Evidence for the Single-Site Quadrupolar Kondo Effect in the Dilute Non-Kramers System Y_{1-x}Pr_{x}Ir_{2}Zn_{20}.

Acoustic signatures of the single-site quadrupolar Kondo effect in Y_{0.966}Pr_{0.034}Ir_{2}Zn_{20} are presented. The elastic constant (C_{11}-C_{12})/2, corresponding to the Γ_{3}(E)-symmetry electric-quadrupolar response, reveals a logarithmic temperature dependence of the quadrupolar susceptibility in the low-magnetic-field region below ∼0.3 K. Furthermore, the Curie-type divergence of the elastic constant down to ∼1 K indicates that the Pr ions in this diluted system have a non-Kramers ground-state doublet. These observations evidence the single-site quadrupolar Kondo effect, as previously suggested based on specific-heat and electrical-resistivity data.

Successful Steroid Therapy for Lipoid Pneumonia Developing After Allogeneic Hematopoietic Stem Cell Transplant: A Case Report.

Lipoid pneumonia is an uncommon noninfectious inflammatory lung disease characterized by lipid deposition in the alveoli, and its etiology and treatment have not been elucidated. We report the case of a 32-year-old woman who developed lipoid pneumonia 9 months after allogeneic hematopoietic stem cell transplant for chronic myelogenous leukemia in lymphoid blast crisis. She complained of progressive cough and dyspnea shortly after discontinuation of immunosuppressive therapy given for graft-vs-host disease. Computed tomography demonstrated diffuse ground-glass opacities in the lungs, and pulmonary function test revealed restrictive impairment. Bronchoalveolar lavage fluid showed milky appearance, and transbronchial lung biopsy specimen revealed foamy macrophages infiltrating the alveoli. Based on these findings, she was diagnosed as having lipoid pneumonia. Prednisolone (1 mg/kg/d) promptly improved the symptoms, pulmonary shadows, and pulmonary function. The findings and clinical course of this case suggest that lipoid pneumonia should be recognized as one of the pulmonary complications of allogeneic hematopoietic stem cell transplantation.

Single-Site Non-Fermi-Liquid Behaviors in a Diluted 4f

Electrical resistivity ρ(T) and specific heat C(T) measurements have been made on the diluted 4f^{2} system Y(Pr)Ir_{2}Zn_{20}. Both data of ρ and magnetic specific heat C_{m} per Pr ion are well scaled as a function of T/T_{0}, where T_{0} is a characteristic temperature of non-Fermi-liquid (NFL) behaviors. Furthermore, the temperature dependences of ρ and C_{m}/T agree with the NFL behaviors predicted by the two-channel Kondo model for the strong coupling limit. Therefore, we infer that the observed NFL behaviors result from the single-site quadrupole Kondo effect due to the hybridization of the 4f^{2} states with multichannel conduction electrons.

Nosocomial BK Polyomavirus Infection Causing Hemorrhagic Cystitis Among Patients With Hematological Malignancies After Hematopoietic Stem Cell Transplantation.

BK polyomavirus (BKPyV) is recognized as a pathogen that causes diseases such as hemorrhagic cystitis and nephritis after allogeneic hematopoietic stem cell transplantation (HSCT) or renal transplantation. BKPyV-associated disease is thought to occur through reactivation under immunosuppression. However, the possibility of its nosocomial transmission and the clinical significance of such transmission have not been elucidated. During a 6-month period, nine adult patients (median age: 47 years) who had hematological disorders and who were treated with HSCT (n = 7) or chemotherapy (n = 2) in a single hematology department developed hemorrhagic cystitis due to BKPyV infection. The polymerase chain reaction products of BKPyV DNA obtained from each patient were sequenced. Of the nine patients, six had subtype I, 2 had subtype IV, and 1 had subtype II or III. In the alignment of sequences, four and two of the six subtype I strains were completely homologous (100%). These results strongly suggest that BKPyV has the potential to cause nosocomial infection within a medical facility, especially among recipients of HSCT. Further studies are clearly warranted to elucidate the route(s) of BKPyV transmission in order to establish optimal infection control.

Post-transplant lymphoproliferative disorder of the adrenal gland after allogeneic hematopoietic stem cell transplantation: report of two cases and literature review.

Post-transplant lymphoproliferative disorder (PTLD) is one of the life-threatening complications after hematopoietic stem cell transplantation (HSCT) and solid organ transplantation (SOT), and it is associated almost exclusively with Epstein-Barr virus (EBV). We herein report 2 cases of EBV-associated PTLD after allogeneic HSCT localized in the adrenal gland. Both patients developed adrenal tumor within 3 months after HSCT and were successfully treated with rituximab or tapering immunosuppressive agents. Both remained alive without recurrence. A literature review revealed 12 reported cases of PTLD involving the adrenal gland, but the adrenal gland was involved as one of the lesions of advanced-stage PTLD after SOT. To the best of our knowledge, this is the first report to show cases of isolated EBV-associated adrenal PTLD after HSCT. PTLD should be recognized as one of the causes of isolated adrenal tumor after HSCT.

Continuous generation of spinmotive force in a patterned ferromagnetic film.

We study, both experimentally and theoretically, the generation of a dc spinmotive force. By exciting a ferromagnetic resonance of a comb-shaped ferromagnetic thin film, a continuous spinmotive force is generated. Experimental results are well reproduced by theoretical calculations, offering a quantitative and microscopic understanding of this spinmotive force.

The effect of angiotensin-converting enzyme inhibitors of left atrial pressure in dogs with mitral valve regurgitation.

BACKGROUND: Despite many epidemiological reports concerning the efficacy of angiotensin-converting enzyme (ACE) inhibitors in dogs with mitral regurgitation (MR), the hemodynamic effects of ACE inhibitor administration have not been fully evaluated. OBJECTIVES: To document left atrial pressure (LAP) in dogs with MR administered ACE inhibitors, in order to obtain interesting information about daily LAP changes with administration of ACE inhibitors. ANIMALS: Five healthy Beagle dogs weighing 9.8 to 14.2 kg (2 males and 3 females; aged 2 years). METHODS: Experimental, crossover, and interventional study. Chordae tendineae rupture was induced, and a radiotelemetry transmitter catheter was inserted into the left atrium. LAP was recorded for 72 consecutive hours during which each of 3 ACE inhibitors--nalapril (0.5 mg/kg/d), temocapril (0.1 mg/kg/d), and alacepril (3.0 mg/kg/d)--were administered in a crossover study. RESULTS: Averaged diurnal LAP was significantly, but slightly reduced by alacepril (P = .03, 19.03 +/- 3.01-18.24 +/- 3.07 mmHg). The nightly drops in LAP caused by alacepril and enalapril were significantly higher than the daily drops (P = .03, -0.98 +/- 0.19 to -0.07 +/- 0.25 mmHg, and P = .03, -0.54 +/- 0.21-0.02 +/- 0.17 mmHg, respectively), despite the fact that the oral administrations were given in the morning. Systolic blood pressure (122.7 +/- 14.4-117.4 +/- 13.1 mmHg, P = .04) and systemic vascular resistance (5800 +/- 2685-5144 +/- 2077 dyne x s/cm5, P = .03) were decreased by ACE inhibitors. CONCLUSIONS AND CLINICAL IMPORTANCE: ACE inhibitors decrease LAP minimally, despite reductions in left ventricular afterload. ACE inhibitors should not be used to decrease LAP.

Daily rhythms of left atrial pressure in beagle dogs with mitral valve regurgitation.

BACKGROUND: Mitral valve regurgitation (MR) causes increased left atrial pressure (LAP) and is associated with occurrence of clinical signs. It will be useful to understand diurnal variations of LAP for the management of MR. HYPOTHESIS: Circulatory parameters and diurnal rhythm are linked to clinical signs in cardiac diseases. LAP also exhibits a diurnal rhythm in dogs with MR. ANIMALS: Five healthy Beagle dogs weighing 9.8-12.8 kg (3 males and 2 females; aged 2 years) were used. METHODS: A radiotelemetry system for continuous measurement of LAP was used in this study. Rupture of the chordae tendineae was experimentally induced via left atriotomy, and a transmitter catheter was inserted into the left atrium. The body of the transmitter was implanted SC. After clinical condition was stabilized, the severity of MR was evaluated by echocardiography, and LAP was recorded for 72 consecutive hours for the analysis of diurnal variation. RESULTS: Abrupt increases in LAP, which averaged 16.7 mmHg, were observed at feeding periods. In contrast, strong diurnal LAP variations were found, with a significant but slight increase in daytime LAP compared with nighttime LAP. CONCLUSIONS AND CLINICAL IMPORTANCE: Diurnal LAP is characterized by a slight but significant nocturnal decrease and abrupt increases in response to excitation. The latter seemed to be more important considering the relationship with clinical manifestations. The clinical relevance of exercise restriction in the management of MR was acknowledged.

Efficacy of open patch-grafting under cardiopulmonary bypass for pulmonic stenosis in small dogs.

OBJECTIVE: To assess the efficacy of an open patch-graft technique under cardiopulmonary bypass (CPB) in small dogs. DESIGN AND METHODS: A retrospective analysis of 10 dogs with pulmonic stenosis. Records between 1992 and 2002 were reviewed. The effect of surgical correction was evaluated and perioperative parameters were compared between survivors and non-survivors. RESULTS: The postoperative pulmonary pressure gradient was reduced in all seven surviving patients. Mean +/- SE was 21.5 +/- 7.4 mmHg (range 3.0-54.2 mmHg) and 6/7 dogs were < 40 mmHg at 3 months postoperatively. Comparing the data between those patients that survived and those that did not, the preoperative pressure gradient (P = 0.04) and volume of the Glucose-Insulin-Kalium solution used (P = 0.001) were significantly higher in those that did not survive. CONCLUSION: Open patch-grafting can be performed in small-breed dogs and decreased the pulmonary pressure gradient in survivors at 3 months postoperatively. However, this technique is more invasive than balloon valvuloplasty and should be used cautiously in severely stenosed patients.

Complete atrioventricular block associated with lymphocytic myocarditis of the atrioventricular node in two young adult dogs.

A histological investigation of the atrioventricular (AV) conduction system was performed in two young adult dogs with complete AV block. In both cases, infiltration of lymphocytes and plasma cells into the AV node and loss and disappearance of the conduction fibres were observed. Such inflammatory lesions of the AV conduction system were associated with complete AV block. The aetiology of these changes and the cause of its location at the AV node were not elucidated.

A histological study of the cardiac conduction system in canine cases of mitral valve endocardiosis with complete atrioventricular block.

The cardiac conduction system was examined histologically in four canine cases of endocardiosis of the mitral valve (MV) with complete atrioventricular (AV) block. In all cases, moderate to severe reduction of the conduction fibres due to fibrous or fibro-fatty replacement was observed in the penetrating and branching portions of the AV bundle. In addition, degenerative and fibrotic lesions were commonly seen at the upper portions of the left and right bundle branches. These changes in the AV conduction system were associated with marked degeneration and fibrosis of the base of the central fibrous body and the upper part of the ventricular septum. The degenerative and sclerotic changes of the AV junctional region, affecting the AV bundle and bundle branches, were qualitatively similar to those in age-matched control dogs, but were more severe. It is possible that the pathological process occurred as a result of ageing and may have been exaggerated or accelerated by the abnormal mechanical forces created by excessive motion of the prolapsed MV and the long-term haemodynamic stresses of mitral regurgitation, resulting in interruption of the AV conduction system to produce complete AV block. Conduction abnormalities represent a possible complication in some canine cases of MV endocardiosis.

The anatomical basis of complete atrioventricular block in cats with hypertrophic cardiomyopathy.

The cardiac conduction system was examined histologically in 13 feline cases of hypertrophic cardiomyopathy (HCM) with complete atrioventricular (AV) block. Marked degeneration and fibrous replacement of the AV conduction system were consistently observed in the combined regions of the branching portion of the AV bundle and the upper portion of the left bundle branch. These changes were associated with extensive fibrosis of the central fibrous body and endocardial and myocardial fibrosis in the upper border of the ventricular septum. Chondrometaplastic lesions or osseous lesions, or both, present in the base of the central fibrous body, compressed the underlying penetrating or branching (or both) portions of the AV bundle, causing apparent reduction of the conduction fibres. The pathological process and the nature and predilection sites of the lesions resembled those associated with ageing in human patients with complete AV block. It is possible that the pathological process in the cats was fundamentally related to the normal ageing phenomenon and may have been exacerbated by mechanical forces created by the cardiac hypertrophy associated with HCM.

Surgical management of a double-chambered right ventricle and chylothorax in a Labrador retriever.

A 22-month-old, male Labrador retriever was presented with anorexia, dyspnoea, and fainting. The dog was diagnosed with a double-chambered right ventricle and tricuspid valve dysplasia using echocardiography and cardiac catheterisation. A marked bilateral pleural effusion was also present and chemical analysis of the fluid confirmed the diagnosis of chylothorax. Using echocardiography, a pressure gradient of 87.1 mmHg was found between the proximal and distal chambers of the double-chambered right ventricle. Initiation of cardiopulmonary bypass allowed the anomalous muscle bundle that divided the right ventricle into two chambers to be resected via a right ventriculotomy. The fainting completely resolved postoperatively, and this treatment seemed quite effective in the reduction of pressure overload ascribable to ejection disturbance. Because the tricuspid dysplasia was not corrected in the first operation, the postoperative chyle effusion was reduced but did not cease. A combination of thoracic duct ligation and passive pleuroperitoneal shunting was effective in the resolution of the chyle effusion.

Surgical correction of ventricular septal defect with aortic regurgitation in a dog.

An 8-month-old entire Miniature Dachshund, weighing 4.2 kg, was presented for examination following delvelopment of a cough. Ventricular septal defect had been diagnosed tentatively in its infancy on the basis of a cardiac murmur detected by auscultation and echocardiography. Echocardiography using a B mode right parasternal long-axis view showed a defect at the atrioventricular junction and a thickened cusp of the aortic valve prolapsing into the defect. Colour-flow Doppler showed shunt blood flow across the defect at the level of the atrioventricular junction, from left to right. The sinus of Valsalva was dilated, with turbulent blood flow. Aortic regurgitation was also observed. Cardiac catheterisation studies confirmed the diagnosis of a supracristal ventricular septal defect with aortic regurgitation. Despite medication with digoxin, enalapril and aminophylin, started from the first admission, left ventricular internal dimensions gradually increased, and fractional shortening of the left ventricle gradually decreased. Surgery, with the aid of extracorporeal circulation, to close the ventricular septal defect, was performed 1 year after the initial examination. The aortic valve was left untreated. Postoperatively, the systolic murmur disappeared. Shunt flow from the left to the right ventricle was no longer observed on echocardiography, however there was still a small amount of aortic regurgitation during diastole visualised with colour-flow Doppler echocardiography. The prolapse of the cusp of the aortic valve on B-mode echocardiography was no longer observed and thickening of the cusp had not progressed. Left ventricular function measurement using M mode echocardiography showed a reduced left ventricular volume overload with reduced left ventricular internal dimensions and increased fractional shortening. The cough was relieved and no follow-up medication was scheduled. Early surgical closure of the ventricular septal defect improved the patient's condition and controlled prolapse and thickening of the aortic valve.

Numerous nonclonal chromosomal aberrations arising in residual recipient hematopoietic cells following allogeneic bone marrow transplantation.

A young female patient in a second remission of acute lymphoblastic leukemia underwent bone marrow transplantation after total body irradiation and high-dose cytarabine from her HLA-matched brother. Following successful engraftment, mixed chimerism was seen 75 days post transplant. The karyotype contained numerous abnormalities in residual recipient cells. Chromosomes 1, 7, 13, and X were significantly more affected than other chromosomes. The high-frequency breakpoints identified were 1p22.2, 5q31.2, and 13q14.2. Some karyotypes specific for leukemia, such as t(9;22)(q34.1;q11.2) and t(8;21)(q22.2;q22.2), not seen with the original disease, were also present. As the frequency of aberrant chromosomes increased markedly with time, donor leukocytes were infused 14 months after BMT, which effectively eradicated the abnormal karyotypes.

Ethnic differences in the formation of small LDL particles in Asians: a comparison of Koreans, Japanese and Mongolians.

BACKGROUND: The presence of small, dense LDL particles has been recognized as an independent risk factor for coronary heart disease (CHD) but is not directly representative of CHD mortality rate beyond any given population. We investigated whether such inconsistency between three Asian ethnic groups might have arisen from anthropometric and metabolic factors. DESIGN: We conducted a cross-sectional survey among adult Koreans (412), Japanese (453) and Mongolians (253). RESULTS: The prevalence of small LDL particles was 36% in the Koreans, 21% in the Japanese and 7% in the Mongolians. Multiple logistic regression analysis revealed plasma triglyceride (TG) levels to be the strongest determinant of small LDL particle size in all three groups, with sex, HDL-cholesterol and non-HDL-C being other ethnic-specific significant determinants. Body mass index (BMI), FFA and insulin resistance were not significant factors in the regression analysis. Of the subjects with low TG levels (< 133 mg dL(-1)), 25% of the Koreans and 10% of the Japanese, but no Mongolians, had small LDL particles. CONCLUSIONS: Results of the present study suggest that traditionally, high-carbohydrate diets in Korea and Japan possibly contribute to higher TG-levels compared with BMI-matched Mongolians, and to the formation of small LDL particles, even in instances of low TG levels.

[In what case can we abbreviate mediastinal lymph nodes dissection of peripheral small-sized lung cancer?].

UNLABELLED: We analyzed 723 cases of non small cell lung cancer (459 adenocarcinomas and 264 squamous cell carcinomas) from the view point of lymph nodes metastases, according to histological type, location of cancer and tumor size. METHOD: Histological type was adenocarcinoma or squamous cell carcinoma. Location was divided into 8 areas [right side; 4 areas, upper lobe (RUL)/middle lobe (RML)/S6 (RS6)/basal segment of lower lobe (RBS): left side; 4 areas, upper division of upper lobe (LUD)/lingula (LLS)/S6 (LS6)/Basal segment of lower lobe (LBS)]. Tumor size was divided by centimeters, namely 0.0-1.0 cm, 1.1-2.0 cm, 2.1-3.0 cm, etc.. RESULTS: Safety size of lung cancer in which we can abbreviate mediastinal lymph nodes dissection was as follows. In adenocarcinoma, in RUL/RML/RBS 1.0 cm, in RS6 2.0 cm, in LUD 1.0 cm, in LLS/LS6/LBS 2.0 cm. In squamous cell carcinoma, in RUL 1.0 cm, in RML/RS6/RBS 2.0 cm, in LUD 1.0 cm, in LLS/LS6/LBS 2.0 cm. CONCLUSION: In 1.0 cm or smaller non small cell lung cancer we might abbreviate mediastinal lymph nodes dissection. Moreover, in squamous cell carcinoma of (RML, LLS, right or left lower lobe) of 2.0 cm or smaller size, we might abbreviate mediastinal lymph nodes dissection.

Overweight Japanese with body mass indexes of 23.0-24.9 have higher risks for obesity-associated disorders: a comparison of Japanese and Mongolians.

OBJECTIVE: The degree of obesity of Asians is less than that of Caucasians. It has been suggested that Japanese, categorized as having normal weight (BMI<25.0), as defined by WHO (2000), have a tendency toward increased incidences of dyslipidemia and diabetes. Our objective was to analyze parameters constituting obesity-associated disorders in overweight Japanese and Mongolians with a body mass index (BMI) of 23.0-24.9, and to assess the suitability for Asians of the Regional Office for Western Pacific Region of WHO criteria pertaining to obesity (WPRO criteria, 2000). DESIGN: Cross-sectional study in a workplace setting. SUBJECTS: A total of 386 Japanese men and 363 Japanese women, and 102 Mongolian men and 155 Mongolian women. MEASUREMENTS: Anthropometric measurements (weight, height, waist circumference, hip circumference and blood pressure) and metabolic measurements (plasma levels of total cholesterol, HDL cholesterol, triglyceride, glucose and insulin). RESULTS: Graded increases in BMI of Japanese and Mongolians were positively associated with body fat percent, waist circumference, hip circumference and waist/hip ratio. The Japanese were categorized as 22% overweight, 22% obese I, 3% obese II; the Mongolians rated as 18% overweight, 34% obese I, 19% obese II, based on the WPRO BMI criteria. The Mongolians had a higher prevalence of obesity and a higher body fat percent, but a lesser gradation of dyslipidemia, than did the BMI-matched Japanese groups. Overweight Japanese (BMI 23.0-24.9), in comparison to normal Japanese (BMI 18.5-22.9), had significant differences in systolic blood pressure, HDL-cholesterol and triglyceride in men, and in systolic and diastolic blood pressure, HDL-cholesterol, triglyceride, insulin and Homoeostasis model assessment-insulin resistance in women. In contrast, the Mongolians showed no significant differences in metabolic parameters between overweight and normal subjects, except for diastolic blood pressure. CONCLUSION: Since the relationship between abdominal fat mass and BMI is ethnic-specific, a universal BMI cutoff point is inappropriate for Asian populations such as the Japanese and Mongolians. The present investigation suggests that, while the WPRO criteria are suitable for Japanese, the WHO criteria are more appropriate for Mongolians.

Cardiac myxoma of the tricuspid valve in a dog.

A case of cardiac myxoma arising from the tricuspid valve is described in an 8-year-old dog that had suffered intermittent episodes of syncope. At surgical operation, a large, irregular, gelatinous mass was found attached to the septal leaflet of the tricuspid valve. The excised tumour, measuring 5x4x3.5 cm, had a grey-to-yellow, friable, mucoid, multilobulated and polypoid appearance, with focal haemorrhage. Histologically, the tumour consisted of a hypocellular mass of a myxoid matrix, rich in acid mucopolysaccharides, with a supporting structure of spindle-like, elongated or stellate cells scattered in an abundant stroma. The surface of the mass was covered by a single layer of endothelial-like cells. Immunohistochemistry revealed that the surface cells of the mass were positive for the endothelial marker CD34 and the constituent cells within the mass reacted positively and uniformly with antibodies to vimentin and alpha-smooth muscle actin. The dog died 36 h after the operation and, at necropsy, wide dissemination of myxomatous embolization to the intrapulmonary arteries was found.