Differentiation of blast cells from a Down's syndrome patient with transient myeloproliferative disorder

A male neonate with Down's syndrome and congenital myeloproliferative disorder was studied. His blood picture showed the unique coexistence of leukocytosis with matured cells and a large number of blast cells. The in vitro proliferation and differentiation of blast cells into various lineages in the presence of phytohemagglutinin-stimulated leukocyte conditioned medium (PHA-LCM) was examined by using a liquid culture and a methylcellulose culture system. The differentiation of blast cells into myeloid cells was confirmed by specific cytochemical stainings, electron microscopy, and an immunologic study. No specific factors in the plasma of the patient promoted the proliferation or differentiation of blast cells. The cellular composition of colonies grown in methylcellulose culture from single blast cells was studied by a micromanipulation technique. High plating efficiency was observed. Of 136 cultures, 78 showed colony growth. Half of the blast cells were colony-forming cells that could proliferate and differentiate into basophils, neutrophils, eosinophils, macrophages, and erythrocytes in the presence of PHA-LCM. Using the blast cells with a high differentiation capacity to the basophil pathway, we studied the effect of recombinant granulocyte-macrophage colony-stimulating factor (GM- CSF). Recombinant GM-CSF support neutrophils, eosinophils, and macrophages but not typical basophils. These findings of the cell differentiation of blast cells into various kinds of cells in vitro were in agreement with the finding of neutrophilia, eosinophilia, basophilia, and thrombocythemia in this patient.     

Improvement of oxygen metabolic reserve after extracranial-intracranial bypass surgery in patients with severe haemodynamic insufficiency

Summary The effectiveness of extracranial-intracranial arterial bypass (EC-IC bypass) surgery on impaired haemodynamic status was studied in 12 patients with reduced regional cerebral perfusion pressure (rCPP) and elevated regional oxygen extraction fraction (rOEF) in the area distal to the symptomatic arterial lesion. Postoperative positron emission tomography (PET) study demonstrated a statistically significant decrease of rOEF in the operated hemispheres with disappearance of the pre-operative interhemispheric rOEF difference. Regional cerebral blood flow (rCBF) and regional cerebral oxygen metabolism (rCMRO2) were also increased in the operated hemispheres with disappearance of the pre-operative interhemispheric differences. Regional CBF/regional cerebral blood volume (rCBV) ratios of the symptomatic hemispheres were increased after surgery, but were still lower than in the contralateral hemispheres. We conclude that EC-IC bypass surgery improves impaired cerebral oxygen metabolic reserve.     

Proton NMR studies on ischemic rat brain tissue.

The spin-lattice relaxation time (T1) of water protons and the cross-relaxation time (TIS) between irradiated protein protons and observed water protons were measured in order to study water-macromolecular interactions in ischemic rat brain tissues. Tissues were obtained by bilateral common carotid artery occlusion from stroke-prone spontaneously hypertensive rats. Water, Na, and K contents were measured in ischemic brain tissue at the same time. Water and Na content increased while the TIS value and K content decreased following ischemic insults. The T1 value did not change until 180 min after ischemia had been induced. Changes in the TIS value occurred earlier than changes observed for the T1 value, water, and electrolyte contents. Results indicate that the value of TIS may be useful for detecting cerebral ischemia and that the physical structure of water-macromolecular interaction may be altered soon after ischemic onset in brain tissue.     

Effect of denopamine on residual left ventricular dysfunction after complete revascularization]

Denopamine (15 mg/day) was administered to 20 patients with residual left ventricular dysfunction after successful percutaneous transluminal coronary angioplasty (75% or more diameter stenosis). Echocardiography was performed before and 6 months after denopamine administration to analyze the left ventricular function. There were significant decreases in both end-diastolic and end-systolic dimensions from 58 +/- 8.3 to 54 +/- 8.4 mm (p = 0.001), and from 44 +/- 10.1 to 40 +/- 10.3 mm (p = 0.005)), respectively, while % fractional shortening remained nearly constant (from 25 +/- 8.3 to 27 +/- 9.6%). Thus, denopamine improved the left ventricular function by decreasing left ventricular size while maintaining wall contractility.     

Immunohistochemical identification of mouse adenohypophysial gonadotropes

Mouse pituitary gonadotropes were identified using immunohistochemical techniques with OsO4 single fixation. Most gonadotropes are immunostained with both LH beta and FSH antisera (FSH/LH gonadotropes), whereas a few gonadotropes are positive only for LH beta (LH gonadotropes). The former gonadotropes are large rounded or oval cells and contain two types of secretory granules: electron-dense smaller ones (about 100-200 nm in diameter) and electron-transparent larger ones (maximum diameter, about 400 nm) enclosed by a halo. The endoplasmic reticulum appears as a series of dilated sacs, and the Golgi apparatus is distinct. The mitochondria are found to have an electron-dense matrix throughout the cytoplasm, but are often concentrated in and around the region of the Golgi apparatus. These fine structural features are somewhat similar to those of the classical Barnes "FSH cell" The LH gonadotropes are polygonal cells of medium size. Small granules, as described above, are seen, but large granules are not. The Golgi apparatus is distinct, but small. The LH gonadotropes resemble neither the Barnes "LH cell" nor the Kurosumi-Oota "LH cell".     

Immunohistochemical study of adenohypophysial gonadotropes in the musk shrew, Suncus murinus L. (Insectivora)

Most gonadotropes in the pituitary of male Suncus murinus L. are immunostained with both LH beta and FSH antisera, whereas only a few gonadotropes are positive only for LH beta. The former gonadotropes consist of polygonal or polyhedral cells of medium size, and can be identified by the presence of two types of secretory granules of low density: smaller ones (about 150-250 nm in diameter) which are spherical in shape, and larger ones of irregular form with a maximum diameter of about 1,500 nm. The endoplasmic reticulum is not prominent, while the Golgi apparatus is distinct. Mitochondria are found throughout the cytoplasm but are often concentrated in and around the region of the Golgi apparatus. These fine structural features are somewhat similar to those of the classical Barnes "FSH cells" and Kurosumi-Oota "FSH cells".     

A young adult male with primary carcinoma of the jejunum

A 37-year-old male was admitted to our hospital because of epigastric pain and weight loss. He was in a stable state of health until 2 months earlier but gradually worsened and lost weight about 13 kg during 1 month. After 1 month, he consulted our clinic. Upper GI barium studies revealed malignant stenosis in about 50 cm from the ligament of Treitz. Radical surgical resection was performed including the segment in 25 cm of intestine containing the primary tumor. Lymph node and liver metastases were not seen. Pathologic findings revealed "well differentiated adenocarcinoma". Thirteen months after the operation, he is well and has gained weight to state of health.