Between Jan 1986 and Dec 1997, 323 breast, 94 colorectal, 36 renal and 17 prostate cancer patients were serially followed-up with CEA-TPA-CA15.3, CEA-TPA-GICA-CA72.4, GICA-TPA-ferritin associations and PSA respectively. All patients presenting bone scintigraphy (BS) with equivocal interpretation and concomitant constant elevation (CE) or progressive increase (PI) in one or more of tumor markers (TM) were selected for computed tomography (CT), except those with equivocal BS of ribs, who were evaluated by skeletal x-ray. In non relapsed patients affected by the different cancer types, concomitant dynamic TM evaluation allowed to decrease by 13% up to 48% the equivocal BS subjects to be studied further with CT or x-ray. Moreover TM selected for radiological investigation 81% to 100% of those with skeletal metastases and equivocal BS. These data point out the relevant role of TM in improving BS specificity and in selecting those who need further radiological examinations.

BACKGROUND:The aim of this work is to describe an approach allowing extracorporeal hemodialysis (HD) with administration of low molecular weight heparin (LMWH) and to compare the dialyzer efficiency of this approach versus infractionated heparin (UFH) used alone.METHODS:Low molecular weight heparin (Nadroparin, molecular weight 4500 d) administered in a single injection (dose 3075 IU AXa) plus prostacyclin (Epoprostenol sodium salt, molecular weight 375 d) by continuous infusion (3 ng/kg/min) have been used as anticoagulants during hemodialysis in 8 patients. In comparison, standard continuous heparinization by unfractionated heparin was used. Hemodialysis efficiency (dialyzer clearance for urea, creatinine, uric acid and phosphate), coagulation (activated partial thromboplastin time, antithrombin III, fibrinogen platelet count, prothrombin time) and hemodynamic parameters (blood arterial pressure and heart rate) were also evaluated during dialysis.RESULTS AND CONCLUSIONS:Simultaneous infusion of low molecular weight heparin plus prostacyclin allowed safe and effective anticoagulation without affecting hemodialysis efficiency.

Background The authors evaluated the chronic post-mastectomy lymphoedematous tissue and the effects of manual lymphatic drainage (Leduc method) with and without compressive bandage.Methods. The arms were measured before and after physical therapy and the results were expressed as a percentage decrease. Physical therapy was performed first by manual lymphatic drainage only and after by manual lymphatic drainage plus compressive bandage.Results, We observed that during manual lymphatic drainage plus compressive bandage the total percentage decrease of whole limb was the highest: 41.1 +/- 12.2% versus 30.4 +/- 15.8% (p<0.05), Clinical and physiopathological implications are discussed.

BACKGROUND:This study was performed to evaluate the prothrombin time in normal healthy people (102 subjects) by means of two thromboplastins.METHODS:Dade Thromboplastin IS (rabbit brain thromboplastin) and Dade Innovin (recombinant tissue factor) were used. Derived fibrinogen, Claus fibrinogen and in vitro sensibility of these thromboplastins to known amount of heparin were also measured.RESULTS:A different behaviour of prothrombin time measurement linked to different thromboplastin sensibility connected to the age was observed. A different fibrinogen (Claus and derived) behaviour connected to the age that may help to explain thromboplastin sensibility difference with the age was also observed. Finally different sensibility of these two thromboplastins to heparin in vitro was observed.CONCLUSIONS:This result should be considered when anticoagulation is started with oral anti coagulant drug and heparin together.

The plasma concentration of prothrombin fragment 1+2 (F1+2) is considered a very sensitive parameter for specific detection of latent hypercoagulability. To evaluate the degree of hypercoagulation associated with chronic uremia, we measured F1+2 by ELISA in the plasma of 51 patients with severe or end-stage chronic renal failure (35 males, 16 females, aged 22–81 years): 24 on dietary treatment, 15 on combined dietary and once a week hemodialysis, and 12 on regular maintenance hemodialysis; 33 healthy subjects served as a control group. Plasma F1+2 showed a significant elevation in the group on dietary treatment; it was further increased in the group on once a week hemodialysis, and even more markedly increased in the group on maintenance hemodialysis. In patients on dietary treatment a positive correlation was found between plasma F1+2 and serum creatinine. In patients on maintenance hemodialysis, no increase in the F1+2 plasma level was found during the course of a single hemodialysis session. Low molecular weight heparin, administered to 7 patients on dietary treatment, caused a marked drop in the F1+2 plasma level, providing evidence that the elevation in F1+2 indicates an accelerated in vivo thrombin generation rather than impaired renal catabolism. The enhanced coagulation activation appears to be related to the reduction of residual renal function, i.e., to the severity of renal failure, and may contribute to the increased risk of vascular events in uremic patients.

Many mediators of phlogosis may play an important role in renal glomerular pathology. PAF seems to have a prominent role. The aim of this study is the evaluation of the mechanism of action by which PAF may contribute to renal glomerular damage.

The authors have evaluated the behaviour of protein C activity, factor X and factor VII coagulant activity, and serum lipoprotein(a) before and after haemodialytic treatment in the plasma of patients on maintenance haemodialysis. The plasma level of protein C activity, depressed before haemodialysis, significantly increased during the course of haemodialysis; factor X and factor VII increased as well despite heparinization; serum lipoprotein(a) was abnormally elevated before haemodialysis and did not change after haemodialysis. In vitro incubation (30' at 37 degrees C) of uremic and healthy blood samples resulted in a decrease of serum lipoprotein(a) concentration. After heparin addition (final concentration 0.5 U/ml) lipoprotein(a) became higher in uremic blood only.