Easy Bleeding

Abstract: Easy bleeding is a phenomenon discovered in some tenthredinid insects which possess a particularly low mechanical resistance of the integument, leading under mechanical stress to haemolymph exudation It has a defensive effect against ants and wasps through harmful plant compounds which are sequestered in the haemolymph Here we describe etho-ecological and some chemical aspects of the defence of easy bleeders and specify the range of predators to which easy bleeding might be effective Beside a high haemolymph deterrence associated with low integument resistance across sawfly species, we also detected toxicity of the haemolymph of some species to workers of the ant Myrmica rubra The behaviour of easy bleeders is to move slowly and, once disturbed, to become motionless, thereby probably impeding the tendency of a predator to attack This behaviour had no beneficial effect for easy bleeders when attacked by the predatory bug Podisus maculiventris Bugs could successfully and without harm prey on sawfly larvae without evoking easy bleeding For the easy bleeder Athalia rosae, host plants with different secondary metabolite profiles, and, consequently, changes in haemolymph chemistry only slightly affected the feeding behaviour of the bugs To test the effectiveness of easy bleeding towards a vertebrate predator, easy bleeders were offered to birds, Sturnus vulgaris The body colouration of the sawfly larvae was of prime importance in determining the predator’s response when testing birds in a group It is likely that easy bleeding is a defence strategy directed primarily towards foraging insects with biting-chewing mandibles and that it is much less active towards predatory insects with piercing-sucking mandibles as well as birds The involvement of chemical and/or physical cues in the strategy is discussed with respect to these types of predators

Abstract: Von Willebrand's disease (VWD) is the most commonly inherited coagulopathy. In a group of 1,000 plastic surgery patients, 8 or 9 individuals are affected by this disease, making basic knowledge of VWD and its management imperative. In this investigation, 1,000 plastic surgery patients were studied for details of their clinical evaluation, history of bleeding and bruising, and excessive bleeding during or after surgery. If the patient reported a history of easy bleeding or bruising, in addition to routine coagulation studies such as PT, PTT, and platelet count, the bleeding time was measured. When the index of suspicion dictated, more extensive coagulation studies, such as factor VIII assay, were conducted. This resulted in the detection of VWD in 9 patients (8 female and 1 male). All patients had a positive history of easy bleeding or bruising. Six of the 9 patients had a bleeding time greater than 6 minutes. Seven patients were diagnosed to have VWD type I, 1 had type II-a, and 1 suffered from type II-b disease. Perioperative bleeding was controlled in all patients in this study with the administration of 0.3 microgram/kg of body weight (usually a total dose of 20 micrograms) of 1-deamino-8-D-arginine-vasopressin intravenously every 12 hours for the first 24 hours. Two patients with type II VWD required fresh frozen plasma and cryoprecipitate 1 week subsequent to surgery to control late bleeding.

Abstract: A 57-year-old man presented on multiple occasions to various hospitals with thrombocytopenia and complaints of easy bleeding. Despite his repeated denials of quinine use, laboratory investigations confirmed a diagnosis of quinine-induced thrombocytopenia. He appeared to have factitious disorder and to have discovered a novel means of precipitating symptoms.

Abstract: 緩和ケア領域で経験する頭頸部がんや各種がんの皮膚転移, 非切除乳がんなどの体表部悪性腫瘍の出血に対しては, 有用な方法がなく止血に難渋していた. 今回われわれは, 中咽頭がん再発病巣から出血を繰り返し, 1日に5回前後の包交を必要としていた患者に対して, Mohsペーストを使用することにより著明な止血効果と滲出液やにおいの軽減が認められた症例を経験したので報告する. Mohsペーストは, 安価な材料を用いて院内調製が可能であり, その作用機序は主成分の塩化亜鉛が潰瘍面の水分によりイオン化し, 亜鉛イオンのタンパク凝集作用によって腫瘍細胞や腫瘍血管, および二次感染した細菌の細胞膜が硬化することによる. 本症例においてMohsペーストは, 予後の限られた患者が出血や滲出液, においに悩まされることなくQOLを維持するために効果的であった. 今後, 製剤の安定性や使用方法が確立され, 本法が普及することが期待される. Palliat Care Res 2009; 4(2): 346-350