James Blundell--pioneer transfusionist.
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Biomedical subjects
Publications and source records attributed to B A Myhre.
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Blood was drawn from volunteer donors and frozen using the high glycerin, mechanical freezing procedure accepted by the United States Navy. Subsequently, the units of blood were thawed and washed. Various anticoagulants were added, and the red cells were stored in a refrigerator at 4 degrees C for periods of up to 28 days. Chemical analyses were performed periodically. These showed that the addition of the anticoagulants ACD, CPD and CPDA-1 caused the red cells to be preserved better than the currently accepted 0.9-percent NaCl, 0.2-percent glucose solution. In vivo 51Cr viability studies performed on blood stored with CPDA-1 for 14 days showed a 24-hour viability of 78.8 +/- 8.4 percent. In a subsequent study, the blood was stored for 21 days prior to freezing and then was rejuvenated and frozen. The cells were thawed, washed, and stored at 4 degrees C with CPDA-1 for an additional 14 days. The 24-hour viability of these cells was determined to be 74.0 +/- 5.1 percent. These findings show that the postthaw storage time of red cells can be increased greatly over the now-accepted 24 hours, if bacterial sterility can be assured.
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The transfusion of blood was only one of many scientific competitions in which the citizens of France and England engaged in the 1600s. This particular competition laid the foundations for transfusion therapy that were built on 100 years later when more was known about blood. At the time of the studies discussed here, the most important goal seemed to be the establishment of the primacy of the discovery by one or the other nation. In this, most scholars give Lower and the English the first animal-to-animal transfusion and Denys and the French the first animal-to-man transfusion. However, even though this national primacy might not seem so important now, we must realize that the international competition created knowledge that still benefits us today, and those results might not have been produced so swiftly if the competition had not taken place.
A series of tables based on mathematical calculations is given as guidelines for the number of directed donors needed by members of various ethnic/racial groups to provide a desired number of units of blood with a selected probability of achieving this result. From these tables, certain conclusions can be drawn. Unrelated donors who do not know their blood type are an inefficient source of directed donors. Rh-negative patients are unlikely to obtain enough directed-donor units from either related or unrelated donors with confidence unless these donors known their blood type. In general, siblings, parents, and offspring are the most efficient directed donors from the standpoint of compatibility. Cousins, uncles, aunts, nieces, and nephews are not much more likely to be compatible than unrelated donors are. It is easier to obtain suitable directed-donor units among Hispanics than among whites, blacks, or Asians, due to their skewed blood group frequencies. In general, using O-negative directed donors for Rh-positive recipients does not significantly increase the likelihood of finding suitable donors.
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Whole blood and red cells were stored using citrate-phosphate-dextrose (CPD) and citrate-phosphate-dextrose-adenine (CPDA-1) anticoagulants in polyvinylchloride bags made flexible with di-(2-ethylhexyl)phthalate (DEHP) or tri-(2-ethylhexyl)trimellitate (TOTM) plasticizers. After storage the posttransfusion viability of these cells was tested in autologous donors. Cells stored in TOTM-plasticized film had a survival rate less than 75% when stored for 35 days, while other systems had a survival greater than this. When compared with the red cells stored in CPD-DEHP-plasticized film, the viability of whole blood and red cells stored in CPDA-TOTM showed a statistically significant decrease (p = less than 0.01). Therefore, red cell storage in TOTM-plasticized PVC with current anticoagulant should be limited to 21 days.
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This article will review the historical use of the computer in the blood bank and will show some examples of its current use today. A discussion will be included of the major areas in the blood bank where a computer would be particularly valuable and also of areas where it would be contraindicated. A few examples of the use in various institutions will be cited. Discussion of telecommunications as a possible method of inventory leveling and inventory control between blood banks will be included.
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The field of bloodstain analysis is undergoing considerable change. Newer technics are being used, and new legal decisions are providing specimens which are of better diagnostic use. However, the cost of the equipment, and the necessary training needed, has caused a considerable decrease in the number of individuals who are performing studies for the defense. At the same time the technics have made it possible for the courts to have better scientific evidence available to help them in their decisions. It is hoped that defense experts will keep pace with those of the prosecution, and ensure the right to fair trial for any individual.
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