Interleukin-5 is at 5q31 and is deleted in the 5q- syndrome

Human interleukin-5 (IL-5) is a selective eosinophilopoietic and eosinophil-activating growth hormone. By in situ hybridization this gene is mapped to chromosome 5q23.3 to 5q32. It is shown to be deleted in two patients with the 5q-syndrome and in one patient previously diagnosed with myelodysplasia whose condition had progressed to acute myeloblastic leukemia. The clustering of other genes involved in hematopoiesis (IL-3, granulocyte-macrophage colony-stimulating factor, feline sarcoma viral oncogene homolog, colony-stimulating factor 1) to the same region as IL-5 suggests a nonrandom localization and raises interesting questions concerning the evolution and regulation of these genes.     

A prospective study of multiple needle biopsies versus a single open biopsy for testicular sperm extraction in men with non-obstructive azoospermia

Little is known about the efficacy and the factors affecting the outcome of fine needle aspiration biopsy of the testis for sperm retrieval in azoospermic men with defective spermatogenesis. A prospective study was designed to compare the efficacy of needle and open (window) testicular biopsies for testicular epididymal sperm extraction (TESE) in 35 consecutive men with azoospermia due to defective spermatogenesis undergoing testicular biopsy for intracytoplasmic injection of oocytes. Each of the consecutive 35 patients underwent TESE using a 19 gauge butterfly needle followed by a window (1-1.5 cm-sized incision) testicular biopsy in the same procedure. The extraction of spermatozoa into culture medium was compared with the assessment of testicular biopsies by histology, the mode of biopsy (needle or open biopsy) and the amount of tissue retrieved by either method. Testicular spermatozoa were retrieved in 22 (63%) who had an open testicular biopsy compared with five (14%) patients who had multiple needle biopsies, respectively; the difference was statistically significant. Open testicular biopsy retrieves more testicular tissue than needle biopsy. Needle testicular biopsy retrieved testicular spermatozoa in 50% of those with hypospermatogenesis, 10% with focal spermatogenesis and in no patients with maturation arrest or Sertoli cell-only pattern. In contrast, sperm retrieval was successful in 100%, 90% and 66% of those with respective histologies using open testicular biopsy. Other than bruising, for which they required no analgesia, none of the patients suffered any obvious complications associated with traditional testicular biopsy. We conclude that open testicular biopsy is more effective than needle biopsy for the retrieval of testicular spermatozoa in azoospermic men with defective spermatogenesis. The difference observed may be related to the amount of testicular tissue retrieved and to the influence of testicular histology.      

Enhancing patency,safety and cost effectiveness of catheters

Catheters are generally known to be the last resort for blood access in dialysis. Because of the many problems related to catheter use, catheters are banned from vascular access courses organized by professional societies and the development of catheters and catheter related equipment relies on a few interested medical doctors with limited knowledge of hydraulics and material science. Rather than accepting the need for catheters and the need for improving catheters and catheter related procedures, vascular access meetings typically begin and end with statements saying that the use of fistulas must be increased and catheters must be banned. Several small companies have developed new catheters and catheter related equipment, which potentially overcome many of the problems related to the use of catheters. The authors had the privilege of participating in one of these developments and report about basic features and clinical experience of the DIALOCK® blood access port and an antimicrobial catheter locking solution (CLS) which is used with conventional catheters as well as with the DIALOCK®.     

Motivations for active commuting: a qualitative investigation of the period of home or work relocation

ABSTRACT: BACKGROUND: Promoting walking or cycling to work (active commuting) could help to increase population physical activity levels. According to the habit discontinuity and residential self-selection hypotheses, moving home or workplace is a period when people (re)assess, and may be more likely to change, their travel behavior. Research in this area is dominated by the use of quantitative research methods, but qualitative approaches can provide in-depth insight into the experiences and processes of travel behavior change. This qualitative study aimed to explore experiences and motivations regarding travel behavior around the period of relocation, in an effort to understand how active commuting might be promoted more effectively. METHODS: Participants were recruited from the Commuting and Health in Cambridge study cohort in the UK. Commuters who had moved home, workplace or both between 2009 and 2010 were identified, and a purposive sample was invited to participate in semi-structured interviews regarding their experiences of, and travel behavior before and after, relocating. A grounded theory approach was taken to analysis. RESULTS: Twenty-six commuters participated. Participants were motivated by convenience, speed, cost and reliability when selecting modes of travel for commuting. Physical activity was not a primary motivation, but incidental increases in physical activity were described and valued in association with active commuting, the use of public transport and the use of park-and-ride facilities. CONCLUSIONS: Emphasizing and improving the relative convenience, cost, speed and reliability of active commuting may be a more promising approach to promoting its uptake than emphasizing the health benefits, at least around the time of relocation. Providing good quality public transport and free car parking within walking or cycling distance of major employment sites may encourage the inclusion of active travel in the journey to work, particularly for people who live too far from work to walk or cycle the entire journey. Contrary to a straightforward interpretation of the self-selection hypothesis, people do not necessarily decide how they prefer to travel, relocate, and then travel in their expected way; rather, there is constant negotiation, reassessment and adjustment of travel behavior following relocation which may offer an extended window of opportunity for travel behavior change.     

Some observations on the Inb antigen and evidence that anti-Inb causes accelerated destruction of radiolabeled red cells

This report describes an example of anti-Inb, a red cell alloantibody directed against a high-frequency antigen, detected in a prenatal sample obtained from a Canadian woman of Asian Indian extraction. Although the antibody is IgG1, it could not be detected in the serum or on the red cells (RBCs) of her In(b+) infant. Evidence is provided that the Inb antigen is denatured by papain, ficin, trypsin, bromelin, cystein-activated papain/dithiothreitol, 6 percent aminoethylisothiouronium, and 50 mM dithiothreitol, but not by neuraminidase. Inb antigen strength appears reduced on the In(Lu) type but not on the LuLu type of Lu(a-b-) RBCs. RBCs from a patient with paroxysmal nocturnal hemoglobinuria showed normal Inb antigen strength as did Ko, Ge:-2,3, Ge:-2,-3, and Yt(a-) RBCs. A RBC survival study using 51Cr-labeled In(b+) RBCs showed 97 percent survival 90 minutes after injection but reduced survivals of 62 and 14 percent at 24 and 96 hours, respectively. These results indicate that this example of anti-Inb is unlikely to be implicated in an immediate hemolytic transfusion reaction, but that delayed extravascular hemolysis might occur.     

Allogeneic blood stem cell transplantation for refractory leukemia and lymphoma: potential advantage of blood over marrow allografts [see comments]

Peripheral blood stem cells (PBSCs) have been used rarely for allogeneic transplantation because of concerns regarding graft failure and graft-versus-host disease (GVHD). We evaluated the results of allogeneic PBSC transplantation (allo-PBSCT) in 9 patients with refractory leukemia or lymphoma receiving myeloablative therapy followed by allo-PBSCT from an HLA-identical sibling donor. Three patients had relapsed 11 to 21 months after allogeneic bone marrow transplantation (allo-BMT) and underwent allo-PBSCT using the same donor. Six patients received PBSCs as their initial allogeneic transplant. Filgrastim-mobilized PBSCs were collected from the donors in 3 to 4 aphereses and cryopreserved. The apheresis collections contained a median nucleated cell count of 16.5 x 10(8)/kg (range, 10.8 to 28.7 x 10(8), 10.7 x 10(6) CD34+ cells/kg (range, 7.5 to 22.5 x 10(6)), and 300.0 x 10(6) CD3+ cells/kg (range, 127.8 to 1,523.2 x 10(6)). The median recovery of CD34+ progenitor cells after freezing, thawing, and washing was 106.4% (range, 36.7% to 132.0%). All patients received filgrastim posttransplant through engraftment, and cyclosporine and methylprednisolone were used for GVHD prophylaxis. Neutrophil recovery to greater than 0.5 x 10(9)/L and greater than 1.0 x 10(9)/L occurred at a median of 9 (range, 8 to 10) and 9 days (range, 8 to 11) posttransplant, respectively, which was similar to historical controls after allo-BMT and granulocyte colony-stimulating factor therapy. Platelets recovered to greater than 20 x 10(9)/L and greater than 50 x 10(9)/L at a median of 12 (range, 8 to 25) and 15 days (range, 11 to 59), respectively, which was significantly more rapid than for the controls (P < .01). Donor cell engraftment was documented by cytogenetics, fluorescence in situ hybridization, and/or restriction fragment length polymorphisms with longest follow-up of 283 + days. Three patients developed grade 2 acute GVHD involving only the skin. Three of five evaluable patients show limited chronic GVHD. Cryopreserved, filgrastim-stimulated allogeneic PBSCs may be a suitable alternative to allogeneic marrow for transplantation with the advantage of more rapid platelet recovery. Acute GVHD was minimal despite the infusion of 1 log more CD3 cells than with marrow allografts. Further studies are required to assess long-term risks of chronic GVHD.     

Prefrontal cortex white matter tracts in prodromal Huntington disease

Huntington disease (HD) is most widely known for its selective degeneration of striatal neurons but there is also growing evidence for white matter (WM) deterioration. The primary objective of this research was to conduct a large‐scale analysis using multisite diffusion‐weighted imaging (DWI) tractography data to quantify diffusivity properties along major prefrontal cortex WM tracts in prodromal HD. Fifteen international sites participating in the PREDICT‐HD study collected imaging and neuropsychological data on gene‐positive HD participants without a clinical diagnosis (i.e., prodromal) and gene‐negative control participants. The anatomical prefrontal WM tracts of the corpus callosum (PFCC), anterior thalamic radiations (ATRs), inferior fronto‐occipital fasciculi (IFO), and uncinate fasciculi (UNC) were identified using streamline tractography of DWI. Within each of these tracts, tensor scalars for fractional anisotropy, mean diffusivity, radial diffusivity, and axial diffusivity coefficients were calculated. We divided prodromal HD subjects into three CAG‐age product (CAP) groups having Low, Medium, or High probabilities of onset indexed by genetic exposure. We observed significant differences in WM properties for each of the four anatomical tracts for the High CAP group in comparison to controls. Additionally, the Medium CAP group presented differences in the ATR and IFO in comparison to controls. Furthermore, WM alterations in the PFCC, ATR, and IFO showed robust associations with neuropsychological measures of executive functioning. These results suggest long‐range tracts essential for cross‐region information transfer show early vulnerability in HD and may explain cognitive problems often present in the prodromal stage. Hum Brain Mapp 36:3717–3732, 2015. © 2015 Wiley Periodicals, Inc.