Platelets can adhere to surfaces by forming pseudopods. This ability is made use of here to simplify conventional platelet suspension immunofluorescence tests, since steps like serum and FITC incubations, washing and microscopic evaluation are done on platelets adhered to glass surfaces. By eliminating time-consuming manipulations like washing in individual test tubes and mounting platelets to microscopic slides, large scale studies can now be performed (up to 480 tests per day and technician). Antibodies can be detected with fresh as well as with frozen platelets from a well defined cell panel. The PAIFT is 2 to 3 times more sensitive than the NIH-standard-micro-lymphocytotoxicity-test (NIH-LCT), thus allowing earlier recognition of alloimmunization of patients.
After nerve injury, the therapy of choice is primary suture. If this, however, is not possible or inadequate, a secondary reconstruction must be carried out within a suitable period of time. This study shows results after nerve transplantation within a timeframe of six weeks. Seventeen children with peripheral nerve injuries of the upper extremity were treated. Secondary nerve reconstruction was accomplished by sural nerve transplantation. Eight children, aged from 5 to 13 years, were examined. The median nerve was affected in three and the ulnar nerve in five cases. The examination included clinical and electrophysiological assessments. The length of grafts was correlated with the clinical result. Besides the calculation of sensitive and motor nerve conduction velocity the number of motor units from the flexor pollicis brevis muscle or abductor digiti minimi muscle were determined by motor-unit-estimation (MUE) on both sides. The observation time period was on an average 2.9 years. Results were good to excellent. A persisting Hoffmann-Tinel's sign was found only once in median nerve lesion. Loss of sensitivity following harvesting of sural nerve was not noted as a problem by any of these children. Length of grafts did not affect the results. Standard values were reached in every case in the electrophysiological examination. The number of motor units of the abductor pollicis brevis muscle and abductor digiti minimi muscle decreased to approximately 50% compared to the healthy side. Sural nerve grafting resulted in good motor and sensory function. We recommend grafting within six weeks, as Wallerian degeneration is completed and regeneration from the proximal nerve stump is optimal. Although children have a very good regeneration potential, the examined cases did not achieve a complete restoration of all motor units of the muscles.
Between October 1979 and March 1982, bone marrow transplantations were performed by the Tübingen Group for BMT on 19 patients with acute leukemia in remission and on one patient with chronic myelocytic leukemia in chronic phase. The conditioning regimen consisted of 2 x 60 mg cyclophosphamide/kg and 10 Gy whole-body irradiation with the linear accelerator. The lung dose was limited by shielding to 8 Gy. In 15 patients, the bone marrow cell suspension of the donor was preincubated with antihuman T-cell globulin (AHTCG) for prophylaxis of graft-versus-host disease (GVHD). All patients showed prompt engraftment of donor cells with good hemopoietic function and complete chimerism. Under reverse isolation in sterile units, no severe bacterial or fungal infections were seen in the phase of bone marrow aplasia. Twelve in twenty patients survived between 25 and 900 days. A severe GVHD was seen only in two patients - one after preincubation with AHTCG. One patient died from relapse of his leukemia, another patient had a testicular relapse which was treated with local radiotherapy. Major problems were seen with chronic GVHD (six patients) and infectious complications, most importantly interstitial pneumonia, in the late post-transplant period.
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