Complement fixation reaction in toxoplasmosis

In toxoplasmosis serodiagnosis the complement fixation reaction (CF) is barely sensitive and specific and supplies results below the general standard levels of this technique. The reasons for this deficiency are discussed and detected in the preparation modalities of the toxoplasma antigens. Two diagnostic antigens are prepared and evaluated; the former, a suspension of whole toxoplasma (WT) the latter a total extract of toxoplasma (TET). The antigens are characterized by the preparative process, culture host and the extractive technique with a modified ultrasonic disintegrator. The antigens are used in the CF reaction, performed with the modified LBCF method, with a 100% hemolysis reading (H 100). The LBCF-H 100 reaction with WT and TET antigens is evaluated parellely to the indirect immunofluorescence reaction (IF) and dye test (DT) on 2514 human sera from cases os suspected toxoplasmosis and pregnant women. The analysis of the serological results pointed out that the LBCF-H 100 reaction performed with WT antigen, shows a sensitivity and specificity equivalent to that of the DT. The LBCF-H 100 reaction with TET antigen extends the range of the antibodies detectable with WT antigen. The optimal serological combination to identify the highest number of seropositive cases of toxplasma infection is given by LBCF-TET and IF reactions.

Polymorphic pemphigoid

We describe 20 patients with a chronic polymorphic eruption; they shared clinical, histopathological, and therapeutic features of both dermatitis herpetiformis and bullous pemphigoid (BP). In 14 of these 20 cases, direct and indirect immunofluorescence studies corresponded to BP. The remaining six patients showed IgA deposits in a linear pattern at the basement membrane zone, and two of these six showed IgA pemphigoid antibodies in their sera as well. No significant clinical and histological differences were detected in the patients, in connection with the immunological findings. Furthermore, one patient's condition, which was studied by repeated immunofluorescence examinations, changed from a linear IgA pattern and a negative indirect test to a linear IgG pattern and a positive reaction for IgG pemphigoid antibodies. We concluded that these cases constitute a polymorphic variant of BP.

Clinical and histological kidney involvement in human kala-azar

A 19-year-old women developed prolonged fever, weight loss, hepatosplenomegaly, anemia, leukopenia, and hyperglobulinemia. Appropriate tests indicated that she had visceral leishmaniasis (kala-azar). Urinalysis demonstrated significant proteinuria and microhematuria with the presence of red cell casts. A kidney biopsy was performed. Light microscopy showed a slight mesangial thickening and segmental mesangial proliferation. Immunofluorescence demonstrated deposits of immunoglobulins A and M, complement, and fibrinogen. Electron microscopy showed subendothelial and intramembranous deposits. After treatment with N-methylglucamine antimonate the proteinuria and microhematuria disappeared and the patient recovered uneventfully.

Medical therapy of cerebral ischemia. Vasoactive and eumetabolic therapy

After briefly evaluating the contraindications and indications of vasoactive and eumetabolic therapy of cerebral ischemia, the paper considers the main drugs at present in use in therapy of the syndrome induced by diffused cerebral arteriosclerosis. Among the drugs with a mainly vasoactive effect, consideration is given in particular to nifedipine, cetiedil and nicergoline, which induced not only an improvement in the subjective symptoms, but also an increase--which was notable at times--in the sphygmic amplitude of the rheoencephalogram. Where drugs with a mainly eumetabolic action are concerned, xanthinol nicotinate, vincamine and (-)eburnamonine are discussed. The latter, in particular, proved effective in improving intellective recovery and mediate and deferred memory, accompanied by a fair increase in the sphygmic speed and amplitude on the rheoencephalogram.

Effects of ketanserin on blood pressure, peripheral circulation and haemocoagulative parameters in essential hypertensives with or without arteriosclerosis obliterans of the lower limbs

Ketanserin is a new strong antiserotoninergic drug that, unlike the previous ones, is selective for 5-hydroxytryptamine receptors. This drug has been employed successfully in the treatment of arterial hypertension and of some peripheral vascular diseases. The authors are carrying out a trial on medium term treatment with ketanserin (K) or propranolol (P) in comparison with placebo, to evaluate their effects on blood pressure, haemocoagulative parameters and peripheral circulation. The trial is a double-blind cross-over random trial on subjects with mild or moderate hypertension. Until now 13 patients have ended the study; six of them are suffering from arteriosclerosis obliterans of the lower limbs at 1st or 2nd stage according to Fontaine. Both propranolol and ketanserin significantly reduced the blood pressure, although the decrease in systolic blood pressure was more evident after propranolol. Heart rate diminished significantly only after propranolol administration. The noninvasive, intermittent (every 30 min) monitoring of blood pressure showed a significant 24-hour reduction of blood pressure after administration of propranolol or ketanserin without significant changes of circadian behaviour of the blood pressure. After administration of ketanserin a slight improvement in peripheral circulation was demonstrated, evaluated by using strain-gauge plethysmography. As regards the results obtained for platelet function and other haemocoagulative parameters examined, adenosine diphosphate-induced platelet aggregation, adenosine diphosphate slope, collagen lag period, antithrombin III biological activity, and serum fibrinogen did not show noticeable modifications after treatment, while beta-thromboglobulin levels decreased slightly after ketanserin administration.