Biomedical subjects

J Askergren

Publications and source records attributed to J Askergren.

28 records · Page 2Linked to original sources

PubMed1981

[Splenectomy in idiopathic thrombopenic purpura and in myelofibrosis. A retrospective study of platelet increase, hemorrhagic complications and mortality].

In a retrospective study of 39 splenectomies, patients with increased blood cell breakdown (13 cases of idiopathic thrombocytopenic purpura (ITP), 5 cases of hereditary spherocytosis, 2 of Felty's syndrome and 2 of autoimmune hemolytic anemia) were compared with those patients also presenting decreased blood cell production [14 cases of myelofibrosis (MF) with splenomegaly and 3 cases of advanced chronic myelogeneous leukemia (CML)]. Platelet regeneration post-operatively was significantly (p less than 0.01) more rapid in the ITP than in the MF group. Only 1/22 patients in the ITP group had major post-operative complications as compared to 10/17 in the MF group. None of the patients in the ITP group died within 25 days of operation as compared to 5/17 in the MF group. Only 3/22 patients in the ITP group lost more than 800 ml of blood during the operation as compared to 8/17 with MF. No statistically significant higher blood loss was found in patients with less than 30 x 10(9) platelets/l preoperatively, compared to those with higher platelet counts. However, correlation between the splenic weights and amount of blood loss was statistically significant (p less than 0.01). Thus, splenectomy seems much better tolerated in patients with ITP, even if platelets are low, than in patients with myelofibrosis.

Adult↗

PubMed1981

On the size and tumor involvement of the spleen in Hodgkin's disease.

Fifty-four untreated patients with Hodgkin's disease (HD) subjected to splenectomy were studied with respect to preoperatively assessed spleen size compared to postoperative findings. Before splenectomy, nine patients had "normal sized" spleens, 18 patients had spleens weighing greater than or equal to 200 g and 14/39 spleens were tumor-involved. Nine patients had "enlarged" but unpalpable spleens. Eight of these weighed greater than 200 g and 3/9 spleens showed tumor involvement. Six patients with preoperatively palpable spleens showed tumor involvement, their spleens weighed greater than 660 g. The results confirm the inaccuracy of non-invasive procedures in prediction of spleen size and tumor involvement in HD.

Adolescent↗

PubMed1981

Routine laboratory tests in relation to spleen size and tumour involvement in untreated Hodgkin's disease.

A number of routine laboratory tests were studied in 39 untreated patients with Hodgkin's disease with respect to size and tumour involvement of the spleen. Eighteen patients with tumour-engaged spleens had lower total lymphocyte counts and IgG and IgM levels than patients with non-involved spleens. However, no significant differences in these respects were found between patients with tumour-involved spleens weighing less than 500 g and patients without splenic tumour involvement. Hemoglobin values were inversely and reticulocyte counts positively correlated with the weight of involved spleens. Remaining laboratory variables under study, e.g. total granulocyte counts, platelet counts, ESR and liver enzymes, were not associated with the size or tumour involvement of the spleen. It may be concluded that routine laboratory tests yield no specific information as to splenic tumour involvement or size.

Adolescent↗

PubMed1981

Spontaneously DNA synthesizing blood and spleen lymphocytes in Hodgkin's disease.

Spontaneously DNA synthesizing blood and spleen lymphocytes in 9 patients with Hodgkin's disease have been studied by surface markers and by autoradiography after in vitro labelling with 3H-thymidine of cell specimens separated according to size. The findings have been related to functional characteristics of blood lymphocytes. The distribution of E and EAC rosetting cells in blood and spleen was similar also after separation according to cell size. The number of mainly large activated blood and spleen cells was increased in patients as compared to controls. Both E and EAC rosetting cells participated in this unexplained cell challenge.

Adult↗

PubMed1980

Prognostic effect of early diagnostic splenectomy in Hodgkin's disease: a randomized trial.

A randomized trial is reported which evaluates the effect of early diagnostic splenectomy on the prognosis of patients with Hodgkin's disease (HD) and uncertain prognosis. This was started in January 1973 and concluded in April 1979. Sixty-seven patients were entered in the study and 31 were randomized for splenectomy. All patients except 2 received total nodal irradiation, excluding the splenic and hepatic areas. After 40 months' observation there was no difference between the groups in respect of survival and the number of recurrences. However, relapses occurred earlier in the splenectomized patients. Pneumococcal septicaemia was recorded in 2 splenectomized patients. It is concluded that prognosis is not improved by diagnostic splenectomy in HD patients with uncertain prognosis and treated with total nodal irradiation.

Adolescent↗

PubMed1980

Long-term influence of splenectomy on immune functions in patients with Hodgkin's disease.

Immunological functions of 9 non-splenectomized and 8 splenectomized patients with Hodgkin's disease were studied before and after treatment. The two groups compared well with regard to age, clinical and immunological findings at diagnosis and observation time. When retested, all patients had enjoyed an unmaintained complete remission for 2 to 5 years following total nodal radiotherapy. After therapy, total lymphocyte and T-lymphocyte counts decreased in non-splenectomized patients but remained unchanged in splenectomized patients. The blood lymphocyte DNA synthesis after activation by concanavalin A or pokeweed mitogen persisted at the same low level after treatment. The delayed skin hypersensitivity and the lymphocyte activation by PPD antigen were restored in several patients in both groups. The IgM concentration decreased after therapy independent of splenectomy. The IgA level was low in non-splenectomized patients. Splenectomy seems to protect from the therapy-induced lymphocytopenia. No alterations of immunoglobulins and blood lymphocyte functions could be ascribed to splenectomy.

DNA↗

PubMed1980

Blood lymphocyte functions in relation to splenic weight and tumor involvement in untreated Hodgkin's disease.

Spontaneous and mitogen induced blood lymphocyte DNA synthesis was studied in relation to weight and tumor involvement of the spleen in 33 untreated patients with Hodgkin's Disease. Splenic tumor involvement was found in 14 patients. In this group there was a strong inverse correlation between spleen weight and lymphocyte DNA synthesis induced by PWM, ConA and PPD. In patients with uninvolved spleens the spontaneous blood lymphocyte DNA synthesis increased with spleen weight. No correlation with the mitogen response was observed in this group.

Adolescent↗

PubMed1980

Post-splenectomy septicemia in Hodgkin's disease and other disorders.

The frequencies of splenectomy and post-splenectomy septicemia over a 10-year period in the Stockholm area were studied. The main observation was a significantly increased risk of pneumococcal septicemia in splenectomized patients, in particular HD patients. At the two clinics for infectious diseases in Stockholm, 1310 septicemia patients were treated, and among these, 14 splenectomized patients. In the total material, pneumococci were the causative agent in 4.7% but splenectomized patients had pneumococcal septicemia in 71% (10/14). In the 12 surgical clinics of Stockholm, 1148 splenectomies had been performed during the period, among these, 76 in HD patients. Pneumococcal septicemia occurred in 5 splenectomized HD patients.

Adolescent↗

PubMed1978

Acute phase of sarcoidosis with splenomegaly and hypercalcemia. Description of a case, including a report about splenectomy and the preparation and testing of a Kveim antigen from the spleen.

A young man had a mild, slightly progressive pulmonary sarcoidosis. After 4 years he developed an acute disease with splenomegaly, anemia, marked elevation of ESR, hypercalcemia and mild renal insufficiency. The anemia and ESR elevation disappeared after splenectomy, whereas the hypercalcemia still needs corticosteroid treatment. Attempts to withdraw this treatment resulted in recurrence of the hypercalcemia, but no other abnormalities. In contrast to other organs examined, the sarcoid tissue in the spleen revealed necrosis formation, consistent with a recent process. A Kveim antigen preparation from the spleen was less potent than antigen from mediastinal lymph nodes. It is suggested that the acute phase of the disease involved mainly the spleen. Speculations about the possible role of infectious agent(s) are put forward.

Acute Disease↗

PubMed1977

Prognostic factors in Hodgkin's disease. I. Analysis of histopathology, stage distribution and results of therapy.

An unselected material of 83 consecutive and previously untreated adult patients with Hodgkin's disease (HD) from the Stockholm area is presented. The distribution of patients according to age was characteristically bimodal. The histopathological subtypes were 16% lymphocyte predominance (LP), 33% nodular sclerosis (NS), 37% mixed cellularity (MC) and 11% lymphocyte depletion (LD). The patients were treated with aggressive megavoltage irradiation and multidrug chemotherapy. Major factors affecting prognosis were age, clinical stage and constitutional symptoms. Patients with LP and NS subtypes had only slightly better prognosis that patients classified as MC and LD. The overall survival was 68% at 41/2 years, which is close to that reported from other groups with similar composition of their materials with regard to age, histopathology and stage.

Adolescent↗