Red blood cells of a type B patient became polyagglutinable eight years ago and have remained so to the present. No infection or other cause for the phenomenon has been diacovered and laboratory studies have established conclusively that the polyagglutinability is distinguishable from Tantigen activation and Irom the effect of periodate treatment in vitro. Cambind 51Cr and Ashby di&rcntial agglutination studies of the survival in Vivo of normal type B donor blood demonstrated that the transfused cells did not become polyag glutinable during more than four months in the patient's circulation. I t is concluded that the underlying abnormality of the patient's red blood cella originates during their formative stage in the bone marrow. The clinical implications of these findings and their possible relationship to the patient's accompanying leukopenia and thrombocytopenia are discussed briefly. POLYACCLUTINABILITY of human red blood cells; i.e., the condition in which the individual's red blood cells are agglutinated by the majority of normal and ABO compatible human sera, can create difficulties in blood typing and testing for compatibility. T h e clinical implications of polyagglutinability and its associated laboratory problems could be dealt with more
Elongation with kinking of the internal carotid artery is not an uncommon finding. Cerebral vascular insufficiency has been reported secondary to this abnormality. Although arteriosclerosis is a frequent cause in adults, the etiology in children has never been explained. Three children with significant kinking of the internal carotid artery are reported here. Each underwent surgical correction by excision and reconstruction. Histological review showed the elastic tissue to be disrupted, diminished in amount, and unevenly distributed. Retrospective examination of this elastic tissue dysplasia showed it to be localized, there being normal morphology both proximally and distal to the involved area. There was recurrence of elongation and kinking in one patient due to incomplete excision. Correction was accomplished after re-excision of the involved tissue with a vein graft interposition. From this study, it can be concluded that elongation and kinking of the internal carotid artery in children is secondary to elastic tissue dysplasia. It is imperative that the entire involved area be removed in order to prevent recurrence. The excised specimen should be studied histologically with elastic tissue stains. Such stains cannot be performed as frozen section. Should permanent studies show the margins of resection not to be beyond the dysplastic tissue, careful followup of these children is essential to recognize recurrence.
Although marine vibrio wound infections and septicemia are being reported with increasing frequency, description of the histopathologic changes has been scanty. The histologic alterations in three patients with primary marine vibrio wound infections are presented. The lesions are characterized by intense acute cellulitis of the subcutis with much tissue destruction and extension into the adjacent dermis. The superficial dermis is devitalized and lacks an inflammatory cellular infiltrate. Subepidermal noninflammatory bullae are formed. Many organisms are seen both within the areas of intense acute inflammation and in devitalized areas. Organisms and inflammation are especially oriented around vessels, with associated acute vasculitis. It is concluded that the morphologic picture in marine vibrio wound infections is nonspecific yet characteristic.
Fresh whole blood is the ideal medium for the restoration of fibrinogen, thrombin, platelets, and other possible unknown clotting factors. The use of autologous blood alleviates the inherent dangers of homologous blood. Autotransfusion, known to be the safest source of blood replacement, seems to be particularly applicable in conjunction with extracorporeal circulation. 4'6"1'19 In order to evaluate the safety and effectiviness of fresh autologous blood transfusions with extracorporeal The average size and weight were similar in each group and the ages ranged from 2 months to 77 years. The types of operations varied but were relatively similar in both groups. The average time in which extracorporeal circulation was used did not differ between the groups. Excluded from the study were all patients who preoperatively gave evidence of an abnormal clotting mechanism, a deficit of 10% or more of predicted normal blood volume, impaired renal function, or those who postoperatively bled as the result of faulty operative management.Group 1 received fresh autologous transfusions following extracorporeal circulation and stored whole homologous blood when further blood replacement was necessary. Group II received stored whole homologous blood following extracorporeal circulation and wvhen further blood replacement was necessary.To obtain the blood for autologous transfusion, 20% of the blood volume of each patient in Group I was removed via a 16-gauge intra-arterial needle into plastic blood donor bags containing citrate-phosphate-dextrose (CPD). We have used the term hemospasia for this process. Twice the volume of blood removed was re-
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