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Biomedical subjects

B Ly

Publications and source records attributed to B Ly.

At least 37 records · Page 2Linked to original sources

[Treatment of iliofemoral venous thrombosis].

In a series of 41 patients with iliofemoral venous thrombosis, 23 were treated with heparin only. Five patients received ultra high dose streptokinase without any detectable thrombolysis. 11 patients were treated according to the conventional dose regimen for streptokinase. Three of these obtained complete thrombolysis, and two partial thrombolysis. Two patients were treated primarily with thrombectomy, whereas five patients were referred to thrombectomy after streptokinase had failed. Operation resulted in complete recanalization in four cases, and partial recanalization in two cases. We recommend the conventional dose regimen for streptokinase as first-line therapy for iliofemoral venous thrombosis. Thrombectomy should be considered if phlegmasia cerulea dolens is present, or when streptokinase is contraindicated. Thrombectomy can be carried out equally well after streptokinase failure, if major symptoms last less than a week.

Adult↗

Immunological typing of acute leukemias: immunoenzymatic staining of fixed cells compared with immunofluorescence staining of unfixed cells in suspension.

A panel of 14 monoclonal antibodies (McAb) against hematopoietic cell surface antigens was applied on mononuclear blood or bone marrow cells from 40 cases of acute leukemia in order to compare immunoenzymatic staining (IE) (alkaline phosphatase) of fixed cells with immunofluorescence staining (IF) of unfixed suspended cells. According to the immunological results, 25 cases were phenotyped as ALL and 15 cases as AML. Cases with blast crisis secondary to chronic myelogenous leukemia (CML-BC) were not represented in this series. In all ALL cases the two methods gave an identical antigenic distribution. In 20 our of 21 cases of non-T-cell ALL, a B-cell progenitor origin was demonstrated by a positive staining reaction with the anti-CD19 McAb AB1 or HD37, and in 10 cases additionally with the anti-CD20 McAb B1 or 1F5. In contrast to the results obtained with IF, IE revealed a poor preservation of the AB1 epitope on CD19, whereas the HD37 epitope was equally well demonstrated by both methods. In 15 cases of AML the distribution of positive versus negative cells with IE or IF was identical for all McAb except J5 (anti-CALLA) (CD10) and B1 (CD20). Thus, 10/15 AML cases expressed CALLA with IE compared to 2/15 with IF. The corresponding figures for B1 were 5/15 and 0/15, respectively. Accordingly, normal myeloid precursor cells were CALLA-positive with IE but negative with IF. The discrepancy probably reflects the fact that, whereas both intracytoplasmatic and membrane-bound antigens are exposed in IE, only the latter are in IF. If the alteration of antigenic accessibility after fixation is considered, IE can safely be used for immunophenotyping of acute leukemia.

Antibodies, Monoclonal↗

Selective vitamin B12 malabsorption in adult coeliac disease. Report on three cases with associated autoimmune diseases.

Three cases of adult coeliac disease with severe vitamin B12 deficiency not accompanied by folate or iron depletion are presented. Two of the patients had the extremely rare combination of coeliac disease and lack of intrinsic factor and autoimmune thrombocytopenic purpura. A close association between coeliac disease and autoimmunity is indicated by the development of autoimmune thyroiditis in the third patient. Vitamin B12 malabsorption caused by coeliac disease is emphasized as a pathogenetic mechanism of megaloblastic anaemia.

Adult↗

Subcutaneous heparin treatment of deep venous thrombosis: a comparison of unfractionated and low molecular weight heparin.

In a double-blind study, patients with phlebographically proven deep venous thrombosis (DVT) were treated with subcutaneous injections twice a day of either unfractionated heparin (UH; n = 27) or low molecular weight heparin (LH; n = 29) for 7 days, and the dose was adjusted until therapeutic range was reached, according to a chromogenic substrate anti-Xa assay. Forty-eight percent of the LH group did not need dose adjustment as compared to 24% of the UH group. During the course of heparin administration, deviation from initial heparin activity was frequent in both groups, but mean activity did not indicate a cumulative effect in either group. There was 1 incidence of pulmonary embolism (LH) and only 1 minor bleeding episode (UH). Half of the patients in both groups were phlebographically improved. We conclude that subcutaneous heparin treatment with UH or LH appears safe and convenient.

Adult↗

An enzyme immunoassay design using labelled antibodies for the determination of haptens. Application to methotrexate assay.

A competitive enzyme immunoassay with labelled antibodies has been developed for methotrexate (MTX). Methotrexate in the sample and a constant quantity of this hapten physically absorbed to polystyrene spheres through a methylated bovine albumin carrier were allowed to compete for a limiting amount of peroxidase labelled antibody. After washing, the residual enzyme activity bound to the solid phase was measured. This test was able to detect 10 fm of MTX per sample. A comparative study of this test with a commercial radioimmunoassay kit using the same antiserum and a high pressure liquid chromatography method showed that the sensitivity, specificity and precision of this test were as good as of the radioimmunoassay. The high pressure liquid chromatography method was 500 times less sensitive. Good agreement was found among the 3 methods on 83 serum samples from patients receiving methotrexate therapy.

Animals↗

Characterization of an antibody to factor VIII in a patient with acquired hemophilia with circulating immune complexes.

A 73-year-old previously healthy woman was admitted because of severe bleeding from esophagitic lesions and intraabdominal bleeding following hysterectomy. Acquired hemophilia, probably due to an IgG antibody to factor VIII (64 inhibitor units/ml) was noticed, the VIII:C in the patient's plasma being 18% or normal. Immune complexes isolated by polyethylene glycol precipitation had only a weak factor VIII inhibiting activity whereas IgG purified from the complexes and monomeric IgG present in her plasma exerted a strong inhibition. Removal of the complexes from plasma had no effect on the inhibitor titer thus indicating that only a minor part of the antibody was circulating as immune complexes. Plasma or purified IgG from the patient decreased the VIII:C of normal plasma to 18 og 14%, respectively, total inhibition being impossible to achieve even in antibody excess, probably reflecting residual activity of factor VIII bound to the patient's antibodies. The ristocetin cofactor activity of normal plasma was unaffected by the antibodies. Transfusion of factor VIII concentrate to the patient resulted in therapeutic levels of circulating factor VIII and transfused factor VIII circulated longer than usual. Partial remission of the disease with adequate levels of VIII:C occurred after 3 months.

Aged↗

Streptokinase of heparin in the treatment of deep vein thrombosis. Follow-up results of a prospective study.

In a previous study on 42 patients with acute deep vein thrombosis, randomly allocated to treatment with streptokinase or heparin, we found that 71.4% of the streptokinase-treated patients achieved phlebographically significant thrombolysis as compared to 23.8% in the heparin group. These patients have been reevaluated after a mean observation period of 6 1/2 years. Seven patients had died and there were no other drop-outs. Thus, 35 patients were subjected to the follow-up study consisting of phlebography and clinical examination. The evaluations were performed without knowledge of the initial therapy. Seven patients had phlebographically normal veins, and all belonged to the streptokinase group. This difference between the treatment groups is statistically highly significant (p less than 0.01). At clinical examination, 13 of the 17 patients in the streptokinase group had normal legs and 4 exhibited moderate postthrombotic changes. In contrast, 3 of the heparin-treated patients showed serious postthrombotic changes with open leg ulcers, and only 6 of 18 patients in this group had normal legs. The present results strongly support the assumption that streptokinase therapy is the best treatment at present in patients with acute deep vein thrombosis. This has been shown for the initial thrombolysis, and now also for the avoidance of late postthrombotic changes.

Adult↗