Heparin-associated thrombocytopenia and thrombosis as the cause of a fatal thrombus on extracorporeal membrane oxygenation.

A rare state of acquired hypercoagulability known as heparin-associated or heparin-induced thrombocytopenia and thrombosis (HATT, HITT) exists. It appears to be caused by an antibody reaction with heparin-platelet factor 4 complexes. A mild and severe form exist, but both varieties occur after exposure to heparin. The authors describe a fatal neonatal case of hypercoagulability on extracorporeal membrane oxygenation, and their evaluation that determined the etiology as type II HATT. They discuss the pathophysiology of HATT as well as possible alternative anticoagulation approaches.

Dermal absorption of three waterborne chloroethanes in rainbow trout (Oncorhynchus mykiss) and channel catfish (Ictalurus punctatus).

In vivo estimates of xenobiotic chemical flux across the dermal surface of intact fish were obtained by measuring chemical loss from venous blood to expired water. An experimental system was developed to separate the dermal route of exposure from all other routes. The system was then used to measure dermal absorption of tetrachloroethane (TCE), pentachloroethane (PCE), and hexachloroethane (HCE) in channel catfish (Ictalurus punctatus) and rainbow trout (Oncorhynchus mykiss), two fish with very different skin anatomies. The kinetics of accumulation varied among chemicals, but for each compound were similar among species. TCE accumulated rapidly, reaching steady state in blood within 48 hr. Steady state was not reached in 48 hr with PCE or HCE, although blood levels of PCE were probably close to steady-state values. Dermal flux estimates (based on branchial efflux) for TCE, PCE, and HCE were two to four times greater in catfish than in trout. Arterial blood concentrations of each compound were three to six times greater in catfish. These observations are indicative of greater flux across catfish skin, augmented by higher blood:water chemical partitioning. Trout skin is covered with scales and has no taste buds, while catfish skin does not possess scales and has numerous taste bud papillae. Both scales and taste bud papillae originate in the dermis and extend to the skin surface through the epidermis. In catfish these taste buds may offer channels through which chemicals diffuse across the epidermis to the more vascularized dermis. A comparison of dermal and branchial uptake was made by estimating zero-time dermal and branchial fluxes for all three chloroethanes. The mean dermal fluxes for TCE, PCE, and HCE ranged from 1.4 to 2.8, 1.8 to 3.6, and 1.4 to 3.2% of the total flux (branchial plus dermal) in rainbow trout and channel catfish, respectively. This research demonstrates that dermal absorption of waterborne chemicals occurs in large adult fish and results in distribution kinetics similar to those observed in inhalation exposures. Compared to branchial uptake, the dermal route of exposure appears to be relatively unimportant in large fish. It may, however, be very important in smaller fish and for juveniles of larger species.

Oocyte atresia and reproductive success in fathead minnows (Pimephales promelas) exposed to acidified hardwater environments.

The ovarian histology of fathead minnows (Pimephales promelas) chronically exposed to three levels of environmental pH was examined for evidence of reproductive impairment. Exposures occurred in three experimental running-water channels receiving Mississippi River water. One of these channels was not acidified and two were dosed with H2SO4. The pH was approximately 8 in untreated river water and 6 and 5 in the two channels receiving H2SO4. Fish for ovarian examination were taken from these channels at four stages of the reproductive season: initiation of spawning (June 19), mid-spawning (July 12), end of spawning (August 14-15), and approximately 1 mo. post-spawning (September 19). The fish exhibited ovarian histological changes and depression of reproductive success which were directly associated with the level of environmental stress experienced. The association between these three factors was most consistent and pronounced if the fish were sampled near the end of the spawning season. When sampled at this time, reproductive impairment in a population was found when the ratio of the volume of atretic (resorbing) oocytes present in the ovary to the total ovarian volume exceeded 20% in all fish sampled. This was the case in the pH 5 channel fish sampled in August. At this same time, not all of the fish in the pH 6 channel exhibited such an accumulation of atretic oocytes, and egg deposition in that population was not reduced. None of the fish from the pH 8 channel were so affected nor was their reproduction.

Cemental annulation enhancement: a technique for age determination in man.

Cemental annulations are easily countable in teeth from animals that have an exaggerated regular change of food intake from season to season. Although present in human teeth, cemental annulations are not always easy to count. A method for preparing human teeth for evaluation involving collection, identification, measuring, sectioning, cleaning, acid etching, staining, and mounting is reported. Sections 100-microns thick were stained with cresyl fast violet as a stain of choice and were photographed using standard light microscopic techniques as well as Nomarsky interference microscopy. Countability of annulations from photographic enlargements was evaluated.