FI96918B - Composition for stabilizing blood plasma during pasteurization - Google Patents

Composition for stabilizing blood plasma during pasteurization Download PDF

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FI96918B
FI96918B FI920934A FI920934A FI96918B FI 96918 B FI96918 B FI 96918B FI 920934 A FI920934 A FI 920934A FI 920934 A FI920934 A FI 920934A FI 96918 B FI96918 B FI 96918B
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Thierry Burnouf
Miryana Burnouf-Radosevich
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Centre Regional De Transfusion
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Abstract

Composition for stabilizing blood plasma, whole or lacking cryoproteins, during pasteurization. The composition according to the invention is used for pasteurizing substantial volumes of plasma (up to several hundreds of litres). The invention also concerns a process for the pasteurization of plasma using said stabilizing composition. The pasteurized plasma obtained is for therapeutic use.

Description

9691896918

Koostumus veriplasman stabiloimiseksi pastöroinnin aikanaComposition for stabilizing blood plasma during pasteurization

Keksintö koskee koostumusta, joka mahdollistaa veriplasman stabiloinnin pastöroinnin aikana, ja menetelmää, 5 jossa käytetään mainittua koostumusta.The invention relates to a composition for stabilizing blood plasma during pasteurization and to a method using said composition.

Ihmisen kokoplasmaa tai kryokomponentteja sisältämätöntä ihmisen plasmaa käytetään edelleen korvaushoitona vakavasti palaneille ja vakavasti loukkaantuneille tai suuren leikkauksen läpikäyneille potilaille, ts. kaikissa 10 tapauksissa, joissa potilaiden nestehukka on huomattava.Whole human plasma or cryoprocomponent-free human plasma is still used as replacement therapy for severely burned and severely injured or major surgery patients, i.e., in all 10 cases where patients have significant dehydration.

Tämäntyyppisessä hoidossa käytetään yleensä plasmaa, joka on saatu yksittäisiltä luovuttajilta, terveiltä henkilöiltä, jotka on testattu ennalta virussairauksien mahdollisen tartutusriskin sulkemiseksi pois. Tämä menet-15 tely ei kuitenkaan anna mahdollisuutta välttää kaikkia kontaminaatioriskejä, joita aiheuttavat esiserologisessa vaiheessa olevat virukset, erityisesti erilaiset hepatiittivirukset ja AIDS-virus.This type of treatment usually uses plasma obtained from individual donors, healthy individuals who have been pre-tested to rule out a possible risk of infection with viral diseases. However, this procedure does not make it possible to avoid all the risks of contamination caused by viruses at the pre-serological stage, in particular the various hepatitis viruses and the AIDS virus.

Siksi olisi edullista kehittää menetelmä virusten 20 inaktivoimiseksi, joka ei vaikuta plasman erilaisiin bio logisiin toimintoihin.Therefore, it would be advantageous to develop a method for inactivating viruses that does not affect the various biological functions of the plasma.

On selvästi osoitettu, että hepatiitti B -virus inaktivoituu täydellisesti kuumennettaessa sitä 10 tuntia lämpötilassa 60 °C natriumsitraatin ollessa läsnä pitoi-. 25 suutena 0,5 mol/1 [Tabor et ai., Thrombosis Res. 22 (1981) 233 - 238]. Tämä käsittely johtaa kuitenkin biologisen aktiivisuuden häviämiseen tiettyjen plasmaproteiinien ollessa kyseessä [Tabor et ai. ja Barrowcliffe et ai., Fr.It has been clearly shown that the hepatitis B virus is completely inactivated when heated for 10 hours at 60 ° C in the presence of sodium citrate. At 0.5 mol / L [Tabor et al., Thrombosis Res. 22 (1981) 233-238]. However, this treatment results in the loss of biological activity for certain plasma proteins [Tabor et al. and Barrowcliffe et al., Fr.

J. Haemotology 55 (1983) 37 - 46].J. Haemotology 55 (1983) 37-46].

30 On ollut mahdollista pastöroida erilaisia terapeut tisesti arvokkaita, veriplasmasta puhdistettuja proteiineja tavanomaisesti lämpötilassa 60 °C 10 tuntia erilaisten 2 96918 stabilointiaineiden läsnä ollessa. Huomautettakoon kuitenkin, että molekyylit, jotka stabiloivat jonkin biologisen aktiivisuuden, saattavat olla täysin tehottomia jonkin toisen suhteen.It has been possible to pasteurize various therapeutically valuable, plasma-purified proteins, conventionally at 60 ° C, for 10 hours in the presence of various 2,96918 stabilizers. It should be noted, however, that molecules that stabilize one biological activity may be completely ineffective with another.

5 Albumiini voidaan esimerkiksi stabiloida asetyyli- tryptofaanilla ja kaprylaatilla [Gellis et ai., J. Clin. Invest. 27 (1948) 239 - 244], kun taas plasminogeeniin näillä stabilointiaineilla ei ole ollenkaan vaikutusta. Trombiini voidaan stabiloida korkeilla sokeripitoisuuksil-10 la [Seegers, Arch. Biochem. 3 (1944) 363 - 367], kun taas protrombiinia ne eivät suojaa. Lisäämällä aminohappoa ja sokeria on saatu hyviä tuloksia tekijän VIII ja antitrom-biini III:n suhteen (DE-patenttijulkaisu 2 916 711).For example, albumin can be stabilized with acetyltryptophan and caprylate [Gellis et al., J. Clin. Invest. 27 (1948) 239-244], while plasminogen is not affected at all by these stabilizers. Thrombin can be stabilized at high sugar levels of 10-la [Seegers, Arch. Biochem. 3 (1944) 363-367], while they do not protect prothrombin. The addition of amino acid and sugar has given good results for factor VIII and antithrombin III (DE patent 2,916,711).

EP-patenttijulkaisussa 0 035 204 esitetään a-anti-15 trypsiinin, antitrombiini III:n, prekallikreiinin, fibro-nektiinin ja tekijä VIII:n stabilointia polyolin läsnä ollessa ja esitetään sakkaroosi ainoana esimerkkinä viimeksi mainituista; julkaisussa kuitenkin mainitaan, että tekijä IX ja prekallikreiini menettävät samoissa olosuh-20 teissä kokonaan terapeuttisen aktiivisuutensa.EP 0 035 204 discloses the stabilization of α-anti-15 trypsin, antithrombin III, prekallikrein, fibroectin and factor VIII in the presence of a polyol and discloses sucrose as the only example of the latter; however, the publication mentions that factor IX and prekallikrein completely lose their therapeutic activity under the same conditions.

Nämä erilaiset kokeelliset tulokset vahvistavat yleisesti hyväksytyn ajatuksen, ettei kokoplasman (tuore plasma, pakastettu tuore plasma tai kylmäsaostussuperna-tantti) virusten inaktivointia pystytä saamaan aikaan pas-25 töroimalla.These different experimental results confirm the generally accepted idea that inactivation of whole plasma (fresh plasma, frozen fresh plasma, or cold precipitation supernatant) viruses cannot be achieved by pasteurization.

Koska kokoplasmaa tarvitaan lääketieteessä edelleen, hakija on pyrkinyt kehittämään koostumuksen, joka takaa samanaikaisesti kaikkien kiinnostuksen kohteena olevien terapeuttisten tekijöiden biologisen aktiivisuuden 30 suojaamisen denaturoitumiselta pastöroinnin aikana.Since whole plasma is still needed in medicine, the applicant has sought to develop a composition which simultaneously guarantees the protection of the biological activity of all therapeutic agents of interest from denaturation during pasteurization.

Koska hakija on havainnut, että sorbitoli antaa tietynasteisen suojan termistä denaturoitumista vastaan tulosten kuitenkin vaihdellessa plasmanäytteestä toiseen ja saantojen ollessa heikkoja, on etsitty erilaisia lisä-However, as the applicant has found that sorbitol provides a certain degree of protection against thermal denaturation when the results vary from one plasma sample to another and the yields are poor, various additional

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96918 3 aineita, joiden seos sorbitolin kanssa parantaisi tämän stabilointitehoa.96918 3 substances whose mixture with sorbitol would improve its stabilizing effect.

Keksinnön mukainen koostumus sisältää siten sorbitolin, kalsiumkloridin, hepariinin ja lysiinin seosta. Eri 5 aineosien pitoisuudet säädetään siten, että saadaan seu-raavat loppupitoisuudet pastöroitavassa plasmassa: - 50 - 80, edullisesti 60 % sorbitolia - 0,1 - 1, edullisesti 0,5 yksikköä/ml hepariinia - 1 - 10, edullisesti 4 g/1 lysiiniä 10 - 3 - 5, edullisesti 4 mmol/1 CaCl2:a.The composition of the invention thus contains a mixture of sorbitol, calcium chloride, heparin and lysine. The concentrations of the various components are adjusted so as to obtain the following final concentrations in the plasma to be pasteurized: - 50 to 80, preferably 60% sorbitol - 0.1 to 1, preferably 0.5 units / ml heparin - 1 to 10, preferably 4 g / l lysine 10 to 3 to 5, preferably 4 mmol / l CaCl 2.

Keksinnön mukaista koostumusta lisätään tuoreeseen plasmaan, pakastettuun ja sulatettuun tuoreeseen plasmaan tai kylmäsaostuvia proteiineja sisältämättömään plasmaan ennen sen pastörointia kuumentamalla 10 tuntia lämpötilas-15 sa 60 ± 1 °C.The composition of the invention is added to fresh plasma, frozen and thawed fresh plasma or plasma free of cold precipitating proteins before pasteurization by heating at 60 ± 1 ° C for 10 hours.

Pastöroinnin jälkeen lämpötila alennetaan asteittain arvoon 20 °C ja liuos dialysoidaan sorbitolin ja hepariinin poistamiseksi. Dialysointipuskurin pH on 7, ja se sisältää 4-10 mmol/1 natriumsitraattia, 4 mmol/1 kal-20 siumkloridia, 0,13 mol/1 natriumkloridia ja 4 g/1 lysiiniä. Tarpeen mukaan voidaan käyttää myös koostumukseltaan erilaisia dialysointipuskureita. Sitten liuos konsentroidaan fysiologisen plasmaproteiinipitoisuuden palauttamiseksi. Tuloksena oleva liuos steriloidaan suodattamalla, 25 pakataan ja pakastetaan tai kylmäkuivataan.After pasteurization, the temperature is gradually lowered to 20 ° C and the solution is dialyzed to remove sorbitol and heparin. The dialysis buffer has a pH of 7 and contains 4-10 mmol / l sodium citrate, 4 mmol / l calcium chloride, 0.13 mol / l sodium chloride and 4 g / l lysine. Dialysis buffers of different compositions can also be used as needed. The solution is then concentrated to restore physiological plasma protein levels. The resulting solution is sterilized by filtration, packaged and frozen or lyophilized.

Keksintö koskee myös menetelmää plasman pastörointi-seksi, jossa lisätään keksinnön mukaista koostumusta plasmaan ennen sen kuumentamista ja dialysoidaan pastöroitu plasma edellä määriteltyä puskuria vastaan.The invention also relates to a process for the pasteurization of plasma, in which the composition according to the invention is added to the plasma before it is heated and the pasteurized plasma is dialyzed against a buffer as defined above.

30 Tämä menetelmä on erityisen edullinen, koska sitä voidaan soveltaa suuriin plasmaeriin, joita on kerätty useista lähteistä. Tarkemmin määriteltynä pastöroimalla 100 - 200 litran tai isompia eriä on mahdollista, asianmukaisten testien suorittamisen jälkeen, taata, että erät 35 ovat laadultaan yhtenäisiä.This method is particularly advantageous because it can be applied to large batches of plasma collected from multiple sources. More specifically, by pasteurizing batches of 100 to 200 liters or larger, it is possible, after performing appropriate tests, to guarantee that the batches 35 are of uniform quality.

4 969'if4,969'if

Lisäksi plasmaerät, jotka on pastöroitu käyttämällä keksinnön mukaista menetelmää, voivat toimia korvaavina tuotteina potilaille, joilla on vajausta hyytymistekijöissä, joista ei ole olemassa puhdistettuja konsentraatteja, 5 kuten tekijässä V, XI tai XIII.In addition, batches of plasma pasteurized using the method of the invention can serve as substitutes for patients deficient in coagulation factors for which there are no purified concentrates, such as factor V, XI or XIII.

Keksinnön mukaisella menetelmällä pastöroituja plasmaliuoksia voidaan käyttää tekijöiden V, XI ja XIII vajausten hoitoon ja toisaalta korvaaviin hoitoihin, joissa tarvitaan kokoplasmaa tai kylmäsaostussupernatanttia. 10 Seuraavassa esimerkissä kuvataan keksinnön yhtä suoritusmuotoa rajoittamatta kuitenkaan keksinnön suoja-alaa.Pasteurized plasma solutions according to the invention can be used for the treatment of deficiencies of factors V, XI and XIII and, on the other hand, for substitution treatments which require whole plasma or cold precipitation supernatant. The following example illustrates one embodiment of the invention without limiting the scope of the invention.

EsimerkkiExample

Sulatettuun plasmaan (2 1) lisätään 1000 yksikköä 15 hepariinia, 8 g lysiiniä ja 220 mg kalsiumkloridia. Nämä kaksi tuotetta lisätään suoloina jauhemuodossa sekoittaen plasmaa varovasti. Sitten kaadetaan joukkoon asteittain 1200 g liuottamatonta sorbitolia.To the molten plasma (2 L) is added 1000 units of heparin, 8 g of lysine and 220 mg of calcium chloride. The two products are added as salts in powder form with gentle mixing of the plasma. 1200 g of insoluble sorbitol are then gradually poured into the mixture.

Pastörointi tehdään 5 litran astiassa kuumentamalla 20 10 tuntia lämpötilassa 60 eC käyttämällä vesihaudetta tai termostaattisäädettyä säiliötä. Pastöroinnin jälkeen sorbitoli ja hepariini poistetaan dialysoimalla keinomunuaisen avulla tai ultrasuodatusjärjestelmällä, kuten kaseteilla käyttämällä Pellicon™-järjestelmää, käyttämällä . 25 sitraattipuskuria, joka sisältää 4 g/1 lysiiniä, 4 mmol/1Pasteurization is carried out in a 5 liter vessel by heating at 60 eC for 20 to 10 hours using a water bath or a thermostatically controlled tank. After pasteurization, sorbitol and heparin are removed by dialysis using an artificial kidney or an ultrafiltration system such as cartridges using a Pellicon® system. 25 citrate buffer containing 4 g / l lysine, 4 mmol / l

CaCl2:a ja 0,13 mol/1 NaCl:a. Dialyysin jälkeen voidaan tehdä konsentrointi, jossa käytetään samaa laitteistoa, hyytymistekijäpitoisuuksien palauttamiseksi suunnilleen arvoon 1 yksikkö/ml, jollaisia ne ovat hyvälaatuisessa 30 terapeuttisessa plasmassa. Tuote dialysoidaan käyttämällä • osmolaarisuusarvoa 370 mosmol/1 pH:n ollessa 7. Sitten tuote steriloidaan suodattamalla käyttämällä esimerkiksi Millipack™-suodatinta 40 (Millipore), jonka huokoskoko onCaCl 2 and 0.13 mol / L NaCl. After dialysis, concentration using the same equipment can be performed to restore coagulation factor concentrations to approximately 1 unit / ml as they are in good quality therapeutic plasma. The product is dialyzed using • an osmolarity of 370 mosmol / l at pH 7. The product is then sterilized by filtration using, for example, a Millipack ™ filter 40 (Millipore) with a pore size of

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96918 s 0,22 μπι. Tuote pakataan muovipusseihin pakastamista varten tai pulloihin kylmäkuivausta varten.96918 s 0.22 μπι. The product is packed in plastic bags for freezing or in bottles for freeze-drying.

Plasman stabilointi pastöroinnin ja ultrasuodatuk-sen aikana lisäämällä kalsiumia, hepariinia ja lysiiniä 5 antaa mahdollisuuden saada aikaan seuraavia saantoja suhteessa (ilmoitettu seuraavassa sanalla "versus”) vertailu tuotteeseen, joka sisältää vain lysiiniä ja sorbitolia: FVIIIc 87 % versus 66 % FVc 77 % versus 35 % 10 FVIIc 55 % versus 52 % FIXc 60 % versus 49 %Plasma stabilization during pasteurization and ultrafiltration by the addition of calcium, heparin and lysine 5 allows the following yields to be obtained in relation to (compared to "versus") a comparison with a product containing only lysine and sorbitol: FVIIIc 87% versus 66% FVc 77% versus 35% 10 FVIIc 55% versus 52% FIXc 60% versus 49%

Koaguloituva fibrinogeeni 81 % versus 57 % FXI1I 77 % versus 71 %.Coagulating fibrinogen 81% versus 57% FXI1I 77% versus 71%.

15 Merkkejä hyytymistekijöiden aktivoitumisesta tämän kalsiummäärän läsnä ollessa ei havaita. Niinpä suhde naudan FVII/koagulantti-FVII on 0,95 ja vertailutuotteella 1,09. Stabiilius, joka testattiin seuraamalla FVIII-aktiivisuutta, kun tuotetta on säilytetty 24 tuntia nestemäi-20 sessä tilassa ympäristön lämpötilassa, ei ole heikentynyt verrattuna vertailunäytteeseen (aktiivisuussaanto 100 %). Tämä sopii yhteen pastöroitujen ja vertailutuotteiden PKA-asteen <2 % kanssa.15 No signs of activation of coagulation factors are observed in the presence of this amount of calcium. Thus, the ratio of bovine FVII / coagulant to FVII is 0.95 and that of the reference product is 1.09. The stability tested by monitoring the FVIII activity after storage of the product for 24 hours in a liquid state at ambient temperature is not impaired compared to the control sample (activity yield 100%). This is consistent with a PKA grade of <2% for pasteurized and reference products.

Lisäksi rottakokeet, joissa injektoitiin laskimon-25 sisäisesti siten pastöroitua plasmaa, osoittavat verenpainetta kohottavan vaikutuksen puuttumisen eivätkä osoita minkäänlaisia pulssimuutoksia.In addition, rat experiments in which the thus pasteurized plasma was injected intravenously show the absence of an antihypertensive effect and do not show any pulse changes.

Claims (9)

1. Komposition för stabilisering av blodplasma under pastörisering, kännetecknad därav, att den 5 bildas av en blandning av sorbitol, heparin, kalciumklorid och lysin.Composition for stabilizing blood plasma during pasteurization, characterized in that it is formed from a mixture of sorbitol, heparin, calcium chloride and lysine. 2. Komposition enligt patentkravet 1, kännetecknad därav, att sorbitolkoncentrationen är 500 - 800 g/1.Composition according to claim 1, characterized in that the sorbitol concentration is 500 - 800 g / l. 3. Komposition enligt patentkravet 2, kännetecknad därav, att sorbitolkoncentrationen är 600 g/1.Composition according to claim 2, characterized in that the sorbitol concentration is 600 g / l. 4. Komposition enligt nägot av patentkraven 1-3, kännetecknad därav, att heparinkoncentrationen 15 är 100 - 1000 enheter/1, företrädesvis 500 enheter/1.4. A composition according to any one of claims 1-3, characterized in that the concentration of heparin is 100-1000 units / l, preferably 500 units / l. 5. Komposition enligt nägot av patentkraven 1-4, kännetecknad därav, att kalciumkloridkoncen-trationen är 3 - 5 mmol/1, företrädesvis 4 mmol/1.Composition according to any one of claims 1-4, characterized in that the calcium chloride concentration is 3-5 mmol / l, preferably 4 mmol / l. 6. Komposition enligt nägot av patentkraven 1-5, 20 kännetecknad därav, att lysinkoncentrationen är 1 - 10 g/1, företrädesvis 4 g/1.6. A composition according to any one of claims 1-5, characterized in that the concentration of lysine is 1 - 10 g / l, preferably 4 g / l. 7. Förfarande för pastörisering av blodplasma, kännetecknat därav, att man i plasman tillsät-ter en komposition enligt nägot av patentkraven 1-6 före 25 uppvärmningssteget och senare avlägsnar nämnda komposition genom dialys.Process for pasteurizing blood plasma, characterized in that in the plasma a composition according to any one of claims 1-6 is added prior to the heating step and later the said composition is removed by dialysis. 8. Förfarande enligt patentkravet 7, kännetecknat därav, att dialysen utförs vid ett pH-vär-de av 7 mot en buffertlösning, vilken innehäller 4-10 30 mmol/1 natriumcitrat, 4 mmol/1 kalciumklorid, 0,13 mol/1 natriumklorid och 4 g/1 lysin.Process according to claim 7, characterized in that the dialysis is carried out at a pH of 7 against a buffer solution containing 4-10 30 mmol / 1 sodium citrate, 4 mmol / 1 calcium chloride, 0.13 mol / 1 sodium chloride. and 4 g / l lysine. 9. Förfarande enligt patentkravet 7 eller 8, kännetecknat därav, att det kan tillämpas pä plasmavolymer mellan 1 liter och flera hundra liter.9. A process according to claim 7 or 8, characterized in that it can be applied to plasma volumes between 1 liter and several hundred liters.
FI920934A 1990-07-03 1992-03-02 Composition for stabilizing blood plasma during pasteurization FI96918C (en)

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
FR9008375A FR2664165B1 (en) 1990-07-03 1990-07-03 COMPOSITION FOR STABILIZING BLOOD PLASMA DURING PASTEURIZATION.
FR9008375 1990-07-03
FR9100493 1991-06-20
PCT/FR1991/000493 WO1992000767A1 (en) 1990-07-03 1991-06-20 Composition for stabilizing blood plasma during pasteurization

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FI920934A0 FI920934A0 (en) 1992-03-02
FI96918B true FI96918B (en) 1996-06-14
FI96918C FI96918C (en) 1996-09-25

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AT (1) ATE135238T1 (en)
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CA (1) CA2065284A1 (en)
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DE (1) DE69117920T2 (en)
DK (1) DK0497929T3 (en)
ES (1) ES2084821T3 (en)
FI (1) FI96918C (en)
FR (1) FR2664165B1 (en)
GR (1) GR3020048T3 (en)
HU (1) HU208404B (en)
LT (1) LT3419B (en)
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NO (1) NO179127C (en)
PL (1) PL166579B1 (en)
PT (1) PT98190B (en)
RU (1) RU2045902C1 (en)
SK (1) SK279031B6 (en)
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FR2687317B1 (en) 1992-02-13 1995-06-23 Aetsrn COMPOSITION FOR STABILIZING BLOOD PLASMA DURING PASTEURIZATION AND PASTEURIZED PLASMATIC SOLUTION FOR THERAPEUTIC USE.
DE4240103A1 (en) * 1992-05-26 1993-12-02 Behringwerke Ag Process for inactivating viruses in protein preparations
DE19508192A1 (en) 1995-03-09 1996-09-12 Behringwerke Ag Stable transglutaminase preparations and process for their preparation
US20060019234A1 (en) * 2004-07-22 2006-01-26 Shanbrom Technologies, Llc Modern blood banking employing improved cell preservation composition
US11682319B2 (en) 2016-03-10 2023-06-20 Intuitive Surgical Operations, Inc. Fake blood for use in simulated surgical procedures

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DE2916711A1 (en) 1979-04-25 1980-11-06 Behringwerke Ag Blood coagulation factors and process for their manufacture
DE3176491D1 (en) 1980-03-05 1987-11-26 Miles Lab Pasteurized therapeutically active protein compositions
DE3045153A1 (en) * 1980-11-29 1982-07-08 Behringwerke Ag, 3550 Marburg METHOD FOR THE PRODUCTION OF BLOOD COagulation FACTORS AND THE PREPARATION OF FACTORS IX AND X THEREFORE PRODUCED
DE3336631A1 (en) * 1983-10-08 1985-04-18 Behringwerke Ag, 3550 Marburg METHOD FOR THE PASTEURIZATION OF PLASMA OR CONCENTRATES OF THE BLOOD COAGINING FACTORS II, VII, IX AND X
US4543210A (en) * 1984-10-04 1985-09-24 Miles Laboratories, Inc. Process for producing a high purity antihemophilic factor concentrate
DK18288D0 (en) * 1988-01-15 1988-01-15 Nordisk Gentofte PROCEDURE FOR PASTEURIZATION OF Aqueous SOLUTIONS OF FACTOR VIII

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HUT60148A (en) 1992-08-28
NO179127C (en) 1996-08-14
CA2065284A1 (en) 1992-01-04
LT3419B (en) 1995-09-25
CS57992A3 (en) 1992-08-12
NO920791D0 (en) 1992-02-28
HU208404B (en) 1993-10-28
PL166579B1 (en) 1995-06-30
EP0497929B1 (en) 1996-03-13
DE69117920T2 (en) 1996-10-02
JP3132828B2 (en) 2001-02-05
GR3020048T3 (en) 1996-08-31
ZA914848B (en) 1992-04-29
FI920934A0 (en) 1992-03-02
LV10384A (en) 1995-02-20
HU9200701D0 (en) 1992-05-28
SK279031B6 (en) 1998-05-06
CZ281431B6 (en) 1996-09-11
FR2664165A1 (en) 1992-01-10
PT98190B (en) 1998-12-31
FI96918C (en) 1996-09-25
LTIP264A (en) 1994-10-25
DE69117920D1 (en) 1996-04-18
NO920791L (en) 1992-02-28
ES2084821T3 (en) 1996-05-16
FR2664165B1 (en) 1992-10-16
ATE135238T1 (en) 1996-03-15
RU2045902C1 (en) 1995-10-20
EP0497929A1 (en) 1992-08-12
PL294037A1 (en) 1993-01-11
AU8062991A (en) 1992-02-04
DK0497929T3 (en) 1996-07-22
NO179127B (en) 1996-05-06
WO1992000767A1 (en) 1992-01-23
LV10384B (en) 1995-04-20
PT98190A (en) 1992-05-29
JPH05501417A (en) 1993-03-18

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