巻号一覧
23 巻, 12 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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浅野 洋治, 友安 茂, 横山 新一郎, 布上 直和, 鶴岡 延熹, 清水 盈行, 牧野 義彰1982 年 23 巻 12 号 p. 1841-1846
発行日: 1982年
公開日: 2009/01/26
ジャーナル 認証ありApotransferrin was administered intravenously to 7 patients with anemia accompanied by hypotransferrinemia, consisting of 5 cases of liver cirrhosis and 2 cases of malabsorption syndrome.
Chemical properties of apotransferrin used were analysed by polyacrylamide gel electrophoresis and isoelectric focusing. Iron binding capacity of apotransferrin was also confirmed in vitro.
One case of malabsorption syndrome and one case of liver cirrhosis had a hypoceruloplasminemia. Ceruloplasmin was administered simultaneously to these patients.
Hb level and RBC count rose to almost normal level after administration of apotransferrin. Rise of Hb was 1.6 to 4.2 g/dl and that of RBC 53 to 145×101/cmm. Serum transferrin level rose in all cases by 40 to 95 mg/dl after administration of apotransferrin.
Side effects were not observed except diarrhea in one case and increased urine output in another.
Parenteral administration of apotransferrin was a useful supplement therapy in patients with anemia accompanied by hypotransferrinemia.抄録全体を表示PDF形式でダウンロード (434K) -
嵐 方之, 赤保内 良和, 大嶋 哲夫, 谷内 昭1982 年 23 巻 12 号 p. 1847-1854
発行日: 1982年
公開日: 2009/01/26
ジャーナル 認証ありLymphocytes isolated from various human lymphoid tissues were cultured for 7 days under stimulation with pokeweed mitogen (PWM). Then, dimeric and monomeric IgA in cellfree supernatants were fractionated by high speed liquid chromatography and determined by radioimmunoassay. The proportions of dimeric and monomeric IgA in them were compared with those of sera in order to investigate the origin of serum IgA.
Peripheral blood lymphocytes (PBL) from normal controls produced mainly dimeric IgA, on the average of 74%. This contrasted strongly with serum IgA, which mostly consisted of the monomeric form (82%). Lymphocytes isolated from the gut-associated lymphoid tissues, such as large bowel mucosa and mesenteric lymph nodes, produced predominantly dimeric IgA (74%). In addition, IgA produced by lymphocytes from the spleen showed primarily the dimeric form (65%), while those from the palatine tonsils revealed nearly the same proportion of dimeric (56%) and monomeric IgA (44%). In contrast, lymphocytes from bone marrow blood produced predominantly monomeric IgA (76%).
These results suggest that dimeric IgA in human serum appears to be mainly derived from the gut-associated lymphoid tissues, wheraeas monomeric IgA appears to be, at least partially, derived from extraintestinal lymphoid tissues, such as bone marrow, the tonsils and the spleen.抄録全体を表示PDF形式でダウンロード (601K) -
山田 博豊, 山口 博, 森島 泰雄, 小寺 良尚, 川島 康平, 大野 竜三, 珠玖 洋, 山田 一正, 吉川 敏, 平林 紀男1982 年 23 巻 12 号 p. 1855-1862
発行日: 1982年
公開日: 2009/01/26
ジャーナル 認証ありOut of 14 patients with refractory acute leukemia who received allogeneic bone marrow transplantation (BMT), ten had interstitial pneumonia (IP). All patients were preconditioned by cyclophosphamide (60 mg/kg/day×4) and 1,000 rad total body irradiation. The radiation rate ranged from 7.6 to 27.0 rad/min. In twelve cases, granulocytes collected by filtration leukapheresis from random donors were transfused.
Initial clinical signs and symptoms of IP were abnormal shadows in chest films in 7 cases, dyspnea in 2 and low PaO2 in one. The period from the onset of IP to death varied according to the severity of graft-versus-host disease (GVHD). It was 3 days in three cases with severe GVHD and 17 days in other seven cases with mild or no GVHD.
These IP were diagnosed by autopsies as cytomegalovirus (CMV)-pneumonia in 7 cases and as idiopathic in 3 cases. No elevation of serum CMV antibody was noted in all of 7 CMV-pneumonia, although it was elevated in 2 out of 3 idiopathic IP.
CMV-pneumonia was able to be classified into two patterns pathologically. One was multi-focal alveolar hemorrhage and necrosis with many CMV inclusion cells. The other showed a few CMV inclusion bodies without hemorrhage and necrosis. The pathological patterns of CMV-pneumonia did not correlate with the severity of GVHD, nor the period from the onset of IP to death.
In BMT, the prophylaxis of CMV infection seems to be one of the urgent problems to be solved, since CMV is the major cause of lethal IP among these patients.抄録全体を表示PDF形式でダウンロード (902K) -
—Methotrexate大量静注法と頭蓋放射線療法のrandomized controlled study (Phase III)—横山 隆, 藤本 孟男, 日吉 保彦, 川井 進, 佐々木 邦明, 長谷川 恵子, 伊藤 正宣, 新垣 義清, 小泉 晶一, 三間屋 純一, ...1982 年 23 巻 12 号 p. 1863-1870
発行日: 1982年
公開日: 2009/01/26
ジャーナル 認証ありThis study was designed to evaluate the e fficacy of CNS-prophylaxis with high-dose methotrexate (MTX).
Seventy children with previously untreated acute lymphoblastic leukemia (ALL) entered to this study between July 1978 and December 1980. According to initial white blood count (WBC), they were stratified to induce remission with; vincristine and prednine in low initial WBC (<25,000/mm3) group and these two agents plus adriamycin in high initial WBC ( ?? 25,000/mm3) group. After inducing remission, 62 children who achieved CR, received different CNS-prophlaxis; using a regimen of three doses of weekly high-dose MTX (1,000mg/m2) 6-hour infusion, which was repeated every 12 weeks-Group A (n=14); high-dose MTX followed by 2400 rad cranial irradiation plus three doses of i.t. MTX-Group B (n=15), 2400 rad cranial irradiation plus three doses of i.t. MTX-Group C (n=16), and in 17 patients with high initial WBC, same as in Group A-Group D (n=17).
During an intravenous 6-h infusion of MTX at a dose of 1,000mg/m2, the CSF concentration of MTX rose to 2.3±2.4×10-6M after initiation of infusion and remained in 10-7 M level for 48 hours.
CNS-leukemia terminated complete remission in one of 14 children in Group A, two of 15 in Grup B, two of 16 in Group C and two of 17 in Group D. The cumulative incidence of CNS-leukemia at 20 months culculated by the technique of Kaplan and Meier was 0% in Group A, 18.1% in Group B, 7.1% in Group C and 50.8% in Group D. There was no statistical difference among Groups A, B and C.
These data suggested that CNS-prophylaxis with high-dose intravenous MTX was effective as well as 2400 rad cranial irradiation plus three doses of i.t. MTX in childhood ALL with low initial WBC.抄録全体を表示PDF形式でダウンロード (542K) -
岡本 真一郎, 外山 圭助, 山本 美保子, 大竹 皓子, 加野 象次郎, 渡辺 清明1982 年 23 巻 12 号 p. 1871-1877
発行日: 1982年
公開日: 2009/01/26
ジャーナル 認証ありTo investigate the immune mechanism of pure red cell aplasia (PRCA), we studied two cases of adult PRCA using in vitro colony formation. Erythroid progenitor cells were assayed using a methylcellulose culture system. The number of CFU-E formed by the marrow cells taken from the two cases of PRCA was less than in normal volunteer and BFU-E in their marrow cells was barely detectable.
In the first case, varying numbers of patient's peripheral mononuclear cells (PMNCs) were cocultured with normal and autologous marrow cells, resulting in a marked reduction of erythroid colony formation. The supernatant media of patient's PMNCs demonstrated an inhibitory effect on CFU-E, but not on BFU-E. This inhibitory effect disappeared in the supernatant media when the patient's PMNCs were cultured with prednisolone. Furthermore, this suppression of erythroid colony formation was reversed when the patient's bone marrow cells were pretreated with anti-lymphocyte globulin and complement. There was no evidence of the inhibitory effect in IgG and IgM fraction of the patient's serum.
In the second case, no inhibitory effect on erythroid colony formation was observed in the patient's PMNCs and its supernatant media. The whole serum and isolated serum IgG from this patient produced a marked reduction in the number of CFU-E from normal and autologous bone marrow. This inhibitory effect did not require complement in the culture system, and subsided when the patient's IgG was pretreated with anti-human IgG sera. No inhibitory activity in CFU-E was found in patient's IgM. Neither IgG nor IgM showed any inhibition on formation of BFU-E.
These results indicate that there are at least two mechanisms of pathogenesis of PRCA.抄録全体を表示PDF形式でダウンロード (538K) -
佐甲 隆, 川崎 肇, 登 勉, 神谷 齊, 櫻井 実1982 年 23 巻 12 号 p. 1878-1883
発行日: 1982年
公開日: 2009/01/26
ジャーナル 認証ありPurine nucleoside phosphorylase (PNP) activity was measured in mononuclear cells obtained from 35 patients with acute leukemia or lymphoma in children, and was correlated with laboratory findings and other purine enzymes, e.g. adenosine deaminase (ADA), adenine phosphoribosyltransferase (APRT), hypoxanthine-guanine phosphoribosyltransferase (HGPRT) activity.
PNP activity in normal mononuclear cells ranged from 4.6 U. to 38.5 U., with a mean of 18.0 U.. Null-cell lymphoblasts and T-cell lymphoblasts demonstrated diminished PNP activity. The mean activity in null-cell lymphoblasts was 5.9 U. and in T-cell lymphoblasts it was 2.6 U..
ADA/PNP ratio showed higher level in null-cell and T-cell lymphoblasts than in normal mononuclear cells.
Positive correlation was seen between PNP activity and APRT/HGPRT ratio, but no correlation between PNP activity and HGPRT or APRT activity. No significant correlation was seen between PNP activity and uric acid excretion.
Evaluation of PNP activity provides further biochemical and immunological findings of acute leukemia.抄録全体を表示PDF形式でダウンロード (440K)
症例
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浅野 太郎, 天野 哲基, 矢野 啓介, 鈴木 信也, 太田 善介, 大藤 眞1982 年 23 巻 12 号 p. 1884-1888
発行日: 1982年
公開日: 2009/01/26
ジャーナル 認証ありA case of IgG cold agglutinin disease was studied for its immunoglobulin class and mechanisms of hemolysis. A 42 year-old woman was admitted to our clinic because of the sudden onset of severe hemolytic anemia. Cold agglutinin was detected at the titer of 1:1024. The elution studies of her cold agglutinin and the 2-ME treatment of her serum showed that its immunoglobulin class was IgG κλ type. Repeated Coombs' test determined by either anti-Ig or anti-C3 antiserum were negative and a complement consumption test with her serum was also negative. These results suggested that her IgG cold agglutinin did not activate complement system. Furthermore, auto-rosette formation between mononuclear cell and erythrocytes was observed after incubating whole heparinized blood at 4°C. Since these rosettes were still observed even when Ca++ was depleted by the addition of EDTA, the rosettes were seemed to be formed through the interaction with Fc-receptors of mononuclear cells but not with C3-receptors. After administration of larger dosis of prednisolone, hemolysis improved and numbers of auto-rosette decreased.抄録全体を表示PDF形式でダウンロード (509K) -
斉藤 憲治, 山崎 竜弥, 高橋 勝則, 難波 泰子, 浜口 裕之, 坂巻 壽, 間 栄, 榎原 英夫, 古沢 新平, 宍戸 英雄1982 年 23 巻 12 号 p. 1889-1894
発行日: 1982年
公開日: 2009/01/26
ジャーナル 認証ありA 67-year-old male was admitted to our hospital because of marked thrombocytosis and leukocytosis. Peripheral blood examination revealed RBC 355×104/cmm, Hb 10.7 g/dl, leukocyte count 15,400/cmm with 62% neutrophils, 9% eosinophils and 5% basophils, and platelet count 139.8×104/cmm. Bone marrow aspirate showed hypercellularity of three myeloid elements with 22% erythroblasts and megakaryocyte count 465/cmm. Ringed sideroblasts were seen in 58% of erythroblasts. Chromosome analysis of the bone marrow cells showed no abnormality. Both the activities of ALA synthetase and neutral protease in erythroblasts were reduced.
This patient was thought to have two diseases, acquired sideroblastic anemia and thrombocythemia. As both are supposed to be a myeloid stem cell disorder, it seems to be a matter of choice whether he is diagnosed as primary acquired sideroblastic anemia associated with thrombocytosis or primary thrombocythemia associated with acquired sideroblastic anemia.抄録全体を表示PDF形式でダウンロード (568K) -
佐藤 佳子, 外岡 立人, 松本 隆任, 上野 範博, 大川 正人, 武田 武夫1982 年 23 巻 12 号 p. 1895-1901
発行日: 1982年
公開日: 2009/01/26
ジャーナル 認証ありWe report here a case of hypereosinophilic syndrome (HES) associated with ALL which had an abnormal karyotype. An 8-year-old boy was admitted, because of fever and cough persisting for 2 weeks. Peripheral blood examination revealed marked eosinophilia (120,000/mm3) with frequent Pelger-Huët anomaly and a few lymphoblasts. A bone marrow aspirate revealed an almost same abnormality. Blastic cells were morphologically lymphoblastic and were negative for PAS and peroxidase. A chromosomal analysis of bone marrow showed that 12.5% cells of metaphases had abnormal karyotype of 46XY, t(5;14) (q31;q32). Platelet count was slightly decreased, but no anemia was observed. A chest X-ray showed interstitial pneumonia-like shadows, and ECG did IRBBB. Therapy consisting of prednisolone and cyclo-phosphamide was started. However his eosinophil count rapidly increased, and on the 4th day after admission he died of severe dyspnea and complete A-V block. At the end stage, his sputum and urine contained many eosinophils with Pelgar-Huët anomaly. Histologically his lungs and liver were infiltrated with eosinophils.抄録全体を表示PDF形式でダウンロード (715K) -
佐藤 正, 酒井 一吉, 鈴木 重文, 七島 勉, 木村 秀夫, 松田 信, 内田 立身, 刈米 重夫1982 年 23 巻 12 号 p. 1902-1906
発行日: 1982年
公開日: 2009/01/26
ジャーナル 認証ありA 38-year-old male was admitted on June 1980 with 3 months history of marked anemia and malaise. The peripheral blood showed pancytopenia with a few immature granulocytes and erythroblasts. Bone marrow was hypercellular with erythroid hyperplasia and maturation block was prominent. Myeloid, erythroid and megakaryocytic elements showed various morphological abnormalities, and peroxidase negative neutrophils were frequently observed. A diagnosis of hemopoietic dysplasia was made. The ferrokinetic study and marrow scintigram suggested ineffective hematopoiesis with marked expansion. Absent colony formation and decreased colony/cluster ratio in CFU-C assay suggested abnormal clone in bone marrow. These stable hematological abnormalities continued until bone marrow blasts were increased up to 79.4% in August. Based on cytochemical findings, a diagnosis of acute myelomonocytic leukemia was made. He died of cerebral bleeding after antileukemic treatment in November. This case was discussed retrospectively relevant to preleukemic states.抄録全体を表示PDF形式でダウンロード (418K) -
—慢性期例および摘脾後急転例—前山 忠美, 内田 立身, 松田 信, 佐藤 正, 海野 政治, 七島 勉, 刈米 重夫, 吉田 博1982 年 23 巻 12 号 p. 1907-1911
発行日: 1982年
公開日: 2009/01/26
ジャーナル 認証ありTwo patients with priapism complicating chronic myeloid leukemia (CML) were reported. The first case, 27 years old male, splenectomized 8 months after a diagnosis of CML revealed blastic crisis with 43% of promyelocytes and myeloblasts in peripheral blood and marked infiltration of myeloblasts into skin and lymph nodes. Priapism was complicated the following day of the admission, which was treated by cavernous bypass operations. The second case, 26 years old male, was suffered from priapism at a diagnosis of CML chronic phase, who was also treated by bypass operation. Priapism is the rare complication at 1-2% of all male patients with CML, and we have never known the case complicating after blastic crisis splenectomized. It is suggested that this complication occurred as a results of sludging effects of leukemic cells accumulated in the corpora cavernosa and dorsal vein of the penis as is shown in Case 2.抄録全体を表示PDF形式でダウンロード (481K) -
名取 英世, 山口 達夫, 安田 佳織, 江上 康一郎, 田中 健, 加地 正郎, 笹栗 靖之1982 年 23 巻 12 号 p. 1912-1917
発行日: 1982年
公開日: 2009/01/26
ジャーナル 認証ありA 73-year-old man was admitted to the hospital because of nasal bleeding.
The hemoglobin value was 4.9 g/dl, white blood cell count 45300/cmm with 82% blasts of the myelomonocytic type. The platelet count was 74000/cmm. Bone marrow aspirations revealed 81.6% blasts of mylomonocytic type. Leukemic cells stained intensely possitive for α-naphthyl butylate and naphthol-AS-D-chloroacetate esterase or both, and were inhibited by the addition of sodium fluoride.
The serum lysozyme levels were 537 μg/ml, and the urine lysozyme levels 2024 μg/ml.
Coagulation abnormalities were prolonged prothrombin time, partial thromboplastin time, and hypofibrinogenemia.
He was diagnosed as acute myelomonocytic leukemia (AMMOL-M4) complicating with DIC, and was treated with DCMP and heparin. But he died of the respiratory distress three days after the admission.
At autopsy leukemic involvement was found in the bone marrow, lungs, liver, spleen, kidney, esophagus, stomach, intestine and lymph nodes. Organized thromboemboli (predominately fibrin and leukemic cells) were found in the lungs, stomach and klidneys.
In this patient, it was suggested that the destruction of leukemic cells caused a release of a thromboplastic substance.抄録全体を表示PDF形式でダウンロード (591K) -
松下 竹次, 山口 正司, 大網 弘1982 年 23 巻 12 号 p. 1918-1923
発行日: 1982年
公開日: 2009/01/26
ジャーナル 認証ありA case of a 8 years old boy with non-Hodgkin's lymphoma arising from left femur is reported. In this case, the relapse occured as a testicular invasion 2 years and 8 months and the patient died 4 years and 2 months later from the begining of the therapy.
The diagnosis in this case was not easy to differenciate from the Ewing's sarcoma and the electron microscopic study was important to make appropriate diagnosis.
The non-Hodgkin's lymphoma of bone is relatively rare as a extranodal type and not favourable prognosis at present.抄録全体を表示PDF形式でダウンロード (670K) -
桑原 哲夫, 坂本 文夫, 堀越 晴男, 檀 和夫, 厨 信一郎, 野村 武夫1982 年 23 巻 12 号 p. 1924-1929
発行日: 1982年
公開日: 2009/01/26
ジャーナル 認証ありA 53-year-old housewife presented jaundice persistent for at least 2 years. She had cholecystectomy for cholelithiasis at the age of 39 years. On examination the scleara was icteric, and the spleen extended 3 cm below the left costal margin. The blood count showed a Hb of 9.7 g/dl and a reticulocyte count of 4%. There was moderate anisocytosis but no poikilocytosis. The bone marrow was characterized by marked erythroid hyperplasia, numerous multinucleated erythroblasts, and frequent appearance of Gaucher-like cells containing PAS-positive needle-like inclusions. On electron microscopy, ‘double membrane structures’ were detected in the cytoplasm of mature erythroblasts. Granulocytes and platelets were normal numerically and morphologically. Erythrokinetic studies showed definite ineffective erythropoiesis and moderately shortened erythrocyte survival. The patient's erythrocytes were strongly agglutinated by both anti-I and anti-i sera.
Family study revealed that her sister, who underwent splenectomy with a diagnosis of hereditary spherocytosis 2 years previously, had the same abnormalities in the bone marrow. Her two brothers were also thought to have CDA type II since they had undergone cholecystectomy for cholelithiasis and had persistent jaundice.抄録全体を表示PDF形式でダウンロード (644K) -
大谷 敏嘉, 青山 雅, 江本 直也, 三崎 明実, 渕之上 眞澄, 片平 潤一, 押味 和夫, 溝口 秀昭, 平山 章, 渡辺 昌, 大川 ...1982 年 23 巻 12 号 p. 1930-1933
発行日: 1982年
公開日: 2009/01/26
ジャーナル 認証ありA case of T cell lymphoma with suppressor T cell phenotype and probable helper T cell function is reported.
A 60-year-old man was admitted to our hospital because of lymphadenopathy. Physical examination on admission revealed generalized lymphadenopathy and hepatosplenomegaly. The white-cell count in the peripheral blood was 12,700 with 50 per cent eosinophils. The protein was 8.1g per 100 ml with 2.6g per 100 ml γ-globulin. The hypergammaglobulinemia was polyclonal, and IgG was 3,420mg, IgA 918mg, IgM 688mg, per 100 ml and IgE 30,946 IU per ml. Biopsy of a lymph node revealed tumor cells, medium to small in size, and proliferations of branching capillaries and perivascular plasma cells. The diagnosis of immunoblastic lymphadenopathy (IBL)-like T cell lymphoma was made. Immunological examination of the lymph node lymphocytes showed 86.3 per cent ERFC, negative TdT, 19.3 per cent OKT 3+, 9.6 per cent OKT 4+ and 72.6 per cent OKT 8+, indicating that most cells had suppressor/cytotoxic phenotype. Helper function was shown in these T cells by the pokeweed mitogen (PWM)-added culture of normal B cells and the lymph node T cells. As far as we know, this is the first report on the case of T cell lymphoma with suppressor T cell phenotype and helper T cell function.抄録全体を表示PDF形式でダウンロード (313K)
例会
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1982 年 23 巻 12 号 p. 1934-1963
発行日: 1982年
公開日: 2009/01/26
ジャーナル 認証ありPDF形式でダウンロード (2862K)
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