All issues
Volume 25, Issue 10
Displaying 1-23 of 23 articles from this issue
- |<
- <
- 1
- >
- >|
-
Hiroyuki MIYAGI, Yoichi KOHNO, Hironori NAKAJIMA1984 Volume 25 Issue 10 Pages 1567-1573
Published: 1984
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSPlatelet binding immunoglobulins in sera (PBIg) were studied in children with acute and chronic idiopathic thrombocytopenic purpura (ITP), using the microtiter solid-phase enzyme-linked immunosorbent assay (ELISA). Both groups had significantly greater PBIg values than healthy individuals (p<0.001), and 11 of 13 patients with acute ITP (85%), 5 of 6 patients with chronic ITP (83%) showed elevated PBIg values.
We analysed binding activities of PBIg to platelet from patients with acute and chronic ITP by the techniques of ultracentrifugation and pepsin digestion. After ultracentrifugation, the values of PBIg from patients with acute ITP were remarkably reduced to the levels found in healthy individuals, whereas those from patients with chronic ITP were higher than those from patients with acute ITP and healthy individuals. After digestion of sera by pepsin, the pepsin-treated sera from patients with chronic ITP still had strong binding activities to platelets, whereas the pepsin-treated sera from patients with acute ITP did not exhibit significant binding activities to platelets.
Based on these findings, we can conclude that the majority of PBIg from patients with acute ITP consist of circulating immune complexes, while patients with chronic ITP have antibodies with specificities for platelet-associated antigens.
Immunological anlysis of PBIg can help to differentiate acute and chronic ITP of childhood, and can also be of use in the follow-up these diseases.View full abstractDownload PDF (768K) -
Kouichi YAOI, Shigeru YAMAMOTO, Kazuto TATSUMI, Akihide INOUE, Eiji WA ...1984 Volume 25 Issue 10 Pages 1574-1580
Published: 1984
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSWhen two children with acute lymphocytic leukemia, in bone marrow relapse became resistant to vincristine, they were treated with vincristine and calcium antagonist; diltiazem.
They were administrated diltiazem 3.6∼7.0 mg per kilogram per day per os with vincristine and other anticancer drugs and reached hematologic remission within 3∼4 weeks. No toxicity was found in this therapy. Duration of hematologic remission was about 40 days.
From this result, it is probable that the resistance to vinbristine could be clinically overcome by diltiazem. But duration of remission was very short, so it is hoped that favarable maintenance therapy will be studied.View full abstractDownload PDF (438K) -
Yuri SUGIURA, Seitoku FUJIOKA, Sho YOSHIDA1984 Volume 25 Issue 10 Pages 1581-1586
Published: 1984
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSIntermediates in pyrimidine de novo pathway in human normal and hematodyscrasial cells were studied by incorporation of Na214CO3 as a tracer in order to investigate the proliferation mechanisms and the regulation in metabolism of nucleic acid of these cells.
Blood specimens from 3 patients with acute leukemia (AL), one chronic myelocytic leukemia in blastic crisis (CML-crisis) and one myelofibrosis (MF) and bone marrow specimens from one with AL, 2 aplastic anemia (AA), one pure red cell aplasia (PRCA) and 4 controls without hematological disorder were studied.
Pyrimidine de novo pathways were recognized in both cells from the patients and controls by each radioactive intermediate.
Carbamyl aspartate (CA) and uridine monophosphate (UMP) showed higher levels of radioactivity than dihydroorotate (DHO) and orotate (OA) in the same pattern as in the intermediates in the cells of various mammalian organs.
The levels of each intermediate in the cells from patients with AL and CML-crisis did not differ from those observed with controls in spite of their high percentage of leukemic cells.
It indicates that proliferative rate in the majority of the cells from the patients with AL and CML-crisis is low and they are in steady state.
The levels of UMP showed lower in the cells from the patients with AA than those with controls.
It is assumed that the proliferative behavior in the cells from the patients with AA is low as well as the decreased production of stem cells.
In contrast with these disorders, the cells from the patients with MF showed high proliferative behavior.View full abstractDownload PDF (421K) -
Yoshiaki MORIYAMA, Ken SATO, Miwako NARITA, Tomio TAKESHIGE, Hiroyuki ...1984 Volume 25 Issue 10 Pages 1587-1593
Published: 1984
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSBetween 1979 and 1984, 102 adult patients with acute leukemia were prospectively classified according to the FAB system and treated on the (L)DVP (daunomycin, vincristine, prednisolone and/or L-asparraginase) or the DCV(M)P (DVP+cytosine arabinoside and/or 6MP-R) induction therapy for acute lymphoblastic leukemia (ALL), and on the DCMP, BH-ACAMP (BH-Ara-C and aclacinomycin+MP), or low dose Ara-C induction protocol for acute myeloid leukemia (AML).
In ALL (L1:2 and L2:20 cases), 86.4% complete remission rate was induced with (L)DVP and DCV(M)P regimens, and 11 out of 22 patients with ALL are still alive. However, elderly patients with L2 type were found to be poorly prognostic.
In AML (M1:18, M2:18, M3:15, M4:9, M5:10, M6:3 cases), an overall complete remission rate of 71.2% was achieved with DCMP, BH-ACAMP and low dose Ara-C treatments, indicating that response of AML to the combination chemotherapy appears to be less than that of ALL. In subtypes, we obtained remissions in 83.3% of M2 and 80.0% of M5 patients, respectively. Eleven out of 18 patients with M2 are still alive. However, M1, M3, M4, and M6 patients appeared to do less well than M2 and M5 patients according to the FAB classification. There was a good correlation between FAB classification and prognosis on our protocols. These findings suggest that the FAB system is likely to be useful for diagnosis and treatment of acute leukemia. However, lack of megakaryoblastic acute leukemia in the FAB system is one of the important problems to use it clinically. This point is discussed in the text.
On the other hand, elderly patients aged 60yr or over were poorly prognostic indicating less complete remission rate and survival as compared with those of patients aged 16-59yr. This suggests that age is one of adverse prognostic factors for response and survival in acute leukemia.View full abstractDownload PDF (552K) -
Toshiji SHITARA, Toshio KURIBAYASHI, Yukio OSHIMA, Noriyuki SUETAKE, Y ...1984 Volume 25 Issue 10 Pages 1594-1599
Published: 1984
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSTen children with previously untreated non-Hodgkin's lymphoma (NHL) were treated according to the multi-drug regimen (modified LSA2L2 protocol).
Nine of the ten children (90%) obtained complete remission (CR). One child who had central nervous system (CNS) involvement at the time of diagnosis failed to achieve CR. Of the nine children who achieved CR, two had subsequent relapse, one in bone marrow and the other in CNS.
The complete remission rate at 24 months was 64.3%, and the two-year survival rate was 71.1%. Three children are off therapy now.
Complications were not uncommon, including severe bone marrow suppression, acute renal failure, gastric perforation, intestinal ulceration and esophageal stenosis.
Appropriate supportive care was essential for this protocol.View full abstractDownload PDF (447K) -
Kazuo DAN, Kiyoyuki OGATA, Seiji GOMI, Ichiro OHKI, Tetsuo KUWABARA, H ...1984 Volume 25 Issue 10 Pages 1600-1605
Published: 1984
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSSix patients with myelodysplastic syndrome or with myelodysplastic syndrome transforming into acute myeloid leukemia were treated with small doses of Ara-C (10 mg/sqm/12h, subcutaneous injections) for 11 to 55 days. Complete remissions were observed in four patients, and a partial response in one. Two patients did not experience marrow aplasia before remission while the remaining two entered remission after passing through marrow aplasia. These results suggest that small-dose Ara-C may function by inducing differentiation of leukemic blasts in some patients and by exerting usual cytoxic effects in others.View full abstractDownload PDF (449K) -
—Clinical Study on Remission Mechanism by Serial Chromosomal Findings, Colony Formation and Plasma Ara-C Concentration—Masuko TAGAWA, Masao TOMONAGA, Junji SHIBATA, Kenji NISHINO, Hiroaki N ...1984 Volume 25 Issue 10 Pages 1606-1617
Published: 1984
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSIn a series of 6 patients (4 hypoplastic leukemia, 1 acute leukemia from RAEB and 1 erythroleukemia) 7 courses of low dose Ara-C (10∼12 mg/day) regimen were performed for 11∼31 days. Response was noted in 5 patients (6 courses), and complete remission (CR) obtained in 3 patients (4 courses) and partial remission in 2 patients (2 courses).
In CR cases a definite cytoreduction phase was observed in bone marrow before normal hematopoiesis recurred. In Case 1 and Case 2 which have 8 trisomy clone (78% and 40%, respectively) before therapy, the bone marrow of CR showed only normal karyotypes in all metaphases examined.
Cytogenetic study on single granulocytic colonies and erythroid bursts also revealed only normal karyotypes in Case 1. These findings indicated clonal alternation from leukemic to normal. In all response cases, a few normal granulocyte/macrophage colonies and/or erythroid bursts were observed before therapy and recoverd sufficiently in numbers after therapy.
Plasma Ara-C concentration estimated in 6 cases by radioimmunoassay was between 3.53 to 7.38 ng/ml (15 nM∼30nM). According to Harries et al. this level of Ara-C concentration can exert inhibitory activity on DNA sythesis by leukemic myeloblasts to a certain extent.
These observations favor a view that low dose Ara-C regimen can induce remission by cytoreduction rather than differentiation-induction.View full abstractDownload PDF (927K) -
Kenji KISHI, Hideo HIROSAWA, Masahiro FUJIWARA, Yoshiaki MORIYAMA, Sho ...1984 Volume 25 Issue 10 Pages 1618-1625
Published: 1984
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSA new sarcoma cell line producing colony stimulating factor(s) (CSF) is reported. A case with renal rhabdomyosarcoma showed marked leukocytosis with mature granulocytes and the tumor was suspected to be producing CSF. The tumor obtained at autopsy was cultured in liquid medium. Media conditioned in the initial tumor culture was able to stimulate granulocytic colony growth in normal human marrow cultures. From this in vitro observation, the tumor obtained from the patient was proved to be producing CSF. Tumor cells grew in liquid medium for 14 months, and a new cell line called SPT-2 was established. CSF activity of the supernate (TCM) was studied in vitro. Human and mouse marrow cells were sensitive to TCM and formed colonies, but rat and rabbit cells were not. Cytological studies of these colonies showed that granulocytic colonies were formed from human marrow cells and macrophage colonies from mouse marrow cells. This activity was heat labile at 60°C and stable for 7 days at room temperature. Gel filtration studies of TCM revealed that the molecular weight of the CSF activity was approximately 30,000 dalton for human and 45,000 for mouse. CSF producing cell lines are useful to clarify the mechanisms of hematopoietic regulation. However, further examinations of SPT-2 cell should be needed.View full abstractDownload PDF (852K) -
—The Application of LDH/LCBM Index in a Remission Predictive Model—Hayato MIYACHI, Yuzuru TAKEMURA, Keisuke TOYAMA, Toshiaki HIGASHI, Nao ...1984 Volume 25 Issue 10 Pages 1626-1629
Published: 1984
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSThe pretreatment characteristics in 85 adults with acute leukemia who were treated at Keio University Hospital between 1973 and March 1983 have been evaluated to assess their value as prognostic indicators. In addition to characteristics previously known to provide prognostic information such as morphology, temperature status, and hemoglobin level, we identified the LDH/LCBM Index (serum LDH level/leukemic cell number in bone marrow (×104)) as being significantly associated with probability of obtaining a complete remission, although serum LDH level has been identified as not being significantly related to rate of complete remission. From this natural-history analysis a predictive model for response has been developed using multivariate logistic regression techniques. LDH/LCBM Index may be an index of the rate of cell turnover, and this may explain the importance of it in predicting the prognosis of acute leukemia.View full abstractDownload PDF (304K)
-
Successful Splenectomy after a High-dose Intravenous Administration of ImmunoglobulinHisomu YAMAGUCHI, Yoshitomo MUTO, Shinichi MORINAGA, Hiroshi AKIYAMA, ...1984 Volume 25 Issue 10 Pages 1630-1634
Published: 1984
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSIn three cases with ITP with inadequate response to high-dose corticosteroid administration splenectomy was sucessfully done after an increase in the platelet counts following the high-dose intravenous administraion of IG-100 (Sandoglobulin).
They were with 45, 27, and 22 years of age. Duration of the illness ranged between three months to fourty years. A diagnosis of ITP was made based upon a markedly reduced platelet count, increase in marrow megakaryocytes and shortened platelet life span.
IG-100 was administered in a dose of 400 mgm/kg/day for consecutive five days. Immediate and remarkable rise in the platelet counts were observed and after a splenectomy further rise in the platelet counts and the prolongation of the platelet life span followed in all the three cases.
The dose of orally administrered coricosteroid was gradually diminished, and the platelet counts have been within normal limits. In two of them no steroid is prescribed at present.View full abstractDownload PDF (371K) -
Immune Suppression of Hemopoietic Progenitor Cells in the Presence of the patient's Peripheral Blood Cells, Acute Serum and DrugKenichi KOIKE, Kuniaki NAGANUMA, Eizaburo ISHII, Kohichiro TSUJI, Osaa ...1984 Volume 25 Issue 10 Pages 1635-1640
Published: 1984
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSWe report a child with pancytopenia and systemic lupus erythematosus (SLE) associated with ethosuximide therapy. In order to determine the mechanism of pancytopenia, we used an in vitro technique for granulocyte-macrophage and erythroid progenitor cells (CFU-GM, BFU-E).
Numbers of colonies from control and autologous marrow CFU-GM and BFU-E were significantly reduced by the addition of all of the patient's blood mononuclear cells, acute serum and ethosuximide. The allogeneic bone marrow colony-suppression activity of the patient's peripheral blood cells was the strongest when studied at the relapse of SLE as evidenced by the laboratory findings. There was no suppression of colony growth when a drug such as phenobarbital or diphenylhydantoin was added to the culture instead of ethosuximide, or the patient's recovery serum was added instead of acute serum.
These findings indicate the existence of pancytopenia due to drug-induced autoimmune suppression of hemopoiesis.View full abstractDownload PDF (401K) -
Ryuji AKIYOSHI, Ichiro MURATA, Kohjin KIN, Shinobu SAKAMOTO, Keita HID ...1984 Volume 25 Issue 10 Pages 1641-1645
Published: 1984
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSAn 81-year-old male was admitted to the Tokyo Kyosai Hospital with complaints of palpitation and general fatigue in September 1980. He had been diagnosed as having anemia of unknown cause with elevated serum iron, folic acid and vitamine B12 and had been treated with oral iron and blood transfusions for 5 years at another hospital. In April 1980, he underwent cholecystectomy because of cholelithiasis at our hospital. In June 1980, a bone marrow aspiration was performed because of aggravation of anemia after the operation. Bone marrow findings were compatible with those of sideroblastic anemia.
On the day of admission, examination of the bone marrow disclosed the findings compatible with sideroblastic anemia except for the slight excess of blastoid cells (6.0%). After several blood transfusions, he was discharged. In November 1980, he was readmitted to the hospital because of the appearance of blastoid cells (20%) in the peripheral blood. Examination of the bone marrow revealed a proliferation of blastoid cells (78.3%). Light and electron microscopic studies and cytochemical and immunologic studies demonstrated these cells to be TdT-positive non-T, non-B lymphoblasts. A diagnosis of transformation into acute lymphoblastic leukemia was made. In December 1980, he died of congestive heart failure. At autopsy, wide-spread leukemic infiltration was demonstrated. No evidence of hemosiderosis was revealed, but no diseases causing secondary sideroblastic anemia were demonstrated.View full abstractDownload PDF (658K) -
Tadao FUNATO, Masatoshi HAYASHI, Keiko ICHIKAWA, Yasushi HIRASAWA, Hid ...1984 Volume 25 Issue 10 Pages 1646-1652
Published: 1984
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSA 70-year-old woman with multiple myeloma is described. She had diphasic IgG-κ and IgA-κ type M-proteins in serum and a κ-type Bence-Jones protein in urine. Examination of myeloma cells with immunofluorescent and immunoenzyme assay showed a heterogeneous staining patterns. However, with both methods, it was found that the some cells were stained with the both antisera. From these results, it was suggested that most of the myeloma cells from the patient secreted of the two immunoglobulins but some of the cells secreted both immunoglobulins.View full abstractDownload PDF (2127K) -
Hiroshi FUJII, Yasuyuki SONODA, Taira MAEKAWA1984 Volume 25 Issue 10 Pages 1653-1657
Published: 1984
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSTwo cases of colony stimulating factor (CSF) producing lung tumor were presented.
Case 1: A 54 year-old male with cancer (squamous cell carcinoma) presented with marked leukocytosis up to 177,000/cmm and hypercalcemia up to 15.2mg/dl in his terminal stage. After resection of lung tumor, the white blood cell count temporarily returned to the normal value. Case 2: A 63 year-old male with multiple lung tumors (malignant mesothelioma) presented with marked leukocytosis up to 130,000/cmm. In these two cases, there was no evidence of superimposed infection and the degree of granulocytosis correlated with the tumor burden. Leukocytosis was due to an increase in mature neutrophilic granulocytes and bone marrow aspiration demonstrated myeloid hyperplasia. Philadelphia chromosome was absent. The concentration of CFU-C in the bone marrow was slightly increased in Case 2.
CSF was investigated using non-adherent cells of normal bone marrow and patient's bone marrow as the target cells. CSF was detected not only in these patient's serum also in the medium conditioned with the tumor tissue of Case 2.
The present results indicated that the tumor tissue of these two patients produced CSF in vivo.View full abstractDownload PDF (377K) -
Haruo NIIKURA, Hiraku MORI, Hideo TERADA1984 Volume 25 Issue 10 Pages 1658-1664
Published: 1984
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSMarked thrombocytosis was developed in 2 cases together with sideroblastic anemia and leukoerythroblastosis.
The first case was 70-year-old male whose peripheral blood examination revealed Hb 10.9 g/dl with normal RBC indeces, WBC 13,200/μl and platelet count 1,405,000/μl. The peripheral blood smears showed dimorphism of erythrocytes, leukoerythroblastosis and anisocytosis of platelets. The bone marrow specimen showed hypercellularity of three hematopoietic elements and there were many platelet aggregates and a few megaloblastoid cells. Sideroblasts were markedly increased (96% of erythroblasts) with a presence of ringed form (28%).
The second case was 66-year-old female whose blood count revealed Hb 9 g/dl with normal RBC indeces, WBC 32,800/μl and platelet count 2,675,000/μl. The peripheral blood smears showed a few hypochromic erythrocytes, leukoerythroblastosis and anisocytosis of platelets. The bone marrow specimen showed megakaryocytic hyperplasia with many platelet aggregates. Sideroblasts were moderately increased (78% of erythroblasts) with a few ringed forms (5%). About 2 years later, sideroblasts in the bone marrow were increased to 98% and ringed forms were seen in 41% of erythroblasts.
Both cases had abnormal platelet function, normal karyotype and decreased activity of δALA synthetase in erythroblasts. Ferrokinetic studies showed inffective erythropoietic pattern.
It was difficult to determine which was the primary change either thrombocytosis or sideroblastic anemia. Both essential thrombocythemia and primary acquired sideroblastic anemia were supposed to be a hematopoietic stem cell disorder. Therefore, it seemed to be reasonable that both patients had defects in stem cell level whose hematological manifestation were thrombocythemia and acquired sideroblastic anemia.View full abstractDownload PDF (636K) -
Masatoshi HAYASHI, Mitsunori TAKASAKI, Yoshihiko WATANABE, Tadao FUNAT ...1984 Volume 25 Issue 10 Pages 1665-1670
Published: 1984
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSA 66-year-old female was admitted to the Kitasato University Hospital in December 1980 because of dark urine, easy fatigability and acrocyanosis at cold. On physical examination, the patient was pale and icteric. No hepatosplenomegaly and no lymphadenopathy were observed. Laboratory examination demonstrated hemoglobinuria and anemia due to hemolysis. Peripheral blood smear revealed marked aggregation of red blood cells. Cold agglutinin was demonstrated at a titer of 1: 16384 with specificity of anti-I type. The eluted cold agglutinin was shown to be IgM-κ type. Direct Coombs' test was strongly positive for complements. The patient was kept warm and transfused with washed red blood cells. Five months after the admission, she began received prednisolone because there was a rapid progress of anemia. About eight months after the prednisolone therapy had started, left cervical lymphadenopathy was noted. The lymph node biopsy specimen disclosed non-Hodgkin's lymphoma, diffuse lymphoma, pleomorphic type (LSG classification). The patient was treated with prednisolone, cyclophosphamide and vincristine. She was discharged from the hospital after an improvement of cervical lymphadenopathy. The patient remaind on a regimen of 10 to 20 mg of prednisolone per day for the next two years. Her condition has been well controlled, with a compensated mild hemolytic process at cold.
The delayed occurrence of malignant lymphoma in the course of cold agglutinin disease has rarely been reported. We reviewed literature and discussed about malignant lymphoma complicated with the cold agglutinin disease.View full abstractDownload PDF (496K) -
Yoshio TANIGUCHI, Michihiko YAMASOWA, Hiroshi KAMESAKI, Kaori NASU, Sh ...1984 Volume 25 Issue 10 Pages 1671-1679
Published: 1984
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSA 21 year-old woman was autopsied because of gradually progressive immune deficiency and generalized lymphadenopathy that started shortly after birth and eventually terminated in non-Hodgkin's lymphoma with threatening stenosis of the respiratory tract. Lymphnode biopsies up to the age of 14 revealed nonspecific chronic lymphadenitis. However, on the latest admission at the age of 21, the right inguinal lymphnode biopsy was diagnosed as non-Hodgkin's lymphoma, diffuse mixed type (Classification of the Lymphoma Study Group, Japan) with the dominant lymphocyte markers of OKT3 and OKT8. The clonal karyotypic abnormality of 14q+ was detected in the lymphnode lymphocytes that responded to pokeweed mitogen. Recurrent infections during childhood responded well to antibiotic therapies, but cellular immunity apparently started to be defective at the age of 12, and humoral immunity at the age of 21. Hence, with other immunological findings, the patient was diagnosed as common variable immunodeficiency. She received VP therapy (combination of vindesin with prednisolone), got into remission, fell into relapse two months later, and died of pneumonia.
Such an immune deficiency with a life-long follow up of gradually progressing severity is a rare case. The identification of the clonal karyotypic abnormality of 14q+ in a primary immune deficiency other than ataxia telangiectasia has been also rarely reported.View full abstractDownload PDF (1230K) -
Kenji MINEOKA, Kazuko YAMAMOTO, Takuji ISEMURA, Hiroshi FUJII, Shigeo ...1984 Volume 25 Issue 10 Pages 1680-1685
Published: 1984
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSA 15-year-old high school boy visited our hospital because of the passing of “Cola”-like dark urine which occurred immediately after “Kendo” training and lasted for several hours only.
“Kendo” exercise test was performed: he was instructed to repeat to step barefoot strenuously on floor board (“fumikomi” training) for 60 minutes.
The examination of the urine and blood taken immediately after exercise revealed the hallmarks of intravascular hemolysis including a raised plasma hemoglobin value, lowered serum haptoglobin, elevated serum lactic dehydrogenase level and hemoglobinuria with no red blood cell in sediment. Only a trace of myoglobin was detected in the urine. These abnormalities gradually decreased in intensity and all of them except serum haptoglobin were normalized 24 hours after the exercise test.
Based on the clinical findings and the results of exercise test, a diagnosis of march hemoglobinuria following “kendo” exercise was made. The trace of the myoglobin in the urine was considered to be due to physiological phenomenon for muscle activity.
It was reported in addition that his apparently healthy elder brother was tested in the same way and the urine was straw colored and clear, with no hemoglobin, while the blood showed significant increases of plasma hemoglobin and serum lactic dehydrogenase and a significant decrease of serum haptoglobin.View full abstractDownload PDF (552K) -
Yuji YAMAGUCHI, Satoshi HITSUMOTO, Shyozo CHIBA1984 Volume 25 Issue 10 Pages 1686-1691
Published: 1984
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSCase 1. 31 year-old male was admitted to the hospital with complaints of dry cough and low grade fever on Jun. 2, 1982. Laboratory findings on admission revealed definite leukocytosis (34,200/cmm) with 18% of lobulated atypical lymphocyte in the peripheral blood as well as 12.8% of same shaped atypical cells in the bone marrow, although normal counts of RBC and platelet.
Slight abnormalities were also demonstrated in the amount of serum GOT, GPT, ALP, and LDH. Biopsy specimens of the inguinal lymph node showed the histological picture of malignant lymphoma, diffuse, medium-sized cell type. A diagnosis of ATL was made. A chest X-ray film revealed bilateral patchy interstitial infiltrations. The methenamine silver staining of specimens of transbronchial lung biopsy (TBLB) disclosed organisms of pneumocystis carinii and the abnormal shadow on chest X-ray film disappeared after TMP-SMX (Baktar) treatment for three months. After discharged, he has been received the maintenance therapy at the outpatient clinic.
Case 2. A 48 year-old female was admitted to the hospital with complaints of dry cough and pyrexia on Mar. 2, 1983. Laboratory finding on admission revealed definite leukocytosis (29,100/cmm) with 34% of lobulated atypical lymphocyte in the peripheral blood as well as 12.8% of same shaped atypical cells in the bone marrow, although normal counts of RBC and platelet. Slight abnormalities were also demonstrated in the amount of ALP and LDH. Biopsy specimens of the inguinal lymph node showed the histological pitcture of malignant lymphoma, diffuse, medium-sized cell type. A diagnosis of ATL was made. A chest X-ray film revealed bilateral patchy interstitial infiltrations. The methenamine silver staining of specimens of TBLB disclosed organisms of P. carinii and abnormal shadow disappeared after TMP-SMX (Baktar) treatment for three months. But she was died of systemic bleeding due to DIC with increase in atypical lymphoid cells 4 months later.View full abstractDownload PDF (784K) -
Yaeko HANEDA, Hiromitsu TAKEMORI, Yoichi CHIBA, Yutaka YOSHIDA, Yoshih ...1984 Volume 25 Issue 10 Pages 1692-1698
Published: 1984
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSA case of hemolytic anemia with increased red cell membrane lipids (phosphatidyl choline and free cholesterol) is reported. A 26-year-old male was first seen with mild anemia, slight jaundice and hepatosplenomegaly. Hemolytic anemia was evident from indirect bilirubinemia, reticulocytosis and the presence of gallstones. Red cell morphology was unremarkable except for stomatocytic changes and occasional target cells. Osmotic fragility of red cells was decreased. Apparent red cell life span (51Cr T 1/2) was 7 days. Of the glycolytic enzymes, the activity of adenosine deaminase was decreased to 50%, but other enzymes were essentially normal. Abnormal hemoglobins were not demonstrated.
Plasma lipid analysis showed decrease of total cholesterol, HDL-cholesterol and Apo AI. Additionally, the activity of lecithin: cholesterol acyltransferase was slightly low. Liver biopsy noted normal histology and a normal amount of copper. Concomitant to the abnormalities of membrane lipids, a marked increase of sodium influx was obserbed with increased Na+-K+-ATPase activities. Red cell sodium was elevated with a diminished potassium content during in vitro incubation.View full abstractDownload PDF (562K) -
Koichiro NAGATA, Tetsuto KOJIME, Osamu KAMIYA, Kanji OHARA, Akira HOSH ...1984 Volume 25 Issue 10 Pages 1699-1704
Published: 1984
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSA 42-year-old man was admitted to Anjyo Kosei Hospital with one week history of headache and dysarthria. Physical examination on admission revealed mental changes and petechiae over the lower extremities. The diagnosis of TTP was made because of thrombocytopenia, microangiopathic hemolytic anemia, fever and fluctuating neurologic symptoms. The treatment, cnsisted of prednisolone 120 mg/day, aspirin 2,250 mg/day, dipyridamole 150 mg/day, heparin 6,000 U/day, and urokinase 12,000 I.U./day, were started on day 4 of hospitaization. Plasmapheresis was performed with a Haemonetics Model 30 from day 6 to 22. Total volume of plasmapheresis was 422 ml/kg. Because no clinical improvement was observed by day 22, splenectomy was performed, which resulted in a rapid remission. Pathological specimens of the spleen showed hyaline thrombi of arterioles and capillaries, which histologically confirmed the diagnosis of TTP. After the sutsained remission for 25 days, the patient developed pneumonia and septicemia on day 60, then gradually deteriolated, and expired on day 97. Autopsy revealed no histological findings of TTP. A hypothesis of the presence of platelet aggregating factor in the plasma of TTP, by Lian et al., is unlikely in this case, because this factor was difficult to be detected in the patient's plasma and the plasmpheresis was not effective in this patient.
The contribution of the spleen to the pathogenesis of TTP in this case is strongly conceivable.View full abstractDownload PDF (764K) -
—Cytochemical and Ultrastructural Study—Hirotaka TAKAHASHI, Ryo KOIDE, Yukiko TSUNEMATSU, Michiko SASAKI, Taij ...1984 Volume 25 Issue 10 Pages 1705-1712
Published: 1984
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSThree childhood cases of acute myeloid leukemia with karyotypic abnormalities, 8; 21 translocation and missing Y chromosome, were reported. All three cases were classified in FAB M2 and showed a very low neutrophil alkaline phosphatase score. Mature neutrophils had Auer rods in two cases.
Two morphological features in bone marrow smear were found in these three cases. 1. Some of promyelocytes, myelocytes and metamyelocytes had scarse Azur granules, pale salmon-pink cytoplasms and basophilic peripheral borders by May-Giemsa stain. 2. “Monocytoid” cells having lobulated nuclei, pale salmon-pink cytoplasms and basophilic peripheral borders were found. These “monocytoid” cells had strongly positive peroxidase, naphthol AS-D chloroacetate esterase reaction, but negative non-specific esterase reaction. Some of them had also Auer rods in two cases. Therefore they were thought to be atypical myeloblasts.
Blast cells in two cases had positive reaction in alpha-naphthyl acetate esterase stain, which was blocked with sodium fluoride. In one of these cases, the distribution of mean granular sizes of primary (peroxidase-positive) granules in the leukemic cells in ultrastructural study was small and resembled to that of mature monocytes. It was suggested that the myeloblasts in these two cases of AML with t (8; 21) (q22; q22) differentiate to the monocyte in some degrees.View full abstractDownload PDF (1054K) -
Hitoshi OHNO, Mari KANNAGI, Michihiko YAMASOWA, Shoichi DOI, Tadashi K ...1984 Volume 25 Issue 10 Pages 1713-1717
Published: 1984
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSA case of diffuse lymphoma with a t(14; 18) is reported. A 43-year-old man, having a prior diagnosis of diffuse lymphoma, was readmitted into Kyoto University Hospital because of the relapse. Biopsied lymph node was again diagnosed as non-Hodgkin's lymphoma, diffuse, mixed type. Marker studies showed E-rosette negative, Fcγ-receptor positive, C3b-receptor positive, but negative for surface and cytoplasmic immunoglobulin. Chromosome analysis revealed that tumor cells were clonally marked with a t(14; 18) (q32; q21) [46, XY, t(14: 18) (q32; q21)]. Responding to chemotherapy, he again entered into a complete remission, and he has survived for six years since the first diagnosis.
Lymphoma cells of this patient showed a diffuse pattern of growth, although he had a favorable clinical course, a common feature of the lymphoid malignancies with a t(14; 18). Interestingly, tumor cells, being considered to be originated from follicular center, cells, lacked immunoglobulin expression.View full abstractDownload PDF (1492K)
- |<
- <
- 1
- >
- >|