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Volume 22, Issue 8
Displaying 1-13 of 13 articles from this issue
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...1981 Volume 22 Issue 8 Pages 1215-1225
Published: 1981
Released on J-STAGE: January 26, 2009
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Masato TSUJIMOTO, Tadaaki TSUDA, Masahiro OHATA1981 Volume 22 Issue 8 Pages 1226-1231
Published: 1981
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSPatients with multiple myeloma usually have depressed polyclonal immunoglobulin levels in their sera, to which a polyclonal decrease of immunoglobulin synthesis contributes most importantly. A comparison was made between peripheral blood lymphocytes (PBL) from 6 patients with myeloma and those from age matched normal subjects with regard to their abilities to secrete IgG into the medium after 8 days culture with pokeweed mitogen (PWM). In normal subjects, PWM-stimulated PBL secreted nearly 4.9-fold more IgG compared to unstimulated PBL, whereas in patients with myeloma an IgG increment was only 1.36-fold. Thus, myeloma PBL failed to show a rise in IgG production under PWM stimulation.
Mixed cultures of T and B cells originating from the two groups were made for a period of 8 days at various concentrations of PWM (0∼20μl/ml). IgG secretion by myeloma T cell/normal B cell combinations was initially enhanced and was further stimulated with PWM, which suggests that helper activity of myeloma T cell was not disturbed. In contrast, IgG secretion by normal T cell/myeloma B cell combinations was low at any concentration of PWM which is consistent with an idea that IgG secretion by myeloma B cells remained low despite a helper function of normal T cells. Taking into consideration inclusion of 30% monocytes in our B cell fraction, we suggest that decreased polyclonal immunoglobulin synthesis in myeloma may be attributed to an intrinsic defect of B cells per se and/or a suppressive action of monocytes.View full abstractDownload PDF (477K) -
Akitada ICHINOSE, Ikuro MARUYAMA, Mitsuru IMAGUMA, Tokiko SONODA, Akih ...1981 Volume 22 Issue 8 Pages 1232-1236
Published: 1981
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSPlasma clotting factor XII (Hageman factor, F. XII) activity was determined by the clotting assay using F. XII deficient plasma in 21 normal adults and 137 patients with various diseases.
The mean±S. D. of normal plasma F. XII was 99.7±18.7%, it was increased at the early stage of thrombosis probably due to the presence of the activated clotting factors.
F. XII was significantly reduced in disseminated intravascular coagulation (DIC) by consumption and in liver diseases by impaired synthesis.
It was lowered in a patient with systemic lupus erythematosus (SLE) like disorder associated with renal artery thrombosis and chorea, in those with other collagen diseases, and also in those with PEP syndrome (pigmentation, edema and polyneuropathy).
The change of plasma F. XII level may play an important role in these diseases, because it triggers several surface mediated plasma reactions such as the intrinsic pathway of blood coagulation, the extrinsic one, fibrinolysis, kinin generation and complement system.View full abstractDownload PDF (398K) -
Kazuko HIRAMATSU, Shigeru ARIMORI1981 Volume 22 Issue 8 Pages 1237-1240
Published: 1981
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSMicroviscosity and lipid composition of lymphocytes were examined in six healthy subjects, five patients with systemic lupus erythematosus and five patients with myasthenia gravis. Microviscosity of healthy lymphocytes was 1.549, and one of patients with systemic lupus erythematosus and myasthenia gravis decreased to 1.203 (p<0.05) and 1.082 (p<0.001), respectively.
The weight percentage ratio of phosphatidylethanolamine to phosphatidylcholine also decreased in systemic lupus erythematosus and myasthenia gravis than in healthy controls, although there was no difference in molar ratio of free cholesterol to phospholipid and sphngomyelin to phosphatidylcholine among healthy controls, myasthenia gravis and systemic lupus erythematosus. Changes of microviscosity of these lymphocytes well correlated to the severities of disease.View full abstractDownload PDF (266K)
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Kenji SAITO, Yasuko NAMBA, Sakae HAZAMA, Hideo ENOKIHARA, Koji HIROSE, ...1981 Volume 22 Issue 8 Pages 1241-1248
Published: 1981
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSA 47-year-old male was admitted to our hospital with chief complaints of gum bleeding and plethoric face. Physical examination showed slight splenomegaly. Laboratory studies revealed Ht 66%, leukocyte count 30,200/cmm with a neutrophilic leukocytosis, platelet count 64.6×104/cmm, total red cell mass 68ml/kg, arterial O2 saturation 97%. The serum total proteins were 9.0g/dl with 2.2g/dl of γ-globulin. Serum protein electro phoresis showed a narrow M-band with a slightly wavy pattern in the γ region. Immunoelectrophoresis demonstrated an IgG-λ paraprotein. Serum immunoglobulin levels were as follows: IgG 2,560mg/dl, IgA 85mg/dl, IgM 70mg/dl. Urinary Bence Jones protein was negative. A bone marrow aspirate showed hypercellularity of three elements with slight increase in plasma cells of 4.2% most of which appeared mature. Bone survey revealed no abnormal findings. Renal function was normal.
He was diagnosed as having polycythemia vera associated with monoclonal gammopathy. Therapy consisted of phlebotomies and the administration of busulfan for 5 months. although he has been followed without any specific therapy over a period of next 8 months, he has been doing well and the levels of the paraprotein has remained constant since the initial diagnosis. It has been difficult to determine whether the monoclonal gammopathy belongs to a benign type or multiple myeloma, although the former seems to be more probable at present.View full abstractDownload PDF (699K) -
Hitoshi AOYAMA, Gen FUKUSHI, Shiro FUJIWARA, Setsuko KAWAMURA, Yoichi ...1981 Volume 22 Issue 8 Pages 1249-1254
Published: 1981
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSAn adult case of Down's syndrome with acute leukemia was reported. He has a history of retarded standing up at his age of 2 and was subsequently diagnosed to have Down's syndrome with I. Q. level of 19. At his age of 26, he was admitted because of right lower abdominal pain and leukocytosis on Sept. 17, 1979. He was born at her mother's age of 35, without any abnormal family history. Hematological studies revealed as follows; RBC 360×104/cmm. WBC 30,800/cmm with 70% blast cells. Platlet 6.7×104/cmm. PT, PTT and bleeding time as wells liver function tests were normal. HBs-Ag·Ab and α-Fetoprotein test were negative. Bone marrow specimen revealed nucleated cell count 21×104/cmm with blast cells 96% and again 21-Trisomy. PAS, naphthol AS-D chloroacetate esterase and peroxidase reaction of the blast cells were negative.
The patient was treated with VEMP therapy resulted in complete remission. He died of meningeal bleeding with leukemic infiltration 15 months after the treatment. Histological and cytological findings of postmortem examination with electronmicroscopic technique were mentioned. Transient abnormal myelopoiesis in Down's syndrome was discussed. This was seemed to be the first adult case of acute leukemia associated with Down's syndrome in Japan.View full abstractDownload PDF (705K) -
Jiro INUI, Sadako TAMAI, Yoshiaki IWAHASHI, Kohzo SHIZUKI, Koji SAITO, ...1981 Volume 22 Issue 8 Pages 1255-1261
Published: 1981
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSA 61-year-old man was admitted to our hospital because of uveitis in June, 1979. An elevated level of serum IgD was noted in August. A diagnosis of lymphosarcoma was made on the biopsy of the orbital and testicular tumor in October. A half month later, pleural effusion and hepatosplenomegaly were noted, and the patient died from acute renal failure.
The findings of the peripheral blood and the bone marrow revealed marked proliferation of the lymphoid cells, which possesed moderately developed rough ER in the cytoplasm by electron microscopy. On the immunological marker studies, cytoplasmic IgD was detected in the lymphoid cells of the bone marrow and orbital tumor. Furthermore, the peripheral lymphocytes produced IgD in vitro following the stimulation by PWM. The immunoelectrophoresis showed serum monoclonal IgD and Bence Jones protein. The light chain determinant of monoclonal IgD unmasked after the treatment of alkylation by SDS-electrophoresis.
It is suggested that the leukemic neoplastic cells belonging to B-cell series had the function of synthesizing and secreating IgD in this case.View full abstractDownload PDF (1581K) -
Shigeichi KOBAYASHI, Toshio SUDA, Sadako MATSUOKA, Masayoshi YANAGISAW ...1981 Volume 22 Issue 8 Pages 1262-1268
Published: 1981
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSThe authors report two cases of autoimmune hemolytic anemia, one in a 3-week-old female neonate (Case 2) and the other in a 2-month-old female infant (Case 1). Both patients were healthy until several days after upper respiratory infection when severe hemolytic anemia developed abruptly. Immunological studies revealed a positive Coombs' test in both cases. In case 1, the involved antibodies were IgG with complement. In case 2, antibody typing was not successful because of low antibody titer. In both cases the antibodies were non-specific to blood group antigen. Both cases followed a good clinical course into complete remission without steroid therapy. They each required only two transfusions.
On reviewing the literature, 12 cases of autoimmune hemolytic anemia before one year of age have been described in Japan. They include 6 male and 5 female infants, (one not described). The clinical courses were acute in 4 cases and chronic in 4 cases. (In the other 4 cases not enough data available). Steroid therapy was instituted in all cases. The results were complete or partial remissions in 6 cases, and death in 6 cases including the 4 chronic cases.
The present cases were the youngest of those reported and they followed the most favorable courses.View full abstractDownload PDF (490K) -
Michiko HANDA, Keisuke TOYAMA, Tetsuhei OGAWA, Hiroyuki MURAKI, Schizu ...1981 Volume 22 Issue 8 Pages 1269-1276
Published: 1981
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSA 77-year-old male was admitted on March 29, 1977 because of fever, severe anemia and leukocytosis. On admission his hemoglobin was 4.6g/dl, platelet 2,000/cmm, and WBC 23,600/cmm with 1.5% blasts, 83% basophils (12% immature, 71% mature and no hiatus basophilicus). The bone marrow aspiration revealed 35.95% blasts, 29.4% basophils (21.5% immature, 7.9% mature) 24.9% eosinophils (20.85% immature, 4.05% mature). Neutrophilic alkaline phosphatase score was 29, Ph1 chromosome was negative, and hepatosplenomegaly was not present. Following therapy with daunomycin, cytosine arabinoside, vincristine, 6MP and prednisolone, complete remission was obtained about 2 months later. Although maintenance therapy with 6MP and prednisolone had been given for 4 months, he was readmitted because of fever and pancytopenia. On second admission blood findings were 1,100 of leukocytes with 7% blasts, 6% basophils and 5% neutrophils in peripheral blood, and 55.6% blasts and 10.8% basophils in the bone marrow. He rapidly deteriorated by complicating pneumonia and heart failure and died on Oct. 29. He never showed the symptoms of hyperhistaminemia. Through a review of literatures, our case was not fully compatible with the definition of acute basophilic leukemia despite of the clinical features resembling to acute leukemia, but hematological findings suggested some relation to chronic myelogenous leukemia.View full abstractDownload PDF (1595K) -
Kunihiko YAMAUCHI, Tadami NAGAO, Shigeru ARIMORI1981 Volume 22 Issue 8 Pages 1277-1283
Published: 1981
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSA 71-year-old male was admitted to our clinic because of refractory pancytopenia with myeloblasts in the peripheral blood.
This hypoplastic bone marrow showed erythroblasts with bizarre feature of nucleus, the increase of micromegakaryocytes and mild increased numbers of myeloblasts which meant hiatus leukemicus.
This acute myelogenous leukemia (AML) is therefore called a low percentage leukemia or hypoplastic leukemia. Because the increased numbers of myeloblasts in the marrow were stable throughout the course of 8 months, this case is said smoldering acute leukemia or refractory anemia with excess of myeloblasts (RAEM) in other words.
19 years ago, radical gastrectomy has been performed for advanced type of gastric cancer, pathologically tubular adenocarcinoma, well differentiated. In follow-up of gastroscope after the diagnosis of AML, biopsy-specimen of gastric stoma showed both signet ring cell carcinoma and tubular adenocarcinoma, moderately differentiated.
This case with smoldering AML is presented who has first been seen advanced, gastric cancer 19 years ago and subsequently developed once more gastric cancer in situ in stoma.View full abstractDownload PDF (749K) -
Yoshio NAMBA, Hideo ONODERA, Taro ASANO, Keisuke YANO, Zensuke OTA, Ta ...1981 Volume 22 Issue 8 Pages 1284-1291
Published: 1981
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSA 25-year-old female had complaints of low grade fever and back pain and her chest X ray film revealed the bilateral hilar lymphoadenopathy (BHL). She was diagnosed as sarcoidosis from the histrogical findings of biopsied paraaortic lymph nodes.
The serum IgA level was less than 5 mg/dl, but serum IgG and IgM slightly increased and secretory component in salivary and duodenal juice was normal.
The percentage of ERFC of her peripheral blood lymphocytes (PBL) was 67.7%, and membrane immuno-fluoresence technique revealed 29.8% s-IgG bearing cells, 26.1% s-IgA bearing cells and 20.6% s-IgM bearing cells. In her bone marrow smear and duodenal mucosa specimen, IgA containing cells were not found. Antinuclear antibodies, circulating immune complex and anti-lymphocytic antibody were negative.
Amounts of IgA synthesized by PWM-stimulated PBL from this patient were measured by radioimmunoassay, and the level of IgA was about a half of normal synthesis.
In this patient, we suppose that the hyperfuction of the class-specific suppressor cells or the defect in T helper function may cause the abnormality preventing the differentiation of IgA bearing B lymphocytes into IgA secreting plasma cells.
This patient was administered prednisolone (PSL). About 6 months later her BHL disappered, and serum IgA was begining to increase a year after of begining treatment with PSL. So, this suggests that selective IgA deficiency had closely related with sarcoidosis in this patient.View full abstractDownload PDF (976K)
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1981 Volume 22 Issue 8 Pages 1292-1327
Published: 1981
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSDownload PDF (3475K) -
1981 Volume 22 Issue 8 Pages 1328-1364
Published: 1981
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSDownload PDF (3593K)
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