Psychosocial factors predicting symptoms of depression and anxiety in allogeneic hematopoietic stem cell transplant recipients in Japan.

OBJECTIVE: We explored whether a patient's psychosocial background before allogeneic hematopoietic stem cell transplantation (allo-HSCT) could predict the occurrence of psychiatric symptoms during treatment and after hospital discharge. METHOD: Logistic regression analysis was performed using INTERMED, a scale that comprehensively evaluates psychological factors such as psychiatric history, current mental status, and coping skills, and social factors such as social participation status, relationships with others, and living environment, which were used as independent variables. The Center for Epidemiologic Studies Depression Scale was used to measure depression, while the Profile of Mood States was used to measure anxiety and other symptoms. Both measures were used as dependent variables and were administered upon clean room admission, during clean room stay, at clean room discharge, and at 3, 6, and 12 months after hospital discharge. RESULTS: Participants included 70 patients (45 males and 25 females, mean age 53.3 ± 12.3 years). Thirty-eight patients participated in the program for the entire period, up to 12 months after hospital discharge. The total score on the Japanese version of the INTERMED and psychological factor scores assessed at baseline were significant predictors of depressed mood on discharge; however, there were no significant predictors of scores on the Profile of Mood States. CONCLUSIONS: A comprehensive pretransplant evaluation of psychosocial background can help predict the appearance of psychiatric symptoms after allo-HSCT. In patients who are expected to develop psychiatric symptoms after allo-HSCT, it is important to consider early intervention by a specialist and close monitoring by a medical team.

New Roles for Albumin/Globulin Ratio in the Early-Onset Hyperbilirubinemia among Infants Born Weighing 1,000 to 2,499 Grams.

INTRODUCTION: Early-onset hyperbilirubinemia (EOH) is a clinical issue for premature infants. We predicted that EOH management would be improved by fast results from common laboratory tests. Total serum bilirubin (TSB) level and the albumin/globulin ratio may contribute to improving the management of EOH. OBJECTIVE: The aim of the study is to examine the relationship between EOH and perinatal variables among infants born weighing 1,000 to 2,499 g. STUDY DESIGNS: A single center study was undertaken at Ohta Nishinouchi Hospital between April 1, 2016 and January 31, 2022, using blood samples prospectively collected from infants admitted to the neonatal intensive care unit that were assessed by univariate analyses and multivariate logistic regression analysis. Due to a correlation between gestational age (GA) and birth weight (BW), each variable was entered separately into Model 1 (including GA) and 2 (including BW). RESULTS: A total of 508 infants were analyzed (270 in the non EOH group and 238 in the EOH group). No infants experienced feto-maternal transfusion syndrome or hemolytic diseases such as blood type (ABO or Rh) incompatibility or glucose-6-phosphate dehydrogenase deficiency during perinatal period. Significant relationships were observed between EOH and BW (p <0.01, odds ratio [OR], 0.997; 95% confidence interval [CI], 0.996-0.997), albumin (p <0.01, OR, 0.278; 95% CI, 0.129-0.599), albumin/globulin ratio (p <0.01, OR, 2.695; 95% CI, 1.378-5.270), TSB (p <0.01, OR, 2.774; 95% CI, 1.795-4.287), and antenatal corticoid therapy (p = 0.02, OR, 1.852; 95% CI, 1.108-3.097) in Model 2. Per receiver operating characteristic curves, an albumin/globulin ratio of 1.84 could predict EOH at a sensitivity of 50.0% and specificity of 75.6% (AUC = 0.652, p <0.01, 95% CI, 0.603-0.700). CONCLUSION: Albumin/globulin ratio among infants born weighing 1,000 to 2,499 g may be a useful indicator of EOH. KEY POINTS: · Early-onset hyperbilirubinemia (EOH) is a clinical issue for premature infants.. · EOH management expected to be improved through the use of common laboratory tests.. · Albumin/globulin ratio among low birth weight infants may be a useful indicator of EOH..

Effect of gestational weight gain on placental weight: A single tertiary referral center study of Japanese women.

AIM: The effect of gestational weight gain on placental weight has not been elucidated. We aimed to examine the effect of body weight gain during pregnancy on the Japanese standardized z-score of placental weight, based on the pre-pregnancy body mass index. METHODS: This retrospective cohort study included Japanese women with singleton pregnancies who gave birth during 2013-2019 at Ohta Nishinouchi Hospital. Participants (n = 3610) were categorized by their pre-pregnancy body mass index: G1 (<18.5 kg/m2 ), G2 (18.5 to <20.0 kg/m2 ), G3 (20.0 to <23.0 kg/m2 ), G4 (23.0 to <25.0 kg/m2 ), and G5 (≥25.0 kg/m2 ). Multiple linear regression analysis was used to identify associations between insufficient or excessive gestational weight gain in each body mass index category and z-score of placental weight, with adjustments for maternal age, assisted reproductive technology, and maternal pre-pregnancy conditions, such as hypertension, diabetes mellitus, myoma uteri, and uterine anomalies. RESULTS: Among the 3610 women assessed, 479, 692, 1292, 435, and 711 were in G1-G5, respectively. In G1, G3, and G4, excessive weight gain increased the placental weight z-score ([B: 0.50, 95% confidence interval [CI]: 0.23-0.76], [B: 0.19, 95% CI: 0.19-0.33], and [B: 0.18, 95% CI: 0.10-0.26]). Insufficient weight gain decreased the placental weight z-score in G3 (B: -0.19, 95% CI: -0.33 to -0.06) and G4 (B: -0.21, 95% CI: -0.29 to -0.13) women. CONCLUSION: The effect of weight gain during pregnancy on placental size varies by pre-pregnancy body mass index. This result may guide personalized pre-conception counseling to improve the outcomes of offspring.

Rate Constants for Reactions of HCCO and HCCCO Radicals with O2 over the Temperature Range 243-423 K.

A pulsed laser photolysis-photoionization mass spectrometer system has been employed to measure the rate constants of HCCO + O2 and HCCCO + O2 over the temperature range 243-423 K in 1.2-8.4 Torr of He or N2. Radicals of HCCO and HCCCO were produced by 193 nm ArF laser photolysis of ethyl ethynyl ether and methyl propiolate, respectively. HCCO was photoionized by a Kr resonance lamp with a CaF2 window (10.03 eV), and HCCCO was ionized by a Xe lamp with a sapphire window (8.44 eV). Both ions were detected as parent ions in a quadrupole mass spectrometer. From analysis of the time profiles of the ion signals for various O2 concentrations, the overall rate constants at 298 K are represented by the values k2 = (6.3 ± 1.0) × 10-13 for HCCO + O2 and k5 = (5.7 ± 0.6) × 10-12 for HCCCO + O2 in the units cm3 molecule-1 s-1. The rate coefficients for the two reactions can be described by k2(T) = (1.5-0.7+1.5) × 10-12 exp[-(225 ± 220)/T] and k5(T) = (1.8-0.9+1.9) × 10-12 exp[(343 ± 228)/T] in the units cm3 molecule-1 s-1 over the temperature range 243-423 K.

Laser-induced fluorescence of the trans-CHBrCHO radical.

A new laser-induced fluorescence spectrum was observed in the region of 350 nm-360 nm. The spectrum was observed in the reaction between the CHBrCHBr and OH radicals and in the reaction of CHBrCHBr and CH2CHBr with atomic oxygen O(3P). The spectrum was assigned to the B̃--X̃ transition of the trans-CHBrCHO (trans-2-bromovinoxy) radical. The B̃--X̃ electronic transition energy (T0) was 28 542 cm-1, which was 242 cm-1 lower than that of the unsubstituted vinoxy radical (CH2CHO). From an analysis of the laser-induced single vibronic level fluorescence aided by ab initio calculations, some of the vibrational frequencies were assigned to the ground electronic state ν3 (C-O str.) = 1581 cm-1, ν6 (C-C str.) = 1130 cm-1, and ν8 (C-C-O bend.) = 409 cm-1. The fluorescence lifetimes of the excited B̃ state were 35 ns-75 ns, depending on the excited vibrational modes, implying that predissociation had accelerated as the energy level (v') increased.

Effect of Oxidation Process on Complex Refractive Index of Secondary Organic Aerosol Generated from Isoprene.

Oxidation of isoprene by hydroxyl radical (OH), ozone (O3), or nitrate radical (NO3) leads to the formation of secondary organic aerosol (SOA) in the atmosphere. This SOA contributes to the radiation balance by scattering and absorbing solar radiation. In this study, the effect of oxidation processes on the wavelength-dependent complex refractive index (RI) of SOA generated from isoprene was examined. Oxidation conditions did not have a large effect on magnitude and wavelength dependence of the real part of the RI. In the case of SOA generated in the presence of sulfur dioxide (SO2), significant light absorption at short visible and ultraviolet wavelengths with the imaginary part of the RI, up to 0.011 at 375 nm, was observed during oxidation with OH. However, smaller and negligible values were observed during oxidation with O3 and NO3, respectively. Moreover, in the absence of SO2, light absorption was not observed regardless of the oxidation process. There was an empirical correlation between the imaginary part of the RI and the average degree of unsaturation of organic molecules. The results obtained herein demonstrate that oxidation processes should be considered for estimating the radiative effect of isoprene-derived SOA.

Large Deviations of a Tracer in the Symmetric Exclusion Process.

The one-dimensional symmetric exclusion process, the simplest interacting particle process, is a lattice gas made of particles that hop symmetrically on a discrete line respecting hard-core exclusion. The system is prepared on the infinite lattice with a step initial profile with average densities ρ_{+} and ρ_{-} on the right and on the left of the origin. When ρ_{+}=ρ_{-}, the gas is at equilibrium and undergoes stationary fluctuations. When these densities are unequal, the gas is out of equilibrium and will remain so forever. A tracer, or a tagged particle, is initially located at the boundary between the two domains; its position X_{t} is a random observable in time that carries information on the nonequilibrium dynamics of the whole system. We derive an exact formula for the cumulant generating function and the large deviation function of X_{t} in the long-time limit and deduce the full statistical properties of the tracer's position. The equilibrium fluctuations of the tracer's position, when the density is uniform, are obtained as an important special case.

The Microbiome of the Lower Respiratory Tract in Premature Infants with and without Severe Bronchopulmonary Dysplasia.

Aim We determined whether the bacteria in the lower respiratory tract (LRT) in extremely premature infants with severe bronchopulmonary dysplasia (BPD) are different from those with nonsevere BPD. Study Design We conducted a retrospective study of extremely premature infants who were admitted to the neonatal intensive care unit of Fukushima Medical University Hospital, Japan between April 2005 and March 2014. We screened for the bacterial colonization of the LRT using tracheobronchial aspirate fluid. Results A total of 169 extremely premature infants were included. Overall, 102 did not experience severe BPD, whereas the remaining 67 experienced severe BPD. Corynebacterium species (Cs) were more frequently detected in the severe BPD than nonsevere BPD infants (p = 0.03). There were significant differences between infants with and without severe BPD in the duration of endotracheal ventilation (p = 0.00, odds ratio [OR], 1.03; 95% confidence interval [CI], 1.01-1.06), the duration of supplemental oxygen (p = 0.00, OR, 1.02; 95% CI, 1.01-1.03) before 36 weeks of postmenstrual age, and the frequency of sepsis after 7 postnatal days (p = 0.01, OR, 1.73; 95% CI, 1.18-2.54). Conclusion Cs are more likely to be present in the severe BPD infants with longer duration of endotracheal ventilation.

Volumetric Analysis of Gallbladder in Extremely Premature Infants.

BACKGROUND: We hypothesized that gallbladder (GB) volume is affected by serial changes during the early infancy period in extremely premature infants. METHODS: We conducted a prospective study of extremely premature infants admitted to the neonatal intensive care unit of Fukushima Medical University Hospital, Fukushima City, Japan between January 2014 and December 2015. GB volume was measured by an abdominal ultrasound ellipsoid method between Day 0 and Day 56 after birth within 60 minutes before enteral feeding. We calculated GB volume (mL)/weight (kg), which was evaluated as GV/W. RESULTS: Intotal, 30 infants were included. Themediangestationalageoftheinfantswas 26 weeks 5 days (range, 23 weeks 1 day-28 weeks 6 days), and the median birth weight was 731 g (range, 398-1220 g). The detection rate of GB decreased in the infants over time; the rates were > 93% between Day 0 and Day 7 and < 77% between Day 10 and Day 56 after birth. GV/W decreased in the infants over time. The median GV/W values were 0.18 (range, 0.05 -0.59) in infants on admission and constantly < 0.05 in those between Day 10 and Day 56 after birth. There was no correlation of GV/W with clinical variables after birth. CONCLUSION: It is considered that GB volume is not affected by serial changes without nonfavor-able course of enteral nutrition.

Plasma TGF-ß1 Levels Are Elevated in Down Syndrome Infants with Transient Abnormal Myelopoiesis.

Infants with Down syndrome (DS) are at risk of developing a transient myeloproliferative disorder during the neonatal period, known as transient abnormal myelopoiesis (TAM). It is characterized by clonal myeloproliferation and is typically self-limiting. However, TAM can be a life-threatening disorder, when complicated by liver fibrosis. Here, we evaluated cytokine profiles in two male DS infants having TAM with or without liver dysfunction. The first patient, Patient 1, had hyperleukocytosis with cholestatic liver dysfunction, coagulopathy, and increased counts of blasts and was treated with exchange transfusion (ExT) due to the serious general condition. In Patient 1, serum interleukin (IL)-8 and plasma transforming growth factor (TGF)-ß1 levels were markedly elevated before ExT (1,518.2 pg/mL and 17,635 pg/mL, respectively). After ExT, serum IL-8 and plasma TGF-ß1 levels decreased to 40.7 pg/mL and 6,847 pg/mL, respectively. However, Patient 1 died on day 56 due to cholestatic liver dysfunction; namely, this patient represents fatal TAM. The second patient, Patient 2, had hyperleukocytosis with increased counts of blasts without liver dysfunction and was treated with cytarabine. In Patient 2, plasma TGF-ß1 levels, but not plasma IL-8, were elevated (9,068 pg/mL and 28 pg/mL, respectively). Patient 2 was discharged on day 47. In summary, plasma TGF-ß1 levels were elevated in the two DS infants with TAM, regardless of the presence or absence of hepatic fibrosis. Importantly, fatal TAM is assoicated with the elevated serum level of IL-8. We thus propose that IL-8 may be involved in the pathogenesis of liver fibrosis.

Effects of human herpesvirus 6B reactivation on cognitive function in cord blood transplant recipients: a prospective multicenter study.

This prospective multicenter study aimed to determine the effects of human herpesvirus-6B (HHV-6B) reactivation on central nervous system (CNS) function in cord blood transplant (CBT) recipients. Our focus was to track HHV-6B reactivation and evaluate its association with delirium and cognitive function, specifically in the domains of verbal memory, attention/processing speed, and quality of life (QOL). A cohort of 38 patients participated in this study. Of the 37 patients evaluated, seven (18.9%) developed delirium, with six of these cases emerging after HHV-6B reactivation (median lag, 7 days). Evaluation of verbal memory showed that the final trial score for unrelated words at 70 days after transplantation was significantly lower than that before preconditioning (P = 0.004) among patients (n = 15) who experienced higher-level HHV-6B reactivation (median or higher maximum plasma HHV-6 DNA load for participating patients). Patients without higher-level reactivation did not show significant declines in verbal memory scores. QOL was assessed using the 36-item Short-Form Health Survey, and the social functioning score 1 year post-transplantation was significantly lower in patients who experienced higher-level HHV-6B reactivation than in those who did not. Our findings suggest that higher-level HHV-6B reactivation can detrimentally affect certain cognitive functions in CBT recipients.

Glucocorticoid receptor expression in whole blood with preterm infants.

BACKGROUND: Although glucocorticoid hormones play important roles in fetal development, the expression of their receptors in the whole blood of preterm infants remains unknown. OBJECTIVES: The aim of this study was to investigate the levels of glucocorticoid receptor (GR) α and ß in the whole blood of preterm and term infants. STUDY DESIGN: The study group consisted of 131 infants, of which 54 (41%) were preterm. Whole blood from preterm and term infants was analyzed by real-time PCR to monitor the levels of each receptor mRNA. RESULTS: GRß mRNA were detected in 96.6% and GRα mRNA in 100% of participants. The GRα and GRß isoforms were detected at a ratio of 1:0.0002. GRß mRNA/GAPDH expression in preterm infants was significantly higher than that in term infants (p=0.002). There was significant correlation between GRα/GRß ratio and birth weight in preterm infants (rs=0.317, p=0.019), as well as between GRß/GAPDH expression and birth weight (rs=-0.296, p=0.030). Furthermore, in preterm infants, GRß/GAPDH expression was higher in those with SGA than in those without SGA (p=0.022). CONCLUSION: Importantly, in preterm infants, both the expression of GRß and the GRα/GRß ratio were associated with birth weight. Further studies with larger populations are necessary to determine the relation between the expression of GR and the clinical relevance of preterm infants.

Continuous hemodialysis therapy for an extremely low-birthweight infant with hyperammonemia.

Hyperammonemia of newborns should be treated promptly, and the outcome depends on the rapid elimination of excessive plasma ammonia. We encountered a case of transient hyperammonemia in an extremely low-birthweight infant whose plasma ammonia decreased sufficiently after continuous hemodialysis therapy. It seems that continuous hemodialysis therapy using the peripheral artery and umbilical vein is useful for hyperammonemia of extremely low-birthweight infants; however, there are several problems to consider due to the immaturity of these infants.

[A case of long remission for about 5 years as an outpatient with second-line chemotherapy of weekly PTX after palliative distal gastrectomy for pStage IV advanced gastric cancer].

A 59-year-old man underwent palliative distal gastrectomy for Stage IV advanced gastric cancer with cytological and histopathological peritoneal dissemination. After surgery, he began to receive chemotherapy by S-1 oral administration as an outpatient. About one year and 9 months after surgery, cartinomatous peritonitis grew, and severe obstruction of gastrojejunostomy and dilatation of residual stomach were detected by CT tomography. Then, second-line chemotherapy by weekly paclitaxel(PTX)was started. After one course of weekly PTX was completed, he was feeling better gradually with obvious improvement of carcinomatous peritonitis, which was revealed by sequential CT tomography examinations. Weekly PTX chemotherapy has been continued successfully for 43 courses, and he remains alive today with a good QOL, about 5 years after surgery. He is an outpatient with only a grade 2 or less complication of peripheral neuropathy.

A novel real-time PCR method for determination and quantification of each cytomegalovirus glycoprotein H subtype in clinical samples.

To investigate reinfection in patients with congenital cytomegalovirus (CMV) infection, we established a CMV subtype-specific real-time quantitative PCR method targeting the CMV gH epitope region that can be used for evaluating pathogenic CMV strains in cases of mixed CMV infection.

Exact solution for the stationary Kardar-Parisi-Zhang equation.

We obtain the first exact solution for the stationary one-dimensional Kardar-Parisi-Zhang equation. A formula for the distribution of the height is given in terms of a Fredholm determinant, which is valid for any finite time t. The expression is explicit and compact enough so that it can be evaluated numerically. Furthermore, by extending the same scheme, we find an exact formula for the stationary two-point correlation function.

Kinetic study of the daytime atmospheric fate of (Z)-3-hexenal.

Rate coefficients for three daytime atmospheric reactions of (Z)-3-hexenal (3HA)-photolysis (J(1)), reaction with OH radicals (k(2)), and reaction with ozone (k(3))-were measured at 760 Torr and 298 K using a 6 m(3) photochemical reaction chamber. The UV absorption cross sections (σ(3HA)(λ)) were obtained in the wavelength range 240-350 nm. The photodissociation rate of 3HA relative to that of NO(2) was measured by a solar simulator at 760 Torr and was determined to be J(1)/J(NO2) = (4.7 ± 0.4) × 10(-3). Using the obtained σ(3HA)(λ) and J(1)/J(NO2), the effective photodissociation quantum yield was calculated to be Φ(3HA) = 0.25 ± 0.06. The rate coefficient for the reaction with OH radicals was measured by the relative rate method with three reference compounds and was determined to be k(2) = (6.9 ± 0.9) × 10(-11) cm(3) molecule(-1) s(-1). The rate coefficient for the reaction with ozone was measured by an absolute method and was determined to be k(3) = (3.5 ± 0.2) × 10(-17) cm(3) molecule(-1) s(-1). Using the obtained rate coefficients, the daytime atmospheric lifetime of 3HA was estimated.

Development of an enzyme-linked immunosorbent assay for the measurement of antibodies against infectious coryza vaccine.

Infectious coryza is an acute respiratory disease caused by infection with Avibacterium (Haemophilus) paragallinarum. It is characterized by nasal discharge and facial swelling and is associated with growth retardation and a reduction in egg production. Hemagglutination inhibition (HI) tests are used to estimate vaccine-induced immunity against infectious coryza in vitro; however, these procedures are complicated and their sensitivity is insufficient. To address these problems, an enzyme-linked immunosorbent assay (ELISA) technique using serovar-specific regions of HMTp210 (210 kDa), an outer-membrane protein of A. paragallinarum, was developed to measure the antibodies against infectious coryza. Chickens with an ELISA titer of 0.3 or more did not exhibit clinical signs of infectious coryza against challenge with A. paragallinarum, although their HI antibody titers were negative. On the other hand, chickens with an ELISA titer below 0.3 exhibited clinical signs of the disease with one exception. Antibody prevalence rates on ELISA were 80% and 60% against infection with serovars A and C, respectively, and ELISA also detected antibodies in chickens infected with A. paragallinarum with a sensitivity higher than that of HI tests. Taken together, the ELISA technique developed in this study is a valuable tool for the measurement of antibodies produced against the infectious coryza vaccine or in response to an infection with A. paragallinarum.

Successful prospective management of neonatal citrullinemia.

Classical citrullinemia generally involves hyperammonemic coma in the first few days of life and leads to neurological sequelae in survivors. We report a case of an elder sister who fell into a hyperammonemic coma on the fifth day after birth. She was successfully treated with intravenous benzoate and hemodialysis, and was subsequently diagnosed with citrullinemia on the basis of biochemical analysis. Two years later, a younger sister was born without prenatal diagnosis. We monitored plasma ammonia and citrulline levels after birth, and again diagnosed her with CTLN1 on the basis of biochemical and DNA analyses. There have been few reports of the prospective treatment of citrullinemia; however, our experience indicates the need for the prospective management and the rapid reduction of ammonia levels to avoid neonatal hyperammonemic coma and subsequent sequelae.