Interleukin-10 gene polymorphism reflects the severity of chronic immune thrombocytopenia in Japanese patients.

INTRODUCTION: T-helper cell type 1 (Th1) polarization of the immune response has been documented in patients with chronic immune thrombocytopenia (ITP). Interleukin (IL)-10 is the most important factor regulating Th1 and T-helper type 2 cytokine synthesis. This study evaluated the impact of IL-10 polymorphisms on both susceptibility to, and severity of, chronic ITP. METHODS: We analyzed -1082(G/A), -812(C/T), and -592(C/A) IL-10 polymorphisms in 90 patients with adult chronic ITP and 202 race- and sex-matched healthy controls. RESULTS: No significant differences in the genotype or haplotype frequencies were observed between the patient with chronic ITP and the control group. However, more patients with the -592AA genotype showed a severe thrombocytopenic state (platelet count <10 x 109/l) than those with the -592CC/CA genotypes (44.1%vs. 19.6%, P = 0.01). Furthermore, more patients with the ATA/ATA haplotype showed a severe thrombocytopenic state than those without the ATA/ATA haplotype (44.1%vs. 19.6%, P = 0.01). CONCLUSION: According to our data, patients with low producer type of IL-10 polymorphisms have more severe thrombocytopenia, suggesting that IL-10 gene polymorphisms may reflect the severity of ITP.

Successful low-dose cytosine arabinoside treatment in a patient with acute leukemia from idiopathic myelofibrosis.

We report a 63-year-old male with acute leukemia developed from idiopathic myelofibrosis. Cytogenetic analysis revealed chromosomal abnormalities; 46,XY,t(3;21)(q21;q22) del(20q). Intensive chemotherapies [combination of adriamycine/vincristine/prednisolone, or idarubicine/cytosine arabinoside (Ara-C)] were unsuccessful. The patient was then treated with continuous intravenous low-dose Ara-C because of his poor physical condition and showed marked hematological improvement. Leukemic cells disappeared from the peripheral blood and the segmented neutrophil count recovered. The dysplastic morphology observed in the segmented neutrophils suggests that the recovery of the neutrophils has resulted mainly from the differentiation activity of Ara-C.

[alpha-thalassemia accompanied with Gilbert's syndrome].

A 15-year-old boy was admitted to our hospital because of microcytic hypochromic erythrocytosis and hyperbilirubinemia in October 1996. The laboratory findings were RBC: 597 x 10(4)/microliter, Hb: 13.1 g/dl, Ht: 40.8%, MCV: 70fl, MCH: 22pg, total bilirubin: 3.2 mg/dl (indirect: 2.2 mg/dl), s-Fe: 99 micrograms/dl, and ferritin: 25 ng/ml. Routine liver function tests were normal. There were no findings of hemolysis except for an increase in serum indirect bilirubin and reticulocytes. Decreased erythrocyte osmotic fragility was observed. The patient's mother and sister also showed microcytic hypochromic erythrocytosis. PCR analysis of genomic DNA from this patient, his mother, and his sister confirmed the diagnosis of the alpha-thalassemia trait. However, the bilirubin-UDP-glucuronosyltransferase 1 (B-UGT 1) gene mutation and the findings of the fasting test indicated the simultaneous presence of Gilbert's syndrome. The association of these two diseases in the same patient appears to be rare, especially in Japan because of the low incidence of thalassemia in this country. We concluded that the hyperbilirubinemia was caused by decreased bilirubin clearance, not by increased erythrocyte destruction.

Collaborative signaling of informational structures by dynamic speech rate.

The research reported in this paper is an attempt to elucidate the functions of dynamic speech rates as contextualization cues in conversational Japanese. We examine five spontaneous task-oriented dialogs conducted in Japanese and analyze the potential of speech rate changes in signaling the structure of the information being exchanged in the dialogs. A correlation is found between speech decelerations and the openings of new information, and another is found between speech accelerations and the absence of information openings. These correlations hold not only in the case of a single speaker's speech, but also in the case of multiple speakers' sequential utterances, both with and without turn shifts. On the basis of these findings, we examine the potential of dynamic speech rates as cues to information structures in dialogs, in terms of their precision, recall, and primacy. We claim that changes in the speech rate in conversational Japanese have a definite potential for cuing the structure of information collaboratively constructed by participants of a conversation.

An analysis of turn-taking and backchannels based on prosodic and syntactic features in Japanese map task dialogs.

In this study, we investigate syntactic and prosodic features of the speaker's speech at points where turn-taking and backchannels occur, on the basis of our analysis of Japanese spontaneous dialogs. Specifically, we focus on features such as part of speech, duration, F0 contour pattern, relative height of the peak F0, energy trajectory pattern, and relative height of the peak energy at the final part of speech segments. We examine, first, the relationship between turn-taking/backchannels and each feature of speech segments independently, showing that the features examined in this study are all related to turn-taking or backchannels and that the way they correlate is fairly consistent with previous studies. Next, we explore the inter-relationship among the features with respect to turn-taking and backchannels. We show that in both turn-taking and backchannels, (1) some instances of syntactic features make extremely strong contributions, and (2) in general, syntax has a stronger contribution than any individual prosodic feature, although the whole prosody contributes as strongly as, or even more strongly than, syntax. We also discuss some implications of our results, comparing them with previous models that have mentioned roles of syntax and prosody in turn-taking and backchannels.