Acta medica Austriaca. Supplement最新文献

Myeloid committed stem cells belong to a subpopulation of small nucleated cells, which are defined by their capacity to form colonies of mature myeloid cells in agar-medium. They are termed "Colony forming Unit, CFUC", and such cells are detectable in bone marrow and peripheral blood. Bone marrow cells from 15 control patients with regular myelopoiesis contained 86 +/- 46 CFUC/10(5) bone marrow cells and 23 +/- 14 CFUC/ml blood. In 10 patients with aplastic anemia, only 0-10, 5 CFUC/10(5) BM-cells were found and no CFUC were detectable in the peripheral blood. 17 patients with chronic myeloid leukaemia showed a moderate elevation of bone marrow CFUC (X = 105), while the circulating CFUC were markedly elevated (105-42.000/ml). The circulating CFUC were closely correlated with the number of leukocytes (p less than 0,001). In 12 patients with primary osteomyelofibrosis, the number of circulating CFUC was also (raised (325-22.199/ml) and again, a correlation with the number of leukocytes was observed (p less than 0,05). As, on the other hand, there was no difference in the leukocyte count between the control group and patients with osteomyelosclerosis, the simultaneous assessment of circulating leukocytes and CFUC proves a diagnostic tool. Pancytopenia with a hypercellular bone marrow results from either neoplastic or metabolic alterations of haemopoiesis; in pancytopenia with neoplastic infiltration or transformation, the number of CFUC was lowered, whereas it was slightly elevated in pancytopenia due to metabolic alterations. In patients with acute leukaemia, only a minority of cells was capable of proliferation in vitro. The growth of leukaemic cells in culture, their prolonged survival along with the expression of functional properties may be clinically used for a more subtle classification of blast populations. The data on patients with acute leukaemia indicate, that basic mechanisms of normal blood cell regulation operate in leukaemic haemopoiesis as well.

The acute bronchodilator effect of the beta 2-adrenoceptor agonist terbutaline was tested single-blind cross-over in out-patients with chronic obstructive airways disease (intrinsic asthma). In 7 series comparisons were made with other marketed bronchodilators. Airways resistance was measured by whole body plethysmography. In another 3 series the effect on heart rate of terbutaline and other adrenocepter agonists was tested in healthy volunteers. Terbutaline and the adrenoceptor agonists clenbuterol, epinephrine, fenoterol, hexoprenaline, isoprenaline, metaproterenol, reproterol and salbutamol, the vagolytics atropine, ipratropium bromide and AA 22-263, the xanthinederivative theophylline ethylenediamine and one combined substance drug were used.

Psychological problems develop in patients with chronic diseases due to three main causes: 1. Because of the situation of the patient, who is admitted to the nursing-hospital in severely ill condition and now has to adapt to this new and fear inducing situation. 2. Because of the hospital staff, who has no previous psychological training and now has to deal with the patient. 3. Because of the adaptation of doctor and nurses who have to deal with the patient in a manner which induces him to accept the nursing hospital as a place where he must remain for the future. To portray these problems more clearly, the case of a patient with carcinoma of the breast, is described.

Gastroscopy is the diagnostic measure of choice in early recognition of gastric carcinoma, offering an accuracy rate of 96-99. However, this goal can only be achieved when biopsies are taken with forceps and snare from all circumscribed lesions which may hide a carcinoma. The common association with hyperplasiogenic polyps (15/86), adenoma and borderline lesion (7/86) and synchronous gastric carcinoma (8/86) request a subtle preoperative diagnosis if one does not perform gastrectomy in principle. Endoscopic resection (5/86) or local excision (6/86) should be debated in carcinomas located close to the cardia, and in high-risk patients. 5-year-survival rates of the "Erlangen early gastric cancer registry", are in accordance with the excellent results reported in the Japanese literature.

The results of chemotherapy in colorectal carcinoma are disappointing and therefore the treatment of metastatic rectal carcinoma, is problematic. 19 patients were treated with 5-FU, CCNU and Vincristin, the response rate was 26.3%, the median duration of remission 3.8 months.