巻号一覧
18 巻, 2 号
選択された号の論文の9件中1～9を表示しています
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臨床研究
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—特にTransient Abnormal Myelopoiesis (TAM)の概念について—新保 敏和, 長尾 大, 木村 清次, 三杉 和章1977 年 18 巻 2 号 p. 99-109
発行日: 1977年
公開日: 2009/01/19
ジャーナル 認証ありSix cases with Down's syndrome who had initially clinical and hematological pictures resembling acute leukemia are reported.
Case 1 and 2 were thought to be typical acute myeloblastic leukemia, while progressed in around two years.
In case 3-6, all the findings suggesting leukemia disappeared spontaneously in later stages. Case 3 and 4 died accidentally of other than leukemia. Their autopsy did not suggest any findings of leukemia.
The leukemia-like blood picture observed newborn period of Down's syndrome, such as case 3-6 were tentatively nominated as “Transient abnormal myelopoiesis (TAM).”
Our cases categorized as TAM had such charactersics as follows;
1) Onset was at less age than six weeks.
2) High white blood cell count was observed with high percentage of blast cells.
3) The percentage of blast cells was lower in bone marrow than in peripheral blood.
4) Remarkable hepatosplenomegaly.
5) Blast cells resembled morphologically to myeloblasts, but their peroxidase staining was negative in most cells. PAS staining was also negative.
6) No marker chromosome.
7) Extramedullary hematopoiesis.
8) Their clinical conditions were spontaneously improved and cured without special therapies.
9) No autopsy findings suggested leukemia.抄録全体を表示PDF形式でダウンロード (1150K) -
—起炎菌のMICならびに臨床効果を中心として—吉川 治哉, 大野 竜三, 川島 康平, 上田 龍三, 竹山 英夫, 小林 政英, 若山 喜久子, 山田 一正, 植谷 忠昭1977 年 18 巻 2 号 p. 110-117
発行日: 1977年
公開日: 2009/01/19
ジャーナル 認証ありFourteen episodes of sepsis were studied in 12 cases of hematological diseases, which comprised 7 cases of acute leukemia, 3 of acute leukemia-like diseases and 2 of aplastic anemia. The effect of large-dose treatment with antibiotics as well as drug sensitivity of etiological agents to various antibiotics were investigated. Following 15 strains were isolated as the causative organisms, all Gram-negative: 7 strains of Pseudomonas sp. which consisted of 3 Ps. cepacia, 3 Ps. aeruginosa and other one, 2 Klebsiella pneumoniae, 2 Escherichia coli, 2 Serratia marcescens and each one Aeromonas hydrophilia and Acinetobacter anitratus. Attention was called for the fact that 3 strains of Ps. cepacia were found from the cases of sepsis.
Each case was treated with two kinds of antibiotics in a large dosage, one belonged to the β-lactam, such as CET, CEZ, CB-PC and SB-PC, and the other to the aminoglycoside such as GM and DKB. It was experienced that only β-lactam antibiotics were effective in two cases, and only aminoglycosides in other two. The results would be understood as a matter of course according to the drug sensitivity of causative organisms. In this point of view, it is emphasized that a group or sort of antibiotics, particularly in case of large-dose treatment, should be selected on the basis of result of the drug sensitivity.
The results of sensitivity test of isolated organisms showed that resistant strains to various antibiotics as CET, CEZ, CB-PC, SB-PC, GM and DKB, had been increasing in septic patients with severe hematologic disorders.抄録全体を表示PDF形式でダウンロード (584K) -
—Protocol 721, 745による4年間の治療成績—藤本 孟男, 長谷川 恵子, 合屋 長英, 宮崎 澄雄, 武 弘道, 日吉 保彦, 横山 隆, 伊藤 正宣, 楊井 正紀, 辻 芳郎, 古庄 ...1977 年 18 巻 2 号 p. 118-130
発行日: 1977年
公開日: 2009/01/19
ジャーナル 認証ありBetween January 1972 and February 1976, ninety-four children with acute leukemia (peroxidase negative type) were treated with multi-drug protocol 721, to compare the effectiveness of two maintenance regimens, and with protocol 745, to compare the effectiveness of two methods of CNS-prophylaxis.
Of 94 patients, 89 had complete remission with induction of VCR and Pred, and the 3 year continuous complete remission and survival rates, calculated by Life-Table Method, were 34.5% and 65.6%, respectively. 5 patients failed to attain initial remission marrow and all died within 13.8 months after diagnosis.
In protocol 721, 47.5% of patients in Group A continued to remain in complete remission at 3 years, in contrast to 17.6% of those in Group B. Statistically, intermittent high-dose infusion of MTX regimen was significantly superior to sequential-complementary method for remission maintenance (p<0.01).
19 patients developed CNS-leukemia and the overall incidence of this complication was 20.2%. None of 19 patients in 745-X who received 2400 rads of prophylactic cranial irradiation developed CNS-leukemia, in contrast to one of 19 patients in 745-AA, receiving CNS-prophylaxis with cyclic intrathecal MTX and HDC. At the present time, however, there was no statistical difference between these two methods of CNS-prophylaxis.
A longer period of observation is needed to assess the longivity of complete remission and the effectiveness of CNS-prophylaxis.抄録全体を表示PDF形式でダウンロード (945K) -
—病理組織学的にみた発生機序—河村 節子, 吉田 豊, 千葉 陽一, 河津 俊太郎, 石原 弘子, 藤原 史郎1977 年 18 巻 2 号 p. 131-136
発行日: 1977年
公開日: 2009/01/19
ジャーナル 認証ありOne hundred and twenty-five cases of acute leukemia observed at our department between 1953 and 1974 were reviewed as to the presence and nature of the accompanying gastrointestinal hemorrhage.
A severe gastrointestinal hemorrhage requiring blood transfusions occurred in 24 cases (19.2%). The most common lesion in the pathohistologic study was the hemorrhagic necrosis of small intestine. There were three forms of hemorrhage. Type I: Thrombocytopenia, hemorrhagic diathesis, diffuse hemorrhage over mucosa and submucosa. No erosions and ulcerations. Type II: No specific findings in pathology. Diffuse hemorrhage, superficial erosions, bacterial and fungal invasions were observed. Type III: Single and/or multiple ulceration, necrosis and perforation of the small intestine and colon. Thrombocytosis was almost always present at the phase of prebleeding in these cases. Intravascular microthrombi at the basis of ulceration were seen. Usually, more than one process was seen in each case.
An appropriate approach to the severe gastrointestinal hemorrhage with a combination of anti-leukemic chemotherapy, anti-coagulant therapy and platelets transfusion, etc. would further add to the number of long term survivors in acute leukemia.抄録全体を表示PDF形式でダウンロード (759K) -
頭蓋放射線照射とMethotrexate, Hydrocortisoneの髄注による効果藤本 孟男, 新 博行, 岸田 邦雄, 武 弘道, 宮崎 澄雄, 合屋 長英, 神宮 賢一, 大竹 久, 松浦 啓一1977 年 18 巻 2 号 p. 137-144
発行日: 1977年
公開日: 2009/01/19
ジャーナル 認証ありA total of 16 patients with previously untreated acute childhood leukemia (peroxidase negative type), aged 2 to 14 years, were enrolled on a treatment program consisting of 3 phases; induction, “prophylactic” CNS-therapy, and maintenance. All of 16 patients who obtained complete remission by a standard induction chemotherap: with vincristine and predonisolone, including one patient with partial remission, received 2400 rads of cranial irradiation plus intrathecal methotrexate 12 mg/M2 and hydrocortisone 12 mg/M2, two weeks apart, for a total of three courses.
All of patients except for two who died with bone marrow relapses at 6 and 17.3 months continued to remain in initial complete remission with a median of 10.8 months (range of 1.0 to 23.9 months) after completion of CNS-prophylaxis. None of patients developed CNS-leukemia at the present time.
Transient somnolence syndrome occured in 4 patients at 4-5 weeks after completion of cranial irradiation. Chemical meningitis associated with transient headache, nausea and fever, developed in 6.3% of 48 episodes of intrathecal methotrexate and hydrocortisone.
“Prophylactic” CNS-therapy with cranial irradiation plus intrathecal MTX and HDC to date appears promissing. A longer period of follow-up, however, is needed to assess its accurate efficacy.抄録全体を表示PDF形式でダウンロード (557K)
症例
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岡田 弘, 服部 譲, 加納 正, 岡田 隆道, 高橋 隆幸, 古川 裕夫, 大賀 辰次郎1977 年 18 巻 2 号 p. 145-152
発行日: 1977年
公開日: 2009/01/19
ジャーナル 認証ありA 57-year-old housewife was admitted to Ohtsu Red Cross Hospital on May 17, 1972, complaining of palpitation on exertion. Physical examination revealed a pale emaciated appearance with hepatosplenomegaly. Examination of the peripheral blood showed marked anemia and 12% immature plasma cells. The aspirated bone marrow was almost replaced by primitive plasma cells. Roentgenograms of the skeleton failed to reveal any abnormality. Serum analyses demonstrated unusually increased monoclonal IgG-K type globulin. Chromosome analyses of the cultured peripheral blood leukocytes with PHA showed partial deletion of long arms of the chromosome 18 in a few cells and a “MG chromosome”.
The patient was initially treated with cyclophosphamide (CPA) 100 mg daily and prednisolone, and 7 months later, a partial remission was obtained. After enjoying home life for 4 months, the patient's condition relapsed with appearance of 60% immature plasma cells in the peripheral blood. She was given CPA 300 mg intermittently with good response. In March 1974, she was noted jaundice and her condition deteriorated. Despite intermittent therapy with large dose of CPA again, she died on September 9, 1974. Survival was 27 months from time of diagnosis. At autopsy, there were diffuse plasmacytic infiltration and amyloidosis of the various organs. Sporadic giant cells were demonstrated in the lymph nodes.
The aberrant chromosomes, giant cells in the lymph nodes and 27 months survival in relation to intermittent chemotherapy with large dose of CPA, observed in this case, were discussed.抄録全体を表示PDF形式でダウンロード (1063K) -
久藤 文雄, 徳弘 英生, 木川田 隆一, 平沢 康1977 年 18 巻 2 号 p. 153-160
発行日: 1977年
公開日: 2009/01/19
ジャーナル 認証ありThe congenital combined deficiency of factor V and factor VIII seems to be rare. Until now, only 5 cases, occurring in 2 families, have been reported in Japan.
This report was made of a 32-year-old Japanese housewife with bleeding tendency characterized by spontaneous bleeding from the gums, excessive bleeding after tooth extraction and following injury. The family history was negative for bleeding disorders. The coagulation studies showed a prolongation of whole blood clotting time, prothrombin time and partial thromboplastin time, but the Thrombotest was normal. The thromboplastin generation tests showed a marked defect in the adsorbed plasma. Single plasma clotting factor assay showed marked reduction of factor V (5%) and of factor VIII (4.2%) levels. Quantitative estimation of VIII AGN by electrophoresis in agarose gel containing rabbit antibody to highly purified human AHF showed that AHF-like antigen was increased. Platelet aggregation studies induced by ADP and Ristocetin were both in normal range.
The data of this case and of the previously reported ones were reviewed especially as to the mode of inheritance and the pathogenesis.抄録全体を表示PDF形式でダウンロード (599K) -
尾木 幸八, 中嶋 幹治, 金子 周司, 本村 正治, 酒井 好古, 小鶴 三男, 井林 博1977 年 18 巻 2 号 p. 161-168
発行日: 1977年
公開日: 2009/01/19
ジャーナル 認証ありA 52-year-old female was admitted on January, 1971, because of hemorrhagic tendency developed two years before. Physical examinations revealed a pallor woman with purpura on her extremities, there were no significant hepatosplenomegaly and lymphadenopathy. Hematologic examinations showed pancytopenia with occational erythroblasts and dry tap marrow specimens revealed erythropoietic hyperplasia with megaloblastoid and polynucleated erythroblasts with negative PAS reaction. The karyotype analysis of bone marrow cells showed hyperdiploid metaphases with 48, XX, +2G predominant, whereas that of blood lymphocytes was normal. Total serum protein was 9.2 g/dl with 32% of γ-globulin and serological examinations showed biological false positive reaction for syphilis, RA-factor (+), ANF (±) and LE-test (-)-(+). The treatment with corticosteroid and anabolic steroid hormone made some improvement in the patient's blood status, but she developed liver injury and cardiac insufficiency and died of pneumonia 42 months after the first admission.
The postmortem examinations revealed hyperplastic bone marrow with three myeloid cell lines including bizarre nuclear megakaryocytes. The silver stain disclosed increase in reticulum cells and fine reticular fibers, and foci of myeloid metaplasia were seen in the liver, spleen, lungs and kidneys, however, there were no significant findings of osteosclerosis and myelofibrosis. These findings were compatible with ‘Panhyperplasia’ form of agnogenic myeloid metaplasia and serological abnormalities in the present case might be due to autoimmune reaction to aberrant marrow cells.抄録全体を表示PDF形式でダウンロード (966K) -
田村 升, 吉田 憲基, 及川 潤一, 佐藤 昇志, 石谷 邦彦, 新津 洋司郎, 松田 幹人, 北郷 正亘1977 年 18 巻 2 号 p. 169-176
発行日: 1977年
公開日: 2009/01/19
ジャーナル 認証ありDespite extensive investigation and speculation, the pathophysiology of the eosinophilia associated with orgonic involvements remains largely unknown.
This case report was concerned with a 27-year-old male who showed initially the edema in the lower extremities, hypertension, and proteinuria, following by a leukocytosis due primarily to increased numbers of mature eosinophils, cardiac insufficiency, renal insufficiency, and hepatosplenomegaly during a course. A sternal aspiration revealed normal in cellularlity with slight increase of eosinophilic elements. The cytogenetic abnormality in bone marrow cells was not demonstrated and neutrophil alkaline phosphatase showed normal range in the activity. Consequently it was difficult to diagnose as eosinophilic leukemia. On the other hand, there was a decrease of serum protein, no significant results in various immuno-serological studies. The biopsy specimen from the skin and muscle also disclosed no fibrinoid degeneration of collagen fibers.
In 1968 Hardy proposed the term “Hypereosinophilic syndrome” to encompas the entire group, Loeffler's syndrome, Loeffler's endocarditis, disseminated eosinophilic collagen disease, eosinophilic leukemia and so on.
From the available evidence this case has closer relationship to the concept of hypereosinophilic syndrome.抄録全体を表示PDF形式でダウンロード (919K)
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