Cytogenetic aberrations in adult acute lymphocytic leukemia: optimal technique may influence the results.

The aim of the present study was to analyse the distribution of cytogenetic aberrations in adult ALL in a population based material and compare the results with literature data. Forty-one patients were diagnosed during a 12-year period. The age varied between 14 and 82 (mean 37, median 32). Thirty-two patients were cytogenetically investigated and in all cases analysable metaphases were obtained (range 10-29, mean 24, median 25, success rate: 100%). Nine (28%) patients had a T-phenotype and 23 (72%) had a pre-B phenotype. High hyperdiploidy was found in four patients (13%). Hypodiploidy was found in 5 patients (16%), 10 (31%) had a pseudodiploid chromosome mode and four (13%) showed low hyperdiploidy (chromosome mode 47-51). Chromosomes 10 and 18 were most frequently involved in numerical aberrations. Structural aberrations most frequently involved chromosomes 6, 9 and 22. t(9;22) was seen in six cases (19%), del(6q) in five cases (16%) and der(9p) in five cases (16%). High hyperdiploid clones, which are associated with a favorable prognosis, were found with the same frequency as in other studies. The frequency of t(9;22) was 19% in our study, others have found frequencies between 11% and 30%. Compared to previously published studies our patients with t(9;22) were younger. Furthermore, those with del(6q) were older, showing a median age equivalent to the patient group as a whole. The differences between our data and previously published studies may be explained by population-based derived data and especially by an optimal technique in obtaining metaphases.

[Acute thrombocytopenic hemorrhage as the initial symptom of infectious mononucleosis]. / Akut trombocytopenisk blødning som debutsymptom ved infektiøs mononukleose.

A case of acute thrombocytopenic haemorrhage caused by infectious mononucleosis is presented. The differential diagnostic deliberations and the treatment are discussed.

[Glycosylated hemoglobin (HbA1c) and acute hemolytic anemia]. / Glykosyleret haemoglobin (HbA1c) og akut haemolytisk anaemi.

The concentrations of glycosylated haemoglobin (HbA1c) were determined in eight patients with acute haemolytic anaemia and were found to be significantly lower than in a control group of 16 patients. A case history is presented in which HbA1c was employed as longitudinal parameter of haemolysis. It is concluded that in haemolytic anaemia in non-diabetic patients, HbA1c is a specific parameter of haemolysis which may be employed as a supplement to the traditional parameters of haemolysis.

Huge renal angiomyolipoma presenting with bleeding in a 76-year-old woman. Case report.

Renal angiomyolipoma is a rare, benign and hypervascular tumour. Its symptoms may be acute, with severe bleeding, or protracted, few and recurrent, due to bleeding and pressure. A symptomatic case is presented. The patient seems to be the oldest on record, and with the longest-lasting symptoms and the biggest tumour.

Plasma concentrations following oral and sublingual administration of lorazepam.

Lorazepam 2.5 mg was given as premedication either orally or sublingually to 20 patients undergoing minor gynaecological surgery. Plasma concentrations were followed for up to 8 h after administration. The time for the maximal plasma concentration (tmax) occurred 40 min after oral administration and 60 min after sublingual administration. No significant differences were found between the two treatments at any time. The plasma concentration after 8 h was high compared to the maximal plasma concentration.

Glycosylated haemoglobin (HbA1c) in iron- and vitamin B12 deficiency.

Glycosylated haemoglobin (HbA1c) was measured in 10 patients with iron deficiency anaemia, 10 patients with vitamin B12 deficiency anaemia and 10 healthy controls. Initially there were no significant differences between the groups (P greater than 0.4), but after treatment with iron and vitamin B12 for 3 and 6 weeks, the glycosylated haemoglobin concentration decreased significantly (P less than 0.01). It was concluded that glycosylated haemoglobin is a sensitive marker of the changes in the erythrocyte population that are observed when predominantly immature erythrocytes are being produced.

The relationship between ECG signs of atrial infarction and the development of supraventricular arrhythmias in patients with acute myocardial infarction.

ECGs obtained on arrival at the hospital from 277 patients with acute myocardial infarction were analyzed retrospectively for PR displacements, which were classified as major or minor criteria for atrial infarction and related to the later occurrence of supraventricular arrhythmia in the hospital. Major criteria were (1) PR segment elevation greater than 0.5 mm in leads V5 and V6 with reciprocal PR segment depression in leads V1 and V2, (2) PR segment elevation greater than 0.5 mm in lead I with reciprocal PR segment depression in leads II and III, and (3) PR segment depression greater than 1.5 mm in precordial leads and greater than 1.2 mm in leads I, II, and III. Abnormal P waves were classified as minor criteria. Major and minor criteria were found in 15 (5.4%) and 19 (6.9%) patients, respectively. Eight (53.3%) patients with major and six (31.6%) with minor criteria had supraventricular arrhythmias, giving odds ratios of 9.9 and 3.7, respectively. Enzyme-estimated infarct size, the occurrence of heart failure, and mortality rates did not differ in patients with or without major criteria for atrial infarction. We conclude that the occurrence of PR segment displacements on the admission ECG may predict the risk of developing supraventricular arrhythmias during hospitalization for myocardial infarction.