Pathophysiological response of the blood coagulation system in acute glomerulonephritis

1. The effects of clonidine on blood pressure, cerebral norepinephrine content and vascular structures of the kidneys were investigated in 21 SHR. Although the body weight was not affected by long term clonidine treatment up to 36 weeks, the syatolic blood pressure was significantly reduced. The reduction of the blood pressure was already obvious after 1 week administration of clonidine but the effect was more prominent after long term treatment of 30 weeks or longer. 2. The cerebral norepinephrine content was significantly lower in SHR, regardless of with or without clonidine treatment, than in the control Wistar rats. Although the cerebral norepinephrine content was slightly increased following clonidine treatment SHR, the increase was not statistically significant. 3. Angiographic study of the kidneys revealed a poor opacification of the blood vessels and glomeruli in SHR compared with the control Wistar rats. There was no difference in the sizes of the arcuate and interlobular arteries in SHR and the control Wistar rats, although the medial muscular hypertrophy of the arteries was slightly more prominent in the SHR histologically. The more prominent in the SHR histologically. The angiographic and histologic findings of the renal arteries were not altered following long term clonidine treatment. A possibility was considered that the renal arterioles are mainly functionally affected in SHR.     

State of blood coagulation in the acute period of a hemorrhagic stroke

In 61 patients with hemorrhagic stroke, hypocoagulation was revealed in the acute period of the disease. This was done by using the reaction of morphological dissociation of coagulated blood (RMDCB). The degree of the hypocoagulation was found to depend on the gravity and the duration of the disease. The graver the state of the patient in the most acute period, the more marked the hypocoagulation, and vice versa. The improvement of patients under the influence of complex treatment was accompanied with an approach of the RMDCB parameters to those of the control group. Thus, the RMDCB may be recommended for use in broad clinical practice for evaluating the state of the blood coagulation system in the final stage of hemocoagulation.     

Intravascular blood coagulation in patients with acute destructive cholecystitis with paravesical infiltration

Data are submitted on changes in the system of regulation of the aggregate state of blood, that result in the development of the second stage of intravascular hemocoagulation syndrome in patients with destructive forms of cholecystitis presenting with paravesicular infiltration in the preoperative period. Disruptions in hemostasis remain after surgery, which fact attests to the need for working out efficient pathogenetically validated methods of correction thereof for the combined treatment of the pathology in question to be raised to a much higher level.     

Reovirus-induced acute myocarditis in mice correlates with viral RNA synthesis rather than generation of infectious virus in cardiac myocytes

The capacity for different reovirus reassortant viruses to induce acute myocarditis in mice correlates with cytopathogenic effect in primary cultures of murine cardiac myocytes. Multiple viral genes encoding proteins involved in viral RNA synthesis are determinants of this disease. We therefore evaluated the role of viral RNA synthesis in induction of acute myocarditis by infecting primary cultures of cardiac myocytes with a panel of myocarditic and nonmyocarditic viruses and quantitating RNA synthesis. RNA synthesis correlated with induction of myocarditis and with the S1 and M1 reovirus genes. Since one consequence of viral RNA synthesis is generation of infectious virus, we looked next at viral yield from cardiac myocyte cultures. Yield of infectious virus at an early time postinfection or as a final yield from primary infections did not correlate with myocarditis, but instead both correlated with the S1 gene. The S1 gene also determined the fraction of cells infected during primary infections in the culture, which varied dramatically between viruses. Viral yields per infected cell were similar for most myocarditic and nonmyocarditic reoviruses and did not correlate with induction of myocarditis or any reovirus gene. Together, the data provide two insights into reovirus-induced acute myocarditis in mice. First, while the S1 gene. which encodes the viral attachment protein sigma1 (as well as a nonstructural protein, sigma1s, of unknown function) does not determine the myocarditic potential of these viruses, it does determine the efficiency with which they infect cardiac myocytes. Second, while viral RNA synthesis is a determinant of acute myocarditis, this is not due to generation of infectious virus. This finding suggests that some other consequence of viral RNA synthesis, for example, induction of interferon, may determine reovirus-induced acute myocarditis.     

Blood coagulation disorders in infants with infectious gastroenteritis

The study included 28 infants with infectious gastroenteritis who evolved with disturbances of coagulation and in whom laboratory tests were practiced by micromethods through capillary puncture. The most frequently seen abnormality was a combination of vitamin K dependent factors deficiency with thrombocytopenia. Another observation in our study is that hypofibrinogenemia in infants with infectious gastroenteritis is not always secondary to disseminated intravascular coagulation. A decrease in fibrinogen in these cases is explained by a lack in synthesis of this factor in infants with malnutrition since out of 16 malnourished infants, 75% evolved with hypofibrinogenemia, while eutrophic infants evolved with normal fibrinogen. The disseminated intravascular coagulation syndrome was seen more frequently in patients with infectious gastroenteritis complicated with septicemia and shock, 57% of the patients did not show manifestations of bleeding nor of thrombosis which justifies in these cases a systematic investigation of the coagulation mechanism.     

Endogenous infectious endophthalmitis]

Spontaneous spinal epidural haematoma is rare. A case of haemophilia-B presenting with cervical spinal cord compression due to epidural haematoma, is reported. This is the second case in literature, to our knowledge, of intraspinal epidural haematoma in a patient with haemophilia-B. The importance of early diagnosis, especially with magnetic resonance imaging and surgical intervention, when deemed necessary, are emphasized.     

Ethical aspects]

The relation is considered between ethical choices, morals and deontology in plastic surgery of the male external genitals. Ethics dictates the behavioural model applied by an individual or group in their actions. Professional ethics--deontology--is the collection of duties governing the exercise of a certain profession. Morals are the set of rules governing an individual's life in society. Ethics, deontology and morals do not always convey the same message, since environmental, racial and religious situations, custom, and even fashion can influence a patient's demands, reflecting his desire to improve his quality of life, even only from the purely hedonistic viewpoint, and the specialist's attitude. Surgeons are increasingly tending to bend to these demands or--much worse--even encourage and foster them, with a view to financial considerations. The attitude and ethical choices available are examined in relation to surgery to lengthen or enlarge the penis.     

Fasting (acute energy deprivation) in man: effect on blood coagulation and fibrinolysis

Blood coagulation and fibrinolysis parameters were studied during 10 days of total fasting in healthy, normal weight males. A reduction of plasma levels of factor VIII activity with a concomitant decrease in factor VIII antigen was found, without other laboratory evidence for a disseminated intravascular coagulation. The effect of 10 days' starvation on blood coagulation appears to be small but the effect of more prolonged starvation might implicate impaired hemostasis.     

Dietary fatty acids and blood coagulation

Factor VII coagulant activity (VIIc) is a risk factor for coronary heart disease (CHD). Plasma VIIc is positively associated with dietary fat intake, suggesting that fat-rich diets are accompanied by a hypercoagulable state. Reduction in total fat consumption is followed by a decrease in VIIc within 24 h. In adults taking diets rich in long-chain saturated fatty acids, a postprandial increase in VIIc occurs after a fatty meal irrespective of its fat composition. This effect has dose-response characteristics, persists for several hours, and is due to activation of factor VII. There is no acute effect of dietary fat on factor VII antigen (VIIag) concentration, but VIIag is positively related to dietary fat intake. More studies are needed on the effects of dietary fat composition on fasting and postprandial factor VII. Dietary fat appears to influence both the atherosclerotic and thrombogenic components of CHD.     

Influence of cation dyes on blood coagulation

Experiments on rabbits showed that intravenous injection of dyestuffs of the thionine series (toluidine blue, azur A, 1:9 dimethylene blue) was accompanied by hypofibrinogenemia, a decrease in the concentration of prothrombin complex factors, thrombocytopenia and the lowering of the blood platelets adhesion against the background of delayed blood thrombogenesis. The blood heparin tolerance and the amount of free heparin were sharply lowered. The authors consider that the hypocoagulative effect of cationic dyestuffs on the blood was caused by the thrombocytopenia and by the lowering of the platelet aggregation activity.     

Eosinophilic myocarditis complicated by acute myocardial infarction--a case report

The authors report a patient with eosinophilic myocarditis who developed severe chest pain with marked elevation of the ST segment on the electrocardiogram, which led them to suspect the presence of acute myocardial infarction. Emergency coronary angiography showed numerous occlusions and stenoses at the distal right and left coronary arteries, especially affecting the latter, owing probably to thrombus. The angiographic findings in this case demonstrate the formation and obstruction of thrombus in the small coronary arteries in a patient in the acute necrotic stage of eosinophilic myocarditis, believed to be the first such case reported.     

Malaria--biological aspects of an infectious disease of importance to humans

Malaria is the most prevalent parasite-transmitted infectious disease in humans, with 300-500 million people infected and 3-5 million persons dying from the disease each year [1]. There is, however, surprisingly little knowledge of the parasite's biology and its evolutionary adaptations to cope with a life as an intracellular parasite within its vertebrate host. This article gives an overview of the parasite's developmental cycle and highlights aspects of the immune response in infected humans and the parasite's mechanisms of immune evasion. In addition, special features of the life cycle of the parasite are presented, especially the invasion process of merozoites into red blood cells. Putative mechanisms of drug action of synthetic antimalaria drugs are discussed as well as hypotheses explaining the development of drug resistance in a variety of parasite strains.