American journal of clinical pathology
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Am. J. Clin. Pathol. · Feb 2004
Case ReportsAmyloid-like pulmonary nodules, including localized light-chain deposition: clinicopathologic analysis of three cases.
Amyloid-like pulmonary nodules have been described in patients with systemic light-chain deposition disease, but their significance in other clinical contexts is unknown. We examined biopsy specimens of amyloid-like pulmonary nodules from 3 women without systemic light-chain deposition disease. ⋯ In all cases, electron microscopic examination showed dense granular extracellular deposits without the fibrillary characteristics of amyloid. Amyloid-like nodules should be distinguished from nodular amyloidosis and, in some patients, might represent a localized form of light-chain deposition.
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Recombinant factor VIIa (rFVIIa) has become available for treating people with hemophilia with inhibitors who experience bleeding or require surgery. It has become apparent that rFVIIa is useful in controlling bleeding in a variety of clinical situations. This review attempts to collate and summarize the nonhemophilia applications of rFVIIa. ⋯ It is an expensive therapy and needs to be prescribed judiciously. This review is meant to be an introduction to this new hemostatic reagent. The uses for rFVIIa will evolve as more studies are published.
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Am. J. Clin. Pathol. · Jan 2004
Comparative StudyNoninvasive monitoring of hemoglobin. The effects of WBC counts on measurement.
The efficacy of a noninvasive hemoglobin monitoring device (Astrin, Sysmex, Kobe, Japan) was evaluated for healthy volunteers and for patients with hematologic disorders. At the same time, the effects of WBC counts on noninvasive monitoring were studied by clinical evaluation and in ex vivo experiments. The hemoglobin levels determined by the device (Ast-Hb) and a conventional analyzer (T-Hb) were compared. ⋯ A comparison of the ratios of measurement errors in hemoglobin levels by Ast-Hb and T-Hb indicated that the number of WBCs had no effect on hemoglobin monitoring. Moreover, ex vivo studies using isolated WBCs and an optical model that imitates blood vessels and tissue in human fingers confirmed these results. Therefore, this new hemoglobin monitoring device can be expected to be useful for continuous hemoglobin monitoring.
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Am. J. Clin. Pathol. · Nov 2003
Immature granulocyte measurement using the Sysmex XE-2100. Relationship to infection and sepsis.
We determined the usefulness of immature granulocyte measurement as a predictor of infection or positive blood culture and compared the results with total WBC count and absolute neutrophil count (ANC). Blood samples from 102 infected and 69 noninfected patients were analyzed using the Sysmex XE-2100 automated blood cell counter (Sysmex, Kobe, Japan). ⋯ Automated immature granulocyte measurements reflect a biologically and clinically relevant phenomenon but are not sensitive enough to be used as screening assays for prediction of infection or bacteremia. However, although infrequently encountered, a percentage of immature granulocytes of more than 3 was a very specific predictor of sepsis and might help expedite microbiologic laboratory evaluation of a subset of patients.