Interaction of Influenza Virus with Blood Platelets

The interaction of human blood platelets with influenza virus (PR-8) wasstudied in vitro and in vivo.

It was found that "live" influenza virus was rapidly adsorbed onto humanblood platelets at 4 C. and completely eluted at 37 C. "Dead" virus wasadsorbed at 4 C. but not eluted at 37 C. unless the platelets were treated withRDE (receptor destroying enzyme). Adorption of virus also occurred at temperatures above 4 C. (from 20 to 37 C.). However, while adsorption wasmaintained throughout incubation at 4 C., slow elution occurred after 30 to 90minutes incubation at 26 to 37 C. Storage of the platelets for lengthy intervalsat 4 C. or coating of the platelets with macromolecules did not interfere withvirus adsorption. After one cycle of adsorption-elution, blood platelets couldnot adsorb virus again. Treatment with RDE greatly reduced virus adsorption.During the process of virus adsorption, prominent platelet clumping occurred.During elution, clumping remained unchanged, and gross alterations in morphology of the platelets were observed. In the process of virus adsorption-elution, large numbers of platelets were lysed.

Comparative experiments were performed simultaneously with human redblood cells (RBC) and identical results were obtained as with blood platelets.However, the extent of adsorption of live virus was equal for platelets andRBC only when the relationship between platelet number and RBC number inthe preparations used was 6:1. This suggested a direct proportion between thesurface area of both platelet and RBC and the number of available virusreceptors.

Virus suspensions infused into rabbits produced a sharp and sustained dropof the platelet count. Survival of radioactively labeled platelets treated withvirus prior to infusion was markedly shortened with live virus and was onlyslightly reduced with dead virus.

It is suggested from these experiments that blood platelets, as other bloodcells, may serve as carriers of viruses in the circulation and that in this processthe platelets are damaged and partially destroyed.

Submitted on June 30, 1965 Accepted on January 31, 1966     

Haemophagocytic lymphohistiocytosis in association with granular lymphocyte proliferative disorders in early childhood: characteristic bone marrow morphology

Five paediatric cases of haemophagocytic lymphohistiocytosis (HLH) which showed proliferation of granular atypical lymphocytoid cells in bone marrow are reported. All cases were girls aged 8 months to 4 years who had marked hepatosplenomegaly. Marker analysis on peripheral blood mononuclear cells revealed an increase in the CD3⁺HLADR⁺ subset in three cases and the CD³⁻CD56⁺ subset in one case. An Epstein-Barr virus genome was detected in three cases, and monoclonality was confirmed in two cases. A characteristic morphology of large granular lymphocytes (LGL) was identified, with elongated bizarre features that resembled horsetail-, tadpole-, cucumber- or shooting star-type configurations on the bone marrow smear. Serum concentrations of soluble interleukin-2 receptor and interferon-gamma were elevated in all cases. All five cases required multi-agent chemotherapy which resulted in two complete remissions, two partial remissions and one no response. Refinement of treatment is required for these paediatric GLPD cases which probably comprise a specific high-risk subgroup among secondary HLH patients which had previously escaped notice.     

Churg–Strauss syndrome presenting with eosinophilic prostatitis

We report a patient with eosinophilic prostatitis associated with Churg-Strauss syndrome. A 74-year-old man, who had been treated for asthma, underwent transurethral resection of the prostate. After the operation he had a high temperature of approximately 40 degrees C. The differential blood count revealed marked eosinophilia of 77.5%. The patient received 20-mg prednisolone and dramatically became afebrile. The pathological diagnosis was eosinophilic prostatitis. These findings strongly indicate Churg-Strauss syndrome.     

A Histopathological Study on Ventral and Dorsal Pancreas Tissues in Patients with Pancreas Divisum

Abstract: Five cases of pancreas divisum, clinically diagnosed by endoscopic retrograde choledochopancreatography (ERCP), were studied histopathologically. They consisted of four biopsied cases and one patient who underwent pancreatoduodenectomy under the diagnosis of a suspected pancreatic carcinoma. Fibrosis was found in three out of the five cases, two cases with fibrosis in the dorsal pancreas and one in the ventral pancreas. In the two dorsal fibrosis pancreas cases, fibrosis was distributed in the intra- and interlobular areas and was accompanied by atrophy or disappearance of the acinar cells. These findings were compatible with chronic obstructive pancreatitis, distal to a stricture of the pancreatic duct. In the one ventral fibrosis pancreas case, i. e., the pancreatoduodenectomized case, fibrosis was distributed mainly in the interlobular area associated with hemosiderin deposition. Hemosiderin deposition was also observed in inflammatory foci at the posterior aspect of the ventral pancreas. Hence, such interlobular fibrosis developed in relation to the inflammatory foci, and was not caused by pancreas divisum. Therefore, in pancreas divisum, abnormal findings were observed in the dorsal pancreas tissue, and they were compatible with chronic obstructive pancreatitis. (Dig Endosc 1994; 6 : 74–79)     

A Case of Widely Split Double P Waves with Marked Intra-Atrial Conduction Delay

Widely Split Double P Wave. We report a 78-year-old man as the first documented case of double P waves separated by 400 msec on 12-lead ECG. These P waves had different polarities on lead V₁. The first P wave represented activation of the lateral wall of the right atrium, and the latter P wave represented activation of the nudial right atrium and the left atrium. Widely spaced double potentials were recorded craniocaudally along the line, presumably corresponding to the crista terminalis during sinus rhythm. For this to occur, conduction disturbance has to be present both in the upper and lower right atrium. Conduction disturbance in the upper right atrium would interrupt excitation from the sinus node to the medial wall, and conduction disturbance in the lower right atrium would interrupt excitation spreading from the lower lateral right atrium to the isthmus area where fragmented potentials were recorded. These multiple discrete lesions appear to constitute a unique electrical atriopathy in this patient.     

Developmental brain-stem pathology in sudden infant death syndrome

The brain-stems of control and sudden infant death syndrome (SIDS) infants were examined developmentally with Golgi and immunohistochemical methods. The development of dendritic spines changed dramatically from the prenatal to postnatal period in the ventrolateral medulla as well as in the reticular formation and vagal nuclei in controls, but persisted in SIDS infants. These observations suggest a delay in maturation of the meduallary respiratory neurons and transneuronal connection between the central chemoreceptor and neural respiratory center in SIDS. In addition, substance P (SP)-positive nerve fibers were increased in the pons of SIDS infants. An increased activity in the afferent SP neurons in SIDS may be due to chronic hypoxia as in brain-stem gliosis, and may be involved in cardiorespiratory regulation.