巻号一覧
24 巻, 3 号
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臨床研究
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—Colman法エンザイム・インヒビターおよびC1INAとの比較—羽根田 やえ子, 伝法 陽子, 千葉 陽一, 吉田 豊1983 年 24 巻 3 号 p. 225-231
発行日: 1983年
公開日: 2009/01/26
ジャーナル 認証ありPlasma kallikrein inhibitor was measured by evaluating the inhibitor activity of patients' plasma towards purified human plasma kallikrein (KABI Co.) using a chromogenic substrate S2302. And the values were compared with that of enzyme inhibitor measured by R. Colman's method in various diseases.
Normal range of kallikein inhibitor was 100±7.0% (n=5). The value was low as 61.4±8.8% (n=5) in decompensated liver cirrhosis and it was normal in compensated liver cirrhosis. It was elevated in most of the hematological malignancies except some patients with severe liver damage and of agonizing state.
The discrepancy between the kallikrein inhibitor and the enzyme inhibitor was observed in hematological malignancies, i.e. this showed low value of the enzyme inhibitor.
A good correlation between kallikrein inhibitor and C1INA was observed (r=0.590, n=37). In some cases lowering of the kallikrein inhibitor was observed while the level of C1INA was normal.抄録全体を表示PDF形式でダウンロード (439K) -
留奥 誠, 久藤 真, 津田 雅之, 長野 正, 和田 英夫, 村嶋 正幸, 伊藤 質, 出口 克巳, 白川 茂1983 年 24 巻 3 号 p. 232-241
発行日: 1983年
公開日: 2009/01/26
ジャーナル 認証ありIn the past 15 years, seven hemophilic patients have undergone 8 major surgical procedures in the general surgery (for appendicitis, gastric ulcer, early gastric cancer and retroperitoneal pseudotumor), neurosurgery (for intracranial hemorrhage) and urology (for 1-ureter stone) at Mie University Hospital.
No abnormal bleeding was experienced during operation under sufficient substitution therapy in these cases. However, postoperative hemorrhage was observed in 3 cases when the dosis of antihemophilic agents was reduced. This suggested that the prolonged postoperative substitution therapy was important to avoid late hemorrhage.
In a case with acute abdomen, CT scan provided helpful diagnostic information to differentiate bleeding from inflammation.
In the 2 cases with CNS trauma, the initiation of substitution therapy was delayed 6 hours in one and 48 hours in the other after trauma, because symptoms had been absent until then. Unfortunately, one of them could not be helped in spite of intensive care. These patients should have received immediate and sufficient replacement therapy, and its necessity in such cases should be fully recognized not only by physicians but also by patients.
Side effects observed during sufficient substitution therapy were hemolytic anemia in hemophilia A by factor VIII concentrate and DIC in hemophilia B by prothrombin complex concentrate. Therefore, careful observation of clinical picture and laboratory findings with particular attention to these complications is required in the prolonged postoperative substitution therapy.抄録全体を表示PDF形式でダウンロード (755K) -
松田 正, 野村 豊樹, 駒田 幹彦, 渥美 伸一郎, 山本 初実, 川崎 肇, 数岡 一吉, 清水 信, 川村 芳秋, 神谷 斎, 桜井 ...1983 年 24 巻 3 号 p. 242-248
発行日: 1983年
公開日: 2009/01/26
ジャーナル 認証ありThe incidence of cytomegalovirus (CMV) infection has recently increased in children with malignant diseases receiving intensive chemotherapy. 5 children with acute lymphoblastic leukemia and 1 child with malignant histiocytosis developed CMV infection among 30 children who received induction chemotherapy during the last one year in our hospital. All cases showed marked rise in CMV CF-titer following clinical symptoms, such as persistent high fever, cough, liver dysfunction, anemia, pneumonitis, et al. In two cases, CMV was successfully separated in saliva and urine. High fever continued for 14 to 30 days. Abnormalities in liver function test appeared early, and roentgenographic findings for pneumonitis were found relatively late. Autoimmune hemolytic anemia occurred in two children. In three cases of our patients, CMV infection occurred 3 to 4 weeks after initiation of chemotherapy. From the immunological aspect, neutropenia, lymphocytopenia and serum γ globulin levels were not correlate to the host predisposition to CMV infection, but interestingly skin test with varicella virus antigen was negative among all three children who had anamnestic infection of natural varicella.抄録全体を表示PDF形式でダウンロード (514K) -
高橋 薫, 桜川 信男, 小出 武比古1983 年 24 巻 3 号 p. 249-255
発行日: 1983年
公開日: 2009/01/26
ジャーナル 認証ありDeficincies and abnormalities of antithrombin III (AT III) are considered to be the very important pathogenesis of thrombosis. We have reported abnormal antithrombin III (AT III-Toyama), in ICTH (Toronto) in 1981. In our case the proband, 23 years-old female, happened to have cerebral thrombosis 5 days after the exploratory laparotomy performed to identify her abdominal tumor, and she experienced a transient and extreme thrombocytopenia at that time. In order to identify the cause of this thrombocytopenia, we investigated the platelet function of this family and found that the sensitivities of this family's platelets against ADP, collagen, epinephrine and thrombin were not significantly different from those of normal persons. And the suppressive effect of heparin against thrombin induced platelet aggregation of her platelet also was found to be almost normal. Therefore, the thrombocytopenia occurred at the time of apoplexy attack is considered to be caused not by the hypersensitivity of her platelet but by the defect of the patient's AT III to neutralize thrombin generated in her plasma.抄録全体を表示PDF形式でダウンロード (500K)
症例
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森 和夫, 比佐 静枝, 鈴木 宗三, 菅井 浩二, 酒井 秀章, 樋渡 信夫, 菊地 孝夫, 宍戸 洋, 後藤 由夫, 高橋 孝1983 年 24 巻 3 号 p. 256-262
発行日: 1983年
公開日: 2009/01/26
ジャーナル 認証ありThe patient is a 14 year old boy, who admitted to our Department because of severe hemorrhagic diathesis and oliguria following a bite by Rhabdophis tigrinus. He had a snake bite on the 5th finger of right hand on September, 28, 1980. After 9 hrs, he noticed the bleeding at the sites of snake bite and gingiva. On the next day, he developed nasal, gastrointestinal, petechial and subcutaneous bleeding and hematoma 2 days later, and macroscopic hematuria 3 days later.
Hemostatic examinations revealed complete incoagulability of whole blood clotting time, partial thromboplastin time, prothrombin time, serial thrombin time, and decreased amount of fibrinogen and elevated level of FDP. However, platelet count increased up to 50×104/mm3 at about 30 hrs after the snake bite. About 34 hrs after the first examination, platelet count decreased to 2.3×104/mm3, and at this time a diagnosis of disseminated intravascular coagulation (DIC) syndrome was made. As antiserum against this snake venom was not available, exchange blood transfusion was performed. His clinical feature and the hemostatic function were recovered well on the following days, while chronic renal failure has been persisted for several months.
From above results, the exchange blood transfusion is favorable therapy in order to exclude the snake venom from the blood circulation.抄録全体を表示PDF形式でダウンロード (465K) -
久保 明美, 那須 芳, 北 堅吉, 福原 資郎, 笹田 昌孝, 錦織 優, 内野 治人, 中村 徹, 有吉 秀生1983 年 24 巻 3 号 p. 263-270
発行日: 1983年
公開日: 2009/01/26
ジャーナル 認証ありWe experienced a concurrence of adult T-cell lymphoma in father and daughter.
A 34 year-old woman born in Ehime Prefecture developed inguinal lymphadenopathy in March, 1981. The diagnosis of diffuse lymphoma (plemorphic type) was made by the biopsies which were done at her right inguinal lymph node in April, and at right axillary lymph node in May, 1981. Lymphoma cells had T-lymphocyte surface markers [T 101 (+), OKT3 (+), OKT4 (+), sIg (-), TdT (-)], but ERFC was negative in lymphnode suspension. In spite of strong chemotherapy, radiotherapy and immunotherapy, she died in January, 1982.
Her father born in Ehime Prefecture was 68 years old. In April, 1981, he developed cervical lymphadenopathy and was died in October, 1981. Right cervical lymph node biopsy revealed diffuse lymphoma (medium-sized cell type) which was highly suspected to be T-cell lymphoma. His clinical findings and clinical course supported the diagnosis of adult T-cell lymphoma.
Anti ATLA antibody titer was positive in her (×40), her husband (×20) and her mother (×40). Her father was not examined anti ATLA antibody, and her other siblings and her children were negative (<×10).
It is a interesting case for studying the etiology of adult T-cell lymphoma.抄録全体を表示PDF形式でダウンロード (1391K) -
岡本 真一郎, 中沢 肇, 大西 祥平, 半田 俊之介, 中村 芳郎, 外山 圭助1983 年 24 巻 3 号 p. 271-275
発行日: 1983年
公開日: 2009/01/26
ジャーナル 認証ありTransient pure red cell aplasia was observed in a 38 years old woman after one month administration of α-methyl-DOPA (Aldomet 375 mg/day). Discontinuation of Aldoment brought about recovery of normal erythropoiesis. In this patient, patient's serum did not inhibit the normal erythropoiesis, but patient's peripheral mononuclear cells had a suppressor activity for BFU-E of normal human peripheral blood. It was assumed that in this patient the circulating peripheral mononuclear cells play a pathognomonic role for transient pure red cell aplasia by their suppressing activity on the proliferation of erythroid precurser (BFU-E), and Aldomet may contribute to the presence of such suppressive peripheral mononuclear cells.抄録全体を表示PDF形式でダウンロード (412K) -
山口 一成, 西村 弘道, 松岡 雅雄, 宮本 祐一, 服巻 勝正, 向坂 健男, 高月 清1983 年 24 巻 3 号 p. 276-280
発行日: 1983年
公開日: 2009/01/26
ジャーナル 認証ありA 49-year-old man, born in Saga Prefecture, had been suffering from skin lesions (erythroderma, solar dermatitis) since he first noted an erythema in 1966. He was admitted to the hospital because of skin lesions and proteinuria in 1977. He had inguinal lymph node swelling without hepatosplenomegaly. A white cell count was 7,800 with 2% abnormal lymphocytes. Histologic examination of biopsy specimens of lymph node and erythrodermic skin showed slight infiltration of abnormal lymphocytes in eacho rgan.
In September 1979, he was admitted to the hospital because of renal failure, and received hemodialysis. Hemoglobin concentration was 7.9 g/dl, and white cell count 12,700/cmm with 24% abnormal cells. Despite treatment, he died of renal insufficiency and cerebral hemorrage in August 1981. Autopsy showed lymph nodes, skin, liver, spleen and bone marrow infiltrated with small abnormal lymphocytes.
The clinical course of this patient was “smoldering”. He developed typical ATL after more than 13 years of illness, and died of renal insufficiency.抄録全体を表示PDF形式でダウンロード (603K)
例会
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1983 年 24 巻 3 号 p. 281-302
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 (2133K)
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