Thrombin-activatable fibrinolysis inhibitor in breast cancer patients.

OBJECTIVE: To evaluate the levels of thrombin-activatable fibrinolysis inhibitor (TAFI) activity and also its relationship with other homeostasis markers in breast cancer patients. SUBJECTS AND METHODS: Forty-two female patients with breast cancer and 24 healthy women (controls) were enrolled in the study and fasting blood samples of all cases were drawn from a large antecubital vein for assay of TAFI and other homeostasis tests. RESULTS: The TAFI levels were 79.5 ± 15.5 and 39.3 ± 12.1 in patients and controls, respectively, and the difference was statistically significant (p < 0.001). In the patient group, the serum fibrinogen level was 504.9 ± 224.8, while in the control group it was 393.9 ± 100.5, and the difference was also statistically significant (p < 0.001). CONCLUSION: The data showed that increased levels of TAFI are a contributing factor of thrombotic disorders in breast cancer patients.

Influence of chemical treatments on adhesion properties of hemp fibres.

In addition to be an environmentally friendly material, hemp fibres are also inexpensive reinforcements in thermoplastics or concrete composites, due to their intrinsic mechanical, thermal and acoustic properties. The morphology of hemp fibres has been chemically modified in order to enhance the matrix/fibre interface and has been examined by Scanning Electron Microscopy (SEM). In this paper, Gas Chromatography (GC) and Atomic Force Microscopy (AFM) were used to investigate the influence of treatments on the composition of hemp fibres and also on the micro-adhesive interactions between a silica colloidal probe and the surface of the fibres using Chemical Force Microscopy (CFM). Microscopy studies and chemical analysis showed that each treatment tends to lead to a morphology of interconnected web-like structure of hemp fibres. It was found that on an average, the adhesion force, contribution of capillary force and Van der Waals' forces, is higher in the case of NaOH treatment.

Elevated concentrations of soluble adhesion molecules and large platelets in diabetic patients: are they markers of vascular disease and diabetic nephropathy?

P-selectin, E-selectin, and mean platelet volume are markers associated with platelet reactivity that have been demonstrated to be increased in diabetes. We were particularly interested to see if there was a difference in mean platelet volume and selectins between diabetics and nondiabetics, and in diabetics with and without nephropathy, and whether there was a correlation between mean platelet volume and selectins. One hundred and fourteen diabetic patients and 31 healthy controls were investigated. Plasma levels of P-selectin and E-selectin were higher in the diabetic group than in controls (P = .001 and P = .007, respectively) and in diabetic patients with proteinuria than in patients without proteinuria (P = .002 and P = .004, respectively). Protein excretion was lower in patients with low mean platelet volume values (P = .004). In conclusion, elevated platelet volume and high selectin values may play a role in the development of vasculopathies and complications in diabetes mellitus. Further studies are needed to prove these results.

Plasma levels of thrombin-activatable fibrinolysis inhibitor in primary and secondary thrombocytosis.

An elevated platelet count is a common finding in both hospitalized and ambulatory patients. Thrombosis and bleeding complications are more frequently observed in patients with clonal thrombocytosis than secondary thrombocytosis. The aim of this study was to investigate the behaviors of thrombin-activatable fibrinolysis inhibitor (TAFI) activity, the inhibitor of fibrinolysis, and also prothrombin time (PT), active partial thromboplastin time, and D-dimer and fibrinogen levels in 21 patients affected with clonal thrombocytemia as compared with 21 patients with reactive thrombocytosis and 21 healthy controls. In the clonal thrombocytemia group, plasma levels of TAFI activity were significantly higher than in both the reactive thrombocytosis and the control group. Plasma levels of leukocyte and platelet counts were significantly higher in the clonal thrombocytemia group than in the other two groups and also higher in the reactive thrombocytosis group than in the control group, which was also significant. Fibrinogen and D-dimer levels were higher in patients than in the control group but showed no significant difference between the clonal and secondary thrombocytosis groups. Plasma levels of PT and aPTT were higher in secondary thrombocytosis group than the clonal thrombocytosis group. The results of this study showed for the first time that TAFI activity is increased in patients with clonal thrombocytosis. These increased levels in clonal thrombocytosis can be considered a factor to explain the thrombotic tendency in myeloproliferative disorders.

Coronary artery disease and infection with chlamydia pneumonia.

The association between chlamydia pneumonia and coronary artery disease is well documented, however less is known about the correlation between chlamydia pneumonia infection and blood inflammatory markers or lipid levels. In 100 patients with proven coronary artery disease (25 females, 61.0 +/- 4.0 years old), and 60 healthy volunteer control cases (15 females, 60.6 +/- 3.4 years old), anti chlamydia pneumonia IgG, blood lipid, C-reactive protein and fibrinogen levels were detected. In cases with coronary artery disease seropositivity for IgG antibodies to chlamydia pneumonia (74% versus 34%, p < 0.0001), C-reactive protein (mg / l) (2.8 +/- 0.6 versus 1.4 +/- 0.6; p < 0.0001), fibrinogen (mg / dl) (317.4 +/- 38.2 versus 256.2 +/- 34.5, p < 0.0001), triglyceride (mg / dl) (217.5 +/- 39.0 versus 191.0 +/- 25.9, p < 0.0001), LDL-cholesterol (mg / dl) (126.9 +/- 19.2 versus 110.6 +/- 19.5, p < 0.0001) levels and total cholesterol / HDL-cholesterol ratio (7.7 +/- 1.8 versus 4.4 +/- 1.2, p < 0.0001) were higher but the level of HDL-cholesterol (mg / dl) (26.4 +/- 6.7 versus 47.0 +/- 11.2, p < 0.0001) was lower. The levels of total cholesterol did not differ between the two groups (p=0.9). Levels of triglyceride (r=0.60, p < 0.00001), LDL-cholesterol (r = 0.27, p = 0.0004), C-reactive protein (r = 0.69, p < 0.00001), fibrinogen (r = 0.60, p < 0.00001) and total cholesterol / HDL-cholesterol ratio (r = 0.74, p < 0.00001) had a direct relation, but the level of HDL-cholesterol had a negative (r= -0.80, p < 0.00001) relation with the seropositivity for chlamydia pneumonia. As a result, seropositivity for IgG antibodies to chlamydia pneumonia is considered as a risk factor for coronary artery disease by its association with the atherogenic lipid profile and procoagulant activity.

QT intervals and heart rate variability in hypertensive patients.

Low heart rate variability and increased QT dispersion are risk factors for cardiac mortality in various patient populations. We studied dispersion of QT interval, i.e. an index of inhomogeneity of repolarization, and heart rate variability (HRV) i.e., a measure of cardiac autonomic modulation in 76 essential hypertension cases (45 women, 53.0 +/- 11.1 years, body mass index: 25.1 +/- 1.4 kg/m2) and 70 healthy cases (42 women, 54.0 +/- 10.2 years, body mass index: 25.5 +/- 1.6 kg/m2, p > 0.05). QT-corrected QT intervals and their dispersions were significantly higher in the hypertensive group (p < 0.0001), all showing a direct relation with the level of systolic and diastolic blood pressures, ventricular mass index and high Lown grade ventricular rhythm problems. Time domain measures like standard deviation of RR intervals, standard deviation of the means of all corrected RR intervals calculated at 5 min intervals (p < 0.0001), proportion of adjacent RR intervals differing by > 50 msec (p = 0.005), HRV triangular index (p = 0.007), the square root of the mean squared differences of successive RR intervals (p = 0.011), and the high frequency (HF, 0.16-0.40 Hz, p < 0.0001) part of the frequency domain measure of HRV were all decreased, whereas the low frequency (LF, 0.04-0.15 Hz, p = 0.013) part of the frequency domain measures and LF / HF ratio (p < 0.0001) were increased in hypertensive cases. Time domain and the HF part of frequency domain measures of heart rate variability showed an inverse relation with the increased levels of both systolic and diastolic blood pressures and Lown grading system of ventricular rhythm problems, whereas LF and LF / HF showed direct relations with high levels of systolic and diastolic blood pressures and high Lown grade ventricular rhythm problems. The measures of heart rate variability apart from LF and LF / HF were inversely related with the QT intervals and dispersions, whereas LF / HF was directly related with them. Therefore, we conclude that the levels of both systolic and diastolic blood pressures are related to the generation of ventricular rhythm problems either via increasing left ventricular mass which results in an increase in QT parameter measurements, or by altering heart rate variability measures indicating a disturbance in cardiac autonomic balance in essential hypertension.

Markers of chronic infection and inflammation. Are they important in cases with chronic coronary heart disease.

The human cytomegalovirus plays a causal role in atherosclerosis etiology, but it is discussed as controversial. We conducted a case control study to investigate whether previous infection with cytomegalovirus is associated with coronary heart disease and markers of systemic inflammation, because systemic inflammation may play a role in atherosclerosis too. We also studied the correlation between anti-cytomegalovirus antibody titer and coronary artery disease. The study involved 150 cases (45 females, mean age +/- SD is 58.73 +/- 7.68 years) with a documented coronary heart disease and 160 healthy volunteers (50 females, mean age +/- SD is 57.82 +/- 7.68, p > 0.05). Cytomegalovirus serology was performed to determine the presence of specific IgG antibodies and titers of the anti-cytomegalovirus IgG antibodies. In addition, C-Reactive protein levels were determined for each case. The prevalence of specific antibodies to cytomegalovirus was 57.30% for the patients and 56% for the controls (p = 0.39). But higher levels of anti-cytomegalovirus IgG antibody titer (> 1/800) were seen in the patient group (28.6% versus 10%, p = 0.0000). Mean value of C-reactive protein was higher in the patient group (2.99 +/- 0.92 mg/l versus 1.79 +/- 0.51 mg/l, p = 0.0000), and there was a linar correlation with the high antibody titers and the level of C-reactive protein (r = 0.35, p = 0.0000) These findings support that not the seropositivity of the population but rather the titer of anti-cytomegalovirus antibody and the levels of C-reactive protein could predict patients with a high risk of coronary heart disease.