巻号一覧
17 巻, 5 号
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第17回総会
円卓討議 再生不良性貧血の成因・定義
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島峰 徹郎1976 年 17 巻 5 号 p. 467-470
発行日: 1976年
公開日: 2009/01/19
ジャーナル 認証ありPDF形式でダウンロード (293K) -
三浦 恭定1976 年 17 巻 5 号 p. 471-473
発行日: 1976年
公開日: 2009/01/19
ジャーナル 認証ありPDF形式でダウンロード (239K) -
金丸 昭久, 原 宏1976 年 17 巻 5 号 p. 474-477
発行日: 1976年
公開日: 2009/01/19
ジャーナル 認証ありPDF形式でダウンロード (279K) -
梅原 千治1976 年 17 巻 5 号 p. 478-485
発行日: 1976年
公開日: 2009/01/19
ジャーナル 認証ありPDF形式でダウンロード (2129K) -
小宮 正文1976 年 17 巻 5 号 p. 486-490
発行日: 1976年
公開日: 2009/01/19
ジャーナル 認証ありPDF形式でダウンロード (457K) -
田口 信行1976 年 17 巻 5 号 p. 491-494
発行日: 1976年
公開日: 2009/01/19
ジャーナル 認証ありFifty patients with aplastic or hypoplastic anemia under 15 years of age, who were seen between 1965 and 1975 at the National Children's Hospital, were examined. The patients include 5 cases of Fanconi's anemia and 4 cases of congenital pure red cell anemia.
In the family history, a high rate of consanguinity in parents of patients were revealed. Nine patients were children of related parents.
In 19 out of 50 patients, some congenital anomalies including minor anomalies such as Dubois' sign were observed. In the patients who suffer from Fanconi's anemia, the most common congenital anomalies were skeletal deformities, abnormal skin pigmentation, short stature and chromosomal aberrations. So-called Dubois' sign were observed in 14 out of 30 patients.
From my data the possibility that aplastic anemia in children may originate on the basis of constitutional weakness of bone marrow may be considered.抄録全体を表示PDF形式でダウンロード (308K) -
長谷川 弥人, 小川 哲平1976 年 17 巻 5 号 p. 495-499
発行日: 1976年
公開日: 2009/01/19
ジャーナル 認証ありAnalysis of 95 cases with idiopathic aplastic anemia for the period of 14 years between 1962 and 1975 in Keio University Hospital led us to conclude that aplastic anemia consists of two types: one is typical aplastic anemia, the other atypical aplastic anemia. The diagnosis of atipical aplastic anemia should be made when found any two of following items: 1) reticulocytosis 2) absence of relative lymphocytosis 3) monocytosis 4) erythroid hyperplasia of bone marrow prior to treatment 5) left shift of myeloid series in bone marrow 6) absence of decrease of megakaryocyte count 7) normal level of serum iron 8) splenomegaly.
In 22 cases of atypical aplastic anemia, 6 instances terminated in acute myelogenous leukemia and in 7 cases, aplastic anemia PNH syndrome or a variant developed.抄録全体を表示PDF形式でダウンロード (398K)
臨床研究
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—主として細胞性免疫の面から—星崎 東明, 馬場 百合, 仁木 洋子, 森川 景子1976 年 17 巻 5 号 p. 506-514
発行日: 1976年
公開日: 2009/01/19
ジャーナル 認証ありThe purpose of the present report is to determine the correlation between the lymphocyte blast transformation by various mitogens and the prognosis of the patients with acute leukemia.
Examination was made on 44 acute leukemia patients admitted to our hospital. Among them were 40 cases with acute myelogenous leukemia and 4 cases with acute lymphocytic leukemia. As the control group 60 normal cases were selected.
The blast transformation rate by PHA was 76.1+8.6 for the control group, and 74.9+12.1 at the complete remission. The cases, which showed the same value as the control value at the remission induction, attained remission. On the other hand, the cases, which indicated low value at the remission induction, often failed to attain remission and infection, supervened.
Almost the same results on the blast transformation rate were obtained by PWM and ConA.
The results indicated that the blast transformation at the remission was the same as that of the control value. However, many of our cases indicated that if the blast transformation was much decreased in remission induction, remission could not be achieved, suggesting infection, while the value was the same as that of the control value at the remission induction remission was attained.
Judging from the results of the blast transformation between the culture added with patients autoserum and fetal calf serum, it seems that some factors might exist in the serum of acute leukemia patients, which suppress the blast transformation.
In conclusion it was suggested that the rate of blast transformation was a good indicator for clinical course and prognosis in acute leukemia.抄録全体を表示PDF形式でダウンロード (653K) -
北島 和彦, 山田 治, 是沢 俊輔, 八幡 義人, 柴田 進, 菅田 溥, 仲座 勇1976 年 17 巻 5 号 p. 515-519
発行日: 1976年
公開日: 2009/01/19
ジャーナル 認証ありThe combined chemotherapy (MOPP) with endoxan (instead of Mustard), vincristine (Oncovin), procarbazine, and prednisolone (Predonin) was examined on 15 patients of the advanced malignant lymphoma. These patients were classified as stage IIIb or IVb, and resistant to 60Co irradiation and/or other types of chemotherapy. The effectiveness of the MOPP therapy was marked in 53% of these patients, moderate in 26%, slight in 7%, and none in 14%, and it was independent of the histological classification of the lymphoma tissues.
The major side-effects of this therapy were gastric ulcer, diabetes mellitus, and infections associated with neutropenia.
A representative case of lymphosarcoma was presented to demonstrate the effect of this therapy.抄録全体を表示PDF形式でダウンロード (402K) -
—とくにWhole Body Linear Scanningを中心として—滝田 資也, 堀田 知光, 山田 英雄, 斉藤 宏1976 年 17 巻 5 号 p. 520-526
発行日: 1976年
公開日: 2009/01/19
ジャーナル 認証ありThe distribution patterns of the erythropoietic marrows in 17 patients with polycythemia vera were evaluated with a Ring-type Whole Body Linear Scanning using 59Fe. Ferrokinetics indices calculated by Huff's method were as follows: PID T1/2 42±24 min. (Mean±S.D.), RCU 86±17%, PIT 1.00±0.58 mg/kg/day, EIT 0.91±0.61 mg/kg/day. RCU and EIT in polycythemia vera cases with myelofibrotic change were lower than those in polychytemia vera cases without myelofibrotic change. After the injection of 59Fe, the longitudihal as well as transverse linear scanning were performed at 6 hours, 24 hours, 5th day and 10th day period. The distribution patterns of 59Fe at 24 hours, which reflect the erythropoietic marrow distribution, were devided into 3 patterns, that is, normal, marrow expansion and extramedullary erythropoiesis. Among 20 cases, 5 had normal, 7 had marrow expansion and 13 had extramedullary erythropoiesis. The frequency of extramedullary erythropoiesis was significantly high in patients with splenomegaly. The accumulation of 59Fe at the 10th day in the spleen reflecting the hemolysis and the pooling of the red cell was found in 19 among 20 cases with polycythemia vera. The whole body linear scanning is useful for the diagnosis, treatment and studies of pathophysiology of polycythemia vera.抄録全体を表示PDF形式でダウンロード (515K) -
金子 安比古, 武田 武夫1976 年 17 巻 5 号 p. 527-533
発行日: 1976年
公開日: 2009/01/19
ジャーナル 認証ありIn an attempt to evaluate possible secondary carcinogenic and genetic effects of intensive chemotherapy and radiotherapy, the types and frequencies of chromosome abnormalities were investigated in cultured lymphocytes from 15 children with acute leukemia who achieved therapeutically a complete remission. For control, were provided 14 healthy adults (group A). Out of the 15 leukemic children 12 received only chemotherapy (group B), while the remaining 3 received both chemotherapy and radiotherapy of central nervous system (group C). In addition, 2 brain tumor patients who received a cranial radiotherapy were studied (group D).
A significantly higher incidence of chromosome abnormalities was observed in group B, C and D, as compared with group A. The aberration incidence was highest in group C, which was ascribed to the increased number of hypodiploid cells with chromosome-type structural rearrangements, probably due to the radiotherapy. In contrast, the chromosome aberrations shown in group B were mostly of chromatid type, though chromosome-type aberrations were also noted in some cases of this group. Comparing the aberration rates between group C and D, it was suggested that the cranial irradiation was less hazardous than the spino-cranial irradiations.抄録全体を表示PDF形式でダウンロード (641K) -
浜崎 豊, 井上 正和, 多喜 紀雄, 神谷 齊, 吉住 完, 桜井 実, 井沢 道1976 年 17 巻 5 号 p. 534-543
発行日: 1976年
公開日: 2009/01/19
ジャーナル 認証ありTwenty three cases of childhood leukemias were autopsied during the last 10 years from 1974 and their histologic studies were reported.
1) Leukemic involvement was found frequently, with the following order: in the lymph nodes, spleen, liver, bone marrow, lungs and kidneys, and the incidence ranged from 91 percent to 57 percent. The involvement was less frequent in the thymus, adrenals, gastrointestinal tract, testes, ovaries, CNS, heart and skin. The extramedullary leukemic infiltration during marrow remission was also noted.
2) The morphologic changes referable to drug toxicity were fatty metamorphosis of hepatocytes and degenerative atrophy of the adrenals.
3) The lympho-reticular proliferation of the marrow, nodes or spleen during the course of leukemia was a characteristic finding, occurring as frequent as 65 percent to 70 percent. On the other hand, the thymus showed conspicuous involution, i.e. degeneration and atrophy of Hassal's bodies and decreased thymic lymphocytes. These changes could be referable to drug effects, mostly steroids.
4) Infection was also characteristic finding of the cases with leukemia and pulmonary infection was most frequently found with the incidence of 57 percent. Candida, aspergillus or virus infections were also noted.
5) Haemorrhage was seen of this order in the lungs, adrenals, spleen, kidneys, GI tract and CNS with the incidence of 20 percent to 62 percent.抄録全体を表示PDF形式でダウンロード (1197K)
症例
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岩永 隆行, 北見 翼, 阿部 光昭, 西田 雅喜, 天木 一太, 河野 均也, 堀内 篤1976 年 17 巻 5 号 p. 544-552
発行日: 1976年
公開日: 2009/01/19
ジャーナル 認証ありA 53-year-old man was admitted to the hospital on February 12, 1972 because of fever, lymphadenopathy and anemia.
He had been well until two months previously when he experienced a fever and lymph node swelling in inguinal regions. Physical examination on admission revealed anemia, generalized lymphadenopathy and hepatosplenomegaly. Blood examination disclosed normochromic anemia, leukocytosis and thrombocytopenia. Both plasma cells and plasma cell-like atypical cells appeared in the peripheral blood and bone marrow. Serum electrophoresis revealed a diffuse increase in the gamma globulin fraction and immunoelectrophoresis showed the presence of Fc fragment in serum and Fab and Fc fragments and light chains (κ, λ) in urine. Biopsy of the inguinal lymph node demonstrated the proliferation of plasma cells and large immature plasma cells by means of electronmicroscopic observation. Histological diagnosis was interpreted as reticulosis.
Administration of prednisolone did not result in favorable response for lymphadenopathy and hypergammaglobulinemia. He died of gastrointestinal bleeding on March 16, 1972.
Postmortem examination revealed generalized enlargement of the lymph bodes, hepatomegaly, splenomegaly and duodenal ulcer. The lymph nodes lost the normal architecture with the diffuse proliferation of plasmacytoid cells and large cells resembling reticulum cells, infiltration of these cells were noted in the liver, spleen and kidneys. Pathological diagnosis was malignant reticulohistiocytosis.
From these clinical and pathological findings, pathogenesis of the present case was discussed as compared with lymphoreticulosis hyperglobulinemica in the literature.抄録全体を表示PDF形式でダウンロード (907K) -
吉川 治哉, 竹山 英夫, 西脇 洋, 神谷 忠, 山田 一正, 佐光 富士男, 植谷 忠昭, 平林 紀男, 社本 幹博, 星野 完光1976 年 17 巻 5 号 p. 553-561
発行日: 1976年
公開日: 2009/01/19
ジャーナル 認証ありA case of leukemic reticulosis, myelogenous type was reported.
Twenty-nine-year-old male was admitted to the hospital because of low grade fever and purpura. On physical examination, ecchymosis and petechiae were present on the lower extremities and the left arm. A lymph node (2×3 cm) was palpated in the left axilla. The hilar lymphadenopathy and mediastinal masses were noted by the chest film. Mild anemia, moderate leukocytosis and marked thrombocytopenia were noted. Differential counts revealed thirty three percent of atypical cells in the peripheral blood and ninty one percent in the bone marrow. Morphological features of the atypical cells were thought to be consistent with those of leukemic reticulosis (acute type) by various cytological studies. Coagulation studies revealed marked decrease of fibrinogen, prothrombin, Factor V, Factor VIII and plasminogen in plasma together with increased whole blood clot lysis and positive FDP in the serum which was suggestive of the presence of consumption coagulopathy.
Combination chemotherapy was started immediately, which brought him non remission and he died about 3 months after the onset of the disease.
Pathological examination revealed the presence of mediastinal tumor involving the thymus and a diffuse infiltration of atypical reticulum cells in the reticuloendothelial system, particulary in the bone marrow, thymus and lymph nodes. From the pattern of reticulum cell infiltration, the primary lesion was interpreted as being in the bone marrow, while the mediastinal tumor as a secondary manifestation.抄録全体を表示PDF形式でダウンロード (1177K) -
山口 博志, 武藤 一己, 上平 憲, 岡部 信和, 池田 柊一, 市丸 道人, 中田 剛弘1976 年 17 巻 5 号 p. 562-568
発行日: 1976年
公開日: 2009/01/19
ジャーナル 認証ありPure Red Cell Aplasia Well Responding to Splenectomy.
A 24-year-old woman was hospitalized because of acutely progressive symptoms of anemia. Blood studies included: erythrocyte count, 1.06×106/mm3; hemoglobin, 1.7 g/100 ml; leukocyte count, 6300/mm3, with normal differential, reticulocyte, 0%; and platelet count, 147.5×103/mm3. Bone-marrow nucleated cell count was 145×103/mm3, with normal granulocytic series and megakaryocytes. Erythropoiesis, however, was not present at all. There were neither thymoma nor immunological abnormalities including anti-erythroblast antibody or several other autoantibodies. Diagnosed as the pure red cell aplasia without any detectable immunological abnormalities, she was treated with blood transfusion, large doses of corticosteroids, vitamins, and azathioprine, but because of no response, she finally underwent splenectomy. Splenectomy alone could not bring about improvement in blood picture, but when combined with short period administration of smaller doses of cyclophosphamide and corticosteroids, a complete remission was obtained. Five months after discontinuance of medication, the patient has not shown any signs of relapse. The pathogenesis in this particular case is estimated as due to a humoral factor synthesized in spleen and depressed the erythropoiesis, rather than an autoantibody originating in spleen and directly destroyed the erythroblasts.抄録全体を表示PDF形式でダウンロード (644K)
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