without detectable blast infiltration. At diagnosis of MDS, interface cytogenetic and RT-PCR analyses, respectively, showed trisomy 8 and absence of AF9-MLL rearrangement in Introduction the bone marrow (BM). On readmission with florid leukemia, his peripheral white blood cell count was 13 200/mm 3 , with A subtle, reciprocal translocation exchanging the terminal 56% leukemic blasts. His hemoglobin concentration was short and long arm segments of chromosomes 9 and 11, 15.0 g/dl, and his platelet count was 22 000/mm 3 . The bone respectively t(9;11)(p21-22;q23), is associated with acute marrow aspiration showed 92% leukemic blasts, and the mormyeloid leukemia (AML)-M5, 1 particularly the M5a subtype. 2 phological diagnosis was made as AML-M5a. Cytogenetic Ascertainment may be difficult in suboptimal preparations analysis was interpreted as: 47, XY, +8, t(9;11)(p22;q23). and, despite being regarded as the 'standard' cytogenetic Immunophenotyping analysis of fresh leukemia blasts change in acute monoblastic leukemia, its overall incidence revealed no significant expression of CD antigens associated and pattern of associations remain uncertain. 2 A recent study with the myelo-monocytic lineage. CD34 was 30% positive comparing AML-M1 and -M5 patients, analyzed simuland non-lineage-associated HLA-DR was found to be positive taneously by reverse transcriptase-polymerase chain reaction at 70%; whereas those indicative of lymphoid lineage includ-(RT-PCR), Southern blotting and fluorescence in situ hybridizing CD3, CD4, CD8, CD10, CD19 were absent or weakly ation (FISH) with an MLL-specific yeast artificial chromosome expressed. Myeloperoxidase activity was weakly detected on (YAC) probe, suggests the overall incidence of MLL rearrangethe fresh leukemic blasts. Despite receiving chemotherapy, he ment in AML-M5 may be as high as 60%. 3 It was apparent in succumbed to rapidly progressive leukemia on 15 August that study that approximately half the cases with MLL 1995. rearrangement went undetected by cytogenetic methods, including a cryptic t(6;11)(q27;q23) resulting from a cytogenetically invisible insertion juxtaposing AF6 and MLL.Materials and methods A case of AML-M5a with de novo MLL-AF9 fusion evolving from MDS with trisomy 8 present at all phases has recently Cell culture been described. 4 We describe a pair of cell lines, MOLM-13 During relapse, after chemotherapy, a heparinized peripheral blood specimen, obtained with informed consent, was proCorrespondence: Y Matsuo,

The aim of the present study was to predict the prognosis of Chronic obstructive pulmonary disease (COPD) patients who underwent comprehensive pulmonary rehabilitation (PR). A total of 144 patients who performed PR between 1992 and 1999 was assessed. After PR, 67 patients underwent lung volume reduction surgery (LVRS). Baseline data before PR consisted of body mass index, serum albumin levels, use of supplement oxygen at home, pulmonary function, arterial blood gas analysis, and distance and fall of hemoglobin oxygen saturation (DeltaSpO(2)) in 6-min walk test. In addition to pre-PR factors, treatment with LVRS was taken into the analysis. The prognostic significance of variables influencing survival was determined by univariate analysis with Log rank test or multivariate analysis using Cox's proportional hazard model. By a median follow-up time of 8.4 years, the median survival time was 8.1 years (95% confidence interval: 6.9-9.4 years). Albumin level, PaCO(2), distance and DeltaSpO(2) were significant prognostic factors in univariate analysis. LVRS did not affect the prognosis. The multivariate analysis showed short distance and increase of DeltaSpO(2) as significant independent predictors of the risk of death. 6-min walk test was very useful for predicting the prognosis of the COPD patients.

Alkyl 16alpha- and -beta-glycosides of a series of N3-alkyl homologues of streptozotocin were synthesized from glucosamine hydrochloride. These compounds, when tested against ascites Sarcoma 180, Ehrlich ascites carcinoma, or leukemia L1210, exhibited potent antitumor activities, and antibacterial and diabetogenic activities were eliminated. Furthermore, the acute toxicities of these compounds were lower than that of streptozotocin. The methyl, ethyl, n-propyl, and n-butyl glycosides of streptozotocin, whether alpha- or beta-anomers, all showed higher antitumor activities than streptozotocin itself. The most active compound was found to be the methyl beta-streptozotocin.

A new classification for the severity of COPD was proposed at GOLD 2003: stage I: FEV(1) > or = 80% predicted; stage II: 50% < or = FEV(1)<80%; stage III: 30% < or = FEV(1)<50%; and stage IV: FEV(1) < 30%. To elucidate the acute effects of pulmonary rehabilitation (PR) on patients with different stages of COPD, data on pulmonary function, arterial blood gas analysis, the 6-min walk test, respiratory muscle strength, and activities of daily living were analyzed before and after our comprehensive 4- to 8-week inpatient PR program between 1992 and 2003. A total of 225 patients (201 men and 24 women; 21 with stage II, 79 with stage III, and 125 with stage IV COPD) was assessed. There were significant differences in FEV(1)% predicted and % residual volume in stages III and IV, in % vital capacity in stages II, III and IV, and in % total lung capacity in stage II when comparing the changes between pre- and post-PR. Significant differences of PaO(2) in stages III and IV and PaCO(2) in stage IV were found when comparing the changes between pre- and post-PR. The 6-min walk distance was significantly increased after PR by an average of approximately 50m for all staged patients. Respiratory muscle strength was also significantly increased in stages III and IV. Activities of daily living were significantly improved in all stages. These results showed that patients with COPD had benefited from PR regardless of disease severity. The effects included improvement in pulmonary function, arterial blood gas analysis, 6-min walk distance, respiratory muscle strength, and activities of daily living although there were some differences among the three stages.