PubMed Health⌕ Search

Biomedical subjects

S T Lillevang

Publications and source records attributed to S T Lillevang.

At least 19 recordsLinked to original sources
PubMed2001

Leukocyte-depletion of blood components does not significantly reduce the risk of infectious complications. Results of a double-blinded, randomized study.

Allogeneic blood transfusions are claimed to be an independent risk factor for postoperative infections in open colorectal surgery due to immunomodulation. Leukocyte-depletion of erythrocyte suspensions has been shown in some open randomized studies to reduce the rate of postoperative infection to levels observed in nontransfused patients. Using a double-blinded, randomized design, we studied the postoperative infection rate in patients undergoing open colorectal surgery transfused with either leukocyte-depleted erythrocyte suspensions (LD-SAGM) or non-leukocyte-depleted erythrocyte suspensions (SAGM). Unselected patients (n 279) were allocated to receive LD-SAGM (n 139) or SAGM (n 140) if transfusion was indicated. Forty-five percent were transfused, yielding 48 patients in the LD-SAGM group and 64 in the SAGM group. Thirteen patients were excluded because they received one type of transfusion in spite of randomization to the other type. No significant differences in the rates of postoperative infections (P=0.5250) or postoperative complications (P=0.1779) were seen between the two transfused groups. Infection rates were 45% and 38% in the transfused groups and 21% and 23% in the nontransfused groups. No significant difference between the transfused groups was seen on any single infectious event, mortality rate, or duration of hospitalization. Leukocyte-depletion of erythrocyte suspensions transfused to patients undergoing open colorectal surgery does not reduce postoperative infection rates.

Aged↗
PubMed1995

Three-colour flow cytometric immunophenotyping in HIV-patients; comparison to dual-colour protocols.

Flow cytometric measurement of circulating CD4+ lymphocytes is important in the evaluation of disease progression in HIV-infected patients. Development of dyes that can be exited at 488 nm and have emission maximum in the far red area has made three-colour protocols, together with fluorescein isothiocyanate (FITC) and R-phycoerythrin (PE), possible in most clinical flow cytometers. We report here the comparison of a two-tube, three-colour protocol (including CD45/CD4/ CD3 and CD8/CD4/CD3) with our conventional dual-colour protocol. No significant differences were found between percentage of CD3+ lymphocytic cells determined with three different antibody combinations. When the CD8/CD4/CD3 combination was used a systematic overestimation of CD3+ CD4+% cells was found. This turned out to be caused by the formation of 'CD8-escapees'. These are clumps of CD8+ cells that fall outside the lymphocyte gating region, principally because of high side scatter. The problem can be overcome by rigorous vortexing to loosen aggregates. The lymphocyte gating principle used in this protocol (gating on a side scatter/CD45 dot plot) is readily applicable to other antibody combinations. This was demonstrated by measuring CD5+ B lymphocytes, a subset receiving increasing attention in the study of HIV-induced immune deviations. We conclude that our three-colour protocol for CD4+ T-lymphocyte determinations offers significant advantages to the conventional dual-colour method, and we suggest that when possible anti-CD45 be added to dual-colour combinations in order to improve lymphocyte gating.

Antigens, CD↗
PubMed1994

Stimulation of intercellular adhesion molecule-1 (ICAM-1) antigen expression and shedding by interferon-gamma and phorbol ester in human renal carcinoma cell cultures: relation to peripheral blood mononuclear cell adhesion.

In the present study we investigated the effect of interferon-gamma (IFN-gamma) and phorbol-12-myristate 13 acetate (PMA) on intercellular adhesion molecule-1 (ICAM-1) antigen expression and shedding in human renal carcinoma cell cultures. We also examined the functional consequences of ICAM-1 antigen expression and soluble ICAM-1 molecules on the adhesion of peripheral blood mononuclear cells (PBMC). Incubation of the human renal carcinoma cell line CaKi-1 with IFN-gamma or PMA enhanced ICAM-1 antigen expression. The calcium ionophore, 4-bromo-calcium ionophore A23187 (Bromo-A23187) significantly enhanced the IFN-gamma and PMA effect. Soluble ICAM-1 (sICAM-1) was detected in the supernatants of stimulated but not unstimulated cultures, and correlated significantly with cellular expression. Using 51Cr-labelled peripheral blood mononuclear cells in a cell adhesion assay, we demonstrated increased adhesion in IFN-gamma-treated CaKi-1 cultures, which was augmented by Bromo-A23187. This adhesion was blocked by preincubation of CaKi-1 cells with monoclonal antibody against ICAM-1 or by preincubation of PBMC with either monoclonal antibody against leucocyte function associated antigen-1 alpha (LFA-1 alpha), a major receptor for ICAM-1, supernatants from treated cultures or purified sICAM-1 molecules. Thus, shedding of ICAM-1 may play a role during the escape from immunosurveillance by renal carcinoma cells.

Antigens, Neoplasm↗
PubMed1994

Interferon-gamma increases cellular calcium ion concentration and inositol 1,4,5-trisphosphate formation in human renal carcinoma cells: relation to ICAM-1 antigen expression.

In the present study, we investigated the effect of interferon-gamma (IFN-gamma) on cellular calcium ion concentration [Ca2+]i and inositol 1,4,5-trisphosphate (Ins 1,4,5-P3) formation in the human renal carcinoma cell line CaKi-1. We also examined the possible role of a Ca(2+)-dependent mechanism during IFN-gamma-induced intercellular adhesion molecule 1 (ICAM-1) antigen expression. IFN-gamma caused a rapid concentration-dependent rise in [Ca2+]i, which was partly inhibited by diltiazem, a calcium channel blocker, TMB-8, an inhibitor of intracellular calcium redistribution, and in calcium-free medium. IFN-gamma caused a fourfold increase in Ins 1,4,5-P3 formation. The induction of ICAM-1 antigen expression was synergistically enhanced by 4-bromocalcium ionophore A23187. Finally, the calcium antagonists diltiazem. TMB-8 and EGTA, as well as two potent inhibitors of Ca(2+)-dependent kinases, calmidazolium (R24571) and W7, had no or only a minor inhibitory effect on IFN-gamma induction. Our data suggest that IFN-gamma increases [Ca2+]i in CaKi-1 cells by stimulating influx of Ca2+ and release of Ca2+ from intracellular stores, probably via Ins 1,4,5-P3 formation. IFN-gamma signal transduction in our model may not be limited to an increase in [Ca2+]i and Ins 1,4,5-P3, since IFN-gamma-induced ICAM-1 antigen expression was abrogated to a minor degree by calcium antagonists and not coupled to Ins 1,4,5-P3 formation.

Antigens↗
PubMed1994

Effect of radiographic contrast media on granulocyte phagocytosis of Escherichia coli in a whole blood flow cytometric assay.

RATIONALE AND OBJECTIVES: Earlier studies have demonstrated an adverse effect of radiographic contrast media (CM) on granulocyte phagocytosis. Most studies in the past have depended on granulocyte separative procedures that may themselves affect granulocyte functions. This study was performed to evaluate the effect of CM on phagocytosis using a flow cytometric assay allowing more physiological assay conditions. METHODS: Twenty consecutive patients were blindly randomized to receive the nonionic ratio 3.0 CM iohexol or the ionic ratio 3.0 CM ioxaglate for intravenous urography. Granulocyte phagocytic potential was measured before and at 1, 5, and 20 minutes after CM administration with a flow cytometric whole blood method evaluating the ingestion of complement- and immunoglobulin G (IgG)-opsonized fluorescent Escherichia Coli bacteria. RESULTS: The ability of granulocytes to phagocytize opsonized E. Coli was adversely affected by both CM used. Compared with baseline values, significantly decreased phagocytic activity was observed for iohexol at 1, 5, and 20 minutes and for ioxaglate at 1 and 5 minutes. The largest decrease with ioxaglate was from 85.3 +/- 10.5 to 69.3 +/- 16.3 (5 minutes), and the largest change with iohexol was from 87.1 +/- 8.5 to 74.5 +/- 15.9 (5 minutes). CONCLUSION: These results confirm earlier reports that ionic and nonionic CM adversely affect the phagocytic ability of granulocytes after intravenous administration.

Escherichia coli↗
PubMed1994

Redistribution of granulocytes during adrenaline infusion and following administration of cortisol in healthy volunteers.

Major surgical procedures induce an endocrine metabolic stress response characterized by increased secretion of adrenaline and cortisol. Furthermore, surgical stress is accompanied by granulocytosis in peripheral blood. The granulocytosis may be due to increased adrenaline and cortisol secretion. The purpose of this study was to investigate the redistribution of granulocytes during adrenaline infusion and following administration of cortisol. Granulocytes were isolated from peripheral blood from eight healthy volunteers, labelled with indium-111-tropolene and reinjected. The distribution of granulocytes was imaged by using a gamma camera and calculated with an interfaced computer three times during a control period and three times during a corresponding hour af adrenaline infusion 0.05 micrograms kg b.w.-1 min-1. The distribution was then measured every second h for another 6-h control period and then for 6 h following administration of cortisol 3.6 mg kg b.w.-1. Infusion of adrenaline resulted in granulocytosis in peripheral blood and a reduction of radioactivity of the spleen to 83.0% of the initial value. The effect of adrenaline on the bone marrow was negligible. Cortisol administration was followed by granulocytosis and decreased radioactivity of both the spleen (81.5%) and the bone marrow (79.8%). It is concluded that the spleen is an active immunological organ as both adrenaline and cortisol induces efflux of granulocytes from the spleen. The cortisol induced efflux of granulocytes from the bone marrow explains that granulocytosis also occurs in splenectomized patients after major surgery.

Adult↗
PubMed1994

The redistribution of granulocytes following E. coli endotoxin induced sepsis.

Infusion of endotoxin elicits granulocytopenia followed by increased numbers of granulocytes in peripheral blood. The purpose of this study was to investigate the redistribution and sequestration of granulocytes in the tissues following E. coli endotoxin induced sepsis. From 16 rabbits granulocytes were isolated, labelled with Indium and reinjected intravenously. Eight rabbits received an infusion of E. coli endotoxin 2 micrograms kg-1 while eight received isotonic saline. The redistribution of granulocytes was imaged with a gamma camera and calculated with a connected computer before and 2 and 6 hours after infusion of endotoxin or saline. Serum cortisol and interleukin-1 beta were measured. In another seven rabbits, respiratory burst activity and degranulation of granulocytes were measured prior to and from 5 min to 6 hours after infusion of E. coli endotoxin 2 micrograms kg-1 BW. Following infusion of endotoxin, the number of granulocytes in peripheral blood decreased from 2.44 to 0.064 x 10 l-1 two hours later. Within 5 min after infusion the overall oxidative burst of the peripheral blood granulocytes was increased and the granularity had decreased. Serum cortisol and interleukin-1 beta increased significantly. The radioactivity of labelled cells in the bone marrow and spleen decreased to 83.1% and 91.6% of initial values. At the same time there was a transient sequestration of labelled granulocytes in the lungs reaching 117.6% of initial values. The radioactivity of the liver increased continuously to 118.4%. The results indicate that endotoxin induces an efflux in activated granulocytes from peripheral blood, bone marrow and spleen to the lungs and liver.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1994

An antibody screening test based on the antiglobulin gel technique, pooled test cells, and plasma.

The recently introduced gel technique offers significantly advances compared to traditional tube tests. The purpose of the present study was to design an antibody screening test based on the gel technique, pooled cells, and plasma and to evaluate this test by comparison with a conventional spin-tube indirect antiglobulin test (IAT) combined with a two-stage papain technique. Pilot studies were performed to establish optimal parameters during the design phase, and finally 5,446 consecutive samples were screened for irregular antibodies by the gel technique in parallel with routine techniques. Irregular erythrocyte antibodies were detected in 151 samples, and the gel technique proved equal or superior to the tube test in the detection of all antibodies except 'enzyme-only' anti-E and anti-Lea. We conclude from this study that screening for unexpected antibodies using the gel IAT in our set-up, which includes: (1) omission of enzyme technique; (2) the use of stabilized (EDTA) plasma instead of serum as test material in order to facilitate automation; and (3) pooling 2 by 2 of 4 test cells (to make the gel technique price competitive), is a fast, reliable and sensitive procedure that maintains transfusion safety and compares favourably with our previous routine of saline IAT combined with a two-stage papain technique.

ABO Blood-Group System↗
PubMed1994

Redistribution of granulocytes in patients after major surgical stress.

Major surgery induces a stress response characterized by granulocytosis in peripheral blood, and increased secretion of adrenaline and cortisol. The purpose of this study was to investigate the redistribution of granulocytes in response to major surgical stress. Granulocytes were isolated from eight surgical patients and eight healthy volunteers, labelled with Indium-111-tropolone, and reinjected. The distribution of granulocytes was imaged with a gamma camera and calculated by an interfaced computer before surgery and at 2, 4 and 6 h after the end of surgery. The volunteers served as a control group. In the hours after surgery the radioactivity of the area around the surgical field increased to 410.7% of initial values, while the radioactivity of the spleen decreased to 77.5%. In conclusion, the spleen constitutes a readily mobilizable source of granulocytes. This in vivo model demonstrates pronounced postoperative efflux of granulocytes to the area around the surgical field within hours.

Adult↗
PubMed1994

Chronic parvovirus infection mimicking myelodysplastic syndrome in a child with subclinical immunodeficiency.

PURPOSE: We present a report of a child with subclinical immunodeficiency who became chronically infected with parvovirus resulting in pancytopenia and morphologic abnormalities in the bone marrow mimicking myelodysplastic syndrome (MDS). PATIENTS: An 8-year-old boy presented with severe anemia, moderate thrombocytopenia and granulocytopenia. The patient showed hyper-immunoglobulin M (IgM) immunodeficiency but no increased susceptibility to infections. The bone marrow was hypercellular with dysplastic granulocytopoiesis and erythroblastopenia. RESULTS: Treatment with cyclosporine and i.v. Ig resulted in temporary normalization of the hemoglobin level. For several years it was assumed that the patient had MDS. A diagnosis of parvovirus infection was initially rejected due to the lack of specific antibodies and the absence of giant pronormoblasts in the bone marrow. When the polymerase chain reaction technique became available, parvovirus DNA was detected from the entire disease course. CONCLUSIONS: This case report expands our conception of the clinical spectrum of parvovirus infection and emphasizes that parvovirus must be considered as a differential diagnosis in MDS. We recommend performing a parvovirus DNA test despite negative serologic findings in patients with MDS, especially when associated with immunologic abnormalities.

Child↗