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Biomedical subjects

M U Heim

Publications and source records attributed to M U Heim.

At least 55 records · Page 3Linked to original sources
PubMed1988

[Exchange transfusion and (or) plasmapheresis: effective measures in severe tropical malaria?].

A 42-year-old man was admitted to hospital with, previously wrongly diagnosed, fulminant falciparum malaria, 14 days after a two-week trip to Kenya. He had a high fever and was jaundiced, with severe anaemia and thrombocytopenia. He was given quinine intravenously and pyrimethamine/sulfadoxine (Fansidar) by mouth. He developed acute renal failure and increasingly severe cerebral symptoms, at times coma. An exchange transfusion and several plasmaphereses were, therefore, performed. The cerebral symptoms quickly abated during the exchange transfusion, but renal function failed to improve. Because of continuing fever, mefloquin (Lariam) and doxy-cycline (Vibramycin) were also administered. After several dialysis periods the patient improved gradually and was discharged after three weeks in generally good condition with normal renal function.

Acute Disease↗
PubMed1988

[Antibody detection in emergency transfusions. A comparison of 3 different methods].

We compared the manual Polybrene technique to three standard methods (albumin/Coombs, LISS/Coombs, and enzyme/papain) on 113 red cell antibodies. Polybrene identified 8 antibodies of the Rhesus system missed by standard methods, whereas 3 antibodies could only be detected by the standard techniques. Four antibodies were identified only in saline solution at room temperature; 6 were found by use of Polybrene exclusively in the additional Coombs phase. In addition, 61 antibodies were tested by 4 different LISS. No considerable differences in the quality of the various LISS were seen. The manual Polybrene test appears to be suitable for crossmatching and rapid antibody identification in emergency situations.

Blood Group Antigens↗
PubMed1986

Acquired immune haemolysis by anti A 1 antibody following bone marrow transplantation.

In ABO mismatched organ or bone marrow transplants recently some cases of acquired immune hemolysis have been reported. It was felt that these life threatening complications were due to immunosuppressive treatment with cyclosporin-A. A case of severe hemolysis following mismatched BMT is reported. Here no cyclosporin-A treatment was given since the bone marrow was T-cell deprived by an E-rosetting technique. Apparently T-cell purging can under these conditions become dangerous.

ABO Blood-Group System↗
PubMed1985

Recognition of a positive MLR within 4 hours using a carrier free electrophoresis system.

Indicator cells--tanned, surface stabilized sheep erythrocytes--were incubated for 1 h in supernatants of 3 h MLCs. Their electrophoretic mobility was measured by an analytical, carrier free electrophoresis system. The change in their mobility compared with an appropriate control was calculated in per cent and correlated with the conventional measured MLR-cpm. The correlation of the two quantities is statistically highly significant (p less than 0.01). Furthermore, the difference of the electrophoretic mobility values of the group of HLA-D-identical and the groups of HLA-D-haploidentical or -different donors is significant beyond the 1% level (p less than 0.0005). Our method enables, therefore recognition of a positive or negative MLC after only 4 h. Typing for HLA-D-determinants seems to be possible. This could be of great importance for histocompatibility testing and organ transplantation.

Carrier Proteins↗
PubMed1985

[Influence on immune function parameters in histiocytosis-X of thymostimulin].

Immune function (mitogen and antigen stimulation, suppressor cell activity, T-cell subpopulation distribution) and immunogenetics (HLA-gene determination) were studied in 13 patients with histiocytosis-X and in 88 healthy controls. We found three clusters with significantly different immune responses (F-values greater than 4-20, p less than 0.05-0.001) against mitogenic and antigenic stimulation among the controls which differed, too, in HLA-gene distribution. As suppressor cell activity and T-cell subpopulation distribution are the same in all three control clusters, these reactivity differences should be functional ones and may be genetically determined. Patients with histiocytosis-X show a significantly reduced suppressor cell activity and their helper cells are significantly reduced compared to the controls (p less than 0.01). Furthermore, their lymphocyte reactivity does not correspond with their immunogenetics, but is significantly reduced (p less than 0.05-0.001). Suppressor cell activity, helper cells and lymphocyte reactivity normalized in all eight patients treated systemically with thymostimulin (Tp-1 Serono). It seems to be possible therefore, to influence immunological aberrations in vivo by thymostimulin. In our opinion, the results of this study justify further investigations of the immunoregulatory mechanisms of histiocytosis-X and larger prospective clinical trials with thymic factors to find out, whether such a therapy may be a real alternative to the conventional therapeutic approach in this disease.

Adult↗
PubMedDate not supplied

Rh antibodies against the pretransplant red cells following Rh-incompatible bone marrow transplantation.

A 22-year-old, blood group O, Rh-positive (R2r) man received bone marrow from his blood group A, Rh-negative (rr), HLA-identical sister for treatment of acute lymphocytic leukemia. The patient's pretransplantation serum contained anti-A in a low concentration; therefore, plasmapheresis was not done prior to transfusion of bone marrow. To prevent graft-versus-host disease, bone marrow was incubated with absorbed rabbit antithymocyte globulin prior to infusion, and the patient was treated with methotrexate in the posttransplantation period. After transplantation, the patient received 6 units of group O, Rh-negative (rr) packed red cells from random donors and 6 units of platelets from the marrow donor. Three months after transplantation, 0.5 percent of his red cells were still of the host's type (group O, Rh-positive), as detected by immunofluorescence technique in blood smears. Four months after transplantation, three different Rh antibodies--anti-D, -E, and -G--were detected. Since the patient received only Rh-negative red cell transfusions, it is concluded that he was immunized to his original red cells.

Adult↗
PubMedDate not supplied

Cryopreservation of human platelets with dimethyl sulfoxide: changes in biochemistry and cell function.

BACKGROUND: The shelf life of liquid-stored platelet concentrates is limited to 5 days. Therefore, much work has been carried out in an attempt to establish the optimum method for cryopreservation. Among the various cryoprotectants, dimethyl sulfoxide (DMSO) has been shown to be the most effective. However, DMSO-frozen platelets are characterized by a number of cell lesions. This report describes metabolic and functional changes that should give rise to some concern about the functional integrity of these cells. STUDY DESIGN AND METHODS: Single-donor platelet concentrates were frozen in liquid nitrogen by use of DMSO (5%). After thawing, the cells were washed and resuspended in autologous plasma. Before, during, and after the freezing process, samples for analysis of metabolic measures (e.g., pH; calcium, potassium, and lactate dehydrogenase concentrations; plasma complement factors) and functional measures (e.g., aggregometry, in vitro bleeding time, alpha-granule membrane protein-140 expression) were taken. RESULTS: Mean platelet volume increases during the deep-freezing process. Potassium, calcium, and lactate dehydrogenase are released from the intracellular space to the extracellular space. A strong activation of complement, which is mainly due to the addition of DMSO, is observed. Platelets become activated as indicated by the expression of alpha-granule membrane protein-140. Accordingly, decreased platelet function can be observed. CONCLUSION: DMSO-frozen platelets are characterized by several metabolic and functional changes. Although these cells have been shown to exert hemostatic effects in vivo, it is conceivable that those effects could be improved by further development of platelet-freezing techniques.

Blood Platelets↗