Cigarette smoking increases the mean platelet volume in elderly patients with risk factors for atherosclerosis.

To study the effects of cigarette smoking and atherosclerosis on platelet size, we measured the mean platelet volume (MPV) and other platelet parameters in 142 elderly smokers and nonsmokers with or without atherosclerotic risk factors. The MPV and the platelet count were highest and their inverse correlation was strongest in the atherosclerotic smokers (r = 0.54, P < 0.

Imbalance between thrombin and plasmin activity in disseminated intravascular coagulation. Assessment by the thrombin-antithrombin-III complex/plasmin-alpha-2-antiplasmin complex ratio.

We investigated the imbalance between thrombin and plasmin activity in vivo with various grades of severity of disseminated intravascular coagulation (DIC) in relation to the underlying diseases. Plasma thrombin-antithrombin-III complex (TAT) and plasmin-alpha 2-antiplasmin complex (PAP) levels were measured in 133 blood samples obtained from patients with DIC. The TAT/PAP ratio was higher in patients with sepsis or solid cancer than in those with hematologic malignancies.

[Three cases of human fascioliasis].

Three patients with hepatic fascioliasis are presented. (case 1) A 36-year-old female was admitted in January, 1988, because of intermittent high-grade fever. Laboratory findings included white blood cell count 8,050/mm3 with 29% eosinophils, and CRP 9.

[Serum uric acid and factor VII hyperactivity in the elderly].

To study the relationship between serum uric acid, lipid fractions, and coagulation factor VII (FVII) in the elderly, we measured FVII coagulation activity (FVIIc). FVII antigen (FVIIag), in 138 normal subjects without alcohol intake ranging in age from 60 to 98 years. We also measured blood lipid fractions including apolipoprotein A-I, A-II, B, E, and serum cholinesterase activity (ChE).

[Thrombin.antithrombin III complex].

Increase of TAT is reflected by the generation of thrombin in hypercoagulable state. TAT might increase in DIC characterized by the formation of disseminated micro-thrombosis. DIC was classified into three groups according to the results of screening tests (FDP, platelet count, fibrinogen, prothrombin time).

[Fibrin monomer assay].

Quantitative assay for fibrin monomer was done by use of a chromogenic substrate (S-2390, Coa set fibrin monomer). Samples from DIC prone patients with the underlying disease were assayed and classified into four groups. The pre DIC group showed higher FM values than the control with no laboratory coagulation abnormality, although the FDP .

[A case of left main bronchial rupture due to bronchocath tube].

A 68-year-old woman underwent a right upper lobectomy for lung cancer. After resection, we noticed the left main bronchial rupture due to bronchocath tube (polyvinyl chloride double lumen tube). The lesion of the rupture was repaired by interrupted sutures with 4-0 prolene.

[Alpha 2plasmin-inhibitor . plasmin complex (PIC)--useful diagnostic and prognostic parameter].

To evaluate the diagnostic and prognostic value of PIC, we compared it with the DIC score (which is calculated from platelet count, fibrinogen, FDP, and prothrombin time). We examined 182 samples from 60 patients with coaglo-fibrinolytic abnormalities. For the diagnosis of DIC, the sensitivity of PIC was significantly higher than that of DIC score (78.

Which factors affect high D-dimer levels in the elderly?

To study the age-related changes in plasma D-dimer levels and the effect of atherosclerotic disease and long-term immobilization on haemostasis the elderly, we measured plasma D-dimer levels in 148 subjects aged from 60 to 94 years using an ELISA. We also measured plasma fibrinogen, serum uric acid, total cholesterol, triglycerides, HDL cholesterol, beta-lipoprotein fractions, and apolipoproteins (A-I, A-II, B, E). Plasma D-dimer levels (326 +/- 148 ng/ml) were significantly higher in the healthy elderly subjects than in younger controls (180 +/- 58 ng/ml, p less than 0.

[A case of localized pleural mesothelioma].

A case of localized pleural mesothelioma is reported. A 49-year-old man was operated for coin lesion detected on routine chest X-ray. A tumor arose from the visceral pleura of right lower lobe and was pedunculated.

Factor VII hyperactivity in the elderly.

To investigate the age-related increase in coagulation factor VII (FVII) and its significance in the elderly, we measured FVII coagulation activity (FVIIc), FVII antigen (FVIIag), and D-dimer levels in 150 normal subjects ranging in age from 60 to 98 years. We also measured blood lipid fractions and serum cholinesterase activity (ChE), as an indicator of hepatic protein synthesis. FVIIc (141 +/- 36%), FVIIag (136 +/- 28%), and D-dimer (0.

Xanthine urolithiasis: ultrastructure analysis of renal and bladder calculi.

The surface structure of a xanthine stone from a patient with hereditary xanthinuria was examined using scanning electron microscopy. This revealed that the xanthine stone was composed of at least two very different structures. One was a spherical protrusion with craters and a fine granular surface and the other consisted of a granular growth of plate-like crystals.

Serum erythropoietin levels in the elderly.

We evaluated the relationship between erythropoietin (EPO) and hemoglobin (Hb) concentrations in 156 normal subjects ranging from 60 to 98 years old. EPO was determined by a radioimmunoassay. The serum EPO concentration in subjects with Hb concentrations greater than 12.

Anticoagulant therapy in a congenital antithrombin III (ATIII)-deficient patient with chronic renal failure undergoing regular hemodialysis.

We describe a 43-year-old male patient with congenital antithrombin III deficiency requiring hemodialysis due to extension of venous thrombus from recurrent deep vein thrombosis. During dialysis with adequate heparinization, the patient often revealed clot formation in the extracorporeal circuit resulting in unexpected discontinuation of dialysis. When either a combination of antithrombin III concentrate + heparin or the newly developed synthetic antithrombin preparation, MD805, was administered during dialysis, he could be uneventfully dialyzed with either of the two regimens.

Activity of tissue plasminogen activator and plasminogen activator inhibitor in noninsulin-dependent diabetes mellitus.

The activity of free tissue plasminogen activator (f-tPA) and plasminogen activator inhibitor (PAI) in the plasma of 82 noninsulin-dependent diabetics (NIDDM) was measured by bioimmunoassay of the euglobulin fraction obtained from the plasma, and the levels were compared with those of age- and gender-matched normal subjects. Comparison of these levels in both groups revealed that the f-tPA activity tended to be lower in NIDDM than in the controls, although the differences were not significant. Normal activity of PAI was seen, but f-tPA in NIDDM, when accompanied by macroangiopathy such as ischemic heart disease, was significantly depressed.

[Successful treatment of CML in accelerated phase with mithramycin].

The patient, an 18-year-old male, was admitted on May 17, 1988, because of high-grade fever, neuralgia and generalized lymphadenopathy. Bone marrow examination revealed a large number of small nests with myeloid blastic cells negative for both peroxidase and TdT activity. Ph1 chromosome and bcr rearranged fragment were positive.

[Spotted fever group rickettsiosis on Awaji Island, Japan].

Three cases of spotted fever group rickettsiosis occurring on Awaji Island, Hyogo Prefecture, the first reported in the Kinki District, are described. The illness appeared from August to September in 1988. High-grade fever and papular erythema were observed in all cases.

[A case of extraskeletal Ewing's sarcoma of the chest wall].

A case of extraskeletal Ewing's sarcoma arising in the chest wall of a 15-year-old male is reported in this paper. His complaint was chest and back pain. Physical examination and laboratory data disclosed no abnormality.

Effect of aspirin on heparin-induced thrombocytopenia (HIT) in a patient requiring hemodialysis.

The present report describes the management of a 75-year-old uremic patient with delayed-onset heparin-induced thrombocytopenia and clot formation in extracorporeal circulation. The test for serum heparin-dependent platelet aggregation factor was positive and the serum platelet binding IgG (PBIgG) became elevated after the onset of heparin-induced thrombocytopenia. He required continuous exposure to heparin for hemodialysis.

Choice of anticoagulant in a congenital antithrombin III (AT III)-deficient patient with chronic renal failure undergoing regular haemodialysis.

We describe a 43-year-old male patient with congenital antithrombin III deficiency requiring haemodialysis due to extension of venous thrombus from recurrent deep vein thrombosis. During dialysis with adequate heparinization, the patient often revealed clot formation in the extracorporeal circuit resulting in unexpected discontinuation of dialysis. When either a combination of antithrombin III concentrate plus heparin or the newly developed synthetic antithrombin preparation, MD805, was infused during dialysis, he could be uneventfully dialysed with either of the two regimens.