Ndani anayambitsa utoto wofiirira wopaka magazi? Methylene blue, Malachowski, Romanowsky, ndi Giemsa

Eosin ndi wofiira. Methylene blue ndi wabuluu. Sakanizani awiriwa, pakani chisakanizocho pa magazi amene afalikitsidwa n’kuumitsidwa kukhala wosanjikiza woonda, ndipo mbali zina zimakhala zofiirira.

Si mbali zonse. Pakukonza bwino, maphata a maselo oyera a magazi amakhala ofiira-wofiirira, ndipo kromatini yomwe ili mkati mwa tizilombo toyambitsa malungo imakhala ndi mtundu womwewo, pamene maselo ofiira ozungulira amakhalabe apinki ndipo saitopulazimu imakhalabe yotuwa-wabuluu. Mtundu wofiirira ndi umene umapangitsa kuti mitundu ya maselo isiyanitsidwe.

Palibe botolo lililonse mwa awiriwa limene lili ndi utoto wofiirira. Mtunduwo umaoneka pokhapokha chinthu china chapadera chochokera pakuwonongeka kwa methylene blue chikakumana ndi eosin pagalasi la maikulosikopu. M’zaka za m’ma 1880 ndi m’ma 1890 palibe amene ankadziwa kuti chinthucho chinalipo, osanenapo kuti chinali chiyani. Anthu amene ankafufuza mtunduwo ankagwira ntchito ndi mitundu ya utoto yosakhala yoyera kwathunthu, aliyense payekha, popanda njira yodalirika yodziwira zomwe zinali m’botolo litakhala pashelefu kwa miyezi iwiri.

N’chifukwa chake funso la m’mutuwu lili ndi mayankho oposa limodzi amene angathandizidwe ndi umboni, komanso chifukwa chake yankholo linasintha mu 2011.

Zomwe zinkaoneka zinasintha pamene chisakanizo chinasintha

Utoto wopaka magaziwu sunapangidwe ndi munthu mmodzi nthawi imodzi. Unakula pang’onopang’ono. Kusintha kulikonse kwa chisakanizo kunawonjezera chinthu chimodzi chatsopano chooneka, ndipo kutsatizana kwa zinthu zimenezi ndi njira yomveka bwino kwambiri yowerengera mbiriyi.

Zomwe zikuonekera m’gawo lomaliza ndi zofunika kwambiri. Kupita patsogolo kulikonse kunawonjezera mitundu yooneka, ndipo kuwonjezeka kulikonse kunapangitsa kuti gawo linanso la kapangidwe lioneke. Mtundu wofiirira si wokongoletsa njira imeneyi; ndi kusiyana pakati pa kuona kuti tizilombo toyambitsa matenda tilipo ndi kuona zomwe tatopangidwa nazo. Mmene utotowo unachokera ku fakitale ya utoto ya BASF n’kufika m’zachipatala ndi mbiri yaitali yokhala ndi zolemba zake. Mndandanda wonse wa pamwambawu, pamodzi ndi gwero la umboni wa chinthu chilichonse, uli mu mndandanda wa anthu amene anathandiza pa chitukuko chake motsatira nthawi, wokhala ndi maulalo a magwero.

Chithunzi: zosakaniza zisanu ndi chimodzi zomwezo, zosonyeza zomwe zinali m’mbale ndi zomwe zinatuluka mmenemo. Mabwalowa ali ndi mitundu ya utoto; timabokosi ta pansi tili ndi mitundu imene utotowo unkatha kupanga pa magazi ofalikitsidwa kukhala wosanjikiza woonda. Palibe chisakanizo cha isanafike 1890 chimene chili ndi kabokosi kofiira-wofiirira, ndipo palibe cha pambuyo pake chimene kalibemo.

Munthu amene anagwiritsa ntchito borax mwadala

Ernst Malachowski anali dokotala ku Breslau, komwe masiku ano kumatchedwa Wrocław. Pa ntchito yake yonse ankachita ntchito zachipatala payekha komanso m’chipatala chaching’ono chimene ankayendetsa ndi mnzake, ndipo ankachita ntchito za labotale pa nthawi yake yopuma. Anabadwira ku Strzelno pa 12 March 1857, anaphunzira zachipatala ku University of Breslau, ndipo kuyambira mu 1882 mpaka mu 1887 anagwira ntchito ngati wothandizira m’gawo la matenda a m’thupi ku All Saints Hospital, yomwe panthawiyo inali chipatala chachiwiri pa kukula ku Germany.

Anayamba mu 1888 ndi utoto wa mitundu iwiri wa Chęciński ndi Plehn. Pa chitsanzo chimene anakonza mu 1889, anaona kuti kromatini ya phata la tizilombo ta plasmodium inapaka mtundu wosiyana ndi wa saitopulazimu, koma kenako analephera kubwereza zotsatirazo. Anayesa kupanga methylene blue kukhala wa asidi, zomwe zinaipitsa zinthu. Anayesa kuupanga kukhala wamchere pogwiritsa ntchito borax, ndipo zimenezi zinkagwira ntchito nthawi zonse. Anaonetsa njirayo poyera pa 15 June 1890 ndipo anafalitsa kufotokoza kwake kokwanira mu August 1891, kuphatikizapo malangizo ogwiritsa ntchito borax. Ananena kuti kupaka utotoko kunkatenga maola makumi awiri ndi anayi ndipo zotsatira zake zinkatha kubwerezedwa mosavuta.

Maola makumi awiri ndi anayi ndi nthawi yaitali mu labotale yofufuza matenda, ndipo nkhani yake sinafotokoze kwambiri mtundu wofiirira-wofiira wa phata la tizilombo toyambitsa matendato. Kaya chifukwa chake chinali chiyani, palibe amene anayambanso kupanga methylene blue kukhala wamchere mwadala mpaka Nocht atachitanso zimenezi mu 1898. Malachowski sanalembenso za kupaka utoto pa magazi.

Chifukwa chimene zambiri zokhudza iye sizinadziwike mpaka posachedwapa chili pa kupezeka kwa zolemba zakale, osati chinsinsi china. Pafupifupi palibe mbiri ya moyo wake imene inasungidwa m’zolemba zachipatala, ndipo zomwe zinatsala zinadutsa m’njira imodzi. Mwana wake wamkazi Marie anachoka ku Germany kupita ku London mu 1939, anatumikira m’gulu lankhondo la Britain, ndipo anakakhala ku Canada. Zolemba za banja zimene anasunga zinakafika ku Leo Baeck Institute ku New York. Mchimwene wake Leo anaphedwa pa Nkhondo Yoyamba Yapadziko Lonse. Mlongo wake Eva anathamangitsidwa kuchokera ku Breslau kupita ku msasa wodutsiramo wa Izbica mu April 1942 ndipo sanabwererenso. Amayi ake Hedwig anadzipha pa 22 April 1942 m’malo moyembekezera kuthamangitsidwa chimodzimodzi. Malachowski anamwalira mu 1934, zonsezi zisanachitike.

Mbiri ya banja imene imatha motero ndi mbiri imene anthu amasiya kuitchula ngati gwero. Nkhani ziwiri zimene zinabwezeretsa Malachowski m’mbiri ya chitukuko cha utotowu, zonse zofalitsidwa mu 2011, zinakonzedwa kuchokera ku zolemba zakale za ku Poznań ndi Wrocław komanso ku zolemba za Marie ku New York.

Botolo lokhala ndi nkhungu ndi munthu wa ku Russia wamwayi

Dmitri Romanowsky anaphunzira zachipatala ku Military Medical Academy ku St Petersburg ndipo anagwira ntchito yokhudza malungo kwa nthawi yambiri ya ntchito yake. Mu 1890 anafalitsa njira imene, malinga ndi momwe inalembedwera, inali pafupifupi yofanana ndi ya Chęciński: methylene blue wosasinthidwa ndi eosin, kungowonjezera eosin pang’ono.

Mu September 1891 anafalitsa njira imene inamupangitsa kukhala wotchuka, ndipo mfundo yofunikayo inali yobisika m’malangizo. Zotsatira zake zabwino kwambiri zinachokera ku madzi osungidwa a methylene blue, madzi amene methylene blue anasungunulidwamo ndipo anakhala kwa miyezi yoposa iwiri ali ndi nkhungu yomwe inkamera pamwamba pake. Nkhunguyo komanso nthawi imene madziwo anakhala zinachotsa magulu ena a methyl mu utotowo. Romanowsky sankadziwa zimenezi ndipo sakanatha kuzilamulira, ndipo anthu ena amene anayesa njira yake sanathe kupeza mtundu wofiirira. Anali atapereka kale chikalata chake cha kafukufuku ku St Petersburg mu June 1891, n’chifukwa chake mbiri yodziwika imatchula 1891 ngati chaka chimene mtunduwo unapezeka.

Malachowski anali ataonetsa njira yake mu June 1890, patatsala chaka choposa chimodzi, ndipo njira yake inkagwira ntchito mwadala.

Chifukwa chake dzina la utotowo linachokera kwa munthu wolakwika

Umboni wochirikiza Malachowski unasonkhanitsidwa ndi Kristine Krafts, Ernst Hempelmann ndi Barbara Oleksyn, ndipo umadalira zinthu zinayi. Tsiku loonetsa njirayo poyera, June 1890 poyerekezera ndi September 1891. Mawu akuti mwadala poyerekezera ndi akuti mwangozi yamwayi. Mfundo yakuti Malachowski anafalitsa njira yake yonse, kuphatikizapo borax, pamene ya Romanowsky inkadalira chinthu chimene sichinkalamulidwa. Ndiponso mfundo yakuti kufotokoza phata la tizilombo ta plasmodium, pamodzi ndi mtundu wofiirira umene unalionetsa, kunatheratu m’zolemba zachipatala kwa zaka zisanu ndi ziwiri, chifukwa palibe amene ankatha kubwereza njira yangoziyo.

Amanena mosapita m’mbali zimene anapeza. M’nkhani ya mbiri ya moyo wake, amatcha kupereka ulemuko kwa munthu winayo “kupotoza choonadi koopsa”, ndipo amagwira mawu a Ralph Lillie, amene mu 1978 analemba kuti “mwina tiyenera kutcha gulu ili la mitundu ya utoto kuti mitundu ya utoto ya Malachowski”.

Mfundoyi imatsutsidwa, monga zimachitikira nthawi zambiri pa nkhani za amene anali woyamba, ndipo mmene kutsutsanako kulili n’koyenera kufotokozedwa m’malo moweruza. Kutsutsana za amene anali woyamba kuyenera kufotokoza kuti chinthu chopezekacho chinali chiyani. Ngati chinali mtundu wofiirira, Malachowski ali ndi umboni wa kuonetsa kwake koyambirira. Ngati chinali njira yofalitsidwa, amuna onse awiri anafalitsa njira zawo mu 1891 ndipo dzina linachokera kwa Romanowsky. Ngati chinali kufotokoza chifukwa chake, palibe mmodzi wa iwo amene angati anali woyamba, chifukwa palibe amene ankadziwa kuti kukhwima kwa utoto kunali kuchotsedwa kwa magulu a methyl, ndipo palibe amene ankatha kunena chifukwa chake mtunduwo unkaoneka. Mfundo yomalizayi ndi imene nkhani zofotokozedwa kwa anthu ambiri zimadumpha. Chinthu chimene chinkagwira ntchitoyo chinali chosakanikirana ndi utoto chimene palibe amene anali atachizindikira, ndipo munthu woyamba kupanga mtunduwo mwadala anachita zimenezo potsatira njira yoyesedwa imene inkatha kubwerezedwa, osati chifukwa chomvetsa zimene njirayo inkachita.

Nkhani ziwiri za mu 2011 ndi zofotokoza zathunthu kwambiri zofalitsidwa za umboni wochirikiza Malachowski, ndipo zonsezi zingawerengedwe kwaulere pa PubMed: nkhani yaitali yowunika mbiriyi pa PMID 21235291 ndi nkhani ya mbiri ya moyo wake pa PMID 21660627. Zolemba za PubMed za nkhani yowunikayo zimatchulanso ndemanga yake, yofalitsidwa m’magazini yomweyo chakacho chitapita patsogolo pa 86(5):366, zomwe zikutikumbutsa moyenera kuti mfundoyi inatsutsidwa m’zolemba itangofalitsidwa.

Kutsutsanaku si kusagwirizana pa za chemistry. Onse okhudzidwa amavomereza kuti mtundu wofiirira ndi chiyani komanso zinthu zimene zimaupanga. Kusagwirizana kuli pa amene anafika pamenepo koyamba, ndiponso ngati kupeza chinthu mwangozi chimene palibe akanatha kubwereza kungawerengedwe ngati kufika pamenepo.

Zomwe anthu odziwika pambuyo pake anawonjezera

Ngati Malachowski anapanga mtundu wofiirira koyamba, n’chifukwa chiyani utotowo uli ndi mayina a Romanowsky, Wright ndi Giemsa?

Chifukwa utoto umene umagwira ntchito kamodzi m’manja mwa munthu amene anaupanga si chinthu chodalirika chogwiritsidwa ntchito mu labotale. Ntchito ya pambuyo pake inasandutsa chisakanizo chosakhazikika kukhala chinthu chimene wogwira ntchito mu labotale ya m’dziko lina akanatha kugwiritsa ntchito Lachiwiri lililonse.

Nocht anafika pamenepo poganizira umboni. Atalephera kupeza zotsatira zodalirika kuchokera ku utoto wosavuta wosalowerera pakati, anaganiza kuti mtundu wofiirira uyenera kuchokera ku chinthu china m’kati mwa methylene blue chimene sichinali methylene blue, ndipo anayamba kuchifufuza. Unna anali ataona kale kuti madzi a methylene blue amene anakhala kwa nthawi yaitali ankapaka tinthu ta m’maselo a mast mtundu wofiira, ndipo anapereka lingaliro lakuti chinthu chatsopano chinkapangika pamene utotowo unkakhwima. Bernthsen anali ataonetsa mu 1885 kuti kukhala wamchere kumachotsa magulu a methyl mu methylene blue, ndipo zinthu zomwe zimapangikazo ndi zomwe tsopano timatcha ma azure. Nocht anachotsa gawo logwira ntchitolo pogwiritsa ntchito chloroform ndipo ankatha kungolitcha wofiira wochokera ku methylene blue; Michaelis analitcha azure I mu 1901. Jenner anathetsa vuto la kukonza ndi kugwiritsa ntchito utotowo. Kusungunulanso mu methanol yopanda madzi zinthu zolimba zomwe zinasiyana ndi madzi a methylene blue ndi eosin kunapanga madzi amodzi okhazikika amene ankakhazikitsa wosanjikiza wa magazi pamene ankapaka utoto, n’kuthetsa kufunika kogwiritsa ntchito kutentha poukhazikitsa. Leishman ndi Reuter anasakaniza utoto wosinthidwa kukhala wa mitundu yambiri ndi chosungunulira cha alcohol, ndipo anapeza kukhazikika ndi mtundu wofiirira pamodzi. Wright anasintha njira ya kusunga chisakanizo kwa maola khumi ndi awiri pa 65 °C ndi kuchisiya kwa masiku khumi kukhala kungochiyika mu nthunzi woyenda kwa ola limodzi. Giemsa anasiya kudalira madzi a utoto amene ankakhwima mwachisawawa, n’kugwiritsa ntchito miyeso yeniyeni ya mitundu ya utoto yodziwika pamodzi ndi glycerol mu methanol kuti chisakanizocho chisawonongeke ndi kutentha kwa m’madera otentha. Sanafalitse konse mmene ankapangira methylene azure yoyera. Anaigulitsa ku labotale ya Dr Grübler ku Leipzig, yomwe inkaigulitsa monga azure I n’kunena kuti mtundu wake wokha ndiwo unali utoto weniweni wa Giemsa.

Zomwe azure imeneyo inali zikadali zotsutsidwa. Ena amati inali chabe methylene blue wosinthidwa kukhala wa mitundu yambiri, pamene ena amati inali ndi azure B wochuluka. Yankholo linachokera ku nkhondo. Mitundu ya utoto ya ku Germany itasiya kupezeka, gulu la United States Public Health Service, la Ralph Lillie pamodzi ndi Maurice Roe ndi Aimee Wilcox, linapeza kuti kupaka utoto kwabwino kwambiri kunachokera ku zinthu zitatu zolekanitsidwa: methylene blue wosasinthidwa, azure B amene amachokera pakuwonongeka kwake pamene magulu a methyl achotsedwa, ndi eosin. Azure B analowa m’malo mwa azure I amene sankapezeka, ndipo zinthu zitatuzi zikadali maziko a utoto umene umagwiritsidwa ntchito pozindikira malungo masiku ano.

Mmene zinthu zitatuzi zimagwirizanirana pagalasi la maikulosikopu ndi funso lina la chemistry lomwe lili patsamba lina. Nkhani ya ntchito za mitundu ya utoto ndi chemistry ya utoto wa mtundu wa Romanowsky imafotokoza zomwe azure B ndi eosin aliyense amachita, komanso chifukwa chake awiriwa amapanga mtundu umene palibe aliyense wa iwo amaupanga payekha. Tsamba la kugwiritsa ntchito maikulosikopu ndi ntchito za labotale limafotokoza mbali ya ntchito yeniyeni: zomwe chitsanzo chokonzedwa chimasonyeza, ndi mmene mungadziwire ngati chinthu china chili choyenera njira imene mukufuna kugwiritsa ntchito.

Mbali ya mbiriyi imene ikadali yofunika masiku ano

Mfundo imodzi ya m’nkhaniyi sinasiye kukhala yoona mu 1902. Kwa zaka pafupifupi makumi asanu, chinthu chofunika kwambiri mu utoto wopaka magazi womwe unkagwiritsidwa ntchito padziko lonse pozindikira malungo chinali chinthu chosakanikirana ndi utotowo chopanda dzina. Chinalipo mwangozi, kuchuluka kwake kunkasiyana pakati pa mabotolo, chomwe chinali chinabisidwa ngati chinsinsi cha malonda kwa nthawi ina, ndipo mulingo wake unkatsutsidwa mpaka m’zaka za m’ma 1940. Anthu amene ankagwiritsa ntchito utotowo sanali osasamala. Analibe njira yodziwira zomwe zinali m’botolo.

Mtundu wamakono wa vuto lomweli ndi ndondomeko ya zofunikira yomwe imafotokoza mbali yokha ya chinthucho. Kutsatira muyezo wa USP ndi njira yopezera kuyera kwakukulu kwambiri komwe kuli pamsika, chifukwa ndi muyezo wathunthu wofalitsidwa osati muyeso umodzi wokha: kutsimikizira kuti chinthucho ndi chimene chikunenedwa, kuyera kwake, zosakaniza zosafunikira za organic kuphatikizapo mitundu ya utoto ya azure, zotsalira za zosungunulira, zosakaniza zosafunikira za ma elementi, zotsalira pambuyo poyatsa, malire a tizilombo tating’onoting’ono ndi ma endotoxin a mabakiteriya. Blupreme imapeza methylene blue wake kuchokera kwa wopanga mankhwala ndipo imafalitsa satifiketi yonse ya kusanthula, kuti mfundo iliyonse ya mndandandawo iyang’anidwe m’malo mongonenedwa. Satifiketi imene imangopereka zotsatira za kuyesa zitsulo zolemera n’kuzitcha kutsatira USP ndi yofanana masiku ano ndi botolo lolembedwa kuti “methylene blue wokhwima”: mwina ndi chinthu chabwino chogwiritsidwa ntchito mu labotale, koma chizindikirocho sichikukuuzani zomwe zili mmenemo.