Reference Ranges of Lymphocyte Subsets in Healthy Individuals from Southern Iran.

BACKGROUND: Lymphocyte immune-phenotyping is considered as a useful tool in diagnosis and monitoring different medical conditions. This study aimed to establish a reference value of different lymphocyte subsets in healthy individuals from southern Iran. METHODS: Flow cytometric method was used to determine the frequency of T cells, helper T cells, cytotoxic T cells, activated T cells, NK cells, NKT cells, and B cells in peripheral blood of 86 healthy subjects from southern Iran. RESULTS: Regardless of gender, the mean percentage of the lymphocyte subsets have been observed as T cells (69.2 ± 8.84%), B cells (11.88 ± 4.14%), T helper cells (39.85 ± 7.75%), T cytotoxic cells (33.97 ± 6.64%), activated T cells (6.67 ± 3.60%), NK cells (12.56 ± 7.32%), and NKT cells (5.07 ± 2.83%). The ratio of CD4+/CD8+ was found to be 1.22 ± 0.4. An insignificant difference was found between lymphocytes of male and female. The percentage of helper T-cells has demonstrated a positive correlation and the percentage of cytotoxic T-cells and NK cells have il-lustrated a negative correlation with age. CONCLUSIONS: The results provide normal reference values of peripheral blood lymphocyte subsets in healthy individuals from southern Iran with the age range of 15 - 55 years old. Moreover, the results support this approach that reference values of lymphocyte subsets should be provided for each population. The reference range value of circulating lymphocytes is a powerful tool for monitoring and/or clinical management of immune related disorders.

Gastrotracheal Fistula as a Result of Transhiatal Esophagectomy for Esophageal Cancer: An Unusual Complication.

Gastrotracheal fistula following open transhiatal esophagectomy (Orringer's technique) for esophageal cancer is an unusual but lethal complication. Surgical intervention with resection of the fistula tract and primary interrupted suturing of gastric and tracheal orifices using a muscle flap interposition has proved to be a successful method. We report the case of a 73-year-old male with an adenocarcinoma of the distal part of the esophagus, who underwent open transhiatal esophagectomy (Orringer's technique) with gastric tube reconstruction and cervical anastomosis. The patient did not receive induction chemoradiotherapy before the esophagectomy. Two attempts of surgical repair of fistula failed and the patient died. Being aware of warning signs such as dyspnea and respiratory distress accompanied by bilious content in the tracheal tube is helpful in the early detection and treatment of this type of fistula.