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1.
Decreased levels of procoagulant phospholipids in bleeding patients treated by vitamin K antagonists.
Mathieu, E, Van Dreden, P, Aulagnier, J, Grusse, M, Dreyfus, JF, François, D, Vasse, M
Thrombosis research. 2016;:36-40
Abstract
International Normalized Ratio (INR) is currently used to monitor vitamin K antagonist therapy, and the bleeding incidence becomes exponential for INR>4.5. Inversely, more than 50% of patients with a supratherapeutic INR are asymptomatic. Therefore it could be of interest to identify patients with a higher bleeding risk. Microparticles derived from different cell types express procoagulant phospholipids (PPL) which can be evaluated by a chronometric coagulation assay where a shortening of the clotting times is associated with increased levels of PPL. In a series of 174 consecutive patients referred to our Emergency Department with an INR>5, median level of PPL was significantly (p=0.004) lower (38.2s) in the 119 asymptomatic patients than in patients with nonmajor (43.6s, n=35) or major bleeding (46.6s, n=19), indicating higher levels of procoagulant phospholipids in asymptomatic patients. By receiver operating characteristic curve analysis, a cut-off of 43.5s discriminated patients with higher haemorrhagic risk (area under the curve=0.648). In contrast, thrombomodulin levels, quantified either by immunological or functional assays were not significantly different between both groups. In conclusion, evaluation of PPL could be of interest to define the haemorrhagic risk of VKA- treated patients.
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2.
Contrast-enhanced ultrasound using real-time contrast harmonic imaging in invasive breast cancer: comparison of enhancement dynamics with three different doses of contrast agent.
Saracco, A, Szabó, BK, Aspelin, P, Leifland, K, Tánczos, E, Wilczek, B, Axelsson, R
Acta radiologica (Stockholm, Sweden : 1987). 2015;(1):34-41
Abstract
BACKGROUND In the last few years new potential applications have been developed for contrast-enhanced ultrasound (CEUS) and the management of breast diseases, but there is still some debate concerning the optimal dose to evaluate breast lesions, especially as a diagnostic tool. PURPOSE To compare different CEUS doses of injected contrast agent in order to establish an optimal dose for the diagnosis of invasive breast cancer. MATERIAL AND METHODS In Group A we compared the bolus dose of 1.2 mL vs. 2.4 mL and in Group B we compared the bolus dose of 2.4 mL vs. 4.8 mL (26 and 25 invasive carcinomas, respectively). CEUS was performed in real-time contrast harmonic imaging (CHI) using a L9-3 MHz probe. All examinations were recorded in a contrast side/side imaging mode loop for 120 s. Wash-in and wash-out patterns of the contrast agent were analyzed with advanced US quantification software and kinetic curves were used for statistical analysis. RESULTS In Group B (2.4 mL vs. 4.8 mL), more and stronger correlation was found among kinetic parameters (area under the curve, P < 0.00001; lognormal model parameters, μ, P = 0.0007 and σ, P < 0.0001; mean transit time, P < 0.0001; model-based wash-out ratios, W21m, P = 0.0002; W50m, P = 0.0001; time-to-peak, P = 0.005) as compared to Group A (1.2 mL vs. 2.4 mL). CONCLUSION The optimal way to evaluate kinetic features of invasive breast tumors using real-time CEUS is with an injection of contrast agent of either 2.4 mL or 4.8 mL.
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3.
Double-contrast-enhanced sonography for diagnosis of rectal lesions with pathologic correlation.
Lu, M, Yan, B, Song, J, Ping, W, Yue, LX, Song, B
Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine. 2014;(4):575-83
Abstract
OBJECTIVES Transabdominal sonography with a gastrointestinal contrast agent has been widely used in China for investigation of digestive disorders. Double-contrast-enhanced sonography combines a gastrointestinal luminal contrast agent with an intravenous contrast agent for imaging of lesions. The purpose of this pilot study was to assess the value of double-contrast-enhanced sonography for preoperative diagnosis of rectal lesions. METHODS We conducted a prospective single-center study using double-contrast-enhanced sonography of rectal lesions. Patients were administered both rectal and intravenous contrast agents, and imaging was performed transabdominally, transanally, and transrectally. Morphologic characteristics and perfusion parameters were compared between histologically proven adenocarcinomas, adenomas, and inflammatory masses. Perfusion parameters were analyzed with time-intensity curves, measuring the contrast arrival time, time to peak, peak intensity, and area under the curve of the lesions and normal rectal tissue. RESULTS From January 2009 to September 2012, 420 patients were recruited, with 227 patients meeting inclusion/exclusion criteria and having 232 rectal lesions analyzed (172 rectal adenocarcinomas, 45 adenomas, and 15 inflammatory masses). Adenocarcinomas had variable enhancement patterns. Adenomas were all hypoenhanced in a homogeneous pattern. Inflammatory masses had a hyperenhanced rim with no central enhancement. Time-intensity curve perfusion parameters (arrival time, time to peak, peak intensity, and area under the curve) of rectal adenocarcinomas, adenomas, and inflammatory masses were significantly different compared to normal rectal tissue (P < .05). The differences in the arrival time, peak intensity, and time to peak among the different lesions were also significant (P < .05). CONCLUSIONS Double-contrast-enhanced sonographic assessment of morphologic enhancement patterns combined with vascularity parameters may help differentiate benign and malignant rectal lesions.
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4.
Decreased procoagulant phospholipids in patients treated by vitamin K antagonists.
Rousseau, A, Woodhams, B, Paunet-Bobo, M, Van Dreden, P, Bigot, D, Leclerc, S, Lenormand, B, Vasse, M
Thrombosis research. 2012;(3):491-4
Abstract
INTRODUCTION The stimulation of cells by thrombin is associated with the release of microparticles (MPs) from cell membranes. These MPs can express procoagulant activity. As vitamin K antagonists (VKA) decrease the generation of thrombin, we compared plasma procoagulant phospholipids (PPL) levels in patients with a previous history of venous thrombosis who were being treated with VKA and compared them with an untreated group. MATERIALS AND METHODS Plasma PPL were measured using a factor Xa-based coagulation assay. sGPV, a marker of platelet activation by thrombin, was measured by ELISA. Platelet MPs were also evaluated using standard flow cytometric techniques. Ninety-six VKA-treated patients and 80 patients not undergoing VKA therapy were tested and the results compared. RESULTS PPL activity was significantly reduced (p<0.0001) in VKA-treated patients compared with the untreated group. PPL were correlated with platelet and white blood cell count and with sGPV levels in the untreated group, but not in VKA-treated patients. PPL were correlated with fibrinogen levels in both groups, but not with C-reactive protein. Polymorphonuclear neutrophils (PMN) were significantly lower (p=0.01) in VKA-treated patients than in untreated patients. CONCLUSION The difference between PPL levels in VKA-treated patients and patients without treatment could be related to the decrease in PMN count. It remains to be established if this decrease of PPL is directly related to the capacity of activated PMN to generate MPs, or indirectly by reducing the amount of pro-inflammatory cytokines or reactive oxygen species produced by PMN.
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5.
Heterogeneous staining in the liver parenchyma after the injection of perflubutane microbubble contrast agent.
Shimada, T, Maruyama, H, Sekimoto, T, Kamezaki, H, Takahashi, M, Yokosuka, O
Ultrasound in medicine & biology. 2012;(8):1317-23
Abstract
This study aimed to characterize the features of heterogeneous staining in the liver after injection of perflubutane microbubble agent (Sonazoid(TM), 0.0075 mL/kg). Digitized hepatic contrast sonograms from 906 subjects were reviewed to assess time-related changes in heterogeneous staining and the possible association between this effect and the clinical backgrounds was analyzed. Heterogeneous staining was found in seven subjects (0.77%) on 15-min phase sonograms. The staining initially appeared as hyper-enhanced circular spots in the liver 10 min or later after the agent injection. The number of spots increased gradually with unequally-spaced distribution. Although the staining pattern did not improve during the examination, there were no abnormal findings in vital signs or symptoms on the day and blood test results or sonograms on the following day. Heterogeneous staining is a side effect that impedes ultrasound examination. However, at present, the precise causes and underlying mechanisms of this event are unknown.
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6.
Therapeutic effect of bezafibrate against biliary damage: a study of phospholipid secretion via the PPARalpha-MDR3 pathway.
Nakamuta, M, Fujino, T, Yada, R, Yasutake, K, Yoshimoto, T, Harada, N, Yada, M, Higuchi, N, Kato, M, Kohjima, M, et al
International journal of clinical pharmacology and therapeutics. 2010;(1):22-8
Abstract
OBJECTIVE Bezafibrate (BF) has been used to treat biliary damage, particularly in patients with primary biliary cirrhosis (PBC), and its clinical efficacy has been demonstrated. The mechanism of action is thought to involve activation of the PPARalpha-MDR3-phospholipid (PL) secretion pathway. We tried to confirm this hypothesis in patients with hepatobiliary disease. METHODS The levels of serum gamma-glutamyl transpeptidase and alkaline phosphatase, and those of bile components were examined before and after BF administration in patients with obstructive jaundice undergoing percutaneous transhepatic biliary drainage (PTBD). Hepatic expression of PPARalpha and MDR3 was quantified by real-time PCR in patients with PBC or non-alcoholic fatty liver disease (NAFLD). RESULTS In patients with obstructive jaundice, BF decreased the serum levels of biliary enzymes and increased the bile concentration of PL. In patients with PBC or NAFLD, the expression levels of MDR3 were already up-regulated before starting the BF treatment. Although BF treatment did not further up-regulate MDR3 expression in NAFLD patients, PPARalpha expression was significantly increased. CONCLUSIONS BF enhanced the secretion of PL into bile in cholestatic patients undergoing PTBD. However, in patients with PBC or NAFLD, diseases that represent cholesterol overload, MDR3 was already expressed at a high level to compensate for bile acids overproduction, and its expression was hardly affected by BF. In patients with chronic liver diseases such as PBC, BF may induce clinical effects via mechanisms independent of PL secretion.
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7.
Positive impact of long-term lifestyle change on erythrocyte fatty acid profile after acute coronary syndromes.
Caspar-Bauguil, S, Garcia, J, Galinier, A, Périquet, B, Ferrières, J, Allenbach, S, Morin, N, Héricotte, P, Salvayre, R, Baudet, M
Archives of cardiovascular diseases. 2010;(2):106-14
Abstract
BACKGROUND The outcome of coronary diseases is influenced by lifestyle and diet. Among dietary factors, n-3 polyunsaturated fatty acids reduce mortality from cardiovascular diseases. AIMS To evaluate the impact of dietary and lifestyle advice by calculation of scores and analysis of plasmatic lipids and the fatty acid composition of erythrocyte membrane phospholipids after 1 year of patient education in 66 patients with acute coronary syndromes. METHODS The answers given by patients during questioning were transformed into scores (atherosclerosis risk, dietary habits and global scores) at inclusion and after 1 year of follow-up. Classical metabolic risk factors and fatty acid composition of erythrocyte phospholipids were determined at the same time. RESULTS After 1 year of education, patients improved their different scores, particularly by changing dietary habits. The positive impact was seen in the blood lipid and erythrocyte fatty acid levels: plasma low-density lipoprotein cholesterol and triglyceride concentrations were lowered and n-3 polyunsaturated fatty acid percentages were improved in phospholipids. CONCLUSION Global score, lipid variables and the nature of the polyunsaturated fatty acids in erythrocyte phospholipids help us to evaluate patients with high coronary artery disease risk and the benefits of long-term dietary and lifestyle advice.
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8.
[A new therapy concept for the treatment of dry eye--the usefulness of phospholipid liposomes].
Lee, S, Dausch, S, Maierhofer, G, Dausch, D
Klinische Monatsblatter fur Augenheilkunde. 2004;(10):825-36
Abstract
BACKGROUND Most of the eye drops currently used replace only the aqueous phase of the tear film. But, due to the fact that, with approximately 80 % of the patients with a dry eye, a disturbance of the lipid phase is present, an approach for new treatment methods needed to be found. We examined a new therapy concept with an eye spray containing liposomes for the therapy of the "dry eye" in a long-term study. GOAL An examination of the effectiveness of a liposome eye spray (TEARS AGAIN, Optima Pharmaceutical GmbH, Germany) in patients with "dry eye" compared with a spray containing a balanced salt solution was carried out. METHODS Between August 2003 and May 2004 a double-blind study with 382 patients was accomplished. The treatment group (V; n = 191) was compared with the control group (K; n = 191) for a period of 6 months regarding the following examination criteria: eyelid edge parallel conjunctival folds (LIPCOF), BREAK UP time (BUT), Schirmer I test, best corrected visual acuity, as well as slit lamp findings of the cornea and conjunctiva. Follow-up was after 4 weeks and 6 months. The statistical analysis was performed with the statistical program SPSS v.11.5. RESULTS The examined parameters such as LIPCOF, BUT and Schirmer were significantly better in the treatment group than in the control group. We found likewise significant improvements of the inflammations of the edge of eyelid with a remarkable decrease of around 89.5 %. Questioning of the patients resulted in, among other things, the belief that the liposome eye spray led altogether to a clear subjective improvement of the symptoms in 72 % of the cases, although an initial burning sensation was mentioned after the application. All patients were of the opinion that application with a spray is more favourably and more pleasant than teardrops. CONCLUSION The liposome tear substitute shows statistically significant advantages against a balanced salt solution. This new liposome eye spray represents a new, revolutionary and effective procedure in the therapy of the "dry eye". Considering the disturbance of the lipid phase in 80 % of the patients, TEARS AGAIN ought to be a first choice treatment.
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9.
The effects of anionic and zwitterionic phospholipids on the tear film lipid layer.
Korb, DR, Greiner, JV, Glonek, T
Advances in experimental medicine and biology. 2002;(Pt A):495-9
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10.
Fatty acid profile of skeletal muscle phospholipids in trained and untrained young men.
Andersson, A, Sjödin, A, Hedman, A, Olsson, R, Vessby, B
American journal of physiology. Endocrinology and metabolism. 2000;(4):E744-51
Abstract
Endurance trained (n = 14) and untrained young men (n = 15) were compared regarding the fatty acid profile of the vastus lateralis muscle after 8 wk on diets with a similar fatty acid composition. The skeletal muscle phospholipids in the trained group contained lower proportions of palmitic acid (16:0) (-12.4%, P < 0.001) and di-homo-gamma-linolenic acid [20:3(n-6)] (-15.3%, P = 0.018), a lower n-6-to-n-3 ratio (-42.0%, P = 0.015), higher proportions of stearic acid (18:0) (+9.8%, P = 0.004) and sum of n-3 polyunsaturated fatty acids (+33.8%, P = 0.009), and a higher ratio between 20:4(n-6) to 20:3(n-6) (+18.4%, P = 0.006) compared with those in the untrained group. The group differences in 16:0, 20:3(n-6), 18:0/16:0, and 20:4(n-6)/20:3(n-6) were independent of fiber-type distribution. The trained group also showed a lower proportion of 16:0 (-7.9%, P < 0.001) in skeletal muscle triglycerides irrespective of fiber type. In conclusion, the fatty acid profile of the skeletal muscle differed between trained and untrained individuals, although the dietary fatty acid composition was similar. This difference was not explained by different fiber-type distribution alone but appears to be a direct consequence of changes in fatty acid metabolism due to the higher level of physical activity.