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Haematologica. 2000 Nov;85(11):1211-3.
Isolated spleen agenesis: a rare cause of thrombocytosis mimicking essential thrombocythemia.
Chanet V, Tournilhac O, Dieu-Bellamy V, Boiret N, Spitz P, Baud O, Darcha C, Travade P, Laurichesse H.
Federation des Maladies Infectieuses, Medecine interne et Hematologie Adultes, Hopital Hotel Dieu, Clermont-Ferrand, France.
Thrombocytosis is a common feature of myeloproliferative disorders but may also result from various conditions including chronic iron deficiency, hemorrhage, chronic inflammation and splenectomy. We report two cases of secondary thrombocytosis caused by isolated and congenital asplenia, mimicking essential thrombocythemia. These two adult cases of spleen agenesis were unexpected. We conclude that in thrombocytosis without clinical evidence of splenomegaly, attentive screening of blood in search of Howell-Jolly bodies and abdominal ultrasonography should always be performed not only to detect mild spleen enlargement but also to make sure of the presence of this organ.
Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11064471&dopt=Abstract hemorrhage
Heart Surg Forum. 2000;3(1):56-61.
The use of a novel tissue sealant as a hemostatic adjunct in cardiac surgery.
White JK, Titus JS, Tanabe H, Aretz HT, Torchiana DF.
Division of Cardiac Surgery and Department of Pathology, Massachusetts General Hospital, Boston, MA 02114, USA.
BACKGROUND: In spite of advances in the management of bleeding associated with cardiac surgery, hemorrhage remains a troublesome problem, particularly in complex cases and high risk patients. In minimally invasive cardiac surgery, limited exposure and tight quarters may make accurate suturing difficult, and increase the risk of surgical bleeding. A surgical sealant that effectively prevents suture line bleeding would be a valuable resource for cardiac surgeons and might help to facilitate minimal access cases. METHODS: We undertook acute canine studies with a new polyethylene glycol-based tissue sealant (FocalSeal, Focal, Inc., Lexington, MA) to determine its effectiveness in controlling bleeding from graduated needle punctures sites in the arteries of heparinized animals. For chronic canine studies, the sealant was applied to the suture line of a left internal mammary artery (LIMA) to left anterior descending (LAD) anastomoses. The anastomoses were then evaluated for patency and tissue reaction after a three-month recovery period. RESULTS: The sealant prevented bleeding from arterial puncture wounds up to 2.5 mm in diameter. Three months following the application of sealant to coronary anastomoses, no adverse tissue reaction was found on histologic examination. All anastomoses treated with the sealant remained patent. CONCLUSION: When applied as a hemostatic adjunct to sutures at a coronary anastomosis, the sealant appears to be an effective means of preventing bleeding without adverse tissue reaction or scarring.
Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11064548&dopt=Abstract hemorrhage
J Comput Assist Tomogr. 2002 Sep-Oct;26(5):756-61.
Granulosa cell tumor of the ovary: common findings and unusual appearances on CT and MR.
Kim SH, Kim SH.
Department of Radiology, Gachon Medical School, Gil Medical Center, Inchon, Korea.
PURPOSE: The purpose of this article was to demonstrate CT and MR findings of granulosa cell tumor of the ovary. METHODS: MR (n = 7) and CT (n = 6) images of 11 tumors were analyzed. Uterine changes were also assessed. RESULTS: Multiseptated cystic mass (n = 4; mean, 14.5 cm) and unlobulated solid mass with internal cysts (n = 4; mean, 5.3 cm) were two common forms. Hemorrhage was found in five on MRI. Three tumors showed unusual appearances (an unilocular cystic mass, a lobulated solid mass with nonhemorrhagic cysts, and an entirely solid mass) and were not accompanied by any abnormal uterine changes, whereas all the tumors of common forms were associated with uterine changes explainable by hormonal stimuli in the postmenopausal patients. CONCLUSIONS: Large multiseptated cystic mass and medium solid mass with internal cysts were two common forms. Hemorrhage was a common MR finding. Uterine changes were frequently associated with the tumors with these common findings.
Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12439311&dopt=Abstract hemorrhage
Neurosci Lett. 2000 Oct 20;293(1):49-52.
Co-induction of heme oxygenase-1 and peroxiredoxin I in astrocytes and microglia around hemorrhagic region in the rat brain.
Nakaso K, Kitayama M, Mizuta E, Fukuda H, Ishii T, Nakashima K, Yamada K.
Department of Biochemistry, Faculty of Medicine, Tottori University, Yonago, Japan. kazuhirrape.med.tottori-u.ac.jp
Heme[none1] oxygenase-1 (HO-1) and peroxiredoxin I (PrxI) are known to be oxidative stress- and heme-related proteins. The antioxidant activity of PrxI is inhibited by heme, therefore co-expression of HO-1 and PrxI is considered to be a reasonable mechanism to maintain its antioxidative function. Immunoblotting demonstrated that HO-1 and PrxI were induced around the hemorrhagic region. Immunohistochemical studies revealed that, in acute phase, HO-1 and PrxI were induced primarily in microglia. In the subacute and chronic phase, the immunoreactivity of HO-1 and PrxI in astrocytes was the most intense. These data are the first to demonstrate co-induction of HO-1 and PrxI in the brain. Our results suggest that HO-1 and PrxI are localized in a similar manner to assure the antioxidant activity of PrxI under stress conditions associated with intracerebral hemorrhage.
Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11065135&dopt=Abstract hemorrhage
J Pediatr. 2000 Nov;137(5):608-16.
Treatment choices for extremely preterm infants: an international perspective.
De Leeuw R, Cuttini M, Nadai M, Berbik I, Hansen G, Kucinskas A, Lenoir S, Levin A, Persson J, Rebagliato M, Reid M, Schroell M, de Vonderweid U; EURONIC study group.
Department of Neonatology, Amsterdam University, Amsterdam, The Netherlands.
OBJECTIVE: To compare treatment choices of neonatal physicians and nurses in 11 European countries for a hypothetical case of extreme prematurity (24 weeks' gestational age, birth weight of 560 g, Apgar score of 1 at 1 minute). STUDY DESIGN: An anonymous, self-administered questionnaire was completed by 1401 physicians (response rate, 89%) and 3425 nurses (response rate, 86%) from a large, representative sample of 143 European neonatal intensive care units. Italy, Spain, France, Germany, the Netherlands, Luxembourg, Great Britain, Sweden, Hungary, Estonia, and Lithuania participated. RESULTS: Most physicians in every country but the Netherlands would resuscitate this baby and start intensive care. On subsequent deterioration of clinical conditions caused by a severe intraventricular hemorrhage, attitudes diverge: most neonatologists in Germany, Italy, Estonia, and Hungary would favor continuation of intensive care, whereas in the other countries some form of limitation of treatment would be the preferred choice. Parental wishes appear to play a role especially in Great Britain and the Netherlands. Nurses are more prone than doctors to withhold resuscitation in the delivery room and to ask parental opinion regarding subsequent treatment choices. CONCLUSION: An extremely premature infant is regarded as viable by most physicians, whereas after deterioration of the clinical conditions decision-making patterns vary according to country. These findings have implications for the ethical debate surrounding treatment of infants of borderline viability and for the interpretation and comparison of international statistics.
Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11060524&dopt=Abstract hemorrhage
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