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At least 127 records · Page 7Linked to original sources

The relationship between hematocrit, blood lost, and blood transfused in total knee replacement. Implications for postoperative blood salvage and reinfusion.

The relationship between patient hematocrit level, red blood cell volume lost, and blood units transfused is important in determining conservation strategies in patients undergoing total knee replacement surgery. In a series of 30 such patients, 3 (10%) received allogeneic blood, despite preoperative autologous blood donation in 28 patients. There was no evidence that the degree of anemia affected rate or volume of postoperative wound blood drainage. The wound drainage volume that could have been salvaged and reinfused in bilateral procedures was substantial. A combination of one or more conservation techniques along with conservative transfusion practice is necessary to achieve minimal allogeneic blood exposure.

Aged↗

Comparison of ethanol concentrations in right cardiac blood, left cardiac blood and peripheral blood in a series of 30 cases.

The aim of this study was to compare ethanol concentrations in right cardiac blood, left cardiac blood and peripheral blood. Samples were taken from a series of 30 medicolegal autopsies. Ethanol was measured by headspace GC-FID. In each case, the degree of putrefaction, chest or abdominal injury, and/or regurgitation of gastric contents into the airways were noted. Our results show that there exists in certain cases a marked increase in ethanol concentration in left cardiac blood compared with right cardiac blood and peripheral blood. In these cases, we observed (i) a high concentration of ethanol in the gastric contents and (ii) regurgitation of gastric contents into the airways. The authors discuss the post-mortem redistribution mechanisms which could explain these results and stress the value of sampling right cardiac blood at autopsy.

Central Nervous System Depressants↗

[Application of an automatic blood cell analyzer "MICROX" to the blood of experimental animals. I. Differential counts of white blood cells in monkeys and dogs].

Automatic blood cell analyzer "MICROX" was examined for possible applicability to the differential count of white blood cell in the monkey and in the dog. Spun blood smear slides prepared from 42 monkeys and 60 dogs were stained with Wright's dye and totals of 4971 white blood cells of the monkey and 7189 cells of the dog were counted, respectively. The identification rate of MICROX was checked by the cell by cell counting method on a monitor TV of the instrument. Analysis of the data was made to examine correlationship between the results of MICROX and of optical microscopy on the same slides. 1) Identification rates and misclassification rates were 97.0% and 3.0% respectively in monkeys and 96.4% and 3.6% in dogs. 2) A high degree of correlation was observed between the results by MICROX and by optical microscopy in respect of segmented neutrophils and lymphocytes. 3) There were an average of 15.5 cells counted as unknown cells in monkey blood and 16.5 in dog blood per 100 cells, respectively. Of the unknown cells about 40 to 50% were closely disposed leukocytes within the same counting squares and almost all of atypical lymphocytes and erythroblasts were also counted as unknown cells on the analyzer. The data support the feasibility of the use of MICROX for the differential count of white blood cells of normal monkeys and dogs.

Animals↗

Determination of eicosanoid and cytokine production in salvaged blood, stored red blood cell concentrates, and whole blood.

STUDY OBJECTIVE: To determine the production of the eicosanoids prostaglandin 2 (PGE2) and thromboxane 2 (TxB2) and the cytokines interleukin 1 beta (IL-1-beta) and interleukin 6 (IL-6) in whole blood (WB), unfiltered red blood cell (RBC), and filtered RBC concentrates, and salvaged blood. DESIGN: Prospective study. SETTING: University hospital of Erlangen. PATIENTS: 32 healthy volunteers and 14 ASA physical status I, II, and III radical prostatectomy patients (mean age 65 yrs). INTERVENTIONS: Sixteen WB units and 16 RBC units (divided into 16 filtered and unfiltered units each) were taken from 32 volunteers. Fourteen salvaged RBC units were obtained from the 14 radical prostatectomy patients. Sixteen WB units were stored for 35 days. From the 16 WB donations, RBC concentrates (PAGGS-M) were prepared. The RBC concentrates were halved, one half had its leukocytes removed at day 0; both halves were stored for 49 days. Salvaged blood (n = 14) was stored up to 2 hours during surgery and then retransfused. MEASUREMENTS AND MAIN RESULTS: Immediately at the start of the study, in all blood units (WB, RBC filtered, and RBC unfiltered units) at days 0 and 21, and at the end of the storage period (WB: 35 days, RBC concentrates: 49 days) and in the salvaged RBC units, the following parameters were measured: PGE2, TxB2, IL-1-beta, IL-6, hematocrit, platelet number, leukocytes, blood volume, and hemoglobin. During storage, different levels of PGE2, TxB2, IL-1-beta, IL-6 for WB, filtered RBC concentrates, and unfiltered RBCs were found. The higher levels of PGE2, TxB2, IL-1-beta, and IL-6 were found in the WB and RBC salvaged units than the filtered RBCs or unfiltered RBC units. There was no statistically significant difference between WB and salvaged RBCs. Higher levels of leukocytes and platelets were found in WB units and salvaged RBCs as compared to filtered or unfiltered RBCs. CONCLUSIONS: The eicosanoid and cytokine levels in the salvaged, filtered RBC, unfiltered RBC, and WB units stayed within physiological limits, suggesting that these levels do not contribute to the risk of nonhemolytic, immunomodulated transfusion reactions, even in massive transfusions.

Adjuvants, Immunologic↗

Risk of HIV infection from former blood donations of donors found to be HIV antibody-positive in blood bank routine testing. "Look-back" study in German Red Cross Blood Banks in the FRG.

Recipients of blood given by 52 repeat blood donors found to be positive by Western blot analysis for anti-HIV from April 1985 to December 1987, among a total of 1.6 million blood donors in the German Red Cross Blood Banks in the FRG, were investigated. Of 149 recipients identified, 76 (51%) had died. Ten recipients refused to be tested. Of those recipients who were tested at least 5 months after transfusion, 46 were HIV antibody negative and 17 were Western blot-positive. In 14 of the HIV antibody-positive recipients, transfusion was given during the period from 1982 to the begin of routine testing in 1985. Three recipients of HIV antibody-negative donations were subsequently identified as HIV positive. The blood had been donated a median of 3 months before HIV antibodies were detected in the donors. From a total of 3 million donations since testing has been introduced, the risk of HIV transmission in tested blood is 1:1 million in our donor population where the HIV antibody prevalence (in Western blot) is about 1 per 100,000 donations/donors.

AIDS Serodiagnosis↗

Decrease in cochlear blood flow with infusion of nitric oxide synthase inhibitor and its recovery with L-arginine infusion: comparison with abdominal blood flow and auricular blood flow.

We observed changes in cochlear blood flow (CoBF), abdominal blood flow (AbBF) and auricular blood flow (AuBF) in rats after administration of the nitric oxide (NO) synthase inhibitor N-nitro-L-arginine-methyl ester (L-NAME). Ten min after i.v. infusion of L-NAME, L-arginine, a substrate of NO, was infused (100 mg/kg) intravenously. Using a laser Doppler flowmeter, changes in blood flow were recorded from the basal turn of the right cochlea, abdominal wall or right auricle, and systemic blood pressure (BP) was recorded simultaneously from the left femoral artery. As another parameter of vascular response, vascular conductance (VC) was calculated from blood flow/mean BP. I.v. infusion of L-NAME produced a dose-dependent depression of cochlear VC at concentrations of 0.2 (-18.9%), 1 (-37.9%), 5 (-45.8%) and 10 mg/kg (-48.3%). Infusion of L-arginine partially reversed the decrease of CoBF caused by L-NAME. The group that received a 0.2 mg/kg infusion of L-NAME showed the largest degree of recovery (23.8%) with L-arginine, while the 10 mg/kg group showed the smallest degree of recovery (10.1%). AbBF also decreased after infusion of L-NAME (5 mg/kg) but to a lesser degree (-41.1% depression of VC) and with no significance compared to the decrease in CoBF (5 mg/kg L-NAME). Likewise, AuBF showed a decrease (-44.0% depression of VC) after infusion of L-NAME (10 mg/kg), the decrease being less than that of CoBF (10 mg/kg L-NAME). Recoveries from these decreased levels of VC in the AbBF and AuBF groups appeared to be smaller than those in the CoBF groups at the same dose of L-NAME (5.5% vs 17.3% in abdominal VC; 5.3% vs 10.1% in auricular VC). In a previous study comparing the CoBF changes caused by i.v. infusion and round window application of L-NAME, we proposed that i.v. infusion of L-NAME in rats primarily affects the precapillary arteriole of the spiral modiolar artery, which effectively regulates cochlear microcirculation as a resistance artery. Thus we assume that there may exist an active pathway of the NO/soluble guanylate cyclase/cyclic guanosine monophosphate system in the above vessels. With regard to the finding of a smaller recovery of VC with L-arginine in both the AbBF and AuBF groups, we consider that differences in L-arginine availability or uptake, and in the synthesis of NO, may exist between the cochlear and cutaneous vasculatures.

Abdominal Wall↗

[A cohort study on the relationship between body mass index and blood pressure, blood lipid, blood glucose, left ventricular structure and function in adolescents during transition period].

OBJECTIVE: To investigate the relationship between body mass index(BMI) and blood pressure, blood lipid level, blood glucose, left ventricular structure and function in adolescents during transition period. METHODS: A vertical sectional survey on 193 pupils aged 7-11 years in primary school in 1996 was performed. 9 years later, the same research subjects aged 16-20 years were studied again in 2005. The subjects were divided into obesity,overweight and normal weight groups according to their BMI in 1996. Height, body weight, blood pressure, total cholesterol, triglyceride and blood glucose were collected and analyzed, and left ventricular structure and function were examined by echocardiography. RESULTS: Body mass index (24.71 kg/m(2)+/-4.57 kg/m(2), 20.54 kg/m(2)+/-2.84 kg/m(2) ), systolic blood pressure (117.22 mm Hg+/-17.44 mm Hg vs. 102.20 mm Hg+/-11.68 mm Hg), thickness of inter-ventricular septum and posterior wall (0.87 cm+/-0.12 cm vs. 0.77 cm+/-0.12 cm, and 0.91 cm+/-0.13 cm vs. 0.79 cm+/-0.31 cm), left ventricular mass and mass index (167.84 g+/-16.29 g vs. 128.95 g+/-63.00 g, and 88.12 g/m(2) +/-17.19 g/m(2) vs. 79.35 g/m(2)+/-39.01 g/m(2)) were found significantly higher in obesity group than in normal weight group 9 years later (P<0.05, P< 0.01 or P< 0.001). End diastolic volume and cardiac output were increased(P <0.05) and ejection fraction and fractional shortening decreased( P< 0.05). There were no differences found in cardiac diastolic function between the studied groups. CONCLUSION: The results suggested that simple obesity in childhood was an important cardiovascular risk factor when they grew into adolescents and adults. ;

Adolescent↗

[Blood loss and the need for homologous blood transfusion in elective general surgery as a basis for indications for preoperative autologous blood donation].

The records of 279 surgical patients of 1986 were retrospectively evaluated for blood loss and blood-transfusion in order to provide a basis for an autologous blood donation program. 90% of the large bowel resections, gastrectomy and peripheral artery interventions with a blood loss between 0.5 and 1.51 could have been performed with the sole use of autologous blood. 50% of the operations of the abdominal aorta and all operations of the oesophagus would have required the additional use of other autotransfusion techniques or homologous blood transfusions.

Blood Transfusion, Autologous↗

[Acute "normovolemic" hemodilution with 3.5% polygel (Haemaccel) for patients in the Wertheim-Meigs-operation. Blood loss of 87% blood volume without perioperative blood transfusion].

QUESTION: Is polygeline (Haemaccel) a suitable colloid to perform preoperative acute normovolemic hemodilution (ANH) and to replace a large intraoperative blood loss? METHODS: In a sixty-eight-year-old patient undergoing radical hysterectomy preoperative ANH was performed to a hematocrit of 23% using 3.5% polygeline (Haemaccel). Intraoperative retransfusion of ANH blood was started at a hematocrit of 13%. Plasma volume (indocyanine green-dilution technique) and hematocrit were measured before and after ANH, 3 times intraoperatively (once before retransfusion) and postoperatively. Red cell volume (by labelling erythrocytes with fluorescein) was determined before and after ANH, before retransfusion, and postoperatively. RESULTS: After removal of 1,940 ml of blood and replacement with 15% more of colloid, blood volume decreased by 760 ml. After a mean blood loss of 4,600 ml, 290 ml and 260 ml of red cells were saved due to ANH and use of a cell saver, respectively. CONCLUSIONS: The exact double label measurements of blood volume demonstrated that polygeline, which has a volume effect of only 50%, cannot be considered to be a suitable colloidal substitute during ANH.

Aged↗

Plateletpheresis experience with the Haemonetics Blood Processor 30, the IBM Blood Processor 2997, and the Fenwal CS-3000 Blood Processor.

Comparisons were made of the apheresis instruments Haemonetics Blood Processor 30, IBM Blood Processor 2997 and Fenwal CS-3000, for collection of platelets from normal donors. With each instrument the mean recovery was at least 4 x 10(11) platelets per procedure, and each instrument afforded a safe and reliable collection. The Haemonetics Blood Processor gave the lowest recovery of platelets per minute per procedure. The IBM Blood Processor 2997 required the longest time for set-up and priming and processed 1.5 liters more donor blood per collection than the other instruments. The Fenwal CS-3000, which is a computer-controlled instrument, was the least time consuming. The donor suffered a significantly greater drop in platelet count after collection with the IBM Blood Processor 2997 (31%) than after collection with the other instruments (19%), and we were unable to account for this observation.

Blood Platelets↗

Blood donor white blood cell reduction filters as a source of human peripheral blood-derived endothelial progenitor cells.

BACKGROUND: Neovascularization in tumors, wounds, and sites of ischemic injury occurs by both angiogenesis (proliferation from existing vessels) and by vasculogenesis (differentiation into endothelial cells from circulating endothelial progenitor cells [EPCs]). EPCs can be obtained from marrow, from cord blood, or by ex vivo expansion of human peripheral blood (PB). The ease of obtaining human PB EPCs has led many recent studies to utilize PB EPCs. The ability to obtain large numbers of PB EPCs would greatly facilitate characterization to further our understanding of EPC biology and their application in cellular gene therapy. STUDY DESIGN AND METHODS: Peripheral blood mononuclear cells (PBMNCs) from whole blood or from the material obtained from white blood cell (WBC) reduction filters were isolated. The cells from both sources were then cultured separately under defined conditions to quantify EPC yield from each source. RESULTS: The yield of EPCs per million PBMNCs plated was approximately 3.5-fold higher from fresh PB. Because greater numbers of PBMNCs were obtained from each filter, however, the mean yield of EPCs from one filter versus fresh blood was 5.4 million versus 0.4 million, respectively (approx. 14-fold increased yield). CONCLUSION: The use of WBC reduction filters provides a safe, inexpensive, and readily available source for large numbers of PBMNCs from which culture-expanded EPCs can be generated for further study.

Blood Donors↗

Basic investigation of the lectin method for separation and recovery of nucleated red blood cells in maternal blood, and a study into the frequency of nucleated red blood cells in fetomaternal disorders.

We previously reported the separation and recovery of nucleated red blood cells (NRBCs) in maternal blood using the lectin method. In the present study, we verified the lectin method and investigated the appearance of NRBCs during pregnancy. For the concentration of lectin soy bean agglutinin, 7 mL of maternal peripheral blood was collected from 20 subjects, and the relative fluorescence intensity was measured using flowcytometry; 50 mg/mL, used in previous studies, was the optimal concentration. The number of cells recovered at each step of the lectin method was also investigated by FACS using fluorescence-labeled CD11a and CD33, and the results showed the usefulness of the method. Next, 7 mL of maternal peripheral blood was collected from 292 women with a normal single pregnancy (389 specimens), and NRBCs were separated and recovered using the lectin method. NRBCs slightly increased over the course of pregnancy (y = 4.29x + 5.03, r2 = 0.11). When blood was collected multiple times in the same subjects, NRBCs increased in 63 of 77 subjects (83.1%, percent change: 2.4 +/- 19.0). No NRBCs were recovered in 17 subjects (4.7%). Regarding the relationship between fetomaternal disorders and the frequency of NRBCs, 89.4 +/- 92.6 cells appeared per 10 mL of maternal blood in the normal group, but NRBCs increased in patients with 18 trisomy, placenta previa, pre-eclampsia, intrauterine fetal death, and 21 trisomy. NRBC examination may play an assisting role not only in fetal diagnosis but also in fetomaternal diagnosis.

Cell Nucleus↗