Interaction between histidine-rich glycoprotein and platelet factor 4 with dermatan sulfate and low-molecular-weight dermatan sulfate.

There is a controversy about whether or not histidine-rich glycoprotein (HRG), the most abundant plasma protein with glycosaminoglycans-neutralizing capacity, is able to prevent the inhibition of human thrombin by heparin cofactor II (HC II) in the presence of dermatan sulfate (DS). The authors studied the interaction of DS and low molecular weight DS, in a purified system with HRG, platelet factor 4 (PF 4), and with HC II. Their results show that HRG, like PF 4, has an affinity, not only for heparin, but also for DS. However, this affinity seems very weak. In fact, HRG is 10 times less effective than PF 4 in neutralizing the 50% antithrombin activity of HC II in the presence of DS.

Hemorheological study in patients with coronary artery disease.

Hemorheological parameters (viscosity of whole blood, plasma viscosity, hematocrit, velocity of red blood cells) were studied in 30 patients with coronary artery disease (15 patients with acute myocardial infarction, 15 patients with chronic angina), 14 subjects at high risk for ischemic heart disease and 14 normal volunteers matched for sex and age. Viscosity of whole blood was high in all coronary disease patients and in high-risk subjects as compared with controls. Velocity of red blood cells was significantly decreased in these patients. On the other hand, plasma viscosity and fibrinogen values were in the normal range in both groups and hematocrit was only slightly elevated in patients with angina. Furthermore, there were no changes in rheological parameters during the period of observation (1 week). We can suppose that the hyperviscosity is due, above all, to the decreased red blood cell deformability both in coronary disease patients but also in high-risk subjects. It is probable that red blood cell damage is present before the acute ischemic event, and that is a preexisting cause and not a consequence of it.

Variability of plasma viscosity in monoclonal IgM gammopathies.

Hyperviscosity syndromes can caused by both plasmatic and cellular factors. We have studied 20 patients affected by IgM gammopathy of different origin and 12 healthy subjects matched for sex and age, in order to evaluate the relation between paraprotein levels and plasma viscosity. We have observed a significant plasma viscosity increase only in 14 patients with monoclonal IgMk gammopathy. In the same patients was also evident an hyperviscosity syndrome. In the other 6 patients, with monoclonal IgM or polyclonal gammopathy and without clinical symptoms, plasma viscosity was only slightly increased. We have also observed a significant correlation between IgM and light chains (kappa, lambda) serum level and increased plasma viscosity. These results suggest that one can't consider all IgM gammopathies as cause of hyperviscosity syndrome.

[Thromboembolism in dilative primary myocardiopathies]. / La tromboembolia nelle miocardiopathie primitive dilatative.

A clinicopathologic correlation has been carried out in 26 autopsy cases of congestive cardiomyopathy, in order to establish the incidence and site of mural thrombosis and pulmonary and systemic embolism, and to evaluate the embolization in the natural history of the disease. Mural thombosis was observed in 15 on 26 cases (58%). 11 on 25 patients (42%) showed features of recent thromboembolism. In 2 of the latter, embolism occurred as a consequence of atrial fibrillation. Most of the embolic phenomena had not been recognized on the clinical ground. Thromboembolism represented the first symptom of the disease as well as a complication or the fatal event.

Effect of infused hypothalamic phospholipids on the maturation of foetal rabbit lungs.

The effect of hypothalamic phospholipids on the maturation of foetal lung was investigated in a series of experiments in rabbits. Sixteen pregnant does were injected with hypothalamic phospholipids (2 mg day-1 kg-1) from day 21 of gestation. A second group of 16 does was injected with saline, and served as controls. The foetuses were delivered at gestational ages between 27 and 28 days by means of caesarean section under intravenous pentothal anaesthesia. Foetuses born from treated mothers were more active, breathed better, and their lungs expanded to a greater extent compared with the foetuses born to control mothers. In the animals of treated mothers there was, on electron microscopy, evidence of accelerated maturation of alveolar epithelial cells.

[Idiopathic congestive cardiomyopathy. Absence of histopatological for adrenergic hyperactivity (author's transl)]. / Cardiomiopatia idiopatica congestizia. Assenza di lesioni istopatologiche da iperattività adrenergica.

Extensive histopathological investigation of hearts from patients with idiopathic congestive cardiomyopathy failed to reveal "myofibrillar degeneration", a lesion ascribed specifically to cathecolamine cardiac overstimulation. Morphological support of the theory of adrenergic hyperactivity in the development and progression of this disease is not provided by the present study.

Sudden death due to Waterhouse-Friderichsen syndrome and purulent leptomeningitis caused by Acinetobacter calcoaceticus (Mima polymorpha).

A case of Waterhouse-Friderichsen syndrome presenting with purulent leptomeningitis causing sudden death is described. The causative agent, Acinetobacter calcoaceticus (Mina polymorpha), was determined by post-mortem microbiological examination.

Anatomical study of truncus arteriousus communis with embryological and surgical considerations.

Twelve specimens of truncus arteriosus communis have been studied anatomically, with special reference to the conal anatomy and to the associated cardiac anomalies which can create additional problems if surgical repair is planned. A wide spectrum of conal morphology has been observed, suggesting that differential conal absorption is a developmental characteristic of truncus arteriousus as well as of transposition complexes. The invariable absence of septation of the ventricular infundibula and semilunar valves, in spite of the variable anatomy of the free wall of the conus, indicates that all types of truncus arteriosus, ontogenetically, should be considered as a single undivided conotruncus. Various types of ventircular septal defect were found: (a) ventricular septal defect with absent crista, in which no remnants of conal septum are present; (b) supracristal ventricular septal defect, in which vestigial conal septum is seen in front of the membranous septum; (c) bulloventricular foramen, associated with univentricular origin of the truncus from the right ventricle. Frequent associated anomalies are underdevelopment of the aortic arch, truncal valve malformations, and obstructive ventricular septal defect. The AV conduction system studied in one case showed an arrangement similar to Fallot's tetralogy with the His bundle and the left bundle-branch in a safe position behind the posteroinferior rim of the defect. The postoperative fate of the frequently abnormal truncal valve and the theoretical indications for total repair for Type IV truncus are also discussed.