RESUMEN
Le Fort I osteotomy is often needed in bilateral cleft patients. The usual approach to the maxillae may compromise the premaxillary vascularisation. We present a subperiosteal exposure preserving two paramedian vascular pedicles that respect premaxillary blood-supply.
Asunto(s)
Labio Leporino/cirugía , Fisura del Paladar/cirugía , Osteotomía Le Fort/métodos , Aumento de la Cresta Alveolar/métodos , Labio Leporino/complicaciones , Fisura del Paladar/complicaciones , Craneotomía/efectos adversos , Craneotomía/métodos , Humanos , Masculino , Maxilar/irrigación sanguínea , Maxilar/cirugía , Osteotomía Le Fort/efectos adversos , Adulto JovenRESUMEN
Acute myeloid leukaemia (AML) is characterized by the inability of myeloid cells to reach terminal maturation. We examined to what degree granulocytic maturation could be achieved by stimulating AML blast cells in an in vitro serum-free system with a combination of granulocyte-colony stimulating factor (G-CSF) and all-trans-retinoic acid (RA). Specimens from 41 AML patients were cultured for 7 d and then examined for cytochemistry (myeloperoxidase, Sudan Black, naphthyl-ASD-chloracetate esterase, periodic acid Schiff) an nitroblue tetrazolium reduction. The expression of CD11a, CD11b, CD11c, CD15, CD18, CD10, CD24 and B13-3 membrane antigens was also evaluated. Morphological and cytochemical studies were also performed after AML colony culture and culture of normal bone marrow cells (NBM). The comparative analysis of the panel of parameters was indicative of granulocytic maturation although to different degrees. The cells from 25/41 cases showed morphologic maturation (May-Grünwald-Giemsa). A positive correlation was evident between morphological maturation and CD11b expression (11/22 patients) as well as that of CD11c and CD15 (6 patients). Napthyl ASD chloroacetate esterase and PAS stainings also correlated with morphology (in 10/22 and 10/24 patients respectively). Nevertheless, the pattern of granulocytic maturation was remarkably variable among the 41 cases examined. The cells from only a few patients acquired the full spectrum of granulocytic markers. The comparison with normal bone marrow blasts indicates that serum-free culture conditions can, per se, limit granulocytic maturation, but it also confirms the intrinsic inability of AML cells to attain complete maturation in response to two potent granulocytic inducers.
Asunto(s)
Factor Estimulante de Colonias de Granulocitos/farmacología , Granulocitos/efectos de los fármacos , Leucemia Mieloide Aguda/patología , Tretinoina/farmacología , Adulto , Antígenos CD/análisis , Antígenos de Neoplasias/análisis , Diferenciación Celular/efectos de los fármacos , Granulocitos/patología , Humanos , Técnicas In Vitro , Leucemia Mieloide Aguda/inmunología , Células Tumorales Cultivadas/efectos de los fármacosRESUMEN
In a retrospective study of 96 patients with a myelodysplastic syndrome the FAB classification, Bournemouth score and other parameters were correlated with leukaemic transformation and survival. Diagnosis was refractory anaemia (RA) in 7 patients, acquired idiopathic sideroblastic anaemia (AISA) in 2, chronic myelomonocytic leukaemia (CMML) in 31, refractory anaemia with excess of blasts (RAEB) in 34 and RAEB in transformation (RAEB-t) in 22. Median survival for all patients was 37 weeks (RA and AISA 103, CMML 67, RAEB 35, RAEB-t 27). Scoring according to the Bournemouth criteria showed significant differences in survival between groups A, B and C. Of the separate variables, only percentage of bone marrow blasts and haemoglobin level were prognostically significant. A modified scoring system based upon these two variables was even more discriminative. It proved to be particularly useful in CMML, a subtype with a wide range of survival times. Leukaemic transformation was seen in 39% (RA and AISA 0%, CMML 30%, RAEB 39%, RAEB-t 75%).
Asunto(s)
Síndromes Mielodisplásicos/fisiopatología , Médula Ósea/patología , Causas de Muerte , Humanos , Leucemia Mieloide Aguda/etiología , Leucemia Mieloide Aguda/mortalidad , Síndromes Mielodisplásicos/complicaciones , Síndromes Mielodisplásicos/mortalidadRESUMEN
In a retrospective study of 96 patients with a myelodysplastic syndrome, the reproducibility of the French-American-British (FAB) classification was determined. Morphological abnormalities in peripheral blood and bone marrow were studied. Slides were reviewed by 3 examiners. All 3 observers agreed on morphological classification in 61% of cases, pairs of 2 in 64, 76 and 76%. The final diagnosis was refractory anaemia (RA) in 7 patients, acquired sideroblastic anaemia (AISA) in 2, chronic myelomonocytic leukaemia (CMML) in 31, refractory anaemia with excess of blasts (RAEB) in 34 and RAEB in transformation (RAEB-t) in 22. Dyserythropoiesis, dysgranulopoiesis and dysmegakaryopoiesis were found in all FAB subgroups. Dyserythropoiesis was significantly more frequently encountered in RAEB than in RAEB-t and CMML.