The rectum, bladder and both kidneys appeared normal This led to

The rectum, bladder and both kidneys appeared normal. This led to the diagnosis of MRKH syndrome. Karyotyping was performed and showed normal female karyotype. Her factor VIII level at this stage was 2 IU dL−1 and VWF antigen and activity levels were both <1 IU dL−1. The findings of MRKH were discussed with the patient and her parents by a multidisciplinary team including consultant gynaecologist, haematologist, Nutlin-3 in vivo haemophilia nurse specialist, family therapist and counsellor. This

was performed in a stepwise manner and required regular meetings with the team. The patient was then given an open access to the clinic, to attend for discussion whenever she had any queries or required medical advice. The implications of having type 3 VWD also discussed, absence of uterus meant that she would not have

menstruations. However, her ovarian cycle would be normal and she would be at risk of ovulation bleeding and recurrence of ovarian haemorrhagic cysts. To prevent BMS-354825 solubility dmso recurrent ovarian bleeding and haemorrhagic ovarian cysts, the option of combined oral contraceptive pill (OCP) was discussed and commenced. A repeat MRI, 3 months later showed resolution of majority of ovarian cysts and recognition of normal ovarian tissue in both ovaries. Long-term implications and management of MRKH discussed. This included the need for vaginal dilatation and/or reconstruction when she becomes sexually active as well as her future reproductive options. We describe the first case of MRKH syndrome in a young girl with type 3 VWD. To our knowledge, coexistence of MRKH syndrome and type 3 VWD had not been previously reported. The fallopian tubes, uterus, cervix and upper two-thirds

MCE of the vagina arise from the müllerian ducts. The manifestations of müllerian abnormalities can range from minor anatomical variations in uterus up to total organ aplasia, the latter is caused by MRKH syndrome in 90% of affected women [4]. MRKH syndrome is subdivided into two types; type 1, where MRKH occurs in isolation, and the more common type 2 where there is incomplete aplasia of the uterus and vagina together with other associated malformations. The most common associated abnormalities are of the urinary system and skeletal system abnormalities [2]. Other abnormalities include hearing loss and rarely cardiac defects. Diagnosis of MRKH is made by physical examination and imaging techniques in adolescent girls presenting with primary amenorrhoea despite normal secondary sex characteristics. Trans abdominal ultrasonography is a non-invasive first-line investigation. MRI is used to accurately delineate uterine aplasia and the extent of vaginal aplasia. MRI can also be used to screen for other associated malformations. In this case, there was no associated abnormality of the urinary tract, echocardiography, and auditory function assessment were also normal.

We used an RNAi-based knockdown approach to understand whether MA

We used an RNAi-based knockdown approach to understand whether MAT genes play a role during HSC activation and proliferation. As shown in Fig. 3A,B, knockdown of MAT2A for 48 hours in primary rat HSCs resulted in decreased HSC activation as measured by the lower levels of Col1A2 mRNA and type I collagen protein, respectively, compared to scrambled RNAi controls. A similar decrease in α-SMA mRNA and protein was also observed after MAT2A silencing. MAT2A gene silencing did not cause any change in cellular proliferation at this time, thereby indicating a lack of any toxicity at the 48-hour timepoint during which gene expression changes were measured (Fig. 3C). However, longer periods of MAT2A knockdown

(80 hours) resulted in decreased BrDU incorporation in HSCs indicative of suppressed cell growth (Fig. Torin 1 research buy 3C). Despite several attempts, we were unable to get sufficient knockdown of the MAT2β gene in primary rat HSCs. In order to examine the role of MAT2β in HSC activation, we performed gene silencing studies in the easily transfectable, human LX-2 cell line. As shown in Fig. 4A, knockdown of either MAT2A by 80% or MAT2β by 93% inhibited expression of Col1A2 and α-SMA mRNA by 50% as compared 3-MA mouse to scrambled RNAi-treated cells. These results were further confirmed at the protein level (Fig. 4B). Concurrent with the findings in primary HSCs (Fig. 3), knockdown of MAT2A or

MAT2β in LX-2 cells did not significantly affect cell growth up to 48 hours but there was decreased proliferation at the 72-hour timepoint (Fig. 4C). Toxicity effects of MAT gene knockdown were also evaluated by performing apoptosis assays in LX-2 cells. As shown in Fig. 4D, knockdown of either MAT2A or MAT2β

up to 48 hours did not significantly affect the number of apoptotic cells compared to scrambled RNAi controls. However, at 72 hours there was a significant increase in the percent apoptosis when compared to scrambled RNAi. Because MAT2A or MAT2β silencing affects growth in LX-2 cells, we investigated 上海皓元 the mechanism by which these genes influence cell proliferation and apoptosis. Our results showed that MAT2A knockdown lowered intracellular SAMe levels by 75% compared to control or scrambled RNAi-treated cells (Table 4). We also examined the effect of MAT2A or MAT2β silencing on the survival signaling pathways, ERK and PI-3K, in LX-2 cells. In Fig. 5 we showed that knockdown of MAT2A did not significantly influence phosphorylation of ERK or AKT (a measure of PI-3K signaling) but knockdown of MAT2β prevented activation of both ERK and AKT in LX-2 cells, thereby indicating a role of this gene in signal transduction pathways associated with HSC activation. The expression of MAT genes in the liver is a determinant of cell proliferation and differentiation. Although MAT1A is a marker of differentiation, MAT2A and MAT2β are markers of growth and dedifferentiation.

Failures were categorized as within the radiation field (locoregi

Failures were categorized as within the radiation field (locoregional failure) and outside the radiation field (distant failure).

Results: 57 patients (41.9%) reached complete remission after CCRT. Tumor location, uptake of positron emission tomography, esophageal obstruction, T staging, node staging, M staging(by 6th AJCC) before treatment, and consolidation chemotherapy were associated with complete remission after CCRT. At a mean follow-up duration of 20.3(±15.5) months, 74 patients (54.4%) had experienced selleck chemicals locoregional failure, 26 (19.1%) had outfield failure, and 35 (25.7%) had no evidence of failure. Esophageal obstruction before CCRT, residual tumor on first endoscopy after CCRT, and higher T stage on follow-up computed tomography were significantly associated with locoregional failure. Conclusion: About

70% of patients who had experienced treatment failure were locoregional failure after CCRT in esophageal SCC. Future therapeutic strategies such as high dose RT or additive surgical resection may be necessary to enhance local control, especially in the cases of esophageal obstruction before CCRT, residual tumor on the first endoscopy after CCRT, and higher T stage on follow-up computed tomography in esophageal SCC. Key Word(s): 1. SCC; 2. CCRT; 3. treatment failure; 4. Local control; Presenting Author: FAN YUJING Additional Authors: LAN YU Corresponding Author: FAN YUJING Affiliations: Beijing Jishuitan

Hospital Objective: Eosinophilic esophagitis(EE)is an uncommon disease characterized by focal or diffuse eosinophilic infiltration of the esophagus. NVP-BKM120 nmr The symptoms of EE is usually associated with dyspepsia, diarrhea and peripheral eosinophilia,but 上海皓元 obstraction is rarely. Methods: Mr W was a 62-year-old worker. 18 months ago, he suffered cerebral infarction and had motor aphasia caused by sequela. 17 months ago, he suffered bullous pemphigoid and began to received prednisone treatment. The maintenance treatment last so far and the dosage was decreased gradually to 10 mg qd.Since suffered cerebral infarction, he often presented with intermittent nausea and vomitting after meal but no attention was payed. His symptoms worsened and he developed vomtting after eating food or water immediately over the past two mo.EGD revealed esophageal longitudinal ulcer with partial distal esophageal obstruction. Histological examination of the biopsy from the esophagus demonstratedesophagitis with heavy eosinophilic infiltration. we give him barium X-ray examnition. It revealed that the muscal of lower esophagus was smooth. Based on the above findings, the diagnosis of eosinophilic esophagitis was made, The patient was started on prednisone 30 mg daily and responded promptly with resolution of symptoms.two weeks later, His eosinophil count decreaseed a lot and his symptoms continued to improve on maintenance steroids.

9 To date, no molecular predictive biomarker for sorafenib respon

9 To date, no molecular predictive biomarker for sorafenib response

in HCC treatment has been validated and accepted in clinical practice. Efforts in such a direction were performed RAD001 research buy during the SHARP molecular biomarker program, but were of limited success.10 Furthermore in the same trial, 10 plasma biomarkers implicated in hepatocarcinogenesis were measured serially in 305 patients, and only high s-c-KIT or low hepatocyte growth factor showed trends toward enhanced survival. In addition, exploratory subset analyses of the Asia-Pacific trial also failed to identify markers associated with superior response to sorafenib.5 Working along this line of research, currently, Arao et al. have successfully identified a novel potential molecular biomarker: fibroblast growth factors 3 and 4 (FGF3/FGF4) amplification in a patient with partial response and long-term survival under sorafenib. Based on this finding and by employing copy number polymerase chain reaction, fluorescence in situ hybridization, and gene-expression analysis,

the investigators AZD9668 extended their investigation and retrospectively identified FGF3/FGF4 amplification in 30% of sorafenib responders (3 of 1011). This frequency is significantly increased, compared with the overall reported rate of FGF3/FGF4 amplification, amounting to 2.4% in unselected patients with HCC. Therefore, the investigators conclude that FGF3/FGF4 amplification with consecutive up-regulation of gene expression seems to be associated with a substantially increased likelihood and degree of response to sorafenib. These findings were functionally confirmed by the screening of various

cancer cell lines for FGF3/FGF4 up-regulation and by its correlation with in vitro response to sorafenib. In addition, enhanced proliferation in a cell clone expressing FGF4 was reversed by sorafenib in a nude mouse assay. Although elegantly performed and scientifically sound, the study by Arao et al. is somewhat hampered by several limitations. First, a small cohort of patients is studied and retrospective analyses may lead to a selection bias. Second, an unbiased genome-wide evaluation was performed only in the index patient, and the finding in this patient (FGF3/FGF4 gene amplification) was confirmed in 3 MCE公司 of 10 other patients, but without genome-wide assessment in this population. Therefore, it remains unclear whether the proposed amplification is a driving genetic alteration rendering the affected cells particularly susceptible to sorafenib treatment and, if so, by which mechanism. Alternatively, the finding could represent a secondary bystander phenomenon. Based on clinical and molecular data, up-regulated signaling through FGF family receptors (FGFRs) has been identified as a promising therapeutic target in patients with HCC.

05) For PET/CT, a blind designed or non-blind designed study was

05). For PET/CT, a blind designed or non-blind designed study was the possible source of heterogeneity in PET/CT (P < 0.05). In subgroup analysis, the sensitivity of enhanced versus unenhanced PET/CT in the detection of pancreatic cancer was 0.91 (95% CI, 0.86–0.96) versus 0.84 (95% CI, 0.78–0.90), the specificity 0.88 (95% CI, 0.73–1.00) versus 0.81 (95% CI, 0.69–0.94), but there were no significant differences (P > 0.05). In this meta-analysis, we found that FDG-PET/CT was highly sensitive and DWI was a highly specific diagnostic modality for patients suspected to have pancreatic cancer. ICG-001 cell line This indicates that PET/CT and DWI could play

different roles in diagnosing pancreatic carcinoma. But the diagnostic value of PET/CT and DWI is restricted by its high heterogeneity. To explore sources of heterogeneity in the studies for PET/CT and DWI, the meta-regression analysis was performed. The heterogeneity for PET/CT and DWI is caused by other factors like study characteristics and imaging

techniques. The results of meta-regression analysis indicate that the subgroup of lesion size is the most important characteristic, which significantly influenced its diagnostic accuracy for DWI. A blind designed or non-blind designed study was the possible source of heterogeneity in PET/CT. More recently, a study confirmed that the use of enhanced PET/CT was accurate and superior to unenhanced PET/CT in Gefitinib ic50 the assessment of resectability.17 Kauhanen et al.34 also reported PET/CT combined with contrast-enhanced MDCT could be used as a first-line imaging method in patients with suspicion of pancreatic cancer to detect optimally unexpected metastatic lesions and FDG-negative histologic types. Similar results were published by Farma et al.39 Our further subgroup analysis showed that contrast enhanced PET/CT seems to be superior to non-contrast PET/CT as well. However, the use of CT contrast agents in PET/CT is still controversial.

Some argue that CT image data should be used only for attenuation 上海皓元 correction of PET, reduction of acquisition time, and localization of hypermetabolic lesions with a low radiation dose,42,43 whereas others advocate the need to perform contrast-enhanced, full-dose, and high resolution CT (“diagnostic CT”) in various types of cancer.44,45 Some reports have stated that there is an increase in standardized uptake value in normal and pathologic regions of high concentration when intravenous contrast-enhanced CT is used for attenuation; this increase is clinically insignificant in the evaluation of patients with cancer, and contrast-enhanced CT could be used for attenuation correction.44 Further study in larger patient populations is needed to elucidate the efficacy, radiation exposure, and cost-effectiveness of PET/contrast-enhanced CT. In the present study, DWI appears to be a highly specific modality for pancreas cancer.

05) For PET/CT, a blind designed or non-blind designed study was

05). For PET/CT, a blind designed or non-blind designed study was the possible source of heterogeneity in PET/CT (P < 0.05). In subgroup analysis, the sensitivity of enhanced versus unenhanced PET/CT in the detection of pancreatic cancer was 0.91 (95% CI, 0.86–0.96) versus 0.84 (95% CI, 0.78–0.90), the specificity 0.88 (95% CI, 0.73–1.00) versus 0.81 (95% CI, 0.69–0.94), but there were no significant differences (P > 0.05). In this meta-analysis, we found that FDG-PET/CT was highly sensitive and DWI was a highly specific diagnostic modality for patients suspected to have pancreatic cancer. INCB024360 mouse This indicates that PET/CT and DWI could play

different roles in diagnosing pancreatic carcinoma. But the diagnostic value of PET/CT and DWI is restricted by its high heterogeneity. To explore sources of heterogeneity in the studies for PET/CT and DWI, the meta-regression analysis was performed. The heterogeneity for PET/CT and DWI is caused by other factors like study characteristics and imaging

techniques. The results of meta-regression analysis indicate that the subgroup of lesion size is the most important characteristic, which significantly influenced its diagnostic accuracy for DWI. A blind designed or non-blind designed study was the possible source of heterogeneity in PET/CT. More recently, a study confirmed that the use of enhanced PET/CT was accurate and superior to unenhanced PET/CT in selleck chemicals llc the assessment of resectability.17 Kauhanen et al.34 also reported PET/CT combined with contrast-enhanced MDCT could be used as a first-line imaging method in patients with suspicion of pancreatic cancer to detect optimally unexpected metastatic lesions and FDG-negative histologic types. Similar results were published by Farma et al.39 Our further subgroup analysis showed that contrast enhanced PET/CT seems to be superior to non-contrast PET/CT as well. However, the use of CT contrast agents in PET/CT is still controversial.

Some argue that CT image data should be used only for attenuation 上海皓元医药股份有限公司 correction of PET, reduction of acquisition time, and localization of hypermetabolic lesions with a low radiation dose,42,43 whereas others advocate the need to perform contrast-enhanced, full-dose, and high resolution CT (“diagnostic CT”) in various types of cancer.44,45 Some reports have stated that there is an increase in standardized uptake value in normal and pathologic regions of high concentration when intravenous contrast-enhanced CT is used for attenuation; this increase is clinically insignificant in the evaluation of patients with cancer, and contrast-enhanced CT could be used for attenuation correction.44 Further study in larger patient populations is needed to elucidate the efficacy, radiation exposure, and cost-effectiveness of PET/contrast-enhanced CT. In the present study, DWI appears to be a highly specific modality for pancreas cancer.

4 A total of 81 cases of patients with cirrhosis of the liver ba

4. A total of 81 cases of patients with cirrhosis of the liver basis, of which 39 patients received chemoembolization, the median survival was 4.08 months, 42 patients received embolization, the median survival of 3.5 months, The average of TTP, mediansurvival and survival curves difference between two groups of patients has not statistically significant.j Conclusion: TAE was effective and safety for primary hepatocellular carcinoma associated with ascites, leukopenia, and portal vein tumor thrombus, liver cirrhosis. Key Word(s): 1. TACE,; 2. HCC; 3. leukopenia; Presenting

Author: LILI DING Additional Authors: JUNPU GAO, QIJUN NIU Corresponding Author: LILI DING Affiliations: jilin university Objective: The objective of the present study was to explore Raf inhibitor the different metabolic substances in sera between hepatocellular carcinoma (HCC) caused by hepatitis B virus (HBV) or hepatitis C virus (HCV). We used the metabonomic method to profiling the sera among liver cirrhosis, see more liver cancer

and normal persons, and find potential tumor biomarkers. Methods: UPLC/Q-TOF-MS was utilized to profile the different metabolic substances in sera among 29 cases of liver cirrhosis which induced by HBV and HCV respectively, 38 and 32 cases of HCC sera which induced by HBV and HCV respectively, and

30 cases of normal persons. We got retention time, m/z and total electrories MCE strength related figure, then matched peaks, normalized these peaks, and analysed the data with PCA and PLS methods, matched these substances with human metabonomics database, the different substances between each team may be the potential biomarkers. Results: Metabolic substances in liver cirrhosis caused by HBV and HCV had no differences. Twenty-six substances were identified as potential tumor markers, ten compounds were identified as: LysoPC (20 : 1), LysoPC (20 : 2), LysoPC (P-18 : 0), LysoPC (P-18 : 0), LysoPC (15 : 0), arachidonic acid, hemolysis phosphatidyl choline, carnitine, glycine, tryptophan, N-Arachidonoyl glycine. Conclusion: There were no differences between liver cirrhosis between HBV and HCV induced liver cancer in metabolites level. Through analysising liver cirrhosis and liver cancer sera, Twenty-six different substances were found, LysoPC (20 : 1), LysoPC (20 : 2), LysoPC (P-18 : 0), LysoPC (P-18 : 0), LysoPC (15 : 0), arachidonic acid, hemolysis phosphatidyl choline, carnitine (C18 : 1), carnitine (C18 : 2), glycine, tryptophan, N-Arachidonoyl glycine, they are the potential tumor biomarkers of HCC. Key Word(s): 1. Metabonomics; 2. HCC; 3. liver cirrhosis; 4.

richtersi The first lab oviposition of mature females collected

richtersi. The first lab oviposition of mature females collected in the field in the spring and fall as well as cohorts of eggs laid by females born in the laboratory were used. The eggs of all samples, maintained under the same constant experimental conditions, had a high hatching percentage (from 75 to 93%) but a high variability occurred in the hatching time. Four patterns were identified. First, subitaneous eggs hatched within 30–40 days from oviposition. Second, delayed-hatching eggs hatched gradually GDC-0449 in vitro over 41–62 days.

Some eggs did not hatch within 90 days from oviposition when water was maintained in the culture. Within this group, 13% of eggs (diapause resting eggs; third category) do not hatch until they are subjected to desiccation,

followed by rehydration, while 87% never complete their development (abortive eggs; fourth category). The four categories of eggs had no morphological differences. The high variability in the hatching time of tardigrade eggs might be considered a form of bet-hedging. “
“In November 2002 the Prestige tanker spilled 59 000 tonnes of oil off Galicia (north-west Spain) and contaminated a vast coastal area extending from northern Portugal to Brittany (France). Two study areas, a coastal lagoon (1 sample point) and a stretch of rocky coast (includes 5 sample points), were selected to examine changes on the diet of otters Lutra lutra L. before MCE公司 and after the oil spill. Diet was assessed from 1103 spraints, 553 collected in 2000, before the spill and 550 in 2003, after the spill. In the coastal SCH772984 manufacturer lagoon, after spill, spraints contained more shrimp (Palaemon sp.), more prey of marine origin, and fewer gobies (Pomatoschistus sp.) and eels Anguilla anguilla. A decline of the eel population in the coastal lagoon may have caused otters to make more frequent visits to the sea. On the rocky coast, spraints contained more blennids in 1 of the 5 sampling points, however, the seasonal patterns of the principal prey species (Blennidae, Gadidae and Labridae)

were similar across the 2 years of study. The differences may be attributed to common interannual variations in the diet of marine otters, but the design of this study cannot assess the degree of natural variation in the diet of coastal otters before the oil spill. “
“It has been proposed that sympatric bumblebee species form mimicry rings to profit from learnt avoidance behaviour by predators. This hypothesis can be tested by comparing the predation rates of local bumblebees with those of imported non-native bumblebees, whose coat colour is different from that of local bees, so that their coloration is unfamiliar to local predators. To test whether populations of non-native bumblebees suffer higher worker loss rates during foraging, we conducted transplant experiments in the UK, Germany and Sardinia.

richtersi The first lab oviposition of mature females collected

richtersi. The first lab oviposition of mature females collected in the field in the spring and fall as well as cohorts of eggs laid by females born in the laboratory were used. The eggs of all samples, maintained under the same constant experimental conditions, had a high hatching percentage (from 75 to 93%) but a high variability occurred in the hatching time. Four patterns were identified. First, subitaneous eggs hatched within 30–40 days from oviposition. Second, delayed-hatching eggs hatched gradually MK-1775 cell line over 41–62 days.

Some eggs did not hatch within 90 days from oviposition when water was maintained in the culture. Within this group, 13% of eggs (diapause resting eggs; third category) do not hatch until they are subjected to desiccation,

followed by rehydration, while 87% never complete their development (abortive eggs; fourth category). The four categories of eggs had no morphological differences. The high variability in the hatching time of tardigrade eggs might be considered a form of bet-hedging. “
“In November 2002 the Prestige tanker spilled 59 000 tonnes of oil off Galicia (north-west Spain) and contaminated a vast coastal area extending from northern Portugal to Brittany (France). Two study areas, a coastal lagoon (1 sample point) and a stretch of rocky coast (includes 5 sample points), were selected to examine changes on the diet of otters Lutra lutra L. before 上海皓元 and after the oil spill. Diet was assessed from 1103 spraints, 553 collected in 2000, before the spill and 550 in 2003, after the spill. In the coastal ITF2357 cell line lagoon, after spill, spraints contained more shrimp (Palaemon sp.), more prey of marine origin, and fewer gobies (Pomatoschistus sp.) and eels Anguilla anguilla. A decline of the eel population in the coastal lagoon may have caused otters to make more frequent visits to the sea. On the rocky coast, spraints contained more blennids in 1 of the 5 sampling points, however, the seasonal patterns of the principal prey species (Blennidae, Gadidae and Labridae)

were similar across the 2 years of study. The differences may be attributed to common interannual variations in the diet of marine otters, but the design of this study cannot assess the degree of natural variation in the diet of coastal otters before the oil spill. “
“It has been proposed that sympatric bumblebee species form mimicry rings to profit from learnt avoidance behaviour by predators. This hypothesis can be tested by comparing the predation rates of local bumblebees with those of imported non-native bumblebees, whose coat colour is different from that of local bees, so that their coloration is unfamiliar to local predators. To test whether populations of non-native bumblebees suffer higher worker loss rates during foraging, we conducted transplant experiments in the UK, Germany and Sardinia.

Thus, CWA has greater versatility and considerable potential for

Thus, CWA has greater versatility and considerable potential for the evaluation of overall clotting function in various disorders of haemostasis. Internationally recognized standardization of methods and test parameters are required, however, for optimization of the technique. Platelet selleck inhibitor function disorders are quite prevalent among individuals with bleeding problems [1–5]. At present, aggregation and dense granule release assays are the commonly performed, and the most useful tests to diagnose platelet function disorders [1–4,6,7]. Laboratories need to consider recent evidence on aggregation and dense granule release tests

for platelet disorders [1–5,8], and the guideline recommendations on these assays [9–12] to optimize their diagnostic evaluation of platelet function disorders. Light transmittance aggregometry (LTA) is considered the “gold standard” of platelet function tests, despite its lack of standardization [13,14]. The usefulness of LTA, for diagnosing impaired platelet function among individuals referred for bleeding disorder assessments, has been estimated in recent prospective studies [1,3]. A merit of these studies is that they tested LTA in accordance with guidelines [9,10], using validated reference intervals (RI) for maximal aggregation (MA) [15]. When LTA MA is abnormal with two or more panel agonists, PD0325901 ic50 there is a high likelihood (estimated as OR, odds ratio) of

impaired function from a bleeding disorder (OR: ≥23), and an inherited secretion defect (OR: ≥91) which is the most common type of platelet function disorder [1,3]. In comparison, the bleeding time is much less useful (OR for bleeding disorders: 3.5) [1]. Most LTA abnormalities with single agonists are false positive results, not predictive of bleeding problems [1,3]. In general, LTA shows good reproducibility and

less variability than dense granule release endpoints [2–4]. Receiver operator curves (ROC), which evaluate sensitivity and specificity, indicate LTA has high specificity and moderate sensitivity for inherited platelet disorders [1,3]. Abnormal findings can also reflect acquired disorders [1,3]. LTA medchemexpress agonists that are sensitive to common inherited platelet function defects include commonly tested agonists (i.e. Horm collagen, tested at 1.25 μg mL−1; epinephrine; and arachidonic acid) and thromboxane analogue U46619 [1], which is used less frequently [7,14,16]. ontroversies have emerged about whether LTA should be performed using native platelet rich plasma (PRP) or PRP adjusted to a standardized platelet count as native samples show more aggregation with weak agonists [3,17–20] A recent prospective study was the first to rigorously compare these samples types for bleeding disorder diagnosis, using non-inferiority analysis of the areas under ROC for MA data, with predefined ROC area differences (<0.15 to define non-inferiority; >0 to define superiority) to evaluate detection of bleeding disorders and inherited platelet secretion defects [3].