SYNOPSIS In this study the method of Ellis and Stransky (1961) to determine plasma fibrinogen is evaluated, and modifications are described which have been introduced to improve the sensitivity and reduce the time taken for the test.
SUMMARY A combined chemical and electron microscopic study of normal platelets and platelets from patients with the carcinoid syndrome has revealed an association between their serotonin content and certain alterations in their cytoplasmic structure. In addition to a fibrillary structure of possible cytoskeletal significance, platelets also contain a system of microtubules and vesicles. When the platelet serotonin content is high this tubular structure is prominent and communicates with large vacuoles which may contain granular material. Normal platelets incubated with serotonin show similar alterations in structure. In addition, serial investigations of platelets from two carcinoid patients suggest that in addition to the normal active transport process for absorbing serotonin a diffusion process can operate when the cell is exposed to high environmental concentrations. The significance of these storage mechanisms in relation to normal and elevated platelet serotonin concentration is discussed.
SYNOPSIS Exudative lesions and capsular drops have been examined in a renal biopsy series of 25 diabetics and a post-mortem series of 100 consecutive diabetics. Electron microscopy of a capsular drop and an exudative lesion is described. Exudative lesions were found in 480% of the biopsies and 47 % of the necropsy material. Capsular drops were found in 60 % of the biopsies and 29 % of the necropsy material. No correlation with age, proteinuria, hypertension, or uraemia was noted. The incidence of both types of lesion increased with the known duration of the diabetes.In addition to the nodular lesion (Kimmelstiel and Wilson, 1936) and the diffuse lesion (Fahr, 1942;Laipply, Eitzen, and Dutra, 1944) the renal glomeruli of diabetics may contain deposits of eosinophilic, hyaline, or granular material having some of the staining reactions of fibrin. These deposits are not specific for diabetes since similar lesions may be found in a variety of renal conditions. Most of the previous descriptions have been from post-mortem material and it has been generally considered that the deposits were terminal. Similar lesions have been found in renal biopsy specimens from diabetics of all ages and severity and the incidence is much higher than might be expected. This communication deals with a series of renal biopsies from 25 diabetics and a series of post-mortem specimens from 100 consecutive cases of diabetes mellitus.The term 'exudative lesion' was used by Hall (1952) MATERIALS AND METHODSBIOPSY SERIES Twenty-five patients were selected aged between 12 and 54 years and of varying duration of diabetes since diagnosis. The earliest biopsy was carried out three weeks after the onset of acute diabetes and the latest 28 years after diagnosis. The patients had varying severity of diabetes, many had proteinuria, and a few were mildly hypertensive; none were uraemic.The renal biopsy material, obtained by the method of Muehrcke, Kark, and Pirani (1955), was fixed in formolcorrosive and serial sections taken almost completely through the specimens. These were stained routinely with haematoxylin and eosin, periodic acid Schiff, and Van Gieson's fluid. Several of the biopsies were split and one part was fixed in 1 % buffered osmium tetroxide for 30 to 60 minutes and embedded in methacrylate for electron microscopy. In one of these specimens a capsular drop and an exudative lesion within a hyalinized glomerulus were located and examined on a Siemens series 6 electron microscope.
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