ABSTRACT
OBJECTIVE: Steroid pulse therapy is used to relieve pancytopenias in our hospital and is effective in some patients. However, it is unclear which patients will benefit from such therapy. Thus, we retrospectively analyzed the clinical features of patients undergoing allogeneic hematopoietic stem cell transplantation who received steroid pulse therapy to facilitate recovery in their blood cell counts. METHODS: Between 2004 and 2012, 24 patients underwent steroid pulse therapy and the medical records of 17 of these evaluable patients (11 men, 6 women) were retrospectively reviewed. Bone marrow smears were assessed to calculate the proportion of hemophagocytic macrophages just prior to receiving pulse therapy. RESULTS: Steroid pulse therapy was started at a median of 15 days after transplantation (range, 10-28 days). The median white blood cell count was 0.02×10(3)/µL (range, 0.01-0.4×10(3)/µL). Eight patients responded to pulse therapy and subsequent engraftment was achieved in all responders. None of the patients who underwent cord blood transplantation responded to the pulse therapy. Among the non-responders, only two patients achieved engraftment and four of nine non-responders died within one month. When evaluating the efficacy of steroid pulse therapy according to the ferritin level and proportion of hemophagocytic macrophages among patients undergoing bone marrow or peripheral blood stem cell transplantation, both values were higher in responders than in non-responders. CONCLUSION: We speculate that responders have a hemophagocytic syndrome which is responsive to steroid pulse therapy. Thus, our results imply that the use of ferritin levels in combination with the proportion of hemophagocytic macrophages may be useful for the early detection of potential hemophagocytic syndrome after hematopoietic stem cell transplantation.
Subject(s)
Blood Cells/immunology , Glucocorticoids/administration & dosage , Hematopoietic Stem Cell Transplantation/methods , Pancytopenia/therapy , Adult , Aged , Blood Cell Count , Female , Humans , Male , Middle Aged , Pancytopenia/immunology , Peripheral Blood Stem Cell Transplantation/methods , Pulse Therapy, Drug , Retrospective StudiesABSTRACT
The purpose of this study was to investigate the effect of phosphoric acid etching on the bond strength between enamel and three luting materials employing self-etching primer (PanaviaF2.0, Linkmax, and Multibond). A luting material without self-etching primer (Super-Bond) was used as a control. Two etching agents (K-etchant and Red Activator) were prepared. The surfaces of bovine enamel were ground, etched with either K-etchant or Red Activator, and then bonded to a stainless steel rod. Tensile bond strengths were determined following 24-hour immersion in water. Without etching, all of the luting materials showed the same statistical bond strength. When K-etchant was applied, the bond strengths of PanaviaF2.0, Linkmax, Multibond, and Super-Bond were significantly greater than that of non-etched control. No significant differences were found between K-etchant and Red Activator. Strongest bonds were obtained for Super-Bond in conjunction with K-etchant (23.6 +/- 6.3 MPa) or Red Activator (21.0 +/- 6.5 MPa), whereby the values were statistically comparable.
Subject(s)
Acid Etching, Dental/methods , Dental Bonding , Dental Enamel/drug effects , Phosphoric Acids/pharmacology , Resin Cements , Analysis of Variance , Animals , Boron Compounds , Cattle , Composite Resins , Dental Stress Analysis , Materials Testing , Methacrylates , Methylmethacrylates , Random Allocation , Statistics, Nonparametric , Tensile StrengthABSTRACT
Equivalent MIC breakpoints to detect beta-lactamase negative ampicillin resistant Haemophilus influenzae (BLNAR) were controversial. We studied the relationship of drug resistance with gene alterations in 74 clinical isolates of H. influenzae. Out of 74 isolates, 26 showed MIC of ampicillin (ABPC) > or = 1 microg/ml. All isolates, except one, with MIC of ABPC > or = 4 microg/ml were found to produce beta-lactamase, while all 19 isolates with MIC of ABPC at 1 or 2 microg/ml were non-producing. Twenty-six ABPC resistant isolates were subjected to the analysis of genes involved in the drug resistance such as pbp3-1 pbp3-2, and TEM by the Haemophilus influenzae gene detection kit (Wakunaga Pharmaceutical Co., Ltd.) according to the supplier's instructions. Three (21.4%) of 14 beta-lactamase non-producing isolates with ABPC-MIC of 1 microg/ml had mutations of pbp3-1 gene, while all 5 non-producing isolates with ABPC-MIC of 2 microg/ml showed mutations of both pbp3-1 and pbp3-2 genes. Accordingly, it seems appropriate to set ABPC-MIC > or = 2 microg/ml for detection of BLNAR. In this study, six (8.1%) of 74 isolates were found to be BLNAR, and all of these six isolates were derived from patients of 5 year-old or younger.