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In chronic lymphocytic leukaemia (CLL) bone marrow trephine biopsy (BMT) is not required for diagnosis but can have a significant prognostic value and can be used for the detection of the minimal residual disease (MRD) and for assessment of the effectiveness of the treatment applied. The aim of the study was to evaluate the morphological changes in bone marrow after treatment with purine nucleoside analogues cladribine and fludarabine. Bone marrow trephine biopsy was taken routinely from 15 patients with CLL. Bone marrow trephine biopsy was performed on every patient before as well as after chemotherapy. The number of cell elements of the marrow (the degree of atrophy), the patterns of bone marrow infiltration, the presence of reticulin and collagen fibres and the disturbances in bone marrow stroma were assessed. The infiltration of bone marrow by neoplastic cells was observed in all the patients before administration of chemotherapy. The infiltration was followed by an increase in the number of reticulin fibres. After the treatment a regression of the reticulin fibres was observed with the lessening of the infiltration. After the treatment the levels of marrow infiltrate were decreased. Increased hypoplasia of the bone marrow was observed after the chemotherapy.
The aim of the study was an estimation of the histomorphometry of megakaryocytes (MK) in bone marrow in selected myeloproliferative and lymphoproliferative diseases. Bone marrow specimens were obtained by trephine biopsies from 41 patients with polycythaemia rubra vera (PV), idiopathic myelofibrosis (MF), chronic lymphocytic leukaemia (CLL), hairy cell leukaemia (HCL) and diffuse large B-cell lymphoma (L). Morphometric evaluation was performed using a standard program set MicroImage (OLYMPUS). The greatest number of typical nucleated MK, “naked” nuclei, anucleated cytoplasmic fragments and the largest area were found in PV. The circular deviation factor of MK and their nuclei increased in all cases. The greatest number of clusters was observed in PV and HCL. A significant increase in the number of dysplastic and “naked” nuclei of MK was noted in all selected haematological diseases. The presence of neoplastic cells in bone marrow increased the morphological changes in MK. Quantitative and morphometrical significant differentiation of MK in separate microscopic field in the same slides confirms the necessity of performing trephine biopsies in each patient with haematological disorders.
In the course of hyperbaric expositions divers undergo extremely stressful conditions. Insufficient compensatory mechanisms and/or inadequate procedure of decompression most frequently lead to the development of decompression sickness (DCS). The formation of gas bubbles in tissue is thought to be a key factor in the onset of DCS. However there are several reported cases of DCS in which gas bubbles could not be detected. Thus a predictive biochemical marker of increased risk of DCS is still much sought after. There is also no general agreement on the nature of reported changes in the number of circulating blood cells induced by diving and decompression. The aim of this study was to evaluate the effect of two different breathing mixtures used in simulated hyperbaric expositions on circulating blood cells and its predictive role in DCS risk assessment. 60 healthy divers underwent hyperbaric exposures at 0.7 MPa with 35 min plateau. 21 divers used air and the other group of 39 divers used trimix (pO2-0.04 MPa, pN2-0.08 MPa, pHe-0.71 MPa) as a breathing mixture. Total decompression time in both groups was 3 hours and 7 min. The following parameters were measured: erythrocyte, leukocyte, neutrophile, and platelet count, haematocrit, MPV, MCHC, MCV, CD61, CD62P expression on platelets, and microplatelets. Hyperbaric exposures and decompressions had a pronounced effect on platelets in the group using air as a breathing mixture contrary to the group using heliox as a breathing mixture where in fact the number of platelets decreased. There were also observed increased amounts of microplatelets in the group using air. CD62P expression in the air group increased after decompression whereas expression of CD61 was not affected in both groups of divers. We observed an increased number of leukocytes and neutrophiles in both groups of divers. Diving and decompression had no significant effect on the number of erythrocytes and their morphology in both groups. Conclusion: Measurements of platelet count, microplatelets as well as the expression of CD62P on platelets seem to be of importance in the assessment of the risk of DCS. The predictive role of the observed changes in leukocyte and neutrophile count after decompression should be further investigated.
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