Somatic PTPN11 mutation with a heterogeneous clonal origin in children with juvenile myelomonocytic leukemia.
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Publications and source records attributed to T Mori.
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BACKGROUND: The poor quality of oral health care for people with intellectual disability (ID) has been recognized, and the strong fears about dental treatment suggested as a major reason for disturbances of visits to dentists by such patients. Intravenous sedation is a useful method for relieving the anxiety and fear of such patients about dental treatment, and is frequently essential for ID patients undergoing dental treatment. However, decision regarding the dose of sedative required to be administered for an adequate level of sedation is difficult because the effect of sedation cannot be adequately assessed in patients with severe ID. As an appropriate sedative dose for dental patients with ID has not been fully established, we investigated sedative doses required and the effect of sedation in patients with ID, compared with other dental patients. METHODS: We reviewed the anaesthetic records of dental patients with ID (73 cases) and other dental patients (19 cases) aged between 20 and 29 years who had undergone intravenous sedation with midazolam and propofol in Okayama University Dental Hospital, from January 2000 to December 2000. Intravenous sedation was induced with a bolus intravenous administration of midazolam (2-3 mg) and maintained with a continuous infusion of propofol. The dose of propofol was titrated to achieve an adequate level of sedation: asleep but responding to painful stimulation. The efficacy of sedation, the required doses of propofol, and the wake-up times were investigated for all subjects. The efficacy of sedation was evaluated by judging whether the patient became cooperative and allowed the dental treatment to be carried out or not. The complications induced by intravenous sedation were also evaluated in each subject. Differences in variables between subjects with ID and other subjects were analysed using the Mann-Whitney U-test. RESULTS: Intravenous sedation was effective for dental treatment in all subjects with or without ID. The required dose of propofol in subjects with ID was 4.74 mg/kg/h (2.63-10.33 mg/kg/h), significantly higher than that required for other subjects (3.31, 1.72-4.80 mg/kg/h). Wake-up times of subjects with ID were similar to those of the other subjects. Severe complications were not seen during or after intravenous sedation. CONCLUSION: The results of this study show that intravenous sedation is a useful method for dental patients with ID as well as for other dental patients, but indicate that dental patients with ID need higher doses of sedative to obtain an adequate level of sedation.
BACKGROUND: Endoscopic sphincterotomy (ES) carries a substantial risk of recurrent choledocholithiasis but retreatment with endoscopic retrograde cholangiopancreatography (ERCP) is safe and feasible. However, long term results of repeat ERCP and risk factors for late complications are largely unknown. AIMS: To investigate the long term outcome of repeat ERCP for recurrent bile duct stones after ES and to identify risk factors predicting late choledochal complications. METHODS: Eighty four patients underwent repeat ERCP, combined with ES in 69, for post-ES recurrent choledocholithiasis. Long term outcomes of repeat ERCP were retrospectively investigated and factors predicting late complications were assessed by multivariate analysis. RESULTS: Complete stone clearance was achieved in all patients. Forty nine patients had no visible evidence of prior sphincterotomy. Two patients experienced early complications. During a follow up period of 2.2-26.0 years (median 10.9 years), 31 patients (37%) developed late complications, including stone recurrence (n = 26), acute acalculous cholangitis(n = 4), and acute cholecystitis (n = 1). There were neither biliary malignancies nor deaths attributable to biliary disease. Multivariate analysis identified three independent risk factors for choledochal complications: interval between initial ES and repeat ERCP < or =5 years, bile duct diameter > or =15 mm, and periampullary diverticulum. Choledochal complications were successfully treated with repeat ERCP in 29 patients. CONCLUSIONS: Choledochal complications after repeat ERCP are relatively frequent but are endoscopically manageable. Careful follow up is necessary, particularly for patients with a dilated bile duct, periampullary diverticulum, or early recurrence. Repeat ERCP is a reasonable treatment even for recurrent choledocholithiasis after ES.
Although monoclonal antibodies have demonstrated clinical potentials as tumor targeting agents, poor tumor penetration of the antibodies due to the size of molecules and liver/bone marrow toxicity by non-specific uptake of the antibodies are the two major limitations of antibody therapy. Peptidic targeting agents may ease the problems associated with antibody cancer therapy. Combinatorial libraries displayed on microorganisms have successfully been utilized to discover cell surface-binding peptides, which can be tumor-targeting agents. Among many molecular display techniques, phage display has been the most popular approach. Peptides can be used as targeting molecules of receptor-targeted toxins and gene therapy, imaging and/or therapeutic agents, and nano-medical technologies. Recent results from preclinical studies with various peptides support their targeting potential and suggest that the role of peptides as targeting molecules in drug development should be further exploited.
SETTING: Chiang Rai province, Northern Thailand. OBJECTIVE: To study the probability of acquiring drug resistance to isoniazid (H) and rifampicin (R) on recurrence after treatment success, default and failure, among sputum smear-positive pulmonary tuberculosis (TB) patients treated with standardised short-course chemotherapy. DESIGN: Retrospective analysis of registration records of TB patients from May 1996 to December 2000 in Chiang Rai, where routine drug susceptibility testing (DST) is conducted for surveillance purposes. Patients registered twice or more were examined. RESULTS: Of 59 cases treated with HRZE/HR who underwent DST at the time of registration, 31 were fully susceptible to H and R at first registration, of whom four acquired drug resistance to H or R. Of 13 cases resistant to H or R at first registration, 11 became multidrug-resistant (MDR). The remaining 15 patients were original MDR cases. Among 28 MDR or H- or R-resistant cases, six reverted from resistant to susceptible. DISCUSSION: A high proportion of patients with H- or R-resistant TB became MDR after treatment with 2HRZE/HR. Using this regimen, MDR may increase in a population with a high prevalence of H or R resistance. We are unable to explain why some drug-resistant cases became drug-susceptible. Further investigation is necessary.
The authors report a case study of a 54-year-old male admitted to our hospital with severe chest pain and ST depression in II, III and aVf lead on the electrocardiogram. The chest X-ray showed an enlarged superior mediastinum. An enhanced computed tomography (CT) was performed and confirmed the diagnosis of acute type A aortic dissection. The patient underwent emergency surgical repair with the replacement of the ascending aorta. The patient recovered without complication until the fifteenth postoperative day, when another severe chest pain appeared. Emergency coronary angiography revealed a remaining dissection in both the left anterior descending artery (LAD) and the left circumflex artery (LCx). Implantation of Elite stents to the LAD and the LCx was performed. The patient recovered uneventfully after this operation. Remaining coronary artery dissection after the replacement of the ascending aorta is very rare. In this case coronary intervention with Elite stents was effective.
We report evidence for the decay mode B-->phiphiK based on an analysis of 78 fb(-1) of data collected with the Belle detector at KEKB. This is the first example of a b-->sssss transition. The branching fraction for this decay is measured to be B(B+/--->phiphiK+/-)=(2.6(+1.1)(-0.9)+/-0.3)x10(-6) for a phiphi invariant mass below 2.85 GeV/c(2). Results for other related charmonium decay modes are also reported.
The altered form of the high-mobility group A2 (HMGA2) gene is somehow related to the generation of human benign and malignant tumours of mesenchymal origin. However, only a few data on the expression of HMGA2 in malignant tumour originating from epithelial tissue are available. In this study, we examined the HMGA2 expression level in pancreatic carcinoma, and investigated whether alterations in the HMGA2 expression level are associated with a malignant phenotype in pancreatic tissue. High-mobility group A2 mRNA and protein expression was determined in eight surgically resected specimens of non-neoplastic tissue (six specimens of normal pancreatic tissue and two of chronic pancreatitis tissue) and 27 pancreatic carcinomas by highly sensitive reverse transcriptase-polymerase chain reaction (RT-PCR) techniques and immunohistochemical staining, respectively. Reverse transcriptase-polymerase chain reaction analysis revealed the expression of the HMGA2 gene in non-neoplastic pancreatic tissue, although its expression level was significantly lower than that in carcinoma. Immunohistochemical analysis indicated that the presence of the HMGA2 gene in non-neoplastic pancreatic tissue observed in RT-PCR reflects its abundant expression in islet cells, together with its focal expression in duct epithelial cells. Intense and multifocal or diffuse HMGA2 immunoreactivity was noted in all the pancreatic carcinoma examined. A strong correlation between HMGA2 overexpression and the diagnosis of carcinoma was statistically verified. Based on these findings, we propose that an increased expression level of the HMGA2 protein is closely associated with the malignant phenotype in the pancreatic exocrine system, and accordingly, HMGA2 could serve as a potential diagnostic molecular marker for distinguishing pancreatic malignant cells from non-neoplastic pancreatic exocrine cells.
BACKGROUND: Natural killer (NK) activity plays an important role in the prevention of tumor metastasis. However, few studies compared changes in NK activities between gas(less) laparoscopy and open surgery. MATERIALS AND METHODS: Donryu rats were randomized to 4 groups ( n = 6-9, for each lime point in each group): gasless group, pneumoperitoneum group, laparotomy group, and control group. The surgical treatment groups received additional cecal resection at the end of the procedures. Spleen cells and hepatic nonparenchymal cells were harvested at 6, 24, or 96 h, to determine the splenic and hepatic NK activities against YAC-1 cells. RESULTS: Compared with the anesthesia control, laparotomy and pneumoperitoneum depressed splenic NK activity at 24 h ( p < 0.01 for laparotomy and p < 0.05, for pneumoperitoneum) and 96 h ( p < 0.05). Laparotomy also depressed hepatic NK activity at 24 h ( p < 0.05). In contrast, the gasless procedure did not show any deterioration in the splenic and hepatic NK activities. CONCLUSION: These results suggest that gasless laparoscopic surgery would be a favorable approach in terms of the preservation of NK activities.
We present the first measurement of decay amplitudes in B-->phiK* and measurements of branching fractions in B-->phiK(*) decays based on 78.1 fb(-1) of data recorded at the Upsilon(4S) resonance with the Belle detector at the KEKB e+e- storage ring. The decay amplitudes for the different phiK*0 helicity states are measured from the angular distributions of final state particles in the transversity basis. The longitudinal and transverse complex amplitudes are |A0|2=0.43+/-0.09+/-0.04, |A(perpendicular)|2=0.41+/-0.10+/-0.04, arg((A(parallel))=-2.57+/-0.39+/-0.09, and arg((A(perpendicular))=0.48+/-0.32+/-0.06. The direct CP-violating asymmetries are found to be consistent with zero.
To understand the regulatory mechanisms of chloroplast proliferation, chloroplast replication was studied in cultured leaf disks cut from plants of 25 species. In leaf disks from Brassica rapa var. perviridis, the number of chloroplasts per cell increased remarkably in culture. We examined chloroplast replication in this plant in vivo and in culture media with and without benzyladenine, a cytokinin. In whole plants, leaf cells undergo two phases from leaf emergence to full expansion: an early proliferative stage, in which mitosis occurs, and a differential stage after mitosis has diminished. During the proliferative stage, chloroplast replication keeps pace with cell division. In the differential phase, cell division ceases but chloroplast replication continues for two or three more cycles, with the number of chloroplasts per cell reaching about 60. In the leaf disks, the number of chloroplasts per cell increased from about 18 to 300 without benzyladenine, and to over 600 with benzyladenine, indicating that this cytokinin enhances chloroplast replication in cultured tissue. We also studied changes in ploidy and cell volume between in vivo cells and cells grown in culture with and without benzyladenine. Ploidy and cell volume increased in a manner very similar to that of the number of chloroplasts, suggesting a relationship between these phenomena.
We report the first observation of the charmless hyperonic B decay, B0-->pLambda(pi)(-), using a 78 fb(-1) data sample recorded on the Upsilon(4S) resonance with the Belle detector at KEKB. The measured branching fraction is B(B0-->pLambda(pi)(-))=(3.97(+1.00)(-0.80)+/-0.56)x10(-6). Searches for B0-->pLambda(K)- and pSigma(0)pi(-) yield no significant signals and we set 90% confidence-level upper limits of B(B0-->pLambda(K)-)<8.2x10(-7) and B(B0-->pSigma(0)pi(-))<3.8x10(-6).
BACKGROUND: Few studies have examined tumor cell distribution following laparoscopic surgery for colorectal cancer. We examined the effect of carbon dioxide pneumoperitoneum on the distribution of intrasplenically injected colon cancer cells in mice. METHODS: Mice were intrasplenically injected with 2 x 10(4) colon 26 cells labeled with 111In-oxine and were randomized to undergo pneumoperitoneum at 10 mmHg for 30 min or to receive no treatment other than anesthesia. Radioactivity of the liver, lungs, and spleen was measured 30, 60, 90, or 150 min following tumor inoculation. RESULTS: The dynamic changes in the hepatic radioactivity were not similar between groups. However, the values were not significantly different at any time point. The radioactivity of lungs was extremely low in both groups throughout the experimental period. CONCLUSIONS: Pneumoperitoneum does not appear to cause the accumulation of intraportally spreading tumor cells in the liver, but it may affect the dynamic changes of tumor cells. Also, tumor cell localization in the lungs is negligible in both pneumoperitoneum and control groups.
The biodegradation of chloronaphthalene (CN) and polycyclic aromatic hydrocarbons by the white-rot fungus Phlebia lindtneri, which can degrade dichlorinated dioxins and non-chlorinated dioxin-like compounds, was investigated. Naphthalene, phenanthrene, 1-chloronaphthalene (1-CN) and 2-chloronaphthalene (2-CN) were metabolized by the fungus to form several oxidized products. Naphthalene and phenanthrene were metabolized to the corresponding hydroxylated and dihydrodihydroxylated metabolites. 2-CN was metabolized to 3-chloro-2-naphtol, 6-chloro-1-naphtol and two other chloronaphtols, CN-dihydrodiols and CN-diols. Significant inhibition of the degradation of these substrates was observed when they were incubated with the cytochrome P-450 monooxygenase inhibitors 1-aminobenzotriazole and piperonyl butoxide. These results suggest that P. lindtneri initially oxidizes these substrates by a cytochrome P-450 monooxygenase.
We report measurements of branching fractions for charged and neutral B-->eta(c)K decays where the eta(c) meson is reconstructed in the K(0)(S)K+/-pi(-/+), K+K-pi(0), K(*0)K-pi(+), and pp; decay channels. The neutral B0 channel is a CP eigenstate and can be used to measure the CP violation parameter sin(2phi(1). We also report the first observation of the B0-->eta(c)K(*0) mode. The results are based on an analysis of 29.1 fb(-1) of data collected by the Belle detector at KEKB.
BACKGROUND: Preoperative assessment of the likelihood of malignancy in intraductal papillary-mucinous tumour (IPMT) of the pancreas is often difficult. Predictive factors for malignancy and invasive carcinoma in IPMT were analysed. METHODS: Sixty-two patients with IPMT underwent surgical treatment, with histological confirmation of adenoma in 28, carcinoma in situ in 14 and invasive carcinoma in 20. Tumours were of the main duct type in 14 patients, branch duct type in 32, and combined type in 16. A multivariate analysis of 17 potential predictive factors, including preoperative clinical and imaging findings, was conducted. RESULTS: Multivariate analysis identified two independent predictive factors for malignancy: mural nodules and main pancreatic duct diameter of 7 mm or more. Mural nodules in the main duct or combined type, and mural nodules and tumour diameter of 30 mm or more in the branch duct type were particularly indicative of malignancy. Mural nodules, jaundice and main duct or combined type were predictors of invasive carcinoma in the multivariate analysis. CONCLUSION: The above factors should be considered in the diagnosis of IPMT to facilitate appropriate management.
A 77-yr-old man died of metastising adenocarcinoma of the lung. He had been treated with hydrocortisone for isolated ACTH deficiency for 9 yr. At autopsy, the pituitary and the adrenal glands were atrophic. Lymphocyte infiltration was not observed in the pituitary, the adrenal and the thyroid glands. Immunohistochemistry revealed selective loss of ACTH-like immunoreactivity in the pituitary gland whereas CRH-immunoreactive cells were found in the paraventricular nucleus of the hypothalamus. This is the first report demonstrating immunohistochemical examinations of the pituitary and the hypothalamus in isolated ACTH deficiency.