巻号一覧
24 巻, 11 号
選択された号の論文の18件中1～18を表示しています
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綜説
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長尾 忠美, Castro-Malaspina, Hugo1983 年 24 巻 11 号 p. 1455-1463
発行日: 1983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 (769K)
臨床研究
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澤田 博義, 山岸 司久, 望月 敏弘, 石倉 浩人, 和泉 洋一郎, 朴 英薫, 和野 雅治, 臼井 忠男, 内野 治人, 稲本 康彦, ...1983 年 24 巻 11 号 p. 1464-1472
発行日: 1983年
公開日: 2009/01/26
ジャーナル 認証ありFive patients with atypical ANLL and a patient with RAEB, all aged persons, were treated with low dose of Ara-C, and complete remission was obtained in 4 patients.
Leukemic types of responders were as follows; a case with RAEB, a case with hypoplostic leukemia and two cases with acute myelocytic leukemias (both M 2 type, one was a relapsed AML case and the other was a untreated AML case). Non-responders were a case with acute monocytic leukemia (M 5 b type) and a case with acute myelocytic leukemia (M 1 type). Non-responders were shown to be older and have higher percentages of pathologic blasts in bone marrow than responders. In our cases there was usually severe pancytopenia in peripheral blood before complete remission was achieved.
We also mesured the concentration of Ara-C in serum, and found the maximum serum concentration of Ara-C was 52∼132ng/ml (mean 84.2ng/ml) at 15 min after the injection (10mg/M2 S.C.). The mechanism of action of such low dose of Ara-C with special reference to cell differentiation was discussed.抄録全体を表示PDF形式でダウンロード (568K) -
加藤 雅子, 白井 達男, 高橋 信夫, 山内 幹雄, 山口 了三, 木谷 信行1983 年 24 巻 11 号 p. 1473-1478
発行日: 1983年
公開日: 2009/01/26
ジャーナル 認証ありPolymorphonuclear leukocytes from 22 cases of the aged (age over 80) were analysed for their chemotactic activity, random mobility, phagocytic activity and NBT test, to evaluate whether the altered non-specific host defense mechanisms may be responsible for the susceptibility to infection in the aged. Results indicated that there were no significant change in both phagocytosis and NBT test compared to younger normal controls (age 20 to 35). As to neutrophil migration, although chemotactic activity was normal, the random mobility was significantly lower (p<0.001) by the agarose plate method.
And in all of the 3 cases which developed urinary infection on their clinical course, both chemotactic activity and random mobility, which were measured before the patients developed infection, were apparently depressed.
It is suggested that the susceptibility to infection in the aged could be attributed to their neutrophil dysfunction, especially the impairment of chemotaxis and random mobility.抄録全体を表示PDF形式でダウンロード (415K) -
設楽 利二, 栗林 俊夫, 大島 幸雄, 平石 友1983 年 24 巻 11 号 p. 1479-1483
発行日: 1983年
公開日: 2009/01/26
ジャーナル 認証ありTen children with acute lymphoblastic leukemia (ALL) in the first or multiple relapse were treated according to the multi-drug regimen (modified LSA2L2 protocol) Eight of the ten children (80%) obtained complete remission (CR) Of the eight children who achieved CR, seven had subsequent relapse, and one remained in continuous CR 14 months after the second remission induction. The duration of CR ranged from 4 to 15 months (mean 9.8+months).
The 50% survival length of the ten children was 24 months after the first bone marrow relapse, whereas it was only six months in the nine children who relapsed or failed after this protocol, implicating grave prognosis of those who had bone marrow relapse after intensive chemotherapy.
The complications include severe granulocytopenia less than 500/mm3 in nine of the ten children (90%), and thrombocytopenia less than 20,000/mm3 in three of the ten children (30%). One child died of pneumonia in CR during the consolidation phase.抄録全体を表示PDF形式でダウンロード (360K)
症例
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真栄田 篤彦, 佐々木 哲哉, 立花 直樹, 河内 暁一, 工藤 雄爾, 佐藤 雄一, 武部 幸侃, 横山 〓, 羽根田 敏1983 年 24 巻 11 号 p. 1484-1489
発行日: 1983年
公開日: 2009/01/26
ジャーナル 認証ありA 14-year old girl was diagnosed as anemia and treated with iron by a doctor in January of 1980. However, her anemia gradually increased and she had referred to our institution in June of 1980. Laboratory examination revealed a marked anemia with reticulocytosis. WBC and Platelet were slightly decreased. Cellular bone marrow with an increase in erythroblast was shown. It was not accompanied by any decrease of granuloid elements and megakaryocytes. Ham's test, sugar-water test and hemosiderinuria were positive. A decrease of acetylcholine esterase and low alkali phosphatase score were found in the RBC and WBC of the patient. Half life of RBC was shortened to 9 days. From these findings, she was diagnosed as PNH. Prednisolone showed a partial effect to improve hemolytic process. However, hemosiderinuria persisted through her hospital course and a decreasing dosis of the drug resulted in hemolytic attack. Bone marrow cells were cultured in a plasma clot or in soft agar in order to investigate hematopoietic precursor cells. CFU-C and CFU-E were markedly decreased. These findings may indicate that pathogenic changes occured not only in red cell membranes but also in hemopoietic stem cells in this disorder.抄録全体を表示PDF形式でダウンロード (457K) -
毛利 博, 荻原 昭二, 森 啓, 松野 一彦, 新倉 春男, 寺田 秀夫1983 年 24 巻 11 号 p. 1490-1494
発行日: 1983年
公開日: 2009/01/26
ジャーナル 認証ありA 49-year-old male diagnosed as Ph1 positive CML on January 1979, had been treated with carboquone (0.5∼1.5mg/day). He was again admitted to our hospital because of high fever, general fatigue and ishias-like pain on March 1981.
Peripheral blood examination revealed marked leukocytosis (WBC 204,000/μl) with 2% myeloblasts and 2.5% promyelocytes. Bone marrow aspiration showed hypercellular marrow with 2.7% myeloblasts, and 19.3% atypical cells recognized erythrophagocytosis. These atypical cells were positive for PAS activity with coarse granules, non-specific esterase activity and acid phosphatase activity, and negative for peroxidase activity and TdT activity. Cytogenetic analysis of peripheral blood cells revealed a karyotype of 46 XY, t_(9; 22), and that of bone marrow cells consisted of a karyotype of 46 XY, t (9; 22) and those of 41∼46 XY with marker chromosomes.
Though 6-MP, vincristine, or combination chemotherapy (CHOP) was instituted, no effect was obtained. On July 21, 1981, he died of sepsis and acute renal failure.抄録全体を表示PDF形式でダウンロード (535K) -
—臨床経過に伴う胎児型ヘモグロビン(Hb F)のGγ鎖優位からAγ鎖優位への変換—伊藤 俊晴, 寺沢 崇, 葛西 四朗, 鈴木 仁1983 年 24 巻 11 号 p. 1495-1502
発行日: 1983年
公開日: 2009/01/26
ジャーナル 認証ありA one-year five-month old male demenstrated the typical clinical and laboratory features of juvenile chronic myelogenous leukemia (J-CML), including massive hepatosplenomegaly, generalized lymphoadenopathies, thrombocytopenia, low neutrophil alkaline phosphatase activity, absence of Philadelphia chromosomes (Ph1), and a markedly elevated level of fetal hemoglobin (Hb F).
We reported here the clinical course examination of the relative rates of Gγ and Aγ globin chains of Hb F in the peripheral blood of a patient with J-CML. Globin chains were separated by isoelectric focusing (IEF) and quantitated by densitometric tracings. The ratios of Gγ/(Gγ+Aγ) on admission, 17, 24 and 38 hospital day revealed 0.66, 0.61, 0.54 and 0.46, respectively. The compositions of γ chains of Hb F in the patient peripheral blood switched from fetal blood to adult blood pattern during clinical course.
The results of our study may suggest that the level of Hb F in J-CML is controlled and expressed, not by a true reversion to the fetal erythropoiesis programs, but by the disorganized and incomplete developmental programs (malignant changes).抄録全体を表示PDF形式でダウンロード (590K) -
蓮沼 桂司, 王 伯銘, 遠藤 伸行, 中村 博敏, 安 徳純, 伊藤 国明, 浅井 隆善, 藤岡 成徳1983 年 24 巻 11 号 p. 1503-1508
発行日: 1983年
公開日: 2009/01/26
ジャーナル 認証ありA 68-year-old female patient was admitted because of severe anemia. Physical examination revealed anemia, papillary atrophy of tongue, systolic heart murmur and ecchymosis. Peripheral blood examination showed pancytopenia; RBC 154×104/cmm, Hb 6.1g/dl, MCV 114 fl, WBC 1,900/cmm, and platelet count 4.4×104/cmm. Erythroblasts and hypersegmented neutrophils were observed in the smear of pripheral blood. Bone marrow study revealed megaloblastic changes in the erythroid series and also myeloid series, with 18% plasma cells. The laboratory data, such as the low VB12, normal folic acid, high LDH, positive Schilling test, anti-intrinsic factor antibody, and achlorhydria, supported the diagnosis of pernicious anemia. The total protein was 9.7 g/dl. M-component (IgG-λ) was detected in serum in γ-region by immunoelectrophoresis. Bence Jones protein in urine was negative. Radiologic examination of the bone revealed no abnormality.
By the treatment of VB12, improvement of anemia and disappearance of megaloblasts in the bone marrow were observed. There was no significant change in the level of M-component in serum or the percentage of plasma cells in the bone marrow during 19 months, although slight change in plasma cells was noted morphologically. The hypergammaglobulinemia may be of benign type, but possibility of myeloma still remains.
About thirty cases of pernicious anemia in association with monoclonal hypergammaglobulinemia have been reported in the world. In our coutry, this is the second case.抄録全体を表示PDF形式でダウンロード (451K) -
—白質脳症との関連において—秋山 祐一, 大久保 雄二郎, 奥野 武彦, 三河 春樹, 太田 茂1983 年 24 巻 11 号 p. 1509-1513
発行日: 1983年
公開日: 2009/01/26
ジャーナル 認証ありA child of Acte Lymphocytic Leukemia with seizures and mental retardation which developed gradually during and after maintenance chemotherapy is reported.
This child received only 1940 skull irradiation and five doses of intrathecal methotrexate and never had intravenous nor intrathecal methotrexate during maintenance chemotherapy.
The etiology of neurological impairment in this case was discussed with special reference to leukoencephalopathy. A need for national wide research on grave neurological sequalae in chemoradiotherapy of childhood ALL was stressed.抄録全体を表示PDF形式でダウンロード (400K) -
中野 優, 黒須 知二, 潮平 優, 重福 英俊, 森 真爾, 大戸 隆明, 古明地 孝, 田中 邦生, 伊藤 健次郎, 長村 重之1983 年 24 巻 11 号 p. 1514-1520
発行日: 1983年
公開日: 2009/01/26
ジャーナル 認証ありA case of Hodgkin's disease with bone marrow involvement and variegated haemophagocytosis in the terminal stage is reported.
A 47-year-old man was admitted because of high fever, perspiration and dry cough for the third time after CHOP therapy based on pathological diagnosis of Hodgkin's disease of mixed cellularity by cervical lymph node biopsy with clinical stage I-B on the first admission and VEMP therapy on the second admission with the progression of clinical stage to III-B.
Physical examination on the third admission revealed marked hepatomegaly with severe hepatic dysfunction, and the clinical stage was diagnosed as IV-B.
His clinical condition was temporarily improved by VEMP therapy, but pneumonia was induced by pancytopenia with the appearance of abnormal cells in the peripheral blood. Bone marrow aspiration just before death disclosed an infiltration of Hodgkin's cells or Reed-Sternberg's cells, and in addition, marked haemophagocytosis characteristic of this case, namely, active phagocytosis of erythroblasts, myelocytes, metamyelocytes, mature neutrophils and thrombocytes by mononuclear or polynuclear atypical macrophages.
This haemophagocytosis is reminiscent of malignant histiocytosis which is a malignancy of macrophage, and a macrophage origin of Hodgkin's cells or Reed-Sternberg's cells was suggested in this case.抄録全体を表示PDF形式でダウンロード (674K) -
新名主 宏一, 岡留 敏秀, 丸山 征郎, 井形 昭弘1983 年 24 巻 11 号 p. 1521-1527
発行日: 1983年
公開日: 2009/01/26
ジャーナル 認証ありWe presented a case of abdominal aortic aneurysm associated with chronic consumption coagulopathy and cerebral hemorrhage.
A 70-year-old man was admitted with a 9-months' history of spontaneous ecchymoses and an episode of cerebral hemorrhage. On physical examination mild mental deterioration, emotional lability, right hemiparesis, petechiae on arms, mild acrocyanosis, weakened pulsation of pedal arteries and a pulsatile abdominal mass were noted. Ultrasonography revealed a large dissecting abdominal aortic aneurysm with multiple intraluminal thrombi. The surface scanning after intravenous injection of 125I-human fibrinogen demonstrated an increased accumulation of the radioactivity over the aneurysm. No maliganant diseases were disclosed by extensive investigations.
Coagulation studies revealed moderate thrombocytopenia, markedly impaired aggregation responses to ADP and collagen, moderately increased levels of plasma β-thromboglobulin and FDP, mild prolongation of prothrombin time and activated partial thromboplastin time, moderately decreased level of fibriongen with markedly shortened survival T1/2, mildly to moderately decreased levels of various coagulation factors, plasminogen, α2-plasmin inhibitor and antithrombin III, and markedly increased levels of plasma factor VIII related antigen and factor VIII related von Willebrand factor activity.
A diagnosis of consumption coagulopathy associated with abdominal aortic aneurysm was made and treated successfully by continuous intravenous infusions of small dose of heparin, with rapid improvement of above coagulation abnormalities except for a markedly high level of plasma factor VIII related antigen.
The pathogenetic mechanisms of consumption coagulopathy and its relationship with cerebral hemorrhage were discussed.抄録全体を表示PDF形式でダウンロード (597K) -
神林 裕行, 岩谷 恭子, 吉田 博, 松本 秀一, 鈴木 照夫, 熊野 仁昌, 松田 信, 内田 立身, 刈米 重夫, 阿部 正文1983 年 24 巻 11 号 p. 1528-1533
発行日: 1983年
公開日: 2009/01/26
ジャーナル 認証ありAn unusual case of immunoblastic lymphadenopathy (IBL) like T cell lymphoma with a rare clinical course is reported. A 47 year-old man was admitted to the hospital because of fever and general lymph-node swelling. On admission, physical examination revealed edema of hands and inferior extremities, splenomegaly, muscle pain, night sweats and diffuse skin rash. Laboratory examination showed leukocytosis with relative lymphocytopenia (atypical lymphocyte 2%), polyclonal hypergammaglobulinemia and elevated anti-herpes simplex virus titer. A lymphnode biopsy specimen exhibited the typical histologic picture of IBL like T cell lymphoma. The tumor cells formed E-rosette but not EAC-rosette. In peripheral blood, suppressor/cytotoxic T cell was increased. This case was observed without any chemotherapy, but it showed spontaneous remission after about seven weeks. Duration of complete remission was continued during about one year.抄録全体を表示PDF形式でダウンロード (488K) -
深山 牧子, 村井 善郎, 池淵 研二, 三輪 哲義, 倉田 寛一, 森 真由美1983 年 24 巻 11 号 p. 1534-1538
発行日: 1983年
公開日: 2009/01/26
ジャーナル 認証ありA case of acute polyradiculoneuritis with thrombocytopenia after rubella infection is reported. On April 20 1982, a 32-year-old woman sufferd from rubella infection. When rash dissapeared, progressive weakness and numbness in the extremities developed. She was taken to a hospital, and labolatory findings showed no abnomalities except hemoglobin 8.0 g/dl and platelet count 90,000/cmm. The diagnosis of acute polyradiculoneurtis was made, and she was treated with prednisolone, starting 40 mg/any. On 2nd June, she was transfered to our hospital. On neurological examination, there noted profound quadri-paresis with muscle atrophy. All sensation were diminished in the distal extremities. The CSF showed 4/3 (L 3, N 1), protein level 83.2 mg/dl. At the same time laboratory studies showed a platelet count of 3,700/cmm, with a hemoglobin value of 9.0 g/dl. The WBC count 5,200 and a bone marrow aspiration disclosed numerous megakaryocytes. The diagnosis of idiopathic thrombocytopenic purpura was added. Despite the therapy of prednisolone, γ-globulin and immunosupressant, it was not improved. As for acute polyradiculoneuritis she showed substantial recovery by October.抄録全体を表示PDF形式でダウンロード (386K) -
気賀沢 寿人, 豊田 泰徳, 花田 良二, 飯塚 敦夫, 西平 浩一, 長尾 大1983 年 24 巻 11 号 p. 1539-1543
発行日: 1983年
公開日: 2009/01/26
ジャーナル 認証ありAllogeneic bone marrow transplantion was performed for a 7-year-old girl with severe aplastic anemia from a 10-year-old brother with success. Although CFU-C in her bone marrow was not detected before grafting, the number of CFU-Cs increased to 84/2×105 marrow cells on day 12 in spite of severe bone marrow hypoplasia. The incidence of CFU-Cs was raised slowly and normalized after cessation of methotrexate iv.
CSA in serum was high before grafting and decreased with recovey of neutrophils, but it was still detectable on day 116. BPA (burst promoting activity) in serum was also high before grafing and was detectable on day 15. However it was not detected on day 50 when reticulocytes increased and blood transfusions were not needed.抄録全体を表示PDF形式でダウンロード (332K) -
松野 一彦, 田中 一正, 西山 博明, 寺田 秀夫1983 年 24 巻 11 号 p. 1544-1548
発行日: 1983年
公開日: 2009/01/26
ジャーナル 認証ありA-63-years-old housewife was admitted to our hospital complaining of fever and general fatigue. On physical examination systenic lymphadenopathy and hepatosplenomegaly were present, and crepitant rales and sibilant brhonchi were audible throughout the entire lung fields. She had anemia, thrombocytopenia, and leucocytosis with leukemoid reaction and plasmacytoid lymphocyte. She showed a polyclonal hypergammaglobulinemia, positive direct Coombs test, positive anti-toxoplama antibody, hypocomplementemia and Bence-Jones proteinuria.
She died of respiratory failure revealing bilateral interstitial infiltrates on chest roentgenogram, in spite of adrenocorticoid therapy. A diagnosis of immunoblastic lymphadenopathy was made by histopathology of lymphnode. The white cell counts was elevated to 6,2650/μl with a differential count of 44.5% plasmacytoid lymphocyte (socalled immunocyte and immunoblast), and examination of bone marrow imprints disclosed an abnormal increase in immunocyte and immunoblast up to about 80%.
These data shows that her termial state appears to be leukemic phase of immunoblastic lyphadenopathy. And her prominent hypocomplementemia suggests that complements were consumed by immune mechanism in immunoblatic lymphadenopathy.抄録全体を表示PDF形式でダウンロード (517K)
地方会
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1983 年 24 巻 11 号 p. 1549-1553
発行日: 1983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 (504K)
第24回総会
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1983 年 24 巻 11 号 p. 1563-1594
発行日: 1983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 (3269K) -
1983 年 24 巻 11 号 p. 1595-1632
発行日: 1983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 (3869K)
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