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We present a case of an arterio-venous fistula that developed in the early postoperative course after wedge resection of the right upper lobe. A 57-year old male treated for acute myeloid leukemia was referred from the hematology department because of a right upper lobe tumor. Wedge resection was performed. Three weeks later recurrent tumor was visualized on chest X-ray. Angio-CT diagnosed an arterio-venous fistula and the patient was scheduled for redo surgery. Completion upper lobectomy was performed and the pathological examination confirmed iatrogenic arterio-venous fistula. To our knowledge such an early complication has never been reported so far. Iatrogenic intrapulmonary arterio-venous fistulas are very rare. We present a case of such fistula that developed early after wedge resection of the right lung upper lobe tumor and presented as recurrent pulmonary mass. To the best of our knowledge this is the first description of such a case.

Genotypic diagnosis of HSV drug resistance can be performed routinely in a clinically relevant time. Nevertheless, data about HSV mutations (polymorphism or resistance) is not exhaustive which hinders the interpretation of such tests. The UL23, UL30, and UL5 genes are of greatest interest as these encode, respectively, thymidine kinase, DNA polymerase, and helicase, which, if mutated may affect the effectiveness of acyclovir, foscarnet, cidofovir, and helicase-primase inhibitors. The present study aimed to extensively characterize UL23, UL30, and UL5 genes. A total of 239 clinical HSV1 recovered from patients admitted to the hematology departments of the Lyon teaching hospitals were included in this single-center retrospective study. Drug resistance was evaluated using the neutral red dye-uptake assay, and sequencing using the Sanger method. Additional information on HSV1 natural polymorphism and resistance is now available. Twenty-two amino acid substitutions related to polymorphism were described on UL23 (E43A, L50M, L68R, Q109K, A133V, A136N, S150L, D258N, S263L, P280S, N301S, A316S, M322L, I326V, D330A, D338H, Q342H, T344I, Q349R, V352L, R370W, E371D), and 6 amino acid substitutions on UL30 (G641R, G645D, E649G, G679D, R681L, I966M). Moreover, the UL23 substitution L242P was added to ACV resistance-related mutations. There were 12 substitutions on UL23 (A37S, V70M, S74L, H151N, P154S, P155Q, L159R, E225L, Y248H, Q270R, N303Y, M372I), and 8 on UL5 (L49I, L138V, S173L, A280T, A575V, V600A, A602T, D862N) that remain of unclear significance with regards to drug resistance. The mean (±standard deviation, SD) number of natural polymorphisms in UL23 was 2.53 (±2.55), in UL30 it was 0.83 (±1.02), and in UL5 it was 5.00 (±1.59) There was no association between HSV1 phenotype and the frequency of substitutions. The results reported herein provide valuable new information concerning HSV1 mutations that will assist the interpretation of genotypic assays.

Introduction: Non-Hodgkin lymphomas are characterized by monoclonal malignant proliferation of B or T lymphoid cells, rarely NK. The objective of the study was to determine the main difficulties in the management of patients being followed for non-Hodgkin lymphoma. Methodology: This was a descriptive cross-sectional study carried out at the Hematology Department of the Conakry University Hospital. It took place over a period from January 2015 to September 2019. It consisted of data collection from the records of patients meeting the inclusion criteria during the study period. Results: We included 49 cases in which NHL accounted for 51.12% of all hematological malignancies. The M/F sex ratio was 2.11. The mean age was 43 years with extremes of 17 and 75 years. The most affected age group was 45-59 years of age. Diagnosis was made on the basis of: histology (93.88%), immunohistochemistry (4.08%), cytology (2.04%). The diagnostic delay was less than 6 months (10.20%), between 6 and 12 months (42.85%) and more than 12 months (46.95%). The most frequent histological type was diffuse large cell lymphoma (41%), followed by Burkitt lymphoma (20.41%) and marginal zone lymphoma (19%). Treatment was mainly CHOP21 (61.02%), COP (14.28%), and the rest of the patients were untreated. For those treated, the therapeutic plan was respected in 38.25% of cases. Conclusion: Diagnostic delay, unavailability of immunohistochemistry and specific drugs, low socioeconomic status, and illiteracy for some patients were the main problems found in the management of non-Hodgkin lymphoma in our exercise setting.

a Department of Clinical Pathology, Faculty of Medicine, Cairo University, Egypt b Department of Clinical Pathology, Faculty of Medicine, Suez Canal University, Egypt c Histology and Cell Biology Department, Al-Azhar University, Cairo, Egypt d Cytogenetics Department, Faculty of Medicine, Cairo University, Egypt e Clinical Oncology Department, Faculty of Medicine, Cairo University, Egypt f Clinical Hematology Department, Maadi Armed Forces Hospital, Egypt g Medical Biochemistry & Molecular Biology Department, Faculty of Medicine, Cairo University, Egypt

S U N D A Y 307 Interleukin-4 and Transforming Growth Factor-Beta Single Nucleotide Genes Polymorphisms Confer Susceptibility To Atopic Dermatitis Dr. Nima Rezaei, MD, PhD, Ms. Zahra Aryan, Dr. Nasrin Behniafard, MD, Ms. Elham Farhadi, MSc, Dr. Soheila Sotoudeh, MD, Dr. Mojdeh Khaledi, MD, Dr. Maryam Mahmoudi, MD, Prof. Asghar Aghamohammadi, Prof. Ali Akbar Amirzargar, PhD, Dr. Mohammad Gharagozlou, MD; Research Center for Immunodeficiencies, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Tehran, Iran, Molecular Immunology Research Center; and Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran, Student Scientific Research Center (SSRC), School of Medicine, Tehran University of Medical Sciences, Tehran, Iran, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Tehran, Iran, Hematology Department, School of Allied Medical Science, Tehran University of Medical Sciences, Tehran, Tehran, Iran, Growth and Development Research Center, Tehran University of Medical Sciences, Tehran, Tehran, Iran, School of Nutrition and Dietetics, Tehran University of Medical Sciences, Tehran, Tehran, Iran, Research Center for Immunodeficiencies, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran. RATIONALE: Atopic dermatitis (AD) is a chronic inflammation of the skin, seems to have a strong genetic background. Interleukin-4 (IL-4) is one of the cytokines implicated in promotion of allergic diseases and transforming growth factor-beta (TGF-b) is an anti-inflammatory cytokine promoting counter-regulatory responses to IL-4. This study aimed to investigate association of polymorphisms at genes encoding IL-4 or TGF-b with susceptibility to AD. METHODS: This case-control study comprised 89 children with established diagnosis of AD and 139 healthy controls. Single nucleotide polymorphisms at IL-4 -1098T>G (rs243248), -590C>T (rs2243250), -33C>T (rs2070874), and TGF-b codon10C>T (rs1982073) and codon25G>C (rs1800471) were typed. Frequencies of alleles, genotypes and haplotypes were estimated and compared between patients and controls. RESULTS: Patients with AD had significantly higher percentage of T allele at IL-4-1098T>G (84.4%) and C allele at IL-4-590C>T(85.0%) and IL-4 -33C>T (84.4%, all p G [OR 3.65, 95%CI (1.99-6.71)] and CC genotype at both IL-4-590C>T [OR 31.75, 95%CI (13.61-76.07)] and IL-4-33C>T [OR 3.52, 95%CI (1.926.52)] were overrepresented in AD patients (p T [OR 15.34, 95%CI (7.55-31.55)] and CG at codon25G>C (100%) were overrepresented (p

A case combining Christmas disease and tricuspid atresia is presented. A severe coagulation defect in a hypoxic, polycythemic patient poses an added grave risk to major surgery. In the presence of marked and worsening symptoms, however, major surgery can he performed in these difficult cases. Close liason with a skilled hematology department is essential. Minimal tissue dissection is advised, and the usefulness of a reversed saphenous vein conduit is described.

Resume Une epidemie d'aspergillose a ete observee dans le service d'hematologie de l'hopital Saint-Antoine en 1984. L'enquete que nous rapportons a ete menee afin d'en preciser l'origine. Nous avons pu conclure que dans la plupart des chambres, la pollution fongique est proche de celle mesuree a l'exterieur avec cependant une concentration des spores en certains endroits. Nous n'avons pas retrouve de source d'emission permanente d' Aspergillus sp. L'epidemie observee est tres probablement en rapport avec des travaux effectues quelques semaines auparavant. Devant cette situation, il a ete decide de restructurer le service avec creation d'un secteur dont les chambres doivent etre equipees de lits a flux laminaires, afin de proteger au mieux les malades susceptibles de developper une infection opportuniste dont l'agent pathogene est vehicule par l'air.