Treatment of pure red-cell aplasia following major ABO-mismatched T-cell-depleted bone marrow transplantation: Two case reports with successful response to plasmapheresis

Abstract. Major ABO-mismatched bone marrow transplantation (BMT) may be accompanied by red-cell haemolysis, but pure red-cell aplasia following BMT is a rare complication. Two cases of transient pure red-cell aplasia following T-lymphocyte-depleted BMT for a period of > 20 weeks are described, both of which responded to one cycle of plasmapheresis. The prompt response of the two patients described with red-cell aplasia with no evidence of haemolysis suggests that plasmapheresis may be considered in such clinical situations as a first treatment of choice before attempting more complex modes of therapy.     

Modulation of the masking phenomenon by the crossed part of the medial olivocochlear bundle

The masking phenomenon is used in clinical investigation of the inner ear to determine the frequency selectivity properties of the auditory system. Sectioning of the crossed part of the medial efferent bundle in a guinea pig model decreases the simultaneous masking phenomenon. The efferent effect seen in the forward masking varied with the masking paradigm used. When the masker onset precedes the maskee onset by more than 40 ms, masking diminishes after sectioning the crossed part of the medial efferent bundle. When this duration was shortest (30 ms), no effect was observed. This phenomenon could be explained by the time necessary to stimulate the medial efferent loop. Our results could explain some differences observed in the compound action potential masking curves with different masking paradigms.     

Plasmapheresis for thrombotic thrombocytopenic purpura following bone marrow transplantation.

Recognition of thrombotic thrombocytopenic purpura (TTP)/hemolytic uremic syndrome (HUS) following bone marrow transplantation (BMT) has increased in recent years. The use of plasma exchange has greatly improved the outlook of de novo TTP. Fewer data are available on its use in post-BMT TTP but small uncontrolled series showed poor results with low response rates. We present here a case of a young patient who developed manifestations of TTP 10 months after BMT with complete recovery following treatment with plasma exchange for 1 month. This case suggests that plasma exchange could be life saving and should be tried in every patient with post-BMT TTP.     

Removal of broken interlocking nails and reosteosynthesis--related clinical problems]

Nine patients with six fractures of the intramedullary cannulated nails and four Gamma nails are presented. In five patients broken implants had been removed by simple and safe method by use of tape extractor and than four patients has had intramedullary reosteosynthesis by closed method. The main causes in most cases were technical errors and early full weighbearing.     

Consequences of late diagnosis and long-term conservative treatment of patients with congenital heart defects

Of adult patients of the Cardiac Defects Clinic, National Institute of Cardiology (in Warsaw) we can distinguish several groups of patients with congenital heart defects among which those who were diagnosed after the age of 18 or those who despite of early and correct diagnosis, not underwent surgery on the childhood due to many reasons. In this paper we analyzed the group of 218 patients treated in our clinic between 1981-1987; 103 women aged 13-64 (mean-32 years) and 115 men aged 15-58 (mean-28 years). We classified congenital heart defects into 6 group: ASD, VSD, Tetralogy of Fallot, Persistent Ductus Arteriosus, Coarctation of Aorta and others (19.2%). We classified the range of health care before admission to our Department into the following categories: cardiosurgery (palliative or total correction); no therapy after congenital heart defects diagnosis; medical treatment after diagnosis; admission to our clinic immediately after the diagnosis of a heart defect. We compared that range of health care with qualifications of our Institute-(1. qualification for operation, 2. contraindication for operation, 3. operation unnecessary as the defect is not significant). We conclude basing on our results that, late diagnosis of a congenital heart defect does not finally effect on cardiosurgery possibilities. the majority of patients with C.H.D. have been waiting for many years for a specialist diagnosis and optimal therapeutic decision. long term conservative therapy of the patients with C.H.D. significantly reduces the changes of surgical correction.