Search

The effects of dextran on the antithrombin (AT) III activity and blood coagulation, evaluated with thromboelastography, were investigated in 26 patients (anaesthesia risk class I or II) scheduled for minor surgery under general anaesthesia. In the Dextran group the patients were infused first with dextran 7 ml/kg, then with Ringer's acetate. In the Ringer group, the patients received only Ringer's acetate. In the recovery room fluid therapy was continued with 5% dextrose in water until the first postoperative day. Blood loss and fluid replacement were comparable in the groups. Haematocrit (Hcr) decreased significantly in the Dextran group, and the platelet count decreased in both groups during surgery. The median baseline AT III values were similar in the study groups. In the recovery room, the median AT III value was lower in the Dextran than in the Ringer group, 78% and 92%, respectively (P < 0.05). By the following day, the AT III values had returned near the initial level. After surgery, the maximal amplitude of thromboelastogram was 48 mm in the Dextran group, and 58 mm in the Ringer group (P < 0.05). In conclusion, fluid replacement with dextran resulted in modest and short-lived alterations in blood coagulation.

Two prophylactic immunosuppressive drugs, cyclosporine and methylprednisolone (MP), were compared for their effect on the in situ inflammatory reaction of granulation tissue formation and on wound healing. Granulation tissue was generated via implantation of viscous cellulose sponges in Sprague-Dawley rats. The rats were divided into six groups: One group received 40 mg/kg/day of cyclosporine, the second 10 mg/kg/day of cyclosporine, the third 2.5 mg/kg/day of cyclosporine, the fourth 12 mg/kg/day of MP, the fifth received the cyclosporine solvent, and the sixth group was given only saline. All drugs were given i.p. No reduction in the number of inflammatory cells was observed in the cyclosporine-treated sponges compared with the controls, whereas MP suppressed the inflammation strongly. Differential counts demonstrated a relative enrichment of macrophages in the cyclosporine-treated versus the MP-treated or control sponges. Chemical analyses of the sponge extracts agreed well with the cytological data: MP suppressed the total DNA content of the sponges, a marker of total cellularity, as well as the content of acid phosphatase and beta-glucuronidase, both markers of macrophages, but no such suppression was seen in the cyclosporine-treated sponges. The alkaline phosphatase content, a marker for granulocytes, was similar in all groups. A remarkable suppression in the contents of hydroxyproline, reflecting the amount of collagen, and in that of hemoglobin, reflecting the amount of neovascularization, was observed in the MP-treated sponges, whereas no such suppression--but possibly a slight enhancement of the second parameter--was observed in the cyclosporine-treated sponges. We conclude that, in contrast to MP, cyclosporine does not inhibit the inflammatory reaction of granulation tissue formation or the regenerative process of wound healing.

The stability of IgG solutions during the dating period can be predicted by measuring the degree of degradation after elevated storage conditions at +37 degrees C with added streptokinase. The measurement of proteolytic activity with a synthetic substrate correlates with the results obtained by SDS-disc gel electrophoresis and gel filtration. IgG molecules having Anti-D activity were observed to be essentially more sensitive to proteolytic degradation by plasmin than IgG molecules in general. It seems, therefore, that the methods which are suitable for the study of the stability of normal IgG preparations are not sufficient to predict the stability of anti-D gammaglobulin preparations.

A variant of haemoglobin A, named earlier haemoglobin Hijiyama, was found in three generations of a Finnish family in connection with the determination of glycosylated haemoglobin of a diabetic patient. The biochemical abnormality is in the beta-chain at residue 120 where lysine is replaced by glutamic acid. In the heterozygote carriers of the abnormal haemoglobin there was no apparent association with clinical or haematological abnormalities. By isoelectric focusing in thin-layer polyacrylamide gels, haemoglobin Hijiyama could be distinguished with high specificity from haemoglobin A as well as from other haemoglobin variants earlier found in Finland. The glycosylated haemoglobin fractions (haemoglobin A1 and haemoglobin Hijiyama 1) in the diabetic patient sample could be determined by colorimetric and electrophoretic methods.

The performance of the FP-900 Analyzing system manufactured by Labsystems Oy, Helsinki, Finland, was evaluated in a multi-centre study according to the principle outlined in the 1st Draft of the Standard for Instrument Testing produced by the European Committee for Clinical Laboratory Standards (ECCLS). The FP-900 System comprises a photometer for simultaneous measurement of the absorbance in a nine-compartment cuvette block, and the accessories for handling samples (sampler, simultaneous dispensing of 9 reagent charges, incubator with thermostat and shaker, and centrifuge); the photometer function, printout of results and data processing are programmable with a microprocessor. The performance specifications given by the manufacturer were checked when appropriate. As examples of typical methodologies cholesterol was selected as an end-point absorbance method, creatinine as a fixed-time (two-point) kinetic and aspartate aminotransferase as multi-point, continuous method. The within- and between-laboratory imprecision, deviation from assigned values of commercial control sera, and carry-over were determined. The performance was compared with other analytical systems: Mark I Autoanalyzer and Hitachi 705. The cost, speed and capacity was estimated from the results of the present study. The performance of the analyser and results of applying the ECCLS Draft to actual instrument testing are discussed.

Two Finnish variants of reduced erythrocyte glucose-6-phosphate dehydrogenase (G-6-PD) activity were studied. The G-6-PD Espoo variant is characterized by severe enzyme deficiency which is normally non-haemolytic although primaquine sensitive. The other variant, G-6-PD Helsinki, in which the enzyme activity is moderately reduced, is associated with chronic haemolytic anaemia. The activity of the pentose phosphate pathway was not stimulated by methylene blue in G-6-PD Espoo cells, whereas in normal and G-6-PD Helsinki cells there were increases in shunt activity of 64.5- and 5.3-fold, respectively. As judged by the accumulation of 6-phosphogluconate after incubation with 6-aminonicotinamide, the activity of the pentose phosphate pathway was similar in normal and G-6-PD Helsinki cells, whereas in G-6-PD Espoo cells the metabolic flux through this pathway was decreased. Quantities of sulphydryl groups in intact cells and isolated membranes were similar in normal and G-6-PD deficient cells, as revealed by spin label experiments. In contrast to the situation in normal cells, sulphydryl groups in G-6-PD Espoo cells, and to a lesser extent in G-6-PD Helsinki cells, were sensitive to oxidation by acetylphenylhydrazine. In the G-6-PD Helsinki cells, but not in the G-6-PD Espoo cells, membrane fluidity was increased, as judged from the increased mobility of the stearic acid spin label. Mechanisms are discussed by which G-6-PD deficient cells retain adequate levels of NADPH during resting conditions, and it is suggested that the chronic haemolysis associated with G-6-PD Helsinki could be due to a defect in the lipid region of the cell membrane.

Plasma beta-thromboglobulin, hemoglobin A1c and serum creatinine were measured in 56 diabetic patients. Patients with diabetic complications had a significantly higher beta-thromboglobulin level than the controls, but patients without complications did not differ from the controls. beta-Thromboglobulin correlated positively with serum creatinine and the highest values were encountered in patients with abnormal creatinine concentration. There were, however, patients with normal creatinine but high plasma beta-thromboglobulin levels. In these patients the abnormal beta-thromboglobulin level most probably indicates undue stimulation of platelets. There was no correlation between beta-thromboglobulin and hemoglobin A1c.