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Biomedical subjects

S B Moore

Publications and source records attributed to S B Moore.

155 records · Page 9Linked to original sources
PubMedDate not supplied

Cause of spontaneous echocardiographic contrast as assessed by scanning electron microscopy.

Spontaneous echo contrast ("echocardiographic smoke") is known to occur in low-flow states and to require the presence of red cells and plasma proteins. Limited morphologic information regarding the microanatomic structure of red cells exhibiting spontaneous echo contrast is known. The study was designed to evaluate the microanatomic features of red cells exhibiting spontaneous echocardiographic contrast with scanning electron microscopy. With human blood, a beaker, and a stirring bar, a simple model for demonstration of spontaneous echo contrast and its reversal was devised. Blood elements were "sampled" from within this model at times of high and low spontaneous echogenicity by adherence of blood elements to poly-L-lysine-coated slides that were subsequently fixed and examined with scanning electron microscopy. Spontaneous echo contrast was maximal at complete stasis or low-flow states and could be abolished by agitation of blood with continuous stirring. Sampling during low-flow states with high echogenicity showed a preponderance of clumped red cells, whereas at high-flow and low echogenicity states red cells were dispersed and usually solitary. No morphologic features suggestive of activation of the coagulation system were noted. Spontaneous echo contrast is caused by reversible red blood cell clumping, which occurs in fresh human blood at low-flow (low shear rate) states and can be abolished by increasing flow. This phenomenon is independent of activation of the clotting system.

Blood Specimen Collection↗
PubMedDate not supplied

Diagnostic and pathogenetic considerations in transfusion-related acute lung injury.

Transfusion-related acute lung injury (TRALI) is an infrequent but life-threatening complication of hemotherapy. The findings in 36 cases are described. The typical clinical presentation includes acute respiratory distress characterized by hypoxemia and fulminant pulmonary edema. The onset is usually within 4 hours of transfusion and is accompanied by hypotension. In most patients (81%), recovery is rapid and complete. In 89 percent of cases, granulocyte or lymphocytotoxic antibodies are found in the serum of the implicated blood product which contained plasma. HLA-specific antibodies were identified in donor serums in 65 percent of cases evaluated. The passive transfer of these antibodies may promote complement activation and subsequent pulmonary injury. TRALI is an important cause of transfusion-associated morbidity and is probably often misdiagnosed. Blood banks need to identify donors whose plasma causes these reactions in order to prevent their recurrence.

Adult↗
PubMedDate not supplied

Morning admission to the hospital for surgery the same day. A practical problem for the blood bank.

Morning admissions for surgery the same day are increasing because of economic incentives. These admissions permit less time for red cell serologic preparation before surgery than do the more conventional methods of patient admission. During a 4-month period, serologic problems arose in 70 of 2859 cases. In 36 of the 70 cases, the sample arrived at the blood bank about the time of the beginning of the operation; in 19 of these 36 cases, the operation had begun before serologic resolution, and in 7 of these 19, the antibody was found to be of hemolytic potential. It was concluded that administrative and logistic changes need to be made to ensure sufficient time for the serologic testing necessary for safe transfusion support for same-day surgical admissions.

Ambulatory Surgical Procedures↗
PubMedDate not supplied

Delayed immune hemolysis in a patient receiving cyclosporine after orthotopic liver transplantation.

Immune hemolytic anemia in patients after organ transplantation has been reported generally to be graft-cell-derived due to elaboration by the donor's "passenger" lymphocytes of the antibodies directed against the recipient's red cell antigens. In contrast, this report presents a case that illustrates postoperative red cell alloantibody production by the recipient of an orthotopic liver transplant. Anti-Jka, -c, and -S, detected in the recipient's serum 9 days after transplantation, resulted in significant hemolysis. These alloantibodies had not been present in the recipient's serum before transplantation or in the sera of the liver or blood donors. In addition, anti-Jka and -c were eluted from posttransfusion red cells. The patient was transfused during surgery with crossmatch-compatible blood, that carried the alloantigens Jka, c, and S. The liver donor's red cells also carried the Jka, c, and S antigens. The recipient's pretransplantation red cell phenotyping was Jk(a-), c-, S-. The recipient had received only one transfusion 10 years prior to this operation, after which time he was noted to have anti-K. Immunosuppression initially consisted of cyclosporine, azathioprine, and prednisolone. This is believed to be the first report of delayed immune hemolysis due to non-ABO antibodies in a liver transplant patient treated with cyclosporine.

Adult↗
PubMedDate not supplied

Blood transfusion exposure does not influence survival in patients with carcinoma of the breast.

There is abundant evidence of immune modulation induced by exposure to blood transfusions. Some studies have demonstrated a detrimental effect of transfusion on the recurrence of malignant disease and survival. We retrospectively studied the impact of blood transfusion exposure on 229 patients with breast cancer who were seen from July 1973 to September 1980, had at least 5 years' follow-up and had been randomized by therapy at the time of diagnosis. The patients were divided into four groups according to transfusion history: Group 1 (111 patients), no transfusion; Group 2 (34 patients), first transfusion after mastectomy; Group 3 (41 patients), first transfusion at mastectomy; and Group 4 (43 patients), first transfusion before mastectomy. All transfused patients received red cells or whole blood or both. At the time of analysis, 124 (54%) of the patients had died. Only Group 2 was statistically associated with decreased survival; recurrence of disease was 85 percent in this group, compared with 53 percent to 61 percent in the other three groups (p = 0.006, log-rank test). In general, Group 2 patients received transfusions because of recurrent disease. We conclude that transfusions before or at mastectomy are not associated with increased recurrence or reduced survival in patients with breast cancer.

Breast Neoplasms↗
PubMedDate not supplied

Serum IgG anti-native type II collagen antibodies in rheumatoid arthritis: association with HLA DR4 and lack of clinical correlation.

Serum anti-type II collagen antibodies were measured in 85 rheumatoid arthritis patients before and after treatment with disease modifying drugs. These patients were also serotyped for HLA class II antigens. High anti-type II collagen antibodies (anti-CII) were detected in 35% and 29% of patients at onset and completion of study, respectively. Eighty percent of patients with high anti-CII initially had HLA DR4 (p less than 0.05). There was no correlation of anti-CII levels with severity of disease or response to treatment.

Adult↗
PubMedDate not supplied

HLA-DR locus antigens in polymyalgia rheumatica and giant cell arteritis.

HLA-DR locus antigens were determined in 69 patients with giant cell arteritis, polymyalgia rheumatica, or both. The frequencies of HLA-DR4 and HLA-DRW6 in these patients were increased above normals. But the differences were not significant in the total group nor when the patients were separated according to the presence or absence of polymyalgia rheumatica.

Aged↗