Julius R. Krevans

Further Experimental Studies on the Prevention of Rh Haemolytic Disease

In a previous report (Finn et al., 1961) we gave reasons for thinking that the rapid removal of Rh-positive foetal erythrocytes from the circulation of a mother who was Rh-negative would prevent her from becoming immunized and producing Rh antibodies. We have now investigated the matter further, and the present paper describes the completed results of the earlier work (Experiment I) and then gives details of some subsequent observations (Experiments II and III). The reasoning involved and the scope of the investigations are first discussed.

Evaluation of Humanistic Qualities in the Internist

Excerpt In an important decision on 6 June 1983 the American Board of Internal Medicine accepted the following report of its Subcommittee on Evaluation of Humanistic Qualities in the Internist. In ...

Development of neurologic manifestations of pernicious anemia during multivitamin therapy.

IN SOME patients with pernicious anemia neurologic manifestations occur before significant anemia develops. Such cases have been uncommon in the past. At the Johns Hopkins Hospital in the five-year...

Prolonged treatment of pernicious anemia with vitamin B12

Abstract A large group of patients with pernicious anemia has been treated with vitamin B 12 for periods as long as forty months. Parenterally administered B 12 was as effective as refined liver extract in producing and maintaining clinical and hematologic remission. No evidence was found that patients with uncomplicated pernicious anemia need any therapy other than vitamin B 12 . Orally administered vitamin B 12 was effective in the treatment of pernicious anemia provided that the oral dose was about 100 times the amount which was adequate when given parenterally. Until the adequacy of oral dosage schedules has been demonstrated patients with pernicious anemia should receive parenteral therapy. An intramuscular injection of 45 μg. of vitamin B 12 given every six weeks appeared to be adequate for satisfactory maintenance therapy and protected against hematologic and neurologic relapse. Vitamin B 12 seems preferable to liver extract in the treatment of pernicious anemia because it causes less discomfort at the site of injection, does not give rise to untoward reactions and is less expensive than liver extract.

Radioactive tracer tests for the recognition and identification of vitamin B12 deficiency states

Abstract Over 100 studies of vitamin B12 absorption were performed in 92 subjects using vitamin B12 labeled with radioactive cobalt. Impaired absorption of vitamin B12 from the gastrointestinal tract was observed in patients with pernicious anemia, sprue, regional ileitis, jejunal diverticulosis, and in patients after total gastrectomy or after resection of large portions of the small intestine. Administration of intrinsic factor preparations corrected the absorption defect in pernicious anemia and after total gastrectomy, but was without effect in the other disorders. Administration of an antibiotic improved the absorption of vitamin B12 in a patient with jejunal diverticulosis presumably by eliminating bacterial competition for vitamin B12. The use of radioactive vitamin B12 provides a simple and useful clinical test which has its greatest value in the recognition of pernicious anemia in patients who are in remission as a result of previous therapy.

NEW DEVELOPMENTS IN THE DIAGNOSIS AND TREATMENT OF PERNICIOUS ANEMIA

Excerpt Criteria for the diagnosis of pernicious anemia must be reevaluated in light of the changing pattern of this disease. The profound physical abnormalities and extreme hematologic aberrations...

Rapid Clearance of Rh Positive Blood During Experimental Rh Immunisation

Summary. When Rh negative male volunteers were given successive small injections of Rh positive blood, it was repeatedly found that rapid clearance of the cells took place in the absence of detectable antibody. It is thought likely that primary immunisation to the D (Rho) antigen had occurred in these cases and that a similar state occurs as a result of Rh positive pregnancies in Rh negative mothers. These findings have a relevance to the assessment of trials in which gammaglobulin anti‐D is given to prevent Rh immunisation.

Transplacental hemorrhage in cesarean section

Summary A modification of the Finns method of quantitatively estimating small transplacental hemorrhage is presented and discussed. Amount of transplacental hemorrhage caused by cesarean section and cesarean section hysterectomy is estimated in 30 cases, showing that 21 out of 30 in our series have a transplacental hemorrhage equal to or less than 0.25 c.c. The clinical history of the patients and their surgical procedures are correlated with the amount of transplacental hemorrhage.

Treatment of megaloblastic anemias

Abstract Megaloblastic anemia is almost always the consequence of a deficiency state. The proper management of this disorder requires the identification of the nature of the underlying abnormality, since this dictates the choice of the specific therapeutic agent for the deficiency, the duration of treatment required, and the other therapeutic measures which may be necessary.

Out of the Wastebasket

Excerpt Tuesday Been examining the great waterfall. It is the finest thing on the estate, I think. The new creature calls it Niagara Falls—why, I am sure I do not know. Says itlookslike Niagara Fal...