Terminal complement complex in blood of patients with neurological diseases.

The local involvement of complement (C) in the pathophysiology of tissue lesions in several neurological diseases is known, but it has never been studied whether or not in neurological disorders the C activity in the circulation is altered as well. This was the aim of the present investigations. We measured in blood plasma, with an automatic device for analysis and quantitation of the haemolytic activity of the terminal complement complex, the variables T1, T2 and T3 which define the latter quantitatively. We did this, on the one hand, in 100 patients who had 46 neurological disorders systematized in 16 nosological groups, and, on the other hand, in a control group of 40 healthy blood-donors. The mean values of all variables found in the patients have not been statistically different from those found in the controls. This demonstrates that in neurological disorders possible activations of C remain restricted to the local tissue lesions and do not occur in blood, probably due to the opposition against C activation of the known inhibitor system.

Carbohydrate metabolism, as reflected by glycosylated hemoglobin, in clinically active definite multiple sclerosis.

In 30 patients with the diagnosis of definite multiple sclerosis (MS) established on clinical criteria (CDMS-A1 patients), who were in a severe clinical state of MS, i.e., in whom one or more MS clinical signs or symptoms had become obvious during the last 10 days, the integrated concentration of plasma glucose over long-term (the last 6-8 weeks) was established by measurement of the percent of the glycosylated fraction of hemoglobin (Hb A1). This was also investigated in two control groups: CG-1, which consisted in 33 registered healthy blood donors matched for sex and age with the MS patients, and CG-2, consisting in 7 patients with diabetic neuropathy. The mean-value of Hb A1 of 5.1% (SD = 0.82) in the MS patients and that of 5.12% (SD = 0.96) in CG-1 controls are not statistically different (t = 0.09). The Hb A1 mean-value of 10.53% (SD = 3.5) found in the CG-2 controls is different (p < 0.001) from both the mean-values in MS patients and CG-1 controls, which validates the reliability of the HB A1 investigation. The findings indicate that clinical activation in definite MS is not associated with disturbances of glucose metabolism.

Early prognosis of survival or death after a recent stroke by blood levels of acute-phase proteins.

From 129 patients with a recent stroke 105 survived and 24 died within 3 weeks from stroke-onset. At around 40 hours after the latter, the blood-levels of the acute-phase proteins ceruloplasmin and albumin did not forecast the death of the respective patients, but, in contradistinction, the level of fibrinogen was significantly higher in those who eventually died, than in those who survived. Therefore, a higher level of fibrinogen could be a risk-factor for death after stroke.

Acute-phase proteins in stroke: influences of its cause (cerebral hemorrhage or infarction), of the cerebral site of infarction, and of the sex of patients.

In most of the 129 patients with a recent stroke by cerebral hemorrhage or infarction a note-worthy acute-phase response was found, as demonstrated by important quantitative alterations of blood levels of several acute-phase proteins (APP). These alterations were different in patients with cerebral hemorrhage as compared to those with cerebral infarction. The alterations due to cerebral infarction were not different according to the site of the infarction in brain, i.e. in the brain territories irrigated by the carotid artery system or by the basilar artery system. The APP alterations do not depend on the sex of patients or on the time elapsed from stroke-onset to blood collection.

[The dynamics of antibodies with IgD-class cardiolipin and treponemal group specificity in syphilis assessed quantitatively by radial immunodiffusion]. / Dinamica anticorpilor cu specificitate cardiolipinica si treponemica de grup din clasa IgD in sifilis, estimata cantitativ prin imunodifuzie radiala.

150 sera (positive at the VDRL, ELISA-Reiter, FTA-ABS tests) were tested by IDRS for the IgD quantification in syphilis. They were collected from men, 25-45 years old, in different stages of the disease, treated or not. The reference normal values for the seric IgD were established on 154 sera taken from men, 25-45 years old, apparently healthy: 0-131.2 UI/ml, with an average of 29.92 +/- 29.61 UI/ml. The IgD values with cardiolipin or group treponemal specificity were obtained from the difference between the values of the immunodiffusion diameters produced by sera, before and after the complete absorbtion with VDRL antigen or delipidated treponemal suspension. The individual values for each serum, mean +/- SD, and the percent values against the total IgD, for each stage of the disease were calculated. The medium levels of the total IgD range within normal limits, except for epsilon 2, where they are considerably higher than normal (52.53 +/- 26.66 UI/ml). All the individual minimal values, between 7.09 and 14.89 UI/ml, are higher than the normal minimal values, under 3.54 UI/ml. Treponemal IgD are present in all the sera in all stages of the disease and the cardiolipin IgD are completely absent. The mean values of the treponemal IgD are about 7-9 UI/ml, with a maximum of 19.3 UI/ml in epsilon 2. A higher percent of treponemal IgD is found, around 30%, with a maximum of 36.7% in epsilon 2. The high percent of the treponemal IgD in epsilon latent and epsilon treated persistent positive shows a continuous activation of the circulating B lymphocytes by the treponemal antigens and therefore an active infectious process. The exclusive presence of the treponemal IgD in all the cases of syphilis, irrespective of the evolution stages, indicated the extremely specific diagnosis value of their detection.

Erythrocyte rheology in acute cerebral thrombosis. Effects of ABO blood groups.

Within a few hours after a cerebral thrombosis in 220 patients, the flow-properties of the red blood cells (RBC) were analyzed by a filtration test that expresses quantitatively the deformability and aggregability of the RBC by the filtration indexes pT. Abnormal deformability of the RBC washed clean of plasma was found in 27.5% of the patients. Aggregability disorders, caused by the plasma trapped between the unwashed RBC, were found in 78.6% of the patients: computation of correlation coefficients between pT indexes and fibrinogen, which was found abnormally high in 88.2% of cases, demonstrated significantly that in the patients with A and B blood groups these aggregability disorders were due to fibrinogen and that they were caused by other components of plasma in patients with O and AB blood groups. All these disorders can account for blood hyperviscosity.

Two cases of choreatic syndrome caused by polycythemia vera.

Two patients with choreatic syndromes caused by polycythemia vera recovered after treatment of the polycythemia by only two venesections: this proves that the syndrome is due to reversible alterations. Investigations of the cerebral circulation in one of the patients showed that blood flow was lowest in the grey matter at the basal region of the brain: this suggests that the alterations might mainly occur there. However, investigation of erythrocyte rheology, glucose-6-phosphate dehydrogenase, serum concentrations of caeruloplasmin and serotonin, and urinary excretion of epinephrine, norepinephrine and vanillylmandelic acid gave normal results in both patients. There are therefore no indications as to the possible pathophysiology of these alterations. There are now 24 cases reported, including our 2 patients, which suggests that the association of these two diseases may not be so rare as supposed.