巻号一覧
19 巻, 3 号
選択された号の論文の16件中1～16を表示しています
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臨床研究
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山内 勝世, 篠原 建次, 松本 昇, 三輪 史朗1978 年 19 巻 3 号 p. 199-206
発行日: 1978年
公開日: 2009/01/19
ジャーナル 認証ありRefractory idiopathic thrombocytopenic purpura (refractory ITP) is defined as ITP of greater than 7 months' duration and which failed to respond to both corticosteroids and splenectomy. Among 19 cases, 2 were refractory ITP. One case was 32-year-old male with ecchymoses and gum bleeding. Platelet count was 8,000/mm3. He had been treated with prednisolone and azathioprine, then splenectomized. These treatments revealed no effect and now he is followed in our out-patient clinic. Another case was 63-year-old male with tarry stool, ecchymoses, petechiae and anemia. Prednisolone was administered and splenectomy was performed. After that, azathioprine, then vincristine was administered. Although tarry stool stopped, the effect was not satisfactory.
In refractory ITP, it can be suggested that liver as well as spleen contributes significantly as a site of production of anti-platelet antibody and the sequestration of affected platelets. We discussed the immunosuppressants for the treatment of refractory ITP, reviewing previously reported cases.抄録全体を表示PDF形式でダウンロード (532K) -
吉川 治哉, 植谷 忠昭, 佐光 富士男, 山口 博, 吉川 敏, 西脇 洋, 村上 栄, 一宮 恵, 竹山 英夫, 緒方 完治, 小林 政 ...1978 年 19 巻 3 号 p. 207-213
発行日: 1978年
公開日: 2009/01/19
ジャーナル 認証ありIn a case of acute myeloblastic leukemia (AML) resistant to quadruple combination chemotherapy (Neo-DCMP), sequential 5-drug regimen including daunomycin (DM), cytosine arabinoside (CA), cytoxan (EX), vincristine sulfate (VCR) and prednisolone (Pred.) was tried. Soon after this therapy, complete remission was achieved, which would be understood by the study of cell cycle effect of leukemic cells by chemotherapies. According to this experience, combination chemotherapy with CA 80mg/m2/day×4, DM 25mg/m2/day×4, EX 120mg/m2/day×4, Pred. 60mg/m2/day×4 and VCR 1.2mg/m2/week×1 or×2 was established and codenamed PADOC.
Thirty courses of PADOC were administered in 20 therapy-resistant cases of acute non-lymphocytic leukemia: all adult patients from 19 to 74 (median 40) year-old; AML, 11 cases, acute monocytic leukemia (AMoL), 8 cases and paramyeloblastic (AMpL), 1 case.
Of 20 patients 12 (60.0%) obtained complete remission (CR) and 8 (40.0%) failure. There was not so much difference in chemotherapy effect between patients older than 40 years and younger than that; the CR rate being 5/10 (50.0%) and 7/10 (70.0%), the median survival 8 months and 10 months respectively. The CR rate in each type of acute leukemia was 6/11 (54.5%) in AML, 6/8 (75.0%) in AMoL and 0/1 in AMpL. CR was obtained after 1 or 2 courses of PADOC. The median duration to reach CR was 36 days from the beginning of the treatment (19∼68 days). The median survival of 20 patients was 10 (2∼42. 1/3+) months.
The prolongation of survival was obtained by PADOC in therapy-resistant cases with acute non-lymphocytic leukemia.抄録全体を表示PDF形式でダウンロード (492K) -
千葉 陽一, 羽根田 やえ子, 瀬川 政治, 清野 義郎, 岡本 勝博, 吉田 豊1978 年 19 巻 3 号 p. 214-220
発行日: 1978年
公開日: 2009/01/19
ジャーナル 認証ありThe authors measured the human plasma kallikrein (S) kallikreinogen (K) and inhibitor (I) by R. W. Colman's method, and further evaluated the results to compare with that of the method using chromogenic synthetic substrate S 2302 by AB KABI.
Normal range by Colman's method was 11.4±3.0 μM/ml. h for S, 112.0±20.0 μM/ml. h for K and 1.11±0.14U for I. The relation of TAME hydrolysis μM/ml.h equals 4/3·103. OD/min. at 405 nm by S2302 method was obtained. S 2302 was thought to be accurate to measure the plasma kallikrein but not to be sensitive to inhibitor.
The results on plasma samples from 79 cases with various disorder were discussed. They revealed quite interesting and rewarding data for evaluation of pathophysiological role of kallikrein system in various disorders, especially in the intravascular coagulation and fibrinolysis syndrome.抄録全体を表示PDF形式でダウンロード (541K) -
—末梢血，脾および脾動，静脈血のIn vitro colony形成能—山口 昭彦, 吉田 廣作, 福田 光之, 福島 幸隆, 佐野 まり子, 柴田 昭1978 年 19 巻 3 号 p. 221-225
発行日: 1978年
公開日: 2009/01/19
ジャーナル 認証ありIn vitro colony forming capacity of the peripheral blood, spleens, splenic arterial and venous blood in three patients with primary myelofibrosis (PM) was studied. The culture was carried out according to the method of Robinson and Pike.
Considerable increase of CFU-c was observed in the peripheral blood of all three patients.
Extramedullary haematopoiesis was histologically detectable in the spleens of two splenectomized patients, and numbers of CFU-c were more elevated in the spleens of patients with PM than two patients with stomach cancer.
White blood cells and CFU-c in the splenic venous blood increased more than splenic arterial blood in one patient with PM.
These results suggest that a part of granulocytic stem cells probably proliferates in the spleen and goes out into the circulation.抄録全体を表示PDF形式でダウンロード (410K)
症例
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永井 良樹, 池辺 健二, 伊藤 幸治, 西沢 常男, 赤岡 家雄, 村中 正治, 堀内 淑彦1978 年 19 巻 3 号 p. 226-233
発行日: 1978年
公開日: 2009/01/19
ジャーナル 認証ありA case of secondary gout associated with myelofibrosis in a 70-year-old male was reported.
At the age of 50 he was noted to be plethoric; at age 54 he was afflicted with gouty arthritis and came to our clinic where he was treated with colchicine with a good response. During his first admission at the age of 56, laboratory studies revealed RBC 980×104, WBC 16,200, Plt 63.8×104, serum uric acid 10.8mg/dl and he had no other disease which would lead to secondary polycythemia. Then he was diagnosed as having secondary gout associated with polycythemia vera. After discharge he was treated with 32P and venesection; however his blood count showed no improvement, and he suffered from gouty attacks from one to five times a year.
At 68 of his age his blood pictures changed to those of anemia.
During his second admission at age 70, he was diagnosed as having myelofibrosis, on the bases of splenomegaly, leukoerythroblastic anemia, ineffective and extramedullary erythropoiesis by ferrokinetic study, no aspirate on bone marrow puncture, and myelofibrosis by bone marrow biopsy. His blood uric acid level was 9.6mg/dl.
During the entire period, even after he became anemic, his blood uric acid levels had been constantly high, associated with gouty arthritis.
This is the 4th case of myelofibrosis with anemia following polycythemia vera in Japan and the first case of secondary gout associated with myelofibrosis there.抄録全体を表示PDF形式でダウンロード (677K) -
平井 博, 志田 光正, 伊芸 巌, 西成田 進, 高橋 好一, 竹内 仁, 馬場 真澄, 菊岡 正和, 武尾 宏, 東野 広也, 竹下 得 ...1978 年 19 巻 3 号 p. 234-239
発行日: 1978年
公開日: 2009/01/19
ジャーナル 認証ありRecently we experienced adult Fanconi syndrome seemed as being secondary to Bence Jones protein kappa type myeloma.
The patient was a thirty-one year old man who had had glycosuria and proteinuria since about seven years. In the bone marrow were observed myeloma cells containing needle-shaped cytoplasmic inclusion bodies. Bence Jones protein kappa type was detected by urine protein immunoelectrophoresis. Kidney biopsy specimen showed remarkable deposition of protein-like bodies in proximal tubules.
In the future, the presence of plasma cell dyscrasia should be taken into consideration in patients with adult Fanconi syndrome.
However, monoclonal increase of immunoglobulin is rare in this type of myeloma, therefore, it appears necessary to detect Bence Jones protein thoroughly by such means as urine protein immunoelectrophoresis.抄録全体を表示PDF形式でダウンロード (692K) -
鹿志村 紀美枝, 広津 卓夫, 赤塚 順一1978 年 19 巻 3 号 p. 240-245
発行日: 1978年
公開日: 2009/01/19
ジャーナル 認証ありA 5 year-old boy with hypochromic anemia and deafness was diagnosed as having hereditary sideroblastic anemia, because hematologic studies revealed hyperferremia and numerous ringed sideroblasts in his bone marrow smears. A similar type of anemia was also found in his uncle who had been diagnosed as a case of primary sideroblastic anemia at another hospital. He did not respond to a large dose of pyridoxal phosphate (200mg/day) administered over several months. Our patient is the youngest case of hereditary sideroblastic anemia ever documented in Japan.抄録全体を表示PDF形式でダウンロード (595K) -
中尾 功, 原島 三郎, 成井 貴, 中川 健1978 年 19 巻 3 号 p. 246-251
発行日: 1978年
公開日: 2009/01/19
ジャーナル 認証ありTwo cases of methemoglobinemia and hemolytic anemia caused by Z 4,828 (trophosphamide) are reported.
Case 1 was a 48-year-old woman. After surgical operation on cancer of the left breast, there appeared metastasis to the lung and after exstirpation of the ovaries and suprarenal gland, she was administered 150mg of Z 4828. She suddenly developed cyanosis and anemia on an occasion. There appeared erythroblasts in the peripheral blood. Coombs test was negative and the spectrometric examination showed a rise in methemoglobin. The symptoms were improved by discontinuation of all drugs.
Case 2 was 39-year-old woman who showed metastasis to the lung after operation on cancer of the lung. 200mg of Z 4828 was administered orally, when jaundice and anemia appeared one week later and there were observed increase of indirect bilirubin and swelling of the liver.
With discontinuation of administration of this drug, the symptoms were improved, but as administration was resumed, they were aggravated again to show 14% methemoglobin.
The glycolytic enzyme of erythrocytes and intermediate metabolistes were investigated in this case, but no abnormality was found.
These two cases were considered to be methemoglobinemia and hemolytic anemia, caused by Z 4828, and as to the hemolytic mechanism, it was concluded that metabolites of this preparation caused disturbance of erythrocyte metabolism.抄録全体を表示PDF形式でダウンロード (413K) -
森川 景子, 仁木 洋子, 星崎 東明, 馬場 百合1978 年 19 巻 3 号 p. 252-257
発行日: 1978年
公開日: 2009/01/19
ジャーナル 認証ありA 27-year-old woman delivered of a boy on June, 1974. She noticed purpura over the extremities and a genital bleeding after one month. She was admitted to our hospital on Aug. 30, because of thrombocytopenia. Blood examination disclosed 4,500,000/mm3 RBC, 12.5g/dl Hb, 4,100/mm3 WBC, 27,000/mm3 platelet. Bone marrow was normoplastic and megakaryocytes were slightly increased. Neither hepatosplenomegaly nor lymph node swelling was observed. No antibody was detected in the patient's serum. A diagnosis of ITP was made. The platelet count increased to 100,000/mm3 with administration of high doses of steroid (SH). However, the patient relapsed without SH. The use of azathiopurin was non-effective. The leucocyte count decreased gradually and hemorrhagic tendency has reappeared since Jan., 1975. Splenomegaly was palpable by one fingerbreath at that time. Blood findingsshowed 4,000,000/mm3 RBC, 10.6g/dl Hb, 2,800/mm3 WBC and 20,000/mm3 platelet. The progressive splenic enlargement was observed with leuco-thrombocytopenia. On April 7, 1976, she was operated and massive hematoma was discovered in the spleen. The pathological diagnosis was splenic pseudo-cyst. All of the blood cells normalized after splenoctomy and she has been in good health. As for the splenic cyst complicated with thrombocytopenia, only four cases have been cited in the literature up until 1975. None of them were followed up hematologically. The patient was submitted to a follow-up study for two years from the onset of the illness. The possible relationship between splenic cyst and thrombocytopenia was briefly discussed.抄録全体を表示PDF形式でダウンロード (572K) -
神田 誠, 星加 明徳, 前川 悟志, 牛山 允, 堀田 〓, 西村 昂三1978 年 19 巻 3 号 p. 258-263
発行日: 1978年
公開日: 2009/01/19
ジャーナル 認証ありAn autopsy case of 4-year-old boy with acute lymphocytic leukemia is reported.
His initial symptom was an enlargement of cervical lymph nodes.
Remission was induced by the combination of vincristine and prednisolone, and maintained by 6-mercaptopurine, but he relapsed 9 months later and died 19 months following the diagnosis.
An interesting feature of this case was that he had multiple complications such as anxiety attack, testicular involvement, headache, facial palsy, glaucoma, urinary retention in his clinical course.
An autopsy specimen of the iris showed perivascular infiltration of leukemic cells, and the filtration angle was involved.抄録全体を表示PDF形式でダウンロード (785K) -
II. 全身照射後双生児より骨髄移植した白血性リンパ肉腫症の1例佐藤 允副, 森山 美昭, 大野 康彦, 黒川 和泉, 斉藤 秀晁, 小島 健一1978 年 19 巻 3 号 p. 264-271
発行日: 1978年
公開日: 2009/01/19
ジャーナル 認証ありA 15-year-old man with leukemic lymphosarkomatosis unresponsive to conventional chemotherapy who received a marrow infusion from a normal identical twin brother after 1,000 rad whole body irradiation was reported.
The recipient received chemotherapy (cyclophosphamide) and whole body irradiation, and then an intravenous infusion of the marrow (1.2×1010 nucleated cells) obtained from the donor brother under anesthesia. Granulocyte transfusion from the same donor were done because of severe lukopenia after the irradiation. Eighteen days after a marrow transplant, WBC rapidly increased in number with an increase of platelet and reticulocyte counts, and his marrow was restored to normal.
The patient reported here, however, developed leukemic transformation 45 days after a marrow infusion and died of sepsis by Clostridium perfringens, type A without any response to chemotherapy.
The origin of pathologic cells in the development of leukemic transformation remained unknown between twins. From this experience, it would be suggested that bone marrow transplantation should be considered as a clinically useful technique for the treatment of hematological malignancies.抄録全体を表示PDF形式でダウンロード (1003K) -
石毛 憲治, 高木 敏之, 小黒 昌夫, 馬島 尚1978 年 19 巻 3 号 p. 272-279
発行日: 1978年
公開日: 2009/01/19
ジャーナル 認証ありA 43 years old man was admitted to Chiba Cancer Center Hospital, because of anemia and bleeding tendency on October 10, 1975. Hematological examination revealed moderate anemia, severe thrombocytopenia and marked leukocytosis with 80% plasma cells. Further work up confirmed plasma cell leukemia (IgD λ type). The patient was treated with daily prednisolone 50mg without response. On October 24, 2mg vincristine was administered intravenously. Ten days after medication, the patient had complete remission and was followed without maintenance. In September, after one month of complete remission, hematological relapse was observed. This time vincristine administration did not revealed complete response. In March 1976, the patient was re-admitted accompanied with serum hepatitis. Jaundice subsided by prednisolone administration, but plasma cell leukemia gradually progressed.
Despite intensive chemotherapy with adriamycin, cyclophosphamide, prednisolone and vincristine, he developed meningeal involvement and died on May 18, 1976 with 11 month of duration. In the literature, 40 cases of plasma cell leukemia were reported in Japan in the period from 1950∼1972. Clinical findings, treatment and prognosis of plasma cell leukemia were discussed.抄録全体を表示PDF形式でダウンロード (734K) -
平沢 康, 久藤 文雄, 徳弘 英生, 木川田 隆一1978 年 19 巻 3 号 p. 280-287
発行日: 1978年
公開日: 2009/01/19
ジャーナル 認証ありA 51-year-old female, who had been suffered from heart failure for twenty years with no special treatment, was admitted on September 24, 1976, complaining of fever and cough of one week's duration.
On admission, there were clinical and radiological signs of pneumonia in both lung bases and mitral stenosis.
On the 8th hospital day, there occured a severe hemolytic attack with marked reticulocytosis and leuco-erythroblastosis. Examination of the sternal marrow showed a decided erythroid hyperplasia.
Cold agglutinin was present in a titer of 1 to 2,048, CF titer for Mycoplasma pneumoniae was 1 to 64, and IHA titer was 1 to 80. Cold agglutinin appeared to have specificity within the Pr-complex, which reacted with adult I and cord i cells strongly and equally.
There was no improvement in her condition by prednisolone and antibiotics.
Two weeks after admission, anemia rather aggravated with the findings of pancytopenia including reticulocytopenia, and hemorrhagic tendency developed.
On the 35th days, sudden death was caused by ventricular fibrillation.
Autopsy findings showed marked hypoplasia in the bone marrow, hemorrhage in all visceral organs and mitral stenosis of unknown origin.
The possible relationship between immune hemolytic anemia and bone marrow aplasia was discussed.抄録全体を表示PDF形式でダウンロード (868K) -
山口 潜, 浅井 一太郎, 塚田 理康, 態田 博光1978 年 19 巻 3 号 p. 288-294
発行日: 1978年
公開日: 2009/01/19
ジャーナル 認証ありA 36-year-old atomic bomb survivor was admitted to the Toranomon Hospital on January 21, 1975 because of cough and bloody sputum of a half year's duration. White cells were 150,000 per μl with 95 per cent Auer body positive myeloblasts. He had been diagnosed as acute myeloblastic leukemia. A complete remission was achieved by combination chemotherapy with prednisolone, cytosine arabinoside, vincristine and cyclophosphamide.
Since June 1975 cough, bloody sputum and fever reappeared and he was re-admitted on August 26, 1975. Cytology of the sputum was diagnosed to be of Class 5. Chest roentgenogram revealed again irregular reticular shadows. He succumbed to Pseudomonas septicemia on September 1975.
An autopsy revealed acute myeloblastic leukemia with a remarkable myeloblastic infiltration in the mediastinum and around the proximal bronchus. Hemorrhagic pneumonia was noted in both lungs.抄録全体を表示PDF形式でダウンロード (993K) -
井原 章裕, 清水 裕弘, 岡田 浩佑, 鎌田 七男, 蔵本 淳, 内野 治人1978 年 19 巻 3 号 p. 295-303
発行日: 1978年
公開日: 2009/01/19
ジャーナル 認証ありA 29 years old female, who complained of subcutaneous bleeding for three years, visited to our hospital in August 1964 and was diagnosed as idiopathic thrombocytopenic purpura (ITP). She was treated with predonisolone and 6MP, but her platelet count did not increase. Four years later, she was splenectomized in March 1966 but her platelet count remained still 4-5×104/mm3.
Low neutrophil alkaline phosphatase, positive platelet antibody and atypical megakaryocyte were outstanding features when she had been treated as ITP.
Ten years later, she was pregnant and delivered of a girl in March 1972 in full term without life-threatening hemorrhage. Six months from the delivery, in August 1972, she was diagnosed as acute myelogenous leukemia with increased myeloblast (21%) of bone marrow aspirates and was treated with DCMP. Being not put in complete remission, she died of pneumonia 6 months later in January 1973. The cause of thrombocytopenia whether it was due to increased destruction by immune mechanism or due to ineffective thrombopoiesis in the process of leukemogenesis remained unknown.抄録全体を表示PDF形式でダウンロード (1118K) -
吉田 弥太郎, 宮坂 昌之, 清水 史郎, 栗林 景容, 小中 義照, 広瀬 優子, 菅井 進, 滝口 智夫, 紺田 進1978 年 19 巻 3 号 p. 304-310
発行日: 1978年
公開日: 2009/01/19
ジャーナル 認証ありTwo cases of gas producing intramuscular abscess in a 62 year-old female with monocytic leukemia and 28 year-old male with erythroleukemia are described. The abscess was characterized by painful swelling, local warmth and marked tenderness of the right gastrocnemius muscle in the first case, and the left major pectoral muscle in the second case. Roentogenogram revealed homogenous collection of air in the affected areas as irregularly shaped, well demarcated clear zones in the first case, and multiple small bubbles in the second case. The local inflammatory signs subsided only after surgical incision and drainage. The causative microorganisms were Aeromonas hydrophila in the first and Klebsiella pneumoniae in the second case. Klebsiella septicemia preceded the abscess formation in the second case.
Chemotherapy induced granulocytopenia, diabetes mellitus and septicemia have been discussed in relation to the probable pathogenetic predisposition leading to this uncommon complication.抄録全体を表示PDF形式でダウンロード (889K)
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