I THE FIBRINOLYTIC SYSTEM:
A review of the literature is presented together with an
evaluation of the present methods for the measurement of its
The methods adopted in the course of this study include (l)
the heated fibrin plate for the estimation of plasmin, (2) the
plasma euglobulin lysis time for the determination of the overall
"fibrinolytic activity" and/or the activator, (3) a caseinolytic
method for the measurement of plasminogen and (A) an assay of
(a) A study of the fibrinolytic system in some congenital and
hereditary haemorrhagic disorders was carried out in order to
evaluate the theory that, in vivo, the coagulation and the fibrinolytic
processes normally exist in a state of dynamic equilibrium. It
was thought that if this theory held true, then a change in one of the
components of the equilibrium state, (for example a delayed or dim¬
inished coagulation mechanism as in certain haemorrhagic disorders)
would lead to a balancing diminution in the other component and hence
to a decrease in fibrinolytic activity. It was found that the
fibrinolytic system was normal in these states and that its activation
during and following operative procedures,followed a normal sequence.
These findings may cast some doubt on the theory of physiological
(b) The changes in the fibrinolytic system observed in eighteen
patients with cardiac disease undergoing open-heart surgery on cardio-pulmonary bypass with hypothermia were studied. This revealed that
excessive fibrinolysis is inevitable at some time during the procedure,
but need not, however, cause any serious consequences as shown
in the patients studied. Plasminogen and fibrinogen diminution
was noted, while changes in the aatifibrinolysins were less clear.
II A COMPARISON OF HAPTOGLOBIN PHENOTYPES IN
HAEMOPHILICS AND NORMAL PERSONS IN SCOTLAND:
Haptoglobin phenotyping by starch-gel electrophoresis was
done in thirty-eight patients with haemophilia and other congenital
and hereditary haemorrhagic disorders, and in one hundred normal
individuals in Scotland. This study was undertaken in an
endeavour to find a genetic link for these conditions and as a
way of investigating the relation between blood groups and/or
haptoglobin types and disease states.
Haptoglobin type distribution in these conditions matched
that in the control series which, in its turn, was in accord with
that of neighbouring populations.
III PLASMA THROMBOPLASTIN GENERATION
BLOCKING ANTICOAGULANT IN HAEMOPHILIA.
GLINICO-PATHOLOGICAL STUDY OF A REFRACTORY CASE:
This investigation presented a clinical study, together with
an attempt at the characterization of and speculations on the
aetiology of an unusual form of circulating anticoagulant which
developed in a patient with classical haemophilia. The anticoagulant
in this case blocked the interaction leading to the generation of
plasma thromboplastin activity, but did not destroy factor VIII.