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Biomedical subjects

C Rozman

Publications and source records attributed to C Rozman.

At least 469 records · Page 26Linked to original sources

[Massive pulmonary embolism due to hydatid vesicles. Report of a case (author's transl)].

A patient with hepatic and peritoneal hydatidosis suffered acute episodes of restrictive bronchial disease for the last 2 years. The patient was admitted during the course of one of this acute episodes with clinical symptoms of pulmonary embolism. Supportive therapeutic measures were prescribed, but the patient died 12 hours latter. Autopsy revealed hepatic, peritoneal and pulmonary hidatidosis as well as multiple pulmonary thromboembolisms due to hydatid vesicles. Literature on this subject is reviewed, and different clinical forms and therapeutic possibilities are discussed. The importance of small therapeutic possibilities are discussed. The importance of small recurrent hydatid embolisms in the pathogenesis of acute or subacute cor pulmonale in patients with liver hydatidosis is stressed.

Acute Disease↗

Acute and chronic graft-vs-host reaction in skin: report of two cases.

The cutaneous changes of the acute form of graft-vs-host reaction are described in two patients who underwent bone marrow transplantation for treatment of severe aplastic anaemia. One patient went on to develop a chronic reaction of the lichenoid type. Histopathology confirmed the presence of 'satellite cell necrosis' from the acute stage of the disease onwards. Direct immunofluorescence showed deposits of immunoglobulin (IgG, IgM), fibrinogen and complement on the necrotic keratinocytes, whilst the basement membrane was positive for C3. These findings suggest that humoral immunity as well as cellular immunity may play a part in the production of the rash.

Acute Disease↗

Ultrastructural findings in acute and chronic graft-vs-hos reaction of the skin.

Two cases of graft-vs-host reaction (GVHR) after allogeneic bone marrow transplantation were studied by transmission electron microscopy. One was observed only in the acute phase and the other, after a mild acute reaction, showed a chronic lichen planus-like pattern. All types of skin damage described in experimental GVHR have been confirmed in both cases. Our findings indicate an involvement of aggressor lymphocytes against keratinocytes as the chief pathogenetic mechanism of the disease, even in its chronic form, although the participation of humoral factors in some phases of the disorder cannot be excluded. The participation of Langerhans cells and macrophages in the reaction could not be demonstrated in these cases.

Acantholysis↗

Lymphocyte size and survival of patients with chronic lymphocytic leukaemia (B-type).

In 57 cases of B-type chronic lymphocytic leukaemia (B-CLL), the size of peripheral blood lymphocytes was estimated by means of transmission electron microscopy. The mean lymphocyte diameter (MLD) of 50 cells was correlated with the clinical staging as well as the survival. 30 out of 38 patients found in stages 0, I, and II displayed a normal or increased MLD. Conversely, this value was decreased in 12 out of 17 cases in stages III and IV. MLD of patients in clinical stages III and IV was significantly lower as compared with MLD of patients in stages 0, I, and II (P < 0.001). The actuarial curve of 57 patients showed a roughly estimated median survival probability of 43 months. This was of more than 54 months in patients with normal or increased MLD, but only of 22 months in those with a decreased MLD. The difference between these 2 survival curves was statistically significant (P < 0.01). A reduced peripheral blood lymphocyte size, as estimated in suspension by means of transmission electron microscopy, appears to have a bad prognostic significance.

B-Lymphocytes↗

Low-dose vincristine in the treatment of corticosteroid-refractory idiopathic thrombocytopenic purpura (ITP) in non-splenectomized patients.

Eight non-splenectomized patients with corticosteroid-refractory idiopathic thrombocytopenic purpura (ITP) were treated with low-dose vincristine (1 mg/week up to a total dose of 4 mg). Complete remission was achieved in 2 cases and partial remission in 3. Bleeding stopped in one patient who failed to remit. No statistical relationship was found between the response to vincristine and the duration of the disease or the corticosteroid-therapy. Side effects were only observed in one patient. By comparing these results with those reported in the literature, it can be inferred that low-dose vincristine may be useful in the management of corticosteroid-refractory ITP.

Adolescent↗

Thrombocytosis in quiescent chronic granulocytic leukaemia after vincristine and 6-mercaptopurine therapy.

In an attempt to retard the appearance of blastic transformation 11 patients recently diagnosed with chronic granulocytic leukaemia were given courses of vincristine and 6-mercaptopurine after stabilization of the disease by busulfan. In 4 of the patients a marked thrombocytosis developed shortly after the administration of such courses. When we compared the clinical and biological features at the moment of diagnosis, the patients in whom thrombocytosis developed after vincristine and 6-mercaptopurine courses showed higher platelet counts and a smaller spleen size than the other ones, although no statistical significance was reached. A possible thrombocytopoietic effect of vincristine is discussed.

Adolescent↗

[Value of hemophagocytosis in the morphological examination of the bone marrow (author's transl)].

The hemophagocytosis or the process of ingestion of blood cells by phagocytes and macrophages of the mononuclear phagocytic system (MFS), is a phenomenon that rarely could be observed in the morphological examination of the bone marrow aspirate. Occasionally it is present in certain pathologic conditions such as, malignant histiocitosis, autimmune hemolytic anemia, or some chronic inflammatory diseases. The capacity of ingestion is not an exlusive property of the phagocytes and macrophages of the MFS, so that different neoplastic cells can show it too. This study analyzes the presence of hemophagocytosis by neoplastic cells in a total of 552 bone marrow aspirates corresponding to a series of 130 patients with acute leukemia and 422 patients with diverse solid tumors. In the group of patients with acute leukemia, hemophagocytosis by blastic cells was observed in five cases with acute monocytic leukemia. In the other group with solid tumors, hemophagocytosis was present in three patients with oat-cell lung carcinomas and diffuse bone marrow metastases. The interest of the evaluation of hemophagocytosis by neoplastic cells in the morphological examination of the bone marrow is stressed, as well as it possible value in the cytological diagnosis of acute monocytic leukemia. However, in these circumstances a sdiffuse metastases by solid tumors should be always discarded, since their cytomorphological characteristics are in most cases superimposed to those of the leukemic bone marrow infiltrate.

Bone Marrow↗

[Endocarditis by Coxiella burnetti. A chronic form of Q fever. Report of one case (author's transl)].

The authors describe a case of chronic endocarditis by Q fever, in a patient who had been operated for coarctation of the aorta twelve years previously and at the same time was carrier of a congenital bivalve aorta. The clinical picture was suggestive of subacute endocarditis, but the blood culture was negative repeatedly. There was also a prolonged and relapsing febrile syndrome over a period of one-year-and-a-half. The following data are also worthy of note: the coexistence of a liver disorder and a focal and segmentary glomerulonephritis. Based on some recent publications (one by the same group) the authors feel that Coxiellosis burnetti must be more frequent in their environment than is suspected.

Adult↗

[Chronic lymphoid leukemia. Survival in relation to clinical stages. Statistical analysis of 95 cases (author's transl)].

The prognosis of patients with chronic lymphocytic leukemia is very difficult to evaluate. The classification system by stages, which at the present time is the most simple and useful method for the prognosis of this disease, recognizes five degrees of involvement: stage 0 (medullary and peripheral lymphocytosis); stage I (lymphocytosis + enlarged lymph nodes); stage II (lymphocyosis + hepato-and/or splenomegaly); stage III (lymphocytosis + anemia), and stage IV (lymphocytosis + thrombocytopenia). In the present report 95 controlled patients at the Farreras Valentí School of Hematology are analyzed using the classification by stages; there were 19 cases in stage 0; 16 in stage I; 30 in stage II; 21 in stage III, and 9 in stage IV. The mean survival rate in the global series was 63 months and the average 90.9 months. As in other series, it was observed that patients in stages 0 and I have a much better prognosis than those in stages III and IV. Stage II occupies an intermediate position in relation to prognosis, since the actuarial survival figure for this stage can practically be superimposed on that of the global series. The classification of chronic lymphocytic leukemia by stages permits the specification of the therapeutic indications for this condition; it also encourages the search for new modalities of treatment for stages with poor prognosis, since in these cases chronic lymphocytic leukemia behaves in the manner of an acute or subacute hemopathy.

Adult↗

Chronic myelomonocytic leukemia associated with hereditary pyruvate kinase deficiency and multiple acquired erythrocyte abnormalities.

A congenital erythrocyte pyruvate kinase (PK) deficiency was found in a 72-year old female patient with chronic myelomonocytic leukemia (CMML). Erythrocyte PK deficiency was associated with an increase in the activity of hexokinase, 6-phosphogluconate dehydrogenase and glutathione peroxidase in erythrocytes as well as a decrease in acetylcholinesterase, glutathione reductase and glucosephosphate isomerase activities. The enzymatic abnormalities were accompanied by alterations in hemoglobin and in i antigen content of erythrocyte membrane. In addition, bone marrow ultrastructural studies showed dyshemopoietic changes in all blood cell lines and especially in erythroblasts. The present findings confirm the close relationship between CMML and acquired dyserythropoietic syndromes and constitute a new observation of the infrequent association of hereditary erythrocyte enzymopathies and leukemia. A survey of the literature is presented.

Acetylcholinesterase↗