Transcatheter arterial infusion chemotherapy with cisplatin–lipiodol suspension in patients with hepatocellular carcinoma

Purpose  

The aim of this study was to investigate the antitumor efficacy of treatment, identify prognostic factors, and construct a prognostic index in patients with hepatocellular carcinoma treated by transcatheter arterial infusion chemotherapy (TAI) using cisplatin suspended in lipiodol.     

Antimicrobial susceptibilityof clinical isolates of aerobic gram-negative bacteria in 2008

We determined MICs of antibacterial agents against 1145 clinical strains of aerobic Gram-negative bacteria (22 species) isolated at 16 Japanese facilities in 2008. MICs were determined using mostly broth microdilution method and antibacterial activity was assessed. Strains producing extended-spectrum beta-lactamases (ESBL) accounted for 3.8% of Escherichia coli, 2.6% of Klebsiella pneumoniae, 6.8% of Klebsiella oxytoca, 5.5% of Proteus mirabilis and 1.8% of Proteus vulgaris. ESBL produced strains were 6.8% at K. oxytoca that increased compared with 3.2% and 5.5% at P. mirabilis that decreased compared with 18.8% in 2006. Among Haemophilus influenzae, 61.7% that decreased compared with 67.7% in 2006, equaled 58.7% in 2004, were strains when classified by penicillin-binding protein 3 mutation. Against Pseudomonas aeruginosa, the activity of most antibacterial agents was similar to that in 2006. Although two antibacterial agents that tobramycin showed an MIC90 of 1 microg/mL and doripenem showed an MIC90 of 4 microg/mL against P. aeruginosa have potent activity. Of all P. aeruginosa strains, 4.3% were resistant to six agents of nine antipseudomonal agents, that decreased compared to 12.2% in 2004 and 5.7% in 2006. Against other glucose-non-fermentative Gram-negative rods, the activity of most antibacterial agents was similar to that in 2006.     

Gliding Distance of the Extensor Pollicis Longus Tendon with Respect to Wrist Positioning: Observation in the Hands of Healthy Volunteers Using High-Resolution Ultrasonography

Study DesignCross-sectional experimental bench.IntroductionOptimal tendon gliding is necessary for normal thumb function.Purpose of the StudyMeasure the gliding distance of the extensor pollicis longus (EPL) tendons during passive thumb flexion from high-resolution echo images at four wrist positions.MethodsGliding distance of the EPL tendon in zone 4 of the thumb was measured during passive flexion in four different wrist positions in 25 healthy female volunteers. Tendon gliding was evaluated from high-resolution ultrasonography in a frame-by-frame cross-correlation analysis.ResultsMean gliding distance of the EPL tendon was 1.79, 2.45, 1.09, and 1.36 mm with the wrist positioned in neutral, 30 degrees of extension, 30 degrees of flexion, and 20 degrees of ulnar deviation, respectively. There were statistically significant differences in the gliding distance of the EPL tendon among all of four wrist positions except for that between the wrist flexion and wrist ulnar deviation conditions.ConclusionsWrist extension induces the greatest magnitude EPL tendon gliding.     

Stress‐coping strategies of patients with gender identity disorder

Aims: Previous research has not addressed gender differences in coping strategies among patients with gender identity disorder (GID). Nor has the relationship of coping strategies to other demographic characteristics ever been clarified in GID. In this study, we tried to clarify the relationship between stress‐coping strategies and demographic characteristics among patients with GID. Methods: The coping strategies of 344 patients with GID [227 female‐to‐male (FTM) and 117 male‐to‐female (MTF)] were assessed using the Japanese version of the Ways of Coping Questionnaires, Lazarus Stress‐coping Inventory. Results: Comparison of the stress‐coping inventory between MTF and FTM GID patients revealed that FTM GID patients were significantly more reliant on positive reappraisal strategies in stressful situations than MTF GID patients (P = 0.007). Conclusions: The difference in the usage of positive reappraisal strategies between MTF and FTM type GID patients was not explained by other demographic characteristics, and we suppose that the gender difference in GID patients might influence the usage of positive reappraisal strategies. The ratio of FTM GID patients might be higher at our center because MTF GID patients can obtain vaginoplasty easily, whereas phalloplasty surgery for FTM GID patients is performed at only a few centers, including our clinic, in Japan. As a result, more FTM GID patients come to our clinic with a clear intention to undergo sexual rearrangement surgery, which might influence the gender difference in using positive reappraisal.     

Predictive factors for long-term prognosis in adults with cyanotic congenital heart disease--Japanese multi-center study

ObjectiveAdults with cyanotic congenital heart disease (CCHD) are associated with a significant incidence of morbid events and premature deaths that may be predicted during childhood. We aimed to identify predictive factors related to long-term prognosis through a Japanese multi-center cross-sectional study.MethodsData were collected from 253 adults with CCHD (126 men; age 28 (18 to 56) years) from 15 participating centers between 1998 and 2003. Laboratory data such as cardiothoracic ratio (CTR), percutaneous oxygen saturation (SpO₂), hematocrit levels (Ht) and platelet counts (Pl-c) at the age of 15 years were collected for predictive factor analysis for death and cardiovascular and systematic events. Predictive factors were determined by multivariate Cox regression analysis.ResultsAfter a mean follow-up of 21 (0–42) years, 23 patients died with a median age of 29 (18–54) years (heart failure in 8, sudden in 6 and systematic complications in 9). Survival since 18 years of age was 91% and 84% at 10 and 20 years, respectively. Significant predictive factor for death was Pl-c < 130 × 10⁹/l and for renal failure (n = 7) was Ht > 65%. 162 patients were hospitalized and predictors for hospitalization due to heart failure (n = 45) were common atrioventricular canal CTR > 60% and Pl-c < 100 × 10⁹/l and that due to arrhythmias (n = 44) were systematic right ventricle and CTR > 60%.ConclusionsThis multi-center study provides an objective basis of assessing the long-term prognosis in patients with CCHD. These data are useful in making decisions regarding medical management and in favorably altering the non-operative course of the disease.     

FDG PET findings of chronic myeloid leukemia in the chronic phase before and after treatment

We report 2 patients with chronic myeloid leukemia in the chronic phase showing diffusely increased F-18 fluorodeoxyglucose (FDG) uptake in the bone marrow before treatment. Follow-up FDG positron emission tomography (PET) scans were performed in a patient after cessation of treatment and in the other under treatment. Both FDG PET findings showed reduced FDG uptake in the bone marrow. A series of these FDG PET findings suggest the usefulness of FDG PET for the diagnosis and monitoring of chronic myeloid leukemia after treatment.     

Establishment of cell lines using a doxycycline-inducible gene expression system to regulate expression of hepatitis B virus X protein

The hepatitis B virus (HBV) X gene plays an important role in HBV-associated pathogenesis, especially hepatocarcinogenesis. Establishment of a stable and regulable HBx expression system will allow study of the function of this gene. Here, we describe the development of a doxycycline-inducible recombinant plasmid (pBPSTR3-FlagX) with the full-length HBV X gene and all components of the tetracycline-on (“Tet-on”) gene expression system. This vector exhibited dose-dependent doxycycline-dependent induction of the Flag-HBx protein in HepG2 and Hep3B cells. We also observed dose-dependent doxycycline transactivation of HBx in HepG2 cells. After transfecting HepG2 cells with the pBPSTR3-FlagX plasmid, we isolated five puromycin-resistant cell clones with stable HBx expression, two of which exhibited stable and tight control of HBx expression by doxycycline. This new system has great potential for functional studies of the HBV X gene.     

Crk-associated substrate lymphocyte type regulates myeloid cell motility and suppresses the progression of leukemia induced by p210Bcr/Abl

The p210Bcr/Abl and p190Bcr/Abl fusion oncoproteins are known to cause chronic myelogenous leukemia (CML) and acute lymphoblastic leukemia (ALL). Bcr/Abl phosphorylates several proteins that can lead to leukemogenesis. Crk-associated substrate lymphocyte type (Cas-L)/human enhancer of filamentation-1 (HEF1)/neural precursor cell expressed, developmentally down-regulated 9 (NEDD9) is an adapter protein at focal adhesions known to be associated with solid tumor metastasis. Crk-associated substrate lymphocyte type has also been reported to be tyrosine phosphorylated by p190Bcr/Abl. We demonstrated that Cas-L was expressed in murine granulocytes, as well as in lymphocytes, and that Cas-L-deficient (Cas-L(-/-) ) granulocytes had increased migratory activity and decreased adhesiveness. To examine whether Cas-L was involved in leukemogenesis by p210Bcr/Abl, we generated Cas-L(-/-) p210Bcr/Abl transgenic mice. The mice displayed early development of myeloproliferative neoplasm seen in the chronic phase of CML, which resulted in the early death of the mice. Pathologically, increased infiltration of myeloid cells into several tissues was detected in the absence of Cas-L. In a hematopoietic reconstitution assay, Cas-L(-/-) p210Bcr/Abl transgenic cells showed a low population in the spleen, although only their myeloid cell population was normal. Thus, Cas-L seems to regulate the progression of CML in a negative way, presumably by attenuating extramedullary hyperplasia.