Charles R. Spillert

Protective effect of a splenic extract in mice with endotoxemia.

We have previously described the isolation of a lipoidal splenic extract (LSE) that demonstrated a variety of hematologic effects including inhibition of platelet aggregation both in vivo and in vitro. Since endotoxin causes platelet aggregation and microembolism the protective effect of LSE in endotoxemia was examined in the present study. Both young and elderly Swiss mice given LSE 2--3 hours before endotoxin challenge showed a statistically significant increase in survival compared with saline-treated controls. However, no significant improvement in survival was noted when LSE was administered at the same time as endotoxin. These results add further support to the role of the spleen in the control of infection.

Gastric Necrosis due to Acute Dilatation of the Stomach

Because of a generous blood supply, infarction of the stomach is much less likely to occur than in the rest of the gastrointestinal tract. The purpose of this communication is to describe a case of no

A functional clotting assay to monitor the hirudin dosage.

Hirudin, a direct thrombin inhibitor, has potential advantages over indirect thrombin inhibitors and is increasingly used in clinical settings. There are, however, large variations in individual responses to this drug and no recognized clinical laboratory tests used to monitor its anticoagulant effects. We evaluated the use of the thromboelastograph, a common clinical coagulation instrument, to monitor the effects of hirudin in vitro. We developed a novel, whole blood clotting assay that utilizes the tissue factor stimulating properties of mercuric ion to measure the anticoagulant potential of therapeutic doses of hirudin. At doses equivalent to those found in the therapeutic range, the thromboelastograph was capable of showing significant changes when compared with control and different concentrations of hirudin (P < 0.05). A linear relationship was observed between increasing concentrations of recombinant hirudin and clotting times. In conclusion, the use of this test system warrants further investigation for monitoring hirudin.

Acute Chylous Peritonitis

During the management of acute abdominal disease, the intraoperative gross findings assume paramount importance in surgical decision making. Frequently and fortunately, histopathologic confirmation of

Brunner’s Gland Adenoma

Brunner’s gland adenomas, also referred to as hamartomas, polypoid harmartomas or as nodular hyperplasia, are rarely accounted for in clinical practice. In this communication the case of a patient wit

Procoagulant effect of aqueous humor on in vitro clotting of blood and plasma

Fresh and previously frozen aqueous humor was found to shorten the recalcification time of both canine citrated blood and human citrated plasma. This state of accelerated coagulation was dose related and preliminary studies indicate that aqueous humor acts as a procoagulant rather than a thromboplastin-like substance.

Protective Effect of a Splenic Factor in Mice with Burns

We have previously described the protective effect of a lipoidal splenic factor (SF) against lethal endotoxemia in mice. Since this protective effect is also accompanied by significant antithrombotic changes, and since burn injury causes thrombosis and consumptive coagulopathy, it was postulated that SF decreased the severity of the burn wound. Swiss white mice were anesthetized with pentobarbital sodium and then burned on a depilated area of the lower back with a 2-cm diameter stainless steel weight at 95 degrees for 10 sec. SF (10 mg/kg) (n = 20) or an equal volume of saline (controls) (n = 13) was administered within 1 hour after thermal injury. Severity of burn injury was assessed by examination of hematoxylin and eosin-stained biopsies obtained 24 hours postburn by a grading scale of 0 (normal) to 4 (severe) depending on the degree of epidermal loss, coagulation necrosis, and inflammatory cell infiltrate. Average degree of burn severity was 1.10 +/- 0.20 for SF recipients and 2.85 +/- 0.27 for the controls (p less than 0.001).

A colocutaneous fistula occurring 50 years after a shotgun injury

Traumatic fistulae of the gastrointestinal tract are usually acute processes which occur at the time of, or shortly after, the injury. Because of its rarity, we report here a case of a colocutaneous fistula that developed 50 years after a shotgun wound of the abdomen.