Biomedical subjects

D Sugimura

Publications and source records attributed to D Sugimura.

5 recordsLinked to original sources

PubMed1996

[Changes of factor XIII a and b subunit in patients with disseminated intravascular coagulation syndrome].

Factor XIII is composed of two distinct proteins, a and b subunit. The dimers of each subunit form a tetrameric complex of a2b2 in plasma. Two separate ELISA systems were developed to measure either factor XIII a or b subunit in plasma. Sensitivity of the ELISAs was 3.0% of factor XIII a and b subunit in normal plasma. The ELISA for factor XIII b subunit quantitate free b2 and a2b2 complex in a equimolar manner. In order to evaluate the changes of each factor XIII subunit in a state of hypercoagulation, 16 plasmas from proteins with disseminated intravascular coagulation syndrome (DIC) were examined. Factor XIII a and b subunit showed 56.5 +/- 30.5% and 63.4 +/- 22.5%, respectively in the DIC subjects compared to normal pooled plasma as 100%. The ratio of factor XIII a and b subunit (a/b ratio) were between 0.5 and 1.0 in DIC cases which improved after treatment. However, the ratios were less than 0.5 in the cases with DIC which deteriorated in spite of the treatment. These results suggest that the a/b ratio would indicate the prognosis of patients with DIC.

Biomarkers↗

PubMed1995

Factor VIII inhibitor developed in a 60-year-old patient with mild hemophilia A after surgery for colon cancer.

Most factor VIII inhibitors are developed at an early age and in patients with severe type of hemophilia A. We report a case of newly developed factor VIII inhibitor in a 60-year-old patient with mild hemophilia A who had been treated with several kinds of factor VIII concentrates. The patient was treated with a total of 103,580 units of recombinant factor VIII concentrate by continuous and bolus infusions for the open surgery of sigmoid colon cancer. On the 95th postoperative day, the patient had right low limb muscle bleeding and was infused with 1,000 units of recombinant factor VIII concentrate for three days. Subsequently, the level of factor VIII inhibitor in the patient's plasma was 2 Bethesda units (BU)/ml. Since then numerous subcutaneous hemorrhages developed, but an adequate hemostatic effect was not obtained even with the administration of a high dose of recombinant factor VIII concentrate. The patient was switched to bypass therapy using human plasma-derived factor VIIa concentrate, which showed a favorable hemostatic effect.

Adenocarcinoma↗

PubMed1995

[Massive and progressive hepatosplenomegaly caused by disseminated nontuberculous mycobacteriosis in a patient with acquired immunodeficiency syndrome].

A 28-year-old hemophilia A patient was admitted to our hospital in July, 1991 because of high fever, chronic diarrhea and anemia. The patient had been recognized as a asymptomatic carrier of human immunodeficiency virus (HIV) in 1985 and had developed Pneumocystis carinii pneumonia and had been diagnosed as acquired immunodeficiency syndrome (AIDS) in 1990. Hematologic laboratory examinations on admission revealed pancytopenia and a CD4+ cell count of 3/mm3. X-ray findings of chest and abdomen were normal and bacterial cultures of sputum, urine, blood, stool, cerebrospinal fluid and bone marrow yielded no pathogenic microorganisms. Microscopical examination of the stained specimens showed no acid-fast bacilli. On his fifth hospital day, his liver and spleen enlarged markedly and an abdominal CT scan obtained on the 13th day revealed high-grade hepatosplenomegaly. Administration of several kinds of antibiotics, antifungal agents, antiviral agents, antituberculous agents and gamma-globulin medicines did not relieve the symptoms. On the 28th day the patient had developed a subarachnoid hemorrhage and died five days later. Retrospectively all cultures for acid-fast bacilli of the specimens on his admission yielded nontuberculous mycobacteria. The bacteria were identified as Mycobacterium avium by polymerase chain reaction and his disease was eventually diagnosed as disseminated Mycobacterium avium complex (MAC) infection. The liver and spleen weighed 2,660 g and 1,840 g respectively at autopsy. Although hepatosplenomegaly is commonly recognized in AIDS patients with disseminated MAC infection, such massive and rapid enlargement has been rarely observed. This case study emphasize the importance of diagnosis and rapid treatment at the early stage of MAC infection.

AIDS-Related Opportunistic Infections↗

PubMed1995

[Factor XIII].

Explore the source record for details and available documents.

Factor XIII↗

PubMed1993

[Thrombocytopenia in HIV-1 seropositive hemophiliacs].

When platelet counts were compared in 1986 and 1992 in 117 anti-HIV antibody positive and negative hemophilia patients, a clear decrease was found in the positive group. In 1992 platelet counts < 150 x 10(9) were present in 23.5% of the positive group in contrast to 5.8% of the negative group. Comparing platelet counts with other clinical parameters, a positive correlation was found with cholinesterase and a negative correlation with IgG in both the positive and negative groups, while negative correlations with beta 2-microglobulin and platelet-associated IgG were found in only the positive group. These findings implicate the chronic liver dysfunction present in hemophilia patients, apart from HIV infection, in the decrease in platelet counts, with immunodeficiency playing an additional role in the positive group. In the treatment of a hemophilia B patient showing decreased platelet counts, these counts increased consistent with the administration of Acyclovir and Zidovudine. It was demonstrated that HSV-1 and HIV-1 antigen are present on the soluble platelets of this patient and are recognized by antibodies in the patient's serum.

Adolescent↗