T-cells and psychopathology in schizophrenia: relationship to the outcome of neuroleptic therapy.

Until recently, attention has been focused on the pathogenetic aspects of immunological findings in schizophrenic patients. There has been no mention of the relationship between such findings and schizophrenic symptoms. To study the probable relationship between T-cells and T-cell subgroups in the course and prognosis of schizophrenia, immunological and psychopathological parameters were correlated in 55 patients suffering from schizophrenia (ICD-9: 295.

[Quality assurance in preoperative autologous blood collection from the viewpoint of the transfusion medicine physician].

The overall risk of autologous hemotherapy, consisting of the risks due to donation and transfusion, has to be lower than that of homologous hemotherapy. To maintain the advantage of autologous blood, for example preoperative blood deposit, it has to be collected and prepared according to the guidelines on the production of homologous blood, except some obvious deviations concerning donor criteria. In this paper we recommend measures for the quality assurance in autologous predeposits from the point of view of transfusion medicine.

[Optimizing leukocytapheresis for collection of circulating hematopoietic stem- and precursor cells by multiparameter flow cytometry].

Peripheral blood stem cells are an alternative to bone marrow-harvested stem cells. We report on the feasibility of predicting optimal timing for leukapheresis by means of blood monitoring for CD34-positive cells by flow cytometry. In addition to monitoring, determinations of CD34-positive cells also are predictive for the hemopoietic potency of cells harvested by leukapheresis, as close correlations of numbers of CFU-GM and of CD34-positive cells, respectively, in leukapheresis samples are determined.

[Mobilization of hematopoietic stem cells in peripheral blood by leukapheresis].

To improve the separation results of peripheral blood stem cells (PBSC), cytokines (GM-CSF, G-CSF or IL3) can be administered to patients. The most important prerequisites for successful PBSC separation are daily monitoring of CD-34-positive cells to determine the separation days and the use of optimized separation programs. To improve the performance of the cell separation, we increased the process volume to more than patients' blood volume and obtained increased MNC and CFU recoveries.

[Initial experiences with routine use of the AS-104 cell separator in a single needle procedure].

Since 1992, the Fresenius cell separator AS-104 offers a single-needle option. The authors present data on their first experience with this new single-needle thrombocytapheresis system.

Bone marrow purging prior to autologous transplantation.

Our data suggest that ex vivo bone marrow purging using monoclonal antibodies (MoAbs) and sheep-anti-mouse immunobeads (SAM beads) prior to autologous bone marrow transplantation (ABMT) allows satisfactory tumor cell reduction without critical stem cell losses. Nevertheless, there is only a reduction but no elimination of tumor cells. The consequences will have to be clinically discussed.

Microfollicular thyroid adenoma and congenital goitrous hypothyroidism.

Three patients with congenital goitrous hypothyroidism are reported. They were treated with adequate thyroxine replacement and developed well defined microfollicular thyroid adenomas despite being euthyroid clinically and biochemically throughout their clinical course. Patients with congenital goitrous hypothyroidism appear to be at increased risk of developing thyroid adenoma in childhood despite the use of replacement thyroxine treatment in physiological doses.

The acute appendicitis syndrome: psychological aspects of the inflamed and non-inflamed appendix.

The aetiological importance of stressful life events and psychological characteristics was assessed amongst 280 appendicectomy patients of whom 80% were classified with 'acutely inflamed' (organic) appendicitis and 20% with 'non-inflamed' (non-organic) appendicitis. Patients were compared with a community comparison group. Specific characteristics of life stressors, namely severe goal frustration for organic patients and severe threat for non-organic patients, were the best predictors of patient outcome.

Effective derosetting of mononuclear cells isolated by immunomagnetic beads.

A rapid and effective method for the derosetting of peripheral mononuclear cells (PMNC) isolated by CD8 monoclonal antibody (MoAb) coated immunomagnetic beads (IMB) is described. PMNC are positively selected and enriched by CD8-IMB and then derosetted from the IMB by a polyclonal antibody (PoAb) preparation against mouse Fab. Our experiments confirm the feasibility of this method with a high derosetting efficiency.

[Changes in thrombocytapheresis concentrations caused by leukocyte depletion with polyester filters].

We studied platelet loss, leukocyte depletion, T/B-cell-ratio, platelet morphology and platelet function (aggregation, hypotonic shock reaction, retention and retraction) prior to and after filtration through two different polyester filters (Sepacell PL-5A, Pall PL100) as well as the posttransfusional platelet increment 1 h after transfusion in 8 pairs of single donor platelet concentrates (Cobe Spectra, Fresenius AS 104). Leukocyte depletion was effective (greater than 99.9%) and platelet loss acceptable in both filters, all tests showing no indication of a diminished platelet function by filtration.

[Erythropoiesis and iron metabolism in autologous blood donation].

Autologous blood donation before elective surgery has been widely endorsed as good transfusion practice. Although only 6 percent of patients undergoing elective orthopedic surgery are unable to donate 3 autologous units, 40 percent cannot donate 4 units because they become anemic [1,2]. According to the results of our study this must be due to different problems in bone marrow dynamics, which cannot be overcome by unselected use of human recombinant erythropoietin alone [3].

Bone marrow processing with the Fresenius AS 104: initial results.

Prior to purging, cryopreservation, or ABO-incompatible bone marrow (BM) transplantation, we have concentrated 23 BM harvests using a modification of the "grancollect-protocol" and the recently available bone marrow stem cell (BMSC) protocol of the Fresenius AS 104 cell separator with the P1-Y set. Within 40-70 minutes, the initial marrow volume of 922 ml (+/- 408 ml) was processed two to three times. A mean of 59% (+/- 20%) of the initial mononuclear cells was recovered in a mean volume of 119 ml (+/- 31 ml).

[Follow-up of blood donors with indeterminate reaction to anti-HIV 1/2 EIA or isolated detection of antibodies to HIV-1 core antigens (anti-p24)].

Over a period of 20 months we identified 10 voluntary blood donors with indeterminate reactions in anti-HIV 1/2 EIA tests. Western blot (WB) patterns of 6 of these 10 donors showed isolated core antibodies (anti-p24), in 4 cases WB patterns were negative. After a median follow-up period of 58 weeks (range 12-93) we have not seen a case of typical seroconversion.

[Anti-M after transfusion as an indication of a genetic variant of the MN locus].

We report a case of an anti-M antibody (titer 128) and MN red blood cells (RBC) in a 76-year-old female German patient. In our case, however, RBC showed weak reactions to human anti-M compared with strong reactions using rabbit anti-M. Papain treatment destroyed the RBC reactivity to human anti-M whereas the strong reactivity to rabbit anti-M was unchanged.

[Examination of a Berlin blood donation branch for antibodies to hepatitis C virus with the anti-HCV test and for circulating HCV-RNA using polymerase chain reaction].

Hepatitis C virus (HCV) is responsible for the majority of cases of transfusion-related hepatitis. We performed a first-generation anti-HCV EIA in 665 repeat and 168 first-time blood donors from Berlin. 4.

[Acquired autoimmune hemolytic anemia after liver transplantation by "auto"-anti-A and "auto"-anti-P1].

A 47-year-old man (group A) received a cadaver liver from a group 0 donor. On day 8 after the transplant the recipient developed severe immune hemolysis and showed a positive direct antiglobulin test due to two antibodies (anti-A and anti-P1) of transplant donor origin. The possible mechanisms involved in "autoantibody" formation in the recipient are discussed.

[Strong and weak histocompatibility antigens and immune response].

In blood samples of 88 healthy donors various red cell, HLA-A, -B, -Cw and -Dr antigens were determined by standard methods. Lymphocyte reactivity was measured by 3H-thymidine uptake into DNA of lymphoblastic cells stimulated by 14 different mitogens and antigens. Cluster analysis confirmed by t test and F test defined 3 distinct clusters of lymphocyte reactivity.

[Attempts in developing a standardized test system of immunologic reactivity].

Stimulation of lymphocytes with mitogens and antigens is an established model for in vitro testing of immunoreactivity. Due to the great variability of blastogenic response the interpretation of these results is difficult. Our results suggest that multivariate experiments and statistics improve the interpretation.

[Hemoglobin follow-up of orthopedic autologous blood transfusion patients].

Patients undergoing autologous donation prior to elective orthopedic surgery show better Hb values during the perioperative period compared to those without autologous donation, all patients in both groups receiving no homologous transfusion. The widely assumed improvement of Hb regeneration during the postoperative period according to an erythropoiesis stimulated by preoperative autologous donation is not supported by our data.

[Autologous blood donation and erythropoiesis].

Autologous blood donation before elective surgery has been widely endorsed as good transfusion practice. Although only 6% of patients undergoing elective orthopedic surgery are unable to donate 3 autologous units, 40% cannot donate 4 units because they become anemic. According to the results of our study this must be due to different problems of bone marrow dynamics, which cannot be overcome by unselected use of human recombinant erythropoietin.

[Effect of leukocyte depleting polyester filters on thrombocytapheresis concentrates].

We studied platelet loss, leukocyte depletion, T/B cell ratio, platelet morphology and platelet function (aggregation, hypotonic shock reaction, retention and retraction) prior to and after filtration through two different polyester filters (Sepacell PL-5A, Pall PL100) as well as the posttransfusional platelet increment 1 h after transfusion in 8 pairs of single-donor platelet concentrates (Cobe Spectra, Fresenius AS 104). Leukocyte depletion was effective (>99.9%) and platelet loss acceptable in both filters, all tests showing no indication of a diminished platelet function by filtration.

Giant Teflon granuloma of the larynx.

Endolaryngeal injection of Teflon paste to augment and medialize the paralyzed hemilarynx aims to improve dysphonia and relieve aspiration. After an initial short-lived inflammatory reaction in the laryngeal tissues, a foreign body granuloma forms around the Teflon. In most cases the results are good but it may occasionally be necessary to consider removal of the granuloma if too large a volume has been injected, if it is inappropriately placed, or if the paralyzed vocal cord subsequently recovers.

Cellular immunity in schizophrenic patients before and during neuroleptic treatment.

A possible connection between immunological alterations and schizophrenia has been discussed for many years. We studied 55 schizophrenic patients in an acute stage of illness before they began neuroleptic treatment. 35 patients who showed clinical improvement on neuroleptics, and 51 healthy controls.

Renal oncocytomas--an Australian experience.

A review was made of 24 cases of renal oncocytoma seen between 1978 and 1989. There was considerable overlap between the clinical presentation of renal oncocytomas and renal carcinomas. Although pre-operative radiological, cytological and pathological investigations may suggest the presence of an oncocytoma, these studies cannot make a definitive diagnosis.

[Risks of autologous blood transfusion].

Underutilization of autologous blood for transfusion is widespread. Our results suggest that this problem could only gradually be corrected, as some patients show insufficient erythropoietic recovery after a predeposit autologous donation.