[Melena, purpura, backache and pyrexia (blood pictures and bone marrow pathology): (multiple myeloma)].
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Biomedical subjects
Publications and source records attributed to Y Chiba.
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The characteristics of about 2,000 Japanese sarcoidosis cases collected by the Japan Sarcoidosis Committee during the 10-yr period, 1963-1972, were chronological increase with decreasing infectious diseases (represented by tuberculosis), north-to-south decline in sarcoidosis incidence in accordance with the Oxford Atlas Seasonal Climates, the age of cases shifting to the younger group in areas of high incidence, a local outbreak, and familial aggreagations. These results led the authors to an hypothesis that sarcoidosis is a disease induced by an infective agent or agents, prevalent in cold places, becoming influential in association with ecological changes, and affecting persons with predispositions.
The rubella-specific antibody, activity the levels of immunoglobulins and complement in the serum, the number of T cells, and the nature of cell-mediated immunity as measured by lymphocyte transformation (LTF) of circulating lymphocytes in response to rubella virus and phyto-hemagglutinin (PHA) were studied in 15 children who manifested arthralgia or arthritis after parenteral immunization with HPV-77 DE/5 or RA27/3 live attenuated rubella virus vaccines. Eighteen appropriately matched subjects who developed no post-vaccine complications were included as controls. The immunoglobulins, complement, and rubella antibody levels were similar in all subjects. Although significant rubella specific cell-mediated immunity was detectable in most control subjects, the activity was markedly depressed in subjects with arthritis. The LTF activity in response to PHA was approximately equal in both groups. These findings suggest a selective depression of cell-mediated immunity to rubella virus in subjects with arthritis associated with rubella vaccination.
The antibody and cell-mediated immune response to mumps virus infection was studied in groups of subjects after natrually acquired mumps virus infection, after parenteral immunization with live attenuated mumps vaccine, and in a population of mumps seronegative subjects. The technique of neutralization of tissue culture infectivity was utilized to study mumps specific antibody. The cell-mediated immunity (CMI) was detected by specific immune release (SIR) of radioactivity by purified lymphocytes after they were reacted with radioactive chromium (51Cr) labeled human conjunctival cell cultures chronically infected with mumps virus. No SIR activity was observed in lymphocytes obtained from cord blood and young individuals seronegative for antibody to mumps virus. Detectable SIR activity was observed in a few older seronegative subjects; however, immunization with mumps vaccine in such antibody negative subjects failed to result in the development of any antibody response in the serum. High SIR activity was observed in the lymphocytes of naturally infected and vaccinated subjects. Although all naturally infected or immunized subjects had varying levels of mumps specific antibody activity in the serum, no correlation existed between the levels of antibody and SIR activity. These observations suggest the development of mumps specific in vitro correlates of CMI after naturally acquired or vaccine-induced mumps virus infection.
Antibody and cell-mediated immune response in systemic and external mucosal sites was studied after natural or vaccine induced infections with rubella and mumps viruses. Natural rubella infection or immunization with RA27/3 rubella vaccine by intranasal and frequently by the subcutaneous route resulted in regular appearance of antibody response in the serum and respiratory tract and cellular immunity in circulating lymphocytes and tonsillar lymphoid tissue. Subcutaneous immunization with HPV-77 and Cendehill rubella vaccine resulted in antibody response in the serum with little or no response in the respiratory tract. A minimal cell-mediated immune response in systemic or respiratory lymphoid tissue was observed after such immunization. Intranasal immunization with HPV-77 frequently elicited a transient antibody and cell-mediated activity in the respiratory tract with no response in the serum and peripheral lymphocytes. Studies carried out with natural mumps infection or subcutaneous immunization with live attenuated mumps vaccine suggested that either route of infection may result in the development of antibody and cell-mediated immune responses in systemic sites as well as in the respiratory tract. These observations suggest that the immunologic outcome of immunization by non-parenteral route may be determined by the types of viral antigen employed, the nature of locally available immuno-competent tissue, the ability of mucosal site to capture an antigen or accept replication of live virus vaccines, and the degree of prior sensitization with the same antigen.
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Antibody activity against mumps, measles, polio, and rubella viruses was determined in patients with juvenile rheumatoid arthritis (J.R.A.), rubella-vaccine associated arthritis, adult rheumatoid arthritis, other chronic systemic disorders (e.g., systemic lupus and dermatomyositis), and in a matched population of normal, non-rheumatoid (control) children. The antibody levels against mumps, measles, and poliovirus were similar in all patients. Rubella-antibody levels in rheumatoid arthritis and other systemic disorders were similar to those observed in controls. The mean rubella-antibody levels in rubella-vaccine arthritis were 4 times higher than in controls. The IgM and IgG rubella-antibody levels in J.R.A. were found to be 4-6 times higher when compared to titres observed in the controls. Highest antibody levels were seen in younger children with J.R.A. Detection of rubella-virus antigen was attempted by immunofluorescence in the sediment smears of synovial fluid of patients with J.R.A., adult rheumatoid arthritis, and other non-rheumatoid joint diseases. Specific staining for rubella virus antigen was observed in the synovial fluid of 33 percent of patients with J.R.A. No antigen was detected in the synovial fluid from other patients. These observations suggest a possible role of rubella-virus infection in J.R.A.
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Both bone marrow and peripheral blood was investigated light and electron microscopically in 3 cases with polycythemia vera, 2 cases with primary thrombocythemia and 1 case with panmyelosis. In 5 cases the peripheral blood showed persistent increase in cells of two or three hematopoietic systems. Giant thrombocytes in the peripheral blood were seen in 3 cases. Erythroblasts, granulocytic young forms, and megakaryocytes were often observed in the blood. Histologic bone marrow examination showed prominent proliferation of all 3 hematopoietic cells in every case. Cytological and electron microscopical examinations of the bone marrow revealed many mitotic figures, morphological abnormalities, and unbalanced nucleocytoplasmic maturation in various hematopoietic cells. These findings suggested that the proliferation of all 3 hematopoietic cells in the bone marrow was not simply reactive in nature, but an idiopathic progressive process. It is considered that these disorders and primary myelosclerosis represent no separate entities and must be unified as "chronic panmyelosis".
A 3-week-old infant with haemophilia A developed fever and mononucleosis and was found to have cytomegalovirus, infection, possibly acquired by blood transfusion. At 6 months, while still excreting cytomgalovirus, he developed transient clinical jaundice with a hepatitis-like picture.
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