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Biomedical subjects

R D Barr

Publications and source records attributed to R D Barr.

At least 127 records · Page 7Linked to original sources

Valproic acid and immune thrombocytopenia.

During the course of a prospective serial study over a period of one year, findings compatible with immune-mediated thrombocytolysis accompanied the administration of valproic acid in about half of 45 children with epilepsy. Thrombocytopenia occurred in 15 and neutropenia in 12 patients, but was transient and self-limiting in each. The association is probably one of cause and effect, and it may reflect the structural similarity between valproic acid and constituents of cell membranes.

Adolescent↗

Soft-tissue necrosis induced by extravasated cancer chemotherapeutic agents.

The inadvertent extravasation of anticancer drugs in clinical use may result in the development of indolent lesions at the site of injection. Investigation of this phenomenon in Hartley guinea pigs showed that the pathogenesis was based on direct tissue toxicity and not on sensitization. The risk of a serious reaction appeared to be related to the localization of the injurious agent within the dermis rather than at the subcutaneous site.

Animals↗

Transient Donath-Landsteiner haemolytic anaemia.

Five children with 'paroxysmal cold haemoglobinuria' are described. In all of them an upper respiratory tract infection preceded the episode of acute intravascular haemolysis and potentially pathogenic organisms were recovered from four. The haematological features are presented and the importance of technique in the detection of the pathognomonic antibody is stressed and discussed in detail. Although the clinical manifestations are usually self-limiting and of short duration, it may be necessary, because of the rapidity and severity of anaemia, to provide interim support with appropriate blood transfusion. Since the disease is not usually recurrent and not clearly related to exposure to cold, it is suggested that it be re-named Donath-Landsteiner haemolytic anaemia.

Antibodies↗

Chronic myeloid leukemia. A possible new variant in a child.

A case of Philadelphia (Ph') chromosome negative chronic myeloid leukemia (CML) in a child is reported. The age of onset (7 years) and duration of survival (40 months) are not typical of juvenile CML and the relatively low leukocyte and hemoglobin F concentrations are more akin to the findings in Ph' negative CML in adults. There was refractoriness to chemotherapy with the exception of a dramatic response to a combination of prednisone and vincristine, despite the absence of terminal transferase activity in circulating blood cells. Splenic irradiation, splenectomy, and leukapheresis were ineffective. Transition to a terminal aggressive phase caused a marked change in the growth characteristics of peripheral blood cells in vitro. This patient may represent a new variant in the spectrum of childhood CML.

Child↗

Erythrocytotoxicity induced by cancer chemotherapeutic agents. In vitro studies of osmotic fragility and methaemoglobin generation.

Increased osmotic fragility and methaemoglobin generation in vitro have resulted from the exposure of normal human erythrocytes to numerous cancer chemotherapeutic agents. These findings offer a possible explanation for the earlier, consistent clinical observation of the rapid development of anaemia, during consolidation therapy, in children with acute lymphoblastic leukaemia in remission.

Adult↗

The role of the lymphocyte in haemopoiesis.

According to current dogma, circulating blood cells are all derived from the same progenitor, which therefore must be both pluripotent and capable of prolific self-replication. In the irradiated mouse, such haemopoietic stem cells (HSC) give rise to splenic colonies, and thus are designated as CFU-S (colony forming units-spleen). Definitive identification of a similar entity in man so far has proved elusive. However, primitive unipotent cells, committed to development along a single pathway, can be detected in human blood-forming tissues under appropriate culture conditions. Operationally defined as CFU-E (erythrocyte), CFU-GM (granulocyte/macrophage) etc., the ontogenetic relationships of these cells to each other and to the HSC have been the objects of exhaustive study. A population of lymphocytes, classed as "null" cells, do not exhibit the surface membrane markers which characterize commitment to differentiation in the thymus-dependent (T-cell) or bursa- equivalent (B cell) lineages. Accumulating evidence points to the null lymphocyte as a potential precursor of haemopoietic tissue. In bone marrow, the activity of terminal deoxynucleotidyl transferase (TdT) is concentrated in null cells, but the relevance of this unique enzyme to lymphocytic differentiation remains uncertain. Nevertheless, it appears that the functional heterogeneity, expressed within the family of lymphocytes, extends to haemopoiesis. The roles of various lymphocyte populations, in the generation and functional control of blood-forming tissue, are examined in this review.

Animals↗

Influence of physical factors on morphological features of mononuclear cells in human blood. Lymphocyte-monocyte interconversion.

The recovery of monocytes, following density sedimentation of human peripheral blood, was previously observed to be greater than 100%. An explanation was sought in the present study. No evidence for erroneous estimation of these cells was found. Rather, the data suggest that lymphocytes may take on the appearance of monocytes as a consequence of cytocentrifugation. This phenomenon does not appear to be influenced by the osmolality or viscosity of the suspending medium, nor by the process of sedimentation. Moreover, polymorphonuclear leukocytes do not seem to participate in the process of transformation, which may depend instead on the transfer of cytoplasm from monocytes to lymphocytes.

Blood Sedimentation↗

Dysfibrinogenaemia and liver cell growth.

From the evidence presented, it is proposed that 'dysfibrinogenaemia' represents the production of normal fetal fibrinogen by rapidly proliferating liver cells in both regenerating and neoplastic tissue. Prolongation of the reptilase clotting time, which was formerly believed to reflect dysfibrinogenaemia, may be rather the result of hepatocytic death.

Batroxobin↗