Search

Forty-two patients who had attempted suicide by burning were admitted to the North West Thames Regional Burns Unit over a 5-year period. Over three-quarters of these patients had previous psychiatric illness and a quarter had previously attempted suicide. In no case was political or religious protest a motive. The number of non-Caucasians was higher than expected from population statistics and fatal burns were more common in this group. The mean age was 36 years and the overall mortality rate was 48 per cent. The mortality was not significantly higher than for accidental burns of comparable severity.

The effects of intravenous and intraportal infusions of hypertonic NaCl and glucose solutions on the resistance and capacitance vessels of the intact feline liver were studied. All doses infused produced vasodilation of the hepatic artery. A rough estimate would suggest that the tonicity changes equal to those seen after hemorrhage might produce an increase of arterial conductance to no less than 110% and no greater than 140% of control conductance. In response to intravenous infusions, portal flow increased to the same extent as did arterial flows. The resistance vessels were equally affected by equal osmolal loads of glucose or NaCl but the hepatic volume changes were quite different depending on the substances infused. In marked contrast with the resistance vessel response to hypertonic NaCl, the hepatic capacitance vessels did not dilate. Liver volume decreased but whether due to mild capacitance stimulation or water egress from hepatocytes is not known. Cessation of the infusion resulted in increases of hepatic volume to above control levels. Glucose produced consistent steady increases in volume that may have been associated with fluid uptake by the hepatocytes in conjunction with glucose uptake.

Acute leukemia was diagnosed in 62 adults and children over a recent 13-month period. Using light microscopy, cytochemical profiles, surface markers, and cytogenetics, 25 cases were classified as acute myeloid leukemia (AML) and 32 as acute lymphoblastic leukemia (ALL). The remaining 5 cases of de novo acute leukemia were unclassifiable. The routine cytochemical battery used on these 62 cases included: myeloperoxidase, sudan black B, nonspecific esterase, and periodic acid-Schiff (PAS). Flow markers utilized were: T3, T4, T5, T8, T10, T11, B1, B4, kappa, lambda, Ia, CALLA, Mo1, Mo2, My4, My7, My8, and My9. TdT was performed by immunoperoxidase and ELISA methods. The five unclassified cases were cytochemically negative and expressed no B- or T-cell-specific antigens, or TdT positivity. The morphologic differential diagnosis was between FAB L-2 and M-1. Karyotypic abnormalities involving chromosomes 3 and 7 were suggestive of myeloid origin in 2 of 4 patients studied. Flow cytometry demonstrated My7 on greater than 50% of blasts from two cases. Myeloperoxidase ultracytochemistry showed reaction product in small primary granules of blasts from all 5 cases. Positive cells contained only 1-2 granules/cell profile. The number of positive cells per case was in the range 10-20%. We conclude from this study that ultracytochemistry is very useful in providing definitive diagnosis and accurate subclassification of some AML FAB M-1 cases, particularly when light microscopic cytochemistry, cytogenetics, and flow cytometric markers are noncontributory. We propose to designate these acute "unclassified" leukemias as AML FAB M-1 "microgranular" type.

A sensitive and specific gas chromatography/mass spectrometry (GC/MS) method has been developed for the analysis of 4,4'-diaminodiphenylmethane (DDM), 3-ethyl DDM (EDDM), and 3,3'-diethyl DDM (DEDDM) in urine. The method has been applied to the analysis of urine samples from workers exposed to a mixture of all three compounds, and the analysis has shown that EDDM and DEDDM are excreted in urine. We have also shown that there are two classes of conjugates present in urine. EDDM and DEDDM are excreted as heat labile conjugates, while DDM and EDDM are excreted, at least in part, as heat stable but alkaline hydrolyzable conjugates. It is proposed that the method described here could be used for biological monitoring of workers exposed to mixtures of DDM, EDDM, and DEDDM.