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Biomedical subjects

V Rasi

Publications and source records attributed to V Rasi.

At least 19 recordsLinked to original sources

Fibrinogenemia Tampere--a dysfibrinogenemia with defective gelation and thromboembolic disease.

Fibrinogen Tampere was found in a woman with severe thromboembolic disease. The thrombin induced clotting time of her plasma and purified fibrinogen was slightly prolonged. The activation of fibrinogen Tampere appeared to be normal but subsequent gelation was defective. We studied fibrin gels formed at different ionic strengths and at different fibrinogen and calcium concentrations by liquid permeation, turbidity, and 3D laser microscopy. Crosslinking was studied by SDS-gel electrophoresis. The gels formed from fibrinogen Tampere were at ionic strength above 0.2 much tighter and had lower fiber mass-length ratios than normal gels as judged by permeability and turbidity data. At ionic strength 0.15 and at different calcium concentrations analysis by permeability showed the same results for fibrinogen Tampere as for normal gels. Analysis by turbidity at ionic strength 0.15 suggested swelling of the fibers at low calcium concentrations. 3D microscopy revealed perturbed clot architecture under all conditions. In fibrin gels from fibrinogen Tampere, the gamma-chain crosslinking was normal but the crosslinking of alpha-chains was delayed at ionic strength 0.2 and also at lower ionic strengths on lowering the calcium concentration. The abnormal gelation may be due to a mutation in the fibrinogen molecule. Tendency to form tight fibrin gels and/or insufficient crosslinked fibrin matrix may be pathogenetic in this thrombotic disease.

Adult

Association of hormone replacement therapy with hemostatic and other cardiovascular risk factors. The FINRISK Hemostasis Study.

The risk of cardiovascular diseases in women is small until menopause but increases considerably afterwards. When all age groups are considered, cardiovascular diseases are responsible for approximately half of the total mortality in women. It has been suggested that hormone replacement therapy (HRT) in perimenopausal and postmenopausal women could be useful in the prevention of cardiovascular diseases, but its effects are insufficiently known. We performed a cross-sectional study on the associations of menopause and HRT with cardiovascular risk factors, in particular with hemostatic factors, on female participants of the FINRISK Hemostasis Study. The participants, aged 45 to 64 years, were recruited from the Finnish population register by random sampling from three geographically defined areas. The participation rate of women was 83.2%. Of the 1202 women included in the study, 29.2% were current users of HRT. Differences in cardiovascular risk factors by menopausal status and by HRT use were examined after adjustment for age, study area, current smoking, body mass index, self-reported diabetes, and years of education. Postmenopausal women not using exogenous sex hormones had on average a total cholesterol level 0.5 mmol/L (8.9%) higher and an LDL cholesterol level 0.4 mmol/L (11.4%) higher than premenopausal women. Women reporting irregular menstruation (presumably due to perimenopause) had higher adjusted plasma fibrinogen, factor VII coagulant activity, and factor VII antigen than women with regular menstruation or no menstrual periods.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Coagulation

Deficiency in the A-subunit of coagulation factor XIII: two novel point mutations demonstrate different effects on transcript levels.

Congenital deficiency in coagulation factor XIII is a rare autosomal recessive bleeding disorder. Although the defect was characterized over 30 years ago, little is known about the molecular basis of the disorder. Here, we show two novel point mutations in the gene of the A-subunit of factor XIII in the genetically isolated population of Finland. All eight factor XIII-deficient families identified in Finland were studied. The exons of the gene of A-subunit were amplified individually by polymerase chain reaction and subsequently screened by single-strand conformation polymorphism. Sequence analysis of the abnormally migrating fragments showed two point mutations resulting in an amino acid alteration. A C-to-T transition at Arg-661 in exon XIV created a premature stop codon. This mutation was detected in six of the eight families, thus being the major alteration causing FXIII deficiency in Finland. In two of the six families, the patients were compound heterozygotes with the Arg-661-Stop mutation in one allele and either a T-to-C point mutation in exon VI or a thus far uncharacterized mutation in the other allele. The T-to-C transition in exon VI resulted in a substitution of threonine for methionine 242. The transition was found in one family only, where it was in the heterozygote form combined with the Arg-661-Stop mutation. To evaluate the consequences of these mutations, steady-state FXIII mRNA levels were quantitated by solid-phase minisequencing. In addition to the termination of translation 70 amino acids before the initial stop codon, the Arg-661-Stop mutation causes a 10- to 30-fold reduction in FXIII mRNA levels. This is also likely to result in a low translation level in the truncated polypeptide. In contrast, Met-242-Thr mutation does not seem to affect the level of mRNA. Here, the absence of a functional and immunodetectable protein is probably caused by an altered conformation of the mutant polypeptide, resulting in early degradation of the defective protein.

Adolescent

Haemostatic factors and prevalent coronary heart disease; the FINRISK Haemostasis Study.

We examined the association of haemostatic factors with prevalent coronary heart disease (CHD) in the population-based FINRISK Haemostasis Study. Of the 2365 participants aged 45-64 years, 88 men and 44 women with prevalent CHD were identified. The participants with CHD were older and had lower high density lipoprotein cholesterol, higher triglycerides and higher body mass index than the participants without CHD. Men with CHD had significantly higher plasma fibrinogen (P < 0.0001, adjusted for age and smoking) and lipoprotein (a) (Lp (a), P = 0.001, adjusted for age) concentrations than those without CHD. Among women, the findings were consistent with those of men, but only fibrinogen reached the conventional level of statistical significance (P = 0.04). No difference was observed in factor VII antigen, factor VII activity or in plasminogen. The association of Lp (a) with prevalent CHD was dependent on fibrinogen concentration (P = 0.02 for the interaction-term) and on non-HDL cholesterol concentration (P = 0.01 for the interaction-term). These cross-sectional results do not prove causality, but they demonstrate a considerable accumulation of prevalent CHD among persons with high Lp (a), fibrinogen and non-HDL cholesterol.

Antigens

The effects of saturated fat and n-6 polyunsaturated fat on postprandial lipemia and hemostatic activity.

The effect of different fat loads on postprandial lipemia and hemostatic activity was examined in 10 middle-aged men using 3 different meals. One meal was rich in saturated fatty acids (cream), the other rich in n-6 polyunsaturated fatty acids (sunflower oil) and the third was fat-free containing only carbohydrates. Lipoprotein lipids and hemostatic parameters were measured during fasting and 2, 4, 6 and 8 h after the test meal. In fasting samples, several hemostatic parameters were significantly associated with lipoprotein lipids. Most notable were the strong associations of fibrinolysis parameters tissue plasminogen activator antigen and plasminogen activator inhibitor activity (PAI-1) with total and very low density lipoprotein (VLDL) triglycerides. During lipemia, the associations were approximately similar or slightly weaker than in the fasting state. Both fat loads resulted in similar postprandial lipid responses: VLDL and high density lipoprotein (HDL) triglycerides reached maximum at 4 h after the meal. VLDL cholesterol also increased 4 and 6 h after the fat loads. HDL3 cholesterol declined after the fatty meals but no change was observed in the HDL2 fraction. The fat-free meal gave no significant lipid changes during the time course studied. Factor VII activity (F VII:C) increased 6 and 8 h after the fatty meals, whereas a decrease was observed after the fat-free meal. The changes (+/- S.D.) at 8 h after cream, sunflower oil and fat-free meal were 5.2 +/- 3.3, 3.3 +/- 4.2 and -5.8 +/- 7.9 percentage points, respectively, and the effect of the meal on the changes was statistically significant (F (8,99) = 2.99, P = 0.0048). F VII antigen (F VII:Ag) tended to decline during the day but there was no difference between the meals. Factor VIII activity (F VIII:C) was highest after the polyunsaturated fat meal and lowest after the fat-free meal. PAI-1 declined during the day and the decline tended to be steepest after the fat-free morning meal. The effect of the meal on the changes in lipoprotein lipids and hemostatic factors varied significantly between individuals. In conclusion, postprandial lipemia after a single fatty meal was associated with procoagulatory change in F VII:C but there was no difference between saturated fat and n-6 polyunsaturated fat.

Adult

Anaesthesia affects plasma concentrations of vasopressin, von Willebrand factor and coagulation factor VIII in cardiac surgical patients.

Operative stress may affect haemostatic mechanisms through hormonal systems. As the endocrine stress response to surgery may be modulated by anaesthesia, we have altered stress hormone concentrations by using either opioid or inhalation based anaesthesia to study haemostatic mechanisms in cardiac surgical patients. Thirty patients undergoing coronary artery surgery were allocated randomly to receive fentanyl (non-stress group) or enflurane (stress group) as the main anaesthetic agent. After cardiopulmonary bypass (CPB), plasma arginine vasopressin (AVP) concentrations were significantly (P < 0.001) greater in the stress group (81.8 (46.9-142.9) pg ml-1, mean with 95% confidence limits) than in the non-stress group (5.8 (3.3-10.2) pg ml-1). Plasma noradrenaline and adrenaline concentrations increased similarly in both groups after CPB. Plasma concentrations of both von Willebrand factor (stress: 1.56 (1.33-1.79) IU ml-1; non-stress: 1.00 (0.76-1.25) IU ml-1) and coagulation factor VIII: C (stress 1.15 (0.87-1.44) IU ml-1; non-stress: 0.69 (0.55-0.80) IU ml-1) were significantly (P < 0.01) greater in the stress group than in the non-stress group after CPB. The results indicate that there is a temporal relationship between the increased plasma concentrations of AVP and von Willebrand factor and factor VIII: C. It is not clear if this indicates a causal relationship. However, variable stress control by anaesthesia may modify haemostasis in cardiac surgical patients.

Adult

Inorganic element concentrations in cataractous human lenses.

We evaluated the presence of calcium, potassium, zinc, copper, and selenium in human lenses (53 cataractous and 10 clear lenses). The determinations of these elements were done using atomic absorption spectrometry techniques, namely flame and flameless methods, after acidic digestion of the samples. Compared with the results obtained from samples of normal lenses (zinc, 16.5 +/- 2.5 mg/kg dry weight; copper, 0.53 +/- 0.08 mg/kg dry weight; selenium, 0.83 +/- 0.18mg/kg dry weight; potassium, 10,306 +/- 1232mg/kg dry weight, and calcium, 9.9 +/- 2.7mg/kg dry weight), the mean concentration values of the cataractous lenses showed some significant changes. Increases were found for zinc, copper, and calcium; the potassium concentration decreased. No significant changes occurred in selenium values. A positive correlation was found between zinc and copper concentrations (y = 0.030x + 0.007, r = .79). An inverse correlation was evident between calcium and potassium values (y = -0.097x + 1141, r = -.65).

Aged

Familial clustering of defective release of t-PA.

91 unrelated patients with idiopathic or familial deep vein thrombosis (DVT) and 72 (34 with DVT) relatives from 26 families were screened for hypofibrinolysis by measuring tissue plasminogen activator antigen (t-PA:Ag) after venous occlusion (VO) for 10 and 20 min and by measuring t-PA inhibitor activity (PAI) at rest. 21 healthy subjects served as controls. Defective release of t-PA:Ag was found in eight out of the 91 patients (9%). A partial family study of six of these eight patients was performed. This study included 10 family members with and 21 without DVT. A defective release of t-PA:Ag was found in 50% (5/10) of the family members with DVT, which is significantly more frequent than the 9% (8/91) prevalence in the unrelated patients (P less than 0.001). Furthermore, 24% (5/21) of asymptomatic members of these families also had defective release of t-PA:Ag. In the 18 families where the propositus had a normal level of t-PA:Ag, none of the 24 studied family members with DVT had defective release of t-PA:Ag. In contrast to the defective release of t-PA:Ag, increased basal level of PAI did not show familial clustering. In conclusion, low release of t-PA during VO shows familial clustering in a proportion of the cases.

Adult

Hemophilia A: genetic prediction and linkage studies in all available families in Finland.

RFLP studies were done in 82 (75%) of all known hemophilia A families in the Finnish population (approximately 5 million). Two intragenic RFLPs (Bc1I/F8A, XbaI/p482.6) and two extragenic markers (TaqI/St14, Bg1II/DX13) were used. Among 263 females at risk, carriership could be evaluated with an intragenic marker in 47% and with an extragenic marker in 26%. In 27% of the females, carriership could be neither excluded nor confirmed; 68% of these females were relatives of an isolated patient. Eight recombinations between the factor VIII gene (F8C) and DXS52 (lod 25.02 at theta max 0.06), eight recombinations between F8C and DXS15 (lod 21.91 at theta max 0.05), and two recombinations between DXS52 and DXS15 (lod 33.56 at theta max 0.01) were found. Using multipoint linkage analysis, the most likely order of loci supported by the data was: F8C-DXS15-DXS52-DXS134. RFLP segregation analysis provides a highly useful method of carrier detection and prenatal diagnosis of hemophilia A, but its limitations must be carefully taken into account.

Feasibility Studies

Low prevalence of antibodies against human immunodeficiency virus in Finnish haemophiliacs.

National yearly surveys were carried out between 1985 and 1989 to determine the prevalence of antibodies for human immunodeficiency virus (HIV) in Finnish patients with bleeding disorders. From 192 out of the 214 haemophiliacs (90%) tested, 2 patients were positive for anti-HIV. No seropositivities were found after 1985. Fourteen out of 21 patients (67%) with type III von Willebrand's disease, and 7 out of 8 patients (88%) with factor XIII deficiency were tested with negative results. The low prevalence of anti-HIV (0.94%; 2/213 tested), is mainly due to the self-sufficiency for clotting factors, the low prevalence of HIV in the population, and the use of cryoprecipitate during the critical period.

Adolescent

Transmission of hepatitis C virus to sexual partners of seropositive patients with bleeding disorders: a rare event.

Sexual transmission of hepatitis C virus (HCV) was studied in 30 partners to anti-HCV positive multitransfused patients with a bleeding disorder. Anti-HCV ELISA C-100 was used as a screening test. Positive results were confirmed with the first generation RIBA test. Indeterminate samples were tested also with the second generation RIBA to verify the positivity. The time of sexual exposure added up was at least 95 years. 29 partners were anti-HCV seronegative. Only 1 partner was anti-HCV indeterminate. Thus sexual transmission of HCV was a rare event.

Adult