[Serum immunoglobulin types and their levels in patients with proliferative and autoimmune diseases of the hematopoietic system]. / Stezenie typów immunoglobulin i ich wzajemne proporcje w surowicach osób z proliferacyjnymi i autoimmunologicznymi chorobami ukladu krwiotwórczego.

The one-direction radial diffusion method has been used in studies of the blood sera from 75 subjects and the kappa and lambda immunoglobulin types levels have been determined. The kappa:lambda (K:L) index was also calculated. The index values in sera of 20 healthy subjects remained in the range from 1.58:1 to 2.14:1 (mean: 1.86:1). The normal index values have been stated in 5/5 sera of patients with bacterial pneumonia. In 12/12 sera from patients with plasma cell myeloma the significant abnormalities of the index values have been noted. Abnormal index values have also been stated in 9/10 patients with acute leukemia, 4/9 patients with chronic lymphocytic leukemia, 7/8 patients with lupus erythematosus and 4/4 patients with autoimmune hemolytic anemia. The quantitative determination of particular immunoglobulin types may be useful in the diagnostics of the immunoglobulin types may be useful in the diagnostics of the immunoglobulin monoclonal synthesis. The abnormalities of the K:L index observed in patients with leukemias and autoimmune disease suggest that these diseases are frequently characterized by the monoclonal synthesis of immunoglobulins.

Formation of prostacyclin-sensitive platelet aggregates in human whole blood in vitro. Part II. The occurrence of the phenomenon in males suffering from acute myocardial infarction.

The de-aggregatory effect of prostacyclin (PGI2) and the rate of spontaneous platelet aggregation (SPA) were studied in vitro in whole blood of 24 males with acute myocardial infarction (MI) and 18 males, patient controls (PC). The de-aggregatory effect of PGI2 and the rate of SPA (measured as a percentage of changes in free platelet number in whole blood) were higher (p less than 0.01) in MI than PC. The de-aggregatory effect of PGI2 in whole blood was higher (p less than 0.05) on the first day of MI than on day 14 following MI. The highest de-aggregatory effect of PGI2 was found in whole blood of patients with MI complicated by ventricular fibrillation. In neither of the groups did the de-aggregatory effect of PGI2 correlate with patients' age, haematocrit, erythrocyte and leucocyte counts, triglycerides, HDL, LDL or total cholesterol levels. In the MI group, de-aggregatory effect of PGI2 was correlated with free platelet concentration (r = -0.59, p less than 0.05), elevation of glutamic oxalacetic transaminase (r = 0.53, p less than 0.05) and creatinine phosphokinase (r = 0.69, p less than 0.001). The de-aggregatory effect of PGI2 in blood of patients with evolving MI did not differ from that in PC. It is concluded that the increased rate of SPA and formation of PGI2-sensitive platelet aggregates in vitro in whole blood of MI patients are secondary to myocardial necrosis.

Hemodynamic effects of intravenous hydralazine in pregnant women with severe hypertension.

The hemodynamic changes after intravenous administration of hydralazine were assessed using M-mode echocardiography in 13 pregnant patients with severe hypertension. The patients were divided into two groups: eight who had preeclampsia (group 1) and five who had essential hypertension and/or superimposed preeclampsia (group 2). Patients in group 1 had significantly lower pretreatment cardiac indexes and higher systemic vascular resistances (P less than .01) than did patients of group 2, despite similar mean blood pressure values. Thirty minutes after intravenous administration of 12.5 mg hydralazine, a significant decrease in mean arterial pressure (21%) and systemic vascular resistance (41%) and also a significant increase in heart rate (22%) and cardiac index (33%) were observed in group 1. The hemodynamic response in group 2 was attenuated; the mean arterial pressure and systemic vascular resistance fell by an average of 11 and 13%, respectively. The post-hydralazine percent changes in mean blood pressure for the total patient population did not correlate with the initial values of blood pressure (r = .091). In contrast, the percent reduction in systemic vascular resistance after administration of hydralazine inversely correlated with the control values of vascular resistance (r = -.742). These findings indicate that cardiovascular response to acute hydralazine administration is related to the baseline hemodynamic setting. M-mode echocardiography seems to be a reliable method for comprehensive analysis of cardiovascular effects of pharmacologic intervention in pregnant women with hypertension.

Effect of PGI2 on platelet aggregates in myocardial infarction evaluated in vitro in whole blood. The method for quantification of platelet aggregates.

PGI2 was found to increase the number of free platelets (FP) in citrated whole blood (WB) as a result of incomplete dispersion of platelet aggregates of various magnitudes. In WB from young, male volunteers the effect of PGI2 on FP number was absent immediately after blood collection, increased with time of blood storage, and was dose-dependent. In WB from 14 males with myocardial infarction (MI) effect of PGI2 on FP number was higher than in 11 male patient controls (PC). On 14th day after MI effect of PGI2 on FP in WB was reduced. It is concluded that measurement of PGI2-sensitive platelet aggregates may be of some clinical significance. However, presented results did not allow for differentiation between circulating platelet aggregates and those formed in vitro during spontaneous aggregation of platelets.

Echocardiographic estimation of hemodynamics in hypertensive pregnancy.

M-mode echocardiography and indirect blood pressure measurements were used to examine hemodynamics in three groups of pregnant patients: 19 who were preeclamptic, nine who had essential hypertension, and 19 who were normotensive. The preeclamptic patients had significantly lower heart rate (68.4 versus 74.7 beats/min, p less than 0.05), stroke volume (89 versus 101 ml; p less than 0.02), and cardiac index (5.9 versus 7.5 L/min/sq m; p less than 0.001) than those of control patients matched for age, parity, and gestational age. The mean values for heart rate, stroke volume, and cardiac index in patients with essential hypertension were not significantly different from those in the control group; however, the former had widely varying individual hemodynamic patterns. The significant inverse correlation was found between cardiac index and mean blood pressure (r = -0.602) in preeclamptic patients. There was a positive correlation between maternal cardiac index and infant birth weight (r = 0.813) and also inverse relationship between systemic vascular resistance and infant birth weight (r = -0.890) in this group. Possible explanations for these findings are discussed.