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Biomedical subjects

S Stenbjerg

Publications and source records attributed to S Stenbjerg.

At least 37 records · Page 2Linked to original sources

HTLV-III seropositivity in European haemophiliacs exposed to Factor VIII concentrate imported from the USA.

77 Scottish haemophiliacs and 22 Danish haemophiliacs were serologically tested for antibodies to human T-cell leukaemia virus III (HTLV-III). Since 1979 the Scottish patients had been treated largely with factor VIII concentrate produced in Scotland, whereas all but 2 of the Danish patients had received both locally prepared concentrate and commercial concentrate made from US donor material. 15.6% of Scottish and 59.1% of Danish haemophiliacs were antibody positive (p less than 0.001). None of 11 haemophiliacs not treated in the period 1979-84 was seropositive. 2 (6.7%) of 30 subjects who had been treated with locally produced concentrate only were antibody positive, compared with 23 (39.7%) of 58 subjects who had been treated with commercial concentrate. Among 52 users of both commercially and locally produced factor VIII concentrate, seropositivity was directly correlated with the consumption of commercial concentrate (p less than 0.001) but not locally produced material. These data indicate that European haemophiliacs were exposed to HTLV-III via some factor VIII concentrates obtained from the USA.

Adolescent↗

Factor VIII inhibitor treatment with high doses of F VIII.

A hemophilic patient with F VIII inhibitor was treated with intermittent F VIII infusions of 40 - 50 units per kg bodyweight per week. Although the inhibitor declined during treatment, an anamnestic response was recorded on two occasions. A continuous high dose F VIII regimen of 200 units per kg per day resulted in reduction of the inhibitor concentration to less than 1 unit per ml. No anamnestic response was seen after a later exposure to intensive F VIII therapy.

Antibodies↗

Platelet aggregation in focal cerebral ischemia -a clinical study.

In a consecutive series of 35 patients with transient ischemic attacks (TIAs) 26 patients (74%) had pathological platelet aggregation 4 weeks after the latest TIA. Pathological platelet aggregation was the most frequent factor leading to a prophylactic treatment of the TIAs. Among 12 patients with reversible ischemic neurological deficit (RIND) only one had pathological platelet aggregation, and among 54 patients with completed stroke 37% had pathological platelet aggregation 4 weeks after the cerebral infarction. It is possible by the antiaggregating agents acetylsalicylic acid and dipyridamole to normalize in vitro pathological platelet aggregation. The frequency of side effects was low. During this treatment further TIAs were stopped in 17/19 patients, and remission were seen in 14/14 stroke patients. Compared with the remissions during treatment with anticoagulants there was a tendency of more favourable outcome in the group of stroke patients when treated with antiaggregating agents.

Adult↗

Heparin levels and activated clotting time (ACT) during open heart surgery.

Heparin levels were followed by an amidolytic method during open heart surgery in 10 adult patients and correlated to the activated clotting time (ACT) (Haemochron). There was a good correlation between the 2 parameters when the ACT was below 600 s. Based on the present and previous studies of the ACT the authors conclude that the ACT is a useful tool in control of heparinization during open heart surgery.

Blood Coagulation Tests↗

Platelet function and fibrinolytic activity after a single dose of diflunisal (Donobid).

ADP and collagen-induced platelet aggregation and parameters related to the fibrinolytic system were studied in groups of healthy persons who had ingested 500 mg of diflunisal. A single dose of diflunisal resulted in a depression of platelet function in most cases. However, the effect was limited and only of clinical relevance in patients with a defective platelet function. A frequent finding was an enhanced fibrinolytic activity in plasma and saliva 2 h after ingestion of diflunisal. In approximately one-third of the cases studied, the fibrinolytic activity in saliva rose to levels that induced clot lysis within a few minutes. This could explain the clinical observation that administration of diflunisal prior to dental surgery is followed by dry socket symptoms in one-third of the patients.

Adenosine Diphosphate↗

A specific, fluorescent activity staining procedure applied to plasma and red blood cells in congenital factor XIII deficiency.

The activity staining procedure introduced by Stenberg & Stenflo (1979) has been applied to studies on human blood transamidases (transglutaminases; endo-gamma-glutamine:epsilon-lysine transferases; e.g. factor XIII). The technique combines agarose gel electrophoresis with activity staining based on the transamidase catalysed incorporation of monodansylthiacadaverine (N-(5-amino-3-thiapentyl)-5-dimethylamino-1-naphtalenesulfonamide) into casein. The method permits detection of plasma factor XIII activity down to 1% of the normal adult standard. The technique was used on plasma from two patients with tentative congenital plasma factor XIII deficiency (based on clot solubility). No activity was found in platelet poor as well as in platelet rich plasma which confirmed the diagnosis. In the erythrocytes studied in genetic determinations of the plasma and red blood cell transamidases. Using immunoelectrophoresis, the plasma factor XIII b subunit was found to be 43% and 44% of the concentration in normal standard plasma.

Adolescent↗

Possible increased tendency to thrombosis after cerebral angiography.

Two patients are presented in whom cerebral angiography was complicated by bioccipital infarcts resulting in cortical blindness with persisting severe restriction of the visual field (case 1) and persisting cortical blindness (case 2). One patient (case 1) demonstrated a compensated, protracted disseminated intravascular coagulation (Table 1), which disappeared after treatment with phenprocoumon (Marcoumar). The other patient (case 2) demonstrated increasee spontaneous platelet aggregability (Table 2), which was treated sucessfully with acetylsalicylic acid (Magnyl) and dipyridamole (Persantine). We presume that the coagulation disturbances demonstrated after the angiography may be pathogenetic to the complications. We propose that patients with transient cerebral ischemia and apoplexy who are undergoing cerebral angiography should be studied with regard to coagulation before and after the cerebral angiography so that coagulation disturbances demonstrated may be treated before, or corrected after the angiography.

Blindness↗

Evaluation of the activated whole blood clotting time (ACT) in vitro.

The activated whole blood clotting time (ACT) was analyzed in vitro using blood samples from normal individuals and from patients with heart disease, scheduled for open heart surgery. The ACT was found to be normally distributed in a group of normal individuals with a mean of 135 sec. In patients with heart diseases, the average ACT was slightly shorter than in normal individuals. A linear relationship between ACT and heparin concentrations was established. Haemodilution and depletion of platelets did not significantly influence the ACT. When a clean venipuncture with disposable needles is used, ACT is a reliable, uncomplicated bedside technique by which heparinisation can be monitored.

Blood Coagulation Tests↗

Fibrinolytic factors in aqueous humour and serum from patients with Fuchs' dystrophy and patients with cataract.

The concentration of alpha 2-macroglobulin, alpha 1-antitrypsin, plasminogen, C3-complement, fibrinogen degradation products (FDP) and fibrinolytic activity, were studied in the aqueous humour and serum from nine patients with Fuchs' endothelial dystrophy, 17 patients with uncomplicated senile cataract and in the secondary aqueous from six cataract patients. Finally, the aqueous humour and serum from two patients anterior uveitis were studied. An increased concentration of alpha 2-macroglobulin, alpha 1-antitrypsin, plasminogen and C3-complement was found in both the aqueous and the serum from patients with Fuchs' dystrophy when compared with the primary aqueous and serum from patients with cataract but this was only significant for alpha 1-antitrypsin in aqueous humour. A significant increase in the amount of FDP was found in the serum of the Fuchs' patients compared with the cataract patients. Fibrinolytic activity could not be demonstrated in the serum in any of the patient groups. The concentrations of the various factors found in the secondary aqueous of the cataract patients differed only slightly from the content of the primary aqueous of the Fuchs' patients.

Aged↗

Activated F IX concentrate (FEIBA) used in the treatment of haemophilic patients with antibody to F VIII.

Bleeding episodes in five haemophiliacs with antibody to F VIII were treated by activated F IX concentrate (FEIBA). Relief of pain and haemostasis in affected muscles and joints were recorded in each case. One patient developed a mild attack of disseminated intravascular coagulation with an uneventful recovery. A substantial rise in natural inhibitors of coagulation was seen in two patients, and all but one experienced a rise in F VIII antibody titer.

Adult↗