Elmer L. DeGowin

A case of infection with brucella sius, causing endocarditis and nephritis; Death from rupture of mycotic aneurysm

Abstract The case of a man with Br. suis bacteriemia is reported. The infection lasted approximately two hundred days, during which endocarditis and nephritis developed. He recovered from uremia, only to succumb to rupture of a mycotic aneurysm of the left femoral artery. Sulfonamide therapy and the administration of convalescent serum failed to influence the infection. The pooled serum was prepared from the blood of donors who had recovered from Br. suis bacteriemia. Anatomic studies after death revealed, among other things, ulceration and vegetations on a previously normal mitral valve. The specific nature of the lesions was proved, during life, by the repeated isolation of Br. suis in pure culture from the blood stream, and, after death, by obtaining pure cultures of Br. suis from the vegetations from the endocardium, the walls of the mycotic aneurysm, and other tissues. The blood contained specific agglutinins, but the skin did not react to brucellergin intradermally. So far as we are aware, this is the first reported case in which ulcerative endocarditis has been proved, beyond doubt, to be due to Br. suis . It is the second reported instance in which rupture of a mycotic aneurysm due to Br. suis has caused death.

Hemolysis of human erythrocytes by a sulfhydryl inhibitor, p-chloromercuribenzoic acid.

Conclusions 1. The sulfhydryl reagent, p-chloromercuribenzoic acid, causes hemolysis of human erythrocytes. This action can be prevented by prior reaction with sulfhydryl groups. 2. The hemolytic action of PCMB is reversible by washing cells for as long as 30 minutes after contact with this agent. Reversibility of hemolysis lasts up to 60 minutes after addition of free sulfhydryl group. 3. No protection from PCMB hemolysis was noted with stroma whereas hemoglobin solution was effective. 4. The reaction between PCMB and the -SH group of erythrocytes is relatively slow. 5. A physiologic concentration of glucose offered no protection from hemolysis in this system.

Studies on Preserved Human Blood. V. Decrease in Prothrombin Titer During Storage.

Summary The rate of disintegration of the plasma prothrombin in preserved blood stored aseptically at 5° was studied by the quantitative prothrombin method of Warner, Brinkhous and Smith. The prothrombin values were found to decrease very gradually, reaching the 50% level at the end of about 3 weeks. No difference in the rate of disintegration was found between blood stored in sodium citrate and that stored in a citrate-dextrose mixture.

Rates of Hemolysis in Human Blood Stored in Dextrose Solutions and in Other Mixtures

Summary The addition of dextrose to blood-citrate mixtures markedly inhibits hemolysis during storage at 2°C. Sucrose is not so effective and NaCl and KCl increase the rate of hemolysis. The final concentration of dextrose in the blood mixture required for the maximal inhibition of hemolysis is approximately 3%. The use of a preservative mixture containing this amount of dextrose ordinarily permits the safe storage of blood for 30 days or more.

Osmotic Changes in Erythrocytes of Human Blood During Storage

Summary In citrate-blood the erythrocytes undergo progressive swelling during storage at 2°C; this is reflected in the increase in the fragility to hypotonic saline solutions. This property is not reversible by washing in isotonic saline. Red cells stored in sucrose-citrate solutions shrink. Erythrocytes in 5.4% dextrose-citrate undergo rapid swelling which is due to the diffusion of dextrose and water into the cells. The process can be reversed by washing with isotonic saline. The addition of hypertonic dextrose solutions to blood-citrate produces hypertonic cell contents during storage. The transfusion of such cells results in intravascular hemolysis by action of the recipients plasma. The osmotic activity of the erythrocytes thus becomes another criterion for the suitability of stored blood for transfusion. Blood collected in dextrose solutions should be chilled rapidly to avoid osmotic hemolysis during refrigeration.

Oxygen uptake of human erythrocytes in fresh and stored blood.

Summary The oxygen uptake of human whole blood is essentially the same whether sodium citrate or heparin is used as an anticoagulant. There is a significant difference between the oxygen uptake of the blood of men and women. A significant fluctuation was noted in the oxygen uptake of fresh blood from one person from day to day. The oxygen uptake of human blood stored in ACD solution rapidly decreases for 20 days then fluctuates for at least 60 more days in an erratic fashion.

Textbook of Medical Treatment, ed 2.

Every clinician whose practice and interests extend beyond the confines of a small specialty needs a book on medical treatment that is completely revised every two or three years by physicians experienced in their various fields. Changes in modern therapy are so many and they occur so rapidly that one cannot expect discussions in 2,000-page texts to be up to date. My specifications for such a book are met almost completely by the present volume. Its 11 editions have appeared at intervals from two to five years since 1939; the last few have been two years apart. The present edition represents the work of 37 writers from Scotland, most of whom were from its universities. In 700 pages they have covered (in excellent fashion) antibiotics and chemotherapy; infectious diseases; tuberculosis; diseases of the heart and circulation; diseases of the blood vessels of the limbs; disorders of the blood; anticoagulant

The Thyroid: A Fundamental and Clinical Text.

About ten years ago the thiourea derivatives and radioiodine became available to medicine for experiment and therapy. Since then, the number of published investigations on the physiology of the thyroid gland and the therapy of its diseases has increased to such an extent that well over 3000 papers are said to be appearing annually in the medical literature. As a result of these studies, for example, the therapy of thyrotoxicosis has undergone two radical revisions in this decade. The newer tests of thyroid function and the current therapy of thyroid disease demand of the physician a detailed knowledge of the recent advances. The present book seems to be a logical means of furnishing him with this equipment. Sixty persons, each of whom has intensively cultivated a part of this field of knowledge, have contributed essays on the details most familiar to them. In this way the vast literature has been