Rinsho Ketsueki
Online ISSN : 1882-0824
Print ISSN : 0485-1439
ISSN-L : 0485-1439
Volume 15, Issue 9
Displaying 1-11 of 11 articles from this issue
  • after the administration of chloramphenicol
    Munemoto ITO, Yuichi FUKUIYA
    1974 Volume 15 Issue 9 Pages 985-992
    Published: 1974
    Released on J-STAGE: October 31, 2008
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    It is not so uncommon that aplastic anemia is induced by chloramphenicol. As regards aplastic anemia occured after hepatitis, however, only sixty cases have been reported, up to the present. This complex is called “the syndrome of hepatitis and aplastic anemis” by Rubin. Hodgikinson has recently documented the cases in which firstly hepatitis, secondary aplstic anemia are caused after the administration of chloramphenicol as the name of “Chloramphenicol—hepatitis—aplastic anemia syndrome”.
    Our patient, thirty two years old, a house-wife was administrated 42 grams of chloramphenicol during the period of one month and suffered from hepatitis with marked jaundice four weeks later. In spite of recovering of liver function, she died of aplastic anemia.
    Discussion of this paper are described about context of above three factors as follows; chloramphenicol and liver damage, hepatitis and aplastic anemia, and involvement of bone marrow and chloramphenicol.
    Moreover the relationship between “Sinocapillaropathy of bone marrow” and each above mentioned three factors is discussed.
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  • II. The Evaluation of Androgen and Anabolic Androgenic Steroid Therapy of Adult Aplastic Anemia
    Osamu KAMIYA, Toshihiko SHIBATA
    1974 Volume 15 Issue 9 Pages 993-1001
    Published: 1974
    Released on J-STAGE: October 31, 2008
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    It was reported in this paper on the therapeutic effects of androgens and anabolic androgenic steroids in 17 adult patients with aplastic anemia and to demonstrate the relationship between their effects and the degree of the initial bone marrow failure. The severity of the disease was classified into the three groups (mild, moderate, severe) by combination of four paramaters, neutrophil count, reticulocyte count, platelet count, and % marrow hematopoietic cell.
    Remission defined by normalization of Hb levels without transfusion was obtained in all of 7 cases of mild degree and in 3 out of 9 cases of moderate degree, while one case of severe degree did not respond to oxymetholone. It is concluded from our results that the milder the initial bone marrow failure, the higher the remission rate with aplastic anemia.
    The side effects of these drugs were also reported and, above all hepatoloxicity were discussed with reference to the blood transfusion and pretherapeutic hepatic disturbance.
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  • Hirokazu NISHIHIRA, Akihiko SAKAI, Yukiaki MIYAGAWA, Tatsutoshi NAKAHA ...
    1974 Volume 15 Issue 9 Pages 1002-1010
    Published: 1974
    Released on J-STAGE: October 31, 2008
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    The proliferation and differentiation of bone marrow hematopoietic cells in normal children and children with acute leukemia and idiopathic aplastic anemia were studied in vitro.
    In vitro diffusion chamber technic, described by Sumner et al and Golde et al, was employed as the method of the cell culture.
    McCoy's 5A Medium supplemented with 15% fetal calf serum and antibiotics, were used without addition of exogenous granulocyte stimulating substances.
    The culture apparatus contained the bone marrow cells (2-6×106) were incubated at 37°C in a humidified environment with 7.5% CO2 in air.
    The cultures were harvested up to 14 days and sequential observations were done on viable cell counts, differential counts of May-Grunwald-Giemsa stained cells, and radioautographs, prepared after incubation of the cells with 1μC/ml of 3H-Thymidine for 1 hour.
    Briefly, the results were as follows:
    1) In the culture of normal bone marrow, various maturational stages of granulocytes were found after the 10-14th day, and small numbers of lymphocyts, erythroblastes and rare megakaryocytes were found. The macrophages increased gradually.
    The viable cell counts were falling until 3-5th day, followed by a rise or slight decrease toward the 14th day.
    3H-Thymidine up-take rate (labelling indices) paralled to the variations of cell counts.
    2) The growth of leukemic cells from children with acute lymphoblastic leukemia showed maturation arrest. The cells of acute myeloblastic leukemia showed partially cytoplasmic changes with irregular shape and bulky vacuoles.
    3) In idiopathic aplastic anemia, although small numbers of mature granulocytes were presented, lymphoid cells and macrophages were predominant.
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  • Takeshi OHSHIRO, K. MUKAI, J. KANBAYASHI, M. MONDEN, S. KOH, A. SUGITA ...
    1974 Volume 15 Issue 9 Pages 1011-1020
    Published: 1974
    Released on J-STAGE: October 31, 2008
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    The hereditary spherocytosis (HS) is probably inherited as a mendelian dominant, but the clinical abnormality is less than the theoretical frequency. This may be due to the reason why the mildly affected cases could not be easily distinquished from the normal persons.
    Recently, many papers reported that serum haptoglobin (Hp) disappeared from the blood circulation in hemolytic diseases.
    This study investigated the correlation between HS and Hp, especially on the family and relative examinations.
    The results were as follows.
    1. The sera of 4 indibiduals with HS had no free Hp.
    2. After splenectomy, serum Hp levels were rapidly raised and almost kept within the normal range.
    3. The family and relative examinations were performed in case 11 who had no history of familiar transmission of HS, and 5 cases of hypohaptoglobinemia were found out of 20 cases, including the patient.
    4. 5 cases were comparatively located in some families, that is, 2 cases in 56 years old uncle's, 2 cases in patient's and 1 case in 46 years old uncle's families.
    5. Hypohaptoglobinemia was related to the decreased osmotic fragility rather than the anemia, high reticulocytosis or splenomegaly.
    6. We considered that they might be the affected family members with slightly chronic hemolysis.
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  • Tadami NAGAO, Okinobu KAMIMURA, Takefumi FUCHIMOTO, Hakumei CHEN, Hiro ...
    1974 Volume 15 Issue 9 Pages 1021-1027
    Published: 1974
    Released on J-STAGE: October 31, 2008
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    Seven cases with acute promyelocytic leukemia were treated with Neocarzinostatin alone and concomitantly with other antileukemic agents.
    A complete remission was obtained in 4 of 7 cases (57.1%).
    The duration of complete remission was more than 14 months for the first case, 6 months for the third case and more than 3 months for the forth case. These cases had been treated with Neocarzinostatin in combination with other antileukemic agents. The duration of complete remission was 2 months and survival was 6 months for the second case who had been treated with Neocarzinostatin alone.
    Whereas a complete remission was obtained in 2 of 13 cases (15.4%) for the groupe in which had been treated with antileukemic agents except for Neocarzinostatin.
    It is conculuded that chemotherapy with Neocarzinostatin alone and concomitantly with other antileukemic agents seems excellent in induction of acute promyelocytic leukemia.
    In leukemic cells enlargement and degeneration due to Neocarzinostatin treatment were observed light and electron microscopically.
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  • Yasuyuki ENDO, Akira SHIBATA, Akira B. MIURA, Tetsuo AKIHAMA, Yasuko S ...
    1974 Volume 15 Issue 9 Pages 1028-1035
    Published: 1974
    Released on J-STAGE: October 31, 2008
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    Among congenital coagulation factor deficiencies, factor V deficiency is considered a very rare disease. It may be cited as one of the reasons that this disease is not easily found because it is accompanied by only slight hemorrhagic tendency.
    Two cases of congenital factor V deficiency were presented. Case I had undergone three surgical operations and had no abnormalities in menstruation, and as diagnosed as this disease at the age of 55. She died of intracranial hemorrhage. Case 2 showed only a slight hemorrhagic tendency, having had only three bleeding episodes up to the age of 30, but was diagnosed as this disease because of the formation of deep hematomas. The factor V level was 2.7 and 6.4% in two cases. A genetic history was noted in Case I, but not in Case 2. No abnormalities were found in the other coagulation factor and fibrinolysis. Platelet function, especially a simple method for determining platelet factor I has also been described.
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  • Toshio FUKUI, Hiroko YOSHITAKE, Shigetaka OKAJIMA, Konosuke KONISHI, S ...
    1974 Volume 15 Issue 9 Pages 1036-1041
    Published: 1974
    Released on J-STAGE: October 31, 2008
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    A 57-year-old man was admitted on January in 1973, because of anemia and multiple subcutaneous nodules located at anterior chest wall.
    The urinalysis gave negative tests for protein, the erythrocyte sedimentation rate was 13 mm/hr, hypoproteinemia and hypogammaglobulinemia were found. Biopsy of subcutaneous nodules and bone marrow revealed malignant plasmocytoid tumor by an ordinary and electron microscopic examination.
    Immunoelectrophoretic analysis demonstrated a formation of M bow in IgD and λ chain, but IgG, IgA and IgM levels were all decreased. Concentrated urine was examined with Ouchterlony method, but no Bence Jones protein was detected.
    Cyclophosphamide, prednisolone and melphalan were administrated with slight clinical improvement. However, subcutaneous nodules enlarged again. Eradiation of 60Co was carried out but patient expired 6 months after the onset of the disease.
    Autopsy showed wide-spread myeloma cells throughout the body.
    In this case, persistent negative Bence Jones protein and normal erythrocyte sedimentation rate were of special interest concerning the diagnosis of myeloma.
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  • Hisatomo HAYASHI, Masahide SASAKI, Hiroo YOSHIOKA, Kenzi NIIYA, Atsuma ...
    1974 Volume 15 Issue 9 Pages 1042-1048
    Published: 1974
    Released on J-STAGE: October 31, 2008
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    A congenital factor VII deficiency is relatively rare disease and up to now, only 15 cases (11 families) have been reported in Japan. The present report concerns a female case of congenital factor VII deficiency, diagnosed at the age of 59. On admission, the physical examination revealed no abnormalities except for pyorrhea with continuous gum bleeding. She had often suffered from epistaxis, macrohematuria and petechiae with bruise since 10 years old. She had delivered 4 normal children without unusual bleeding. There was no history of hemorrhagic tendency in her family. Coagulation data showed the characteristic findings for pure factor VII deficiency (2% of normal) with vascular fragility. Liver function chemistries were within normal limit. The prolonged one stage prothrombin time was not shortened either by adding the prove congenital factor VII deficiency plasma or by the Vitamin K administration per os. The administration of Konyne-Cutter before dental extractions was effective for hemostasis.
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  • Fumitaka OSUZU, Keisuke TOYAMA, Masao KASAHARA
    1974 Volume 15 Issue 9 Pages 1049-1054
    Published: 1974
    Released on J-STAGE: October 31, 2008
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    A forty-three-year-old woman entered the Keio University hospital because of fever, induration of left anterior chest wall and left axillary lymphadenopathy. She suffered from tuberculous empyema 20 years ago. A lymph-node biopsy showed pleomorphic reticulum cell sarcoma or Hodgkin's sarcoma. Autopsy findings revealed pleomorphic reticulum cell sarcoma. Main lesions were contact with caseous pleuritis without another superficial lymphadenopathy, and roentgenographically it was very difficult to discern tumor shadow. A pleural biopsy was unsuccessful in yielding sufficient tissue for diagnosis. Afterwards X-ray films of the chest showed irregular border of the ribs, and infiltration of reticulum cell sarcoma to the left lung was suspected.
    Ichthyosiform scale appeared almost all skin except face and head. Disturbance of sweating due to skin eruptions might have been the cause of a high fever. There were not skin eruptions till the appearance of a high fever and lymphadnopathy, and no skin diseases are known in her family. So ichthyosiform scale was regarded as acquired ichthyosis. Although Dijk described the ocurrence of ichthyosiform atrophy of the skin in patients with malignant internal diseases as Hodgkin's disease, a brief report seems warranted in view of the rarity of this association.
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  • Fumimaro TAKATSU, Motoharu KIMOTO, Hisomu YAMAGUCHI, Ichitaro ASAI, Hi ...
    1974 Volume 15 Issue 9 Pages 1055-1062
    Published: 1974
    Released on J-STAGE: October 31, 2008
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    This thirty-eight-year-old male was first seen on 26 December, 1972, with the chief complaint of muscle weakness. On admission papules were noted on the whole body. Lymph node swelling was seen at the both inguinal regions. Spleen was felt three fingerbreadths. Proximal type muscle atrophy, weakness and hyporeflexia were remarkable. No pathological reflexes were demonstrated.
    Blood examination revealed hemoglobin 16.7 Gm./100 ml., red blood cells 5,630,000 per cu. mm., white blood cells 38,000 per cu. mm. with 49 per cent of lymphosarcoma cells, and platelet 196,000 per cu. mm. A sternal aspirate revealed slightly hypocellular marrow with 11 per cent of lymphosarcoma cells.
    A biopsy specimen of the left inguinal lymph node showed a total disappearance of lymph follicles and a lymphosarcoma cell infiltration in the medullary cord. Biopsy findings of the M. triceps and M. peroneus revealed an extensive infiltration of the lymphosarcoma cells into the muscle tissue and a remarkable myogenic and partially neurogenic atrophy of the muscle fibers. During the hospital course the patient showed a meningeal lymphosarcomatosis, hypercalcemia and other complicated findings.
    The patients died of cerebral hemorrhage on March 21, 1973. An extensive infiltration of the lymphosarcoma cells to the skeletal muscles was noted on autopsy.
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