bluuebunny/crossref_metadata_2025 huggingface dataset:
Adaptation and psychometric evaluation of the Swedish version of the Good Nursing Care Scale for Patients
Authors: Rehnström Lisbeth , Christensson Lennart , Leino‐Kilpi Helena , Unosson Mitra
Published: December 2004

The aim of this study was to adapt the instrument ‘Good Nursing Care Scale for Patients' to Swedish conditions as a measure of patients’ satisfaction, as well as estimating its reliability and validity. Following a pilot test, discussions in the author group, testing for readability among patients and judgement of content validity by a panel of experts, the final version was reduced to 72 items focusing on good caring. The refined instrument was assessed for internal consistency in 447 surgical in‐patients, for 2 week test–retest reliability in 100 patients and subjected to orthogonal principal components factor analysis with varimax rotation, followed by second‐order factor analysis. The internal consistency item–item correlation coefficient ranged from 0.15 to 0.91, correlation between each item and the total scale was ≥0.30 for 70 items, Cronbach's alpha coefficient for the final scale was 0.79 and test–retest reliability was 0.75. An orthogonal principal components factor analysis with varimax rotation was conducted on the final 71 items and the 15 first‐order factors with eigenvalues ≥1 explained 66% of the total variance. A second‐order factor analysis of these 15 factors as items resulted in a seven‐factor solution. The total variance explained by the seven factors was 79%. Cronbach's alpha coefficient for the seven factors ranged between 0.32 and 0.95. The instrument seems reliable and valid to assess the patients’ satisfaction with what happened during their hospital stay. To confirm the factor structure and improve factor consistency additional development and testing is suggested.
Wound bed preparation: a systematic approach to wound management
Authors: Schultz Gregory S. , Sibbald R. Gary , Falanga Vincent , Ayello Elizabeth A. , Dowsett Caroline , Harding Keith , Romanelli Marco , Stacey Michael C. , Teot Luc , Vanscheidt Wolfgang
Published: December 2004

The healing process in acute wounds has been extensively studied and the knowledge derived from these studies has often been extrapolated to the care of chronic wounds, on the assumption that nonhealing chronic wounds were simply aberrations of the normal tissue repair process. However, this approach is less than satisfactory, as the chronic wound healing process differs in many important respects from that seen in acute wounds. In chronic wounds, the orderly sequence of events seen in acute wounds becomes disrupted or “stuck” at one or more of the different stages of wound healing. For the normal repair process to resume, the barrier to healing must be identified and removed through application of the correct techniques. It is important, therefore, to understand the molecular events that are involved in the wound healing process in order to select the most appropriate intervention. Wound bed preparation is the management of a wound in order to accelerate endogenous healing or to facilitate the effectiveness of other therapeutic measures. Experts in wound management consider that wound bed preparation is an important concept with significant potential as an educational tool in wound management.

This article was developed after a meeting of wound healing experts in June 2002 and is intended to provide an overview of the current status, role, and key elements of wound bed preparation. Readers will be able to examine the following issues;

• the current status of wound bed preparation;

• an analysis of the acute and chronic wound environments;

• how wound healing can take place in these environments;

• the role of wound bed preparation in the clinic;

• the clinical and cellular components of the wound bed preparation concept;

• a detailed analysis of the components of wound bed preparation.

(WOUND REP REG 2003;11:1–28)
Effects of vascular endothelial growth factor on wound closure rates in the genetically diabetic mouse model
Authors: Kirchner Loren M. , Meerbaum Sharon O. , Gruber Brian S. , Knoll Andrew K. , Bulgrin Jeffery , Taylor R.A.J. , Schmidt Steven P.
Published: December 2004

Impaired wound healing is characteristic of diabetic patients. Potential reasons include poor inflammatory response, granulation tissue formation, and abnormal patterns of cytokine release and response. Vascular endothelial growth factor, abnormally regulated during healing in diabetics, is the major factor stimulating angiogenesis during normal wound healing. We tested our hypothesis that topically applied vascular endothelial growth factor would improve wound closure rates in diabetic animals in a full‐thickness wound model in genetically diabetic mice (C57 BL/KsJ db/db). Animals received either 1.0 µg of vascular endothelial growth factor165 or polyethylene glycol alone topically to wounds daily between days 0 and 4 postwounding. Wound area was measured at days 0, 5, 10, 15, and 21. Data were analyzed using probit analysis and expressed as length‐of‐time (LT) to 50, 90, and 95% wound closure. Among untreated animals, nondiabetics had an LT50 of 8.5 days (fiducial limits 8.3–8.7), while diabetics had an LT50 of 15.8 days (15.6–16.1). Vascular endothelial growth factor‐treated animals had LT50 values of 7.8 (7.6–8.1) and 11.8 days (11.6–12.0) for nondiabetics and diabetics, respectively, representing a 25% improvement in time to 50% closure in treated diabetics. We conclude that topically applied vascular endothelial growth factor improves time to wound closure in the genetically diabetic mouse model.

(WOUND REP REG 2003;11:127–131)
THE CLINICAL EPIDEMIOLOGY OF CARDIOVASCULAR DISEASES IN CHRONIC KIDNEY DISEASE: Uremia‐Related Metabolic Cardiac Risk Factors in Chronic Kidney Disease
Authors: Madore François
Published: December 2004

Growing evidence has been gathered over the last 15 years regarding the role of nontraditional or uremia‐related risk factors in the pathogenesis of atherosclerosis in subjects with renal failure. Among those factors, dyslipidemia, inflammation, hyperhomocysteinemia, and oxidant stress have been extensively studied. However, the clinical significance of many of these factors remains controversial in light of reported studies. In this article, the existing evidence regarding the role of uremia‐related risk factors in the pathogenesis of atherosclerosis is reviewed, with special emphasis on prevalence, cardiac risk, and management in patients with chronic kidney disease (CKD). Consensus treatment recommendations are provided for risk factors for which there is evidence to support preventive or therapeutic interventions.
THE CLINICAL EPIDEMIOLOGY OF CARDIOVASCULAR DISEASES IN CHRONIC KIDNEY DISEASE: Applying Multiple Interventions in Chronic Kidney Disease
Authors: Barrett Brendan J.
Published: December 2004

The medical, social, and financial burdens posed by end‐stage renal disease (ESRD) are many and growing rapidly. People generally reach ESRD as a result of chronic progressive kidney disease. Advancing kidney disease is associated with several treatable complications, which if poorly managed reduce the length and quality of life. In addition, there are strong links between chronic kidney disease (CKD) and cardiovascular disease (CVD). Many people with less advanced CKD will die or suffer complications of CVD before reaching ESRD. Efficacious interventions, such as lowering blood pressure and treating dyslipidemia, can substantially reduce the progression of both kidney and cardiovascular disease. Careful management of these complex and interrelated diseases and risk factors requires detailed longitudinal and focused care which does not seem to be optimally delivered by health service practitioners organized in traditional ways. A disease management approach offers promise in this setting, but requires further study of clinical and economic impact.
Extracorporeal Endotoxin Removal For The Treatment of Sepsis:Endotoxin Adsorption Cartridge (Toraymyxin)
Authors: Shoji Hisataka
Published: December 2004

Abstract:  Toray Industries Inc. has developed an endotoxin removalcartridge (Toraymyxin) composed of a polymyxin B immobilized, fibrousadsorbent. Toraymyxin has been listed as a blood purification medicaldevice for endotoxin removal to be reimbursed by the Japanese nationalhealth insurance since 1994. Toraymyxin can be applied to patientswith endotoxemia or suspected gram‐negative infection, which fulfilllthe conditions of Systemic Inflammatory Response Syndrome (SIRS)and have septic shock demanding vasopressor infusion. Since 1994,over 30 000 patients have received this treatment. Thesafety of this device has been confirmed and improvement of hemodynamicdysfunction has been shown to be a major benefit. Infection resultingfrom an acute abdominal condition requiring surgery hasbeen shown to be one of the good indications for Toraymyxin. Further studies are now ongoing to establish Toraymyxin treatment as one of the options to treat sepsisand septic shock patients and to clarify the mechanisms involved in this therapy.
Treatment of Autoimmune Diseases in Mice by a New Method for Allogeneic Bone Marrow Transplantation
Authors: Ikehara Susumu
Published: December 2004

Abstract: Remarkable advances have been made in bone marrow transplantation (BMT), which has become a powerful strategy for the treatment of leukemia, aplastic anemia, congenital immunodeficiency, and also autoimmune disease. Using various animal models, allogeneic (allo) BMT has been found to be useful in the treatment of various autoimmune diseases. In MRL/lpr mice, which are radiosensitive (<8.5 Gy) and are an animal model for autoimmune diseases, conventional BMT resulted in only transient effects; the manifestations of the autoimmune diseases recurred 3 months after BMT. Using MRL/lpr mice, we have very recently established a new strategy for allo BMT. We injected bone marrow cells (BMC) directly into the bone marrow cavity (intrabone marrow [IBM] injection) of recipients that had received fractionated irradiation. This ‘IBM‐BMT’ was found to be effective in treating autoimmune diseases in radiation‐sensitive and chimeric‐resistant MRL/lpr mice. In addition, this strategy was found to be applicable for the transplantation of organs. We believe that these strategies for BMT and organ transplantation herald a new era in transplantation.
Apheresis in the Treatment of Cholesterol Embolic Disease
Authors: Hasegawa Midori , Sugiyama Satoshi
Published: December 2004

Abstract:  Cholesterol embolic disease is a devastating complication of atherosclerosis. Universally recommended treatment is lacking thus far. Recent data suggest that a therapeutic protocol aimed at specifically combating three causes of mortality, recurrent bouts of cholesterol embolism, cardiac failure, and cahexia, were associated with a favorable clinical outcome. As for drug therapy, corticosteroid has been reported to be beneficial in reducing local and general inflammatory responses. Concerning apheresis, combined therapy consisting of plasma exchange and low to intermediate–dose corticosteroid therapy has been shown to be effective in multivisceral cholesterol embolism. Low density lipoprotein (LDL) apheresis has been reported to be beneficial for cholesterol embolism‐induced damage to the skin and brain.
AnIn VitroBiomechanical Comparison of a Prototype Intramedullary Pin‐Plate with a Dynamic Compression Plate for Equine Metacarpophalangeal Arthrodesis
Authors: Sod Gary A. , Martin George S.
Published: December 2004

ObjectivesTo compare the biomechanical properties of a prototype intramedullary pin‐plate (IMPP) implant specifically designed for equine metacarpophalangeal (MCP) arthrodesis with a dynamic compression plate (DCP) system.

Study DesignIn vitrobiomechanical testing of paired cadaveric equine forelimbs with a simulated traumatic disruption of the suspensory apparatus, stabilized by one of two methods for MCP arthrodesis.

Animal PopulationTwenty‐one pairs of adult equine cadaveric forelimbs.

MethodsEach forelimb had the distal sesamoidean ligaments severed to create a disrupted suspensory apparatus. For each forelimb pair, the MCP joint was stabilized with the IMPP in one limb, and a DCP in the other limb. Seven matching limb pairs were tested in axial compression in a single cycle to failure, 7 matching limb pairs were tested in torsion in a single cycle to failure, and 7 matching limb pairs were fatigued tested in axial compression. Mean test variable values for each method were compared using a pairedt‐test within each group. Significance was set atP<.05.

ResultsThe mean yield load, yield stiffness, and failure load (axial compression, torsional loading) was significantly greater for the IMPP compared with the DCP system. Mean cycles to failure for axial compression was significantly greater for the IMPP compared with the DCP system. Significance in all tests wasP<.0001.

ConclusionThe IMPP was superior to the DCP system in resisting the biomechanical forces most likely to cause failure of MCP joint arthrodesis.

Clinical RelevanceThe IMPP implant should be considered for MCP arthrodesis in horses with traumatic disruption of the suspensory apparatus. The specific design of the IMPP implant may facilitate equine MCP arthrodesis and avoid convalescent complications related to cyclic fatigue.
A Protocol for Cryoprecipitate Production
Authors: Burka E. R. , Harker L. A. , Kasper C. K. , Kevy S. V. , Ness P. M.
Published: December 2004

A three‐year contract research program to study the production of cryoprecipitate has been completed. The investigators hare collaborated to propose changes in the methods of production of cryoprecipitate. The investigators believe that the problem of low and variable yield of cryoprecipitate can be overcome and cryoprecipitate can be produced which contains, on an average, at least 100 Factor VIII units in nearly every bag. It is emphasized that breaches of technique and time delays in cryoprecipitate processing must be scrupulously avoided to achieve optimum, standardized yields.
A Technique for Separation of Canine Lymphocytes and Their Use in the Lymphocytotoxic, Blastogenic, and Rosette Assays
Authors: Whitacre C. C. , Lang R. W.
Published: December 2004

When the techniques established for preparing lymphocytes from human blood were applied to canine blood, the resulting preparations were contaminated with significant numbers of other blood cells. A three‐step technique is described here for the separation of canine lymphocytes from blood which eliminates most granulocytes, platelets, and erythrocytes. Defibrinated blood is incubated with iron particles to allow phagocytosis by granulocytes. When mixed with Plasmagel, erythrocytes and iron‐containing granulocytes sediment rapidly, leaving a lymphocyte‐rich supernate plasma which is recovered and banded by centrifugation on a Ficoll‐Hypaque gradient. Any erythrocytes remaining in the lymphocyte suspension aspirated from the gradient are eliminated by hypotonic lysis and centrifugation. The resulting preparation, representing 30 per cent recovery of the circulating lymphocytes, contained 85 to 94 per cent lymphocytes with a cell viability of 99 per cent. The functional capacity of the lymphocyte preparation was tested in three assays: 1) lymphoblastic transformation using phytohemagglutinin and pokeweed mitogen, 2) E rosette formation with human erythrocytes showed a mean 5 per cent rosette forming lymphocytes, 3) antibody‐mediated lymphocytotoxicity using a canine anti‐lymphocyte serum showed titers reproducible within one tube dilution.
The Kidd Minus‐Minus Phenotype in a Caucasian
Authors: Sussman L. N. , Solomon R. , Grogan S.
Published: December 2004

This is the first reported example in a Caucasian with the phenotype Jk(a–b–). A strongly reacting antibody was present which was of a single specificity and which could be completely absorbed by either Jk(a + b–) or Jk(a–b+) cells. Since no compatible donors could be found, autotransfusion was done. Family study failed to reveal any other members with the Jk(a–b–) phenotype. The question of a third allele at the Kidd locus is considered.
Harvesting of Granulocytes using a Hydroxyethyl Starch Solution
Authors: Sussman L. N. , Colli W. , Pichetshote C.
Published: December 2004

The need for sophisticated component therapy has resulted in improved techniques for obtaining concentrates of platelets and granulocytes. The use of single donors as a source for these products is advisable to avoid multiple sensitizations. Obtaining concentrated granulocytes represents a problem because of the difficulty in separating granulocytes from red blood cells by differential centrifugation or sedimentation since the specific gravities are similar. Hydroxyethyl starch (HES) makes the separation more effective. A solution made of 250 ml of 6 per cent HES, 250 ml of distilled water, and 15 g of sodium citrate in 30 ml distilled water provided a satisfactory anticoagulant solution for this purpose. The granulocytes collected averaged 49 per cent of the total available in the processed blood; the platelets averaged 82 per cent. A satisfactory yield could thus be obtained from a single donor, and this could be repeated several times in a month. The value of ABO, Rh, and HL‐A compatibility between donor and recipient probably increases the viability and safety of this procedure. The Haemonetic No. 30 Cell Separator provided an easy and rapid method for this procedure.
Leukapheresis of a Five‐Year‐Old Girl with Chronic Granulocytic Leukemia
Authors: Huestis D. W. , Corrigan J. J. , Johnson H. V.
Published: December 2004

A therapeutic leukapheresis of a five‐year‐old girl with adult‐type chronic granulocytic leukemia is described, with techniques for minimizing the effects of hypovolemia. The patient's unduly rapid response to chemotherapy suggested that the procedure had effected a substantial reduction in the leukocyte mass.
Removal of HBsAg from Blood In Vitro
Authors: Contreras T. J. , Valeri C. R.
Published: December 2004

Red blood cells from HBsAg‐positive blood were washed in the Fenwal Elutramatic, Haemonetics Processor 15, or the IBM Blood Processor with sodium chloride solutions, or in the Huggins Cytoglomerator with sugar solutions. The Fenwal Elutramatic and IBM Blood Processor were the most efficient washing systems, the Haemonetics Processor 15 was less efficient, and the Huggins Cvtoglomerator was the least efficient in removing the HBsAg. Washing to remove the HBsAg from red blood cells containing 40 per cent W/V glycerol in an ionic medium was more efficient than washing HBsAg from liquid‐stored red blood cells or red blood cells containing 20 per cent W/V glycerol. The original and modified dilution/agglomeration wash cycles used in the Huggins Cytoglomerator were not able to remove the HBsAg from units of blood that were radioimmune assay (RIA) positive and counterelectrophoresis (CEP) negative. Freezing had no effect on the removal of the HBsAg in vitro, whereas the concentration of 40 per cent W/V glycerol in the red blood cells that were washed did. HBsAg was not found in the amorphous debris remaining in the polycarbonate disposable bowl used in the Haemonetics Processor 15 or in the microaggregates remaining in washed red blood cells.
A Method for Radioactive Antiglobulin Testing with 125I Labeled Anti‐IgG
Authors: Jenkins D. E. , Moore W. H. , Hawiger A.
Published: December 2004

The present report describes a method for 125I anti‐IgG antiglobulin testing. The method involves the use of a labeled DEAE cellulose IgG fraction of goat anti‐human IgG globulin. Leukocyte‐free red blood cells were used in the test procedure. Both the labeled antiserum and the red blood cell suspensions were diluted in normal rabbit serum to prevent nonspecific uptake of labeled antiserum by normal, un‐coated red blood cells.

The results of the study show that the method is highly reproducible and relatively easy to perform once the labeled anti‐IgG is prepared. Furthermore, the use of labeled antiserum permits analysis of antiserum specificity by radioimmunoelectrophoresis. The problem of determining anti‐IgG/IgG binding ratios remains the major disadvantage to using the method to determine precise amounts of human IgG coating red blood cells.
Citrate anticoagulants for plateletpheresis
Authors: Huestis DW , Fletcher JL , White RF , Price MJ
Published: December 2004

In 112 plateletphereses done by the Haemonetics blood processor, the comparative effectiveness of ACD formula A, ACD formula B, and 2 per cent citrate in saline was evaluated. With respect to yields of platelets and white blood cells (e.g., lymphocytes), ACD‐B was significantly better than the other two. Both ACD‐B and 2 per cent citrate gave a much lower incidence of citrate reactions in the donors than were encountered with ACD‐A.
Use of dextran 75 as a macromolecular agent in centrifugal leukapheresis
Authors: Huestis DW
Published: December 2004

Twenty‐five leukaphereses were done by the Haemonetics system using citrated Dextran 75 in normal saline as anticoagulant, and were compared with a much larger series using hydroxyethyl starch (HES) with and without steroid premedication. The granulocyte and platelet yields were only minimally different between the two agents. Both were inferior in granulocyte collection to the group that was premedicated with a steroid. Dextran is thus a satisfactory substitute for HES in leukapheresis with this system.
Acute hemolytic transfusion reactions—a fresh look at pathogenesis and considerations regarding therapy
Authors: Goldfinger D.
Published: December 2004

A review of our knowledge of acute hemolytic transfusion reactions indicates that we have learned much in recent years about the pathogenetic mechanisms involved. An approach to effective therapy for patients suffering such reactions should be based on our latest understanding of the pathophysiology of this syndrome. However, changes in our therapeutic approach have not kept abreast of our increased awareness of the etiologic factors, and the patient, therefore, is not getting the benefit of our increased knowledge in this area. The primary pathogenetic mechanisms involved in these reactions appear to be disseminated intravascular coagulation and a series of hemodynamic alterations leading to ischemic necrosis of tissues. Therapy would best be aimed at interfering with these primary pathophysiologic pathways.
Platelet preservation V. Survival, serotonin uptake velocity, and response to hypotonic stress of fresh and cryopreserved human platelets
Authors: Odink J. , Brand A.
Published: December 2004

The survival in vivo of 51Cr‐labeled autologous human platelets, the serotonin uptake velocity, and the response to hypotonic stress were determined both before and after cryopreservation. Changes in platelet survival corresponded to changes in serotonin uptake velocity and response to hypotonic stress. No correlation was observed between the values of the survivla in vivo, the serotonin uptake velocity, and the response to hypotonic stress within the separate suspensions of fresh and cryopreserved platelets. There was no indication that hypercoagulability was induced by infusion of small amounts of cryopreserved platelets.
Hemoglobin screening in prospective blood donors: a comparison of methods
Authors: Avoy Donald R. , Canuel Muriel L. , Otton Birdena , Mileski Emma B.
Published: December 2004

The microhematocrit (MHCT) (MHCT) of blood obtained by ear lobe puncture (ELP) was found to be higher than that obtained by fingerstick (FS). Using copper sulfate solution to estimate hemoglobin concentration of ELP blood will lead to accepting prospective blood donors that would be rejected by fingerstick obtained samples. Raising the specific gravity of the copper sulfate solution from 1.053 to 1.055 for females and from 1.055 to 1.057 for males eliminates the discordance for males but leads to rejection of females at a high rate (20 per cent). The use of FS/MHCT to recheck those failing the gravimetric test with higher specific gravity copper sulfate is suggested. The MHCT of venous samples obtained via the needle at the conclusion of phlebotomy will be lower than the MHCT of a capillary sample obtained during screening because of a combination of: 1) hemodilution due to assumption of the recumbent position and 2) hemodilution in response to phlebotomy.
A chemical refrigerant
Authors: McPeak Dailey W. , Shulthise A. J. , Camp Col. Frank R.
Published: December 2004

For the past several decades wet ice has been the common coolant used to maintain whole blood at 4 to 10 C during transit. This practice was introduced by the military during the early part of World War II, when whole blood was shipped from the United States to the War Zone.1 The data presented herein, collected during recent field studies, show that a chemically produced refrigerant provides a satisfactory substitute for wet ice. A noteworthy advantage of this type coolant is that it may be produced independent of electrical current; especially important during disaster and power failure. The purpose of this paper is to further augment earlier work by McPeak and Camp.2 The refrigerant was made from 12 pounds of a highly soluble crystalline, nitrogenous synthetic compound (CONH2) mixed with 2,500 ml of water.
Metabolism by Man of Intravenously Administered Adenine
Authors: Bartlett G. R.
Published: December 2004

A study was made of the metabolism by a human subject of adenine administered intravenously at a dose of 10 mg/kg with 200 μCi of 8‐14C‐adenine to learn how similar and different the results might be from those obtained by a much more extensive study by this Laboratory on the rabbit. A rapid initial disappearance of radioactivity from the blood was followed by a slower loss with a half‐life of about an hour. The first was probably due to diffusion into the extravascular fluid and the second to metabolism in the tissues. Fifteen per cent of the radioactivity infused was excreted in the urine during the first three hours as unchanged adenine and another 8 per cent was excreted during the first six hours as a mixture, in almost equal parts, of 8‐oxyadenine and 2,8‐dioxyadenine. Radioactivity in the urine after the second day, starting at 1.5 per cent of the dose per day and declining steadily to 0.5 per cent at three months, was predominantly in uric acid, reflecting turnover of the adenine which had entered body pools of purine nucleotide. Approximately 2 per cent of the injected radioactivity was incorporated into red blood cell AMP, ADP and ATP, each of which, by the second day, had the same specific radioactivity, which then decayed at a rate of 1.3 per cent per day. The results were remarkably similar to those obtained in a previous study on the rabbit. A variety of clinical observations and tests on blood and urine showed no abnormalities attributable to the infusion with adenine.
Consequences of Prior Alloimmunization during Granulocyte Transfusion
Authors: Appelbaum F. R. , Trapani R. J. , Graw R. G.
Published: December 2004

The transfusion of leukocyte‐containing blood products can lead to the production of antibodies to antigens on the surface of leukocytes. Such antibodies can be detected by a variety of techniques including assays for lymphocytotoxicity, granulocytotoxicity, and leukoag‐glutination. In order to evaluate the effect of preformed anti‐leukocyte antibodies during granulocyte transfusion therapy, recipient beagles were sensitized to donor foxhound antigens. After being made granulocytopenic with cyclophosphamide, these animals were transfused with a set dose of granulocytes collected by continuous flow centrifugation. When compared to the results of similar transfusions to nonsensitized recipients, granulocyte transfusions to animals with preformed anti‐leukocyte antibodies resulted in lower one‐hour posttransfusion leukocyte increments (p < .04) and in less migration of neutrophils through a skin abrasion into a chamber containing a strong chemoattractant, autologous serum (p < .0001). Also, profound thrombocytopenia was found in sensitized animals, but not in nonsensitized recipients, one hour after the granulocyte transfusion.
Preservation of Human Granulocytes: II. Characteristics of Granulocytes Obtained by Counterflow Centrifugation
Authors: Lionetti F. J. , Hunt S. M. , Lin P. S. , Kurtz S. R. , Valeri C. R.
Published: December 2004

Human granulocytes were isolated from whole blood and from the buffy coat of blood by counterflow centrifugation using the Beckman JE‐6 rotor. Ninety‐one per cent of granulocytes in the human blood sample were isolated in 59 studies. The differential white blood cell count showed 97 per cent segmented neutrophils, 1 per cent lymphocytes and 2 per cent others. The ratio of polymorphonuclear white blood cells to red blood cells was 9:1 when the granulocytes were isolated from whole blood and 40:1 when the granulocytes were isolated from the buffy coat of CPD‐collected blood. The size distribution showed a single symmetrical peak. Measurements of oxygen consumption, chemotaxis, and phagocytosis in granulocytes isolated by counter‐flow centrifugation were similar to those in granulocytes isolated from blood by dextran sedimentation. The granulocytes had normal adenine and guanine di‐ and trinucleotide levels.

Scanning electron microscopy demonstrated spherical granulocytes with ridge‐like profiles and leafy folded exoplasm. After fluorescein diacetate treatment, the cytoplasm of 98.5 + 0.7 per cent of fresh granulocytes was positive, while 98.5 + 1.2 per cent of the fresh granulocytes excluded ethidium bromide from their nuclei. The response of freeze‐preserved granulocytes to treatment with fluorescein diacetate and ethidium bromide showed that 75 per cent of granulocytes survived freezing and thawing in 5 per cent DMSO but were progressively unstable after incubation for two hours at 37 C.
Autoimmune Hemolytic Anemia with Anti Jka Specificity in a Patient Taking Aldomet
Authors: Patten E. , Becki C. E. , Scholl C. , Stroope R. A. , Wukasch C.
Published: December 2004

Autoimmune hemolytic anemia (hemoglobin 5.2 g, reticulocyte count 31.0 per cent) developed in a 53‐year‐old hypertensive woman who was taking Aldomet. Both the patient's serum and the eluate prepared from her red blood cells contained an antibody with anti‐Jka specificity. Rapid sustained improvement in the anemia occurred after cessation of Aldomet and a two week course of prednisone therapy. Eight months later, anti‐Jka was no longer detectable in the patient's serum and the direct antiglobulin test was nonreactive.
The Relationship between Donor‐Recipient Lymphocytotoxicity and the Transfusion Response using HLA‐Matched Platelet Concentrates
Authors: Herzig R. H. , Terasaki P. I. , Trapani R. J. , Herzig G. P. , Graw R. G.
Published: December 2004

Matching donor‐recipient pairs for HLA antigens provides a logical starting point for selecting platelet donors for thrombocytopenic recipients who have demonstrated refractoriness to pooled random donor platelet transfusions. However, not all recipients achieve a compatible transfusion response with platelets selected by HLA type, indicating that additional selection methods are required. Because of studies indicating that a positive lymphocyte cross‐match assay between recipient serum (antibody) and donor lymphocytes predict acute renal allograft rejection, it was hoped that this assay might be useful in predicting the platelet transfusion response for alloimmunized patients. The data herein indicate that the results of this assay in no way correlate with the platelet transfusion response. The lymphocyte cross‐match would seem to be helpful in the selection of donors where known HLA antigen mismatches occur between donor and recipient. However, even in this situation, no correlation was observed between the transfusion response and donor‐recipient lymphocytotoxicity reaction. Clearly additional assays are needed for the selection of compatible donors from those matched by HLA antigens.
Delayed Hemolytic Transfusion Reaction
Authors: Pineda A. A. , Taswell H. F. , Brzica S. M.
Published: December 2004

Twenty‐three cases of delayed hemolytic transfusion reaction (DHTR) occurring at the Mayo Clinic from 1964 through 1973 are reviewed. Nineteen patients had clinical manifestations of hemolysis, of which fever was the most frequent presenting symptom. The degree of hemolysis served as an index of morbidity. In four cases, there was oliguria, two of these patients experiencing renal shutdown. In one case, hemolysis led to a disseminated intravascular coagulation syndrome. Death occurred subsequent to DHTR in three patients. The direct antiglobulin test was positive in all but one case; this finding coincided with elevated unconjugated bilirubin in 14 cases and decreased haptoglobin levels in 15 cases. Anti‐Jka antibody accounted for somewhat more than one‐third of reactions and, along with anti‐E, c, D, Fya, and K antibodies accounted for 91 per cent of cases.
Rapid Cytoreduction in Acute Leukemia
Authors: Eisenstaedt R. S. , Berkman E. M.
Published: December 2004

A patient with acute myelogenous leukemia and symptoms of cerebral leukostasis failed to respond to initial chemotherapy. Reduction in blast count from 220,‐000/μl to 40,000/μl was accomplished over a five hour period by leukapheresis using an intermittent flow cell separator, and symptomatic improvement was dramatic. The technique is simple and rapidly effective and may prove a useful adjunct in the treatment of patients with acute leukemia and high blast counts.
Therapy with Factor IX Concentrate Resulting in DIC and Thromboembolic Phenomena
Authors: Campbell E. W. , Neff S. , Bowdler A. J.
Published: December 2004

The development of subclinical DIC in a patient with factor IX hemophilia receiving concentrate replacement therapy during surgery is discussed with respect to pertinent laboratory features, Subsequent thromboembolic phenomena are presented in the context of current literature. Of significance is the failure of heparin given with the factor IX concentrate to prevent DIC. The value of adequate laboratory monitoring during therapy is stressed.
Demonstration of Anti‐Wrb in a Second Serum Containing Anti‐Ena
Authors: Pavone B. G. , Pirkola A. , Nevanlinna H. R. , Issitt P. D.
Published: December 2004

Many persons who are of a “deletion” or “null” phenotype with regard to a particular blood group system, form a complex specificity antibody or mixture of antibodies, when immunized. Recently, we demonstrated that M.E.P., the En(a–), Wr(a – b–)proposita in a family described by Darnborough has at least, anti‐Ena and anti‐Wrb in her serum. We suggested that the same two antibodies might be present in the serum of G.W., the En(a–), Wr(a–b–) propositus in the family reported by Furuhjelm et al. We have now been able to confirm that G.W.‘s serum does contain antiEna and anti‐Wrb and that the antibodies can be separated by adsorption. Because, at this time, it is not known if En(a–), Wr(a–b–) people lack other common antigens from their red blood cells, the possibility remains that the anti‐Ena, separated from the anti‐Wrb, might be a mixture of antibodies. These findings are important in that they show that reported typings for Ena were actually performed with mixtures of at least anti‐Ena and anti‐Wrb. Anti‐Ena, lacking anti Wrb, can be made only by adsorption of a serum containing the two antibodies, onto En(a+), Wr(a + b–) red blood cells, with recovery of the anti‐Ena by elution.
Platelet Use in Pediatric Oncology: A Review of 393 Transfusions
Authors: van Eys J. , Thomas D. , Olivos B.
Published: December 2004

A total of 393 platelet transfusions, administered on the pediatric service at the M. D. Anderson Hospital and Tumor Institute between March, 1973, to December, 1974, were reviewed. Of these 64 were administered on indications of hemorrhage or surgery, while 324 were administered prophylactically. In only 33 per cent was an adequate platelet rise seen, and in only 40 per cent of those bleeding was the bleeding controlled. The primary factor precluding the success was the number of previously administered platelet transfusions. Infection, the use of random or single donors, and ABO matching had no effect on the outcome, but this was not accentuated in the bleeding patients. Surprisingly, transfusions in patients with leukemia resulted in greater success than transfusions in patients with solid tumors. The lower the platelet count prior to transfusion, the less likely the transfusion was to be successful.
Red Blood Cell Preservation in Protein‐Poor Media: I. Leukocyte Enzymes as a Cause of Hemolysis
Authors: Högman C. F. , Hedlund K. , Akerblom O. , Venge P.
Published: December 2004

Red blood cells were prepared from CPD whole blood concentrated to 90 per cent hematocrit, diluted with saline‐adenine‐glucose (SAG) media and then stored for 35 days. The dilution was undertaken to improve the flow properties of the blood and to provide the cells with glucose and adenine allowing prolonged storage. Several different compositions were tested. ATP could be maintained at about 70 per cent of the initial level and the 24 hour red blood cell posttransfusion survival was 82 per cent. The leakage of potassium was less than in CPD‐adenine whole blood if the dilution volume was half or less of the red blood cell volume. The only problem was that the hemolysis was greater in SAG‐stored blood than in CPD whole blood or undiluted CPD red blood cell concentrate. Hemolysis could be reduced by removal of huffy coat cells or by storage of blood in the presence of synthetic enzyme inhibitors. A chymotrypsin‐like enzyme isolated from human leukocytes had a potent hemolytic effect. The hypothesis is presented that red blood cells stored in an electrolyte medium in the presence of leukocytes undergo increased hemolysis because they lack the protecting effect of plasma enzyme inhibitors which normally inhibit any hemolytic enzymes leaking from damaged leukocytes. The study has practical implications for the prolonged storage of buffy‐poor red blood cell preparations to be used in transfusion therapy.
Transplantation of Hepatitis B Surface Antigen Positive Bone Marrow
Authors: Falk P. M. , Feig S. A. , Gitnick G. L. , Wilkinson R. W. , Gale R. P.
Published: December 2004

We considered for bone marrow transplantation a boy whose only histocompatible donor was positive for hepatitis B surface antigen (HBsAg). He was conditioned for transplantation with cyclophosphamide and total body irradiation. Hepatitis hyperimmune gamma globulin was administered following the bone marrow infusion. Fourteen months after transplantation, the recipient remains a chronic HBsAg carrier, but he has neither developed fulminant liver disease nor has there been any evidence of graft failure.
The Impact of Converting to an all Frozen Blood System in a Large Regional Blood Center
Authors: Kahn R. A. , McDonough B. , Rowe A. , Ellis F. R. , Pino B.
Published: December 2004

We studied the impact of converting to an all frozen blood system in a large regional blood center. Several basic assumptions were made including the availability of a sterile docking device which would increase the shelf life of deglycerolized blood to 72 hours. Our study indicated that the most economical manner in which to implement such a program would be to supply deglycerolized blood to all hospitals transfusing more than 500 units per year and to provide frozen units to hospitals transfusing less then this amount (those hospitals would deglycerolize the blood they use). The estimated total cost of the proposed conversion was 3.9 million dollars or a 76 per cent increase over the present operation. Relative to our present fee structure, the average cost of a unit of blood would increase 80 per cent if only frozen or deglycerolized red blood cells were distributed.
The Ito “Flow‐Through” Centrifuge A New Device for Long‐Term (24 hours) Plasmapheresis without Platelet Deterioration
Authors: Suaudeau J. , Kolobow T. , Vaillancourt R. , Carvalho A. , Ito Y. , Erdmann A. J.
Published: December 2004

An efficacious procedure for continuous plasmapheresis in long‐term extracorporeal circulation has not yet been developed. This technique could be important in plasma exchange or cross‐exchange and in artificial organ support if it could be accomplished safely using heparin as the anticoagulant. When sheep were connected to the Centrifuge® for 23 hours and administered 150 units/kg per hour heparin anticoagulant, we found gross platelet clumping in separated plasma and a 60 per cent fall in platelet count. When 120,000 units of heparin were directly injected into the centrifuge bowl at the onset of the centrifugation followed by hourly heparin administration at 500 units/kg, there was no platelet clumping but the platelet count fell to 52 per cent. Under identical conditions the Ito Flow‐Through Centrifuge, a new continuous flow centrifuge with no rotating seals, was used. We found no platelet aggregates and no drop in platelet count, and there was a 100 per cent recovery of platelets in the separated plasma. Platelets sampled from arterial blood and separated plasma were found to have normal function in vitro, and responded 100 per cent to both collagen and ADP. These results indicate that the Ito Flow‐Through Centrifuge can be used in plasmapheresis with heparin anticoagulation with no donor platelet loss and normal function in separated plasma.
Bacteriological Sterility of Washed Deglycerolized Red Blood Cells after 72 Hours Storage
Authors: Radcliffe J. H. , Denham M. A. , Gaydos C. , Simpson M. B.
Published: December 2004

Samples of reconstituted frozen red blood cells, maintained at 4 C for 72 hours prior to culture, revealed a bacterial contamination rate of less than 0.2 per cent, suggesting that the present shelf life of 24 hours may be safely extended to 72 hours.
Modified Microtiter Tray Method for Blood Typing
Authors: Parker J. L. , Marcoux D. A. , Hafleigh E. B. , Grumet F. C.
Published: December 2004

A simple technique for red blood cell typing is described utilizing V‐bottom microtiter trays with cell suspensions of 0.2%. This technique is many times more sensitive than tube or slide methods and can be used for direct agglutination, antiglobulin tests and mixed field agglutination.
Anti‐Lea as an Autoantibody in the Serum of a Le (a – b+) Individual
Authors: Judd W. J. , Steiner E. A. , Friedman B. A. , Oberman H. A.
Published: December 2004

The first example of anti‐Lea, as an autoantibody, in the serum of a phenotypically Le (a–b+) individual is described. The patient is a 55 year old male with squamous cell carcinoma of the esophagus. His saliva contains Lea, Leb and H substances, and inhibits the hemagglutinating activity of his serum anti‐Lea. The Leb antigen content of his red blood cells is approximately half that of control Le (a–b+) red blood cells. The patient's disease process may be responsible for the development of this unexpected autoantibody.
The Anatomy of a Volunteer Blood Donation System
Authors: Oborne D. J. , Bradley S. , Lloyd‐Griffiths M.
Published: December 2004

This paper describes a questionnaire and interview study to determine motivational factors important in blood donor, nondonor and exdonor behaviors. From the results, a model of blood donor behavior was developed from which certain predictions of donor behavior could be made.
Difficulty in LW Typing as Revealed by a Family Study
Authors: Behzad O. , Pothiawala M. , Rolih S. D. , Issitt P. D. , Lee C. L.
Published: December 2004

A family is described in which two members of the second generation are of the phenotype LW3. In the course of the investigation the mother of the LW3 propositus was at first believed to be phenotypically LW3 as well. Eventually, it was shown that she is, in fact, phenotypically LW2 but that her R−1 (no D), LWlw, genotype had resulted in less LW being present on her red blood cells than is expected in LW2 persons. This reduced level of LW could not be detected with one example of anti‐LW made by an LW3 individual.
In Vitro Studies of Cryopreserved Baboon Granulocytes
Authors: Lionetti F. J. , Hunt S. M. , Mattaliano R. J. , Valeri C. R.
Published: December 2004

Granulocytes were isolated from the buffy coat of baboon blood by counterflow centrifugation. They were frozen in polypropylene tubes in 2.0 ml volumes containing 1 × 107 granulocytes. The medium consisted of 5% DMSO, 6% HES, 4% human serum albumin, and 6 mM glucose in Normosol‐R, pH 7.1. Granulocytes were cooled to 4 C for 30 minutes, then cooled at 4 C per minute to –80 C and stored for one to three weeks in liquid nitrogen at –197 C. Cooling rates of 1 C and 10 C per minute were less efficacious. Tubes were thawed manually with swirling for 130 seconds at 42 C in a water bath. The yield after thawing was 98 ± 14 per cent.

Granulocytes isolated from fresh blood all fluoresced green when incubated with fluorescein diacetate (FDA). Less than one per cent of cells showed nuclear uptake of ethidium bromide (EB). After freezing and thawing, an average of 79 ± 8 per cent granulocytes fluoresced green with FDA and 21 ± 8 per cent fluoresced red with EB. About 98 ± 2 per cent of the granulocytes isolated from fresh blood exhibited a serum dependent capacity for ingestion of latex and yeast. Thawed granulocytes were diluted 1:4 dropwise with a medium containing 7% HES, 4% albumin, and 6 mM glucose in Normosol‐R, incubated with fluorescent latex or fluorescent zymosan at 37 C for 30 minutes and then washed twice. After this, 75 ± 5 per cent demonstrated serum‐dependent latex ingestion and 67 ± 8 per cent ingested zymosan.
Regional Blood Center Automation: Computer Surveillance of Donor Blood Processing
Authors: Allen F. H. , Brodheim E. , Hirsch R. L. , Steele D. R. , Ying W.
Published: December 2004

Computer assistance in blood processing is necessary in large blood donor centers if errors are to be eliminated. Sample identification, recording of data, and use of the computer data file in final labeling are most important.
Distribution of Di‐ and Mono‐(2‐Ethylhexyl) Phthalate in Human Plasma
Authors: Albro P. W. , Corbett J. T.
Published: December 2004

The distributions of di‐(2‐ethylhexyl) phthalate and mono‐(2‐ethylhexyl) phthalate among the protein constituents of human plasma were studied by selective precipitation and chromatographic procedures. The distributions resulting from the leaching of phthalates from blood bags were simulated conveniently by allowing plasma to extract phthalates from coated Celite. More than 80 per cent of the diester was associated with lipoproteins, in the order: LDL > VLDL > HDL > chylomicrons. The remaining diester was apparently adsorbed weakly and nonspecifically to other proteins, including albumin. Mono‐(2‐ethylhexyl) phthalate was in equilibrium between free in solution and adsorbed to albumin; none was bound to lipoproteins. Extraction of phthalate from Celite into plasma should provide a convenient preparation for toxicity or pharmacokinetic studies.