Showing papers in "American Journal of Clinical Pathology in 1979"

Prognostic factors in adrenal cortical tumors. A mathematical analysis of clinical and morphologic data.

Abstract: Forty-one patients with adrenal cortical tumors were evaluated retrospectively for the presence of histologic and non-histologic features associated with malignant behavior. The patients who survived operation were followed at least five years. The association of these features with subsequent metastasis was examined by both parametric and nonparametric statistical methods. Twelve criteria were statistically significant in predicting subsequent metastasis. The most significant of these were: clinical evidence of weight loss, broad fibrous bands traversing the tumor, a diffuse growth pattern, vascular invasion, tumor cell necrosis, and tumor mass. The tendency toward metastasis for each tumor was expressed in indices that correlated well with diagnoses made by conventional histologic means, but were more accurate in predicting subsequent clinical behavior than nonquantitative methods of evaluation.

Chordoma: A Clinicopathologic Study of Metastasis

Abstract: Thirty cases of chordoma were reviewed with respect to the incidence of distant metastases. Follow-up information was obtained in 27 (90%), and the incidence of metastases was approximately 30%. The sites of the metastasizing primary tumors were predominantly sacral and vertebral. The sites of the metastases were predominantly skin and bone, although metastases were found in the lungs and lymph nodes. In two of the three patients with dermal metastases, the metastases were present prior to the diagnosis of the primary lesions. All three dermal metastases were initially diagnosed as mixed tumors of the skin, and all three patients had at least four such lesions of the skin. Accurate prediction of which chordomas will eventually metastasize is difficult. Clinically, local aggressiveness and radiotherapy were positively correlated with this ability; histologically, more anaplastic chordomas were more likely to metastasize.

Immunoperoxidase Technics in Diagnostic Pathology: Report of a Workshop Sponsored by the National Cancer Institute

Abstract: The use of immunoperoxidase technics has spread dramatically in recent years to almost daily use in certain clinical and surgical pathology laboratories. A wide variety of cell products, including enzymes, polypeptide and steroid hormones, immunoglobulins, oncodevelopmental antigens, viral antigens, and other cell-specific proteins, have been demonstrated in frozen or conventionally fixed and embedded tissue sections by the use of these methods. Major applications of these technics at present include demonstration of various immunoglobulin classes in tumors of lymphoreticular origin and atypical lymphoproliferative processes, identification of polypeptide hormones in endocrine tumors, and demonstration of various tumor markers such as carcinoembryonic antigen and alpha fetoprotein in neoplastic and preneoplastic conditions. The indirect peroxidase conjugate and peroxidase antiperoxidase procedures are presented and reviewed in detail with emphasis on tissue preparative procedures, evaluation of tissue and immunologic controls, background staining, and evaluation of results. The danger of false-negative and false-positive results should be dealt with in a precise manner so that results from different laboratories are both reliable and reproducible. The application of immunoperoxidase technics represents a major advance for the surgical pathologist, but additional evaluation, development, and standardization are required. To accomplish this, comparative studies of the same material, including known positive and negative tissue controls, by different laboratories should be encouraged.

Hemostatic Abnormalities in Malignancy, a Prospective Study of One Hundred Eight Patients: Part I. Coagulation Studies

Abstract: A prospective study of hemostatic abnormalities in 108 cancer patients was undertaken at an oncology clinic in a university teaching hospital. Tests included Quick prothrombin time, activated partial thromboplastin time, thrombin time, platelet count, modified Ivy bleeding time, fibrinogen, fibrin degradation products (FDP), euglobulin lysis time, protamine sulfate test, and factor V, VII, VIII and X assays. Ninety-eight per cent of the patients had one or more abnormal coagulation tests. The commonest abnormalities were elevated fibrin degradation products and prolonged thrombin time. Thrombocytosis occurred in 57% of patients, hyperfibrinogenemia in 46%, thrombocytopenia in 11%, and none had hypofibrinogenemia. It is suggested that platelet count, fibrinogen concentration, and serum FDP assay are the most useful tests in assessing the hemostatic abnormalities in cancer patients, although thrombin time, factor V assay, and bleeding time may also be helpful. The peripheral blood smears of 53 patients were reviewed, and only one showed microangiopathic hemolytic anemia. The data illustrate that subclinical coagulopathy is relatively frequent in patients with malignancy.

Statistical principles underlying analytic goal-setting in clinical chemistry.

Abstract: The Survey programs of the College of American Pathologists (CAP) have assessed current levels of analytic variance in many biochemical measurements, and a number of clinical chemists have proposed analytic goals. The practical importance of further reductions in analytic variance depends on the specific use of the laboratory test. Three general areas of application are described: 1) surveying a population to detect disease, 2) determining whether a particular individual's level of a given analyte is above or below a predefined alarm point, 3) monitoring an individual over a period of time to detect trends. Within each of these different contests, statistical methods are proposed for judging the practical effect of improvements in current levels of analytic precision, taking into account recent estimates of biological variation within the average individual and between individuals. As might be expected, reductions in analytic variance have greatest impact in those applications where biological variance is minimal. Such reductions will generally have little effect on the efficiency of a population survey but may be extremely valuable in decision-making concerning a particular hospital patient.

Malignant lymphoma, T-cell type. A distinct morphologic variant with large multilobated nuclei, with a report of four cases.

Abstract: Clinical, morphologic, and immunologic features in four cases of a cytologically distinctive variant of T-cell lymphoma of large multilobated lymphoid (“histiocytic”) cell type are described. Clinical features included weight loss, fever, and night sweats. The ages of the patients ranged from 42 to 63 years. An extranodal manifestation and distribution of disease was observed in three of the four patients, with a predilection for skin and subcutaneous tissue, bone, gonads, and the central nervous system. Lymphadenopathy was present in all cases but represented the major clinical finding in only one. Splenomegaly was not observed. Histologically, the lymphomatous infiltrate was characterized by large lymphoid cells with markedly irregular, multilobated or hypersegmented nuclei, with relatively fine chromatin, and small to inconspicuous nucleoli. Neoplastic lymphoid cells were identified as T-cell type on the basis of spontaneous rosette formation with sheep erythrocytes (E rosettes). Cytochemically, these cells demonstrated strong punctate cytoplasmic acid phosphatase activity, and α -naphtyl butyrate esterase activity (punctate or dot-like staining pattern). The unusual cytologic features of this variant of malignant lymphoma differentiate it from other types of non-Hodgkin’s lymphomas, and from non-lymphoid malignancies, which it may simulate histologically and clinically.

The histopathology of enteric infection with Yersinia pseudotuberculosis.

Abstract: The gross and microscopic pathologic changes in 70 cases of serologically proven enteric infections with Yersinia pseudotuberculosis are presented The highest incidence was in young males, and the commonest infecting organism belonged to serologic O-group I Clinically, the illness resembled acute appendicitis, but the most consistent finding at laparotomy was mesentric lymphadenitis Surgical specimens examined included 69 mesenteric lymph nodes, 18 appendices, five terminal ileums, and two ascending colons Histologically, four stages of the disease were identified, leading to the formation of characteristic granulomas with central necrosis and microabscess formation Ulceration of the intestinal and appendicular mucosa may occur The illness usually runs a benign course, and antibiotic treatment is rarely necessary The pathogenesis and differential diagnosis are discussed with reference to the current literature

Verruciform xanthoma of the vulva. Report of two cases.

Abstract: Two cases of verruciform xanthoma of the vulva are described. This rare lesion, previously reported to occur only in the oral cavity, is characterized by a verrucous epithelial proliferation accompanied by xanthoma cells distributed exclusively in the papillary dermis. The histologic features of the lesion are diagnostic and include (1) regular acanthosis in which the rete pegs extend to a uniform level into the dermis; (2) hyperkeratosis with parakeratosis often extending deep into the rete pegs and manifesting a massive neutrophilic infiltrate; (3) hyalinization of the collagen and infiltrates of xanthoma cells that are restricted to the papillary dermis between the rete pegs. Additionally, a lichenoid inflammatory infiltrate is seen at the periphery of the verrucous lesions, and in one case this has the pattern of classic lichen sclerosus. Verruciform xanthoma must be differentiated from verruca vulgaris, condyloma acuminatum, granular cell tumor with pseudoepitheliomatous hyperplasia, and verrucous carcinoma.

Mammary carcinoma with osteoclast-like giant cells. A study of eight cases with follow-up data.

Abstract: Eight cases of a rare, distinctive variant of infiltrating mammary carcinoma featuring benign multinucleated osteoclast-like giant cells are reported. The multinucleated osteoclast-like giant cells are reported. The multinucleated giant cells were associated with ductal carcinoma in five cases and with infiltrating lobular carcinoma in three cases. Although three patients had lymph nodal metastases in level one, none of the nodal metastases contained giant cells. From the limited follow-up data of this report, it seems likely that the prognosis for patients who have this type of adenocarcinoma is not especially favorable. The observation that the giant cells generally occurred in areas of prominent angiogenesis suggests that the angiogenesis may be induced by some chemical substance produced by the tumor cells. Biochemical and immunologic investigations may eventually provide an explanation for this unusual morphologic manifestation of host reaction to mammary carcinoma.

Cryptosporidiosis in an immunosuppressed renal-transplant recipient with IgA deficiency.

Abstract: Cryptosporidia are sporozoan parasites that infect epithelial cells of the gastrointestinal tract. Infection with cryptosporidia has been found most commonly in a variety of animal species and only rarely in man. The authors report a case of an immunosuppressed renal-transplant recipient with IgA deficiency who experienced diarrhea and fever and was found to have cryptosporidia in a jejunal biopsy specimen and in air-dried smears of the specimen. By electron microscopy, trophozoite, schizont, and macrogamete forms were identified, and these forms ahd morphologic features similar to those of cryptosporidia previously found in guinea pigs. Treatment of the cryptosporidial infection in this case was with trisulfapyrimidines. The efficacy of this treatment could not be evaluated because of complications.

Extralobar pulmonary sequestration: analysis of 15 cases.

Abstract: Extralobar pulmonary sequestrations occurring in 15 patients were studied Twelve of the lesions were discovered during the first day of life; all of these patients died The lesions occurred more often in male patients (11 cases) Polyhydramnios was present in four infants, and these four plus an additional infant had localized or generalized edema Associated congenital anomalies were present in ten patients, including three examples each of diaphragmatic hernia and bronchogenic cyst In one case the extralobar pulmonary sequestration was composed entirely of a congenital cystic adenomatoid malformation In one other case, congenital adenomatoid malformation was present in a nonsequestered portion of lung Significant lymphatic dilatation was found in four cases, two of which resembled congenital lymphangiectasis Hyaline membranes, present in the normal lungs of three preterm infants, were absent in extralobar pulmonary sequestrations

Opportunistic fungal infection among cancer patients. A ten-year autopsy study.

Abstract: A high incidence of opportunistic fungal infections among cancer patients has been a pressing problem confronting clinicians. The fungal infections in 3,278 consecutive autopsies at Thomas Jefferson University Hospital during a ten-year period (1966-1975) were studied. There were 1,204 (36.7%) cancer patients; 85 (7.1%) of these patients had concomitant fungal infections. The incidence was 9.3% during the last five-year period; 5.1% during the first five-year period. Candidiasis was the most frequent fungal infection (52.2%) among these patients, followed by aspergillosis (31.1%), mucormycosis, cryptococcosis, histoplasmosis and nocardiosis. The leukemias and lymphomas were the most frequent malignancies associated with fungal infections. However, in this study, unlike others, the incidences of fungal infection in patients with some solid tumors were also high, especially those in patients with cancers of the colon and pancreas.

Chronic neutrophilic leukemia. Report of two cases and review of the literature.

Abstract: Chronic neutrophilic leukemia is a rare, infrequently recognized, myeloproliferative disorder. It usually manifests as a leukemoid reaction, with mostly mature granulocytes in the peripheral blood, with rare to occasional immature forms, and sometimes with normoblasts. The clinical manifestations also include hepatosplenomegaly, elevated leukocytic alkaline phosphatase, elevated serum vitamin B12 and serum vitamin B12 binder ("R" fraction), and elevated serum uric acid. Distinction from a leukemegaly, the absence of sepsis, usually normal erythrocytic sedimentation, and the absence of fever. Leukemoid reactions may be associated with elevated serum vitamin B12 and uric acid, but the levels are usually lower than those found in chronic neutrophilic leukemia. Many patients have gouty symptoms, especially after treatment with Busulfan, and many have an unexplained hemorrhagic tendency, making major operations a risk. The authors add two cases to the 11 previously described.

Lipomatous Hypertrophy of the Cardiac Interatrial Septum: A Report of 38 Cases and Review of the Literature

Abstract: Thirty-eight cases of lipomatous hypertrophy of the cardiac interatrial septum are presented and analyzed, together with those previously reported. Available data indicate that this entity is more likely to be seen in the seventh to eighth decade of life, in Caucasians, and with age-associated increases of epicardial fat. It differs from cardiac lipoma, which is a true neoplasm occurring in a younger age group. It is probably more frequent than reported as it is usually not looked for. Atrial arrhythmias sometimes coexist with this lesion, but a cause-and-effect relationship would be difficult to prove. The lesion should be included in the differential consideration of atrial masses found by ultrasound, cineangiocardiogram, and gated radionuclide cardiac imaging.

Solid and mucinous varieties of so-called mammary carcinoid tumors.

Abstract: Three neoplasms that had histologic features reminiscent of carcinoid tumors of other sites were encountered in a review of 3,300 examples of invasive mammary cancer in women (.09%). One of these showed cytoplasmic argyrophilia. This, as well as the two putative carcinoids, lacked argentaffinity. Attention is directed to the occurence of variable numbers of argyrophilic cells in eight of 19 so-called mucinous cancers of the breast studied. Further, neurosecretory-type granules were observed in cells of all four mucinous cancers suitably prepared for electron microscopic examination. The possible reasons for the lack of universal argyrophilic reactions in these lesions is discussed. It is concluded that there may be two types of mammary carcinoid tumors, the solid and mucinous varieties. No patient who had the latter type had experienced treatment failure after five years of observation. Various numbers of ductal epithelial cells in four of 45 examples of banal fibrocystic disease showed cytoplasmic argyrophilia, and neurosecretory-type granules were found in two of eight examples suitably prepared for electron microscopic examination. Whether this demonstration establishes the existence of precursor elements for the development of the carcinoid tumors is at present uncertain.

Increase of IgA-bearing lymphocytes in peripheral blood from patients with IgA nephropathy.

Abstract: Aberration of IgA-bearing B lymphocytes in patients with IgA nephropathy has been investigated. Twelve patients with IgA nephropathy demonstrated a marked increase of IgA-bearing lymphocytes in peripheral blood, while ten patients with chronic proliferative glomerulonephritis without mesangial deposition of IgA showed normal amounts of IgA-bearing lymphocytes. The increase of IgA-bearing lymphocytes reflected that of IgA-producing lymphocytes, since lymphocytes obtained from patients with IgA nephropathy restored a high percentage of IgA-bearing cells in vitro after treatment with trypsin. Quantitation of IgA-bearing lymphocytes in peripheral blood is a useful method for screening of patients with IgA nephropathy.

A nonencapsulated sclerosing lesion of the breast.

Abstract: A histological study of 15 examples of a unique proliferative and tubular lesion (Fenoglio and Lattes) of the breast was performed. Although it consistently lacked infiltration of adipose tissue, the commonality of some of its morphologic features and those of tubular cancer provokes the possibility that these lesions may represent incipient tubular cancers. Nevertheless, such lesions may be satisfactorily treated by simple excision. Since we are certain only about its topographic and clinical behavior, but not its precise biologic nature, we regard the designation nonencapsulated sclerosing lesion most appropriate. Stromal and periductal elastosis was not infrequently encountered in examples of overt sclerosing and blunt ductal adenosis which may mimic, but can readily be distinguished from, the nonencapsulated sclerosing lesion.

Pitfalls in the Interpretation of Leukocyte Counts of Newborn Infants

Abstract: Some pitfalls in the interpretation of neonatal leukocyte counts are identified. The well-known variability in neonatal leukocyte counts was investigated by simultaneously sampling arterial, venous and capillary blood, and during periods of rest and mild and violent exercise. Venous blood leukocyte counts were 82% +/- 3.5 (mean +/- SE, P = less than .001) of counts in simultaneously drawn capillary blood from heel punctures; arterial blood counts were 77% +/- 5.3 (P less than .001) of capillary blood values. Following violent crying, capillary blood leukocyte counts increased to 146% +/- 6.1 (P less than .001) of baseline values, and a shift to the left occurred. Milder exercise induced an increase to 113% +/- 5.2 (P less than .05), without a leftward shift. Thus, counts from different vascular sources cannot be considered equivalent. Also, counts from vigorously crying babies may show leukocytosis and a leftward shift, and erroneously suggest bacterial infection. It is recommended that serial counts be obtained from a consistent vascular source in resting babies.

Correlation of estrogen receptor levels with histology and cytomorphology in human mammary cancer.

Abstract: Histologic and cytomorphologic features of mammary carcinoma have been correlated with estrogen receptor (ER) levels determined by the dextran-coated charcoal (Scatchard) analysis in 51 primary mammary carcinomas. The results were expressed as follows: ER-positive above and ER-negative below 10 fmol/mg protein and ER-rich above and ER-poor below 250 fmol/g tissue for premenopausal patients (750 fmol for postmenopausal patients). Most lobular carcinomas were ER-positive and ER-rich (84.6%). A similarly high percentage (88.9%) of ER-positive and ER-rich determinations was seen in ductal carcinomas with tubular features, whereas only about half of the remaining ductal tumors were ER-positive or ER-rich. The highest ER values were obtained in the lobular carcinomas and in ductal carcinomas with tubular features. Three cytomorphologic indices independent of variation in tumor histology showed a strong correlation with ER values: maximal epithelial cellularity of the tumor (P less than 0.001); cellular size (P less than 0.05); nuclear size (P less than 0.05).

Eosinophilic Cystitis: A Study of 16 Cases

Abstract: The authors describe 16 examples of eosinophilic cystitis. Cases were predominately in older men, and usually were associated with other conditions of the bladder or prostate. In contrast, most of the 21 cases reported in the English language were in women and children who had a low incidence of associated bladder conditions, but often had allergic disorders and eosinophilia. It appears that either bladder injury or allergy predisposes to eosinophilic cystitis. The bladder-injury type probably occurs fairly commonly and can be misdiagnosed both clinically and pathologically. In most of the present series, the clinical diagnosis was carcinoma of the bladder, and some biopsy specimens superficially resembled specimens from cases of nonspecific chronic inflammation. There was muscle necrosis in most examples, and significant replacement fibrosis of muscle in all the latter sometimes masquerading as mucosal fibrosis. Giemsa stain for eosinophils and trichrome stain for muscle fibrosis are helpful diagnostic aids. Also, eosinophilic cystitis appears related to allergic cystitis and interstitial cystitis.

Comparison of the Diagnostic Values of Biopsies of the Pleura and Cytologic Evaluation of Pleural Fluids

Abstract: Results of a comparison of the diagnostic efficacy of percutaneous needle biopsy of the parietal pleura with that of cytologic examination of pleural fluid sediment obtained concurrently from 166 patients with benign or cancerous pleural disorders are reported. Of 44 patients with confirmatory evidence of cancer involving the pleural surfaces, 43 had positive cytologic findings, whereas pleural biopsies were diagnostic in only 16 cases. Of a total of 122 patients with benign pleural diseases, cytology provided the diagnosis in two cases of eosinophilic pleurisy, and pleural biopsy contributed the diagnosis in four of ten cases of tuberculosis. The data indicate that percutaneous needle biopsy of the parietal pleura is less efficacious in the diagnosis of malignant pleural disease than is cytologic evaluation of the fluid sediment, whereas in the diagnosis of tuberculous pleurisy, pleural biopsy proved superior.

The immunologic approach to the pathology of malignant lymphomas.

Abstract: Presentations of malignant lymphomas in the past did not have the benefit of modern developments in immunology and do not bear any relationship to our modern understanding of immunology. The malignant lymphomas in our immunologic approach are regarded as neoplasms of the immune system and involve principally the T- and B-cell systems and alterations in lymphocyte transformation. The cytologic types of our new classification are an attempt to identify specific functional subtypes of the T- and B-cell systems as defective expressions of their normal counterparts. The results of our multiparameter studies on large case series of non-Hodgkin's lymphomas and those of others have demonstrated that the malignant lymphomas for the most part mark as T- or B-cell types, with the exception of a rare lymphoma of true histiocytic type and the unmarked portion of acute lymphocytic leukemia (ALL) of childhood. They have demonstrated the heterogeneity of the cytologic types of the past that possibly account for the diversity of their clinical manifestations and responses to therapy. The immunologic approach has permitted the identification of homogeneous cytologic types that are emerging as clinical morphologic immunologic entities.

Candidal infection of gastric ulcers. Histology, incidence, and clinical significance.

Abstract: Fungal organisms morphologically resembling Candida were found in one third of 72 consecutive surgically resected gastric ulcers. In over half of these cases the organisms were present in the mycelial form. Large numbers of fungi forming clusters were found in 13 cases (18%) and were associated with a surprisingly high postoperative mortality, (38.5%). These organisms are most likely one manifestation of debility in otherwise poor-risk patients rather than a cause of the high morbidity and mortality in these patients. Although organisms of the Candida group are probably not directly etiologic in the development of gastric ulcers, it is possible that their presence aggravates and perpetuates gastric ulceration.

An improved histochemical method for detection of estrogen receptors in mammary cancer. Comparison with biochemical assay.

Abstract: Unselected, consecutive surgical specimens from 120 women with cancer of the breast were subjected to histochemical assay for the presence of estrogen receptor. A fluoresceinated bovine serum albumin--estradiol conjugate was used that linked estradiol at position 17 and contained 5 mol fluorescein and 4 mol estradiol per mole albumin. Simultaneous competitive binding studies with excess unlabeled estradiol, diethylstilbestrol, and the antiestrogen nitromifene citrate were regularly performed. Results were compared to those obtained by the dextran-coated charcoal receptor assay. Three specimens were necrotic, two others thawed, and two lacked sufficient protein for biochemical analysis. One specimen did not contain tumor, and 11 others showed a predominant nuclear staining pattern. Nuclear receptor was not assayed biochemically. Comparison of results in the remaining 101 cases showed agreement in 92%. The precedure is uncomplicated, economical, and could be performed and interpreted in any pathology laboratory.

Terminal deoxynucleotidyl transferase immunofluorescence of bone marrow smears: experience in 156 cases.

Abstract: Terminal deoxynucleotidyl transferase (TdT) is a valuable marker for non-B-, non-T-, and T-cell lymphoblastic disorders. Determination of TdT activity by enzymatic assay is laborious and requires fresh cells. The authors evaluated a new technic for TdT determination, using indirect immunofluorescence on air-dried bone marrow smears. Specimens from 156 consecutive patients with hematologic, oncologic, and other disease states were tested. The TdT visualization by indirect immunofluorescence gives results comparable to those previously reported for lymphoproliferative disorders. Several unusual cases with positive TdT were uncovered. TdT by indirect immunofluorescence is a convenient and rapid technic that enables easier access to TdT determinations than the enzymatic assay.

Aspergillus Mural Endocarditis

Abstract: Infectious mural endocarditis is uncommon and not well documented. The clinical setting and pathologic features of five patients with Aspergillus mural endocarditis are described. Leukemia, carcinoma, renal transplantation, and hepatic failure were the primary diseases. Associated conditions include high-dose corticosteroids, cytotoxic therapy, renal failure, gram-negative sepsis, and endotracheal intubation. All patients received prolonged antibiotic therapy or treatment with three or more antibiotics. All had clinically undetected aspergillosis and severe fungal pneumonia. Fungal myocardial abscesses were present in each patient. Aspergillus mural endocarditis developed in more than 40% of patients with cardiac aspergillosis. Endocardial vegetations were contiguous with underlying myocardial infection; yet they may develop initially as a subendocardial focus rather than from a myocardial abscess. Aspergillus mural endocarditis progressed to destroy the mitral valve ring and served as a source of mycotic embolization to vital organs.

Recovery of soil Amebas from the nasal passages of children during the dusty harmattan period in Zaria.

Abstract: Following a fatal case of primary amebic meningoencephalitis during the dusty harmattan period in an 8-month-old child in whose case Naegleria fowleri was recovered both from the cerebrospinal fluid and from material from the nose in absence of a history of swimming, it was hypothesized that dust during the harmattan might harbor amebic cysts, which may be inhaled by human beings and cause infection. A preliminary survey was thus carried out to examine the nasal passages of children for the presence of soil amebas during the harmattan. In all, 50 children were evaluated for the presence of soil amebas. Positive cultures for the soil amebas were obtained from 12 children (24%). Four species of amebas were isolated singly or in combination with other species. Pathogenic Naegleria fowleri, proved pathogenic for mice, were cultured from specimens from two children.

Current Concepts of Platelet Structure

Abstract: The involvement of blood platelets in hemostasis, hemorrhagic disorders, and thrombotic disease is well known. In more recent years it has been appreciated that platelets also participate in host defense against infection, transplantation rejection, would healing, and the pathogenesis of atherosclerosis. As a result, it became essential to develop knowledge of basic relationships between platelet structure, biochemistry, and function in order to define the mechanisms involved in normal hemostatic activity and pathologic behavior. The specialized approach to identify these associations has been termed platelet structural physiology and pathology. This H. P. Smith lecture summarizes relationships between platelet structure, biochemistry, and hemostatic activity and presents some of the new concepts which have resulted from the multidisciplinary approach.

Increase of IgA-bearing peripheral blood lymphocytes in families of patients with IgA nephropathy.

Abstract: IgA-bearing peripheral blood lymphocytes, serum IgA, urinary sediments and HLA types of patients with IgA nephropathy and members of their families were examined to elucidate whether some familial factors might be related to the development of IgA nephropathy. Ten patients with IgA nephropathy, 31 family members and 36 age-matched healthy persons were examined. All families included certain members with increased amounts of IgA-bearing peripheral blood lymphocytes. The pattern of the emergence of family members with increased IgA-bearing lymphocytes was vertical. Some family members who had increased IgA-bearing lymphocytes showed microhematuria at the time of the study. There was no significant correlation between the amounts of IgA- bearing peripheral blood lymphocytes and levels of serum IgA. HLA types of the ten patients did not show significant deviation from those in the general population. It is suggested that the measurement of IgA-bearing peripheral blood lymphocytes among family members is useful for the screening of patients with IgA nephropathy.