[Vinblastine-loaded platelet therapy in adult patients with chronic idiopathic thrombocytopenic purpura].
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Biomedical subjects
Publications and source records attributed to S Shionoya.
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Human acute myeloid leukemia (ML-1 and HL-60) cells grew continuously in the serum-free liquid medium supplemented with human transferrin and bovine insulin. Both ML-1 and HL-60 cells formed clusters and colonies in the serum-free agar medium supplemented with bovine serum albumin, human transferrin, cholesterol, and L-alpha-phosphatidylcholine. Medium conditioned by phytohemagglutinin-stimulated leukocytes prepared in the absence of serum had three types of colony-stimulating factors on normal human bone marrow cells. When fetal calf serum was present, medium conditioned by phytohemagglutinin-stimulated leukocytes stimulated the clonal growth of HL-60 cells at the lower concentration. However, it inhibited that of ML-1 cells. In contrast, under serum-free conditions, medium conditioned by phytohemagglutinin-stimulated leukocytes promoted the clonal growth of both ML-1 and HL-60 cells at the lower concentrations. The study using a Sephadex G-200 column revealed that, in the serum-supplemented cultures, HL-60 cells responded to one of the three colony-stimulating factors and an activity with molecular weight of around 12,000, while ML-1 cells responded only to an activity with molecular weight of around 12,000. In the serum-free cultures, both ML-1 and HL-60 cells were stimulated by activities with molecular weights of 62,000 and 54,000, respectively. These studies demonstrate that the determination of growth factors for cell lines is dependent on culture conditions, particularly on serum component; that there is a heterogeneity of ML-1 and HL-60 cells in response to the growth factors; and that there is potential importance of demonstration of heterogeneity among different cell lines in establishing requirements for different stages of differentiation.
The effects of bone marrow-conditioned medium obtained from colony-stimulating factor-producing tumor-bearing nude mice (G-BM-CM) on mouse and human granulocyte-macrophage colony formation and mouse erythroid colony and burst formation were studied. Addition of G-BM-CM into the mouse granulocyte-macrophage colony-forming system containing colony-stimulating activity more strongly inhibited granulocyte colony formation than did mixed granulocyte-macrophage and macrophage colony formation, while it did not change the number of granulocyte colonies formed by human bone marrow cells stimulated by human granulocyte colony-stimulating activity. Addition of G-BM-CM slightly increased mouse erythroid colony and burst numbers when it was added into an erythroid colony-forming system stimulated by erythropoietin (1 unit/ml), and into the erythroid burst-forming system stimulated by erythropoietin (1 unit/ml) and 7% spleen cell-conditioned medium. These results might indicate that G-BM-CM mainly blocked commitment of mouse granulocyte-macrophage colony-forming cells to granulocytic progeny.
A traumatic aneurysm of the abdominal aorta resulting in acute peripheral thrombosis is rare. A 29-year-old man suffered a sudden occlusion of the terminal abdominal aorta and bilateral iliac arteries. An infrarenal abdominal aortic aneurysm was found, along with destruction of lumbar vertebrae and an aberrant renal artery. The pathogenesis of this false aneurysm was thought to be traumatic rather than inflammatory because the patient's history and laboratory findings showed no signs of inflammatory reactions. He had been in an automobile accident five years previously, resulting in lumbar vertebral injury. Arterial reconstruction and intraoperative perfusion of the aberrant renal artery were performed successfully. To our knowledge, our case is the seventh one reported in the English literature of a traumatic aneurysm of the abdominal aorta successfully repaired by surgery.
Replantation of a completely severed finger, hand or arm is now performed with wide success. We now report an extremely rare complication of this replantation, an arterio-venous (A-V) shunt formation. Pathogenesis of the new A-V fistula formation is discussed.
In a 50-year-old patient with plasma cell leukemia, the leukemic cells were found to have a 14q+ marker chromosome derived from the same translocation as that seen in Burkitt's lymphoma, namely, t(8;14)(q24;q32). A 14q+ marker has been reported so far in 13 cases of plasma cell dyscrasia, but only in 3 of them was the origin of the extra material on the 14q+ identified by banding analysis. The present case is the first one shown to involve a 14q+ marker derived from a Burkitt-type 8;14 translocation. Of particular interest is the association of the 8;14 translocation with lymphoid malignancies of the B-cell lineage.
Seventy-five limbs of 66 patients undergoing arterial reconstruction of the lower extremity were studied. In 41 of 64 limbs that were not involved in early failure, API returned to normal immediately and the increased API was maintained as long as grafts remained patent. The limbs exhibiting a rise in API of 0.1 or more following proximal reconstruction in the cases with combined iliac and femoral arterial occlusion or bypass grafting to an isolated segment obtained marked improvement of symptoms. Postoperative increase in TPI was not so marked as in API, and TPI remained very low in the limbs with arterial obstructive lesions below the ankle after successful reconstruction. Early or late failure could not be predicted on the basis of preoperative or postoperative API, TPI or A-T gradient. In the limbs with no recovery of TPI, blood flow or flow velocity in the foot was of value predicting which limbs would be salvaged.
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Revascularization syndrome is one of the dangerous postoperative complications which results sometimes in loss of a limb, renal shutdown and death due to myoglobin-nephrosis and hyperkalemia. During the past 3 years, 2 cases of revascularization syndrome were experienced in 16 cases of thrombo-embolectomies for acute peripheral arterial occlusion. One patient died from hyperkalemia 100 minutes after revascularization. Another patient suffered from a renal shutdown, and was treated with hemodialysis and thigh amputation. It is sometimes very difficult to predict whether the revascularization syndrome will occur or not. When revascularization is performed within 12 hours after an onset of acute occlusion and when the amount of ischemic muscle is not large, the syndrome may not occur. When the time-interval between the onset of ischemia and revascularization is longer than 24 hours and when the mass of ischemic muscle is large, the syndrome will occur. Preoperative serum creatinine and urea nitrogen level are important parameters predicting the prognosis.
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The pattern of arterial occlusion in Buerger's disease was analyzed by simultaneous bilateral femoral arteriography in 210 limbs of 105 patients with Buerger's disease. In 55 limbs of 42 patients, the femoropopliteal segment was affected in addition to the infrapopliteal arterial obstructive lesion. The pattern of crural arterial occlusion was similar in about 40% of both the patients with femoropopliteal occlusion and the patients with crural occlusion. Toes were ulcerated in 4 of 58 limbs with continuous arterial flow, and ulceration occurred in 86 of 152 limbs with a discontinuous flow. The rate of occurrence of bilateral trophic lesion in the group with an arteriographically similar occlusion pattern was not significantly higher than that in the group with a different pattern. The pattern of arterial occlusion in Buerger's disease seemed to be fixed mainly within 1 year after the onset of symptoms, and the skip-lesion in the main artery was favorable to proximal progression of the disease.
In the present study, systolic blood pressure in all toes was measured by using a bladder-free cuff in 20 normal limbs and 106 limbs with arterial occlusive disease, and the clinical significance of blood pressure measurement in all toes was studied. In 97 of 106 limbs with arterial occlusion, all 5 toes showed a significantly decreased blood pressure, indicating that any toe can be used for the purpose of diagnosis of arterial occlusions. However, 41% of cases showed the difference in blood pressure of more than 15 mm Hg between any 2 toes. Great variations of blood pressure among 5 toes were observed especially in limbs with gangrene or with other skin ischemic symptoms such as cold sensitivity, numbness, or history of gangrene in the toes. In these cases, evaluation of hemodynamics in each toe is considered to be of use for prognostic study of gangrene, selection and evaluation of treatments, and follow-up study. In limbs with intermittent claudication, however, blood pressure measurement in all toes may have little value in clinical practice because of small variation among blood pressure values of 5 toes. In comparison of blood pressure values in each toe from limbs with gangrene, toes with gangrene showed a significantly lower blood pressure than toes without gangrene. However, even in these toes without gangrene, a significantly lower blood pressure was observed than in toes from limbs without gangrene. These findings indicate that severe damage to digital circulation due to an occlusive process proximal to the toes is a primarily indispensable condition for development of gangrene in arterial occlusive disease.
Activities of delta-aminolevulinic acid (ALA) synthase and ALA dehydratase, the first and the second enzymes of the heme biosynthetic pathway, were determined in erythroid colonies derived from normal human bone marrow in culture. ALA synthase and ALA dehydratase were induced when normal human bone marrow cells were incubated in the presence of erythropoietin (Ep) in culture, and the extent of induction of ALA synthase as well as ALA dehydratase was dependent on Ep concentrations and culture periods. Both ALA synthase and ALA dehydratase were increased in cultured erythroid cells before the appearance of morphologically recognizable hemoglobinized colonies, corroborating the sequential induction of heme biosynthetic pathway enzymes in human bone marrow erythroid cells.
By means of a tracer technique with 99mTc-pertechnetate, provided with seven zonal regions of interest, 6 mm in width, placed at equal spaces of 18 mm, from the toe tip to the midfoot at a right angle to the long axis of the foot, arterial flow velocity in the foot during reactive hyperemia was measured. The mean velocity in the foot was 5.66 +/- 1.78 cm/sec in 14 normal limbs, 1.58 +/- 1.07 cm/sec in 29 limbs with distal thromboangiitis obliterans (TAO), 0.89 +/- 0.61 cm/sec in 13 limbs with proximal TAO, and 0.97 +/- 0.85 cm/sec in 15 limbs with arteriosclerosis obliterans (ASO). The velocity returned to normal in all 12 limbs after successful arterial reconstruction, whereas the foot or toe blood pressure remained pathologic in 9 of the 12 limbs postoperatively; the velocity reverted to normal in 4 of 13 limbs after lumbar sympathectomy. When the velocity was normalized after operation, the ulceration healed favorably, and the ischemic limb was salvaged. The most characteristic feature of peripheral arterial occlusive disease of the lower extremity was a stagnation of arterial circulation in the foot, and the flow velocity in the foot was a sensitive predictive index of limb salvage.
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