巨核球の臨床血液病学的観察
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概要
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The megacaryocytes in various kinds of hematological diseases were examined, with special respect to their number, morphological aspect, and the formation of blood platelets. For the purpose of the measurement of megacaryocytes there exist histological method, counting chamber method, and smearing method; however, by the only method among them the conclusive estimation is impossible. There can be denoted the relative correlation between the numbers of megacaryocytes per total white cell count measured by these three kinks of methods. Both pernicious anemia and hypoplastic anemia show the abnormal aspect of megacaryocytes. In Banti's symptom complex, the increase in number of megacaryocytes and the decrease in blood platelet count were found. Leucosis does not show any definite fluctuation of megacaryocyte count, but there is found a tendency to increase in the aleucemic state and decrease in the leucemic. In addition, the megacaryocytes display often the abnormal aspect. There can be ascertained any clear-cut relationship between hepatic function and megacaryocyte count. Between splenomegalia and megacaryocyte count, there are observed various kinds of changes according to underlying disorders. From the results above mentioned, the existence of the characteristic features in certain diseases may be, to some extent, emphasized. In thorombopenic purpura, there can be observed the increase in number of megacaryocytes, despite of not abnormal aspect. In purpura abdominalis there is found not any abnormal appearance of both megacaryocytes and platelets. Appendix: Clinical Evalution of Actinomycin C for the treatment of Lymphogranulomatosis (Hodgkin) Author had a chance to evaluate Actinomycin C (Sanamycin "Bayer") for the treatment of malignant lymphogranuloma, and obtained the results as follows. The lymphatic glands which can be per cutaneously palpated, decrease in their size, while then increase in their hardness. The effects upon the lymphatic glands of mediastinum, abdomen and so on, are ascertained not only clinically, but also by autopsy. The diminution of hepatomegalia is not striking, however, the splenomegalia decreased in its size considerably. The dosage depends upon individual reaction and existence of complication; usually the initial dosis ranges from 100 to 200 γ pro die, then with due regards to reduction of tumour size and extent of size effects, 2 or 3 times weekly method is applied by which the favourable effect can be far advanced. The therapy with large amount is apt to display more side effect. Erosion and rhagades can be observed in the alimentary mucosa, but soon afterward the cessation of the medication these side effects are used to disappear. So far as the dosage used by author is concerned, there can not be recognized any disturbances of liver, heart, kidney and so on. Comparing with therapies applied hitherto, this treatment posses far less damage to bone marrow; although Actinomycin C reduces the intramedullary cellular components to some extent, after the stoppage of the administration this effect recovers gradually within relative short time. The increase of plasma cells their counts can not be found intramedullarily and peripherally in this disorder, so that the influence of this drug upon the count of plasma cells remains undecided. Both intramedullarily and peripherally, there can be seen more or less the increase in monocytes which are not directly affected with the use of this preparate. The only case among total observation (in cases) showed eosinophilia, but the count of eosinophils does not recover up to the normal range by this treatment. Except for no. 3, the neutrophils decrease in their count relatively, and by the treatment there can be found the tendency to return within normal limits. After the cessation of the treatment, the histological findings observed 2 months later showed the new development of the cellular hyperplasia around the fibrosis. So far as the experience of author is concerned, there can be seen the remission for 1 or 2 months after the cessation of the treatment, therefore the maintenance dosis of Actinomycin C should be continured long enough, even after the subjective improvement.
- 千葉大学の論文