Hematology Morphology Forum

The Kleihauer test has been used world-wide for many years to quantify feto-maternal haemorhage, and to ensure that an appropriate dose of anti-D Immunoglobulin (anti-D Ig) is administered both ante-natally and postnatally to RhD negative women to prevent Rh alloimmunisation. Although apparently a simple test to perform, recent reports have suggested that unless meticulous attention is paid to both technique and interpretation, the accuracy of the test cannot be guaranteed. It is suggested that it should be replaced with a flow cytometric test for the presence of fetal RhD positive cells which would give more relevant and accurate results. Flow cytometers are not, however, available to all laboratories performing estimations of feto-matemal haemorrhage (FMH). This study was undertaken to assess the comparability of results obtained using a standardised Kleihauer technique with results obtained using a variety of techniques within hospital laboratories and with flow cytometry. A total of 957 samples were analysed, referring hospitals initially performing a routine Kleihauer test and then forwarding the same sample to the Mersey Transfusion Centre where a standardised Kleihauer test and flow cytometric analysis of FMH were performed. Our results showed that there is variation in Kleihauer results, even when the same sample is used, particularly in quantifying an FMH for which additional anti-D Ig may be required. The tendency however, appears to be to over-estimate the size of FMH and administer unnecessary anti-D Ig. Our results suggest that if careful attention is paid to performing a standardised Kleihauer test, then it is of value in estimating the size of FMH, and that flow cytometry may be of additional value for cases in which the Kleihauer result is equivocal or indicates that a large FMH has occurred which requires the administration of additional anti-D Ig.     

The effect of testosterone replacement therapy on bladder functions,histology, apoptosis,and Rho-kinase expression in bladder outlet obstruction and hypogonadism rat model

Background/aimThe effect of testosterone replacement therapy was investigated on bladder functions, histology, apoptosis as well as Rho-kinase expression in the rat bladder outlet obstruction (BOO) and hypogonadism models. Materials and methods30 mature male rats divided into 4 groups: sham group (n = 8), BOO group (n = 8), BOO + orchiectomy group (n = 7), BOO + orchiectomy + testosterone (T) treatment group (n = 7). Cystometric findings, apoptosis index, Rho-kinase (ROCK-2) expression, and smooth muscle/collagen ratio were compared. Results BOO did not change ROCK-2 expression level, compared to sham group (P > 0.05). However, when compared to BOO group (P < 0.01), BOO + orchiectomy led ROCK-2 increase. The testosterone treatment failed to reverse the up-regulation of ROCK-2 induced by orchiectomy although it tended to lower ROCK-2 level. Compared to sham group (P = 0.002), changes in maximal bladder capacity and leak point pressure were higher (P = 0.026, P = 0.001), and bladder compliance was lower in BOO group. Also, the apoptosis index was different between the two groups (P = 0.380). Smooth muscle/collagen ratio was higher in BOO + orchiectomy + T group than in BOO + orchiectomy group (P = 0.010).ConclusionsThe research draws attention to alternating treatment approaches in case of the presence of hypogonadism and BOO.