Leucocytic Reaction Research Articles

Omental torsion: a diagnostic challenge

Torsion of the greater omentum is a rare acute abdominal condition that is seldom diagnosed preoperatively. We report a case of surgically proved right-sided torsion of the greater omentum that occurred secondary to recurrent inguinal hernia. A 39-year-old man presented to our hospital with abdominal pain.He had been diagnosed with right indirect inguinal hernia many years back for which herniorrhaphy was done. Contrast-enhanced Computed Tomography (CT) of the abdomen showed omental torsion with extension in the right inguinal hernia, mild ascites with subtle layering of blood. Exploratory laparotomy revealed torsion and gangrene of the greater omentum with small bloody ascites. An omentectomy was performed. Post-operative period was uneventful. Omental torsion is a rare cause of acute abdominal pain but should be included in the differential diagnosis of acute abdomen, especially in patients with untreated inguinal hernia. Knowledge of this pathology is important to the surgeon as it mimics common acute surgical abdomen. For this reason, in the absence of diagnosed preexisting abdominal pathology including cysts, tumors, foci of intra-abdominal inflammation, post-surgical wounds or scarring, omental torsion can present a surprise. Exploratory laparotomy represents the diagnostic and definitive therapeutic procedure.Presently laparoscopy is the first choice procedure. A rare and unique case of omental torsion with gangrene presenting with abdominal signs of peritonism without leucocytic reaction is being reported.

Cardiac rupture: histological study of ruptured and non-ruptured myocardial infarcts (author's transl)

178 myocardial infarcts with wall rupture and 116 without were studied histologically. Mean morphological age of the infarct was 3.7 in the ruptured and 2.9 days in the non-ruptured cases. 57.7% of patients had died within the first 24 hours from a non-ruptured infarct. Death rate within the first 24 hours after infarction was 57.7% among the non-ruptured cases, 25.8% among those with rupture. 23.1% of infarcts had ruptured between the third and fourth day. Only 5.1% of patients with non-ruptured infarcts had died on the third or fourth day. Transmural infarction was present in 71.7% of those that had ruptured. The ruptured channel in general ran through the middle of the necrotic-infarcted, leucocyte-infiltrated myocardium. Infarct recurrence was demonstrated in 20% of ruptured and 73% of non-ruptured infarcts. Morphological comparison indicated that transmural infarction and marked leucocytic reaction in a not previously infarct-damaged myocardium are the main causes for rupture in myocardial infarction.

Histologic appearance of fractured thyroid cartilage and surrounding tissues

Histological appearances of the fractured superior horns (SH) of the thyroid cartilage and their surrounding tissues were reviewed, with particular reference to signs of vital origin of the fracture. Twenty-nine autopsies with either histories or findings indicating asphyxial neck compression, with a total of 39 fractured SHs, and three autopsies with history of suicidal jump from height with a total of two SH fractures, were examined. Fifteen autopsies with finding of 19 artefactually fractured SHs while removing neck organs at autopsy were used as controls. In the cases of neck compression and victims of jump from height haemorrhages, retraction of fractured SH fragments with invagination or squeezing of the perichondrium, contraction bands, contraction band necrosis and ‘opaque fibres’, in the adjacent muscle fibres could be seen. Fibrin deposition and/or leucocytic reaction were noted in cases where circumstances of death indicated prolonged death struggle (as in incomplete hanging, resuscitation or homicidal neck compression). However, retraction of fractured fragments and invagination of perichondrium between artefactually fractured SH fragments were observed in both control cases and cases with antemortem trauma to the larynx. Many of these histological findings, including haemorrhages and fractures had not been evident at gross examination. We conclude that histological examination of SHs may not only uncover macroscopically overlooked injuries but also may facilitate the clarification of an injury’s vital origin.

Mechanisms of mast cell modulating effect on the leukocyte reaction in inflammation

On the model of acute infectious peritonitis in rats with using the antagonists of the main biologic active products of mast cells it is shown that modulating effect of mast cells on the leucocytic reaction in inflammation is realized with the histamine, serotonin and heparin participation; in this way histamine influences mainly through H2-receptors on neutrophils and H1-receptors on monocytes.

Cytometric and cytochemical study of peritoneal and alveolar macrophages from Yersinia pseudotuberculosis infected ground squirrels (Citellus citellus).

The enzymic activity (succinate dehydrogenase, acid and alkaline phosphatase) of alveolar and peritoneal macrophages as well as leucocytic reaction of ground squirrels infected with Yersinia pseudotuberculosis (I and III serovar) have been investigated in dynamics from the 1st up to the 30th day. The animals infected with III serovar survived only to the 7th day, while those infected with I serovar survived up to the 30th day after inoculation. A massive influx of leucocytes having peak values (100-fold increase) on the 3rd day after infection has been found in the peritoneal cavity of the animals infected with I serovar. Moderate leucocytosis in the blood, and insignificant fluctuations in alveolar macrophage number have been established too. An earlier and higher activation of succinate dehydrogenase in alveolar and peritoneal macrophages from animals infected with III serovar in comparison with those infected with I serovar was observed. No differences in alkaline phosphatase activity of alveolar and peritoneal macrophages have been found between the animals infected with I and III serovar. A correlation has been found between the number of leucocytes and changes in the enzymatic activity of the macrophages. A metabolic transformation was demonstrated typical for different macrophages (peritoneal and alveolar), in the course of this experimental intraperitoneal infection. Obviously, more virulent serovar III of Y. pseudotuberculosis fails to attract leucocytes to the peritoneal cavity sufficiently quickly, so it overcome the local protective mechanisms with consequent systemic cytochemical changes. On the other hand the virulent serovar I attracts leucocytes to the peritoneum and is presumably destroyed by them.

Pelvic Lymph Node Metastases in Early Invasive Carcinoma of the Cervix - Histopathological ‘Risk’ Factors

Histopathological features in 89 cases of Stage 1B and early 2A invasive carcinoma of the cervix who underwent Wertheim radical hysterectomy and pelvic lymphadenectomy were studied. Depth of tumour invasion and lymphatic/vascular space permeation by tumour cells were significantly associated with lymph node metastases. The other features such as tumour type, and stromal leucocytic reaction showed no significant relationship to the presence of lymph node metastases.

The Role of White Blood Cells in Post-Mortem Wounds

Walcher in 1936 pointed out the importance of studying a lesion microscopically in order to distinguish between ante-mortem and post-mortem injuries. According to him and to many other authors (Raekallio, 1984; Ojala et al., 1969; Fatteh, 1966) leucocytic reaction is the earliest histological sign of inflammation, and it is the most reliable sign of the vitality of wounds. The pavementation (also known as margination) of the vascular endothelium of white blood cells, and the beginning of their extravasation, may be seen during the first hour (Ojala et al., 1969), 6 hours (Malik, 1970), 8 hours (Fatteh, 1966) or 8–16 hours (Raekallio, 1964) after the injury.Profuse bleeding and fibrin deposition are no longer regarded as necessarily signs of vitality of wounds. (Shapiro and Robertson, 1962; Laiho, 1967), yet the behaviour of white blood cells in post-mortem wounds remains unknown.It was therefore decided to study the effects of chemotactic materials injected intradermally and in the anterior abdominal wall in dead rats. The experimental findings are presented, along with discussion, and a review of the literature.

Experimental study on fulminant angitis with fibrinoid-like degeneration

Administration of high doses of Na2EDTA or feeding animals a low calcium diet leads to angiolytic changes of the mesenteric arteries as reported in previous papers. Slight inflammatory reactions in the arterial wall including leucocytic infiltration and exudation could be demonstrated. The reason is thought to be the lack of morphological changes of the endothelium. As far as the endothelium was concerned a lift up phenomenon of the endothelial cells and the formation of subendothelial vacuoles was observed, but no endothelial gap formation or desquamation. Administration of Na2EDTA resulted in rapid removal of calcium ions from living animals, but injurious effects on the morphology of the cells did not occur except of changes of the cellular shape, both of endothelial and smooth muscle cells. Without any morpho-functional alterations of the endothelial lining cells, severe exudation and leucocytic trapping could not be induced. The morphological changes of the vascular wall following the above procedures are said to be angiolytic and not angitic. In this experiment, dysproteinemia was provoked in Na2EDTA treated animals by repeated administration of bovine serum albumin (BSA). As a result, angitis-like lesions with severe exudation, similar to those of fibrinoid degeneration and leucocytic reaction against it, were demonstrated. These facts showed that angitis is not merely due to exogenous factors and hostal predisposition.

Histopathologic findings in fresh myocardial injuries. Contribution to vital reactions

Histopathological findings are demonstrated, which arose in 17 myocardial injuries. The injuries concerned were nine stab wounds, six gunshot wounds, one contusion, and one rupture. Initial coagulation necrosis, contraction banding, and sarcoplasmatic vacuoles could be observed, not only intravitally but also supravitally . These changes could be seen much earlier than in cases exclusively restricted to ischemic damage. When a leucocytic reaction occurs at the same time, a longer survival time is indicated.

Tissue Damage by Fatty Acids Released by Lipolysis: Contribution to the Pathogenesis of Acute Pancreatitis

Local application of a mixture of emulsified olive oil and pancreatic lipase produces massive necrosis in liver, kidney, pancreas, skeletal muscle, and perivascular sheath within 3 hours with subsequent spread. The necrosis is accompanied by a marked leucocytic reaction and, - after 16-24 hours -, involves the walls of veins and arteries resembling the vascular necrosis of acute hemorrhagic pancreatitis. Electron microscopy shows necrosis of emigrated leucocytes after only 120 minutes. Vascular necrosis is not seen before the second day. The results clearly demonstrate the ability of free fatty acids to damage cells and tissue, and support the hypothesis that the morphological change of necrotizing pancreatitis are mainly produced by the release of fatty acids by active lipase.

The antigenicity of Kiel bone in the human host

The immunological response of the human host to xenograft bone after combined xenografts of Kiel bone and autologous marrow has been studied by serological methods in twenty-eight patients and by the leucocytic reaction in the peripheral blood in fifteen. The clinical findings in these patients have already been reported. The results suggest that Kiel bone is very weakly antigenic in the human host. These results are discussed in the light of previous experimental findings and a possible explanation put forward. The advantages of osteogenesis by autologous marrow cells are also discussed.

Trichinella spiralis: Peripheral blood, intestinal, and bone-marrow eosinophilia in rats and its relationship to the inoculating dose of larvae, antibody response and parasitism

Peripheral eosinophilia, preceded by a period of eosinopenia, characterized trichinella infections in 140 rats inoculated with 11 different doses of larvae. Eosinophilia was also evident in the small intestine and in the bone marrow; eosinopenia also occurred in the intestine, but not in the bone marrow. The peak peripheral eosinophil response occurred between days 11 and 27 of infection, depending on the inoculating dose and was independent of the general inflammatory leucocytic reaction. Eosinopenia was more prominent and of longer duration in the more heavily inoculated animals; it lasted for about 4 days in animals inoculated with three larvae per gram body weight and for about 12 days in animals inoculated with 50 larvae per gram body weight. The numbers of circulating eosinophils at the peak response were positively correlated with the inoculating dose and with the number of muscle larvae. The antibody response was independent of eosinophilia in the blood, small intestine, and the bone marrow.

Changes in coronary arteries of mice fed a high-fat, low-protein diet followed by a normal diet.

AbstractFemale mice of a Swiss albino stock were fed a high‐fat, low‐protein, hypolipotropic diet which produces rapid cardiovascular lesions in this stock of mice. Half of the animals were killed after 45 days and the others were placed back on a diet of normal laboratory chow and killed after one, two and three weeks of refeeding.In animals killed after receiving the experimental diet for 45 days small, focal deposits of hyalin in media of large coronary arteries of the right ventricle was the major change.During the first week of recovery (fed a normal diet) the incidence and severity of arterial lesions increased and within individual hearts arteries of all sizes and in both atria and both ventricles were involved. Following hyalinization an acute arteritis developed that involved all layers of the arterial wall and extended into the perivascular space.After two and three weeks recovery the coronary arteries were characterized by a periarterial fibrosis and by a decrease or absence of the leucocytic reaction. A subendothelial hyperplasia of smooth muscle, arranged longitudinally, was accompanied by an increase in reticular and collagenous fibers. Circular smooth muscle in the media was also hyperplastic.

INTERRUPTION OF PREGNANCY IN THE RAT BY A UTERINE SUTURE.

Silk sutures were inserted into the uterine lumen of Holtzman rats. 3-5 days after insertion the female rats were caged with males and were removed on the morning that spermatozoa were recovered in the vaginal smear (designated as Day 1 of pregnancy). 8-10 days postcoitum laparotomy was performed and the number of embryos was counted in the treated and the contralateral uterine horns. Portions of both cornua were removed for histologic study from representative tracts. Another series of mated animals was killed on Days 2-5 postcoitum and ova were flushed from the oviducts and cornua with a 26 gauge needle attached to a 1 ml syringe. It was demonstrated that a silk suture inserted into the uterine lumen prevented implantation in the rat. Normal embryos were present in the oviduct until Day 4 of pregnancy but were missing from the tract by Day 5. If the threaded uterus were ligated at the cervix at Day 4 degenerating ova were recovered the next day. This indicates that shortly after the ova entered the uterus they were usually expelled per vaginam. A leucocytic infiltration of the endometrium was consistently observed in cornua from which embryos were missing. The location of the thread determined whether a leucocytic reaction occurred. Implantation took place in the treated cornu if the thread had not penetrated into the lumen but lodged instead in the stroma. This accounted for the presence of embryos in some of the threaded uteri despite the in situ location of the suture. Pregnancy continued when the thread was deliberately placed in the stroma at some distance from the lumen.(AUTHORS MODIFIED)

LOCAL SUBCUTANEOUS EOSINOPHIL LEUCOCYTIC REACTION TO THE INOCULATION OF ISOLATED NORMAL OR TUMOUR CELLS IN MICE.

Local Subcutaneous Eosinophil Leucocytic Reaction to the Inoculation of Isolated Normal or Tumour Cells in Mice

The influence of various amounts of pyrogenal on the formation of scars of the spinal cord

To determine the action of various doses of pyrogenal on the formation of a scar caused by incomplete division of the spinal cord, three different doses of this substance were tested. The first dose was of 0.65 μ g/kg and caused no leucocytic or temperature reaction; the second was of 10 μ g/kg and induced a distinct leucocytosis, but did not affect the body temperature. The third dose of 40 μ g/kg induced leukopenia followed by a leucocytosis and a slight rise of temperature. The results show that 2/12 months after the operation the character of the scar was related to the dose of pyrogenal given. The scar was most rarified in the group receiving the smallest dose. A scar of medium density was seen in the group in which a moderate dose was employed, and the scar was densest in the control group. In the group receiving the maximum dose most of the animals developed a scar of medium density whereas the rest showed a rarified scar. Therefore to delay the formation of a scar in the spinal cord subfebrile pyrogenal doses proved the most effective.

The involvement of the cerebral cortex in the regulation of the leucocytic response

Until now involvement of the cerebral cortex in regulating leucocytic reactions was considered doubtful. However recent reports indicate that regulation is chiefly of a conditioned reflex nature. We have regarded the cerebral cortex as the organ mediating higher unconditioned reflex regulation of various bodily functions, and have demonstrated some features of this regulation. Redistributive leucocytic reactions were induced by an intravenous injection of a threshold insulin dose into decorticate and into intact dogs. The reduction of the threshold value of the insulin dose required to elicit the leucocytic response after decortication, and the greater duration of the leucopenia induced by the insulin injection led us to conclude that the unconditioned reflex arc which induces the redistributive leucocytic reaction has a humoral link.

Aggressin-Like Character of Gastric Mucin

Summary1. Virulent staphylococci injected in mucin do not produce a characteristic leucocytic reaction in the peritoneal cavity. 2. Staphylococci injected intraperitoneally in mucin remain viable and spread from the abdominal cavity; without mucin, they are rapidly destroyed. 3. Staphylococcus vaccine suspended in mucin does not produce leuco-cytosis during the first hours after injection. 4. C. diphtheriae and meningococcus injected intra-abdominally are influenced in the same manner by the presence of mucin. 5. The leucocytic reaction of aleuronat is inhibited by simultaneous injection with mucin. A later injection of mucin does not destroy leucocytes already present in the peritoneal fluid. 6. The virulence-enhancing effect of mucin can be neutralized by leucocytosis previously induced by aleuronat. 7. All these observations suggest that mucin decreases the resistance of the host to bacterial invasion and imparts to microorganisms of otherwise low virulence the potentialities of highly invasive microbes.

SUBCLINICAL PULMONARY TUBERCULOSIS; A PRESENTATION OF FORTY CASES

Article1 June 1940SUBCLINICAL PULMONARY TUBERCULOSIS; A PRESENTATION OF FORTY CASESR. H. STIEHM, M.D.R. H. STIEHM, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-13-12-2285 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe individual destined to develop pulmonary tuberculosis will in most instances have it diagnosed no earlier today than years ago. Though the death rate continues to show a yearly drop, evidence indicates that this favorable occurrence has resulted from factors other than an early diagnosis.1, 2, 3Efforts in the past have been directed primarily toward studying disease in its later stages as it occurs at the bedside, when symptoms and physical signs have made their appearance, and later, unfortunately, in a still more advanced stage, at the postmortem table. Relatively little is known at present of subclinical disease, of...Bibliography1. DROLET GJ: Tuberculosis hospitalization (Abstract), Nat. Tuberc. Assoc. Trans., 1926, xxii, 327-332. (Minimal, 16 per cent; mod. advanced, 34 per cent; far advanced, 50 per cent.) Google Scholar2. WHITNEY JS: Bull. Nat. Tuberc. Assoc., 1933, p. 24. (Minimal, 16 per cent; mod. advanced, 30 per cent; far advanced, 54 per cent.) Google Scholar3. : Survey of tuberculosis hospitals and sanatoriums in the United States, Jr. Am. Med. Assoc., 1935, cv, 1855-1915. (Minimal, 13 per cent; mod. advanced, 30 per cent; far advanced, 57 per cent.) Google Scholar4. MCCARTERGETZSTIEHM JHRRH: A comparison of intracutaneous reactions in man to purified protein derivatives of several species of acid-fast bacteria, Am. Jr. Med. Sci., 1938, cxcv, 479-493. CrossrefGoogle Scholar5. LUMSDENDEARINGBROWN LLWPRA: Questionable value of skin testing—as means of establishing epidemiological index of tuberculous infection, Am. Jr. Pub. Health, 1939, xxix, 25-34. CrossrefGoogle Scholar6. STIEHM RH: Tubercle bacilli in gastric contents—an important diagnostic and prognostic finding, Am. Jr. Med. Sci., 1937, cxciv, 340-344. A review of a five-year tuberculosis program among University of Wisconsin students, Am. Jr. Med. Sci., 1939, cxcv, 517-533. CrossrefGoogle Scholar7. CUTLER JW: Graphic method for blood sedimentation test; presentation of 1-c.c. technique and other important modifications and suggestions, Am. Rev. Tuberc., 1929, xix, 544-558. Google Scholar8. MEDLAR EM: Evaluation of the leucocytic reaction in blood as found in cases of tuberculosis, Am. Rev. Tuberc., 1929, xx, 312-346. Google Scholar9. CRAWFORD AM: Further studies on pathological significance of leucocytic reaction in tuberculosis; presentation of leucocytic index with calculator to facilitate its computation, Am. Rev. Tuberc., 1935, xxxi, 611-620. Google Scholar10. MEDLAR EM: Further studies on pathological significance of leucocytic reaction in tuberculosis; presentation of pathological concept through use of leucocytic index in selected groups of tuberculous cases, Am. Rev. Tuberc., 1935, xxxi, 621-627. Google Scholar11. BLACKFANDIAMOND KDLK: Monocyte in active tuberculosis; supravital studies of blood, Am. Jr. Dis. Child., 1929, xxxvii, 233-243. Google Scholar12. CUNNINGHAMSABINSUGIJAMAKINDWALL RSFRSJA: Rôle of the monocyte in tuberculosis, Bull. Johns Hopkins Hosp., 1925, xxxvii, 231-280. Google Scholar13. WEBBGILBERTNEWMAN GBGBJA: Lymphocyte index in tuberculosis, Am. Rev. Tuberc., 1923, vi, 1073-1077. Google Scholar14. MEDLAR EM: Further studies on pathological significance of leucocytic reaction in tuberculosis; test of validity of pathological interpretation placed upon leucocytic reaction, Am. Rev. Tuberc., 1935, xxxi, 642-657. Google Scholar15. MYERSDIEHLBOYNTONTRACH JAHSREB: Development of tuberculosis in adult life, Arch. Int. Med., 1937, lix, 1-31. CrossrefGoogle Scholar16. MYERS JA: The physician and tuberculosis, Jr. Am. Med. Assoc., 1939, cxiii, 189-194. CrossrefGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Madison, Wisconsin*Received for publication November 24, 1939.I wish to express my appreciation to Miss Ethel Thewlis, Dr. Gertrude Stewart, and Miss Thekla Klatt for having done the total and differential leukocyte counts in this study. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 June 1940Volume 13, Issue 12Page: 2285-2305KeywordsDeath ratesSigns and symptoms ePublished: 1 December 2008 Issue Published: 1 June 1940 PDF downloadLoading ...

A STUDY OF THE MECHANISM OF HYPERTENSION FOLLOWING INTRACISTERNAL KAOLIN INJECTION IN RATS; LEUCOCYTIC REACTION AND EFFECT ON LYMPHATIC ABSORPTION

ArticleA STUDY OF THE MECHANISM OF HYPERTENSION FOLLOWING INTRACISTERNAL KAOLIN INJECTION IN RATS; LEUCOCYTIC REACTION AND EFFECT ON LYMPHATIC ABSORPTIONJ. Q. Griffith JR., W. A. Jeffers, and M. A. LindauerJ. Q. Griffith JR.From the Robinette Foundation, the Medical Clinic of the Hospital and the Pepper Laboratory of the University of PennsylvaniaSearch for more papers by this author, W. A. JeffersFrom the Robinette Foundation, the Medical Clinic of the Hospital and the Pepper Laboratory of the University of PennsylvaniaSearch for more papers by this author, and M. A. LindauerFrom the Robinette Foundation, the Medical Clinic of the Hospital and the Pepper Laboratory of the University of PennsylvaniaSearch for more papers by this authorPublished Online:30 Sep 1935https://doi.org/10.1152/ajplegacy.1935.113.2.285MoreSectionsPDF (771 KB)Download PDF ToolsExport citationAdd to favoritesGet permissionsTrack citations ShareShare onFacebookTwitterLinkedInWeChat Previous Back to Top Next Download PDF FiguresReferencesRelatedInformation More from this issue > Volume 113Issue 2September 1935Pages 285-290 Copyright & PermissionsCopyright © 1935 by American Physiological Societyhttps://doi.org/10.1152/ajplegacy.1935.113.2.285History Received 6 June 1935 Published online 30 September 1935 Published in print 30 September 1935 Metrics