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Volume 28, Issue 1
Displaying 1-20 of 20 articles from this issue
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Hiroji OKAWA, Shigeaki NONOYAMA, Junichi MINAGUCHI, Kouzou TAKASE, Shu ...1987 Volume 28 Issue 1 Pages 1-8
Published: 1987
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSThere are many problems in the classfication of lymphoid cells with monoclonal antibodies such as non-specific binding of monoclonal antibodies, specificity of monoclonal antibodies and the estimation of the positive ratio.
Resolving these problems lymphoid malignant cells from 87 cases were classified with monoclonal antibodies mainly according to cluster classification.
B cell lineage cases (B4+) were 58.6% of all cases; Ia+B4+ 4.6% Ia+B4+J5+32%, Ia+B4+J5+B1+17%. Cytoplasmic μ(+) cells were 13.8% and were divided nito these three subclass. SIg (+) cases were 12.6%.
T cell lineage cases (T11+) were 20.7%. Major part of TALL and T cell malignant lymphoma were included in pre-T cell type (T3-, T11+) while all T CLL and ATL were mature T cell type (T3+, T11+).
Non T, non B cell type were divided into three subtype. Leukemic cells reacted only with Ia antibodies may be lymphoid stem cell. The cells bearing Ia and myeloid macrophage antigens may belong to myelogenous leukemia. Among non T non B lymphoid leukemic cells without T3 antigens, T precursor cells may be detected by the reactivity with CD7 and the presence of T cell receptor rearrengement.View full abstractDownload PDF (530K) -
Fumio BESSHO, Shun-ichiro YOKOTA, Hiroshi KINUMAKI1987 Volume 28 Issue 1 Pages 9-15
Published: 1987
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSForty-eight percent of relapses of childhood acute lymphocytic leukemia (ALL) was found by routine examinations of bone marrow and/or cerebrospinal fluid before any appearance of symptoms or peripheral blood abnormalities. The possibility of survival more than 1 year after relapse, an interval between the first relapse and the second relapse and the survival after the first relapse of the cases with asymptomatic relapse were superior to that of the cases with symptomatic relapse. The risk factors at diagnosis was not related to the prognosis after relapse, but the cases with symptomatic relapse and any of risk factors seemed to be difficult to attain the second remission. At present the routine examination seems to have favorable effects on the prognosis of ALL.View full abstractDownload PDF (473K) -
Junko TATSUMI, Motofumi HIYOSHI, Yasuo YOKOMATSU, Taesung IM, Noriyuki ...1987 Volume 28 Issue 1 Pages 16-21
Published: 1987
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSCharacteristics of several parametrs of red cells were investigated for aged patients with iron deficiency state using a new automated blood cell counter, Model H-1. The patients showed decreased red cell production in spite of low grade of iron deficiency. RDW (red cell distridution width) showed a high correlation to MCV, and HDW (hemoglobin concentration distribution width) showed higher correlation to MCH than to MCHC. Both RDW and HDW showed iron deficiency state, and the aged showed lower RDW and HDW. Samples after blood transfusions showed two peaks on the hemoglobin distribution curve. We concluded that the above-mentioned parameters would be available for clinical purpose.View full abstractDownload PDF (481K) -
Kazuo DAN, Kenji TAJIKA, Takashi YAMADA, Kiyoyuki OGATA, Seiji GOMI, Y ...1987 Volume 28 Issue 1 Pages 22-27
Published: 1987
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSEight patients with severe or moderately severe aplastic anemia were treated with high-dose bolus methylprednisolone. Good response was attained in only one patient by day 30. Seven refractory patients subsequently received androgens with the results of good responses 4∼19 months later in all but one patient who could not tolerate androgens because of liver damage. These favorable results would be ascribable to delayed effects of the immunosuppressive therapy or to androgens whose hematopoietic action was possibly augumented by prior immunosuppression.
Suppressive effects of patient's peipheral mononuclear cells on CFU-C and CFU-E colony formation from normal marrow cells, and enhancing effects of adrenocorticosteroids on colony formation from patients's marrow cells were examined before therapy. Results of these in vitro tests did not correlate with therapeutic results of high-dose bolus methylprednisolone therapy.View full abstractDownload PDF (454K) -
Minoru UEMATSU, Makoto KONDO, Shozo HASHIMOTO, Tositake NAKAYAMA, Tour ...1987 Volume 28 Issue 1 Pages 28-33
Published: 1987
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSIn the last 8 years, 12 clinical stage (CS) I-II patients received total nodal irradiation (TNI) or subtotal nodal irradiation (STN), 6 of whom underwent staging laparotomy. Other 6 CS I-II patients had mantle field irradiation (MA). Before referring us, two patients with TNI or STN had chemotherapy of small doses, but they showed no response. All 6 patients with MA also received chemotherapy of small doses. Laparotomy showed 2 patients had upper abdominal disease, resulting in changes of their radiation fields. Planned irradiation schedules could be performed safely in all 18 patients. After completion of irradiation, they have been followed up for 10∼96 months without severe late complications. Of the 12 patients with TNI or STN, only one with multiple splenic involvements has experienced relapse, well within the radiation fields. He has achieved complete remission again using C-MOPP, and is alive and well as of this writing. On the other hand, three of the 6 patients with MA relapsed mainly outside the radiation fields, two of whom have died of disease. We conclude that large field irradiation such as TNI or STN is feasible to perform, and will improve relapse free survival of Japanese patients with Hodgkin's disease. Staging laparotomy is also feasible, and plays an important role to increase cure rates and decrease treatmemt morbidity.View full abstractDownload PDF (509K) -
Shuichi MIYAWAKI, Kazuo NEMOTO, Ryoji WAKAMATSU, Noboru BABA, Kunihiko ...1987 Volume 28 Issue 1 Pages 34-39
Published: 1987
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSEight patients with acute myelocytic leukemia (AML) in relapse or refractory to the standard initial chemotherapy were treated with “A-Triple-V” (VP 16-213, ara-C or BH-AC, vincristine, vinblastine) regimen. Four patients including 2 with M5 achived complete remission after 1 or 2 courses of therapy and marked cytoreduction was obtained in remaining patients. Three patients in whom ara-C was replaced with BH-AC entered complete remission. Gastrointestinal toxicity, such as nausea, and alopecia were frequently seen, but these side effects were generally mild and well tolerated. These results indicate that “A-Triple-V” regimen may be a useful combination particularly for relapsed or refractory AML. The substitution of ara-C with BH-AC appeared to be at least as effective as the original combination.View full abstractDownload PDF (459K) -
Kazuaki KUBO, Kazuyuki NAITO, Yukihiro AKAO, Akikazu HIRAIWA, Tomoki N ...1987 Volume 28 Issue 1 Pages 40-46
Published: 1987
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSBased on the cytoreductive regimen reported by O'Reilly et al, we transplanted to four patients with hematological malignancy the bone marrow cells harvested from their HLA identical siblings. In our method, they were pretreated with hyperfractionated total body irradiation (120R×11 times) and high dose of cyclophosphamide prior to transplantation. Case 1: 19 year-old, female, ALL. She had a temporal GVHD (Grade I) on day 23, and suffered from interstitial pneumonia (IP) on day 72 that responded well to the steroid therapy. She is now healthy (day 717). Case 2: 15 year-old, female, ALL. She had a mild GVHD on day 20 and IP on day 175 that recovered shortly after treated with steroid. She had an acute nephritis temporarily on day 410, as well. She is now healthy (day 668). Case 3: 39 year-old, female, AML. She suffered from a GVHD (Grade IV) with severe skin eruption, diarrhea and jaundice, which started on day 15. She died of hepatic failure on day 74, for which GVHD was responsible. Case 4: 25 year-old, male, Burkitt Lymphoma. He had a mild GVHD on day 33, which recovered soon with the steroid therapy. On day 150, he suffered from IP to which the steroid therapy was effective. However, IP was recurrent as well as his pneumothorax that happened subsequently. He is now healthy (day 458).View full abstractDownload PDF (540K) -
Toshiyuki SAKAI, Yoshiaki OHKUBO, Ichiro TANAKA, Kazukuni YAMAMOTO, Ak ...1987 Volume 28 Issue 1 Pages 47-52
Published: 1987
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSThe proteolytic activation of partially purified F.IX induced by F.XIa/Ca2+ was investigated in the patients with hemophilia B variants. When partially purified normal F.IX (BaCl2 adsorption and elution) was cleaved by F.XIa/Ca2+, a polypeptide band (MW=60,000) disappeared with the concordant appearance of a peptide with MW=50,000 (F.IXaβ) on SDS gel autoradiography in the absence of reducing agent. In the presence of reducing agent, a new band with MW=30,000 (heavy chain of F.IX) was observed. F.IX (Niigata) and F.IX (Kiryu) with Hemophilia BM were cleaved by F.XIa/Ca2+ at the rate similar to normal F.IX. F.IX (Takatsuki) with Hemophilia BM was slowly cleaved by F.XIa/Ca2+ compared to normal F.IX. When F.IX (Kashihara) was activated by F.XIa/Ca2+, no new band was seen in non-reducing gels, whereas only one new band appeared in reducing gels, corresponding to MW=40,000. These showed that F.IX (Kashihara) was cleaved only at Arg-Ala bond and not at Arg-Val bond. F.IX (Nagoya I), F.IX (Nagoya II) and F.IX (R) were not cleaved by F.XIa/Ca2+ in this system. The proteolytic activation of partially purified F.IX induced by F.XIa/Ca2+ was investigated in the patients with Hemophilia B variants using western blotting technique.View full abstractDownload PDF (545K) -
Yutaka TAKAI, Hisatomo HAYASI, Naokazu TSURUMI, Takashi TSUDA, Toshiak ...1987 Volume 28 Issue 1 Pages 53-64
Published: 1987
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA 63-year-old female without personal or family history of bleeding presented a hemorrhagic diathesis of recent origin. On admission, the patient had a prolonged bleeding time of more than 40 min, low level of von Willebrand antigen (vWF: Ag) and ristocetin cofactor activity (RCo), but normal level of factor VIII procoagulant activity (VIII: C).
Monoclonal gammopathy (IgM kappa immunoglobulin 3.7 gm/L) and Bence Jones proteinuria were then found in the patient, but no inhibitory activity to RCo or to ristocetin-induced platelet aggregation (RIPA) could be demonstrated in the plasma.
Following cryoprecipitate or 1-Deamino-8-D-Arginine Vasopression (DDAVP) infusion, she had higher immediate rise in VIII: C, vWF: Ag and RCo than expected, and there was no rapid decline in all three components.
Crossed immunoelectrophoresis patterns of vWF: Ag in the plasma were normal as far as those were examined, but according to the analysis of vWF multimers, larger multimers having been lacked on admission appeared after about 1 year, when level of plasma vWF: Ag came up to normal.
Biopsy of the right supra-clavicular lymphnode that acutely swelled at 30 months after the brusing onset established a diagnosis of Malignant lymphoma (non-Hodgkin, Diffuse, Large cell type).View full abstractDownload PDF (898K) -
Minoru YOSHIDA, Shinobu SAKAMOTO, Yasusada MIURA1987 Volume 28 Issue 1 Pages 65-69
Published: 1987
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSAll of the blood cultures in febrile patients with severe hematological diseases who were admitted to Jichi Medical School hospital were reviewed. From January 1978 to March 1986, except the months from July to November in 1980 (because total sample numbers were unknown), 2688 blood samples were cultured. Among them 287 samples (10.7%) were microbiologically documented. Positive cultures were found in 9.8% (228/2318) in venous blood, 14.4% (29/202) in arterial blood and 71.1% (27/38) in postmortem cardiac blood. Three hundred twenty three microbiological organisms were documented during this period including the 1980 July to November period and the details were as follows; gram-negative bacilli 58.8%, gram-positive organisms 29.4%, anaerobic bacteria 3.4% and fungus 8.4%.
The most common organisms causing sepsis were Pseudomonas aeruginosa, Escherichia coli, Enterobacter cloacae, Staphylococcus epidermidis, Staphylococcus aureus and Candida Spp..
Although gram-negative bacilli were responsible for the majority of sepsis, their incidence has been decreasing since 1982.View full abstractDownload PDF (343K)
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Kanji SUGITA, Shinpei NAKAZAWA, Taijiro MORI, Kazuyoshi NISHINO, Takas ...1987 Volume 28 Issue 1 Pages 70-75
Published: 1987
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSWe describe a case of a girl with common ALL, initially presented as superior vena cava syndrome by a superior mediastinal mass, which has been regarded as a specific characteristic of T-cell type ALL.
A 6-year-old girl was admitted because of fever and edema in the face and arms. The chest X-ray film revealed a superior mediastinal mass, and the bone marrow was occupied by lymphoblastoid cells. She acieved complete remission (CR) by induction chemotherapy, but relapsed with CNS 8 months after CR and then hematologically relapsed with generalized leukemia cutis 2 years after CR.
Immunological analysis of blasts at relapse showed that she had common ALL because of the expression of common ALL antigen, Ia-like antigen and B-related antigen, with no surface immunoglobulins, receptor to sheep erythrocyte or T-related antigen.View full abstractDownload PDF (1381K) -
Hisaya NAKADATE, Ryoji KOBAYASHI, Mitiko YANAZUME, Motoi NISHI, Takuya ...1987 Volume 28 Issue 1 Pages 76-80
Published: 1987
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA case of childhood chronic myelogenous leukemia with blastic crisis showing pre-B cell and myelocyte phenotypes was presented. A 8 year-old boy with huge hepatosplenomegaly was admitted to the Sapporo National Hospital on August, 1984. Clinical evaluations on admission revealed early phase of blastic crisis. He was treated with chemotherapeutic agents succsessfully. After 3 months later, second blastic crisis was seen. The blastic cells strongly reacted with B cell (J-5, la, B-1, B-4) or myelomonocyte (Mo-1) related monoclonal antibodies. This was suggested biclonal blastic crisis showing pre-B cell and myelocyte phenotypes. The overlapping persentage of cells expressing characterics for eigher lymphocytic and myelocytic phenotypes suggested simultaneous expression of the two phenotypes by individual blasts. Such crisis was termed the biphenotipic crisis.
After the second crisis, he was deteriorated. He was died of pneumonia on Feburary, 1985. Autopsy was not permitted.View full abstractDownload PDF (470K) -
—Ultrastructural Observation of a Case—Setsuo SUGIYAMA, Mitsuoki EGUCHI, Chie TERAMOTO, Toshiharu FURUKAWA, T ...1987 Volume 28 Issue 1 Pages 81-89
Published: 1987
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSThe second Japanese case of congenital dyserythropoietic anemia type III is reported. The patient was a 9-month-old boy with anemia and hepatosplenomegaly. The peripheral RBC exhibited anisocytosis and poikilocytosis. Bone marrow specimens showed marked erythroid hyperplasia with numerous multinucleated erythroblasts and giant blasts. The acidified serum test was negative with normal sera, and the RBC of the patient exhibited strong agglutination with anti-i sera. Hemoglobin analysis revealed increased hemoglobin F without an imbalance in globin chain synthesis, which has not been reported in congenital dyserythropoietic anemia type III. Ultrastructurally, there were many bi- to multi-nucleated erythroblasts in the bone marrow. The nucleus of the abnormal erythroblasts included uneven condensation of chromatin, mild spongy change and loss of nuclear membrane. The formation of clefts and blebs in the nuclei were not frequently observed. The cytoplasm contained karyorrhexis, iron-filled mitochondria and myelin figures. No abnormal structure was noted in white blood cells or megakaryocytes.View full abstractDownload PDF (1719K) -
Yasuo MARUYAMA, Yasushi YAHARA, Yasusuke ONOZAWA, Kenji KAWAGUCHI, Mor ...1987 Volume 28 Issue 1 Pages 90-94
Published: 1987
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA 36 year-old female was referred to the Tokyo Metropolitan Komagome Hospital because of severe anemia, leukopenia and fever.
High fever, emaciation, huge spleen and an abscess in the left thigh were noted on physical examination. The hemoglobin was 6.6 g/dl and white cell count was 1,600/μl with 43% atypical lymphoid tumor cells. The platelet count was 155,000/μl. There were 28% lymphoid tumor cells with the large basophilic cytoplasm and many pseudopods in bone marrow. Transmission electron microscopy demonstrated prominent and numerous cytoplasmic projections, suggesting hairy cell leukemia. These tumor cells were positive for tartrate resistant acid-phosphatase. Surface marker analysis of tumor cells was positive for IgG, λ chain and OKB2. Inspite of the intensive antibiotics therapy, persistent high fever continued and the staphylococcal abscess in the left thigh became progressively worse. No hematological improvement was noticed. So splenectomy was thought to be the only therapy left for this seriously sick patient.
Resection of the spleen weighing 5,100 g was performed without any complication and soon after that, she became afebrile and her clinical and hematological conditions improved dramatically.View full abstractDownload PDF (470K) -
Takahiko KONNO, Tohru NAKABAYASHI1987 Volume 28 Issue 1 Pages 95-99
Published: 1987
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA 62-year-old housewife was admitted to the hospital with a complaint of exertional dyspnea.
The physical examinations on admission showed generalized pigmentation with dark brown color and hepatosplenomegaly. Laboratory findings on admission were as follows: Hb 10.5 g/dl, platelet count 9.3×104/mm3, serum protein 4.4 g/dl, SGOT 159U/l, SGPT 88U/l, Al-Pase 27.9 KAU, LDH 1,091U/l, CPK 253U/l, ICG 41.5%/15M, serum iron 184μg/dl, UIBC 32μg/dl, ferritin 7,600 ng/ml and excretion of urinary iron with desferrioxamine test 6.97 mg/day. She had bilateral pleural effusion on chest X-rays and white varix of the oesophagus on gastrofiberscopy.
Microscopic section of the liver showed micro-nodular cirrhosis with hemosiderin deposits in the parenchymal cells, but not in the reticuloendothelial cells. Also, microscopic section of the thyroid gland showed atrophic acini and fibrosis of the stroma with lymphoid cell infiltration and histiocytes containing hemosiderin.
A diagnosis of idiopathic hemochromatosis associated with primary hypothyroidism (first case in Japan) was made on the basis of the laboratory findings.
Evaluation of 6 cases of the idiopathic hemochromatosis associated with primary hypothyroidism collected from the literature showed that immunological mechanisms secondary to iron deposition in the thyroid gland might play a role in the development of the hypothyroidism.View full abstractDownload PDF (540K) -
Ei-ichi YAO, Kunihiro TSUKASAKI, Toshiaki KAMEI, Kazutaka KURIYAMA, Mi ...1987 Volume 28 Issue 1 Pages 100-105
Published: 1987
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA 66-year-old woman was admitted due to aplastic anemia. She had been treated for 19.5 months with cimetidine (total doses 249,600 mg) for duodenal ulcer. In April 1985 exertional dyspnea and edema developed. She was diagnosed as aplastic anemia because of pancytopenia and severe bone marrow aplasia. Three courses of bolus methylprednisolone (mPSL) therapy were given to the patient during 6 weeks. There was a good response and metenolone enanthate was added to the third mPSL therapy. Analysis of T lymphocytes using several monoclonal antibodies revealed that OKT4/OKT8 was within normal limits and that T lymphocyte expressing OKIal were relatively increased during the course of aplastic anemia. We reported here the first case in the world which the bolus mPSL therapy took effect very well on cimetidine-associated aplastic anemia.View full abstractDownload PDF (470K) -
Shigenori HIGUCHI, Toshimitsu OGATA, Hidenori TAKAHASHI, Yasuhiro KUWA ...1987 Volume 28 Issue 1 Pages 106-111
Published: 1987
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA 12-year-old girl was admitted because of neutropenia with positive anti-granulocyte antibodies (IgG).
Gamma-globulin was given at a dose of 300 mg/kg/day intravenously for three days and neutrophils increased transiently. After the second infusions of gamma-globulin (300 mg/kg/day for three days), the neutrophil count rose to normal and remained elevated for 13 months until now.
Bone-marrow examination revealed a decrease in mature granulocytes. During the phase of sharp increase of neutrophils, a bone-marrow aspirate revealed normal neutrophil maturation but a finding of maturation arrest reappeared after decrease of neutrophils.
Bone-marrow smears normalized again when leukocyte counts normalized after the second gamma-globulin therapy.
The titer of granulocyte autoantibodies was 1: 128 on admission and it decreased to 1: 2 4 months later.View full abstractDownload PDF (465K) -
Taira MAEKAWA, Hiroshi FUJII, Tsukasa OKUDA, Shigeo HORIIKE1987 Volume 28 Issue 1 Pages 112-117
Published: 1987
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA 78-year-old Japanese male had been diagnosed to have a primary aquired refractory anemia (PARA) accompanied by paraproteinemia on April, 1982. The patient has been recurrently complicated with bronchial pneumonia for three years. He was readmitted because of dyspnea and fever on June, 1985. Hematological examinations disclosed that he was suffered from refractory anemia with excess of blasts (RAEB) accompanied by paraproteinemia (IgG, λ). He was treated only with blood transfusions and antibiotics for six months. On December, 1985, he was diagnosed to be transformed to acute myelogenous leukemia (AML-M2) and despite of therapy consisting of low doses of ara-C, he died of respiratory failure on February, 1986.
Cytogenetical analysis performed on June, 1985, revealed a chromosome abnormality of 1q-trisomy; 46, XY, -22, +der (1) t (1; 22) (p11; p11)/46, XY. No additional chromosome abnormalities could be found when the diagnosis of AML made. The growth of CFU-C-, CFU-E-, and BFU-E derived colonies was quite poor at the state of RAEB and no growth could be observed at the phase of AML. The pathophysiological significance of paraproteinemia in this case was obscure. This fact may suggest, however, the involvement of B-cell lineage in myelodysplastic syndromes.View full abstractDownload PDF (608K) -
Naoki SUGAYA, Soutaro ABE, Taijiro ISHIYAMA, Yoshihisa WAKABAYASHI, Sh ...1987 Volume 28 Issue 1 Pages 118-122
Published: 1987
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA 39 years old woman was referred to our hospital for bleeding tendency. Physical examination showed remarkable shortstatue, defect of pubic hair, gum bleeding, and purpura of lower extremities. Peripheral blood examinations revealed severe thrombocytopenia. Bone marrow aspiration showed moderate increasing of megakaryocytes wth sex chromosome abnormality of 45 XO.
So we diagnosed Turner's syndrome complicated with ITP. Therapy was started with prednisolone, and she got well with increasing of platelets.
The case of Turner's syndrome complicated with ITP may be the first report in Japam as far as we investigated.View full abstractDownload PDF (450K)
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1987 Volume 28 Issue 1 Pages 123-157
Published: 1987
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSDownload PDF (3233K)
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