Spontaneous recanalization in deep venous thrombosis: a prospective duplex ultrasound study.

AIM: The aim of this study was to evaluate the dynamics of the recanalization process (spontaneous fibrinolysis) in completely occlusive deep venous thrombosis (DVT) using duplex ultrasound examination and to investigate the influence of different factors on the evolution of thrombus regression. METHODS: This longitudinal prospective study was done with 74 consecutive patients with completely occlusive acute multilevel DVT, confirmed by echo duplex scan after 1, 3, 6, and 12 months. At each re-evaluation, the degree and the type of recanalization were determined. Efficacy of tinzaparin (175 IU/kg, s.c., q.d. for 7-14 days) and continued with warfarin (12 months at INR 2-3) as well as patients' compliance with compressive elastic hosiery wearing were carefully followed. Relationship between the degree and pattern of recanalization and patients' age, gender, as well as thrombosis etiology and location were determined. RESULTS: Sixty-four patients completed the study. The mean recanalization rate was 39.7% at 1, 64.8% at 3, 82% at 6, and 90.3% at 12 months. Marginal recanalization was more frequently observed, but recanalization pattern was changing during follow-up. CONCLUSIONS: In the case of efficient anticoagulant and compressive therapy, the spontaneous recanalization process of DVT is important from the very first month of evolution, but an almost complete re-permeabilization is observed only after 12 months of treatment. The unilocular, marginal pattern of thrombus lysis is often observed and has better evolution than the multilocular cavernous one. The dynamics of recanalization are characterized by distal-to-proximal extension and in the first 6 months are significantly influenced by patient's gender and thrombosis etiology.

Experimental oral anticoagulation by a directly acting thrombin inhibitor (RGH-2958).

D-Phenylalanyl-L-prolyl-L-arginine aldehyde sulfate (RGH-2958), a directly acting synthetic thrombin inhibitor proved to be effective by experimental oral application. The rapid onset of its action has a special importance both from theoretical and practical point of view. Its antiplatelet effect relates to thrombin induced PA and runs parallel with the anticoagulant effect. RGH-2958 significantly reduced the thrombus weight in an experimental thrombosis model in rabbits. In the light of the therapeutic indices of the compound there is a real possibility to open a third way in the prevention and therapy of thrombosis.

The preparation and properties of a highly specific antiserum elicited with 3-dehydrocholylglycine 3-succinyl-bovine serum albumin conjugate.

This report describes the synthesis of a new cholylglycine derivative-bovine serum albumin conjugate. The hapten is linked to the carrier protein at the C-3 position, through a hemisuccinate bridge. Antiserum elicited by this antigen is highly specific to cholylglycine. Cross-reactions with free cholic acid (less than 0.1%) or cholyltaurine (0.5%) are minimal.

Production and properties of antiserum for radioimmunoassay of serum conjugated chenodeoxycholic acid and its preliminary application.

Sensitive tritiated radioimmunoassay was developed for conjugated chenodeoxycholic acid, using immunogen prepared by the mixed anhydride method. The obtained molar bile salt-BSA ratio in the immunogen was 19:1. The distinguishing features of the immunization procedure were a preliminary vaccination of the animal with antitubercular vaccine (VDS), and the administration of very small doses of immunogen (50 micrograms). Assay sensitivity for this bile salt fell in the picomole range with the standard curve extending from 1.5 to 150 pmol. Specificity of the antiserum was compared with that of the commercially available "Glycochenodeoxycholic acid RIA kit" (Nordiclab Oy, Oulu, Finland), and proved to be satisfactory. Fasting serum conjugated chenodeoxycholic acid concentration in 25 healthy subjects and 15 patients with cirrhosis was 0.63 mumol/l and 43.05 mumol/l, respectively. The assay was performed on unextracted sera.

Capillary gas chromatographic studies of cholesterol biosynthesis in rats treated with EGYT-1299.

Cholesterol and desmosterol concentrations were assayed by high-performance capillary gas chromatography. It was established that no toxic desmosterol accumulation occurred either in the serum or liver of rats receiving EGYT-1299 treatment. Desmosterol accumulation induced by triparanol was reduced by the agent at doses ten times lower than Atromid S; consequently its cholesterol lowering effect may be attributed to interference with cholesterol biosynthesis.