Clinical evaluation of a 51Cr-labeled red blood cell survival test for in vivo blood compatibility testing.

Modified red blood cell survival studies with use of 51Cr were performed in three groups of subjects. Group 1 consisted of normal subjects who were given labeled autologous blood, group 2 were subjects in need of blood transfusions and given labeled ABO and Rh crossmatch-compatible blood, and group 3 were patients in need of blood transfusion but in whom problems arose in finding compatible blood. The results of the studies suggest that for patients with blood compatibility problems, normal red blood cell survival values at 1 hour do not exclude the possibility of severe hemolysis 24 hours later. Thus, if a 1-hour test result is normal, the procedure should be extended routinely to 24 hours. Moreover, the test can be used to evaluate the clinical importance of antibodies. We showed that anti-Yka and anti-Lan were clinically significant, but high-titer, low-avidity antibodies, anti-Kna, anti-I, and anti-HI were clinically insignificant in the cases studied. This finding emphasizes the importance of an in vivo test for the final compatibility evaluation in complicated blood replacement problems.

Treatment of thrombotic thrombocytopenic purpura with plasma exchange, antiplatelet agents, corticosteroid, and plasma infusion: Mayo Clinic experience.

Ten patients with thrombocytopenia (TTP) were treated recently in our institution with plasma exchange (PE), steroids, and antiplatelet drugs. Additionally, fresh frozen plasma (FFP) was administered to nine patients, with folic acid given to eight patients. After 13 to 25 months of follow-up, we found that four patients achieved and remained in remission after initial treatment. Three patients had four relapses, which developed while they were taking antiplatelet therapy, and which were treated successfully with FFP alone, or with PE in addition to FFP. Four patients suffered major neurological or renal damage during their presentation or initial treatment. One of these patients died during his initial hospitalization. Another patient died 7 months after initial treatment. After analyzing this experience, we have concluded that antiplatelet drugs or corticosteroid should be used as the sole initial treatment most cautiously. The relative importance of the exchange process, per se, versus plasma infusion cannot be inferred from our observations, but plasma exchange with FFP appears to have had a real impact on recovery.

Benign chondrolipomatous tumour of the breast.

Cartilage associated with malignant neoplasms of breast has been known and documented for over 200 years. Benign breast tumours containing cartilage are rare. A case of such a tumour was encountered. Histologically it comprised multiple foci of mature benign cartilage in benign fibrous and adipose stroma. Other cases of similar tumours in the literature are reviewed.

Uterine lipomas.

Pure lipoma of the uterus is a rare entity and few authenticated cases have been recorded. We studied three cases of uterine lipomas. These are typical in their clinical, gross, and microscopic findings, appearing clinically as leiomyomas of the uterus. Histogenesis of this tumor remains unknown.