Etsuo Kawada

A transient rise in plasma β-endorphin after a traditional 47°C hot-spring bath in Kusatsu-spa, Japan

Abstract To clarify the mechanism of the intoxicating feeling attained after a traditional 47°C hot-spring bath called ‘jikan-yu’ in Kusatsu-spa, Japan, we examined the change in plasma levels of β-endorphin and methionine enkephalin in 7 healthy subjects. The mean sublingual temperature rose from 36.8°C to 38.6°C and the plasma β-endorphin level from 16.2 pg/ml to 49.5 pg/ml 2 minutes after completing a 3-minute bath in 47°C hot-spring water. However, the plasma methionine enkephalin level was not changed. This feeling of intoxication may be explained by the transient rise in plasma β-endorphin level.

Possible involvement of protein kinase C in the aberrant regulation of erythropoiesis in polycythemia vera.

To examine the possible involvement of protein kinase C (PKC) in the regulation of aberrant erythropoiesis of polycythemia vera (PV), we investigated the effects of PKC inhibitors on in vitro burst-forming unit of erythroid (BFU-E)-derived colony formation by bone marrow (BM) and peripheral blood (PB) cells obtained from five PV patients. 1-(Isoquinoline-sulfonyl)-2-methylpiperazine dihydrochloride (H-7), an inhibitor of PKC, suppressed the colony formation by BM and PB cells of PV patients in a dose-dependent manner, similar to those in the normal individuals. However, the 50% inhibitory concentrations (IC50) of H-7 in PV BM and PB cells were significantly higher than those in normal BM and PB cells, respectively. The BFU-E-derived colony formation by PV BM and PB cells was also less affected by Staurosporine, another PKC inhibitor, than those in a normal subject. Furthermore, in the study of PV, the IC50 of endogenous colonies formed in the absence of erythropoietin was much higher than that of colonies formed by the stimulation of erythropoietin. By contrast, N-(2-guanidinoethyl)-5-isoquinolinesulfonamide dihydrochloride (HA1004), a cyclic AMP-dependent kinase inhibitor, did not have such inhibitory effects. These findings suggest that PKC, as a second messenger, is involved in the regulation of aberrant erythropoiesis of PV.

Complete cure of urinary and faecal incontinence after intravenous vitamin B12 therapy in a patient with post-gastrectomy megaloblastic anaemia

Abstract. The case of a 59‐year‐old Japanese woman with post‐gastrectomy megaloblastic anaemia having urinary and faecal incontinence and paraesthesia in four extremities is described. While the haematological abnormalities were improved by administration of a total dose of 17 mg of intramuscular mecobalamin, the neurological abnormalities remained unchanged. Five months later, a total dose of 7.5 mg of mecobalamin was injected intravenously over a period of 5 weeks, although the serum level of vitamin B12 was > 1180 pmol l−1. Immediately after initiation of the therapy, the urinary and faecal incontinence were gradually improved, and were completely cured within 2 months. The peripheral neuropathy was also ameliorated. The effectiveness of intravenous vitamin B12 injection for the neurological abnormalities due to vitamin B12 deficiency is emphasized.

In long-term bedridden elderly patients with dietary copper deficiency, biochemical markers of bone resorption are increased with copper supplementation during 12 weeks

Background: Although the effect of copper on bone has been tested in animals and healthy subjects, no studies concerning the effect of copper supplementation on bone metabolism in patients with copper deficiency have been reported because of the rarity of these patients. This study was conducted to investigate the effect of copper supplementation on bone metabolism in copper-deficient patients. Method: This study included 10 patients (83.7 ± 8.3 years) with dietary copper deficiency under long-term bed rest for more than 12 months. They had their diets supplemented with copper sulfate (3 mg/day) over 12 weeks in addition to their diet of only one kind of enteral food with a low concentration of copper. Serum copper and ceruloplasmin, urinary deoxypyridinoline (DPD) and collagen-type 1 N-telopeptide (NTX) (biomarkers of bone resorption), serum osteocalcin (OC) and bone-specific alkaline phosphatase (Bone ALP) (biomarkers of bone formation) were analyzed at baseline, 4 and 12 weeks after copper supplementation. Results: DPD and NTX excretion were significantly increased 4 weeks after copper supplementation (p = 0.009 and p = 0.013, respectively). Serum bone ALP and OC were not significantly changed 12 weeks after copper supplementation (p = 0.051 and p = 0.594). Conclusions: In patients with nutritional copper deficiency, bone resorption markers are increased with copper supplementation.

Primary nonsecretory plasma cell leukemia: a rare variant of multiple myeloma

Abstract We report a patient with primary nonsecretory plasma cell leukemia. These cells resembled prolymphocytes and expressed only CD38 and CD56. Due to the atypical morphology and lack of monoclonal immunoglobulins in both serum and urine, it was difficult to make a correct diagnosis. Electron-microscopic and immunocytochemical cytoplasmic studies were useful.

Nonsecretion of myeloma protein in spite of an increase in tumor burden by chemotherapy.

SummaryA unique case of IgA κ myeloma is presented. While the myeloma cells had secreted a large quantity of IgA κ monoclonal protein, they were induced to stop secreting the monoclonal protein by cyclophosphamide and vincristine, in spite of a remarkable increase in tumor burden. The absence of intracytoplasmic IgAκ was clearly evidenced by the immunofluorescence technique using anti-IgA and anti-κ monoclonal antibodies.

Cyclic haemopoiesis at 7‐ or 8‐day intervals

Summary. We report a patient with severe anaemia and cyclic oscillations of reticulocyte and leucocyte counts, as well as serum iron (Fe), unsaturated iron‐binding capacity (UIBC), ferritin, C‐reactive protein (CRP) levels and temperature, at regular intervals of 7 or 8 d. After treatment with prednisolone, anaemia was corrected and the cyclic oscillations of these parameters ceased; whereas treatment with indomethacin, recombinant granulocyte‐colony stimulating factor (G‐CSF) and erythropoietin (Epo) were unsuccessful.

PHILADELPHIA CHROMOSOME IN A SARCOIDOSIS PATIENT

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