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At least 379 records · Page 21Linked to original sources
PubMed1984

[Significance of hematoma irrigation with trephination therapy (HITT) in the management of acute subdural hematoma].

Decompressive craniectomy in the management of acute traumatic subdural hematoma (acute SDH) has been advocated as a treatment for the cerebral edema or swelling associated with it. The bony decompression with dural grafting seems successful in some patients, but surely enhances cerebral swelling and exacerbates edema in others. Whether the external or internal decompression could be justified is therefore a subject of controversy for the surgical treatment of choice. The authors, herein, proposed the new method with small craniectomy, 3 cm in diameter and irrigation with Nelaton's catheter for acute SDH with cerebral edema or swelling, that is the hematoma irrigation with trephination therapy (HITT) and performed it in 27 adult cases, 19 to 84 years of age (20 males and 7 females), who were transported within 24 hours after trauma and hospitalized in Department of Emergency Medicine, University of Tokyo Hospital during the period from January, 1982 to January, 1984, whose Glasgow coma scale points were 3 to 8 on admission, 16 cases (59%) of whom showed unilateral or bilateral absence of light reflex. The patients were all placed under the intensive care, using artificial ventilation (27 cases, 100%), hemodynamic management with Swan-Ganz catheter insertion (10 cases, 37%), continuous intracranial pressure monitoring (27 cases, 100%) and barbiturate therapy (13 cases, 48%). Ten cases (37%) recovered, 3 (11%) fell in vegetative state, 2 of whom died of medical complications afterwards and 14 (52%) could not avoid progressive deterioration to result in brain death.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1984

Histopathological trephine biopsy findings in cases of 'dry tap' bone marrow aspirations.

Out of 3,173 bone marrow biopsies, we found 138 cases (4.3%) of 'dry tap' aspirations: 35/218 (16%) acute leukemias, 44/445 (9.8%) myeloproliferative syndromes, 29/328 (8.8%) malignant lymphomas and Hodgkin's diseases, 10/208 (4.8%) myelomas and 10/74 (13.5%) metastatic carcinomas. Histology showed that the most common changes associated with scanty yield aspirations were bone marrow fibrosis (patchy or diffuse) and hypercellularity (especially if due to immature cells). None of the 'dry tap' cases showed normal bone marrow by trephine biopsy. It is concluded that the finding of a 'dry tap' should never be dismissed as being due to faulty technique and always needs a bone marrow biopsy.

Biopsy, Needle↗
PubMed1980

A disposable corneal trephine.

Postoperative astigmatism might be reduced in penetrating keratoplasty if surgeons could cut a straight-sided round hole in the recipient cornea and place in that hole a round donor button also having straight sides. We present a disposable trephine which assists in cutting a perfect graft by supporting the cornea with a suction ring while an uncommonly sharp, round blade traverses the tissue.

Corneal Transplantation↗
PubMed1994

Three-dimensional reconstruction of histologic structures in human bone marrow from serial sections of trephine biopsies. Spatial appearance of sinusoidal vessels in primary (idiopathic) osteomyelofibrosis.

Computer-based three-dimensional (3D) reconstruction of histologic features permits the assessment of the spatial arrangement of complex structures and has the additional advantage of demonstrating aspects that may be obscured in conventional, two-dimensional evaluations. Until now the spatial appearance of histotopographic details in human bone marrow has not been investigated. In the present study we explored the use of 3D visualization techniques to determine the configuration of sinusoidal vessels and surrounding megakaryocytes in osteomyelofibrosis. Up to 34 serial sections were cut from each trephine biopsy block and stained sequentially by monoclonal antibodies against collagen type IV and megakaryocytes (CD61-Y2/51) to discriminate relevant structures selectively and with high contrast. Images were digitized, and contours were traced manually. A new fast and graphically interactive software package for the reconstruction of 3D objects employing a low-cost personal computer was developed. The system allows reconstructions from any serial image in solid model form using a fast triangulation algorithm. 3D reconstruction emphasizes the close spatial relationship between sinus walls and megakaryocytes in this disorder and exhibits enhanced vascularity with a complex 3D meshwork of branching and tortuous sinusoidal vessels. Furthermore, an increase in luminal distention and aberration from normal shape could be observed. Large and ameboid megakaryocytes were frequently found adjacent to the abluminal surface of the sinus. The method described permits more elaborate insight into the complex topographic relationship of these two morphologic features in human bone marrow and may stimulate applications to other interesting specimens that warrant 3D visualization.

Biopsy↗
PubMed1994

[Fixation and decalcification in trephination biopsy].

We tested several modifications of paraffin embedding technique when examining bone marrow biopsies in order to achieve an optimal combination of morphology and antigen preservation. Short pre-fixation in formalin followed by mixture of formalin and 10% formic acid were found optimal for quick tissue processing where electron microscopy was not planned. Formalin pre-fixation prevents the occurrence of imperfect stainability of superficial parts of trephine cylinders caused by an effect of formic acid on non-fixed bone marrow tissues. Decalcification in mixture of formol and EDTA is recommended if there is time enough. The supersensitive streptavidin-biotin detection system with alkaline phosphatase was found to provide the best results.

Biopsy↗
PubMed1993

[Value of bone marrow trephine biopsy in evaluating the extent of small cell lung cancer].

Bone marrow metastases using Jamshidi needle were found before treatment in 28 of 146 small cell lung cancer patients (19.2%). Bone marrow was a sole site of distant metastases in 3.4% of all cases and in 8.2% of those with no metastases in other organs. Patients with bone marrow involvement had more often metastases in 3 or more organs and had significantly more often liver metastases as well. Bone marrow infiltration was more often observed in patients with poor performance status and with disseminated disease, but was also found in 4 of 47 patients with good performance status and without metastases in other organs. Bone marrow trephine biopsy should be included in staging procedure in small cell lung cancer patients with good performance status, without metastases in other organs and with abnormalities in peripheral blood picture.

Adult↗
PubMed1993

[Percutaneous trephine for vertebral biopsy].

We performed percutaneous vertebral biopsy on 18 patients (March 1978 to March 1992) using a Craig trephine needle under fluoroscopic control, a more reliable and safer procedure than open vertebral body biopsy. Material for histopathologic examination was obtained in 17 of the 18 patients and there were no complications. Possible complications involve mostly in the cervical and dorsal spine. They can be prevented by using very precise and delicate technique under reliable fluoroscopic control in the operating room.

Adolescent↗
PubMed1995

Trephine colostomy: a warning.

A case of trephine colostomy is presented in which air insufflation incorrectly identified the distal limb. Disaster was averted by correct identification at laparotomy. The probable cause of the error and methods of avoidance are discussed.

Colostomy↗
PubMedDate not supplied

Bone marrow involvement in lymphoblastic lymphoma and small non-cleaved cell lymphoma: the role of trephine biopsy.

Trephine biopsy (TB) combined with bone marrow aspiration (BMA) is the most common method for evaluating bone marrow (BM) involvement in non-Hodgkin's lymphomas. Nevertheless, the role of TB in high-grade lymphomas remains controversial. We reviewed the results of 42 consecutive BMAs and TBs performed simultaneously in 29 patients with lymphoblastic lymphoma (LL) and small, non-cleaved cell lymphoma (SNCL). In LL, 8M involvement was documented in 35.4% of the cases by BMA and 22.5% of the cases by TB. In SNCL it was documented in 45.4% of the cases by BMA and 36.3% by TB. There were no statistically significant differences (p > 0.05) in the rates of BM involvement found by TB or BMA in the two types of lymphoma, although BMA appeared to be more sensitive than TB. These observations suggest that routine TB may not be necessary in assessing BM involvement in patients with LL and SNCL.

Biopsy, Needle↗
PubMedDate not supplied

Classification of acute myeloid leukaemia in trephine biopsies with special reference to lactoferrin.

In spite of advances in immunohistochemical techniques, the histological subclassification of acute myeloid leukaemia (AML) in bone marrow biopsy has remained difficult. In particular, the translation of the diagnostic criteria of the French-American-British (FAB) cooperative group as primarily defined by bone marrow cytology into histology poses considerable problems. In this study, we investigated the expression of lactoferrin (LF) in various subtypes of AML and studied the usefulness of its immunohistochemical detection combined with a panel of antibodies directed against myeloperoxidase (MPOX), lysozyme (LYS), CD34 and naphthol-AS-D-chloroacetate esterase (NACE) staining in solving this problem. Trephine biopsies of 52 cases of AML were selected for histological evaluation in comparison to bone marrow aspirates classified according to FAB (M1 n = 10, M2 n = 7, M3 n = 11, M4 n = 13 and M5 n = 11). The results obtained confirmed the specificity of LF as a marker for secondary granules in neutrophilic myeloid cells and as a tool to subclassify AML. Its parallel application with (immuno-)staining for MPOX, LYS and NACE has allowed the identification of M1, M3, M5 cases, where there LF is lacking. Typically M2 is characterized by a subpopulation of LF-positive cells which tend to display a myelocytic differentiation. However, M4 shows a heterogeneous expression pattern of LF: M4a may be defined as more immature variant without LF expression while in M4b a more mature myeloid subpopulation stains positive for LF.

Adult↗