Studies on Lipid of Red Cell Membrane in Patients with Iron Deficiency Anemia by the Use of Iatroscan

Studies on red cell membrane lipid composition in patient with iron deficiency anemia (IDA) disclosed the possibility of abnormal metabolism of cellular membrane. Inversion of the SM/PC ratio (SM, sphingomyelin and PC, phosphatidyl choline, are the lipids of the outer lamella of erythrocyte membrane) might be responsible for the poikilocytosis seen in this anemia. In IDA patients, phosphatidyl ethanolamine (PE) and phosphatidyl serine (PS), which are the lipids of inner lamella of the membrane decreased, but they returned to the normal range with increase in reticulocytes which were produced in accordance with the beneficial effect of the iron therapy

Severe Superior Epistaxis Controlled by Clipping the Anterior Ethmoidal Artery : Report of a Case

The case of a 40-year-old woman in whom severe superior epistaxis was controlled by clipping the left anterior ethmoidal artery is reported. The patient suddenly developed an uncontrolled epistaxis, and was brought to our hospital by ambulance. Though a Bellocq\u27s tampon was left in place for seven days, severe superior epistaxis recurred. Therefore the left anterior ethmoidal artery was clipped with self-locking hemostatic clips using an external ethmoid incision under local anesthesia, after which the symptom became inactive. Based on this experience, hemostasis of epistaxis in our division with special reference to clipping of the anterior ethmoidal artery is discussed

Changes in Platelet Volume in Various Patients with Thrombocytopenia and Thrombocytosis as Observed by the Platelet Saponin Test

Platelet volume, the expansion ratio (ER) and the shrinkage ratio (SR) were measured by the platelet saponin test in various patients with thrombocytopenia and thrombocytosis. In patients with platelet counts of less than 10×10 4/μl the platelet volume increased to above the normal range (p<0.001, t-test) with reduction of the ER (p<0.001, t-test). The SR was heightened in thrombocytopenias due to diminished megakaryopoiesis resulting from enhanced platelet aggregation. On the other hand, in thrombocytopenias due to increased platelet destruction the SR level was normal notwithstanding and enlarged platelet volume presumably due to lowered platelet activity. In thrombocytosis with platelet count above 40×10 4/μl, both the platelet volume (p<0.05) and the ER (p<0.01, t-test) were smaller than in normal subjects. The numerical results obtained by the platelet saponin test reflect the qualitative platelet abnormalities in patients with thrombocytopenia and thrombocytosis

A Case of Hb S/A -α-thalassemia Exhibiting Quadriplegia Due to Distal Renal Tubular Acidosis

A 46-year-old negro seaman who called at Port Mizushima, Kurashiki City, from West Africa on May 21, 1981 developed quadriplegia shortly after having taken a tablet of an antipyretic agent on the ship. At the Port Clinic in Mizushima, hypopotassemia was detected and Guillain Barre syndrome was suspected. Adrenocorticosteroids therapy was started, but he became dyspneic because of the progression of the paralysis up to the level of respiratory muscle. He was, therefore, transferred to our emergency center and hospitalized. On the sixth hospital day (May 27), clinical manifestations improved by intravenous administration of potassium. Diagnosis of distal renal tubular acidosis was entertained on the basis of the presence of metabolic acidosis, hypopotassemia and the absence of acidification of urine by short duration NH4C1 acid-loading test. The hematological studies revealed a combination of sickle cell trait (Hb S/A) with α-thalassemia trait. It is well known that sickle cell anemia (Hb S/S) occasionally causes secondary distal renal tubular acidosis. However, the occurrence of renal tubular acidosis in sickle cell trait (Hb S/A) and in α-thalassemia trait (αTh/A) has not yet been reported in the literature. It is therefore thought that our observation on this case will deserve special description as one of the possible clinical signs of sickle cell trait

Plasmapheresis for Spur Cell Anemia

A 45-year-old male patient with spur cell anemia was treated by plasmapheresis. At first, a membrane plasma separator was employed six times successively to try to prevent the progressive anemia. No significant improvement was achieved with respect to hematological parameters of hemolysis. A discontinuous flow centrifuge was then used four times consecutively. The spur cell count decreased and the progression of the anemia was transiently interrupted after every plasmapheresis of this type. Sequential measurements of the free cholesterol/phospholipid (FC/PL) molar ratio of the red cell membrane lipid revealed the importance of a plasma factor for spur cell formation. It showed that abnormal changes in FC/PL ratio of the red cell membrane were entirely dependent on a precursory change in the lipid composition of the patient\u27s plasma. Although, to our knowledge, plasmapheresis to treat spur cell anemia has not yet been recorded in the literature, in our experience, this therapeutic measure is recommendable for patients with spur cell anemia unresponsive to other forms of treatment

Resectable hepatoblastoma with tumor thrombus extending into the right atrium after chemotherapy: A case report

AbstractHepatoblastoma with intraatrial tumor thrombus is relatively rare. We report a case of hepatoblastoma with tumor thrombus extending into the right atrium, which responded well to chemotherapy and was resected using extracorporeal circulation. A 4-year-old girl was referred to our hospital because of abdominal distention and tenderness. A computed tomography (CT) scan showed a large tumor occupying the left 3 segments of the liver with tumor thrombus extending into the right atrium. There was also a small intrahepatic metastasis in the right lobe of the liver. She was diagnosed with hepatoblastoma on the basis of the results of open biopsy. Neoadjuvant chemotherapy with an intense CDDP-based regimen was performed. The tumor responded well to chemotherapy, and intrahepatic metastasis became undetectable on CT scan, although the tumor thrombus remained in the right atrium. After 7 courses of chemotherapy, we performed resection using extracorporeal circulation. The postoperative course was uneventful, and adjuvant chemotherapy was started 10 days after the operation. Her serum alpha-fetoprotein (AFP) level decreased to the normal range, and she was free of disease for 1 year after the operation. Tumor resection using extracorporeal circulation can be performed safely and is justified in patients with intraatrial tumor thrombus

In Vitro Assessment of Factors Affecting the Apparent Diffusion Coefficient of Jurkat Cells Using Bio-phantoms

It is well known that many tumor tissues show lower apparent diffusion coefficient (ADC) values, and that several factors are involved in the reduction of ADC values. The aim of this study was to clarify how much each factor contributes to decreases in ADC values. We investigate the roles of cell density, extracellular space, intracellular factors, apoptosis and necrosis in ADC values using bio-phantoms. The ADC values of bio-phantoms, in which Jurkat cells were encapsulated by gellan gum, were measured by a 1.5-Tesla magnetic resonance imaging device with constant diffusion time of 30sec. Heating at 42℃ was used to induce apoptosis while heating at 48℃ was used to induce necrosis. Cell death after heating was evaluated by flow cytometric analysis and electron microscopy. The ADC values of bio-phantoms including non-heated cells decreased linearly with increases in cell density, and showed a steep decline when the distance between cells became less than 3μm. The analysis of ADC values of cells after destruction of cellular structures by sonication suggested that approximately two-thirds of the ADC values of cells originate from their cellular structures. The ADC values of bio-phantoms including necrotic cells increased while those including apoptotic cells decreased. This study quantitatively clarified the role of the cellular factors and the extracellular space in determining the ADC values produced by tumor cells. The intermediate diffusion time of 30msec might be optimal to distinguish between apoptosis and necrosis