Tomoyoshi Nohira

Successful management by recombinant activated factor VII in a case of disseminated intravascular coagulopathy caused by obstetric hemorrhage

Postpartum hemorrhage (PPH) is a life‐threatening emergency in obstetrics. Although recombinant activated factor VII (rFVIIa) has become used for the treatment of some cases of massive hemorrhage, its applications in the field of obstetrics are still limited. We describe a case of successful treatment with rFVIIa for PPH due to placenta accreta. The patient was a 33‐year‐old woman with placental previa. Cesarean section (CS) was performed at gestational week 35. During CS, there was massive hemorrhage due to placenta accreta. After CS, disseminated intravascular coagulopathy and hypovolemic shock were diagnosed. The PPH was not controlled by transfusion therapy. On the fourth day after CS, rFVIIa (90 µg/kg × 2) was given because of the persistent PPH. Bleeding decreased and no further transfusion was required from 2 days after administration. rFVIIa was useful in the treatment of this case of obstetric hemorrhage.

Xanthoangelols isolated from Angelica keiskei inhibit inflammatory-induced plasminogen activator inhibitor 1 (PAI-1) production.

The folk medicine Angelica keiskei (Ashitaba) exhibits antitumor, antioxidant and antidiabetic activities and it has recently attracted attention as a health food. Ashitaba is thought to have antithrombotic properties, but this has not yet been scientifically proven. The elevation of plasma plasminogen activator inhibitor 1 (PAI-1), an inhibitor of fibrinolysis results in a predisposition to the risk of thrombosis. The present study showed that Ashitaba exudates injected intraperitoneally and orally administered over long-term suppressed the lipopolysaccharide (LPS) induced PAI-1 increase in mouse plasma. We also found that xanthoangelol, xanthoangelols B and D, the components of Ashitaba exudates, significantly inhibited TNFα-induced PAI-1 production from human umbilical vein endothelial cells (HUVECs). These findings suggest that Ashitaba can decrease elevated PAI-1 production, and that daily consumption of Ashitaba product might maintain anticoagulant status by inhibiting elevations in PAI-1 under inflammatory conditions.

Pregnancy Complicated with Bartter's Syndrome: A Case Report

Bartters syndrome is a rare renal disorder, and since there are few case reports of Bartters syndrome complicating pregnancy are few, the changes of electrolytes and hormonal metabolism during pregnancy are unknown. We describe and discuss the course of pregnancy complicated with Bartters syndrome.

Propolis and its constituent chrysin inhibit plasminogen activator inhibitor 1 production induced by tumour necrosis factor-α and lipopolysaccharide

Summary Propolis is thought to help prevent thrombotic and related cardiovascular diseases in humans, but this has not yet been definitively demonstrated. Elevated levels of plasma plasminogen activator inhibitor 1 (PAI-1), an inhibitor of fibrinolysis, predisposes individuals to a risk of developing thrombotic diseases. Plasma PAI-1 increases under inflammatory conditions such as infection, obesity and atherosclerosis. Maintaining physiological PAI-1 levels in plasma might represent a promising intervention for treating various diseases. The present study examines the effects of propolis and its components including flavonoids and derivatives of benzoic, cinnamic and quinic acids, on the increase in PAI-1 induced by inflammation. Propolis inhibited the increase in PAI-1 induced by tumour necrosis factor (TNF)-α in HUVEC culture medium. We also showed that the flavonoid chrysin is an active constituent. Both propolis and chrysin inhibited the increase in PAI-1 induced by LPS in mouse plasma. Thus propolis and its constituent, chrysin, inhibited PAI-1 production. The present findings confirmed the potential of propolis and its constituents in treating or preventing thrombotic disorders, or as an antithrombotic food supplement.