[A case of gastrointestinal GVHD (graft-versus-host disease) and cytomegalovirus ileitis with bone marrow transplantation].
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Biomedical subjects
Publications and source records attributed to F Kawano.
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A 45-year-old woman with Bence-Jones type multiple myeloma was treated with natural type alpha-interferon (Namalwa interferon), 3 million IU every other day subcutaneously. After about 5 months, she developed hemolytic anemia. However, screening tests for autoantibodies, including direct and indirect antiglobulin (Coombs' tests), were negative. This report is the first case in which hemolytic anemia appeared to be caused by natural type alpha-interferon. It is likely that interferons will be used in treating increasing numbers of patients and that more patients will develop this complication.
We report a case of chronic myeloid leukemia (CML) in myelomonocytic transformation associated with bone marrow (BM) eosinophilia. At diagnosis, all BM cells showed a Ph chromosome. At the time of blastic phase, more than 50% of Ph+ cells had a pericentric inversion of chromosome 16, inv(16)(p13q22). This case confirms that blastic transformation of CML can involve any committed progenitor, and myelomonocytic leukemia with BM eosinophilia is specifically associated with rearrangement of chromosome 16 at band p13 and q22.
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The bond strength of six commercial soft denture liners was evaluated using a modified tensile test. The soft denture liners investigated were Prolastic, VinaSoft, Flexor, Molloplast-B, Novus, and Super-Soft. The samples were processed according to the manufacturers' instructions to cured denture base resin (polymethyl methacrylate; PMMA). The soft denture liners were 10 x 10 x 3 mm and were processed between two PMMA blocks. The samples were placed in tension until failure. The mode of failure, cohesive or adhesive, was also recorded. The results of this study showed that the bond strength is related to the components of the materials. Prolastic, VinaSoft, and Flexor had the lowest bond strength to cured PMMA and ranged from 9.6 to 11.3 kg/cm2. Super-Soft, Novus, and Molloplast-B demonstrated better bond strengths and ranged from 16.7 to 17.6 kg/cm2. The bond strength of Novus could be improved by using the recommended bonding agent and bonded Novus at 26.1 kg/cm2 had the highest bond strength of all materials tested.
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The creep behavior of amalgam in Class I cavity was simulated by an axi-symmetric elastic creep finite element method. In this procedure, the stress and time dependencies of the creep strain of amalgam were incorporated. Exponents of stress and time dependencies were postulated as 2.0 and 1.0, respectively. Amalgam with 1.0% of creep value (tested by American Dental Association Specification No. 1) were selected for the material to calculate. Simulation was conducted for the occlusal force of 40, 100, and 150 N, respectively, on the caps of enamel and vertical direction to the axis of the tooth. Results show that creep strain of amalgam in the cavity did not increase linearly with time because the amalgam deformed to become stress-free and creep rate was a function of the stress. It was concluded that elastic deformation of the crown with no filling material in its cavity is an important factor in determining the creep strain and the gap between the cavity and the restorative material.
Six of 14 patients with acute myeloblastic leukemia (AML) complicated reactive histiocytosis during initial remission induction therapy. All six patients had a high fever without signs of infection during initial chemotherapy, and periods of myelosuppression were prolonged. Histiocytes with a mature appearance, some of which phagocyted erythrocytes, thrombocytes or neutrophils, increased in the bone marrow. All of 3 patients tested showed high serum levels of ferritin. Two of 3 patients treated with 125 mg/day methylprednisolone achieved complete remission. In the remaining 3 patients, one patient achieved complete remission, but the others died of fungal pneumonia or sepsis. Thus, reactive histiocytosis is one of the severe complications in patients with AML undergoing chemotherapy.
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An adult T cell leukemia (ATL) accompanied with Isospora belli infection was described. A 65-year-old male was admitted to our hospital because of a two month history of watery diarrhea. On admission, physical examination showed slight pallor but no detectable superficial lymphadenopathies. Hepatosplenomegaly was not observed. Laboratory examination revealed a leukocyte count 5,500/microliters with 10% abnormal lymphoid cells. A majority of the abnormal lymphoid cells expressed both CD 4 and CD 8 antigens. The patient was diagnosed as chronic ATL, since anti-HTLV-1 antibody in his serum and monoclonal integration of HTLV-1 proviral DNA in his peripheral mononuclear cells were detected. Isospora belli was found in his feces thereafter, and trimethoprim/sulfamethoxazole was effective for diarrhea. In Japan, there have been only 9 reported cases of lymphoproliferative disorders (including five ATL patients) accompanied with Isospora belli infection. From the descriptions in those reports, these 9 cases might all be ATL patients.
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Several soft lining materials are available at present that differ in physical and mechanical properties. To examine the feasibility of soft lining materials used as so-called "tissue conditioners," the properties of soft lining materials were investigated by using a static creep test and a pressure distribution test. Six typical materials were used. The pressure on the testing plate was distributed uniformly on the soft lining materials. The soft lining material acted as a cushion for the external forces. However, the variation of pressures increased with time in the cases of Hydro-cast and Softone materials, but decreased with time in the case of Coe-comfort material.
To analyze the development pathways of early hematopoietic cells, we studied the rearrangement and expression of the immunoglobulin (Ig) and T-cell receptor (TCR) genes in 12 patients with acute unclassified leukemia (AUL). Leukemia cells from these patients were negative for myeloperoxidase staining and failed to express B-cell, T-cell, or megakaryocyte associated antigens. The expression of the CD7 antigen, myeloid associated antigens, or both was detected in three patients each. Ig and/or TCR gene rearrangements were detected in seven of the 12 patients, and five had rearrangement of both the Ig and TCR genes. Full length mature TCR gene transcripts were not demonstrated in most of the patients showing TCR gene rearrangements. In contrast, cells from two patients with germline configurations of the Ig and TCR genes tested expressed truncated forms of both Ig and TCR genes. These results suggest that AUL may generally originate from undifferentiated cells with an aberrant rearrangement and/or expression of the Ig and TCR genes.
A 78-year-old man was admitted because of lumbago and chest pain. A diagnosis of non-secretory primary plasma cell leukemia was made based on the laboratory findings and his history. However, the plaque-forming cells assay of bone marrow cells revealed secretion of monoclonal immunoglobulin from the myeloma cells. Hyperammonemia was detected in the serum. Although the patient was treated with 4 courses of combination chemotherapy (vincristine, adriamycin, cyclophosphamide, methylprednisolone), he died of respiratory failure five months after diagnosis. Autopsy showed widespread multiple myeloma and prominent infiltration of myeloma cell in the sinusoid of the liver. Recently, there have been a few reports which increased the plasma ammonia concentration with multiple myeloma. This report strongly suggested that liver infiltration of myeloma cell caused hyperammonemia.
Histocompatibility antigens (HLA-A,B,C,DR, and DQ antigens) were investigated in 25 Japanese patients with the Crow-Fukase syndrome (Takatsuki's disease). No significant associations were detected between the patients with the Crow-Fukase syndrome and the healthy controls.