RESUMEN
Vascular Ehlers-Danlos syndrome (vEDS) is a hereditary connective tissue disorder (HCTD) characterized by arterial dissection/aneurysm/rupture, sigmoid colon rupture, or uterine rupture. Diagnosis is confirmed by detecting heterozygous variants in COL3A1. This is the largest Asian case series and the first to apply an amplification-based next-generation sequencing through custom panels of causative genes for HCTDs, including a specific method of evaluating copy number variations. Among 429 patients with suspected HCTDs analyzed, 101 were suspected to have vEDS, and 33 of them (32.4%) were found to have COL3A1 variants. Two patients with a clinical diagnosis of Loeys-Dietz syndrome and/or familial thoracic aortic aneurysm and dissection were also found to have COL3A1 variants. Twenty cases (57.1%) had missense variants leading to glycine (Gly) substitutions in the triple helical domain, one (2.9%) had a missense variant leading to non-Gly substitution in this domain, eight (22.9%) had splice site alterations, three (8.6%) had nonsense variants, two (5.7%) had in-frame deletions, and one (2.9%) had a multi-exon deletion, including two deceased patients analyzed with formalin-fixed and paraffin-embedded samples. This is a clinically useful system to detect a wide spectrum of variants from various types of samples.
Asunto(s)
Síndrome de Ehlers-Danlos Tipo IV , Síndrome de Ehlers-Danlos , Embarazo , Femenino , Humanos , Síndrome de Ehlers-Danlos/diagnóstico , Síndrome de Ehlers-Danlos/genética , Colágeno Tipo III/genética , Variaciones en el Número de Copia de ADN , Pruebas GenéticasRESUMEN
We report here rare cases of discordant lymphoma consisting of MALT lymphoma and follicular lymphoma. Case 1: A 53-year-old woman was diagnosed with MALT lymphoma of the left parotid gland and follicular lymphoma of the duodenum and small intestine. Case 2: A 38-year-old woman was diagnosed with MALT lymphoma of the intestine and follicular lymphoma of the duodenum and bone marrow. Recently, it has been suggested that duodenal follicular lymphoma has intermediate characteristics of nodal follicular lymphoma and MALT lymphoma. It is interesting that both of these cases demonstrated duodenal follicular lymphoma. These cases suggest that MALT lymphoma and duodenal follicular lymphoma share some common pathological condition.
Asunto(s)
Neoplasias de la Médula Ósea/patología , Neoplasias Duodenales/patología , Neoplasias Intestinales/patología , Intestino Delgado , Linfoma de Células B de la Zona Marginal/patología , Linfoma Folicular/patología , Neoplasias Primarias Múltiples , Neoplasias de la Parótida/patología , Adulto , Femenino , Humanos , Persona de Mediana EdadRESUMEN
The electron-doped SrTiO3 exhibits good thermoelectric properties, which makes this material a promising candidate of an n-type oxide thermoelectric device. Recent studies indicated that only a few percent co-doping of La and Mn in SrTiO3 substantially reduces the thermal conductivity, thereby greatly improving the thermoelectric figure of merit at room temperature. Our time-of-flight neutron scattering studies revealed that by doping both La and Mn into SrTiO3, the inelastic scattering spectrum shows a momentum-independent increase in the low-energy spectral weight approximately below 10 meV. The increase in the low-energy spectral weight exhibits a clear correlation with thermal conductivity. The correlation is attributed to dynamical and local structural fluctuations caused by the Jahn-Teller instability in Mn3+ ions coupled with the incipient ferroelectric nature of SrTiO3, as the origin of the low thermal conductivity.
RESUMEN
A 74-year-old man was diagnosed as having Sézary syndrome in 1999. Treatment with combination chemotherapy could not completely control both the erythroderma and Sézary cells. However, treatment with oral administration of etoposide was able to maintain the patient in a good condition for about 4 years. In June 2004, he developed topoisomerase II inhibitor-related acute promyelocytic leukemia. Chromosomal analysis demonstrated abnormalities of t(1;10) (q21;q26) and t(15;17) (q22;q12) in 17 of 20 cells. Despite treatment with ATRA and combination chemotherapy, the patient died of brain hemorrhage.
Asunto(s)
Antineoplásicos Fitogénicos/efectos adversos , Etopósido/efectos adversos , Leucemia Promielocítica Aguda/inducido químicamente , Inhibidores de la Síntesis del Ácido Nucleico/efectos adversos , Síndrome de Sézary/complicaciones , Neoplasias Cutáneas/complicaciones , Anciano , Humanos , Masculino , Síndrome de Sézary/tratamiento farmacológico , Neoplasias Cutáneas/tratamiento farmacológicoRESUMEN
In our experience with thalidomide treatment for refractory multiple myeloma (MM), most patients with progressive disease (PD) did not show an increase in M-protein despite the tumor burden of myeloma cells. This finding led us to suspect that proliferation of immature myeloma cells showing MPC-1(-)/CD49e(-) phenotype may be a sign of PD. We report the results of consecutive analysis of the phenotype of myeloma (plasma) cells in an MM patient with PD during treatment with thalidomide. The myeloma cells decreased by thalidomide therapy were mature (MPC-1(+)/CD49e(+)) and intermediate (MPC-1(+)/CD49e(-)) types. When the patient was in the PD state, extramedullary plasmacytoma was recognized without proliferation of myeloma cells in the bone marrow (BM). The phenotype of myeloma (plasma) cells in both of these locations was that of immature myeloma cells (MPC-1(-)/CD49e(-)), and they showed decreased intensity of CD38 expression. The level of immunoglobulin G (IgG) in serum was decreased, and myeloma (plasma) cells in BM did not increase in PD. Although these clinical features may not be specific to MM patients in PD undergoing treatment with thalidomide, we suggest that immature myeloma cells may be resistant to thalidomide.
Asunto(s)
Resistencia a Medicamentos , Mieloma Múltiple/tratamiento farmacológico , Mieloma Múltiple/patología , Células Plasmáticas/patología , Talidomida/uso terapéutico , Anciano , División Celular , Progresión de la Enfermedad , Humanos , Integrina alfa5/análisis , Masculino , Proteínas de Neoplasias/análisis , Fenotipo , Insuficiencia del TratamientoRESUMEN
A 13-year-old male was diagnosed as having pineal germinoma in July 1998. Since then, he had been treated with tumor excision, radiation and chemotherapy. In June 2002, he was diagnosed as having the chronic phase of chronic myelogenous leukemia (CML), and following treatment with interferon-alpha, he achieved hematological complete remission. Although CML is rare in secondary leukemia, the present case seemed therapy-related CML because of its clinical course, as the CML occurred after the period with radiation and chemotherapy. This is the first case of secondary CML following therapy for intracranial tumors.
Asunto(s)
Germinoma/terapia , Leucemia Mielógena Crónica BCR-ABL Positiva/etiología , Neoplasias Primarias Secundarias , Pinealoma/terapia , Adolescente , Antineoplásicos/uso terapéutico , Terapia Combinada , Humanos , Hidroxiurea/uso terapéutico , Interferón-alfa/uso terapéutico , Leucemia Mielógena Crónica BCR-ABL Positiva/terapia , Masculino , Inducción de RemisiónRESUMEN
Thalidomide as a single agent (200-400 mg/day) was administered in fourteen cases of refractory myeloma, from March 2001 till February 2002. The median age was 71 years (range 58 to 85 years), and the efficacy of thalidomide was observed in cases receiving treatment for at least three consecutive months. Response was evaluated in February 2002, according to the criteria for assessment of response described by Kakimoto et al. At the time of evaluation, two cases were in the PR2 state, one in PR3, two were stable, and three were PD. Evaluation of the response was not possible in six cases in whom treatment had to be discontinued due to intolerable side effects. The response to thalidomide was variable, with some cases responding well even to a low dose (200 mg/day) while a few others showed an early relapse due to the refractory nature of the disease in its response to the drug. The efficacy of treatment seemed to be correlated with the maturation pattern of myeloma cells. Side effects included neurological complications like somnolence, physiological symptoms such as constipation and so on, etc but all were relieved with symptomatic treatment. The drug was well tolerated in geriatric patients. Neutropenia was a dose limiting factor with half of the cases (7/14) presenting with severe neutropenia (grade 3-4), but a response was observed in all of them on administration of G-CSF. Thromboembolism occurred in two cases, the cause of which is not clear. These results suggest that thalidomide is a well tolerated drug and can be considered as a mainstay in the therapy of refractory myeloma.
Asunto(s)
Mieloma Múltiple/tratamiento farmacológico , Talidomida/administración & dosificación , Anciano , Anciano de 80 o más Años , Estreñimiento/inducido químicamente , Progresión de la Enfermedad , Trastornos de Somnolencia Excesiva/inducido químicamente , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neutropenia/inducido químicamente , Talidomida/efectos adversos , Resultado del TratamientoRESUMEN
In an attempt to determine the pathological significance of a long arm deletion of chromosome 13 (13q-) in bone marrow failure syndrome, we reviewed the clinical records of nine patients who were initially diagnosed with aplastic anaemia due to bone marrow hypoplasia without dysplasia. Six patients responded to immunosuppressive therapy and the other three improved with steroids. None of the patients developed acute leukaemia (follow up: 54-129 months) and the estimated 5-year survival was 78%. These findings indicate that pancytopenia with 13q- represents bone marrow failure of a benign nature, similar to aplastic anaemia without karyotypic abnormalities, rather than preleukaemia.