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Biomedical subjects

K Schimpf

Publications and source records attributed to K Schimpf.

At least 37 records · Page 2Linked to original sources
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↗
PubMed1986

Correlation of immune defects in hemophilia with HTLV-III antibody titers.

Of 170 hemophilia patients, 22% had high-titer, 29% had low-titer, and 49% had no antibodies against HTLV-III. The strength of HTLV-III antibodies was correlated significantly with a decreased OKT4/T8 ratio (p less than 0.0005), decreased in vitro response to pokeweed mitogen (p less than 0.025), and elevated serum neopterin (p less than 0.05) and serum IgG (p less than 0.0005). The fraction of patients with abnormal immunological findings was consistently greater among patients with high-titer than among patients with low-titer HTLV-III antibodies. Testing these immunological parameters may be useful for monitoring the breakdown of immune functions leading to AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Selected blood coagulation parameters during extracorporeal circulation.

We investigated selected coagulation parameters in 13 patients who had undergone open heart surgery with extracorporeal circulation (ECC). During ECC factor XIIa increased considerably to 38%. This may lead to intravascular coagulation, which is however inhibited during ECC by the administered heparin. The C1-inhibitor activity decreased to 12% during ECC, this decrease was considerably greater and lasted longer than the decrease of the C1-inhibitor concentration, which declined to 59%. The levels of the other coagulation factors I, II, V, VII, X, XII, antithrombin III, alpha 2-antiplasmin and platelets decreased to 50-60%. The latter was predominantly due to hemodilution at the beginning of ECC. We assume that the critical period for the coagulation system in ECC appears when ECC is discontinued. At this point we have a high factor XIIa level and a low C1-inhibitor activity so that intravascular coagulation (DIC) may occur because then the inhibitory effect of heparin is neutralized by protamine.

Adult↗
PubMed1985

Transmission of non-A, non-B hepatitis by heat-treated factor VIII concentrate.

In-vitro and animal studies have shown that viral agents can be removed from or inactivated in clotting factor concentrates by physical or chemical treatment. However, clinical data have as yet not substantiated the results of these studies. 13 haemophilia A patients who had not been treated previously with blood or blood products were given a dry-heated factor VIII concentrate and were tested serologically over the next 12 months. Hepatitis developed in 11 patients (84%) and was invariably of type non-A, non-B. Morbidity was not related to the lot of the therapeutic material or to the number of infusions. The incubation period was either 5 or 8-11 weeks, and only 1 patient had symptoms. Aminotransferase elevation showed both monophasic and biphasic patterns. During the follow-up period signs of the disease disappeared in 10 patients (90%). These findings contrast with the absence of non-A, non-B hepatitis in chimpanzees given the same heated concentrate. Thus, clinical studies in first-exposure haemophiliacs are essential for the true evaluation of the safety of new "treated" concentrates.

Adolescent↗
PubMed1985

Antibodies to adult T-cell leukemia virus (ATLV/HTLV-I) in AIDS patients and people at risk of AIDS in Germany.

A total of 2048 serum samples from Germany were examined for antibodies to adult T-cell leukemia virus (ATLV) structural polypeptides with an enzyme-linked immuno sorbent assay (ELISA) and confirmative immuno precipitation. The origin of the sera samples was: 850 samples taken for virological or protozoal diagnosis; 626 samples from male homosexuals, about 20% of whom had lymphadenopathy syndrome; 164 from hemophiliacs; 184 were from multiple transfused, mostly dialysis patients; 9 from intravenous drug abusers; 182 from suspected cases of acquired immuno deficiency syndrome (AIDS) and 33 from AIDS-patients. In none of these sera did we detect antibodies to ATLV, except in the serum of one patient who had been on hemodialysis for over 11 years. Obviously infection with ATLV or a serologically related agent is very rare in our country and an association with AIDS could not be observed.

Acquired Immunodeficiency Syndrome↗
PubMed1983

[Post-transfusion hepatitis and its sequelae in the treatment of hemophilia].

As a result of the frequent application of factor VIII and IX concentrates of single donor cryoprecipitates as well as of concentrates from large plasma pools a very important side-effect became evident: the transmission of serum hepatitis in its two forms B and Non A Non B. Dependent on the factor dosage, up to 100% of the patients showed signs of an active hepatitis or contact of the defense system with hepatitis viruses. With increasing frequency of chronic hepatitis (65%) there is also an increase in the aggravation to liver cirrhosis which manifests itself 13 years earlier than in the normal population. In future, greatest attention will have to be devoted to avoiding the transmission of hepatitis and other viral infections by concentrates of clotting factors.

Blood Transfusion↗
PubMed1981

[Ultrasound diagnosis of muscle haematomas in haemophiliac patients (author's transl)].

Ultrasound was used for the diagnosis of muscle haematomas in seventeen patients with congenital clotting abnormalities. Fifteen patients had haematomas in the extremities or the gluteal muscles, whereas in four cases there was retroperitoneal bleeding. In three of the nineteen examinations there was no sonographic evidence of recent bleeding at the first attempt, but in sixteen cases the size, localisation and relationship to neighbouring organs could be demonstrated. It was possible to distinguish between localised haematomas and diffuse ones. Comparison of the two sides was used with semi-quantitative evaluation of the amplitude profile. The condition in the extremities favours ultrasound examination and makes it possible to use high frequencies in order to achieve better resolution; the diagnosis of bleeding into the retroperitoneal space may be difficult. At times other methods of examination, particularly computer tomography, may have to be used.

Adolescent↗
PubMed1978

[The effect of tri-iodinated contrast media on clotting. An investigation of thrombocyte aggregation (author's transl)].

In vitro investigations showed that renographic and cholecystographic contrast media reduced thrombocyte aggregation proportionate to contrast concentration. In vivo this disturbance of thrombocyte function could not be demonstrated. Other factors investigated, such as clotting time and thrombocyte counts, remained unaffected in vivo and in vitro. Age and sex and the presence of various types of pathology were also found to have no affect. These findings and their significance are discussed.

Age Factors↗
PubMed1976

[Treatment of haemophilia with factor VIII inhibitor by giving isoagglutinin-free factor VIII concentrate (author's transl)].

Two nine-year-old boys with haemophilia A and circulating inhibitor against factor VIII were given large doses of commercial AHG concentrates to control bleeding. But the isoagglutinins in the AHG concentrates caused haemolysis in both patients. When AHF (Immuno) from AB donors - a cryoprecipate without isoagglutinins - was used no further inhibitor activity was detectable, previously observed anaphylactoid reactions no longer occurred and usual doses of AHG were now sufficient to control bleeding.

Child↗
PubMed1976

[A controlled study of long-term treatment of haemophilia B on an out-patient basis (author's transl)].

Eight patients with severe or moderately severe haemophilia B were treated for six months, according to three schemata for two months each: 18, twice 18, or twice 9 U of factor IX per kg body-weight weekly. The sequence of the six possible treatment schemes was determined strictly at random. One patient had to be excluded because he developed hepatitis, another because allergic signs developed. In the pre-trial period the number of bleedings per two months had been about 40, as recorded by the patients. The bleedings were reduced to nine after 18 U of factor IX per kg body-weight weekly, falling to two after twice 9 and twice 18 U/kg weekly. The patients themselves considered twice 9 U/kg as the ideal dosage. It is recommended that this dosage scheme should be used initially if one decides to employ permanent substitution in haemophilia B. Once freedom from bleedings and strengthening of the motor system have been achieved one can then try 18 U per kg body-weight once a week.

Adolescent↗