bluuebunny/crossref_metadata_2025 huggingface dataset:
Acid‐citrate‐dextrose‐phosphoenolpyruvate medium as a rejuvenant for blood storage
Authors: Hamasaki N. , Hirota‐Chigita C.
Published: December 2004

Stored, depleted RBC were rejuvenated with respect to their levels of adenosine triphosphate (ATP), 2,3‐diphosphoglycerate (2,3‐DPG), and P50 by acid‐citrate‐dextrose per‐servatives containing phosphoenolpyruvate (PEP) without sucrose. The restorations of P50 and 2,3‐DPG were dependent on the phosphoenolpyruvate concentration. Erythrocyte P50 and 2,3‐DPG, even after treatment with these preservatives, decreased with increasing storage period, but the P50 and 2,3‐DPG of five‐week‐old blood were still higher than the corresponding values of fresh blood. ATP concentration was also increased by treating stored blood with preservatives containing phosphoenolpyruvate, but the elevated ATP of five‐week‐old blood was only about 50 percent of fresh blood. The ATP level could not be raised further by increasing phosphoenolpyruvate concentration but was improved by supplementation with adenine and nucleosides. Incubation of stored blood with 15 mM phosphoenolpyruvate was sufficient to restore ATP, 2,3‐DPG and P50 of three‐week‐old blood to nearly normal. The results of these studies indicate that sucrose is not necessary for PEP to be effective as a preservative additive.
Leukocyte‐depleted blood A comparison of filtration techniques
Authors: Mijović V. , Brozovic B. , Hughes A. S. B. , Davies T. D.
Published: December 2004

Febrile transfusion reactions due to leukoagglutinins are commonly seen in multitransfused patients. It has been suggested that reduction of the number of leukocytes per transfusion to 0.5 times 109 or less would prevent nonhemolytic febrile transfusion reactions in the majority of patients. Therefore, we have compared the ability of several filters to reduce the leukocyte content of stored whole blood drawn into citrate‐phosphate‐dextrose. The leukocyte absorption filters, Imugard IG500 and Erypur, produced 98.3 ±2.4 and 98.3± 1.7 percent leukocyte depletion, respectively. The leukocyte adherence filter, Leuko‐Pak, produced a depletion of 54.6 ± 14.7 percent. The microaggregate filters, Biotest MF10B Microfiltration set, Ultipor Blood Transfusion Filter SQ40S, and Travenol 20 micron High Capacity Transfusion Filter, produced 37.5 ± 10.8, 13.3 ± 11.2, and 44.5 ±11.3 percent leukocyte depletion, respectively. It would appear that of the filters tested, the Imugard IG500 and the Erypur are the only filters which can invariably reduce the absolute number of leukocytes in a unit of stored whole blood to below 0.5 times 109
Studies on the blood of an Miv/Mk proposita and her family
Authors: Judd W. J. , Geisland J. R. , Issitt P. D. , Wilkinson S. L. , Anstee D. J. , Shin C. , Glidden H.
Published: December 2004

An individual (J‐1) was shown to be heterozygous for the Mivand Mk genes. Her red cells typed as M+(weak), N‐, S‐, s+(strong), U+, Hil+, Wr(a‐b‐), En(a+weak). Poly‐acrylamide gel electrophoresis analysis of her red cell membranes revealed absence of PAS‐staining bands corresponding to normal MN and Ss sialoglycoprotein (SGP), and presence of a hybrid MNSs SGP [(α ‐ δ)Miv] similar but not identical to that reported for an Miv homozygote. However, J‐1 cannot be homozygous for Miv since the red cells of two of her children are Hil‐ and s‐, carry only a single dose of M antigen, and have a sialic acid content that is consistent with the presumption that they are Mk heterozygotes. J‐I's hybrid MNSs SGP is considered to be gene‐fusion product resulting from unequal crossover between a normal αMand δ gene, and her red cells lack that portion of the Ena antigen that is resistant to ficin. Her hybrid MNSs SGP differs, therefore, from that reported for the Miv homozygote, which probably arose from unequal crossover between αv and δ genes. Further, the red cells of the Miv homozygote carry the ficin‐resistant Ena determinant
Enzyme‐linked immunoassay for hepatitis B surface antigen An evaluation of commercial test kits
Authors: Nath N. , Dodd R Y. , Fang C. T.
Published: December 2004

A commercial, licensed test for hepatitis B surface antigen (HBsAg) based upon an enzyme‐linked immunoassay principle was evaluated. The sensitivity, when tested under field conditions, was 0.65 and 0.9 ng/ml for ad and ay subtypes of HBsAg, respectively. Only 0.03 percent of 61,798 units of blood screened were reactive and specific for HBsAg while an additional 0.01% gave nonspecific (nonneutralizable) reactivity
Depressed blood group antigens on red cells from a Mexican donor
Authors: Biro V. , Garratty G. , Johnson C. L. , Marsh W. L.
Published: December 2004

Red cells from a Mexican blood donor had depressed H, lF, lD, i, Sda, Sdx, D, LW, Dib, Vel and JMH antigens. A wide range of other blood group antigens had normal activity. The unusual red cell phenotype may be caused by a membrane anomaly that alters orientation of certain cell surface components. The specificities of the depressed red cell antigens in this phenomenon differ from those affected in Melanesians with ovalocytosis or in individuals with the In(Lu) inhibitor gene
Further studies on the dependence of some examples of anti‐M and anti‐N on the presence of red‐cell‐borne sialic acid
Authors: Issitt P. D. , Wilkinson S. L.
Published: December 2004

Previous studies have shown that some examples of anti‐M and anti‐N fail to agglutinate neuraminidase‐treated (NeuNAc‐depleted) red cells. This investigation extends those observations and shows that the antibodies fail to bind to such treated red cells. These observations may mean that NeuNAc residues act to orient the protein portion of the MN sialoglycoprotein so that it is recognized by the antibodies. Alternatively, it is possible that NeuNAc residues are an integral part of the antigen defined.
Quantitation of minor red cell populations using the single‐channel autoanalyzer
Authors: Jeje M. O. , Newton D. , Blajchman M. A.
Published: December 2004

An automated hemagglutination technique has been applied to the quantitation of the size of minor red cell populations. By choosing an antibody to an antigen present only on the minor population, it was possible to estimate the size of the minor population by measuring the antibody following incubation with the red cell mixture. The size was directly proportional to the amount of antibody consumed and was calculated from a regression plot established from standard mixtures. With this method, it was possible to detect minor red cell populations as dilute as 1:5000.
Stability of red cell antigens during prolonged storage in citrate‐phosphate‐dextrose and a new preservative solution
Authors: Snyder E. L. , Hezzey A. , Joyner R. , Davisson W. , Buchholz D. H.
Published: December 2004

Red cells anticoagulated with citrate‐phosphate‐dextrose (CPD) or a commercial preservative solution containing adenine, sodium chloride, and mannitol (ADSOL™) and stored in heat‐sealed segments of plastic tubing were tested for antigen stability after refrigeration at 4°C for up to 56 days. Reactivity of the A, B, c, D, K, Lea, Fya, M, and P, antigens was maintained adequately during the storage period in both solutions. Heat‐sealed segments containing red cells suspended in either CPD or ADSOL preservation solutions for up to 56 days appear acceptable for use in compatibility testing.
Microaggregate blood filtration and the febrile transfusion reaction
Authors: Wenz B.
Published: December 2004

Seventy‐four patients with chronic transfusion requirements and histories of repetitive febrile reactions were transfused with 1138 units of microaggregate‐filtered red cells. The filtered blood was prepared using either a direct interception or a depth filter. One‐half of the units were centrifuged immediately prior to filtration. Microaggregate filtration reduced the overall incidence of febrile transfusion reactions by 77 percent. The centrifugation‐filtration protocol reduced the rate of reactions by 98 percent. There were no differences between the ability of the different filters to reduce the reaction rate; however, red cell loss was twice as large with the depth filter as with the direct interception filter. The numerical criterion for “leukocyte‐poor blood” was met in all units processed by centrifugation‐filtration. Only units processed during the last 2 weeks of shelf‐life fulfilled this criterion when centrifugation was omitted from the procedure. The majority of the latter units were clinically tolerated well due to their reduced granulocyte content.
Comparative functional analysis of lymphocytes and monocytes from plateletapheresis
Authors: Lopez‐Berestein G. , Reuben J. , Hersh E. M. , Kilbourn R. , Hester J. P. , Bielski M. , Talpaz M. , Mavligit G. M.
Published: December 2004

Large numbers (2.9 ± 1.2 times 109) of mononuclear cells can be obtained from Incidental samples collected during routine plateletapheresis. We conducted studies comparing characteristics and functions of mononuclear cells derived from venous blood samples and from routine plateletapheresis in the same normal donors. Cell viability was similar in both samples (96 ± 1% plateletapheresis vs 97 ± 2% venous blood). Higher concentration of monocytes were observed in the plateletapheresis samples (32.3 ± 6%) than in the venous blood (14.3 ± 4%). The procedure of plateletapheresis does not seem to alter lymphocyte or monocyte function. Thus, the functional integrity of these cell populations was demonstrated in terms of natural killer cell activity, blastogenic response to mitogens, local graft‐versus‐host reactions, monocyte‐mediated antibody‐dependent cellular cytotoxicity against human red cells, monocyte‐mediated tumor cell cytotoxicity, latex phagocytosis, and monocyte‐dependent lymphocyte blastogenesis. We conclude that monocytes and lymphocytes obtained during routine plateletapheresis are functionally intact.
Glycerol‐glucose cryopreservation of platelets
Authors: Redmond J. , Bolin R. B. , Cheney B. A.
Published: December 2004

Extended storage of platelets can be achieved by cryopreservation. However, most cryopreservation techniques require extensive manipulation prior to administration, limiting their practicality. A simple cryopreservative system using glycerol and glucose as cryoprotectants would eliminate the need to wash the platelets after freezing, since neither of these agents is toxic. We evaluated such a system in vivo and compared the results to 72‐hour liquid‐stored platelets. The percentage of in vivo recovery was significantly less (p < 0.01) for cryopreserved (21.1 ± 3.4% [χ ± 1 SD]) than liquid‐stored (43.8 ± 7.4%) platelets, but those frozen‐thawed cells that were viable had normal survivals (8.4 ±1.7 days). Liquid‐stored cell appeared to be less viable (5.9 ±1.8 days). These results indicate that cryopreservation with the glycerol‐glucose system produces significant injury to the majority of platelets and therefore, is inadequate for general blood bank use.
Iron stores assessed in blood donors by hematofluorometry
Authors: Raftos J. , Schuller M. , Lovric V. A.
Published: December 2004

Body iron stores in blood donors were assessed using front‐face fluorometric assays of erythrocyte protoporphyrin/heme ratios. Comparison was made with hemoglobin levels and serum ferritin assays. Erythrocyte protoporphyrin/heme assays provide quick and reliable information about possible underlying iron deficiency in the absence of anemia, particularly in regular blood donors.
Safety of autologous blood donation prior to elective surgery for a variety of potentially “high‐risk” patients
Authors: Mann M. , Sacks H. J. , Goldfinger D.
Published: December 2004

We studied 342 potentially “high‐risk” patients, including patients with severe heart disease, elderly patients, children, and pregnant women, to determine the incidence of complications related to phlebotomy. Our patients had an adverse reaction rate associated with blood donation of 4 percent, which is no greater than would be expected among normal volunteer blood donors. No patient experienced a dangerous complication associated with phlebotomy. We conclude that many patients currently denied the opportunity to donate blood preoperatively are actually suitable candidates for autologous blood transfusion programs.
Action of α‐galactosidase from Clostridium sporogenes and coffee beans on blood group B antigen of erythrocytes The effect on the viability of erythrocytes in circulation
Authors: Dybus S. , Aminoff D.
Published: December 2004

The effect of α‐galactosidase, purified from Clostridium sporogenes (Maebashi), was examined on erythrocytes from rats, rabbits and gibbons. The amount of galactose released by α‐galactosidase from Cl. sporogenes and from coffee beans was compared. The amount of sialic acid released by Vibrio cholera sialidase was also determined. Loss of blood group B specificity following treatment with α‐galactosidase was demonstrated with anti‐B lectin. In animal models, removal of all the α‐galactosyl residues with the coffee bean or clostridial α‐galactosidase resulted in no change in the sequestration pattern of the treated erythrocytes overa period of several days. In contrast, erythrocytes treated with sialidase were rapidly sequestered from the circulation.
A Japanese family with two Kp (a‐b‐c+) members, presumed genotype Kpc/Ko
Authors: Kikuchi M. , Endo N. , Seno T. , Okubo Y. , Yamaguchi H.
Published: December 2004

While screening blood donors with anti‐Kpb, an unusual phenotype in the Kell blood group system was found. The proposita and her sister are Kp(a‐b‐c+). Unlike previously described individuals of this rare phenotype, the genotype of the two sisters is presumably Kpc/Ko: their parents are presumably KpbIKpc and Kpb/Ko
Number of random test cells for antibody detection
Authors: REBULLA P. , MILANI S. , GREPPI N. , SIRCHIA G.
Published: December 2004

ABSTRACT: The sensitivity of antibody screening carried out by reacting a serum with random test cells depends on the probability of a given antigen being present in the cell panel. This probability (p) is defined by the formula p = 1‐(1‐f)n where f is the antigen phenotype frequency and n the number of reacted random cells.
Potential HLA‐matched platelet donor availability for alloimmunized patients
Authors: Schiffer C. A. , Keller C. , Dutcher J. P. , Aisner J. , Hogge D. , Wiernik P. H.
Published: December 2004

An analysis of the computer searches for HLA‐matched donors was done for 100 alloimmunized patients requiring HLA‐matched platelet transfusion support. With a pool of 2470 donors, an average of only 1.3 (range 0–14) perfectly matched donors were potentially available per patient. Patients had an average of 9 donors with no mismatched antigens. Although the number of potential donors increased when cross reactive or single antigen mismatches were considered, our estimate of donor availability of this type is lower than reported previously. More donors were identified for the 39 patients with relatively common genotypes than for the remaining 61 patients. Of the latter group, 25 patients did not have any potential donors with “no mismatches” while in most of the others the only suitable donor was a family member. These data suggest that, given the limitations of platelet donor selection using current HLA typing technology, it may be difficult to provide long‐term platelet transfusion support for alloimmunized patients with unusual HLA types. This fact should be considered when planning intensive therapeutic regimens for alloimmunized patients with leukemia.
Automated platelet production during plasmapheresis
Authors: Rock G. , Herzig R. , McCombie N. , Lazarus H. M. , Tittley P.
Published: December 2004

Manual plasmapheresis is widely used to permit collection of fresh‐frozen plasma with return of the red cells to the donor. However, this method is time‐consuming and carries the inherent risk of returning the wrong cells to any individual donor. Automated plasmapheresis, using a specially designed discontinuous cell separator, permits the collection of 500 ml of plasma within 30 minutes without disconnecting the donor from the bag containing the donor's red cells. However, this plasma contains a small number of platelets which are not suitable for transfusion. We now report the modification of this machine to permit simultaneous collection of 3 units of platelet concentrate as well as 500 ml of plasma in less than 50 minutes. Reduction of the g force of the separator from 1200 to 650 g permits the simultaneous collection of plasma and a platelet concentrate with an averageyield of 2.21 × 1011 platelets. Platelet size distribution, in‐vitro function. 51Cr survival, posttransfusion increment, and bleeding time correction are all normal. This modification has increased the flexibility of the separator and provides an instrument which can be used with a random volunteer blood donor population to generate both plasma and cells in less than 50 minutes and with increased cost‐effectiveness over plasmapheresis alone.
Rapid estimation of the glycerol concentration of frozen‐thawed red cells prepared by the agglomeration technique
Authors: Bongiovanni M. B. , Hughlett M. A. , Wurzel H. A.
Published: December 2004

The glycerol concentration of frozen‐thawed red cells must be less than 2 percent to prevent hemolysis upon transfusion. Three methods were investigated for monitoring the glycerol concentration of frozen‐thawed red cells prepared by the agglomeration technique. The supernatant osmolality and glycerol concentration were determined on 47 units of frozen‐thawed red cells prepared by agglomeration, and were found to be linearly related (r = 0.83, p < 0.001). The supernatant refractive index was determined on 29 of the same units. There also was a linear relationship between the refractive index and the glycerol concentration (r = 0.74, p < 0.001). The relationships were different from those previously reported for red cells prepared by other methods. The simulated transfusion test was done on red cells from three units whose glycerol concentration had been artificially elevated. The simulated transfusion test was found to be sensitive to glycerol concentrations above 2 percent. All three of the methods evaluated can be used to estimate the glycerol concentration of frozen‐thawed red cells prepared by the agglomeration technique.
Use of rabbit red cells for adsorption of cold autoagglutinins
Authors: Waligora S. K. , Edwards J. M.
Published: December 2004

This study investigated the use of formaldehyde‐fixed rabbit red cells and rabbit red cell stroma for the adsorption of cold autoagglutinins. Both methods were equally effective and removed all antibody activity at room temperature in 92 percent of the samples. However, some alloantibodies such as anti‐D1 ‐E, and ‐Leb were also reduced in titer or completely absorbed.
Shelf‐life of bank blood and stored plasma with special reference to coagulation factors
Authors: Nilsson L. , Hedner U. , Nilsson I. M. , Robertson B.
Published: December 2004

Whole blood and plasma drawn into plastic bags containing citrate‐phosphate‐dextrose (CPD) and stored at 4°C for various periods were studied for variations of coagulation factor and fibrinolytic activity. The blood was collected and processed in the conventional way. The most labile component, factor VIII coagulant activity, decreased to about 50 percent of its original value within the first 24 hours in whole blood, but thereafter, it decreased more slowly. Storage of whole blood for 6 hours at 4°C had an insignificant effect on VIII coagulant activity; an even slower decrease was found for factor VIII coagulant antigen. The major fall in VIII coagulant activity occurred between 6 and 24 hours of whole blood storage. Factor Vlll‐related antigen remained normal for about 1 week, but on further storage showed signs of proteolytic degradation.

In plasma, there was a successive decrease in VIII coagulant activity with its minimum level (about 50% decrease as compared with the original level) after 7 to 14 days of storage. All other factor VIII activities in plasma remained unchanged throughout the study.

Factor V retained its activity for about 1 week in the whole blood. Factors II, VII, IX, X, XII, XIII and fibrinogen did not fall below normal during a storage period of 35 days, nor was there any indication of increased fibrinolytic activity in either whole blood or plasma. Storage of whole blood and plasma at 4°C for 1 to 2 weeks seems to have relatively little effect on the levels and function of various coagulation components with the possible exception of factor VIII coagulant activity.
Studies on the blood of an MsHe/MSu proposita and her family
Authors: Judd W. J. , Rolih S. D. , Dahr W. , Oilshlager R. , Miller F. M. , Lau P.
Published: December 2004

The serum of a black woman has been found to contain a potent alloanti‐N that reacted in direct agglutination tests with the ‘N’ antigen carried on Ss‐active sialoglycoprotein. Thus far, such antibodies have been observed only in the sera of MSu/MSu individuals. However, our proposita had red cells that lacked ‘N’. Her blood type was M+, N−, S−, s+, U+, He+. Results of family studies indicate that she is of the genotype MsHe/MSu. Our findings are consistent with recently reported data on the structure of the Henshaw antigen, which is located on a Ss‐active sialoglycoprotein that does not carry ‘N’.
Neutrophil transfusion In vivo function of neutrophils collected using cell separators
Authors: Pricem T. H.
Published: December 2004

Effective transfusion therapy depends, in part, upon the ability of the transfused neutrophils to function normally in the recipient. To evaluate the in vivo function of neutrophils obtained with two widely used newer cell separators (Fenwal CS‐3000 and IBM 2997), neutrophil concentrates from 12 normal subjects were labeled in vitro with 3H‐diisopropylfluorophosphate, reinfused into the donor, and blood kinetics and skin chamber accumulation of the labeled cells were measured. Results were compared with previously obtained data (referred to as “normal”) using neutrophils collected by phlebotomy. Blood kinetic measurements of cells obtained with the CS‐3000 were normal, whereas blood recovery of cells obtained with the 2997 was decreased moderately. The percent of infused neutrophils localizing to the skin chamber was 0.101 and 0.044 for CS‐3000 and 2997 cells, respectively; neither value was significantly different from normal (0.066). Thus, neutrophils collected using either of these cell separators function normally or nearly so in vivo.
The production of platelet controls for assays quantitating platelet‐associated IgG
Authors: Denomme G. , Kelton J. G.
Published: December 2004

A variety of assays are available for measuring platelet‐associated IgG (PAIgG) but the complexity of these assays increases the potential for technical errors. These errors are difficult to detect and, if possible, known positive and negative control platelets should be included with each run. However, patient platelets with elevated levels of IgG are seldom available. This report describes a method for producing positive control platelets that can be labeled with differing amounts of IgG. Normal serum IgG (Cohn fraction II) was incubated with washed 2 percent formalin‐fixed platelets for 60 minutes at 37°C. The amount of IgG on the platelets was proportional to the concentration of soluble IgG and the number of incubations. Normal platelet IgG levels were 1.2 ± 0.1 fg per platelet (mean ± SEM, n = 34)and positive control platelets had 4.6±0.2 (n = 12) or 8.4 ± 0.4 (n =7). There was no change in the level of PAIgG when stored at 4° C for 1 week, although there was a 28 percent loss in recoverable platelets. When mixed 1:1 with 60 percentglycerol and stored at —70°C, the level of PAIgG was stable for 3 months, with less than 12 percent platelet loss on recovery (n = 12). These positive control platelets have proved useful for monitoring assay performance.
Detection of fetal‐maternal hemorrhage in a mother with sickle trait and hereditary persistence of fetal hemoglobin
Authors: Krauss J.S. , Fadel H.E. , Squires J. , Baisden C.R.
Published: December 2004

An Rh‐negative term primigravida with sickle trait and hereditary persistence of fetal hemoglobin and an Rh‐positive infant were evaluated postpartum for fetal‐maternal hemorrhage (FMH) by the acid‐elution test for fetal hemoglobin (HbF) cells. Using the acid‐elution test, 100 percent of the cells contained HbF. The patient received one vial of Rh immune globulin and was discharged. This report illustrates that lack of specificity is a major problem of the acid‐elution test for detection of fetal‐maternal hemorrhage, due to its failure to differentiate true fetal Rh‐positive cells from maternal Rh‐negative HbF cells. Moreover, productivity studies suggest performance of agglutination tests such as the immune rosetting test is more convenient than performance of the acid‐elution test to screen for FMH. The recently developed enzyme‐linked antiglobulin test, however, may replace both of these procedures for detection of FMH.
Autologous transfusion: current trends and research issues.
Authors:   National Heart, Lung, and Blood Institute Autologous Transfusion Symposium Working Group
Published: December 2004

Dr. Toy concluded the meeting by summarizing the major controversial issues highlighted by the speakers. PABD PABD is, in principle, a safe and effective method for avoiding exposure to allogeneic blood in appropriate circumstances, and a substantial amount of clinical literature has been published to support its role. However, additional research is needed in the following areas: The optimal number of units that should be collected for specific surgical procedures to ensure maximum savings in use of allogenic blood and minimum wastage; The safety of PABD in patients, including a better understanding of which patients are at risk for complications, what the risks are, and what alternative collection strategies should be employed. Adequate control groups are needed in these studies; A definition of the transfusion trigger as it applies to autologous RBCs; An investigation of the role of rEPO in facilitating PABDs; The development of better collection logistics (e.g., double‐unit collections) and storage protocols (e.g., improved additive solutions); and Additional studies of the costs associated with autologous blood collection and development of more cost‐effective strategies. Acute normovolemic hemodilution Much of the published literature related to hemodilution describes the concept and specific protocols; in contrast, relatively little clinical research relating to the efficacy of this technique exists.(ABSTRACT TRUNCATED AT 250 WORDS)
Comparison of RBCs and FFP with whole blood during liver transplant surgery
Authors: Laine Edward , Steadman Randolph , Calhoun Loni , Blackall Douglas , Levin Philip , Braunfeld Michelle , Nourmand Hamid , Neelakanta Gundappa , Ting Lena , Gornbein Jeffrey , Busuttil Ronald , Petz Lawrence
Published: December 2004

BACKGROUND : Component therapy has become the accepted standard of care in transfusion medicine. In instances of large blood loss, the transfusion of whole blood rather than the combination of RBCs and FFP is rational and may be preferred.

STUDY DESIGN AND METHODS : In a controlled, prospective, randomized study of 33 patients undergoing orthotopic liver transplantation, the effectiveness of component therapy (RBCs and FFP) was compared with the use of whole blood. Coagulation tests (prothrombin time and activated partial thromboplastin time), clotting factor levels (FV, FVIII, fibrinogen), platelet counts, the number of donor exposures, and the total volume of blood transfused for the whole‐blood group and the component‐therapy group were compared at designated times before surgery, during surgery, and 24 hours after surgery.

RESULTS : There was a significant difference (p = 0.015) in the median number of donor exposures for RBCs and FFP, with fewer occuring in the whole‐blood group (n = 14.5) compared with the component group (n = 25). There was no significant difference between groups in coagulation profiles during any of the phases of surgery except for a mild decrease in fibrinogen levels in the whole‐blood group at the conclusion of surgery. There were no differences between the groups in the median volume of blood component replacement, the median age of blood components, the patients' Hct or the number of RBC‐containing components transfused.

CONCLUSION : Whole blood, when compared with component therapy, is associated with fewer donor exposures yet provided equally effective replacement therapy for blood loss in liver transplantation patients.
Incidence of breakage of human RBCs frozen with 40‐percent wt/vol glycerol using two different methods for storage at –80°C
Authors: Valeri C. Robert , Lane Joseph P. , Srey Rithy , Ragno Gina
Published: December 2004

BACKGROUND : We reported previously that the incidence of breakage was 34.2 percent when human RBCs were frozen with 40‐percent wt/vol glycerol in polyolefin plastic bags stored in aluminum containers at –80°C and subjected to transportation. When human RBCs were frozen with 40‐percent wt/vol glycerol at –80°C in PVC plastic bags placed in polyester plastic bags and stored in rigid corrugated cardboard boxes, transportation resulted in a 2.4‐percent incidence of breakage. The present study was done to confirm this incidence of breakage.

STUDY DESIGN AND METHODS : The Meryman‐ Hornblower freezing method was compared to the Naval Blood Research Laboratory (NBRL) method of freezing for incidence of bag breakage. Human RBCs frozen by the Meryman‐Hornblower method with 40‐percent wt/vol glycerol with supernatant glycerol and stored in polyolefin plastic bags in aluminum containers at –80°C were stored at the NBRL from 1974 to 2002. With the NBRL method, human RBCs frozen at –80°C without supernatant glycerol in the 800‐mL PVC plastic primary bag inside a polyester plastic bag in a rigid corrugated cardboard box were stored at the NBRL from 1984 to 2002.

RESULTS : The incidence of breakage for 532 units of RBCs that had been frozen by the Meryman‐ Hornblower method and stored in aluminum containers was 47.3 percent for nontransported units. RBCs that had been frozen by the NBRL method and stored in rigid corrugated cardboard boxes exhibited breakage of 2.4 percent for 2424 nontransported units and 6.7 percent for 633 transported units.

DISCUSSION : The incidence of breakage was significantly lower for RBCs frozen by the NBRL method than for the RBCs frozen by the Meryman‐Hornblower method.
Diclofenac‐induced antibodies against RBCs and platelets: two case reports and a concise review
Authors: Meyer Oliver , Hoffmann Till , Aslan Tunay , Ahrens Norber , Kiesewetter Holger , Salama Abdulgabar
Published: December 2004

BACKGROUND : Diclofenac has frequently been implicated as the cause of immune hemolytic anemias and less frequently of immune thrombocytopenia. The presence of the causative antibodies has only been demonstrated in patients with immune hemolytic anemia, but not yet in patients with thrombocytopenia. The cases of two patients in whom diclofenac simultaneously induced antibodies against platelets and RBCs are reported.

STUDY DESIGN AND METHODS : The investigation was carried out with standard serologic tests for detection of antibodies against platelets and RBCs. The patients' sera were tested in the presence and absence of diclofenac and its metabolites.

RESULTS : One of the two patients developed severe hemolysis and significant thrombocytopenic purpura. The other patient developed significant thrombocytopenia but no hemolysis. Both patients had a positive DAT and drug‐ and/or metabolite‐dependent antibodies against RBCs and platelets.

CONCLUSION : Based on our findings and those of other investigators, we believe that diclofenac leads to the production of antibodies against RBCs and/or platelets.
DNA microsatellite and linkage analysis supports the inclusion of LOCR in the Rh blood group system
Authors: Coghlan Gail , Zelinski Teresa
Published: December 2004

BACKGROUND: In 1994, a new low‐incidence RBC antigen called LOCR was described. It was established that RBCs expressing LOCR had altered expression of Rh antigens (c or e). Unfortunately, because of an insufficient number of informative families, it was not possible to formally assign LOCR to the Rh blood group system by serology alone.

STUDY DESIGN AND METHODS: Genomic DNA from 19 family members segregating for LOCR was analyzed for repeat polymorphisms of the chromosome 1p microsatellite markers D1S1612, D1S1597, D1S552, D1S247, and D1S2134.

RESULTS: No evidence of recombination (in either paternal or maternal meioses) between LOCR and D1S1597, D1S552, or D1S247 was observed. Peak lods for combined paternal and maternal meioses were 2.41 for either LOCR:D1S552 or LOCR:D1S247. Lods for linkage between LOCR and D1S1597 peaked at 1.81 for maternal meioses alone.

CONCLUSIONS: With serologic methods, a peak lod of 2.107 was determined previously between LOCR and RH. In this study, DNA analysis of the only informative family (with seven children) not segregating for RH yielded a peak lod of 1.81 between LOCR and D1S1597‐D1S552‐D1S247. By combining the results generated by each approach (lods of 3.917), evidence has been provided that supports the placement of LOCR in the Rh blood group system.
Orthopedic Surgery Transfusion Hemoglobin European Overview (OSTHEO) study: blood management in elective knee and hip arthroplasty in Europe*
Authors: Rosencher Nadia , Kerkkamp Hans E.M. , Macheras G. , Munuera L.M. , Menichella G. , Barton David M. , Cremers Saskia , Abraham Ivo L. , For The OSTHEO Investigation
Published: December 2004

BACKGROUND: The purpose of this study was to assess current practices in blood management in elective orthopedic surgery in Europe.

STUDY DESIGN AND METHODS: For this 225‐center prospective survey, data were collected on 3996 patients. Actual perioperative blood loss was compared to preoperative estimates. Differences in Hb levels and other outcome variables for patients receiving allogeneic versus autologous transfusions were evaluated. The probability of allogeneic transfusion based on selected predictor variables was estimated.

RESULTS: A total of 2640 (67%) hip and 1305 (33%) knee arthroplasty patients were evaluated. Estimated blood loss (median, 750 mL) was significantly lower than computed blood loss (median, 1944 mL). A total of 2762 (69%) patients received transfusions, including 1393 (35%) autologous‐only and 1024 (25%) allogeneic‐only. The probability of allogeneic transfusion decreased with increasing baseline Hb, but differentially so for men and women. Transfusion triggers were Hb levels of 8.93 ± 1.83 g per dL for allogeneic transfusions, and 21 percent of these occurred when the Hb level was greater than 10 g per dL. Autologous blood transfusion was associated with a significantly lower rate (1%) of wound infections than allogeneic blood transfusion (4.2%).

CONCLUSION: Accurate assessment of preoperative Hb levels, better estimation of perioperative blood loss, efficient use of autologous blood, adherence to transfusion guidelines, and pharmacologic alternatives contribute to effective and comprehensive blood and anemia management.
Frozen preoperative autologous blood donation for heart transplantation at the Mayo Clinic from 1988 to 1999
Authors: Fontaine Magali J. , Winters Jeffrey L. , Moore S. Breanndan , McGregor Christopher G.A. , Santrach Paula J.
Published: December 2004

BACKGROUND: Preoperative autologous blood donation (PABD) has been used to reduce the need for allogeneic RBC transfusion, decreasing risk and conserving supply. A frozen PABD program for heart transplant patients was instituted at the Mayo Clinic in 1988, but participation has steadily declined. The aims of this study were to determine how the availability of PABD influenced the transfusion RBC components, whether the availability of PABD reduced exposure to allogeneic RBC components, and the costs of providing PABD units.

STUDY DESIGN AND METHODS: A retrospective review of all heart transplant cases from 1988 to 1999 was performed (n = 141). Data on collection and transfusion practices were compared for patients with (n = 88, 62%) and without PABD (n = 53, 38%).

RESULTS: Total RBC transfusion requirements did not differ between the groups. Patients with frozen PABD received fewer allogeneic units, but they also had less blood salvaged and reinfused. Twenty patients (23%) completely avoided exposure to allogeneic RBCs in the PABD group versus three patients (6%) in the group without PABD. Although patients in the PABD group successfully donated a total of 423 units, 41 percent were discarded. Over 11 years, the need for 251 units of allogeneic RBCs was avoided ($27,610), but $283,500 was spent to have the frozen PABD units available.

CONCLUSION: PABD can be performed for heart transplantation, but it is expensive.
Thrombotic thrombocytopenic purpura after cephalosporin administration: a possible relationship
Authors: Baron Beverly W. , Van Besien Koen , Hoffman Philip C. , Kohn Orly F. , Rossof Arthur H. , Baron Joseph M.
Published: December 2004

BACKGROUND:  Acquired thrombotic thrombocytopenic purpura (TTP) is an autoimmune disorder. The pathogenesis is believed to be mediated by an autoantibody directed against the metalloproteinase responsible for the degradation of the very‐high‐molecular‐weight multimers of the vWF. The syndrome can be precipitated by a variety of conditions, and certain medications also have been implicated.

CASE REPORTS:  The cases of two patients who took a cephalosporin antibiotic, cephalexin (Keflex, Eli Lilly), and then developed TTP are reported. One patient subsequently received a third‐generation cephalosporin, ceftriaxone (Rocephin, Roche), without adverse reaction. Of interest, one patient had taken cefaclor (Ceclor, Eli Lilly) 8 years before and had also developed TTP at that time. The other patient also took cefaclor for approximately 3 weeks before taking cephalexin. In addition, she had had a dose of clarithromycin (Biaxin, Abbott Laboratories) the day before the onset of the TTP symptoms.

CONCLUSIONS:  To our knowledge, TTP has not been reported previously after administration of cephalosporin antibiotics. Attention is called to the possibility that this syndrome may occur after exposure to some of these drugs, although the incidence is very rare or, alternatively, underdiagnosed.
A 10‐week randomized trial comparing eccentric vs. concentric hamstring strength training in well‐trained soccer players
Authors: Mjølsnes Roald , Arnason Arni , østhagen Tor , Raastad Truls , Bahr Roald
Published: December 2004

Purpose:  To compare the effects of a 10‐week training program with two different exercises – traditional hamstring curl (HC) and Nordic hamstrings (NH), a partner exercise focusing the eccentric phase – on muscle strength among male soccer players.

Methods:  Subjects were 21 well‐trained players who were randomized to NH training (n=11) or HC training (n=10). The programs were similar, with a gradual increase in the number of repetitions from two sets of six reps to three sets of eight to 12 reps over 4 weeks, and then increasing load during the final 6 weeks of training. Strength was measured as maximal torque on a Cybex dynamometer before and after the training period.

Results:  In the NH group, there was an 11% increase in eccentric hamstring torque measured at 60° s−1, as well as a 7% increase in isometric hamstring strength at 90°, 60° and 30° of knee flexion. Since there was no effect on concentric quadriceps strength, there was a significant increase in the hamstrings:quadriceps ratio from 0.89±0.12 to 0.98±0.17 (11%) in the NH group. No changes were observed in the HC group.

Conclusion:  NH training for 10 weeks more effectively develops maximal eccentric hamstring strength in well‐trained soccer players than a comparable program based on traditional HC.
A Complete Set of SNAREs in Yeast
Authors: Burri Lena , Lithgow Trevor
Published: December 2004

Trafficking of cargo molecules through the secretory pathway relies on packaging and delivery of membrane vesicles. These vesicles, laden with cargo, carry integral membrane proteins that can determine with which target membrane the vesicle might productively fuse. The membrane fusion process is highly conserved in all eukaryotes and the central components driving membrane fusion events involved in vesicle delivery to target membranes are a set of integral membrane proteins called SNAREs. The yeast Saccharomyces cerevisiae has served as an extremely useful model for characterizing components of membrane fusion through genetics, biochemistry and bioinformatics, and it is now likely that the complete set of SNAREs is at hand. Here, we present the details from the searches for SNAREs, summarize the domain structures of the complete set, review what is known about localization of SNAREs to discrete membranes, and highlight some of the surprises that have come from the search.
θ frequency stimulation up-regulates the synaptic strength of the pathway from CA1 to subiculum region of hippocampus
Authors: Huang Yan-You , Kandel Eric R.
Published: December 2004

The subiculum (SB) is the principal target of the axons of the CA1 pyramidal cells and serves as the final relay in the trisynaptic loop between the entorhinal cortex and the hippocampus. We have examined synaptic plasticity in the synaptic pathway between the CA1 pyramidal cells and the SB in hippocampal slices and compared it under the same experimental condition with the synaptic plasticity in Shaffer collateral pathway (CA3-CA1). We find that the frequency response curve of synaptic strength induced by prolonged low-frequency stimulation (1-5 Hz) is systematically up-shifted from Shaffer collateral to the CA1-SB pathway. The up-regulation of synaptic strength is mediated by the activity-dependent modulation by β-adrenergic transmission. Because the CA3-CA1 and the CA1-SB synaptic pathways are in series and the β-adrenergic modulation is region-specific, this modulation seems to be involved in the selective control of signal transmission between the different regions of hippocampus.
RPTPα is essential for NCAM-mediated p59fyn activation and neurite elongation
Authors: Bodrikov Vsevolod , Leshchyns'ka Iryna , Sytnyk Vladimir , Overvoorde John , den Hertog Jeroen , Schachner Melitta
Published: December 2004

The neural cell adhesion molecule (NCAM) forms a complex with p59fyn kinase and activates it via a mechanism that has remained unknown. We show that the NCAM140 isoform directly interacts with the intracellular domain of the receptor-like protein tyrosine phosphatase RPTPα, a known activator of p59fyn. Whereas this direct interaction is Ca2+ independent, formation of the complex is enhanced by Ca2+-dependent spectrin cytoskeleton–mediated cross-linking of NCAM and RPTPα in response to NCAM activation and is accompanied by redistribution of the complex to lipid rafts. Association between NCAM and p59fyn is lost in RPTPα-deficient brains and is disrupted by dominant-negative RPTPα mutants, demonstrating that RPTPα is a link between NCAM and p59fyn. NCAM-mediated p59fyn activation is abolished in RPTPα-deficient neurons, and disruption of the NCAM–p59fyn complex in RPTPα-deficient neurons or with dominant-negative RPTPα mutants blocks NCAM-dependent neurite outgrowth, implicating RPTPα as a major phosphatase involved in NCAM-mediated signaling.
HECT ubiquitin ligases link viral and cellular PPXY motifs to the vacuolar protein-sorting pathway
Authors: Martin-Serrano Juan , Eastman Scott W. , Chung Wayne , Bieniasz Paul D.
Published: December 2004

Many enveloped viruses exploit the class E vacuolar protein-sorting (VPS) pathway to bud from cells, and use peptide motifs to recruit specific class E VPS factors. Homologous to E6AP COOH terminus (HECT) ubiquitin ligases have been implicated as cofactors for PPXY motif–dependent budding, but precisely which members of this family are responsible, and how they access the VPS pathway is unclear. Here, we show that PPXY-dependent viral budding is unusually sensitive to inhibitory fragments derived from specific HECT ubiquitin ligases, namely WWP1 and WWP2. We also show that WWP1, WWP2, or Itch ubiquitin ligase recruitment promotes PPXY-dependent virion release, and that this function requires that the HECT ubiquitin ligase domain be catalytically active. Finally, we show that several mammalian HECT ubiquitin ligases, including WWP1, WWP2, and Itch are recruited to class E compartments induced by dominant negative forms of the class E VPS ATPase, VPS4. These data indicate that specific HECT ubiquitin ligases can link PPXY motifs to the VPS pathway to induce viral budding.
Identification of poxvirus CD8+ T cell determinants to enable rational design and characterization of smallpox vaccines
Authors: Tscharke David C. , Karupiah Gunasegaran , Zhou Jie , Palmore Tara , Irvine Kari R. , Haeryfar S.M. Mansour , Williams Shanicka , Sidney John , Sette Alessandro , Bennink Jack R. , Yewdell Jonathan W.
Published: December 2004

The large size of poxvirus genomes has stymied attempts to identify determinants recognized by CD8+ T cells and greatly impeded development of mouse smallpox vaccination models. Here, we use a vaccinia virus (VACV) expression library containing each of the predicted 258 open reading frames to identify five peptide determinants that account for approximately half of the VACV-specific CD8+ T cell response in C57BL/6 mice. We show that the primary immunodominance hierarchy is greatly affected by the route of VACV infection and the poxvirus strain used. Modified vaccinia virus ankara (MVA), a candidate replacement smallpox vaccine, failed to induce responses to two of the defined determinants. This could not be predicted by genomic comparison of viruses and is not due strictly to limited MVA replication in mice. Several determinants are immunogenic in cowpox and ectromelia (mousepox) virus infections, and immunization with the immunodominant determinant provided significant protection against lethal mousepox. These findings have important implications for understanding poxvirus immunity in animal models and bench-marking immune responses to poxvirus vaccines in humans.
Social Capital and Dropping Out of High School: Benefits to At-Risk Students of Teachers’ Support and Guidance
Authors: Croninger Robert G. , Lee Valerie E.
Published: December 2004

Do teachers provide students with valuable forms of social capital? Do these forms of social capital increase the likelihood that students complete high school, particularly students who are at risk of failure? Using data from the National Educational Longitudinal Study (NELS:88), we address these questions and examine whether social capital reduces the likelihood of dropping out between the 10th and 12th grades for a cohort of 11,000 adolescents who attended more than 1,000 public and private high schools between 1990 and 1992. We measure social capital in two ways: (a) students’ beliefs about how much their 10th-grade teachers support their efforts to succeed in school and (b) teachers’ reports about whether individual 10th-grade students receive guidance from them about school or personal matters. We find that teachers are an important source of social capital for students. These teacher-based forms of social capital reduce the probability of dropping out by nearly half. However, students who come from socially disadvantaged backgrounds and who have had academic difficulties in the past find guidance and assistance from teachers especially helpful. We discuss the implications of these findings for investigations of dropping out, risk, and social capital.