Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0023418 (leukemia)
93,477 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Karl Wittmaack, head of the otology department at Greifswald (1904-1908) and professor of otorhinolaryngology at the universities of Jena (1908-1925) und Hamburg (1926-1946) created a unique histological collection of human and animal temporal bones that is thought to be the largest of its kind in the world. The serial sections of more than 1700 human temporal bones still represent current otological problems--many of which are now rare but are still encountered--such as tuberculosis, lues or diphtheria of the ear. Complications following acute otitis--which were much more frequent and dangerous in the pre-antibiotic era--can be studied in detail. There are numerous cases of labyrinthitis, meningitis, sinus thrombosis, brain abscess etc.--complications which must always be borne in mind to this day. The same is true for tumors like acoustic neurinomas or even malignant tumors, metastases, or manifestations of leukemia. Differences in pneumatization or changes of the bone structure as in otosclerosis have been the subjects of studies dating from Wittmaack's time until very recently. In spite of its topicality, the true value of the collection has only be appreciated by a limited group of persons, which may be due in part to difficulties in orientation within this vast amount of material. Although there are catalogues, it may be difficult to find the appropriate preparations for particular questions. Searching for such specimens often requires rummaging through the whole collection, sometimes resulting in damage or loss of slides or handwritten notes.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[The Wittmaack temporal bone collection and possibilities for cataloguing with electronic data processing]. 828 75

Currently intravenous ceftazidime with or without an aminoglycoside or alternatively ciprofloxacin are the recommended antibiotics of choice in Pseudomonas aeruginosa meningitis. A case of atraumatic, spontaneous Ps. aeruginosa meningitis in a child with acute lymphoblastic leukaemia is described. Despite the organism demonstrating in vitro sensitivity to ceftazidime, netilmicin and ciprofloxacin, intravenous therapy with these drugs failed to sterilise the cerebrospinal fluid (CSF). Both netilmicin and ciprofloxacin failed to attain therapeutic levels in the CSF. Intrathecal aminoglycoside therapy via an intraventricular reservoir was successful in eradicating the infection. In children with meningitis due to Ps. aeruginosa where intravenous therapy is unsuccessful despite in vitro sensitivity to recommended antibiotics; intraventricular medications should be commenced as soon as possible.
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PMID:The treatment of Pseudomonas aeruginosa meningitis--old regime or newer drugs? 846 Mar 54

Following the establishment of university departments of pediatrics after World War II, national pediatric associations were formed in several countries (in Korea in 1945 and in Nepal in 1981). In Papua New Guinea, the Papuan Medical College began in 1959, and a university department of pediatrics was established in 1974. The population of Papua New Guinea is growing at a rate of 2.3% a year, and less than 70% of women receive prenatal care. Only 40% of deliveries are done under medical supervision. Most of child health problems are associated with malnutrition, pneumonia, gastroenteritis, malaria, meningitis, and tuberculosis. Nonetheless, the infant mortality rate (IMR) dropped from 134/1000 in 1971 to 72/1000 in 1980, and to 60/1000 in 1991. In Nepal, improved child health is a national priority, because the IMR is 129/1000 live births, the under-five mortality rate is 200/1000 live births, life expectancy is 52 years, and adult literacy rates are 39% for males and 12% for females. Nurses receive graduate pediatric training, and there is a postgraduate Diploma in Child Health. In Thailand, supervision of births increased from 33.7% in 1980 to 64.8% in 1988; the IMR dropped from 54.8/1000 live births in 1980 to 42/1000 in 1988; and malnutrition in under-fives dropped from 35.6% in 1980 to 28.5% in 1988. However, 85% of children live in rural communities, and rapid urbanization has resulted in overcrowding, with infectious and parasitic diseases, and high maternal malnutrition. Industrialization profoundly affected child health indices. In Korea the IMR was only 12.5/1000 in 1987, life expectancy was 67 years for males and 75 years for females. In Japan, the IMR dropped from 124/1000 in 1930 to 5.2/1000 in 1986; and maternal mortality declined from 176/100,000 live births in 1950 to 10.8 in 1989. Life expectancy increased from 59.6 years for males and 63 years for females in 1950 to 75.5 years and 81.3 years in 1988, respectively. In Australia, children's hospitals mostly treat asthma, congenital anomalies, and leukemia. Pediatric postgraduate education programs had been developed by the 1980's in most countries. The 7th Asian Congress of Pediatrics was held in Perth, Australia, in May 1991, focusing on priorities of child health.
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PMID:Paediatrics in the Asia-Pacific region. 848 6

In a 17-year-old male patient with acute lymphoblastic leukaemia, who was being treated with chemotherapy, a Staphylococcus epidermidis infection with several septicaemias developed during a period of protracted neutropenia. The patient was treated with vancomycin and fusidic acid, but blood cultures remained positive. The patient also developed staphylococcal meningitis. After the antibiotic regimen was supplemented by fosfomycin, the blood cultures became sterile. Combination treatment with vancomycin and fosfomycin was continued for two months without apparent toxicity. In individual cases of infection with multiresistant S. epidermidis fosfomycin may be included in the antibiotic regimen. This is the first report of parenteral use of fosfomycin in the Netherlands.
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PMID:[A patient with acute leukemia and meningitis caused by Staphylococcus epidermidis treated with fosfomycin]. 853 88

Chronic lymphocytic leukemia is the most common human leukemia but infrequently causes neurologic symptoms. We have reviewed all previously reported cases of chronic lymphocytic leukemia in the CNS along with three new cases; one patient was diagnosed antemortem and treated with immediate improvement and 4-year survival. In addition, we reviewed all autopsy cases since 1972 and available lumbar puncture data on patients with chronic lymphocytic leukemia admitted to the Massachusetts General Hospital. Invasion of the CNS by chronic lymphocytic leukemia often leads to confusional state, meningitis with cranial nerve abnormalities, optic neuropathy, or cerebellar dysfunction. Lumbar puncture shows a lymphocytosis consisting of monoclonal B cells, but CSF cytology studies are of limited value in establishing the diagnosis. Long-term survival may be related to the stage of chronic lymphocytic leukemia at the time of CNS disease and may be associated with intrathecal chemotherapy. A mild, asymptomatic infiltration of the brain, frequently noted in late-stage chronic lymphocytic leukemia in autopsy series, may explain the CSF lymphocytosis in some patients with late-stage chronic lymphocytic leukemia.
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PMID:Chronic lymphocytic leukemia and the central nervous system: a clinical and pathological study. 879 4

An increase in the incidence and severity of bacteremia caused by group A streptococci was noted in 1993 and 1994 in the Hadassah University Medical Center, Jerusalem. During the 6-year period 1987 to 1992, 12 children with group A streptococcal bacteremia were hospitalized, whereas in 1993 and 1994 there were 17 patients, 5 of them with 1 each of the following severe clinical manifestations: meningitis and septic shock; streptococcal toxic shock syndrome; septic shock; pleural empyema; and fatal outcome. Our 29 patients with group A streptococcal bacteremia were younger than those reported in the literature: 10 (35%) were < 3 months of age; 17 (59%) were < 1 year old. Most children were previously healthy and only 3 had an underlying immunodeficiency predisposing to infection (1 case each): leukemia; Di George syndrome; and congenital nephrotic syndrome. Two children were recovering from varicella. The skin was the most common site of primary infection (16 of 29). The average white blood cell (WBC) count was 18 150 cells/mm3 (range, 2200 to 34,200). The cases were not related epidemiologically and were caused by a variety of M-protein types. Polymerase chain reaction amplification of the genes encoding exotoxins A (speA) and C (speC) was done on 19 isolates and disclosed 2 strains positive for speA and 5 positive for speC. One of the speA-positive isolates was from the single patient with toxic shock syndrome.
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PMID:Increased incidence and severity of Streptococcus pyogenes bacteremia in young children. 855 25

Although it has been recognized previously that several markers are present in the cerebrospinal fluid (CSF), their clinical usefulness of these markers in the diagnosis of malignant lymphoma infiltrating to the CNS has not yet been established. In order to determine their diagnostic usefulness as markers of meningeal infiltration by lymphoma cells in patients with adult T-cell leukemia (ATL), we measured some soluble factors in the CSF of patients with ATL and non-ATL patients. Soluble CD4 (sCD4) was highly elevated in all patients with ATL and meningeal infiltration. The CSF level of the soluble interleukin-2 receptor (sIL-2R; sCD25) was markedly elevated in 13 (72.2%) of 18 patients with ATL and meningeal infiltration. Levels of sCD4 and sCD25 in the CSF of patients with ATL and meningeal infiltration were significantly higher than in non-ATL patients (p < .01 and p < .001, respectively). These findings indicate that levels of sCD4 and sCD25 in the CSF are probably associated with meningeal infiltration by leukemia cells expressing CD4 and CD25 on surface membranes. CSF levels of sCD4 in 14 (60.9%) of 23 ATL patients and sCD25 in 13 (72.2%) of 18 ATL patients without meningeal infiltration were moderately elevated. These findings suggest that a small number of leukemic cells which were not detected by conventional CSF examination may have infiltrated the meninges in these patients. Sequential measurements of sCD4 and sCD25 in CSF obtained from patients with meningeal infiltration by leukemic cells showed that sCD4 and sCD25 levels reflected the activity of leukemic meningitis and correlated with the number of cells in CSF. However, the levels of sCD4 in CSF did not fall below the limit of detection even when the number of cells in CSF became normal. It is thought that the level of sCD4 in CSF is a more sensitive marker for detecting the infiltration of leukemic cells in CSF than the number of cells present in the CSF considering the clinical course of two patients with acute type ATL. Therefore, ATL patients with meningeal infiltration should receive treatments until sCD4 levels become normal and not just until the number of cells become normal. Our results also suggest that measurement of CSF levels of sCD4 and sCD25 is useful for the differential diagnosis of aseptic meningitis and meningeal infiltration by leukemic cells in patients with smoldering ATL. We conclude that measurement of soluble factors in CSF plays an important role in diagnosis, prophylaxis and treatment of meningitis in patients with ATL.
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PMID:Significance of elevated levels of soluble factors in the cerebrospinal fluid in patients with adult T-cell leukemia. 859 Aug 44

We measured soluble interleukin-2 receptor (sIL-2R) and macrophage colony-stimulating factor (M-CSF) levels in the cerebrospinal fluid (CSF) of patients with hematological malignancies with or without meningeal infiltration and meningitis. Levels of sIL-2R and M-CSF in the CSF of adult T-cell leukemia (ATL) patients with meningeal infiltration were significantly higher than those of ATL patients without meningeal infiltration and non-ATL patients with meningeal infiltration. There was a significant positive correlation between sIL-2R levels and numbers of mononuclear cells in CSF of ATL patients with meningeal infiltration. However, M-CSF levels did not correlate with numbers of mononuclear cells. There was no correlation between CSF and serum levels of sIL-2R. There was also no correlation between sIL-2R and M-CSF in the CSF. Therefore, sIL-2R and M-CSF levels in the CSF may be useful in the diagnosis of meningeal infiltration in patients with ATL. In particular sIL-2R may be a sensitive marker.
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PMID:[Soluble interleukin-2 receptor and macrophage colony-stimulating factor (M-CSF) in cerebrospinal fluid in patients with hematological malignancies: clinical significance in adult T-cell leukemia with meningeal infiltration]. 877 81

Causal organisms and their changes were evaluated in 158 cases of septicaemia admitted to Jikei University Hospital from 1975 to 1994. Eighty patients (50.6%) were aged less than 1 year, and 37 patients (23.4%) were newborns. The average mortality rate was 18.4%. The mortality rate between 1975 and 1984 was 26.8%, and that of the past 10 years (from 1985 to 1994) decreased to 13.7%. Staphylococcus aureus (29 cases, 19.4%) was the most common pathogens isolated, followed by Pseudomonas sp. (24 cases, 15.2%), Escherichia coli (19 cases, 12.0%), and Haemophilus influenzae (18 cases, 11.4%). H. influenzae, Acinetobacter sp., Streptococcus pneumoniae and Group B streptococcus (GBS) increased in the past 10 years (from 1985 to 1994), compared with the preceding 10 years (from 1975 to 1984). The mortality rate of Klebsiella sp. septicaemia (28.6%) was highest, followed by Pseudomonas sp. (25.0%), S. aureus (24.1%), S. pneumoniae (22.2%). H. influenzae and Acinetobacter sp. septicaemia were not fatal. E. coli and GBS were common among neonates and patients aged less than 1 year. H. influenzae septicaemia occurred mainly in patients with meningitis, in those younger than school age. Acinetobacter sp. was common among neonates and children with leukaemia Pseudomonas sp., Klebsiella sp., and Acinetobacter sp. were mainly detected in patients with underlying diseases. E. coli, H. influenzae, S. pneumoniae and GBS were mainly detected in patients without underlying diseases.
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PMID:[Study on septicaemia in infants and children in the past 20 years. Part 1. An analysis of causal organisms]. 889 May 44

Underlying diseases, complications, clinical findings, and laboratory findings were evaluated in 158 cases of septicaemia admitted to Jikei University Hospital from 1975 to 1994, in order to conjectured factors that prescribe for the prognosis. 50% of the patients had underlying diseases. Malignancy including leukaemia (31 cases, 39.2%) was the most common underlying disease, followed by low birth weight infant (17 cases, 21.5%), aplastic anemia (9 case, 11.4%), and congenital heart disease (7 cases, 8.9%). The death rate for patients with underlying disease (27.8%) was significantly greater than the mortality for normal patients with septicaemia (8.9%) (p < 0.05). Meningitis (24.7%) was the most common complication, followed by DIC (19.6%), shock (15.2%), and pneumonia (10.8%). The mortality rate of septicaemia complicated by shock was 66.7% (p < 0.01), and that complicated by DIC was 45.2% (p < 0.01). The mortality rate for patients with the clinical findings of respiratory distress, cough, abdominal distention, cyanosis, splenomegaly, or peripheral coldness was more than 40% and significantly greater (p < 0.01). Mortality rate in patients with granulocyte counts of < 4.000/mm3, platelet counts of < 5 x 10(4)/ mm3, total protein of < 5.0 g/dl, or ESR of < 20 mm/hr were significantly greater (p < 0.01) than those in patients with normal laboratory findings. Coincidence rate of blood and stool cultures was 57.9% for E. coli, and 28.6% for Klebsiella sp., and that of blood and throat cultures was more than 30% for Pseudomonas sp., Haemophilus influenzae, and Staphylococcus aureus. In the study of antimicrobial susceptibility for microorganisms isolated, the number of drug resistant S. aureus had increased in the last 10 years.
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PMID:[Study on septicaemia in infants and children in the past 20 years. Part 2. An analysis of factors that prescribe for the prognosis]. 889 May 45


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