Monday, July 25 KYOTO JAPAN XXIII Congress of The International Society on Thrombosis and Haemostasis

Tuesday, July 26 KYOTO JAPAN XXIII Congress of The International Society on Thrombosis and Haemostasis

INSIDE MAGELLAN Study MAGELLAN Study: page 1 Reducing the Risk of VTE in Acutely Ill Medical Patients Highlights from Opening Ceremony Rivaroxaban, one of a new class with rivaroxaban and the optimal diagnosed with acute heart failure, page 1 of anticoagulants, is not only duration of treatment. just under-third diagnosed with 57th Annual Meeting of effective in the treatment of deep In his presentation on Monday, acute infectious disease, and just the ISTH Scientific and vein thrombosis (DVT) but has also Alexander T. Cohen, MBBS, MSc, under one-quarter diagnosed with Standardization Committee been associated with a reduced MD, King’s College Hospital, London, acute respiratory failure. page 2 Wednesday, July 27 risk of venous thromboembolism UK, discussed results from the The two arms of the trial involved The ISTH XXIII General (VTE) in patients with acute medical multicenter, randomized, double- patients receiving either 10 mg Membership AssemblyKYOTOillness. JAPAN However, questions remain blind MAGELLAN study conducted once daily of oral rivaroxaban page 4 regarding increased bleeding risks to evaluate oral treatment with for 35 days or 40 mg once daily PreviewXXIII of Plenary Congress Lectures of The International Society on Thrombosis and Haemostasis Challenge to Novel Bioactive Peptides rivaroxaban compared with a of enoxaparin by subcutaneous - Kenji Kangawa standard 10-day treatment with injection for 10 days. Double- Recent Progress in Anticoagulant subcutaneous enoxaparin. blinding involved patients taking Therapy: Oral Direct Inhibitors of Thrombin and Factor Xa The study randomized 8,101 either 35 days of an oral placebo - Kenneth A. Bauer patients from 52 countries aged or 10 days of a placebo injection page 6 40 years or older and hospitalized accompanying the treatment ISTH Academy e-learning for an acute medical illness. assignment. Information Patients had a diverse range of The study’s primary efficacy page 12 medical conditions, with one-third (continued on page 12) Highlights from the Opening Ceremony Tuesday at a Glance More than 4,400 participants have Sunday evening. Thursday, July 28 convened in Kyoto to take part The Ceremony opened with a Ongoing in the XXIII Congress of the ISTH vibrant traditional Japanese taiko Oral Communications KYOTO2011. JAPAN Congress President Yasuo drumming performance. Audience State -of-the-Art Lectures Ikeda, MD, PhD, extended a warm members were each given a pair of SymposiaXXIII Congress of The International Society on Thrombosis and Haemostasis welcome to delegates hailing 3D glasses for a special viewing of 9:45 a.m. – 10:30 a.m. from more than 70 countries at iconic Japanese scenery, changing Plenary Lecture the official Opening Ceremony on (continued on page 12) Challenge to Novel Bioactive Peptides (K. Kangawa) Changes & Corrections in ISTH2011 Final Program 12:15p.m.-1:15p.m. O-TU-047=Withdrawn P-TU-249=Withdrawn Poster Discussion O-TU-082=INTER-INDIVIDUAL VARIABILITY IN WARFARIN DOSE P-TU-278=Withdrawn 5:15p.m.-6:00p.m. REQUIREMENT IN CHILDREN CAN BE EXPLAINED BY VKORC1 AND CYP2C9 GENOTYPE AND PATIENT CHARACTERISTICS Plenary Lecture P-TU-312=COMPETING RISK OF ATHEROSCLEROTIC RISK FACTORS FOR Elizabeth Chalmers* Recent Progress in Anticoagulation ARTERIAL AND VENOUS THROMBOSIS IN A GENERAL POPULATION. THE O-TU-142=ADAMTS13 CONTAINS TWO BINDING SITES FOR VWF TROMSO STUDY 1994-2007 Therapy (K. A. Bauer) THAT COORDINATE ENZYME-SUBSTRATE INTERACTION: AN ATOMIC John-Bjarne Hansen* FORCE MICROSCOPY STUDY P-TU-378=Withdrawn 6:15p.m.-7:45p.m. Cheng Zhu* P-TU-465=Withdrawn Technical Sessions P-TU-089=Withdrawn Satellite Symposia (GlaxoSmithKline) =Wednesday July 27, 2011 14:15 - 15:45 Satellite Symposia P-TU-107=ABNORMAL PLATELET FUNCTIONS IN TWO PATIENTS WITH FILAMIN A MUTATIONS Satellite Symposia (Loyola University Medical Center)=Wednesday July 27, Marijke Bryckaert* (FR), Eliane Berrou, Frederic Adam, Marilyne 2011 14:15 - 15:45 Lebret, Alexandre Kauskot, Martine Jandrot-Perrus, Jean-Philippe Satellite Symposia (Pfizer)=Wednesday July 27, 2011 14:15 - 15:45 ISTH2011 Congress Daily is Rosa, Cyril Goizet, Alan T. Nurden, Paquita Nurden published four times during the congress. Tuesday, July 26, 18:15 - 19:45 Industry Sponsored Satellite Symposia TIPS OF THE DAY • Join the Revolution: Advances in Oral Anticoagulation (Boehringer Ingelheim) Annex Hall 1 Exhibition open from 10:30a.m. to • Progress in Haemophilia Care: New Molecules on the Horizon (Novo Nordisk) Room A 18:00p.m. • Atypical Hemolytic Uremic Syndrome (aHUS): New Insights and Emerging Treatment Options (Alexion Obun Printing Co., Inc. Pharmaceuticals) Room B2 For a chance to win an autographed 1-17-2 Bunkyo-ku, Tokyo 113-8484 • Chronic Anticoagulation in Prevention and Treatment of VTE (Daiichi Sankyo) Room D Liverpool Football Club shirt, visit the Tel: 03-3817-5920 • Can We Predict Interventions in Haemostasis and Thrombosis? (Stago) Room E SSC 2012 booth at the entrance of the ISTH 2011 Exhibition.

The ISTH 2011 Daily Congress news will also appear on the ISTH website at www.isth.org. ISTH 2011 DAILY Tuesday, July 26

57th Annual Meeting of the ISTH Scientific and Standardization Committee Anna Falanga, MD Chairman, ISTH Scientific and Standardization Committee

he 57th annual meeting of ISTH. These programs reflected gave an overview and information assembled their their part of the Tof the ISTH Scientific and the SSC spirit of international on the recent advances in the program. Standardization Committee (SSC) continuous collaboration and the wide spectrum of bleeding and The growth in the SSC meetings was held prior to the start of the strong scientific involvement and thrombotic disorders, ranging from in recent years owes much to the biennial ISTH Congress, according to skill of all members to creating pathogenesis, diagnostic tools, inclusion of educational sessions. a long-lasting tradition. relevant projects aimed to respond animal models, basic research, to The multiple activities of the SSC The work of the SSC is organized in to laboratory and clinical needs finally prophylaxis and treatment. subcommittees demonstrate that 21 different subcommittees and 2 in the field of thrombosis and The main goals were to highlight the SSC is the ideal environment to working groups. They are established haemostasis. The results of several the most recent finding, but also promote the cooperation between as needed to address practical of these projects have been or provide indications useful to leading international scientists and matters related to nomenclature, will be published as Official SSC improve the capability to diagnose direct their energies to projects standards, and methods. The Communications in the JTH. precociously and treat accurately generating reliable and standardised scientific programs of each session As started in 2009 in Boston, the the various disorders of hemostasis, clinical and basic tools. presented at the 57th annual 2011 scientific program of the SSC which is of particular value to the It is desirable that more and more meeting were elegantly constructed subcommittees began with an younger colleagues that face these young investigators with an interest by the Chairmen and Co-Chairmen Educational Session, followed by topics for the first time. in thrombosis and hemostasis will of each Scientific Subcommittees the update of the ongoing scientific This year's program was very be joining the ISTH-SSC ongoing and provided an excellent activities and the proposal of new exciting, and indeed all chairs and projects and become leaders of the introduction to the main Congress ones. The Educational sessions co-chairs of the SSC masterfully future ones.

SSC Reports and Recommendations 2010-2011

Animals Models intravascular coagulation. J Thromb Haemost, 8 (5): 1116–1118. Greene, T. K., Schiviz, A., Hoellriegl, W., Poncz, M., Muchitsch, E.-M. and on behalf of the Fibrinolysis Animal Models Subcommittee of the Scientific and Standardization Committee of the Longstaff, C, Rigsby, P, Whitton, C and on behalf of the SSC Subcommittee on ISTH (2010), Towards a standardization of the murine tail bleeding model. Journal of Fibrinolysis, OFFICIAL COMMUNICATION OF THE SSC: Calibration of the WHO 1st Thrombosis and Haemostasis, 8(12): 2820–2822. International Standard and SSC/ISTH Secondary Coagulation Standard for Tissue Biorheology Plasminogen Activator Antigen in Plasma. J Thromb Haemost, 8 (8): 1855–1857. Heemskerk, J. W. M., Sakariassen, K. S., Zwaginga, J. J., Brass, L. F., Jackson, S. P., Farndale, Perinatal/Pediatric Hemostasis R. W. and Biorheology Subcommittee of the SSC of the ISTH (2011), Collagen surfaces Rodeghiero, F, Tosetto, A, Abshire, T, Arnold, DM, Coller B, James, P, Neunert, C, Lillicrap, to measure thrombus formation under flow: possibilities for standardization. Journal of D and On Behalf Of The ISTH/SSC Joint vWF and Perinatal/Pediatric Hemostasis Thrombosis and Haemostasis, 9(4): 856–858. Subcommittees Working Group (2010), ISTH/SSC bleeding assessment tool: a Control of Anticoagulation standardized questionnaire and a proposal for a new bleeding score for inherited Kearon, C., Iorio, A., Palareti, G. and on behalf of the Subcommittee on Control bleeding disorders. J Thromb Haemost, 8: 2063–2065 of Anticoagulation of the SSC of the ISTH (2010), Risk of recurrent venous Vascular Biology thromboembolism after stopping treatment in cohort studies: recommendation for Lacroix, R., Robert, S., Poncelet, P., Kasthuri, R. S., Key, N. S., Dignat-George, F. and acceptable rates and standardized reporting. Journal of Thrombosis and Haemostasis, 8 on behalf of the ISTH SSC Workshop (2010), Standardization of platelet-derived (10): 2313–2315. microparticle enumeration by flow cytometry with calibrated beads: results of the Tripodi, A, Chantarangkul, V, van den Besselaar, AMHP, Witteveen, E, Hubbard, AR and International Society on Thrombosis and Haemostasis SSC Collaborative workshop. on behalf of the Subcommittee on Control of Anticoagulation of the SSC of the ISTH Journal of Thrombosis and Haemostasis, 8(11): 2571–2574. (2010), International Collaborative Study for the Calibration of a Proposed International Von Willebrand Factor Standard for thromboplastin, human, plain. J Thromb Haemost, 8 (9): 2066–2068. Lee, C. A., Hubbard, A., Sabin, C. A., Budde, U., Castaman, G., Favaloro, E. J., Friedman, K. D., Tripodi, A, Baglin, T, Robert, A, Kitchen, S, Lisman, T, Trotter, JF and on behalf of the Federici, A. B. and on behalf of the ISTH-SSC Subcommittee on VWF (2011), Laboratory Subcommittee on Control of Anticoagulation of the Scientific and Standardisation diagnosis of von Willebrand disease: results from a prospective and blind study in Committee of the International Society on Thrombosis and Haemostasis (2010), 32 laboratories worldwide using lyophilized plasmas. Journal of Thrombosis and Reporting prothrombin time results as international normalized ratios for patients with Haemostasis, 9(1): 220–222. chronic liver disease. J Thromb Haemost, 8 (6): 1410–1412. Working Group on Coagulation Standards Schulman, S, Angerås, U, Bergqvist, D, Eriksson, B, Lassen, MR, Fisher, W and on behalf of Hubbard, A. R., Kitchen, S., Beeharry, M., Bevan, S. A., Bowyer, A. and on behalf of the SSC the Subcommittee on Control of Anticoagulation of the Scientific and Standardization Working Group on Coagulation Standards of the ISTH (2011), Long-term stability of the Committee of the International Society on Thrombosis and Haemostasis (2010), Scientific and Standardization Committee Secondary Coagulation Standard (SSC Lot Definition of major bleeding in clinical investigations of antihemostatic medicinal no. 3). Journal of Thrombosis and Haemostasis, 9(6): 1246–1248. products in surgical patients. J Thromb Haemost, 8 (1): 202–204. Working Group on Gene Nomenclature Disseminated Intravascular Coagulation (DIC) Goodeve, A. C., Reitsma, P. H., Mcvey, J. H. and on behalf of the Working Group on Kim, HK, Hong, KH, Toh, CH and on behalf of the Scientific and Standardization Nomenclature of the Scientific and Standardisation Committee of the International Committee on DIC of the International Society on Thrombosis and Haemostasis (2010), Society on Thrombosis and Haemostasis (2011), Nomenclature of genetic variants in Application of the international normalized ratio in the scoring system for disseminated hemostasis. Journal of Thrombosis and Haemostasis, 9(4): 852–855.

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ISTH 2011 DAILY Tuesday, July 26

The ISTH XXIII General Membership Assembly he ISTH XXIII General Membership Assembly will take place Programs and activities of ISTH and the Scientific and Standardization T on Wednesday, July 27, in the Main Hall from 11:00 to 11:15. Committee (SSC) are entirely member-driven and include: Members will receive reports from the Society’s leaders: • The Journal of Thrombosis and Haemostasis: JTH • Congress President Dr. Yasuo Ikeda on the organization of the XXIII • Congresses and SSC annual meetings Congress. • SSC scientific subcommittees • ISTH Council Chairman Dr. Henri Bounameaux reporting to the • ISTH programs, such as the Reach the World Initiative with its education membership on actions of Council taken at this year’s business meeting. and outreach components. ISTH members are encouraged to attend • ISTH Executive Director Thomas Reiser summarizing the state of the this brief meeting. This is the membership’s opportunity to hear from Society. leadership, and this is the leadership’s opportunity to hear from you.

The ISTH is an individual membership organization and exists for and by the will of all members as an international nongovernmental organization.

Update on ISTH Nursing Forum 2011

he Nursing Program recommendations. study presentations, care pathways, T provides a forum for Opportunities ripe for systematic and protocols. nurses internationally to share study are literally too numerous In summary, the Nursing workgroup practice related (translational) to count and priorities must be provided an ambitious program knowledge pertaining to disorders set. To meet goals set forth for this to support nurses in translational of haemostasis and thrombosis congress, the Nursing Program research focusing on a framework in both pediatric and adult encompassed four distinctive of clinical challenges, adherence populations. The goal is to promote sessions, including discussions on and knowledge translation to the evidenced based findings and the following; Research, exploring patient / family, locally within their practice through knowledge the mechanisms by which nurses institution and to the medical Maura A.Dumas translation, standardization and engage in education, patient community as a whole. The Nursing systematic evaluation in clinical management or supportive workgroup provides a collaborative to generate novel evidence and practice settings. The primary care interventions to employ a environment where knowledge and clinical recommendations through aim reflects the ISTH Nursing collaborative research framework practice patterns are shared and development of a collaborative Workgroup’s commitment to in order to better promote the systematic evaluation of each are research agenda. advancing the promotion of both significance and generalisability supported to promote the utility For more information as well as original research conducted by of their initiatives; Education, and applications of initiatives. A to become involved in the ISTH nurses and the uptake of evidence examining the development future direction being explored Nursing Workgroup, please contact into practice within the nursing of university accredited degree during the 2011 ISTH Congress is the Maura Dumas at: maura.a.dumas@ profession. To support this aim, module in UK for anticoagulation feasibility of the nursing discipline hitchcock.org the committee proposes a distinct and VTE prevention; Optimizing session devoted to “Nursing Health, reviewing available data “Visit the Exhibition“ announcement Research”. Secondary aims regarding the impact of general include knowledge translation aging issues in the hemophilia ISTH delegates can get their first look on Monday at the ISTH as applied to clinical patient population and examining harm Exhibition. Participants can visit booths to find out more about challenges, optimizing health and reduction techniques using the latest technology, health care advances and opportunities. Commercial displays of international organizations, sponsor health advocacy with a focus on evidence-based research on risks/ pharmaceutical companies, media publishers and scientific societies optimizing adherence of patients benefits to sport participation will be located in Event Hall and Exhibition Hall 1 & 2. with disorders of thrombosis or through education tools; and Exhibition hours sMonday 10:30-18:00 sTuesday 10:30-18:00 haemostasis, consistent with Knowledge Translation, putting sWednesday 09:30-14:00 sThursday 09:30-16:00 the World Health Organization evidence into practice through case

Webcasting information

Webcasts from the ISTH 2011 XXIII Congress are coming soon! The downloadable podcast to computers. You will be able to access the Congress Plenary Lectures, State of the Art Lectures, and the Presidential sessions via the “Members Only” section of the ISTH website. Instructions Symposium will be webcast for the post-meeting use of registered will be directly emailed to all ISTH members and registered delegates in delegates and all ISTH members. The session will be available as a the weeks following the Congress.

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ISTH 2011 DAILY Tuesday, July 26 Preview of Plenary Lectures

TODAY at 9:15 am - 10:30 am: Main Hall Challenge to Novel Bioactive Peptides

r Kenji Kangawa will present the Oscar Ratnoff cardiovascular and energy metabolism, and “Neuromedin DMemorial Lecture on the subject of bioactive S (NMS),” from rat brain, which is implicated in the peptides. Human atrial natriuretic peptides (ANP) regulation of circadian rhythm, both peptides that Dr were first identified worldwide by Dr. Kangawa and Kangawa has discovered. his coworkers in 1984. He is an expert on searching Dr Kangawa, who holds a Ph.D from Osaka University for orphan GPCR ligands as well as the biochemical School of Science, is presently the Director General of the and physiological analysis of brain and cardiovascular National Cerebral and Cardiovascular Center in Osaka, peptides, having discovered more than 40 novel as well as Professor at the Graduate School of Medicine bioactive peptides using his original methods. In the of Kyoto University. He has received various awards and course of these studies he has shed some light on honors for his outstanding achievements, internationally, the molecular basis of cardiovascular pathogenesis amongst others, the Asia and Oceania Medal of the and pathophysiology. He will also discuss "Ghrelin," a Society for Endocrinology (UK), as well as in Japan, the growth hormone-releasing peptide in rats that is also most recent of which include the Japan Academy Prize in Kenji Kangawa involved in the stimulation of feeding and regulation of 2008 and the Keio Medical Science Prize in 2009.

Oscar Ratnoff (1926-2008) was a distinguished physician-scientist who made seminal contributions to our understanding of blood coagulation mechanisms and bleeding disorders. Over a 60-year career at Johns Hopkins and Case Western Reserve Universities, he conducted original studies that revolutionized and advanced the field. His achievements included the proposal of the waterfall sequence of blood coagulation with Earl Davie, the discovery of Factor XII (Hageman factor) and high molecular weight kininogen (Fitzgerald factor), the development of an immunoassay to differentiate Factor VIII deficiency and von Willebrand disease and early recognition of potential danger of contamination with a putative AIDS agent in Factor VIII concentrates. Ratnoff was an outstanding teacher and clinician who trained many fellows who went on to establish their own distinguished careers. The Ratnoff Lectureship was established following his death in 2008. The initial lecture was given at the XXII Congress in Boston, 2009, by Philip Hogg.

TODAY at 5:15 pm - 6:00 pm: Main Hall Recent Progress in Anticoagulant Therapy: Oral Direct Inhibitors of Thrombin and Factor Xa

r. Kenneth A. Bauer will discuss in the Sol Sherry Dr. Bauer is Professor of Medicine at Harvard Medical Dmemorial lecture new oral anticoagulants School, Chief of Hematology at VA Boston Healthcare selectively inhibiting thrombin or factor Xa that have System, and Director of Thrombosis Clinical Research recently been approved in various countries worldwide. at Beth Israel Deaconess Medical Center in Boston. The advantages of these new drugs include their oral He trained in Medical Oncology and the Division of route of administration, a rapid onset of action, a wide Thrombosis and Hemostasis at Dana Farber Cancer therapeutic range, and the absence of the need for Institute, as well as in Hematology-Oncology at Beth regular laboratory monitoring. However, compliance Israel Deaconess Medical Center. He has also taken a with dosing will be extremely important to achieve good leadership role in the International Society on Thrombosis outcomes in practice due to their short half-lives and and Haemostasis (ISTH) and is a member of the American no need for regular laboratory monitoring. Furthermore Society of Hematology. His interests include the without validated methods to assess and interpret elucidation of mechanisms leading to a prethrombotic Kenneth A. Bauer blood levels and the absence of a specific antidote, state and the evaluation of new antithrombotic drugs. He the management of patients who develop recurrent has published over 200 original reports, reviews and book thrombosis or major bleeding will present challenges. chapters.

Sol Sherry (1916-1993) made immense contributions to the field of thrombosis and thrombolysis. In particular, he introduced streptokinase into clinical practice for the treatment of thrombotic disorders, such as deep vein thrombosis, pulmonary embolism and acute myocardial infarction, which has saved many lives and improved the quality of life for patients at risk for thrombotic disorders. His scientific career spanned more than 50 years, and his contributions to scientific research on thrombosis and thrombolysis and subsequent clinical application has earned him the title of “Father of Thrombolytic Therapy.” He was a founder of the International Society on Thrombosis and Haemostasis and a leader of the Society as its first chairman. He received the Society’s highest honor, the Robert Grant Medal, in 1977 for his accomplishments and service. The lecture in Dr. Sherry’s name was established after his death in 1993. Previous Sherry lecturers include Charles Esmon, Victor Marder, Meyer Samama, Jos Vermylen, Jürgen van de Loo, Salim Yusuf, Marie-Germaine Bousser, Frits Rosendaal, Harry Büller, Jay Degen, and William Geerts.

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ISTH 2011 DAILY Tuesday, July 26

What to do and see in Kyoto

The official travel agency of ISTH2011, JTB, is organizing the following excursions during the conference period. Wednesday 27 will be set aside for optional excursions and no lectures will be scheduled on this afternoon. The following tours are operated by JTB. For application, please come to the following JTB TOUR DESK.

Name of tour Time Fare Visit EX-3 World Cultural Heritage 3 13:00-16:00 JPY 7,000 Golden Pavilion, Daisen-in Temple EX-4 World Cultural Heritage 4 13:00-17:00 JPY 7,000 Shoren-in, Byodoin Temple EX-5 Flower (Lotus) & Arashiyama 9:00-13:00 JPY 6,500 Ryoanji Temple, Arashiyama, Tenryuji Temple EX-7 Fushimi Inari & Japanese Sake Brewery 13:00-17:00 JPY 7,500 Fushimi Inari, Gekeikan Sake Brewery with Box lunch EX-10 Mt. Hiei, Lake Biwa & Ohara 9:00-17:00 JPY 17,000 Enryakuji Temple, Lake Biwa, Sanzen-in Temple with lunch

EX-3 EX-7 Golden Pavilion: A UNESCO World Heritage Site, Fushimi Inari: The head shrine of more than Kinkakuji was built in 1397 by Shogun Ashikaga 40,000 Inari shrines throughout Japan, Fushimi Yoshimitsu as his retirement villa. The gardens Inari Shrine is one of the oldest in Kyoto. are designated as a special national historic and Enshrining the god of good harvests and good scenic site. The "Sekka-tei" tea house, located in business, the shrine is crowded with people the garden, is famous for its staggered shelves during the New Year and on the first day of each made of bush clover wood, and its Nanten alcove pillar. month. Daisen-in: Founded in 1319 by Abbot Daito. Later, Abbot Ikkyu reconstructed Gekeikan Sake Brewery: Sake is a traditional Japanese rice wine, produced it as one of the chief temples of the rinzai sect. Having been supported by tea strictly from moldy rice, steamed rice and water; it has an alcoholic content masters, warriors and rich merchants, there are many subordinate temples of 15 to 17 percent. It is inseparable from the daily life of the Japanese, to in the precincts of this temple and almost all of them possess numerous say nothing of all ceremonial occasions. Gekkeikan has the honour of being priceless paintings and landscaped gardens dating from the 15th to the 17th appointed as purveyor to Imperial Household. Sake tasting will take place at centuries. The garden of Daisen-in is perhaps most remarkable. Its karesansui the end of the tour. dry landscape is known for its special scenic beauty. EX-10 EX-4 Enryakuji Temple: Located atop Mt. Hiei in Shoren-in Temple: This elegant temple, also known as the Awata palace, a thick grove of Japanese cypress-trees. It was once served as a place of refuge for the emperor after a giant fire destroyed established in 788 by Priest Saicho, better known much of Kyoto in 1788. It houses many cultural properties including a drawing as Dengyo-Daishi, founder of the Tendai sect of the Fudomyoo-nidoji, which is a National Treasure. by order of Emperor Kammu. The object of its Byodoin Temple: A UNESCO World Heritage Site, this temple was once the foundation was to protect the new capital from villa of Fujiwara Michinaga, the model for the hero in the Japanese classic "The evil spirits which were supposed to come from the northeast direction. Tale of Genji". It was turned into a temple by Fujiwara's son in 1052 and now Lake Biwa: The largest fresh-water lake in Japan, with a circumference of 188 includes numerous national treasures. The main hall -called Ho-oh-doh or kilometers and an area of 674 square kilometers. Enjoy a delightful cruise on "Phoenix Hall" - was built in 1053 and is a national Lake Biwa aboard a large sightseeing vessel called the "Michigan". treasure. The hall enshrines a large statue of Sanzen-in Temple: This temple belongs to Tendai sect of Buddhism. It was Amida Buddha sculpted by famous artist Jocho built in 1118. The temple's main statue of an Amida Nyorai (made of wood) that is also a national treasure. The temple's and its statues of the Ryowaki samurai are designated important national elegant bell is considered one of the finest such cultural properties. The garden, covered with moss and surrounded by old bells in Japan and is another national treasure. cedar trees, is very beautiful. In the rainy season, about 3,000 hydrangea bushes add a magnificent explosion of color at the back of the temple EX-5 gardens. Jakkoin Temple is a convent built on a perfectly secluded site. It is Ryoanji Temple: A UNESCO World Heritage Site, this Zen temple was famous as the place where the Empress Kenreimon-in, mother of the infant established in 1450 by Hosokawa Katsumoto. Its dry landscape garden, Emperor Antoku, became a nun in 1185. She consisting of 15 large and small rocks on a bed of white sand spread out over spent the rest of her life here after her imperial an eastwest rectangular plot, is the most famous of its kind in the world. son perished along with the rest of the Taira clan Tenryuji Temple: A UNESCO World Heritage Site, was established by Shogun at Dan-no-ura. Her tomb lies on a hill behind the Ashikaga Takauji in 1339 as a Zen temple. The garden, designated as Japan's temple. The convent's garden is regarded as one first special national historic site, blends the elegance of an imperial court of the finest places for maple-viewing in Kyoto. garden with that of classic Zen garden design, and borrows the Kameyama and Arashiyama mountains as a magnificent backdrop.

Also you can enjoy following tours on Thursday 28.

Name of tour Time Fare Visit EX-2 World Cultural Heritage 2 9:00-13:00 JPY6,800 Nishi Honganji Temple, Kiyomizu Temple EX-9 Nara 1 Day 8:30-18:00 JPY13,000 Kasuga Shrine, Todaiji Temple,.Horyuji Temple with lunch

TOUR TICKETS are available at JTB TOUR DESK from 8:00 to 19:00 (8:00 to 13:00 on July 27). 10

ISTH 2011 DAILY Tuesday, July 26

ISTH Academy e-learning Information

nderstanding the processes those training in internal medicine, of thrombosis, its diagnosis and interactive and multimedia, Ubehind blood clotting can haematology or vascular biology management, may improve featuring a number of fascinating have far reaching consequences, to (bio)medical students and detection and reduce associated key lectures from some of the from preventing heart attacks and researchers. morbidity and mortality. leading experts in the field, treating haemophilia to saving the An understanding of thrombosis The ISTH Academy’s modules contemporary conceptual lives of trauma patients. is important across many take you through many aspects animations and classic “paper- The ISTH Academy’s content is medical fields (e.g. orthopedics, of thrombosis, including its based” learning. open and relevant to all those neurology, neurosurgery) because basis in the coagulation system, Visit us at stand 67-70 or go online looking for a working knowledge of a venous thrombosis can arise etiology and prognosis, diagnosis to www.isthacademy.org, try our thrombosis, from clinicians working as a complication of many other and management. As well as test modules and provide your with thrombosis patients and conditions. Improved knowledge educational, the modules are feedback!

(continued from page 1) cannot be recommended routinely later this year. across the heterogeneous acutely ill “We’re still trying to see whether patient group studied. the population that has an elevated MAGELLAN Study The net clinical benefit data from D-dimer is the one that, firstly, is outcome was a composite of in the rivaroxaban arm across the the MAGELLAN study is being at risk of venous thrombosis, and asymptomatic proximal deep vein entire study period,” said Dr. Cohen. presented at the Congress in the secondly, benefits from prolonged thrombosis (DVT), symptomatic “These findings were generally form of a late-breaking clinical trials prophylaxis,” said Dr. Cohen. “This is DVT, symptomatic non-fatal consistent across all subgroups poster. “The net clinical benefit data that’s brand new – it’s never pulmonary embolism and VTE- analyzed.” depends on how you define been seen before.” related death. Extended-duration rivaroxaban was the term,” explained Dr. Cohen. “What we showed in the Dr. Cohen commented, “This was more effective overall in reducing “According to the study protocol, MEDENOX study many years ago a positive study – the MAGELLAN the incidence of VTE compared with we used a very broad definition was that medical patients with results showed that rivaroxaban was enoxaparin across all covariates to include clinically relevant non- normal D-dimers did not develop noninferior to enoxaparin at day analyzed. Dr. Cohen showed that major bleeding. If you include that, thrombosis,” he added. “Those 10, and was superior to enoxaparin the effects were most significant in it favors enoxaparin. If you look who got thromboprophylaxis with followed by placebo at day 35.” patients aged 75 years or older and at the traditional definition of net enoxaparin had a fall in D-dimers, The principal safety outcome was in patients with acute infectious clinical benefit, which just has major and also a fall in thrombosis rates. clinically relevant bleeding, the and inflammatory disease. bleeding, it favors rivaroxaban.” In our study, those with an elevated composite of treatment-emergent At day 35, compared to enoxaparin Dr. Cohen commented that D-dimer – in other words, equal to major bleeding and non-major with a placebo, rivaroxaban was he is aiming to present further or above two times the upper limit clinically relevant bleeding. superior with a roughly 23% risk information on the MAGELLAN of normal – seemed to have the “Overall bleeding rates were low, reduction. Dr. Cohen noted that subgroups analyses, and in maximum benefit from prolonged but rates were significantly higher extended thromboprophylaxis particular D-dimer information, thromboprophylaxis.”

(continued from page 1) Opening Ceremony attention to this year’s e-learning fibrinolysis, thrombolysis, and the shakuhachi (bamboo flute) and booths on epidemiology, thrombosis entire field of hemostasis and koto (13-string harp) filled the season by season, which vividly and blood coagulation. He urged all atherosclerosis. Dr. Collen thanked evening air as delegates enjoyed brought to life Kyoto’s myriad participants to visit the booths and his collaborators and Japanese an open-air reception in the cultural attractions. feedback their experiences. colleagues for their constructive tranquil surroundings of the Kyoto In his opening remarks, Dr Ikeda During the presentation of awards, contributions over the years. International Conference Centre’s conveyed his deepest sympathy to Dr Bounameux presented a plaque The distinctive sounds of Japanese-style garden. all those affected by the Great East to Dr. Gilbert C. White II, MD, Japan Earthquake and observed MS, ISTH Executive Director from a moment of silence in memory 1999-2010, in recognition of his of those who lost their lives. He extraordinary commitment to ISTH. Visit the ISTH Booth expressed gratitude to all who have Dr. White paid tribute to his mentor, Located in the Main Event Hall editorial staff from the Society’s worked so hard behind the scenes Harold Roberts, as well as past and at Booth #5, the ISTH booth official journal, Journal of to organize the XXIII Congress in present Presidents of the ISTH. will provide delegates with Thrombosis and Haemostasis. unprecedented circumstances. The Robert P. Grant Medal, the information about the Society Find information at the booth Dr Henri Bounameaux, MD, highest honor bestowed by and its programs and activities. about other ISTH educational Chairman of the Council, noted that the ISTH, was awarded to Dr. Easily renew your membership resources and benefits. Visit the each Congress presents new features Désiré Collen, MD, PhD, for his or sign up as a member. ISTH Booth today! Here you can also speak with and educational programs, and drew outstanding contributions to 12