Aggregates in platelet concentrates van der Meer, Pieter F.; Dumont, L. J.; Lozano, Miguel ...
Vox sanguinis,
01/2015, Letnik:
108, Številka:
1
Journal Article
Background and Objectives We previously developed a novel additive solution (M‐sol) with a high ability to preserve the in vitro qualities of platelets (PLTs) in washed PLTs Here, we compared the ...ability of M‐sol with that of commercially available additive solutions (ASs) to preserve the in vitro qualities (pH, mean PLT volume, %disc, P‐selectin, %hypotonic shock response and aggregation) of PLTs at a low plasma concentration.
Materials and Methods The platelet concentrate was divided into two equal aliquots (control group and test group). After centrifugation of both groups and removal of as much supernatant as possible, the pellet of the control group was resuspended in M‐sol and those of the test group were resuspended in other ASs, and subsequently stored in polyolefin bags with agitating at 20–24°C.
Results Compared with those stored in M‐sol, the qualities of PLTs stored in PAS‐B (alternative name; PAS‐II or T‐sol), PAS‐ C (alternative name; PAS‐III or Intersol) or Plasma Lyte were degraded as early as 24 h after washing. The qualities of PLTs stored in PAS‐D (alternative name; Composol PS) or PAS‐E (alternative name; PAS‐IIIM or SSP+) were comparable to that of those stored in M‐sol 24 h after washing; however, the qualities had deteriorated 72 h after washing.
Conclusions At a low plasma concentration (5% or less), the M‐sol showed a higher ability to preserve PLTs than the five ASs studied here. Although PAS‐D and PAS‐E are available as an AS for short‐term storage of washed PLTs, M‐sol is thought to be preferable for longer storage.
Coronary microcirculation plays an important role in the progression of cardiac remodeling. Among angiogenic factors, it has been reported that angiotensin II may contribute to neovascularization. ...However, it is unknown whether inhibition of the renin-angiotensin system suppresses angiogenesis, especially within the heart. Our aim was to evaluate the effects of the angiotensin-converting enzyme inhibitor enalapril and the angiotensin II receptor type I blocker valsartan on cardiac microvasculature, function, vascular endothelial growth factor (VEGF) expression, and survival in cardiomyopathic hamsters.
Male cardiomyopathic hamsters (BIO TO2) were administered either a placebo (group C), enalapril (30 mg/kg/day) (group E), or valsartan (40 mg/kg/day) (group V), starting at the age of 6 weeks. This continued until death. Hemodynamic study, histological analysis, and northern blot analysis were performed at 39 weeks.
Group V showed significant increases in percent fibrosis, end diastolic pressure, and LV dP/dt min, and significant decreases in percent fractional shortening, LV dP/dt max, capillary density, and the level of mRNA expression of VEGF compared with group C. Group E showed significant increases in percent fractional shortening while the capillary density and level of mRNA expression of VEGF were unchanged. The 300-day survival rate was significantly lower in group V (25.0%) but higher in group E (100%) than that of group C (66.7%).
Therapy with valsartan may have adverse effects on survival rate concomitant with the progression of cardiac remodeling owing to impaired VEGF-mediated angiogenesis. Therapy with enalapril has a neutral effect on VEGF-mediated angiogenesis, leading to the suppression of cardiac remodeling and an increase in life expectancy.
Case report.
Department of Neurosurgery, Sapporo Azabu Neurosurgical Hospital and Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
A patient presented to ...us with complete C4 tetraplegia after a 3-m fall. MRI performed 120 min after his fall showed spinal canal stenosis due to disk protrusion at the C3/4 level without spinal cord signal changes on T1- and T2-weighted images. He underwent laminoplasty between C2 and C6. Intraoperative ultrasound, performed 6 h after his fall, disclosed a hyperechoic lesion at the C3/4 level of the cervical cord; postoperative T2-weighted MRI, obtained at 8 h after his fall, showed high intensity at the same level.
In patients with cerebral infarction, approximately 6 h between the insult and the acquisition of T2-weighted MRI are required to detect signal changes. We postulate that the time course on MRI scans obtained immediately after spinal cord injury is similar in patients with spinal cord injury and cerebral infarction and suggest that the absence of spinal cord abnormalities in the ultra-early post-injury stage is not always predictive of a good prognosis.
We retrospectively evaluated the pre- and postoperative course of 34 tethered cord patients with occult spinal dysraphism in an attempt to infer the natural history of this disorder and to determine ...the effectiveness of the surgical treatment. There were 32 cases with lumbosacral lipoma and 2 with tight filum terminale. The age at surgery ranged from 1 month to 47 years old. Eight patients, aged 1 month to 4 years old, were asymptomatic; 26 had neurogenic bladder (26 cases) or motor problems affecting the legs (8 cases). None of the patients older than 5 years of age were asymptomatic. Untethering of the spinal cord was performed in all cases. The postoperative follow-up period ranged from 5 months to 11 years. During these periods, 7 (88%) of the 8 asymptomatic patients remained neurologically intact, 6 (23%) of the 26 symptomatic patients showed improved symptoms, and 15 patients (58%) remained unchanged. These results indicate that the neurological symptoms will appear progressively in the tethered cord patients, and that prophylactic surgery should be considered as early as possible.
Osteopontin (OPN) is upregulated in several experimental models of cardiac fibrosis and remodeling. However, its direct effects remain unclear. We examined the hypothesis that OPN is important for ...the development of cardiac fibrosis and remodeling. Moreover, we examined whether the inhibitory effect of eplerenone (Ep), a novel aldosterone receptor antagonist, was mediated through the inhibition of OPN expression against cardiac fibrosis and remodeling. Wild-type (WT) and OPN-deficient mice were treated with angiotensin II (Ang II) for 4 weeks. WT mice receiving Ang II were divided into 2 groups: a control group and an Ep treatment group. Ang II treatment significantly elevated blood pressure and caused cardiac hypertrophy and fibrosis in WT mice. Ep treatment and OPN deficiency could reduce the Ang II-induced elevation of blood pressure and ameliorate the development of cardiac fibrosis, whereas Ep-only treatment abolished the development of cardiac hypertrophy. Most compelling, the reduction of cardiac fibrosis led to an impairment of cardiac systolic function and subsequent left ventricular dilatation in Ang II-treated OPN-deficient mice. These results suggest that OPN has a pivotal role in the development of Ang II-induced cardiac fibrosis and remodeling. Moreover, the effect of Ep on the prevention of cardiac fibrosis, but not cardiac hypertrophy, might be partially mediated through the inhibition of OPN expression.
Osteopontin (OPN), a noncollagenous adhesive protein, is implicated in atherosclerosis, in which macrophages within atherosclerotic plaques express OPN. However, it is not known whether the elevated ...OPN expression is a cause or result of atherosclerosis.
We generated mice that lacked OPN and crossed them with apolipoprotein (apo) E-deficient mice and analyzed these mice with a mixed C57BL/6x129 background after 36 weeks on a normal chow diet. In female mice, OP+/-E-/- and OP-/-E-/- mice had significantly smaller atherosclerotic and inflammatory lesions compared with OP+/+E-/- mice, and that was reflected by smaller area of MOMA-2-positive staining. In male mice, however, there was no significant difference in the atherosclerosis lesion areas among 3 genotypes. In both OP-/-E-/- and OP+/+E-/- mice, typical atherosclerotic lesions were detected, which include necrotic core, foamy cell collections, and cholesterol clefts. However, we found that vascular mineral-deposited areas in 60-week-old male OP-/-E-/- mice were significantly increased compared with those in OP+/+E-/- male mice.
These results suggest that OPN plays a promoting effect in atherosclerosis and inhibitory effect in vascular calcification. The suppression of OPN expression in females should be considered a therapeutic possibility in atherosclerosis.
Abstract Background Complex fractionated atrial electrogram (CFAE)-targeted catheter ablation (CFAE ablation) requires a high rate of atrial fibrillation (AF) termination to provide good outcomes. We ...determined the optimal settings of CFAE software. Methods In our 430 consecutive patients, AF was terminated in 97 (234/242) and 79% (149/188) of patients with paroxysmal and persistent AF, respectively, by CFAE ablation combined with (31%) or without (69%) pulmonary vein isolation, occasionally with nifekalant infusion. We analyzed 109 consecutive patients who underwent CFAE ablation to determine the optimal settings for comparing subjective versus objective decisions by the CFAE software on CARTO3. We compared three settings: the default setting (0.05–0.15 mV, 50–120 ms) and two modified settings (#1: 0.05–0.30 mV, 40–70 ms, #2: 0.05–0.13 mV, 10–20 ms). We retrospectively analyzed 11,425 points during left atrial mapping before ablation and 10,306 points that were subjectively detected and ablated as CFAE points. An interval confidence level ≥6 denoted a site with CFAE. Results With the default setting, the accuracy, sensitivity, specificity, positive productive value, and negative productive values were 67, 42, 77, 48, and 73%, respectively. With modified setting #1, the values were 78, 55, 87, 74, and 77%, respectively, versus 64, 82, 60, 53, and 91%, respectively, for modified setting #2. Conclusion These data suggest that setting #1 was generally superior to the default setting, whereas setting #2 was optimal for excluding areas not requiring ablation. The optimal CFAE software setting was a voltage of 0.05–0.30 mV and an interval parameter of 40–70 ms.
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