Atypical peripheral ossifying fibroma. A case report.

The typical peripheral ossifying fibroma (POF) usually occurs on the free margin of the gingiva. POF is also thought to arise from the periodontal ligament. The case presented here is unique by virtue of its etiology, size and location.

Submandibular gland sialolithiasis: a case report.

Most cases of sialolithiasis of the submandibular duct are resolved by an intraoral surgical approach. This case is unique in that by virtue of the sialolith's proximity to the hilum of the gland, it was more prudent to perform an excision of the entire gland through an extraoral approach.

Toxic effects of alkyl-lysophospholipids on human bone marrow and de novo leukaemias. A short overview.

Alkyl-lysophospholipids (ALPs) are reported to have an antineoplastic activity against leukaemic cells. We have tested some halogen-containing ALPs from the Central Institute of Molecular Biology (H. Brachwitz) in comparison with racemic 1-ostadecyl-2-methyl-glycero-3-phosphocholine (ET-18-OCH3) (P.G. Munder, Max-Planck-Institut für Immunobiologie, Freiburg, FRG). We found freshly dissolved ALPs to be very toxic both to human bone marrow and to leukaemic cells of patients. ALP-incubation before cryopreservation is more toxic to bone marrow (but not to AML blasts) than after cryopreservation. All experiments to test the selectivity and to establish a purging protocol should be done using 1, remission marrow including a cryopreservation step and 2, blasts of de novo leukaemias instead of cell as sensitive as HL 60 to ALP-incubation. We found direct toxicity of ALPs to be not suitable for purging lines of bone marrow from patients in remission.

Allogeneic bone marrow transplantation for leukaemia and aplastic anaemia. Results of the Leipzig BMT Group.

In acute leukaemias there was a stable plateau in the survival curve at 45% after two years if grafted in first complete remission (n = 20) but only 13% of the patients are disease-free alive if grafted in a more advanced stage of the disease (n = 8). In 16 patients transplanted for chronic myeloid leukaemia the overall survival is 40%, in cases with graft-versus-host disease (GVHD) prevention by cyclosporine survival rate could be improved. Only 8 patients with severe aplastic anaemia, partially in low performance status were able to be transplanted; three died of infections, another by acute GVHD. The fatal complications in our study characterize the international well-known major problems in BMT: GVHD, interstitial pneumonitis, infections, graft failure in aplastic anaemia and recurrence of leukaemia, especially in more advanced leukaemia stage.

Autologous bone marrow transplantation (ABMT) using unpurged marrow as intensification for first complete remission in acute leukaemia (AL).

In order to assess the clinical advantage of autologous bone marrow transplantation (ABMT) without ex vivo purging, the results in 26 patients (10 AML, 16 ALL) in 1. CR were analyzed retrospectively. All patients received 3 consolidation cycles "in-vivo purging" before marrow harvesting. Beside relapses infections and cardiac failure were the most frequent complications. After 1 to 12.5 months 11 cases relapsed with a higher probability in patients who had a longer period of induction and between CR and ABMT. 12 patients became relapse-free survivors 6 to 53 months after ABMT with a stable plateau after 12.5 months for 8 patients. In conclusion, ABMT following "in-vivo purging" as the strongest one-step postremission therapy in patients with acute leukaemias may be a way for better long-term results in these patients.

Transplantation of stem cells of embryonic liver in a patient with severe combined immunodeficiency.

A patient had severe combined immunodeficiency syndrome and X-chromosomal recessive heredity. Since the parents and siblings were not suitable as HLA-compatible bone marrow donors, stem cells from embryonic liver were transplanted intravenously in 3 stages (6 X 10(6); 3.5 X 10(6), and 9 X 10(7]. Transplantation was tolerated well; there were no signs of a graft-versus-host reaction. Examination of the immunological condition after transplantation showed evidence of T-cell reconstitution, immunohistochemistry revealed beginning immune globulin production. The child died at the age of 5 months due to respiratory failure.

[Indication for prophylactic and therapeutic thrombocyte substitution]. / Indikation zur prophylaktischen und therapeutischen Thrombozytensubstitution.

The substitution of thrombocytes is on principle indicated only when a disturbance of the formation is present. The prophylactic application, i.e. before the occurrence of a haemorrhage, which is sometimes life-limiting, is to be preferred, however, on account of the danger of sensitization it is bound to particular conditions: temporarily limited need of substitution, decreased immune reagibility of the recipient (basic disease, therapy), medico-therapeutically induced thrombocytopenia (cytostatic drugs); example: haemoblastoses. Prerequisites are subtile control of clinical effectiveness and formation of antibodies. In planned bone marrow transplantation only preparation of individual donors (not related!) with HLA-A/B match are to be used. The same is applied to already alloimmunized patients, in which case a negative lymphocytotox cross test must still be present. Patients without option to transplantation or without HLA-antibodies may receive also random preparations of individual donors or mixed preparations. AB0-minor-incompatibilities are without significance, AB0-major-incompatibilities are not permissible. The introduction of thrombocyte-specific testings is urgently to be aspired to.--Exclusively therapeutic substitution of thrombocytes, i.e. in manifest haemorrhage, is performed in a primarily not limited period of substitution, in a completely immune competent recipient with regularly low values of thrombocytes without cytoreductive therapy (example: aplastic anaemia). In these cases on account of high danger of sensitization only preparations of individual donors with HLA-A/B-match should be used. In cases of exception in thrombocytopenic, life-threatening haemorrhages on account of metabolic disturbances (immune thrombocytopenia, massive transfusions) the substitution with thrombocytic mixed concentrates is satisfied.--The substitution of thrombocytes is a common task of clinic and blood donation service, which opens new possibilities of therapy (e.g. transplantation of bone marrow).

[Thrombocyte substitution in acute leukemia. Effect of histocompatibility on the clinical efficacy]. / Thrombozytensubstitution bei akuter Leukämie. Einfluss der Histokompatibilität auf die klinische Wirksamkeit.

Thrombocyte substitution is an essential prerequisite for intensive cytoreductive therapy in acute leukemia. Evaluating 228 thrombocyte transfusions in 17 patients shows that the clinical effectiveness of thrombocyte concentrates can be increased by making the coordination of HLA antigens of donor and receiver as good as possible. When measured in the corrected increment (CI) 24 hours after transfusion, the effectiveness of A3/B1 match preparations (CI = 7.0 +/- 1.6) is significantly higher than that of random preparations (CI = 3.0 +/- 0.5). With the presence of HLA antibodies an effective substitution (CI24 greater than or equal to 4.5) can only be achieved by A3/B1 match thrombocytes. This can only be realized by applying the fourfold thrombapheresis of single donors.

[Valuation of autologous bone marrow transplantation in radio- and chemotherapy of malignant tumours (author's transl)]. / Zur Wertigkeit der Auto-Human-Knoehenmarktransplantation bei der Strahlen- und Chemotherapie maligner Tumoren.

This paper discusses the prerequisites of bone marrow autotransplantation performed as part of cancer therapy, the emphasis being on the condition of the patient, the facilities available to the institution for the treatment of cancer patients, the biology of the tumour, and the present possibilities of carrying out what is called superdose cancer therapy. The practical performance of a bone marrow autograft is based upon the withdrawal of bone marrow with indefinite vital stem cell preservation by deep cooling at a time when the tumour has not yet led to bone marrow metastasizing. The conserved bone marrow is used, in subsequent radiological and/or cytostatic superdose therapy, as a reserve in the case of extreme damage to hematopoiesis. The discussion of the current status of this method and the prospects for its general use reflects the whole spectrum of the problems associated with the most favorable procedure to be used, the type of superdose therapy to be employed, the time of regrafting, and the accurate assessment of the results obtained.

[Steatosis of the liver cells--subclinical liver damage or more?]. / Leberzellverfettung--subklinischer Leberschaden oder mehr

The basis of the results are histological investigations of the preparations of liver biopsy of 134 donors who were evident in the SGPT-screening and of 100 patients with viral hepatitis after normalisation of the clinical and the laboratory-chemical findings. The liver casts were got by means of Menghini's method. In patients with hepatitis we found in 43% and in donors in 44% a small-droplet to medium size droplet fatty change in the liver cells. A large-droplet fatty change in the liver cells occurred in the patients with hepatitis only in 2% of the cases, in the donors, however, in 25%. Factors which favour the fatty change in the liver cells, such as adiposis, alcohol and prednisone therapy, were excluded. Our results increase the suspicion that in one part of the clinically healthy donors who are evident in the SGPT-screening we have to do with persons who are in the healing phase of a viral hepatitis with abortive course. Therefore, these persons should be excluded from blood donation. Donors and patients with the findings of a large-droplet fatty change in the liver cells must be investigated systemically. Blood donors with the findings of a fatty liver may remain in the team of donors.

[Studies on the vitality of human bone marrow during collection and deep-freeze preservation]. / Untersuchungen zur Vitalität von Human-Knochenmark bei der Gewinnung und Tieftemperaturkonservierung.

The cryoprotective effect of dimethylsulfoxide, glycerol and polyethylenglycol during freezing and thawing of human bone marrow was investigated by eosin staining test, an acridinorange fluochrome staining test and by RNA- and DNA-synthesis tests. In these tests the overall yield of vital nucleated cells, referred to the number in the absence of cryoprotectants and freezing and thawing, amounted to 50% with dimethylsulfoxide, 30% with glycerol, and 10% with polyethylenglycol. With dimethylsulfoxide and glycerol the loss of vital nucleated cells is almost entirely due to the addition of cryoprotectants. Polyethylenglycol freezing and thawing also leads to a great loss of vital nucleated cells. The results with dimethylsulfoxide show that the currently employed techniques of punction, preparation, freezing and thawing of bone marrow are suitable for clinical application.

[A test system for the measurement of cellular RNA-synthesis in the human bone marrow]. / Ein Testsystem zur Messung der zellulären RNS-Synthese von humanem Knochenmark.

A test for the cellular RNA-synthesis (incorporation of 3H-uridine in the RNA) of human bone marrow has been standardized with respect to the time of incorporation, the number of cells and the concentration of 3H-uridine. The following parameters were estimated for 500 microleter standard assay and 100 microleter aliquots for the determination of the radioactivity: time of incubation 80 min, number of nucleated cells 8 - 10(5), concentration of 3H-uridine 8,3 - 10(-6) M. Actinomycin D inhibits the RNA-synthesis to 90% in a concentration of 1.2 - 10(2) microgram/ml. The test appears generally applicable for the determination of the vitality of bone marrow after cryopreservation, the testing of cryoprotectants and haematotoxic substances and the control of the reaction of the bone marrow during chemical- or irradiation treatment of tumors.