Second Allogeneic Transplantation for Relapsed Acute Leukemia after Initial Allogeneic Hematopoietic Stem Cell Transplantation

We retrospectively reviewed the medical records of 45 patients with relapsed acute leukemia after initial allogeneic hematopoietic stem ell transplantation (allo-HSCT). Among 45 patients, a total of 11 patients eventually underwent second allo-HSCT (HSCT-2). Median survival after relapse was 294?days (range, 135-942?days) for HSCT-2. Multivariate analysis showed significantly better survival for recipients of second allo-HSCT than for other patients (hazard ratio, 4.38; 95?% confidence interval, 1.45-13.2; P?=?0.009). Although outcomes for patients with relapsed leukemia were generally poor, our results suggest that second HSCT could offer a survival advantage over other conventional salvage strategies.     

Significance of IDH mutations varies with tumor histology, grade, and genetics in Japanese glioma patients

Mutations in isocitrate dehydrogenase 1 (IDH1) and IDH2 are found frequently in malignant gliomas and are likely involved in early gliomagenesis. To understand the prevalence of these mutations and their relationship to other genetic alterations and impact on prognosis for Japanese glioma patients, we analyzed 250 glioma cases. Mutations of IDH1 and IDH2 were found in 73 (29%) and 2 (1%) cases, respectively. All detected mutations were heterozygous, and most mutations were an Arg132His (G395A) substitution. IDH mutations were frequent in oligodendroglial tumors (37/52, 71%) and diffuse astrocytomas (17/29, 59%), and were less frequent in anaplastic astrocytomas (8/29, 28%) and glioblastomas (13/125, 10%). The pilocytic astrocytomas and gangliogliomas did not have either mutation. Notably, 28 of 30 oligodendroglial tumors harboring the 1p/19q co-deletion also had an IDH mutation, and these alterations were significantly correlated (P < 0.001). The association between TP53 and IDH mutation was significant in diffuse astrocytomas (P = 0.0018). MGMT promoter methylation was significantly associated with IDH mutation in grade 2 (P < 0.001) and grade 3 (P = 0.02) gliomas. IDH mutation and 1p/19q co-deletion were independent favorable prognostic factors for patients with grade 3 gliomas. For patients with grade 3 gliomas and without 1p/19q co-deletion, IDH mutation was strongly associated with increased progression-free survival (P < 0.0001) and overall survival (P < 0.0001), but no such marked correlation was observed with grade 2 gliomas or glioblastomas. Therefore, IDH mutation would be most useful when assessing prognosis of patients with grade 3 glioma with intact 1p/19q; anaplastic astrocytomas account for most of these grade 3 gliomas.     

Pineal parenchymal tumor of intermediate differentiation with marked elevation of MIB-1 labeling index

We report a case of pineal parenchymal tumor (PPT) in an 11-year-old girl. Brain magnetic resonance imaging (MRI) revealed a large tumor (48?mm) located in the pineal region with heterogeneous enhancement after gadolinium administration. The patient underwent tumor removal with craniotomy; only partial tumor resection could be performed because of massive intratumoral bleeding. Histopathological examination of the tumor showed lobular proliferation of round cells with moderate atypia. Cellularity varied by area, and focal Homer Wright rosettes were identified. Examination of tumor cells revealed a few mitoses (two mitotic figures per 10 high-powered fields), and immunohistochemical staining revealed positivity for synaptophysin, slight positivity for neurofilament protein (NFP) with antibody clone 2F11, and strong positivity for NFP with clone NF-M+H. The pathological diagnosis was pineal parenchymal tumor of intermediate differentiation grade II according to World Health Organization criteria despite a high (22%) MIB-1 labeling index (LI). The patient had a favorable clinical course after an intensified chemotherapy regimen designed for pineoblastoma and radiotherapy administered to the entire neuraxis, followed by stereotactic radiotherapy. In conclusion, MIB-1 LI could be a useful tool for deciding therapeutic strategies for PPT treatment when there is a discrepancy between clinical findings and pathological grading.     

Ultrasonic monitoring of the setting of glass-ionomer luting cements

This study used ultrasonic measurements to monitor the setting behaviour, and changes in the elastic modulus, of glass–ionomer cements. The ultrasonic equipment comprised a pulser–receiver, transducers, and an oscilloscope. The two-way transit time through the mixing cement disk was divided by two, in order to account for the down-and-back travel path, and then multiplied by the sonic velocity within the material. The sonic velocities of the longitudinal and shear waves were used to determine the elastic modulus. In the earliest stages of the setting process, most of the ultrasound energy was absorbed by the cements and the second echoes were relatively weak. As the cements hardened, the sound velocities increased until they reached a plateau. The changes in sound velocities differed among the glass–ionomer cements tested. The mean elastic moduli of the specimens ranged from 2.6 to 6.2 GPa after 15 min, from 13.4 to 20.4 GPa after 24 h, and from 11.4 to 22.4 GPa after 1 month. The ultrasonic method used in this study has considerable potential for determining the setting processes of luting cements.     

Influence of chlorine dioxide on cell death and cell cycle of human gingival fibroblasts

OBJECTIVES: The effects of chlorine dioxide (ClO2), sodium hypochlorite (NaOCl), and hydrogen peroxide (H2O2) on cell death and the cell cycle of human gingival fibroblast (HGF) cells were examined. METHODS: The inhibition of HGF cell growth was evaluated using a Cell Counting Kit-8. The cell cycle was assessed with propidium iodide-stained cells (distribution of cells in G0/G1, S, and G2/M phases) using flow cytometry. The patterns of cell death (necrosis and apoptosis) were analyzed using flow cytometry with annexin V-FITC/PI staining. RESULTS: The lethal doses for 50% of the cells (LD50) of ClO2, NaOCl, and H2O2 were 0.16, 0.79, and 0.11 mM, respectively. All three dental disinfectants induced G0/G1 cell cycle arrest. H2O2 induced apoptosis at concentrations of 0.05 and 0.1 mM, while NaOCl and ClO2 did not induce significant apoptosis at any concentration examined. CONCLUSIONS: These results suggest that ClO2 is sufficient for use as a dental disinfectant compared with H2O2 or NaOCl.     

Setting behaviour of luting cements monitored by an ultrasonic method

The purpose of this study was to monitor the setting behaviour and elastic modulus of luting cements using an ultrasonic device. The ultrasonic equipment comprised a pulser-receiver, transducers and an oscilloscope. The transit time through the cement disk was multiplied by the thickness of the specimen, and the sonic velocity within the material was then calculated. The sonic velocities of the longitudinal and shear waves were used to determine the elastic modulus. Analysis of variance and the Tukey HSD test were used to compare the elastic moduli of the set cements. In the earliest stages of the setting process, most of the ultrasound energy was absorbed by the cements and the sound waves were relatively weak. As the cements hardened, the sound velocities increased and this tendency differed among the luting cements used. The mean elastic moduli of the specimens ranged from 2.9 to 9.9 GPa after 15 min, from 14.4 to 20.3 GPa after 24 h and from 12.1 to 15.9 GPa after 1 month. The setting processes of the luting cements were thus clearly defined by using the present ultrasonic method.