Biomedical subjects
Publications and source records attributed to I Hoppe.
HLA typing was performed in 40 thyroid carcinoma patients. No association was found between antigens of the HLA system and papillary, follicular or medullary thyroid carcinomas. Literature reports on different HLA associations are probably due more to the small number of cases in the studies involved than to ethnic or geographic differences.
We report of a case of a 56 years old female patient who died of severe haemolytic anaemia induced by an injection of a single dose of diclofenac. We suppose that an immune complex reaction caused the haemolytic crisis.
It is reported about a first successful program of gamete intra fallopian transfer (GIFT) as a supplement to intrauterine insemination and to in vitro fertilization (IVF). In 29 patients after HMG stimulation of the ovaries and laparoscopic aspiration of follicles recovered oocytes have been introduced together with prepared sperm via a special catheter directly into the ampulla of the oviduct. In 21 patients with different causes of infertility optimal stimulation conditions could be achieved. A pregnancy rate of 41.4% is the result of 29 GIFT events and 3 of them resulted in spontaneous term deliveries (10.3%).
In a controlled, prospective clinical trial with almost 300 patients undergoing cardiovascular surgery, the hepatitis risk was examined of a new prothrombin complex (PPSB) preparation produced from pooled plasma, which was cold sterilized according to the method of LoGrippo with beta-propiolactone and UV-light. Of 268 evaluable patients, 102 belonged to a group receiving PPSB and 166 belonged to a control group without PPSB. 25 batches of PPSB in dosages of up to 4,500 units per patient, in total, were used. The mean requirement for transfusion of blood or plasma was 10 units per patient in the group receiving PPSB and slightly more than 2 units per patient in the control group. In both of the groups, 3 hepatitis infections occurred (5 cases of non-A, non-B, 1 case of type B), corresponding to hepatitis incidences of 2.9 and 1.8%, respectively. The difference in hepatitis incidence between both groups was statistically not significant. This demonstrates, on the one hand, the hepatitis safety of the sterilized PPSB and, on the other, that multiple transfusion is no longer associated with a high risk of hepatitis when the guidelines of modern donor screening are followed.
114 patients from four clinics participated in a double blind study designed to assess the efficacy of a nifedipine-acebutolol fixed combination -10 mg + 100 mg - as compared with acebutolol -200 mg- in essential hypertension. During the ten week study the mean blood pressure readings (s.d.) 1-3 h after treatment decreased from 179.2/104.8 (10.2/6.2) to 150.3/87.7 (9.8/7.7) in the combination group and from 181.7/106.5 (14.4/7.0) to 150.4/89.0 (15.0/10.4) in the acebutolol group. The mean systolic and diastolic blood pressures were also decreased after exertion (load) and 24 hours after treatment at the end of the 6th week of the study. A doubling of the dose from week 7 to 10 did not change these figures. These results reveal the possibility of treating essential hypertension with a low dose of beta-adrenergic blocking agents in combination with 10 mg nifedipine. Both drugs were well tolerated. 3 patients (5%) in the combination group and 3 patients in the acebutolol group were withdrawn from the study because of headache and dizziness.
In a prospective study on the causes and frequency of hepatitis after operations on the open heart, two homogeneous groups of patients were formed. In one of them, the amount of homologous blood was reduced to half by means of preoperative donations of autologous blood, the total blood requirement remaining the same. Hepatitis occurred postoperatively in 10% of the cases. The factors which gave rise to the hepatitis were large-pool clotting preparations, transfusion with homologous blood and cross-infection in the hospital. Even after exclusion of other risk factors, the frequency of hepatitis among the recipients of coagulation preparations was around 60%. The frequency of the cases of hepatitis due to foreign blood was about 5 per 100 patients or about 1 per 100 units of blood. By use of autologous blood collected preoperatively, the risk due to transfusion could be lowered by 50%. In polytransfusion, a disproportionately high rise in the risk of hepatitis was observed. It is probably to be ascribed to unknown factors in the hospital environment ("nosocomial hepatitis").
Histocompatibility antigens were determined in 27 patients with SLE and 283 normal blood donors. HLA-B8 was significantly increased in patients with SLE (59.3%) as compared to the controls (20.5%, Pc less than 0.005). The relative risk for HLA-B8 was 5.64. No correlation could be demonstrated to specific organ involvement, immunopathological data, age of onset or prognosis.
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A great number of commercially available immunoglobulins was screened for erythrocyte-, HLA- and autoantibodies. Isoagglutinin titers were in general low, hemolysins were not detected. No preparation was found to contain detectable amounts of autoantibodies versus nuclei, mitochondria, smooth muscle or parietal cells. Yet 7 out of 22 immunoglobulin charges contained irregular red cell antibodies, aside of polyspecific albumin reactive types in 5 cases a distinct anti-D. Only the preparation examined in 1975 contained polyspecific HLA-antibodies. 1977/78 all preparations for intravenous use were free from undesired antibodies, while those for intramuscular application were contaminated with irregular red cell antibodies 1975 as well as 1978. Because of their low strength these antibodies imply no clinical risk. Nonetheless an improvement of the official rules for the production and control of immunoglobulin preparations is inevitable to avoid damage caused by exceptional charges with extremely strong antibodies of this type.
The hisG gene is the most operator-proximal structural gene of the histidine operon; it encodes the feedback-inhibitable first enzyme of the biosynthetic pathway. Previously, hisG mutants were mapped into seven intervals defined by the availble deletion mutations having endpoints in the hisG gene. The map has been refined using over 60 new deletion mutants. The new map divides the gene into 40 deletion intervals, which average approximately 30 base pairs in length. The map has been used to analyze the distribution of insertion sites for the transposable element Tn10 and has permitted conclusions on the diistribution of duplication endpoints. The map promises to be useful in analysis of his regulation and, more particularly, in the determination of the possible role of the hisG enzyme in this mechanism.
UNLABELLED: Sera of 832 healthy persons and patients suffering from chronic inflammatory liver disease were investigated by radioimmunoassay for HBsAg and anti-HBs. Diagnosis in patients was secured by biopsy. The persons were divided into: 1. Healthy persons: n = 478 blood donors, hospital especially exposed to HBV, patients with healed hepatitis; 2. PATIENTS: n = 354 acute hepatitis, chronic persistent and aggressive hepatitis, post-hepatitic, cryptogenic and alcoholic cirrhosis. The results demonstrate considerable accumulation of HBsAg in chronic liver disease (72% in CAH, 66% in posthepatic liver cirrhosis) whereas anti-HBs was more frequently observed in healthy persons (38% in hospital staff, 49% in healed hepatitis). Furthermore, HBsAg and anti-HBs were frequently observed simultaneously in chronic hepatitis and cirrhosis (23% in CAH). A strong shift in the relation of antigen to antibody to the disadvantage of antibody in the examined collectives of chronic hepatitis and cirrhosis is evident. Chronic inflammatory HBsAg positive liver disease should therefore be regarded as chronic virus infection. We suppose an absolute or relative deficiency of antibody to HBsAg is probably an important factor for the development of chronicity of hepatitis B.
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In 1975/76 the risk of hepatitis from human clotting preparations (fibrinogen, prothrombin complex) prepared from pooled plasma was studied prospectively in patients who had undergone open-heart surgery with cardiopulmonary bypass. Of 247 patients 25 (10%) developed hepatitis postoperatively, while of 17 recipients of plasma-fraction concentrates 12 developed hepatitis (71%). Even taking into account other potential risk factors this rate of hepatitis is statistically significant. It demonstrates that even with the most modern screening methods it is not possible to produce clotting preparations from "large pool" human plasma which is free of hepatitis risk, unless additional virus-inactivating measures are taken.
In an unselected group of patients undergoing a wide variety of cardiovascular operations, the possibilities of long-term preoperative autologous blood collection combined with oxygenator hemodilution were examined. The mean number of preoperative donations was 2.5 units of blood. It was 50 p.c. higher in men than in women. One third of the men, but no female patient, collected 4-5 units of autologous blood, thus equalling the mean calculated blood requirements. Short- or long-term disavantages of the donations were not seen. --The total amount of homologous blood required could be diminished by 50 p.c., in atrial septal defects even by 70 p.c. The percentage of patients without homologous blood increased from 3 to 25 p.c. of the total material, but in atrial septal defects from 13 to 67. Further improvements of these values may be expected from an earlier entry into the program of autologous donations and, correspondingly, by an earlier iron substitution. Only thus, without special methods of storage, roughly calculated one half of all cardiovascular surgical patients may come through without homologous blood. In view of the risks of homologous blood transfusion, already now no atrial septal defect and, with limitations, no valve replacement should come to surgery without adequate autologous blood collection.
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Salmonella phage P22 has been used in the construction of three sorts of specialized transducing phage: P22 proAB, P22 proABlac and P22 argF. The bacterial genes carried are derived from E. coli K12. Since E. coli and Salmonella chromosomes recombine very poorly, E. coli genes cannot be transduced into Salmonella recipients by P22's generalized transduction mechanism. Therefore, stable inheritance of E. coli material provides a means of detecting specialized transduction. Formation of these phages was possible because the P22 prophage recognizes an attachment site in the E. coli F' prolac episome. Salmonella strains carrying the F' prolac episome can be lysogenized by P22 so as to leave the prophage inserted into the E. coli material of the F' factor. Improper prophage excision can then lead to formation of P22 specialized phages carrying E. coli genetic material.