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Biomedical subjects

J N Fiessinger

Publications and source records attributed to J N Fiessinger.

At least 163 records · Page 9Linked to original sources
PubMed1987

Circulating activities during constant infusion of heparin or a low molecular weight derivative (enoxaparine): failure to demonstrate any circadian variations.

We compared in six patients successively treated with an unfractionated heparin (UFH) and a low molecular weight heparin (LMWH) the variations in plasma anti-Xa activity, measured in a chromogenic assay, during a 36 h constant infusion. The values varied in a wider range during UHF infusion, but remained in the therapeutic range except once in one patient. No circadian rhythm could be demonstrated in our six patients. LMWH infusion yielded very constant anti-Xa circulating activities. In both cases, there were no significant modifications of three proteins with high heparin affinity (antithrombin III, heparin cofactor II, histidine-rich glycoprotein). Our results suggest that the circadian rhythm of the biological activities previously observed in patients treated with constant heparin infusion using clotting method is due to other factors than heparin itself.

Adult↗
PubMed1987

An abnormal antithrombin III (AT III) with low heparin affinity: AT III Clichy.

We have identified an inherited qualitative deficiency of antithrombin III (AT III) in a family with apparently no increased incidence of venous thrombosis. Plasma antithrombin and anti-Xa activities were normal, but the interaction with heparin, heparan sulphate and low molecular weight heparin was uniformly decreased. An immunoblotting technique performed in plasma showed normal complex formation with thrombin. By using heparin-Sepharose affinity chromatography and crossed immunoelectrophoresis, the variant could be separated: at least two fractions of low affinity AT III were obtained. A minor one had no antiprotease activity; the other one was further purified to homogeneity and found to have normal specific activity in absence of heparin and a 50% decreased activity in presence of heparin. We propose to call this new variant AT III Clichy.

Adult↗
PubMed1987

Effects of insulin and hydrostatic forces on the metabolism of the aorta.

To better understand the putative association between insulin and atherosclerosis many experimental studies have explored the metabolic effects of insulin upon the arterial intima-media (which is essentially made up of smooth muscle cells). This tissue appears to be insulin-sensitive in vivo but not in vitro, suggesting that the actions of insulin on arterial metabolism are probably indirect. Yet, cultured arterial smooth muscle cells do increase their anabolism when physiological concentrations of insulin (10-250 microU/ml) are added to the medium. To account for these discrepancies we have proposed a haemodynamic explanation : hydrostatic forces present in vivo but absent in vitro, would be necessary for insulin to reach the cells of the media and act upon them. We demonstrated such an effect using an isolated rat aorta perfused under variable pressure. But only highly unphysiological concentrations of insulin (0.1 mU/ml) could stimulate the metabolism of intima-media significantly. The insulin-sensitivity of the target tissue for atherosclerosis remains an enigma. We speculate that the variable phenotype of arterial smooth muscle cells (either contractile or synthetic) might be an interesting clue to this problem.

Animals↗
PubMed1987

[Role of computerized pulmonary angiography by peripheral venous approach in the study of deep venous thromboses of the legs].

A pulmonary angiography through peripheral venous approach was systematically performed in 40 consecutive patients presenting a recent deep venous thrombosis. None of these patients had been sent for a suspected pulmonary embolus. The analysis of the images that were obtained, enabled to confirm the diagnosis of pulmonary migration in 9 of these patients (22.5%). The retrospective study of the files confirms the fact that these pulmonary emboli present few symptoms or are asymptomatic in 17.5 p. cent of the cases. The quality of the images, the good acceptability and the moderate cost of pulmonary angiography through peripheral venous approach allow the performance of this examination during the initial work-up of a deep venous thrombosis. The demonstration of a latent pulmonary embolus must enable to separate high risk patients and thus guide subsequent therapy.

Adult↗
PubMed1987

[Functional follow-up of pulmonary localization of scleroderma].

Pulmonary lesions of scleroderma are frequent, but little is known of their course, especially where lung function is concerned. We report the results of a longitudinal study performed in 32 patients with generalized scleroderma (ARA criteria) explored on at least 2 occasions with an interval of at least 24 months between the two examinations. Functional alterations seemed to be more pronounced in patients with severe Raynaud's syndrome, but in view of major individual variations no pathognomonic functional profile could be described.

Adult↗
PubMed1987

Local thrombolysis in peripheral arteries and bypass grafts.

Sixty-two patients hospitalized for recent angiographically documented arterial occlusion in the legs (46 femoropopliteal arteries and 16 grafts) benefited from local fibrinolytic therapy delivered at the site of the occlusion with a No. 4F or No. 5F catheter. This therapy combined a continuous urokinase (UK) infusion of 1000 U/kg/hr and a lysyl plasminogen (LYS-PLG) infusion of 15 mukat every 30 minutes. Angiographically confirmed lysis was obtained in 77% of the cases. Five percent of the patients had major and 8% had minor groin hematomas. Only two patients had concentrations of fibrinogen as low as 100 mg/dl. Intravascular infusion of UK and LYS-PLG is as effective as streptokinase but produces lower systemic fibrinolysis. However, local fibrinolysis remains a potentially hazardous procedure (10% suffered major complications) and must only be applied to patients with severe ischemia and little or no possibility of surgical intervention.

Adult↗
PubMed1986

Active proliferation of telangiectases in skin of patients with progressive systemic sclerosis (PSS).

The labeling index of endothelial cells as measured by in vitro autoradiography with 3H-thymidine and the electron microscopic structure of microvessels were studied in telangiectases. The telangiectases of eight patients with progressive systemic sclerosis (PSS) were compared with the cherry angiomas of six healthy controls subjects. The ultrastructural features of telangiectases were similar in the two groups and were characteristic of capillaries and postcapillary venules of the dermis, with multilayering of the vascular basement membrane. However, a significant difference existed between these two groups in an autoradiographic study: in PSS telangiectases, the average labeling index was 5.9%, whereas in cherry angiomas it was around 0.8%. Thus, the telangiectases in PSS are structures with accelerated endothelial proliferation, as are the other endothelial cells of microvessels anywhere in dermis in this disease. However, the great heterogeneity of the labeling index (varying from 0.5% to 27%) must be emphasized in telangiectases.

Aged↗
PubMed1986

Acute peripheral arterial and graft occlusion: treatment with selective infusion of urokinase and lysyl plasminogen.

Thirty-five patients hospitalized for recent angiographically documented arterial occlusion in the legs (27 femoropopliteal arteries and eight grafts) benefited from local fibrinolytic therapy delivered at the site of the occlusion with a 4- or 5-F catheter. This therapy combined a continuous urokinase (UK) infusion of 1,000 U/kg/hour and a lysyl plasminogen (LYS-PLG) infusion of 15 microkatals every 30 minutes. Angiographically confirmed lysis was obtained in 85% of the cases. Only 3% of the patients had major and 6% had minor groin hematomas. Only two patients had concentrations of fibrinogen as low as 100 mg/dl. Intravascular infusion of UK-LYS-PLG is as effective as streptokinase. Its excellent tolerance makes it a good alternative in the treatment of acute ischemia in the lower limbs.

Adult↗