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PubMed1969

Clotting problems with the Teflon-Silastic arteriovenous shunt in patients on regular haemodialysis.

Episodes of clotting that occurred in 22 patients on regular haemodialysis were studied over a six-month period. The venous pressure during dialysis and the radiology of the Teflon-Silastic arteriovenous shunt were found to be satisfactory guides for the management of the shunt. The failure of the shunt during the early stage was mainly due to technical reasons. Histological study of the excised vessels in removed long-term shunts showed that these had failed because of rigidity and thickening of the vessel wall due to calcium and iron deposits or chronic inflammation, or both.

Arteries↗
PubMed1963

De Quervain's subacute granulomatous thyroiditis: histological identification and incidence.

The histological features of de Quervain's subacute granulomatous thyroiditis are described, on the basis of a study of six specimens. This condition, unlike Hashimoto's disease, rarely causes permanent hypothyroidism; its histological identification is thus of practical importance. Areas of thyroid affected by the disease show intrafollicular cellular infiltration, with partial or complete loss of colloid from infiltrated follicles, partial or complete disruption of their lining epithelium, and abnormalities of the basement membrane. These changes tend eventually to lead to replacement of the damaged follicle by a granuloma-like structure devoid of colloid content and without a recognizable epithelial lining. The disease also causes interfollicular fibrosis and an interstitial inflammatory cell reaction. The histological pattern is typically multiform. Formative follicle lesions present a striking appearance, aiding recognition of the disease. Some follicles contain numerous giant cells, often grouped around a central pool of residual colloid; others may contain a considerable proportion of neutrophil polymorphs or show radially aligned spindle-shaped cells.A study has also been made of the incidence of de Quervain's thyroiditis in surgical material in Sheffield during the seven year period 1955-61. Only two examples were found in a total of 1,282 cases of primary thyroid disease, an incidence of 1.6 per 1,000 (0.16%); there is, however, reason to believe that the overall clinical incidence is higher than that indicated by the surgical figures.

Fibrosis↗
PubMed1963

A RAPID MICRO METHOD FOR RECORDING RED CELL OSMOTIC FRAGILITY BY CONTINUOUS DECREASE OF SALT CONCENTRATION.

A single volume of 0.075 ml. of a 1 in 10 dilution of whole blood in isotonic NaCl solution is introduced into a container cell, two walls of which are made of a dialysing membrane. The container cell is introduced into a test tube of distilled water, placed in an instrument which is essentially a colorimeter with a recorder, between the source of light and the photoelectric cell. Dialysis through the membrane results in a continuous decrease in the salt concentration of the medium surrounding the erythrocytes. The measurement of the degree of haemolysis is based on the increasing transparency of the erythrocyte suspension while haemolysis takes place. Recording this increasing light transmission as a function of time, i.e., as a function of decreasing salt concentration, yields the osmotic fragility curve. The automatically recorded curve is obtained in less than 10 minutes.

Erythrocytes↗
PubMed1964

A HISTOLOGICAL STUDY OF HYALINE DEPOSITS IN LARYNGEAL, AURAL, AND NASAL POLYPS AND THEIR DIFFERENTIATION FROM AMYLOID.

Sections of hyalinized laryngeal polyps stained with haematoxylin and eosin or Congo red can easily be confused with localized amyloid of the larynx. Several histological methods were applied to 61 specimens containing hyaline deposits or hyalinized tissues which included 36 laryngeal polyps. The results were compared with seven cases of localized amyloidosis of the upper respiratory tract and four cases of secondary amyloidosis. The hyaline deposits gave a pattern of results which were different from amyloid. They showed no metachromasia, low affinity for Congo red, weak birefringence in an unstained state, no birefringence if stained with Congo red, weak or negative fluorescence if stained with Thioflavin T, low resistance to pepsin digestion, positive phosphotungstic acid haematoxylin staining areas, and a high affinity for the picric acid component of van Gieson stain. Hyalinized collagen closely resembles amyloid, but it can be excluded by a van Gieson stain. No evidence of amyloid formation was found in areas of hyaline deposits in the larynx. This supports the view that localized amyloidosis of the larynx and hyalinized laryngeal polyps are different pathological entities.

Amyloid↗