bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lack of transmission of TT virus through immunoglobulins
Authors: Azzari Chiara , Resti Massimo , Moriondo Maria , Gambineri Eleonora , Rossi Maria Elisabetta , Novembre Elio , Vierucci Alberto 
Published: March 2003

BACKGROUND: A high prevalence of TT virus (TTV) infection has been found in patients who received blood or blood components. Viral DNA was demonstrated in commercial preparations of FVIII and F IX, but very few data have been reported on immunoglobulins. The risk of TTV infection associated with intramuscular or IV immunoglobulin administration is unclear.STUDY DESIGN AND METHODS: The prevalence of TTV infection in a group of patients undergoing lifelong therapy because of congenital immunodeficiency has been evaluated in a long term follow‐up (median, 6 years). Seventeen patients with congenital immunodeficiency receiving monthly administration of IVIG were included in the study. TTV DNA was repeatedly evaluated by PCR in serum samples from each patient during the follow‐up. Research of antibodies against TTV was not applicable, as the patients studied were unable to produce antibodies. The presence of TTV was also evaluated in 15 IVIG lots.RESULTS: The total amount of immunoglobulin administered was 18,773 g. TTV infection was not found in any patients included in the study. None of the 15 immunoglobulin preparations analyzed was found positive for TTV DNA.CONCLUSION: Despite the high prevalence of TTV in blood donors, commercial immunoglobulins are safe and unable to transmit TTV.
Processing of peripheral blood progenitor cell components in improved clean areas does not reduce the rate of microbial contamination
Authors: Cassens Uwe , Ahlke Christoph , Garritsen Henk , Krakowitzky Petra , Wüllenweber Jörg , Fischer Rudolf‐Josef , Peters Georg , Sibrowski Walter 
Published: March 2003

BACKGROUND: Microbial contamination of peripheral blood progenitor cell components (PBPCs) may cause severe complications in immunosuppressed recipients. Therefore, principles of Good Manufacturing Practice (GMP) are applicable for processing of PBPC components to reduce potential risks of contamination. STUDY DESIGN AND METHODS: It was investigated in a retrospective study whether the microbial contamination of PBPC components could be reduced after processing in improved clean areas according to the “Manufacture of Sterile Medicinal Products.” Starting in 1994, a total of 1478 autologous and allogeneic PBPC components have been collected and processed into 3149 cryopreservation bags at the Department of Transfusion Medicine. Sterility testing was performed for all bags. Until December 1998, 783 PBPC components were processed at a clean bench only (group I). Thereafter, 695 PBPC components have been processed at a clean bench located in a clean area with an airlock system for personnel and equipment (group II). RESULTS: In group I, 16 of 1555 bags (1.03%) showed positive results in the first sterility testing. In group II, 21 of 1594 bags (1.32%) were positive (p = NS). The clinical follow‐up was inconspicuous. CONCLUSION: Microbial contamination of PBPC components could not be reduced by installation of improved clean area conditions.
Volume of RBCs, 24‐ and 48‐hour posttransfusion survivals, and the lifespan of 51Cr and biotin‐X‐N‐hydroxysuccinimide (NHS)‐labeled autologous baboon RBCs: effect of the anticoagulant and blood pH on 51Cr and biotin‐X‐NHS elution in vivo
Authors: Valeri C. Robert , Pivacek Linda E. , Cassidy George P. , Ragno Gina 
Published: March 2003

BACKGROUND: The RBC injury that occurs during collection of the first few milliliters of blood into the pH 5.0 ACD (NIH, Formula A) is referred to as the lesion of collection. The RBC injury was evaluated by labeling the ACD RBCs with 51Cr and measuring the 24‐hour posttransfusion survival. The effect of the acidification of ACD blood on the in vivo elution of 51Cr from the RBC has not been reported. STUDY DESIGN AND METHODS: Baboon blood was collected in heparin and in ACD and CP2D at different ratios of blood to anticoagulant. ACD blood with a pH of 5.7 to 6.9 was labeled with 51Cr. Heparinized blood with a pH of 7.4 was labeled with biotin‐X‐N‐hydroxysuccinimide (NHS). ACD blood with a pH of 5.9 was labeled with both 51Cr and biotin‐X‐NHS. The RBC volumes, 24‐ and 48‐hour posttransfusion survivals, and lifespans (T50) were measured. RESULTS: The RBC volume of ACD blood with a pH ranging from 5.7 to 6.9 was not affected by 51Cr labeling. 51Cr‐labeled ACD blood with a pH of 6.9 had an RBC volume that was significantly greater than that seen in heparinized blood with a pH of 7.4 labeled with biotin‐X‐NHS. In vivo elution of 51Cr from the RBCs prepared from the ACD blood with a pH of 5.7 to 6.9 and in vivo elution of biotin‐X‐NHS from RBCs prepared from ACD blood with a pH of 5.9 were associated with reductions in 24‐ and 48‐hour posttransfusion survivals and T50. CONCLUSIONS:The anticoagulant and the pH of the medium in which the RBCs were labeled with 51Cr or biotin‐X‐NHS affected in vivo elution of the label from the RBCs and may reduce posttransfusion survival values.
Evaluation of a new generation of culture bottle using an automated bacterial culture system for detecting nine common contaminating organisms found in platelet components
Authors: Brecher M.E. , Heath D.G. , Hay S.N. , Rothenberg S.J. , Stutzman L.C. 
Published: March 2003

BACKGROUND : An automated bacterial culture system (BacT/ALERT 3D, bioMérieux) has been previously validated with a variety of bacteria in platelets. The recovery of bacteria in platelets using a new generation of culture bottles that do not require venting and that use a liquid emulsion sensor was studied. STUDY DESIGN AND METHODS
:
Bacillus cereus, Enterobacter cloacae, Escherichia coli, Klebsiella oxytoca, Staphylococcus aureus, Staphylococcus epidermidis, Serratia marcescens, Streptococcus viridans,
and
Propionibacterium acnes isolates were inoculated into Day 2 platelets to concentrations of 10 and 100 CFU per mL. Samples were then studied with current and new aerobic, anaerobic, and pediatric bottles. RESULTS
: All organisms, except
P. acnes,
were detected in a mean time of 9.2 to 20.4 (10 CFU/mL) or 8.7 to 18.6 (100 CFU/mL) hours.
P. acnes was detected in a mean time of 69.2 (10 CFU/mL) or 66.0 (100 CFU/mL) hours. The 10‐fold increase in inoculum was associated with a mean 9.2 percent difference in detection time. The aerobic, anaerobic, and pediatric bottles had a mean difference in detection time (hours) between the current and new bottles of 0.10 (p = 0.61), 0.4 (p = 0.38), and 1.0 (p < 0.001), respectively. CONCLUSION : No difference in detection time between the current and new aerobic and anaerobic bottles was demonstrated. The new pediatric bottles had a small but significant delay in detection.
The band III ligand dipyridamole protects human RBCs during photodynamic treatment while extracellular virus inactivation is not affected
Authors: Besselink G.A.J. , Van Engelenburg F.A.C. , Korsten H.G. , Blokker D.E. , Lagerberg J.W.A. , Brand A. , De Korte D. , Verhoeven A.J. 
Published: March 2003

BACKGROUND : Recently, the potential usefulness of dipyridamole (DIP) in protecting RBCs against the harmful side effects of photodynamic sterilization was demonstrated. In the present study, the use of DIP for selective protection of RBCs was investigated under conditions more relevant for blood bank practice. STUDY DESIGN AND METHODS : WBC‐reduced RBC suspensions (30% Hct) were treated with 1,9‐dimethylmethylene blue and red light, and the influence of the inclusion of DIP on photohemolysis was assessed as a function of sensitizer concentration, light dose, and storage time. Furthermore, the possible interference of DIP with inactivation of extracellular virus by use of a panel of different viruses (HIV‐1, pseudorabies virus [PRV], bovine viral diarrhea virus [BVDV], VSV, encephalomyocarditis, and canine parvovirus) was investigated. RESULTS : In WBC‐reduced RBC suspensions (30% Hct), DIP exerted a clear protective effect against photohemolysis. Part of this protection was achieved with concentrations near the dissociation constant for band III binding. Importantly, efficiency of inactivation of extracellular HIV‐1, PRV, BVDV, and VSV was not significantly impaired by the inclusion of DIP. Phototreatment conditions, resulting in a 4 to 5 log inactivation of extracellular HIV‐1 and PRV, resulted in a high level of hemolysis after 28 days of storage. This long‐term hemolysis could be decreased, but not completely prevented, by the inclusion of DIP. CONCLUSION : Photohemolysis in RBC concentrates can be reduced substantially by the application of DIP, while the efficacy of inactivation of HIV‐1 and other viruses remains unchanged.
The role of the paternal health history in cord blood banking
Authors: Askari Sabeen , Miller John , Clay Mary , Moran Sheila , Chrysler Gayl , McCullough Jeffrey 
Published: March 2003

BACKGROUND : Umbilical cord blood (UCB) transplantation is becoming more widely used, yet ethical and policy issues regarding consent and health history persist. Whereas most UCB banks do not require paternal consent or paternal health history (PHH), both are obtained at this institution whenever possible. This study assessed the value of PHH in making UCB safer. STUDY DESIGN AND METHODS : A retrospective review was performed of all cord blood units (CBUs) collected by this bank between November 1999 and October 2000. All discarded CBUs were studied to identify those deferred based exclusively on PHH provided by the father in the PHH questionnaire. RESULTS : PHH was obtained for 301 of 655 (46%) CBUs collected. Of the 339 CBUs banked, 269 (79%) had PHH available. Three of the 301 CBUs in which PHH was available were discarded based solely on PHH, since maternal medical history and infectious disease testing were negative. Paternal high‐risk factors in those three cases were: gave money or drugs for sex; traveled to an HIV high‐risk area; and did not answer high‐risk questions. CONCLUSION : Considerable time and effort is expended in the process and follow‐up of obtaining PHH with an overall indistinct and unconvincing role in minimizing infectious disease transmission risk in UCB banking.
Improved efficiency of national HIV, HCV, and HTLV antibody testing algorithms based on sequential screening immunoassays
Authors: Seed Clive R. , Margaritis Angelo R. , Bolton Wayne V. , Kiely Philip , Parker Susan , Piscitelli Lisa ,   Virology Subcommittee of the National Donor and Product Safety Committee, Australian Red Cross Blood Service
Published: March 2003

BACKGROUND : Traditional strategies for clarifying the antibody status of donors giving repeatedly reactive (RR) results on primary screening immunoassays (IA1) have usually involved direct testing by immunoblot. However, such strategies can generate nonspecific in determinate results. The aim of this report is to present the results of an alternative strategy based on the use of sequential immunoassays (SI) before immunoblot testing. STUDY DESIGN AND METHODS : The efficiency of traditional and SI strategies was compared in terms of the number of IA1 RR samples requiring immunoblot testing and the percentage of immunoblot tests giving indeterminate results. In addition, the biologic false‐ reactive overlap between the PRISM assays selected as IA1 and candidate secondary screening immuno‐ assays (IA2) was calculated to determine the most efficient IA1/IA2 combinations. RESULTS
: There was a significant decrease in the proportion of IA1 RR samples requiring immunoblot testing under the SI strategy when compared with existing site‐specific strategies for HIV (0.49 vs. 0.08, p
<
0.05), HCV (0.85 vs. 0.42, p
<
0.05), and HTLV (0.69 vs. 0.05, p
< 0.05) algorithms. In addition, there was a significant decrease in the percentage of immunoblot tests giving indeterminate results for HIV and HTLV under the SI strategy. However, there was no significant difference in the proportion of confirmed positive results for HIV, HCV, or HTLV before and after national SI algorithm implementation. For the anti‐HIV IA2s, there was considerable variation of biologic false‐reactive overlap with the PRISM HIV O plus chemiluminescent immunoassay (range, 1.6‐15.6%). CONCLUSIONS : The results presented in this report demonstrate that the sequential use of screening immunoassays before immunoblot testing can significantly reduce both the number of immunoblot tests and proportion of indeterminate results, without impacting sensitivity, thereby improving algorithm efficiency and simplifying donor management.
Task Performance in Stapedotomy: Comparison Between Surgeons of Different Experience Levels
Authors: Rothbaum Daniel L. , Roy Jaydeep , Hager Gregory D. , Taylor Russell H. , Whitcomb Louis L. , Francis Howard W. , Niparko John K. 
Published: February 2003

OBJECTIVESTwo steps in stapedotomy are particularly challenging: (1) micropick fenestration of the stapes footplate (SF) and (2) crimping of the stapes prosthesis (SP) to the incus. We conducted trials to determine if experience correlates with differences in performance for these tasks.METHODSIn a surgical model of stapedotomy, performance was measured for 3 experienced and 3 novice surgeons. For fenestration, we measured ability to target the fenestration and force applied to the SF. For crimping, we measured crimp quality, movement of the SP during crimping, and force applied to the SF.RESULTSExperienced surgeons demonstrated significantly better ability to target the fenestration and, during crimping, caused less SP movement and a significantly lower rate of SP dislodgment.CONCLUSIONSClear differences in task performance are measurable between more and less experienced surgeons during critical steps of stapedotomy.CLINICAL SIGNIFICANCEThe observed differences in task performance may contribute to an understanding of maneuvers that increase the risk of inadequate prosthesis placement and cochlear trauma—factors likely responsible for variable hearing results with strapedotomy.
Complications of Mandibulotomy: Midline Versus Paramidline
Authors: Dai Tsung‐Sung , Hao Sheng‐Po , Chang Kai‐Ping , Pan Whei‐Lin , Yeh Hwey‐Chin , Tsang Ngan‐Ming 
Published: February 2003

OBJECTIVEMandibulotomy is an important surgical approach to oral cavity and oropharynx. The objective of this study was to evaluate the related complications of 2 common mandibulotomies: midline (osteotomy between 2 central incisors) and paramidline (osteotomy between lateral incisor and canine).STUDY DESIGNNinety‐six patients who had cancer in the oral cavity or oropharynx had preoperative evaluation of the mandible with panoramic films. Among them, 42 patients underwent mandibulotomies: midline for 19 patients and paramidline for 23.RESULTSTwenty (47.6%) of 42 patients had mandibulotomy‐related complications, including 9 (21.4%) minor complications and 11 (26.2%) major complications. There were 6 (31.6%) major and 4 (21.1%) minor complications in the midline mandibulotomy and both 5 (21.7%) major and minor complications in the paramidline mandibulotomy.CONCLUSIONThere was no significant difference in the mandibulotomy‐related complication rate between midline and paramidline mandibulotomies. Paramidline mandibulotomy, which preserves the geniohyoid and genioglossus muscles, should be a better function‐preserving operation than midline mandibulotomy.
Image‐Guided Sinus Surgery: Lessons Learned from the First 1000 Cases
Authors: Metson Ralph 
Published: February 2003

OBJECTIVETo study physician utilization and experience with image‐guidance technology for sinus surgery.STUDY DESIGN AND SETTINGRetrospective review of the first 1000 image‐guided sinus operations performed by 42 surgeons at an academic medical center.RESULTSUtilization of image‐guidance systems showed a dramatic increase in both number of cases performed and surgeons who used this equipment (70.6% and 92.8%, respectively) during the first 2 years of its availability. Surgical volume subsequently decreased by a mean of 9.3% per year, whereas the number of surgeons using this technology plateaued. The majority of surgeons continued to perform image‐guided surgery throughout the study period for selected cases. The knowledge base gained from this experience can best be summarized as a series of lessons learned.CONCLUSIONIt is likely that the availability and utilization of image‐guidance systems for sinus surgery will continue to increase in the future. Physicians who learn to use this new technology must do so with an appreciation for both its potential benefits and pitfalls.
Quality of Life for Children with Persistent Sinonasal Symptoms
Authors: Kay David J. , Rosenfeld Richard M. 
Published: February 2003

OBJECTIVEThe goal was to validate the SN‐5 survey as a measure of longitudinal change in health‐related quality of life (HRQoL) for children with persistent sinonasal symptoms.DESIGN AND SETTINGWe conducted a before and after study of 85 children aged 2 to 12 years in a metropolitan pediatric otolaryngology practice. Caregivers completed the SN‐5 survey at entry and at least 4 weeks later. The survey included 5 symptom‐cluster items covering the domains of sinus infection, nasal obstruction, allergy symptoms, emotional distress, and activity limitations.RESULTSGood test‐retest reliability (R = 0.70) was obtained for the overall SN‐5 score and the individual survey items (R ≥ 0.58). The mean baseline SN‐5 score was 3.8 (SD, 1.0) of a maximum of 7.0, with higher scores indicating poorer HRQoL. All SN‐5 items had adequate correlation (R ≥ 0.36) with external constructs. The mean change in SN‐5 score after routine clinical care was 0.88 (SD, 1.19) with an effect size of 0.74 indicating good responsiveness to longitudinal change. The change scores correlated appropriately with changes in related external constructs (R ≥ 0.42).CONCLUSIONSThe SN‐5 is a valid, reliable, and responsive measure of HRQoL for children with persistent sinonasal symptoms, suitable for use in outcomes studies and routine clinical care.
Significance of Empty Sella in Cerebrospinal Fluid Leaks
Authors: Schlosser Rodney J. , Bolger William E. 
Published: February 2003

OBJECTIVEThe role of elevated cerebrospinal fluid (CSF) pressures in the pathophysiology of various CSF leaks is not clear. Empty sella syndrome (ESS) is a radiographic finding that can be associated with elevated CSF pressures and may represent a radiographic indicator of intracranial hypertension. We present our experience with CSF leaks of various causes, the prevalence of ESS in the spontaneous and nonspontaneous categories, and the potential pathophysiology and unique management issues of the spontaneous CSF leak group.METHODSWe conducted a retrospective review of medical records, imaging studies, and surgical treatment of CSF leaks in patients treated by the senior author.RESULTSSixteen patients with spontaneous CSF leaks and 12 patients with nonspontaneous CSF leaks were surgically treated from 1996 through 2002. In the spontaneous group, 15 patients had complete imaging of the sella turcica. Ten had completely empty sellae and 5 had partially empty sellae, for a total of 100% (15 of 15). In the nonspontaneous group, 9 patients had complete imaging of the sella. Only 11% (1 of 9) had a partially empty sella and that was a congenital leak. Comparison of proportions between these 2 groups was significant (P = 0.01). The spontaneous group consisted primarily of obese, middle‐aged females (13 of 16 patients).CONCLUSIONEmpty sella probably represents a sign of elevated intracranial pressure that leads to idiopathic, spontaneous CSF leaks. Spontaneous CSF leaks are strongly associated with the radiographic finding of an empty sella and are more common in obese females, similar to benign intracranial hypertension. This unique population may require more aggressive surgical and medical treatment to prevent recurrent or multiple leaks.
Establishment of Normative Cochlear and Vestibular Measurements to Aid in the Diagnosis of Inner Ear Malformations
Authors: Purcell Derk , Johnson Jacob , Fischbein Nancy , Lalwani Anil K. 
Published: February 2003

OBJECTIVEWe sought to establish normative measurements of the inner ear using computed tomography (CT) of the temporal bone to aid in the diagnosis of inner ear malformations.STUDY DESIGN AND SETTINGProspective measurements of the inner ear structures were made on axial and coronal temporal bone CT scans on 15 patients with normal hearing and 15 patients with sensorineural hearing loss.RESULTSThe vertical height of the cochlea on coronal scan and the size of the central bony island within the lateral semicircular canal on axial scan along with visual inspection identified 7 inner ear abnormalities in 6 patients: 5 cases of lateral semicircular canal dysplasia and 2 cases of cochlear hypoplasia. In contrast, visual inspection alone identified only 4 of the 7 abnormalities.CONCLUSIONS AND SIGNIFICANCERoutine measurement of the cochlear height and bony island of the lateral semicircular canal, in conjunction with visual inspection of CT images, will increase recognition of common inner ear malformations.
The Association between Laryngopharyngeal Sensory Deficits, Pharyngeal Motor Function, and the Prevalence of Aspiration with Thin Liquids
Authors: Setzen Michael , Cohen Manderly A. , Perlman Philip W. , Belafsky Peter C. , Guss Joel , Mattucci Kenneth F. , Ditkoff Michael 
Published: February 2003

OBJECTIVEThe study goal was to evaluate the association among laryngopharyngeal sensory deficits, pharyngeal motor function, and the prevalence of aspiration with thin liquids.STUDY DESIGN AND SETTINGWe conducted a prospective study of 204 consecutive patients undergoing flexible endoscopic evaluation of swallowing with sensory testing and an assessment of pharyngeal motor function (pharyngeal squeeze). Patients were divided into 6 groups depending on the results of sensory and motor testing in the laryngopharynx. Subjects were given 5 mL of thin liquid, and the prevalence of aspiration in each group was compared.RESULTSThe mean age of the entire cohort was 65 years (58% female). The prevalence of aspiration in patients with intact laryngopharyngeal sensation was 2% (3 of 137) in persons with intact pharyngeal motor function and 29% (2 of 7) when pharyngeal motor function was impaired (P < 0.05). The prevalence of aspiration in patients with a moderate decrease in laryngopharyngeal sensation was 0% (0 of 9) in persons with intact pharyngeal motor function and 67% (2 of 3) when pharyngeal motor function was impaired (P < 0.05). The prevalence of aspiration in patients with severely diminished or absent laryngopharyngeal sensation was 15% (5 of 33) in persons with intact pharyngeal motor function and 100% (15 of 15) when pharyngeal motor function was impaired (P < 0.05).CONCLUSIONPatients with severely diminished laryngopharyngeal sensation and pharyngeal motor function are at an extremely high risk of aspirating thin liquids (100%). Moderate sensory deficits only appear to influence the prevalence of thin liquid aspiration in the presence of pharyngeal motor dysfunction. Severe laryngopharyngeal sensory deficits are associated with the aspiration of thin liquids regardless of the integrity of pharyngeal motor function. We assume that all persons with an insensate laryngopharynx aspirate thin liquids until proved otherwise. These results emphasize the relationship between laryngopharyngeal sensation and pharyngeal motor function in the evaluation of patients for suspected aspiration.