Lifestyle and health factors associated with stress urinary incontinence in Japanese women

Objectives

Studies focusing on lifestyle and health factors and stress urinary incontinence (SUI) are scarce in Japan. The aim of this study is to examine the association of lifestyle and health factors in SUI.

Methods

Study subjects were retrieved from Japanese women participating in a health checkup program provided by a general hospital between October 2003 and March 2006. The presence of SUI was confirmed by responses to a self-administered questionnaire assessing lower urinary tract symptoms. The questionnaire included other questions on lifestyle and health factors. Each subject underwent weight and height measurements.

Results

A total of 823 women completed the questionnaire and were included in the analyses (the response rate was 62.6%). Of them, 70 (8.5%) women had SUI. BMI and parity were significantly positively associated with SUI (OR = 3.47 and 7.17, 95% CI 1.65–7.33 and 1.71–30.04, respectively). Multiple logistic regression analysis controlling for age, parity, and BMI showed that first delivery at age >27 (OR = 1.82, 95% CI 0.97–3.41), past estrogen use (OR = 2.50, 95% CI 1.14–5.47), and unilateral ovariectomy (OR = 3.07, 95% CI 1.16–8.13) were also significantly associated with SUI.

Conclusions

The data suggested that lifestyle and health factors such as parity, BMI, age at first delivery, past estrogen use, and unilateral ovariectomy were associated with SUI in Japanese women.     

Predictive value of the original content of CD34(+) cells for enrichment of hematopoietic progenitor cells from bone marrow harvests by the apheresis procedure

We retrospectively investigated the feasibility of the apheresis procedure for red blood cell (RBC) reduction with a closed-bag system. We also sought to determine the optimal processing volume for the maximal recovery of hematopoietic progenitor cells (HPC). Twelve bone marrow (BM) harvests were processed for major ABO-incompatible allogeneic transplantation and one BM harvest was processed for autologous transplantation. The processing was performed through seven apheresis cycles with a two-bag system using COBE Spectra Version 6.1. The mean recovery rates were compared in the products after four cycles and seven cycles of BM processing. Mean cell recovery rates were 79.2% (67.6-97.5%) and 87.3% (68.9-111.9%) for the mononuclear cells (MNC) and 84.5% (69.4-109.5%) and 92.0% (79.0-107.7%) for the CD34(+) cells after four and seven cycles, respectively. A mean of 96.3% (93.0-98.1%) of the RBCs were finally removed. The yield of CD34(+) cells after seven cycles of processing (median: 10.35 x 10(7) cells) was 7.9% greater than that after four cycles of processing (median: 9.65 x 10(7) cells), exhibiting a less-than-significant enhancement in yield. The CD34(+) cell contents recovered in the concentrates up to four cycles (r = 0.989) and up to seven cycles (r = 0.993) were strongly correlated with the original content of the CD34(+) cells. Engraftment was obtained in all patients except one patient infused with purified CD34(+) cells. This latter result confirmed the hematopoietic potential of the cell populations recovered. Granulocyte recovery (defined as an absolute neutrophil cell count > or = 500/microL for a period of three consecutive days) ranged from 8 to 25 days (median: 16 days) post-transplantation. No hemolytic reaction was observed in any of the patients. Our results confirmed the efficacy of BM processing cycles with the COBE Spectra device. However, we could not conclude that the large-volume apheresis for BM processing significantly enhanced the yields of HPC. The final recovery of CD34(+) cells after processing could be predicted from the CD34(+) cell content of the original collected marrow.     

Casitas B-cell lymphoma mutation in childhood T-cell acute lymphoblastic leukemia

Somatic CBL mutations have been reported in a variety of myeloid neoplasms but are rare in acute lymphoblastic leukemia (ALL). We analyzed 77 samples from hematologic malignancies, identifying a somatic mutation in CBL (p.C381R) in one patient with T-ALL that was associated with a uniparental disomy at the CBL locus and a germline heterozygous mutation in one patient with JMML. Two NOTCH1 mutations and homozygous deletions in LEF1 and CDKN2A were identified in T-ALL cells. The activation of the RAS pathway was enhanced, and activation of the NOTCH1 pathway was inhibited in NIH 3T3 cells that expressed p.C381R. This study appears to be the first to identify a CBL mutation in T-ALL.     

Spontaneous disappearance of multiple lung metastases after nephroureterectomy from sarcomatoid carcinoma of the renal pelvis: A case report

We report a case in which lung metastases disappeared spontaneously after nephroureterectomy from sarcomatoid carcinoma of the renal pelvis. A 58-year-old man presented with gross hematuria. Computed tomography (CT) revealed a left renal tumor and multiple lung metastases. Intravenous pyelography revealed a filling defect in the upper renal calyx. Urine cytology was positive. Left renal pelvic cancer was diagnosed and nephroureterectomy performed. The resected specimen was diagnosed pathologically as sarcomatoid carcinoma of the renal pelvis. Approximately 5 months later, CT revealed that the lung metastases had disappeared. There has been no evidence of disease for 46 months postoperatively.     

Long-term follow-up of children with refractory immune thrombocytopenia treated with rituximab

Data on long-term outcomes of children with refractory immune thrombocytopenia (ITP) treated with rituximab are limited. We retrospectively analyzed the long-term effect of rituximab on 22 pediatric ITP patients (11 boys and 11 girls). Compete response (CR) (platelet count ≥100 × 10⁹/L) and partial response (PR) (platelet count 30–99 × 10⁹/L) were achieved in nine (41 %) and two (9 %) patients, respectively. Of the 11 responders, eight subsequently relapsed 2–26 months after initial rituximab treatment. The 5-year relapse-free rate was 14 % (3/22, 95 % confidence interval: 0–27 %) with a median follow-up period of 6.4 years. Five initial responders with subsequent relapse and one non-responder received multiple rituximab treatments of nine courses; all patients responded to the second rituximab therapy without any significant toxicity. All eight patients who relapsed after an initial response and six of 11 non-responders achieved CR or PR with subsequent treatment, including repeated courses of rituximab, splenectomy, steroids, and other immunomodulating agents. Our findings indicated that the sustained effect of rituximab on children with refractory ITP is low, but that the long-term outcome of ITP itself is not poor. Furthermore, repeated rituximab administration may be a promising therapy for those who relapse after an initial response.     

Outcome of children with relapsed acute myeloid leukemia following initial therapy under the AML99 protocol

The outcomes of children with relapsed acute myeloid leukemia (AML) are known to be poor, but remain obscure. We retrospectively analyzed 71 patients who had relapsed following first-line treatment under the AML99 protocol. We investigated the time and site of recurrence, response to re-induction therapy, and performance of hematopoietic stem cell transplantation (HSCT) in relapsed cases, and performed a multivariate analysis to identify prognostic factors. The 5-year overall-survival (OS) rate after relapse was 37 %. Of 71 patients, three died without any anti-leukemic therapy and two underwent allogeneic HSCT. The remaining 66 patients received re-induction chemotherapy, and 33 (50 %) achieved second CR (CR2). Twenty-two of 25 (88 %) late relapse patients and 11 of 41 (27 %) early relapse patients achieved CR2 (P < 0.001). Twenty-nine CR2 cases and 35 non-CR2 cases underwent allogeneic HSCT. The 5-year OS rate was significantly higher in patients who underwent HSCT in CR2 than those in non-CR2 (66 vs. 17 %, P < 0.000001). Multivariate analysis indicated that early relapse (P < 0.05) and the positivity of the FMS-like tyrosine kinase 3—internal tandem duplication (P < 0.05) were adverse prognostic factors for survival. In conclusion, the etiology of relapsed pediatric AML needs to be elucidated and effective chemotherapy should be administered to obtain CR2.