Severe Yersinia enterocolitica sepsis after blood transfusion.

A 23-year-old male received multiple blood transfusions following complicated thoracic surgery. He developed progressive haemorrhagic shock and multiple organ dysfunction syndrome. Blood cultures grew Yersinia enterocolitica. The patient was proven negative for Yersinia enterocolitica; however, one of the donors was found to be positive. Although strict selection of blood transfusion donors is warranted in the Netherlands, contamination of blood components may still occur and therefore should be considered whenever adverse events occur during or after blood transfusion.

The determination of the complement components C1q, C4 and C3 in serum and cerebrospinal fluid by radioimmunoassay.

Non-competitive 2-site radioimmunoassays (RIA) for the determination of the complement proteins C1q, C4 and C3 in cerebrospinal fluid (CSF) are described. The quantitative results of the RIAs were the same as those obtained by other assay methods: radial immunodiffusion and turbidimetry and, in the case of C4, the haemolytic assay. The concentrations of the complement proteins in paired CSF and serum samples from a group of 60 patients were measured, as well as those of albumin and IgG. The ratios (concentration in CSF)/(concentration in serum) of the complement proteins correlated poorly with that of albumin. In contrast, the ratio of IgG was significantly correlated with that of albumin. The ratios of the complement proteins were higher than might be expected on the basis of their molecular masses. This suggests that these proteins may be synthesized within the normal central nervous system.

Preparation of an optically clear frozen human control serum.

A new method was developed for the preparation of a human control serum. All equipment used will be available in any clinical laboratory. An in-between storage period of 2 months at -20 degrees C for the combined serum pool proved obligatory to obtain a stable, well defined control serum. In our procedure the heavy turbidity inherent to outdated thawed serum is removed by vacuum filtration over Avicel cellulose. The resulting serum filtrate is clarified to a degree such that it can readily be passed through a filterset consisting of four filters with diminishing pore size from 8.0 to 0.22 micron. The time needed for the total filtration of 10 litres will not exceed 2 to 3 h using 90 mm diameter filters. In our experience over a period of more than 3 years, these controls stored at -20 degrees C had a stability of at least 1 year for non-enzymatic as well as most enzymatic components. Information is provided on the stability and concentration levels of components measured by immunological methods, that is, radioimmunoassay and turbidimetry. We monitor 50 parameters with the control serum described.

Influence of ambient temperature on the Ektachem DT60 results for total bilirubin and total protein.

We evaluated the Kodak Ektachem DT60 analyzer with the DTE module in a two-month clinical trial before its introduction in the Netherlands. At ambient temperatures that differed from that at which the DT60 was calibrated, aberrant behavior for total bilirubin and total protein assays was observed. At subnormal temperatures the former gave higher results than expected, and the latter, lower results. We found a similar effect for total protein determined by the manual biuret reaction at different temperatures, when results were calculated from calibration at a fixed temperature. Total bilirubin assayed by the manual diazobilirubin method showed no such effect. Although the DT60 analyzer is equipped with a temperature-regulated incubator, we conclude that the manufactures's recommended room temperature range for these assays should be narrowed and the three-month calibration period adjusted according to external circumstances.