Whatman 3 MM dried blood spots for identifying alpha-thalassemia-1

The present study was undertaken to assess the feasibility of whole dried blood spots to identify alpha-thalassemia-1 by PCR technique. Logistical constraints associated with sample collection and processing make the measurement of alpha-thalassemia-1 at community laboratories difficult. Dried blood spot samples provide a relatively convenient and minimally invasive means for collecting and transporting samples. We present Whatman 3 MM paper for spotting blood samples used for the first time for alpha-thalassemia-1 detection. Measurements of fresh EDTA whole blood and Whatman 3 MM dried blood spots prepared from venous blood were performed in 60 subjects. Whatman 3 MM dried blood spots results were precise and reliable. There was no actual difference in comparison to fresh EDTA whole blood samples. Whatman 3 MM dried blood spots for alpha-thalassemia-1 detection using the PCR technique showed no changes for 6 months.     

Immunophenotypes and Outcome of Philadelphia Chromosome-Positive and -Negative Thai Adult Acute Lymphoblastic Leukemia

Little evidence exists in Asian countries regarding the incidence, immunologic characteristics, and clinical outcomes of adult patients with Philadelphia chromosome-positive (Ph+) and -negative (Ph-) acute lymphoblastic leukemia (ALL). In this study, we prospectively studied 324 Thai adult acute leukemia patients, 79 (24%) of whom were identified as having ALL. Immunophenotyping was performed by 5-parameter flow cytometry, and karyotyping was conducted by standard banding methods. The Ph chromosome was detected in 18.5% of cases. The mean age of Ph+ ALL patients was 29 years (50% male), and that of Ph- ALL patients was 33 years (62% female). The Ph+ ALL patients had significantly higher white blood cell (WBC) counts (mean, 93 x 10(9)/L), with 67% having WBC counts higher than 50 x 10(9)/L. In contrast, most Ph- ALL patients had WBC counts lower than 50 x 10(9)/L (mean, 36 x 10(9)/L; P < .05). CD10 and CD34 were more highly expressed in the Ph+ ALL patients (mean expression, 83% and 87%, respectively) than in the Ph- ALL patients (45% and 57%; P < .005). The aberrant expression of myeloid antigens, including CD33 and CD13, was also significantly observed in the Ph+ ALL patients. The median survival time of Ph+ ALL patients was 8 months, compared with 22 months for the Ph- ALL patients. In conclusion, immunophenotyping results showed that Ph+ ALL in Thai adults arises from B-cells at an earlier stage of development. Extreme leukocytosis, a younger age, male sex, high expression levels of CD10 and CD34, aberrant myeloid antigens, and poorer rates of survival appeared to be associated with the Ph chromosome in Thai adult ALL cases. The incidence of the Ph chromosome among Thai adult ALL patients was not different from that found in Western countries.     

Association of Elevated Urinary Cadmium with Urinary Stone, Hypercalciuria and Renal Tubular Dysfunction in the Population of Cadmium-Contaminated Area

Excessive urinary calcium is the major risk of renal tubular dysfunction and urinary stone formation. We examined the association of elevated urinary cadmium with urinary stones and chronic kidney disease (CKD) in 1,085 study residents of 13 cadmium-contaminated villages. Elevated urinary cadmium was significantly correlated with urinary stone and CKD. Elevated urinary cadmium appeared to increase risk of urinary stone and CKD; ORs and 95?% CIs were 2.73 (1.16, 6.42) and 3.73 (2.50, 5.57) after adjusting for other co-variables. This study revealed that elevated urinary stone and CKD induced by cadmium might increase the risk of urinary stone and CKD.     

Absent Pulmonary Valve: Echocardiographic Features

Congenital absence of the pulmonary valve, a rare anomaly, is characterized by absent or rudimentary pulmonary valve, often with annular stenosis, and aneurysmal dilatation of the pulmonary arteries. This defect is most commonly an accompaniment of tetralogy of Fallot but occasionally occurs alone. Four patients with this abnormality were examined by two-dimensional echocardiography at the Mayo Clinic. Doppler echocardiography provided hemodynamic assessment of the magnitude of outflow obstruction and valve regurgitation. The two-dimensional echocardio-graphic and Doppler features of absent or rudimentary pulmonary valve provided diagnostic information sufficient to proceed directly to surgical correction.     

Eleven-year experience on anti-TB drugs direct susceptibility testing from Siriraj Hospital,Thailand

The early detection of drug-resistant tuberculosis (TB) strains is of utmost importance for patient management and effective TB control programs. This study aimed to demonstrate the performance of direct drug susceptibility testing (DST) performed in our laboratory in the past 11 years. The direct DST was performed on Middlebrook 7H10 medium using isoniazid (INH) and rifampicin (RIF), and the results were compared with those obtained from indirect DST (gold standard). The direct DST was performed with 15,598 smear-positive sputum samples, of which 11,284 (72%) yielded reportable results. Sensitivity, specificity, positive predictive value, and negative predictive value were calculated and revealed 89%, 99%, 95%, and 99%, respectively, for RIF and 90%, 98%, 93%, and 97%, respectively, for INH. Direct DST results could be reported within 1 month after sample processing. This method was also shown to be suitable for use in resource-limited countries, particularly in settings with high numbers of TB cases.     

Successful treatment of disseminated BCG infection in a SCID patient with granulocyte colony stimulating factor

Severe combined immunodeficiencies (SCID) are disorders with impairment of humoral and cellular immune functions. The prognosis of disseminated bacillus Calmette-Guérin (BCG) infection in immunocompromised host is unfavorable since response to standard therapy is poor. We report a successful treatment of disseminated BCG infection with granulocyte colony stimulating factor (G-CSF) in a patient with severe combined immunodeficiency. The patient failed to response to intensive anti-tuberculous (anti-TB) therapy. After 2 months of G-CSF, in addition to anti-TB treatment, the clinical signs of disseminated BCG infection were improved. Since serious BCG infections in SCID are not uncommon in developing countries, where BCG vaccination is mandatory to all newborns, the combination of G-CSF and anti-TB drugs should be considered in immunocompromised patients with protracted mycobacterial infection.     

A β-resorcylic macrolide from the seagrass-derived fungus <Emphasis Type="Italic">Fusarium</Emphasis> sp. PSU-ES73

A new β-resorcylic macrolide, 5′-hydroxyzearalenone (1), and six known β-resorcylic macrolides were isolated from the seagrass-derived fungus Fusarium sp. PSU-ES73. Their structures were established by analysis of spectral data. All of the isolated compounds were evaluated for their antibacterial activity against Staphylococcus aureus, both standard and methicillin-resistant strains, as well as their antifungal activity against Cryptococcus neoformans. Only the known compound zearalenone (2) displayed weak antibacterial and antifungal activities.