bluuebunny/crossref_metadata_2025_split huggingface dataset:
THE ROLE OF ALLERGY IN THE PATHOGENESIS OF PURPURA AND THROMBOCYTOPENIA
Authors: MADISON FREDERICK W. 
Published: October 2019

Abstract
It has been suggested that, for purposes of etiologic investigation, thrombocytopenic purpura be separated into its two component parts, thrombocytopenia and purpura, and that they be regarded as two coexisting abnormalities rather than as a single disease. Historical review of the development of knowledge of the pathogenesis of purpura emphasizes the importance and soundness of this dual approach. Both thrombocytopenia and purpura have been shown to have a complex etiologic pattern with multiple potential etiologic factors. The curious similarity of these two groups of factors may at least partially explain the frequent coexistence of the two abnormalities in the clinical picture of thrombocytopenic purpura.
It has been shown that allergy has long been recognized as an etiologic factor of major importance in both purpura and thrombocytopenia. It is logical, therefore, that it should frequently be an important etiologic factor when the two conditions exist together, and it is suggested that when diagnostic methods are more adequate a considerable number of cases of "idiopathic" thrombocytopenic purpura will fall into that category and will yield therapeutically to a proper allergic approach.
HEMORRHAGIC DIATHESIS ASSOCIATED WITH THE PRESENCE OF AN ANTICOAGULANT IN CIRCULATING BLOOD. CASE REPORT AND LABORATORY STUDIES
Authors: SOULIER J. P. , BURSTEIN M. 
Published: October 2019

Abstract
A new observation of a hemorrhagic diathesis associated with the presence of an anticoagulant in the circulating blood is reported here. The patient was a 21 year old male, appearing by clinical evaluation to have hemophilia, but without a family history of hemophilia. The blood and plasma were strongly anticlotting and had a very long clotting time. The clotting time of recalcified citrated plasma was greatly delayed by removing the platelets. Freezing and thawing of platelet-rich plasma resulted in a marked shortening of the clotting time. Dilution of the plasma shortened the clotting time, while the addition of calcium and storage of the plasma had no effect.
The prolonged clotting time was not corrected by the addition of normal plasma or plasma fractions having antihemophilic activity. The prothrombin time was nearly normal. Small quantities of thromboplastin were very effective in shortening the clotting time. The anticoagulant had no antithrombin activity. The "progressive" antithrombin and antifibrinolysin of the patient’s plasma were normal.
The anticoagulant acts during the first phase of coagulation by inhibiting an (plasma) activator of prothrombin. It appears to be identical with the anticoagulant described in three previous publications from the United States.
A QUANTITATIVE METHOD FOR THE DETERMINATION AND CHARTING OF THE ERYTHROCYTE HYPOTONIC FRAGILITY
Authors: SUESS JOHN , LIMENTANI DAVIDE , DAMESHEK WILLIAM , DOLLOFF MIRIAM J. 
Published: October 2019

Abstract
A method is described for the determination and charting of the fragility of the red blood cells to hypotonic sodium chloride solution. For plotting the results obtained, a new method was used, employing the principle of "hemolytic increments," i.e., plotting the additional amount of hemolysis occurring in each successive tube of solutions of decreasing saline concentration.
By this method, curves are obtained somewhat similar to those of Price-Jones curves of red cell diameters. Such curves, when properly analyzed, afford an interpretation of the varying diameter thickness range of the red cell population and indirectly an insight into the types of red cells present, and of the possible hemolytic mechanisms present. Preliminary investigations indicate that they are particularly instructive in the hemolytic anemias and especially in the Mediterranean anemias.
A simplified shorter method was also devised for routine clinical use. This method, although not as useful for research purposes, has proved to be more accurate and yet less time consuming than most methods currently used.
THE EFFECT OF ENDOCRINOPATHIES ON THE BLOOD
Authors: DAUGHADAY WILLIAM H. , WILLIAMS ROBERT H. , DALAND GENEVA A. 
Published: October 2019

Abstract
Evidence has been presented that the gonads, thyroid, adrenal cortex and pituitary glands have a definite influence on blood formation. The normal sex difference in erythrocyte levels in animals, and probably in man, can be obliterated by castration and restored by appropriate replacement therapy. Hypothyroidism results in a moderately severe anemia in animals. In the uncomplicated form, the anemia is slightly macrocytic and associated with a hypoplastic bone marrow. In clinical experience the anemia may be complicated by the secondary effects of achylia gastrica leading either to iron deficiency or to a deficiency in the antipernicious anemia factor. Hyperthyroidism causes some alterations in the white blood cells, but has little effect on the red blood cell series. Hyperactive states of the adrenal cortex may be associated with a mild polycythemia. Adrenal steroids also have a marked lymphocytic effect, causing the release of beta and gamma globulins from lymphoid tissue. A mechanism involving the anterior pituitary and adrenal seems to exist, controlling the release of antibodies under certain conditions. It is suggested that other mechanisms also exist which control the number of circulating lymphocytes.
Deficiency of the anterior pituitary secretions results in anemia in animals and man. The anemia in animals is usually microcytic and hypochromic and may respond to several types of replacement therapy. In man anemia develops slowly and is rarely severe. Moderate reductions in the red blood cell count occur and the color index varies. There is hypoplasia of the bone marrow. The anemia in man does not respond uniformly well to the therapy now available, but improvement often occurs with the replacement of "end-organ" hormones.
The preponderance of evidence indicates that the regulation of blood formation is not primarily under hormonal control. The effects noted in various glandular disorders are due to alterations in metabolism produced in the bone marrow as well as all other body tissues.
STUDIES ON FREE ERYTHROCYTE PROTOPORPHYRIN, PLASMA IRON AND PLASMA COPPER IN NORMAL AND ANEMIC SUBJECTS
Authors: CARTWRIGHT G. E. , HUGULEY C. M. , ASHENBRUCKER HELEN , FAY JANE , WINTROBE M. M. 
Published: October 2019

Abstract
1. A total of 108 erythrocyte protoporphyrin determinations has been made in 66 normal individuals. The geometric mean ± standard error of the mean was 31 (26-38).
2. A total of 196 determinations of plasma iron in 92 normal individuals was made. The mean ± standard error of the mean was 104.7 ± 3.4 µg per cent.
3. In a total of 150 determinations of plasma copper in 105 normal individuals, the mean ± standard error of the mean was 118.6 ± 1.2. µg per cent.
4. No significant difference in plasma iron was noted between the sexes but in females the plasma copper was significantly higher and the erythrocyte protoporphyrin slightly higher than in males.
5. Erythrocyte protoporphyrin, plasma iron, and plasma copper determinations have been made in over 112 patients with a variety of clinical conditions associated with anemia. In general, it was found that in pernicious anemia in relapse the erythrocyte protoporphyrin values were normal, the plasma iron normal or high and the plasma copper usually normal. Anemia due to iron deficiency as well as the anemia of infection were accompanied by high values for erythrocyte protoporphyrin, hypoferremia and hypcrcupremia. In nephritis with anemia the erythrocyte protoporphyrin was generally increased, the plasma iron low or normal and the plasma copper increased. Anemia associated with lymph node disorders or leukemia was accompanied by a normal or high EP, a low or normal plasma iron and an increase in plasma copper. Thalassemia major was found to be accompanied by both hypercupremia and hyperferremia; in thalassemia minor the serum iron values were normal although hypercupremia was found. Hyperferremia was noted in aplastic anemia. In cases of plumbism the erythrocyte protoporphyrin was markedly increased. Hypocupremia was noted only twice, in one patient with severe nephritis and hypoalbuminemia and in one patient with hemochromatosis.
RELATION OF ADRENAL CORTICAL HORMONE TO LYMPHOID TISSUE AND LYMPHOCYTES
Authors: VALENTINE WILLIAM N. , CRADDOCK CHARLES G. , LAWRENCE JOHN S. 
Published: October 2019

Abstract
The hormonal control through the hypophyseo-adrenal cortical system of lymphoid tissue structure and function is an important concept. We cannot at the present time regard that the concept is established fact. Final judgment must await additional work and the clarification of some of the inconsistencies which appear to exist. It seems reasonable that lymphoid tissue is one of the end organs of adrenal cortical hormone and that it may perhaps play a role in the response of the organism to stress. It seems quite clear that the sugar hormone of the adrenal cortex is capable of producing structural alterations in lymphoid tissue. Change in thoracic duct lymphocyte numbers as a result of augmentation in the amount of available adrenal cortical hormone is at present controversial. Experiments in this laboratory have failed to demonstrate it. The production of lymphopenia, at least in some species and possibly in man, by increasing available sugar hormone is supported by some evidence. The exact mechanism of production of lymphopenia is open to question, its relationship to changes in lymphoid tissue structure being one of inference. The converse situation—absolute lympocytosis resulting from deprivation of adrenal cortical hormone—is the subject of controversial reports. At best, it must be admitted that relatively slight alterations from the accepted normal range of lymphocyte values occur in the adrenal insufficient organism. Changes in plasma gamma globulins and antibody titers associated with changes in the amount of available cortical hormone are reported. It should be clarified whether such changes have necessarily resulted from lymphocyte dissolution or are related to other of the variegated actions of adrenal cortical hormone.
The relationship of adrenal cortical hormone to lymphoid tissue and lymphocytes and the relationship of the latter to the response of the organism to stress must indeed be complex. It is reasonably well established that the life span of the lymphocyte is very short indeed1,58,22 and each lymphocyte presumably liberates its metabolically important contents within a few hours at the most. If stress continues for any period of time, as often it does, it is difficult to visualize the wisdom of interfering with the production of metabolically vital substances in order to secure the transient benefits of lymphoid tissue dissolution. It is also somewhat difficult to regard as proved that the various changes reported after hormone augmentation or deprivation necessarily represent the normal mechanism by which these factors are regulated and kept within physiologic limits. More investigations are required to answer such questions and to further elucidate the interrelationship of the adrenal cortex and lymphoid tissues.
CHANGES IN CIRCULATING LEUKOCYTES INDUCED BY THE ADMINISTRATION OF PITUITARY ADRENOCORTICOTROPHIC HORMONE (ACTH) IN MAN
Authors: HILLS A. GORMAN , FORSHAM PETER H. , FINCH CLEMENT A. 
Published: October 2019

Abstract
1. Pituitary adrenocorticotrophic hormone (ACTH), when administered in a single intramuscular dose of 25 mg. to human subjects with unimpaired adrenal function, results in a characteristic alteration of the leukocytic pattern. This consists of an increase of circulating neutrophils and a decrease of circulating lymphocytes and eosinophils.
2. The decrease in circulating lymphocytes and eosinophils is contingent upon the stimulation of a functionally competent adrenal cortex, and does not occur in its absence. The neutrophilic response is present but somewhat diminished in adrenal insufficiency.
3. The entire pattern of leukocytic alterations found in normal subjects after administration of ACTH can be induced in patients with Addison’s disease by 17-hydroxycorticosterone (20 mg.) but not with desoxycorticosterone glucoside (30 mg.).
4. Prolonged adrenal stimulation by ACTH, given over a four day period in a dose of 10 mg. every six hours, results in a sustained and striking elevation of neutrophils and depression of eosinophils; the lymphocytes, after an initial depression lasting not more than twenty-four hours, may increase above their initial levels in spite of the continued increased secretion of adrenal hormones.
5. The relation of the adrenal cortex to the characteristic nonspecific leukocyte pattern, observed as a response of the organism to any type of insult, is discussed.
THE BLOOD PICTURE IN ADDISON’S DISEASE
Authors: BÁEZ-VILLASEÑOR JOSÉ , RATH CHARLES E. , FINCH CLEMENT A. 
Published: October 2019

Abstract
The blood picture of 100 patients with Addison’s disease was analyzed. Under basal conditions, there was a tendency toward lymphocytosis and neutropenia. Under stress, the blood picture remained fixed. The impaired ability of those patients to show leucocytosis and lymphopenia is attributable to their impaired adrenal function. While large doses of desoxycorticosterone and maintenance doses of adrenal extract had no effect on the blood picture, 17-oxysteroids produce both neutrophilia and lymphopenia. The anemia present in Addison’s disease is normocytic and normochromic.
ACUTE THROMBOCYTOPENIA INDUCED IN DOGS BY ADMINISTRATION OF URETHANE (ETHYLCARBAMATE)
Authors: CRUZ W. O. , MOUSSATCHÉ H. 
Published: October 2019

Abstract
1. Dogs treated for one to two weeks with daily injections of urethane (ethyl carbamate) subcutaneously, in doses of 0.4 Gm. per Kg. of body weight, presented a typical picture of thrombocytopenic purpura.
2. The pathologic changes consisted in numerous purpuric lesions in the small intestine and a smaller number on the skin, heart, lung, cortical zone of the kidney, epiploon, and, rarely, on the stomach and large intestine.
3. The hematologic changes occurred in the following sequence: leukocytosis, leukopenia and thrombocytopenia, and finally acute anemia coinciding with severe intestinal hemorrhage. In the final phase, the coagulation time was normal and the bleeding time very much increased.
ACUTE RENAL INSUFFICIENCY DUE TO INCOMPATIBLE TRANSFUSION AND OTHER CAUSES, WITH PARTICULAR EMPHASIS ON MANAGEMENT
Authors: MUIRHEAD E. E. , HALEY A. E. , HABERMAN SOL , HILL J. M. 
Published: October 2019

Abstract
1. Of 28,630 blood transfusions administered in Baylor Hospital over an eight year period there were 17 known hemolytic reactions (0.593 per 1000) of which 17.6 per cent were fatal.
2. Acute renal insufficiency occurred in 55.5 per cent of 18 cases of hemolytic reaction.
3. Factors other than hemolysis per se often occurred. The most common complication was hemorrhage with hypotension.
4. The mortality rate of the hemolytic cases with acute renal insufficiency need not be as high as one gathers from reports in the literature.
5. Good results may be obtained with a regime based on physiopathological principles and the main clinical abnormalities. The outstanding premise for the "three-phase" management is based on the consideration that damaged kidneys require time for regeneration and recovery.
6. Five main steps in the proposed method of management are: (a) adequate compatible blood for anemia and hypovolemia, (b) limitation of fluid intake during renal insufficiency to that immediately lost, (c) adequate dietary intake, (d) prevention of severe acidosis, (e) adequate water and salts replacement during diuresis.
7. Support was gained for this regime by successful application to other types of acute renal damage and insufficiency. Demonstrated complications were averted.
8. Common complications due to other types of management were: anemia and hypotension, fluid overload with cerebral and pulmonary signs, dehydration with shocklike state and at times convulsions during the recovery phase.
9. Peritoneal irrigation in its present form resulted in two major complications averted by the proposed method of management.
HEMOLYTIC Rh IMMUNE GLOBULINS: EVIDENCE FOR A POSSIBLE THIRD ORDER OF ANTIBODIES INCAPABLE OF AGGLUTINATION OR BLOCKING
Authors: HILL JOSEPH M. , HABERMAN SOL , JONES FRANCES 
Published: October 2019

Abstract
We believe that sufficient evidence exists to justify 3 classes of Rh antibodies based on their reactivity. These are the classical agglutinin, the blocking antibody, and the proposed "cryptagglutinoid." Sufficient distinction exists to retain the blocking antibody as determined by Wiener’s original blocking test. This antibody is further characterized by failure to act in Chown’s capillary technic. The identity of this antibody with its important role in reawakening investigation in this field of immunology should not be lost through inclusion in the broader group of those antibodies determined by the albumin test and similar methods. The proposed third order antibody or "cryptagglutinoid" which is usually, but not always, detected by these more inclusive tests, and the capillary technic, appears to be of great clinical importance because of the frequency with which it appears in significant titres. Detection of isoimmunization and closer correlation of antibody titre with clinical severity of disease should be possible through study of this "cryptagglutinoid" antibody.
PERIODIC (CYCLIC) NEUTROPENIA, AN ENTITY A COLLECTION OF SIXTEEN CASES
Authors: REIMANN HOBART A. , DEBERARDINIS C. THOMAS 
Published: October 2019

Abstract
Sixteen cases of an entity, periodic neutropenia, have been collected. They are characterized by remarkable clinical uniformity and regular recurrences of neutropenia at three week intervals. The entity may be a variant of a larger group of periodic conditions. The cause is unknown.
A NOTE ON THE EFFECTIVENESS OF VITAMIN B12 IN THE TREATMENT OF TROPICAL SPRUE IN RELAPSE
Authors: SUAREZ RAMON M. , SPIES TOM D. , HERNANDEZ-MORALES F. , PEREZ ENRIQUE , BENITEZ-GAUTIER MISS CLEMENCIA 
Published: October 2019

Abstract
Three cases of tropical sprue were treated with repeated injections of vitamin B12 and showed dramatic and sustained therapeutic responses.
FAMILIAL HYPOCHROMIC ANEMIA ASSOCIATED WITH POSTSPLENECTOMY ERYTHROCYTIC INCLUSION BODIES
Authors: MILLS HAROLD , LUCIA S. P. 
Published: October 2019

Abstract
A case is presented of familial, hypochromic, microcytic anemia, associated with the appearance of siderocytes in the peripheral blood following splenectomy. The medical literature of the recent past focuses attention on the clinical recognition of inclusion bodies, but their origin and significance have not been completely clarified. Rundles and Falls4 were the first to demonstrate them in hereditary hypochromic microcytic anemia, and in addition they have been shown to appear in acquired hemolytic anemia,2, 3 Banti’s syndrome,1 lead poisoning,3, 15 and in hemochromatosis, bacterial toxemias, industrial solvent poisoning, sickle cell anemia and acholuric jaundice.15
It is probable that the anemia in the case under discussion may have been due to some defect in iron metabolism. Neither the subject nor his maternal half-brother were demonstrated to have any objective evidence of hemolysis, and neither revealed reticulocytosis, despite intensive iron and liver therapy, a point in favor of poor utilization of iron. Furthermore, marked hemosiderosis was an outstanding feature of both cases signifying that at least one form of storage iron was available but not utilized.
The significance of inclusion bodies within erythrocytes is discussed and a classification of inclusion bodies is offered. A final statement regarding the nature of iron granules within red cells must await further research. When present within the erythrocytes of the peripheral blood or in the erythroid series of the bone marrow, they probably are the result of faulty iron metabolism either due to some inherent defect or secondary to the action of some noxious agent. Their prognostic significance is obscure, but this is probably related to the severity of the disease process of which they are an expression.
INFLUENCE OF FIBRINOGEN CONCENTRATION UPON PLASMA PROTHROMBIN TIME
Authors: WEINER MURRAY , SHAPIRO SHEPARD 
Published: October 2019

Abstract
The effect of the normal variations of fibrinogen concentration (180 mg. per cent to 650 mg. per cent) on the diluted (12.5 per cent) plasma prothrombin time in man, as observed in this study, is not significant.
Damaged DNA in lymphocytes of aplastic anemia
Authors: Hashimoto Y , Takaku F , Kosaka K 
Published: October 2019

Abstract
The size of single-stranded DNA in lymphocytes in GO stage from 22 patients with acquired primary and secondary aplastic anemia was estimated by alkaline sucrose gradient centrifugation. The average size was 9.3 (+/-0.3) times 10(7) daltons. The lymphocytes of patients contained significantly more single-strand breaks in DNA, compared to those of normal persons. The difference in size of single-stranded DNA which had been present in nontransformed lymphocytes could also be observed in transformed lymphocytes. Some characteristic differences could be observed in the sedimentation patterns of single-stranded DNA in the lymphocytes of patients with aplastic anemia and those of normal persons. The single-strand breaks in DNA suggested that the repair processes were disturbed in the DNA molecules of circulating lymphocytes from patients with acquired primary and secondary aplastic anemia.
A hitherto undescribed plasma factor acting at the contact phase of blood coagulation (Flaujeac factor): case report and coagulation studies
Authors: Lacombe MJ , Varet B , Levy JP 
Published: October 2019

Abstract
This paper reports an asymptomatic coagulation defect responsible for an abnormality at the contact phase of blood coagulation in vitro, distinct from Hageman factor and Fletcher factor deficiencies. Coagulation studies in a 50-yr-old French woman without bleeding tendency revealed the following results: whole-blood clotting time in glass tubes and activated partial thromboplastin time with kaolin and ellagic acid were greatly prolonged; one-stage prothrombin was normal; no circulating anticoagulant was detected, and the infusion of normal plasma corrected the coagulation defect with an estimated half-life of 6.5 days; the levels of factor VIII, IX, XI, and XII were normal; mutual correction was obtained with a Fletcher factor-deficient plasma; the level of whole complement was normal. Studies of the contact phase of blood coagulation and contact-induced fibrinolysis showed the same abnormalities as in Hageman factor- and Fletcher-deficient plasmas. These results indicate that the patient's plasma is deficient in a previously undescribed coagulation factor, which participates in the initial stage of the blood coagulation process in vitro. Family studies revealed consanguinity in the propositus' parents. The assay of this newly described factor in the propositus' children revealed a partial defect, compatible with a heterozygous state, in three of the four tested children. This indicates a recessive inheritance of this new blood coagulation defect.