Effects of retinal detachment surgery on protein C antigen level.

BACKGROUND: The purpose of the study was to evaluate perioperative changes in protein C antigen (PC Ag) in patients undergoing retinal detachment surgery under general or local anesthesia. MATERIAL AND METHODS: Prospective study of 39 patients: 27 patients, 14 male, 13 female, age from 15 to 78 (mean: 50.8, SD=18.6), undergoing retinal detachment surgery (encirclement with scleral buckling) performed under general anesthesia (group A), and 12 patients, 5 male, 7 female, age from 25 to 78 (mean: 52.9, SD=19.2), operated under local anesthesia (group B). Patients with venous or arterial disease or other factors which could affect the evaluated parameters were excluded from the study. Blood samples were collected from the cubital vein one day before surgery, immediately after induction of anesthesia but before surgery, immediately after the completion of the operation but before the termination of anesthesia, and after surgery (on the 1st and 4th day). The PC Ag concentration was measured in the citrate plasma of the patients studied, utilizing a commercially available enzyme-linked immunosorbent assay. RESULTS: In both groups, the pattern of changes in perioperative PC antigen was similar. A trend towards moderately lower intraoperative levels of PC Ag could be observed. In both groups, PC Ag concentration increased on the first postoperative day, but a significant change was noted only in general anesthesia group. CONCLUSIONS: Retinal detachment surgery evokes a less than statistically significant decrease in intraoperative PC antigen levels in systemic circulation, and these changes are not affected by the type of anesthesia. An increase in PC Ag was observed on the 1st postoperative day, but this was statistically significant only in the general anesthesia group.

Thrombomodulin--endothelial thrombin receptor in blood of patients with unstable angina pectoris.

BACKGROUND: Thrombomodulin (TM) a membrane receptor for thrombin generated in blood in vivo, is present on the surface of vascular endothelium cells. The aim of our work was the determination of thrombomodulin in the blood of patients with unstable angina pectoris. MATERIAL AND METHODS: In the study took part 87 patients with unstable angina pectoris (40 women and 47 men) at age 41-79 years. Thrombomodulin was determined in citrated blood plasma with the use of enzyme immunoassay ELISA with the diagnostic kit manufactured by American Diagnostica. RESULTS: Statistically significant higher thrombomodulin concentration (sTM) was found in the patients when compared with the values recorded in control group. Elevated sTM levels depended on patients age and they were significantly higher in patients over 50 years old. There were no statistically significant differences with respect to patients gender and coexistent risk factors such as arterial hypertension, diabetes or smoking, but significantly higher sTM concentration was observed in patients with high serum cholesterol level. CONCLUSION: Elevated sTM concentrations result from the damage to vascular endothelium cells by the atheromatous process manifested in unstable angina pectoris.

[Endothelin in the plasma and cerebrospinal fluid of patients after head injury]. / Endotelina w osoczu i plynie mózgowo--rdzeniowym chorych po urazie glowy.

UNLABELLED: Endothelin (ET) is identified as a potent vasoconstrictor peptide. It can cause a cerebral vasospam after subarachnoid hemorrhage. Its long-lasting vasoconstricting activity has been well documented. The role of ET in response to head injury is not clear. ET can participate in astrocyte activation and oxidative stress after trauma. The aim of this presentation was to investigate ET in the plasma and cerebrospinal fluid of patients after head injury and estimation of relation between the ET csf level and clinical condition of the patients and also relation of ET csf level and changes in the CT-scan and usefulness of ET as independent prognostic factor. We examined 30 patients at Day 1 after trauma (28 male, 2 female, aged 19-34 y, mean 30, 4, GCS ranged 8-15). CT-examination showed post-traumatic changes in 19 cases (11 with brain edema only, 8 with brain contusion). We measured ET by immunoenzymatic method using standard kits (Biomedica). The ET plasma level reached 1.12 +/- 0.63 fmol/ml (in the control group--0.44 +/- 0.19 fmol/ml) and c ET csf level 1.03 +/- 0.49 (in the control group--0.07 +/- 0.09 fmol/ml). W confirmed the correlation between the ET level and patients consciousness (by GCS) (p < 0.01). The ET csf level was highest in the patients with brain contusion in CT-scan (p < 0.02). Using multivariate analyses, we showed that ET can be used as a prognostic factor of results of treatment (p < 0.02). CONCLUSIONS: The ET level is elevated in the plasma of patients after head injury. ET is also present and strongly elevated in the cerebrospinal fluid of the same patients. The ET level in cerebrospinal fluid is associated with clinical condition of patients and elevated in cases with brain edema and structural brain damage. The ET level in cerebrospinal fluid is related to post-traumatic changes of the brain such as oedema and structural damage present in the CT-scan. ET can be used as a prognostic factor of results of treatment.

[Von Willebrand factor in patients with subarachnoid hemorrhage]. / Czynnik von Willebranda u chorych z krwotokiem podpajeczynówkowym.

UNLABELLED: Von Willebrand factor (vWF) plays an important role in the coagulation system. It affects platelet aggregation in the place of vessel endothelium damage. The importance of vWF in cerebrovascular disease is not clear. The aim of this presentation was to evaluate the vWF level in the plasma and cerebrospinal fluid of patients after subarachnoid hemorrhage including cases with cerebral vasospasm and cerebral infarct. We investigated 66 patients (38 persons graded I-III H&H and 28 persons graded IV H&H). The control group consists of 8 subjects. VWF was measured by ELISA method using standard kit Asserachrom (Boehringer). The vWF level in the plasma reached 288.81 +/- 99.66% (in the control group, 98.84 +/- 14.53%) without significant differences regarding clinical condition of patients. In the cerebrospinal fluid the vWF level was significantly different in I-III H&H patients and in IV H&H patients (1.21 +/- 0.52% and 9.18 +/- 7.58%, respectively, p < 0.001) and in the control group (0.13 +/- 0.33%). Our data indicate that there is correlation (Pearson, p < 0.01) between the level of vWF and neurological condition (GCS) of patients. There is also correlation (p < 0.01) between the level of VWF and the presence of clinical disorders (cerebral vasospasm, delayed neurological deficit (DIND) and cerebral infarct). Based on multivariate analysis, we confirmed that vWF is an independent prognostic factor of cerebral vasospasm (p < 0.01) and ischemic complications (p < 0.02). CONCLUSIONS: vWF is elevated in the plasma of patients after subarachnoid hemorrhage in early stage of the disease. VWF is present in the cerebrospinal fluid of patients with SAH and its level is higher in patients with poor neurological condition. The VWF elevation in csf is correlated with clinical condition of patients and also the presence of cerebral vasospasm and cerebral infarct. VWF can be used as an independent prognostic factor of cerebral vasospasm and ischemic complications.

[Tissue plasminogen activator in urine of patients with prostatic carcinoma and benign prostatic hyperplasia]. / Antygen tkankowego aktywatora plazminogenu w moczu chorych na raka i lagodny rozrost gruczolu krokowego.

In the 20 patients with prostatic carcinoma (PC) and the 18 with benign prostatic hyperplasia (BPH) the level of tissue type plasminogen activator (t-PA:Ag) was examined. As a compared group consisted of 24 healthy volunteers. In the urine of examined patients with PC and BPH and control the t-PA:Ag was absent or present only in trace amounts. We concluded that the t-PA:Ag in the urine of patients with PC can not be as a marker in the diagnosis of prostatic diseases especially in the prostatic carcinoma.

[Post-mortem concentration of tissue plasminogen activator (t-PA) and plasminogen activator inhibitor (PAI-1) in the vitreous body of the human eye]. / Posmiertne stezenie tkankowego aktywatora plazminogenu (t-PA) i inhibitora aktywatora plazminogenu (PAI-1) w ciele szklistym oka ludzkiego.

UNLABELLED: After sudden death the blood remains fluid and after late death the thrombi are present in heart and vasa. Earlier we observed after sudden death high concentrations of t-PA Ag in plasma with strong activation of fibrinolysis, consumption of PAI-1, plasminogen, fibrinogen, alfa-2 antiplasmin and a big increase of FDP. Fibrinolysis is mainly regulated by t-PA, u-PA and PAI-1. PURPOSE: The aim of our study was the evaluation of t-PA and PAI-1 in corpus vitreous and plasma of patients after sudden (26) and late death (12). MATERIAL AND METHODS: The concentration of t-PA Ag was measured with COA SET of Kabi Vitrum and the activity of PAI-1 with reagents of Biopool. RESULTS: In corpus vitreous the concentration of t-PA after sudden death was 3.65 +/- 1.83 ng/ml and after late death 1.93 +/- 1.63 ng/ml. The activity of PAI-1 was respectively 0.61 +/- 1.2 IU/ml and 2.25 +/- 3.30 IU/ml. After sudden death the concentration of t-PA was twice higher and PAI-1 three times lower as after late death. CONCLUSION: No dependence of t-PA concentration and the time after death could be observed.