Harold M. Schoolman

Quantitative-morphologic evaluation of postnecrotic cirrhosis

This quantitative study has been undertaken for the exact evaluation of the morphologic criteria of “postnecrotic cirrhosis”. Determination of the average nodular size, the range of nodular size, and the ratio of multilobular to pseudolobular nodules in 219 cirrhotic livers resulted in curves of normal distribution, with 66% of all cases concentrated around the mean value. There was an approximately equal distribution of the remaining 34% toward both extremes of the curves. According to average nodular size or range of nodular size, three groups of cirrhosis could be distinguished: Group A: fine nodular cirrhosis (values smaller than the mean minus one standard deviation); Group B: mean nodular corrhisis (values within the range of the mean plus or minus one standard deviation); Group C: coarse nodular cirrhosis (values larger than the mean plus one standard deviation). Group A: fine nodular cirrhosis (values smaller than the mean minus one standard deviation); Group B: mean nodular corrhisis (values within the range of the mean plus or minus one standard deviation); Group C: coarse nodular cirrhosis (values larger than the mean plus one standard deviation). The incidence of areas of collapse in all cirrhotic liver examined by multiple sections was 77.6%. Group A showed areas of collapse in 44.85%, Group B in 66.15%, and Group C in 100%. Group C of our material was characterized not only by the large average size of the nodules, but also by the great variation of nodular size, and by the highest incidence of multilobular nodules and areas of collapse. Group A showed uniformity in the size of the nodules and the lowest incidence of areas of primary collapse. This quantitative analysis of the basic morphologic criteria of hepatic cirrhosis failed to reveal a sharp or natural borderline between “postnecrotic cirrhosis” and “portal (Laennecs) cirrhosis”. Zweck dieser quantitativen Untersuchung war die exakte Auswertung der morphologischen Kriteria der „postnekrotischen Cirrhose”. Bestimmung der mittleren Knötchengröße, des Variationsbereiches der Knötchengröße und das Häufigkeitsverhältnis zwischen multilobulären und pseudolobulären Knötchen in 219 Lebercirrhosen ergaben Gaußsche Verteilungskurven. 66% aller Fälle lagen nahe dem Mittelwert. Die übrigen 34% der Fälle waren annähernd gleichmäßig zu beiden Seiten des Mittelwertes verteilt. Nach der mittleren Knötchengröße und dem Variationsbereich der Knötchengröße konnten drei Cirrhosegruppen unterschieden werden: Gruppe A: feinknotige Cirrhose (Werte kleiner als der Mittelwert minus einer Standardabweichung); Gruppe B: mittelknotige Cirrhose (Werte im Bereich des Mittelwertes, plus oder minus einer Standardabweichung); Gruppe C: grobknotige Cirrhose (Werte größer als der Mittelwert, plus einer Standardabweichung). Kollapsfelder (nach den histologischen Kriteria von P.Steiner) lagen in 77,6% aller durch mehrere Schnitte untersuchten Lebercirrhosen vor. Gruppe A zeigte Kollapsfelder in 44,85%, Gruppe B in 66,5% und Gruppe C in 100%. Charakteristisch für die Gruppe C unseres Materials waren neben der groben Knötchengröße, die größte Variationsbreite der Knötchengröße und der größte Prozentsatz von multilobulären Knötchen und von Kollapsfeldern. Gruppe A dagegen zeigte gleichmäßige Knötchengröße und den kleinsten Prozentsatz von Kollapsfeldern. Diese quantitative Analyse von Grundkriteria der Lebercirrhose ließ keine scharfe oder natürliche Trennungslinie zwischen „postnekrotischer Cirrhose“ und „portaler (Laennecscher) Cirrhose” erkennen.

Studies in Leukemia: XIV. Effect of Human Serum on Development of Leukemia in AKR Mice.

Summary Human volunteers were inoculated with a cell-free filtrate prepared from a pool of brains obtained from patients who died of acute leukemia. The antiserum from these volunteers afforded significant protection of AKR mice challenged with cell-free filtrates of leukemic human brains. This protection was not afforded by pooled normal serum, and was apparent at various dilutions of the challenging material.

Studies in Leukemia: XI. Active Immunization of C3H x 101 Mice Against Induction of Leukemia.

Summary 1. Leukemic and non-leukemic cell-free brain filtrates were irradiated with ultraviolet light. C3H x 101 mice were actively immunized by subcutaneous inoculations. 2. Active immunization with ultraviolet irradiated leukemic cell-free brain filtrate gave significant protection against challenge of leukemic cell-free brain filtrate. 3. Active immunization with ultraviolet irradiated cell-free brain filtrates did not protect against challenge of a high concentration of tumor-cell suspension.

Leukemia. VIII. Leukemogenic effect of brain filtrates after serial passage through mice.

Summary 1. Cell-free filtrates of leukemic AKR and Swiss mouse and human brains were prepared. 2. The filtrates were serially passed through Swiss mice in the case of AKR mouse and human brains and through C3Heb mice in the case of Swiss mice. 3. After 5 passages leukemogenic activity could be demonstrated by reintroduction of the material into the starting strain in case of the mice, and into AKR mice in case of human brains. 4. No activity or little activity could be demonstrated when leukemic tissues served as sources of the original material. 5. The experiments demonstrate that the activity of the material is not dependent on cells. 6. The dilution resulting from the passages described is such as to compel the assumption that the activity has been replicated.