Background: It is still difficult to give a final diagnosis in chronic myeloproliferative disorders (CMPDs) because of the overlap of the common pathological and clinical features of these disorders like bone marrow fibrosis which is considered important because it affects the normal function of the bone marrow. The collagen fibers are of different types, but in the bone marrow, the two main types are: collagen I, which is the most abundant type and collagen III (reticular) which is often associated with type I.
Objectives:To study bone marrow fibrosis (BMF) in samples of bone marrow biopsies (BMB) of chronic myeloid leukemia (CML) and other chronic myeloproliferative disorders using histochemical stains to establish the grade of fibrosis and enabling a correct differentiation between chronic myeloid leukemia, essential thrombocythemia (ET), polycythemia rubra vera (PRV), and idiopathic marrow fibrosis (IMF) as subtypes of myeloproliferative disorders.
Patients and methods: This retrospective study included collection of previously preserved formalin fixed- paraffin embedded bone marrow trephine biopsies of patients with chronic myeloproliferative disorders from January 2003 through December 2008 .The relevant clinical data of patients were retrieved from the stored case sheets. Applied histochemical stains (Reticulin stain, Van Gieson stain, and trichrome stain) with Haematoxylin and Eosin (H&E) stain on sections from these specimens. These stains were used to detect the presence and the degree of pathological marrow fibrosis by the most recent grading system, the European Consensus 2005(EC2005) originally described by Thiele at 2003. Using Trichrome stain for collagen type I and reticulin stain for reticulin fibers (collagen type III) and by using a special marrow fibrosis grading system as a routine work with H&E is valuable in determining the degree of marrow fibrosis on bone marrow biopsy examination and simplifies the diagnosis.
Results: Sixty eight percent of chronic myeloproliferative disorders patients had no marrow fibrosis when diagnosed by H&E, while only 30% of chronic myeloproliferative disorders patients had no marrow fibrosis when the diagnosis was made by special stains and marrow fibrosis grading system. There is rare marrow fibrosis in essential thrombocythemia, polycythemia rubra vera, but present in chronic myeloid leukemia and almost always in marrow fibrosis. Some patients really have myelofibrosis of different grades and the histological findings by using histochemical stains are crucial to distinguish between myeloproliferative diseases
Conclusion: Patients with chronic myeloid leukemia and other chronic myeloproliferative disorders had marrow fibrosis of different grades, which is confirmed by using histochemical stains for different collagen fibers and special grading system for marrow fibrosis (EC2005) that has to be applied. It can be used routinely to avoid misdiagnosis of the primary disease or its conversion and transition to another chronic myeloproliferative disorders type, in which the clinical and laboratory features overlap, but the prognosis and therapeutic implications are significantly different.
Background: Laparoscopic sleeve gastrectomy (LSG)is derived from the biliopancreatic diversion with duodenal switch operation(BPD-DS). Specific and potentially severe complications of LSG are bleeding from the staple line and staple line leakage (SLL). A staple line leak may result in severe morbidity with potential sepsis and multi- organ failure.
Objectives: To review our experience with the definitive surgical management of staple line leak Post sleeve gastrectomy and its outcomes.
Patients and methods: retrospective review of patients who underwent definitive surgical treatment of staple line leak post sleeve gastrectomy from May 2014 till June 2016 at Saint Raphael center of morbid obesity, Primary surgery was laparoscopic sle
Abstract
The analysis of Least Squares: LS is often unsuccessful in the case of outliers in the studied phenomena. OLS will lose their properties and then lose the property of Beast Linear Unbiased Estimator (BLUE), because of the Outliers have a bad effect on the phenomenon. To address this problem, new statistical methods have been developed so that they are not easily affected by outliers. These methods are characterized by robustness or (resistance). The Least Trimmed Squares: LTS method was therefore a good alternative to achieving more feasible results and optimization. However, it is possible to assume weights that take into consideration the location of the outliers in the data and det
... Show Moreتتطلب عملية التنمية الاقتصـادية في الدول النامية مبالغ كبيرة من رؤوس الأمـوال اللازمة لتنفيذ البرامج والخطط الاقتصادية، ولما كانت الاسـتثمارات التي تنفذها هذه الدول خلال حقبة معينة، تزيد على ما تم تحقيقه من موارد مالية محلية، فلابد أنْ يمول الفرق من خلال انسياب صافٍ لرأس المال الأجنبي (قروض ومساعدات) إلى الداخل خلال المدة نفسها، لغـرض سَدّ الفجوة في المـوارد المحلية المعدة للاسـتثمار، وعانت بعض د
... Show MoreThe researcher tried to show the importance of using environmental taxes as an effective economic factor for reducing contaminators resulting from cars exhausts, and presenting a suggested pattern for environmental taxes as a nucleus and a starting point for a wider implementing of environmental taxes in Iraq. &nbs
... Show MoreThe body has the ability to effect the audience in the the theatrical show , since he or she is transmitter , sender , seen and viewer of the humanitarian discourse as well the the images and connotations of the theatrical show, it is a tool of communication that substitutes for millions of spoken words, the modern schools of direction focused on the body language of the actor and gave it prominence in depicting facts by different connotations. The researcher studies the physical performance of the actor throughout focusing on the connotational dimensions of the body within the theatrical show , as well as the positioning of performative body within the modern schools of direction depending on the theatrical show (Rebuke ) of the Iraqi d
... Show MoreResearch is aimed at defining the risks that the sales activity of the General Company for Leather Industries about a special, then diagnose these risks, through a set of indicators, which indicate its existence and try to overcome them, and minimizing the negative effects on those activities.
The research found some conclusions, which emphasizes that the General Company for Leather Industries, suffer from a lack of profit, and a large decrease in sales; a result of absence of demand on its products and rising cost of the expenses to income ratio of, which was reflected in the cost per unit produced. Also the conclusions shown that the number of sales outlets for the company to cover the geographical area is not enough, in spite
... Show MoreThis research means a study (the impact of the Arab-Islamic environment on contemporary painting, the artist Abd al-Rahman al-Suleiman as a model). The research falls into two axes: the first: the theoretical axis, and the second: the applied axis. The first axis dealt with an introduction that contained: (the research problem, its importance, its goal, its limits, and the definition of terms). This research aims to uncover (the impact of the Arab-Islamic environment on contemporary painting, and the artist Suleiman was a model). And the research limits spatially: Saudi Arabia, and temporally: 2010-2014. This theme included two topics: The first: the characteristics of the Saudi environment and its impact on art. The second: the s
... Show MoreA la fin du XVIIIe siècle, les penseurs français dont Rousseau et Saint-Pierre, commencent à mettre en question la civilisation européenne. Dans leurs œuvres les plus importantes, ces deux auteurs parlent de la société européenne d'une façon très banale. Ils font, par contre, une invitation à la Solitude et l'isolement dans la nature afin d'éviter la corruption de l'âme par la société mondaine. Ces écrivains-penseurs croient que la société peut gâter l'humanité de l'individu. Ils suggèrent à travers les images innocentes de leurs principaux personnages vivant dans la campagne, un monde idéal où il n'y a que pureté et chasteté. Dans les deux œuvres que nous avons choisies (Paul et Virginie de Bernardin de
... Show Moreتضمن البحث تحقيق مخطوط"، سرور الفؤاد بالصافنات الجياد في معرفة الخيل
وأسمائياالشيخ محمد العمري" وكما ظاىر من عنوان المخطوط إنوُ يتناول الخيل، والخيل
موضوع ميم في حياة العربي قبل الاسلام باعتباره يمثل جزءاً من تفاصيل حياتو الملازمة لوُ
واعتماده عمييا ىذا أولاً وثانياً ماتحمموُ الخيول من معاني الفروسية والعنفوان وماتثيره في
الأنسان من حب الأقتناع والمتعة المتحققة من النظر إلييا وحبو لمسبق،