Hitoshi Take

Effective physical therapy for chronic obstructive pulmonary disease : Pilot study of exercise in hot spring water

Respiratory function and arterial blood gas were examined before and after a two-month exercise program performed in a pool filled with hot spring water in 22 patients (70.9 +/- 9.1 years of age) with stable chronic obstructive pulmonary disease (12 cases of bronchial asthma and 10 cases of pulmonary emphysema) treated at our hospital between 1991 and 1994. The ratio of forced expired volume in one second to forced vital capacity (FEV1%) was significantly increased after the exercise program (P < 0.05), whereas the ratio of forced vital capacity to predicted normal value (%FVC) did not change. In addition, a tendency toward an increase in peak flow without an increase in maximum expiratory flow at 25 and 50% (V25 and V50) was observed. Although PaO2 was not increased, PaCO2 was selectively decreased by the exercise program (P < 0.05). The changes in respiratory function and arterial blood gas were considered attributable to respiratory muscle training and small airway clearance. Exercise in a pool filled with hot spring water may be useful in treating chronic obstructive pulmonary disease.

Effects of hyperthermal stress on the ultrastructure of platelets with reference to the localization of platelet peroxidase and fibrinogen in vivo.

Ultrastructure of platelets with the localization of platelet peroxidase and fibrinogen through 3‐min 47°C hot‐spring bathing was investigated in eight healthy volunteers. The mean sublingual temperature rose about 1.8°C 5 min after the start of bathing. The frequencies of fold, pseudopods, vacuoles, and centralization were increased after bathing. Platelet peroxidase activity was decreased after bathing. Furthermore, fibrinogen was decreased in α‐granules after bathing. Thus, hyperthermal stress in vivo may activate platelets, resulting in consumption of platelet peroxidase and fibrinogen. Am. J. Hematol. 56:244–247, 1997.

SEVERE ANAPHYLACTIC TRANSFUSION REACTION ASSOCIATED WITH HLA-INCOMPATIBLE PLATELETS

pointed out that two alternative explanations may exist. First, it may be supposed that only a minority of the stem cell pool belongs to the tumour population. However, in true stem cell disorders, as for example chronic myelogenous leukaemia, the majority of haematopoiesis is neoplastic, as expected in a multiple myeloma patient with 60% plasma cell infiltration. Second, ras mutations can be a late genetic lesion during myeloma tumourigenesis, even if they are usually considered an early lesion in human tumourigenesis, as it has been shown for myelodisplasias and colon adenomas (Fearon & Vogelstein, 1990). Our results, therefore, do not support the hypothesis of a stem cell origin for multiple myeloma. However, to definitively exclude such origin, further analyses on a large panel of cases are required.

An indolent type of Epstein-Barr virus-associated T-cell-rich B-cell lymphoma of the skin: report of a case.

A 74‐year‐old Japanese man presented with systemic lymphadenopathy, hepatosplenomegaly, and erythroderma in December 1991. A characteristic pattern of anti‐EBV antibodies was suggestive of latent EBV infection. A skin tumor biopsied in April 1993 contained biclonal EBV genomes diffusely in the infiltrate of polyclonal T cells and monoclonal B cells. The clinical course was rather mild in contrast to that of classical EBV‐associated disorders. Our case was considered a rare indolent type of EBV‐associated T‐cell‐rich B‐cell lymphoma of the skin.

Spontaneous regression in B cell, diffuse large cell type non-Hodgkin's lymphoma.

A rare case of non-Hodgkins lymphoma (NHL) that showed transient spontaneous regression (SR) is described. After 6 months of remission, recurrence was noted in the lymph nodes, pleura and the spleen. Although transient improvement was observed following combination chemotherapy, the pleural effusion became refractory to chemotherapy and the patient died 9 months after the relapse.

Elderly onset of adult Still's disease: Report of a case

SummaryAdult Stills disease is a variant of juvenile rheumatoid arthritis occurring most frequently in women 16–35 years of age, but rarely in elderly people. We describe a 75-year-old woman who was considered as having adult Stills disease.

Acquired total immunoglobulin G deficiency in a patient with primary biliary cirrhosis.

Abstract. A 38‐year‐old Japanese woman was hospitalized for susceptibility to respiratory tract infections. Clinical examinations revealed asymptomatic primary cholestasis, abnormally elevated immunoglobulin M (IgM) and antimitochondrial antibody, being consistent with asymptomatic primary biliary cirrhosis. Three years later her serum immunoglobulin G (IgG) decreased remarkably, whereas other immunoglobulins were unchanged. Immunological examinations on the peripheral blood lymphocytes demonstrated spontaneous over‐synthesis of serum IgM and decreased synthesis of IgG due to abnormal function of both T and B cells. Our case suggests a new possible association between primary biliary cirrhosis and IgG deficiency.