Yoshiko Saito

A Recurrent Nonrandom Translocation (3;7)(q27;p12) Associated with Bcl-6 Gene Rearrangement in B-Cell Diffuse Large Cell Lymphoma

Two cases of B-cell diffuse large cell lymphoma associated with the t(3;7)(q27;p12) and BCL-6 rearrangement are described. Cytogenetic studies revealed [case 1] 47,XY,t(3;7)(q27;p12),+12 and [case 2] 45,X,-Y,t(3;7)(q27;p12),del(6)(q21q25),+16,-21. The translocation of each case had a non-random chromosomal change involving a 3q27 locus associated with BCL-6 gene rearrangement identified by Southern blot analysis. Both cases involved multiple lymph nodes and extranodal regions, such as stomach and peritoneal cavity in case 1, extranodal retroperitoneal space, subcutis, probable liver, and colon in case 2. Chemotherapy provided only short survival after onset: 17 and 16 months, respectively. Altered expression of adhesion molecules CD44, CD54 (case 1) and CD11a and CD18 (case 2) may help to explain the poor outcome of these patients.

In Vivo Measurement of Small Velocity Signals and Change in Thickness of the Heart Walls

We have previously developed a new method for accurately tracking the movement of the heart wall based on both the phase and magnitude of the demodulated signals to determine the instantaneous position of an object. By this method, velocity signals of the heart wall with small amplitudes less than several micrometers on the motion resulting from a heartbeat can be accurately detected. Moreover, the method has been applied to multiple points preset in the heart wall along an ultrasonic beam so that the spatial distributions of the local change in thickness during one cardiac cycle is determined. In this paper, the method is applied to the free wall of the right ventricle (RV), the interventricular septum (IVS), and the posterior wall of the left ventricle (LV). From the relationships among the results for these parts of the heart, new findings which characterize the velocity signals and the change in thickness in each cardiac period are described. This method offers potential for quantitative myocardial diagnosis.

Fifty-five essential thrombocythemia patients follow-up study in single institution of Japan

Background: Report on the changes of diagnostic criteria since 1970 and correspondence due to the development of new therapeutic drugs during long term clinical period. Patients and method: The subjects were Fifty-five ET patients who were 21-95years old who newly diagnosed Sendai Blood Disease Center (renaming Sendai Tomita Hospital from March 2013) between 1991 year and 2010 year. As a substitute for bone biopsy for convenient diagnostic tool, we diagnosed essential thrombocythemia (ET) by the smear sample of bone marrow aspiration focusing on platelet production of megakaryocyte cytoplasm. Result: We classified megakaryocytes into 7 types (0 to 5 and U) with platelet counts in the cytoplasm. We named Type U which was filled and spilling out platelets from megakaryocyte. Type U was not observed in our experienced 25 chronic myeloid leukemia cases, 10 polycythemia vera cases and another hematologic malignancies. The proportion of seven types was Type 0 was 35.9%, type I 4.7%, type II 6.0%, type III 3.0%, type IV 0.8%, type NK 4.4% and type U was 45.2% respectively. 30 males and 25 females, the age at the time of diagnosis was the median 64 years and range 21 to 95 with 61.8% above the age 60 years. The observation periods was from 17 months to 303 months and the median was 94 months. The main goal in ET is to prevent thrombohemorrhagic complications and the same for older patients. The frailty of elderly people, 15 of the 19 patients who stopped receiving medical examination was brought about by falls and aspiration pneumonia which caused the physical condition to decrease, not accompanied by ET treatment. The cause of frailty in older ET patients was irrespective ET treatment, and so on based on risk-adapted therapy was necessary for older ET patients. Conclusion: Megakaryocytes of ET patients showed platelet-free production and overproduction of platelets in cytoplasm. Based on risk-adapted therapy was necessary for frail older ET patients. Correspondence to: Yoshiko Saito, Aoikai Sendai Hospital, Sendai city, Miyagi Prefecture Japan, Tel: (81)-22-380-1000, Fax: (81)22-244-5755, E-mail: sy33814@topaz.ocn.ne.jp / ysaitou@mgu.ac.jp

Noninvasive early detection of anthracycline‐induced cardiotoxicity in patients with hematologic malignancies using the phased tracking method

Anthracyclines are among the most effective and widely used anticancer drugs; however, their use is limited by serious cardiotoxicity. Early detection is necessary to prevent the high mortality rate associated with heart failure (HF). We evaluated cardiac function in 142 patients using conventional echocardiography and the phased tracking method (PTM), which was measured using the minute vibration and the rapid motion components, neither of which is recognized in standard M‐mode nor in tissue Doppler imaging. For systolic function comparison, we compared left ventricular ejection fraction (LVEF) in conventional echocardiography with the average velocity of ventricular septum myocytes (Vave) in the PTM. The Vave of 12 healthy volunteers was 1.5 (m/s)/m or more. At baseline of 99 patients, there was a positive correlation between LVEF and Vave in all patients. There were no significant differences in baseline cardiac function between patients with and without HF. There was a negative correlation between the cumulative anthracycline dose and LVEF or Vave among all patients. We determined that Vave 1.5 (m/s)/m was equivalent to LVEF 60%, 1.25 (m/s)/m to 55%, and 1.0 (m/s)/m to 50%. During the follow‐up period, there was a pathological decrease in LVEF (<55%) and Vave (<1.25 m/s/m) in patients with HF; decreases in Vave were detected significantly earlier than those in LVEF (P < 0.001). When Vave declined to 1.5 (m/s)/m or less, careful continuous observation and cardiac examination was required. When Vave further declined to 1.0 (m/s)/m or lower, chemotherapy was postponed or discontinued; thus, serious drug‐induced cardiomyopathy was avoided in patients who did not relapse. The PTM was superior to echocardiography for early, noninvasive detection and intermediate‐term monitoring of left ventricle systolic function associated with anthracycline chemotherapy, among patients with hematologic malignancies. The PTM was an effective laboratory procedure to avoid the progression to serious cardiomyopathy.