Correlation of the hypotonic shock response and extent of shape change with the new ThromboLUX ™.

ThromboLUX (TLX)-Score was compared with hypotonic shock response (HSR) and extent of shape change (ESC) in 99 samples from 42 platelet concentrates. Tests were performed in parallel and duplicate. Mean values for TLX Score, HSR and ESC were 30.3 ± 3.8%, 69.0 ± 12.2% and 23.2 ± 4.9%, respectively. We found no significant correlation between TLX Score and HSR or ESC (r = -0.158, P = 0.118 and r = -115, P = 0.255, respectively), whereas HSR and ESC correlated significantly (r = 0.351, P < 0.001). As TLX Score did not show significant correlation with HSR and ESC, the value of TLX for platelet quality testing remains unclear. Studies comparing these parameters with transfusion outcome are needed.

The influence of four different anticoagulants on dynamic light scattering of platelets.

For testing of dynamic light scattering of platelets with ThromboLUX (TLX) in platelet-rich plasma (PRP) derived from venous whole blood (vWB), anticoagulation is needed. We compared TLX score in PRPs containing citrate, ethylene-diamine-tetraacetic-acid (EDTA), citrate-phosphate-dextrose-adenine (CPDA) or citrate-theophylline-adenosine-dipyridamole. Initial and late TLX scores were measured after 30-120 min or four to six hours, respectively. Compared with citrate, mean differences in initial TLX score were only significant for CPDA. Also, mean differences between initial and late TLX scores were only significant for CPDA. TLX failed to detect EDTA-induced platelet alterations. The clinical relevance of TLX needs further studies.

The structure of the von Willebrand factor is not altered in patients with colorectal carcinoma.

AIM: Elevated levels of von Willebrand factor (VWF) are often observed in many diseases including colorectal cancer, but this finding is not definite. The aim of our study was to examine the change in VWF multimer distribution in patients with colorectal cancer. METHOD: We randomly selected nine patients from each of the four Union for International Cancer Control (UICC) stages of colon cancer. VWF antigen (VWF:Ag), VWF-cleaving protease ADAMTS-13 level and factor VIII activity (FVIII:C) were determined. The multimer distribution of VWF was visualized using electrophoretic multimer analysis. RESULTS: The VWF multimer structure was normal with no difference between the four UICC stages. There was no significant increase in VWF:Ag and FVIII:C levels in the more advanced UICC stages. There was no significant difference in the ADAMTS-13 level according to the UICC stage. CONCLUSION: There was no change in the VWF multimer distribution to indicate acquired von Willebrand disease.

Transitory interruption of recommended storage conditions does not cause significant changes in in vitro parameters of leucocyte-depleted red blood cells.

BACKGROUND AND OBJECTIVES: Conventional quality control studies of the shelf life of RBC units do not consider cold chain interruptions that occur during cross-matching or between the release of RBCs from the blood bank and their return from the ward. These interruptions may, however, lead to a considerable loss of quality. On the other hand, differences in the quality of RBCs may derive from the different manufacturing processes employed in various blood centres. MATERIALS AND METHODS: One day after the expiry date of the RBC unit, we analysed complete blood count, blood gas, potassium, LDH, hydroxybutyrate dehydrogenase, glucose, lactate, total and free haemoglobin (Hb) and ATP and compared the results with regard to the frequency of storage interruptions and to two manufacturers of these RBCs. RESULTS: We could not find any correlations between the frequency of interruptions (0-11) and these parameters in any of the data sets. However, we found significant differences when comparing the two suppliers. RBCs of manufacturer A ('A', inline filtration of whole blood) contained 25% more Hb than those of manufacturer B ('B', inline filtration after buffy coat reduction). Sixteen percentage of 'A'-RBC, but none of 'B'-RBC, exceeded a haemolysis of 0.8%. CONCLUSIONS: Transitory interruptions of cold chain do not measurably impair the quality of RBCs. The effect on storage of RBCs in the blood bank is not as significant a factor as the differences that exist between RBC manufacturing procedures.

Storage induced apoptosis of peripheral blood mononuclear cells obtained from leucoreduction system chambers.

BACKGROUND AND OBJECTIVES: Recently, it was reported that leucocytes obtained from leucoreduction system chambers (LRSCs) after plateletapheresis show excellent quality due to culture of dendritic cells. This study analysed apoptosis of mononuclear cells derived from LRSCs of single platelet units (SPUs) and double platelet units (DPUs) during storage. MATERIALS AND METHODS: This randomized prospective study compared eighteen single and double platelet units produced with the Trima Accel cell separator. Buffy coat was drained from the LRSCs and analysed after 1, 6, 24, 48 and 72 h. CD45+ lymphocytes and CD14+ monocytes cells as well as Annexin-V+ and 7-AAD+ mononuclear cells were measured by flow cytometry. RESULTS: The WBC concentration of LRSCs obtained from SPUs and DPUs differed significantly (SPUs: 0·93 ± 0·32 ×10(5) per µl WBCs; DPUs: 1·71 ± 0·55 ×10(5) per µl WBCs; P<0·001). Processed blood volume (PBV) correlated significantly with WBC concentration (r(2)=0·75, P<0·001). Fifty percent of monocytes were Annexin-V-positive 1 h after production decreasing to 30% during 24 h of storage. Compared to that, the part of late apoptotic or necrotic PBMCs increased later on, after 24 h. After 24 h, Annexin-V- and 7-AAD-positive, late apoptotic and necrotic lymphocytes and monocytes doubled. CONCLUSION: PBMCs stored in autologous plasma in PVC-bags at room temperature did not show an increase of 7-AAD-positive PBMCs during 24 h prior to cell processing but increased significantly thereafter.

Retinblastoma: a modification in radiation therapy technique.

Patients with retinoblastoma treated with a single lateral field often suffer multiple recurrences in the anterior portion of the retina. The authors believe that these marginal recurrences are related to dose heterogeneity and that the entire retinal surface is at risk. In an attempt to treat the entire retinal surface and still protect the lens and anterior chamber, a conventional lateral field with the anterior beam edge at the equator of the globe is used with a second anterior field in which the central divergent lens block is hung in a pendulum fashion along the central axis. The shadow of the central block projects a diameter of 10 mm at the anterior corneal surface which well encompasses the lens. The fields are weighted 1:4.5 (anterior to lateral).

Sphincter preservation in patients with low rectal cancer treated with radiation therapy with or without local excision or fulguration.

Twenty-six patients with small cancers limited to the lower two-thirds of the rectum were treated with conservative surgery and radiation therapy (XRT). The selection factors for this approach were age, refusal of a permanent colostomy, or the high risk of local recurrence because of inadequate surgical margin or palpable residual tumor after local surgical treatment alone. In patients treated with local excision or fulguration followed by XRT, there was a 6% local failure rate (one in 17); in 16 of 17 patients receiving radiation doses above 4,500 cGy, the local control was complete for follow-up periods of 6 months to 7 years. In nine patients treated with XRT for residual tumor, local failure occurred in five (56%). The disease-free survival for those without residual tumor versus those with residual tumor was 88% and 44%, with median follow-up periods of 20 and 23 months, respectively. Serious late complications occurred only if total doses were greater than 6,300 cGy. Local excision combined with XRT proved to be a safe alternative to radical surgery in selected patients and resulted in excellent local control while allowing preservation of anal sphincter function.