During the one-year period from April 1992 through March 1993, we measured 25, 498 blood samples by the use of a sequential multichannel autoanalyzer, which our hospital installed in August 1991. Of the total, 4, 707 samples were thoroughly examined under the microscope. They included those from the patients for which physicians indicated laboratory testing, those samples whose white cell counts were less than 3, 000/μlor more than 10, 000/μl, the cases in which the amount of hemoglobin was less than 10.0g/dl, and the samples which defied blood typing. The result was that three cases of myelodysplastic syndrome were detected, although the autoanalyzer failed to find any abnormalities in these three cases.
Laboratory technicians in hospital are so busy that they hardly have time enough for thoroughgoing examination of hemogram. Nevertheless, the recent experience has brought home to us the importance of a microscopic scrutiny, into hemogram and its application to diagnosis.

Objective: The long-term efficacy of deep brain stimulation (DBS) for motor fluctuations in advanced Parkinson’s disease (PD) has been well established; however, motor fluctuations may recur over time despite multiple adjustments of DBS settings and medications. Methods: We conducted a retrospective chart review of three patients for whom levodopa-carbidopa intestinal gel (LCIG) was additionally administered as a rescue therapy for secondary DBS failure due to the recurrence of motor fluctuations. Results: The three patients had advanced PD with a disease duration of 14–19 years, and had undergone DBS for motor fluctuations refractory to standard medical management. LCIG was administered to the patients because of symptom recurrence years after DBS and provided complementary effects in all patients. Conclusion The cases presented here show that rescue LCIG therapy may be a complementary treatment option for patients with post-DBS advanced PD who have a recurrence of troublesome motor complications.