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Mean platelet volume (MPV) is an indicator of thrombocyte volume and tendency to thrombosis can be mentioned in case of MPV elevation. Cancers are one of the important groups of thrombotic diseases. In the present study, MPV value was scrutinized in patients with cancer that developed thrombosis. Totally 43 patients followed in Kayseri Training and Research Hospital, in who thromboembolus has been developed, were prospectively recruited in the study. Thrombocyte, MPV, and platicrit (PCT) values were recorded at the time of cancer diagnosis and thrombosis development. Frequency analysis, crosstabs, and paired samples t test were used. Analyses showed that MPV values at the time of thrombosis development were significantly low as compared to those at the time of cancer diagnosis ( P = .041). Thrombocyte count and PCT values were also low but not significant. The result of the present study is likely to show that thrombocytes have ignorable effect on thrombosis development in patients with cancer.

This paper is the first report whether or not pneumatic tube system affects the selection of apheresis donors according to the results of complete blood count. According to the apheresis guidelines, hemoglobin level must be ≥12.5. g/dL and platelet level ≥150/μL to be a donor. Paired blood samples of 26 healthy volunteers were transported by either hand delivered or a pneumatic tube system to the laboratory. No statistically significant differences were observed in order to mean values of routine complete blood cell count and white cell differential parameters that were send for selection of apheresis donor before the procedure. Therefore, all healthy volunteers decided as a donor according to the laboratory results independent from transport method. © 2012 Elsevier Ltd.

Human brucellosis is a multisystem disease with a wide spectrum of clinical manifestations. Brucellosis can mimic several primary hematological diseases. Several non-specific hematologic abnormalities have been reported with brucellosis including anemia, leukopenia, thrombocytopenia and pancytopenia. We discussed about steroid therapy and described a child case of acute brucellosis presenting with Coombs-positive AIHA. A 3.5-year-old girl was admitted to our hospital by pallor, palpitation, fever , scleral icterus. Laboratory test showed hemoglobin 7.4 g/dL, direct Coombs IgG plus C3d test strongly positive (3+). Serology for Brucella was strongly positive (Wright agglutination reaction [1/2560], coombs agglutination reaction [1/5120]). The differential diagnosis child of Coombs-positive AIHA should include brucellosis, especially in patients living in endemic areas.Early diagnosis and treatment of disease at AIHA depentdent brucellos is important because of they could be determined to severe acute hemolysis.

PubMedID: 21859378 Background: In April 2009 a novel strain of human influenza A, identified as H1N1 virus, rapidly spread worldwide, and in early June 2009 the World Health Organization raised the pandemic alert level to phase 6. Herein we present the largest series of children who were hospitalized due to pandemic H1N1 infection in Turkey. Methods: We conducted a retrospective multicentre analysis of case records involving children hospitalized with influenza-like illness, in whom 2009 H1N1 influenza was diagnosed by reverse-transcriptase polymerase chain reaction assay, at 17 different tertiary hospitals. Results: A total of 821 children with 2009 pandemic H1N1 were hospitalized. The majority of admitted children (56.9%) were younger than 5 y of age. Three hundred and seventy-six children (45.8%) had 1 or more pre-existing conditions. Respiratory complications including wheezing, pneumonia, pneumothorax, pneumomediastinum, and hypoxemia were seen in 272 (33.2%) children. Ninety of the patients (11.0%) were admitted or transferred to the paediatric intensive care units (PICU) and 52 (6.3%) received mechanical ventilation. Thirty-five children (4.3%) died. The mortality rate did not differ between age groups. Of the patients who died, 25.7% were healthy before the H1N1 virus infection. However, the death rate was significantly higher in patients with malignancy, chronic neurological disease, immunosuppressive therapy, at least 1 pre-existing condition, and respiratory complications. The most common causes of mortality were pneumonia and sepsis. Conclusions: In Turkey, 2009 H1N1 infection caused high mortality and PICU admission due to severe respiratory illness and complications, especially in children with an underlying condition. © 2011 Informa Healthcare. Ankara Universitesi Medical School, University of Michigan 7Pediatric 5Pediatric Faculty of Medicine, Assiut University From the 1Department of Pediatrics,Ankara University Medical School,Ankara,Turkey,2Department of Pediatric Infection Diseases,Dr.Sami Ulus Maternity and Children Training and Research Hospital,Ankara,Turkey, 3Department of Pediatrics, Republic of Turkey Ministry of Health Ankara Dıs¸kapı Children’s and Research Hospital, Ankara,Turkey, 4Department of Pediatrics, Ondokuz Mayıs University Medical School, Samsun,Turkey, 5Pediatric Infectious Diseases Unit,Dr.Behçet Uz Children’s Hospital,Izmir,Turkey,6Division of Pediatric Infectious Diseases,S¸is¸li Etfal Training and Research Hospital, Istanbul,Turkey, 7Pediatric Infectious Diseases Unit, Department of Pediatrics, Hacettepe University Faculty of Medicine,Ankara,Turkey,8Division of Pediatrics,Adana Numune Research and Training Hospital,Adana, Turkey,9Department of Pediatrics,Gazi University Medical School,Ankara,Turkey,10Department of Pediatrics,Selçuk University Meram Medical Faculty, Konya,Turkey, 11Department of Pediatrics and Pediatric Infectious Diseases, Uludag^ University Medical School, Bursa,Turkey, 12Clinics of Pediatrics,Tepecik Training and Research Hospital, Izmir,Turkey, 13Division of Pediatric Infectious Diseases, Department of Children’s Health and Diseases, Çukurova University Faculty of Medicine,Adana,Turkey,14Department of Pediatrics,Eskis¸ehir Osmangazi University Faculty of Medicine,Eskis¸ehir, Turkey, 15Pediatric Infectious Diseases Unit, Department of Pediatrics, Süleyman Demirel University Faculty of Medicine, Isparta,Turkey, 16Department of Pediatrics, Marmara University Medical School, Istanbul,Turkey, 17Department of Pediatrics,Mersin University Medical School,Mersin,Turkey,and 18Department of Biostatistics,Ankara University Medical School, Ankara, Turkey

Introduction and Methods: The prevalence of obesity in patients with hemophilia (PWH) is increasing. We investigated whether hemostatic changes seen in obesity differ between men with and without hemophilia, by comparing coagulation and fibrinolytic markers between 98 hemophilia A patients (50 obese and 48 non-obese) and 92 age- and BMI-matched non-hemophilic men (42 obese and 50 non-obese). Results: Mean age was 50 ± 13 years and 33 PWH had FVIII activity

Introduction and Methods: The prevalence of obesity in patients with hemophilia (PWH) is increasing. We investigated whether hemostatic changes seen in obesity differ between men with and without hemophilia, by comparing coagulation and fibrinolytic markers between 98 hemophilia A patients (50 obese and 48 non-obese) and 92 age- and BMI-matched non-hemophilic men (42 obese and 50 non-obese). Results: Mean age was 50 ± 13 years and 33 PWH had FVIII activity

Background: The aspartate aminotransferases (AST) to platelet ratio index (APRI) may serve as a noninvasive marker to assess liver fibrosis. Objectives: To assess the diagnostic ability of the APRI for prediction of fibrosis in patients with chronic hepatitis B (CHB), chronic hepatitis C (CHC), and non-alcoholic fatty liver disease (NAFLD). Patients and Methods: This retrospective study included 207 patients with CHB,108 with CHC, and 140 patients with NAFLD. The APRI was calculated as (AST level/upper normal limit for AST)/platelet counts (109/L) x 100. The stage of liver fibrosis in patients with chronic viral hepatitis was graded using the METAVIR scale. The Kleiner system for grading fibrosis was used in patients with NAFLD. Results: Bivariate correlation analyses showed that the APRI was significantly associated with fibrosis scores in patients with CHC (p = 0.2634, p = 0.0059) and NAFLD (p = 0.2273, p = 0.0069), but not in those with CHB (p = 0.1005, p = 0.1495). Receiver operating characteristic (ROC) curves were used for assessing the ability of the APRI as a predictor of the absence or presence of liver fibrosis (fibrosis score of 0 vs fibrosis scores of 1-4). In patients with CHC, the APRI showed a sensitivity of 72.7% and a specificity of 62.4% for detection of fibrosis (p

Essential thrombocythemia is characterized by persistent elevation and functional disturbances of platelets. Both the platelet function analyzer-100 (PFA-100) collagen-epinephrine (CEPI) cartridge and aggregometry with epinephrine are considered sensitive and valid methods in detecting abnormal platelet function in essential thrombocythemia. We attempted to confirm that restoration of abnormal platelet function results from platelet count reduction in essential thrombocythemia, by using these two methods. Thirty-nine essential thrombocythemia patients were divided into two groups on the basis of their platelet count. Group A participants (n = 20) exhibited platelet counts greater than 500 × 10 9/l, whereas group B participants (n = 19) had platelet counts below this limit. Hematological parameters, plasma von Willebrand factor (vWF) antigen and activity levels were assessed. Platelet function was analyzed by the PFA-100 and light transmission aggregometry with epinephrine, collagen, and ADP. The point mutation JAK2 V617F was identified and its effect on platelet function tests was also investigated. By using logistic regression analysis, white blood cell count, vWF activity level, and the measurements of aggregation in response to epinephrine were significantly different between the two groups. Epinephrine-induced aggregation retained the statistical significance in the multivariable procedure (P: 0.002). PFA-100 CEPI closure times were lower-but not statistically significant-in group B. Neither the JAK2 V617F positivity nor different cytoreductive treatments had any influence on ex-vivo platelet function tests. Our findings demonstrate normalization of platelet function resulting from platelet count reduction in essential thrombocythemia and reinforce the concept of lowering platelet counts in these patients. © 2011 Wolters Kluwer Health | Lippincott Williams &Wilkins. 22 6 457 462

Human infection with H1N1 virus reached pandemic status by the spring of 2009. Consequently, the rates of morbidity and mortality related with H1N1 2009 infections have been reported to be higher in pregnant women. H1N1 viremia is rare in the mother, and the risk for transmission of H1N1 2009 influenza from mother to fetus is unknown. To our knowledge, the literature contains only one previous report of a premature infant with H1N1 2009 infection whose mother also had H1N1 2009 infection. Here, we report an H1N1 pandemic influenza 2009-positive female premature infant born at 32 weeks of gestation whose mother had a confirmed H1N1 2009 infection by real-time reverse transcriptase polymerase chain reaction (rRT-PCR). This case suggests that H1N1 2009 virus might be transmitted across the placenta, and therefore, all infants born to an H1N1 2009-positive mother must be evaluated for possible H1N1 2009 infection.

The current study was conducted to assess 3435C>T multidrug resistance 1 gene polymorphism and the efficacy of high dose methylprednisolone (HDMP) in childhood acute idiopathic thrombocytopenic purpura patients. Methods: A total of 31 childhood acute Idiopathic thrombocytopenic purpura patients (17 females, 14 males) between the ages of 2 and 16 years of age were included in the study. High-dose methylprednisolone was given at a dose of 30 mg/kg/day for 3 days and 20 mg/kg/day for 4 days, consecutively and intravenously. Polymerase chain reaction-restriction fragment length polymorphism was used for the detection of C3435T single nucleotide polymorphism. Fragments obtained were 238 bp to T/T genotype, 172 bp and 60 bp fragments to the C/C genotype, and 238 bp, 172 bp and 60 bp to the C/T genotype. Results: The distribution of CC, CT, and TT genotypes were 19.0%, 61.3%, and 19.4%, respectively. Both allele frequencies of C and T were the same - 50%. There was no significant difference in genotype and allele distribution between the patients with ITP and the control group (Χ 2=0.84 p=0.65, Χ 2=0.2 p=0.63, respectively). There were no significant differences in age, gender, and pre- and post-treatment platelet counts between CC, CT, and TT genotypes of the MDR gene. Response to treatment shows no significant difference between genotype and allele groups. Conclusion: In our study, there was no difference in the HDMP treatment response between MDR1 gene genotypes. However, it should be noted that this study includes a small group of patients. Our data should therefore be considered preliminary, awaiting further confirmatory studies on an expanded patient base. © 2011 Elsevier B.V.

Sepsis/endotoxemia causes platelet dysfunctions, abnormalities in coagulation and hemostatic mechanisms leading to organ dysfunctions and mortality. Choline prevents organ injury and improves survival during endotoxemia. The main objective of the present study was to determine the effects of choline or cytidine-5'-diphosphocholine (CDP-choline) on endotoxin-induced activation of coagulation and development of disseminated intravascular coagulation (DIC). Dogs were treated intravenously (i.v.) with saline, choline (20 mg/kg), or CDP-choline (70 mg/kg) three times with 4-h intervals starting 5 min before i.v. injection of endotoxin (1 mg/kg). Platelet counts and functions, prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen, coagulation factors, D-dimer and antithrombin (AT) were measured before and at 0.5-96 h after endotoxin. Circulating platelet, fibrinogen, coagulation factors and AT were decreased, whereas PT and aPTT were prolonged and serum D-dimer levels were elevated after endotoxin. Endotoxin-induced reductions in platelet counts and functions, fibrinogen, coagulation factors and AT were attenuated or blocked by choline or CDP-choline. Choline or CDP-choline blocked endotoxin-induced prolongation in PT and aPTT and enhancement in D-dimer. Elevated DIC scores were attenuated by choline and blocked by CDP-choline. Choline administration increased serum choline concentrations and caused bradycardia. Choline also increased choline and acetylcholine contents of circulating mononuclear cells and inhibited radioligand binding to their cholinergic receptors. These data show that choline administration, as choline chloride or CDP-choline, restores the abnormalities in the primary, secondary, and tertiary hemostasis and prevents the development of DIC during experimental endotoxemia in dogs probably by increasing both neuronal and nonneuronal cholinergic activity. Blood Coagul Fibrinolysis 21:339-348 Türkiye Bilimler Akademisi (TÜBA)

In 2004 the Netherlands Twin Register (NTR) started a large scale biological sample collection in twin families to create a resource for genetic studies on health, lifestyle and personality. Between January 2004 and July 2008, adult participants from NTR research projects were invited into the study. During a home visit between 7:00 and 10:00 am, fasting blood and morning urine samples were collected. Fertile women were bled on day 2-4 of the menstrual cycle, or in their pill-free week. Biological samples were collected for DNA isolation, gene expression studies, creation of cell lines and for biomarker assessment. At the time of blood sampling, additional phenotypic information concerning health, medication use, body composition and smoking was collected. Of the participants contacted, 69% participated. Blood and urine samples were collected in 9,530 participants (63% female, average age 44.4 (SD 15.5) years) from 3,477 families. Lipid profile, glucose, insulin, HbA1c, haematology, CRP, fibrinogen, liver enzymes and creatinine have been assessed. Longitudinal survey data on health, personality and lifestyle are currently available for 90% of all participants. Genome-wide SNP data are available for 3,524 participants, with additional genotyping ongoing. The NTR biobank, combined with the extensive phenotypic information available within the NTR, provides a valuable resource for the study of genetic determinants of individual differences in mental and physical health. It offers opportunities for DNA-based and gene expression studies as well as for future metabolomic and proteomic projects.

Current developmental and reproductive toxicity protocols include only a limited set of parameters for effects on the developing immune system. In this study, a wide range of immunological parameters were included in a pre- and postnatal developmental toxicity study. Dose-response data were compared to determine the relative sensitivity of different immune and developmental parameters. Mated female Wistar rats were dosed daily by gavage with methylmercury (0, 0.1, 0.4, 0.7, 1.0, 1.5, and 2.0 mg/kg BW/day) from gestational day 6 to postnatal day (PND) 10. In addition to general, reproductive, and developmental parameters, a wide range of immunological parameters were assessed in male offspring at PNDs 21, 42, and 70. The T cell-dependent antibody response to keyhole limpet hemocyanin (KLH) was assessed following sc immunizations on PNDs 21 and 35. Dose-response data were analyzed using the benchmark dose (BMD) approach by fitting dose-response models to the various endpoints. Methylmercury induced effects on developmental parameters, such as growth parameters and pup mortality. Effects on the immune system were found at doses without observed developmental toxicity. Immune effects differed at the three time points and consisted mainly of effects on functional parameters. The parameter with the lowest 5% lower confidence bound of the BMD (BMDL) was the primary KLH-specific IgG antibody response, which showed a dose-dependent decrease with a BMD of 0.039 mg/kg BW/day (CI 0.010-0.12). These data show the relatively high sensitivity of the developing immune system and thereby illustrate the relevance of testing immune parameters in reproductive and developmental toxicity testing protocols. © The Author 2010. Published by Oxford University Press on behalf of the Society of Toxicology. All rights reserved.

Current developmental and reproductive toxicity protocols include only a limited set of parameters for effects on the developing immune system. In this study, a wide range of immunological parameters were included in a pre- and postnatal developmental toxicity study. Dose-response data were compared to determine the relative sensitivity of different immune and developmental parameters. Mated female Wistar rats were dosed daily by gavage with methylmercury (0, 0.1, 0.4, 0.7, 1.0, 1.5, and 2.0 mg/kg BW/day) from gestational day 6 to postnatal day (PND) 10. In addition to general, reproductive, and developmental parameters, a wide range of immunological parameters were assessed in male offspring at PNDs 21, 42, and 70. The T cell-dependent antibody response to keyhole limpet hemocyanin (KLH) was assessed following sc immunizations on PNDs 21 and 35. Dose-response data were analyzed using the benchmark dose (BMD) approach by fitting dose-response models to the various endpoints. Methylmercury induced effects on developmental parameters, such as growth parameters and pup mortality. Effects on the immune system were found at doses without observed developmental toxicity. Immune effects differed at the three time points and consisted mainly of effects on functional parameters. The parameter with the lowest 5% lower confidence bound of the BMD (BMDL) was the primary KLH-specific IgG antibody response, which showed a dose-dependent decrease with a BMD of 0.039 mg/kg BW/day (CI 0.010-0.12). These data show the relatively high sensitivity of the developing immune system and thereby illustrate the relevance of testing immune parameters in reproductive and developmental toxicity testing protocols. © The Author 2010. Published by Oxford University Press on behalf of the Society of Toxicology. All rights reserved.

In 2004 the Netherlands Twin Register (NTR) started a large scale biological sample collection in twin families to create a resource for genetic studies on health, lifestyle and personality. Between January 2004 and July 2008, adult participants from NTR research projects were invited into the study. During a home visit between 7:00 and 10:00 am, fasting blood and morning urine samples were collected. Fertile women were bled on day 2–4 of the menstrual cycle, or in their pill-free week. Biological samples were collected for DNA isolation, gene expression studies, creation of cell lines and for biomarker assessment. At the time of blood sampling, additional phenotypic information concerning health, medication use, body composition and smoking was collected. Of the participants contacted, 69% participated. Blood and urine samples were collected in 9,530 participants (63% female, average age 44.4 (SD 15.5) years) from 3,477 families. Lipid profile, glucose, insulin, HbA1c, haematology, CRP, fibrinogen, liver enzymes and creatinine have been assessed. Longitudinal survey data on health, personality and lifestyle are currently available for 90% of all participants. Genome-wide SNP data are available for 3,524 participants, with additional genotyping ongoing. The NTR biobank, combined with the extensive phenotypic information available within the NTR, provides a valuable resource for the study of genetic determinants of individual differences in mental and physical health. It offers opportunities for DNA-based and gene expression studies as well as for future metabolomic and proteomic projects.

In this study, the authors aimed to evaluate the frequency of pulmonary hypertension (PHT) in asymptomatic thalassemia major (TM) patients, and to investigate the impact of pulmonary function test (PFT) and CO diffusion results on the evaluation of pulmonary hypertension. Data from 50 asymptomatic patients with TM over age 10 were evaluated. Pulmonary hypertension was diagnosed in 10 patients (20%). High tricuspid regurgitant jet velocity was found in 14% of adults and in 25% of children. Pulmonary function test including CO diffusion testing results were not different between the TM patients with or without pulmonary hypertension. In conclusion, PHT was frequent among TM patients even they were asymptomatic and although PFT results has shown lack of association, it should be investigated in larger population. © 2010 Informa Healthcare USA, Inc.

Objective: The aim of this study was to determine the factors associated with the prognosis of newborns born to mothers with idiopathic thrombocytopenic purpura (ITP), and to compare the infants with/without thrombocytopenia in terms of maternal and neonatal characteristics. Study Design: We reviewed the charts of 29 parturients with ITP and their newborns who were born between January 1998 and December 2008. Result: A total of 16 (55%) gravidas had been diagnosed with ITP before pregnancy and 13 (45%) were diagnosed during pregnancy. Thrombocytopenia was observed in 21 gravidas. In total, 17 (58%) gravidas received treatment to increase the platelet count. The majority of deliveries (72.5%) were vaginal. The infant platelet counts at birth ranged from 20 to 336 x 10(9) per liter. None of the neonates had complications attributable to the mode of delivery. Normal platelet counts were determined in 15 newborns, whereas 14 infants had thrombocytopenia at birth. Three (10.3%) neonates had mild, four neonates (13.7%) had moderate and seven neonates (24.1%) had severe thrombocytopenia. The age of the mothers having infants with thrombocytopenia was significantly higher (30 +/- 5.3 vs 25.3 +/- 3.8 years), most of the infants (10/14 (71%)) were males (P

Sweet syndrome or acute febrile neutrophilic dermatosis is a condition characterized by painful erythematous papules, nodules, and plaques, which demonstrate mature neutrophilic infiltration of the upper dermis histopathologically, and is usually associated with systemic symptoms such as fever and neutrophilia. Generalized Sweet syndrome lesions are usually noted,in association with malignancies. Sweet syndrome lesions are rarely seen in patients with Behcet disease and, if present, are usually fewer in number. In this report, we present two female patients who developed generalized Sweet syndrome lesions during follow-up after the diagnosis of Behcet disease. The clinical and histopathologic findings in our patients together with the data in the literature suggest that generalized Sweet syndrome lesions in a patient with clinically inactive Behcet disease should remind the clinician that a strict differential diagnosis needs to be made between Sweet syndrome associated with Behcet disease and the rare cutaneous manifestation of Behcet disease that resembles the lesions of Sweet syndrome.

Interventional cardiology in a day-case setting might reduce logistic constraints on hospital resources. However, in contrast with coronary angioplasty, few data support the feasibility and safety of radiofrequency catheter ablation (RCA). The aim of this prospective, multicenter cohort study was to evaluate the feasibility and safety of RCA in 1,342 patients (814 men; mean age 57 ± 17 years) considered eligible for ambulatory RCA, according to specific set of criteria, for common atrial flutter (n = 632), atrioventricular nodal reentrant tachycardia (n = 436), accessory pathways (n = 202), and atrial tachycardia (n = 72). Patients suitable for early discharge (4 to 6 hours after uncomplicated RCA) were scheduled for 1-month follow-up. Predictive factors for delayed complications were studied by multivariate analysis. Of the 1,342 enrolled patients, 1,270 (94.6%) were discharged the same day and followed for 1 month; no deaths occurred, and the readmission rate was 0.79% (95% confidence interval 0.30% to 1.27%). Six patients had significant puncture complications, 2 presented with symptomatic delayed pulmonary embolism, and 2 had new onset of poorly tolerated atrial flutter. None of these complications was life threatening. Multivariate analysis did not identify any significant independent predictors for delayed complications. In conclusion, these data suggest that same-day discharge after uncomplicated RCA for routine supraventricular arrhythmias is safe and may be applicable in clinical practice. This approach is known to be associated with significant patient satisfaction and cost savings and can be considered a first-line option in most patients who undergo routine ablation procedures. © 2009 Elsevier Inc. All rights reserved.

Many hematological abnormalities, such as pancytopenia, anemia, and leukocytosis, can be associated with tuberculosis (TB). Immune thrombocytopenic purpura (ITP) is an extremely rare event in TB. We report a 46-year-old male patient who was admitted to hospital with a history of weight loss, combined with hemoptysis, fever, cough, sputum, general malaise, and night sweats. Physical examination revealed a body temperature of 38.8A degrees C, and petechiae distributed over the lower extremities. Laboratory findings were as follows: erythrocyte sedimentation rate, 84 mm/h; white blood cells, 7070/mm(3); hemoglobin, 11.7 g/dl; and platelet count, 4000/mm(3). On Ziehl-Neelsen stain of sputum, acid-fast bacilli were observed. Anti-tuberculosis therapy was started, together with prednisolone, 0.5 mg/kg per day, from the day of admission. He was treated successfully with the steroid and antituberculous drugs.

Non-Hodgkin lymphoma of the breast is a rare malignancy and present with almost equal frequency either as a primary or a secondary disease. Survival is poor in most cases of secondary breast lymphoma because of their advanced stage. We report a 35-year-old woman presenting with dyspnea as well as swelling, tenderness, and ruddiness in the left breast with non-cyclic pain for several months and maculopapular skin eruption in the same breast. Physical examination revealed fixed lymphadenopathies in both axillary regions. Radiologic evaluations (bilateral mammaograpy and ultrasonography) showed skin thickening in the left breast, asymmetrical densities in both breasts, and confirmed lymphadenopathies in the axillary regions. Excisional biopsies were performed to the left axillary lymph nodes and the breast skin eruptions. The histologic and immunohistochemical features were diagnosed as an ALK (-) anaplastic large cell lymphoma. A Computed Tomography examination was performed for staging the lymphoma and then chemotherapy was started. Thirty months after the diagnosis, the patient is still alive with disease. Because of the presence of systemic symptoms such as skin involvement and generalized lymphadenopathies (mediastinal, axillary or cervical), T cell lymphoma cases with breast involvement could mimic the clinical presentation of inflammatory breast carcinoma. Pathologic examination is needed for the correct diagnosis. © 2008 Springer-Verlag.

In 16 hospitalized children aged 3 months to 14 years EDTA-blood samples were taken simultaneously from an anticubital vein and from a finger tip. Haematological measurements were subsequently performed in an Ortho ELT 800/WS ® analyzer. The thrombocyte count and the red cell indices were nearly identical in the two sets of samples. The ‘capillary’ erythrocyte count, haematocrit and haemoglobin values exceeded those of venous blood by 2%, and the mean ‘capillary’ total leukocyte count by about 20%. The relative frequency of lymphocytes, granulocytes and mononuclear cells did not alter between the two sets of samples. The significant differences demonstrated may in certain clinical settings be of medical importance. Their possible explanations are discussed.

Avascular necrosis (AVN) is a devastating adverse effect of steroid therapy rarely reported in idiopathic thrombocytopenic purpura (ITP). We describe a 64-year-old woman with progressive left knee and hip pain for 30 days resulting with the inability to ambulate. After she had been diagnosed ITP pulse steroid treatment was started in the department of Hematology. Two weeks later she described left knee and left hip pain. On physical examination, motion in her left knee and hip was severely painful without inflammation but range of motion was not limited. Magnetic resonance imaging showed multiple bony infarcts in the proximal femur, distal femur and proximal tibia, consistent with AVN. This case report is the first to define concurrent hip and knee AVN at a very early stage due to steroid use in a patient with ITP. © 2008 The Japanese Society of Internal Medicine.

Among 994 patients with essential thrombocythemia (ET) who were genotyped for the MPLW515L/K mutation, 30 patients carrying the mutation were identified (3.0%), 8 of whom also displayed the JAK2V671F mutation. MPLW515L/K patients presented lower hemoglobin levels and higher platelet counts than did wild type (wt) MPL; these differences were highly significant compared with MPLwt/JAK2V617F–positive patients. Reduced hemoglobin and increased platelet levels were preferentially associated with the W515L and W515K alleles, respectively. MPL mutation was a significant risk factor for microvessel disturbances, suggesting platelet hyperreactivity associated with constitutively active MPL; arterial thromboses were increased only in comparison to MPLwt/JAK2wt patients. MPLW515L/K patients presented reduced total and erythroid bone marrow cellularity, whereas the numbers of megakaryocytes, megakaryocytic clusters, and small-sized megakaryocytes were all significantly increased. These data indicate that MPLW515L/K mutations do not define a distinct phenotype in ET, although some differences depended on the JAK2V617F mutational status of the counterpart.

Case report: Ovarian pregnancy is a rarely seen form of ectopic pregnancies. We present a 34-year-old women who had a diagnosis of ovarian ectopic pregnancy based on clinical and laboratory findings. Laparoscopic surgery was performed for conservative management of the case. Risk factors are outlined and vaginal douching as a possible cause for ectopic pregnancies have been discussed. Conclusion: We suppose that frequent vaginal douching may be a risk factor for the development of ovarian ectopic pregnancies. © 2007 Springer-Verlag.

The present study was undertaken with the objective of determining the micrometrical values of blood cells of 8 normal and healthy adult Emu birds (>1 year of age), maintained under optimum conditions of feed and management at a private Poultry Farm, Anand. Mean, standard error and the range of all the micrometric values of the various blood cells of Emu are obtained. Total Erythrocyte Count (TEC), Total Leucocyte count (TLC), Thrombocyte count and Differential leucocyte count (DLC) were also determined. The mean±SE (range) of the length (μm) and the width (μm) of erythrocyte were 13.2±0.21 (12.8–14.4) and 6.45±0.24 (5.33–6.93). The mean±SE (Range) of the length and the width of nucleus of erythrocyte were 6.08±0.21 (4.8–6.4) and 2.96±0.12 (2.4–3.2), respectively. The mean±SE (range) of diameter (μm) of the heterophils were 10.78±0.43 (12.8–8.8), eosinophils were10.46±0.25 (11.2–9.6), basophils were 8.96±0.26 (8–9.6), small lymphocyte were 5.44±0.23 (4.8–6.4), large lymphocyte were 8.92±0.33 (7.6–10.4) and monocytes were 13.34±0.54 (11–16). The mean±SE (range) of the length (μm) and the width (μm) of thrombocytes were 5.6±0.26 (4.8–6.4) and 4.64±0.37 (3.2–6.4). This can serves as baseline for the future research on the micrometrical and morphological studies on the blood cells of emu.