日本輸血学会雑誌
Online ISSN : 1883-8383
Print ISSN : 0546-1448
ISSN-L : 0546-1448
34 巻, 6 号
選択された号の論文の13件中1~13を表示しています
  • 西垣 文敬, 深沢 雄一郎, 近藤 信夫, 吉木 敬, 伊藤 哲夫, 与田 一男
    1988 年 34 巻 6 号 p. 581-586
    発行日: 1988年
    公開日: 2010/03/12
    ジャーナル フリー
    Immunohistochemical and HLA typing studies of a premature baby (female, 24 gestation weeks, 651g at birth) with post-transfusion graft-versus-host disease were presented. After clinical manifestation of the disease, HLA typing of the patient blood showed positivity for HLA-A24 which was theoretically absent from HLA typing of her parents. It was suggested that HLA-A24 positive lymphocytes must have been derived from one of the blood donors. In order to confirm these results, immunohistochemical study was performed on biopsied skin by using anti-HLA-A24 monoclonal antibody, HU-49. Lymphocytes infiltrating in the skin, mainly at the epidermo-dermal juncton showed strong positivity for HU-49 reactive antigen. In addition, the majority of those lymphocytes was Leu-2a positive. The collective evidence strongly indicates that the HLA-A24 and Leu-2a positive T cells derived from blood transfusion caused GVHD in this case. Lastly immunohistochemical analysis of the skin biopsy material using monoclonal anti-HLA antibodies appears to be useful for the early diagnosis of post-transfusion GVHD.
  • 特にPA法低希釈倍率陽性検体について
    植松 俊昭, 花田 修一, 大塚 真紀, 島崎 隆, 桑水流 康夫, 斉藤 毅, 橋本 修治, 新原 正明
    1988 年 34 巻 6 号 p. 587-591
    発行日: 1988年
    公開日: 2010/03/12
    ジャーナル フリー
    In the plasma and/or sera from donated volunteer from July to November in 1987 at Kagoshima Red Cross Blood Center, the prevalence of antibodies to adult T-cell leukemia associated antigen (anti-ATLA) was 11.1% (6, 740/60, 771 persons). Of these persons with anti-ATLA, 2, 842 out of 6, 740 persons (42.2%) showed low titer of seropositivity (24-26). Ninety-eight sera which showed low titer of anti-ATLA in CPD added plasma were randomly collected and examined in this study. Anti-ATLA in 93 out of 98 sera could be studied for anti-ATLA by the PA and the ELISA method and compared, each other. Of these 93 sera, 44 sera (47.3%) showed low titer (24-25) positive by the PA method, but negative by the ELISA method.
    Ninety-eight sera could be studied for anti-ATLA (IgG and IgM antibody) by Western blotting (WB) method. IgG antibody was detected only in 1 serum, but IgM antibody was not seen in any sera.
    Of 98 sera, which were available for this study, 44 sera showed low titer positive by the PA method in both CPD added plasma and serum. Of these 44 sera, anti-DNA antibody was positive only in 1 serum and antinuclear factor in 2 sera.
    These results elicited the following:
    1) In donated volunteers in Kagoshima district, an endemic area of human T-cell leukemia virus type I, the rate of positive sera with low titer (24-26) for anti-ATLA examined by the PA method was high (42.2%). 2) There are many sera showing false positive in the positive sera with low titer for anti-ATLA. 3) Factors which cause false positive reaction for anti-ATLA by the PA method might not be associated with autoantibodies in serum. Moreover, it was seen more frequently in plasma than in serum.
    In conclusion, the PA method for anti-ATLA, which is now performed, is considered to contain some problems in the procedure. Therefore, it is necessary to clarify these problems in the PA method in order to make good use of blood transfusion, effectively.
  • 大戸 斉
    1988 年 34 巻 6 号 p. 592-596
    発行日: 1988年
    公開日: 2010/03/12
    ジャーナル フリー
    The incidence of transfusion-associated hepatitis was evaluated in 108 patients having surgery who received 547 blood units from healthy donors. Non-A, non-B hepatitis developed in 14 (13.0%) patients. Number of transfusion units was associated with the development of hepatitis. Of 76 patients who received 1-5 units, 8 (10.5%) developed hepatitis, compared with 4 (18.2%) of 22 recipients with 6-10 units and 3 (30.0%) of 10 recipients of 11-19 units.
    Patients receiving one unit or more with an elevated ALT level (>20KU/L=41IU/L) had a higher rate of hepatitis than did recipients of blood with a lower level (20.7 vs 13.6%), but the difference was not significant.
    Anti-HBc were detected 9.7% of 731 donated blood studied. There was no relationship of donor anti-HBc status to recipient hepatitis.
    By the poverty of data on clinial significance of post-transfusion hepatitis and in the economic implications of introduction of anti-HBc screening test, I conclude that such a screening programme cannot be justified in Japan.
  • 山岸 司久, 吉田 弥太郎, 内野 治人, 伊藤 和彦
    1988 年 34 巻 6 号 p. 597-600
    発行日: 1988年
    公開日: 2010/03/12
    ジャーナル フリー
    Studies were made on platelet (PLT) counts in aplastic anemia patients with respect to the necessity of PLT transfusions. The conclusions obtained were as follows.
    1) PLT transfusion is not necessary when PLT counts are always above 10, 000/μl and bleeding tendency is mild.
    2) When PLT counts fall frequently below 10, 000/μl but the median is above it and bleeding tendency is mild, PLT transfusion is usually not necessary.
    3) Even if median PLT count is slightly less than 10, 000/μl, PLT transfusion is probably unnecesary in chronic cases.
    4) PLT transfusion is necessary when bleeding tendency is strong irrespectie of PLT counts.
  • IgGサブクラスの検討
    浮田 昌彦, 渡辺 幸子, 山田 紀子, 森分 智子, 渡辺 文江
    1988 年 34 巻 6 号 p. 601-606
    発行日: 1988年
    公開日: 2010/03/12
    ジャーナル フリー
    Direct antiglobulin test (DAT) and heat elution test were examined on the cord red cells of 257 A or B infants weighing over 2, 500g born to O mothers. DAT was positive in 43 infants (group I), while was negative in 95 infants which were detected anti-A and/or anti-B antibodies by elution test (group II), and remaining 119 infants were not detected any antibody in their eluates. IgG subclasses were determined in 138 infants of group I and group II. In 59 out of 131 infants without ABO hemolytic disease (ABO-HDN), all IgG subclasses were undetectable in their eluates. In the eluates of 72 others, IgG1 was detected in 29/72, IgG2 in 63/72, and IgG3 was not detected in any infant. In 7 infants with ABO-HDN, DAT was positive in 4 cases and negative in 3. In conclusion, in DAT positive infants without HDN the only IgG subclasses bound to erythrocytes are IgG2 or IgG2 with a small amount of IgG1 which cannot cause hemolysis, and in DAT-positive ABO-HDN the amount of IgG1 is enough to cause hemolysis. In DAT-negative ABO-HDN, IgG3 is responsible for hemolysis even though in amounts undetectable by DAT.
  • 大戸 斉, 遠山 ゆり子, 安田 広康, 刈米 重夫, 重田 勝義, 松田 信
    1988 年 34 巻 6 号 p. 607-610
    発行日: 1988年
    公開日: 2010/03/12
    ジャーナル フリー
    A 69-year-old man, suffered from lumbago, was found to have an Rh antibody with anti-f specificity that was reactive with bromelin treated f-antigen positive cells at room temperature. The antibody did not react by albumin-antihuman globulin test and was labile to DTT treatment. He had no previous history of blood transfusion. The blood groups of the patient were AB, CCDee (f-), kk, MMss, Fy (a+b+) and Jk (a-b+).
    In order to evaluate the clinical significance of the antibody, an in vivo survival test of AB, ccdee (f+) donor red cells was performed. Although initial T1/2 was estimated within normal limits, an increased destruction curve was plotted after two weeks. The titre of anti-f was elevated from 1:8 to 1:32 and IgG antibody resistant against DTT treatment was developed after the in vivo survival test.
    These ovservations indicated that IgM dominant anti-f may invoke hemolytic reactions.
  • 石川 善英, 笹川 滋, 畑田 研司
    1988 年 34 巻 6 号 p. 611-614
    発行日: 1988年
    公開日: 2010/03/12
    ジャーナル フリー
    A CPD-triple bags for 200ml whole blood were produced and one satellite bag (150ml) for storage of platelet concentrate (PC) was made of PVC sheet which was glow-dicharged in the presence of H2 gas for the prevention of plasticizer (DEHP) leakage. PC was prepared routinely and then stored in the satellite bag. The functions of the stored platelets were measured on ADP-, collagen-, ADP+ collagen-induced aggregability, shape change ability and hypotonic shock response (%HSR). The decrease of aggregabilities was the same as that of platelets stored in a bag from which DEHP leached. The shape change ablity and %HSR, however, did not decrease at all. It was comformed that the glow discharge-treated bag is a superior container for platelet storage.
  • 関口 定美, 伊藤 碩侯, 竹内 次雄, 沓沢 久史, 太田 政一, 石川 元, 鶴見 隆, 大沢 直樹, 深田 誠司, 佐谷 満州夫, 山 ...
    1988 年 34 巻 6 号 p. 615-617
    発行日: 1988年
    公開日: 2010/03/12
    ジャーナル フリー
    The applicability of BMM to Cohn's fractionation process for manufacturing immunoglobulin preperation was investigated from the view point of filtration characteristics such as the values of filtration-capacity (FC), and of sieving-coefficient (SC) of protein, and of the change in electrophoretic pattern (EP) according to filtration.
    The filtration conditions for the intermediate products was settled so as to fit the acutual manufacturing conditions.
    For the semifinal products, the dependences of FC, SC and EP on the filtration-temperature (FT), protein-concentration (PC) and the mean pore size of BMM (2rf) were evaluated.
    The values of FC and SC increased when the intermediate products approached to the final one or 2rf increased or FT elevated or PC decreased.
    We concluded that BMM was applicable for the liquid before dispensing into a bottle and for the supernatant-II-3.
  • 河島 道雄, 坪倉 兌雄, 河津 俊次, 大鉢 義典
    1988 年 34 巻 6 号 p. 618-625
    発行日: 1988年
    公開日: 2010/03/12
    ジャーナル フリー
    The shelf life of 2-unit platelet concentrates (PC) stored in a ordinary 300ml polyvinylchloride (PVC) bag is 72 hours after collection. However, PC obtained by apheresis must be transfused within 24 hours due to the falling of pH which is associated with a loss of viability. We have developed a new 2000ml PVC bag (0.30mm in thickness) with improved gas transmission to store 10-unit PC obtained by apheresis.
    In our study, 12 units of PC from random donors were pooled in a bag. After immediate gentle mixing, they were then divided into two bags, the new 2000ml bag containd 10 units of PC, the other 300ml bag containd 2 units of PC. Both bags were stored at 22°C and rotated on a horizontal agitator for 96 hours. During storage we monitored platelet count, pH, aggregation response, glucose consumption, lactate production, % hypotonic shock response (%HSR), mean platelet volume (MPV), lactate dehydrogenase (LDH) discharge and morphology score.
    Mean platelet count did not change during the stroage. The pH became significantly higher in the new 2000ml bag from 24 to 72 hours of storage than that of the 300ml bag (p<0.05). In the new 2000ml bag showed slightly lower lactate production and lower glucose consumption as compared to the ordinary 300ml bag. Aggregation response, %HSR, MPV, LDH discharge and morphology score were approximately the same in comparison with the ordinary 300ml bag.
    The data indicate that as measured by in vitro response, 10-unit PC obtained by apheresis can be maintained for up to 72 hours if stored in the new 2000ml bag.
  • 吉田 久博, 山下 紀美子, 伊藤 和彦, 神谷 晃
    1988 年 34 巻 6 号 p. 626-630
    発行日: 1988年
    公開日: 2010/03/12
    ジャーナル フリー
    A new method was developed to identify antibodies bound to red cell antigens using a small volume of sensitized red cells. Red cell (50μl) sensitized with Rh-Hr antibodies were reacted with panel cells (50μl) in test tube under various conditions. After centrifugation, agglutination did not occur with saline, albumin or low ionic strength solution, but did occur with antiglobulin and an enzyme method. However, the agglutination specificity for sensitized cells was observed with the two-stage enzyme method but not with antiglobulin or the one-stage enzyme method. The same results were obtained using umbilical cord cells collected from Rho incompatible pregnant women. The optimum conditions of the reaction between sensitized red cells and panel cells in the two-stage enzyme method were: an incubation time of 15min, centrifugation for 30sec at 1000rpm, and 1.5% sensitized red cells. Compared to the ether elution method, the sensitivity of detecting antibodies with this new method was twice that for anti-D, about 70 times that for anti-E and similar to that for anti-C. These results indicate that the new method is very useful for identifying antibodies bound to red cells when blood sampling from patients is very difficult and the sampling volume is small.
  • 金光 靖, 吉田 真由美, 虫明 住子, 井上 昌子, 阿波屋 典子, 藤田 往子, 藤川 容子, 椿 和央, 堀内 篤
    1988 年 34 巻 6 号 p. 631-635
    発行日: 1988年
    公開日: 2010/03/12
    ジャーナル フリー
    As a result of popularization of a computer, a computer is using for the business in hospital. The usefulness of computerized system in transfusion bussiness was developed to prevent a transfusion errors and, to manage for transaction quickly and accurately. Furthermore, the stored information could be use for various purpose. This system was programed using d-BASEIII™ by medical technologist in blood transfusion service, and was included management of the blood for transfusion and patients' blood group, unexpectd antibody, anti-lymphocyto antibody, anti-platelet antibody, transfusion history and transfusion reaction. As these information can be refered conveniently and quickly, this system had made our routin works more safely and accurately.
  • 浮田 昌彦, 渡辺 幸子, 渡辺 文江, 内山 英一, 直木 恭子
    1988 年 34 巻 6 号 p. 636-641
    発行日: 1988年
    公開日: 2010/03/12
    ジャーナル フリー
    The second example of Jra incompatible pregnancy in our hospital is reported, with the serological findings of the mother and infant and the clinical course of the infant. In reviewing the literature on Jra incompatible pregnancies the following findings were demonstrated. In 14 out of 18 Jr (a-) pregnant women, anti-Jra antibodies were produced by pregnancy and in 7 out of these 14 cases antibodies appeared during their first pregnancy. The immunoglobulin class of the anti Jra antibodies was IgG in all cases, and the subclass of IgG belonged to IgG1 and/or IgG3 in 6 cases. The direct antiglobulin test on cord red cells was positive in 15 out of 18 infants. No exchange transfusion was reported, and 16.7% of infants received phototherapy. On the basis of the above findings, it is considered that severe jaundice cannot occur in infants born to Jra incompatible pregnancies and that there is no need for amniocentesis during gestation. It is suggested that the mechanism by which no hemolysis was demonstrated despite the positive antiglobulin test in Jra incompatible infants depends on the antigen and not on the antibody.
  • 平野 聡子, 田中 真典, 鴛海 久美子, 野原 正信, 田中 明美, 高岡 通, 坂本 久浩
    1988 年 34 巻 6 号 p. 642-645
    発行日: 1988年
    公開日: 2010/03/12
    ジャーナル フリー
    Four premature infants who suffered from a GVHD-like syndrome prompted us to irradiate blood for transfusion on infants, and some efforts were made to minimize the transfusion volume and not to use incompletely screened and heparinized blood.
    Consequently, we have not had a case of GVHD-like syndrome and other severe side effects due to blood transfusion. However, blood units for emergency use have not been irradiated yet. Therefore, supplies of irradiated whole blood units and small blood volume units for infants is needed from the Red Cross Blood Center.
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