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[Sternal puncture].

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Bone Marrow Examination↗
PubMed1997

[The foramen sternale: a minor anomaly--great relevance].

PURPOSE: Evaluation of the incidence of a midline sternal foramen, as a developmental anomaly, in order to avoid fatal complications following sternal puncture of sternal acupuncture treatment. MATERIAL AND METHODS: 100 chest computed tomograms were evaluated in reference to the incidence of this anomaly and its various features. RESULTS: The variety of CT aspects ranged from very incomplete types with only sandglass-like retraction of sternal cortex, to a complete foraminal defect. The incidence of midline sternal foramen in a feature bearing a risk of complication, is approximately 6%. CONCLUSION: We conclude that--if sternal acupuncture is planned in the region of corpus--previous radiographs should be done to rule out this anomaly. Furthermore, we strongly recommend the acupuncture technique of the "Wiener Schule", which prescribes a safe superficial-oblique approach to the sternum.

Acupuncture Therapy↗
PubMed1982

[Value of Beckenkamm histobiopsy in the diagnosis of malignant lymphoma infiltrates in bone marrow].

In order to find out the optimum method for the proof of infiltrates of malignant lymphomas in the bone marrow the frequencies of positive findings of the marrow in 41 patients with Hodgkin's disease and 89 patients with a malignant non-Hodgkin-lymphoma which were established by sternal puncture, cytology of the iliac crest and histology of the iliac crest were compared. It could be elaborated that the histobiopsy of the bone marrow is the only sufficient method for proving a specific affection of the marrow in Hodgkin's disease, since the gain of positive findings in the cytology of the iliac crest and in the sternal puncture was significantly lower in Hodgkin's disease as well as in the malignant non-Hodgkin-lymphomas. In these cases the inferiority of the cytologic methods could be explained on the one hand by the often only focal spreading of the lymphoma infiltrates in the bone marrow and on the other hand by an increased inclination to fibrosis in the focal as well as in the diffuse infiltrates. By comparison with present findings of post-mortem-examinations the representation of the biopsy cylinder of the iliac crest could be derived for the whole marrow organ, as far as the biopsy was performed technically correct.

Biopsy, Needle↗
PubMed2005

[Therapy of Duchenne muscular dystrophy with umbilical cord blood stem cell transplantation].

OBJECTIVE: To analyze a Duchenne muscular dystrophy(DMD) patient's muscular regeneration, dystrophin expression and locomotive variation before and after he underwent umbilical cord blood stem cell transplantation in order to assess the therapeutic effect. METHODS: A 12-year-old DMD boy who could not walk for 3 years was confirmed by gene analysis and dystrophin protein immune test on his muscle. He had no other chronic disease. By HLA matching, a piece of umbilical cord blood stem cell with 6 HLA sites matching to the boy was found in Guangdong Umbilical Cord Blood Bank. The number of the nucleated cells of the umbilical cord blood stem cell was 24.08x 10(8). After pretreatment for the DMD boy with busulfan, cyclophosphamide and rabbit anti-human thymocyte globulin, the allergenic cord blood stem cells were transplanted into him by intravenous injection. Cyclosporin A, methylprednisolone, MMF, prostaglandin E1 and ganciclovir were given after the transplantation. At the same time, Gran, the granulocytic cell stimulating factor, and gamma globulin were administered. The biochemistry profile including serum creatine kinase (CK), the reconstruction of blood making, the deletion exon of DMD gene, the regenerating muscles, the dystrophin protein expression, and the locomotive function of the DMD boy were tested regularly. RESULTS: (1) The white blood cells (WBC) of peripheral blood decreased gradually to zero after pretreatment. In a period of 15 days after transplantation, the neutrophil increased to 0.5x 10(9)/L; at 25 days, WBC increased to normal level. Blood platelet was more than 20x 10(9)/L at 22 days. The hemoglobin rose to 85-100 g/L. At 140 days, sternal puncture revealed the rapid growth of neutrophil, blood platelet and hemoglobin. (2)At 140 days, the blood type of the DMD boy transformed from type O to type AB (the donor's blood type being AB). There was no grafe versus host reaction. (3) At 18, 30, 43, 55, 74 and 233 days after transplantation, the PCR-short tandem repeat test of the boy's peripheral blood DNA showed that his genotype was completely the same as the donor's. The results of PCR-short tandem repeat tests of the bone marrow cells DNA by sternal puncture at 140, 183 and 235 days were the same as those of the blood DNA. (4) At 60 days, DMD gene analysis by PCR showed that the defected DMD gene (exon 19 deletion) had been corrected by the umbilical cord stem cells transplantation. (5) At 75 days, the biopsy of calf muscle showed there were myoblast cells and muscular tubes growing. The dystrophin expressions were weak, but a few of them were strong. DNA analysis showed that the donor's gene DNA accounted for 1%-13%. At 126 days, obviously increased dystrophin positive muscular fibers of the boy were found. The donor's fibers rose to 2.5%-25%. (6) The serum CK of the boy declined from 5735 U/L to 274 U/L. (7) At 100 days, physical examination revealed improvement in his arms and legs. CONCLUSION: The therapy of Duchenne muscular dystrophy with allogeneic umbilical cord blood hematopoietic stem cell transplantation may reset up the blood-making function, decrease the serum CK level, restore the dystrophin in muscles, and improve the locomotive function of the DMD boy. These data suggest that the allogeneic umbilical cord blood hematopoietic stem cell transplantation may benefit the DMD boys.

Alprostadil↗
PubMed1993

[Late post-traumatic pericardial effusion. Identification of promoting conditions and literature review apropos of 2 cases].

The authors report two cases of post traumatic haemopericardium discovered 18 days after a iatrogenic penetrating trauma (sternal puncture) for the first one, and 102 days after a fall with blunt thoracic trauma and multiple associated injuries, for the second one. After admission, the first case rapidly developed a severe tamponade requiring a pericardial drainage, of 420 ml of non coagulated blood. The second case, in spite of a volume of liquid of more than 1000 ml, showed only a fatigue and a dyspnea, without any sign of haemodynamic failure. A literature review allows to be more specific about the characteristics of the tamponade and the different mechanisms responsible for cardiac injuries connected to thoracic traumas. For many reasons, the cardiac damages and/or their complications are often misjudged, particularly in thoracic traumas associated with multiple lesions. Among the sequelae, pericarditis, with or without effusion, is particularly frequent and it is essential to systematically look for it before dismissing a patient who went through a thoracic trauma. As for the bone marrow sampling, the sternal puncture generates a great number of injuries and must be proscribed. The iliac crest puncture should take its place.

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