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PubMedDate not supplied

Potassium load in CPD-preserved whole blood and two types of packed red blood cells.

The potassium load of transfused blood must be minimized. We have compared the total plasma potassium content of units of CPD-preserved stored whole blood (SWB), stored packed cells (SPC), and packed cells prepared from stored whole blood (WB-PC). Plasma potassium concentrations, unit weights, and hematocrits of 20 units of SWB, 27 units of SPC, and 20 units of WB-PC of various ages were measured. During the 21-day storage period, total plasma potassium content per unit increased in units of SPC at the same rate as in units of SWB, because plasma potassium concentration increased in SPC at three times the rate of SWB. The values for total plasma potassium per unit at 14 and 21 days in mEq/unit were: SWB, 4.4, 5.8; SPC 3.1, 4.4; and WB-PC 1.9, 2.5. Thus, SPC units may contain substantial amounts of plasma potassium when stored for two to three weeks. However, removal of most of the remaining supernatant plasma from SPC units just prior to administration provides a readily available supply of low potassium blood while allowing maximum conservation of scarce blood resources.

Blood Preservation↗
PubMedDate not supplied

Reversal of the storage lesion of CPD bank blood: a problem in clinical medicine.

The effect of phosphate buffer on the course of pH, ATP, and 2,3-PDG of CPD red blood cells stored at three temperatures was observed. Basic phosphate at an equilibrated level of 10 mM (as iP) maintained pH above 7.00 and ATP and 2,3-DPG above 70 per cent of initial value in cells stored at 37 C for 24 hours. In contrast however, at 25 and 4 C no buffering was obtained with basic phosphate concentrations up to 50 mM, but values for both ATP and 2,3-DPG were higher in phosphate treated aliquots than in controls throughout storage. When the pH of blood stored at 4 C was adjusted into the range 7.15 to 7.25 with tromethamine and the level of iP raised to 10 mM by addition of Na2HPO4 on day seven, it was found that ATP and 2,3-DPG levels were maintained at 90 and 120 per cent, while control levels fell to 60 and 12 per cent, respectively at 21 days. The process described parallels the normal repair of damaged red blood cells of bank blood that occurs in vivo following transfusion.

Adenosine Diphosphate↗
PubMedDate not supplied

Plasma adenine and cellular ATP in red cell concentrates collected and stored in modified CPD at 4 C.

Eight units of blood were drawn into modified CPD containing 25 per cent higher glucose and 17.3 mg adenine (0.25 mM in blood). Red blood cell concentrates (RCC) were prepared to a mean hematocrit (Hct) of 70, the cells stored at 4 C, and plasma adenine and red blood cell adenosine triphosphate (ATP) were measured weekly for 42 days. The removal of plasma in the preparation of RCC reduced by 39 per cent the available adenine. As a result measurable plasma adenine was depleted by 21 days. The loss of ATP in RCC occurs at a significantly faster rate than in whole blood stored under the same conditions. When red blood cells are stored at higher HCT or for periods longer than 35 days, increased anticoagulant adenine levels are recommended.

Adenine↗
PubMedDate not supplied

Discocyte--echinocyte reversibility in blood stored in CPD over a period of 56 days.

Blood collected with CPD and stored was examined with optical (LM) and scanning electron microscopy (SEM) before and after reversal of echinocytes into discocytes. Reversal was achieved by incubation of the red blood cells at 37 C in an adenosine containing medium. The transformation of discocytes into echinocytes occurred rapidly during the first three weeks of storage. A shape/density relationship was observed in the various fractions. The denser cells were found to have the more advanced echinocytic changes. After incubation with adenosine, most of the cells reversed into discocytes and early stages of stomatocytes. When spheroechinocytes I and II were present, they reversed into spherostomatocytes. No echinocytogenic property was found in plasma during 5 weeks of storage at 4 C and no immediate reversion of echinocytes was obtained in fresh plasma, therefore the initial discocyte--echinocyte transformation was explained by intracellular changes. The data from the various fractions showed that the more dense cells were more spherocytic. We suggest that removal of this part of the population of stored red blood cells might improve the survival of transfused cells.

Adenosine↗
PubMedDate not supplied

Blood preservation. XXIX. Pyruvate maintains normal red cell 2,3-DPG for six weeks of storage in CPD-adenine.

Pyruvate was placed in experimental CPD-adenine (0.25 mM) blood preservative mixtures in four concentrations ranging from 40 to 320 mM. In the 320 mM pyruvate preservative, 2,3-DPG levels were elevated above normal for six weeks of whole blood storage at 4 C. The lower pyruvate concentrations maintained elevated or normal 2,3-DPG levels for less time: four weeks with 160 mM, two weeks with 80 mM, and one week or less with 40 mM or the control. ATP values were best maintained in the control. The higher pyruvate concentrations resulted in the most rapid decreases at ATP. However, even the 320 mM pyruvate did not cause ATP to fall below 2 microM/gm of Hb. The higher pyruvate concentrations produced and maintained a higher pH during storage. On the other hand, 2,3-DPG levels increased with pyruvate during the first week of storage when the pH was decreasing rapidly. This could be the result of its oxidation of NADH to NAD. The high pyruvate concentration which maintained elevated 2,3-DPG levels throughout the six weeks might be simulating the effect reported in pyruvate kinase-deficient red blood cells, in which blockage of glycolysis at that step is preventing 2,3-DPG catabolism.

Adenine↗
PubMedDate not supplied

Changes of blood oxygen affinity in different CPD solutions during liquid storage.

Soft and hard-packed red blood cells in four different CPD anticoagulant-preservative solutions were stored with and without added glucose, adenine, and electrolytes. The hemoglobin-oxygen affinity of the red blood cell concentrates was tested over a six-week storage period. No single solution conferred better protection than any other against an expected increase in oxygen affinity due to loss of 2,3-DPG during storage. In all solutions, P50 at pH 7.4 decreased linearly when measured in a physiological system using CO2. After six weeks' storage at 4 C, the normal oxygen-binding properties of red blood cells could be restored in all instances following incubation for one hour in a rejuvenation solution. By contrast, red blood cell ATP levels were highest when resuspending solutions contained adenine and added glucose, but did not significantly compensate the allosteric role of 2,3-DPG in regulating oxygen affinity when the latter became depleted.

2,3-Diphosphoglycerate↗
PubMed2003

Genomic structure of the cucumber CPD photolyase gene.

Light-dependent transcriptional activation of the photolyase gene imparts UVB tolerance to a plant. In the present study, the cucumber CPD photolyase gene (CsPHR) was isolated from a genomic DNA library and its genomic structure was scrutinized. As a result, putative light-responsive cis-acting elements were found in the CsPHR promoter.

Amino Acid Sequence↗
PubMed1981

Red cell ATP and 2,3-diphosphoglycerate concentrations as a function of dihydroxyacetone supplementation of CPD adenine.

Units of CPDA-1 whole blood were subdivided and each treated with additions of dihydroxyacetone (DHA) to give final concentrations from 0 to 80 mM. The 'optimum' concentration of DHA to maintain 2,3-diphosphoglycerate (2,3-DPG) with minimal loss of ATP during 42 days of storage appeared to be 30 mM of DHA. With this formulation, red cell 2,3-DPG concentrations rose to 130-140% of normal by 14 days and then decreased in a near-linear manner to 50-60% normal by 42 days, while maintaining adequate ATP levels. In addition, packed red cells were prepared form CPD fresh blood and treated with adenine, glucose, and various concentrations (0-80 mM) of DHA. The cells also responded most favorably to 30mM DHA, although the response was not as positive as whole blood. This concentration of DHA produced nearly 100% maintenance of 2,3-DPG at 14 days with subsequent fall to 30% of normal by 42 days.

2,3-Diphosphoglycerate↗
PubMed2001

Fowlpox virus encodes a novel DNA repair enzyme, CPD-photolyase, that restores infectivity of UV light-damaged virus.

Fowlpox virus (FPV), a pathogen of poultry, can persist in desiccated scabs shed from infected hosts. Although the mechanisms which ensure virus survival are unknown, it is likely that some type of remedial action against environmentally induced damage is required. In this regard, we have identified an open reading frame (ORF) coding for a putative class II cyclobutane pyrimidine dimer (CPD)-photolyase in the genome of FPV. This enzyme repairs the UV light-induced formation of CPDs in DNA by using blue light as an energy source and thus could enhance the viability of FPV during its exposure to sunlight. Based on transcriptional analyses, the photolyase gene was found to be expressed late during the FPV replicative cycle. That the resultant protein retained DNA repair activity was demonstrated by the ability of the corresponding FPV ORF to complement functionally a photolyase-deficient Escherichia coli strain. Interestingly, insertional inactivation of the FPV photolyase gene did not impair the replication of such a genetically altered virus in cultured cells. However, greater sensitivity of this mutant than of the parental virus to UV light irradiation was evident when both were subsequently photoreactivated in the absence of host participation. Therefore, FPV appears to incorporate its photolyase into mature virions where the enzyme can promote their survival in the environment. Although expression of a homologous protein has been predicted for some chordopoxviruses, this report is the first to demonstrate that a poxvirus can utilize light to repair damage to its genome.

Amino Acid Sequence↗
PubMed1993

Posttransfusional changes of 2,3-diphosphoglycerate and nucleotides in CPD-SAGM-preserved erythrocytes.

BACKGROUND: Posttransfusional changes of preserved red blood cells can influence the oxygen equilibrium curve which is mainly affected by the concentration of erythrocyte 2,3-diphosphoglycerate (DPG). MATERIAL AND METHODS: The regeneration kinetics of DPG and nucleotides (ATP, ADP, AMP, GTP, GDP) was determined over a period of 0-48 h in surgically treated patients following transfusion of DPG-depleted packed red cells stored for 14 days in CPD-SAGM. RESULTS: 3 h after transfusion the DPG levels raised up to 40% of the patients' prior DPG concentrations. Complete regeneration of the DPG concentrations occurred 36-48 h after transfusion. Changes in the nucleotide pattern indicate, after a temporary decrease of ATP and GTP levels (after 10-30 min) and an activation phase (after 3-12 h), the full regeneration of these parameters 24-48 h after transfusion. CONCLUSIONS: The regeneration kinetics of DPG should be taken into consideration for transfusions with blood units stored for more than 14 days, especially in patients with reduced compensatory mechanisms (coronary and cerebral scleroses, pacemaker, etc.) and large transfusion volumes.

2,3-Diphosphoglycerate↗
PubMed1993

Adherence of Serratia marcescens, Serratia liquefaciens, Pseudomonas aeruginosa and Staphylococcus epidermidis to blood transfusion bags (CPD-SAGMAN sets).

The adherence of 4 isolates of Serratia marcescens, 1 isolate of Serratia liquefaciens, 1 of Pseudomonas aeruginosa, and 2 of Staphylococcus epidermidis to blood transfusion sets (CPD-SAGMAN) consisting of bags and connecting tubing was tested. All strains adhered well to the connecting tubes (polyvinyl chloride) from the transfusion sets from 3 manufacturers. Three isolates from a Swedish outbreak of septicaemia associated with contaminated blood bags showed greater adherence than an isolate from a urinary tract infection. There was no significant adherence of S. marcescens to the blood bags. In general, there were no significant differences in the adherence of a given isolate to the plastics from different manufacturers. Appropriate hygienic procedures for the production of transfusion sets appear to be of greater importance than differences in the plastic material as regards the incidence of transfusion-related bacteremia.

Bacteremia↗
PubMedDate not supplied

Developing and accrediting a CPD framework.

This article describes the process to formally accredit existing in-house education courses in a continuing professional development (CPD) framework. The partnership was between two Lothian NHS organisations and a higher education institution (HEI). The nature of the partnership and the differing approaches taken by the organisations are discussed. The authors explore the context of learning in the NHS in relation to the different organisations, and describe the issues identified and the strategies used to address these. The benefits to all stakeholders are listed. Although this case study refers to an initiative in Scotland, the framework model for flexible and work-based education could be adopted across the UK.

Accreditation↗
PubMed1999

Erythrocytes stored in CPD SAG-mannitol: evaluation of their deformability.

The erythrocytes deformability of three blood samples coming from healthy donors has been evaluated by Laser-assisted Optical Rotational Cell Analyzer (LORCA). Blood samples were stored in CPD SAG-mannitol. The study of progressive reduction in the Elongation Index (EI) during the preservation may be used as way of evaluation of erythrocyte vitality in stored blood samples.

Adenine↗
PubMed2004

Activity of irinotecan, cisplatin and dacarbazine (CPD) combination in previously treated patients with advanced colorectal carcinoma.

AIM: Irinotecan is an active drug after fluorouracil (FU) failure in patients with colorectal cancer (CRC). Also a modest activity of cisplatin and dacarbazine combination in FU resistant patients have been reported. We aimed to assess the efficacy of irinotecan, cisplatin and dacarbazine combination in previously treated patients with measurable advanced CRC. METHODS: Treatment schedule was irinotecan 150 mg/m2, iv, d1; cisplatin 20 mg/m2 and dacarbazine 200 mg/m2 iv, d1-d3; every 21 days. 48 patients with a median age of 51 were entered the study. RESULTS: Objective response rate was 33.3%. The overall disease stabilization rate was 75.6%. The median survival was 14 months, and the median progression-free survival was 7 months. Main toxicities were grade 2-3 vomiting (39.2%) and grade 3-4 neutropenia (17.4%). CONCLUSION: CPD combination seems to be very active, with acceptable safety profile, in patients with advanced CRC resistant to FUFA.

Adult↗
PubMedDate not supplied

The utility of CPD for older adult mental health nurses.

AIM: To investigate how mental health nurses working with older adults perceive the benefits and realities of developing the outcomes of current continuing professional development training into actual clinical practice. METHOD: A structured questionnaire was used with a convenience sample of nursing staff. Qualitative analysis was performed using a grounded theory approach in order to identify emergent themes, concepts and categories of data. Four randomly selected nurses were subjected to a voluntary semistructured interview using the questionnaire as a basis for information gathering. RESULTS: The main reason for attending courses was developing skills. Of those attending courses, 42 per cent of qualified and 35 per cent of unqualified staff had a personal development plan (PDP) or individual performance review (IPR). Significantly, all unqualified staff who had not been on a course had no PDP or IPR. Learning was described as applicable to practice by 85 per cent of unqualified and 70 per cent of qualified staff. However, 28 per cent of unqualified staff and 20 per cent of qualified staff felt their practice had not changed as a result of their learning. CONCLUSION: CPD can be a positive experience, providing nurses with the opportunity to direct their professional development.

Aged↗
PubMedDate not supplied

Effects of irradiation on red cells stored in CPDA-1 and CPD-ADSOL (AS-1).

Red blood cells (pRBC) collected in citrate, phosphate, dextrose, adenine-formula 1 (CPDA-1) and citrate, phosphate, dextrose-adenine, manitol saline solution (CPD-ADSOL [AS-1]) anticoagulants are increasingly being stored for variable periods in transfusion service inventories following irradiation. While anecdotal reports of increased K+ following irradiation and storage have recently appeared in the literature, concomitant in vitro biochemical changes resulting from differences in anticoagulants have not been reported. Utilizing two venipunctures, two units each of 225 mL of blood from five volunteers were collected in anticoagulant-adjusted CPDA-1 and AS-1 bags. Within two hours of collection, each unit was equally divided. One of each pair was irradiated (2000 rads). Samples were analyzed on Days 0, 1, 3, 7, and every seven days to expiration. Irradiation resulted in a 2.3 fold increase in K+ during the first seven days of storage for both anticoagulants, although significantly greater K+ levels were observed in the CPDA-1 pairs compared to the AS-1 pairs. Comparison of glucose utilization, plasma free hemoglobin, 2,3-diphosphoglycerate (2,3-DPG) and lactate dehydrogenase between control and irradiated CPDA-1 and AS-1 pairs and between anticoagulants were documented.

2,3-Diphosphoglycerate↗
PubMed1980

The effect of increasing glucose in CPD on the quality of stored blood.

Changes in quality of blood units containing one and a half or double amounts of glucose, stored at +4 degrees C for three weeks were analysed. An experimental preservative containing glucose and fructose (1 : 1) was also used. No other additives (purine or purine-nucleoside) were applied. A standard CPD preservative of the National Inst. of Haematology and Blood Transfusion was used as control. The pH, plasma free haemoglobin, K+ content, red blood cell (RBC) ATP and 2,3-DPG content, and RBC fragility index were determined in each sample. Increase of glucose concentration, the addition of fructose had a beneficial effect on blood pH, and on plasma free haemoglobin and K+ concentration. 150% glucose improved the 2,3-DPG maintenance in stored blood.

Adenosine Triphosphate↗
PubMed1994

Higher KT/V urea associated with greater protein catabolic rate and dietary protein intake in children treated with CCPD compared to CAPD. Mid-European Pediatric CPD Study Group (MPCS).

Being more suitable to children's lifestyle habits, continuous cycling peritoneal dialysis (CCPD) is becoming the treatment modality of first choice in the pediatric CPD population. In order to establish whether these regimens, prescribed on an empirical basis, provide an equally effective dialysis as does standard continuous ambulatory peritoneal dialysis (CAPD), we performed a cross-sectional analysis of dialysate and residual renal small molecule clearances in 85 children aged 3 months to 20 years, who were treated in 16 pediatric dialysis centers. Forty-three children were on CAPD and 42 were on CCPD. The two patient groups did not differ in age, body size, duration of dialysis, underlying disease distribution, or residual renal function. The CAPD patients achieved an average daily drain volume of 159 +/- 40 mL/kg body weight, as compared to 208 +/- 95 mL/kg in the CCPD group (p < 0.005). Average serum creatinine and BUN values were similar in both groups. While the (total) creatinine clearance did not differ, the KT/V urea was significantly higher in the patients treated with CCPD (0.35 +/- 0.12 vs 0.28 +/- 0.13, p < 0.05). The estimated protein catabolic rate (PCR) was significantly higher in the CCPD group (1.39 +/- 0.6 g/kg d) than in the CAPD patients (1.08 +/- 0.48 g/kg d, p < 0.05). Three-day dietary histories, available in 20 patients, showed a similar difference in dietary protein intake between CCPD and CAPD patients. We conclude that CCPD treatment regimens, at the dose currently prescribed in Mid-European pediatric dialysis centers, provide a higher clearance of urea and, possibly, other small molecules.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗