Plasma proteins and lymphocyte phenotypes in long-term plasma donors

BACKGROUND: The possible effects of long-term plasma donation remain unknown, but it is important to investigate them so that donor safety is ensured. The purpose of this study was to determine if long-term plasma donation alters plasma proteins or lymphocyte phenotypes. STUDY DESIGN AND METHODS: Two groups of long-term plasma donors, source plasma donors (n = 20) and Rh immune globulin plasma donors (n = 26), were compared with whole blood donors (n = 29) and nondonor controls (n = 30). Blood samples were obtained prior to donation. Serum protein, albumin, globulin, and immunoglobulin levels were determined. In an assay using whole blood, lymphocyte phenotypes were characterized with a panel of single- and dual-labeled monoclonal antibodies and subsequent analysis by flow cytometry. RESULTS: As compared to the nondonor controls and/or whole blood donors, the mean values for serum protein, globulin, and IgG levels were lower in both plasma donor groups, with a significant negative correlation between donation frequency and serum protein values for the source plasma donors. Albumin levels were within normal ranges for both groups of plasma donors. No significant differences existed among the donor groups in total white cell counts, the percentage or absolute number of lymphocytes, T (CD3) cells, or helper T (CD4) cells. However, there were increased percentages of B (CD19) cells and decreased percentages of suppressor T (CD8+/CD11b+) cells and natural killer cells in both groups of plasma donors as compared to nondonor controls. CONCLUSION: Many plasma donors have low levels of serum protein, globulin, and IgG. In addition, they have increased percentages of B cells and decreased percentages of suppressor T and natural killer cells. The clinical significance of these findings warrants further investigation.     

Straight line sign: appearance and significance during CT portography

The computed tomographic (CT) angiograms of 44 patients who were being evaluated for possible hepatic surgery were studied. All patients were imaged with CT arterial portography (CTAP), delayed CT of the liver, and magnetic resonance (MR) imaging. All CTAP studies were evaluated for a "straight line," a linear variation in contrast within the liver. Sixteen patients (36%) demonstrated the straight line sign. All 16 had a mass at the proximal portion of the defect. Nine of 16 had defects that clearly correlated with portal venous distribution seen at limited digital angiography. Fourteen of the 16 patients showed loss of the straight line sign at delayed CT and/or MR imaging of the liver. These defects are thought to be due to vascular obstruction. The straight line sign will probably be seen more frequently as CTAP is more commonly used. Recognition of the sign is important in the evaluation of primary liver carcinomas, since it signifies that the tumor may be inoperable. Also, if metastatic disease is present, it alerts the surgeon to the proximity of the portal vein to the neoplasm.     

Chronic illness perception in adolescence: Implications for the doctor-patient relationship

To describe the inter-relationship of chronic illness severity as perceived by adolescents with both psychosocial well-being and objective measures of illness severity. Additionally to compare the adolescents' perception of illness severity with how their physicians believe that the adolescents perceive their illness severity.

Methods:

The psychological well-being of 48 adolescents with either cystic fibrosis (CF) or insulin-dependent diabetes mellitus (IDDM) was measured by four standardized questionnaires. The adolescents' perception of severity of illness was measured using an original instrument (PSCI), and this measure was compared to their physicians' estimates of how the adolescents perceived the severity of their illness and clinical illness.

Results:

There were 24 patients in both the CF and IDDM groups. Both groups were found to function well psychosocially; although, there were more patients with low self image compared to normative values. Depression and low self image were associated with a greater adolescent perception of illness severity. For both chronic illness groups, physicians' assessment of assumed adolescent perception of disease severity correlated with clinical indices of disease severity and was higher than the perception of illness severity reported by the adolescents. For adolescents with CF, but not with IDDM, perception of severity of chronic illness correlated with clinical indices.

Conclusions:

For adolescents with chronic illness, their perception of illness severity is an important indicator of psychosocial well-being. Physicians do not accurately infer their patients' perception of illness severity.     

Second Derivative Infrared Spectroscopy as a Non-Destructive Tool to Assess the Purity and Structural Integrity of Proteins

Second derivative infrared (IR) spectroscopy can be used as a quick, easy, reproducible, cost-effective, non-destructive tool by which to evaluate the purity and structural integrity of samples of water-soluble proteins from a variety of sources. For this study, second derivative IR spectra were collected at ambient conditions for aqueous (D₂O) solutions of seven different commercial samples of the same enzyme, porcine pancreatic elastase (2.0 to 3.8 mg protein/100 µL D₂O, pD = 5.4 to 9.1). As with other globular proteins possessing a large fraction of -structure, the amide I region [1700-1620 cm^–1] of the second derivative IR spectra for each of the seven elastase samples exhibits a characteristic pair of bands: one of weak intensity appears near 1684 cm^–1; the other close to 1633 cm^–1is moderate-to-strong. However, one of the seven samples shows a striking decrease in the observed intensities of the amide I bands relative to the 1516 cm^–1 absorption, along with the appearance of a strong, new band at 1614 cm^–1. These intensity disparities strongly suggest that this sample is of much lower quality than the others and clearly has an appreciable proportion of the protein present in a non-native state. In addition, minor differences evident in the position and relative intensity of some individual amide I bands among the seven spectra imply that subtle variations exist in the conformation of the peptide backbone of the seven samples. For two of the samples, these small, but reproducible, changes seem to be correlated with marked losses of enzyme activity. Finally, bands outside the amide I region may prove useful in assessing sample purity and identifying non-protein contaminants.     

枢丹与氟哌啶预防术后恶心呕吐的比较

1临床资料妇科手术50例(枢丹组25例,氟哌啶组25例),年龄27～66岁,体质量47～84 kg,ASA Ⅰ,Ⅱ级.术前无恶心呕吐.术前24 h未用任何抗呕吐药.全部采用连续硬膜外阻滞L2-3椎间隙穿刺,使用1.33g/L利多卡因40.17g/L丁卡因(含0.05g/L肾上腺素),阻滞平面上界在T6.于麻醉阻滞平面完全,手术开始时枢丹8 mg,氟哌啶组iv氟哌啶2.5mg,注速均为0.5～1 min.