Shingo Tokita

Effect of Thrombomodulin Alfa on Disseminated Intravascular Coagulation in Patients with Lung Cancer

Objective The mortality rate due to disseminated intravascular coagulation (DIC) is higher in patients with lung cancer than in those without. We examined the effect of treatment with thrombomodulin alfa (TM-α) for DIC in lung cancer patients. Methods Subjects were 57 patients with DIC (43 men, 14 women; mean age, 71.7 years), comprising 31 with lung cancer and 26 without. DIC patients with or without lung cancer did not differ significantly in their background characteristics. Results No significant difference was noted in the mortality rate between patients with lung cancer (61.3%) and those without (57.7%). However, the dose of TM-α was higher for survivors with lung cancer than for non-survivors (473.1 U/kg/day vs. 380.6 U/kg/day; p<0.01). Although no significant difference was noted in the DIC score between these four groups, the serum C-reactive protein level (6.9 mg/dL vs. 11.6 mg/dL; p<0.05) and prothrombin time-international normalized ratio (PT-INR; 1.10 vs. 1.52; p<0.05) were lower in survivors with lung cancer than in the non-survivors with lung cancer. The initial body temperature in non-survivors without lung cancer was lower than that in survivors without lung cancer (37.2℃ vs. 37.9℃, p<0.01), and the platelet count and the time to recovery from DIC in patients without lung cancer showed a significant negative correlation (r2=0.438, p<0.05). Conclusion Our findings suggest that although 380 U/kg/day of TM-α is the recommended dose for DIC treatment, a higher dose may reduce the mortality rate of lung cancer patients with DIC. Furthermore, TM-α should be initiated before worsening of DIC parameters.

Risk factors for disseminated intravascular coagulation in patients with lung cancer: Risk factors for DIC with lung cancer

The mortality rate from disseminated intravascular coagulation (DIC) is higher in patients with lung cancer than in non‐lung cancer patients. Moreover, the prevalence of DIC varies among the pathologic types of lung cancer. This study analyzed the relationship between coagulation factors and the pathologic types of lung cancer.

Survey on the proper use of an adrenaline auto-injector in 551 Japanese outdoor workers after Hymenoptera stings

Sex Men 1179 (96.6) Women 29 (2.4) Unknown 12 (1.0) Age (years) 10e19 13 (1.1) 20e29 125 (10.2) 30e39 307 (25.2) 40e49 320 (26.2) 50e59 250 (20.5) 60e69 174 (14.3) 70 27 (2.2) Unknown 4 (0.3) Questionnaire 1: A Hymenoptera sting after prescription of an adrenaline autoinjector Yes 551 (45.2) No 662 (54.3) Unknown 7 (0.6) 2: Systemic reaction after a Hymenoptera stingy Yes 65 (11.8) No 475 (86.2) Unknown 11 (2.0) 3: Use of an adrenaline auto-injector after a Hymenoptera stingy Yes 46 (8.3) No 503 (91.3) Unknown 2 (0.4) 4: Hospital visit immediately after use of an adrenaline auto-injectorz Yes 39 (84.8) No 6 (13.0) Unknown 1 (2.2) 5: Re-prescription of an adrenaline auto-injector Yes 701 (57.5) No 146 (12.0) First prescription, before expiration day 356 (29.2)