Biomedical subjects
Publications and source records attributed to T Aso.
Ultrasonographic examination on a fetus at 24 weeks of gestation revealed an intrathoracic cystic mass with fetal hydrops and polyhydramnios. Pathological findings obtained at autopsy which was conducted on the fetus at 28 weeks indicated a typical congenital cystic adenomatoid malformation (CCAM) of the lung. The differential diagnosis and possible intrauterine treatment for lung CCAM are discussed.
A case of hybrid phenotypic chronic myelomonocytic leukemia (CMMoL) transformed from a hematological remission state of severe aplastic anemia is reported. A 63-year-old woman was admitted to our hospital with complaints of easy fatigability and dizziness in December 1978. A diagnosis of aplastic anemia was made from findings of pancytopenia and hypoplastic marrow without dysplasia, and she was treated successfully with mepitiostane. Seven years later, anemia and thrombocytopenia reappeared with monocytosis. On the second admission, the peripheral blood showed a white blood cells count of 3.5 X 10(3)/microliters with 54% monocytes. The bone marrow was hypercellular with monocytosis, and dysplasia of three cell lineages was noted. A diagnosis of CMMoL was made. Cytogenetic analysis of bone marrow cells revealed a karyotype of 45 XX, -7, 11q-, and surface markers were polyphenotypic, including CD20+, CD14+ and CD13+. This is the first report of CMMoL with biphenotype which was transformed from aplastic anemia.
A case of heterogeneous acute lymphoblastic leukemia of the Burkitt type (L3-ALL) is reported. A 58-year-old woman was admitted to our hospital with complaints of palpitation and shortness of breath in December 1988. On admission, the peripheral blood showed severe pancytopenia. The bone marrow was hypercellular with abnormal lymphoblasts; the cytoplasm was moderately abundant and intensely basophilic with prominent vacuoles. A diagnosis of L3-ALL was made. Cytogenetic analysis of bone marrow cells revealed a karyotype of 46,XX. The leukemic blasts were HLA-DR+, CD10+, CD19+ and CD20+, but no surface or cytoplasmic immunoglobulins were detected. This is the first report in Japan of a case of L3-ALL without chromosome abnormality and lacking surface and cytoplasmic immunoglobulins.
Acute myeloblastic leukemia (AML) was diagnosed in a 54-year-old male, a chronic hepatitis B surface antigen (HBsAg) carrier, in June, 1983. Prompt remission was achieved, and maintenance and intensification chemotherapy were given for five years. He was readmitted in March, 1988 because of a mass in the liver and was diagnosed as having hepatocellular carcinoma (HCC). Curative right segmentectomy was performed in May, 1988. In December, 1988, transitional cell carcinoma of the bladder was discovered, and resected transurethrally. These secondary neoplasms, HCC and bladder cancer, were thought to be associated with the long-term chemotherapy given for the AML.
The purpose of this study was to investigate the combined effect of bromocriptine (Brc) and clomiphene citrate (Cl) treatment on 40 patients with normoprolactinemic amenorrhea who failed to respond to Cl alone. The ovulation rate in this treatment was 57.3% (23/40) in the 40 cases, 55.6% (99/178) in 178 cycles; the pregnancy rate was 26.7%. This treatment was effective in 14 of 21 women with polycystic ovary-like syndrome (66.7%). Among those women who responded to treatment, prolactin (PRL) and LH levels were significantly decreased. Estradiol and progesterone levels were significantly increased in the patients who responded. Before treatment, the responsiveness of LH to LHRH among responders to Brc/Cl therapy was significantly higher than among the nonresponders. After treatment, the LH-releasing response following a conjugated estrogen injection in the patients who responded to the treatment was significantly greater than that in the patients who did not respond. The results suggest that the therapeutic effect of this treatment may be primarily due to the restoration and improvement of the impaired hypothalamo-pituitary axis.
From January 1981 to December 1990, intracardiac repair of tetralogy of Fallot in 148 pediatric patients, with one surgical death, was directed toward preservation of the native pulmonary valve. Using the accepted preoperative angiographic criterion for the pulmonary valve annulus area (PVA) of 1.8 cm2/m2, 85 patients were candidates for transannular right ventricular outflow patch (TAP). However, in 54 patients with a mean PVA of 1.5 cm2/m2 (range 1.06-1.76), the valve was preserved without using TAP because the morphological changes (cusp thickening and annular distensibility) seemed acceptable for preservation in view of its probable hemodynamic efficiency and growth potential. A morphological classification of pulmonary valve changes has evolved. Retrospectively, 24 (77%) of the 31 patients with TAP had moderate to severe cusp thickening and ring rigidity; this incidence was significantly higher (p < 0.001) than that in preserved patients (18 of 54 or 33%). The incidence of morphological changes increased with operative age; that is, 2 of 13 (15%) patients younger than 1 year versus 23 of 40 (58%) patients older than 4 years (p < 0.01). All 54 patients with preserved pulmonary valves were catheterized one month postoperatively. The intraoperative right to left ventricular systolic pressure ratio (RVP/LVP) decreased significantly (p < 0.005) in one month, from a mean of 0.79 (range 0.44-1.36) to 0.57 (range 0.36-0.97). The PVA increased from a mean of 1.5 to 1.9 cm2/m2 (range 1.20-2.65), and the rate of its increase was significantly larger (p < 0.005) as operative age decreased. Pulmonary valve regurgitation of greater than mild degree occurred in 8 of 54 (15%) patients with the valve preserved.(ABSTRACT TRUNCATED AT 250 WORDS)
A study was made of formation of the pool of sex steroid hormones and their precursors in the blood plasma of male Paio hamadryas. Cannulation and simultaneous recovery of the blood from the adrenal, testicular, left iliac veins and the aorta were carried out under nembutal anesthesia. Thirteen steroid hormones and their precursors were determined by the radioimmunological method in all the blood portions. Steroid function was tested on columns with celite. Pregnenolone, 17alpha-oxypregnenolone, and 17alpha-oxyprogesterone were secreted chiefly by the adrenal glands. Dihydroepiandrosterone was produced by the adrenal glands and utilized by the testes. Androstendion and dihydrotestosterone were mostly of adrenal, and testosterone--testicular origin. Estron is secreted by the adrenal glands only, whereas estradiol is produced by the testes in larger quantities than by the adrenal glands. The sulfate forms of pregnenolone and dihydroepiandrosterone are produced chiefly by the adrenal glands.
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