RESUMO
An unusual case of ulnar translocation of the carpus after a radiocarpal dislocation is described. Persistent instability was noted despite attempted reattachment of the avulsed palmar capsuloligamentous structures. A successful outcome occurred after radiolunate arthrodesis and external fixation of the wrist.
Assuntos
Luxações Articulares/complicações , Instabilidade Articular/etiologia , Traumatismos do Punho/complicações , Adolescente , Artrodese/métodos , Ossos do Carpo/diagnóstico por imagem , Humanos , Instabilidade Articular/cirurgia , Masculino , Radiografia , Rádio (Anatomia)/diagnóstico por imagem , Ulna/diagnóstico por imagemRESUMO
The authors describe a patient with a long-standing history of systemic lupus erythematosus and leukopenia who received multiple intermittent doses of recombinant granulocyte colony-stimulating factor (G-CSF) and who underwent splenectomy because of a clinical impression of sequestration of granulocytes by the spleen. Histologic evaluation of the spleen revealed marked granulocytic hyperplasia with an increase in immature myeloid precursors, morphologically indistinguishable from a myeloid leukemic infiltrate. A postsplenectomy bone marrow aspirate and biopsy revealed a normocellular bone marrow with active hematopoiesis and trilineage maturation. The bone marrow aspirate cultured cells showed no numeric or structural chromosomal abnormality. Extramedullary hematopoiesis after receipt of G-CSF was previously reported, but, to our knowledge, ours is the first report of morphologic changes virtually identical to a leukemic infiltrate in spleen after G-CSF treatment. We describe the histologic and immunohistochemical findings in the spleen, compare our observations with those of others reported in the literature, and postulate a possible mechanism for this phenomenon.
Assuntos
Fator Estimulador de Colônias de Granulócitos/efeitos adversos , Granulócitos/efeitos dos fármacos , Leucemia Mieloide/induzido quimicamente , Infiltração Leucêmica/induzido quimicamente , Baço/efeitos dos fármacos , Adulto , Divisão Celular/efeitos dos fármacos , Feminino , Fator Estimulador de Colônias de Granulócitos/uso terapêutico , Granulócitos/citologia , Granulócitos/patologia , Humanos , Leucemia Mieloide/patologia , Lúpus Eritematoso Sistêmico/tratamento farmacológico , Proteínas Recombinantes , Baço/citologia , Baço/patologiaRESUMO
Surface analysis techniques and in vitro biologic assays were used to characterize sterilized commercially pure titanium surfaces. Significant surface alterations were observed following sterilization treatments. These alterations led to decreased fibroblast cell attachment and altered cellular spreading phenomena compared to nonsterilized control surfaces.
