Atypical Mycobacterial Infection in Hairy Cell Leukemia Treated with Cladribine

We report a case of hairy cell leukemia who improved after cladribine but succumbed to disseminated atypical mycobacterial infection 2 months after completing cladribine.     

Predictors of success after bilateral epididymovasostomy performed during vasectomy reversal: A multi-institutional analysis

IntroductionVasectomy reversal (VR) represents an excellent option for paternity in men who desire to expand their family following vasectomy. Traditional VR via vasovasostomy has a success rate upwards of 90%^1,2 but when sperm or sperm parts are not present in vasal fluid, epididymovasostomy (EV) must be performed instead. Our objective was to determine which factors influence success after bilateral EV.MethodsA prospectively maintained database with data from the U.S. and Canada was used to identify men who underwent bilateral EV at time of VR. Success was defined as motile sperm in any postoperative semen analyses. Multivariable logistic regression was used to identify predictors of success.ResultsA total of 200 men had at least one postoperative semen analysis, and 171 men were included in the analysis. Average age was 44.7 years, with average followup of seven months. Median time elapsed between vasectomy and EV was 15 years (interquartile range [IQR] 10–18). Overall success rate was 50%. Despite the study being adequately powered, factors such as years since vasectomy (odds ratio [OR] 1.01, confidence interval [CI] 0.95–1.06), age (OR 0.96, CI 0.91–1.01), intraoperative presence of motile sperm (OR 0.81, CI 0.41–1.62), and epidydimal fluid characteristics did not predict success.ConclusionsBilateral EV at time of VR is successful in 50% of cases in a multi-institutional, North American cohort. Microsurgeons can be reassured that neither time elapsed nor epididymal fluid characteristics negatively impact success rates as long as sperm or sperm parts are present. Surgeons performing VR should be comfortable and prepared to perform EV if indicated.     

Right ventricular outflow tract obstruction caused by a right coronary cusp prolapse: An unusual finding

Patients with large sub-pulmonic ventricular septal defect (VSD) present early as a results of their complications. Some present late, due to the restriction of VSD by the right coronary cusp (RCC) due to its prolapse. In this report, we present a rare case of sub-pulmonic VSD in a 33-year-old man who developed a sub-pulmonic stenosis due to the prolapse of the RCC into the right ventricular outflow tract.     

Some characteristics of the larval breeding sites of Anopheles culicifacies species B and E in Sri Lanka

BACKGROUND & OBJECTIVES: Anopheles culicifacies Giles, the major malaria vector in Sri Lanka, exists as a species complex comprising two sympatric sibling species--species B and E. Species E is reported to be the major vector of Plasmodium vivax and P. falciparum parasites in Sri Lanka, whilst species B is a poor or nonvector as in India. Knowledge of the breeding habits of the two sibling species can help in designing optimal vector control strategies. Hence, a survey was conducted in Sri Lanka to study the preferential breeding habitats of An. culicifacies species B and E. METHODS: Immature forms of An. culicifacies were collected from identified breeding sites in malarious districts. Collected larvae were typed for their sibling species status based on mitotic Y-chromosome structure. Data was analysed using Statistical Package for Social Science version 10.0. RESULTS: An. culicifacies immature forms were found in 23 collection sites. Among these samples 19 were found to have species E and four to have species B. All species B larvae were collected from Tonigala village in the Puttalam district. None of the 23 sites was found to have both species B and E. Species E, the major vector of malaria, appears to breed in variety of breeding sites which can be of an indication of its adaptive variation to exploit breeding sites with varying limnological characteristics. INTERPRETATION & CONCLUSION: The present findings have to be taken into account when formulating more effective larval control measures. They also show the need for a detailed study of possible different preferences for larval breeding sites between species B and E.     

Surface T- and B-cell markers on murine lymphomas and plasmacytomas

Seven murine lymphomas and three plasmacytomas were examined for the distribution of the theta antigen, immunoglobulin determinants, the receptor for Fc portion of antigen—antibody complexes and the receptor for the third component of complement. The theta-bearing tumours lacked C3 and Fc receptors and easily detectable surface immunoglobulin. The theta-negative lymphomas, while being morphologically lymphocytic, lacked all but the Fc receptors. One of the plasmacytomas possessed clearly detectable surface immunoglobulin. All three lacked the receptors for Fc and C3.