Background/Aims: Desmopressin decreases bleeding time in uremic patients. Although bleeding time is the most frequently used measure of global platelet function, this test has important disadvantages. In vitro closure time (CT) is a relatively new and efficient test of primary hemostasis. We designed a prospective randomized study to evaluate the effect of desmopressin on platelet function, as measured by in vitro CT, in uremic patients. Methods: Forty-eight uremic patients, about to commence hemodialysis and with prolonged CT, were randomized to infusion with desmopressin (n = 24) or saline alone (n = 24). Complete blood count, prothrombin time, activated partial thrombin time, levels of plasma fibrinogen, von Willebrand factor (VWF), factor VIII (FVIII) and CT were measured before and 1 h after desmopressin or saline infusion. Results: Following desmopressin infusion, collagen/epinephrine and collagen/adenosine diphosphate CT were significantly shortened from 212 ± 58 to 152 ± 45 s (p = 0.01) and from 189 ± 78 to 147 ± 58 s (p = 0.012), respectively; levels of FVIII and VWF were significantly increased from 188 ± 66 to 252 ± 93% (p = 0.017) and from 113 ± 9 to 121 ± 9% (p = 0.043), respectively. There were no significant changes in the control group. Conclusions: Desmopressin improved platelet dysfunction and increased the plasma concentrations of VWF and FVIII, suggesting that desmopressin may play a role in improving the bleeding tendency in uremic patients.
New low temperature, low cost, small size packaging technology of novel bulk-micromachined MEMS sensor for mobile applications was developed. The sensor was fabricated with the bulk-micromachining process of SOI substrates and composed with a proof mass, membrane and electrodes for capacitance sensing. The sensor device was capped with very thin (130um-thickness) top and bottom silicon cap wafers which have a 80um-depth cavity. Top and bottom cap wafers were bonded with the sensor wafer with a low temperature curing polymer adhesive lower than 200°C. It is needed that the low temperature packaging technology and the passivation of top and bottom sides of the sensor for keeping the sensor performances and preventing stiction of the proof-mass during the molding processes. After bonding the three substrates, the top cap silicon was dry etched to expose bonding pads for the signal interconnection. The ASIC chip was polished to 75um-thickness, diced and bonded on a half-etched 200um-thick lead-frame with a DAF. The diced wafer-level-capped sensor was stacked on the ASIC, wire bonding was accomplished between the sensor and the ASIC, and the ASIC and the lead-frame and finally transfer molding process was done. The developed package is 24-leads QFN and the dimension is 4.0mm×4.0mm×1.1/1.2mm.
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