Reduction of hypercalciuria in tetraplegia after weight-bearing and strengthening exercises.
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Biomedical subjects
Publications and source records attributed to E Gilbert.
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Erythroblastic islands are distinct anatomical units allowing direct transfer of ferritin molecule into developing erythroblasts. A patient with Fanconi's anemia who developed acute erythroleukemia and hypotransferrinemia exhibited numerous erythroblastic islands in the bone marrow. This unusual finding in our patient is thought to be in response to an increased demand for iron caused by neoplastic erythropoietic proliferation in the absence of an adequate amount of transferrin.
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A fatal, widespread, polyclonal, B-cell immunoblastic lymphoproliferative disorder developed in three children with combined immunodeficiency shortly after intra-abdominal transplantation of cultured thymus epithelium for immunoreconstitution. All three had surface immunoglobulin-bearing cells (15 to 20 per cent) in the peripheral blood before transplantation and polyclonally elevated immunoglobulins afterward. Abnormal immunoregulation was demonstrated by a lack of concanavalin A-induced suppressor-cell activity in mixed leukocyte culture in all three patients before transplantation and in two afterward. We suggest that the transplant acted as a promoter through immunostimulation or production of promoter factors, and that excessive polyclonal B-cell proliferation resulted because of inadequate immunoregulatory mechanisms. Although this complication occurred in only three of 30 patients with various forms of immunodeficiency treated with cultured thymus, these cases illustrate a potential problem in immunoreconstitution of combined immunodeficiency disorders.
A family is described in which four children developed cancer affecting different organs:lymphoma, meningeal sarcoma, osteogenic sarcoma, and adenocarcinoma of the cecum. Since there was only one other case of cancer in previous generations of this family, an hypothesis is put forth to explain this unusual aggregation on the basis of recombination of common genes. It is postulated that each parent carried a different combination of genes which, though not associated with increased cancer predisposition in the combinations in which they were present in the parents, due to independent assortment resulted in a combination producing cancer susceptibility in half of the offspring. Such genetic loci could include factors similar to an oncogene which is normally held in control by genes at another locus; thus the dominant oncogene without the dominant controlling genes would make for cancer susceptibility, while the controlling genes without the oncogene would be associated with cancer resistance since two mutations would then be required for malignant development. To explain the occurrence of lymphoma in one of the children in this family, a third set of genes is included in this model--genes affecting immunocompetence, in which the normal allele is dominant. This three locus model has the advantage of being able to explain not only the occasional cancer family, but also the distribution of cancer susceptibility and resistance in the general population.
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Regeneration of bone marrow following radiation only was investigated using 111Indium as a bone scanning agent. Factors which influence local marrow regeneration are dose, age of the patient, and the total amount of the marrow which was irradiated. Time effects are not demonstrated in this study, except to the extent that most regeneration did occur within the first 12 months following irradiation. The most striking finding is the effect of the irradiation volume. Apparent inconsistencies in earlier reports concerning the dose effect could be explained by this effect alone.
The cerebellar vermises from a 1 day old child who died with cystic dysplastic kidneys (Potter Type II) and from a 28 day old who died with infantile polycystic kidneys (Potter Type I) were studied by the Golgi silver method and electron microscopical procedures. Golgi stains showed that Purkinje cells from both cases had the following abnormal characteristics: (1) they retained perikaryal processes even at 37-42 weeks after conception although these processes are normally absent from the cerebellar vermis after 34 weeks of gestation; (2) The Purkinje cell dendrites had dilations at their numerous branchpoints. Ultrastructural studies indicated that climbing fibers remained in contact with the perikaryon of the Purkinje cell in both cases although they are not normally present on the perikaryon after 33 weeks gestation. The 1 day old child (Type II) had unusual synaptic structures of the dyad and serial type. The concurrence of cerebellar and kidney cell maldevelopment in this and a variety of other conditions suggests that there may be a pathogenetic and causal relationship between the two.
Invasion into blood vessels by malignant melanoma at the primary cutaneous site is a superior discriminant for an adverse prognosis. However, until the question of relative prognostic values is resolved conclusively, surgical pathologists should document the collection of histopathologic observations recommended by McGovern and co-conferees.
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