巻号一覧
20 巻, 12 号
選択された号の論文の19件中1～19を表示しています
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綜説
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真田 雅好, 高橋 益広, 岸 賢治, 森山 美昭, 柴田 昭1979 年 20 巻 12 号 p. 1539-1547
発行日: 1979年
公開日: 2009/01/19
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内田 立身1979 年 20 巻 12 号 p. 1548-1561
発行日: 1979年
公開日: 2009/01/19
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臨床研究
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小橋 秀広, 三好 勇夫, 坪田 輝彦, 平木 俊吉, 久保西 一郎, 木村 郁郎, 瀬崎 達雄, 浅野 健夫1979 年 20 巻 12 号 p. 1562-1568
発行日: 1979年
公開日: 2009/01/19
ジャーナル 認証ありIt has been speculated that immunologic mechanism may be involved in the pathogenesis of hypoplastic anemia (HA). In the present experiment, attempts were made to explore the possible existence of lymphocytes that may suppress CFU-C in bone marrow of patients with HA. In the first experiment, marrow lymphocytes from two patients with HA were co-cultured with human cord leukocytes or normal bone marrow leukocytes in soft agar over the underlayer of normal peripheral leukocytes. This procedure in both cases greatly reduced cord CFU-C or normal bone marrow CFU-C in comparison with cord leukocytes co-cultured with normal peripheral lymphocytes or normal bone marrow leukocytes alone. In the second experiment, marrow cells from 14 patients with HA were first treated with rabbit antihuman thymocyte serum and complement and then assayed for CFU-C. This treatment significantly increased HA marrow CFU-C in 4 of them.
It is suggested from these findings that bone marrow from some patients with HA contains T-lymphocytes suppressive to CFU-C.抄録全体を表示PDF形式でダウンロード (446K) -
—臨床的ならびに基礎的検討—白幡 聰, 野尻 外士雄, 山田 兼雄, 目黒 嵩1979 年 20 巻 12 号 p. 1569-1578
発行日: 1979年
公開日: 2009/01/19
ジャーナル 認証ありA study was made on the reactive thrombocytosis in infants and children. The main purposes were to classify the basic diseases and to observe the properties of platelets in the reactive thrombocytosis.
Among the 672 cases surveyed, 107 (15.9%) exhibited thrombocytosis in excess of 500,000/cmm. The basic diseases in these cases comprised MCLS (22 cases), pulmonary infection (25), other respiratory infections (10), urinary tract infection (6), and others (44). The diseases in patients with severe thrombocytosis in excess of 750,000/cmm consisted mainly of MCLS (20cases) and pulmonary infection (8cases). These represented 56% and 22% of all cases with severe thrombocytosis, respectively.
In cases with high platelet counts, the platelet volume, platelet protein and platelet sialic acid per 109 platelets were decreased, while sialic acid per platelet protein showed an increase The levels of platelet retention to glass bead were decreased by Hellem-II in these cases. On the other hand, spontaneous platelet aggregation was demonstrated in assays using original platelet rich plasma, indicating a tendency for in vivo hyperaggregability in these cases. Such spontaneous platelet aggregation was suppressed by the administration of antiplatelet agents such as aspirin or flurbiprofen.抄録全体を表示PDF形式でダウンロード (724K) -
田坂 英子, 岡村 純, 生野 茅子, 高山 一雄, 寺嶋 広美1979 年 20 巻 12 号 p. 1579-1585
発行日: 1979年
公開日: 2009/01/19
ジャーナル 認証ありSixteen patients with malignant lymphoma in childhood, two cases of Hodgkin's disease, ten lymphocytic lymphoma and four histiocytic lymphoma, were treated with combination chemotherapy with or without irradiation. Age ranged from 1 to 15 years (average 7 years). Initial sites were orbit in one, bones in one, cervical nodes in six and mediastium in six.
Staging was done by Ann Arbor classification. Five cases were in Stage I, one in Stage II, two in Stage IIE, one in Stage III and seven in Stage IV. Surface IV. marker of tumor cells was analyzed in six cases with lymphocytic type. Three cases were of T-cell type, two null-cell and one B-cell type. In lymphocytic type, bone marrow and/or central nervous system involvements were found in nine out of ten cases.
Complete remission was sustained after cessation of therapy in two cases with Hodgkin's disease for 92+ and 33+ months, one with lymphocytic type for 47+ months and two with histiocytic type for 63+ and 53+ months. Median survival in the treated malignant lymphoma cannot be calculated at present.抄録全体を表示PDF形式でダウンロード (473K) -
1. 溶血について吉田 博, 三浦 信雄, 油井 徳雄, 木村 秀夫, 田中 鉄五郎, 松田 信, 麻喜 恒雄, 秋月 健, 内田 立身, 刈米 重夫1979 年 20 巻 12 号 p. 1586-1593
発行日: 1979年
公開日: 2009/01/19
ジャーナル 認証ありRed cell survival with autologous 51Cr labeled red cells, effective destruction, reticulocyte counts and red cell fragmentation in peripheral blood, haptoglobin, LDH, iron and iron saturation rate in serum, hemosiderin and hemoglobin in urine, cardiac index due to dye dilution test were examined in 27 cases with valvular heart disease and 5 cases with valve replacement, in order to ascertain the existence of vascular hemolysis in these patients due to the abnormality of hemodynamics or the organic changes of endocardium.
In many cases of these patients, high incidence of the shortness of red cell survival, high value of serum LDH, low value of serum haptoglobin, and the existence of urinary hemosiderin were observed. Shortness of red cell survival were relatively slight degree and the relationship between the amount of hemoglobin destruction and the serum LDH values was closely correlated in all cases.
From these results, it is concluded that there are intravascular hemolysis certainly in these patients due to physical damage of red cells but the degree of hemolysis is not so high in them.抄録全体を表示PDF形式でダウンロード (586K) -
依田 安弘, 花田 尚, 阿部 帥1979 年 20 巻 12 号 p. 1594-1601
発行日: 1979年
公開日: 2009/01/19
ジャーナル 認証ありSerum ferritin levels (F levels) were studied on 21 cases of untreated acute leukemia in whom seven had been transfused on admission and 14 had not. 78.6% of initial F levels in untransfused patients and 100% of those in transfused ones were above normal range. The mean average of the latter was significantly higher than that of the former (p<0.001). Patients with high percentage of leukemia cells in the initial bone marrow study frequently but not necessarily showed high F levels. No statistically significant correlation was found between percentages of leukemia cells in bone marrow and F levels, while serum LDH activities significantly correlated with the former (r=0.72, p<0.001). Cumulative units of blood transfusion were found to have significant correlation with F levels of patients in remission (r=0.68, p<0.02) and of those who were treated without chemotherapy (r=0.85, p<0.01). F levels of nine cases in remission without abnormality in liver function tests were apparently higher than those on admission, while LDH activities were lower in remission. When patients developed hepatitis, F levels behaved almost in parallel with GOT activities. On the basis of these findings the clinical significance and limited usefulness of F levels in patients with acute leukemia were discussed.抄録全体を表示PDF形式でダウンロード (564K) -
沖 一, 高島 昭佳1979 年 20 巻 12 号 p. 1602-1609
発行日: 1979年
公開日: 2009/01/19
ジャーナル 認証ありAntiplatelet alloantibody (APA) was determined with Karpatkin's modified method, immune adherence hemagglutination method and mixed hemadsorption method, and antilymphocyte antibody (ALA) was determined with cytotoxicity test in cases given blood transfusion. APA and ALA appeared in 14 and 12 out of 34 cases given whole blood, 3 and 2 out of 4 cases given platelets, 1 and 2 out of 2 cases given leukocytes, respectively, but did not appeared in 7 cases given leukocyte-poor red blood cells and 8 cases given fresh frozen plasma. The appearance rates of APA or ALA were increased as the amounts of blood transfusion were increased. APA appeared 2∼4 weeks after the initiation of transfusion in cases with duration of transfusions within 8 days, and 5∼7 weeks after in cases with duration of transfusions over 9 days.
The latter cases showed highter titer of APA. Most of these APA and ALA were common antibodies to both to platelets and lymphocytes, and these ALA differed from ALA in systemic lupus erythematosus or polyarteritis nodosa. On the other hands, antibodies not common to platelet and lymphocyte antigen did exist. These indicates varieties of APA or ALA in polytransfused cases.抄録全体を表示PDF形式でダウンロード (564K)
症例
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平井 博子, 山岸 厚子, 早川 欽哉, 山田 清美1979 年 20 巻 12 号 p. 1610-1618
発行日: 1979年
公開日: 2009/01/19
ジャーナル 認証ありA 26-year-old man. During the treatment on acute hepatitis, cystitis was complicated. After an administration of 5g of chloramphenicol and 8g of thiophenicol, he fell into pancytopenia and 16% of myeloblast was seen in the peripheral blood. However, no increase in myeloblasts was noted in the bone marrow. Anemia was improved when the drugs were discontinued, but thrombocytopenia persisted and a few myeloblasts were seen in the peripheral blood. He fell into severe anemia 6 months after the administration of chloramphenicol. He developed erythroleukemia with sideroblastic anemia. He became better for a moment after the administration of adrenocortical steroids, but he suffered from pneumonia at the end stage and died about 23 months after the occurrence of pancytopenia or 17 months after the occurrence of erythroleukemia. The authors reported this case with reference of the literature.抄録全体を表示PDF形式でダウンロード (1545K) -
平岡 篤信, 山本 孝吉, 上島 嘉美, 山岸 司久, 内野 治人, 藤原 久義1979 年 20 巻 12 号 p. 1619-1626
発行日: 1979年
公開日: 2009/01/19
ジャーナル 認証ありA 71-year-old male presented himself with marked pallor of the skin. The peripheral blood showed pancytopenia at the beginning, but the leukocyte and platelet counts became normal soon thereafter. The bone marrow was markedly hyperplastic. Initial manifestations suggested refractory anemia with hyperplastic bone marrow and probably preleukemia. He was treated with corticosteroid and anabolic steroid without effect and required frequent blood transfusions. About 8 months later leukocytosis gradually appeared. The leukocytosis without hiatus leukemicus up to 232×103/μl was reduced to the level of 60 to 90×103/μl by the use of dibromomannitol. NAP was of low level, but Ph1 chromosome was negative. He had hepatomegaly and lymph node enlargement which waxed and waned along with the leukocyte counts. However, the spleen never became palpable. Terminally he developed marked jaundice and died. The duration of his clinical course was approximately 2 years. Autopsy findings included: 1) infiltration of immature myeloid cells in the bone marrow and other organs, 2) infection: right perinephritis, pericarditis and splenitis, and 3) hemosiderosis of the liver and pancreas. This case was thought to be essentially one of the atypical variants of AML, though there were a few findings similar to those of CML.抄録全体を表示PDF形式でダウンロード (873K) -
佐竹 立成, 吉田 和子, 山田 博豊, 竹山 英夫1979 年 20 巻 12 号 p. 1627-1634
発行日: 1979年
公開日: 2009/01/19
ジャーナル 認証ありA case of histiocytic medullary reticulosis named by Scott & Robb-Smith (1939) was reported.
A 52-year-old boiler man noticed malaise, fever initially and rapidly went on to downhill cource. He was treated a number of antibiotics and blood transfusions totalling up to 96 units but there was no response and finally died due to purulent panperitonitis two months after onset.
On hematologic examinations the peripheral blood picture showed pancytopenia and bone marrow aspiration showed dry tap. Bone marrow sections revealed hypocellular without abnormal cells. On postmortem examintaion, one of the duodenal ulcers was perforated. The paratracheal, parabroncheal, mesenteric and paraaortic lymphnodes were slightly enlarged with massive caseation necrosis. The histopathological picture was characterized by proliferation of atypical histiocytes in the lymph nodes, liver, spleen and bone marrow.抄録全体を表示PDF形式でダウンロード (906K) -
川村 恒博, 住岡 秀史, 原 洋, 宮永 一, 寺田 茲久, 辻 勝弘, 中村 充男, 中川 雅夫, 杉島 聖章1979 年 20 巻 12 号 p. 1635-1641
発行日: 1979年
公開日: 2009/01/19
ジャーナル 認証ありThis paper deals with a patient of Pelger-Huet anomaly of granulocyte with SLE.
A 26-year-old female patient was admitted to our service, because of the frequent episodes of arthralgia and erythema after her first delivery. On admission the disturbance of articular movement, erythema and goiter were observed.
Peripheral blood examination showed microcytic hypochromic anemia and 60% of band neutrophil with mild leukopenia. Nuclei of these cells were peanut-shaped and these chromatin net works were conspicuously dense. Examination of the phagocytic activity and the histochemical study revealed no difference from the normal neutrophils. This anomaly of granulocyte was also observed in her healthy father.
From the laboratory examination of positive LE-cell and anti-DNA antibody and lympho node biopsy, a diagnosis of SLE was made. Hashimoto-thyroiditis was also diagnosed by the finding of the thyroid biopsy.
Her general condition due to SLE and Hashimoto-thyroiditis was improved by the administration of glucocorticoid and the replacement therapy by desiccated thyroid powder, but to this anomaly of granulocytes little response was observed under these therapy. Then familial Pelger-Huet anomaly was suspected.
Although Pelger-Huet anomaly in association with various diseases had been reported, the case report of familial Pelger-Huet anomaly with SLE was rare.
Whether this association is accidental or not is a matter of argument.抄録全体を表示PDF形式でダウンロード (939K) -
吉川 治哉, 丸尾 國造1979 年 20 巻 12 号 p. 1642-1654
発行日: 1979年
公開日: 2009/01/19
ジャーナル 認証ありCase 1, 60-year-old male, acute myelocytic leukemia: Partial remission was attained after three courses of PADOC therapy. An additional course of PADOC therapy failed to achieve a complete remission (CR). On the contrary, by an AAAP therapy (Jap. J. Clin. Hematol., 19: 1332∼1340, 1978), which was performed six months later only once, a CR was attained. The patient was in a state of CR during the period of eight months without receiving any chemotherapy. He survived for 17 months.
Case 2, 46-year-old male, acute monocytic leukemia: He was initially treated with three courses of PADOC therapy and obtained a transient CR. After the relapse of leukemia, AAAP therapy was performed. After only one course of AAAP therapy, a CR was reattained, which was maintained for over eleven months. He has been alive for over 14 months.
Case 3, 51-year-old male, acute monocytic leukemia: He was initially treated with two courses of AAAP therapy, then attained a CR which was maintained for six months. The survival was 9 2/3 months.
In these three cases, leukopenia, aleukemic hemogram and hypocellularity of the bone marrow were noted prior to the chemotherapy, and the histology of the marrow showed normocellularity when CR was achieved by the AAAP therapy.
It was suggested from the experience of these three cases that AAAP therapy should be one of the chemotherapeutic procedures highly recommended for the introduction of a remission in “hypoplastic leukemia”.抄録全体を表示PDF形式でダウンロード (2265K) -
香月 昭人, 栢分 節夫, 米田 誠一, 浜見 拓哉, 中田 哲雄, 西尾 晃, 細田 光蔵, 春山 春枝, 杉島 聖章, 伊地知 浜夫, ...1979 年 20 巻 12 号 p. 1655-1661
発行日: 1979年
公開日: 2009/01/19
ジャーナル 認証ありA case of hemopoietic dysplasia or acute myeloproliferative disorder was reported.
Recently, the incidence of atypical leukemia has been increased especially at the aged population. Furthermore, the clinical nomenclature of atypical leukemia has been confused and overlapped. Since hemopoietic dysplasia can be recognized as those diseases which are not distinguishable from leukemia on the clinical and hematological findings, the proliferative ability of the abnormal hematological clones was considered to be so promoted in this case that the series of gradual loss of differentiation ability was not observed until the death due to diffuse infiltration with the abnormal cells into many organs.
Although the relationship between the abnormal immunological findings and the expression of hemopoietic dysplasia is not clear at present time, the various prodromal symptoms observed in this case are suggestive to the possibilit es that the immunological response of the host to the newly obtained antigens of the abnormal clones or the autoimmune like response of the already altered host lymphocytes.
Further studies on immunological aspect of hemopoietic dysplasia are ardently required which may provide a clue to elucidate the etiological mechanism of leukemia itself.抄録全体を表示PDF形式でダウンロード (831K) -
橋村 俊一, 橋本 清保, 岩永 隆行, 入交 清博, 堀内 篤, 伊藤 浩行1979 年 20 巻 12 号 p. 1662-1667
発行日: 1979年
公開日: 2009/01/19
ジャーナル 認証ありA 50-year-old man was admitted to the Kinki University Hospital in February, 1978, because of cough and exertional dyspnea. Two years before admission the patient was pointed out the monoclonal gammopathy (3.2g/dl M-protein) in serum at another hospital, therefore, he was reffered to our hospital for precise detailed examination. There was a long history of essential hypertension, which was regulated with oral medication.
The bone marrow showed 12.5% of atypical plasma cells. Monoclonal gammopathy was observed IgG (L) type on immunoelectrophoresis. Quantity of the immunoglobulins were 5850mg/dl IgG, 30mg/dl IgA and 40mg/dl IgM. Bence-Jones protein in urine was negative. He was discharged on 20th hospital day with the diagnosis of IgG (L) type myeloma without chemotherapy.
Nine months before admission the patient began to have lower back pain, and intermittent therapy of melphalan was performed. Three weeks before admission he was developed cough and exertional dyspnea. X-ray films of the chest disclosed left pleural effusion, and he was readmitted to our hospital on February 19, 1978. Bloody fluid with no atypical cells were obtained by pleural puncture. Cyclophsphamide and prednisolone were administered. On the end of May, X-ray films of the chest disclosed multiple nodular shadow in the both lung field without hilar lymphadenopathy. The patient died on the 144th hospital day.
Autopsy findings revealed multiple myeloma in lumbar vertebrae and costae, and Grawitz's tumor on the upper pole of left kidney. Metastases of Grawitz's tumor disclosed the both lung, diaphragma and peribronchial lymph nodes. Complication of multiple myeloma and carcinoma were reviewed.抄録全体を表示PDF形式でダウンロード (923K) -
奥野 哲二, 黒川 達也, 池田 康夫, 外山 圭助, 張ケ谷 健一1979 年 20 巻 12 号 p. 1668-1674
発行日: 1979年
公開日: 2009/01/19
ジャーナル 認証ありA case of chronic myelogenous leukemia associated with prominent peripheral lymphadenopathy is reported. A 29-year-old man was first admitted to the Tachikawa Kyosai Hospital because of fever and general malaise. A diagnosis of chronic myelogenous leukemia was established on the basis of anemia, thrombocytosis, marked leukocytosis with shift to the left, marked splenomegaly and positive Ph1 chromosome. He was first placed on busulfan, then 6MP was added. Reduction in WBC and splenomegaly was noted. One month later, he developed fever and enlargement of spleen again, followed by marked generalized peripheral lymphadenopathy. Biopsy of the cervical nodes revealed diffuse infiltration of myeloid cells with all stages of maturation. Imprints of resected nodes, stained with May-Giemsa staining solution, further demonstrated myeloid cell infiltration, in addition, the presence of megakaryocytes and erythroid cells. Double Ph1 chromosome was also demostrated in the culture of biopsied lymphnodes. There was no evidence of acute blastic transformation in the peripheral blood smears or biopsied specimens of bone marrow. Two month later, he developed frank blastic crisis and died of septicemia in spite of intensive treatment with antibiotics and chemotherapeutic agents.抄録全体を表示PDF形式でダウンロード (974K) -
福田 幸治, 岩永 隆行, 堀内 篤1979 年 20 巻 12 号 p. 1675-1680
発行日: 1979年
公開日: 2009/01/19
ジャーナル 認証ありA 35-year-old woman was admitted to the hospital because of gum bleeding and purpura on extremities. She was well until one month before entry, when she aborted. After she aborted, the bleeding tendency was appeared. The physical examination revealed the purpura on the both of shoulders and legs. Many dental caries and goiter were found, but other examination was negative. The hematocrit was 34.1%, the white cell count was 5,300 with a normal differentiation. The platelet count was 3,000. Examination of bone marrow revaled normal cellurality and the number of megakarytes was seen within normal range with a few platelet production. The bleeding time was 15 minutes, but other coagulation tests were normal. Anti-platelet antibody was detected, and ANA and anti-DNA antibody were also positive. Thyroid function was normal. Prednisolone (40mg/day) was administered under the diagnosis of ITP. The platelet count rose to over 100,000, and the symptoms and the laboratory datas were markedly improved after treatment. As the prednisolone reudced, she complaind of dryness of mouth and eyes. A diagnosis of Sjogren's syndrome was made by sialography and schirmer test. Thyroid biopsy was performed because of anti-microsome antibody and anti-thyroglobulin antibody were detected. Typical findings of Hashimoto's disease was observed histologically.
Overlapping of other autoimmune diseases is characteristic of Sjogren's syndrome. The overlapping case with Sjogren's syndrome, ITP and Hashimoto's disease was discussed.抄録全体を表示PDF形式でダウンロード (568K) -
間宮 繁夫, 遠藤 安行, 山口 昭彦, 吉田 廣作, 福田 光之, 三浦 亮1979 年 20 巻 12 号 p. 1681-1687
発行日: 1979年
公開日: 2009/01/19
ジャーナル 認証ありTwo patients with chronic myeloid leukemia (CML) and one with hereditary spherocytosis (HS) complicated by epilepsy after splenectomy were described.
Case 1; A 25-year-old woman was admitted to our clinic in February 1976. She was nine months pregnant at that time and the diagnosis of CML was made soon after admission. In March 1976, she underwent cesarean section and splenectomy. Four month later, she developed an acute episode of unconsciousness and convulsion for several minutes. Thereafter the attack occurred three times, and her platelet count was estimated between 1,100,000/mm3 to 2,300,000/mm3 at each episode.
Case 2; A 45-year-old man was diagnosed to have CML in February and splenctomized in March 1977. After splenectomy the platelet count consistently and promptly showed marked increase up to 6,000,000/mm3 with occurrence of numerous episodes of convulsion. He did not respond to anticonvulsive agents and antithrombotic therapy.
Case 3; A 12-year-old girl was hospitalized and the diagnosis of hereditary spherocytosis was made in August, 1975. After routine splenectomy, she developed repetitive episodes of convulsion and unconsciousness. At this time, a platelet count showed the usual elevation to between 560,000/mm3 and 900,000/mm3.
Three patients had no clinical signs and laboratory findings of cerebral thrombosis.
There was no clear explanation for the relationship between thrombocytosis and epilepsy.抄録全体を表示PDF形式でダウンロード (422K)
例会
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1979 年 20 巻 12 号 p. 1688-1714
発行日: 1979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 (2639K)
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