巻号一覧
31 巻, 12 号
選択された号の論文の15件中1～15を表示しています
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臨床研究
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—特にTLIにおける骨盤部の照射野について—花田 良二, 川上 哲夫, 芥 直子, 森脇 浩一, 加藤 静恵, 稲葉 俊哉, 林 泰秀, 山本 圭子1990 年 31 巻 12 号 p. 1901-1905
発行日: 1990年
公開日: 2009/03/12
ジャーナル 認証ありA preparative regimen for allogeneic bone marrow transplantation, consisting of total lymphoid irradiation (TLI) with 750 cGy and cyclophosphamide (CY), was used in five girls with aplastic anemia. All patients received bone marrow from HLA matched/mixed lymphocyte culture negative siblings. In our regimen the “inverted Y” field to irradiate the pelvic nodes was modified, which did not include the whole pelvic cavity in an attempt to protect the ovaries from irradiation. Although some of the pelvic nodes was supposted not to be irradiated in order to protect the ovaries, engraftment occurred in all five patients including four who had been transfused prior to transplantation. All five are alive from 47 days to 1378 days (median 285 days) after transplantation without transplantation-associated complications. The calculated dose to the ovaries was sixteen percent of the entire dose of the regimen. Both of the two evaluable patients that had received tranplantation just before or during the puberty are developing normal sex maturity including menstruation. This study suggests that our preparative regimen is efective not only for engraftment of the donor marrow but also for protecting the ovaries from irradiation.抄録全体を表示PDF形式でダウンロード (482K) -
倉田 寛一, 平井 真希子, 三輪 哲義, 村井 善郎, 森 真由美1990 年 31 巻 12 号 p. 1906-1913
発行日: 1990年
公開日: 2009/03/12
ジャーナル 認証ありWe examined fourteen patients with chronic myelomonocytic leukemia (CMMoL) according to the following staging criteria at diagnosis; Group A: bone marrow (BM) blast less than 5% (eight cases), Group B; BM blast more than 5% and less than 30% (five cases), Group C; BM blast more than 30% (one case).
Compared with Group A, Group B patients have much more peripheral blood leukocyte, granulocyte and monocyte counts, LDH level, and serum and urine lysozyme levels. Two of the five Group B cases transformed to acute leukemia (BC) within one and a half year, and other three patients died of infection and hemorrhage within a year. On the contrary, three of the eight Group A patients survived four years, and transformation to acute leukemia occurred in only one case after four years. Autopsy revealed multiple organ infiltration of monocytoid granulocytes on the patients with advanced stage and more bone marrow blasts.
Two cases have coexistence of myeloproliferative disorders, one with essential thrombocythemia, and another with myelofibrosis, which, later, transformed to acute leukemia. And a Group C patient transformed to chronic phase with chemotherapy, and maintained the state for six years, but at the end stage, mature monocytes increased and pancytopenia developed.
These findings indicate the heterogeneity of CMMoL in respect of the disease stage and the coexistence of other myeloproliferative disorders.抄録全体を表示PDF形式でダウンロード (599K) -
—炎症，手術，透析による変化—西郷 勝康, 吉田 明憲, 菅野 亘, 寮 隆吉, 山口 延男1990 年 31 巻 12 号 p. 1914-1919
発行日: 1990年
公開日: 2009/03/12
ジャーナル 認証ありSerum or plasma histidine-rich glycoprotein (HRGP) levels were determined in several conditions.
In normal volunteers, HRGP levels did not correlate with either plasminogen contents or plasminogen activity, although HRGP has been believed to be a modulator for fibrinolysis system.
In acute inflammation, HRGP levels in serum changed as a negative acute phase reactant, which was also confirmed after surgical operation. At the time of demonstrating decreased HRGP values, expression of HRGP fragment was studied using heparin-Sepharose beads. However, no new fragments were detected, suggesting that the decrease was not due to enzymatic destruction.
On the other hand, in patients with rheumatoid arthritis (chronic inflammation), HRGP levels were similar to those in control subjects.
As HRGP is a potent heparin antagonist, HRGP levels in plasma during hemodialysis with heparin were studied. Both levels of HRGP and albumin increased after hemodialysis in a similar degree due to concentration, indicating that turnover of HRGP was not altered in short period after heparin administration.抄録全体を表示PDF形式でダウンロード (454K) -
—急性リンパ性白血病，副腎皮質ステロイドホルモン療法中の再生不良性貧血，自己免疫疾患などにおける比較検討—脇口 宏, 藤枝 幹也, 久川 浩章, 久保田 晴郎, 松本 健治, 倉繁 隆信1990 年 31 巻 12 号 p. 1920-1923
発行日: 1990年
公開日: 2009/03/12
ジャーナル 認証ありSerum levels of IgG subclasses were analysed in 15 children with acute lymphoblastic leukemia (ALL) receiving maintenance chemotherapy and 10 children with aplastic anemia and autoimmune diseases receiving prednisolone therapy longer than 2 months (Steroid group). The results were as follows. Serum levels of IgG1 in ALL were significantly (p<0.05) lower than age matched normal controls, while the IgG1 levels in the Steroid group were as high as in normal controls. Serum levels of IgG2 in ALL and the Steroid group were significantly (p<0.005, p<0.02) lower than in normal controls. Serum levels of IgG3 in ALL and the Steroid group were as high as in normal controls. Serum levels of IgG4 in ALL and the Steroid group were significantly (p<0.005, p<0.05) lower than in normal controls.
IgG2 and IgG4 should be more susceptible to suppression by immunosuppressive chemotherapy than IgG1, and IgG3 would hardly suppressed by immunosuppressive chemotherapy.抄録全体を表示PDF形式でダウンロード (309K)
症例
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中山 志郎, 矢部 博樹, 永井 謙一1990 年 31 巻 12 号 p. 1924-1928
発行日: 1990年
公開日: 2009/03/12
ジャーナル 認証ありA 31-year-old man was admitted for investigation of proteinuria and hematuria. Physical examination on admission revealed systemic lymphoadenopathy, no hepatosplenomegaly, and ankle edema. Hemoglobin was 14.3 g/dl, platelet 21.4×104/μl and WBC 40800/μl which contained 86% mature lymphoid cells. lmmunological phenotyping of peripheral lymphoid cells gave positivve reactions for CD19, and CD20, and negative reaction for smlg. Urinary protein excretion was 8.3 g/dl in 24h. Serum total protein was 4.1 g/dl with albumin of 2.5 g/dl. Serum IgG was 302 mg/dl, IgA 43 mg/dl, and IgM 56 mg/dl. Renal biopsy showed characteristic features of membranoproliferative glomerulonephritis (MPGN). He was diagnosed as having nephrotic syndrome associated with B-cell chronic lymphocytic leukemia (B-CLL), and was treated with prednisolone and cyclophosphamide without effect. Therefore, he was treated with 18 MU of recombinant-alpha-2a-interferon (IFN-α)/day. This treatment reesulted in almost normal WBC and differential counts, and urinary protein excretion of 3g in 24h 2 months later. After IFN-α treatment was discontinued, WBC count and the amount of urinary protein again increased. He was again treated with IFN-α at the dose of 9.0 MU/day three times a week, and is now well without any complaints.
This is the first case report in which IFN-α was effective in a patient with nephrotic syndrome assoceated with B-CLL. We think that IFN-α therapy is worth trying in similar cases.抄録全体を表示PDF形式でダウンロード (447K) -
賀来 秀文, 別所 文雄, 横田 俊一郎, 林 泰秀1990 年 31 巻 12 号 p. 1929-1933
発行日: 1990年
公開日: 2009/03/12
ジャーナル 認証ありTwo cases of childhood acute nonlymphocytic leukemia (ANLL) with 21 trisomy as a sole cytogenetic change are reported. The first case was a 4-year-old boy with FAB-M5a. 47, XY, +21 was found in 7 of 12 metaphases at diagnosis and in all 15 metaphases examined at relapse 4 years and 3 months later. The second case was a 14-year-old boy with FAB-M1, all 20 cells examined showed 21 trisomy at diagnosis. His peripheral blood in remission revealed normal male karyotype. Although 21 trisomy is relatively common in ANLL of children, 21 trisomy as a sole anomaly is extremely rare, and to our knowledge, only 2 cases (19 included adult cases) have previously been reported.抄録全体を表示PDF形式でダウンロード (376K) -
大塚 英一, 大野 栄治, 小野 敬司, 佐分利 能生, 菊池 博, 那須 勝, 糸賀 敬1990 年 31 巻 12 号 p. 1934-1938
発行日: 1990年
公開日: 2009/03/12
ジャーナル 認証ありA 38-year old female patient with thrombotic thrombocytopenic pupura (TTP) did not respond to plasmapheresis and treatment with corticosteroids and antiplatelet agents but did respond to subsequent high-dose γ-globulin therapy and vincristine slow infusion therapy. Remission, thought to be due to vincristine, was achieved. The administration schedule of vincristine was 1 or 2 mg once a week by intravenous drip infusion over a period of 6 to 8 hr. Improvement tended to be seen after the 6th administration, and remission was achieved after the 12th administration (total dose: 15 mg), and continues to the time of this writing. In this case, it was thought that vincristine inhibited a certain excessive reaction in the process of PAIgG-related platelet consumption. We conclude that vincristine should be administered at least 5 to 6 times, and the therapeutic method should be established based on the experience in a larger number of clinical cases.抄録全体を表示PDF形式でダウンロード (359K) -
畑江 芳郎, 武田 武夫, 中舘 尚也, 畑山 由起子, 木住野 達也, 小川 泰弘1990 年 31 巻 12 号 p. 1939-1944
発行日: 1990年
公開日: 2009/03/12
ジャーナル 認証ありThis report describes three cases with Down's syndrome. These cases initially had transient abnormal myelopoieses (TAM), from which they recovered spontaneously. They finally developed into overt acute leukemia characterized by an increase of blasts, hepatosplenomegaly, and elevated lactic dehydrogenase. Of these three cases, one was thought to have ANLL, which broke out 5 months after spontaneous remission. The other two had ALL, each occurring 8 and 9 years later.
Chromosomal abnormality, in addition to trisomy 21, was detected in blast cells from one of the patients with acute leukemia. All three patients with acute leukemia experienced complete remission. However, two of the three patients relapsed and died. It is noted in the literature that remission is permanent in most cases of TAM, and is rarely terminated by leukemic relapse. In view of our observations, the importance of following up on such patients who evidence apparent remission of their leukemia-like disorder is emphasized.抄録全体を表示PDF形式でダウンロード (535K) -
井本 しおん, 伊藤 光宏, 中川 俊太郎1990 年 31 巻 12 号 p. 1945-1949
発行日: 1990年
公開日: 2009/03/12
ジャーナル 認証ありA 20-year-old man was admitted because of general fatigue. Peripheral blood examination revealed pancytopenia (WBC 1,700/μl, RBC 210×104/μl, Plt 3.2×104/μl) with remarkable erythroblastosis. Bone marrow examination revealed erythroid hyperplasia and an increase of abnormal myeloblasts with Auer bodies (37% of non erythroid cells). A diagnosis of erythroleukemia (AML M6) was made. He recieved two courses of combination chemotherapy (BHAC-DMP and VAMA (VP-16, Ara-C, 6-MP, and doxorubicin (ADR))) but complete remission (CR) could not be achieved.
Consequently, he was treated with LDAC. After two courses of LDAC. CR was obtained. Subsequently, he received two courses of HDAC as consolidation, and therapy has been off thereafter. He remains in CR state for more than 12 months.抄録全体を表示PDF形式でダウンロード (437K) -
鏡味 良豊, 村手 隆, 市川 篤, 堀田 知光, 斎藤 英彦1990 年 31 巻 12 号 p. 1950-1954
発行日: 1990年
公開日: 2009/03/12
ジャーナル 認証ありWe reported a prednisolone effective case of T 8 lymphocytosis. The patient was 83 years old male, who had suffered from hypoplastic anemia for more than 5 years before he admitted to our hospital. His blood picture was peculiar because adding to granulocytepenia, CD8 (+) large granular lymphocytes were dominant among his lymphocytes. A few days after administration of bolus methylprednisolone, prominent reticulocytosis and rapid improvement of anemia occured and the latter continued for more than 1 years. We performed in vitro study on the mechanism of his cytopenias. The result of Southern blot analysis showed that his blood lymphocytes had a unique rearranged pattern of T cell receptor β chain gene. Mononuclear cells had an inhibitory effect on autologous and allogenic CFU-E colony formation of bone marrow cells. These facts suggest that clonaly proliferating CD8 (+) lymphocytes had an inhibitory effect on erythropoieis in vivo, and prednisolone blocked this inhibitory pathway in this patient.抄録全体を表示PDF形式でダウンロード (416K) -
尾辻 啓, 尾辻 典子, 大野 敏之, 関根 隆夫, 池田 健, 川上 恵基, 片山 直之, 北 堅吉, 白川 茂1990 年 31 巻 12 号 p. 1955-1959
発行日: 1990年
公開日: 2009/03/12
ジャーナル 認証ありWe report a case of a 61-year-old woman with large granular lymphocytosis associated with pulmonary tuberculosis. She was admitted to our hospital because of high fever, anemia and splenomegary. On admission, the leukocyte count was 6,890/μl with 52% of large granular lymphocytes. Immunophenotypical analysis of the increased cells showed following results; CD2+, CD3-, CD16+, CD57+. These cells had natural killer (NK) activity. Molecular genetical analysis showed these cells had germline configuration of the T cell recepter β chain genes. About four months after admission, chest X-P revealed multiple mass shadow and the diagnosis of pulmonary tuberculosis was made by the examination of gastric juice. Anti-tuberculosis therapy was started, and soon after clinical symptom and pancytopenia were improved. For about one year, anti-tuberculosis therapy was continued, and now hematological abnormality is not found. We considered that this case was reactive large granular lymphocytosis of NK cells to lung tuberculosis.抄録全体を表示PDF形式でダウンロード (386K) -
宗方 律子, 宮澤 郁夫, 松崎 廣子, 吉野 克正, 平野 正憲, 向山 明孝, 成内 秀雄1990 年 31 巻 12 号 p. 1960-1964
発行日: 1990年
公開日: 2009/03/12
ジャーナル 認証ありA 52 year-old male was admitted to our hospital with the complaint of the hypochondrial pain after meal in February 1989. He was diagnosed to be RAEB and to have common bile duct stone. His red blood cells (RBC) could not be agglutinated with anti-A, anti-B, or anti-A, B. The agglutinability of the cells to Ulex europaeus (anti-H) was the same to the normal type B RBC, and his serum contained anti-I, anti-E, and anti-c. In his saliva, both B and H antigens were detected. The glycosyl B transferase in his serum showed similar activity to that of normal individual with type B RBC. When his RBC were treated with normal type B transferase, the cells obtained the reactivity to anti-B but they agglutinated much weaker than the type O cells treated with the enzyme. These results indicated that the low agglutinability of his RBC could not be due to the low transferase activity but the qualitative or quantitative changes of the precursor molecules of the type B substance of the cells.抄録全体を表示PDF形式でダウンロード (391K) -
田口 文博, 身吉 剛, 中島 直樹, 西村 純二, 名和田 新1990 年 31 巻 12 号 p. 1965-1966
発行日: 1990年
公開日: 2009/03/12
ジャーナル 認証ありA-36-year old Japanese female who had been suffered from systemic lupus erythematosus (SLE) and treated with prednisolone for 3.5 years developed de novo acute promyelocytic leukemia (APL) without preleukemic state. She had a short period of complete remission in leukemia but she died with recurrence of leukemia. While malignant tumors including lymphoid malignancy have been shown to develop occasionally in the course of SLE, acute myelogenous leukemia (AML) following SLE is a very rare condition. Although combination of SLE and AML may be incidental, review of the literatures revealed some interesting insight into the pathogenesis of SLE and AML.抄録全体を表示PDF形式でダウンロード (160K)
短報
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中瀬 勉, 森田 孝一, 留奥 誠, 加藤 正美, 金丸 正泰, 白川 茂1990 年 31 巻 12 号 p. 1967-1968
発行日: 1990年
公開日: 2009/03/12
ジャーナル 認証ありA 66-year-old female was admitted to our hospital with lumbago. On admission, laboratory examination revealed hemolytic anemia. Direct Coombs' test was positive, and also direct monospecific-Coombs' test by anti-C3d serum was positive. Immunoelectrophoresis showed IgA-λ type M proteins in serum. Bone marrow aspiration disclosed increased atypical plasma cells. X-ray of skull showed punched-out lesion. From these findings, she was diagnosed as IgA (λ) myeloma complicating with autoimmune hemolytic anemia. Hemolysis was improved by chemotherapy. It was thought that IgA and C3 were related well to hemolysis in this case.抄録全体を表示PDF形式でダウンロード (151K) -
中瀬 一則, 伊藤 質, 辻 幸太, 宮西 永樹, 森田 孝一, 白川 茂1990 年 31 巻 12 号 p. 1969-1970
発行日: 1990年
公開日: 2009/03/12
ジャーナル 認証ありA 72-year-old woman had been given cimetidine 400mg/day for her gastritis since June 17, 1987. On August 8, she developed oral bleeding. Peripheral blood showed pancytopenia (WBC 1,900/μl, RBC 208×104/μl, Plt 0.8×104/μl) and bone marrow studies revealed markedly depressed hematopoiesis. Bolus methylprednisolone and high dose gamma globulin were administered, but not effective. On December 11, 1987, she lapsed into coma and died three days later. Autopsy disclosed nonbacterial thrombotic endocarditis and cerebral infarction.抄録全体を表示PDF形式でダウンロード (282K)
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