Varicella zoster-associated severe aplastic anemia in a child and its successful treatment with peripheral blood stem cell transplantation from HLA-5/6-identical donor.

BACKGROUND: Varicella zoster virus is very rarely associated with aplastic anemia. Bone marrow transplantation from an HLA-identical sibling is the treatment of choice. CASE REPORT: A seven-year-old boy presented with aplastic anemia (AA) following chicken pox infection. No clinical improvement was observed with pharmaceutical therapy and peripheral blood stem cell transplantation (PBSCT) was performed from his HLA 5/6 identical mother. Since the transplantation, the patient has had a durable, trilineage hematological response for 12 months. CONCLUSIONS: The present case with varicella zoster-associated aplastic anemia was non-responsive to conventional therapies (ATG protocol, ALG protocol, oxymethalone, and cyclosporine A) and successfully treated with bone marrow transplantation from his 5/6 identical mother.     

Splenic pseudocyst: aspiration or cyst decapsulation

A 12 year old boy with a splenic pseudocyst is reported. Percutaneous drainage resulted in complete emptying but rapid reaccumulation. Cyst decapsulation with splenic preservation was curative and is recommended for definitive therapy of splenic pseudocysts.     

Haemolytic anaemia associated with splenic haemangiomata

We describe a 33 year old woman who developed unexplained haemolytic anaemia following renal transplantation and who was found to have multiple splenic haemangiomata. This case demonstrates that splenic haemangiomata may be a cause of haemolytic anaemia in the absence of abnormalities in coagulation.     

Successful obstetric outcome after simultaneous pancreas and kidney transplantation.

A 34-year-old woman became pregnant two years after having a simultaneous pancreas and kidney (SPK) transplantation, necessitated by type 1 diabetes and end-stage renal disease. The pregnancy was uneventful until 30 weeks' gestation, when she developed pancreatitis and a worsening of mild hypertension. A healthy 1700 g boy was delivered by caesarean section at 34 weeks' gestation. This is the first report of a successful pregnancy after SPK transplantation in Australia.     

Torsion of a wandering spleen with whorled appearance of the splenic hilum in CT scan

An eight-year-old boy admitted for acute abdominal pain was diagnosed to have torsion of the spleen (TS) based on contrast enhanced computerised tomography (CECT) of the abdomen. CECT showed whorled appearance in the splenic hilum. Whorl sign' refers to the presence of a twisted splenic pedicle intermingled with fat, resulting in alternating circular bands of radiodensity and radiolucency and is considered diagnostic of TS. This is the fourth reported case of whorl sign in children with TS and the first from Malaysia.     

经大鼠脾动脉行肝细胞移植建立动物模型

 目的 建立经SD大鼠颈动脉途径脾动脉插管行肝细胞移植的动物模型,并探讨其临床意义。方法 采用D-氨基半乳糖(D-galactosamine,D-gal)诱导大鼠急性肝损伤(acute liver injury,ALI),24 h后40只SD大鼠分为两组:A组(n=20)经左侧颈动脉插管,进入腹腔干,通过脾动脉移植1×107个肝细胞;B组(n=20)通过同样的方法经脾动脉注射0.5 mL Hank′s液作为对照,观察不同时间点（1、3、6、10、15天）大鼠肝功能的变化情况以及脾内白蛋白合成作用,HE染色观察脾内肝细胞分布情况。结果 经颈动脉途径脾动脉插管成功率约90%,荧光示踪剂CFDA SE标记的肝细胞脾内移植1天后,受体大鼠脾脏可以看到散在绿色荧光分布。A组移植10天后,HE染色可以看到肝细胞在脾脏散在分布;A组移植15天后,共聚焦白蛋白免疫荧光结果表明,脾内有白蛋白绿色荧光信号。结论 经大鼠颈动脉途径脾动脉插管移植的肝细胞能在脾内存活,证实该途径是肝细胞有效移植途径之一。     

Retrograde ileo-ileal intussusception.

A case of retrograde ileo-ileal intussusception in a boy of 16 years is reported. There was no apparent predisposing cause. The patient was treated by resection-anastomosis of the ileum and recovered uneventfully.     

儿童外伤性脾破裂诊治分析:附70例报告

目的 探讨儿童外伤性脾破裂治疗方法的选择.方法 回顾性分析了70例儿童外伤性脾破裂病例.结果 10例患儿经非手术治疗治愈.60例患儿采用手术治疗,其中35例采取脾部分切除或修补术;5例全脾切除,其中1例实行自体脾移植术.术后随访61例,随访时间3个月～5年,无脾切除后凶险性感染.结论 儿童脾外伤后应根据病情和脾脏损伤的程度选择合理的治疗方式,对于脾切除患儿自体脾片移植是安全有效的疗法.     

儿童外伤性脾破裂诊治分析：附70例报告

目的 探讨儿童外伤性脾破裂治疗方法的选择。方法 回顾性分析了70例儿童外伤性脾破裂病例。结果 10例患儿经非手术治疗治愈。60例患儿采用手术治疗，其中35例采取脾部分切除或修补术；25例全脾切除，其中21例实行自体脾移植术。术后随访61例，随访时间3个月～5年，无脾切除后凶险性感染。结论 儿童脾外伤后应根据病情和脾脏损伤的程度选择合理的治疗方式，对于脾切除患儿自体脾片移植是安全有效的疗法。     

脾动脉结扎后脾脏和脾组织移植的形态学及其吞噬功能的实验研究

本文通过~(51)铬标记变性红细胞测定脾的吞噬功能和组织学检查观察脾动脉结扎后保留脾脏和脾织组移植的形态及吞噬功能的变化。结果如下:原位保留脾脏的吞噬功能比异位移植脾组织恢复要快,尤其在60天保留全脾的吞噬功能比异位移植的有显著差别。病理组织检查:大多数动物的脾脏形态正常,个别的稍有缩小。光、电镜检查脾红髓存在,脾小体增生。因之,脾动脉结扎后原位保留脾脏不会引起脾脏缺血和机能的改变,它比脾移植优越,脾动脉结扎保留半脾和半脾移植可作为选择性脾损伤的治疗。     

临床活体部分小肠移植术移植肠的处理

目的 报告我国首例活体小肠移植术的移植肠处理体会。方法 为１例１８岁男性超短肠综合征患放行了活体部分小肠移植术,供肠来自患的父亲（４４岁）,切取供体回肠１５０ｃｍ,ＵＷ液灌洗血管,将移植肠动、静脉车受体腹主动及及下腔静脉而吻合,移植肠近端与受体空肠近端行端端吻合,远端与受体空肠远端行侧端吻合,末端造口,术后给子抗排斥,抗感染,抗凝及营养支持等治疗。结果 术后管出现贫血,单纯疱疹病感染和急性排斥     

冻融胚胎移植的临床应用

目的：积累体外受精冻融胚胎移植技术的经验。方法：对20例在体外受精形成的多个胚胎，在移植后将剩余胚胎全部冷冻保存，如本周期未获妊娠，在以后的周期再行解冻移植。结果：20例进行20个周期的冻融胚胎移植，获临床妊娠7例，临床妊娠率为35％。其中自然周期移植13例获临床妊娠5例，妊娠率为38．5％；激素替代周期7例，获临床妊娠2例，妊娠率为28．5％。首例冻融胚胎于2002年6月28日孕38周分娩一男婴，新生儿发育良好。结论：采取冻融胚胎移植可提高累积妊娠率，并可减少卵巢过度刺激综合征及多胎妊娠的发生。     

Co-existence of spontaneous splenic rupture and tuberculosis of the spleen

A rare case of splenic tuberculosis complicated by splenic rupture is reported. A 73-year-old man, hospitalized for peptic ulcer bleeding, presented in oligemic shock, was transferred to the operating room. Hemoperitoneum, due to rupture of an enlarged spleen was detected. The pathology revealed splenic tuberculosis. He had an uneventful recovery. Postoperatively, he received a combination of anti-tuberculous therapy for 6 months.     

Pulmonary alveolar microlithiasis presenting with chronic cough.

A case of a 10 year old boy with pulmonary alveolar microlithiasis is presented. Although most children with this disease are asymptomatic, our patient had persistent cough for more than 3 years. It is likely that his chronic cough was a direct consequence of the disease.     

脾组织移植的实验研究与临床应用

31例临床自体脾移植和56只大白鼠脾移植实验结果表明:片状移植脾组织较糊状成活率高,且不少于金脾的25%,移植脾在12周后才成活。     

Acute transverse myelopathy complicating tetanus.

A 12-year-old boy presented with typical features of short incubation tetanus. Spastic paraparesis with a mid-thoracic sensory level was present from the time of the initial examination. X-rays of the spine and lumbar myelogram were normal. The paraparesis improved rapidly and within a month the patient was free of neurological deficit. The case is possibly a rare example of tetanus involving the central nervous system other than the anterior horn cells.     

Spontaneous rupture of a splenotic nodule

A case is presented of spontaneous rupture of splenic tissue occurring 14 years after a splenectomy was carried out for trauma. Spontaneous rupture of a splenotic nodule has not previously been described and it may be added to the list of causes of spontaneous haemoperitoneum. The incidence and function of residual splenic tissue are briefly discussed and other causes of splenic rupture are outlined.     

Splenic rupture following splenic vein thrombosis in a man with protein S deficiency.

We present a case of spontaneous splenic rupture in a man with splenic vein thrombosis. The splenic vein thrombosis appears to have been caused by protein S deficiency. We are not aware of this having been described before.     

ITP患者自体脾移植再生脾免疫结构变化的临床研究

探讨原发性血小板减少性紫癜患者自体脾移植后再生脾的免疫结构变化及其对原发病的影响。方法：对１２例ＩＴＰ患者行脾切除自体脾移植术,术后６月活检再生脾组织,应用ＡＢＣ免疫组织化和图像分析,结合透射电镜对脾组织的形态结构,巨噬细胞和树突状细胞等主要免疫细胞成份进行观察。     

Association of cholelithiasis with total parenteral nutrition and fasting in a preterm infant.

Cholelithiasis is uncommon in infants. A case of cholelithiasis in a preterm boy who required total parenteral nutrition (TPN) because of prolonged fasting is described. The diagnosis was confirmed by ultrasonography. Despite cholestasis, reintroduction of oral feeding and discontinuation of TPN resulted in the spontaneous disappearance of the gallstones.