bluuebunny/crossref_metadata_2025 huggingface dataset:
Platelet storage lesion of WBC‐reduced, pooled, buffy coat‐derived platelet concentrates prepared in three in‐process filter/storage bag combinations
Authors: Krailadsiri Pranee , Seghatchian Jerard , Williamson Lorna M.
Published: March 2003

BACKGROUND: With the implementation of universal WBC reduction in the United Kingdom, in‐process WBC‐reduction filters for pooled buffy coat (BC)‐derived platelet concentrates (PCs) are used in routine production. The effects of three filter/storage bag combinations on platelet activation and mi‐crovesiculation and on the activation of coagulation were investigated.

STUDY DESIGN AND METHODS: Using pooled BCs from the same donors, three filter/storage bag combinations (Autostop BC/CLX, Pall Biomedical; Sepacell PLX5/PL2410, Asahi Medical; and Imugard III‐PL 4P/Teruflex, Terumo) were compared with unfiltered controls for their effects on microvesiculation and other storage‐induced changes in platelets. Process efficiency was measured by platelet yield and residual WBC count. The storage changes were assessed: pH, activation of platelets measured by CD62P on the platelet surface and in supernatant plasma, quantitation of platelet‐derived and RBC‐derived microvesicles, cellular injury measured by annexin V in the supernatant plasma, and activation of the coagulation system measured by kallikrein‐like and thrombin‐like activities, prothrombin fragment 1+2, and thrombin‐antithrombin complex.

RESULTS: All three filters were comparable in terms of platelet recovery and WBC removal, and none induced immediate platelet activation or microvesiculation. With storage, platelet activation or microvesiculation increased in platelets prepared by all three filters and in unfiltered controls, but these effects were significantly less in the Imugard PCs than in controls. These findings were consistent with those for annexin V in the supernatant plasma, which were lower in Imugard PCs than in other products. Sepacell and Imugard filters reduced RBC‐derived microvesicles to 50 percent of control levels, but the Autostop filter had no effect. On storage, levels of RBC‐derived microvesicles in filtered products remained static, but levels in the unfiltered control doubled. Kallikrein‐ and thrombin‐like activities were generated only by the Autostop filter without any further increment on storage.

CONCLUSION: WBC‐reduced pooled BC‐PCs prepared by various filter/bag combinations were equivalent on Day 1 but differed during storage in terms of platelet activation or microvesiculation.
The low‐incidence MNS antigens Mv, sD, and Mit arise from single amino acid substitutions on GPB
Authors: Storry Jill R. , Reid Marion E. , MacLennan Sheila , Lubenko Anatole , Nortman Peter
Published: March 2003

BACKGROUND: GPB carries ‘N’ at its N‐terminus and S and s, determined by a polymorphism at amino acid position 29 (Met29Thr). The low‐incidence antigens Mv, sD, and Mit are associated with weakened expression of S and/or s, and the purpose of this study was to define their molecular bases.

METHODS: The GPB gene (GYPB) was sequenced after RT‐PCR of RNA from four samples: two Mv+, one sD+, and one Mit+. The point mutations observed were confirmed by sequencing of genomic DNA from these and other examples of sD+ and Mit+ samples.

RESULTS: A point mutation of 65C>G observed in the Mv+ samples predicted a change of Thr3Ser. A mutation of C>G at nucleotide 173 of the GYPB coding sequence, observed in two sD+ samples, predicted a change of Pro39Arg. Three Mit+ samples showed a nucleotide substitution of 161G>A, which predicted a change of Arg35His. Altered expression of S or s was confirmed by serologic tests.

CONCLUSION: These results confirm that Arg35 is important for full expression of S. Pro39 and, surprisingly, Thr3 are also important for full expression of s. Furthermore, Thr3 must be essential for expression of ‘N,’ as Mv+ RBCs lack ‘N.’
Routine HCV PCR screening of blood donations to identify early HCV infection in blood donors lacking antibodies to HCV
Authors: Hitzler Walter E. , Runkel Stefan
Published: March 2003

BACKGROUND: Detection of early hepatitis C infection of blood donors is still a major problem for blood transfusion. Common anti‐HCV screening assays show differences in sensitivity and specificity. The often mild symptoms of acute hepatitis C also cause difficulties in the identification of early HCV infection. The feasibility and efficacy of routine screening of blood donations for HCV RNA were investigated.

STUDY DESIGN AND METHODS: Blood donations (n = 251,737) were screened for HCV RNA over 4 years. RNA extraction, amplification, and detection were done by two commercial HCV PCR kits (HCV Cobas Amplicor and HCV Cobas Amplicor 2.0, Roche Diagnostics). Screening was done by pool testing with a maximum pool size of 40 serum samples.

RESULTS: Three donations out of 251,737 were HCV RNA positive and anti‐HCV negative. ALT levels of these donations were 271, 32, and 10 U per L. The HCV infection of a fourth HCV RNA‐positive donor could not be identified by routine, second‐generation HCV EIA (Abbott Diagnostika). In this case, two previous donations were also HCV RNA positive, and three second‐generation test systems (Abbott) could not detect anti‐HCV, whereas third‐generation anti‐HCV screening assays detected antibody with different sensitivity. The first HCV RNA‐positive donation was identified only by the HCV ELISA 3.0 (Ortho Diagnostic Systems). The results of confirmatory assays like RIBA HCV 3.0 (Ortho) and Matrix (Abbott) indicate a restricted immune response to NS3 only.

CONCLUSION: HCV RNA detection by PCR can be carried out routinely in blood donor screening without significant delay of release of the components. The residual risk of transmission can be reduced by identification of early infection, which can lead to an improved safety of blood components. RNA screening can also be advantageous in cases of incomplete or lack of antibody response to HCV.
Virus inactivation of plasma‐derived proteins by pasteurization in the presence of guanidine hydrochloride
Authors: Schlegel Andreas , Immelmann Andreas , Kempf Christoph
Published: March 2003

BACKGROUND: Viruses, among them parvovirus B19 and other small, nonenveloped viruses, may be present in human blood and may contaminate plasma‐derived therapeutics. Efficient inactivation or removal of such viruses, especially parvoviruses, represents a current problem and corresponding technologies are under investigation. In this report, such a technology is described.

STUDY DESIGN AND METHODS: A recently developed pasteurization of human apolipoprotein A‐I (apoA‐I), which is performed at 60°C for 10 hours in the presence of guanidine hydrochloride (GdnHCl), was validated by using a series of model viruses, including members of the families parvoviridae and picornaviridae. The model viruses were spiked into the apoA‐I‐ and GdnHCl‐containing solutions, and virus inactivation was evaluated by infectivity assays in cell cultures. The mechanism of virus inactivation was studied by virus sedimentation analysis using the picornavirus model.

RESULTS: All viruses tested were inactivated to levels below the limit of detection, although different inactivation kinetics were obtained for the different viruses. The mechanism of virus inactivation by this pasteurization was disassembly of the virus particles into single proteins or small noninfectious viral subunits.

CONCLUSION: The pasteurization validated in this report has the potential to inactivate a wide range of transfusion‐relevant viruses including parvoviruses and picornaviruses.
Immunochemical determination of cellular prion proteinin plasma from healthy subjects and patients withsporadic CJD or other neurologic diseases
Authors: Völkel Dirk , Zimmermann Klaus , Zerr Inga , Bodemer Monica , Lindner Thomas , Turecek Peter L. , Poser Sigrid , Schwarz Hans P.
Published: March 2003

BACKGROUND: Creutzfeldt‐Jakob disease is thought to be caused by conversion of cellular prion protein (PrP) from its soluble form (PrPsen) to a pathologic form (PrPres). The occurrence of a new variant of CJD has increased the demand for a rapid assay capable of detecting a theoretical risk of transmission of the disease by blood or plasma.

STUDY DESIGN AND METHODS: A quantitative sandwich ELISA for routine screening was developed for analysis of PrP levels in plasma. The time‐resolved dissociation‐enhanced fluorescence technology allowed a detection limit in plasma samples of approximately 50 pg/mL. Levels of PrPsen were tested in plasma from 31 patients with CJD, from 11 patients with other neurodegenerative diseases, and from a control group of 200 healthy subjects.

RESULTS: The assay recognized both PrPsen and pathologic PrPres, but did not differentiate between the two isoforms. PrPsen levels were higher in plasma from both patient groups than in plasma from the control group: 27 of the 31 (87%) CJD patients and all patients with other neurodegenerative diseases had higher levels than the highest concentration found in the control group. No correlation was found between age and PrP level. No signal could be detected in the CJD samples after protease K digestion, indicating that all detected PrP was protease‐sensitive and therefore not pathologic.

CONCLUSION: These data suggest that soluble PrPsen in plasma samples might be useful as a surrogate marker for a broad spectrum of neurologic diseases as well as for CJD.
Platelet‐reactive HLA antibodies associated with low posttransfusion platelet increments:a comparison between the monoclonal antibody‐specific immobilization of platelet antigens assay and the lymphocytotoxicity test
Authors: Kurz Martin , Knöbl Paul , Kalhs Peter , Greinix Hildegard T. , Höcker Paul , Panzer Simon
Published: March 2003

BACKGROUND: Platelet‐reactive HLA antibodies are a major reason for low posttransfusion platelet increments. The clinical importance and value of the test systems for their in vitro determination is still controversial.

STUDY DESIGN AND METHODS: A prospective analysis of HLA antibodies was performed in sera obtained once a week for at least 4 consecutive weeks from 55 patients (female/male, 28/27; age: median, 49 years; range, 18‐69) undergoing intensive chemotherapy and in need of prophylactic platelet transfusions. All sera (n = 330) were analyzed by the monoclonal antibody‐specific immobilization of platelet antigens (MAIPA) assay and by the standard lymphocytotoxicity test (LCT).

RESULTS: In the MAIPA, 24.5 percent of sera (81/330) obtained from 22 patients contained HLA antibodies. These were detected significantly more often by the MAIPA assay than by the LCT (24.5% vs. 8.2%). Fifty‐five sera (20 patients) were positive in the MAIPA assay only. In 15 patients, HLA antibodies were transient. In 3 patients, HLA antibodies were detected earlier by the MAIPA assay than by the LCT. Significantly more sera obtained at the time of low posttransfusion platelet increments were positive in MAIPA alone, rather than in both MAIPA and the LCT (44% vs. 17%).

CONCLUSION: The MAIPA assay is more sensitive than the standard LCT in detecting platelet‐reactive HLA antibodies. These MAIPA‐positive/LCT‐negative HLA antibodies affect the posttransfusion platelet increment.
Single‐donor platelets reduce the risk of septic platelet transfusion reactions
Authors: Ness Paul , Braine Hayden , King Karen , Barrasso Christine , Kickler Thomas , Fuller Alice , Blades Natalie
Published: March 2003

BACKGROUND: Septic platelet transfusion reactions (SPTRs) are the most common, serious risk of transfusion. Because SPTRs result from donor skin flora or asymptomatic bacteremia, the use of single‐donor platelets (SDPs) has been proposed to reduce the risk of SPTRs from the risks with pools of platelet concentrates (PCs).

STUDY DESIGN AND METHODS: Beginning in 1986, all febrile transfusion reactions were evaluated by culture of the platelet bag. Confirmed SPTRs were identified by isolation of the same bacteria from the bag and the patient's blood or by positive Gram's stain of the bag that confirmed a positive platelet culture. In 1987, a program to minimize PC use in favor of SDP use was initiated as a means of reducing SPTRs.

RESULTS: In 12 years, the use of SDPs increased from 51.7 percent to 99.4 percent of all platelet transfusions at one institution. SPTRs fell from three events in 1 year to the current rate of one event per year. The incidence of SPTRs decreased from 1 in 4,818 transfusions to 1 in 15,098 transfusions. The rate of SPTRs due to PCs was 5.39 times higher than that of SPTRs due to SDPs (95% CI, 1.89,12.9).

CONCLUSION: The use of SDPs is a simple means of reducing SPTRs. Other measures such as sterilization will be required to eliminate all SPTRs.
Role of oral versus IV iron supplementation in the erythropoietic response to rHuEPO: a randomized, placebo‐controlled trial
Authors: Olijhoek Ger , Megens Johannes G.N. , Musto Paulo , Nogarin Livio , Gassmann‐Mayer Christiana , Vercammen Els , Hayes‐Licitra Sandra A.
Published: March 2003

BACKGROUND: Preoperative treatment with rHuEPO (epoetin alfa: EPREX, Janssen‐Cilag; or PROCRIT, Ortho Biotech) in conjunction with iron supplementation increases the erythropoietic response in elective orthopedic surgery patients, but it is not known whether the magnitude of this response is dependent on the route of iron administration.

STUDY DESIGN and METHODS: Non‐iron‐deficient patients undergoing elective orthopedic surgery (N = 110) with baseline Hb ≥10 to ≤13 g per dL were randomly assigned to receive either epoetin alfa (600 IU/kg) plus IV iron (n = 29) or oral iron (n = 29) or placebo plus IV iron (n = 25) or oral iron (n = 27) in this 14‐day study. RBC production, Hb, Hct, reticulocytes, iron status, and adverse events were monitored throughout the study.

RESULTS: Epoetin alfa treatment plus either oral or IV iron supplementation significantly increased total RBC production, Hb, Hct, and reticulocytes over the values seen with the respective placebo treatments (p = 0.0001). There were no differences between the epoetin alfa treatment groups. Placebo treatment plus oral or IV iron supplementation was not associated with increases in hematologic values. There were no differences in the incidence of adverse events among the treatment groups.

CONCLUSION: There was a comparable erythropoietic response to epoetin alfa, irrespective of the route of iron administration. The route of iron administration, therefore, does not modulate the erythropoietic response to epoetin alfa in patients who are not iron deficient. Safety and convenience benefits may be gained by adopting oral iron supplementation in this patient subset.
Inverse relationship between patient peripheral blood CD34+ cell counts and collection efficiency for CD34+ cellsin two automated leukapheresis systems
Authors: Heuft Hans‐Gert , Dubiel Mark , Rick Oliver , Kingreen Dorothea , Serke Stefan , Schwella Nimrod
Published: March 2003

BACKGROUND: The purpose of this study was to analyze the CD34 cell collection efficiency (CE) of automated leukapheresis protocols of two blood cell separators (Spectra, COBE [AutoPBSC protocol] and AS104, Fresenius [PBSC‐Lym, protocol]) for peripheral blood progenitor cell (PBPC) harvest in patients with malignant diseases.

STUDY DESIGN AND METHODS: PBPCs were collected by the Spectra AutoPBSC protocol in 95 patients (123 collections) and the AS104 PBSC‐Lym protocol in 87 patients (115 harvests). Patients underwent a median of one (range, 1‐4) conventional‐volume apheresis procedure of 10.8 L (9.0‐13.9) to obtain a target cell dose of ≥2.5 × 106 CD34+ cells per kg.

RESULTS: The median overall CD34 CE was significantly better on the AS104 than on the Spectra: 55.8 percent versus 42.4 percent (p = 0.000). This was also true below (59.2% vs. 50.1%; p = 0.022) and above (51.2% vs. 41.3%; p = 0.001) the preleukapheresis threshold of 40 CD34+ cells per μL needed to collect a single‐apheresis autograft. However, at ≥40 circulating CD34+ cells per μL, both cell separators achieved the target of ≥2.5 × 106 CD34+ cells per kg. The CD34 CE dropped significantly, from 59.2 percent at <40 cells per μL to 51.2 percent at ≥40 cells per μL on the AS104 (p = 0.017) and from 50.1 percent to 41.3 percent on the Spectra (p = 0.033).

CONCLUSION: Whereas the CD34 CE was significantly different with the AS104 and the Spectra, the CD34 CE of both machines correlated inversely with peripheral blood CD34+ cell counts, showing a significant decline with increasing numbers of circulating CD34+ cells. Nevertheless, at ≥40 preapheresis CD34+ cells per μL, sufficient hematopoietic autografts of ≥2.5 × 106 CD34+ cells per kg were harvested by a single conventional‐volume (11 L) leukapheresis on both cell separators.
HLA class II antibodies in transfusion‐related acute lung injury
Authors: Kopko Patricia M. , Popovsky Mark A. , MacKenzie Malcolm R. , Paglieroni Teresa G. , Muto Kathryn N. , Holland Paul V.
Published: March 2003

BACKGROUND: Transfusion‐related acute lung injury (TRALI) is a serious, sometimes fatal, complication of transfusion. Granulocyte and HLA class I antibodies present in blood donors have been associated with TRALI. HLA class II antibodies have recently been described in a few cases of TRALI.

STUDY DESIGN AND METHODS: Donors involved in TRALI reactions reported to a blood center over an 18‐month period were tested for HLA class I and II antibodies as well as granulocyte antibodies, if HLA antibodies were not identified.

RESULTS: HLA class II antibodies were identified, in at least one donor, in 7 (64%) of 11 cases of TRALI. HLA class I antibodies were identified in combination with HLA class II antibodies in 5 of these 7 cases. HLA class I antibodies were exclusively identified in 2 cases. Granuloctye antibodies were identified in 1 case, and no antibodies were identified in another.

CONCLUSION: In addition to HLA class I antibodies, HLA class II antibodies are associated with TRALI. Testing of donors for HLA class II antibodies as well as HLA class I and granulocyte antibodies is recommended as part of the investigation of suspected cases of TRALI.
Multicenter evaluation of PCR methods fordetecting CMV DNA in blood donors
Authors: Roback John D. , Hillyer Christopher D. , Drew W. Lawrence , Laycock Megan E. , Luka Janos , Mocarski Edward S. , Slobedman Barry , Smith James W. , Soderberg‐Naucler Cecilia , Todd Deborah S. , Woxenius Susanne , Busch Michael P.
Published: March 2003

BACKGROUND: CMV DNA screening may be a useful adjunct to serologic tests in distinguishing potentially infectious blood donations from those that are “CMV‐safe.” However, there is currently no consensus on the optimal assay method for accurate detection of CMV DNA in donors.

STUDY DESIGN AND METHODS: A blinded multicenter evaluation of seven CMV PCR assays was performed by five laboratories by using coded sets of analytical controls and donor blood samples.

RESULTS: Five assays displayed sufficient sensitivity for donor screening, as judged by consistent detection of a minimum of 25 CMV genome equivalents (geq) in analytical controls constructed to contain from 1 to 100 CMV geq in background DNA from 250,000 cells, while the other two assays displayed inadequate sensitivity. Three sensitive assays, two based on nested PCR directed at the UL93 and UL32 regions of the CMV genome and another test (Monitor Assay, Roche), did not detect CMV DNA in samples from any of 20 pedigreed CMV‐seronegative, Western blot‐negative (S–/WB–) donors. Two other assays based on nested PCR occasionally detected CMV DNA in S–WB– samples, and one sensitive nested PCR assay directed at UL123 detected CMV DNA in a large proportion (85%) of S–WB– samples.

CONCLUSION: Seven CMV PCR assays currently used for research and/or diagnostic applications displayed marked variations in sensitivity, specificity, and reproducibility when applied to coded analytical and clinical control samples containing cellular DNA from the equivalent of 250,000 WBCs. These results will be useful in the selection of assays with performance characteristics appropriate to donor screening objectives. They may also help explain discrepant findings from previous studies that used PCR to determine CMV DNA prevalence in seronegative and seropositive blood donors.
Arterial puncture phlebotomy in whole‐blood donors
Authors: Newman Bruce H.
Published: March 2003

BACKGROUND: An arterial puncture during whole‐blood phlebotomy is a rare event. A series of arterial punctures was evaluated to determine the clinical findings and the incidence of complications.

STUDY DESIGN AND METHODS: Arterial punctures reported by staff between January 1, 1999, and February 28, 2001, were evaluated. Follow‐up interviews were done with the phlebotomy nurses to determine what the clinical findings were and what the incidence of complications was.

RESULTS: Twelve cases of arterial punctures were identified from 410,000 blood donations (0.0029%; 1/34,000). Eleven cases had a fast blood‐flow rate of <4 minutes; 9 units (75%) were bright red; and in 4 cases (33%), the needle was pulsating. One case was diagnosed because the donor developed a brachial artery pseudoaneurysm 3 days after donation. Four hematomas occurred, for an occurence rate of 33 percent (0.35% in the general donor population). There was also an association with newly trained staff.

CONCLUSION: Fast blood‐flow rate is the most common clinical feature after an arterial puncture. Bright red blood is usually, but not always, present, and a pulsating needle is sometimes present. Hematoma is a relatively common complication, and brachial artery pseudoaneurysms are rare, although one case was seen in this study.
Exposure to allogeneic plasma and risk of postoperative pneumonia and/or wound infection in coronary artery bypass graft surgery
Authors: Vamvakas Eleftherios C. , Carven Joan H.
Published: March 2003

BACKGROUND: A relationship may exist between the immunomodulatory effects of allogeneic blood transfusion and the volume of transfused allogeneic plasma and/or the number of transfused plasma‐containing units.

STUDY DESIGN AND METHODS: The records of 416 consecutive patients undergoing coronary artery bypass graft operations at the Massachusetts General Hospital were reviewed. Exposure to allogeneic plasma in units of transfused RBCs, platelets, FFP, and cryoprecipitate was recorded, and diagnoses of postoperative pneumonia and wound infection were made by CDC criteria. The association between postoperative infection and exposure to allogeneic plasma was calculated by logistic regression analyses adjusting for the effects of confounding factors that related to severity of illness, difficulty of operation, and risk of postoperative pneumonia.

RESULTS: Two hundred seventy‐four patients received (mean ± SE) 636.2 ± 64.3 mL of allogeneic plasma, contained in 8.5 ± 0.7 units of blood components. Sixty‐four patients (15.4%) developed pneumonia and/or wound infection, and 54 (13.0%) developed pneumonia. Patients who did (n = 64) or did not develop infection received 956.6 ± 180.6 and 321.3 ± 39.6 mL of plasma, respectively (p<0.0001). In multivariate analyses, the volume of transfused allogeneic plasma was not associated with postoperative pneumonia and/or wound infection (p = 0.24), pneumonia (p = 0.21), or wound infection (p = 0.74). Similarly, the number of transfused plasma‐containing units was not associated with these outcomes (p = 0.08, p = 0.08, and p = 0.46, respectively).

CONCLUSION: A relationship between the exposure to allogeneic plasma and the risk of postoperative pneumonia and/or wound infection was not detected in this study population.
Prevalence of circulating Treponema pallidum DNA and RNA in blood donors with confirmed‐positive syphilis tests
Authors: Orton Sharyn L. , Liu Hsi , Dodd Roger Y. , Williams Alan E. ,   ARCNET Epidemiology Group
Published: March 2003

BACKGROUND: Although there have been no well‐documented cases of transfusion‐transmitted syphilis in more than 30 years, serologic tests for syphilis (STS) continues to be required for donated blood. Previously, the methods for detecting viable spirochetes were dependent on the use of the rabbit infectivity test. DNA PCR and RNA RT‐PCR were applied to assess the presence of Treponema pallidum DNA or RNA in blood donors with confirmed‐positive results in STS.

STUDY DESIGN AND METHODS: This case series describes T. pallidum DNA and RNA testing of platelet concentrates prepared from blood donors with reactive results in an automated treponemal screening test and positive test results in the fluorescent treponomal antibody absorption test. The first DNA test was specific for the T. palladium polA gene. The second DNA test was a multiplex PCR using a T. pallidum 47‐kDa gene target. The RT‐PCR for RNA used T. pallidum 16S rRNA as a template for production of a cDNA target.

RESULTS: One hundred sixty‐nine samples (including rapid plasma reagin [RPR]+ and RPR–) tested for T. pallidum DNA and/or RNA were negative.

CONCLUSIONS: A lack of demonstrable T. pallidum DNA or RNA suggests that blood donors with confirmed‐positive results in STS are unlikely to have circulating T. pallidum in their blood and that that their blood is unlikely to be infectious for syphilis.
Detecting bacteria in platelet concentrates by use of reagent strips
Authors: Werch J.B. , Mhawech Paulette , Stager C.E. , Banez E.I. , Lichtiger Benjamin
Published: March 2003

BACKGROUND : Iatrogenic infection of immunosuppressed or immunocompromised hosts secondary to receipt of blood components containing bacteria may result in serious adverse outcomes. Measurement of pH and glucose by use of inexpensive reagent strips has been proposed as a practical means of screening for bacteria in platelet concentrate (PC) units.

STUDY DESIGN AND METHODS : Glucose and pH were measured in 3093 PC units by use of reagent strips (Multistix, Bayer Corp.) to screen for bacterial content. Any PC classified by the reagent strip method as containing bacteria was subsequently cultured to confirm the presence and quantity of bacteria present.

RESULTS
: Thirty of 3093 PC units were classified as containing bacteria by the reagent strip method. Two of the 30 PC units positive by the reagent strip method were also positive by standard bacterial culture technique.

Bacillus cereus
was isolated from both units.

CONCLUSION
: Screening PC units by the reagent strip method resulted in 9.7 units per 1000 being wasted, but prevented two patients from receiving a PC unit containing

B. cereus.
Hemovigilance network in France: organization and analysis of immediate transfusion incident reports from 1994 to 1998
Authors: Andreu Georges , Morel Pascal , Forestier François , Debeir Joëlle , Rebibo Danielle , Janvier Gérard , Hervé Patrick
Published: March 2003

BACKGROUND : Hemovigilance networks have been introduced in several countries to improve knowledge of blood transfusion‐related morbidity and mortality. The general organization of the French network and its results from 1994 through March 1999 are presented here.

STUDY DESIGN AND METHODS : The hemovigilance network relies on blood transfusion centers and hospital correspondents, who analyze unexpected and untoward blood transfusion‐related effects and transmit a Transfusion Incident Report (TIR) to a national database (Transfusion Incident Reports Electronic Data Management [GIFIT]).

RESULTS : As of March 1, 1999, the GIFIT database contained 24,234 TIRs related to incidents that occurred from the start of the hemovigilance network until December 31, 1998. The network was not fully implemented until 1996; but the reporting rate seems to have since stabilized at approximately 7000 per year (2.5 reports per 1000 blood components). The highest reporting rate is observed with platelet concentrates (4.02/1000), followed by RBCs (1.71/1000) and FFP (0.34/1000). Bacterial contamination quickly appeared as a major cause of morbidity and mortality (185 cases and 18 fatalities). However, a general trend of reduction in this type of incident was observed over time, which can be attributed to adoption of several preventive measures. In contrast, major ABO mismatchings during RBC transfusion remained at a constant rate throughout this period and accounted for six fatalities. After the implementation of universal WBC reduction, some incidents known to be related to WBCs, such as nonhemolytic febrile transfusion reactions (NHFTR) and HLA immunization, were dramatically reduced.

CONCLUSION : Hemovigilance is an important tool not only to analyze blood transfusion incidents, but also to measure the effects of new processes or corrective actions at a national level.
Profound ionized hypomagnesemia induced by therapeutic plasma exchange in liver failure patients
Authors: Kamochi Masayuki , Aibara Keiji , Nakata Koichi , Murakami Masahiro , Nandate Koichiro , Sakamoto Hisahiro , Sata Takeyoshi , Shigematsu Akio
Published: March 2003

BACKGROUND
: Various adverse effects, including cardiac arrest, have been induced by plasma exchange (PE). Electrolyte derangement is frequently observed. The purpose of this study was to assess the effect of PE on the serum ionized magnesium (Mg
2+ ) concentration in acute liver failure patients.

STUDY DESIGN AND METHODS
: Seven liver failure patients requiring PE were enrolled in this study. PE was performed 21 times in total. Blood samples were drawn before PE and serially after the start of the PE. Serum Mg
2+ was measured by the ion‐ selective electrode method.

RESULTS
: After PE was started, Mg
2+
concentrations began to fall significantly. The low Mg
2+
blood concentration continued during PE. After PE, the Mg
2+
level recovered to about 80 percent of the control value within 2 hours in six patients. However, in one patient, the Mg
2+ concentration was still low even at 2 hours after PE. This patient complained of chest discomfort during PE and ECG analysis showed sporadic supraventricular premature contractions.

CONCLUSION : Profound ionized hypomagnesemia was induced by PE in liver failure patients.
Residual WBC subsets in filtered prestorage RBCs
Authors: Ariga Hiromichi , Lee Tzong‐Hae , Laycock Megan E. , Mohr Beth A. , Kalish Leslie A. , Yomtovian Roslyn , Gernsheimer Terry , Busch Michael P. ,   Viral Activation Transfusion Study
Published: March 2003

BACKGROUND : New‐generation RBC filters reduce WBC concentrations by 4 to 5 logs and may prevent or decrease transfusion complications such as HLA alloimmunization, nonhemolytic febrile reaction, and transfusion‐transmitted infections. The residual level of WBC subsets may influence efficacy of WBC reduction for preventing various complications. This study analyzed subsets of residual WBCs in WBC‐reduced RBC components prepared for a large, multicenter prospective study.

STUDY DESIGN AND METHODS : The Viral Activation Transfusion Study (VATS) assessed the impact of WBC reduction in HIV‐1‐infected patients undergoing RBC transfusion. WBC‐reduced RBC from 11 clinical sites with variable filtration practices were sorted into “low,”“middle,” and “high” groups based on residual WBC concentration. Subsets were isolated from units by immunocapture (anti‐CD4‐, anti‐CD8‐, anti‐CD15‐, and anti‐CD19‐coated magnetic beads) and quantified by PCR amplification.

RESULTS : After validation studies confirming test methodology, 105 VATS WBC‐reduced RBC samples were analyzed. Concentrations of subsets in low and middle residual WBC groups were very low in contrast to relatively high concentrations in the high group. Although highly significant differences were identified between the middle and high groups for total WBCs and all subsets, no single subset predominated.

CONCLUSION : These results suggest that overall efficacy of WBC filtration correlates with removal of WBC subsets.
Trehalose ameliorates the cryopreservation of cord blood in a preclinical system and increases the recovery of CFUs, long‐term culture‐initiating cells, and nonobese diabetic‐SCID repopulating cells
Authors: Zhang Xiao Bing , Li Karen , Yau Kwai Heung , Tsang Kam Sze , Fok Tai Fai , Li Chi Kong , Lee Shuk Man , Yuen Patrick Man Pan
Published: March 2003

BACKGROUND : The cryopreservation of HPCs in DMSO has been practiced by cord blood (CB) banks worldwide. Inevitably, some detriment to biologic function occurs as the result of freezing injuries and DMSO toxicity. Trehalose, a disaccharide, is a natural cryoprotectant in organisms capable of surviving extreme dehydration and cold. The objective of this study was to establish the cryopreservation of CB under preclinical conditions using trehalose as a supplement to DMSO.

STUDY DESIGN AND METHODS : In a preclinical protocol, the effects of 5‐percent trehalose with 10‐percent DMSO or 5‐percent DMSO on the cryopreservation of CB MNCs or nucleated cells (NCs) were further evaluated. The read‐out system consisted of a panel of HPCs: early progenitors (CFU‐GEMM, long‐term culture‐initiating cells [LTC‐IC]) and committed progenitors (CFU‐GM, CFU/BFU‐E, CFU‐megakaryocyte [CFU‐MK]). The homing and engraftment capacity of these cells were assessed in nonobese diabetic (NOD)‐SCID mice.

RESULTS : Trehalose increased the recoveries of CFU‐GM, CFU/BFU‐E, CFU‐GEMM, and LTC‐IC by over 7.25 percent (mean), 11.9 percent, 19.2 percent, and 12.9 percent, respectively, when compared with those in paired CB samples cryopreserved in 10‐percent DMSO. Freezing and thawing reduced the yields of CFU‐MK by 35.5 percent (mean) and 28.4 percent in MNC and NC samples, respectively, and the inclusion of 5‐percent trehalose significantly retrieved these progenitor cells to over 90 percent of fresh samples. The improved recovery of functional HPLs was reflected by their multilineage engraftment in NOD‐SCID mice.

CONCLUSION : Trehalose at 5 percent significantly ameliorates the cryopreservation of CB progenitor cells at a preclinical protocol. The increased recoveries of these cells might potentially improve the engraftment outcomes of CB transplants.
The Insistent Fringe: Moving Images and Historical Consciousness
Authors: Sobchack Vivian
Published: March 2003

Using the form of cinematic montage, this essay explores the nature of historical consciousness in a mass‐mediated culture where historical discourse takes the form of both showing and saying, moving images and written words. The title draws upon and argues with Roland Barthes's critique of the duplicity of the “insistent fringes” that supposedly reduce and naturalize “Roman‐ness” to fringed hair in popular historical film. Barthes presumes a “certainty” in such a cinematic image, and hence deems it mythological—that is, “it goes without saying.” Countering Barthes with Walter Benjamin, one might argue that the “insistent fringe” is insistently historical and constitutes, in its insistence, a “dialectical image”: a site and sight full of contradictions and open to excavation. That is, it concretizes historiographic saying by showing. Neither historiographic saying nor showing are privileged in medias res—in a culture saturated in images and textuality, in competing modes of expression each of which has its limits. Historical consciousness is sparked and constituted from both showing and saying. Indeed, the “insistent fringe” is precisely not clear‐cut—and, if it insists on anything, it is its serrated nature, its articulation as a limit that differs from, but is constituted by, the elements of the two distinct domains which it both separates and connects. Similarly, there is a dynamic, functional, and hardly clear‐cut relation that exists between the mythological histories wrought by Hollywood cinema (and other visual arts) and the academic histories written by scholars. They coexist, compete, and cooperate in a contingent, heteroglossic, and always shifting ratio—thus constituting the “rationality” of contemporary historical consciousness.
Structure and Agency in the Holocaust: Daniel J. Goldhagen and His Critics
Authors: Moses A. D.
Published: March 2003

A striking aspect of the so‐called “Goldhagen debate” hasbeen the bifurcated reception Hitler's Willing Executioners hasreceived: the enthusiastic welcome of journalists and the public was as warm as the impatientdismissal of most historians was cool. This article seeks to transcend the current impasse byanalyzing the underlying issues of Holocaust research at stake here. It argues that a “deepstructure” necessarily characterizes the historiography of the Holocaust, comprising atension between its positioning in “univeralism” and“particularism” narratives. While the former conceptualizes the Holocaust as anabstract human tragedy and explains its occurrence in terms of processes common to modernsocieties, the latter casts its analysis in ethnic and national categories: the Holocaust as anexclusively German and Jewish affair. These narratives possess important implications for thebalance of structure and human agency in the explanation of the Holocaust: where theuniversalism narrative emphasizes the role of impersonal structures in mediating human action,the particularism narrative highlights the agency of human actors. Although historical accountsusually combine these narratives, recent research on the Holocaust tends in the universalistdirection, and this bears on the sensitive issue of responsibility for the Holocaust byproblematizing the common‐sense notion of the perpetrators' intention and responsibility.Goldhagen is responding to this trend, but by retreating to the particularism narrative andemploying an inadequate definition of intention, he fails to move the debate forward. It is time torethink the concept of intention in relation to events like the Holocaust.
Reconstructing Culture in Historical Explanation: Narratives as Cultural Structure and Practice
Authors: Kane Anne
Published: March 2003

The problem of how to access and deploy the explanatory power of culture in historical accounts has long remained vexing. A recent approach, combining and transcending the “culture as structure”/“culture as practice” divide among social historians, puts explanatory focus on the recursivity of meaning, agency, and structure in historical transformation. This article argues that meaning construction is at the nexus of culture, social structure, and social action, and must be the explicit target of investigation into the cultural dimension of historical explanation. Through an empirical analysis of political alliance during the Irish Land War, 1879–1882, I demonstrate that historians can uncover meaning construction by analyzing the symbolic structures and practices of narrative discourse.
On Language, Culture, and Social Action
Authors: Cabrera Miguel A.
Published: March 2003

This article outlines the theoretical developments experienced in historical studies over the last two decades. As a consequence of the growing critical reconsideration of some of the main theoretical assumptions underlying historical explanation of individuals’ meaningful actions, a new theory of society has taken shape among historians during this time. By emphasizing the empirical and analytical distinction between language as a pattern of meanings and language as a means of communication, a significant group of historians has thoroughly recast the conventional notions of society, experience, interests, culture, and identity, and has developed a new concept of social action. Thus, historiographical debate seems to have started to transcend, for the first time, the longstanding and increasingly futile contest or dilemma between objectivism and subjectivism, between materialism and culturalism, between social and intentional explanation, or between social constraints and human agency. The groundwork has now been laid for an alternative to the declining paradigm of social history that does not entail a revisionist return (be it partial or complete) to idealist history but opens a quite different path.
Being Hegelian after Danto
Authors: Hilmer Brigitte
Published: March 2003

In this article I will discuss some systematic issues of Arthur Danto's philosophy of art and art history from a Hegelian perspective. Belonging to “Absolute Spirit,” art can be called a “spiritual kind.” Since spiritual kinds are reflective and self‐determining, they are not susceptible to philosophical definition. Nevertheless, elements of essentialism can be maintained when describing art's historicity and conceptual structure. To this end, “art” can be interpreted as a two‐tier concept: in inherently reflecting its concept, it projects its own conditions into the past, co‐opting “prehistorical” artworks as predecessors and classical examples. Hegel's view of art as conceptually structured in itself can have disenfranchising or reenfranchising consequences: either reducing art to minor philosophy, or acknowledging its privileged access to its own essence. After Danto's detachment of the philosophy of art from aesthetics, Hegel would himself be deprived of the possibility to “define” art by intuition (Anschauung). Even if the spirit consists of essential kinds, philosophy is not in a privileged position to establish the essence of art and thus the difference between art and philosophy. Rather, philosophy must acknowledge art as a neighbor (Heidegger) and as partner in a dialogue.
Why No Shop Committees in America: A Narrative History
Authors: Brody David
Published: March 2003

This article explores the origins of the prohibition against shop committees in modern labor law. It identifies World War I as the crystallizing moment and argues that shop committees might have become a permanent feature of American industrial relations at that time but for a series of contingent events arising in particular from the great steel strike of 1919. Historians have missed this linkage, the article concludes, because in the intervening 1920s, employee representation became disassociated from industrial democracy, with the notable exception of the railroads, where blatantly antiunion use of employee representation prompted the judicial condemnation of employer domination of labor organizations that provided the doctrinal foundation for Section 8a(2) of the National Labor Relations Act.
Two Routes to Team Production: Saturn and Chrysler Compared
Authors: Shaiken Harley , Lopez Steven , Mankita Isaac
Published: March 2003

This article explores two examples of new approaches to work organization with experienced workers in a unionized setting: General Motors' (GM's) Saturn Corporation and Chrysler's Jefferson North plant. Both represent variations of "team" production which differ markedly from stereotypical portraits of lean production. The article argues that the presence or absence of teams is less important than the manner in which they are integrated into the production process.
Religious Market Share and Intensity of Church Involvement in Five Denominations
Authors: Perl Paul , Olson Daniel V.A.
Published: March 2003

Proponents of the supply side approach to religion theorize that religious market share—the proportion of people in a geographical area who belong to a given denomination—is inversely related to religious commitment in that denomination. They argue that a small market share motivates religious leaders to compete harder in the religious market place, increasing the participation of members. Another perspective, often associated with secularization theory, make the opposite prediction. It argues that people find it difficult to remain religiously committed in social environments where they are numerical minoritiesbecause other people do not reinforce their beliefs and practices. We use data from a large study of financial giving to analyze the relationship between market share and commitment for five denominations in the United States. We find that market share has a negative effect on church financial giving within all five denominations and a weaker negative effect on attendance in threeof the denominations. We explore whether these effects are the spurious byproducts of pro‐religious cultural norms associated with either the South or the presence of conservative Protestants in local areas. In models pooling all denominations, the negative effect of market share on financial giving and attendance cannot be explained away by either of these factors. However, the effect on attendance can be accounted for by congregational size.
The Supply‐Side Model of Religion: The Nordic and Baltic States
Authors: Bruce Steve
Published: March 2003

The paper uses the fortunes of religion in the Nordic and Baltic States to identify weakness s in the supply‐side model of religious behaviour promoted by Stark, Finke and Iannaccone. Changes in religious observance in the Nordic countries over the twentieth century, and comparisons between them, contradict a number of supply‐side propositions. Comparisons between the Baltic states similarly show no support for supply‐side claims. Instead both clusters suggest that the fate of religion owes more to its links with ethnicity, national consciousness and national conflict and to the theology and ecclesiology of the religion in question than to issues of state regulation.
‘To Whom Much Has Been Given...’: Religious Capital and Community Voluntarism Among Churchgoing Protestants
Authors: Park Jerry Z. , Smith Christian
Published: March 2003

Research on volunteering behavior has consistently found a positive relationship between religion and volunteering. Using a sample of churchgoing Protestants (N=1,738)from the Religious Identity and Influence Survey we examine the specific influences of religiosity, religious identity, religious socialization, and religious social networks on local volunteer activity in church programs and non‐church organizations, as well as general volunteering tendencies. These influences are presented within the theoretical framework of religious capital. Logistic regression techniques were applied to determine the strength of the contribution of these influences while accounting for basic background factors. Findings suggest that churchgoing Protestants are influenced by all measures to some degree, but religiosity (specifically participation in church activities) remains the strongest influence. Significant religious influences overall are most pronounced within the context of church‐related volunteering which suggests that churchgoing Protestants exhibit a strong sense of community identity through their local churches. A discussion of these results and their implications for volunteering follows.
Changing Attitude and Moral Obligation: Their Independent Effects on Behavior
Authors: Ortberg John C. , Gorsuch Richard L. , Kim Grace J.
Published: March 2003

It was hypothesized that the study of religion should distinguish between attitudes and religious values/moral obligations such that both aid in predicting religiously relevant behavior and changing either will change behavior. However, if they are distinct, then changing one will not necessarily change the other. For the 195 religious participants, attitudes predicted a church‐sponsored blood donation and moral obligations increased that prediction. Using both posttest only and pre‐post control group designs, an intervention to shift the effect underlying the attitude increased participants' attitude and donating behavior while a religious values intervention increased moral obligations and behavior. Zero to 4 percent of the control groups donated blood, while 13 to 48 percent of the intervention groups donated blood. Results confirm that psychology of religion should distinguish moral obligations from attitude because (1) additional prediction, (2) changing one does not necessarily change the other, and (3) changes based on religious values impact moral obligations.