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1.

論文(リポジトリ)

論文(リポジトリ)
高橋, 芳右
出版情報: 新潟医学会雑誌 — 新潟医学会雑誌.  110  pp.161-165,  1996-05.  新潟医学会
本文リンク: http://hdl.handle.net/10191/43051
概要: In disseminated intravascular coagulation (DIC), clinical and laboratory manifestations are extremely variable among patients, depending in most part on the underlying diseases. Patients with DIC caused by leukemia and vascular lesions show marked activation of fibrinolysis, resulting in the predominant bleeding tendency. In addition to the synthesis of procoagulant tissue factor, leukemic cells, especially acute promyelocytic leukemia cells, produce and secrete profibrinolytic plasminogen activators and leukocyte proteases, which would contribute to the excessive fibrinolysis seen in these patients. Patients with sepsis show relatively suppressed fibrinolysis and are frequently complicated by organ damage. Endotoxin, TNF and IL-1 stimulate the synthesis of tissue factor and plasminogen activator inhibitor-1, and decrease the expression of thrombomodulin and heparan sulfate in endothelial cells, which result in the predominant activation of coagulation and suppression of fibrinolysis. Intermediate profiles are observed in patients with solid cancer and malignant lymphoma. Since the pathogenesis and hemostatic profiles are thus variable among patients with DIC, management should be individualized for each patient. 続きを見る
2.

論文(リポジトリ)

論文(リポジトリ)
品田, 章二 ; 小島, 秀男 ; 佐藤, 善計 ; 渡辺, 苗美 ; 石黒, 真里子 ; 小林, 幸子 ; 土屋, ヒデ子 ; 山田, 恵子 ; 石口, 重子 ; 富樫, 和枝 ; 大竹, 幸子 ; 柴田, 昭
出版情報: 新潟医学会雑誌 — 新潟医学会雑誌.  104  pp.617-620,  1990-07.  新潟医学会
本文リンク: http://hdl.handle.net/10191/34475
概要: Blood components transfused to patients with hematological malignancies from 1978 to 1988 fiscal years at Niigata Univer sity Hospital were analysed and discussed. Between 52 and 98 cases were transfused each year. Since survival of hematological malignancies has been prolonged and the same case was counted as one in each fiscal year due to long survival, the patient number has gradually increased from 3.5% to 7.1% of total transfused patients. Approximately 95% of platelet concentrates (PC) supplied from Niigata Prefecture Red Cross Blood Center were transfused to these hematological malignacies. Since the introduction, in 1980, of an automatic blood component separator, patterns of blood components for leukemia and lymphoma therapy have changed markedly. In 1987 and 1988, the unit of PC processed through the separator was greater than that which was processed through sequential centrifugations of blood bags. Hospital processed granulocyte components reached peak levels in 1984, but have since decreased due to restrictions placed on these components which permit them to be used for therapeutic purpose only. In the future, we should implement a system to test HLA during their remission phase or to cryopreserve patient's own platelets in order to manage at their platelet refractoriness. 続きを見る
3.

論文(リポジトリ)

論文(リポジトリ)
長山, 礼三 ; 佐藤, 健 ; 柴田, 昭
出版情報: 新潟医学会雑誌 — 新潟医学会雑誌.  101  pp.173-180,  1987-03.  新潟医学会
本文リンク: http://hdl.handle.net/10191/36379
概要: The following are indications for platelet transfusion in leukemia, aplastic anemia, idiopathic thrombocytopenic purpura (ITP), and platelet dysfunction gained from our clinical experiences. During intensive chemotherapy to patients with leukemia, prophylactic and/or therapeutic platelet transfusions were administered when their platelet counts were less than 20,000/ul. When disseminated intravascular coagulation (DIC) complication occured, we kept their platelet levels at more than 50,000/ul by heparin and platelet concentrates (PC). We also gave 2 or 3 times more PC than usual when infection or fever was noticed. In patients with aplastic anemia, if their platelet count was above 5,000/ul and general condition was steady they did not hemorrhage. Therefore, we ordered PC tranfusions when their platelet level was less than 5,000/ul and administered threefold PC to patients with infection or high fever. Platelet transfusion was mandatory when hemorrhaging because patient’s condition could deteriorate rapidly. Although we did not usually transfuse PC to ITP patients, we gave PC, corticosteroids and high doses of immunoglobulins to special cases showing life. threatening organ bleeding, with remarkable effects. In cases of plalelet dysfunction, PC indications were almost the same as in thrombocytopenic states described of leukemia. In a girl with hereditary thromboasthenia, who experienced massive hematemesis or melena occasionally, local treatments were important to stop bleeding as well as PC transfusion. 続きを見る
4.

論文(リポジトリ)

論文(リポジトリ)
花野, 政晴
出版情報: 新潟医学会雑誌 — 新潟医学会雑誌.  102  pp.91-97,  1988-02.  新潟医学会
本文リンク: http://hdl.handle.net/10191/40624
概要: The problems associated with pregnancy in patients with idiopathic thrombocytopenic purpura (ITP), aplastic anemia, leukemia and thrombotic disorders were discussed. During the past 5 years, we experienced 6 pregnancies in 5 patients with ITP and 4 pregnancies in 4 patients with aplastic anemia. The patients with ITP could be well managed with the administration of corticosteroid and/or high-dose immunoglobulin. Bleeding tendency and anemia in the patients with aplastic anemia could be also well controlled by blood component transfusion. From our experiences we thought that the risk of infection in the perinatal period seemed to be extremely high in the patients with aplastic anemia. I introduced here a recomendation of Catanzarite about the management of the patients with acute leukemia in pregnancy and the anticardiolipin syndrome characterized by a high titer anticardiolipin antibody multiple thrombosis and abortion. 続きを見る