Linfocitose extrema associada à leucemia linfoblástica aguda (LLA) de células T em um cão jovem: relato de caso / Extreme lymphocytosis associated with acute T-cell lymphoblastic leukemia (ALL) in a young dog: case report

A leucemia linfoblástica aguda (LLA) é uma enfermidade de origem linfóide e consiste na proliferação de células neoplásicas na medula óssea. O objetivo desse trabalho é relatar o caso de um cão macho, sem raça definida, de apenas um ano de idade, atendido no Hospital Universitário de Medicina Veterinária Prof. Firmino Mársico Filho (HUVET) da Universidade Federal Fluminense (UFF) com queixa principal de inapetência e diarreia há três dias e que foi diagnosticado com essa neoplasia por meio da sintomatologia clínica, resultados do hemograma e do mielograma. O paciente apresentava valores exacerbados de linfócitos (553.094 células/µL), além de anemia, trombocitopenia, hipoalbuminemia e elevação da atividade das enzimas fosfatase alcalina e ALT. Foram observadas manchas de Gümprecht, linfócitos atípicos apresentando anisocitose, anisocariose, intensa basofilia citoplasmática e monócitos ativados. O mielograma apresentou também um aumento de linfócitos e contagem de linfoblastos superior a 30% na medula, confirmando o diagnóstico de leucemia linfoblástica aguda. Ademais, posteriormente, foi realizado exame de Reação em Cadeia de Polimerase (PCR) para rearranjos de receptores de antígenos e foi detectado clonalidade para linfócitos T. O animal foi submetido à quimioterapia (protocolo com ciclofosfamida, vincristina e prednisona) mas não resistiu à gravidade do quadro, vindo a óbito após a primeira sessão, pouco tempo após o diagnóstico.

Acute lymphoblastic leukemia (LLA) is a disease with a lymphoid origin and consists of the proliferation of neoplastic cells in the bone marrow. The aim of this study was to report the case of only one year old mixed breed male dog, attended at the University Hospital of Veterinary Medicine Prof. Firmino Mársico Filho (HUVET) from Universidade Federal Fluminense (UFF), with major complaint of inappetence and diarrhea three days ago and which was diagnosed with this neoplasm through clinical symptoms, complete blood count and myelogram results. The patient had increased values of lymphocytes (553,094 cells/µL), in addition to anemia, thrombocytopenia, hypoalbuminemia and elevated alkaline phosphatase and ALT activities. Gümprecht shadows, atypical lymphocytes presenting anisocytosis, anisocariosis, and severe cytoplasmic basophilia and activated monocytes were observed. Myelogram also showed an increase in lymphocytes and a lymphoblastic count greater than 30% in the marrow, confirming the diagnosis of LLA. In addition, polymerase chain reaction (PCR) for antigen receptor rearrangements was performed and clonality for T lymphocytes was detected. The animal underwent chemotherapy (protocol with cyclophosphamide, vincristine and prednisone), but did not withstand the severity of the disease, coming to death after the first session, shorly after diagnosis.

Linfocitose extrema associada à leucemia linfoblástica aguda (LLA) de células T em um cão jovem: relato de caso / Extreme lymphocytosis associated with acute T-cell lymphoblastic leukemia(ALL) in a young dog: case report

A leucemia linfoblástica aguda (LLA) é uma enfermidade de origem linfóide e consiste na proliferação de células neoplásicas na medula óssea. O objetivo desse trabalho é relatar o caso de um cão macho, sem raça definida, de apenas um ano de idade, atendido no Hospital Universitário de Medicina Veterinária Prof. Firmino Mársico Filho (HUVET) da Universidade Federal Fluminense (UFF) com queixa principal de inapetência e diarreia há três dias e que foi diagnosticado com essa neoplasia por meio da sintomatologia clínica, resultados do hemograma e do mielograma. O paciente apresentava valores exacerbados de linfócitos (553.094 células/µL), além de anemia, trombocitopenia, hipoalbuminemia e elevação da atividade das enzimas fosfatase alcalina e ALT. Foram observadas manchas de Gümprecht, linfócitos atípicos apresentando anisocitose, anisocariose, intensa basofilia citoplasmática e monócitos ativados. O mielograma apresentou também um aumento de linfócitos e contagem de linfoblastos superior a 30% na medula, confirmando o diagnóstico de leucemia linfoblástica aguda. Ademais, posteriormente, foi realizado exame de Reação em Cadeia de Polimerase (PCR) para rearranjos de receptores de antígenos e foi detectado clonalidade para linfócitos T. O animal foi submetido à quimioterapia (protocolo com ciclofosfamida, vincristina e prednisona), mas não resistiu à gravidade do quadro, vindo a óbito após a primeira sessão, pouco tempo após o diagnóstico.

Acute lymphoblastic leukemia (LLA) is a disease with a lymphoid origin and consists of the proliferation of neoplastic cells in the bone marrow. The aim of this study was to report the case of only one year old mixed breed male dog, attended at the University Hospital of Veterinary Medicine Prof. Firmino Mársico Filho (HUVET) from Universidade Federal Fluminense (UFF), with major complaint of inappetence and diarrhea three days ago and which was diagnosed with this neoplasm through clinical symptoms, complete blood count and myelogram results. The patient had increased values of lymphocytes (553,094 cells/μL), in addition to anemia, thrombocytopenia, hypoalbuminemia and elevated alkaline phosphatase and ALT activities. Gümprecht shadows, atypical lymphocytes presenting anisocytosis, anisocariosis, and severe cytoplasmic basophilia and activated monocytes were observed. Myelogram also showed an increase in lymphocytes and a lymphoblastic count greater than 30% in the marrow, confirming the diagnosis of LLA. In addition, polymerase chain reaction (PCR) for antigen receptor rearrangements was performed and clonality for T lymphocytes was detected. The animal underwent chemotherapy (protocol with cyclophosphamide, vincristine and prednisone), but did not withstand the severity of the disease, coming to death after the first session, shortly after diagnosis.

Aqueous wheat extract (Triticuma estivum) prevents carboplatin-induced myelosuppression and oxidative stress in Wistar rats / Extrato aquoso de trigo (Triticum aestivum) na prevenção da mielossupressão e estresse oxidativo induzidos pela carboplatina em ratos Wistar

ABSTRACT: The present study aimed to evaluate the use of aqueous wheat extracts as an adjunct to antineoplastic therapy with carboplatin. In this study, 32 rats were used which were randomly distributed into 4 groups: G1 - negative control; G2 - control treated with physiological solution; G3 - animals treated with aqueous extract of wheat in the concentration of 100mg/kg; G4 - animals treated with aqueous wheat extract at the concentration of 400mg/kg; 300mg/m² of carboplatin was administered intraperitoneally at day 0 in animals from groups G2, G3, and G4, whereas 1ml of physiological solution was administered by the same route in animals from group G1. Animals were treated daily for 21 days by orogastric gavage according to their respective experimental group. Blood was collected from animals on days 3, 7 and 21 for complete blood count (CBC), biochemistry, and measurement of paraoxonase 1 (PON1) activity. On day 21, animals were euthanized and necropsied. Promising results were obtained regarding oxidative balance in groups G3 and G4. Both presented better PON1 activity in comparison with group G2 (P<0.05). Total leukocyte count of group G4 differed significantly from group G2 (P<0.05) on day 21. Myelogram values of animals from groups G3 and G4 were ​​similar to those from G1; animals from G3 had lower numbers of promyelocytes and increased numbers of erythrocytes and rubriblasts than animals from G2 (P<0.05). In the present experimental study, aqueous wheat extract was safe at the doses used in the animals, and was an effective treatment for myelosuppression and for the prevention of an excessive release of free radicals induced by carboplatin.

RESUMO: O presente estudo avaliou a utilização dos extratos aquosos de trigo como adjuvante a terapia antineoplásica com carboplatina. No estudo foram utilizadas 32 ratas, as quais foram aleatoriamente distribuídas em quatro grupos: G1 - controle negativo; G2 - controle tratado com solução fisiológica; G3 - tratado com extrato aquoso de trigo na concentração de 100mg/kg; G4 - tratado com extrato aquoso de trigo na concentração de 400mg/kg. Administrou-se 300mg/m² de carboplatina por via intraperitoneal no dia 0 nos grupos G2, G3, e G4, enquanto no G1 foi administrado 1mL de solução fisiológica pela mesma via. Os animais foram tratados diariamente durante 21 dias por gavagem orogástrica de acordo com seu respectivo grupo experimental. Foi coletado sangue dos animais nos dias três, sete e 21, para realização de hemograma, testes bioquímicos e mensuração da atividade da paraoxanase 1 (PON1). No dia 21 os animais foram eutanasiados e realizada coleta de medula óssea, rim e fígado. Foram observados resultados promissores com relação ao balanço oxidativo no G3 e G4, pois ambos apresentaram melhor atividade da PON1 em relação ao G2 (P<0,05). Além disso, foi constatado que os mesmos grupos apresentaram contagem de leucócitos totais superiores ao G2 durante todo o período experimental, com G4 diferindo significativamente do G2 (P<0,05) no dia 21. Os mielogramas dos animais do G3 e G4 apresentaram valores análogos ao G1, sendo que o G3 apresentou menor contagem de promielócitos e maior de células eritroides e rubroblastos que o G2 (P<0,05). Nas condições experimentais deste estudo os extratos aquosos de trigo mostraram-se seguros nas doses utilizadas e úteis no tratamento da mielossupressão e liberação excessiva de radicais livres induzidas pelo fármaco carboplatina.

Relation between anaemia and bone marrow features and serum erythropoietin in dogs with chronic kidney disease / Relação entre anemia e achados de medula óssea e eritropoetina sérica em cães com doença renal crônica

Chronic anaemia is one of the most severe complications of chronic kidney disease, contributing to morbidity and mortality caused by the disease; therefore, bone marrow cytological evaluation is needed to monitor the progression of anaemia. This study aimed to correlate the anaemia in dogs at different stages of chronic kidney disease with their serum biochemistry, myelogram results and serum erythropoietin findings. Sixty-three dogs were grouped according to International Renal Interest Society (IRIS) classification in stages 1, 2, 3 and 4. Haematologic, serum and urinary biochemistry and serum erythropoietin were performed for comparison with the findings of bone marrow cytology obtained by aspiration of the manubrium. Cytological findings for erythroid hypoplasia were described in 93.65% of dogs, and the anaemia was observed in 84.1% of them. The haematological findings were correlated with azotaemia (p<0.05). It was concluded that the erythroid hypoplasia has correlation with persistent anaemia in dogs at all stages of chronic kidney disease, with iron deficiency in dogs in the early stages and with peripheral destruction of erythrocytes caused by azotaemia.(AU)

A anemia crônica é umas das complicações mais graves da doença renal crônica, contribuindo para a morbidade e mortalidade causada pela doença; Portanto, a avaliação citológica da medula óssea é necessária para monitorar a progressão da anemia. Assim, esse estudo objetivou correlacionar a anemia em cães em diferentes estágios da doença renal crônica aos achados de bioquímica sérica, mielograma e concentração sérica de eritropoietina. Sessenta e três cães foram agrupados de acordo com a classificação da International Renal Interest Society (IRIS) em estágios 1, 2, 3 e 4. Foram realizadas análises hematológicas, bioquímicas séricas e urinárias, e dosagem sérica de eritropoetina para comparação com os achados medulares obtidos por citologia aspirativa do manúbrio. Os achados citológicos de hipoplasia eritróide foram descritos em 93,65% dos cães, e a anemia foi observada em 84,1% dos cães. Os resultados hematológicos foram correlacionados com azotemia (p<0,05). Concluiu-se que a hipoplasia eritróide teve associação com a anemia persistente em cães em todas as fases de doença renal crônica, com deficiência de ferro em cães em fases iniciais e com a destruição periférica dos eritrócitos causada pela azotemia.(AU)

Bone marrow cytological evaluation in dogs with chronic kidney disease / Avaliação citológica da medula óssea de cães com doença renal crônica

Since anemia is indicated as an important compromising factor for the quality of life of dogs with chronic kidney disease (CKD), bone marrow cytological analysis may provide more information on the hematological profile these dogs and, therefore, allow clinicians to not only choose the most adequate treatment but also monitor the response to therapy. The aim of this study was to investigate the feasibility with sternal bone marrow puncture in chronic kidney disease (CKD) using only local anesthesia and check if the cytological analysis is helpful to determine the hematological status. We found that erythroid hypoplasia occurred only in terminal CKD patients, and that the bone marrows of dogs with CKD stages 2 and 3 were quantitatively similar to those of elderly dogs. All dogs tolerated the bone marrow puncture using only local anesthesia with lidocaine and bone marrow cytological evaluation may be a useful tool for hematopoietic evaluation of anemic dogs with CKD...

Sendo a anemia apontada como um importante fator comprometedor da qualidade de vida dos cães portadores de doença renal crônica (DRC), a análise citológica da medula óssea poderia fornecer mais informações acerca do perfil hematológico desses animais e, portanto, possibilitar ao clínico não somente optar por um tratamento mais adequado, mas também monitorar a resposta à terapia. Diante disso, objetivou-se com este estudo avaliar a praticabilidade e a aceitação do procedimento de coleta de medula óssea do osso esterno de cães com doença renal crônica (DRC) utilizando somente anestesia local, bem como verificar se os resultados fornecidos na análise citológica fazem-se úteis à composição do quadro hematológico desses pacientes. Observou-se que a manifestação de hipoplasia da série eritroide só ocorreu nos pacientes em estádio terminal da DRC, e que as medulas ósseas dos DRC em estádio 2 e 3 assemelharam-se quantitativamente à medula de animais idosos. Os cães de todos dos grupos toleraram bem a punção do osso esterno somente com uso de lidocaína, podendo ser esta, portanto, uma ferramenta útil na complementação da abordagem hematopoiética de cães anêmicos com DRC...

Desvio para a esquerda associado a compartimento medular de reserva dos neutrófilos não esgotado em cadelas portadoras de piometra / Nuclear left deviation associated with medullary reserve compartment of non exhausted neutrophils in female dogs with pyometra

From fifteen female dogs with clinical diagnoses of pyometra, hematological exams were performed at three times: M0 (prior to the surgery), M24 (24h after ovarysalpingohisterectomy-OSH) and M48 (48h after OSH). Anemia was seen in 80% of the cases, characterized as mild normocytic normochromic type. The means of total leukocyte counts were 27.043, 57.940 and 40.139 céls/µL in M0, M24 and M48. A total of80% of the animals presented neutrophilic left shift in all moments. During medullar exams, the cellular, iron reserve and megakaryocytic concentration were raised as well as the ME ratio, showing a value of 26,3:1,0, probably due to the elevation of granular proliferation and maturation compartment, as the mean of the reserve compartment was within normal range. As 83% of the animals with neutrophilic left shift showed a melullary reserve compartment raised, it can be concluded that female dogs with piometra had left shift of neutrophils with disproportionally between compartments, without segmented medullar saturation.(AU)

An application of moderately T2-weighted 3D TSE-FS pulse sequence to MRI myelography in investigation of patient with cervical spondylotic radiculopathy.

Conventional MRI and MRI-myelography studies were classified as positive when morphological alterations noted correlated with clinical presentations. This study was to analyse the usefulness of MRI myelography of the cervical spine using technique of moderate T2-weighted Three Dimensional Turbo Spin Echo-Fat Sequence pulse sequence in identifying nerve root compression in patients with cervical spondylotic radiculopathy. MRI myelogram detected less nerve root compression 5% but conventional MRI 8%. Clinical findings were significantly associated with imaging findings in both imaging techniques (p<0.001). MRI myelogram overreported 45 and conventional MRI over-reported 80 nerve roots compression when correlated with clinical presentation (p<0.001). There was 50% alteration on conventional MRI when viewed together with MRI myelogram. There was significant difference with nerve root compression and clinical findings between MRI myelogram and conventional MRI (p<0.001). MRI myelogram underestimated the number of nerve roots compressed but it altered the interpretation of conventional MRI in 5% cases when viewed together. The addition of MRI myelogram increased the number of positive nerve roots. MRI myelogram is a useful adjunct to conventional axial and sagittal imaging in the investigation of cervical spondylotic radiculopathy.

Anemia mielotísica por osteopetrose em um cão: relato de caso / Mielotisic anemia caused by osteopetrosis in a dog: case report

A osteopetrose é uma doença rara, caracterizada pelo aumento generalizado da densidade óssea. Tem como característica principal, a reabsorção osteoclástica defeituosa, resultando no acúmulo de massa óssea. Além disso, pode ocorrer retardo do crescimento, desnutrição progressiva, anemia e caquexia. O presente relato descreve o caso de uma cadela, com aproximadamente nove meses de idade, sem raça definida, com histórico de apatia e disorexia. Hemogramas seriados demonstraram pancitopenia persistente. Vários exames laboratoriais foram realizados para excluir doenças como erliquiose, leishmaniose e cinomose, porém todos foram negativos. O mielograma constatou hipocelularidade relativa por provável aplasia/hipoplasia medular. Exames radiográficos evidenciaram o aumento da radiopacidade óssea e hipertrofia da região cortical, e a necropsia confirmou a redução do canal medular. O exame histopatológico confirmou a osteopetrose. Conclui-se que a osteopetrose pode causar comprometimento na produção de células sanguíneas, sendo uma causa rara de anemia mielotísica, além de alterações neurológicas secundárias à má-formação dos ossos do crânio.

Osteopetrosis is a rare disease characterized by generalized increase in bone density. The defective osteoclastic resorption results in the accumulation of bone mass. Furthermore, there may be growth delay, progressive malnutrition, anemia and cachexy. This report describes the case of a nine month old, mixed breed, female dog presented with apathy and disorexia. Laboratory tests were performed to rule out Ehrlichiosis, Leishmaniasis, and Canine distemper, but all were negative. Hemogram showed persistent pancytopenia and myelogram showed relative hypocellularity, probably due to spinal cord aplasia/hypoplasia. Radiographs showed increased bone opacity and hypertrophy of the cortical region, and the necropsy confirmed the reduction of the medullary canal. Histopathological examination confirmed osteopetrosis. In conclusion, osteopetrosis can compromise blood cell production, and is a rare cause of mielotisic anemia. It can also cause neurological deficits due to cranium bone deformation.

Mielograma de ratas com disfunção tireoidiana / Bone marrow examination in rats with thyroid dysfunction

The cells of the myelo id, lymphoid , and erythroid lineage s of the bone marrow were quantified in rats with hypo and hyperthyroidism. Fifteen Wistar rats were divided into three groups: hypothyroid (n=5), hyperthyroid (n=5) , and control (n=5). Three months after the onset of the treatment s, euthanasia was performed . Bone marrow was aspirated from femurs of each animal to perform smear s that were stained with Quick Panoptic. T he percentage s of rubroblast, prorubrocyte, metarubrocyte, myeloblast, promyelocytes, metamyelocytes, myel ocytes, segmented, eosinophils, basophils, lymphocytes, plasma cells and monocytes in were determined a total of 500 cells. The bone marrow of animals with hypothyroidism had hypoplasia. The myeloid:erythroid ratio was higher in animals with thyroid dysfun ction. In hypo and hyperthyroidism, there was a significant reduction of the percentage of rubrocyte, metarubrocyte , and lymphocytes and increase of myelocytes and segmented cells. In hypothyroidism, there was a significant increase in the percentage of me tamyelocytes. It is c oncluded that both hypo and hyperfunction of thyroid increase the myeloid:erythroid ratio by increasing the number of cells of the myeloid lineage and reducing the cells of the erythroid lineage.

Mielose eritrêmica em um gato / Erythremic myelosis in a cat

Neste relato, é descrito um caso de mielose eritrêmica em um gato. Essa doença é considerada de aparecimento raro na clínica médica veterinária. Uma gata, raça Siamês, de um ano de idade, foi atendida com sinais clínicos de acentuada anemia, emaciação e febre. Havia marcada anemia arregenerativa, com grande número de precursores eritróides e megaloblastos atípicos, identificados pelo hemograma. O mielograma revelou população eritrocitária acima de 85 por cento, quando comparada com a mielóide. A citologia aspirativa por agulha fina dos linfonodos revelou a presença de células eritróides imaturas. Na necropsia, o baço, os linfonodos e a medula óssea estavam obliterados por células neoplásicas. O diagnóstico de mielose eritrêmica foi dado com base nos achados clínico-laboratoriais e anatomopatológicos.

The aim of this research is to describe a case of erythremic myelosis in a cat. This disease is considered rare in veterinary clinics. A one-year-old female siamese cat was brought to the veterinary hospital with clinical signs of severe anemia, emaciation and fever. The blood panel revealed marked nonregenerative anemia with elevated number of atypical erythroid progenitors and megacaryoblasts. Elevated atypical erythroid over myeloid precursors (above 85 percent) were also found in bone marrow biopsy. Fine-needle aspiration cytology of lymph nodes revealed immature erythoid cells. At necropsy, spleen, lymph nodes and bone marrow were obliterated by neoplastic cells. The diagnosis of erythremic myelosis was given by clinical, laboratorial and pathological findings.

Generalized Tonic-Clonic Seizure following Myelography with Iohexol (Omnipaque.): A Case Report / 대한정형외과학회잡지

We encountered a patient who had a rare occurrence of a seizure after lumbar myelography from the beginning of this untoward side effect. Clinical trials with iohexol in myelography have demonstrated a good tolerability of this water-soluble contrast medium. However, there have been a few reports that have shown acute adverse reactions such as headaches, vomiting, psychosis, confusion and generalized tonic-clonic seizures. Despite the reports on the safety of iohexol use, it may cause a generalized seizure attack without an epileptogenic history. Therefore, thorough attention and the preparation for emergency treatments for the seizure are essential in every myelography using iohexol as a contrast medium. Moreover, in order to avoid unwanted legal problems, the patients and their family need to be informed of the necessity and possible side effects associated with myelography.

The result of examination on the myelogram of 24 Vietnamese healthy people

To carry out examination on the myelogram of 24 Vietnamese healthy people (12 men and 12 women) from 30 to 50 old age. The myelogram was made from 0.5ml aspirated material sucked from the right posterior iliac spine. The results showed that: - Indices of bone marrow cells on this objects were same as that using recently. However, mean number of nucleated cells in bone marrow distance (59.28(16.69G/l) and in women it is higher that that of men. Percentage and absolute number of erythrocytic line and lymphocytic line are relatively high. - Mean number of mega karyocytes per one marrow film is 13.34(6.02 in women it is also higher than that of men. This index can be useful for quantitative analysis on the mega-karyocytic line.

Sacral Perineural Cyst: Another Cause of Sciatica

About 25% of intrasacral perineural cyst cause sciatica resembling lumbar disc herniation or lumbar stenosis. We report a case of sacral perineural cyst in a 38-year-old female who complained of sciatica and neurogenic intermittent claudication. Delayed X-ray after 3 hours from initial myelogram revealed round cyst at the sacral canal. CT and MRI revealed a cystic mass which has cerebrospinal fluid(CSF) signal intensity. The patient underwent surgery via sacral laminotomy and ligation of cyst including S2 nerve root. The patient returned to work with complete relief of symptoms.

Some opinions of the myelogram in 2,445 cases implemented in the Ho Chi Minh center for Hematology and Blood Transfusion

Compiling 2,445 bone marrow aspiration cytology done at hematology department of HCM city and Blood Transfuson Centre (between Mar 1996-Aug 1998) we found the following results. -Acute leukemia: 737 cases (30.1%) -Myelohyperplasia syndrome: 132 cases (5.4%). - Aplastic anemia: 98 cases (4%). - Myelodysplasia: 49 cases (22%). -Lympho profilerative disease: 41 cases (1.7%). - Megaloblastic anemia: 14 cases (0,6%).- Cancer metastasis 26 cases (1.1%). - Extramedullary disorders: 1,100 cases (45%) - Normal Bone marrow cytology 213 cases (8.7%). Needle bone marrow aspiration technic, simple, nearly without complication, now still has remained the major diagnostic test for hematology disorders.

Anterior Sacral Meningocele: Case Report

Anterior sacral meningocele is a rare congenital lesion. The authors report a case of anterior sacral meningocele in a 51-year-old male who complained of lower abdominal pain and small caliber stool. Myelogram and magnetic resonance imaging(MRI) revealed a meningocele on anterior part of the sacrum communicating to the spinal canal. Total laminectomy on S 3, 4 and a ligation of the spinal canal between normal dura and meningocele on S 2/3 level were carried out. The patient returned to home 2 weeks postoperatively with complete relief of symptoms.

Thoracic Disc Herniation Treated by Transthoracic Transpleural Approach

Thoracic disc herniation is uncommon disease and its diagnosis and treatment still remain difficult. We present a case of thoracic disc herniation at T7-8 vertebral level presenting with signs of spinal cord compression. The lesion was diagnosed by magnetic resonance image(MRI) and iopamidol-enhanced computed tomography(CT). The patient was operated by transthoracic transpleural approach using the surgical microscope. the operative result was excellent. A brief review of the literature is given.

A Case of Intramedullary Glioblastoma Multiforme Involving Thoracic Cord in Child

Primary spinal glioblastoma multiforme is very rare, especially in childhood. 13-year-old boy was admitted to our neurosurgical department because of paraparesis, sensory loss below T10 and sphincter disturbance. Thoracic myelogram showed complete obstruction at T10 level and total laminectomy with partial removal of the intramedullary cord tumor mass was performed under the impression of spinal cord tumor. Postoperatively, his symptoms and signs unchanged. Pathological diagnosis was intramedullary glioblastoma multiforme involving thoracic cord.

INFLUENCE OF FLEXION-EXTENSION MOTION OF LUMBAR SPINE ON LUMBOSACRAL DURAL SAC ?AN EXPERIMENTAL STUDY / 第二军医大学学报

In order to analyse the effects of flexion-extension motion of lumbar spine on the position and shape of lumbosacral dural sac, measurements were performed on 10 flexion/extension lateral myelograms of cadaver specimens of normal lumbar spine.It could be seen that from flexion to extension both sagittal diameter and length of the dural sac increased significantly, the dural sac moved caudally, and the sagittal diameter of the anterior epidural space decreased in the mid-vertebral level but increased in the inter vertebral level.The dynamic changes of the dural sac, the influence factors and the clinical relevances were discussed.