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Biomedical subjects

L Glasser

Publications and source records attributed to L Glasser.

At least 55 records · Page 3Linked to original sources

Accuracy of low electronic platelet counts using platelet distribution curves.

At low platelet levels electronic counts are inaccurate because background counts are an increasingly important contribution to the total count. In this study the background contribution was selectively eliminated by coupling a multichannel particle size analyzer (Coulter Channelyzer II) to an electronic counter (Coulter ZBI). Platelet counts below 50 x 10(9)/l required an adjustment of the lower threshold in 11 of 15 specimens. Non-platelet counts averaged 18 percent of the platelet particle count with a maximum value of 50 percent. In contrast, platelet counts between 50 to 100 x 10(9)/l required only a minimum adjustment of the lower threshold and extraneous counts averaged only 2.7 percent of the platelet particle count. Phase platelet counts ranging from 4.0 x 10(9)/l to 115 x 10(9)/l were compared in ZBI-Channelyzer counts in 30 patients. The electronic counts showed good agreement with the reference method. Results were statistically analyzed using linear regression analysis and paired t tests. Technical errors involved in electronic and visual platelet counts are discussed.

Blood Platelets↗

Phagocytosis in acute leukemia.

The phagocytic potential of leukemic cells in various types of acute leukemia was studied. Cases included lymphoblastic leukemia, myeloblastic leukemia, myelomonocytic leukemia, monocytic leukemia, progranulocytic leukemia, blast transformation of chronic myelocytic leukemia, and unclassified leukemias. Cytochemical stains were used as an aid in classification. These included Sudan black B, naphthol AS-D chloroacetate esterase, alpha-naphthyl butyrate esterase, acid phosphatase, and periodic acid-Schiff. Phagocytosis was evaluated after incubation of leukemic cells with Candida albicans. Rare phogocytic activity was seen in lymphoblastic leukemia, unclassified leukemias, blast crises in chronic myelocytic leukemia, and progranulocytic leukemia. Myeloblastic leukemias were feebly phagocytic. Myelomonocytic leukemia and monocytic leukemia both exhibited marked phagocytosis which distinguished them from the other acute leukemias. Myelomonocytic leukemia could be differentiated from acute monocytic leukemia by its greater phagocytic capacity.

Candida albicans↗

Neutrophil migration under agarose: quantitation and variables.

Several variables have been evaluated for the in-vitro measurement of neutrophil migration under agarose. Commonly used anticoagulants do not alter migration. Cells may be collected in heparin, sodium citrate, or EDTA. Neither hypotonic or ammonium chloride lysis of erythrocytes affects chemotactic activity. Saponin, however, decreased both leukocytic viability and migration. Passage of neutrophils through a Hypaque-Ficoll density gradient improved migration scores, presumably by removing contaminating material and cells. Both lymphocyte and erythrocyte contamination decreased test scores. Platelets did not have a detrimental effect on neutrophil migration. Fresh serum was the most potent chemotactic agent. This was followed, in order, by zymosan-activated serum, N-formyl-L-methionyl-L-phenylalanine, casein, and Escherichia coli supernatant. A scoring method that combines features of both counting leukocytes and measuring the migration distance has been devised. The technic has a coefficient of variation of 9.2%. Scores for the normal adult population show a gaussian distribution.

Anticoagulants↗

The effect of steroids on peripheral blood lymphocytes containing parallel tubular arrays.

The response of lymphocytes containing cytoplasmic inclusions called parallel tubular arrays (PTA) was determined after the administration of the glucocorticoid dexamethasone to 10 healthy volunteers. The percentage of these lymphocytes was found to increase during the lymphopenia induced by steroid administration. The size and number of parallel tubular arrays per cell showed no differences before and after steroid administration, indicating that the increase was a result of a change in the proportion of whole cells. This indicates, for the first time, that a morphologically defined population of lymphocytes from the normal peripheral circulation has been linked to a specific response, ie, steroid resistance. The possible mechanism of steroid resistance is discussed.

Adult↗

Functional capabilities of steroid-recruited neutrophils harvested for clinical transfusion.

To determine whether steroids exert a direct inhibitory effect on neutrophil function, thus contraindicating their use to increase granulocyte yields for white-cell transfusions to infected neutropenic patients, we gave normal donors a single intravenous dose of dexamethasone (4 mg per square meter of body-surface area). Approximately two hours later the absolute neutrophil count increased from an initial value (mean +/- 1S.D.) of 3800 +/- 1400 to 5700 +/- 2400 per microliter. Granulocytes were then collected by discontinuous-flow centrifugation and tested. Viability (98.4 per cent), the percentage of neutrophils capable of phagocytosis (97.6), particle accumulation (12.3 candida per phagocyte), fungicidal activity (1.08 "ghost" yeast cells per phagocyte), the percentage of bacteria killed (97.7) and chemotaxis (119 per cent) did not significantly differ from observations in nontreated paired controls. The functional competence of neutrophils used for granulocyte transfusions was not altered after short-term exposure of these healthy donors to steroid medication.

Blood Bactericidal Activity↗

The in vivo development of plasma cells: a morphologic study of human cerebrospinal fluid.

This is a case study of a patient with the clinical diagnosis of meningoencephalitis. It demonstrates the in vivo development of plasma cells in the central nervous system. All the stages of in vitro mitogen-induced lymphocyte transformation previously described by light and electron microscopy are recapitulated in this analysis of cerebrospinal fluid. It is postulated that this represents a local humoral immune reaction in the central nervous system and provides morphologic support for the concept that the gamma globulin in cerebrospinal fluid is produced locally in part, in addition to its origin from the plasma proteins.

Cerebrospinal Fluid↗

Effect of storage on normal neutrophils collected by discontinuous-flow centrifugation leukapheresis.

Storage limits for granulocytes have not been defined. The purpose of this study was to determine these limits for neutrophils collected by discontinuous-flow centrifugation and stored at 4 degrees-6 degrees C. The parameters studied were total leukocyte and absolute cell counts, viability measured by dye exclusion, morphology, percentage phagocytic neutrophils, number of Candida organisms ingested per phagocytic neutrophil, candidacidal activity by differential staining, and chemotaxis under agarose. There was a progressive loss of neutrophils on storage that was statistically significant by 48 hr. Phagocytosis was the best preserved function. Microbial killing measured by candidacidal activity was less well preserved. Chemotaxis was the most poorly maintained parameter. There was mild impairment at 24 hr and a severe functional loss at 48 hr. The data suggest the following: (1) the first functions lost on storage are the most highly integrated, i.e., chemotaxis, followed by microbial killing and then phagocytosis; and (2) assuming that these functional losses are irreversible, storage of normal neutrophils used for transfusion should be limited to approximately 24 hr because a severe defect in migration occurs between the first and second days.

Blood Preservation↗

Basophilic meningitis secondary to lymphoma.

In this case report of basophilic meningitis, the patient was a 5-year-old girl under treatment for a diffuse lymphocytic lymphoma. She presented with headache and bilateral papilledema. Cerebrospinal fluid examination showed 60 percent basophils. Subsequent specimens showed a rare blast. It is postulated that after the lymphoma cells had spread to the meninges, a cell-mediated immune reaction was initiated with the appearance of basophils in the exudate.

Basophils↗

Hypoplastic acute leukemia: review of 70 cases with multivariate regression analysis.

Between 1971 and 1984, 22 of 190 adult patients (11.6 per cent) with acute leukemia seen at the University of Arizona had hypocellular acute leukemia (HAL), defined as lymphoblasts or myeloblasts (plus atypical promyelocytes) of greater than or equal to 30 per cent, but marrow cellularity of the core biopsy or clot section of less than or equal to 50 per cent based on a 1000 point count. These 22 patients with HAL plus the 48 previously published patients with well documented HAL (combined series of 70 patients) were evaluated in detail with multivariate analysis. The median leukocyte count was 2700/microL, hemoglobin of 8.2 g/dl, and platelet count 63,000/microL. Circulating blasts were noted in 27 of 52 patients (52 per cent). Twenty-seven of 34 patients (79 per cent) had abnormal cytogenetics. The overall median survival was 8 months (range: 0.1-48). The median survival for the 22 patients managed with supportive care alone was 4 months, 6 months for the 16 patients treated with non-aggressive induction therapy, and 13 months for the 32 patients treated with aggressive induction therapy (p less than 0.02 versus other categories). Multivariate analysis confirmed that aggressive induction therapy was a major favourable prognostic factor (p = 0.016). Multivariate analysis of the aggressively induced patients revealed that younger patients (less than or equal to 65; p = 0.04) and patients with no AHD (p = 0.09) lived longer. Thus, aggressive remission induction can be attempted in HAL and appears to contribute to prolonged survival especially under age 65 years.

Acute Disease↗

Discontinuous flow centrifugation leukapheresis and neutrophil function.

Neutrophils collected by discontinuous flow centrifugation using hydroxyethyl starch were evaluated. Morphology was studied by light and electron microscopy. Functional integrity was assessed by measuring viability, chemotaxis, phagocytosis, and killing power. The harvested granulocytes were morphologically normal and showed no functional impairment.

Cell Survival↗

Characteristics of stored granulocytes collected from donors stimulated with dexamethasone.

Two hours after normal donors were given intravenous dexamethasone, their leukocytes were collected by intermittent flow centrifugation. Neutrophils were tested immediately after collection and following storage at 4 to 6 C for 24, 48, 72 and 96 hours. Tests included total leukocyte and absolute neutrophil counts, plasma glucose concentrations, the percentage of phagocytic neutrophils, the ability of phagocytes to accumulate particles, candidacidal activity, bactericidal capacity and chemotaxis. Total leukocyte and absolute neutrophil counts in the stored suspensions were decreased after 48 hours (p = .005). Plasma glucose levels in the suspensions declined at first, then stabilized at 48 hours of storage probably because of loss of cellular integrity. Chemotaxis, candidacidal activity, phagocytosis and dye exclusion showed statistically significant decreases at 24 hours. Chemotaxis deteriorated rapidly, with a mean 63 per cent functional loss at 48 hours. We conclude that treatment of donors with dexamethasone does not extend the storage limits of granulocyte concentrates used for clinical transfusions. Based on these and our previous observations, unless the storage changes should be shown to be reversible, granulocyte concentrates should probably not be stored more than 24 hours before transfusion.

Blood Glucose↗

Stability of solutions of human granulocyte lactate dehydrogenase stored at different temperatures.

Granulocyte suspensions from eight healthy individuals were lysed ultrasonically in 0.15 M NaCl or serum. The leukolysates were tested for lactate dehydrogenase after being stored at 22 C, 5 C, -20 C and -196 C for one, two, three, four and seven days. The LDH content of granulocytes was 291 IU/10(10) cells (mean) and the enzyme had a characteristic isoenzyme pattern rich in LDH-5 with stepwise increases in each fraction from LDH-1 to LDH-5. The enzyme was unstable in saline solutions. This was marked at -20 C and related to the duration of storage. All the isoenzyme fractions showed significant inactivation. A mean 10% loss of activity occurred at -196 C. This loss was independent of the duration of storage and related to the process of freezing and thawing. Moderate inactivation occurred at room temperature while refrigerated samples were stable for four days. Serum protected the enzyme from denaturation and samples stored at -20, -196 and 22 C were stable for the seven days of the experiment.

Drug Stability↗