Masataka Nagayama

Cervical pregnancy as a possible sequela of induced abortion. Report of 19 cases.

Clinical details of 19 cases of cervical pregnancy are presented. None of the women were nulligravida and all had had at least 1 legal abortion. The interval between the last pregnancy and the cervical pregnancy ranged from 2 months to 8 years. 17 of the women were treated with total hysterectomy and 2 with partial hysterectomy. In all cases the vaginal hemorrhage was uncontrollable.

The coagulation-fibrinolysis system in man during ëthrane® anaesthesia and surgery

SummaryThe coagulation-fibrinolysis system was studied during ēthrane® anaesthesia and gynaecological operations in 20 patients.No particular change was noted in the platelet counts, which remained within the normal range. In the coagulation system, no appreciable change was observed except for the partial thromboplastin time(P.T.T.) which was significantly short-ended, both 30 minutes after the start of operation and in the recovery room when the patient had completely awakened from the anaesthesia.In the fibrinolytic system, the plasminogen level and the fibrinogen level declined significantly.It is considered that the fibrinolytic system is prominently accelerated under Ethrane® anaesthesia, but the haemostatic mechanism works in such a manner that bleeding is controlled. However, ēthrane® anaesthesia should be avoided or pre-operative administration of an antiplasmic agent recommended for patients with an abnormal haemostatic mechanism.Résumé1.Le système coagulation-fibrinolyse a été étudié chez 20 patientes au cours d’interventions gynécologiques, sous anesthésie à l’Ethrane.®2.Aucune modification particulière ne fut trouvée dans la numération plaquettaire qui est demeurée dans les limites normales. Le coagulogramme n’a pas été modifié de façon appréciable sauf le temps de thromboplastine partiel (P.T.T.) qui était diminué de façon significative, ceci après 30 minutes de chirurgie et après l’éveil complet.3.Pour ce qui est du système fibrinolytique, les taux de plasminogène et de fibrinogène étaient diminués de façon significative; le fibrinogène en particulier était abaissé de façon marquée.4.Nous considérons que sous anesthésie à l’Ethrane, le système fibrinolytique est accéléré, mais que les mécanismes hémostatiques agissent de telle façon que l’hémorragie est contrôlée. Cependant, chez les patients présentant des troubles de l’hémostase, on devrait éviter l’anesthésie à l’Ethrane à moins de leur administrer un agent antifibrinoly-tique avant l’intervention.

Anticoagulant release during shock

Abstract The anticoagulant release was observed in obstetrical shock and experimentally induced disseminated intravascular coagulation by endotoxin infusion into rabbits. The anticoagulant was partially purified from the incoagulable rabbit plasma by using salting out and chromatographic procedures. The experiment revealed that this anticoagulant had the following properties: 1. protein, approximate molecular weight of 60,000, 2. no antithrombin activity, 3. inhibition on thromboplastin generation and on factor VIII. The origin and significance of the substance are unknown. It may act as one of the defense mechanisms against disseminated intravascular coagulation.