Blood coagulation tests of gorillas.

In coagulation tests on five lowland gorillas, values within or close to the normal human range were found with the following tests: partial thromboplastin time, prothrombin time, thrombin time, factor XIII screen, factor II assay, factor V assay, fibrinogen and antithrombin III. Factor XII levels were very high. Factor VIII coagulant activity was moderately elevated but factor VIII antigen was very high in all and ristocetin cofactor activity was low in four of five.

An unusual factor-X inhibitor in leprosy.

Two cases of Hansen disease demonstrating a lupus-like inhibitor directed against the activation of coagulation factor X are described. Each case showed factor-X activity markedly depressed by an inhibitor when measured in one assay system; yet normal levels were measured by three alternate factor-X assay systems.

Bovine plasma as a reference standard for the factor VIII assay.

Definition of one unit of factor VIII procoagulant activity may be imprecise, for a number of reasons. Levels in individual normal plasmas differ sufficiently that small pools do not have equivalent activities. Large pools cannot be prepared without loss of activity because of the lability of factor VIII. Human factor VIII may not be stable at --20 C. Lyophilized standards may vary in activity because of difficulties in dissolving the materials. The authors have prepared standards that are stable at --20 C for years using beef plasma diluted in outdated human blood bank plasma. The level of activity of this working standard is verified by repeated assays of lyophilized national standards and of small pools of normal donor plasma. The standard is equally applicable to one- or two-stage assays for factor VIII.

Re-evaluation of plasmas from patients previously diagnosed as having von Willebrand's disease with the factor VIII-related antigen and ristocetin cofactor assay.

Diagnosis of deficiencies of coagulation factor VIII can be difficult to establish in some cases. The use of the factor VIII-related antigen and the use of the ristocetin cofactor assays have increased the reliability of diagnosis of factor VIII deficiency in patients with hemophilia A or von Willebrand's disease, and in carriers of hemophilia A. The authors re-evaluated samples, from frozen storage, of blood from patients previously diagnosed as having von Willebrand's disease. This diagnosis was based on clinical history, family history, bleeding time, factor VIII procoagulant activity, and response to ristocetin in platelet-aggregation studies. Eleven cases were studied by the review of previously obtained data and the addition of the factor VIII-related antigen and ristocetin-cofactor assays. In two of eleven cases, the diagnosis was changed to possible hemophilia A carrier state.

Platelet loss on exposure of citrated blood to various foreign surfaces.

Citrated whole blood was rotated in tubes or closed loops of tubing and the percentage of platelets lost on exposure to the surface of the container was noted. Platelet loss in the presence of uncoated glass surfaces (mean loss 31%) was significantly less than in the presence of glass siliconed with two different reagents (82% and 86%). Platelets adhered to siliconed glass but not to uncoated glass. Other inert surfaces also resulted in a high degree of platelet loss: Teflon 90 per cent, silicone rubber 85 per cent, Parawax 84 per cent, polysytrene 82 per cent, polyethylene 79 per cent, polypropylene 60 per cent, and polycarbonate 58 per cent. One lot of polyvinyl chloride transfusion grade tubing resulted in only 2 per cent loss of platelets, but other lots varied between 35 and 84 per cent. Loss of platelets on exposure to the surface of plastic containers may have to be considered when evaluating new materials for preparation of blood components.