Haemolytic activity of Actinobacillus actinomycetemcomitans strains on different blood types

Haemolytic activity of sixty nine Actinobacillus actinomycetemcomitans strains on different animal and human blood types was examined by using a trypticase soy agar supplemented with yeast extract (0.5%). Blood types used were: rabbit, sheep and human (A, Rh+; A, Rh-; B, Rh+; B, Rh-; O, Rh+; O, Rh-; AB, Rh+; AB, Rh- groups). Plates were inoculated and, incubated in microaerophilic conditions, at 37ºC, for 48 h. The haemolytic activity of the tested strains was characterized as alpha-haemolysis. Only two isolates were not haemolytic on all blood types (2.9%), two strains were haemolytic only on human blood (one strain on AB, Rh+ group and another one on A, Rh+ and AB, Rh+ groups). No specificity between haemolysin produced by the tested strains and blood type was observed.

Frequencies of DEA blood types in a purebred canine blood donor population in Porto Alegre, RS, Brazil

The study of canine immunohematology is very important for veterinary transfusion medicine. The objective of this study was to determine the DEA blood type frequencies in a purebred canine blood donor population from Porto Alegre, RS, Brazil. One hundred clinically healthy purebred dogs were chosen, 20 dogs from each breed (Great Dane, Rottweiler, Golden Retriever, German Shepherd and Argentine Dogo). Blood samples were taken in ACD-A tubes and the MSU hemagglutination tube test (MI, USA) was used to determine the blood types. The studied population presented general frequencies of 61% for DEA 1.1, 22% for DEA 1.2, 7% for DEA 3, 100% for DEA 4, 9% for DEA 5 and 16% for DEA 7. A significant association was found between breeds and certain combinations of blood types in this population. The results are in agreement with the literature since most part of the canine population studied was positive for DEA 1.1, the most antigenic blood type in dogs. Differences were found among the studied breeds and those should be considered when selecting a blood donor. The knowledge of blood types frequencies and their combinations in different canine populations, including different breeds, is important because it shows the particularities of each group, helps to keep a data bank of local frequencies and minimizes the risks of transfusion reactions.

Mechatronic system for ABO human blood typing

In medical emergency situations, when a patient needs a blood transfusion, the universal blood type O− is administered. This procedure may lead to the depletion of stock reserves of O− blood. Nowadays, there is no commercial equipment capable of determining the patient's blood type in situ, in a fast and reliable process. Human blood typing is usually performed through the manual test, which involves a macroscopic observation and interpretation of the results by an analyst. This test, despite of having a fast response time, may lead to human errors, which sometimes can be fatal to the patient. This paper presents the development of an automatic mechatronic prototype for determining human blood typing (ABO and Rh systems) through image processing techniques. The prototype design takes into account the characteristics of reliability of analysis, portability, and response time allowing the system to be used in emergency situations. The developed prototype performs blood and reagents mixture acquires the resultant image and processes the data (based on image processing techniques) to determine the sample blood type. It was tested in a laboratory, using cataloged samples of blood types, provided by the Portuguese Institute of Blood and Transplantation. Hereafter, it is expected to test and validate the prototype in clinical environments.

Correlation of blood type with thrombosis in pancreatic cancer patients

Objective: The study aimed to identify the risk factors involved in initiating thromboembolism (TE) in pancreatic cancer (PC) patients, with focus on ABO blood type. ^ Methods and Patients: There were 35.7% confirmed cases of TE and 64.3% cases remained free of TE (n=687). There were 12.7% only Pulmonary embolism (PE), 9% only Deep vein thrombosis (DVT), 53.5% only other sites, 3.3% combined PE and DVT, 8.6% combined PE and other sites, 9.8% combined DVT and other sites, and 3.3% all three combined cases. ^ Results: The risk factors for thrombosis identified by multivariate logistic regression were: history of previous anti-thrombotic treatment, tumor site in pancreatic body or tail, large tumor size, maximum glucose category more than 126 and 200 mg/dL. ^ The factors with worse overall survival by multivariate Cox regression and Kaplan Meier analyses were: locally advanced or metastatic stage, worsening performance status, high CA 19-9 levels, and HbA1C levels more than 6 %, at diagnosis. ^ There were 29.1% and 39.1% of the patients with thrombosis in the O and non-O blood type groups respectively. Both Non-O blood type (P=0.02) and the A, B and AB blood types (P= 0.007) were associated with thrombosis as compared to O type. The odds of thrombosis were nearly half in O blood type patients as compared to non-O blood type [OR-0.54 (95% C.I.- 0.37-0.79), P<0.001]. ^ Conclusion: A better understanding of the TE and PC relationship and involved risk factors may provide insights on tumor biology and patient response to prophylactic anticoagulation therapy.^

Blood type classification using computer vision and machine learning

In emergency situations, where time for blood transfusion is reduced, the O negative blood type (the universal donor) is administrated. However, sometimes even the universal donor can cause transfusion reactions that can be fatal to the patient. As commercial systems do not allow fast results and are not suitable for emergency situations, this paper presents the steps considered for the development and validation of a prototype, able to determine blood type compatibilities, even in emergency situations. Thus it is possible, using the developed system, to administer a compatible blood type, since the first blood unit transfused. In order to increase the system’s reliability, this prototype uses different approaches to classify blood types, the first of which is based on Decision Trees and the second one based on support vector machines. The features used to evaluate these classifiers are the standard deviation values, histogram, Histogram of Oriented Gradients and fast Fourier transform, computed on different regions of interest. The main characteristics of the presented prototype are small size, lightweight, easy transportation, ease of use, fast results, high reliability and low cost. These features are perfectly suited for emergency scenarios, where the prototype is expected to be used.

Mechatronic system for performing blood pre-transfusion tests

The blood types determination is essential to perform safe blood transfusions. In emergency situations isadministrated the “universal donor” blood type. However, sometimes, this blood type can cause incom-patibilities in the transfusion receptor. A mechatronic prototype was developed to solve this problem.The prototype was built to meet specific goals, incorporating all the necessary components. The obtainedsolution is close to the final system that will be produced later, at industrial scale, as a medical device.The prototype is a portable and low cost device, and can be used in remote locations. A computer appli-cation, previously developed is used to operate with the developed mechatronic prototype, and obtainautomatically test results. It allows image acquisition, processing and analysis, based on Computer Visionalgorithms, Machine Learning algorithms and deterministic algorithms. The Machine Learning algorithmsenable the classification of occurrence, or alack of agglutination in the mixture (blood/reagents), and amore reliable and a safer methodology as test data are stored in a database. The work developed allowsthe administration of a compatible blood type in emergency situations, avoiding the discontinuity of the“universal donor” blood type stocks, and reducing the occurrence of human errors in the transfusion practice.

Simultaneous high-resolution pH and spectrophotometric recordings of oxygen binding in native blood microvolumes, link to supplementary material

Oxygen equilibrium curves have been widely used to understand oxygen transport in numerous organisms. A major challenge has been to monitor oxygen binding characteristics and concomitant pH changes as they occur in vivo, in limited sample volumes. Here we report a technique allowing highly resolved and simultaneous monitoring of pH and blood pigment saturation in minute blood volumes. We equipped a gas diffusion chamber with a broad range fibre optic spectrophotometer and a micro-pH optode and recorded changes of pigment oxygenation along PO2 and pH gradients to test the setup. Oxygen binding parameters derived from measurements in only 15 µl of haemolymph from the cephalopod Octopus vulgaris showed low instrumental error (0.93%) and good agreement with published data. Broad range spectra, each resolving 2048 data points, provided detailed insight into the complex absorbance characteristics of diverse blood types. After consideration of photobleaching and intrinsic fluorescence, pH optodes yielded accurate recordings and resolved a sigmoidal shift of 0.03 pH units in response to changing PO2 from 0-21 kPa. Highly resolved continuous recordings along pH gradients conformed to stepwise measurements at low rates of pH changes. In this study we showed that a diffusion chamber upgraded with a broad range spectrophotometer and an optical pH sensor accurately characterizes oxygen binding with minimal sample consumption and manipulation. We conclude that the modified diffusion chamber is highly suitable for experimental biologists who demand high flexibility, detailed insight into oxygen binding as well as experimental and biological accuracy combined in a single set up.

Contribuição para o estudo das transfusões sanguíneas no cão e no gato : situação em Portugal e estudo de 61 transfusões

Os avanços na área da Medicina transfucional, nomeadamente a descoberta de nova informação sobre os grupos sanguíneos de várias espécies, a introdução rotineira da tipificação sanguínea e das provas de compatibilidade eritrocitária, o estudo das reacções transfusionais adversas, o despiste de doenças infeciosas no dador e a aplicação da terapia por componentes, têm contribuído para aumentar a segurança da transfusão sanguínea em Medicina Veterinária e, por consequência, a sua utilização é cada vez mais frequente. O presente trabalho é constituído por três objectivos: perspectivar a medicina transfusional em Portugal através da análise dos resultados de um inquérito, dirigido aos CAMV, nomeadamente sobre o uso da terapia por componentes, as principais indicações de transfusão e a ocorrência de reacções transfusionais; caracterizar a população de gatos e cães receptores de transfusões sanguíneas, com enfoque na prevalência dos diferentes grupos sanguíneos, na indicação para a realização da transfusão e tipo de produto administrado; determinar a ocorrência de reacções transfusionais através da monotorização do doente antes, durante e após a administração das transfusões. No presente estudo, 86% dos Centros de Atendimento Médico Veterinário (CAMV) inquiridos recorrem à transfusão sanguínea como terapia complementar. Destes, 54.7% utiliza sangue total e produtos do sangue, 41.3% apenas sangue total e 4% apenas produtos do sangue. Os produtos do sangue mais utilizados são o concentrado de glóbulos vermelhos e o plasma fresco congelado (34.2% e 31.6% respectivamente). A anemia constitui o principal motivo para a realização de transfusões sanguíneas e a hipertermia a reacção transfusional mais frequente. Relativamente à caracterização da população de cães e gatos que receberam transfusão sanguínea conclui-se que 77.8% dos cães pertenciam ao grupo DEA 1.1 negativo e 22.2% ao grupo DEA 1.1 positivo. Todos os gatos incluídos neste estudo pertenciam ao grupo sanguíneo A. A anemia por hemorragia foi a indicação predominante para a administração de sangue nos cães (54.3%). Nos gatos a anemia por não produção de eritrócitos prevalece (60%). No que respeita às reacções transfusionais, das 61 transfusões realizadas apenas se registou uma dispneia num gato.

Aspectos estruturais, farmacológicos e biológicos de fucanas da alga marrom sargassum vulgare

The present study examines the chemical composition and their effects on free radicals, inflammation, angiogenesis, coagulation, VEGF effects and cellular proliferation of a polysaccharides from alga Sargassum vulgare. The sulfated polysaccharide was extracted from brown seaweed by proteolysis with enzymes maxataze. The presence of proteins and sugars were observed in crude polysaccharides. Fractionation of this crude extract was made with growing concentration of acetone (0.3-1.5 v) and produced four groups of polysaccharides. Anionic polysaccharides from brown seaweed Sargassum vulgare, SV1and PSV1 were fractionated (SV1) and purified (PSV1), and displayed with high total sugars and sulfate content and very low level of protein. This fucan SV1 contains low levels of protein and high carbohydrate and sulfate content. This polysaccharides prolonged activated partial thromboplastin time (aPTT) at 50 μg (>240 s). SV1 was found to have no effect on prothrombin time (PT), corresponding to the extrinsic pathway of coagulation. SV1 exhibits high antithrombotic action in vivo, with a concentration ten times higher than heparin. Polysaccharides from S. vulgare promoted direct inhibition enzymatic activity of thrombin and stimulated enzymatic activity of FXa. SV1 showed optimal inhibitory activity of thrombin (50.2±0.28%) at a concentration of 25 μg/mL. Its antioxidant action on scavenging radicals by DPPH was (22%), indicating the polymer has no cytotoxic action (hemolytic) on ABO and Rh blood types in different erythrocyte groups and displays strong anti-inflammatory action on all concentrations tested in the carrageenan-induced paw edema model, demonstrated by reduced edema and cellular infiltration. Angiogenesis is a dynamic process of proliferation and differentiation. It requires endothelial proliferation, migration, and tube formation. In this context, endothelial cells are a preferred target for several studies and therapies. The antiangiogenic efficacy of polysaccharides was examined in vivo in the chick chorioallantoic membrane (CAM) model by using fertilized eggs. Decreases in the density of the capillaries were assessed and scored. The results showed that SV1 and PSV1 have an inhibitory effect on angiogenesis. These results were also confirmed by inhibition tubulogenesis in rabbit aorta endothelial cell (RAEC) in matrigel. These compounds were assessed in Apoptosis assay (Annexin V - FITC / PI) and cell viability by MTT assay of RAEC. These polysaccharides do not affect the viability and do not have apoptotic or necrotic action. RAEC cell when incubated with SV1 and PSV1showed inhibition of VEGF secretion, observed when compounds were incubated at 25, 50 and 100 μg/μL. The VEGF secretion with the RAEC cell line for 24 h, was more effective for PSV1 at 50 μg/μL(71.4%) than SV1 100 μg/μL (75.9%). SV1 and PSV1 had an antiproliferative action (47%) against tumor cell line HeLa. Our results indicate that these sulfated polysaccharides have antiangiogenic and antitumoral actions

Untersuchungen über ADAMTS13 in Gerinnungsfaktorpräparaten

Zusammenfassung rnIn der vorliegenden Arbeit wurden sechs VWF/FVIII Gerinnungsfaktorkonzentrate unterschiedlicher Chargen auf ihre ADAMTS13 Aktivität, Antigen und VWF Multimere untersucht. Grund dafür ist die Annahme, dass bei der Aufkonzentrierung des VWFs möglicherweise auch erhöhte Mengen an ADAMTS13 vorhanden sind. Wäre dies nachweisbar, könnten die entsprechenden Konzentrate auch Anwendung bei TTP Patienten finden. Neben den Gerinnungsfaktorkonzentraten wurden ebenfalls die zur Plasmapherese verwendeten Therapeutika FFP und s/d Plasma analysiert. Es soll getestet werden, ob Unterschiede hinsichtlich der Qualität zwischen den Präparaten bestehen und inwiefern die Blutgruppen eine Auswirkung auf die ADAMTS13 Aktivität/Antigen haben. Überdies wurde die Bedeutung von ADAMTS13 als wichtiges diagnostisches Merkmal im Rahmen der Gegenüberstellung von Patienten mit thrombotischen Mikroangiopathien erörtert. Alle angewandten Methoden wurden zudem kritisch miteinander verglichen und auf ihre Eignung für die klinische Diagnostik getestet. Zur Untersuchung der ADAMTS13 Aktivität kamen drei unterschiedliche Methoden zur Anwendung, die BCS-Methode nach Böhm und zwei FRET Kits (Technozym®ADAMTS13/ActifluorTMADAMTS13). Für die Bestimmung des ADAMTS13 Antigen wurde das Technozym®ADAMTS13 Kit verwendete als auch der Imubind®ELISA angewendet. Mittels der SDS-Gelelektrophorese konnten die VWF Multimere dargestellt werden. Die Untersuchungen konnten zeigen, dass nur in Haemate®P, deutlich höhere ADAMTS13 Aktivitäten (12,3% bzw. 470ng/ml) sowie ein physiologische Antigenwerte vorlagen. Die anderen Faktorkonzentrate wiesen entweder nur sehr geringe bzw. keine Aktivitäten auf. Das Antigen lag bei allen Konzentraten im nachweisbaren Bereich. Folglich ist ein Einsatz von Haemate®P bei der Therapie der TTP, insbesondere bei hereditären Formen sowie bei Kindern, die durch eine Plasmapherese stark belastet werden, und bei Schwangeren, könnten, in Erwägung zu ziehen und innerhalb der Klinik zu testen. Die Plasmapräparate FFP und Octaplas® wiesen in allen Untersuchungen ADAMTS13 Aktivitäten und Antigen im mittleren bis hohen physiologischen Bereich auf. Insbesondere bei Blutgruppe 0 ließ sich beiden Präparaten eine höhere ADAMTS13 Aktivität und Antigen gegenüber den drei anderen Blutgruppen darstellen. Insgesamt waren die interindividuellen Schwankungen bei FFP deutlich höher als bei Octaplas®, was sich in der unterschiedlichen Herstellung der Präparate begründen lässt. Octaplas® ist also genauso geeignet zur Plasmapherese bei der TTP wie FFP, kann jedoch aufgrund seiner intensiveren Virusinaktivierung eine größere Sicherheit aufweisen und stellt sich auch in der Klinik als nebenwirkungsärmer dar. Bei der Gegenüberstellung der thrombotischen Mikroangiopathien konnte gezeigt werden, dass eine verminderte ADAMTS13 Aktivität ein wichtiges Unterscheidungsmerkmal ist und auch während der Remission schon diagnostizierbar werden kann. Auf der Grundlage der labordiagnostischen Werte und dem klinischen Erscheinungsbild im akuten Schub und in der Remission konnte ein diagnostischer Algorithmus für den klinischen Alltag erstellt werden. In der Methodenvalidierung erwies sich der ActifluorTMADAMTS13 Kit als der beste Kit, da er innerhalb kürzester Zeit zuverlässige Werte in Standardeinheiten liefert. Nach neuesten Erkenntnissen, bei der eine Unterscheidung von ADAMTS13 Aktivitäten über und unter 5 % von großer prognostischer Bedeutung sind, ist die BCS-Methode nach Böhm mit einer unteren Nachweisgrenze von 6,2% zu ungenau und auch hinsichtlich ihres Zeitaufwandes eher ungünstig.rn

Chemical camouflage of antigenic determinants: Stealth erythrocytes

In a number of clinical circumstances it would be desirable to artificially conceal cellular antigenic determinants to permit survival of heterologous donor cells. A case in point is the problem encountered in transfusions of patients with rare blood types or chronically transfused patients who become allosensitized to minor blood group determinants. We have tested the possibility that chemical modification of the red blood cell (RBC) membrane might serve to occlude antigenic determinants, thereby minimizing transfusion reactions. To this end, we have covalently bound methoxy(polyethylene glycol) (mPEG) to the surface of mammalian RBC via cyanuric chloride coupling. Human RBC treated with this technique lose ABO blood group reactivity as assessed by solution–phase antisera agglutination. In accord with this, we also find a profound decrease in anti-blood group antibody binding. Furthermore, whereas human monocytes avidly phagocytose untreated sheep RBC, mPEG-derivatized sheep RBC are ineffectively phagocytosed. Surprisingly, human and mouse RBC appear unaffected by this covalent modification of the cell membrane. Thus, mPEG-treated RBC are morphologically normal, have normal osmotic fragility, and mPEG-derivatized murine RBC have normal in vivo survival, even following repeated infusions. Finally, in preliminary experiments, mPEG-modified sheep RBC intraperitoneally transfused into mice show significantly improved (up to 360-fold) survival when compared with untreated sheep RBC. We speculate that similar chemical camouflage of intact cells may have significant clinical applications in both transfusion (e.g., allosensitization and autoimmune hemolytic disease) and transplantation (e.g., endothelial cells and pancreatic β cells) medicine.

Aspectos estruturais, farmacológicos e biológicos de fucanas da alga marrom sargassum vulgare

The present study examines the chemical composition and their effects on free radicals, inflammation, angiogenesis, coagulation, VEGF effects and cellular proliferation of a polysaccharides from alga Sargassum vulgare. The sulfated polysaccharide was extracted from brown seaweed by proteolysis with enzymes maxataze. The presence of proteins and sugars were observed in crude polysaccharides. Fractionation of this crude extract was made with growing concentration of acetone (0.3-1.5 v) and produced four groups of polysaccharides. Anionic polysaccharides from brown seaweed Sargassum vulgare, SV1and PSV1 were fractionated (SV1) and purified (PSV1), and displayed with high total sugars and sulfate content and very low level of protein. This fucan SV1 contains low levels of protein and high carbohydrate and sulfate content. This polysaccharides prolonged activated partial thromboplastin time (aPTT) at 50 μg (>240 s). SV1 was found to have no effect on prothrombin time (PT), corresponding to the extrinsic pathway of coagulation. SV1 exhibits high antithrombotic action in vivo, with a concentration ten times higher than heparin. Polysaccharides from S. vulgare promoted direct inhibition enzymatic activity of thrombin and stimulated enzymatic activity of FXa. SV1 showed optimal inhibitory activity of thrombin (50.2±0.28%) at a concentration of 25 μg/mL. Its antioxidant action on scavenging radicals by DPPH was (22%), indicating the polymer has no cytotoxic action (hemolytic) on ABO and Rh blood types in different erythrocyte groups and displays strong anti-inflammatory action on all concentrations tested in the carrageenan-induced paw edema model, demonstrated by reduced edema and cellular infiltration. Angiogenesis is a dynamic process of proliferation and differentiation. It requires endothelial proliferation, migration, and tube formation. In this context, endothelial cells are a preferred target for several studies and therapies. The antiangiogenic efficacy of polysaccharides was examined in vivo in the chick chorioallantoic membrane (CAM) model by using fertilized eggs. Decreases in the density of the capillaries were assessed and scored. The results showed that SV1 and PSV1 have an inhibitory effect on angiogenesis. These results were also confirmed by inhibition tubulogenesis in rabbit aorta endothelial cell (RAEC) in matrigel. These compounds were assessed in Apoptosis assay (Annexin V - FITC / PI) and cell viability by MTT assay of RAEC. These polysaccharides do not affect the viability and do not have apoptotic or necrotic action. RAEC cell when incubated with SV1 and PSV1showed inhibition of VEGF secretion, observed when compounds were incubated at 25, 50 and 100 μg/μL. The VEGF secretion with the RAEC cell line for 24 h, was more effective for PSV1 at 50 μg/μL(71.4%) than SV1 100 μg/μL (75.9%). SV1 and PSV1 had an antiproliferative action (47%) against tumor cell line HeLa. Our results indicate that these sulfated polysaccharides have antiangiogenic and antitumoral actions

Evaluation of androgenicity, abdominal adiposity, blood pressure and types of ovulatory patterns in a sample of women with menstrual irregularities

Objective: To determine the prevalence of and the relationships between the degree and source of hyperandrogenemia, ovulatory patterns and cardiovascular disease risk indicators (blood pressure, indices or amount of obesity and fat distribution) in women with menstrual irregularities seen at endocrinologists' clinic. Design: A cross-sectional study design. Participants: A sample of 159 women with menstrual irregularities, aged 15-44, seen at endocrinologists' clinic. Main Outcome Measures: androgen levels, body mass index (BMI), waist-hip ratio (WHR), systolic and diastolic blood pressure (SBP & DBP), source of androgens, ovulatory activity. Results: The prevalence of hyperandrogenemia was 54.7% in this study sample. As expected, women with acne or hirsutism had an odds ratio 12.5 (95%CI = 5.2-25.5) times and 36 (95%CI = 12.9-99.5) times more likely to have hyperandrogenemia than those without acne or hirsutism. The main findings of this study were the following: Hyperandrogenemic women were more likely to have oligomenorrheic cycles (OR = 3.8, 95%CI = 1.5-9.9), anovulatory cycles (OR = 6.6, 95%CI = 2.8-15.4), general obesity (BMI $\ge$ 27) (OR = 6.8, 95%CI = 2.2-27.2) and central obesity (WHR $\ge$ 127) (OR = 14.5, 95%CI = 6.1-38.7) than euandrogenemic women. Hyperandrogenemic women with non-suppressible androgens had a higher mean BMI (29.3 $\pm$ 8.9) than those with suppressible androgens (27.9 $\pm$ 7.9); the converse was true for abdominal adiposity (WHR). Hyperandrogenemic women had a 2.4 odds ratio (95%CI = 1.0-6.2) for an elevated SBP and a 2.7 odds ratio (95%CI = 0.8-8.8) for elevated DBP. When age differences were accounted for, this relationship was strengthened and further strengthened when sources of androgens were controlled. When the differences in BMI were controlled, the odds ratio for elevated SBP in hyperandrogenemic women increased to 8.8 (95%CI = 1.1-69.9). When the age, the source of androgens, the amount of obesity and the type of obesity were controlled, hyperandrogenemic women had 13.5 (95%CI = 1.1-158.9) odds ratio for elevated SBP. Conclusions: In this study population, the presence of menstrual irregularities are highly predictive for the presence of elevated androgens. Women with elevated androgens have a high risk for obesity, more specifically for central obesity. The androgenemic status is an independent predictor of blood pressure elevation. It is probable that in the general population, the presence of menstrual irregularities are predictive of hyperandrogenemia. There is a great need for a population study of the prevalence of hyperandrogenemia and for longitudinal studies in hyperandrogenemic women (adrenarche to menopause) to investigate the evolution of these relationships. ^

Influence of two types of self-retaining retractors on multifidus muscle blood flow during dorsolateral thoracolumbar hemilaminectomy in dogs

OBJECTIVES To assess the influence of the use of Gelpi and Grevel retractors on multifidus muscle blood flow during hemilaminectomy, using a dorsolateral approach, for acute disc extrusion in dogs as measured by laser speckle contrast imaging (LSCI). METHODS Blood flow in the multifidus muscles was measured intra-operatively using LSCI prior to insertion of the retractors, immediately after hemilaminectomy and removal of the retractors, and after 10 minutes of lavage of the surgical site. Plasma creatine kinase levels were measured preoperatively and 12-24 hours postoperatively. RESULTS Muscular blood flow was significantly decreased following retraction and remained lower than initial values 10 minutes after lavage in all dogs. The decrease in blood flow was significantly greater with Gelpi retractors (n = 8) than with Grevel retractors (n = 10). No significant relation was found between the duration of retraction and postoperative changes in creatine kinase levels or blood flow. CLINICAL SIGNIFICANCE Findings in this study demonstrate a drop in blood flow within the multifidus muscles using the dorsolateral approach regardless of retractor type used. Gelpi retractors seem to have greater influence on muscular blood flow than Grevel retractors. Further studies are warranted to confirm this second finding.

A population of HLA-DR+ immature cells accumulates in the blood dendritic cell compartment of patients with different types of cancer

Dendritic cell (DC) defects are an important component of immunosuppression in cancer. Here, we assessed whether cancer could affect circulating DC populations and its correlation with tumor progression. The blood DC compartment was evaluated in 136 patients with breast cancer, prostate cancer, and malignant glioma. Phenotypic, quantitative, and functional analyses were performed at various stages of disease. Patients had significantly fewer circulating myeloid (CD11c(+)) and plasmacytoid (CD123(+)) DC, and a concurrent accumulation of CD11c(-)CD123(-) immature cells that expressed high levels of HLA-DR+ immature cells (DR+IC). Although DR+IC exhibited a limited expression of markers ascribed to mature hematopoietic lineages, expression of HLA-DR, CD40, and CD86 suggested a role as antigen-presenting cells. Nevertheless, DR+IC had reduced capacity to capture antigens and elicited poor proliferation and interferon-gamma secretion by T-lymphocytes. Importantly, increased numbers of DR+IC correlated with disease status. Patients with metastatic breast cancer showed a larger number of DR+IC in the circulation than patients with local/nodal disease. Similarly, in patients with fully resected glioma, the proportion of DR+IC in the blood increased when evaluation indicated tumor recurrence. Reduction of blood DC correlating with accumulation of a population of immature cells with poor immunologic function may be associated with increased immunodeficiency observed in cancer.