Cryoglobulinemia and liver involvement.

Liver involvement during essential mixed cryoglobulinemia (EMC) and cryoglobulins secondary to acute and chronic liver diseases has often been reported. Cryoglobulins in the serum seem to depend on an abnormal balance between their production and clearance. In this paper, 58 cases of mixed, mainly polyclonal cryoglobulinemia secondary to chronic liver diseases, and 23 cases of EMC, mainly monoclonal, are described. Amongst the EMC, 15 cases have been histologically followed-up and we have shown different types of related pathological liver involvement: from 'pathosis torbida' and chronic persistent hepatitis to chronic active hepatitis and liver cirrhosis. Only a few hepatic lymphoid infiltrates were nodular. According to our data and to those in the literature, we can suggest the following correlations between mixed cryoglobulinemic states and liver diseases: transient polyclonal cryoglobulins are secondary to acute viral liver diseases; polyclonal cryoglobulins are related to chronic liver diseases, initially produced by a polyclonal stimulation; mainly monoclonal, but also polyclonal cryoglobulins in which there is not always liver damage, but nodular infiltrates can be seen at the hepatic site; monoclonal, but also polyclonal cryoglobulins, in which there are nodular lymphoid infiltrates and vasculitis, as in immune complex diseases.

[Serological survey for virus and Mycoplasma infections (author's transl)]. / Comportamento delle reazioni sierologiche e liquorali per infezioni virali e da Micoplasmi nel corso di un biennio.

The Authors describe the two years follow up of complement fixing antibodies vs 4 viral antigens (Herpes simplex, Herpes zoster, Cytomegalovirus, respiratory syncytial virus, Mycoplasma pneumoniae). They evaluate the seasonal trend and the eventual clinical correlations on 3267 sera and 254 spinal fluids from hospitalized patients.

[Cerebro-spinal fluid assay (author's transl)]. / Esame del liquido cefalo-rachidiano.

The Author describes an analytical comparative method between cerebrospinal fluid and serum which allows to calculate some protein indices in CSF and in CSF and blood that are very useful in the diagnosis of the nervous system diseases.

[Diagnostic patterns of CSF immune response (author's transl)]. / Aspetti diagnostici della risposta immunitaria liquorale.

The AA. critically evaluate the different methods used for the study of the CSF proteins and particularly examine the diagnostic meaning of some blood and CSF proteins ratios. According to the cases they report, the AA. think that some patterns characteristic of the nervous system diseases can be defined and they point out the importance of the contemporaneity of the examination of the CSF and of the serum in order to improve the significance of laboratory data.

[The kaolin-activated recalcification test in the screening of coagulation disorders and in the control of anticoagulant therapy]. / Il test di ricalcificazione attivato con caolino nello screening delle coagulopatie e nel controllo delle terapie anticoagulanti.

The AA. have standardized a method for determining the kaolin activated plasma recalcification time (TRA) and have fixed its normal range between 33 and 60 seconds (average +/- 3 DS) testing 2000 normal subjects. By this method they have been able to demonstrate that TRA is more sensitive than PTT during the haemorrhagic manifestations in thrombocytopenic patients and in monitoring heparin therapy, while it shows a behaviour similar to PTT in detecting coagulation defects. It has also been found that TRA had remarkably increased its values in thrombocytopatic non thrombocytopenic patients, when PTT was normal. TRA does not seem to be useful in coumarin or indanedione therapy, since its values are constantly but not proportionally increased only when prothromsitive than PTT during the haemorrhagic manifestations in thrombocytopenic pabin time is very prolonged. Finally TRA can advantageusly substitute the whole blood clotting time and the non activated recalcification time for its easy performance, remarkable precision and low cost.

[Value of TPHA in the serological screening of lues]. / Validità del TPHA nello screening sierologico della lue

In the present work, 21,400 not selected sera were tested with hemagglutination test (TPHA) and flocculation test (VDRL) with cardiolipin for screening of syphilis; sera that gave negative results against both tests showed remarkable agreement (97,81%). 468 sera gave positive results to least one of the tests employed in screening and were tested with the following procedures: fluorescent Treponemal antibody-absorption (FTA/ABS) test, complement fixation (by Kolmer, modified) with proteic (KP) and lipidic (KL) antigen; 100 of these sera were also tested with T. pallidum immobilizaiton (TPI) test. The agreement among the before mentioned tests and sera that gave positive results only to VDRL was significatively low; on the contrary, the agreement was remarkable in the case of those positive only to TPHA (99% with FTA/ABS, 83% with TPI, 52,5% with KP and 21,5% with KL). The results obtained in attesting sensitivity and specificity of TPHA indicate that it is a very valuable screening test, and suggest to the AA. to emphasize that TPHA/VDRL association a definitive conclusion in syphilis serological negativity.

[Automatic method for determination of serum antistreptolysin]. / Metodo automatico di dosaggio delle antistreptolisine sieriche

The AA. describe a method of determination of serum antistreptolysin employing "Technicon" AutoAnalyzer, this method permitting the execution of 40 determinations in an hour, with a time of analysis of about 16 minutes. The procedure of analysis is very easy, with a very high selectivity of values; a variation coefficient of 5,3% and an accuracy index of 4,4% were found. Since the amount of serum employed is 50 mul this method appears to be particularly suitable in paediatry and in serological screening.