A thromboembolic event in patients later given a diagnosis of cancer is the result rather than the cause of the cancer. The risk of hidden cancer is significantly higher for patients with recurrent idiopathic thromboembolism compared to those with secondary deep vein thrombosis. Microemboli from hepatic or adrenal metastases and large-sized emboli from the great veins invaded by the tumor are the sources of tumor embolization. The intraarterial tumor emboli less likely invade the arterial wall. Thrombus formation and organization may be capable of destroying tumor cells within pulmonary blood vessels. Therefore, all tumor emboli are not true metastases. The treatment of deep vein thrombosis and pulmonary embolism in patients with cancer consists of anticoagulation with heparin and warfarin, venacaval filters, appropriate anti-neoplastic agents, and surgical methods(embolectomy, thromboendarterectomy). However, considerable literatures suggest that oral anticoagulant such as warfarin is ineffective in the treatment of those. We report a case of primary unknown squamous cell carcinoma incidentally found in the thrombus after pulmonary embolectomy.
Blood Vessels ; Carcinoma, Squamous Cell* ; Diagnosis ; Embolectomy* ; Heparin ; Humans ; Neoplasm Metastasis ; Pulmonary Embolism ; Thromboembolism ; Thrombosis* ; Veins ; Venous Thrombosis ; Warfarin

OBJECTIVETo establish a modified plasma protamine paracoagulation test.

METHODSPlasma protamine paracoagulation, modified plasma protamine paracoagulation and D-dimer (D-D) tests were performed for the plasma samples collected from 98 cases of disseminated intravascular coagulation (DIC) and 156 normal subjects. The sensitivity and specificity of the 3 tests were analyzed. The plasma samples from 8 cases of suspected myocardial infarction were detected using modified plasma protamine paracoagulation for diagnostic purpose.

RESULTSThe sensitivity of plasma protamine paracoagulation, modified plasma protamine paracoagulation and D-D tests was 16.33%, 88.76% and 77.56%, and the specificity was 100%, 88.46% and 97.44%, respectively. Positive results occurred earlier in modified plasma protamine paracoagulation test than in plasma protamine paracoagulation and D-D tests in 5 cases of myocardial infarction.

CONCLUSIONThe modified plasma protamine paracoagulation test has a higher sensitivity than plasma protamine paracoagulation test and a higher specificity than D-D test, and can be helpful in early diagnosis of thrombosis and fibrinolysis.

Adult ; Blood Coagulation Tests ; methods ; Female ; Humans ; Male ; Middle Aged ; Protamines ; blood ; Sensitivity and Specificity ; Thrombosis ; blood ; diagnosis

Blood Coagulation Factors ; analysis ; Evidence-Based Medicine ; Hematologic Tests ; methods ; Hemostatic Techniques ; Humans ; Thrombosis ; diagnosis

Deep venous thrombosis (DVT) is one of the most common complications after total joint replacement, which is also one of the most concerned problems for clinicians. Domestic research data shows that the incidence of DVT in patients without thrombotic prophylaxis after joint replacement surgery are 20.6%-40.0%. The occurrence mechanism of DVT is explained by the Virchow theory, that is blood stasis, the blood vessel wall damage and blood coagulation state. The diagnostic rate of DVT is not satisfactory. The diagnosis of symptomatic DVT depends mainly on clinical symptoms and auxiliary examination. The diagnosis of asymptomatic DVT is mainly based on the auxiliary examination. The prevention and treatment of DVT after artificial joint replacement is currently mainly concentrated in the aspects of new oral anticoagulant agents, drug prevention method, and time limit.
Anticoagulants ; therapeutic use ; Arthroplasty, Replacement ; adverse effects ; Blood Coagulation ; Humans ; Incidence ; Venous Thrombosis ; diagnosis ; therapy

Patients with diabetes mellitus (DM) are associated with an increased risk of thrombosis, and are susceptible to a series of complications including nephropathy. It has also been known that plasma tissue factor (TF) antigen levels increase significantly in certain disease states. To investigate the clinical significance of an association with the various complications in patients with type 2 non-insulin-dependent DM (NIDDM), we measured the plasma levels of TF antigen in 63 patients (35 males and 28 females, mean age 60.8 yrs) with NIDDM and in 22 normal subjects (14 males and 8 females, mean age 56.0 yrs). The mean concentrations of TF were higher for patients with NIDDM (253.7 +/- 144.9 pg/ml) than in normal subjects (187.3 +/- 108.7 pg/ml with marginal statistical significance (p= 0.0530). The TF levels were higher for patients with a nephropathy than for patients without a nephropathy (p=0.0402). There was a significant positive correlation between levels of TF and BUN (r=0.84, p < 0.0001) or creatinine (r=0.93, p < 0.0001). However, TF levels were found to be similar for both groups with and without thrombosis, neuropathy, retinopathy, or infection. These results suggest that plasma TF antigen levels may be associated with nephropathy and they may reflect a renal dysfunction in NIDDM.
Biological Markers ; Diabetes Mellitus, Type II/*blood/*diagnosis ; Diabetic Nephropathies/blood/diagnosis ; Diabetic Retinopathy/blood/diagnosis ; Female ; Human ; Infection/blood/diagnosis ; Male ; Middle Aged ; Support, Non-U.S. Gov't ; Thromboplastin/*metabolism ; Thrombosis/blood/diagnosis

We experienced a case of acute cerebral infarction during spinal anesthesia. The patient was a seventy years old male with diagnosis of right femur periprosthetic fracture scheduled for a open reduction & internal fixation under spinal anesthesia. Intraoperatively, he developed a mental confusion and his blood pressure decreased from 115/70 mmHg to 80/45 mmHg. After operation, he appeared to have left hemiparesis and left facial palsy. Angiogram revealed thrombus in superior division of the right middle cerebral artery. He expired 3 months after the surgery despite supportive measures.
Anesthesia, Spinal* ; Blood Pressure ; Cerebral Infarction ; Diagnosis ; Facial Paralysis ; Femur ; Humans ; Male ; Middle Cerebral Artery ; Paresis ; Periprosthetic Fractures ; Thrombosis

Angiomatous nasal polyps are a rarely reported subtype of inflammatory sinonasal polyps that are characterized by extensive vascular proliferation and ectasia. The blood vessels present in these sinonasal polyps may be subjected to compromise at certain areas within the nasal cavity, leading to venous stasis, thrombosis and infarction. Recently, we experienced a case of angiomatous nasal polyp that caused significant diagnostic difficulty at the time of her presentation in a 12-year-old girl. Although entirely benign, angiomatous nasal polyps may simulate neoplastic process, thus awareness of their existence is of considerable importance. Especially, differential diagnosis between angiomatous polyp and angiofibroma is important for evaluation and treatment. In the present paper, the clinical, radiological and pathological features of angiomatous nasal polyps is also discussed.
Angiofibroma ; Blood Vessels ; Child ; Diagnosis, Differential ; Dilatation, Pathologic ; Female ; Humans ; Infarction ; Nasal Cavity ; Nasal Polyps* ; Polyps ; Thrombosis

OBJECTIVE: To explore the predictive value of four items of new thrombus markers combined with conventional coagulation tests for thrombosis in antiphospholipid syndrome. METHODS: A total of 121 antiphospholipid syndrome (APS) patients who hospitalized at Peking University People's Hospital from March 2022 to January 2023 were selected and divided into thrombus group (50 cases) and nonthrombus group (71 cases) according to whether thrombosis occurred. The differences of laboratory characteristics including antiphospholipid antibodies were compared between the thrombotic and non-thrombotic groups. Chemiluminescent immunoassay was used to detect thrombomodulin (TM), thrombin-antithrombin complex (TAT), Plasmin-α2 plasmin inhibitor complex (PIC), and tissue plasminogen activator inhibitor complex (t-PAIC) in plasma from venous. The independent risk factors of thrombosis in patients with APS were determined using binary Logistic regression. Receiver operating characteristic (ROC) curve analysis was applied to evaluate the efficacy of each index on the prediction of thrombosis. RESULTS: Compared with the patients without thrombosis, the patients with thrombosis were older [49 (32, 64) years vs. 36 (32, 39) years, P < 0.05]. The percentages of male, smoking, hypertension, and global antiphospholipid syndrome score (GAPSS)≥10 in the patients with thrombosis were significantly higher than those in the patients without thrombosis (P < 0.05). The positive rates of anticardiolipin antibody (aCL) and lupus anticoagulant (LA) in the thrombotic group were significantly higher than those in the non-thrombotic group (P < 0.05), and the levels of prothrombin time, activated partial thromboplastin time, fibrinogen, fibrin degradation product in the thrombotic group were significantly higher than those in the non-thrombotic group (P < 0.05).Among the thrombosis group, venous thrombosis accounted for 19 (38.00%), including deep vein thrombosis (16, 84.21%) and pulmonary embolism accounted (5, 26.32%); Arterial thrombosis accounted for 35 (70.00%), including myocardial infarction (6, 17.14%) cerebral infarction (30, 85.71%). The patients in the thrombotic group had significantly greater TM levels than those in the non-thrombotic group (P < 0.05).There were no significant dif-ferences between the two groups in TAT (Z=-1.420, P=0.156), PIC (Z=-0.064, P=0.949), and t-PAIC (Z=-1.487, P=0.137). Univariate and binary Logistic regression analysis of relevant variables showed that advanced age [OR=1.126, P=0.002], elevated TM [OR=1.325, P=0.048], prolonged prothrombin time (PT) [OR=4.127, P=0.008] were independent risk factors for thrombosis in the patients with APS. ROC curve analysis of the above three independent risk factors showed that the combined detection of age, PT and TM had the highest Yoden index (0.727) and sensitivity (83.0%), with a specificity of 89.7%. CONCLUSION TAT, PIC, TM, and t-PAIC may reflect thrombus formation from the coagulation system, fibrinolysis system, and endothelial system. The combined of age TM and PT is superior to the application of a single marker, which has diagnostic value for the early identification of APS thrombosis.
Humans ; Male ; Antiphospholipid Syndrome/diagnosis* ; Tissue Plasminogen Activator ; Thrombosis/etiology* ; Antibodies, Antiphospholipid/analysis* ; Blood Coagulation Tests/adverse effects*

Diagnostic Errors ; Female ; Humans ; Hysterectomy ; Leiomyoma ; diagnosis ; surgery ; Middle Aged ; Tomography, X-Ray Computed ; Ultrasonography ; Uterine Neoplasms ; diagnosis ; surgery ; Uterus ; blood supply ; diagnostic imaging ; Venous Thrombosis ; diagnosis ; surgery

PURPOSE: Behcet's disease, distinguished by the triad of chronic oral aphthae, recurrent genital ulcers and uveitis, is a chronic, relapsing systemic disease. Vascular complications occur in 7~29% of Behcet's patients and are the most common causes of death. Consequently, vascular surgeons should be familiar with the vascular manifestations in Behcet's disease. METHOD: Between October 1994 and July 2002, we retrospectively reviewed 779 patients diagnosed with Behcet's disease in Samsung Medical Center. RESULT: Thirty cases of the 779 patients had vascular manifestations. Male to Female ratio was 25 (83.3%) to 5 (16.7%). In age distribution, males were most frequent in their 30s, while females were equally distributed. Arterial involvement occured in 10 cases (33.3%), venous involvement in 16 (53.3%) and combined arterial and venous involvement in 4 (13.3%). As for arterial manifestations, arterial occlusion occured in 7 cases, aneurysm in 5 and pseudoaneurysm in 4. Venous manifestations were all deep vein thrombosis (DVT). Iliofemoral vein DVT occured in 14 cases, IVC thrombosis in 5, and renal vein thrombosis in 1. Surgical treatment was performed in 5 cases; one primary repair and one arterial ligation were done in 2 cases of pseudoaneurysm, two combined aneurysmal resection and bypass in 2 cases of aneurysm, and one bypass in 1 case of arterial occlusion. Radiologic intervention was done in 5 cases. Stent graft insertion was performed in 2 cases, combined thrombolysis and percutaneous transluminal angioplasty in 1 case, occluder balloon in 1 case, and inf. vena cava filter insertion in 1 case. CONCLUSION: Behcet's disease is a chronic and systemic disease that may involve multiple organs. Because of vascular involvements, in particular the high fatality of arterial complications in Behcet's disease, we must always perform early diagnosis, proper clinical intervention and continuous follow up.
Age Distribution ; Aneurysm ; Aneurysm, False ; Angioplasty ; Blood Vessel Prosthesis ; Cause of Death ; Early Diagnosis ; Female ; Follow-Up Studies ; Humans ; Ligation ; Male ; Renal Veins ; Retrospective Studies ; Stomatitis, Aphthous ; Thrombosis ; Ulcer ; Uveitis ; Veins ; Vena Cava Filters ; Venous Thrombosis