Use of Testosterone and Busulfan in the Treatment of Myelofibrosis with Myeloid Metaplasia

Clinical, hematologic, and isotope data from 10 patients with myelofibrosiswith myeloid metaplasia, before and after treatment with testosterone andbusulfan, are presented. Of the 10 patients treated with testosterone, fiveshowed a good response, three a slight response, and two, no response. Thebest therapeutic responses were seen in five women who either had a previoussplenectomy or in whom the spleen was not massively enlarged. Of the fivepatients treated with bulsufan only, one beneficial response was observed.The indications for and the consequences of the use of these drugs are discussed.

Submitted on May 14, 1963 Accepted on October 5, 1963     

Use of the Plasma Thrombin Time to Assess the Adequacy of in Vivo Neutralization of Heparin: Comparative Studies Following Operations Employing Extracorporeal Circulation

1. The dosage of protamine necessary for the postoperative neutralizationof heparin, used as anticoagulant during extracorporeal circulation, wasstudied in 25 patients by means of both the protamine titration test andthe plasma thrombin time.

2. The plasma thrombin time was found to be far more sensitive in thedetection of small quantities of residual heparin than was the protaminetitration test, which failed to demonstrate significant quantities of circulatingheparin.

3. Adequate neutralization of circulating heparin was achieved when aninitial postoperative protamine dose of 1.5 times the calculated residualheparin was given and followed by additional protamine when indicatedby the result of the plasma thrombin time.

4. No toxic effects of protamine were noted on such a dosage schedule.

Submitted on October 9, 1958 Accepted on December 21, 1958     

RNA Synthesis in Cultures of Normal Human Peripheral Blood

RNA and DNA synthesis were measured in cultures of normal human peripheral blood using tritiated cytidine and thymidine and autoradiographictechnics. RNA synthesis preceded DNA synthesis by 24 hours. RNA synthesisoccurred predominantly in the large and medium-sized "blast-like" cells, butdid occur, to a lesser extent, in the small lymphocytes. RNA synthesis did notoccur in the absence of phytohemagglutinin, nor did DNA synthesis. Mechanisms of action of phytohemagglutinin are discussed with particular referenceto its possible antigenic nature.

Submitted on August 12, 1963 Accepted on January 6, 1964     

Solid phase red cell adherence immunoassay for anti-HIV 1: a simple, rapid, and accurate method for donor screening

In technically developed countries in which acquired immunodeficiency syndrome is a risk to the recipients of blood or tissue, it is mandatory to screen the donor for evidence of HIV (human immunodeficiency virus) infection. Current tests, based on enzyme-linked immunoassay, are time-consuming and expensive and as such are unsuitable for developing countries. We describe a second generation test using anti-human IgG coupled to red cells as the indicator of antibody having reacted with test antigen (1). The test is complete within ten minutes, simple to perform and to read and has 100% sensitivity and 99% specificity compared with Western blot. It is ideal for the rapid screening of organ donors and for the screening of blood donors where cost is a major consideration.     

Marked hyperlipasemia in diabetic ketoacidosis. A report of three cases.

We report three patients with diabetic ketoacidosis (DKA) who presented with striking elevations of serum lipase levels and less striking elevations of amylase and trypsinogen. All three had nausea and vomiting, but none had objective evidence of abdominal pain, and computed tomography scans of the pancreas were unremarkable. These cases suggest the association of asymptomatic enzyme elevations with DKA. We review the literature on this subject.     

Review article: urease, gastric ammonium/ammonia, and Helicobacter pylori — the past, the present, and recommendations for future research

The presence of ammonium in gastric contents was described in 1852; urease activity in the stomach was identified 70 years later. The discovery of gastric urease resulted in intense research activity to discover its origin, function, and relation to the gastric levels of ammonium and urea. Interest in urease waned in the 1960s as most pertinent questions appeared to have been addressed and there was strong evidence that gastric urease was not a property of the stomach but was of microbial origin. Identification of Helicobacter pylori as the source of urease in the stomach in the last decade has resulted in a rebirth of interest in gastric urease and its products.^1–15 There is little actual evidence to support a role for toxicity of ammonia in relation to H. pylori and the bulk of the evidence suggests that the products of urease activity are not toxic and may even be beneficial. The purpose of this review is to examine the older literature and to examine- new findings in the perspective of what is already known and to suggest areas remaining to be examined. We ask, ‘What is old, what is new, and what needs to be done?’