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)

The records of 36 infants and children who underwent emergency open lung biopsy at the Hospital for Sick Children, Toronto, between 1969 and 1976 were studied in order to assess the safety and value of performing this procedure in patients with failing respiratory function. Prior to their respiratory illness, 14 of these patients were receiving steroids, chemotherapy, and radiotherapy singly or in combination as treatment for various sytemic diseases of which leukemia was the most prominent. In all cases the biopsy was performed under general anesthesia and lasted about 1 hour. The biopsy was diagnostic in all but one of these children, permitting the institution of appropriate therapy. Six preventible postoperative complications required treatment but there were no deaths attributable to operation in this series. Emergency open lung biopsy is strongly recommended even in patients in severe respiratory failure when all routine investigations fail to yield a diagnosis.
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PMID:The value of emergency open lung biopsy in infants and children. 49 Feb 86

A set of feedings of a lipid solution of 7,12-dimethylbenz(a)anthracene given biweekly by gastric intubation to young adult female mice of the non-inbred CF-1 strain elicited lymphatic leukemia in 73% of the animals in 112 +/- 24 days. Brief ether anesthesia facilitated alimentary administration of hydrocarbons and steroids. Inoculation of whole blood of mice with lymphatic leukemia into the subcutaneous tissue of allogeneic newborn resulted in lymphosarcomas at the injection site sometimes associated with leukemia. The lymphosarcomas of infant mice regressed rapidly following administration of cortisone or dexamethasone. They frequently, but not invariably, recurred; 14% of the mice were free from lymphosarcoma 3 months after treatment with the glucocorticoids.
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PMID:Induction of lymphatic leukemia in non-inbred mice and its control with glucocorticoids. The Lucy Wortham James lecture. 81 25

The effect of prolonged light halothane anesthesia (0.8%) on the proliferation rate of different mouse tissues was investigated, using [5-125I]5-iodo-2-deoxyuridine uptake into DNA as the test parameter. It was found that DNA synthesis in spleen, femoral bone marrow, and, occasionally, the small intestine was significantly depressed after exposure for 24 hr to halothane in vivo. The time course of DNA synthesis inhibition was then investigated by utilizing a shorter (6-hr) exposure time. This period was found to be insufficient to cause DNA synthesis inhibition in any of test tissues. Because anesthesia was found to be associated with hypothermia at normal room temperatures, it was established that the inhibition of DNA synthesis was not due to cooling of the mice under anesthesia by demonstrating that inhibition in sensitive tissues occurred at warmer temperatures as well. To examine the specificity of this finding, the DNA synthesis rate of cells in other normal tissues, e.g., skin and muscle, and in s.c.-growing tumor cells of a mouse mammary carcinoma, L1210 leukemia, and a first transplant AKR lymphoma were examined. In none were responses noted with 24 hr of halothane exposure. However, halothane was found to inhibit DNA synthesis in regenerating marrow. Finally, it was found that after significant exposure to halothane, complete recovery was seen in the spleen after 24 hr, whereas femur DNA synthesis was still depressed by 20% at the same time.
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PMID:Preferential inhibition of DNA synthesis in mouse hemopoietic cells by halothane. 97 81

Splenomegaly associated with myelodysplastic disorders in children may be massive and can result in pancytopenia, abdominal discomfort, and respiratory distress. When these symptoms cannot be relieved by nonsurgical means, splenectomy may be indicated. Under such conditions, surgical splenectomy carries increased risks, as the thrombocytopenia is difficult to correct secondary to splenic sequestration. Additionally, the surgical anatomy is often distorted secondary to the massive spleen and dissection can be difficult. These factors can lead to uncontrollable hemorrhage. In an attempt to decrease intraoperative blood loss, the authors successfully performed preoperative splenic artery embolization in 11 of 12 children (age range, 1-11 years) with pancytopenia due to hypersplenism. Hypersplenism requiring surgical splenectomy was due to leukemia (n = 9), myelodysplastic syndrome (n = 1), immune thrombocytopenia (n = 1), and osteopetrosis (n = 1). Embolization was performed under general anesthesia, prior to surgery, with gelatin sponge particles alone, Gianturco coils alone, or a combination of polyvinyl alcohol sponge particles and Gianturco coils. Embolization allowed for safe surgical splenectomy.
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PMID:Preoperative embolization of the spleen in children with hypersplenism. 144 26

Leukaemia and its associated therapy result in pathophysiological peculiarities relevant to anaesthesia. Leukaemic patients suffer from anaemia, coagulation disorders, and the consequences of immunosuppression. In addition, some patients show infiltrations of the oropharynx, potentially resulting in difficult intubation and/or pharyngeal haemorrhage. Mediastinal masses can induce complete airway obstruction during general anaesthesia. Patients with a white blood cell count (WBC) greater than 100,000/mm3 (hyperleukocytosis) can suffer from the leukostasis syndrome with acute respiratory failure as well as cerebral vascular occlusions and bleeding due to increased blood viscosity and disturbed microvascular perfusion. Since this syndrome may be triggered by surgery, the WBC should be reduced prior to general anaesthesia in patients with hyperleukocytosis. To avoid development of the leukostasis syndrome, transfusion of packed red cells should be restricted in these patients. Hyperleukocytosis can simulate in-vitro hypoxaemia due to the excessive oxygen consumption of the mass of leukaemic blood cells during routine blood gas analysis. Therapy of leukaemia can lead to the tumor-lysis syndrome with hyperuricaemia, hyperphosphataemia, hyperkalaemia, hypocalcaemia, and hypoglycaemia, and may induce acute renal failure. Since drug interactions have only been evaluated for the combination of two or three drugs, interactions of cytotoxic agents with anaesthetics can hardly be predicted because of the large number of drugs simultaneously administered to leukaemic patients. The heart and lungs are target organs for the acute or chronic side effects of cytotoxic drugs, resulting in non-cardiogenic pulmonary oedema (e.g., cytosine-arabinoside), lung fibrosis (e.g., bleomycin), or arrhythmias and cardiac failure (e.g., adriamycin). The severity of these side effects depends on pre-existing organ disease and only in part on drug dosage. Only HLA- and CMV-compatible blood components should be administered to leukaemic patients. Hyperleukocytosis and the first days of cytotoxic treatment represent relative contraindications to general anaesthesia.
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PMID:[Pathophysiologic and anesthesiologic characteristics of patients with leukemia]. 152 54

Between January 1987 and September 1989 three children presented to the childrens' casualty department with spontaneous hyphaema. Physical examination and haematological investigations were sufficient to determine their cause in two cases (sickle cell disease and acute lymphoblastic leukaemia). In the third child an ophthalmological examination under general anaesthesia revealed a granulomatous lesion of the iris consistent with the diagnosis of juvenile xanthogranuloma.
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PMID:Spontaneous hyphaema in childhood. 191 83

Eight children (1-17 yr) underwent bone marrow harvesting while in cytostatic-induced remission of their disease (leukemia [n = 6], Ewing sarcoma, and non-Hodgkin lymphoma). After the induction of general anesthesia, all patients were loaded with 10 mL/kg of a 6% high-molecular dextran solution (Macrodex--Pharmacia), which resulted in a significant preoperative decrease in hematocrit (Hct) from 32% +/- 6% to 28% +/- 5% (hypervolemic hemodilution) and also allowed the procedure to be performed without systemic heparinization. The blood aspirated during the harvest (24 +/- 6 mL/kg; mean +/- SD) was replaced with a solution of 6% dextran and Ringer's acetate solution, and the Hct decreased from 28% +/- 5% to a minimum of 18% +/- 3%. Immediately after the harvest, 10 mL/kg of homologous packed red blood cells was transfused, increasing Hct to 25% +/- 3%. Oxygen saturation in the superior caval vein (ScvO2) decreased from 79% +/- 4% before the harvest to 70% +/- 3% (P less than 0.01) at the end of it, and then increased to 74% +/- 3% after the transfusion of homologous packed red blood cells. There was a strong linear correlation between mean values for Hct and ScvO2 during the various stages (r = 0.99). Mean heart rate decreased gradually during the procedure, from 106 +/- 10 to 86 +/- 7 beats/min. There was no significant change in arterial pressure, but cardiac output measured by impedance cardiography was about 30% greater during harvesting than during undisturbed anesthesia. Pulse oximetric saturation was 99% or 100% throughout. Caval venous blood lactate and pyruvate concentrations remained within normal limits in all children.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Hemodilution during bone marrow harvesting in children. 201 22

This report describes an exploratory population-based study of maternal and perinatal risk factors for childhood leukemia in Sweden. The Swedish National Cancer Registry ascertained 411 cases in successive birth cohorts from 1973 through 1984 recorded in the Swedish Medical Birth Registry. Using the latter, we matched five controls without cancer to each case by sex and month and year of birth. Mothers of children with leukemia were more likely to have been exposed to nitrous oxide anesthesia during delivery than mothers of controls [odds ratio (OR) = 1.3; 95% confidence interval (CI) = 1.0, 1.6]. Children with leukemia were more likely than controls to have Down's syndrome (OR = 32.5; 95% CI = 7.3, 144.0) or cleft lip or cleft palate (OR = 5.0; 95% CI = 1.0, 24.8); to have had a diagnosis associated with difficult labor but unspecified complications (OR = 4.5; 95% CI = 1.1, 18.2) or with other conditions of the fetus or newborn (OR = 1.5; 95% CI = 1.1, 2.1), specifically, uncomplicated physiological jaundice (OR = 1.9; 95% CI = 1.2, 2.9); or to have received supplemental oxygen (OR = 2.6; 95% CI = 1.3, 1.3, 4.9). Because multiple potential risk factors were analyzed in this study, future studies need to check these findings. We did not confirm the previously reported higher risks for childhood leukemia associated with being male, having a high birth weight, or being born to a woman of advanced maternal age.
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PMID:Maternal and perinatal risk factors for childhood leukemia. 206 25

Magnetic resonance imaging was applied to measure the volumes of spleens and lymph nodes of mice infected with three different leukemia retroviruses (LP-BM5 murine leukemia virus, Friend, and Rauscher) in vivo. Anesthesia by rapid intraperitoneal injection of Saffan was sufficient for magnetic resonance imaging and could be repeated at appropriate intervals. Eleven frontal magnetic resonance images through the abdomen with a center-to-center distance of 1.5 mm between adjacent slices were acquired simultaneously. To optimally demarcate spleens from the surrounding tissues, the magnetic resonance images were mildly T2-weighted for mice infected with LP-BM5 murine leukemia virus and mildly T1-weighted for those infected with Friend and Rauscher virus. Measurements requiring only 3 to 4 hours in groups of 24 to 28 mice were accomplished by using a standardized holder (i) accommodating two animals in the supine position and (ii) ensuring reproducible positioning in the magnetic resonance-instrument, and (iii) by reducing the number of phase-encoding steps of mildly T2-weighted magnetic resonance images from 256 to 128. Volumes of spleens and inguinal lymph nodes were calculated from the respective cross-sectional areas. The weights and magnetic resonance image-derived volumes of spleens and inguinal lymph nodes correlated well (r greater than 0.95). Despite large variations in the extent of splenomegaly and lymphadenopathy at any given time, the progression of the disease could easily be followed by repeating magnetic resonance imaging at intervals. Thus, statistically relevant results can be obtained in an infection model requiring the use of only a few animals.
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PMID:Course of murine leukemia retrovirus infection determined in vivo by magnetic resonance imaging. 217 50

Eighty-one children with clinically suspected malignant tumors were subjected to percutaneous fine needle aspiration cytology (FNAC) at the Pathology Department of the National Institute of Child Health, Jinnah Postgraduate Medical Centre, Karachi, from August 1986 through July 1987. There were 47 malignant diagnoses including lymphoma, neuroblastoma, nephroblastoma, Ewing's sarcoma, and leukemia. Histological findings confirmed the FNAC diagnoses in 36 cases in which a subsequent incisional biopsy or surgically removed specimen was available. FNAC results were confirmed in all benign cases. In 10 advanced cases of NonHodgkin's lymphoma, surgery was not possible because of marked malnourishment. One false negative and no false positive result was encountered. Forty-eight were females and thirty-three males. FNAC can be a quick, effective, and inexpensive alternative to open biopsy, particularly in advanced cases of malignancy in undernourished children where anesthesia and immediate surgery are contraindicated.
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PMID:Fine needle aspiration cytology in advanced pediatric tumors. 255 98


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