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Volume 33, Issue 4
Displaying 1-23 of 23 articles from this issue
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Tohru MURAYAMA, Keiko MATSUSHITA, Tetsuya TAKAHASHI, Sachiko MATOZAKI, ...1992 Volume 33 Issue 4 Pages 413-417
Published: 1992
Released on J-STAGE: April 24, 2009
JOURNAL RESTRICTED ACCESSCyclosporin A, a strong immunosuppressive agent, has been used to prevent rejection or graft-versus-host disease (GVHD) after organ transplantations including bone marrow transplantations. Monitoring of cyclosporin A concentration in whole blood is necessary for its high frequency of side effects. The authors to measured its concentration by means of radioimmunoassay (RIA) as well as fluorescence polarization Immunoassay (FPIA) a cases after bone marrow transplantation. There was a good correlation between these two methods. FPIA is less specific for cyclosporin A than RIA, but it is an easier method. It is important to measure the concentration of cyclosporin with FPIA because there are metabolites of cyclosporin A which cannot be measured with RIA. Thus FPIA can be applied to the routine monitoring of cyclosporin.View full abstractDownload PDF (364K) -
Hisae FUSEGAWA, Hayato MIYACHI, Toshio OHSHIMA, Shigeru ARIMORI, Yasuh ...1992 Volume 33 Issue 4 Pages 418-422
Published: 1992
Released on J-STAGE: April 24, 2009
JOURNAL RESTRICTED ACCESSIn patients with malignant blood disease, infection is the most serious complication. The prompt differential diagnosis of tuberculosis leads to an appropriate treatment. A method based on DNA amplification and hybridization for the rapid detection of Mycobacterium tuberculosis was used to test 10 clinical specimens (sputum, gastric aspirate and pleural effusion) from blood disease patients in whom tuberculosis was suspected. Mycobacterium tuberculosis DNA was detected in 3 specimens, including one which was negative on standard microbiological criteria (microscopy and/or culture). The other 7 specimens with fever or abnormal shadow on a chest X-ray were negative by both our method and the Standard microbiological criteria. Rapid diagnosis of tuberculosis by amplification of mycobacterial DNA in cases of blood disease is clinically useful.View full abstractDownload PDF (415K) -
Shuya KUSUMOTO1992 Volume 33 Issue 4 Pages 423-429
Published: 1992
Released on J-STAGE: April 24, 2009
JOURNAL RESTRICTED ACCESSMagnetic resonance imaging (MRI) of bone marrow was performed in 16 patients with aplastic anemia (AA) and myelodysplastic syndrome (MDS). Sagittal images from the lower thoracic and lumbar vertebral marrow were evaluated on short TI IR sequences (STIR, IR 2000/160/20). Four distinct patterns of signal intensity (SI) of the STIR images corresponding with active red marrow were classified as follows: pattern I, homogeneously low SI (4 cases); II, marginally high SI (2 cases); III, heterogeneously high SI (8 cases); IV, homogeneously high SI (2 cases). The SI distribution of STIR images strongly correlated with the cellularity of clot specimens of aspirates from sternum using the Wiebel test plate. In all three patients with AA, the STIR images revealed pattern I. In 8 of 13 cases of MDS patients, the STIR images were classified into pattern III. In one patient with hypoplastic MDS, the STIR image showed low SI. The STIR images of two AA patients at clinical remission after treatment showed marginally high SI similar to those of normal marrow. MRI of bone marrow can be a useful technique for the diagnosis of AA and MDS and for monitoring therapeutic effects.View full abstractDownload PDF (1759K) -
Seiji KINOSHITA, Keiichiro YOSHIOKA, Giichi TSUJINO, Takahito SHINDO, ...1992 Volume 33 Issue 4 Pages 430-435
Published: 1992
Released on J-STAGE: April 24, 2009
JOURNAL RESTRICTED ACCESSThree cases of suspected variant thrombasthenia patients (out of 10 cases of Glanzmann's thrombasthenia), who had significant amounts of platelet GPIIbIIIa, underwent flow cytometry to analyse the binding capacity of monoclonal antibodies against GPIIbIIIa to latelets. The monoclonal antibodies used in this study were as follows: PLT-1 and AP-2 recognizing the IIbIIIa complex; TP 80, P2 and AP-4 recognizing IIb:; AP-5 recognizing IIIa; OP-G2, which binds an epitope near the RGD binding site and 3F11. OP-G2 also recognizes comformational changes of activated platelets by increased binding. Case 1 platelets showed a binding capacity of 28∼63% of that of normal platelets for TP80, AP-2, AP-4, and 3F11, but no binding to OP-G2. Case 2 platelets also showed 16∼44% binding with TP80, AP-2, AP-4, AP-5, and 3F11, but no binding to OP-G2. These findings indicated the presence of structural abnormalities of the functional site of platelet GPIIbIIIa in cases 1 and 2. Case 3 platelets bound with all monoclonal antibodies normally, but normal increase in the binding of OP-G2 to platelets activated by thrombin or ADP was not seen, indicating a lack of activation of the fibrinogen binding site of platelet GPIIbIIIa.View full abstractDownload PDF (510K) -
Kozue NAKAMURA, Shuki MIZUTANI, Takao MATSUE1992 Volume 33 Issue 4 Pages 436-444
Published: 1992
Released on J-STAGE: April 24, 2009
JOURNAL RESTRICTED ACCESSThirty three patients with chronic myelogenous leukemia (CML) treated by allogeneic bone marrow transplantation (BMT) were evaluated for bcr/abl mRNA using the reverse transcriptase-polymerase chain reaction (RT-PCR). The bcr/abl mRNA was detected in 22 out of 33 patients in clinical complete remission after BMT. The bcr/abl mRNA was present only transiently in 6 patients. It was speculated that leukemia cells were not eradicated by conditioning therapy of BMT, but patients maintained clinical complete remission due to GVL (graft versus leukemia) effect. Further study is necessary to estimatethe clinical value of this technique to predict the outcome in CML patients.View full abstractDownload PDF (646K) -
Yoichi AZUNO, Yukio HIROSHIGE, Masahisa TANAKA, Yoichiro NISHIMURA, Hi ...1992 Volume 33 Issue 4 Pages 445-450
Published: 1992
Released on J-STAGE: April 24, 2009
JOURNAL RESTRICTED ACCESSA 14-year-old girl with aute promyelocytic leukemia (APL) developed cardiomyopathy following chemotherapy for remission induction and subsequent consolidation consisting of cumulative doses of 644 mg/m2 of daunorubicin and 31 mg/m2 of mitoxantrone. Six months after the first complete remission, when relapse of APL was recognized an allogeneic bone marrow transplantation (BMT) from her HLA-identical brother was performed. A preconditioning regimen, consisting of cytarabine (Ara-C, 2 g/m2/day×3 days and 4 g/m2/day×3 days), total body irradiation (TBI, 1200 cGy) and etoposide (VP-16, 50 mg/kg) caused moderate gastrointestinal symptoms and transient hemorrhagic cystitis, but did not worsen her cardiac function. Both continuous intravenous administration of heparin to control DIC and continuous low dose dopamine infusion to prevent cardiac failure achieved their purpose. The patient is leukemia-free and has no symptoms related to cardiomyopathy at the eight month after BMT. A precoditioning regimen (Ara-C, TBI and VP-16) appeared to be suitable for BMT to a patient with anthracycline-induced cardiomyopathy.View full abstractDownload PDF (472K) -
Makoto HANDA, Yasuo IKEDA, Yoshiyuki KURATA, Kazuhide TSUBAKI, Atsushi ...1992 Volume 33 Issue 4 Pages 451-460
Published: 1992
Released on J-STAGE: April 24, 2009
JOURNAL RESTRICTED ACCESSA prospective multiinstitutional study was conducted to assess the efficacy of leukocyte-depleted platelet concentrates, prepared by a method using a newly developed polyester filter, in the prevention of HLA-alloimmunization in patients with hematological disorders. Patients who were expected frequent platelet transfusions, were assigned into two groups, receiving either standard platelet concentrates (control group) or leukocyte-depleted platelet concentrates prepared through a polyester platelet filter, Sepacell-PL (filtered group). All patients received leukocyte-depleted red cell products. Of 111 patients enrolled, 72 were evaluable, 23 in the control and 49 in the filtered group. Both groups were comparable according to age, sex ratio, underlying disorders, previous exposure to alloantigens by transfusion and/or pregnancy. There was no statistically significant difference in the number and duration of transfusion in the two groups. There were significant differences in HLA-alloimmunization rate (9 cases out of 23, 39% in the control group versus 4 cases out of 49, 8% in the filtered group; p<0.01) and refractoriness to platelet transfusion from random donors (6 cases out of 23, 26% in the control group versus 2 cases out of 49, 4% in the filtered group; p<0.05). These results indicated that leukocyte-depleted platelet concentrates prepared through the polyester platelet filter are benefical to reduce HLA-alloimmunization in patients with frequent platelet transfusions.View full abstractDownload PDF (835K)
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Norifumi TSUKAMOTO, Kazuto INOSE, Takafumi MATSUSHIMA, Toshimasa UCHIY ...1992 Volume 33 Issue 4 Pages 461-466
Published: 1992
Released on J-STAGE: April 24, 2009
JOURNAL RESTRICTED ACCESSA 76 year old female with atypical leukemia complicated by vitamin B12 deficiecy demostrated marked fluctuation in blast percentage and hemopoiesis over 8 month period. She underwent surgical removal of pancreas head cancer 5.5 years ago. In January 1989 severe pancytopenia and mild increase of bone marrow blasts were found. Blood transfusions and inadvertent administration of Vitamin B12 resulted in alleviation of pancytopenia and decrease in blast percentage. Several months later her bone marrow blast exceeded 30%, when serum B12 concentration was below 90 pg/ml. B12 injection and blood transfusion resulted in significant improvement in her hematological condition, but shortly thereafter she died of fulminant hepatitis. Her bone marrow cells showed a polyclonal constitution, as assessed by the RFLP-methylation technique using the PGK gene as a probe. The coexistence of leukemic- and normal clones under Vitamin B12 deficiency conditions and the differing behavior of such clones to B12 supplementation may explain the unusual clinical course observed in this patient.View full abstractDownload PDF (472K) -
Junko HORIGUCHI, Shigeko YAMAMURA, Tadashi NEMOTO, Touru FUJIKAWA, Sat ...1992 Volume 33 Issue 4 Pages 467-472
Published: 1992
Released on J-STAGE: April 24, 2009
JOURNAL RESTRICTED ACCESSA 59-year-old man was admitted because of generalized lymphadenopathy with fever and vomiting. His peripheral blood showed leukocytosis with a WBC of 93,500/μl, and the bone marrow picture revealed a predominance of blast cells. The blasts were negative for peroxidase, alpha-naphtyl butyrate esterase and PAS, and had the phenotype of CD7, 13 and 33 positive. A diagnosis of AML M0 was made, based on the criteria of the NCI-sponsored workshop in 1988. His initial status had been compromised by acute renal failure which necessitated hemodialysis. He responded partially to chemotherapy consisting of daunorubicin, cytarabine and prednisolone. However leukemia recurred and the patient suffered from various episodes of infection and died six months after admission. The Southern blotting showed the germ line configuration for TCR-beta chain and immunoglobulin heavy chain genes. No messenger RNA was detected for myeloperoxidase, c-myc and c-jun, while c-fms, c-fos and c-myb were expressed on Northern blotting. It is intriguing to detect c-fms and c-fos expression in these poorly differentiated leukemic cells.View full abstractDownload PDF (521K) -
Akira YOSHIDA, Michihiko UCHIDA, Toshihiro FUKUSHIMA, Tuneo TANAKA, Fu ...1992 Volume 33 Issue 4 Pages 473-477
Published: 1992
Released on J-STAGE: April 24, 2009
JOURNAL RESTRICTED ACCESSCase of hematological disorders associated with acute myocardial infarction had been found in five of forty five autopsy cases which had hematological disorders during the past seven years. The five cases of hematological disorders consisted of two cases of myelodysplastic syndrome, a case of aplastic anemia, a case of primary myelofibrosis in blast transformation, and a case of acute myelogenous leukemia. All the patients were over 60 years old. Four patients had coronary artery stenosis and extensive myocardial infarction. Fibrinogen degradation products were elevated in four patients. DIC was recognized in two and suspected in two others. In all cases, platelet counts markedly decreased to less than 2.5×1010/L. Since no chest pain was noted by any patient, it was difficult to diagnose acute myocardial infarction without autopsy, except in one case. It is important to recognize the possibility of severe cardiac dysfunction due to myocardial infarction in thrombocytopenia, especially in the aged with DIC.View full abstractDownload PDF (426K) -
Shintaro NISHIMURA, Hiromitsu MATSUZAKI, Kouji FUJIMOTO, Makoto KAWAKI ...1992 Volume 33 Issue 4 Pages 478-482
Published: 1992
Released on J-STAGE: April 24, 2009
JOURNAL RESTRICTED ACCESSA patient with Münchhausen syndrome who had severe iron deficiency anemia (IDA) is reported. A 31 year-old female presented with irregular genital bleeding. However, gynecological examination disclosed no evidence of specific disorders causing bleeding. Tests for bleeding tendency and hemolysis were all negative. Although massive bleeding was absent, she had three episodes of a rapid fall in Hb level associated with marked fatigue and weakness, and subsequently rapidly developed serious IDA afterwards. Factitious bleeding was strongly suspected. Blood transfusion performed when the patient was not being watched failed to increase Hb, while transfusions given while the patient was watched were effective. She was not cooperative throughout the hospital course and was discharged on her own request. In outpatient clinic, the diagnosis was confirmed by the evidence that she diluted her own blood samples.View full abstractDownload PDF (378K) -
Toshikazu MATSUI, Fumio MARUYAMA, Hitoshi MIYAZAKI, Toshiyuki NOMURA, ...1992 Volume 33 Issue 4 Pages 483-487
Published: 1992
Released on J-STAGE: April 24, 2009
JOURNAL RESTRICTED ACCESSA 76-year-old man was diagnosed as having malignant lymphoma (non-Hodgkin's lymphoma, diffuse medium cell-sized, B cell type). He was treated with CHOP therapy but with no response. In the terminal stage, he had continuous high temperature despite the administration of anti-bacterial and anti-fungal agents. Paralytic ileus, liver and pancreas dysfunction, and gastrointestinal bleeding developed. No skin eruptions occurred throughout the clinical course. He died on day 36 of treatment. Postmortem examination revealed foci of hemorrhagic necrosis containing many multinuclear giant-cells some of which with intranuclear inclusion bodies (Cowdry type A), in the liver, pancreas, gastrointestinal tract, bone marrow and other organs. Electron microscopy showed viral particles in the cytoplasm but not the nuclei of infected cells which were covered with a capsule, which was characteristic of varicella-zoster virus infection. Cells of the above organs were positive for immunohistochemical staining using anti-varicella-zoster antibodies. The multiorgan failure seen in the terminal stage was considered to be due to disseminated varicella-zoster infection.View full abstractDownload PDF (568K) -
Toshio KATAYAMA, Hidekazu MASUOKA, Mayumi YOSHIDA, Reijirou WATANABE, ...1992 Volume 33 Issue 4 Pages 488-493
Published: 1992
Released on J-STAGE: April 24, 2009
JOURNAL RESTRICTED ACCESSA 38-year-old woman presented with ear pain and vertigo. No hepatosplenomegaly or lymphadenopathy were found, but her platelet counts markedly rose to 414×104/μl with an increase of megakaryocytes in the bone marrow (859/μl). Cytogenetic assay revealed positive Ph1 chromosome and rearrangement of the break point cluster region (bcr). Although platelet counts remained under 100×104/μl after the administration of carboquone, a high fever and pancytopenia appeared 31 months later. Bone marrow biopsy showed marked myelofibrosis which was improved by low dose etoposide. This case was thought to be Ph1 positive ET, but it was more compatible with CML megakaryocytic predominance type according to the newly proposed “Hannover criteria for myeloproliferative disorders” and cytogenetic assay.View full abstractDownload PDF (664K) -
Hiroshi FURUYA, Shinichi TSUCHIYAMA, Toshiaki SATO, Rieko ISHIBASHI, K ...1992 Volume 33 Issue 4 Pages 494-499
Published: 1992
Released on J-STAGE: April 24, 2009
JOURNAL RESTRICTED ACCESSA 57-year-old famale presented with general fatigue. She had neither lymphadenopathy nor hepatosplenomegaly. Laboratory data revealed anemia and leukopenia (1,500/μl) with a differential count of 4.5% leukemic cells. The myelogram revealed 34.4% leukemic cells, of which diameter ranged from 20 to 28μm. The diagnosis was acute myelogenous leukemia (FAB:M2) with myelodysplasia. Cytogenetic analysis revealed that the leukemic cells had chromosome abnormalities involving both diploidy and tetraploidy with structural rearrangement. Structural rearrangement included del(5)(q22q33), del(15)(q22q24), and t(3;12)(q25;p13). Small dose aclacinomycin-A treatment was effective in reducing the number of leukemic cells in bone marrow, and both anemia and leukocytopenia were improved.View full abstractDownload PDF (500K) -
Ken-ichiro HINO, Seitetsu SATO, Akiko SAKASHITA, Shigeru TOMOYASU, Nob ...1992 Volume 33 Issue 4 Pages 500-506
Published: 1992
Released on J-STAGE: April 24, 2009
JOURNAL RESTRICTED ACCESSA 57-year-old male who had suffered from polycythemia vera (PV) and had been treated with pipobroman, carbazilquinon and busulfan for ten years presented with fever. CBC revealed anemia and thrombocytopenia without an increase of leukemic blasts (WBC 7,700/μl, RBC 294×104/μl, Hb 9.1 g/dl, Plt 1.5×104/μl). Bone marrow aspiration resulted in dry tap. Bone marrow biopsy showed hyperplastic marrow with fibrosis and no increase in leukemic blasts. Eleven days later the patient became leukemic and he died of DIC. Blast cells showed a high nucleo-cytoplasmic ratio, basophilic cytoplasm and cytoplasmic blebs. Cytochemical and immunophenotypical analysis of the blast cells showed the following results; myeloperoxidase (-), chloroacetate esterase (-), Sudan black B (-), acid phosphatase (+), acetate esterase (+), PAS (+), HLA-DR (+) and GPIIb/IIIa (+). Platelet peroxidase reaction on electron microscopy was positive in perinuclear spaces and endoplasmic reticulum. A diagnosis of megakaryoblastic transformation of PV was made. Although acute myelogenous leukemia has been shown to develope occasionally in the course of PV, acute megakaryoblastic leukemia with DIC following PV is a very rare condition.View full abstractDownload PDF (558K) -
Yasufumi IMAI, Kou YAMAMOTO, Ken SUZUKI, Shuji TOHDA, Tohru MIKI, Yuic ...1992 Volume 33 Issue 4 Pages 507-513
Published: 1992
Released on J-STAGE: April 24, 2009
JOURNAL RESTRICTED ACCESSA 49 years-old man presented with dry cough, low grade fever, and abnormal shadow on a chest X-ray. He had suffered from follicular lymphoma of the liver 5 years previously. He received irradiation therapy in combination with chemotherapy for approximately three years and had been in complete remission. Physical and radiological examination revealed pleural effusion and softly dense masses in the right lung. The laboratory data were within normal limits. He was diagnosed as having lymphomatoid granulomatosis (LYG) by open lung biopsy. The lung lesion was mainly infiltrated with T cells. The patient received prednisolone and the lung lesions disappeared. However, when a lung mass was noted two months later, he started to receive combination chemotherapy consisting of cyclophosphamide, adriamycin, vincristine, and prednisolone every three months. He has not shown relapse of LYG so far. To investigate the association between the preceding follicular lymphoma and subsequent LYG at this time, DNA analysis using the PCR technique was carried out. The LYG lesion did not show a rearranged band for the JH probe, while the paraffin-embedded specimen of the preceding follicular lymphoma had shown rearranged band for the JH band. Southern blot analysis of the LYG lesion, showed no rearrangement for TCR β, γ or JH probe. These findings indicate that the LYG was different from the preceding follicular lymphoma in terms of origin. LYG is considered to be induced in the immunosuppressive state due to lymphoma.View full abstractDownload PDF (1132K) -
Hideharu MARUYAMA, Kiyohide KAWANO, Hisamitsu UNO, Hitoshi MATSUOKA, R ...1992 Volume 33 Issue 4 Pages 514-519
Published: 1992
Released on J-STAGE: April 24, 2009
JOURNAL RESTRICTED ACCESSA 37-year-old female with hypercalcemia presented with lumbago, nausea and vomiting. Peripheral blood (PB) and bone marrow (BM) smears revealed no lymphoblasts on the first admission. The value of parathyroid hormone related protein (PTHrP) was increased and osteoporosis was found in the lumbar vertebrae. After 5 months, diagnosis of acute lymphocytic leukemia (ALL) was made on the evidence that lymphoblasts were found in PB (1%) and in BM (98%). Treatment with vincristine, daunorubicin, prednisolone and L-asparaginase achieved complete remission (CR) and the serum calcium level returned to the normal range. She has maintained CR, and is currently treated with consolidation therapy by cyclophosphamide and methotrexate. Acute leukemia is known to be rarely accompanied with hypercalcemia. This rare case was accompanied with hypercalcemia in acute leukemia. Hypercalcemia appeared to be attributable to the increased bone absorption by PTHrP derived from tumor cells. This important case will help understanding the etiology of hypercalcemia associated with ALL.View full abstractDownload PDF (467K) -
Yoshihisa AKIMOTO, Taijiro ISHIYAMA, Motoharu SANO, Hideyuki UENO, Tsu ...1992 Volume 33 Issue 4 Pages 520-524
Published: 1992
Released on J-STAGE: April 24, 2009
JOURNAL RESTRICTED ACCESSA 66-year-old man was presented with thrombocytosis in February, 1988. Laboratory examinations on admission revealed a white blood cell count of 17,700/μl and a platelet count of 274.4×104/μl. Bone marrow aspirates showed an increase of megakaryocytes (1,294/μl). There was no fibrosis or Ph1 chromosome. He was diagnosed as having essential thrombocythemia and was treated with thrombopheresis, carboquone and ranimustine (MCNU). Subsequently his platelet count was well controlled approximately for three years. He was readmitted because of pyrexia and left hypochondralgia in February 1991. Physical examination revealed hepatosplenomegaly. Peripheral blood revealed leukoerythroblastosis associated with the occurrence of tear drop cells. Bone marrow aspiration resulted in a dry tap and the biopsy specimen showed reticulin fibrosis. This is a fairly rare case of essential thrombocythemia that transformed to myelofibrosis.View full abstractDownload PDF (442K) -
Atsushi HIRANO, Isao TAKAHASHI, Yuro HARUTA, Tooru NAKAMURA, Hiroyuki ...1992 Volume 33 Issue 4 Pages 525-531
Published: 1992
Released on J-STAGE: April 24, 2009
JOURNAL RESTRICTED ACCESSTwo cases of unclassified chronic myeloproliferative disorders (UCMPD), diagnosed by hematological, cytogenetic and DNA analyses, are described. Case 1: a 63 year old female was admitted because of leukocytosis (96,800/μl) and splenomegaly. Hematological examinations revealed an increase of the granulocytes in the peripheral blood and bone marrow. The neutrophil alkaline phosphatase (NAP) score was 121. The patient developed blast crisis after 12 months of the chronic phase. Case 2: a 48 year old male was presented with fever and leukocytosis (20,000/μl). Hematological examinations revealed an increase of granulocytes in the peripheral blood and bone marrow. The NAP score was 33. Maturation-arrest in granulocytic series and morphological abnomalities of marrow cells were not observed in the two cases. Cytogenetic analysis of bone marrow cells disclosed 46, XX, i(17q) in case 1 and 47, XY, +8 in case 2. Southern blot analysis using 3' bcr probe and TransProbe-1 showed no bcr rearrangement. These cases are thought to be valuable in order to clarify the relationship between UCMPD and CMPD such as Ph1 negative chronic myelocytic leukemia and myelodysplastic syndromes.View full abstractDownload PDF (506K) -
Keita KIRITO, Hiroo SHINDO, Naohiko CHIBA, Toshio KOYAMA, Hiroshi YOKO ...1992 Volume 33 Issue 4 Pages 532-536
Published: 1992
Released on J-STAGE: April 24, 2009
JOURNAL RESTRICTED ACCESSA 65-year-old man, who had been treated for multiple myeloma (MM) since 1986, was admitted because of loss of consciousness in September 1989. An electrocardiogram taken just before admission showed a sinus arrest, junctional escaped rhythm, and marked bradycardia. The diagnosis of sick sinus syndrome (SSS) was made. Soon a temporary pacemaker was inserted, and the dyspnea ameliorated. However on the second day in the hospital, he had a high fever and Staphylococcus aureus was detected in the cultured blood. A diagnosis of septicemia was made, and the pacemaker was removed. He was then treated with β-stimulants, but died in November 1989. Necropsy revealed cardiomegaly and microscopic examination showed amyloid deposits in the sinoatrial node, and the walls of the ventricles and coronary arteries. Although amyloidosis is often a complication of MM and the heart is frequently affected, SSS caused by amyloidosis associated with MM is quite unusual. In such patients, the use of a pacemaker is controversial, because amyloid deposits are occasionally accelerated by insertion of a pacemaker and for patients with hematological disorders, septicemia associated with pacemaker insertion may prove fatal.View full abstractDownload PDF (422K) -
Naoki MORI, Kazumi URA, Shuichi MURAKAMI, Ryosuke OGAWA, Atsushi WAKE, ...1992 Volume 33 Issue 4 Pages 537-541
Published: 1992
Released on J-STAGE: April 24, 2009
JOURNAL RESTRICTED ACCESSA 49-year old female in the course of chemotherapy for adult T-cell leukemia (ATL) noticed blurred vision and visual field defect in her right eye on February 26, 1991. Ophthalmoscopic findings showed exudative necrotizing retinitis with white exudative patches and scattered retinal hemorrhages in both eyes. CMV was isolated from the urine by the shell vial cell culture assay. Anti-viral therapy was commenced using ganciclovir and γ-globulin, which are rich in anti-CMV antibodies. The exudative lesions were absorbed gradually. The ocular signs and symptoms agreed with the patient's systemic immunosuppressed T cell function state. CMV retinitis should be considered in the differential diagnosis of retinitis in immunocompromised patients. CMV retinitis will certainly be found more frequently in accordance with the increasing number of immunocompromised hosts who have received immunosuppressive therapy or transplantation.View full abstractDownload PDF (473K)
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Kazuo MUROI, Tohru IZUMI, Minoru YOSHIDA, Toshio SUDA, Akiyoshi MIWA, ...1992 Volume 33 Issue 4 Pages 542-544
Published: 1992
Released on J-STAGE: April 24, 2009
JOURNAL RESTRICTED ACCESSA case of Burkitt's lymphoma with granulocytosis including immature cells and a high level of C-reactive protein (CRP) is reported. The activity of interleukin-1α (IL-1α) was detected in the sera, although its activity was not detected in the supernate of the cultured lymphoblasts. The lymphoblasts stimulated production of IL-1α from human umbilical endothelial cells. Therefore, the lymphoblasts infiltrating bone marrow may have stimulated production of IL-1α from bone marrow stroma cells, and IL-1α may have induced granulocytosis and a high level of CRP.View full abstractDownload PDF (187K) -
Koichi SHINMYOZU, Naoko MACHIGASHIRA, Takahiro ITOYAMA, Ikuro MARUYAMA ...1992 Volume 33 Issue 4 Pages 545-547
Published: 1992
Released on J-STAGE: April 24, 2009
JOURNAL RESTRICTED ACCESSThe authors measured serum neopterin by HPLC in 3 patients with hemophagocytic histiocytosis (HH) with DIC which occurred during the clinical course of T cell malignant lymphoma (T-ML). Extremely high levels of serum neopterin (754.3±SD 467.3 pmol/ml) were found in the patients, about 200, 13 and 10 times higher than that of normal subjects, non-HH DIC patients and non-HH/DIC T-ML patients. Moreover their serum soluble interleukin-2 receptor levels were markedly elevated. These results indicate that markedly raised serum neopterin would be a sensitive parameter for activation of the mononuclear phagocyte system closely associated with T-cell activation and may serve as a useful diagnostic marker for HH.View full abstractDownload PDF (216K)
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