Comparison of conventional tube test technique and gel microcolumn assay for direct antiglobulin test: a large study.

Gel microcolumn assay (GMA) is a modified serological technique that has been used for ABO and Rh typing, direct antiglobulin test (DAT), detecting alloantibodies, red cell phenotyping, and other applications. However, for DAT, the role of GMA is controversial. The purpose of this large study was to compare the performance of the conventional tube test (CTT) to GMA for detecting potentially significant antibodies coating red blood cells in vivo. From January 1996 to May 2002, we performed DATs by GMA and CTT on 9,862 blood samples submitted to our reference laboratory, using LISS/Coombs cards (DiaMed-Latino America, Lagoa Santa-MG, Brazil) for GMA and polyspecific and monospecific anti-IgG reagents for CTT. Acid eluates were prepared from all positive DAT samples. The specificity of eluates was determined by GMA. We detected nonconcordant results in 2,079 out of 3,163 positive DATs (65.7%). All of these tests were only positive in GMA. Sensitivity and specificity for DATs was 100% and 83.0% for gel, and 50.7% and 97.8% for tube, respectively. Based on this study GMA showed to be more sensitive than CTT for detecting potentially significant antibodies coating red blood cells in vivo.

Comparison of conventional tube test with diamed gel microcolumn assay for anti-D titration.

Anti-D titration is the first step in the evaluation of the RhD-sensitized patient. Traditionally, anti-D titration has been performed by tube agglutination. Gel microcolumn assay is a method that has gained widespread usage throughout the world, mainly for ABO/Rh typing, unexpected antibody screening and direct antiglobulin tests. As gel assay has become widely used as a routine method to detect red blood cell alloantibodies, a critical anti-D titer needs to be established. Seventy-nine known blood samples with anti-D (titers 1-32) were titrated simultaneously by the conventional tube test and the gel microcolumn assay. Red blood cells (R0r phenotype) were used, with a final concentration of 3% for tube and 0.8% for gel. Serial twofold dilutions (2-2.048) were prepared for each technique, followed by reading in antiglobulin phase. Anti-D titration in the gel microcolumn assay showed significantly higher titers (mean 3.4-fold) than the conventional tube test in all samples studied. Based on these data, it was not possible to determine a critical titer for anti-D titration by the gel microcolumn assay.

[Plastic surgery of the abdominal wall in laparocele in a patient with previous kidney transplant]. / Plastica della parete addominale per laparocele in paziente con pregresso trapianto renale.

The authors report the case of a patient undergoing kidney transplant from a non-related but compatible living donor who subsequently developed a voluminous incisional hernia affecting almost the entire small intestine in the right iliac fossa, the site of earlier surgery. After having analysed the problems involved when a transplant patient requires further surgery owing to the chronic administration of drugs, the authors describe the case. The patient was treated using the insertion of a prolene graft and remodelling the abdominal wall in correspondence with the lower quadrants using abdominoplasty without repositioning the umbilicus.

[Plastic surgery by the Limberg-Dufourmentel method in the treatment of a pilonidal sinus. The anatomicosurgical considerations and an emblematic case]. / La plastica secondo Limberg-Dufourmentel nel trattamento del sinus pilonidalis. Considerazioni anatomo-chirurgiche e presentazione di un caso emblematico.

Limberg-Dufourmentel's cutaneous flap may be used to fill in the loss of residual substance after the radical excision of sinus pilonidalis in the sacrococcygeal region. According to the authors, this technique enables some aspects of the locoregional anatomic conformation typically linked to the onset of this pathology to be modified, as well as permitting more accurate radical surgery. By way of example, the authors report the case of a 20-year-old subject with sinus pilonidalis who was successfully treated using this surgical technique.

[Surgical treatment of rhinophyma using dermo-epidermal graft. A case report]. / Trattamento chirurgico del rinofima con innesto dermo-epidermico. Caso clinico.

Rhinophyma is a nosographical form that has always attracted attention, even among non-experts, owing to the marked aesthetic damage it often causes. Several types of surgery have been proposed for its treatment in an attempt to elaborate a technique that is easy to apply and guarantees satisfactory results in clinical and aesthetic terms. After a short review of the general aspects of the pathology, the authors illustrate the case of a patient with rhinophyma treated with a full thickness dermo-epidermic graft, and emphasise that this surgical solution, provided that the indications are correct, is still a valid alternative.