Relatively simple procedures for quantitative determination of erythrocyte glutamic-oxaloacetic transaminase (GOT), glucose6-phosphate dehydrogenase (G-6-PD) and cholinesterase utilizing AutoAnalyzer were described, and the results of red cell enzyme activities from a variety of patients with anemias and from cord blood were presented.
Of the enzymes studied, erythrocyte GOT and G-6-PD activities were found to be high in cases with hemolytic anemias, pernicious anemia on B₁₂ as well as iron deficiency anemia on iron therapies, indicating that increased enzyme activities were sensitive reflection of the presence of young red cell population. In two cases with paroxysmal nocturnal hemoglobinuria, erythrocyte cholinesterase were found to be low.

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By combining ferrous sulfate with a polymer of high molecular weight (PVMMA), we could obtain a controlled-release form of iron (PVMMA-Fe).
Measuring the absorption of labeled PVMMA-⁵⁹Fe and ⁵⁹FeSO₄ from the intestinal tract of rats with a total body counter, it was found that the PVMMA-Fe was absorbed more slowly than the ferrous sulfate.
The PVMMA-Fe stayed longer in the intestinal tract than FeSO₄. Total amounts of iron absorbed, however, were identical in PVMMA-Fe and FeSO₄.
Thirteen patients with iron-deficiency anemia treated with PVMMA-Fe showed a satisfactory recovery. Amounts of PVMMA-combined iron utilized for heme synthesis during the recovery from the anemia had been similar to those from the other form of iron-pellets.

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From the investigation on the total 104 cases of variuos hematological diseases, the following results were obtaind.
The platelet productivity of megakaryocytes strikingly decreased in the cases of acute and chronic leukemia. However, the number of megakaryocytes in chronic leukemia remarkably increased contrary to the marked decrease of megakaryecytes in acute leukemia.
The definite correlation between the phase of acute leukemia in childhood and platelet productivity of megakaryocytes was obtained.
In the cases of ITP, platelet formation from megakaryocytes remarkably diminished in spite of the increase of their number. The cases of iron deficiency anemia, secondary anemia and hypoplastic anemia revealed no decrease of platelet production. The cases of Banti's syndrome indicated a slight depression of platelet formation.
In a case of megaloblastic anemia following the total gastretomy, platelet production from megakaryocytes decreased before treatment, and recovered after the injection of V. B₁₂.

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The fibrin stabilizing factor (FSF, Factor XIII) in children was investigated. Materials were obtained from 99 normal children ranging from one-day-old infants to 15-year-old children, and 25 cases with disorders such as purpura, leukemia, hemophilia, congenital afibrinogenemia, defibrination syndrome, etc. Two methods were used simultaneously on each material. One is a simpler method, in which the fibrin clot was produced by mixing plasma, calcium ion and Owrens buffer (pH 7.4) (method A), and in another method, the clot was produced by mixing serially diluted plasma, FSF free fibrinogen, and thrombin (method B). In the former method, the complete dissolution of the clot in 1% monochloroacetic acid (MCA) was examined daily for 5 days, and in the latter method, the level of FSF was expressed by the lowest concentration of plasma, which showed the complete dissolution of the clot in 2% MCA solution after the elapse of 18 hours.
Results showed that the values of FSF were low in the newborn period and they reached normal within 2 to 3 weeks. In the premature infants, the value of the factor remained low even 2 months after birth.
In about 20 per cent of pathological cases, including those of defibrination syndrome, leukemia, and purpura, the values of the factor were lower than the normal.
The results obtained from the normal newborn by both methods showed good correlation which could not be proved in the pathological group, esp. in ITP.

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A trial of therapy of iron deficiency anemia was carried out using PVMMA-Fe, a new oral iron preparation in slow-release form in which ferrous ion is bound with ionic bond to copolymer of methylvinylether and maleic acid.
Patients with proven iron deficiency anemia were given one capsule of PVMMA-Fe (containing 100 mg. elemental iron) each morning on an empty stomach. The average daily rise in hemoglobin was 0.176 Gm./100 ml. in the first 2 weeks of treatment, thus it was calculated that 25.8 per cent of iron administered in this period of time was utilized for hemoglobin synthesis. The figures are comparable with the daily rise of hemoglobin and the utilization of iron obtained by ordinary iron preparations or Fero-gradumet in the equivalent dose of elemental iron.
Considering few untoward side effects and simple administration as well as its effectiveness, PVMMA-Fe is an useful agent for the treatment of iron deficiency anemia.

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Renal parenchymal involvement with leukemia is relatively frequent, but clinical symptoms appear rarely. and literature dealing with the impairment of renal function due to leukemic kidney involvement is rarely seen. The patient reported here had a left upper quadrant tumor as his chief complaint. Case. K.N., a boy, was 5-year-10-month old when he was admitted. Leukemic symptoms was not recognized when joint pains initially came out. Thereafter, however, the symptoms of sub-and aleukemic leukemia, such as the appearance of vacuolated immature leukemic cells in the peripheral blood and bone marrow, were developped. Intravenous urograms and pneumoretroperitoneum-roentgenogram demonstrated large bilateral homogeneous masses compatible with enlarged kidneys.
The results of phenolsulfonphthalein test were suggestive of hypofunction of the kidneys, and the decrease of tubular function was evidenced by diminished renal plasma flow. Radioisotope renogram with ortho-iodohippurate-I¹³¹ (OIH-I¹³¹) showed marked loss of renal function. These renographic changes correlated well with enormously enlarged and diffusely infiltrated kidneys. Careful observation on the behavior and response of the kidney to leukemic process might give more significance to its clinical and pathological evaluation.

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Ten families, 39 cases of the May-Hegglin anomaly have been reported to date. The present report deals with the case of this anomaly, presumably the first description in Japan.
The propositus was a 26-year-old male who had in good health except an episode of excess post operative bleeding at the time of maxillary sinectomy, until he consulted us for upper abdominal discomfort and melena. Diagnosis of malignant tumor of the stomach was made by the X-ray and the endoscopic examination. Surgical operation was successfully performed and the histological diagnosis of the removed tumor was “carcinoma simplex”.
Examination of peripheral blood smear revealed the characteristic features of the May-Hegglin anomaly, i.e., the presence of the leukocytic inclusion bodies and the giant platelet.
Leukocytic inclusion bodies (Döhle body), usually crescent, fusiform or spindle-like in shape, were persisted after the removal of the malignant tumor. Basophilic and pyroninophilic properties of the inclusion body were lost after RNAase treatment. They appeared in neutrophils, eosinophils and basophils, but not in lymphocytes. They also appeared in monocytes, although they were less frequent and distinct.
Moderate thrombocytopenia and the presence of cigarshaped giant platelet was detected at the admission and throughout the observation period. Succeeding examinatian revealed mild prolongation of bleeding time and coagulation time, but definite defect of coagulation factors were not confirmed.
Family study was performed on 20 blood relatives. Typical leukocytic inclusion bodies and giant platelet were detected in father and sister of the propositus. All of the remaining members were negative.
Chromosomal analysis of the propositus, both direct and indirect methods, failed to confirm any morphological abnormality.

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A case with acute erythremic myelosis who showed a marked erythroid depression on chloramphenicol administration is reported. Neoplastic erythroblasts appeared to have a sensitivity to chloramphenicol comparable to that of normal erythroblasts. Since the depressant effect of the antibiotic was only temporary, its clinical value is limited for the treatment of the disease.

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A 31-year-old male, taxi-driver, was first admitted to the Tokyo University Hospital on July 14, 1966, with the chief complaints of fever, general malaise, visual disturbance and general lymph node swelling. The swelling of the mesenteric lymph nodes had been noted in April 1964 on the appendectomy.
Physical examinations on admission revealed anemia, general lymphadenopathy and hepatosplenomegaly. Hemoglobin was 5.9 g/100 ml, RBC 1,910,000 with marked rouleaux formation, WBC 3,600 and platelets 130,000. A sternal marrow aspirate was hypercellular with 6.6 per cent early plasma cells. Urinalysis showed Bence Jones proteinuria. Total serum protein level was 12.0 g/100 ml with 79.7% of β-γ globulin. ESR 168 mm/hr (Westergren) and zinc turbidity test was over 40. Biopsy of the inguinal lymph node showed a plasma cell proliferation. Prednisolone and blood transfusions were began on the suspicion of multiple myeloma and the symptoms subsided. He was discharged on September 16, 1966. General malaise, fever and visual disturbance reappeared and he was readmitted on May 4, 1967.
On the second admission conditions were almost the same as were on the first. Immuno-electrophoresis of the patient's serum revealed the simultaneous increase in γG, γM and γA without M-component. Immunoelectrophoresis and Ouchterlony diffusion technic showed κ, λ, Fc and γG itself in the unconcentrated urine. Bone x-rays revealed no change.
Corticosteroid treatment and blood transfusions were again successful in controlling the complaints. Biopsy findings of the inguinal lymph node were almost the same as on the first admission. On July 19, he was diagnosed as the rupture of the right kidney, with sudden colicky pain and shock-like appearance. An emergency operation, right nephrectomy, was done. Histology of the resected kidney revealed the proliferation of the glomerular mesangium, the thickening of the basement membrane and marked, focal round cell infiltration in the interstitium. The cause of the kidney rupture remains unknown.
Simultaneous increase in γG, γM and γA was noted in the patient's serum and both heavy and light chains were demonstrated in his urine. The diagnosis shoud be, at present, “immunoglobulin fragment disease (Miyoshi)”.

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