Thrombolytic treatment of pulmonary embolism with APSAC.

BRL 26921 (Eminase registered trade mark in Belgium, Germany and The Netherlands) is the p-anisoyl derivative of the primary (human) lys plasminogen-streptokinase activator complex (APSAC). The acyl-enzyme has the theoretical advantage of causing fibrinolysis in situ in the presence of fibrin clotbound plasminogen. It was administered to 34 patients with severe pulmonary embolism (PE) in an open multicentre study. PE was suspected on clinical, blood gas, ECG, and radiographic data. Pulmonary angiograms performed pre- and post-treatment confirmed the diagnosis and were assessed using the Miller Index (MI). Fibrinogen, plasminogen, alpha-2-antiplasmin, fibrinogen degradation products (FDP), activated partial thromboplastin time (APTT), partial thromboplastin time (PTT) were closely monitored before and after each administration of APSAC. Median angiographic improvement was 50% (range 0-94%). The following adverse events were reported: bleeding at puncture sites (n = 12), haematuria (n = 1), epistaxis (n = 3), fever (n = 2). A blood transfusion was given in one patient with an inguinal haematoma. Systemic fibrinogenolysis occurred in 20/28 patients.

Evaluation of the role of pre- and postsynaptic serotonergic receptors in electroconvulsive shock therapy.

Despite the well-established clinical efficacy of electroconvulsive therapy (ECT) in the treatment of affective disorders, there is no generally accepted theory regarding its mode of action. Pre- and postsynaptic serotonin (5-hydroxytryptamine, 5-HT) receptors were studied following treatment of rabbits with electroconvulsive therapy (8 shocks). No change was observed in the binding at the postsynaptic 5-HT2 receptor in frontoparietal cortex, as indicated by an unchanged affinity and by the total number of receptors. In control rabbits, exogenously added serotonin and metitepin modulated the electrically evoked 3H-serotonin release, probably by acting on a presynaptic serotonin autoreceptor. Following electroconvulsive therapy, exogenous serotonin still inhibited the 3H-serotonin release, whereas metitepin had lost its enhancing effect. This observation provides evidence for a decreased amount of endogenous neurotransmitter present in the synaptic cleft at stimulation. The results indicate that postsynaptic receptor changes following antidepressant treatments are related to the presynaptic autoreceptor changes.

Comparison of biometric data of children with high and low levels of lead in the blood.

This paper deals with a biometric study of 312 boys and girls, aged 2.5-16 years, living in an area with a long history of pollution by lead. The aim was to search for eventual relationships between ten biometric variables and measures of lead absorption in the bodies, i.e. the amount of lead in the blood (PbB), of these children. Standardized values of the biometric variables were compared in the high-PbB and low-PbB categories, by multivariate analysis of variance. Comparison of the vectors of the ten biometric variables reveals a significant difference between the two categories of PbB levels. We found some evidence that the younger children (below 8 years of age) are more likely to absorb lead in the body and are more vulnerable to the effects of subclinical lead intoxication than their older counterparts. The differences between the averages of biometric variables in the two PbB categories are consistently (although not significantly) greater among younger children. This trend disappeared in the older age group. These results confirm data from the literature that young children are especially at risk. It can be concluded that there is a subtle, but significant, influence of lead absorption on the biometric profiles of children and that this effect is probably more important in children below 8 years of age.

C heterochromatin variation in couples with recurrent early abortions.

The possible influence of the high polymorphic C heterochromatic regions of human chromosomes 1, 9, 16, and Y on meiotic chromosome segregation was investigated. Faulty chromosome segregation may be the result of either an abnormal quantity of C heterochromatin on the homologues, or disequilibrium between the homologues. The aim of our study was to determine whether either a variation in the amounts of total C heterochromatin or differences in the amounts of C heterochromatin between homologues could lead to faulty chromosome segregation. The study was performed on C banded metaphases obtained from peripheral lymphocyte cultures of 15 couples with recurrent early abortions and 15 control couples, all Caucasians. Analysis of variance was first performed on separate metaphases to measure intra-individual, inter-individual, and between population variation in a hierarchical model. Since the significant intra-individual differences covered the other parameters we performed, secondly, a one way analysis of variance on the mean values of metaphases per person in order to measure the inter-individual and between population variation. The results did not show a relationship between C heterochromatin lengths and occurrence of recurrent abortions.