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Biomedical subjects

K Rhyner

Publications and source records attributed to K Rhyner.

85 records · Page 5Linked to original sources
PubMed1977

[Hairy-cell leukemia with osteolytic bone changes].

Spontaneous bone fractures and/or focal osteolytic lesions were observed in three patients with morphologically and cytochemically confirmed hairy-cell leukemia 1-3 years after diagnosis and splenectomy. In a bone biopsy obtained from the body of the 12th thoracic vertebra light microscopy revealed a medullary osteopathy, the marrow cavities being infiltrated by a uniform population of rounded or slightly elongated cells. In addition, focal osteolytic lesions were observed on the trabeculae. Ultrastructurally, the cellular infiltrates consisted of reticulum cells, few mature and immature plasmocytes and numerous typical hairy cells with or without ribosome-lamella complexes. These observations demonstrate that hairy-cell leukemia may be associated with severe bone lesions similar to those observed in plasmocytoma. Moreover, these findings support the hypothesis that the hairy cell is a leukemic cell with B-lymphocyte properties.

Adult↗
PubMed1977

[Juvenile diabetes, tapeto-retinal degeneration, neurogenic hearing disorder (Alström syndrome), associated with congenital dyserythropoietic type III anemia].

The case is reported of a 32 year old female with diabetes mellitus, tapeto-retinal degeneration and neurogenous deafness combined with congenital dyserythropoietic anemia. The ophthalmological, otological, neurological and hematological findings are discussed and compared with those in the literature. Light microscopic and ultrastructural aspects of erythroblasts in congenital dyserythropoiesis of type III are shown. With the exception of the congenital dyserythropoietic anemia, the clinical findings cn be attributed to Alström syndrome.

Adult↗
PubMed1975

[Hemolysis and hemolysis mechanisms in congenital dyserythropoietic anemia (CDA) of type I. II., III].

On the basis of clinical symptoms, bone marrow morphology, electronmicroscopy and serological tests congenital dyserythropoietic anemia (CDA) was diagnosed in 3 families and identified as CDA type I, II, III respectively. Aside from intramedullary hemolysis, members of all three families showed peripheral hemolysis, in some cases severe, which was mediated through splenic (in all types) and additional intravascular destruction in types I and II. The underlying cause of the peripheral hemolysis appears to be reduced deformability of erythrocytes, as documented by reduced filterability. The latter appears to be caused, at least in type II, by an increase in viscosity of the cytoplasm which in turn is probably related to increased susceptibility to oxidative injury leading to inclusion body formation. Splenectomy in one patient with CDA II led to a definite reduction of hemolysis and cessation of hemolytic crises.

Anemia, Aplastic↗
PubMedDate not supplied

Initial treatment of sepsis in non-neutropenic patients: ceftazidime alone versus 'best guess' combined antibiotic therapy.

We conducted a prospective, randomized, multicentric study in community hospitals. Patients with clinical sepsis, rectal temperature > or = 38 degrees C and pulse rate > or = 100 bpm were randomized to receive ceftazidime (group CAZ) or a combination of antibiotics freely chosen by the clinician following his 'best guess' (group COMB). On specified grounds, the clinician could also treat patients in an open group with a free combination of antibiotics (group OPEN). The severity of disease at study admission was assessed by a clinical estimation and an Apache II score. There were 128 patients included: 56 randomized in group CAZ, 50 in group COMB, and 22 in the OPEN group. Ninety-one patients were evaluable: 41 in group CAZ, 30 in group COMB, 20 in OPEN group. At the end of the period of empirical treatment (48-72 h), the clinical success rates (improvement of status) were 93, 93 and 75% (p for group OPEN vs. groups CAZ or COMB: 0.10). The bacteriological success rates (sterile blood cultures) were 91, 88 and 80% (p not significant). mean Apache II score was 16.7 and the score correlated significantly with outcome, as did clinical evaluation. In conclusion, ceftazidime alone was a safe antibiotic therapy in this study and we could not demonstrate a superiority of a combined antibiotic therapy chosen by the clinician following his 'best guess' over ceftazidime.

APACHE↗