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  • Acute respiratory distress syndrome  (3)
  • Computed tomography  (3)
  • Immunophenotype  (2)
  • 1
    Electronic Resource
    Electronic Resource
    Characterization of aberrant phenotypes in acute myeloblastic leukemia (1995)
    Springer
    Annals of hematology 70 (1995), S. 189-194 
    Details
    ISSN: 1432-0584
    Keywords: Minimal residual disease ; Myeloblastic leukemia ; Immunophenotype ; Aberrant phenotype
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The existence of leukemic-associated phenotypes has been suggested to be a valuable tool for the detection of minimal residual disease (MRD) in AML patients, as they would allow to distinguish leukemic blast cells from normal hematopoietic progenitors. The present study was designed to analyze in which proportion of AML patients the immunological detection of MRD is feasible, based on the presence of aberrant phenotypes that allow the distinction of leukemic from normal cells. For this purpose we have prospectively investigated the blast cells from 40 AML patients at diagnosis with a large panel of MoAb in double and triple staining combinations analyzed at flow cytometry, in order to detect aberrant phenotypes on blast cells (lineage infidelity, antigenic overexpression, and asynchronous antigenic expression, as well as aberrant lightscatter pattern). In the analysis of the 40 AML cases more than one blast cell subset, distinguished by its different antigenic expression, was detected in 85% of the patients: five different phenotypic blast cell subsets were observed in six cases, four in 13 patients, three subsets in three cases, and two in 12 patients; only six cases showed a homogeneous phenotypical blast cell population. Twenty-nine of the 40 AML cases analyzed (73%) showed the existence of at least one aberrant phenotype: in 15 cases the myeloid blast cells co-expressed lymphoid-associated antigens (CD2, CD5, CD7, and/or CD19) - lineage infidelity -; asynchronous antigen expression was detected in 25 patients (CD34+CD56+, CD34+CD11b+, CD34+CD14+, CD117+CD15+, CD33-CD13+, CD13-CD15+, HLADR+CD15+++, HLADR-CD14+CD11b+ CD4+); seven cases displayed antigen overexpression (CD13, CD33, CD15, or CD14); and in 13 patients leukemic cells had an abnormal FSC/SSC distribution according to their phenotype. These results suggest that immunological methods for the detection of MRD based on the existence of aberrant phenotypes could be used in the majority of AML patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01700374
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Characterization of aberrant phenotypes in acute myeloblastic leukemia (1995)
    Springer
    Annals of hematology 70 (1995), S. 189-194 
    Details
    ISSN: 1432-0584
    Keywords: Key words Minimal residual disease ; Myeloblastic leukemia ; Immunophenotype ; Aberrant phenotype
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  The existence of leukemic-associated phenotypes has been suggested to be a valuable tool for the detection of minimal residual disease (MRD) in AML patients, as they would allow to distinguish leukemic blast cells from normal hematopoietic progenitors. The present study was designed to analyze in which proportion of AML patients the immunological detection of MRD is feasible, based on the presence of aberrant phenotypes that allow the distinction of leukemic from normal cells. For this purpose we have prospectively investigated the blast cells from 40 AML patients at diagnosis with a large panel of MoAb in double and triple staining combinations analyzed at flow cytometry, in order to detect aberrant phenotypes on blast cells (lineage infidelity, antigenic overexpression, and asynchronous antigenic expression, as well as aberrant light-scatter pattern). In the analysis of the 40 AML cases more than one blast cell subset, distinguished by its different antigenic expression, was detected in 85% of the patients: five different phenotypic blast cell subsets were observed in six cases, four in 13 patients, three subsets in three cases, and two in 12 patients; only six cases showed a homogeneous phenotypical blast cell population. Twenty-nine of the 40 AML cases analyzed (73%) showed the existence of at least one aberrant phenotype: in 15 cases the myeloid blast cells co-expressed lymphoid-associated antigens (CD2, CD5, CD7, and/or CD19) – lineage infidelity –; asynchronous antigen expression was detected in 25 patients (CD34+CD56+, CD34+CD11b+, CD34+CD14+, CD117+CD15+, CD33–CD13+, CD13–CD15+, HLADR+CD15+++, HLADR–CD14+CD11b+ CD4+); seven cases displayed antigen overexpression (CD13, CD33, CD15, or CD14); and in 13 patients leukemic cells had an abnormal FSC/SSC distribution according to their phenotype. These results suggest that immunological methods for the detection of MRD based on the existence of aberrant phenotypes could be used in the majority of AML patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01700374
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Hemodynamic and gas exchange responses to inhalation of nitric oxide in patients with the acute respiratory distress syndrome and in hypoxemic patients with chronic obstructive pulmonary disease (1997)
    Springer
    Intensive care medicine 23 (1997), S. 51-57 
    Details
    ISSN: 1432-1238
    Keywords: Key words Nitric oxide ; Gas exchange ; Mechanical ventilation ; Chronic obstructive pulmonary disease ; Acute respiratory distress syndrome
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: Inhalation of nitric oxide (NO) can improve oxygenation and decrease mean pulmonary artery pressure (MPAP) in patients with the acute respiratory distress syndrome (ARDS). It is not known whether inhaled NO exerts a similar effect in hypoxemic patients with chronic obstructive pulmonary disease (COPD). Design: Prospective clinical study. Setting: General intensive care unit in Sabadell, Spain. Patients: Nine mechanically ventilated COPD patients (mean age 72±2 years; forced expiratory volume in 1 s 0.91±0.11 l) and nine ARDS patients (mean age 57±6 years; mean lung injury score 2.8±0.1) Measurements and results: We measured hemodynamic and gas exchange parameters before NO inhalation (basal 1), during inhalation of 10 ppm NO (NO-10), and 20 min after NO was discontinued (in basal 2) in the ARDS group. In the COPD group, these parameters were measured before NO inhalation (basal 1), during different doses of inhaled NO (10, 20, and 30 ppm), and 20 min after NO was discontinued (basal 2). A positive response to NO was defined as a 20% increment in basal arterial partial pressure of oxygen (PaO2). MPAP and pulmonary vascular resistance (PVR) decreased significantly, while other hemodynamic parameters remained unchanged after NO-10 in both groups. Basal oxygenation was higher in the COPD group (PaO2/FIO2 (fractional inspired oxygen) 190±18 mmHg) than in the ARDS group (PaO2/FIO2 98±12 mmHg), (p〈0.01). After NO-10, PaO2/FIO2 increased (to 141±17 mmHg, p〈0.01) and Qva/Qt decreased (39±3 to 34±3%, p〈0.01) in the ARDS group. There were no changes in PaO2/FIO2 and Qva/Qt when the NO concentration was increased to 30 ppm in the COPD group. In both groups, a correlation was found between basal MPAP and basal PVR, and between the NO-induced decrease in MPAP and in PVR. The NO-induced increase in PaO2/FIO2 was not correlated with basal PaO2/FIO2. In the ARDS group, six of the nine patients (66%) responded to NO and in the COPD group, two of nine (22%) (p=0.05). Conclusions: NO inhalation had similar effects on hemodynamics but not on gas exchange in ARDS and COPD patients, and this response probably depends on the underlying disease.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001340050290
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  • 4
    Electronic Resource
    Electronic Resource
    Short-term effects of prone position in critically ill patients with acute respiratory distress syndrome (1997)
    Springer
    Intensive care medicine 23 (1997), S. 1033-1039 
    Details
    ISSN: 1432-1238
    Keywords: Key words Prone position ; Gas exchange ; Respiratory system mechanics ; Acute respiratory distress syndrome
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Objective: Changing the position from supine to prone is an emerging strategy to improve gas exchange in patients with the acute respiratory distress syndrome (ARDS). The aim of this study was to evaluate the acute effects on gas exchange, hemodynamics, and respiratory system mechanics of turning critically ill patients with ARDS from supine to prone. Design: Open, prospective study. Setting: General intensive care units. Patients: 23 patients [mean age 56 ± 17 (SD) years] who met ARDS criteria and had a Lung Injury Score 〉 2.5 (mean 3.25 ± 0.3). Interventions: The decision to turn a patient was made using a protocol based on impaired oxygenation despite the use of positive end-expiratory pressure and a fractional inspired oxygen (FIO2) of 1. Measurements and results: We measured gas exchange and hemodynamic variables in all patients and in 16 patients calculated respiratory system compliance when they were supine and 60 to 90 min after turning them to a prone position. This latter position was remarkably well tolerated, and no clinically relevant complications or events were detected either during turning or while prone. The partial pressure of oxygen in arterial blood (PaO2)/FIO2 ratio improved from 78 ± 37 mm Hg supine to 115 ± 31 mm Hg prone (p 〈 0.001), and intrapulmonary shunt decreased from 43 ± 11 to 34 ± 8 % (p 〈 0.001). Cardiac output and other hemodynamic parameters were not affected. Respiratory system compliance slightly improved from 24.7 ± 10.2 ml/cmH2O supine to 27.8 ± 13.2 ml/cmH2O prone (p 〈 0.05). An improvement in PaO2/FIO2 of more than 15 % from changing from supine to prone was found in 16 patients (responders). Responders had more hypoxemia (PaO2/FIO2 70 ± 23 vs 99 ± 53 mm Hg in non-responders, p 〈 0.01), more hypercapnia (partial pressure of carbon dioxide in arterial blood (70 ± 27 vs 64 ± 9 mm Hg, p 〈 0.01), and a shorter elapsed time to the onset of ARDS and turning to the prone position (11.8 ± 16 vs 32.8 ± 42 days, p 〈 0.01). Conclusions: Turning critically ill, severely hypoxemic patients from the supine to the prone position is a safe and useful therapeutic intervention. Our data suggest that prone positioning should be carried out early in the course of ARDS.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001340050453
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  • 5
    Electronic Resource
    Electronic Resource
    Improvement in oxygenation by prone position and nitric oxide in patients with acute respiratory distress syndrome (1999)
    Springer
    Intensive care medicine 25 (1999), S. 29-36 
    Details
    ISSN: 1432-1238
    Keywords: Key words Prone position ; Nitric oxide ; Acute respiratory distress syndrome ; Oxygenation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: Inhaled nitric oxide (NO) and prone position improve arterial oxygenation in patients with the acute respiratory distress syndrome. This study was undertaken to assess the combined effects of NO and prone position in these patients. Design: Prospective clinical study. Setting: General intensive care service in a community teaching hospital. Patients: 14 mechanically ventilated adult patients with the acute respiratory distress syndrome (mean lung injury score 3.23 ± 0.27). Measurements and results: We measured hemodynamic and oxygenation parameters in the supine position and 2 h later in the prone position, before and during inhalation of 10 ppm NO. A positive response in oxygenation was defined as a ≥ 20 % increment in the arterial oxygen tension/fractional inspired oxygen ratio (PaO2/FIO2). In the prone position PaO2/FIO2 increased significantly (from 110 ± 55 to 161 ± 89 mmHg, p 〈 0.01) and venous admixture decreased (from 38 ± 12 to 30 ± 7 %, p 〈 0.01) compared to the supine position. Ten of the 14 patients were responders in the prone position. In the supine position, inhalation of NO improved oxygenation to a lesser extent, increasing PaO2/FIO2 to 134 ± 64 mmHg (p 〈 0.01) and decreasing venous admixture to 35 ± 12 %, (p 〈 0.01). Five of the 14 patients responded to NO inhalation supine and 8 of 14 responded prone (p = 0.22). The combination of NO therapy and prone positioning was additive in increasing PaO2/FIO2 (197 ± 92 mmHg) and decreasing venous admixture (27 ± 8 %) (p 〈 0.01). This combination also showed a positive oxygenation response on compared to the supine value without NO in 13 of the 14 patients (93 %). NO-induced changes in PaO2/FIO2 were correlated to changes in pulmonary vascular resistance only in the prone position. Conclusions: In patients with the acute respiratory distress syndrome, the combination of NO and prone position is a valuable adjunct to mechanical ventilation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001340050783
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  • 6
    Electronic Resource
    Electronic Resource
    Acute bilateral striatal necrosis in an infant: CT and MRI (1994)
    Springer
    Neuroradiology 36 (1994), S. 245-246 
    Details
    ISSN: 1432-1920
    Keywords: Basal ganglia ; Encephalitis ; Computed tomography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report a case of acute bilateral striatal necrosis in an infant. CT and MRI findings are described.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00588144
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  • 7
    Electronic Resource
    Electronic Resource
    Acrylic vertebroplasty in symptomatic cervical vertebral haemangiomas: report of 2 cases (1996)
    Springer
    Neuroradiology 38 (1996), S. 389-391 
    Details
    ISSN: 1432-1920
    Keywords: Key words Acrylic vertebroplasty ; Vertebral haemangioma ; Cervical spine ; Computed tomography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report two cases of acrylic vertebroplasty in symptomatic cervical vertebral haemangiomas. In both cases significant improvement of symptoms was rapid. One patient was able to return to work.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00596600
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  • 8
    Electronic Resource
    Electronic Resource
    Acrylic vertebroplasty in symptomatic cervical vertebral haemangiomas: report of 2 cases (1996)
    Springer
    Neuroradiology 38 (1996), S. 389-391 
    Details
    ISSN: 1432-1920
    Keywords: Acrylic vertebroplasty ; Vertebral haemangioma ; Cervical spine ; Computed tomography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report two cases of acrylic vertebroplasty in symptomatic cervical vertebral haemangiomas. In both cases significant improvement of symptoms was rapid. One patient was able to return to work.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00596600
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    Paper (German National Licenses)
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