[A case of primary myelofibrosis terminating in acute megakaryoblastic leukemia: identification by the demonstration of platelet peroxidase].
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Biomedical subjects
Publications and source records attributed to M Akahoshi.
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This is a case report of a 37-year-old Japanese woman with primary aldosteronism who was found to have high plasma renin activity during toxemia of pregnancy and who died of a dissecting aneurysm of the aorta about 2 years later. The autopsy findings showed cystic medial necrosis in the aorta and a right adrenocortical adenoma. The dissecting aneurysm in this case is probably related to hypertension and cystic medial necrosis. A definite diagnosis of primary aldosteronism cannot be made during toxemia of pregnancy, and it is necessary to do serial determinations of plasma renin activity and plasma aldosterone concentration after delivery to confirm the diagnosis.
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In order to study the clinical significance of cholylglycine (CG), CG in both fasting levels and after oral loading of 300 mg ursodeoxycholic acid (UDCA) were determined by radioimmunoassay in 313 patients with various liver diseases. Elevated fasting CG levels were found in 66.6% of patients with acute hepatitis (AH), 34.8% chronic inactive hepatitis (CIH), 79.3% chronic active hepatitis (CAH), 97.1% liver cirrhosis (LC), 94.7% hepatocellular carcinoma (HCC), and 80% of gall stones (GS). Changes of fasting CG during the course of AH were found to be parallel with values of transaminases. On oral loading of UDCA, different CG responses were found in CIH and CAH, and in compensated and decompensated LC. From these results we concluded that the determinations of serum CG gave additional informations of various liver diseases.
An 18-year-old man had hypertension with hyperreninemia and marked difference in plasma renin activity between both renal veins after tilting. Selective renal arteriography revealed a stenotic lesion in a segmental artery to the upper pole of the left kidney with poststenotic dilatation. The upper pole of the kidney with abnormal arterial segment was resected and the blood pressure returned to normal. Electron microscopically, a large number of mature juxtaglomerular cell granules were associated with many protogranules in the epitheloid cell. These findings suggest that his hypertension was due to overproduction of renin from the upper pole.
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The intrafamilial transmission pattern of hepatitis C virus (HCV) was examined in 118 family members of 61 index patients with type C chronic liver disease using anti-HCV antibodies and HCV RNA assay. The study subjects consisted of eight parents, 49 spouses, 50 children, eight siblings and three other relatives. The positivity rates of anti-C100, anti-JCC, second-generation anti-HCV and HCV RNA were 6.8, 12.7, 12.7 and 11.0%, respectively. Positivity in one or more anti-HCV antibody assay was detected in 3/24 (12.5%) father-child pairs, 3/17 (17.6%) mother-child pairs, 2/8 (25%) sibling pairs, 6/38 (15.8%) husband-wife pairs and 2/13 (15.4%) wife-husband pairs. In spouses, positivity for anti-HCV antibody or HCV RNA was observed after 40 years of age. None of 11 spouses married < 15 years was positive for any anti-HCV assay or HCV RNA. In spouses whose age was > 50 years and duration of marriage was > 25 years, anti-HCV or HCV RNA was frequently detected (32.0%). However, when seven pairs involving four spouses, one mother-daughter pair and two sibling pairs were subtyped, the same HCV subtypes were found in only four pairs (type II in three pairs and type III in one pair). Further, the agreement rate between anti-HCV and HCV RNA was > 90%. These results suggest that intrafamilial transmission of HCV, revealed by the subtyping method, is considered lower than the percentage of positivity for anti-HCV antibodies or HCV RNA in family members of patients with type C chronic liver disease.(ABSTRACT TRUNCATED AT 250 WORDS)
The use of a remote access infusion pump system in patients receiving intravenous therapy in the home provided a method to monitor patients and to reduce the number of unscheduled and after-hours nursing visits. Option Care of Rockwall, Texas, a locally owned IV company that is part of a national network, was able to avoid 13 nursing visits during a 4-month period with patients receiving pain management or continuous heparin therapy with the use of an infusion pump system that allowed remote access by telephone. An appreciable cost savings was documented with the use of this device.