摘要:

Abstract.This report examines the results of treatment in 21 patients with thrombotic thrombocytopenic purpura (TTP) diagnosed over a 4‐year time period (1976–1980) with a review of the possible role of each form of therapy in relationship to the various proposed pathogenic mechanisms. There was a 76.2% (16/21) overall survival with no significant difference in initial hematologic values in patients not surviving. Patients not surviving did not achieve a sustained platelet count greater than 150,000/μ1 at any time during their clinical course. 16 patients received steroids, antiplatelet agents and plasma exchange, with a total volume exchanged ranging from 20.8 to 1,455 ml/kg, as part of their treatment protocol. In this group of patients there was an 81.2% (13/16) survival, with 4 patients receiving additional therapy including splenectomy and/or vincristine. There was no correlation between the intensity of plasma exchange and the time to hematologic recovery. It is apparent that controlled clinical trials are necessary to better define the effectiveness of the present forms of the

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1983.tb01904.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

Abstract.We present data on 5 cases with autoimmune thrombocytopenic purpura treated with plasma exchange in whom conventional drug therapy had been ineffective. In 3, preparation for splenectomy allowed the operation to be performed without bleeding problems. 1 patient who was unfit for splenectomy underwent successful coronary artery vein grafting following preparation with plasma exchange. 2 patients were maintained for variable periods with intermittent exchanges, 1 prior to splenectomy and 1 post‐splenecto‐my.In summary we had no prolonged response to plasma exchange but found it a useful technique as preparation for or adjunctive to more conventional therapy. It was also helpful in patients unresponsive to other forms of therapy who required a brief increase in platelet count to cover surgery or spontaneous haemorrh

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1983.tb01905.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

Abstract.Investigations were performed concerning the elimination of the risk of hepatitis B transmission of potentially infectious plasma derivatives by the addition of a low dose of hepatitis B immunoglobulin (HBIg). To this end, clotting factor VIII concentrate, prothrombin complex, C1 esterase inhibitor concentrate, plasminogen and antithrombin III were prepared from plasma strongly positive for hepatitis B surface antigen (HBsAg). To one half of every preparation, HBIg was added up to a final concentration of 0.4 IU anti‐HBs/ml (test preparations), the other half was not treated (control preparations). Furthermore, to 10‐3diluted infectious reference plasma (Bureau of Biologics, FDA, USA), an overdose HBIg was added to a final concentration of about 0.4 IU anti‐HBs/ml.6 chimpanzees, injected either with the control plasma derivatives or with the untreated infectious reference plasma, were infected with hepatitis B virus, whereas 5 chimpanzees, injected either with the test plasma derivatives or the infectious reference plasma to which the HBIg had been added, did not show any evidence of hepatitis B infection during the follow‐up of 1 year. Addition of a low dose of HBIg to potentially infectious plasma derivatives appears to be a reliable measure to eliminate the hepatitis B transmission and is preferred to other methods for labile plasma deri

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1983.tb01906.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

Abstract.Red cells depleted of buffy coat and more than 90% of the plasma were suspended and stored in a medium composed of sodium chloride, adenine, glucose and man‐nitol (SAGM). The 24‐hour posttransfusion survival of51Cr‐labeled red cells was 83.5 ± 5.3% (n = 4) after storage for 35 days and 77.4 ± 4.7%o (n = 6) after 42 days. No abnormal in vivo hemolysis occurred as judged from posttransfusion haptoglobin consumption studies. No abnormal body temperature elevation was found at continuous pertrans‐fusion recordings. The frequency of febrile or urticaria1 transfusion reactions was 0.19% as compared to 0.68% during a whole‐blood transfusion period. Since a mean of 280 ml of plasma can be collected from each blood unit the plasma‐saving effects of the system are considerable. Favorable large‐scale clinical experie

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1983.tb01907.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

Abstract.The appearance of fibrinopeptide A (FPA) in plasma indicates that factor VIII has been at least partially activated; consequently, we asked the following questions: (1) Is the FPA content of single donor plasma influenced by the method of blood collection? (2) Does a high FPA content of the starting fresh frozen plasma impair the quality of factor VIII preparations? Using a modified procedure adapted to the assay of large series of samples, we surveyed the FPA content of normal donor plasma. Our results show that the FPA content of donor plasma depends strongly on the quality of blood collection. Improved mixing of the anticoagulant with the blood led to a drastic reduction of the FPA content of the plasma. Furthermore, two lots of factor VIII concentrates produced from FPA‐poor plasma showed significant improvement in stability and solubilit

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1983.tb01908.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

Abstract.Blood collected into different anticoagulants was stored in small tubes at +4 °C for up to 26 h. Seven blood coagulation analyses were performed under standardized conditions. High yield and stability of factor VIII: C were found for ACD and CPD‐adenine. No changes could be found in the other six parameters tested. Whole blood in blood bags could be stored for 2–4 h at +4 °C with maximal yield of F VIII:C, with blood stored overnight the recovery was 65%. In plasma F VIII: C was stable for at least 2 h at room temperature. F VIIIR: Ag and F VIIIR: RCoF were stable in both whole blood and plasma. No activation by plasmin as measured by Bβ 15–42 could be demonstrated. The initial FPA levels, reflecting thrombin activation, in the donated blood differed individually and in some blood bags very high concentrations were found. The levels of FPA were not correlated to the time for collection of a bag

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1983.tb01909.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

Abstract.A competitive inhibition assay for functional fibronectin (Fn), based on ELISA technology, is described. The assay measures Fn's physiologic ability to bind to denatured collagen (gelatin). Affinity‐purified Fn inhibits the binding of alkaline phosphatase coupled Fn to gelatin‐coated wells of a microtiter plate in a concentration‐dependent manner. The assay range is 50–500 μg Fn/ml, which is suitable for the measurement of plasma Fn in both normal and opsonin deficient individuals. It is reproducible over an eightfold dilution of plasma and is resistant to interference by normal plasma proteins. The assay described is quick, quantitative, and reproducible, and satisfies the need for a measure of functional Fn activity in the clinical la

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1983.tb01910.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

Abstract.An example of auto‐anti‐Kpbin a Kp (a + b‐) patient is described. The antibody present in the patient's serum and in eluates from her red cells was IgG. It did not bind complement, and did not cause in vivo hemolysis. 9 months after recognition of the autoimmune state the direct antiglobulin test had become negative and anti‐Kpbwas no longer detectable. It is postulated that autoimmunity involving the Kell blood group may be precipitated by antigens or enzymes of microbial

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1983.tb01911.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1983.tb01912.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1983.tb01913.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY