A comprehensive program to ensure quality in intraoperative blood salvage

Driven by widespread concern about transfusion-transmitted disease, intraoperative blood salvage (IBS) and other forms of autologous transfusion are playing an increasing role in medical practice. A quality assurance (QA) program is one of the most important elements of a successful IBS program. A large and successful QA program is described, the key elements of which are: 1) direction by a physician dedicated to the program; 2) use of full-time IBS personnel; 3) use of procedure and training manuals; 4) development of detailed patient identification procedures; 5) quality control of identification procedures, hematocrit, washing efficiency, and sterility; 6) use of extensive patient records; and 7) preventive maintenance procedures. In the past 6 years, 14,522 procedures have been performed and 38,899 salvaged units of blood collected without significant complications. Much of this success is attributed to the comprehensive QA program used during this time.     

Spectrophotometric method of quantifying adult cat flea (Siphonaptera: Pulicidae) feces.

Cat flea, Ctenocephalides felis felis (Bouché), feces are an essential part of larval nutrition under natural conditions. The mass values of adult flea feces can be measured by dissolving samples of flea feces in Drabkin's reagent, filtering, centrifuging, and measuring absorbance spectrophotometrically at 540 nm. Either flea feces or air-dried host blood can be used to generate the standard curve used to convert absorbance (optical density) values into mass values. Debris collected from flea-infested house cats averaged 23.02 mg debris per cat per h with an average of 10.41 mg flea feces per cat per h. Flea feces deposited in the environment serve as potential larval food. Adult flea feces comprised an average of 44.28% of the debris deposited from infested domestic house cats in this study.     

Homozygous microdeletion of chromosome 4q11-q12 causes severe limb-girdle muscular dystrophy type 2E with joint hyperlaxity and contractures

Microdeletion syndromes are commonly transmitted as dominant traits and are frequently associated with variably expressed pleiotropic phenotypes. Nonlethal homozygous microdeletions, on the other hand, are very rare. Here, we delineate the fifth and so far largest homozygous microdeletion in nonmalignancies of approximately 400 kb on chromosome 4q11-q12 in a large consanguineous East-Anatolian family with six affected patients. The deleted region contains the beta-sarcoglycan gene (SGCB), the predicted gene SPATA18 (spermatogenesis associated 18 homolog) and several expressed sequence tags. Patients presented with a severe and progressive Duchenne-like muscular dystrophy phenotype, a combination of hyperlaxity and joint contractures, chest pain, palpitations, and dyspnea.     

Demonstration of a capsule plasmid in Bacillus anthracis

Virulent and certain avirulent strains of Bacillus anthracis harbor a plasmid, designated pXO2, which is involved in the synthesis of capsules. Two classes of rough, noncapsulated (Cap-) variants were isolated from the capsule-producing (Cap+) Pasteur vaccine strains ATCC 6602 and ATCC 4229. One class was cured of pXO2, and the other class still carried it. Reversion to Cap+ was demonstrable only in rough variants which had retained pXO2. Proof that pXO2 is involved in capsule synthesis came from experiments in which the plasmid was transferred by CP-51-mediated transduction and by a mating system in which plasmid transfer is mediated by a Bacillus thuringiensis fertility plasmid, pXO12. Cells of Bacillus cereus and a previously noncapsulated (pXO2-) strain of B. anthracis produced capsules after the acquisition of pXO2.     

Fetal fuels II: contributions of selected carbon fuels to oxidative metabolism in rat conceptus

The effects of fasting on the oxidative disposition of selective fuels in tissues of the rat conceptus were examined on day 20 of gestation. Placentas and portions of fetal liver and brain from fed and 48-h fasted mothers were incubated in vitro with artificial mixtures containing glucose, lactate, and beta-hydroxybutyrate in concentrations simulating those that obtain in fed or 48-h fasted animals in vivo. Oxidative contributions from individual components were evaluated by separate incubations in which only one of the three fuels was 14C-labeled. As judged by the evolution of 14CO2, rates of oxidation of individual fuels by tissues of the conceptus appeared to be conditioned by ambient fuel concentrations rather than the dietary status of the mother. Additional studies indicated that evolution of 14CO2 from glucose or lactate may be depressed directly by adding beta-hydroxybutyrate to the incubation medium. This substitutive property of beta-hydroxybutyrate may "spare" glucose and lactate within the placenta for transfer to the fetus and preserve glucose and lactate availability for biosynthetic rather than oxidative disposition within the fetus.     

Production of hemolysin and other extracellular enzymes by clinical isolates of Pseudomonas pseudomallei.

One hundred clinical isolates of Pseudomonas pseudomallei from humans were tested for their ability to produce extracellular, biologically active substances which are thought to contribute to the virulence of Pseudomonas species. All isolates produced at least on extracellular enzyme; 91 strains were positive for lecithinase, lipase, and protease; but none was positive for elastase. Ninety-three strains produced a hemolysin which was detectable around the heavy growth on saline-washed sheep erythrocyte brain heart infusion agar but not demonstrable around individual colonies or in broth culture filtrate. In contrast, a hemolysin which was cytolytic around individual colonies of P. pseudomallei on the assay plate and in broth culture filtrate was exhibited by four strains. By using one of these four isolates as the test strain, the latter hemolysin was characterized further. It was heat labile, most active in an acid environment (pH 5.5), and cytolytic in broth culture filtrate for a variety of animal and human erythrocytes. Sterols, particularly cholesterol and 7-dehydrocholesterol, inhibited its hemolytic activity, but the activity was not enhanced by reducing agents or suppressed by reagents which modify sulfhydryl-activated hemolysins. A nonhemolytic mutant of the test strain of P. pseudomallei retained the extracellular enzymes of its parent, indicating that the hemolysin was not a lecithinase, lipase, or protease.     

Kraepelin-oriented research-diagnosable schizophrenia,mania, and depression in schneider-negative schizophrenics

Summary The rigorous neo-Kraepelinean research criteria of the St. Louis/ Iowa and Taylor groups were applied to case record data of 116 first admissions of Schneider-negative schizophrenics—that is, those without first-rank symptoms (FRSs)—hospitalized in a strongly Schneider-oriented German University Psychiatric Clinic from 1962 to 1971. This sample had a total of 45.7% (53 cases) of psychiatric illness diagnosable by research methods. Indeed, only 31% (36 cases) of Schneider-negative schizophrenics turned out to have research-positive Kraepelin-oriented schizophrenia; and of these, 21 fulfilled both sets of research criteria for schizophrenia. It is important that 14.6% (17 cases) of Schneider-negative schizophrenia consisted of research-diagnosable affective disorder, with mania making up 5.2% and depression 9.4% of this figure. The findings suggest that a sample of Schneider-oriented schizophrenia without FRSs as routinely diagnosed in Germany does not seem to represent a clear-cut homogeneous and uncontaminated group of schizophrenics.