<研究ノート> 過去に対する自己肯定感尺度作成の試み

人間は、過去、現在、未来という時間軸とその広がりの中で、自己を捉えることが可能である。さらに、過去や現在、未来をいかに捉えるかによって、自己評価や将来展望などが変化する。これまでの時間的展望に関する研究では、主に現在から未来に視点を向けた研究が中心であり、過去に対する視点の研究が少なかった。その一方で、過去のとらえ方と精神的健康との関係では、主に自己受容に関する研究から行われてきた。しかし、人間は、自分の過去についてすべて自己受容できなくとも、人は前向きに生きることができるのではないだろうか。また、過去の自分の至らない点を振り返りながら、現在の自分とを比較することで、自己成長を認識することもあるだろう。そこで、本研究では、過去に対する自己肯定感尺度の開発を試みることにした。その結果、過去に対する自己肯定感尺度は、主成分分析から1因子構造にまとまり、α=.829 と高い信頼性が確認された。時間的展望体験尺度との関係からは、基準関連妥当性も確認され、概ね実用可能であると判断された

Monocyte chemiluminescence and macrophage precursors in the aged.

Age-related alterations in the host defense system have been vigorously investigated because of increased susceptibility to infection and neoplasms in the aged. Although monocyte-macrophages form a major part of the cellular defense against microorganisms, the majority of investigations has been limited to neutrophils and lymphocytes. The present study, designed to determine the influence of age on mononuclear phagocytes, revealed no significant decrease in the absolute number of blood monocytes, but did reveal a tendency for the chemiluminescence of blood monocytes to decrease (p less than 0.10) and a significant decrease in the numbers of macrophage precursors (p less than 0.05) in the aged (over 70 year old), in comparison with controls (under 40 years old). On the basis of these findings, functional alterations of monocyte-macrophages seem to participate in the increased susceptibility to infection in the aged.</p

Aclarubicin in the treatment of elderly patients with acute nonlymphocytic leukemia.

Thirteen previously untreated patients aged 70 and above with acute nonlymphocytic leukemia were treated with aclarubicin (ACR) alone. Among 10 cases (3, acute myelocytic leukemia; 4, acute myelomonocytic leukemia; 2, acute monocytic leukemia; and one, acute erythroleukemia) in which an evaluation was possible, 5 cases (3, acute myelomonocytic leukemia; and 2, acute monocytic leukemia) obtained complete remission (CR). The CR rate was 83% in 6 patients with acute myelomonocytic leukemia or acute monocytic leukemia. The median CR duration and survival was 7.5 and 10 + months, respectively. Although side effects of the drug on digestive system such as nausea, vomiting and anorexia were observed in all patients, they were controllable by conventional treatments. The results suggest that ACR is effective for the clinical management of elderly patients with acute nonlymphocytic leukemia, especially those with acute myelomonocytic leukemia or acute monocytic leukemia.</p

Clinical studies of relapse in acute leukemia Part 1. Cellular composition of bone marrow in remission and prediction of relapse in acute leukemiaPart 1. Cellular composition of bone marrow in remission and prediction of relapse in acute leukemia

The cellular composition of remission marrow from patients with acute myelocytic leukemia (AML) was studied in order to obtain informations for the prediction of relapse. Hematological findings such as (1) Myeloblast 3%, (2) Promyelocyte 12%, (3) Erythroblasts 45% and (4) Erythroblasts 15% were thought to be atypical in remission marrow. Among these atypical finings, the coexsistence of (1) and (3) or (1) and (4) were important in the prediction of relapse. In the first month after the recognition of (1)+(3) or (1)+(4), the cumulative relapse rate was 35% and 50%, respectively. The rates were 71% and 58% by the second month, respectively. The median remission duration of patients treated within two weeks after the recognition of (1) was longer than that of patients treated after two weeks (4.7 months vs 1.5 months, p<0.05). These results indicate that the coexsistence of atypical findings, (1)+(3) or (1)+(4), are important not only in the predicting of the relapse of AML but also to analyze the dyshemopoiesis of preleukemic states or myelodysplastic syndromes

Clinical studies of relapse in acute leukemia Part 2. Immunosuppressive acidic protein (IAP) in acute leukemia

Serum levels of immunosuppressive acidic protein (IAP) in 17 patients with acute leukemia were measured. The patients included 5 with acute myelocytic leukemia (AML), 4 with acute promyelocytic leukemia (APL), 3 with acute monocytic/myelomonocytic leukemia (AMoL/AMMoL), and 5 with acute lymphocytic leukemia (ALL). Serum IAP levels in untreated acute leukemia patients were higher than those in normal healthy individuals (763.2±321.1 ng/ml vs 389.8±96.7 ng/ml, p<0.05). They tended to decrease to a normal range in complete remission. A correlation was observed between serum IAP levels and the leukemic cell population in the bone marrow (r=0.39, p<0.05). Serum IAP levels increased in febrile patients compared to those in afebrile patients (p<0.05). Patients with more than 500ng/ml of IAP in remission had more risk of relapse in comparison to those with less than 500ng/ml (7 of 10, 70% vs 2 of 15, 13.3%, p<0.05). These results suggest that the measurement of serum IAP is useful for monitoring the leukemic patient