The dead leukocyte content of the blood in normal and leukemic patients

The dead leukocyte content of the blood of normal and leukemic subjects wasdetermined by the technic of the unstained-cell counts of Schrek. A small andconstant number of dead leukocytes was found in the normal blood, averaging46 per cu. mm. In patients with chronic lymphocytic leukemia and acute leukemia, higher numbers of dead leukocytes were commonly found, ranging fromnormal values to as high as 4,600 per cu. mm. No correlation was found betweenthe numbers of smudge forms on blood smears from these patients and the number of dead leukocytes. The smudge forms on blood smears appear to result fromthe mechanical trauma produced in making the smears. The leukocytes fromchronic lymphocytic leukemia and acute leukemia appear to be much more susceptible to the mechanical forces produced in the preparation of blood smearsthan are leukocytes from normals and patients with chronic granulocytic leukemia.

Submitted on June 25, 1956 Accepted on August 12, 1956     

In Vivo Cultivation of Leukocytes in Diffusion Chambers: Requirement of Ascorbic Acid for Differentiation of Mononuclear Leukocytes to Fibroblasts

Studies were made to evaluate the influence of ascorbic acid upon thedifferentiation of mononuclear leukocytes to fibroblasts when cultivated indiffusion chambers, in vivo. Ascorbic acid-depleted leukocytes grown in ascorbic acid-deficient host guinea pigs developed into abnormal cellular formscharacterized by nuclear enlargement, multipolar mitoses, and giant formsThese changes could be reversed by treatment of the host guinea pigs withascorbic acid. The findings indicate a direct cellular role of ascorbic acidin the differentiation of mononuclear leukocytes to fibroblasts.

Submitted on April 12, 1961 Accepted on June 14, 1961     

The influence of respiratory movements upon the circulating leukocytes

1. The leukocyte content of venous and arterial blood of 17 subjects wasstudied repeatedly and frequently during respirations and the Valsalva andMuller maneuvers. The venous and arterial samples were drawn simultaneouslyand were obtained by direct puncture from freely-flowing peripheral veins orarteries or by catheterization from the right ventricle, pulmonary artery, hepaticvein, left ventricle or aorta.

2. During the Valsalva maneuver, the arterial leukocyte count decreasedmarkedly with relatively little alteration in the simultaneous venous counts;upon release of the forced expiration both counts promptly regained the controllevel.

3. During the Muller maneuver, increases in both arterial and venous leukocyte counts occurred in one patient, while no significant effect was observed invenous samples in a second subject.

4. During inspiration the arterial leukocyte count fell and the simultaneousvenous count rose with reciprocal changes upon expiration. These changes occurred whether the initial counts were elevated, normal or leukopenic.

5. The changes in leukocyte number of both arterial and venous blood duringrespiratory movements are not due to hemoconcentration or hemodilution andsuggest a tidal ebb and flow of leukocytes into and from the pulmonary circulation of a significant degree.

Submitted on November 14, 1951 Accepted on February 14, 1952     

Major hepatectomy and right hemicolectomy at the time of primary cytoreductive surgery for advanced ovarian cancer: report of a case

Major liver involvement at the time of diagnosis is a rare event in patients with ovarian cancer, and the issue of major hepatectomy at the time of primary cytoreductive surgery is controversial. A 61-year-old woman was admitted to our hospital with nonspecific abdominal pain of 2-month duration and weight loss of 5 kg during the last semester. A computed tomography scan demonstrated bilateral ovarian masses, extending to the right iliac fossa, pressing the cecum-ascending colon. In the liver parenchyma, three cystic lesions were found of about 6-cm maximum diameter each, along with pelvic lymphadenopathy. There was no ascites. The diagnosis of advanced ovarian cancer was clinically suspected; the patient underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy, right hemicolectomy, omentectomy, left lobectomy, deroofing, and draining of the cystic formation of the right liver lobe along with systematic pelvic and para-aortic lymphadenectomy. Systemic chemotherapy (six cycles of paclitaxel/carboplatin) was subsequently administered, and after 15 months of follow-up period, the patient is still in first remission and alive. Ovarian cancer with concomitant extensive right colon infiltration and hematogenous liver metastases can be successfully managed with aggressive surgical resection and postoperative chemotherapy in carefully selected patients.     

The cytophotometric estimation of the desoxyribonucleic acid (DNA) content of individual plasma cells from multiple myeloma and nonspecific plasmacytoses

The cytophotometric technic employing the Feulgen reagent was used todetermine the relative amount of DNA in the nuclei of individual myeloma andplasma cells aspirated from the bone marrow. Individual myeloma cells werefound to contain markedly elevated amounts of DNA as compared to that inthe plasma cells of non-specific plasmacytoses. Myeloma cells were found tocontain geometric multiples (2, 4, 8) of the amount of DNA present in normallymphocytes, and the degree of DNA "ploidy" was related to the morphologicstage of immaturity. Polyploid DNA values were not found in the non-specificplasmacytoses. The possible mechanisms of formation were discussed. Thefindings are interpreted as suggesting the presence of a basic alteration in thequantitative DNA-chromosome relationship in myeloma cells, and they offeradditional support for the separation of the myeloma plasmacytoses from nonspecific plasmacytoses.

Submitted on April 26, 1955 Accepted on August 3, 1955