Since 1952, postgraduate courses for practising physicians and speci alists have been given by the Medical Faculty of the University of Leiden in the Boerhaave Quarter, in which most of its clinics and laboratories are located. During these years, recent advances in a wide variety of m~dical fields and subjects have been discussed by distin guished speakers from many countries. The steadily increasing atten dance has shown that, as could be expected from the rapid progress of modern medicine, there is a widely felt need for this form of postgra duate study. In 1957, therefore, the Leiden Medical Faculty appointed a permanent committee for the organization of postgraduate medical education. Of the courses given since then, certain material proved to have sufficient immediate scientific value to justify publication, and it now gives the Committee great pleasure to announce that in collaboration with the Leiden University Press it will publish the Boerhaave Series for Postgraduate Medical Education. The first volume of this new series is the product of the course on Human Blood Coagulation given in Novem ber 1968. It is our hope that this book will prove valuable not only to those who participated in the course but also to many others working in this and associated fields.

Klappentext

Since 1952, postgraduate courses for practising physicians and speci­ alists have been given by the Medical Faculty of the University of Leiden in the Boerhaave Quarter, in which most of its clinics and laboratories are located. During these years, recent advances in a wide variety of m~dical fields and subjects have been discussed by distin­ guished speakers from many countries. The steadily increasing atten­ dance has shown that, as could be expected from the rapid progress of modern medicine, there is a widely felt need for this form of postgra­ duate study. In 1957, therefore, the Leiden Medical Faculty appointed a permanent committee for the organization of postgraduate medical education. Of the courses given since then, certain material proved to have sufficient immediate scientific value to justify publication, and it now gives the Committee great pleasure to announce that in collaboration with the Leiden University Press it will publish the Boerhaave Series for Postgraduate Medical Education. The first volume of this new series is the product of the course on Human Blood Coagulation given in Novem­ ber 1968. It is our hope that this book will prove valuable not only to those who participated in the course but also to many others working in this and associated fields.

Inhalt
Blood coagulation in medicine and biochemistry.- I Reaction Mechanism of Blood Coagulation.- The formation of the fibrin clot from fibrinogen.- Discussion.- On the structure of thrombin and prothrombin.- Discussion.- The interaction of prothrombin and factors v and x with phospholipids and calcium ions.- Discussion.- The nature of prothrombinase.- Discussion.- The interaction of factors vii, ix, and x.- Discussion.- The nature of the factor ix activating principle.- Discussion.- The possible role of factor vii in the intrinsic system.- Discussion.- Factor vii and tissue thromboplastin.- Discussion.- Enzyme systems triggered by the contact factors.- Discussion.- Enzyme kinetic evaluation of coagulation systems.- Discussion.- Round Table Discussion.- II Physiopathology.- The mechanism of haemostasis.- Morphology of the process of haemostasis.- Laboratory investigation.- Indication, assay procedures, diagnosis, and advice.- Defibrination syndrome.- The role of the degradation products of fibrinogen and fibrin in the blood.- Quantification of split products.- Treatment of haemorrhagic diathesis.- General considerations concerning the treatment of haemorrhagic diathesis.- Platelet transfusion in patients with platelet isoantibodies.- Purification and clinical application of the four factors of the prothrombin complex.- Four clotting factors concentrate.- Preparation and clinical application of cryoprecipitate.- Some remarks concerning the production and administration of cryoprecipitates.- Genetic counselling in haemostatic disorders.- III Blood Coagulation Control in Oral Anticoagulant Treatment.- General considerations on coumarin-induced hypocoagulability and its control.- The Netherlands Thrombosis Service.- Laboratory tests Prothrombin time.- The Manchester ComparativeReagent. A national reference standard for anticoagulant therapy.- Discussion.- Thrombotest.- The history of Thrombotest.- Quality control of Thrombotest (TT) and Normotest (NT).- of Thrombotest at the Netherlands Thrombosis Services.- of Thrombotest at the Amsterdam Thrombosis Service.- Thrombotest versus conventional thromboplastins.- Discussion.- Therapeutic levels.- Thrombotest levels in relation to recurrence and bleeding complications in long-term treatment of patients suffering from coronary heart disease.- The Utrecht double-blind trial of long-term anticoagulant treatment after myocardial infarction.- The Leiden double-blind trial of long-term anticoagulant treatment after myocardial infarction.- Discussion.- Vitamin K1 therapy.- IV The Assessment of Liver Function by Blood Coagulation Tests.- Blood coagulation and liver function.- The Thrombotest dilution curve and its diagnostic significance.- Normotest in the evaluation o liver function.- Clinical experience with Normotest.- Preliminary experience with Normotest.- Discussion.- Index of subjects.