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Biomedical subjects

J Skodlar

Publications and source records attributed to J Skodlar.

14 recordsLinked to original sources
PubMed2005

The use of a World Health Organization Transfusion Basic Information Sheet to evaluate transfusion practice in Croatia.

BACKGROUND AND OBJECTIVES: To assess the feasibility of using the World Health Organization (WHO) Transfusion Basic Information Sheet as a bedside tool for data collection and assessing transfusion practice. MATERIALS AND METHODS: A prospective 6-month audit of all transfusion episodes using the tool. RESULTS: Eight hundred and twenty-two forms were completed, capturing data on 59.7% of transfusion episodes. Completion of data fields was > 80%, except for the clinician's transfusion targets that were documented in only 58.5% of cases. Twenty per cent of patients received single red cell unit transfusions. CONCLUSIONS: The Basic Information Sheet can be incorporated into bedside clinical practice. We have identified the need to encourage clinicians to determine and document their transfusion targets before prescribing blood components.

Blood Component Transfusion↗
PubMed2003

Products of advanced glycation in patients with type 2 diabetes and vascular disease.

BACKGROUND: Non-enzymatic glycation leading to advanced glycation endproduct (AGE) formation is thought to contribute to vascular pathology. In the present study, AGEs and anti-AGE antibodies in free and immune complex-bound form were assayed in the serum of diabetic (DMCAD) (n = 69) and nondiabetic (n = 78) patients with coronary artery disease (CAD) and in control subjects (n = 47) free from vascular disease. METHODS: A blocking enzyme-linked immunosorbent assay (ELISA) was used to test immunoreactivity against AGE epitope(s) and a competitive ELISA was used to measure total AGE content. RESULTS: Anti-AGE immunoreactivity was significantly higher in diabetic than in control subjects (P = 0.045). Although a wide range of anti-AGE antibody titres were observed in nondiabetic CAD patients, there was no significant difference from those of control subjects. Both diabetic and nondiabetic CAD patients had a higher concentration of circulating immune complexes containing the AGE moiety as antigen than did control subjects (DMCAD versus control, P = 0.041; CAD versus control, P = 0.047). Study patients showed a positive correlation between serum AGE and AGE-immune complexes (DM, r = 0.29, P = 0.014; CAD, r = 0.26, P = 0.019), whereas no such correlation was recorded in controls (r = 0.08, P = 0.89). CONCLUSION: To our knowledge, this is the first study demonstrating increased AGE-immune complexes in patients with CAD, either with or without diabetes, suggesting that AGE-immune complexes might be involved in the atherosclerotic process, either as the result of it or as part of the pathophysiologic process.

Adult↗
PubMed2002

Soluble LDL-immune complexes in type 2 diabetes and vascular disease.

BACKGROUND AND AIMS: The oxidative modification of LDL has been shown to affect its clearance and to exert cytotoxic and immunogenic effects. The objective of our study was to analyse markers of LDL oxidation-soluble LDL containing immune complexes (LDL-ICs) in type 2 diabetes with micro- and macrovascular disease. PATIENTS AND METHODS: The study included 69 diabetic patients with coronary artery disease (DM + CAD), 78 non-diabetics with CAD, 47 controls, and 27 diabetics with nephropathy and 36 free from complications. OxLDL antibodies and advanced glycated end-products were measured by ELISA, and LDL-IC apo B content after PEG precipitation. RESULTS: Determination of a broad range of oxLDL antibody activity in all study groups showed no significant differences. In contrast, the content of apo B, a component of the antigen moiety of oxLDL-ICs, was higher in CAD and diabetes (+ CAD) than in LDL-ICs isolated from controls (p < 0.001). LDL-ICs did not differ between patients with CAD + DM and CAD patients free from diabetes. LDL-IC levels in diabetic patients with or without microangiopathy were significantly higher than in healthy volunteers (PEG-apo B 0.278 +/- 0.107 vs. 0.165 +/- 105 g/l, p < 0.002; PEG-IgG 151.7 +/- 76 vs. 115.4 +/- 62 g/l, p < 0.05). However, there was no significant difference in the level of circulating LDL-ICs between the subgroup of diabetic patients with nephropathy/retinopathy and patients free of microvascular disease (Ab-oxLDL 27.7 +/- 10.4 vs. 27.1 +/- 9.3 AU, NS; PEG-apo B 0.324 +/- 0.111 vs. 0.287 +/- 0.124 g/l, NS; PEG-IgG 1.68 +/- 0.68 vs. 1.42 +/- 0.80 g/l, NS). There was a statistically significant positive correlation between AGE content and LDL-ICs (r = 0.35, p < 0.009). A significant but inverse correlation was recorded between triglyceride concentration and level of LDL-ICs in DM + CAD (r = - 0.32, p < 0.016) and CAD patients (r = - 0.35, p < 0.002). A highly significant negative correlation between triglycerides and circulating LDL-ICs (r = - 0.54, p < 0.039) was observed in patients with early nephropathy, but not in those with physiological proteinuria. It is known that at a high triglyceride level in type 2 diabetes, the majority of LDL are small and dense, thus being more susceptible to oxidative modification. This could be a possible mechanism explaining why more LDL-ICs, with a level inversely correlating with triglyceride concentration, are generated in diabetes. CONCLUSION: The increased level of circulating LDL-ICs is a risk factor for the general population, including those with diabetes. Our results suggested the contribution of LDL-ICs to the development of atherosclerosis to probably be more significant than the direct contribution of oxLDLAb itself.

Antigen-Antibody Complex↗
PubMed2001

Transfusion medicine in the new millennium.

Blood is a tissue like all other tissues, however, it has always had a special meaning for man. Blood used to be attributed characteristics of the man whose body it was circulating through. Attempts were made to influence the person's character, properties, or disease, such as strength, old age and illness, by the bloodletting or blood administration. Blood was for centuries considered an elixir of life, and was ascribed various meanings at different times, e.g., mystic, religious, symbolic, racial, patriotic, biological, medical, scientific, industrial, and economic. Nowadays, the meaning of blood is most pronounced in the science, medicine, and economy.

Blood Component Transfusion↗
PubMed2000

Thiorphan, an inhibitor of neutral endopeptidase/enkephalinase (CD10/CALLA) enhances cell proliferation in bone marrow cultures of patients with acute leukemia in remission.

Thiorphan, (DL-mercapto-2-benzylpropanoyl)-glycine is a potent and specific inhibitor of membrane metallo-endopeptidase (EC 3.4.24.11, CD10). We explored its effects in short-term clonal cultures of the bone marrow from 10 patients with acute leukemia in remission. The cell suspensions were incubated with thiorphan (10(-13) to 10(-5) M) and seeded for the granulocyte/macrophage-colony forming unit (GM-CFU) assay. In normal bone marrow samples the median seeding efficiency was 119 colonies and clusters per 10(5) cells and thiorphan caused slight stimulation of the clonal growth in concentrations above 10(-9) M. In the leukemic samples, the median seeding efficiency varied from 10 to 366 colonies and clusters per 10(5) seeded cells. Meaningful alterations of the clonal growth were noted in 32 out of 83 thiorphan-treated cultures (39%). In those 32 cultures the stimulatory effects outnumbered the inhibitory effects (24 versus 8). Thus, thiorphan stimulated the progenitor cell proliferation in bone marrow samples from the normal donor and from the patients with acute leukemia in remission. Thiorphan binding to CD10 might interfere with the processing of neuropeptide hemoregulatory factors and thus influence the progenitor cell proliferation.

Acute Disease↗
PubMed2000

Effect of opioid peptide methionine-enkephalin in long-term cultures of human bone marrow.

Methionine enkephalin, an opioid peptide belonging to the family of neuropeptides, has been shown to function as a neurotransmitter, hormone and growth factor. The present work explored its effects in long-term culture of bone marrow cells, harvested from a patient with acute lymphoid leukemia (ALL-L3) in the second complete remission. Nine cultivation flasks were established and maintained for five weeks, with medium renewal once a week. At each re-feeding, methionine-enkephalin was added to the cultures in final concentrations 10(-8), 10(-10) or 10(-12) M, and granulocyte-macrophage progenitor cells (GM-CFU) were determined among the harvested, nonadherent cell populations. The total number of nonadherent cells was 8% to 42% higher in the treated cultures than in the control, nontreated cultures, and the GM-CFU counts were three to four times higher. Those changes, although evident, did not reach statistical significance because of the small group sizes. In 1 of 9 cultures the adherent cell layer was atypical, the cell population consisted of small cells resembling the lymphoblasts, and the cell count was 2-8 times higher than in the controls. That aberrant culture has presumably arisen from residual leukemic cells remaining in the bone marrow after chemotherapy. The findings support the idea that opioid peptides, including methionine-enkephalin, participate in regulation of hematopoiesis. Two mechanisms may have accounted for the observed effects of enkephalin on cultured bone marrow cells: an indirect action, via interleukins secreted from the stromal cells upon stimulation of the opioid receptors, or a direct action on hematopoietic precursors.

Bone Marrow Cells↗
PubMed1998

Thiorphan stimulates clonal growth of GM-CFU in short-term cultures of bone marrow from a healthy donor and from patients with non-Hodgkin lymphoma.

Thiorphan, a specific inhibitor of membrane neutral endopeptidase (NEP, EC 3.4.24.11) also known as the common acute lymphoblastic leukemia antigen (CALLA, CD10) was added into short-term clonal cultures of the buffy coat concentrates of human bone marrow obtained from a healthy donor (six experiments) and from ten patients with non-Hodgkin lymphoma (NHL) (eight in complete remission, one in partial remission and one in relapse). Thiorphan concentrations ranged from 10(-5) to 10(-13) M. Nanomolar and higher concentrations of the drug mildly stimulated the granulocyte-macrophage colony-forming unit (GM-CFU) counts in the cultures of normal bone marrow, reaching the significance at 10(-7) M. Meaningful alterations of the GM-CFU counts were noted in 31 of 79 thiorphan-treated cultures of NHL bone marrow (39%). In those cultures the stimulatory effects (33%) outnumbered the inhibitory ones (6%). The stimulatory effects occurred mainly in the bone marrow samples of the patients with highly malignant NHL. The observations are compatible with the idea that the membrane endopeptidase (CALLA, CD10) participates in processes controlling the proliferation and differentiation of hematopoetic cells by cleaving the neuropeptides and related hemoregulatory peptides.

Bone Marrow↗
PubMed1995

Autologous bone marrow transplantation for haematological malignancies--experiences of the centre of Zagreb.

From April 1988 to May 1993, 71 patients (32 acute myelogenous leukaemia [AML], 24 acute lymphoblastic leukaemia [ALL], 7 Hodgkin's disease [HD], 5 non-Hodgkin lymphoma [NHL], 2 neuroblastoma, 1 chronic myelogenous leukaemia [CML]) were treated with myeloablative therapy followed by reinfusion of cryopreserved autologous bone marrow (ABMT). The majority of patients with acute leukaemia were in first complete remission (CR), while 11 AML patients and 9 ALL patients were in advanced stage of the disease (> I CR or relapse). The BM was reinfused without purging. The conditioning regimen for all ALL and proportion of AML patients consisted of cyclophosphamide (CY) 120 mg/kg and fractionated total body irradiation (TB) in a total dose of 12 Gy. 18 AML patients received busulfan 16 mg/kg instead of TBI. Leukaemia-free survival (LFS) for first CR AML patients was 48% at 43 months with the median follow-up of 17 months. Probability of relapse was 44%. LFS for advanced AML was only 9% and the probability of relapse 89%. LFS for first CR ALL patients was 72% at 53 months with the median follow-up of 15 months, while probability of relapse was only 23%. For advanced ALL, LFS was 32% at 33 months and probability of relapse 64%. Probability of toxic death for first CR patients was 11%. We found a predictive value of viability testing and in vitro CFU-GM assay for haematologic recovery after ABMT. We conclude that ABMT with cryopreserved BM is a relatively safe method for consolidation therapy of AL. The results of treatment are encouraging.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

[Quality control of frozen plasma in 8 blood transfusion centers in the Croatian Republic].

Fresh frozen plasma (FFP) is one of the most frequently used blood components. Its use is continuously increasing, although 50 to 80% of units are not used according to the approved indications. The quality control of FFP was performed in 6 blood transfusion centers. The volume of FFP unit was between 178 and 234 ml. F VIII: C above 0.70 i. u./ml was observed in 40.9 of units. Plasma in 0.9% of units was not sterile and the concentration of total proteins and hemoglobin were within the acceptable range.

Blood Transfusion↗
PubMedDate not supplied

[Autologous blood transfusion in orthopedic surgery patients].

During a 16-month period, blood for autologous transfusion treatment was taken in 186/788 (23.6%) orthopedic patients. Vasovagal reactions during blood withdrawal were observed in 8.6% of patients. Transfusiologic treatment with autologous blood alone was carried out in 134 (72%) patients. In 36 (19.4%) patients, homologous blood was given in addition to autologous blood. Withdrawal of the required blood unites could not be completed in 33 (17.7%) patients. In this group of patients, the need of homologous blood transfusion was highest (39.3%). In 98.3% of patients, mean values of hemoglobin and hematocrit immediately before the surgical procedure exceeded 100 g/L and 30%, respectively.

Adolescent↗
PubMedDate not supplied

[The effect of leukocytes and erythrocytes on the metabolism and function of thrombocytes during preservation of thrombocyte concentrate at 22 degrees centigrade].

The effect of leukocytes and erythrocytes on metabolic and functional changes was studied in 70 platelet concentrates kept for 72 hours at 22 degrees C in plastic PVC bags. On separating the platelet-rich plasma, a portion of buffy coat (i.e. a layer of leukocytes and erythrocytes) was added to one of the two series of platelet concentrates. These platelet concentrates did not differ from platelet concentrates prepared by the usual method, either by the platelet volume or count (p less than 0.05). The mean leukocyte count was 2.42 x 10(9)/L and 21.2 x 10(9)/L in the control and study series, respectively. After a 72 hour storage, a statistically significant difference (p less than 0.05) in the increase of lactate and ammonium concentrations, and a decrease in the glucose concentration and plasma pH were observed in platelet concentrates with a higher leukocyte count. The metabolic changes were accompanied by a statistically significant fall in the hypotonic shock (p less than 0.05). The results obtained in this study indicate that leukocytes in platelet concentrates elicit an adverse effect upon the platelet metabolism and function in vitro. In order to maintain the pH value at 6.0 during a 72 hour storage, the leukocyte count in platelet concentrates should not exceed 15.6 x 10(9)/L.

Blood Platelets↗