Measurement of axial phase difference of density fluctuations owing to spontaneously excited waves by using microwave reflectometer on GAMMA 10/PDX.

In the GAMMA 10/PDX tandem mirror, plasma with strong ion-temperature anisotropy is produced by using the ion cyclotron range of frequency waves. This anisotropy of ion temperature causes several Alfvén-Ion-Cyclotron (AIC) waves to spontaneously excite in the frequency range just below the ion cyclotron frequency. In addition, difference-frequency (DF) waves are excited in the radial inner region of the plasma by wave-wave coupling among the AIC waves. The radial density profiles were measured at multi-axial positions using a frequency-modulation reflectometer with an axial array of microwave antennas, and an axial variation of the density was found to be significant. In addition, a relative phase difference of the DF wave between axially separated two points was first obtained by finely choosing the probing frequency of the reflectometers with a maximum coherence used as a measure, indicating that the DF wave is a propagating wave, while the pump AIC waves are standing waves in the axial region of measurement.

Safe anastomosis in laparoscopic low anterior resection for rectal cancer.

INTRODUCTION: In laparoscopic rectal surgery, there are some limitations on a surgeon's ability to maneuver, especially in transection of the lower rectum. To achieve minimally invasive surgery, safe anastomosis, including proper rectal transaction, is necessary. METHODS: To overcome the difficulty in lower rectal resection, we followed a series of steps. First, we completely mobilized the rectum to the pelvic bottom, just above the anal canal, making the lower rectum mobile and allowing for an easy rectal transection. To secure the transaction, the mesorectum around the transection must be properly divided. We recommend placing the lower right quadrant port as caudal as possible to properly staple the rectum. We found a 60 mm compression-type stapler most suitable for rectal transection. To wash and flatten the rectum, a detachable intestinal clip is quite useful because of its flexibility. Finally, in addition to conventional abdominal drains around the anastomotic site, we employed transanal tube to actively decompress rectal pressure inside the anastomotic site. RESULTS: Between August 2009 and July 2010, 101 patients underwent laparoscopic low anterior resection using this technique. Most patients, 98.0% (99/101), underwent lower rectum transection using a single-fire cartridge. The anastomotic leakage rate was only 1.0% (1/101) in total and 1.3% (1/78), when not including patients with diverting stoma. CONCLUSION: We have to follow up with more patients to conclude whether our technique is effective in the long term. However, this step-by-step technique could lead to safe anastomosis in laparoscopic low anterior resection for rectal cancer.

Enhanced in vitro maturation of subcultivated fetal human hepatocytes in three dimensional culture using poly-L-lactic acid scaffolds in the presence of oncostatin M.

Fetal human liver cell fractions, which contain large numbers of hepatocyte progenitors, have high proliferation potential in vitro. To create an engineered liver tissue equivalent of a clinically significant size, however, repeated subcultivation and functional maturation are necessary in vitro. A commercially available human fetal liver cell fraction that was cultivated for some time in vitro has been reported to lose liver specific functions almost completely. We therefore investigated the effects of oncostatin M (OSM) and hepatocyte growth factor (HGF) in long-term three-dimensional (3D) culture using macroporous poly-L-lactic acid (PLLA) scaffolds on the restoration of such liver-specific functions of the fraction. 3D culture using PLLA scaffolds with OSM remarkably enhanced the albumin production and cytochrome P450 1A1/2 capacity with the culture time. HGF alone had no preferable effect on these functions even in 3D culture. Alpha-fetoprotein production was consistently suppressed in the 3D culture compared with that in monolayers. This suppression was not observed in the same types of culture of hepatocarcinoma Hep G2 cells. Despite these favorable observations on the 3D culture with OSM, the final attained functional levels at the 5th week were still over ten-times lower than those of Hep G2 cells when standardized with a cellular DNA amount. Although further improvement is needed for the complete functional restoration and maturation in vitro, these results demonstrate that a combination of 3D culture using PLLA scaffolds and OSM offers promising culture conditions for in vitro maturation of human hepatocyte progenitors.

Serum thymidine kinase and soluble interleukin-2 receptor predict recurrence of malignant lymphoma.

Before and after therapy, serum thymidine kinase (TK) and soluble interleukin-2 receptor (sIL-2R) were serially determined in 28 patients with malignant lymphoma (ML). In 15 patients achieving and maintaining complete remission (CR) for more than 2 years, serum TK and sIL-2R were unchanged or decreased gradually. In contrast, logarithmic linear increases of TK and sIL-2R were observed in 13 relapsed patients. The increments of the serum markers occurred more than 10 months before the relapse. A significant positive correlation between the slope of the line for TK and that for sIL-2R was noted. The doubling time for TK estimated from the slope also showed a positive correlation with that for sIL-2R. Taken together, serum TK and sIL-2R were shown to be quite sensitive and interrelated serum markers for the recurrence of ML. Slopes of logarithmic linear increase, which are proper and specific for the individual patients, are inversely correlated with the doubling time and reflect proliferation of ML. We conclude that serum TK and sIL-2R are better predictors of relapse than LDH and the international prognostic index (IPI).

Fusion of ETV6 to fibroblast growth factor receptor 3 in peripheral T-cell lymphoma with a t(4;12)(p16;p13) chromosomal translocation.

Fusions of the ETV6/TEL gene to receptor or protein tyrosine kinases (TKs), such as PDGFRbeta, JAK2, ABL, ABL2, TRKC, and Syk, have been reported in various hematological malignancies. Expression of the resultant chimeric proteins is believed to lead to constitutive TK activity through activation by the helix-loop-helix (HLH) domain of ETV6. We identified a novel ETV6 partner gene, fibroblast growth factor receptor 3 (FGFR3), in a patient with peripheral T-cell lymphoma (PTCL) with a t(4;12)(p16;p13) translocation. The ETV6-FGFR3 transcript showed a fusion of exon 5 of ETV6 to exon 10 of FGFR3, resulting in an open reading frame for a chimeric protein consisting of the HLH domain of ETV6 and the TK domains of FGFR3. This is the first report of ETV6 and FGFR3 involvement in PTCL.

[CD7(+) acute myeloid leukemia (M0) associated with a mediastinal bulky mass lesion].

A 41-year-old man visited his doctor in May 2000 because of a sore throat and high fever. His symptoms did not improve, despite administration of antibiotics and nonsteroidal anti-inflammatory drugs. Since a chest X-ray examination revealed an anterior mediastinal bulky tumor, he was referred and admitted to our hospital on June 21, 2000. The peripheral white blood cell count was 44,540/microliter with 74% myeloblasts. Bone marrow aspiration revealed a hypercellular marrow with 82% myeloblasts, which were negative for peroxidase and alpha-naphthyl butylate esterase staining. Blast cells were positive for CD7, CD13, CD33, CD34, and HLA-DR, and negative for CD56. A needle biopsy specimen of the mediastinal tumor consisted of myeloblasts. We diagnosed the patient as having CD7 (+) acute myeloid leukemia (AML) (M0) with a bulky mediastinal mass based on the surface marker analysis, although the clinical features resembled myeloid/NK precursor acute leukemia. The patient achieved a complete remission after two courses of induction therapy. We are planning an allogeneic stem cell transplantation during his first remission because of the high risk of relapse.

[Effect of oxygen inhalation on myocardial opacification using levovist: an animal experimental study].

OBJECTIVES: Levovist can opacify the myocardium via venous injection, and is widely used in the clinical field. However, left ventricular opacification deteriorates during oxygen inhalation using Albunex, one of the first generation of contrast agents. This study examines the effect of blood oxygen pressure on the myocardial opacification by Levovist. METHODS: Myocardial contrast echocardiography (Toshiba Power Vision 6000) was performed using second harmonic imaging, intermittent exposure of ultrasound (every 4 cardiac beats) and acoustic power of 1.4 mechanical index. The video intensity of the ventricular septum after venous injection of Levovist (0.5 ml of 300 mg/ml) was measured under various respiratory conditions by manipulating the respirator and oxygen inhalation. Arterial blood gas was measured and correlated with the myocardial video intensity. RESULTS: The video intensity of myocardial opacification was lower with higher oxygen pressure in the arterial blood. Visual recognition of myocardial opacification was only 14% under high oxygen pressure over 200 mmHg. Microbubbles of Levovist form from normal air, and are easily affected by the gas concentration of the surrounding blood. CONCLUSIONS: Myocardial opacification using Levovist is deteriorated under high oxygen pressure at examination.

[Usefulness of intravenous myocardial contrast echocardiography in rats].

OBJECTIVES: Few intravenous myocardial contrast echocardiography trials have evaluated myocardial perfusion in small animals. The feasibility of using intravenous myocardial contrast echocardiography to assess the ischemic area in rats was investigated. METHODS: Fourteen open chest Wister male rats were examined. Intravenous myocardial contrast echocardiography was performed by fundamental and intermittent mode using a high frequency (5-12 MHz) transducer (SONOS 5500) with injection of NC100100 (20% dilution) into the femoral vein. The mechanical index was set to 1.6. Baseline-subtracted video intensity (256 level) was measured in the anterior, posterior, septal and lateral walls of the left ventricle. The left anterior descending artery was ligated in 16 rats. The area at risk was evaluated by myocardial contrast echocardiography and compared to the area of defect by Evans Blue staining. RESULTS: All wall segments were clearly opacified (anterior 63.8 +/- 24.7, posterior 27.0 +/- 11.0, septal 44.5 +/- 11.6, lateral 52.3 +/- 19.1), although the baseline-subtracted video intensity of the posterior wall was low. The area at risk was clearly observed, and there was a good correlation with the nonperfused area by Evans Blue staining (y = 1.13x-3.54, r = 0.98). CONCLUSIONS: Intravenous myocardial contrast echocardiography can detect the perfusion defect even in rats using a high frequency transducer and suitable setup of equipment.

A case of hypervascular renal capsule leiomyoma.

A case of leiomyoma of the kidney is reported. A 54-year-old woman was found incidentally to have a solid left renal mass on abdominal ultrasound examination performed during a follow-up study for chronic hepatitis, type C. Computed tomography (CT), dynamic magnetic resonance imaging (MRI), and angiography revealed the hypervascular mass. Partial nephrectomy was performed under a preoperative diagnosis of renal cell carcinoma. Histopathology diagnosed the mass as renal capsular leiomyoma. We considered that the hypervascularity of the tumor was related to the presence of rich capillary beds.

Differences in IgE isotype switching induced by anti-CD40 monoclonal antibody and cytokines among subtypes of chronic B lymphoid leukemias.

OBJECTIVE: Immunologic differences among the chronic B lymphoid leukemias defined by the French-American-British (FAB) classification were evaluated with respect to IgE isotype switching induced by anti-CD40 monoclonal antibody (mAb) and cytokines. MATERIALS AND METHODS: We immunocytochemically studied IgE isotype switching of leukemic B cells from 25 cases and three cell lines established from the leukemias after stimulation with anti-CD40 mAb, plus each of the following cytokines: interleukin 2 (IL-2); IL-4; IL-10; tumor necrosis factor alpha (TNF-alpha); and transforming growth factor beta (TGF-beta). Also, genomic Cepsilon and Cepsilon transcripts were analyzed by polymerase chain reaction and reverse transcriptase polymerase chain reaction. RESULTS: Leukemic cells from hairy cell leukemia variant and its cell line, with deletion of the Cepsilon gene, did not undergo IgE isotype switching in response to any of the stimuli. In contrast, a cell line (FH-5) established from chronic lymphocytic leukemia cells, bearing the Cepsilon gene, underwent the highest level of IgE isotype switching on stimulation with anti-CD40 mAb and IL-4. This response was correlated with the production of Cepsilon transcripts. IL-4, IL-10, and TNF-alpha induced higher levels of IgE isotype switching than the others. No IgE isotype switching was observed in any of the non-Hodgkin's lymphomas examined, except mantle cell lymphoma and lymphoplasmacytic lymphoma. Percentages of CD40(+) cells in five cases with follicular lymphoma were significantly lower than the other leukemias. CONCLUSIONS: IgE isotype switching induced by anti-CD40 mAb with cytokines other than IL-4 was first demonstrated, whereas none of the non-Hodgkin's lymphomas except mantle cell lymphoma and lymphoplasmacytic lymphoma showed IgE isotype switching in response to any of the stimuli. Cells of follicular lymphoma were suggested to be different from cells of the other leukemias.

[Assessment of myocardial perfusion with second harmonic imaging--using intravenous injection of Albunex and Levovist].

The objection of this study was to determine whether a method of harmonic imaging could improve the myocardial contrast after injection of Albunex and Levovist. Two dogs were imaged harmonic mode from transdiaphragm approach (transmit at 2.5 MHz and received at 5.0 MHz). Albunex (0.22 ml/kg) and Levovist (400 mg/ml x 2 ml) was injected intravenously for each dog. Venous injection of Albunex coupled with harmonic imaging produced only coronary flow. Venous injection of Levovist coupled with harmonic imaging produced myocardial opacification. It is possible that venous injection of Levovist coupled with harmonic imaging method will also useful in studying myocardial perfusion.

The oocyte of triploid fluke receiving intrusion of sperm from a diploid fluke--evidence for the origin of tetraploids in Paragonimus westermani.

An experiment was conducted to elucidate the origin of tetraploids (2n = 4x = 44) of Paragonimus westermani that occur together with diploid (2n = 2x = 22) and triploid (2n = 3x = 33) types in Liaoning Province, the People's Republic of China. Metacercariae of the diploid type, obtained from Hyogo Prefecture, Japan, and those of the triploid type from Tsushima, Nagasaki Prefecture, Japan, were mixed and inoculated into dogs and cats. The following results were obtained. The flukes were found in pairs within cysts in random combinations of 2x + 2x, 2x + 3x, and 3x + 3x (7:15:7). Oocytes in the oviduct were at stages from diplotene to metaphase. In a triploid fluke encysted with a diploid fluke, the primary oocytes were intruded by sperms from the diploid fluke. In the primary oocytes of diploid as well as triploid flukes, from diplotene to diakinesis, the homologues of the nucleolar chromosomes were heteromorphic as far as the size of the short arm was concerned. This implies that the triploid is an autotriploid generated in an ancestral diploid population that was polymorphic for the nucleolar chromosome.

IgD class switching: identification of a novel recombination site in neoplastic and normal B cells.

IgD on normal B lymphocytes usually is co-expressed with IgM. A minority of normal plasma cells and rare B cell malignancies express exclusively IgD (IgM-IgD+). The low frequency has been explained by the lack of a recognizable switch region within the C mu-C delta intron. We analyzed four cases of IgM-IgD+ hairy cell leukemia (HCL) by Southern (DNA) blot analysis and identified two cases with a recombinatorial event within the C mu-C delta intron and deletion of C mu. DNA sequence analysis of junctional regions showed that S mu or the immediate upstream region was used as a donor site and that the C mu-C delta intronic sigma delta region was used as acceptor site. Using polymerase chain reaction, we subsequently analyzed whether similar S mu-sigma delta recombinations occur in normal tonsils containing IgM-IgD+ plasma cells. Multiple products with a size range of 200-800 base pairs were detected in all four individuals, suggesting clustering of acceptor sites within sigma delta. Sequence analysis of three cloned products showed S mu-sigma delta recombinations similar those observed in HCL. The sigma delta region contains a relatively high content of pentameric repeats with an extremely G-rich area and appears to function as a vestigial switch recombination site in normal and neoplastic IgM-IgD+ B cells.