Garenoxacin Prophylaxis for Febrile Neutropenia after Chemotherapy in Hematological Malignancies

Background: Febrile neutropenia is one of the most serious adverse events in patients with hematological malignancies and chemotherapy. The routine use of fluoroquinolone prophylaxis in patients with hematological malignancies is controversial. Therefore, we prospectively evaluated the efficacy and safety of prophylactic use of garenoxacin for febrile neutropenia. Patients and Methods: Consecutive adult patients with hematological malignancies who were at risk for chemotherapy-induced neutropenia lasting more than seven days were eligible for present study. They received oral garenoxacin (400 mg daily) from the neutrophil count decreased to less than 1000/μl and continued until the neutropenia had resolved. The primary endpoint was incidence of febrile neutropenia, and the secondary endpoints were the type and incidence of adverse events. Results: We enrolled 46 consecutive patients (median age, 59 years). The underlying diseases comprised acute myeloid leukemia (n = 17), acute lymphoblastic leukemia (n = 3), malignant lymphoma (n = 23), and multiple myeloma (n = 3). There were 23 febrile neutropenia episodes and 2 episodes of bacteremia. There were no grade 3 or 4 adverse events;however serum creatinine levels were significantly elevated after garenoxacin administration. The overall prophylactic efficacy of garenoxacin was 50%, and there were no infection-related deaths. Conclusions: Prophylactic use of garenoxacin is effective and safe in patients with hematological malignancies. (Clinical trial registration number: UMIN000004979).

Proteomic Analysis of Celecoxib on Chondrocytes from Patients with Osteoarthritis

Objective: To study a comprehensive proteomic analysis of celecoxib in oseteoarthritis (OA) chondrocytes. Methods: OA chondrocytes were stimulated with celecoxib, IL-1β and IL-1β together with celecoxib. Proteins were extracted from the cells and subjected to 2-dimensional differential image gel electrophoresis (2D-DIGE). Proteins of interest were identified by mass spectrometry. Results: Eighty-six protein spots showed significantly different intensities with each reagent or reagent combination. AAA+ protein, HSP47/Serpin, cAMP-dependent protein kinase type II-beta regulatory subunit, alpha-actin-4 and tubulin decreased with the addition of celecoxib, while apolipoprotein A-V, glutamate carboxipeptide 2, mitochondrial stress-70 protein, sorting nexin-9 and GRP78 increased with the addition of celecoxib. GRP78 is a stress protein and may be chondroprotective. Celecoxib modulated IL-1β stimulated chondrocytes, and CD200R and moesin were identified as such resulting proteins. Conclusion: Protein profiles of OA chondrocytes changed after administration of celecoxib. Further investigation is needed to elucidate the function of each protein in OA chondrocytes.

Rikkunshi-to Partially Reverses Cancer Chemotherapy-Induced Decrease in Plasma Valproic Acid Concentration in a Patient with Malignant Lymphoma

A fifty-five-year-old male patient with malignant lymphoma who took oral valproic acid (VPA) tablets and itraconazole (ITZ) capsles received 3 courses of cancer chemotherapy, including 2 courses of a combination of rituximab/methotrexate/ifosphamide/etoposide/ carboplatin/ methylpredonisolon (R-IMVP16/CBDCA regimen) and subsequent one course of a combination of rituximab/ranimustine/citara bine/etoposide/merphalan (R-MEAM regimen). Plasma concentration of VPA dramatically decreased below the therapeutic concentration after the first and second chemotherapy and seizures appeared in both cases. Plasma concentration of ITZ was also lowered after the second chemotherapy course. At the third chemotherapy, Rikkunshi-to, a Japanese herbal medicine, was prescribed for 14 days. Plasma VPA concentration decreased, though to a lesser extent, after chemotherapy, in which the level was near the border of therapeutic concentration. No convulsion was observed. Therefore, care should be taken to monitor plasma drug concentration during cancer chemotherapy. Rikkunshi-to may be useful to alleviate the chemotherapy-induced decrease in plasma concentrations of orally administered drugs.

A Large Calcifying Cystic Odontogenic Tumor Occupying the Maxillary Sinus: A Case Report and Review of Literature

Calcifying cystic odontogenic tumor (CCOT) is an uncommon benign cystic neoplasm of the jaw that develops from the odontogenic epithelium. It is clinically characterized as a painless—slow-growing tumor that affects the maxilla as well as the mandible, and generally occurs in young adults in the third or fourth decade of life. Herein, we present the case of a 16-year-old Japanese boy who showed a CCOT in the maxillary sinus. Panoramic radiography showed a unilocular lesion in the left maxillary sinus. Computed tomography showed an approximately 5-cm well-defined unilocular expansile lesion with multiple radiopaque calcific specks, arising from the left maxillary alveolar ridge. The lesion was surgically removed, under general anesthesia, and the patient was followed up for 3 years after the surgery, and there have not been any signs of recurrence.

杜鹃对两种远距离的近缘苇莺的巢寄生:一个平行协同进化的案例?(英文)

大杜鹃(Cuculus canorus)通常寄生小型雀形目鸟类。由于杜鹃雏鸟的排他性拱卵或拱雏,导致宿主繁殖失败,因此宿主进化出如卵识别能力的反寄生策略。反过来,杜鹃也同时进化出如模拟宿主卵的寄生策略。于是两者之间的相互作用可形成类似军备竞赛的协同进化关系。在匈牙利,大苇莺(Acrocephalus arundinaceus)是大杜鹃的主要宿主,寄生率可高达约 40-65%。以往被认为是大苇莺一个亚种的东方大苇莺(A. orientalis)在日本的种群也被大杜鹃寄生(25-40%)。通过采用光纤光谱仪量化大杜鹃及其宿主的卵色特征,我们比较了东、西半球大杜鹃对两种苇莺的寄生模拟程度。鸟类视觉模型显示,对于可见光颜色,杜鹃与宿主之间卵色的模拟程度在匈牙利高于日本,但匈牙利杜鹃和宿主均较大的卵色变异程度可导致卵色模拟困难。杜鹃与苇莺卵色的量度差异在日本较低,这被证明是宿主拒卵行为的一个重要影响因素。苇莺对大杜鹃卵的拒绝率在日本(35%)和匈牙利(37%)相似。与匈牙利不同,在日本,宿主对杜鹃寄生的应对策略如拒卵行为,先于杜鹃的反适应对策。我们认为,两种近缘物种大苇莺对杜鹃寄生的不同反寄生行为,代表了协同进化军备竞赛的不同演化阶段。

Endoscopic Examination for Patients with Diarrhea after Allogeneic Stem Cell Transplantation

Objective: Intestinal graft-versus-host disease (GVHD) represents one of the most serious complications of allogeneic stem cell transplantation (allo-SCT). Endoscopic and histological proof is required due to the number of differential diagnoses manifesting as diarrhea. We investigated the safety of endoscopic biopsies, and the role of conducting biopsies and inspections of the terminalileum. Patients: Thirty two colonoscopic examinations and 29 biopsies were performed for 19 patients after allo-SCT in our institute between October 2011 and May 2015. Results: Endoscopic examinations and biopsies were performed safely under the policy of transfusing platelets for thrombocytopenia (3/μL). For biopsied cases, the diagnostic consistency rate with endoscopic findings was 60%, with a tendency toward negative correlations with early examinations after diarrhea onset (25% for 0 - 1 days;62.5% for later) or low-grade GVHD according to Freiburg criteria (41.2% for grade 1, 66.7% for grade 2, 100% for higher). The terminal ileum was inspected with colonoscopy in 13 cases. Endoscopic diagnoses of the ileum were provided in 11 cases and histological diagnoses in 9 cases. Diagnostic consistency for diagnosis of the terminal ileum between endoscopy and histology was 77.8%. Conclusion: Because endoscopic and histopathological findings do not always match, caution is required when focusing on endoscopic findings alone, as there is a risk of misdiagnosis. Extensive inspection of the terminal ileum with biopsy appears useful to identify otherwise undetected lesions. Our data thus support invasive endoscopic examinations for gastrointestinal complications, including ileac inspection and biopsies under appropriate management.

热海鸟巢

每每看到乌鸦用衣架建造的巢穴，设计师都会有所触动。因为衣架不仅坚固耐用、具有一定的弹性，而且衣架本身有钩子，相较于一般枝条更易连接在一起，因此非常容易组装。乌鸦巧妙地处理了自然与人工的关系，打造出兼具功能性及舒适性的居住环境。

丝带教堂

合二为一的螺旋体 该项目位于广岛县尾道市一家名为“Bella Vista Sakaigahama”的度假酒店的花园之中。项目场地位于半山腰，在此可以欣赏到日本内海的全部美景。两座螺旋形楼梯缠绕在一起，以一种前所未有的组合方式构筑了这样一座独立的建筑，并且用一种纯粹的结构形式完美地诠释了婚姻这一行为的意义。单个螺旋形楼梯在水平方向很难保持稳定，并且极易引起垂直方向的震动，因此非常不稳固。设计师通过将互为依靠的两座螺旋形楼梯组合在一起，形成一个可以独立支撑的稳定结构。正如相爱的两个人在结合之前需要经历磨合，两个螺旋形楼梯在15．4m高的顶部位置无缝对接在一起，形成一条完整的丝带。两个螺旋形楼梯环绕的核心处就是婚礼教堂，教堂的走道通向一棵具有象征意义的树。圣坛就在这裸树前，圣坛前的80个座椅设计巧妙，坐在座椅上就可以看到树林另一侧的海景。