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β-THROMBOGLOBULIN LEVELS IN POSTOPERATIVE DEEP-VEIN THROMBOSIS
1427
surgery
surgery
’
Levels of &bgr;-TG in saliva after hip surgery.
DURING
PRE
Cyclosporin A dose and
serum
trough levels before,
POST
during and after
period of hyperbilirubinaemia.
Two patients had episodes of hyperbilirubinaemia lasting 6 days. These were divided into three 2 day periods, for which average bilirubin, CyA dose, and trough levels were calculated.
2 h post dose
levels greater than 400 and 1000 ng/ml, respectively. This does not mean that high CyA levels always cause hyperbilirubinaemia. However, it does suggest that episodes of hepatotoxicity can be reduced by maintaining CyA serum levels within this therapeutic/toxic range. We are taking part in the Canadian Multicentre Transplant Group trial of two hundred and seventy patients, comparing CyA with standard therapy for renal transplantation; data from that study may permit more definitive
CyA
analysis. A. L. is
a
samples
collected from
patients before and
a
0
a
surgery
POST-OPERATIVE DAY
Medical Research Council Fellow.
Nephrology and Transplantation Unit, Department of Medicine, University Hospital, University of Western Ontario, London, Ontario, Canada
A. LAUPACIS P. A. KEOWN R. A. ULAN N. R. SINCLAIR C. R. STILLER
overcomes
many of the
problems associated with the measurement
of &bgr;-TG in plasma.5 Since this protein is present in body fluids other than blood and urine,we have investigated &bgr;-TG levels in saliva as a possible means of detecting DVT. Saliva samples were obtained from patients before and after hip surgery, and the &bgr;-TG content was measured by radioimmunoassay. Ascending percutaneous phlebography was done 7-10 days after the operation. In four of the ten patients investigated no recent thrombi were detected on phlebography and the other six patients had evidence of fresh calf vein thrombosis. In three of the patients without DVT the salivary &bgr;-TG levels remained near the preoperative levels through the postoperative period (see figure, patients 1-3), and in the other high value was obtained on a single occasion postoperatively (patient 4). In the six patients with evidence of fresh thrombosis salivary &bgr;-TG levels were more persistently raised after hip surgery (patients 5-10). These preliminary findings suggest that a moreextensive investigation is indicated in the various groups of patients at risk of developing venous thromboembolism. Department of Medical Electronics, St Bartholomew’s Hospital, EC 1
E.D. COOKE
Department of Biochemistry, North East London Polytechnic
A. E. BOLTON
Department of Orthopaedics, The London Hospital, E1
B. LEVACK
&bgr;-THROMBOGLOBULIN LEVELS IN POSTOPERATIVE DEEP-VEIN THROMBOSIS
SIR,—There is a high incidence of deep-vein thrombosis (DVT) after hip arthroplasty,1-3 and we have found that measurement of the platelet-specific protein &bgr;-thromboglobulin (&bgr;-TG) in urine is a useful means of screening postoperative patients for DVTand 1.
Coventry MB, Declan RN, Beckenbaugh RD. "Delayed" prophylactic coagulation: a study of results and complications in 2012 total hip arthroplasties. J Bone Joint Surg
1973; 55A: 1487-92. 2. Cooke ED, Pilcher MF. Deep vein thrombosis: Preclinical diagnosis by thermography. Br J Surg 1974; 61: 971-78. 3. Cooke ED, Gordon YB, Bowcock SA, Sola CM, Pilcher MF, Chard T, Ibbotson RM, Ainsworth ME. Serum fibrin(ogen) degradation products in diagnosis of deep vein thrombosis and pulmonary embolism after hip surgery. Lancet 1975; ii: 51-54. 4. Bolton AE, Cooke ED, Lekhwani CP, Bowcock SA. Urinary &bgr;-thromboglobulin levels as a diagnostic marker for post-operative deep vein thrombosis. Thrombos Res 1980; 19: 249-55.
HEPATITIS A VIRUS AMONG CAPTIVE PANAMANIAN OWL MONKEYS
SIR,—Infectious hepatitis due to hepatitis A virus (HAV) has long been recognised as a major cause of human morbidity. However, research has, until recently, been hampered by the lack of both a simple assay to detect viral antigen and antibody and a readily available laboratory animal model. We describe here a sustained outbreak of HAV in a colony of owl monkeys (Aotus trivirgatus) at CA, Cash JD. Studies on the liberation of &bgr;-thromboglobulin from human 1976; 33: 239-47. J platelets in vitro. Br Haematol Dawes J, Smith RC, Pepper DA. The release, distribution and clearance of human &bgr;-thromboglobulin and platelet factor 4. Thrombos Res 1978; 12: 851-61.
5. Ludlam 6.
surgery
surgery
’
Levels of &bgr;-TG in saliva after hip surgery.
DURING
PRE
Cyclosporin A dose and
serum
trough levels before,
POST
during and after
period of hyperbilirubinaemia.
Two patients had episodes of hyperbilirubinaemia lasting 6 days. These were divided into three 2 day periods, for which average bilirubin, CyA dose, and trough levels were calculated.
2 h post dose
levels greater than 400 and 1000 ng/ml, respectively. This does not mean that high CyA levels always cause hyperbilirubinaemia. However, it does suggest that episodes of hepatotoxicity can be reduced by maintaining CyA serum levels within this therapeutic/toxic range. We are taking part in the Canadian Multicentre Transplant Group trial of two hundred and seventy patients, comparing CyA with standard therapy for renal transplantation; data from that study may permit more definitive
CyA
analysis. A. L. is
a
samples
collected from
patients before and
a
0
a
surgery
POST-OPERATIVE DAY
Medical Research Council Fellow.
Nephrology and Transplantation Unit, Department of Medicine, University Hospital, University of Western Ontario, London, Ontario, Canada
A. LAUPACIS P. A. KEOWN R. A. ULAN N. R. SINCLAIR C. R. STILLER
overcomes
many of the
problems associated with the measurement
of &bgr;-TG in plasma.5 Since this protein is present in body fluids other than blood and urine,we have investigated &bgr;-TG levels in saliva as a possible means of detecting DVT. Saliva samples were obtained from patients before and after hip surgery, and the &bgr;-TG content was measured by radioimmunoassay. Ascending percutaneous phlebography was done 7-10 days after the operation. In four of the ten patients investigated no recent thrombi were detected on phlebography and the other six patients had evidence of fresh calf vein thrombosis. In three of the patients without DVT the salivary &bgr;-TG levels remained near the preoperative levels through the postoperative period (see figure, patients 1-3), and in the other high value was obtained on a single occasion postoperatively (patient 4). In the six patients with evidence of fresh thrombosis salivary &bgr;-TG levels were more persistently raised after hip surgery (patients 5-10). These preliminary findings suggest that a moreextensive investigation is indicated in the various groups of patients at risk of developing venous thromboembolism. Department of Medical Electronics, St Bartholomew’s Hospital, EC 1
E.D. COOKE
Department of Biochemistry, North East London Polytechnic
A. E. BOLTON
Department of Orthopaedics, The London Hospital, E1
B. LEVACK
&bgr;-THROMBOGLOBULIN LEVELS IN POSTOPERATIVE DEEP-VEIN THROMBOSIS
SIR,—There is a high incidence of deep-vein thrombosis (DVT) after hip arthroplasty,1-3 and we have found that measurement of the platelet-specific protein &bgr;-thromboglobulin (&bgr;-TG) in urine is a useful means of screening postoperative patients for DVTand 1.
Coventry MB, Declan RN, Beckenbaugh RD. "Delayed" prophylactic coagulation: a study of results and complications in 2012 total hip arthroplasties. J Bone Joint Surg
1973; 55A: 1487-92. 2. Cooke ED, Pilcher MF. Deep vein thrombosis: Preclinical diagnosis by thermography. Br J Surg 1974; 61: 971-78. 3. Cooke ED, Gordon YB, Bowcock SA, Sola CM, Pilcher MF, Chard T, Ibbotson RM, Ainsworth ME. Serum fibrin(ogen) degradation products in diagnosis of deep vein thrombosis and pulmonary embolism after hip surgery. Lancet 1975; ii: 51-54. 4. Bolton AE, Cooke ED, Lekhwani CP, Bowcock SA. Urinary &bgr;-thromboglobulin levels as a diagnostic marker for post-operative deep vein thrombosis. Thrombos Res 1980; 19: 249-55.
HEPATITIS A VIRUS AMONG CAPTIVE PANAMANIAN OWL MONKEYS
SIR,—Infectious hepatitis due to hepatitis A virus (HAV) has long been recognised as a major cause of human morbidity. However, research has, until recently, been hampered by the lack of both a simple assay to detect viral antigen and antibody and a readily available laboratory animal model. We describe here a sustained outbreak of HAV in a colony of owl monkeys (Aotus trivirgatus) at CA, Cash JD. Studies on the liberation of &bgr;-thromboglobulin from human 1976; 33: 239-47. J platelets in vitro. Br Haematol Dawes J, Smith RC, Pepper DA. The release, distribution and clearance of human &bgr;-thromboglobulin and platelet factor 4. Thrombos Res 1978; 12: 851-61.
5. Ludlam 6.