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Volume 43, Issue 3
Displaying 1-13 of 13 articles from this issue
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[in Japanese]2002 Volume 43 Issue 3 Pages 139-145
Published: 2002
Released on J-STAGE: July 28, 2009
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[in Japanese]2002 Volume 43 Issue 3 Pages 146-150
Published: 2002
Released on J-STAGE: July 28, 2009
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[in Japanese]2002 Volume 43 Issue 3 Pages 151-156
Published: 2002
Released on J-STAGE: July 28, 2009
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[in Japanese]2002 Volume 43 Issue 3 Pages 157-160
Published: 2002
Released on J-STAGE: July 28, 2009
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[in Japanese]2002 Volume 43 Issue 3 Pages 161-164
Published: 2002
Released on J-STAGE: July 28, 2009
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Yumi TAKASAKI, Yukiyoshi MORIUCHI, Hideki TSUSHIMA, Eiichirou IKEDA, S ...2002 Volume 43 Issue 3 Pages 165-169
Published: 2002
Released on J-STAGE: July 28, 2009
JOURNAL RESTRICTED ACCESSWe investigated the efficacy of oral vitamin B12 (B12) therapy in patients with B12-deficiency anemia. Between June 1994 and June 2000, 17 patients, who were diagnosed as having B12-deficiency anemia and gave their informed consent, were enrolled in this study. Of these patients, 7 were further treated with a maintenance dose of methylcobalamin (1,500 μg daily for 7 days every 1-3 months). Correction of hematological and neurological abnormalities was prompt. The hemoglobin level and serum concentration of B12 were normalized within two months after starting the treatment. Recovery from neurological disturbance was observed within one month. To maintain a normal serum concentration of B12, a 7-day regime of administration was needed every month in 3 patients, every 2 months in 3 patients, and every 3 months in 1 patient. These results demonstrate the effectiveness of oral cobalamin therapy, and also that oral intermittent therapy is useful for maintaining a normal serum B12 concentration. Oral cobalamin therapy might be as effective as conventional injection therapy, and useful for long-term treatment.View full abstractDownload PDF (439K) -
Hitoshi OHNO, Takayuki ISHIKAWA, Hiroyuki KITAJIMA, Shosaku NOMURA, Ta ...2002 Volume 43 Issue 3 Pages 170-175
Published: 2002
Released on J-STAGE: July 28, 2009
JOURNAL RESTRICTED ACCESSA multi-center series of 117 patients with malignant lymphoma were analyzed to evaluate the clinical significance of soluble interleukin-2 receptor α chain (sIL-2Rα). The initial levels of sIL-2Rα ranged from 277 U/ml to 22,800 U/ml with a mean level of 3,451±4,268 U/ml and a median level of 1,600 U/ml. The sIL-2Rα levels of the diffuse lymphoma/intermediate-grade subtypes defined by the LSG classification/Working Formulation were higher than those of the follicular lymphoma/low-grade subtypes. There was a tendency for B-cell lymphomas to show higher sIL-2Rα levels than T-cell lymphomas. The sIL-2Rα level was correlated with the Ann Arbor clinical stage (I, II versus III, IV), presence or absence of B symptoms, and performance status (0, 1 versus 2, 3, 4) of the patients. The sIL-2Rα levels were in good accordance with the four risk groups defined by the International Prognostic Indices. Of 21 patients whose tumor burden was serially measured, the coefficients of correlation between sIL-2Rα and tumor mass were >0.6 in 18 cases. Sixty-two patients achieved complete remission (CR) during the study; the initial and minimum sIL-2Rα levels were lower than those of the non-CR patients. This study confirmed that sIL-2Rα is a convenient and useful marker in the management of malignant lymphoma.View full abstractDownload PDF (486K) -
Takako KAWAKAMI, Tetsuo MITSUI, Dai SENDO, Chikako KANAZAWA, Shoko MAE ...2002 Volume 43 Issue 3 Pages 176-182
Published: 2002
Released on J-STAGE: July 28, 2009
JOURNAL RESTRICTED ACCESSTo clarify the frequency and cause of acute pancreatitis following hematopoietic stem cell transplantation (SCT), we examined retrospectively 57 patients who underwent hematopoietic SCT in our institute from 1984 to 2000. Twelve (21%) of the patients showed an elevated level of serum pancreatic amylase following SCT. However, only 3 patients were clinically diagnosed as having acute pancreatitis. Among these 12 patients, 11 had undergone allogeneic transplantation. Furthermore, patients who had undergone unrelated transplantation (7/16; 44%) tended to show a higher incidence of increased amylase than those who had undergone related transplantation (4/24; 17%). Six patients were at an advanced stage of acute GVHD (grade III or IV) and all showed an elevated level of serum amylase, whereas only four patients showed an elevated serum amylase level among 34 with mild acute GVHD (grade I or II) or without GVHD. Furthermore, five out of 12 patients who showed an increased amylase level were concurrently diagnosed as having viral infection such as cytomegalovirus, adenovirus, or varicella zoster virus. We conclude that pancreatitis following SCT occurs more often than realized, and is mostly subclinical. This is closely associated with severe acute GVHD, and possibly viral infection.View full abstractDownload PDF (569K)
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Masanori NAKAMURA, Keita TERASHIMA, Yoshifumi TAKASHIMA, Koji AMANO, Y ...2002 Volume 43 Issue 3 Pages 183-188
Published: 2002
Released on J-STAGE: July 28, 2009
JOURNAL RESTRICTED ACCESSRecombinant activated factor VII (rFVIIa) is a recently added new agent for the treatment of hemophiliacs with inhibitors. A major drawback to the use of rFVIIa is its short half-life, necessitating frequent and intermittent bolus injections. Continuous infusion of rFVIIa has been reported as a feasible, convenient, safe and cost-effective alternative to intermittent bolus injections. We report the use of continuous rFVIIa infusion during and after left elbow arthroplasty in a hemophiliac with a high titer of inhibitor to factor VIII. rFVIIa was administered as a bolus injection (100 μg/kg) at the start of the operation, after which continuous infusion (10-30 μg/kg/h) was immediately started and continued for 6 days. Tranexamic acid (50 mg/kg/day, po) was also administered as an antifibrinolytic treatment. Laboratory monitoring of hemostatic efficacy was performed in this case using prothrombin time and the thrombelastogram. Finally, effective intra and postoperative hemostasis and normal healing of the surgical incisions were achieved, except for local thrombophlebitis. Although the optimal maintenance or target level of rFVIIa has been a matter of debate, we consider continuous infusion of rFVIIa to be a feasible, convenient, safe and cost-effective alternative to intermittent bolus injections.View full abstractDownload PDF (478K) -
Kazuhiro NISHII, Hidetsugu MITANI, Hiroyuki MIYASHITA, Natsuki HOSHINO ...2002 Volume 43 Issue 3 Pages 189-193
Published: 2002
Released on J-STAGE: July 28, 2009
JOURNAL RESTRICTED ACCESSA 52-year-old man was admitted for treatment of hypoplastic leukemia (M1). After induction chemotherapy with IDR and AraC, the patient developed prolonged febrile neutropenia, and a diagnosis of invasive pulmonary aspergillosis was made. We started administration of AMPH-B and G-CSF, but the patient showed no clinical improvement. M-CSF was added to the regimen, and this led to an increase in the white blood cell count with resolution of pneumonia. It is suggested that administration of M-CSF with antibiotics and G-CSF may be beneficial for treating acute leukemia patients with prolonged febrile neutropenia after intensive chemotherapy.View full abstractDownload PDF (356K) -
Yoshitaka NAKAMORI, Naofumi FUKUDA, Kenji SHINOHARA, Yukio HATTORI2002 Volume 43 Issue 3 Pages 194-198
Published: 2002
Released on J-STAGE: July 28, 2009
JOURNAL RESTRICTED ACCESSWe report a 43-year-old Japanese woman with microcytic and hypochromic anemia, who had been erroneously diagnosed as having iron deficiency anemia 20 years previously at the time of her first labor, and treated with iron and blood transfusion. At the present visit to our clinic, she was found to have an increased HbA2 level and prolonged glycerol lysis time. Genetic analysis of the β-globin gene revealed deletion of 3 bases at codons 127/128 (CAG/GCT→CCT). A genetic study of the patient's family showed that two of her four children possessed the same mutation. The patient had mild anemia, her first son had very mild anemia, and her second daughter had moderate anemia with hemolysis. These affected family members were diagnosed as having dominant-phenotype β-thalassemia.View full abstractDownload PDF (430K) -
Naofumi FUKUDA, Yoko SHIMOHAKAMADA, Yoshitaka NAKAMORI, Takayuki TOMIN ...2002 Volume 43 Issue 3 Pages 199-203
Published: 2002
Released on J-STAGE: July 28, 2009
JOURNAL RESTRICTED ACCESSWe describe a case of thoracic aortic aneurysm complicated by chronic disseminated intravascular coagulation (DIC). Initially the DIC was controlled successfully by administration of gabexate mesilate and dalteparin. However, because these drugs were given intravenously, the patient could not be discharged. Subsequently, the DIC was treated successfully by changing to orally administered camostat mesilate, warfarin and aspirin, which allowed the patient to leave hospital.View full abstractDownload PDF (411K)
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Yuko NAKAMURA, Yukihiro ARAI, Fumihiko NAKAMURA, Kazuhiro MAKI, Arina ...2002 Volume 43 Issue 3 Pages 204-206
Published: 2002
Released on J-STAGE: July 28, 2009
JOURNAL RESTRICTED ACCESSA 69-year-old man was diagnosed as having idiopathic thrombocytopenic purpura (ITP) in April 2000, and treated with prednisolone (PSL) without effect. Splenectomy performed in June 2000 had only a transient and marginal influence on his platelet count. Two months later, he developed autoimmune hemolytic anemia (AIHA) without Coombs test positivity, and his diagnosis was changed to Coombsnegative Evans syndrome. Treatment with PSL led to recovery of his hemoglobin level, but not his platelet count. Although the mechanism responsible for development of AIHA after splenectomy in this patient with ITP remains unknown, close observation is required for any association with other autoimmune diseases such as SLE.View full abstractDownload PDF (229K)
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