Differential energy requirements for platelet responses. A simultaneous study of aggregation, three secretory processes, arachidonate liberation, phosphatidylinositol breakdown and phosphatidate production.

Previous studies have indicated different energy requirements for some platelet responses; these differences could, however, be due to inadequate methodology and differences in platelet preparation. The present study describes the effect of decreasing ATP availability on seven platelet responses measured in gel-filtered human platelets. The cells, prelabelled with 5-hydroxy[(3)H]tryptamine, [(3)H]- or [(14)C]adenine, [(32)P]P(i) or [(3)H]arachidonate, were incubated with antimycin A and 2-deoxy-d-glucose.

A case analysis method for the model of human occupation.

This paper introduces a method for analyzing clinical cases, which is based on ten primary questions and on criteria for selecting level of treatment. The questions and the criteria are derived from the model of human occupation. Four steps in the method are: gathering data in relevant categories; reviewing and analyzing data using the questions in sequence; selecting levels of treatment; and recording case studies.

Fibrinopeptide A, platelet factor 4, and beta-thromboglobulin levels in coronary heart disease.

In vivo platelet alpha-granule release and fibrin I formation were measured in 82 patients with ischemic heart disease by radioimmunoassay of platelet factor 4, beta-thromboglobulin, and fibrinopeptide A. The presence and extent of coronary artery disease were determined by coronary arteriography, and the extent of left ventricular regional dysfunction was assessed by contrast left ventriculography. In patients with abnormal coronary arteriograms without previous myocardial infarction, mean levels of platelet factor 4, beta-thromboglobulin, and fibrinopeptide A were not elevated.

Clinical evaluation of the relative effectiveness of multidose crystalloid and cold blood potassium cardioplegia in coronary artery bypass graft surgery: a nonrandomized matched-pair analysis.

Controversy exists concerning the most effective method of myocardial protection during coronary artery bypass graft operations. Accordingly, we performed a matched-pair analysis between 25 patients receiving multidose hypothermic potassium crystalloid cardioplegia and 25 other patients receiving cold blood potassium cardioplegia. Patients were matched on the basis of preoperative ejection fraction (EF) and the number of anatomically similar stenotic coronary arteries.

Effects of acetyl glyceryl ether phosphorylcholine on human platelet function in vitro.

AGEPC (PAF), at 1.9 x 10(-8) M or higher, induced concentration-dependent aggregation and release in human platelet-rich plasma. Comparative studies with arachidonate, collagen, ionophore, and ADP suggested that AGEPC was a strong stimulus for platelet aggregation and probably a moderate agonist for release, as well as a relatively weak inducer of TXA2 production.

ADP and epinephrine-induced release of platelet fibrinogen.

Human platelets gel-filtered into Tyrode's buffer containing 1 mM Mg++ and 0.35% bovine serum albumin were studied to determine whether they would undergo biphasic aggregation and release of alpha-granule proteins in response to adenosine diphosphate (ADP) or epinephrine without addition of exogenous fibrinogen. Fibrinogen concentration in the supernatant of unaggregated gel-filtered platelets was less than 1 pmole/ml.

Nonrandomized matched pair analysis of intermittent ischemic arrest versus potassium crystalloid cardioplegia during myocardial revascularization.

The quest for the ideal method of myocardial preservation during coronary artery bypass graft (CABG) surgery continues at a rapid pace. Nevertheless, in the present clinical practice of cardiac surgery, the choice is chiefly between hypothermic intermittent ischemic arrest and hypothermic potassium cardioplegia. This study applies newer technics in radionuclear cardiology, as well as more conventional enzymatic, electrocardiographic, and hemodynamic determinations, to the evaluation of the effectiveness of the previously mentioned modes of myocardial protection.

Fibrinopeptide A cleavage and platelet release in whole blood in vitro. Effects of stimuli, inhibitors, and agitation.

The relationship between platelet release and fibrinopeptide A cleavage from fibrinogen to form fibrin I in vitro was examined in blood allowed to clot undisturbed or with gentle agitation. In undisturbed or agitated blood platelet release and fibrin I formation occurred simultaneously. When hirudin was added to undisturbed blood it prevented platelet release as well as fibrin I formation.

Problems in the management of aggressive behavior on a medical ward. A multidisciplinary case conference.

Following admission to a medical ward, a 69-year-old man with a life-long history of seizure disorder and antisocial personality features showed poor control of aggressive impulses, assaulted staff, and presented a host of problems for the consulting psychiatrist. These problems included staff's denial of the man as a patient on the medical ward, a breakdown in the medical workup, and hostility toward the consulting psychiatrist. This paper described how these specific problems were approached, with emphasis on the need for a systems approach in treatment planning.

Plasma levels of beta-thromboglobulin and platelet factor 4 as indices of platelet activation in vivo.

Measurement of plasma levels of two secreted platelet proteins (beta-thromboglobulin and platelet factor 4) has been suggested as a means for detecting increased platelet activation in vivo. A crucial question in the measurement is the distinction between in vivo and in vitro secretion of the proteins. One approach to this distinction is the measurement of both proteins in each sample.

The multidisciplinary approach to vasculogenic impotence.

The proper assessment of erectile dysfunction can be objectively accomplished only by examining the vascular, hormonal, neurologic, and psychologic components. The vascular surgeon today requires the ability to participate in multidisciplinary approach to diagnosis and needs an understanding of pelvic hemodynamics to design aortoiliac reconstructions that optimize pelvic blood flow. We perform a history and physical examination carefully designed to evaluate erectile ability and detail vascular involvement.

Lack of platelet effect with the aspirin analog, salsalate.

Platelet function as determined by platelet aggregation and the release reaction was found to be normal in 8 patients receiving a nonacetylated analog of aspirin, salsalate, while all 5 aspirin controls had abnormal platelet function. Mean bleeding time in patients taking salsalate was less than that in aspirin controls. This study demonstrates that salsalate, which has anti-inflammatory activity and reduces prostaglandin synthesis, does not interfere with normal platelet function.

Acquired storage pool deficiency with increased platelet-associated IgG. Report of five cases.

Acquired abnormalities of platelet aggregation have been reported with increasing frequency. We studied five patients (including two with systemic lupus erythematosus and one with compensated chronic idiopathic thrombocytopenic purpura) in whom platelet aggregation responses to collagen, epinephrine and ADP are impaired; in all cases, we found that levels of platelet-associated immunoglobulin G (IgG) were increased. In all five patients substances stored in platelet-dense granules (ATP, ADP, serotonin and calcium) were diminished.

Anemia with Haemophilus influenzae meningitis.

The hematologic values in patients with Haemophilus influenzae meningitis were contrasted with those of patients with other types of bacterial meningitis and aseptic meningitis in an attempt to determine whether anemia is either specific for or more common in patients with H influenzae meningitis. Patients with H influenzae meningitis had significantly lower admission hemoglobin values because they were significantly younger than the other two groups. The H influenzae meningitis patients with the lowest hemoglobin values on admission had been sicker for longer periods prior to diagnosis and had higher initial white cell counts.

Rapid drop in serum iron concentration in myocardial infarction.

Two hundred one patients admitted to the Coronary Care Unit had repeated serum iron determinations. There was a rapid (within 24 to 48 hours), pronounced decrease (mean = 64%) of the serum iron concentration in 87% of the 112 patients who had a diagnosis of acute myocardial infarction. Seventy-nine per cent of the 89 patients who did not have an acute myocardial infarction did not have a drop in serum iron concentration.

The spouses of your heart attack patients: ways of helping with their emotional response.

The family physician must be prepared to deal with the emotional responses of the spouses of heart attack patients. The family physician has much useful prior knowledge of the family and can positively affect the patient's rehabilitation by involving the spouse. Marital partners' overprotectiveness or emotional inhibition can be prevented by the family physician's interventions.