TLG is a more accurate predictor of disease progression than SUVmax or MTV. TLG enables accurate preoperative assessment of aggressiveness comparable with conventional clinicopathological parameters.
We evaluated the outcome of children and adolescents with acquired severe aplastic anemia (SAA) who received haploidentical hematopoietic stem cell transplantation (HHCT) with in vitro T cell-depleted peripheral blood stem cells. Twelve patients with acquired SAA received a total of 15 HHCTs with in vitro CD3-depleted grafts between July 2009 and July 2012. Among the 12 patients, 11 achieved neutrophil engraftment at a median of 10 days (range, 9 to 13 days) after HHCT. One patient failed to achieve primary engraftment, and two experienced graft rejection soon after engraftment. All three patients who experienced early graft failure received a second HHCT and achieved sustained engraftment. Thus, the final engraftment rate was 100%. Acute graft-versus-host disease was assessed in 9 patients, excluding the 3 patients with early graft failure. Three of these patients developed acute graft-versus-host disease (two ≥ grade II and one with grade III). All 12 patients survived and were transfusion-independent at a median follow-up of 14.3 months (range, 4.1 to 40.7 months). Hematopoietic stem cell transplantation from haploidentical family donors with in vitro CD3 T cell depletion is a reasonable therapeutic option for children and adolescents with acquired SAA. Our future trial with a uniform protocol will help to solve the problems associated with HHCT and provide a valuable platform for the further development of HHCT as a therapy for SAA.
High-dose chemotherapy may improve the survival of children with newly diagnosed high-risk MB/sPNET, and, to some extent, the survival of those with relapsed MB/sPNET. Further study is necessary to elucidate the efficacy of tandem double HDCT.
Unsafe driving performance and car crashes during simulated driving were more prevalent in older drivers than in younger drivers. Unsafe performance in steering, vehicle positioning, making lane changes, and car crashes were associated with cognitive-perceptual dysfunction.
This study examined the changes in knee alignment after an open wedge high tibial osteotomy before and after weight-bearing. From 2004 to 2006, 36 high tibial osteotomies were performed to treat unicompartmental arthritis with a varus deformity. Thirteen patients without instability and with an accurate radiographic evaluation were included. The changes in the deviation of the mechanical axis and femorotibial angle were evaluated retrospectively using whole extremity radiographs immediately after surgery (supine position) and 4 months after surgery (weight-bearing position). In the nonweight-bearing radiograph obtained immediately after surgery, the mean deviation of the mechanical axis was 22% laterally and the mean femorotibial angle was valgus 8.9 degrees . The weight-bearing radiograph at 4 months after surgery showed that the former shifted laterally 34% and the latter shifted valgus 10.6 degrees . The changes in the mechanical axis and femorotibial angle were significant (P < 0.001). During open wedge high tibial osteotomy, the surgeon should consider the increase in deviation of the mechanical axis and femorotibial angle after weight-bearing.
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