Blood transfusion: Yesterday,today, and tomorrow

The evolution of blood transfusion practice into modern transfusion medicine is reported. The impact of great wars on the technique of blood storage and organization of blood supply is discussed. The progress of immunotechnology and fractionation of plasma contributed greatly to contemporary transfusion medicine and the implementation of blood and plasma component therapy. Three basic indications for use of blood in surgery are summarized: restoration of acute loss of circulating blood volume, improvement of oxygen transport, and delivery and correction of coagulation disorders. Some factors arising from storage lesion of blood (citrate intoxication, 2,3-DPG depletion, cellular aggregates) are described. The recent research in blood transfusion refers particularly to red cell substitutes. The oxygen-carrying solutions, perfluorocarbons, stroma-free hemoglobin, and current research on artificial red cells are discussed. The in vitro culturing, recombinant DNA technology, and the practical application of monoclonal antibodies in clinical practice are emphasized. The advent of great technological advances in transfusion medicine makes it possible to predict several future developments. Blood will be substituted by oxygen carriers, human protein and cells by biotechnological and genetic engineering. The education of tomorrow's surgeons must be adapted to the recent progress and advances of transfusion medicine.

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Resumen Se informa la evolución de la práctica de transfusión sanguínea hacia la moderna medicina de transfusiones. El impacto de las grandes guerras sobre las técnicas de almacenamiento y la organización de la distribución de sangre es revisado. El progreso de la inmunotecnología y el fraccionamiento del plasma ha contribuído grandemente al desarrollo de la moderna medicina de transfusiones y al perfeccionamiento de la terapia con componentes de plasma y de sangre. Se resumen 3 indicaciones básicas para el uso de sangre en cirugía: restauración de la pérdida aguda de volumen circulatorio, mejoramiento del transporte de oxígeno, y corrección de alteraciones de la coagulación. Se describen algunos factores derivados de la lesión de la sangre por almacenamiento (intoxicación por citrato, depleción de 2,3-DPG, agregados celulares). La investigación reciente en transfusión se refiere principalmente a los sustitutos de glóbulos rojos. Se discute el desarrollo de las soluciones capaces de transportar oxígeno, los perfluorocarbonos, la hemoglobina libre de estroma y la investigación contemporánea sobre células artificiales, con énfasis en los cultivos in vitro, la tecnología de DNA recombinante, y la aplicación práctica de anticuerpos monoclonales en la práctica clínica. El advenimiento de grandes avances tecnológicos en la medicine de transfusiones hace posible predecir algunos desarrollos futuros. La sangre será sustituída por sustancias transportadoras de oxígeno, la proteína humana y las células mediante ingeniería biotecnológica y genética. La educación de los cirujanos del mañana debe ser adaptada a los progresos y avances recientes de la medicina de transfusiones.

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Résumé L'évolution de la transfusion sanguine dans la pratique médicale moderne est rapportée. L'impact des grandes guerres sur la technique de conservation du sang et l'organisation de l'approvisionnement du sang sont discutés. Les progrès de l'immunotechnologie et du fractionnement des composants plasmatiques ont contribué à l'établisement de la transfusion moderne et à la mise en oeuvre du traitement par les constituants plasmatiques. Les indications majeures de la transfusion en chirurgie sont au nombre de trois: restauration immédiate de toute perte rapide et abondante du sang circulant, amélioration du transport de l'oxygène, correction des troubles de la coagulation. Quelques faits anormaux imputables à la conservation du sang (intoxication citratée, agrégats de cellules, déplétion du 2,3-DPG érythrocytaire) sont décrits. La recherche récente concernant la transfusion sanguine est consacrée particulièrement à l'étude des substituts érythrocytaires. Les solutions transportant l'oxygène, le perfluorocarbone, la SFHS, les hématies artificielles sont étudiées. La culture cellulaire in vitro, la technologie de recombinaison de l'ADN, l'emploi d'anticorps monoclonaux sont également analysés. Des progrès technologiques nouveaux dans la pratique de la transfusion laissent présager de futurs développements. Le sang sera remplacé par des transporteurs d'oxygène, par des protéines et des cellules fournies par les méthodes génétiques et la biotechnologie. L'éducation des chirurgiens de demain doit être adaptée en fonction de ces nouvelles données.

     

Experimental dental bio-adhesives for direct restorations: the influence of PMnEDM homologs structure on bond strength.

OBJECTIVES: The purpose of this study was to evaluate the effect of PMnEDM dental monomer homologs chemical structure on shear bond strength between polymer-based composite and alloy. METHODS: Four light-cured experimental universal dental bio-adhesives (group codes: A (PMDM), B (PM2EDM), C (PM3EDM), D (PM4EDM)) were preliminarily evaluated with respect to sensitivity to ambient light, curing time, depth of cure, and uncured film thickness according to standardized procedures. Appropriate tests were performed to measure shear bond strength (SBS) of polymer-based composite to cobalt-based alloy with the use of the adhesives investigated. Variability of results was evaluated by use of the coefficient of variation (CV). Results were estimated with the aid of one-way analysis of variance (ANOVA), performed on the logarithmic values, with alpha=0.05 significance level. RESULTS: All materials passed the requirements according to physicochemical properties. Except for formulation D, all results estimating SBS were positive with respect to standardized requirements. The uppermost mean SBS was achieved for the A adhesive (11.45 MPa) and appeared to be significantly different compared to D one (5.07 MPa) (p=0.0495). Also the B adhesive, having slightly lower mean SBS value (10.50 MPa) exhibited a significant difference in respect to D one (p=0.0455). The means for other trial pairs did not differ statistically. SIGNIFICANCE: The materials here studied might be considered to have a practical use in dental clinics, especially the formulations B and C.     

Terpolymerization of polar vinyl monomers with butadiene and styrene in the presence of Lewis acids

Terpolymerizations of polar vinyl monomers, acrylonitrile, methyl acrylate, or methyl methacrylate with butadiene and styrene in the presence of ethylaluminium dichloride, zinc chloride, or other Lewis acids were carried out. The yield and the contents in monomer units of the terpolymer and the yields of the polar vinyl monomer/butadiene 1,4-cycloaddition byproduct formed in these systems were determined. Butadiene conversions in the above terpolymerizations and 1,4-cycloaddition side reactions were related to those in the copolymerization and 1,4-cycloaddition proceeding in corresponding binary systems without styrene. The results are discussed in terms of a radical polymerization and a polar 1,4-cycloaddition mechanisms.     

Effect of histamine in sinus node arrested with reserpine

Summary Histamine restored spontaneous activity in the isolated rabbit sinus node arrested with reserpine. This fact suggests that catecholamines are not the unique activators of adenylate cyclase required for cardiac pacemaking, and may be replaced by histamine.     

Effect of quinidine on membrane properties: Depression of the lipid phase transition temperature and changes in the permeability of the lipid bilayer

The influence of an antiarrhythmic drug, quinidine, on the physical state of membrane phospholipids was investigated using model membranes, liposomes. Turbidimetric measurements on liposomes prepared from neutral (dipalmitoyl phosphatidylcholine) and acidic (dipalmitoyl phosphatidic acid) phospholipids showed that quinidine reduces the temp of the gel to liquid-crystalline phase transition and broadens the temp range of the transition. The effect of quinidine on the thermal behaviour of model membranes depends on both the pH and the type of phospholipids used. It is markedly stronger for acidic than for neutral phospholipids, suggesting the importance of electrostatic effects in drug-membrane interaction. The ability of quinidine to interact with the lipid bilayer was confirmed by permeability measurements with the use of a self-quenched fluorescent compound, calcein. It is suggested that quinidine-phospholipid interaction may contribute to the mechanisms by which the drug exerts its physiological and pharmacological effects.     

Pityriasis Rosea in Nigerians

ABSTRACT: One hundred thirty-eight Nigerian patients with pityriasis rosea were studied. Patients with the condition constituting 2.4% of all patients seen in two skin clinics in Northern Nigeria in a period of over three years. The proportional rate of pityriasis rosea parallels figures from other African studies, and is higher than values obtained in European series. Pityriasis rosea in Nigerians appears to be more florid and has a greater tendency to overstep the classic boundaries of distribution on the body, to affect the face and involve the oral cavity. The sex and age distribution was similar to European series, although some lowering of the age of onset of the condition was observed. No relationship between the frequency of pityriasis rosea and season was found.     

Neurofibrillary degeneration of nerve cells after intracerebral injection of aluminium cream

Summary Intracerebral administration of aluminium cream (aluminium hydroxide) in rabbits resulted in the development of pathological EEG, convulsive seizures, paresis of the extremities and neuronal changes consisted in a focal clearings in the cytoplasm filled by neurofibrillary tangles. In principle, the topography of the neurofibrillary changes was the same as that observed byKlatzo, Winiewski andStreicher in rabbits after injection of aluminium phosphate.

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Zusammenfassung Intracerebrale Applikation von Aluminiumpaste (Aluminiumoxyd) bei Kaninchen führte zum Auftreten von pathologischen EEG-Veränderungen, Krampf-anfällen, Extremitätenparesen sowie von Nervenzellveränderungen in Form fokaler Cytoplasmaaufhellungen, die von verplumpten Neurofibrillen erfüllt sind. Die Topographie der neurofibrillären Veränderungen entsprach grundsätzlich den Beobachtungen vonKlatzo, Winiewski u.Streicher an Kaninchen nach Injektion von Aluminiumphosphat.

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This work was supported by grand PL 480, agreement No. 227706 sponsored by the United States Public Health Service.     

Effect of the heteroatom x in the catalytic system ZnR2/o- or m-HXC6H4XH on the copolymerization of carbon dioxide with propylene oxide

A series of new catalytic systems ZnEt₂/cocatalyst were prepared and their activity in the alternating copolymerization of carbon dioxide with propylene oxide was studied. The systems ZnEt₂/m-HXC₆H₄XH (mole ratio 1:1) system (X = NH, S) were chosen to elucidate the influence of the heteroatom on the activity of the catalytic system. The obtained results were discussed in terms of the influence of the basicity of the heteroatom and of its hybridization on the structure and association of the catalyst molecule.     

Die Wirbelkanalstenose nach der Spondylodese (iatrogene Stenose des Wirbelkanals)

Archives of Orthopaedic and Trauma Surgery - Des Verfassers Erfahrung basiert auf 15 Fälle iatrogener Wirbelkanalstenosen der Thorakal- und Lendenabschnitte. Die Stenose hat sich als Folge...     

Cytisine for the treatment of nicotine addiction: from a molecule to therapeutic efficacy

Cytisine, a natural plant alkaloid, has been marketed in Central and Eastern Europe for over 40 years for the clinical management of smoking cessation. Despite the fact that cytisine has been used by millions of smokers, its characteristics have not been reviewed in scientific literature in English, and presently existing clinical studies on its effectiveness and safety are insufficient to warrant licensing by modern standards. Understanding of the mechanism of cytisine action as a smoking cessation aid provides a necessary basis for conducting clinical trials to confirm its efficacy as an optimal antismoking therapy. Hereafter, we present a review of current knowledge about the pharmacokinetics, pharmacodynamics, toxicity, therapeutic efficacy and safety of cytisine, and about its derivatives that are under development. Recent pharmacological research has elucidated that the drug is a low efficacy partial agonist of alpha4beta2 nicotinic acetylcholine receptors, which are believed to be central to the effect of nicotine (NIC) on the reward pathway. The drug reduces the effects of NIC on dopamine release in the mesolimbic system when given alone, while simultaneously attenuating NIC withdrawal symptoms that accompany cessation attempts. Clinical studies on cytisine as a smoking cessation aid have demonstrated that the drug is effective and safe. Our recent uncontrolled trial has shown that a 12-month carbon monoxide-verified continuous abstinence rate following a standard course of treatment with cytisine with minimal behavioral support is similar (13.8%; N = 436) to that observed following treatment with NIC replacement therapy. Since cytisine exhibits a desirable pharmacological profile which makes it an attractive smoking cessation drug, it should be advanced to randomized clinical trials. However, more detailed preclinical studies on its pharmacokinetics and safety profile are required.