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Volume 25, Issue 1
Displaying 1-15 of 15 articles from this issue
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[in Japanese]1984 Volume 25 Issue 1 Pages 1-8
Published: 1984
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSDownload PDF (663K)
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III. Relationship between α-glycoprotein and the Suppressor Function of MonocytesTadao FUNATO, Yoshihiko WATANABE, Masatoshi HAYASHI, Asao KOIDE, Yasus ...1984 Volume 25 Issue 1 Pages 9-16
Published: 1984
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSThe monocytes in 18 out of 31 patients with multiple myeloma were found significantly to inhibit the capacity of B lymphocytes to mature into immunoglobulin-secretory cells. The present study deals with relationship between α-glycoprotein and the suppressor function of monocytes. In the case with monocytes which have suppressor function serum α2-macroglobulin (α2M) was significantly decreased. In addition, the α2M-secretory cells of monocytes were also decreased. On the other hand, these were no significant changes of serum α2M and the α2M-secretory cells of monocytes in cases with multiple myeloma without the suppressor function of monocytes and in benigh monoclonal gammopathy. It was suggested from these findings that the suppressor function of monocytes might be related to the decreased secretion of α2M.View full abstractDownload PDF (514K) -
Ken-ichi SAWADA, Shoki SAKURAMA, Yoshinori KOYANAGAWA, Masataka DENO, ...1984 Volume 25 Issue 1 Pages 17-24
Published: 1984
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSWe studied CFU-E colony in a case of pure red cell aplasia by the plasma clot method in the autologous system.
The following results were obtained:
(1) Both CFU-E colony from bone marrow buffy coat and bone marrow mononuclear cells markedly decreased in the active phase.
(2) In the convalescent phase, CFU-E colony from bone marrow buffy coat cells came to normal range, but CFU-E colony from bone marrow mononuclear cells remained at low level.
(3) CFU-E colony from bone marrow mononuclear cells in the convalescent phase returned to normal when T cells were depleted from mononuclear cells.
(4) The coculture between bone marrow buffy coat cells and peripheral T cells resulted in reduction in CFU-E colony.
On the basis of these findings, it was concluded that CFU-E colony suppressing T cells might play a role, at least in part, in the development of anemia of pure red cell aplasia.View full abstractDownload PDF (591K) -
Shizuyo KUSUMI, Makoto KOBAYASHI, Noboru TAKATA, Fumio IMANAKA, Shuji ...1984 Volume 25 Issue 1 Pages 25-30
Published: 1984
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSA 37 year old male patient with pain in the lower abdomen and in the left lower extremity is presented. His anti thrombin III activity determined by chromogenic substrate was 47% and the antigen level measured by single radial immunodiffusion was 12.5 mg/dl. He was diagnosed as congenital AT III deficiency (Nagy type I). His family is considered to be the 14th famiy with AT III deficiency trait in Japan.
For treatment, AT III concentrate was administered (Green Cross Co. Lot No. 016 GE) in order to prevent the development of thromboembolic episodes in the left lower extremity and favorable improvement of both clinical and laboratory findings was observed, with the following results.
(1) The recovery rate of AT III in the circulation at 15 min after infusion was 87% when it was injected singly and 98% when injected with heparin and warfarin (2 mg/day).
(2) The maximum correction of the coagulation and fibrinolytic systems appeared three days after administration of AT III alone, but in one hour when administered together with heparin. Administration of AT III together with heparin was more rapid and effective in preventing thromboembolism in AT III deficiency. By maintaining the AT III level over 60% with warfarin at 2∼3.5 mg/day, the recurrence of thrombosis could be prevented.
(3) The half life of AT III was 3.5 days without heparin and 1.7 days with heparin.
(4) Administration of 96×104 units of UK led to the improvement of thrombotic symptoms. However, after injection of UK we observed fall in AT III level by 11% and in antigen level by 2.6 mg/dl in addition to the fall in α2-antiplasmin.View full abstractDownload PDF (424K) -
—Effect of Introduction of Facter VIII Concentrate—Seiji KOJIMA, Tsutomu TONOUCHI, Miyako IKEGAYA, Junichi MIMAYA1984 Volume 25 Issue 1 Pages 31-36
Published: 1984
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSRecent advances in hemophilia therapy include the introduction of Facter VIII concentrate, that of home therapy programs, and prophylactic treatment. The purpose of this study is to determine whether these changes had an effect on the incidence of the chronic liver dysfunction in patients with hemophilia A.
Liver dysfunction and exposure to hepatitis B virus were studied in 36 patients with hemophilia A who received Facter VIII concentrate during the period of 1981 to 1982. As a control, a retrospective survey on liver dysfunction and exposure to hepatitis B virus was done in 19 patients with hemophilia A who received only lyophilized cryoprecipitate before the introduction of Facter VIII concentrate during the period of 1977 to 1979.
In the former group, HBV marker was found in 87% of patients and 33% of them had chronic liver enzyme abnormalities. HBV marker was found in 95% of the patients in the latter group and 21% of them had chronic liver enzyme abnormalities. There was no statistically significant difference in the rate of exposure to HBV and the incidence of chronic liver dysfunction between the two groups.
The incidence of chronic liver dysfunction was correlated with patient age, and somewhat less correlated with the total amount of Facter VIII concentrates infused.View full abstractDownload PDF (450K) -
Kenji NIIYA, Masaaki MITANI, Takao KITAGAWA, Kenji YAMATO, Masatoshi F ...1984 Volume 25 Issue 1 Pages 37-44
Published: 1984
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSThe incidence of deficiency of vitamin K-dependent coagulation factors has recently increased in patients receiving broad-spectrum antibiotics. We had three adult cases of deficiency of vitamin K-dependent coagulation factors for the last one year. The vitamin K-deficiency developed from poor dietary intake and concomitant administration of several broad-spectrum antibiotics in cases 1 and 2 and from intractable self-induced vomiting and purging in case 3. The abnormal prothrombin was demonstrated in the plasmas of all three cases by antigen-antibody crossed immunoelectrophoresis using barbital buffer containing calcium ion. In case 3 the discrepancy between the plasma prothrombin coagulant activity and antigen was demonstrated by serial examination after intravenous administration of vitamin K1. The plasma taken 21 hours after intravenous administration of 30 mg of vitamin K1 contained a significant amount of abnormal prothrombin but the thrombotest, plasma prothrombin time and activated partial thromboplastin time were almost within normal limits. The present results indicated that the deficiency of vitamin K-dependent coagulation factors is not rare in patients with poor or no dietary intake and concomitant treatment of antibiotics.View full abstractDownload PDF (773K) -
Mine HARADA, Shinji NAKAO, Mikio UEDA, Kunio KONDO, Kazuaki ODAKA, Shi ...1984 Volume 25 Issue 1 Pages 45-51
Published: 1984
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSEleven patients with acute leukemia received allogeneic bone marrow transplantation from ABO incompatible donors; 7 with major ABO incompatibility and 4 with minor ABO incompatibility. For major ABO incompatible bone marrow transplantation, incompatible erythrocytes were depleted from the donor's bone marrow infusate by using the Ficoll-Hypaque method in 4 patients while anti-ABO antibodies were removed from the recipient by plasma exchanges prior to transplantation in the remaining 3 patients. Both techniques were effective to prevent the risk of hemolysis due to ABO incompatible red cell transfusions. Despite the presence of high anti-ABO antibodies, engraftment was confirmed in the recipients who received mononuclear bone marrow cells isolated by the Ficoll-Hypaque method, which were enriched with hematopoietic stem cells. Emergence of the donor type red cells was documented 16∼43 days after transplantation in all of 3 evaluable patients. Erythrocyte depletion of the marrow inoculum is relatively simple and effective method for bone marrow transplantation from major ABO incompatible donors. Although repeated exchanges of large volume plasma are effective to reduce anti-ABO antibody titers for the prevention of acute hemolytic transfusion reaction, the procedure is time-consuming and is associated with risks such as viral hepatitis, anticoagulant toxicity and platelet decrements. Compared with minor ABO incompatible bone marrow transplantation, relatively delayed hematologic recovery was observed in patients who received major ABO-incompatiple erythrocyte-depleted bone marrow.View full abstractDownload PDF (514K)
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Kunio TANAKA, Kozo TAKASE, Shuji TAKAGI, Tastuo HANDA, Makoto INADA, Y ...1984 Volume 25 Issue 1 Pages 52-56
Published: 1984
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSA case of Philadelphia chromosome (Ph1) positive acute lymphoblastic leukemia is reported. The patient was 11 year old boy, who was admitted on Decemper 18, 1980 to out hospital with the chief complaints of fever and nasal bleeding. Physical examination showed moderate hepatosplenomegaly and petechiae. Laboratory examinations on admission revealed remarkable leukocytosis (174,000/mm3) with 90% of lymphoblasts in peripheral blood in adittion to thrombocytopenia. Blastic cells were Peroxidase negative, PAS negative and morphologically seemed to belong to L2 type ALL. Chromosomal study on peripheral plood cells showed that lymphoblasts had an abnormal karyotype of 46, XY, 1p+q-, t(9;22) (q34;q11). The patient reached a complete remission by the induction therapy consisted of VCR (1×/W ×5), L-asparaginase (every other day ×8) and prednisolone. He was given intrathecal injection of methotrexate and cranial irradiations of 2,400 rads as the prophylaxis of meningeal leukemia. Philadelphia chromosome was lost during remission. A hematological relapse occured soon after the completion of cranial irradiation and Ph1 chromosome became to be detected again. He received the re-induction therapy, for example, COAP, Asp-VDP and AAAP therapy, but failed to reach a remission. He became febrile with septicemia and died on August 17, 1981. At autopsy, infiltration of leukemic cells was seen in the bone marrow, lymphnodes, testicles, kidney, liver and spleen.View full abstractDownload PDF (875K) -
Yoichiro IZUMI, Hiroshi KONISHI, Toshihiro MOCHIZUKI, Hiroto ISHIKURA, ...1984 Volume 25 Issue 1 Pages 57-62
Published: 1984
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSA case of ALL, complicated with pancreatic pseudocysts following a remission induction therapy including l-asparaginase was reported.
A 44 years old man had been febrile since April, 1980. A diagnosis of ALL (FAB: L2) was established and VP therapy was begun in July. Thereafter he had been in remission. In January, 1981, he relapsed and was admitted to our hospital. A remission induction chemotherapy by vindesine, prednisolone, and l-asparginase which was administrated by drip intravenous infusion daily, was started on 31st of January. On 7th of February, slight epigastralgia developed and became severe. S-, and u-amylase were markedly elevated and he was diagnosed as acute pancreatitis probably caused by l-asparaginase. About 3 weeks after, epigastrial tumor was palpable and gradually grew in size. Severe abdominal pain developed again. CT-scan and abdominal ultrasonography revealed multiple pancreatic pseudocysts. In May, he underwent cystojejunostomy. But he became worse in general conditions and died of sudden cardiac arrest on 27th of July.
Among major toxicities of l-asparaginase, acute pancreatitis as well as anaphylaxis may be lethal. From our experience, it is thought to be important that early diagnosis of l-asparaginase-induced acute pancreatitis must be made with great attention by frequent measurement of s-, and u-amylase and weekly abdominal ultrasonography.View full abstractDownload PDF (682K) -
Kazuo MIMURA, Teruhisa OTSUKA, Yoshiyuki NIHO, Akira YAMADA, Kohei NAG ...1984 Volume 25 Issue 1 Pages 63-68
Published: 1984
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSA case of eosinophilic-basophilic meningitis which developed during treatment of CML was reported.
A 30 year old man developed severe headache, fever, followed by delirium state.
Lumbar puncture revealed marked eosinophilia and basophilia with lymphocyte-like mononuclear cells in the cerebrospinal fluid. Meningeal symptoms were relieved by the intrathecal administration of methotrexate, cytosine arabinoside and hydrocortisone.
The number of eosinophils and basophils changed parallel to meningitic symptoms.
But the rate of eosinophils and basophils in bone marrow and peripheral blood was always less than 10% in the course of meningitis episode.
Eosinophilic-basophilic meningitis in CML which was successful treated, has rarely been reported.View full abstractDownload PDF (373K) -
Shigehiko IMAGAWA, Haruhiko NINOMIYA, Zi bin WANG, Masaki NAKAZAWA, Ha ...1984 Volume 25 Issue 1 Pages 69-74
Published: 1984
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSA case of IgG-Bence Jones protein (BJP) κ type multiple myeloma complicated by adult Fanconi syndrome and osteomalacia is reported. A 60-year-old female was admitted to Tsukuba University Hospital in September 1981, because of a back pain. The diagnosis of multiple myeloma was made on the basis of Bence Jones κ proteinuria, IgG (κ) paraprotein and BJP (κ) on serum immunoelectrophoresis and plasmocytosis in the bone marrow (14.4%). The plasma cells were found to have vacuole-like and granular structure in the cytoplasm, in which filament-like structures of various density were identified by electron microscopy. Analyses of serum and urine appeared hypouricemia, hypophosphatemia, hypokalemia, glycosuria, proteinuria and panaminoaciduria. Results of creatinine clearance, phosphate clearance and uric acid clearance showed renal dysfunction predominantly in proximal tubules. X-ray study revealed multiple bone fractures. Osteomalacia was found by iliac bone biopsy. These findings were interpreted that IgG-BJP (κ) type multiple myeloma was complicated by adult Fanconi syndrome as well as osteomalacia. We reviewed literatures and discussed about adult Fanconi syndrome and osteomalacia complicated to multiple myeloma.View full abstractDownload PDF (1056K) -
Chizuko OHTA, Naoyuki KATAYAMA, Nobuo UNO, Nobuyuki MINAMI, Yoshiaki K ...1984 Volume 25 Issue 1 Pages 75-81
Published: 1984
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSA case of familial pyruvate kinase deficiency anemia associated with acute myelomonocytic leukemia was reported.
A 57-year-old man was admitted to our hospital in August, 1981, because of severe anemia and jaundice. Blood examination showed RBC 152×104/cmm, Hb 5.3 g/dl, Hct 16.5%. reticulocyte 100‰, WBC 3,500/cmm, platelet 6.6×104/cmm, indirect bilirubin 5.6 mg/dl, serum iron 299 μg/dl, haptoglobin under 10 μg/dl, and 5 days of half life span of erythrocyte (T 1/2). A bone marrow examination revealed erythroid hyperplasia.
More detailed examination of this hemolysis revealed pyruvate kinase deficiency of erythrocyte. His son and daughter also have pyruvate kinase deficiency of erythrocyte, but without active hemolysis, so that their enzyme deficiency of erythrocyte was considered familial.
In Novenber, 1981, blast cells appeared in the peripheral blood and increased progressively. The bone marrow contained 44.2% blast cells and then a diagnosis of acute myelomonocytic leukemia was made cytologically. Though intensive combination therapy was performed, the patient achieved no remission and died in March, 1982.View full abstractDownload PDF (600K) -
Toshihiko YANASE, Tsukuru UMEMURA, Kazuhiro OHUCHI, Koichiro ITO, Masa ...1984 Volume 25 Issue 1 Pages 82-86
Published: 1984
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSA 73-year-old woman noticed left cervical lymphadenopathy in July 1979, which spontaneously diasppeared. She again noticed lymph node swelling on the neck and right inguinal region in September, then she was examined by the biopsy of the inguinal lymph node. The specimen showed marked arborizing vascular proliferation, but no malignant change.
On Feburuary 8, 1982, she was admitted to our hospital because of generalized lymphadenopathy and abdominal distension. On physical examination she had hepatosplenomegaly and ascites. Hypergammaglobulinemia and high LDH level were seen in serum. A biopsy specimen of cervical lymphnode revealed monotonous clear cell proliferation, especially around post capillary venule. It also accompanied moderate vascular proliferation and deposit of acidophilic interstitial material.
Despite the absence of cell marker's identification, clear cell lymphoma was supposed to be T cell lymphoma because of its histologically characteristic feature. Our case of clear cell lymphoma seems to be very similar to IBL-like T cell lymphoma.
Our case may be evoluted from IBL considering the marked vascular proliferation of the lymph node two years before admission and frequent appearence of clear cell clusters in IBL. Our case is very significant to investigate the independency of IBL-like T cell lymphoma as a new clinical entity.View full abstractDownload PDF (688K) -
Yasuhide HAYASHI, Yasuhiko KANEKO, Kazumi SAMPI, Masaharu SAKURAI, Mas ...1984 Volume 25 Issue 1 Pages 87-91
Published: 1984
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSA child of AMoL with a chromosome translocation t(9; 11) was reported. A nine-year-old girl was hospitalized because of headache and petechiae in March, 1982. On admission she had lymphadenopathy, gingival swelling and hepatosplenomegaly. Her hemoglobin content was 11.4 g/dl, and blood cell counts were WBC 382,000/mm3 with 98% leukemic blasts, and platelets 73,000/mm3. Her bone marrow was hypecrellular with 90.8% abnormal cells as seen in the peripheral blood. The leukemic cells showed positive peroxidase stain and strongly positive ANB esterase stain, which was completely inhibited with NaF. They had Fc-receptors, and ingested india-ink particles. Serum lysozyme value was 141.6 μg/ml (normal range 2.8∼8.0). She was diagnosed as having AMoL (M5, poorly differentiated) based on the morphological features of the leukemic cells and the above findings, and therapy was started with daunorubicin and cytosine arabinoside. She died of intracranial bleeding probably due to DIC on the second hospital day. Autopsy of the cranium revealed multiple hemorrhagic foci in various portions of the brain. Peripheral blood and bone marrow chromosomal analyses by G-and Q-banding revealed 47, XX, +8, t(9; 11) (p22; q23). Thus, this patient showed morphological and clinical characteristics similar to those of the seven patients with t(9; 11) so far reported in the literature.View full abstractDownload PDF (453K)
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1984 Volume 25 Issue 1 Pages 92-114
Published: 1984
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSDownload PDF (2221K)
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