Is it reasonable for the use of Rh-ee blood? A hospital-based survey from a southern medical center in Taiwan

Identification of alloantibodies and achieving a reduction in the rate of red blood cell (RBC) alloimmunization are important issues to prevent transfusion complications. The aim of this study was to identify the antigen and alloantibodies in our patients and to study the association of alloimmunization with previous transfusion. Transfusion records from the blood bank of Kaohsiung Medical University Hospital between 2015 and 2017 were retrospectively enrolled in the study. Antigen and antibody identification was performed using routine blood bank methods. In total, 56,422 transfusion records from 2015 to 2017 were included in the study. Among them, 1858 alloantibody episodes were found in the pre-transfusion survey, and anti-Mia, anti-E, and cold antibodies were the most common alloantibodies, with a prevalence of 3.29% (1858/56,422). Among them, 130 episodes involved newly found alloantibodies with no alloantibodies found in the previous transfusion survey. Tracing back to these newly transfusion-induced alloantibodies, the antibody was found with a mean of 10.8 ± 7.8 units of packed RBC transfusion, a mean of 66.3 ± 52.8 days, and with a mean of 4.3 ± 2.7 times of transfusion from the first transfusion therapy. An antibody survey revealed that Rh-ee (62.1%) was the most common phenotype in these newly identified antibodies. In summary, this hospital-based study revealed that RBC alloantibody rates were present at rates of 3.29%, with anti-Mia, anti-E, and cold antibodies being the most common alloantibodies. Among them, anti-E was the most commonly developed alloantibody. Given that the Rh-ee group is the most common phenotype in our population, the strategy of using Rh-ee blood for Rh-ee recipients is reasonable for transfusion safety.

Adult intussusception: 5-year experience in Sarawak

Adult intussusception is rare. It represents only 5% of all intussusceptions and 1% of bowel obstruction. Clinical presentations are usually variable with a variety of acute, intermittent and chronic symptoms. It is associated with an underlying pathologic process in 90% of cases. A lack of Malaysia data prompted review of the Sarawak experience with this uncommon entity, focusing on the clinical features, diagnostic procedure and treatment. During the last 5 years, there were 14 cases of surgically proven adult intussusception. Mean age was 45.9 years. There were 9 enteric and 5 colonic intussusceptions. Ninety-three percent of the intussusceptions were associated with a pathologic lesion. Thirty-three percent of the enteric lesions were malignant and 67% were benign. Eighty percent of the colonic lesions were malignant and 20% were benign. Computed tomography scan has a good diagnostic accuracy of 83% and should be considered for all patients with nonspecific abdominal symptoms or suspected bowel obstruction. Treatment of choice for colonic intussusception in adults is en bloc resection without reduction whenever possible, whereas a more selective approach for enteric lesions.

Polymorphisms in the apoptosis-associated genes FAS and FASL and risk of oral cancer and malignant potential of oral premalignant lesions in a Taiwanese population

BACKGROUND

Our aim was to measure the relationship of FAS (-1377G>A and -670A>G), FASL (-844C>T) gene variants and risk of oral cancer.

METHODS

Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis was used to determine the FAS and FASL polymorphisms in 294 oral squamous cell carcinoma (OSCC), 53 oral submucous fibrosis (OSF), and 84 oral leukoplakia (OL) patients, as well as in 333 healthy controls. A standardized questionnaire was applied to collect demographic data, and potential confounding factors. JMP statistical software was used to analyze the association.

RESULTS

FAS and FASL polymorphisms were not correlated with OSCC development or the malignant potential of OL by simple and multivariate logistic regression. However, a two- to fourfold difference in the risks of betel quid chewing, alcohol consumption, and smoking on OSCC development were observed between participants with different FAS polymorphisms. FAS polymorphisms were significantly correlated with the malignant potential of OSF. Multivariate logistic regression analysis indicated that FAS A(-1377)-G(-670) vs. G(-1377)-A(-670) haplotype (OR = 2.26, 95% CI = 1.16-4.41) was correlated with the malignant potential of OSF.

CONCLUSIONS

We suggest that FAS and FASL polymorphisms are not significantly correlated with OSCC development or malignant potential of OL. The impact of substance usage on OSCC development could be differentiated by FAS polymorphisms. FAS A(-1377)-G(-670) haplotype may play a role in the malignant potential of OSF.

Pitching stabilization via caudal fin-wave propagation in a forward-sinking parrot cichlid (Cichlasoma citrinellum x Cichlasoma synspilum)

Caudal fin-wave propagation (CFP) is a commonly observed behavior in a fish but has been little investigated. Our objective is to understand the function of a CFP for a forward-sinking parrot cichlid that adopts a tilted-down swimming posture. We utilized stereoscopic digital particle-image velocimetry to measure the velocity fields in the wake of both the caudal fin and the pectoral fins and to evaluate the corresponding hydrodynamic forces. The tilted-down posture of this fish is inherently unstable because of the presence of the head-down pitching moment induced from the buoyant force of the body. The down-stroke of the pectoral fins results also in a head-down pitching moment that destabilizes the fish. Our results indicate that a CFP facilitates the pitching stabilization of a fish. In a forward-sinking parrot cichlid, a CFP produces periodic jets (CFP jets) that are oriented laterally and posterodorsally, which result in both thrust and negative lift that induce a head-up pitching moment. The CFP jets are initially trapped by the ventral part of the caudal fin, strengthened and reoriented by the dorsally propagating fin wave, and expelled near the dorsal part of the caudal fin.

Automating Veterans Administration libraries: II. Implementation at the Kansas City Medical Center Library

In 1985, the Kansas City Veterans Administration Medical Center began implementation of the Decentralized Hospital Computer Program (DHCP). An integrated library system, a subset of that program, was started by the medical library for acquisitions and an outline catalog. To test the system, staff of the Neurology Service were trained to use the outline catalog and electronic mail to request interlibrary loans and literature searches. In implementing the project with the Neurology Service, the library is paving the way for many types of electronic access and interaction with the library.