Forty-six patients (23M, 23F) ranging in age from 19 to 79 yr with a clinical history of a nonunion fracture, surgery, diabetes or a soft-tissue infection were studied with [111In]oxine WBCs to detect osteomyelitis. There were 27 true-positive, nine true-negative, two false-positive and one false-negative. The false-positives and the false-negative occurred in patients with soft-tissue infections overlying the area of interest. All diagnoses were confirmed by intraoperative bone biopsies and cultures. Bone biopsy and scan were performed within 2 days of each other in 39 patients. The overall sensitivity was 97% (27/28), specificity, 82% (9/11) and the diagnostic accuracy, 92% (36/39). The remaining seven patients had negative [111In]WBC scans several months after positive bone biopsies and definite antibiotic treatment. This suggests that [In]WBC scans become negative after appropriate therapy is undertaken. Interobserver data was obtained from four nuclear physicians of varying experience blinded to clinical information. A high degree of agreement was found in over 90% of the cases. This study demonstrates the utility of [111In]WBC scans in the diagnosis and follow-up of complicated osteomyelitis and a high level of interobserver agreement in scan interpretation.

Adult↗

PubMed1987

[24-hour study of thawed erythrocytes. Value of a protective solution].

We have previously shown that thawed RBC concentrate can be stored at +4 degrees C during 9 days if resuspended in a synthetic medium: ESOC. We now report the in vitro evolution of thawed RBC stored with or without protective medium during the 24 hours legal time-limit. (Formula: see text) We show that without protection, the ATP and 2,3-DPG levels remain acceptable, but spontaneous or caused hemolysis is high. The level of free Hb is soon over the legal limit. The addition of our protective medium enhances ATP and hemolysis is strongly reduced. We conclude that a protective medium should be added to all thawed RBC concentrates.

Blood Preservation↗

PubMed1985

[Deformability of thawed erythrocytes: introduction of a new preservative solution].

Recently, KANE et al. (Centre de Transfusion Sanguine, Strasbourg) designed an original preservative medium, called ESOC, allowing a prolonged storage of thawed RBC. We studied on 15 days the evolution of thawed RBC deformability, while RBC where kept preserved, on the one hand in this ESOC solution, on the other hand in physiologic water, without any preservative medium. We tried to correlate this rheological evolution with cellular ATP, cellular 2,3-DPG and membrane proteins evolution. Deformability was measured by filterability with an Hemorheometre. The results are given as a rigidity index, IR. In ESOC, IR and cellular ATP stay in normal values during the 15 days. In physiologic water, deformability decreases strongly and IR is out of normal values after the fifth day. Cellular ATP decreases out of normal values as soon as the third day. 2,3-DPG decreases in both media. Membrane proteins electrophoresis does not show any difference neither in ESOC nor in physiological water, all fifteen days long. We only observed parallelism between deformability and cellular ATP and IR was higher than normal values. We found no correlation between deformability and 2,3-DPG. We also can conclude, with this study, that ESOC allows a good preservation of thawed RBC and by this way complies with the needs for delayed transfusion in current practice.

2,3-Diphosphoglycerate↗

PubMed1984

[The delay of a time-limitation for thawed blood. New perspectives].

In order to comply with the needs for delayed transfusion in current practice (rare blood types dispatched to other centers, thawed blood not finally transfused to a patient, blood bank supply of Rh negative blood), we have investigated preservative media for thawed blood. We have previously shown that thawed RBC concentrates resuspended in isologous or autologous plasma remain viable and functional for 72 hours. We have extended these investigations by resuspending thawed RBC concentrates in an original synthetic preservative medium designed in our laboratory, containing: (table; see text) The following parameters have been investigated before freezing and during 15 days following thawing and washing: sterility, pH and 2,3-DPG, ATP and energy charge, free Hb levels in the supernatant, 24 h post-transfusion life and half-life of 51Cr-labeled RBC. This preservative allows the conservation of thawed RBC for up to nine days at +4 degrees C. During that time, sterility is maintained, pH is 6.80, 2,-3-DPG levels are 50% of the original values, ATP levels are 100% of the original values, free Hb is 122 mg per blood unit, energy charge is 0.90; RBC labeled 7 days after thawing showed a 89% survival rate 24 h after transfusion and a half-life of 19 days.

2,3-Diphosphoglycerate↗

PubMedDate not supplied

Nine days post-thawing red cell conservation in a synthetic medium. Biochemical studies.

The expiration of thawed red cells (RBC) currently is 24 hours. This leads to problems in current transfusion practice, and often wastes rare and costly products. To remedy this situation, we developed a synthetic medium containing 0.085 g per l adenine, 5 g per l glucose, 48.0 g per l sucrose, 0.75 g per l NaH2PO4.H2O, 4 g per l Na2HPO4.2H2O, and 2.5 g per l NaCl, with a pH of 7.40, and an osmolarity of 320 mOsm. After 15 days post-thawing storage at 4 degrees C in our medium, the viability and function of RBC were maintained. We propose the storage of thawed RBC at 4 degrees C in our medium for up to 9 days: sterility was maintained, pH was 6.80, and 2,3-diphosphate glycerate was 50 percent, and adenosine triphosphate 100 percent of the original values. Free hemoglobin was 122 mg per unit, adenylate energy charge was 0.90, and RBC labeled 7 days after thawing showed 89 percent survival 24 hours after transfusion and a one-half disappearance of 22 days.

Adenosine Triphosphate↗