scholarly journals Blood group A and B antigens are strongly expressed on platelets of some individuals

Blood ◽  
2000 ◽  
Vol 96 (4) ◽  
pp. 1574-1581 ◽  
Author(s):  
Brian R. Curtis ◽  
Jennifer T. Edwards ◽  
Martin J. Hessner ◽  
John P. Klein ◽  
Richard H. Aster

It is widely thought that expression of ABH antigens on platelets is insufficient to materially affect the survival of ABH-incompatible platelets in transfusion recipients, but anecdotal reports of poor survival of A and B mismatched platelets suggest that this is not always the case. The A and B antigen expression on platelets of 100 group A1 and group B blood donors was measured, and 7% and 4%, respectively, had platelets whose A and B antigen levels consistently exceeded the mean plus 2 SD. On the basis of flow cytometric and statistical analysis, donors whose platelets contained higher than normal levels of A antigen were subdivided into 2 groups, designated Type I and Type II (“high expressers”). Serum A1- and B-glycosyltransferase levels of A and B high expressers were significantly higher than those of group A1 and B individuals with normal expression. H antigen levels were low on the red cells of high expressers, indicating that the anomaly affects other cell lineages. Immunochemical studies demonstrated high levels of A antigen on various glycoproteins (GPs) from high-expresser platelets, especially GPIIb and PECAM (CD31). The A1 Type II high-expresser phenotype was inherited as an autosomal dominant trait in one family. The sequences of exons 5, 6, and 7 of the A1-transferase gene of one Type II A1 high expresser and exon 7 from 3 other genes were identical to the reported normal sequences. Further studies are needed to define the molecular basis for the high-expresser trait and to characterize its clinical implications.

Blood ◽  
2000 ◽  
Vol 96 (4) ◽  
pp. 1574-1581 ◽  
Author(s):  
Brian R. Curtis ◽  
Jennifer T. Edwards ◽  
Martin J. Hessner ◽  
John P. Klein ◽  
Richard H. Aster

Abstract It is widely thought that expression of ABH antigens on platelets is insufficient to materially affect the survival of ABH-incompatible platelets in transfusion recipients, but anecdotal reports of poor survival of A and B mismatched platelets suggest that this is not always the case. The A and B antigen expression on platelets of 100 group A1 and group B blood donors was measured, and 7% and 4%, respectively, had platelets whose A and B antigen levels consistently exceeded the mean plus 2 SD. On the basis of flow cytometric and statistical analysis, donors whose platelets contained higher than normal levels of A antigen were subdivided into 2 groups, designated Type I and Type II (“high expressers”). Serum A1- and B-glycosyltransferase levels of A and B high expressers were significantly higher than those of group A1 and B individuals with normal expression. H antigen levels were low on the red cells of high expressers, indicating that the anomaly affects other cell lineages. Immunochemical studies demonstrated high levels of A antigen on various glycoproteins (GPs) from high-expresser platelets, especially GPIIb and PECAM (CD31). The A1 Type II high-expresser phenotype was inherited as an autosomal dominant trait in one family. The sequences of exons 5, 6, and 7 of the A1-transferase gene of one Type II A1 high expresser and exon 7 from 3 other genes were identical to the reported normal sequences. Further studies are needed to define the molecular basis for the high-expresser trait and to characterize its clinical implications.


2018 ◽  
Vol 4 (4) ◽  
pp. 519-522
Author(s):  
Jeyakumar S ◽  
Jagatheesan Alagesan ◽  
T.S. Muthukumar

Background: Frozen shoulder is disorder of the connective tissue that limits the normal Range of motion of the shoulder in diabetes, frozen shoulder is thought to be caused by changes to the collagen in the shoulder joint as a result of long term Hypoglycemia. Mobilization is a therapeutic movement of the joint. The goal is to restore normal joint motion and rhythm. The use of mobilization with movement for peripheral joints was developed by mulligan. This technique combines a sustained application of manual technique “gliding” force to the joint with concurrent physiologic motion of joint, either actively or passively. This study aims to find out the effects of mobilization with movement and end range mobilization in frozen shoulder in Type I diabetics. Materials and Methods: 30 subjects both male and female, suffering with shoulder pain and clinically diagnosed with frozen shoulder was recruited for the study and divided into two groups with 15 patients each based on convenient sampling method. Group A patients received mobilization with movement and Group B patients received end range mobilization for three weeks. The outcome measurements were SPADI, Functional hand to back scale, abduction range of motion using goniometer and VAS. Results: The mean values of all parameters showed significant differences in group A as compared to group B in terms of decreased pain, increased abduction range and other outcome measures. Conclusion: Based on the results it has been concluded that treating the type 1 diabetic patient with frozen shoulder, mobilization with movement exercise shows better results than end range mobilization in reducing pain and increase functional activities and mobility in frozen shoulder.


2020 ◽  
Author(s):  
Shijie Liao ◽  
Tiantian Wang ◽  
Qian Huang ◽  
Yun Liu ◽  
Rongbin Lu ◽  
...  

Abstract PurposeThe present study aimed to explore the influence of ulnar bow on the surgical treatment of Bado type I missed Monteggia fracture in children.MethodsThis study is a retrospective review of 24 patients between November 2010 and March 2019. All patients were treated with open reduction of the radial head and ulnar opening wedge osteotomy without annular ligament reconstruction. The mean interval between injury onset and surgery was five months (range: 2–12 months). The average age of participants at the time of surgery was 6.4 years (range: 3–10 years). We evaluated the maximum ulnar bow (MUB) and MUB position (P-MUB) via radiography. The patients were divided into middle group (group A: 14 cases, MUB located at 40% to 60% of the distal ulna) and distal group (group B: 10 cases, MUB located at 20% to 40% from the distal end of the ulna) based on P-MUB. The mean period of follow-up was 37 months (range: 6–102 months).ResultsAt the last follow-up, all the children showed stable reduction of the radial head, and the flexion function of elbow joint improved after operation (P<0.05). Group A presented a larger the ratio of maximum ulnar bow(R-MUB) and angle of ulnar osteotomy(OA) than group B (P<0.05). There was statistically significant difference between group A and Group B in the P-MUB (P < 0.05). The osteotomy angle was positively correlated with the R-MUB (R2 =0.497,P=0.013), The osteotomy angle was positively correlated with the P-MUB (R2=0.731,P=0.000), The R-MUB is proportional to the P-MUB (R2 =0.597,P=0.002). The regression equation of P-MUB and osteotomy angle: Angle=7.064+33.227* P-MUB (R2=0.459, P =0.000).ConclusionWhen the ulnar bow is positioned at the middle ulna, a stable reduction of radial head need to be achieved through a larger angle in the ulnar osteotomy. If the position of maximum ulnar bow (P-MUB) is closer to the middle of the ulna or the ratio of maximum ulnar bow (R-MUB) is larger, the osteotomy angle is larger.


Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 2119-2119
Author(s):  
Diarmaid O Donghaile ◽  
Vince P Jenkins ◽  
Rachel McGrath ◽  
Lisa Preston ◽  
Roger JS Preston ◽  
...  

Abstract Abstract 2119 Poster Board II-96 ABO(H) blood group antigen expression on platelets varies widely among normal blood donors. An ABO ‚High Expresser' phenotype (HXP) that exhibits significantly increased A and/or B antigen expression on platelets has been identified in ∼7% of normal donors. HXP has been implicated in both platelet-refractoriness and neonatal alloimmune thrombocytopenic purpura, however, the underlying molecular and genetic elements that mediate this phenomenon are not well-defined. To investigate the mechanisms underlying HXP, blood samples were collected from 231 group A (180 A1and 51 A2) and 310 group O individual apheresis platelet donors. Quantitative expression of platelet A and H antigen were then assessed by flow cytometry of platelet-rich plasma. In total, 10 A1 donors (5.6%) exhibited HXP. Analysis of the platelet A antigen expression in these individuals identified 8 HXP donors who exhibited ‚type I' HXP (normal bimodal population of platelets, but with predominant A antigen expression) whereas 2 individuals exhibited ‚type II' HXP (a single uniform population of platelets, strongly positive for blood group A expression). Both types of HXP were found to be a stable donor characteristic. ABO(H) determinants have also been identified on the N-linked glycans of the plasma von Willebrand factor (VWF), and influence plasma VWF levels and susceptibility to proteolysis by ADAMTS13. To determine whether HXP was platelet-specific, blood group A antigen expression on plasma VWF from group A donors was determined. Interestingly, blood group A antigen expression on plasma VWF was concordantly increased in donors with type I and type II HXP, indicative of increased glycosyltransferase expression in HXP individuals. To ascertain whether increased glycosyltransferase expression contributes to HXP, ABO genotype was determined for all 231 group A donors by PCR-RFLP analysis. Genotype at the ABO locus on 9q34 exerts a dosage effect on glycosyltransferase expression. 80% HXP (all type I) donors were genotyped A1A1. suggesting increased A transferase activity contributes to type I HXP. Despite this, the majority of A1A1individuals (67%) did not exhibit HXP, and 2 HXP donors were found to possess the A2 allele, which expresses limited A transferase enzymatic activity. Collectively, this data clearly demonstrates the contribution of additional factors to ABO genotype that contribute to HXP. To identify additional HXP modifiers, potential enhancer repeat elements upstream of the ABO gene were examined in group A donors, including those with HXP. Typically, A1alleles contain a single 43-base pair repeat within a minisatellite positive regulatory region upstream of the ABO gene. In contrast, A2and O1alleles contain four 43bp repeats, which are associated with a 100-fold enhancement of transcriptional activity. Analysis of this enhancer region demonstrated two HXP donors with A1alleles containing four copies of the 43-base pair repeat. Consequently, this allele would be predicted to modulate A transferase expression via enhanced ABO gene transcription. In conclusion, we have demonstrated the multi-factorial nature of the regulatory elements mediating platelet type I and type II HXP. A1alleles containing novel upstream enhancer repeats identified in donor individuals may represent a novel genetic mediator of HXP, and contribute to the pathophysiology associated with this phenomenon independently of ABO genotype. Disclosures: No relevant conflicts of interest to declare.


2007 ◽  
Vol 6 (3) ◽  
pp. 216-221 ◽  
Author(s):  
Atsushi Ono ◽  
Futoshi Suetsuna ◽  
Kazumasa Ueyama ◽  
Toru Yokoyama ◽  
Shuichi Aburakawa ◽  
...  

Object The clinical characteristics of pediatric scoliosis associated with syringomyelia have been reported in previous studies, but scoliosis associated with syringomyelia in adults is rarely treated, and there is a paucity of detailed studies. In the present study of adult syringomyelia associated with Chiari malformation Type I, the authors investigated the relationships among the syrinx, scoliosis, and neurological data. Methods The population was composed of 27 patients (≥ 20 years of age) who underwent foramen magnum decompression for the treatment of syringomyelia. The patients were divided into two groups: those with scoliosis of 10° or more (Group A) and those without scoliosis (Group B). The authors assessed the length of the syrinx, duration of morbidity, and clinical status before and after surgery based on the Japanese Orthopaedic Association (JOA) Scale. There were 15 cases in Group A and 12 in Group B. The mean length of the syrinx was 12.8 vertebral bodies (VBs) in Group A and 7.2 VBs in Group B. The mean duration of morbidity was 14.2 years in Group A and 6.8 years in Group B. The mean preoperative JOA score was 10.1 in Group A and 14.4 in Group B, whereas the mean postoperative JOA scores were 11.9 and 15.8, respectively. There were significant differences between Groups A and B in length of the syrinx, duration of morbidity, and pre- and postoperative JOA scores. Conclusions In patients with syringomyelia and scoliosis the syringes spanned a greater number of VBs, the duration of morbidity was greater, neurological dysfunction was more severe, and surgical results were poorer. Scoliosis could be a predicting factor of the prognosis in patients with syringomyelia and Chiari malformation Type I.


Author(s):  
Umesh Kumar ◽  
Pradeep Jain

Abstract Background The sagittal maxillary fracture often coexists with maxillary fractures and warrants a definitive management strategy together with other maxillary fractures. Method This study was conducted on 60 patients suffering from sagittal maxillary fracture. Palatal fractures were classified into six subgroups. During management, patients were divided into three groups. In group A, patients with type I, IV, V, and VI were managed with maxillomandibular fixation and anterior maxillary buttress stabilization. Group B patients included type II, III, and IV palatal fractures. These fractures were undisplaced and were managed with maxillomandibular fixation, anterior alveolar plating, and anterior maxillary buttress stabilization. Group C included type II and III fractures with visible gap in the palate and were managed with maxillomandibular fixation, palatal vault plating, anterior alveolar plating, and anterior maxillary buttress stabilization. Result Sagittal maxillary fracture was more common in young males. Le Fort I and II fractures were more frequently associated with it in isolation or in combination. Parasagittal and sagittal fractures were the most common types. Sixteen patients of group A, twenty patients of group B, and twenty-four patients of group C were managed. Malocclusion (2), plate extrusion (2), and oroantral fistula (2) were the most common complications. Conclusion Sagittal maxillary fracture can be diagnosed with clinical and radiological examination. Palatal vault plating is required in displaced palatal fractures of type II and III. Single plate fixed in posterior half of middle one-third of palate gives sufficient stability to the palatal vault.


2019 ◽  
Vol 3 (11) ◽  
pp. 1738-1749 ◽  
Author(s):  
Mathivanan Chinnaraj ◽  
William Planer ◽  
Vittorio Pengo ◽  
Nicola Pozzi

Abstract Anti-phosphatidylserine/prothrombin (aPS/PT) antibodies are often detected in patients with antiphospholipid syndrome (APS), but how aPS/PT engage prothrombin at the molecular level remains unknown. Here, the antigenic determinants of immunoglobulin G aPS/PT were investigated in 24 triple-positive APS patients at high risk of thrombosis by using prothrombin mutants biochemically trapped in closed and open conformations, and relevant fragments spanning the entire length of prothrombin. Two novel unexpected findings emerged from these studies. First, we discovered that some aPS/PT are unique among other anti-prothrombin antibodies insofar as they efficiently recognize prothrombin in solution after a conformational change requiring exposure of fragment-1 to the solvent. Second, we identified and characterized 2 previously unknown subpopulations of aPS/PT, namely type I and type II, which engage fragment-1 of prothrombin at different epitopes and with different mechanisms. Type I target a discontinuous density-dependent epitope, whereas type II engage the C-terminal portion of the Gla-domain, which remains available for binding even when prothrombin is bound to the phospholipids. Based on these findings, APS patients positive for aPS/PT were classified into 2 groups, group A and group B, according to their autoantibody profile. Group A contains mostly type I antibodies whereas group B contains both type I and type II antibodies. In conclusion, this study offers a first encouraging step toward unveiling the heterogeneity of anti-prothrombin antibodies in correlation with thrombosis, shedding new light on the mechanisms of antigen–autoantibody recognition in APS.


Author(s):  
Zhen-Guo Huang ◽  
Cun-li Wang ◽  
Hong-liang Sun ◽  
Shu-Zhu Qin ◽  
Chuan-Dong Li ◽  
...  

Objectives: To evaluate the effect of the position of microcoil proximal end on the incidence of microcoil dislocation during CT-guided microcoil localization of pulmonary nodules (PNs). Methods: This retrospective study included all patients with PNs who received CT-guided microcoil localization before video-assisted thoracoscopic urgery (VATS) resection from June 2016 to December 2019 in our institution. The microcoil distal end was less than 1 cm away from the nodule, and the microcoil proximal end was in the pleural cavity (the pleural cavity group) or chest wall (the chest wall group). The length of microcoil outside the pleura was measured and divided into less than 0.5 cm (group A), 0.5 to 2 cm (group B) and more than 2 cm (group C). Microcoil dislocation was defined as complete retraction into the lung (type I) or complete withdrawal from the lung (type II). The rate of microcoil dislocation between different groups was compared. Results: A total of 519 consecutive patients with 571 PNs were included in this study. According to the position of microcoils proximal end on post-marking CT, there were 95 microcoils in the pleural cavity group and 476 in the chest wall group. The number of microcoils in group A, B, and C were 67, 448 and 56, respectively. VATS showed dislocation of 42 microcoils, of which 30 were type II and 12 were type I. There was no statistical difference in the rate of microcoil dislocation between the pleural cavity group and the chest wall group (6.3% vs 7.6%, x2 = 0.18, p = 0.433). The difference in the rate of microcoil dislocation among group A, B, and C was statistically significant (11.9%, 5.8%, and 14.3% for group A, B, and C, respectively, x2 = 7.60, p = 0.008). In group A, 75% (6/8) of dislocations were type I, while all eight dislocations were type II in group C. Conclusions: During CT-guided microcoil localization of PNs, placing the microcoil proximal end in the pleura cavity or chest wall had no significant effect on the incidence of microcoil dislocation. The length of microcoil outside the pleura should be 0.5 to 2 cm to reduce the rate of microcoil dislocation. Advances in knowledge: : CT-guided microcoil localization can effectively guide VATS to resect invisible and impalpable PNs. Microcoil dislocation is the main cause of localization failure. The length of microcoil outside the pleura is significantly correlated with the rate and type of microcoil dislocation. Placing the microcoil proximal end in the pleura cavity or chest wall has no significant effect on the rate of microcoil dislocation.


Author(s):  
N.K. Svyrydova ◽  
G.M. Chupryna ◽  
V.M. Dubуnetska ◽  
Z.L. Tyzhuk

The article analyzes the physical and psychological components of the quality of life (QOL) in patients with diabetic polyneuropathy (DP) on the background of type I and II diabetes mellitus (DM) with comorbidity. Has been demonstrated the prevalence of more frequent multimorbidity in this nosology and its effect on patients’ QOL. QOL is recognized as an integral part of a comprehensive analysis of new methods of diagnosis, treatment, prevention, quality of treatment and medical assistance [2]. With the highest frequency in DM detect sensory or sensorimotor forms of distal symmetrical DP. However, there are motor symptoms in DM, including cranial neuropathy and Bruns-Garland syndrome (diabetic amyotrophy) [3], which interfere with the satisfactory functioning of patients. The purpose of our work was to assess the extent of physical and mental functioning of people with DP on the background of multimorbidity. Materials and methods. We examined 92 patients with DP on the background of type I and II DM, aged from 19 to 69 years, which were divided into 2 groups: from DP on the background of type 1 DM (group I) and type II (group II). We distinguished such subgroups: DP on the background of type I DM and concomitant cardiovascular pathology (CVP) (group A), DP on the background of type II DM and concomitant CVP (group B), DP on the background of type I DM and gastroenterological pathology (GEP) (group C), DP on the background of type II DM and GEP (group D), DP on the background of type I DM and pathology of the thyroid gland (thyroid) (group E), DP on the background of type II DM and thyroid pathology (group F). Patients underwent clinical and neurological examination, laboratory tests and ultrasound examination of the abdominal cavity and thyroid gland, electromyography (EMG). Static calculation was done in MS Excel 2003. Results and discussion. In groups A and B with the highest frequency among CVP was arterial hypertension - 91% vs 97% and coronary heart disease - 27% vs 41%. In group C - chronic hepatitis (40%), chronic cholecystitis (40%), chronic pancreatitis (40%), chronic gastroduodenitis (40%). In people of group D, gallstone disease was diagnosed more often than in other pathologies (43%). The leading place in group E was occupied by autoimmune thyroiditis (29%), idiopathic hypothyroidism (29%), thyrotoxicosis (29%), in group F - nodular goiter (57%). The longest duration of DM was observed in group A - 24.54 ± 2.46 years, the smallest in group D - 7.14 ± 1.01 years. Diabetic foot syndrome was diagnosed in patients of groups A and B in 14%, group C - in 2%. In patients of group I, the indicators of QOL were higher than in group II. The highest indicators were of groups I and II in the domains social (SF) and physical functioning (PF) - 66.75 ± 2.41; 65.5 ± 3.23 and 63.39 ± 3.54; 61.42 ± 3.88. In group A, the level of QOL was slightly higher than in group B, in particular in the domains of mental health (MH) - 53.09 ± 3.12, bodily pain (BP) - 50.90 ± 4.05. In addition, the manifestations of DP in such group of individuals (group A) were manifested by the absence or mild pain, which causes in people of this group higher rate of QOL. QOL in patients of group C was higher than in group D, in particular, the indicators of physical functioning (PF) - 68.75 ± 5.88, social functioning (SF) - 65.62 ± 5.35, role emotional (RE) - 58.33 ± 18.75, mental health (MH) - 54 ± 5.36. In group D, the data were high in the domains of social functioning (SF) 60.71 ± 16.0 and physical functioning (PF) 57.14 ± 8.37. In the examined patients of group F the level of QOL was higher than in group E, it was, in the domains of physical functioning (PF) - 76.42 ± 7.99, bodily pain (BP) - 61.28 ± 11.18, general health (GH) - 60.85 ± 7.33. Physical health (PH) was low in all groups, but slightly higher in group F (47.90 ± 3.45). The mental health (MH) was low in all groups of patients, slightly higher in group C (47.89 ± 3.59). Conclusions. The level of QOL in persons with DP on the background of type I and II DM with multimorbidity was generally not high. Patients in group D showed the lowest levels of QOL, they also had a level of glycated hemoglobin much higher than in other groups. In group F, the data of QOL were higher, because people with DP on the background of type I DM (group E) had a higher frequency of concomitant thyroid damage, the manifestations of which significantly complicate the course of the underlying disease and reduce levels of functioning. Often manifestations of diabetic foot occur in the onset of DP, when the fibers responsible for sensitivity were damaged, which causes the appearance of the neuropathic component of pain, so in persons of group B the lowest among all groups was the level of QOL in the domain of pain intensity. In addition, it was convenient to monitor the results of treatment by conducting a QOL survey several times a year. Careful analysis of QOL in all areas of functioning in patients with DP allowed detecting early mental disorders and timely start treatment, including psychotherapy sessions. Keywords: quality of life, diabetic polyneuropathy, comorbidity, diabetic foot.


Author(s):  
Coda Marco ◽  
Novak Anna ◽  
Aliberti Daniele ◽  
Ciccone Vincenzo ◽  
Carbone Mattia

Computed tomography angiography (CTA) has been widely used in diagnostic evaluation of many aortic diseases, but there are not standardized techniques for aortic CTA. The purpose of this study is to compare two methods: biphasic technique and split bolus. A 64-slice CT scanner has been used. There were a total of 28 patients involved in the study. The patients have been divided in two groups: - Group A: 18 patients - Group B: 10 patients The biphasic technique has been used on 18 patients in group A. In this protocol was used a low dose acquisition without contrast medium (CM) and two contrastographic phases with CM. The split bolus technique was performed on 10 patients of group B. 120-140 ml of CM are divided in two boluses. The first bolus of 55-90 ml of CM was injected at a flow of 1,5-2 ml/s, followed by 20ml of physiological solution at a flow of 1,5-2ml/s. After physiological solution the second bolus of 35-60 ml was injected at a flow of 3,5ml/s followed by 20ml of Nacl at a flow of 3,5ml/s. In group A 6 patients had endoleak type I, n=2 endoleak type II, n=8 endoleak type III, n=2 endoleak type IV. (dose of 43.2 mSv). In group B 2 patients had endoleak type I, n= 4 endoleak type II, n=3 endoleak type III and n=1 endoleak type IV. (dose of 16,39 mSv). The biphasic technique has high spatial resolution and contrast resolution, reduction of acquisition times and reduction of artifacts, but an unacceptable a great amount of radiation is involved. The split bolus technique provides results comparable to the biphasic technique but with a lower dose of radiation.


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