To investigate treatment effects of thrombomodulin alfa (TM-α) in patients with disseminated intravascular coagulation (DIC) having infection as the underlying disease, retrospective subanalysis of a double-blind, randomized controlled phase 3 trial was conducted. In the phase 3 trial, 227 DIC patients (full-analysis set) having infection and/or hematologic malignancy as the underlying disease received either TM-α (0.06 mg·kg for 30 min once daily) or heparin (8 U·kg·h for 24 h) for 6 days using the double-dummy method. Among these patients, 147 patients with noninfectious comorbidity leading to severe thrombocytopenia (e.g., hematologic malignancy, or aplastic anemia) were excluded from the present analysis, and 80 patients with infectious disease and DIC were extracted and subjected to the present retrospective subanalysis. Disseminated intravascular coagulation resolution rates were determined using the DIC diagnostic criteria for critically ill patients at 7 days, and mortality rates were evaluated at 28 days. In the TM-α and heparin groups, DIC resolution rates were 67.5% (27/40) and 55.6% (20/36), and 28-day mortality rates were 21.4% (9/42) and 31.6% (12/38), respectively. Mortality rates of patients who recovered from DIC were 3.7% (1/27) in the TM-α group and 15% (3/20) in the heparin group. These results suggest TM-α may be valuable in the treatment of DIC associated with infection.

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Abstract-The x-ray powder diffraction patterns of 50-1 00 p m C-rich grains from five ureilitic meteoritesKenna, Allan Hills (ALH) 78019, Yamato (Y)-82100, Y-791538, and ALH 77257-were obtained by using a Gandolfi camera. The results reveal that the basal spacing of part of the graphite coexisting with diamond is slightly smaller compared to the normal spacing. Compressed graphite is experimentally known to occur at the initial stage of the direct transformation from graphite to diamond structures at high pressures and temperatures. The presence of the compressed graphite in ureilites, therefore, gives clear evidence that the diamond formed by high-pressure conversion of graphite. The modes of occurrence of C minerals observed with reflected light through an optical microscope reveal that graphite coexisted with olivine and pyroxene during igneous or metamorphic processes and, furthermore, that part of the graphite was converted to diamond by impact. The relative x-ray intensity of diamond to graphite increases in the following order: ALH 78019 and Y-82100 < Y-791538 < Kenna < ALH 77257. This correlates with the shock level that is estimated mainly on the basis of the shock features of silicates. Therefore, the relative amounts of diamond to graphite suggested by x-ray intensities may be useful as a measure of the degree of shock.

This study demonstrated that intravenous infusion of recombinant human soluble thrombomodulin (rhs-TM) could inhibit disseminated intravascular coagulation (DIC) caused by 4 hr infusion of tissue factor (TF) in rats. Extended infusion of TF reduced fibrinogen and platelet counts and elevated serum FDP level. Pretreatment and coinfusion of rhs-TM could block changes of these DIC-parameters without prolongation of APTT. Heparin, which is a potent anti-DIC drug, could also inhibit these changes with extra prolongation of APTT and PT. Thus, these results suggest thrombomodulin prevent DIC less bleeding tendency than heparin.

Abstract--The surface microtopographic observations and analyses of Izumiyama hydrothermal illite particles were made by utilizing tapping-mode atomic force microscopy (TMAFM). The Izumiyama illite particles showed platy to lath shapes. Platy particles exhibited various spiral growth patterns, i.e. circular, malformed circular, or polygonal single unit-cell layer spirals, polygonal parallel step spiral, or interlaced spiral patterns. The polygonal parallel step spiral and interlaced spiral patterns are formed by two single unit-cell layers rotated by 180 ~ and 120" arising from a single screw dislocation point, respectively. The spiral patterns indicate that the illite particles have IM, 20 and 2Mr polytypes. Lath-shaped particles show only interlacing patterns supporting the formation of 2Ml structures.Particles showing circular or malformed circular spirals were found to be thinner and to have narrower step separations than particles showing polygonal spirals. Polygonal platy and lath-shaped particles showing interlaced patterns tended to be thicker and to have wider step separations than the other polygonal platy particles.These results suggest that the Izumiyama illites crystallize as the result of a mechanism involving solution-mediated polytypes and spiral-type transformations of illite. The mechanism involves the Ostwald ripening process, i.e. a transformation of the polytype and spiral shape. The sequence of crystallization of the Izumiyama illite is: 1M circular spirals -~ IM, 20 polygonal spirals -~ 2M~ polygonal spirals occurring during crystal growth and sequentially overgrowing on the initial particle surfaces. The supersaturation of the hydrothermal solution probably decreases gradually during the transformation, and this decrease may cause not only the transformation from a circular to a polygonal crystal morphology but also the development of a lath habit due to the inhibition of the growth rate in the [010] direction of the particle.