Fucosylated alpha-fetoprotein as marker of early hepatocellular carcinoma.
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Biomedical subjects
Publications and source records attributed to K Soga.
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Ceftriaxone (Ro 13-9904, CTRX) was administered to 3 cases with gynecological infections and following results were obtained. CTRX was administered by intravenous drip infusion or intravenous injection with 2 g per day for 4 to 6 days. The clinical efficacy was good in all cases (2 cases with pyometra, 1 case with adnexitis and endometritis). No side effect could be determined in all cases.
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The reactivity of alpha-fetoprotein (AFP) with concanavalin A (Con A) and Lens culinaris agglutinin (LCA) was studied by crossed immuno-affinoelectrophoresis of the serum samples of 146 patients from three groups (groups I, II and III). Fifty-one patients with benign liver diseases were included in group I, 83 patients with hepatocellular carcinoma in group II, and 12 patients with carcinoma metastatic to the liver from digestive organs in group III. In group I, the percentage of Con A-reactive species of AFP was high (97 +/- 5%, mean +/- SD), but that of LCA-reactive species was very low (3 +/- 5%). The percentage of LCA-reactive species of AFP in group II (45 +/- 33%) was higher than that in group I (P less than 0.001), while the Con A binding pattern of AFP in this group, as demonstrated by immuno-affinoelectrophoresis, was similar to that of group I. The percentage of Con A-reactive species of AFP in group III (55 +/- 24%) was much lower than that in group II (97 +/- 5%) (P less than 0.001). The above results indicate that measurement of the reactivity of AFP in serum samples with Con A and LCA is useful for the differentiation of AFP species which are found in association with benign liver diseases, hepatocellular carcinoma and carcinoma metastatic to the liver.
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Levels of prekallikrein and HMW kininogen that had increased during pregnancy decreased with start of labor. The role of the kinin-forming system with oxytocin in the mechanism of labor was suggested from the results of decreased prekallikrein and HMW kininogen, appearance of a free kallikrein-like enzyme during labor, and from the case of arrested labor in which both prekallikrein and HMW kininogen were markedly decreased. Prekallikrein was markedly decreased in patients with acute obstetrical DIC and severe toxemia of pregnancy. The excessive activation of prekallikrein in DIC seemed to be of help for understanding such clinical signs as shock, abnormal labor, and increased permeability in obstetrical DIC.
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Plasma kallikrein acts as a chemical mediator of microcirculation and as a contracting agent of smooth muscle by liberating bradykinin from high molecular weight kininogen. In addition, prekallikrein relates to coagulation process of blood. It is, therefore, a intriguous problem to know the behavior of prekallikrein in obstetrics, especially as to the mechanisms of labor, edema of toxemia and DIC. The following results were obtained: 1) Plasma prekallikrein determined by chromogenic tripeptide substrate was increased with advance of gestational ages, and reached maximum (213.5 +/- 31.1%) at the term. At the beginning of labor, the prekallikrein level was suddenly decreased, and remained low during labor. Rapidly lowered plasma prekallikrein during labor seems to be result from consumption of prekallikrein due to conversion to kallikrein. The kallikrein probably relates to uterine contraction by forming bradykinin. 2) A lowered plasma prekallikrein level was observed in 29 cases of toxemia, especially in edema type. In toxemic cases, kallikrein may play an important role in producing edema by bradykinin. 3) In 16 cases of DIC, prekallikrein was significantly low (p less than 0.001) especially in cases of endotoxic shock, suggesting consumption of prekallikrein as in other various coagulation fibrinolysis factors in DIC.
From the standpoint of labor mechanism, behavior of prekallikrein, a kinin-forming enzyme, during pregnancy and labor has been of great importance. Plasma prekallikrein determined by synthetic chromogenic tripeptide substrate was increased with advancing gestational ages, reaching approximately 200% of normal. When labor started, it decreased rapidly to 70%, then returned gradually to the normal level after delivery. Prekallikrein and kininogen are only two plasma proteins which change so markedly during labor among many plasma proteins. Role of prekallikrein in the mechanism of labor is presumptively as follows: (1) Prekallikrein is converted to kallikrein resulting in its consumption and decrease. (2) Kallikrein contributes to uterine contraction by liberating kinin from kininogen.
Fibronectin was isolated from human plasma by affinity chromatography with gelatin-coupled Sepharose 4B. Anti-fibronectin antiserum was prepared using rabbits, and human liver biopsy specimens at various stages of fibrosis were investigated for distribution of fibronectin by the indirect immunofluorescence technique. Fibronectin was absent in liver parenchymal cells, while it was detected markedly in reticulin and the area containing collagen fibers. The existence of fibronectin in the necrotic area and in prematured fibers suggests the earlier deposition of fibronectin than that of collagen at the locus of tissue repairing, and thus the important role of fibronectin at the early stage of fibrosis.
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It has been a general concept that fibrinolytic activity is diminished during pregnancy. However, increase in FDP (fibrin/fibrinogen degradation products by plasmin digestion) which indicates accelerated fibrinolytic activity is also observed during pregnancy. To clarify these conflicting findings, alpha-2-plasmin inhibitor and FDP, sensitive indicators of fibrinolytic activity, were studied during pregnancy. Decrease in plasmin inhibitor and increase in FDP were found during pregnancy suggesting that fibrinolytic activity is accelerated during pregnancy. Since FDP level was higher in blood samples from the uterine vein than those from the artery, the accelerated fibrinolysis characterized by decrease in plasmin inhibitor and increased FDP, might be reflection of local event. On the other hand, systemic blood remains still hypofibrinolytic in normal pregnant condition.
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A 15-year old female presented with bilateral popliteal artery entrapment syndrome. The left popliteal artery was completely occluded and thromboendarterectomy was performed. Angiography on passive dorsiflexion revealed compression of the right popliteal artery, although it was free of symptoms and of normal caliber. End-to-end anastomosis in the normal anatomical position without division of the medial head of the gastrocnemius muscle was performed on both sides.