Anti-A and anti-B titers, age, gender, biochemical parameters, and body mass index in Japanese blood donors.

It has been reported that anti-A and anti-B (ABO antibody) titers decrease with age, but little is known about the association between ABO antibody titers and physiologic/biochemical parameters such as body mass index (BMI), gamma-glutamyl transpeptidase (GGT), and total cholesterol (T-Cho). We investigated the present situation of ABO antibody titers among healthy blood donors in Japan and the physiologic/biochemical factors that may be associated with changes in ABO antibody titers. Plasma from 7450 Japanese blood donors was tested for ABO antibody titers using ABO reverse typing reagents by an automated microplate system; donor samples were classified into low, middle, and high titers according to the agglutination results obtained with diluted plasma samples. Multivariate regression analysis was performed to analyze the association between ABO antibody titers and age, gender, biochemical parameters (alanine transaminase [ALT], GGT, globulin, T-Cho, and glycosylated albumin [GA]), and BMI according to the ABO blood groups. A significant correlation between ABO antibody titers and age/gender, except for gender in anti-A of blood group B donors, was observed. BMI showed significant but negative correlations with anti-A and anti-B (ß = -0.085 and -0.062, respectively; p < 0.01) in blood group O donors. In addition, significant but negative correlations between GGT and T-Cho with anti-B of blood group A donors (ß = -0.055 and -0.047, respectively; p < 0.05) were observed. Although differences existed among the ABO blood groups, ABO antibody titers seem to be associated with physiologic and biochemical parameters of healthy individuals.

Association between forest and greenspace walking and stress-coping skills among workers of Tsukuba Science City, Japan: A cross-sectional study.

Objectives: Recently, "sense of coherence" (SOC) as a concept of stress-coping, has been gaining considerable attention. Although many studies have investigated the factors related to strong SOC, we found little evidence about the associations between SOC and habits that are easy to perform in everyday life. The aim our study was to examine the prevalence of workers who engage in forest walking and greenspace walking and examine their association with SOC score. Study design: A cross-sectional study. Methods: An anonymous, self-report web questionnaire was conducted in November 2017. The study population included 19481 workers belonging to the Tsukuba Science City Network and data of 6466 participants (3965 men and 2501 women) were analyzed. Results: The percentage of participants who engage in forest and greenspace walking at least once a year were 55.9% and 75.9%, respectively. Associations between forest/greenspace walking and SOC score were calculated using Chi-squared tests. Multinomial logistic regression analyses with SOC score group (strong/middle/weak) as a dependent variable and forest/greenspace walking as explanatory variables were performed. Statistically significant positive associations were observed between strong SOC and those who engaged in forest/greenspace walking after adjusting for socioeconomic factors. The odds ratios for strong SOC were 3.65 (95% CI â€‹= â€‹1.70-7.85) for forest walking at least once a week and 2.12 for greenspace walking (95% CI â€‹= â€‹1.54-2.92) at least once a week. Conclusions: Our findings suggested that forest/greenspace walking may enhance workers' stress-coping skills.

The effect of immunoadsorption therapy by a protein A column on patients with thrombocytopenia.

Immunoadsorption therapy employing protein A columns (PROSORBA columns) was used for the treatment of patients with naturally occurring or transfusion-induced immune thrombocytopenia purpura (ITP). Plasma from one unit of blood was perfused through the columns and returned to each patient. This procedure was performed once or twice weekly. In two cases of acute ITP, platelets markedly increased, and platelet-associated IgG (Pa-IgG) and circulating immune complexes (CIC) were decreased following the treatments. A transient increase in platelets was achieved in one patient with chronic ITP. Some improved response to platelet transfusions was noticed in one patient with aplastic anemia and platelet alloimmunization. Two mechanisms are suggested for the effect of protein A column therapy: one is the stimulation of the production of anti-idiotype antibody that neutralizes platelet auto-antibody and the other is activation of complement that induces solubilization and removal of CIC containing platelet autoantibodies. Immunoadsorption by protein A column is a useful therapy for some ITP cases, especially those that are acute.

Medium pH determines the differentiation of human promyelocytic leukemia cells to basophils or eosinophils by culturing in a protein- and serum-free medium.

Cells containing large basophilic granules in the cytoplasm appeared after culturing human promyelocytic leukemia cells (HL-60) in a protein- and serum-free alkaline medium. These granules were stained with toluidine blue and alcian blue. Cells were morphologically and cytochemically similar to basophils. The existence of histamine in the cell lysates was detected in both uninduced and alkaline medium-induced HL-60 cells. After culturing HL-60 cells in a protein- and serum-free acidic medium, cells containing eosin-stained small granules (eosinophils) appeared. The differentiation of HL-60 cells to basophils or eosinophils may therefore depend on medium pH by culturing in a protein- and serum-free medium.

Expression profiles of I and sialosyl-I antigens on blood cells: the sialosyl-I antigen is expressed along the monocytic differentiation.

Expression of I and sialosyl-I antigens was examined using specific monoclonal antibodies. The anti-I antibody C6 reacted with monocytes (24%), T cells (55%), B cells (80%) but not with neutrophils (4%), bone marrow (BM) CD34+ cells (2%) or mobilized peripheral blood (PB) CD34+ cells (1%). The anti-sialosyl-I antibody NUH2 reacted with monocytes (38%) and BM CD34+ cells (41%) but not with T cells (2%), B cells (0%) or neutrophils (1%) and it hardly reacted with mobilized PB CD34+ cells (8%). Flow cytometric analyses of CD34+ cells enriched from BM showed that most of the sialosyl-I cells expressed CD13, CD33, CD117, and HLA-DR. Sialosyl-I+ CD34+ cells isolated from BM produced a large number of granulocyte-macrophage colonies and macrophage colonies. Therefore, sialosyl-I+ CD34+ cells are suggested to be colony-forming units granulocyte-macrophage (CFU-GM) and colony-forming units macrophage (CFU-M). BM CD34+ cells cultured in medium containing cytokines produced I+ CD14+ monoblasts and sialosyl-I+ CD14+ monoblasts. Leukemic cells from patients with acute myeloid leukemia were I-negative (32/32) and sialosyl-I-positive (one/32). Leukemic cells from patients with acute lymphoid leukemia were I-positive (four/ten) and sialosyl-I-negative (ten/ten). These results indicate that (1) the I antigen is broadly expressed by monoblasts, monocytes, lymphocytes, and leukemic lymphoblasts, and (2) the sialosyl-I antigen is expressed along the normal differentiation of CFU-GM to monocytes.

Analysis of C-KIT, TIE and HTK expression on leukemic cells using flow cytometry: a preliminary report.

C-KIT, TIE and HKT expression on leukemic cells from patients were simultaneously analyzed using flow cytometry. Consistent with previous reports, leukemic cells from most patients with de novo acute myeloid leukemia (AML) were C-KIT-positive (28/35), while those from patients with B-lineage acute lymphoid leukemia (B-ALL) were C-KIT-negative (0/9). In the B-ALL patients, leukemic cells trom seven patients had one or more myeloid antigen such as CD13, CD15 and CD33. In contrast to C-KIT expression, leukemic cells from only one patient with acute monocytic leukemia were TIE-positive. Similarly, leukemic cells from only two patients (one, B-ALL with t(4;11)(q21;q23) and one, essential thrombocythemia in myeloblastic transformation (ET-MBT)) were HTK-positive. These results suggest that among the three receptor tyrosine kinases, C-KIT is the most useful marker for identifying AML.

Analysis of peripheral blood CD34+ cells mobilized with granulocyte colony-stimulating factor (G-CSF) using a long-term culture system.

G-CSF administered to healthy volunteers at a dose of 3 microg/kg for 5 days mobilized colony-forming units granulocyte-macrophage (CFU-GM), burst-forming units-erythroid (BFU-E), and long-term culture-initiating cells (LTC-IC) to a maximal level on day 4 or 5. To determine the number of primitive hematopoietic progenitors in the peripheral blood, mononuclear cells (MNCs) or CD34+ cells were cultured in a long-term culture (LTC) system. We defined the colonies produced by cells during LTC at week 2 as differentiated progenitors and those at week 5 as primitive progenitors. G-CSF administered to healthy volunteers increased the number of differentiated progenitors from day 4 and primitive progenitors on days 3-5. Enriched CD34+ cells from healthy volunteers treated with G-CSF (PB-G) or without it (PB-SS), and patients treated with chemotherapy plus G-CSF (PB-CG) were subjected to LTC for 7 weeks. PB CD34+ cells from PB-G contained less primitive progenitors than those from PB-CG. Therefore, in healthy donors administered G-CSF at a dose of 3 microg/kg, the number of PB CD34+ cells should be harvested as much as possible to perform allogeneic peripheral blood stem cell transplantation (PBSCT).

Cytomegalovirus pneumonitis, activated prothrombin time prolongation and subacute thyroiditis after unrelated allogeneic bone marrow transplantation.

A 22-year-old female with acute myeloid leukemia (AML) in complete remission received a conditioning regimen containing antithymocyte globulin for an unrelated bone marrow transplant (BMT). After BMT, the patient suffered from cytomegalovirus (CMV) pneumonitis with markedly high levels of CMV antigenemia, activated prothrombin time (APTT) prolongation, and subacute thyroiditis. Recovery of CD4+ cells was delayed as long as 1 year after BMT. An association between these three episodes and viral infection due to the delayed recovery of CD4+ cells is suggested.

Vitreous surgery simulator.

OBJECTIVE: To reduce the surgical risks to patients and expose surgeons to surgical experience and complications, we have developed a practical system of vitreous surgery using virtual-reality technology. METHODS: The system is composed of high-resolution color stereo binoculars, haptic devices, foot switches, and a high-speed graphics computer. To simulate vitreous surgery, we created several virtual patient eyes with retinal diseases such as preretinal membranes and subretinal neovascular tissue at the fovea. RESULTS: The simulator provided the trainees with an operating environment similar to an actual one, and allowed them to learn to maneuver surgical instruments and remove proliferative tissue on the retina, under the retina, or both. This system allowed surgeons to avoid iatrogenic complications through visual signs such as retinal hemorrhage when the instrument contacted the retinal surface. CONCLUSIONS: This simulator may not only be suitable for residents to learn ocular surgical techniques but may also allow veteran surgeons to develop new surgical methods and skills.

Long-term bone marrow failure accompanied by skin pigmentation.

A rare case of long-term bone marrow failure with skin pigmentation is presented. The patient was a female with a long history of anemia and skin pigmentation since childhood, although she had no malformations nor chromosomal abnormalities. Hematological improvement has been maintained by the administration of prednisolone. This case may differ from other disorders known as congenital aplastic anemia.

Second relapse of acute promyelocytic leukemia (ANLL-M3) with t(15;17) and t(1;3)(p36;q21).

We describe herein a patient with acute promyelocytic leukemia (APL)-(ANLL-M3) whose bone marrow cells in the second relapse showed t(1;3)(p36;q21) together with t(15;17) (q22;q11-q12). Although a total of 21 patients with t(1;3) have been reported so far, among which three cases with de novo acute nonlymphocytic leukemia were included, our patient is the first case with APL. The hematologic findings in our case confirmed the previous observations that this anomaly is associated with relatively high platelet count and the multi-myeloid lineage involvement of leukemic cells. Our patient responded well to chemotherapy and achieved first and second remission with 42 months of total survival, contrary to our expectation that patients with this anomaly have a poor prognosis.

Therapy-related leukemia with a novel 21q22 rearrangement.

We present a case of a 59-year-old Japanese man with therapy-related acute myeloblastic leukemia (AML) after the chemotherapy for non-Hodgkin's lymphoma (NHL). Accumulated doses of cyclophosphamide, procarbazine, doxorubicin, mitoxantrone, and etoposide were 18,300 mg, 3000 mg, 580 mg, 100 mg, and 4150 mg, respectively, which had been administered for the treatment of NHL. Myeloblasts in the peripheral blood increased 43 months after the onset of NHL. He was diagnosed as having AML (M2; FAB classification). The karyotype of the bone marrow cells in the present case contained the following abnormalities: t(2;21)(q21;q22), t(8;21)(q22;q22), and add(13)(q34). In the present case, 645 base pairs of chimeric mRNA were detected by reverse transcription-polymerase chain reaction, indicating the presence of AML1/MTG8 rearrangement. Translocation (2;21)(q21;q22) has not been described previously to our knowledge. It is interesting that the breakpoint of 21q22 existed both in t(2;21) and t(8;21). The disrupted AML1 gene resulting from two 21q22 rearrangements may be involved in the pathogenesis of AML in the present case. The clinical importance of therapy-related AML having the 21q22 rearrangement remains to be examined.

Expression of c-kit receptor (CD117) and CD34 in leukemic cells.

The expression of c-kit receptor (c-kit R; CD117) and CD34 was examined in acute myeloid leukemia (AML), acute lymphoid leukemia (ALL), chronic myeloid leukemia (CML) in blastic transformation (BT), and myelofibrosis (MF) in myeloid BT. In myeloid leukemia including AML, CML-myeloid BT and MF-myeloid BT, both c-kit R and CD34 were expressed synchronously, while in lymphoid leukemia including ALL and CML-lymphoid BT, only CD34 was highly expressed. A close correlation between c-kit R and CD33 expression and an inverse correlation between c-kit R and CD19 expression were observed when all of the myeloid plus lymphoid leukemia cells were analysed. There was a close correlation between c-kit R and CD34 expression in the myeloid leukemia cells. c-kit R expression may be associated with myeloid phenotypes of leukemic cells and may be useful for the diagnosis of myeloid leukemia. The literature of c-kit R expression in leukemic cells is reviewed here and the comparison of c-kit R and CD34 expression in normal hematopoietic progenitor cells with those on the leukemic counterparts was discussed.

Expression of sialosyl-T and disialosyl-T antigens in erythroid cells.

Expression of T, sialosyl-T and disialosyl-T antigens on normal blood and bone marrow cells as well as transformed cells was examined using specific monoclonal antibodies and multidimensional flow cytometry. Both anti-sialosyl-T (QSH1) and anti-disialosyl-T (QSH2) monoclonal antibodies aggregated erythrocytes. The anti-disialosyl-T antibody was specific for the erythroid lineage and did not react with neutrophils, monocytes or T-lymphocytes, while the anti-sialosyl-T antibody reacted with erythroid cells and a subset of T-lymphocytes. The developing erythroid cells in bone marrow showed coordinate expression of glycophorin A and the two carbohydrate chains, sialosyl-T and disialosyl-T. Analysis of neoplastic cells showed that the anti-disialosyl-T antibody only reacted with glycophorin A-positive blasts from erythroleukemia (FAB M6) patients (4/4) and one patient with chronic myeloid leukemia in erythroblastic transformation (CMLET). Leukemic blasts from these patients demonstrated coordinate quantitative expression of glycophorin A and disialosyl-T. The anti-sialosyl-T antibody reacted with glycophorin A-positive blasts from FAB M6 patients (4/4) and one CMLET patient; however, the antibody also reacted with glycophorin A-negative blasts from one FAB M6 and the one CMLET patients and transformed cells from other types of leukemia. The anti-T monoclonal antibody (HH8) did not react with any of the other cells tested. These results indicate that glycophorin A and disialosyl-T expression are tightly linked during normal erythroid development and erythroid leukemogenesis.

CAM-cytarabine, aclarubicin plus macrophage colony-stimulating factor in the treatment of acute myelogenous leukemia with trilineage dysplasia: usefulness of in vitro apoptosis in leukemic cells.

A 67-year-old woman was treated for acute myelogenous leukemia with trilineage dysplasia (AML-TLD) by combination chemotherapy with cytarabine, aclarubicin plus macrophage colony-stimulating factor (M-CSF) (referred to as CAM therapy). Complete remission was achieved after two courses of CAM therapy. After coculture of her bone marrow mononuclear cells with M-CSF in vitro, differentiation of leukemic cells into macrophages with apoptotis was observed. This case confirms an earlier report that an effect of M-CSF inducible by differentiation with apoptotic phenomena, against human leukemic cells was shown both in vitro and in vivo when achieving complete remission.

Autologous peripheral blood stem cell transplantation for adults with B-lineage acute lymphoblastic leukemia: a pilot study.

We conducted a pilot study on autologous peripheral blood stem cell transplantation (PBSCT) for 11 adults with B-lineage acute lymphoblastic leukemia (ALL) in first complete remission (CR) or even in those with more advanced stages. All patients achieved CR by induction therapy, of whom 10 were treated with anthracycline, vincristine and prednisolone-based regimens. After consolidation therapy, all patients except one received high-dose cytarabine followed by granulocyte colony-stimulating factor (G-CSF) administration to collect PBSCs. Ten patients received busulfan 4 mg/kg for 4 days, etoposide 20 mg/kg for 3 days and ranimustine 200 mg/m2 for 2 days as a conditioning regimen. One received a regimen consisting of etoposide, cyclophosphamide and total body irradiation. From day 1, G-CSF was given intravenously, and no additional chemotherapy was administered. At the median follow-up time of 30.8 months, four of six patients with standard-risk B-lineage ALL survived within the range of 19.7 to 85.4 months without relapse. In contrast, only one of five with high-risk B-lineage ALL survived for 36.3 months without relapse. Autologous PBSCT as post-remission therapy may prolong CR in adults with standard-risk B-lineage ALL.

B-cell lymphoma terminating in acute monoblastic leukemia.

A case of CD11b-, CD14- and CD36-positive B-cell lymphoma terminating in acute monoblastic leukemia is presented. The patient was initially suspected as having angiotrophic lymphoma due to proliferation of lymphoma cells within the sinusoid of the liver and clinical signs. Following chemotherapy, the lymphoma cells were converted into CD11b- and CD36-positive monoblasts. Lineage switching of B-cell lymphoma to acute monoblastic leukemia may have occurred in this case.