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A tired old lady
Published in Tim French, Terry Wardle, The Problem-Based Learning Workbook, 2022
Examination of the bone marrow is one of the most valuable diagnostic tests in the evaluation of haematological disorders. Bone marrow is usually extracted from the iliac crest using either aspiration or trephine biopsy. The aspirate is then spread onto a slide and stained for microscopy. A trephine biopsy is a solid cylinder of bone, which is fixed, decalcified and sectioned. The aspirate is useful for examination of single marrow-derived cells, whereas trephine biopsy provides architectural information. Marrow samples can be analysed for immunological and cytochemical markers, which are assuming greater importance in the diagnosis of haematological disorders.
Tissue Grafting Techniques
Published in Vineet Relhan, Vijay Kumar Garg, Sneha Ghunawat, Khushbu Mahajan, Comprehensive Textbook on Vitiligo, 2020
The skin punch or surgical punch is an instrument used almost solely by dermatologists. It is interesting to note that it was originally used as a trephine to cut through the skull bone. Its use was documented in abscess removal from tibia as early as in 1852 [25]. In 1878, Watson described its use in the correction of accidental gunpowder disfigurement [26], but the importance of the cutaneous punch instrument in dermatology was first established by Keyes in 1887 [27].
Management of skin disease
Published in Ronald Marks, Richard Motley, Common Skin Diseases, 2019
The removal of a small fragment of skin tissue by trephine (punch biopsy) for routine histological preparation for electron microscopy, immunofluorescence or microbial culture is usually adequate. Sharp, disposable trephines are available, 2–6 mm in diameter. Sutures are not necessary for biopsies of less than 4 mm diameter taken this way, and only occasionally for 4 mm trephines. The following are useful tips for taking biopsies. Choose a new or typical lesion or the edge of an established lesion.It may be necessary to biopsy at different times or to sample different appearing lesions.Handle the biopsy as gently as possible.Take care when biopsying human immunodeficiency virus (HIV)-positive and hepatitis B-positive patients – the laboratories need to be notified beforehand.Patients with bleeding diatheses and heart disease may need prophylactic treatment.
Corneal neovascularization inhibition and wound healing impregnability of conbercept on rabbit cornea after penetrating keratoplasty
Published in Cutaneous and Ocular Toxicology, 2022
Jianbin An, Yue Zeng, Huan Liu, Liying Huang, Jia Yao, Enchong Hou, Xiaorong Zhang
108 New Zealand white rabbits, weighing about 2.5 kg, were provided by the Animal Research Centre of Hebei Medical University (Hebei, China), and were eligible for the national standard for medical animals. 36 rabbits were sacrificed and both eyes were enucleated, and these 72 corneas were obtained as donors for further corneal transplantation. Regular penetrating keratoplasty (PKP) was performed on the right eye of 72 rabbits by one or two authors under general anaesthesia. Before the experiment, the cornea was examined by slit lamp microscopy, and no other ocular diseases were observed. All rabbits were given general anaesthesia by intravenous injection of pentobarbital sodium before the experiment. After the rabbits were killed by auricular vein air embolisation, the corneas of both sides were made into donor cornea tissue. The right eye was selected as the corneal transplant eye, and 0.5% proparacaine was added for corneal topical anaesthesia before surgery. 7.5 mm trephine was used to prepare the grafts, and the 7.25 mm trephine was used to prepare the graft beds. 10–0 nylon thread was used to stitch. Tobramycin eye ointment was used after PKP. In the process of postoperative suture, the suture lines were uniform and the suture nodes were not embedded, thus inducing corneal neovascularization.
Neuritin provides neuroprotection against experimental traumatic brain injury in rats
Published in International Journal of Neuroscience, 2018
Qi Liu, Hang Zhang, Jian Xu, Dong Zhao
The TBI model was used as previously described [20]. Briefly, the rats were anesthetized by an intraperitoneal injection of chloral hydrate (3.0 mg/kg). Surgery was performed under aseptic conditions, and the rats were mounted on a stereotaxic system (ZH0002053, Zhenghua Instruments, Anhui Province, China). A midline incision on the scalp exposed the skull without requiring muscle retraction. For the trephine method, a 5 millimeter diameter electric trephine (ZH-GSZ, Zhenghua Instruments, Anhui Province, China) was carefully used to penetrate the skull to remove the bone flap. Rats were subjected to TBI on the left part of their brain (bone flap centered at the bregma + 1.5 mm, lateral right 2.5 mm) using a weight-drop device. This consisted of a 20 g weight dropped from 30 cm onto a 4 mm diameter footplate resting on the dura with a controlled depth of 1.0 mm. The craniotomy did not significantly affect physiological parameters (i.e. arterial pressure, heart rate or body weight) and was closed immediately after the TBI.
Evaluation of sensitivity and specificity of bone marrow trephine biopsy tests in an Indian teaching hospital
Published in Alexandria Journal of Medicine, 2018
Sima Chauhan, Sarita Pradhan, Ripunjaya Mohanty, Abhishek Saini, Kumudini Devi, Mahesh Chandra Sahu
BMB is not only the ‘clue’ for infiltration, but also provides pattern of involvement.4 In earlier days surgical trephine biopsy was in practice. With introduction of needle trephine biopsy in late 1950s, things have become much simpler and minimally invasive.4 However, trephine biopsy, unlike aspiration, demands more technical skills and is time consuming as well as a painful procedure. Interpretation depends on numerous factors like quality of tissue section and availability of ancillary techniques like immunohistochemistry, special staining and good coordination between hematopathologists and histopathologists.5 Bone marrow procedures help in confirming the clinical diagnosis as well as some new diagnosis, which were not suspected previously. Few studies have analyzed the diagnostic accuracy of marrow aspirates with trephine biopsies.1, 6–8 Here, we compare these two tests i.e. BMB and BMA, to evaluate the sensitivity and specificity of BMB in haematological and non-haematological patients in the same sitting.