Biomedical subjects

B Gullbring

Publications and source records attributed to B Gullbring.

At least 19 recordsLinked to original sources

PubMed1990

The incidence of cancer among blood donors.

This study presents data on cancer incidence among 37,795 blood donors in an attempt to test the hypothesis that blood donation might be associated with cancer development. At a median follow-up time of nine years (range 5-13 years) a total of 1152 cancer cases have been diagnosed. The expected number of cancer cases derived from an age-matched population was 1459 giving a relative risk ratio (RR) of 0.79 (p less than 0.001). Calculations were made with and without latency periods between first blood donation and the diagnosis of cancer (0, 5, 10, 15 years). Overall, significantly decreased cancer incidence was observed (p less than 0.001) though the number of observed cases of haematological malignancies was not significantly different from that expected. For polycythaemia vera, however, the O/E ratio was 1.81 possibly indicating an association with blood donation. A more likely explanation is that this reflects increased diagnosis of polycythaemia vera in the blood donor population.

Blood Donors↗

PubMed1986

Preservation of red blood cells: content of microaggregates and di-2-ethylhexylphthalate (DEHP) in red blood cells stored in saline-adenine-glucose-mannitol (SAGM) medium.

The content of microaggregates was determined in leukocyte-poor red blood cells (RBC) after 5 weeks of storage in citrate-phosphate-dextrose (CPD)-adenine plasma and in saline-adenine-glucose-mannitol (SAGM) medium. The size range was 3,600-200,000 fl, corresponding to a particle diameter of 19-73 micron, presuming a spherical particle shape. In comparison with CPD-adenine whole blood (100%), the total number of particles per unit of RBC was found to be 41.2% (CPD-adenine anticoagulant) and 25.4% (SAGM medium). The corresponding data for total particle volumes were 43.3 and 30.3%. The significant differences between the two categories of RBC could not be explained on the basis of differences concerning pH or cell composition. A majority of particles (50-62%) was observed in the lowest size range (19-29 microns), corresponding to only 18-26% of the total particle volume. The accumulation of di-2-ethylhexylphthalate (DEHP) was determined in two variations of RBC stored in SAGM medium and in RBC stored in CPD-adenine plasma. The quantities of DEHP per unit of RBC after 5 weeks were significantly smaller in SAGM medium (9.0 +/- 3.6 and 22.7 +/- 6.1 mg, respectively) compared to CPD-adenine plasma (30.1 +/- 9.5 mg).

Adenine↗

PubMed1985

Studies on blood coagulation activity during storage of red cell products intended for transfusion.

Preservation of red blood cells in special media, such as saline-adenine-glucose-mannitol (SAGM) solution involves storage at a citrate and plasma protein concentration much lower than found in normal CPD or CPD-adenine plasma. In the present study, the effects on the coagulation and other connected enzymatic systems in SAGM medium have been investigated. Significantly higher levels of fibrinopeptide A (FPA) and plasma kallikrein activity were observed in the SAGM medium compared to CPD plasma, indicating an increased enzymatic activation in the SAGM medium. For this reason storage of red cells in SAGM solution, supplemented with citrate, was tested and compared with storage in SAGM and CPD plasma. The results demonstrate a positive effect of citrate as an added ingredient in the SAGM solution. Significantly lower levels of primarily FPA but also decreased activities of plasma kallikrein and general proteolysis were noticed. The decreased citrate concentration in Red Blood Cells stored in SAGM protein poor medium must be considered to have a destabilizing influence on the coagulation and on other connected enzymatic systems.

Blood Coagulation↗

PubMed1979

Treatment of acute nonlymphoblastic leukemia in adults with daunorubicin-DNA complex: a preliminary report.

Forty-four adult patients under 60 years of age with acute nonlymphoblastic leukemia were randomized for induction treatment with one of the following three regimens: R 1 = courses of daunorubicin on day 1 + ARA-C on days 1--5; R 2 = courses of daunorubicin on days 1 and 2 + ARA-C on days 4--8; R 3 = courses of daunorubicin-DNA complex on days 1--2 + ARA-C on days 4--8. Out of 14 patients, 9 went into remission on R 1, 6 out of 14 on R 2, and 8 out of 16 on R 3. The preliminary results suggest that daunorubicin-DNA complex has the same efficacy for inducing remission as daunorubicin alone, if the same time intervals and dosages are used.

Acute Disease↗

PubMed1978

Effects of stored and fresh blood transfusions on postoperative pulmonary function. A clinical study on patients following extracorporeal circulation in association with aortic valve surgery.

The effects on postoperative pulmonary function of fresh versus stored blood when priming the heart-lung machine were studied in 49 patients subjected to aortic valvular replacement. The onset of extracorporeal circulation was considered to mimic the conditions of massive blood transfusion. The patients receiving heparinized fresh blood required more oxygen in the respirator than those receiving stored blood, but still had a significantly lower arterial oxygen tension during the first and second postoperative days. The fresh blood patients also showed a tendency to require a larger amount of diuretics to maintain adequate urine output. Pre- and postoperative bleeding and changes in postoperative hematological variables did not differ in the two groups. The results imply that stored blood should be preferable when substituting blood losses.

Aortic Valve↗

PubMed1976

Hypersensitive reactions and antibody formation during L-asparaginase treatment of children and adults with acute leukemia.

One hundred and fourteen patients with acute leukemia, 57 children (10 AML and 47 ALL) and 57 adults (37 AML and 20 ALL) were treated with L-asparaginase (Asnase) 200 or 1000 IU/kg daily for 30 days unless withdrawn on account of side effects. Combinations with other cytotoxic drugs were used in all but eight patients. Hypersensitive reactions, decrease in Asnase activity in plasma, and bivalent antibodies to Asnase appeared more frequently in adults (28%, 46%, and 79%, respectively) than in children (16%, 17%, and 25% respectively). There was a clear association between these three parameters. Thus hypersensitive reactions generally developed at the time of or after the decrease in plasma Asnase activity. Antibodies were detected only where Asnase activity had disappeared from the plasma. This time sequence, and in vitro experiments, suggest the formation of antigen-antibody complexes which might be responsible for inactivation of Asnase and for the development of hypersensitive reactions. However in many cases antibodies were found without concomitant enzyme inactivation or hypersensitive reactions. Antibodies to Asnase of IgE type (reagins) were found in only 10 children and 6 adults. There was no correlation between hypersensitive reactions, decrease in Asnase activity, and IgE antibodies. The frequency of remission among patients developing bivalent antibodies to Asnase was 68% (13/19) in contrast to 27% (3/11) among patients whose sera contained no detectable antibodies to Asnase, but the difference was not statistically significant.

Adult↗

PubMed1975

L-asparaginase and prednisolone pretreatment followed by rubidomycin and cytosine arabinoside for induction of remission in adult patients with acute myeloblastic leukaemia.

77 unselected adult patients with acute myeloblastic leukaemia (AML), including practically all AML patients from an area with 1.9 million inhabitants, were randomized for either (1) 5 days pretreatment with 1-asparaginase and prednisolone followed by a combination of rubidomycin and cytosine arabinoside (ARAP), or (2) treatment with a combination of rubidomycin, cytosine arabinoside and prednisolone without 1-asparaginase pretreatment (RAP). Complete remission was induced with ARAP in 12 patients (31%) and with RAP in 13 patients (34%). Thus pretreatment with 1-asparaginase did not improve the therapeutic response. The overall remission frequency was significantly higher below the age of 60; 50% compared to 13% above this age. Side-effects such as liver dysfunction, nausea and vomiting were more common in patients pretreated with 1-asparaginase. Sterilization of the gut did not improve the remission frequency with either regime.

Adolescent↗

PubMed1974