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11. Morphologic studies in syphilitic lesions during the herxheimer reaction
Southern Society for Clinical Research recommend it for use in tumor therapy. Having one of the best cross sections to thermal neutron flux, it is economically prepared in the uranium pile. The insolubility of colloidal metallic gold in body fluids enables one to set up millions of uniformly dispersed focal sources of beta radiation in discrete tumor masses or metastatic lesions causing a minimum of encroachment on neighboring normal structures in contrast to radiation from radium, radon or x-ray. Preliminary use in readily accessible tumors subject to follow-up inspection. will be described. The potentialities in con_junction with surgery in the therapy of deep seated neoplasms will be considered. Present limiting factors in the exploitation of this valuable isotope are: (1) lack of knowledge of the various human tissue tolerances for beta radiation; (2) ignorance of various tumor sensitivities to this radiation and (3) relatively few experienced qualified investigators and therapists in this field.
10.
FRACTIONATION
AND CHEMICAL
SES OF A MALIGNANT
THOMAS
From
MOUSE
ANALY-
THYMOMA
N. WARREN, M.D. (introduced by Aljred Chanutin, M.D.)
the
Biochemical Laboratory, University of Virginia, Charlottesville, Va. (This work was supported by a grant from the National Institute of Health and the National Cancer Institute.)
After subcutaneous transplantation of tumor cells into dbazln mice, the animals survive about three weeks and shortly before death the tissue is grossly necrotic; at the end of two weeks this tumor is quite large and is classified as “healthy.” The tumor tissue was treated so that (a) the stroma, (b) the tumor cells and (c) the cell-free saline extract were obtained. Each of these main fractions was further fractionated with the aid of ethanol and cold. All of the eleven subfractions were analyzed for total lipide carbon, total cholesterol, total phospholipides, total nuclei acids and desoxyribosenucleic acid. Data will be presented for the fractions of fourteen-day (“healthy”) and the twenty-day (necrotic) tumor tissues. The outstanding differences between these two groups are the decreased neutral fats or fatty acids and the increased total cholesterol in the necrotic tumor. Each subfraction has a characteristic and distinct chemical composition. AMERICAN
JOURNAL
OF
MEDICINE
The data for the thymomas of mice treated with urethane and a nitrogen mustard and mice fed on a choline-enriched diet will be shown. The growth of the tumor at the end of twenty days in mice treated with urethane and HN2 was greatly inhibited, but the percentage concentrations of the various constituents were not markedly affected. Choline exerted very little effect on either the size or chemical composition. From these data it would appear that the inhibition of tumor growth is not reflected by changes in the chemical composition of the tissue.
11. MORPHOLOGIC STUDIES IN SYPHILITIC LESIONS DURING THE HERXHEIMER REACTION WALTER
H.
SHELDON, M.D. and ALBERT HEY-
MAN, M.D. (introduced by Paul B. Beeson, M.D.) From the Departments of Pathology and Medicine of Grady Memorial Hospital and the Emory University School of Medicine, Atlanta, Ga.
The occurrence of the Herxheimer reaction in the treatment of syphilis has long been recognized but its mechanism has never been thoroughly investigated. Although the syphilitic lesions during this reaction frequently show gross changes, these have never been observed morphologically. We have made histologic studies of the cutaneous and mucosal lesions during the Herxheimer reaction in series of patients with secondary syphilis. Definite morphologic changes occur during this reaction. They consist of congestion, edema, alteration of the vascular endothelium and acute inflammatory cell infiltration. These changes are confiried strictly to the syphilitic lesions and disappear within six to eight hours. These histologic findings were observed in practically all patients with clinical evidence of the Herxheimer reaction. The same changes probably occur in the Herxheimer reaction of the cardiovascular and central nervous systems and may account for the serious clinical complications which are occasionally encountered. Our studies suggest a similarity between the Herxheimer reaction and the tuberculin reaction and further investigation comparing these two phenomena may lead to a better understanding of some of the immunologic aspects of syphilitic infection.
10.
FRACTIONATION
AND CHEMICAL
SES OF A MALIGNANT
THOMAS
From
MOUSE
ANALY-
THYMOMA
N. WARREN, M.D. (introduced by Aljred Chanutin, M.D.)
the
Biochemical Laboratory, University of Virginia, Charlottesville, Va. (This work was supported by a grant from the National Institute of Health and the National Cancer Institute.)
After subcutaneous transplantation of tumor cells into dbazln mice, the animals survive about three weeks and shortly before death the tissue is grossly necrotic; at the end of two weeks this tumor is quite large and is classified as “healthy.” The tumor tissue was treated so that (a) the stroma, (b) the tumor cells and (c) the cell-free saline extract were obtained. Each of these main fractions was further fractionated with the aid of ethanol and cold. All of the eleven subfractions were analyzed for total lipide carbon, total cholesterol, total phospholipides, total nuclei acids and desoxyribosenucleic acid. Data will be presented for the fractions of fourteen-day (“healthy”) and the twenty-day (necrotic) tumor tissues. The outstanding differences between these two groups are the decreased neutral fats or fatty acids and the increased total cholesterol in the necrotic tumor. Each subfraction has a characteristic and distinct chemical composition. AMERICAN
JOURNAL
OF
MEDICINE
The data for the thymomas of mice treated with urethane and a nitrogen mustard and mice fed on a choline-enriched diet will be shown. The growth of the tumor at the end of twenty days in mice treated with urethane and HN2 was greatly inhibited, but the percentage concentrations of the various constituents were not markedly affected. Choline exerted very little effect on either the size or chemical composition. From these data it would appear that the inhibition of tumor growth is not reflected by changes in the chemical composition of the tissue.
11. MORPHOLOGIC STUDIES IN SYPHILITIC LESIONS DURING THE HERXHEIMER REACTION WALTER
H.
SHELDON, M.D. and ALBERT HEY-
MAN, M.D. (introduced by Paul B. Beeson, M.D.) From the Departments of Pathology and Medicine of Grady Memorial Hospital and the Emory University School of Medicine, Atlanta, Ga.
The occurrence of the Herxheimer reaction in the treatment of syphilis has long been recognized but its mechanism has never been thoroughly investigated. Although the syphilitic lesions during this reaction frequently show gross changes, these have never been observed morphologically. We have made histologic studies of the cutaneous and mucosal lesions during the Herxheimer reaction in series of patients with secondary syphilis. Definite morphologic changes occur during this reaction. They consist of congestion, edema, alteration of the vascular endothelium and acute inflammatory cell infiltration. These changes are confiried strictly to the syphilitic lesions and disappear within six to eight hours. These histologic findings were observed in practically all patients with clinical evidence of the Herxheimer reaction. The same changes probably occur in the Herxheimer reaction of the cardiovascular and central nervous systems and may account for the serious clinical complications which are occasionally encountered. Our studies suggest a similarity between the Herxheimer reaction and the tuberculin reaction and further investigation comparing these two phenomena may lead to a better understanding of some of the immunologic aspects of syphilitic infection.