Motoaki Tanigawa

Increased tissue factor pathway inhibitor in patients with acute myocardial infarction.

We examined hemostatic abnormalities in 23 patients with acute myocardial infarction (AMI), 10 with pulmonary embolism (PE), and 10 with deep vein thrombosis (DVT). At the onset of AMI, plasma levels of tissue‐type plasminogen activator (t‐PA), PA inhibitor‐I (PAI‐I), fibrin‐D‐dimer, thrombin‐antithrombin complex (TAT), and plasmin‐plasmin inhibitor complex (PPIC) were significantly increased. Both the plasma total TFPI and free‐TFPI levels in the AMI patients were significantly higher than those in the healthy volunteers, PE patients, and DVT patients. There was no significant difference in total TFPI or free‐TFPI among patients with PE, those with DVT, and healthy volunteers. One hour after percutaneous transluminal coronary angioplasty (PTCA) in the AMI group, the total TFPI level was further increased, and it was significantly reduced 24 hr after PTCA, to a level similar to that in healthy volunteers. Free‐TFPI showed a pattern similar to that of total TFPI. The ratio of free‐TFPI/total TFPI was highest 1 hr after PTCA. Increased TFPI in AMI patients might be released from ischemic tissues. Am. J. Hematol. 55:183–187, 1997.

Ovarian Metastases from ALK-rearranged Lung Adenocarcinoma: A Case Report and Literature Review

We herein report a 37-year-old woman with lung adenocarcinoma with brain metastases and an asymptomatic ovarian tumor. Immunohistochemistry and a fluorescent in situ hybridization analysis of the biopsied lung tumor revealed anaplastic lymphoma kinase (ALK) gene rearrangement. Although the origin of the ovarian tumor remained unclear, alectinib administration was initiated, and radiological responses were observed in all lesions, which confirmed that the ovarian tumor was a metastasis from lung cancer. Although differentiating the origin of an ovarian tumor is difficult in lung cancer patients due to the rarity of ovarian metastases, alectinib therapy can replace an invasive biopsy, especially in ALK-rearranged lung cancer patients.

Lung abscess caused by Streptococcus pneumoniae serotype 6B

Lung abscess has been considered to be a rare complication of pneumococcal infection, and most cases are reported to be Streptococcus pneumoniae serotype 3. A 67-year-old man presented with fever and was diagnosed to have lung abscess caused by S. pneumoniae serotype 6B. The minimal inhibitory concentration (MIC) of penicillin for the isolate was 1 μg/mL. He was treated with high-dose intravenous sulbactam/ampicillin as definitive therapy based on susceptibility testing for S. pneumoniae and recovered successfully without surgical intervention. S. pneumoniae serotype 6B can cause lung abscess.

HTLV‐1 unrelated adult T‐cell leukemia/lymphoma with unique phenotype and karyotype

We describe a unique case of adult T‐cell leukemia/lymphoma (ATL). The patient had typical clinicohematological features as ATL, but showed a lack of antibody to human T‐cell leukemia virus type‐1 (HTLV‐1) and was negative for HTLV‐I proviral DNA in the peripheral mononuclear cells by means of polymerase chain reaction. The phenotype of tumor cells revealed CD7+, CD5+, CD2+, CD3+, WT31−, TcR δ 1−, CD4−, CD8−, CD25−, and the karyotype showed a 5q‐, t(12;18). HTLV‐I unrelated ATL is very rare, and the karyotype as in our case has not been reported previously. Am. J. Hematol. 64:64–66, 2000.

Generation of Tissue Factor Activity by Mononuclear Cells, Vascular Endothelial Cells and Vascular Endothelial Cells incubated with Mononuclear Cells Supernatants.

We examined the tissue factor (TF) activity in human mononuclear cells (MNCs), human umbilical vein endothelial cells (HUVECs) or HUVECs incubated with the medium from MNCs. The TF activity of HUVEC cultured without stimulation was hardly detected, but that of MNC cultured without it increased until 18 hours. When they were cultured with lipopolysaccharide (LPS) and cytokines, the TF activity was further increased dose-dependently, and reached a maximum within 6-12 hours. The TF activity of MNC cultured with LPS, interleukin-1 (IL-1) and interleukin-6 (IL-6) was significantly increased. That of HUVEC cultured with LPS, IL-1 or tumor necrosis factor (TNF) was markedly increased. Furthermore, TF activity of HUVEC incubated with the medium from MNCs cultured with various cytokines was more increased. Although TF activity of HUVEC or MNC cultured with colony stimulating factor and interferron was hardly increased, that of HUVEC incubated with the medium from MNC cultured with them was markedly increased. The TF activity of HUVEC incubated with the medium from MNCs cultured with LPS was dependent on the cell number of cultured MNC. LPS-stimulated MNC also released TNF and IL-1, and the levels within 12-24 hours. We speculated that MNCs and vascular endothelial cells interacted together and played an important role in hemostasis.