bluuebunny/crossref_metadata_2025 huggingface dataset:
Telomeres and Telomerase: Basic Science Implications for Aging
Authors: Ahmed Ali , Tollefsbol Trygve
Published: March 2003

Life expectancy in the United States and other developed nations has increased remarkably over the past century, and continues to increase. However, lifespan has remained relatively unchanged over this period. As life expectancy approaches maximum human lifespan, further increase in life expectancy would only be possible if lifespan could also be increased. Although little is known about the aging process, increasing lifespan and delaying aging are the research challenges of the new century, and have caused intense debate and research activities among biogerontologists.

Many theories have been proposed to explain the aging process. However, damage to deoxyribonucleic acid (DNA) is the centerpiece of most of these. Recently telomere shortening has been described to be associated with DNA damage. Located at the ends of eukaryotic chromosomes and synthesized by telomerase, telomeres maintain the length of chromosomes. The loss of telomeres can lead to DNA damage.

The association between cellular senescence and telomere shortening in vitro is well established. In the laboratory, telomerase‐negative differentiated somatic cells maintain a youthful state, instead of aging, when transfected with vectors encoding telomerase. Many human cancer cells demonstrate high telomerase activity. Evidence is also accumulating that telomere shortening is associated with cellular senescence in vivo. What causes changes in expression of telomerase in different cell types and premature aging syndromes? Does the key to “youthfulness” lie in our ability to control the expression of telomerase? We have reviewed the contemporary literature to find answers to these questions and explore the association between aging, telomeres, and telomerase.
Do We Need to Create Geriatric Hospitals?
Authors: Gillick Muriel R.
Published: March 2003

During a single illness episode, the sickest, frailest older patients are often treated in multiple distinct sites, including the emergency room, the intensive care unit, a general medical floor, and a skilled nursing facility. Such frequent transfers involve changes in physician, changes in nursing care, the rewriting of orders, and physical dislocation, all of which can adversely affect outcomes. This system, although efficient, increases the chance of medical errors, promotes delirium, and undermines the doctor‐patient relationship. Partial solutions include a team approach to care, an electronic medical record, and substitution of home for hospital care. A more comprehensive solution is to create a geriatric hospital for treatment of the most common medical and surgical problems and for provision of rehabilitative or skilled nursing care. Designing new institutions for geriatric care will require new legislation and a new set of regulations but should be considered for the oldest and frailest patients.
Healthcare for Older Persons, A Country Profile: Nigeria
Authors: Akanji Bola O. , Ogunniyi Adesola , Baiyewu O.
Published: March 2003

The Nigerian population is undergoing demographic transition, with an increasing population of older people. Nuclear and extended family members traditionally care for older persons at home. We have observed changes in home living conditions due to reduced family size, and urban migration for economic reasons are likely to affect the care of older people. The inadequately funded healthcare system has placed little emphasis on the care of older people because there are more‐pressing health problems and funding for older people is limited. This paper advocates improved attention to the health needs of older people through improved budgetary allocation, revision of the training curriculum of all cadres of health staff to include geriatrics, and utilization of primary healthcare facilities.
Age‐Related Determinants of Outcome After Acute Myocardial Infarction: A Dobutamine‐Atropine Stress Echocardiographic Study
Authors: Smart Steven , Sagar Kiran , Tresch Donald
Published: March 2003

OBJECTIVES: To investigate the cause of worse survival in older patients after myocardial infarction (MI).

DESIGN: Prospective 18‐month and longer follow‐up study of a cohort of 167 patients (mean age ± standard deviation 58 ± 12, including 71 aged ≥65) with acute MI for cardiac events, defined as cardiac death, recurrent MI, or resuscitated ventricular tachycardia or fibrillation (VT/VF).

SETTING: Milwaukee County Medical Complex and the Zablocki Veterans Affairs Medical Center, Milwaukee, WI.

PARTICIPANTS: One hundred sixty‐seven patients who underwent dobutamine‐atropine stress echocardiography (DASE) in the first week (2–7 days) after acute MI and were medically managed.

MEASUREMENTS: Comparison of event rates in older (≥65 years) and younger (<65 years) patients and of clinical, resting echocardiographic, DASE, and angiographic findings in patients with and without events. Coronary angiography was performed in 141.

RESULTS: Older and younger patients tolerated DASE well. During follow‐up, there were 29 cardiac events (cardiac death in 17, nonfatal MI in 10, and VT/VF in 2). Events were more common in older patients (26% vs 12%, P < .05), especially death (19% vs 5%, P < .05). Scar size in the infarct zone by DASE was larger (4.0 ± 2.8 vs 3.0 ± 2.7 segments, P < .05) and remote wall motion abnormalities more common (47 vs 29%, P < .05) in older patients. Univariate determinants of outcome (P < .05) in older patients were diabetes mellitus; remote wall motion abnormalities; angiographic multivessel disease; scar size; ejection fraction; and resting, low‐, and peak‐dose wall motion score. Univariate determinants in younger patients were similar, but diabetes mellitus was not. Multivariate analysis revealed that remote wall motion abnormalities and scar size by DASE were independently predictive of outcome in older and younger patients and diabetes mellitus only in older patients. Low‐ and peak‐dose DASE data enhanced (P < .01) the prediction of outcome in all patients with acute MI relative to clinical data and resting echocardiography.

CONCLUSION: DASE was more predictive of outcome than clinical data and resting echocardiography in both age groups. Scar size and remote wall motion abnormalities were the primary determinants of outcome irrespective of age. The worse prognosis of older patients correlated with diabetes mellitus, greater scar size, and higher incidence of remote inducible ischemia.
Comparison of Mammography Use by Older Black and White Women
Authors: Han Beth , Wells Barbara L. , Primas Marion
Published: March 2003

OBJECTIVES: To identify differences in the prevalence of ever having had a mammogram and having had a recent mammogram between older black and white women and to compare factors associated with mammography use in older black and white women.

DESIGN: Data analysis and comparative study using nationally representative multistage sampling survey.

SETTING: Data were obtained from the 1998 National Health Interview Survey.

PARTICIPANTS: Four hundred forty‐nine black and 3,328 white older women were examined.

MEASUREMENTS: The outcome variables included never having had a mammogram (yes/no) and not having had a mammogram in the past 3 years (yes/no).

RESULTS: The results of chi‐square tests showed that older blacks were less likely to have ever had a mammogram than older whites, but there was no difference in having had a recent mammogram between older blacks and whites. After adjusting for other related factors, race was not related to mammography use in older blacks and whites. Health insurance was related to mammography use in older whites but not in older blacks. Family income was associated with never having had a mammogram in older whites but not in older blacks. Older blacks with less than 12 years of education were less likely to have had a mammogram (recently or ever) than older whites with less than 12 years of education.

CONCLUSIONS: Even though race, per se, was not associated with mammography use in older black and white women, many barriers to mammography use between older black and white women were different or did not have similar effects. To promote mammography use in older black and white women, barriers need to be specifically targeted for each group to enhance the effectiveness of breast cancer screening programs.
Disorders of the Sacroiliac Joint
Authors: Sizer Phillip S. , Phelps Valerie , Thompsen, Kirk
Published: March 2003

Abstract: Controversies have surrounded the sacroiliac joint. The sacroiliac joint (SIJ) is a considerably complex and strong joint with limited mobility, mechanically serving as a force transducer and a shock absorber. Anatomical changes are seen in the SIJ throughout an individual's lifetime. The ligamentous system associated with the SIJ serves to enhance stability and offer proprioceptive feedback in context with the rich plexus of articular receptors. Stability in the SIJ is related to form and force closure. Movement in the SIJ is 3‐D about an axis outside of the joint. The functional examination of the SIJ is related to a clinical triad.
Radiofrequency Treatment in the Netherlands
Authors: Van Dasselaar N.T.
Published: March 2003

Abstract: A national enquiry was developed by the Pain Control Department of the Dutch Society of Anesthesiology (NVA) in co‐operation with the National Organisation for Quality Assurance in Hospitals (CBO). A questionnaire for retrospective collection of invasive pain control data was sent to all (147) Dutch hospitals as part of the “Quality Assurance of Anesthesiological Pain Control Study” which took place from 1991 to 1997.

The questionnaire related to the organisation of pain departments, availability of personnel, material and space facilities, use of treatment protocols, type and number of procedures carried out in cancer and non‐cancer pain management during a 1 year period (1990‐1991). The response rate to the enquiry was 98 per cent; this high response rate was important to evaluate the status of anesthesiological pain control in the Netherlands. During the study period 92 per cent of the respondents carried out 9,700 invasive cancer pain procedures; 85 per cent of the respondents were active in the field of chronic non‐cancer pain control and were responsible for approximately 63,000 procedures.
Measurement of the viability of stored red cells by the single‐isotope technique using 51Cr. Analysis of validity
Authors: Beutler E. , West C.
Published: March 2003

A single‐isotope 51Cr method often is used to evaluate the viability of stored red cells. In this technique, the red cell mass is measured by back‐extrapolation to time zero (t0) of the radioactivity of the blood between 5 and 20 minutes after infusion of the sample. If there is early destruction of stored cells, this method provides an overestimate of the red cell mass and, hence, of the viability of the stored cells. Freshly drawn red cells from normal donors were labeled with 99mTc, and cells from the same donor which had been stored in citrate‐phosphate‐ dextrose‐adenine‐one (CPDA‐1) for periods ranging from 7 to 49 days were labeled with 51Cr. A comparison of the “true red cell mass” as determined with 99mTc with the back‐extrapolated red cell mass from stored 51Cr‐labeled cells has made it possible to define the magnitude of error introduced by early loss of red cells. The overestimation of red cell mass and viability was diminished if only the 51Cr radioactivity between 5 and 15 minutes after infusion was used in back‐ extrapolating to t0. The degree of overestimation of red cell mass was greatest when the red cell viability had declined to very low levels. However, in the entire range of 10 to 80 percent viability, the overestimate of viability was usually less than 4 percent. The overestimate of viability proved to be quite similar for all samples and may be taken into account when using the single‐isotope technique for measurement of red cell viability.(ABSTRACT TRUNCATED AT 250 WORDS)
Survival and biochemical characteristics of stored red cells preserved with citrate‐phosphate‐dextrose‐adenine‐one and two and prepared from whole blood maintained at 20 to 24 degrees C for eight hours following phlebotomy
Authors: Moroff G. , Morse E.E. , Katz A.J. , Kahn R.A. , Dende D. , Swatman L. , Staggs S.D.
Published: March 2003

Studies were conducted to evaluate the characteristics of red cells stored for 35 days following preparation from units of whole blood anticoagulated with citrate‐phosphate‐dextrose‐adenine‐one and two (CPDA‐1 and CPDA‐2) and maintained at 20 to 24 degrees C for 8 hours after phlebotomy. The mean (+/− 1 SD) 24‐hour survival for transfused CPDA‐1 autologous red cells with hematocrit levels of 78.1 +/− 2.3 percent was 78.0 +/− 8.1 percent (n = 9). The 24‐hour survival of red cells from units preserved with CPDA‐2 with hematocrit levels of 79.3 +/− 4.5 percent was 74.8 +/− 8.6 percent (n = 15). This difference in survival was not significant. Red cells from control units stored for 1 day showed a 24‐hour survival of 91.9 +/− 4.2 percent (n = 7). During the 8‐hour holding, red cell adenosine triphosphate levels increased by 15 to 25 percent in units drawn into both CPDA‐1 and CPDA‐2. After the initial 8‐hour period, the red cell 2,3 diphosphoglycerate levels were 54 +/− 12 percent (mean +/− 1 SD) of initial levels in units drawn into CPDA‐1 and 58 +/− 8 percent of initial levels in units drawn into CPDA‐ 2. Following 35 days of storage, units of red cells prepared from whole blood drawn into CPDA‐1 and CPDA‐2 had comparable plasma cation and ammonia levels and similar amounts of cell‐free hemoglobin. These data indicate that red cells can be stored satisfactorily for 35 days when prepared from whole blood held at 20 to 24 degrees C for 8 hours.
Quantitation of the third component of complement on stored red cells
Authors: Szymanski I.O. , Swanton R.E. , Odgren P.R.
Published: March 2003

By means of an automated anti‐C3c consumption technic, we quantitated the molecules of the third component of human complement (containing the C3c fragment) that accumulate on red cells (RBCs) during liquid whole‐blood storage. Calibrated C‐3 sensitized zymosan particles (ZyC3) were used as standards for bound C3. Although the dose‐response curves of anti‐C3c neutralization by ZyC3 and stored RBCs were similar, mathematical analysis showed that the shapes of these two sigmoidal curves were significantly different. This indicated that the large C3 molecules bound to stored RBCs differed antigenically from those bound to ZyC3. Despite this difference, the former could be quantitated adequately by the automated anti‐C3c consumption technic. Red cell‐ bound large C3 molecules were measured following various periods of storage at 4 degrees C of whole blood samples (n=102). An average of 48 molecules were detected on RBCs stored for 21 days. Statistical analysis of these data indicated that during storage at 4 degrees C there was a continuous accumulation of C3 on RBCs, followed by cleavage of C3c fragments. The degree of agglutination of stored RBCs with anti‐ C3c was proportional to the number of cell‐bound large C3 molecules.
Protein and colloid osmotic pressure changes with albumin and/or saline replacement during plasma exchange
Authors: Lasky L.C. , Finnerty E.P. , Genis L. , Polesky H.F.
Published: March 2003

Colloid osmotic pressure (COP) has been used as a predictor of fluid egress from the vascular space and edema development in the lungs and elsewhere. We investigated the relative safety, as predicted by the COP, of 5 percent albumin plus saline and 5 percent albumin alone as replacement fluids during plasma exchange. Fifty‐three one and one‐half plasma volume exchanges were performed in 15 patients with a variety of diagnoses using intermittent flow cell separators. On specimens obtained, before, during, and after each plasma exchange, the COP was measured directly with a membrane oncometer, and total protein, albumin, and protein electrophoresis were determined using standard biochemical techniques. COP dropped significantly with one to one 5 percent albumin replacement but even more with one‐half 5 percent albumin and one‐half saline replacement during the exchange. COP did not fall below 12.5 torr at the end of the plasma exchange, even with one‐half saline replacement, compared to the 10 to 12 torr level at which pulmonary edema might be expected. The fall in COP during exchange when saline was given first did approach this range but rapidly reversed itself with albumin administration. Clinically, no evidence of tissue or pulmonary edema was observed. Recovery in total protein and COP between plasma exchanges was significant.
The AB genotype expressed as A2B on the red cells of individuals with strong B gene‐specific transferases
Authors: Fredrick J. , Hunter J. , Greenwell P. , Winter K. , Gottschall J. L.
Published: March 2003

Two paternity cases involving black persons are reported in which possible paternal exclusions existed if the A2B red cell phenotype represented the genotype A2B. ABH transferase assays were performed to determine if the A2B phenotypes arose from the genotype A1B or A2B. These assays confirmed that all group A members carried the A1 gene and not the A2 gene. Therefore, the alleged father was not excluded in either case. The B transferase showed increased activity in both AB individuals, possibly accounting for the observed A2B red cell phenotypes. Therefore, in the presence of a B gene, accurate assignment of A subtypes using standard serological methods may not be possible.
The persistence and significance of elevated alanine aminotransferase levels in blood donors
Authors: Sampliner Richard E. , Beluk Daniel , Harrow Edward J. , Rivers Shirley
Published: March 2003

The level of alanine aminotransferase (ALT) in blood donors has been related to the frequency of posttransfusion hepatitis in recipients. Sixty‐seven donors with elevated ALT levels were evaluated to define the duration and significance of the elevation. The ALT level remained elevated in 41 donors (61%) for a mean interval of 9 months. The ALT level was greater than the aspartate aminotransferase in all of the donors. Alcohol intake did not correlate with ALT level. Donors with persistently elevated ALT levels had a significantly higher mean percent ideal body weight (128 +/− 3.9) than donors whose ALT level became normal (116 +/− 3.1). Nine donors with elevated ALT levels for at least 6 months had needle biopsies of the liver. Seven had prominent fatty vacuolization of hepatocytes without evidence of alcoholic hepatitis. One biopsy demonstrated chronic persistent hepatitis. No other cause for the elevated ALT levels could be identified. An overweight male donor with an isolated ALT elevation may need no further investigation unless clinical evaluation suggests a source of liver injury.
Successful cardiac surgery following plasmapheresis in a patient with hemophilia B
Authors: Raish Robert J. , Witte David L. , Goldsmith Jonathan C.
Published: March 2003

A case of successful coronary artery bypass grafting in a patient with hemophilia B is described. The patient underwent preoperative plasmapheresis and replacement with fresh‐frozen plasma. Fresh‐frozen plasma was administered pre‐ and postoperatively. The use of factor IX concentrate was avoided.
The effect of storage on degranulation by human neutrophils
Authors: Lane Thomas A. , Lamkin Geraldine E.
Published: March 2003

We investigated the possibility that the functional impairment in neutrophil (PMN) chemotaxis which occurs during granulocyte concentrate storage might be due to autotoxicity from the release of neutrophil granule contents during storage. Preliminary experiments confirmed that the exposure of fresh PMNs to the intracellular contents of disrupted PMNs, decreased the subsequent chemotaxis of the fresh PMNs by 63 +/− 5 percent compared to control PMNs (p less than .01). Freshly harvested neutrophils were stored at low (2 × 10(7) PMN/ml) or high cell concentration (8 × 10(7) PMN/ml) with or without 15 mM sodium bicarbonate (in order to maintain pH). Prior to storage, and 24 and 48 hours after storage at 22 to 24 degrees C, we measured the cell and unit plasma content of lactate dehydrogenase (LDH), beta‐glucuronidase, and lysozyme. These enzymes served as markers for cell lysis, and primary and specific neutrophil granule contents, respectively. We also measured the effect on neutrophil chemotaxis of adding a protease inhibitor, phenylmethylsulfonyl fluoride (PMSF), to the storage medium. In addition, we measured the ability of PMNs to degranulate in response to an inflammatory stimulus before and after storage. The cell content of granule markers was largely unchanged during storage, except in the case of the units at a concentration of 8 × 10(7) PMN per ml stored without bicarbonate. In these units, lysozyme activity decreased by 15 +/− 7 percent after 48 hours of storage (p less than 0.02 vs. fresh PMNs). Likewise, the plasma content of LDH, beta‐glucuronidase, and lysozyme increased significantly during storage, especially in units of high cell concentration stored without bicarbonate.(ABSTRACT TRUNCATED AT 250 WORDS)
Statistical evaluation of red cell antibody panels
Authors: AuBuchon J. P.
Published: March 2003

The evaluation of a red cell antibody identification panel is a subjective and lengthy process. This study evaluated red cell panels using several statistical parameters and derived an objective, numerical tool for panel evaluation. Nineteen panels were subjectively evaluated by five immunohematologists; a composite ranking was derived from a compilation of their subjective evaluations. A rank indicative of good general utility correlated with 1) the extent to which the panel was composed of red cells with homozygous genotypes in each blood group system, and 2) the number of antibody specificity exclusions which could be made using the panel. A statistical predictor of panel rank was empirically derived based on a score dependent upon the zygosity of each cell in each antigen system and the relative clinical importance of antibodies of each of these specificities. This numerical tool could be applied to a panel in less than 5 minutes. The objective evaluation on each panel tested closely correlated with the composite subjective rank (r = 0.935;p<0.001). Objective numerical evaluation of red cell panels may be useful in their rapid evaluation and comparison, particularly during their construction by computers.
Complement activation and adult respiratory distress syndrome during intermittent flow apheresis procedures
Authors: Boogaerts M. A. , Roelant C. , Goossens W. , Verwilghen R. L.
Published: March 2003

We observed complement (C) activation during intermittent flow apheresis procedures (Haemonetics model 30) in four subjects, two of whom developed adult respiratory distress syndrome (ARDS). Actual C3 conversion during apheresis was illustrated by the finding of significantly elevated C3d levels (p < 0.05) and of significantly increased alpha‐1‐antitrypsin/C3 ratios (p < 0.05) in postapheresis serums. Similarly, marked granulocyte aggregating activity was found in these serums, indicative of the generation of significant amounts of the C‐derived anaphylatoxin, C5a or C5a desarginine. A mean decrease of 59.75 percent in neutrophil count during the four procedures suggested sequestration of aggregated granulocytes in the pulmonary vasculature. Moreover, granulocytes activated by apheresis serums induced significant 51Cr leak from cultured human endothelial cells in vitro (p < 0.001). We conclude that inflammatory C components produced during apheresis procedures may provoke granulocyte aggregation and embolization, leading to plugging of the pulmonary vasculature, and that apheresis‐activated granulocytes may induce endothelial cytotoxicity, leading to the capillary leakage syndrome, characteristic of ARDS. Individual variability in C5a generation capacity or alterations in normal C5a clearing mechanisms may account for the low incidence of clinical C activation and true ARDS during apheresis. In these instances, high‐dose steroids, which interfere with granulocyte‐C interactions, may be beneficial.
Comparison of three methods for detecting antibody to cytomegalovirus
Authors: Taswell H. F. , Reisner R. K. , Rabe D. E. , Shelley C. D. , Smith T. F.
Published: March 2003

To determine the availability of cytomegalic inclusion virus (CMV) antibody‐negative blood among our local donor population, 1384 consecutive group O donors were tested for CMV antibody by the indirect hemagglutination assay (IHA); 51 percent (711) were seronegative (titer <8). The highest percentage of seronegative findings (60%) was among donors 18 to 35 years old. This age group represented 57 percent of the donors. IHA, enzyme immunoassay (EIA), and passive latex agglutination (PLA) methods were compared on 491 donor samples. The reference method was the anticomplement immunofluorescence test. Sensitivities were: IHA, 89 percent; EIA, 93 percent; and PLA, 90 percent. Specificities were: IHA, 90 percent; EIA, 95 percent; and PLA, 100 percent. All but two of the false‐negative samples contained antibody at low titer (≤10), which is of doubtful significance relative to transfusion‐transmitted CMV infections. All three methods were suitable for screening blood donors. The PLA was easy to perform and had a short processing time that would allow rapid assay of fresh (<7 days old) untested blood at the time of selection for transfusion. Thus, both the amount of pretested blood kept in stock and the cost of obtaining each CMV‐seronegative unit could be reduced.
Practical dosimetric aspects of blood and blood product irradiation
Authors: Fearon T. C. , Luban N. L. C.
Published: March 2003

The method of choice to reduce susceptibility to transfusion‐transmitted graft‐versus‐host disease is irradiation of allogenic blood and blood products for transfusion to immunosuppressed recipients. Optimal irradiation requires delivery of a known and homogeneous absorbed dose. The use of absorbed dose in air measured at the center of the irradiation volume without proper compensation for sample absorption can lead to approximately 20 percent underexposure. A lucite cylinder was used to provide the delivery of a homogeneous irradiation dose to blood products of different volumes by allowing rotation of the product.
Loss of blood group A in acute leukemia: Morphologic and biochemical studies of red cells
Authors: Atkinson J.B. , Tanley P.C. , Wallas C.H.
Published: March 2003

A patient with blood type A had acute myelomonocytic leukemia; his red cells (RBCs) typed as O and his serum had anti‐B. RBC membranes were isolated from the patient as well as from controls with group A and O red cells. The membranes were incubated with uridine diphosphate (UDP)‐ N‐acetyl‐D‐14C galactosamine in plasma from the patient and controls with group A and O red cells. RBC membranes from the patient behaved normally in that they incorporated the terminal carbohydrate responsible for blood group A activity. Scanning electron microscopy showed that the patient's RBCs had striking morphologic changes, with marked crenation and numerous knisocytes and dacryocytes. It was concluded that loss of the A antigen in this patient was not due to an abnormality of the enzyme required to convert H substance to A substance. It was postulated that weakening of the A antigen in some patients with leukemia may be related to a steric modification associated with abnormal red cell morphology.
Extension of platelet concentrate storage to 7 days in second‐ generation bags
Authors: Simon T.L. , Nelson E.J. , Murphy S.
Published: March 2003

Platelet concentrates stored for 7 days in 50 ml of plasma in both thin film and enlarged variations of the standard 5‐day CLX plastic bags were evaluated for pH maintenance and in vivo viability by two laboratories working independently. 51Cr‐labeled platelets were reinfused into normal volunteers at the end of storage and recovery and half‐life calculated. The pH was maintained well; < 10 percent of units fell below 6.0 at 7 days. Mean 7‐day recovery for both laboratories was 43.6 ± 11.6 percent in the thin‐film bag and 45.4 ± 8.52 percent in the enlarged bag, compared with 43.6 ± 8.8 percent at 5 days in the 5‐day plastic licensed bag. After 7 days storage the half‐ life was 3.6 ± 0.9 days in the thin‐film bag and 3.7 ± 0.6 days in the enlarged bag, compared with 3.6 ± 0.5 days in the previously licensed CLX plastic bag after 5 days. Thus, platelet viability was maintained well at 7 days of storage in both of the container variations that allowed increased gas exchange.
Evidence for a ‘new’ Rh gene complex producing the rare Cx (Rh9) antigen in the Somali population of East Africa
Authors: Sistonen P. , Abdulle O.A. , Sahid M.
Published: March 2003

Four unrelated propositi with an unusual Cx‐positive Rh phenotype were found during a population survey of 513 Somalis. The Rh phenotypes of the propositi and their available relatives showed that the gene that produces the Cx antigen differs from that found in whites in that it is inherited with an Rh gene complex that produces no C or D. Instead, this gene complex produced es, c, and probably V, although it appeared that no f (ce) antigen was made. These findings suggest that Cx cannot be considered a simple variant form of C but rather a distinct rare Rh antigen that may occur in association with different Rh gene complexes.
Three‐hour collection of committed and multipotent hematopoietic progenitor cells by apheresis
Authors: Lasky L. C. , Smith J. A. , Mccullough J. , Zanjani E. D.
Published: March 2003

Although multipotent progenitor cells have been collected from blood in humans by apheresis in 1‐ to 2‐hour collections, longer‐term collections of multipotent progenitor cells have not been reported. To determine whether such collections could be sustained, the authors performed six 3‐hour collections on five normal volunteers, processing a mean of 8024 ml of blood. Blood samples were taken at 0, 1.5, and 3 hours, and component samples were taken at 1.5 and 3 hours. Cell counts, differentials, and committed myeloid (CFU‐GM), erythroid (BFU‐ E), and multipotent (CFU‐MIX or CFU‐GEMM) progenitor cell assays were performed. Collection efficiency for progenitor cells, the number of cells collected divided by the number in the blood processed, did not diminish significantly. The number collected in the second 1.5‐hour period resembled the number collected during the first. Circulating numbers did not fall significantly during apheresis. Prolongation of apheresis collections may reliably increase the number of progenitor cells available for eventual hematopoietic reconstitution.
Prevalence of Babesia antibody in a selected blood donor population
Authors: Popovsky M.A. , Lindberg L.E. , Syrek A.L. , Page P.L.
Published: March 2003

Human babesiosis, a parasitic disease transmitted by the tick, Ixodes dammini, was confined previously to limited areas of the northeastern United States. It is a rare but potentially life‐threatening complication of transfusion. Red cells and platelets prepared from asymptomatic donors have been implicated in transfusion‐transmitted cases. More cases of babesiosis are being reported as the range of the vector expands in the United States. Blood donors from an endemic area were tested for antibody to Babesia microti during the summer. Only 3.7 percent of the 779 donors were seropositive, compared with 4.7 percent (p > 0.05) of donors from a nonendemic area. An epidemiologic survey of seropositive and matched seronegative controls demonstrated no significant differences that would assist in screening donors.
Iron stores in remunerated blood donors as evaluated by plasma ferritin levels
Authors: Jaime J.C. , Cazarez R. , Mares M.A. , Marfil L.J. , Harrison C.R.
Published: March 2003

This study was undertaken to investigate body iron stores in so‐called remunerated blood donors as well as to evaluate the sensitivity of hemoglobin determination in detecting iron deficiency in two populations of blood donors. The authors studied 522 male donors who were divided into three groups: Group I, first‐time volunteer donors with hemoglobin levels greater than or equal to 13 g per dl; Group II, remunerated donors with hemoglobin levels greater than or equal to 13 g per dl; and Group III, remunerated donors rejected because their hemoglobin levels were less than 13 g per dl. Iron stores were evaluated with an enzyme‐linked immunosorbent assay for plasma ferritin. In Group I, 4.5 percent were iron‐deficient with a mean ferritin value of 55.3 ng per ml; in Group II, 59.7 percent were iron deficient with a mean ferritin level of 17.4 ng per ml, and in Group III, 82.5 percent were iron‐deficient and the mean ferritin level was 8.4 ng per ml. The last values represent the highest percentage of iron deficiency and the lowest mean ferritin value thus far reported. In Group I, hemoglobin determination had a sensitivity of 95 percent in detecting iron deficiency, but in Group II had only 40 percent sensitivity. These results indicate that a more accurate and reliable test, such as a plasma or serum ferritin determination, may be necessary to detect iron deficiency in blood donors when they donate more than five times per year, particularly those who are remunerated.
Cost comparison of intraoperative autologous versus homologous transfusion
Authors: Solomon M. D. , Rutledge M.L. , Kane L.E. , Yawn D.H.
Published: March 2003

The cost of autologous transfusions using semiautomated instruments in 52 orthopedic cases, 75 coronary artery bypass graft (CABG) cases, and 218 aortic aneurysm cases was compared to the cost of equal amounts of homologous blood. While none of the orthopedic cases reached cost equivalence (median cost deficit per case, $97), 31 percent of the CABG cases (median cost deficit per case, $61) and 56 percent of the thoracic aortic aneurysm cases (mean cost surplus per case, $30) did so. In most cases, the major orthopedic and CABG procedures do not reach cost equivalence and might be served better by other means of autologous blood recovery. The more expensive semicontinuous flow devices are more cost‐effective for higher‐yield cases, such as major aortic aneurysm procedures.
Prevention of acquired defects in platelet function during blood processing
Authors: Washitani Y. , Irita Y. , Yamamoto K. , Shiraki H. , Kiyokawa H. , Maeda Y. , Yoshinari M.
Published: March 2003

Two kinds of platelet concentrates were prepared in this study: one as pelleted platelets from platelet‐rich plasma (PCs), and the other as a platelet suspension from the buffy coat fraction (nonpelleted PCs). The characteristics of both platelet concentrates were studied. White cell contamination in the nonpelleted PCs was below the threshold of detection by a microcell counter (less than 300 cells/μl of concentrate); in the pelleted PCs, it was 3 ± 1 × 107 cells per concentrate. The difference between the white cell contamination in pelleted PCs and nonpelleted PCs was significant (p < 0.001). The degree of aggregation induced in pelleted PCs by ADP (9 μM) and collagen decreased to 33 and 55 percent, respectively, of that in platelet‐rich plasma. The secondary wave of platelet aggregation induced by ADP and epinephrine was absent in pelleted PCs, and ATP secretion from these platelets by ADP stimulation also decreased remarkably. However, the°of aggregation and ATP secretion in nonpelleted PCs were similar to those in platelet‐rich plasma. Furthermore, it was found that the amount of platelet factor 4 release seen in pelleted PCs was large in comparison to that in nonpelleted PCs and platelet‐rich plasma. These results suggested that the deterioration of platelet function might have resulted from the platelet activation induced by pellet formation during the preparation of PCs from platelet‐rich plasma.
Storage of pooled platelet concentrates
Authors: Snyder E. L. , Stack G. , Napychank P. , Roberts S.
Published: March 2003

The use of sterile connecting devices will permit up to 5‐day storage of pooled platelet concentrates (PCs). However, there are no data evaluating long‐term storage of PCs pooled from multiple donors. Four units of ABO‐compatible or ‐incompatible PCs were pooled and stored in single 300‐ml PL‐732 storage bags for up to 5 days. Results of in vitro assays showed acceptable storage values regardless of the ABO types in the pool. Pool pH on Day 5 was 6.83 ± 0.3 (mean ± 1 SD). The in vitro storage characteristics were comparable to those of unpooled age‐matched platelets reported previously from our laboratory. For in vivo studies, 4‐unit pools of ABO‐compatible random‐donor PCs stored for up to 96 hours in 1000‐ml PL‐732 bags were transfused into patients who were thrombocytopenic due to bone marrow failure, and the corrected count increments (CCI) were determined. In vivo results showed a mean 1‐hour CCl of 11,368 ± 5824 for the pooled stored platelets and 7819 ± 5189 for unpooled controls (p>0.05). To evaluate the possibility that passenger lymphocytes in the concentrates would generate mixed lymphocyte reactions (MLR) in the pooling bag during storage, lymphocytes were studied over 5 days of storage by the use of monoclonal antibodies against activated T‐cell markers and by 3H thymidine uptake. Results failed to show evidence of either the generation of activated T‐cell markers or the uptake of 3H thymidine. We conclude that pooled stored PCs show acceptable in vitro and in vivo characteristics and do not generate MLR in the storage bag under routine blood bank storage conditions. Pooled stored PCs are acceptable for use in clinical transfusion practice.
Comparison of plateletpheresis using two cell separators and identical donors
Authors: Bertholf M. F. , Mintz P. D.
Published: March 2003

For prospective comparison of product yield and volume, collection efficiency, white cell (WBC) and red cell (RBC) contamination, donor acceptability, and staff acceptance, each of 31 donors underwent plateletpheresis on two different cell separators (the Fenwal CS‐3000 and the COBE Spectra). The same operator performed the paired procedures and collected all study data. The instruments provided equivalent high‐yield platelet products (CS‐3000: 5.3 × 1011; Spectra: 5.7 × 1011). Platelet collection efficiency was greater with the Spectra (81%) than with the CS‐3000 (57%) (p<0.0005). All products contained less than 1 mL of RBCs, but the Spectra products were more likely to contain <106 WBCs (14/31) than those of the CS‐3000 (1/31) (p<0.001). In the remaining products, the mean WBC contamination was 1.0 × 108 for the CS‐3000 and 0.03 × 108 for the Spectra (p<0.001). More ACD‐A anticoagulant was infused with Spectra (463 mL) than with CS‐3000 procedures (400 mL) (p = 0.002). Although postdonation ionized calcium (Ca2+) levels and the percentage of decrease in Ca2+ were not significantly different between groups, more Spectra donors experienced symptoms of hypocalcemia (20/31 vs 9/31; p = 0.015). CS‐3000 products had lower mean volumes (217 mL) than Spectra collections (300 mL) (p<0.0005). Both instruments were accepted well by volunteer donors and the technical staff.
Efficacy of various methods of confidential unit exclusion in identifying potentially infectious blood donations
Authors: LOIACONO B.R. , CARTER G.R. , CARTER C.S. , LEITMAN S.F. , KLEIN H.G.
Published: March 2003

ABSTRACT: To determine the efficacy of various methods of confidential unit exclusion (CUE) among donors at increased risk of HIV exposure, we surveyed AABB institutional members on their experience with 3 CUE methods: ballot or barcode, completed at the time of donation, and call‐back, performed by the donor after leaving the donor center. From June 1985 to December 1987, 5,049,883 donations at 48 donor centers were evaluable for analysis. The results of this survey suggest that ballot and barcode methods of CUE are important adjuncts to other donor screening procedures in identifying potentially infectious units, and that both of these methods are superior to the call‐back system of unit exclusion.
A new radioimmunoassay for the detection of small amounts of white cells and platelets in red cell concentrates: implications for blood transfusion
Authors: Wester M.R. , Prins H.K. , Huisman J.G.
Published: March 2003

In the procedure for quality control of red cell concentrates, made white cell (WBC)‐poor by filtration, the particle‐counting technique was found to be insufficiently sensitive in detecting the remaining WBCs and platelets. Therefore, direct radioimmunoassays were developed using murine monoclonal antibodies specific for platelets, granulocytes, and T lymphocytes. The sensitivity for platelets was 40 times 103 per mL, that for granulocytes was 10 times 103 per mL (starting from 0.2 mL of red cell filtrate), and that for T lymphocytes was 0.006 times 106 per mL (starting from 5 mL) and 0.0015 times 106 per mL (starting from 50 mL). These direct assays were used in experiments on filtration with three types of filters: the Cellselect B‐1005, B‐1014 and the B‐1013 (bedside filter). After filtration of 1 unit of blood cell suspension through the B‐1005, the number of remaining platelets was found to vary between ≤0.04 times 106 and >15 times 106 per mL (n = 16); after filtration through the B‐1013 filter, the remaining platelets were >0.04 times 106 per mL. Upon filtration of a second unit of blood cell suspension through the B‐1013 filter, the number of remaining platelets varied between ≤0.04 times 106 and 5 times 106. In both filter types, the number of remaining granulocytes was always >0.01 times 106 per mL. A study of T‐lymphocyte contamination revealed that, upon filtration of 1 unit of blood through the B‐1005, T‐lymphocyte numbers were ≤0.0015 times 106 to 0.15 times 106 per mL (starting from 5 and 50 mL); upon filtration through the B‐1013 filter, the number of remaining T lymphocytes varied between ≤0.006 times 106 and 0.2 times 106 per mL (starting from 5 mL). After filtration of a second unit of blood cell suspension through the B‐1013 filter, the number of remaining T lymphocytes ranged from ≤0.006 times 106 to 0.1 to 0.5 times 106 per mL (starting from 5 mL). The direct radioimmunoassay is an improvement over the present electronic particle‐counting techniques with regard to both sensitivity and specificity and may therefore be useful in quality control procedures in blood transfusion as well as in the development of new filters.
Prolonged storage of red cells with ammonium chloride and mannitol
Authors: Mazor D. , Dvilansky A. , Meyerstein N.
Published: March 2003

Recently, a new preservation medium consisting of ammonium chloride added to adenine, glucose, mannitol, citrate, and potassium phosphate, was described. Unexpectedly, the predominant effect on red cell storage was an initial elevation of ATP levels, followed by remarkable maintenance of these levels at 12 to 18 weeks with acceptable 24‐hour survival. The aim of the study reported here was to investigate the reasons for the advantageous effects of the different constituents. With the new preservation medium, ATP content was maintained at acceptable levels for at least 8 weeks with low spontaneous hemolysis. However, similarly high ATP levels were also maintained in the absence of ammonium chloride. Comparable results were obtained on substituting sodium for potassium salts in the new medium. When the main cation in the preservation medium was replaced by sodium, the addition of ammonium or rubidium chloride did not provide an advantage. Therefore, ammonium chloride was not essential for this medium, whereas mannitol does seem to be essential in a solution whose content of nonpermeant solutes is hypotonic.
Flow cytometric studies of the D antigen of various Rh phenotypes with particular reference to Du and Del
Authors: Hasekura H. , Ota M. , Ito S. , Hasegawa Y. , Ichinose A. , Fukushima H. , Ogata H.
Published: March 2003

Flow cytometric analysis was performed on red cells (RBCs) to compare the antigen activity of various Rh phenotypes, including the rare variants Del and Du (both high‐grade and low‐grade), whose genotypes were confirmed or presumed by the family study. This appears to be the first report that the Del phenotype is due to the inhibitory effect of Cde. This study also compares the quantity of the D antigen in different phenotypes, whose genotypes comprise the same Du gene (cDuE) transmitted in a family. RBCs were stained by the indirect immunofluorescence method using IgG anti‐D purified through a protein‐A affinity column. The mean fluorescence intensity obtained for each genotype representing the activity of the D antigen decreased in the following order (percentages show relative fluorescence intensity taking cDE/cDE control as 100% and Cde/cde as 0%): CDe/cDE, 76 percent; CDe/cde, 73 percent; cDE/Cde, 70 percent; cDE/cDuE, 68 percent; CDe/Cde (high‐grade Du), 59 percent; cDuE/cde (low‐grade Du), 6 percent; and cDuE/Cde (Del), 3 to 4 percent.
Posttransfusion hepatitis B transmitted by blood from a hepatitis B surface antigen‐negative hepatitis B virus carrier
Authors: Larsen J. , Hetland G. , Skaug K.
Published: March 2003

A female blood donor at our institution was implicated in three cases of clinical posttransfusion hepatitis B. She had given blood 25 times in 8 years. Twenty‐seven recipients were followed up, and about one‐half of those who were still living had serologic markers of hepatitis B virus (HBV) infection. The donor was repeatedly negative for hepatitis B surface antigen (HBsAg) and antibody, but she had high titers of antibody to hepatitis B core antigen. We conclude that blood from this HBsAg‐negative blood donor was capable of transmitting hepatitis B.
Posttransfusion purpura: the therapeutic value of PlA1‐negative platelets
Authors: Brecher M.E. , Moore S.B. , Letendre L.
Published: March 2003

A case of PlA1‐associated posttransfusion purpura (PTP) is reported, in which a previously sensitized patient developed life‐threatening thrombocytopenia, purpura, hematuria, and bronchial bleeding. The patient was transfused with PlA1‐negative single‐donor apheresis platelets (from four different donors) on four occasions. The first transfusion resulted in a 1‐hour posttransfusion increment of 57 times 109 per L. The use of two additional PlA1‐negative apheresis platelets provided support for a tracheostomy. Bronchial bleeding leading to respiratory arrest was controlled with a fourth transfusion. All PlA1‐negative platelet transfusions resulted in transient increases in the patient's platelet count. This is the first reported case of repeated, transiently effective transfusion of PlA1‐negative platelets demonstrated during the acute phase of thrombocytopenia.
The prevalence of anti‐HCV among Chinese voluntary blood donors in Taiwan
Authors: Lin‐Chu M. , Tsai S.J.L. , Watanabe J. , Nishioka K.
Published: March 2003

ABSTRACT: In Taiwan, the prevalence of circulating anti‐HCV is 2 percent among first‐time voluntary Chinese blood donors, 10 percent among donors with elevated ALT levels (>45 IU/L), and higher among older men. The carrier rate for HBsAg was 18.6 percent and the frequency of positive HBV marker(s) (HBsAg, anti‐HBc, anti‐HBs) was 86.4 percent among first‐time donors. There is no significant correlation between HBV and HCV infections in Taiwan, because there is no significant difference in the frequency of anti‐HCV among donors with or without HBV markers. The frequency of anti‐HCV among qualified donors in Taiwan (ALT <45 IU/L, not tested for anti‐HBc) is 1.8 percent, which is not significantly different from the frequency (1.6%) in donors with normal ALT and negative for HBV marker(s) (qualified donors by Western Standards). Therefore, ALT is the most important surrogate marker for HCV infection in Taiwan.