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Biomedical subjects

H Klinkmann

Publications and source records attributed to H Klinkmann.

At least 19 recordsLinked to original sources
PubMed1992

Three years with a national apheresis registry.

The large number of unsolved problems in plasma exchange therapy makes an apheresis registry appear useful. The results of such an open prospective observational study from 1987 to 1989 in East Germany are presented in this paper. With 1,945 procedures in a total of 419 patients (on average 4.1 treatments per patient) about 80% of all treatments in the country were registered. Exchange volume averaged 2.7 (+/- 0.78) l or 43 (+/- 13.9) ml/kg body weight. Substitutes were albumin (51% of the cases), FFP (22%), and both (22%). Nephrological (25%) and neurological (23%) diagnoses prevailed among the treated diseases. Haematologic diseases (12%) were underrepresented and hepatic coma (20%) was overrepresented. Minor side effects occurred in 22% of all treatments and severe complications in 38 treatments (2%). Four fatalities probably resulted from plasmapheresis therapy. The registry permits an assessment of the treatment results and of several trends during the period of observation.

Adolescent↗
PubMed1991

Immunoadsorption and plasma exchange in multiple sclerosis: complement and plasma protein behaviour.

Three groups of patients suffering from acute attacks or progressive multiple sclerosis (MS) are under investigation. First results revealed remarkable clinical improvements of patients with acute attacks in the groups treated by therapeutic plasma exchange (TPE) and immunoadsorption (IA). Only slight or no improvements were seen in the patients of the control group treated only with steroids. Plasma protein levels (IgG, IgM, IgA, fibrinogen) were considerably reduced in patients of the TPE group after each treatment procedure as expected. The same holds true concerning the total hemolytic capacities (THC) of the complement of the classic (CP) and the alternative (AP) pathway. On the other hand in the IA group only slight decreases of plasma proteins (about 20%) were observed, but the behaviour of THC's were quite similar than those seen in the patients of the TPE group. The THC decreases in both groups can be explained by removal of all complement factors (TPE group) or by the adsorption of single factors (IA group) of both complement pathways according to earlier in vitro investigations. The THC decreases in patients of both groups suffering from acute MS attacks could mean an "antiinflammatory" effect and could--at least partially--contribute to the clinical improvements of these patients.

Blood Proteins↗
PubMed1991

Detection of charges and their distribution on dialysis membranes with cationic/anionic dyes using confocal laser scanning microscopy.

Methods for the detection of positive or negative charges on the surface of biomaterials/membranes and inside a membrane are important for the characterisation of such materials. We tested different dyes and optimized staining procedures. Under standardized conditions negatively charged membranes were stained with cationic triarylmethane compounds such as crystal violet and positively charged membranes with the anionic anthraquinone dye anthralan blue B. There was no staining of uncharged cellulose membranes. The applicability of these methods was demonstrated on membranes coated to varying degrees with charged compounds such as heparin, these changes in charge being detectible quantitatively by photometry. The distribution of charges inside a membrane was detected by optical sectioning across the stained (FITC labelled poly-L-lysine) membrane using confocal laser scanning microscopy (LSM). LSM offers a completely new application possibility in biomaterial and biocompatibility research.

Biocompatible Materials↗
PubMed1991

Importance of endotoxins in high-flux dialysis.

Endotoxins are not only important for inducing pyrogenic reactions during haemodialysis but also for the stimulation of different blood cells. This is followed by the release of interleukin-1 and other powerful biological active substances, resulting in a broad spectrum of biological activities. Permeation of LPS (endotoxins) through dialysis and haemofiltration membranes is of great importance. Using a quantitative turbidimetric method based on the LAL (limulus amoebocyte lysate) test LPS concentrations were measured in a closed in vitro system for 11 different dialysers and haemofilters. To assess the passage of endotoxin through the membrane, permeation was measured from the dialysate to the blood side as well as from the blood compartment to the dialysate side.

Endotoxins↗
PubMed1991

Changes in rheology and red blood cell function under recombinant human erythropoietin therapy.

The rh-EPO is a potent drug to treat renal anaemia. RBC aggregation is not influenced by the rh-EPO therapy. Membrane elasticity and RBC deformability improve remarkably after rh-EPO which might benefit microcirculation. Rh-EPO therapy can not prolong RBC life span. Obviously uremic milieu alone determines RBC life time. Rh-EPO treatment corrects renal anemia by increasing the number of RBC and the RBC volume.

Adult↗
PubMed1990

[Ergometric results of r-erythropoietin treatment of hemodialysis patients].

To investigate the effect of partial correction of anemia in patients maintained by chronic intermittent hemodialysis on exercise capacity, patients underwent a bicycle acido-ergometry before and after treatment with recombinant human erythropoietin. The results demonstrate a (subjective) improvement of exercise capacity without any evidence for that in the pH values.

Acid-Base Equilibrium↗
PubMed1990

Biomedical and clinical applications of automated single cell electrophoresis.

The automated single cell electrophoresis microscope Parmoquant has been used for the discrimination of lymphocytes and the study of the interaction of substances with cells and synthetic particles. Electrophoretic histograms allowed the determination of changes in the proportion of lymphocyte populations after kidney transplantation, during dialysis treatment, open heart surgery and during pregnancy. Discrimination of leukemic cells on the basis of electrophoresis was used as an additional parameter in diagnosis. In a mouse tumor model, histogram determination enabled the in vivo effect of the tumor necrosis factor on immune cells to be evaluated. Cell electrophoresis was shown to be suitable to detect the influence of antibodies, lectins and bacteria on the cell surface. Protein adsorption was studied on synthetic particles using cell electrophoresis. This method was applied to investigate the phenomena of blood interaction with biomaterials used in artificial organs and to determine differences in the protein composition of serum or other body fluids connected with diseases.

Animals↗
PubMed1990

Measurements of plasma colloid osmotic pressure, total protein and sodium concentration during haemodialysis: can single-pool sodium modelling explain the results?

Considering the plasma colloid osmotic pressure (COP) as a possible parameter for the monitoring of dialysis treatment compatibility, a characteristic time course was found. The COP and the total protein concentration very often do not increase significantly during the first treatment hour in spite of ultrafiltration. An increase in the plasma sodium concentration, which was higher than expected, was found to be the reason for a plasma dilution effect. This can be explained by a transcapillary sodium transfer coefficient which is not infinitely high as assumed in single-pool sodium modelling. From a 2-pool model considering the plasma volume as a separate pool and including capillary filtration time courses for plasma sodium, total protein concentration and COP could be calculated, which was very similar to the measured curves.

Blood Proteins↗
PubMed1990

A newly developed LDL-binding material.

Results of in vitro and ex vivo experiments with a newly developed LDL-binding material are presented. This material consists of macroporous bead cellulose which is capable to bind selectively LDL. LDL-cholesterol is considerably decreased after contacts of plasma or serum samples with this bead cellulose. On the other hand high density lipoproteins (HDL) and other plasma components (proteins, enzymes, electrolytes, and metabolic substances) remained high or unchanged. Triglycerides (TG)--transported by very low density lipoproteins--are also bound up to a certain degree. 1 g of the adsorbent wet mass binds at least 20 mg cholesterol. The capacity suffices to decrease two- to threefold increased cholesterol and LDL plasma levels to the low normal range following passage of the sevenfold plasma volume' through two the three LDL adsorbent columns (results of perfusion experiments). In vitro and dog experiments revealed only slight drops of the hemolytic capacities of the classic complement pathway and moderate decreases of the alternative one. But no detectable side effects were noticed in the dog experiments.

Adsorption↗