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Biomedical subjects

E Ikkala

Publications and source records attributed to E Ikkala.

At least 37 records · Page 2Linked to original sources

Spontaneous erythroid colony formation in the differential diagnosis of erythrocytosis.

Erythroid colony formation in vitro was studied in 80 patients with erythrocytosis. 43 of the patients had polycythaemia vera (PV), 18 patients had secondary erythrocytosis, 6 had normal red cell mass, and 13 patients were regarded as unclassified. Spontaneous erythroid colony formation, in the absence of exogenous erythropoietin in the cultures, was discovered in all patients with PV, whereas no patient with secondary erythrocytosis or with normal red cell mass showed this phenomenon. 8 of the 13 patients with unclassified erythrocytosis spontaneously formed erythroid colonies. 7 patient with unclassified erythrocytosis have been followed for 5 yr. 3 of the 4 patients with spontaneous colony growth but none of the 3 without it can now be classified as PV. Thus, spontaneous erythroid colony formation indicates PV even in early and atypical cases. Therefore, the culture of erythroid progenitors is very useful in the differential diagnosis of problematic cases with erythrocytosis.

Adult↗

Splenic dynamics of indium-111 labeled platelets in idiopathic thrombocytopenic purpura.

Splenic dynamics of 111In-labeled platelets and platelet-associated IgG in 33 patients with idiopathic thrombocytopenic purpura (ITP) were studied. Two half-lives were calculated for the biexponential splenic time-activity curve after i.v. injection of 111In-labeled platelets. There was no difference in the mean half-life of the rapid component of the splenic curve (ST1) when patients with negative or slightly positive platelet suspension immunofluorescence test (PSIFT) were compared to those with strongly positive PSIFT (3.0 +/- 0.7 min vs. 3.6 +/- 0.4, p greater than 0.05). Mean half-life of the slow component of the splenic curve (ST2) was found to be longer in patients with a strongly positive than a negative or weakly positive PSIFT (26 +/- 5 min vs. 13.2 +/- 1.0 min, p less than 0.01). It seems that determination of the two components of the splenic time-activity curve provides a useful method for studying platelet kinetics in ITP.

Adolescent↗

Prevalence of hemochromatosis in Finland.

Transferrin saturation was determined in 11,431 men and 10,639 women aged 15 or more drawn from different areas in southern and central Finland and attending a multiphasic health screening examination in 1967-1972. All the 163 men and 66 women with transferrin saturation greater than or equal to 70% at the initial examination and still alive at the end of 1983 were invited to a re-examination. Of the invited persons, 76% attended the re-examination. Transferrin saturation and serum ferritin were the initial screening methods in the re-examination. All persons with suspected hemochromatosis were clinically examined and a laparoscopy was performed. Four men and four women were found with unequivocal hemochromatosis. Only one of these cases was diagnosed beforehand. According to these data the prevalence of hemochromatosis in Finland is about 50/100,000.

Adult↗

Megakaryocytic colony formation in polycythaemia vera and secondary erythrocytosis.

Megakaryocytic colony formation by progenitor cells of 18 patients with polycythaemia vera, seven with secondary erythrocytosis and four with erythrocytosis of unexplained origin was studied in vitro by the methyl cellulose culture assay. Fourteen of the 18 patients with polycythaemia vera showed spontaneous megakaryocytic colony formation, i.e. colony growth with normal human plasma as the only source of colony stimulation. None of the patients with secondary erythrocytosis or erythrocytosis of unknown origin or of the normal controls grew colonies in the presence of normal human plasma only. When the plasma of a patient with aplastic anaemia was used instead of normal human plasma and phytohaemagglutinin stimulated leucocyte conditioned medium (PHA-LCM) was added to the culture medium, two of the patients with polycythaemia vera and one with secondary erythrocytosis formed slightly increased numbers of megakaryocytic colonies, while the rest of the patients showed normal colony formation. All of the patients with polycythaemia vera but none of those with secondary erythrocytosis or erythrocytosis of unknown origin showed spontaneous erythroid colony growth. The present study shows that most patients with polycythaemia vera form spontaneous megakaryocytic colonies in vitro. This phenomenon has recently also been demonstrated in essential thrombocythaemia and it is apparently analogous to spontaneous erythroid colony growth seen in all myeloproliferative disorders.

Adult↗

Platelet associated IgG, platelet mean life span and treatment with intravenous immunoglobulin in idiopathic thrombocytopenic purpura.

The clinical significance of platelet associated IgG in ITP detected by direct platelet suspension immunofluorescence test (PSIFT) was studied. The platelet mean life span (MLS) was measured with 111In-labelled platelets in 17 adult patients. All the patients had shortened platelet MLS. The direct PSIFT was positive in 14 patients. Patients were initially treated with prednisone; 12 patients with poor response to the drug were splenectomised. 8 of these 12 patients were treated with intravenous immunoglobulin (IvIg) before splenectomy. The response to IvIg was as good or better in the 3 patients with negative PSIFT, than in the 5 patients with positive PSIFT.

Adolescent↗

Low platelet arachidonic acid in young patients with brain infarction.

Fatty acid patterns of plasma and platelet lipids, platelet aggregation and thromboxane A2 (TxA2) production were studied in young patients (n = 12) with brain infarction and in healthy controls (n = 13). Platelet arachidonic acid content was significantly reduced in the stroke patients, but in vitro platelet aggregation was similar in the two groups. A low dose of acetosalicylic acid (ASA) (100 mg) suppressed thromboxane production and normalized the platelet arachidonic acid values. The low arachidonic acid in platelets is probably due to its increased consumption, indicating platelet activation in vivo.

Adult↗

Structure and function of a new hemoglobin variant, Hb meilahti (alpha 2 beta 2 36(C2)Pro----Thr), characterized by mass spectrometry.

An abnormal hemoglobin was found by isoelectric focusing in the blood of a Finnish woman with erythrocytosis. Oxygen equilibrium curves of the patient's hemolysate indicated the presence of a variant with a very high oxygen affinity. Structural analysis was carried out by mass spectrometry. In the spectrum of the tryptic digest, an abnormal peptide was found at m/z1278 which corresponded to the mass number of the protonated molecular ion of beta T4 with 36Pro----Thr substitution. The structure was confirmed by the mass spectrum of the chymotryptic digest.

Genetic Variation↗

Evaluation of risk factors in intraoperative bleeding tendency.

The effects of preoperative administration of non-steroidal anti-inflammatory drugs, intraoperative infusion of plasma expanders, type of anaesthesia, blood group and certain coagulation parameters on the bleeding tendency of 354 patients undergoing abdominal and urological surgery were analyzed. The bleeding tendency was estimated by the surgeon at the end of the operation. The preoperative use of non-steroidal anti-inflammatory drugs was associated with an increased bleeding tendency (p less than 0.05). Excessive bleeding was more common in patients who had received dextran intraoperatively, but did not reach statistical significance. Other potential risk factors were not associated with increased bleeding tendency. Two months after the operation, factors VIII:C and vWF:Ag of 32 patients were analyzed. Increased bleeding tendency was not more common in patients with low F VIII activity associated with blood group O, than in others. We conclude that the disorder of primary haemostasis caused by non-steroidal anti-inflammatory drugs is common and causes increased bleeding tendency in surgical patients. If the patient has additional risks of haemostasis, or if accurate surgical haemostasis is of particular importance, it seems justified to withdraw non-steroidal anti-inflammatory drug medication before operation.

Adult↗

Haemostatic parameters in Cushing's syndrome.

We have studied haemostatic parameters in 12 patients with Cushing's syndrome. Three patients had prolonged bleeding times, and in all seven patients whose bleeding times were measured 3-6 months after surgical treatment the postoperative bleeding times were shorter (mean 7.5 min) than the pretreatment times (mean 12.3 min). In ADP- or adrenaline-induced aggregation the second wave was lacking in six and the degree of aggregation was borderline or subnormal in five patients. One patient had, in addition, a severe defect in collagen-induced aggregation. However, thromboxane B2 production of the platelets from both endogenous and exogenous arachidonic acid was unaffected. Factor VIII:C, RAg and Rcof activities were all elevated, and in patients with severe disease F VIIIR:Ag and F VIII:Rcof activities were markedly more elevated than F VIII:C activity. The changes in both primary haemostasis and in factor VIII activities correlated clearly with the clinical severity of the disease.

Adolescent↗

Plasma beta-thromboglobulin in severe infection.

The plasma concentration of beta-thromboglobulin was serially measured in nine patients with septicemia, ten patients with pneumonia and five thrombo- and granulocytopenic patients with acute leukemia. Six patients with septicemia out of the eight studied on days 1-3 and all eight patients studied 7-14 days after onset had an abnormal high beta-thromboglobulin level. One patient with pneumonia out of six studied on days 1-3 and six out of nine studied on 7-14 days after onset had an abnormal high value. A rising trend in plasma beta-thromboglobulin with the highest mean levels at one to two weeks after onset was common to both groups. Positive ethanol gelation, increased level of fibrin/fibrinogen degradation products, decreased antithrombin III, increased FVIII complex and disproportionate ratio of FVIII:C to FVIIIR:Ag were common in both groups in the early stages of the disease. All the five patients with leukemia had a lower than normal beta-thromboglobulin level throughout the study but showed in the coagulation parameters changes similar to those observed in the other groups. Judging from the commonness of abnormal beta-thromboglobulin values in the two first patient groups, low grade platelet activation is a normal response in severe infection.

Acute Disease↗

Plasma beta-thromboglobulin in acute myocardial infarction.

Serial measurements of plasma beta-thromboglobulin concentration were made in 25 patients with acute myocardial infarction. The beta-thromboglobulin level was elevated in 18 patients on the day of presentation and the mean beta-thromboglobulin of the patients (83 ng/ml) differed significantly from the normal mean (26 ng/ml; p less than 0.001). When grouped according to the clinical severity, the most severely affected patients had the highest values (mean 128 ng/ml; n = 11). Two patients with a mild or moderate clinical course had a normal beta-thromboglobulin level throughout the study. The patients showed a distinct pattern in the evolution of the plasma beta-thromboglobulin values. The initial elevation was followed by a decrease in beta-thromboglobulin levels (mean 37 ng/ml on day 3), when only the severely affected patients differed from the normals. The beta-thromboglobulin level started to increase thereafter, reaching in many cases the highest and in some cases the only abnormally high values at the end of the second week (mean 75 ng/ml) in the survivors. The levels were mostly normal again 4-6 months after the infarction.

Adult↗