fibrin and Foramen-Ovale--Patent

Mesothelial/monocytic incidental cardiac excrescence (MICE) is a rare entity which is an amalgam of mesothelial cells, histiocytes, and fibrin, often found occasionally during cardiac valve replacement. We report a case in a 25-year-old Chinese female with serous mitral stenosis and patent foramen ovale. Routine and immunohistochemical stains and ultrastructure examination revealed the vegetation was predominantly composed of histocytes with scattered mesothelial cells. In fact nodular histiocytic/mesothelial hyperplasia (NHMH) is a similar lesion to MICE. MICE and NHMH could be unified, and NHMH may be a better choice.

Topics: Adult; Biomarkers; Epithelium; Female; Fibrin; Foramen Ovale, Patent; Heart Valve Prosthesis Implantation; Humans; Hyperplasia; Immunohistochemistry; Microscopy, Electron; Mitral Valve; Mitral Valve Stenosis; Monocytes; Terminology as Topic

We tested the hypothesis that fibrin structure/function is unfavorably altered in patients with cryptogenic ischemic stroke.. Ex vivo plasma fibrin clot permeability, turbidimetry, and efficiency of fibrinolysis were determined in 89 patients with patent foramen ovale (PFO) and a history of first-ever stroke, 58 patients with first-ever stroke and no PFO, and 120 healthy controls.. Stroke patients, evaluated 3 to 19 months after the event, and controls did not differ with regard to age, sex, smoking, and fibrinogen. Stroke patients with or without PFO had lower clot permeability (P<0.0001), faster fibrin polymerization (P<0.0001), prolonged clot lysis time (P<0.0001), higher maximum D-dimer levels released from clots (P<0.0001), and maximum rate of D-dimer release (P=0.02) than controls. Time from stroke occurrence showed no association with any clot variables. Scanning electron microscopy of fibrin clots showed increased fiber diameter and density in stroke patients. Clots from stroke patients with PFO were more permeable and showed shorter lysis time compared to those without PFO, and this was related to lower proportion of smokers in the former group.. Altered fibrin clot structure and resistance to fibrinolysis are associated with cryptogenic stroke.

Topics: Adult; Blood Coagulation; Brain Ischemia; Female; Fibrin; Fibrin Fibrinogen Degradation Products; Fibrinolysis; Foramen Ovale, Patent; Humans; Male; Microscopy, Electron, Scanning; Middle Aged; Nephelometry and Turbidimetry; Permeability; Stroke