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In this case, relapse was detected early when there was no bleeding symptom, and remission was rapidly achieved with a small amount of IST without any adverse effects. There are few reports on AHA relapse; we believe that the present report will contribute meaningfully to the literature on this subject and would be useful when considering the long-term management of AHA.We report the case of a 26-year-old male patient with chronic myelogenous leukemia in the chronic phase with the e13a3 (b2a3) variant of BCR-ABL1 fusion. Despite the presence of Philadelphia chromosome and fluorescence in situ hybridization-detectable BCR-ABL1 fusion signals, quantitative measurement of BCR-ABL1 on the ABL1 using a reverse primer in exon 2 of ABL1 failed to detect the fusion transcripts. PCR direct sequencing analysis with a sense primer for exon 13 of BCR and an antisense primer for exon 3 of ABL1 revealed the e13a3 variant of BCR-ABL1 fusion. The variant fusion transcript level was successfully monitored by the TaqMan assay using a forward primer and probe both in exon 13 of BCR and a reverse primer in exon 3 of ABL1. The patient responded extremely well to imatinib treatment, similar to previously reported e13a3 cases. The patient achieved a molecular response (undetectable e13a3 transcripts) after 12 months of treatment.Acquired thrombotic thrombocytopenic purpura (aTTP) is a life-threatening systemic thrombotic microangiopathy characterized by the presence of anti-ADAMTS13 antibodies (inhibitor). Here we report the case of a patient with refractory aTTP successfully treated with cyclosporine. A 69-year-old man presenting with hematuria and petechiae was referred to our hospital; he was disoriented and febrile. Laboratory results revealed Coombs-negative hemolytic anemia, thrombocytopenia, and renal failure. Undetectable ADAMTS13 activity and presence of anti-ADAMTS13 antibodies (inhibitor) confirmed the diagnosis of aTTP. Despite performing plasma exchange and administering prednisolone and rituximab (375 mg/m2), we were unable to restore his platelet counts to the normal level. Therefore, he was treated with cyclophosphamide (500 mg/bodyweight), vincristine (1.4 mg/m2), bortezomib (1.3 mg/m2), and cyclosporine (2.5 mg/kg). After the cyclosporine therapy, his platelet counts gradually normalized. Continuous cyclosporine maintenance therapy led to complete disappearance of the inhibitor. Therapeutic strategies for refractory aTTP have not yet been established. Further investigations are warranted to establish a therapeutic strategy for refractory aTTP.Post-transplant lymphoproliferative disorder (PTLD) usually develops with systemic symptoms, such as fever, generalized lymphadenopathy, and elevation in the lactate dehydrogenase level. Here, we present the case of a 65-year-old female patient with PTLD localized to the colon; the patient only had mild diarrhea without systemic symptoms. She had myelodysplastic syndrome and was treated with cord blood transplantation (CBT). She had a past medical history of sigmoid colon cancer treated with colonosectomy and adjuvant chemotherapy. After CBT, she achieved complete remission and was discharged after 60 days. Further, 79 days after CBT, she presented with abdominal pain. Computed tomography scan revealed adhesive ileus. The abdominal pain was resolved in 1 day with conservative treatment, however, mild diarrhea persisted. Therefore, we performed colonoscopy and found multiple ulcerative lesions in the upper colon. A pathological examination revealed PTLD. Furthermore, elevation of EBV-DNA in the blood was also confirmed. There was no detectable lesion on positron emission tomography-computed tomography (PET-CT) outside the colon; thus, we diagnosed PTLD localized into the colon that was successfully treated with rituximab. Our present experience suggests that it might be important to perform endoscopy and monitoring of EBV-DNA for early detection of PTLD, especially localized in the gastrointestinal tract.To perform chimeric antigen receptor T (CAR-T) cell therapy in heavily pretreated patients with progressive disease and depleted lymphocytes, an optimized leukapheresis protocol must be established. To probe the effects of patient-related parameters on the collection efficiency of CD3+ cells, we retrospectively analyzed patients with relapsed/refractory diffuse large B-cell lymphoma who underwent leukapheresis for tisagenlecleucel at two centers. A total of 51 patients were analyzed, with a median age at apheresis of 59 years, and precollection hemoglobin levels, CD3+ cell counts, and platelet counts of 9.2 g/dl, 574/µl, and 15.8×104/µl, respectively. A median of 3.0×109 (0.7-8.4) CD3+ cells were harvested with 8.7 (4.0-15.7) l apheresis volume. The collection efficiency 2 (CE2) for CD3+ cells was 61.0% (21.0-127.3). One-day apheresis was sufficient to obtain the designated cell numbers in all cases. Lower hemoglobin levels, higher CD3+ cell counts, and higher platelet counts before apheresis were significantly associated with lower CE2 for CD3+ cells. These results suggest a need to increase the apheresis volume in anemic, lymphocyte- or platelet-rich patients due to an expected low CE2. Erythrocyte transfusions before or during apheresis may be a reasonable option for patients with anemia.Bacillus cereus bacteremia is an infectious disease that may sometimes be fatal with a rapid clinical course. We performed a retrospective analysis on 12 patients with Bacillus cereus bacteremia recruited from January 2010 to March 2015. The primary diseases were acute leukemia (n=5), myelodysplastic syndromes (n=3), malignant lymphoma (n=3), and hemophagocytic syndrome (n=1). Neutrophil count at the onset of this bacteremia was less than 500 cells/µl in 9 patients. At the onset of bacteremia, we observed neurological symptoms (n=7), gastrointestinal symptoms (n=6), and findings suspected of infection at the venous catheter insertion site (n=6). Vancomycin was administered to all the patients; 10 patients showed improvement whereas 2 died early after allogeneic hematopoietic stem cell transplantation owing to bacteremia. Three patients had sequelae of central nervous system disorders. TP0427736 price Neurological and gastrointestinal symptoms with fever may be predictors for this bacteremia, and early administration of appropriate antibacterial drugs may improve the prognosis. Future research should be aimed toward the identification of the clinical features of poor prognosis and establishment of remedies for Bacillus cereus bacteremia.Twenty-three of 42 European rabbits (Oryctolagus cuniculus), belonging to the same rabbit colony, died in March 2020 (55% mortality) in Chiba prefecture, Japan. The disease course was extremely acute without indicators of death or hemorrhage. Necropsy revealed liver swelling, discoloration, cloudiness and fragility, and pulmonary edema. Histologically, severe hepatocellular necrosis (mainly peripheral) and intra-glomerular capillary hyalin thrombi were observed. On molecular-biological examination, reverse transcription polymerase chain reaction analysis of RNA from tissues detected a rabbit hemorrhagic disease virus, confirmed as a RHDV-2 VP60 fragment, which shared 99.42% nucleotide identity with the homologous fragment of RHDV-2 German isolate by nucleotide sequence analysis. This report shows the outbreak of rabbit hemorrhagic disease caused by RHDV-2, an emerging infectious disease, in Japan.The purpose of this study was to evaluate the application of fiberglass reinforcement method in thermoplastic mouthguard materials to improve flexural properties and adhesive strength. Commonly used two types of commercial mouth guard materials (ethylene-vinyl acetate copolymer-based and polyolefin-based) were reinforced with glass fiber clothes by two-step hot press. Flexural strength and adhesive strength with each base material were examine via three-point bending test and delamination test, respectively. Ethylene-vinyl acetate copolymer-based fiberglass-reinforced material has significantly greater adhesive strength with base material and improvement of flexural properties compared with polyolefin-based material. These results suggest that flexural properties of both conventional commercial mouthguard materials were improved when the glass-fiber-reinforced method was applied to reinforce mouthguard materials, and more, ethylene-vinyl acetate copolymer was more desirable for the base material.The aim of the present study was to assess the duration of dentin tubule occlusion by the calcium phosphate precipitation (CPP) method in the vital teeth of beagle dogs. Vital teeth were treated using the CPP method, potassium oxalate, or a bonding agent (Liner bond II) after cavity preparation and acid etching. The dentin tubules of all groups, except for the bonding agent, opened more widely with time in the absence of plaque control. Dentin tubules treated with the CPP method were open and no precipitate remained in the absence of plaque control. Differences were observed in dentin tubule occlusion when plaque control was achieved by daily tooth brushing. The majority of dentin tubules were occluded with an apatitic precipitate seven days after the CPP method with plaque control. The present results demonstrated that the CPP method is useful with proper plaque control.Radiofrequency magnetron sputtering of silicon was applied onto zirconia surfaces by use of a non-doped Si wafer at 2%, 5%, 8%, and 10% oxygen volumes. Immediately after sputtering, the contact angle was practically 0 for all oxygen volume specimens. In terms of sustainability of the hydrophilicity, however, 5% oxygen volume was found to be optimal. Scanning electron microscopy and energy dispersive X-ray spectroscopy clearly suggested the presence of silica layer on zirconia surfaces. The shear bond strength of the pre-treated zirconia and resin was 35.03±4.97 MPa, which was approximately 3.5 times higher than that of zirconia without any sputtering treatment (9.26±1.21 MPa). The failure mode of the pre-treated zirconia specimen was cohesive failure, whereas that of the control specimen was observed to be interface failure.The effects of space setting values and restorative materials on the bonding of metal-free CAD/CAM onlay restoration were examined quantitatively and qualitatively. Seventy-two standardized MODB onlay cavities, prepared using human molars were restored under nine conditions, based on three space setting values, Increased (IC), Standard (SC, control), Decreased (DC), and three restorative block materials, resin-composites (RC), lithium disilicate glass-ceramics (LD), Feldspar ceramics (FC, control). All the restored specimens were subjected to cyclic loading and thereafter the microtensile bond strength (µ-TBS) was measured and analyzed statistically. The effect of space setting value on the µ-TBS varied with the restorative material. The bonding reliability of RC and the bonding durability of LD were significantly superior to FC. The bonding characteristics of RC under IC and DC were similar to those under SC. LD under DC and FC under IC were effective in obtaining an excellent bonding reliability relative to their SC.We investigated the remineralization effects of Nanoseal (NS) dentin desensitizer on demineralized root dentin. Baseline lesion specimens prepared from bovine root dentin were immersed in artificial saliva (AS) or deionized water (DW) after treatment with NS or fluoride-free Nanoseal (NS(-)). Treatment and control groups comprised 1, AS; 2, NS/AS; 3, NS(-)/AS; 4,NS/DW; 5, NS(-)/DW; and 6, baseline demineralization. Integrated mineral loss (IML) and lesion depth (LD) were determined by transverse microradiography. Fluoride concentrations in the immersion solutions were measured. AS, NS/AS and NS(-)/AS showed higher mineral volume % at the surface and lesion body than did other groups. NS/AS showed significantly lower IML than did AS. There was no significant difference in IML between NS/AS and NS(-)/AS. The highest concentration of fluoride was in the NS/AS immersion solution. The findings suggest Nanoseal facilitated remineralization of demineralized root dentin, and fluoride and other ions included may have contributed to this effect.
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