Compression therapy using surgical gloves is ineffective for the prevention of vincristine-induced neuropathy in patients with malignant lymphoma.

PURPOSE: Vincristine (VCR) often induces peripheral neuropathy (PN) as an adverse event. Currently, there is no consensus on the prevention of vincristine-induced PN (VIPN). In this study, we aimed to investigate the efficacy of compression therapy using surgical gloves for preventing VIPN. METHODS: Patients with malignant lymphoma (vincristine-naïve) who were receiving chemotherapy with cyclophosphamide, doxorubicin, VCR, and prednisolone, with or without rituximab, every 3 weeks for six cycles were eligible. For every VCR infusion, each patient wore two one-size-smaller gloves on one hand (study hand) for 90 min. The other hand was left bare (control hand). PN was assessed at each treatment using the Common Terminology Criteria for Adverse Events ver. 4.0. RESULTS: Fifty-one patients with malignant lymphoma were enrolled and 44 were evaluated. At 1 month after treatment, the occurrence rates of grade ≥ 2 sensory PN were 13.6 and 13.6% in the study and control hands, respectively (p = 1.0), and those of grade ≥ 2 motor PN were 15.9 and 15.9% in the study and control hands, respectively (p = 1.0). CONCLUSION: Compression therapy using surgical gloves showed no significant effect for the prevention of VIPN. TRIAL REGISTRATION: November 1, 2018, National University Hospital Council of Japan (UMIN 000034145).

[TCL1-family negative T-cell prolymphocytic leukemia with rapid progression of extranodal disease despite a normal white blood cell count].

Here we describe the case of a 69-year-old man who was found to have moderate thrombocytopenia and severe splenomegaly during a medical checkup at the age of 67. At the first visit, his white blood cell (WBC) count was 7,400/µl with 80% lymphocytes, and bone marrow aspiration showed 24% atypical lymphocytes. Flow cytometry of atypical lymphocytes was positive for mature T-cell markers, and T-cell clonality was revealed by T-cell receptor gene rearrangement. TCL1 was negative on immunohistochemistry. We diagnosed TCL1-family negative T-cell prolymphocytic leukemia (T-PLL) and employed watchful waiting. Thirty months after diagnosis, the patient developed urinary retention and right lower-limb paresis despite a normal WBC count, and an extradural tumor around the thoracic vertebrae and spinal cord compression were detected. The tumor was diagnosed as extranodal involvement of TCL1-family negative T-PLL, but the patient's general condition deteriorated rapidly, and no treatment was possible. T-PLL is a rare disease characterized by leukocytosis, and the WBC count generally increases with disease progression. Although blood counts are recommended for observation, it is important to keep in mind that the disease may worsen even if blood counts do not change.

Alterations in Intratumoral Immune Response before and during Early-On Nivolumab Treatment for Unresectable Advanced or Recurrent Gastric Cancer.

We investigated the tumor immune response in gastric cancer patients receiving third-line nivolumab monotherapy to identify immune-related biomarkers for better patient selection. Nineteen patients (10 males, median age 67 years) who received nivolumab as a third- or later-line therapy were enrolled. We analyzed the tumor immune response in durable clinical benefit (DCB) and non-DCB patients. Pre-treatment and early-on-treatment tumor transcriptomes were examined, and gene expression profiles, immunograms, and T cell receptor (TCR) repertoire were analyzed. DCB was observed in 15.8% of patients, with comparable secondary endpoints (ORR; objective response rate, OS; overall survival, PFS; progression-free survival) to previous trials. The immunograms of individual subjects displayed no significant changes before or early in the treatment, except for the regulatory T cell (Treg) score. Moreover, there were no consistent alterations observed among cases experiencing DCB. The intratumoral immune response was suppressed by previous treatments in most third- or later-line nivolumab recipients. TCR repertoire analysis revealed newly emerged clonotypes in early-on-treatment tumors, but clonal replacement did not impact efficacy. High T cell/Treg ratios and a low UV-radiation-response gene signature were linked to DCB and treatment response. This study emphasizes the tumor immune response's importance in nivolumab efficacy for gastric cancer. High T cell/Treg ratios and specific gene expression signatures show promise as potential biomarkers for treatment response. The tumor-infiltrating immune response was compromised by prior treatments in third-line therapy, implying that, to enhance immunotherapeutic outcomes, commencing treatment at an earlier stage might be preferable. Larger cohort validation is crucial to optimize immune-checkpoint inhibitors in gastric cancer treatment.

[Myeloid sarcomas of the shoulder and testis relapsing 9 years after allogenic stem cell transplantation for acute myeloid leukemia].

This report describes a 56-year-old man who was diagnosed with myeloid sarcoma (MS) of the testis and right shoulder after receiving allogenic stem cell transplantation (allo-SCT) at the age of 47 for acute myeloid leukemia (AML) with inv (16) (p13.1;q22). Nine years after allo-SCT, he complained of a painful right testicular mass. He underwent orchiectomy, and the pathologic diagnosis was MS. Inv (16) was identified by fluorescence in situ hybridization (FISH) using testicular tumor specimens. 18F-fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET-CT) revealed FDG accumulation in the right shoulder. FISH analysis of bone marrow aspirate revealed no increase in blasts and ruled out CBFB-MYH11 fusion. Reinduction chemotherapy, consolidation, and local radiation therapy for the left testis and right shoulder were administered to him. After that, he received a second allo-SCT from an unrelated donor who was HLA-matched. As of 2 years after the second allo-SCT, recurrence of neither AML nor myeloid sarcoma has been observed. The recurrence of MSs without bone marrow involvement is frequently reported in single, multiple single organs, or multiple single regions. Even if MSs recur in a distant location, combining systemic and local treatment may be a better treatment strategy.

[FIP1L1::PDGFRA-positive chronic eosinophilic leukemia showing slowly progressive cardiac impairment].

This report describes a 69-year-old man with eosinophilia that was detected during a medical check-up. A review of his medical history revealed that his absolute eosinophil count was 990/µl at the age of 55 and increased to 5,380/µl at the age of 69. Electrocardiogram revealed first-degree atrioventricular block at the age of 58, followed by ST-segment depression and a negative T wave at the age of 65. The echocardiogram was normal at the age of 65. We diagnosed him with FIP1L1::PDGFRA-positive chronic eosinophilic leukemia by detecting the FIP1L1::PDGFRA fusion gene by fluorescence in situ hybridization. He had no symptoms at the first visit; however, echocardiography and contrast-enhanced computed tomography revealed an abnormal structure, considered a thrombus, within the left ventricular apex and apex wall thickening. We initiated imatinib (100 mg/day), and the eosinophilia disappeared in a month. However, his cardiac impairment worsened, and he gradually developed symptoms of heart failure. This case is valuable because it shows the long-term course of the disease, with 15 years of laboratory findings until diagnosis. Our findings suggest that in cases of eosinophilia with an abnormal electrocardiogram, contrast-enhanced cardiac magnetic resonance imaging should be considered earlier.

The effectiveness of bench press training with or without throws on strength and shot put distance of competitive university athletes.

PURPOSE: Maximum force exertion against various resistance levels (heavy-light) is commonly implemented to improve both strength- and speed-oriented components of power. Medium-light resistances allow rapid accelerations, yet incur significant decelerations in the later concentric phase to bring the bar to a halt, which may limit the concentric effort and, therefore, the effectiveness of training. Accordingly, ballistic actions have been recommended. This study evaluated the effectiveness of power bench press training, with the bar thrown on a Smith machine (BPthrow) or without throwing (BPnon-throw), for developing strength and shot put distance. METHODS: Nine university shot-putters performed BPthrow and BPnon-throw at 50, 40 and 30% 1RM, as well as seated and standing shot put trials. Peak angular velocities at the elbow were measured in these tasks using a wireless electro-goniometer. Participants underwent 24 sessions of training (12 weeks) with either BPthrow (n = 5) or BPnon-throw (n = 4) at the three intensities (20 s × 2 sets at 50, 40 and 30% 1RM). RESULTS: The peak elbow velocity during BPthrow was 1.7 times greater than BPnon-throw for all intensities. The velocity of BPthrow at 30% 1RM (854.7°/s), however, was still slower than seated (1121.3°/s) and standing (1539.1°/s) shot puts. BPthrow training significantly improved 1RM (+ 10.0%) and the distances of seated (+ 11.7%) and standing (+ 3.8%) shot puts, while no performance changes occurred after BPnon-throw training. CONCLUSION: When undergoing power bench press against medium-light resistances, maximum ballistic actions are important strategies for improving 1RM and shot put performance of university shot-putters.

Myelodysplastic syndrome with neutrophilic dermatosis successfully treated with azacitidine.

A 66-year-old male underwent prednisolone (PSL) therapy of 13 mg/day for rheumatoid arthritis (RA). Antiphospholipid antibody syndrome, neutrophilic dermatosis (ND), and myelodysplastic syndrome (MDS) developed. Treatment of MDS required red cell concentrate transfusion, and second courses of azacitidine therapy (75 mg/m2 daily, intravenous injection for 7 consecutive days) led to hematologic remission. Furthermore, ND improved early after the start of azacitidine therapy, making it possible to decrease the dose of PSL. After 12th courses of azacitidine therapy, treatment was discontinued and the long-term remission of MDS and ND has been maintained. During the course, the level of matrix metalloproteinase-3, as a marker of RA, also decreased. There are few case reports of MDS in which azacitidine was effective for autoimmune diseases, including ND. We report the present case.

[Acute painful crisis in a female Nigerian patient with sickle cell disease].

We report a 38-year-old Nigerian woman with sickle cell disease. Sickle cell disease had been diagnosed when she experienced her first sickle cell crisis episode at age 8 years. Thereafter, she had infrequent minor episodes. She visited a hospital presenting with fever, anemia, jaundice, and systemic pain, and was then transferred to our hospital. Together with rehydration and red blood cell transfusion, analgesics and antibiotics were prescribed, and produced gradual improvement of all symptoms and signs. The patient was discharged on day 9 of hospitalization. Sickle cell crisis is an acute painful episode caused by occlusion of arterioles. The degree of pain and accompanying symptoms, as well as the frequencies of crises, are variable. Moreover, one third of individuals with sickle cell disease never experience a crisis. As our society becomes increasingly globalized, the probabilities of encountering sickle cell disease patients will be higher.

In vitro Evaluation Method of UV Protecting Ability of Sunscreens: Clarifying and Overcoming Problems to Develop New Method.

Factors influencing on in vitro evaluation of UV protecting ability of sunscreens were analyzed. It was found that any factors making the sunscreen layer spatially inhomogeneous, such as directional viscous fingering during the sunscreen application, dewetting of applied sunscreen layer, and the surface roughness of the standard PMMA plate, alter the UV transmittance. New application procedure and new type of flat hydrophilic plate were developed for inhibiting the generation of spatial inhomogeneity in applied sunscreen layer. The method created by the combination of these newly developed technologies succeeded in providing reliable and reproducible in vitro evaluation of UV protecting ability.

Investigation on the Validity of in vitro Sun Protection Factor and Ultraviolet-A Protection Factor Evaluation Method for Sunscreen Samples.

Factors affecting the in vitro Sun Protection Factor (SPF) and Ultraviolet-A Protection Factor (UVA-PF) of sunscreens were analyzed for verifying the validity and reliability of the ISO24443 evaluation method. UV absorbance measurements by different spectrophotometers did not lead to the large difference in in vitro SPF/UVA-PF, although the UV absorbance determined by each spectrophotometer exhibited relatively large difference when it was larger than 2. On the other hand, relatively large difference was found in in vitro SPF/UVA-PF by utilizing European Cosmetic and Perfumery Association (Colipa) 1994 or UV-solar simulated radiation (UV-SSR) for the spectral irradiance. Appropriateness of employing the coefficient of adjustment for the determination of in vitro UVA-PF was also found to be reexamined.

Follicular lymphoma with secondary central nervous system relapse: a case report and literature review.

Secondary central nervous system (CNS) relapse by aggressive non-Hodgkin's lymphoma is a well-known complication portending a very poor prognosis. Conversely, patients with indolent lymphoma-like follicular lymphoma (FL) rarely present with CNS involvement and, thus, limited information is currently available. We herein describe a patient with FL who developed CNS involvement during chemotherapy. Treatment including high-dose methotrexate and radiation therapy was ineffective and the patient died 5 months after CNS relapse. In a literature review, there were 8 case reports of the secondary CNS relapse of FL. The findings obtained suggest that bone marrow infiltration is a risk factor for CNS relapse. Moreover, 5 out of 9 patients died within 2.5 years, indicating a poorer prognosis than that of FL. Therefore, it is important to promptly perform detailed examinations as soon as neurological findings appear.

Organizing Pneumonia in a Case of cold Agglutinin Disease with Pulmonary Thrombosis.

Cold agglutinin disease is a subtype of autoimmune hemolytic anemia that occurs via the activation of specific anti-red blood cell antibodies (agglutinins) at low temperatures. Autoimmune hemolytic anemia has been reported to cause interstitial pneumonia; however, the underlying mechanism remains unclear. We herein report a 46-year-old man diagnosed with cold agglutinin disease complicated by pulmonary thrombosis and organizing pneumonia. Treatment with prednisolone improved the course of cold agglutinin disease and organizing pneumonia in a similar manner. To our knowledge, this is the first report of cold agglutinin associated with organizing pneumonia, suggesting a potential link between the two.

New in vitro SPF Evaluation Method for Hydrophilic Sunscreen Samples.

A new method was developed for the in vitro sun protection factor (SPF) evaluation of sunscreen samples. A new type of substrate, a hydroxyalkyl cellulose-coated plate, was also prepared specifically for hydrophilic samples. This new substrate was required because hydrophilic samples would be unlikely to wet the surface of the standard cosmetic PMMA UV evaluation plate. A super-hydrophilic quartz plate was prepared by corona-discharge treatment before an aqueous solution of hydroxyalkyl cellulose was spread on it. A flat and uniform hydroxyalkyl cellulose film was subsequently formed through the evaporation of water. Special care was taken to inhibit the generation of spatial non-uniformity. Six hydrophilic sunscreen samples with in vivo SPF values of 56, 55, 52, 25, 15, and 4, were then applied to the prepared hydroxyalkyl cellulose-coated plate, as well as a super-hydrophilic quartz plate and a flat hydrophobic PMMA plate. The thicknesses of the applied layers were determined using a wheel-shaped wet film thickness gauge immediately after the application, and UV transmission was measured using an SPF analyzer. The value of in vitro SPF was calculated from the UV absorbance and the thickness of the layer. For two out of the six samples, PMMA plate could not be available, as the samples were unable to wet the PMMA surface. Relatively small differences were observed between the in vitro SPF values when the super-hydrophilic and hydroxyalkyl cellulose-coated plates were used. Samples exhibiting higher in vivo SPF were also associated with higher in vitro SPF values, although a linear relationship was not observed. In contrast to the super-hydrophilic plate whose half-life of the super-hydrophilicity is only approximately five days, the hydrophilicity of the hydroxyalkyl cellulose-coated plate scarcely varied during six months of storage. Finally, a simplified evaluation method was also proposed. The validity of the method was verified through a ring test where three researchers employed this method in different laboratories at three independent organizations.

Surface Structures of Cosmetic Standard Poly Methyl Methacrylate UV Evaluation Plates and their Influence on the in vitro Evaluation of UV Protection Abilities of Cosmetic Sunscreens.

Cosmetic standard poly methyl methacrylate (PMMA) UV evaluation plates, i.e., roughened PMMA plates, are used in the EU and the US for the in vitro evaluation of UV protection abilities of sunscreen, such as in vitro UVA-PF and critical wavelength for the Broad-spectrum approval. In our previous studies, inhomogeneity in the thickness of a pseudo-sunscreen layer applied on a flat quartz plate was observed to alter UV transmission. Thus, the surface roughness of the standard plates should have a significant influence on the in vitro evaluation. In the present study, we have analyzed the surface structures of three cosmetic standard PMMA UV evaluation plates: Helioplates HD6 (Sa = 6 µm) and ISO plates (Ra = 2 and 5 µm). A decamethylcyclopentasiloxane and 2-propanol-mixed solvent solution of acrylsilicone resin was prepared, and the solution was added dropwise onto the plates. After the evaporation of the solvents, the plates were cut and the cross section was analyzed using SEM-EDS. The distribution of silicon atoms at the cross-section suggested that the maximum depth of penetrating of acrylsilicone resin was larger than Ra for all the standard plates, and the surface structure was significantly different for each standard plate. In addition, cracks into which the acrylsilicone resin deeply penetrated were observed on the surface of some plates. Clear-solution-type pseudo-sunscreen samples in which UV absorbers and acrylsilicone resin were dissolved were deposited on the standard roughened PMMA plates. It was observed that the addition of acrylsilicone resin drastically changed the net UV transmission. The degree to which the hollows of the roughened surface were filled with the pseudo-sunscreen samples determined the variation of UV transmittance.

Fabrication of spatially periodic double roughness structures by directional viscous fingering and spinodal dewetting for water-repellent surfaces.

Water-repellent and self-cleaning properties of lotus leaves are considered to be due to its double roughness structure, protrusion structure (approximately 20 microm) and hairy structure (0.2-1.0 microm). In this study, attempts to fabricate a spatially periodic double roughness structure by two far-from-equilibrium self-organization phenomena, a directional viscous fingering and a spinodal dewetting, were made. A mixture of an octylsilyl titanium dioxide particle having an average diameter of 35 nm suspended in volatile silicone, decamethyl cyclopentasiloxane, and octyl p-methoxycinnamate was spread on a glass plate by dragging an applicator across the top. Formation of a stripe pattern parallel to the direction of dragging, called directional viscous fingering, was sometimes observed. Influences of spreading conditions on the pattern formation were analyzed. In addition, attempts were made to apply the stripe pattern formation to the preparation of a water repellent surface. We have succeeded in preparing a highly water-repellent surface by immersing a glass plate, on which a spatially periodic stripe pattern having a characteristic wavelength of 200-700 microm was formed, in water, after the completion of evaporation of decamethyl cyclopentasiloxane. In this case, dewetting patterns having a characteristic wavelength at around 5 microm were formed at the bottom part of the stripe patterns. Neither the surface on which only the mesoscopic spatially periodic stripe pattern was formed nor the one on which only the microscopic dewetting pattern was formed showed high water-repellent properties, indicating that the coexistence of the two different scales of patterns increased the water-repellent properties of the hydrophobic surface.

The first case of POEMS syndrome with synchronous breast cancer: What are the associated diagnostic challenges?

Polyneuropathy, Organomegaly, Endocrinopathy, Monoclonal gammopathy, Skin changes (POEMS) syndrome is a rare plasma cell disorder that causes a paraneoplastic syndrome. We report the first case of POEMS syndrome with synchronous breast cancer. The patient was at risk of being misdiagnosed with metastatic cancer, and it is important to emphasize that physical examinations provided vital diagnostic clues.

Problems on the Evaluation of the Critical Wavelength of Sunscreens for "Broad Spectrum" Approval Brought on by Viscous Fingering During Sunscreen Application.

When a viscous liquid is applied to a solid substrate, a patterned liquid layer is usually formed by the phenomenon called viscous fingering, since the moving liquid surface is in far-from-equilibrium conditions to let the morphological fluctuation to grow. Pseudosunscreen solutions were prepared and applied on a flat quartz plate. A spatially periodic stripe pattern was formed on the pseudosunscreen layer when a block applicator was used, whereas a flat surface layer was formed when a four-sided applicator was used. UV absorbance of the patterned layer was lower than that of the flat layer having the same average thickness. In addition, a larger decrease in the UV absorbance by the pattern formation was observed at wavelengths at which the UV absorbance of the flat layer was large, which was consistent with theoretical simulations. In 2011, US FDA introduced a new rule using the term "Broad Spectrum" for labeling the sunscreens. The different decrease in the UV absorbance at each wavelength was found to change the critical wavelength, which is a criterion for sunscreens to be labeled as "Broad Spectrum" protection. The result of this study makes the problem on the evaluation of the critical wavelength come to the surface.

Preparation of highly water-repellent surface by spontaneous formation of double scale roughness pattern.

Hydrophobic organic-inorganic hybrid composite suspensions were prepared by mixing hydrophobic octylsilyl titanium dioxide particles having average diameter of 35 nm with drying oil or moisture cure room temperature vulcanization silicone gum in volatile silicone. They were spread on a glass plate by using a linear motor coater and an applicator. Spatially periodic stripe patterns parallel to the direction of dragging the applicator were usually generated. The phenomenon is called directional viscous fingering, i.e. spontaneous pattern formation by the growth of fluctuation in morphology of mobile interface during the dragging coat. The pattern spontaneously formed on the surface became double scale when stored samples were coated. In this case, the large scale spatially periodic pattern was formed by the directional viscous fingering and the small ragged random pattern may be due to the giant molecules formed by cross-linking of silicone gum. Double scale roughness patterns were also generated by double dragging coat. The large and small scale pattern was formed by the first and second dragging coat, respectively. The formation of double scale roughness enhanced the water-repellent property of the hydrophobic surface. In some cases, water contact angle increased by 20 degrees to realize super water-repellent surface with a value exceeding 150 degrees.