Microbiologic contamination of peripheral blood progenitor cells collected for hematopoietic cell transplantation

BACKGROUND: Peripheral blood progenitor cells (PBPCs) rather than bone marrow are used increasingly to provide hematologic reconstitution when transfused after marrow-ablative chemotherapy. PBPCs often are collected via central venous catheters that have remained in place for long periods of time and that may become infected. STUDY DESIGN AND METHODS: The investigators reviewed their 5-year experience in collecting PBPCs for the prevalence of bacterial contamination. Except for cotrimoxazole therapy given to prevent Pneumocystis cariini pneumonia, patients were not given antibiotic prophylaxis. RESULTS: Each patient underwent a median of 7 (range, 2–21) PBPC collections; 0.2 percent (3/1040 collections) were culture positive for bacteria (two collections contained coagulase-negative staphylococci and one contained Serratia marcescens). All culture-positive collections were discarded; no PBPCs were culture positive at the time of thawing and transfusion. CONCLUSION: This contamination rate is below that previously reported for bone marrow harvests and platelet concentrate collections. Obtaining PBPCs through large-bore central venous catheters has not added to the risk of infection in transplant patients. A program of screening in vitro cultures and strict adherence to sterility techniques can result in very low microbiologic contamination and thus obviates the need for prophylactic antimicrobials in the PBPCs and in the patient.     

CLIMACTERIC SYMPTOMS IN HEALTHY MIDDLE-AGED WOMEN

SUMMARY The incidence of climacteric symptoms was determined in 247 healthy premenopausal women in a community setting. These volunteers had been recruited to a longitudinal study of bone density. Of these subjects, 46 ceased to menstruate during the study, and in this subgroup symptoms were compared before and after cessation of menstruation. Only hot flushes increased after cessation of menstruation in the longitudinal study and showed age correlation in the cross-sectional study. Hot flushes thus emerged as a true menopausal symptom. Although evidence for this is weaker, cold sweats and suffocation seem likely to be genuinely menopausal. Breast discomfort and the four mood symptoms of irritability, excitability, depression and poor concentration improved after cessation of menstruation, and this study gives no support for their being part of the menopausal syndrome; it suggests that these symptoms are more likely to be related to menstruation than to the menopause.     

Nonrandom chromosome abnormalities in acute leukemia and dysmyelopoietic syndromes in patients with previously treated malignant disease

Cytogenetic studies were performed on 26 patients who developed acute nonlymphocytic leukemia (ANLL) or a dysmyelopoietic syndrome after treatment of a primary malignancy. Fifteen patients had radiotherapy and chemotherapy, seven had only chemotherapy, and four had only radiotherapy. The median times from diagnosis of the initial disease to the development of bone marrow dysfunction for these treatment groups were 50, 46, and 49 mo, respectively. Twenty-five patients had an abnormal karyotype in myeloid cells. Loss of part or all of no. 5 and/or no. 7 was noted in 23 of 25 patients with aneuploidy. Loss of no. 5 was noted only in patients who previously had malignant lymphoma, whereas loss of no. 7 was seen in these patients as well as in those who had other malignancies. Abnormalities of both nos. 5 and 7 occurred in 53% of the patients treated with combined therapy and in only 27% of patients treated with either modality alone. Although these changes are distinctly different from those noted in lymphomas, they are similar to those seen in 25% of aneuploid patients with ANLL de novo.     

Hypoxic hepatitis in children after cardiac surgery

<正>To the Editor: Hypoxic hepatitis(HH), also known as ischemic hepatitis or shock liver, is a liver injury characterized by necrosis of centrilobular hepatocytes with a rapid increase in serum aminotransferase levels. The incidence rate of HH among patients in the intensive care unit(ICU) was found to be 0.9%-11.9% [1]. Occurrence of HH appears to have a significant impact on the clinical outcome.     

保存血小板的体外评估:是否有希望预见输入后血小板的生存和功能

输入病人体内的血小板的循环能力和功能与体外保存损害和受者的体内环境有关。患有血小板减少症的住院病人,体内影响血小板存活和功能的因素比体外保存损害的影响更重要。然而人们长久以来一直认为,预测血小板成分在体内的作用可以为现行的输血措施提供有价值的参考,也可能进一步提高临床疗效,同时更有效的管理血小板贮存。确实,新的病原菌灭活方法推动了临床应用,同时可能使浓缩血小板保存更安全、保存时间更长,精确评定临床有意义的浓缩血小板质量。 保存血小板在输血后的存活和功能差异较大。如果血小板处理小心,也没有长时间保存(采集后24—48小时内)便很快     

香烟提取物诱导牛冠状动脉内皮细胞损伤的机制

目的通过观察香烟提取物对牛冠状动脉内皮细胞(BCAEC)的损伤作用,为研究吸烟与心血管疾病之间的关系提供依据。方法以吸烟者体内通常的尼古丁浓度为基准,分别用尼古丁、香烟主流烟雾提取物(MSW)和侧流烟雾提取物(SSW)对 BCAEC 进行染毒(尼古丁染毒终浓度分别为1×10~(-5)、0.8×10~(-5)、0.9×10~(-5)mol/L),用显微数码成像系统记录细胞形态变化,检测凋亡细胞与坏死细胞的发生比例,测定 caspase 酶活力。结果经尼古丁、MSW 处理的 BCAEC 形态上发生凋亡样变化,处理24 h 后凋亡细胞发生率为5.89%和11.94%。而 SSW 处理后的 BCAEC 呈坏死样变化.处理24 h 后62.84%的细胞发生坏死。尼古丁和 MSW 可诱导 caspase-3活力增高。结论香烟提取物可诱导牛冠状动脉内皮细胞损伤,MSW 可引起细胞凋亡,SSW 导致细胞坏死,caspase-3的激活可能是香烟提取物诱导牛冠状动脉内皮细胞凋亡的机制。