Our dwindling national blood supply.
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Biomedical subjects
Publications and source records attributed to A J Marengo-Rowe.
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The transmission of human immunodeficiency virus (HIV) by blood or blood components is a major concern in blood banking. A photodynamic flow cell system was designed to inactivate cell-free HIV mixed with blood from a healthy donor. Blood containing 4 x 10(3) infectious units of HIV was treated with 10 and 20 micrograms per mL of commercially available dihematoporphyrin ether (DHE) per mL. Aliquots of this mixture were then held in the dark or irradiated in a flow cell illuminated at a light energy density of 5 J per cm2 provided by a xenon light source equipped with a 630 +/- 5 nm band-pass interference filter; the aliquots were subsequently placed in A.301 cells. All infected cultures were assessed for reverse transcriptase (RT) activity for 17 days. RT activity for either concentration of dye was significantly reduced in irradiated samples as compared to that in samples held in the dark. Blood samples from volunteers also were assessed for the effects of the inactivation process on red cells at concentrations of DHE up to 200 micrograms per mL. No effects were observed on red cell 2,3 DPG or ATP, whole blood potassium concentrations, red cell osmotic fragility, or blood cell antigens.
1. Blood coagulation factor levels and the normal ranges of commonly used coagulation tests were established for Sigmodon hispidus. 2. The white cell, red cell and platelet counts have been determined together with the red cell parameters as measured by the Coulter model S-plus. 3. The relationship between the results reported here and those published for related species are discussed.
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The evaluation of excessive hemorrhage was carried out in 774 patients after cardiopulmonary bypass. Excessive hemorrhage was defined in any adult patient as chest tube drainage of more than 600 ml within the first eight hours after operation. Using the prothrombin time, partial thromboplastin time, fibrinogen level, and tri-F titer tests, it was possible to differentiate medical from surgical bleeding. Hyperfibrinolytic bleeding was the most frequently identifiable coagulation disorder and occurred in 159 patients (20%). All these patients were successfully treated with Amicar (epsilon-aminocaproic acid) alone, or with Amicar supplemented with cryoprecipitate or fresh-frozen plasma. Three patients (0.4%) were noted to have residual heparin and required additional protamine sulfate. Five patients (0.6%) had normal coagulation studies and required immediate reexploration. The overall blood consumption per patient was 2.1 units of packed cells. Whole blood and platelets were not used.
The evaluation of the bleeding patient starts with the integration of data from the history and physical examination. From this results either one probable explanation that can easily be substatniated by laboratory studies or, as more commonly occurs in practice, several possibilities that are reasonable and must be investigated by more extensive laboratory tests. In either event, the initial laboratory evaluation usually includes examination of the peripheral blood and measurement of the platelet count, bleeding time, prothrombin time, partial thromboplastin time, and thrombin time. More specific laboratory tests are then performed if indicated.
A healthy 20-year-old man presented with a spontaneous unilateral retinal hemorrhage. Because of a history of easy bruisability, we obtained hematologic studies and diagnosed thrombasthenia, a hereditary hemorrhagic disorder. The association of retinal hemorrhage and thrombasthenia is rare. Thrombasthenia and other platelet functional disorders are becoming better defined as tests for these abnormalities become more reliable and available. Patients with apparent spontaneous retinal hemorrhages of unknown origin should be questioned about hemorrhagic tendencies, and the various tests for hemorrhagic disorders should be obtained. The hematologic survey should include the more sophisticated tests of platelet function. Patients with thrombasthenia should avoid aspirin intake.
The microhematocrit provides accurate and reproducible test results. This laboratory procedure is useful not only in determining the hematocrit value, but also in the identification of conditions that may be of primary interest to the clinician. The information it provides is valuable in treatment planning, in choosing an anesthetic technique, and in helping to avoid operative and postoperative complications. This test can be easily and inexpensively performed and can be incorporated into the normal office routine with little difficulty.
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A family study is reported in which all three siblings were shown to be doubly heterozygous for haemoglobin D Los Angeles and beta thalassaemia, which resulted in a complete suppression of haemoglobin A synthesis. This demonstrates the effects of genetic interaction which occur when the genes for haemoglobin D Los Angeles and beta thalassaemia are both transmitted to the offspring. The importance of family studies in the investigation of haemoglobin abnormalities is stressed.
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Explore the source record for details and available documents.