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Brochier A, Mairesse A, Saussoy P, Gavard C, Desmet S, Hermans C, Gruson D, van Dievoet MA. Short-term biological variation study of plasma hemophilia and thrombophilia parameters in a population of apparently healthy Caucasian adults. Clin Chem Lab Med 2022; 60:1409-1415. [PMID: 35751849 DOI: 10.1515/cclm-2022-0377] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 06/20/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Biological variation (BV) data obtained in a standardized way is valuable to assess the analytical requirements and the utility of a reference interval. Our study aimed to determine the short-term BV of thrombophilia (protein S, protein C, activated protein C resistance (APCR) and factor VIII) and hemophilia (factors VIII, IX and XI) parameters in plasma. Coagulation factors V and XII were also evaluated. Based on the obtained data, we assessed analytical performance specifications for the parameters. Finally, we intended to provide a robust tool for comparison of serial measurements of factors V, VIII, IX and XI. METHODS A blood draw was performed weekly in 19 apparently healthy Caucasian adults for five weeks at Saint-Luc University Hospital (Brussels, Belgium). Parameters were measured in duplicate. BV components were calculated with a nested analysis of variance after exclusion of outliers. RESULTS The analytical coefficient of variation (CV) varied from 1.5 to 4.6%, the within-subject CV from 1.6 to 8.9% and the between-subject CV from 3.8 to 24.1%. All parameters showed high individuality. For most parameters, the analytical goal was met with our assays. Reference change values (RCV) of -16.7% to +20.0%, -20.7% to +26.0%, -15.3% to +18.1% and -13.1% to +15.1% were obtained for factors V, VIII, IX and XI respectively. CONCLUSIONS All studied parameters were highly individualized. The assessment of BV data can guide setting analytical goal specifications. Comparison of serial measurements in the follow-up of patients suffering from hepatic failure or mild hemophilia is facilitated by evaluation of the RCV.
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Affiliation(s)
- Alice Brochier
- Hematology Department of Laboratory Medicine, Saint-Luc University Hospital, Brussels, Belgium
| | - Antoine Mairesse
- Hematology Department of Laboratory Medicine, Saint-Luc University Hospital, Brussels, Belgium
| | - Pascale Saussoy
- Hematology Department of Laboratory Medicine, Saint-Luc University Hospital, Brussels, Belgium
| | - Christel Gavard
- Hematology Department of Laboratory Medicine, Saint-Luc University Hospital, Brussels, Belgium
| | - Sandrine Desmet
- Hematology Department of Laboratory Medicine, Saint-Luc University Hospital, Brussels, Belgium
| | - Cédric Hermans
- Hemostasis and Thrombosis Unit/Hemophilia Treatment Centre/Division of Hematology, Saint-Luc University Hospital, Brussels, Belgium
| | - Damien Gruson
- Biochemistry Department of Laboratory Medicine, Saint-Luc University Hospital, Brussels, Belgium
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Leysen L, Delbeke H, Desmet S, Schauwvlieghe PP, Maes P, Blanckaert G, Matthys E, Joossens M, Casteels I. In search of viable SARS-CoV-2 in the tear film: a prospective clinical study in hospitalized symptomatic patients. Clin Microbiol Infect 2022; 28:1172-1173. [PMID: 35367365 PMCID: PMC8968149 DOI: 10.1016/j.cmi.2022.03.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 03/17/2022] [Accepted: 03/20/2022] [Indexed: 11/29/2022]
Affiliation(s)
- L Leysen
- Department of Ophthalmology, University Hospitals Leuven
| | - H Delbeke
- Department of Ophthalmology, University Hospitals Leuven; Biomedical Sciences Group, Department of Neurosciences, Research group Ophthalmology, University Hospitals Leuven.
| | - S Desmet
- Department of Clinical Biology, University Hospitals Leuven
| | | | - P Maes
- Department of Laboratory of Clinical and Epidemiological Virology (Rega Institute), Catholic University of Leuven
| | - G Blanckaert
- Department of Ophthalmology, University Hospitals Leuven
| | - E Matthys
- Department of Ophthalmology, University Hospitals Leuven
| | - M Joossens
- Department of Microbiology and Immunology, KU Leuven; Department of Biochemistry and Microbiology, Ghent University
| | - I Casteels
- Department of Ophthalmology, University Hospitals Leuven; Biomedical Sciences Group, Department of Neurosciences, Research group Ophthalmology, University Hospitals Leuven
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Mairesse A, Bayart JL, Desmet S, Lopes Dos Santos H, Saussoy P, Defour JP, Eeckhoudt S, van Dievoet MA. Biological variation data and analytical specification goal estimates of the thrombin generation assay with and without thrombomodulin in healthy individuals. Int J Lab Hematol 2020; 43:450-457. [PMID: 33185328 DOI: 10.1111/ijlh.13388] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 10/15/2020] [Accepted: 10/19/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Evaluation of an individual's thrombin-generating capacity enables a global assessment of the coagulation cascade and is therefore thought to better reflect the clotting function of blood. However, the lack of standardization still hampers the use in routine clinical practice. METHODS Nineteen healthy subjects were sampled once a week for 5 consecutive weeks. Thrombin generation assay (TGA) was performed in duplicate by calibrated automated thrombogram (CAT) on platelet poor plasma with and without thrombomodulin. After exclusion of outliers, a nested analysis of variance (ANOVA) was performed to evaluate the biological variability (BV) results. Analytical variation (CVA ), within-individual variation (CVI ), between-individual variation (CVG ), index of individuality (II), and reference change value (RCV) were calculated. RESULTS All parameters taken together, the CVA, CVI , and CVG without TM, ranged from 2.8% to 6.5%, from 4.1% to 13.3% and from 10.4% to 28.4%, respectively. For TG with TM, CVI and CVG were higher and ranged from 5.0% to 18.1% and from 14.9% to 35.3%, respectively. For endogenous thrombin potential (ETP), a CVI of 4.1% and CVG of 10.4% were obtained without addition of thrombomodulin (TM). With addition of TM, both CVI and CVG were higher: 14.0% and 34.8%, respectively. The II was low and the RCV ranged from 17.2% to 50.4%. CONCLUSION CAT parameters are highly individualized and population-based reference values could be called into question. The assessment of BV and RCV for thrombin generation assays could optimize interpretation of serial patient results and guide setting of analytical specification goals.
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Affiliation(s)
- Antoine Mairesse
- Département des Laboratoires Cliniques, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Jean-Louis Bayart
- Département des Laboratoires Cliniques, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Sandrine Desmet
- Département des Laboratoires Cliniques, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Helder Lopes Dos Santos
- Département des Laboratoires Cliniques, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Pascale Saussoy
- Département des Laboratoires Cliniques, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Jean-Philippe Defour
- Département des Laboratoires Cliniques, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Stéphane Eeckhoudt
- Département des Laboratoires Cliniques, Cliniques Universitaires Saint-Luc, Brussels, Belgium
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Van Elslande J, Houben E, Depypere M, Brackenier A, Desmet S, André E, Van Ranst M, Lagrou K, Vermeersch P. Diagnostic performance of seven rapid IgG/IgM antibody tests and the Euroimmun IgA/IgG ELISA in COVID-19 patients. Clin Microbiol Infect 2020; 26:1082-1087. [PMID: 32473953 PMCID: PMC7255746 DOI: 10.1016/j.cmi.2020.05.023] [Citation(s) in RCA: 180] [Impact Index Per Article: 45.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 05/17/2020] [Accepted: 05/20/2020] [Indexed: 01/21/2023]
Abstract
OBJECTIVES To evaluate the diagnostic performance of seven rapid IgG/IgM tests and the Euroimmun IgA/IgG ELISA for antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in COVID-19 patients. METHODS Specificity was evaluated in 103 samples collected before January 2020. Sensitivity and time to seropositivity was evaluated in 167 samples from 94 patients with COVID-19 confirmed with RT-PCR on nasopharyngeal swab. RESULTS Specificity (confidence interval) of lateral flow assays (LFAs) was ≥91.3% (84.0-95.5) for IgM, ≥90.3% (82.9-94.8) for IgG, and ≥85.4% (77.2-91.1) for the combination IgM OR IgG. Specificity of the ELISA was 96.1% (90.1-98.8) for IgG and only 73.8% (64.5-81.4) for IgA. Sensitivity 14-25 days after the onset of symptoms was between ≥92.1% (78.5-98.0) and 100% (95.7-100) for IgG LFA compared to 89.5% (75.3-96.4) for IgG ELISA. Positivity of IgM OR IgG for LFA resulted in a decrease in specificity compared to IgG alone without a gain in diagnostic performance, except for VivaDiag. The results for IgM varied significantly between the LFAs with an average overall agreement of only 70% compared to 89% for IgG. The average dynamic trend to seropositivity for IgM was not shorter than for IgG. At the time of hospital admission the sensitivity of LFA was <60%. CONCLUSIONS Sensitivity for the detection of IgG antibodies 14-25 days after the onset of symptoms was ≥92.1% for all seven LFAs compared to 89.5% for the IgG ELISA. The results for IgM varied significantly, and including IgM antibodies in addition to IgG for the interpretation of LFAs did not improve the diagnostic performance.
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Affiliation(s)
- J Van Elslande
- Clinical Department of Laboratory Medicine and National Reference Centre for Respiratory Pathogens, University Hospitals Leuven, Leuven, Belgium
| | - E Houben
- Clinical Department of Laboratory Medicine and National Reference Centre for Respiratory Pathogens, University Hospitals Leuven, Leuven, Belgium
| | - M Depypere
- Clinical Department of Laboratory Medicine and National Reference Centre for Respiratory Pathogens, University Hospitals Leuven, Leuven, Belgium
| | | | - S Desmet
- Clinical Department of Laboratory Medicine and National Reference Centre for Respiratory Pathogens, University Hospitals Leuven, Leuven, Belgium; Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
| | - E André
- Clinical Department of Laboratory Medicine and National Reference Centre for Respiratory Pathogens, University Hospitals Leuven, Leuven, Belgium; Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
| | - M Van Ranst
- Clinical Department of Laboratory Medicine and National Reference Centre for Respiratory Pathogens, University Hospitals Leuven, Leuven, Belgium; Laboratory of Clinical and Epidemiological Virology (Rega Institute), KU Leuven, Leuven, Belgium
| | - K Lagrou
- Clinical Department of Laboratory Medicine and National Reference Centre for Respiratory Pathogens, University Hospitals Leuven, Leuven, Belgium; Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
| | - P Vermeersch
- Clinical Department of Laboratory Medicine and National Reference Centre for Respiratory Pathogens, University Hospitals Leuven, Leuven, Belgium; Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium.
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Desmet S, Verhaegen J, Glupzcynski Y, Van Eldere J, Melin P, Goossens H, Piérard D, Declercq P, Lagrou K, Boel A, Cartuyvels R, Denis O, Vandewal W, Saegeman V. Development of a national EUCAST challenge panel for antimicrobial susceptibility testing. Clin Microbiol Infect 2016; 22:704-10. [PMID: 27234934 DOI: 10.1016/j.cmi.2016.05.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Revised: 04/25/2016] [Accepted: 05/11/2016] [Indexed: 11/29/2022]
Abstract
A challenge panel of bacterial strains useful for clinical laboratories to validate their European Committee on Antimicrobial Susceptibility Testing (EUCAST) antimicrobial susceptibility test (AST) system was established. A total of 117 strains, obtained from Belgian Reference Centres (n = 57) and from routine clinical samples (n = 60) was selected based on resistance pattern. These strains were analysed in seven different laboratories by three different automated AST systems (Vitek (n = 2), Phoenix (n = 2) and Microscan (n = 2)) and by disc diffusion from five different manufacturers (Rosco (n = 2), Becton-Dickinson (n = 2), Biomérieux (n = 1), Bio-rad (n = 1) and i2a (n = 1)). To select the challenge panel, selection criteria were set for categorical agreement between the different systems and the number of very major errors, major errors and minor errors. Very major and major errors for at least two antibiotics were observed in 43% of all strains, leading to the exclusion of these strains from the selected panel. In only 10% of all tested strains was there 100% categorical agreement for all antibiotics. Finally, 28 strains (14 Gram-positive and 14 Gram-negative) covering a wide spectrum of resistance mechanisms were selected. Pilot-testing of this challenge panel in 20 laboratories mainly confirmed the results of the validation study. Only six strains withheld for the pilot study could not be used as challenge strain due to an overall (very) major error rate of >5% for a particular antibiotic (n = 5) or for two antibiotics (n = 1). To conclude, this challenge panel should facilitate the implementation and use of EUCAST breakpoints in laboratories.
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Affiliation(s)
- S Desmet
- Department of Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium; Department of Microbiology and Immunology, KU Leuven - University of Leuven, Leuven, Belgium.
| | - J Verhaegen
- Department of Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium; Department of Microbiology and Immunology, KU Leuven - University of Leuven, Leuven, Belgium
| | - Y Glupzcynski
- Belgian Reference Laboratory of Multi-resistant Enterobacteriaceae and Multi-resistant Pseudomonas and Acinetobacter, CHU Dinant-Godinne UCL-Namur, Belgium
| | - J Van Eldere
- Department of Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium; Department of Microbiology and Immunology, KU Leuven - University of Leuven, Leuven, Belgium
| | - P Melin
- Belgian Reference Centre for Streptococcus agalactiae, Department of Clinical Microbiology, University Hospital of Liege, Liege, Belgium
| | - H Goossens
- Belgian Reference Laboratory of Enterococcus spp, Streptococcus pyogenes and other beta-hemolytic streptococci non-group B, University Hospital Antwerp, Antwerp, Belgium
| | - D Piérard
- Department of Laboratory Medicine, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - P Declercq
- Department of Laboratory Medicine, Sint-Jozefskliniek, Izegem, Belgium
| | - K Lagrou
- Department of Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium; Department of Microbiology and Immunology, KU Leuven - University of Leuven, Leuven, Belgium
| | - A Boel
- Clinical Laboratory of Microbiology OLVZ Aalst, Aalst, Belgium
| | - R Cartuyvels
- Department of Laboratory Medicine, Jessa Hasselt, Hasselt, Belgium
| | - O Denis
- Belgian Reference Laboratory of Staphylococcus aureus, Hopital Erasme, Brussels, Belgium
| | - W Vandewal
- Department of Laboratory Medicine, AZ Sint-Lucas Brugge, Brugge, Belgium
| | - V Saegeman
- Department of Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium; Department of Microbiology and Immunology, KU Leuven - University of Leuven, Leuven, Belgium
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Kindt D, Verhaeghe A, Desmet S, Verhelle K. CP-003 Deprescribing psychoactive medication for geriatric patients in a multidisciplinary way. Eur J Hosp Pharm 2016. [DOI: 10.1136/ejhpharm-2016-000875.3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Kefer JM, Galanti LM, Desmet S, Deneys V, Hanet CE. Time course of release of inflammatory markers after coronary stenting: comparison between bare metal stent and sirolimus-eluting stent. Coron Artery Dis 2005; 16:505-9. [PMID: 16319662 DOI: 10.1097/00019501-200512000-00009] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND High levels of release of inflammatory markers after coronary angioplasty are predictors of late restenosis. Sirolimus-eluting stent reduces the risk of restenosis. AIM OF THE STUDY To compare the release of inflammatory markers after coronary angioplasty with sirolimus-eluting stent and bare metal stent. METHODS Sixteen patients with a proximal left anterior descending coronery artery stenosis were randomly assigned to receive either bare metal stent (n = 8) or sirolimus-eluting stent (n = 8). We measured simultaneously aortic and coronary sinus concentrations of the von Willebrand factor antigen, tumor necrosis factor-alpha and interleukin-6 before, immediately and after 2 h after stenting. High-sensitivity C-reactive protein and troponin-I circulating levels were measured before and 6 and 24 h after coronary angioplasty. RESULTS Before stenting, all values were similar in both groups. The coronary sinus change of the von Willebrand factor antigen level between baseline and 2 h after stenting was + 20.1 +/- 26.9% in the bare metal stent group and -5.7 +/- 23.02% in the sirolimus-eluting stent group (P < 0.05). We observed a significant increase in the von Willebrand factor antigen (from 132.8+/-58.8 to 169 +/- 40.7%, P < 0.05) systemic concentrations 24 h after stenting in the bare metal stent group but not in the sirolimus-eluting stent group (from 140.6+/-84% to 136 +/- 39.5%), P = NS). CONCLUSION The present study shows that a difference in the release of inflammatory markers can be detected after coronary stenting with bare metal stent or sirolimus-eluting stent. The lower release of the von Willebrand factor antigen in the coronary sinus 2 h after the procedure and the lower systemic concentrations of the von Willebrand factor antigen 24 h after stenting in the sirolimus-eluting stent group are likely to reflect a reduced production of the von Willebrand factor antigen at the site of the vascular injury.
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Affiliation(s)
- Joëlle M Kefer
- Divisions of Cardiology Haemostasis, University of Louvain, Brussels, Belgium
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Desmet S, Devos SA, Chan I, Hamada T, Dhooge I, McGrath JA, Naeyaert JM. Clinical and molecular abnormalities in lipoid proteinosis. Eur J Dermatol 2005; 15:344-6. [PMID: 16172042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2005] [Indexed: 05/04/2023]
Abstract
Lipoid proteinosis (hyalinosis cutis et mucosae) is a rare, autosomal recessive disease. The main clinicopathological features comprise skin and mucous membrane infiltration and scarring with deposition of hyaline material. In this report, we describe a 6-year-old boy in whom a diagnosis of lipoid proteinosis was first suspected when he presented with blisters and erosions at 4 years, a history of life-long dysphonia and a previous epileptic convulsion. The diagnosis was confirmed by histology and identification of a homozygous frameshift mutation, 501insC, in exon 6 of the gene encoding extracellular matrix protein 1, ECM1. Lipoid proteinosis may show protean clinical features and be difficult to diagnose on clinical grounds alone. This case report illustrates that lipoid proteinosis may show protean clinical features and yet remain undiagnosed for many years. Although the gold standard for definite diagnosis remains histology, molecular characterisation of the gene mutation will add to our understanding of genotype-phenotype correlation and perhaps to the development of a rationale for future therapeutics.
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Affiliation(s)
- S Desmet
- Department of Dermatology, Ghent University Hospital, De Pintelaan 185, B-9000 Gent, Belgium
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Abu El-Asrar AM, Desmet S, Meersschaert A, Dralands L, Missotten L, Geboes K. Expression of the inducible isoform of nitric oxide synthase in the retinas of human subjects with diabetes mellitus. Am J Ophthalmol 2001; 132:551-6. [PMID: 11589878 DOI: 10.1016/s0002-9394(01)01127-8] [Citation(s) in RCA: 86] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
PURPOSE Inducible nitric oxide synthase has been implicated in the pathogenesis of cerebral ischemic damage, in the angiogenic process and in diabetic vascular damage. This study was undertaken to determine whether inducible nitric oxide synthase is present in the retinas from human subjects with diabetes mellitus. METHODS This was an experimental immunohistochemical prospective study. Ten postmortem eyes from five subjects with diabetes mellitus, 10 eyes from five subjects without diabetes and without known ocular disease, and two eyes from one subject with unilateral ocular ischemic syndrome secondary to severe carotid artery obstruction were examined. We used immunohistochemical techniques and antibodies directed against inducible nitric oxide synthase, glial fibrillary acidic protein, and vimentin. The main outcome measure was immunoreactivity for these antibodies. RESULTS Immunoreactivity for inducible nitric oxide synthase was not observed in retinas from all subjects without diabetes and without ocular disease. Six retinas from three subjects with diabetes and nonproliferative retinopathy, and the retina from the eye with ocular ischemic syndrome showed immunoreactivity for inducible nitric oxide synthase in cells with elongated processes. Based on morphology and on glial fibrillary acidic protein and vimentin immunoreactivity, this inducible nitric oxide synthase immunoreactivity appeared to localize to retinal Müller glial cells. CONCLUSIONS These observations suggest that Müller cells may be involved in the microvascular remodeling of the diseased retina and that high concentrations of nitric oxide produced by inducible nitric oxide synthase could contribute to neurotoxicity and angiogenesis that occur in diabetic retinopathy.
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Affiliation(s)
- A M Abu El-Asrar
- Department of Ophthalmology, College of Medicine, King Saud University, Riyadh 11411, Saudi Arabia.
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Félix B, Henry B, Desmet S, Letoret P, Taymans L, Mols P. P-5 Effects of different positions and regimens of active compression decompression-CPR on mean blood pressure, heart rate, and respiratory rate in rescuers compared to standard CPR. Resuscitation 1996. [DOI: 10.1016/0300-9572(96)83867-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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