Superior outcome of infant acute myeloid leukemia with intensive chemotherapy: results of the Japan Infant Leukemia Study Group.

This study analyzed data on 35 infants with acute myeloid leukemia (AML) who were treated with intensive chemotherapy between 1995 and 1998 in Japan. The incidence of boys, younger age (< 6 months old), and hyperleukocytosis at onset was high in patients with the M4/M5 subtype (n = 23) in the French-American-British classification, compared with the non-M4/M5 subtype (n = 12). Thirteen (56%) and 16 (70%) patients with the M4/M5 subtype also showed 11q23 translocations and MLL gene rearrangements, respectively, whereas only one patient with the non-M4/M5 subtype had this rearrangement. All 35 patients were treated with the ANLL91 protocol consisting of etoposide, high-dose cytarabine, and anthracyclines. Overall survival and the event-free survival (EFS) rates at 3 years of all patients were 76% (95% confidence interval [CI], 61.3%-90.7%) and 72% (95% CI, 56.4%-87.9%), respectively. EFS showed no significant difference between 2 subgroups divided by age, gender, presence of the MLL gene rearrangements, and white blood cell count at onset; EFS in patients with the M4/M5 subtype tended to be better than those with the non-M4/M5 subtype. Although all 6 patients who underwent allogeneic stem cell transplantation (SCT) have been in complete remission, no benefit of SCT was confirmed. These findings suggest that the intensive chemotherapy with the ANLL91 protocol might have been responsible for the observed good outcome of infant AML, even without SCT. The presence of the MLL gene rearrangements or the age at onset had no impact on the outcome of infant AML.

[Nutritional consideration for changes in dietary habit and health promotion practices in community health care; from the view point of selenium].

The Japanese recommended dietary allowances (RDA) for major and some minor nutrients were revised in 1999, and included those for trace elements such as selenium. The requirement of selenium in animals was first recognized in 1957. It has been shown that cellular glutathione peroxidase (GPx) contains selenium but it was subsequently revealed that selenium has diverse biochemical effects, rather than simply functioning in the enzyme. At least twelve different selenoproteins have been identified. The role of selenium has been known as antioxidant, and non-antioxidant mediated through these enzymes. Now, selenium is well recognized as a preventive factor for cancer and cardiovascular diseases. Several dietary studies have shown that the selenium intake in Japan is adequate. One study estimated daily selenium intake to be 104.2 micrograms/day for adults. This value was 2 or 3 times higher than the lower limit of the safe range of dietary selenium (40 micrograms/day for men and 30 micrograms/day for women) estimated by WHO, and also exceeded the newly established RDA of 55-60 micrograms/day for men and 45 micrograms/day for women by the Japanese Public Health Council. However, the established RDA for selenium is tentative because of a lack of information on the 1) chemical forms of selenium in food, 2) differences in absorption rate and bio-availability in the chemical forms, and 3) interactions with other metals and trace elements. There are two potential problems concerning selenium nutrition in Japan. The first problem is that rice, which is the Japanese staple food, contains less than 0.05 microgram/g selenium whereas U.S. rice contains more than 0.3 microgram/g, probably due to differences in soil chemistry. The second problem is that although studies have shown that seafood, fish, shellfish and oysters, contain high levels of selenium (0.4-0.5 microgram/g), these being the main selenium source for Japanese, the bio-availability in fish is low. Thus, it is likely that the selenium status of those Japanese who eat an imbalanced diet is not sufficient or is not optimal even if the intake exceeds the RDA. Further studies are needed so that community health care specialists have available appropriate knowledge on the role of trace nutrients, including selenium, in human nutrition and health, to promote proper nutritional practices in the community.

Iron nutrition and anaemia in a malaria-endemic environment: haematological investigation of the Gidra-speaking population in lowland Papua New Guinea.

Blood examination was conducted for the four Gidra-speaking village groups in Papua New Guinea, who were characterized by high Fe intake and high malaria prevalence with marked inter-village differences. The northern riverine villagers, whose Fe intake was higher than the other three village groups, did not suffer from Fe-deficiency anaemia in their malaria-endemic environment; nor did the inland villagers, with their second highest Fe intake and their malaria-free environment, suffer from Fe-deficiency anaemia. However, several individuals of the southern riverine village suffered from anaemia in a malaria-endemic environment, although their Fe intake was almost the same as the inland villagers'. A considerable proportion of the coastal villagers were anaemic, reflecting the lowest Fe intake and the highest malaria prevalence. An inter-village comparison of the relationships between haemoglobin levels and transferrin saturation revealed that the southern riverine villagers needed smaller amounts of circulating Fe for erythropoiesis than the northern riverine and inland villagers, reflecting the long-term human-environment conditions such as the density of malaria vectors and the people's dietary habits. Fe supplementation was not judged effective against hypoferraemia and/or anaemia in such a population. As the incidence of malaria had no significant long-lasting effect on Fe stores or circulating Fe concentration, but did have an effect on anaemia, the hypothesis that malaria causes a transfer of Fe from the blood to parenchymal tissues as a defence against infectious diseases was not supported.

The hair-organ relationship in mercury concentration in contemporary Japanese.

The hair-organ relationship of mercury concentration was investigated in 46 autopsy samples in Tokyo, Japan. Hair mercury levels were highly significantly correlated with organ Hg levels in the cerebrum, cerebellum, heart, spleen, liver, kidney cortex, and kidney medulla, when the total mercury or methyl mercury value in the organ was compared with the hair total mercury or organic mercury, respectively. When the inorganic mercury value was tested, significant correlations remained, with weaker coefficients in all the organs but the spleen. Stepwise multiple regression analysis evidenced that the hair organic mercury value was the major explanatory variable for the organ total mercury or organ methyl mercury value in all the organs. To explain the organ inorganic mercury value, the hair organic mercury value was the major variable for the cerebrum and kidney (both cortex and medulla), the hair inorganic mercury value was the major variable for the cerebellum and heart, and the hair phosphorous and hair organic mercury were the major variables for the liver; no explanatory variable existed for the spleen. Auxiliary explanatory variables accounted for the organ total mercury and inorganic mercury levels, among which the hair selenium value was conspicuous with negative regression coefficients.

An acute mercuric mercury poisoning: chemical speciation of hair mercury shows a peak of inorganic mercury value.

A woman ingested a dose of sublimate (approximately 0.9 g) in an attempted suicide. She survived and recovered in response to a combination of therapies including chelate (BAL) therapy, plasma exchange, haemodialysis and peritoneal dialysis. Serum inorganic mercury concentration, urinary inorganic mercury excretion and hair inorganic and organic mercury and selenium concentrations, along the length from the scalp to the distal part, were measured. Longitudinal analysis of hair, revealed a peak in inorganic mercury corresponding to the time of mercury ingestion. Organic mercury and selenium in the hair had different patterns of longitudinal variation from that of inorganic mercury. The biological half-life (23.5 d) of serum inorganic mercury levels was in good agreement with values previously reported in the literature.

Development of the low impedance points in the auricular skin of experimental peritonitis rats.

Electrical impedance of the auricular skin was measured in experimental peritonitis rats. Constant voltage pulses (10ms, 4V) were applied to the skin, then the impedance was estimated. Low impedance points were gradually increased after the operation for 7-14 days then they returned to the control level. The pseudo-sweating responses accompanied by the development of peritonitis were also observed. Histological study could not find any sweat glands in the auricular skin. These results suggest that the activation of the sweat glands is not the major cause of the formation of the low impedance points. Other possibilities of these phenomena were discussed.

Minerals in plasma and urine and gustatory function tests for salt in a group of healthy young men.

Detection threshold for salt (NaCl) and discrimination between two levels of NaCl concentration (0.6 and 0.7%) in foods, and their relation to some selected biochemical parameters in plasma and urine (Zn, Na, K, Mg, Ca, Se for plasma and urine, Cu and retinol binding protein for plasma) were investigated in 15 healthy male college students. No subject failed to discriminate the NaCl concentrations in more than 50% of the tests. The rate of correct discrimination (RCD) was not associated with plasma Zn (P-Zn), plasma retinol binding protein (P-RBP), urinary potassium (U-K) or urinary sodium (U-Na), which significantly correlated with RCD in our previous study, while the detection threshold was significantly correlated with urinary Ca-Mg ratio (U-Ca/Mg), urinary Ca (U-Ca), U-Na, and urinary Mg. In the stepwise multiple regression analysis, U-Ca/Mg, plasma Ca, plasma Na, and RCD were selected as significant independent variables. These indicate that the status of minerals such as Na, Ca, and Mg is related to the gustatory function. One possible explanation for the discrepancy between the present and previous results is the elevated P-Zn and P-RBP levels in the present subjects.

[Spectral EEG analysis in children treated with high-dose methotrexate].

During the use of a therapeutic regimen of high-dose methotrexate (HD-MTX) with leucovorin rescue in two cases of osteogenic sarcoma and malignant lymphoma without central nervous system (CNS) involvement, serial EEG monitoring before and after MTX infusion was performed with special reference to occipital basic activity. The EEGs were analyzed as to the power average spectrum using an ATAC-450 (NIHON KOHDEN). At 48 hours after the initiation of MTX, there was a transient but statistically significant slowing, such as a drop in the dominant frequency and a decrease in the alpha/theta ratio. Complete recovery of EEG changes occurred within one week. No clinical symptoms suggestive of CNS impairment were noted in either case. These data suggest that EEG alterations might be a reflection of subclinical CNS impairment. Therefore, serial EEGs might be a good early indicator for the detection of leukoencephalopathy in high-risk patients.

[Anticancer drug sensitivity test using the short-term microplate culture and MTT dye reduction assay].

We have applied the MTT dye reduction assay to the anticancer drugs sensitivity test using short-term microplate cultures. The tumor cells were cultured with the anticancer drugs for 2 and 4 days. After culture, MTT dye was placed in each microwell and culture was carried out again for 4 more hours. The formazans generated by living cells were dissolved in acidified isopropyl alcohol and the absorbances of each well were measured at a wavelength of 540 nm. When tables of cytotoxicity indices classified into anticancer drugs, concentrations and durations of culture for each type of leukemic cell were made, it became possible to compare each drug and to select the effective ones. This assay is simple, precise, rapid, has no washing steps and is convenient for handling a large volume of material. We apply this assay in clinical practice.

Elemental composition of ancient Japanese bones.

Excavated bones (rib) obtained from 50 sites in Japan were measured by ICP atomic emission spectrometry and atomic absorption spectrometry for concentration of 19 elements, including Al, B, Ca, Cd, Cr, Co, Cu, Fe, K, Mg, Mn, Na, Ni, P, Pb, Sr, Ti, V and Zn. One hundred and forty-one specimens were classified into five groups according to Japanese prehistoric and historic eras (Jomon, Yayoi, Kofun, Kamakura and Muromachi, and Edo). The elements, with concentrations which showed no significant change with era were Al, B and Cr. Average concentrations of Ca were in the range 2-2.5 X 10(-1) g g-1 and those of P ranged from 1.1 to 1.3 X 10(-1) g g-1, indicating a well-preserved bone mineral matrix. The Ca/P ratio (mol/mol) was lowest in the Edo group--1.48 as compared with 1.54-1.66 in the other groups. Among the elements which showed changes with era were Pb, Fe, Co and Mn, all of which showed remarkably elevated concentrations in the Edo group. In addition to this unique elemental composition of Edo bones, samples from the Kofun era showed a completely different composition from those of other periods, i.e. they had the highest concentrations of Cd, Zn and Mg, and the lowest concentrations of Cu, K, Ni and Sr. The cause of the elevated Pb concentration in Edo bones is discussed in relation to human activities which may have led to environmental Pb pollution.

Mercury-selenium interaction in workers exposed to elemental mercury vapor.

Mercury (Hg) and selenium (Se) levels were determined for erythrocytes, plasma and urine of 25 male and 29 female workers exposed to elemental mercury (Hgo) vapor. Interrelationship between the Hg levels and the Se levels was examined by the correlational analysis and the stepwise regression analysis. Indicators of Se status (erythrocyte Se levels, plasma Se levels and urinary Se levels) were closely intercorrelated; similarly, indicators of exposure to Hgo vapor (erythrocyte inorganic Hg levels, plasma Hg levels and urinary Hg levels) were significantly intercorrelated. Since plasma Hg level was one of the significant independent variables in determining the erythrocyte Se and plasma Se levels, Hgo vapor exposure was thought likely to influence the Se metabolism in workers. None of the Se status indicators were significant as determinants of the indicators of Hgo vapor exposure.

Elemental contamination of Japanese women's hair from historical samples.

Japanese women's hair, which had been cut in the past and preserved was examined for the presence of 12 elements (Na, K, Mg, Ca, Sr, Mn, Fe, Cu, Zn, Hg, Pb and P). Elevated levels of Fe, Mn, Cu, Pb and Hg (inorganic mercury) were conspicuous in the samples cut in the period 1880-1929 and used as hair pieces (kamoji). The effects of washing on element concentration depended on both the method of washing and the type of element. The least effective was washing with acetone and water, compared with two other methods involving anionic or non-ionic surface active agents. The most resistant elements to washing were Pb, Hg, Cu and Zn. From the intercorrelation of element content and factor analysis, by examining the diminution of contents by washing and by comparing the detected levels with the values measured on contemporary Japanese women's hair, the contribution of exogenous contamination to hair levels was found to be very strong for Fe, Mn, Cu, Hg (inorganic mercury), and Pb, moderate for Na and Zn, and negligible for Ca, Mg, Sr, K, Hg (organic mercury), and P.

Toxic effects of selenodiglutathione on pregnant mice.

A single dose of selenodiglutathione (GSSeSG) or sodium selenite (SS) was injected i.v. into pregnant CD-1 mice on day 12 of gestation at dosages varying from 16.4-32.0 mumol/kg body weight. Dose-dependent elevation of maternal death rates was observed for both treatments, and the slope of the dose-response curve was significantly steeper following GSSeSG treatment. However, fetotoxic effects were not different between the treatments.