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Biomedical subjects

H Borberg

Publications and source records attributed to H Borberg.

At least 55 records · Page 3Linked to original sources
PubMed1991

[Evaluating a new, fully automated blood separator with continuous blood flow].

The AS 104 separator provides for platelet yields in agreement with given standards. The number of undesired cells (leukocytes, erythrocytes) compares favorably with other technical separation systems. Concentrate volumes, total amount of ACD-A used, extracorporal blood volume and the reduction of donor blood cells are no challenge for the donor. The number of technical problems is not unusual for a new separation system entering into the first clinical evaluation. These data, as well as the deviation of yields, recommend further optimation. The technical optimation achieved so far and an expanded evaluation using statistical procedures permit an optimal, donor-independent (using variance analysis) or individual (using regression analysis) equilibration of the machine and permit the recognition of potential differences between different separators, centers or software versions, thus allowing the calculation of the number of runs needed to recognize differences from optimal standards.

Adult↗
PubMed1991

[Comparative evaluation of 3 leukocyte filters for thrombocyte concentrates].

Several polyester adsorption filters are available for the removal of leukocytes during bedside filtration of platelet concentrates (PC). We tried to evaluate the efficacy of three leukocyte filters: PL-100 (Pall, USA), Sepacell PL-5A and PL-10A (both Asahi, Japan) using single donor PCs. All filters were used according to the manufacturer's instructions. The main difference in handling is the recommendation of priming and rinsing the Asahi filters with saline. Platelet counts were performed by an automatic cell counter, leukocyte (WBC) counts using a modified chamber method. Biocompatibility was examined by assessing anaphylatoxin, PMN-elastase and LDH levels, platelet function by measuring induced aggregation, hypotonic shock response, beta-thromboglobulin levels and the mean platelet volume. According to the different initial WBC contamination, three groups of PCs were tested. Group I and II were processed one hour after apheresis. Group III (n = 30) was stored at 12 degrees C up to five days before filtration. Function and integrity of post-filtration platelets were not affected as compared to the prefiltration status and bioincompatibility could not be detected. Our results indicate that the WBC reduction capacity of the filters is related to the initial WBC contamination of the PC. Beyond an initial contamination of 10(9) WBC, none of the filters is capable of reducing the leukocyte count below 10(6) WBC/PC. All but PL-5A reduce the WBC reliably below 10(6)/PC as determined from PCs routinely prepared. The Asahi filters cause significantly less platelet loss apparently due to the suggested postfiltration rinsing. Storage of PC does not influence the WBC reduction capacity, however increases the platelet loss for the PL-100.

Blood Component Transfusion↗
PubMed1991

Erythrocyte apheresis in combination with elimination of fibrinogen and plasma proteins of higher molecular weight in macular disease and in uveal effusion syndrome.

Reduction of hematocrit as well as elimination of fibrinogen and plasma proteins of higher molecular weight are effective approaches in hemorheology. A combination of these therapeutical concepts was applied in one patient with uveal effusion syndrome and in 16 patients with maculopathy. The hematocrit was reduced by erythrocyte apheresis. Fibrinogen and plasma proteins were eliminated by plasma exchange. In the case of uveal effusion syndrome the filling of the scleral veins as well as the uveal effusion were reduced. Furthermore visual function was improved significantly. In 9 of the 16 patients with maculopathy a significant increase in visual acuity occurred. The therapy described lowers significantly the following parameters: hematocrit, fibrinogen, serum proteins, plasma viscosity, erythrocyte aggregation and apparent whole blood viscosity (native and standardized). In a multiple linear regression analysis we found correlations as follows: plasma viscosity correlates with fibrinogen and proteins of higher molecular weight (r = 0.82), erythrocyte aggregation with fibrinogen and proteins of higher molecular weight (r = 0.88), standardized apparent whole blood viscosity with fibrinogen and proteins of higher molecular weight (r = 0.88) and native apparent whole blood viscosity with hematocrit, fibrinogen and proteins of higher molecular weight (r = 0.91).

Blood Component Removal↗
PubMed1990

Biocompatibility of extracorporeal immunoadsorption systems.

Following the first publication of a technique aiming for clinical application in 1969, extracorporeal immunoadsorption is increasingly finding a place among haemapheresis techniques. The apparent advantages outweigh the technical difficulties and economical drawbacks still connected with this treatment modality. At present three different developments are under clinical investigation: Staphylococcus Protein-A based immunoadsorption (SpA), the antibody-mediated adsorption (therapeutic affinity chromotography) and hydrophobic interaction-based immunoglobulin adsorption. The exact binding capacity and mechanism has not been completely elucidated for SpA and amino acid-based techniques. The lack of knowledge about pathogenic substrates exclusively responsible for the pathogenicity of many diseases, appears to be the major drawback for the prospective development of affinity chromatography-based extracorporeal systems. The practical application of molecular-biologic diagnostic procedures with a high grade of detection specificity (monoclonal antibodies) appears to be promising for the development of extracorporeal immunoadsorption. The immunomodulatory effect that results from the interaction of blood and plasma with artificial surfaces is an interesting subject of investigation, derived mainly from biocompatibility studies. The careful clinical and laboratory investigation of the biocompatibility of extracorporeal immunoadsorption systems contribute considerably to the prevention of undesired side effects.

Anticoagulants↗
PubMed1990

Role of therapeutic plasmapheresis in chronic inflammatory demyelinating polyneuropathy.

Therapeutic plasmapheresis is an effective therapy in the management of CIDP. A varying percentage of patients, approximately 30 to 60%, may benefit from the treatment. The optimal frequency and volume of PE need to be clarified, but, taking into account the heterogeneity of the disease, a too rigid approach should be avoided. According to our experience, neither morphological findings on sural nerve biopsy, nor conduction slowing, conduction block, or the amount of spontaneous activity on needle electromyography in a weak muscle correlated clearly with the later outcome of PE. Possibly our patient number is too small to provide any statistically significant predictor of outcome. In our opinion it is essential to combine plasmapheresis with effective immunosuppression to avoid a rebound with overshooting synthesis of putative pathogenic antibodies or factors. Finally, IA with T-PVA columns has proven effective in single, case-controlled patients with CIDP. It may be a promising supplement to PE avoiding the need and risks of protein replacement.

Autoimmune Diseases↗
PubMed1989

The safety of blood component preparation with blood cell separators.

Despite initial skepticism following the introduction of cytapheresis with blood cell separators, this technology is now accepted in the field of blood donation. Serious, life-threatening reactions have not been observed and thus could not influence the development, and minor problems can be reduced further on the basis of recommended safety guidelines. Additionally, the continuous registration of side effects is helpful for a complete elimination of undesired reactions.

Blood Cells↗
PubMed1987

[The safety of apparative cytapheresis].

In a retrospective analysis 1568 platelet apheresis procedures and 652 leukocytophereses performed from April 1976 to June 1986 were examined. 886 procedures were performed using the Fenwal CS 3000, 777 with the IBM 2997, and 293 with the Haemonetics V50, whereas in 264 procedures the Model 30 was used. The study aims to answer 3 donor-related questions: To what extent are the blood cells changed by the donation? How does the donor respond to the technical requirements of the donation, such as length of the procedure, blood volume processed, amount of concentrate removed during the donation? How often did side-effects or undesired reactions occur? We found that thrombocytapheresis led to a decrease in platelets in the peripheral blood of between 20% (CS3000) and 33.7% (IBM), and an increase in leukocytes of between 4.24% (IBM) and 17.8% (Model 30), whereas erythrocytes, hemoglobin and hematocrit showed a similar decrease within a range of between 1.1% and 2.67% in all systems. Following leukocytapheresis the leukocyte counts of the peripheral blood were decreased by up to 12%, erythrocyte counts by up to 5% and platelets between 15% (IBM) and 29% (Model 30). The list of irregularities included technical problems and donor reactions (e.g., citrate reactions, reactions of blood circulation, and blood flow in the donor). There were no serious side-effects. Early terminations of 42 (= 1.9%) donations were for prophylactic reasons exclusively. Few moderate undesired reactions occurred (4 = 0.2%), but none of the donors contributing to the more than 2,000 donations were ever hospitalized, demonstrating the safety of cytapheresis with all separators.

Blood Cell Count↗
PubMed1986

[Regression of coronary sclerosis in familial hypercholesterolemia IIa by specific LDL apheresis].

The long-term effect of specific LDL plasma immunabsorption on the course of coronary arteriosclerosis was tested in ten patients with familial hypercholesteremia type IIa (seven females, three males; age range 15-57 years). Available were ECG, bicycle ergometry, hemodynamic and angiographic data. These tests were repeated seriatim in the course of the LDL immunabsorption. It was found that exercise tolerance markedly increased, ischemic ST-changes became less marked and the initial hemodynamic parameters remained unchanged. The morphology of the coronary arteries was influenced lastingly: among 22 stenoses only one progressed, there was no further progression in 11 stenoses and regression in ten. When there was generalized arteriosclerosis, progression occurred in two of 79 coronary artery segments, progression was arrested in 56 and regression was noted in 21 of 79 segments. These results demonstrate that specific LDL plasma immunabsorption for the elimination of LDL cholesterol favorably influences the course of coronary arteriosclerosis in patients with familial hypercholeremia type IIa. The findings support the lipid theory of atherosclerosis and coronary arteriosclerosis, at least in this special group of patients.

Adolescent↗