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An increasing number of long-term surviving bone marrow transplant (BMT) recipients have recovered from their primary disease but are at risk of developing failure of endocrine organs. We investigated 147 patients who underwent allogeneic BMT. Thyroid function was evaluated by serial measurement of basal TSH and free T4 levels as well as by TRH provocative test. Thyroid ultrasound examination was performed for evaluation of thyroid tumor after BMT. Five patients were found to have overt thyroid dysfunction (hypothyroidism in four patients and hyperthyroidism in one patient). Twenty-three patients in the under 9-yr-old group at BMT and 16 patients in the over 10-yr-old group at BMT had subclinical compensated hypothyroidism. Younger age at BMT was the strongest factor for developing thyroid dysfunction, compared with older age (P < 0.001). Only in patients with subclinical compensated hypothyroidism did median basal and peak TSH increase to the upper half of the normal range by 8 yr after BMT and then returned slightly to the middle of the normal range spontaneously. These results suggest that thyroid dysfunction in long-term BMT survivors depends on age at BMT, with a greater risk among younger patients, indicating the need for life-long surveillance.

Half-wave potentials E(1/2) relative to a Ag/Ag(+) electrode, mean diffusion coefficients D, and standard electrode reaction rate constants k(el) are reported for the decamethylferrocene(+/0) couple (DmFc(+/0)) in nine organic solvents at variable pressure and (for five solvents) temperature. Limited data on the ferrocene(+/0) (Fc(+/0)) and Fe(phen)(3)(3+/2+) electrode reactions are included for comparison. Although E(1/2) for DmFc(+/0) correlates only loosely with the reciprocal of the solvent dielectric constant epsilon at ambient pressure, its pressure dependence expressed as the volume of reaction Delta V(cell) is a linear function of Phi = (1/epsilon)( partial differential ln epsilon/ partial differential P)(T) (the Drude-Nernst relation). Interpretation of the temperature dependence data is made difficult by enthalpy-entropy compensation. Measurements of D for solutions containing 0.5 mol L(-1) tetrabutylammonium perchlorate (TBAP) at 25 degrees C and ambient pressure are inversely proportional to the viscosities eta of the pure solvents as expected from the Stokes-Einstein relation, despite the fact that increasing [TBAP] results in increased eta. The activation volume Delta V(diff)(++) for diffusion of DmFc(+/0) ranges from 7 to 17 cm(3) mol(-1) and generally increases with increasing eta and thus with increasing [TBAP]. The activation volumes Delta V(el)(++) for the electrode reactions of DmFc(+/0) and Fc(+/0) are all positive, equaling the corresponding Delta V(diff)(++) values within the experimental uncertainty and contrast sharply with the negative Delta V(ex)(++) values characteristic of the corresponding self-exchange reactions in homogeneous solution. These facts, together with the thermal activation parameters, point to solvent dynamical control of the electrode (but not the homogeneous self-exchange) reactions. The apparent radii of the electroactive species according to the Drude-Nernst and Stokes-Einstein relations cannot be satisfactorily related to their crystallographic radii and are better regarded as adjustable parameters with limited physical significance.

We report a case of perivascular epithelioid cell tumor (PEComa) with an SFPQ/PSF-TFE3 gene fusion in a 14-year-old girl treated for adrenal neuroblastoma for 4 years. Imaging studies revealed a tumor in the wall of the sigmoid colon, which was radiologically different from the neuroblastoma, together with several inguinal and cervical lymph node metastases of the neuroblastoma. Microscopically, the tumor in the sigmoid colon showed sheet-like growth of epithelioid cells with abundant clear cytoplasm and round nuclei, which were separated by thin fibrovascular septa. These epithelioid cells were immunohistochemically positive for vimentin, gp100 (detected with monoclonal antibody HMB-45), and TFE3, and the tumor was diagnosed as PEComa. In a fluorescence in situ hybridization assay using an in-house probe for TFE3, the tumor cells showed split signals, indicating a rearrangement of TFE3. Molecular cloning using 5' rapid amplification of complementary DNA ends and subsequent reverse transcription-polymerase chain reaction revealed an SFPQ/PSF-TFE3 gene fusion. To the best of our knowledge, this is the second reported case of metachronous PEComa subsequent to a primary tumor, and the first report confirming an SFPQ/PSF-TFE3 gene fusion in PEComa.