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Volume 30, Issue 3
Displaying 1-24 of 24 articles from this issue
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Nobuo NARA1989 Volume 30 Issue 3 Pages 275-281
Published: 1989
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSDespite substantial recent advances in leukemia therapy, most leukemia patients eventually relapse and die of reccurrent or refractory leukemia. Important issues are how to treat the patients in relapse of leukemia and how to overcome drug-resistant leukemic cells. Multidrug resistance of tumor cells has been vigorously studied in terms of P-glycoprotein, which may play important roles in the transport of antitumor drugs through cell membrane. In the present article, the author has reviewed the recent advances in understanding the pathophysiology of drug-resistance in leukemic cells and discussed the clinical approaches to drug-resistant leukemia.View full abstractDownload PDF (623K)
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Hidehiro KOBASHI, Tomiro ADACHI, Teruhiko TSUBOTA, Kenwo ASANO, Machik ...1989 Volume 30 Issue 3 Pages 282-288
Published: 1989
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSThe in vitro effects of the causative drugs and lymphocytes from the patients with agranulocytosis were tested against granulocyte-macrophage colony formation (CFU-C) of bone marrow cells from normal individuals and the patients in recovery stage. A semisolid culture system was used for CFU-C assay. The drug concentrations were adjusted to the therapeutic levels in sera, and the lymphocytes were obtained from the patient's peripheral blood. Three patients with agranulocytosis and one patient with pancytopenia caused by disopyramide, methimazole, sodium valproate, and Towasaal®, respectively, were examined. Each of the four drugs except disopyramide suppressed the CFU-C of normal and patient's bone marrow cells in a dose-dependent manner. When the patients' bone marrow cells were cultured with respective drugs and their own lymphocytes or with the culture supernatant of the drug and lymphocytes, CFU-C suppressions was significantly augmented. Phenacetin, an agent of Towasaal®, significantly supperssed CFU-C and also CFU-E.
These results indicate that humoral factor (s) produced from patient's lymphocytes by reacting with the drugs may function as an immunological mechanism in the patients with drug-induced agranulocytosis.View full abstractDownload PDF (517K) -
Kazunori OHNISHI, Tomomitsu HOTTA, Takashi MURATE, Chikako INOUE, Atsu ...1989 Volume 30 Issue 3 Pages 289-296
Published: 1989
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSTwenty patients with refractory malignant lymphoma were treated with a combination of VP-16, ifosfamide, procarbazine, prednisolone, bleomycin and methotrexate (VIPP-BM) as salvage chemotherapy. These patients were either resistant to front-line therapy or refractory in their relapses. Two patients (10%) achieved a complete remission and eleven patients (55%) atained a partial remission. An overall response rate was 65%. Major toxicities were myelosuppression, nausea and vomiting, and mucositis. However they were well tolerated. This regimen has been effective in the treatment for the patients with refractory lymphoma.View full abstractDownload PDF (566K) -
Tsutomu SHICHISHIMA, Takashi TERASAWA, Tatsumi UCHIDA, Shigeo KARIYONE1989 Volume 30 Issue 3 Pages 297-302
Published: 1989
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSIn order to clarify the erythropoiesis of complement-sensitive red cells in paroxysmal nocturnal hemoglobinuria (PNH), the proportion of complement-sensitive red cells and compositional classification of examined red cells were investigated by means of complement lysis sensitivity test in 27 patients with initial diagnosis of PNH and 17 patients with aplastic anemia-PNH syndrome, and their bone marrow nucleated cell counts were also compared.
The proportion of complement-sensitive erythrocytes was 41.0±22.0% (n=26) in PNH and 29.5±15.0% (n=17) in aplastic anemia-PNH syndrome, and no significant difference was recognized between them. The nucleated cell count at the time of PNH diagnosis was 19.1±12.5×104/μl (n=21) in PNH and 12.6±8.8×104/μl (n=12) in aplastic anemia-PNH syndrome, and no significant difference between them was apparent.
These findings suggest that the erythropoiesis of complement-sensitive red cells shows a similarity between PNH at initial occurrence and aplastic anemia-PNH syndrome, once PNH has occurred.View full abstractDownload PDF (442K) -
Minoru FUKUDA, Seiji KOJIMA, Takaharu MATSUYAMA1989 Volume 30 Issue 3 Pages 303-308
Published: 1989
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSPeripheral blood stem cells released following chemotherapy were examined in 21 children with malignancies in early remission. In order to obtain more than 1×105CFU-GM per liter which is the minimal concentration to achieve autologous blood stem cell transplantation by cytapheresis, myelosuppressive chemotherapy which reduced leukocyte count below 1,000/μl or neutrophil count below 200/μl was necessary. Because the repetition of chemotherapy reduced the release of CFU-GM in peripheral blood, blood stem cells should be collected early after the beginning of chemotherapy. By long term culture method, peripheral blood stem cells seemed to contain pluripotent stem cells. Using our therapeutic protocol, more than 1×105CFU-GM per liter could be obtained in malignant lymphoma and acute non-lymphoblastic leukemia, thus autologous blood stem cell transplantation seemed to be possible in these diseases.View full abstractDownload PDF (422K) -
Kazuyuki SHIMIZU, Kazuo HARA, Akira KUNII1989 Volume 30 Issue 3 Pages 309-315
Published: 1989
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESS“Weekly CHOP” therapy characterized by reduced dosages of cyclophosphamide, doxorubicin and vincristine, was evaluated in 33 patients with advanced diffuse large cell lymphomas (LSG classification). There were 19 complete responders (59%) and 8 partial responders (25%) with a response rate of 84%. A prolonged disease-free survival rate (survival plateau) of 60% was considered comparable to the results of second-generation chemotherapies. The response was poor in patients with high grade malignancy (large cell, immunoblastic category in Working Formulation for Clinical Usage) as well as in patients with bone marrow invasion.View full abstractDownload PDF (527K) -
Yoshinobu TAKEMOTO, Akihisa KANAMARU, Kiyoyasu NAGAI, Hiroshi HARA, Sh ...1989 Volume 30 Issue 3 Pages 316-322
Published: 1989
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSClinical effects of the monotherapy with ceftazidime (CAZ) were evaluated in patients with severe infections associated with febrile granulocytopenia in hematological disorders in 10 institutions. CAZ (4-6g/day) was administered intravenously by drip infusion divided into 2 to 4 doses. 83% of the underlying diseases were hematological malignancies. Infections mainly consisted of documented sepsis (10%), presumed sepsis (60%). Overall efficacy rate was 65%, and that of septic patients was 83.3%. Adverse reactions were minimal, and this study revealed safety of CAZ.View full abstractDownload PDF (482K) -
Susumu OKUBO, Kojiro YASUNAGA, Tomoko ISHIDA1989 Volume 30 Issue 3 Pages 323-326
Published: 1989
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSAnti-A and anti-B antibodies (1:1∼1:1,024) of IgM or IgG type of the titers 1:1∼1:1,024 were detected in all of the lots of heat-treated human plasma protein (38 Lots), albumin (15 Lots), factor VIII or IX products (9 Lots) and immune globulin preparations for intravenous use (IVIG) (20 Lots) examined. Twelve out of 20 lots of IVIG contained unexpected anti-erythrocyte antibodies of IgG type. Though IgG1 antibody was detected in all of these 12 lots, antibodies composed of all subclasses including IgG3 could be detected in only 8 lots of them, all showing the anti-erythrocyte antibody titer of IgG type over 1:64. Conversely, none of the lots, in which the titer was less than 1:32, contained IgG3 antibodies. A patient of chronic ITP, 28-year-old female of blood type A and Rh-positive, showed contradictive results between the main (A type) and the accessory test (O type) of red blood cell grouping, accompanied with hemolytic anemia, following intravenous high-dose immune globulin therapy (400 mg/kg×successive 5 days), which was attributable to the anti-A antibody of IgG type composed of IgG1,2,3,4 in the IVIG administered. For high dosage administration of human plasma preparation products, those containing only low titer of unexpected anti-erythrocyte antibody should be selected.View full abstractDownload PDF (303K) -
Yoshifumi KAWANO, Yoichi TAKAUE, Tsutomu WATANABE, Tsuneo NINOMIYA, Ya ...1989 Volume 30 Issue 3 Pages 327-331
Published: 1989
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSThe lymphocytotoxicity and mitogenicity between six different ALG preparations on the clinical use world wide were compared. No significant difference in the lympholytic activity was observed between preparations and 100% cell lysis was achieved at a concentration of 50 μg/ml in the presence of complement. On the other hand, four preparations now in use in European countries and USA showed variable mitogenic activities on lymphocytes in the absence of complement, whereas two ALGs used in Japan did not.
As the stimulatory effects of ALG on lymphocytes may contribute to the clinical outcome in the treatment of severe aplastic anemia (Kawano et al, 1988), these date can explain the poor clinical results of ALG therapy with those two preparations in Japan. Careful measures should be paid in the construction of treatment protocol and selection of ALG preparations to yield the best results.View full abstractDownload PDF (405K)
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Yuichi YOSHIMURA, Akiko NAKAYAMA, Jun OGUCHI, Juzo MATSUDA, Masahide K ...1989 Volume 30 Issue 3 Pages 332-337
Published: 1989
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSEssential thrombocythemia is a myeloproliferative disorder not known to have consistent cytogenetic abnormalities.
A 38-year-old woman with essential thrombocythemia having Philadelphia chromosome (Ph1) is reported. The patient first presented with gastrointestinal bleeding, accompanied by thrombocytosis. Treatment of the gastrointestinal bleedisg did not influence the elevation of platelet counts. The patient's clinical and hematological manifestations were consistent with essential thrombocythemia, but not with any other myeloproliferative diseases.
Ph1 chromosome was constantly proved in bone marrow preparations from this patient over two years and four months and gave us a certain impression that Ph1 chromosome might have had some relation to development of essential thrombocythemia to chronic myelogenous leukemia in this patient.View full abstractDownload PDF (575K) -
Takeshi INOUE, Takahisa YAMANE, Atsuko SASAKI, Yuichi SANNOMIYA, Taesu ...1989 Volume 30 Issue 3 Pages 338-342
Published: 1989
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA 58-year old male was admitted to Osaka City University Hospital because of diplopia in May, 1987. Hematological examinations revealed abnormal blastoid cells in his peripheral blood and bone marrow. We found many mitochondrias and polysomes in the cytoplasm of the blastoid cells by the electron microscopy. Moreover, left axillar lymphnode biopsy specimen disclosed the typical “starry sky” pattern. The blastoid cells in the bone marrow had chromosomal abnormality; 47XY, 8q-, 14q+, 22q-, +mar. Therefore, the diagnosis of Burkitt's lymphoma (leukemic change) was performed.
He was treated with chemotherapy, but the blastoid cells resisted many anticancer agents and he died in September 30.
On admission left ocular motor disturbance was revealed. Generally, it was reported that meningitis with CNS involvement of lymphoma is acompanied by cranial nerves pulsy. However in this case lymphoma cells was not found in the cerebrospinal fluid. The cause of ocular motor disturbance was the adhesion to the medial rectus muscle and compression to the ocular motor nerves of the lymphoma mass.View full abstractDownload PDF (628K) -
Osamu SHINZATO, Tadao SHIMOJI, Koichi ARAKI, Goro MIMURA, Tadayosi TOD ...1989 Volume 30 Issue 3 Pages 343-348
Published: 1989
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSWe report a case of acquired immunodeficiency syndrome (AIDS) complicated by disseminated CMV infection and neurological disturbance. A 21 years old male with hemophilia A was diagnosed as having AIDS in Feb. 1986 because of interstitial pneumonia and esophageal candidiasis. Since Jan. 1987 he had complained of hypesthesia in the legs. On Mar. -14 he was admitted due to diarrhea. The laboratory data revealed that WBC was 4,000/μl including 29% of lymphocytes, 1.6% of OKT4+-, 71.6% of OKT8+-lymphocytes, T4/T8 ratio 0.02 and positive HIV antibody and HTLV-1 antibody. After the admission, sensory disturbance exacerbated to complicate paraplegia. He developed acute hepatitis associated with leukopenia, thrombocytopenia, pneumonia and melena, and eventually died on May-29. The autopsy findings disclosed CMV infection in the lungs, colons, and adrenal glands, suggesting that the primary cause of death was adrenal insufficiency. Degeneration of cerebro-spinal nerve cells and peripheral neuritis were thought to result from direct HIV infection to the nervous system.View full abstractDownload PDF (882K) -
Kouji YAMAMOTO, Yoshitaka ONO, Tatsuya ITO, Minoru SAITO, Kouichiro NA ...1989 Volume 30 Issue 3 Pages 349-353
Published: 1989
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA 65-year-old male admitted to the Anjo Kosei Hospital due to pancytopenia. The findings at the time of admission were; leukocyte count 2,000/μl, erythrocyte count 1,580,000/μl, and platelet count 88,000/μl. Bone marrow specimen revealed mild hypocellularity with 26% of the blast cells. He was diagnosed RAEB in transformation. Chromosome analysis showed 46, XY, -7, +8, -17, +marker in three cells and 45, XY, -7, -17, +marker in two cells out of five cells. He was treated with the low-dose Ara-C (20mg/body s.c. injections every 12hrs) for 9 days. Twenty five days later, the blast cells in the bone marrow decreased to 4%, and the complete remission was obtained. The duration of remission is 27+ weeks. At the time of complete remission, the bone marrow cells showed the normal karyotype. In this case, the effect of low-dose Ara-C to the blast cells may have not resulted from induction of differentiation but cytocydal action.View full abstractDownload PDF (419K) -
Yutaka TAKAI, Hiromichi KOYA, Sigeru HIMEI1989 Volume 30 Issue 3 Pages 354-360
Published: 1989
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA new case of acquired von Willebrand syndrome (AvWS) with Hashitoxicosis and pernicious anemia combined in a 73-years-old male is reported.
He was admitted because of appetite loss and general malaise. Physical examination showed severe anemia and general edema. The red-cell count was 103×104/μl with a MCV of 122 fl; the white-cell count was 2,900/μl with 24.5% hypersegmented neutrophils; the platelet count was 17.2×104/μl. the lactate dehydrogenase was 9,513 U/ml and vitamin B12 was 87 pg/dl. An aspirated specimen of bone marrow was diagnostic of megaloblastic anemia. The thyroid hormones were decreased with the thyroid stimulating hormone increased. From the immunological findings, the thyroid-test, microsome-test, and anti-intrinsic factor were positive, but M proteinemia and Bence Jones proteinuria were absent. Histology of the thyroid gland and the gastric mucosa established the diagnosis of chronic thyroiditis and chronic atrophic gastritis.
Subcutaneous hemorrhages after veni-puncture were observed on admission. He had a normal bleeding time, but the coagulation studies indicated the presence of von Willebrand disease, but as his family and past history were negative, this suggested the presence of an AvWS. The analysis of von Willebrand factor (vWF) multimeric composition had showed the lack of the larger multimers in the plasma, but it was normalized after the administration of levothyroxine sodium and hydroxocobalamin with vWF: Ag/RCo ratio paralleled. As far as we know, this is the first report of AvWS with Hashitoxicosis and pernicious anemia combined.View full abstractDownload PDF (657K) -
Saburo TSUNODA, Ryuhei SASAKI, Akiyoshi MIWA, Ikunosuke SAKURABAYASHI, ...1989 Volume 30 Issue 3 Pages 361-365
Published: 1989
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA 63-year-old man was admitted to our hospital with tremor and somnolence, followed soon by coma. Anemia and retinal bleeding were observed. The blood smear exhibited rouleaux formation and leukoerythroblastosis. A bone marrow aspiration resulted in dry tap. The biopsy specimens revealed remarkable infiltration of myeloma cells with fibrosis. The M-component of IgG-λ type and hyperammonemia were detected in the serum. Liver and renal functions, however, were within normal range. His consciousness recovered after plasmapheresis. Two courses of VMCP (vincristine, melphalan, carboquone and prednisolone) did not affect the paraproteinemia. Five courses of VAD (vincristine, adriamycin and dexamethasone) could lower the level of IgG. He died of pneumonia. The plasma of some patients with multiple myeloma may contain unidentified factors which increase the plasma ammonia.View full abstractDownload PDF (501K) -
Hiroharu SAITOH, Nobuko HORINO, Takaharu OHIE, Hitoshi SEJIMA, Chuzo M ...1989 Volume 30 Issue 3 Pages 366-370
Published: 1989
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA 4 4/12-year-old girl with hereditary spherocytosis (HS) who presented with an aplastic crisis during a human parvovirus (HPV) B19 infection is reported. IgM and IgG antibodies to the HPVB19 and HPV19 DNA were detected. Each of Leu 7+, Leu 11+ and HLA-DR+ cells increased. OKT4/OKT8 ratio decreased to 0.71. In order to investigate the mechanism of aplastic crisis, we used an in vitro culture technique for erythroid and granulocyte-macrophage progenitor cells (BFU-E, CFU-E and CFU-C). The patient's HPV 19 DNA-containing aplastic phase serum inhibited the formation of BFU-E, CFU-E and CFU-C. After removal of the adherent cells from the aplastic phase bone marrow, the numbers of BFU-E significantly increased. These results suggest that aplastic crisis of the patient with HS was caused by HPVB19, and that monocytes-macrophages and NK cells played an important role in the pathogenesis of aplastic crisis.View full abstractDownload PDF (419K) -
Takashi YAMADA, Nobuo SUEOKA, Yoshihiro TANABE, Kazuo DAN, Shin-ichiro ...1989 Volume 30 Issue 3 Pages 371-375
Published: 1989
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSTwo patients with refractory anemia with excess of blasts in transformation having entered remission and in continuing complete remission with the small-dose cytarabine therapy (SDCA) are reported. SDCA was the only chemotherapy used in these two patients. Cytarabine was injected subcutaneously every 12 hours at doses 15 mg and 10 mg, respectively, in cases 1 and 2. Case 1, a 60-year-old woman, achieved remission after a 14-day course of SDCA. Thereafter, she received SDCA for seven consecutive days every month or every other months in the first year and every two or three months in subsequent years. Her remission has been maintained for 57 months. Case 2, a 76-year-old man, attained a remission after three courses of SDCA, each consisting of 16, 11 and 14 days, respectively. SDCA was then repeated every month for 6 consecutive days. He is still in remission after 33 months. Whereas SDCA caused severe bone marrow suppression during induction, it was well tolerated when given in remission without necessitating any supportive measure.View full abstractDownload PDF (508K) -
Kanji SUGITA, Shinpei NAKAZAWA, Taijiro MORI, Kazuyoshi NISHINO, Takas ...1989 Volume 30 Issue 3 Pages 376-381
Published: 1989
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSWe report a 17-year-old female with chronic myeloid leukemia (CML) who developed monocytic crisis. She was diagnosed as chronic phase of Ph1-chromosome positive CML at 14 years old. Three years after the diagnosis of the disease, she was admitted to the hospital because of low grade fever, lethargy and marked splenomegaly. Small dose of Ara-C relieved her symptoms and splenomegaly. Six months later, however, a marked leukocytosis over 70,000/μl were observed, and the peripheral blood smear disclosed that about 80% of the leukocytes were relatively mature monocytoid cells. Chromosomal analysis revealed additional abnormalities (double Ph1, +8, +9, +19). Lysozyme levels in serum and urine were high and NAP score was elevated. These monocytoid cells expressed receptors for IgG-Fc and C3, phagocytic activity, and monocytoid antigens which were determined by monoclonal antibodies (MY4, Mo2, OKM5). Cytochemically, almost all of monocytoid cells were positive for peroxidase and naphthol-ASD-chloroacetate esterase (CAE), but the monocytoid cells positive for non-specific esterase were limited. These data suggested that this case was monocytic crisis in CML with proliferation of CAE positive monocytoid cells.
Among several types of blast crisis, monocytic crisis is extreamly rare condition. The definite monocytic crisis demonstrated by this case may support the hypothesis that target cells of CML are pluripotent hematopoietic precursors.View full abstractDownload PDF (607K) -
Miwako MATSUZAKI, Yoshinori SHIMAMOTO, Yuko YOKOYAMA, Kenji SUGA, Take ...1989 Volume 30 Issue 3 Pages 382-386
Published: 1989
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA 59-year-old man was admitted to the Saga Medical School Hospital in November 1986 because of unconsciousness and lymph node swelling. He had café au leit spots and multiple neurofibromas since his thirties. The leukocyte count was increased. The level of serum LDH and Ca were extremely elevated. His bone marrow aspiration showed the invasion of lymphoma cells. Lymph node biopsy from his left neck and the study of surface markers were performed. And then, his illness was diagnosed as non-Hodgkin's lymphoma (diffuse, medium sized cell type, B cell type, stage IV B.) following von Recklinghausen's disease. After the admission, his general condition improved by chemotherapy, but he had a relapse 6 months later. And he died in November 1987.
The case of von Recklinghausen's disease associated with malignant lymphoma in rarely reported. We reviewed the literature and discussed von Recklinghausen's disease associated with malignant lymphoma including this case.View full abstractDownload PDF (570K) -
Hideki MITSUI, Hitoshi KITAYAMA, Tamotsu YAMAGAMI, Yasufumi OSUGA, Hir ...1989 Volume 30 Issue 3 Pages 387-391
Published: 1989
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSAn 11-years old girl with CML in chronic phase was treated with allogeneic bone marrow transplantation (BMT). She had had no episode of heart disease, and her chest roentogenogram and electrocardiogram were within normal ranges. She had no anthracycline, but 120 mg/kg (2.01 g/m2/d×2 days) of cyclophosphamide (CY) for conditioning of BMT. She suffered from an acute heart failure on 14 days after BMT and died 2 days later. Autopsy revealed “specific heart muscular disease” with apparent degeneration and necrosis of heart muscle cells.
More than 30 fatal cases of CY cardiotoxicity after BMT have been reported, and most patients developed acute heart failure within 10 days after CY dosing. Goldberg et al. reviewed 14 cases of CY cardiotoxicity, and considered more than 1.55 g/m2/day to be the critical dosis for the onset of fatal cardiomyopathy. This case was considered to be first case in Japan. CY cardiomyopathy is an early fatal complication of BMT when CY used for conditioning. The dosing schedule may be considered.View full abstractDownload PDF (489K) -
Masatoshi FUJISHITA, Ryusaku KATAOKA, Taisuke EGUCHI, Tatsushi MIYAGI, ...1989 Volume 30 Issue 3 Pages 392-395
Published: 1989
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSWe report here four patients with acute leukemia, who developed seizure or tremor following treatment with imipenem, a new broad-spectram antibiotic. All four patients had no renal dysfuction and recovered after discontinuation of the drug. Two patients who developed seizure had a past history of cerebral hemorrhage with symptoms of meningitis in one and the other had received frequent intrathecal injections of methotrexate. Seizure also occurred in another patient who was given multiple intrathecal injections of methotrexate. The remaining old patient developed tremor after the first administration of imipenem which did not progress to convulsion. Cerebral hemorrhage or meningitis is known to predispose patients for convulsion following imipenem treatment. In addition, the present study suggests that central nervous system damage related with intrathecal injections of methotrexate may be a predisposing factor. Thus, imipenem should be given with caution to acute leukemia patients who often have risk factors for developing imipenem-related complications.View full abstractDownload PDF (318K) -
Seiichi HORIE, Taijiro ISHIYAMA, Masakuni SUGIMOTO, Takao OKADA, Hiros ...1989 Volume 30 Issue 3 Pages 396-399
Published: 1989
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA 47 year-old-man was admitted because of mild congestive heart failure. A differential white blood cell count revealed eosinophilia and a biopsied inguinal lymph node showed well-developed lymphoid follicles with germinal centers, eosinophil infiltration and marked proliferating vessels with swollen endotherial cells. He was diagnosed as eosinophilic lymphfolliculosis (Kimura's disease). He also was hypertensive and vascular murmur was pointed out in his abdomen. Angiography revealed the complication of aortitis syndrome.
Renal complication in eosinophilic lymphfolliculosis was reported in some cases and it was though that the disease had a clinical aspect of systemic diseases. The complication of aortitis syndrome in our case is interesting from a point of view of eosinophilic lymphfolliculosis as a systemic disease.View full abstractDownload PDF (481K) -
George KOIKE, Teruhisa OTSUKA, Tsunefumi SHIBUYA, Yoshiyuki NIHO1989 Volume 30 Issue 3 Pages 400-403
Published: 1989
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA 39-year-old Japanese female who had been followed as chronic myelogenous leukemia (CML) since 1984 was admitted to our hospital because of dizziness. On admission, platelet count markedly increased (245×104/μl) in spite of daily administration of busulfan 2 mg. She was diagnosed as accelerated phase CML with thrombocytosis. So we tried to use interferon alpha (IFN-α) finally given in a dose of 9×106 U daily by subcutaneous injection. After that, platelet count decreased to 70×104/μl and megakaryocyte count in bone marrow decreased from 887.5/μl to 395.7/μl. But we had to stop IFN-α because of severe side effects.View full abstractDownload PDF (412K) -
Michiaki KOIKE, Noboru IIDA, Yoshihisa WAKABAYASHI, Taijiro ISHIYAMA, ...1989 Volume 30 Issue 3 Pages 404-407
Published: 1989
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA 53-year-old woman born in Kamo village of Shizuoka prefecture was admitted to Juntendo Izunagaoka hospital complaining cough and appetite loss. On physical examinations, general lymphadenopathy and hepatosplenomegaly were recognized. And also dry rales and wet rales were heard in the bilateral lungs. On hematological examinations, leukocytes has counted 74,900/μl, of which 61% atypical lymphocytes, and there were HTLV-I infection and positive anti-ATLA antibody. By the above results, she was diagnosed as adult T cell leukemia (ATL). T cell subset analysis was (CD4-, CD8-, CD3-), which is rare in ATL. Three months after the admission, she was died of disturbances of respiratory function in spite of VEPA therapy. Surface marker changed from CD3- to CD3+ in the course. To illuminate this mechanism will be a key step for the future study.View full abstractDownload PDF (399K)
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