RESUMEN
AIMS: To characterize Oenococcus oeni strains isolated from North-Apulian wines where malic acid degradation is usually achieved by spontaneous fermentations, and to determine the influence of bacterial inoculation time on the malolactic performances in 'Nero di Troia' wine using a complete autochthonous microbial regime. METHODS AND RESULTS: Oenococcus oeni strains from wines produced with the autochthonous (Apulia Region, southern Italy) grape variety 'Uva di Troia' were isolated, selected and characterized. Multilocus sequence typing and variable number tandem repeat analysis were used to investigate intraspecific diversity. Oenococcus oeni strains were tested in co-inoculation and in sequential inoculation, with two autochthonous yeast strains previously isolated from 'Nero di Troia' wine. After a preliminary screening using co-inoculation regime, the O. oeni strains were grouped in reason of the different behaviour in malic acid performances. Results suggested that the efficient degradation of malic acid in co-inoculation is a strain-dependent characteristic. CONCLUSIONS: Autochthonous yeast/bacterium combinations were identified as starter culture, and used in a co-inoculation approach, for vinification of regional wines. SIGNIFICANCE AND IMPACT OF THE STUDY: The 'microbial terroir' of typical fermented food and beverage production represents a dynamic sector of applied research in food microbiology. In this work, we propose the use of autochthonous bacteria and yeast for wine production from an indigenous grape variety.
Asunto(s)
Oenococcus/metabolismo , Saccharomyces cerevisiae/metabolismo , Vitis/microbiología , Vino/microbiología , Fermentación , Microbiología de Alimentos , Italia , Malatos/metabolismo , Datos de Secuencia Molecular , Vitis/clasificación , Vino/análisisRESUMEN
Alcoholic fermentation of grape must is a complex process, involving several yeast genera and species. The early stages in fermentation are dominated by non-Saccharomyces yeasts that are gradually replaced by the Saccharomyces cerevisiae species, which takes over the fermentation. Quantitative studies have reported the influence of non-Saccharomyces yeast species on wine quality and evaluated their biotechnological interest. The industrial yeast market, which, until recently, exclusively focused on S. cerevisiae, now offers S. cerevisiae/non-Saccharomyces (including Torulaspora delbrueckii) multi-starters. The development of these new mixed industrial starters requires a better understanding of the interaction mechanisms between yeast populations in order to optimize the aromatic impact of the non-Saccharomyces yeast while ensuring complete alcoholic fermentation thanks to S. cerevisiae. For this purpose, a new double-compartment fermentor was designed with the following characteristics: (1) physical separation of two yeast populations, (2) homogeneity of the culture medium in both compartments, (3) fermentation kinetics monitored by weight loss due to CO2 release, and (4) independent monitoring of growth kinetics in the two compartments. This tool was used to compare mixed inoculations of S. cerevisiae/T. delbrueckii with and without physical separation. Our results revealed that physical contact/proximity between S. cerevisiae and T. delbrueckii induced rapid death of T. delbrueckii, a phenomenon previously described and attributed to a cell-cell contact mechanism. In contrast, when physically separated from S. cerevisiae, T. delbrueckii maintained its viability and its metabolic activity had a marked impact on S. cerevisiae growth and viability. The double fermentor is thus a powerful tool for studying yeast interactions. Our findings shed new light on interaction mechanisms described in microorganism populations.
Asunto(s)
Saccharomyces cerevisiae/metabolismo , Vino , Fermentación , Torulaspora/metabolismoRESUMEN
Partial or whole-genome duplications have played a major role in the evolution of new species. We have investigated the variation of ploidy level in a panel of domesticated strains of Saccharomyces cerevisiae coming from different geographical origins. Segregation studies and crosses with tester strains of different ploidy levels showed that part of the strains were well-balanced autotetraploids displaying tetrasomic inheritance. The presence of up to four different alleles for various loci is consistent with a polyploidization mechanism relying on the fusion of two nonreduced meiospores coming from two S. cerevisiae strains. Autotetraploidy was also in accordance with karyotype and flow cytometry analyses. Interestingly, most bakery strains were tetraploids, suggesting a link between ploidy level and human use. The null or drastically reduced fertility of the hybrids between tetraploid and diploid strains indicated that domesticated S. cerevisiae strains are composed of two groups isolated by post-zygotic reproductive barriers.
Asunto(s)
Especiación Genética , Poliploidía , Saccharomyces cerevisiae/genética , Alelos , Variación Genética , Genotipo , Cariotipificación , Repeticiones de Microsatélite , Reproducción , Saccharomyces cerevisiae/clasificación , Saccharomyces cerevisiae/fisiologíaRESUMEN
Amyloidosis is characterized by extracellular deposition of protein fibrils of chemically heterogeneous composition. Early recognition and identification of amyloid deposits allows an early start of therapy, which may entail a better prognosis. Congo red staining according to Romhányi (1971) is a highly specific and sensitive method for early microscopic recognition of amyloidosis. The main and most important types of amyloidosis may be distinguished by classic histochemical methods of performate pretreatment according to Romhányi (1979), or by KMnO4 oxidation according to Wright (1977) followed by Congo red staining and viewed under polarized light. Differences in the speed of breakdown (disintegration) of amyloid deposits according to Bély and Apáthy allow a more precise distinction of various types of amyloid.
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Amiloide/ultraestructura , Amiloidosis/patología , Aumento de la Imagen/métodos , Microscopía de Polarización/métodos , Rojo Congo , Diagnóstico Diferencial , HumanosRESUMEN
Wine yeast strains exhibit a wide variability in their technological properties. The large number of allelic variants and the high degree of heterozygosity explain this genetic variability found among the yeast flora. Furthermore, most enological traits are controlled by polygenic systems presenting complex interactions between the alleles. Taking this into account, we hypothesized that the meiotic segregation of such alleles from a given strain might generate a progeny population with very different technological properties. In this work, a population of 50 progeny clones derived from four industrial wine strains of Saccharomyces cerevisiae was characterized for three major enological traits: ethanol tolerance, volatile-acidity production and hydrogen sulphide production. For this purpose, reliable laboratory fermentation tests were developed in accordance with enological practice. A wide variability in the values of the various parameters was found among spore clones obtained after sporulation. Many clones presenting better aptitudes than the parental strains were obtained. Moreover, analysis of the progeny demonstrated that: (1) traits are in part inheritable; (2) traits are clearly polygenic; (3) broad relations of dominance/recessivity can be established. All these findings constitute an initial step for establishing breeding strategies for wine yeast improvement.
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Saccharomyces cerevisiae/genética , Saccharomyces cerevisiae/metabolismo , Vino/microbiología , Medios de Cultivo , Etanol/metabolismo , Fermentación , Microbiología de Alimentos , Sulfuro de Hidrógeno/metabolismo , Concentración de Iones de Hidrógeno , Cariotipificación , Meiosis , Carácter Cuantitativo Heredable , Esporas FúngicasRESUMEN
A hereditary and an acquired type of C1-esterase inhibitor deficiency have been described. Manifestations characteristic of both forms include recurrent subcutaneous and submucosal angiooedema. Acquired C1-esterase inhibitor deficiency has been observed in association with lymphoproliferative disorders, malignancy, autoimmune diseases and infections. We report on a case with the acquired form of the disease accompanied by leucocytoclastic vasculitis. Treatment with antimalarial agents resulted in complete resolution of symptoms and signs. Furthermore, C1-esterase inhibitor concentration and activity, as well as C1 levels, all returned to normal.
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Angioedema/enzimología , Proteínas Inactivadoras del Complemento 1/deficiencia , Vasculitis Leucocitoclástica Cutánea/enzimología , Adulto , Angioedema/tratamiento farmacológico , Antimaláricos/uso terapéutico , Cloroquina/uso terapéutico , Proteínas del Sistema Complemento , Femenino , Humanos , Hidroxicloroquina/uso terapéutico , Resultado del Tratamiento , Vasculitis Leucocitoclástica Cutánea/tratamiento farmacológicoRESUMEN
Systemic sclerosis is a generalized disease characterized mainly by the accumulation of collagen in the skin and internal organs. The aim of our study was to determine the amount of collagen cross-link pyridinoline (Pyd) in a variety of fibrotic tissues (skin, fascia, endocardium, bladder) from an autopsy patient with diffuse systemic sclerosis, and to compare these with normal tissues from the same patient. Mean concentrations of Pyd in the fibrotic skin samples (66 mmol/mol collagen) were more than two-times greater than those in the uninvolved normal samples (27 mmol/mol collagen). The increase of Pyd in the endocardium, fascia, and bladder was also markedly higher (1.41 x, 1.26 x and 2.64 x higher than normal samples). The increased deposition of collagen in systemic sclerosis is accompanied by a significantly increased amount of Pyd in the collagen of fibrotic tissues.
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Aminoácidos/análisis , Colágeno/química , Esclerodermia Sistémica/metabolismo , Piel/química , Endocardio/química , Fascia/química , Fibrosis , Humanos , Vejiga Urinaria/químicaRESUMEN
BACKGROUND: Apoptosis is one of the major events following total androgen blockade (TAB). The aim of this study was to determine the predictive value of some histological parameters including apoptosis and gene products which influence apoptosis, based on repeated biopsies taken from the same patients. METHODS: At the time of diagnosis by needle biopsy TNM stage, serum PSA, Gleason's grade, apoptotic and mitotic index, Ki67, p53, and bcl(2) expression were investigated in 60 prostate carcinoma patients. Antiandrogen therapy supplemented with surgical or chemical castration was administered. Serum PSA-test and needle biopsy were repeated 13-14 weeks after starting the therapy, simultaneously with determination of the apoptotic and mitotic index, Ki67, p53, and bcl(2) expression. RESULTS: Forty-seven patients were alive at the end of the study, 13 patients died. Decrease in mitotic, increase in apoptotic index predicted favourable long-term response to antiandrogen therapy. Lower Ki67 and (mutant) p53 expression in the first and also in the second biopsy pointed to favourable effect of antiandrogen treatment. Since the ratio between Ki67 and apoptotic index strongly decreased in the survivors upon therapy, changes in Ki67/apoptosis ratio is recommended as a histologically detectable predictive factor. bcl(2) expression did not show significant correlation with the outcome of the disease. CONCLUSIONS: Histological evaluation of mitotic and apoptotic index, Ki67, and p53 expression in repeated biopsies contributes to predicting the value of the actual treatment and may be useful to institute alterations in therapy.
Asunto(s)
Antagonistas de Andrógenos/uso terapéutico , Antineoplásicos Hormonales/uso terapéutico , Carcinoma/tratamiento farmacológico , Carcinoma/patología , Neoplasias de la Próstata/tratamiento farmacológico , Neoplasias de la Próstata/patología , Factores de Edad , Anciano , Apoptosis/efectos de los fármacos , Biopsia , Humanos , Inmunohistoquímica , Antígeno Ki-67/biosíntesis , Masculino , Índice Mitótico , Estadificación de Neoplasias , Antígeno Prostático Específico/sangre , Proteínas Proto-Oncogénicas c-bcl-2/biosíntesis , Proteína p53 Supresora de Tumor/biosíntesisRESUMEN
A young female patient underwent ureteral resection and Hynes-Anderson pyeloureteroplasty because of pyeloureteral junction stenosis and a ureteral valve (UV), which caused hydronephrosis. Despite using ultrasonography and intravenous urography the ureteral valve was observed only on exploration. UV should be considered as a possible cause of upper urinary tract obstruction; retrograde urography can be essential.
Asunto(s)
Hidronefrosis/etiología , Pelvis Renal , Uréter/anomalías , Obstrucción Ureteral/complicaciones , Adulto , Femenino , HumanosRESUMEN
The clinical history of a 49 year old female patient suggested a multifocal, rapidly progressive liver disease of one month duration, apparently due to metastatic tumour. An open needle biopsy of the liver revealed a primary hepatocellular carcinoma of low grade malignancy; the diagnosis was confirmed by histological, immunohistochemical and electron microscopic studies. Besides the ultrastructural examination of the liver biopsy disclosed an unusually marked proliferation of perisinusoidal (Ito)-cells. The authors assume that the myofibroblast proliferation and transformation of Ito-cells in the noncirrhotic liver led to the formation of multifocal areas. The perisinusoidal cell proliferation was presumably due to vitamin A intoxication caused by an extreme vegetarian diet (daily consumption of large amounts of carrot juice for years, as disclosed by a retrospectively obtained history). It is assumed that the vitamin A abuse, and perisinusoidal cell proliferation may have promoted the unusually rapid progression of the multifocal, but histologically low grade hepatocellular tumour. Spectacular clinical improvement could be observed after chemotherapy, combined with local hyperthermic treatment. Presumably, the change in diet (cessation of excessive retinol and carotene intake) also may have had a beneficial effect. After one year the clinical course suggests a slower progression of tumour growth which would be more in keeping with the prognosis based on the histologic appearance of the low grade hepatocellular carcinoma. This patient's case illustrates the importance of electron microscopy supplementing diagnostic histological and immunohistochemical examinations.
Asunto(s)
Carcinoma Hepatocelular/patología , Hepatocitos/patología , Neoplasias Hepáticas/patología , Carcinoma Hepatocelular/ultraestructura , Femenino , Hepatocitos/diagnóstico por imagen , Humanos , Neoplasias Hepáticas/ultraestructura , Microscopía , Microscopía Electrónica , Persona de Mediana Edad , UltrasonografíaRESUMEN
The histochemical and immunohistochemical differential diagnosis of amyloidosis in surgical pathology in a referral center is presented. Different forms of amyloidosis are considered e.g. systemic generalized amyloidosis: secondary (AA), primary (AL), senile, hemodialysis-associated, hereditary and organ (tissue)-limited (localized) amyloidosis: cerebral, dystrophic (age-related, so-called "senile"), endocrine-related, localized to tumours, focal (concentrated secretion), and isolated plasma cell (solitary plasmacytoma, B-cell) dyscrasia related amyloidosis. The amyloid deposits were identified and characterized histochemically by Congo red staining after performate pre-treatment at 20 degrees C for 1, 3, 5, 10, 15, 20 or 25 sec, and with oxidation induced proteolysis by trypsin digestion at 20 degrees C for 5, 10, or 30 sec, 1, 2, 3, 4, 5, 6 or 10 min and covered with gum-arabic according to Romhányi, and confirmed by streptavidin-biotin-complex/horseradish peroxidase immunohistochemical reactions. The "sensitivity" or "resistance" to pre-treatment of amyloid deposits depends on the type of amyloid, and the length of pre-treatment. Secondary (AA) amyloid is sensitive to KMnO4 oxidation, followed by trypsin digestion (for 1 min), and its green birefringence under polarized light disappears, while primary (AL) (for 1-5 min), senile (for 1-10 min), and most forms of organ (tissue)-limited (localized) amyloid (for 1-10 min) are resistant. Performate pre-treatment is followed by pronounced congophilia. Secondary (AA) is sensitive to performate pre-treatment (for 1 sec), while primary (AL) amyloid (for 1-20 sec), senile (for 1-25 sec), and most forms of organ (tissue)-limited (localized, isolated) amyloid deposits (for 1-25 sec) are resistant, and are constantly positively birefringent. Early identification and differentiation of amyloid deposits is important for the prognosis and for the choice of therapy. The authors conclude that the presented classical histochemical methods are useful as first line screens for the histological identification of amyloidosis.
Asunto(s)
Amiloide/análisis , Amiloidosis/diagnóstico , Colorantes/análisis , Rojo Congo/análisis , Coloración y Etiquetado/métodos , Amiloide/efectos de los fármacos , Péptidos beta-Amiloides/análisis , Amiloidosis/clasificación , Amiloidosis/etiología , Amiloidosis/metabolismo , Amiloidosis/patología , Enfermedades Autoinmunes/complicaciones , Autopsia , Biopsia , Birrefringencia , Diagnóstico Diferencial , Formiatos/farmacología , Humanos , Técnicas para Inmunoenzimas , Cadenas kappa de Inmunoglobulina/análisis , Especificidad de Órganos , Permanganato de Potasio/farmacología , Reproducibilidad de los Resultados , Proteína Amiloide A Sérica/análisis , Componente Amiloide P Sérico/análisis , Tripsina/farmacologíaRESUMEN
The authors describe the case of a male patient who had had Paget's disease since 1973 which led to the diffuse swelling of the proximal femur in 1993. The elevated alkaline phosphatase level and the destructive lytic lesions on the X-ray of the femur raised the possibility of malignancy. The bone scan showed increased accumulation in the proximal part of the left femur. On the MR the low T1 and the elevated T2 signal intensity suggested malignity despite that in some regions signals typical of adipose tissue could also be seen, which is usually interpreted as a sign of benignity. In the histological specimens no signs of malignant tumour cells were identified. The patient received bisphosphonate treatment which decreased his pain and swelling and also the alkaline phosphatase level. The patient died because of a rapidly progressing retroperitoneal fibrosarcoma and lung metastasis in 1996. The autopsy did not prove any malignant transformation of Paget's disease of bone in the proximal femur.
Asunto(s)
Neoplasias Óseas/diagnóstico , Fémur , Fibrosarcoma/diagnóstico , Osteítis Deformante/complicaciones , Biopsia , Neoplasias Óseas/complicaciones , Diagnóstico Diferencial , Resultado Fatal , Fémur/diagnóstico por imagen , Fémur/patología , Fibrosarcoma/etiología , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Osteítis Deformante/diagnóstico , Tomografía Computarizada por Rayos XRESUMEN
In this report the authors present the case of a highly malignant non-Hodgkin lymphoma in a young operated patient. They call attention to the gastrointestinal form which is difficult to diagnose. In this case the lymphoma was detected only by laparotomy. The prognosis of secondary generalized lymphoma is poor. In most cases just like in the on described above--it ends with sepsis and death.
Asunto(s)
Abdomen Agudo/etiología , Linfoma de Células B/complicaciones , Linfoma de Células B/diagnóstico , Adolescente , Diagnóstico Diferencial , Humanos , Inmunohistoquímica , Laparotomía , Linfoma de Células B/cirugía , Masculino , Estadificación de NeoplasiasRESUMEN
A prospective study on 16 patients with advanced (stage III and IV) prostate cancer was carried out. TNM stage, general clinical status, serum PSA level, the histological type and Gleason's grade of the tumor were registered. Total androgen blockade or single-drug therapy (flutamide) was performed. On average, 4.81 months after the start of therapy rebiopsy, serum PSA determination and general clinical examination were performed. Histologic examination before and after treatment of HE-stained slides, as well as apop-tag reaction to show apoptotic cells, p53, bcl(2), and Ki-67 immunostaining. Clinical improvement manifested by regression or lack of progression was observed in 10 patients. Increase of the apoptotic index and decrease of the mitotic index was detected in these cases. Serum PSA level decreased in all patients except in 3 fatal cases. The 6 clinically nonresponders who died after the second biopsy did not show an increased apoptotic or decreased mitotic index. Ki-67 positivity correlated well with the mitotic activity. Mutant p53 expression was higher in patients in whom antiandrogen therapy was ineffective. The bcl(2) expression was a characteristic of the tumors of patients who later died. These results show that the degree of induction of apoptosis in prostate carcinoma by hormonal therapy varies from case to case. A given prostate cancer patient's response to therapy may be predicted by following apoptotic and mitotic activity, as well as Ki-67 and p53 expression in repeated biopsies.
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Antagonistas de Andrógenos/uso terapéutico , Flutamida/uso terapéutico , Neoplasias de la Próstata/terapia , Adenocarcinoma/metabolismo , Adenocarcinoma/terapia , Anciano , Antineoplásicos Hormonales/uso terapéutico , Apoptosis , Humanos , Antígeno Ki-67/metabolismo , Masculino , Persona de Mediana Edad , Orquiectomía , Estudios Prospectivos , Próstata/metabolismo , Próstata/patología , Neoplasias de la Próstata/metabolismo , Proteínas Proto-Oncogénicas c-bcl-2/metabolismo , Resultado del Tratamiento , Proteína p53 Supresora de Tumor/metabolismoRESUMEN
Authors report on a 75-year-old man with bilateral testicular lymphoma. He complained of painless right testicular enlargement. Orchidectomy was indicated by ultrasound examination and the diagnosis (large cell, non-Hodgkin lymphoma B-cell origin) was established by histology and immunohistochemistry. Two months later, the left testis enlarged, orchidectomy was performed, and a lymphoma with identical histology was found. PET revealed retroperitoneal spread of the tumor. Irradiation (18 Gy) was applied. Three months later, because of gastric metastases of the lymphoma the patient underwent CVP and CAVP (Cyclophosphamide, Adriablastin, Vincristin, Prednisolone) chemotherapy. Despite of the repeated courses, eleven months after the primary diagnosis the patient died due to of multiple metastases.
Asunto(s)
Linfoma/diagnóstico , Neoplasias Testiculares/diagnóstico , Anciano , Antineoplásicos/uso terapéutico , Resultado Fatal , Humanos , Linfoma/diagnóstico por imagen , Linfoma/tratamiento farmacológico , Linfoma/patología , Masculino , Neoplasias Testiculares/diagnóstico por imagen , Neoplasias Testiculares/tratamiento farmacológico , Neoplasias Testiculares/patología , UltrasonografíaRESUMEN
A patient with two diseases, based presumably on different immunopathological mechanisms, hereditary angioedema (HAE) and Crohn's disease, was followed for 8 years. For more than three years of this observation period, detailed laboratory data were also available and could be analyzed. Both diseases had severe courses requiring chronic treatment with danazol and sulfasalazine, respectively. During exacerbation of Crohn's disease, the levels of C4 was found to be significantly lower than during the periods free of symptoms of both diseases. This drop was probably due to an impaired C1-inhibitor activity. HAE attacks and acute exacerbation of Crohn's disease never occurred simultaneously. This finding may be a mere chance but may also indicate that the different immunopathological processes underlying HAE and Crohn's disease influence each other.
Asunto(s)
Angioedema/complicaciones , Enfermedad de Crohn/complicaciones , Adulto , Angioedema/inmunología , Angioedema/patología , Proteínas Inactivadoras del Complemento 1/deficiencia , Complemento C4/análisis , Vía Clásica del Complemento , Enfermedad de Crohn/inmunología , Enfermedad de Crohn/patología , Humanos , Estudios Longitudinales , MasculinoRESUMEN
Benign (bTu) and malignant tumours (mTu) were studied in a randomised autopsy material of 161 patients with rheumatoid arthritis (RA). The tissue specimens were fixed in 8% formaldehyde solution at pH 7.6 and embedded in paraffin. The tumours were diagnosed histologically and confirmed by immunohistochemical methods. Five benign (3.1%), and thirteen malignant tumours (8.1%) found observed in 18 (11.2%) of 161 cases. There was no significant difference between laboratory parameters of patients with malignant tumours and without tumours. One benign (0.62%) and seven malignant (4.35%) tumours led to death in 8 (4.97%) of 18 cases altogether. Neoplasms were detected clinically in 8 of 18 cases (44.4 rel%). None of tumorous patients received immunosuppressive treatment and only five had gold (Tauredon) therapy. Paraneoplastic syndromes with rheumatoid complaints may be excluded by the onset and duration of RA and tumours. Benign neurogenic tumours and malignant bronchioloalveolar carcinoma were frequently associated with RA not treated by immunosuppressive drugs. Our data do not support the assumption of a high risk of malignant lymphomas associated with RA treated with immunosuppressive therapy.
Asunto(s)
Artritis Reumatoide/patología , Neoplasias/patología , Anciano , Artritis Reumatoide/complicaciones , Autopsia , Cadáver , Causas de Muerte , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias/complicaciones , Distribución AleatoriaRESUMEN
This article describes a one-step operative technique for the treatment of circumscript cartilage defects of weight-bearing surfaces of the knee. Since 1992, a total of 227 patients were treated using this technique for full-thickness lesions resulting from chondropathy, traumatic chondral defects, and osteochondritis dissecans; the procedure was evaluated in 57 patients who had > 3 years of follow-up. Magnetic resonance imaging, computed tomography arthrographies, ultrasound, and arthroscopy were used to evaluate the technique. Using the modified Hospital for Special Surgery (HSS) knee scoring system, 91% of the patients achieved a good or excellent result. The operative technique, clinical results, and complications are detailed.
Asunto(s)
Cartílago Articular/lesiones , Cartílago Articular/trasplante , Traumatismos de la Rodilla/cirugía , Procedimientos Ortopédicos/métodos , Adolescente , Adulto , Artroscopía , Femenino , Humanos , Traumatismos de la Rodilla/diagnóstico , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , RoturaRESUMEN
Cryoglobulinemia can be associated with several infections, immunoproliferative tumors, chronic liver, renal and systemic autoimmune diseases. In the first part of the publication the authors give a review of the main clinical and laboratory properties of cryoglobulins. In essential mixed cryoglobulinemia syndrome (purpura, arthralgia, weakness) clinical and laboratory signs of damaged liver function can often be seen. However, there are mixed cryoglobulins in chronic liver disease of different etiologies as well. In 30-94% of patients with hepatitis C virus infection and hepatitis C virus-induced chronic liver diseases laboratory signs (occasionally clinical symptoms as well) or mixed cryoglobulinemia can be diagnosed. Serological markers of hepatitis C virus infection have been found in the cryoprecipitates of patients with mixed cryoglobulinemia. A high prevalence of mixed cryoglobulins in serum of patients with chronic hepatitis C virus infection and hepatitis C virus-induced chronic liver disease suggests that this virus has a significant role in the pathogenesis of mixed cryoglobulins. Also, an impaired clearance function of the liver in the uptake of cryo(immuno)complexes may be an important causative factor in the production of cryoglobulins in chronic liver diseases of different etiologies.