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Biomedical subjects

H Heimpel

Publications and source records attributed to H Heimpel.

At least 199 records · Page 11Linked to original sources
PubMed1985

[Fibrin pleurodesis in malignant pleural effusions].

Fibrin pleurodesis was performed on 30 patients with malignant pleural effusions. A pleural catheter was inserted to empty the pleural space and effect the pleurodesis. When the pleural space was dry, 20 000 U of aprotinin were instilled intrapleurally for local fibrinolysis inhibition. 10 ml fibrinogen concentrate and 10 ml thrombin (500 U/ml) and 3000 KI U/ml aprotinin were then applied. Complete success was achieved in 19 of 27 patients, partial success in two. The results could not be evaluated in three patients. The only side-effect of the treatment was a subfebrile temperature in three of the 30 patients. Fibrin pleurodesis thus proved itself as an effective form of treatment with few side-effects (10%).

Adult↗
PubMed1985

Karyotypic evolution in patients with myelodysplastic syndromes.

Serial cytogenetic studies were performed in 33 patients with myelodysplastic syndrome in order to establish the frequency of karyotypic evolution and to correlate the chromosome and clinical findings during the course of the disease. Fifteen of the 33 patients (45%) showed abnormalities in the first cytogenetic study and this percentage increased to 57% during the course of the disease. A stable karyotype (normal or abnormal) was found in 19 patients (58%), whereas the rest (42%) showed an unstable karyotype. Trisomy 8, monosomy 7, and del5q were the most frequent abnormalities, not only at presentation, but also during karyotypic evolution. Seven patients (23%) with a known evolution proceeded to leukemia; four of them had stable (22%) and three unstable (25%) karyotypes; however, 33% of patients with unstable karyotypes and only 5% with stable karyotypes died from complications of the disease. Our results suggest that karyotypic evolution is relatively frequent in these patients; this evolution could be related to a poor clinical prognosis, either evolving to leukemia or death.

Acute Disease↗
PubMed1985

Platelet-adjusted IFN dosage in the treatment of advanced hairy cell leukemia.

It has been demonstrated that hairy cell leukemia (HCL) can be efficiently treated by various preparations of alpha interferons (IFN). Nevertheless, there are several open questions, such as the route, mode and dosage of IFN application. These variables of IFN treatment may be critical since a myelosuppressive effect of IFN, which is commonly seen in the initial phase of treatment, can result in further deterioration of the already impaired platelet production in advanced HCL. The present study shows that serious side effects can be avoided and the flu-like syndromes described by others almost completely reduced by s.c. application of IFN via a portable pump during a daily 8 h period. IFN is initially given five times a week and the daily dose is adjusted according to the actual platelet count. The efficiency controls show that the increase of platelets in the peripheral blood, which is most critical in advanced HCL, may be seen earlier by this than by other protocols, which usually recommend higher daily doses of IFN and only three instead of five weekly applications.

Adult↗
PubMed1985

Prevalence of antibodies to human T-lymphotropic virus-III (HTLV-III) in hemophiliacs and other patients chronically substituted with blood products.

The prevalence of antibodies to human T-lymphotropic virus III (HTLV-III) was determined in a total of 140 hemophiliacs and 36 polytransfused patients from three medical centers by an enzyme linked immunosorbent assay (ELISA) and confirmatory tests. 58 hemophiliacs (41.4%) were seropositive. In all instances where the origin of the coagulation factors given to these patients could be determined, blood products came from the United States. In addition, 2 of 36 polytransfused patients, mostly with acute leukemias, who were transfused with blood products from local donors were positive for HTLV-III antibodies. No HTLV-III antibodies were detected in 237 blood donors selected in part from the donor pool of the polytransfused patients.

Antibodies, Viral↗
PubMed1985

Idiopathic combined immunocytopenia.

Four patients with combined immunocytopenia of unknown origin were investigated. Two patients with pancytopenia had allo- and autoantibodies against erythrocytes, granulocytes and thrombocytes. Two other patients with granulocytopenia and thrombocytopenia showed allo- and autoantibodies against granulocytes and thrombocytes. All patients went into a transient or persistent remission under immunosuppressive therapy. The normalization of peripheral blood correlated with the disappearance of antibodies suggesting that the cytopenia was caused by an antibody mediated autoimmune mechanism.

Adult↗
PubMed1985

Unclassified type of congenital dyserythropoietic anaemia (CDA) with prominent peripheral erythroblastosis.

Two unrelated cases of congenital dyserythropoietic anaemia (CDA) are described. They show striking similarities which could not be attributed to one of the well-known types of CDA or any other congenital disease of the erythroid system. Both patients were followed for many years before and after splenectomy. There was a long-lasting, prominent post-splenectomy erythroblastosis, suggesting impairment of red cell denucleation. The type of heredity is unknown, and the enzymatic or molecular basis of the changes observed is not understood.

Adult↗
PubMed1985

Extramedullary haemopoiesis after bone marrow transplantation.

44 patients underwent bone marrow transplantation (BMT) for treatment of severe aplastic anaemia or haematological malignancies. During their post-transplant phase all patients had erythroblasts and granulocytic precursors in their peripheral blood. 15 patients died between day +6 and +346 after BMT and autopsies were performed. The sections of all 15 patients revealed extramedullary haemopoiesis in the spleen. Extramedullary haemopoiesis in the liver was found only in those patients who died early (between d +6 and d +21 after BMT). Medullary haemopoiesis, normally only occurring in the vertebral body, was also observed in the shaft of the femur. The present data show that after BMT all tissues with a haemopoietic matrix in ontogenesis can be repopulated with haemopoiesis in the early phase of reconstitution, possibly to compensate for the haemopoietic insufficiency after conditioning therapy. The expansion of haemopoiesis in the later period of up to 1 year after BMT, remains to be explained.

Acute Disease↗
PubMed1985

Drug-induced agranulocytosis: evidence for the commitment of bone marrow haematopoiesis.

Clinical and haematological features of 61 patients with drug-induced agranulocytosis (63 episodes) are presented. Multiple drug consumption was a common observation and complicated the attempt to incriminate a particular drug as being aetiologically involved. Bone marrow analysis shortly after the diagnosis revealed evidence for an impairment of proliferative granulopoiesis in the majority of cases. This observation was confirmed by in vitro culturing of granuloid precursor cells (CFU-c). Moreover, the data clearly demonstrated that drug-induced agranulocytosis may not be restricted to the granulocytic series. Thrombocytosis and reticulocytosis during the recovery phase are taken as an indication for the commitment of all haemopoietic cell lineages in agranulocytosis. These observations were in accordance with cytomorphological studies and in vitro culture data of erythroid precursor cells (CFU-e, BFU-e) of bone marrow aspirates taken in the initial phase of agranulocytosis. More than 25% of the patients showed a marked erythroid depression in the marrow.

Adolescent↗
PubMed1985

Modified immunocytochemical slide technique for demonstrating surface antigens on viable cells.

Further developments of an immunoenzymatic slide technique to demonstrate cell surface antigens with monoclonal antibodies are described. In this method cells are attached to polylysine coated glass slides in order to facilitate the handling of low cell numbers and to save antibodies and time for washing the cells. The technique has been modified for the labelling of viable cells. Endogenous peroxidase is used as an additional cell marker which does not interfere with the demonstration of antigens on the cell surface by immunoperoxidase methods. Damaged cells can be identified reliably, thereby minimising interpretation errors due to non-specific antibody uptake. A double labelling technique employing peroxidase and alkaline phosphatase coupled reagents is presented. Results of this slide technique are clear cut, so that evaluation can be performed by trained technicians.

Alkaline Phosphatase↗
PubMed1985

Aplastic anaemia: residue analysis of chlorinated hydrocarbons in human bone marrow biopsy specimens by high resolution gas chromatography.

In a first small study the chlorinated hydrocarbons present in the bone marrow of haematologically normal persons and of 6 randomly selected patients with severe aplastic anaemia have been identified and quantified by glass-capillary gas chromatography. We found great interindividual differences in the concentrations of these compounds both within the control group and within the patient group, but no definite difference between the two groups. So far, we have been unable to detect known toxic concentrations of chlorinated hydrocarbons in any of our samples, which could have supported the idea of a deficiency in the metabolism of these chemicals in some patients with aplastic anaemia.

Adult↗
PubMed1985

[Therapeutic results in acute myelogenous leukemia in the years from 1970 to 1982].

In a retrospective study, three groups of patients with acute myeloid leukaemia were analyzed in respect to the outcome of remission induction therapy: group I (vincristine, daunorubicin and prednisone) was treated between 1970 and 1976, group II (daunorubicin and cytosine-arabinoside) between 1976 and 1980 and group III (daunorubicin, cytosine-arabinoside, 6-thioguanine and consolidation therapy with cyclophosphamide, vincristine, cytosine-arabinoside and prednisone) between 1980 and 1982. Complete remissions were achieved in 49% (group I), 46% (group II) and 65% (group III) of the patients (p greater than 0.05, chi-square test). The mortality rate of the remission induction therapy was significantly reduced from 27% in group I to 15% and 13% in group II and III, respectively (p less than 0.05, chi-square test). The median remission duration increased significantly from four months (group I) to nine months (group III) (p less than 0.05, log-rank test). The long term results were about the same in the three groups. After three years, the proportion of patients being still in first remission was less than 10% in group I and II 13% in group III.

Adolescent↗
PubMed1985

Prevalence of antibodies to HTLV-III in AIDS risk groups in West Germany.

The prevalence of antibodies to human T-lymphotropic virus III was determined in acquired immunodeficiency syndrome (AIDS) risk groups by an enzyme linked immunosorbent assay and confirmatory tests in four different areas in West Germany. Twenty-four of 28 homosexual AIDS patients (86%), 24 of 33 homosexual patients with lymphadenopathy syndrome or AIDS related complex (73%), and 44 of 113 asymptomatic homosexuals at risk for AIDS (39%) were seropositive. In three groups of hemophiliacs, 8 of 35 in 1983 (23%), 25 of 65 in early 1984 (39%), and 19 of 23 in late 1984 (83%) showed positive results. Two sera from 36 polytransfused patients were also positive, whereas 36 selected blood donors, and 32 healthy laboratory and clinical personnel were all negative. Also no human T-lymphotropic virus III antibodies were detected in sera of 187 prostitutes in the Munich area.

Acquired Immunodeficiency Syndrome↗
PubMed1985

Growth and cytogenetic characteristics of bone marrow colonies from patients with 5q-syndrome.

Early erythroid precursor cells and myeloid progenitor cells (CFU-GM) from four patients with 5q-syndrome were cultured in order to study the in vitro growth patterns and to determine the clonal origin of this hematologic disorder. Cultures of CFU-GM exhibited normal colony growth, while erythroid progenitor cells demonstrated a marked decrease or absence of colony growth. Chromosomal studies indicate the 5q-chromosome is present in both hematopoietic progenitor cells, suggesting that the syndrome is an acquired clonal disease arising from a pluripotent hematopoietic stem cell. Follow-up cytogenetic studies reveal a decrease in the number of normal metaphases. This finding is consistent with reports that emphasize the slowly progressive nature of this malignant stem cell defect.

Aged↗