Search PubMed⌕ Search

Biomedical subjects

R T Card

Publications and source records attributed to R T Card.

35 records · Page 2Linked to original sources

Successful pregnancy after high dose chemotherapy and marrow transplantation for treatment of aplastic anemia.

A 29-year-old woman with severe idiopathic aplastic anemia was given immunosuppressive therapy with procarbazine, 37.5 mg/kg, antithymocyte globulin, 36 mg IgG/kg, and cyclophosphamide, 200 mg/kg. This was followed by a marrow transplant from her HLA identical sister, immunosuppressive therapy with intermittent methotrexate for 3 months postgrafting and ultimate restoration of hematopoiesis. Two years after transplantation the patient delivered a healthy male infant. This is the first successful pregnancy after a high dose chemotherapy and marrow transplantation for treatment of aplastic anemia.

Adult↗

Alterations in red cell metabolism during and following cardiac bypass surgery.

Reduced concentrations of red cell organic phosphates and increased hemoglobin--oxygen affinity have been reported during and following cardiac bypass surgery. Some have related these changes to low concentrations of ATP and 2,3-diphosphoglycerate (DPG) in stored blood while others have related them to use of the pump oxygenator. There was a 10% decrease in DPG concentration in seven dogs on cardiac bypass although the animals received no transfusions. In 16 patients who received 0 to 7 units of blood during cardiac bypass there was a decrease of 10% in the red cell DPG concentration from the preoperative value, but it did not relate to the concentration of DPG in the transfused blood bags. The magnitude of the decrease was not sufficient to impair oxygen delivery severely. The results suggest that a re-evaluation of indications for the use of fresh red cells in cardiac surgery is necessary.

Adenosine Triphosphate↗

Portal hypertension complicating myelofibrosis: reversal following splenectomy.

Portal hypertension occurs in approximately 10% of patients with myelofibrosis. Increased portal blood flow secondary to splenomegaly has been proposed to explain its development. In a 60-year-old woman with proven myelofibrosis of 10 years' duration and gross splenomegaly, portal hypertension developed with esophageal varices and ascites. There was no demonstrable obstruction to portal blood flow. Following splenectomy the ascites and esophageal varices disappeared. Despite the presence of splenic myeloid metaplasia, splenectomy did not impair the patient's hematologic status. Portal hypertension complicating myelofibrosis has a poor prognosis, so careful attention should be given to its detection. Splenectomy may be preferable to portal-systemic shunting in the management of this complication.

Ascites↗

Chronic myelomonocytic leukemia: an ultrastructural study by transmission and scanning electron microscopy.

The hematologic findings in three cases of chronic myelomonocytic leukemia are presented, with results of ultrastructural studies by transmission and scanning electron microscopy on two of the cases. In the peripheral blood there was a dual, non-lymphocytic, markedly increased population of granulocytes and monocytes. The granulocytes showed marked nuclear abnormality and nuclear cytoplasmic organelle asynchrony. In the marrow the majority of the cells appeared granulocytic but atypical forms and intermediate difficult to distinguish from monocyte precursors were evident by electron microscopy. The ultrastructural findings lend some support to the concept that the neoplastic granulocytes and monocytes having a common precursor.

Aged↗

Determination of hemoglobin-oxygen affinity on micro samples.

The spectrophotometric determination of hemoglobin-oxygen dissociation on dilute red cell suspensions has been modified by the use of a bicarbonate buffer containing bovine serum albumin. The red cell suspension is equillibrated with known ratios of air and nitrogen and 5 per cent carbon dioxide at atmospheric pressure using two gas pumps. The method enables the hemoglobin-oxygen dissociation curve to be measured on 10 to 20 mul of whole blood, and has given values for the P50 (the oxygen tension at 50 per cent hemoglobin-oxygen saturation) of 25.9 plus or minus 1.5 S. D. which are comparable to the value of 26.0 plus or minus 1.0 S. D. obtained by the mixing technique and by other methods. The addition of bovine albumin (35 mg. per cent or greater) increased the P50 by 3 mm. Hg above that obtained with buffer alone. The P50 value has been compared in bis-Tris and phosphate buffers with and without albumin, and in bicarbonate buffers with the addition of approximately equimolar concentrations of either human or bovine serum albumin or polyvinyl-pyrrolidone (PVP), and buffer alone. The effect of albumin on the P50 value was most marked in bicarbonate buffer, and was statistically significantly greater in the presence of human or bovine albumin than in buffer alone or buffer plus PVP. The addition of albumin could not be explained through an alteration of cell shape or volume, but may be an influence on intracellular pH.

Adenosine Triphosphate↗

Deformability of stored red blood cells. Relationship to degree of packing.

An ektacytometer was used to measure red blood cell deformability during blood storage for 42 days at different degrees of cell packing in citrate-phosphate-dextrose preservative. Observed changes in deformability were studied in relationship to red blood cell adenosine triphosphate (ATP) levels, lipid content, osmotic fragility, and hematocrit during storage. Decrease in whole cell deformability as measured in isotonic medium did not occur until cellular ATP levels were reduced to less than 30 percent of initial values. The rate of deformability loss during storage increased with increased degrees of cell packing because of more rapid substrate depletion. The loss in isotonic deformability was further magnified when deformability measurements were carried out in hypotonic media, suggesting that a reduction in surface area-to-volume ratio was the dominant cause of the reduced deformability of stored red blood cells. Marked spherocytosis, decreased membrane lipid content and increased osmotic fragility confirmed loss of membrane surface area during storage. The significantly higher rate of deformability loss observed in packed red blood cells suggests that careful control of storage hematocrit may be necessary to avoid loss of cellular deformability and possibly posttransfusion viability.

Adenosine Triphosphate↗