- Email: [email protected]
VENOUS STASIS AND FIBRINOLYSIS
95 SYSTEMIC INFECTIONS IN HEROIN ADDICTS SIR,-Assuming that Dr. Beckett is correct in his supposition last week (p. 48) that heroin effects on metabolism should be maintained during systemic infections in addicts, is there any reason to suppose that this cannot be achieved by using
methadone, which
any doctor may
prescribe ?
West Middlesex Hospital, Isleworth, Middlesex.
F. P. HALDANE.
YY SYNDROME IN AN AMERICAN NEGRO SiR,—Welch et al. have confirmed our impression that all XYY cases reported to date have been in Caucasians. This may be the result of many factors, including the possibility of a racial difference in the incidence of the XYY syndrome. We describe here the identification of a 47/XYY Negro male, apparently the first such case to be reported in a Negro. He was found during the screening of nineteen tall youngsters (thirteen Negro, six White) in a detention centre for juvenile delinquents where he was held for sexual assault. This sixteen-year-old Negro was 741/2 in. (187 cm.) tall; the lower segment measuring 411/2 in. (104 cm.) and the upper segment 33 in. (83 cm.). His arm-span was 78 in. (195 cm.) and his weight 146 lb. (66-3 kg.). He had facial acne, a feature we have observed in four out of the five XYY males we have identified. Dental casts revealed malocclusion2 on the right side and complete absence of occlusion on the left. Many of the permanent teeth were larger than the mean size reported, the lower right first molar exceeding 2 S.D. in its mesiodistal diameter. Psychological tests (Wechsler adult intelligence scale) showed a full-scale l.Q. of 83. Repeated cytogenetic studies consistently revealed a normal male buccal smear and a 47/XYY
karyotype. Further details of this case together with data on additional XYY males are in preparation. We are grateful for the financial support of the Samuel S. Fels Fund; for the cooperation of Dr. Gerald R. Clark, Dr. Nicholas Frignito, and Mr. Robert Perkins; and to Dr. Dino Angelici (University of Pittsburgh) for evaluating the dental casts.
MARY A. TELFER DAVID BAKER LUCIEN LONGTIN.
The
Elwyn Institute, Elwyn, Pennsylvania 19063, U.S.A.
VENOUS STASIS AND FIBRINOLYSIS SIR,-As pointed out by Dr. Menon (Dec. 16, p. 1304), there is much experimental evidence to indicate that the plasminogen activator appearing in blood after venous stasis originates in the veins. We should like to present the results of a small series of tests which further support this suggestion and which show that the capillaries play no active part in the process.
Fibrinolytic activity was measured in venous blood by the dilute-blood-clot-lysis (D.B.C.L.) method3 and in capillary blood by a newly developed micromodification of this test.4 In normal, unstressed individuals and in subjects in whom increased fibrinolytic activity has been induced in the general circulation by exercise, the results of these two tests correlate well. However, in a series of eight subjects in whom the fibrinolytic system was activated by venous stasis the level of plasminogen activator in the capillaries did not change, although venous blood showed increased levels (see table). In this experiment the venous return of the left arm was occluded by maintaining a pressure half-way between systolic and diastolic for five minutes with a sphygmomanometer cuff. Before releasing the pressure, blood was obtained from an antecubital vein for the standard D.B.C.L. test and simultaneously from a finger-prick for the microtest. At the same time similar 1.
Welch, J. P., Borgaonkar,
D.
S., Herr,
H. M.
Nature, Lond. 1967, 214,
500.
2. 3. 4.
D.B.C.L.-TIMES ON VENOUS AND CAPILLARY BLOOD AFTER VENOUS OCCLUSION
Kosenow, W., Pfeiffer, R. A. Lancet, 1966, i, 1375. Fearnley, G. R., Balmforth, G. V., Fearnley, E. Clin. Sci. 1957, 16, 645. Spittle, C. R., Lansdown, N., Hawkey, C. Unpublished.
collected from the right arm without venous up in duplicate. As judged by the lysis-times, the level of plasminogen activator was greater in the occluded vein of the left arm than in the non-occluded vein of the right arm. However, venous occlusion did not affect the lysis-time of clotted peripheral blood. These results therefore support the suggestion that plasminogen activator appearing in the blood during ischaemia originates in the veins and further indicate that no significant contribution is made by the capillaries.
samples
were
stasis. All
tests were set
This work was supported by a grant from the British Heart Foundation. Pathology Department, Nuffield Institute of Comparative Medicine, CHRISTINE HAWKEY The Zoological Society of London, London N.W.1.
NOEL LANSDOWN.
HYPERBLASTIC RESPONSE TO DILUTE P.H.A. IN
DOWN’S SYNDROME
SiR,—Lejeune 1 has stated, and we have felt, that lymphocytes from patients with Down’s syndrome (D.S.) seem to be easier to culture and to show more mitoses than those from normal subjects. We have therefore been encouraged to carry out the following investigation.
Peripheral lymphocytes from fourteen children with D.s. who had typical trisomy 21 in their karyotypes, and from seventeen control children were collected and cultured in vitro for three days by a modified Moorhead’s method. 106 lymphocytes in 0-5 ml. of autologous plasma were cultured in 2 ml. ofT.C. 1.
Lejeune, Z. in 9th International Cancer Congress, October, 1966, Tokyo.
TABLE I-BLASTIC RESPONSE OF PERIPHERAL LYMPHOCYTES IN VITRO TO P.H.A. IN PATIENTS WITH D.S.
methadone, which
any doctor may
prescribe ?
West Middlesex Hospital, Isleworth, Middlesex.
F. P. HALDANE.
YY SYNDROME IN AN AMERICAN NEGRO SiR,—Welch et al. have confirmed our impression that all XYY cases reported to date have been in Caucasians. This may be the result of many factors, including the possibility of a racial difference in the incidence of the XYY syndrome. We describe here the identification of a 47/XYY Negro male, apparently the first such case to be reported in a Negro. He was found during the screening of nineteen tall youngsters (thirteen Negro, six White) in a detention centre for juvenile delinquents where he was held for sexual assault. This sixteen-year-old Negro was 741/2 in. (187 cm.) tall; the lower segment measuring 411/2 in. (104 cm.) and the upper segment 33 in. (83 cm.). His arm-span was 78 in. (195 cm.) and his weight 146 lb. (66-3 kg.). He had facial acne, a feature we have observed in four out of the five XYY males we have identified. Dental casts revealed malocclusion2 on the right side and complete absence of occlusion on the left. Many of the permanent teeth were larger than the mean size reported, the lower right first molar exceeding 2 S.D. in its mesiodistal diameter. Psychological tests (Wechsler adult intelligence scale) showed a full-scale l.Q. of 83. Repeated cytogenetic studies consistently revealed a normal male buccal smear and a 47/XYY
karyotype. Further details of this case together with data on additional XYY males are in preparation. We are grateful for the financial support of the Samuel S. Fels Fund; for the cooperation of Dr. Gerald R. Clark, Dr. Nicholas Frignito, and Mr. Robert Perkins; and to Dr. Dino Angelici (University of Pittsburgh) for evaluating the dental casts.
MARY A. TELFER DAVID BAKER LUCIEN LONGTIN.
The
Elwyn Institute, Elwyn, Pennsylvania 19063, U.S.A.
VENOUS STASIS AND FIBRINOLYSIS SIR,-As pointed out by Dr. Menon (Dec. 16, p. 1304), there is much experimental evidence to indicate that the plasminogen activator appearing in blood after venous stasis originates in the veins. We should like to present the results of a small series of tests which further support this suggestion and which show that the capillaries play no active part in the process.
Fibrinolytic activity was measured in venous blood by the dilute-blood-clot-lysis (D.B.C.L.) method3 and in capillary blood by a newly developed micromodification of this test.4 In normal, unstressed individuals and in subjects in whom increased fibrinolytic activity has been induced in the general circulation by exercise, the results of these two tests correlate well. However, in a series of eight subjects in whom the fibrinolytic system was activated by venous stasis the level of plasminogen activator in the capillaries did not change, although venous blood showed increased levels (see table). In this experiment the venous return of the left arm was occluded by maintaining a pressure half-way between systolic and diastolic for five minutes with a sphygmomanometer cuff. Before releasing the pressure, blood was obtained from an antecubital vein for the standard D.B.C.L. test and simultaneously from a finger-prick for the microtest. At the same time similar 1.
Welch, J. P., Borgaonkar,
D.
S., Herr,
H. M.
Nature, Lond. 1967, 214,
500.
2. 3. 4.
D.B.C.L.-TIMES ON VENOUS AND CAPILLARY BLOOD AFTER VENOUS OCCLUSION
Kosenow, W., Pfeiffer, R. A. Lancet, 1966, i, 1375. Fearnley, G. R., Balmforth, G. V., Fearnley, E. Clin. Sci. 1957, 16, 645. Spittle, C. R., Lansdown, N., Hawkey, C. Unpublished.
collected from the right arm without venous up in duplicate. As judged by the lysis-times, the level of plasminogen activator was greater in the occluded vein of the left arm than in the non-occluded vein of the right arm. However, venous occlusion did not affect the lysis-time of clotted peripheral blood. These results therefore support the suggestion that plasminogen activator appearing in the blood during ischaemia originates in the veins and further indicate that no significant contribution is made by the capillaries.
samples
were
stasis. All
tests were set
This work was supported by a grant from the British Heart Foundation. Pathology Department, Nuffield Institute of Comparative Medicine, CHRISTINE HAWKEY The Zoological Society of London, London N.W.1.
NOEL LANSDOWN.
HYPERBLASTIC RESPONSE TO DILUTE P.H.A. IN
DOWN’S SYNDROME
SiR,—Lejeune 1 has stated, and we have felt, that lymphocytes from patients with Down’s syndrome (D.S.) seem to be easier to culture and to show more mitoses than those from normal subjects. We have therefore been encouraged to carry out the following investigation.
Peripheral lymphocytes from fourteen children with D.s. who had typical trisomy 21 in their karyotypes, and from seventeen control children were collected and cultured in vitro for three days by a modified Moorhead’s method. 106 lymphocytes in 0-5 ml. of autologous plasma were cultured in 2 ml. ofT.C. 1.
Lejeune, Z. in 9th International Cancer Congress, October, 1966, Tokyo.
TABLE I-BLASTIC RESPONSE OF PERIPHERAL LYMPHOCYTES IN VITRO TO P.H.A. IN PATIENTS WITH D.S.