The diagnostic value of examination of sternal marrow (continued from Vol. II, No. 2)

The first study on bone marrow in the Philippines is presentedThe total cell count and the differential bone marrow picture are discussed. The bone marrow cell count is about 100,000 per cm. for the normal Filipino adult. The total cell count includes nucleated red cells and all white cells. The relation between erythroblasts and white cells in adults is 10-20:100: in children it is higher, in the first year of life 30-40:10, then it slowly decreases with advance in ageThe bone marrow biopsy is indispensable for the diagnosis of all blood diseases. In pernicious anemia the diagnosis is based on the presence of megaloblasts in the bone marrow. The effect of liver therapy can be observed by the disappearance of the megaloblasts. All regenerative anemias are characterized by a severe erythropoetic activity of the bone marrow, and so the ratio of erythroblasts to white cells must be high. Post-infectious anemias are characterized by a shift to the left do not suggest splenectomy. The third possibility, the megakaryopenic purpura, is a clear contraindication for splenectomyIn infectious diseases such as septico-pyemias, pneumonias, etc. there are remarkable changes in the bone marrow. However,these changes are only of pathologic interest and we would not suggest sternal punctures in these cases because they do not help in the diagnosis. Similarly in Hogdkins disease there are no characteristic changes in the bone marrowBone marrow changes in malign new-growth are studied. There is sometimes a eosinophilia, but this is not constant. Both erythropoetic and hypoplastic responses of the bone marrow are observed. In old age the cell count and erythropoetic activity seem to be decreased. X-ray treatment of new-growth has a very important effect in the bone marrow, producing low cell counts and poor erythropoetic activity. (Summary)

Comparative studies on tuberculin testing

The relative sensitivity of tuberculin testing was studied with the use of a commercial preparation of Vollmers Patch, Mantoux 0.1 mg. OT, and first strength dose (0.00002 mg.) Purified Protein Derivative, and 1.0 mg. OTIt was found that the Vollmers Patch is almost as sensitive as Mantoux 0.1 mg. and better than first strength dose of PPD, but about 16.6% less sensitive than 1.0 mg. OTIn spite of some minor objections, the patch test is the method of choice to be recommended in the first testing for tuberculin reaction. It should be followed by either 1 mg. OT, or 0.002 (1/2 second strength dose) of PPD. (Summary and Conclusion)

Acute aseptic meningitis syndrome

Observations in acute aseptic meningitis syndrome are presented with a report of 10 cases, 7 males and 3 females, varying in age from 4 months to 10 years. Two cousins who lived together, and 2 brothers developed the disease within 3 to 5 days intervals between each other tending to show its infectious natureThe term acute aseptic meningitis is discussed and some practical points in the use of the term and diagnosis of the disease are presented. (Summary)