Lymphoma associated bone marrow necrosis with raised anticardiolipin antibody.

A case of high grade B cell lymphoma presented with bone marrow necrosis, followed by development of extensive marrow fibrosis, the evolution of which was documented by serial magnetic resonance imaging and bone marrow trephine histology. A markedly raised anticardiolipin antibody titre at diagnosis suggests that lymphoma associated antiphospholipid syndrome may have contributed to the aetiology of the bone marrow necrosis.     

Increased mucosal inflammatory cytokines in children with Helicobacter pylori-associated gastritis

The concentrations of tumour necrosis factor-alpha (TNF-α), interleukin-6 (IL-6) and IL-1-β in tissue homogenates of gastric mucosal biopsy specimens, and in gastric juice samples from Helicobacter pylori-positive and -negative children, were determined. The study population comprised 30 children with recurrent abdominal pain attending upper gastrointestinal endoscopy. Of these patients 18 were infected with H. pylori. Cytokine concentrations in gastric biopsy homogenate supernatants and in gastric juice were measured by enzyme-linked immunosorbent assay (ELISA). TNF-α levels in gastric juice and in gastric biopsy homogenate supernatants in patients with H. pylori-positive gastritis were found to be significantly higher than those in children without H. pylori infection. IL-6 levels were also higher in H. pylori -infected subjects, but the difference in IL-6 concentrations measured in gastric juice and biopsy homogenate supernatants did not reach statistical significance. IL-1-β concentrations in both specimens showed no significant difference between the two groups of children. It was suggested that increased levels of inflammatory cytokines, especially TNF-α and IL-6 generated locally within the gastric mucosa might be implicated in the pathogenesis of H. pylori-associated gastritis in childhood.     

Do PaCO2 and peripheral venous PCO2 become comparable when the peripheral venous oxygen saturation is above a certain critical value?

Dear editor,Peripheral venous blood gas(VBG)analysis is increasingly used as an alternative to arterial sampling in Emergency Departments throughout the world.[1]There are multiple advantages using peripheral venous samples for blood gas analysis-technical ease,reduced pain and fewer complications.The difference in sample site chosen for blood gas analysis between European and Australian centres has been notable for members of our author group,prompting discussion and review of the literature.     

Safe cannulation of the ascending aorta.

Numerous complications have been reported secondary to cannulation of the ascending aorta. This report describes our technique of cannulating the ascending aorta and presents the results of this safe mode of perfusion in 684 consecutive patients.