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Cytologic studies on rheumatic fever. 1. The characteristic cell of the rheumatic granuloma
ABSTRACT8
mitral and/or aortic endoearditie lesions, patchy parenchymatous degeneration, nuclear changes, increase in the diameter of the muscle cells and a slight round cell infiltration. Positive relationship between experimentally produced focal dental infections and cardiac hypertrophy as measured by diameter of muscle cells was noted. Direct measurement of diameters of cardiac muscle fibers under the experimental conditions was a more reliable criterion of cardiac hypertrophy than ratios of lreart weight to body weight or of heart weight to body surface area. Stress and strain in the absence of focal infection did not affect the gross or the microscopic characteristics of the heart. S&u&,
M.
p.,
and
Swift,
Homer
F.:
Reaction
parative Sensitizing Effect of Intracutaneous Doses. J. Exper. Med. 55: 591, 1932.
of Rabbits
to Streptococci:
and Intravenous
Corn-
Inocula in Minute
Rabbits were rendered very hypersensitive by relatively small doses of green streptococci given intraeutaneously and somewhat less hypersensitive by similar doses of heat killed vaccine prepared from hemolytie streptococci. Animals receiving the same doses intravenously gave upon subsequent testing lesions slightly more marked than normal controls, but these lesions were qualitatively hard and nodular compared with the large edematous lesions in the cutaneously sensitized group. There was no parallelism between the degree of cutaneous or ophthalmic hypersensitivity and agglutinin titer in the blood serum. It is believed that bacterial hypersensitivity to whole streptococci appears to depend more upon previously induced focal infection than upon circulating antibodies.
Currier: Cytologic Studies on Rheumatic Fever. 1. The Characteristic Cell of the Rheumatic Granuloma. J. Exper. Med. 55: 745, 1932.
RWEwen,
Scrapings of subcutaneous nodules from 10 patients with rheumatic fever were examined microscopically after being st.ained with supravital dyes. From the uniform results obtained the following conclusions h.ave been drawn: (1) Supravital staining of cells from these lesions gives information unobtainable with ordinary -histologic methods. (2) The scrapings show a great predominance of certain cells almost entirely devoid of phagocytic power. All the supravitally stained preparations showed small masses of tissue compose’d of many cells lying in a fibrillar mesh work and of wavy fibrils such as occur in similar preparations of tendons or deep fascia. Only at the margins of these masses, however, could the cells be clearly distinguished. Lying between the bits of tissue were large numbers of these same cells which because of their isolated positions could be more accurately studied. All transitions in the type of the cells were seen, ranging from small cells about the size of intermediate lymphocytes to spindleshaped cells and large, multinucleated giant forms. The predominating cell was from 15 to 20 microns wide by 30 to 30 microns long. The small cells, however, were sometimes only 8 x 15 microns in diameter, whife the multinucleated cells measured 32 x 77 microns. The shape was usually oval, but many of the cells had pointed processes at one end which were often at a sharp angle to the rest of the cell. The cell membrane in freshly studied preparations was very indistinct but more definite in those kept in the icebox for forty-eight hours. The cytoplasma had a coarse, ground glass appearance, and its pale yellowish gray color showed it to be slightly basophilic. The nucleus was oval and large,, almost filling the small eells but occupying relatively less of the larger ones. In sharp contrast to the vague cell outline, the nuclear membrane was extremely distinct. The
688
THE
AMERICAN
ISEART
JOURNAL
nuclear background had almost the same appearance as the cytoplasm, but the ground glass markings were coarser and the basophilia slightly greater. The nucleus and cytoplasm were so similar that if it had not been for the sharply outlined nuclear membrane it would have been difficult to distinguish between them. One or two nucleoli were usually present. Definite mitochondria were never seen although in a few cells a faint suggestion of minute, pale blue dots was noted. A striking contrast to this was observed in the case of lymphocytes present in small numbers in many of the preparations. The failure of the cells to take up neutral red was their most striking characepithclioid cells and clasmatteristic which distinguishes them from monoeytes, tocytes; hence they differ from the essential cells of tuberculosis and experimental syphilis. These differences are probably of a functional and developmental rather than of a genetic nature. (3) The cells probably arise from the undifferentiated mesenchymal elements of loose connective tissue, although it is possible that endothelial cells take part in their formation in some instances. (4) Since t,here is little doubt that the subcutaneous rheumatic nodules are pathologically identical with rheumatic granulomata elsewhere in the body, these conclusions are considered applicable also to the Aschoff body cells of the myoeardial submilisry nodules.
Hamilton, Joseph E., Lichty, Joseph S., and Pitts, William Response of Healthy Young Men to Postural Variations tures. Am. J. Physiol. 100: 383, 1932.
R.: Cardiovascular at Varied Tempera-
Tilting subjects from a horizontal to a vertical position head up, has certain effects upon the cardiovascular response at all temperatures. The systolic pressure curve remains nearly level, while the diastolic pressure steadily approarhes it as the vertical posit,ion is neared. The resulting pulse pressure shows a physiological narrowing. The pulse rate rises steadily to a maximum at 80 or 90 degrees. When the subjects are returned to the horizontal position, the pulse pressure immediately widens in excess of the reading at the commencement of the experiment. The pulse rate rapidly drops. The effects of high temperature are as follows: The systolic pressure tends to fall slightly at the higher temperatures, but since the diastolic pressure curve is lowered more than is the systolic pressure curve, the pulse pressure is wider than at room temperature. The pulse rate increases directly as the temperature. In this study there were three instances of fainting at 120” F. and one instance at 130” F. all occurring above the angles of 50”. Tilting experiments were carried out in which the subject’s ventilation was measured by means of a special spirometer. The results show a steady increase in ventilation as tho subject is tilted from horizontal to vertical, a mechanism which by its aspirating effects helps to return the blood to the right heart in erect positions. In regard to a scoring system of cardiovascular efficiency, the authors feel that the data obtained in, these experiments justify only a general estimate of any given response such as “good,” ‘(fair,” or ilpoor. :’
Turley, F. C., and Harrison, Smoking and by Athletics.
T. R.: Am.
Respiratory
J. M.
Se. 183:
Measurements 702,
as Affected
by
1932.
Respiratory measurements were made on a group of 75 medical students and on 13 football players in active training with the idea of determining whether persons who smoke excessively are more short winded than individuals who do As a result of these measurements of ventilation, the following not smoke. conclusions may be drawn. “ Heavy smoking, ” twenty cigarettes or more a day
mitral and/or aortic endoearditie lesions, patchy parenchymatous degeneration, nuclear changes, increase in the diameter of the muscle cells and a slight round cell infiltration. Positive relationship between experimentally produced focal dental infections and cardiac hypertrophy as measured by diameter of muscle cells was noted. Direct measurement of diameters of cardiac muscle fibers under the experimental conditions was a more reliable criterion of cardiac hypertrophy than ratios of lreart weight to body weight or of heart weight to body surface area. Stress and strain in the absence of focal infection did not affect the gross or the microscopic characteristics of the heart. S&u&,
M.
p.,
and
Swift,
Homer
F.:
Reaction
parative Sensitizing Effect of Intracutaneous Doses. J. Exper. Med. 55: 591, 1932.
of Rabbits
to Streptococci:
and Intravenous
Corn-
Inocula in Minute
Rabbits were rendered very hypersensitive by relatively small doses of green streptococci given intraeutaneously and somewhat less hypersensitive by similar doses of heat killed vaccine prepared from hemolytie streptococci. Animals receiving the same doses intravenously gave upon subsequent testing lesions slightly more marked than normal controls, but these lesions were qualitatively hard and nodular compared with the large edematous lesions in the cutaneously sensitized group. There was no parallelism between the degree of cutaneous or ophthalmic hypersensitivity and agglutinin titer in the blood serum. It is believed that bacterial hypersensitivity to whole streptococci appears to depend more upon previously induced focal infection than upon circulating antibodies.
Currier: Cytologic Studies on Rheumatic Fever. 1. The Characteristic Cell of the Rheumatic Granuloma. J. Exper. Med. 55: 745, 1932.
RWEwen,
Scrapings of subcutaneous nodules from 10 patients with rheumatic fever were examined microscopically after being st.ained with supravital dyes. From the uniform results obtained the following conclusions h.ave been drawn: (1) Supravital staining of cells from these lesions gives information unobtainable with ordinary -histologic methods. (2) The scrapings show a great predominance of certain cells almost entirely devoid of phagocytic power. All the supravitally stained preparations showed small masses of tissue compose’d of many cells lying in a fibrillar mesh work and of wavy fibrils such as occur in similar preparations of tendons or deep fascia. Only at the margins of these masses, however, could the cells be clearly distinguished. Lying between the bits of tissue were large numbers of these same cells which because of their isolated positions could be more accurately studied. All transitions in the type of the cells were seen, ranging from small cells about the size of intermediate lymphocytes to spindleshaped cells and large, multinucleated giant forms. The predominating cell was from 15 to 20 microns wide by 30 to 30 microns long. The small cells, however, were sometimes only 8 x 15 microns in diameter, whife the multinucleated cells measured 32 x 77 microns. The shape was usually oval, but many of the cells had pointed processes at one end which were often at a sharp angle to the rest of the cell. The cell membrane in freshly studied preparations was very indistinct but more definite in those kept in the icebox for forty-eight hours. The cytoplasma had a coarse, ground glass appearance, and its pale yellowish gray color showed it to be slightly basophilic. The nucleus was oval and large,, almost filling the small eells but occupying relatively less of the larger ones. In sharp contrast to the vague cell outline, the nuclear membrane was extremely distinct. The
688
THE
AMERICAN
ISEART
JOURNAL
nuclear background had almost the same appearance as the cytoplasm, but the ground glass markings were coarser and the basophilia slightly greater. The nucleus and cytoplasm were so similar that if it had not been for the sharply outlined nuclear membrane it would have been difficult to distinguish between them. One or two nucleoli were usually present. Definite mitochondria were never seen although in a few cells a faint suggestion of minute, pale blue dots was noted. A striking contrast to this was observed in the case of lymphocytes present in small numbers in many of the preparations. The failure of the cells to take up neutral red was their most striking characepithclioid cells and clasmatteristic which distinguishes them from monoeytes, tocytes; hence they differ from the essential cells of tuberculosis and experimental syphilis. These differences are probably of a functional and developmental rather than of a genetic nature. (3) The cells probably arise from the undifferentiated mesenchymal elements of loose connective tissue, although it is possible that endothelial cells take part in their formation in some instances. (4) Since t,here is little doubt that the subcutaneous rheumatic nodules are pathologically identical with rheumatic granulomata elsewhere in the body, these conclusions are considered applicable also to the Aschoff body cells of the myoeardial submilisry nodules.
Hamilton, Joseph E., Lichty, Joseph S., and Pitts, William Response of Healthy Young Men to Postural Variations tures. Am. J. Physiol. 100: 383, 1932.
R.: Cardiovascular at Varied Tempera-
Tilting subjects from a horizontal to a vertical position head up, has certain effects upon the cardiovascular response at all temperatures. The systolic pressure curve remains nearly level, while the diastolic pressure steadily approarhes it as the vertical posit,ion is neared. The resulting pulse pressure shows a physiological narrowing. The pulse rate rises steadily to a maximum at 80 or 90 degrees. When the subjects are returned to the horizontal position, the pulse pressure immediately widens in excess of the reading at the commencement of the experiment. The pulse rate rapidly drops. The effects of high temperature are as follows: The systolic pressure tends to fall slightly at the higher temperatures, but since the diastolic pressure curve is lowered more than is the systolic pressure curve, the pulse pressure is wider than at room temperature. The pulse rate increases directly as the temperature. In this study there were three instances of fainting at 120” F. and one instance at 130” F. all occurring above the angles of 50”. Tilting experiments were carried out in which the subject’s ventilation was measured by means of a special spirometer. The results show a steady increase in ventilation as tho subject is tilted from horizontal to vertical, a mechanism which by its aspirating effects helps to return the blood to the right heart in erect positions. In regard to a scoring system of cardiovascular efficiency, the authors feel that the data obtained in, these experiments justify only a general estimate of any given response such as “good,” ‘(fair,” or ilpoor. :’
Turley, F. C., and Harrison, Smoking and by Athletics.
T. R.: Am.
Respiratory
J. M.
Se. 183:
Measurements 702,
as Affected
by
1932.
Respiratory measurements were made on a group of 75 medical students and on 13 football players in active training with the idea of determining whether persons who smoke excessively are more short winded than individuals who do As a result of these measurements of ventilation, the following not smoke. conclusions may be drawn. “ Heavy smoking, ” twenty cigarettes or more a day