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Biomedical subjects

B Wiechel

Publications and source records attributed to B Wiechel.

17 recordsLinked to original sources
PubMed1995

A solid-phase test using antiglobulin and enzyme-enhanced techniques for erythrocyte antibody screening during pregnancy.

We have modified previously described solid-phase tests for erythrocyte antibody screening to develop a method, suitable for antiglobulin- and enzyme-enhanced techniques (SPH-IAT and SPH-ENZ). In this study we compared the SPH tests with an autoanalyzer (AA) technique. The results were more specific with the SPH tests than with the AA. Of 4,234 unselected samples from pregnant women, screen-positive samples were reduced from 96 (2.27%) by the AA, to 56 (1.32%) by the SPH tests. This difference was due to the reduced number of false-positive reactions with the SPH tests, 0.47% compared to 1.44% with the AA. Antibodies detected by the AA and the SPH-IAT and -ENZ were: 9 Rh prophylaxis, 2 anti-c, 1 anti-K and anti-M, and 1 anti-Jka. Antibodies detected only by the SPH tests were 1 anti-K, 1 anti-Le(a) (SPH-IAT and -ENZ), 1 anti-M (SPH-IAT) and 4 anti-Jka (SPH-ENZ). One anti-C, 2 anti-D, 3 Rh prophylaxis and 1 anti-E were detected by the AA and the SPH-ENZ but failed to react by the SPH-IAT. One anti-Le(a) and 8 Rh prophylaxis antibodies were detected by AA only. All clinically important antibodies were detected by the SPH tests. We conclude that the SPH-IAT and SPH-ENZ are screening methods with high specificity that are readily adaptable to larger series of samples from pregnant women and suitable for automated handling throughout the screening and identification process.

Antibodies, Anti-Idiotypic↗
PubMed1992

Storage of platelets in additive solutions: a new method for storage using sodium chloride solution.

The in vitro effect of 6-day storage of platelets prepared from 6 pooled buffy coat (BC) units and stored in a platelet storage medium containing approximately 40 percent CPD-plasma and 60 percent platelet additive solution (PAS) was evaluated. PAS is composed of sodium and potassium chloride, citrate, phosphate, and mannitol. The total count of platelets per pooled unit included in the in vitro studies (n = 25) was 376 +/- 59 x 10(9) (mean +/- SD). The present study included three steps. 1. Evaluation of platelet storage in one (n = 7) and two (n = 6) 1000-mL polyolefin containers using PAS. During storage in one container, significantly lower values were found for pH, pO2, glucose, ATP, and the ratio of ATP to AMP+ADP+ATP. The values for mean platelet volume, pCO2, lactate, and extracellular adenylate kinase activity were significantly higher. These results indicate that storage in only one polyolefin container is not appropriate for maintaining satisfactory platelet quality. During storage in two polyolefin containers, a remarkably decreased lactate production (0.07 +/- 0.02 mmol/day/10(11) platelets) was noted. 2. PAS was substituted for saline during 6-day storage in two 1000-mL polyolefin containers (n = 12). The composition of the platelet preparations was the same in all other respects. Similar in vitro results were noted with PAS and saline, which indicated that PAS has no specific effect on the storage of platelets different from that of saline.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenosine Triphosphate↗
PubMed1991

A study of the effect of ABO incompatible plasma in platelet concentrates transfused to bone marrow transplant recipients.

Bone marrow transplant recipients at Huddinge Hospital have routinely received single-donor platelet concentrates (PC) from blood group O donors. These PC contain approximately 350 ml plasma, which is incompatible with patients of group A, B and AB. In 27 patients transplanted with an ABO-identical bone marrow, serological investigations have been performed every week after transplantation (median 6 weeks, range 3-14). Nine of 11 recipients with blood group A developed a positive direct antiglobulin test (DAT) after PC transfusions, while none of 15 patients of blood group O developed a positive DAT. Anti-A could be eluted in DAT-positive cases. In no case was there any clinical sign of hemolysis. Nor did recipients of groups A, B or AB (n = 34) require more red blood cells or PC transfusions compared to recipients of group O (n = 47).

ABO Blood-Group System↗
PubMed1988

HIV transmission by blood transfusions in Stockholm 1979-1985: nearly uniform transmission from infected donors.

Thirty-five out of approximately 800 known HIV-seropositive people in Stockholm by mid-1986 were blood donors during the period 1979-1986. Almost all, i.e. 349 recipients of their blood components (red blood cells, platelets, plasma) could be traced. One hundred and eighty were still alive and 112 of these on further analysis, were suspected of being infected. They were contacted and all but one agreed to be tested for HIV antibodies. Fifty recipients were found to be seropositive. They had been transfused with blood components from 14 of the 35 donors. The earliest observed transmission occurred in June 1982. The patterns of HIV transmission showed, with only one exception, that each donor who had transmitted HIV to one recipient had also transmitted it to all later recipients. Appropriate preserved sera and clinical records from five of the donors who had not transmitted the virus were found and analysed. The result indicated that these donors had acquired their HIV infection after their last blood donation. In conclusion, our study indicates that every antibody-positive donor transmits HIV to almost every recipient.

Acquired Immunodeficiency Syndrome↗
PubMed1987

On the unreliability of one-stage factor VIII:C clotting assays after infusion of factor VIII concentrates.

A multicentre study was undertaken in order to determine the reliability of the methods of assay of F VIII:C and the position of the peak value obtained after infusion of F VIII:C concentrates. Blood samples were drawn before and 10, 30 and 60 min after injection of F VIII concentrates in six haemophiliacs in one of the centres. Coded, frozen plasma samples were dispatched to the laboratories of the other four centres. F VIII:C was determined by different one-stage methods using the same international standard but with different activators. The results of the different laboratories differed widely and no agreement was reached on the existence of a lag period. To reach a valid conclusion not only the same sample has to be analysed, as in this study, but also the same laboratory technique has to be used by all participating investigators. To reach agreement on in vivo recovery and on elimination curves for different F VIII concentrates multicentre studies must be based on reliable methods of assay.

Adult↗
PubMed1987

HIV infection in a defined population of Swedish haemophiliacs.

The results of a clinical follow-up of 124 Swedish patients with haemophilia A and B or severe form of von Willebrand's disease are reported, especially with regard to HIV infection and complications thereof. 44 of the patients were anti-HIV positive. In this group there was an increasing prevalence of lymphadenopathy (18 cases), diarrhoea and fungal infections. 10 patients had generalized persistent lymphadenopathy. Platelet counts were significantly lower and IgG, IgA and IgM levels significantly higher than in the anti-HIV negative group. Oligoclonal protein bands in the gammaglobulin region were found in 8 of the anti-HIV positive patients. The vast majority of these changes have appeared during the past year, and 1-5 years after seroconversion. Presently 22/44 (50%) anti-HIV positive haemophiliacs have at least one symptom related to this infection. Most of the clinical complications have been possible to treat or to mitigate so far.

AIDS-Related Complex↗
PubMed1985

HTLV-III infection in homosexuals and hemophiliacs in Sweden.

Two hundred and three homosexual (HS) men and 114 hemophiliacs in Sweden were examined for serum antibodies to human T-lymphotropic virus type III (HTLV-III) and for alterations of T-lymphocyte subsets. Sera were screened for HTLV-III antibodies by an enzyme-linked immunosorbent assay and/or a dot immunobinding assay, and positive reactions were confirmed by Western blotting. HTLV-III antibodies were demonstrated in 13 of 13 (100%) HS men with acquired immune deficiency syndrome, in 63 of 67 (94%) HS men with persistent generalized lymphadenopathy, in 17 of 45 (38%) symptomatic HS men, and in 6 of 78 (8%) asymptomatic HS men but in none of 108 male blood donors. Seropositive HS men had significantly lower T4/T8 (helper/suppressor) cell ratios and T4 cell numbers than had seronegative HS men. Seronegative HS men had decreased T-cell ratios compared to controls but not decreased T4 cell numbers. Among hemophilia A patients, HTLV III antibodies were demonstrated in 40 of 48 (83%) cases treated with American factor VIII concentrate and in 17 of 29 (59%) cases treated with both American and Swedish concentrates but in none of 13 cases treated exclusively with Swedish factor VIII. Twenty-one hemophilia B patients treated with Swedish factor IX concentrates were all seronegative, whereas one of 3 hemophilia B cases treated with imported factor IX was seropositive. T4/T8 cell ratios were significantly lower in seropositive as compared to seronegative hemophilia A patients.

Acquired Immunodeficiency Syndrome↗
PubMed1984

Hepatitis, epidemiology and liver function in hemophiliacs in Sweden.

The epidemiology of viral hepatitis and liver function were studied in a retrospective survey of 69 patients with moderate and severe hemophilia A and B, and with severe von Willebrand's disease. Forty-nine patients were on prophylactic self-therapy and 20 on episodic treatment by medical personnel. Serologic markers of viral hepatitis (HBsAg, anti-HBs, anti-HBc, anti-HAV, and in some cases HBeAg and anti-HBe) and liver function tests (ASAT, ALAT, IgG) were followed for up to 12 years. There was a history of clinical hepatitis in 19%, and 96% showed some serologic evidence of exposure to hepatitis B virus. Only one patient was a HBsAg carrier. The prevalence of elevated ASAT and/or ALAT was 65% and the incidence 96%. In 68% of the patients there had been a transaminase elevation for more than 6 months. The clinical picture, serologic markers or liver function tests showed no significant difference between the types of hemophilia, amounts and modes of therapy, or age groups. The chronic hepatitis seen in our hemophiliacs seemed to be a slowly or non-progressive disease.

Adolescent↗
PubMed1983

Deaths in Swedish hemophiliacs, 1957-1980.

One hundred and eighteen patients with hemophilia A or B died in Sweden between 1957 and 1980. The causes and circumstances of death have been the subject of a retrospective study. The most striking feature was the increase in age at death. In severe hemophilia cases the age increased from 19 in the first half of the period to 50 in the second. In moderate and mild hemophilia cases the increases were similar, although less pronounced. The main cause of death was intracranial hemorrhage, which accounted for one-third of all deaths. In the last 12-year period, however, no patient below the age of 45 had succumbed to this. Age-related causes of death, such as malignancy and ischemic heart disease, had increased, as was to be expected from the increase in the mean and median ages of living hemophiliacs. The proportion of deaths unrelated to hemophilia was 36%. Antibodies were found in 5 (16.7%) of the patients with severe hemophilia A.

Adult↗
PubMed1980

Influence of age, sex and blood groups on 15 blood coagulation laboratory variables in a reference material composed of 80 blood donors.

15 blood coagulation and fibrinolysis variables were determined in 80 healthy blood donors. Males were shown to have significantly higher levels of factor VII and factor X, and in subjects with blood group O significantly lower levels of VIIIR:AG were observed. In individuals with blood group O a skewed distribution of VIIIR:AG suggested a mixed population of this antigenic determinant. No significant correlation (r less than 0.36) was found between age and any of the laboratory variables.

Adult↗
PubMedDate not supplied

Immunoglobulin levels in haemophiliacs at HIV seroconversion and during follow up.

Immunoglobulins and aminotransferases were followed in 66 haemophilia patients and 13 von Willebrand patients over a six-year period. The results were correlated to HIV serology and lymphocyte subsets. Elevated IgG levels were found in 29/53 patients with haemophilia A, 2/13 with haemophilia B and in 0/13 with von Willebrand's disease. Elevated IgA and IgM levels were seen in 20% and 27% of the patients respectively, with a distribution similar to the elevated IgG levels, except that elevated IgA and IgM levels were also seen in 4/13 patients with von Willebrand's disease. Patients with HIV antibodies had significantly higher immunoglobulin levels than seronegative patients, and this elevation occurred in connection with seroconversion in the majority of the former. The IgG levels could not be correlated to the T4 cell count, but there has been a trend to less clinical symptoms related to HIV infection among those with stable IgG levels during the past few years. No correlation was found between elevated IgG levels and the aminotransferase levels, nor was any correlation found with the amount of blood coagulation factor concentrate given to the patients. The elevation of immunoglobulins observed in our haemophiliacs is multifactorial, but HIV infection is maybe the most important mechanism. The longitudinal IgG pattern may contribute to the prediction of the clinical outcome of this infection.

Adolescent↗
PubMedDate not supplied

Factor VIII concentrate prepared from blood donors stimulated by intranasal administration of a vasopressin analogue.

With an interval of eight weeks between collections, blood was drawn twice from 120 blood donors. At one of the donations, 0.25 ml of synthetic vasopressin, (DDAVP, 1300 micrograms/ml), was administered intranasally 60 minutes prior to collection of the blood. No drug was given at the other donation. The yield of factor VIII clotting activity (VIII:C) and factor VIII antigen (VIIIR:Ag) was compared in blood drawn from the treated and untreated donors. To prevent degradation of VIII:C by fibrinolysis, tranexamic acid was added to the plasma from treated donors immediately after separation from the red blood cells. Plasma from treated donors and the derived Cohn fraction I-O contained approximately twice as much VIII:C as plasma and fraction I-O from untreated control donors. The concentration of VIIIR: Ag was also increased in fraction I-O made from plasma from treated donors, however to a lesser degree. The in vivo properties of factor VIII concentrates made from each group of donors were studied. Half-life in plasma and recovery of VIII:C were identical. Thus, intranasal synthetic vasopressin may be used to increase the yield of VIII:C in production of factor VIII concentrates.

Administration, Intranasal↗