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Volume 41 (1989)
- Issue 6 Pages 769-
- Issue 5 Pages 681-
- Issue 4 Pages 561-
- Issue 3 Pages 293-
- Issue 2 Pages 173-
- Issue 1 Pages 1-
Volume 41, Issue 3
Displaying 1-12 of 12 articles from this issue
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Ichiro TATSUTA, Osamu ISHIKO, Keizo NAKA, Masaaki DEGUCHI, Tadashi SUG ...1989 Volume 41 Issue 3 Pages 293-303
Published: 1989
Released on J-STAGE: July 05, 2011
JOURNAL FREE ACCESSOn the basis of the results of hematological and clinical studies, we learned that most cases of cancer anemia consist of normochromic normocytic anemia. Also, the cause of cancer anemia was not a decrease in hematopoiesis in the bone marrow but an increase in hemolysis in the spleen due to fragility of the erythrocytes.
Anemia-inducing substance (AIS), found in the serum of cachectic patients, is known to have a detrimental effect on RBCs and shorten the lifespan of RBCs.
The effects of AIS were examined, and the findings can be summarized as follows. (1) The osmotic resistance and the deformability of RBCs were decreased in patients with terminal cancer. (2) Normal human RBCs showed reduced deformability and their membranes became fragile after treatment with cachectic serum from the terminal cancer patients, and those changes in the physical properties of RBCs were irreversible. (3) The energy metabolism of the RBCs was affected by AIS, that is, the ATP concentration and pyruvate kinase activity in the RBCs were lowered and the trans-membrane glucose influx was suppressed. These observations strongly suggest that AIS appears in the blood of patients with terminal cancer, causes impairment of RBCs and plays a role in the pathogenesis of cancer anemia.View full abstractDownload PDF (7218K) -
Production of AIS and its immunosuppressive effectKeizo NAKA, Osamu ISHIKO, Ichiro TATSUTA, Masaaki DEGUCHI, Tadashi SUG ...1989 Volume 41 Issue 3 Pages 305-312
Published: 1989
Released on J-STAGE: July 05, 2011
JOURNAL FREE ACCESSIn this study we paid particular attention to anemia-inducing substance (AIS) in the plasma of tumor-bearing subjects and investigated its effects on the red blood cells (RBCs) and cellular immunity. The results are summarized below.
1. AIS appears in the blood circulation with the progression of a cancer. It binds to RBC membranes, causing changes in the physical properties of RBCs such as decreased deformability and decreased membrane osmotic resistance. Impaired RBCs are eventually taken up by the reticulo-endothelial system, especially the spleen. This process is thought to be one of the major causes of cancer anemia, which is usually observed in cancer cachexy.
2. AIS was removed from cachectic plasma by repeated adsorption with normal RBCs, and the inhibitory effect on cellular immunity decreased as AIS was removed.
3. AIS was detected in cachectic RBC membranes and monocytes by indirect immunofluorescence using rabbit anti-AIS antibody prepared by us. AIS was also detected in the tumor tissue by the PAP method using the anti-AIS antibody.
4. AIS also binds to immunologically competent cells, causing suppression of cellular immunity.
These observations strongly suggest that tumor-origin AIS, which appears in the blood of patients with terminal cancer, shows cytotoxity to RBCs and immunologically competent cells and plays a role in the pathogenesis of cancer cachexy.View full abstractDownload PDF (6917K) -
Masami KAWABATA1989 Volume 41 Issue 3 Pages 313-324
Published: 1989
Released on J-STAGE: July 05, 2011
JOURNAL FREE ACCESSImmunologically, the fetus is recognized as a semiallograft. The immunological mechanisms which prevent maternal rejection of the fetus have not yet been fully elucidated. Thus, it is very important to clarify the immunological environment of the decidual tissue existing at the interface between the fetus and the mother. We first studied the characteristics of the leukocytes infiltrating the decidual tissue, using monoclonal antibodies specific for the various surface antigens of leukocytes. Immunohistological studies showed that OKT 3+ cells, representing T lymphocytes, were present in a cluster around the epithelial glands at the muscular-decidua junction, but not in the decidua compacta. OKT 8+ cells, which are suppressor/cytotoxic T cells, were observed in greater numbers than OKT 4+ cells, which are helper/inducer T cells. Furthermore, two-color staining showed that 81% of OKT 8+ cells were cytotoxic T cells (OKT 8+Leu-15-cells). Large numbers of OKla+ and OKM 3+ cells, which are macrophages, were detected in the decidua compacta. Few OKB 7+ cells, which are B cells, were observed in the decidual tissue.
Decidual mononuclear cells (D-MNC) were studied for suppressive activity and natural killer (NK) activity. D-MNC significantly suppressed the Con A response of peripheral MNC, but the NK activity of D-MNC was lower than that of peripheral MNC.
The supernatant from cultured decidual cells (DS) was also subjected to immunolojical studies. Decidual tissue was obtained from human early pregnancy, and DS was obtained by 48-hr culture of 1x106 decidual cells. DS suppressed the PHA (phytohemagglutinin) response of peripheral MNC by 41%. The lymphokine-activated killer (LAK) activity of peripheral MNC and proliferation of CTLL, whose growth depends on interleukin-2 (IL-2), were significantly suppressed by DS addition. The suppressive effects of DS were abolished by indomethacin addition, which is known to inhibit prostaglandin synthesis. The suppressive factor in DS was analyzed using a diethylamino-ethyl sepharose column and SDS-10% polyacrylamide gel electrophoresis (SDS-PAGE). A protein with a molecular weight of 59, 000 was separated and found to exert a suppressive effect on the mitogen response of peripheral MNC.
In conclusion, although cytotoxic T cells increased in number and seemed to attack the fetus in the decidua compacta, immunological rejection of the fetus is prevented by the actions of suppressor T cells, prostaglandin E and a decidua-derived suppressive factor.View full abstractDownload PDF (7745K) -
Akihiko NISHIO, Makoto HOSHINA, Matuto MOCHIZUKI1989 Volume 41 Issue 3 Pages 325-333
Published: 1989
Released on J-STAGE: July 05, 2011
JOURNAL FREE ACCESSHCG (α, β) and hPL are major protein hormones synthesized by placental trophoblast.
The expressions of these peptides occur during trophoblast transformation from proliferatively active cytotrophoblast to inactive syncytiotrophoblast. In the trophoblast of free villous surface, first, hCGα is expressed in intermediate trophoblast and then hCGβ expression appears. In well differentiated syncytiotrophoblast hPL begins to synthesize. On the base of the sequential expressions of these peptides, we immunohistochemically studied the prognostic value of the peptides for trophoblastic disease.
Two cases of partial mole, 35 cases of complete mole, 3 cases of invasive mole, 9 cases of choriocarcinoma, 5 cases of metastatic lesion of choriocarcinoma and 4 cases of placental site trophoblastic tumor (PSTT) were studied.
We observed immunohistorogically in normal placental villi, hCGβ and hPL were positive and hCGα was negative.
Hydatidiform moles showed similar results to normal villi. Neverthless there were exceptional cases of hydatidiform mole that showed strong positivity in hCGα staining. These cases developed invasive mole later. On the contrary, the cases of hCGα positive choriocarcinoma responded well to chemotherapy. The choriocarcinoma with metastatic lesion that showed week hCGβ staining was chemotherapy resistant.
PSTT showed as entirely different sequence of the expression of these peptides. In PSTT, hPL seems to be expressed first then hCGα and hCGβ occour. Therefore we speculate that trophoblasts in free villous surfaces, and placental sites have different sequential expressions of the peptides. Immunohistological observation of these peptides especially for hCGα, give prognostic value for trophoblastic disease.View full abstractDownload PDF (4759K) -
Masayoshi AKASAKI1989 Volume 41 Issue 3 Pages 335-343
Published: 1989
Released on J-STAGE: July 05, 2011
JOURNAL FREE ACCESSTaurine, 2-aminoethane sulfonic acid, is a simple sulfur-containing compound that plays an important nutritional and physiological role throughout the perinatal period.
The concentration of taurine in fetal blood is very high. It was found, however, that the concentration in maternal blood was higher than that in the umbilical vein, which in turn was higher than the fetal arterial concentration. These findings suggest that 14C-taurine, which the fetus metabolizes and uses for its development, is pooled in the placenta.
The platelet concentration of taurine is higher than that of other amino acids, and sodium-dependent transport of taurine is already established by the 28 th week in premature neonates even though the infants' systems are still immature. The platelet aggregation rate in the presence of taurine was significantly lower (p<0.01) than in the control group, and this was found to be more pronounced in premature infants than in term infants.
It was also found that uterine contraction in pregnant rats could be inhibited about 30-50 % with 1.0×10-2 Mol of taurine.View full abstractDownload PDF (1406K) -
Takefumi BESSHO, Yasuaki MATSUURA, Yasuki KOYASU, Minoru SHIGETA, Shoz ...1989 Volume 41 Issue 3 Pages 345-348
Published: 1989
Released on J-STAGE: July 05, 2011
JOURNAL FREE ACCESSThis study was undertaken to investigate whether or not there are any differences in oocyte retrieval rates, fertilization & cleavage, pregnancy rate and luteal function by the method of collecting oocytes in IVF program. The oocyte retrieval rates by laparoscopic, transvesical ultrasound-guided and transvaginal ultrasound-guided collection were 62.4, 48.6 and 58.9%, respectively. The fertilization rates of the retrieved oocytes were 63.1, 56.4 and 55.8% and the cleavage rates were 95.3, 89.5 and 93.1% respectively. No significant difference was demonstrated in these parameters among three groups, and no major complication occured. At present, transvaginal ultrasound-guided oocyte retrieval seems to be superior to other two methods on effectiveness and safety.View full abstractDownload PDF (715K) -
Yumiko KATO, Shigeru SAITO, Yoshimasa Tsuji, Ikuko MORIYAMA, Motohiko ...1989 Volume 41 Issue 3 Pages 349-353
Published: 1989
Released on J-STAGE: July 05, 2011
JOURNAL FREE ACCESSAML accounts for about half of all leukemia cases and in recent years a growing number of cases have been reported. More cases of pregnant women with leukemia are also being reported, many of which are being treated with chemotherapeutic drugs. This paper reports on one such case at our hospital.
A hematological examination of a 27 year-old pregnant patient with no subjective symptoms in the 36 th week of pregnancy revealed a decreased platelet count. A diagnosis of AML was made on the basis of peripheral blood images and bone marrow findings, and a course of postpartum chemotherapy was decided upon. First, to treat the thrombocytopenia prior to delivery, platelets collected from blood donors (10-15 E from each) using a blood cell separator were transfused into the patient. Delivery was induced when the platelet count exceeded 80, 000/mm3, and the patient delivered a live baby (2, 776g, Ap 9-1) transvaginally. There was a great deal of intrapartum hemorrhaging, reaching 1, 040 ml. This was mainly attributed to atonic hemorrhaging and was treated through the administration of oxytocins and blood transfusions.
Although the patient's course following delivery was favorable there was little improvement transfusion was performed daily during the initial postnatal stage. Remission of the AML was successfully achieved. Following intensification and consolidation therapies, the AML is still in a state of remission and the patient is in satisfactory health.View full abstractDownload PDF (3106K) -
Susumu ADACHI, Tsuneo NADA, Yasuhiko KIYOZUKA, Masayo MARUYAMA, Motohi ...1989 Volume 41 Issue 3 Pages 355-359
Published: 1989
Released on J-STAGE: July 05, 2011
JOURNAL FREE ACCESSThe clinical and pathological features of a case of leiomyoblastoma arising in the uterus are presented in this paper. The prognosis of leiomyoblastoma is discussed with reference to the literature.
A 45-year-old, gravida 3 para 4, woman consulted us with a complaint of hypermenorrhea. She had a hen egg-sized myoma protruding from the cervical canal. Abdominal total hysterectomy was performed, with the working diagnosis being uterine leiomyoma. Preoperative cytologic evaluation of the ecto-cervix was negative. The uterus was swollen to fist size, with a pedunculated submucous tumor of the uterine corpus.
Macroscopically, the leiomyoma-like tumor nodule was brodered clearly by surrounding normal uterine muscle tissue. However, histologically, the tumor consisted of round or epitheloid cells with clear cytoplasm, whose nuclei were unevenly distributed. The almost round nuclei were uniform in their size and chromatin pattern, and showed occasional mitosis. The cytoplasm was negative to PAS and mucicarmine staining. Silver staining of the mesenchymal tissue around the tumor cells showed the characteristic boxing image. Thus histological findings led us to the diagnosis of leiomyblastoma of the uterus.
Leiomyoblastoma was first described by Martin et al. in 1960 and Stout proposed the term leiomyoblastoma in 1962. Most have been reported as having arisen in the stomach. However, a few uterine tumors have also been reported. In JAPAN, Hiramatsu first reported uterine leiomyoblastoma in 1982. And this paper is the 5 th case report since then.
Generally speaking, leiomyoblastoma is regarded to originate in smooth muscle. Most of the cases are known to follow a benign clinical course, however, some of them metastasive and lesions also occur, recurrently.
One year after the operation, the patient remains well.View full abstractDownload PDF (5810K) -
Yoshiyuki IHARA, Hayato NIWA, Takashi SHIMIZU, Kinya INOUE, Nobuya AND ...1989 Volume 41 Issue 3 Pages 361-365
Published: 1989
Released on J-STAGE: July 05, 2011
JOURNAL FREE ACCESSLife-threatening neonatal hemorrhage is associated with maternal anticonvulsants, such as phenytoin, phenobarbital and primidone. We experienced a neonate born from a epileptic mother treated with phenytoin and phenobarbital, who died at 25 hours after birth from profuse intraabdominal hemorrhage resulting from ruptured subcapsular hematoma of the liver. After the pregnancy, the regimen of anticonvulsants was altered from phenytoin and phenobarbital to valproate sodium alone. She became pregnant again and delivered a healthy neonate uneventfully.
In epileptic women who have encountered hemorrhage or coagulation defect of their offsprings in previous pregnacies, the regimen of anticonvulsants should be altered to other drugs than phenytoin, phenobarbital and primidone, before the next pregnancy.View full abstractDownload PDF (736K) -
Masahiro TAHARA, Masahide OHMICHI, Keiichi TASAKA, Nagatoshi SUGITA, O ...1989 Volume 41 Issue 3 Pages 367-370
Published: 1989
Released on J-STAGE: July 05, 2011
JOURNAL FREE ACCESSA first case is reported of hydramnion due to excessive amount of fetal urine production along with congenital mesoblastic nephroma. Rapid growth of right renal tumor and fetal urine production were detected by measuring the size of the tumor and hourly fetal urine production (H.F.U.P.) together with the course of development of hydramnion between 28-34 weeks of gestation. A female infant weighing 2, 200 gram was born at 34 weeks of gestation. She lost 18 percent of her birth weight in 48 hours due to neonatal polyuria. Then right nephrectomy and ureterectomy were performed at the age of 2 days. After operation the neonatal polyuria improved dramatically. Right renal tumor was identified histologically as a mesoblastic nephroma.View full abstractDownload PDF (4115K) -
Hiroaki Jikihara, Tomio Fujita, Shiro Imai, Takeshi Taniguchi, Kenichi ...1989 Volume 41 Issue 3 Pages 371-374
Published: 1989
Released on J-STAGE: July 05, 2011
JOURNAL FREE ACCESSEssential thormbocythemia is a rare myeloproliferative disorder of unknown cause characterized by elevation in platelet counts and increased marrow megakaryocytes. Little is known about the clinical course of this disease in pregnancy, because it usually occure in the late reproductive and menopausal years. We report one case of essential thrombocythemia diagnosed in the first trimester of pregnancy. A 32-year old woman (gravida 3, para 2) visited our hospital because of her poor obstetric history. In her first pregnancy, she aborted spontaneously. In the second, she delivered prematurely at 36 weeks of gestation. In the third pregnancy, she experienced abruptio placentae and DIC at 28 weeks of gestation. And she was given a 2, 000 ml blood transfusion. In our hospital, her platelet count was 84.7×104/mm3 and she was diagnosed as having a twin pregnancy at 9 weeks of geatation by ultrasonography. At the moment antiplatelet therapy (aspirin 30 mg and dipyridamole 150 mg daily) was started. She was hospitalized at 28 weeks of gestation because her platelet count was continuously greater than 100×104/mm3. From that time, heparin (10, 000 i.u. daily) was intravenously administered to her. At 34 and 6/7 weeks of gestation, two healthy boys of 2350 gm and 2328 gm were born by cesarean section. The 1-and 5-minute Apgar scores were 6 and 9 in the first boy, 3 and 8 in the second boy. The placenta showed large thrombosis and ischemia. Her platelet count rose to 342×104/mm3 3 weeks after delivery. From the result of our case of essential thrombocythemia in pregnancy, antiplatelet therapy may be useful for the treatment in this disease.View full abstractDownload PDF (2439K) -
1989 Volume 41 Issue 3 Pages 401-467
Published: 1989
Released on J-STAGE: July 05, 2011
JOURNAL FREE ACCESSDownload PDF (8668K)
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