Horner's syndrome and demyelinating peripheral neuropathy caused by high-dose cytosine arabinoside.

High-dose cytosine arabinoside may benefit patients with refractory acute leukemia. Peripheral nervous system disturbances caused by cytosine arabinoside have rarely been reported. We describe a patient with acute leukemia who developed Horner's syndrome and a severe demyelinating peripheral neuropathy leading to death after receiving high-dose cytosine arabinoside. Peripheral nerve dysfunction is a potentially serious complication of high-dose cytosine arabinoside.

Liver lymphoma in systemic lupus erythematosus.

Systemic lupus erythematosus (SLE) has been associated with an increased incidence of lymphoma. We describe the occurrence of hepatic lymphoma, which was likely primary in origin, in a patient with SLE and discuss the etiologic and diagnostic implications.

Screening tests of the hemostatic system.

The hemostatic system consists of the subcutaneous tissue/vessel wall/platelet system and the coagulation cascade. Hemostasis occurs initially through the interaction between circulating platelets and subendothelial collagen, so that a platelet plug is formed. The platelet plug produces hemostasis, but is unstable and will disintegrate unless the coagulation cascade generates fibrin. The presence of the fibrin in the plug results in permanent hemostasis. The five tests of hemostasis - platelet count, bleeding time, partial thromboplastin time, prothrombin time and Factor XIII assay - are described.

In vivo behavior of fibrinogen fragment D in experimental renal, hepatic and reticuloendothelial dysfunction.

Fibrinogen Fg-D, obtained by plasmin-induced cleavage of fibrinogen, was separated and purified by ion exchange chromatography. The in vivo behavior was studied by administering 2 mg of (125)I-labeled Fg-D intravenously into each of 3 normal, 3 partially hepatectomized, 3 reticuloendothelial system (RES) blockaded, 4 nephrectomized and 2 ureter ligated rabbits. The plasma clearance in normal rabbits showed two components: 66.0 +/- 6.0% was cleared with a t(1/2) of 0.9 +/- 0.2 hours and 32.3 +/- 5.3% cleared with a t(1/2) of 3.6 +/- 0.3 hours. In both the partially hepatectomized and RES-blockaded groups, the clearance patterns were similar to those observed in the normal animals. In contrast, in the nephrectomized group, while the t(1/2) of the first component was similar to that in the normal group, the second component had a longer t(1/2) (6.0 +/- 1.0 hours) than the other groups. In the animals with both ureters occluded, the t(1/2)'s were similar to the normal animals. Measurements of urinary radioactivity suggested that complete in vivo catabolism had occurred. In vivo subfragments of Fg-D could not be detected in the plasma. Neither Fg-D nor subfragments were found in the urine. These results indicate that Fg-D is rapidly cleared from the plasma, that in vivo subfragmentation does not occur, and that the kidneys are important in the catabolism of a portion of Fg-D.