Biomedical subjects
A Macfie
Publications and source records attributed to A Macfie.
The use of fresh blood to control severe haemorrhage associated with massive blood transfusion after cardiopulmonary bypass.
A 61-year-old man with severe factor XI deficiency presented for coronary artery bypass surgery. The clotting deficiency was corrected preoperatively with factor XI concentrate. Surgery resulted in severe postoperative haemorrhage of 55 liters of blood. This was managed successfully with a cell saver device (Haemonetics). Repeated platelet transfusions were ineffective in correcting the platelet dysfunction. The severe haemorrhage stopped suddenly after the infusion of 4 units of fresh blood. The case demonstrates how fresh blood can be useful in the management of severe haemorrhage after massive blood transfusion.
Comparison of in vitro demyelination and cytotoxicity of humoral factors in multiple sclerosis and other neurological diseases.
The distribution and nature of serum factors causing in vitro demyelination and glial lysis were investigated in multiple sclerosis (MS), other neurological diseases (OND), ill control and control groups. MS sera were unique in affecting only CNS myelin and glia whereas stroke and Guillain-Barré syndrome (GBS) sera brought changes to both CNS and PNS tissue. Through both visual scoring of myelin damage and the quantitative measurement of radiolabel release from cerebellar cultures, it was evident that the MS and OND groups have similar myelino- and cytotoxic effects. This may reflect MS and OND sera sharing similar humoral factors. 74% MS, 68% OND and 22% of control scores were above a score threshold designed to exclude culture handling trauma effects. When classified by their current disease state MS patients with severe and mild disease yielded higher in vitro scores than did those with moderate disease who comprised an older age group. No other clinical features of MS patients gave any association with in vitro serum effects. The rare demonstration of bound Fab IgG in cultures after MS serum tests indicates that immune mechanisms are unlikely to make a large contribution to serum-induced demyelination and cellular change in vitro.