Biomedical subjects
Publications and source records attributed to V Kretschmer.
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Cryoprecipitates (CP) and cryodepleted plasma (CDP) were prepared from fresh frozen plasma (FFP). Plasma was easily and cleanly frozen at -50 degrees C using a methanol-bath Ultracryostat, which has been available commercially for the past few years. From a random sample (n = 6), factors VIII:C, IX:C, V:C, fibrinogen, antithrombin III and fibronectin were determined. Concerning the total contents and the in-vitro-recovery of factor VIII:C (x:104 IU/53.5%) and fibrinogen x:175 mg/36.9%), the preparation method was as efficient as other equally common methods. Apart from the well-known applications, CP may be used for the substitution of fibronectin (x:46.2 mg/73.0%). The supernatant plasma of cryoprecipitation (CDP) can be utilized for substitution of coagulation disorders especially deficiencies of the prothrombincomplex and antithrombin III (x:IX:C:183 IU/76.2%; V:C:140.5 U/73.8%; AT III:162 U/80.2%).
FAZYTAN, a system for fast automated cell segmentation, cell image analysis and extraction of nuclear features, was used to analyze cervical cell images variously stained by the conventional Papanicolaou stain, the new Papanicolaou stain and hematoxylin and thionin only; the last two dyes are used as the nuclear stains in the two versions of the Papanicolaou stain. Other dyes were also tried in cell classification experiments. All cell images in the variously stained samples could be described by the same nuclear features as had been adapted for the discrimination of conventional-Papanicolaou-stained cells. Variances were lower for thionin-stained cells as compared with hematoxylin-stained cells. By application of spectrophotometry, it was confirmed that the spectra of the cytoplasmic counterstains are superimposed on those of the nuclear stains. It appears that a variety of dyes are suitable as cytologic stains for cell classification by the FAZYTAN system, provided that they achieve sufficiently strong nuclear-cytoplasmic contrast by precisely delineating the chromatin texture.
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The morphologic and spectroscopic characteristics of a new and reproducible modification of the Papanicolaou stain are briefly described. The main features of this modification are (1) replacement of the natural dye hematoxylin by the synthetic and chemically well defined dye thionin, (2) introduction of an alcoholic counterstain consisting of eosin gamma and fast green FCF only and (3) employment of alcoholic solutions only. The absorption characteristics of hematoxylin and thionin bound to chromatin are influenced by the cytoplasmic counterstaining, especially by the two green dyes, the absorption peaks of which are close to those of the nuclear stains. The implications of these results for visual and automated cytologic diagnosis are briefly discussed.
Granulocyte transfusions (n = 222) were administered to 41 patients with granulocytopenia (less than 500 X 10(6)/1) and antibiotics-resistant infections. The average granulocyte content per transfusion was 2.1 X 10(10), 212 transfusions had been obtained by filter leucapheresis. Infections improved in 25 episodes, and 18 patients survived the 30th day. There was no influence in 18 episodes and only 2 patients survived beyond the 30th day. Extent and duration of bone marrow insufficiency, and type and grade of infection, clearly influenced prognosis. Further prognostically relevant risk factors were age (greater than 60 years) and platelet deficiency (less than 20 X 10(9)/1), as well as liver and renal insufficiency. Adherence to precise guidelines may prevent pointless transfusions.
To evaluate the applicability of a radioactive 125I-anti-IgG test (RIAT) for the detection of small amounts of IgG antibodies on red blood cells (RBC) of patients with autoimmune hemolytic anemia of warm type (AIHA), RBC of 125 patients were studied (AIHA, n = 53; Coombs'-negative AIHA, n = 6; chronic cold agglutinin disease, n = 7; non-immune anemias, n = 59). It was found that the RBC of all cases (33/33) with a positive direct IgG antiglobulin test (DAT-IgG), but also 13 out of 20 patients with a negative DAT-IgG, but detectable complement (C3/C4), and 4 out of 6 cases with Coombs'-negative AIHA gave positive results in the direct RIAT. RBC-associated IgG was higher in the DAT-IgG positive group (n = 33; -x = 8.1%) than in the DAT-IgG negative group (n = 26; -x3.4%). There was no correlation between hypergammaglobulinemia and RBC-associated IgG. The sensitivity of the indirect RIAT was not remarkable better as compared to the indirect antiglobulin test. The RIAT is valuable in the serology of borderline cases of AIHA.
Blood cell separators have been successfully used in the treatment of chronic leukaemias. With the intermittent flow system Haemonetics model 30, we found it important to collect 150-300 ml buffy coat/cycle in order to obtain a substantial depletory effect. In 2 patients with chronic myeloid leukaemia on short-term leukapheresis and in 1 patient with prolymphocytic leukaemia on long-term leukapheresis we found a definite decrease in the WBC count. 2 of them experienced a transitory improvement of their disease. Only minor side-effects occurred. However, the loss of erythrocytes and plasma albumin necessitated replacement therapy. From our experience the intermittent flow blood cell separator can be successfully used in the treatment of well-defined forms of chronic leukaemia.
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Blood component therapy aims at satisfying the clinical need of the individual patient without interfering with the general supply of blood products. This aim can be achieved on a common base by applying strict guide lines as regards the use of fresh whole blood, platelet units and coagulation concentrates and increased transfusion of packed red cells and fresh frozen plasma in a reasonable ratio (3:1) instead of whole blood. The current intention of transfusion medicine must be to improve the quality of the blood components in response to the clinical requirements. In this context the production of buffy coat poor erythrocyte concentrates with low viscosity should be generally intended. Beyond this, there are many questions still to be answered dealing with transfusion therapy.
The case of an 18-year-old male patient with aplastic anemia is reported who was successfully treated by platelets from his father, mother and uncle over a period 8 months because of the very rare constellation of HLA-A,B identity in the family. The patient deceased from uncontrollable septicemia.