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Query: UMLS:C0012739 (disseminated intravascular coagulation)
 8,673 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We retrospectively reviewed blood smears from patients with septic shock and/or disseminated intravascular coagulation (DIC) in order to determine whether the appearance of leukocytic fragments on blood smears has any clinical significance. Leukocytic fragments were seen in six of twelve cases with septic shock but in none of three cases of DIC without sepsis. All six cases with leukocytic fragments also showed fragmented erythrocytes. The fact that five of these six cases died and that four were dead within two days after the leukocytic fragments were noted may indicate that this appearance heralds a severe and terminal condition of sepsis. Although the exact reason for the appearance of these fragments is unclear, it seems to be related either to mechanical shearing through microangiopathic fibrin strands, which may also cause erythrocytic fragments, or to a complex alteration in the cell membrane due to bacteria, endotoxin, or other factors. We would like to stress that the presence of leukocytic fragments on blood smears provides an important clue to the patient's prognosis.
Acta Pathol Jpn 1990 Dec
PMID:Leukocytic fragments in blood smears. 209 93

Death from traumatic shock has been associated with loss of blood externally or internally. However, many patients die after trauma, even though blood volume restoration is adequate. Death is often due to pulmonary failure (adult respiratory distress syndrome [ARDS]). Death and ARDS have been associated with disseminated intravascular coagulation (DIC) and microclots in the lungs. Dissolution of the microclots after trauma can be achieved by activation of endogenous plasmin. Nine pigs were anesthetized for 48 h. Trauma was administered by 60 standard blows to each thigh resulting in a bruise of muscle but no skin, bone, or major vessel injury. Nutrition and respiration were maintained at normal levels. All nine pigs died with severe lung pathology and low PaO2. Ten other traumatized pigs were treated with a plasminogen activator iv 4 h after trauma. Five of these were treated with tissue plasminogen activator (tPA) and five with urokinase. All treated pigs survived 48 h and maintained a normal PaO2. Autopsy showed minimal lung pathology.
Crit Care Med 1990 Dec
PMID:Prevention of adult respiratory distress syndrome with plasminogen activator in pigs. 212 44

Changes of blood coagulation in 32 cases of SLE were investigated. Abnormalities frequently found were elevation of blood fibrinogen, FDP, V111R: Ag levels, prolonged or shortened KPTT time, and depressed AT-III value. Half of the patients with SLE showed laboratory changes compatible with the diagnostic criteria of DIC, but acute DIC was encountered clinically only in 2 cases hypercoagulation state or hypercoagulation with lower fibrinolysis, however were frequently seen. Lupus anticoagulant were detected in 6 patients and deep vein thrombosis of lower extremity in 1 patient. Examination of blood coagulation in patients with SLE was, therefore, of clinical importance.
Zhonghua Nei Ke Za Zhi 1990 Dec
PMID:[Blood coagulation changes in systemic lupus erythematosus]. 212 40

The localization of tissue plasminogen activator (t-PA) or urokinase plasminogen activator (u-PA) on thrombi was investigated in disseminated intravascular coagulation rats (DIC rats) induced by thrombin. One hour after the intravenous infusion of thrombin to rats, the plasma fibrinogen level decreased, while the plasminogen activator activity in the plasma euglobulin fraction increased. The whole body autoradiography was studied after an injection of [125I]fibrinogen in DIC rats. The high radioactivity which indicated the presence of microthrombi was observed in the renal cortex, liver, spleen and lung. Furthermore, a large venous thrombus with higher radioactivity was observed in the abdominal vena cava. These results show that the thrombin-treated animal is one of the best DIC models. After the intravenous administration of [125I]t-PA, the autoradiograms of DIC rats showed a radioactivity in the blood and much higher radioactivities in the renal cortex, spleen and lung in comparison with the normal rat. However, there was no difference in the distribution of [125I]u-PA between normal and DIC rats at all. The strong radioactivity of [125I]t-PA but not [125I]u-PA was observed on the surface of large thrombus in the vena cava. These results suggest that t-PA localizes more preferentially on microthrombi than u-PA. The ratio of the radioactivity in the tissue to that in the blood was calculated to compare quantitatively the localization of [125I]t-PA and [125I]u-PA on microthrombi formed in organs.(ABSTRACT TRUNCATED AT 250 WORDS)
J Pharmacobiodyn 1990 Dec
PMID:Localization of tissue plasminogen activator on experimental thrombi in rats. 212 28

Because the important increase of cocaine abuse and the frequent pathology associated, we present two cases of males who had a multiorganic failure cause by severe rabdomyolysis, renal failure with myoglobinuria and disseminated intravascular coagulation, after the cocaine consumption. In one case a pancreatitis associated was observed, this not being described before. Both cases are recovered.
An Med Interna 1990 Dec
PMID:[Rhabdomyolysis in acute cocaine poisoning. Presentation of 2 cases]. 213 76

Percutaneous nephrolithotomy has been proved an efficient management of renal calculi. We report, in present review, the complications of PCNL procedure referred by several authors and our casistic since 1985. Major complications occurred in 3-6% of treated patients: severe bleeding, arteriovenosal fistulas, haematoma perirenal, water syndrome, sepsis, DIC, etc.). Nephrectomy was necessary in less than 1% of reported cases. 5 patients died for complications related to PCNL. Early complications occurred during the percutaneous puncture, tract dilation and lithotripsy. Postoperatively bleeding at the time of nephrostomic tube removal was reported in 0.5-1% of cases. Late sequelae of PCNL: stricture, fistulas, renal damage, renal function loss, high lithiasis recurrence rate were reported rarely. We, herein, believe PCNL is a safe and effective procedure with minimal rate of complications and late effects, according to other important authors.
Arch Ital Urol Nefrol Androl 1990 Dec
PMID:[Complications of percutaneous litholapaxy]. 215 Feb 32

The extent to which fertilization failure in in vitro inseminated human oocytes obtained from hyperstimulated ovaries was associated with alterations in cellular structure and cytoplasmic organization was examined by a combination of DIC, fluorescence, time-lapse video, and transmission electron microscopy. Detailed analysis of meiotically mature preovulatory (uninseminated) oocytes, and of oocytes that failed to fertilize in vitro, indicated that between 10% and 15% of grossly normal-appearing MII-stage oocytes displayed one of the following cellular perturbations: 1) a subtle change in organelle distribution, 2) a small region(s) of intracellular cytolysis, 3) a massive aggregation of SER tubules, 4) an accumulation of vesicles presumed to be of SER origin, 5) a change in the structural organization of the cortical cytoplasm and overlying plasma membrane, 6) a sudden and rapid internalization of perivitelline fluid by means of an apparently aberrant process of endocytosis, and 7) a premature and partial exocytosis of cortical granules. The description of these disorders is discussed with respect to the developmental consequences for the oocyte.
J Electron Microsc Tech 1990 Dec
PMID:Occurrence and developmental consequences of aberrant cellular organization in meiotically mature human oocytes after exogenous ovarian hyperstimulation. 225 Jan 86

We analyzed autopsy findings on 26 patients who died following percutaneous transluminal coronary angioplasty (PTCA). Twenty-one patients died within 3 weeks of undergoing PTCA; demonstrable cardiac complications were found in 19 patients: platelet-fibrin thrombi (10 patients [48%]), coronary artery dissections (17 patients [81%]), thromboemboli (13 patients [62%]), atheroemboli (seven patients [33%]), and myocardial infarcts (17 patients [81%]). An increased incidence of coronary platelet-fibrin thrombi was noted when compared with a non-PTCA cardiac autopsy population (five of 53 patients). Apparently there was an increased incidence of coronary atheroemboli and thromboemboli in the patients with coronary platelet-fibrin thrombi (eight patients) when compared with patients who did not have platelet-fibrin thrombi (five patients), although this was not statistically significant. There was no evidence of a systemic hypercoagulable state or of disseminated intravascular coagulation. The pathogenesis of this is unclear; however, vasospasm and a disruption of the endothelial surface induced by PTCA with subsequent platelet activation are possible causes. Although not statistically significant, there was a proponderance of female subjects (seven patients) and an increased incidence of diabetes mellitus (six patients) and hypertension (13 patients) when compared with a control population of all patients undergoing PTCA at The Cleveland (Ohio) Clinic Foundation in 1987, suggesting that diabetes mellitus, hypertension, and female sex may be clinical risk factors for fatal complications following PTCA.
Arch Pathol Lab Med 1990 Dec
PMID:An analysis of outcome following percutaneous transluminal coronary artery angioplasty. An autopsy series. 225 16

Infection occurring in patients suffering from severe trauma or burns often leads to hypotension, disseminated intravascular coagulation, multiorgan failure, and death. These latter pathophysiologic changes often are associated with Gram-negative sepsis and endotoxemia. Substantial progress has been made in understanding the effector mechanisms for endotoxin (LPS) action with the recognition of the importance of LPS-inducible products of cells of monocytic lineage in mediating LPS-induced injury. Here we will review recent evidence that supports a model for monocyte/macrophage activation by LPS that involves a plasma protein known as lipopolysaccharide binding protein (LBP) and the monocyte differentiation antigen, CD14.
J Trauma 1990 Dec
PMID:A new model of macrophage stimulation by bacterial lipopolysaccharide. 225 81

Many neurologic disorders, such as eclampsia, pseudotumor cerebri, stroke, obstetric nerve palsies, subarachnoid hemorrhage, pituitary tumors, and choriocarcinoma, can develop in the pregnant patient. Maternal mortality from eclampsia, which ranges from 0 to 14%, can be due to intracerebral hemorrhage, pulmonary edema, disseminated intravascular coagulation, abruptio placentae, or failure of the liver or kidneys. Associated fetal mortality ranges from 10 to 28% and is directly related to decreased placental perfusion. Pseudotumor cerebri can be associated with serious visual complications; thus, the therapeutic goal is to prevent loss of vision. The risk of stroke in the pregnant patient is 13 times the risk in the nonpregnant patient of the same age. The major causes of stroke in pregnant patients are arterial occlusion and cerebral venous thrombosis. Lumbar disk prolapse is common in pregnant patients, and lumbosacral plexus injuries can occur during labor or delivery. In addition, peripheral nerve compression or entrapment syndromes are thought to be caused by the retention of fluid during pregnancy. The incidence of subarachnoid hemorrhage during pregnancy is 1 in every 10,000 patients, a rate 5 times higher than in nonpregnant women. Because of a proliferation of prolactin-secreting cells, the pituitary gland can enlarge dramatically during pregnancy, a change that can disclose a previously unknown tumor or cause a known pituitary tumor to become symptomatic. The incidence of choriocarcinoma is 1 in 50,000 full-term pregnancies but 1 in 30 molar pregnancies. This malignant tumor has a high rate of cerebral metastatic lesions. In addition to these disorders that develop during pregnancy, the pregnant state can affect numerous preexisting neurologic conditions, including epilepsy, headaches, multiple sclerosis, myasthenia gravis, spinal cord injury, and brain tumors. We discuss advice for patients with such conditions who wish to become pregnant, recommendations for medical and surgical management, and surgical considerations for neurologic complications during pregnancy.
Mayo Clin Proc 1990 Dec
PMID:Selected neurologic complications of pregnancy. 225 22


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