Summary:analysis of the marrow revealed trisomy 8 and t(15;17) ( Table 1). He was treated with Ara-C and amsacrine and a second remission was achieved after two courses. FollowAfter treatment of acute leukemia (typically ALL and the monocytic variants of AML), relapse may occur at up marrow cytogenetic analysis was normal. This hospitalization was complicated by Aspergillus flavus pneumonia sites other than the marrow. Isolated extramedullary relapse of acute promyelocytic leukemia (APL) howrequiring ICU admission and treatment with 3000 mg of amphotericin B. He was eventually discharged home on cisever, is rare. We describe such an event in a man who underwent allogeneic BMT for APL in second relapse retinoic acid in October 1985.Because of concern about Aspergillus reactivation, an and 4 years later presented with testicular relapse. The marrow was morphologically and cytogenetically norallogeneic BMT was considered inappropriate at this time.He remained well on cis-retinoic acid until December 1987 mal, but RT-PCR analysis revealed the specific PML/RAR chimeric RNA transcript.when he developed hemoptysis. Bronchoscopy was performed and later right upper lobectomy for presumed AsperKeywords: testicular relapse; acute promyelocytic leukemia; allogeneic BMT gillus infection. The pathology of the resected lung, however, revealed necrotizing granulomas consistent with active pulmonary tuberculosis. He was therefore treated with an 8-month course of anti-tuberculous medication. Acute promyelocytic leukemia (APL) is a distinct subtype Treatment with cis-retinoic acid continued. of AML characterized by a consumptive coagulopathy, a Second relapse occurred in September 1990. Cytogenetic specific chromosomal rearrangement, a defined molecular analysis of the marrow revealed tetrasomy 8 and t(15;17) abnormality in a retinoid receptor, and a relatively good (Table 1). He was treated with Ara-C and DNR but a folprognosis. The (15;17) chromosomal translocation fuses the low-up marrow revealed persistent disease. In October PML gene on chromosome 15 with the RAR gene on chro-1990, he underwent an HLA-matched sibling donor BMT mosome 17, resulting in a hybrid gene PML/RAR which using BU, CY conditioning and CsA with methylprednisoencodes a fusion protein, undoubtedly involved in leukelone as GVHD prophylaxis. His hospital course was relamogenesis. 1 Both combination chemotherapy 2 and all-trans retinoic acid (ATRA) 3 are effective treatments.We describe an unusual case in which isolated testicular Table 1 Karyotype of marrow cells at various time points from relapse of APL occurred after allogeneic BMT. 1984-1994 Marrow karyotypeCase report Diagnosis (March 1984) Failed analysisA 34-year-old East Indian man presented in March 1984First relapse (August 1985) 47, XY, +8, t(15;17) [10] with APL. Remission was achieved with high-dose Ara-C Second remission (September 1985) 46, XY [25] and DNR, and consolidated with the same drugs.
Pneumonia is a severe infection that causes high morbidity and mortality rate worldwide. It is caused by Klebsiella pneumoniae, which generally causes upper respiratory tract infection. In case of such type of infection, levels of oxidant and antioxidant become imbalanced, which may contribute to lung injury. The present study was planned to evaluate the status of oxidant and antioxidant enzyme activities in plasma and lung tissue of pneumonia-infected rats model. Animals were randomly distributed into 3 groups of 8 rats each: groups I (control, normal saline treated), II (infected group), and III (infected + treated group). The findings showed that there was significant increase (P < .001) in body temperature along with decreased body weight in the infected group as compared to the control group. Similarly, all the activities of antioxidant enzymes (superoxide dismutase [SOD], catalase) were significantly decreased along with increased malonaldialdehyde (MDA) levels in plasma and lung tissue of the infected group as compared to the control group. These enzyme activities along with MDA levels were improved and came back near to normal level after administration of cefepime plus amikacin (potentox) for 7 days in group III. These studies concluded that fixed-dose combination of potentox improved oxidant and antioxidant levels in pneumonia infection.
The study was done to access the outcome of the factors affecting Atrio-Venous Fistula procedure in Indian subjects. A prospective study based on evaluation for construction of Atrio-Venous Fistula for haemodialysis in Indian patients of ESRD was carried out. Preoperative assessment of both arterial and venous components by physical examination and by CDFI was done and feasibility of construction of AVF was based on the same. Studies on Western subjects have shown the success of AVF with vein diameter more than 2.5mm and arterial diameter more than 2mm plus AVF has maximal flow if the Fistula if the Fistula diameter is 75% more than the diameter of the artery. In this study we incorporated similar guidelines ,however AV Fistulas were constructed even if caliber of vessels were lesser than the above mentioned caliber ,it is a known fact that that Europeans and Western subjects have larger caliber blood vessels as compared to Indian subjects. Of all the radio-cephalic AVF the diameter of radial artery was more than 02 mm, .range 2.1mm-2.5mm and however cephalic vein diameter was less than 2.5mm,range 1.0-2.3mm and in brachio-cephalic AVF the diameter of brachial artery was > 2mm,range 3.7-6.0mm and cephalic vein diameter >2.5mm,range3.9-4.1mm. After one year follow up 38 AVF were functional(01 underwent renal transplant) and 12 AVF were non-functional. The AVF should be constructed even if the vein diameter is less than 2.5mm and arterial diameter is less than 2.0mm in Indian subject, as the patency was 75.6% after 01 year.
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