both coagulation and inflammation, rather than specific therapies aimed at one of these systems could be more successful in stroke therapy. PMID:21577333

  8. Thrombin antithrombin complex and IL-18 serum levels in stroke patients

    Directory of Open Access Journals (Sweden)

    Ornella Piazza

    2010-02-01

    Full Text Available The complex picture of inflammation and coagulation alterations comes to life in acute stroke phases. Increasing evidence points to a strong interaction and extensive crosstalk between the inflammation and coagulation systems: the interest towards this relationship has increased since recent experimental research showed that the early administration of antithrombin III (ATIII decreases the volume of ischemia in mice and might be neuroprotective, playing an antiinflammatory role. We aimed to establish the extent of the relationship among markers of inflammation (S100B and IL-18 and procoagulant and fibrinolytic markers (ATIII, thrombin-antithrombin III complex (TAT, Fibrin Degradation Products (FDP, D-dimer in 13 comatose patients affected by focal cerebral ischemia. Plasma levels of TAT, D-dimer and FDP, IL18 and S100B were increased. IL-18 and S100B high serum levels in ischemic patients suggest an early activation of the inflammatory cascade in acute ischemic injury. The basic principles of the interaction between inflammatory and coagulation systems are revised, from the perspective that simultaneous modulation of both coagulation and inflammation, rather than specific therapies aimed at one of these systems could be more successful in stroke therapy.

  9. D-二聚体检测在2型糖尿病并发症诊断中的应用%D-dimer in the detection of complications of diabetes diagnosis

    Institute of Scientific and Technical Information of China (English)

    彭易清

    2009-01-01

    目的 研究血浆D-二聚体在2型糖尿病相关并发症诊断的价值.方法 将74例糖尿病患者分为无并发症组(45例)、并发症组(29例),同时设健康对照组(46例),采用ELISA法分别测定各组血浆D-二聚体水平并进行比较.结果 糖尿病并发症组D-二聚体水平明显高于健康对照组(P0.05).结论 检测糖尿病D-二聚体是糖尿病并发血管病变的诊断指标之一.严格控制血糖、监测D-二聚体对防治糖尿病并发症有一定意义.%Objective To study the clinical significance of blood plasma D-dimer in diabetes mel-litus patients. Methods Divides into 74 example diabetes group without the complication group (45 examples), the complication group (29examples), and carries on the comparison with the control group 46 examples, uses the ELISA method to determine each group of blood plasma D-direct level separate-ly. Results Diabetes complication group D-dimer level is higher than the control group obviously(P0.05). Conclusion The examination diabetes D-direct is one of diabetes con-current blood vessel pathological change's diagnosis targets. The strict control blood sugar, monitors the D-dimer to prevent and control diabetes complication to have certain significance.

  10. Tissue factor pathway inhibitor relates to fibrin degradation in patients with acute deep venous thrombosis

    DEFF Research Database (Denmark)

    Sidelmann, Johannes J; Bladbjerg, Else-Marie; Gram, Jørgen

    2008-01-01

    Reduced concentration of tissue factor pathway inhibitor is a risk factor for development of deep venous thrombosis, whereas elevated concentrations of tissue factor pathway inhibitor are observed in patients with acute myocardial infarction and disseminated intravascular coagulation. Presently, we...... studied the association between inflammation, endothelial cell perturbation, fibrin degradation and the concentration of tissue factor pathway inhibitor in patients suspected for acute deep venous thrombosis. We determined the tissue factor pathway inhibitor -33T/C polymorphism, free and total tissue...... factor pathway inhibitor, C-reactive protein, von Willebrand factor and D-Dimer in 160 consecutive patients admitted to hospital with a tentative diagnosis of acute deep venous thrombosis. Deep venous thrombosis was identified in 57 patients (18 distal and 39 proximal). The distribution of the tissue...

  11. 同型半胱氨酸与D-二聚体检测在妊娠期高血压诊断中的应用%Application of homocysteine and the D-dimer detection in pregnancy induced hypertension

    Institute of Scientific and Technical Information of China (English)

    王海鲜

    2014-01-01

    目的:探讨妊娠期高血压患者检测同型半胱氨酸、血浆D-二聚体的临床意义。方法:检测83例妊娠期高血压患者以及80例血压正常的孕妇的同型半胱氨酸、血浆D-二聚体水平,同时选择85例非妊娠妇女作为对照。结果:妊娠期高血压患者同型半胱氨酸、D-二聚体水平与健康孕妇和非妊娠妇女相比较,差异均有统计学意义(P<0.01);健康孕妇和非妊娠对照组的D-二聚体水平相比较,差异有统计学意义(P<0.01),而同型半胱氨酸水平差异无统计学意义(P>0.05)。结论:同型半胱氨酸、D-二聚体测定在妊娠期高血压的早期诊断和预后判定中具有重要诊断价值。%Objective to study the patients with gestational hypertension homocysteine and the clinical significance of plasma D -dimer.Methods to test 83 cases of gestational hypertension patients,80 cases of pregnant women with normal blood pressure homocys-teine,plasma D -dimer level,at the same time,choose 85 cases of without pregnant women as control .results the patients with gestational hypertension homocysteine,D -dimer level compared with healthy pregnant women and without pregnant women,the difference had statistical significance (P0. 01)conclusion ho-mocysteine,determination of D -dimer in gestational hypertension has important value in early diagnosis and prognosis judgement.

  12. Fibrin Sealants in Dura Sealing: A Systematic Literature Review.

    Directory of Open Access Journals (Sweden)

    Felice Esposito

    Full Text Available Fibrin sealants are widely used in neurosurgery to seal the suture line, provide watertight closure, and prevent cerebrospinal fluid leaks. The aim of this systematic review is to summarize the current efficacy and safety literature of fibrin sealants in dura sealing and the prevention/treatment of cerebrospinal fluid leaks.A comprehensive electronic literature search was run in the following databases: Cochrane Database of Systematic Reviews, Cochrane Central Resister of Controlled Trials, clinicaltrials.gov, MEDLINE/PubMed, and EMBASE. Titles and abstracts of potential articles of interest were reviewed independently by 3 of the authors.A total of 1006 database records and additional records were identified. After screening for duplicates and relevance, a total of 78 articles were assessed by the investigators for eligibility. Thirty-eight were excluded and the full-text of 40 articles were included in the qualitative synthesis. Seven of these included only safety data and were included in the safety assessment. The remaining 33 articles included findings from 32 studies that enrolled a total of 2935 patients who were exposed to fibrin sealant. Among these 33 studies there were only 3 randomized controlled trials, with the remaining being prospective cohort analysis, case controlled studies, prospective or retrospective case series. One randomized controlled trial, with 89 patients exposed to fibrin sealant, found a greater rate of intraoperative watertight dura closure in the fibrin sealant group than the control group (92.1% versus 38.0%, p0.05. Other clinical trials evaluated the effect of fibrin sealant in the postoperative prevention of cerebrospinal fluid leaks. These were generally lower level evidence studies (ie, not prospective, randomized, controlled trials that were not designed or powered to demonstrate a significant advantage to fibrin sealant use. Two small case series studies evaluated the effect of fibrin sealants in

  13. 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.

  14. Fibrin clot formation and lysis: basic mechanisms

    DEFF Research Database (Denmark)

    Sidelmann, JJ; Gram, J; Jespersen, J

    2000-01-01

    induced by coagulation factor XIII (FXIII), and the degradation of fibrinogen and fibrin mediated by plasmin and elastase. Furthermore, factors influencing fibrin structure and fibrin breakdown are addressed; in particular polymorphisms in the genes coding for fibrinogen and FXIII, but also the physical...

  15. Role of Fibrin Sealants in Liver Surgery

    NARCIS (Netherlands)

    de Boer, Marieke T.; Boonstra, Elizabeth A.; Lisman, Ton; Porte, Robert J.

    2012-01-01

    Background: Fibrin sealants are widely used in liver surgery. The aim of this article is to review the literature on evidence of hemostatic and biliostatic capacities of different fibrin sealants in liver surgery. Methods: In PubMed, a literature search was done with the search terms 'fibrin sealant

  16. Safe Exclusion of Deep Vein Thrombosis by a Rapid Sensitive ELISA D-dimer and Compression Ultrasonography in 1330 Outpatients With Suspected DVT.

    Science.gov (United States)

    Michiels, Jan Jacques; Maasland, Hanny; Moossdorff, Wim; Lao, Mildred; Gadiseur, Alain; Schroyens, Wilfried

    2016-09-01

    Of 1330 outpatients with suspected deep vein thrombosis (DVT), a normal enzyme-linked immunosorbent assay (ELISA) d-dimer (VIDAS) of DVT, the CUS was positive for the alternative diagnoses (AD): Bakers cyst, muscle hematoma, or old DVT in 62 (5.8%); superficial vein thrombosis without DVT in 78 (7.4%), and leg edema or varices in 17%. A second CUS in 641 patients was positive in 26 (4.0%), indicating an NPV of 96% after a first negative CUS. The NPV of the combination of a negative first CUS and a ELISA d-dimer test DVT and AD for subsequent evaluation in a large prospective study.

  17. Comparison of three kinds of methods of detection of d-dimer%3种检测D-二聚体方法的比较

    Institute of Scientific and Technical Information of China (English)

    裴依菲; 尹娟

    2015-01-01

    目的:干式免疫散射色谱法,免疫比浊法,VIDAS D-二聚体定量分析3种方法测定D-二聚体进行比较。方法:用干式免疫散射色谱法,免疫比浊法,VIDAS D-二聚体定量分析3种方法对待测样本分别进行测定。结果:3组特异性较一致,但VIDAS D-二聚体定量分析方法准确度和线性范围均优于另外2种方法,且不受溶血、脂血、胆血及类风湿因子( RF)的影响。结论:VIDAS D-二聚体定量分析方法准确度高和灵敏度高,线性范围广,且不受溶血、脂血、胆血及类风湿因子( RF)的影响,WHO建议D-二聚体国际检测标准方法为ELISA( VIDAS D-Dimer),是检测D-二聚体的首选方法。%Objective To discuss dry scatter chromatography, immunoturbidimetric method, VIDAS d-dimer in quantitative analysis of three kinds of methods for the determination of d-dimer were compared.Methods:Using dry scatter chromatography, immunoturbidimet-ric method, VIDAS d-dimer analysis three ways to measure the samples were measured.Results:Three groups of specificity was gener-ally agreed, VIDAS d-dimer method accuracy and linearity were better than the other two methods, and was not affected by hemolysis, blood lipid, blood and bile of rheumatoid factor ( RF) effects.Conclusion:VIDAS d-dimer analysis method of high accuracy and high sensitivity, wide range of linear and not affected by hemolysis, blood lipid, blood and bile of rheumatoid factor ( RF) of, WHO recom-mended international standard method for detecting d-dimer as ELISA ( VIDAS D-Dimer) , which should be the preferred method for the detection of d-dimer.

  18. The Evaluation of Pulmonary Embolism Diagnosis Using SPECT V/Q Imaging Combined with D-Dimer Assay

    Directory of Open Access Journals (Sweden)

    LU Xia;MENG Jing-jing;XIE Xiao-fen;WANG Qian

    2016-11-01

    Full Text Available 全文: PDF (2692 KB HTML (1 KB 输出: BibTeX | EndNote (RIS 摘要 研究V/Q断层显像半定量分析联合测定血浆D-二聚体早期、准确诊断肺栓塞的价值,尤其在小面积肺栓塞诊断中的应用优势。疑诊肺栓塞来核医学科行V/Q断层显像患者共156例,以CT肺血管造影(computed tomographic pulmonary angiography, CTPA)检查及临床诊断为分组标准,肺栓塞组患者101例,非肺栓塞组患者55例。比较SPECT V/Q断层显像、血浆D-二聚体测定以及SPECT V/Q断层显像联合血浆D-二聚体测定三种方法对肺栓塞的诊断效能。应用Philips公司Oasis图像后处理软件对栓塞面积进行半定量分析,进一步评估对于肺栓塞面积占双肺容积≤15%的小面积肺栓塞的诊断价值。结果显示,血浆D-二聚体测定对于肺栓塞的诊断有较高的灵敏度(70.3%),但是特异性(61.8%)差;SPECT V/Q断层显像半定量分析对于肺栓塞的诊断具有较高的灵敏度和特异性,分别为85.1%、90.9%;而二者联合应用,诊断肺栓塞效能最高,灵敏度和特异性分别为91.1%、98.2%。 其中SPECT V/Q断层显像半定量分析对于肺栓塞面积小于15%的小面积肺栓塞诊断有优势。放射性核素SPECT V/Q断层显像联合测定血浆D-二聚体能显著提高肺栓塞的诊断效能,是临床实用、安全有效的肺栓塞疑诊患者诊断策略。 服务 把本文推荐给朋友 加入我的书架 加入引用管理器 E-mail Alert RSS 作者相关文章 卢霞 孟晶晶 解小芬 王蒨 关键词 : 肺栓塞, SPECT V/Q显像, 血浆D-二聚体测定, 诊断效能 Abstract: To evaluate the early and accurate diagnostic value of SPECT V/Q imaging combined with D-dimer assay,especially in non massive pulmonary embolism group. 156 patients with computed tomographic pulmonary angiography (CTPA, Geneva score, response of anticoagulation treatments, who was selected from 321

  19. 脊柱关节炎患者D-二聚体和纤维蛋白原检测临床意义初探%Detection and clinical significance of blood of D-Dimer and fibrinogen in spondyloarthritis

    Institute of Scientific and Technical Information of China (English)

    王育凯

    2013-01-01

    Objective To detect the clinical significance of D-Dimer and fibrinogen in the blood of spondyloarthritis (SpA) patients.Methods D-Dimer and fibrinogen of blood were detected among 50 patients with SpA,rheumatoid arthritis (RA),and systemic lupus erythematosus (SLE).further to investigate the relationship of other factors,such as patient global score (PGS),doctor global score (DGS),erythrocyte sedimentation rate (ESR),C-reactvie protein (CRP),platelet (PLT),serum ferritin (SF),and Human Leucocyte Antigen-B27 (HLA-B27).Results The titer of D-Dimer in SpA was significantly lower than that of the RA and SLE group [(535 ±748),(3477 ±4808) and (1285 ±2131) μg/L respectively,P <0.05].The level of fibrinogen in three groups was no significant difference.PGS and DGS was higher in SpA patients with positive D-Dimer and fibrinogen than those with control group (P < 0.05).The values of ESR,CRP and SF in SpA patients with positive D-Dimer and fibrinogen were significantly higher than those in patients with control group.There was positive correlation between D-Dimer and fibrinogen and ESR (r =0.37 and 0.55 respectively,P < 0.01),CRP (r =0.54 and 0.54 respectively,P < 0.01),and DGS (r =0.13 and 0.19 respectively,P<0.01).D-Dimer had positive correlation with PGS (r=0.15,P<0.01).Conclusion The level of D-Dimer and fibrinogen in the blood of SpA patients in increased,and is positively correlated with disease activities.The results indicated that the activation of coagulation-fibrinolytic system may play a role in the pathogenesis of SpA.%目的 探讨检测D-二聚体和纤维蛋白原(Fib)在脊柱关节炎(SpA)患者中的临床意义.方法 比较50例SpA、50例类风湿关节炎(RA)和50例SLE患者血中D-二聚体和Fib水平.并研究其与患者总体评分(PGS)、医生总体评分(DGS)、ESR、CRP、血小板、铁蛋白、HLA-B27等指标的关系.结果 SpA组、RA组、SLE组的血D-二聚体水平分别为(535±748)、(3 477±4 808)和(1 285±2 131

  20. Selective D-dimer thresholds in the diagnostic management for symptomatic pulmonary embolism does not lead to acceptable 3 months venous thromboembolism recurrence rates

    NARCIS (Netherlands)

    Van Der Hulle, T.; Den Exter, P.L.; Klok, F.A.; Erkens, P.G.M.; Van Es, J.; Kamphuisen, P.W.; Huisman, M.V.; Mos, I.C.M.; Ten Cate, H.

    2013-01-01

    Background: With current diagnostic algorithms for pulmonary embolism (PE) CT-scan imaging is still frequently necessary. For deep vein thrombosis it was very recently shown (Linkins et al. Ann Intern Med 2013; 158:93-100) that doubling the D-dimer threshold in patients with low clinical probability

  1. Clinical study on the influence of phloroglucinol on plasma angiotensin II and D-Dimer index in patients with severe pregnancy-induced hypertension.

    Science.gov (United States)

    Ai, Liang; Lan, Xinzhi; Wang, Limin; Xu, Yanjie; Zhang, Bin

    2016-07-01

    To observe the effect of phloroglucinol on plasma angiotensin II and D-dimer index when it was applied to patients with severe pregnancy-induced hypertension. 212 cases of severe pregnancy-induced hypertension patients diagnosed clinically were selected to be randomly divided into the research group and the control group. The research groups were given phloroglucinol, while the control groups were given magnesium sulfate. The plasma angiotensin II and D-dimer index in patients were detected before treatment and after 7 days respectively with statistical analysis of results. The diffidence after treatment was statistically significant (P0.05). It showed that the research group could reduce the plasma D-dimer and angiotensin II index in severe pregnancy-induced hypertension patients, and its effect was significantly better than the control group according to the plasma D-dimer and angiotensin II index changes in patients, it indicated that it was effective of phloroglucinol treatment for patients with pregnancy-induced hypertension disease and superior to the western medicine conventional treatment, worth clinical promotion.

  2. The predictive values of D-dimer for the early prognosis of the acute myocardial infarction(AMI):a review of 3134 AMI patients

    Institute of Scientific and Technical Information of China (English)

    杨军

    2013-01-01

    Objective To investigate whether D-dimer could be an early warning signal for patients with acute myocardial infarction(AMI),then may be helpful in risk accessment in emergency department. Methods Three thousand one hundred and thirty-four emergency AMI cases admitted to

  3. C reactive protein, calcitonin and D-dimer in patients of community acquired pneumonia

    Institute of Scientific and Technical Information of China (English)

    Xue-Lin Zhang; Zhen Wang; Shu-Hui Lv; Hai-Jun Jing; Jian-Yun Kang; Jian-Qing Zhao

    2016-01-01

    Objective:To investigate the clinical significance of C- reactive protein (CRP), calcitonin (PCT) and D- two (D-D) in community acquired pneumonia.Methods:A total of 102 patients with community-acquired pneumonia (CAP) admitted from March 2015- March 2016 as the research objects. A total of 5 mL peripheral venous blood of CAP patients (within 24 h of admission, before antibiotic therapy) were collected, and centrifuged to obtain serum. Immune turbidimetric method was used in determination of CRP and DD, immune fluorescence method was used for determination of PCT.Results:As grade increasing, the levels of CRP, PCT, D-D were increased gradually, with significant difference among different levels (P<0.05); CRP, PCT and D-D levels of severe group were significantly higher than those of non severe group (P<0.05); death group, CRP, PCT and D-D levels of death group were significantly higher than those of the survival group (P< 0.05).Conclusions:CRP, PCT, D-D levels have certain correlation with degree of severity. They can be used as important indicators to judge the severity of the disease, and predict the prognosis. High levels of CRP, PCT, D-D indicate severity of the disease and poor prognosis.

  4. Genipin-crosslinked fibrin hydrogels as a potential adhesive to augment intervertebral disc annulus repair.

    Science.gov (United States)

    Schek, R M; Michalek, A J; Iatridis, J C

    2011-04-18

    Treatment of damaged intervertebral discs is a significant clinical problem and, despite advances in the repair and replacement of the nucleus pulposus, there are few effective strategies to restore defects in the annulus fibrosus. An annular repair material should meet three specifications: have a modulus similar to the native annulus tissue, support the growth of disc cells, and maintain adhesion to tissue under physiological strain levels. We hypothesized that a genipin crosslinked fibrin gel could meet these requirements. Our mechanical results showed that genipin crosslinked fibrin gels could be created with a modulus in the range of native annular tissue. We also demonstrated that this material is compatible with the in vitro growth of human disc cells, when genipin:fibrin ratios were 0.25:1 or less, although cell proliferation was slower and cell morphology more rounded than for fibrin alone. Finally, lap tests were performed to evaluate adhesion between fibrin gels and pieces of annular tissue. Specimens created without genipin had poor handling properties and readily delaminated, while genipin crosslinked fibrin gels remained adhered to the tissue pieces at strains exceeding physiological levels and failed at 15-30%. This study demonstrated that genipin crosslinked fibrin gels show promise as a gap-filling adhesive biomaterial with tunable material properties, yet the slow cell proliferation suggests this biomaterial may be best suited as a sealant for small annulus fibrosus defects or as an adhesive to augment large annulus repairs. Future studies will evaluate degradation rate, fatigue behaviors, and long-term biocompatibility.

  5. Residual vein thrombosis and D-dimer for optimizing duration of anticoagulation in idiopathic deep vein thrombosis.

    Science.gov (United States)

    Malato, Alessandra; Saccullo, Giorgia; Iorio, Alfonso; Ageno, Walter; Siragusa, Sergio

    2010-01-01

    Long-term anticoagulant treatment is highly effective in preventing recurrent Venous Thrombo-Embolism (VTE) in patients with idiopathic Deep Vein Thrombosis (DVT) of the lower limbs, though associated with an increased risk for major bleeding that may offset the benefits of anticoagulation. Accordingly to recent guidelines, patients with idiopathic DVT should be treated for at least 3 months and then should be evaluated for the risk-benefit ratio of long-term therapy. However, such 'time for decision' is often unclear and the optimal duration of VKA remains debatable. In recent studies, markers for the assessment of the individual risk for recurrent thrombosis have been proposed, which can be of help to establish the optimal duration of VKA treatment; among them, the D-dimer (D-d) assay and the Residual Vein Thrombosis (RVT) assessment by Compression Ultra-Sonography (CUS) were shown to be the most suitable. Studies' results showed that negative results of these parameters after 3 to 6 months of therapy, identify a group of patients at low-risk for recurrent thrombosis in whom VKA treatment can be withheld. In the present review we will discuss advantages and potential limits of using these individual markers for the management of patients with a first episode of DVT of the lower limbs.

  6. [Pelvic vein thrombosis with elevated D-dimer level and normal ultrasound scan of the femoral vein].

    Science.gov (United States)

    Stenberg, Morten Roos; Tveskov, Claus

    2014-01-13

    A 17-year-old female presented with an isolated pelvic vein thrombosis (PVT) which was not visualised at the first compression ultrasound scan of the femoral vein. Isolated PVT should be suspected when the patient demonstrates the possible symptoms of a deep vein thrombosis with unilateral leg swelling extending to the groin and a negative compression ultrasound scan of the femoral vein. Supplemental ultrasound scan with Doppler flow, computed tomography or magnetic resonance venography are alternative diagnostic modalities if PVT is suspected.

  7. Exact solution of the 2d dimer model: Corner free energy, correlation functions and combinatorics

    Energy Technology Data Exchange (ETDEWEB)

    Allegra, Nicolas, E-mail: nicolas.allegra@univ-lorraine.fr

    2015-05-15

    In this work, some classical results of the pfaffian theory of the dimer model based on the work of Kasteleyn, Fisher and Temperley are introduced in a fermionic framework. Then we shall detail the bosonic formulation of the model via the so-called height mapping and the nature of boundary conditions is unravelled. The complete and detailed fermionic solution of the dimer model on the square lattice with an arbitrary number of monomers is presented, and finite size effect analysis is performed to study surface and corner effects, leading to the extrapolation of the central charge of the model. The solution allows for exact calculations of monomer and dimer correlation functions in the discrete level and the scaling behavior can be inferred in order to find the set of scaling dimensions and compare to the bosonic theory which predicts particular features concerning corner behaviors. Finally, some combinatorial and numerical properties of partition functions with boundary monomers are discussed, proved and checked with enumeration algorithms.

  8. 凝血四项和D-二聚体检测对子痫前期的应用价值%The Application Value of Detection of Four Items of Coagulation Routine and D-Dimer in the Early Stage of Eclampsia

    Institute of Scientific and Technical Information of China (English)

    张佳夫; 李艳玲

    2016-01-01

    Objective To discuss the application value of the detection of coagulation routine and D-Dimer for preeclampsia.Methods Detection of 67 cases in PE, 60 normal pregnant women and 70 non-pregnant women in coagulation routine and D-Dimer levels.ResultsThe time of TT, PT and the level of D-dimer in observation group were higher than those in control group (P<0.05). The TT and PT time and the level of D-dimer of severe PE patients were higher than those of low-grade PE patients (P<0.05).Conclusion The blood of pregnant women with preeclampsia is a high coagulation state, the pathological and physiological basis of eclampsia, MODS and DIC and the D-dimer level can be used as one of the indicators to judge the severity of PE.%目的:探讨检测凝血四项[凝血酶时间(TT)、部分凝血活酶时间(APTT)、凝血酶原时间(PT)和纤维蛋白原含量(FBG)]和D-二聚体(D-Dimer)在子痫前期(PE)的应用价值。方法检测67例PE孕妇、60例正常孕妇和70例非孕期妇女的凝血四项、D-Dimer和hs-CRP水平。结果观察组TT、PT时间和D-D水平高于对照组(P <0.05),APTT时间和FBG水平低于对照组(P<0.05);重度PE患者TT、PT时间和D-D水平高于轻度PE患者(P<0.05),APTT时间和FBG水平低于轻度PE患者(P<0.05)。结论子痫前期孕妇血液呈高凝状态,可能是发生子痫抽搐、MODS和DIC的病理生理基础,D-D水平可作为初步判断PE病情严重程度的指标之一。

  9. Fibrin degradation products

    Science.gov (United States)

    ... order this test if you have signs of disseminated intravascular coagulation (DIC) or another clot-dissolving disorder. ... that is present at birth ( congenital heart disease ) Disseminated intravascular coagulation (DIC) Low level of oxygen in the blood ...

  10. Concentration independent modulation of local micromechanics in a fibrin gel.

    Directory of Open Access Journals (Sweden)

    Maxwell A Kotlarchyk

    Full Text Available Methods for tuning extracellular matrix (ECM mechanics in 3D cell culture that rely on increasing the concentration of either protein or cross-linking molecules fail to control important parameters such as pore size, ligand density, and molecular diffusivity. Alternatively, ECM stiffness can be modulated independently from protein concentration by mechanically loading the ECM. We have developed a novel device for generating stiffness gradients in naturally derived ECMs, where stiffness is tuned by inducing strain, while local mechanical properties are directly determined by laser tweezers based active microrheology (AMR. Hydrogel substrates polymerized within 35 mm diameter Petri dishes are strained non-uniformly by the precise rotation of an embedded cylindrical post, and exhibit a position-dependent stiffness with little to no modulation of local mesh geometry. Here we present the device in the context of fibrin hydrogels. First AMR is used to directly measure local micromechanics in unstrained hydrogels of increasing fibrin concentration. Changes in stiffness are then mapped within our device, where fibrin concentration is held constant. Fluorescence confocal imaging and orbital particle tracking are used to quantify structural changes in fibrin on the micro and nano levels respectively. The micromechanical strain stiffening measured by microrheology is not accompanied by ECM microstructural changes under our applied loads, as measured by confocal microscopy. However, super-resolution orbital tracking reveals nanostructural straightening, lengthening, and reduced movement of fibrin fibers. Furthermore, we show that aortic smooth muscle cells cultured within our device are morphologically sensitive to the induced mechanical gradient. Our results demonstrate a powerful cell culture tool that can be used in the study of mechanical effects on cellular physiology in naturally derived 3D ECM tissues.

  11. D-dimer Test

    Science.gov (United States)

    Advertisement Proceeds from website advertising help sustain Lab Tests Online. AACC is a not-for-profit organization and does not endorse non-AACC products and services. Advertising & Sponsorship: Policy | Opportunities ...

  12. Usefulness of Clinical Prediction Rules, D-dimer, and Arterial Blood Gas Analysis to Predict Pulmonary Embolism in Cancer Patients

    Directory of Open Access Journals (Sweden)

    Shazia Awan

    2017-03-01

    Full Text Available Objectives: Pulmonary embolism (PE is seven times more common in cancer patients than non-cancer patients. Since the existing clinical prediction rules (CPRs were validated predominantly in a non-cancer population, we decided to look at the utility of arterial blood gas (ABG analysis and D-dimer in predicting PE in cancer patients. Methods: Electronic medical records were reviewed between December 2005 and November 2010. A total of 177 computed tomography pulmonary angiograms (CTPAs were performed. We selected 104 individuals based on completeness of laboratory and clinical data. Patients were divided into two groups, CTPA positive (patients with PE and CTPA negative (PE excluded. Wells score, Geneva score, and modified Geneva score were calculated for each patient. Primary outcomes of interest were the sensitivities, specificities, positive, and negative predictive values for all three CPRs. Results: Of the total of 104 individuals who had CTPAs, 33 (31.7% were positive for PE and 71 (68.3% were negative. There was no difference in basic demographics between the two groups. Laboratory parameters were compared and partial pressure of oxygen was significantly lower in patients with PE (68.1 mmHg vs. 71 mmHg, p = 0.030. Clinical prediction rules showed good sensitivities (88−100% and negative predictive values (93−100%. An alveolar-arterial (A-a gradient > 20 had 100% sensitivity and negative predictive values. Conclusions: CPRs and a low A-a gradient were useful in excluding PE in cancer patients. There is a need for prospective trials to validate these results.

  13. Usefulness of Clinical Prediction Rules, D-dimer, and Arterial Blood Gas Analysis to Predict Pulmonary Embolism in Cancer Patients.

    Science.gov (United States)

    Karamat, Asifa; Awan, Shazia; Hussain, Muhammad Ghazanfar; Al Hameed, Fahad; Butt, Faheem; Wahla, Ali Saeed

    2017-03-01

    Pulmonary embolism (PE) is seven times more common in cancer patients than non-cancer patients. Since the existing clinical prediction rules (CPRs) were validated predominantly in a non-cancer population, we decided to look at the utility of arterial blood gas (ABG) analysis and D-dimer in predicting PE in cancer patients. Electronic medical records were reviewed between December 2005 and November 2010. A total of 177 computed tomography pulmonary angiograms (CTPAs) were performed. We selected 104 individuals based on completeness of laboratory and clinical data. Patients were divided into two groups, CTPA positive (patients with PE) and CTPA negative (PE excluded). Wells score, Geneva score, and modified Geneva score were calculated for each patient. Primary outcomes of interest were the sensitivities, specificities, positive, and negative predictive values for all three CPRs. Of the total of 104 individuals who had CTPAs, 33 (31.7%) were positive for PE and 71 (68.3%) were negative. There was no difference in basic demographics between the two groups. Laboratory parameters were compared and partial pressure of oxygen was significantly lower in patients with PE (68.1 mmHg vs. 71 mmHg, p = 0.030). Clinical prediction rules showed good sensitivities (88-100%) and negative predictive values (93-100%). An alveolar-arterial (A-a) gradient > 20 had 100% sensitivity and negative predictive values. CPRs and a low A-a gradient were useful in excluding PE in cancer patients. There is a need for prospective trials to validate these results.

  14. The Value of D-dimer and Fibrinogen in the Diagnosis of Coronary Artery Disease%血浆D-二聚体和纤维蛋白原检测在冠心病临床诊断中的价值

    Institute of Scientific and Technical Information of China (English)

    陈高科

    2014-01-01

    Objective:To study the significance of detection of plasma D-dimer and fibrinogen in the diagnosis of coronary artery disease.Method:The level of plasma D-dimer and fibrinogen of 108 patients with different types of coronary artery diseases and 62 health people from May 2011 to Dec 2012 were detected. The results of plasma D-dimer and fibrinogen were analyzed.Result:The levels of plasma D-dimer and fibrinogen of acute myocardial infarction(AMI) patients were higher than those of healthy people,unstable angina pectoris(UAP) and stable angina pectoris(SAP) patients(P0.05).Conclusion:The detection of plasma D-dimer and fibrinogen contribute to the diagnosis and typing of coronary heart disease.%目的:研究血浆D-二聚体和纤维蛋白原检测在冠心病临床诊断中的意义。方法:对2011年5月-2012年12月在笔者所在医院就诊的108例不同类型的冠心病患者及62例正常体检者的血浆D-二聚体及纤维蛋白原水平进行检测,分析D-二聚体及纤维蛋白原检测结果在冠心病临床诊断中的意义。结果:急性心肌梗死患者的D-二聚体及纤维蛋白原水平高于正常体检者、不稳定型心绞痛患者和稳定型心绞痛组患者,差异均有统计学意义(P0.05)。结论:临床血浆D-二聚体及纤维蛋白原水平的检测有助于冠心病分型诊断。

  15. The original and simplified Wells rules and age-adjusted D-dimer testing to rule out pulmonary embolism: an individual patient data meta-analysis.

    Science.gov (United States)

    van Es, N; Kraaijpoel, N; Klok, F A; Huisman, M V; Den Exter, P L; Mos, I C M; Galipienzo, J; Büller, H R; Bossuyt, P M

    2017-04-01

    Essentials Evidence for the simplified Wells rule in ruling out acute pulmonary embolism (PE) is scarce. This was a post-hoc analysis on data from 6 studies comprising 7268 patients with suspected PE. The simplified Wells rule combined with age-adjusted D-dimer testing may safely rule out PE. Given its ease of use, the simplified Wells rule is to be preferred over the original Wells rule.

  16. Diagnostic Value of D-Dimer’s Serum Level in Iranian Patients with Cerebral Venous Thrombosis

    Science.gov (United States)

    Hashami, Leila; Rakhshan, Vahid; Karimian, Hoda; Moghaddasi, Mehdi

    2016-01-01

    Cerebral venous thrombosis (CVT) is a long-term debilitating vascular brain disease with high morbidity and mortality. It may be associated with rise in D-dimer level. The aim of this study was to examine this potential association and identify the critical D-dimer cut-off level corresponding to increase the risk of CVT. This case-control study was conducted on two groups of patients with and without CVT attending the Rasool Akram Hospital (Iran) during 2014 and 2015. D-dimer levels were measured by the rapid sensitive D-dimer assay. Data were analyzed by Spearman’s correlation coefficient test, independent-samples t-test, backward-selection multiple linear regression and multiple binary logistic regression analyses. Sensitivity-specificity tests were used to detect D-dimer cut-off for CVT. Differences between the D-dimer levels of the case and control groups were significant (P<0.001). It showed that each level of increase in the number of symptoms could increase the risk of thrombosis occurrence for about 3.5 times. All symptom types except for headache were associated with D-dimer level, while headache has negative association with D-dimer level. D-dimer cut-off point for CVT diagnosis was estimated at 350 ng/mg. We concluded that D-dimer serum level significantly rises in CVT patients. A rounded cut-off point of 350 ng/mg can be used as a diagnostic criterion for CVT prediction. PMID:27441064

  17. Diagnostic value of D-dimer’s serum level in Iranian patients with cerebral venous thrombosis

    Directory of Open Access Journals (Sweden)

    Leila Hashami

    2016-06-01

    Full Text Available Cerebral venous thrombosis (CVT is a longterm debilitating vascular brain disease with high morbidity and mortality. It may be associated with rise in D-dimer level. The aim of this study was to examine this potential association and identify the critical D-dimer cut-off level corresponding to increase the risk of CVT. This case-control study was conducted on two groups of patients with and without CVT attending the Rasool Akram Hospital (Iran during 2014 and 2015. D-dimer levels were measured by the rapid sensitive D-dimer assay. Data were analyzed by Spearman’s correlation coefficient test, independent-samples t-test, backward-selection multiple linear regression and multiple binary logistic regression analyses. Sensitivity-specificity tests were used to detect D-dimer cut-off for CVT. Differences between the D-dimer levels of the case and control groups were significant (P<0.001. It showed that each level of increase in the number of symptoms could increase the risk of thrombosis occurrence for about 3.5 times. All symptom types except for headache were associated with D-dimer level, while headache has negative association with D-dimer level. D-dimer cut-off point for CVT diagnosis was estimated at 350 ng/mg. We concluded that D-dimer serum level significantly rises in CVT patients. A rounded cut-off point of 350 ng/mg can be used as a diagnostic criterion for CVT prediction.

  18. Fibrin ring granulomas in hepatitis A.

    Science.gov (United States)

    Ruel, M; Sevestre, H; Henry-Biabaud, E; Courouce, A M; Capron, J P; Erlinger, S

    1992-12-01

    Fibrin ring granuloma is characterized by a fibrinous ring surrounding a central fat vacuole. It has been found in the liver and bone marrow of patients with Q fever, and occasionally with visceral leishmaniasis, cytomegalovirus, Epstein-Barr virus, Staphylococcus epidermidis infections, Hodgkin's lymphoma, and hypersensitivity to allopurinol. We describe a case of serologically confirmed viral hepatitis A with this lesion in the liver biopsy. A false positive anti-hepatitis A virus IgM result has been excluded. This is, to our knowledge, the second reported case of type A hepatitis with hepatic fibrin ring granulomas. It confirms that hepatitis A should be included in the differential diagnosis of this lesion.

  19. Fibrin clot properties and haemostatic function in men and women with type 1 diabetes.

    Science.gov (United States)

    Tehrani, Sara; Jörneskog, Gun; Ågren, Anna; Lins, Per-Eric; Wallén, Håkan; Antovic, Aleksandra

    2015-02-01

    The increased risk of vascular complications in type 1 diabetes may in part be explained by changes in haemostatic function. In the present study, we investigated the fibrin clot properties in patients with type 1 diabetes in relation to sex and microvascular complications. The study included 236 patients (107 women) aged between 20-70 years and without any history of cardiovascular disease. Fibrin clot properties, assessed by determination of the permeability coefficient (Ks) and turbidimetric clotting and lysis assays, did not differ between men and women. Compared with men, women had worse glycaemic control as well as higher levels of prothrombin fragment 1+2 and peak thrombin generation in vitro, indicating increased thrombin generation both in vivo and in vitro. Subgroup analyses of patients younger than 30 years revealed less permeable fibrin clots and prolonged lysis time in females compared with age-matched men. Patients with microvascular complications had higher fibrinogen concentrations and denser and less permeable fibrin clots. Thus, we conclude that in vitro fibrin clot properties in patients with type 1 diabetes without cardiovascular disease are not different between the sexes, but associate with prevalence of microvascular complications. Tighter fibrin clot formation in younger women, as suggested by our results, may affect their future cardiovascular risk and should be investigated in a larger population.

  20. 联检NSE、CYFRA21-1、D-二聚体、Fib在肺癌患者中的临床意义%Clinical significance of the combined determination of NSE, CYFRA21-1, D-Dimer, Fibrinogen for the patients with lung cancer

    Institute of Scientific and Technical Information of China (English)

    谢颖; 贾张军; 张云生

    2014-01-01

    Objective To discuss the clinical significance of the combined determination of NSE,CYFRA21-1, D-Dimer, Fibrinogen for lung cancer patients. Methods The levels of serum NSE and CYFRA21-1 were detected by electrochemical analysis in 256 lung cancer patients, 200 patients with benign lung diseases and 200 health subjects. The levels of plasma D-Dimer and Fibrinogen were detected by immunoturbidimetric assays. The relationship of NSE, CYFRA21-1, D-Dimer and Fibrinogen levels with the clinical stages of lung cancer was analyzed by statistics. Results The levels of NSE, CYFRA21-1, D-Dimer and Fibrinogen in patients with lung cancer were significantly higher than those in patients with benign lung diseases and healthy controls(PCYFRA21-1 > D-Dimer > Fibrinogen.CYFRA21-1 showed the highest sensitivity(69.0%) in squamous cellcarcinoma, and NSE showed the highest sensitivity(68.4%%) in smal celllung cancer. The combined determination of NSE, CYFRA21-1, D-Dimer, Fibrinogen might significantly improve the sensitivity for the diagnosis of lung cancer. The combined determination of NSE,CYFRA21-1, D-Dimer, Fibrinogen showed the highest sensitivity(89.8%).NSE,CYFRA21-1, D-Dimer, Fibrinogen were positively related to the clinical stages of lung cancer. With the increasing of clinical stages, the levels of NSE,CYFRA21-1, D-Dimer, Fibrinogen in Ⅲ/Ⅳ stage were significantly higher than those in Ⅰ/Ⅱ stage(correlation coefficie nt(r)=0.315,0.425,0.669,0.523,). Conclusions The combined determination of NSE, CYFRA21-1, D-Dimer, Fibrinogen has an important clinical significance in the clinical diagnosis, differentiation, monitor and clinical stage of lung cancer.%联合检测神经元特异烯醇化酶(NSE)、细胞角蛋白19片段(CYFRA21-1)、D-二聚体(D-D)、Fib(纤维蛋白原),探讨其在肺癌患者中的临床意义。方法肺癌组(256例)、肺良性疾病组(200例)和正常对照组(200例)的血清NSE、CYFRA21-1水平采用电化学发光分析法检测,血

  1. A Review of Bioceramics and Fibrin Sealant

    Directory of Open Access Journals (Sweden)

    Le Guéhennec L.

    2004-09-01

    Full Text Available This review focuses on bone substitute composites made by mixing ceramic biomaterials with fibrin sealants. Different biomaterials such as coral, bone-derived materials, bioactive glass ceramics, and synthetic calcium phosphate have been mixed with fibrin sealant, resulting in a combination of the biological properties of the two components. This type of association has not produced identical results in all studies. In the past for some, the addition of fibrin sealant to the biomaterial failed to produce any significant, positive effect on osteointegration, whereas others found a positive impact on bone colonization. Despite the negative biological effects reported previously, bioceramic-fibrin composites have been widely used in various types of bone surgery because they are easy to manipulate. In particular, the intra-operative preparation of these composites makes it possible to add bone growth factors or autologous osteoprogenitor cells prior to bone reconstruction. The bone growth factors and autologous osteoprogenitor cells associated with the bioceramic-fibrin composites should provide surgeons with tissue engineered grafts with enhanced osteointegrative properties. This review discusses both the advantages and disadvantages, as well as the future perspectives, of using bioceramic-fibrin composites in various clinical indications.

  2. Genipin-crosslinked fibrin hydrogels as a potential adhesive to augment intervertebral disc annulus repair

    Directory of Open Access Journals (Sweden)

    RM Schek

    2011-04-01

    Full Text Available Treatment of damaged intervertebral discs is a significant clinical problem and, despite advances in the repair and replacement of the nucleus pulposus, there are few effective strategies to restore defects in the annulus fibrosus. An annular repair material should meet three specifications: have a modulus similar to the native annulus tissue, support the growth of disc cells, and maintain adhesion to tissue under physiological strain levels. We hypothesized that a genipin crosslinked fibrin gel could meet these requirements. Our mechanical results showed that genipin crosslinked fibrin gels could be created with a modulus in the range of native annular tissue. We also demonstrated that this material is compatible with the in vitro growth of human disc cells, when genipin:fibrin ratios were 0.25:1 or less, although cell proliferation was slower and cell morphology more rounded than for fibrin alone. Finally, lap tests were performed to evaluate adhesion between fibrin gels and pieces of annular tissue. Specimens created without genipin had poor handling properties and readily delaminated, while genipin crosslinked fibrin gels remained adhered to the tissue pieces at strains exceeding physiological levels and failed at 15-30%. This study demonstrated that genipin crosslinked fibrin gels show promise as a gap-filling adhesive biomaterial with tunable material properties, yet the slow cell proliferation suggests this biomaterial may be best suited as a sealant for small annulus fibrosus defects or as an adhesive to augment large annulus repairs. Future studies will evaluate degradation rate, fatigue behaviors, and long-term biocompatibility.

  3. Thrombin interaction with fibrin polymerization sites.

    Science.gov (United States)

    Hsieh, K

    1997-05-15

    Thrombin is central to hemostasis, and postclotting fibrinolysis and wound healing. During clotting, thrombin transforms plasma fibrinogen into polymerizing fibrin, which selectively adsorbs the enzyme into the clot. This protects thrombin from heparin-antithrombin inactivation, thus preserving the enzyme for postclotting events. To determine how the fibrin N-terminal polymerization sites of A alpha 17-23 (GPRVVER) and B beta 15-25 (GHRPLDKKREE) and their analogs may interact with thrombin, amidolysis vs. plasma- and fibrinogen-clotting assays were used to differentiate blockade of catalytic site vs. other thrombin domains. Amidolysis studies suggest GPRVVER inhibition of thrombin catalytic site through hydrophobic interaction, and GPRVVER inhibited clotting. Neither GPRP nor VVER nor the B beta 15-25 homologs inhibited amidolysis. Contrary to heparin, acyl-DKKREE promoted plasma-clotting, but inhibited fibrinogen-clotting. In addition, acyl-DKKREE reversed the anticoagulant effect of heparin (0.1 U/ml) in plasma. The results suggest fibrin B beta 15-25 interaction with thrombin, possibly by blocking the heparin-binding site. Together with the reported fibrin A alpha 27-50 binding to thrombin, polymerizing fibrin appears to initially bind to thrombin catalytic site and exosite-1 through A alpha 17-50, and to another thrombin site through B beta 15-25. As these fibrin sites are also involved in polymerization, competition of the polymerization process with thrombin-binding could subsequently dislodge thrombin from fibrin alpha-chain. This may re-expose the catalytic site and exosite-1, thus explaining the thrombogenicity of clot-bound thrombin. The implications of these findings in polymerization mechanism and anticoagulant design are discussed.

  4. Evolution of fibrin glue applicators.

    Science.gov (United States)

    Marx, Gerard

    2003-10-01

    Fibrin glue (FG) is used worldwide as a potent surgical tool, which establishes hemostasis in wounds and also bonds tissue. The standard FG applicator is based on a dual-syringe system. This review, based mainly on the patent literature, describes the development of the quasi-standard dual syringe system as well as the rise of other FG applicator designs based on mechanical force (ratchet systems), Bernoulli gas flow, positive gas pressure, or electro-servo devices. The packaging of commercial FG components is reviewed within the context of "loading" the FG applicators and the need to minimize the number of needles required to access the packaged (vials) components. Parameters such as internal clogging, homogeneity of spray, the requirement for gas or vacuum house lines, the number of parts that must be handled, and the time required to assemble the applicator, load it, and have it ready for use are also discussed. A rating system is proposed that permits one to use such parameters to rank the various applicator designs, relative to the dual-syringe system. Hopefully, this review will stimulate the design of better FG applicators and packaging required for elective surgery, emergency treatments, and tissue engineering in the 21st century.

  5. 21 CFR 864.7300 - Fibrin monomer paracoagulation test.

    Science.gov (United States)

    2010-04-01

    ... to detect fibrin monomer in the diagnosis of disseminated intravascular coagulation (nonlocalized clotting within a blood vessel) or in the differential diagnosis between disseminated intravascular coagulation and primary fibrinolysis (dissolution of the fibrin in a blood clot). (b) Classification. Class...

  6. Fibrin sealant for mesh fixation in laparoscopic umbilical hernia repair

    DEFF Research Database (Denmark)

    Eriksen, J R; Bisgaard, T; Assaadzadeh, S;

    2013-01-01

    Fibrin sealant for mesh fixation has significant positive effects on early outcome after laparoscopic ventral hernia repair (LVHR) compared with titanium tacks. Whether fibrin sealant fixation also results in better long-term outcome is unknown.......Fibrin sealant for mesh fixation has significant positive effects on early outcome after laparoscopic ventral hernia repair (LVHR) compared with titanium tacks. Whether fibrin sealant fixation also results in better long-term outcome is unknown....

  7. Effect of Tongmai Jiangzhi Oral Liquid (通脉降脂口服液) on Serum P-selectin,von Willebrand Factors and D-Dimer in Patients with Atherosclerosis

    Institute of Scientific and Technical Information of China (English)

    沈晓君; 史云菊; 王玲

    2004-01-01

    Objective: To explore the role of cytokines on the pathogenesis of atherosclerosis, and the lectins (Ps), von Willebrand (vWF), and D-dimer (D-D) in atherosclerosis (AS) patients. Methods: Sixtythree AS patients were randomly divided into the treated group ( n = 33, treated with TMJZ, 10 ml each time, three times a day) and the control group (n = 30, treated with Lovastatin, 10 mg, once daily). The levels of serum lipids (enzymatic methods), Ps, vWF, and D-D were measured before and after 8 weeks of treatment. Results: Serum total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), apo-protein B-100 (apoB-100) were significantly decreased (P<0.05 or P< 0.01) and high-density lipoprotein cholesterol (HDL-C) was significantly raised (P<0.05) after TM JZ treatment. Serum Ps,vWF, and D-D also declined (P<0.05) after treatment. There was no significant difference between the treated and the control groups in these parameters except serum HDL-C level. Conclusion: TMJZ has good therapeutic effect in regulating serum lipids, improving endothelial cell function, inhibiting activation of platelets, and preventing the disturbance of blood coagulation/fibrinolysis function in patients with AS.

  8. Topical tissue plasminogen activator appears ineffective for the clearance of intraocular fibrin.

    Science.gov (United States)

    Zwaan, J; Latimer, W B

    1998-06-01

    To determine the efficacy of topical tissue plasminogen activator (tPA) for the resolution of postoperative or inflammatory intraocular fibrinous exudates. Each treatment consisted of drops of 1 mg/ml tPA given 9 times 5 minutes apart. Records were reviewed and the results at 24 and 48 hours were recorded. Sixty-two patients had a total of 94 treatments. Fibrin exudates following intraocular surgery in 34 patients were treated 44 times. In 6 patients there was a positive result. Fibrin associated with intraocular infection was treated in 9 patients. None showed clear improvement. Nineteen patients had a total of 34 treatments for poorly controlled intraocular pressure (IOP) after glaucoma surgery. Five patients showed adequate control of the IOP, 12 did not change, and 2 had a questionable improvement. Eleven patients had adequate IOP control after additional treatment. Seven required suture lysis, 2 ab interno bleb revision, and 2 YAG capsulotomy or iridotomy to reduce the IOP to an acceptable level. Within the limits of this retrospective study and taking into account that fibrin may resolve spontaneously, it appears that topical tPA drops are not effective for the liquefaction of intraocular fibrin after surgery or in association with intraocular inflammation. They did not improve IOP control after glaucoma surgery.

  9. Fibrin formation and dissolution in women receiving oral contraceptive drugs.

    Science.gov (United States)

    Ball, A P; McKee, P A

    1977-04-01

    Factors affecting fibrin formation and dissolution were compared for 15 women taking combined oral contraceptives and 15 women using nonpharmacological methods of birth control. The two groups were matched for age, body weight, time of blood collection, and day in menstrual cycle; none of the women was receiving other drugs known to affect the blood coagulation or fibrinolytic parameters measured in this study. Fibrinogen concentrations tended to be higher in the experimental group; the degree of fibrinogen degradation, number of fibrin cross-links, and levels of factor XIII and plasminogen were the same for both group. There were significant reductions in antithrombin activity, the euglobulin lysis time, and fibrinolytic inhibitor level in women using oral contraceptives. An estrogen dose effect was suggested for fibrinogen concentration and the degree of antithrombin activity. The increased fibrinolytic activity and decreased fibrinolytic inhibitor levels are consistent with in vitro observations that antithrombin also inhibits plasmin activity. Thus while oral contraceptive-induced depression of antithrombin III could possibly predispose to thrombosis by diminishing the inhibition of the serine protease clotting factors, the concomitant decreased level of plasmin inhibition might balance the system by favoring thrombolysis as well as the digestion and inactivation of certain clotting factors by plasmin.

  10. Clinical Application of D dimer in Venous Thromboembolism%D二聚体测定在静脉血栓栓塞中的临床应用

    Institute of Scientific and Technical Information of China (English)

    李恒; 张凯; 黄津; 王毅

    2011-01-01

    @@ 静脉血栓栓塞(venous thromboembolism ,VTE)是临床常见的血栓性疾病,其中最主要的是深静脉血栓栓塞症(deep venous thrombosis ,DVT)和肺栓塞(pulmonary embolism ,PE),因其发病率和致死率均高而倍受国内外医者之重视.D二聚体(D-dimer,D-D)是经凝血酶及因子作用的交联纤维蛋白经纤溶酶降解后产生的终末产物,是反映体内凝血和纤溶的理想分子标志物之一.

  11. Platelet-rich fibrin: the benefits.

    Science.gov (United States)

    Kumar, Yuvika Raj; Mohanty, Sujata; Verma, Mahesh; Kaur, Raunaq Reet; Bhatia, Priyanka; Kumar, Varun Raj; Chaudhary, Zainab

    2016-01-01

    Current published data presents confusing results about the effects of platelet-rich fibrin on bone, and there is a need for studies that throw light on its effect. Our main objective therefore was to evaluate (by fractal analysis) osseous regeneration in extraction sockets with and without platelet-rich fibrin in a study with a substantial sample and a reliable technique to calibrate its effects on bone cells. We also assessed the soft tissue response. Thirty-four patients had their bilaterally impacted third molars (68 surgical sites) extracted in this split-mouth study, following which platelet-rich fibrin was placed in one of the sockets. Patients were followed up clinically and radiographically, and a pain score and fractal analysis were used to evaluate healing of soft tissue and bone, respectively. We conclude that platelet-rich fibrin improves healing of both soft and hard tissues. Although osseous healing did not differ significantly between the groups, healing of soft tissue as judged by the pain score was significantly better in the experimental group.

  12. UROKINASE MUTANT WITH BETTER FIBRIN SPECIFICITY

    Institute of Scientific and Technical Information of China (English)

    MaZhong; YuRuirong; HuaZichun; ZhuDexu

    1997-01-01

    Urokinsae (UK),one of the principal activators of plasminogen, has been widely used in the clinical therapy of thrombosis. However ,it lacks fibrin specificity ,and can lead to extensive systemic activation of plasminogen when injected into veins in large doses. On the other hand,

  13. Application of fibrin glue on endoscopic liposuction

    Institute of Scientific and Technical Information of China (English)

    CHEN Zhong-cun; YANG Jia-feng; CHEN Qian-qian

    2001-01-01

    @@ OBJECTIVE To deserve the effects of FG (Fibrin Glue)on endoscopic liposuction. Methods:From Oct. 1998 to Aug. 2000 forty cases were undergoing for the liposuction. Atthe aids of tumescent teachnique, endoscopy and FG were used, of which 20 casesoperation on their abdominal walls, 8 cases upper abdomen walls and 12 cases ownerabdominal.

  14. [Anaphylactic shock caused by fibrin glue].

    Science.gov (United States)

    Orsel, I; Guillaume, A; Feiss, P

    1997-01-01

    We observed a case of anaphylactic shock in a 68-year-old woman after a nasal intramucosal injection of fibrin glue for telangiectasies therapy. The tests showed an allergy to aprotinin contained in the glue. In the previous years, glue and aprotinin had been administered to the patient several times for nasal bleeding.

  15. Preparation of hybrid scaffold from fibrin and biodegradable polymer fiber.

    Science.gov (United States)

    Hokugo, Akishige; Takamoto, Tomoaki; Tabata, Yasuhiko

    2006-01-01

    A biodegradable hybrid scaffold was prepared from fibrin and poly(glycolic acid) (PGA) fiber. Mixed fibrinogen and thrombin solution homogeneously dispersed in the presence of various amounts (0, 1.5, 3.0, and 6.0mg) of PGA fiber was freeze-dried to obtain fibrin sponges with or without PGA fiber incorporation. By scanning electron microscopy observation, the fibrin sponges had an interconnected pore structure, irrespective of the amount of PGA fiber incorporated. PGA fiber incorporation enabled the fibrin sponges to significantly enhance their compression strength. In vitro cell culture studies revealed that the number of L929 fibroblasts initially attached was significantly larger for any fibrin sponge with PGA fiber incorporation than for the fibrin sponge without PGA fiber. The shrinkage of sponges after cell seeding was suppressed by fiber incorporation. It is possible that the shrinkage suppression of sponges maintains their intraspace, resulting in the superior cell attachment of a sponge with PGA fiber incorporation. After subcutaneous implantation into the backs of mice, the residual volume of a fibrin sponge with PGA fiber incorporation was significant compared with that of a fibrin sponge without PGA fiber. Larger number of cells infiltrated deep inside the fibrin sponges with PGA fiber incorporation implanted subcutaneously. It is concluded that the fibrin sponge reinforced by fiber incorporation is a promising three-dimensional scaffold of cells for tissue engineering.

  16. 儿童单纯性肥胖危险因素分析及与血浆D-二聚体的相关性%Analysis of risk factors of childhood simple obesity and its relationship with plasma D-dimer

    Institute of Scientific and Technical Information of China (English)

    张晓杰; 刘静; 孙利伟; 田玉玲

    2012-01-01

    目的 探讨儿童单纯性肥胖的危险因素以及血浆D-二聚体与肥胖的相关性.方法 采用问卷调查和体格测量的方法调查2006年1月 - 2010年12月就诊的单纯性肥胖儿童530例,其中102例测定血浆D-二聚体.同时选取120例性别、年龄、地区分布相匹配的健康儿童作对照,其中89例测定血浆D-二聚体.结果 肥胖儿童出生体质量、其父母平均体质指数(BMI)均较对照组明显增高,差异有统计学意义(P均< 0.01);肥胖儿童较正常对照儿童每日运动时间少,睡眠时间和看电视时间多,差异均有统计学意义(P均< 0.01);儿童肥胖与饮食有关;肥胖儿童有心血管病家族史的比例明显高于对照组,血浆D-二聚体含量(0.85 ± 0.31)mg/L亦较对照组(0.30 ± 0.11)mg/L明显增高,差异均有统计学意义(P < 0.001).结论 儿童肥胖是遗传因素和环境因素共同作用的结果,血浆D-二聚体与儿童单纯性肥胖具有相关性.%Objective To investigate the risk factors of children simple obesity and the association of plasma D-dimer and children simple obesity. Methods The height and body weight of 530 outpatients with simple obesity were measured and questionnaire survey was processed from January 2006 to December 2010. The plasma D-dimer was tested in 102 children of them. Meanwhile, 120 healthy children were selected as control with matched gender, age and region. The plasma D-dimer was also measured. Results The birth weight and the mean parents BMI of obese children were significantly higher than those of control group (P < 0.01). Compared with the control group, obese children daily exercised less time but spent more time on sleeping and watching TV (all P < 0.01). Children obesity was diet related, and the percentage of family history of cardiovascular disease and the levels of D-dimer in obese children were significantly higher than those in control group (P < 0.001). Conclusions Obesity in children is

  17. 茂名地区中老年人血浆D-二聚体参考区间的建立及应用评估%The plasma D-Dimer reference range establishment and the evaluation in the middle-aged and elderly of Maoming Area

    Institute of Scientific and Technical Information of China (English)

    冯程娟; 苏东梅; 陈和勇; 杨松娣

    2015-01-01

    目的:建立并了解中老年人血浆D-二聚体的参考区间,提高血浆D-二聚体在中老年人患者中的应用价值。方法选取2012年10月~2014年11月广州中医药大学附属茂名市中医院内科健康体检的50岁以上中老年人685名(男411名,女274名),发生肺栓塞5例,静脉血栓症4例及健康青年对照组164名。将50岁以上的中老年人按男、女及年龄分为50~0.05)。D-二聚体参考区间随年龄而逐渐升高,各年龄段均高于健康人群的疾病界定值(0.5 mg/L)。采用上述参考区间评估9例患者的D-二聚体水平,均为阳性结果。结论本研究初步建立并评估了茂名地区50岁以上中老年人血浆D-二聚体参考区间,提高了D-二聚体检测在中老年人群中的应用价值。%Objective To establish and understand the plasmatic D-Dimer reference range in the middle-aged and el-derly, and improve the application value of D-Dimer in the middle-aged and elderly. Methods From Octorber 2012 to Novenber 2014, selected 685 old people aged over 50 years (male 411 cases, female 274 cases) who had joined the medicine health examination in Department of Internal Medicine, Maoming Traditional Chinese Medical Hospital Affili-ated to Guangzhou University of Traditional Chinese Medicine, and 5 patients with venous, 4 patients with venous throm-bosis and 164 healthy youths (as the control group). The elderly aged over 50 years were divided into 50-0.05). With the age increasing, the diseased value of definition of all ages were higher than those in healthy population (0.5 mg/L). Using the reference interval to evaluate the D-Dimer level of 9 patients, the results were positive. Conclusion This study es-tablishes and evaluates the plasma D-Dimer reference interval among the elderly aged over 50 years old in Maoming Area, and improves the application value of D-Dimer in the middle-aged and elderly.

  18. Clinical Significance of B Type Natriuretic Peptide and D-dimer in Patients with Chronic Pulmonary Heart Disease Detection%B型脑钠肽和D-二聚体在慢性肺源性心脏病患者中检测的临床意义

    Institute of Scientific and Technical Information of China (English)

    郭春霞

    2013-01-01

    目的:探讨B型脑钠肽(BNP)和D-二聚体(D-dimer)在慢性肺源性心脏病(CPHD)患者中的水平变化,分析其临床意义。方法:用免疫比浊法测定单纯慢性阻塞性肺疾病(COPD)患者,慢性肺源性心脏病(CPHD)急性加重期和临床缓解期患者的血浆D-二聚体含量,同时用免疫荧光法检测各组患者的B型脑钠肽水平,用血气分析仪测定各组患者的pH值、动脉血氧压(PaO2)、动脉二氧化碳分压(PaCO2),观察比较各组BNP、D-dimer含量的差异和进行动脉血气分析。结果:慢性肺源性心脏病患者急性加重期和临床缓解期患者血浆D-二聚体含量分别为(2.74±0.87)μg/L、(2.09±0.77)μg/L,均较单纯性COPD组患者的(1.67±0.65)μg/L明显升高,差异均有统计学意义(P<0.05);CPHD急性加重期和临床缓解期患者BNP水平分别为(919.34±189.33)pg/mL、(213.60±31.74)pg/mL,较单纯性COPD组患者(37.30±12.74)pg/mL明显增高,各组比较差异均有统计学意义(P<0.01)。BNP、D-dimer含量与PaO2呈负相关,与PaCO2呈正相关(P<0.05)。结论:联合检测B型脑钠肽和D-二聚体水平变化对慢性肺源性心脏病患者病情变化、疗效监测及预后有重要的临床意义。%Objective:To study the B-type natriuretic peptide(BNP)and D- dimer(D-dimer)levels in patients with chronic pulmonary heart disease(CPHD)and analyze its clinical significance.Method:Plasma D-dimer content by nephelometry and B-type natriuretic peptide levels by immunofluorescence assay were detected in patients with simple chronic obstructive pulmonary disease(COPD),chronic pulmonary heart disease (CPHD)in acute exacerbation and remission respectively,pH value,PaO2 and PaCO2 were determined by blood gas analyzer.Differences of the content of BNP,the D-dimer levels and arterial blood gas analysis were observed and compared among the groups.Result:Plasma D-dimer

  19. Establishment of D-dimer reference intervals for pregnant women of 34 gestational weeks and its predictive value on postpartumhemorrhage%上海地区孕晚期血浆D-二聚体参考范围的建立及其预测产后出血的意义

    Institute of Scientific and Technical Information of China (English)

    蔡眉; 沈虹; 唐振华

    2015-01-01

    Objective: To establish reference intervals for D-dimer during the third trimester of pregnancy in Shang-hai women, and to analyze the factors influencing the D-dimer level for evaluating its clinical significance in postpartum hemorrhage. Methods: 6398 cases of healthy pregnant women (healthy group) of 34 weeks gestation aged 19 to 49 years from maternity department in our hospital were enrolled, they had received routine medical examination from January 2013 to July 2014. Immune turbidimetric method was used to detect the plasma D-dimer level in pregnant woman at 34 weeks gestation. Changes in D-dimer level were analyzed in 2 834 cases with obstetric risk factors (uterus anomaly, abnormal placenta, anemia, amniotic fluid anomalies, history of high blood pressure, diabetes, adverse pregnancy) (observed group) and in 347 cases of postpartum hemorrhage. Forty healthy non-pregnant women when not menstruating were enrolled as control group. Results:The median level of plasma D-dimer was 1.25 mg/L (95%CI:1.22-1.28) in 6 398 healthy pregnant women,and was 1.89 mg/L (95%CI:1.82-1.96) in 2 834 cases with obstetric risk factors. There was significant difference between the two groups (P0.05). D-dimer level was 0.30 mg/L(95%CI:0.22-0.38)in control group. Plasma D-dimer level had predictive value for postpartum hemorrhage in pregnant women with obstetric risk factors (OR=2.01, 95%CI:1.57-2.56), while had no predic-tive value for postpartum hemorrhage in healthy pregnant women. Conclusions: The 95% reference range for D-dimer in-tervals in healthy pregnant women at 34 weeks gestation is <3.05 mg/L, which is much higher than that in healthy non-pregnant women when not menstruating. D-dimer has predictive value for postpartum hemorrhage in pregnant women with obstetric risk factors.%目的:建立上海地区健康孕妇孕晚期(34孕周)血浆D-二聚体参考范围,对影响D-二聚体的相关因素进行统计分析,评价其在预测孕妇产后出血中的

  20. Relativity analysis of serum D-dimer content to stage and onset age of stroke%血浆D-二聚体含量与脑卒中病期、发病年龄的相关性研究

    Institute of Scientific and Technical Information of China (English)

    李东燕

    2002-01-01

    Objective To assess its significance to diagnosis, treating and prognosis of ischemic cerebrovascular disease by measuring plasma D dimer of 100 patients. Method By enzyme linked immunosorbent assay and double antibody sandwich assay, making color matching under 492 nm wavelength and to gain the plasma D dimer content value according to the standard curve.Result Serum D dimer content of acute cerebral infarction patients was significantly increase, which reflect increase of fibrinolysis activity and increase of thrombin production.It is a valuable index to hypercoagulation state and thrombosis. The Older the age, the higher the plasma D dimer content. Conclusion It is suggested that there was apparent change of D dimer in course of ischemic cerebrovascular diseases and in patients beyond 60, which engender hypercoagulation state leading to disease.

  1. Lyophilized platelet-rich fibrin (PRF) promotes craniofacial bone regeneration through Runx2.

    Science.gov (United States)

    Li, Qi; Reed, David A; Min, Liu; Gopinathan, Gokul; Li, Steve; Dangaria, Smit J; Li, Leo; Geng, Yajun; Galang, Maria-Therese; Gajendrareddy, Praveen; Zhou, Yanmin; Luan, Xianghong; Diekwisch, Thomas G H

    2014-05-14

    Freeze-drying is an effective means to control scaffold pore size and preserve its composition. The purpose of the present study was to determine the applicability of lyophilized Platelet-rich fibrin (LPRF) as a scaffold for craniofacial tissue regeneration and to compare its biological effects with commonly used fresh Platelet-rich fibrin (PRF). LPRF caused a 4.8-fold±0.4-fold elevation in Runt-related transcription factor 2 (Runx2) expression in alveolar bone cells, compared to a 3.6-fold±0.2-fold increase when using fresh PRF, and a more than 10-fold rise of alkaline phosphatase levels and mineralization markers. LPRF-induced Runx2 expression only occurred in alveolar bone and not in periodontal or dental follicle cells. LPRF also caused a 1.6-fold increase in osteoblast proliferation (pPRF. When applied in a rat craniofacial defect model for six weeks, LPRF resulted in 97% bony coverage of the defect, compared to 84% for fresh PRF, 64% for fibrin, and 16% without scaffold. Moreover, LPRF thickened the trabecular diameter by 25% when compared to fresh PRF and fibrin, and only LPRF and fresh PRF resulted in the formation of interconnected trabeculae across the defect. Together, these studies support the application of lyophilized PRF as a biomimetic scaffold for craniofacial bone regeneration and mineralized tissue engineering.

  2. Lyophilized Platelet-Rich Fibrin (PRF Promotes Craniofacial Bone Regeneration through Runx2

    Directory of Open Access Journals (Sweden)

    Qi Li

    2014-05-01

    Full Text Available Freeze-drying is an effective means to control scaffold pore size and preserve its composition. The purpose of the present study was to determine the applicability of lyophilized Platelet-rich fibrin (LPRF as a scaffold for craniofacial tissue regeneration and to compare its biological effects with commonly used fresh Platelet-rich fibrin (PRF. LPRF caused a 4.8-fold ± 0.4-fold elevation in Runt-related transcription factor 2 (Runx2 expression in alveolar bone cells, compared to a 3.6-fold ± 0.2-fold increase when using fresh PRF, and a more than 10-fold rise of alkaline phosphatase levels and mineralization markers. LPRF-induced Runx2 expression only occurred in alveolar bone and not in periodontal or dental follicle cells. LPRF also caused a 1.6-fold increase in osteoblast proliferation (p < 0.001 when compared to fresh PRF. When applied in a rat craniofacial defect model for six weeks, LPRF resulted in 97% bony coverage of the defect, compared to 84% for fresh PRF, 64% for fibrin, and 16% without scaffold. Moreover, LPRF thickened the trabecular diameter by 25% when compared to fresh PRF and fibrin, and only LPRF and fresh PRF resulted in the formation of interconnected trabeculae across the defect. Together, these studies support the application of lyophilized PRF as a biomimetic scaffold for craniofacial bone regeneration and mineralized tissue engineering.

  3. 儿童过敏性紫癜外周血血小板参数及D-二聚体水平变化%Analysis of Peripheral Platelet Parameters and D-dimer in Children with Henoch-Sch(o)nlein Purpura

    Institute of Scientific and Technical Information of China (English)

    孙燕; 张惠君; 常红; 张秋业; 陈玉秀

    2013-01-01

    目的:探讨外周血血小板参数及D-二聚体水平在儿童过敏性紫癜(Henoch-Schonlein purpura,HSP)的变化及临床意义.方法:选择2010年6月至2012年5月间青岛大学医学院附属医院儿科住院过敏性紫癜患儿137例为研究对象,儿童保健科健康查体儿童50例为对照组.血小板参数包括血小板计数(PLT)、平均血小板体积(MPV)、血小板压积(PCT)、血小板体积分布宽度(PDW),采用XE-2100全血细胞分析仪、电阻抗法检测;血浆D-二聚体采用胶乳比浊法检测.结果:与对照组比较,HSP患儿急性期外周血PLT、PCT显著升高(P<0.05),而MPV显著降低(P<0.05),PDW无显著差异(P>0.05);有无胃肠道出血HSP组间和有无肾脏受损HSP组间血小板参数并无显著性差异(p>0.05).84例(61.3%)HSP患儿急性期血浆D-二聚体水平增高,其绝对浓度(中位数)为435 ng/ml,显著高于正常水平(0-300 ng/ml);不同HSP临床表型组间血D-二聚体异常率和绝对浓度均无显著性差异(X2=2.75,P>0.05;H=3.37,P>0.05);合并胃肠道出血组与无消化道出血组比较HSP病儿血浆D-二聚体水平显著升高(Z=-2.691,P<0.05);合并肾损害与无肾损害组比较HSP病儿血浆D-二聚体水平显著降低(Z=-4.063,P<0.05).结论:HSP患儿急性期血液处于高凝及继发的纤溶状态,早期检测血小板参数及D-二聚体变化水平,指导临床诊断及临床用药.%Objective:To investigate the levels and clinical significance of peripheral platelet parameters and d-dimer in children with Henoch-Sch?nlein purpura (HSP).Methods:One hundred and thirty-seven patients diagnosed as HSP and fifty healthy children were enrolled.Platelet parameters,including platelet counts (PLT),mean platelet volume (MPV),platelet crit (PCT),platelet distribution width (PDW) were measured by resistance method using XE-2100 automatic blood count device.Plasma d-dimer was measured by latex turbidity.Results:Compared with that in

  4. Fibrin sealant in general surgery. Personal experience and literary review.

    Science.gov (United States)

    Gubitosi, Adelmo; Ruggiero, Roberto; Docimo, Giovanni; Esposito, Alessandro

    2014-01-01

    In consideration of the use of fibrin glue in a general surgery department, authors analyze their last two years series. Operations on liver and biliary ducts, bowel and proctologic surgery, thyroid and breast surgery, abdominal wall hernias, fistulas and difficult wounds are considered with a literary review on fibrin sealant.

  5. Identification of fibrin clot-bound plasma proteins

    NARCIS (Netherlands)

    S. Talens (Simone); F.W.G. Leebeek (Frank); J.A.A. Demmers (Jeroen); D.C. Rijken (Dingeman)

    2012-01-01

    textabstractSeveral proteins are known to bind to a fibrin network and to change clot properties or function. In this study we aimed to get an overview of fibrin clot-bound plasma proteins. A plasma clot was formed by adding thrombin, CaCl2 and aprotinin to citrated platelet-poor plasma and unbound

  6. 慢性阻塞性肺疾病急性加重期二氧化碳分压与D-二聚体的相关性研究%Study on the relationship between partial pressure of carbon dioxide and D-dimer in acute exacerbation of chronic obstructive pulmonary disease

    Institute of Scientific and Technical Information of China (English)

    王志安

    2014-01-01

    Objective To study the relationship between partial pressure of carbon dioxide(PaCO2) and D-dimer in acute exacerbation of chronic obstructive pulmonary disease (COPD),to provide a scientific basis and guidance for clinical treatment.Methods Forty-six COPD with acute exacerbation patients from January 2011 to January 2013 in our hospital were selected as observation objects,set as observation group,measured D-dimer and PaCO2 levels before and after treatment; forty-six healthy volunteers were selected as control group,measured D-dimer and PaCO2 level,and compared the levels between two groups.Results The observation group before treatment,two D-dimer,PaCO2 levels were (353±220.8) μg/L,(64.7±16.2) mmHg,control group D-two mer,PaCO2 levels were (73.6±21.1) μg/L,(40.3±4.5) mmHg,the observation group were significantly higher than those in control group,the difference between the two groups was significant (P <0.05) ;observation after treatment,D-two dimer,PaCO2 levels were (96.4 ± 24.8) μg/L,(46.3 ± 7.4) mmHg,the no significant difference with the control group (P >0.05).Conclusions Partial pressure of carbon dioxide and D-dimer levels in acute exacerbation of COPD was significantly higher inhealthy people,so the treatment of COPD patients,need to closely monitor patients with D-dimer and PaCO2 levels,to understand the progress of disease.%目的 探讨COPD患者在急性加重期PaCO2和D-二聚体的相关性,为临床治疗提供科学依据和指导.方法 选择2011年1月至2013年1月在鄂州市中心医院住院治疗的46例COPD急性加重期患者作为观察对象,设为观察组,测定治疗前后血浆D-二聚体、PaCO2水平;选择46例健康志愿者作为对照组,检测其血浆D-二聚体、PaCO2水平,比较两组血浆D-二聚体、PaCO2水平.结果 观察组治疗前D-二聚体、PaCO2水平分别为(353±220.8) μg/L、(64.7±16.2) mmHg,对照组D-二聚体、PaCO2水平分别为(73.6±21.1) μg/L、(40.3±4.5) mmHg,观察组均

  7. Clinical Significance of Brain Natriuretic Peptide(BNP),Cadiac TroponinⅠ(cTnⅠ),and D-dimer Detection in the Acute Pulmonary Embolism(APE)%血浆脑钠肽、肌钙蛋白Ⅰ联合D-二聚体检测对急性肺栓塞患者的临床意义

    Institute of Scientific and Technical Information of China (English)

    常慧

    2016-01-01

    Objective:To discuss the clinical significance of BNP, cTnⅠ and D-dimer detection in patients with APE.Method:76 patients with APE were divided into the massive APE group of 36 cases and the non massive APE group of 40 cases according to the embolization area, then the levels of BNP,cTnⅠ and D-dimer, right heart function and mortality of two groups were contrasted.Result:The levels of BNP and cTnⅠ in the massive APE group were significantly higher than the non massive APE group,the differences were statistically significant(P0.05).The incidence of right heart function failure and the fatality rate in the massive APE group was respectively 69.4% and 22.2%, significantly higher than 15.0% and 2.5% in the non massive PE group,the difference was statistically significant(P0.05)。大面积APE患者患右心功能不全发生率及病死率分别为69.4%与22.2%,均显著高于非大面积APE组的15.0%与2.5%,两组比较差异均有统计学意义(P<0.01)。结论:通过对APE患者血浆BNP、cTnⅠ水平的检测可对患者进行危险分层及预后评估,D-二聚体水平的检测可作为诊断APE的排除指标。

  8. Clinical analysis of hemorheology, fibrinogen, D-dimer change in acute myocardial infarction%急性心肌梗死患者血液流变学、纤维蛋白原及D-二聚体的变化及其临床意义

    Institute of Scientific and Technical Information of China (English)

    苏华; 谢睿彬

    2012-01-01

    目的 观察急性心肌梗死(AMI)患者血液流变学、纤维蛋白原及D-二聚体的变化,探讨其临床价值.方法 选择我院收治的AMI患者44例作为AMI组,陈旧性心肌梗死(OMI)患者32作为OMI组,并选取同期门诊体检的健康人30例作为NC组.应用全自动血黏度测试仪测定受试对象血液流变学指标、纤维蛋白原(Fig)和D-二聚体水平,并对结果进行比较分析.结果 ①AMI组纤维蛋白原、D-二聚体水平较OMI组和NC组明显升高,差异有统计学意义(P<0.05),OMI组与NC组纤维蛋白原、D-二聚体水平比较差异无统计学意义(P>0.05);②AMI组与OMI组和NC组比较,血液流变学检查全血黏度低切、全血黏度中切、全血黏度高切、血浆黏度、红细胞压积、红细胞聚集指数、血沉均有不同程度的增高,差异有统计学意义(P<0.05),OMI组与NC组血液流变学指标比较差异无统计学意义(P>0.05).结论 急性心肌梗死患者血浆纤维蛋白原、D-二聚体水平明显升高,血液流变学指标发生明显改变,血液流变学及凝血机制异常在急性心肌梗死的发生和发展中起到重要作用,对于急性心肌梗死的诊断、疗效观察和预后判断有一定的临床价值.%Objective To observe hemorheology, fibrinogen, D-dimer change in acute myocardial infarction, and discuss its clinical value. Methods 44 patients with acute myocardial infarction (AMI) were selected as AMI group, 32 patients with old myocardial infarction (OMI) as the OMI group, and 30 cases of healthy people during the same period as the NC group. Hemorheology, fibrinogen (FIG), and the D-dimer levels were tested. Results FIG and D-dimer levels in AMI group were significantly increased compared with those in the OMI group or NC group (P< 0.05), but no difference of FIG and D-dimerbetween OMI group and NC group. Hemorheology check blood viscosity, low cut, cut in whole blood viscosity, high shear whole blood viscosity, plasma

  9. Fibrin powder turbidity measurement for rapid assessment of antiplasmins.

    Science.gov (United States)

    Exner, T; Rickard, K A; Kronenberg, H

    1975-11-01

    Fibrinolytic activity was determined from the rate of disappearance of turbidity in a suspension of heat-treated fibrin powder. Using this method for estimating residual fibrinolytic activity in mixtures of serum and plasmin, antiplasmin behaviors of specimens from patients with various clinical disorders were determined after long and short preincubation times. Slow-acting antiplasmins were found to be increased in a variety of conditions among these patients, while immediate acting antiplasmins were generally decreased, compared with those in specimens from a large pool of normal, healthy vounteers. Normal women taking oral contraceptives had consitently high levels of slow antiplasmins. Tests in vitro showed that the antifibrinolytic agents epsilon-aminocaproic acid, Trasylol and soybean trypsin inhibitor act only as fast antiplasmins.

  10. Autologous fibrin adhesive in experimental tubal anastomosis.

    Science.gov (United States)

    Rajaram, S; Rusia, U; Agarwal, S; Agarwal, N

    1996-01-01

    To evaluate autologous fibrin in rabbit oviduct anastomosis versus 7-0 vikryl, a conventional suture material used in tubal anastomosis. Thrombin was added to the autologous fibrinogen at the site of anastomosis to obtain a tissue adhesive. The anastomotic time, pregnancy rate, and litter size were evaluated. Three months later, a relaparotomy was done to evaluate patency and degree of adhesions, and a tubal biopsy was taken from the site of anastomosis. Analysis of results showed a statistically significant (P < .001) shortened anastomotic time and superior histopathological union in the tissue adhesive group. Patency rate, pregnancy rate, and degree of adhesions were comparable in both groups.

  11. Biocompatibility, biodegradation, and neovascularization of human single-unit platelet-rich fibrin glue: an in vivo analysis

    Institute of Scientific and Technical Information of China (English)

    Wu Xiuwen; Ren Jianan; Yao Genhong; Zhou Bo; Wang Gefei; Gu Guosheng; Luan Jianfeng

    2014-01-01

    Background The clinical applications of fibrin glue span over several surgical modalities.The aim of this study was to evaluate the biocompatibility and biodegradation of different formulations of platelet-rich fibrin glue in vivo and examine its effects on the neovascularization of wound sites.Methods Human-derived single-unit fibrin glue was prepared.Incisions were made on the backs of rats,and these were coated with homemade glues containing different concentrations of aminomethylbenzoic acid (Groups A-F) or commercial adhesives (Group G).A sham control group was included (Group H).The wounds were examined by histological analysis and immunohistochemistry at several time points.Results Successful wound closure was achieved in all groups by day 12.Acute inflammation occurred during the first six days,but gradually disappeared.The longest sealant duration was achieved using the lowest concentration of antifibrinolytic agent in a 1:10 volume ratio with cryoprecipitate.Expression levels of the platelet endothelial cell adhesion molecule-1 were significantly higher in Groups A and C compared to the control groups (Groups G and H) on day 3 (P <0.05).Conclusions Single-unit platelet-rich fibrin glue has excellent biocompatibility and is associated with the upregulation of neovascularization.The addition of aminomethylbenzoic acid could prevent the degradation of fibrin glue.

  12. A recently developed bifacial platelet-rich fibrin matrix.

    Science.gov (United States)

    Lucarelli, E; Beretta, R; Dozza, B; Tazzari, P L; O'Connel, S M; Ricci, F; Pierini, M; Squarzoni, S; Pagliaro, P P; Oprita, E I; Donati, D

    2010-07-01

    Platelet-rich plasma (PRP) is used clinically in liquid or gel form to promote tissue repair. Because of the poor mechanical properties, conventional PRP is often difficult to handle when used in clinical settings and requires secure implantation in a specific site, otherwise when released growth factors could be washed out during an operation. In this study, we analyzed the end product of a recently developed commercially available system (FIBRINET), which is a dense pliable, platelet-rich fibrin matrix (PRFM). We characterized the mechanical properties of PRFM and tested whether PRFM releases growth factors and whether released factors induce the proliferation of mesenchymal stem cells (MSC). Mechanical properties as well as platelet distribution were evaluated in PRFM. PRFM demonstrated robust mechanical properties, with a tear elastic modulus of 937.3 +/- 314.6 kPa, stress at a break of 1476.0 +/- 526.3 kPa, and an elongation at break of 146.3 +/- 33.8 %. PRFM maintained its mechanical properties throughout the testing process. Microscopic observations showed that the platelets were localized on one side of the matrix. Elevated levels of PDGF-AA, PDGF-AB, EGF, VEGF, bFGF and TGF-beta1 were measured in the day 1-conditioned media (CM) of PRFM and growth factor levels decreased thereafter. BMP2 and BMP7 were not detectable. MSC culture media supplemented with 20% PRFM-CM stimulated MSC cell proliferation; at 24 and 48 hours the induction of the proliferation was significantly greater than the induction obtained with media supplemented with 20% foetal bovine serum. The present study shows that the production of a dense, physically robust PRFM made through high-speed centrifugation of intact platelets and fibrin in the absence of exogenous thrombin yields a potential tool for accelerating tissue repair.

  13. A recently developed bifacial platelet-rich fibrin matrix

    Directory of Open Access Journals (Sweden)

    E Lucarelli

    2010-07-01

    Full Text Available Platelet-rich plasma (PRP is used clinically in liquid or gel form to promote tissue repair. Because of the poor mechanical properties, conventional PRP is often difficult to handle when used in clinical settings and requires secure implantation in a specific site, otherwise when released growth factors could be washed out during an operation. In this study, we analyzed the end product of a recently developed commercially available system (FIBRINET®, which is a dense pliable, platelet-rich fibrin matrix (PRFM. We characterized the mechanical properties of PRFM and tested whether PRFM releases growth factors and whether released factors induce the proliferation of mesenchymal stem cells (MSC. Mechanical properties as well as platelet distribution were evaluated in PRFM. PRFM demonstrated robust mechanical properties, with a tear elastic modulus of 937.3 + 314.6 kPa, stress at a break of 1476.0 + 526.3 kPa, and an elongation at break of 146.3 + 33.8 %. PRFM maintained its mechanical properties throughout the testing process. Microscopic observations showed that the platelets were localized on one side of the matrix. Elevated levels of PDGF-AA, PDGF-AB, EGF, VEGF, bFGF and TGF-β1 were measured in the day 1-conditioned media (CM of PRFM and growth factor levels decreased thereafter. BMP2 and BMP7 were not detectable. MSC culture media supplemented with 20% PRFM-CM stimulated MSC cell proliferation; at 24 and 48 hours the induction of the proliferation was significantly greater than the induction obtained with media supplemented with 20% foetal bovine serum. The present study shows that the production of a dense, physically robust PRFM made through high-speed centrifugation of intact platelets and fibrin in the absence of exogenous thrombin yields a potential tool for accelerating tissue repair.

  14. Change of pregnancy-associated protein A,urinary transferrin, D-dimer in patients with hypertension in pregnancy%妊娠相关蛋白 A、尿转铁蛋白、D-二聚体在妊娠期高血压病患者中的变化

    Institute of Scientific and Technical Information of China (English)

    张丽岩; 刘艳庚; 颜媛

    2015-01-01

    Objective To observe the significance of pregnancy-associated protein A (PAPP-A ), urinary transferrin,D-dimer in patients with hypertension in pregnancy and their correlation.Methods The study enrolled 120 patients with pregnancy-induced hypertension syndrome as pregnancy-induced hypertension group,at the same period, 30 healthy pregnant women with a full-term pregnancy were selected as the normal pregnancy group and 20 non-pregnant healthy women were as the healthy control group.The levels of PAPP-A,urinary transferrin and D-dimer were observed in pregnancy-induced hypertension group,normal pregnancy group and healthy control group,their levels and disease severity were detected in pregnancy-induced hypertension group and their relationship was explored. Results The levels of PAPP-A,urinary transferrin and D-dimer in pregnancy-induced hypertension group were significantly higher than those of normal pregnancy group and healthy control group (P < 0.01 ),and the levels in normal pregnancy group were also higher compared with those of healthy control group (P <0.01),as the severity of pregnancy-induced hypertension increased,the levels of PAPP-A,urinary transferrin and D-dimer increased (P <0.01).There were positive correlation between PAPP-A and urinary transferrin (r =0.593,P <0.01)or D-dimer (r=0.692,P <0.01),while there were positive correlation between D-dimer and urinary transferrin (r =0.622,P <0.01).Conclusion There are of great significances between the severity of pregnancy-induced hypertension and levels of PAPP-A,urinary transferrin,D-dimmer,and the items can be provided for the early diagnosis and treatment of pregnancy-induced hypertension.%目的:观察妊娠相关蛋白 A(PAPP-A)、尿转铁蛋白、D-二聚体在妊娠期高血压疾病患者检测中的意义及其相关性分析。方法选择在我院就诊的妊娠期高血压疾病患者120例,为妊娠期高血压疾病组,选择同期足月妊娠的健康孕妇30例,为正常妊娠组,选

  15. Towards evidence-based emergency medicine: best BETs from the Manchester Royal Infirmary. BET 2: The use of age-related D-dimers to rule out deep vein thrombosis.

    Science.gov (United States)

    Taylor, Catherine; Sultan, Laith

    2015-09-01

    A short cut review was carried out to establish whether the use of age-adjusted D-dimer cut-offs is better than the standard, unadjusted diagnostic cut-off for excluding the diagnosis of deep vein thrombosis (DVT) in the Emergency Department. Three studies were directly relevant to the question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated. The clinical bottom line is that the use of an age-adjusted D-dimer cut-off in patients aged over 50 years increases the ability to safely exclude DVT in patients with low clinical probability without the need for ultrasound scanning. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  16. 富血小板纤维蛋白体外释放TGF-β和PDGF-AB影响因素的探讨%Investigation of effect factors of TGF-β and PDGF-AB levels in platelet-rich fibrin releasing in vitro

    Institute of Scientific and Technical Information of China (English)

    李艳秋; 周延民; 孙晓琳; 张天首; 朱婷

    2012-01-01

    目的 探讨不同方法对制备的富血小板纤维蛋白(platelet-rich fibrin,PRF)释放生长因子的影响.方法 对志愿者进行静脉采血,分别以不同离心速度(2500r/min、3000r/min、3500r/min)、离心时间(10min、15min、20min)和除水方法(快速除水和缓慢除水)制备PRF,收集PRF所释放的生长因子,通过ELISA法比较不同方法所获得的PRF释放的TGF-β和PDGF-AB的浓度差异.结果 以3000r/min的离心速度制备的PRF释放TGF-β和PDGF-AB含量显著高于其他两组;10min组和15min组制备的PRF释放TGF-β含量高于20min组,而PDGF-AB含量10min组显著高于其他两组;两种除水方法制备的PRF释放TGF-β和PDGF-AB含量无统计学差异(P>0.05).结论 不同离心速度、离心时间对PRF的特性存在一定的影响,而快速除水和缓慢除水对PRF特性的影响无显著性差异.%Objective To investigate the influence factors of platelet-rich fibrin releasing growth factors with different kinds. Methods PRF were produced by different centrifugal speed (2500r/min、3000r/min、3500r/min) , centrifugal time (10min、15min、20min) and dehydration methods (fast dehydration methods and slow dehydration methods) from volunteers.Collect the growth factors in PRF ,and Compare the TGF-β and PDGF-AB concentration by ELISA. Results TGF-pand PDGF-AB levels in the PRF prepared by 3000r/min were higher ; TGF-filevel in the PRF prepared by 10min and 15min were higher, and PDGF-AB level in the PRF prepared by 10min were higher;but the two dehydration methods showed no statistics significance (R>0.05). Conclusion Different centrifugal speed and centrifugal time may affect the characteristics of PRF, and dehydration methods may not affect the characteristics of PRF.

  17. D-二聚体和凝血4项检测在孕妇产前检查中的临床价值分析%The clinical value analysis of D-Dimer and cruor detection in antenatal examination for pregnantwomen

    Institute of Scientific and Technical Information of China (English)

    邹庆红

    2013-01-01

    目的 探讨D二聚体和凝血4项检测在孕妇产前检查中的临床价值,提高妊娠高血压综合征孕妇分娩的安全性.方法 2011年8月~2012年5月,收集正常晚期妊娠妇女50例(晚孕正常组)、晚期妊娠合并妊娠高血压综合征妇女50例(晚孕妊高征组)和门诊体检非妊娠健康妇女50例(对照组),检测D-二聚体、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)和纤维蛋白原(FIB).结果 晚孕妊高征组血清D-二聚体水平最高,对照组最低,差异有统计学意义(p<0.05).晚孕妊高征组PT和APTT水平最低,FIB水平最高,对照组PT和APTT水平最高,FIB水平最低,3组之间差异有统计学意义(P<0.05);3组间TT水平比较,差异无统计学意义(P>0.05).结论 正常妊娠妇女及妊娠高血压综合征妇女血液均处于高凝状态,产前检测D二聚体和凝血4项水平,有助于防止孕妇在分娩过程中发生血栓性疾病或弥漫性血管内凝血,减少产科意外的发生,可以作为产前筛查的主要指标.%Objective To investigate D-Dimer and cruor detection in antenatal examination for pregnant women, and improve the safety of pregnancy-induced hypertension pregnant woman. Methods From August 2011 to May 2012,researchers collected 50 cases of normal late pregnancy women (late pregnancy normal group) , 50 cases of iate pregnancy with pregnancy-induced hypertension women (late pregnancy with pregnancy-induced hypertension group) and 50 cases of non pregnancy healthy women (control group) , detected d-dimer, prothrombin time (PT) , activated part thromboplastin time (APTT) , thrombin time (TT) and fibrinogen ( FIB). Results The D-Dimer level of late pregnancy with pregnancy-induced hypertension group is the highest, and which of the control group is minimum, the differences indicated statistical significance (P 0. 05). Conclusion Normal pregnancy women and pregnancy-induced hypertension women are at a high cruor

  18. Availability of the B beta(15-21) epitope on cross-linked human fibrin and its plasmic degradation products

    Science.gov (United States)

    Chen, F.; Haber, E.; Matsueda, G. R.

    1992-01-01

    The binding of radiolabeled monoclonal antifibrin antibody 59D8 (specific for fibrin but not fibrinogen) to a series of degraded fibrin clots showed that the availability of the B beta(15-21) epitope (against which 59D8 had been raised) was inversely proportional to the extent of clot lysis. Examination of digest supernatants revealed that the B beta(15-21) epitope was released from clots as a high molecular weight degradation product in the presence of calcium ions but that the generation of low molecular weight peptides occurred in the absence of calcium ions. To address the question of epitope accessibility, we compared levels of fibrin clot binding among four radioactively labeled antibodies: antifibrin monoclonal antibody 59D8, two antifibrinogen monoclonal antibodies that cross-reacted with fibrin, and an affinity-purified polyclonal antifibrinogen antibody. We expected that the antifibrinogen antibodies would show enhanced binding to clots in comparison with the antifibrin antibody. However, the epitope accessibility experiments showed that all four antibody preparations bound fibrin clots at comparable levels. Taken together, these studies demonstrated that one fibrin-specific epitope, B beta(15-21), remains available on clots as they undergo degradation by plasmin and, importantly, that the epitope is not solubilized at a rate faster than the rate at which the clot is itself solubilized. The availability of the B beta(15-21) epitope during the course of plasminolysis assures the potential utility of antifibrin antibodies such as 59D8 for detecting thrombi and targeting plasminogen activators.

  19. Role of plasma-rich fibrin in oral surgery

    Science.gov (United States)

    Kumar, K. Retna; Genmorgan, K.; Abdul Rahman, S. M.; Rajan, M. Alaguvel; Kumar, T. Arul; Prasad, V. Srinivas

    2016-01-01

    Platelet-rich fibrin (PRF) is a fibrin meshwork, in which platelet cytokines, growth factors, and cells are entrapped and discharged after a period and can serve as a resorbable film. PRF is the next generation of platelet concentrates equipped to improve arrangement without biochemical blood handling; PRF is an evolution of the fibrin adhesive, which is widely used in the oral surgery. The guidelines of this innovation depend on concentrating platelets and growth factors in a plasma medium, and initiating them in a fibrin gel, keeping in mind the end goal to enhance the healing of wounds. Maxillary bone loss requires numerous regenerative techniques: as a supplement to the procedures of tissue regeneration, a platelet concentrate called PRF was tested for the 1st time in France by Dr. Choukroun. This article enriches the benefits and role of plasma-rich fibrin in oral surgery. Platelet-concentrate fibrin is an evolution of the fibrin glue, which is widely used in the oral surgery. PMID:27829743

  20. Role of plasma-rich fibrin in oral surgery

    Directory of Open Access Journals (Sweden)

    K Retna Kumar

    2016-01-01

    Full Text Available Platelet-rich fibrin (PRF is a fibrin meshwork, in which platelet cytokines, growth factors, and cells are entrapped and discharged after a period and can serve as a resorbable film. PRF is the next generation of platelet concentrates equipped to improve arrangement without biochemical blood handling; PRF is an evolution of the fibrin adhesive, which is widely used in the oral surgery. The guidelines of this innovation depend on concentrating platelets and growth factors in a plasma medium, and initiating them in a fibrin gel, keeping in mind the end goal to enhance the healing of wounds. Maxillary bone loss requires numerous regenerative techniques: as a supplement to the procedures of tissue regeneration, a platelet concentrate called PRF was tested for the 1st time in France by Dr. Choukroun. This article enriches the benefits and role of plasma-rich fibrin in oral surgery. Platelet-concentrate fibrin is an evolution of the fibrin glue, which is widely used in the oral surgery.

  1. Predictive factors for anterior chamber fibrin formation after vitreoretinal surgery

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    Leonardo Provetti Cunha

    2014-04-01

    Full Text Available Purpose: The aim of this study was to investigate possible predictive factors related to anterior chamber fibrin formation after vitreoretinal surgery in a large series of patients. Methods: The data of 185 eyes of 185 patients submitted to vitreoretinal surgery was reviewed. The following variables were evaluated: the postoperatively presence of fibrin, age, diabetes mellitus, the vitrectomy system gauge (20, 23 or 25 gauge, the type of vitreous substitute, the influence of prior surgical procedures and the combination with cataract extraction. To evaluate predictive factors for anterior chamber fibrin formation, univariate analysis was performed. A multivariate stepwise logistic regression model was adjusted to investigate factors associated with fibrin formation (p<0.05. Results: Fibrinoid anterior chamber reaction was found in 12 (6.4% patients. For multivariate logistic regression analysis, balanced salt solution (BSS, the chance of fibrin occurrence was 5 times greater (odds ratio 4.83, CI 95% 1.302 - 17.892; p=0.019, while combination with phacoemulsification increased the chance of fibrin formation by 20 times (odds ratio 20, CI 95% 2.480 - 161.347; p=0.005. No significant difference was found regarding other variables. Conclusion: Anterior chamber fibrin formation is an unwanted complication after vitreoretinal surgery. Factors such as combined performance of phacoemulsification and the use of balanced salt solution as a vitreous substitute may predispose the occurrence of this complication.

  2. Tumour imaging by the detection of fibrin clots in tumour stroma using an anti-fibrin Fab fragment.

    Science.gov (United States)

    Obonai, Toshifumi; Fuchigami, Hirobumi; Furuya, Fumiaki; Kozuka, Naoyuki; Yasunaga, Masahiro; Matsumura, Yasuhiro

    2016-01-01

    The diagnosis of early and aggressive types of cancer is important for providing effective cancer therapy. Cancer-induced fibrin clots exist only within lesions. Previously, we developed a monoclonal antibody (clone 102-10) that recognizes insoluble fibrin but not fibrinogen or soluble fibrin and confirmed that fibrin clots form continuously in various cancers. Here, we describe the development of a Fab fragment probe of clone 102-10 for tumour imaging. The distribution of 102-10 Fab was investigated in genetically engineered mice bearing pancreatic ductal adenocarcinoma (PDAC), and its effect on blood coagulation was examined. Immunohistochemical and ex vivo imaging revealed that 102-10 Fab was distributed selectively in fibrin clots in PDAC tumours 3 h after injection and that it disappeared from the body after 24 h. 102-10 Fab had no influence on blood coagulation or fibrinolysis. Tumour imaging using anti-fibrin Fab may provide a safe and effective method for the diagnosis of invasive cancers by detecting fibrin clots in tumour stroma.

  3. High-density cholesterol and apolipoprotein AI as modifiers of plasma fibrin clot properties in apparently healthy individuals.

    Science.gov (United States)

    Ząbczyk, Michał; Hońdo, Łukasz; Krzek, Marzena; Undas, Anetta

    2013-01-01

    Low high-density lipoprotein cholesterol (HDL-C) increases cardiovascular risk, whereas its high levels protect against atherosclerosis via multiple beneficial effects. Dense and poorly lysable fibrin clot formation is observed in cardiovascular disease. We sought to investigate whether HDL-C and its major component apolipoprotein A (Apo A)-I affect fibrin clot properties. In 136 apparently healthy individuals (99 men, 37 women, aged 49-69 years) we determined plasma fibrin clot permeability (Ks coefficient) and lysis time (t50%) together with Apo A-I and lipoprotein (a) [Lp(a)] levels. The median HDL-C level was 1.33  mmol/l (range from 0.77 to 2.19  mmol/l). HDL-C was positively associated with Apo A-I (r = 0.62, P Ks (r = 0.52, P Ks and t50% were associated with Lp(a) (r = -0.42, P Ks (P = 0.00016) and 17% shorter t50% (P = 0.0012) than the remainder. After adjustment for age, fibrinogen, and Lp(a), HDL-C was the independent predictor of Ks (β = 0.7, P < 0.00001) and t50% (β = -0.62, P < 0.00001). This study shows that elevated HDL-C levels are associated with improved fibrin clot permeability and lysis, indicating a novel antithrombotic mechanism underlying the postulated beneficial effects of therapy targeted at HDL-C.

  4. Clinical and morphological evaluation of snake venom derived fibrin glue on the tendon healing in dogs

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    G. C. Ferraro

    2005-12-01

    Full Text Available The aim of this study was to evaluate the effect of snake venom derived fibrin glue on the healing of the deep digital flexor tendon, during three periods. The tendon of the 2nd digit of 30 thoracic limbs of dogs was partially sectioned for glue application. Biopsies were performed 7, 15, and 30 days post surgery for the clinical and morphological study of tendons. Analysis of the results showed that 73.3% of the tendons showed stump retraction and 16.6% moderate to excessive adherence, which affected sliding. There was a significant difference in the number of inflammatory cells among the three studied periods, being the highest on day 15. The morphological analysis revealed a typical tendon healing process with a lower level of inflammation in the acute phase, facilitating the cicatricial maturation phase. Snake venom derived fibrin glue promotes the healing in dog flexor tendon.

  5. [Pterygium surgery and fibrin glue: avoiding dehiscence].

    Science.gov (United States)

    Pérez-Silguero, D; Díaz-Ginory, A; Santana-Rodríguez, C; Pérez-Silguero, M A

    2014-01-01

    The purpose of the study is to evaluate those cases of pterygium surgery with fibrin sealant that produced dehiscence of the graft, and then apply and evaluate the efficacy of a different surgical technique in an attempt eliminate this complication in previously identified cases of high risk. The first phase is a retrospective study of 42 cases of pterygium surgery. In the second phase, the variation in the surgical technique was prospectively used in 14 cases of pterygium surgery. Cases of recurrent pterygium, broad pterygium, and complicated surgery were identified as the groups with a risk of suffering dehiscence of the graft. With the variant applied surgery no dehiscence occurred when using the variation in surgical technique, with no added complications. Copyright © 2012 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.

  6. Altered plasma fibrin clot properties in essential thrombocythemia.

    Science.gov (United States)

    Małecki, Rafał; Gacka, Małgorzata; Kuliszkiewicz-Janus, Małgorzata; Jakobsche-Policht, Urszula; Kwiatkowski, Jacek; Adamiec, Rajmund; Undas, Anetta

    2016-01-01

    Patients with increased thromboembolic risk tend to form denser fibrin clots which are relatively resistant to lysis. We sought to investigate whether essential thrombocythemia (ET) is associated with altered fibrin clot properties in plasma. Ex vivo plasma fibrin clot permeability coefficient (Ks), turbidimetry and clot lysis time (CLT) were measured in 43 consecutive patients with ET (platelet count from 245 to 991 × 10(3)/µL) and 50 control subjects matched for age, sex and comorbidities. Fibrinolysis proteins and inhibitors together with platelet activation markers were determined. Reduced Ks (-38%, p Ks inversely correlated with fibrinogen, PF4 and C-reactive protein. CLT positively correlated only with PAI-1. Patients with ET display prothrombotic plasma fibrin clot phenotype including impaired fibrinolysis, which represents a new prothrombotic mechanism in this disease.

  7. Multivalent viral capsids with internal cargo for fibrin imaging.

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    Allie C Obermeyer

    Full Text Available Thrombosis is the cause of many cardiovascular syndromes and is a significant contributor to life-threatening diseases, such as myocardial infarction and stroke. Thrombus targeted imaging agents have the capability to provide molecular information about pathological clots, potentially improving detection, risk stratification, and therapy of thrombosis-related diseases. Nanocarriers are a promising platform for the development of molecular imaging agents as they can be modified to have external targeting ligands and internal functional cargo. In this work, we report the synthesis and use of chemically functionalized bacteriophage MS2 capsids as biomolecule-based nanoparticles for fibrin imaging. The capsids were modified using an oxidative coupling reaction, conjugating ∼90 copies of a fibrin targeting peptide to the exterior of each protein shell. The ability of the multivalent, targeted capsids to bind fibrin was first demonstrated by determining the impact on thrombin-mediated clot formation. The modified capsids out-performed the free peptides and were shown to inhibit clot formation at effective concentrations over ten-fold lower than the monomeric peptide alone. The installation of near-infrared fluorophores on the interior surface of the capsids enabled optical detection of binding to fibrin clots. The targeted capsids bound to fibrin, exhibiting higher signal-to-background than control, non-targeted MS2-based nanoagents. The in vitro assessment of the capsids suggests that fibrin-targeted MS2 capsids could be used as delivery agents to thrombi for diagnostic or therapeutic applications.

  8. Fibrin sealant use in pilonidal sinus: Systematic review

    Institute of Scientific and Technical Information of China (English)

    Cuneyt Kayaalp; Ismail Ertugrul; Kerem Tolan; Fatih Sumer

    2016-01-01

    AIM: To review the current data about the success rates of fibrin sealant use in pilonidal disease.METHODS: Fibrin sealant can be used for different purposes in pilonidal sinus treatment, such as filling in the sinus tracts, covering the open wound after excision and lay-open treatment, or obliterating the subcutaneous dead space before skin closure. We searched Pubmed, Google-Scholar, Ebsco-Host, clinicaltrials, and Cochrane databases and found nine studies eligible for analysis; these studies included a total of 217 patients(84% male, mean age 24.2 ± 7.8). RESULTS: In cases where fibrin sealant was used to obliterate the subcutaneous dead space, there was no reduction in wound complication rates(9.8% vs 14.6%, P = 0.48). In cases where sealant was used to cover the laid-open area, the wound healing time and patient comfort were reported better than in previous studies(mean 17 d, 88% satisfaction). When fibrin sealant was used to fill the sinus tracts, the recurrence rate was around 20%, despite the highly selected grouping of patients.CONCLUSION: Consequently, using fibrin sealant to decrease the risk of seroma formation was determined to be an ineffective course of action. It was not advisable to fill the sinus tracts with fibrin sealant because it was not superior to other cost-effective and minimally invasive treatments. New comparative studies can be conducted to confirm the results of sealant use in covering the laid-open area.

  9. Fibrin sealant use in pilonidal sinus: Systematic review.

    Science.gov (United States)

    Kayaalp, Cuneyt; Ertugrul, Ismail; Tolan, Kerem; Sumer, Fatih

    2016-03-27

    To review the current data about the success rates of fibrin sealant use in pilonidal disease. Fibrin sealant can be used for different purposes in pilonidal sinus treatment, such as filling in the sinus tracts, covering the open wound after excision and lay-open treatment, or obliterating the subcutaneous dead space before skin closure. We searched Pubmed, Google-Scholar, Ebsco-Host, clinicaltrials, and Cochrane databases and found nine studies eligible for analysis; these studies included a total of 217 patients (84% male, mean age 24.2 ± 7.8). In cases where fibrin sealant was used to obliterate the subcutaneous dead space, there was no reduction in wound complication rates (9.8% vs 14.6%, P = 0.48). In cases where sealant was used to cover the laid-open area, the wound healing time and patient comfort were reported better than in previous studies (mean 17 d, 88% satisfaction). When fibrin sealant was used to fill the sinus tracts, the recurrence rate was around 20%, despite the highly selected grouping of patients. Consequently, using fibrin sealant to decrease the risk of seroma formation was determined to be an ineffective course of action. It was not advisable to fill the sinus tracts with fibrin sealant because it was not superior to other cost-effective and minimally invasive treatments. New comparative studies can be conducted to confirm the results of sealant use in covering the laid-open area.

  10. Platelet-Rich Fibrin: An Autologous Fibrin Matrix in Surgical Procedures: A Case Report and Review of Literature

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    Amir Hossein Nejat

    2011-01-01

    Full Text Available Introduction: The healing process after surgery is a challenging issue for surgeons. Various materials and techniques have been developed to facilitate this process and reduce its period. Fibrin adhesives are often used in cardiothoracic and vascular surgery to seal diffuse microvascular bleeding and in general and plastic surgery to seal wound borders. This Case report and literature review will introduce the various usages of platelet-rich fibrin in different surgical procedures and the method of producing the matrix. Case Report: A 24-year old man with periorbital skin avulsion treated with PRF membrane has been reported and discussed in this paper.  Conclusion: Platelet-rich fibrin is a natural autologous fibrin matrix, which can be produced with a simple blood sample and a table centrifuge. The material has been used in a wide range of surgical procedures to shorten the healing period and reduce post-surgical complications.

  11. Comparison of commercial fibrin sealants in facelift surgery: a prospective study

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    Botti G

    2013-11-01

    Full Text Available Giovanni Botti,1 Michele Pascali,2 Chiara Botti,1 Florian Bodog,3 Pietro Gentile,2 Valerio Cervelli2 1Villa Bella Clinic, Salò, 2Department of Plastic and Reconstructive Surgery, University of Rome Tor Vergata, Italy; 3University of Oradea, Oradea, Romania Background: The aim of this study was to compare the effects of two types of fibrin glue in patients undergoing facelift surgery. Methods: A prospective, controlled "right-left side" study was carried out in 20 patients. The two fibrin sealants used were Quixil® and Tissucol®. The two sealants were used at the same time, ie, one on one side of the face and the other on the contralateral side. Comparisons were made with regard to rates of hematoma and seroma, degree of induration, edema, ecchymosis, pain levels, and patient satisfaction. Results: The results were almost equivalent. The only exception was a significant (40 mL hematoma in a patient treated with Quixil. Bleeding was most likely due to a sudden rise in blood pressure during the immediate postoperative period. However, it must be emphasized that, while Tissucol actually seals the undermined area, thus virtually eliminating the dead space, Quixil acts differently, in that its effectiveness in preventing hematoma is linked mainly to its hemostatic effect. Conclusion: The two fibrin sealants used were nearly identical with regard to patient safety and quality of the result. Nevertheless, it is noted that, while Tissucol has both hemostatic and "gluing" effects, Quixil is mainly effective in securing hemostasis. Keywords: facelift surgery, rhytidectomy, fibrin sealants, hematoma

  12. Role of plasma-derived fibrin on keratinocyte and fibroblast wound healing.

    Science.gov (United States)

    Law, Jia Xian; Chowdhury, Shiplu Roy; Aminuddin, Bin Saim; Ruszymah, Binti Haji Idrus

    2017-07-26

    Fibrin has excellent biocompatibility and biological properties to support tissue regeneration and promote wound healing. However, the role of diluted fibrin in wound healing has yet to be elucidated as it is commonly used in high concentration. This study was aimed to examine the effects of diluted plasma-derived fibrin (PDF) on keratinocyte and fibroblast wound healing in term of cell proliferation, migration, extracellular matrix (ECM) production and soluble factor secretion. Two PDF concentrations, 10 and 20% (v/v) were tested on keratinocytes and fibroblasts indirectly co-cultured in the transwell system. The control group was cultured with 5% FBS. Results showed that PDF reduced the keratinocyte growth rate and fibroblast migration, and increased the fibroblast ECM gene expression whereby significant differences were found between the 20% PDF group and the 5% FBS group. Similar trend was seen for the 10% PDF group but the differences were not significant. Comparison of the soluble factors between the PDF groups demonstrated that the level of growth-related oncogene alpha, interleukin-8 and epithelial neutrophil-activating peptide-78 were significantly higher in the 10% PDF group, whilst interleukin-1 alpha and granulocyte-macrophage colony stimulating factor were significantly more concentrated in the 20% PDF group. Our results suggested that PDF selectively elevated the expression of collagen type 1 and collagen type 3 in fibroblasts but slowed down the migration in concentration-dependent manner. These novel findings provide new insight into the role of PDF in wound healing and may have important implications for the use of fibrin in skin tissue engineering.

  13. Sensitivität des D-Dimers zum Ausschluß venöser thromboembolischer Erkrankungen im klinischen Alltag

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    Lohr G

    2007-01-01

    (falsch negative Rate 1,3 %. Die Sensitivität betrug hier 98,7 %. In unserer Arbeit zeigen sich im Vergleich D-Dimere alleine und Kombination D-Dimertest/KW mit verschiedenen Scoresystemen zwar nicht signifikante Unterschiede in den falsch negativen Ergebnissen, bei allerdings geringer Fallzahl. Die falsch negative Rate von 3,8 % bei alleiniger D-Dimertestung ist bei diesen potentiell tödlichen Erkrankungen hoch. Die Sensitivität und die Sicherheit der Ausschlußdiagnostik kann durch den Einsatz von Scoresystemen in Kombination mit D-Dimertests, die nicht invasiv sind, erhöht werden, und somit eine einfache, leicht durchzuführende und optimale Ergänzung darstellen.

  14. Fibrin glue mixed with platelet-rich fibrin as a scaffold seeded with dental bud cells for tooth regeneration.

    Science.gov (United States)

    Yang, Kai-Chiang; Wang, Chun-Hao; Chang, Hao-Hueng; Chan, Wing P; Chi, Chau-Hwa; Kuo, Tzong-Fu

    2012-11-01

    Odontogenesis is a complex process with a series of epithelial-mesenchymal interactions and odontogenic molecular cascades. In tissue engineering of teeth from stem cells, platelet-rich fibrin (PRF), which is rich in growth factors and cytokines, may improve regeneration. Accordingly, PRF was added into fibrin glue to enrich the microenvironment with growth factors. Unerupted second molar tooth buds were harvested from miniature swine and cultured in vitro for 3 weeks to obtain dental bud cells (DBCs). Whole blood was collected for the preparation of PRF and fibrin glue before surgery. DBCs were suspended in fibrin glue and then enclosed with PRF, and the DBC-fibrin glue-PRF composite was autografted back into the original alveolar sockets. Radiographic and histological examinations were used to identify the regenerated tooth structure 36 weeks after implantation. Immunohistochemical staining was used to detect proteins specific to tooth regeneration. One pig developed a complete tooth with crown, root, pulp, enamel, dentin, odontoblast, cementum, blood vessels, and periodontal ligaments in indiscriminate shape. Another animal had an unerupted tooth that expressed cytokeratin 14, dentin matrix protein-1, vascular endothelial growth factor, and osteopontin. This study demonstrated, using autogenic cell transplantation in a porcine model, that DBCs seeded into fibrin glue-PRF could regenerate a complete tooth.

  15. 妊娠高血压患者与D-二聚体、维生素B12、血清同型半胱氨酸的关系%The relationship between pregnancy-induced hypertension and D-dimer, vitamin B12 and serum homocysteine

    Institute of Scientific and Technical Information of China (English)

    俞小飞; 徐燕; 张梦

    2015-01-01

    目的:探讨不同孕期孕妇D-二聚体(D-D)、维生素B12、血清同型半胱氨酸(HCY)与妊娠高血压疾病(PIH)之间的关系。方法:选取在我院进行产检的孕妇287例为研究对象,其中PIH孕妇86例,正常妊娠孕妇201例,根据孕期对不同孕妇血清D-D、维生素B12、HCY水平进行检测。结果:PIH组与正常妊娠组比较,孕中期及孕晚期血清HCY水平与D-D水平明显升高(P<0.05),且在孕中期及孕晚期,PIH组及正常妊娠组孕妇血清HCY水平与D-D水平呈正相关,而与维生素B12均无相关性。结论:在孕中晚期进行HCY水平及D-D水平检测可作为预测PIH的一个重要的危险因素。%Objective:To evaluate the Relationship between the serum levels of homocysteine, D-dimer, vitamin B12 and pregnancy-induced hypertension in different pregnancies. Methods:287 pregnant women who registered for prenatal examination of pregnant in the hospital were selected as research subjects. And there were 86 cases of PIH and 201 cases of normal pregnancy among them. The serum levels of homocysteine, D-dimer, vitamin B12 were detected according to different pregnancy.Results:Compared with normal pregnancy group, the serum HCY and D-D level of PIH group significantly increased in medium and late pregnancy periods (P0.05). Conclusions:n middle and late pregnancy periods, to detect the levels of HCY and D-D be an improtant risk factor of PIH.

  16. 高压氧联合神经节苷脂对脑出血患者凝血酶、血清髓鞘碱性蛋白、D-二聚体的影响%Effect of hyperbaric oxygen combined with ganglion glycosides on thrombin, serum myelin basic protein and D-dimer in patients with intracerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    陈伟; 王茂德; 王宁; 鲍刚; 王拓

    2016-01-01

    Objective To observe the effect of hyperbaric oxygen combined with ganglion glycosides on thrombin, se-rum myelin basic protein and D-dimer in patients with intracerebral hemorrhage.Methods Selected from June 2014 to June 2015, 100 cases of cerebral hemorrhage patients in Xi'an Jiaotong University First Affiliated Hospital neurosurgery department as the research object, according to the order of admission, they were randomly divided into control group and observation group, each group of 50 cases, on the basis of conventional therapy patients in control group were treated with ganglioside treatment, the observation group given hyperbaric oxygen combined with ganglioside treatment.Before and after treatment, thrombin, serum myelin basic protein, D-dimer, hematoma volume, neurological function defect score ( NIHSS) , daily life a-bility score ( ADL) were observed, and the clinical effect was evaluated.Results Before treatment, 2 groups of thrombin, serum myelin basic protein ( MBP) , D-dimer, volume of hematoma, NIHSS and ADL score differences had no statistical sig-nificance ( P >0.05), after treatment, two groups of thrombin, serum myelin basic protein (MBP), D-dimer, hematoma volume and NIHSS score compared with those before treatment were significantly decreased ( P <0.05), ADL score before treatment were significantly higher ( P <0.05) , and the observation group was more obvious than that of the control group, the above indicators improved ( P <0.05).The control group cured rate, significant progress rate, improvement rate were 24.00%, 36.00%, 24.00%, the observation group were 30.00%and 40.00%, 24.00%observed group, the total efficien-cy is remarkably higher than that of the control group (94.00%vs.84.00%,χ2 =3.55, P <0.05).Conclusion Hyperbaric oxygen combined with ganglion glycosides can reduce the level of thrombin, serum myelin basic protein and D-dimer levels in patients with cerebral hemorrhage,and improve the therapeutic effect.%目的:观察高压

  17. Fibrin clot structure and platelet aggregation in patients with aspirin treatment failure.

    Directory of Open Access Journals (Sweden)

    Søs Neergaard-Petersen

    Full Text Available BACKGROUND: Aspirin is a cornerstone in prevention of cardiovascular events and modulates both platelet aggregation and fibrin clot formation. Some patients experience cardiovascular events whilst on aspirin, often termed aspirin treatment failure (ATF. This study evaluated both platelet aggregation and fibrin clot structure in patients with ATF. METHODS: We included 177 stable coronary artery disease patients on aspirin monotherapy. Among these, 116 (66% had ATF defined as myocardial infarction (MI whilst on aspirin. Platelet aggregation was assessed by Multiplate® aggregometry and VerifyNow®, whereas turbidimetric assays and scanning electron microscopy were employed to study fibrin clot characteristics. RESULTS: Enhanced platelet aggregation was observed in patients with ATF compared with non-MI patients following stimulation with arachidonic acid 1.0 mM (median 161 (IQR 95; 222 vs. 97 (60; 1776 AU*min, p = 0.005 and collagen 1.0 µg/mL (293 (198; 427 vs. 220 (165; 370 AU*min, p = 0.03. Similarly, clot maximum absorbance, a measure of fibrin network density, was increased in patients with ATF (0.48 (0.41; 0.52 vs. 0.42 (0.38; 0.50, p = 0.02, and this was associated with thinner fibres (mean ± SD: 119.7±27.5 vs. 127.8±31.1 nm, p = 0.003 and prolonged lysis time (552 (498; 756 vs. 519 (468; 633 seconds; p = 0.02. Patients with ATF also had increased levels of C-reactive protein (CRP (1.34 (0.48; 2.94 and 0.88 (0.32; 1.77 mg/L, p = 0.01 compared with the non-MI group. Clot maximum absorbance correlated with platelet aggregation (r = 0.31-0.35, p-values<0.001 and CRP levels (r = 0.60, p<0.001. CONCLUSIONS: Patients with aspirin treatment failure showed increased platelet aggregation and altered clot structure with impaired fibrinolysis compared with stable CAD patients without previous MI. These findings suggest that an increased risk of aspirin treatment failure may be identified by measuring both platelet

  18. Fibronectin alters the rate of formation and structure of the fibrin matrix.

    Science.gov (United States)

    Ramanathan, Anand; Karuri, Nancy

    2014-01-10

    Plasma fibronectin is a vital component of the fibrin clot; however its role on clot structure is not clearly understood. The goal of this study was to examine the influence of fibronectin on the kinetics of formation, structural characteristics and composition of reconstituted fibrin clots or fibrin matrices. Fibrin matrices were formed by adding thrombin to 1, 2 or 4 mg/ml fibrinogen supplemented with 0-0.4 mg/ml fibronectin. The rate of fibrin matrix formation was then monitored by measuring light absorbance properties at different time points. Confocal microscopy of fluorescein conjugated fibrinogen was used to visualize the structural characteristics of fibrin matrices. The amount of fibronectin in fibrin matrices was determined through electrophoresis and immunoblotting of solubilized matrices. Fibronectin concentration positively correlated with the initial rate of fibrin matrix formation and with steady state light absorbance values of fibrin matrices. An increase in fibronectin concentration resulted in thinner and denser fibers in the fibrin matrices. Electrophoresis and immunoblotting showed that fibronectin was covalently and non-covalently bound to fibrin matrices and in the form of high molecular weight multimers. The formation of fibronectin multimers was attributed to cross-linking of fibronectin by trace amounts Factor XIIIa. These findings are novel because they link results from light absorbance studies to microcopy analyses and demonstrate an influence of fibronectin on fibrin matrix structural characteristics. This data is important in developing therapies that destabilize fibrin clots.

  19. A CCR2 macrophage endocytic pathway mediates extravascular fibrin clearance in vivo

    Science.gov (United States)

    Motley, Michael P.; Madsen, Daniel H.; Jürgensen, Henrik J.; Spencer, David E.; Szabo, Roman; Holmbeck, Kenn; Flick, Matthew J.; Lawrence, Daniel A.; Castellino, Francis J.; Weigert, Roberto

    2016-01-01

    Extravascular fibrin deposition accompanies many human diseases and causes chronic inflammation and organ damage, unless removed in a timely manner. Here, we used intravital microscopy to investigate how fibrin is removed from extravascular space. Fibrin placed into the dermis of mice underwent cellular endocytosis and lysosomal targeting, revealing a novel intracellular pathway for extravascular fibrin degradation. A C-C chemokine receptor type 2 (CCR2)-positive macrophage subpopulation constituted the majority of fibrin-uptaking cells. Consequently, cellular fibrin uptake was diminished by elimination of CCR2-expressing cells. The CCR2-positive macrophage subtype was different from collagen-internalizing M2-like macrophages. Cellular fibrin uptake was strictly dependent on plasminogen and plasminogen activator. Surprisingly, however, fibrin endocytosis was unimpeded by the absence of the fibrin(ogen) receptors, αMβ2 and ICAM-1, the myeloid cell integrin-binding site on fibrin or the endocytic collagen receptor, the mannose receptor. The study identifies a novel fibrin endocytic pathway engaged in extravascular fibrin clearance and shows that interstitial fibrin and collagen are cleared by different subsets of macrophages employing distinct molecular pathways. PMID:26647393

  20. Failure mechanisms of fibrin-based surgical tissue adhesives

    Science.gov (United States)

    Sierra, David Hugh

    A series of studies was performed to investigate the potential impact of heterogeneity in the matrix of multiple-component fibrin-based tissue adhesives upon their mechanical and biomechanical properties both in vivo and in vitro. Investigations into the failure mechanisms by stereological techniques demonstrated that heterogeneity could be measured quantitatively and that the variation in heterogeneity could be altered both by the means of component mixing and delivery and by the formulation of the sealant. Ex vivo tensile adhesive strength was found to be inversely proportional to the amount of heterogeneity. In contrast, in vivo tensile wound-closure strength was found to be relatively unaffected by the degree of heterogeneity, while in vivo parenchymal organ hemostasis in rabbits was found to be affected: greater heterogeneity appeared to correlate with an increase in hemostasis time and amount of sealant necessary to effect hemostasis. Tensile testing of the bulk sealant showed that mechanical parameters were proportional to fibrin concentration and that the physical characteristics of the failure supported a ductile mechanism. Strain hardening as a function of percentage of strain, and strain rate was observed for both concentrations, and syneresis was observed at low strain rates for the lower fibrin concentration. Blister testing demonstrated that burst pressure and failure energy were proportional to fibrin concentration and decreased with increasing flow rate. Higher fibrin concentration demonstrated predominately compact morphology debonds with cohesive failure loci, demonstrating shear or viscous failure in a viscoelastic rubbery adhesive. The lower fibrin concentration sealant exhibited predominately fractal morphology debonds with cohesive failure loci, supporting an elastoviscous material condition. The failure mechanism for these was hypothesized and shown to be flow-induced ductile fracture. Based on these findings, the failure mechanism was

  1. Ultrastructural changes to rabbit fibrin and platelets due to aspartame.

    Science.gov (United States)

    Pretorius, E; Humphries, P

    2007-01-01

    The coagulation process, including thrombin, fibrin, as well as platelets, plays an important role in hemostasis, contributing to the general well-being of humans. Fibrin formation and platelet activation are delicate processes that are under the control of many small physiological events. Any one of these many processes may be influenced or changed by external factors, including pharmaceutical or nutritional products, e.g., the sweetener aspartame (L-aspartyl-L-phenylalanine methyl ester). It is known that phenylalanine is present at position P(9) and aspartate at position P(10) of the alpha-chain of human fibrinogen, and plays an important role in the conversion of fibrinogen to fibrin by the catalyst alpha-thrombin. The authors investigate the effect of aspartame on platelet and fibrin ultrastructure, by using the rabbit animal model and the scanning electron microscope. Animals were exposed to 34 mg/kg of aspartame 26x during a 2-month period. Aspartame-exposed fibrin networks appeared denser, with a thick matted fine fiber network covering thick major fibers. Also, the platelet aggregates appeared more granular than the globular control platelet aggregates. The authors conclude by suggesting that aspartame usage may interfere with the coagulation process and might cause delayed fibrin breakup after clot formation. They suggest this, as the fibrin networks from aspartame-exposed rabbits are more complex and dense, due to the netlike appearance of the minor, thin fibers. Aspartame usage should possibly be limited by people on anti-clotting medicine or those with prone to clot formation.

  2. Calix[4]arene methylenebisphosphonic acids as inhibitors of fibrin polymerization.

    Science.gov (United States)

    Lugovskoy, Eduard V; Gritsenko, Pavel G; Koshel, Tatyana A; Koliesnik, Ievgen O; Cherenok, Serhey O; Kalchenko, Olga I; Kalchenko, Vitaliy I; Komisarenko, Serhey V

    2011-04-01

    Calix[4]arenes bearing two or four methylenebisphosphonic acid groups at the macrocyclic upper rim have been studied with respect to their effects on fibrin polymerization. The most potent inhibitor proved to be calix[4]arene tetrakis-methylene-bis-phosphonic acid (C-192), in which case the maximum rate of fibrin polymerization in the fibrinogen + thrombin reaction decreased by 50% at concentrations of 0.52 × 10(-6) M (IC(50)). At this concentration, the molar ratio of the compound to fibrinogen was 1.7 : 1. For the case of desAABB fibrin polymerization, the IC(50) was 1.26 × 10(-6) M at a molar ratio of C-192 to fibrin monomer of 4 : 1. Dipropoxycalix[4]arene bis-methylene-bis-phosphonic acid (C-98) inhibited fibrin desAABB polymerization with an IC(50) = 1.31 × 10(-4) M. We hypothesized that C-192 blocks fibrin formation by combining with polymerization site 'A' (Aα17-19), which ordinarily initiates protofibril formation in a 'knob-hole' manner. This suggestion was confirmed by an HPLC assay, which showed a host-guest inclusion complex of C-192 with the synthetic peptide Gly-Pro-Arg-Pro, an analogue of site 'A'. Further confirmation that the inhibitor was acting at the initial step of the reaction was obtained by electron microscopy, with no evidence of protofibril formation being evident. Calixarene C-192 also doubled both the prothrombin time and the activated partial thromboplastin time in normal human blood plasma at concentrations of 7.13 × 10(-5) M and 1.10 × 10(-5) M, respectively. These experiments demonstrate that C-192 is a specific inhibitor of fibrin polymerization and blood coagulation and can be used for the design of a new class of antithrombotic agents.

  3. Platelet rich fibrin in jaw defects

    Science.gov (United States)

    Nica, Diana; Ianes, Emilia; Pricop, Marius

    2016-03-01

    Platelet rich fibrin (PRF) is a tissue product of autologous origin abundant in growth factors, widely used in regenerative procedures. Aim of the study: Evaluation of the regenerative effect of PRF added in the bony defects (after tooth removal or after cystectomy) Material and methods: The comparative nonrandomized study included 22 patients divided into 2 groups. The first group (the test group) included 10 patients where the bony defects were treated without any harvesting material. The second group included 12 patients where the bony defects were filled with PRF. The bony defect design was not critical, with one to two walls missing. After the surgeries, a close clinically monitoring was carried out. The selected cases were investigated using both cone beam computer tomography (CBCT) and radiographic techniques after 10 weeks postoperatively. Results: Faster bone regeneration was observed in the bony defects filled with PRF comparing with the not grafted bony defects. Conclusions: PRF added in the bony defects accelerates the bone regeneration. This simplifies the surgical procedures and decreases the economic costs.

  4. Relationship between serum biomarkers of procalcitonin, lactate, D-dimer and disease severity in sepsis children%降钙素原、乳酸、D-二聚体水平与脓毒血症患儿病情的关系

    Institute of Scientific and Technical Information of China (English)

    汪江萍; 刘自光; 郭彩云

    2013-01-01

    Objective To explore the relationship between serum biomarkers of procalcitonin (PCT),lactate,D-dimer and disease severity in sepsis children.Methods 86 cases of sepsis were reviewed from January 2008 to January 2013.86 cases of sepsis were classified as early sepsis group,severe sepsis group and septic shock group.Patients were divided into survival group and death group according to their outcome.Serum biomarkers of PCT,lactate and D-dimer were measured and were analyzed their correlation with the prognosis of critically ill children according to pediatric critical illness score (PCIS).Results There were significantly difference on the level of three biomarkers in early sepsis group,severe sepsis group and septic shock group (P<0.05).There were significantly negative correction on the survival group and death group with PCIS (P<0.05).Conclusions The joint detection of serum biomarkers of PCT,lactate and D-dimer has guiding significance in the early diagnosis for children sepsis.Children with higher PCT,lactate and D-dimerin levels and lower PCIS were worse and had poorer prognosis.%目的 探讨血降钙素原(PCT)、乳酸和D-二聚体3种生物标记物评估脓毒血症患儿病情严重程度及预后的临床价值.方法 收集2008年1月至2013年1月86例脓毒血症患儿的临床资料,将其按病情严重程度分为早期脓毒症组、严重脓毒症组和脓毒症休克组;回顾性研究则将所有患儿根据预后分为生存组及死亡组.分别比较各组患儿血降钙素原、乳酸、D-二聚体水平和小儿危重病例评分(PCIS),观察血降钙素原、乳酸、D-二聚体3种标记物水平评估病情严重程度及预后的临床价值.结果 不同严重程度的脓毒血症的3组患儿中,3种标记物水平及PCIS比较差异均有统计学意义(P<0.05).生存组患儿血降钙素原、乳酸、D-二聚体水平和PCIS与死亡组比较差异均有统计学意义(P<0.05),且呈负相关关系.结论 血降钙素原

  5. Three-dimensional culture of single embryonic stem-derived neural/stem progenitor cells in fibrin hydrogels: neuronal network formation and matrix remodelling.

    Science.gov (United States)

    Bento, Ana R; Quelhas, Pedro; Oliveira, Maria J; Pêgo, Ana P; Amaral, Isabel F

    2016-12-29

    In an attempt to improve the efficacy of neural stem/progenitor cell (NSPC) based therapies, fibrin hydrogels are being explored to provide a favourable microenvironment for cell survival and differentiation following transplantation. In the present work, the ability of fibrin to support the survival, proliferation, and neuronal differentiation of NSPCs derived from embryonic stem (ES) cells under monolayer culture was explored. Single mouse ES-NSPCs were cultured within fibrin (fibrinogen concentration: 6 mg/ml) under neuronal differentiation conditions up to 14 days. The ES-NSPCs retained high cell viability and proliferated within small-sized spheroids. Neuronal differentiation was confirmed by an increase in the levels of βIII-tubulin and NF200 over time. At day 14, cell-matrix constructs mainly comprised NSPCs and neurons (46.5% βIII-tubulin(+) cells). Gamma-aminobutyric acid (GABA)ergic and dopaminergic/noradrenergic neurons were also observed, along with a network of synaptic proteins. The ES-NSPCs expressed matriptase and secreted MMP-2/9, with MMP-2 activity increasing along time. Fibronectin, laminin and collagen type IV deposition was also detected. Fibrin gels prepared with higher fibrinogen concentrations (8/10 mg/ml) were less permissive to neurite extension and neuronal differentiation, possibly owing to their smaller pore area and higher rigidity. Overall, it is shown that ES-NSPCs within fibrin are able to establish neuronal networks and to remodel fibrin through MMP secretion and extracellular matrix (ECM) deposition. This three-dimensional (3D) culture system was also shown to support cell viability, neuronal differentiation and ECM deposition of human ES-NSPCs. The settled 3D platform is expected to constitute a valuable tool to develop fibrin-based hydrogels for ES-NSPC delivery into the injured central nervous system. Copyright © 2016 John Wiley & Sons, Ltd.

  6. Comparison of PCT, CRP, D-Dimer, Lactate, TNF-α, IL-1β, IL-6 and lL-10 in Development of Systemic Inflammatory Response Syndrome and Sepsis on Patients with Isolated Head Trauma and Polytrauma

    Directory of Open Access Journals (Sweden)

    Emine Dağlı

    2012-12-01

    Full Text Available Objective: In this study, it was aimed to compare the relationship between Glasgow Coma Scale (GKS, ISS values, PCT, CRP, D-Dimer, laktat, TNF-α, IL-1β, IL-6, IL-10 in patients with polytrauma and isolated head trauma in conjunction with SIRS and sepsis. Material and Method: Total of 68 patients (32 polytrauma, 36 isolated head trauma aged between 18-65 years were enrolled in the study. For 7 days of follow up, the biochemical parameters were analysed on the days 0, 1, 3, 5, 7 and the ISS, GCS score and growth rates of SIRS and sepsis were recorded. Results: It was demonstrated that for patients with isolated head trauma, SIRS (80.6%, sepsis (38.9% and mortality values (71.4% were higher and there is a statistically important linear and inverse relationship between ISS and GCS values (p<0.05. During sepsis and SIRS phases, CRP elevated in both groups, whereas PCT only in the polytrauma group. D-Dimer values were investigated high in both groups, but atypically decreased on day 3 in isolated head trauma group. Lactate, TNF-α and, IL-1β were within reference values, IL-6 and IL-10 values were elevated in both groups but were higher in the polytrauma group. Conclusion: Although multiple variations were detected in serum markers of pro-inflamatory and acute phase proteins, we thought that these are inadequate in predicting mortality and complications such as SIRS and sepsis.

  7. Fibrin clot structure and platelet aggregation in patients with aspirin treatment failure.

    Science.gov (United States)

    Neergaard-Petersen, Søs; Ajjan, Ramzi; Hvas, Anne-Mette; Hess, Katharina; Larsen, Sanne Bøjet; Kristensen, Steen Dalby; Grove, Erik Lerkevang

    2013-01-01

    Aspirin is a cornerstone in prevention of cardiovascular events and modulates both platelet aggregation and fibrin clot formation. Some patients experience cardiovascular events whilst on aspirin, often termed aspirin treatment failure (ATF). This study evaluated both platelet aggregation and fibrin clot structure in patients with ATF. We included 177 stable coronary artery disease patients on aspirin monotherapy. Among these, 116 (66%) had ATF defined as myocardial infarction (MI) whilst on aspirin. Platelet aggregation was assessed by Multiplate® aggregometry and VerifyNow®, whereas turbidimetric assays and scanning electron microscopy were employed to study fibrin clot characteristics. Enhanced platelet aggregation was observed in patients with ATF compared with non-MI patients following stimulation with arachidonic acid 1.0 mM (median 161 (IQR 95; 222) vs. 97 (60; 1776) AU*min, p = 0.005) and collagen 1.0 µg/mL (293 (198; 427) vs. 220 (165; 370) AU*min, p = 0.03). Similarly, clot maximum absorbance, a measure of fibrin network density, was increased in patients with ATF (0.48 (0.41; 0.52) vs. 0.42 (0.38; 0.50), p = 0.02), and this was associated with thinner fibres (mean ± SD: 119.7±27.5 vs. 127.8±31.1 nm, p = 0.003) and prolonged lysis time (552 (498; 756) vs. 519 (468; 633) seconds; p = 0.02). Patients with ATF also had increased levels of C-reactive protein (CRP) (1.34 (0.48; 2.94) and 0.88 (0.32; 1.77) mg/L, p = 0.01) compared with the non-MI group. Clot maximum absorbance correlated with platelet aggregation (r = 0.31-0.35, p-valuesaspirin treatment failure showed increased platelet aggregation and altered clot structure with impaired fibrinolysis compared with stable CAD patients without previous MI. These findings suggest that an increased risk of aspirin treatment failure may be identified by measuring both platelet function and fibrin clot structure.

  8. Platelet rich fibrin and xenograft in treatment of intrabony defect

    Directory of Open Access Journals (Sweden)

    Saurav Panda

    2014-01-01

    Full Text Available For complete periodontal regeneration, delivery of growth factors in the local environment holds a great deal in adjunct to bone grafts. Platelet rich fibrin (PRF is considered as second generation platelet concentrate, consisting of viable platelets, releasing various growth factors such as platelet-derived growth factor, vascular endothelial growth factor, transforming growth factor, insulin-like growth factor, epidermal growth factor and basic fibroblast growth factor. Hence, this case report aims to investigate the clinical and radiological (bone fill effectiveness of autologous PRF along with the use of xenogenic bone mineral in the treatment of intra bony defects. Intrabony defect was treated with autologous PRF along with the use of xenogenic bone mineral. A decrease in probing pocket depth, gain in clinical attachment level and significant bone fill was observed at end of 6 months. The result obtained with the use of PRF may be attributed to the sustained and simultaneous release of various growth factors over a period of 7 days. In this case report, the positive clinical impact of additional application of PRF with xenogenic graft material in the treatment of periodontal intrabony defect was seen.

  9. Fibrin sealant fixation of a skin graft in mandibular vestibuloplasty. Case report.

    Science.gov (United States)

    Yaman, Z

    1998-08-01

    Fibrin sealant fixation of a skin graft without the use of sutures or a stent in mandibular vestibuloplasty is presented in this case report. The advantages of the fibrin sealant in preprosthetic surgery are discussed.

  10. Fibrin-fiber architecture influences cell spreading and differentiation.

    Science.gov (United States)

    Bruekers, Stéphanie M C; Jaspers, Maarten; Hendriks, José M A; Kurniawan, Nicholas A; Koenderink, Gijsje H; Kouwer, Paul H J; Rowan, Alan E; T S Huck, Wilhelm

    2016-09-02

    The mechanical and structural properties of the extracellular matrix (ECM) play an important role in regulating cell fate. The natural ECM has a complex fibrillar structure and shows nonlinear mechanical properties, which are both difficult to mimic synthetically. Therefore, systematically testing the influence of ECM properties on cellular behavior is very challenging. In this work we show two different approaches to tune the fibrillar structure and mechanical properties of fibrin hydrogels. Addition of extra thrombin before gelation increases the protein density within the fibrin fibers without significantly altering the mechanical properties of the resulting hydrogel. On the other hand, by forming a composite hydrogel with a synthetic biomimetic polyisocyanide network the protein density within the fibrin fibers decreases, and the mechanics of the composite material can be tuned by the PIC/fibrin mass ratio. The effect of the changes in gel structure and mechanics on cellular behavior are investigated, by studying human mesenchymal stem cell (hMSC) spreading and differentiation on these gels. We find that the trends observed in cell spreading and differentiation cannot be explained by the bulk mechanics of the gels, but correlate to the density of the fibrin fibers the gels are composed of. These findings strongly suggest that the microscopic properties of individual fibers in fibrous networks play an essential role in determining cell behavior.

  11. Laminin-111 enriched fibrin hydrogels for skeletal muscle regeneration.

    Science.gov (United States)

    Marcinczyk, Madison; Elmashhady, Hady; Talovic, Muhamed; Dunn, Andrew; Bugis, Faiz; Garg, Koyal

    2017-10-01

    Laminin (LM)-111 supplementation has improved muscle regeneration in several models of disease and injury. This study investigated a novel hydrogel composed of fibrinogen and LM-111. Increasing LM-111 concentration (50-450 μg/mL) in fibrin hydrogels resulted in highly fibrous scaffolds with progressively thinner interlaced fibers. Rheological testing showed that all hydrogels had viscoelastic behavior and the Young's modulus ranged from 2-6KPa. C2C12 myobalsts showed a significant increase in VEGF production and decrease in IL-6 production on LM-111 enriched fibrin hydrogels as compared to pure fibrin hydrogels on day 4. Western blotting results showed a significant increase in MyoD and desmin protein quantity but a significant decrease in myogenin protein quantity in myoblasts cultured on the LM-111 (450 μg/mL) enriched fibrin hydrogel. Combined application of electromechanical stimulation significantly enhanced the production of VEGF and IGF-1 from myoblast seeded fibrin-LM-111 hydrogels. Taken together, these observations offer an important first step toward optimizing a tissue engineered constructs for skeletal muscle regeneration. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. Effect of collagen sponge and fibrin glue on bone repair

    Directory of Open Access Journals (Sweden)

    Thiago de Santana SANTOS

    2015-12-01

    Full Text Available ABSTRACT The ability of hemostatic agents to promote bone repair has been investigated using in vitro and in vivo models but, up to now, the results are inconclusive. Objective In this context, the aim of this study was to compare the potential of bone repair of collagen sponge with fibrin glue in a rat calvarial defect model. Material and Methods Defects of 5 mm in diameter were created in rat calvariae and treated with either collagen sponge or fibrin glue; untreated defects were used as control. At 4 and 8 weeks, histological analysis and micro-CT-based histomorphometry were carried out and data were compared by two-way ANOVA followed by Student-Newman-Keuls test when appropriated (p≤0.05. Results Three-dimensional reconstructions showed increased bone formation in defects treated with either collagen sponge or fibrin glue compared with untreated defects, which was confirmed by the histological analysis. Morphometric parameters indicated the progression of bone formation from 4 to 8 weeks. Additionally, fibrin glue displayed slightly higher bone formation rate when compared with collagen sponge. Conclusion Our results have shown the benefits of using collagen sponge and fibrin glue to promote new bone formation in rat calvarial bone defects, the latter being discreetly more advantageous.

  13. Phase-separated chitosan-fibrin microbeads for cell delivery.

    Science.gov (United States)

    Chen, Zhewei; Wang, Limin; Stegemann, Jan P

    2011-01-01

    Matrix-enhanced delivery of cells is a promising approach to improving current cell therapies. Our objective was to create cell-laden composite microbeads that combine the attractive features of the natural polymers chitosan and fibrin. Liquid polydimethylsiloxane was used to emulsify a chitosan-fibrinogen solution containing suspended human fibroblast cells, followed by initiation of thrombin-mediated polymerization of fibrin and thermal/pH-mediated gelation of chitosan. Chitosan/fibrin weight percent (wt%) ratios of 100/0, 75/25, 50/50 and 25/75 were investigated. Microbead diameters ranged from 275 ± 99 µm to 38 ± 10 µm using impeller speeds from 600 to 1400 rpm. Fibroblasts remained viable on day 1 post-fabrication in all matrices, but cell viability was markedly higher in high-fibrin microbeads by day 8 post-fabrication. Cell spreading and interaction with the extracellular matrix was also markedly increased in high-fibrin matrices. Such composite microbeads containing viable entrapped cells have potential for minimally invasive delivery of cells for a variety of tissue repair applications.

  14. Identification of fibrin clot-bound plasma proteins.

    Directory of Open Access Journals (Sweden)

    Simone Talens

    Full Text Available Several proteins are known to bind to a fibrin network and to change clot properties or function. In this study we aimed to get an overview of fibrin clot-bound plasma proteins. A plasma clot was formed by adding thrombin, CaCl(2 and aprotinin to citrated platelet-poor plasma and unbound proteins were washed away with Tris-buffered saline. Non-covalently bound proteins were extracted, separated with 2D gel electrophoresis and visualized with Sypro Ruby. Excised protein spots were analyzed with mass spectrometry. The identity of the proteins was verified by checking the mass of the protein, and, if necessary, by Western blot analysis. Next to established fibrin-binding proteins we identified several novel fibrin clot-bound plasma proteins, including α(2-macroglobulin, carboxypeptidase N, α(1-antitrypsin, haptoglobin, serum amyloid P, and the apolipoproteins A-I, E, J, and A-IV. The latter six proteins are associated with high-density lipoprotein particles. In addition we showed that high-density lipoprotein associated proteins were also present in fibrinogen preparations purified from plasma. Most plasma proteins in a fibrin clot can be classified into three groups according to either blood coagulation, protease inhibition or high-density lipoprotein metabolism. The presence of high-density lipoprotein in clots might point to a role in hemostasis.

  15. Measurement of clottability of fibrin polymers using magnetic orientation

    Science.gov (United States)

    Iwasaka, M.; Ueno, S.; Tsuda, H.

    1996-04-01

    Fibrin polymers, as a kind of diamagnetic material, are oriented parallel to the direction of magnetic fields. We investigated the polymerization of partially digested fibrinogens in an 8 T magnetic field in order to observe the clotting ability of various sizes of fibrinogen fractions using a magnetic orientation technique. We purified high-molecular weight fraction (F1) and low-molecular weight fraction from human fibrinogen (F2). Fibrin gels were formed in an 8 T magnetic field for 9 h, and transmittancies were measured to evaluate the degree of magnetic orientation. The results show that a lack at the C-terminal half of one Aα chain did not affect the magnetic orientation of fibrin. We also investigated the effect of the digestion of fibrinogen by plasmin on the magnetic orientation of fibrin. The result shows that partially digested fibrin molecules also orient in an 8 T magnetic field. However, the degree of magnetic orientation significantly decreases when fragment X and fragment Y appear.

  16. Clinical observation on fibrin glue application during pterygium surgery

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    Qi-Feng Lei

    2015-02-01

    Full Text Available AIM:To observe the clinical results of pterygium excision combined with conjunctival autograft transplantation using fibrin glue.METHODS: A total of 60 patients(60 eyeswith primary nasal pterygium were randomly divided into two groups: the fibrin glue group(experimental group, 30 eyesand suture group(control group, 30 eyes. All patients underwent pterygium excision combined with conjunctival autograft transplantation. In the experimental group autograft was attached to sclera with fibrin glue while in control group 10-0 polyamide was used. The patients were followed up for 6mo. The time of operation, post operation comfort, complications and recurrence were evaluated. RESULTS:The average surgical time was 24.5±6.5min with fibrin glue group while 35.2±5.4min with suture group, with statistically significant difference between two groups(PPPCONCLUSION:It's a safe and effective way to attach conjunctival autograft during pterygium surgery by fibrin glue. It can reduce surgical time, postoperative complications and relieve postoperative discomfort.

  17. Alignment of the Fibrin Network Within an Autologous Plasma Clot.

    Science.gov (United States)

    Gessmann, Jan; Seybold, Dominik; Peter, Elvira; Schildhauer, Thomas Armin; Köller, Manfred

    2016-01-01

    Autologous plasma clots with longitudinally aligned fibrin fibers could serve as a scaffold for longitudinal axonal regrowth in cases of traumatic peripheral nerve injuries. Three different techniques for assembling longitudinally oriented fibrin fibers during the fibrin polymerization process were investigated as follows: fiber alignment was induced by the application of either a magnetic field or-as a novel approach-electric field or by the induction of orientated flow. Fiber alignment was characterized by scanning electron microscopy analysis followed by image processing using fast Fourier transformation (FFT). Besides FFT output images, area xmin to xmax, as well as full width at half maximum (FWHM) of the FFT graph plot peaks, was calculated to determine the relative degree of fiber alignment. In addition, fluorescently labeled human fibrinogen and mesenchymal stem cells (MSCs) were used to visualize fibrin and cell orientation in aligned and nonaligned plasma clots. Varying degrees of fiber alignment were achieved by the three different methods, with the electric field application producing the highest degree of fiber alignment. The embedded MSCs showed a longitudinal orientation in the electric field-aligned plasma clots. The key feature of this study is the ability to produce autologous plasma clots with aligned fibrin fibers using physical techniques. This orientated internal structure of an autologous biomaterial is promising for distinct therapeutic applications, such as a guiding structure for cell migration and growth dynamics.

  18. The significance of detection of D-dimer, fibrinogen and antithrombin-Ⅲin the patients with typy-2 diabet-ic nephropathy%D-二聚体、纤维蛋白原及抗凝血酶Ⅲ联合检测对早期2型糖尿病肾病的诊断价值

    Institute of Scientific and Technical Information of China (English)

    杨玲

    2015-01-01

    目的:探究D-二聚体、纤维蛋白原( FIB)及抗凝血酶Ⅲ( AT-Ⅲ)联合检测2型糖尿病早期肾损伤的临床诊断价值。方法选取某院2型糖尿病患者206例,根据24 h尿白蛋白排泄率( UAE)分为无蛋白尿组116例( UAE<30 mg/24 h)与微量白蛋白尿组90例(30 mg/24 h≤UAE<300 mg/24 h),并选取同期健康体检者103例作为健康对照组,比较血浆D-二聚体、FIB、AT-Ⅲ3项指标的变化。结果微量白蛋白尿组D-二聚体、FIB含量明显高于无蛋白尿组和健康对照组,差异均有统计学意义(P<0畅05),而三组AT-Ⅲ的活性比较差异无统计学意义(P>0畅05)。3项指标联合检测的微量蛋白尿组患者为93畅3%,比单项检测的阳性率高,差异有统计学意义(P<0畅05)。 D-二聚体、FIB、AT-Ⅲ与尿白蛋白排泄率呈正相关,相关系数(r)依次为0畅812、0畅672、0畅621(P<0畅05)。结论 D-二聚体、FIB检测对于2型糖尿病肾病的早期判断以及疾病的早期预防和病情监测有重要意义。%Objective To explore the D-dimer, fibrinogen (FIB), antithrombin Ⅲ (AT-Ⅲ) joint detection of early renal damage in type 2 diabetes to assess the diagnostic value of clinical application.Methods According to the 24 h urine albumin excre-tion rate ( UAE) , 206 patients selected from type 2 diabetes patients were divided into 116 cases without albuminuria group ( UAE0.05).Three indicators of joint detection of trace albuminuria group of patients was 93.3%, positive rate than single detection are high, the difference was statistically significant (P<0.05).D-dimer, FIB, the AT-Ⅲand UAE are positively related to the level of the correlation coefficient r of 0.812, 0.672, and 0.621 (P<0.05).Conclusion The detection of D-dimer, FIB in type 2 diabetic nephropathy early judgement and early prevention of disease and illness monitoring is im-portant.

  19. 五种D-二聚体检测方法用于排除可疑静脉血栓栓塞症的临床评价%Evaluation of Five D-dimer Assays for the Exclusion of Venous Thromboembolism

    Institute of Scientific and Technical Information of China (English)

    周静; 孙家瑜; 孙加冠; 刘琳; 徐勇; 江虹

    2009-01-01

    目的 评价5种D-二聚体(D-dimer,DD)检测方法在排除疑似静脉血栓栓塞症(VTE)中的价值.方法 采用传统酶联免疫吸附法(ELISA)、快速ELISA法(VIDAS DD)、光电散射免疫比浊法(DD Plus)、免疫比浊法(Liatest STAGO DD)、胶体金免疫渗透法(NycoCard DD),检测75例临床疑似VTE患者血浆DD含量,其结果与疾病诊断的金标准进行比较,以评价各种方法的特点、相关性及诊断效能.结果 Liatest STAGO DD、DD Plus,VIDAS DD、传统ELISA DD检测都显示出良好的诊断效能(AUC均大于0.7),其中Liatest STAGO DD 的敏感性(96.7%)和阴性预测值(95.5%)最高,AUC(0.814)最大,对排除VTE的诊断效能最大.传统ELISA法的特异性最高,为48.9%.各方法间有明显的相关性,其中VIDAS DD与Liatest STAGO DD相关性最好(r=0.9106),与传统ELISA方法相关性比较表明Liatest STAGO DD和VIDAS DD与传统ELISA方法相关性较好,r分别为0.8360和0.8764.结论 Liatest STAGO DD、DD Plus、VIDAS DD检测快速简便,适用于单个样本的检测,有良好的诊断效能,有望取代传统ELISA法用于临床;临床应结合自身实际情况选择DD检测方法并确定其用于排除VTE的临界值.%Objective To evaluate the diagnostic performance of five D-dimer assays for the exclusion of suspected venous thromboembolis (VTE). Methods The plasma D-dimer levels of 75 suspected VTE patients were tested with ELISA, VIDAS DD, DD Plus, Liatest STAGO DD, and NycoCard DD. The results of the five assays were compared with the gold standard of diagnosis of VTE. Results Liatest STAGO DD, DD Plus, VIDAS DD and ELISA had good diagnostic performance for the exclusion of suspected VTE. Liatest STAGO DD had the greatest accuracy for differentiating diagnosis, with 0. 814 of area under the curve (AUC), 96. 7% of sensitivity, and 95. 5% of negative predictive value. ELISA had the greatest specificity (48. 9%). The five assays showed good correlations, with VIDAS DD and Liatest STAGO DD

  20. Histological effects of fibrin glue on nervous tissue: a safety study in rats.

    NARCIS (Netherlands)

    Vries, J. de; Menovsky, T.; Gulik, S. van; Wesseling, P.

    2002-01-01

    BACKGROUND: Little is known of the histologic effects of fibrin glue on normal nervous tissue. To verify the safety of intracranial application of fibrin glue, we investigated the histologic effects of fibrin glue on brain tissue and intracranial nerves of rats. METHODS: In Group I (n =12), bifronta

  1. A CCR2 macrophage endocytic pathway mediates extravascular fibrin clearance in vivo

    DEFF Research Database (Denmark)

    Motley, Michael P; Madsen, Daniel H; Jürgensen, Henrik J;

    2016-01-01

    Extravascular fibrin deposition accompanies many human diseases and causes chronic inflammation and organ damage, unless removed in a timely manner. Here, we used intravital microscopy to investigate how fibrin is removed from extravascular space. Fibrin placed into the dermis of mice underwent c...

  2. Characterization of Leukocyte-platelet Rich Fibrin, A Novel Biomaterial.

    Science.gov (United States)

    Madurantakam, Parthasarathy; Yoganarasimha, Suyog; Hasan, Fadi K

    2015-09-29

    Autologous platelet concentrates represent promising innovative tools in the field of regenerative medicine and have been extensively used in oral surgery. Unlike platelet rich plasma (PRP) that is a gel or a suspension, Leukocyte-Platelet Rich Fibrin (L-PRF) is a solid 3D fibrin membrane generated chair-side from whole blood containing no anti-coagulant. The membrane has a dense three dimensional fibrin matrix with enriched platelets and abundant growth factors. L-PRF is a popular adjunct in surgeries because of its superior handling characteristics as well as its suturability to the wound bed. The goal of the study is to demonstrate generation as well as provide detailed characterization of relevant properties of L-PRF that underlie its clinical success.

  3. Thrombin as important factor for cutaneous wound healing: comparison of fibrin biomatrices in vitro and in a rat excisional wound healing model.

    Science.gov (United States)

    Gugerell, Alfred; Pasteiner, Waltraud; Nürnberger, Sylvia; Kober, Johanna; Meinl, Alexandra; Pfeifer, Sabine; Hartinger, Joachim; Wolbank, Susanne; Goppelt, Andreas; Redl, Heinz; Mittermayr, Rainer

    2014-01-01

    Fibrin biomatrices have been used for many years for hemostasis and sealing and are a well-established surgical tool. The objective of the present study was to compare two commercially available fibrin biomatrices regarding the effect of their thrombin concentration on keratinocytes and wound healing in vitro and in vivo. Keratinocytes showed significant differences in adhesion, viability, and morphology in the presence of the fibrin matrices in vitro. A high thrombin concentration (800-1,200 IU/mL) caused deteriorated cell compatibility. By using a thrombin inhibitor, those differences could be reversed. In a rat excisional wound healing model, we observed more rapid wound closure and less wound severity in wounds treated with a fibrin matrix containing a lower concentration of thrombin (4 IU/mL). Furthermore, fewer new functional vessels and a lower level of vascular endothelial growth factor were measured in wounds after 7 days treated with the matrix with higher thrombin concentration. These in vivo results may be partially explained by the in vitro biocompatibility data. Additionally, results show that low thrombin biomatrices were degraded faster than the high thrombin material. Hence, we conclude that the composition of fibrin biomatrices influences keratinocytes and therefore has an impact on wound healing.

  4. Fibrin Adhesive: Clinical Application in Coronary Artery Bypass Graft Surgery

    Science.gov (United States)

    Fundaró, Pino; Velardi, Antonio R.; Santoli, Carmine

    1985-01-01

    Fibrin adhesive was used 72 times in a group of 67 patients undergoing elective coronary artery bypass graft surgery. The indications were prophylactic sealing of potential sources of bleeding, topical hemostasis (control of bleeding sites dangerous or difficult to suture), and fixation of the graft in the optimal position. The method of glue application under varying circumstances is described and the results are reported. This experience suggests that in some cases the glue expedites the operation and makes it safer. We conclude that the fibrin sealing represents a valid aid in coronary artery bypass graft surgery. PMID:15227018

  5. 血浆FIB、FDP及D-二聚体在妊娠期高血压疾病中的临床应用%The clinical application of FIB, FDP and the D - dimer in high blood pressure in pregnancy

    Institute of Scientific and Technical Information of China (English)

    娄峻; 王永利

    2012-01-01

    目的:探讨妊娠期高血压患者血浆FIB、FDP及D-二聚体病理变化.方法:选择健康组非妊娠妇女80名,正常妊娠组62名,妊娠期高血压患者轻度32名、中度40名、重度28名,分别同时测量血浆FIB、FDP及D-二聚体值.结果:妊娠期高血压组血浆中FIB、FDP及D-二聚体的测定值明显高于健康非妊娠组及正常妊娠组,差异均有统计学意义(P<0.05),且随妊娠期高血压病情的严重程度而增加.结论:对于妊娠期高血压疾病临床早期预防、发现、治疗及重度妊娠期高血压疾病的DIC与子癫形成具有临床应用价值.%Objective: To study the pathological changes of FIB, FDP and the D - dimer in plasma of the patients with high blood pressure in pregnancyMethods; The 80 health no - pregnant women and 62 normal pregnancy women and 100 patients with high blood pressure in pregnancy were choose. Of the 100 patients, 32 patients were mild, 40 were moderate, and 28 were severe. FIB, FDP and the D -dimer value in plasma of all the women were measured respectivelyResulte: FIB, FDP and the D - dimer value in plasma of the patients with high blood pressure in pregnancy were significantly higher than that of the health no - pregnant women and the normal pregnancy women ( P <0. 05) . Conclusion; Early prevention, diagnosis and treatment of hypertensive disorder complicating pregnancy have clinical application value for avoiding the occurring of D1C and edampsia

  6. Discrimination between Fibrin and Fibrinogen by a Monoclonal Antibody against a Synthetic Peptide

    Science.gov (United States)

    Scheefers-Borchel, Ursula; Muller-Berghaus, Gert; Fuhge, Peter; Eberle, Reinhard; Heimburger, Nobert

    1985-10-01

    Circulating soluble fibrin, observed in the blood of patients with ongoing intravascular coagulation, is generated from the plasma protein fibrinogen by the limited proteolytic action of thrombin. We report the production of a monoclonal antibody that discriminates between fibrin and fibrinogen in blood. The synthetic hexapeptide Gly-Pro-Arg-Val-Val-Glu, representing the amino terminus of the α chain of human fibrin, was used as immunogen. This hexapeptide is located within the Aα chain of fibrinogen but becomes the amino terminus of the fibrin α chain, after fibrinopeptide A is removed by the action of thrombin, and thus becomes accessible for antibody binding. The monoclonal antibody we have prepared can discriminate between fibrin and fibrinogen and thus can be used in assay systems to quantitate soluble fibrin or, potentially, to image fibrin-rich thrombi.

  7. 全国225家实验室 D-二聚体决定限的调查与分析%National wide survey and analysis on decision limits of D-Dimer in 225 laboratories

    Institute of Scientific and Technical Information of China (English)

    何法霖; 王薇; 钟堃; 张妍; 赵彦; 李国华; 王治国

    2015-01-01

    Objective To calculate and describe the decision limits of 2014 external quality assessment(EQA) programs in D-Dimer of 225 labs.Methods To collectedthe information of decision limits which come from the 2014 External Quality Assessment ( EQA) programs in D-Dimer.All data from maternal and child care service centers , children′s hospitals and corporations were excluded .Then all the abnormal values and errors were eliminated either .Data of 225 labs statistics were processed by Microsoft Excel 2007, which include the mean, median, maximum value, minimum value, P2.5 and P97.5.Weanalyzed the sources of decision limits and then get the data filtered .The reagent manufacturer 's instructions data are reservedas a reference source and data are analyzed according to differentreagents .Results According to the surveys of decision limits sources ,most of thereference sources use the reagent manufacturer′s instructions. According to the surveys,the mean and median of each test project is close .The P2.5 and P97.5 distribution ranges are: D-Dimer(DDU) 0.3 -1.33 μg/ml,D-Dimer(FEU) 0.23 -1.50 μg/ml,with significant differences.According to the surveys , most P2.5 and P97.5 reagent distributions are significantly different . Conclusion The decision limitsof the mean and median of each test item are approximate ,and the P2.5 and P97.5 distributions of each test item are poorly consistent .%目的:统计并描述2014年全国225家回报D-二聚体决定限。方法选择卫生部临床检验中心2014年全国D-二聚体室间质量评价回报结果中参评单位的决定限信息,剔除所有妇幼保健院、儿童医院和各类公司的结果,再剔除所有异常值和错误数据,使用Microsoft Excel 2007对225家实验室进行统计分析,包括平均值、中位数、最小值、最大值、P2.5和P97.5。统计决定限来源,同时对数据进行筛选,保留决定限来源于试剂厂家说明书的数据,

  8. PLATELET RICH FIBRIN: A PROMISING INNOVATION IN REGENERATIVE THERAPY

    Directory of Open Access Journals (Sweden)

    Arun

    2015-04-01

    Full Text Available Platelets can play a crucial role in regenerative therapy as they are reservoirs of growth factors and cytokines which are the key factors for regeneration of the bone and maturation of the soft tissue. Platelet - rich fibr in (PRF was first described by Choukroun et al. in France. It has been referred to as a second - generation platelet concentrate, which has been shown to have several advantages over traditionally prepared PRP. Platelet - rich fibrin (PRF is autologous plate let concentrates prepared from patient’s own blood. It is a natural fibrin - based biomaterial prepared from an anticoagulant - free blood harvest without any artificial biochemical modification that allows obtaining fibrin membranes enriched with platelets a nd growth factors. Evidence from the literature suggests the potential role of PRF in regeneration and tissue engineering. The slow polymerisation during centrifugation and fibrin - based structure makes PRF a better healing biomaterial than PRP and other fi brin adhesives. The purpose of this review article is to describe the novel second - generation platelet concentrate PRF, which is an improvement over the traditionally prepared PRP for use in regenerative dentistry.

  9. Enzymatically induced mineralization of platelet-rich fibrin.

    NARCIS (Netherlands)

    Douglas, T.E.L.; Gassling, V.; Declercq, H.A.; Purcz, N.; Pamula, E.; Haugen, H.J.; Chasan, S.; Mulder, E.L.W. de; Jansen, J.A.; Leeuwenburgh, S.C.G.

    2012-01-01

    Membranes of the autologous blood-derived biomaterial platelet-rich fibrin (PRF) were functionalized by incorporation of alkaline phosphatase (ALP), an enzyme involved in mineralization of bone, and subsequently incubated in calcium glycerophosphate (CaGP) solution to induce PRFs mineralization with

  10. Enzymatically induced mineralization of platelet-rich fibrin.

    NARCIS (Netherlands)

    Douglas, T.E.L.; Gassling, V.; Declercq, H.A.; Purcz, N.; Pamula, E.; Haugen, H.J.; Chasan, S.; Mulder, E.L.W. de; Jansen, J.A.; Leeuwenburgh, S.C.G.

    2012-01-01

    Membranes of the autologous blood-derived biomaterial platelet-rich fibrin (PRF) were functionalized by incorporation of alkaline phosphatase (ALP), an enzyme involved in mineralization of bone, and subsequently incubated in calcium glycerophosphate (CaGP) solution to induce PRFs mineralization with

  11. Calix[4]arene methylenebisphosphonic acids as inhibitors of fibrin polymerization.

    NARCIS (Netherlands)

    Lugovskoy, E.V.; Gritsenko, P.; Koshel, T.A.; Koliesnik, I.O.; Cherenok, S.O.; Kalchenko, O.I.; Kalchenko, V.I.; Komisarenko, S.V.

    2011-01-01

    Calix[4]arenes bearing two or four methylenebisphosphonic acid groups at the macrocyclic upper rim have been studied with respect to their effects on fibrin polymerization. The most potent inhibitor proved to be calix[4]arene tetrakis-methylene-bis-phosphonic acid (C-192), in which case the maximum

  12. Establishment of reference intervals of plasma D-dimer for different age crowd of a certain hospital%某医院不同年龄人群D-二聚体生物参考区间的建立

    Institute of Scientific and Technical Information of China (English)

    杨明; 齐永志; 李娜; 张海超; 马骢

    2011-01-01

    Objective To establish reference intervals of plasma D-dimer for different age crowd of a certain hospital.Methods Plasma D-dimer of 618 healthy individuals was detected by the automated blood coagulation analyzer ACLTOP.Data of different age groups were statistically analyzed by SPSS 13.0.Results Biological reference intervals were obtained for different age groups:the 30 -50 years group (0 -217 mg/L),the 51 -80 years group (0 -343 mg/L) and the 81 -90 years group (0 -540 mg/L).Conclusions The biological reference intervals derived from our experimental laboratory conditions are more suitable to clinical application.%目的 建立某医院不同年龄人群D-二聚体生物参考区间.方法 用ACLTOP全自动血液凝固分析仪对618名健康体检者的血浆进行D-二聚体检测,运用SPSS 13.0对不同年龄组的数据进行统计分析.结果 得到不同年龄人群D-二聚体生物参考区间:30~50岁0~217 mg/L,51~80岁0~343 mg/L,81 ~90岁0~540 mg/L.结论 本实验室获得的D-二聚体参考区间适合本院临床应用.

  13. D-Dimer Use and Pulmonary Embolism Diagnosis in Emergency Units: Why Is There Such a Difference in Pulmonary Embolism Prevalence between the United States of America and Countries Outside USA?

    Science.gov (United States)

    Pernod, Gilles; Caterino, Jeffrey; Maignan, Maxime; Tissier, Cindy; Kassis, Jeannine; Lazarchick, John

    2017-01-01

    Objective Although diagnostic guidelines are similar, there is a huge difference in pulmonary embolism (PE) prevalence between the United States of America (US) and countries outside the USA (OUS) in the emergency care setting. In this study, we prospectively analyze patients’ characteristics and differences in clinical care that may influence PE prevalence in different countries. Methods An international multicenter prospective diagnostic study was conducted in a standard-of-care setting. Consecutive outpatients presenting to the emergency unit and suspected for PE were managed using the Wells score, STA-Liatest® D-Dimers and imaging. Results The prevalence of PE in the study was 7.9% in low and moderate risk patients. Among the 1060 patients with low or moderate pre-test probability (PTP), PE prevalence was four times higher in OUS (10.7%) than in the US (2.5%) (P < 0.0001). The mean number of imaging procedures performed for one new PE diagnosis was 3.3 in OUS vs 17 in the US (P < 0.001). Stopping investigation in the case of negative D-dimers (DD combined) with low/moderate PTP was more frequent in OUS (92.7%) than in the US (75.7%) (P < 0.01). Moreover, the use of imaging was much higher in the US (44.4% vs 19.2% in OUS) in the case of moderate PTP combined with negative DD. Conclusion Differences between US and OUS PE prevalence in emergency setting might be explained by differences in patients' characteristics and mostly in care patterns. US physicians performed computed tomographic pulmonary angiography more often than in Europe in cases of low/moderate PTP combined with negative DD. Trial Registration ClinicalTrials.gov NCT01221805 PMID:28085911

  14. Radioimmunoassay of fragment E-related neoantigen: validation studies and clinical application. [Fibrinogen-fibrin degradation products

    Energy Technology Data Exchange (ETDEWEB)

    Chen, J.P.; Hanna, W.T.; Williams, T.K.; Krauss, S. (Tennessee Univ., Knoxville (USA). Memorial Research Center and Hospital)

    1984-05-01

    An E-neoantigen radioimmunoassay (Eneo RIA) is described which can determine normal and pathological plasma levels of E-related fibrinogen-fibrin degradation products (FDP). The assay employs rabbit antiserum produced against fragment E derived from a plasmin digest of fibrinogen and subsequently absorbed with fibrinogen. The absorbed antiserum contains antibodies which are equally reactive with fibrinogen derived E (Fg-E) and fibrin derived E(Fb-E) but not with fibrinogen at 1 mg/ml. The Eneo RIA was validated by assay parallelism and by recovery experiments. Plasma Eneo immunoreactivities in 14 normals were 4-22 ng/ml (mean 12.7 ng/ml). Plasma Eneo levels in 23 of 24 patients with neoplastic and haematological diseases were elevated above normal (range 27-2027 ng/ml). Unusually high Eneo values were observed with three patients whose diseases were complicated by either disseminated intravascular coagulation (DIC) or deep vein thrombosis. After heparin therapy, the Eneo level of a patient with chronic DIC declined. A pathological plasma was eluted from a Sephadex G-200 column and Eneo immunoreactivity was determined on the eluates. The gel filtration pattern of Eneo indicates that E-related FDP is a family of plasmic fragments derived from crosslinked fibrin.

  15. Single-molecule force spectroscopy studies of fibrin 'A-a' polymerization interactions via the atomic force microscope

    Science.gov (United States)

    Averett, Laurel E.

    Fibrin, the polymerized form of the soluble plasma protein fibrinogen, plays a critical role in hemostasis as the structural scaffold of blood clots. The primary functions of fibrin are to withstand the shear forces of blood flow and provide mechanical stability to the clot, protecting the wound. While studies have investigated the mechanical properties of fibrin constructs, the response to force of critical polymerization interactions such as the 'A--a' knob--hole interaction remains unclear. Herein, the response of the 'A--a' bond to force was examined at the single-molecule level using the atomic force microscope. Force spectroscopy methodology was developed to examine the 'A--a' interaction while reducing the incidence of both nonspecific and multiple molecule interactions. The rupture of this interaction resulted in a previously unreported characteristic force profile comprised of up to four events. We hypothesized that the first event represented reorientation of the fibrinogen molecule, the second and third represented unfolding of structures in the D region of fibrinogen, and the last event was the rupture of the 'A--a' bond weakened by prior structural unfolding. The configuration, molecular extension, and kinetic parameters of each event in the characteristic pattern were examined to compare the unfolding of fibrin to other proteins unfolded by force. Fitting the pattern with polymer models showed that the D region of fibrinogen could lengthen by ˜50% of the length of a fibrin monomer before rupture of the 'A--a' bond. Analysis showed that the second and third events had kinetic parameters similar to other protein structures unfolded by force. Studies of the dependence of the characteristic pattern on calcium, concentration of sodium chloride, pH, and temperature demonstrated that the incidence of the last event was affected by solution conditions. However, only low pH and high temperatures reduced the probability that an interaction was characteristic

  16. Platelet Rich Fibrin (PRF) in Regeneration of Intrabony Defects- A Randomized Controlled Trial.

    Science.gov (United States)

    Kumar Patel, Gauresh; Kumar Gujjari, Sheela; Kumar S C, Veerendra

    2017-08-18

    Platelet-rich fibrin (PRF) is a autologous non transfusional hemo-component with a high concentration of platelets. It incorporates leukocytes, platelets and growth factors within the dense fibrin matrix and can be used as healing biomaterial. This study assessed the adjunctive use of PRF in regenerative management of intrabony defects in comparison with open flap debridement. 26 bilateral defects (13 per group) in 13 patients were randomized as either PRF (Test group) or Open flap debridement alone (control group) sites. Probing depth (PD), clinical attachment level (CAL) and bone probing depth were recorded. Reduction in defect depth and percentage of bone fill was assessed radiographically. Primary outcomes assessed were the changes in pocket depth, attachment level and percentage of bone fill assessed at 6months, 9 months and 12 months. Secondary outcome was assessment of wound healing using a wound healing index. The PRF group showed significant improvement in clinical parameters over control group at 6, 9, and 12 months. PRF group showed a bone fill of 45.18±7.57 percent which was statistically significant compared to 21.6±9.3 percent seen in control group at end of study period. Wound healing index (WHI) also showed significant advantages for the PRF group. PRF also showed significant soft tissue healing and reduction in probing depth. The adjunctive use of PRF to conventional open flap debridement may be potentially used in the treatment of intrabony defects.

  17. Elastic behavior and platelet retraction in low- and high-density fibrin gels.

    Science.gov (United States)

    Wufsus, Adam R; Rana, Kuldeepsinh; Brown, Andrea; Dorgan, John R; Liberatore, Matthew W; Neeves, Keith B

    2015-01-06

    Fibrin is a biopolymer that gives thrombi the mechanical strength to withstand the forces imparted on them by blood flow. Importantly, fibrin is highly extensible, but strain hardens at low deformation rates. The density of fibrin in clots, especially arterial clots, is higher than that in gels made at plasma concentrations of fibrinogen (3-10 mg/mL), where most rheology studies have been conducted. Our objective in this study was to measure and characterize the elastic regimes of low (3-10 mg/mL) and high (30-100 mg/mL) density fibrin gels using shear and extensional rheology. Confocal microscopy of the gels shows that fiber density increases with fibrinogen concentration. At low strains, fibrin gels act as thermal networks independent of fibrinogen concentration. Within the low-strain regime, one can predict the mesh size of fibrin gels by the elastic modulus using semiflexible polymer theory. Significantly, this provides a link between gel mechanics and interstitial fluid flow. At moderate strains, we find that low-density fibrin gels act as nonaffine mechanical networks and transition to affine mechanical networks with increasing strains within the moderate regime, whereas high-density fibrin gels only act as affine mechanical networks. At high strains, the backbone of individual fibrin fibers stretches for all fibrin gels. Platelets can retract low-density gels by >80% of their initial volumes, but retraction is attenuated in high-density fibrin gels and with decreasing platelet density. Taken together, these results show that the nature of fibrin deformation is a strong function of fibrin fiber density, which has ramifications for the growth, embolization, and lysis of thrombi.

  18. Physical and Biological Characterization of Ferromagnetic Fiber Networks: Effect of Fibrin Deposition on Short-Term In Vitro Responses of Human Osteoblasts

    Science.gov (United States)

    Spear, Rose L.; Srigengan, Brajith; Neelakantan, Suresh; Bosbach, Wolfram; Brooks, Roger A.

    2015-01-01

    Ferromagnetic fiber networks have the potential to deform in vivo imparting therapeutic levels of strain on in-growing periprosthetic bone tissue. 444 Ferritic stainless steel provides a suitable material for this application due to its ability to support cultures of human osteoblasts (HObs) without eliciting undue inflammatory responses from monocytes in vitro. In the present article, a 444 fiber network, containing 17 vol% fibers, has been investigated. The network architecture was obtained by applying a skeletonization algorithm to three-dimensional tomographic reconstructions of the fiber networks. Elastic properties were measured using low-frequency vibration testing, providing globally averaged properties as opposed to mechanical methods that yield only local properties. The optimal region for transduction of strain to cells lies between the ferromagnetic fibers. However, cell attachment, at early time points, occurs primarily on fiber surfaces. Deposition of fibrin, a fibrous protein involved in acute inflammatory responses, can facilitate cell attachment within this optimal region at early time points. The current work compared physiological (3 and 5 g·L−1) and supraphysiological fibrinogen concentrations (10 g·L−1), using static in vitro seeding of HObs, to determine the effect of fibrin deposition on cell responses during the first week of cell culture. Early cell attachment within the interfiber spaces was observed in all fibrin-containing samples, supported by fibrin nanofibers. Fibrin deposition influenced the seeding, metabolic activity, and early stage differentiation of HObs cultured in the fibrin-containing fiber networks in a concentration-dependant manner. While initial cell attachment for networks with fibrin deposited from low physiological concentrations was similar to control samples without fibrin deposition, significantly higher HObs attached onto high physiological and supraphysiological concentrations. Despite higher cell

  19. The mechanics of fibrin networks and their alterations by platelets

    Science.gov (United States)

    Jawerth, Louise Marie

    Fibrin is a biopolymer that assembles into a network during blood coagulation to become the structural scaffold of a blood clot. The precise mechanics of this network are crucial for a blood clot to properly stem the flow of blood at the site of vascular injury while still remaining pliable enough to avoid dislocation. A hallmark of fibrin's mechanical response is strain-stiffening: at small strains, its response is low and linear; while at high strains, its stiffness increases non-linearly with increasing strain. The physical origins of strain-stiffening have been studied for other biopolymer systems but have remained elusive for biopolymer networks composed of stiff filaments, such as fibrin. To understand the origins of this intriguing behavior, we directly observe and quantify the motion of all of the fibers in the fibrin networks as they undergo shear in 3D using confocal microscopy. We show that the strain-stiffening response of a clot is a result of the full network deformation rather than an intrinsic strain-stiffening response of the individual fibers. We observe a distinct transition from a linear, low-strain regime, where all fibers avoid any internal stretching, to a non-linear, high-strain regime, where an increasing number of fibers become stretched. This transition is characterized by a high degree of non-affine motion. Moreover, we are able to precisely calculate the non-linear stress-strain response of the network by using the strains on each fiber measured directly with confocal microscopy and by assuming the fibers behave like linearly elastic beams. This result confirms that it is the network deformation that causes the strain-stiffening behavior of fibrin clots. These data are consistent with predictions for low-connectivity networks with soft, bending, or floppy modes. Moreover, we show that the addition of small contractile cells, platelets, increases the low-strain stiffness of the network while the high-strain stiffness is independent of

  20. Treatment of Peri-implant Bone Defects with Platelet-Rich Fibrin.

    Science.gov (United States)

    Hamzacebi, Burak; Oduncuoglu, Bahar; Alaaddinoglu, Emine Elif

    2015-01-01

    The objective of this study was to investigate and compare the clinical effectiveness of the application of platelet-rich fibrin (PRF) and conventional flap surgery for the treatment of peri-implant bone loss. Nineteen patients (8 women, 11 men) with peri-implant bone loss were randomly allocated to two groups, with the PRF group comprising patients who received fibrin scaffold and the control group made up of those who received only the access flap. At 3 and 6 months after surgery, respectively, the PRF group demonstrated higher mean probing depth reductions (2.41 ± 1.06 and 2.82 ± 1.03 mm versus 1.65 ± 1.02 and 2.05 ± 0.77 mm) and more gains in clinical attachment level (2.89 ± 1.01 and 3.31 ± 1.08 mm versus 1.43 ± 1.08 and 1.84 ± 0.81 mm) compared with the control group. In addition, the increase in the amount of keratinized mucosa from baseline to 6 months postoperatively was statistically significant for the PRF group (P < .001). Hence, the data from the current study led to the conclusion that PRF application in periimplant bone loss provided better clinical results than conventional flap surgery.

  1. Platelet-rich fibrin matrix for facial plastic surgery.

    Science.gov (United States)

    Sclafani, Anthony P; Saman, Masoud

    2012-05-01

    Platelets are known primarily for their role in hemostasis, but there is increasing interest in the effect of platelets on wound healing. Platelet isolates such as platelet-rich plasma have been advocated to enhance and accelerate wound healing. This article describes the use of a novel preparation, platelet-rich fibrin matrix (PRFM), for facial plastic surgery applications such as volume augmentation, fat transfer supplementation, and as an adjunct to open surgical procedures.

  2. An Unusual Presentation of Acute Fibrinous and Organizing Pneumonia.

    Science.gov (United States)

    Jabbour, Rami; Kumar, Hanesh; Alvi, Shaheen; Nannaka, Varalaxmi Bhavani; Niazi, Masooma; Patel, Madanmohan; Chilimuri, Sridhar

    2017-05-15

    BACKGROUND Acute fibrinous and organizing pneumonia (AFOP) is a newly evolving rare non-infectious lung pathology, characterized by intra-alveolar fibrin balls on histology. It is often difficult to diagnose and is usually mistaken for other lung pathologies. We present an interesting case of AFOP with unusual radiologic findings and disease course. CASE REPORT A 56-year-old woman presented with a 1-day history of high-grade fever, chills, and profuse sweating. She was febrile to 101.2 degree Fahrenheit on presentation. On physical examination, she had decreased air entry in the left upper lobe of the lung. Laboratory testing showed a white cell count of 27,000 cells per microliter of blood with left shift. A chest radiograph showed a left upper lobe consolidation. Computed tomography (CT) of the chest without intravenous contrast showed advanced centrilobular emphysema and left upper lobe consolidation measuring 6.2×5.9 cm. The patient was started on antibiotics. She clinically improved and was discharged on oral antibiotics. After discharge, a trans-bronchial lung biopsy showed acute inflammatory cell infiltrate with intra-alveolar fibrin balls but no hyaline membrane formation or significant eosinophils. These findings were consistent with acute fibrinous and organizing pneumonia. However, she was subsequently lost to follow-up. CONCLUSIONS Our case adds to the literature a new and unusual finding of upper lobe infiltrates, in contrast to most cases presenting as bilateral lower lobe infiltrates. In our case, symptomatic improvement after antibiotic treatment suggests a possible role of antibiotics in management of this entity.

  3. Diagnostic and genetic studies on fibrin-stabilizing factor with a new assay based on amine incorporation.

    Science.gov (United States)

    Lorand, L; Urayama, T; De Kiewiet, J W; Nossel, H L

    1969-06-01

    Fibrinoligase, the fibrin cross-linking enzyme, transiently appearing during the course of coagulation in normal blood, was shown to catalyze the incorporation of a fluorescent amine, monodansylcadaverine [or N-(5-aminopentyl)-5-dimethylamino-1-naphthalene-sulfonamide] into casein. The reaction provided the basis of a sensitive fluorimetric method for measuring the activity of the enzyme (and also of similar other transpeptidases, such as transglutaminase). In tests involving plasma, certain difficulties had to be overcome which were mainly due to the fact that the enzyme itself does not occur in citrated plasma. Only its precursor (fibrin-stabilizing factor or factor XIII) is present, still requiring limited proteolytic activation by thrombin. Thus, in order to measure amine incorporation with plasma as a source of the factor, thrombin must be added. This necessitated a differential desensitization of the intrinsic fibrinogen so that the latter could not clot and could not thereby interfere with amine incorporation. Also, the thrombin-inactivating capacity of plasma had to be saturated to enable full conversion of the factor to the transpeptidase. Concentrations of casein, monodansylcadaverine, calcium, and hydrogen ions were chosen to permit almost maximal velocity of amine incorporation. A linear relationship with regard to plasma concentration could be obtained only under such conditions. No similar assay is presently available for quantitatively evaluating fibrin-stabilizing factor levels in plasma.The amine incorporation test was applied to a clinical case of hereditary total fibrin-stabilizing factor deficiency. The effect of transfusion therapy was studied, and some of the patient's relatives were examined. Whereas a paternal aunt and uncle gave values well within the normal range, a brother and the mother proved to be partially deficient and could be considered as heterozygous carriers. The father appeared to have a reduced level of fibrin

  4. A Novel Role for Erythropoietin During Fibrin-Induced Wound-Healing Response

    OpenAIRE

    Haroon, Zishan A.; Amin, Khalid; Jiang, XiaoHong; Arcasoy, Murat O.

    2003-01-01

    In this study, we investigated the role of the hematopoietic cytokine erythropoietin (EPO) during wound healing, the physiological response to tissue injury. We used an in vivo wound-healing assay (fibrin Z-chambers) consisting of fibrin-filled chambers implanted subcutaneously in rats. The fibrin inside the chambers is replaced by granulation tissue consisting of new blood vessels, macrophages and fibroblasts as part of the wound-healing response. Local, exogenous recombinant EPO administrat...

  5. A Novel Role for Erythropoietin During Fibrin-Induced Wound-Healing Response

    OpenAIRE

    Haroon, Zishan A.; Amin, Khalid; Jiang, Xiaohong; Arcasoy, Murat O.

    2003-01-01

    In this study, we investigated the role of the hematopoietic cytokine erythropoietin (EPO) during wound healing, the physiological response to tissue injury. We used an in vivo wound-healing assay (fibrin Z-chambers) consisting of fibrin-filled chambers implanted subcutaneously in rats. The fibrin inside the chambers is replaced by granulation tissue consisting of new blood vessels, macrophages and fibroblasts as part of the wound-healing response. Local, exogenous recombinant EPO administrat...

  6. An automated method for fibrin clot permeability assessment.

    Science.gov (United States)

    Ząbczyk, Michał; Piłat, Adam; Awsiuk, Magdalena; Undas, Anetta

    2015-01-01

    The fibrin clot permeability coefficient (Ks) is a useful measure of porosity of the fibrin network, which is determined by a number of genetic and environmental factors. Currently available methods to evaluate Ks are time-consuming, require constant supervision and provide only one parameter. We present an automated method in which drops are weighed individually, buffer is dosed by the pump and well defined clot washing is controlled by the software. The presence of a straight association between drop mass and their dripping time allows to shorten the measurement time twice. In 40 healthy individuals, Ks, the number of drops required to reach the plateau (DTP), the time to achieve the plateau (TTP) and the DTP/TTP ratio (DTR) were calculated. There was a positive association between Ks (r = 0.69, P Ks (r = -0.55, P Ks (r = 0.70, P < 0.0001 for the manual method and r = 0.76, P < 0.0001 for the automated method), fibrinogen (r = -0.58, P < 0.0001) and C-reactive protein (CRP) (r = -0.47, P < 0.01). The automated method might be a suitable tool for research and clinical use and may offer more additional parameters describing fibrin clot structure.

  7. Platelet rich fibrin: a new paradigm in periodontal regeneration.

    Science.gov (United States)

    Kumar, R Vinaya; Shubhashini, N

    2013-09-01

    Among the great challenges facing clinical research is the development of bioactive surgical additives regulating inflammation and increasing healing. Although the use of fibrin adhesives and platelet-rich plasma (PRP) is well documented, they have their own limitations. Hence, reconstructive dental surgeons are looking for an "edge" that jump starts the healing process to maximize predictability as well as the volume of regenerated bone. Overcoming the restrictions related to the reimplantation of blood-derived products, a new family of platelet concentrate, which is neither a fibrin glue nor a classical platelet concentrate, was developed in France. This second generation platelet concentrate called platelet-rich fibrin (PRF), has been widely used to accelerate soft and hard tissue healing. Its advantages over the better known PRP include ease of preparation/application, minimal expense, and lack of biochemical modification (no bovine thrombin or anticoagulant is required). This article serves as an introduction to the PRF "concept" and its potential clinical applications with emphasis on periodontal regeneration.

  8. [Application of fibrin glue in facial nerve repair].

    Science.gov (United States)

    Wang, Qinying; Hua, Qingquan; Wang, Shenqing

    2007-06-01

    This animal experiment was aimed to apply fibrin in facial nerve repair and to quest for technical improvements in facial surgery. In each of 15 healthy large ear white rabbits, a unilateral 5 mm intratemporal facial nerve gap was created, the proximal and distal stumps were inserted into chitin tube, 1 ml autologous fibrin glue was applied around the anastomotic zone, and no suture was employed. At 3 months and 5 months after opertion, electrophysioligical study was performed. Compared with normal nerves, the regenerating nerves in both the chitin tube bridged group and the perineurium suture group had longer incubation period, lower amplitude, slower nerve-muscle conduction velocity at 3 months postoperatively. The differences were distinctly significant (P < 0.01). Although being decreased at 5 months after operation, the differences were still statistically significant (P < 0.05). There were no significant differences between the chitin tube bridged group and perineurium suture group at 3 months and 5 months, respectively. The study suggests that facial nerve repair using fibrin glue and chitin tube has the advantages of being easier,faster and more stable.

  9. Effects of unidirectional flow shear stresses on the formation, fractal microstructure and rigidity of incipient whole blood clots and fibrin gels

    Science.gov (United States)

    Badiei, N.; Sowedan, A.M.; Curtis, D.J.; Brown, M.R.; Lawrence, M.J.; Campbell, A.I.; Sabra, A.; Evans, P.A.; Weisel, J.W.; Chernysh, I.N.; Nagaswami, C.; Williams, P.R.; Hawkins, K.

    2015-01-01

    Abstract Incipient clot formation in whole blood and fibrin gels was studied by the rheometric techniques of controlled stress parallel superposition (CSPS) and small amplitude oscillatory shear (SAOS). The effects of unidirectional shear stress on incipient clot microstructure, formation kinetics and elasticity are reported in terms of the fractal dimension (df) of the fibrin network, the gel network formation time (TGP) and the shear elastic modulus, respectively. The results of this first haemorheological application of CSPS reveal the marked sensitivity of incipient clot microstructure to physiologically relevant levels of shear stress, these being an order of magnitude lower than have previously been studied by SAOS. CSPS tests revealed that exposure of forming clots to increasing levels of shear stress produces a corresponding elevation in df, consistent with the formation of tighter, more compact clot microstructures under unidirectional flow. A corresponding increase in shear elasticity was recorded. The scaling relationship established between shear elasticity and df for fibrin clots and whole blood confirms the fibrin network as the dominant microstructural component of the incipient clot in terms of its response to imposed stress. Supplementary studies of fibrin clot formation by rheometry and microscopy revealed the substantial additional network mass required to increase df and provide evidence to support the hypothesis that microstructural changes in blood clotted under unidirectional shear may be attributed to flow enhanced thrombin generation and activation. CSPS also identified a threshold value of unidirectional shear stress above which no incipient clot formation could be detected. CSPS was shown to be a valuable haemorheological tool for the study of the effects of physiological and pathological levels of shear on clot properties. PMID:25624413

  10. Effects of unidirectional flow shear stresses on the formation, fractal microstructure and rigidity of incipient whole blood clots and fibrin gels.

    Science.gov (United States)

    Badiei, N; Sowedan, A M; Curtis, D J; Brown, M R; Lawrence, M J; Campbell, A I; Sabra, A; Evans, P A; Weisel, J W; Chernysh, I N; Nagaswami, C; Williams, P R; Hawkins, K

    2015-01-01

    Incipient clot formation in whole blood and fibrin gels was studied by the rheometric techniques of controlled stress parallel superposition (CSPS) and small amplitude oscillatory shear (SAOS). The effects of unidirectional shear stress on incipient clot microstructure, formation kinetics and elasticity are reported in terms of the fractal dimension (df) of the fibrin network, the gel network formation time (TGP) and the shear elastic modulus, respectively. The results of this first haemorheological application of CSPS reveal the marked sensitivity of incipient clot microstructure to physiologically relevant levels of shear stress, these being an order of magnitude lower than have previously been studied by SAOS. CSPS tests revealed that exposure of forming clots to increasing levels of shear stress produces a corresponding elevation in df, consistent with the formation of tighter, more compact clot microstructures under unidirectional flow. A corresponding increase in shear elasticity was recorded. The scaling relationship established between shear elasticity and df for fibrin clots and whole blood confirms the fibrin network as the dominant microstructural component of the incipient clot in terms of its response to imposed stress. Supplementary studies of fibrin clot formation by rheometry and microscopy revealed the substantial additional network mass required to increase df and provide evidence to support the hypothesis that microstructural changes in blood clotted under unidirectional shear may be attributed to flow enhanced thrombin generation and activation. CSPS also identified a threshold value of unidirectional shear stress above which no incipient clot formation could be detected. CSPS was shown to be a valuable haemorheological tool for the study of the effects of physiological and pathological levels of shear on clot properties.

  11. Experimental use of fibrin glue derived from snake venom in non-pregnant canine uterus

    Directory of Open Access Journals (Sweden)

    J.R.E. Moraes

    2004-01-01

    Full Text Available This study evaluated the use of fibrin glue derived from snake venom in the healing process after canine hysterorrhaphy. Three groups of four animals were submitted to uterine hysterotomy followed by wound closure. In Group 1, double-layer suture was used, the first with Schimieden pattern, the second with Cushing pattern; in Group 2, only fibrin glue; and in Group 3, the same as for Group 1 but with fibrin glue as suture reinforcement. Results indicated that fibrin glue produced less inflammation in the exudative phase, and exacerbated deposition of connective tissue and angiogenesis in the proliferative and maturation phases of the healing process, favoring its evolution.

  12. A PEGylated Fibrin-Based Wound Dressing with Antimicrobial and Angiogenic Activity

    Science.gov (United States)

    2011-04-13

    CSM–PEGylated fibrin gel showing the uniform dispersion of SSD–CSM. (C) Rheology data shows that the PEGylated fibrin gel and SSD–CSM–PEGylated...and SSD–CSM in PEGylated fibrin gels (±SD) over a 72 h period (A) using a Franz apparatus or (B) under sink conditions. (C) Rheology data indicate...PEGylated fibrin gel Angiogenesis Adipose-derived stem cells a b s t r a c t Wounds sustained under battlefield conditions are considered to be contaminated

  13. The potential applications of fibrin-coated electrospun polylactide nanofibers in skin tissue engineering.

    Science.gov (United States)

    Bacakova, Marketa; Musilkova, Jana; Riedel, Tomas; Stranska, Denisa; Brynda, Eduard; Zaloudkova, Margit; Bacakova, Lucie

    2016-01-01

    Fibrin plays an important role during wound healing and skin regeneration. It is often applied in clinical practice for treatment of skin injuries or as a component of skin substitutes. We prepared electrospun nanofibrous membranes made from poly(l-lactide) modified with a thin fibrin nanocoating. Fibrin surrounded the individual fibers in the membrane and also formed a thin fibrous mesh on several places on the membrane surface. The cell-free fibrin nanocoating remained stable in the cell culture medium for 14 days and did not change its morphology. On membranes populated with human dermal fibroblasts, the rate of fibrin degradation correlated with the degree of cell proliferation. The cell spreading, mitochondrial activity, and cell population density were significantly higher on membranes coated with fibrin than on nonmodified membranes, and this cell performance was further improved by the addition of ascorbic acid in the cell culture medium. Similarly, fibrin stimulated the expression and synthesis of collagen I in human dermal fibroblasts, and this effect was further enhanced by ascorbic acid. The expression of beta1-integrins was also improved by fibrin, and on pure polylactide membranes, it was slightly enhanced by ascorbic acid. In addition, ascorbic acid promoted deposition of collagen I in the form of a fibrous extracellular matrix. Thus, the combination of nanofibrous membranes with a fibrin nanocoating and ascorbic acid seems to be particularly advantageous for skin tissue engineering.

  14. The diagnostic value of plasma D-dimer and fibrinogen in lower limb deep venous thrombosis%血浆D-二聚体与纤维蛋白原在下肢深静脉血栓中的诊断价值

    Institute of Scientific and Technical Information of China (English)

    王旭东

    2014-01-01

    目的:探讨D-二聚体(DD)和纤维蛋白原(FIB)在下肢深静脉血栓形成(DVT)诊断中的临床意义。方法对52例疑似DVT患者进行血浆DD和FIB检测,并计算D-二聚体/纤维蛋白原比值(D/F值),根据彩色多普勒超声检查结果明确诊断,同时选取健康体检者50例作为对照组。结果 DVT组血浆DD、FIB及D/F值均明显高于健康对照组,差异有统计学意义(P<0.01);DVT组与非DVT组比较,DVT组DD、FIB和D/F值明显高于非DVT组具有显著性差异(P<0.01),D/F值、DD、FIB对诊断DVT的敏感度分别为98%、94%、85%,D/F值在诊断DVT中较单独应用DD或FIB有较高的敏感度。结论检测血浆DD、FIB及D/F比值可提高DVT临床诊断的特异性,对下肢深静脉血栓的早期诊断具有重要的临床意义。%Objective To explore the diagnostic value of plasma D-dimer and fibrinogen in lower limb deep venous thrombosis(DVT). Methods 52 patients with suspected DVT were selected to be carried out the test on plasma DD and FIB :and calculated d-dimer/fibrinogen ratio(D/F values).According to color doppler ultrasonography examination results determined diagnosis. At the same time: 50 healthy subjects were in the control group. Results The plasma DD and FIB levels and D/F values in DVT group were significantly higher than that of the healthy control group:the differences were statistically significant(P < 0.01). The plasma DD and FIB levels and D/F values in DVT group were higher than those in non-DVT group:and there was significant difference(P<0.01). The sensitivity of D/F values:DD and FIB were respectively 98%,94%,85%.The D/F values had higher sensitivity than the DD or FIB increased in the diagnosis of DVT. Conclusion The testing of plasma DD:FIB and D/F values could improve the specificity in DVT diagnosis and had important clinical significance on the early diagnosis of DVT.

  15. Clinico-pathological analysis referring hemeoxygenase-1 in acute fibrinous and organizing pneumonia patients

    Directory of Open Access Journals (Sweden)

    Yu Hara

    2015-01-01

    We experienced two cases of subacute form AFOP for these 10 years and reviewed clinico-pathological characteristics. The average age was 62 years old and both were male. The etiology of both cases was idiopathic. The average PaO2/FIO2 ratio was 274.5 ± 84.1. The average levels of C-reactive protein and surfactant protein - A of the serum were elevated to 19.8 ± 6.3 mg/dL and 67.6 ± 15.8 ng/mL, respectively. Serum sialylated carbohydrate antigen levels were normal in both cases. The characteristic radiographic findings were bilateral consolidations and ground glass opacities. Lung biopsy specimens revealed fibrin balls and alveolitis with abundant cellular HO-1 expression. Steroid response was excellent and the pulmonary involvements absolutely disappeared for about 3 months.

  16. Does tranexamic acid stabilised fibrin support the osteogenic differentiation of human periosteum derived cells?

    Directory of Open Access Journals (Sweden)

    J Demol

    2011-03-01

    Full Text Available Fibrin sealants have long been used as carrier for osteogenic cells in bone regeneration. However, it has not been demonstrated whether fibrin’s role is limited to delivering cells to the bone defect or whether fibrin enhances osteogenesis. This study investigated fibrin’s influence on the behaviour of human periosteum-derived cells (hPDCs when cultured in vitro under osteogenic conditions in two-dimensional (fibrin substrate and three-dimensional (fibrin carrier environments. Tranexamic acid (TEA was used to reduce fibrin degradation after investigating its effect on hPDCs in monolayer culture on plastic.TEA did not affect proliferation nor calcium deposition of hPDCs under these conditions. Expression profiles of specific osteogenic markers were also maintained within the presence of TEA, apart from reduced alkaline phosphatase (ALP expression (day 14. Compared to plastic, proliferation was upregulated on 2D fibrin substrates with a 220% higher DNA content by day 21. Gene expression was also altered, with significantly (p<0.05 decreased Runx2 (day 7 and ALP (day 14 expression and increased collagen I expression (day 14 and 21. In contrast to plastic, mineralisation was absent on fibrin substrates. Inside fibrin carriers, hPDCs were uniformly distributed. Moderate cell growth and reduced osteogenic marker expression was observed inside fibrin carriers. After 2 weeks, increased cell death was present in the carrier’s centre. In conclusion, fibrin negatively influences osteogenic differentiation, compared to culture plastic, but enhanced proliferation (at least in 2D cultures for hPDCs cultured in osteogenic conditions. TEA maintained the integrity of fibrin-based constructs, with minor effects on the osteogenic differentiation of hPDCs.

  17. Caveolin-1 is important for nitric oxide-mediated angiogenesis in fibrin gels with human umbilical vein endothelial cells

    Institute of Scientific and Technical Information of China (English)

    Yi-ming PAN; Yong-zhong YAO; Zhang-hua ZHU; Xi-tai SUN; Yu-dong QIU; Yi-tao DING

    2006-01-01

    Aim: The role of caveolin-l (Cav-1) in angiogenesis remains poorly understood. The endothelial nitric oxide (NO) synthase (eNOS), a caveolin-interacting protein, was demonstrated to play a predominant role in vascular endothelial growth factor (VEGF) -induced angiogenesis. The purpose of our study was to examine the role of Cav-1 and the eNOS complex in NO-mediated angiogenesis. Methods: Human umbilical vein endothelial cells (HUVEC) were isolated and cultured in 3-D fibrin gels to form capillary-like tubules by VEGF stimulation. The expression of Cav-1 and eNOS was detected by semiquantitative RT-PCR. The HUVEC were treated with antisense oligonucleotides to downregulate Cav-1 expression. Both transduced and non-infected HUVEC were cultured in fibrin gels in the presence or absence of VEGF (20 ng/mL) and NG-nitro-L-arginine methyl ester (L-NAME; 5 mmol/L). NO was measured using a NO assay kit and capillary-like tubules were quantified by tubule formation index using the Image J program. Results: RT-PCR analysis revealed that Cav-1 levels steadily increased in a time-dependent manner and reached their maximum after 5 d of incubation, but there were no obvious changes in eNOS mRNA expression in response to VEGF in the fibrin gel model. VEGF (20 ng/mL) can promote NO production and the formation of capillary-like tubules, and this promoting effect of VEGF was blocked by the addition of L-NAME (5 mmol/L). When transduced HUVEC with the antisense Cav-1 oligonucleotides were plated in the fibrin gels, the capillary-like tubules were significantly fewer than those of the non-infected cells. The capillary-like tubules formation and NO production of transduced HUVEC with the antisense Cav-1 oligonucleotides cultured in fibrin gels showed no responses to the addition of VEGF (20 ng/mL) and L-NAME (5.0 mmol/L). Conclusion: NO was a critical angiogenic mediator in this model. Cav-1 was essential for NO-mediated angiogenesis and may be an important target of anti

  18. Modification of fibrin network ultrastructure by Fab fragments specific for different domain of fibrinogen.

    Science.gov (United States)

    Cierniewski, C S; Janiak, A; Wyroba, E

    1986-01-01

    Kinetics of inhibition of fibrin monomer polymerization produced by Fab fragments prepared from immunochemically purified monospecific antibodies to the surface epitopes of different domains of fibrinogen molecule has been correlated with electron microscopic observations of resulting specimens. Fab fragments prepared from anti FgD antisera were the most efficient inhibitors of thrombin-catalysed conversion of fibrinogen to fibrin; polymerization of fibrin monomers as detected spectrophotometrically was abolished at 2:1 molar ratio of anti FgD Fab fragments to fibra monomer. These Fab fragments acting as a steric hindrance of polymerization sites inhibited the first stage of fibrin monomer aggregation. Interaction of Fab fragments derived from antibodies specific for alpha 239-476 with corresponding segment of fibrinogen molecule resulted in a weak inhibition of fibrin monomer polymerization. However, fibrin obtained in the presence of these Fab fragments was significantly modified and showed no periodicity. This observation may suggest that anti alpha 239-476 Fab impaired the course of the second stage of fibrin monomer polymerization, i.e. lateral association of fibrin fibrils.

  19. Influence of a constant magnetic field on the fibrinogen-fibrin system. [in blood coagulation process

    Science.gov (United States)

    Matskevichene, V. B.; Platonova, A. T.

    1974-01-01

    The effect of a constant magnetic field with a strength of 2500 oersteds on the fibrinogen-fibrin system was studied in the organism of healthy rabbits with exposure times of 1 and 5 hours. The results obtained indicate disruptions in the stage of conversion of fibrinogen to fibrin and an increase in the amount of fibrinogen.

  20. Anti-fibrin antibody binding in valvular vegetations and kidney lesions during experimental endocarditis.

    Science.gov (United States)

    Yokota, M; Basi, D L; Herzberg, M C; Meyer, M W

    2001-01-01

    In Streptococcus sanguinis (sanguis) induced experimental endocarditis, we sought evidence that the development of aortic valvular vegetation depends on the availability of fibrin. Endocarditis was induced in New Zealand white rabbits by catheter placement into the left ventricle and inoculation of the bacteria. Fibrin was localized in the developing vegetation with 99mTechnetium (Tc)-labeled anti-fibrin antibody one or three days later. When rabbit anti-fibrin antibody was given intravenously on day 1, the mass of aortic valvular vegetation was significantly reduced at day 3; infusion of non-specific rabbit IgG showed no effect. The 99mTc-labeled anti-fibrin antibody also labeled kidneys that showed macroscopic subcapsular hemorrhage. To learn if the deposition of fibrin in the kidneys was a consequence of endocarditis required a comparison of farm-bred and specific pathogen-free rabbits before and after the induction of endocarditis. Before induction, the kidneys of farm-bred rabbits were labeled, but specific pathogen-free rabbits were free of labeling and signs of macroscopic hemorrhage. After 3 days of endocarditis, kidneys of 10 of 14 specific pathogen-free rabbits labeled with 99mTc-labeled anti-fibrin antibody and showed hemorrhage. Kidney lesions were suggested to be a frequent sequellae of S. sanguinis infective endocarditis. For the first time, fibrin was shown to be required for the continued development of aortic valvular vegetations.

  1. Molecular weight fibrinogen variants determine angiogenesis rate in a fibrin matrix in vitro and in vivo

    NARCIS (Netherlands)

    Kaijzel, E.L.; Koolwijk, P.; Erck, M.G.M. van; Hinsbergh, V.W.M. van; Maat, M.P.M. de

    2006-01-01

    Background: During wound repair, fibrin acts both as a barrier to prevent blood loss and as a temporary matrix for the invasion and ingrowth of endothelial and tissue cells. A well-controlled angiogenesis process in the fibrinous exudate matrix is crucial for optimal wound healing. The composition a

  2. Biomimetic interconnected porous keratin-fibrin-gelatin 3D sponge for tissue engineering application.

    Science.gov (United States)

    Singaravelu, Sivakumar; Ramanathan, Giriprasath; Raja, M D; Nagiah, Naveen; Padmapriya, P; Kaveri, Krishnasamy; Sivagnanam, Uma Tiruchirapalli

    2016-05-01

    The medicated wound dressing material with highly interconnected pores, mimicking the function of the extracellular matrix was fabricated for the promotion of cell growth. In this study, keratin (K), fibrin (F) and gelatin (G) composite scaffold (KFG-SPG) was fabricated by freeze drying technique and the mupirocin (D) drug was successfully incorporated with KFG-SPG (KFG-SPG-D) intended for tissue engineering applications. The fabrication of scaffold was performed without the use of any strong chemical solvents, and the solid sponge scaffold was obtained with well interconnected pores. The porous morphology of the scaffold was confirmed by SEM analysis and exhibited competent mechanical properties. KFG-SPG and KFG-SPG-D possess high level of biocompatibility, cell proliferation and cell adhesion of NIH 3T3 fibroblast and human keratinocytes (HaCaT) cell lines thereby indicating the scaffolds potential as a suitable medicated dressing for wound healing.

  3. Increased activation of blood coagulation in pregnant women with the Factor V Leiden mutation.

    Science.gov (United States)

    Kjellberg, Ulla; van Rooijen, Marianne; Bremme, Katarina; Hellgren, Margareta

    2014-10-01

    The risk of venous thromboembolism is enhanced in pregnant carriers of the Factor V Leiden mutation. The primary aim of the study was to compare prothrombin fragments 1+2, soluble fibrin and D-dimer levels in pregnant Factor V Leiden mutation carriers with those in non-carriers. Secondary aims were to evaluate whether these biomarkers could predict placenta-mediated complications or venous thromboembolism, and to study blood coagulation after caesarean section with thromboprophylaxis and after vaginal delivery without thromboprophylaxis. Prothrombin fragments 1+2, soluble fibrin and D-dimer levels were studied longitudinally in 476 carriers with singleton pregnancies from gestational weeks 23-25 until 8-10 weeks postpartum. Prothrombin fragments 1+2 and D-dimer levels gradually increased during pregnancy. D-dimer levels were higher in carriers, both during pregnancy and puerperium, compared to non-carriers. D-dimer levels above 0.5mg/l were found in about 30% and 20% of the heterozygous carriers at 4-5 and 8-10 weeks postpartum, respectively. Soluble fibrin levels were mainly unchanged during pregnancy, with no difference between carriers and non-carriers. Biomarker levels were similar in carriers with uncomplicated and complicated pregnancies. Higher D-dimer levels indicate increased blood coagulation and fibrinolysis activity in carriers. The high proportion of carriers with D-dimer levels exceeding 0.5mg/l postpartum must be considered when assessing the probability of venous thromboembolism. Large overlaps in biomarker levels in normal and complicated pregnancies suggest that these biomarkers cannot be used as predictors. Thromboprophylaxis following caesarean section may prevent increased activation of blood coagulation. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. Preparation of two component Fibrin Glue and its clinical evaluation in skin grafts and flaps

    Directory of Open Access Journals (Sweden)

    Jain P

    2003-01-01

    Full Text Available Tissue adhesive is one of the alternative to conventional suturing and has some added advantages. Fibrin glue has been used in obtaining haemostasis following trauma to spleen and liver. It has also been used in repair of dural tear and bronchial fistula. Fibrin glue is a biological tissue adhesive based on the final stage of coagulation wherein. Thrombin acting on fibrinogen converts it into fibrin. Thus, it has two components, one is fibrinogen and another is thrombin. We have prepared both components of fibrin glue. Fibrinogen was obtained from patient's own blood and thrombin from fresh frozen plasma of screened healthy donor. The glue was used in 20 cases requiring skin graft or flap. The results were compared with conventional suturing method. Use of the fibrin glue is simple, safe, cost effective, and rapid technique to fix the skin grafts and flaps with avoidance of peroperative bleeding and postoperative collection. It also has better overall results.

  5. Fibrinous anterior uveitis following laser in situ keratomileusis

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    Parmar Pragya

    2009-01-01

    Full Text Available A 29-year-old woman who underwent laser in situ keratomileusis (LASIK for myopic astigmatism in both eyes presented with severe pain, photophobia and decreased visual acuity in the left eye eight days after surgery. Examination revealed severe anterior uveitis with fibrinous exudates in the anterior chamber, flap edema and epithelial bullae. Laboratory investigations for uveitis were negative and the patient required systemic and intensive topical steroids with cycloplegics to control the inflammation. This case demonstrates that severe anterior uveitis may develop after LASIK and needs prompt and vigorous management for resolution.

  6. Revitalization of traumatized immature tooth with platelet-rich fibrin

    Directory of Open Access Journals (Sweden)

    Umrana Faizuddin

    2015-01-01

    Full Text Available Endodontic treatment options for immature, nonvital teeth conventionally include surgical endodontics, apexification with calcium hydroxide, or single visit mineral trioxide aggregate plug. Regeneration is a new concept which is been introduced in the treatment of traumatized open apex tooth. Regeneration of pulp-dentin complex in an infected necrotic tooth with an open apex is possible if the canal is effectively disinfected. The purpose of this case report is to add a new vista in regenerative, endodontic therapy by using platelet-rich fibrin for revitalization of immature nonvital tooth.

  7. Platelet rich fibrin - a novel acumen into regenerative endodontic therapy

    Directory of Open Access Journals (Sweden)

    Kavita Hotwani

    2014-02-01

    Full Text Available Research into regenerative dentistry has added impetus onto the field of molecular biology. It can be documented as a prototype shift in the therapeutic armamentarium for dental disease. Regenerative endodontic procedures are widely being added to the current armamentarium of pulp therapy procedures. The regenerative potential of platelets has been deliberated. A new family of platelet concentrates called the platelet rich fibrin (PRF has been recently used by several investigators and has shown application in diverse disciplines of dentistry. This paper is intended to add light on the various prospects of PRF and clinical insights to regenerative endodontic therapy.

  8. Platelet rich fibrin - a novel acumen into regenerative endodontic therapy.

    Science.gov (United States)

    Hotwani, Kavita; Sharma, Krishna

    2014-02-01

    Research into regenerative dentistry has added impetus onto the field of molecular biology. It can be documented as a prototype shift in the therapeutic armamentarium for dental disease. Regenerative endodontic procedures are widely being added to the current armamentarium of pulp therapy procedures. The regenerative potential of platelets has been deliberated. A new family of platelet concentrates called the platelet rich fibrin (PRF) has been recently used by several investigators and has shown application in diverse disciplines of dentistry. This paper is intended to add light on the various prospects of PRF and clinical insights to regenerative endodontic therapy.

  9. Revitalization of traumatized immature tooth with platelet-rich fibrin

    Science.gov (United States)

    Faizuddin, Umrana; Solomon, Raji Viola; Mattapathi, Jayadev; Guniganti, Sushma Shravani

    2015-01-01

    Endodontic treatment options for immature, nonvital teeth conventionally include surgical endodontics, apexification with calcium hydroxide, or single visit mineral trioxide aggregate plug. Regeneration is a new concept which is been introduced in the treatment of traumatized open apex tooth. Regeneration of pulp-dentin complex in an infected necrotic tooth with an open apex is possible if the canal is effectively disinfected. The purpose of this case report is to add a new vista in regenerative, endodontic therapy by using platelet-rich fibrin for revitalization of immature nonvital tooth. PMID:26681870

  10. Platelet-rich fibrin application in dentistry: a literature review.

    Science.gov (United States)

    Borie, Eduardo; Oliví, Daniel García; Orsi, Iara Augusta; Garlet, Katia; Weber, Benjamín; Beltrán, Víctor; Fuentes, Ramón

    2015-01-01

    The development of bioactive surgical additives to regulate the inflammation and increase the speed of healing process is one of the great challenges in clinical research. In this sense, platelet rich fibrin (PRF) appears as a natural and satisfactory alternative with favorable results and low risks. The following review attempts to summarize the relevant literature regarding the technique of using PRF, focusing on its preparation, advantages, and disadvantages of using it in clinical applications. PRF alone or in combination with other biomaterials seems to have several advantages and indications both for medicine and dentistry, due it is a minimally invasive technique with low risks and satisfactory clinical results.

  11. Fibrin Glue Does Not Improve Healing of Gastrointestinal Anastomoses

    DEFF Research Database (Denmark)

    Nordentoft, Tyge; Pommergaard, Hans-Christian; Rosenberg, Jacob

    2015-01-01

    BACKGROUND/AIM: Anastomotic leakage remains a frequent and serious complication in gastrointestinal surgery. In order to reduce its incidence, several clinical and experimental studies on anastomotic sealing have been performed. In a number of these studies, the sealing material has been fibrin...... on the healing effects of FG on gastrointestinal anastomoses. METHODS: PubMed, EMBASE and the Cochrane databases were searched for studies evaluating the healing process of gastrointestinal anastomoses after any kind of FG application. The search period was from 1953 to December 2013. RESULTS: Twenty...

  12. Balloon angioplasty for disruption of tunneled dialysis catheter fibrin sheath.

    Science.gov (United States)

    Watorek, Ewa; Golebiowski, Tomasz; Letachowicz, Krzysztof; Garcarek, Jerzy; Kurcz, Jacek; Bartosik, Hanna Augustyniak; Letachowicz, Waldemar; Weyde, Waclaw; Klinger, Marian

    2012-01-01

    Management of failing tunneled hemodialysis catheters, sometimes the only vascular access for hemodialysis, presents a difficult problem. In spite of various techniques having been developed, no consensus has been reached about the preferred technique, associated with the longest catheter patency. We report disruption of the fibrin sheath covering dysfunctional tunneled hemodialysis catheter by means of angioplasty, followed by over guidewire catheter exchange. Following the procedure, the catheter placed in the recovered lumen of the vessel presented correct function. The described procedure allowed maintenance of vascular access in our patient. Additionally, dilatation of the concomitant central vein stenosis opens an option for another attempt for arteriovenous fistula creation.

  13. Microbiology and pathology of fibrinous pericarditis in Danish slaughter pigs

    DEFF Research Database (Denmark)

    Buttenschøn, J.; Friis, N.F.; Aalbaek, B.

    1997-01-01

    The prevalence of fibrinous pericarditis detected at slaughter in Danish slaughter pigs is approximately 0.02 %. The microbiology and pathology of this disorder was studied through 46 field cases collected at slaughter from May 1994 to August 1995. Mycoplasmas (Mycoplasma hyopneumoniae, M...... from the pericardium in three cases. The pericardium was sterile in three cases and contained a low grade mixed flora in two; the latter is believed to be a result of the slaughter procedure rather than an infection. No chlamydiae were found in connection with the microbiological examination...

  14. Microbiology and pathology of fibrinous pericarditis in Danish slaughter pigs

    DEFF Research Database (Denmark)

    Buttenschøn, J.; Friis, N.F.; Aalbaek, B.

    1997-01-01

    The prevalence of fibrinous pericarditis detected at slaughter in Danish slaughter pigs is approximately 0.02 %. The microbiology and pathology of this disorder was studied through 46 field cases collected at slaughter from May 1994 to August 1995. Mycoplasmas (Mycoplasma hyopneumoniae, M...... from the pericardium in three cases. The pericardium was sterile in three cases and contained a low grade mixed flora in two; the latter is believed to be a result of the slaughter procedure rather than an infection. No chlamydiae were found in connection with the microbiological examination...

  15. Computational imaging analysis of fibrin matrices with the inclusion of erythrocytes from homozygous SS blood reveals agglomerated and amorphous structures.

    Science.gov (United States)

    Averett, Rodney D; Norton, David G; Fan, Natalie K; Platt, Manu O

    2017-01-01

    Sickle cell disease is a single point mutation disease that is known to alter the coagulation system, leading to hypercoagulable plasma conditions. These hypercoagulable conditions can lead to complications in the vasculature, caused by fibrin clots that form undesirably. There is a need to understand the morphology and structure of fibrin clots from patients with sickle cell disease, as this could lead to further discovery of treatments and life-saving therapies. In this work, a computational imaging analysis method is presented to evaluate fibrin agglomeration in the presence of erythrocytes (RBCs) homozygous for the sickle cell mutation (SS). Numerical algorithms were used to determine agglomeration of fibrin fibers within a matrix with SS RBCs to test the hypothesis that fibrin matrices with the inclusion of SS RBCs possess a more agglomerated structure than native fibrin matrices with AA RBCs. The numerical results showed that fibrin structures with SS RBCs displayed an overall higher degree of agglomeration as compared to native fibrin structures. The computational algorithm was also used to evaluate fibrin fiber overlap (aggregation) and anisotropy (orientation) in normal fibrin matrices compared to fibrin matrices polymerized around SS RBCs; however, there was no statistical difference. Ultrasound measurements of stiffness revealed rigid RBCs in the case of samples derived from homozygous SS blood, and densely evolving matrices, when compared to normal fibrin with the inclusion of AA RBCs. An agglomeration model is suggested to quantify the fibrin aggregation/clustering near RBCs for both normal fibrin matrices and for the altered structures. The results of this work are important in the sense that the understanding of aggregation and morphology in fibrin clots with incorporation of RBCs from persons living with sickle cell anemia may elucidate the complexities of comorbidities and other disease complications.

  16. D-二聚体在老年下肢深静脉血栓预测中的临界值探讨%Critical Value of D-dimer in Elderly Patients in Lower Limb Deep Vein Thrombosis

    Institute of Scientific and Technical Information of China (English)

    殷明春

    2014-01-01

    Objective:To investigate the D-dimer (DD) in elderly patients with lower extremity deep vein thrombosis (DVT) of the prediction critical value,in order to provide reference for clinical diagnosis of senile lower limb DVT.Methods:482 patients with DD enzyme-linked immunosorbent method of elderly hospitalized patients with clinical data were retrospectively analyzed,73 cases of lower limb DVT occurred for DVT group,in which 34 cases aged 60~79,p 80,39,409 cases lower extremity DVT occurred not as a set of DVT.Results:DVT group average DD(2.67±0.61)mg/L,not DVT group is(1.71±0.35)mg/L,DVT is significantly higher than non DVT group (P0.05),specificity is higher than in patients with 60~69 years old or 80 years old patients (P0.05),2.0mg/L,3.0mg/L in two age groups the sensitivity and specificity of comparative differences statistically significant (P0.05),对60~69岁患者诊断特异性高于≥80岁患者(P0.05),2.0mg/L、3.0mg/L时两个年龄段的敏感性及特异性比较差异具有统计学意义(P<0.05)。结论:60~69岁老年患者DD预测下肢DVT时临界值以0.5mg/L适宜,年龄≥80岁的老年患者则DD临界值调整为2.0mg/L更为合适。

  17. 肝硬化患者血浆D-二聚体的检测与分析(比浊法)%Testing and analysis of Plasma D-dimer in patients with liver cirrhosis

    Institute of Scientific and Technical Information of China (English)

    于广名

    2010-01-01

    目的:经过检测不同临床分级的肝硬化患者血浆中D-二聚体(D-Dimer)的水平,进一步来研究其鉴别诊断的意义和肝病凝血功能障碍的发病机理.方法:应用日本Sysmex CA1500检测仪,采用免疫比浊法来检测样本的D-二聚体含量.结果:肝硬化患者D-二聚体水平明显高于对照组(健康人),差异有统计学意义(P<0.01).肝硬化患者肝功能A、B、C级者血浆D-二聚体水平逐渐升高,分别与对照组进行两两比较,差异均有统计学意义(P<0.01).肝硬化并消化道出血者血浆D-二聚体水平非出血者高,差异有统计学意义(P<0.01).肝硬化患者HBsAg阳性的血浆D-二聚体水平较HBsAg阴性高,差异有统计学意义(P<0.05).故病情及肝功能损害越重,血浆D-二聚体含量越高.结论:血浆D-二聚体的含量在肝硬化各临床分级的患者血浆中明显增高,患者的病情越严重、肝脏功能越差则其血浆中D-二聚体的含量就越高.

  18. D-二聚体定量检测在排除静脉血栓性疾病中的作用——推荐性指南(CLSI H59-P)解读%Value of D-dimer quantitative detection in precluding venous throbosis-understanding of CLSI H59 guide

    Institute of Scientific and Technical Information of China (English)

    陈华云; 胡晓波

    2011-01-01

    @@ 2010年,临床实验室标准化研究所(Clinical andLaboratory Standards Institute,CLSI)出版了H59-P指南.该指南指出,在低、中临床危险度峰值时,定量检测D-二聚体(D-Dimer,D-D)用作静脉血栓栓塞症(VTE)的排除性诊断.

  19. Teknik Lem Fibrin Otologus pada Cangkok Konjungtiva Bulbi Mata Kelinci

    Directory of Open Access Journals (Sweden)

    Sutarya Enus

    2009-12-01

    Full Text Available Commercial Fibrin Glue (CFG as a biomaterial adhesive from fresh frozen plasma donor and bovine has been tested having various superiorities compared to suturing in bulbar conjunctiva grafting of pterygium surgery. Due to CFG has not been available in Indonesia led the author to make an Autologous Fibrin Glue (AFG directly from patient's own blood. The study aim was to investigate the effectiveness of AFG attachment. This study was an animal experimental, conducted in 24 New Zealand White rabbits divided into AFG group and suturing group of 12 rabbits each, held in Laboratory of Bio Farma, Bandung, from September to December 2006. The assessment included duration (in minute of AFG compared to suturing techniques, also at first day and one week post grafting attachments in bulbar conjunctiva grafting. The statistical analysis used Mann-Whitney and Wilcoxon rank test. In time duration of surgical treatment, AFG technique was significantly shorter than suturing technique (p=0.0001, while first day and one week post grafting AFG attachment showed significantly greater than those of suturing attachment (p=0.0001. In the meantime, first day and one week post grafting AFG attachment was steady state, whereas in suturing technique was different (p=0.0174. In conclusion, AFG technique is more effective than suturing technique in bulbar conjunctiva grafting because of shorter surgical duration, excellent and stable graft attachment.

  20. Fibrin sealant reduces pain after tonsillectomy: prospective randomized study.

    Science.gov (United States)

    Vaiman, Michael; Krakovski, Daniel; Gavriel, Haim

    2006-07-01

    Postsurgical pain in adults following tonsillectomy with fibrin sealant or electrocoagulation was assessed by surface electromyography (sEMG), a dysphagia severity rating scale (DSRS), and a visual analog scale (VAS) pain For group 1 (n = 40), hemostasis was achieved by fibrin sealant spraying to the tonsillar fossae. For group 2 (n = 40), hemostasis was achieved by bipolar or needle point electrocautery. The timing of single swallowing and continuous drinking and the mean electrical activity of the masseter, infrahyoid, and submental-submandibular muscles were compared with a normative database during 30 days and with DSRS and VAS scores. Electrical activity of the masseter and infrahyoid muscles was significantly higher in both groups in comparison with the normative database (p sEMG, DSRS, and VAS assessment showed that tonsillectomy ended with sealant causes less pain than electrocoagulation (p sEMG records, whereas the VAS pain score was less informative. The combined sEMG and pain score data indicate that the electrocautery hemostatic technique is more painful and traumatic than the sealant technique. Surface electromyography of swallowing is a simple, reliable evaluation method for postsurgical odynophagia complaints and might be used as an objective tool for pain assessment.

  1. Soft fibrin gels promote selection and growth of tumorigenic cells

    Science.gov (United States)

    Liu, Jing; Tan, Youhua; Zhang, Huafeng; Zhang, Yi; Xu, Pingwei; Chen, Junwei; Poh, Yeh-Chuin; Tang, Ke; Wang, Ning; Huang, Bo

    2012-08-01

    The identification of stem-cell-like cancer cells through conventional methods that depend on stem cell markers is often unreliable. We developed a mechanical method for selecting tumorigenic cells by culturing single cancer cells in fibrin matrices of ~100 Pa in stiffness. When cultured within these gels, primary human cancer cells or single cancer cells from mouse or human cancer cell lines grew within a few days into individual round colonies that resembled embryonic stem cell colonies. Subcutaneous or intravenous injection of 10 or 100 fibrin-cultured cells in syngeneic or severe combined immunodeficiency mice led to the formation of solid tumours at the site of injection or at the distant lung organ much more efficiently than control cancer cells selected using conventional surface marker methods or cultured on conventional rigid dishes or on soft gels. Remarkably, as few as ten such cells were able to survive and form tumours in the lungs of wild-type non-syngeneic mice.

  2. Fibrin glue in the treatment of anal fistula: a systematic review

    Directory of Open Access Journals (Sweden)

    Covarelli Piero

    2009-11-01

    Full Text Available Abstract Background New sphincter-saving approaches have been applied in the treatment of perianal fistula in order to avoid the risk of fecal incontinence. Among them, the fibrin glue technique is popular because of its simplicity and repeatability. The aim of this review is to compare the fibrin glue application to surgery alone, considering the healing and complication rates. Methods We performed a systematic review searching for published randomized and controlled clinical trials without any language restriction by using electronic databases. All these studies were assessed as to whether they compared conventional surgical treatment versus fibrin glue treatment in patients with anal fistulas, in order to establish both the efficacy and safety of each treatment. We used Review Manager 5 to conduct the review. Results The healing rate is higher in those patients who underwent the conventional surgical treatment (P = 0,68, although the treatment with fibrin glue gives no evidence of anal incontinence (P = 0,08. Furthermore two subgroup analyses were performed: fibrin glue in combination with intra-adhesive antibiotics versus fibrin glue alone and anal fistula plug versus fibrin glue. In the first subgroup there were not differences in healing (P = 0,65. Whereas in the second subgroup analysis the healing rate is statistically significant for the patients who underwent the anal fistula plug treatment instead of the fibrin glue treatment (P = 0,02. Conclusion In literature there are only two randomized controlled trials comparing the conventional surgical management versus the fibrin glue treatment in patients with anal fistulas. Although from our statistical analysis we cannot find any statistically significant result, the healing rate remains higher in patients who underwent the conventional surgical treatment (P = 0,68, and the anal incontinence rate is very low in the fibrin glue treatment group (P = 0,08. Anyway the limited collected data do

  3. Sildenafil attenuates pulmonary inflammation and fibrin deposition, mortality and right ventricular hypertrophy in neonatal hyperoxic lung injury

    Directory of Open Access Journals (Sweden)

    Boersma Hester

    2009-04-01

    Full Text Available Abstract Background Phosphodiesterase-5 inhibition with sildenafil has been used to treat severe pulmonary hypertension and bronchopulmonary dysplasia (BPD, a chronic lung disease in very preterm infants who were mechanically ventilated for respiratory distress syndrome. Methods Sildenafil treatment was investigated in 2 models of experimental BPD: a lethal neonatal model, in which rat pups were continuously exposed to hyperoxia and treated daily with sildenafil (50–150 mg/kg body weight/day; injected subcutaneously and a neonatal lung injury-recovery model in which rat pups were exposed to hyperoxia for 9 days, followed by 9 days of recovery in room air and started sildenafil treatment on day 6 of hyperoxia exposure. Parameters investigated include survival, histopathology, fibrin deposition, alveolar vascular leakage, right ventricular hypertrophy, and differential mRNA expression in lung and heart tissue. Results Prophylactic treatment with an optimal dose of sildenafil (2 × 50 mg/kg/day significantly increased lung cGMP levels, prolonged median survival, reduced fibrin deposition, total protein content in bronchoalveolar lavage fluid, inflammation and septum thickness. Treatment with sildenafil partially corrected the differential mRNA expression of amphiregulin, plasminogen activator inhibitor-1, fibroblast growth factor receptor-4 and vascular endothelial growth factor receptor-2 in the lung and of brain and c-type natriuretic peptides and the natriuretic peptide receptors NPR-A, -B, and -C in the right ventricle. In the lethal and injury-recovery model we demonstrated improved alveolarization and angiogenesis by attenuating mean linear intercept and arteriolar wall thickness and increasing pulmonary blood vessel density, and right ventricular hypertrophy (RVH. Conclusion Sildenafil treatment, started simultaneously with exposure to hyperoxia after birth, prolongs survival, increases pulmonary cGMP levels, reduces the pulmonary

  4. Fibrin/platelet plug counteracts cutaneous wound contraction: the hypothesis of "skipping stone".

    Science.gov (United States)

    Farahani, Ramin Mostofi Zadeh

    2007-01-01

    Cutaneous wound contraction and epithelialization act collaboratively to minimize the exposed wound surface. However excessive wound contraction is undesirable due to the resultant disfigurement and scarring. Fibrin clot has greater stiffness than surrounding tissue and mechanical strain further enhances its stiffness. On the contrary, skin exhibits diminished stiffness when affected by high strain rates. Therefore during early stages of wound healing, the contractile wound border is confronted by fibrin clot forming a high strain region in the interface of contractile tissue and fibrin clot--which is evidenced by computer simulation. Due to the stress relaxation property of skin, the contractile strain is partly neutralized. Meanwhile, gradually the stiffness of fibrin clot decreases which is followed by another cycle of wound contraction. This cyclic pattern of contraction resembles the movement of a stone over water or "skipping stone". The stone bounces repeatedly when thrown across the surface of water with reduction of jumping altitude with each bounce till the stone stops completely. This hypothesis is further supported by the observed initial delay in wound contraction and the chronological correlation of enhanced wound contraction with loss of superficial eschar and substitution of fibrin clot with granulation tissue. Also there is evidence that fibrin inhibits fibroblast-mediated contraction of collagen. Furthermore, modest increase in wound contraction rate in fibrinogen deficient mice and fibrin-mediated diminished wound contraction are agreement with the proposed hypothesis.

  5. Microvascular anastomosis using fibrin glue and venous cuff in rat carotid artery.

    Science.gov (United States)

    Sacak, Bulent; Tosun, Ugur; Egemen, Onur; Sakiz, Damlanur; Ugurlu, Kemal

    2015-04-01

    Conventional anastomosis with interrupted sutures can be time-consuming, can cause vessel narrowing, and can lead to thrombosis at the site of repair. The amount of suture material inside the lumen can impair the endothelium of the vessel, triggering thrombosis. In microsurgery, fibrin sealants have the potential beneficial effects of reducing anastomosis time and promoting accurate haemostasis at the anastomotic site. However, there has been a general reluctance to use fibrin glue for microvascular anastomoses because the fibrin polymer is highly thrombogenic and may not provide adequate strength. To overcome these problems, a novel technique was defined for microvascular anastomosis with fibrin glue and a venous cuff. Sixty-four rats in two groups are included in the study. In the experimental group (n = 32), end-to-end arterial anastomosis was performed with two stay sutures, fibrin glue, and a venous cuff. In the control group (n = 32), conventional end-to-end arterial anastomosis was performed. Fibrin glue assisted anastomosis with a venous cuff took less time, caused less bleeding at the anastomotic site, and achieved a patency rate comparable to that provided by the conventional technique. Fibrin sealant assisted microvascular anastomosis with venous cuff is a rapid, easy, and reliable technique compared to the end-to-end arterial anastomosis.

  6. Fibronectin provides a conduit for fibroblast transmigration from collagenous stroma into fibrin clot provisional matrix.

    Science.gov (United States)

    Greiling, D; Clark, R A

    1997-04-01

    After injury, the wound space is filled with a fibrin/fibronectin clot containing growth factors released by platelets and monocytes. In response to these factors, fibroblasts migrate into the fibrin clot and contribute to the formation of granulation tissue. The functional mechanisms allowing fibroblasts to leave the collagenous matrix of normal connective tissue and invade the provisional matrix of the fibrin clot have not been fully defined. To investigate these mechanisms we established a new in vitro model which simulates specific aspects of early wound healing, that is, the migration of fibroblasts from a three-dimensional collagen matrix into a fibrin clot. This transmigration could be induced by physiological concentrations of platelet releasate or platelet-derived growth factor BB (PDGF-BB) in a concentration-dependent manner. At 24 hours irradiated fibroblasts invaded the fibrin gel almost as well as non-irradiated cells, indicating that transmigration was independent of proliferation. Plasminogen and its activators appear to be necessary for invasion of the fibrin clot since protease inhibitors decreased the amount of migration. These serine proteases, however, were not necessary for exit from the collagen gel as fibroblasts migrated out of the collagen gel onto a surface coated with fibrin fibrils even in the presence of inhibitors. Removal of fibronectin (FN) from either the collagen gel or the fibrin gel markedly decreased the number of migrating cells, suggesting that FN provides a conduit for transmigration. Cell movement in the in vitro model was inhibited by RGD peptide, and by monoclonal antibodies against the subunits of the alpha5 beta1 and alpha v beta3 integrin receptor. Thus, the functional requirements for fibroblast transmigration from collagen-rich to fibrin-rich matrices, such as occurs in early wound healing, have been partially defined using an in vitro paradigm of this important biologic process.

  7. Morphological Study of Isolated Ovarian Preantral Follicles Using Fibrin Gel Plus Platelet Lysate after Subcutaneous Transplantation

    Directory of Open Access Journals (Sweden)

    Ali Reza Rajabzadeh

    2015-04-01

    Full Text Available Objective: Ovarian and follicle transplantation may preserve fertility in young cancer survivors. In this study, we have transplanted preantral follicles using fibrin gel as a carrier and fibrin gel supplemented with platelet lysate (PL as a rich source of angiogenic and growth factors. The purpose of this study was to evaluate the role of fibrin gel and PL in follicle transplantation. Materials and Methods: In this experimental study, ovaries were taken from 14-dayold Naval Medical Research Institute (NMRI mice. Preantral follicles were dissected from the ovaries and encapsulated into fibrin gel supplemented with 5, 10, 15 or 20% PL, then transplanted back into the same donor mice. Fibrin gels supplemented with PL that contained preantral follicles were placed in a subcutaneous pocket in the back of the neck of the recipient, donor mouse (the same mouse that follicles were collected. After 14 days the grafts were processed and embedded in paraffin blocks, then serially sectioned for histological evaluation. We counted the follicles and classified them according to stage (preantral or antral. Data were presented as mean ± standard error of mean (SEM and analysed by analysis of variance (ANOVA and the Kruskal-Wallistest. Results: The mean percentage of recovered follicles encapsulated and transplanted in each group were 33.30 ± 2.47 (fibrin gel, 31.96 ± 1.90 (fibrin gel+5% PL, 34.02 ± 2.44 (fibrin gel+10% PL, 48.31 ± 2.06 (fibrin gel+15% PL and 17.60 ± 2.79 (fibrin gel+20% PL. There was a significant increase in the recovery rate of grafted follicles with fibrin gel+15% PL (48.31%; p<0.001. The percentage of preantral follicles showed no significant difference in all groups (p<0.05. The percentage of antral follicles showed a significant decrease in follicles grafted with fibrin gel+20% PL when compared to the other groups (11.77%; p<0.005 but no significant difference was observed in the other groups. Conclusion: The use of PL in follicle

  8. Venous gas embolism caused by fibrin sealant application to the prostate during greenlight laser photoselective vaporization.

    Science.gov (United States)

    Lee, Alexander; Vazquez, Rafael

    2015-04-15

    Venous gas embolism is a complication of fibrin sealant application and is a well-described event during various modes of prostate resection. We describe the case of a nitrogen venous gas embolism during Greenlight laser photovaporization of the prostate during the application of fibrin sealant to the operative site for hemostasis. Fibrin sealant application by a compressed gas applicator is a cause of venous air embolism, and this case highlights the need to keep venous gas embolism in mind when compressed gas applicators are used.

  9. The Platelet Integrin αIIbβ3 Differentially Interacts with Fibrin Versus Fibrinogen.

    Science.gov (United States)

    Litvinov, Rustem I; Farrell, David H; Weisel, John W; Bennett, Joel S

    2016-04-08

    Fibrinogen binding to the integrin αIIbβ3 mediates platelet aggregation and spreading on fibrinogen-coated surfaces. However,in vivoαIIbβ3 activation and fibrinogen conversion to fibrin occur simultaneously, although the relative contributions of fibrinogenversusfibrin to αIIbβ3-mediated platelet functions are unknown. Here, we compared the interaction of αIIbβ3 with fibrin and fibrinogen to explore their differential effects. A microscopic bead coated with fibrinogen or monomeric fibrin produced by treating the immobilized fibrinogen with thrombin was captured by a laser beam and repeatedly brought into contact with surface-attached purified αIIbβ3. When αIIbβ3-ligand complexes were detected, the rupture forces were measured and displayed as force histograms. Monomeric fibrin displayed a higher probability of interacting with αIIbβ3 and a greater binding strength. αIIbβ3-fibrin interactions were also less sensitive to inhibition by abciximab and eptifibatide. Both fibrinogen- and fibrin-αIIbβ3 interactions were partially inhibited by RGD peptides, suggesting the existence of common RGD-containing binding motifs. This assumption was supported using the fibrin variants αD97E or αD574E with mutated RGD motifs. Fibrin made from a fibrinogen γ'/γ' variant lacking the γC αIIbβ3-binding motif was more reactive with αIIbβ3 than the parent fibrinogen. These results demonstrate that fibrin is more reactive with αIIbβ3 than fibrinogen. Fibrin is also less sensitive to αIIbβ3 inhibitors, suggesting that fibrin and fibrinogen have distinct binding requirements. In particular, the maintenance of αIIbβ3 binding activity in the absence of the γC-dodecapeptide and the α-chain RGD sequences suggests that the αIIbβ3-binding sites in fibrin are not confined to its known γ-chain and RGD motifs.

  10. Correlative Analysis of the Relationships and Differences on D-dimer, Fibrinogen and Antithrombin Ⅲ Between Varied Clinical Periods of Cerebral Infarction%D-D、Fb和AT-Ⅲ在脑梗死不同时期的变化及相关性分析

    Institute of Scientific and Technical Information of China (English)

    徐威香; 武蓉珍; 胡晓蕾

    2012-01-01

    目的:探讨血浆D-二聚体(D-D)、纤维蛋白原(Fb)和抗凝血酶Ⅲ(AT-Ⅲ)在脑梗死(CI)不同时期的变化及其临床意义.方法:根据临床特征,对260例CI患者进行分组,其中CI急性期组80例、进展期组41例、非进展期组65例、康复期组74例;90例体检健康者为正常对照组.采用SYSMEX CA7000血凝仪分别检测其血浆D-D、Fb和AT-Ⅲ水平.结果:CI急性期、进展期、非进展期患者D-D、Fb含量均明显高于正常对照组(P<0.01),AT-Ⅲ低于正常对照组(P<0.01);脑梗死组中,D-D与AT-Ⅲ呈负相关(P<0.01),D-D与Fb呈正相关(P<0.01),AT-Ⅲ与Fb无相关性.结论:CI患者D-D、Fb、AT-Ⅲ变化显著,D-D升高伴随AT-Ⅲ含量降低,提示D-D、Fb、AT-Ⅲ共同参与了梗死发生发展的病理生理过程,可作为CI临床危险分级和病情监测的指标.%Objective To investigate the differences and its clinical significance of D-dimer, fibrinogen and antithrombin Ⅲ between varied clinical periods of cerebral infarction( CI). Methods 328 CI patients were rolled into the study, and they were divided into four groups due to their different clinical periods as follows: group acute period (80) , group progressing(41) , group non-pro-gressing(65) , group convalescence(74). And, 90 healthy volunteers were rolled into the normal control group. Their plasma D-dimer, fibrinogen and antithrombin HI were detected on SYSMEX CA7000 automatic coagulation analyzer. Results D-dimer and fibrinogen of CI patients in the acute, progressing and non-progressing periods were significantly higher (P <0.01) than those of healthy volunteers, while antithrombin Ⅲ of them was significantly lower (P<0.01) than that of healthy volunteers. In CI patients, D-dimer correlated negatively with antithrombin Ⅲ, while positively with fibrinogen. No significant relationship was observed between antithrombin Ⅲ and fibrinogen. ConclUSin D-dimer, fibrinogen and antithrombin Ⅲ of CI patients varied significantly

  11. Platelet-rich-fibrin: A novel root coverage approach

    Directory of Open Access Journals (Sweden)

    Anilkumar K

    2009-01-01

    Full Text Available Treatment of gingival recession has become an important therapeutic issue due to increasing cosmetic demand. Multiple surgical procedures have been developed to obtain predictable esthetic root coverage. More specifically, after periodontal regenerative surgery, the aim is to achieve complete wound healing and regeneration of the periodontal unit. A recent innovation in dentistry is the preparation and use of platelet-rich plasma (PRP, a concentrated suspension of the growth factors, found in platelets. These growth factors are involved in wound healing and postulated as promoters of tissue regeneration. This paper reports the use of PRF membrane for root coverage on the labial surfaces of the mandibular anterior teeth. This was accomplished using laterally displaced flap technique with platelet rich fibrin (PRF membrane at the recipient site.

  12. Growth of hydroxyapatite on physiologically clotted fibrin capped gold nanoparticles

    Energy Technology Data Exchange (ETDEWEB)

    Sastry, T P; Sundaraseelan, J; Swarnalatha, K; Sobhana, S S Liji; Makheswari, M Uma; Sekar, S; Mandal, A B [Central Leather Research Institute, Chennai-600020, Tamilnadu (India)], E-mail: sastrytp@hotmail.com, E-mail: abmandal@hotmail.com

    2008-06-18

    The growth of hydroxyapatite (HAp) on physiologically clotted fibrin (PCF)-gold nanoparticles is presented for the first time by employing a wet precipitation method. Fourier transform infrared (FTIR) spectroscopy confirmed the characteristic functionalities of PCF and HAp in the PCF-Au-HAp nanocomposite. Scanning electron microscopy (SEM) images have shown cuboidal nanostructures having a size in the range of 70-300 nm of HAp, whereas 2-50 nm sized particles were visualized in high-resolution transmission electron microscopy (TEM). Energy-dispersive x-ray (EDX) and x-ray diffraction (XRD) studies have confirmed the presence of HAp. These results show that gold nanoparticles with PCF acted as a matrix for the growth of HAp, and that PCF-Au-HAp nanocomposite is expected to have better osteoinductive properties.

  13. Platelet-rich fibrin: a boon in regenerative endodontics.

    Science.gov (United States)

    Rebentish, Priyanka D; Umashetty, Girish; Kaur, Harpreet; Doizode, Trupthi; Kaslekar, Mithun; Chowdhury, Shouvik

    2016-12-01

    Research into regenerative dentistry has contributed momentum to the field of molecular biology. Periapical surgery aims at removing periapical pathology to achieve complete wound healing and regeneration of bone and periodontal tissue. Regenerative endodontic procedures are widely being added to the current armamentarium of pulp therapy procedures. The regenerative potential of platelets has been deliberated. Platelet-rich fibrin (PRF) is a wonderful tissue-engineering product and has recently gained much popularity due its promising results in wound healing bone induction. The features of this product are an attribute of platelets which, after cellular interactions, release growth factors and have shown application in diverse disciplines of dentistry. This paper is intended to shed light onto the various prospects of PRF and to provide clinical insight into regenerative endodontic therapy.

  14. A new approach for pancreatic tissue engineering: human endometrial stem cells encapsulated in fibrin gel can differentiate to pancreatic islet beta-cell.

    Science.gov (United States)

    Niknamasl, Azadeh; Ostad, Seyed Nasser; Soleimani, Mansoureh; Azami, Mahmoud; Salmani, Maryam Kabir; Lotfibakhshaiesh, Nasrin; Ebrahimi-Barough, Somayeh; Karimi, Roya; Roozafzoon, Reza; Ai, Jafar

    2014-10-01

    Metabolic diabetes mellitus as the most serious and prevalent metabolic disease in the world has various complications. The most effective treatment of type I diabetes seems to be islet cell transplantation. Shortage of donors and difficult procedures and high rate of rejection have always restricted this approach. Tissue engineering is a novel effective solution to many medical problems such as diabetes. Endometrial mesenchymal stem cells as a lineage which have the potential to differentiate to mesodermal and endodermal tissues seem to be suitable for this purpose. Fibrin hydrogel with a high degree of biocompatibility and specific properties making it similar to normal pancreas seems to be an ideal scaffold. After successfully isolating stem cells (hEnSCs) from human endometrium, a three-step protocol was used to differentiate them into pancreatic beta cells. Fibrin was used as 3D scaffold. After 2 weeks, cells formed clusters like islets cells, and secretion of insulin was measured by chemiluminescence. PDX1, proinsulin, and c-peptide as special markers of β cells were detected by immunofluorescence. Expression of glucagon, PDX1, and insulin genes in mRNA level was detected by Real time PCR and gel electrophoresis. The former showed higher levels of gene expression in 3D cultures. SEM analysis showed good integrity between cells and scaffold. No toxicity was detected with fibrin scaffold by MTT assay.

  15. Albumin removal from human fibrinogen preparations for manufacturing human fibrin-based biomaterials

    Directory of Open Access Journals (Sweden)

    Vaibhav Sharma

    2015-01-01

    Full Text Available Commercially available two component human fibrin sealants are commonly used to manufacture human fibrin-based biomaterials. However, this method is costly and allows little room for further tuning of the biomaterial. Human fibrinogen solutions offer a more cost-effective and versatile alternative to manufacture human fibrin-based biomaterials. Yet, human fibrinogen is highly unstable and contains certain impurities like human albumin. Within the context of biomaterials and tissue engineering we offer a simple yet novel solution based on classical biochemical techniques to significantly reduce albumin in human fibrinogen solutions. This method can be used for various tissue engineering and biomedical applications as an initial step in the manufacturing of human fibrin-based biomaterials to optimise their regenerative application.

  16. Sealing of Gastrointestinal Anastomoses with a Fibrin Glue-Coated Collagen Patch: A Safety Study

    DEFF Research Database (Denmark)

    Nordentoft, Tyge; Rømer, John; Sørensen, Michael

    2007-01-01

    Sealing of anastomoses has previously been tested with several methods, including sealing with liquid fibrin glue. Sealing with a collagen patch coated with fibrin glue components has never been systematically examined. The aim of the present study was to determine the safety of sealing...... gastrointestinal anastomoses with a collagen patch coated with fibrin glue. The study is a prospective, experimental animal study comparing sealed and unsealed gastrointestinal anastomoses. Laparotomy was performed in 11 pigs under general anesthesia. In each pig two anastomoses were performed on the small...... intestine. One of the anastomoses was sealed with a collagen patch coated with fibrin glue components (TachoSil). The other anastomosis contained no sealing. The pigs were observed for 1 to 6 weeks. The observation period was followed by in vivo examination under general anesthesia and included observation...

  17. Lower reoperation rates with the use of fibrin sealant versus tacks for mesh fixation

    DEFF Research Database (Denmark)

    Helvind, Neel Maria; Andresen, Kristoffer; Rosenberg, Jacob

    2013-01-01

    BACKGROUND: Groin hernia repair may be associated with long-term complications such as chronic pain, believed to result from damage to regional nerves by tissue penetrating mesh fixation. Studies have shown that mesh fixation with fibrin sealant reduces the risk of these long-term complications......, but data on recurrence and reoperation rates after the use of fibrin sealant compared with tacks are not available. This study aimed to determine whether fibrin sealant is a safe and feasible alternative to tacks with regard to reoperation rates after laparoscopic groin hernia repair. METHODS: The current...... study compared reoperation rates after laparoscopic groin hernia repair between fibrin sealant and tacks used for mesh fixation. The study used data collected prospectively from The National Danish Hernia Database and analyzed 8,314 laparoscopic groin hernia repairs for reoperation rates. Mesh fixation...

  18. Fibrin and fibrinogen degradation products in plasma : clinical and methodological studies using enzyme immuno assays

    NARCIS (Netherlands)

    H. Kroneman (Herman)

    1992-01-01

    textabstractThis thesis comprises studies with monoclonal antibody-based plasma assays for derivatives of fibrin and fibrinogen in patients with diseases and conditions characterized by an activated state of coagulation and fibrinolysis

  19. Aulogous fibrin sealant (Vivostat ® in the neurosurgical practice: Part II: Vertebro-spinal procedures

    Directory of Open Access Journals (Sweden)

    Francesca Graziano

    2016-01-01

    Conclusions: In this preliminary study, the application of autologous fibrin sealant with Vivostat ® resulted in rapid hemostasis and/or acted as an effective dural sealant. Although this product appears to be safe and effective, further investigations are warranted.

  20. CYLD enhances severe listeriosis by impairing IL-6/STAT3-dependent fibrin production.

    Directory of Open Access Journals (Sweden)

    Gopala Nishanth

    Full Text Available The facultative intracellular bacterium Listeria monocytogenes (Lm may cause severe infection in humans and livestock. Control of acute listeriosis is primarily dependent on innate immune responses, which are strongly regulated by NF-κB, and tissue protective factors including fibrin. However, molecular pathways connecting NF-κB and fibrin production are poorly described. Here, we investigated whether the deubiquitinating enzyme CYLD, which is an inhibitor of NF-κB-dependent immune responses, regulated these protective host responses in murine listeriosis. Upon high dose systemic infection, all C57BL/6 Cyld(-/- mice survived, whereas 100% of wildtype mice succumbed due to severe liver pathology with impaired pathogen control and hemorrhage within 6 days. Upon in vitro infection with Lm, CYLD reduced NF-κB-dependent production of reactive oxygen species, interleukin (IL-6 secretion, and control of bacteria in macrophages. Furthermore, Western blot analyses showed that CYLD impaired STAT3-dependent fibrin production in cultivated hepatocytes. Immunoprecipitation experiments revealed that CYLD interacted with STAT3 in the cytoplasm and strongly reduced K63-ubiquitination of STAT3 in IL-6 stimulated hepatocytes. In addition, CYLD diminished IL-6-induced STAT3 activity by reducing nuclear accumulation of phosphorylated STAT3. In vivo, CYLD also reduced hepatic STAT3 K63-ubiquitination and activation, NF-κB activation, IL-6 and NOX2 mRNA production as well as fibrin production in murine listeriosis. In vivo neutralization of IL-6 by anti-IL-6 antibody, STAT3 by siRNA, and fibrin by warfarin treatment, respectively, demonstrated that IL-6-induced, STAT3-mediated fibrin production significantly contributed to protection in Cyld(-/- mice. In addition, in vivo Cyld siRNA treatment increased STAT3 phosphorylation, fibrin production, pathogen control and survival of Lm-infected WT mice illustrating that therapeutic inhibition of CYLD augments the

  1. CYLD enhances severe listeriosis by impairing IL-6/STAT3-dependent fibrin production.

    Science.gov (United States)

    Nishanth, Gopala; Deckert, Martina; Wex, Katharina; Massoumi, Ramin; Schweitzer, Katrin; Naumann, Michael; Schlüter, Dirk

    2013-01-01

    The facultative intracellular bacterium Listeria monocytogenes (Lm) may cause severe infection in humans and livestock. Control of acute listeriosis is primarily dependent on innate immune responses, which are strongly regulated by NF-κB, and tissue protective factors including fibrin. However, molecular pathways connecting NF-κB and fibrin production are poorly described. Here, we investigated whether the deubiquitinating enzyme CYLD, which is an inhibitor of NF-κB-dependent immune responses, regulated these protective host responses in murine listeriosis. Upon high dose systemic infection, all C57BL/6 Cyld(-/-) mice survived, whereas 100% of wildtype mice succumbed due to severe liver pathology with impaired pathogen control and hemorrhage within 6 days. Upon in vitro infection with Lm, CYLD reduced NF-κB-dependent production of reactive oxygen species, interleukin (IL)-6 secretion, and control of bacteria in macrophages. Furthermore, Western blot analyses showed that CYLD impaired STAT3-dependent fibrin production in cultivated hepatocytes. Immunoprecipitation experiments revealed that CYLD interacted with STAT3 in the cytoplasm and strongly reduced K63-ubiquitination of STAT3 in IL-6 stimulated hepatocytes. In addition, CYLD diminished IL-6-induced STAT3 activity by reducing nuclear accumulation of phosphorylated STAT3. In vivo, CYLD also reduced hepatic STAT3 K63-ubiquitination and activation, NF-κB activation, IL-6 and NOX2 mRNA production as well as fibrin production in murine listeriosis. In vivo neutralization of IL-6 by anti-IL-6 antibody, STAT3 by siRNA, and fibrin by warfarin treatment, respectively, demonstrated that IL-6-induced, STAT3-mediated fibrin production significantly contributed to protection in Cyld(-/-) mice. In addition, in vivo Cyld siRNA treatment increased STAT3 phosphorylation, fibrin production, pathogen control and survival of Lm-infected WT mice illustrating that therapeutic inhibition of CYLD augments the protective NF

  2. An Antithrombin-Heparin Complex Increases the Anticoagulant Activity of Fibrin Clots

    Directory of Open Access Journals (Sweden)

    Lesley J. Smith

    2008-01-01

    Full Text Available Clotting blood contains fibrin-bound thrombin, which is a major source of procoagulant activity leading to clot extension and further activation of coagulation. When bound to fibrin, thrombin is protected from inhibition by antithrombin (AT + heparin but is neutralized when AT and heparin are covalently linked (ATH. Here, we report the surprising observation that, rather than yielding an inert complex, thrombin-ATH formation converts clots into anticoagulant surfaces that effectively catalyze inhibition of thrombin in the surrounding environment.

  3. Role of platelet-rich-fibrin in enhancing palatal wound healing after free graft

    OpenAIRE

    2012-01-01

    Platelet-rich fibrin has long been used as a wound healing therapy in skin wounds and recently evidence has suggested its usage in oral cavity for different treatment procedures. This article proposes an overview of use of platelet-rich fibrin in management of complicated oral wounds. Excessive hemorrhage of the donor area, necrosis of epithelium, and morbidity associated with donor site have been described as the possible complications after harvesting subepithelial connective tissue graft, ...

  4. Platelet-rich fibrin versus albumin in surgical wound repair: a randomized trial with paired design

    DEFF Research Database (Denmark)

    Danielsen, Patricia L; Ågren, Sven Per Magnus; Jørgensen, Lars Nannestad

    2010-01-01

    To study the effects of autologous platelet-rich fibrin (PRF) versus human albumin on incisional wound breaking strength and subcutaneous collagen deposition in patients undergoing laparoscopic cholecystectomy in a randomized trial.......To study the effects of autologous platelet-rich fibrin (PRF) versus human albumin on incisional wound breaking strength and subcutaneous collagen deposition in patients undergoing laparoscopic cholecystectomy in a randomized trial....

  5. Spatial distribution of factor Xa, thrombin, and fibrin(ogen on thrombi at venous shear.

    Directory of Open Access Journals (Sweden)

    Michelle A Berny

    Full Text Available BACKGROUND: The generation of thrombin is a critical process in the formation of venous thrombi. In isolated plasma under static conditions, phosphatidylserine (PS-exposing platelets support coagulation factor activation and thrombin generation; however, their role in supporting coagulation factor binding under shear conditions remains unclear. We sought to determine where activated factor X (FXa, (prothrombin, and fibrin(ogen are localized in thrombi formed under venous shear. METHODOLOGY/PRINCIPAL FINDINGS: Fluorescence microscopy was used to study the accumulation of platelets, FXa, (prothrombin, and fibrin(ogen in thrombi formed in vitro and in vivo. Co-perfusion of human blood with tissue factor resulted in formation of visible fibrin at low, but not at high shear rate. At low shear, platelets demonstrated increased Ca(2+ signaling and PS exposure, and supported binding of FXa and prothrombin. However, once cleaved, (prothrombin was observed on fibrin fibers, covering the whole thrombus. In vivo, wild-type mice were injected with fluorescently labeled coagulation factors and venous thrombus formation was monitored in mesenteric veins treated with FeCl(3. Thrombi formed in vivo consisted of platelet aggregates, focal spots of platelets binding FXa, and large areas binding (prothrombin and fibrin(ogen. CONCLUSIONS/SIGNIFICANCE: FXa bound in a punctate manner to thrombi under shear, while thrombin and fibrin(ogen distributed ubiquitously over platelet-fibrin thrombi. During thrombus formation under venous shear, thrombin may relocate from focal sites of formation (on FXa-binding platelets to dispersed sites of action (on fibrin fibers.

  6. Application of Fibrin Glue Sealant After Hepatectomy Does Not Seem Justified

    Science.gov (United States)

    Figueras, Juan; Llado, Laura; Miro, Mónica; Ramos, Emilio; Torras, Jaume; Fabregat, Juan; Serrano, Teresa

    2007-01-01

    Objective: To evaluate the efficacy, amount of hemorrhage, biliary leakage, complications, and postoperative evolution after fibrin glue sealant application in patients undergoing liver resection. Summary Background Data: Fibrin sealants have become popular as a means of improving perioperative hemostasis and reducing biliary leakage after liver surgery. However, trials regarding its use in liver surgery remain limited and of poor methodologic quality. Patients and Methods: A total of 300 patients undergoing hepatic resection were randomly assigned to fibrin glue application or control groups. Characteristics and debit of drainage and postoperative complications were evaluated. The amount of blood loss, measurements of hematologic parameters liver test, and postoperative evolution (particularly involving biliary fistula and morbidity) was also recorded. Results: Postoperatively, no differences were observed in the amount of transfusion (0.15 ± 0.66 vs. 0.17 ± 0.63 PRCU; P = 0.7234) or in the patients that required transfusion (18% vs. 12%; P = 0.2), respectively, for the fibrin glue or control group. There were no differences in overall drainage volumes (1180 ± 2528 vs. 960 ± 1253 mL) or in days of postoperative drainage (7.9 ± 5 vs. 7.1 ± 4.7). Incidence of biliary fistula was similar in the fibrin glue and control groups, (10% vs. 11%). There were no differences regarding postoperative morbidity between groups (23% vs. 23%; P = 1). Conclusions: Application of fibrin sealant in the raw surface of the liver does not seem justified. Blood loss, transfusion, incidence of biliary fistula, and outcome are comparable to patients without fibrin glue. Therefore, discontinuation of routine use of fibrin sealant would result in significant cost saving. PMID:17414601

  7. [APPLICATION OF FISTULA PLUG WITH THE FIBRIN ADHESIVE IN TREATMENT OF RECTAL FISTULAS].

    Science.gov (United States)

    Aydinova, P R; Aliyev, E A

    2015-05-01

    Results of surgical treatment of 21 patients, suffering high transsphincteric and extrasphincteric rectal fistulas, were studied. In patients of Group I the fistula passage was closed, using fistula plug obturator; and in patients of Group II--by the same, but preprocessed by fibrin adhesive. The fistula aperture germeticity, prophylaxis of rude cicatrices development in operative wound zone, promotion of better fixation of bioplastic material were guaranteed, using fistula plug obturator with preprocessing, using fibrin adhesive.

  8. Tunneled dialysis catheter exchange with fibrin sheath disruption is not associated with increased rate of bacteremia.

    Science.gov (United States)

    Valliant, Amanda M; Chaudhry, Muhammad K; Yevzlin, Alexander S; Astor, Brad; Chan, Micah R

    2015-01-01

    Tunneled dialysis catheters are the most common form of vascular access among incident dialysis patients in the United States. Fibrin sheath formation is a frequent cause of late catheter dysfunction requiring an exchange procedure with balloon disruption of the fibrin sheath. It is unknown whether fibrin sheath disruption is associated with increased incidence of bacteremia or catheter failure. We reviewed all tunneled dialysis catheter exchange procedures at the University of Wisconsin between January 2008 and December 2011. The primary outcome was incidence of bacteremia, defined as positive blood cultures within 2 weeks of the procedure. Catheter failure, requiring intervention or replacement, was examined as a secondary outcome. Baseline characteristics examined included diabetic status, gender, race and age. A total of 163 procedures were reviewed; 67 (41.1%) had fibrin sheath disruption and 96 did not. Bacteremia occurred in 4.5% (3/67) of those with and 3.1% (3/97) of those without fibrin sheath disruption (p=0.65). Fibrin sheath disruption was not significantly associated with the risk of catheter failure (adjusted hazard ratio [aHR]=1.34; 95% confidence interval [CI]: 0.87-2.10; p=0.18). Diabetes was associated with greater risk of catheter failure (aHR=1.88; 95% CI: 1.19-2.95; p=0.006), whereas higher age was associated with a lower risk of catheter failure (aHR per 10 years=0.83; 95% CI: 0.72-0.96; p=0.01). This study demonstrates that there is no significant increase in bacteremia and subsequent catheter dysfunction rates after fibrin sheath disruption compared to simple over the wire exchange. These results are encouraging given the large numbers of patients utilizing tunneled catheters for initial hemodialysis access and the known rates of fibrin sheath formation leading to catheter failure.

  9. Platelet-rich fibrin versus albumin in surgical wound repair: a randomized trial with paired design

    DEFF Research Database (Denmark)

    Danielsen, Patricia L; Ågren, Sven Per Magnus; Jørgensen, Lars Nannestad

    2010-01-01

    To study the effects of autologous platelet-rich fibrin (PRF) versus human albumin on incisional wound breaking strength and subcutaneous collagen deposition in patients undergoing laparoscopic cholecystectomy in a randomized trial.......To study the effects of autologous platelet-rich fibrin (PRF) versus human albumin on incisional wound breaking strength and subcutaneous collagen deposition in patients undergoing laparoscopic cholecystectomy in a randomized trial....

  10. Interpenetrating Fibrin-Alginate Matrices for in vitro Ovarian Follicle Development

    OpenAIRE

    Shikanov, Ariella; Xu, Min; Woodruff, Teresa K.; Shea, Lonnie D.

    2009-01-01

    In this report, we investigate the fibrin-alginate inter penetrating network (FA-IPN) to provide dynamic cell-responsive mechanical properties, which we apply to the in vitro growth of ovarian follicles. The mechanical properties and polymerization rate of the gels were investigated by rheology, and the fiber structure was imaged by electron microscopy. Using a mouse model, two-layered secondary follicles were encapsulated in FA-IPNs, and growth, morphology, hormone production, fibrin degrada...

  11. Reduction of the closure time of postoperative enterocutaneous fistulas with fibrin sealant

    Institute of Scientific and Technical Information of China (English)

    Jorge; Avalos-González; Eliseo; Portilla-deBuen; Caridad; Aurea; Leal-Cortés; Abel; Orozco-Mosqueda; María; del; Carmen; Estrada-Aguilar; Gabriela; Abigail; Velázquez-Ramírez; Gabriela; Ambriz-González; Clotilde; Fuentes-Orozco; Aldo; Emmerson; Guzmán-Gurrola; Alejandro; González-Ojeda

    2010-01-01

    AIM: To assess whether the use of fibrin sealantshortens the closure time of postoperative enterocutaneous fistulas (ECFs). METHODS: The prospective case-control study included 70 patients with postoperative ECFs with an output of 2 cm and without any local complication. They were divided into study (n = 23) and control groups (n = 47). Esophageal, gastric and colocutaneous fistulas were monitored under endoscopic visualization, which also allowed fibrin glue application d...

  12. Does Fibrin Sealant Reduce Seroma after Immediate Breast Reconstruction Utilizing a Latissimus Dorsi Myocutaneous Flap?

    Directory of Open Access Journals (Sweden)

    Han Gyu Cha

    2012-09-01

    Full Text Available Background The most common complication of latissimus dorsi myocutaneous flap in breastreconstruction is seroma formation in the back. Many clinical studies have shown that fibrinsealant reduces seroma formation. We investigated any statistically significant differences inpostoperative drainage and seroma formation when utilizing the fibrin sealant on the site ofthe latissimus dorsi myocutaneous flap harvested for immediate breast reconstruction afterskin-sparing partial mastectomy.Methods A total of 46 patients underwent immediate breast reconstruction utilizing alatissimus dorsi myocutaneous island flap. Of those, 23 patients underwent the procedurewithout fibrin sealant and the other 23 were administered the fibrin sealant. All flaps wereelevated with manual dissection by the same surgeon and were analyzed to evaluate thepotential benefits of the fibrin sealant. The correlation analysis and Mann-Whitney U testwere used for analyzing the drainage volume according to age, weight of the breast specimen,and body mass index.Results Although not statistically significant, the cumulative drainage fluid volume was higherin the control group until postoperative day 2 (530.1 mL compared to 502.3 mL, but thefibrin sealant group showed more drainage beginning on postoperative day 3. The donor sitecomparisons showed the fibrin sealant group had more drainage beginning on postoperativeday 3 and the drain was removed 1 day earlier in the control group.Conclusions The use of fibrin sealant resulted in no reduction of seroma formation. Becausethe benefits of the fibrin sealant are not clear, the use of fibrin sealant must be fully discussedwith patients before its use as a part of informed consent.

  13. High-Pressure Fibrin Sealant Foam: An Effective Hemostatic Agent for Treating Severe Parenchymal Hemorrhage

    Science.gov (United States)

    2008-01-01

    compression or vascular control. Materials and methods. FSF with high fibrinogen concentration (20 mg/mL) and low thrombin activity (5 U/mL) was prepared and...fibrin sealant foam (FSF) into a body cavity via trocar would spread throughout the cavity, bind to damaged tissue, and stop bleeding from inaccessible...liver hemorrhage model in anticoagulated rabbits. We then compared pressurized FSF with liq- uid and a powdered form of fibrin sealant. MATERIALS AND

  14. CLINICAL SIGNIFICANCE OF PLASMA D-DIMERS LEVELS IN CHILEREN WITH ALLERGIC PURPURA%过敏性紫癜患儿血D-二聚体检测的临床意义

    Institute of Scientific and Technical Information of China (English)

    秦晓红; 胡浩忠

    2003-01-01

    目的研究过敏性紫癜(HSP)患儿血D-二聚体的变化,以探讨HSP患儿体内血液凝溶功能的改变.方法应用ELISA法及反向血凝法分别检测28例HSP急性期患儿和16例正常健康儿童外周静脉血D-二聚体和纤维蛋白降解产物(FDP).结果 HSP病例组患儿血D-二聚体、FDP值明显高于正常对照组(t=3.88,P<0.01;t=2.41,P<0.05).结论血D-二聚体检测显示HSP患儿体内存在高凝状态,为临床应用抗凝治疗提供理论依据.

  15. Incorporation of exudates of human platelet-rich fibrin gel in biodegradable fibrin scaffolds for tissue engineering of cartilage.

    Science.gov (United States)

    Chien, Chi-Sheng; Ho, Hsiu-O; Liang, Yu-Chih; Ko, Pai-Hung; Sheu, Ming-Thau; Chen, Chien-Ho

    2012-05-01

    The goal of this study was to assess the incorporation of exudates of human platelet-rich fibrin (hPRF) that is abundant in platelet cytokines and growth factors into biodegradable fibrin (FB) scaffolds as a regeneration matrix for promoting chondrocyte proliferation and re-differentiation. hPRF was obtained from human blood by centrifugation without an anticoagulant, and the exudate of hPRF was collected and mixed with bovine fibrinogen, and then thrombin was added to form the FB scaffold. Proliferation and differentiation of human primary chondrocytes and a human chondrosarcoma cell line, the SW-1353, embedded in the three-dimensional (3D) scaffolds and on the two-dimensional (2D) surface of the FB scaffolds so produced were evaluated in comparison with an agarose (AG) scaffold serving as the control. Results demonstrated that the amounts of these cytokines and growth factors in hPRF exudates were higher than those in the blood-derived products except for TGF-β1. Chondrocytes and SW1353 cells on the 2D and 3D FB scaffolds with the addition of the exudates of PRF exhibited more-available proliferation and differentiation than cells on 2D and 3D FB and AG scaffolds. It was concluded that FB scaffolds can provide an appropriate environment for chondrocyte proliferation and re-differentiation, and it could be improved by adding exudates of hPRF. These 3D scaffolds have great promise for cartilage tissue engineering. Copyright © 2012 Wiley Periodicals, Inc.

  16. Fibrin Gel as an Injectable Biodegradable Scaffold and Cell Carrier for Tissue Engineering

    Directory of Open Access Journals (Sweden)

    Yuting Li

    2015-01-01

    Full Text Available Due to the increasing needs for organ transplantation and a universal shortage of donated tissues, tissue engineering emerges as a useful approach to engineer functional tissues. Although different synthetic materials have been used to fabricate tissue engineering scaffolds, they have many limitations such as the biocompatibility concerns, the inability to support cell attachment, and undesirable degradation rate. Fibrin gel, a biopolymeric material, provides numerous advantages over synthetic materials in functioning as a tissue engineering scaffold and a cell carrier. Fibrin gel exhibits excellent biocompatibility, promotes cell attachment, and can degrade in a controllable manner. Additionally, fibrin gel mimics the natural blood-clotting process and self-assembles into a polymer network. The ability for fibrin to cure in situ has been exploited to develop injectable scaffolds for the repair of damaged cardiac and cartilage tissues. Additionally, fibrin gel has been utilized as a cell carrier to protect cells from the forces during the application and cell delivery processes while enhancing the cell viability and tissue regeneration. Here, we review the recent advancement in developing fibrin-based biomaterials for the development of injectable tissue engineering scaffold and cell carriers.

  17. Taurolidine-Fibrin-Sealant-Matrix using spray application for local treatment of brain tumors.

    Science.gov (United States)

    Stendel, Ruediger; Scheurer, Louis; Schlatterer, Kathrin; Gminski, Richard; Möhler, Hanns

    2004-01-01

    Malignant gliomas tend to recur in the vast majority of cases. Recurrent gliomas may arise from vital tumor cells present in this zone around the resection margin. It appears promising to combine tumor resection with local chemotherapy using an antineoplastic, but non-toxic agent. Taurolidine exerts a selective antineoplastic effect by induction of programmed cell death and has anti-angiogenic activity. Fibrin sealant is completely degradable and firmly adheres to brain tissue, suggesting that it would provide a suitable matrix for taurolidine delivery--a Taurolidine-Fibrin-Sealant-Matrix (TFM)--in the local treatment of brain tumors. The potential of local delivery of taurolidine out of a fibrin sealant matrix was investigated. Taurolidine could be suspended homogeneously in both the thrombin and the procoagulant protein components of the fibrin sealant. The fibrin sealant matrix was a suitable carrier for the suspension of taurolidine at a concentration that ensured the release of therapeutically effective amounts of the drug over a period of 2 weeks in vitro. The antineoplastic action of taurolidine was not affected by embedding in the fibrin sealant matrix. The described drug delivery system may be suitable for local taurolidine treatment of brain tumors following complete or partial resection or of tumors that are non-resectable because of their location.

  18. A Novel Platelet Concentrate: Titanium-Prepared Platelet-Rich Fibrin

    Directory of Open Access Journals (Sweden)

    Mustafa Tunalı

    2014-01-01

    Full Text Available We developed a new product called titanium-prepared platelet-rich fibrin (T-PRF. The T-PRF method is based on the hypothesis that titanium may be more effective in activating platelets than the silica activators used with glass tubes in Chouckroun’s leukocyte- and platelet-rich fibrin (L-PRF method. In this study, we aimed to define the structural characteristics of T-PRF and compare it with L-PRF. Blood samples were collected from 10 healthy male volunteers. The blood samples were drawn using a syringe. Nine milliliters was transferred to a dry glass tube, and 9 mL was transferred to a titanium tube. Half of each clot (i.e., the blood that was clotted using T-PRF or L-PRF was processed with a scanning electron microscope (SEM. The other half of each clot was processed for fluorescence microscopy analysis and light microscopy analysis. The T-PRF samples seemed to have a highly organized network with continuous integrity compared to the other L-PRF samples. Histomorphometric analysis showed that T-PRF fibrin network covers larger area than L-PRF fibrin network; also fibrin seemed thicker in the T-PRF samples. This is the first human study to define T-PRF as an autogenous leukocyte- and platelet-rich fibrin product. The platelet activation by titanium seems to offer some high characteristics to T-PRF.

  19. A novel platelet concentrate: titanium-prepared platelet-rich fibrin.

    Science.gov (United States)

    Tunalı, Mustafa; Özdemir, Hakan; Küçükodacı, Zafer; Akman, Serhan; Yaprak, Emre; Toker, Hülya; Fıratlı, Erhan

    2014-01-01

    We developed a new product called titanium-prepared platelet-rich fibrin (T-PRF). The T-PRF method is based on the hypothesis that titanium may be more effective in activating platelets than the silica activators used with glass tubes in Chouckroun's leukocyte- and platelet-rich fibrin (L-PRF) method. In this study, we aimed to define the structural characteristics of T-PRF and compare it with L-PRF. Blood samples were collected from 10 healthy male volunteers. The blood samples were drawn using a syringe. Nine milliliters was transferred to a dry glass tube, and 9 mL was transferred to a titanium tube. Half of each clot (i.e., the blood that was clotted using T-PRF or L-PRF) was processed with a scanning electron microscope (SEM). The other half of each clot was processed for fluorescence microscopy analysis and light microscopy analysis. The T-PRF samples seemed to have a highly organized network with continuous integrity compared to the other L-PRF samples. Histomorphometric analysis showed that T-PRF fibrin network covers larger area than L-PRF fibrin network; also fibrin seemed thicker in the T-PRF samples. This is the first human study to define T-PRF as an autogenous leukocyte- and platelet-rich fibrin product. The platelet activation by titanium seems to offer some high characteristics to T-PRF.

  20. Enhanced Viability of Endothelial Colony Forming Cells in Fibrin Microbeads for Sensor Vascularization

    Directory of Open Access Journals (Sweden)

    Jarel K. Gandhi

    2015-09-01

    Full Text Available Enhanced vascularization at sensor interfaces can improve long-term function. Fibrin, a natural polymer, has shown promise as a biomaterial for sensor coating due to its ability to sustain endothelial cell growth and promote local vascularization. However, the culture of cells, particularly endothelial cells (EC, within 3D scaffolds for more than a few days is challenging due to rapid loss of EC viability. In this manuscript, a robust method for developing fibrin microbead scaffolds for long-term culture of encapsulated ECs is described. Fibrin microbeads are formed using sodium alginate as a structural template. The size, swelling and structural properties of the microbeads were varied with needle gauge and composition and concentration of the pre-gel solution. Endothelial colony-forming cells (ECFCs were suspended in the fibrin beads and cultured within a perfusion bioreactor system. The perfusion bioreactor enhanced ECFCs viability and genome stability in fibrin beads relative to static culture. Perfusion bioreactors enable 3D culture of ECs within fibrin beads for potential application as a sensor coating.

  1. Human Kunitz-type protease inhibitor engineered for enhanced matrix retention extends longevity of fibrin biomaterials.

    Science.gov (United States)

    Briquez, Priscilla S; Lorentz, Kristen M; Larsson, Hans M; Frey, Peter; Hubbell, Jeffrey A

    2017-08-01

    Aprotinin is a broad-spectrum serine protease inhibitor used in the clinic as an anti-fibrinolytic agent in fibrin-based tissue sealants. However, upon re-exposure, some patients suffer from hypersensitivity immune reactions likely related to the bovine origin of aprotinin. Here, we aimed to develop a human-derived substitute to aprotinin. Based on sequence homology analyses, we identified the Kunitz-type protease inhibitor (KPI) domain of human amyloid-β A4 precursor protein as being a potential candidate. While KPI has a lower intrinsic anti-fibrinolytic activity than aprotinin, we reasoned that its efficacy is additionally limited by its fast release from fibrin material, just as aprotinin's is. Thus, we engineered KPI variants for controlled retention in fibrin biomaterials, using either covalent binding through incorporation of a substrate for the coagulation transglutaminase Factor XIIIa or through engineering of extracellular matrix protein super-affinity domains for sequestration into fibrin. We showed that both engineered KPI variants significantly slowed plasmin-mediated fibrinolysis in vitro, outperforming aprotinin. In vivo, our best engineered KPI variant (incorporating the transglutaminase substrate) extended fibrin matrix longevity by 50%, at a dose at which aprotinin did not show efficacy, thus qualifying it as a competitive substitute of aprotinin in fibrin sealants. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  2. Fibrin Networks Support Recurring Mechanical Loads by Adapting their Structure across Multiple Scales.

    Science.gov (United States)

    Kurniawan, Nicholas A; Vos, Bart E; Biebricher, Andreas; Wuite, Gijs J L; Peterman, Erwin J G; Koenderink, Gijsje H

    2016-09-06

    Tissues and cells sustain recurring mechanical loads that span a wide range of loading amplitudes and timescales as a consequence of exposure to blood flow, muscle activity, and external impact. Both tissues and cells derive their mechanical strength from fibrous protein scaffolds, which typically have a complex hierarchical structure. In this study, we focus on a prototypical hierarchical biomaterial, fibrin, which is one of the most resilient naturally occurring biopolymers and forms the structural scaffold of blood clots. We show how fibrous networks composed of fibrin utilize irreversible changes in their hierarchical structure at different scales to maintain reversible stress stiffening up to large strains. To trace the origin of this paradoxical resilience, we systematically tuned the microstructural parameters of fibrin and used a combination of optical tweezers and fluorescence microscopy to measure the interactions of single fibrin fibers for the first time, to our knowledge. We demonstrate that fibrin networks adapt to moderate strains by remodeling at the network scale through the spontaneous formation of new bonds between fibers, whereas they adapt to high strains by plastic remodeling of the fibers themselves. This multiscale adaptation mechanism endows fibrin gels with the remarkable ability to sustain recurring loads due to shear flows and wound stretching. Our findings therefore reveal a microscopic mechanism by which tissues and cells can balance elastic nonlinearity and plasticity, and thus can provide microstructural insights into cell-driven remodeling of tissues.

  3. Characteristics of an autologous leukocyte and platelet-rich fibrin patch intended for the treatment of recalcitrant wounds.

    Science.gov (United States)

    Lundquist, Rasmus; Holmstrøm, Kim; Clausen, Christian; Jørgensen, Bo; Karlsmark, Tonny

    2013-01-01

    We have investigated the physical, biochemical, and cellular properties of an autologous leukocyte and platelet-rich fibrin patch. This was generated in an automated device from a sample of a patient's blood at the point of care. Using microscopy, cell counting, enzyme-linked immunosorbent assay, antibody arrays, and cell culture assays, we show that the patch is a three-layered membrane comprising a fibrin sheet, a layer of platelets, and a layer of leukocytes. Mean recovery of platelets from the donated blood was 98% (±95%CI 0.8%). Mean levels of platelet-derived growth factor AB, human transforming growth factor beta 1, and vascular endothelial growth factor extracted from the patch were determined as 127 ng (±95% CI 20), 92 ng (±95%CI 17), and 1.35 ng (±95%CI 0.37), respectively. We showed a continued release of PDGF-AB over several days, the rate of which was increased by the addition of chronic wound fluid. By comparison with traditional platelet-rich plasma, differences in immune components were found. The relevance of these findings was assessed by showing a mitogenic and migratory effect on cultured human dermal fibroblasts. Further, we showed that fibrocytes, a cell type important for acute wound healing, could be grown from the patch. The relevance of these findings in relation to the use of the patch for treating recalcitrant wounds is discussed.

  4. Ultrastructural characteristics of fibrin clots from canine and feline platelet concentrates activated with calcium gluconate or calcium gluconate plus batroxobin

    OpenAIRE

    Silva, Raúl F; Carmona, Jorge U; Rezende, Cleuza MF

    2013-01-01

    Background The aim of this study was to use transmission electron microscopy to describe the ultrastructural characteristics of clots obtained from canine and feline platelet concentrates (PC) that had been activated with calcium gluconate (CG) or CG plus batroxobin (CGB). Platelets from fibrin clots were classified according their morphological changes. The area of the intercellular space (μm2), the area of the fibrin fibers (μm2), and the width of the fibrin fibers (μm) were determined for ...

  5. Value and Signiifcance of Antithrombin III, D-dimer and Platelet Detection for Sepsis in Children%抗凝血酶Ⅲ、D-二聚体和血小板检测在儿童脓毒症中的价值意义

    Institute of Scientific and Technical Information of China (English)

    程文文; 仇丽霞

    2016-01-01

    Objective to analyze value and significance of Antithrombin III, D-dimer and platelet detection for sepsis in children. Methods choose 40 cases sepsis patients treated in our hospital and 40 cases healthy checkup children as observation objects, admission time was from June 2014 to August 2015, healthy children were treated as control group, and sepsis children as experimental group, exam antithrombin III, D-dimer and platelet and observe index difference between healthy and sepsis children.Results examination result difference of antithrombin III, D-dimer and platelet between control healthy children and experimental sepsis group showed statistical significance (P< 0.05).Conclusion examination of antithrombin III, D-dimer and platelet for sepsis children has great value, which is worthy of clinical promotion.%目的:分析抗凝血酶Ⅲ、D-二聚体和血小板检测在儿童脓毒症中的价值及意义。方法选择我院收治的40例脓毒症患儿及40例健康体检儿童作为本次观察对象,收治时间为2014年6月至2015年8月,将健康体检儿童作为对照组,将脓毒症患儿作为实验组,检测抗凝血酶Ⅲ、D-二聚体和血小板,观察健康体检儿童及脓毒症患儿之间检测指标的差异。结果对照组健康体检儿童及实验组脓毒症患儿之间对比的抗凝血酶Ⅲ、D-二聚体和血小板检测结果均存在显著差异(P<0.05),统计学有意义。结论针对儿童脓毒症患儿实施抗凝血酶Ⅲ、D-二聚体和血小板检测的价值意义较大,值得临床推广。

  6. A safe and efficient method to retrieve mesenchymal stem cells from three-dimensional fibrin gels.

    Science.gov (United States)

    Carrion, Bita; Janson, Isaac A; Kong, Yen P; Putnam, Andrew J

    2014-03-01

    Mesenchymal stem cells (MSCs) display multipotent characteristics that make them ideal for potential therapeutic applications. MSCs are typically cultured as monolayers on tissue culture plastic, but there is increasing evidence suggesting that they may lose their multipotency over time in vitro and eventually cease to retain any resemblance to in vivo resident MSCs. Three-dimensional (3D) culture systems that more closely recapitulate the physiological environment of MSCs and other cell types are increasingly explored for their capacity to support and maintain the cell phenotypes. In much of our own work, we have utilized fibrin, a natural protein-based material that serves as the provisional extracellular matrix during wound healing. Fibrin has proven to be useful in numerous tissue engineering applications and has been used clinically as a hemostatic material. Its rapid self-assembly driven by thrombin-mediated alteration of fibrinogen makes fibrin an attractive 3D substrate, in which cells can adhere, spread, proliferate, and undergo complex morphogenetic programs. However, there is a significant need for simple cost-effective methods to safely retrieve cells encapsulated within fibrin hydrogels to perform additional analyses or use the cells for therapy. Here, we present a safe and efficient protocol for the isolation of MSCs from 3D fibrin gels. The key ingredient of our successful extraction method is nattokinase, a serine protease of the subtilisin family that has a strong fibrinolytic activity. Our data show that MSCs recovered from 3D fibrin gels using nattokinase are not only viable but also retain their proliferative and multilineage potentials. Demonstrated for MSCs, this method can be readily adapted to retrieve any other cell type from 3D fibrin gel constructs for various applications, including expansion, bioassays, and in vivo implantation.

  7. Fabrication and physical and biological properties of fibrin gel derived from human plasma.

    Science.gov (United States)

    Zhao, Haiguang; Ma, Lie; Zhou, Jie; Mao, Zhengwei; Gao, Changyou; Shen, Jiacong

    2008-03-01

    The fast development of tissue engineering and regenerative medicine drives the old biomaterials, for example, fibrin glue, to find new applications in these areas. Aiming at developing a commercially available hydrogel for cell entrapment and delivery, in this study we optimized the fabrication and gelation conditions of fibrin gel. Fibrinogen was isolated from human plasma by a freeze-thaw circle. Gelation of the fibrinogen was accomplished by mixing with thrombin. Absorbance of the fibrinogen/thrombin mixture at 550 nm as a function of reaction time was monitored by UV-VIS spectroscopy. It was found that the clotting time is significantly influenced by the thrombin concentration and the temperature, while less influenced by the fibrinogen concentration. After freeze-drying, the fibrin gel was characterized by scanning electron microscopy (SEM), revealing fibrous microstructure. Thermal gravimetric analysis found that the degradation temperature of the crosslinked fibrin gel starts from 288 degrees C, which is about 30 degrees C higher than that of the fibrinogen. The hydrogel has an initial water-uptake ratio of approximately 50, decreased to 30-40 after incubation in water for 11 h depending on the thrombin concentration. The fibrin gels lost their weights in PBS very rapidly, while slowly in DMEM/fetal bovine serum and DMEM. In vitro cell culture found that human fibroblasts could normally proliferate in the fibrin gel with spreading morphology. In conclusion, the fibrin gel containing higher concentration of fibrinogen (20 mg ml(-1)) and thrombin (5 U ml(-1)) has suitable gelation time and handling properties, and thus is applicable as a delivery vehicle for cells such as fibroblasts.

  8. Inhibition of fibrin polymerization by synthetic peptides corresponding to Aalpha195-205 and gamma69-77 sites of fibrin molecule

    NARCIS (Netherlands)

    Pozniak, T.A.; Urvant, L.P.; Gritsenko, P.; Chernishov, V.I.; Pydiura, N.A.; Lugovskoi, E.V.; Komisarenko, S.V.

    2014-01-01

    Using the idea of "proline brackets" we have found four sites in fibrin amino acid sequence, and appropriate peptides were synthesized: gamma69NPDESSKPN77, Bbeta228QPDSSVKPY236, Bbeta455RPFFPQ460 and Aalpha195LPSRDRQHLPL205. Turbidity and electron-microscopy analyses have demonstrated that synthetic

  9. Optical Measurement of Micromechanics and Structure in a 3D Fibrin Extracellular Matrix

    Science.gov (United States)

    Kotlarchyk, Maxwell Aaron

    2011-07-01

    In recent years, a significant number of studies have focused on linking substrate mechanics to cell function using standard methodologies to characterize the bulk properties of the hydrogel substrates. However, current understanding of the correlations between the microstructural mechanical properties of hydrogels and cell function in 3D is poor, in part because of a lack of appropriate techniques. Methods for tuning extracellular matrix (ECM) mechanics in 3D cell culture that rely on increasing the concentration of either protein or cross-linking molecules fail to control important parameters such as pore size, ligand density, and molecular diffusivity. Alternatively, ECM stiffness can be modulated independently from protein concentration by mechanically loading the ECM. We have developed an optical tweezers-based microrheology system to investigate the fundamental role of ECM mechanical properties in determining cellular behavior. Further, this thesis outlines the development of a novel device for generating stiffness gradients in naturally derived ECMs, where stiffness is tuned by inducing strain, while local structure and mechanical properties are directly determined by laser tweezers-based passive and active microrheology respectively. Hydrogel substrates polymerized within 35 mm diameter Petri dishes are strained non-uniformly by the precise rotation of an embedded cylindrical post, and exhibit a position-dependent stiffness with little to no modulation of local mesh geometry. Here we present microrheological studies in the context of fibrin hydrogels. Microrheology and confocal imaging were used to directly measure local changes in micromechanics and structure respectively in unstrained hydrogels of increasing fibrinogen concentration, as well as in our strain gradient device, in which the concentration of fibrinogen is held constant. Orbital particle tracking, and raster image correlation analysis are used to quantify changes in fibrin mechanics on the

  10. Fibrin-genipin annulus fibrosus sealant as a delivery system for anti-TNFα drug

    Science.gov (United States)

    Likhitpanichkul, Morakot; Kim, Yesul; Torre, Olivia M; See, Eugene; Kazezian, Zepur; Pandit, Abhay; Hecht, Andrew C

    2015-01-01

    Background context Intervertebral discs (IVD) are attractive targets for local drug delivery because they are avascular structures with limited transport. Painful IVDs are in a chronic inflammatory state. While anti-inflammatories show poor performance in clinical trials their efficacy treating IVD cells suggests that sustained, local drug delivery directly to painful IVDs may be beneficial. Purpose To determine if genipin crosslinked fibrin (FibGen) with collagen type I hollow spheres (CHS) can serve as a drug delivery carrier for the anti-TNFα drug, infliximab. Infliximab was chosen as a model drug because of the known role of TNFα in increasing downstream production of several pro-inflammatory cytokines and pain mediators. FibGen was used as drug carrier because it is adhesive injectable, slowly degrading hydrogel with potential to seal annulus fibrosus (AF) defects. CHS allow simple and non-damaging drug loading and could act as a drug reservoir to improve sustained delivery. Study Design/Setting Biomaterials and human AF cell culture study to determine drug release kinetics and efficacy. Methods Infliximab was delivered at low and high concentrations using FibGen with and without CHS. Gels were analyzed for structure, drug release kinetics, and efficacy treating human AF cells following release. This work was funded by grants from the NIAMS/NIH (R01 AR057397), AO Foundation, and from the Icahn School of Medicine at Mount Sinai. Results Fibrin showed rapid infliximab drug release but degraded quickly. CHS alone showed a sustained release profile but the small spheres may not remain in a degenerated IVD with fissures. FibGen showed steady and low levels of infliximab release that was increased when loaded with higher drug concentrations. Infliximab was bound in CHS when delivered within FibGen and was only released following enzymatic degradation. The infliximab released over 20 days retained its bioactivity as confirmed by the sustained reduction of IL-1

  11. The use of platelet-rich fibrin membrane in gingival recession treatment

    Directory of Open Access Journals (Sweden)

    Aleksić Zoran

    2010-01-01

    Full Text Available Introduction. Fibrin, fibronectin, platelet derived growth factor, and transforming growth factors from platelet concetrate are crucial for tissue reparation and regeneration. Objective. This study was designed to evaluate clinical effectiveness of activated platelet-rich fibrin (PRF membrane in treatment of gingival recession. Methods. 19 gingival recessions Miller class I or II were treated with a coronally advanced flap and the PRF membrane (PRF group. Following the elevation of the flap, bone and root surfaces were covered with the PRF membrane. After suturing, the PRF membrane was covered with a coronally advanced flap. In the same patients, 19 other gingival recessions were treated with CTG in combination with the coronally advanced flap (the CTG group. Clinical recordings were made of vertical recession depth (VRD, probing depth (PD, clinical attachment level (CAL and keratinized tissue width (KTW before and 12 months after mucogingival surgical treatment. Clinical evaluation of healing events was estimated with recordings of the healing index (HI. Recordings of HI were performed in the 1st, 2nd and 3rd week post-surgically. Results. Mean root coverage was significant in both groups (the PRF group 79.94% and the CTG group 88.56% %; p<0.01. The difference between the two tested groups was not statistically significant. Results of the keratinized tissue width showed significant increase (p<0.05 12 months after the surgery in both, the PRF and CTG groups. Results of KTW showed statistical significance of recorded differences obtained in the two evaluated groups (p<0.05. There was no statistical significance in reduction of PD and CAL recorded in the PRF and CTG groups. The values of HI recorded in the 1st and 2nd week postoperatively were significantly enhanced in the PRF group (p<0.05. Conclusion. Results of this study confirm both procedures as effective with equivalence of clinical results in solving gingival recession problems. The

  12. 抗凝血酶Ⅲ、D-二聚体和血小板检测在儿童脓毒症中的价值%The clinical value of antithrombin-III, D-dimer and platelet in children with sepsis

    Institute of Scientific and Technical Information of China (English)

    黄彩芝; 莫丽亚; 邓永超; 李爱国; 杨娟

    2013-01-01

    目的 探讨检测血浆抗凝血酶Ⅲ(AT- Ⅲ)活性、D-二聚体(DD)水平和血小板(PLT)数量在儿童脓毒症中的临床价值.方法 选取儿科重症监护病房住院患儿103 例,其中普通感染组30 例,脓毒症组73 例;另选择30 例健康儿童为正常对照组.检测并比较血浆AT- Ⅲ活性、DD 水平和PLT 数量.结果 与正常对照组和普通感染组比较,脓毒症组AT- Ⅲ活性和PLT 数量明显降低,DD 水平明显升高,差异有统计学意义(P 均0.05);脓毒症患儿中严重脓毒症组、DIC 组和死亡组的AT- Ⅲ活性和PLT 数量明显降低,DD 水平明显升高,差异有统计学意义(P 均<0.01),DIC 组三项指标同时异常的发生率为70.37%.结论 儿童脓毒症存在明显的凝血纤溶功能紊乱,血浆AT- Ⅲ活性、DD 水平和PLT 数量检测有助于儿童脓毒症时DIC 的早期诊断,并且对患儿的病情估计和预后判断有一定的临床价值.%Objectives To study the clinical value of antithrombin-Ⅲ (AT-Ⅲ), D-dimer (DD) and platelet (PLT) in children with sepsis. Methods One hundred and three children in pediatric intensive care unit were divided into ordinary infection group (n=30) and sepsis group (n=73), and 30 healthy children were selected as control group. Plasma AT-Ⅲ activity, DD level and PLT count were detected. Results Compared with control group and ordinary infection group, AT-Ⅲ activity and PLT count were both significantly lower (P<0.01) and DD level was significantly higher (P<0.01) in sepsis group. The differences of the three parameters were not significant between control group and ordinary infection group. However, AT-Ⅲ activity and PLT count were both significantly lower (P<0.05) and DD level was significantly higher (P<0.01) in severe sepsis group, disseminated intravascular coagulation (DIC) group and death group. The abnormal rate of all the three parameters was 70.37% in DIC group. Conclusions Children with sepsis have obvious dysfunction

  13. The clinical application of cystatin C, retinol binding protein and D-dimer in preeclampsia diagnosis%子痫前期患者胱抑素C、视黄醇结合蛋白、D-二聚体检测的临床应用研究

    Institute of Scientific and Technical Information of China (English)

    王艳春; 雒雪

    2016-01-01

    目的:探讨胱抑素C(cystatin C, CysC)、视黄醇结合蛋白(retinol binding protein, RBP)、D-二聚体(D-dimer, D-D)在子痫前期患者诊断中的临床应用价值。方法选取我院220例晚期妊娠住院的子痫前期患者为研究对象,分为轻度子痫前期组120例,重度子痫前期组100例,选择同期正常孕妇100例为对照组,检测所有受试者CysC、RBP及D-D的水平,对检测结果进行统计学分析。结果轻度子痫前期组、重度子痫前期组及对照组间CysC、RBP及D-D差异均有统计学意义(P均<0.05);轻度子痫前期组、重度子痫前期组CysC、RBP及D-D检测结果均高于对照组,且差异均具有统计学意义(P均<0.05);轻度子痫前期组CysC、RBP及D-D的检测结果均高于对照组,且差异均有统计学意义(P均<0.05)。结论 CysC、RBP及D-D在子痫前期病情严重程度评估方面有重要的临床参考意义。%Objective To study the clinical application value of cystatin C (CysC), retinol binding protein(RBP) and D-dimer(D-D) in preeclampsia diagnosis. Methods 220 cases patients with preeclamp-sia in our hospital from May 2015 to February 2016 were collected , and were divided into mild preeclampsia group(120 cases), severe preeclampsia group(100 cases). 100 cases normal pregnant women at the same pe-riod were collected as control group. The CysC, RBP and D-D levels of all the subjects were all detected, and the results were analyzed statistically. Results There were statistical significance in the differences of serum CysC, RBP and D-D levels among mild preeclampsia group, severe preeclampsia group and control group (Pall<0.05). The CysC, RBP and D-D levels in mild preeclampsia group and severe preeclampsia group were all higher than that of control group, and the differences all had statistical significance(Pall<0.05). The CysC, RBP and D-D levels in severe preeclampsia group were all

  14. A quicker preparation method for autologous fibrin glue.

    Science.gov (United States)

    Yoshida, H; Kamiya, A

    1998-12-01

    To establish a quicker preparation procedure for cryoprecipitate (Cryo) from a patient's autologous plasma, to be used as fibrin glue, we examined the effects of various conditions on the concentrations and yields of coagulation factors in Cryo. Human plasma from healthy volunteers was divided and treated under various freezing, shaking and defrosting conditions. The concentrations of fibrinogen, plasminogen, fibronectin, and factor XIII in Cryo were then measured. Results were as follows: (1) concentrations and yields of plasma components in Cryo obtained from plasma stored at -20 degrees C were significantly higher than those in Cryo from plasma stored at -80 degrees C; (2) shaking at 70 cycles/min during the freezing process had a favorable effect on the concentrations and yields of coagulation factors in the Cryo; (3) a shaking thaw process in a cold water bath was a rapid method for obtaining adequate yields of coagulation factors; (4) shaking in the defrosting process did not affect the yields of coagulation factors. These results indicated that Cryo containing high concentrations of coagulation factors could be prepared easily and rapidly from a patient's autologous plasma (within 4-5 h).

  15. Mechanical and degradation properties of advanced platelet-rich fibrin (A-PRF), concentrated growth factors (CGF), and platelet-poor plasma-derived fibrin (PPTF).

    Science.gov (United States)

    Isobe, Kazushige; Watanebe, Taisuke; Kawabata, Hideo; Kitamura, Yutaka; Okudera, Toshimitsu; Okudera, Hajime; Uematsu, Kohya; Okuda, Kazuhiro; Nakata, Koh; Tanaka, Takaaki; Kawase, Tomoyuki

    2017-12-01

    Fibrin clot membranes prepared from advanced platelet-rich fibrin (A-PRF) or concentrated growth factors (CGF), despite their relatively rapid biodegradability, have been used as bioactive barrier membranes for alveolar bone tissue regeneration. As the membranes degrade, it is thought that the growth factors are gradually released. However, the mechanical and degradable properties of these membranes have not well been characterized. The purpose of this study was to mechanically and chemically characterize these membranes. A-PRF and CGF clots were prepared from blood samples collected from non-smoking, healthy donors and were compressed to form 1-mm-thick membranes. Platelet-poor plasma-derived fibrin (PPTF) clots were prepared by adding bovine thrombin to platelet-poor plasma. A tensile test was performed at the speed of 1 mm/min. Morphology of the fibrin fibers was examined by SEM. A digestion test was performed in PBS containing trypsin and EDTA. In the tensile test, statistical difference was not observed in Young's modulus, strain at break, or maximum stress between A-PRF and CGF. In strain at break, PPTF was significantly weaker than CGF. Likewise, fibrin fiber thickness and crosslink density of PPTF were less than those of other membranes, and PPTF degraded faster than others. Although the centrifugal conditions are different, A-PRF and CGF are prepared by essentially identical mechanisms. Therefore, it is conceivable that both membranes have similar mechanical and chemical properties. Only PPTF, which was prepared by a different mechanism, was characterized as mechanically weaker and enzymatically more degradable.

  16. The interplay between tissue plasminogen activator domains and fibrin structures in the regulation of fibrinolysis: kinetic and microscopic studies.

    Science.gov (United States)

    Longstaff, Colin; Thelwell, Craig; Williams, Stella C; Silva, Marta M C G; Szabó, László; Kolev, Krasimir

    2011-01-13

    Regulation of tissue-type plasminogen activator (tPA) depends on fibrin binding and fibrin structure. tPA structure/function relationships were investigated in fibrin formed by high or low thrombin concentrations to produce a fine mesh and small pores, or thick fibers and coarse structure, respectively. Kinetics studies were performed to investigate plasminogen activation and fibrinolysis in the 2 types of fibrin, using wild-type tPA (F-G-K1-K2-P, F and K2 binding), K1K1-tPA (F-G-K1-K1-P, F binding), and delF-tPA (G-K1-K2-P, K2 binding). There was a trend of enzyme potency of tPA > K1K1-tPA > delF-tPA, highlighting the importance of the finger domain in regulating activity, but the differences were less apparent in fine fibrin. Fine fibrin was a better surface for plasminogen activation but more resistant to lysis. Scanning electron and confocal microscopy using orange fluorescent fibrin with green fluorescent protein-labeled tPA variants showed that tPA was strongly associated with agglomerates in coarse but not in fine fibrin. In later lytic stages, delF-tPA-green fluorescent protein diffused more rapidly through fibrin in contrast to full-length tPA, highlighting the importance of finger domain-agglomerate interactions. Thus, the regulation of fibrinolysis depends on the starting nature of fibrin fibers and complex dynamic interaction between tPA and fibrin structures that vary over time.

  17. Fibrin Association at Hybrid Biointerfaces Made of Clot-Binding Peptides and Polythiophene.

    Science.gov (United States)

    Puiggalí-Jou, A; Del Valle, Luis J; Armelin, Elaine; Alemán, Carlos

    2016-10-01

    The properties as biointerfaces of electroactive conducting polymer-peptide biocomposites formed by poly(3,4-ethylenedioxythiophene) (PEDOT) and CREKA or CR(NMe)EKA peptide sequences (where Glu has been replaced by N-methyl-Glu in the latter) have been compared. CREKA is a linear pentapeptide that recognizes clotted plasma proteins and selectively homes to tumors, while CR(NMe)EKA is an engineer to improve such properties by altering peptide-fibrin interactions. Differences between PEDOT-CREKA and PEDOT-CR(NMe)EKA reflect dissemblance in the organization of the peptides into the polymeric matrix. Both peptides affect fibrinogen thrombin-catalyzed polymerization causing the immediate formation of fibrin, whereas in the absence of thrombin this phenomenon is only observed for CR(NMe)EKA. Consistently, the fibrin-adsorption capacity is higher for PEDOT-CR(NMe)EKA than for PEDOT-CREKA, even though in both cases adsorbed fibrin exhibits round-like morphologies rather than the characteristic fibrous structure. PEDOT-peptide films coated with fibrin are selective in terms of cell adhesion, promoting the attachment of metastatic cells with respect to normal cells. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  18. Excess Fibrin Deposits Decrease Fetal Weight of Pregnant Mice Infected by Plasmodium berghei

    Directory of Open Access Journals (Sweden)

    Desy Andari

    2014-05-01

    Full Text Available Low birth weight is commonly attributed to malaria in pregnancy, but the cellular and molecular mechanisms that underlie this poor birth outcome are incompletely understood. A universally described histopathological feature of placental malaria is excessive deposition of fibrin, the end-product of the coagulation cascade. This study was conducted to compare fibrin deposit in pregnant mice that infected by Plasmodium berghei (treatment group to the normal pregnant mice (control group and its association with fetal weight. This research is in vivo experimental laboratory study that used 18 pregnant Balb/c mice which divided to the control the group (8 mice and treatment group (9 mice infected by P.berghei. Placentas were staining with Haematoxylin-Eosin (HE for fibrin deposits examination whereas fetal weight was performed with Mettler analytical balance AE 50. Fetal weight of the treatment group was lower than those of the control group (t test, p=0,002. Fibrin deposits were increased in the treatment group (t test, p=0,005 and influenced weight of fetuses (Spearman r= -0,586, p= 0,014. Weights of fetuses are interfered by fibrin deposits during malaria infection.

  19. The application of plastic compression to modulate fibrin hydrogel mechanical properties.

    Science.gov (United States)

    Haugh, Matthew G; Thorpe, Stephen D; Vinardell, Tatiana; Buckley, Conor T; Kelly, Daniel J

    2012-12-01

    The inherent biocompatibility of fibrin hydrogels makes them an attractive material for use in a wide range of tissue engineering applications. Despite this, their relatively low stiffness and high compliance limits their potential for certain orthopaedic applications. Enhanced mechanical properties are desirable so as to withstand surgical handling and in vivo loading after implantation and additionally, can provide important cues to cells seeded within the hydrogel. Standard methods used to enhance the mechanical properties of biological scaffolds such as chemical or thermal crosslinking cannot be used with fibrin hydrogels as cell seeding and gel formation occurs simultaneously. The objective of this study was to investigate the use of plastic compression as a means to improve the mechanical properties of chondrocyte-seeded fibrin hydrogels and to determine the influence of such compression on cell viability within these constructs. It was found that the application of 80% strain to fibrin hydrogels for 30 min (which resulted in a permanent strain of 47.4%) produced a 2.1-fold increase in the subsequent compressive modulus. Additionally, chondrocyte viability was maintained in the plastically compressed gels with significant cellular proliferation and extracellular matrix accumulation observed over 28 days of culture. In conclusion, plastic compression can be used to modulate the density and mechanical properties of cell-seeded fibrin hydrogels and represents a useful tool for both in theatre and in vitro tissue engineering applications.

  20. Human umbilical cord stem cell encapsulation in novel macroporous and injectable fibrin for muscle tissue engineering

    Science.gov (United States)

    Liu, Jun; Xu, Hockin H.K.; Zhou, Hongzhi; Weir, Michael D.; Chen, Qianming; Trotman, Carroll Ann

    2012-01-01

    There has been little research on the seeding of human umbilical cord mesenchymal stem cells (hUCMSCs) in three-dimensional scaffolds for muscle tissue engineering. The objectives of this study were: (i) to seed hUCMSCs in a fibrin hydrogel containing fast-degradable microbeads (dMBs) to create macropores to enhance cell viability; and (ii) to investigate the encapsulated cell proliferation and myogenic differentiation for muscle tissue engineering. Mass fractions of 0–80% of dMBs were tested, and 35% of dMBs in fibrin was shown to avoid fibrin shrinkage while creating macropores and promoting cell viability. This construct was referred to as “dMB35”. Fibrin without dMBs was termed “dMB0”. Microbead degradation created macropores in fibrin and improved cell viability. The percentage of live cells in dMB35 reached 91% at 16 days, higher than the 81% in dMB0 (p muscle tissue engineering applications. PMID:22902812

  1. Characterization of Fibrin and Collagen Gels for Engineering Wound Healing Models

    Directory of Open Access Journals (Sweden)

    Oihana Moreno-Arotzena

    2015-04-01

    Full Text Available Hydrogels are used for 3D in vitro assays and tissue engineering and regeneration purposes. For a thorough interpretation of this technology, an integral biomechanical characterization of the materials is required. In this work, we characterize the mechanical and functional behavior of two specific hydrogels that play critical roles in wound healing, collagen and fibrin. A coherent and complementary characterization was performed using a generalized and standard composition of each hydrogel and a combination of techniques. Microstructural analysis was performed by scanning electron microscopy and confocal reflection imaging. Permeability was measured using a microfluidic-based experimental set-up, and mechanical responses were analyzed by rheology. We measured a pore size of 2.84 and 1.69 μm for collagen and fibrin, respectively. Correspondingly, the permeability of the gels was 1.00·10−12 and 5.73·10−13 m2. The shear modulus in the linear viscoelastic regime was 15 Pa for collagen and 300 Pa for fibrin. The gels exhibited strain-hardening behavior at ca. 10% and 50% strain for fibrin and collagen, respectively. This consistent biomechanical characterization provides a detailed and robust starting point for different 3D in vitro bioapplications, such as collagen and/or fibrin gels. These features may have major implications for 3D cellular behavior by inducing divergent microenvironmental cues.

  2. Treatment of gingival recession using free gingival graft with fibrin fibronectin sealing system: A novel approach.

    Science.gov (United States)

    Srinivas, B V V; Rupa, N; Halini Kumari, K V; Rajender, A; Reddy, M Narendra

    2015-08-01

    Periodontal plastic surgery is the branch of periodontology that is focused mainly on the correction or elimination of mucogingival problems associated with lack of attached gingiva, a shallow vestibule and aberrant frenum. Various mucogingival surgical procedures are used to halt the progression of the gingival recession and to correct poor esthetic appearance. Free gingival autograft is one of the most common techniques used for a gingival recession in areas of inadequate attached gingiva in the mandibular anterior region. Fibrin sealants are human plasma derivatives that mimic the final stages of blood coagulation, forming a fibrin clot. Fibrin Sealants enhances the overall outcome of surgical intervention because of their hemostatic, adhesive, and healing properties. These properties of fibrin sealants may reduce operating time, prevent complications, and enhance the overall outcome of many surgical interventions. Hence, this case report aims to investigate the clinical effectiveness of free gingival graft along with the commercially available fibrin-fibronectin sealing system (Tissucol(®)) in the treatment of Miller's class II gingival recession.

  3. Fibrin glue as a protective tool for microanastomoses in limb reconstructive surgery

    Directory of Open Access Journals (Sweden)

    Langer, Stefan

    2015-12-01

    Full Text Available Aim: Fibrin glue becomes a more and more routinely used tool for stabilization of microanastomoses and nerve repair. This paper summarizes the technical properties and advantages of its use in a wide variety of microsurgical contexts, and includes an exemplary limb reconstructive case.Patients and methods: A total of 131 patients who had undergone elective and emergency microsurgery mainly of the limbs were retrospectively analyzed, as was the use of free flaps.Results: The use of fibrin glue allows for proper positioning of anastomoses and repaired nerves. No torsion of the pedicle could be seen. The flap survival rated >94%. The fibrin glue could stay in place in >99%. In the rare case of revision, the fibrin glue could easily be removed without damaging the region of the microanastomosis.Conclusion: Fibrin glue should not be used to repair insufficient, i.e., leaking anastomoses, but it does protect the site of anastomosis from tissue and fluid pressure. It prevents the pedickle from torsion and its use facilitates relocation of the microanastomoses in cases of revision surgery.

  4. 临床预测评分与D-二聚体结合诊断肺动脉栓塞的价值分析%The value analysis of clinical prediction score and D-dimer combination in the diagnosis of pulmona-ry embolism

    Institute of Scientific and Technical Information of China (English)

    王欣; 贾俐聪; 冯靖涛

    2016-01-01

    Objective In order to improve the early diagnosis of pulmonary embolism prediction ability,study and application of the receiver operating characteristic curve( ROC)analysis and comparison of plasma D-dimer,Wells score and modified Ge-neva score predictive value in diagnosis of pulmonary embolism. Method A retrospective analysis of 50 patients with suspected pulmonary embolism patients,plasma D-dimer,Wells score and modified Geneva score and spiral CT pulmonary angiography ( CTPA)examination. Application of ROC curve comparison of plasma D-dimer,Wells score and modified Geneva score predic-tive value in diagnosis of pulmonary embolism. Results The accuracy rate of plasma D-dimer in the diagnosis of pulmonary em-bolism was 80%,which was significantly higher than the Wells score(40%)and modified Geneva score(72%). The diagnostic accuracy rate of D-dimer detection and modified Geneva score combined was 94. 7%( 36/38 ),which was significantly higher than only using clinical prediction score diagnosis accuracy rate;Wells score and modified Geneva score was higher,the greater the probability of pulmonary embolism,predict the layered modified Geneva score was significantly higher than that in the accura-cy of Wells score,The plasma D-dimer,Wells score and modified Geneva score ROC curve prediction area pulmonary embolism respectively(0. 891 ± 0. 047),(0. 766 ± 0. 073)and(0. 815 ± 0. 070),statistically significant difference between groups( P﹤0. 05). 30 cases of plasma D-dimer detection with suspected pulmonary embolism negative,in the later follow-up(3 months) imaging were not found in pulmonary embolism. Conclusion The combination of plasma D-dimer and modified Geneva score is an effective means to predict early diagnosis of pulmonary embolism.%目的:为提高肺动脉栓塞早期预测诊断能力,探讨并应用受试者工作特征曲线( ROC)分析比较D-二聚体、Wells评分和改良Geneva评分对肺栓塞的预测诊断价

  5. Fibrin glue is a candidate scaffold for long-term therapeutic protein expression in spontaneously differentiated adipocytes in vitro

    Energy Technology Data Exchange (ETDEWEB)

    Aoyagi, Yasuyuki [Center for Advanced Medicine, Chiba University Hospital, Chiba University, Chiba (Japan); Department of Genome Research and Clinical Application, Graduate School of Medicine, Chiba University, Chiba (Japan); Kuroda, Masayuki, E-mail: kurodam@faculty.chiba-u.jp [Center for Advanced Medicine, Chiba University Hospital, Chiba University, Chiba (Japan); Department of Genome Research and Clinical Application, Graduate School of Medicine, Chiba University, Chiba (Japan); Asada, Sakiyo [Center for Advanced Medicine, Chiba University Hospital, Chiba University, Chiba (Japan); Department of Genome Research and Clinical Application, Graduate School of Medicine, Chiba University, Chiba (Japan); Tanaka, Shigeaki; Konno, Shunichi; Tanio, Masami; Aso, Masayuki [CellGenTech, Inc., Chiba (Japan); Okamoto, Yoshitaka [Center for Advanced Medicine, Chiba University Hospital, Chiba University, Chiba (Japan); Nakayama, Toshinori [Department of Immunology, Graduate School of Medicine, Chiba University, Chiba (Japan); Saito, Yasushi [Chiba University, Chiba (Japan); Bujo, Hideaki [Department of Genome Research and Clinical Application, Graduate School of Medicine, Chiba University, Chiba (Japan)

    2012-01-01

    Adipose tissue is expected to provide a source of cells for protein replacement therapies via auto-transplantation. However, the conditioning of the environment surrounding the transplanted adipocytes for their long-term survival and protein secretion properties has not been established. We have recently developed a preparation procedure for preadipocytes, ceiling culture-derived proliferative adipocytes (ccdPAs), as a therapeutic gene vehicle suitable for stable gene product secretion. We herein report the results of our evaluation of using fibrin glue as a scaffold for the transplanted ccdPAs for the expression of a transduced gene in a three-dimensional culture system. The ccdPAs secreted the functional protein translated from an exogenously transduced gene, as well as physiological adipocyte proteins, and the long viability of ccdPAs (up to 84 days) was dependent on the fibrinogen concentrations. The ccdPAs spontaneously accumulated lipid droplets, and their expression levels of the transduced exogenous gene with its product were maintained for at least 56 days. The fibrinogen concentration modified the adipogenic differentiation of ccdPAs and their exogenous gene expression levels, and the levels of exogenously transduced gene expression at the different fibrinogen concentrations were dependent on the extent of adipogenic differentiation in the gel. These results indicate that fibrin glue helps to maintain the high adipogenic potential of cultured adipocytes after passaging in a 3D culture system, and suggests that once they are successfully implanted at the transplantation site, the cells exhibit increased expression of the transduced gene with adipogenic differentiation.

  6. High Circulating Adrenaline Levels at Admission Predict Increased Mortality After Trauma

    DEFF Research Database (Denmark)

    Johansson, Pär Ingemar; Stensballe, Jakob; Rasmussen, Lars Simon

    2012-01-01

    partial thromboplastin time, international normalized ratio, hematology, biochemistry, circulating adrenaline and noradrenaline, 11 biomarkers of tissue and endothelial damage, glycocalyx degradation, natural anticoagulation and fibrinolysis (histone-complexed DNA fragments, high-mobility group box 1......:: The adrenaline level was increased in nonsurvivors (p = 0.026), it was independently associated with increased activated partial thromboplastin time (p = 0.034) and syndecan-1 (p = 0.007), a marker of glycocalyx degradation, and it correlated with biomarkers of tissue and endothelial damage (histone......-complexed DNA, high-mobility group box 1, soluble thrombomodulin) and hyperfibrinolysis (tissue-type plasminogen activator, d-dimer). Furthermore, nonsurvivors had higher syndecan-1, tissue factor pathway inhibitor, and d-dimer levels (all p adrenaline was independently associated with 30...

  7. Modulation of 3D Fibrin Matrix Stiffness by Intrinsic Fibrinogen–Thrombin Compositions and by Extrinsic Cellular Activity

    Science.gov (United States)

    Duong, Haison; Wu, Benjamin

    2009-01-01

    Fibrin is a substance formed through catalytic conversion of coagulation constituents: fibrinogen and thrombin. The kinetics of the two constituents determines the structural properties of the fibrin architecture. We have shown previously that changing the fibrinogen and thrombin concentrations in the final three-dimensional (3D) fibrin matrix influenced cell proliferation and differentiation. In this study, we further examined the effect of changing fibrinogen and thrombin concentrations in the absence or presence of fibroblasts on the structural modulus or stiffness of 3D fibrin matrices. We have prepared fibroblast-free and fibroblast-embedded 3D fibrin matrices of different fibrinogen and thrombin formulations, and tested the stiffness of these constructs using standard mechanical testing assays. Results showed that there was a corresponding increase in stiffness with increasing thrombin and fibrinogen concentrations; the increase was more notable with fibrinogen and to a lesser degree with thrombin. The effect of fibroblasts on the stiffness of the fibrin construct was also examined. We have observed a small increase in the stiffness of the fibroblast-incorporated fibrin construct as they proliferated and exhibited spreading morphology. To our knowledge, this is the first comprehensive report detailing the relationship between fibrinogen and thrombin concentrations, cell proliferation, and stiffness in 3D fibrin matrices. The data obtained may lead to optimally design suitable bioscaffolds where we can control both cell proliferation and structural integrity for a variety of tissue engineering applications. PMID:19309239

  8. Fibrin Sealant for Prevention of Resection Surface-Related Complications After Liver Resection A Randomized Controlled Trial

    NARCIS (Netherlands)

    de Boer, Marieke T.; Klaase, Joost M.; Verhoef, Cornelis; van Dam, Ronald M.; van Gulik, Thomas M.; Molenaar, I. Quintus; Bosscha, Koop; Dejong, Cornelis H. C.; Van der Jagt, Eric J.; Porte, Robert J.

    2012-01-01

    Objective: To evaluate the efficacy of fibrin sealant in reducing resection surface-related complications in liver surgery. Background: Bile leakage, bleeding, and abscess formation are major resection surface-related complications after liver resection. It is unclear whether application of fibrin s

  9. Management of an endo-perio lesion in an immature tooth using autologous platelet-rich fibrin: A case report

    Directory of Open Access Journals (Sweden)

    N B Nagaveni

    2015-01-01

    Full Text Available Treatment of an endo-perio lesion involving a non-vital young permanent tooth is a highly challenging task to Pediatric Dentists. There is a quest for the newer biological approach to management of these lesions as traditional methods have various disadvantages. Recently, platelet-rich fibrin (PRF, a second-generation platelet concentrate, is rich in growth factors have been used in the periodontal regeneration procedure. The purpose of this paper is to describe the efficacy of PRF in the treatment of a deep intra bony defect associated with an endo-perio lesion in an immature right mandibular first premolar of 12-year-old female patient. A freshly prepared autologous PRF membrane was placed in the bony defect following debridement. Clinical and radiographic follow-up were performed at regular intervals that revealed absence of pain, gain in clinical attachment level, reduction in probing depth, and excellent bone regeneration indicating successful outcome.

  10. Management of an endo-perio lesion in an immature tooth using autologous platelet-rich fibrin: a case report.

    Science.gov (United States)

    Nagaveni, N B; Kumari, K Nandini; Poornima, P; Reddy, V V Subba

    2015-01-01

    Treatment of an endo-perio lesion involving a non-vital young permanent tooth is a highly challenging task to Pediatric Dentists. There is a quest for the newer biological approach to management of these lesions as traditional methods have various disadvantages. Recently, platelet-rich fibrin (PRF), a second-generation platelet concentrate, is rich in growth factors have been used in the periodontal regeneration procedure. The purpose of this paper is to describe the efficacy of PRF in the treatment of a deep intra bony defect associated with an endo-perio lesion in an immature right mandibular first premolar of 12-year-old female patient. A freshly prepared autologous PRF membrane was placed in the bony defect following debridement. Clinical and radiographic follow-up were performed at regular intervals that revealed absence of pain, gain in clinical attachment level, reduction in probing depth, and excellent bone regeneration indicating successful outcome.

  11. Role of platelet-rich-fibrin in enhancing palatal wound healing after free graft

    Directory of Open Access Journals (Sweden)

    Vinita Jain

    2012-01-01

    Full Text Available Platelet-rich fibrin has long been used as a wound healing therapy in skin wounds and recently evidence has suggested its usage in oral cavity for different treatment procedures. This article proposes an overview of use of platelet-rich fibrin in management of complicated oral wounds. Excessive hemorrhage of the donor area, necrosis of epithelium, and morbidity associated with donor site have been described as the possible complications after harvesting subepithelial connective tissue graft, but little has been mentioned about their management. The article includes a case report of a 45-year-old male patient who showed a delayed wound healing after subepithelial connective tissue graft harvestation, which was treated with platelet-rich fibrin.

  12. Crosslinked fibrin gels for tissue engineering: two approaches to improve their properties.

    Science.gov (United States)

    Gamboa-Martínez, Tatiana C; Luque-Guillén, Victoria; González-García, Cristina; Gómez Ribelles, José Luis; Gallego-Ferrer, Gloria

    2015-02-01

    Fibrin is a protein that can be used as an ideal scaffolding material to promote tissue regeneration. In order to enhance its physical properties in this study a natural crosslinker, genipin (GP), was employed with the aim to obtain a hydrogel with tuneable properties for tissue engineering applications. The fibrin gel was crosslinked by two different methods using four concentrations of GP to get a stable hydrogel network. Crosslinking density, mechanical properties, swelling, and enzymatic degradation of the hydrogels were tested for each GP content and method employed. The method I: Crosslinking after gel formation promotes a high crosslinking and retains the gel shape for long term whilst the method II: Simultaneous gel formation and crosslinking improves the mechanical properties of the gel. This study confirms the use of GP at different concentrations as a suitable crosslinker of fibrin that promotes the cellular viability of L929 for 21 days of in vitro culture.

  13. [Results of fibrin clot application for acceleration of regeneration of the damaged mandible in experiment].

    Science.gov (United States)

    Maĭborodin, I V; Kolesnikov, I S; Shevela, A I; Sheplev, B V; Drovosekov, M N; Toder, M S

    2011-01-01

    The processes of regeneration of the damaged rat bottom jaw bone after application of enriched thrombocytes a fibrin clot were studied by morphological and radiovisiographic methods. At a natural course of regeneration the artificial aperture of bone was filled with blood and there the blood clot was formed. After 1 week the separate bone islets of a young tissue occurred in bone defect. In 2-3 weeks the aperture in a bottom jaw bone was completely closed by a young bone tissue. After operation with filling of bone bottom jaw defect by fibrin clot there was no formation of a blood clot. Already after 1 week the bone tissue defect was filled by the merged islets of again generated bone. By second week after fibrin use the further formation of bone tissue in defect and formation of a bone callosity was noted.

  14. Fibrin network architectures in pure platelet-rich plasma as characterized by fiber radius and correlated with clotting time.

    Science.gov (United States)

    Perez, Amanda G M; Rodrigues, Ana A; Luzo, Angela C M; Lana, José F S D; Belangero, William D; Santana, Maria H A

    2014-08-01

    Fibrin networks are obtained through activation of platelet-rich plasma (PRP) for use in tissue regeneration. The importance of fibrin networks relies on mediation of release of growth factors, proliferation of tissue cells and rheological properties of the fibrin gels. Activation of PRP usually involves the decomposition of fibrinogen by agonists, in a wide range of concentrations. Therefore fibrin networks with a large structural diversity are formed, making comparative evaluations difficult. In order to standardize the fibrin networks, we used the statistical techniques central composite rotatable design and response-surface analysis, to correlate the radius of the fibers with the ratios between the agonists (autologous serum/calcium chloride) and agonist/PRP. From an individual and interactive analysis of the variables, architectures characterized by thick, medium and thin fibers were delineated on the response-surface. Furthermore, the architectures were correlated with coagulation time. This approach is valuable for standardizing the PRP preparation for clinical applications.

  15. Fibrin sheath angioplasty: a technique to prevent superior vena cava stenosis secondary to dialysis catheters.

    Science.gov (United States)

    Hacker, Robert I; Garcia, Lorena De Marco; Chawla, Ankur; Panetta, Thomas F

    2012-09-01

    Fibrin sheaths are a heterogeneous matrix of cells and debris that form around catheters and are a known cause of central venous stenosis and catheter failure. A total of 50 cases of central venous catheter fibrin sheath angioplasty (FSA) after catheter removal or exchange are presented. A retrospective review of an outpatient office database identified 70 eligible patients over a 19-month period. After informed consent was obtained, the dialysis catheter exiting the skin was clamped, amputated, and a wire was inserted. The catheter was then removed and a 9-French sheath was inserted into the superior vena cava, a venogram was performed. If a fibrin sheath was present, angioplasty was performed using an 8 × 4 or 10 × 4 balloon along the entire length of the fibrin sheath. A completion venogram was performed to document obliteration of the sheath. During the study, 50 patients were diagnosed with a fibrin sheath, and 43 had no pre-existing central venous stenosis. After FSA, 39 of the 43 patient's (91%) central systems remained patent without the need for subsequent interventions; 3 patients (7%) developed subclavian stenoses requiring repeat angioplasty and stenting; 1 patent (2.3%) developed an occlusion requiring a reintervention. Seven patients with prior central stenosis required multiple angioplasties; five required stenting of their central lesions. Every patient had follow-up fistulograms to document long-term patency. We propose that FSA is a prudent and safe procedure that may help reduce the risk of central venous stenosis from fibrin sheaths due to central venous catheters.

  16. Determination of fibrin glue with antibiotics on collagen production in colon anastomosis

    Directory of Open Access Journals (Sweden)

    Stanojković Zoran

    2008-01-01

    Full Text Available Background/Aim. Fibrin glue is used as a matrix for local application of antibiotics. The aim of this study was to determine whether application of fibrin glue in combination with antibiotics can strengthen collagen production, prevent dehiscence of colon anastomoses due to infection, and reduce frequency of mortality and morbidity comparing to the control group and the group with fibrin glue application. Methods. The adult male Wistar rats divided into three groups were used in the experiment. The group 1 was the control one (after partial colon resection, colonic anastomoses performed were not treated, while to the group 2 and the group 3 were applied fibrin glue and fibrin glue with antibiotics (clindamycin and ceftriaxon on the site of anastomoses, respectively. Quality of colonic anastomoses were estimated by means of determination of collagen (L-hydroxyproline amount in the collon wall with anastomoses and histological analysis of this colon segment using light and electronic microscope on the days 5, 7 and 13 postoperatively. Results. The highest morbidity rate was registered in the group 1 (30%, then in the group 2 (13.3% and the lowest one in the group 3 (3.33%; p < 0,05 vs group 1. Mortality rate was significantly higher in the group 1 than in the group 3 (20% and 0%, respectively; p < 0,05. In the postoperative course, the highest concentrations of collagen in the colon wall on the site of anastomoses, which was confirmed by both light and electronic microscopy, were found in the group 3. Conclusion. The application of fibrin glue with antibiotics on colon anastomoses reduces the number of dehiscence, provides good mechanical protection and shorten the time of anastomoses healing.

  17. Fibroblast-fibronectin patterning and network formation in 3D fibrin matrices.

    Science.gov (United States)

    Miron-Mendoza, Miguel; Graham, Eric; Manohar, Sujal; Petroll, W Matthew

    2017-06-07

    We previously reported that fibroblasts migrating within 3-D collagen matrices move independently, whereas fibroblasts within 3-D fibrin matrices form an interconnected network. Similar networks have been identified previously during in vivo corneal wound healing. In this study, we investigate the role of fibronectin in mediating this mechanism of collective cell spreading, migration and patterning. To assess cell spreading, corneal fibroblasts were plated within fibrillar collagen or fibrin matrices. To assess migration, compacted cell-populated collagen matrices were nested inside cell-free fibrin matrices. Constructs were cultured in serum-free media containing PDGF, with or without RGD peptide, anti-α5 or anti-fibronectin blocking antibodies. In some experiments, LifeAct and fluorescent fibronectin were used to allow dynamic assessment of cell-induced fibronectin reorganization. 3-D and 4-D imaging were used to assess cell mechanical behavior, connectivity, F-actin, α5 integrin and fibronectin organization. Corneal fibroblasts within 3-D fibrin matrices formed an interconnected network that was lined with cell-secreted fibronectin. Live cell imaging demonstrated that fibronectin tracks were formed at the leading edge of spreading and migrating cells. Furthermore, fibroblasts preferentially migrated through fibronectin tracks laid down by other cells. Interfering with cell-fibronectin binding with RGD, anti α5 integrin or anti fibronectin antibodies inhibited cell spreading and migration through fibrin, but did not affect cell behavior in collagen. In this study, a novel mode of cell patterning was identified in which corneal fibroblasts secrete and attach to fibronectin via α5β1 integrin to facilitate spreading and migration within 3-D fibrin matrices, resulting in the formation of localized fibronectin tracks. Other cells use these fibronectin tracks as conduits, resulting in an interconnected cell-fibronectin network. Copyright © 2017 International

  18. Recombinant human bone morphogenetic protein-2 suspended in fibrin glue enhances bone formation during distraction osteogenesis in rabbits

    Science.gov (United States)

    Li, Yunfeng; Li, Rui; Hu, Jing; Song, Donghui; Jiang, Xiaowen

    2016-01-01

    Introduction Bone morphogenetic protein-2 (BMP-2) has high potential for bone formation, but its in vivo effects are unpredictable due to the short life time. This study was designed to evaluate the effects of recombinant human (rh) BMP-2 suspended in fibrin on bone formation during distraction osteogenesis (DO) in rabbits. Material and methods The in vitro release kinetics of rhBMP-2 suspended in fibrin was tested using an enzyme-linked immunosorbent assay. Unilateral tibial lengthening for 10 mm was achieved in 48 rabbits. At the completion of osteodistraction, vehicle, fibrin, rhBMP-2 or rhBMP-2 suspended in fibrin (rhBMP-2 + fibrin) was injected into the center of the lengthened gap, with 12 animals in each group. Eight weeks later, the distracted callus was examined by histology, micro-CT and biomechanical testing. Radiographs of the distracted tibiae were taken at both 4 and 8 weeks after drug treatment. Results It was found that fibrin prolonged the life span of rhBMP-2 in vitro with sustained release during 17 days. The rhBMP-2 + fibrin treated animals showed the best results in bone mineral density, bone volume fraction, cortical bone thickness by micro-CT evaluation and mechanical properties by the three-point bending test when compared to the other groups (p < 0.05). In histological images, rhBMP-2 + fibrin treatment showed increased callus formation and better gap bridging compared to the other groups. Conclusions The results of this study suggest that fibrin holds promise to be a good carrier of rhBMP-2, and rhBMP-2 suspended in fibrin showed a stronger promoting effect on bone formation during DO in rabbits. PMID:27279839

  19. Use of platelet-rich fibrin over skin wounds: Modified secondary intention healing

    Directory of Open Access Journals (Sweden)

    Chirag B Desai

    2013-01-01

    Full Text Available The healing process after any surgical intervention has always posed a challenge for the surgeons. In spite of the advances in wound closure techniques and devices, there is a crucial need for newer methods of enhancing the healing process to achieve optimal outcomes. Fibrin adhesives and platelet concentrates have proven useful in various treatment modalities in the fields of microvascular and plastic surgery. This case report shows its unique use in the field of maxillofacial and cutaneous surgery. It shows an innovative technique of enhancement of skin wound healing by local application of platelet-rich fibrin.

  20. Treatment of post-prostatectomy rectourethral fistula with fibrin sealant (Quixil™) injection: a novel application.

    Science.gov (United States)

    Verriello, V; Altomare, M; Masiello, G; Curatolo, C; Balacco, G; Altomare, D F

    2010-12-01

    Rectourethral fistulas in adults is a rare but potentially devastating postoperative condition requiring complex and demanding surgery. Fibrin glue treatment has been used with some success in anal and rectovaginal fistulas, and in the case we present here this indication has been extended to a postoperative rectourethral fistula following radical prostatectomy. For the first time, to our knowledge, a fibrin sealant (Quixil) was injected into the fistula tract, and a rectal mucosal flap was used to close the internal opening. The fistula healed in few weeks, and the patient is symptom free after 1 year of follow-up.

  1. Nitrogenous subcutaneous emphysema caused by spray application of fibrin glue during retroperitoneal laparoscopic surgery.

    Science.gov (United States)

    Matsuse, Shinji; Maruyama, Atsushi; Hara, Yoshiki

    2011-06-01

    We report a case of a patient treated by retroperitoneoscopic partial nephrectomy who developed nitrogenous subcutaneous emphysema (SCE) as a complication. The use of a nitrogen gas-pressured fibrin tissue adhesive applied as a spray caused excessively increased pressure in the closed retroperitoneal space and resulted in widespread SCE with protracted clinical course. To the best of our knowledge, this is the first report of nitrogenous SCE associated with pneumoperitoneum. The clinical significance of nitrogenous SCE is emphasized, and the risks associated with the use of fibrin glue as a spray during laparoscopic surgery are discussed.

  2. El fibrinógeno como factor de riesgo de enfermedad aterotrombótica

    OpenAIRE

    Julio César Fernández Travieso

    2009-01-01

    La disfunción endotelial y la inflamación representan un decisivo papel desde las etapas tempranas de la aterosclerosis hasta la aparición de los síndromes coronarios agudos, en los cuales el fibrinógeno ha demostrado tener una activa participación. Además, en concentraciones elevadas se relaciona con la trombosis y ha sido demostrado que es un factor independiente de riesgo cardiovascular. Hoy día, concentraciones elevadas de fibrinógeno junto con la proteína C-reactiva, la lipoproteína (a) ...

  3. [Healing of tubal anastomoses--microsurgery vs. fibrin gluing: morphologic aspects].

    Science.gov (United States)

    Gauwerky, J F; Klose, R P; Forssmann, W G

    1994-01-01

    The healing of anastomoses either by microsurgical suture technique or by fibrin sealant technique has been examined in an experimental morphological study. With view to morphological criteria the healing of tubal anastomoses after one month is completed. Afterwards only little areas of regeneration could be found in the region of the anastomosis. These statements are valid for both types of anastomoses. In single cases a more progressive regeneration of the mucosa could be demonstrated. Using fibrin glue a more pronounced fibrosis could not be seen.

  4. Influence of Chinese traditional medicine Tongmaijiangzhi on blood lipids and D-dimer of the hypercholesterolemia in quails%通脉降脂口服液对高胆固醇血症鹌鹑血脂及D-二聚体水平的影响

    Institute of Scientific and Technical Information of China (English)

    韩桂英; 王婉真; 兴华

    2005-01-01

    BACKGROUND: The incidence and development of atherosclerotic plaque is caused by the disorder of blood coagulation or / and fibrinolysis.The level of blood lipid and D-dimer can reflect the activities of both blood coagulation in vivo and fibrinolysis.OBJECTIVE: To investigate the role of blood lipid , D-dimer level of atherosclerosis in quail model , and the interventional effect of Tongmaijiangzhi , as compared with that of lovatatin.DESIGN: Randomly controlled trial.SETTING: Department of Basic Medicine, Medical College of Zhengzhou Railway Vocational Technology CollegeMATERIALS: This experiment was conducted in the Experimental Center of Medical College of Zhengzhou Railway Vocational Technology College in January 2001. Total 125 quails with body mass varying from 100 to 120 g were selected. The animals were randomly divided into five groups with 25 per group: normal control group, hyperlipidemia group, lovastatin group, hyperlipidemia group with the treatment of low dosage of Tongmaijiangzhi, and hyperlipidemia group with the treatment of high dosage of Tongmaijiangzhi. Blood lipid-depressing medicine Tongmaijiangzhi was extracted from the medicinal herb including chuanxiong rhizome, Chinese angelica root, red sage root notoginseng, oriental water-plantain rhizome,rhubarb, and cassia seed.METHODS: High-fat diet was given the animals in the hyperlipidemia group, lovatatin group, low dosage Tongmaijiangzhi group and treatment high dosage of Tongmaijiangzhi group to establish animals models of quails with hypercholesterolemia, and then the animals in the normal control group and hyperlipidemia group were stomach-perfused with 1.5 mL of distilled water; the animals in the lovatatin group was stomach-perfused with 1.5 mL of lovatatin solution (0.53 g/mL) ; the animals in the low dosage of Tongmaijiangzhi group and high dosage of Tongmaijiangzhi group were stomach-perfused with 1.5 mL of low dosage of Tongmaijiangzhi (1.27 g/mL) and high dosage of Tongmaijiangzhi (2

  5. D-二聚体和肌钙蛋白I比值在致命性胸痛病因诊断中的应用%Application of the ratio of D-dimer and Troponin I in etiological diagnosis of acute chest pain

    Institute of Scientific and Technical Information of China (English)

    夏武杰; 杨鹏麟

    2016-01-01

    Objective To investigate the value of plasma d- dimer, troponin I and their ratio in etiological diagnosis of acute chest pain. Methods The data of 786 patients (534 male, 252 female, aged from 28 to 93 years) admission for acute chest pain and diagnosed as either acute myocardial infarction (AMI), acute pulmonary embolism (APE) or acute aorta dissection (AAD) were analyzed retrospectively. AMI was divided into ST segment elevation and non- ST segment elevation myocardial infarciton (STEMI, NSTEMI). Serum d- dimer, troponin I and their ratio were analyzed. The receiver operating characteristic curve (ROC curve) was performed to determine the value of d- dimer, troponin I, the ratio of d- dimer to troponin I (Rd) and troponin I to d- dimer (Rc) in the differential diagnosis of STEMI, NSTEMI, APE and AAD. Results D- dimer was significantly higher in AAD(11.13μg/ml) and APE groups(3.92μg/ml)than STEMI(0.38μg/ml) and NSTEMI groups(0.34μg/ml)(al P<0.05). There was significant difference between ADD and APE groups(P<0.05) and no significant difference between STEMI and NSTEMI groups. Troponin I was significantly higher in STEMI group(5.000ng/ml) than in NSTEMI group (3.035 ng/ml)(P<0.05). Both of them were significantly higher than 0.030 ng/ml in APE and AAD groups (al P<0.05). From STEMI to NSTEMI to APE to AAD, Rc was decreasing and Rd was increasing. There was significant difference between any two groups (al P<0.05). The ROC curve showed that Rc was superior to troponin I and Rd superior to d- dimer in the differential diagnosis of these diseases. Conclusion The ratios of D- dimmer to troponin I and troponin I to D- dimmer are benefit to improve the sensitivity and specificity of each parameter in the diagnosis of acute chest pain.%目的:探讨D-二聚体、肌钙蛋白I及其比值在鉴别致命性胸痛病因诊断中的应用。方法因胸痛或胸闷至我院急诊确诊为心肌梗死、肺栓塞、主动脉夹层的患者786例,男性534

  6. Pre-ART levels of inflammation and coagulation markers are strong predictors of death in a South African cohort with advanced HIV disease.

    Directory of Open Access Journals (Sweden)

    Lotty Ledwaba

    Full Text Available BACKGROUND: Levels of high-sensitivity C-reactive protein (hsCRP, interleukin-6 (IL-6, and D-dimer predict mortality in HIV patients on antiretroviral therapy (ART with relatively preserved CD4+ T cell counts. We hypothesized that elevated pre-ART levels of these markers among patients with advanced HIV would be associated with an increased risk of death following the initiation of ART. METHODS: Pre-ART plasma from patients with advanced HIV in South Africa was used to measure hsCRP, IL-6 and D-dimer. Using a nested case-control study design, the biomarkers were measured for 187 deaths and two controls matched on age, sex, clinical site, follow-up time and CD4+ cell counts. Odds ratios were estimated using conditional logistic regression. In addition, for a random sample of 100 patients, biomarkers were measured at baseline and 6 months following randomization to determine whether ART altered their levels. RESULTS: Median baseline biomarkers levels for cases and controls, respectively, were 11.25 vs. 3.6 mg/L for hsCRP, 1.41 vs. 0.98 mg/L for D-dimer, and 9.02 vs. 4.20 pg/mL for IL-6 (all p<0.0001. Adjusted odds ratios for the highest versus lowest quartile of baseline biomarker levels were 3.5 (95% CI: 1.9-6.7 for hsCRP, 2.6 (95%CI 1.4-4.9 for D-dimer, and 3.8 (95% CI: 1.8-7.8 for IL-6. These associations were stronger for deaths that occurred more proximal to the biomarker measurements. Levels of D-dimer and IL-6, but not hsCRP, were significantly lower at month 6 after commencing ART compared to baseline (p<0.0001. CONCLUSIONS: Among patients with advanced HIV disease, elevated pre-ART levels of hsCRP, IL-6 and D-dimer are strongly associated with early mortality after commencing ART. Elevated levels of inflammatory and coagulation biomarkers may identify patients who may benefit from aggressive clinical monitoring after commencing ART. Further investigation of strategies to reduce biomarkers of inflammation and coagulation in patients with

  7. Experimental research on the effect of mitomycin C fibrin gel on spinal peridural scar tissue in rats.

    Science.gov (United States)

    Liu, Wenping

    2014-09-01

    This paper aimed to study the best working concentration of mitomycin C (MMC) fibrin gel on spinal peridural scar tissue in rats and the sustained release function of peridural adhesion after laminectomy of rats. 96 SD rats were divided into four groups. They were conducted L1 laminectomy and sprayed FG-MMC. The concentration of MMC was detected and the best working concentration of MMC was selected. Then other 48 SD rats were divided into four groups to construct L1 vertebral plate excision model. Materials were drawn 4 weeks after the operation for Rydell grading. In addition, we observed HE staining and fibroblast proliferation and collagen distribution situation after Masson staining. And concentration of hydroxyproline was also detected. The best working concentration of MMC experiment showed that except experimental group C, the other groups all appeared drug release peak in the 4th week after the operation. MMC concentration of group C appeared drug release peak in the 5th week besides the 2nd week. Moreover, adhesion of endorhachis and peripheral tissue in group A was the most obvious while the group C was the weakest. Experiment on the slow-release effect of different adhesion materials on peridural adhesion showed that compared to the contrast group and group F, Rydell grading in group E and G was Level 0 and with low adhesion degree, little fibroblast and fibrocyte, low collagen content, regular collagen fibers arrangement and no inflammatory cells after HE staning and Masson staining. In addition, content of hydroxyproline(HOP) decreased significantly especially the group of FG-MMC mixture. It was concluded that MMC fibrin gel mixture had a good slow-release effect on adhesion of spinal peridural scar tissue in rats and the best working concentration was 0.5 mg FG-MMC/ml.

  8. Perivenous application of fibrin glue prevents the early injury of jugular vein graft to arterial circulation in rabbits

    Institute of Scientific and Technical Information of China (English)

    WAN Li; LI Dian-yuan; YANG Bing; WU Qing-yu

    2006-01-01

    Background Placement of an external support has been reported to prevent intimal hyperplasia of vein grafts. However, it is limited by potential complications. In the present study, we investigated the effect of fibrin glue on preventing vein graft failure as perivenous application. Methods Twenty-four rabbits were divided into non-supported group (n=12) and fibrin glue group (n=12). All animals underwent unilateral jugular vein into common carotid artery interposition grafting and then fibrin glue was applied as perivenous support. Samples of tissues were harvested after 4 weeks. Results The vein grafts with fibrin glue demonstrated a statistically significant decrease in proliferating cell nuclear antigen in the medial/intimal region [13.38% (11.26%-15.11%)] compared with non-supported vein grafts [31.22% (27.15%-35.98%)] (P<0.001). Light microscopy showed remarkable attenuation of endothelial cell loss and numerous microvessels in neoadventitia in the fibrin glue group compared with the non-supported group. The smooth muscle cells migrated into adventitia significantly in fibrin glue group, whereas the smooth muscle cells migrated into intima in non-supported group.Conclusion Perivenous support of vein graft with fibrin glue in vivo can attenuate the severe injury encountered in the non-supported vein grafts exposed to artery.

  9. Optimization of acidic fibroblast growth factor (FGF-1) and its delivery through a modified degradable fibrin scaffold

    Science.gov (United States)

    Pandit, Abhay Smashikant

    The aim of this investigation was to develop a degradable fibrin wound dressing that can deliver an optimized dose of acidic fibroblast growth factor (FGF-1). This aim led to three distinct phases of study. In the first phase, a structurally modified fibrin degradable scaffold was developed and tested in a rabbit ear ulcer model. A significant increase in the angiogenic and fibroblastic response with a corresponding decrease in healing time was seen in the modified fibrin-treated ulcers as compared with untreated ulcers and ulcers treated with non-modified fibrin systems. In the second phase of the study, a biochemical factor, FGF-1, was added to this scaffold. An optimal dose of 8 mug of FGF-1 was determined to be required to initiate a desired wound-healing response in a rabbit ear ulcer model, based on an enhanced angiogenic and fibroblastic response and an increased epithelialization rate. The objective of the last phase was to investigate the efficacy of a modified scaffold as a vehicle for FGF-1. In vivo testing was conducted in a full-thickness defect model in a rabbit. Improvements were seen in the angiogenic and fibroblastic responses in the FGF-1/modified fibrin treatment group and, hence, FGF-1/modified fibrin was the preferred treatment. In conclusion, the modified fibrin/FGF-1 matrix served as a suitable vehicle for the growth factor, providing a desired healing response and a desirable release rate and, thus, was determined to be an effective scaffold.

  10. Impaired thrombin generation and fibrin clot formation in patients with dilutional coagulopathy during major surgery.

    NARCIS (Netherlands)

    Schols, S.E.; Lance, M.D.; Feijge, M.A.; Damoiseaux, J.; Marcus, M.A.; Hamulyak, K.; Cate, H. ten; Heemskerk, J.W.M.; Pampus, E.C.M. van

    2010-01-01

    Patients subjected to haemodilution during surgery are at increased risk of bleeding. We hypothesised that, in the acquired dilutional coagulopathy, insufficient haemostasis is due to either insufficient thrombin generation or insufficient fibrin clot formation. In tissue factor-activated plasmas fr

  11. Effect of implanting fibrin sealant with ropivacaine on pain after laparoscopic cholecystectomy

    Institute of Scientific and Technical Information of China (English)

    Jian-Zhu Fu; Jie Li; Ze-Li Yu

    2009-01-01

    AIM: To investigate the safety and efficacy of implanting fibrin sealant with sustained-release ropivacaine in the gallbladder bed for pain after laparoscopic cholecystectomy (LC). METHODS: Sixty patients (American Society of Anesthesiologists physical status was Ⅰ or Ⅱ and underwent LC) were randomly divided into three equal groups: group A (implantation of fibrin sealant in the gallbladder bed), group B (implantation of fibrin sealant carrying ropivacaine in the gallbladder bed), and group C (normal saline in the gallbladder bed). Postoperative pain was evaluated, and pain relief was assessed by visual analog scale (VAS) scoring. RESULTS: The findings showed that 81.7% of patients had visceral pain, 50% experienced parietal, and 26.7% reported shoulder pain after LC. Visceral pain was significantly less in group B patients than in the other groups ( P < 0.05), and only one patient in this group experienced shoulder pain. The mean VAS score in group B patients was lower than that in the other groups. CONCLUSION: Visceral pain is prominent after LC and can be effectively controlled by implanting fibrin sealant combined with ropivacaine in the gallbladder bed.

  12. Bioreactor Conditioning for Accelerated Remodeling of Fibrin-Based Tissue Engineered Heart Valves

    Science.gov (United States)

    Schmidt, Jillian Beth

    Fibrin is a promising scaffold material for tissue engineered heart valves, as it is completely biological, allows for engineered matrix alignment, and is able to be degraded and replaced with collagen by entrapped cells. However, the initial fibrin matrix is mechanically weak, and extensive in vitro culture is required to create valves with sufficient mechanical strength and stiffness for in vivo function. Culture in bioreactor systems, which provide cyclic stretching and enhance nutrient transport, has been shown to increase collagen production by cells entrapped in a fibrin scaffold, accelerating strengthening of the tissue and reducing the required culture time. In the present work, steps were taken to improve bioreactor culture conditions with the goal of accelerating collagen production in fibrin-based tissue engineered heart valves using two approaches: (i) optimizing the cyclic stretching protocol and (ii) developing a novel bioreactor system that permits transmural and lumenal flow of culture medium for improved nutrient transport. The results indicated that incrementally increasing strain amplitude cyclic stretching with small, frequent increments in strain amplitude was optimal for collagen production in our system. In addition, proof of concept studies were performed in the novel bioreactor system and increased cellularity and collagen deposition near the lumenal surface of the tissue were observed.

  13. Platelet-Rich Fibrin Promotes Periodontal Regeneration and Enhances Alveolar Bone Augmentation

    Directory of Open Access Journals (Sweden)

    Qi Li

    2013-01-01

    Full Text Available In the present study we have determined the suitability of platelet-rich fibrin (PRF as a complex scaffold for periodontal tissue regeneration. Replacing PRF with its major component fibrin increased mineralization in alveolar bone progenitors when compared to periodontal progenitors, suggesting that fibrin played a substantial role in PRF-induced osteogenic lineage differentiation. Moreover, there was a 3.6-fold increase in the early osteoblast transcription factor RUNX2 and a 3.1-fold reduction of the mineralization inhibitor MGP as a result of PRF application in alveolar bone progenitors, a trend not observed in periodontal progenitors. Subcutaneous implantation studies revealed that PRF readily integrated with surrounding tissues and was partially replaced with collagen fibers 2 weeks after implantation. Finally, clinical pilot studies in human patients documented an approximately 5 mm elevation of alveolar bone height in tandem with oral mucosal wound healing. Together, these studies suggest that PRF enhances osteogenic lineage differentiation of alveolar bone progenitors more than of periodontal progenitors by augmenting osteoblast differentiation, RUNX2 expression, and mineralized nodule formation via its principal component fibrin. They also document that PRF functions as a complex regenerative scaffold promoting both tissue-specific alveolar bone augmentation and surrounding periodontal soft tissue regeneration via progenitor-specific mechanisms.

  14. Platelet-rich fibrin matrix improves wound angiogenesis via inducing endothelial cell proliferation.

    Science.gov (United States)

    Roy, Sashwati; Driggs, Jason; Elgharably, Haytham; Biswas, Sabyasachi; Findley, Muna; Khanna, Savita; Gnyawali, Urmila; Bergdall, Valerie K; Sen, Chandan K

    2011-11-01

    The economic, social, and public health burden of chronic ulcers and other compromised wounds is enormous and rapidly increasing with the aging population. The growth factors derived from platelets play an important role in tissue remodeling including neovascularization. Platelet-rich plasma (PRP) has been utilized and studied for the last four decades. Platelet gel and fibrin sealant, derived from PRP mixed with thrombin and calcium chloride, have been exogenously applied to tissues to promote wound healing, bone growth, hemostasis, and tissue sealing. In this study, we first characterized recovery and viability of as well as growth factor release from platelets in a novel preparation of platelet gel and fibrin matrix, namely platelet-rich fibrin matrix (PRFM). Next, the effect of PRFM application in a delayed model of ischemic wound angiogenesis was investigated. The study, for the first time, shows the kinetics of the viability of platelet-embedded fibrin matrix. A slow and steady release of growth factors from PRFM was observed. The vascular endothelial growth factor released from PRFM was primarily responsible for endothelial mitogenic response via extracellular signal-regulated protein kinase activation pathway. Finally, this preparation of PRFM effectively induced endothelial cell proliferation and improved wound angiogenesis in chronic wounds, providing evidence of probable mechanisms of action of PRFM in healing of chronic ulcers.

  15. Platelet-rich fibrin promotes periodontal regeneration and enhances alveolar bone augmentation.

    Science.gov (United States)

    Li, Qi; Pan, Shuang; Dangaria, Smit J; Gopinathan, Gokul; Kolokythas, Antonia; Chu, Shunli; Geng, Yajun; Zhou, Yanmin; Luan, Xianghong

    2013-01-01

    In the present study we have determined the suitability of platelet-rich fibrin (PRF) as a complex scaffold for periodontal tissue regeneration. Replacing PRF with its major component fibrin increased mineralization in alveolar bone progenitors when compared to periodontal progenitors, suggesting that fibrin played a substantial role in PRF-induced osteogenic lineage differentiation. Moreover, there was a 3.6-fold increase in the early osteoblast transcription factor RUNX2 and a 3.1-fold reduction of the mineralization inhibitor MGP as a result of PRF application in alveolar bone progenitors, a trend not observed in periodontal progenitors. Subcutaneous implantation studies revealed that PRF readily integrated with surrounding tissues and was partially replaced with collagen fibers 2 weeks after implantation. Finally, clinical pilot studies in human patients documented an approximately 5 mm elevation of alveolar bone height in tandem with oral mucosal wound healing. Together, these studies suggest that PRF enhances osteogenic lineage differentiation of alveolar bone progenitors more than of periodontal progenitors by augmenting osteoblast differentiation, RUNX2 expression, and mineralized nodule formation via its principal component fibrin. They also document that PRF functions as a complex regenerative scaffold promoting both tissue-specific alveolar bone augmentation and surrounding periodontal soft tissue regeneration via progenitor-specific mechanisms.

  16. Long-Standing Motor and Sensory Recovery following Acute Fibrin Sealant Based Neonatal Sciatic Nerve Repair

    Directory of Open Access Journals (Sweden)

    Natalia Perussi Biscola

    2016-01-01

    Full Text Available Brachial plexus lesion results in loss of motor and sensory function, being more harmful in the neonate. Therefore, this study evaluated neuroprotection and regeneration after neonatal peripheral nerve coaptation with fibrin sealant. Thus, P2 neonatal Lewis rats were divided into three groups: AX: sciatic nerve axotomy (SNA without treatment; AX+FS: SNA followed by end-to-end coaptation with fibrin sealant derived from snake venom; AX+CFS: SNA followed by end-to-end coaptation with commercial fibrin sealant. Results were analyzed 4, 8, and 12 weeks after lesion. Astrogliosis, microglial reaction, and synapse preservation were evaluated by immunohistochemistry. Neuronal survival, axonal regeneration, and ultrastructural changes at ventral spinal cord were also investigated. Sensory-motor recovery was behaviorally studied. Coaptation preserved synaptic covering on lesioned motoneurons and led to neuronal survival. Reactive gliosis and microglial reaction decreased in the same groups (AX+FS, AX+CFS at 4 weeks. Regarding axonal regeneration, coaptation allowed recovery of greater number of myelinated fibers, with improved morphometric parameters. Preservation of inhibitory synaptic terminals was accompanied by significant improvement in the motor as well as in the nociceptive recovery. Overall, the present data suggest that acute repair of neonatal peripheral nerves with fibrin sealant results in neuroprotection and regeneration of motor and sensory axons.

  17. Fibrin sealant prevents gastrointestinal anastomosis dehiscence in intra-abdominal sepsis.

    Science.gov (United States)

    Wang, Xinbo; Ren, Jianan; Zhu, Weiming; Li, Ning; Li, Jieshou

    2007-01-01

    We observed the potential use of fibrin sealant as a therapeutic modality for successful resolution of gastrointestinal anastomosis dehiscence in intra-abdominal sepsis. Forty-eight patients (33 men and 15 women) suffering from intra-abdominal sepsis were subjected to prophylactic appliance of fibrin sealant during immediate primary anastomosis during the laparotomy. The perioperative management invariably involved fluid resuscitation, active suction drainage of the abdominal liquor puris, nutritional supplementation, and growth hormone. The total surgical-related success ratio was 91.7% (44/48) for primary anastomosis with fibrin sealant in intra-abdominal sepsis. Anastomotic leakage occurred in the other four patients, two of which died because of leakage complications in our hospital. The hospital stay after the operation was 30.2 +/- 12.0 days. There has been no sign of recurrence over a follow-up period of 1-15 months. It is concluded that fibrin sealant may be useful in preventing gastrointestinal anastomosis dehiscence in intra-abdominal sepsis.

  18. Platelet-rich fibrin membranes as scaffolds for periosteal tissue engineering.

    NARCIS (Netherlands)

    Gassling, V.; Douglas, T.E.L.; Warnke, P.H.; Acil, Y.; Wiltfang, J.; Becker, S.T.

    2010-01-01

    OBJECTIVES: Platelet-rich fibrin (PRF)-based membranes have been used for covering alveolar ridge augmentation side in several in vivo studies. Few in vitro studies on PRF and no studies using human periosteal cells for tissue engineering have been published. The aim is a comparison of PRF with the

  19. Mechanical stability and fibrinolytic resistance of clots containing fibrin, DNA, and histones.

    Science.gov (United States)

    Longstaff, Colin; Varjú, Imre; Sótonyi, Péter; Szabó, László; Krumrey, Michael; Hoell, Armin; Bóta, Attila; Varga, Zoltán; Komorowicz, Erzsébet; Kolev, Krasimir

    2013-03-08

    Neutrophil extracellular traps are networks of DNA and associated proteins produced by nucleosome release from activated neutrophils in response to infection stimuli and have recently been identified as key mediators between innate immunity, inflammation, and hemostasis. The interaction of DNA and histones with a number of hemostatic factors has been shown to promote clotting and is associated with increased thrombosis, but little is known about the effects of DNA and histones on the regulation of fibrin stability and fibrinolysis. Here we demonstrate that the addition of histone-DNA complexes to fibrin results in thicker fibers (increase in median diameter from 84 to 123 nm according to scanning electron microscopy data) accompanied by improved stability and rigidity (the critical shear stress causing loss of fibrin viscosity increases from 150 to 376 Pa whereas the storage modulus of the gel increases from 62 to 82 pascals according to oscillation rheometric data). The effects of DNA and histones alone are subtle and suggest that histones affect clot structure whereas DNA changes the way clots are lysed. The combination of histones + DNA significantly prolongs clot lysis. Isothermal titration and confocal microscopy studies suggest that histones and DNA bind large fibrin degradation products with 191 and 136 nM dissociation constants, respectively, interactions that inhibit clot lysis. Heparin, which is known to interfere with the formation of neutrophil extracellular traps, appears to prolong lysis time at a concentration favoring ternary histone-DNA-heparin complex formation, and DNase effectively promotes clot lysis in combination with tissue plasminogen activator.

  20. Mechanical Stability and Fibrinolytic Resistance of Clots Containing Fibrin, DNA, and Histones*

    Science.gov (United States)

    Longstaff, Colin; Varjú, Imre; Sótonyi, Péter; Szabó, László; Krumrey, Michael; Hoell, Armin; Bóta, Attila; Varga, Zoltán; Komorowicz, Erzsébet; Kolev, Krasimir

    2013-01-01

    Neutrophil extracellular traps are networks of DNA and associated proteins produced by nucleosome release from activated neutrophils in response to infection stimuli and have recently been identified as key mediators between innate immunity, inflammation, and hemostasis. The interaction of DNA and histones with a number of hemostatic factors has been shown to promote clotting and is associated with increased thrombosis, but little is known about the effects of DNA and histones on the regulation of fibrin stability and fibrinolysis. Here we demonstrate that the addition of histone-DNA complexes to fibrin results in thicker fibers (increase in median diameter from 84 to 123 nm according to scanning electron microscopy data) accompanied by improved stability and rigidity (the critical shear stress causing loss of fibrin viscosity increases from 150 to 376 Pa whereas the storage modulus of the gel increases from 62 to 82 pascals according to oscillation rheometric data). The effects of DNA and histones alone are subtle and suggest that histones affect clot structure whereas DNA changes the way clots are lysed. The combination of histones + DNA significantly prolongs clot lysis. Isothermal titration and confocal microscopy studies suggest that histones and DNA bind large fibrin degradation products with 191 and 136 nm dissociation constants, respectively, interactions that inhibit clot lysis. Heparin, which is known to interfere with the formation of neutrophil extracellular traps, appears to prolong lysis time at a concentration favoring ternary histone-DNA-heparin complex formation, and DNase effectively promotes clot lysis in combination with tissue plasminogen activator. PMID:23293023

  1. Sealing of Gastrointestinal Anastomoses with a Fibrin Glue-Coated Collagen Patch: A Safety Study

    DEFF Research Database (Denmark)

    Nordentoft, Tyge; Rømer, John; Sørensen, Michael

    2007-01-01

    intestine. One of the anastomoses was sealed with a collagen patch coated with fibrin glue components (TachoSil). The other anastomosis contained no sealing. The pigs were observed for 1 to 6 weeks. The observation period was followed by in vivo examination under general anesthesia and included observation...

  2. Supplementation of fibrin gels with sodium chloride enhances physical properties and ensuing osteogenic response.

    Science.gov (United States)

    Davis, H E; Miller, S L; Case, E M; Leach, J K

    2011-02-01

    Modifying the relative concentrations of fibrinogen and thrombin can control the physical properties of fibrin gels, while the viability of associated cells has been linked to the gel's final network structure. It was hypothesized that increasing the gel ionic strength during fabrication through supplementation with sodium chloride (NaCl) would provide an improved approach for tailoring the physical properties of fibrin gels and maintaining the viability and osteogenic potential of entrapped cells. Fibrin gels were formed by mixing fibrinogen, thrombin and calcium chloride with varying masses of NaCl (0-4.40% w/v), and the osteogenic potential of entrapped human mesenchymal stem cells (MSC) was examined over 14 days. Physical properties including gelation time, compressive modulus and fiber diameter were dependent upon NaCl content, with gels containing 2.60% NaCl possessing compressive moduli threefold higher than gels without NaCl. Alkaline phosphatase activity was highest for MSC entrapped in gels containing 2.15-2.60% NaCl after 14 days, and all gels exhibited increased calcium incorporation over the culture period. These data confirm that varying the salt concentration of the pre-gel solution can modulate the material properties of fibrin constructs without additional fibrinogen or thrombin, thereby offering a new approach for generating improved cell transplantation vehicles for use in bone tissue regeneration.

  3. Histological assessment of titanium and polypropylene fiber mesh implantation with and without fibrin tissue glue

    NARCIS (Netherlands)

    Hallers, E.J.O. ten; Jansen, J.A.; Marres, H.A.M.; Rakhorst, G.; Verkerke, G.J.

    2007-01-01

    Polypropylene (PP) and titanium (Ti) meshes are well-known surgical implants that provoke a relative low foreign body reaction. Firm stabilization of the implant is important to prevent migration and subsequent failure of the operation. Fibrin tissue glues are commercially available adhesives and ar

  4. Fibrin glue used successfully in peritoneal dialysis catheter leakage in children.

    NARCIS (Netherlands)

    Rusthoven, E.; Kar, N.C.A.J. van de; Monnens, L.A.H.; Schröder, C.H.

    2004-01-01

    BACKGROUND: Acute renal failure in infants and small children is generally treated with peritoneal dialysis (PD). Dialysis has to be started immediately after catheter implantation. Early dialysate leakage can complicate the effectiveness of dialysis. Fibrin glue applied to the external part of the

  5. Application of fibrin glue to damaged bladder mucosa in a case of BK viral hemorrhagic cystitis.

    Science.gov (United States)

    Purves, J Todd; Graham, Michael L; Ramakumar, Sanjay

    2005-09-01

    BK virus is a common cause of severe hemorrhagic cystitis refractory to standard treatment. We describe a technique to achieve hemostasis after failed conservative therapy using fibrin glue applied suprapubically while visualizing and insufflating the bladder through a cystoscope. Long-term hemostasis was achieved using this novel procedure.

  6. Safety and efficacy of a novel, dry powder fibrin sealant for hemostasis in hepatic resection.

    NARCIS (Netherlands)

    Ruitenbeek, K.; Ayez, N.; Verhoef, C.; Wilt, J.H.W. de; Bottema, J.; Rijken, A.M.; Rij, M. van; Koopman, J; Zuckerman, L.A.; Frohna, P.; Porte, R.J.

    2014-01-01

    BACKGROUND/AIMS: Fibrocaps is a dry powder fibrin sealant containing human plasma-derived fibrinogen and thrombin. The safety, efficacy, and application methods for Fibrocaps were evaluated in an exploratory, first-in-human, noncomparative, clinical study. METHODS: Patients with minor bleeding/oozin

  7. Combined treatment of iatrogenic rectourethral fistula with endoscopic fibrin glue application and clipping.

    Science.gov (United States)

    Dolay, Kemal; Aras, Bekir; Tuğcu, Volkan; Ozbay, Bedi; Aygün, Erşan; Taşçi, Ali Ihsan

    2007-04-01

    Rectourethral fistula (RUF) formation is a rare complication of prostatic surgery and other pelvic surgical procedures. The results of operations to correct RUF are not always satisfying, with a particular risk of recurrent breakdown or stricture formation at the site of the urethral closure. We present a case of a small RUF treated videoendoscopically with fibrin-glue application combined with endoscopic clipping.

  8. Safety and Efficacy of a Novel, Dry Powder Fibrin Sealant for Hemostasis in Hepatic Resection

    NARCIS (Netherlands)

    Ruitenbeek, Karin; Ayez, N.; Verhoef, C.; de Wilt, J. Hans W.; Bottema, Jan; Rijken, Arjen M.; van Rij, Monique; Koopman, Jaap; Zuckerman, Linda A.; Frohna, Paul; Porte, Robert J.

    2014-01-01

    Background/Aims: Fibrocaps is a dry powder fibrin sealant containing human plasma-derived fibrinogen and thrombin. The safety, efficacy, and application methods for Fibrocaps were evaluated in an exploratory, first-in-human, non-comparative, clinical study. Methods: Patients with minor bleeding/oozi

  9. Fibrin glue used successfully in peritoneal dialysis catheter leakage in children.

    NARCIS (Netherlands)

    Rusthoven, E.; Kar, N.C.A.J. van de; Monnens, L.A.H.; Schröder, C.H.

    2004-01-01

    BACKGROUND: Acute renal failure in infants and small children is generally treated with peritoneal dialysis (PD). Dialysis has to be started immediately after catheter implantation. Early dialysate leakage can complicate the effectiveness of dialysis. Fibrin glue applied to the external part of the

  10. Simultaneous sinus lift and implantation using platelet-rich fibrin as sole grafting material.

    Science.gov (United States)

    Jeong, Seung-Mi; Lee, Chun-Ui; Son, Jeong-Seog; Oh, Ji-Hyeon; Fang, Yiqin; Choi, Byung-Ho

    2014-09-01

    Recently, several authors have shown that simultaneous sinus lift and implantation using autologous platelet-rich fibrin as the sole filling material is a reliable procedure promoting bone augmentation in the maxillary sinus. The aim of this study was to examine the effect of simultaneous sinus lift and implantation using platelet-rich fibrin as the sole grafting material on bone formation in a canine sinus model. An implant was placed after sinus membrane elevation in the maxillary sinus of six adult female mongrel dogs. The resulting space between the membrane and sinus floor was filled with autologous platelet-rich fibrin retrieved from each dog. The implants were left in place for six months. Bone tissue was seen at the lower part of the implants introduced into the sinus cavity. The height of the newly formed bone around the implants ranged from 0 mm to 4.9 mm (mean; 2.6 ± 2.0 mm) on the buccal side and from 0 mm to 4.2 mm (mean; 1.3 ± 1.8 mm) on the palatal side. The findings from this study suggest that simultaneous sinus lift and implantation using platelet-rich fibrin as sole grafting material is not a predictable and reproducible procedure, especially with respect to the bone formation around the implants in the sinus cavity.

  11. Modelling of platelet-fibrin clot formation in flow with a DPD-PDE method.

    Science.gov (United States)

    Tosenberger, A; Ataullakhanov, F; Bessonov, N; Panteleev, M; Tokarev, A; Volpert, V

    2016-02-01

    The paper is devoted to mathematical modelling of clot growth in blood flow. Great complexity of the hemostatic system dictates the need of usage of the mathematical models to understand its functioning in the normal and especially in pathological situations. In this work we investigate the interaction of blood flow, platelet aggregation and plasma coagulation. We develop a hybrid DPD-PDE model where dissipative particle dynamics (DPD) is used to model plasma flow and platelets, while the regulatory network of plasma coagulation is described by a system of partial differential equations. Modelling results confirm the potency of the scenario of clot growth where at the first stage of clot formation platelets form an aggregate due to weak inter-platelet connections and then due to their activation. This enables the formation of the fibrin net in the centre of the platelet aggregate where the flow velocity is significantly reduced. The fibrin net reinforces the clot and allows its further growth. When the clot becomes sufficiently large, it stops growing due to the narrowed vessel and the increase of flow shear rate at the surface of the clot. Its outer part is detached by the flow revealing the inner part covered by fibrin. This fibrin cap does not allow new platelets to attach at the high shear rate, and the clot stops growing. Dependence of the final clot size on wall shear rate and on other parameters is studied.

  12. Canine articular cartilage regeneration using mesenchymal stem cells seeded on platelet rich fibrin

    Science.gov (United States)

    Shams Asenjan, K.; Dehdilani, N.; Parsa, H.

    2017-01-01

    Objectives Mesenchymal stem cells have the ability to differentiate into various cell types, and thus have emerged as promising alternatives to chondrocytes in cell-based cartilage repair methods. The aim of this experimental study was to investigate the effect of bone marrow derived mesenchymal stem cells combined with platelet rich fibrin on osteochondral defect repair and articular cartilage regeneration in a canine model. Methods Osteochondral defects were created on the medial femoral condyles of 12 adult male mixed breed dogs. They were either treated with stem cells seeded on platelet rich fibrin or left empty. Macroscopic and histological evaluation of the repair tissue was conducted after four, 16 and 24 weeks using the International Cartilage Repair Society macroscopic and the O’Driscoll histological grading systems. Results were reported as mean and standard deviation (sd) and compared at different time points between the two groups using the Mann-Whitney U test, with a value regeneration. It is postulated that platelet rich fibrin creates a suitable environment for proliferation and differentiation of stem cells by releasing endogenous growth factors resulting in creation of a hyaline-like reparative tissue. Cite this article: D. Kazemi, K. Shams Asenjan, N. Dehdilani, H. Parsa. Canine articular cartilage regeneration using mesenchymal stem cells seeded on platelet rich fibrin: Macroscopic and histological assessments. Bone Joint Res 2017;6:98–107. DOI: 10.1302/2046-3758.62.BJR-2016-0188.R1. PMID:28235767

  13. Platelet-rich fibrin membranes as scaffolds for periosteal tissue engineering.

    NARCIS (Netherlands)

    Gassling, V.; Douglas, T.E.L.; Warnke, P.H.; Acil, Y.; Wiltfang, J.; Becker, S.T.

    2010-01-01

    OBJECTIVES: Platelet-rich fibrin (PRF)-based membranes have been used for covering alveolar ridge augmentation side in several in vivo studies. Few in vitro studies on PRF and no studies using human periosteal cells for tissue engineering have been published. The aim is a comparison of PRF with the

  14. Fibrin matrices enhance the transplant and efficacy of cytotoxic stem cell therapy for post-surgical cancer.

    Science.gov (United States)

    Bagó, Juli R; Pegna, Guillaume J; Okolie, Onyi; Hingtgen, Shawn D

    2016-04-01

    Tumor-homing cytotoxic stem cell (SC) therapy is a promising new approach for treating the incurable brain cancer glioblastoma (GBM). However, problems of retaining cytotoxic SCs within the post-surgical GBM resection cavity are likely to significantly limit the clinical utility of this strategy. Here, we describe a new fibrin-based transplant approach capable of increasing cytotoxic SC retention and persistence within the resection cavity, yet remaining permissive to tumoritropic migration. This fibrin-based transplant can effectively treat both solid and post-surgical human GBM in mice. Using our murine model of image-guided model of GBM resection, we discovered that suspending human mesenchymal stem cells (hMSCS) in a fibrin matrix increased initial retention in the surgical resection cavity 2-fold and prolonged persistence in the cavity 3-fold compared to conventional delivery strategies. Time-lapse motion analysis revealed that cytotoxic hMSCs in the fibrin matrix remain tumoritropic, rapidly migrating from the fibrin matrix to co-localize with cultured human GBM cells. We encapsulated hMSCs releasing the cytotoxic agent TRAIL (hMSC-sTR) in fibrin, and found hMSC-sTR/fibrin therapy reduced the viability of multiple 3-D human GBM spheroids and regressed established human GBM xenografts 3-fold in 11 days. Mimicking clinical therapy of surgically resected GBM, intra-cavity seeding of therapeutic hMSC-sTR encapsulated in fibrin reduced post-surgical GBM volumes 6-fold, increased time to recurrence 4-fold, and prolonged median survival from 15 to 36 days compared to control-treated animals. Fibrin-based SC therapy could represent a clinically compatible, viable treatment to suppress recurrence of post-surgical GBM and other lethal cancer types.

  15. Fibrin-mediated integrin signaling plays a critical role in hepatic regeneration after partial hepatectomy in mice

    Science.gov (United States)

    Beier, Juliane I.; Guo, Luping; Joshi-Barve, Swati; Ritzenthaler, Jeffrey D.; Roman, Jesse; Arteel, Gavin E.

    2016-01-01

    Background The regenerative capacity of the liver is critical for proper responses to injury. Fibrin extracellular matrix (ECM) deposition is a common response to insult and contributes to inflammatory liver injury. However, the role of this matrix in hepatic regeneration has not been determined. Objective The purpose of this study was first to determine the role of fibrin ECM in hepatic regeneration followed by the role of the fibrin-binding αvβ3 integrin in mediating this effect. Material and methods C57BI/6J (WT) or PAI-1 knockout (KO) mice underwent 70% partial hepatectomy (PHx); plasma and histologic indices of regeneration were determined, as well as expression of key genes involved in hepatic regeneration. Results PHx promoted transient fibrin deposition by activating coagulation and concomitantly decreasing fibrinolysis. Inhibiting fibrin deposition, either by blocking thrombin (hirudin) in WT mice or by knocking out PAI-1, was associated with a decrease in hepatocyte proliferation after PHx. This strongly suggested a role for fibrin ECM in liver regeneration. To investigate if αvβ3 integrin mediates this action, we tested the effects of the anti-αvβ3 cyclic peptide RGDfV in animals after PHx. As was observed with inhibition of fibrin deposition, competitive inhibition of αvβ3 integrin delayed regeneration after PHx, while not affecting fibrin deposition. These effects of RGDfV correlated with impaired angiogenesis and STAT3 signaling, as well as transient endothelial dysfunction. In conclusion, these data suggest that αvβ3 integrin plays an important role in coordinating hepatocyte division during liver regeneration after PHx via crosstalk with fibrin ECM. PMID:27493116

  16. Platelet Rich Fibrin in the revitalization of tooth with necrotic pulp and open apex

    Directory of Open Access Journals (Sweden)

    Vasundara Yayathi Shivashankar

    2012-01-01

    Full Text Available Regeneration of pulp-dentin complex in an infected necrotic tooth with an open apex is possible if the canal is effectively disinfected. The purpose of this case report is to add a regenerative endodontic case to the existing literature about using Platelet Rich Fibrin (PRF. A nine year old boy who accidently broke his immature maxillary central incisor tooth, developed pulpal necrosis with apical periodontitis. After the access cavity preparation, the canal was effectively irrigated with 20 ml of 5.25% sodium hypochlorite solution and 10ml of 0.2% chlorhexidine solution and dried with paper points. Triple antibiotic paste was placed inside the canal and left for 21 days. 12 ml of whole blood was drawn from the patient′s right antecubital vein and centrifuged for 10 minutes to obtain the Choukroun′s PRF. After the removal of the triple antibiotic paste, the PRF was placed into the canal till the level of cementoenamel junction and 3mm of grey MTA was placed directly over the PRF clot. The setting of MTA was confirmed 3 days later and the tooth was double sealed with GIC and Composite restoration.After 1 year the clinical examination revealed negative responses to percussion and palpation tests. The tooth responded positively to cold and electric pulp tests. Radiographic examination revealed continued thickening of the dentinal walls, root lengthening, regression of the periapical lesion and apical closure. On the basis of the results obtained in our case report we conclude that revitalization of necrotic infected immature tooth is possible under conditions of total canal disinfection and PRF is an ideal biomaterial for pulp-dentin complex regeneration.

  17. Fibrin-genipin adhesive hydrogel for annulus fibrosus repair: performance evaluation with large animal organ culture, in situ biomechanics, and in vivo degradation tests

    Directory of Open Access Journals (Sweden)

    M Likhitpanichkul

    2014-07-01

    Full Text Available Annulus fibrosus (AF defects from annular tears, herniation, and discectomy procedures are associated with painful conditions and accelerated intervertebral disc (IVD degeneration. Currently, no effective treatments exist to repair AF damage, restore IVD biomechanics and promote tissue regeneration. An injectable fibrin-genipin adhesive hydrogel (Fib-Gen was evaluated for its performance repairing large AF defects in a bovine caudal IVD model using ex vivo organ culture and biomechanical testing of motion segments, and for its in vivo longevity and biocompatibility in a rat model by subcutaneous implantation. Fib-Gen sealed AF defects, prevented IVD height loss, and remained well-integrated with native AF tissue following approximately 14,000 cycles of compression in 6-day organ culture experiments. Fib-Gen repair also retained high viability of native AF cells near the repair site, reduced nitric oxide released to the media, and showed evidence of AF cell migration into the gel. Biomechanically, Fib-Gen fully restored compressive stiffness to intact levels validating organ culture findings. However, only partial restoration of tensile and torsional stiffness was obtained, suggesting opportunities to enhance this formulation. Subcutaneous implantation results, when compared with the literature, suggested Fib-Gen exhibited similar biocompatibility behaviour to fibrin alone but degraded much more slowly. We conclude that injectable Fib-Gen successfully sealed large AF defects, promoted functional restoration with improved motion segment biomechanics, and served as a biocompatible adhesive biomaterial that had greatly enhanced in vivo longevity compared to fibrin. Fib-Gen offers promise for AF repairs that may prevent painful conditions and accelerated degeneration of the IVD, and warrants further material development and evaluation.

  18. Reduction of the closure time of postoperative enterocutaneous fistulas with fibrin sealant

    Science.gov (United States)

    Avalos-González, Jorge; Portilla-deBuen, Eliseo; Leal-Cortés, Caridad Aurea; Orozco-Mosqueda, Abel; del Carmen Estrada-Aguilar, María; Velázquez-Ramírez, Gabriela Abigail; Ambriz-González, Gabriela; Fuentes-Orozco, Clotilde; Guzmán-Gurrola, Aldo Emmerson; González-Ojeda, Alejandro

    2010-01-01

    AIM: To assess whether the use of fibrin sealant shortens the closure time of postoperative enterocutaneous fistulas (ECFs). METHODS: The prospective case-control study included 70 patients with postoperative ECFs with an output of 2 cm and without any local complication. They were divided into study (n = 23) and control groups (n = 47). Esophageal, gastric and colocutaneous fistulas were monitored under endoscopic visualization, which also allowed fibrin glue application directly through the external hole. Outcome variables included closure time, time to resume oral feeding and morbidity related to nutritional support. RESULTS: There were no differences in mean age, fistula output, and follow-up. Closure-time for all patients of the study group was 12.5 ± 14.2 d and 32.5 ± 17.9 d for the control group (P < 0.001), and morbidity related to nutritional support was 8.6% and 42.5%, respectively (P < 0.01). In patients with colonic fistulas, complete closure occurred 23.5 ± 19.5 d after the first application of fibrin glue, and spontaneous closure was observed after 36.2 ± 22.8 d in the control group (P = 0.36). Recurrences were observed in 2 patients because of residual disease. One patient of each group died during follow-up as a consequence of septic complications related to parenteral nutrition. CONCLUSION: Closure time was significantly reduced with the use of fibrin sealant, and oral feeding was resumed faster. We suggest the use of fibrin sealant for the management of stable enterocutaneous fistulas. PMID:20533600

  19. Platelet-rich fibrin-induced bone marrow mesenchymal stem cell differentiation into osteoblast-like cells and neural cells

    Institute of Scientific and Technical Information of China (English)

    Qi Li; Yajun Geng; Lei Lu; Tingting Yang; Mingrui Zhang; Yanmin Zhou

    2011-01-01

    Bone marrow mesenchymal stem cells were allowed to develop for 14 days in a platelet-rich fibrin environment. Results demonstrated that platelet-rich fibrin significantly promoted bone marrow mesenchymal stem cell proliferation. In addition, there was a dose-dependent increase in Runt-related transcription factor-2 and bone morphogenetic protein-2 mRNA expression, as well as neuron-specific enolase and glial acidic protein. Results showed that platelet-rich fibrin promoted bone marrow mesenchymal stem cell proliferation and differentiation of osteoblastlike cells and neural cells in a dose-dependent manner.

  20. The Value of Clinical Examination of C-reactive Protein and D-dimer in Patients with Acute Leukemia and Infection%C反应蛋白和D-二聚体对急性白血病伴感染患者的临床检查价值

    Institute of Scientific and Technical Information of China (English)

    林少芳; 罗志敏

    2014-01-01

    目的:探讨C反应蛋白和D-二聚体对急性白血病伴感染患者的临床检查价值。方法选取该院血液科2011年1月—2013年12月诊断为急性白血病的住院病人,诊断为有感染的患者定义为感染组40例;诊断为弥漫性血管内凝血的患者为弥漫性血管内凝血组40例;同时有感染与弥漫性血管内凝血的患者归为感染+弥漫性血管内凝血组40例。测取各组C反应蛋白和D-二聚体数值。结果感染组、弥漫性血管内凝血组及感染+弥漫性血管内凝血组C反应蛋白和D-二聚体分别为[(42.8依10.5)mg/L、(0.8依0.3)μg/L;(16.5依5.8)mg/L、(1.5依0.6)μg/L;(88.7依21.7)mg/L、(6.8依1.7)μg/L],C反应蛋白和D-二聚体以联合组最高,弥漫性血管内凝血组最低,三组的差异有统计学意义(P<0.05);以C反应蛋白[(<10 mg/L)、(10≤,<100 mg/L)、(≥100 mg/L)]进行分层,CRP≥100 mg/L的人群中,发生DIC比例及血中D-二聚体值最高,而C反应蛋白<10 mg/L的人群中,发生DIC比例及血中D-二聚体值最低,差异有统计学意义(P<0.05)。结论该研究认为急性白血病病人普遍存在感染和异常凝血,可以C反应蛋白和D-二聚体作为检测指标,判断患者是否有发生弥漫性血管内凝血与感染的风险。%Objective To evaluate the value of clinical examination of C-reactive protein and D-dimer in acute leukemia patients with infection. Methods The inpatients diagnosed with acute leukemia in the Department of Hematology of our hospital were se-lected. Those acute leukemia patients complicated by infection were set as the infection group(40 cases), those complicated by dis-seminated intravascular coagulation(DIC) were set as the disseminated intravascular coagulation group(40 cases), and those compli-cated by infection and DIC were set as the infection and disseminated intravascular coagulation group(40 cases). And the values of C-reactive protein and D-dimer

  1. A novel bioreactor for the generation of highly aligned 3D skeletal muscle-like constructs through orientation of fibrin via application of static strain.

    Science.gov (United States)

    Heher, Philipp; Maleiner, Babette; Prüller, Johanna; Teuschl, Andreas Herbert; Kollmitzer, Josef; Monforte, Xavier; Wolbank, Susanne; Redl, Heinz; Rünzler, Dominik; Fuchs, Christiane

    2015-09-01

    The generation of functional biomimetic skeletal muscle constructs is still one of the fundamental challenges in skeletal muscle tissue engineering. With the notion that structure strongly dictates functional capabilities, a myriad of cell types, scaffold materials and stimulation strategies have been combined. To further optimize muscle engineered constructs, we have developed a novel bioreactor system (MagneTissue) for rapid engineering of skeletal muscle-like constructs with the aim to resemble native muscle in terms of structure, gene expression profile and maturity. Myoblasts embedded in fibrin, a natural hydrogel that serves as extracellular matrix, are subjected to mechanical stimulation via magnetic force transmission. We identify static mechanical strain as a trigger for cellular alignment concomitant with the orientation of the scaffold into highly organized fibrin fibrils. This ultimately yields myotubes with a more mature phenotype in terms of sarcomeric patterning, diameter and length. On the molecular level, a faster progression of the myogenic gene expression program is evident as myogenic determination markers MyoD and Myogenin as well as the Ca(2+) dependent contractile structural marker TnnT1 are significantly upregulated when strain is applied. The major advantage of the MagneTissue bioreactor system is that the generated tension is not exclusively relying on the strain generated by the cells themselves in response to scaffold anchoring but its ability to subject the constructs to individually adjustable strain protocols. In future work, this will allow applying mechanical stimulation with different strain regimes in the maturation process of tissue engineered constructs and elucidating the role of mechanotransduction in myogenesis. Mechanical stimulation of tissue engineered skeletal muscle constructs is a promising approach to increase tissue functionality. We have developed a novel bioreactor-based 3D culture system, giving the user the

  2. sEPCR Levels in Chronic Myeloproliferative Diseases and Their Association with Thromboembolic Events: A Case-Control Study

    Directory of Open Access Journals (Sweden)

    Figen Atalay

    2014-06-01

    Full Text Available OBJECTIVE: Venous, arterial, and microcirculatory events are frequently encountered in the clinical course of essential thrombocytosis and polycythemia vera. We aimed to investigate the levels of soluble endothelial protein C receptor (sEPCR in myeloproliferative diseases to see whether there was a difference between the patients with and without history of thromboembolism. METHODS: The study included patients with polycythemia vera (n=12, patients with essential thrombocytosis (n=13, and controls (n=29. In all groups, we measured proteins C and S, antithrombin and sEPCR levels, and plasma concentrations of thrombin-antithrombin complex, prothrombin fragments 1+2, and D-dimer. RESULTS: Comparing the patients with and without history of thromboembolic attack, statistically significant differences were not observed in terms of sEPCR, D-dimer, thrombin-antithrombin complex, prothrombin fragments 1+2, and hematocrit levels (p=0.318, 0.722, 0.743, 0.324, and 0.065, respectively. CONCLUSION: Significant increase in the parameters that reflect activation of coagulation, such as sEPCR, thrombinantithrombin complex, prothrombin fragments 1+2, and D-dimer, reflects the presence of a basal condition that leads to a tendency toward thrombosis development in ET and PV when compared to healthy controls.

  3. In-vitro-Studie zum Einfluss von Fibrin in Knorpelkonstrukten auf der Basis von PGA-Vliesstoffen

    DEFF Research Database (Denmark)

    Schmal, H; Mehlhorn, A T; Kurze, C

    2008-01-01

    and cultured using a serum-free technique. The cells were seeded on PGA-91 scaffolds with and without an additional fibrin component; the constructs were cultured for 2 weeks in vitro. Besides cell viability, DNA content, pH, aggrecan production, mRNA expression of aggrecan, and collagen types I and II were...... remained within a physiologic range. The Alcian blue staining of the constructs showed the homogeneous cell distribution and a cell-associated proteoglycan production. Aggrecan concentration in the supernatants of fibrin-containing constructs was significantly lower compared to fibrin-free grafts (-24......BACKGROUND: The matrix component in autologous chondrocyte implantation plays an important role. In this study the influence of an additional fibrin component in cartilage constructs based on polyglycolide polymers (PGA) was investigated. METHODS: Human chondrocytes of femoral heads were isolated...

  4. Fibroblast invasive migration into fibronectin/fibrin gels requires a previously uncharacterized dermatan sulfate-CD44 proteoglycan

    DEFF Research Database (Denmark)

    Clark, Richard A F; Lin, Fubao; Greiling, Doris

    2004-01-01

    After tissue injury, fibroblast migration from the peri-wound collagenous stroma into the fibrin-laden wound is critical for granulation tissue formation and subsequent healing. Recently we found that fibroblast transmigration from a collagen matrix into a fibrin matrix required the presence...... migration into a fibronectin/fibrin gel. This conclusion was based on beta-xyloside inhibition of glycanation and specific glycosaminoglycan degradation. CD44, a cell surface receptor known to bind hyaluronan, not infrequently exists as a proteoglycan, decorated with various glycosaminoglycan chains...... including heparan sulfate and chondroitin sulfate, and as such can bind fibronectin. We found that CD44H, the non-spliced isoform of CD44, was necessary for fibroblast invasion into fibronectin/fibrin gels. Resting fibroblasts expressed mostly nonglycanated CD44H core protein, which became glycanated...

  5. Finite Element Analysis of Magnetic Microparticle Induced Strain on a Fibrin Matrix due to the Influence of an Electromagnetic Field

    CERN Document Server

    Averett, Rodney D; Scogin, Tyler; Walker, Mitchell L R

    2016-01-01

    Blood clots occur in the human body when they are required to prevent bleeding. In pathological states such as diabetes and sickle cell disease, blood clots can also form undesirably due to hypercoagulable plasma conditions. With the continued effort in developing fibrin therapies for potential life-saving solutions, more mechanical modeling is needed to understand the properties of fibrin structures with inclusions. In this study, a fibrin matrix embedded with magnetic micro particles was subjected to a magnetic field to determine the plastic deformation of the clot. Using finite element analysis, we estimate the magnetic force from an electromagnet at a sample space located approximately 3 cm away from the coil center. This electromagnetic force along with gravity is applied on a fibrin sub model to calculate the stresses and displacements. Initial analyses show the forces are not sufficient to create fibrinolysis and hence we extended the study using parametric sweep analysis and redesign the coil paramete...

  6. Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part II: platelet-related biologic features.

    Science.gov (United States)

    Dohan, David M; Choukroun, Joseph; Diss, Antoine; Dohan, Steve L; Dohan, Anthony J J; Mouhyi, Jaafar; Gogly, Bruno

    2006-03-01

    Platelet-rich fibrin (PRF) belongs to a new generation of platelet concentrates, with simplified processing and without biochemical blood handling. In this second article, we investigate the platelet-associated features of this biomaterial. During PRF processing by centrifugation, platelets are activated and their massive degranulation implies a very significant cytokine release. Concentrated platelet-rich plasma platelet cytokines have already been quantified in many technologic configurations. To carry out a comparative study, we therefore undertook to quantify PDGF-BB, TGFbeta-1, and IGF-I within PPP (platelet-poor plasma) supernatant and PRF clot exudate serum. These initial analyses revealed that slow fibrin polymerization during PRF processing leads to the intrinsic incorporation of platelet cytokines and glycanic chains in the fibrin meshes. This result would imply that PRF, unlike the other platelet concentrates, would be able to progressively release cytokines during fibrin matrix remodeling; such a mechanism might explain the clinically observed healing properties of PRF.

  7. Fibrin sealant for mesh fixation in laparoscopic groin hernia repair does not increase long-term recurrence

    DEFF Research Database (Denmark)

    Fenger, Andreas Qwist; Helvind, Neel Maria; Pommergaard, Hans-Christian;

    2016-01-01

    ) laparoscopic groin hernia repair using either fibrin sealant or tacks for mesh fixation. METHODS: This study used data from the Danish Hernia Database to create the following cohort: All patients operated laparoscopically for primary groin hernia with a TAPP procedure using fibrin sealant for mesh fixation....... These patients were matched 1:2 with patients, where the mesh was fixated using tacks. A validated questionnaire was sent to all included patients to determine recurrence, which was defined as reoperation or clinical diagnosis of recurrence by a physician. Follow-up was from index operation to either reoperation...... were found, of which 30 (5.8%) were in the fibrin sealant group and 84 (8.3%) in the tacks group (p = 0.084). The Cox regression analysis found no difference in recurrence with the use of tacks compared to fibrin sealant (hazard ratio 0.8) [95% CI (0.5-1.2)]. CONCLUSION: We found no significant...

  8. [Experience in fibrin glue application for the treatment of non-formed fistulas of the gastrointestinal tract].

    Science.gov (United States)

    Chernousov, A F; Khorobrykh, T V; Ishchenko, O V

    2006-01-01

    Fibrin glue was used for conservative closure of non-formed fistulas of the gastrointestinal tract in 38 patients. The variant of fibrin glue produced with cryoprecipitation (concentration of coagulant protein not less than 60 g/l) was applied as reparation stimulator. Fibrin glue has been used for closure of 8 duodenal and 4 gastric fistulas with chime loss to 1.5 l per day. Surgeries for palliative arrest of the intestinal loop with a fistula and classical obturators were not performed. The fistulas have been closed in 36 patients, 3 patients died (only 1 of them due to fistula). Fibrin glue reduced surgical aggression and improved treatment results in critically ill patients.

  9. Role of pH Changes on Transforming Growth Factor-β1 Release and on the Fibrin Architecture of Platelet-rich Fibrin When Layered with Biodentine, Glass Ionomer Cement, and Intermediate Restorative Material.

    Science.gov (United States)

    Mullaguri, Harish; Suresh, Nandini; Surendran, Smitha; Velmurugan, Natanasabapathy; Chitra, Selvarajan

    2016-05-01

    The purpose of this study was to evaluate the influence of pH that is due to setting reaction of Biodentine, glass ionomer cement (GIC), and intermediate restorative material (IRM) on transforming growth factor-β1 (TGF-β1) release and on the fibrin architecture of platelet-rich fibrin (PRF). PRF was obtained from 8 volunteers and layered over the freshly prepared GIC, IRM, and Biodentine mixtures. TGF-β1 release was estimated by using enzyme-linked immunosorbent assay (ELISA), and fibrin structure of PRF was analyzed by using scanning electron microscope at 1 and 5 hours. Biodentine, GIC, and IRM increased the TGF-β1 release in comparison with that of control group (PRF alone) at both 1 and 5 hours. Biodentine released significantly more TGF-β1 than GIC and IRM at 1 hour. At 5 hours both GIC and Biodentine released significantly more TGF-β1 than IRM. The fibrin architecture of the Biodentine group was similar to that of control group at both 1 and 5 hours. In GIC and IRM groups the fibrillar structure of fibrin was collapsed, ill-defined, and cloudy with very thick fibers and irregularly reduced porosities. Biodentine induces larger amount of TGF-β1 release and also maintains the integrity of fibrin structure when compared with GIC and IRM when layered over PRF. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  10. Experimental closure of gunshot wounds by fibrin glue with antibiotics in pigs

    Directory of Open Access Journals (Sweden)

    Đenić Nebojša

    2015-01-01

    Full Text Available Background/Aim. Gunshot wounds caused by the automatic rifle M70AB2 (AK-47 7.62 mm, after the primary surgical management, were closed with delayed primary suture during the next four to seven days. This period coincides with the fibroblastic phase of wound healing. Fibrin glue is used as a local hemostatic and as a matrix for the local dosed release of antibiotics. Antibiotics addition to fibrin glue resulted in continuous diffusion into the surrounding next 4 to 7 days. The aim of this study was to create the preconditions for gunshot wounds closing without complications by the application of fibrin glue with antibiotics 24 h after primary surgical treatment. Methods. A total of 14 pigs were wounded in the gluteofemoral region by the bullet M67, initial velocity of 720 m/s. All wounded animals were surgically treated according to the principles of the warsurgery doctrine. Seven wounds were closed with primary delayed suture four days after the primary surgical treatment (traditional approach. Fibrin glue with antibiotics was introduced in seven wounds during the primary surgical treatment and primary delayed suture was done after 24 h. The macroscopic appearance and the clinical assessment of the wound were done during the primary surgical treatment and during its revision after 24 h, as well as histopathological findings at the days 4 and 7 after wounding. Results. Gunshot wounds caused by the automatic rifle M70AB2 (AK-47 7.62 mm, and treated with fibrin glue with antibiotics after primary surgical management, were closed with primary delayed suture after 24 h. In further wound evolution there were no complications. Conclusion. Uncomplicated soft-tissue wounds caused by an automatic M70AB2 rifle may be closed primarily with delayed suture without the risk of developing complications if on revision, 24 h after primary surgery, there were no present necrotic tissues, hematoma, and any signs of infection when fibrin glue with antibiotics

  11. Comparison of viability of adipose-derived Mesenchymal stem cells on agarose and fibrin glue scaffolds

    Directory of Open Access Journals (Sweden)

    Farzaneh Tafvizi

    2015-06-01

    Full Text Available Background & aim: Utilizing tissue engineering techniques and designing similar structures of the damaged tissues require the use of tools such as scaffolds, cells, and bioactive molecules in vitro. Meanwhile, appropriate cell cultures with the ability to divide and differentiate on the natural scaffolds lacking features like immunogenicity and tumorgenesis is particularly important. Adipose tissue has attracted researchers’ attention due to its abundance of mesenchymal stem cells and its availability through a liposuction. The purpose of the present study was to investigate the reproducibility and viability of the adipose-derived stem cells on natural scaffolds of fibrin glue and agarose. Methods: In the present experimental study, the isolation and identification of the mesenchymal stem cells was performed on tissue obtained from liposuction. The tissues were extensively washed with PBS and were digested with collagenase I, then the mesenchymal stem cells were isolated. The cells were cultured in RPMI medium supplemented with antibiotic. Subsequently, the expression of cell surface markers including CD34, CD44, CD90, and CD105 were analyzed by flow cytometry to confirm the mesenchymal cells. After preparing fibrin glue and agarose scaffolds, the viability and proliferation of the adipose tissue-derived mesenchymal stem cells were examined at the period of 24, 48, and 72 hours by MTT and ELISA assays. The obtained results were analyzed by SPSS ver.19. Results: The results of adipose tissue-derived mesenchymal stem cells culture on the fibrin glue and agarose scaffolds indicated that cell viability on fibrin glue and agarose scaffold were 68.22% and 89.75% in 24 hrs, 64.04% and 66.97% in 48 hours, 222.87% and 1089.68% in 72 hours respectively. Significant proliferation and viability cells on a synthesized agarose scaffold were seen compared to the fibrin glue scaffold after 72 hrs. The viability of the cells significantly increased on the

  12. A new heterologous fibrin sealant as a scaffold to cartilage repair-Experimental study and preliminary results.

    Science.gov (United States)

    de Barros, Caio Nunes; Miluzzi Yamada, Ana Lúcia; Junior, Rui Seabra F; Barraviera, Benedito; Hussni, Carlos Alberto; de Souza, Jaqueline Brandão; Watanabe, Marcos Jun; Rodrigues, Celso Antônio; Garcia Alves, Ana Liz

    2016-07-01

    Autologous fibrin gel is commonly used as a scaffold for filling defects in articular cartilage. This biomaterial can also be used as a sealant to control small hemorrhages and is especially helpful in situations where tissue reparation capacity is limited. In particular, fibrin can act as a scaffold for various cell types because it can accommodate cell migration, differentiation, and proliferation. Despite knowledge of the advantages of this biomaterial and mastery of the techniques required for its application, the durability of several types of sealant at the site of injury remains questionable. Due to the importance of such data for evaluating the quality and efficiency of fibrin gel formulations on its use as a scaffold, this study sought to analyze the heterologous fibrin sealant developed from the venom of Crotalus durissus terrificus using studies in ovine experimental models. The fibrin gel developed from the venom of this snake was shown to act as a safe, stable, and durable scaffold for up to seven days, without causing adverse side effects. Fibrin gel produced from the venom of the Crotalus durissus terrificus snake possesses many clinical and surgical uses. It presents the potential to be used as a biomaterial to help repair skin lesions or control bleeding, and it may also be used as a scaffold when applied together with various cell types. The intralesional use of the fibrin gel from the venom of this snake may improve surgical and clinical treatments in addition to being inexpensive and adequately consistent, durable, and stable. The new heterologous fibrin sealant is a scaffold candidate to cartilage repair in this study.

  13. A new heterologous fibrin sealant as a scaffold to cartilage repair—Experimental study and preliminary results

    Science.gov (United States)

    de Barros, Caio Nunes; Miluzzi Yamada, Ana Lúcia; Junior, Rui Seabra F; Barraviera, Benedito; Hussni, Carlos Alberto; de Souza, Jaqueline Brandão; Watanabe, Marcos Jun; Rodrigues, Celso Antônio

    2015-01-01

    Autologous fibrin gel is commonly used as a scaffold for filling defects in articular cartilage. This biomaterial can also be used as a sealant to control small hemorrhages and is especially helpful in situations where tissue reparation capacity is limited. In particular, fibrin can act as a scaffold for various cell types because it can accommodate cell migration, differentiation, and proliferation. Despite knowledge of the advantages of this biomaterial and mastery of the techniques required for its application, the durability of several types of sealant at the site of injury remains questionable. Due to the importance of such data for evaluating the quality and efficiency of fibrin gel formulations on its use as a scaffold, this study sought to analyze the heterologous fibrin sealant developed from the venom of Crotalus durissus terrificus using studies in ovine experimental models. The fibrin gel developed from the venom of this snake was shown to act as a safe, stable, and durable scaffold for up to seven days, without causing adverse side effects. Fibrin gel produced from the venom of the Crotalus durissus terrificus snake possesses many clinical and surgical uses. It presents the potential to be used as a biomaterial to help repair skin lesions or control bleeding, and it may also be used as a scaffold when applied together with various cell types. The intralesional use of the fibrin gel from the venom of this snake may improve surgical and clinical treatments in addition to being inexpensive and adequately consistent, durable, and stable. The new heterologous fibrin sealant is a scaffold candidate to cartilage repair in this study. PMID:26264444

  14. Evaluación de fibrinógeno plasmático en pacientes con enfermedad periodontal

    OpenAIRE

    Milla-Torres, Daniela; García-Linares, Sixto

    2014-01-01

    Objetivo: Comprobar si la presencia de enfermedad periodontal aumenta los niveles de fibrinógeno, para sumar evidencia en la relación de causalidad entre las enfermedades periodontal y cardiovascular. Material y métodos: Se evaluaron un total de 40 individuos, divididos en 4 grupos: control (n=10), enfermedad periodontal localizada (n=15) y enfermedad periodontal generalizada (n=15). Resultados: Los pacientes con enfermedad periodontal presentan niveles de fibrinógeno significativamente mayor...

  15. Injectable platelet rich fibrin (i-PRF): opportunities in regenerative dentistry?

    Science.gov (United States)

    Miron, Richard J; Fujioka-Kobayashi, Masako; Hernandez, Maria; Kandalam, Umadevi; Zhang, Yufeng; Ghanaati, Shahram; Choukroun, Joseph

    2017-02-02

    Platelet rich plasma (PRP) has been utilized in regenerative dentistry as a supra-physiological concentrate of autologous growth factors capable of stimulating tissue regeneration. Despite this, concerns have been expressed regarding the use of anti-coagulants, agents known to inhibit wound healing. In this study, a liquid formulation of platelet rich fibrin (PRF) termed injectable-PRF (i-PRF) without the use of anti-coagulants was investigated. Standard PRP and i-PRF (centrifuged at 700 rpm (60G) for 3 min) were compared for growth factor release up to 10 days (8 donor samples). Furthermore, fibroblast biocompatibility at 24 h (live/dead assay); migration at 24 h; proliferation at 1, 3, and 5 days, and expression of PDGF, TGF-β, and collagen1 at 3 and 7 days were investigated. Growth factor release demonstrated that in general PRP had higher early release of growth factors whereas i-PRF showed significantly higher levels of total long-term release of PDGF-AA, PDGF-AB, EGF, and IGF-1 after 10 days. PRP showed higher levels of TGF-β1 and VEGF at 10 days. While both formulations exhibited high biocompatibility and higher fibroblast migration and proliferation when compared to control tissue-culture plastic, i-PRF induced significantly highest migration whereas PRP demonstrated significantly highest cellular proliferation. Furthermore, i-PRF showed significantly highest mRNA levels of TGF-β at 7 days, PDGF at 3 days, and collagen1 expression at both 3 and 7 days when compared to PRP. i-PRF demonstrated the ability to release higher concentrations of various growth factors and induced higher fibroblast migration and expression of PDGF, TGF-β, and collagen1. Future animal research is now necessary to further validate the use of i-PRF as a bioactive agent capable of stimulating tissue regeneration. The findings from the present study demonstrate that a potent formulation of liquid platelet concentrates could be obtained without use of anti-coagulants.

  16. Acute fibrinous and organising pneumonia: a rare histopathological variant of chemotherapy-induced lung injury.

    Science.gov (United States)

    Gupta, Arjun; Sen, Shiraj; Naina, Harris

    2016-04-06

    Bleomycin-induced lung injury is the most common chemotherapy-associated lung disease, and is linked with several histopathological patterns. Acute fibrinous and organising pneumonia (AFOP) is a relatively new and rare histological pattern of diffuse lung injury. We report the first known case of bleomycin-induced AFOP. A 36-year-old man with metastatic testicular cancer received three cycles of bleomycin, etoposide and cisplatin, before being transitioned to paclitaxel, ifosfamide and cisplatin. He subsequently presented with exertional dyspnoea, cough and pleuritic chest pain. CT of the chest demonstrated bilateral ground glass opacities with peribronchovascular distribution and pulmonary function tests demonstrated a restrictive pattern of lung disease with impaired diffusion. Transbronchial biopsy revealed intra-alveolar fibrin deposits with organising pneumonia, consisting of intraluminal loose connective tissue consistent with AFOP. The patient received high-dose corticosteroids with symptomatic and radiographic improvement. AFOP should be recognised as a histopathological variant of bleomycin-induced lung injury.

  17. Bioactivity and stability of endogenous fibrogenic factors in platelet-rich fibrin

    DEFF Research Database (Denmark)

    Lundquist, R.; Dziegiel, M.H.; Agren, M.S.

    2008-01-01

    Platelet-rich fibrin (PRF) is an autologous fibrin sealant (FS) enriched with a platelet concentrate (> 1,000,000 platelets/microL) produced by the automated Vivostat system and used to enhance wound healing. The effects of PRF were compared with supernatant from thrombin-activated platelet...... concentrate, recombinant human platelet-derived growth factor (rhPDGF) isoforms, and a homologous FS in cultured normal human dermal fibroblasts. Also, the release of selected endogenous growth factors from PRF and their stability against proteolytic degradation were studied. The proliferative effect of PRF...... exceeded that of FS and rhPDGF-BB, although it was lower than thrombin-activated platelet concentrate possibly due to sustained growth factor release from platelets in PRF. Anti-PDGF antibody blocked the mitogenic effect of rhPDGF-BB but not that of PRF in growth-arrested fibroblasts. PRF promoted...

  18. Anisotropic mechanical properties of magnetically aligned fibrin gels measured by magnetic resonance elastography.

    Science.gov (United States)

    Namani, Ravi; Wood, Matthew D; Sakiyama-Elbert, Shelly E; Bayly, Philip V

    2009-09-18

    The anisotropic mechanical properties of magnetically aligned fibrin gels were measured by magnetic resonance elastography (MRE) and by a standard mechanical test: unconfined compression. Soft anisotropic biomaterials are notoriously difficult to characterize, especially in vivo. MRE is well-suited for efficient, non-invasive, and non-destructive assessment of shear modulus. Direction-dependent differences in shear modulus were found to be statistically significant for gels polymerized at magnetic fields of 11.7 and 4.7 T compared to control gels. Mechanical anisotropy was greater in the gels polymerized at the higher magnetic field. These observations were consistent with results from unconfined compression tests. Analysis of confocal microscopy images of gels showed measurable alignment of fibrils in gels polymerized at 11.7 T. This study provides direct, quantitative measurements of the anisotropy in mechanical properties that accompanies fibril alignment in fibrin gels.

  19. Application of collagen-chitosan/fibrin glue asymmetric scaffolds in skin tissue engineering*

    Science.gov (United States)

    Han, Chun-mao; Zhang, Li-ping; Sun, Jin-zhang; Shi, Hai-fei; Zhou, Jie; Gao, Chang-you

    2010-01-01

    To create a scaffold that is suitable for the construction of tissue-engineered skin, a novel asymmetric porous scaffold with different pore sizes on either side was prepared by combining a collagen-chitosan porous membrane with fibrin glue. Tissue-engineered skin was fabricated using this asymmetric scaffold, fibroblasts, and a human keratinocyte line (HaCaT). Epidermal cells could be seen growing easily and achieved confluence on the fibrin glue on the upper surface of the scaffold. Scanning electron microscopy showed typical shuttle-like fibroblasts adhering to the wall of the scaffold and fluorescence microscopy showed them growing in the dermal layer of the scaffold. The constructed composite skin substitute had a histological structure similar to that of normal skin tissue after three weeks of culture. The results of our study suggest that the asymmetric scaffold is a promising biologically functional material for skin tissue engineering, with prospects for clinical applications. PMID:20593518

  20. Application of collagen-chitosan/fibrin glue asymmetric scaffolds in skin tissue engineering.

    Science.gov (United States)

    Han, Chun-mao; Zhang, Li-ping; Sun, Jin-zhang; Shi, Hai-fei; Zhou, Jie; Gao, Chang-you

    2010-07-01

    To create a scaffold that is suitable for the construction of tissue-engineered skin, a novel asymmetric porous scaffold with different pore sizes on either side was prepared by combining a collagen-chitosan porous membrane with fibrin glue. Tissue-engineered skin was fabricated using this asymmetric scaffold, fibroblasts, and a human keratinocyte line (HaCaT). Epidermal cells could be seen growing easily and achieved confluence on the fibrin glue on the upper surface of the scaffold. Scanning electron microscopy showed typical shuttle-like fibroblasts adhering to the wall of the scaffold and fluorescence microscopy showed them growing in the dermal layer of the scaffold. The constructed composite skin substitute had a histological structure similar to that of normal skin tissue after three weeks of culture. The results of our study suggest that the asymmetric scaffold is a promising biologically functional material for skin tissue engineering, with prospects for clinical applications.

  1. Acute Fibrinous and Organizing Pneumonia Associated With Allogenic Hematopoietic Stem Cell Transplant Successfully Treated With Corticosteroids

    Directory of Open Access Journals (Sweden)

    Lam-Phuong Nguyen DO

    2016-04-01

    Full Text Available Acute fibrinous and organizing pneumonia (AFOP is an extremely rare, relatively new, and distinct histological pattern of acute lung injury characterized predominately by the presence of intra-alveolar fibrin and associated organizing pneumonia. AFOP may be idiopathic or associated with a wide spectrum of clinical conditions. It has a variable clinical presentation from mild respiratory symptoms to that similar to the acute respiratory distress syndrome. Currently there is no consensus on treatment, and corticosteroids previously were of unclear benefit. To date, there are less than 40 cases of AFOP reported in the literature and only one has been linked to hematopoietic stem cell transplantation. Here we report the first case series of 2 patients who developed AFOP following allogenic stem cell transplant that were successfully treated with high-dose corticosteroids.

  2. Bioactivity and stability of endogenous fibrogenic factors in platelet-rich fibrin