bluuebunny/crossref_metadata_2025_split huggingface dataset:
Retrospective Analysis of Blood Transfusion Recipients: Evidence for Post‐Transfusion Hepatitis E
Authors: Arankalle V.A. , Chobe L.P. 
Published: December 2004

Abstract
Background and Objectives:
Of 200 volunteer blood donors we had screened earlier for hepatitis E virus (HEV) RNA, using reverse‐transcription polymerase chain reaction, 3 were positive, raising the possibility of transfusion‐associated hepatitis E in areas endemic for this virus. This retrospective study was to reassess the extent of post‐transfusion hepatitis E among transfusion recipients, investigated in 1982. Materials and Methods: We re‐evaluated 56 recipients followed biweekly for 3 months after transfusion. The controls were 51 normal, healthy persons who gave blood at a 2‐month interval, as well as 412 blood donors from whom blood was taken once in 1982. Results: Of the 56 transfusion recipients, 19 were positive for lgG antibodies against HEV (anti‐HEV) in the pretransfusion sample. Two of the 37 lgG anti‐HEV‐negative recipients seroconverted to lgM and lgG anti‐HEV 5 and 4 weeks after transfusion, 1 with raised serum alanine aminotransferase levels. None showed symptoms of hepatitis. Attempts to detect HEV RNA in transfused blood, from aliquot units stored at −20°C for over 17 years, were not successful. Of the controls, 17 out of 51 were lgG anti‐HEV positive in the initial sample itself. None of the 34 lgG anti‐HEV‐negative controls seroconverted during the 2‐month follow‐up. Of the blood donors, 154 out of 412 were lgG anti‐HEV positive. None of the 412 donors had circulating lgM anti‐HEV antibodies. A significantly higher (p<0.03) proportion of susceptible transfusion recipients were lgM anti‐HEV positive as compared with susceptible blood donors. Conclusion: The results suggest that, in countries where HEV is endemic, the transmission of hepatitis E may be associated with blood transfusion.
Gamma‐Ray‐Irradiated Red Blood Cells Stored in Mannitol‐Adenine‐Phosphate Medium: Rheological Evaluation and Susceptibility to Oxidative Stress
Authors: Cicha Iwona , Suzuki Yoji , Tateishi Norihiko , Shiba Masayuki , Muraoka Masato , Tadokoro Kenji , Maeda Nobuji 
Published: December 2004

Abstract
Background and Objectives:
To evaluate the rheological properties and the oxidative susceptibility of γ‐ray‐irradiated red blood cells (RBCs). Materials and Methods: RBCs in mannitol‐adenine‐phosphate (MAP) medium were irradiated with 35 Gy and stored at 4°C for 4 weeks. The deformability of the RBCs was examined under shear flow in relation to the morphological and biochemical changes. The RBCs were further exposed to 1mM FeSO4 and 5 mM ascorbate to examine the oxidative susceptibility. Results: The RBC deformability was decreased during storage, and the impairment was further enhanced by the irradiation, which promoted cell shrinkage and intracellular hemoglobin condensation accompanying potassium loss. Lipid peroxidation and protein aggregation of the RBC membrane as well as echinocytosis were not enhanced by the irradiation. The exposure to free iron did not stimulate the oxidation of the irradiated RBC membrane. Conclusion: The decreased deformability of γ‐ray‐irradiated RBCs in MAP medium was mainly induced by dehydration due to potassium loss, and the membrane lipids and proteins were stably preserved against oxidative stress.
Variable Leukocyte Composition of Red Blood Cell Concentrates Prepared in Top‐Bottom Systems: Possible Implications for Pre‐Transplant Blood Transfusion
Authors: Weinreich S.S. , Remmerswaal E.B.M. , Laport R. , van Rhenen D.J. , Rombout‐Sastrienkova E. , Smit Sibinga C.T. , Vrielink H. , Boog C.J.P. 
Published: December 2004

Abstract
Background and Objectives:
The beneficial effect of blood transfusion on kidney graft survival requires the presence of leukocytes in the transfusate, but a minimal dose has not been defined, nor has the role of individual leukocyte subsets been investigated. In the Netherlands, a standard pre‐transplant blood transfusion consists of a buffy coat (BC)‐depleted red blood cell concentrate (RBCC) containing a maximum of 1.2 × 109 residual leukocytes per unit. However, leukocyte subset composition is not standardized. Materials and Methods: Using FACS analysis, this study compared the residual leukocyte composition of RBCCs produced by Compomat® and Optipress®, two currently used top‐bottom systems. Results: While the total leukocyte content of the RBCCs was equivalent in both press types (0.5 × 109), the percentage of mononuclear cells (lymphocytes and monocytes) was significantly higher in the Compomat as compared with the Optipress system (p < 0.0001), resulting in significantly higher numbers of transfused T cells, B cells, HLADR‐positive cells, NK cells and stem cells. Conclusions: The leukocyte composition of a pre‐transplant blood transfusion depends on the BC depletion method used; this might differentially affect the tolerizing or immunizing potential of a pre‐transplant blood transfusion.
Transfusion‐Related Acute Lung Injury Associated with Interdonor Incompatibility for the Neutrophil‐Specific Antigen HNA‐1a
Authors: Lucas G. , Rogers S. , Evans R. , Hambley H. , Win N. 
Published: December 2004

Abstract
Background and Objectives:
A patient transfused with two pooled platelet concentrates became breathless. Bilateral infiltrates were seen on chest X‐ray. A diagnosis of transfusion‐related acute lung injury (TRALI) was made. The patient received 100% oxygen and recovered after 5 days. Materials and Methods: Antibody screening, cross‐matching for granulocyte and lymphocyte antibodies and typing for granulocyte antigens was undertaken. Results: The patient typed as HNA‐1b/HNA‐1b. Granulocyte and lymphocyte antibodies were not detected in the patient's serum or in any of the donor sera by cross‐match. In antibody screening against typed panel granulocytes, complement‐fixing anti‐HNA‐1a IgM antibodies were detected in the serum of one femaledonor. Two of the other donors who contributed to the pooled platelet concentrate containing the HNA‐1a IgM antibodies typed as HNA‐1a/HNA‐1b. Conclusion: Anti HNA‐1a IgM antibodies may have formed immune complexes with white cell fragments or soluble FcγRIII from HNA‐1a+ donors in the pooled platelet concentrate and initiated TRALI.
Retrospective Study on Red Cell Usage in Primary Total Knee Replacement Surgery
Authors: Boralessa Hari , Boralessa Harsha , Contreras Marcela , Lang‐Stevenson Andrew , Knowles Sue , Cockburn Hazel 
Published: December 2004

Abstract
Background and Objectives:
There is wide variation in the use of red cell transfusions for the same clinical indication. The purpose of the study was to comment on preoperative and discharge haemoglobin (Hb) levels and perioperative blood loss, and to project the Hb level if transfusions were not administered. Materials and Methods: The case notes of 187 patients who underwent primary total knee replacement were reviewed retrospectively. Results: More than 90% of the transfusions were given in the immediate postoperative period as a matter of routine and a significant number of transfusions appeared to be unnecessary. Conclusion: For surgical procedures involving moderate blood loss, transfusions should not be given as a routine and the decision to transfuse should take into consideration the clinical state of the patient, blood loss and pre‐ and postoperative Hb levels.
Effect of manufacturing process parameters on virus inactivation by solvent–detergent treatment in a high‐purity factor IX concentrate
Authors: Roberts P. L. , Dunkerley C. 
Published: December 2004

Background and Objectives  Treatment with solvent–detergent is widely used for ensuring the virus safety of plasma products. Laboratory studies have shown this procedure to be effective for inactivating enveloped viruses under manufacturing conditions. In the present study, the effect of different manufacturing process parameters on virus inactivation by treatment with polysorbate 80 and tri‐n‐butyl phosphate were investigated for a high‐purity factor IX concentrate in order to evaluate the robustness of this step.Materials and Methods Samples of factor IX intermediate were obtained, virus was added and the kinetics of virus inactivation followed during incubation. The effect of altering the conditions on virus inactivation was tested.Results Solvent–detergent treatment was confirmed to effectively inactivate, i.e. by ≥ 5 log, a wide range of representative enveloped viruses under standard conditions. Virus inactivation was consistently effective in a number of different manufacturing batches. Of the parameters tested, only solvent–detergent concentration and temperature significantly effected virus inactivation.Conclusions The robustness of the solvent–detergent step for virus inactivation has been confirmed. Using the data generated, appropriate limits can be set for this manufacturing process step.
Associations among nucleated cell, CD34+ cell and colony‐forming cell contents in cord blood units obtained through a standardized banking process
Authors: Aroviita P. , Teramo K. , Westman P. , Hiilesmaa V. , Kekomäki R. 
Published: December 2004

Background and Objectives Nucleated cell content is one of the main components used when evaluating cord blood (CB) units for clinical use. However, other indicators of the haematopoietic potential of a CB unit, such as CD34+ cell and colony‐forming cell (CFU‐TOT) content, have also been investigated. The aim of this study was to determine whether the CD34+ cell content could be used in selecting CB collections for banking.Materials and Methods The collection data, as well as cellular contents of 588 CB collections obtained using a standardized CB banking process, were analysed.Results Altogether, 526 CB units from the 588 collections accepted for processing were included in international search registries. The volume collected was, as expected, 69 ml (range 28–116 ml). The correlation between total CD34+ cell and CFU‐TOT (n = 88) content in the CB collection was higher (r = 0·87) than the correlation between the total nucleated cell and CFU‐TOT content (r = 0·69, both P < 0·0001). The correlations of pre‐ and postvolume reduction values of the total nucleated cell and CD34+ cell numbers were highly significant (r = 0·96, P < 0·0001, both). The total CFU‐TOT content of the CB collection correlated significantly with the total CD34+ cell content of the CB unit before cryopreservation (but after volume reduction) (r = 0·89, P < 0·0001).Conclusions CD34+ cell content predicts the haematopoietic potential of a CB unit better than nucleated cell content. Accordingly, the CD34+ cell content of CB could be used to select CB for banking purposes and for transplantation.
Collaborative studies to establish the first WHO Reference Reagent for detection of human antibody against human platelet antigen‐5b
Authors: Metcalfe P. , Ouwehand W. H. , Sands D. , Barrowcliffe T. W. 
Published: December 2004

Background and Objectives This report describes the production of a freeze‐dried preparation of pooled human plasma, coded 99/666, containing immunoglobulin G (IgG) antibodies against human platelet antigen 5b (HPA‐5b).Materials and Methods The material is intended for use as a minimum sensitivity reagent in the assays currently used for detection of antibodies to HPA‐5b. Laboratories can use it to assess the sensitivity of their ‘in‐house’ assays for antibodies to HPA‐5b and to calibrate local controls for routine use in each batch of tests.Results Two collaborative studies demonstrated that the two candidate materials contained antibodies to HPA‐5b and that there were no other HPA or human leucocyte antigen (HLA) antibodies which might confuse the detection of antibodies to HPA‐5b. The two samples were pooled and freeze‐dried in 1‐ml ampoules.Conclusions The minimum dilution of the antibody against 5b required to yield a positive result was determined, by two international collaborative studies involving a total of 49 laboratories in 26 countries, to be 1 in 2.
Inflammatory mediators in autotransfusion drain blood after knee arthroplasty, with and without leucocyte reduction
Authors: Dalén T. , Bengtsson A. , Brorsson B. , Engström K. G. 
Published: December 2004

Background and Objectives The aim of this study was to evaluate whether leucocyte‐reducing filters influenced complement activation and the formation of pro‐inflammatory cytokines in autotransfusion drain blood after knee arthroplasty.Materials and Methods Twenty‐three patients undergoing knee arthroplasty were divided into two groups. All patients were given salvage blood postoperatively. In Group A, a leucocyte filter was connected between the wound and the drain blood container. In Group B the drain blood was not leucocyte filtered. Complement split products and cytokines were analysed in circulating blood and in drain blood, together with blood‐cellular differential counts.Results Drain blood showed activation vs. venous blood, with elevated concentrations of C3a, SC5b‐9, interleukin (IL)‐6, IL‐8, polymophonuclear (PMN) elastase and tumour necrosis factor‐α (TNF‐α) (P < 0·05 to P < 0·001). The leucocyte filter reduced TNF‐α (P < 0·01), but triggered complement activation (P < 0·05). Room‐temperature incubation increased the concentration of IL‐8 (P < 0·01), which was seen in both venous and drain blood. The leucocyte filter prevented formation of IL‐8 (P < 0·01). In drain blood at 24 h the inflammatory reactions accelerated (P < 0·05–0·001), although the filter reduced the leucocyte counts and TNF‐α concentrations.Conclusions The leucocyte filter reduced IL‐8 and TNF‐α in drain blood, but at the same time triggered complement activation. Incubation affected the inflammatory spectrum of both drain blood and control venous blood, and the filtering reduced this activation.
Restoration of red blood cell volume following 2‐unit red blood cell apheresis
Authors: Valeri C. R. , Ragno G. , Srey R. 
Published: December 2004

Background and Objectives Blood donors who weigh at least 130 lbs (59 kg) and have a haematocrit of at least 40 V per cent can donate 2 units of blood, from which a 360‐ml volume of red blood cells (RBC) can be isolated. This study was carried out in seven healthy male blood donors to assess the restoration of the RBC volume 1 month following a 2‐unit RBC apheresis procedure.Materials and Methods RBC volumes were measured prior to donation and 4 weeks after the 2‐unit RBC apheresis procedure without oral iron supplementation.Results Four weeks after the removal of 2 units of RBC from the male donors not supplemented with oral iron, the RBC volume was restored to 92% of the precollection value. The 360‐ml volume of RBC collected represented 12–19% of the donor's original RBC volume.Conclusions Male donors can safely donate 2 units of RBC and will restore a mean of 92% of their RBC volume within 1 month without iron supplementation.
Structure and presumptive function of the iridocorneal angle of the West Indian manatee (Trichechus manatus), short‐finned pilot whale (Globicephala macrorhynchus), hippopotamus (Hippopotamus amphibius), and African elephant (Loxodonta africana)
Authors: Hatfield Jessie R. , Samuelson Don A. , Lewis Patricia A. , Chisholm Mae 
Published: December 2004

AbstractThe iridocorneal angles of prepared eyes from the West Indian manatee, short‐finned pilot whale, hippopotamus and African elephant were examined and compared using light microscopy. The manatee and pilot whale demonstrated capacity for a large amount of aqueous outflow, probably as part of a system compensating for lack of ciliary musculature, and possibly also related to environmental changes associated with life at varying depths. The elephant angle displayed many characteristics of large herbivores, but was found to have relatively low capacity for aqueous outflow via both primary and secondary routes. The hippopotamus shared characteristics with both land‐ and water‐dwelling mammals; uveoscleral aqueous outflow may be substantial as in the marine mammals, but the angular aqueous plexus was less extensive and a robust pectinate ligament was present. The angles varied greatly in size and composition among the four species, and most structures were found to be uniquely suited to the habitat of each animal.
P52Ultrasonographic diagnosis of an approach to a case with intrauterine clitoromegaly
Authors: Tekin B. , Hassa H. , Şenses T. 
Published: December 2004

IntroductionAdrenal androgens are one of the important determinants of sexual differentiation in fetal period. Increased circulating levels of adrenal androgens as seen in congenital adrenal hyperplasia, interact with genital skin androgen receptors and induce clitoral enlargement, fusion of labial folds and cause migration of the urethral‐vaginal perineal orifice resulting in ambiguous genitalia. We are reporting a female newborn with clitoromegaly from a nulliparous mother at term pregnancy.Case reportThe mother was followed up from 22 weeks of gestation with no signs of hyperandrogenism. Because of late application for antenatal follow up and since clitoromegaly was observed at 29 weeks of pregnancy, amniocentesis could not be done. During ultrasonographic evaluation at 29 weeks of gestation, clitoris with a size of 13 × 18 mm was detected and dexamethasone 1 × 0.5 mg orally was started to use. In reevaluation at 33 weeks of gestation clitoral size was measured as 4.8 × 6.8 mm and treatment was stopped. At 40 weeks of gestation a female neonate with 10–10 apgar scores, weighing 4040 g was delivered with caesarian section due to cephalopelvic disproportion. After delivery physical examination of the neonate revealed clitoral measurements consistent with clitoromegaly. Hyperandrogenic state of the case persists and evaluation of the newborn is going on in Pediatrics Clinic.DiscussionAlthough adrenal androgen secretion starts at 6–8 weeks of gestation and dexamethasone therapy was shown to be effective in regression of virilization if it was used as early as 6–8 weeks of gestation, our case was diagnosed later in the course of pregnancy. But when similar regimen was applied similar result was obtained. So we propose that patients with intrauterine virilization signs like clitoromegaly and ones with risk of congenital adrenal hyperplasia should take glucocorticoid therapy whenever it is determined in order to ameliorate genital ambiguity in female fetuses.
P82Fetal death in pregnancies with absent or reversed end‐diastolic velocity waveforms in the umbilical artery
Authors: Yamamoto R. M. , Francisco R. P. V. , Sakamoto K. , Miyadahira S. , Zugaib  
Published: December 2004

BackgroundDescription of pregnancies with fetal death following absent or reversed end‐diastolic velocity (AREDV).MethodBetween 1992 and 2000, 249 singleton high risk pregnancies with AREDV were followed. Twenty‐nine cases of intrauterine fetal death (IUFD) were reviewed. All the patients were hospitalized after the AREDV diagnosis, and followed with intensive surveillance of fetal vitality.ResultsThe results are shown in the table:

AREDV diagnosis
19–24 week  (n = 14)
25–28 week  (n = 15)
Total  (n = 29)

Fetal weight
454 + 180
694 + 194
578 ± 221

GA at AREDV diagnosis
22.8 + 1.5
26.5 + 1.1
24.8 + 2.3

Interval AREDV‐IUFD   (days)
12.4 + 12.2
6.3 + 6.4
9.2 + 9.9

Reversed flow
7  (50%)
9  (60%)
16 (55%)

Interval reversed flow‐IUFD   (days)
5.0 ± 4.1
4.8 ± 5.5
4.9 ± 4.8

ConclusionPregnancies with severe placental insufficiency that presented fetal death showed a high incidence of reverse flow in the umbilical artery. The cases that presented early fetal death showed a higher time interval between the AREDV diagnosis and IUFD
P84Early neonatal death according to metabolic acidosis at birth in pregnancies with absent or reversed end‐diastolic velocity flow in the umbilical artery
Authors: Yamamoto R. M. , Francisco R. P. V. , Okatani D. , Miyadahira S. , Zugaib M. 
Published: December 2004

BackgroundAn analysis, in pregnancies with absent or reversed end‐diastolic velocity (AREDV) flow in the umbilical artery, of the relation between blood gas values at birth and the occurrence of early neonatal death (until 7 days after delivery).MethodBetween 1992 and 2000, 146 high risk pregnancies with AREDV where it was possible to obtain blood gas analysis results at birth were studied. The criteria used for delivery included: fetal distress, fetal maturity, worsening of maternal condition and severe oligohydramnios. The umbilical arterial blood gas values at birth were compared to early neonatal death.ResultsThe results are shown in the table (*P < 0.05):

pH < 7.15
pH < 7.20
BE < −10
pH < 7.15  and BE < −10

ND (≤ 7d)
10/43 (23%)
11/75 (15%)
13/56 (23%)*
9/30 (30%)*

n = 21

ND (total) n = 36
14/43 (32%)
19/75 (25%)
31/56 (55%)
20/30 (67%)

ConclusionBuffer base depletion (negative base excess‐BE), and when this variable is associated with low pH values (pH < 7.15 and BE < −10) showed a significant statistical correlation with early neonatal death.
P92Early second trimester low umbilical coiling index predicts small for gestational age fetuses
Authors: Degani S. , Leibovich Z. , Shapiro I. , Gonen R. , Ohel G. 
Published: December 2004

ObjectiveTo evaluate the role of early second trimester Doppler velocimetric studies, umbilical coiling index and umbilical cord cross‐sectional area as a test for the prediction of small for gestational age (SGA) infants.Study designDoppler blood flow studies in 147 singleton pregnancies at risk for delivery of a SGA newborn were performed at 15 ± 1 weeks of gestation from umbilical artery, middle cerebral artery, inferior vena cava and ductus venosus. Pulsatility index (PI) values were calculated for the arteries and preload index (PLI) and S/A values for the veins. The sonographic cross‐sectional area of the umbilical cord was measured in a plane adjacent to the insertion into the fetal abdomen. The umbilical coiling index was calculated using sonographic longitudinal views of cord vessels from several segments antenatally. SGA newborn was identified when the birth weight was below the 10th percentile for gestational age.ResultsAmong 147 pregnancies studied, 124 fulfilled the study criteria. 39 of the fetuses were SGA at birth (31.5%). The mean gestational age at delivery (± SD) of the normally grown fetuses was 39.7 ± 1.28 weeks and of the SGA newborns was 34.6 ± 2.9 weeks (range 28–40 weeks). The best single predictor of a SGA infant was the coiling index with a sensitivity of 79% specificity of 86%, positive predictive value of 72% and negative predictive value of 90%.ConclusionUmbilical coiling index measured in the early 2nd trimester is useful in predicting birth of a SGA infant and may be a marker of subsequent growth restriction.