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  1. Article: [Overview].

    Asakura, Hidesaku

    Rinsho ketsueki] The Japanese journal of clinical hematology

    2022  Volume 63, Issue 5, Page(s) 440

    Language Japanese
    Publishing date 2022-04-30
    Publishing country Japan
    Document type Journal Article
    ZDB-ID 390900-1
    ISSN 0485-1439
    ISSN 0485-1439
    DOI 10.11406/rinketsu.63.440
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  2. Article ; Online: Diversity of disseminated intravascular coagulation and selection of appropriate treatments.

    Asakura, Hidesaku

    International journal of hematology

    2020  Volume 113, Issue 1, Page(s) 10–14

    MeSH term(s) Disseminated Intravascular Coagulation/classification ; Disseminated Intravascular Coagulation/therapy ; Humans
    Keywords covid19
    Language English
    Publishing date 2020-11-07
    Publishing country Japan
    Document type Editorial
    ZDB-ID 1076875-0
    ISSN 1865-3774 ; 0917-1258 ; 0925-5710
    ISSN (online) 1865-3774
    ISSN 0917-1258 ; 0925-5710
    DOI 10.1007/s12185-020-03030-5
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  3. Article: [DIC: state-of-the-art in diagnosis and management].

    Asakura, Hidesaku

    Rinsho ketsueki] The Japanese journal of clinical hematology

    2019  Volume 60, Issue 6, Page(s) 659–666

    Abstract: Disseminated intravascular coagulation (DIC) is a serious disease that, in the presence of underlying disease, causes persistent, generalized, marked coagulation activation and recurrent formation of microthrombi in microvessels. Although the DIC ... ...

    Abstract Disseminated intravascular coagulation (DIC) is a serious disease that, in the presence of underlying disease, causes persistent, generalized, marked coagulation activation and recurrent formation of microthrombi in microvessels. Although the DIC pathophysiology differs from that of thrombotic microangiopathy (TMA), distinguishing the two is sometimes challenging. At least, differential diagnosis using coagulation tests of values such as PT and APTT is difficult. While the mechanisms of DIC development differ according to the underlying disease, tissue factor plays a vital role in common. The classification of the DIC type is essential not only for understanding pathophysiology but also for the appropriate choice of DIC treatment. As a revision of the old DIC diagnostic criteria of the Japanese Ministry of Health, Labour and Welfare, new diagnostic criteria for DIC have been established by the Japanese Society on Thrombosis and Hemostasis (2017 edition). The new criteria are estimated to play a pivotal role in the future diagnosis of DIC. From the perspective of analysis by genetic techniques, the protein C/thrombomodulin system and plasminogen activator inhibitor play crucial roles in the control and development of DIC.
    MeSH term(s) Blood Coagulation Tests ; Diagnosis, Differential ; Disseminated Intravascular Coagulation/diagnosis ; Disseminated Intravascular Coagulation/therapy ; Hemostasis ; Humans ; Thrombosis
    Language Japanese
    Publishing date 2019-06-06
    Publishing country Japan
    Document type Journal Article ; Review
    ZDB-ID 390900-1
    ISSN 0485-1439
    ISSN 0485-1439
    DOI 10.11406/rinketsu.60.659
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  4. Article ; Online: Therapeutic Strategies for Disseminated Intravascular Coagulation Associated with Aortic Aneurysm.

    Yamada, Shinya / Asakura, Hidesaku

    International journal of molecular sciences

    2022  Volume 23, Issue 3

    Abstract: Aortic aneurysms are sometimes associated with enhanced-fibrinolytic-type disseminated intravascular coagulation (DIC). In enhanced-fibrinolytic-type DIC, both coagulation and fibrinolysis are markedly activated. Typical cases show decreased platelet ... ...

    Abstract Aortic aneurysms are sometimes associated with enhanced-fibrinolytic-type disseminated intravascular coagulation (DIC). In enhanced-fibrinolytic-type DIC, both coagulation and fibrinolysis are markedly activated. Typical cases show decreased platelet counts and fibrinogen levels, increased concentrations of fibrin/fibrinogen degradation products (FDP) and D-dimer, and increased FDP/D-dimer ratios. Thrombin-antithrombin complex or prothrombin fragment 1 + 2, as markers of coagulation activation, and plasmin-α
    MeSH term(s) Anticoagulants/pharmacology ; Antifibrinolytic Agents/blood ; Aortic Aneurysm/complications ; Disseminated Intravascular Coagulation/therapy ; Fibrin Fibrinogen Degradation Products ; Fibrinolysin ; Fibrinolysis/drug effects ; Fibrinolysis/physiology ; Heparin/pharmacology ; Humans ; Partial Thromboplastin Time ; Prothrombin Time ; alpha-2-Antiplasmin
    Chemical Substances Anticoagulants ; Antifibrinolytic Agents ; Fibrin Fibrinogen Degradation Products ; alpha-2-Antiplasmin ; fibrin fragment D ; plasmin-plasmin inhibitor complex ; Heparin (9005-49-6) ; Fibrinolysin (EC 3.4.21.7)
    Language English
    Publishing date 2022-01-24
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2019364-6
    ISSN 1422-0067 ; 1422-0067 ; 1661-6596
    ISSN (online) 1422-0067
    ISSN 1422-0067 ; 1661-6596
    DOI 10.3390/ijms23031296
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  5. Article ; Online: Coagulopathy and Fibrinolytic Pathophysiology in COVID-19 and SARS-CoV-2 Vaccination.

    Yamada, Shinya / Asakura, Hidesaku

    International journal of molecular sciences

    2022  Volume 23, Issue 6

    Abstract: Coronavirus Disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and is frequently complicated by thrombosis. In some cases of severe COVID-19, fibrinolysis may be markedly enhanced within a few days, ... ...

    Abstract Coronavirus Disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and is frequently complicated by thrombosis. In some cases of severe COVID-19, fibrinolysis may be markedly enhanced within a few days, resulting in fatal bleeding. In the treatment of COVID-19, attention should be paid to both coagulation activation and fibrinolytic activation. Various thromboses are known to occur after vaccination with SARS-CoV-2 vaccines. Vaccine-induced immune thrombotic thrombocytopenia (VITT) can occur after adenovirus-vectored vaccination, and is characterized by the detection of anti-platelet factor 4 antibodies by enzyme-linked immunosorbent assay and thrombosis in unusual locations such as cerebral venous sinuses and visceral veins. Treatment comprises high-dose immunoglobulin, argatroban, and fondaparinux. Some VITT cases show marked decreases in fibrinogen and platelets and marked increases in D-dimer, suggesting the presence of enhanced-fibrinolytic-type disseminated intravascular coagulation with a high risk of bleeding. In the treatment of VITT, evaluation of both coagulation activation and fibrinolytic activation is important, adjusting treatments accordingly to improve outcomes.
    MeSH term(s) Biomarkers ; Blood Coagulation ; Blood Coagulation Disorders/diagnosis ; Blood Coagulation Disorders/etiology ; Blood Coagulation Disorders/prevention & control ; Blood Coagulation Disorders/therapy ; Blood Coagulation Tests ; COVID-19/complications ; COVID-19/immunology ; COVID-19/prevention & control ; COVID-19 Vaccines/adverse effects ; COVID-19 Vaccines/immunology ; Combined Modality Therapy ; Disease Management ; Disease Susceptibility ; Fibrinolysis ; Humans ; Prognosis ; SARS-CoV-2 ; Treatment Outcome
    Chemical Substances Biomarkers ; COVID-19 Vaccines
    Language English
    Publishing date 2022-03-19
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2019364-6
    ISSN 1422-0067 ; 1422-0067 ; 1661-6596
    ISSN (online) 1422-0067
    ISSN 1422-0067 ; 1661-6596
    DOI 10.3390/ijms23063338
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  6. Article: [Improving outcome of COVID-19-associated thrombosis: the need for evaluation of fibrinolytic activation].

    Yamada, Shinya / Asakura, Hidesaku

    Rinsho ketsueki] The Japanese journal of clinical hematology

    2022  Volume 63, Issue 5, Page(s) 471–480

    Abstract: Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 and is known to have thrombotic complications. Various-sized thrombosis occurs in the arteries and veins, especially in lung tissue. The prevention and ... ...

    Abstract Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 and is known to have thrombotic complications. Various-sized thrombosis occurs in the arteries and veins, especially in lung tissue. The prevention and treatment of thrombosis is an important issue that is directly linked to its prognosis. Additionally, the drastic fibrinolytic enhancement and lethal bleeding in some severe COVID-19 are important issues. The efficacy of antiplatelet for COVID-19 is controversial. Thus, warfarin or tranexamic acid alone should be avoided. Heparin is effective for mild to moderate COVID-19 but is ineffective in severe cases since the anticoagulant activity of heparin is insufficient or heparin increases major bleeding. In severe COVID-19 cases with drastic fibrinolytic enhancement, heparin and nafamostat combination therapy may avoid lethal bleeding. In COVID-19 clinical practice, not only the coagulation activation was evaluated but also the fibrinolytic activation to consider treatment strategies.
    MeSH term(s) Anticoagulants/therapeutic use ; COVID-19/complications ; Fibrinolytic Agents/therapeutic use ; Hemorrhage/drug therapy ; Heparin ; Humans ; SARS-CoV-2 ; Thrombosis/drug therapy ; Thrombosis/etiology ; Thrombosis/prevention & control
    Chemical Substances Anticoagulants ; Fibrinolytic Agents ; Heparin (9005-49-6)
    Language Japanese
    Publishing date 2022-05-17
    Publishing country Japan
    Document type Journal Article
    ZDB-ID 390900-1
    ISSN 0485-1439
    ISSN 0485-1439
    DOI 10.11406/rinketsu.63.471
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    In stock of ZB MED Cologne/Königswinter

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  7. Article ; Online: Coagulopathy and Fibrinolytic Pathophysiology in COVID-19 and SARS-CoV-2 Vaccination

    Shinya Yamada / Hidesaku Asakura

    International Journal of Molecular Sciences, Vol 23, Iss 3338, p

    2022  Volume 3338

    Abstract: Coronavirus Disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and is frequently complicated by thrombosis. In some cases of severe COVID-19, fibrinolysis may be markedly enhanced within a few days, ... ...

    Abstract Coronavirus Disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and is frequently complicated by thrombosis. In some cases of severe COVID-19, fibrinolysis may be markedly enhanced within a few days, resulting in fatal bleeding. In the treatment of COVID-19, attention should be paid to both coagulation activation and fibrinolytic activation. Various thromboses are known to occur after vaccination with SARS-CoV-2 vaccines. Vaccine-induced immune thrombotic thrombocytopenia (VITT) can occur after adenovirus-vectored vaccination, and is characterized by the detection of anti-platelet factor 4 antibodies by enzyme-linked immunosorbent assay and thrombosis in unusual locations such as cerebral venous sinuses and visceral veins. Treatment comprises high-dose immunoglobulin, argatroban, and fondaparinux. Some VITT cases show marked decreases in fibrinogen and platelets and marked increases in D-dimer, suggesting the presence of enhanced-fibrinolytic-type disseminated intravascular coagulation with a high risk of bleeding. In the treatment of VITT, evaluation of both coagulation activation and fibrinolytic activation is important, adjusting treatments accordingly to improve outcomes.
    Keywords COVID-19 ; SARS-CoV-2 vaccine ; coagulopathy ; fibrinolysis ; enhanced-fibrinolytic-type DIC ; nafamostat ; Biology (General) ; QH301-705.5 ; Chemistry ; QD1-999
    Subject code 610
    Language English
    Publishing date 2022-03-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  8. Article ; Online: Therapeutic Strategies for Disseminated Intravascular Coagulation Associated with Aortic Aneurysm

    Shinya Yamada / Hidesaku Asakura

    International Journal of Molecular Sciences, Vol 23, Iss 1296, p

    2022  Volume 1296

    Abstract: Aortic aneurysms are sometimes associated with enhanced-fibrinolytic-type disseminated intravascular coagulation (DIC). In enhanced-fibrinolytic-type DIC, both coagulation and fibrinolysis are markedly activated. Typical cases show decreased platelet ... ...

    Abstract Aortic aneurysms are sometimes associated with enhanced-fibrinolytic-type disseminated intravascular coagulation (DIC). In enhanced-fibrinolytic-type DIC, both coagulation and fibrinolysis are markedly activated. Typical cases show decreased platelet counts and fibrinogen levels, increased concentrations of fibrin/fibrinogen degradation products (FDP) and D-dimer, and increased FDP/D-dimer ratios. Thrombin-antithrombin complex or prothrombin fragment 1 + 2, as markers of coagulation activation, and plasmin-α 2 plasmin inhibitor complex, a marker of fibrinolytic activation, are all markedly increased. Prolongation of prothrombin time (PT) is not so obvious, and the activated partial thromboplastin time (APTT) is rather shortened in some cases. As a result, DIC can be neither diagnosed nor excluded based on PT and APTT alone. Many of the factors involved in coagulation and fibrinolysis activation are serine proteases. Treatment of enhanced-fibrinolytic-type DIC requires consideration of how to control the function of these serine proteases. The cornerstone of DIC treatment is treatment of the underlying pathology. However, in some cases surgery is either not possible or exacerbates the DIC associated with aortic aneurysm. In such cases, pharmacotherapy becomes even more important. Unfractionated heparin, other heparins, synthetic protease inhibitors, recombinant thrombomodulin, and direct oral anticoagulants (DOACs) are agents that inhibit serine proteases, and all are effective against DIC. Inhibition of activated coagulation factors by anticoagulants is key to the treatment of DIC. Among them, DOACs can be taken orally and is useful for outpatient treatment. Combination therapy of heparin and nafamostat allows fine-adjustment of anticoagulant and antifibrinolytic effects. While warfarin is an anticoagulant, this agent is ineffective in the treatment of DIC because it inhibits the production of coagulation factors as substrates without inhibiting activated coagulation factors. In addition, monotherapy using ...
    Keywords enhanced-fibrinolytic-type disseminated intravascular coagulation ; serine protease ; synthetic protease inhibitor ; nafamostat ; direct oral anticoagulant ; Biology (General) ; QH301-705.5 ; Chemistry ; QD1-999
    Subject code 610
    Language English
    Publishing date 2022-01-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  9. Article: [Thrombosis in myeloproliferative neoplasms].

    Asakura, Hidesaku

    Rinsho ketsueki] The Japanese journal of clinical hematology

    2018  Volume 59, Issue 8, Page(s) 1034–1041

    Abstract: Among all types of myeloproliferative neoplasms (MPNs), polycythemia vera (PV) and essential thrombocythemia (ET) require careful management of both thrombosis and hemostasis. One recent concern associated with MPNs is the JAK2 mutation (V617F). This ... ...

    Abstract Among all types of myeloproliferative neoplasms (MPNs), polycythemia vera (PV) and essential thrombocythemia (ET) require careful management of both thrombosis and hemostasis. One recent concern associated with MPNs is the JAK2 mutation (V617F). This mutation is essential for MPN pathology, but it has also garnered attention for its association with thrombosis. Several studies have reported the mechanisms underlying the onset of thrombosis in both PV and ET and have also discussed the association between JAK2 mutations and thrombotic tendencies. Arterial thrombosis is a common clinical symptom that is associated with the diagnosis and course of both PV and ET. Particularly, cerebral infarction has been identified as the leading cause of death in patients with untreated PV. Notably, PV and ET are also associated with a high incidence of venous thromboembolism (VTE). The occurrence of this type of thrombosis at atypical sites, such as cerebral venous sinus thrombosis and splanchnic vein thrombosis (SVT), is not uncommon. Generally, patients with PV and ET have good life expectancy; their treatment essentially focuses on dealing with thrombosis and bleeding. Phlebotomy may be used for treating patients with PV; however, low-dose aspirin is used to prevent the onset of arterial thrombosis. For patients with a history of VTE, oral anticoagulants are commonly prescribed to prevent recurrence.
    MeSH term(s) Humans ; Janus Kinase 2/genetics ; Mutation ; Myeloproliferative Disorders/complications ; Polycythemia Vera/complications ; Thrombocythemia, Essential/complications ; Thrombosis/complications
    Chemical Substances JAK2 protein, human (EC 2.7.10.2) ; Janus Kinase 2 (EC 2.7.10.2)
    Language Japanese
    Publishing date 2018-09-05
    Publishing country Japan
    Document type Journal Article ; Review
    ZDB-ID 390900-1
    ISSN 0485-1439
    ISSN 0485-1439
    DOI 10.11406/rinketsu.59.1034
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  10. Article ; Online: Vaccine-induced immune thrombotic thrombocytopenia: Update on diagnosis and management considering different resources: Comment from Yamada et al.

    Yamada, Shinya / Asakura, Hidesaku

    Journal of thrombosis and haemostasis : JTH

    2021  Volume 20, Issue 2, Page(s) 540–541

    MeSH term(s) Autoimmunity ; Humans ; Purpura, Thrombocytopenic, Idiopathic ; Thrombocytopenia/chemically induced ; Thrombocytopenia/diagnosis ; Thrombocytopenia/therapy ; Thrombosis ; Vaccines
    Chemical Substances Vaccines
    Language English
    Publishing date 2021-12-21
    Publishing country England
    Document type Letter ; Comment
    ZDB-ID 2112661-6
    ISSN 1538-7836 ; 1538-7933
    ISSN (online) 1538-7836
    ISSN 1538-7933
    DOI 10.1111/jth.15618
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