Successful mobilization using a combination of plerixafor and G-CSF in pediatric patients who failed previous chemomobilization with G-CSF alone and possible complications of the treatment

Peripheral blood stem cell (PBSC) mobilization, which uses plerixafor (AMD 3100), a newly developed specific inhibitor of the CXCR4 receptor, in combination with granulocyte-colony stimulating factor(G-CSF), has been shown to enhance the stem cell mobilization in adult patients, but pediatric data are scarce. We documented our experience with this drug in 6 Korean pediatric patients who had failed in chemomobilization, using G-CSF, alone. All patients were mobilized CD34+ cells (median, 11.08 × 106/kg: range, 6.34-28.97 × 106/kg) successfully within 2 to 3 cycles of apheresis, without complications. A total of 7 autologous transplantations were performed, including 1 tandem transplantation. However, 2 patients with brain tumors showed severe pulmonary complications, including spontaneous pneumomediastinum. This is the first study of PBSC mobilization with plerixafor in Asian pediatric patients. Furthermore our study suggests that mobilization with plerixafor may be effective in Korean pediatric patients, who have previously been heavily treated and have failed PBSC mobilization with classical chemomobilization, using G-CSF. However, further studies are needed to examine the possible complications of autologous transplantation, using a mobilized plerixafor product in children

Disposable Solid-State pH Sensor Using Nanoporous Platinum and Copolyelectrolytic Junction

A disposable solid-state pH sensor was realized by utilizing two nanoporous Pt (npPt) electrodes and a copolyelectrolytic junction One nanoporous Pt electrode was to measure the pH as an indicating electrode (pH-IE) and the other assembled with copolyelectrolytic junction was to maintain constant open circuit potential (E(oc)) as a solid-state reference electrode (SSRE) The copolyelectrolytic Junction was composed of cationic and anionic polymers immobilized by photo-polymerization of N,N`-methylenebisacrylamide, making buffered electrolytic environment on the SSRE It was expected to make The nanoporous Pt surrounded by a constant pH excellently worked as a solid state reference electrode so as to stabilize the system within 30 s and retain the electrochemical environment regardless of unknown sample solutions Combination between the SSRE and the pH-IE commonly based on nanoporous Pt yielded a complete solid-state pH sensor that requires no internal filling solution The solid state pH sensing chip is simple and easy to fabricate so that it could be practically used for disposable purposes Moreover the solid-state pH sensor successfully functions in calibration-free mode in a variety of buffers and surfactant samplesThis work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MEST) (No. 2005-2001287), the Ministry of Knowledge Economy in Korea (09MC3310, Programmable Bio-CMOS Field Effect Transistors), the Korea Research Foundation Grant funded by Korea Government (MOEHRD, Basic Research Promotion Fund) (KRF-2005-075-C00021), and the Nano/Bio Science & Technology Program (M10536090001- 05N3609-00110) of the Ministry of Education, Science and Technology (MEST), Republic of Korea.Kim KB, 2010, APPL PHYS LETT, V96, DOI 10.1063/1.3389492SUSAN C, 2010, ANAL CHEM, V82, P878Guth U, 2009, J SOLID STATE ELECTR, V13, P27, DOI 10.1007/s10008-008-0574-7Han JW, 2009, JPN J APPL PHYS, V48, DOI 10.1143/JJAP.48.010205Park S, 2007, CHEM MATER, V19, P3373, DOI 10.1021/cm0710756Han JH, 2007, ELECTROANAL, V19, P786, DOI 10.1002/elan.200603772Kwon NH, 2007, ANALYST, V132, P906, DOI 10.1039/b706905gPark S, 2005, ANAL CHEM, V77, P7695, DOI 10.1021/ac050968jHa J, 2005, ANAL CHIM ACTA, V549, P59, DOI 10.1016/j.aca.2005.06.011Chun HG, 2005, ANAL CHEM, V77, P2490, DOI 10.1021/ac048535oVonau W, 2004, ELECTROCHIM ACTA, V49, P3745, DOI 10.1016/j.electacta.2004.02.048Marzouk SAM, 2003, ANAL CHEM, V75, P1258, DOI 10.1021/ac0261404Lee HJ, 1998, ANAL CHEM, V70, P3377Baur JE, 1998, J ELECTROANAL CHEM, V443, P208Suzuki H, 1998, SENSOR ACTUAT B-CHEM, V46, P104Nolan MA, 1997, ANAL CHEM, V69, P1244, DOI 10.1021/ac961020fShin JH, 1996, ANAL CHEM, V68, P3166

Comparison of total body irradiation-based or non-total body irradiation-based conditioning regimens for allogeneic stem cell transplantation in pediatric leukemia patients

Purpose : This study aims to compare the outcome of total body irradiation (TBI)- or non-TBI-containing conditioning regimens for leukemia in children. Methods : We retrospectively evaluated 77 children conditioned with TBI (n=40) or non-TBI (n=37) regimens, transplanted at Chonnam National University Hospital between January 1996 and December 2007. The type of transplantation, disease status at the time of transplant, conditioning regimen, engraftment kinetics, development of graft-versus-host disease (GVHD), complications, cause of deaths, overall survival (OS), and event-free survival (EFS) were compared between the 2 groups. Results : Among 34 patients with acute lymphoblastic leukemia (ALL), 28 (82.4%) were in the TBI group, while 72.7% (24/33) of patients with myeloid leukemia were in the non-TBI group. Although the 5-year EFS of the 2 groups was similar for all patients (62% vs 63%), the TBI group showed a better 5-year EFS than the non-TBI group when only ALL patients were analyzed (65% vs 17%&#59; P =0.005). In acute myelogenous leukemia patients, the non-TBI group had better survival tendency (73% vs 38%&#59; P=0.089). The incidence of GVHD, engraftment, survival, cause of death, and late complications was not different between the 2 groups. Conclusion : The TBI and non-TBI groups showed comparable results, but the TBI group showed a significantly higher 5-year EFS than the non-TBI group in ALL patients. Further prospective, randomized controlled studies involving larger number of patients are needed to assess the late-onset complications and to compare the socioeconomic quality of life

Comparison of fiberoptic bronchoscopic intubation using silicone and polyvinyl chloride double-lumen tubes

Background Direct insertion of a double-lumen tube (DLT) using a flexible fiberoptic bronchoscope (FOB) is an option for DLT intubation. The difficult process of fiberoptic intubation is that the different properties of polyvinyl chloride and silicone DLTs may affect railroading differently. Therefore, we aimed to compare intubation using polyvinyl chloride and silicone DLTs over an FOB. Methods Patients aged 19–75 years who required one-lung ventilation under general anesthesia were enrolled in this study. After induction of anesthesia, the anesthesiologist intubated the DLT using FOB. The primary outcome was the difficulty of railroading over the flexible FOB scaled into five grades (I, II-1, II-2, III, and IV). Additionally, the intubation time and mucosal damage were recorded. Results A total of 46 patients participated in this study, 23 each in the silicone and polyvinyl groups. The difficulty of railroading over the FOB was significantly different between the two groups (P < 0.001). In the silicone group, the grades of difficulty in railroading were limited to I and II-1; 20 patients (87%) presented no difficulty in advancing the tube. In contrast, in the polyvinyl group, 13 patients (57%) had scores of II-2 and III. Both the intubation time and mucosal damage were significantly better in the silicone group than in the polyvinyl group. Conclusions Intubation using a silicone DLT over an FOB was easier and faster than that with a polyvinyl chloride DLT with lesser trauma around the glottis

Multimodality imaging studies of intraductal tubulopapillary neoplasms of the pancreas

PURPOSEWe aimed to investigate multimodality imaging findings of intraductal tubulopapillary neoplasms (ITPN) of the pancreas.METHODSThis study was approved by the institutional review board with waived informed consent. A total of eight patients were histopathologically diagnosed with pancreatic ITPN in a single institution over a 6-year period. The imaging findings of dynamic contrast-enhanced computed tomography (CT), magnetic resonance cholangiopancreatography (MRCP), endoscopic ultrasonography (EUS), and positron emission tomography-computed tomography (PET-CT) were reviewed and correlated with clinicopathologic findings.RESULTSHistopathologically, an invasive carcinoma component was found in 5 of 8 patients (62.5%). The median diameter of the lesions and the main pancreatic ducts were larger in ITPN with invasive carcinoma (19 mm, 13.3–98.0 mm and 13 mm, 5.9–16.3 mm, respectively) than in ITPN without invasive carcinoma (13 mm, 12.7–18.5 mm and 6 mm, 5.6–6.1 mm, respectively), but not significantly (lesions, P = 0.229 and main pancreatic ducts, P = 0.143). Pancreatolithiasis accompanied invasive carcinoma in 3 of 5 patients (60%). Intraductal solid tumors were demonstrated on CT (5/8, 62.5%), MRCP (5/7, 71.4%), and EUS (7/7, 100%). In addition, various imaging findings mimicking chronic autoimmune pancreatitis or pancreatic ductal adenocarcinoma were found in 3 patients (37.5%) on multimodality imaging. The lesion multiplicity and synchronous or metachronous biliary cancer occurred in 3 patients (37.5%), respectively.CONCLUSIONPatients with associated invasive carcinoma from pancreatic ITPN may have presented a trend toward larger tumor size and dilated pancreatic duct with pancreatoliths, but the difference was not statistically significant. Further studies with a larger number of patients are needed to provide better insight into these findings. Pancreatic ITPN can show various atypical imaging findings as well as typical intraductal solid tumor on multimodality imaging. The presence of lesion multiplicity and synchronous or metachronous biliary cancer can be helpful for assisting with the diagnosis of pancreatic ITPN

Kinematics Characteristic of Lower Extremity during Simulated Skiing Exercise

We analyze the kinematic factors of sectional and total movements in healthy participants to providing group dependent information during simulated exercise. Participants in this study's experiment were 26 male adults, the elapsed times in each phase, the difference in the lower extremity angles, and muscle activity were computed through analysis of kinematic factors. We revealed that motions of the experts took shorter to perform than non-experts, and showed larger variation of lower limb joint angle in most events during simulated skiing. There were also significant group dependent differences in the peak and mean EMG values during simulated skiing. Referring to these results, such a non-expert's posture leads to enhance muscle activity to keep the lower body in balance. Non-experts should maintain appropriate ROM with lower-intensity exercise to improve muscle endurance initially, and it can be useful in providing preliminary data for future training and rehabilitation studies, as well as improvements in muscle strength