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Biomedical subjects

J M Thomson

Publications and source records attributed to J M Thomson.

115 records · Page 7Linked to original sources

Use of the activated partial thromboplastin time for monitoring heparin therapy: problems and possible solutions.

There is considerable variation in available methods for the activated partial thromboplastin time (APTT), giving widely differing results with patients on heparin treatment. The study is primarily concerned with the assessment of five of the widest used APTT reagents. The heparin response of these reagents has been related to their lipid composition and physical properties. Of the various correlations between lipid composition of the reagents and clotting performance only electrophoretic mobility was associated with the APTT response to heparin. There was a highly significant negative correlation between the APTT prolongation with heparin and electrophoretic mobility. When plasma is heparinized in vitro a differing order of ranking for APTT reagents is obtained than when heparinized patients are tested. The APTT response in patients with recent thrombosis must therefore be the best guide to the clinical dose of heparin. The therapeutic range of conventional heparin therapy is generally regarded as 1.5-2.5 times the control. External quality assessment programmes in the UK and USA have shown considerable differences between heparin dosage according to the APTT test systems. The definition of the therapeutic range must be derived from randomized clinical studies. The need for progress in standardization of the APTT monitoring of heparin is demonstrated.

Blood Coagulation Tests↗

Quality control of the prothrombin time and international normalized ratios. National and international schemes.

The international normalized ratios (INR) system allows valid comparisons in results and quality of performance to be made between users of different thromboplastin reagents. In the international quality control surveys currently over 80% of the 53 countries participating report INR. Stated local international sensitivity index (ISI) values show fair agreement with values calculated from quality control returns obtained with local and reference reagents. The coefficient of variations (CV) of the INR in these surveys are between 11-22% depending upon INR values. In comparison, CV of the UK national scheme are currently 7-13%. However, analysis of UK results has shown high CV with high ISI reagents. This is due to the ISI effect as CV of INR is CV of prothrombin ratio (PR) multiplied by the ISI. Ideal thromboplastins should show good precision of PR and a low ISI to prevent this apparent deterioration when PR results are transformed into the INR scale. Instrumentation has a further effect on the INR result. Unfortunately, the effect is not uniform even within instrument type and model or even between normal and therapeutic results. Local instrument adjustment or local calibration is therefore necessary. Thus, quality control surveys continue to highlight problems in prothrombin time standardization.

Automation↗

Identification of a differential display product associated with apoptosis in chicken thymocytes.

To further elucidate the cellular mechanisms that mediate programmed cell death in avian immune cells, differential display analysis was employed to identify differentially expressed genes in chicken thymocytes undergoing apoptosis. Primary cultures of thymocytes were treated with dexamethasone to activate apoptosis and RNA was isolated for differential display analysis. A differential display product designated A1 (479 bp) was identified. This display product was subcloned and induced expression of the genes was confirmed by ribonuclease protection analysis. Nucleotide sequence analysis of A1 revealed a putative 82 amino acid open reading frame that demonstrated limited homology with Bad, an apoptotic regulatory protein. Thus, A1 may represent the avian homolog of Bad.

Amino Acid Sequence↗