The Thermographically Observed Effects of Hyperoxia on Vascular Headache Patients and Non-Headache Individuals

SYNOPSIS
This study utilizes electronic thermography to investigate the response of 30 headache patients (migraine and mixed) and 20 non-headache individuals to inhaling 100% oxygen at 10 liters per minute for 5 minutes. Observations were made prior to, immediately following, and at 3, 6 and 10 minutes post-inhalation.
Thermograms were inspected to determine the influence of hyperoxia on facial pattern temperatures across time. Chi-square analysis determined that there was a significant difference (P<.01) in response between the control group and headache patients immediately following inhalation. While the temperature of each control subject decreased, 14 (46.67%) patients displayed a 0.5 to 1.0°C paradoxical rise. There was no significant difference in response between the types of headache. Statistically significant difference in response continued during the post-inhalation phase; at 10 minutes, 6 (20.00%) patients continued to display temperatures above baseline, The response to hyperoxia did not differ if the patient was experiencing a headache, nor did oxygen significantly reduce pain. No difference in response was noted in those patients who were prescribed beta or calcium channel block-ere. Hyperoxia increased migraine "cold patch" size. Regardless of temperature fluctuations, facial patterns remained stable across conditions. A blind calling of pre- and post-inhalation thermograms was 93% accurate.
The response of the medial canthi did not significantly differ between conditions. Hyperoxia generally increased size, temperature and symmetry. During the post-inhalation phase original patterns generally returned.
This study supports previous headache/thermography findings and points to vascular dissimilarities between headache and non-headache individuals.     

Plasma porphyrins in the porphyrias.

BACKGROUND: As an aid in the diagnosis and management of porphyria we have developed a method to fractionate and quantify plasma porphyrins and have evaluated its use in various porphyrias. METHODS: We used HPLC with fluorometric detection to measure plasma concentrations of uroporphyrin I and III, heptacarboxyl III, hexacarboxyl III, pentacarboxyl III, and coproporphyrin I and III. We studied 245 healthy subjects, 32 patients with classical porphyria cutanea tarda (PCT), 12 patients with PCT of renal failure, 13 patients with renal failure, 8 patients with pseudoporphyria of renal failure, 3 patients with acute intermittent porphyria, 5 patients with variegate porphyria, 5 patients with hereditary coproporphyria, and 4 patients with erythropoietic protoporphyria. RESULTS: Between-run CVs were 5.4-13%. The recoveries of porphyrins added to plasma were 71-114% except for protoporphyrin, which could not be reliably measured with this technique. Plasma porphyrin patterns clearly identified PCT, and its clinical sensitivity equaled that of urine porphyrin fractionation. The patterns also allowed differentiation of PCT of renal failure from pseudoporphyria of renal failure. CONCLUSIONS: The assay of plasma porphyrins identifies patients with PCT and appears particularly useful for differentiating PCT of renal failure from pseudoporphyria of renal failure.     

Procalcitonin in patients undergoing cardiopulmonary bypass in open heart surgery – first results of the Procalcitonin in Heart Surgery study (ProHearts)

Objective To investigate procalcitonin (PCT) levels in patients undergoing cardiopulmonary bypass (CPB) in order to assess the prevalence and prognostic capacity of elevated PCT levels following CPB in open heart surgery. Design prospective observational study in consecutive patients. Setting Twenty-four-bed ICU, department of thoracic and cardiovascular surgery, university hospital. Patients Seven hundred and twenty two patients, 691 of whom underwent CPB, i.e., 476 had coronary bypass surgery (CABG), 130 valve replacement, 34 combined CABG and valve replacement and 23 thoracic aortic surgery. Interventions Standard perfusion techniques were used with cardioplegic arrest and mild hypothermia (28–32°C). With the exception of thoracic aortic procedures, full-flow perfusion was performed. Measurements and results PCT was measured prior to surgery and daily thereafter until ICU discharge or death. PCT significantly increased at day 1 postoperatively compared to baseline values (0.25±1.65 vs 6.49±22.0 ng/ml, p<0.005). However, in 55.1% of patients PCT was below 1.0 ng/ml. In 12.8% of CABG patients PCT was increased to >5.0 ng/ml, compared to 39% in valve patients and 35% of patients with aortic surgery. An elevated PCT level >1.0–5.0 ng/ml at day 1 was highly predictive of mortality (P<0.03, vs<1.0 ng/ml), with an additional accuracy when levels >5.0 ng/ml were measured (P<0.002 vs<1.0 ng/ml). Conclusions These results provide evidence that PCT might serve as an early prognostic marker in patients undergoing CPB in open heart surgery. It may be worth considering immunomodulating approaches in patients presenting elevated PCT levels in the early phase after CPB.     

Higher Prevalence of Psychopathological Symptoms in Adolescents With Headache. A Population‐Based Cross‐Sectional Study

(Headache 2010;50:738‐748) Background.— Headache is commonly voiced by adolescents and is known to be associated with reduced quality of life. Otherwise, there are only limited data regarding associations between different types of headache and psychopathological symptoms in adolescents. Objectives.— Aim of the present study in adolescents was to assess the impact of headache on psychopathological symptoms and whether these differ between types of headache. Methods.— Data were derived from a population‐based sample (n = 1047, ages 13‐17 years). Type of headache (ie, migraine, tension‐type headache, miscellaneous headache) was ascertained for subjects reporting headache episodes at least once per month. Psychopathological symptoms were assessed with the Strengths and Difficulties Questionnaire. The following dimensions were taken into account: emotional symptoms, conduct problems, hyperactivity/inattention, peer problems (these 4 add to the total difficulties score), and prosocial behavior. Associations were estimated with logistic regression models with adjustment for age group, sex, and family situation. Results.— Headache at least once per month was reported by 47.8% of the adolescents. Subjects with any headache were found to be at higher risk for emotional symptoms (odds ratio 1.5; 95% confidence interval 1.0‐2.2) and hyperactivity/inattention (1.4; 1.0‐1.9), resulting in a higher total difficulties score (1.6; 1.1‐2.4). While the risk for psychopathological symptoms was not significantly increased in subjects with tension‐type headache compared with subjects without headache, significant associations with emotional symptoms were found in subjects with migraine (2.9; 1.3‐6.2; total difficulties score: 3.1; 1.4‐6.8). Miscellaneous headache was associated with a broad spectrum of psychopathological symptoms: emotional symptoms (1.8; 1.0‐3.3), conduct problems (1.6; 1.0‐2.6), hyperactivity/inattention (1.9; 1.2‐3.1), total difficulties score (2.7; 1.6‐5.6). Conclusion.— Previously reported associations between headache and psychopathological symptoms in adolescents could be confirmed, but might vary with type of headache. As psychopathological symptoms may be a precursor for manifest psychiatric disorders, adolescents particularly with migraine and miscellaneous headache appear to be a vulnerable population.     

Procalcitonin in patients undergoing cardiopulmonary bypass in open heart surgery - first results of the Procalcitonin in Heart Surgery study (ProHearts)

Objective: To investigate procalcitonin (PCT) levels in patients undergoing cardiopulmonary bypass (CPB) in order to assess the prevalence and prognostic capacity of elevated PCT levels following CPB in open heart surgery.¶Design: prospective observational study in consecutive patients.¶Setting: Twenty-four-bed ICU, department of thoracic and cardiovascular surgery, university hospital.¶Patients: Seven hundred and twenty two patients, 691 of whom underwent CPB, i. e., 476 had coronary bypass surgery (CABG), 130 valve replacement, 34 combined CABG and valve replacement, and 23 thoracic aortic surgery.¶Interventions: Standard perfusion techniques were used with cardioplegic arrest and mild hypothermia (28-32 °C). With the exception of thoracic aortic procedures, full-flow perfusion was performed.¶Measurements and results: PCT was measured prior to surgery and daily thereafter until ICU discharge or death. PCT significantly increased at day 1 postoperatively compared to baseline values (0.25 - 1.65 vs 6.49 - 22.0 ng/ml, p < 0.005). However, in 55.1 % of patients PCT was below 1.0 ng/ml. In 12.8 % of CABG patients PCT was increased to > 5.0 ng/ml, compared to 39 % in valve patients and 35 % of patients with aortic surgery. An elevated PCT level > 1.0-5.0 ng/ml at day 1 was highly predictive of mortality (P < 0.03, vs < 1.0 ng/ml), with an additional accuracy when levels > 5.0 ng/ml were measured (P < 0.002 vs < 1.0 ng/ml).¶Conclusions: These results provide evidence that PCT might serve as an early prognostic marker in patients undergoing CPB in open heart surgery. It may be worth considering immunomodulating approaches in patients presenting elevated PCT levels in the early phase after CPB.     

Storage of whole blood before separation: the effect of temperature on red cell 2,3 DPG and the accumulation of lactate

BACKGROUND: Although whole blood intended for component preparation is commonly left to cool at ambient temperature, knowledge is insufficient as to the effects this may have on red cell quality, in particular after a prolonged hold.
STUDY DESIGN AND METHODS: Whole blood collected in ACD-A (7% wt/wt) and CPD (12% wt/wt) was incubated at 4, 10, 15, 20, 25, and 30°C for 24 hours. Blood gases, pH, bicarbonate, glucose, lactate, and red cell 2,3 DPG were investigated.
RESULTS: When the blood was stored at 30°C, the 2,3 DPG concentration decreased within 4 hours from 858 ± 106 to 316 ± 172 mmol per mol of hemoglobin (a 63% decrease); 99 percent was lost within 18 hours. At 25°C, 46 percent was lost within 4 hours and 94 percent within 18 hours; at 20°C, the decrease at 18 hours was 62 percent and that at 15°C was 24 percent. No loss of 2,3 DPG was observed at 4°C and 10°C storage. No difference was attributable to the anticoagulant used. After 24 hours, the lactate concentration at 15°C was 2.9 times the original, that at 20°C was 3.8 times the original, that at 25°C was 7.0 times, and that at 30°C was 9.2 times.
CONCLUSIONS: With current anticoagulants, storage of whole blood at temperatures of 25 to 30°C before separation causes a great and rapid loss of 2,3 DPG and an accumulation of acid metabolites. In a hold of blood for >4 hours, rapid cooling is desirable to avoid initial loss of 2,3 DPG.     

An assay of uroporphyrinogen decarboxylase in erythrocytes

Measurement of uroporphyrinogen decarboxylase (UROD; EC 4.1.1.37) activity in erythrocytes is useful in distinguishing between familial porphyria cutanea tarda (PCT), in which UROD activities are low, and acquired PCT, in which UROD activity is normal. In this method for measuring UROD, pentacarboxylic acid porphyrinogen I (PPI) is used as substrate. A sample of the patient's whole blood is incubated with PPI at 37 degrees C for 30 min at pH 6.0. The reaction is stopped by adding trichloroacetic acid/dimethyl sulfoxide containing mesoporphyrin (internal standard). The coproporphyrin so produced is measured directly by high-performance liquid chromatography, with fluorescence detection. Our values by this method for healthy subjects and non-PCT patients ranged from 1.8 to 4.0 U/L. The CV for the assay was 10% at 1.1 U/L and 9% at 2.4 U/L. Twelve of 42 patients with PCT had low erythrocyte UROD activities. In each of six families of patients with low UROD activity we found at least one other family member with a low UROD activity in erythrocytes.     

Prostaglandin E2 (PGE2) induces headache in healthy subjects

The role of prostanoids in nociception is well established. The headache-eliciting effects of prostaglandin E₂ (PGE₂) and its possible mechanisms have previously not been systematically studied in man. We hypothesized that infusion of PGE₂ might induce headache and vasodilation of cranial vessels. PGE₂ (0.40 µg kg⁻¹ min⁻¹) or saline was infused for 25 min into 11 healthy subjects in a cross-over, double-blind study. Headache intensity was scored on a verbal rating scale from 0 to 10. In addition, we recorded mean flow in the middle cerebral artery (V_MCA) by transcranial Doppler and diameter of the superficial temporal artery (STA) by high-resolution ultrasonography. All 11 subjects reported headache on the PGE₂ day and no subjects reported headache on the placebo day ( P  = 0.001). During the immediate phase (0–30 min) ( P  = 0.005) and the postinfusion phase (30–90 min) ( P  = 0.005), the area under the curve for headache score was significantly larger on the PGE₂ day compared with the placebo day. PGE₂ caused dilatation of the STA (23.5%; 95% CI 14.0, 37.8) and the MCA (8.3%; 95% CI 4.0, 12.6). We suggest that PGE₂ induces headache by activation and sensitization of cranial perivascular sensory afferents.     

Prevalence of migraine and non-migrainous headache--head-HUNT, a large population-based study

The objective of this study was to estimate the 1-year prevalence of the following categories of headache; migraine, non-migrainous headache, frequent headache (>6 days/month), and chronic headache (>14 days/month). Between 1995 and 1997, all 92,566 inhabitants 20 years and older in Nord-Tr?ndelag county in Norway were invited to a comprehensive health study. Out of 64,560 participants, a total of 51,383 subjects (80%) completed a headache questionnaire. The overall age-adjusted 1-year prevalence of headache was 38% (46% in women and 30% in men). The prevalence of migraine was 12% (16% in women and 8% in men), and for non-migrainous headache 26% (30% in women and 22% in men). For frequent headache (> 6 days per month) and for chronic headache (>14 days per month), the prevalence was 8% and 2%, respectively. Women had a higher prevalence than men in all age groups and for all headache categories. Prevalence peaked in the fourth decade of life for both men and women, except for 'frequent non-migrainous headache', which was nearly constant across all age groups in both genders. In accordance with findings in other western countries, we found that headache suffering, including migraine, was highly prevalent, especially in younger women.     

肝硬化腹水患者血浆降钙素原水平的临床研究

目的观察肝硬化自发性细菌性腹膜炎(SBP)患者血浆降钙素原(PCT)的水平。方法采用半定量免疫色谱法检测30例肝硬化腹水患者[包括单纯腹水16例(非SBP组)、合并SBP者14例(SBP组)]及20名健康体检者血浆PCT和血清CRP水平。以患者第1次测定值作为基线值。结果 SBP组血浆PCT和血清CRP水平在SBP发生后3、6、12 h均明显高于基线值(P<0.01),并明显高于非SBP组及对照组(P<0.01)。治疗后SBP组和非SBP组中存活的患者血浆PCT水平分别为0.48±0.25和(0.49±0.14)ng/mL,二者比较差异无统计学意义(P>0.05),且均低于基线值(P<0.01)。死亡患者的血浆PCT水平治疗后反而继续升高,SBP组[4例,(37.67±15.48)ng/mL]明显高于非SBP组[4例,(14.75±7.89)ng/mL]。结论血浆PCT水平检测有助于诊断肝硬化腹水患者SBP的发生,若持续升高可能提示有细菌感染和预后不良。     

Prednisone Therapy for Cluster Headache

SYNOPSIS
Prednisone in peak doses of 10-80 mg/day was employed for therapy in 19 patients with cluster headache. Overall, 14 of the 19 patients (73%) had greater than 50% relief and 11 (58%) had 100% relief from headache. The remaining 5 patients had less than 50% improvement. Of the subjects who were greater than 50% improved, 12 received peak doses of prednisone of 40 mg. or more, one received 30 mg. and one received 10 mg. The subjects with less than 50% improvement received peak prednisone doses of 10, 30, 40, 60 and 80 mg. Recurrence of cluster headache was noted in 79% of patients when the prednisone dose was tapered below 10–20 mg./d. Prednisone appears effective in relief of cluster headache but recurrence can be expected as the dose is reduced.     

Kinetics and thermolability of platelet monoamine oxidase in cluster headache and migraine

Platelet monoamine oxidase activity (MAO) from 33 cluster headache patients (17 males, 16 females) and 34 migraine patients (16 males, 18 females) was assayed. The kinetic constants (apparent V_max and apparent K_m) and the thermolability, measured as the ratio of the platelet MAO activity after and before heat treatment (+52°C, 30 min), were determined. The MAO activity and V_max values were significantly lower in cluster headache than in migraine and in both headache disorders compared to a control group (62 males, 66 females). When comparing all groups, K_m was not significantly different except for migraine females, who had lower K_m values compared to control females. Thermolability was significantly higher in cluster headache than in migraine and in both headache disorders compared to the control group. Smokers of five cigarettes or more per day had significantly lower V_max values but similar K_m and thermolability values compared to those smoking less or nothing. The findings of low maximal velocities and high thermolability of platelet MAO in cluster headache and migraine are suggested to represent constitutionally different enzyme properties.     

Hepatitis C virus-related autoimmunity in patients with porphyria cutanea tarda

Abstract. Hepatitis C virus (HCV) infection is frequently found in autoimmune hepatitis and mixed cryoglobulinaemia. In these conditions HCV could be responsible for immuno-mediated organ alterations. The aim of this study was to evaluate the presence of immunological alterations in PCT patients, in which HCV infection has been frequently found. Twenty-three PCT patients were evaluated for clinical and serological alterations, including: chronic hepatitis, other systemic symptoms, serum cryoglobulins and rheumatoid factor (RF), haemolytic complement, serum immunoglobulins, anti-nuclear (ANA), anti-smooth muscle (ASMA), anti-liver-kidney-microso-mal (anti-LKMl), anti-soluble-liver-antigen (SLA), anti-mitochondrial (AMA), anti-GOR antibodies, anti-HCV and HCV RNA. Abnormal serum ALT were present in the majority of cases (20/23, 87%), while liver biopsy revealed a chronic persistent hepatitis or chronic active hepatitis in 15/20 (75%) PCT patients. In a high percentage of subjects (91%) the presence of anti-HCV was detected by ELISA and RIBA II (Chiron, Emeryville CA, USA). In 17/22 (77%) cases the ongoing HCV replication in the serum was demonstrated by the detection of HCV genomes (polymerase chain reaction). The prevalence of both anti-HCV and HCV RNA in PCT was significantly higher if compared to 22 systemic immunological diseases ( P< 0.00l) and 47 healthy subjects ( P<0.001 ). A possible HCV-induced autoimmunity in PCT was suggested by the presence of the following immunological parameter alterations: anti-GOR in 13/23 (57%), ANA in 4/23 (17%), ASMA in 18/23 (78%), anti-LKMI in 1/23 (4%), RFin 23/23 (100%), mixed cryoglobulins in 4/23 (170/0), complement consumption in 10/23 (43%). The high prevalence of HCV infection and various immunological abnormalities suggest that HCV in combination with other factors (genetic, alcohol, etc.) could play a relevant role in the pathogenesis of hepatic and metabolic alterations of PCT.     

IP-10联合PCT和hs-CRP检测对新生儿感染性疾病的诊断价值

目的：探讨干扰素诱导蛋白-10(interferon-induced protein 10,IP-10)、降钙素原(procalcitonin, PCT)和超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)检测在诊断新生儿感染性疾病中的价值。方法：对早期感染组69例（细菌感染组43例、病毒感染组26例）、对照组30例新生儿（非感染组,包括重度窒息、缺氧缺血性脑病等）,分别采用酶联免疫吸附试验、双抗夹心免疫化学发光法、免疫比浊法测定其入院时血中的IP-10、PCT和hs-CRP水平,感染组于治疗2 d后及治愈后重复检测。结果：细菌感染组患儿治疗前的血IP-10、PCT、hs-CRP水平分别为（89.39±23.09） pg/mL、（2.08±0.30） μg/L、（10.49±6.97） mg/L,而对照组分别为（42.03±14.80） pg/mL、（0.27±0.30） μg/L、（5.39±4.20） mg/L,提示细菌感染组这3项指标均明显高于对照组（P<0.05）;病毒感染组患儿治疗前的血IP-10水平（62.91±6.79） pg/mL,也高于对照组（P<0.05）,但较细菌感染组低（P<0.05）。细菌及病毒感染组治疗2 d后及治愈后血中的3项指标均明显降低,与治疗前比较,差异有统计学意义（P<0.05）。对3项单项检测及联合检测进行ROC曲线分析发现,IP-10诊断新生儿感染性疾病的灵敏度、特异度分别为92.3%和94.0%,PCT诊断新生儿感染性疾病的灵敏度、特异度分别为93.1%和89.2%,而hs-CRP诊断新生儿感染性疾病的灵敏度、特异度较前两者低,分别为65.5%和72.6%,将3项指标进行平行检测的诊断灵敏度、特异度更高,分别为95.6%和96.8%。结论：IP-10、PCT对诊断病程48 h内的早期细菌感染有较高的价值;IP-10对诊断病毒感染有一定价值;hs-CRP对鉴别新生儿感染与非感染的诊断价值低于IP-10和PCT。3项指标联合检测能进一步提高对新生儿感染的诊断价值。     

Migraine and Tension Headache: Is There a Physiological Difference?

SYNOPSIS
The purpose of this study was to conduct a controlled comparison of tension and migraine headache under several experimental conditions.
Ten subjects from each of the following diagnostic groups - tension headache, migraine headache, and healthy controls - were observed under conditions of unstructured relaxation, mild stress, and recovery from stress. Forearm and forehead muscle potential, peripheral temperature, electrodermal response, heart rate, and systolic and diastolic blood pressure were monitored during these sessions. In addition, ratings of pain were obtained, and booklets II and III of the Edwards Personality Inventory were completed by each subject. The hypotheses that tension headache is associated with increased frontalis muscle tension and that migraine headache is associated with increased vasomotor activity were not supported with respect to resting levels, response to physical or psychological stress, or in relationship to pain. Personality differences between the three groups were observed. Migraine subjects appeared to be more perfectionistic and success-oriented than the other groups: and tension headache subjects, more anxious and insecure. It was suggested that although personality differences indicate the existence of two distinct disorders, physiological variables that were believed to be basic to the pathophysiology of these headaches (e.g. frontalis EMG in tension headache) do not distinguish these two types of headache.     

Hypersensitivity to Substance P in the Etiology of Postlumbar Puncture Headache

Objective.-Postlumbar puncture headache may represent a model which could be used to test the hypothesis that headache pain is caused by the release of substance P in patients who are predisposed to headache due to hypersensitivity to substance P.
Methods.-We measured substance P in CSF and plasma in 37 patients undergoing diagnostic lumbar puncture. In 9 patients, plasma samples were obtained before lumbar puncture, in 28 patients plasma was obtained after lumbar puncture. Patients were followed up by telephone to determine if they developed postlumbar puncture headache. Patients were also asked about a history of chronic or recurrent headaches. Substance P was determined by radioimmunoassay.
Results.-The mean plasma substance P levels obtained before lumbar puncture was 1.0 ± 0.1 pg/mL and 1.3 ± 1.2 after lumbar puncture (P<0.0005). The mean plasma substance P levels in subjects who developed postlumbar puncture headache was 0.6 ± 0.6 pg/mL compared with 1.4 ± 1.5 in subjects who remained headache-free ( P <0.05). The mean CSF substance P levels in subjects who developed postlumbar puncture headache was 0.7 ± 0.5 pg/mL compared with 1.2 ± 0.8 in subjects who remained headache-free ( P <0.05). There were no significant differences in substance P levels between chronic headache sufferers and nonheadache subjects.
Conclusions.-Postlumbar puncture headache may be mediated by the release of substance P triggered by lumbar puncture, in patients predisposed to headache by a hypersensitivity to substance P. Hypersensitivity to substance P may also represent a mechanism for headache pain in other headache disorders.     

The diagnostic validity of the cervical flexion-rotation test in C1/2-related cervicogenic headache

This single-blind comparative group design aimed to investigate the sensitivity and specificity of the cervical flexion-rotation test in the diagnosis of C1/2-related cervicogenic headache. This study tested 23 cervicogenic headache, 23 asymptomatic controls and 12 migraine with aura subjects, all aged 18-66 years. In stage 1, an experienced manipulative physiotherapist who did not partake in the flexion-rotation test procedure identified C1/2 dysfunction using passive segmental mobility tests in the cervicogenic headache group. Those with C1/2 dysfunction participated in stage 2. In stage 2, using the flexion-rotation test, subjects were tested by two experienced manipulative physiotherapists blinded to the subjects' group allocation. Each therapist stated whether the test was positive or not based on the therapist's interpretation of range of motion. The sensitivity and specificity of the flexion-rotation test was 91% and 90%, respectively (P<.001), with an overall diagnostic accuracy of 91% (P<.001). The cervical flexion-rotation test significantly assists in the differential diagnosis of cervicogenic headache and in the identification of movement impairment at the C1/2 segment in patients with cervicogenic headache.     

Recovery and life span of 111indium-radiolabeled platelets treated with pathogen inactivation with amotosalen HCl (S-59) and ultraviolet A light

BACKGROUND: A photochemical treatment (PCT) method to inactivate pathogens in platelet concentrates has been developed. The system uses a psoralen, amotosalen HCl, coupled with ultraviolet A (UVA) illumination. STUDY DESIGN AND METHODS: Three sequential clinical trials evaluated viability of PCT platelets prepared with a prototype device. Posttransfusion recovery and lifespan of (111)Indium-labeled autologous 5 day-old platelets in healthy subjects was assessed. In the first study, 23 subjects received transfusions of autologous PCT and/or control platelets. In a second study, 16 of these subjects received PCT platelets processed with a Compound Adsorption Device (CAD) (PCT-CAD) to reduce patient exposure to residual amotosalen. In the third study, the effect of gamma-irradiation on PCT platelets was studied. Data from control transfusions from Study A were used for paired comparisons in the latter 2 studies. RESULTS: Mean PCT-CAD platelet recovery for the 16 subjects with paired data was 42.5 +/- 8.7% versus 50.3 +/- 7.7% for control platelets, mean difference of 7.8% (p < 0.01). Mean lifespan for PCT-CAD platelets was 4.8 days (+/-1.3) versus 6.0 days (+/-1.2) for control platelets, mean difference of 1.3 days (p < 0.01). Platelet recovery and lifespan were similar to PCT-CAD for PCT without CAD treatment and PCT-CAD with gamma-irradiation. CONCLUSION: Viability of 5 day-old PCT platelets was less than for control platelets. However, both were within ranges reported for 5 day-old platelets.