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Biomedical subjects

W Hitzler

Publications and source records attributed to W Hitzler.

17 recordsLinked to original sources
PubMed2005

The impact of two whole blood inline filters on markers of coagulation, complement and cell activation.

BACKGROUND AND OBJECTIVES: There exists a current lack of information about the impact of different inline filters, used for the leucoreduction of whole blood (WB), on the levels of clotting factors and markers of coagulation, complement and cell activation in plasma. Only a few small comparisons of different types of WB inline filters have been published to date. MATERIALS AND METHODS: This study compared two plasma types of 200 units each. Both study groups were derived from WB, inline-filtered and held for 2 h at 20 degrees between donation and filtration. Then, 200 units (Group A) were filtered using a positively charged polyester filter (Baxter RZ2000) and the other 200 units (Group B) were filtered using an uncharged polyester filter (Fresenius). After filtration, both groups were analysed for fibrinogen, factors V and VIII:C (FV and FVIII:C, respectively), immunoglobulin G (IgG), residual leucocytes and platelets, and markers of coagulation, complement and cell activation. Predonation plasma samples from CPDA1-anticoagulated blood were obtained from 100 different individuals and served as controls. RESULTS: WB inline filtration did not influence fibrinogen, FV, FVIII:C or IgG levels. Neither filter induced thrombin or fibrin formation. The charged filter caused substantial complement activation and neutrophil elastase and platelet factor 4 release. In contrast, the plasma filtered through the uncharged filter showed markedly lower levels of C3a-desArg, C5a, neutrophil elastase and platelet factor 4, and moderately reduced levels of prothrombin fragments 1+2 and D-dimer, compared with controls. CONCLUSIONS: Filter type has a significant impact on the quality of plasma derived from WB filtered through inline filtration systems. Some filters produce substantial coagulation and complement activation and cell release, while others appear to reduce the plasma levels of activation markers. The clinical significance of these findings remains to be determined.

Adolescent↗
PubMed2002

Longitudinal analysis of the T-cell receptor (TCR)-VA and -VB repertoire in CD8+ T cells from individuals immunized with recombinant hepatitis B surface antigen.

Recent studies have suggested that vaccination induces alterations in the T cell receptor (TCR) repertoire. We investigate the diversity of the TCR repertoire after immunization with a recombinant hepatitis B surface vaccine in seven healthy subjects in CD8+ T cells in peripheral blood lymphocytes. Cellular immune responses were monitored over time by sorting CD8 T cells followed by TCR-VA and -VB complementarity determining region 3 (CDR3) analysis. Frequency of individual VB families was determined by flow cytometry. TCR-VA/VB repertoires obtained from CD8+ T cells drawn after vaccination were compared to the TCR repertoire determined prior to vaccination. Monoclonal TCR transcripts could be detected exclusively in CD8+, but not in CD4+ T cells. Such monoclonal TCR transcripts were either stable in some individuals, or could only be detected at certain time points after vaccination. Sorting of monoclonal TCR-VB3+ T cells, which constituted up to 5% of the CD8+ T cell population from one individual, revealed that this T cell clone recognizes an epitope provided by the recombinant hepatitis B vaccine presented by MHC-class I on autologous antigen-presenting cells. Examination of the structural anatomy, defined by the TCR, and the frequency of T cells responding to the immunizing antigen may be helpful to provide surrogate markers to monitor cellular immune responses induced by protein antigens utilized for vaccination.

Adult↗
PubMed1996

[Enteropathic spondylarthritis in chronic inflammatory bowel diseases: prevalence, manifestation pattern and HLA association].

BACKGROUND: Enteropathic spondylarthropathies (SpA) are the most frequent extraintestinal manifestation of the chronic inflammatory bowel disease (IBD), Crohn's disease (CD) and Ulcerative Colitis (UC). It was the aim of the present study, to analyze a large number of IBD patients for the prevalence and pattern of joint manifestation and the association of SpA with the extend of bowel involvement and HLA-haplotype. PATIENTS AND METHODS: 521 patients (409 CD and 112 UC) were prospectively analyzed over a period of one year. SpA was diagnosed on the basis of an appropriate patient history as well as clinical, radiological and immunoserological parameters. RESULTS: SpA was diagnosed in 10.7% of all CD and 14.4% of all UC patients. In 26.8% of all patients symptoms of SpA occurred prior to and in 14.4% simultaneously with IBD. 28.1% of all patients presented with isolated peripheral arthritis, 26.8% of all patients showed an isolated involvement of the spine or sacroiliic joints and 45.1% of all patients presented with combined involvement. 2/12 UC patients with SpA suffered from rectosigmoiditis, 5/12 from partial colitis and 5/12 had pancolitis. In CD patients with SpA, 8/59 had isolated colitis, 8/59 ileocolitis and 31/59 isolated small bowel involvement. There was a positive correlation between SpA and HLA-B27 (p < 0.01). CONCLUSION: Enteropathic spondylarthropathies are an important extraintestinal manifestation of IBD. Spondylarthropathies occur irrespective of the extend of IBD and frequently become symptomatic prior to IBD. These and recent data describing inflammatory bowel disease in patients with SpA of unknown etiology suggest that both diseases have a common pathogenetic background.

Adult↗
PubMed1993

[The present status of blood filtration--fundamentals and the clinical significance of leukocyte depletion and microaggregate filters in blood transfusion].

In this review the role of the latest generation of leukodepletion blood filters and the adverse reaction of leukocytes i.e. alloimmunisation, immunosuppression, nonhaemolytic febrile transfusion reaction, platelet refractoriness, transmission of infectious agents are described and discussed. Leukocyte-poor blood component is indicated for patients with a history of nonhaemolytic febrile transfusion reaction, in avoiding alloimmunisation in patients waiting for transplantation or platelet refractoriness and in preventing CMV-infection. In the review the role of microaggregate filters in transfusion complications, namely, nonhaemolytic febrile transfusion reaction, thrombocytopenia, adult respiratory distress syndrome (ARDS), fibronectin depletion and histamine release is evaluated. The need of microfiltration of autologous blood is discussed. It appears that the use of 40 microns microfilters is warranted in a broad array of intensive care settings.

Blood Component Removal↗
PubMed1992

[Autologous transfusion--organization and results of preoperative blood donation by heart surgery patients].

This study presents our preoperative autologous blood donation programme that is in use since 1987. 246 patients of cardiothoracic surgery participated in this program. 77% of all patients had preoperative concentrations of haemoglobin above 12g/dl despite frequent donations. 36.5% of patients were transfused exclusively with their own blood products. Reduction of homologous blood transfusion has been achieved with second preoperative plasmaphereses and more restricted indication for blood transfusion. More blood donation could be performed with application of erythropoietin resulting in more frequent preoperative blood donations.

Adult↗
PubMed1992

[Comparative study of antibody identification in the gel centrifugation test (ID Microtyping System), solid phase antiglobulin test (Solidscreen Capture R, Ready ID) and tube test].

The gel centrifugation test (ID Microtyping System)--a new method for antibody screening--was compared with solid phase systems (Solidscreen, Capture R, Ready ID) and the conventional tube test. 141 different antibodies were tested and the results were compared. The ID Microtyping System identified 138 (98%) of all antibodies, the tube test 110 (78%), Capture R 86 (61%), Ready ID 79 (56%) and Solidscreen 75 (53%). The results in identification of all antibodies except cold agglutinins (n = 107) were: in the ID Microtyping System 98% (105), tube test 76% (82), Capture R 70% (75), Ready ID 68% (73) and Solidscreen 61% (65).

Antibody Specificity↗
PubMed1990

[Preoperative autologous blood donation].

This presentation shows our experiences with the preoperative autologous blood donation existing since 1987, 246 patients of the cardiothoracic surgery participated in this program. The preoperative concentration of hemoglobin was above 12g/dl 76.8% of the patients despite the frequent donations, 36.5% of the participants could be transfused with their own blood products. Further reduction of homologous blood transfusion could be achieved with a second preoperative plasmapheresis and the donation of erythropoietin.

Blood Transfusion, Autologous↗
PubMed1990

[The gel centrifugation test in serologic compatibility testing].

The gel centrifugation test is described in compatibility testing. The conventional method was modified resulting in easy handling for technical assistant. 2560 of compatibility testings were performed. 5% of more relevant antibodies could be detected compared with conventional tube test.

ABO Blood-Group System↗
PubMed1989

Two-site immunochemiluminometric assay of intact human parathyrin in serum with use of a tracer peptide purified by reversed-phase high-performance liquid chromatography.

For this two-site immunochemiluminometric assay of intact human parathyrin (hPTH), the luminescent tracer was synthetic hPTH(53-84), conjugated via succinimide linkage to (aminobutyl)ethyl-isoluminol hemisuccinimide (abei-h). Purification of the labeled hPTH(53-84) by reversed-phase high-performance liquid chromatography allowed isolation of the conjugate having the highest incorporation of abei-h, 1.6 mol per mole of hPTH(53-84). The solid-phase antibody directed against the N-terminal part of hPTH was immobilized by adsorption onto the polystyrene surface of the assay tube and extracted the intact hPTH and N-terminal fragments. Another antibody against synthetic hPTH(53-84), which bound to the C-terminal part of intact hPTH, was indirectly labeled at its second free binding site with the abei-h-labeled hPTH(53-84). The assay has a detection limit of 0.5 pmol/L; it is accurate, precise, and reliable; and it shows a linear response for samples containing up to 100 pmol of hPTH per liter. The normal reference interval ranged from 1.8 to 5.9 pmol/L; 56 patients with primary hyperparathyroidism had concentrations ranging from 5.9 to 113 pmol/L. The concentrations detected in patients with idiopathic hypoparathyroidism were below the normal reference interval.

Chromatography, High Pressure Liquid↗
PubMed1988

Two-site assay of intact parathyroid hormone in the investigation of primary hyperparathyroidism and other disorders of calcium metabolism compared with a midregion assay.

We compared the utility of measurements of serum intact human PTH-(1-84) and midregion human PTH-(44-68) in patients with disorders of extracellular calcium metabolism. Serum midregion PTH was determined by RIA, and serum intact PTH was measured by a sensitive and specific immunoradiometric two-site assay. The serum intact PTH concentrations in 70 patients with primary hyperparathyroidism were above the normal range in 69, and thus widely separated from the levels in 40 patients with hypercalcemia of malignancy, in whom serum intact PTH values were usually below normal. In contrast, both groups had overlapping serum midregion PTH values. In patients after renal transplantation and those with chronic renal failure, serum intact PTH levels were in the normal range twice as often as were serum midregion PTH values. The intact PTH assay was also superior in detecting venous gradients of the hormone and changes in PTH secretion caused by altered serum calcium concentrations, and serum intact PTH was remarkably low in hepatic venous effluent. We conclude that this new assay for serum intact PTH is superior to the midregion RIA in investigating parathyroid function in several different clinical conditions.

Adult↗
PubMed1988

[AIDS and anesthesia].

AIDS will become a bigger and bigger problem in future, especially for medical staff who will be increasingly in contact with infected patients. The epidemiology of HIV infection (blood, vaginal secretion, sperm) and the threat of this infection require particularly strict observance of hygienic measures. Unqualified handling of infected material such as HIV-contaminated injection needles or pointed objects represent a major risk of HIV infection for medical personnel. Despite the high degree of safety in the preparation of banked blood we cannot completely guarantee that only absolutely safe HIV-free blood will be transfused. Hence, indication for transfusion must be very strictly limited. Autologous transfusion as a safe alternative to homologous transfusion should be employed more frequently. Seroconversion rate after needle-point injury is now stated to be one per cent. According to Goebel et al. in AIFO 5:227 (1988) four nurses carried out mouth-to-mouth resuscitation in an AIDS patient who had jumped from the third floor of a building in attempted suicide. Despite considerable blood contact the HIV antibody tests remained negative even now after 18 months.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Two homologous radioimmunoassays for parathyrin compared and applied to disorders of calcium metabolism.

These 48-h homologous equilibrium radioimmunoassays for human parathyrin (hPTH) are based on the use of two antisera, MS 6 and MS 7, raised in guinea pigs against human parathyroid adenoma extract. For the assay with MS 6, Tyr43-hPTH(44-68) and hPTH(44-68) were radioiodinated for use as the assay tracer. Labeled peptides were separated from free iodine by passage through Sep-Pak C18 cartridges. This RIA appears to be mid-region specific: hPTH(28-48) and hPTH(64-84) were not recognized, whereas hPTH(53-84) was 100% cross reactive with hPTH(44-68). Thus, the PTH recognition site of antiserum MS 6 must be between amino-acid residues 53 and 63. With antiserum MS 7, which recognized the PTH molecule between amino-acid residues 69 and 84, we used hPTH(53-84) for preparing the standard curve and 125I-labeled Tyr52-hPTH(53-84) as the assay tracer. Because this RIA recognized PTH fragments containing residues 69-84 of hPTH, we termed it a C-terminal assay. Both assays were useful for diagnosis of primary and secondary hyperparathyroidism.

Adenoma↗
PubMed1982

Homologous radioimmunoassay for human parathyrin (residues 53-84).

We describe a sequential saturation double-antibody radioimmunoassay for carboxyl-terminal fragments of human parathyrin (hPTH) in serum. Standards are prepared with synthetic hPTH (residues 53-84) in hPTH-free serum. Antisera are obtained by immunizing guinea pigs with partly purified hPTH extracted from adenomatous glands. Tracer is prepared by labeling hPTH (53-84), presumably at the histidine residue, with 125I by the Chloramine T method at pH 8.6. Dilution curves for hPTH extracted from adenomas are superimposable on dilution curves for the synthetic 53-84 fragment. Dilution of sera from hyperparathyroid patients showed linearity of response with concentration in the present assay, but non-linearity in the heterologous radioimmunoassay. In contrast to the heterologous system, which discriminated 28 of 32 patients with primary hyperparathyroidism from 32 normals (normal range: undetectable to 54 pmol/L, omitting the highest and lowest values from controls), the present assay separated these groups without overlap.

Calcium↗