Overexposure to venetoclax is associated with prolonged-duration of neutropenia during venetoclax and azacitidine therapy in Japanese patients with acute myeloid leukemia

PURPOSE

An observational study was conducted to evaluate the pharmacokinetics of venetoclax and its impact on the efficacy and safety for Japanese patients with acute myeloid leukemia (AML) treated with venetoclax and azacitidine therapy.

METHODS

The association between the plasma concentration, after the first cycle of azacitidine and venetoclax therapy, and the efficacy and safety was evaluated in 33 patients with untreated or relapsed/refractory AML.

RESULTS

Full dose of venetoclax was administered to all patients. Venetoclax treatment was 28 day long in 82% of patients; the relative dose intensity of azacitidine was 82%. Trough concentration was significantly higher among patients with complete remission (CR) and CR with incomplete hematologic recovery (CRi) than those with the morphologic leukemia-free state and partial remission, and no response groups (P = 0.01). Median duration of grade 3 neutropenia was 28 days (range 8-46 days). Area under the concentration-time curve (AUC0-24) was significantly higher among patients with protracted grade 3 neutropenia (≥ 28 days) than those with a shorter duration (< 28 days) (P = 0.03); multivariate analysis revealed that a higher AUC0-24 was a significant predictor of a longer duration of neutropenia (odds ratio 54.3, P = 0.007).

CONCLUSION

Plasma concentrations of venetoclax were variable in Japanese patients with AML. Higher plasma concentrations were associated with CR/CRi and protracted grade 3 neutropenia. Therefore, it is essential to adjust the duration of venetoclax administration based on individual pharmacokinetic data to limit total drug exposure, reduce severe neutropenia, and achieve higher efficacy.

Ponatinib Improved the Prognosis of Philadelphia Chromosome-Positive Acute Lymphoblastic Leukemia: A Japanese Single-Center Cohort Study

Introduction The overall survival (OS) of Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ALL) has improved with the combination of tyrosine kinase inhibitor (TKI) with intensive chemotherapy. In recent years, there has been increased interest in the possibility of long-term survival without allogeneic hematopoietic stem cell transplantation (HSCT) or maintenance therapy. The aim of this study was to determine the effectiveness of treatment and the resultant outcomes in Ph+ALL patients using real-world data. Methods We performed a single-center retrospective analysis utilizing Akita University Hospital data (Akita, Japan) from November 2000 to June 2023 to evaluate the outcomes of TKI with intensive chemotherapy for Ph+ALL. Results Twenty-three patients with Ph+ALL were treated with intensive chemotherapy combined with TKI, including six imatinib, four dasatinib, and 13 ponatinib. The median patient age was 53 years (range; 28-67). Eighteen patients (78%) achieved complete molecular remission (CMR) within three months. HSCT was performed in 16 patients (70%), all of whom did not receive post-transplant TKI maintenance therapy. Six of the seven patients who did not undergo HSCT received maintenance therapy with ponatinib after intensive chemotherapy. The three-year OS was 81%. Ponatinib treatment resulted in a much higher OS rate than imatinib/dasatinib (100% vs. 60%; P=0.011). CMR within three months was identified as a prognostic factor for molecular relapse-free survival (hazard ratio (HR)=0.22; P=0.027). CD20 positivity was identified as a risk factor for hematological relapse (HR=5.2, P=0.032). Conclusion Even in a single-center cohort study, ponatinib, as a combination TKI with intensive chemotherapy or maintenance therapy, may improve the prognosis of Ph+ALL. Patients with CMR within three months might not necessarily need to receive HSCT, but a subsequent treatment-free status could have been achieved only by HSCT. Furthermore, CD20 positivity may be a useful biomarker for future treatment decisions in patients with Ph+ALL.

[Postmortem diagnosis of intravascular large B-cell lymphoma after atraumatic splenic rupture due to splenic infiltration]

Atraumatic splenic rupture (ASR) is a rare but fatal complication of malignant lymphoma. However, only one case of intravascular large B-cell lymphoma (IVLBCL)-related ASR (IVLBCL-ASR) has previously been reported, and the mechanism of IVLBCL-ASR is unknown. We present the case of a 78-year-old man who died unexpectedly and was diagnosed with IVLBCL-ASR pathologically by autopsy. A massive intraperitoneal hemorrhage and four lacerations on the splenic surface were discovered during the autopsy. CD20-positive lymphoma cells that infiltrated into small vessels were highly concentrated in the center of the spleen and were only slightly distributed in the lacerations on the splenic surface. Therefore, increased intrasplenic pressure due to lymphoma cell proliferation was identified as the cause of ASR. The patient had undergone ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) for tongue cancer evaluation 3 months earlier, and positive uptake was found in the right adrenal gland, where lymphoma cell infiltration was confirmed by the autopsy. Our findings suggest that clinicians should be aware that the advanced stage of IVLBCL can cause fatal ASR via increased intrasplenic pressure. Therefore, early diagnosis and early treatment intervention are desirable to prevent the onset of IVLBCL-ASR, and ¹⁸F-FDG PET/CT is useful for the early diagnosis of IVLBCL.

IL-6 Generated from Human Hematopoietic Stem and Progenitor Cells through TLR4 Signaling Promotes Emergency Granulopoiesis by Regulating Transcription Factor Expression

Emergency granulopoiesis, also known as demand-adapted granulopoiesis, is defined as the response of an organism to systemic bacterial infections, and it results in neutrophil mobilization from reservoir pools and increased myelopoiesis in the bone marrow. Indirect and direct initiating mechanisms of emergency granulopoiesis have been hypothesized. However, the detailed mechanism of hyperactive myelopoiesis in the bone marrow, which leads to granulocyte left shift, remains unknown. In this study, we report that TLR4 is expressed on granulo-monocytic progenitors, as well as mobilized human peripheral blood CD34⁺ cells, which account for 0.2% of monocytes in peripheral blood, and ∼ 10% in bone marrow. LPS, a component of Gram-negative bacteria that results in a systemic bacterial infection, induces the differentiation of peripheral blood CD34⁺ cells into myelocytes and monocytes in vitro via the TLR4 signaling pathway. Moreover, CD34⁺ cells directly responded to LPS stimulation by activating the MAPK and NF-κB signaling pathways, and they produced IL-6 that promotes emergency granulopoiesis by phosphorylating C/EBPα and C/EBPβ, and this effect was suppressed by the action of an IL-6 receptor inhibitor. This work supports the finding that TLR is expressed on human hematopoietic stem and progenitor cells, and it provides evidence that human hematopoietic stem and progenitor cells can directly sense pathogens and produce cytokines exerting autocrine and/or paracrine effects, thereby promoting differentiation.

Cdc42 regulates cell polarization and contractile actomyosin rings during terminal differentiation of human erythroblasts

The molecular mechanisms involved in the terminal differentiation of erythroblasts have been elucidated by comparing enucleation and cell division. Although various similarities and differences between erythroblast enucleation and cytokinesis have been reported, the mechanisms that control enucleation remain unclear. We previously reported that dynein and microtubule-organizing centers mediated the polarization of nuclei in human erythroblasts. Moreover, the accumulation of F-actin was noted during the enucleation of erythroblasts. Therefore, during enucleation, upstream effectors in the signal transduction pathway regulating dynein or actin, such as cell division control protein 42 homolog (Cdc42), may be crucial. We herein investigated the effects of the Cdc42 inhibitor, CASIN, on cytokinesis and enucleation in colony-forming units-erythroid (CFU-Es) and mature erythroblasts (day 10). CASIN blocked the proliferation of CFU-Es and their enucleation in a dose-dependent manner. Dynein adopted an island-like distribution in the cytoplasm of non-treated CFU-Es, but was concentrated near the nucleus as a dot and co-localized with γ-tubulin in CASIN-treated cells. CASIN blocked the accumulation of F-actin in CFU-Es and day 10 cells. These results demonstrated that Cdc42 plays an important role in cytokinesis, nuclear polarization and nuclear extrusion through a relationship with dynein and actin filament organization during the terminal differentiation of erythroblasts.

Modular cis-regulatory logic of yellow gene expression in silkmoth larvae

Colour patterns in butterflies and moths are crucial traits for adaptation. Previous investigations have highlighted genes responsible for pigmentation (ie yellow and ebony). However, the mechanisms by which these genes are regulated in lepidopteran insects remain poorly understood. To elucidate this, molecular studies involving dipterans have largely analysed the cis-regulatory regions of pigmentation genes and have revealed cis-regulatory modularity. Here, we used well-developed transgenic techniques in Bombyx mori and demonstrated that cis-regulatory modularity controls tissue-specific expression of the yellow gene. We first identified which body parts are regulated by the yellow gene via black pigmentation. We then isolated three discrete regulatory elements driving tissue-specific gene expression in three regions of B. mori larvae. Finally, we found that there is no apparent sequence conservation of cis-regulatory regions between B. mori and Drosophila melanogaster, and no expression driven by the regulatory regions of one species when introduced into the other species. Therefore, the trans-regulatory landscapes of the yellow gene differ significantly between the two taxa. The results of this study confirm that lepidopteran species use cis-regulatory modules to control gene expression related to pigmentation, and represent a powerful cadre of transgenic tools for studying evolutionary developmental mechanisms.

Genetic diversity and relationships among native Japanese horse breeds, the Japanese Thoroughbred and horses outside of Japan using genome-wide SNP data

Eight horse breeds-Hokkaido, Kiso, Misaki, Noma, Taishu, Tokara, Miyako and Yonaguni-are native to Japan. Although Japanese native breeds are believed to have originated from ancient Mongolian horses imported from the Korean Peninsula, the phylogenetic relationships among these breeds are not well elucidated. In the present study, we compared genetic diversity among 32 international horse breeds previously evaluated by the Equine Genetic Diversity Consortium, the eight Japanese native breeds and Japanese Thoroughbreds using genome-wide SNP genotype data. The proportion of polymorphic loci and expected heterozygosity showed that the native Japanese breeds, with the exception of the Hokkaido, have relatively low diversity compared to the other breeds sampled. Phylogenetic and cluster analyses demonstrated relationships among the breeds that largely reflect their geographic distribution in Japan. Based on these data, we suggest that Japanese horses originated from Mongolian horses migrating through the Korean Peninsula. The Japanese Thoroughbreds were distinct from the native breeds, and although they maintain similar overall diversity as Thoroughbreds from outside Japan, they also show evidence of uniqueness relative to the other Thoroughbred samples. This is the first study to place the eight native Japanese breeds and Japanese Thoroughbred in context with an international sample of diverse breeds.

ATP produced by anaerobic glycolysis is essential for enucleation of human erythroblasts

More than 2million human erythroblasts extrude their nuclei every second in bone marrow under hypoxic conditions (<7% O₂). Enucleation requires specific signal transduction pathways and the local assembly of contractile actomyosin rings. However, the energy source driving these events has not yet been identified. We examined whether different O₂ environments (hypoxic [5% O₂] and normoxic [21% O₂] conditions) affected human CD34⁺ cell erythroblast differentiation. We also investigated the regulatory mechanisms underlying energy production in erythroblasts during terminal differentiation under 5% or 21% O₂ conditions. The results obtained revealed that the enucleation ratio and intracellular levels of adenosine triphosphate (ATP), lactate dehydrogenase (LDH) M₃H, and hypoxia-inducible factor 1α in erythroblasts during terminal differentiation were higher under the 5% O₂ condition than under the 21% O₂ condition. We also found that the enzymatic inhibition of glyceraldehyde 3-phosphate dehydrogenase and LDH, key enzymes in anaerobic glycolysis, blocked the proliferation of colony-forming units-erythroid and enucleation of erythroblasts, and also reduced ATP levels in erythroblasts under both hypoxic and normoxic conditions. Under both conditions, phosphorylation of the Ser232, Ser293, and Ser300 residues in pyruvate dehydrogenase (inactive state of the enzyme) in erythroblasts was involved in regulating the pathway governing energy metabolism during erythroid terminal differentiation. This reaction may be mediated by pyruvate dehydrogenase kinase (PDK) 4, the major PDK isozyme expressed in erythroblasts undergoing enucleation. Collectively, these results suggest that ATP produced by anaerobic glycolysis is the main source of energy for human erythroblast enucleation in the hypoxic bone marrow environment.

Simultaneous measurement of patient dose and distribution of indoor scattered radiation during digital breast tomosynthesis

INTRODUCTION

Breast cancer incidence increases from the age of 30 years. As this age range coincides with that in which women usually pursue pregnancy, undergoing medical examinations for conditions such as breast cancer is a concern, especially when pregnancy is uncertain during the first eight weeks. Moreover, in this age range, breast often exhibits a high density, thus compromising diagnosis. For such density, digital breast tomosynthesis (DBT) provides a more accurate diagnosis than 2D mammography given its higher sensitivity and specificity. However, radiation exposure increases during DBT, and it should be determined.

METHODS

We determined the entrance surface dose, scattered radiation dose, and average glandular dose (AGD), which can be mutually compared following an international protocol. Using our proposed method, the distribution of scattered radiation can be easily and quickly obtained with a minor load to the equipment. Then, we can determine the indoor scattered radiation and surface dose on patients during DBT.

RESULTS

We obtained a maximum AGD of 2.32 mGy. The scattered radiation was distributed over both sides with maximum of approximately 40 μGy, whereas the maximum dose around the eye was approximately 10 μGy.

CONCLUSION

By measuring doses using the proposed method, a correct dose information can be provided for patients to mitigate their concerns about radiation exposure. Although the obtained doses were low, their proper management is still required. Overall, the results from this study can help to enhance dose management for patients and safety management regarding indoor radiation.

Enhancement of ADP-Induced Platelet Aggregation by Exercise Test in Coronary Patients and Its Prevention by Pyridinolcarbamate

ADP-induced platelet aggregation in citrated platelet rich plasma (CPRP) was examined using a photoelectric system. To exclude a variation in intensities of platelet aggregation in repeated measurements and to compare intensities of different samples, the maximum deflection of the optical density of CPRP induced by adding ADP solution was divided by a deflection of the optical density of the platelet free plasma and its value, shown as a percentage, was defined as an intensity of ADP-induced platelet aggregation. In this method, the linearity was found in the dose response curve of the platelet aggregation induced by 10−6, 3 × 10−6 and 10−5 molar of ADP with statistical significance. These variation coefficients were less than 5% in the responses induced by the higher doses of ADP. Changes in the ADP-induced platelet aggregation after a Master’s two step test were examined in 13 patients with angina pectoris 3 h after oral administration of placebo or 1 g of pyridinolcarbamate. Under placebo pretreatment, an enhancement of platelet aggregation was observed 1 min after the exercise test with statistical significance (P < 0.01 ∼ 0.05). In the cases of the same subjects pretreated with pyridinolcarbamate, such change was not observed at any time. Using a parallel line assay, an inhibitory effect of pyridinolcarbamate against enhancement of ADP-induced platelet aggregation after the exercise was also recognized with statistical significance (P < 0.01). In the 10 healthy volunteers, there was no statistically significant enhancement of ADP-induced platelet aggregation using any concentration of ADP 1 to 10 min after the exercise test.

Public health and healthcare-associated risk of electric, warm-water bidet toilets

BACKGROUND

In recent years, installation of bidet toilets within hospitals in Japan has raised concerns regarding potential for cross-contamination by antimicrobial-resistant bacteria from patients who are hospitalized over an extended period.

AIM

To investigate the distribution of antimicrobial-resistant bacteria recovered from bidet toilets at a university-affiliated hospital in Japan.

METHODS

All 292 electric bidet toilets at a university hospital were sampled for contamination. Swabs for culture were used to sample water-jet nozzles and toilet seats.

FINDINGS

Of the 292 toilet seats sampled, warm-water nozzles of 254 (86.9%) were found to be contaminated by one or more of the following organisms: Staphylococcus aureus, Streptococcus spp., Enterococcus spp., Enterobacteriaceae and non-Enterobacteriaceae Gram-negative bacteria. S. aureus was recovered from one water-jet nozzle and nine toilet seats; of these, meticillin-resistant S. aureus was recovered from the water-jet nozzle and from one toilet seat. Both the water-jet nozzle and seat of the same toilet were contaminated with a CTX-M-9 group extended-spectrum β-lactamase-producing Escherichia coli. Of the Gram-negative isolates recovered from samples, the organism with the highest frequency of isolation was Stenotrophomonas maltophilia, which was recovered from 39 bidet toilets.

CONCLUSION

Warm-water nozzles of bidet toilets are contaminated with a wide range of bacteria, making them a potential vehicle for cross-infection. In the hospital setting, shared use of bidet toilets must consider the clinical background of patients. Based on these findings, these devices must be part of the risk management programme, and steps should be included for monitoring and disinfection.

Sandwich ELISA Using a Mouse/Human Chimeric CSLEX-1 Antibody

BACKGROUND

An assay using a mouse antisialyl Lewis X (sLeX) antibody (CSLEX-1) is used clinically for screening and monitoring patients with breast cancer in Japan. However, the IgM isoform of CSLEX-1 is not preferred for the assay because the bulkiness of IgM generally causes poor accessibility to the antigen. To solve this problem, we developed an antisLeX mouse/human chimeric IgG antibody, CH-CSLEX-1, using transgenic silkworms. The performance of a homologous sandwich ELISA of CH-CSLEX1 was then evaluated.

METHODS

To generate CH-CSLEX-1, we used a GAL4/UAS binary gene expression system in transgenic silkworms. The reactivities of CSLEX-1 and CH-CSLEX-1 were determined in a Biacore analysis. To confirm antigen specificity, 3 antigens [sLeX, sLeA, and Lewis Y (LeY)] were used.

RESULTS

CH-CSLEX-1 formed correctly as an IgG class of immunoglobulin molecule with an isoelectric point close to the predicted value. The best combination for capturing and probing in a sandwich ELISA was determined as a homologous combination of CH-CSLEX-1. The CH-CSLEX-1 assay specifically detected sLeX, but not sLeA and LeY. A correlation analysis with 107 human samples showed good concordance between the conventional CSLEX-1 assay (homologous sandwich ELISA using CSLEX-1) and the CH-CSLEX-1 assay (r = 0.98). Moreover, the CH-CSLEX-1 assay was not affected by either human antimouse IgG antibodies (HAMA IgG) or HAMA IgM.

CONCLUSIONS

The mouse/human chimeric antibody CH-CSLEX-1 allowed the establishment of a highly specific sandwich ELISA for sLeX that was not affected by HAMA.

Changes in peripheral anti-Müllerian hormone concentration and their relationship with testicular structure in beef bull calves

The aim of this study was to clarify the time-course of changes in anti-Müllerian hormone (AMH) and testosterone (T) concentrations in peripheral blood and to determine the relationships between blood AMH concentration and testicular development during the early postnatal and prepubertal periods in beef bull calves. A total of 17 Japanese Black bull calves were enrolled in this study. The wk in which the calf was born (within 6 d after birth) was defined as M 0. Blood samples were taken once in every mo from M 0 to M 6 from each bull calf, and plasma AMH and T concentrations were determined. Of the 17 calves, 10 were castrated at 6 mo of age (prepuberty) and the right testis was histologically examined. Plasma AMH concentration (means ± SE) at M 0, 1, and 2 were 123.5 ± 9.8, 189.6 ± 18.7, and 254.6 ± 14.1 ng/mL, respectively. From M 0 through M 2, plasma AMH concentration was significantly greater each mo than in the previous mo (P < 0.05); however, plasma AMH concentration significantly decreased over the last 3 mo of the study (P < 0.05). The average age at which plasma AMH concentration was the highest was 2.3 ± 0.1 mo of age. Plasma T concentration significantly increased from M 0 (0.18 ± 0.02 ng/mL) until M 6 (6.52 ± 1.41 ng/mL). Plasma AMH and T concentrations at M 4, 5, and 6 were significantly negatively correlated (P < 0.05). Linear regression did not reveal a significant relationship between Sertoli or Leydig cell numbers and plasma AMH or T concentrations, respectively. In conclusion, blood AMH concentration peaks at 2 mo of age and is negatively correlated with blood T concentration from 4 to 6 mo of age. Although prepubertal blood AMH or T concentrations did not reflect Sertoli or Leydig cell numbers at the end of the prepubertal period, blood AMH concentration may be indicative of abnormal Sertoli cells function.

Cytosine-Phosphorothionate-Guanine Oligodeoxynucleotides Exacerbates Hemophagocytosis by Inducing Tumor Necrosis Factor-Alpha Production in Mice after Bone Marrow Transplantation

Hemophagocytic syndrome (HPS) is frequently associated with hematopoietic stem cell transplantation and is treated with some benefit derived from TNF-α inhibitors. However, the mechanisms of how HPS occurs and how a TNF-α inhibitor exerts some benefit to HPS management have remained unclear. We evaluated the effect of toll-like receptor (TLR) ligands, especially focusing on cytosine-phosphorothionate-guanine oligodeoxynucleotide (CpG), a TLR9 ligand, on HPS in mice that underwent transplantation with syngeneic or allogeneic bone marrow (BM) cells (Syn-BMT, Allo-BMT), or with allogeneic BM cells plus splenocytes to promote graft-versus-host disease (GVHD mice). Hemophagocytosis was a common feature early after all BMT, but it subsided in Syn-BMT and Allo-BMT mice. In GVHD mice, however, hemophagocytosis persisted and was accompanied by upregulated production of IFN-γ but not TNF-α, and it was suppressed by blockade of IFN-γ but not TNF-α. A single injection of the TLR9 ligand CpG promoted HPS in all BMT mice and was lethal in GVHD mice, accompanied by greatly upregulated production of TNF-α, IL-6, and IFN-γ. Blocking of TNF-α, but not IL-6 or IFN-γ, suppressed CpG-induced HPS in all BMT mice and rescued GVHD mice from CpG-induced mortality. Thus, TLR9 signaling mediates TNF-α-driven HPS in BMT mice and is effectively treated through TNF-α inhibition.

Comprehensive data on ionising radiation from Fukushima Daiichi nuclear power plant in the town of Miharu, Fukushima Prefecture: The Misho Project

Data related to radioactivity released from the Fukushima Daiichi Nuclear Power Plant (FDNPP) accident on 15 March 2011 gathered by residents of Miharu, Fukushima Prefecture, and by Tohoku University are presented. These data sets consist of (1) the earliest radiation monitoring by a Geiger counter in the town, (2) ratios of radioactivity between (132)Te and (137)Cs for a wide area between Fukushima and Tokyo, (3) radiation measurement of soil samples collected from 18 school grounds, and (4) external radiation exposure of 1400 students using OSL badges. By combining and analysing these various data sets, a curve for the cumulative total external exposure as a function of time, with 16 : 00 h on 15 March 2011 being time zero, is obtained. The average cumulative external dosage is estimated to be 10 mSv (σ = 4.2 mSv) over 10 years. In addition, the initiative that the residents of Miharu took in response to the FDNPP accident, which became known as The Misho Project (MP), is documented; in particular, the time at which the municipality instructed the immediate ingestion of iodine tablets by those under the age of 40, 13 : 00 h on 15 March 2011, is assessed.

A preliminary study to determine the diagnostic reference level using dose-area product for limited-area cone beam CT

OBJECTIVES

The aim of this study was to measure the dose-area product (DAP) of limited-area cone beam CT (CBCT) units used by dental offices, and to evaluate the rationale of the DAP with an aid of optically stimulated luminescence (OSL) dosemeter in measuring radiation dose.

METHOD

The DAPs of 21 CBCT units used in the dental offices of Tokyo and the surrounding areas from five different manufacturers were measured using OSL nanoDot dosemeter. An assembly of OSL dosemeters with an X-ray film was exposed by CBCT units at exposure parameters commonly used in each dental office. DAP values were then calculated as expressed in mGy cm(2).

RESULTS

DAP values ranged from 126.7 mGy cm(2) to 1476.9 mGy cm(2), depending on the units used.

CONCLUSION

OSL dosemeter coupled with film can be utilized for a large-scale study to measure DAP. The DAP values for individual CBCT units depend not only on the field of view, but also on the exposure parameters adapted by the dental offices.

Drug-resistance gene expression and progression of astrocytic tumors

To clarify the influence of biochemotherapy on the progression of astrocytic tumors, the expression of O6-methylguanine DNA-methyltransferase (MGMT) mRNA, as well as of other drug-resistance- and drug-sensitivity-related genes such as multidrug resistance gene 1, multidrug resistance-associated protein, glutathione S-transferase-pi, DNA topoisomerase II, and interferon receptor mRNA, and the interferon regulatory factor (IRF)-1 and -2 ratios in gliomas were investigated by quantitative reverse transcription-polymerase chain reaction (RT-PCR). The mean MGMT/beta2-microglobulin (beta2-MG) ratio for 130 neuroepithelial tumors was 8.2 +/- 17.8. The mean ratio of 45 glioblastomas was significantly higher than that for the other 85 tumors. In contrast, the mean of 26 low-grade gliomas was significantly lower than that of other tumors. The mean IRF-1/IRF-2 ratio of 16 other brain tumors that mainly consisted of medulloblastomas was significantly greater than that of the other 114 tumors. Almost no significant differences were observed between primary and recurrent tumors in the expression of any gene, and before and after therapy with corresponding drugs. The mean MGMT/beta2-MG ratio in primary glioblastomas was significantly higher than that in secondary tumors. These findings suggest that native drug resistance is more important than acquired resistance when glioma therapy is considered.

Characterization of optically stimulated luminescence dosemeters to measure organ doses in diagnostic radiology

OBJECTIVE

The aim of this study was to assess the characteristics of an optically stimulated luminescence dosemeter (OSLD) for use in diagnostic radiology and to apply the OSLD in measuring the organ doses by panoramic radiography.

METHODS

The dose linearity, energy dependency and angular dependency of aluminium oxide-based OSLDs were examined using an X-ray generator to simulate various exposure settings in diagnostic radiology. The organ doses were then measured by inserting the dosemeters into an anthropomorphic phantom while using three panoramic machines.

RESULTS

The dosemeters demonstrated consistent dose linearity (coefficient of variation<1.5%) and no significant energy dependency (coefficient of variation<1.5%) under the applied exposure conditions. They also exhibited negligible angular dependency (≤ 10%). The organ doses of the X-ray as a result of panoramic imaging by three machines were calculated using the dosemeters.

CONCLUSION

OSLDs can be utilized to measure the organ doses in diagnostic radiology. The availability of these dosemeters in strip form proves to be reliably advantageous.

Retroperitoneal approach for laparoscopic nephroureterectomy with stripping technique: extracorporeal ligation of ureter and ureteral catheter

INTRODUCTION

The pluck and stripping techniques are used for lower ureter management in renal pelvic cancer patients. Herein, we report our experience of extracorporeal ligation of the ureter and the ureteral catheter through the trocar port, which differs from conventional laparoscopic ligation in the retroperitoneal space. This technique was selected to reduce the time needed for ureter management using the stripping technique and to provide secure ligation.

MATERIALS AND SURGICAL TECHNIQUE

We performed this stripping technique in patients with T1 and T2 stage renal pelvic cancer without imaging-evident lymph node metastasis. After transurethrally placing a ureteral catheter, we resected the circumference of the ureteral orifice. After laparoscopic nephrectomy via a retroperitoneal approach, the ureteral catheter and distal ureter were ligated extracorporeally. The catheter was pulled to invaginate the ureter so it could then be pulled through the external urethral orifice.

DISCUSSION

This technique of extracorporeal ligation ensures more a secure ligation of the ureter and ureteral catheter. This modified stripping technique does not require lower ureter management with laparotomy, and it is also useful in shortening the operative time. This method is effective for relatively early stage renal pelvic cancer.

Study of the excited-state proton-transfer reaction of 5-cyano-2-naphthol in sub- and supercritical water

The excited-state proton-transfer (ESPT) reaction of 5-cyano-2-naphthol (5CN2) has been investigated in sub- and supercritical water using time-resolved fluorescence measurements. Under ambient conditions, a very fast decay of the fluorescence from the excited state of normal 5CN2 (ROH*) and a simultaneous increase of the fluorescence from the excited state of the anion species (RO(-)*) were observed, as reported previously. The very high ESPT rate was evaluated as 0.12 ps(-1). With increasing temperature at a constant pressure of 39.0 MPa, the proton transfer became slow. At 615 K and 39.0 MPa, another fluorescence from a new unknown chemical species appeared, which was assigned to the contact ion pair (CIP) of RO(-)* and the hydronium ion. With decreasing pressure at 664 K, the fluorescence from RO(-)* disappeared, and the fluorescence from ROH* and CIP was observed. At the very low density of supercritical water, only the fluorescence decay of ROH* was detected. The reaction dynamics was analyzed with the help of singular value decomposition and spectral decomposition using model functions. The ESPT rate was correlated with the solvent dielectric constant and/or the hydrogen-bonding ability.

Fabrication of the Large-Area Integrated a-Si Solar Cells

PIN-structure small-area solar cells using a-Si have been frequently reported on, but only a few reports are available on the study of solar cells using a large-area (10-cm square) substrate, all with a resultant conversion efficiency of above 9.0 %[1,2]. Our study has been concentrated on solar cells using a batch of ten 10-cm square substrates with an average conversion efficiency of 9.5 % or more.

As a result, without an anti-reflection coating on the surface of the glass substrate, the following values have been obtained: average conversion efficiency (EFF)=9.63 % (standard deviation of 0.195 %) -Open-circuit voltage (Voc)=12.668 V (standard deviation of 0.215 V) -Short-circuit current (Isc)=78.467 mA (standard deviation of 1.619 mA) -Fill factor (FF)=0.6672 (standard deviation of 0.009)

The process, equipment and methods for measurements through which these results were obtained are described below.

Reduced ability of neutrophils to produce active oxygen species in streptozotocin-induced diabetic rats

We investigated a possible alteration in the ability of neutrophils to produce active oxygen species in streptozotocin (STZ)-induced diabetic rats. The production of superoxide of the neutrophils was assessed by luminol-dependent chemiluminescence (LDCL) after the stimulation by opsonized zymosan. Four days after STZ (60 mg/kg, ip) injection, blood glucose level increased by 399 +/- 9 mg/dl and the LDCL activity was significantly reduced in diabetic rats (control group: 5.12 +/- 1.53 KC/min2/10(6) cells, STZ group: 1.10 +/- 0.07 KC/min2/10(6) cells, p less than 0.01). At Day 17, blood glucose level was maintained high (598 +/- 8 mg/dl) and the LDCL activity (1.01 +/- 0.39 KC/min2/10(6) cells) was almost at the same level as that of diabetic rats at Day 4. Subcutaneous injection of insulin for 10 consecutive days increased the LDCL activity of diabetic rats in a dose-dependent manner (vehicle: 0.82 +/- 0.27 KC/min2/10(6) cells, 0.04 U/day: 1.61 +/- 0.09 KC/min2/10(6) cells, 0.40 U/day: 1.99 +/- 0.47 KC/min2/10(6) cells, 4.00 U/day: 3.33 +/- 0.43 KC/min2/10(6) cells). The data obtained herein indicate that an increased susceptibility to bacterial infection in diabetic rats results from impaired neutrophil function to produce active oxygen species.

Colonic temperature was not changed in the development of obesity after ovariectomy

We tested the hypothesis that altered heat production ability after ovariectomy may be involved in the development of obesity. Two weeks after ovariectomy, food intake of ovariectomized (Ovx) rats was increased and body weight gain was obvious, compared with sham-operated animals. However, colonic temperature of Ovx rats was not different from that of sham-operated animals. Food intake of Ovx rats was similar with that of sham-operated rats at 8 weeks later. In this period, colonic temperature of Ovx rats was not different from that of sham-operated animals and diurnal rhythmicity was maintained. The present data suggested that changes in heat production may be not an important inducer of obesity in both the dynamic and static phases of the development of obesity after ovariectomy.

Altered monoamine metabolism in the hypothalamus of the genetically obese yellow (Ay/a) mouse

Changes in hypothalamic monoamine metabolism were investigated in the genetically obese yellow (Ay/a) mouse. At the age of 6 weeks when there was no difference in body weight between black (a/a) and yellow (Ay/a) mice, the contents of norepinephrine (NE), dopamine (DA) and their main metabolites (MHPG, DOPAC) were already significantly reduced in yellow (Ay/a) mice. Reduction of 5-hydroxytryptamine (5-HT) level and an increasing 5-HIAA/5-HT ratio has been observed. When a significant increase in body weight in the yellow (Ay/a) mouse at the age of 12 weeks was present, both NE and DA contents have been increased in the hypothalamus of the obese mouse. MHPG level was lower than in the lean mouse, resulting in an increase of MHPG/NE ratio. The present study suggests that the observed reduction in hypothalamic NE and DA metabolism might be involved in the development of overweight gain in the yellow (Ay/a) mouse.

Static bone cavity in the condylar neck and mandibular notch of the mandible

This study presents the radiographic findings of two cases of static bone cavity in the inferior aspect of the condylar neck and mandibular notch of the mandible. On plain CT, a soft tissue mass was observed in each cavity. The submandibular gland and the other glands were not found in each cavity. On contrast-enhanced CT, the soft tissue in the cavity in the inferior aspect of the condylar neck had marked linear enhancement and dilated vasculature structure was observed in the cavity. On the contrast-enhanced MRI, the soft tissue in the cavity of the mandibular notch had marked enhancement and flow void was detected in the cavity. In the inferior aspect of the condylar neck, the cavity size had enlarged radiographically over a period of three years. Vascular lesions were found in the cavity located in the inferior aspect of the condylar neck and mandibular notch of the mandible by both CT and MRI. The vascular lesion might explain the enlargement of the static bone cavity.

Glycolytic enzyme Pgk1 is strongly expressed in the developing tooth germ of the mouse lower first molar

This study examined detailed in situ expression patterns and possible functional roles of phosphoglycerate kinase 1 (Pgk1) gene in the developing tooth germ of the mouse lower first molar. The strong expression of Pgk1 mRNA was seen in the odontogenic epithelial cells and surrounding mesenchymal cells of the tooth germ from embryonic day 10.5 (E10.5) to E18.0. Western blotting analysis demonstrated that Pgk1 protein formed 84-kDa protein complex in these embryonic organs. The results of immunoprecipitation-western blotting also suggested this complex to be formed with glyceraldehyde-3-phosphate dehydrogenase (GAPDH). Moreover, the immunofluorescence expression of those proteins was shown to overlap each other in the tooth germ at E15.0. A strong immunofluorescence expression of both Pgk1 and GAPDH also corresponded to the in situ expression of those mRNAs. These results suggested that Pgk1 plays some functional roles in the development of tooth germ and other embryonic organs by forming protein complex with GAPDH.