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Biomedical subjects

B G Solheim

Publications and source records attributed to B G Solheim.

At least 19 recordsLinked to original sources

Self-sufficiency for plasma and plasma proteins in Norway.

Self-sufficiency has been achieved in Norway with regard to all major blood products even with the collection of only 41,906 units of whole blood and 2,586 plasmapheresis sessions per million inhabitants (1994). Since 1989 the collaborative effort of the 'Norwegian Fractionation Project' has secured the self-sufficiency of virus-inactivated plasma and (high/ ultra-high purity) products of plasma proteins. Thus national self-sufficiency for plasma can be obtained by a combination of national guidelines, close collaboration to the clinicians, and a limiting plasmapheresis programme combined with the preparation of FFP from the majority of whole blood collections.

Blood Banks

Vaccination with mutant ras peptides and induction of T-cell responsiveness in pancreatic carcinoma patients carrying the corresponding RAS mutation.

Mutations in codon 12 of K-RAS are frequently found in pancreatic adenocarcinomas. T-cell responses specific for individual RAS mutations can be elicited in vitro by stimulation of peripheral blood mononuclear cells with synthetic peptides. Mutant ras peptides are therefore a candidate vaccine for specific immunotherapy in pancreatic carcinoma patients. When vaccinated with a synthetic ras peptide representing the K-RAS mutation in their tumours, a transient ras-specific T-cell response was induced in two of five patients treated. The vaccination protocol involved multiple infusions of large amounts of peptide-pulsed antigen-presenting-cells obtained by leucapheresis. These results indicate that specific T-cell responses against mutations uniquely harboured in tumour cells can be induced in cancer patients by vaccination.

Adenocarcinoma

[Transfusion-associated graft-versus-host disease. Increased risk when using HLA matched donors].

For 30 years it has been known that immunodeficient patients can have a fatal reaction to transfused blood components containing viable lymphocytes. This risk of a transfusion-associated graft-versus-host reaction can be totally eliminated by irradiation of the blood prior to transfusion. Immunocompetent individuals can have this potentially fatal reaction if the blood donor is homozygous for one of the HLA-haplotypes of the recipient. The probability of this coincidence is low when donor and recipient are unrelated, but considerably higher when they are genetically related. When HLA-matched blood platelets are indicated for transfusing patients refractory to random platelets, the platelets must always be irradiated with minimum 25 Gy, since a large proportion of the donors will be homozygous with one of the HLA-haplotypes of the recipient.

Blood Donors

[Infusion of hematopoietic stem cells from the blood. Simpler and better than bone marrow transplantation?].

Infusion of haematopoietic stem cells, either autologous or allogeneic, allows treatment of malignant diseases with marrow ablative doses of cytostatics or whole body irradiation. Hospitalization and general anaesthesia is necessary for bone marrow harvesting, while the harvest of peripheral stem cells may be performed without hospitalization. Mobilization of haematopoietic stem cells from the bone marrow to peripheral blood, followed by cytapheresis and harvesting of the stem-cell containing fraction is a promising alternative to the harvest of marrow. We have tried this in one patient with advanced acute myeloid leukaemia and discuss our experience and that of others.

Blood Transfusion, Autologous

[Medical coding and classification systems].

Medical coding and classification systems are expected to become increasingly important in the health care sector. Together with and as an integrated part of the electronic health information systems, the coding and classification systems will be used to improve the quality and effectiveness of the medical services. Activities connected to the different coding and classification systems are a very important component of the attempts at standardization taking place both in Norway and in the rest of Europe within the discipline medical informatics. These activities must be secured a proper professional and economic foundation. It is also of vital importance that national health authorities should participate in these activities and establish formal cooperation with professional bodies. In Norway, the Ministry of Health and Social Affairs has accepted with some miner modifications, our suggestion for a model where the Norwegian Medical Association would be responsible for the medical aspects of the coding and classification systems and for their development, and the Norwegian Centre for Medical Informatic's for organization, distribution, electronic version, integration in information systems and user assistance.

Classification

[Changes in consumption of blood--the significance of resource related and economic factors].

During the period 1985 to 1991 there has been a marked change in consumption of blood, and at the National Hospital the number of transfusions decreased by 52% from 41,747 units. However, the number of admitted patients annually has remained unchanged and the patient pattern includes more complicated cases. We conclude that cost accounting, consumer-adapted reporting, vigilant follow-up and an active transfusion committee are important factors for the changes in blood consumption. Furthermore, the professional attitude towards surgical blood conservation techniques and modern haemotherapy have been consolidated at the hospital concerned.

Blood Component Transfusion

[Quality control of leukocyte filtration of blood products].

Quality control of leucocyte depleted blood products has become a problem since the introduction of bedside leucocyte filtration. At our Blood Centre, this problem has been circumvented by testing a sample taken as the filtration is completed by sealing off a 10 cm piece of tubing just under the filter. We have tested four brands of erythrocyte filters, Pall RC100, Erypur Optima b, Sepacell R-200A and Sepacell R-500A(II) using two erythrocyte concentrates for each filter. We have tested two brands of thrombocyte filters, Pall PL100 with 6-8 thrombocyte concentrates, and Sepacell PL-5A with 2-6 concentrates. No transfusion should give more than 5 x 10(6) leucocytes. Pall PL100, Pall RC100 and Sepacell R-500A(II) met the criteria.

Blood Transfusion

[Attitude of blood donors towards cholesterol measurement].

In analyses of cost-effectiveness it is customary to count knowledge of having a high serum cholesterol level as a negative factor. There is little support for this practice in the literature. We have studied the attitude of 305 Norwegian blood donors towards cholesterol testing. 63% stated that they were interested in their serum cholesterol level, and 40% said they knew their own serum cholesterol level. The attitude towards cholesterol testing was clearly positive, both among men and among women, regardless of age. Only one donor stated that she did not want to have her serum cholesterol tested in conjunction with blood donation.

Adult

[Changes in serum cholesterol level in blood donors over a 2-year period].

Serum cholesterol levels were measured in 280 blood donors between November 1988 and May 1989 and again between February and April 1991. In 84 of these persons the cholesterol level was also measured between November 1989 and January 1990. The 122 females showed a 9.6% reduction in mean serum cholesterol from 5.8 mmol/l in the first sample to 5.2 mmol/l in the final sample. The 158 males showed a 7.4% reduction from 5.7 to 5.3 mmol/l. Females with initial values greater than 6 mmol/l showed an average reduction in serum cholesterol of 15.2%. For males with initial values greater than 6 the reduction was 14.0%. There was no difference in reduction between those whose cholesterol was measured at the beginning and the end of the study and those whose cholesterol was also controlled during the course of the study. Our study shows that, in the case of blood donors, a programme involving measuring serum cholesterol and distributing written information can lead to a substantial reduction in serum cholesterol.

Adult

[Allogeneic bone marrow transplantation in adults. Results after fractionated whole body irradiation and high dosage cyclophosphamide and use of HLA-compatible sibling donors].

We present short and long-term results of allogeneic bone marrow transplantation after hyper-fractionated total body irradiation and high dose cyclophosphamide in ten patients treated for leukaemia during the period 1985-89. Three patients died from complications connected to the transplantation, while seven are living free from leukaemia 18 to 59 months after transplantation (mean 41 months). Two patients need treatment for chronic graft versus host disease. Allogeneic bone marrow transplantation is expensive and risky. Close cooperation between clinicians and laboratory specialists is essential. The treatment increases long term survival and probably cures certain patients with leukaemia. Some of these patients will need treatment for chronic graft versus host disease and other late sequelae.

Adult

[The effect of conversion from blood donation to plasma donation on serum ferritin and hemoglobin].

In the present study the effect of a change from whole blood to plasma donation on iron stores is investigated by measuring serum ferritin levels. Paired serum samples from 125 plasma donors showed a significant increase in mean serum ferritin level with plasmapheresis. 76% of the plasma donors showed an increase in serum ferritin. For plasma donors the haemoglobin concentration is not related to serum ferritin level and hence to iron stores, and a change in haemoglobin concentration is not related to a change in serum ferritin. Plasma donation is a good alternative to whole blood donation for fertile women and for blood donors opposed to iron supplements.

Adult