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Hemolysis
Terms modified by Hemolysis Selected AbstractsCan haptoglobin be an indicator for the early diagnosis of neonatal jaundice?JOURNAL OF CLINICAL LABORATORY ANALYSIS, Issue 6 2008Alpay Cakmak Abstract Neonatal jaundice is the result of an imbalance between bilirubin production and elimination. Bilirubin conjugation in newborns is significantly impaired in the first few days; even a small increase in the rate of production can contribute to the development of hyperbilirubinemia. Hemolysis has a significant role in bilirubin increase in newborns. Intrauterine is tolerated by the maternal metabolism in life. When hemolysis takes place, a decrease is accepted in the haptoglobin and hemopoexin blood levels binding hemoglobin in the environment. Therefore, it may be considered that haptoglobin and hemopoexin from the early period umbilical cord (UC) blood in newborns may be an indicator in determining jaundice likely to develop in later stages. Babies were called to the control polyclinic in the third and fifthdays. Eighty-four babies with normal termbirth were included in the study. Gestational age of the mothers was 39.5±1.5 weeks in average. A significant negative correlation was found between the haptoglobin level from the UC taken during delivery and the bilirubin value in the fifth day (r=,0.345; P=0.001). The haptoglobin value from the blood of the UC can be used as a guiding indicator to demonstrate the future occurrence of jaundice in newborns. This way, the babies with high jaundice risk may be detected earlier and closer follow-up of these babies can be obtained. As a result, the haptoglobin level of the blood from the UC during delivery allows us to make an early prediction on whether neonatal jaundice will occur. J. Clin. Lab. Anal. 22:409,414, 2008. © 2008 Wiley-Liss, Inc. [source] Glucose-6-phosphate dehydrogenase deficiency is associated with increased initial clinical severity of acute viral hepatitis AJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 11 2001Israel Gotsman Abstract Background and Aim: In glucose-6-phosphate dehydrogenase (G6PD) deficiency, the enzyme is deficient in liver cells as well as in erythrocytes. It has been suggested that this may be associated with a more severe clinical presentation of acute viral hepatitis A. The aim of this study is to determine the severity of liver disease in patients with viral hepatitis and G6PD deficiency. Methods: Eighteen patients with diagnosed G6PD deficiency and acute hepatitis A were compared with 18 matched control patients with hepatitis A in a university hospital for liver disease severity and clinical outcome. Results: Two of 18 patients with G6PD deficiency had neurological deterioration. Patients with G6PD deficiency had a mean peak prothrombin time (PT) that was significantly prolonged as compared with the control group (15.5 ± 3.7 vs 12.9 ± 2.0 s, respectively, P < 0.02), and a significantly higher proportion had an abnormal PT (PT > 13.3 s): 61 versus 11% (P < 0.0001). Hemolysis occurred in 44% of the G6PD deficiency patients. Total and direct bilirubin were significantly higher in all patients with G6PD deficiency, including patients without hemolysis. There was no significant difference in liver enzyme levels between the two groups. Patients with G6PD deficiency had a longer average hospital stay (9.5 ± 4.8 vs 3.4 ± 0.8 days, respectively, P < 0.001). There was no difference in the final clinical outcome between the two groups, and recovery of liver function was seen in all patients. Conclusions: Glucose-6-phosphate dehydrogenase deficiency in patients with hepatitis A causes a more severe initial clinical presentation, but does not alter the final clinical outcome. [source] Quinacrine Enhances Vesicular Stomatitis Virus Inactivation and Diminishes Hemolysis of Dimethylmethylene Blue,phototreated Red Cells,PHOTOCHEMISTRY & PHOTOBIOLOGY, Issue 5 2002Stephen J. Wagner ABSTRACT Several photodynamic methods for virus inactivation in red blood cell (RBC) suspensions have resulted in unwanted hemolysis during extended 1,6°C storage. To explore the possibility that hemolysis may be mediated by a membrane-bound dye, a molecule similar in structure to yet different in light absorption properties from the photosensitizer was used as an inhibitor for RBC membrane binding in virus photoinactivation and photohemolysis studies. The addition of 500 ,M quinacrine to oxygenated RBC before treatment with 3.6 ,M dimethylmethylene blue (DMMB) and 219 mJ/cm2 red light resulted in an increased extracellular concentration of the sensitizer, increased extracelluar viral inactivation kinetics, and decreased hemolysis during 1,6°C storage without alteration of quinacrine absorption properties. These results collectively suggest that despite its recognized affinity for viral nucleic acid, DMMB also binds to RBC membranes and that the bound dye is, in part, responsible for photoinduced hemolysis. [source] ORIGINAL ARTICLE: Human Serum Complement C3 and Factor H in the Syndrome of Hemolysis, Elevated Liver Enzymes, and Low Platelet CountAMERICAN JOURNAL OF REPRODUCTIVE IMMUNOLOGY, Issue 4 2009Elif Ari Problem, Hemolysis, elevated liver enzymes, and low platelet count syndrome (HELLP syndrome) is a life-threatening variant of severe pre-eclampsia in pregnant women. The complement system may play a role in the pathogenesis of this condition. We sought to determine serum complement 3 (C3) levels and its regulatory protein complement factor H (FH) in the HELLP syndrome. Method of study, Twenty-two pre-eclamptic patients with HELLP syndrome (mean age: 27.8 ± 6.2 years), 21 pre-eclamptic patients without HELLP syndrome (mean age: 27.5 ± 6.8 years) and 24 normotensive, healthy pregnant women (mean age: 26.1 ± 4.4 years) were included in this study. Serum concentrations of C3 and FH were measured in all participants. Results, Concentrations of C3 and FH did not differ significantly between the study groups. In patients with the HELLP syndrome, FH levels were positively associated with platelet count. Conclusion, These findings did not support a major role of complement activation in the HELLP syndrome. In patients with HELLP, lower levels of FH are correlated with a reduced platelet count. [source] Massive Immune Hemolysis Caused by Anti-D After Dual Kidney TransplantationAMERICAN JOURNAL OF TRANSPLANTATION, Issue 10 2005Gregory J. Pomper Massive immune hemolysis due to passenger lymphocyte-derived anti-D has not been reported in renal transplantation. A 50-year-old (B-positive) male received a dual deceased-donor kidney transplant (B-negative) for diabetic renal failure. Two weeks post-transplant, the patient developed severe hemolytic anemia. The donor anti-D titer was 1:8. The recipient anti-D titer (zero pre-transplant) increased from 1:4 to 1:16 over 4 days. Rapid hemolysis caused severe anemia, minimum Hb = 4.2 g/dL, while selectively lysing the patient's autologous red cells during this time. The hemolytic anemia did not impair the allografts and subsided without monoclonal B-cell pharmacotherapy or apheresis. The anti-D titer decreased to barely detectable levels at four months and had cleared when checked 2 years post-transplant. Transfusion support subsided after two months. If complications of anemia can be avoided, the deleterious effects of hemolysis may be well tolerated by renal allografts using antigen negative transfusion alone. [source] Experimental Investigation of Pulsatility Effect on the Deformability and Hemolysis of Blood CellsARTIFICIAL ORGANS, Issue 4 2010Yang Jun Kang Abstract In this study, we investigated the differences between pulsatile cardiopulmonary bypass (CPB) procedure and nonpulsatile CPB procedure in terms of their effects on hemolysis and deformability of red blood cells (RBCs) under various shear stress conditions. In order to research the effects on hemolysis and deformability, four parameters,free hemoglobin (fHb) concentration, normalized index of hemolysis (NIH), deformability index (DI) of RBCs, and elongation index of RBCs,have been deeply investigated. For these investigations, two randomly assigned adult mongrel dog groups,nonpulsatile group (NP, n = 6) and pulsatile group (P, n = 6),were examined. According to our results, both types of perfusion did not show any statistical differences in terms of the concentrations of fHb as well as NIH. In addition, there were no significant differences in RBC deformability between perfusion types within an operation time of 3 h. Therefore, our studies suggest that pulsatile perfusion has no significant difference from nonpulsatile perfusion in terms of hemolysis and deformability of RBCs. [source] Influence of Radial Clearance and Rotor Motion to Hemolysis in a Journal Bearing of a Centrifugal Blood PumpARTIFICIAL ORGANS, Issue 11 2006Hiroyuki Kataoka Abstract:, Hemolysis due to narrow clearance of noncontact bearings is a critical problem for rotary blood pumps. We developed a centrifugal blood pump with a magnetic and hydrodynamic hybrid bearing, and found that the hemolysis in the narrow clearance depends not only on the clearance size, but also on the rotor stability. In this study, we quantified the relation between the hemolysis, radial clearance (c), and rotor stability through the measurement of the rotor motion and hemolysis. As a result, it was confirmed that the rotor of the current pump is stabilized within the oscillation of 20 ,m in blood, and the hemolysis decreases with increase in the c, which is the opposite in the unstable rotor motion with the previous pump. In order to theoretically discuss this hemolysis tendency, we implemented hemolysis estimation in the c according to hydrodynamics and hemodynamics. This estimation can represent the measured hemolysis tendency, and revealed that the flow rate has large influence on the hemolysis in the c. [source] Magnevad Status of Design Improvements Human Blood Results and Preliminary Sheep TrialARTIFICIAL ORGANS, Issue 10 2005Michael Goldowsky Abstract: Magnevad II is an improved version of Magnevad I and both are fourth-generation axial flow left ventricular assist devices. A major simplification has been implemented and tested. Magnevad I used a magnetically suspended rotor requiring active axial control. Magnevad II is completely passive but otherwise similar. A self-washing radial hydrodynamic bearing suspends the rotor. In the axial direction, noncontact axial stiffness is provided by opposing pairs of repulsion magnets (called bumper magnets). Rotor location shifts in response to differential pressure. A low-cost position sensor measures this motion to provide pump differential pressure. This is used to create pulsating flow and physiologic control (like Magnevad I). Hemolysis of Magnevad II using human blood was very low with a normalized index of hemolysis at 0.001,0.002 g/100 L. Our first sheep trial took place in September 2004. No thrombus or deposits were found in the disassembled pump. Longer sheep trials are scheduled in March 2005 at the Foundation Cardio-Infantil in Bogota, Colombia. [source] An Estimation Method of Hemolysis within an Axial Flow Blood Pump by Computational Fluid Dynamics AnalysisARTIFICIAL ORGANS, Issue 10 2003Tetsuya Yano Abstract: Evaluation of hemolysis within a blood pump on a computer is useful for developing rotary blood pumps. The flow fields in the axial flow blood pump were analyzed using computational fluid dynamics (CFD). A blood damage index was calculated based on the changes in shear stress with time along 937 streamlines. Hemolysis of the pumps was measured using bovine blood. A good correlation between the computed and measured hemolysis results was observed. CFD analysis is useful for estimating hemolysis of rotary blood pumps on a computer. [source] An Evaluation of a Polyethersulfone Hollow Fiber Plasma Separator by Animal ExperimentARTIFICIAL ORGANS, Issue 1 2001Zhao Chang-sheng Abstract: Membrane plasma separators are being used routinely for therapy in various diseases. In this study, a newly developed plasma separator made of polyethersulfone (PES) hollow fibers was evaluated for its plasma filtration efficiency and blood compatibility by animal experiment. Hemolysis did not occur under the usual conditions of plasma separation. The sieving coefficients of total protein and albumin were over 95%, and the total cholesterol was over 90% throughout the perfusions. Decreases in white blood cells, platelets, fibrinogen, and coagulation factors were observed during the early stage of plasma separation, but appear to be within acceptable ranges for clinical use. [source] Hemolysis and thrombocytopenia following oxaliplatin administrationASIA-PACIFIC JOURNAL OF CLINICAL ONCOLOGY, Issue 1 2005Brian HC LE Abstract Oxaliplatin is a platinum derivative with an overall excellent safety profile that has a major role in the treatment of colorectal cancer. With a proven role now in the adjuvant setting, rare but potentially life-threatening toxicities become a more significant issue. We report here a case of significant postinfusion hemolysis and thrombocytopenia in a patient undergoing adjuvant chemotherapy for stage III colon cancer, and review the literature. Six cases of hemolysis following oxaliplatin treatment have previously been reported, all in the setting of advanced colorectal cancer, with one case resulting in death. In three of the seven reports (including the present case), warning signs of low grade hemolysis were apparent during preceding cycles, with fever and/or back pain during the infusion being the most common feature. Our case appears to be the first reported with a direct antiglobulin test-negative hemolysis with thrombocytopenia, with each of the previous reports postulating an autoimmune basis. Hemolysis and/or thrombocytopenia are potentially life-threatening complications of oxaliplatin chemotherapy. With the increasing use of oxaliplatin in the adjuvant setting, clinicians need to be aware of this entity and the possible clinical warning signs that may be evident in preceding cycles. [source] Transcatheter closure of patent ductus arteriosus with Nit-Occlud coilsCATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, Issue 4 2005Alpay Celiker MD Abstract The detachable coils have been successfully used for transcatheter occlusion of small- to moderate-sized patent ductus arteriosus (PDA). We report our experience regarding the use of the Nit-Occlud coils (NOCs) for transcatheter PDA and major aortopulmonary collateral (MAPCA) occlusion. Single NOCs were used to close PDA in 26 patients, and one small and two large MAPCAs in two patients. Mean age and weight of the patients were 7.7 ± 5.4 years and 20.6 ± 11.6 kg. Mean minimum duct diameter was 2.8 ± 0.8 mm; ampulla, 8.7 ± 2.4 mm; and PDA length, 9.3 ± 4.4 mm. Mean pulmonary artery pressure ranged from 9 to 51 mm Hg and pulmonary/systemic flow ratio from 1.1 to 5.8. Ductal shape was conical in 24 patients. Route of approach was venous in 23 and arterial in 3. Successful coil implantation was achieved in 24/26 (92.3%). Mean procedure and fluoroscopy time were 67.2 ± 22.1 and 14.9 ± 6.5 min. The three MAPCAs were also successfully occluded using NOC Medium and Flex. Postimplantation angiograms revealed no leak in 3, a trace or small leak in 17, and a medium leak in 4 patients. Mean follow-up was 7 ± 5 months. Complete occlusion was achieved in 17/24 (71%) at 24 hr, 19/24 (79%) by 1 month, 13/15 (87%) by 3 months, 14/15 (93%) by 6 months, and 10/11 (90%) by 12 months postprocedure. Hemolysis, late embolization, duct recanalization, and flow disturbances were not observed. Transcatheter occlusion of moderate-sized PDAs and MAPCAs using NOCs seems to offer a safe, simple, and controlled method in pediatric patients. Catheter Cardiovasc Interv 2005 © 2005 Wiley-Liss, Inc. [source] Protective Effects of Resveratrol and its Analogues against Free Radical-Induced Oxidative Hemolysis of Red Blood Cells,CHINESE JOURNAL OF CHEMISTRY, Issue 11 2002Jian-Guo Fang Abstract The in vitro oxidative hemolysis of human red blood cells (RBCs) was used as a model to study the free radical-induced damage of biological membranes and the protective effect of resveratrol (3,5,4,-trihydroxy-trans-stilbene, 1) and its analogues, i. e., 4-hydroxy- trans -stilbene (2), 3, 5- dihydroxytrans -stilbene (3), 3,4-dihydroxy- trans -stilbene (4), 4,4,-dihydroxy- trans -stilbene (5) and 2, 4, 4,-trihydroxy- trans -stilbene (6). The hemolysis of RBCs was induced by a water-soluble free radical initiator 2, 2,-azobis (2-amidinopropane hydrochloride) (AAPH). It was found that addition of AAPH at 37 °C to the suspension of RBCs caused fast hemolysis after a short period of inhibition period, and addition of 1,6 significantly suppressed the hemolysis. Compound 4 which bears an ortho -dihydroxyl functionality showed much more effective anti-hemolysis activity than that of resveratrol and the other analogues. [source] Investigation of a capillary electrophoretic approach for direct quantification of apolipoprotein A-I in serumELECTROPHORESIS, Issue 9 2003Rainer Lehmann Abstract In the present study a rapid, reproducible and robust capillary electrophoresis (CE) procedure for the quantification of apolipoprotein A-I (Apo A-I) in serum without pretreatment has been developed (total run time, 11 min). The coefficients of variation (CV; n = 10) for the relative peak area are 1.8% at a concentration of 145 mg/dL and 1.6% at 196 mg/dL; and for the inter-assay 8.9% at 161 mg/dL (10 consecutive days), i.e., similar to the CVs of a high-throughput immunonephelometric routine assay. The CV for the migration time is 0.4% (n = 20). The robustness of the CE approach was tested in patient samples with hemolysis, hyperbilirubinemia and hyperlipidemia. A comparison of 99 Apo A-I serum values with results of a fixed-time immunonephelometric routine assay showed a positive constant bias of 60% (mean) for the immunonephelometric values, no deviation from linearity, but significant deviations in several samples. Investigations on interferences in the CE analyses gave no evidence that CE failed. Our study shows that CE is amenable to a fast analysis and a reproducible and reliable quantification of Apo A-I level in sera of various clinical samples. [source] Urinary albumin excretion is associated with pulmonary hypertension in sickle cell disease: potential role of soluble fms-like tyrosine kinase-1EUROPEAN JOURNAL OF HAEMATOLOGY, Issue 3 2010Kenneth I. Ataga Abstract Background:, Pulmonary hypertension (PHT) is reported to be associated with measures of renal function in patients with sickle cell disease (SCD). The purpose of this exploratory study was to determine the relationship between albuminuria and both clinical and laboratory variables in SCD. Design and methods:, This cross-sectional study was performed using a cohort of adult patients with SCD and control subjects without SCD. Spot urine for microalbumin/creatinine ratio, measures of hemolysis, inflammation and other laboratory studies were obtained. Pulmonary artery systolic pressure was determined by Doppler echocardiography, and the diagnosis of PHT was defined using age-, sex- and body mass index-adjusted reference ranges. Results:, Seventy-three patients with SCD and 21 healthy, race-matched control subjects were evaluated. In patients with SCD, normoalbuminuria was observed in 34 patients (46.6%), microalbuminuria in 24 patients (32.9%) and macroalbuminuria in 15 patients (20.5%). There was a significant correlation between urine albumin excretion and age. In patients with HbSS and S,0 thalassemia, the levels of sFLT-1, soluble VCAM and NT pro-BNP were significantly higher in those with macroalbuminuria, compared to patients with microalbuminuria and normoalbuminura, but no significant differences were observed in the levels of laboratory measures of hemolysis. Urine albumin excretion was associated with PHT and a history of stroke. Conclusions:, Our study confirms the high prevalence of albuminuria in SCD. The association of urine albumin excretion with sFLT-1 suggests that this vascular endothelial growth factor receptor family member may contribute to the development of albuminuria in SCD. By inducing endothelial activation and endothelial dysfunction, sFLT-1 appears to be a link between glomerulopathy and PHT in SCD. [source] Interaction of ostreolysin, a cytolytic protein from the edible mushroom Pleurotus ostreatus, with lipid membranes and modulation by lysophospholipidsFEBS JOURNAL, Issue 6 2003Kristina Sep Ostreolysin is a 16-kDa cytolytic protein specifically expressed in primordia and fruiting bodies of the edible mushroom Pleurotus ostreatus. To understand its interaction with lipid membranes, we compared its effects on mammalian cells, on vesicles prepared with either pure lipids or total lipid extracts, and on dispersions of lysophospholipids or fatty acids. At nanomolar concentrations, the protein lysed human, bovine and sheep erythrocytes by a colloid-osmotic mechanism, compatible with the formation of pores of 4 nm diameter, and was cytotoxic to mammalian tumor cells. A search for lipid inhibitors of hemolysis revealed a strong effect of lysophospholipids and fatty acids, occurring below their critical micellar concentration. This effect was distinct from the capacity of ostreolysin to bind to and permeabilize lipid membranes. In fact, permeabilization of vesicles occurred only when they were prepared with lipids extracted from erythrocytes, and not with lipids extracted from P. ostreatus or pure lipid mixtures, even if lysophospholipids or fatty acids were included. Interaction with lipid vesicles, and their permeabilization, correlated with an increase in the intrinsic fluorescence and ,-helical content of the protein, and with aggregation, which were not detected with lysophospholipids. It appears that either an unknown lipid acceptor or a specific lipid complex is required for binding, aggregation and pore formation. The inhibitory effect of lysophospholipids may reflect a regulatory role for these components on the physiological action of ostreolysin and related proteins during fruiting. [source] Congenital dyserythropoietic anemia type II (CDAII) is caused by mutations in the SEC23B gene,HUMAN MUTATION, Issue 9 2009Paola Bianchi Abstract Congenital dyserythropoietic anemia type II (CDAII) is an autosomal recessive disease characterized by ineffective erythropoiesis, hemolysis, erythroblast morphological abnormalities, and hypoglycosylation of some red blood cell (RBC) membrane proteins. Recent studies indicated that CDAII is caused by a defect disturbing Golgi processing in erythroblasts. A linkage analysis located a candidate region on chromosome 20, termed the CDAN2 locus, in the majority of CDAII patients but the aberrant gene has not so far been elucidated. We used a proteomic-genomic approach to identify SEC23B as the candidate gene for CDAII by matching the recently published data on the cytoplasmic proteome of human RBCs with the chromosomic localization of CDAN2 locus. Sequencing analysis of SEC23B gene in 13 CDAII patients from 10 families revealed 12 different mutations: six missense (c.40C>T, c.325G>A, c.1043A>C, c.1489C>T, c.1808C>T, and c.2101C>T), two frameshift (c.428_428delAinsCG and c.1821delT), one splicing (c.689+1G>A), and three nonsense (c.568C>T, c.649C>T, and c.1660C>T). Mutations c.40C>T and c.325G>A were detected in unrelated patients. SEC23B is a member of the Sec23/Sec24 family, a component of the COPII coat protein complex involved in protein transport through membrane vesicles. Abnormalities in this gene are likely to disturb endoplasmic reticulum (ER)-to-Golgi trafficking, affecting different glycosylation pathways and ultimately accounting for the cellular phenotype observed in CDAII. Hum Mutat 30:1,7, 2009. © 2009 Wiley-Liss, Inc. [source] A case of paroxysmal nocturnal hemoglobinuria presenting with intra-abdominal bleeding due to splenic rupture, developing renal infarctINTERNATIONAL JOURNAL OF LABORATORY HEMATOLOGY, Issue 3 2008S. UZUN Summary Paroxysmal nocturnal hemoglobinuria (PNH) is a rare disorder characterized by intravascular hemolysis, hemoglobinuria, and thrombosis. Thrombotic attacks are life threatening and are responsible for nearly 50% of PNH-related deaths. Compared with thrombotic events, bleeding related to thrombocytopenia in PNH is quite rare. This report describes an atypical clinical presentation with problems in the diagnosis and management of a woman who presented with a splenic infarct followed by massive intra-abdominal bleeding due to splenic rupture. She also developed a renal infarct during hospitalization after diagnosis. [source] Value of ADAMTS13 activity and inhibitor in the postmortem diagnosis of thrombotic thrombocytopenic purpuraJOURNAL OF CLINICAL APHERESIS, Issue 3 2009Denis M. Dwyre Abstract Background and Objectives: Thrombotic thrombocytopenic purpura (TTP) is a clinical diagnosis that can be difficult to establish in severely ill patients. We report a case of fulminant TTP in a woman who died before receiving plasma exchange. An autopsy plasma sample was analyzed for ADAMTS13 activity and inhibitor for correlation with the diagnosis of TTP. Recognizing that hemolysis in postmortem blood samples could interfere with ADAMTS13 activity, plasma samples from four additional decedents not suspected of having TTP were analyzed and correlated with their autopsy results. The purpose of this study was to assess whether testing postmortem samples for ADAMTS13 is useful in the postmortem diagnosis of TTP. Material and Methods: Plasma samples from the index case and four non-TTP decedents were analyzed for ADAMTS13 activity, ADAMTS13 inhibitor levels, and plasma free hemoglobin (PFH). Autopsy tissues were evaluated for evidence of platelet microthrombi in all five cases. Results: The ADAMTS13 activity level in the index patient was <4%, and the inhibitor level was 1.0 inhibitor unit. Microthrombi were prominent in the heart, kidneys, pancreas, and adrenal glands, consistent with the clinical diagnosis of TTP. ADAMTS13 activity levels in the four non-TTP decedents ranged from 4 to 82% (3/4 , 26%), and inhibitor was present in two of the four samples. Postmortem PFH levels in the four non-TTP decedents ranged from 64 to 3,917 mg/dL. No microthrombi were observed. Conclusion: Low postmortem ADAMTS13 activity and evidence of inhibitor can occur in decedents without clinical or histologic evidence of TTP. Postmortem ADAMTS13 activity levels may not be valid in establishing a diagnosis of TTP, and high inhibitor levels in this setting may be related to elevated PFH. Caution must be used in the interpretation of ADAMTS13 testing in the presence of hemolysis. J. Clin. Apheresis 2009. © 2009 Wiley-Liss, Inc. [source] Therapeutic plasmapheresis as a bridge to liver transplantation in fulminant Wilson diseaseJOURNAL OF CLINICAL APHERESIS, Issue 1 2007Jeffrey S. Jhang Abstract Wilson disease is an autosomal recessive disorder of copper metabolism that leads to the accumulation of copper mainly in the liver, cornea, brain, and kidney. Rarely, Wilson disease can present as fulminant hepatic failure with direct antiglobulin test,negative hemolytic anemia and renal failure. In the absence of liver transplantation, this disease is uniformly fatal because medical therapy is ineffective. This report describes the successful use of plasmapheresis for a patient with fulminant Wilson disease as a bridge to transplantation. Five daily therapeutic plasmapheresis procedures using fresh frozen plasma as a replacement fluid were performed over 6 days. Serum copper, urinary copper excretion, and hemolysis were significantly reduced and renal function improved. The patient's clinical status improved and she remained clinically stable until a liver transplant was possible. Plasmapheresis can be a successful medical treatment in fulminant Wilson disease and should be considered as a therapeutic measure to stabilize a patient by decreasing serum copper, reducing hemolysis, and helping to prevent renal tubular injury from copper and copper complexes until liver transplantation is possible. J. Clin. Apheresis. 22:, 2007 © 2007 Wiley-Liss, Inc. [source] Negative interference of bilirubin and hemoglobin in the MEIA troponin I assay but not in the MEIA CK‐MB assayJOURNAL OF CLINICAL LABORATORY ANALYSIS, Issue 2 2001Amitava Dasgupta Abstract Troponin I is a sensitive and specific marker for the diagnosis of myocardial infarction. Several commercially available immunoassays measure the concentration of troponin I in serum. The microparticle enzyme immunoassay (MEIA) for troponin I (Abbott Laboratories, Abbott Park, IL) is widely used in clinical laboratories, including our hospital laboratory. We studied the effect of bilirubin and hemolysis on the MEIA for troponin I and compared our assay with a newly available chemiluminescent assay (CLIA) for troponin I (Bayer Diagnostics, Tarrytown, NY). We also measured CK‐MB concentration using the MEIA CK‐MB assay. One serum pool was prepared by combining several specimens of one patient with elevated troponin I and with a diagnosis of myocardial infarction. Other serum pools were prepared by combining sera with similar troponin I values. All serum pools showed normal bilirubin concentrations and had no hemolysis. Then we supplemented aliquots of serum pools with various concentrations of bilirubin (5.0, 10.0, 15.0, and 20.0 mg/dL). After supplementation, troponin I concentrations were measured again using the MEIA and CLIA. We observed a statistically significant decrease in troponin I concentration in the presence of bilirubin with the MEIA. For example, in serum pool 1, the troponin I concentration was 16.3 (bilirubin: 0.8 mg/dL). In the presence of 5.0, 10.0, 15.0 and 20.0 mg/dL of added bilirubin, the cardiac troponin I concentrations were 13.9, 13.4, 13.3 and 13.0 ng/ml respectively. We observed similar negative interference of bilirubin in troponin I measurement by the MEIA in other pools. The troponin I value decreased slightly (not statistically significant) in one pool and did not change in two other pools in the presence of bilirubin when we measured troponin I concentration using the CLIA. Interestingly, bilirubin did not interfere with the MEIA CK‐MB assay. Moderate hemolysis did not have any effect on the troponin I assay using either the MEIA or CLIA. However, gross hemolysis (hemoglobin > 40 mg/dL) interfered with both assays for troponin I. J. Clin. Lab. Anal. 15:76–80, 2001. © 2001 Wiley‐Liss, Inc. [source] Safety and Functional Aspects of Preselected Enterococci for Probiotic Use in Iberian Dry-Fermented SausagesJOURNAL OF FOOD SCIENCE, Issue 7 2009Santiago Ruiz-Moyano ABSTRACT:, The purpose of this study was to investigate enterococci for potential probiotic use in Iberian dry-fermented sausages. A total of 15 strains isolated from Iberian dry-fermented sausages, human feces, and pig feces were evaluated for their safety and functional characteristics including biogenic amine (BA) production, antibiotic susceptibility, hemolysis, virulence determinants, cell adhesion, and antimicrobial activity against foodborne pathogens. The strain,Enterococcus faecium,SE906 was able to establish itself on the intestinal epithelium, inhibiting such pathogenic bacteria as,Listeria monocytogenes in vitro. This strain was also considered safe to be used for its low aminogenic potential, and its antibiotic resistance pattern and virulence determinants, being identified as a potential probiotic meat starter culture suitable for manufacture of dry-fermented Iberian sausages. [source] Reconstructing the Sequence of Events Surrounding Body Disposition Based on Color Staining of Bone,JOURNAL OF FORENSIC SCIENCES, Issue 5 2009Meaghan A. Huculak H.B.Sc. Abstract:, Literature regarding bone color is limited to determining location of primary and secondary dispositions. This research is the first to use bone color to interpret the sequence of events surrounding body disposition. Two scenarios were compared,bones buried and then exposed on the ground surface and bones exposed then buried. Forty juvenile pig humeri with minimal tissue were used in each scenario with an additional 20 controls to determine if decomposing tissue affects bone color. Munsell Color Charts were used to record bone color of surface and 2.5 cm cross-sections. Results reveal five main surface colors attributed to soil, sun, hemolysis, decomposition, and fungi. Fungi on buried bones suggests prior surface exposure. Cross-sections of strictly buried bones are identical to buried then exposed bone, stressing the importance of bone surface analysis. Cross-sectioning may help verify remains have been exposed then buried. Decomposition of excess tissue creates minimal color staining. [source] Glucose-6-phosphate dehydrogenase deficiency is associated with increased initial clinical severity of acute viral hepatitis AJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 11 2001Israel Gotsman Abstract Background and Aim: In glucose-6-phosphate dehydrogenase (G6PD) deficiency, the enzyme is deficient in liver cells as well as in erythrocytes. It has been suggested that this may be associated with a more severe clinical presentation of acute viral hepatitis A. The aim of this study is to determine the severity of liver disease in patients with viral hepatitis and G6PD deficiency. Methods: Eighteen patients with diagnosed G6PD deficiency and acute hepatitis A were compared with 18 matched control patients with hepatitis A in a university hospital for liver disease severity and clinical outcome. Results: Two of 18 patients with G6PD deficiency had neurological deterioration. Patients with G6PD deficiency had a mean peak prothrombin time (PT) that was significantly prolonged as compared with the control group (15.5 ± 3.7 vs 12.9 ± 2.0 s, respectively, P < 0.02), and a significantly higher proportion had an abnormal PT (PT > 13.3 s): 61 versus 11% (P < 0.0001). Hemolysis occurred in 44% of the G6PD deficiency patients. Total and direct bilirubin were significantly higher in all patients with G6PD deficiency, including patients without hemolysis. There was no significant difference in liver enzyme levels between the two groups. Patients with G6PD deficiency had a longer average hospital stay (9.5 ± 4.8 vs 3.4 ± 0.8 days, respectively, P < 0.001). There was no difference in the final clinical outcome between the two groups, and recovery of liver function was seen in all patients. Conclusions: Glucose-6-phosphate dehydrogenase deficiency in patients with hepatitis A causes a more severe initial clinical presentation, but does not alter the final clinical outcome. [source] Percutaneous Closure of Paravalvular LeaksJOURNAL OF INTERVENTIONAL CARDIOLOGY, Issue 2006RALPH HEIN M.D. Paravalvular leak occurs in about 2,3% of patients after surgical valve replacement. The leak may cause heart failure, arrhythmias, or hemolysis. Patients who have had multiple operations or who have significant comorbidity constituting a contraindication to surgery might be considered candidates for transcatheter closure. In the past, occluding paravalvular leaks has been attempted using coils or double umbrella devices; defect specific devices are under development. Interventional experiences with various Amplatzer occluders are described. [source] Transcatheter Closure of Congenital Ventricular Septal Defects: Experience with Various DevicesJOURNAL OF INTERVENTIONAL CARDIOLOGY, Issue 1 2003RAMESH ARORA D.M. Transcatheter closure of congenital ventricular septal defect (VSD) using various devices is gaining acceptance in selected cases of perimembranous and muscular defects, avoiding the inherent risks of cardiopulmonary bypass. The procedure was attempted in 137 patients having congenital defects using Rashkind Umbrella Device (RUD) in 29 patients, Amplatzer ventricular septal occluder (AVSO) in 107 patients, and Detachable Coil in one. All patients were selected using stringent criteria by detailed transthoracic echocardiography and/or transesophageal echocardiography. The location of VSD was perimembranous in 91 patients and was muscular trabecular in 46 patients. Seven patients had left ventricle (LV) to right atrium (RA) communication. Thirty-five patients with perimembranous and two with muscular VSD had aneurysm formation. The patients were 3 to 33 years old, and the diameter of VSD ranged from 3 to 12 mm. The pulmonary to systemic flow ratio was ,2:1 in 47 (34.3%) patients. The procedure was successful in 130 (94.8%) patients, with a success rate of 86.2% with RUD and 97.1% with AVSO. Residual shunt at 24 hours was seen in eight (32%) patients with RUD and in one patient (0.9%) with AVSO. Three (2.8%) developed transient bundle branch block, and two (1.9%) patients had complete heart block. New tricuspid stenosis and tricuspid regurgitation was observed in one patient each with AVSO. After immediate balloon dilatation, the mean pressure gradient across tricuspid valve decreased from 11 to 3 mmHg in the patient with tricuspid stenosis. On a follow-up of 1 to 66(mean 35.2 ± 10.7)months, the device was in position in all. None developed late conduction defect, aortic regurgitation, infective endocarditis, or hemolysis. At 9-month follow-up, the mean pressure gradient across the tricuspid valve was 3 mmHg in the patient with tricuspid stenosis. Complete occlusion of the shunt was achieved in 129 (99.2%) patients. One patient with RUD having persistent residual shunt underwent a second procedure with AVSO. Three out of 107 patients with AVSO had an unsuccessful procedure where the defect was perimembranous with a superior margin of defect less than 3 mm away from the aortic valve, and the specially designed perimembranous AVSO had to be retrieved because of hemodynamic compromise due to significant acute aortic regurgitation, whereas in all others, the defect was either ,3 mm away from the aortic valve or had aneurysm formation. All seven patients with LV to RA communication showed complete abolition of the shunt. Thus, in properly selected cases of perimembranous and muscular ventricular septal defects, the transcatheter closure is safe and efficacious using appropriate devices. The success rate is higher with AVSO compared with the previously used devices, as well as more successful for the muscular defects than those that are perimembranous in location. (J Interven Cardiol 2003;16:83,91) [source] MRI Changes in Thrombotic Microangiopathy Secondary to Malignant HypertensionJOURNAL OF NEUROIMAGING, Issue 2 2007Mandeep Garewal MD ABSTRACT Thrombotic microangiopathy with thrombocytopenia and intravascular hemolysis are characteristic of three disorders: malignant hypertension (MH), disseminated intravascular coagulation (DIC), and thrombocytopenic thrombotic purpura (TTP). We describe a patient with thrombotic microangiopathy secondary to malignant hypertension that caused extensive bilateral cortical ischemic infarction. [source] Group A streptococcal toxic shock syndrome with extremely aggressive course in the third trimesterJOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 4 2010Takashi Sugiyama Abstract Group-A-streptococcus-(GAS)-induced toxic shock syndrome (TSS) is uncommon, but carries a high risk of maternal mortality during pregnancy. The onset of gravidic GAS-TSS has been reported mostly during the puerperium. A 16-year-old woman, who was at 37 weeks of gestation, and without obstetrical care during the last 30 weeks, was referred to our hospital. She complained of fever for one day with headache and abdominal pain after the fever developed. On admission, her consciousness was drowsy, intrauterine fetal death was recognized, and she rapidly developed shock status with coma and hypotension, hemolysis, disseminated intravascular coagulation (DIC), and multi-organ failure. Although we had not obtained the results of a bacterial culture, we suspected sepsis with DIC with homolysis and multi-organ failure resulting from an infection. The patient was treated with antibiotics and intubation because of respiratory insufficiency. Twelve hours after admission to the intensive care unit in our hospital, she died. Cultures from blood, subcutaneous tissue, vaginal discharge, and pharynx all revealed GAS bacteria, and therefore she was diagnosed as having GAS-TSS. GAS-TSS in pregnancy is rare. However, once the infection occurs in a pregnant woman, it rapidly develops into sepsis with multi-organ failure. Therefore, early recognition and intensive treatment for GAS during pregnancy is recommended in women with high fever, muscular pain, hemolysis and DIC during pregnancy. [source] Structural studies and model membrane interactions of two peptides derived from bovine lactoferricinJOURNAL OF PEPTIDE SCIENCE, Issue 7 2005Leonard T. Nguyen Abstract The powerful antimicrobial properties of bovine lactoferricin (LfcinB) make it attractive for the development of new antimicrobial agents. An 11-residue linear peptide portion of LfcinB has been reported to have similar antimicrobial activity to lactoferricin itself, but with lower hemolytic activity. The membrane-binding and membrane-perturbing properties of this peptide were studied together with an amidated synthetic version with an added disulfide bond, which was designed to confer increased stability and possibly activity. The antimicrobial and cytotoxic properties of the peptides were measured against Staphylococcus aureus and Escherichia coli and by hemolysis assays. The peptides were also tested in an anti-cancer assay against neuroblastoma cell lines. Vesicle disruption caused by these LfcinB derivatives was studied using the fluorescent reporter molecule calcein. The extent of burial of the two Trp residues in membrane mimetic environments were quantitated by fluorescence. Finally, the solution NMR structures of the peptides bound to SDS micelles were determined to provide insight into their membrane bound state. The cyclic peptide was found to have greater antimicrobial potency than its linear counterpart. Consistent with this property, the two Trp residues of the modified peptide were suggested to be embedded deeper into the membrane. Although both peptides adopt an amphipathic structure without any regular ,-helical or ß-sheet conformation, the 3D-structures revealed a clearer partitioning of the cationic and hydrophobic faces for the cyclic peptide. Copyright © 2004 European Peptide Society and John Wiley & Sons, Ltd. [source] Methoxypolyethylene glycol- block -polycaprolactone diblock copolymers reduce P-glycoprotein efflux in the absence of a membrane fluidization effect while stimulating P-glycoprotein ATPase activityJOURNAL OF PHARMACEUTICAL SCIENCES, Issue 4 2007Jason Zastre Abstract We have previously shown that amphiphilic diblock copolymers composed of methoxypolyethylene glycol- b -polycaprolactone (MePEG- b -PCL) increased the cellular accumulation and reduced the basolateral to apical flux of the P-glycoprotein substrate, rhodamine 123 (R-123) in caco-2 cells. The purpose of this study was to investigate membrane perturbation effects of MePEG- b -PCL diblock copolymers with erythrocyte membranes and caco-2 cells and the effect on P-gp ATPase activity. The diblock copolymer MePEG17 -b-PCL5 induced increasing erythrocyte hemolysis at concentrations which correlated with increasing accumulation of R-123 into caco-2 cells. However, no increase in cellular accumulation of R-123 by non-P-gp expressing cells was observed, suggesting that diblock did not enhance the transmembrane passive diffusion of R-123, but that the accumulation enhancement effect of the diblock in caco-2 cells was likely mediated primarily via P-gp inhibition. Fluorescence anisotropy measurements of membrane fluidity and P-gp ATPase activity demonstrated that MePEG17 - b -PCL5 decreased caco-2 membrane fluidity while stimulating ATPase activity approximately threefold at concentrations that maximally enhanced R-123 caco-2 accumulation. These results suggest that inhibition of P-gp efflux by MePEG17 - b -PCL5 does not appear to be related to increases in membrane fluidity or through inhibition in P-gp ATPase activities, which are two commonly reported cellular effects for P-gp inhibition mediated by surfactants. © 2006 Wiley-Liss, Inc. and the American Pharmacists Association J Pharm Sci 96: 864,875, 2007 [source] | ||||||||||||||||||||||||||||||||||