Intraoperative electrophysiologic monitoring of ocular motor nerves under conditions of partial neuromuscular blockade during skull base surgery

The feasibility and usefulness of intraoperative electromyographic monitoring of the oculomotor nerve (CN III), trochlear nerve (CN IV), and abducens nerve (CN IV) were evaluated under conditions of partial neuromuscular blockade in 21 patients undergoing skill base surgery. Intracranial electrical stimulation of each nerve was performed, and compound muscle action potentials (CMAPs) were reconded from the inferior or superior rectus muscle, the superior oblique muscle, and the lateral rectus muscle for monitoring of CN III, IV, and VI, respectively. Partial neuromuscular blockade was achieved by controlled infusion of vecuronium titrated to eliminate about 90% of the twitch response of the abductor pollicis brevis to electrical stimulation of the median nerve. A total of 30 cranial nerves were stimulated intraoperatively. Of these, 29 were successfully monitored (19 CN III, 6 CN IV, 4 CN VI). A relationship was found between intraoperative findings of cranial nerve monitoring, such as disappearance of response and increase in latency and stimulus threshold during manipulation of a lesion, and the presence of postoperative nerve deficits. We conclude that intraoperative electromyographic monitoring of ocular motor nerves is feasible during partial neuromuscular blockade, and that partial neuromuscular blockade does not affect the relationship between findings of intraoperative monitoring and postoperative nerve function.

Micafungin does not influence the concentration of tacrolimus in patients after allogeneic hematopoietic stem cell transplantation

BACKGROUND

Tacrolimus is commonly used in stem cell transplant recipients for prophylaxis of graft-vs-host disease. Micafungin is widely used as a strong antifungal agent in empirical therapy in patients with febrile neutropenia. Both tacrolimus and micafungin are substrates of cytochrome P450 3A4 in vitro. Therefore, there is risk of drug interaction with concomitant administration of these drugs.

OBJECTIVE

To estimate the drug interaction of tacrolimus and micafungin by evaluating the pharmacokinetics in 6 patients who had undergone allogeneic stem cell transplantation.

RESULTS

The mean (SD) concentration-dose ratio of tacrolimus in all patients at 1, 4, 8, and 24 hours after concomitant administration of micafungin was 607 ± 306, 653 ± 328, 699 ± 340 and 671 ± 403 (ng/mL)/(mg/kg/d), respectively, and without micafungin was 756 ± 314 (ng/mL)/(mg/kg/d). The percentage of the concentration-dose ratio in patients treated with tacrolimus and micafungin vs patients treated with tacrolimus alone was 98%, 105%, 112%, and 108% at 1, 4, 8, and 24 hours, respectively. For both tacrolimus and micafungin, the 90% confidence intervals for the primary pharmacokinetic parameters (ie, the concentration-dose ratio at each point) ranged from 80% to 125%.

CONCLUSION

We conclude that there is no drug interaction between tacrolimus and concomitantly administered micafungin in stem cell transplantation recipients.

Medical cost analysis for antifungal prophylaxis in neutropenic patients with hematological malignancies: a systematic simulation analysis

GOALS OF WORK

We assessed the medical costs of different antifungal agents for prophylaxis of invasive fungal infections in neutropenic patients in Japan with a cost simulation model designed for the study.

PATIENTS AND METHODS

We used probabilities of prophylaxis failure, possible cases for empiric therapy, probable proportions of infections caused by fungus species among prophylaxis failure patients, and incidence of adverse events caused by any reason, based on systematic analysis of previously reported randomized trials identified by a computerized search of the PubMed database. Antifungal agents were limited to oral fluconazole, oral itraconazole, micafungin, and liposomal amphotericin B. The range of the expected medical cost was simulated as a sensitivity analysis using 95% of confidence interval of a mean.

MAIN RESULTS

Fifteen studies were identified for our analysis. The prophylactic efficacy was comparable between the four agents. The simulated expected cost for invasive fungal infection prophylaxis and treatment of the infection was $1,035.74 when oral itraconazole was used for prophylaxis, $1,552.81 with oral fluconazole, $2,245.96 with micafungin, and $3,028.10 with liposomal amphotericin B. The total cost including treatment cost for adverse events related to each drug was $2,742.14, $3,547.91, $3,034.57, and $3,028.10, respectively. This result was confirmed in a sensitivity analysis in which IFI incidence and therapy duration were tested as parameters.

CONCLUSIONS

Our analysis results suggest that oral itraconazole is the most cost-effective prophylactic antifungal agent for invasive fungal infections in neutropenic patients with hematological malignancies, and this result was robust by sensitivity analysis.

Inhibition of heat-shock protein 27 expression eliminates drug resistance of osteosarcoma to zoledronic acid

BACKGROUND

Although zoledronic acid (ZOL) has been reported to show anti-tumour effects on various malignant tumours, few studies have reported the molecular mechanisms of resistance to ZOL.

MATERIALS AND METHODS

A drug-resistant cell line was developed by repeatedly treating human osteosarcoma cell line HOS with ZOL. Expression status of drug resistance-related molecules including ATP-binding cassette (ABC) and heat-shock protein 27 (HSP27) was confirmed in order to analyse molecular mechanisms of the drug resistance.

RESULTS

Repeated treatment with ZOL induced drug resistance with down-regulation of apoptosis in the resistant cell line. Although ABC expression was down-regulated, up-regulation of HSP27 in the resistant cell line was confirmed. The resistance was overcome by HSP27 silencing.

CONCLUSION

Resistance to ZOL in osteosarcoma cells may be induced by a molecular mechanism different from conventional efflux pump-based resistance. Up-regulation of HSP27 expression may play a role in the development of ZOL resistance in HOS cells.

Lineage switch from precursor B cell acute lymphoblastic leukemia to acute monocytic leukemia at relapse

A lineage switch in leukemia, in which the leukemic cell lineage at onset converts to another lineage at a later time, is an uncommon type of hybrid (mixed) leukemia regarded as a variation of bilineage leukemia. We present a case of a 60-year-old female diagnosed with precursor B cell acute lymphoblastic leukemia (ALL), whose markers in flow cytometry shifted from their original status of CD19+, 22+, 79a+, 13+, HLA-DR+, and TdT+. Although her bone marrow achieved remission after induction therapy, there was a small residual population of leukemic cells in the liver. Residual disease was proved by biopsy and pathologically shown to have an immature phenotype of CD5+, CD10-, CD20-, CD79a- and myeloperoxidase negativity. Two weeks after liver biopsy, blast cells progressively appeared in the peripheral blood; these cells had a monocytoid morphology and phenotype (CD13, 14) but were accompanied by myeloid (CD33) and lymphoid (CD2, 4, 20) cells. Markers CD7, 10 and 19 were negative by flow cytometry. This phenotypical conversion from B-ALL to hybrid leukemia featuring monocytoid characteristics is known as a lineage switch. This case suggests that leukemic subclones tend to carry out dedifferentiation, occasionally in extramedullary sites, which serve as a hotbed for the selection of resistant clones.

Enhanced production of direct photons in Au + Au collisions at square root(S(NN)) = 200 GeV and implications for the initial temperature

The production of e+ e- pairs for m(e+ e-)<0.3 GeV/c2 and 1<p(T)<5 GeV/c is measured in p+p and Au+Au collisions at square root(S(NN))=200 GeV. An enhanced yield above hadronic sources is observed. Treating the excess as photon internal conversions, the invariant yield of direct photons is deduced. In central Au+Au collisions, the excess of the direct photon yield over p+p is exponential in transverse momentum, with an inverse slope T=221+/-19(stat)+/-19(syst) MeV. Hydrodynamical models with initial temperatures ranging from T(init) approximately 300-600 MeV at times of approximately 0.6-0.15 fm/c after the collision are in qualitative agreement with the data. Lattice QCD predicts a phase transition to quark gluon plasma at approximately 170 MeV.

Hedgehog Signaling Pathway Is a New Target of Cancer Stem Cell Therapy for Breast Cancer Patients

Introduction: Hedgehog (Hh) signaling pathway is crucial for growth and patterning during embryonic development. We have shown that Hh pathway is constitutively reactivated in human breast cancer (Kubo M et al. Cancer Res 2004). Recently, it has been proposed that only a small subset, termed cancer stem cells (CSCs), posseses tumorigenicity. And, several investigations suggest contributions of morphogenesis pathways including Hh pathway in the maintenance of CSCs. Purpose of this study is to reveal an essential role of Hh pathway in the maintenance of CSCs, and also to reveal a possibility of Hh pathway as a target of CSCs therapy for breast cancer patients.Materials and Methods: A human breast cancer cell line MCF-7 was used. In the present study, we estimated CD44+CD24-/low cells or side population (SP) cells as CSCs. Flow cytometric analysis and sorting were performed to detect and collect CSCs, respectively. To confirm the high tumorigenicity of CSCs, we used a MCF-7 cell xenograft mouse model in NOD/SCID mice. To assess the expression of Hh pathway-related molecules, real-time RT-PCR and fluorescent immunostaining were performed. For blockade of Hh pathway, a Hh inhibitor, cyclopamine, and small interference RNA (si-RNA) against Gli1, a trans-activator of the Hh pathway, were used. We also synthesized peptides with specific affinity for a transmembrane receptor Patched1 (Ptch1).Results: CD44+CD24-/low cells and SP cells in total MCF-7 cells were 10-25% and 1-4%, respectively and these two populations were overlapped with each other. These CSCs were highly tumorigenic, and resistant to anticancer drugs including taxanes.Hh pathway-related molecules such as Shh, a ligand of Hh pathway, and Gli1 were predominantly expressed in CSCs. Cyclopamine and Ptch1 affinitive peptides could suppress the tumorigenicity of CSCs in NOD/SCID mice xenograft transplantation model.Conclusions: Hh pathway at least partly contributes to the maintenance of CSCs in MCF-7 cells. Thus, Hh pathway may be a valuable therapeutic target for CSCs therapy for breast cancer patients.

Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 1161.

Charged Kaon interferometric probes of space-time evolution in Au+Au collisions at sqrt[S(NN)]=200 GeV

Bose-Einstein correlations of charged kaons are used to probe Au+Au collisions at sqrt[S(NN)]=200 GeV and are compared to charged pion probes, which have a larger hadronic scattering cross section. Three-dimensional Gaussian source radii are extracted, along with a one-dimensional kaon emission source function. The centrality dependences of the three Gaussian radii are well described by a single linear function of N(part)1/3 with a zero intercept. Imaging analysis shows a deviation from a Gaussian tail at r greater than or approximately equal to 10 fm, although the bulk emission at lower radius is well described by a Gaussian. The presence of a non-Gaussian tail in the kaon source reaffirms that the particle emission region in a heavy-ion collision is extended, and that similar measurements with pions are not solely due to the decay of long-lived resonances.

Measurement of bottom versus charm as a function of transverse momentum with electron-hadron correlations in p + p collisions at square root of s = 200 GeV

The momentum distribution of electrons from semileptonic decays of charm and bottom quarks for midrapidity |y|<0.35 in p+p collisions at square root of s=200 GeV is measured by the PHENIX experiment at the Relativistic Heavy Ion Collider over the transverse momentum range 2<pT<7 GeV/c. The ratio of the yield of electrons from bottom to that from charm is presented. The ratio is determined using partial D/D-->e(+/-)K(-/+)X (K unidentified) reconstruction. It is found that the yield of electrons from bottom becomes significant above 4 GeV/c in pT. A fixed-order-plus-next-to-leading-log perturbative quantum chromodynamics calculation agrees with the data within the theoretical and experimental uncertainties. The extracted total bottom production cross section at this energy is sigma(bb)=3.2(-1.1)(+1.2)(stat)(-1.3)(+1.4)(syst)mub.

Mycobacterium kyorinense sp. nov., a novel, slow-growing species, related to Mycobacterium celatum, isolated from human clinical specimens

A novel, non-pigmented, slow-growing mycobacterium was identified on the basis of biochemical and nucleic acid analyses, as well as growth characteristics. Three isolates were cultured from clinical samples (two from sputum and one from pus in lymph nodes) obtained from three immunocompetent patients with infections. Bacterial growth occurred at 28-42 degrees C on Middlebrook 7H11-OADC agar. The isolates showed negative results for Tween hydrolysis, nitrate reductase, semiquantitative catalase, urease activity, 3 day arylsulfatase activity, pyrazinamidase, tellurite reduction and niacin accumulation tests, but positive results for 14 day arylsulfatase activity and heat-stable catalase tests. The isolates contained alpha-, keto-, and dicarboxymycolates in their cell walls. Sequence analysis revealed that all isolates had identical, unique 16S rRNA sequences. Phylogenetic analysis of the 16S rRNA, rpoB, hsp65 and sodA gene sequences confirmed that these isolates are unique but closely related to Mycobacterium celatum. DNA-DNA hybridization of the isolates demonstrated less than 50 % reassociation with M. celatum and Mycobacterium branderi. On the basis of these findings, a novel species designated Mycobacterium kyorinense sp. nov. is proposed. The type strain is KUM 060204(T) (=JCM 15038(T)=DSM 45166(T)).

Impact of fresh-frozen plasma from male-only donors versus mixed-sex donors on postoperative respiratory function in surgical patients: a prospective case-controlled study

BACKGROUND

To reduce the risk of transfusion-related acute lung injury (TRALI), plasma products are mainly made from male donors in some countries because of the lower possibility of alloimmunization; other countries are considering this policy. The advantage of male-only fresh-frozen plasma (FFP) should be examined in a prospective case-control study.

STUDY DESIGN AND METHODS

This study compared pulmonary function after the transfusion of FFP derived from either male donors only (FFP-male) or mixed donors (FFP-mixed) in informed surgical patients treated at a tertiary university hospital in Japan. The factors contributing to pulmonary distress (PD) after transfusion were then statistically examined.

RESULTS

Eighty-two patients participated in this study (FFP-male, n = 55; FFP-mixed, n = 27). Nineteen patients developed PD (PaO(2)/FiO(2) ratio [P/F] < 300) within 6 hours after transfusion: seven had congestive pulmonary edema (transfusion-associated circulatory overload), five had permeability pulmonary edema (possible TRALI), and seven had no apparent pulmonary edema. A multivariate logistic regression analysis revealed that the use of cardiopulmonary bypass and preoperative liver dysfunction were significantly associated with a P/F of less than 300 (odds ratios [ORs], 8.95 [p = 0.004] and 6.54 [p = 0.005], respectively), while the use of FFP-male was significantly associated with the absence of PD (OR, 0.219; p = 0.022). All the patients with possible TRALI had received either white blood cell or granulocyte antibody-positive FFP. The lysophosphatidylcholine level was not correlated with PD.

CONCLUSIONS

Our data suggests that the use of FFP derived from male donors may be advantageous for posttransfusion pulmonary function, although PD is also determined by background characteristics.

First results on angular distributions of thermal dileptons in nuclear collisions

The NA60 experiment at the CERN Super Proton Synchrotron has studied dimuon production in 158A GeV In-In collisions. The strong excess of pairs above the known sources found in the complete mass region 0.2<M<2.6 GeV has previously been interpreted as thermal radiation. We now present first results on the associated angular distributions. Using the Collins-Soper reference frame, the structure function parameters lambda, mu, and nu are measured to be zero, and the projected distributions in polar and azimuth angles are found to be uniform. The absence of any polarization is consistent with the interpretation of the excess dimuons as thermal radiation from a randomized system.

Unusual sonographic appearance of synovial sarcoma of the anterior abdominal wall

We report a case of synovial sarcoma in a 58-year-old woman arising from the anterior abdominal wall. Sonography demonstrated a large mass with an unusual complex "honeycomb" echotexture. Doppler imaging displayed increased vascularity in the solid parts of the tumor.

Response of arginine vasopressin-enhanced green fluorescent protein fusion gene in the hypothalamus of adjuvant-induced arthritic rats

Arginine vasopressin (AVP) and corticotrophin-releasing hormone (CRH) in the parvocellular neurosecretory cells of the paraventricular nucleus (PVN) play a major role in activating the hypothalamic-pituitary-adrenal axis, which is the main neuroendocrine response against the many kinds of stress. We examined the effects of chronic inflammatory/nociceptive stress on the expression of the AVP-enhanced green fluorescent protein (eGFP) fusion gene in the hypothalamus, using the adjuvant arthritis (AA) model. To induce AA, the AVP-eGFP rats were intracutaneously injected heat-killed Mycobacterium butyricum (1 mg/rat) in paraffin liquid at the base of their tails. We measured AVP, oxytocin and corticosterone levels in plasma and changes in eGFP and CRH mRNA in the hypothalamus during the time course of AA development. Then, we examined eGFP fluorescence in the PVN, the supraoptic nucleus (SON), median eminence (ME) and posterior pituitary gland (PP) when AA was established. The plasma concentrations of AVP, oxytocin and corticosterone were significantly increased on days 15 and 22 in AA rats, without affecting the plasma osmolality and sodium. Although CRH mRNA levels in the PVN were significantly decreased, eGFP mRNA levels in the PVN and the SON were significantly increased on days 15 and 22 in AA rats. The eGFP fluorescence in the SON, the PVN, internal and external layers of the ME and PP was apparently increased in AA compared to control rats. These results suggest that the increases in the concentrations of ACTH and corticosterone in AA rats are induced by hypothalamic AVP, based on data from AVP-eGFP transgenic rats.

Formation of sp3-bonded carbon nanostructures by femtosecond laser excitation of graphite

A scanning tunneling microscopy study and ab initio total energy calculations have identified the atomic-level structure of novel sp;{3}-bonded carbon nanoscale domains formed dynamically from graphite by femtosecond-laser excitation. The structure is characterized by a pseudo sp;{3}-bonding configuration that results in inward displacement of surface carbon atoms by 0.5 A in every third row along the [11[over ]00] orientation. This structural periodicity is unique and differs from conventional phases of diamond.

Acute leukemia of ambiguous lineage, biphenotype, without CD34, TdT or TCR-rearrangement

Biphenotypic acute leukemia (BAL) is a rare entity that comprises 0.5-3% of all acute leukemias and probably arises from multipotent progenitor cells. The optimal approach for BAL therapy is unknown. Thus, it is important to elucidate the origin of the neoplastic cells for determination of the appropriate therapy. We report the case of a 41-year-old man with BAL having myeloid and T-lymphoid lineage phenotypes. Strangely, neither CD34 nor TdT expression nor rearrangement of TCR-alpha/beta, delta/gamma genes were shown. This pattern is rarely encountered and suggests that the blast cells were possibly considered immature with aspects of differentiation indicating myeloid lineage, rather than T-lymphoid lineage.

Suppression pattern of neutral pions at high transverse momentum in Au + Au collisions at sqrt[sNN]=200 GeV and constraints on medium transport coefficients

For Au + Au collisions at 200 GeV, we measure neutral pion production with good statistics for transverse momentum, pT, up to 20 GeV/c. A fivefold suppression is found, which is essentially constant for 5 < pT < 20 GeV/c. Experimental uncertainties are small enough to constrain any model-dependent parametrization for the transport coefficient of the medium, e.g., q in the parton quenching model. The spectral shape is similar for all collision classes, and the suppression does not saturate in Au + Au collisions.

[Tolerability of imatinib for patients with chronic myelogeneous leukemia (CML)]

The adequate dose of imatinib has not been defined for the Japanese population. Indeed, about half of patients experience mild to moderate adverse events due to this drug, some of which result in intolerance. We reviewed a patients' cohort treated with imatinib in our hospital in 2007 for chronic myelogeneous leukemia (CML). The cohort included 14 patients (5 men and 9 women) whose median age was 53 (range 16-81). The disease status at onset was chronic phase in 13 patients and accelerated phase in 1. During the 2-year observation period, 2 patients (14%) failed to respond and 6 (42%) became intolerant to imatinib. After the appearance of the intolerance, 5 of the 6 patients were treated with a reduced dose of imatinib (300 mg/day in 4, 200 mg/day in 1). In 4 of these 6 intolerant cases, CR was maintained 2 years after the start of imatinib therapy. Nevertheless, 42% of patients were intolerant to imatinib therapy through 2 years, and progression-free survival was 86%. In conclusion, an adjusted dose exerting minimal toxicity and showing a favorable outcome should be researched in Japanese patients including the elderly.

[Limited but potential efficacy by graft-versus-leukemia (GVL) for Pro T-ALL]

We present a 22-year-old male diagnosed with pro T-acute lymphoblastic leukemia (ALL). His laboratory test showed 181,900/microL of WBC complicated with lymphoadenopathy, pleural effusion, pericardial effusion and hepatosplenomegaly at the onset. Flow cytometry analysis of the leukemic cells showed cCD3+, CD7+, CD2+, CD1a-, CD3-, CD5-, CD4-, CD8-, CD34+, and HLA-DR+ as a pro T-cell phenotype. The patient was treated with induction therapy followed by 3 courses of consolidation therapy and achieved his first complete remission. He underwent up-front stem cell transplantation (SCT) from an HLA-full matched sibling, with early relapse just before transplantation. The conditioning regimen consisted of fludarabine (100 mg/m2) and melphalan (180 mg/m2). He relapsed with an extramedullary mass (gingival, testis, and femoral muscles) 1 year after transplantation. Since bone marrow involvement was not apparent, he received involved field radiation therapy (25.2 Gy/14 frequencies) in each mass. Six months after extramedullary relapse, bone marrow relapse occurred, and the patient died of sepsis due to Pseudomonas aeruginosa during re-induction therapies. Based on the immature T cell phenotype frequently with myeloid markers, a graft-versus- leukemic effect might be expected after allogeneic SCT for Pro T-ALL and a positive indication of SCT for this disease should be considered.

Onset of pi(0) suppression studied in Cu+Cu collisions at sqrt S NN=22.4, 62.4, and 200 GeV

Neutral pion transverse momentum (p(T)) spectra at midrapidity (|y| less than or approximately 0.35) were measured in Cu+Cu collisions at sqrt[s(NN)]=22.4, 62.4, and 200 GeV. Relative to pi_(0) yields in p+p collisions scaled by the number of inelastic nucleon-nucleon collisions (N(coll) the pi_(0) yields for p(T) more than or approximately 2 GeV/c in central Cu+Cu collisions are suppressed at 62.4 and 200 GeV whereas an enhancement is observed at 22.4 GeV. A comparison with a jet-quenching model suggests that final state parton energy loss dominates in central Cu+Cu collisions at 62.4 and 200 GeV, while the enhancement at 22.4 GeV is consistent with nuclear modifications in the initial state alone.

J/psi production in sqrt s_NN=200 GeV Cu+Cu collisions

Yields for J/psi production in Cu+Cu collisions at sqrt s_NN=200 GeV have been measured over the rapidity range |y|<2.2 and compared with results in p+p and Au+Au collisions at the same energy. The Cu+Cu data offer greatly improved precision over existing Au+Au data for J/psi production in collisions with small to intermediate numbers of participants, in the range where the quark-gluon plasma transition threshold is predicted to lie. Cold nuclear matter estimates based on ad hoc fits to d+Au data describe the Cu+Cu data up to N_part approximately 50, corresponding to a Bjorken energy density of at least 1.5 GeV/fm(3).

Particle-species dependent modification of jet-induced correlations in Au+Au collisions at sqrt[s_{NN}]=200 GeV

Measurements in Au+Au collisions at sqrt[s_{NN}]=200 GeV of jet correlations for a trigger hadron at intermediate transverse momentum (p_{T,trig}) with associated mesons or baryons at lower p_{T,assoc} indicate strong modification of the away-side jet. The ratio of jet-associated baryons to mesons increases with centrality and p_{T,assoc}. For the most central collisions, the ratio is similar to that for inclusive measurements. This trend is incompatible with in-vacuum fragmentation but could be due to jetlike contributions from correlated soft partons, which recombine upon hadronization.

Visceral fat thickness in overweight men correlates with alterations in serum fatty acid composition

BACKGROUND

We examined relationships between visceral fat amount and alterations in serum fatty acid composition, both of which represent critical factors in the development of metabolic syndrome.

METHODS

Correlations were analyzed between visceral fat thickness as measured by ultrasonography and proportions of individual fatty acids in 21 normal-weight and 24 overweight Japanese men.

RESULTS

Significant associations were identified in overweight subjects. Visceral fat thickness displayed positive correlations to levels of palmitic acid and saturated fatty acids (r=0.475, P<0.05 and r=0.545, P<0.01, respectively); and negative correlations to levels of linoleic acid and polyunsaturated fatty acids (r=-0.513, P<0.05 and r=-0.428, P<0.05, respectively). Visceral fat thickness was also correlated with estimated desaturase activities, with positive correlations to Delta9- and Delta6-desaturase activities and negative correlations to Delta5-desaturase activity (r=0.580, P<0.01, r=0.669, P<0.01 and r=-0.559, P<0.01, respectively). No significant associations were identified in normal-weight subjects.

CONCLUSIONS

Significant associations between visceral fat amount and alterations in serum fatty acid composition were identified, but only in overweight individuals.

Source breakup dynamics in Au + Au collisions at sqrt[s(NN)]=200 GeV via three-dimensional two-pion source imaging

A three-dimensional correlation function obtained from midrapidity, low p(T), pion pairs in central Au+Au collisions at sqrt[s(NN)]=200 GeV is studied. The extracted model-independent source function indicates a long range tail in the directions of the pion pair transverse momentum (out) and the beam (long). A proper breakup time tau(0) ~ 9 fm/c and a mean proper emission duration Delta tau ~ 2 fm/c, leading to sizable emission time differences ({|Delta t(LCM)|} approximately 12 fm/c), are required to allow models to be successfully matched to these tails. The model comparisons also suggest an outside-in "burning" of the emission source reminiscent of many hydrodynamical models.

Isolated extramedullary relapse presenting as autologous lymphocyte response

Isolated EMR in the CNS is a relatively rare form of recurrent leukemia. We report here a case of a 38-year-old man with inv(16) acute myeloid leukemia (AML, M2) who suffered a central nervous system (CNS) relapse after allogeneic bone marrow transplantation (BMT) from a human leukocyte antigen (HLA)-matched sibling donor. After complete remission was achieved by chemotherapy, he received allogeneic BMT from his HLA-matched sister. His leukemia relapsed in the CNS 2.5 years after the allogeneic BMT. Lumbar puncture revealed 780/muL white blood cells with 67.3% leukemia cells and 32.7% mature lymphocytes. Fluorescent in situ hybridization (FISH) using a probe for the Y chromosome demonstrated that both leukemia cells and lymphocytes in the cerebrospinal fluid (CSF) were derived from the recipient, although the bone marrow cells were from the donor. No leukemia cells with inv(16) were detected by FISH in the bone marrow. This is the first report to clarify the chimerism of lymphocytes in the CSF of patients with isolated EMR in the CNS after allogeneic SCT, in which analysis revealed that autologous immunologic cells rather than donor lymphocytes responded to the recurrent isolated leukemic cells in CNS. This observation suggests that the CNS is a "sanctuary" site not only from chemotherapy but also from the graft-versus-leukemia effect. The present case contributes to our understanding of the possibility of immunological escape phenomenon of recurrent leukemia cells in extramedullary sites.