Fibrinogen date: congenital hypodysfibrinogenemia associated with decreased binding of tissue-plasminogen activator.

A new case of congenital hypodysfibrinogenemia associated with a thrombotic tendency (thrombosis of the peroneal artery, the pulmonary artery and the deep veins of the lower extremities), is reported. Clotting time using Reptilase was significantly prolonged. The low levels of plasma fibrinogen were demonstrated using both thrombin time (Clauss) method (45.0 mg/ml) and radial immunodiffusion technique (106.1 mg/ml). The fibrinogen is also characterized by a defective polymerization of fibrin monomers. Furthermore, the important functional property of this fibrinogen is that the patient's fibrin adsorbs approximately 31-38% of added tissue-plasminogen activator (t-PA) at the time of fibrin formation, whereas control fibrin can adsorb about 79% of added t-PA. This result could provide an explanation for the thrombotic tendency in this patient. This variant fibrinogen appears to have unique characteristics and has been designated as "Fibrinogen Date," according to the city where the proband has lived.

[A case of hepatocellular carcinoma in an elderly patient that improved upon combination therapy of Lentinan and Tegafur].

The case was an 83-year-old man whose chief complaint was right-hypochondralgia and high fever. His laboratory findings at the first visit revealed liver dysfunction and an elevation of AFP level. Abdominal ultra-sonography revealed a giant tumor in his liver. Because of his advanced age and the large size of his tumor, he was given 2 mg Lentinan a week and 750 mg Tegafur every day. After 3 months his serum AFP level decreased to normal range, and on computed tomography his tumor disappeared completely 6 months after the beginning of this therapy. We recommend the combination therapy of Lentinan and Tegafur for patients with a high risk for usual therapies like this case for their quality of life.

Kallikrein-kinin system in diabetic patients.

Various factors in the kallikrein-kinin (K-K) system were examined in diabetic patients, and their clinical significance was evaluated. The plasma prekallikrein level was slightly increased in the entire diabetic group, but was decreased in the patients with microangiopathy. While the plasma kallikrein-like activity was increased in the diabetic patients. The urinary glandular kallikrein activity was decreased in the diabetic patients, and was significantly correlated with the urinary C-peptide level. High-molecular-weight kininogen was increased in the entire diabetic group. In the patients with microangiopathy its level was significantly lower than in diabetic patients without microangiopathy. Low-molecular-weight kininogen was increased significantly in the diabetic patients. These results suggest that the glandular K-K system is suppressed in diabetic patients and the plasma K-K system in those patients is activated according to the degree of impairment of glucose metabolism, and that changes in the plasma levels of its components are associated with those in the components of the coagulation system.

Fundamental and clinical evaluation of vasoactive intestinal peptide (VIP) in pancreatitis by radioimmunoassay kit.

Plasma vasoactive intestinal peptide (VIP) concentrations of normal individuals and patients with pancreatitis were studied using a VIP RIA kit. The inter-assay and intra-assay variation of this kit were between 2.1 and 9.4%. The VIP levels increased in the acute phase of acute pancreatitis and patients with chronic pancreatitis. The VIP concentration increased during the first 30 min of glucose tolerance test, but this increase was much smaller than that in insulin. These results suggest that this kit is useful for physiologic and pathologic changes in the VIP level.