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P Devine

Publications and source records attributed to P Devine.

At least 37 records · Page 2Linked to original sources
PubMed1993

Blood donor-, apheresis-, and transfusion-related activities: results of the 1991 American Association of Blood Banks Institutional Membership Questionnaire.

Approximately 2154 regional blood centers and hospital-based blood banks and transfusion services responded to the 1991 American Association of Blood Banks Institutional Membership Questionnaire that elicited data from 1990. Information from 2144 institutions was considered valid. Questionnaire topics were donor blood collections, hemapheresis, perioperative cell salvage, component usage, and transfusion-associated diseases. Institutional members reported collecting 9.3 million units, of which 90.9 percent were for allogeneic use in the community, 6.0 percent were for autologous use, and 3.1 percent were directed donations. The percentage of directed-donor units that were crossed over for allogeneic use (51%) was greater than the percentage of units transfused to the designated patient (49%). Only 12.5 percent of institutions reported obtaining specific consent for transfusion. Of the 15.4 million transfused blood components, 8.5 million were red cells, 4.1 million were platelets, 1.8 million were fresh-frozen plasma, and 0.9 million were cryoprecipitate. There were 1263 reported cases of transfusion-associated hepatitis. Approximately 44 percent of the patients who were tested proved positive for hepatitis B surface antigen, and 80 percent of the patients who were tested proved positive for antibody to hepatitis C. The questionnaire's aggregate results can be used to assess current patterns of blood donation and transfusion activities.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Detecting semen antisperm antibodies in the clinical laboratory.

Although antisperm antibodies are associated with infertility, many hospital laboratories do not test for these antibodies. This study included 520 males who were referred for infertility evaluation. Semen samples from all patients were tested for antisperm antibodies by using the mixed antiglobulin reaction and immunobead binding tests. These results were correlated with the findings of semen analyses, postcoital tests, and sperm penetration assays. Eighty-eight men (16.9%) tested positive for IgG, IgA, or IgM antisperm antibodies. More samples tested positive for IgG antibodies by the mixed antiglobulin reaction than by the immunobead test (n = 71 vs n = 42); 57 samples tested IgA positive. Both methods showed good reproducibility (97.6%). Antibody-positive males had a higher incidence of abnormal semen analyses (92% vs 74%) and other immune-related fertility test results (94.2% vs 38.4%). The presence of antisperm antibodies correlates with other abnormal semen parameters. Testing for these antibodies should be included in an infertility evaluation and could be readily implemented in a clinical laboratory.

Antibodies↗
PubMed1992

Blood donation and transfusion practices: the 1990 American Association of Blood Banks Institutional Membership Questionnaire.

Responses to the 1990 American Association of Blood Banks (AABB) Institutional Membership Questionnaire were submitted by 2126 regional blood centers, hospital-based blood banks, and transfusion facilities. Data from 2117 of these facilities were considered to be valid. The questionnaire included information on blood donor demographics, number of units collected, and collection procedures; services performed; usage of blood components; and transfusion-transmitted diseases reported during 1989. Institutional members collected 7.4 million whole blood units, of which 90.8 percent were donated for allogeneic use, 6.0 percent were donated for autologous use, and 3.2 percent were donated for directed use. Approximately 630,546 allogeneic and directed-use blood donors were deferred, most often for low hemoglobin or hematocrit values. Approximately 225,205 full allogeneic and directed-donor units were discarded, primarily for elevated alanine aminotransferase levels or the presence of hepatitis B core antibody. The 14.3 million transfused components included 56.7 percent red cell-containing components, 27.4 percent platelets, 11 percent fresh-frozen plasma, and 4.8 percent cryoprecipitate. Institutional members reported 1397 cases of transfusion-associated hepatitis. In this group, 921 patients were tested for hepatitis B surface antigen after the transfusion; 339 (36.8%) were found to be hepatitis B surface antigen positive. The AABB Institutional Questionnaire results provide recent data on blood donor and transfusion-related activities that are vital to the evaluation of current transfusion medicine practices.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Acetazolamide inhibits acidification by the turtle bladder independent of cell pH.

Acetazolamide (ACZL) inhibits luminal acidification by the turtle urinary bladder, a process thought to be mediated by the drug's ability to inhibit carbonic anhydrase (CA) and thus elevate cell pH. To test the hypothesis that these transport changes are actually mediated by changes of cell pH, we measured this parameter in single, identifiable mucosal cells using 4-methylumbelliferone and fluorescence microscopy. In control bladders 5 X 10(-4) M ACZL inhibited proton transport by 80 +/- 6%, and alkalinized cell pH, especially in a subpopulation of CA cells. A much larger cell alkalinization was induced by serosal HCO3- but proton transport fell only 30 +/- 7%. When cell pH was clamped at approximately 7.0 using 50 mM dimethyloxazolidinedione, or when cell pH was acidified using 7.5 mM propionate, transport rates still declined by 74 +/- 2, and 100 +/- 12%, respectively, in response to ACZL. In propionate-acidified bladders, 1 mM sodium azide blocked the inhibition of transport seen with 5 X 10(-4) M ACZL and reversed the inhibition with 10(-5) M ACZL. The apical endocytosis rate was increased by ACZL in normal and propionate-acidified bladders, but was not stimulated by alkalinizing the cell with NH4Cl. We conclude that ACZL can induce cellular alkalinization in this tissue, but that this pH change is not required for the inhibition of transport, or the ACZL-associated stimulation of endocytosis. The drug's ability to inhibit acidification appears to be the result of an azide-sensitive mechanism that has yet to be defined.

Acetazolamide↗
PubMed1989

Phorbol myristate acetate inhibits acidification by turtle urinary bladder.

The effects of phorbol myristate acetate (PMA) on acid secretion by the turtle urinary bladder were examined to evaluate the importance of protein phosphorylation in modulating the distal acidification system. In HCO3-free PO4 buffer 0.2 mM mucosal PMA inhibited reverse short-circuit current (RSCC) by 42%. The inhibition of RSCC was dose dependent, and RSCC approached zero at high concentrations of PMA. PMA also inhibited acid secretion measured titrimetrically but had no effect on RSCC from bladders in which proton secretion was selectively inhibited by an adverse pH gradient or serosal 4,4'-diisothiocyanostilbene-2,2'-disulfonic acid. The inhibition by PMA was duplicated by 1-oleoyl-2-acetyl-rac-glycerol, but not by an inactive phorbol ester. The PMA inhibition was much more potent with mucosal compared with serosal application. The PMA inhibition caused a significant 0.15 pH unit reduction of carbonic anhydrase (CA) cell cytoplasmic pH and a change in the CA cell morphology. Unlike the inhibition of proton transport induced by acetazolamide, the PMA inhibition was neither reversed nor prevented by sodium azide. We conclude that PMA decreases basal acid secretion and blocks the stimulatory effects of CO2 by an azide-insensitive mechanism distinct from that of acetazolamide. In view of recent findings that PMA stimulates HCO3 secretion by the turtle bladder, these results suggest that kinase C-mediated protein phosphorylation may be a central event in the transition from the secretion of acid to the secretion of base.

1-Methyl-3-isobutylxanthine↗
PubMed1989

Passively acquired antibody to hepatitis B surface antigen. Pitfall in evaluating immunity to hepatitis B viral infections.

Antibody to hepatitis B surface antigen (anti-HBs) has been used clinically to indicate an immune response to hepatitis B virus (HBV) and a protection against reinfection with the virus. We describe a child with hemophilia who had high-titer IgG anti-HBs in his serum and who subsequently developed viral B hepatitis. The child had received a unit of fresh frozen plasma 17 days prior to the determination of anti-HBs. The fresh frozen plasma donor was later found to be anti-HBs positive. The patient's anti-HBs was most likely passively acquired and therefore did not signify immunity to HBV. Various tests, including hepatitis B surface antigen group-specific and subtype determinants, ratio units of anti-HBs, and antibody class, have been used to determine whether or not anti-HBs will confer immunity. Although these tests have been thought to accurately predict immune status against infection with HBV, our case shows this may not be true, especially in patients who have been recently transfused. Anti-HBs testing may be predictive of immunity to HBV in the absence of a source of passively acquired anti-HBs.

Antigen-Antibody Reactions↗
PubMed1988

Quality assurance of hospital transfusion practices: the role of nursing staff.

After a pilot study and other data revealed incomplete documentation of patient transfusions, representatives of a hospital blood bank and nursing services organized an education program for nurses on transfusion medicine. The program emphasized transfusion procedures, especially the need to monitor patients; possible adverse reactions and ways to assess them; appropriate interventions; and the importance of documentation. On-going monitoring and a follow-up study indicated substantial improvement in documentation and reaction identification after the in-service training.

Blood Transfusion↗
PubMed1987

Permeabilizing the granular cell of toad and turtle bladder: lack of cell coupling.

Mucosal cells of the toad and turtle urinary bladder have cell membranes that exclude charged fluorescent dyes. We describe a simple and effective method of transiently permeabilizing the apical membranes of mucosal cells in situ by applying mild mechanical stress to the bladder's mucosal face. The technique produces clusters of individually distinguishable granular cells, which are loaded with and retain membrane-impermeant fluoroprobes and macromolecules. Carbonic anhydrase-rich cells are resistant to the permeabilization. The apical membranes regain functional integrity after permeabilization, as indicated by a return of transepithelial electrical resistance, an inability to load cells except immediately after the stress, and the observation that loaded cells behave identically to normal cells in regulating cell pH. With the use of this technique, BCECF and fura-2 were loaded into granular cells and used successfully to follow cell pH and cell calcium. In granular cells loaded with these dyes or Lucifer Yellow, there was no detectable spread of dye into adjacent cells. This lack of dye coupling was confirmed by use of conventional iontophoresis of dye into normal granular cells. Electrical coupling was also undetectable between granular cells separated by distances less than 30 micron. We conclude that none of the mature cells of the bladder surface are directly coupled.

Aminoquinolines↗
PubMed1985

A blood bank consultation service: principles and practice.

In the blood bank setting, a close relationship with both clinicians and patients is essential for good medical practice. In July 1982, the Mayo Clinic Blood Bank and Transfusion Services formally organized a consultation service with daily visits to patients of mutual interest to blood bank consultants and clinicians for practice and education. Detailed diaries of this activity were maintained for 12 months, during which time 802 impatient visits were recorded. The most frequent reasons for consultations were clarification or amplification of the clinical history (34.0%), evaluation of transfusion reactions (27.2%), and assessment of serologic problems (18.2%). These consultations resulted in diagnostic, management, and therapeutic recommendations for a wide variety of medical problems. Of the 802 consultations, 23% were conducted at the direct request of clinicians. We believe that a blood bank consultation service is feasible, is enlightening for the blood bank and clinicians, and contributes to patient care.

Blood Banks↗
PubMed1985

Biliary cystadenocarcinoma arising in a congenital cyst.

The case of a biliary cystadenoma containing foci of cystadenocarcinoma is reported, along with the first electron microscopic description of this lesion. Both neoplastic and congenital origins have been implicated in the pathogenesis of biliary cystadenomas. In this case hamartomatous bile ducts were found, supporting a congenital origin for at least some biliary cystadenomas. Careful pathologic evaluation is emphasized since malignant degeneration can be detected only after thorough sectioning.

Aged↗
PubMed1984

Completely cartilaginous trachea in a child with Crouzon syndrome.

We describe a patient with Crouzon syndrome and congenital tracheal stenosis. The trachea lacked rings and was completely cartilaginous, making it rigid and narrow. The respiratory difficulties that are present in patients with Crouzon syndrome have been ascribed to the nasal or choanal defects that are associated with this condition. However, the presence of congenital tracheobronchial abnormalities as a cause of respiratory problems has not been widely investigated. Congenital tracheal stenosis may occur as an isolated defect or as one of many other congenital defects. In patients with Crouzon syndrome who have recurrent respiratory problems, congenital tracheal or bronchial defects should be considered since surgical intervention may correct the defect.

Abnormalities, Multiple↗
PubMed1984

Nephrogenic adenoma and embryonic kidney tubules share PNA receptor sites.

Nephrogenic adenoma a rare bladder, ureter, or urethral lesion, is of disputed pathogenesis, metaplastic and congenital etiologies both being implicated in its development. Since light and electron microscopy have been unable to fully resolve the lesion's pathogenesis, the authors used biotinylated lectins as probes and avidin-biotin peroxidase complex (ABC) as a visualant to study cases of nephrogenic adenomas and compared their lectin binding patterns with those of normal transitional epithelium, human embryonic kidneys, and cases of cystitis cystica and glandularis and squamous metaplasia of the bladder in an effort to clarify this issue. Only the epithelial lining of the luminal surface and tubuli in nephrogenic adenoma and tubules in embryonic kidney exhibited free PNA receptor sites. The striking staining similarities between the epithelial components of nephrogenic adenomas and mesonephric and metanephric tubules complement previous findings concerning the origin of nephrogenic adenoma.

Adenoma↗
PubMedDate not supplied

Multidisciplinary care of hepatocellular carcinoma.

OBJECTIVES: Multidisciplinary care of cancer patients in varied settings is well described in the literature, but there is little specifically describing the multidisciplinary care of the patient with hepatocellular carcinoma (HCC). The purpose of this article is to describe HCC and the multidisciplinary approach at the Philadelphia Veterans Affairs Medical Center (PVAMC). MATERIALS AND METHODS: HCC is one of the most common solid tumors in the world, but it is rare in North America. It is associated with environmental carcinogens identified in animal studies, hepatitis B and C, cirrhosis of any etiology, and various metabolic diseases. No reliable therapy has been established for HCC. Surgical resection is the best treatment, but it is possible only in the patient with adequate hepatic reserve and limited-stage cancer. From January 1995 to May 1998, 22 patients at PVAMC received a diagnosis of primary HCC. One patient was a candidate for surgery, two patients received radiation therapy, and one patient underwent chemoembolization. Eighteen patients presented with an advanced-stage disease and comorbidities. RESULTS: Therapy goals in these 18 patients were limited to supportive care and enhancement of quality of life. A multidisciplinary team provided care to this challenging patient population. The multidisciplinary team treating HCC at PVAMC consisted of physicians, nurses, pharmacists, social workers, and a chaplain. Most care occurred in the outpatient setting. Supportive therapy included the controlling of ascites and abdominal discomfort, hepatic encephalopathy, and pruritus. Opioids relieved abdominal pain. Psychiatric support and counseling helped patients and families cope with the poor prognosis. CONCLUSIONS: A multidisciplinary team approach helped provide care for this challenging population. Through anecdotal reports, patients and family expressed satisfaction with their care. Research is needed to systematically test interventions designed to enhance quality of life in patients with HCC.

Adult↗
PubMedDate not supplied

Serologic evidence that Scianna null (Sc:-1,-2) red cells lack multiple high-frequency antigens.

Sera from three unrelated persons whose red cells (RBC) had the common Scianna phenotype (Sc:1,-2) contained IgG alloantibodies directed against high-frequency RBC antigens. In each case, sera or eluates or both failed to react only with Scianna null (Sc:-1,-2) cells, although an eluate from one person was compatible with a sibling's Sc:1,-2 cells. Cross-testing cells with sera or eluates, or both, from the three persons revealed no mutual compatibility. These studies show the existence of three additional RBC antigens phenotypically related to the Scianna blood group system. Sc:-1,-2 cells lack these antigens, which indicates that Scianna null cells lack multiple high-frequency antigens.

Aged↗
PubMedDate not supplied

Omeprazole and SCH 28080 inhibit acid secretion by the turtle urinary bladder.

There is now convincing evidence that in addition to the vacuolar-type H(+)-ATPase, a gastric-type H+/K(+)-ATPase participates in acidification by the distal nephron. To determine whether a similar pump exists in the turtle bladder, we examined the dependence of acid secretion on mucosal K+, and the effects of supposedly specific inhibitors of the gastric H+/K(+)-ATPase, omeprazole and SCH 28080. In CO2-stimulated bladders both drugs produced dose-dependent inhibition of electrogenic H+ secretion measured as the reverse short-circuit current (RSCC). At the highest concentrations tested, H+ secretion decreased 45 +/- 16% with mucosal and 20 +/- 7% with serosal omeprazole (P < 0.01). SCH 28080 at 400 microM produced essentially complete inhibition of H+ secretion with either mucosal or serosal application. When H+ secretion was purposefully inhibited by DIDS or an adverse mucosal pH gradient, SCH 28080 had no effect on RSCC. Removing mucosal K+ (measured K+ < 50 microM), with or without mucosal barium, had no effect on RSCC. The inhibition of RSCC by omeprazole was reversed by mercaptoethanol. Finally, HCO3 secretion, as measured by either RSCC or pH-stat titration, increased significantly in response to 400 microM SCH 28080. The results demonstrate that these compounds inhibit acid secretion by the turtle bladder but stimulate the secretion of base. In view of the total independence of acid secretion on potassium, it is unlikely that any of the bladder's acid secretion is mediated by an H+/K(+)-ATPase. The most reasonable interpretation of the data is that omeprazole and SCH 28080, previously thought to be specific inhibitors of the H+/K(+)-ATPase, also inhibit the vacuolar H(+)-ATPase of the turtle bladder. The results also indicate that HCO3 secretion by the bladder employ a different mechanism of H+ transport than is used for acid secretion; there is no simple reversal of polarity in the acid- versus base-secreting cells.

Animals↗