Biomedical subjects

B Lichtiger

Publications and source records attributed to B Lichtiger.

At least 37 records · Page 2Linked to original sources

PubMed1991

Fibrin glue for partial nephrectomy.

Fibrin glue, a mixture of concentrated autologous fibrinogen and bovine-derived thrombin, was used to achieve hemostasis during 7 partial nephrectomies. After transected vessels were suture ligated, topically applied fibrin glue filled all renal defects with an adherent clot that resulted in immediate hemostasis. There was no case of delayed hematoma or abscess formation, and no complications were referrable to the use of fibrin glue. Although fibrin glue is no substitute for early vascular control and careful surgical technique, its ability to stop venous oozing from the cut surface of renal parenchymal tissue dramatically facilitates hemostatic control.

Fibrin Tissue Adhesive↗

PubMed1991

Highly oncolytic adherent lymphocytes: therapeutic relevance for leukemia.

We have generated and characterized a highly oncolytic adherent lymphocyte subset (A-LAK) from eight leukemic patients with non-lymphocytic leukemia (NLL) in remission and one NLL patient in relapse. Our studies demonstrated that A-LAK was superior in its oncolytic activity (tested in a 3-h 51Cr release assay) to conventionally prepared (LAK) and non-adherent (NA) IL-2 cultures. No activity was observed by this highly oncolytic subset against normal bone marrow (BM). A-LAK also displayed highest proliferative activity in 7-11 day cultures (5- to 58-fold expansion) in comparison to LAK (0.7- to 2.7-fold) or NA (1.0- to 2.6-fold) cultures. Analysis of phenotype of unseparated, NA and adherent (A-LAK) lymphocytes 24 h after IL-2 activation showed that the A-LAK was composed predominantly of high intensity (bright) CD11a+ (LFA-1) lymphocytes (75 +/- 4.8%) when compared to the other two populations (12 +/- 2.1%). Similarly, A-LAK contained higher proportion of CD11b (CR3 receptor)-positive lymphocytes (39 +/- 2.1%) than unseparated and NA lymphocytes (11 +/- 1.4%). Double marker phenotypic studies showed that A-LAK cultures were heterogeneous and distribution of individual lymphocyte subsets differed among NLL patients. While in A-LAK culture of some patients the CD56+, CD3- natural killer (NK) cell subset was predominant, CD3+, CD56- lymphocyte subset was prevalent in others. Highest A-LAK lytic activity was always correlated with highest NK cell content. Characterization studies (using the complement-depletion technique) showed that independently of the distribution of lymphocytes in A-LAK cultures, CD16+, CD56+, CD3- NK cell subset displayed highest oncolytic effect. CD5+ subset also participated in cytotoxic function. These observations indicated that A-LAK may represent a new therapeutic approach to treatment of leukemia.

Adult↗

PubMed1991

In vitro response of peripheral blood mononuclear cells to phytohemagglutinin and interleukin-2.

The serological determination of class II antigens is still a mandatory test prior to allotransplantation. It is known that these antigens are normally expressed on B lymphocytes and monocytes. The B lymphocytes that constitute 10% to 15% of total blood lymphocytes are the cells currently used for HLA-DR typing. To avoid HLA-DR typing difficulties, or even impossibilities that are frequently encountered among some patient groups, we studied the response of peripheral blood mononuclear cells--as an alternative source of cells for class II antigen typing--to in vitro mitogen and interleukin-2 activation and propagation. Although the patients included in this study were selected having previously known HLA-DR typing difficulties, all could be adequately typed by this method.

B-Lymphocytes↗

PubMed1991

Leukocyte-poor blood components: issues and indications.

Leukocyte-poor blood components (LPBC) have now become part of the armamentarium of available transfusable blood components. Indications for the use of LPBC vary in accordance with the underlying clinical condition, as well as the intended objectives of the transfusion therapy. Technological advances have made it possible to prepare LPBC using rather simple procedures. However, any manipulation of blood components and the additional use of filters, washing, rinsing solutions, etc. inevitably result in additional costs to the patient, the health-care institution, or third-party payers. Requests for LPBC involve the preparation of RBC or platelets, leuko-depleted by at least one log. Transfusion of LPBC must be done in a logical fashion that meets the needs of the patient. Currently, LPBC is indicated for patients with a history of nonhemolytic febrile transfusion reactions to delay alloimmunization to HLA antigens and avoidance of cytomegalovirus (CMV) infection.

Blood Component Removal↗

PubMed1991

[Manual polybrene test versus saline test as a means of detecting alloantibodies against red cells in the pretransfusion examination].

Two tests for detecting red cell alloantibodies in pre-transfusion studies were compared. Saline test is a well-known and recognized method, although it has a disadvantage: the 30 minutes incubation time at 37 degrees C can become a problem in emergencies. In such cases a method as quick as polybrene manual test (PMT), as recommended by the American Association of Blood Banks (AABB) Manual, seems the method of choice. So, in spite of the good results attained by us with the saline test, both methods were subjected to comparison. The results achieved with the saline test were better than with the PMT since this last failed to detected one anti-D, two anti-E and two anti-K antibodies, plus a warm antibody of undetermined specificity. All the antibodies not detected by PMT have clinical significance, so we decided not to use PMT in routine pre-transfusion testing.

Blood Group Antigens↗

PubMed1991

Spurious serologic test results in patients receiving infusions of intravenous immune gammaglobulin.

Intravenous immune gammaglobulin (IVIgG) has a definite role in the modern armamentarium of therapies for immunocompromised patients. Intravenous IgG is manufactured from the plasma of a large number of donors and contains antibodies against numerous infectious agents. Patients who receive infusions of IVIgG may test false-positive for a variety of viral, bacterial, and other infectious diseases when serologic determinations are performed on their blood samples. It is important that laboratories performing serologic testing be aware that patients have been infused with IVIgG, so that spurious laboratory results can be identified. Serologic testing on implicated lots of IVIgG and on the patient's pretreatment sample may aid in correctly identifying a spurious serologic result due to therapy with IVIgG.

Adolescent↗

PubMed1990

Autologous transfusions for cancer patients undergoing elective ablative surgery.

Patients who have cancer are exposed to the adverse consequences of blood transfusions, such as transmissible diseases. This study presents an examination of a program of autologous blood deposit for cancer patients undergoing elective surgical procedures. Over a 3-year period, 235 patients deposited 388 units of autologous blood: 6 for head and neck tumor surgery, 8 for neurosurgical tumors, 8 for gastrointestinal and colorectal tumor surgery, 14 for adrenal tumor surgery, 16 for gynecologic tumor surgery, 23 for soft tissue and bone tumor surgery, 25 for mastectomies and reconstructive breast surgery, 42 for genitourinary tumor surgery, and 93 for bone marrow aspirations for autologous transplants. One hundred eighty-two patients (77.4%) used 278 units (71.6%) of their autologous blood units during the operations, 50/182 required additional homologous blood, and 53 did not require transfusions with autologous blood. Our study shows that a majority of these patients (132/182) underwent surgery using only autologous transfusions. Therefore, we believe that predeposited autologous blood is a viable alternative to homologous blood for cancer patients undergoing surgery.

Adolescent↗

PubMed1990

Elliptinium acetate in metastatic breast cancer--a phase II study.

Thirty-five patients with metastatic breast cancer who had received one or two prior chemotherapeutic regimens were treated with elliptinium acetate at a dose of 80 mg/m2 for 3 days every 3 weeks. Of the 33 patients evaluable for response, 1 patient achieved complete remission, 4 achieved partial responses (15% overall objective response with 95% confidence interval of 5-32%), and 6 achieved minor response. Toxicity of the treatment was xerostomia, diarrhea, and nausea and vomiting. The drug was not myelosuppressive. Three patients showed evidence of elliptinium antibody, and treatment was discontinued. No episodes of hemolysis were observed. Elliptinium acetate showed modest antitumor activity in previously treated patients with metastatic breast cancer.

Adult↗

PubMed1990

Enrichment of oncolytic cells for adoptive therapy using centrifugal elutriation.

We have shown that centrifugal elutriation (CE) can be used to obtain large numbers of peripheral blood lymphocytes enriched for natural killer (NK) cell activity. Lymphocytes distributed in fraction 3 (F3) were enriched 2.3 fold for large granular lymphocytes, LGL, and 1.8 fold for cells with CD16+ phenotype. Both unseparated and F3 cells proliferated and were activated following culture with interleukin-2 (IL-2), although the NK-enriched cells displayed superior cytolytic activity against tumor cell lines, as well as against fresh leukemic blasts. Comparison of the cell surface phenotype of long-term cultures indicated a significantly higher frequency of CD56+, CD3- and CD16+ NK cells, and a reduced content of CD3+ T cells in F3 populations. These results suggest that IL-2 activated NK-enriched CE-fractionated lymphocytes may be more effective than unseparated mononuclear cells for adoptive therapy purposes.

Centrifugation↗

PubMed1989

Effect of donation time on platelet concentrates and fresh-frozen plasma. An in vitro study.

To investigate the effect of donation time on the quality of blood components, we measured the platelet count and pH on platelet concentrates, and the factor V and VIII:C levels and fibrinopeptide A concentration on fresh-frozen plasma by duration of donation time. Platelet concentrates and fresh-frozen plasma were classified into three groups according to donation time: group 1, less than 10 min; group 2, 10-15 min, and group 3, longer than 15 min. Mean platelet counts of platelet concentrate were: group 1, 8.6 +/- 2.5 (in x 10(10], group 2, 8.1 +/- 2.6, and group 3, 6.5 +/- 3.2 (p less than 0.05). The same pH was maintained in all three groups. The fibrinopeptide A concentrations in groups 1 and 2 were 24 +/- 53 and 169 +/- 64 ng/ml, respectively, while in group 3 all were greater than 200 ng/ml, indicating correlation of a higher fibrinopeptide A level with longer donation time. Although a higher fibrinopeptide A level indicated a greater degree of thrombin generation, assays of factors V and VII:C did not show decreased activity in groups 2 and 3.

Antigens↗

PubMed1988

Positive direct antiglobulin test and high serum immunoglobulin G values.

To investigate the association between the positive direct antiglobulin test (DAT) and hypergammaglobulinemia, the authors prospectively studied 154 patients, classified into three groups: Group 1, 52 patients with a positive DAT result in pretransfusion samples; Group 2, 52 patients with a negative DAT result; and Group 3, 50 patients initially found to have an elevated serum immunoglobulin G (IgG) level. Serum protein electrophoreses and IgG quantifications were performed for all three groups. Serum haptoglobin and lactate dehydrogenase (LD) isoenzyme electrophoreses were also assayed for Group 1. Of 52 patients in Group 1, 17 (33%) had an elevated serum IgG level and nonreactive eluates. Clinical history, haptoglobin, and LD isoenzyme studies did not suggest increased red blood cell destruction. Only 2 (4%) of 52 patients in Group 2 had an elevated serum IgG level. Of 50 in Group 3, 25 (50%) had a positive DAT result with nonreactive eluates and did not have hemolytic diseases. Two of 10 patients (20%) with serum IgG levels ranging from 18 to 20 g/L (1.8-2.0 g/dL), 13 of 29 (45%) with serum IgG levels from 20 to 40 g/L (2.0-4.0 g/dL), 4 of 6 (67%) with serum IgG levels from 40 to 60 g/L (4.0-6.0 g/dL), and 6 of 6 (100%) with serum IgG levels from 60 to 80 g/L (6.0-8.0 g/dL) had a positive DAT result. The authors concluded there is a significant correlation between a positive DAT result and serum IgG concentrations and that the higher the elevated serum IgG, the more frequently the positive DAT result is observed. Elevated serum IgG levels may explain many positive DAT results in pretransfusion blood samples.

Acquired Immunodeficiency Syndrome↗

PubMed1988

Plasma fibronectin values in patients with acquired immunodeficiency syndrome (AIDS) and AIDS-related complex.

The authors studied the circulating fibronectin concentrations in the plasma of 24 patients with acquired immunodeficiency syndrome (AIDS) or AIDS-related complex (ARC) and of 74 age- and sex-matched healthy blood donors. They adapted a commercially available turbidimetric immunoassay for use with a centrifugal analyzer. The assay showed within-run precision of 2.1%, 2.3%, 1.8%, and 1.1%, and an accuracy of 90%, 99%, 98%, and 98% at fibronectin concentrations of 126 mg/L, 200 mg/L, 293 mg/L, and 317 mg/L, respectively. Between-run precision was 5%, 3%, and 2% for 66 mg/L, 218 mg/L, and 283 mg/L concentrations, respectively. Plasma fibronectin values obtained from the healthy blood donors were in good agreement with those values reported by other investigators using various methods. No significant differences between the plasma fibronectin values of the patient population (mean +/- 2 SD = 294 mg/L +/- 110 mg/L) and of the control group (mean +/- 2 SD = 311 mg/L +/- 130 mg/L) were noted. The authors conclude that the measurement of fibronectin concentrations in patients with AIDS or ARC does not contribute significantly to the diagnosis and therapeutic management of these patients.

AIDS-Related Complex↗

PubMed1987

An enzyme-linked immunosorbent assay for the detection of platelet antibodies using detergent-solubilized platelets immobilized on nitrocellulose discs.

A method is detailed for the solubilization of human platelets using a dialyzable detergent, decanoyl-N-methylglucamide (Mega-10). At a detergent/protein ratio of 1:12, the efficiency of solubilization was 27%. This platelet lysate (PLy) was then bound to nitrocellulose (NC) discs to assay retention of the native immunological functions of the platelet membrane antigens. Using alkaline phosphatase-coupled anti-IgG, the major platelet membrane glycoproteins GPIb, GPIIb, and GPIIb/IIIa were detectable with as little as 20 ng of monoclonal antibody. Antisera to the class I histocompatibility antigens HLA-A1, B7, B8, the PlA1 allodeterminant, and serum from multiply transfused, alloimmunized patients were reactive even after 100 days storage of the discs at 4 degrees C, and with as little as 1.0 micrograms of NC-bound PLy. The binding of the same antisera to intact, immobilized platelets as well as specific complement-mediated lymphocytotoxicity was also inhibited by PLy. PLy from HLA-A3- or B44-positive donors, however, did not inhibit cytotoxicity of lymphocytes expressing either antigen using several different antisera. Our results indicate that Mega-10 is an excellent solubilizing agent for the immunological study of platelet membranes. The fact that clinically relevant platelet membrane antigens are preserved, immunologically reactive, and stable over long periods of storage, makes this assay amenable to a routine crossmatching procedure for platelet transfusions.

Autoantibodies↗

PubMed1987

Transfusion reactions in patients with cancer.

In general, the true incidence of transfusion reactions is difficult to determine with certainty. In patients with cancer, it becomes even more complex to define. During a four-year study period in which 100,177 units of red blood cell transfusions were given to 25,744 cancer patients, 245 episodes of transfusion reactions were reported. The incidence of overall reaction was 0.3% of all transfused units, which is significantly lower than other studies. Febrile nonhemolytic reactions and allergic urticarial reactions were the most frequently noted, constituting 51.3% and 36.7%, respectively, of total reactions. There were only 17 hemolytic reactions (four immediate and 13 delayed-type). The incidence of delayed hemolytic reactions in cancer patients is significantly lower than that reported for patients in non-oncology hospital settings. This could result from the inability of cancer patients to produce alloantibodies against blood group antigens as frequently and efficiently as can those with non-neoplastic conditions.

ABO Blood-Group System↗

PubMed1987

Clinical trial of plasma perfusion over immobilized staphylococcal protein A in metastatic breast cancer.

Nineteen patients with metastatic breast cancer refractory to conventional therapy were treated with plasma perfusion over 200 mg of staphylococcal Protein A immobilized on a silica matrix. Fever and chills (33%), pain at the site of tumor (18%), and dyspnea (16%) were the most frequent toxic effects encountered. Four patients (21%) developed a disseminated rash which necessitated cessation of treatment. Of 16 patients evaluable for response, one achieved a minor response of chest wall disease and two had no change in hepatic metastases for 4 and 5 months' duration. Potential mechanisms of antitumor effect are discussed.

Adult↗

PubMed1986

Cross-reactive red blood cell antigen-related substances in human leukocyte alpha interferon.

Human leukocyte alpha interferon (IFN alpha) is a blood product. The possible contamination with blood-group antigens was studied using the double-immunodiffusion technique. With the exception of one lot received in 1980, which did not react, all three recent lots received in 1983 and 1984 reacted with 16, 20, and 21 of the 22 erythrocyte group-specific antisera tested. The only antiserum that did not react with any of the IFN alpha lots was anti-N. Preincubation of the IFN alpha with antisera abolished the precipitate lines seen in double immunodiffusion. Recombinant human alpha interferon used as a control did not show any reaction. Our results indicate the presence of red blood cell antigen-related substances in IFN alpha.

Cross Reactions↗

PubMed1986

Transfusion of Rh-incompatible blood components to cancer patients.

To study the effects of Rh0D incompatible transfusion of platelets and/or granulocyte concentrates, we analyzed the transfusion history of 118 oncology patients. Patients received a mean 36.2 units of random platelets, a mean 6.2 concentrates of single donor platelets, and a mean 8.4 concentrates of granulocytes. Patients were not treated with anti-Rh0D specific immunoglobulin following the incompatible transfusions. The patients were followed for a mean 9.4 months to detect the appearance of Rh0D antibodies. Of the 118 patients, 3 were lost to follow-up. Of the remaining 115, 2 cases (1.74%) developed anti-Rh0D following administration of the incompatible transfusions.

Blood Group Incompatibility↗

PubMed1985

Expression of Rh0(D) antigen in choriocarcinoma of the uterus in an Rh0(D)-negative patient: report of a case.

Choriocarcinoma of the uterus developed in an Rh0(D)-negative woman six weeks after delivery of a normal Rh0(D)-positive child. Although the patient's medical history did not show any previous sensitization, a strong anti-Rh0(D) antibody was detected during evaluation preceding surgical removal of the tumor. The tumor was considered the most probable cause of the Rh0(D) sensitization, since large Rh0(D)-positive areas of tumor were demonstrated by the immunoperoxidase method. This finding indicates that the Rh0(D) antigen is not restricted to erythrocytes, as commonly assumed, but can also be expressed on other tissue, such as tumor tissue.

Adult↗