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Biomedical subjects

E Feliu

Publications and source records attributed to E Feliu.

At least 91 records · Page 5Linked to original sources
PubMed1993

Stereological study of human bone marrow adipocytes. A comparison of four methods for estimating size distributions.

Several methods are available for estimating size distributions of spherical objects in tissue sections. In this article a comparative study of four stereological techniques applied to human bone marrow adipocytes was carried out. In the first part, four stereological methods (Giger-Riedwyl, Saltykov, Wicksell, and Cruz-Orive) were used for the evaluation of adipocyte size in a set of 50 human bone marrow specimens (20 normal controls, 10 aplastic, 10 hyperplastic and 10 dysplastic bone marrows). In the second part, a computer simulation model was employed for generating both control and test populations. The latter were analyzed by means of the four stereological methods and compared to the control. When applied to bone marrow specimens, no statistically significant differences were seen among the four methods. Results were very close between the Giger-Riedwyl and Saltykov methods, and between the Wicksell and Cruz-Orive methods. In the simulation model, Saltykov's method was the most accurate stereological technique for the studied conditions. Additional advantages of this method are that the assumption of Gaussian distribution is not required, and that a higher relative weight is assigned to the largest classes, in which accurate definition is easier in the microphotographs. However, since the differences among the four methods are very small, they may all be considered as valid for the stereological study of human bone marrow adipocytes.

Adipocytes↗
PubMed1993

Comparative study of spleen pathology in drug abusers with thrombocytopenia related to human immunodeficiency virus infection and in patients with idiopathic thrombocytopenic purpura. A morphometric, immunohistochemical, and ultrastructural study.

A morphometric and immunohistochemical study was performed to assess the spleen's alterations in patients with autoimmune thrombocytopenia and in drug abusers with thrombocytopenia (DAT) related to human immunodeficiency virus (HIV) infection. A total of 34 patients were included in the study: 20 DAT patients and 14 with idiopathic thrombocytopenic purpura (ITP). Twenty HIV-negative splenectomy patients without thrombocytopenia were included as controls. Spleen weight in DAT patients (323.25 +/- 149.96 g, mean + standard deviation) was significantly increased compared with the ITP (164.28 +/- 29.79 g, P < 0.0001) and control (175.50 +/- 49.14 g, P < 0.0001) groups. The mean diameter of lymphoid follicles in the spleens of DAT patients (446.83 +/- 99.16 microns, was significantly higher than in those of the control patients (370.87 +/- 55.30 microns, P = 0.019). In control patients' spleens, the number of platelets in Billroth's cords was significantly higher (59.54 +/- 32.72/10(4) microns 2) than in those of the DAT (2.13 +/- 1.42/10(4) microns 2, P < 0.0001) and ITP (P < 0.0001) patients. The number of macrophages and ceroid histiocytes per 10(4) microns 2 of red pulp was significantly increased in both DAT (5.14 +/- 1.90) and ITP (7.48 +/- 4.38) patients compared with the control patients (3.66 +/- 1.10, P < 0.0001) and P = 0.06, respectively), and in ITP patients compared with DAT patients (P = 0.0136). The number of granulopoietic precursors per 10(4) microns 2 of red pulp was higher in the spleens of DAT (1.41 +2- 1.46, P < 0.0001) and ITP (0.92 +/- 0.75, P < 0.0001) patients compared with those of the control group. Transmission electron microscopy studies demonstrated platelet phagocytosis by macrophages of Billroth's cords and presence of myeloid metaplasia in spleens of DAT and ITP patients. Immunohistochemical studies showed a depletion of CD4+ lymphocytes in the T zone of splenic white pulp and an increased number of CD8+ lymphocytes in red pulp of DAT patients' spleens compared with those of ITP and control patients. There were no significant alterations in dendritic reticular cell network in the DAT group compared with the ITP and control groups.

Adolescent↗
PubMed1993

B-type large-cell primary splenic lymphoma with massive involvement of the red pulp.

A B-type large-cell primary splenic lymphoma with massive red-pulp involvement was diagnosed in a 64-year-old woman presenting with malaise, fever, anemia, atypical lymphoid cells in peripheral blood, and splenomegaly. This case differs from most splenic lymphomas both macroscopically and microscopically. At macroscopic examination, the spleen was homogeneously red without tumoral nodules or masses. Microscopically, the cords of the red pulp were extensively invaded by tumor cells maintaining patient sinuses. The white pulp was reduced by expansion of the red pulp. To our knowledge only few additional cases of splenic lymphoma with similar features have been previously described. The differential diagnosis of this unusual form of lymphoma with other lymphoproliferative disorders is briefly discussed.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1993

Electron microscopic identification of parvovirus virions in erythroid and granulocytic-line cells in a patient with human parvovirus B19 induced pancytopenia.

In this short report we describe a patient with human parvovirus B19 (HPV B19)-induced transient pancytopenia. Parvovirus virions were seen by electron microscopy in both erythroid and granulocytic precursors. Erythroid cells are not the only targets in these cases. We draw attention to this disorder so that physicians involved with hematological disorders and transplantation be more aware of this infection.

Adult↗
PubMed1993

[Acute basophilic leukemia with an intense erythroblastic reaction].

A patient is presented who had acute basophilic leukaemia with intense erythroblastic reaction. The patient, a 66 year-old man, complained of general malaise, increased abdominal perimeter and melena. Leucocytosis, as well as severe anaemia and thrombocytopenia, were found in his peripheral blood. Basophils were present in all maturation stages, along with 7% blast-cells showing basophilic stippling, and there were 210 erythroblasts per 100 white cells. Erythropoietic hyperplasia (75%) was found in the bone-marrow aspirate, without dyserythropoietic signs; the PAS-stain reaction was negative. Of the non-erythroid cells, 63% were basophils and 34% blast-cells, some of them showing basophilic stippling plus metachromasia for tholuidin-blue, positivity for omegaexonuclease and negativity for peroxidase stains. The diagnosis of acute basophilic leukaemia was confirmed upon demonstration of basophilic stippling in the ultrastructural study of the blast-cells. The patient developed acute liver failure and renal insufficiency which led him to death. The basis of the diagnosis of acute basophilic leukaemia is discussed, as well as the differential diagnosis with other conditions presenting with basophilia and the probably reactive erythroblastic increase appearing in this case.

Aged↗
PubMed1993

[The adaptation of human bone marrow adipose tissue to various degrees of hematopoietic cellularity].

PURPOSE: To assess whether the variations in the number and size of the adipocytes are proportional, or not, to the changes of the fat tissue fraction (FF) associated to different degrees of hematopoietic cellularity of the bone-marrow. MATERIAL AND METHODS: The material was made up of 28 specimens of bone marrow biopsy, from which 265 microscopic fields representing a wide range of FF were obtained. As index of proportionality, the ratio N/S (adipocyte number/size) was employed. RESULTS: The parameters FF and N/S showed a highly significant correlation (r = 0.89; p = 0.00000003) at low-normal FF range (< 40%), whereas at high FF range (> 40%), such a correlation was lacking (r = 0.01; p = 0.86). CONCLUSION: At low-normal FF the adipocyte number and size vary proportionally. Conversely, at high FF, in some cases a more marked increase of number and in other instances of adipocyte size is detected. Further investigations are needed to find out the responsible factors for this different behaviour.

Adaptation, Physiological↗
PubMed1993

[Splenic lymphoma with circulating villous lymphocytes. Study of 6 patients].

PURPOSE: Splenic lymphoma with circulating villous lymphocytes (SLCVL) is a rare chronic B-type lymphoproliferative disorder, few series having been reported thus far. The major clinical, cytological, immunophenotypic and ultrastructural features, as well as the course and treatment of six cases seen in three hospitals of the Barcelona area in six years are reported herein. METHODS: The criteria of Melo et al were followed for the diagnosis of SLCVL. The clinical manifestations at onset and the morphology of lymphocytes from blood and bone-marrow (aspiration and biopsy samples) were analysed. The samples were subjected to cytochemical (acid phosphatase and L-tartaric acid inhibition), immunophenotypic (alkaline immunophosphatase and immunofluorescence) and ultrastructural studies. The histologic study of the spleen of those patients who underwent splenectomy was also performed. RESULTS: The median age of the series was 63 years (range: 45-86). Five of the patients were women. Anaemia was the commonest clinical finding at onset, and splenomegaly was found in all cases. Villous lymphocytes were found in both peripheral blood, 3% to 85%, and bone-marrow, 31% to 70%; they showed diffuse positivity to acid phosphatase stain, this being inhibited in all cases by L-tartaric acid. None of the patients had associated monoclonal gammopathy. Bone-marrow biopsy was performed in five occasions, showing nodular infiltrative pattern in three cases, interstitial in one and diffuse pattern in another. Nodular infiltration was seen in the white pulp of spleen, with no involvement of the red pulp. The ultrastructural study of villous lymphocytes from peripheral blood or bone-marrow disclosed short, slim villi with narrow bases, no lamellar ribosomal complexes being found. Mature B-type lymphocyte proliferation was present in all instances, showing positivity for surface immunoglobulin; monoclonal antibody CD25 was negative in all cases. Three patients underwent splenectomy, and the remainders received no treatment. The expected survival at three years was 80%. CONCLUSIONS: SLCVL is a rare B-cell chronic lymphoproliferative disorder with recognised morphologic and immunophenotypic characteristics that make it distinguishable from other B-type lymphoproliferative diseases especially hairy cell leukaemia. Its clinical course is chronic and it has good prognosis. Response to splenectomy is usually favourable, although remission of the disease is not achieved.

Actuarial Analysis↗
PubMed1993

Immunophenotypic characteristics of blast crisis of chronic myeloid leukaemia: correlations with clinico-biological features and survival.

Blast cells from 40 patients with Philadelphia-positive chronic myeloid leukaemia (CML) in blast crisis were analysed by immunophenotypic methods. In 27 cases, BCR gene studies were also performed. By light microscopy morphology and cytochemistry the cases were classified as follows: undifferentiated (n = 7; 17.5%), myeloid (n = 27; 67.5%), and lymphoid (n = 6; 15%). On the basis of the immunological markers, the cases were reclassified as: myeloid (n = 17; 42.5%), megakaryoblastic (n = 17; 42.5%), and lymphoid (n = 6; 15%). The seven cases initially considered as undifferentiated by morphological and conventional cytochemical criteria were classified as myeloid (four cases) and megakaryoblastic (three cases) by marker analysis. The monoclonal antibody anti-myeloperoxidase (anti-MPO) was the most sensitive myeloid associated marker in these cases, being positive in five of them. A significant proportion (27%) of non-lymphoid blast crisis cases were CD7-positive, and myeloid markers were positive in the four lymphoid CML-CB cases studied. Analysis of the clinico-haematological characteristics on the various subgroups of patients showed that patients with lymphoid blast crisis had shorter duration of the chronic phase, more frequent extramedullary blastic involvement, more favourable response to therapy, and longer survival. Finally, a trend for an association between megakaryoblastic involvement of blast crisis and breakpoint localization in the 3' extreme of the M-bcr segment was also noted.

Adolescent↗
PubMed1993

Sequential study of myeloid differentiation antigens of neutrophil granulocytes in different phases of chronic myeloid leukaemia: natural history and prognostic significance.

In an attempt to contribute to the knowledge of the natural history of Philadelphia-chromosome-positive chronic myeloid leukaemia (CML) and its prognosis, we analyzed sequentially the myeloid differentiation antigens of peripheral blood neutrophil granulocytes (NG) in different evolutive stages of the disease. Four monoclonal antibodies (CD15, CD24, 31D8, and 13F6) were used, and a total number of 116 sequential studies were performed in 43 patients. At diagnosis, there is a significant decrease of NG expressing myeloid differentiation antigens, which recover to nearly normal levels after initial control of the disease. The onset reduction is probably due to the circulation of incompletely mature NG. In accelerated/blastic phase NG expressing myeloid differentiation antigens decrease again, probably due to a true antigen loss. This reduction could herald by a few months the development of accelerated/blastic phase. In such a case, its predictive strength is higher than that of the well recognized initial prognostic parameters in CML. These results indicate that the sequential study of NG myeloid differentiation antigens may contribute to both a better understanding of the natural history of CML and the evolutive prognosis of this disease.

Adult↗
PubMed1993

Ph-positive chronic myeloid leukemia mimicking essential thrombocythemia and terminating into megakaryoblastic blast crisis: report of two cases with molecular studies.

Two patients with chronic myeloid leukemia (CML) presenting with the hematologic features of essential thrombocythemia (ET) are reported. At diagnosis they showed extremely high platelet counts (4985 and 2800 x 10(9)/l, respectively) and moderate leukocytosis (21 and 17 x 10(9)/l, respectively). In both cases, in addition to the Philadelphia chromosome (Ph), a rearrangement within the major breakpoint cluster region on chromosome 22 was demonstrated, with the breakpoint in the 3' extreme. In patient 1 the disease initially responded to radioactive phosphorus and hydroxyurea, but during the evolutive course a progressive increase in the white blood cell counts was noted, reaching values typical of the chronic phase of CML, and the patient eventually died from blast crisis 45 months after diagnosis. In patient 2, although good control of the platelet counts was achieved with hydroxyurea, the disease also evolved into a blast crisis four months after diagnosis. In both cases monoclonal antibodies and electron microscopy studies demonstrated the megakaryocytic nature of the blast cells. The above features are not consistent with the present and similar cases being Ph-positive ET. Instead, they should be regarded as a special form of CML characterized by a marked protagonism of the megakaryocytic component.

Aged↗
PubMed1993

[Adaptation of human bone marrow adipose tissue to different grades of hemopoietic cellularity].

PURPOSE: To assess whether the variations in the number and size of the adipocytes are proportional, or not, to the changes of the fat tissue fraction (FF) associated to different degrees of hematopoietic cellularity of the bone-marrow. MATERIAL AND METHODS: The material was made up of 28 specimens of bone marrow biopsy, from which 265 microscopic fields representing a wide range of FF were obtained. As index of proportionality, the ratio N/S (adipocyte number/size) was employed. RESULTS: The parameters FF and N/S showed a highly significant correlation (r = 0.89; p = 0.00000003) at low-normal FF range (< 40%), whereas at high FF range (> 40%), such a correlation was lacking (r = 0.01; p = 0.86). CONCLUSION: At low-normal FF the adipocyte number and size vary proportionally. Conversely, at high FF, in some cases a more marked increase of number and in other instances of adipocyte size is detected. Further investigations are needed to find out the responsible factors for this different behaviour.

Adipose Tissue↗
PubMed1993

[Evaluation of the System 9000-AX autoanalyzer].

PURPOSE: The aim of this study was to evaluate the haematologic autoanalyser System-9000 AX (Serono-Baker Diagnostics), which provides 15 parameters of red, white and platelet series and three histograms showing the cellular distribution curves according to the volume of each series. MATERIAL AND METHODS: The accuracy, precision, linearity, carry-over, effective speed and the effect of sample storage on results were studied. Moreover, the leucocyte differential count (LDC), false positive and negative results of the automated differential count and sensitivity, specificity and efficiency of LDC were analysed and compared with conventional methods: a Coulter VCS analyser and a Coulter S-Plus STKR. RESULTS: The accuracy of the results of three haematologic series was very good. In the LDC, the results for the middle and big cells were better in comparison with the manual method (r > 0.80) than the Coulter VCS, (r = 0.28 and 0.48 respectively). The percentage of LDC revisions and the false negative was higher in hospitalized patients than in outpatients (28.14 and 8.46% versus 12.56 and 2.18%). The most common anomalies were the left deviation, monocytosis and eosinophilia. The results of sensitivity, specificity and efficiency were greater than 80% in all cases, except for the sensitivity and efficiency of hospitalized patients, because of the greater number of false negatives. Precision and linearity were excellent in all the parameters studied. No significant contamination was observed among the samples (low carry-over percentage). The samples were stable for 24 hours at 4 degrees C. CONCLUSION: The System 9000 AX is a reliable analyser, which is fast and easy to operate. These characteristics allow this analyser to be a very useful tool for laboratories that require a rapid testing of samples.

Blood Cell Count↗
PubMed1992

[Primary gastrointestinal lymphoma: a study of 25 cases].

BACKGROUND: The digestive tract constitutes the most frequent localization of the extranodular non Hodgkin's lymphoma. The chief clinical and histological characteristics were analyzed as were the evolution and response to treatment of 25 patients diagnosed with primary gastrointestinal lymphoma (PGIL) in one center over a period of eight years. METHODS: To establish the diagnosis of PGIL the Dawson criteria were used and the state was determined by the Ann-Arbor classification modified by Musshoff. To histologically classify of the PGIL the Working Formulation was followed. The influence of the clinical, histological characteristics and the state of the obtention of complete remission (CR), the survival free period of the disease (SFD) and global survival (GS) were analyzed. RESULTS: The mean age of the series was 56 years (standard deviation 15 years) (12 males). The most frequent localization was gastric followed by the small intestine and the large intestine. Abdominal pain and weight loss were the most frequent clinical manifestations in the PGIL, regardless of its site. In 12 patients the PGIL was of an intermediate grade of malignancy, 8 were of low grade and 5 of high grade. The state was IE in 11 patients, IE1 in 9 and IIE2 in 5. The most used treatment was radical surgery followed by polychemotherapy. Complete remission was obtained in 15 patients and 2 recurred. The foreseen SFP at 7 years was 69% of the cases and GS was 53%. In IE state patients was most frequently obtained and GS was also more prolonged in these patients. CONCLUSIONS: In the present series the gastric localization of patients with primary gastrointestinal lymphoma was more frequent than intestinal localization. The HNL of intermediate and high grades of malignancy predominated those of low grade. The prognosis of patients with primary gastrointestinal lymphoma in a IE state was more favorable than the remaining patients. In turn, surgery constituted a good option in the initial treatment of patients with primary gastrointestinal lymphoma.

Adult↗