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Biomedical subjects

J Hermans

Publications and source records attributed to J Hermans.

At least 613 records · Page 34Linked to original sources

Models of fibrin.

High-symmetry models of the fibrin fiber are proposed that reproduce the experimentally observed high specific volume of the fiber. The models meet the following criteria: fibrin monomers have the three-domain Hall and Slayter structure; the monomers are arranged lengthwise into strands (protofibrils) in which successive monomers half overlap; the monomers' alignment is nearly parallel to the fiber axis; and the monomers make adequate longitudinal and lateral contacts, as required by observed fiber properties and the high affinity of monomers for one another. All the models contain helical protofibrils related to each other by rotation axes parallel to the fiber axis; as a consequence the protofibrils are in register in the fiber direction. The protofibrils may contain two, three, or four monomers per helical turn and can be packed in four different symmetries (space groups). A large specific volume is achieved only if the D-domain (which are presumed to contain the lateral polymerization sites) are somewhat displaced from the helical axes of the protofibrils. This displacement may involve either a lateral shift of the monomers away from the helix axis or a tilt of the monomers, which swings the D-domains away from the helix axis. It is shown that the fiber containing tilted monomers is more highly interconnected; the two D-domains of each tilted monomer form lateral contacts with different adjacent protofibrils, whereas the two D-domains of each nontilted monomer contact the same adjacent protofibril(s).

Fibrin↗

Detection of carriers of haemophilia B.

Plasma levels of factor IX activity and factor IX antigen were determined in 18 definite carriers of haemophilia B-, 10 definite carriers of haemophilia B+ and 40 control subjects. Factor IX antigen was determined by the electroimmunoassay technique of Laurell using a rabbit antiserum against factor IX. In haemophilia B-, statistical tolerance regions were constructed containing 90% of the factor IX activity and factor IX antigen values for the carriers and the control subjects. Of the 18 carriers, 10 were outside the tolerance region for the control subjects, and of the 40 control subjects, 17 were outside the tolerance region for the carriers. A better separation of the probabilities of being a carrier was obtained for the B- carriers and the control subjects when factor IX antigen was determined in addition to factor IX activity. In haemophilia B+, factor IX antigen was present in excess of factor IX activity in nine of the 10 carriers. The values for factor IX activity and factor IX antigen for these nine carriers fell outside the 90% tolerance region for the control subjects. It is concluded that the quantitative determination of factor IX antigen may be of value in the detection of carriers of both haemophilia B+ and haemophilia B-.

Adult↗

Hairy cell leukaemia. Clinical features and effect of splenectomy.

Hairy-cell leukaemia (leukaemic reticuloendotheliosis) is a well-defined clinical entity. Most of the recent reports are almost entirely concerned with the pathological and functional aspects of the disease. In the present retrospective study the clinical features and laboratory data of 12 patients were analyzed together with a series of 123 adequately clinically documented cases from the literature. The Hb level and the sex of the patient proved to be the only parameters having some prognostic value for the survival time after diagnosis. The effect of splenectomy was assessed in two comparable groups of 24 splenectomized and 51 non-splenectomized patients. The operation seemed to be beneficial, but after 2 years the difference was not significant(.05 less than P less than .10). Analysis of subgroups showed that splenectomy was definitely beneficial in women, in patients with a Hb level over 8.0 g/dl or a platelet level above 50 X 10(9)/1, in patients with leucocytes below 3 X 10(9/1, , and also in patients with hepatomegaly (P less than .05 in all cases). These findings suggest that splenectomy is beneficial in cases where anaemia and thrombocytopenia are not very severe; in severe cytopenia the operation does not increase the life expectancy.

Adult↗

Interlaboratory oral anticoagulant quality assessment by the Netherlands Federation of Thrombosis Services.

The 50 laboratories of the Netherlands Federation of Thrombosis Services, covering a population of 9 million and responsible for the laboratory control of approximately 150,000 patients under oral anticoagulation, have participated since 1974 in a voluntary external and internal quality control program. The external program comprises a monthly distribution to the member laboratories of a series of artificially prepared control blood samples, two of which are identical. The overall variation of the coagulation times found were 10% (CV) in 1974 and 8% (CV) in 1975. Performance improved rather abruptly at the beginning of 1975, after the application of a tight methodological standardization and improvement by the manufacturer of the thromboplastin preparation (Thrombotest) used by the great majority of the laboratories involved. The main source of variation was found to be random error in the Thrombotest determination, approximately 6%. Interbatch variation of Thrombotest and inter-aliquot variation of control blood samples both do amount to approximately 3%(CV). In terms of rabbit tissue thromboplastins, which have a lower sensitivity than Thrombotest (i.e., a flatter slope of the correlation between the PT and the anticoagulant effect), the total variation in the performance of the Dutch laboratories is 2.2--5.6% (CV), which is unusually low. The main reason for this is the fact that the laboratories can rely not only on the services of the manufacturer but also on a central information office and a reference laboratory responsible for the preparation of the control blood as well as the standardization (calibration) of thromboplastin.

Anticoagulants↗

Role of fibrinopeptide B release: comparison of fibrins produced by thrombin and Ancrod.

The gelation time, opacity, light scattering, and elastic moduli of human fibrin gels clotted in the presence of thrombin, Ancrod, and Reptilase have been compared. At low ionic strength lateral association to thick fibers is observed in all cases. At all ionic strengths thrombin fibrin forms thicker fibers than does Ancrod fibrin. We have demonstrated that an increase in the extent of lateral association is linked to an increase in its velocity and to a decrease in the gelation time. One may consider the removal of fibrinopeptide B to act as a switch: after it is removed fibrin assembles rapidly to thick fibers and gelation is fast; but when this peptide is still attached, there is a slow assembly of thin fibers, and gelation, especially of dilute fibrin, is delayed. We believe that this delay is critical for the complete digestion by plasmin of fibrin formed during in vivo defibrination with Ancrod and of fibrin produced by very small amounts of thrombin (which would still contain fibrinopeptide B), and that slow release of fibrinopeptide B is part of a control mechanism for the regulation of fibrin formation and the prevention of intravascular coagulation.

Ancrod↗

A sensitivity index F, useful to classify patients with glaucoma simplex.

Using a new method to determine the scotoma pressure by means of an Amsler grid chart and an ophthalmodynamometer in addition to three other parameters (the brachialis blood pressure and the intra-ocular pressure), a sensitivity factor F was calculated, useful to classify patients with visual field defects due to glaucoma simplex.

Glaucoma↗

Importance of spicules on clinical staging of carcinoma of the breast.

Spiculated outgrowths around carcinomas of the breast were measured and assessed, both on roentgenograms and on microscopic slides in 104 spiculated carcinomas of the breast. On the basis of macroscopic and microscopic findings, the clinical stage of each tumor was corrected retrospectively. In the sense of an overestimation, 27.9 per cent, or an underestimation, 8.6 per cent, the clinical error reached 36.5 per cent of the true extent of the tumors. The relation of the histopathologic substrate of spicules of carcinoma of the breast upon metastases of axillary lymph nodes and clinical staging is significant.

Axilla↗