Autologous blood donor screening indicated a lower prevalence of viral hepatitis in East vs West Germany: epidemiological benefit from established health resources.

Prevalence data concerning viral hepatitis and human immunodeficiency virus (HIV) in the general population are usually scarce. We aimed for a large cohort representative of the general population that required little funding. Autologous blood donors are relatively representative of the general population, and are tested for viral hepatitis and HIV in many countries. However, frequently these data are not captured for epidemiologic purposes. We analysed data from well over 35,000 autologous blood donors as recorded in 21 different transfusion centres for anti-hepatitis C virus (HCV), HBsAg and anti-HIV, as well as TPHA if available. We found a lower prevalence of hepatitis B virus and HCV in East vs West Germany, 0.2%vs 0.32% and 0.16%vs 0.32% respectively, which confirms earlier data in smaller cohorts, thus supporting the value of our approach. HIV was too rare to disclose significant differences, 0.01%vs 0.02%. TPHA was higher in East (0.34%) vs West Germany (0.29%) without significant differences. HCV was more frequent in women vs men. Transfusion institutes managing autologous blood donations should be used as a resource for epidemiological data relating to viral hepatitis and HIV, if such testing is performed routinely. This approach generates data relating to the general population with special emphasis on undiagnosed cases.

Adverse events in peripheral progenitor cell collection: a 7-year experience.

Collection of peripheral progenitor cells (PPC) by apheresis machines is generally regarded as a safe procedure. However, data about adverse events in PPC harvesting are scarce. In a monocentric retrospective study, the data of 540 PPC collections in a period of 7 years were reviewed. Adverse events were subdivided in collection-associated technical problems and patient/donor-related side effects. Patient/donor-related side effects occurred most often (19.8%); most of them were paresthesias due to citrate toxicity. Paresthesias were treated by oral (20.4%) or intravenous (1.1%) calcium supplementation. Problems with venous access were also seen frequently, resulting in blood flow alarms (11.3%) and blockades in the return line (4.3%). A total of 6.9% of these problems were catheter associated, requiring revision of the central venous line in 2.6%. Technical problems with the blood cell separators were observed in 11.7%. Ten PPC collections were discontinued due to adverse events. The data of this retrospective, monocentric analysis show that patient/donor-associated problems were observed in every fifth PPC harvest. Most of them were paresthesias, which could be easily treated by calcium supplementation. Problems with venous access and technical problems with the cell separators occurred in every tenth PPC collection.

Radiological evaluation of Duhamel's operation in Hirschsprung's disease. Attempt at radio-clinical correlation.

The aim of this study was to evaluate the results of the Duhamel cure technique in a case of Hirschsprung's disease with a barium colorectal opacification by low approach. The overall height of the rectal stump (HR), the depth of the blind part of the rectum (PR), the rectal diameter (DR), the diameter of the colorectal anastomosis (DA) were measured. The rectal volume of its blind part (VRB), the rectal volume of its functional part (VRF), the surface of the colorectal and subanal anastomosis, the VRF/VRB ratio were calculated. Two types of subgroups were analysed: -the patients in whom the rectal stump had been closed by stapling (13 cases) and those where the rectal stump was manually closed (13 cases). -the patients who had no transit trouble (20 cases) and those in whom a stercoroma or coproma had formed, including phenomena either similar to encopresia or to soiling. The manual suture of the top of the rectal stump does not show any significant difference compared to stapling. The rectal height (HR=71 mm+/-1.9), the blind rectal stump depth (PR = 36 mm+/-2.2) of the 6 patients with stercoroma are significantly higher than with the other 20 patients (HR = 51.6+/-2.6 and PR = 24.4+/-2.7, i.e. respectively p = 0.0005 and p = 0.03). VRF and VRB are equal in the group with stercoroma, and VRF is twice or more than VRB in the group without any problem. If it is impossible to obtain a sufficiently short rectal pouch, an excessive HR may be balanced by a longer colorectal anastomosis with a higher VRF/VRB ratio. This is of importance in laparoscopic procedure.

[Common mesentery: clinical and therapeutic aspects in children. Apropos of 58 cases]. / Mésentère commun: aspects cliniques et thérapeutiques chez l'enfant. A propos de 58 observations.

Fifty-eight children with isolated malrotation of the midgut were treated in our service between 1970 and 1993. They presented with acute bilious vomiting in 75% of cases. The remaining 25% consulted for various digestive symptoms. Diagnoses were established by an upper gastrointestinal radiographic study. Prognoses were good whenever an emergency operation was performed.

Excitation transport and trapping in a synthetic chlorophyllide substituted hemoglobin: orientation of the chlorophyll S1 transition dipole.

Excitation transport in synthetic zinc chlorophyllide substituted hemoglobin has been observed by pico -second time-resolved fluorescence depolarization experiments. In this hybrid molecular system, two zinc chlorophyllide molecules are substituted into the beta-chains of hemoglobin, while deoxy hemes remain in the alpha-chains. The rate of excitation transfer between the two chlorophyllides is analyzed in terms of the distance and orientation dependences predicted by the F orster dipole-dipole theory. In this analysis, the beta-beta interchromophore geometry is assumed to be that of the deoxyhemoglobin crystal structure. When combined with steady-state fluorescence depolarization data of the complementary hybrid containing zinc chlorophyllide in the alpha-chains, these experiments provide the necessary information to determine the orientation of the S1 transition dipole moment in the zinc chlorophyllide molecule. We also find that the fluorescence lifetime of the zinc chlorophyllide is 1.42 ns when the heme is in the deoxy state but 3.75 ns when the heme is ligated to carbon monoxide. This is explained by irreversible excitation transfer from the S1 state of the zinc chlorophyllide to the lower energy excited states present in deoxy heme.