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Parameters of fibrinolysis, including plasminogen, alpha 2 plasmin-inhibitor (alpha 2 PI), tissue-type plasminogen activator (t-PA) and plasminogen activator inhibitor-1 (PAI-1) antigens, and fibrinogen were assayed in 53 patients (28 women and 27 men; mean age: 64 years, age range: 32-87 years) with non-insulin-dependent diabetes mellitus (NIDDM). The control group was similarly aged (mean age: 60.4 years, age range: 38-81). The levels of t-PA and t-PA/PAI-1 ratio of the diabetic group (mean +/- SD; 9.8 +/- 4.3 ng/ml, 0.94 +/- 0.47, respectively) were significantly higher than that of the control group (5.5 +/- 2.5 ng/ml, 0.51 +/- 0.23, respectively). The increased levels of t-PA antigen and t-PA/PAI-1 ratio in diabetics mean that free t-PA has been released. However, there was no significant difference in the level of PAI-1 between the diabetic group (12.9 +/- 6.4 ng/ml) and the control group (12.1 +/- 5.6 ng/ml). Levels of fibrinogen, plasminogen and alpha 2 PI in plasma were not different in the two groups. Duration of the disease, levels of glycosylated hemoglobin, differences in treatment and presense of diabetic nephropathy or retinopathy did not affect the fibrinolytic parameters. The levels of fibrinogen was higher in those with nephropathy than in the diabetics without nephropathy and retinopathy (p less than 0.05). There were no significant differences in the levels of t-PA, t-PA/PAI-1 ratio and PAI-1 between younger (less than 65 years) and older (65 years or more) subjects, in either the control or diabetic groups.(ABSTRACT TRUNCATED AT 250 WORDS)

A 68-year old male was referred to our hospital for the treatment of pulmonary tuberculosis. Chest X-ray film revealed left diffuse pleural thickening. Treatment of pulmonary tuberculosis was started with streptomycin, isoniazid and rifampicin. Three months later, although smear and culture of the patient's sputum became negative for M. tuberculosis, he started to complain of dyspnea on exercise and left chest pain. Biopsies of a pleural tumor and a left subclavicular lymph node were done and a diagnosis of invasive thymoma with pleural dissemination and bone and lymph node metastasis was established. After three cycles of combination chemotherapy consisting of cyclophosphamide, adriamycin and vincristine, left chest pain disappeared and pleural thickening showed shrinkage.

The clinical and angiographic features of a patient with right aortic arch and isolation of the left subclavian artery from the aorta were described. This young male patient showed no symptoms and signs of the insufficiency of both brain and left-arm blood flow, in spite of the congenital left subclavian steal.