Cognition as a treatment target in depression.

Cognitive dysfunction in depression is associated with poorer clinical outcomes and impaired psychosocial functioning. However, most treatments for depression do not specifically target cognition. Neurocognitive deficits such as memory and concentration problems tend to persist after mood symptoms recover. Improving cognition in depression requires a better understanding of brain systems implicated in depression. A comprehensive approach is warranted for refined methods of assessing and treating cognitive dysfunction in depression.

Detection of Vibrio cholerae O1 and O139 in environmental waters of rural Bangladesh: a flow-cytometry-based field trial.

Presence of Vibrio cholerae serogroups O1 and O139 in the waters of the rural area of Matlab, Bangladesh, was investigated with quantitative measurements performed with a portable flow cytometer. The relevance of this work relates to the testing of a field-adapted measurement protocol that might prove useful for cholera epidemic surveillance and for validation of mathematical models. Water samples were collected from different water bodies that constitute the hydrological system of the region, a well-known endemic area for cholera. Water was retrieved from ponds, river waters, and irrigation canals during an inter-epidemic time period. Each sample was filtered and analysed with a flow cytometer for a fast determination of V. cholerae cells contained in those environments. More specifically, samples were treated with O1- and O139-specific antibodies, which allowed precise flow-cytometry-based concentration measurements. Both serogroups were present in the environmental waters with a consistent dominance of V. cholerae O1. These results extend earlier studies where V. cholerae O1 and O139 were mostly detected during times of cholera epidemics using standard culturing techniques. Furthermore, our results confirm that an important fraction of the ponds' host populations of V. cholerae are able to self-sustain even when cholera cases are scarce. Those contaminated ponds may constitute a natural reservoir for cholera endemicity in the Matlab region. Correlations of V. cholerae concentrations with environmental factors and the spatial distribution of V. cholerae populations are also discussed.

Era of blood component therapy: time for mandatory pre-donation platelet count for maximizing donor safety and optimizing quality of platelets.

Blood bank regulatory agencies including the Drug and Cosmetics Act (DCA) of India do not mandate a predonation platelet count in whole blood donation. Mandating such practice will definitely optimize the quality of random donor platelets (RDP) in terms of platelet yield and patient therapeutic benefit. We observed poor platelet yield in RDP concentrates prepared at our center with a significant number not meeting the DCA guideline of ≥ 4.5 × 10(10) per bag processed from 450 ml of whole blood. Therefore we planned this study to evaluate the pre-donation hematological values in our blood donor population and effect of these values on the quality of platelet concentrates. The prospective study included 221 blood donors eligible for donating 450 ml of whole blood (WB). Following the departmental standard operating procedure (SOP) RDPs were prepared using the 'Top & Bottom' quadruple bag system and automated component extractor. Quality of RDP was assessed as per departmental protocol. All results were recorded and subsequently transcribed to SPSS working sheet. A significant (p<0.001) decrement of donor blood counts has been observed after WB donation. Mean donor Hb and platelets reduced by 0.72 g/dl and 22.1 × 10(6)/ml respectively. Quality of RDPs in terms of platelet yield was significantly better (p<0.001) when donor platelet count was >200 × 10(6)/ml. Although platelet yield significantly correlated with the donor platelet count however quality of RDPs in terms of red cell contamination showed no correlation with the donor hematocrit. Platelet yield in random donor platelets is a concern in Eastern India. A platelet yield of 4.5 × 10(10) per bag as mandated by the DCA of India was only achieved when the donor platelet count was >200 × 10(6)/ml. Posttransfusion platelet recovery (PPR) was unsatisfactory in the transfused patient. Introduction of pre-donation platelet count in whole blood donation will maximize donor safety and optimize patient platelet transfusion management.

Status of Serum Ferritin Level among Iron Deficiency Anemic Adolescent Girls in Bangladesh.

Adolescence explained as a period of age between 10 to 19 years. This is a major contributing period to build up the health of girls. Ferritin is an intracellular protein that contains iron and releases it in a controlled fashion and it reflects body iron stores and systemic inflammation during adolescent period. It is considered the best single test for the diagnosis of iron deficiency anemia during adolescent because its concentration is directly proportional to total body iron stores in adolescent period. This study was done in the Department of Physiology, Mymensingh Medical College, Mymensingh, Bangladesh to evaluate the changes of serum ferritin levels among iron deficient anemic adolescent girls in comparison to healthy adolescent girls in Bangladesh. This was a cross sectional, prospective, analytical type of study. This study ranged from 10-19 years of adolescent girls. Seventy (70) healthy adolescent girls, as control group (Group I). Seventy (70) iron deficiency anemic adolescent girls as study group (Group II). Serum ferritin was estimated by Micro-particle Enzyme Immunoassay Test Kit. Data were expressed as mean (±SD). Statistical significance of difference among the Group I and Group II were calculated by unpaired students 't' test. The mean±SD level of serum ferritin among Group I and Group II were 26.22±4.03µg/L and 13.33±3.18µg/L respectively. Mean values ±SD of serum ferritin significantly lower in (Group II) in comparison with (Group I). Higher numbers of adolescent girls are still suffering from anemia along with low level of serum ferritin in Bangladesh. For combat this situation, immediate, sustainable and long term public health intervention and nutritional supplementation must be required.

The effect of biosimilar administration on clinical outcomes in patients with adalimumab-controlled psoriasis.

Background: Adalimumab is an anti-tumour necrosis factor administered for the management of severe psoriasis. Previously limited to Humira, new biosimilar medications have now emerged including Amgevita. To date, there have been no comparison studies of adalimumab biosimilar use on different types of psoriasis. Objective: To investigate the implications of biosimilar medications and patient specific factors on clinical outcomes, including Psoriasis Area and Severity Index (PASI) and Dermatology Life Quality Index (DLQI) scores. Methods: A clinical notes review was performed for all dermatology patients with adalimumab-controlled psoriasis at our centre. Demographic profile, psoriasis subtype and changes in clinical patterns as demonstrated by PASI and DLQI were extracted and analysed. Results: Of 91 records identified, 70 patients met the inclusion criteria. 21 patients (30%) demonstrated significant increase in PASI and DLQI scores with Amgevita. Scores improved to baseline once Humira was restarted. Findings reveal no difference in pre-adalimumab disease severity or mean age between the groups. Patients responding only to Humira had a greater proportion of females, and were likelier to have psoriatic arthritis (odds ratio [OR]: 10.63; p < 0.0002) and nail involvement (OR: 6.13, p < 0.02), compared with patients well controlled with Amgevita. Conclusions: This audit of a single dermatology centre suggests switching to a biosimilar adalimumab may exacerbate symptoms of psoriasis. Future studies should investigate whether findings are restricted to our study population, and consider the influence of other factors, such as disease subtypes and medication formulations.

Plateletpheresis in the Era of Automation: Optimizing Donor Safety and Product Quality Using Modern Apheresis Instruments.

The increases in major surgeries, transplantations and speciality clinics have significantly increased the utilization of platelet concentrates including single donor platelets (SDP). The advantages of SDP or apheresis platelet have been discussed elaborately by previous authors as compared to random donor platelets. Here we share our experiences of plateletpheresis procedures using the modern apheresis machines with regards to product quality and donor safety. This study included 3016 procedures of plateletpheresis (1397 on Amicus and 1619 on Trima accel cell separators) on eligible donors using recommended apheresis kits. A target yield of 3 × 1011 was set as the end point of each procedure. Donor details, procedure details and donor adverse reactions if any were documented. Statistical analysis was done using the SPSS statistical package (version 13, USA). Of the total 6276 donors screened 2049 (32.6%) were deferred due to various reasons. Out of remaining 4227 eligible donors; 3016 (71.4%) underwent plateletphereis procedures based on the requirement of SDP by the patients. Mean pre-procedure platelet count and hematocrit in donors were 188.3 × 106/mL and 41.7% respectively. Mean procedure time in Amicus (76.6 min) was significantly more than the Trima accel (64.3 min) (p = 0.02). Platelet yield by Trima accel and Amicus was 2.96 × 1011 and 3.08 × 1011 respectively (p = 0.061). A total of 40 donors (1.33%) suffered adverse effect during or after apheresis procedures. While the modern plateletpheresis devices are both donor and user friendly at the same time they provide quality product consistently in lesser time.

Induction of secondary metabolites on nanoparticles stress in callus culture of Artemisia annua L.

Nanoparticles are known bio elicitors in plant biotechnology. Different concentrations of ZnO, CuO and CoO nanoparticles were used for the enhanced accumulation of secondary metabolites and antioxidant activities in the callus derived from root, shoot and leaf of Artemisia annua L. Biomass of callus was somehow affected on high concentrations of Nps. Phenolic content was observed maximum (60µg) in shoot callus at 0.1mg/l of CuONps. Total antioxidant activity was observed maximum (33µg) in root callus at 0.1mg/l of ZnOnps. Total reducing power maximum (33µg) was observed in root callus at concentration of 0.05 mg/l of CoONps. Maximum radical scavenging activity was observed in shoot callus at 0.05mg/l of ZnONps. Rutin gallic acid and caffic acid were also determined in most of the samples by HPLC. The study concludes that different Nps have positive effect on the induction of secondary metabolites in A.annua plant.

Understanding the magnitude of still birth in Mymensingh Medical College Hospital.

To understand the incidence and causes of still-births occurred in Mymensingh Medical College Hospital, we conducted a retrospective record review study in Department of Gynaecology of the hospital. The study population were the cases of still births occurred the months of January and December 2007. We administered a structured questionnaire to all the Medical Officers working in the department. They were requested to provide information on the still-births they noticed during the study period. They review their personal log books and hospital records to complete the questionnaire. We also reviewed the hospital records to obtain the service statistics. In total 11,146 patients were admitted to seek obstetric care during the study period and of them 7,069(63%) sought delivery care. During this period there were 735(10%) still births. The incidences of still births were more during December and January. The pre-existing maternal diseases that were frequently associated with still births were Antepartum Haemorrhage (APH) 38% and hypertension (27%). The frequently reported direct causes of the still births were obstructed labour (42%), misuse of oxytocin (28%) and foetal distress (20%). In many cases the loss is completely unexpected. Hospital based surveillance and issuing of still-birth certificates may increase the awareness of the problem among the obstetricians and in the community.

Burst abdomen-A preventable morbidity.

A burst abdomen is considered present, when intestine, omentum or other viscera's were seen in the abdominal wound following obstetric surgery. In our country no study found, but observational incidence in the tertiary hospital varies between 0.2-3%. It occurs mostly between the sixth and eight day after operation. Factors relating to the incidence of burst abdomen are suture, closure, incision, coughing, vomiting, distension, obesity, jaundice, malignancy, diabetes mellitus, hypoproteinaemia, anaemia, immuno-compromised patients and wound infection. During the period of February 2001 to February 2006 four cases of burst abdomen were managed in cooperation with team of surgery department. In these cases wound were closed by "May/Mary closure". Abdominal wound dehiscence remains a major cause of morbidity following any laparotomy whether elective or emergency. We should correct the primary risk factors for wound dehiscence. Transverse incisions are generally considered to dehiscence much less than the vertical incision. The suture should have excellent handling and knotting. Its prevention is important to reduce postoperative morbidity, mortality and increased cost of care both in terms of increased hospital stay and treatment of the complication.

Immunohematological and clinical characterizations of mixed autoimmune hemolytic anemia.

BACKGROUND AND AIM: Patients with warm autoimmune hemolytic anemia (AIHA) may carry immunoglobulin (Ig) M antibodies that react at room temperature and are nonpathological, but few may have cold agglutinins that react at or above 30°C and are referred to as "mixed" AIHA (MAIHA). Here, we present our experience on characterizing MAIHA both clinically and serologically. MATERIALS AND METHODS: Out of 134 AIHA patients, 13 diagnosed as MAIHA were subjected to detailed immunohematological characterization. Most patients were severely anemic and required urgent transfusions. Resolution of blood group discrepancy, elution, Donath-Landsteiner test, and adsorption study were performed following established protocol. "Best match" blood units were selected and transfused to patients. RESULTS: Eight of the 13 patients had severe hemolysis. The median age of patient was 37 years with a female preponderance and secondary MAIHA was observed in 8 (61.5%) patients. Blood group discrepancy was encountered in 4 (30.8%) patients. Multiple red cell bound autoantibodies and high titer serum-free IgM autoantibodies were detected in all samples. Twenty-nine units of "best match" packed red blood cells were transfused to 12 patients without any adverse reaction. Improvement in hematological and biochemical values was observed in all follow-up patients. CONCLUSION: Patients with MAIHA often present with severe hemolysis necessitating blood transfusions. While red cells are coated with multiple autoantibodies, both warm reactive IgG and cold reactive IgM autoantibodies are present in the serum. These serological complexities not only render a crossmatch incompatibility but often lead to blood group discrepancy. "Best match" blood transfusion is always lifesaving.

Induction of secondary metabolites on nanoparticles stress in callus culture of Artemisia annua L / Indução de metabólitos secundários no estresse de nanopartículas em cultura de calos de Artemisia annua L

Nanoparticles are known bio elicitors in plant biotechnology. Different concentrations of ZnO, CuO and CoO nanoparticles were used for the enhanced accumulation of secondary metabolites and antioxidant activities in the callus derived from root, shoot and leaf of Artemisia annua L. Biomass of callus was somehow affected on high concentrations of Nps. Phenolic content was observed maximum (60µg) in shoot callus at 0.1mg/l of CuONps. Total antioxidant activity was observed maximum (33µg) in root callus at 0.1mg/l of ZnOnps. Total reducing power maximum (33µg) was observed in root callus at concentration of 0.05 mg/l of CoONps. Maximum radical scavenging activity was observed in shoot callus at 0.05mg/l of ZnONps. Rutin gallic acid and caffic acid were also determined in most of the samples by HPLC. The study concludes that different Nps have positive effect on the induction of secondary metabolites in A.annua plant.

Nanopartículas são bio-elicitores conhecidos em biotecnologia de plantas. Diferentes concentrações de nanopartículas de ZnO, CuO e CoO foram usadas para o acúmulo aumentado de metabólitos secundários e atividades antioxidantes no calo derivado da raiz, parte aérea e folha de Artemisiaannua L. A biomassa do calo foi de alguma forma afetada em altas concentrações de Nps. O conteúdo fenólico foi observado no máximo (60 µg) no calo da parte aérea a 0,1 mg / l de CuONps. A atividade antioxidante total foi observada no máximo (33µg) no calo radicular a 0,1mg / l de ZnOnps. O poder de redução total máximo (33µg) foi observado no calo radicular na concentração de 0,05 mg / l de CoONps. Atividade máxima de eliminação de radicais foi observada no calo da parte aérea a 0,05mg / l de ZnONps. O ácido rutina-gálico e o ácido caffic também foram determinados na maioria das amostras por HPLC. O estudo conclui que diferentes Nps têm efeito positivo na indução de metabólitos secundários na planta de A.annua.

Methicillin resistant Staphylococcus aureus (MRSA) isolated in Saudi Arabia: epidemiology and antimicrobial resistance patterns.

Methicillin resistant Staphylococcus aureus (MRSA) comprised about 7.5% per annum of all S. aureus isolated in a general hospital in Jeddah, Saudi Arabia during the 3 year period 1990-1992. Most isolates were from wound sites (71%). Resistance to gentamicin (83%) and tetracycline (93%) was frequently observed whilst resistance to ciprofloxacin (1%) and rifampicin (6%) was uncommon. Low levels of mupirocin resistance (MIC 8 mg l-1), were detected in 3% of all MRSA isolates.

Heterogeneous distribution of amyotrophic lateral sclerosis patients with SOD-1 gene mutations: preliminary data on an Italian survey.

We report the absence of superoxide dismutase (SOD-1) gene mutations in 30 patients with amyotrophic lateral sclerosis (ALS) including individuals with a confirmed family history of ALS (familial ALS/FALS), ALS with an unclear family history (UFALS) and sporadic ALS (SALS). Single strand conformation polymorphism (SSCP) and sequence analysis of the 5 SOD-1 gene exons were undertaken to improve the accuracy of the mutation detection. Our preliminary data appear to diverge from the results of studies by other groups using different populations. We discuss the possible reasons for this disparity and the apparent heterogeneous distribution of ALS with SOD-1 gene mutations among different ethnic groups.

Voluntary motor function in patients with chronic fatigue syndrome.

INTRODUCTION: The pathogenesis of chronic fatigue syndrome (CFS) remains unknown. In particular, little is known of the involvement of the motor cortex and corticospinal system. METHODS: Transcranial magnetic stimulation (TMS) was used to assess corticospinal function in terms of latency and threshold of motor-evoked potentials (MEPs) in thenar muscles. Reaction times and speed of movement were assessed using button presses in response to auditory tones. RESULTS: Patients had higher (P<.05) self-assessed indices of fatigue (7/10) than for pain (5/10), anxiety (4/10) or depression (3/10). Mean (+/-S.E.M.) simple reaction times (SRTs) were longer (P<.05) in the patients (275+/-19 ms) than in the controls (219+/-9 ms); choice reaction times (CRTs) were not significantly longer in the patients. Movement times, once a reaction task had been initiated, were longer (P<.05) in the patients in both SRTs (patients, 248+/-13 ms; controls, 174+/-9 ms) and CRTs (patients, 269+/-13 ms; controls, 206+/-12 ms). There was no difference (P>.05) in threshold or latency of MEPs in hand muscles between the patients (threshold, 54.5+/-2.2% maximum stimulator output [% MSO]; latency 22+/-0.3 ms) and controls (threshold 54.6+/-3.6% MSO; latency 22.9+/-0.5 ms). Regression analysis showed no correlation (P>.05) of SRTs with either threshold for MEPs or fatigue index. CONCLUSION: Corticospinal conduction times and excitability were within the normal range despite a slower performance time for motor tasks and an increased feeling of fatigue. This suggests that the feeling of fatigue and the slowness of movement seen in CFS are manifest outside the corticospinal system.

Learned control of slow potential interhemispheric asymmetry in schizophrenia.

We report on the feasibility of teaching 16 (DSM-IV) schizophrenic patients, subdivided by syndrome, self-regulation of interhemispheric asymmetry having demonstrated efficient learning of interhemispheric control in normal subjects. Reversal of asymmetry may be important to treatment and recovery in schizophrenia for following improvement on neuroleptic drugs functional hemispheric asymmetries have reversed, with directions of reversal and pre-existing asymmetry dependent on syndrome. Asymmetry reversal in animals, manifested by spatial turning tendencies, has been used as a marker of neuroleptic action and involves striatal dopamine under reciprocal hemispheric control. We gave as feedback the left right asymmetry in slow potential negativity recorded from the sensory motor strip (C3,4). Feedback took the form of a rocket on a screen which rose or fell with leftward or rightward shifts in negativity. Patients were able to learn control (P < 0.01). In those patients with lesser ability this was due to inability to sustain concentration throughout the session rather than slow initial learning. Active syndrome patients were better able to shift negativity rightward and withdrawn patients leftward, directions associated with drug reversal of functional asymmetry and symptom recovery for each syndrome. Accordingly our demonstration that many symptomatic schizophrenic patients are capable of learning control opens the door to electrocortical operant conditioning training in schizophrenia with therapeutic regimens.

Audit of Pseudomonas aeruginosa in a general hospital in Saudi Arabia.

All isolates of Pseudomonas aeruginosa in our laboratory from hospitalised patients were collected over a 4-month period in 1993/94. Details of the patients including length of stay, transfer from another hospital, nationality, diagnosis and antibacterial treatment were noted. Each patient was assessed as to whether the first isolate during the study period was of clinical significance and whether the infection or colonization was nosocomially acquired. The isolates of P. aeruginosa were identified and sensitivity was determined by recognized methods. Isolates were serotyped. 108 different patients were included in the study (median age 50 years, 58% males). 57/77 (74%) isolates where information was noted were nosocomial acquired. Length of patient stay for the nosocomial acquired isolates ranged from less than 1 day to more than 1 year. 19% of patients were transfers from other hospitals. Clinical significance was graded 31% isolates were judged to be highly significant and 44% to have little or no clinical significance. 41% isolates were from superficial sites including wounds, 27% from respiratory sites, 23% from urine and 6% were from blood cultures. Heavy growth of P. aeruginosa was correlated with clinical significance. Coliforms were the other organisms most frequently isolated with the P. aeruginosa but highly significant isolates were usually in pure culture. Serotypes 11, 2 and 4 were the dominant isolates. Serotype 11 was also the most common environmental isolate from the hospital. 60% patients were receiving antibacterial agents when the sample was taken but only 12% patients were receiving potentially anti-pseudomonal agents.

Induction of secondary metabolites on nanoparticles stress in callus culture of Artemisia annua L

Abstract Nanoparticles are known bio elicitors in plant biotechnology. Different concentrations of ZnO, CuO and CoO nanoparticles were used for the enhanced accumulation of secondary metabolites and antioxidant activities in the callus derived from root, shoot and leaf of Artemisia annua L. Biomass of callus was somehow affected on high concentrations of Nps. Phenolic content was observed maximum (60µg) in shoot callus at 0.1mg/l of CuONps. Total antioxidant activity was observed maximum (33µg) in root callus at 0.1mg/l of ZnOnps. Total reducing power maximum (33µg) was observed in root callus at concentration of 0.05 mg/l of CoONps. Maximum radical scavenging activity was observed in shoot callus at 0.05mg/l of ZnONps. Rutin gallic acid and caffic acid were also determined in most of the samples by HPLC. The study concludes that different Nps have positive effect on the induction of secondary metabolites in A.annua plant.

Resumo Nanopartículas são bio-elicitores conhecidos em biotecnologia de plantas. Diferentes concentrações de nanopartículas de ZnO, CuO e CoO foram usadas para o acúmulo aumentado de metabólitos secundários e atividades antioxidantes no calo derivado da raiz, parte aérea e folha de Artemisiaannua L. A biomassa do calo foi de alguma forma afetada em altas concentrações de Nps. O conteúdo fenólico foi observado no máximo (60 µg) no calo da parte aérea a 0,1 mg / l de CuONps. A atividade antioxidante total foi observada no máximo (33µg) no calo radicular a 0,1mg / l de ZnOnps. O poder de redução total máximo (33µg) foi observado no calo radicular na concentração de 0,05 mg / l de CoONps. Atividade máxima de eliminação de radicais foi observada no calo da parte aérea a 0,05mg / l de ZnONps. O ácido rutina-gálico e o ácido caffic também foram determinados na maioria das amostras por HPLC. O estudo conclui que diferentes Nps têm efeito positivo na indução de metabólitos secundários na planta de A.annua.

Burden and outcome of human influenza in a tertiary care hospital of Bangladesh.

OBJECTIVE: To determine the magnitude and outcome of influenza in southern part of Bangladesh and also to identify intrusion of novel influenza virus. METHODS: This study was conducted for two years (2008-2009) in outpatient and inpatient department of both paediatrics and medicine discipline of Khulna Medical College Hospital. Nasal and throat swab specimens were collected from each influenza like illness (ILI) case and kept together in a virus transport media and transported to international centre for diarrhoeal disease and research, Bangladesh laboratory. Influenza virus was detected by rRT-PCR including types and subtypes. RESULTS: A total of 526 patients were enrolled during the study period with the mean (SD) age of 19 (17) years. Identification of influenza virus was 14% and positive cases were mostly found in under-five children (24%). The vast majority (88%) of influenza cases were found during April to September. Virus detection rate was higher in inpatient department (IPD) (21%) than in outpatient department (12%). The dominant virus type and subtype was influenza A (87%) and H3 (49%), respectively. Type A was significantly higher than type B in causing severe illness compared to ILI (OR=7.04, 95%CI: 2.76-18.7, P<0.01). Headache and chest indrawing was found in significantly higher proportion (P<0.05) in influenza positive IPD cases. Among 31 hospitalized cases majority (77%) recovered completely except two cases that needed referral for additional support. CONCLUSIONS: Influenza mostly affected under-five children and young adult. The peak season here was late summer and rainy season.

High-density single nucleotide polymorphism array analysis and ASXL1 gene mutation screening in chronic myeloid leukemia during disease progression.

We have undertaken a genome-wide single nucleotide polymorphism (SNP) array analysis of 41 chronic myeloid leukemia (CML) patients. In total, 44 regions of uniparental disomy (UPD) >3 Mb were identified in 24 of 32 patients in chronic phase (CP), and 21 regions of UPD >3 Mb were identified in 13 of 21 patients in blast crisis (BC). Chromosome 8 had the highest frequency of UPD regions in both CP and BC samples. Eight recurrent regions of UPD were observed among the 41 patients, with chromosome 8 showing the highest frequency. Ten regions of copy number change (CNC) >3 Mb were observed in 4 of 21 patients in BC, whereas none were observed in CP. We have identified several recurrent regions of UPD and CNC in CML that may be of pathogenetic importance. Overrepresentation of genomic aberrations (UPD and copy number gain) mapping to chromosome 8 was observed. Selected candidate genes mapping within the aberrant genomic regions were sequenced and mutation of the TP53 gene was observed in one case in BC and of the ASXL1 gene in 6 of 41 cases in CP or BC. Mutation of ASXL1 represents an important new molecular abnormality in CML.