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Biomedical subjects

H G Klein

Publications and source records attributed to H G Klein.

At least 145 records · Page 8Linked to original sources
PubMed1979

Traumatic cardiac hemolytic anemia: a late complication of a Starr-Edwards mitral valve prosthesis.

Severe, traumatic, cardiac, hemolytic anemia developed in a patient nine years after mitral valve replacement with a Starr-Edwards model 6120 prosthesis. Cardiac catheterization failed to demonstrate a perivalvular leak or prosthetic malfunction. Transfusion on two occasions resulted in accelerated hemolysis and failed to maintain an appreciable elevation of the hemoglobin level. At operation, a perivalvular leak was found. Replacement of the valve led to complete resolution of the hemolytic problem. The case demonstrates that cardiac hemolysis may be a good indicator of valve dysfunction.

Anemia, Hemolytic↗
PubMed1978

The establishment of a chimpanzee breeding colony for hepatitis research.

The chimpanzee is the most appropriate animal model for hepatitis B research. Because these primates are scarce and expensive it is important that optimum use be made of available animals and facilities. The establishment of a chimpanzee breeding colony is described and a model for providing primates for research is outlined.

Animals↗
PubMed1977

A co-operative study for the detection of the carrier state of classic hemophilia.

To determine the specificity and sensitivity of current technics for detecting carriers of classic hemophilia, three investigators simultaneously tested obligate carriers and noncarriers for immunologic and procoagulant factor VIII activity. Overall correct classification ranged from 72 per cent (36 of 50) to 94 per cent (47 of 50). The maximum accuracy obtained with the same linear-discriminant-function method on all data was 90 per cent (26 of 29) in detecting carriers without misclassifying normal persons as carriers (none of 21). Lowest accuracy by the same technic was 66 per cent (19 of 29) carrier detection while misclassifying 19 per cent (four of 21) normal persons. Precision of testing for both factor VII activity and antigen was high (standard deviations from 0.004 to 0.026 on a log scale). Differences between participants seemed related to laboratory technics rather than to statistical methods. The factor VIII activity/antigen measurement is a valid technic for detecting in the carrier state of hemophilia A.

Antigens↗
PubMedDate not supplied

Surgical hypothermia in a patient with a cold agglutinin. Management by plasma exchange.

Cold agglutinins are a potential danger to patients who must be subjected to hypothermia. A patient with a cold agglutinin of moderate titer but broad thermal amplitude was to undergo hypothermia during aortic valve replacement. He was managed preoperatively with an eight-liter plasma exchange by continuous-flow centrifugation to remove the cold agglutinin. There were no adverse effects during or after hypothermia.

Agglutinins↗
PubMedDate not supplied

Modifications of B, I, i, and Lewisb antigens in a patient with DiGuglielmo's erythroleukemia.

Loss of red blood cell antigens has been documented in patients with acute myelocytic leukemia and includes loss of A, B, and H antigens in the ABO system as well as antigens of the Rh, MNSsU, Lewis and Ii systems. The following case represents partial loss of the B, I and Lewisb antigens in a patient with erythroleukemia. Also, the loss of the I antigen was associated with a concomitant increase in i antigen, a known but rare finding. These changes within the ABO, Ii, and Lewis systems do not appear to be coincidental, as these blood group systems share a common biochemical backbone.

ABO Blood-Group System↗
PubMedDate not supplied

Automated partial exchange transfusion in sickle cell anemia.

Partial exchange transfusion is used to manage several of the complications of sickle cell anemia. Automated exchanges have been performed successfully in thirteen homozygous (SS) sickle cell patients and in one patient with hemoglobin SC. Although the expected acute increase in whole blood oxygen affinity occurred in each patient, there was no clinical evidence of detrimental effects during or immediately after each procedure, and in each case the patient was unchanged or improved when evaluated by exercise testing. By using a discontinuous-flow cell separator, it is possible to decrease the time required to achieve a 50 per cent exchange in an adult to approximately two hours. Transfusion of blood with an antigenic marker permits rapid evaluation of exchange efficiency during the procedure. When partial exchange transfusion is indicated, the discontinuous-flow cell separator provides a safe, rapid, and effective procedure.

Adult↗
PubMedDate not supplied

Alloimmunization in two multitransfused patient populations.

A retrospective study was undertaken to determine the frequency of alloimmunization in two multitransfused patient populations. Three hundred eighteen unselected patients whose transfusion records were available were studied. One hundred fifty-seven patients had sickle cell disease (SCD) and 161 had thalassemia. Forty-four antibodies were detected in 23 of the 99 transfused SCD patients. The predominate antibodies were in the Rh group: seventeen were anti-rh"(E), eight were anti-rh'(C), and four were anti-rh'w(Cw). Of the remaining antibodies, five were anti-Kell, three were anti-Jka, two were anti-Jkb, three were anti-Fya, one was anti-Bga, and one was anti-S. In the thalassemic patients, six antibodies were detected in 4 of the 39 transfused patients. Of these, there were two anti-Kell and one anti-Rho (D), anti-rh'(C), anti-rh'w(Cw), and anti-Fya each. Although the SCD patients were more likely to have been transfused at the parent institution than were the thalassemic patients (69% vs. 24%, p less than 0.05), the frequencies of alloimmunized patients, the total number of antibodies, and the number of Rh antibodies did not differ significantly (p greater than 0.05) for transfused patients in the two populations.

Adolescent↗
PubMedDate not supplied

Automatic special case consultations in transfusion medicine.

In the past, consultations in immunohematology were usually delivered only when there was a blood or component shortage, or when the time required for compatibility testing was prolonged due to the presence of a difficult recipient antibody problem. More recently, transfusion medicine physicians have increased their role as clinical consultants concerned about the appropriate indications for blood transfusion. This communication presents a way to begin a sound program of clinical transfusion medicine consultation. The program can fit with community-wide teaching efforts, community or hospital transfusion audits, and specific physician education programs. Automatic or unsolicited consultations appear to have been both accepted well and beneficial in large hospitals and in communities where they have been provided for more than 7 years.

Antibodies, Viral↗
PubMedDate not supplied

Use of a continuous-flow cell separator in density gradient isolation of lymphocytes.

A continuous-flow technique was developed to isolate and concentrate lymphocytes over Ficoll-Hypaque (FH) density gradients using an automated cell separator (Model CS-3000, Fenwal). Lymphocyte concentrates (LC) containing 6.51 X 10(9) mononuclear cells were obtained by standard leukapheresis techniques. Disposable apheresis kits were modified to allow the LC to be pumped into a separation chamber along with a counter-centrifugal flow of saline, removing the platelets and plasma by elutriation. The remaining cells were underlaid with 300 ml of FH, displacing the lymphocytes into a collection bag, where they were washed and concentrated. Mean leukocyte recovery was 59.2 percent (99.9% lymphocytes, n = 14). The final product contained 6.7 percent of the initial platelets and had a hematocrit of less than 1 percent. In paired studies using split leukocyte concentrates (n = 15), lymphocyte recovery obtained by the automated apheresis technique compared favorably with that obtained by standard manual FH gradients (59.8 +/- 3.4% versus 67.3 +/- 4.2%, p greater than 0.05) and platelet contamination was significantly reduced (2.7 +/- 0.5% versus 26.6 +/- 5.7% residual platelets, p less than 0.001). Equivalent lymphokine-activated killer (LAK) activity was generated from cells isolated by both manual and automated techniques. An automated continuous-flow cell separator can be used for rapid FH isolation of large numbers of lymphocytes, providing a sterile product suitable for human use.

Cell Separation↗
PubMedDate not supplied

Bulk cryopreservation of lymphocytes in glycerol.

The authors describe a method for freezing large amounts of peripheral blood lymphocytes (PBL) in a 20 percent glycerol solution. Between 0.6 and 4.3 X 10(9) cells in autologous plasma were frozen in polyethylene freezing bags in a final volume of 50 ml. The recovery after thawing averaged 89 +/- 14 percent with a mean viability by trypan blue dye exclusion of 80 +/- 7 percent (n = 11). In aliquots of fresh and frozen-thawed PBL from the same subjects radiolabeled with 111In, the radiolabeling efficiency for both fresh and thawed cells was 49 +/- 15 percent (p = 0.98, n = 5). The mitogen mean stimulation indices for glycerol-frozen cells (471 with phytohemagglutinin-M, 176 with pokeweed mitogen, and 380 with concanavalin A) were superior to those of cells frozen by a standard technique with dimethylsulfoxide (DMSO) (141, 47, and 123; p less than 0.05) and comparable to those of fresh PBL (403, 75, and 147). In a mixed lymphocyte culture, glycerol-frozen PBL showed significantly greater responsiveness to a pool of stimulator cells than did PBL frozen in DMSO (p = 0.03). Thawed cells are viable and functional as demonstrated by their response to mitogens and their ability to stimulate and respond in mixed lymphocyte culture.

Blood Preservation↗
PubMedDate not supplied

Efficacy of various methods of confidential unit exclusion in identifying potentially infectious blood donations.

To determine the efficacy of various methods of confidential unit exclusion (CUE) among donors at increased risk of HIV exposure, we surveyed AABB institutional members on their experience with 3 CUE methods: ballot or barcode, completed at the time of donation, and call-back, performed by the donor after leaving the donor center. From June 1985 to December 1987, 5,049,883 donations at 48 donor centers were evaluable for analysis. The results of this survey suggest that ballot and barcode methods of CUE are important adjuncts to other donor screening procedures in identifying potentially infectious units, and that both of these methods are superior to the call-back system of unit exclusion.

Blood Banking↗