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A case of severe haemolytic disease of the fetus due to six rare alloantibodies is described. In a pregnant women at 23 weeks gestation after the finding of a positive indirect Coombs test maternal antibodies have been precisely identified and titrated: anti-I: 1/23, anti-c: 1/64, anti-S: 1/16, anti-Fya: 1/128, anti-M: 1/64, anti-Jka: 1/32000. Fetal blood group, free and red blood cell adherent antibodies have been investigated on fetal blood samples obtained by means of cord centesis. A compatible donor has been found. Severe fetal anemia has been corrected by ultrasound guided intrauterine transfusions (one abdominal and two intravascular transfusions) with positive outcome of the pregnancy.

Increased levels of Factor VIII are usually re ported in diabets mellitus, even if contradictory relationships with the vascular complications have been observed,due to unselection of patients. We have measu red Factor VIIIR:Ag and Factor VIII C(two stages method) in 60 insulin dependent diabetics (IDD), aged between 7 and 78, compared to 25 sex and age matched normal controls (NC).The presence of retinopathy (r) or macroangiopathy (m) was assessed by fIuoroangiography and EKG plus oscillography, respectively.No significant correlations were found between FVIIIR:Ag, FVIIIC and concomitant blood glucose, glycosylated hemoglobin, GH, and the duration of diabetes. A progressive increase in FVIIIR:Ag according to the extent of the vascular damage is evident. An enhancement of the level of FVIIIC, greater than that of FV IIIR:Ag, index of enhanced thrombin production, is already present even in absence of vascular damage in IDD, being more pronounced in patients with vascuIar complications.

Four infants with Haemolytic-Uremic Syndrome (HUS) were investigated sequentially for F VIII R: Ag/F VIII: C ratio, F VIII: C (one-stage method)/ F VIII: C (two-stage method) ratio and beta-thromboglobulin levels. There is a close relationship between the patterns of FVIII R: Ag/F VIII: C ratio and beta-thromboglobulin, as well as between these parameters and the course of the disease. High values of F VIII R: Ag/F VIII: C ratio and beta-thromboglobulin levels were found in the acute phase of the disease and normal values during remission (after treatment with plasma and anti-aggregating agents). Moreover, normal values of F VIII: C (one-stage method)/F VIII: C (two-stage method) ratio (indicating enhanced thrombin production) were always found.These data confirm the prominent role of endothelial damage and subsequent platelets aggregation in the pathogenesis of HUS in children.

Authors analyses most recent concepts on pathogenesis of trophic changes in post-phlebitic syndrome: particularly they consider the role of extravascular fibrin deposition, in patients with depressed plasmatic fibrinolytic activity. In this patients, according to recent reports, it seems useful a fibrinolytic therapy to improve trophic conditions of the post-phlebitic limb, particularly in respect to dermatoliposclerosis. Authors refer their experience on a double blind study with stanozolol an anabolizing steroid with fibrinolytic activity: in all treated patients good clinical results were obtained; however no enhancement of plasmatic fibrinolytic activity was demonstrated.

A double blind study was carried out comparing 10-methoxy-1,6-dimethyl-ergoline-8 beta-methanol-(5-bromonicotinate) (nicergoline, Sermion) and placebo in 60 thromboembolic patients on long-term controlled acenocoumarol treatment. Aim of the trial was to assess the hypothesis of an interaction on both the coagulatory parameters and the clinical findings. No significant variations of the acenocoumarol daily dose were required in nicergoline treated group and no interaction was demonstrated in coagulatory parameters. Prothrombin activity and thrombo-test evaluated fortnightly were not statistically different in nicergoline and placebo groups while the platelet antiaggregating activity of nicergoline was confirmed after a three months' treatment. Bleeding time was unaffected. Minor differences in clinical findings were observed in the two groups.

Seven children, 2-5 years old, with HUS, were investigated sequentially for plasma BTG, PF4/FVIII complex. Plasma BTG is reported both as plasma concentration and as BTG/Platelets/μl ratio. Recent data suggest that BTG and PF4 enhance microangiopathic involvment of HUS, by inhibition of prostacyclin availability from vessel walls (BTG) and by bind ing of sulphated GAGs on the endothelial cells (PF4).High values of FVIII R: Ag/FVIII:C ratio are an index of endothelial damage. Six children were treated with plasma and antiaggregating agents and one child was treated only with antiaggregating agents. A close relationship between FVIII R:Ag/FVIII:C ratio and BTG and PF4 levels was found. These laboratory findings were in agreement with the clinical course: high values of FVIII R:Ag/FVIII:C ratio, of BTG and PF4 levels were found in the acute phase of the disease and normal values during remission. All patients had a favourable course of the disease and have now normal renal function. We think that plasma infusion may normalize the platelets/vesseI wall interaction.

Many experimental investigations have shown that labyrinthine fluids play a basic role in the physiology of the inner ear. Modifications of perilymphatic fluids have been demonstrated in perceptive deafness (otosclerosis, Ménière's disease, tympanolabyrinthosclerosis). Vasoactive agents fail to markedly affect the exchange between labyrinthine fluids, so that perceptive syndromes are generally regarded as unresponsive to treatment. Several studies have shown the effectiveness of 10-methoxy-1,6-diemthyl-ergoline-8 beta-methanol-(5-bromonicotinate) (nicergoline, Sermion) in various conditions of the inner ear. In this investigation, 30 patients with presbyacusis were treated with 30 mg/day p.o. for 30 days. Speech audiometric curves were improved in 4 out of 18 cases of physiological presbyacusis and in 6 out of 12 cases of accelerated presbyacusis. These results are very interesting, since few effective therapies are available to treat these conditions.