Edited by two leading orthopedic surgeons who are specialists in the treatment of hemophilia, Orthopedic Surgery in Patients with Hemophilia shows all the surgical techniques needed for surgical treatment of musculoskeletal complications of hemophilia. A practical guide, designed for use on the ward or in the office, this book draws on the experience of numerous specialists worldwide, from developed and developing countries. As well as orthopedic surgery, it also covers research, hematology, and rehabilitation. Although of primary interest to the orthopedic surgeon, rheumatologist, and physiotherapist, this book will also be relevant to the hematologist responsible for the care of the hemophiliac patient. Written for: Orthopedic surgeons, hematologists, physiotherapists, rheumatologists

With great pleasure I welcome you to the City of Groningen. In more than one way there is cause for celebration. Today marks the third lustrum of the annual international sympo sium on blood transfusion, organized by the Rode Kruis Bloedbank Groningen-Drenthe. In my opinion it has been a remarkable initiative of the Bloedbank, to start organizing a scientific conference, as it did, in 1976. It meant, among others, that in case of success the initiative would grow to be an annual item on the international congress calen der. It also meant that a possible third lustrum would coincide with the celebration of the 950th anniversary of the City of Groningen. I am happy to note that the initiative has been successful: over the past fourteen years the Rode Kruis Bloedbank Groningen-Drenthe has succeeded in organizing an annual symposium on blood transfusion, with a different theme each year, and with an average attendance of 250 participants from some 26 countries world-wide. The platform created with the special formula of the symposium, for science and industry, has been well balanced and beneficial to both. Mr. Chairman, ladies and gentlemen, I like to compliment the organizers with the success that they have attained. Allow me to men tion the name of just one person, in whom I like to thank everyone who has been involved in creating the annual Bloedbank-symposia: my warm congratulations to Dr. Smit Sibinga and his staff."

Hemostatis and Desmopressin: Molecular Mechanisms of Cellular Responses to DDAVP; S. Hashemi, et al. Pharmacology and Pharmacodynamics of Desmopressin: Toxicity of Desmopressin and Related Peptides; L.B. Kinter, et al. Desmopressin in Renal Disease: Control of Bleeding in Uremic Patients; Y. Sultan. Desmopressin and Platelets: Desmopressin in the Treatment of Congenital and Acquired Defects of Platelet Function; M. Cattaneo, P.M. Mannucci. Desmopressin and Surgery: Desmopressin, von Willenbrand Factor, and Surgery; M. Weinstein. Desmopressin and Blood Donation: Effects of Desmopressin on Normal Donors in Plasma Exchange Donations; R.J. Sassetti, B.C. McLeod. Clinical Applications of Desmopressin in Hemophilia and von Willenbrand's Disease: Intravenous and Subcutaneous Desmopressin; M. Kohler, G. Mariani. SideEffects and Adverse Reactions of Desmopressin: DDAVP and Tachyphylaxis in Healthy Subjects; V. Vicente, et al. Recapitulation: General Recapitulation and Search for a Consensus; P.M. Mannucci, et al. 33 additional articles. Index.

Before the introduction of DDA VP, centrnl diabetes insipidus was treated by the administration of a more or less purified extract from bovine or porcine posterior pituitaries, and the prepamtions were mostly given in the form of nasal snuff. In 1956, the structure of vasopressin became known and two forms were found, namely arginine vasopressin (A VP) in humans and most other species, and lysine vasopressin (L VP) which was found in the pig. In 1967, Zaornl et al. were the frrst to synthesize l-desamino-8-D-arginine vasopressin, DDA VP. In comparison with the compounds which were previously available, DDA VP offered increased antidiuretic potency and an equally distinct shift of the antidiuretic to pressor potency rntio. As a result of the pioneering studies of Cash and Mannucci, numerous publications appeared in the medical literature of the 80's, widening the fields of clinical application of the drug. A very important aspect of this drug is that it can be used as an alternative treatment for mild factor VllI deficiencies, mild hemophilia A and von Willebrnnd's disease. These congenital deficiencies are far from mre and have, up to now, been treated with plasma-derived factor VIII concentrates; in the countries in which desmopressin has not been used a consistent proportion of these patients have seroconverted for HIV 1 and hepatitis.

While the enzyme cascade that allows coagulation is well known physiologically, its elegant practical examples are vividly demonstrable in the clinical application of blood and components for the treatment of bleeding problems in surgery, trauma or in congenital deficiency in patients. This volume provides the fundamental and recent understanding relating to coagulation pathways, recombinant technology and other methods for coagulation factor production, up to date laboratory assay, preservation of cellular and plasma components, and their clinical use in surgery and medicine, including the immuno response to repeated challenge to contaminating protein in coagulation factor concentrates. The interrelated but multi-disciplinary chapters have been integrated in four sections: Principles and Fundamentals: Mechanism of thrombin formation; structure -- function relationship of coagulation proteins, role of calcium and anticoagulant: blood collection on haemostatic potential of plasma proteins and platelets; Factor VIII yields from anticoagulant exchanged plasma. Preservation Aspects: Platelet function preservation, platelet interaction with vessel wall; trends in the use of coagulation factor concentrate; immuno purification of Factor VIII; structural and fundamental properties of recombinant coagulation factors. Laboratory Aspects: Platelets counting and function testing; platelet crossmatch predictive value; clinical efficacy of platelet concentrate; protein C and protein S; principle of coagulation factor assay; standardisation of clotting factor assays; clinical efficacy of clotting factor concentrates. Clinical Consequences

Edited by two leading orthopedic surgeons who are specialists in the treatment of hemophilia, Orthopedic Surgery in Patients with Hemophilia shows all the surgical techniques needed for surgical treatment of musculoskeletal complications of hemophilia. A practical guide, designed for use on the ward or in the office, this book draws on the experience of numerous specialists worldwide, from developed and developing countries. As well as orthopedic surgery, it also covers research, hematology, and rehabilitation. Although of primary interest to the orthopedic surgeon, rheumatologist, and physiotherapist, this book will also be relevant to the hematologist responsible for the care of the hemophiliac patient.