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At least 73 records · Page 4Linked to original sources
PubMed2001

Granulocyte transfusion therapy: update on potential clinical applications.

The clinical usefulness of granulocyte transfusions for treatment or prevention of life-threatening bacterial and fungal infections remains controversial. Clinical benefit has long been limited by insufficient donor stimulation regimens and suboptimal leukapheresis techniques. Methodologic progress, in particular mobilization of neutrophils in healthy donors by administration of G-CSF, has significantly enhanced leukapheresis yields. A newly published study indicates that unrelated community donors can be effectively and safely used as an alternative to related family donors. Furthermore, several recent studies suggest that it may be possible to store granulocyte concentrates for 24 to 48 hours with adequate preservation of neutrophil function. This review summarizes the current role of granulocyte transfusion therapy in infectious diseases and highlights important recent advances.

Granulocyte Colony-Stimulating Factor↗
PubMedDate not supplied

Minimizing the immunogenicity of antibodies for clinical application.

The clinical utility of murine monoclonal antibodies has been greatly limited by the human anti-murine antibody responses they effect in patients. To make them less immunogenic, murine antibodies have been genetically engineered to progressively replace their murine content with that of their human counterparts. This review describes the genetic approaches that have been used to humanize murine antibodies, including the generation of mouse-human chimeric antibodies, veneering of the mouse variable regions, and the grafting of murine complementarity-determining regions (CDRs) onto the variable light (VL) and variable heavy (VH) frameworks of human immunoglobulin molecules, while retaining only those murine framework residues deemed essential for the integrity of the antigen-binding site. To minimize the anti-idiotypic responses that could still be evoked by the murine CDRs in humanized antibodies, two approaches have also been described. These are based on grafting onto the human frameworks the 'abbreviated' CDRs or only the specificity-determining residues (SDRs), the CDR residues that are involved in antigen interaction. The SDRs are identified through the help of the database of three-dimensional structures of antibody:antigen complexes or by mutational analysis of the antibody-combining site. In addition, we also describe the use of in vitro affinity maturation to enhance the binding affinity of humanized antibodies, as well as the manipulation of framework residues to maximize their human content and minimize their immunogenic potential.

Animals↗
PubMed1985

Nonparametric methods. Clinical applications.

In clinical research, "samples" are studied in order to get ideas about the characteristics of the larger populations from which the samples are taken. Population characteristics are called parameters (the population mean and standard deviation are examples). Parametric statistical methods are those that require estimates of parameters and assumptions about the source populations. Familiar examples of parametric methods are the t test, analysis of variance, and Pearson's correlation coefficient. Nonparametric (NP) methods do not require estimates of population parameters. These methods are sometimes called "distribution-free" because the samples of interest can be evaluated without concern for the shape (distribution) of the values in the populations providing the samples. NP methods also are called "ranking" or "ordering" tests, because the relative size or order of the observations may be evaluated, rather than requiring actual measurements. More than 30% of the research reports that appeared between July 1982 and June 1983, in four pediatric journals, employed at least one nonparametric method. The commonly used tests were chi-square, the Fisher exact test, and various "ranking" methods. An alphabetical list of common nonparametric tests is presented, with brief comments about each. Tables are presented, arranged by types of observations, so that the nature of the data guides the user to the method that might be used.

Pediatrics↗
PubMed1994

Measurement of apolipoproteins B and A by radial immunodiffusion: methodological assessment and clinical applications.

The clinical evaluation of apolipoproteins is of interest in order to characterize the risk profile for ischemic heart disease both in normolipidemic and hyperlipidemic subjects. In the non-specialized and/or small practice clinical laboratory, the measurement of some apolipoproteins can be undertaken by simple methods of immunological analysis, among which radial immunodiffusion can be of interest due to its simplicity of use and because it does not require specific equipment. In this work several methodological questions concerning the measurement of plasma apolipoproteins B and A by radial immunodiffusion have been addressed; the results show that this method is particularly reliable for the apo B assay. Regression analysis between values obtained with radial immunodiffusion and radioimmunoassay was r = 0.972 for apo B and r = 0.782 for apo A. The recovery rate was above 90% for both apolipoproteins (93.8% for apo B and 99.5% for apo A). The inter and intraassay coefficients of variation were below 5%, and the detection limits were estimated as 9.6 mg/dl for apo A and 6.9 mg/dl for apo B. Neither the ingestion of a standard breakfast (500 Cal, 17 g fat, 120 mg cholesterol) 2 h prior to testing nor freezing the sample significantly affected the measurement of apolipoproteins B and A. Mean plasma concentrations of both apolipoproteins measured by radial immunodiffusion in normo and hyperlipidemic subjects are also presented.

Adult↗
PubMedDate not supplied

Beta-2-microglobulin--a rapid and automated determination for a broad range of clinical applications.

The clinical evaluation of the Cobas Core beta 2-Microglobulin EIA was performed on the random access analyzer Cobas Core. The coefficients of variations for the intra-assay and inter-assay precisions ranged between 3% and 6%. In comparison to healthy persons (0.7-2.7 mg/l), significantly elevated serum levels of beta 2-m were found in patients with lymphoproliferative disorders like monoclonal gammopathies of the IgG (1.98-78 mg/l; p = 0.0001), IgA (1.3-7.1 mg/l; p = 0.0002) and of the IgM (2.1-8.7 mg/l; p = 0.0001) type, in malignant lymphoma (1.5-33.5 mg/l; p = 0.0001) and in chronic lymphatic leukemia (1.5-22.4 mg/l; p = 0.0001). In cases of HIV-infection, increasing levels of beta 2-m exhibited an inverse correlation to the CD4+ T-lymphocyte count (p = 0.0001) and indicated disease progression. In patients having renal transplantation a rejection of the graft was accompanied by a rise of the beta 2-m serum level. In summary, the data clearly indicate the reliability of the measuring system as well as the clinical relevance of beta-2-M determinations for such patient groups.

CD4 Lymphocyte Count↗
PubMed1995

[Intravenous patient-controlled analgesia (PCA) in the treatment of postoperative pain: rationale and clinical application].

The clinical use of the patient-controlled analgesia (PCA) represents a further improvement in the treatment of post-operative pain. In this way in success due to inadequate protocols, unpredictability of the drug absorption and variability of the response to one drug or to the same pain patterns between patients can be avoided. This technique allows the patient himself to control the pain without depending upon nurses or physicians for the administration of analgesic drugs. Although the PCA is in use since several years, there are still some unresolved problems which are considered in this paper.

Analgesia, Patient-Controlled↗
PubMed1998

Cultivation of human keratinocyte stem cells: current and future clinical applications.

Cultured human keratinocytes have a wide spectrum of clinical applications. Clinical results reported by several investigators are, however, contradictory. In this review, the authors discuss the biological and surgical issues which play a key role in the clinical outcome of cultured epidermal autografts used for the treatment of massive full-thickness burns. The importance of cultivation of epidermal stem cells and of their transplantation onto a wound bed prepared with donor dermis is emphasised. The paper also reviews recent data showing that: (i) cultured epidermal autografts bearing melanocytes can be used for the treatment of stable vitiligo; (ii) keratinocytes isolated from other lining epithelia, such as oral, urethral and corneal epithelia, can be cultivated and grafted onto patients suffering from disabling epithelial defects; (iii) keratinocyte stem cells can be stably transduced with retroviral vectors and are therefore attractive targets for the gene therapy of genodermatoses.

Burns↗
PubMed1995

NMR spectroscopy in andrology: research uses and possible clinical applications.

Research uses and possible clinical applications of NMR spectroscopy are considered. By monitoring extracts of testes using 31P-NMR spectroscopy, detailed analysis of high-energy phosphates, or pathways such as phospholipid biosynthesis or glycolysis, is possible. By using in-vivo 31P NMR spectroscopy of testes in animal experiments it has proved possible to discriminate non-invasively between experimentally impaired and control testes. It has been demonstrated in several human studies that discrimination between normal testes and those with impaired spermatogenesis and obstruction is possible by non-invasive NMR spectroscopy. In studies of semen, seminal plasma or spermatozoa, NMR spectroscopy is of high experimental value for analysis of sample composition, the kinetics of metabolites or the structure of single components, but clinical applications have not yet been clearly defined.

Animals↗
PubMed1998

Thermology and facial telethermography: Part II. Current and future clinical applications in dentistry.

Selected clinical applications using thermal imaging as an aid in dentistry are reviewed. Facial skin temperature can easily be measured in a clinical setting, without direct skin contact, by monitoring the emitted infrared radiation. This is the basis of static area telethermography (SAT) and dynamic area telethermography (DAT). SAT has recently been shown to be of help to the dentist in (1) the diagnosis of chronic orofacial pain, (2) as a unique tool in assessment of TMJ disorders, (3) as an aid in assessment of inferior alveolar nerve deficit, and (4) as a promising research tool. DAT, recently made possible by advances in computing technology combined with advanced infrared sensor technology, extracts quantitative information about hemodynamic processes from hundreds to thousands of digital thermal images of the affected facial areas, measured and collected within less than 3 min. DAT has promise of offering a better insight into aberrations of the neuronal control of facial skin perfusion and aiding our understanding of the correlation between orofacial pain and facial thermal abnormalities. This promising new insight may help in the management of orofacial pain.

Body Temperature Regulation↗
PubMed1998

Contrast enhancing agents in ultrasonography: clinical applications.

INTRODUCTION: As ultrasound remains a poorly sensitive method, echocontrast agents make a real difference. At least 29 echocontrast agents are currently on trial worldwide; their chemical composition, mechanisms of action and possible clinical applications are different. The state of the art of echocontrast agents is discussed: their established applications, those expected in the near future and finally their hypothetical, ideal applications. POTENTIAL CLINICAL APPLICATIONS: An extravascular and a vascular domain can be considered. The former includes the gastrointestinal tract and body cavities--both the normal (bladder, uterus, tubes and so on) and the abnormal (abscesses, fistulas, pericardium, peritoneum and so on) ones. Echocontrast agents can: (1) create or improve an acoustic window; (2) distend some organs and fill them with a liquid, with homogenous attenuation of the ultrasound beam; (3) displace the air-containing intestinal loops; (4) depict the walls, the shape and the contours of a normal or abnormal cavity; (5) detect abnormal communications, fistulas and drainages; and (6) evaluate the amount of fluid in the pleural, pericardial or peritoneal cavities. As for vascular applications, this domain sees the highest number of echocontrast agents on trial or on the market. The best know of them are: Levovist (Schering AG, Berlin, Germany), BR1 (Bracco, Milan, Italy) and EchoGen (Abbott, USA). All these act by enhancing arteries, veins and capillaries. The clinical applications validated in clinical trials mainly regard studies in intracranial and neck vessels and the vascularity of upper and especially lower limbs of renal vessels. Tumor macrovascularity (and in the future, hopefully microvascularity) can also be studied in parenchymatous and/or glandular organs, as well as in intra- and extra-abdominal parenchymatous organs in the periskeletal soft tissues. Clinical validation has also been obtained in the follow-up of tumors submitted to ablation therapy (chemoembolization, ethanol injection, thermal ablation) and in echocardiography, both for morphological studies in the cardiac cavities and for the cardiac wall perfusion. CONCLUSIONS: In a subgroup of 513 out of 1275 patients examined Europe-wide, the contrast agent Levovist increased the diagnostic confidence from 27.4 +/- 22.5 to 77.2 +/- 22.5%. Such data encourage further trials to validate current preliminary results.

Contrast Media↗