A novel 203 kD aberrant BCR-ABL product in a girl with Philadelphia chromosome positive acute lymphoblastic leultaemia

Summary We report a girl with Ph¹-positive ALL with the aberrant BCR-ABL product. In this case. bcr exon 3 jointed not to ordinal abl exon 2 but to exon 3 resulting in the production of a 20 3 kD BCR-ABL fusion protein with marked tyrosine kinase activity. To our knowledge, this is the first report of an aberrant BCR-ABL product in childhood. This case was characterized with younger age and low leucocyte count at the onset, but relapsed early like the typical Ph^l-positive ALL, suggesting the diversity in the clinicopathogenesis of Ph¹-positive ALL.     

Tricuspid regurgitation due to chest trauma: An unusual laceration around the annulus of the anterior leaflet

Summary A 70-year-old male with tricuspid regurgitation due to a blunt chest trauma inflicted 16 years previously underwent prosthetic valve replacement. At surgery, a tear, which produced tricuspid regurgitation, was found around the annulus of the anterior leaflet of the tricuspid valve. Since this area has not been reported as a location for heart trauma-producing tricuspid regurgitation, a possible mechanism of tricuspid regurgitation is discussed in this patient.     

Noninvasive evaluation of the influence of aortic wave reflection on left ventricular ejection during auxotonic contraction

Summary To develop a noninvasive method for evaluating the influence of aortic wave reflection on left ventricular ejection, the carotid pulse wave and the pulsed Doppler wave in the left ventricular outflow tract were evaluated in 35 patients. Agreement between the pulsed Doppler waveform and the aortic flow velocity contour (obtained invasively) was verified by Fourier analysis. The carotid augmentation index was used to determine the magnitude of the aortic pressure wave reflection. A Doppler index named DR_1/3 was defined as the ratio of deceleration at the first one-third in the deceleration phase to the peak flow velocity of the pulsed Doppler. This index was validated by close correlation with the carotid augmentation index (n = 48,r = 0.70,P < 0.01). Both nitrates and nifedipine induced a significant decrease in DR_1/3 (indicating an increase in left ventricular ejection flow) in relation to a reduction of the reflected pressure wave. The new noninvasive index, DR_1/3, is useful in evaluating the influence of aortic wave reflection as part of the left ventricular afterload and in assessing the benefit of treatment aimed at reducing wave reflection.     

Analysis of the core region of HCV genome isolated from patients with chronic hepatitis C during intervals of normal ALT concentration

We determined the core region nucleotide and amino acid sequences in specimens from two patients with chronic hepatitis C during intervals of normal and elevated alanine aminotransferase (ALT) concentrations. When the ALT concentrations remained normal, the serum HCR-RNA concentration exceeded that before therapy and most of the clones that could be sequenced had a deletion or an amber mutation. The clones isolated from a HLA B44-positive patient had a mutation at amino acid 91. These results suggest that expression of the wild-type HCV core region genome may be associated with liver cell damage.     

Increased nitric oxide in proportion to the severity of heart failure in patients with dilated cardiomyopathy: close correlation of tumor necrosis factor-alpha with systemic and local production of nitric oxide.

Recent studies have demonstrated that proinflammatory cytokines induce large amounts of nitric oxide (NO) and that the amount increases in patients with congestive heart failure (CHF). There are, however, few reports regarding the relationships between NO production, cytokines and the severity of heart failure, so the plasma concentrations of nitrite and nitrate (NOx), tumor necrosis factor-alpha (TNF-alpha) and brain natriuretic peptide (BNP) were measured in 43 patients with CHF caused by dilated cardiomyopathy and 26 age- and sex-matched normal control subjects. Forearm blood flow (FBF) was measured using plethysmography during infusions of acetylcholine and nitroglycerin and after the administration of the NO synthesis inhibitor L-NMMA (N(G)-monomethyl-L-arginine). Plasma concentrations of both NOx and TNF-alpha were significantly higher in the patient group than in the control group (p<0.001) and correlated closely with BNP concentrations (p<0.001). There was a positive relationship between NOx and TNF-alpha concentrations (r=0.80, p<0.001). Administration of L-NMMA significantly reduced FBF in both groups, and the percent change in FBF from baseline correlated significantly with TNF-alpha concentrations (r=0.63, p<0.001). The FBF response to acetylcholine was depressed in the patient group and correlated inversely with TNF-alpha concentrations. The FBF response to nitroglycerin did not correlate with TNF-alpha concentrations. The findings indicate that the concentrations of NO and TNF-alpha in patients with CHF increase in proportion to the severity of heart failure, and that TNF-alpha plays a role in the enhanced systemic and local production of NO.     

Long-term effect of Helicobacter pylori eradication on quality of life,body mass index,and newly developed diseases in Japanese patients with peptic ulcer disease

BACKGROUND/AIMS: Eradication of Helicobacter pylori is known to reduce ulcer recurrence in patients with peptic ulcer disease, however, other long-term effects after eradication therapy are not well known. The aim of this study is to examine the long-term effect of H. pylori eradication on clinical symptoms, quality of life, body mass index, newly emerging symptoms, and newly developed diseases. METHODOLOGY: One hundred and ninety-two Japanese patients with peptic ulcer disease who received H. pylori eradication therapy at Department of Gastroenterology, Osaka City University Hospital between 1993 and 1995 were asked to fill in specially a prepared questionnaire. RESULTS: One hundred and fourteen patients returned the questionnaires; out of them 98 could be analyzed in this study. Successful eradication (n = 88) resulted in alleviation of symptoms, improvement of quality of life and increase of body mass index while failure of eradication (n = 10) had much less or no effects. A relatively high incidence of hyperlipidemia (25.0%) was observed in patients with successful H. pylori eradication. Development of hyperlipidemia was associated with significant improvement of quality of life especially the item concerning eating and drinking habits but not with increased body mass index. In the elderly, no significant change in body mass index was observed, however, post-eradication body mass index was significantly higher in patients with hyperlipidemia than those without. CONCLUSIONS: Cure of H. pylori infection alleviates symptoms and improves quality of life of treated patients, but might be associated with an increased incidence of hyperlipidemia.     

Effects of ethanol on the pancreas of disulfiram-treated rats

To study the effects of ethanol on disulfiram-treated rats, we administered ethanol orally at a does of 2000 mg/kg, twice daily for 5 days. The administration of ethanol or disulfiram alone produced no recognizable changes in pancreatic acinar cells. Ethanol administration. in disulfiram-treated rats resulted in a decrease in the content of zymogen granules in acinar cells, and the appearance of intraplasmic vacuolization. Electron microscopically, these vacuoles appeared on the basal side of nuclei. In addition, similar vacuoles appeared in liver cells, and these vacuolizations seemed to show lipid inclusions. However, ethanol administration to disulfiram-treated rats did not cause inflammatory changes or edema in the pancreas. A comparison of blood ethanol levels in rats receiving ethanol alone and disulfiram plus ethanol showed no significant difference, but acetaldehyde levels in rats receiving ethanol plus disulfiram rats were significantly higher than those in rats receiving ethanol alone. These findings suggested that acetaldehyde caused a decrease of zymogen granules and the presence of lipid inclusions in pancreatic acinar cells.