The 1989 Comprehensive Blood Bank Survey of the College of American Pathologists.

The 1989 Comprehensive Blood Bank Survey included four additional samples for a total of eight antibody detection and identification challenges. The remainder of the survey was unchanged from prior years. Performance on the graded portions has remained good, with only occasional "problem" samples. For this survey year, the discrepant results were as follows: (1) a D-positive sample not reaching 95% consensus of D typing due to a strong positive direct antiglobulin test; (2) failure of 7% of extent 3 laboratories to identify anti-K in the presence of anti-c; and (3) continued, but lessened "identification" of anti-E, which was not present. The ungraded samples continued to provide educational challenges, and supplemental questions were used to survey current practices.

The 1987 Comprehensive Blood Bank Survey of the College of American Pathologists.

The 1987 Comprehensive Blood Bank Survey consisted of four shipments of samples. Each presented graded challenges in ABO and D typing, crossmatching, and antibody detection and identification and ungraded challenges for antigen typing and ungraded serum samples for educational purposes. Practice patterns were elicited through supplemental questions, generally about issues raised by the survey samples. Two of the surveys showed significant problems. Set J-C included serum with anti-Lea, which was not detected by some participants. Anti-Dia was one of two antibodies in the J-D graded sample, and this additional antibody was not detected by a significant number of participants. Although minor problems were encountered in other challenges, in general performance was good.

CAP comprehensive blood bank survey--1985.

Approximately 2800 laboratories participate in the voluntary Comprehensive Blood Bank Survey of the College of American Pathologists, including graded challenges relating to ABO and Rh typing, antibody detection and identification, and crossmatching. The Surveys have shown consistently good performance in these areas. Ungraded responses reporting results of antigen typing, other cell or serum challenges selected for educational value, and supplemental questions are reviewed. The supplemental questions are designed to elicit practice patterns and to present opportunities for educational comments in the critiques.

CAP Comprehensive Blood Bank Survey--1984.

An average of 2750 laboratories participated in the 1984 Comprehensive Blood Bank Survey of the College of American Pathologists. Results from 16 laboratories were utilized to validate results and assure maintenance of specimen character during shipment. Results of ABO grouping, D typing, special antigen typing, antibody detection, and antibody identification by participants remained good and are discussed. Special ungraded samples were provided as additional challenges. The results of these studies and the responses to supplementary questions are discussed.

The malignant cells in a Lennert's lymphoma are T lymphocytes with a mature helper surface phenotype. A multiparameter flow cytometric analysis.

The flow cytometric analysis of DNA content in cells obtained from a case of Lennert's lymphoma demonstrated the presence of a discrete hypotetraploid cell population. Correlated multiparameter analysis of DNA, light scatter, and surface antigens by flow cytometry showed that the hypotetraploid cells were intermediate to large cells expressing T11, T3, and T4 antigens and lacking B1 and T8 antigens. These findings suggest that Lennert's lymphoma represents a malignant neoplasm of T-helper lymphocytes.

Midgut carcinoid tumor with carcinoid heart disease. Its presence in the absence of hepatic metastases--a case report.

A 56-year-old man with a midgut carcinoid tumor had extensive metastatic involvement of lymphatic spaces and carcinoid heart disease. Unlike similar previously reported cases with carcinoid heart disease, hepatic metastases and history of the carcinoid syndrome were absent in this patient. Tumor involvement of cardiac lymphatic spaces may have been responsible for the development of carcinoid heart disease due to a local fibrogenic effect similar to the extensive fibrosis associated with tumor seen within the abdominal cavity at autopsy.

Splenic-gonadal fusion and adrenal cortical rest associated with bilateral cryptorchism.

A patient with bilateral cryptorchism had ectopic splenic tissue adherent to his left testicle and an adrenal cortical rest adherent to his right testicle. The embrylogic basis for these disorders is discussed and the literature reviewed.

Evaluation of serum ionic calcium measurement in a general hospital population.

Direct measurement of ionic calcium was evaluated in light of conflicting reports concerning the correlation of ionic calcium with total calcium and ionic calcium as predicted from total calcium and serum protein. Ionic calcium in the sera of normo- hypo-, and hypercalcemic adult hospitalized patients was measured anaerobically using an Orion model 98-20 calcium flow-thorugh electrode. Good correlation (r = .77) was found with the calculated ionic calcium value derived from total protein and total calcium, using the McLean-Hastings nomogram. Good correlation was also present between the measured ionic and total calcium (r = .80). In view of these correlations, the introduction of serum ionic calcium measurements into the general hospital laboratory repertoire is of questionable value.

Early and late histologic effects of stereotactic neurosurgery.

The histologic lesions produced in the brain by stereotactic chemosurgery and cryosurgery are reviewed in four patients who died from 25 days to 15 years postoperatively. Three of four patients had damage to the internal capsule and died of pulmonary emboli. The early lesions are histologically nonspecific, but the old lesions of chemopallidectomy and chemothalamectomy in one patient contained metaplastic bone. Lesions produced by freezing are more discrete than those made by chemical means.

Carcinoid tumors of the appendix in children.

Carcinoid tumors of the appendix in 30 children younger than 15 years showed no recurrence with up to 24 years' followup, regardless of size, depth of invasion, or presence of perineural involvement. All were treated by appendectomy. Twenty-three of the tumors were in girls, confirming the female preponderance reported in other series.

Compatibility of common intravenous solutions with CPD blood.

Blood anticoagulated with CPD was mixed with lactated Ringer's solution, 5 per cent aqueous dextrose, 5 per cent dextrose in 0.225 per cent saline, 5 per cent dextrose in 0.9 per cent saline, and 0.9 per cent saline solution in varying concentrations and incubated at room temperature and 37 C. Clots formed in the blood-lactated Ringer's mixture after five minutes at a citrate:calcium molar ratio of 4:1 or lower. Aqueous dextrose-blood mixtures showed immediate clumping with gross hemolysis after 30 minutes incubation. Blood mixed with 5 per cent dextrose and 0.225 per cent saline hemolyzed within ten minutes incubation at 37 C. No hemolysis occurred in blood mixed with 5 per cent dextrose in 0.9 per cent saline or with 0.9 per cent saline. Traces of solutions labeled with Evans blue dye remained in intravenous administration tubing even 30 minutes after a simulated transfusion was begun. Lactated Ringer's solution and 5 per cent dextrose in 0.225 per cent saline should not be administered concurrently with blood. Lactated Ringer's solution may also be harmful when used to start transfusions as it rapidly produces clots when mixed with CPD blood.