Shinichiro Hayashi

Plasma Thrombosis-Inducing Activity in 120 Patients with Primary Lung Cancer

One hundred and twenty patients with primary lung cancer were examined for the presence of thrombosis-inducing activity (TIA) in their plasma. TIA was identified in plasma from 16 of 38 patients with stage 3 (42%) and 31 of 65 patients with stage 4 (48%) disease. On the other hand, only 1 of 17 patients with stages 1 and 2 (6%) showed TIA in their plasma. Cell type did not seem to correlate with the presence of plasma TIA, since TIA was identified in plasma from patients with all cell types. Survival of 32 patients with inoperable non-small cell lung cancer, all stage 4, was studied. The mean survival time was 7.2 months in the TIA-positive group and 10.3 months in the TIA-negative group. This difference was statistically significant.

Thrombosis-Inducing Activity in Plasma of Patients with Acute Respiratory Tract Infection Disappears after Treatment

Thrombosis-inducing activity (TIA) was identified in plasma from 16 of 27 patients (59%) with acute respiratory tract infections. On the other hand, it was present in only 9 of 79 subjects (11%) with chronic lung diseases and 4 of 49 healthy volunteers (8%). In the patients with acute respiratory tract infections, there were significant elevations in plasma fibrinogen, C-reactive protein and erythrocyte sedimentation rate in the TIA-positive group compared with the negative group. Plasma TIA disappeared in all of the 8 patients who were retested for TIA 2-5 weeks after they became disease free. Pneumonia was induced in rabbits by transbronchial injection of viable Escherichia coli. TIA was not present in plasma from normal rabbits, but it appeared in plasma collected 3 days after injection. It then disappeared after 1-2 weeks of treatment with antibiotics. TIA may serve as a marker for inflammatory responses and be a factor responsible for elevated blood coagulation activity in patients with acute infectious diseases.

Herpes Zoster in Patients with Sarcoidosis

108 patients with sarcoidosis were retrospectively studied for the development of herpes zoster. Five of these patients (4.6%), 2 of whom were in their twenties, developed herpes zoster. Only 1 patient had been treated with an oral steroid. All 5 had extrathoracic lesions. Zoster tended to occur during the inactive stage of sarcoidosis and did not exacerbate the activity of the sarcoidosis. The clinical course of their zoster infection was typically benign. There have been few reports of herpes zoster in patients with sarcoidosis. Further studies are required to determine whether sarcoidosis predisposes to herpes zoster infection.

Thrombosis-Inducing Activity Found in Plasma from Two Patients with Advanced Lung Cancer

In 2 patients with lung cancer, the coagulation system was supposed to be activated by the findings of elevation of plasma fibrinogen, fibrinogen degradation product (FDP) and/or peripheral platelet counts. The plasma thromboxane B2 and 6-keto-prostaglandin F1 alpha levels in 1 patient were measured and proved to be 160 and 20 times higher than the control level, respectively. When 0.5 ml of plasma from each patient was given intravenously into Balb/c mice, the mice died within 5 min. The multiple thrombosis mainly composed of aggregated platelets and present in the lungs of these mice probably led to death of these animals. On the contrary, no such activity was found in plasma from healthy subjects or other patients with lung cancer who showed no manifestations of enhancement in the coagulation system.

Superoxide (O2-) assay monocyte adherence test for the detection of cell-mediated immunity in cancer patients.

The reactivity of mononuclear cells from patients with breast cancer to the 3 M KCl extract of breast tumor was tested using the superoxide (O2-) assay monocyte adherence test. The mononuclear cells were incubated with the 3 M KCl extract of breast tumor or normal breast tissues in a microcell for spectrophotometer analysis. After 2 h incubation, the nonadherent cells were removed, and the O2- generated from the monocytes adherent to the intersurface of the microcell was assayed. Thirty of 36 patients with breast cancer before treatment reacted to the extract of breast tumor. Sixteen patients showed adherence inhibition and 14 adherence stimulation. None of 8 patients with breast cancer reacted to the extract of lung tumor. Of 31 control donors (19 healthy volunteers and 12 patients with cancer of other organs), only 3 reacted to the extract of breast tumor.

Thrombosis-inducing activity--a factor which appears in plasma of patients with allergic asthma during attack.

Thrombosis-inducing activity (TIA) is a factor which was recently identified in plasma from patients with advanced lung cancer and acute respiratory tract infection. In the present study, TIA was measured during periods of attack and nonattack in patients with the allergic and nonallergic type of asthma and pulmonary emphysema with an asthmatic component. In the allergic type of asthma, the attack was accompanied by the appearance of TIA, but when the attack ended it disappeared from plasma. In the nonallergic type of asthma and emphysema with an asthmatic component, TIA remained negative even during the attack. These observations indicate that TIA has some correlations with allergic asthma.

A case of pulmonary tuberculosis with bilateral hilar lymphadenopathy diagnosed by sputum culture subsequent to open thoracic biopsy

We report a case of pulmonary tuberculosis with bilateral hilar lymphadenopathy. Open thoracic lymph nodes and lung biopsy revealed findings consistent with sarcoidosis. Culture and special staining of the biopsied specimen for mycobacteria were negative. Culture of the postoperative sputum grew Mycobacterium tuberculosis and antituberculous therapy resulted in a decrease in sizes of the lymphadenopathy. A review of the literature, with emphasis on the differential diagnosis between tuberculosis and sarcoidosis, is discussed.