ABSTRACT
A 48-year-old male underwent an osteosynthesis surgery for right patellar fracture without bleeding episodes around the surgery. After 7 months, he presented with a bleeding episode after a nail extraction surgery from his knee joint. He was diagnosed with mild hemophilia A after his second surgery. The patient's clinical course suggested that he had mild hemophilia A, although he had a past surgical history without any bleeding episodes. Early diagnosis is important in patients with mild hemophilia A because bleeding episodes complicated with surgery can be prevented by the administration of prophylactic replacement therapy.
Subject(s)
Hemophilia A/diagnosis , Knee/surgery , Postoperative Hemorrhage/etiology , Humans , Male , Middle AgedABSTRACT
Although cadmium-induced apoptosis of lymphocytes is one of common features in the immunotoxicity of cadmium, the membrane pathway for intracellular cadmium accumulation is not fully elucidated. To characterize membrane Cd(2+) transport of rat thymocytes, the change in intracellular Cd(2+) concentration under various conditions was examined by the use of Fluo-3, a fluorescent probe for monitoring the change in intracellular concentration of divalent metal cations. The membrane Cd(2+) transport was estimated by the augmentation of Fluo-3 fluorescence induced by bath application of CdCl(2). Lowering temperature strongly suppressed the augmentation of Fluo-3 fluorescence by CdCl(2), suggesting that the metabolic process can be involved in membrane Cd(2+) transport. External acidification (decreasing pH) and membrane depolarization by adding KCl attenuated the augmentation, indicating the requirement of electrochemical driving force for membrane Cd(2+) transport into the cells. Bath application of CaCl(2) and ZnCl(2) equally decreased the augmentation, suggesting their competition with Cd(2+) at the membrane transport. The augmentation by CdCl(2) was lesser in the cells treated with N-ethylmaleimide inducing chemical depletion of cellular thiols. The result suggests the contribution of sulfhydryl groups to membrane Cd(2+) transport. Taken together, it is suggested that the cells possess a temperature-sensitive membrane Cd(2+) pathway, driven by electrochemical gradient of Cd(2+) and transmembrane potential, with competitive binding site. Based on the characteristics described above, it is unlikely that the membrane Cd(2+) transport in rat thymocytes is attributed to a single transport system although it has characteristics that are similar to those of divalent cation transporter 1.