SUCCESSFUL PREGNANCY IN A RENAL TRANSPLANT RECIPIENT TAKING CYCLOSPORIN A

A 27 year old woman with a fourth cadaveric renal transplant successfully completed a 33 week pregnancy whilst taking cyclosporin A and prednisolone. Her renal function remained stable despite recurrent urinary tract infections, hypertension, gestational diabetes, and Clostridium difficile associated diarrhea. The infant, delivered electively at 33 weeks, was small for gestational age but otherwise normal.     

BONE FRACTURES IN LIVER TRANSPLANT PATIENTS

Atraumatic bone fractures are a frequent complication in orthotopicliver transplantation (OLT). A retrospective study of 91 adultOLT patients was carried out to detect the prevalence of bonefractures, and to isolate predictive factors for their development. After OLT 22 patients (24%) developed 56 atraumatic bone fractures.All fractures occurred within the first 13 months followingOLT. No predictive pre- or post-OLT risk factors for the developmentof bone fractures were identified. KEY WORDS: Bone disease, Osteoporosis, Vertebral fractures, Organ transplantation     

PATHOLOGIC FRACTURE DUE TO SEVERE OSTEOMALACIA FOLLOWING LOW-DOSE DIPHOSPHONATE TREATMENT OF PAGET'S DISEASE OF BONE

Ethane-l-hydroxy-l, l-diphosphonate (EHDP) 5 mg/kg body weight/day was administered to a patient suffering from Paget's disease of bone. After 150 days of treatment, when the plasma alkaline phosphatase was 40% of initial, he suffered a pathologic fracture of his Pagetic right patella, which was found to have osteomalacia of extreme severity. An iliac crest bone biopsy, following double tetracycline labels, also showed severe osteomalacia of Pagetic bone. Osteoclast acid phosphatase activity was reduced, as occurs in diphosphonate-treated rats. The patient's history included two previous pathologic fractures of Pagetic bone and unusual sensitivity to EHDP. It might be prudent to perform needle bone biopsy in order to exclude osteomalacia in EHDP-treated _ patients with these clinical manifestations.     

骨髓单核细胞和骨髓基质干细胞联合诱导破骨细胞样细胞

目的探讨骨髓单核细胞向破骨细胞前体细胞分化的体外诱导条件。方法4种方法诱导破骨细胞样细胞：（A）单纯骨髓单核细胞法,（B）单纯骨髓单核细胞＋诱导培养液法,（C）骨髓单核细胞＋BMSC共培养（1：1）法,（D）骨髓单核细胞＋BMSC共培养（10：1）法,通过抗酒石酸酸性磷酸酶括性（strACP）测试、TRAP染色评估培养的细胞。结果（B）和（D）接种法能获得破骨细胞样细胞,（D）法得到的破骨细胞样细胞活性高、数目多。结论（D）法诱导破骨细胞优于其它培养法。     

体外甲基纤维素分离骨髓后冷冻保存及其在自体骨髓移植中的应用

首次使用０．０５％的甲基纤维素分离骨髓有核细胞取得了满意的结果。平均分离时间４３分钟，小标本组有核细胞及ＣＦＵ－ＧＭ回收率分别为７９．０±１３２±５．１０％和９３．０±３．１０％，白血病患者大剂量骨髓回收率为８３．４±１５．４５％和９１．０±８．３２％，红细胞残留１２．５％，分离后不经离心浓缩骨髓容积即可减少５５．２％。用此方法分离骨髓后冷冻保存，应用于４例急性白血病患者进行自体骨髓移植，病人移植后均重建了造血，无毒副作用。用甲基纤维素分离骨髓较其他方法简单实用，快速有效。     

IMMUNOLOGICAL RECONSTITUTION IN A PATIENT WITH SEVERE COMBINED IMMUNE DEFICIENCY USING NON-SIBLING BONE MARROW DEPLETED OF T CELLS WITH HuLy-m1

Abstract An infant with severe immune deficiency received bone marrow from an HLA-A, -B, -DR matched, mixed leucocyte reaction non-reactive first cousin. The donor marrow was fractionated on a discontinuous Percoll gradient and before infusion was treated with the anti-human T lymphocyte antibody, HuLy-m1, and rabbit serum as a source of complement. Methotrexate was given during the following two weeks. A rise in the peripheral blood lymphocyte count, indicating engraftment, occurred six weeks after transplantation. There was no clinical evidence of graft versus host disease (GVHD). Engraftment has been sustained for one year and the patient is in normal health and has normal in vitro immunological function. In vitro treatment of human marrow with HuL-m1 allows stable engraftment and may be useful in attempting to diminish or prevent GVHD.     

SEVERE HYPOKALEMIC RHABDOMYOLYSIS DUE TO INGESTION OF LIQUORICE DURING RAMADAN

A 62-year-old man was admitted with severe hypokalemia following ingestion of a modest amount of liquorice during the Islamic holy month of Ramadan. Hypokalemia was associated with typical electrocardiographic changes, marked acid-base disturbance and complicated by rhabdomyolysis. All abnormalities improved with normalisation of serum potassium. The serum creatine kinase isoenzymes (CK-total and MB) returned to normal over a prolonged period. The potential danger of ingesting liquorice even in small amounts over short periods, and the role of concomitant diuretic therapy with the additional factor of fasting during Ramadan in precipitating hypokalemia during liquorice ingestion are discussed.