Nihon rinsho. Japanese journal of clinical medicine
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Pathophysiology of DIC varies with underlining diseases but its precipitating factor is accepted to be mainly as an accerelation of blood coagulation. From these back grounds it is indicated that the removal of the original pathogenetic factor is important as the first step of treatment, and at the same time the anticoagulant treatment has been also advised as a fundamental remedy against this disease state. ⋯ However their beneficial effects or efficasies have not been established yet. This paper reports the pharmacological properties of these anticoagulants and some data of their clinical evaluations.
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Despite of many investigations addressing the problem on the diagnosis of DIC associated with liver diseases, however, an adequate clinical and laboratory criteria has not yet been established. We attempted to clarify this problem by evaluating the changes of plasma levels of PIC, D dimer, TAT and several endothelial factors in 20 patients with severe liver disease who had the evidence of hemorrhage, and were treated with AT III concentrate and gabexate mesilate (FOY). In patients who show a good response to treatment, plasma levels of PIC and D dimer before treatment were both significantly higher (p < 0.01) than those in patients who did not respond, while there was no significant difference in other coagulation fibrinolysis parameters except for platelet count which showed rather lower in the response group (p < 0.05). We believe that combination assay for both PIC and D dimer will be adequate to differentiate whether the hemostatic abnormalities are induced mainly by DIC or hepatic insufficiency.
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Vasopressin is thought to play an important role, not only in the metabolism of water and electrolytes, but also in the regulation of renal hemodynamics. This year, great progress has been achieved in molecular biology of vasopressin receptors. First, the cloning of a complementary DNA, encoding the rat liver V1a arginine vasopressin receptor, was reported. ⋯ In addition, an orally active and specific vasopressin V2 receptor antagonist, OPC-31260 was also reported. Oral administration of OPC-31260 inhibited antidiuretic action of arginine vasopressin. OPC-31260 is thought to be useful in the treatment of certain disorders, such as the syndrome of inappropriate secretion of ADH (SIADH).