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Results for “STERNAL PUNCTURE”

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At least 127 records · Page 7Linked to original sources

PubMed1976

Prognostic value of mitotic studies in myeloid leukaemias.

Seven patients with various forms of myeloid leukaemia have been studied by repeated sternal punctures during the course of illness. None of the patients received cytostatics before or during the study. The mitotic indices declined with time and there was a significant relation between the slopes of the mitotic curves and survival time. Repeated mitotic counts seem to serve as a diagnostic and prognostic tool in myeloid leukaemias.

Adult↗

PubMed2006

No evidence of myocardial restoration following transplantation of mononuclear bone marrow cells in coronary bypass grafting surgery patients based upon cardiac SPECT and 18F-PET.

BACKGROUND: We tested the hypothesis, that intramyocardial injection of mononuclear bone marrow cells combined with coronary artery bypass grafting (CABG) surgery improves tissue viability or function in infarct regions with non-viable myocardium as assessed by nuclear imaging techniques. METHODS: Thus far, 7 patients (60 +/- 10 [SD] years) undergoing elective CABG surgery after a myocardial infarction were included in this study. Prior to sternotomy, bone marrow was harvested by sternal puncture. Mononuclear bone marrow cells were isolated by gradient centrifugation and resuspended in 2 ml volume of Hank's buffered salt solution. At the end of CABG surgery 10 injections of 0.2 ml each were applied to the core area and borderzones of the infarct. Global and regional perfusion and viability were evaluated by ECG-gated 99mTc-tetrofosmin myocardial single-photon emission computed tomograph (SPECT) imaging and 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) in all study patients < 6 days before and 3 months after the intervention. RESULTS: Non-viable segments indicating transmural defects were identified in 5 patients. Two patients were found to have non-transmural defects before surgery. Concomitant surgical revascularisation and bone marrow cell injection was performed in all patients without major complications. The median total injected mononuclear cell number was 7.0 x 10(7) (range: 0.8-20.4). At 3 months 99mTc-tetrofosmin SPECT and 18F-FDG-PET scanning showed in 5 patients (transmural defect n = 4; non-transmural defect n = 1) no change in myocardial viability and in two patients (transmural defect n = 1, non-transmural defect n = 1) enhanced myocardial viability by 75%. Overall, global and regional LV ejection fraction was not significantly increased after surgery compared with the preoperative value. CONCLUSION: In CABG surgery patients with non-viable segments the concurrent use of intramyocardial cell transfer did not show any clear improvement in tissue viability or function by means of non-invasive bioimaging techniques.

Journal Article↗

PubMed1993

Treatment of methimazole-induced agranulocytosis using recombinant human granulocyte colony-stimulating factor (rhG-CSF).

Agranulocytosis, although extremely infrequent, is a serious complication of antithyroidal drug therapy in patients with hyperthyroidism. Presently, there is no specific therapy for this life-threatening complication, and recovery time is highly variable. Recently, recombinant human granulocyte colony-stimulating factor (rhG-CSF) was reported to be effective in shortening the recovery time of the neutropenia in patients undergoing chemotherapy. The present study was undertaken to determine the efficacy of rhG-CSF administration in patients with methimazole-induced (MMI) agranulocytosis. Thirty-four patients (7 males and 27 females, ages 16-68 yr) with MMI agranulocytosis were divided into 3 groups: group A (n = 11) was treated with antibiotics only; group B (n = 11) received antibiotics and dexamethasone, 8 mg/day; and group C (n = 12) was treated with antibiotics and im injections of rhG-CSF, 75 micrograms/day. Patients in groups A and B were studied retrospectively. When rhG-CSF became available, patients in group C were studied prospectively. Bone marrow sternal punctures were performed in all group C patients who were then divided into 2 subgroups according to the granulocyte to erythrocyte count ratio (G:E). Group C1 (n = 6) had a G:E ratio of less than 0.5, and group C2 (n = 6) had a ratio of more than or equal to 0.5. Recovery time in all groups was defined as the number of days required for the peripheral granulocyte count to be greater than 1.0 x 10(9)/L. There was no significant difference in recovery time between groups A and B: 10.1 +/- 2.2 and 12.3 +/- 1.9 days (mean +/- SE), respectively. P was not significant; the administration of dexamethasone proved to be ineffective in shortening the time for recovery from peripheral granulocytes. On the other hand, recovery time was significantly shorter in group C (6.8 +/- 1.2 days mean +/- SE) compared with groups A and B (P < 0.05). Group C2 recovered in 2.2 +/- 0.6 days whereas group C1 took much longer, 9.8 +/- 1.3 days (P < 0.001). There was a direct correlation between the G:E ratio and the peripheral leucocyte count, r = 0.806, P < 0.01. Furthermore, rhG-CSF significantly shortened recovery time when the peripheral granulocyte count was greater than 0.1 x 10(9)/L (group C2) compared with patients whose counts were less than 0.1 x 10(9)/L (group C1), 2.2 +/- 0.4 vs. 8.6 +/- 1.3 days, respectively (P < 0.001). These data indicate that administration of steroids is ineffective in shortening the duration of recovery in patients with MMI agranulocytosis.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗

PubMedDate not supplied

[Leishmaniasis: case report].

INTRODUCTION: Leishmaniasis is a chronic parasitic disease of the reticuloendothelial system which is manifested by gradual onset, unspecific disorders and can take a form of visceral, cutaneous or mucocutaneous leishmaniasis. The aim of the study is to present the patient who was treated for visceral leishmaniasis at the Clinic for Infectious Diseases in Novi Sad. CASE REPORT: A patient, 22 years old, had been admitted at the Clinic one month after the beginning of the disease with gradual onset malaise, fatigue, loss of appetite, intermittent temperature and night sweating. A few days before the admittance to the hospital, dark colour of urine and the pain under the left rib occurred. On admission, the patient had been afebrile, dehydrated, intoxicated, he had subicteric sclerae with enlarged liver and extremely enlarged spleen. Laboratory findings revealed anemia, leucopenia, and increased level of gamma globulins. Hypercellularity of the bone marrow with cells of all degrees of maturity had been determined by sternal puncture. We have epidemiologically obtained information about the bites of a mosquito from the Phlebotomus genus at the Adriatic coastal region, two years and two months ago. The diagnosis had been confirmed by the formol-gel test and by the indirect hemaglutination test. Leishmaniae donovani had been found in the bone marrow punctate. TREATMENT: The patient had been treated by appropriate doses of N-methyl-glucamine-antimonate (Glucantime), during three weeks, after which he was cured. During the one-year follow-up period normalization of laboratory findings as well as liver and spleen ultrasonographic findings occurred. CONCLUSION: Because of gradual onset and polymorphic troubles during the beginning of leishmaniasis, many diseases can be taken into account for diagnostic differentiation. From this study it is obvious that even the possibility of such a disease must be considered, despite the fact that it is rare in our region, because fatal outcome is avoidable only by the timely diagnosis and therapy.

Adult↗

PubMedDate not supplied

Pleomorphic T-cell lymphoma with chondropathia tuberosa; a case report and review.

Pleomorphic T-cell-lymphoma (anaplastic IgA-plasma cell tumor) belongs to the group of malignant non-Hodgkin's lymphomas (NHL). The histological and immunophenotypical subtypes differ with genetic and environmental etiologic factors. Lymphomas arise from the clonal proliferation of precursor cells within lymphoid organs with acquired chromosomal abnormalities. Approximately 5% of all primary malignant bone tumors are NHL, the majority of diffuse large B-cell type. Our case history can be regarded as the first published in English language reporting on a pleomorphic T-cell-lymphoma imitating a Chondropathia tuberosa (Tietze's syndrome): The tumor appeared with a tender tumescence over the sternum and a painful swollen left sterno-clavicular joint--as a rule a typical sign for Tietze's syndrome. Only sternal puncture followed by immune histology confirmed an anaplastic IgA-plasma cell tumor. The primary tumor, and later on an osteolysis of cervical vertebrae I-III with a complete destruction of the axis and an affection of the dens atlantis could not be detected by radiographic examinations. Moreover, this tumor infestation could only be depicted by the magnet resonance imaging and the computed tomography. Furthermore, other results of our report are the very rare manifestation of a T-cell lymphoma as a pedicled tumor near the pancreas or of pancreatic origin and the excellent result of an autologous stem cell transplantation. Reviewing the literature, we want to discuss the present scientific and clinical standards of diagnosis, progress and treatment of Chondropathia tuberosa and T-cell lymphoma, and we want to point out some new aspects of both diseases.

Adult↗

PubMed1975

[A misleading diagnosis of ovarian tumours in a case of paramyeloblastosis (author's transl)].

A case is reported of bilateral ovarian tumours in a 44 year-old patient, who was submitted to total hysterectomy with removal of both appendages. Preoperative laboratory investigations had not yielded any useful information. Histologically, both ovaries showed replacement of the normal tissue by sheets of undifferentiated tumour cells. A sudden rise in temperature with rigors occurred on the 8th postoperative day, in conjunction with a considerable degree of anaemia, the appearance of ascites and a massive increase in size of the liver. Shortly afterwards, 50% of the peripheral leucocytes were found to be paramyeloblasts, the total leucocyte count being 4300. Sternal puncture confirmed the diagnosis of paramyeloblastosis, which proved rapidly fatal in spite of intensive therapy with corticosteroids, antibiotics and blood transfusions. The typical picture of paramyeloblastosis with tumour formation was observed on post-mortem examination, with leukaemic invasion of the liver, spleen, lymph glands and bone marrow.

Adult↗

PubMed1975

[Preclinical form of blast leukosis].

The problem of the early diagnosis "acute" leukosis is of a great practical and theoretical interest. Lately many authors speak of "pre-leukemic syndrome" or of "pre-leukemia". In that sense the notion "acute" leukosis appears to be inaccurate and its substitution for the term "blast" leukosis is more expedient. A woman-patient with an early form of blast leukosis is described in the paper, diagnosed by a sternal puncture 18 months before the typical clinical and cytomorphological manifestations of the disease. The total pre-leukemic "stage" lasted three years, manifested with persisting anemia, acceleated RES, granulocytopenia, monocytosis. Exitus followed after the fifth month of the blast eucosis clinical manifestation.

Acute Disease↗

PubMed2000

A review of intraosseous vascular access: current status and military application.

Austere far-forward battlefield environments present numerous obstacles in providing adequate medical care to the injured solidier. In addition to logistical constraints that limit the volume of isotonic crystalloid fluids available to resuscitate the injured soldier, hypotension, environmental and tactical conditions, and/or the presence of mass casualties can combine to lead to excessive delays in obtaining vascular access. For many years, intraosseous infusion has been a rapid, reliable method of achieving vascular access under emergency conditions in children. Although intraosseous infusion in adults was used extensively in the 1930s and 1940s, and a sternal puncture kit for bone marrow infusions was a common component of emergency medical supplies during World War II, only recently have there been discussions and experimental studies to evaluate intraosseous infusions in adult medical emergencies. With some medical elements of the U.S. military having recently been reissued intraosseous devices, we thought it timely to review the literature on this technique. This review discusses the efficacy and safety of intraosseous infusions of drugs and fluids, including insertion times and flow rates achieved. Although the intent is to evaluate the feasibility of the technique in the injured soldier, literature citations from studies in children, experimental animals, and human cadavers are included to support the statements made and to offer the reader the opportunity to read the original literature.

Adult↗

PubMed1975

[Severe forms of acne with unusual clinical courses].

In two cases we could demonstrate the complications, which might appear in the clinical course of severe forms of juvenile acne. Our first case deals with a young male patient with leukaemic reaction in his peripheral blood and bone-marrow (sternal puncture) and excessively raised erythrocyte-sedimentation-rate, who developed bilateral ileo-sacral-fusion arthritis. The second case dealt with a young female patient with spondylitis and an enormously raised erythrocyte-sedimentation-rate.

Acne Vulgaris↗

PubMed2004

[Phenomenon of hyperexpression of ribosomic cistrons in bone marrow hemopoietic elements in bronchial asthma].

AIM: To study expression of ribosomic cistrons (RC) of bone marrow hemopoietic elements (BMHE) in bronchial asthma (BA). MATERIAL AND METHODS: A total of 37 bronchial asthma (BA) patients were examined. Of them, 20 ones had allergic BA (ABA) and 10--nonallergic BA (NABA). Seven patients received systemic glucocorticoid hormones (SGH). Control included cells of bone marrow from 7 healthy donors. Transcription and maturation of pre-rRNA in BMHE were analysed using bone marrow samples obtained during the sternal puncture (a modified method of Howell and Black). RESULTS: RC activity was high. It depended on BA variant and the disease phase. In ABA high RC activity persisted in remission. GCH suppress RC activity rise. The maximal effect of GCH suppressive action was seen in myeloid lineage, minimal--in erythroid one. The effect is absent in more mature erythroid cells and bone marrow lymphocytes. CONCLUSION: The phenomenon of RC activity rise in myeloid, erythroid and lymphoid lineages of the bone marrow of BA patients may reflect contribution of the bone marrow to formation of BA pathogenesis.

Asthma↗

PubMed2005

[Cardiac amyloidosis revealing multiple myeloma].

INTRODUCTION: Amyloidosis is a rare disease characterized by an extracellular accumulation of a protein polysaccharid complex (Amyloid). Cardiac involvement is considered as a major prognostic factor. OBSERVATIONS: We report the case of two women, hospitalized for heart failure. The diagnosis of cardiac amyloidosis was suggested by echocardiography: Left ventricular concentric hypertrophy and typical amyeloid infiltration with hyperechoic, shiny and granite-like aspect of the interventricular septum. The histological confirmation was obtained by gastric biopsy in the first case and biopsy of the salivary glands in the second revealing an amyloidosis AL. This cardiac amyloidosis was secondary to multiple myeloma: monoclonal Gammopathy with immunoglobulin Lambda in the first and Kappa in the second, and the presence of a plasmocyte infiltration in the sternal puncture. CONCLUSION: Amyloidosis is a rare pathology, the cardiac involvement is frequent in the type AL and can occur with or without clinical manifestations. Echocardiography should be systematic in patients with confirmed amyloidosis.

Amyloidosis↗

PubMed1976

[Early lesions of the human kidney in paraproteinemie an electron microscopic study (author's transl)].

INTRODUCTION: In paraproteinemia, especially in multiple myeloma, the origin and morphology of lesions in the kidneys still remain controversial. In many studies mostly of tissue obtained post mortem and examined with light microscopy, a discrepancy between impairment of renal function and minimal pathomorphological findings is often striking. The few studies done with the electron microscope up to now present a wide variety of morphological findings probably due to the different stages of kidney lesions examined, generally in patients with renal insufficiency and nephrotic syndrome. We have therefore tested the question whether early lesions are detectable in the nephron of patients with paraproteinemia who do not show any impairment of renal function. MATERIAL AND METHOD: Kidney biopsies were obtained from 8 patients with an average age of 58 years. 6 had multiple myeloma (3 IgG-, I IgA-, 2 Bence-Jones plasmacytoma), 1 Waldenström's disease and 1 an idiopathic paraproteinemia. Confirmation of the diagnoses was obtained by immunoelectrophoresis, bone marrow biopsy, and sternal puncture. In all cases creatinine clearance was normal and proteinuria was not increased substantially even in patients with a slight Bence-Jones-proteinuria. For electron microscopy small pieces from the renal biopsies were fixed in aldehydes followed by osmium tetroxide and embedded in Epon. The thin sections were stained with uranyl acetate followed by lead citrate...

Amyloid↗

PubMed1990

[Plasmocellular leukemia with IgD paraproteinemia].

The authors describe the case of an 80-year-old woman with a plasmocytoma IgD-lambda, which developed into plasmocellular leukaemia. The laboratory finding reminded at first of chronic lymphatic leukaemia. The correct diagnosis was assisted by marked leucocytosis with the release of a major number of plasmatic cells into the peripheral blood stream. The finding was confirmed on the basis of sternal puncture, cytochemical examination, immunochemical examination of the blood and urine and X-ray of the skull. Treatment led to marked clinical and laboratory improvement. The patient died, however, from pneumonia three months after establishment of the diagnosis. Post-mortem examination revealed an extensive infiltration of many organs and a myelomatous kidney. The authors present some differential diagnostic reflections on plasmocellular leukaemia.

Aged↗

PubMed1987

[Hematological masks of malignant neoplasms of the internal organs].

Hematological "masks" of malignant tumors of the internal organs are not infrequent in clinical practice. A total of 45 patients with malignant tumors of the internal organs (stomach-12, colon-9, liver-3, lungs-9, kidneys-6, pancreas-2, thyroid-2, bladder-1, prostate-1) were under observation. Hematological signs of bone marrow metastatic involvement were as follows: anemia (mainly hypochromic), leukemoid neutrophilic reaction, leukemoid reaction of myeloid type, erythrocytosis, thrombocytosis, plasmocyte bone marrow reaction. Early cancer diagnosis, especially in obscure peripheral blood changes, requires a complete all-round investigation of a patient including an analysis of clinico-anamnestic data, the use of radiographic and endoscopic methods, sternal puncture and trephine biopsy.

Adolescent↗

PubMed1986

[Jamshidi biopsy in clinical hematology. Method, indications and results of over 1,000 completed biopsies with special reference to chronic myeloproliferative diseases].

One thousand and five bone marrow biopsies were performed in patients with haematologic or oncologic disorders during a ten year period from 1976 to 1985 according to the method of Jamshidi and Swaim. Indications and method of biopsy are discussed in detail. Major side effects were not observed, however minor accidents (0.2%) as well as problems in yielding biopsy-material (1.6%) are reported. The rate of biopsy-failure, including biopsies with insufficient (crushed) material, was 5%. In our hands the predominant value of the Jamshidi-biopsy for diagnosis of hematologic disorders is given by the following reasons: Bone marrow histology gives a more detailed architectural picture than cytologic smears. Sampling of bone marrow for both methods (cytology and histology) through the same instrument is possible. The procedure is easily performed and gives the patient no more discomfort than a simple sternal puncture. Chronic myeloproliferative disorders (CMPD, 31%), malignant lymphomas (40%) and aplastic (hypoplastic) syndromes (4%) were the most frequent indications for bone marrow biopsy. Clinical and histological findings were compared in 235 patients with CMPD. The histological defined entity of chronic megacaryocytic-granulocytic myelosis could be differentiated easily from chronic granulocytic leukemia (CGL), however it was not always distinguishable from primary thrombocythemia by means of clinical and hematological criteria. Myelofibroses on the basis of CGL were separated from idiopathic or postpolycythemic fibroses by hematological findings. The diagnostic value of bone marrow biopsies was superior to cytology in all CMPD and proved to be an essential diagnostic method in cases with high platelet count. Marrow involvement was found in 59% of 218 previously untreated patients with non Hodgkin's lymphomas and in 9% of 123 patients with Hodgkin's disease. Jamshidi-biopsy proved to be a simple and indispensable procedure in staging of Hodgkin's and non-Hodgkin's lymphomas.

Anemia, Aplastic↗

PubMed1977

[Monocytic leukemia. Analysis of clinical and hematological data in 21 patients (author's transl)].

A clinical hematological survey is given of 21 patients with monocytic leukemia. About 1/3 of all immature cell leukoses are monocytic leukemias; a classification of the acute leucoses by enzyme histochemical methods should be attempted. Since more than half of the patients exhibited subleukemic to aleukemic peripheral leukocyte levels, the histological findings of a sternal puncture are diagnostic pointers. The bone marrow picture of monocytic leukemia is characterized by a great preponderance of atypical cell elements of the monocyte series which give a distinctly positive reaction in the non-specific esterase test. The combined use of cytostatics producing remission brought marked improvement in half the patients. Remission lasted from 2 to 8 weeks.

Acute Disease↗

PubMed1979

Correlation of hyperplasia, splenomegaly and hepatomegaly with parasite population in BIO.LP-a mice infected with Leishmania donovani.

Congenic strain of BIO.LP-a male mice were experimentally infected with Leishmania donovani 3S strain from the spleen of a hamster donor. The weight ratio of spleen body, liver body and spleen liver calculated from the weight of six mice taken at weekly intervals for a period of 49 days showed that there is no hepatomegaly or splenomegaly during the first 14 days of infection when the parasite population increases. Maximum enlargement of liver and spleen was observed at day 35 postinfection, when the parasite population had declined to 11 per cent. Slight recovery was noted at day 49 with parasites reducing to 1 per cent. It is suggested that in endemic areas of human visceral leishmaniasis a search for amastigotes should be made from the biopsy of the liver or sternal puncture during the first phase of the disease when the patients suffer from a high fever with rigors. With the enlargement of liver and spleen due to proliferative response and infiltration of plasma cells, the parasite population disappears.

Animals↗

PubMed1978

[Immunopathology in a case of kala-azar (proceedings)].

A 33 year old woman was admitted to hospital for fever of unknown origin. Leishmania donovani was found in histological preparations from lymphnodes and by sternal puncture. Circulating immune complexes present in high concentration were isolated and characterized. The circulating immune complexes remained elevated two months after the disappearance of Leishmania from the bone marrow.

Antigen-Antibody Complex↗