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Experimental bacterial endocarditis. IV. Structure and evolution of very early lesions.

The vegetations of experimental sterile and bacterial endocarditis in rabbits were studied using light, immunofluorescent and electron microscopy. At an early stage, both lesions were composed chiefly of masses of platelets supported in a scaffolding of fibrin strands. In previous studies, this structure has often been described merely as "fibrin". After i.v. injection of Thorotrast, sterile vegetations showed remarkable accumulations of mononuclear phagocytes containing this substance, on surfaces projecting into the bloodstream. Sections fixed 30 min. after i.v. injection of streptococci also showed these phagocytes, which contained large numbers of bacteria. The possibility that BE is initiated by phagocytosis of circulating bacteria has been raised. Smaller numbers of circulating streptococci reached the vegetation by direct adhesion to exposed surfaces. In contrast, a majority of Proteus and Staphylococcus albus adhered directly to vegetations, without phagocytosis. Subsequently, these first settlers multiplied rapidly to form rounded colonies surrounded by capsules of fibrin, which apparently provided protection from phagocytosis. The vegetations grew by accretion of layers of fibrin and platelets, with colonies sandwiched between them. This suggested that a cycle of thrombosis and reseeding by circulating bacteria was a factor in their growth. Colonies showed morphological changes consistent with ageing after two days. Healing occurred by endothelialisation and organisation, and was greatly accelerated by penicillin treatment.

Animals↗

Epidemiological studies of medically used drugs.

In a recent review of chemicals associated with cancer production in man from U.S. National Cancer Institute and two Federal Agencies, seven drugs were listed. The evidence for the carcinogenicity of chlornaphazine will be reviewed and the results of long-term epidemiological studies, which show that phenobarbitone and isoniazid should not be suspected of carcinogenicity, will be discussed.

2-Naphthylamine↗

Thorotrast-induced ruptured hepatic angiosarcoma.

The use of Thorotrast as a contrast medium is now of historical interest. Thorotrast-induced angiosarcoma, though rare, still generates considerable clinical interest because of the characteristic opacification of the liver, spleen, and lymph nodes, and the long latency period between exposure and the onset of the tumor. We present a case of hepatic angiosarcoma which developed 37 years after the administration of Thorotrast.

Hemangiosarcoma↗

Surface differentiation of hemopoietic cells demonstrated ultrastructurally with cationized ferritin.

The ultrastructural cationized ferritin (CF) technique was employed as a probe of the surface binding characteristics of the various cell types present in normal human bone marrow. The number of CF particles per micron length of cell surface were counted and data subjected to statistical analysis. All cells of the bone marrow exhibited CF reactivity. The extent of labeling was cell specific and could be related to the stage of maturation of the cells in a given lineage. In the neutrophilic series, myeloblasts showed moderate labeling while promyelocytes and myelocytes revealed only minimal binding; CF binding increased sequentially in metamyelocytes, band and segmented neutrophils. Eosinophils and eosinophilic myelocytes showed similar membrane differnetiation patterns while basophils exhibited stronger CF labeling that other granulocytic cells. Lymphocytes were strongly reactive while monocytes and their precursors were moderately labeled with CF. Surface reactivity of developing nucleated erythrocytic cells was similar to that of the lymphocytes. Surface labeling from the proerythroblasts to early normoblasts stage was identical, CF binding increased in the late normoblasts stage and then decreased in the reticulocyte and mature erythrocyte stages. The extent of surface CF reactivity of the marrow cells was markedly different from that obtained with Thorotrast and colloidal iron. Thorotrast and colloidal iron stained the surface of all marrow cell intensely but failed to yield distinctive surface labeling patterns for the differing cell population in bone marrow.

Binding Sites↗

Clinicopathological study of hematological disorders after Thorotrast administration in Japan.

Ten leukemia and four aplastic anemia cases were clinicopathologically studied in autopsies from patients who had been administered the contrast medium, Thorotrast, three to five decades previously. The short period from the appearance of hematological symptoms to death, the relatively low percentage of leukemic cells in the peripheral blood, the high frequency of erythroleukemia, i.e., 50% of leukemia patients, and a case of atypical megakaryocyte proliferation were revealed in leukemia patients. Leukemic cell infiltration in the spleen tended to become slight or minimal with the progress of fibrosis. As a result, the degree of spleen swelling was mild or lacking in leukemia patients who had been administered Thorotrast. On the other hand, cases such as hyperplastic or normoplastic bone marrow, an increase in immature granulocytic series or no decrease in the number of megakaryocytes were observed in aplastic anemia of Thorotrast-administered patients. It was thought that fibrosis in the bone marrow as well as in the spleen was induced by Thorotrast deposition. Thus, in hematological disorders of Thorotrast-administered patients, both leukemia and aplastic anemia cases were considered to be mainly of the atypical type, and it was speculated that the damage due to Thorotrast may affect the hemopoietic stem cell level and hemopoietic microenvironment.

Adult↗