[Unscientific observations with reference to the 13th 11-city ice-skating marathon].
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Biomedical subjects
Publications and source records attributed to J Vreeken.
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A method is described for the semi-quantitative biological determination of labile platelet desaggregation-promoting substance(s) in human platelet suspensions and in platelet-free fresh plasma by using the donor's own platelets ("DOP assay"). Using the donor as his own control it is possible to demonstrate a dose-related increase of the platelet desaggregation-promoting potency in response to cod-liver oil. The labile platelet desaggregation-promoting activity can also be observed in fresh platelet-free plasma. Circumstantial evidence is presented for the prostaglandin-like nature of these labile platelet desaggregation-promoting substance(s).
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Ulcerative colitis and Crohn's disease are associated with a high risk of thromboembolic complications. The questions whether reported risk factors such as low antithrombin III concentrations, thrombocytosis and spontaneous platelet aggregation are merely related to the activity of the inflammatory process remains to be answered. Therefore we investigated 40 patients with an established colitis or Crohn's disease, without signs of active inflammation (normal history, normal ESR and leucocyte count). Of these patients only one patient revealed thrombocytosis, six patients spontaneous platelet aggregation. All patients had normal beta-thromboglobulin and platelet factor 4 plasma levels. No other prethrombotic abnormalities were encountered. There was normal factor VIII C (increased in three patients), normal VIII C/VIII R Ag ratio (1.2), antithrombin III, normal plasminogen and normal alpha 2-antiplasmin. Normal fibrinopeptide A and B beta (15-42) plasma levels (n = 15) in these patients excluded in vivo thrombin or plasmin generation. We conclude that stable chronic inflammatory bowel disease is in general not associated with prethrombotic coagulation abnormalities.
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During the decade 1970-9 we investigated circulating fibrin monomers in 3293 patients. Fibrinaemia was determined by means of the ethanol gelation test (EGT). This was positive in 149 patients (4.5%) and was highly correlated with fibrogenal fibrin products. In many diseases the test was only transiently positive (1 or 2 days). However in patients with circulating fibrin monomers, demonstrable for more than 5 days (chronic fibrinaemia) malignant disease was associated in 63%. Chronic fibrinaemia occasionally preceded overt malignancy by a long period. Overall, only 10.8% of patients with malignant disease showed chronic fibrinaemia. The clinical symptoms most often associated with chronic fibrinaemia were those of venous thrombosis (42.8%) and abnormal bleeding (10.7%). Thromboembolism in the absence of malignant disease only occasionally showed short-term positive EGT and chronic fibrinaemia was never seen. Almost half (46.5%) of patients with chronic fibrinaemia had neither thromboembolic disease nor a haemorrhagic diathesis.
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