[Characteristic shifts of IGG subclasses G1 and G2 in malignant diseases].
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Humans↗
Biomedical subjects
H Gombotz
Publications and source records attributed to H Gombotz.
Labile disulfide bonds and free thiol groups in human IgG. I. Assignment to IgG1 and IgG2 subclasses.
The content of free SH groups (about 0.24) and labile S-S bonds (about 0.64) per mole human IgG can be differentially determined by the reaction with 5,5'-dithio(2,2'-dinitro)benzoate (DTNB) for 30 min and 24 h, respectively. Highly significant linear correlations were found between the number of labile S-S and the percentage of IgG1, and the number of free SH and the percentage of IgG2 of the total IgG fraction. It is concluded that the IgG1 molecule contains one S-S bond which is opened during the 24 h interaction with DTNB by a disulfide exchange reaction. This was also confirmed by the investigation of pure monomeric IgG1. The splitting of this bond does not alter molecular weight, antigenic properties or antigen binding activity, but reduces significantly the complement binding activity of IgG. On the other hand, one free SH group could be found in the IgG2 molecule. Changes have been observed in SH and S-S levels of total IgG in patients with various malignant diseases that are to be explained by corresponding changes of the percentages of IgG1 and IgG2.
Disulfides↗
Labile disulfide bonds and free thiol groups in human IgG. II. Characteristic changes in malignant diseases corresponding to shifts of IgG1 and IgG2 subclasses.
As recently shown, the measurement of labile disulfide bonds and free thiol groups of human IgG using 5,5'-dithio(2,2'-dinitro)benzoic acid (DTNB) provides direct information about the relative concentrations of IgG1 and IgG2, respectively. Furthermore, using this technique data have been obtained that show a decrease in labile S-S (corresponding to IgG1) and increase of free SH (corresponding to IgG2) in IgG from patients afflicted with various malignant diseases. In the present study a total of 280 sera from patients with malignancies of various tissue origin was investigated. Significantly reduced sigma S values, i.e. the sum of free SH and labile S-S, were obtained with IgG from cases of carcinoma of the mammary gland, urinary bladder, skin and prostate, as compared to cases with benign diseases of the respective organs. Most pronounced differences were observed between benign and malignant disorders of the prostate. It was confirmed with this group of patients that the reduction of sigma S was due to the decrease of S-S bonds, whereas the number of free SH groups remained unchanged or was increased. The cases of mammary gland carcinoma were grouped according to clinical stage. A clear correlation between reduction of sigma S and tumor size was observed. The possible theoretical and clinical implications of these results are discussed.
Breast Neoplasms↗
[Antithrombin III behavior in open heart operations in infancy and early childhood].
Antithrombin III activity was evaluated preoperatively, intraoperatively and postoperatively in the plasma of 54 children with congenital heart disease undergoing open heart surgery. The patients were divided into an acyanotic and a cyanotic group. A comparison of these two groups indicated a significantly decreased AT III activity in cyanotic children as compared to acyanotic children throughout the perioperative phase. AT III levels decreased in the cyanotic group from 71.9 +/- 3.77% preoperatively to 61.5 +/- 2.15% (p less than 0.01) postoperatively and rose to 69.6 +/- 2.36% (p less than 0.01) on the first and to 78.9 +/- 2.24% (p less than 0.01) on the second postoperative day. In the acyanotic group AT III levels decreased from 84.3 +/- 1.98% to 73 +/- 2.97% (p less than 0.01) postoperatively and increased to 78.5 +/- 2.96% (p less than 0.01) on the first and to 90.2 +/- 3.06% on the second postoperative day. A few acyanotic patients, too, showed decreased values of AT III. However, they were never found to be as low as in the cyanotic group. Preoperative AT III values as well as the severity of underlying disease, the success of corrective surgical treatment and postoperative complications proved to be the predominant influencing factors of AT III activity.
Antithrombin III↗
[Results of emergency aortocoronary bypass surgery in patients with acute myocardial ischemia after percutaneous transluminal coronary angioplasty].
From April 1980 to June 1985 7.3% (15) of 205 PTCA-treated patients required emergency operations. The spectrum of PTCA-induced ischemia included anginal pain alone (2/1, 13%) or transmural infarction (13/15, 87%) with hypotension (8/15), cardiac arrest (4/15), and severe cardiogenic shock (3/15, 20%). 14 patients underwent saphenous-vein-bypass-graft operation (ACBG) with a mean of 1.7 grafts performed per patient. The average time from onset of symptoms to completed revascularisation was 166.5 (110 to 290) minutes. Inspite of the use of IABP one hospital death (6.6%) occurred prior to the institution of ECC in a patient with previous ACBG surgery. No late death was observed during a mean follow up of 11.1 (1 to 33) months with 13/14 patients free of anginal symptoms. Retrospective assessment of postoperative serum enzyme levels of CPK and CK-MB showed evidence of myocardial infarctions in 7/14 (50%) patient. The incidence on ECG of Q-wave infarctions was 35,7% (5/14). With the exception of one patient, IABP was not used pre- or postoperatively. In patients with acute myocardial ischemia following PTCA-attempts immediate restoration of myocardial blood flow can stabilize left ventricular function and reduce the incidence and size of myocardial infarctions. The availability of emergency ACBG-surgery and facilities remain an important prerequisite of PTCA-programs due to the unpredictable natural course of PTCA-induced myocardial ischemia.
Adult↗
[Open heart surgery in Jehovah's Witnesses].
Patients who are Jehovah's Witnesses present a special problem when undergoing open heart surgery since they refuse blood transfusion. We performed 15 open heart operations for both acquired and congenital heart disease using a modified version of isovolaemic haemodilution and bloodless prime technique of extracorporeal circulation. Two patients died. One death might have been at least indirectly related to the regimen which excludes blood substitution. We believe that our experience demonstrates the feasibility of open heart procedures in Jehovah's Witnesses, although the mortality risk is increased in these patients.
Adolescent↗