Luigi Taddeini

Heparin‐induced thrombocytopenia in patients with cerebrovascular ischemic disease

We studied 137 patients who were treated with heparin for cerebral infarction (73), partially reversible ischemic neurologic deficit (22), or transient ischemic attack (42). Platelet counts were performed before therapy, twice weekly, and at cessation of therapy. Platelets decreased in 118 patients (86%). In 21 (15.3%), platelets dropped ≥40%; 9 of 14 new ischemic events and three of six deaths occurred in this group of patients. Because there was a significant association between poor outcome and platelet drop ≥40% (p < 0.001), we believe that platelets should be monitored frequently when patients are treated with heparin for ischemic cerebrovascular disease.

Hypercholesterolemia in experimental and human hepatic porphyria

Administration of the porphyria-inducing chemicals allylisopropylacetamide (AIA) and 3,5-dicarbethoxy-1, 4-dihydrocollidine (DDC) to rabbits, results in the development of marked elevation of serum cholesterol, total lipids and phospholipids. The liver total lipids, cholesterol lipid phosphorus and water concentrations remain unchanged, but the organ becomes greatly enlarged, reflecting active synthesis of new protoplasm. It is suggested that these compounds affect the lipoprotein transport of serum cholesterol in a manner inducing sequestration of the synthesized cholesterol in the plasma and preventing the accumulation of cholesterol in the liver cells hence, the activation of the hepatic feed-back control for cholesterol synthesis. The possibility also exists that AIA and DDC enhances the production of one or more enzymes of cholesterol synthesis, in a way analogous to what Granick and Urata have demonstrated to occur for the enzyme δ-aminolevulinic acid synthetase of the porphyrin synthetic pathway. The chemicals, in fact, may have their primary effect on the genetic control of the rate of synthesis of different proteins by the liver. A review of the records of 51 patients with hepatic porphyria, in whom serum cholesterol determinations were recorded, reveals that hypercholesterolemia, although inconstant, is of common occurrence in the “acute intermittent” and “mixed” forms of the disease.

Hematin therapy in late onset congenital erythropoietic porphyria

Hematin therapy is established in the treatment of the hepatic porphyrias, repressing 5-aminolaevulinic acid (ALA) synthase, and thereby decreasing porphyrin production (Pierach, 19 82). One previous study reported hematin-mediated reduction in porphyrin excretion in a patient with congenital erythropoietic porphyria (CEP) first manifested at birth (Watson et al, 1974). We therefore attempted hematin therapy in an adult onset CEP patient. This is the sixth report of adult onset of this disorder (Deybach et al, 1981). The patient was a 5 1-year-old male of Eastern European descent with no family history of porphyria. He presented with a complaint of fatigue and blistering of sun-exposed skin. Laboratory evaluation revealed normal serum aspartate aminotransferase (GOT), alanine aminotransferase (GPT) alkaline phosphatase (AP), decreased haemoglobin (10.6 g/ dl) and elevated urinary coproporphyrin (COP) (3.46 mg/24

Active rosette-forming T cells in the elderly.

ABSTRACT: The numbers and percentages of active rosette‐forming T cells were measured in two age groups, to assess the effects of aging. The study included 21 healthy persons in the 20–40 age group and 25 persons without major disease in the 60–85 age group. In the younger subjects the number of rosette‐forming cells (RFC) averaged 1430 ± 463/cu mm (mean and S.D.), a count not significantly different from that in the older subjects (1443 ± 398/cu mm). Likewise, the active RFC count in the 20–40 age group (526 ± 185/cu mm) and that in the IJO‐85 age group (558 ± 197/cu mm) were not significantly different. There was no difference for the percentage total RFC (young 78 ± 4%, elderly 78 ± 6%) or the percentage active RFC (young 29 ± 7%, elderly 30 ± 6%). For the total lymphocyte count or the B lymphocyte count, there was no difference between the two groups of subjects. It is concluded that T lymphocytes, measured as total and active rosette‐forming cells, are not decreased in healthy older persons.

Abatement of sézary syndrome lesions following treatment with acyclovir

Sézary syndrome is a malignant form of cutaneous T cell lymphoma in which patients characteristically present with generalized pruritic erythroderma and large numbers of circulating Sézary cells in the peripheral blood. Several previous studies have proposed that viruses may play a role in the cause of cutaneous T cell lymphoma. This report describes a 68-year-old man with Sézary syndrome who received a seven-day course of intravenous acyclovir for treatment of disseminated herpes zoster and was noted to have almost complete disappearance of generalized erythroderma and pruritus. Since acyclovir has been shown to selectively inhibit viral DNA polymerase, the observed clinical response is strong evidence that viruses play a role in the cause of cutaneous T cell lymphoma. Mechanisms that could explain the observed response are discussed, and further studies on the utility of antiviral agents for treatment of cutaneous T cell lymphoma and on possible inhibitory effects of acyclovir on retroviruses are recommended.

Estriol determination in pregnancy urine by gas chromatography

Abstract Determination of free estriol in pregnancy urine by gas chromatography is described and data are presented to support the accuracy of this procedure as compared to the gas chromatography of estriol triacetate. Data from infrared and nuclear magnetic resonance spectroscopy and from mass spectrometric studies on estriol and estriol triacetate obtained after passage through gas Chromatographic columns indicate no structure modifications in these compounds.

Cholesterol synthesis in rat intestine: effect of fasting and of porphyrogenic chemical allylisopropylacetamide

Abstract (a) Administration of allylisopropylacetamide to fasting rats stimulates intestinal sterol synthesis as measured by incorporation of 14 C from [1- 14 C]sodium acetate. Stimulatory effect of AIA is confined to the acetate to mevalonate segment of cholesterol biosynthetic pathway. (b) It is also shown that the suppression of sterol synthesis in the ileum of intact rats produced by fasting is of the same order of magnitude as that observed for liver sterol synthesis due to fasting.