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Volume 19, Issue 11
Displaying 1-13 of 13 articles from this issue
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[in Japanese], [in Japanese], [in Japanese]1978 Volume 19 Issue 11 Pages 1483-1499
Published: 1978
Released on J-STAGE: January 19, 2009
JOURNAL RESTRICTED ACCESSDownload PDF (1434K)
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Ryo KOIDE, Yukiko TSUNEMATSU, Michiko SASAKI, Chiaki OBARA1978 Volume 19 Issue 11 Pages 1500-1508
Published: 1978
Released on J-STAGE: January 19, 2009
JOURNAL RESTRICTED ACCESSWe studied the quantitative relationship between HbF production and red cell carbonic anhydrase (CA) in patients with various hematologic diseases associated with the reappearance of HbF.
HbF and CA were simultaneously analyzed by cellogel electrophoresis. The distribution of the concentration of HbF within red cell (F-cell) was examined by slide elution method.
The electrophoresis results revealed the following two patterns:
(1) elevated level of HbF, associated with normal level of CA.
(2) elevated level of HbF associated with significantly or slightly depressed level of CA. (The physiological fetal red cells have low CA and high HbF values.)
Group (1) contained almost all the cases of aplastic anemia, iron deficiency anemia and half the cases of hemolytic anemia.
Group (2) contained J-CML and the remaining cases of hemolytic anemia. In all cases involving infectious diseases, the tendency of depressing CA level was noted.
We concluded that there were two populations of so-called F-cells with HbF; The one with CA, a non-hemoglobin protein, and the other with depressed level of CA (similar to fetal red cells).View full abstractDownload PDF (957K) -
Mine HARADA, Takeshi KITAO, Tatsuro SUGIYAMA, Hideki KODO, Shigeki OTA ...1978 Volume 19 Issue 11 Pages 1509-1518
Published: 1978
Released on J-STAGE: January 19, 2009
JOURNAL RESTRICTED ACCESSIsogeneic or allogeneic bone marrow transplantation was tried for the treatment of three cases with aplastic anemia. Case 1, a 19-year-old woman, was infused twice with 2.8×109 and 4.25×109 bone marrow cells respectively from her healthy identical twin. However, post-transplantation recovery in hematologic values was not observed. Case 2, a 10-year-old boy, also received an isogeneic graft twice from his identical twin. In spite of grafting an adequate dose of marrow cells (3.5×108/kg) and a transient increase in reticulocyte count, a complete hemopoietic recovery was not obtained. Therefore, there is a possibility that stem cell replacement might be ineffective in these cases. Case 3, a 28-year-old woman, was found to be compatible in ABO and HLA-A, B, D. Then, allogeneic marrow grafting was carried out by infusing 13.6×109 cells from one of these HLA-identical and MLC-nonreactive siblings with the use of an isolation room and the sterilizing regimen (“GVN”). Although both engraftment and GVHD were not observed, a febrile episode was treated by antibiotics and granulocyte transfusions, and hemopoiesis recovered to the pretransplantation level after three months. This case suggests that sterilization and intensive supportive therapy may be of primary importance for lifethreatening myelosuppression by high-dose chemotherapy. In addition, major histocompatibility complex and immune mechanism in aplastic anemia were discussed in association with bone marrow transplantation.View full abstractDownload PDF (777K) -
Shunkichi HIRAKI, Isao MIYOSHI, Kazuo NAKAMURA, Takamasa OHTA, Hiromas ...1978 Volume 19 Issue 11 Pages 1519-1522
Published: 1978
Released on J-STAGE: January 19, 2009
JOURNAL RESTRICTED ACCESSWe have recently established a leukemic T-cell line (TALL-1) in permanent culture from the bone marrow of a patient in terminal leukemic stage of T-cell lymphosarcoma. Intraperitoneal implantation of 1.8∼2.9×107 TALL-1 cells gave rise to invasivetumors in all newborn Syrian hamsters treated with rabbit anti-hamster thymocyte serum after 26∼41 days. TALL-1 cells infiltrated various organs; involvement of the parathymic lymph nodes, liver, gallbladder, brain, meninges and uvea was the characteristic feature. Thus, this in vivo system would be useful for investigators concerned with studies on the characteristics and chemosensitivity of human T-cell leukemia-lymphoma. It is of interest to note that the donor had widespread leukemic involvement including the meninges and eyes during his clinical course.View full abstractDownload PDF (514K)
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Norihiko HINO, Yuichi FUKUIYA, Masafumi KAWATO, Yoshio YONAHARA, Munem ...1978 Volume 19 Issue 11 Pages 1523-1530
Published: 1978
Released on J-STAGE: January 19, 2009
JOURNAL RESTRICTED ACCESSA case of hyperthyroidism with pancytopenia has been experienced in our clinic.
A 47-year-old female was noticed icterus and splenomegaly. Haematologic examina tions revealed hyperchromic anemia and remarkable increasing of polychromatophilic normoerythroblasts in the bone marrow. Erythrocyte survival was markedly shortened and the uptake of iron into erythrocytes was reduced. The uptake of radioactive iron into the bone marrow was also reduced. Osmotic fragility of erythrocytes was within normal limit and Coombs' test, antileucocytic antibody and antithrombocytic antibody were negative respectively.
This case showed no sign of hyperthyroidism, however no abnormality was found except hyperthyroidism in laboratory findings, so that etiology of anemia was thought to be due to hyperthyroidism. Then, methimazole was given. Two months after the administration, whole blood cell components became gradually increased and these values showed to be normal limit 6 months after the administration of methimazole. In this period, no other drug was given.
As to the etiology of anemia, the combination of hemolysis and ineffective erythropoiesis could be thought and splenomegaly might be related to the reduction of leucocytes and thrombocytes.View full abstractDownload PDF (539K) -
Hideo TAKEYAMA, Kohei KAWASHIMA, Eiji WATANABE, Tomomitsu HOTTA, Kazum ...1978 Volume 19 Issue 11 Pages 1531-1537
Published: 1978
Released on J-STAGE: January 19, 2009
JOURNAL RESTRICTED ACCESSA 26 year-old male was admitted to the Nagoya Ekisaikai Hospital with complaints of anemia and fever in April 1977. Prior to admission, the patient had been noted to have 3-year history of schizophrenia and refractory anemia associated with leukopenia.
Hematological findings on admission disclosed mild anemia with dimorphism and leukocytosis with 66% of abnormal cells. These abnormal cells, which were identified as myeloblasts, predominantly occupied bone marrow in cosistent with the diagnosis of acute myeloblastic leukemia. He was treated with multicombination chemotherapy including vincristine, Endoxan, 6 MP and prednisolone. Though he responded well to the chemotherapy with disappearance of leukemic cells from the peripheral blood and bone marrow, thrombocytopenia and hypochromic anemia persisted. Then, he was put on the intensive hematological study which showed elevated serum iron and ineffective erythropoiesis, demonstrating numerous ringed sideroblasts in the bone marrow. In the studies on heme synthesis, his erythroblasts showed markedly reduced δ-aminolevulinic acid synthetase activity. From these data, he was diagnosed sideroblastic anemia complicated by acute myeloblastic leukemia. Thereafter, he was treated with pyridoxine (50 mg daily) for one month without response. In Nov. 1977, he was transfered to the lunatic asylum because of aggravating schizophrenia, and died of recurrence of acute leukemia in Jan. 1978.
The findings of this case suggest that sideroblastic anemia can develop as the consequence of bone marrow stem cell disorder which leads to several types of cellular abnormalities.View full abstractDownload PDF (927K) -
Koji TAKAI, Hideki MIZOGUCHI, Shinobu SAKAMOTO, Yasusada MIURA, Fumima ...1978 Volume 19 Issue 11 Pages 1538-1544
Published: 1978
Released on J-STAGE: January 19, 2009
JOURNAL RESTRICTED ACCESSA 61-year-old man was admitted to our department complaining a general malaise and visual disturbance of 7 months duration.
On physical examination, retinal bleeding and marked hepatosplenomegaly were noticed. No lymphadenopathy was noted.
Laboratory studies revealed white blood cell counts 12×104/cmm with 88% of abnormal lymphocytes.
These abnormal cells were about 15μ in diameter and had a pale blue gray cytoplasm with no projections on Wright-Giemsa stained films. The nucleus was large and oval with fine chromatin structure and one large prominent nucleolus.
Under electronmicroscopy, cytoplasm of the abnormal cell contained a few mitochondria which accumulated to one side of the cells and a few microvilli. Ribosomes were dispersed.
These leukemic cells were not stained by peroxidase, naphthol AS-D chloroacetate esterase, α-naphythyl acetate esterase, nor by PAS staining. Moreover, they were almost negative for acid phosphatase and had no resistance to L (+) tartaric acid. Murmidase activities in the serum and urine were within normal limits. No terminal deoxynucleotidyl transferase activity was detected in these leukemic cells.
Eighty seven per cent of the leukemic cells had monoclonal IgM-K type surface immunoglobulin which was demonstrated by the indirect immunofluorescence method, and forty per cent of the leukemic cells formed the EAC rosette.View full abstractDownload PDF (947K) -
Hiroshi YAMAGUCHI, Eiji UCHIYAMA, Shigeki TOYOTA, Hajime SUGIHARA, Osa ...1978 Volume 19 Issue 11 Pages 1545-1550
Published: 1978
Released on J-STAGE: January 19, 2009
JOURNAL RESTRICTED ACCESSA 46-year-old woman was referred to our hospital for evaluation of a recent history of progressively severe nausea and easy fatigability on walking. She was noted to have had an atomic bomb exposure at a distance of 2km from the hypocenter. A diagnosis of multiple myeloma (IgG, L-type) was established. However, the radiation dose affected to her was estimated too much low level to conclude its direct effect to cause such an impairment. Twenty six days after admission to the hospital, a corticosteroid and melphalan therapy was started on a daily schedule for seventy seven weeks. Immunological findings obtained on admission were revealed lowered cell-mediated immunity, such as negative tuberculin reaction, 37.5% T cell in sub population of lymphocytes and 45% lymphocytes transformation with PHA. After 9 months of treatment she was found to have basal cell carcinoma of skin and rectal adenocarcinoma further 10 months later, of which she died during the remission of the primary disease. It may be assumed that antecedent abberances of the immunological surveillance mechanism associated with preceding myeloma might be causally involved in the successive production of three kinds of neoplasm. Such an immunoregulatory suppression strikingly concerned to the antineoplastic agents against myeloma was thought to be possibly responsible for the development of the ensued neoplasms. For improving prognosis of this disease it may depend not only on early detection, but also appropriate treatment of ensued malignant neoplasm.View full abstractDownload PDF (696K) -
Toshio SUDA, Kenji NIHEI, Masayoshi YANAGISAWA, Shigehiko KAMOSHITA, S ...1978 Volume 19 Issue 11 Pages 1551-1559
Published: 1978
Released on J-STAGE: January 19, 2009
JOURNAL RESTRICTED ACCESSA case of subacute leukoencephalopathy in a 2 year-old boy with acute lymphoblastic leukemia was reported. Because of CNS leukemia, he received a course of intrathecal methotrexate, cytosine arabinoside, and hydrocortisone in addition to 2,650 rads of whole skull radiation. Three months after the onset of CNS leukemia, he developed slurred speech and staggering gait, and his condition was slowly deteriorated. He showed drowsiness, irritability, neck stiffness, involuntary movement of neck, opsoclonus, nystagmus, and left facial palsy. The blast cells were cleared from CSF, but the protein concentration was persistently elevated. EEG showed diffuse slowing of background activity. With the development of spasticity and decerebrated rigidity, he died 3 months later.
The neuropathological examination revealed multifocal necrosis in the cerebral white matter, demyelination, striking axonal damage with swelling and calcification, and thrombosis and fibrinoid necrosis of the blood vessel walls. Intrathecal methotrexate, whole skull radiation, and CNS leukemia may be causally related to the development of this disease. We reviewed in the literatures 26 cases of subacute leukoencephalopathy.View full abstractDownload PDF (928K) -
—Statistical Analysis of Skin Involvement of Autopsied Leukemia in Japan—Kuniaki ITOH, Takayoshi ASAI, Yuri SUGIURA, Kenji ISHIGE, Seitoku FUJI ...1978 Volume 19 Issue 11 Pages 1560-1568
Published: 1978
Released on J-STAGE: January 19, 2009
JOURNAL RESTRICTED ACCESSA 55-year-old man was admitted to the hospital because of generalized skin lesions & leucocytosis. Diagnosis of acute myeloid leukemia was made on the hematological examinations and the biopsy of the leukemic skin lesions.
He was treated with multiple combination chemotherapy and leukemic skin lesions disappeared after changing into erythema, papule, nodule, ulcer and so on.
He remained reasonably well on daily maintenance dose of 6-MP, in spite of failure to induce a complete remission. He died from cerebral hemorrhage 13 months after the initial diagnosis.
Specific skin lesions of autopsied leukemia recorded in the “Annual of the Pathological Autopsy Cases in Japan” during the years 1968 through 1975 were analyzed statistically and the following results were obtained.
1) Total number of autopsied cases of leukemia was 7182 and specific skin involvements were showed in 304 cases (4.2% of total autopsied leukemias) including AML 130 (42.8%) MoL 49 (16.2%) CML 48 (15.9%) and so on.
2) Incidence of specific skin involvement in each type of leukemia was as follows: MoL 12.0%, CLL 9.0%, CML 4.8%, ALL 3.9% and AML 3.3%.View full abstractDownload PDF (1807K) -
Noriaki SHINOMIYA, Humihiro SAWA, Toshio NAKAGAWA, Ichiro TUKIMOTO, Ke ...1978 Volume 19 Issue 11 Pages 1569-1574
Published: 1978
Released on J-STAGE: January 19, 2009
JOURNAL RESTRICTED ACCESSA case of acute lymphoblastic leukemia preceded by neutropenia was reported.
Two years four months old girl was admitted to our hospital for further evaluation of neutropenia. She visited to our clinic because of recurrent infections since her birth and was pointed neutropenia 6 months prior to this admission. Her physical and mental development was normal and had no abnormal physical finding.
Complete blood counts showed hemoglobin 11.6g/dl, WBC 6,800/cmm with 12% of neutrophils and normal platelets count. Bone marrow smear showed normocellularity with 24% of erythroid series, 38% of granuloid series and 12% of lymphoblastoid cells. Myeloid series showed maturation arrest, but no morphorogical abnormalities.
Two months after admission anemia developed gradually. Bone marrow examination showed 90% of lymphoblasts. Patient was treated with vincristine and prednisone and complete remission was induced.
Patient was maintained with 6-MP and VAMP therapy, but expired 3 years after treatment.View full abstractDownload PDF (528K) -
Chikara SAKAI, Tetuo AKIHAMA, Akira B. MIURA, Kanji KOMATSU, Akira SHI ...1978 Volume 19 Issue 11 Pages 1575-1580
Published: 1978
Released on J-STAGE: January 19, 2009
JOURNAL RESTRICTED ACCESSA Case of Mefenamic Acid-Induced Autoimmune Hemolytic Anemia
A 64-year-old woman who had been treated with mefenamic acid 1.5g daily continuously for seven months for arthralgia of left hip-joint was admitted to hospital because of anemia.
On admission she had no jaundice or splenomegaly. Hematological investigations: hemoglobin 7.3g/dl, reticulocytes 88‰, white cell count 6,400/cu.mm., platelet count 255,200/cu.mm. Bone marrow revealed erythroid hyperplasia without megaloblasts. Red cell life-span measured with 51Cr was 12 days. Serological investigations: the direct Coombs test was strongly positive using a specific anti-IgG but negative using anantinon-IgG serum. Antinuclear factor or the Donath-Landsteiner antibody was negative.
After withdrawal of mefenamic acid on admission, anemia improved rapidly without any therapy. We attempted to perform the provocation test in order to prove that this autoimmune hemolytic anemia was induced by mefenamic acid. Readministration of mefenamic acid 1.5g daily started and six weeks later rapid development of anemia with reticulocytosis occurred. As soon as mefenamic acid was stopped, recovery of anemia began and hemoglobin level reached 12g/dl within a month. The direct Coombs test remained positive for seven months and then became negative. She has remained well for nine months without any recurrence of anemia.
She is the third case of mefenamic acid-induced autoimmune hemolytic anemia in Japan.View full abstractDownload PDF (404K) -
Motoharu KONDO, Nobuyoshi YOKOE, Hidetsugu NISHIBORI, Shuhei TAKEMURA, ...1978 Volume 19 Issue 11 Pages 1581-1587
Published: 1978
Released on J-STAGE: January 19, 2009
JOURNAL RESTRICTED ACCESSA 68 year-old female was admitted to our hospital on September, 1976, with a history of recurrent episodes of abdominal pain and angioneurotic edema of the skin, pharynx and larynx since the age of 62. She had no family history of the same symptoms. Both hematological and immunological studies revealed the presence of benign monoclonal gammopathy. Serum complement level CH 50 and complement components C1, C4, C2 and C ?? INH in the patient's serum were found to decrease, but the sera of her son and grandson had normal complement.
After admission she had suffered from episodes of typical angioneurotic edema 2 or 3 times a month. By the administration of t-AMCHA (Transamin), these symptoms disappeared for 50 days. Since the episodes of angioneurotic edema recurred, she was treated with an anabolic steroid (Anadrol). No episode of angioneurotic edema or abdominal pain reappeared as C ?? INH level increased.View full abstractDownload PDF (568K)
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