Validity of the PROMIS Physical Performance Scale in Determining Frailty and Physical Ability in Community-Dwelling Elderly

In many clinical settings, therapists are continuously seeking efficient and valid assessments for older adults to determine their physical abilities and functional status. The Patient Reported Outcome Instrument System (PROMIS) is a newly developed computer adapted test (CAT) that is being incorporated into electronic medical records and has been reported to assess a person’s physical function. The current gold standard to assess different levels of frailty and physical function in older individuals is the Modified Physical Performance Test (mPPT). However, the mPPT is a lengthy performance based outcome measure that takes time to administer. The purpose of this study is to determine a more quick and efficient test to determine physical function

A simple flow cytometric scoring system is useful for distinguishing myelodysplastic syndromes from non-clonal anemic disorders

Myelodysplastic syndromes (MDS) are a myeloid neoplasm characterized by abnormal differentiation, ineffective hematopoiesis, and genetic instability with enhanced risk of transforming to acute myeloid leukemia (AML). The diagnosis of MDS is principally made based on the percentage of blasts in the bone marrow and peripheral blood, type and degree of dysplasia and the presence of ring sideroblasts. Recently, for making an accurate diagnosis of MDS, the aberrant antigen expression detection of hematopoietic cells by flow cytometry has been reported to be a useful. However, the diagnostic systems utilized in those studies are rather complicated. We modified an existing flow cytometric scoring system (FCMSS) based on aberrancies in the myeloid lineage and evaluated its usefulness in diagnosing various anemic disorders, including myelodysplastic syndromes (MDS). The flow cytometric score was significantly higher in MDS patients than in those with other anemic disorders, the exception being megaloblastic anemia (i.e., Vitamin B12 deficiency, folate deficiency). The data suggest that our FCMSS may provide useful information for making the diagnosis of MDS and other anemic disorders

ミヤギケン ニオケル プロジェクト アドベンチャー ノ トリクミ ト カダイ コドモ ノ ジコ コウテイ イシキ ノ コウジョウ ニ チャクモク シテ

There are many problem behavior of children in Japan such as bullying, juvenile delinquency, school violence, vandalism, drug etc. Many factors cause such problems, but we set up a hypothesis that the decline of self-esteem of children is very important factor. From this hypothesis and the examination of the precedence research regarding self-esteem, we set the following 3 points as the aim of this paper; 1) to review the history of Project Adventure (PA) program and to grasp of its definition and contents, 2) to grasp present conditions and problems of PA program in Miyagi Prefecture that firstly introduced it in Japan, 3) to search possibilities and limits of Miyagi PA program in the formation of the self-esteem of children. As a result of research, we conclude next three points: 1) PA is defined as the formalized process of experiential learning that makes a series of adventurous and challenge activities as the means for intending the change of the consciousness and behavior of students. PA program have been advanced the wide use and qualitative change in the process of the occurrence and diffusion in USA. It diffused partially after PAJ (Project Adventure Japan) is established in 1995 in Japan. 2) PA in Miyagi Pref. is being carried out as MAP (Miyagi Adventure Program) under the guidance of PAJ and the fundamental thought is expressed as the \u27cycle of experiential learning\u27. Miyagi Pref. is the only one prefecture which tackles with PA by the board of education as a whole, and promote the program in the cooperation of school education and social education. The program is developed on 4 contents; (1) training of leaders, (2) enlightenment activities, (3) upgrading of the institutions and equipments, and (4) introduction of PA to the school education activities. However, the training of the leader is restrictive, and training activities are relying on PAJ now. Also, it is very difficult to measure the educational effects of PA program to students. 3) The board of education try to introduce the PA program to all public schools, but some teachers and principals reject the PA program because they doubt its effect. The staffs of board of education think that such teachers and principals do not participate the training and do not understand significance of PA program. But we think there is other reason. In the process of introducing PA program to school education, it decreased elements of adventure that improve the self-esteem of children

Erratum to: Expression of myeloperoxidase and gene mutations in AML patients with normal karyotype: double CEBPA mutations are associated with high percentage of MPO positivity in leukemic blasts

Erratum to: International Journal of Hematology, 94(1), pp.81-89: 2011DOI 10.1007/s12185-011-0883-yThe original version of this article unfortunately contained some errors in Table 2 in the column headed ‘‘Amino acid changes’’. The corrected table is given here

Relationship between monoclonal gammopathy of undetermined significance and radiation exposure in Nagasaki atomic bomb survivors.

Radiation exposure is a possible predisposing factor for monoclonal gammopathy of undetermined significance (MGUS), but the association has been uncertain. We investigated the relationship between radiation exposure and MGUS prevalence by using data from the M-protein screening for Nagasaki atomic bomb survivors between 1988 and 2004. Radiation exposure was assessed by exposure distance from the hypocenter and exposure radiation dose. We computed prevalence ratios (PRs) and the 95% confidence intervals (CIs) adjusting for exposure age and sex. A total of 1082 cases of MGUS were identified from 52 525 participants. MGUS prevalence was significantly higher in people exposed at distance within 1.5 km than beyond 3.0 km (PR, 1.4; 95% CI, 1.1-1.9) among those exposed at age 20 years or younger, but it was not found among those exposed at age 20 years or older. MGUS prevalence was also significantly higher in people exposed to more than 0.1 Gy than those exposed to less than 0.01 Gy (PR, 1.7; 95% CI, 1.0-2.8) among those exposed at age 20 years or younger. Thus, people exposed at younger age exhibited a significantly high risk of MGUS when exposed to a high radiation dose. There was no clear association between radiation exposure and the malignant progression of MGUS. Further detailed analysis is needed

Long-term outcome of immunosuppressive therapy for Japanese patients with lower-risk myelodysplastic syndromes

To investigate the long-term usefulness of immunosuppressive therapy (IST) for Japanese patients with lower-risk myelodysplastic syndromes, we retrospectively analyzed 29 MDS patients who were treated with cyclosporine A alone or with anti-thymocyte globulin at a single institute in Japan. A total of 58.6 % of patients showed hematological response to IST. Overall survival of all patients was 74.5 % at 5 years and 48.3 % at 10 years. The major adverse event was the elevation of creatinine level (grade 1 and 2). Eleven patients were still on IST at the time of analysis with, at least, some clinical benefits. Pneumonia was the most frequent cause of death (eight of 12 deaths), followed by bleeding (three of 12); most of the patients who died were non-responders. The presence of paroxysmal nocturnal hemoglobinuria-type cells was significantly associated with both response to IST and long-term survival by univariate analysis. The 10-year overall survival of responders (72.2 %) was significantly superior to that of non-responders (15.6 %, P < 0.0001). These results suggest that IST using cyclosporine A provides long-term benefit for Japanese patients with lower-risk MDS

Expression of myeloperoxidase and gene mutations in AML patients with normal karyotype: double CEBPA mutations are associated with high percentage of MPO positivity in leukemic blasts.

The percentage of myeloperoxidase (MPO)-positive blast cells is a simple and highly significant prognostic factor in AML patients. It has been reported that the high MPO group (MPO-H), in which >50% of blasts are MPO activity positive, is associated with favorable karyotypes, while the low MPO group (≤50% of blasts are MPO activity positive, MPO-L) is associated with adverse karyotypes. The MPO-H group shows better survival even when restricted to patients belonging to the intermediate chromosomal risk group or those with a normal karyotype. It has recently been shown that genotypes defined by the mutational status of NPM1, FLT3, and CEBPA are associated with treatment outcome in patients with cytogenetically normal AML. In this study, we aimed to evaluate the relationship between MPO positivity and gene mutations found in normal karyotypes. Sixty AML patients with normal karyotypes were included in this study. Blast cell MPO positivity was assessed in bone marrow smears stained for MPO. Associated genetic lesions (the NPM1, FLT3-ITD, and CEBPA mutations) were studied using nucleotide sequencing. Thirty-two patients were in the MPO-L group, and 28 patients in the MPO-H group. FLT3-ITD was found in 11 patients (18.3%), NPM1 mutations were found in 19 patients (31.7%), and CEBPA mutations were found in 11 patients (18.3%). In patients with CEBPA mutations, the carrying two simultaneous mutations (CEBPA (double-mut)) was associated with high MPO expression, while the mutant NPM1 without FLT3-ITD genotype was not associated with MPO activity. Both higher MPO expression and the CEBPA (double-mut) genotype appeared to be associated with improved overall survival after intensive chemotherapy. Further studies are required to determine the importance of blast MPO activity as a prognostic factor, especially in CEBPA wild-type patients with a normal karyotype

Natural course of HTLV-1 carriers with monoclonal proliferation of T lymphocytes ("pre-ATL") in a 20-year follow-up study

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