Toxicity of leukaemia therapy in children with Down syndrome.
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Bone Marrow↗
Biomedical subjects
A Poon
Publications and source records attributed to A Poon.
Proximal gastric vagotomy in emergency peptic ulcer perforation.
In order to evaluate proximal gastric vagotomy (PGV) performed under different clinical conditions, we compared the late results of 93 patients who underwent emergency PGV for perforated duodenal ulcers with those of 60 patients who had elective PGV. The emergency group of patients were slightly younger and there was a higher male predominance but they were otherwise comparable with those in the elective group. There were no operative deaths and the postoperative morbidity rate was low in both groups. Three patients had a recurrence in the emergency group, and seven occurred in those in the elective group during the first three postoperative years. The cumulative recurrence-free rate of the emergency group was not lower than that of the elective group. The performance of the individual surgeon exerted a strong influence on the incidence of recurrent ulceration. In properly selected patients, whether the surgeons perform PGV in emergency or elective situations appears to have little influence on the outcome.
Adult↗
Separation of lymphoid and myeloid blasts in the mixed blast crisis of chronic myelogenous leukemia: no evidence for Ig gene rearrangement in CALLA-positive blasts.
Recent studies suggest that lymphoid blast crisis cells of chronic myelogenous leukemia (CML) expressing the common acute lymphoblastic leukemia antigen (CALLA) are B precursor cells, based on the demonstration of immunoglobulin (Ig) gene rearrangement similar to common acute lymphocytic leukemia. There is little evidence to suggest whether the cells with similar lymphoid characteristics in the mixed blast crisis of CML are also committed to B cell lineage. A patient in "mixed" blast crisis of CML was studied. On the basis of morphology, cytochemistry, and immunological studies, the blasts were classified as having either lymphoid or myeloid characteristics. A proportion of the leukemic blasts expressed CALLA, whereas others expressed My7 antigen. In order to characterize both populations of cell further, CALLA+ blasts and My7+ (myeloid) blasts were isolated by fluorescence-activated cell sorting. The My7+ cells were highly proliferative in cell culture blast colony assays, retained the Ph1 chromosome, and were indistinguishable from acute myelogenous leukemia blasts. The CALLA+ cells were also Ph1-chromosome positive, but in contrast, were poorly proliferative in vitro. Of particular note was their retention of germline configuration of Ig genes, thus distinguishing them from blasts in the lymphoid crisis of CML. We conclude that the lymphoid component in mixed blast crisis may represent a stage of differentiation prior to commitment to B lineage.
Adolescent↗
Outcome of renal transplantation in recipients with blood group A.
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ABO Blood-Group System↗
Simple manual method for harvesting granulocytes.
The method described requires no special equipment and permits the harvesting of granulocytes from collections of fresh concentrated erythrocytes with buffy coat. In contrast to the use of a cell separator, it requires little time of technologists and none of medical staff to recover an equivalent number of granulocytes. This method makes granulocyte transfusion practicable for the support of neutropenic patients even in centers with no leukopheresis program.
Cell Separation↗
Leukemia in Down syndrome: a review.
The incidence of leukemia is higher in children with Down syndrome (DS) than in normals. In approximately 50% of cases the type of leukemia is acute megakaryoblastic leukemia (AMKL) and it occurs during the first 4 years of life. The leukemic cell also has features of erythroid progenitors and therefore appears to be a precursor cell with biphenotypic properties. In addition, newborns with DS frequently develop transient leukemia (TL), which is characterized by the presence of megakaryoblasts in the blood which disappear during the first 1-3 months of life. The incidence of this disorder is unknown although preliminary studies suggest that megakaryoblasts may be found frequently in the blood of DS newborns. TL does not occur in normal newborn infants. Although TL disappears spontaneously, many of these children will develop AMKL at 1-4 years of age. Recent surveys suggest that 20-30% of newborns with TL will develop AMKL. Preliminary evidence suggests that TL is a clonal proliferation, can be fatal, and may occur in a specific subgroup of DS children. The observations in this report are drawn from our own experience, reports in the literature, and data accumulated in the Canadian Down Syndrome Leukemia Registry.
Adolescent↗
The economic impact of Staphylococcus aureus infection in New York City hospitals.
We modeled estimates of the incidence, deaths, and direct medical costs of Staphylococcus aureus infections in hospitalized patients in the New York City metropolitan area in 1995 by using hospital discharge data collected by the New York State Department of Health and standard sources for the costs of health care. We also examined the relative impact of methicillin-resistant versus -sensitive strains of S. aureus and of community-acquired versus nosocomial infections. S. aureus-associated hospitalizations resulted in approximately twice the length of stay, deaths, and medical costs of typical hospitalizations; methicillin-resistant and -sensitive infections had similar direct medical costs, but resistant infections caused more deaths (21% versus 8%). Community-acquired and nosocomial infections had similar death rates, but community-acquired infections appeared to have increased direct medical costs per patient ($35,300 versus $28,800). The results of our study indicate that reducing the incidence of methicillin-resistant and -sensitive nosocomial infections would reduce the societal costs of S. aureus infection.
Community-Acquired Infections↗