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Volume 40, Issue 5
Displaying 1-15 of 15 articles from this issue
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[in Japanese]1999 Volume 40 Issue 5 Pages 359-361
Published: 1999
Released on J-STAGE: April 28, 2009
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[in Japanese], [in Japanese]1999 Volume 40 Issue 5 Pages 362-364
Published: 1999
Released on J-STAGE: April 28, 2009
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[in Japanese], [in Japanese]1999 Volume 40 Issue 5 Pages 365-368
Published: 1999
Released on J-STAGE: April 28, 2009
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[in Japanese], [in Japanese]1999 Volume 40 Issue 5 Pages 369-372
Published: 1999
Released on J-STAGE: April 28, 2009
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[in Japanese]1999 Volume 40 Issue 5 Pages 373-377
Published: 1999
Released on J-STAGE: April 28, 2009
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[in Japanese], [in Japanese]1999 Volume 40 Issue 5 Pages 378-381
Published: 1999
Released on J-STAGE: April 28, 2009
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Hiroshi YAGASAKI, Seiji KOJIMA, Jun INABA, Kouji KATO, Takaharu MATSUY ...1999 Volume 40 Issue 5 Pages 382-389
Published: 1999
Released on J-STAGE: April 28, 2009
JOURNAL RESTRICTED ACCESSWe studied the effectiveness of antithymocyte globulin (ATG) in preventing acute graft-versus-host disease (a-GVHD) in children who received bone marrow transplants from unrelated HLA-matched donors at one institution. Of 39 patients who received transplants between 1993 and 1997, 23 were given ATG on the basis of informed consent. Either Thymoglobulin (Pasteur Merieux, 2.5mg/kg/day) or Lymphoglobulin (15mg/kg/day) was administered for 4 days. a-GVHD (≥grade II) developed in 33% of the ATG group (n=21) and in 44% of the non-ATG group (n=16). Although a-GVHD (≥grade II) appeared less frequent in the ATG group, the difference was not statistically significant. Among the subjects with hematological malignancies, no significant difference was observed in frequency of a-GVHD (≥grade II) or 3-year survival rate for the ATG group (n=10) and non-ATG group (n=16). However, the incidence of cytomegalovirus infection was much higher (p<0.01) in the ATG group (70%) than in the non-ATG group (19%). From this study, we were not able to confirm the benefits of ATG as described by other investigators.View full abstractDownload PDF (551K)
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Yong-Dong PARK, Itaru YANAGIHARA, Shigeko SAITOH, Mariko Y. MOMOI, Aki ...1999 Volume 40 Issue 5 Pages 390-395
Published: 1999
Released on J-STAGE: April 28, 2009
JOURNAL RESTRICTED ACCESSWe report on an 8-month-old girl with Pearson's syndrome who presented with transfusion-dependent pancytopenia, exocrine pancreatic dysfunction, and lactic acidosis. Bone marrow findings were consistent with sideroblastic anemia and marked vacuolization of myeloid and erythroid precursors. Southern blot analysis of mitochondrial DNA (mtDNA) revealed a 4.5kb deletion in peripheral blood cells. Gradual hematologic improvement was observed thereafter, and the patient was relieved of the need for blood transfusions. We were able to confirm a decrease of the mtDNA deletion in lymphocytes as well as in lymphoblastoid cell lines cultured from peripheral lymphocytes as the patient made steady hematologic progress.View full abstractDownload PDF (553K) -
Hiromasa TSUDA, Hidesaku ASAKURA, Tamotsu MATSUDA1999 Volume 40 Issue 5 Pages 396-401
Published: 1999
Released on J-STAGE: April 28, 2009
JOURNAL RESTRICTED ACCESSA 45-year-old man was admitted complaining of chest pain and pain and edema in the left lower extremity. Ultrasonography and venography results yielded a diagnosis of left femoral vein thrombosis, and pulmonary embolism was diagnosed later. Intravenous heparin therapy (10,000IU/day) improved the patient's clinical signs. During this therapy, however, pain and edema of the right lower extremity developed, leading to a diagnosis of right femoral vein thrombosis. The patient was admitted to our hospital. At that time, coagulation studies showed an FDP level of 44.7μg/ml and an FDP-DD level of 24.5μg/ml. We surmised that the bilateral deep vein thrombosis had been caused by hyperhomocysteinemia (17.8μmol/l). Genetic and other acquired risk factors for thrombophilia were ruled out. The patient's clinical signs again improved as a result of intravenous heparin therapy (15,000IU/day), and FDP and FDP-DD levels returned to normal. We concluded that hyperhomocysteinemia is a risk factor for thrombosis and that it can generate thrombosis in other locations even during heparin therapy.View full abstractDownload PDF (404K) -
Eichi OTSUKA, Yukihiko MIYAZAKI, Kyouko MORIYAMA, Noritaka UNO, Kenji ...1999 Volume 40 Issue 5 Pages 402-407
Published: 1999
Released on J-STAGE: April 28, 2009
JOURNAL RESTRICTED ACCESSA 65-year-old man who had an 8-year history of chronic lymphocytic leukemia was admitted to our hospital on February 19, 1998 because of high fever, dry cough, and weight loss. Laboratory data on admission included serum lactate dehydrogenase at 980 IU/l, CRP at 21.8 mg/dl, and soluble interleukin-2 receptor at 7,280 U/ml. The results of serological tests for Epstein-Barr virus (EBV) antibodies were as follows: EBV capsid antigen IgG 1: 2560, EBV early antigen IgG 1: 640, and EBV nuclear antigens 1: 20. Computed tomography revealed diffuse interstitial pneumonia in both lungs, hepatosplenomegaly with multiple nodules, and enlarged intra-abdominal lymph nodes. In addition, Gallium-67 scintigraphy demonstrated abnormal accumulations. Although the patient initially responded well to combination chemotherapy, he eventually deteriorated and died on November 2, 1988, despite salvage chemotherapy. Postmortem needle biopsy specimens from the liver and spleen revealed diffuse proliferation of polymorphic large lymphoma cells. The lymphoma cells were positive for L-26, latent membrane protein 1, and EBV nuclear antigen, but negative for UCHL-1 and CD3, 5, 10, and 30. In situ hybridization procedures disclosed the presence of EBV-encoded small RNA in lymphoma cells. These findings suggested the possibility of association with EBV infection in some cases of Richter's syndrome.View full abstractDownload PDF (843K) -
Naoki WAKIMOTO, Fumihiko KIMURA, Ken SATO, Naruo KUWADA, Takuya MATSUM ...1999 Volume 40 Issue 5 Pages 408-413
Published: 1999
Released on J-STAGE: April 28, 2009
JOURNAL RESTRICTED ACCESSA 69-year-old man was admitted to our hospital due to pancytopenia and a marked bleeding tendency. On admission, he had a white cell count of 2.8×109/l, hemoglobin level of 6.0g/dl, and a platelet count of 3×109/l. He was given a diagnosis of refractory anemia on the basis of bone marrow aspiration findings, which disclosed trilineage myelodysplasia. After discharge, the patient remained dependent on blood transfusions. The sole administration of an active form of vitamin D3 (calcitriol) was started in July 1997, and one and a half years later, the patient's transfusion dependency disappeared. However, bone marrow aspiration findings at this point disclosed marked cell dysplasia of erythroid lineage and a prognostically unfavorable chromosomal abnormality (monosomy 7) that had not been found during the initial examination. Nonetheless, the patient's hemoglobin level and platelet count increased to more than 9 g/dl and about 1.0×1011/l, respectively. The finding in this case suggested that vitamin D3 therapy is useful for refractory anemia even if aggravated marrow cell dysplasia and cytogenetic anomalies develop.View full abstractDownload PDF (499K) -
Acute Vincristine Neurotoxicity in a Non-Hodgkin's Lymphoma Patient with Charcot-Marie-Tooth DiseaseShinji UNO, Ko KATAYAMA, Nobuaki DOBASHI, Akio HIRANO, Asahiko OGIHARA ...1999 Volume 40 Issue 5 Pages 414-419
Published: 1999
Released on J-STAGE: April 28, 2009
JOURNAL RESTRICTED ACCESSA 44-year-old, previously healthy man with a diagnosis of non-Hodgkin's lymophoma (NHL, diffuse large B-cell type, stage IIA) was treated with combination chemotherapy including vincristine (VCR). After receiving a cumulative dose of VCR, he experienced rapid and marked weakening which progressed to quadriplegia and bulbar palsy. Prior to this therapy, the patient had no neurological problems, and his siblings were asymptomatic. Physical examination identified pes cavus (hollow foot), and electrodiagnostic studies showed markedly slower nerve conduction velocity of myelinated fibers, with abundant “onion bulb” formations. Chromosomal analysis detected 17p11.2-12 duplication, thus yielding a diagnosis of Charcot-Marie-Tooth (CMT) 1A. CMT disease is a familial neuromuscular disorder, and the incidence is approximately 1 in 2,500. We concluded that if CMT disease is diagnosed, vincristine should be avoided due to the potential severity of neurotoxicity to small doses.View full abstractDownload PDF (449K)
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Seiichi OKABE, Naoyuki YAHATA, Tetsuzo TAUCHI, Masahiko OTAWA, Osamu I ...1999 Volume 40 Issue 5 Pages 420-422
Published: 1999
Released on J-STAGE: April 28, 2009
JOURNAL RESTRICTED ACCESSHypereosinophilic syndrome (HES) with myelofibrosis was diagnosed in a 36-year-old man on the basis of bone marrow biopsy findings and clinical features. Although the patient was treated with steroid (1mg/kg), hydroxyurea, and immunosuppressive therapy, eosinophilia persisted. Patients with HES and myelofibrosis are usually unresponsive to antineoplastic agents and/or immunosuppressants. However, cyclosporin may be an effective alternative for such patients.View full abstractDownload PDF (280K) -
Fumihiko KOMADA, Yoshiki YAMASHITA, Hiroyuki KAWABATA, Akira YAZAKI, K ...1999 Volume 40 Issue 5 Pages 423-426
Published: 1999
Released on J-STAGE: April 28, 2009
JOURNAL RESTRICTED ACCESSWe report an autopsy case of intravascular lymphomatosis (IVL) that arose after radiation therapy and chemotherapy for an inoperable pancreatic carcinoma. A 66-year-old man who suffered from diabetes mellitus and pancreatic carcinoma presented with aggressive progression of consciousness disturbance and high fever. The laboratory findings disclosed marked thrombocytopenia, hypercalcemia, and elevated serum PTH-related peptide. The patient soon died of ventricular fibrillation due to uncontrollable hypercalcemia. Postmortem examination with immunohistochemical analysis revealed a well-differentiated tubular adenocarcinoma in the pancreatic body as well as an accumulation of neoplastic B-lymphocytes in small vessels throughout the body without systemic lymphadenopathy. To our knowledge, double neoplasms including IVL are extremely rare.View full abstractDownload PDF (337K) -
Keitaro MATSUO, Eisei KONDOH, Masanari MITOME, Masami TAKEUCHI, Kosei ...1999 Volume 40 Issue 5 Pages 427-429
Published: 1999
Released on J-STAGE: April 28, 2009
JOURNAL RESTRICTED ACCESSWe report a case of cerebellar astrocytoma occurring 8 years after the second bone marrow transplantation (BMT) in 32-year-old man. The patient was admitted to our hospital in December 1997 because of dysarthria and gait disturbance. He had been treated earlier for acute myeloid leukemia (AML M2) with chemotherapy and cranial irradiation followed by allogeneic BMT from a sibling in december 1988. Three months after the first BMT, testicular relapse was observed and followed by systemic relapse. The patient received reinduction therapy and a second successful BMT. He had been well until about 1 month before admission to our hospital. Neurological examination revealed left cerebellar ataxia, and brain magnetic resonance imaging disclosed a left cerebellar tumor. The tumor was surgically resected and a histological diagnosis of cerebellar astrocytoma was made. The patient was further treated by irradiation for residual tumor and discharged without progression of the disease.View full abstractDownload PDF (485K)
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