[Urological diseases during pregnancy].

Pyelonephritis and urinary calculi are the most frequent urological complications during pregnancy. They are followed by injuries of the urinary system during birth or in connection with multiple traumas in traffic accidents. Kidney transplantation or permanent urinary diversion (Ileum- or Colon-Conduit) are not an absolute obstacle for pregnancies when closely followed.

The amidolytic activity of the SK-plasminogen complex is enhanced by a potentiator which is generated in the presence of vascular plasminogen activator--role of fibrin degradation products.

In the presence of an excess of streptokinase (SK) the amidolytic activity of the plasminogen-SK complex on chromogenic substrates is 12% lower in serum than in the corresponding plasma. However, in subjects in whom venous stasis lead to a shortening of the euglobulin lysis time to less than 60 min (high responders), the amidolytic activity of the plasminogen-SK complex in serum was 60% higher than in the corresponding plasma. Attempts to find alterations of the plasminogen molecule itself which would account for the enhanced activity in high responder serum were negative.

[Rationalization of urine analysis while maintaining diagnostic accuracy (author's transl)].

Screening 720 morning urinary samples for WBC, RBC and protein by test-strip, the number of subsequent microscopic examinations of urinary sediment was reduced to about half, without missing any significant number of clinically significant findings (4.4%). On the other hand, a large number (21.

Partial myeloperoxidase deficiency.

Neutrophil myeloperoxidase (MPO) activity was analyzed by a semi-quantitative cytochemical method in 268 subjects divided into several groups. 17 subjects with significantly reduced MPO activity were found: 11 of 23 in the preleukemia group, 2/14 AMLs, 1/20 myeloproliferative syndrome, 1/7 carcinoma with bone marrow metastases, 1/33 diabetes mellitus and 1/50 normals. Only in the preleukemia group, was MPO significantly reduced in comparison to the normal group (p less than 0.

Lasting Hb F reactivation and Hb A2 reduction induced by the treatment of Hodgkin's disease in a woman heterozygous for beta-thalassemia and the Swiss type of the heterocellular hereditary persistence of Hb F.

A remarkable augmentation of Hb F and a reduction of Hb A2 were observed in a Sicilian woman during and after a course of treatment for Hodgkin's disease. An inverse correlation between the proportion of Hb F and Hb A2 was found over an 8-year period, as well as in populations of red blood cells fractionated by density gradient. She exhibited two genetic defects, the Swiss type of heterocellular hereditary persistence of fetal hemoglobin and a beta-thalassemia trait, which were confirmed by the study of the hemoglobin synthesis and by a family study.

[Fenclofenac in the treatment of rheumatoid arthritis (author's transl)].

The effectiveness of fenclofenac in the treatment of rheumatoid arthritis was compared in a crossover double-blind study of 30 patients with that of indometacin over a period of two weeks. The therapeutic effectiveness of fenclofenac, at a daily dose of 900 mg, was comparable to that of indometacin, at a daily dose of 100 mg. Side effects were less common with fenclofenac than indometacin, especially with respect to gastro-intestinal ones.

[Sarcomas of the uterus: morphological criteria and clinical course (author's transl)].

Sixty-nine cases of uterine sarcoma were reviewed histologically withhh respect to their grade of malignancy. Mitotic activity is the most important criterion of malignancy. A histological grading was performed on the basis of mitotic counts per high power field.

Prevention of venous thromboembolism after total knee replacement by high-dose aspirin or intermittent calf and thigh compression.

A prospective study of patients undergoing total knee replacement was carried out by using a combination of 125I-fibrinogen scanning and phlebography, and showed a high incidence of venous thromboembolic disease (TE). Ventilation-perfusion lung scanning was performed to detect pulmonary emboli in most patients. High doses of aspirin and an intermittent low-pressure pneumatic compression device (IPCD) were effective, even in women, in preventing TE.

[Acquired von Willebrand's syndrome associated with malignant lymphoma].

The sudden development of multiple bleeding episodes in a 63-year-old patient with malignant lymphoma was shown to be due to the presence of an acquired von Willebrand syndrome, characterized by a prolonged bleeding time and low levels of the factors VIII: C, VIIR:Ag and VIII:Rcof. Crossed immunoelectrophoresis demonstrated diminution of the factor VIII portion with least anodic mobility. Mixing experiments of the patient's and normal plasma revealed a weak (T/2: 4.

The hemostatic mechanism after open-heart surgery. III. Correlation between the appearance of an abnormal protein demonstrated by gel electrophoresis and of an inhibitor of the extrinsic coagulation system (PEC).

A prospective study in 13 patients undergoing open-heart surgery with extracorporeal circulation revealed a marked decrease of the mean one-stage prothrombin time activity from 88% to 54% (p less than 0.005) but lesser decreases of factors I, II, V, VII and X. This apparent discrepancy was due to the appearance of an inhibitor of the extrinsic coagulation system, termed PEC (Protein after Extracorporeal Circulation).

[MK-231 (Sulindac) in the treatment of rheumatoid arthritis (author's transl)].

MK-231 (Sulindac), 200-400 mg daily, was given to 25 patients with rheumatoid arthritis. The therapeutic response was good and there were no side effects at all. The drug should be used more frequently than heretofore in the drug treatment of symptoms of rheumatoid arthritis.

Purification and properties of a plasminogen activator from pig heart.

An improved procedure is described for the purification of plasminogen activator from pig heart. The initial purification steps were similar to these described previously (Bachmann, F., Fletcher, A.

[Intermittent pneumatic compression of leg and thigh: a new successful method for the prevention of postoperative thrombosis].

In a prospective study, 54 patients undergoing joint-replacement operations were randomized into a control and a treatment group. In the treatment group low pressure intermittent compression (Phlebo-Dynastat) to calves and thighs was started on the day of operation and continued until patients were fully mobilized. In 34 evaluable patients undergoing total hip arthroplasty the incidence of deep vein thrombosis (DVT) as determined by venography was 43% in the control group and 22% in the treatment group (p = 0.

Complications following total knee replacement.

Forty-two months follow-up examinations on 30 total knee arthroplasties revealed the following significant complications: phlebothrombosis, 13 knees (46%); pulmonary embolism 3 patients (11%); asymptomatic loosening, 8 knees (11.4%); symptomatic loosening, 3 knees (4.8%); superficial infections, 4 knees (5.

Thromboembolic disease in patients undergoing total knee replacement.

In a prospective study fo the incidence of deep-vein thrombosis in thirty patients undergoing total knee replacement, all patients had clinical examinations and 125I fibrinogen scanning, while those suspected of having deep venous thrombosis also had confirmatory venography. Sixteen (53 per cent) of the thirty patients had thromboembolic disease; nine had thrombi only in the limb operated on; four had bilateral deep venous thrombi; and three had pulmonary embolism. In nine patients who took aspirin regularly the incidence of thromboembolism was 11 per cent, while in the eight who did not take aspirin or any other antiplatelet drug the incidence was 88 per cent, a difference which was highly significant (p = 0.

[Proceedings: Hypercoagulability and compensated intravascular coagulation in chronic kidney insufficiency and after kidney transplantation].

Seven blood coagulation tests which may indicate a state of hypercoagulability or of chronic intravascular coagulation were assayed in 106 blood samples from 50 patients with chronic renal insufficiency or after renal transplantation. The following abnormal results were obtained: increased titer of fibrin(ogen) degradation products in 60%, abnormal fibrinogen immunoelectrophoresis in 49%, shortened partial thromboplastin time and whole blood clotting time in 45 and 37% respectively, prolonged thrombin time in 34%, increased cryofibrinogen level in 21% and positive protamine sulfate gelation test in 11%. The greatest number of abnormalities was found during the first week after transplantation and during transplant rejection, and the smallest in patients with stable transplant who were anticoagulated with warfarin.