Allen I. Lipsey

Cerebrospinal fluid endotoxin concentrations in Gram-negative bacterial meningitis.

The limulus lysate assay was utilized to detect and quantitate endotoxin in cerebrospinal fluid from 232 patients with suspected meningitis. The assay was positive in initial specimens of CSF from all 86 patients with gram-negative bacterial meningitis and was uniformly negative in the remaining 146 patients with a variety of infectious and noninfectious processes. Endotoxin concentrations in initial specimens of CSF from patients with gram-negative meningitis ranged from 4 to 2,000 ng/ml. No correlation between initial CSF levels of endotoxin and initial clinical or laboratory variables of infection was noted. With antibiotic therapy, CSF concentrations of endotoxin fall rapidly to undetectable levels after five days.

Antibody responses after splenectomy and splenic autoimplantation in rats

Abstract The sequential immunologic consequences of total splenectomy, partial splenectomy, and total splenectomy with splenic implantation were investigated in an animal model. Adult male albino rats were divided into six groups: sham operated, total splenectomy, 50% splenectomy, 75% splenectomy, splenectomy with 100% intraperitoneal splenic implantation, and splenectomy with 100% subcutaneous splenic implantation. At 2, 4, and 6 months following operation, animals in each group received a single intravenous injection of sheep red blood cells. Six days later, serum hemolysin titers were measured. Results suggest the following: normal immunologic function could be expected if approximately 50% of the spleen is left in situ; intraperitoneal or subcutaneous splenic implantation improves but does not normalize antibody responses; approximately 25% of splenic tissue left in situ results in better immunologic function than 100% ectopic splenic implantation; and following total splenectomy, antibody responses to intravenously administered antigen may improve with time.

Increased Cardiac Muscle Fiber Size and Reduced Cell Number in Down Syndrome: Heart Muscle Cell Number in Down Syndrome

The size of cardiac muscle fibers was determined for 15 patients with Down syndrome who did not have congenital heart disease and for 15 age- and sex-matched control patients by counting the number of cardiac muscle cells in specified areas of microscopic sections (method of Black-Schaffer and Turner). Mean ratio of muscle cells per unit area for the Down patients versus controls was 84.9%, with mean cross-sectional area of Down fibers 117.8% of control value and calculated mean volume of Down cells 127.7% of control value. Mean weights of Down hearts related to normal for age, versus control hearts, was 79.8% of control values. Calculated ratio of total cardiac muscle cell number in Down hearts was 62.5% of the value for controls. This value corresponds closely to the 62.4%, which can be calculated from Naeyes data on cardiac muscle fiber size in Down syndrome based on a point-count method, and is also close to published values for liver cell size and number and skeletal muscle nuclear number in Down syndrome. This study demonstrates that the Black-Schaffer and Turner method gives results equivalent to those of the point-count method for studies of cardiac muscle fiber size, and further supports the suggestion that chromosome 21 controls the size and number of at least certain cell types.

The Renal Lesion of Congenital Hepatic Fibrosis: Pathologic and Morphometry Analysis, with Comparison to the Renal Lesion of Infantile Polycystic Disease

The renal lesion of congenital hepatic fibrosis (CHF = Blyth and Ockendens juvenile polycystic disease of liver and kidneys) was analyzed from 6 specimens from patients aged 3 3/12 to 19 3/12 years and compared with that of 5 patients with infantile polycystic disease (IPCD) aged 6 months to 14 4/12 years. Pathologic, microdissection, injection, and morphometric studies show that the predominantly medullary cystic lesion of CHF shows different distribution in medullary, cortico-medullary, and cortical zones of kidney from the lesion of IPCD, and shows a different time course, from early life to renal insufficiency, from that of IPCD. The renal cysts in CHF affect deep or central collecting tubules, in contrast to the involvement of more peripheral orders of collecting tubules in IPCD. Papillary pore counts, performed for 1 patient, gave significantly low values, in contrast to normal values reported for IPCD. The findings support the previously published conclusion, based on differences in the hepatic lesions of the two conditions, that CHF and IPCD are difference diseases, rather than different permissible manifestations of a single disease.

Plasma fibronectin levels after splenectomy and splenic autoimplantation in rats with and without dietary ascorbic acid supplementation

The critical role of the spleen in protecting subjects from systemic bacterial infection is well known. Plasma fibronectin (PF), cold-insoluble globulin, and opsonic alpha2 surface binding glycoprotein, has regulatory influence on reticuloendothelial system clearance activity and it is important for maximal phagocytosis. Ascorbic acid (AA) also appears to play an important role in phagocytic cell function. The purposes of this study were to determine the effects of splenectomy and splenectomy with autoimplantation, with and without dietary AA supplementation, on PF levels. Six-week-old male Sprague-Dawley rats were divided into four experimental groups of 20 animals each: Nonoperated controls, sham-operated controls, totally splenectomized animals, and splenectomized animals with intraperitoneal autoimplantation. Each group was further randomly divided into two subgroups of 10 animals, those receiving dietary AA supplementation and those not receiving AA. PF levels were measured with a colorimetric assay immediately prior to and at 4 and 8 weeks after operation. Plasma AA determinations documented the effectiveness of dietary AA supplementation. PF levels in nonoperated and sham-operated controls increased significantly during the 8 weeks of experimentation. In contrast, PF levels decreased significantly following total splenectomy from 328 +/- 46 mcg/mL (mean +/- S.D.) to 285 +/- 46 at 4 weeks and rose to 303 +/- 77 at 8 weeks postoperatively in non-AA supplemented animals. Splenic autoimplantation eliminated this decrease in PF levels at 4 weeks. AA supplementation also protected against the decrease in PF levels in the splenectomized group. In the intragroup comparisons, AA supplementation did not produce a significant elevation of PF.(ABSTRACT TRUNCATED AT 250 WORDS)

Morphometric Studies of Cystic and Tubulointerstitial Kidney Diseases with Hepatic Fibrosis in Children

Portal tract fibrosis with biliary ductular enlargement or proliferation occurs in a number of genetic diseases that have cystic or tubulointerstitial renal lesions. These include some with renal cystic disease such as autosomal recessive diseases (e.g., infantile polycystic disease, juvenile polycystic disease, and Meckels syndrome), autosomal dominant diseases (e.g., adult polycystic disease) and, rarely, tuberose sclerosis and dominant glomerulocystic disease. Portal tract fibrosis with biliary enlargement and proliferation occurs also with tubulointerstitial kidney diseases. These probably include at least three disorders in the category nephronophthisis-congenital hepatic fibrosis (one autosomal recessive disease and two either autosomal or X-linked recessive diseases) plus Jeunes syndrome (the tubulointerstitial diseases Fanconis familial nephronophthisis and anti-tubular membrane antibody disease do not regularly cause hepatic fibrosis). Morphometric data on ratios of bile ductules to connective tissue in hepatic portal tracts show high values for infantile polycystic disease (mean, 0.616) compared to lower values for juvenile polycystic disease (mean, 0.286). That the cystic renal lesions of the first two diseases differ in type and time course is known. Similar data on ratios of glomeruli plus tubules to connective tissue in renal cortices and of tubules to connective tissue in outer medullary zones of kidneys, respectively, are as follows: for Fanconis nephronophthisis, 0.445 and 0.197; for anti-tubular basement membrane antibody disease, 0.585 and 0.164; and for the three types of nephronophthisis-congenital hepatic fibrosis studied, 0.668 and 0.446, 1.39 and 0.921, and 1.18 and 0.12. These data support clinical impressions that the category nephrophthisis-congenital hepatic fibrosis includes more than one disease entity.

Microdissection Study of the Incidence of Branched Eccrine Sweat Glands and the Number of Eccrine Glands Per Unit Area of Infants' And Childrens' Skin

That branched eccrine sweat glands occur has rarely been mentioned in the literature, and their incidence has never been determined. All eccrine glands in 0.5-cm2 pieces of anterior trunk skin of 59 children were microdissected, and the total number of glands and the number of branched eccrine glands determined. One-hundred fourteen of 17,539 (0.65%) were branched, 90% in the middermis and 10% at the epidermis. The apparently normal anatomic property that almost 1% of eccrine sweat glands are branched has not hitherto been appreciated. One doubly branched gland was found. Patients with leukemia (11 in the study) possibly had more branched glands than nonleukemic patients of the same body size. The best statistical relation of the number of sweat glands per unit area of skin (GUA) to surface area (SA) or age in children was the natural logarithm of GUA versus the reciprocal of surface area: LnGUA = (0.2205 X 1/SA) + 5.42. This result is consistent with the classical proposition that there is no important degree of formation of new eccrine glands, nor of loss, after birth, the density of glands per unit area of skin reducing as SA rises with growth during childhood.

Correction For the Effects of Cold Agglutinins on Ortho ELT-8 Results

Cold agglutinins can affect all the parameters obtained from automated cell counting instruments. Their effects on results from Coulter instruments can be eliminated by prewarming the sample. Prewarming is not always sufficient to eliminate the effects of cold agglutinins on results from the Ortho ELT-8 cell counter. This article describes a simple and reproducible procedure combining saline washing and prewarming of the sample to correct the effect of cold agglutinins.