摘要:

AbstractVariations in the number of peripheral burst‐forming unit—erythroid (BFU‐E) of healthy women were observed during a prolonged period of observation. These differences were related to different phases of the menstrual cycle. A peak in the number of BFU‐E occurred on day 14 of the cycle corresponding to the serum 17‐β‐estradiol peak. The effect of estrogens and progesterone on the in vitro growth of peripheral BFU‐E of healthy women was assayed. Estrogens demonstrated a stimulatory and progesterone an inhibitory effect in total lymphomonocyte cultures, whereas neither hormone had an effect in monocyte‐depleted cultures. Prostaglandin E1(PGE1) which is known to be secreted by monocytes, stimulated the in vitro growth of peripheral BFU‐E. These data suggest that estrogens and progesterone could have a role in the in vitro growth of peripheral BFU‐E, probably m

ISSN:0361-8609    

DOI:10.1002/ajh.2830380202

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1991

数据来源: WILEY

摘要:

AbstractThe dynamic fluctuation of thrombin‐antithrombin III complex (TAT) was studied in blood obtained during the daytime (at 9AM, noon, 3PM), during extracorporeal circulation and during the course of disseminated intravascular coagulation (DIC), to certify whether the level of TAT in blood can reflect the generation of thrombin. In 10 healthy male volunteers, the mean values of TAT (μg/liter) were 1.74 (±1.36) at 9 AM, 1.22 (±0.47) at noon, and 1.25 (±0.68) at 3PM. TAT did not show a daytime fluctuation, unlike fibrinolytic factors. The mean values of TAT in 38 hemodialyzed patients were 4.83 (±2.8) before the initiation, 6.59 (±4.39) in the first hour, and 13.42 (±10.96) at the end of a dialysis session. In 20 patients undergoing open heart surgery, the mean value of TAT was increased during cardiopulmonary bypass (CPB) and decreased with time after the end of surgery. The fibrinopeptide A (FPA) value was increased with TAT during CPB but achieved a maximum level immediately after heparin neutralization by protamine. In 20 patients with DIC, the values of TAT varied from 5.8 to 297 μg/liter in the blood at the onset of DIC. In seven of eight patients treated with low‐molecular‐weight heparin (LMW‐H), the values of TAT and FPA were lower 24 hr after LMW‐H than before the treatment. These results suggest that the level of TAT in blood reflected the formation of thrombin and could serve as a sensitive parameter of activated coagulation in

ISSN:0361-8609    

DOI:10.1002/ajh.2830380203

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1991

数据来源: WILEY

摘要:

AbstractWe studied the quantitative changes of hemostatic molecular markers with time during the course of disseminated intravascular coagulation (DIC) induced by endoscopic embolization using thrombin for esophageal varices in nine patients with liver cirrhosis. The plasma levels of D–dimer, a product of plasmin degradation of cross‐linked fibrin, and thrombin–antithrombin‐III complex (TAT) were significantly higher in patients before treatment when compared with 60 healthy individuals. The plasma levels of TAT, D‐dimer, and plasmin α2‐plasmin inhibitor complex (PIC) increased significantly 5–15 min after thrombin injection into the varices, earlier than the changes of conventional coagulofibrinolytic factors, reached a maximum level after 180 min, and started to decline after 1 day. Although the plasma PIC level returned to normal after 7 days, both TAT and D‐dimer were still above the pretreatment level.Although there was no change in urokinase‐type plasminogen activator (u‐PA), tissue‐type plasminogen activator (t‐PA) increased significantly after 5 min. The plasma level of plasminogen activator inhibitor type 1 (PAI‐1) showed only a slight elevation after treatment. We propose that the hemostatic molecular markers TAT, D‐dimer, and PIC are suitable for the early diagnosis of DIC after endoscopic embolization using thrombin in patients with liver cirrhosis and that the increase of PAI‐1 is too small for the regulation of fibrinolysis due to t‐PA in

ISSN:0361-8609    

DOI:10.1002/ajh.2830380204

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1991

数据来源: WILEY

摘要:

AbstractPrimary splenic lymphoma is a relatively infrequent cause of splenomegaly, its reported incidence being less than 1%. Nonetheless, various series have reported on its occurrence and its unfavorable prognosis, but these series have reported data on heterogenous populations, including many patients with nodal or hepatic disease.We report on a series of nine patients with primary splenic lymphoma. None of these patients had biopsy‐proven evidence of extrasplenic disease and were categorized as involving spleen only (stage 1) or spleen and splenic hilum (stage 2). In this series, classified by the recent N.C.I. working formulation, four patients had intermediate or high‐grade histology and five patients had low‐grade histology. There was no correlation between histological subtype and prognosis, nor could other factors be delineated to explain their favorable prognosis. The median survival in this group of patients was 7.48 years, and no evidence of relapse has been documented.The data suggest that primary splenic lymphoma, treated by splenectomy alone or combination therapy, may be potentially curative. Further studies should address the question of aggressive accurate staging in hopes of obtaining homogenous patient populations so that appropriate treatment in primary splenic lymphoma can be better de

ISSN:0361-8609    

DOI:10.1002/ajh.2830380205

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1991

数据来源: WILEY

摘要:

AbstractErythroid progenitors circulating in peripheral blood and their response to erythropoietin (EPO), interleukin‐3 (IL3), and phytohemagglutinin‐stimulated, lymphocyte‐conditioned medium (PHALCM) were assessed in sickle cell anemia (SCA) patients and controls. SCA patients have significantly higher numbers of circulating burst‐forming unit–erythroid (BFU‐E) compared with controls (mean ± SEM, 940.27 ± 129.11 per ml and 86.56 ± 19.74 per ml, respectively;P<0.0001). At low doses of EPO, BFU‐E‐derived colonies were significantly increased in SCA patients compared with controls (eachP<0.05). The EPO dose required to produce 50% of maximum colony numbers was 47 times greater in control subjects than in SCA patients. Moreover, in 11 of 17 patients with SCA, spontaneous BFU‐E‐derived colonies were formed without added erythropoietin. This phenomenon was not observed in control subjects (P= 0.035). PHALCM developed from mononuclear cells of SCA patients had significantly greater stimulatory effect than did that derived from controls regardless of the source of target cells (eachP<0.05). A two‐step study of IL3 sensitivity of erythroid progenitors was conducted. First, in a liquid culture system, circulating erythroid progenitors of SCA patients and controls were incubated in the presence of varying doses of IL3. During a second step, CFU‐E‐like colonies were observed in methylcellulose cultures of these cells. The mean numbers of colony‐forming unit‐erythroid (CFU‐E)‐like colonies was significantly higher in SCA patients compared with control subjects at low doses of IL3 (eachP<0.02). The increased response of erythroid progenitors to IL3 and the increased production of hemopoietic growth factors (IL3 or non‐IL3) contribute to the hemopoietic response in SCA patients. These mechanisms and increased sensitivity of the BFU‐E to EPO may explain lower

ISSN:0361-8609    

DOI:10.1002/ajh.2830380206

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1991

数据来源: WILEY

摘要:

AbstractWe report a relatively mild phenotype associated with two siblings who are compound heterozygotes for Hb S and a β°‐thalassemia mutation due to a ˜1.4‐kb deletion of the 5′ region of the β‐globin gene. Each is found to have unusually high levels of Hb A2and Hb F, accounting for more than 20% of the total hemoglobin. These may interfere with intracellular Hb 5 polymerization, thus leading to a mild clin

ISSN:0361-8609    

DOI:10.1002/ajh.2830380207

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1991

数据来源: WILEY

摘要:

AbstractSeventeen adults received the antifibrinolytic drug tranexamic acid during cardiac surgery utilizing extracorporeal circulation (ECC). In 8 patients, drug administration began prior to skin incision (pre‐ECC); infusions commenced after ECC and protamine administration in another 9 patients (post‐ECC). Compared with the post‐ECC group, the pre‐ECC group exhibited less bleeding via mediastinal drains (420 vs. 655 mL/12 h median,P= 0.024), decreased frequency of the presence (≥10 γg/mL) of fibrin split products (P<0.05), and greater platelet dense granule content of adenosine diphosphate after surgery (15.47 vs. 4.05 nmoles/mg protein median,P= 0.021).Follow‐up in vitro study of tranexamic acid inhibition of plasmin‐induced platelet activation utilizing normal human platelet rich plasma and porcine plasmin revealed a 13‐fold lower concentration of tranexamic acid for 50% inhibition when plasmin was preincubated with the drug (1.2 γg/mL, 95% CI = 1.13 – 1.60 γg/mL) compared to when platelet rich plasma was preincubated with the drug (16 γg/mL, 95% CI = 7.3 – 99. γg/mL). Plasmin inactivated with tranexamic acid retained its ability to inhibit thrombininduced platelet activation, thus suggesting that tranexamic acid inhibits plasmin's catalytic activity and not its binding to platelets.Both clot lysis and platelet dysfunction may contribute to bleeding after ECC. Tranexamic acid blocks plasmin‐induced partial platelet activation during ECC, thus preserving platelet function and prom

ISSN:0361-8609    

DOI:10.1002/ajh.2830380208

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1991

数据来源: WILEY

摘要:

AbstractA 24‐year‐old white female with a 10‐year history of juvenile rheumatoid arthritis and splenomegaly developed numerous circulating nucleated red blood cells (NRBC) following splenectomy for chronic abdominal pain. Subsequent evaluation revealed the presence of a congenital dyserythropoietic anemia (CDA) with atypical features. Circulating NRBCs have been reported following splenectomy in three other cases of CDA, each of which had atypical features and did not fit into the customary classification of types I–IV. Follow‐up of our patient at 4 years revealed no untoward consequences of persistent NRBCs in her ci

ISSN:0361-8609    

DOI:10.1002/ajh.2830380209

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1991

数据来源: WILEY

摘要:

AbstractSevere thrombocytopenia is an uncommon (incidence20,000/γL on the 8th to 13th hospital day) or increased bleeding symptoms, IVIG was initiated. Four of the five patients rapidly developed significant increases in their platelet counts (range 44,000/γL to 97,000/γL). Two of these responses were sustained and two relapses occurred (while on continued steroid therapy) which again responded to booster doses of IVIG at similar doses. IVIG has been previously shown to be effective in treating patients with idiopathic thrombocytopenia purpura. Historically, patients with infectious mononucleosis‐related severe thrombocytopenia often are refractory to corticosteroid therapy and our limited experience suggests that IVIG may also be effective in infectious mononucleosis‐related severe thromb

ISSN:0361-8609    

DOI:10.1002/ajh.2830380210

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1991

数据来源: WILEY

摘要:

AbstractWe describe here an investigation of the hematologic response of a child with Gaucher disease to a six‐year therapeutic trial of human placental mannose‐terminated glucocerebrosidase. While on enzyme replacement therapy, the patient's hemoglobin and platelet count significantly increased (6.9 g/dl to 12.2 g/dl, and 39,000/γL to 74,000/γL, respectively). Over the same time interval his absolute reticulocyte count decreased (88.1 × 103/γL to 31.5 × 103/γL). The patient's splenic volume decreased by over 60% (2108ml to 797ml) and his bone marrow demonstrated a dramatic clearing of Gaucher cell infiltration. Serum erythropoietin levels were at the lower range of normal at points in time when he was severely anemic and did not change with improvement in hemoglobin. Coincident with the improvement in the patient's hemoglobin, in vivo survival of autologous radiolabeled RBCs increased 34%. The improved hematopoietic profile appeared to result primarily from an increase in the in vivo survival of mature hematopoietic elements secondary to a decrease in splenic sequestration. Improved marrow function secondary to the clearing of Gaucher cell infiltrates may also playa role in his improved hematolog

ISSN:0361-8609    

DOI:10.1002/ajh.2830380211

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1991

数据来源: WILEY