[Experiences with a logical and a statistical system for diagnostic assistance].
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Biomedical subjects
Publications and source records attributed to R Gross.
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In patients with haemopoietic failure, the low incidence of cells in mitosis often prevents successful chromosome preparations. By performing liquid cultures of myeloid cells a high incidence of mitoses could be obtained even in those cases failing to provide mitoses when the direct preparation technique was used. The cytogenetic studies demonstrated that the mitoses achieved by culture techniques were aneuploid and, thus, there is evidence that they are of leukaemic origin. The combination of short-term liquid culture and chromosome analysis appears to be a diagnostic approach in selected cases of hemopoietic insufficiency.
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Platelets contained in concentrates prepared by intermittent flow centrifugation utilizing 5.0 g total ionized citrate, function normally as assessed by tests for adhesion, spreading, and ADP and collagen-induced aggregation. The ability of platelets to adhere and to aggregate following incubation with ADP is significantly reduced, in samples taken immediately after the collection procedure. Total platelet collection and platelet collection efficiency, is not compromised by use of the above citrate concentration.
In preleukemia and in remission of acute leukemia abnormal mononuclear cells ("string of bead" cells) have been observed and characterized with cytochemical methods. These cells may be resistant to cytostatic therapy and may be characterized as a source of a newly developing leukemic blast cells. Preleukemia and leukemic remissions seem to be identical states. Based on the morphological and cytochemical parallelity of cells in CFU-c-enriched fractions of the bone marrow and the so called string of bead cells we consider these cells to be closely related to the human commited stem cell.
In a retrospective study, factors influencing the eventual course and outcome of patients suffering from aplastic anaemia were analysed. Of the 62 patients with pancytopenia concomitant with an aplastic or hypoplastic bone marrow, 36 have died during the first 24 months following diagnosis, 27 of these 36 cases within the first six months. 26 patients survived more than two years after presentation, but a further six of these cases succumbed during the following months. Of the 62 cases, 46 had neutrophil counts under 1 X 10(9)/l and platelet counts under 20 X 10(9)/l. These cases were subdivided according to their reticulocyte levels. In the age group of patients between 10 and 35 years, all those patients having more than 10,000/mul reticulocytes survived more than two years with only one exception, whereas only one of the 11 patients having reticulocyte counts below 10,000/mul has survived. In our series, the initial neutrophil and platelet counts were not of predictive value in identifying poor prognosis patients. The initial reticulocyte counts, however, appear to be a valid parameter for selecting patients in two groups, one with a favorable, and the other with an extremely unfavorable prognosis on conservative treatment. Young individuals with a poor predicted prognosis could thus be defined as possible candidates for bone marrow transplantation.
Twelve male patients with hyperlipoproteinemia were treated with clofibrate, 1 g twice daily. Serum triglyceride concentration decreased on the average 28 +/- 6%. No significant change of serum cholesterol concentration occurred. Post heparin plasma lipoprotein lipase activity isolated and partially purified by heparin Sepharose affinity chromatography was determined quantitatively. During the clofibrate treatment this enzyme activity increased 48 +/- 9%. The post heparin hepatic triglyceride lipase did not change significantly. The possibility that the serum triglyceride-lowering effect of clofibrate might partly be explained by an increased removal rate of triglyceride rich lipoproteins through increased lipoprotein lipase activity is discussed.
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1 Urinary hydroxyethyl starch (HES) concentrations were determined by the anthrone method, in four healthy normal male volunteers following three consecutive daily 500 ml infusions (total 1500 ml), in order to ascertain excretion rates under normal controlled conditions. 2 The HES was excreted at a rate of 2.57, 2.46, and 2.44 g/h during the first hour postinjection, on days 1, 2, and 3, respectively. 3 The rate during the interval 12-24 h postinjection, averaged 0.14, 0.21, and 0.10 g/h, on days 1,2, and 3, respectively. 4 In the intervals 24-72, 72-120, and 120-168 h after the third and final injection, the excretion rate was 0.07, 0.04, and 0.02 g/h, respectively. 5 Renal function, as assessed by serum creatinine and uric acid concentrations and 24 h void volumes, was normal during the entire period of observation. 6 The results indicate that HES is excreted at a similar rate following three consecutive daily infusions without evidence of renal injury.
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