bluuebunny/crossref_metadata_2025_split huggingface dataset:
Immunoglobulins of HIV positive and negative haemophiliac children treated with different concentrates
Authors: Köhler-Vajita K , Grütler L , Bidlingmaier F 
Published: June 2019

Aim of this investigation is the quantitative comparison of theimmunoglobulins G, A, M in haemophiliac children treated with different types of factor VIII concentrates.Patients and methodsSince May 1984 22 patients with haemophiliaA were investigated. Instead of the more often analysed parameterof the cellular immunity now we want to draw the attention to the immunoglobuline values, especiallyof the HIV negative group of patients treated exclusively with Haemate HS Behringwerke in comparison with other differently treated HIV positive and negative patients.Results The group of patients treated exclusively with Haemate HS Behringwerke (in solution heatsterilized) shows completely normal immunolobuline levels and a safe HIV negativity.Patients treated with conventional, later with heat treated (inlyophilized form) concentrates can be divided into HIV positive and negative groups. HIV positive heamophiliacs show pathological IgG and border line IgA and IgM values. HIV negative patients have IgG, A levels within the normal limits -but clearly higher than the Haemate group. A correlation withliver enzyme status (hepatitis B, NANB) could not be found.
ANTIBODIES TO HUMAN IMMUNODEFICIENCY VIRUS (HIV) IN HAEMOPHILIA AND VON WILLEBRAND'S DISEASE AND IN THEIR HETEROSEXUAL PARTNERS
Authors: Nosari A M , Barbarnano L , Caimi T M , Strinchini A , Muti G , Branbo B , decataldo F , Baudo F 
Published: June 2019

The prevalence of antibodies to HIV in Haemophiliacs varies in different series: the latest figures (19636) are 12-94%, the lower values referring to patients with the mild form or treated by blood bank products. Serum conversion dates back to 1978 in USA and to 1980 in Europe. Antibodies to HIV in heterosexual partners are reported in percentage from 0-24%. Our population of patients:ALL VON WILLEBRANND'disease-patients were treated by crycoprecipitates and are all antibodies to HIV negative lymphocyte subsets: CD4 × 109/1 (x) 863; CD4/CD8(x)1.148.10 hetrosexual partners of anti HIV positive heamophiliacs were tested:Stored samples of prozen plasam of 19 haemophiliacs were also tested:p patients were found anti HIV positive ;1 in 1980;2 in 1982;2 in 1994.
AIDS IN A COHORT OF HEMOPHILIACS
Authors: Kamradt T , Niese D , Brackmann H J , Musch E , Steinbeck A 
Published: June 2019

780 hemophiliacs are treated at the Institut fiir experimentelle Hamatologie, University of Bonn. Of these, 61% (475 patients) are infected with HIV.From 1982 through January 1987, 15 of the HIV-infected hemophiliacs developed AIDS. It seems alarming, that 9 patients had theirprimary manifestations of AIDS in 1986 and one in January 1987. The primary manifestations of AIDS were:We describe here the clinical features of the hemophilic AIDS patients and discuss the differences in clinical manifestation and prognosis compared to AIDS-patients belonging to other risk groups.These data are discussed on the background of other clinical, immunological and epidemiological findings in our large cohort of HIV-infected hemophiliacs.
EXPERIMENTAL STUDIES CONCERNING THE VIRUS SAFETY OF PASTEURIZED FIBRINOGEN
Authors: Heimburger N , Fuhge P , Hilfenhaus J , Kumpe G , Karges H E 
Published: June 2019

Fibrinogen is available for substitution in afibrinogenaemic patientssince about 4 decades. However, it soon turned out that those concentrates bear a high risk of transmitting serum hepatitis. Over many years it was not possible to produce safe concentrates of fibrinogen. Hence, the therapy with this protein was limited to vital indications. We have now succeeded to stabilize fibrinogen inaqueous solution for pasteurization over 10 to 20 hours at 60°C.The efficacy of the virus inactivation was tested using various animal viruses. Following results were obtained.Tests in chimpanzees for hepatitis B safety revealed that this procedure inactivates and eliminates 105.2 CID50 of hepatitis B virus; HIV experiments are going on.By immunizing rabbits with the pasteurized fibrinogen and absorption of the antiserum obtained with the unpasteurized product, an exposition of neoantigens during heating in aqueous solution could be excluded. This result could be further confirmed using passive cutaneous anaphylaxis.The coagulability of the pasteurized fibrinogen is unchanged, compared to not pasteurized material. It iseasily soluble and can be used for both, i. v. infusion and as a tissue adhesive. The clinical tolerability is very good.
PROPERTIES AND VIRUS SAFETY OF A PASTEURIZED ANTITHROMBINIII-CONCENTRATE
Authors: Karges H E , Fuhge P , Heimburger N 
Published: June 2019

The possible occurance of up to now unknown human pathogenic viruses makes it necessary to reconsider thestrategies for the preparation of each plasma protein concentrate used for substitution therapy. Even up to now safe products may be contaminated by infectious particles in the near future. Hence, each procedure for the preparation of such proteins should critically be checked for the elimination of contaminating proteins and should contain an inactivation step for pathogenic agents.Since about 4 decades the pasteurization of albumin in presence of stabilizers has been found to be a safe and mild method to inactivate infectious agents. Using the stabilizersglycine and sucrose, we have now been able to pasteurize antithrombin III without the usual changes in molecular properties.The product is more than 98 % pure and contains only traces of contaminating proteins. The pasteurization does not alter the electrophoretic behavior of the molecule in membrane electrophoresis (ME) and polyacrylamidgel electrophoresis (PAGE). The reactivity with heparin is nearly unchanged as tested by heparin cofactor activity and twodimensional immunoelectrophoresis. No neoantigen formation due to the pasteurization could be detected.Using model viruses the efficacy of the pasteurization step has been tested. The following results have been obtained: HIV ≥106.7 (1), CMV ≥ 104.5 (2), HSV ≥106.8 (4), Poliomyelitis virus ≥106.9 (4); the number in brackets represent the time in hours necessary to totally inactivate the given virus titer.
VARIABLE EXPRESSION OF ALLOANTIGENS IN PLATELET COHORTS OF DIFFERENT MEAN DENSITY:AN EFFECT OF AGING IN VIVO
Authors: Pereira J , Cretney C , Aster R H 
Published: June 2019

Platelets differ widely in size and density, but the relationship of this heterogeneity to platelet age and function is not established. Published evidence suggests that platelet alloantigens of the HLA and PlA systems may be acquired by or releasedfrom platelets in the circulation. We therefore studied expression of HLA, PlAl, and other markers in platelet cohorts of high density (HD) and low density (LD) separated on a linear, isoosmotic arabinogalactan gradient. HD and LD cohorts contained 11-14% of total platelets and did not differ significantly in mean cell volume. Alloantibodies reactive with antigens P1A1, Baka, and HLA-A2 were used to saturate alloantigen sites. Surface markers were quantified (Human Immunol. 15:251, 1986) with radiolabeled monoclonalprobes specific for HLA A, B, C antigens (W6/32), the Fc fragment of IgG (Hb-43) and the glycoprotein IIb/IIIa complex (AP-2).As shown in the Table, HD platelets carry significantly more PlAl (located on GPIIIa) and significantly less HLA than LD platelets. However, HD and LD cohorts express the same number of GPIIb/IIIa and Baka (located on GPIIb) molecules. These findings are consistent with preferential loss of HLA molecules from HD- platelets in the circulation or acquisition by LD platelets. The variable expression of P1A1 in HD and LD cohorts is apparently due to a conformational change in GPIIIa, rather than acquisition or loss of the GPIIIa molecule, because total GPIIb/IIIa was thesame in the two platelet populations. Whether antigen differences in HD and LD platelets are determined at the time of platelet production or result from aging of platelets in the circulation is under investigation.
DO APTT AND ANTI Ila ACTIVITY PERMIT THE PREDICTION OF THE EFFICIENCY OF HEPARIN THERAPY IN PATIENTS WITH PROXIMAL DEEP VEIN THROMBOSIS?
Authors: Villians Ph , Bouvier J L , Le Corff G , Elias A , Juhan-vague I , Serradimigni G 
Published: June 2019

One hundred and forty two patients admitted for proximal deep venous thrombosis (PDVT)from 01.01.85 to 12.20.86 were treated with Na-heparin. After an initial bolus (100 units/kg), a continuous intravenous infusion was started (500 units/kg/24h). Heparin activity in daily drawn blood samples was determined by two different assays = APTT (general diagnostic) and anti Ila activity (clotting method). Doses of heparin were adjusted to maintain APTT ratio between 2 and 3 .A phlebography was performed for each patient at DO and D10. Two groups of patients with PDVT were identified : -Group I:n=14 increased thrombosis -Group II :n=26 partly or fully cleared thrombosisNo difference in localization or etiology of PDVT was found between the two groups. Thrombocytopenia was excluded in the two groups by platelet counts (D0, D5, D10).Daily mean values and mean of mean values were analyzed in each group for APTT ratio andanti Ila activity :Statistical analysis (student's T test) shows no difference between the two groups. It can be concluded that mean values of APTT and anti IIa activity in therapeutic range are not predictive of heparin efficiency for the treatment of PDVT
LONG TERM PROPHYLAXIS OF THROMBOEMBOLISM IN OUTPATIENTS WITH LOW MOLECULAR WEIGHT HEPARIN
Authors: Harenberg J , Leber P , Raedsch R , Zimmermann R 
Published: June 2019

The prophylaxis of thromboembolism with oral anticoagulants and low dose heparin is established. However, bleeding episodes and other side effects may occur. Alternative compunds for further anticoagulation do not exist so far. We report, therefore, of the experiences of 66 outpatients who were treated with low molecular weight heparin up to nineteen months.All patients had major bleeding on conventional anticoagulants. Further anticoagulation was strongly indicated because of recurrent thromboembolism, artificial heart valves, dilative cardiomyopathy or heart valve diseases with artrial fibrillation. The dose ranged from 2.500 to 15.000 aXa units once daily subcutaneously. The LMW heparin Tedelparin (Kabi 2165) was used. The dose was chosen according to the risk ofbleeding or thromboembolism, and body weight of eachpatient. In patients with high bleeding risks (esophagiai varices) the average dose was 100 units/kg bodyweight and in patients with high risk of thromboembolism (artificial heart valves) the average dose was140 units/kg bodyweight. The dose was adjusted according to the aXa activity and aPTT inhibition: 2-4 hours after the s.c. administration 0,3 - 0,6 heparin units/ml or 0,6 - 1,0 units/ml in the above mentioned groups should be reached respectively, and the aPTT should be not more than 10 sec above the upper normal limit.Four of 66 patients experienced rethrombosis, 2 of them were non- compliant. Six of 66 patients had minor haemorrhages, 0 major or fatal bleeding occured. Bleeding was more frequent when the aXa activity increased to more than 1 unit/ml. With a dose reduction of 20 % no recurrence of bleeding was seen and antithrombotic effect was still maintained.The data demonstrate that LMW heparin can be safely and effectively used for long term anticoagulation in patients with major haemorrhage due to cönventional anticoagulants.
RANDOMIZED DOUBLE BLINDED STUDY OF NORMAL AND A LOW MOLECULAR WEIGHT HEPARIN IN GENERAL MEDICAL PATIENTS
Authors: Harenberg I , Kallenbach B , Martin U , Zimmermann R 
Published: June 2019

Low molecular weight (LMW) heparin has been proven effectively and safely at low doses with one injection per day in the postoperative medicine. This hasnot been confirmed so far in general medical patients requiring prophylaxis of thromboembolism. We report here of the results of a double blinded prospective randomized trial with normal and LMW heparin.Two hundred patients were included into the study after having given informed consent. They received 3 × 5.000 units sodium pig intestinal mucosa heparin (MW12.000) or 1 × 1.500 aPTT units (MW 3.800, Sandoz AG, Niimberg, FRG) for 10 days. The development of thromboses was screened by clinical investigation, impedance plethysmography and Doppler sonography of the femoral vein at days 1,3,5,7 and 10. The incidence of haemorrhage was assessed by clinical examination, hemoglobin and hematuria at the same time intervals and factor Xa inhibition, aPTT, thrombin inhibition, antithrombin III and thrombocyte count were measured.The following incidences occuredin the heparin / LMW heparin treated groups: clinically evident thrombosis 4 / 3 (phlebography being indicated only in 1 patient of the LMW heparin group and documenting freshthrombosis), pulmonary embolism 0 / 0, local allergy1 / 0, fatal bleeding complication 2 / 0, mortality 2 / 3 (mortality was not due to thromboembolism or treatment related complications in the LMW heparin group, one patient being antopsied). Local hematomas were 3 times more frequent in the heparin group (p <0,05).It is concluded that one daily injection of low doses of LMW heparin is as effective as normal heparin in preventing thromboembolism in hospitalized patients in general medicine.
ASSESSMENT OF DIAGNOSIS OF DEEP VENOUS THROMBOSIS OF THE LOWER LIMBS USING ESTIMATION OF CLINICAL PROBABILITY
Authors: Krahenbuhl B , Sheybani E , Bounameaux H 
Published: June 2019

The value of a diagnostic test (or test combination) depends not only on its sensitivity and specificity but also on the prevalence of the disease. In the present study, we have re-assessed the value of the clinical diagnosis in a group of 45 consecutive patients suspected of deep venous thrombosis (DVT) of the lower limbs. The clinical probability (CP) of the diagnosis was estimated on a clinical basis alone (history and clinical examination) by trained physicians (2-month training in an Angiology Unit). Afterwards, the diagnosis of DVT was established using the combination of Doppler ultrasounds and venous occlusive plethysmography. Venography was performed when the non invasive techniques were inconclusive.DVT was found in 14 patients (31 %). In the 21 patients in whom CP was ⩽ 0.20, there was no DVT. In the 10 patients in whom CP was ⩾ 0.80, DVT was confirmed in 9 cases. When CP was between 0.21 and 0.79, a DVT was found in 5 out of 14 patients.Thus, when CP is ⩾ 0.80 or ⩽ 0.20, further investigation does not seem to provide additional diagnostic information. The estimation of CP by a trained physician allows to define a subgroup of patients in whom the clinical diagnosis is valuable.Two third of the patients in our series belong to this subgroup. In one third of the patients, CP was intermediate and non invasive tests or venography are necessary.Since the range of clinical probability in which clinical diagnosis is reliable will depend on both the physician and the recruitment of the patients (medical or surgical, ambulatory or hospitalized), it must be determined in each center.
COMPARISON BETWEEN INITIAL AND ACHIEVED ANTICOAGULATION LEVEL WITH PHLEBOGRAPHIC EVOLUTION IN PATIENTS WITH DEEP VEIN THROMBOSIS TREATED BY DIFFERENT HEPARINS
Authors: FAIVRE R , KIEFFER K , DUCELLIER D , BILSTEIN F , BASSAND J P , MAURAT J P 
Published: June 2019

Effectiveness of standard heparin (SH) in patients (pts) with deep vein thrombosis (DVT) remains contreversial in regard with the subcutaneous (sc) or intravenous administration route.To determine the relation between initial (day 1 after the beginning of treatment) and achieved anticoagulation level with base-line to control (at day 10) phlebo-graphic score variations, we carried out a randomized study including 68 pts with acute (less than 2 weeks) DVT treated either by SH, 500 ui/kg/day or low molecular weight heparin (LMWH, CY 222, institut Choay, 750 u anti-Xa IC/kg/day), both given by 2 daily sc injections for 10 days. Plasma was collected at the middle (at 8 a.m) of 2 sc injections to evaluate aPTT (CK prest, STAGO) and anti-Xa activity (Stachrom, Stago). The results show that : 1/ Thrombus reduction was similar (thrombolysis more than 30%, 65% in SH pts and 64% in LMWH pts, p NS) ; 2/ in SH pts, phlebographic score variations were correlated neither with achieved anticoagulation level (mean aPTT of day 3, 5, 10) nor initial day 1 aPTT (R=-.33 and R = .03 respectively) ; 3/ in CY 222 pts, no modification of aPTT was observed during the 10-day treatment, and phlebographic score variations were correlated neither with initial nor achieved anti-Xa activity (R=.06 and R=.24 respectively) ; 4/ only 2 SH pts extended DVT and 1 patient in each group developed a recurrent pulmonary embolism in spite of a well initial or achieved anticoagulation level (aPTT >1.5 the control value in SH pts).In conclusion, SH- or LMWH-related anti coagulation (or antithrombotic) effect is certainly not the sole prognosis parameter for well achieving venous thrombolysis in patients with DVT.
ANABOLIC STEROID AND INTRAPULMONARY HEPARIN IN THE PREVENTION OF POSTOPERATIVE DEEP VEIN THROMBOSIS
Authors: Zawilska K , Tokarz A , Psuja P , Szymczak P , Kawczyński S , Zozulińska M , Turowiecka Z , Sowier J 
Published: June 2019

150 patients over 40 years old undergoing major abdominal surgery were divided into 3 groups:1/ group I - receiving a single injection of long acting anabolic steroid /nandrolone phenylpropio-nate, 50 mg intramusculary/ a day prior to surgery 2/ gropup II - receiving the same dose of anabolic steroid plus a single dose of heparin /800 U/kg of body weight/ intrapulmonary a day prior to surgery 3/ group III - receiving only a single dose of heparin /800 U/kg of body weight/ intrapulmonary a day prior to surgery.The deep vein thrombosis /DVT/ was detected using the 125 I-fibrinogen test. The occurence of DVT was:in group I - 14%in group II - 4%in group III - 8%There were no detectable haemorrhagic complications in patients of group I and III, in 6% of patients of group II a sgliht increase of intraoperative bleeding and/or wound hematoma appeared.We conclude that prophylaxis of DVT in the postoperative period with the single dose of anabolic steroid and intrapulmonary heparin is an effective, safe and easy to handle procedure.
HEMOSTASIS AND HEMORHEOLOGY AFTER ISCHEMIC STROKE IN PATIENTS WITHOUT CARDIOPATHY AND OTHER LOCALISATION OF ATHEROSCLEROSIS
Authors: Boisseau M R , Bonnet J , Freyburger G , Desbordes P , Brottier L , Orgogozo J M , Bricaud H 
Published: June 2019

Hemorheological parameters (whole blood filtration, whole blood viscosity, plasma viscosity and erythrocyte deformability by ektacytometry) and fibrinolysis parameters (Euglobulin Lysis Time ELT, t-PA activity, and Plasminogen ActivatorInhibitor -PAI- before and after Venous Occlusion Test -VOT-) were measured in 20 stroke patients. All these patients had a crerebrovascular accident (CVA) localised to the carotid arterial tree. They has no signs of heart disease and were without risk factors for atherosclerosis (high blood pressure, diabetes) ; they were investigated in the week following the CVA. They were divided into 4 groups : 1/ transcient ischemic accident, 2,3,4/ size of infarct classified from results of C. T. Scan carried out 2 or 3 days after the stroke (2/small +, 3/moderate ++, 4/large +++).For the hemorheological parameters we noted only a slight increase in whole blood filtration (27±8“ vs 21±2”, p<0,05).The ELT was however significantly increased in these patients (258 ±57 min. vs 133 ±33,p<0,001)suggesting impairement of fibrinolysis. The following points were noteworthy : the ELT return to normal after to VOT,there was a relationship between stroke severity and the PAI levels and the viscosity at low shear stress. These two parameters were dramatically impaired in the most severely affected patients. Transcient ischemic accidents had comparable features to the CVA of moderate size.The extend of the disorders of the hemorheological disorders and the abnormalities in fibrinolysis seemed to be related to the severity of the involvement in patients with ischemic stroke with no evidence of heart disease or atherosclerosis in other systems.
HEM0RRHE0L0GY AND KETANSERIN
Authors: De Crée J , Geukens H , Demoen H , Verhaegen H 
Published: June 2019

Red blood cell (RBC) filtration in platelet rich plasma (PRP) and platelet poor plasma (PPP) was equally decreased (p < 0.0001) in 120 patients with acute myocardial infarction (AMI) as compared to a control group. In a double-blind experiment 2 groups of 30 patients with AMI received an acute oral dose of 60 mg of ketanserin, a serotonin (5-HT) antagonist at 5-HT2-receptors, or placebo. Ketanserin treatment improved RBC filtration in PRP with an average increase of 30%. A similar experiment using PPP showed a significant increase of 10%. Filtration of plasma improved after ketanserin treatment in PRP, but not in PPP. Cross-exchange experiments showed the ketanserin-induced improvement of RBC filtration in PRP and PPP to be also plasmadependent. 5-HT in vitro at 10−9M deteriorated RBC filtration in PPP (p < 0.05), and ketanserin in vitro at 10−7M counteracted this phenomenon (p < 0.001). Finally we found that the effect of a subacute treatment with ketanserin on the filtration of RBC Suspensions, enriched with a constant amount of white blood cells (WBC), was more pronounced than on control RBC suspensions of patients with AMI.These results indicate that the impaired RBC filtration, reported in vascular diseases may be dependent on a subtle interaction between platelets, WBC, RBC and plasma. Treatment with ketanserin is capable to interrupt this vicious circle of rheological disturbances at different levels, first of all, by improving RBC deformability, but also by counteracting the platelet mediated effects on RBC and by favourably influencing the physical properties of WBC and so preventing clogging phenomena. Serotonin probably plays a pivotal role in these cascade of events and therapy with ketanserin might be of clinical value in diseases where microcirculatory flow is compromised.
A STANDARD ANTI-CARDIOLIPIN (aCL) TEST: USEFULNESS IN IDENTIFICATION OF THE ANTI-PHOSPHOLIPID SYNDROME
Authors: Harris EN , Asherson RA , Baguley E , Ridley M , Hughes GRV 
Published: June 2019

Some, but not all, patients with the lupus anticoagulant and anti-cardiolipin antibodies are prone to thrombosis, fetal loss and thrombocytopenia. It will be important to identify the particular sub-group of patients with anti-phospholipid (aPL) antibodies most subject to these clinical disorders. A preliminary study has shown that the level of IgG aCL antibody is predicitive for thrombosis, fetal loss, and thrombocytopenia but it will be difficult to substantiate (or refute) these findings unless there is a uniform system to measure aCL antibody levels.Five test sera with defined IgG and IgM aCL levels are currently available to laboratories wishing to standardise the aCL test. The concentrations of aCL in these sera cover the full sensitive range of aCL solid phase assays. Using these. 5 test sera to calibrate our assay system, sera from 3000 patients were analysed: 1400 healthy adults and 1600 consecutive patients with autoimmune disorders. All sera from healthy adults had aCL levels below 10GPL (IgG aCL) or below 10MPL (IgM aCL) units. Of the 1600 autoimmune patients, 115 had levels above 5 GPL and/ or 5MPL units. More than 2/3 of patients with IgG aCL levels above 20 GPL units (30 patients) had thrombosis or fetal loss, but the frequency of these disorders decreased in the 10-20 GPL and 5-10 GPL unit groups. Of the 9 patients with IgM aCL levels above 15 MPL units, 6 had thrombosis or fetal loss.The availability of reference sera to measure IgG and IgM aCL antibody levels may better enable multicenter studies to be performed. A relatively uniform system of measurement may also enable easier identification and management of patients with the anti-phospholipid syndrome.