RESUMO
The Fano effect is ubiquitous in the spectroscopy of, for instance, atoms, bulk solids and semiconductor heterostructures. It arises when quantum interference takes place between two competing optical pathways, one connecting the energy ground state and an excited discrete state, the other connecting the ground state with a continuum of energy states. The nature of the interference changes rapidly as a function of energy, giving rise to characteristically asymmetric lineshapes. The Fano effect is particularly important in the interpretation of electronic transport and optical spectra in semiconductors. Whereas Fano's original theory applies to the linear regime at low power, at higher power a laser field strongly admixes the states and the physics becomes rich, leading, for example, to a remarkable interplay of coherent nonlinear transitions. Despite the general importance of Fano physics, this nonlinear regime has received very little attention experimentally, presumably because the classic autoionization processes, the original test-bed of Fano's ideas, occur in an inconvenient spectral region, the deep ultraviolet. Here we report experiments that access the nonlinear Fano regime by using semiconductor quantum dots, which allow both the continuum states to be engineered and the energies to be rescaled to the near infrared. We measure the absorption cross-section of a single quantum dot and discover clear Fano resonances that we can tune with the device design or even in situ with a voltage bias. In parallel, we develop a nonlinear theory applicable to solid-state systems with fast relaxation of carriers. In the nonlinear regime, the visibility of the Fano quantum interferences increases dramatically, affording a sensitive probe of continuum coupling. This could be a unique method to detect weak couplings of a two-level quantum system (qubits), which should ideally be decoupled from all other states.
RESUMO
BACKGROUND/AIM: True adenomas of the cardia appear to be extremely rare lesions. There are no data on the natural history and histopathological background of these lesions. We report 3 patients with true adenomas of the cardia. METHODS AND RESULTS: Three patients with polypoid masses at the cardia below the Z-line were submitted to a tertiary referral center for further diagnosis and therapy. In 2 of the 3 cases Barrett's esophagus with low-grade intraepithelial neoplasia was assumed on the basis of histopathological examination of biopsy specimens taken from the surface of the lesions. Polypectomy was performed in all 3 cases. In 2 of the 3 cases the final histopathological diagnosis of low-grade adenoma of the cardia could only be established after complete removal of the polypoid masses. CONCLUSIONS: Adenomas of the cardia can be mistaken for dysplasia arising from Barrett's esophagus, if the diagnosis is based on endoscopic biopsies only. It is, therefore, reasonable to completely remove any suspicious lesions by endoscopy not only for therapeutic but also for diagnostic reasons.
Assuntos
Pólipos Adenomatosos/patologia , Cárdia/patologia , Neoplasias Gástricas/patologia , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
UNLABELLED: ESSENTIALS: A hypoxic microenvironment is a common feature of tumors that may influence activation of coagulation. MCF-7 and SK-BR-3 breast cancer cells and breast cancer tissue samples were used. The results showed transcriptional repression of tissue factor pathway inhibitor expression in hypoxia. Hypoxia-inducible factor 1α may be a target for the therapy of cancer-related coagulation and thrombosis. BACKGROUND: Activation of coagulation is a common finding in patients with cancer, and is associated with an increased risk of venous thrombosis. As a hypoxic microenvironment is a common feature of solid tumors, we investigated the role of hypoxia in the regulation of tissue factor (TF) pathway inhibitor (TFPI) expression in breast cancer. OBJECTIVES: To explore the transcriptional regulation of TFPI by hypoxia-inducible factor (HIF)-1α in breast cancer cells and their correlation in breast cancer tissues. METHODS AND RESULTS: MCF-7 and SK-BR-3 breast cancer cells were cultured in 1% oxygen or treated with cobalt chloride (CoCl2 ) to mimic hypoxia. Time-dependent and dose-dependent downregulation of TFPI mRNA (quantitative RT-PCR) and of free TFPI protein (ELISA) were observed in hypoxia. Western blotting showed parallel increases in the levels of HIF-1α protein and TF. HIF-1α inhibitor abolished or attenuated the hypoxia-induced downregulation of TFPI. Luciferase reporter assay showed that both hypoxia and HIF-1α overexpression caused strong repression of TFPI promoter activity. Subsequent chromatin immunoprecipitation and mutagenesis analysis demonstrated a functional hypoxia response element within the TFPI promoter, located at -1065 to -1060 relative to the transcriptional start point. In breast cancer tissue samples, gene expression analyses showed a positive correlation between the mRNA expression of TFPI and that of HIF-1α. CONCLUSIONS: This study demonstrates that HIF-1α is involved in the transcriptional regulation of the TFPI gene, and suggests that a hypoxic microenvironment inside a breast tumor may induce a procoagulant state in breast cancer patients.
Assuntos
Coagulação Sanguínea , Neoplasias da Mama/metabolismo , Lipoproteínas/metabolismo , Oxigênio/metabolismo , Adulto , Idoso , Sítios de Ligação , Neoplasias da Mama/genética , Neoplasias da Mama/patologia , Hipóxia Celular , Regulação para Baixo , Feminino , Regulação Neoplásica da Expressão Gênica , Células HEK293 , Humanos , Subunidade alfa do Fator 1 Induzível por Hipóxia/genética , Subunidade alfa do Fator 1 Induzível por Hipóxia/metabolismo , Lipoproteínas/genética , Células MCF-7 , Pessoa de Meia-Idade , Regiões Promotoras Genéticas , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , Fatores de Tempo , Transcrição Gênica , Transfecção , Microambiente TumoralRESUMO
Islet cell antibodies (ICAs) were determined in a large cohort of white nondiabetic schoolchildren (n = 4287) from a homogenous population in southern Germany. The prevalence of ICA levels greater than or equal to 5 Juvenile Diabetes Foundation (JDF) U was 1.05% (95% confidence interval 0.8-1.4%). Analysis of HLA-DR beta and -DQ beta alleles revealed that the specificities found to be increased in insulin-dependent (type I) diabetic subjects with the same ethnic background were also associated with ICA positivity in the nondiabetic schoolchildren. HLA-DR3 (P less than 0.01) and -DR4 (P less than 0.01) phenotypes and absence of Asp residue (P less than 0.01) at codon 57 of the HLA-DQ beta-chain were significantly increased in ICA+ compared with control subjects. High levels of ICAs, which were categorized as either greater than or equal to 17 or greater than or equal to 30 JDF U, were found to be associated with amino acids other than Asp at position 57 of the HLA-DQ beta-chain. No association of ICA level was found for HLA-DR phenotypes.
Assuntos
Autoanticorpos/análise , Diabetes Mellitus Tipo 1/epidemiologia , Diabetes Mellitus Tipo 1/imunologia , Adolescente , Adulto , Aminoácidos , Autoanticorpos/genética , Criança , Estudos Transversais , DNA/genética , Diabetes Mellitus Tipo 1/genética , Feminino , Alemanha , Antígenos HLA-DQ/análise , Antígenos HLA-DQ/genética , Cadeias beta de HLA-DQ , Antígenos HLA-DR/análise , Antígenos HLA-DR/genética , Humanos , Masculino , Fenótipo , Prevalência , Fatores de RiscoRESUMO
Neuroimmune interactions are an integral part of gut physiology and involved in the pathogenesis of inflammatory and functional bowel disorders. Mast cells and their mediators are important conveyors in the communication from the innate enteric immune system to the enteric nervous system (ENS). However, it is not known whether a mediator cocktail released from activated human mast cells affects neural activity in the ENS. We used the Multi-Site Optical Recording Technique to image single cell activity in guinea-pig and human ENS after application of a mast cell mediator cocktail (MCMC) that was released from isolated human intestinal mucosa mast cells stimulated by IgE-receptor cross-linking. Local application of MCMC onto individual ganglia evoked an excitatory response consisting of action potential discharge. This excitatory response occurred in 31%, 38% or 11% neurons of guinea-pig submucous plexus, human submucous plexus, or guinea-pig myenteric plexus, respectively. Compound action potentials from nerve fibres or fast excitatory synaptic inputs were not affected by MCMC. This study demonstrates immunoneural signalling in the human gut and revealed for the first time that an MCMC released from stimulated human intestinal mast cells induces excitatory actions in the human and guinea-pig ENS.
Assuntos
Citocinas/imunologia , Sistema Nervoso Entérico/efeitos dos fármacos , Intestinos/inervação , Mastócitos/metabolismo , Neurônios/efeitos dos fármacos , Animais , Corantes , Citocinas/metabolismo , Eletrofisiologia , Cobaias , Humanos , Processamento de Imagem Assistida por Computador , Intestinos/efeitos dos fármacos , Intestinos/imunologia , Mastócitos/imunologia , Gravação em VídeoRESUMO
Molecular and genetic events associated with the transition from monoclonal gammopathy of undetermined significance (MGUS) to multiple myeloma (MM) are still poorly characterized. We investigated serial bone marrow specimens from 11 patients with MGUS who eventually progressed to MM (MM post-MGUS) by interphase fluorescence in situ hybridization for immunoglobulin heavy-chain gene (IgH) translocations and chromosome 13q deletions (del(13q)). In nine patients, IgH translocations were present both in MGUS and MM post-MGUS plasma cells, including three t(11;14)(q13;q32) and one t(4;14)(p16;q32), which was observed already 92 months prior to MM. Similarly, all five MM patients with del(13q) had this aberration already at the MGUS stage. Two patients without IgH translocation and del(13q) had chromosomal gains suggesting hyperdiploidy, but IgH translocations and/or del(13q) did not emerge at MM post-MGUS. IgH translocations and del(13q) are early genetic events in monoclonal gammopathies, suggesting that additional events are required for the transition from stable MGUS to progressive MM.
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Cromossomos Humanos Par 13 , Deleção de Genes , Cadeias Pesadas de Imunoglobulinas/genética , Mieloma Múltiplo/genética , Paraproteinemias/genética , Translocação Genética , Idoso , Medula Óssea , Progressão da Doença , Humanos , Hibridização in Situ Fluorescente , Interfase , Pessoa de Meia-IdadeRESUMO
In a multicenter collaborative study a new second-generation HIV-1 antibody enzyme immunoassay (Abbott recombinant HIV-1 EIA) using Escherichia coli-expressed recombinant p24 and p41 proteins as solid-phase antigens was compared with the first-generation H9 cell-line-based Abbott HIV-1 EIA. The results of the confirmatory assays (Western blot, immunofluorescence), combined with clinical information, were used as the reference standard for the detection of HIV-1 antibodies in 10,676 random blood donor serum specimens, in a panel of 840 specimens from symptomatic and asymptomatic patients and a total of 63 serial blood specimens from 23 people at risk. With fresh blood donor sera, the specificity of the first-generation assay ranged between 99.54 and 99.76% (95% confidence limits, CL) compared with 99.81-99.95% (95% CL) for the second-generation EIA. With panel specimens the recombinant HIV-1 EIA achieved an overall sensitivity of 100% and a specificity range of 98.3-99.7% (95% CL); the corresponding sensitivity and specificity ranges observed for the first-generation EIA were 98.0-99.5% (95% CL) and 94.3-96.8% (95% CL), respectively. The improved sensitivity for the second-generation assay was confirmed by testing serial samples from seroconverting patients. The use of recombinant proteins eliminated non-specific reactions due to class II human leukocyte antigen (HLA)-directed antibodies.
Assuntos
Anticorpos Anti-HIV/análise , HIV-1/imunologia , Técnicas Imunoenzimáticas , Doadores de Sangue , Erros de Diagnóstico , Antígenos HIV/imunologia , Proteína do Núcleo p24 do HIV , Proteína gp41 do Envelope de HIV , Soropositividade para HIV/prevenção & controle , Humanos , Programas de Rastreamento , Estudos Multicêntricos como Assunto , Proteínas Recombinantes/imunologia , Proteínas dos Retroviridae/imunologia , Proteínas do Envelope Viral/imunologiaRESUMO
This study examines the sex ratio response of the parasitoid wasp Muscidifurax raptor to conspecific and confamilial females in relation to two groups of functional sex ratio models, local mate competition and host quality models. In some but not all experiments, M. raptor females produced a greater proportion of sons in the presence of a conspecific female than when alone, and this sex ratio effect carried over for a day after the females were isolated from each other M. raptor females also produced a greater proportion of sons in the presence of a female of the confamilial parasitoid Spalangia cameroni than when alone (although only on the second day of exposure to S. cameroni, not on the first). M. raptor's sex ratio increase in the presence of conspecifics is consistent with local mate competition models but not with host quality models because the presence of a conspecific female did not cause there to be more, and thus potentially smaller, offspring developing per host. In contrast, the presence of a S. cameroni female did cause there to be more offspring developing per host than when a M. raptor female was alone; thus M. raptor's sex ratio increase in the presence of S. cameroni may be explained by host quality models. An alternative explanation for the sex ratio increase in response to confamilials is that only a sex ratio response to conspecifics may be adaptive, due to local mate competition; but M. raptor females may be unable to distinguish between conspecific and S. cameroni females.
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A marker with a specific time spectrum of detection and both high sensitivity and specificity is required to diminish the clinically as well as forensically important gap on the time axis between short- and long-term markers of alcohol consumption like ethanol and CDT, GGT or MCV, respectively. Ethyl glucuronide (EtG) is a non-volatile, water-soluble, stable upon storage, direct metabolite of ethanol with a molecular weight of 222 g/mol that can be detected in body fluids for an extended time period after the complete elimination of alcohol from the body. We investigated 107 urine and 78 serum samples of a total of 107 inpatients in 4 groups: (1) 33 inpatients in acute alcohol withdrawal and long term treatment; (2/3) 29 and 15 addicted forensic psychiatric inpatients (#64 StGB, penal code); (4) 30 recently detoxified inpatients of a station for long term treatment by LC/MS-MS with the internal standard d5-EtG and additionally in the fourth group of patients also by gas chromatography/mass spectrometry (GC/MS). In 2 out of 33 inpatients of the first group, EtG could be determined 3 days after hospitalization; in an other subject, a relapse could be detected. In 2 out of 29 and in 1 out of 15 forensic inpatients of group 2 and 3, respectively--where neither clinical impression nor routine laboratory findings gave an indication for relapse--concentrations of EtG ranged between 0.1 and 18 mg/l in urine. For the serum samples of the 30 inpatients of group 4, we could demonstrate a total agreement for the results of the GC/MS and the LC/MS-MS method as to whether a sample was found to be positive or negative for EtG. We suggest that these results strengthen our earlier findings that ethyl glucuronide is a marker of alcohol consumption in general that can be detected for an extended time period after the complete elimination of alcohol from the body and a marker for relapse control with a specific time frame of detection intermediate between short- and long-term markers.
Assuntos
Consumo de Bebidas Alcoólicas/sangue , Consumo de Bebidas Alcoólicas/urina , Glucuronatos/sangue , Glucuronatos/urina , Adulto , Alcoolismo/sangue , Biomarcadores , Cromatografia Líquida , Feminino , Medicina Legal , Cromatografia Gasosa-Espectrometria de Massas , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva , Transtornos Relacionados ao Uso de Substâncias/complicações , Transtornos Relacionados ao Uso de Substâncias/psicologiaRESUMO
In this study, 223 cases of esophageal atresia (Type IIIb: 85.7%; Type II: 5.8%; Type IIIc: 4.0%; Type IIIa: 2.2%; Type IV: 2.2%) from 6 pediatric surgery centers of Austria, were retrospectively examined for the following parameters and their influence on the prognosis: Birth weight (2494.7 +/- 702.0 g), gestation week (range 27-42 weeks; mean 37.3 +/- 3.1 weeks), sex (male: n = 128; female: n = 95), long-gap atresia (> or = 2 cm: n = 33), Tracheomalacia (n = 16), associated malformations (n = 122; cardiac 27.4%, renal 17.9%, skeletal 17.0%, anal: 10.3%, intestinal 9.9%, mediastinal 7.6%, chromosomal 2.2%), preoperative aspiration (n = 92), pneumonia (n = 96), anastomotic insufficiency (n = 45), empyema (n = 5), mediastinitis (n = 8), sepsis (n = 32), other medical complications (n = 122, in 80 infants), other surgical complications (n = 57). The mortality rate was 41.3% overall, from 1975 to 1991; however, it was 25% from 1987 to 1991 and 0% in 1991. A statistically significant correlation was found between prognosis and the following factors: Cardiac malformations (p = 0.0001), medical complications except aspiration and pneumonia (p = 0.0001), empyema (p = 0.0081), mediastinitis (p = 0.0214), and sepsis (p = 0.0295). These 5 significant factors were given different points and a prognostic score was calculated by the addition of these points. This score was predictive for survival in 90.6% of cases and for mortality in 94% of cases.(ABSTRACT TRUNCATED AT 250 WORDS)
Assuntos
Atresia Esofágica/mortalidade , Áustria , Peso ao Nascer , Atresia Esofágica/classificação , Atresia Esofágica/complicações , Atresia Esofágica/fisiopatologia , Atresia Esofágica/cirurgia , Feminino , Idade Gestacional , Humanos , Recém-Nascido , Masculino , Complicações Pós-Operatórias/epidemiologia , Valor Preditivo dos Testes , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Fatores Sexuais , Taxa de Sobrevida , Fatores de TempoRESUMO
Twenty young male volunteers carried out a drinking experiment during which they underwent the Romberg standing test and the Unterberger treading test. These tests were carried out three times each in a sober state, 25 minutes and 2 hours after alcohol consumption. The balance tests were recorded, evaluated and documented by means of a Cranio-Corpo-Graphy. The Romberg standing test proved to be the more sensitive indicator of impaired balance, even when only slightly under the influence of alcohol. Both the degree of anterior-posterior and of lateral swaying increased according to the BAC and decreased after the end of absorption. Only lateral swaying was similarly recorded with the Unterberger test.
Assuntos
Intoxicação Alcoólica/fisiopatologia , Exame Neurológico/instrumentação , Equilíbrio Postural/efeitos dos fármacos , Adolescente , Adulto , Bebidas Alcoólicas/efeitos adversos , Etanol/sangue , Humanos , Masculino , Exame Neurológico/efeitos dos fármacos , Equilíbrio Postural/fisiologia , Valores de ReferênciaRESUMO
During a drinking experiment 20 young male volunteers were asked to estimate the amount of their BAC and commented on their driving ability and their readiness to participate in road traffic. During the resorption phase the majority of the volunteers estimated their BAC too low, whereas in the early elimination phase most of their estimates were to high. The majority of the volunteers felt able to drive throughout the whole experiment which demonstrates an impairment of essential control functions as early as low to medium alcohol intoxication.
Assuntos
Intoxicação Alcoólica/sangue , Condução de Veículo/psicologia , Conscientização , Etanol/farmacocinética , Adolescente , Adulto , Intoxicação Alcoólica/psicologia , Relação Dose-Resposta a Droga , Humanos , Masculino , Assunção de Riscos , Enquadramento PsicológicoRESUMO
The authors describe the suicide of an 21 year old man, who executed himself with a self-constructed "guillotine". In spite of his serious neck wound he was able to deliver himself from the guillotine. He died due to severe haemorrhage from the right carotid artery damaged by the cut.
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Lesões do Pescoço , Suicídio/legislação & jurisprudência , Ferimentos Penetrantes/patologia , Adulto , Artérias Carótidas/patologia , Lesões das Artérias Carótidas , Causas de Morte , Humanos , Masculino , Pescoço/patologia , Choque Hemorrágico/patologiaRESUMO
The authors describe autopsy findings and neuropathological findings in the case of a man killed by an axe cut. Regardless of his expanded brain injuries he had survived for about 16 hours.
Assuntos
Morte Encefálica/patologia , Lesões Encefálicas/patologia , Homicídio/legislação & jurisprudência , Ferimentos Penetrantes/patologia , Hemorragia Cerebral/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Lobo Parietal/lesões , Lobo Parietal/patologia , Lobo Temporal/lesões , Lobo Temporal/patologiaRESUMO
In the present study endoscopically diagnosed changes of the Fürstenberg's rosette were examined histologically. For this purpose the teats of 200 slaughtered cows were inspected. In 19 cases proliferations in the region of the Fürstenberg's rosette were found. Additionally, tissue samples were taken from the Fürstenberg's rosette of 26 cows which showed milk flow disorders due to stenoses of this part of the teat. Teats of slaughtered cows as well as biopsy specimens were fixed in 5% formaldehyde and embedded in paraffin and in plastic. All specimens were stained according to H.E., Giemsa and Turnbull, respectively. Histologically, the proliferations of the Fürstenberg's rosette consisted of fibrovascular tissue (granulation tissue) covered by keratinized squamous epithelium (teat canal epithelium) in eleven cases. In the other cases double-layered cuboid epithelium (cisternal epithelium) was found additionally. The formation of granulation tissue and deposition of blood pigment was observed exclusively in areas covered by stratified epithelium. Therefore a traumatic lesion of the teat canal was supposed to be the cause of the histological findings. In contrast to several reports in the literature, however, no indications of an inversion of the teat canal epithelium were found. On the basis of these findings, the hitherto assumed idea of pathogenesis of proliferations of the Fürstenberg's rosette was modified and a new pathogenesis pattern was developed.
Assuntos
Doenças dos Bovinos/patologia , Glândulas Mamárias Animais/lesões , Glândulas Mamárias Animais/patologia , Animais , Bovinos , Doenças dos Bovinos/cirurgia , Constrição Patológica/patologia , Constrição Patológica/cirurgia , Constrição Patológica/veterinária , Endoscopia/métodos , Endoscopia/veterinária , Feminino , Imuno-Histoquímica/veterinária , Mastite Bovina/patologiaRESUMO
In the present study 795 teats of slaughtered cows were examined endoscopically. Teats which showed lesions were examined histologically. Abnormalities were detected endoscopically in 37 teats. In five cases red discolorations were observed. Histologically these alterations proved to be fresh bleedings within the fibromuscular layer of the teat cistern. Thirteen teats showed yellowish discolorations of the cistern surface. Three of these cases could not be cleared up histologically. In the other cases moderate or severe blood pigment deposition (n = 10) or severe fibrosis (n = 3) of the fibromuscular layer were found. Neither fresh bleeding nor severe blood pigment deposition was found in teats with normal coloured epithelium of the cistern. Cistern surface was smooth in 18 cases, whereas in 19 cases nodules were found. Histologically all nodules consisted of fibrovascular tissue ("granulation tissue") covered with cisternal epithelium. Detailed histological examinations, however, revealed considerable morphological variations regarding the overlying epithelium, the extent and kind of cellular infiltration, the extent of angioplasia and fibroplasia as well as fresh bleedings or deposition of blood pigment in the underlying fibrovascular tissue in some cases. It was concluded, that teat endoscopy enables a differentiation between fresh and old bleedings according to the coloration of the cisternal surface. Nodular proliferations of the cistern surface generally consists of fibrovascular ("granulation") tissue. Further histological details, however, and thus possible information about the pathogenesis of the lesions cannot be assessed endoscopically.
Assuntos
Doenças dos Bovinos/patologia , Glândulas Mamárias Animais/patologia , Glândulas Mamárias Animais/cirurgia , Animais , Bovinos , Endoscopia/veterinária , Feminino , Fibrose/veterinária , Hemorragia/veterinária , Imuno-Histoquímica/veterinária , PigmentaçãoRESUMO
BACKGROUND: Cardiocirculatory arrest (CCA) activates procoagulant pathways. It has also been reported to inhibit fibrinolysis, resulting in fibrin deposition and further impairment of blood flow. Until now, no studies have used whole-blood viscoelastic tests to characterize coagulation and the impact of fibrinolysis in out-of-hospital cardiac arrest (OHCA). METHODS: Patient with established OHCA who underwent cardiopulmonary resuscitation (CPR) were enrolled. Blood samples were obtained immediately after placement of an intravenous line at the scene, for full blood cell count, standard coagulation tests and rotational thromboelastometric (ROTEM(®)) analyses. Patients with return of spontaneous circulation (ROSC) were compared to non-ROSC patients. RESULTS: Fifty-three patients (median age 67 years, interquartile range: 56-73 years) were included in the study. ROSC was established in 25 patients. Prothrombin time index (PTI) was significantly lower and activated partial thromboplastin time (aPTT) was significantly prolonged in non-ROSC patients compared to ROSC patients. Clotting time (CT) in the extrinsically activated ROTEM test (EXTEM) was significantly longer in non-ROSC versus ROSC patients. For the remaining EXTEM parameters, there were no significant differences between ROSC and non-ROSC patients. Hyperfibrinolysis (maximum lysis>15% according to ROTEM test results) was observed in 19 patients (35.8%). There was no difference between ROSC and non-ROSC patients in the incidence of hyperfibrinolysis. CONCLUSIONS: PTI, aPTT and EXTEM CT revealed significant differences between ROSC and non-ROSC patients. Hyperfibrinolysis according to ROTEM test results was much more common than previously assumed. Routine use of fibrinolytic therapy in all patients with prolonged CPR cannot therefore be recommended.
Assuntos
Testes de Coagulação Sanguínea , Fibrinólise , Parada Cardíaca Extra-Hospitalar/sangue , Idoso , Reanimação Cardiopulmonar , Circulação Coronária , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Parada Cardíaca Extra-Hospitalar/terapia , Tempo de Tromboplastina Parcial , Estudos Prospectivos , Tempo de Protrombina , Recuperação de Função FisiológicaRESUMO
A 64-year-old male patient with a serum PSA value of 51.91 ng ml(-1) and an magnetic resonance imaging scan suggestive of prostate cancer was admitted with bilateral hydronephrosis and anemia. A suprapubic cystostomy had been inserted 6 months earlier, owing to voiding difficulties. The patient was found to have huge multiple bladder stones and a massively thickened bladder wall. A sectio alta with bladder stone removal and bilateral ureteral stenting was performed. Histopathological examination revealed the growth of prostate cancer cells in the cystostomy tube needle tract.