Gravity leukapheresis--a simple method of leukocyte collection for transfusion or in vitro study.

Simple and efficient methods of harvesting granulocytes (GRs) are important for widespread availability of GR transfusion. Leukocytes were collected by gravity leukapheresis and the variables for collection were examined in order to determine maximum efficiency. 500 ml of whole ACD blood from normal donors was centrifuged at 4000 rpm × 3 min to collect GRs and platelets together, or at 2600 rpm × 3 min to collect them separately. The packed cells were resuspended in 300 or 500 ml 3% hydroxyethylstarch (HES) in normal saline and allowed to sediment at either 25°C or 37°C for varying lengths of time. After sedimentation, the RBCs were combined with platelet-poor plasma for return to the donor. Temperature had no effect on collection efficiency, but sedimentation in 500 ml was more efficient than in 300 ml (84.6% vs 69.7%, P < 0.005). Sedimentation for 15 min was more efficient than either 9 or 12 min (84.6%, 63.0% and 41.3% respectively, P < 0.05). Sedimentation for ? 15 resulted in mean yields of 1.3 × 10⁹and 1.6 × 10⁹ GR/unit whole blood in 300 and 500 ml HES respectively (range 0.57–2.02 and 0.57–3.90 respectively). This compares favorably to centrifugation leukapheresis. Total yield is limited by the small volume of blood that can be processed. GRs obtained by this method appeared normal morphologically, and had normal phagocytic and bactericidal capacity. This method is useful for the collection of leukocytes or blast cells from donors with chronic or acute leukemia (81.4% and 85% efficient respectively), and allows for control of extracorporeal volume in such donors. This method is also useful for collection of leukocytes from smaller volumes of blood for in vitro study.     

Attention-deficit/hyperactivity disorder with oppositional defiant disorder in Swedish children - an open study of collaborative problem solving

Aim: To evaluate collaborative problem solving (CPS) in Swedish 6–13‐year‐old children with attention‐deficit/hyperactivity disorder and oppositional defiant disorder (ODD). Methods: Seventeen families completed 6–10 sessions of CPS training. Primary outcome measures were SNAP‐IV [attention‐deficit/hyperactivity disorder (ADHD) and ODD scores] and Clinical Global Impression‐Improvement (CGI‐I) scores at baseline, post‐intervention and 6 months later. Secondary outcome measures were the Conners’ 10‐item scale and the Family Burden of Illness Module (FBIM). Results: All 17 participants completed the intervention. The whole group had significant reductions in SNAP‐IV ODD, ADHD, total Conners’ and FBIM scores, both at post‐intervention and at 6‐month follow‐up. Eight of the children, although significantly improved on ODD scores and the Conners’ emotional lability subscale at post‐intervention, had almost no improvement in hyperactivity/impulsivity. Post‐intervention, this group received stimulant medication for their ADHD. CGI‐I scores of much improved or very much improved were reached by 53% (9/17) of all at post‐intervention, and by 81% (13/16) at 6‐month follow‐up. Conclusion: Collaborative problem solving significantly reduced ODD, ADHD and emotional lability symptoms. A subgroup improved in their ADHD symptoms only after adding stimulant medication.     

How to Diagnose Enchondroma,Bone Infarct,and Chondrosarcoma

Enchondromas are among the most common benign tumors seen in the skeleton. They are encountered frequently in routine clinical practice. The purpose of this review is to help radiologists confidently diagnose enchondroma and distinguish it from other entities, such as bone infarct, bone graft, and low-grade chondrosarcoma.