岡山医学会雑誌
Online ISSN : 1882-4528
Print ISSN : 0030-1558
83 巻, 9-10 号
選択された号の論文の10件中1~10を表示しています
  • 池田 久男, 東 博文, 江原 嵩, 久保 信介
    1971 年 83 巻 9-10 号 p. 311-317
    発行日: 1971/10/30
    公開日: 2009/03/30
    ジャーナル フリー
    A report of clinical observation was made on the five cases of low cerebrospinal fluid pressure syndrome that we encountered recently. The age of these patients ranged from 27 to 40 years all being female. As for the causative factors of this condition, the puncture of lumbar spinal fluid appeared to be the cause in one case, the trauma of the head in one, but there could be found not any noteworthy cause for the rest of the cases. The subjective symptomes common to all were headache, nausea and vomiting, and the headache was of the nature to be aggravated on assuming the upright posture. Examinations revealed the low pressure of cerebrospinal fluid was the characteristic feature of this syndrome the maximum of which being 60mmH2O. Otherwise, aside from an increase in the cell counts there could be observed no other noticeable abnormality. As for objective and neurological symptomes no other than bilateral extensor plantar responces and stiffness of the neck could be detected. The administration of hypotonic glucose solution into the vein and physiological saline solution into the subarachnoidal space proved to improve their symptomes and the prognosis was favorable in all.
  • 第1編 悪性腫瘍による類白血病反応
    西原 達郎
    1971 年 83 巻 9-10 号 p. 319-329
    発行日: 1971/10/30
    公開日: 2009/03/30
    ジャーナル フリー
    The blood picture resembling leukemia, known as leukemoid reaction, was observed in the neoplastic and non-neoplastic illnesses. Observation were made by means of routine laboratory as well as the tissue culture technics devised in our Department on patients with malignant neoplasmas who were admitted to our Clinic in the period between April, 1956 to June, 1961. Among them, nine cases developed leukemoid reactions. The results of study on these cases are briefly summerized as follows;
    1. The leukemoid reactions seen in these patients (5 cases of gastric cancer, 2 mammary cancers, l pancreatic cancer and l lymphosarcomatosis) proved to be all of neutrophilic reactions.
    2. Ahemorrhagic tendency was observed in 4 cases and their serum-iron level was slightly lower than normal.
    3. The majority of these patients were of normochromic anemia, and the leukocyte counts varied, that is, one case showed a slight increase while another a decrease. Maturity of leucocytes consisted of myeloblasts in 3 cases and promyelocytes and myelocytes in almost all of the patients. This indicated that cells were in varying stages of maturation. Many erythroblasts were also recognized.
    4. On examining the bone marrow, nucleated cells generally tended to decrease in the numbers, and was observed in any of these cases.
    5. The growth patterns of the bone marrow using the tissue culture technic proved to be mostly of the normal type, and not a single case showed the leukemic pattern. Occasionally, a few tumor cells metastasizing into the bone marrow was also recognized. These findings indicated that the bone marrow tissue culture technic devised in our Clinic is an indispensable method for the differentiating the leukemoid reaction from leukemia.
  • 第2編 悪性腫瘍以外の諸疾患による類白血病反応
    西原 達郎
    1971 年 83 巻 9-10 号 p. 331-341
    発行日: 1971/10/30
    公開日: 2009/03/30
    ジャーナル フリー
    A series of examinations were conducted on the patients with leukemoid reaction who were abmitted to our Clinic for the period of from April, 1956 to June, 1961. These patients were suffering from the diseases other than malignant tumors. The following results were obtained.
    In the 9 cases showing the leukemoid reaction, the incidence of the reaction was about the same as that observable in patients with malignant tumors. Basic disease in these patients were agranulocytosis in 2 cases, 2 infectious diseases, 2 parasitoses and 3 myelofibroses. The blood pictures attributes to the leukemoid reaction varied, namely, consisting of either neutrophils, eosinophils or lymphocytes. This differed in case by case according to individuals.
    Only from several data such as past and present histories, clinical symptoms, blood pictures, bone marrow pictures etc., it may be said that sometimes it is rather difficult to diagnose a disease as a leukemia, while it is possible to distinguish it fairly accurately as a leukemia using the tissue culture technic. In the cases of myelofibrosis whose bone marrow puncture turned out to be a dry tap, the diagnosis was made by the tissue culture on a needle biopsy specimen of the spleen.
  • 第3編 白血病における他種血球系統の類白血病反応
    西原 達郎
    1971 年 83 巻 9-10 号 p. 343-356
    発行日: 1971/10/30
    公開日: 2009/03/30
    ジャーナル フリー
    As a link in the series of studies on the leukemoid reaction, mainly the bone marrow tissue cultures were carried out together with the studies of clinical symptoms on the 162 leukemia patients admitted to our Clinic for the period of from January, 1954 to December, 1960. The following conclusions were drawn.
    Fifty-five cases (34.0%) out of the 162 patients of leukemia revealed leukemoid reaction. The incidence of the leukemoid reaction proved to be high in the patients with acute lymphocytic leukemia and chronic myelogenous leukemia, followed by monocytic leukemia, and some cases in acute myelogenous leukemia.
    The severity of the leukemoid reaction was relatively mild in the majority of cases, but some show a marked reaction making the type difficult to discern. In such instances, it was possible to identify a composing cell series by the tissue culture method.
    As for the cell constituents in the blood attributed to leukemoid reaction in acute myelogenous leukemia, it was either of the neutrophil, the eosinophil or the monocyte series. In Xacute lymphocytic and monocytic leukemias it was mostly of the neutrophil series and, in some cases, either of the eosinophil or the basophil series. In chronic myelogenous leukemia it consisted of both the eosinophil and basophil series.
    As can be seen from these findings, in leukemias, the leukemoid reaction often associated with other white cell series than their own leukemia cell types. Therefore, the diagnosis of a type of leukemoid reaction should be made carefully.
  • 大滝 達郎
    1971 年 83 巻 9-10 号 p. 357-395
    発行日: 1971/10/30
    公開日: 2009/03/30
    ジャーナル フリー
    Clinical and experimental studies on hemolysis during extracorporeal circulation were performed. Various factors of hemolysis were analized as to perfusion methods, refering to erythrocyte life span.
    Conclusions are as follows:
    1) Concerning hemolysis, ACD blood for priming preserved for 2 to 3 days is not inferior to one preserved for a day.
    2) Disc oxygenators give less damage to erythrocytes than bubble oxygenators.
    3) Blood from cyanotic heart diseases has a tendency to show more hemolysis than blood from a cyanotic heart diseases.
    4) Mechanical hemolysis increases as blood temperature drops.
    5) As antihemolytic agents, Mannitol is effective, but Pluronic F-68 shows no recognizable effects in vitro experiments.
    6) Blood retension in the pericardium causes marked hemolysis, resulting in elevation of free Hb level in suction circuit, and return of blood from suction circuit to oxygenator gives a rise to elevation of plasma free Hb level in extracorporeal circulation with a little influence to total free Hb level.
    7) Hemodilution is effective to decrease damage to erythrocytes.
    8) Kind of diluent gives great influence to hemolysis. Gelatin has proved to be best.
    9) Hemoglobinuria is seen at higher level of plasma free Hb than 110140mg/dl after extracorporeal circulation.
    10) Erythrocyte life span is much shortened with even mild mechanical stimulation to erythrocytes. With strong stimulation, it was markedly shortened.
  • 本後 隆史
    1971 年 83 巻 9-10 号 p. 397-433
    発行日: 1971/10/30
    公開日: 2009/03/30
    ジャーナル フリー
    Statistical and clinical studies were conducted on familial occurrence rates of hepatoma and liver cirrhosis in adults with 37 cases of primary hepatoma and 246 cases of liver cirrhosis admitted to our clinic during the 9-year period of 1958 to 1966. As a result there were found 29 families showing familial occurrence of hepatoma or liver cirrhosis. The results of the study are briefly summarized as follows.
    1) The incidence of hepatoma or liver cirrhosis among the relatives of 283 subjects was 1.9% in brother-sister of the patient; 3.9% in the parent; and 0.44% in grandfather-grandmother. These rates were significantly higher than those of the control hepatitis group.
    2) The onset rates in brother-sister of index cases (under whom one of the affected individuals in the lowest ranked generation was designated) among 29 pedigrees of familial occurrence proved to be 32% (12/38) in 8 families of the brother-sister group; 10% (7/70) in 16 families of the parent-child groups (of them 1/29=3.4% in 7 families of the father-child group, 6/22=27% in 6 families of mother-child group, and 0/19 in 3 families of parents-child group). It was 17% (2/12) in the 3 families of 3 consecutive generations (grandparent, mother and their descendants), and in two families of the grandmother as mother's side-grandchild group it was 0/8 (individual). In addition, in the parents of the index cases there was no cousin-to-cousin marriage.
    3) In the same pedigree there could be detected some cases showing similar findings of onset age, type of disease, timelapse pathohistological findings, despite the difference in their modes of living and history. Further, among the patients investigated there were some who took so rapid course from chronic hepatitis of active type or from submassive hepatic necrosis to liver cirrhosis that they could not receive sufficient benefits of steroid treatment or those who died precipitously because of fulminant disease.
    4) In these 29 pedigrees studied, there were observed epidemic nature of hepatitis and drinking as exogenous factors and the propensity to diabetes as inherent cause. Judging from such factors as hepatitis epidemic in the residential district of patients, distance between the residence of patients, the difference in the onset age, and hepatitis history among relatives, it has been assumed that rather than emphasizing epidemic nature of hepatitis in the familial occurrence, a greater emphasis should be placed on the propensity of the patient to hepatitis and on the predisposition to shift to liver cirrhosis. As for the alcohol drinking, those heavy drinkers showed a higher incidence than liver cirrhosis patients showing no familial trend, but there was obserbed onset of hepatoma or liver cirrhosis even in females and males without history of drinking, and in 29 pedigrees the drinking that proved to be a common cause in the family was limited within 4 pedigrees.
    As for the causative factor of diabetes, subjects related by blood having diabetes gave a higher incidence than liver cirrhosis patients not showing familial trend, but there was not a single pedigree having over 2 affected individuals complicated with diabetes in the same family. In other words, these exogenous and inherent causes couldn't be taken as the principal causes of familial occurrence.
    5) In the mother-child group of familial occurrence the rate of incidence was not only higher in child but also there was a trend of the patient to be succeeded by other affected siblings in the order of their birth. In our Au antigen tests conducted with 2 pedigrees, the rest result was positive in the mother (inflicted) and daughter (not inflicted), while inflicted father gave a positive result but the child was negative.
    6) These results suggest that there were genetic factors involved in familial occurrence of hepatoma or liver cirrhosis
  • 中谷 亨
    1971 年 83 巻 9-10 号 p. 435-448
    発行日: 1971/10/30
    公開日: 2009/03/30
    ジャーナル フリー
    There are very few studies of the indicators which measure the effects of irradiation, even though it is very important in assessing the mechanism of radiation injuries and evaluating the effect of chemical protection against radiation hazard. Previous studies used either in vivo survival or in vitro cell counts to measure radiation effects.
    The study describes the use of cell volume, intracellar DNA, and cell counts as indicators of the effects of irradiation on cells in tissue culture, and demonstrated the effects of AET (S2-Amino-ethylisothiuronium bromide) as chemical protection against radiation hazards as measured by these three indicators.
    The results are as follows:
    1) Combined use of the three indicators demonstrated that the effect of radiation on L-strain cell in tissue culture resulted from extension of the cell's mitotic phase and inhibition of cell division.
    2) A positive correlation in the indicators was found with high dose irradiation (800 r) of cells in tissue culture, but there was no correlation noted at lower test doses (200 r and 400 r). This finding demonstrated that it is necessary to study irradiation effects using these indicators in combination, especially at low dose exposures.
    3) The study demonstrated that AET inhibited growth of irradiated L-strain cells and furthermore promoted cell bivision in tissue culture, thus showing the capacity for AET to tissue cells against irradiation.
    4) Use of cell growth indicators such as cell volume, intracellular DNA, and cell counts, in combination, seems superior to previous methods of cell studies related to irradiation effects.
  • 第1編 腫瘍株細胞および腫瘍初代培養細胞におけるScreening
    須原 銀兵衛
    1971 年 83 巻 9-10 号 p. 449-455
    発行日: 1971/10/30
    公開日: 2009/03/30
    ジャーナル フリー
    For the purpose to determine inhibitory effects of Chromonycin A3, and Mitomycin C of the roliferation of tumor cells we conducted tissue cultures in vitro using next 3 established tumor ells, JTC-11 cells (derived from Ehrlich cancer cells), Hela-S3 cells, and human thyroid cancer ells, and using primary culture cells from methylcholanthrene induced tumors in the presence f the above two drugs, and obtained the following results.
    1. Chromomycin A3 shows a marked inhibitory effect on JTC-11 cells in the concentration of 10-3γ/ml, but it rather accelerates the proliferation of these cells at low concentrations of 10-5γ/ml and 10-6γ/ml.
    2. As to the effect of Mitomycin C on JTC-11 cells, it acts inhibitorily at the high concentration of 10-2γ/ml and 10-3γ/ml, but at the concentration of 10-5γ/ml, it accelerates the growth of these cancer cells.
    3. In the presence of Chromomycin A3 at the concentration of 10-3γ/ml it inhibits markedly the proliferation of Hela-S3 cells, and even at a low concentration of 10-5γ/ml there can be seen no accelerative effect.
    4. As to the effect of Chromomycin A3 on human thyroid cancer cells, at the concentration of 10-3γ/ml it shows an inhibitory effects, but at the concentration of 10-4γ/ml it reveals a slight accelerative effect on the growth of human thyroid cancer cells.
    5. The proliferation of primary culture cells from methylcholanthrene induced tumors are inhibited by addition of 10-3γ/ml of Mitomycin C. In the addition of Chromomycin A3 to the primary culture cells, the growth-inhibitory patterns are considerably different at 3 different primary culture cells. It is interesting that the growth of MC2 primary culture cells is rather markedly inhibited at the addition of 10-4γ/ml and 10-5γ/ml of Chromomycin A3 as compared with growth in addition of 10-3γ/ml.
    From these results it seems that the determination of direct effects of these two drugs on the proliferation of tumor cells in tissue culture is technically simple and it would reflect also the effects of the drugs in vivo.
    On the other hand, there is a possibility that when the drug is administered in a low concentration below its optimal concentration in blood, it rather accelerates the tumor proliferation instead of inhibiting it.
  • 第2編 人癌初代培養細胞にたいする各種制癌剤の作用(Adverse effectについて)
    須原 銀兵衛
    1971 年 83 巻 9-10 号 p. 457-464
    発行日: 1971/10/30
    公開日: 2009/03/30
    ジャーナル フリー
    Using the primary cultured cells of cancerous thoracic fluid, cancerous ascites and mammary cancer tissue obtained from cancer patients at operation, these cells were cultured in the presence of antitumor agents such as Mitomycin (MMC), Chromomycin (Chr. A3) and Cobalt protoporphyrin (Copp) either singly of in combination, and the proliferation of the primary cultured cells was observed. The results of the study are briefly summarized as follows.
    1. Cultures in the presence of a single antitumor agent: On addition of MMC or Chr. A3 in the concentration of 10-1γ/ml and 10-2γ/ml respectively shows a marked inhibitory effect or destructive effect on the proliferation of the prinary cultured cells. Copp, on the other hand, does not show any inhibitory effect at the concentration of 10γ/ml, 10-1γ/ml, or 10-2γ/ml.
    2. Cultures in the presence of two antitumor agents: When 10-1γ/ml of MMC and 1γ/ml Copp are added, there can be observed no cumulative inhibitory effect. In the presence of 10-1γ/ml Chr. A3 together with 10-1γ/ml MMC there can be seen a cumulative effect resulting in a marked inhibition of the proliferation.
    3. After treating the primary cultured cells with Chr. A3 at a low concentration for 48 hours, then cultured for 96hrs: When the primary cultured cells are cultured in the presence of Chr. A3 at the concentration of 10-2γ, or 10-4γ/ml for 48 hours, and after removing Chr. A3 by washing, when the cells are further cultured for 96 hours, there can be observed an adverse effect; namely, the growth of the primary cultured cells is accelerated.
    4. Cultures with continuous addition of antitumor agent at a low concentration: In the presence of 10-3γ/ml MMC there can be observed a marked adverse effect, but on further addition of 10-4γ/ml MMC adverse effect can not longer be seen. On the addition of Chr. A3 at the concentration of 10-4γ/ml, similarly a marked acceleration of the growth can be seen, but at a lower concentration of 10-6γ/ml there can be observed only a slight accelerative effect.
    These results indicate that the addition of antitumor agent at a certain low concentration, acting on the cancer cells themselves may bring about an accelerative effect (adverse effect). Therefore, it is desirable to consider the adverse effect so far thought to be induced by the unbalance between the cumulative effect of the resistance of host and tumor proliferative capacity, from a new angle. Hence, on administering antitumor agent in vivo we should do it with utmost precaution.
    Acknowledgement: The author wishes to express profound thanks to Prof. Sanae Tanaka and Dr. Kunzo Orita for kind guidance throughout this work.
  • 島田 宜浩, 福原 純一, 窪田 政寛, 小坂 淳夫
    1971 年 83 巻 9-10 号 p. 465-479
    発行日: 1971/10/30
    公開日: 2009/03/30
    ジャーナル フリー
    In order to elucidate the relationship between SMON (subacute myelo-optico-neuropathy) and chinoform, we carried out comparative studies on the doses and total amounts of chinoform preparations on the both patients of SMON and non-SMON admitted in Hospital I where SMON is most endemic in Okayama Prefecture, during the period of 1968, 1969 and 1970, to the total of 7, 374 cases, and those treated in 1969 at Hospitals P and Q located in other districts, amounting to 11, 953 and 7, 290 cases respectively, all inclusive of SMON and non-SMON patients. The results are briefly summarized as follows.
    1. Of the SMON patients in Hospital I, the ratio of those not receiving chinoform administration prior to the onset of SMON to the total SMON cases proved to be 8 to 55 cases in 1968, 32 to 52 cases in 1969, and 2 to 7 cases in 1970, indicating that the incidence in 1969 is very high. What is more, there is a considerable difference according to the fiscal year, thus giving no uniform results. Even at Hospital P the administration of chinoform cannot be confirmed in 2 cases out of 15 SMON patients and at Hospital Q in 2 out of 5 cases prior to the beginning of neurological symptomes of SMON.
    2. In the region around Hospital I there was observed the highest incidence of SMON in the first half of the fiscal year 1969, and thereafter the incidence decreased rapidly from the latter half of 1969. However, We can find no evidence as to substantiate changes in the chinoform administration from the results of chinoform administered to general non-SMON patients.
    3. The ratio of SMON patients to the total cases treated with chinoform at Hospital I proved to be 13.9% in 1968, 29.6% in 1969, and 5.7% in 1970, and at Hospital P it was 2.7% in 1969 and at Hospital Q 1.8%.
    4. As to the age range of general patients receiving chinoform, the incidence of those non-SMON cases proves to be highest in twenties and thirties irrespective of sex and this finding doesnot coincide at all with the known propensity of SMON being more apt to occur in females of middle age.
    5. As is obvious from these findings, our comparative studies conducted on the effects of chinoform to patients in the three hospitals do not yield any evidence to prove direct relationship between the chinoform administration and the onset of SMON.
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