Evaluation of Efficacy in Platelet Collection by the Haemonetics Component Collection System

Abstract: Platelet concentrate product derived from plateletpheresis from a single donor is preferable in terms of reducing the risks of adverse reactions in platelet transfusion. This study evaluated the status of platelet transfusion and the efficacy and safety of plateletpheresis machines. The average number of donors of platelet product per patient has been decreasing and recently reached nearly 1.0; however, some patients still receive multiple random donor platelet products. Platelet collection efficacy was comparable between the Haemonetics Component Collection System (CCS) and the Multi Component System (Multi). However, the CCS has been shown to be effective in terms of processed blood volume and procedure time, especially in donors with lower hematocrits. These results suggest that the CCS may be preferable and safer for donors with lower hematocrits and lighter body weights. Blood centers should collect platelets more effectively to achieve platelet transfusion with the use of platelets derived from a single donor using effective equipment.     

Determination of the MIC of cefotetan against freshly isolated gram-negative bacilli

Antimicrobial activities (MICs) of cefotetan (CTT) against 575 strains of 16 spp. of Gram-negative bacilli isolated in 1988 were determined to investigate distribution of MICs in comparison with those of cefmetazole (CMZ), cefoxitin (CFX), latamoxef (LMOX) and cefazolin (CEZ). The change in frequencies of incidence of cephem-resistant strains in the latter half of the 1980 was also investigated. Distribution of MIC of CTT varied with test strains. No or very few MICs were at or higher than 12.5 micrograms/ml at an inoculation of 10(6) cfu/ml, thus rates of CTT-resistant strains were low among Escherichia coli, Citrobacter diversus, Klebsiella spp., Proteus spp., Providencia spp., and Haemophilus influenzae. High rates of resistance to CTT were observed, however, among Citrobacter freundii, Enterobacter spp., Serratia marcescens, Morganella morganii, and Bacteroides fragilis. 2. Most CTT-resistant strains of C. freundii, Enterobacter spp. and S. marcescens were also resistant to LMOX. These resistant strains were considered to be multi-resistant strains to antibiotics including oxime type cephalosporins and monobactams. 3. Cephem-resistant E. coli was confirmed to be resistant to 22% of CEZ, 14% of CFX, 10% of CMZ and 2% of CTT tested. The incidence of cephem-resistant E. coli unconditionally showed an increasing tendency. 4. The incidence of resistant strains against cephamycins including CTT is discussed with regard to the mechanism of resistance against all beta-lactam antibiotics, and the problem of the appearance of resistant strains is close and inseparable from social background.     

L-methionine enhances the contractile response to norepinephrine of rat vas deferens

Under Ca-depleted conditions, the contractile responses of rat vas deferens in the presence of norepinephrine were not elicited until the addition of CaCl2. L-Methionine enhanced the contractile response of vas deferens in the presence of methylation blockers under these conditions. The enhancing effect of L-methionine on some other smooth muscles could not be determined because under Ca-depleted conditions, these muscles showed 60-80% of the maximal contractile response on addition of CaCl2 alone. These findings suggested that L-methionine has an enhancing effect on contraction of the rat vas deferens as it does on rat uterine muscle.     

Effect of a direct electric current on modification of bone and ligament repair processes--experimental investigation of a rabbit model

Investigations of the effect of direct current on 1) fracture healing, and 2) ligament healing was conducted by applying 10 microA to 1) the defect of the fibula, and 2) that of the patellar ligament of adult rabbits. After time periods for stimulation all specimens were tested with combinations of roentgenological, histological, biomechanical and biochemical methods. The results were analyzed and compared with the non-stimulated, opposite side and with the normal tissue. The electricity produced 1) a more massive callus with normal histological features in an early stages at the fracture site, and 2) higher tensile stiffness and earlier change of the collagen types in the newly-formed tissue, though no significant differences were observed as to 1) the mechanical parameters of callus and bone material, and 2) histological findings of repairing tissue. Electrical stimulation was indicated not only on bone tissue but also on non-osseous tissues and their components.     

Functional organization of escape circuits built in teleost hindbrain segments

Hindbrain reticulospinal (RS) neurons in goldfish and zebrafish consist of seven clusters spaced periodically along the rostrocaudal axis. Morphologically similar RS neurons, homologs, are arranged in adjacent segments. Electrophysiological examination in goldfish suggests that paired, large M-cells, in the fourth segment (r4) and their homologs, MiD 2 cm in r5 and MiD 3 cm in r6, receive auditory inputs similarly but show different firing pattern in response to depolarization. In addition, there is inhibitory connection from M-cell to its homologs but not in the reverse direction. Calcium imaging of these neurons during escape behavior in larval zebrafish reveals that the M-cell and its homologs fire in a complementary fashion. Thus, the segmentally homologous RS neurons may work as a functional unit to initiate and control escape behavior.     

Amino acid sequence of a phospholipase A2 from the venom of Trimeresurus gramineus (green habu snake)

Two phospholipases A2, named phospholipases A2-I and A2-II, were purified to homogeneity from the venom of Trimeresurus gramineus (green habu snake). The complete amino acid sequence of phospholipase A2-I was determined by sequencing the native protein and the peptides produced by enzymatic (Achromobacter protease I, clostripain, and chymotrypsin) and chemical (hydroxylamine) cleavages of the S-pyridylethylated derivative of the protein. The protein consisted of 122 amino acid residues and was similar in sequence to phospholipases A2 from the venoms of crotalid snakes which belong to the category of Group II. A most striking feature of this protein is that tyrosine at the 28th position which is common in phospholipases A2 and is assumed to be a part of the Ca2(+)-binding loop is replaced by phenylalanine. Such replacement is the first finding in Group II phospholipases A2. Secondary structure compositions of phospholipase A2-I are similar to those of Crotalus atrox phospholipase A2. No appreciable Ca2(+)-induced difference spectrum was observed, due probably to the absence of the effective chromophoric groups in the neighborhood of the Ca2+ binding site although Ca2+ is bound with affinity similar to that for T. flavoviridis phospholipase A2.     

Modification of guide wire for 22-gauge safe guide.

Safe guide is a central venous catheterization kit that serves as both pilot needle and introducer. With a single puncture, a guide wire can be introduced by inserting it through the side port of the 22-gauge needle. The advantage is that this needle can be placed within a blood vessel using no more force than is required to insert a pilot needle. However, the 0.018-inch guide wire is vulnerable to kinks and locking. Because the tip has been shaped into a sharp J-shaped angle, it can kink at the puncture site, and locking sometimes occurs when the guide wire is passed through the side port of the needle, or when the dilator is introduced. In order to resolve these issues, we modified the device by making an experimental guide wire with a gentler angle. In addition, we fortified the body of the wire without altering its thickness. We then investigated the effectiveness of our modifications. The subjects of the study were 120 patients, who required central venous catheterization. They were divided into 2 groups. The original J-type guide wire was used in one group (Group A: n = 60) and the modified guide wire in the other group (Group B: n = 60). Catheters were introduced by right internal jugular vein puncture. We observed the following: 1) incidence of back-flow appearing at withdrawal of the needle without back-flow during advancement, 2) incidence of kinking or locking of the guide wire when it was passed through the side port, 3) incidence of kinking of the guide wire at the puncture site when introducing the dilator, and 4) complications. The results were as follows: 1) back-flow appeared upon withdrawal in 3.4% of both groups; 2) kinking and locking occurred when passing the guide wire through the side port of the Safe guide needle in 16.7% of Group A and 1.7% of Group B; 3) kinking of the guide wire occurred when introducing the dilator in 5 % of Group A in contrast to 0% in Group B; 4) the only complication caused by the passing of the guide wire was accidental puncture of the common carotid artery, which occurred in 1.7% of both groups. No problems with the guide wire were noted in either group. The use of our modified guide wire decreased the incidence of kinking and locking of the guide wire when passing it through the side port. In addition, no guide wire kinking at the puncture site occurred when introducing the dilator. Issues associated with the original J-type guide wire were resolved by 1) changing the guide wire tip to a gentler angle, and 2) fortifying the guide wire by altering its composition.     

The clinical nurse specialist role in the Army Medical Department

Although clinical nurse specialists (CNSs) have been in the Army Medical Department for more than 10 years, there are no reports in the literature regarding role implementation for them. In this study, a survey of all practicing CNSs in the Army Medical Department (AMEDD) and their supervisors was conducted with the purpose of defining their perceived role and the value placed on it by their supervisors. The results showed that the study population (n = 52) has implemented the role with all components (practice, education, consultation, administration, and research) considered important by them. Further, 85% of the CNSs report positive job satisfaction, and 67% believe they have reached role maturation. Their supervisors were equally or more positive about the importance of the role, and all (n = 26) felt it must be maintained despite budget constraints and nursing shortages. Findings were that CNSs experience role satisfaction, have achieved role maturation, and are valued by their supervisors within the AMEDD.