Raymond F. Sheets

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.

Polycythemia: a manifestation of heart disease, lung disease or a primary blood dyscrasia.

DR. GEORGE N. BEDELL: The purpose of this conference is to discuss some of the problems encountered in the differential diagnosis of polycythemia. Poly-cythemia may be a manifestation of heart disease, lung disease, or a primary blood dyscrasia. Polycythemia vera is a disease of unknown cause. In our hospital we make a diagnosis of polyeythemia vera on the basis of finding leukocytosis, high platelet count, and splenomegaly in addition to polycythe-mia. We require exclusion of conditions capable of producing secondary polycythe-mia, such as cyanotic heart disease, lung disease, chronic exposure to high altitude, and respiratory center depression. Secondary polyeythemia is diagnosed when the patient has polycythemia associated with cyanotic heart disease or lung disease in the absence of leukoeytosis, high platelet count, and splenic enlargement. The differentiation of polycythemia vera from secondary poly-cythemia is sometimes a difficult task. Ratto, Briscoe, Morton, and Comroel have discussed the theoretical reasons that make this distinction possible by measuring arterial oxygen saturation. Also they point out the practical obstacles. The hypothesis is that uncomplicated polycythemia vera should not lead to arterial hypoxemia. No disturbance in pulmonary ventilation, pulmonary circulation , or in the ability of oxygen to diffuse from the alveolus into the red blood cell has been demonstrated in patients with polyey-themia vera. If the oxygen saturation of arterial blood is reduced in patients with polyeythemia, this suggests that polycythe-mia is secondary to hypoxemia. This con-elusion is questionable because arterial oxygen desaturation may exist from other causes: 1. Patients with polyeythemia vera are usually more than 50 years of age. Healthy persons of this age may have slight reduction of arterial oxygen saturation.2 2. Patients with polyeythemia vera may have concomitant lung disease to account for arterial hypoxemia. 3. Most patients with polyey-themia vera whose arterial blood has been studied have no hypoxemia,1 3 however, arterial hypoxemia has been reported in poly-cythemia vera.4-6 We believe that arterial desaturation in the polyeythemic patient is evidence that polyeythemia vera exists with another disease or that polyeythemia is secondary to another disease. The following cases have been chosen to illustrate how the patient with polyeythemia can be studied to evaluate his basic disease. CASE 1 Mr. C. K., a 49-year-old farmer, was admitted to the University Hospitals on January 6, 1956. He was active and able to do his work until De-cember 1955. At that time, coughing, dyspnea on exertion, and hemoptysis began. His nails had …

The Epidemiology of Pesticides in a Rural Area

Abstract A random sample of 155 farmers was studied with respect to use of pesticides and to farming habits and products. Significant differences were found between the “high” and “low” pesticide use groups with respect to hematocrit, hemoglobin, and prothrombin time values. Significant correlations were obtained between the use of aldrin and blood uric acid values; atrazine and bilirubin, 1-minute and 30-minute values; benzene hexachloride and total blood chlorinated hydrocarbon residues; benzene hexachloride and urinary creatinine values; and 2, 4-dichlorophenoxy acetic acid herbicides and serum albumin values for the high pesticide use group. Significant correlations were found between the total pesticides employed by the high-use group and the blood uric acid and bilirubin 1-minute values. A significant negative correlation existed with respect to erythrocyte sedimentation rates. No significant correlations were obtained for the low-use group. The blood concentrations of pesticide residue were not pro...

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.

The Many Faces of Megaloblastic Anemia

Megaloblastic anemias share a common feature—disordered DNA synthesis, most often resulting from deficiency of folic acid or vitamin B12 or both. However, the cause of the anemias varies from pregnancy to poor nutrition, gastrointestinal disorders, cirrhosis, hemolytic anemias, drugs, fish tapeworms, orotic aciduria, erythroleukemia or long-term dialysis for uremia.

May-Hegglin Anomaly-Reply

Drs. Oski, Naiman, and Diamond quoted us correctly, that in our judgment there is no evidence of abnormal bleeding in these cases. We shall stand on our judgment and await further evidence. The platelet count of the proband was normal and was inadvertently omitted when the history was condensed. Estimation of the platelet count in other members of the family was made from the blood smear. The platelets were present in normal numbers.