Coagulation tests including platelet count, factor V assay, fibrinogen, fibrin split products, and serial thrombin time were performed on 51 patients with cancer. Elevated fibrin split products and/or abnormal serial thrombin time was present in 24 (48%) patients. Bleeding occurred in three patients; each had normal platelet counts. However, the serial thrombin time was not normal and/or increased fibrin split products were present. The data add support to the hypothesis that cancer patients do have a delicately balanced coagulation mechanism, and chronic disseminated intravascular coagulation may be induced or aggravated by various stimuli, including radiation therapy, chemotherapy, sepsis, and perhaps other unrecognized situations.
THE LENGTH of the small intestine in infants and children has received little attention in the literature. Our interest was aroused by an error in radiographic diagnosis. A film of the abdomen of a 1-day-old infant was interpreted as atresia of the jejunum because only two gasfilled intestinal loops were seen. At operation, the atresia was almost at the ileocecal valve, but the total bowel length was only 50 cm, thereby accounting for the misinterpretation.Standards of small intestinal length in normal infants are few. Benson 1 mentions 248 cm as the average length for the term newborn infant and a 230 cm length of jejunum and ileum in a single 3 lb 11 oz (1,673 gm) premature infant. Benson et al2 state that the proportionately shortened length of small intestines in the premature infant varies from 160-240 cm. Potts 3 states only that the infant's intestine is 305 cm in length. Abnormally short bowels have been described in association with atresia.2 If prenatal bowel injury or vascular accident is responsible for atresia as proposed in recent studies.2·4·5 avas¬ allar necrosis of segments of varying lengths would also occur and result in bowel shortening.Our review did not uncover any reports of short bowel without atresia. No reports of excessively long bowel were found. In order to study bowel lengths further, the autopsy records of 389 unselected patients in which the intestine had been measured were
An accepted diagnostic feature of hemo lytic disease of the newborn due to isoimmu nization by any of the Rh factors is a posi tive direct antiglobulin reaction (Coombs test) with umbilical cord blood. Not so well documented is the usefulness of the direct antiglobulin test for the recog nition of hemolytic disease associated with ABO grouping differences. Some believe the test to be generally negative or weakly posi tive in infants who clinically and hemato logically have hemolytic disease related to ABO incompatibility, whereas others claim to find the direct test positive in 90 per cent of such infants. The latter contention is supported by the findings in the study here described. The direct Coombs test on cord blood is suggested as a useful screening test particu larly when Rh or ABO grouping of the parents is either not known, or so related to each other that a potential isoimmunization problem may ensue in the infant.
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