[Hypercalcemia in acute megakaryoblastic leukemia: a case report].
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Biomedical subjects
Publications and source records attributed to S Fujioka.
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The casual relationship between intraabdominal visceral fat accumulation and metabolic disorders was analyzed in 46 obese subjects (15 males, 31 females) having 34.1 +/- 5.5 of body mass index (BMI). The distribution of fat was determined by our CT scanning technique (Int J Obesity 7:437, 1983). The total cross-cut area, subcutaneous fat area, and intra-abdominal fat area was measured at the umbilical level. The fasting plasma glucose level, area under the plasma glucose concentration curve after oral glucose loading (plasma glucose area), fasting serum triglyceride level, and serum total cholesterol level were all significantly higher or otherwise greater in the group with intraabdominal visceral fat to subcutaneous fat ratio (V/S ratio) of not less than 0.4 than in the group with a lower V/S ratio, when either all or sex-matched obese subjects were examined, though BMI or the duration of obesity was not different between the two groups. The V/S ratio was significantly correlated with the level of plasma glucose area (r = 0.45, P less than .001) under the curve of 75 g oral glucose tolerance test and also with the serum triglyceride (r = 0.65, P less than .001) and total cholesterol levels (r = 0.61, P less than .001). These relationships were also observed when examined in each sex separately and found to be significant after adjustment for BMI and age by multiple regression analyses.(ABSTRACT TRUNCATED AT 250 WORDS)
A 85-year-old woman with a mucin-producing pancreatic cancer is reported. The patient, who had been diabetic for 2 years, was admitted in March of 1984 to our hospital because of a fever and cough. On admission, a hard tumor was found on the right hypochondric region. Ultrasonogram and computed tomography revealed a cystic pancreas head tumor containing mucin and a dilated pancreatic duct. During an ERCP examination, Vater's papilla was found to be enlarged and a biopsy showed papillary adenocarcinoma. Also, the levels of CEA and CA 19-9 were elevated 11.3 ng/ml and 1300 U/ml, respectively. On Feb. 13, 1985, she died due to panperitonitis that resulted from a perforated duodenal ulcer. Microscopic examination of the pancreas showed a papillary adenocarcinoma producing mucin, a dilated pancreatic duct and atrophy of the islets. No metastatic lesion was found. The pathogenesis and the clinical characteristics of the mucin-producing pancreatic cancer are discussed.
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Ultrastructure of the liver in ventromedial hypothalamus (VMH) lesioned rats was studied in parallel with biochemical examination. Ten weeks after the operation, VMH lesioned rats became markedly obese. Electron microscopic examination of the liver revealed lipid droplets in the cytoplasm and a high load of lipoprotein particles in the Golgi elements. Lipoprotein particles, 40-50 nm in diameter, in the Golgi elements, were scattered throughout the cytoplasm. Concentrations of triglyceride and esterified cholesterol markedly increased in the liver, while those of free cholesterol and phospholipids did not increase. Serum concentrations of triglyceride, total cholesterol and HDL-cholesterol in VMH lesioned rats were higher than control ones. These data suggest that lipoprotein synthesis was markedly increased in the livers of VMH lesioned rats.
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Effects of ouabain on the autoregulation of renal blood flow (RBF) and renin release were examined in filtering and nonfiltering kidneys of anesthetized dogs. Autoregulation of RBF was observed in both kidneys; however, autoregulation in the nonfiltering kidney was comparatively less efficient. These findings indicate that both the myogenic mechanism via a sensor element in the afferent arteriole, a so-called baroreceptor, and the tubuloglomerular feedback mechanism via the macula densa are essential for complete autoregulation. In both the control and nonfiltering kidney, intrarenal arterial infusion of ouabain abolished the autoregulation of RBF and glomerular filtration rate, with no change in the renal vascular sensitivity to vasoactive substances or in renin release induced by pressure reduction. Since various vasoactive drugs elicited a normal vascular response, it appears that the site of action of ouabain was not the vascular contractile elements; at least, an impairment of autoregulation during ouabain infusion was apparently not due to a defect in these elements. These results suggest the possible existence of another mediator, a sensor element in the afferent arteriole that is affected by ouabain. Ouabain may abolish the autoregulation of RBF and renin release via a modification of this baroreceptor in the afferent arteriole as well as through inhibition of the macula densa.
Nephrotic range proteinuria occurred in a 42-year-old woman with renal arterial occlusion and hyperreninemia. The administration of captopril, an angiotensin converting enzyme inhibitor, led to an amelioration of the proteinuria and the decrease of blood pressure, without surgical treatment. From the present observation, it is highly probably that the increased activity of the renin-angiotensin system plays an important role in massive proteinuria. Conservative treatment for renovascular hypertension with nephrotic syndrome was effective in this patient.
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The biosynthetic pathways of pyrimidine nucleotides were studied in cells obtained from 10 patients with acute leukemia (AL), 3 with chronic myelocytic leukemia in blastic crisis (CML-crisis) and 4 with chronic myelocytic leukemia (CML) and from 8 controls. In the de novo pathway, synthesis of intermediates was analyzed with NaH[14C]O3 as a tracer. In the salvage pathway, the formation of nucleotides and free bases was studied with [3H]nucleosides (uridine, cytidine, thymidine, deoxyuridine, and deoxycytidine) tracers. Radioactivities of nucleotides were significantly lower in AL and CML-crisis cells than in CML and control cells in both pathways. These results suggest that the proliferative rate of cells was lower in the former cases than in the latter. Biosynthetic activities of nucleotides in the salvage pathway were about 100-300 times higher than those in the de novo pathway. It was calculated however, that as much as 70% of the amount of nucleic acids necessary for AL cells can be supplied by de novo biosynthesis, while in normal bone marrow cells the figure was about 30%. The greater part of pyrimidine biosynthesis can be carried out through the de novo pathway. In particular, AL cells with a longer generation time seemed to depend more on de novo biosynthesis than do normal bone marrow cells. This finding could be important in connection with the design of antileukemic agents.