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Biomedical subjects

W Graninger

Publications and source records attributed to W Graninger.

At least 253 records · Page 14Linked to original sources
PubMed1987

Haemolytic transfusion reactions due to HLA antibodies. A prospective study combining red-cell serology with investigations of chromium-51-labelled red-cell kinetics.

In a prospective study to see whether HLA sensitisation is associated with increased red-blood-cell (RBC) destruction after HLA-incompatible transfusion, chromium-51-labelled RBC survival and site of sequestration were monitored in nine patients in whom HLA antibodies had developed after RBC transfusions. The donors selected were compatible in ABO and RBC-specific antigen systems but mismatched for the HLA antigen in question. Haemolytic transfusion reactions occurred in all four patients who received HLA-B7-incompatible RBC. A direct radioimmune anti-IgG test became positive, Cr51-RBC survival was very short (22.3, 36.9, 41.4, and 44.0 days), and excess sequestration in the spleen was measured. There was a rise in serum lactic dehydrogenase and a fall in haptoglobin. HLA-B7 antibody was detected in the eluate prepared from RBC collected after transfusion. A similar reaction was found in only one further patient, caused by an HLA-A2 incompatibility. No indications of immune-mediated RBC sequestration were discernible after transfusion of HLA-B7-compatible RBC in one of the patients who had shown a reaction with HLA-B7-incompatible blood, nor in any of the other patients who received HLA-B7-compatible RBC. The haemolytic transfusion reactions could not be anticipated by conventional crossmatch procedures, nor by the measurement of the Cr51-RBC survival 1 h after transfusion.

Aged↗
PubMed1987

Excessive myocardial calcinosis in a chronic hemodialyzed patient.

Secondary oxalosis in chronic hemodialyzed patients is caused by impaired renal excretion and inadequate removal of oxalic acid during hemodialysis. Ascorbic acid is a precursor of oxalic acid. We report a parathyroidectomized patient with chronic renal failure, on hemodialysis, who received over a period of several months a total dose of 91.0 g ascorbic acid i.v. The plasma oxalic acid level in this patient was 14-fold higher than in healthy persons. Increased oxalic acid synthesis from its precursor ascorbic acid may be responsible for hyperoxalemia, high content of oxalic acid in myocardium, aorta and lung, and calcium oxalate deposition in soft tissues. Application of high doses of ascorbic acid should be avoided in hemodialysed patients with chronic renal failure.

Adult↗
PubMed1987

Survival and quality of life in 23 patients with severe aplastic anemia treated with bone marrow transplantation (BMT).

Survival and quality of life are reported in 23 pretransfused patients with severe aplastic anemia (SAA) who underwent bone marrow transplantation (BMT). The projected survival is 76% with 18 of 23 patients being alive 332 to 1677 days post graft (median: 842). 5 patients died between day 4 and 416. 12 of 17 patients at risk developed chronic graft versus host disease (GVH-D). 4 of these patients have a diminished quality of life due GVH-D related disabling manifestations. Autologous haemopoietic recovery was excluded in all patients by the demonstration of haemopoietic chimerism. We recommand age-adapted rejection prophylaxis; such strategy may help to diminish disabling graft versus host disease in otherwise haematologically reconstituted survivors.

Adolescent↗
PubMed1987

Mechanism of the t(14;18) chromosomal translocation: structural analysis of both derivative 14 and 18 reciprocal partners.

To elucidate the mechanism of the t(14;18)(q32;q21) chromosomal translocation found in follicular lymphoma, we examined the structure of both derivative (der) chromosomal breakpoints as well as their germ-line predecessors. We noted that chromosome segment 18q21 was juxtaposed with immunoglobulin heavy (H) chain gene diversity (DH) regions on all five der(18) chromosomes we examined, and we confirmed the juncture with immunoglobulin H-chain gene joining (JH) regions on the der(14) chromosome. However, the t(14;18) was not fully reciprocal in that chromosome 14 DNA between the DH and JH regions was deleted. Furthermore, extra nucleotides, reminiscent of "N" segments, were present at the der(14) and possibly der(18) junctions. This indicates that despite the mature B-cell phenotype of follicular lymphoma, the t(14;18) occurs during attempted DH-JH joining, the earliest event in immunoglobulin rearrangement in a pre-B-cell. Our detailed analysis of the germ-line 18q21 region indicated that most breakpoints clustered within a 150-base-pair major breakpoint region. However, we found no evidence for evolutionarily conserved immunoglobulin-like recombinational signals at 18q21, arguing against a role for immunoglobulin recombinase in chromosome 18 breakage. Instead, a direct repeat duplication of chromosome 18 sequences was discovered at both chromosomal junctures, typical of the repair of a naturally occurring staggered double-stranded DNA break. These results prompt a translocation model with illegitimate pairing of a staggered double-stranded DNA break at 18q21 and an immunoglobulin endonuclease-mediated break at 14q32 and with N-segment addition, repair, and ligation to generate der(14) and der(18) chromosomes.

Base Sequence↗
PubMed1987

HLA-DR antigens in systemic lupus erythematosus: association with specificity of autoantibody responses to nuclear antigens.

HLA-DR antigens and autoantibodies to the nuclear or cytoplasmic antigens Ro/SSA, La/SSB, Sm, and RNP were determined in North American and Austrian patients with systemic lupus erythematosus (SLE). Analysis of the association of antibodies to these ribonucleic acid (RNA)-protein antigens with HLA-DR antigens showed that HLA-DR3 was related to the presence of anti-Ro/SSA or anti-La/SSB, or both. In contrast, anti-Sm or anti-RNP, or both were associated with HLA-DR4. HLA-DR5 was associated with absence of these autoantibodies. The data extend evidence for the complexity and heterogeneity of SLE. Moreover, they indicate that, in SLE, genes linked to those coding for HLA-DR antigens, are related to the specificity of autoantibody responses rather than to the primary immunological abnormalities of this disorder.

Adolescent↗
PubMed1987

Effect of cefotaxime, ceftriaxone and latamoxef on blood coagulation in patients on parenteral nutrition.

Plasmatic coagulation parameters were studied in patients on parenteral cephalosporins with different hepatic pharmacokinetics. Sixty patients received either cefotaxime (4 g/day), ceftriaxone (2 g/day) or latamoxef (4 g/day) pre- and postoperatively for at least 5 days at random. They received parenteral nutrition without vitamin K supply and had no oral intake. A significant drop (p less than 0.05) in vitamin-K-dependent coagulation factors was recorded in patients treated with latamoxef, while patients receiving ceftriaxone and cefotaxime did not exhibit a significant change in their plasmatic coagulation parameters. Interference of some cephalosporins with the vitamin-K-dependent hepatic metabolism of clotting factors seems to be likely, rather than a suppression of intestinal vitamin K production by the intestinal microflora.

Aged↗
PubMed1987

In vitro evaluation of teicoplanin and other antimicrobials against streptococci group D bacteria.

In vitro activities of teicoplanin were compared with those of ampicillin, imipenem, rifampicin, coumermycin and vancomycin against clinical isolates of Streptococcus faecalis (n = 100) and Streptococcus faecium (n = 30). Against Str. faecalis, ampicillin and imipenem had an MIC90 and MBC90 of 3.9 micrograms/ml. Coumermycin and rifampicin had poor bactericidal activity with MBC90 values of 31.2 and 62.5 micrograms/ml. Teicoplanin was extremely active with an MIC90 of 0.95 microgram/ml and an MBC90 of 1.86 micrograms/ml.

Anti-Bacterial Agents↗
PubMed1987

Tolerability of a new vitamin K1 preparation for parenteral administration to adults: one case of anaphylactoid reaction.

The efficacy and tolerability of a conventional vitamin K1 preparation containing polyoxyethylated castor oil as solubilizer were compared with those of a new compound containing mixed micelles as solubilizer in 30 patients. A statistically significant increase in the thrombotest was detected after treatment in both groups. No hematological or chemical toxicity was observed during the observation period. One patient had an anaphylactoid reaction after intravenous injection of the mixed micelles preparation. Intradermal testing yielded positive results. The authors conclude that intravenous administration of vitamin K preparations should be reserved for acute emergencies.

Adult↗
PubMed1986

[Addison's disease with enlarged adrenal glands in sonography and computer tomography. Differential diagnostic considerations based on 2 cases of tuberculous adrenalitis].

One of the major causes of chronic adrenal insufficiency (Addison's disease) is tuberculous adrenalopathy. Since sonography and computed tomography have become generally available in recent years and are of potential help in the diagnosis of this disease the merits of these methods are discussed in the light of 2 cases of adrenal tuberculosis, followed by a review of the literature. Adrenal calcification is the most significant, although not specific sign of adrenal insufficiency due to tuberculosis. Computed tomography has proven to be the method of choice in the non-invasive diagnosis of tuberculous adrenalopathy and in the monitoring of tuberculostatic treatment in this disease. Sonography is helpful as a preliminary investigation.

Addison Disease↗
PubMed1986

Efficacy of rhesus antibodies (Anti-Rh0 (D)) in autoimmune thrombocytopenia: correlation with response to high dose IgG and the degree of haemolysis.

We have compared the efficacy of high-dose IgG with that of Rhesus antibodies (anti-Rh0 (D)) in 5 patients with autoimmune thrombocytopenic purpura (3 adults and 2 children). Although only transient, high-dose IgG (0.4 g/kg X 5 days) was effective in all patients (peak values 50-200 X 10(9)/1), whereas anti-Rh0 (D) (11-20 micrograms/kg X 5 days) led to comparable results in only 3 patients (165 X 10(9)/1, 72 X 10(9)/1, 33 X 10(9)/1). This response to anti-Rh0 (D) was neither related to the degree of induced haemolysis (increase of LDH and decrease of haptoglobin) nor to the amount of IgG antibodies bound to red blood cells, as quantified by the 125-I-antiglobulin test. A decrease of platelet-associated IgG was recorded in 3 patients: 2 of them showed an improvement of platelet counts and in one of them there was no response. We conclude that the therapeutic response of high-dose IgG and anti-Rh0 (D) is independent of the degree of induced haemolysis and may not be predicted from the effectiveness of either therapy alone.

Adolescent↗
PubMed1986

Timentin in the treatment of invasive burn wound infection with sepsis.

Twenty-one patients with infected burns were treated with 5.2 g Timentin (ticarcillin 5 g + potassium clavulanate 200 mg) three times a day for an average of 8.3 days. Staphylococcus aureus was the commonest pathogen, there being ten cases of septicaemia with this organism and all were cured. Three patients with Pseudomonas aeruginosa septicaemia and infections with methicillin-resistant S. aureus failed. No drug related side effects were noted.

Adult↗
PubMed1986

Effect of thyroid hormones on plasma protein concentrations in man.

Plasma concentrations of proteins secreted by the liver (prealbumin, haptoglobin, transferrin, ceruloplasmin, alpha 1-antitrypsin, antithrombin III, and T4-binding globulin) and proteins mainly derived from endothelium [fibronectin, angiotensin-converting enzyme (ACE), and factor VIII-related antigen (F VIII R:Ag)] were measured in 27 hyperthyroid and 30 normal women. Significantly increased plasma concentrations (P less than 0.01) of endothelium-associated proteins, including fibronectin, ACE, and F VIII R:Ag, were found in hyperthyroid patients, while levels of proteins of primarily hepatic origin were normal. To determine whether the increase in endothelium-associated proteins in hyperthyroidism was directly related to elevated thyroid hormone levels, seven normal women were given T3 (25 micrograms, three times daily) for 2 weeks. These women had a consistent rise (P less than 0.05) in plasma concentrations of fibronectin, ACE, F VIII R:Ag, and tissue plasminogen activator. The rise in endothelium-associated proteins persisted for 10 days after cessation of T3. Plasma concentrations of hepatically synthesized proteins did not change. We conclude that thyroid hormone action either promotes endothelial protein synthesis or impairs its clearance.

Adolescent↗
PubMed1986

[Antibodies against ds-DNA in systemic lupus erythematosus--value for diagnosis and determination of activity].

The specificities and sensitivities of 3 methods for detection of anti-ds-DNA-antibodies were investigated in 32 SLE-patients and 95 control patients with ANA greater than or equal to 1:100. The sensitivities of CL-IF-assay, filter-RIA and EIA were 47%, 78% and 87%, respectively. The according specificities were 96%, 88% and 84%. In contrast to the CL-IF-assay, the filter-RIA as well as the EIA are of major clinical importance in monitoring SLE-patients.

Antibodies, Antinuclear↗