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AIM: To reveal platelet functional changes manifesting as abnormal rate of platelet aggregation in patients with acute cerebral circulatory disorders (ischemic stroke, transient ischemic attack), to evaluate the effect of homocysteine (Hc) on platelet aggregation, depending on the degree of cerebral blood flow disturbances, patients' gender and age, and to estimate the diagnostic value of their associations. SUBJECTS AND METHODS: 50 patients aged 33 to 98 years (mean age, 63.7 +/- 2.1 years; 20 men and 30 women) with acute cerebral circulatory disorders (18 with transient ischemic attack and 32 with ischemic stroke) were examined. The diagnosis was verified by the results of computed tomography and other clinical examinations. Adenosine diphosphate-, epinephrine-, and collagen-induced platelet aggregation was assessed in platelet-rich plasma; serum Hc concentrations were also studied. RESULTS: Comparison of platelet aggregation and Hc concentration revealed a statistically significant correlation between platelet aggregation with collagen and elevated Hc levels (r = 0.376; p < 0.01). There was no statistically significant correlation with other inducers. Blood Hc concentrations increased with advancing age (r = 0.357; p = 0.015). No statistically significant correlation was found between age and platelet aggregation (p > 0.05). The levels of Hc were statistically significantly higher as cerebral circulatory disorders progressed. CONCLUSION: There was a statistically significantly relationship between collagen-induced platelet aggregation and Hc concentration. The Hc levels were statistically significantly related to the severity of cerebral circulatory disorders and age.

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A new methodology: the method and technical means for studying the coagulation of blood and the acoustic properties of other biological fluids (ultrasound coagulography) was developed. The complex of devices is based on the principle of measuring the rate of ultrasound in a medium studied by means of the impulse method. Arguments for the applicability of the method for studying the process of blood coagulation are adduced, special acoustic chambers were designed, and algorithms and computer programs for immediate processing of the data were developed. The field of application is biology and medicine: studies of the acoustic properties of biological fluids (e.g., blood coagulation), rheological properties, and viscosity of the object for the diagnosis of some diseases. The results of clinical assays of blood coagulation in healthy persons are presented.

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A study of CPK isoenzyme spectrum in acute myocardial infarction, using electrophoresis and isoelectric focusing techniques, demonstrated the possibility of an earlier detection of myocardial necrosis on the basis of changes in CPK MM subzones, rather than the CPK MB test. This approach does not increase the specificity of isoenzyme CPK assays, but improves the reliability of biochemical assessment of the time of onset and depth of myocardial affection.

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An ultrasonic interferometer has been used to study the process of fibrin clot lysis according to the decrease in the rate of propagation of an ultrasonic wave in the latter. A significant decrease in the sound fall rate on adding epsilon-aminocaproic and trans-4-aminomethylcyclohexanecarbonic acids to the system indicates their activity inhibiting fibrinolysis. N-nicotinoyl derivatives of this compounds possess less pronounced antiplasmin activity.

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The paper provides representative data on the indices of lipid metabolism and the activity of cardiospecific (lactate dehydrogenase--LDH, creatine phosphokinase--CPK) in patients with diabetes mellitus, Type I and II, (male inhabitants of Kaunas aged 40 to 59) which were compared with similar data on control persons randomly selected from the population during epidemiological surveys. They covered 85.3% of all detected and followed-up patients of this age with diabetes mellitus. Total and HDL cholesterol and triglycerides were determined by the enzymatic methods, LDH by the spectrophotometric method and CPK by the fluorometric method. It was shown that patients with Type II diabetes mellitus (insulin-independent) in addition to a raised concentration of glucose on an empty stomach were characterized by an increase in the level of cholesterol up to 6.34-0.51 mmol/l and especially triglycerides up to 5.98-1.78 mmol/l as compared to the control values (5.39-0.11 and 1.48-0.12 mmol, respectively). The concentration of HDL cholesterol and CPK and LDH activity in the patients did not differ from the control level.

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The average concentration of malondialdehyde (MDA) in diabetes mellitus males was not higher than in the age-matched controls whereas alpha-tocopherol levels in diabetes mellitus significantly exceeded the normal disregarding the pattern of the disease and closely correlated with the concentration of triglycerides. Lower concentration of retinol in comparison with the control group was observed in the patients. Relative levels of alpha-tocopherol/MDA and retinol/MDA were age-dependent: in patients under 30 and above 50 the levels of alpha-tocopherol/MDA were significantly higher than in their normal age-matches while in 31-50-old ones no elevation in the above mentioned levels was observed. Retinol/MDA levels were significantly lower in the latter age group. The data are indicative of decreased levels of alpha-tocopherol and retinol in diabetes mellitus patients aged 31-50.

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Vitamin E, cholesterol and triglycerides were measured in blood sera of 167 patients (40-59 years old) with angina pectoris. An increase in concentration of vitamin E was observed only in patients with hyperlipidemia, whereas the vitamin content was similar to the control values in patients with hypertension, in smokers and in the persons free of risk factor. Distinct correlation was found only between vitamin E and the triglycerides contents (r = 0.42). These data corresponded to the results of a previous examination of 224 men and 435 women without ischemic heart disease: in men the content of vitamin E correlated with triglycerides (r = 0.50) and in women--with cholesterol (r = 0.34). The ratio of vitamin E/triglycerides appears to be a more adequate index of the vitamin content in men.

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In the framework of the programme on the multi-factorial prophylaxis of myocardial infarction and cerebral stroke in males aged 40-59 years, the authors studied the relationship between type A behaviour pattern as a risk factor for coronary heart disease and somatic and history indices. A study of 5698 men showed that group A was characterized by a greater percentage of subjects with elevated cholesterol and triglyceride levels and with hypercoagulatory changes in the hemostatic system. Group A subjects more frequently complained of chest pain and had a larger proportion of relatives with cardiovascular disease.

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The effect of risk factors contributing to coronary heart disease (CHD) on the trace element levels in the blood plasma, blood red cells and hair was studied in 250 CHD patients and in the control group. CHD without risk factors was associated with significantly higher plasma levels of zinc, manganese and copper, while copper concentrations in the hair were significantly lower than in control. The positive correlation between the manganese content in the red cells and hair in the control group was not true for the CHD patients. Manganese levels were found to be directly correlated with low density lipoproteins and inversely correlated with high density lipoproteins. Plasma zinc levels and erythrocyte calcium concentrations in CHD patients with risk factors were significantly lower than in CHD patients without risk factors.

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The kinetics of and equation for ionized calcium release from human platelet suspension under the action of thrombin are described. A possibility is shown of utilization of ion-selective electrodes in exploring platelet release reaction with a purpose of elucidation of the reaction mechanism and platelet behavior with a variety of abnormal conditions and drugs.

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In 222 men aged 40-59 with ischaemic heart disease an epidemiological investigation established the influence of risk factors (hypercholesterolaemia, hypertension, overweight and smoking) on the vasculo-thrombocytic haemostasis. It was found that the similarity of action of risk factors in increased with their combinations. The authors found enhancement of the contact activity of the blood, the sensitivity of the thrombocytes to aggregants, the reaction of isolation of platelets, the content of the pathological forms of fibrin and fibrinogen, the acceleration of coagulation and the slowing down of retraction. These shifts are considered as an activation of the coagulation system in circulation.

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