Discrepant results have been reported in terms of detecting bcr-abl transcripts in patients with essential thrombocythemia that are Philadelphia (Ph) chromosome-negative. We present two cases of Ph chromosome-negative essential thrombocythemia in whom bcr-abl gene rearrangement was detected. In the diagnosis of both cases, they lacked the splenomegaly, anemia and basophilia, and had high platelet counts (948X10(3)/L and 1,329X10(3)/microL, respectively) and normal leukocyte alkaline phosphatase (LAP) scores on admission without any evidence of inflammation, infection, or therapy. They lacked the Philadelphia chromosome characteristic of classical chronic myelogenous leukemia (CML) and had b3a2 transcripts.
Alkaline Phosphatase ; Anemia ; Diagnosis ; Gene Rearrangement* ; Humans ; Hydrogen-Ion Concentration ; Inflammation ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Leukocytes ; Philadelphia Chromosome ; Platelet Count ; Splenomegaly ; Thrombocythemia, Essential*

BACKGROUND: There is a recent trend of increased use of the gel test for the detection of unexpected antibodies (Abs) because of its simplicity and ease with which definitive interpretation can be made. However, because of the low insurance payments in Korea, only the LISS/Coombs card is used and thus the detection rate of the cold Abs has decreased. We have studied the detection rates of the Abs in patients by using the LISS/Coombs gel test and thus evaluated the clinical usefulness of the LISS/Coombs gel test. METHODS: Abs screening tests have been carried out using the DiaMed(TM) LISS/Coombs gel card test (Murten, Switzerland) on 14,942 patients for whom blood transfusions were ordered between July 1, 1997 and March 31, 2001. When the test for Abs was positive, Ab identification tests were further carried out with the DiaMed(TM) LISS/Coombs gel card and the ID-DiaPanel 1-11. RESULTS: Eighty-one out of 14,942 patients (0.54%) revealed positive results. Of these, 15 showed anti-E, 5 showed anti-E+c, 4 showed anti-C, 3 showed anti-D, 2 showed anti-Jk(a), 1 each showed anti-c, anti-M, anti-Lu(a), and anti-K Abs. CONCLUSIONS: Although the detection rate for the cold Abs of the LISS/Coombs gel test was low, it is considered to be highly useful because of the high detection rate for the clinically important warm Abs, the simplicity in carrying out the test, and the easy readability of test results.
Antibodies ; Blood Transfusion ; Comprehension ; Humans ; Insurance ; Korea ; Mass Screening

BACKGROUND: In contrast with bone formation markers, most of available indices of bone resorption are urine markers and show relatively high degree of variability. The serum resorption assay has therefore been developed. We evaluated serum bone-derived degradation products of type I collagen C-telopeptide (s-CTX) and serum osteocalcin by Elecsys 2010 (Hitachi Boehringer Mannheim, Tokyo, Japan). METHODS: For 18 healthy controls, 15 osteopenic and 7 osteoporotic patients samples, serum CTX and serum osteocalcin were measured by Elecsys 2010 using -CrossLaps/serum (Roche Diagnostic Corp., Indianapolis, USA) kit and N-MID Osteocalcin (Roche Diagnostic Corp. kit, respectively. DPD by Immulite (Diagnostic Products Corp., LA, USA) using Pyrilinks-D(TM) (Diagnostic Products Corp.) kit and serum osteocalcin for correlation by Gamma counter (Hewlett Packard, Meriden, USA) using ELSA-OSTEO (CIS, Cedex, France) kit were measured. RESULTS: The within-run and between-run coefficient of variation (CV) values of s-CTX were 6.41% and 6% in low concentrations and 3.84% and 7% in high concentrations, respectively. The within-run and between-run CV values of serum osteocalcin were 2.21% and 6% in low concentrations and 1.25% and 3% in high concentrations, respectively. The dilution recovery of s-CTX and serum osteocalcin was 100-169% (mean, 134%) and 80-138% (mean, 104%), respectively. S-CTX and DPD (R=0.369, P=0.019), and serum osteocalcin by Elecsys 2010 and RIA (R=0.889, P<0.001) showed positive correlations, respectively. CONCLUSTIONS: S-CTX and serum osteocalcin by Elecsys 2010 exhibits good analytical performance and correlate with DPD and serum osteocalcin by RIA, respectively. Therefore, these may replace DPD and serum osteocalcin by RIA and can be used for bone resorption and formation markers, respectively.
Bone Resorption ; Collagen Type I ; Humans ; Osteocalcin* ; Osteogenesis