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Biomedical subjects

E Patten

Publications and source records attributed to E Patten.

11 recordsLinked to original sources
PubMed1991

Use of red blood cells older than five days for neonatal transfusion.

Sick neonates often require periodic small volume transfusions (10 mL/kg) to replace blood drawn for laboratory monitoring during their hospital stay. We use red blood cells (RBCs), stored as CPDA-1 whole blood, up to their expiration date, and are unaware of any clinical problems with this practice. We proceeded to confirm our clinical impression by reviewing the hospital records of 22 transfused neonates who received a median of 2.5 RBC transfusions (range 1 to 11) with a volume of 16 mL (range 5 to 38) each, and total volume of 60 mL (range 16 to 152). The RBCs were stored a median of 7 days (range 2 to 27). Following transfusion, there was an increase (P less than .05) in hemoglobin (mean 2.8 +/- 1.6 gm/dL [SD]) and hematocrit (9.0% +/- 4.7%). The bilirubin also rose (0.6 +/- 1.5 mg/dL, P less than .05), but this was not considered clinically significant. No significant change occurred in pH or bicarbonate. Paradoxically, RBCs over 10 days of age resulted in a fall in potassium (-0.9 +/- 0.8 mEq/L, P less than .01), but not below 3.4 mEq/L. We could find no evidence by clinical observation or laboratory indexes that small volume transfusion of RBCs more than 5 days old was deleterious to the newborns studied. By using RBCs up to their expiration date, the number of donor exposures and the potential risk of transfusion-transmitted diseases can be decreased.

Blood Preservation↗
PubMed1986

Early events in lymphocyte activation as defined by three new monoclonal antibodies.

Three new lymphocyte activation antigens are described whose kinetics of appearance place them very early in the activation pathway. The 78,000 dalton early antigen (Ea) 1 is present at low levels on resting lymphocytes, and its expression is enhanced twofold to threefold within 3 hr of stimulation. Ea2, a nondisulfide-bonded 86,000 and 73,000 dalton heterodimer, is first detectable 3 hr after activation and peaks by 9 hr. Its presence on all but a few cell lines, plus the variable association with a lower m.w. (28,000) structure, suggest that it may serve as a receptor for a growth factor. Neither Ea1 nor Ea2 are restricted to lymphocytes. The 31,000 dalton Ea3 antigen is induced only by PHA but not by other means of activation, and may pre-exist within the cell. The Ea3 antibody blocks PHA-induced but not OKT3-induced mitogenesis, suggesting differences in the pathways of activation by these two stimuli. These reagents, and OKT3, were used to define the cyclosporine A (CSA)-sensitive stage of lymphocyte activation. CSA blocks at a point before the biosynthesis of Ea1 and after that of T3/T cell receptor loss from the cell surface, at a point close to Ea2 biosynthesis.

Animals↗
PubMed1986

Therapeutic plasmapheresis and plasma exchange.

Plasma exchange is a process in which large volumes of plasma, usually equivalent to one plasma volume, are exchanged with donor plasma or a plasma substitute. This permits the removal of antibody, immune complexes, inflammatory mediators, paraproteins, drugs, toxins, and other plasma constituents. Plasma exchange may also have an effect on the immune system by enhancing the function of the reticuloendothelial system, removing blocking antibody, increasing clearance of tumor cells, and making lymphocytes more vulnerable to immunosuppressive drugs. Over 100 diseases have been treated with plasma exchange with variable success. Results of controlled studies are less dramatic than those of earlier uncontrolled case reports. Reports of complications and even death have tempered initial enthusiasm. Now, over a decade since the initial promising reports began to appear in the literature, the role of plasma exchange remains undefined.

Amyotrophic Lateral Sclerosis↗
PubMedDate not supplied

Autoimmune hemolytic anemia with anti Jka specificity in a patient taking aldomet.

Autoimmune hemolytic anemia (hemoglobin 5.2 g, reticulocyte count 31.0 per cent) developed in a 53-year-old hypertensive woman who was taking Aldomet. Both the patient's serum and the eluate prepared from her red blood cells contained an antibody with anti-Jka specificity. Rapid sustained improvement in the anemia occurred after cessation of Aldomet and a two week course of prednisone therapy. Eight months later, anti-Jka was no longer detectable in the patient's serum and the direct antiglobulin test was nonreactive.

Agglutinins↗
PubMedDate not supplied

Effective leukocyte removal from platelet preparations by centrifugation in a new pooling bag.

A pooling bag (Leukotrap, Cutter Laboratories, Berkeley, CA) with a protruding pocket at the bottom into which heavier cellular elements are collected after centrifugation at 390 X g for 10 minutes, was studied. The tab is clamped before transfusion. Varying numbers of platelet concentrates (PC) that had been stored for different durations were pooled and centrifuged in the bags. When 4 or more units of PC were studied, the results were independent of the number of units and the duration of storage. Approximately 90 percent of the contaminating leukocytes (WBC) were removed with a platelet loss of less than 10 percent. Similar results were obtained with single-donor platelets (WBCs decreased 93%; range, 77-99%; n = 12). Posttransfusion increments were similar to those with unmodified platelets; in four patients, febrile platelet transfusion reactions were eliminated by the WBC removal. Thus, the bags represent a simple, reproducible, and effective means of reducing WBC and red cell contamination of platelet preparations with acceptable platelet losses.

Blood Platelets↗