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Volume 15, Issue 10
Displaying 1-10 of 10 articles from this issue
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Yataro YOSHIDA, Toshiyuki NAKATSUI1974 Volume 15 Issue 10 Pages 1089-1099
Published: 1974
Released on J-STAGE: October 31, 2008
JOURNAL RESTRICTED ACCESSDownload PDF (1089K)
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Takuo SHIRAKURA, Minko MOH, Tadashi SUZUKI, Hiroaki ISHIBASHI, Tadashi ...1974 Volume 15 Issue 10 Pages 1100-1105
Published: 1974
Released on J-STAGE: October 31, 2008
JOURNAL RESTRICTED ACCESSUnderlying mechanism of anemia seen in two cases with hypopituitarism and the other two cases with Addison's disease was investigated. It was observed by 51Crtagged erythrocyte method that circulating red cell volume decreased absolutely in all of these patients, while life span of these erythrocytes was almost normal or slightly shortened in all cases. Ferrokinetic study revealed a normal or decreased effective erythropoiesis in all cases. Thus, anemia seen in these patients resulted from relative or absolute decrease in erythropoiesis. Both anemia and low BMR were corrected by replacement therapy with corticosteroid or thyroid hormone in all cases. Meanwhile, it was noteworthy that both Hb level and BMR were elevated by treatment with testosterone or anabolic steroid in a case of hypopituitarism. Phlebotomy resulted in significant elevation of plasma erythropoietin activity with an increase in reticulocyte count in a case of hypopituitarism. No lowering of ERC activity was noted in all of these patients.
From the results described above, pathogenesis of anemia seen in pituitary-adrenal insufficiency was discussed.View full abstractDownload PDF (492K) -
I. Comparison of High Dose Infusion of MTX as Sequential-Complementary Method for Maintenance of RemissionTakeo FUJIMOTO, Nagahide GOYA, Kinsuke NAKAGAWA, Fumio YAMASHITA, Yosh ...1974 Volume 15 Issue 10 Pages 1106-1113
Published: 1974
Released on J-STAGE: October 31, 2008
JOURNAL RESTRICTED ACCESSThirty-three previously untreated children with acute leukemia (peroxidase negative) were enrolled on a combination drug protocol (721) since January 1972. It consists of 3-Phases.: I-Induction, II-Prophylactic intrathecal medication with MTX, III-Intensive maintenance. This study was designed to compare the therapeutic efficacy and toxicity of high dose infusion of MTX (Group-A) and sequential use of 6-MP (Group-B) with periodic VCR and Pred reforcement therapy for the maintenance of remission.
Complete marrow remission (M-1) was achieved in 33 cases (100%). During the period of prophylactic intrathecal medication with MTX, two patients had hematological relapses and one developed CNS-leukemia.
Of 31 children who continued hematological remission, 16 were randomized to Group-A and 15 to Group-B. In Group-A, all are in hematological remission for a median of 13.3+ months with a range of 5.3+ to 22.7+ months as of March 1974. In Group-B, hematological relapses occurred in 6 (40%) and 9 children are in hematological remission for a median of 8.8+ months with a range of 5.2+ to 15.5+ months.
No significant toxicity occurred with both regimens and these maintenance did not require an unusual supportive care. However, two patients with over 10 years of age in Group-A had GOT elevation after each MTX infusion.
High dose infusion therapy of MTX was more effective for maintenance of remission than sequential-complementary method (p<0.05).
All CNS leukemia occurred in 4 children (11.8%) during hematological remmission.
A longer period of observation is needed to assess the longevity of these remission, incidence of CNS leukemia. However, these preliminary results showed that high dose infusion therapy of MTX seemed to prolong the remission duration of acute childhood leukemia.View full abstractDownload PDF (639K) -
—with Special Reference to the Alteration of Clinical and Hematological Pictures in the Course of the Disease.—Tomomitsu HOTTA, Hideo YAMADA1974 Volume 15 Issue 10 Pages 1114-1122
Published: 1974
Released on J-STAGE: October 31, 2008
JOURNAL RESTRICTED ACCESSSixteen cases of erythroleukemia, which were seen during past 10 years at Nagoya University Hospital and affiliated hospitals and were throughly followed up from their onset until death, were studied with emphasis on the alteration of clinical and hematological pictures in the entire course of the disease. Initial diagnosis was made in 15 cases at erythremic stage and in one at leukemic stage.
The mean survival time of these 16 cases from the time of their initial diagnosis was 9.5 months and its 50% survival time was 5.5 months. All patients at erythremic stage were treated by blood transfusion alone and did not receive any chemotherapy as a rule.
Thirteen out of 15 cases who were initially diagnosed at erythremic stage did develop frank acute leukemia as their terminal events. The mean term of the erythremic stage of 15 cases was 6.4 months, while that of the leukemic stage of 14 cases was 3.1 months. Among other findings, further enlargement of hepatosplenomegaly and reduction of platelet count were two major factors which preceded the leukemic transformation in erythroleukemia and could be used as a prognostic sign for the leukemic transformation of this disease.
Causes of death in 16 cases were as follows: infection in 6 cases, massive GI bleeding with paralytic ileus in 4, intracranial hemorrhage in 3, acute lung edema in 2, and cardiac tamponade in one. It is to be noted that massive GI bleeding and paralytic ileus due to leukemic infiltration in the intestine appeared at high rate as a terminal lifethreatening event.
In none of these 16 cases was there any substantial response to chemotherapy, although cytosine-arabinoside and daunomycin had a strong reducing effect of circulating and marrow leukemic cells.View full abstractDownload PDF (744K) -
—with Special Reference to the Results in Megaloblastic Anemias.—Yoshitomo MUTO, Motoharu KIMOTO, Hisomu YAMAGUCHI, Ichitaro ASAI, Tosh ...1974 Volume 15 Issue 10 Pages 1123-1127
Published: 1974
Released on J-STAGE: October 31, 2008
JOURNAL RESTRICTED ACCESSMany Heinz bodies have been observed in the erythrocytes of the patients with megaloblastic anemia following total gastrectomy and splenectomy. In order to clarify the relationship between these conditions, rate of the erythrocytes with Heinz body (bodies), Heinz body fromation test, red cell enzyme activities, red cell reduced glutathione, glutathione stability test and the presence of the unstable hemoglobin were studied.
The results showed the accelerated Heinz body formation in the untreated megaloblastic anemias; splenectomy did not seem to play any important role and no inborn error in the erythrocytes was detected. Although the acceleration in the Heinz body formation was normalized by the therapy with vitamin B12 in the cases of the Addisonian pernicious anemia, in about half of the patients with postgastrectomy megaloblastic anemia the acceleration did not turn to be normal; the mechanism of the acceleration of the Heinz body formation in the megaloblastic anemias remains unresolved.View full abstractDownload PDF (404K) -
Takefumi MATSUO, Kimio MATSUNAGA1974 Volume 15 Issue 10 Pages 1128-1132
Published: 1974
Released on J-STAGE: October 31, 2008
JOURNAL RESTRICTED ACCESSIt is well known that several factors such as plasmin, plasminogen, activator and fibrinogen in plasma affect a result of fibrinolytic activity which is obtained by the method of euglobulin clot lysis. Because fibrinolytic enzyme resolved fibrin clot formed from fibrinogen in euglobulin, a spontaneous fluctuation of plasma fibrinogen has been regarded as a main factor which had a mostly non-specific influence on euglobulin clot lysis time (ELT) without reflecting of a change of fibrinolytic activity. For the purpose of avoiding the influence of fibrinogen on ELT, a rato of ELT and fibrinogen concentration in euglobulin was calculated. The ratio was useful for comparison with fibrinolytic activity in various diseases, each of which had an obvious difference in plasma fibrinogen levels. Inspite of considerable fluctuation of both plasma fibrinogen and ELT after the acute myocardial infarction, the ratio could easily show the “true” change of fibrinolytic activity.View full abstractDownload PDF (406K)
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Nobuhide KINOSHITA, Akira YOSHIOKA, Shinji KATAGIRI, Hiromu FUKUI1974 Volume 15 Issue 10 Pages 1133-1141
Published: 1974
Released on J-STAGE: October 31, 2008
JOURNAL RESTRICTED ACCESSA report was made of a case of the hemolytic-uremic syndrome associated with consumption coagulopathy in a 2-month-old female infant.
After a week's duration of fever and diarrhea, the patient rapidly developed pallor, petechial hemorrhages and edema.
On admission, she was anemic with a slight jaundice. The liver was 6 cm and the spleen 4 cm palpable,
The hematologic examination showed RBC 3.46×106/mm3, Hb 8.8g/100ml, WBC 2,100/mm3. platelets 60,000/mm3 and reticulocytes 5‰. Peripheral blood smears levealed a marked anisocitosis, poikilocytosis and fragmented erythrocytes. Blood culture was negative, so was Coombs test. The direct serum bilirubin level was 0.9mg/100ml and indirect 1.4mg/100ml. The BUM level was 30mg/100ml. The albumin in urine was 2 plus. The bleeding time was over 30 minutes. Bleeding occurred from venipuncture sites and ear lobe.
A coagulation study revealed a marked prolonged clotting time, recalcification time, prothrombin time, kaolin partial thromboplastin time and thrombin time. The factor I level was 10mg/100ml. Levels of factors V and VIII were 36% and 28%, respectively. A moderate decrease was also found in factors II, VII, IX and X. No abnormal fibrinolysis was observed.
Despite a replacement thrapy of clotting factors and heparin adminstration, levels of factors I, II, VII, IX and X failed to increase on the fifth hospital day. The child died on the seventh hospital day. No autopsy was performed.View full abstractDownload PDF (734K) -
Isao TAKAHASHI, Koichi HARA, Motoharu SUGIYAMA, Toshio NAKANISHI, Hiro ...1974 Volume 15 Issue 10 Pages 1142-1148
Published: 1974
Released on J-STAGE: October 31, 2008
JOURNAL RESTRICTED ACCESSThree cases of leukemia were presented. Two of them demonstrated preleukemic stage and one was monocytic leukemia, whose bone marrow was examined retrospectively. Case 1, a 34-year-old male, showed hypoplastic preleukemic stage characterized by a slight increase of myeloblasts and a relative erythroid hyperplasia in the bone marrow and terminated in acute erythroleukemia preceded by the stage of atypical leukemia. Case 2, a 64-year-old female, was diagnosed as “acquired sideroblastic anemia”. This case terminated in atypical leukemia about 34 months after admission. Case 3, a 61-year-old male, was admitted to our clinic because of acute leukemia. Anemia was pointed out as early as about 6 months before admission and the first bone marrow aspiration was done at the time. Retrospective examination of this bone marrow showed erythroid hyperplasia with a maturation arrest and a slight increase of monoblasts.
It is interesting to note that erythroid hyperplasia with maturation arrest was found among all these cases at preleukemic or early stage. Sideroblastograms in Cases 1 and 2 showed a significant increase of the type III sideroblasts. Furthermore, ringed sideroblasts, which were presumably due to disturbed heme synthesis, were seen at high percentage. The cause of the disturbed erythroid maturation at preleukemic stage have been unknown. However, this disturbed erythroid maturation might give some clues to the prospective examination on preleukemic stage.View full abstractDownload PDF (881K) -
—Syndrome of Inappropriate Secretion of Antidiuretic Hormone Secondary to Vincristine Therapy.—Yukiko TSUNEMATSU, Kiyoko KIKUCHI, Ryo KOIDE1974 Volume 15 Issue 10 Pages 1149-1155
Published: 1974
Released on J-STAGE: October 31, 2008
JOURNAL RESTRICTED ACCESSSevere hyponatremia was observed in two cases of childhood acute myeloid leukemia during vincristine therapy. The patients manifested abdominal distension, loss of tendon reflex, seizures, and disturbance of consciousness without evidence of CNS leukemia.
Biochemical studies on these patients revealed urine osmorality inappropriately higher than that of the serum, and normal renal and adrenal function. It is felt that syndrome was a manifestation of vincristine toxicity.
Syndrome of inappropriate secretion of antidiuretic hormone produced by vincristine toxicity was reviewed.View full abstractDownload PDF (811K) -
Takeshi KITAO, Kozui KIDA, Susumu MIYABO, Kenichi HATTORI1974 Volume 15 Issue 10 Pages 1156-1160
Published: 1974
Released on J-STAGE: October 31, 2008
JOURNAL RESTRICTED ACCESSThe appearance of diabetes insipidus during the course of acute leukemia is very unusual. In this paper a case of acute myelogenous leukemia with concurrent diabetes insipidus is reported. A 37-year-old male was hospitalized in our clinic with the com plaint of gingival bleeding, headache, high fever, thirst, polyuria and pollakisuria of one month duration. Laboratory data showed; WBC, 2500 with 19% myeloblasts; bone marrow, NCC 83 thousands with 31.2% myeloblasts. The urinary output was 4∼7 L/day with a specific gravity of 1,001∼1.006. Hypertonic saline infusion did not reduce urine volume nor increase plasma ADH value. The administration of pitressin and chlorpropamide normalized both urine volume and specific gravity.
At autopsy, perivascular infiltration of leukemic cells was found within the pituitary stalk and posterior pituitary gland, but not in the hypothalamus.View full abstractDownload PDF (468K)
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