Background: Gamma irradiation has been often used for inactivating viable T lymphocytes in the blood product to prevent post-transfusion graft - vs - host disease (PT - GVHD) occurred in the recipients having immunodeficiency. But the irradiating method must be determined to minimize the reverse effects on other blood elements. Objectives: to evaluate the side effects of gamma irradiating with 25 Gy and in different ways on red cells in stored red cell concentrates. Subjects and methods: Each of 30 red cell concentrates was divided into 3 parts and treated in 3 different ways to create 3 groups of sample for studying. All the samples were stored 35 days at 4 - 6\xb0C and measured red cell osmotic fragility, hemoglobin (Hb) level in storage solution in days 1,7,14,21,28,35. Results: 1) Red cell osmotic fragility decreased and free Hb level increased with time in the samples of 3 groups. 2) Red cell osmotic fragility decreased strongly from the 28th day (p < 0.05) and free Hb level increased dramatically from the 14th day (p < 0.001) in the samples of group 2 compared to control group and group 3 with the same storage time, while there was no difference in these parameters in groups 1 and 3. Conclusion: 1) Gamma irradiation with 25 Gy affected the intact of red cells in red cell concentrates only when irradiated right after being produced and stored more than 14 days. 2) The quality of red cell would be unchanged if used immediately after irradiated. \r\n', u'\r\n', u'
Erythrocytes/ radiography

Hand, foot, and mouth disease (HFMD) is an acute, mostly self-limiting infection. Patients usually recover without any sequelae. However, a few cases are life threatening, especially those caused by enterovirus 71 (EV71). A 12-month-old boy was admitted to a primary hospital with high fever and vesicular lesions of the mouth, hands, and feet. After 3 days, he experienced 3 seizure episodes and was referred to our hospital. On admission, he was conscious and his chest radiograph was normal. However, 6 hours later, he suddenly lost consciousness and had developed a massive pulmonary hemorrhage that continued until his death. He experienced several more intermittent seizures, and diffuse infiltration of both lung fields was observed on chest radiography. Intravenous immunoglobulin, dexamethasone, cefotaxime, leukocyte-depleted red blood cells, fresh frozen plasma, inotropics, vitamin K, and endotracheal epinephrine were administered. The patient died 9 hours after intubation, within 3 days from fever onset. EV71 subgenotype C4a was isolated retrospectively from serum and nasopharyngeal swab by real-time reverse transcription-polymerase chain reaction. Here, we report a fatal case of EV71-associated HFMD with sudden-onset massive pulmonary hemorrhage and suspected encephalitis.
Cefotaxime ; Consciousness ; Dexamethasone ; Encephalitis ; Enterovirus* ; Epinephrine ; Erythrocytes ; Fever ; Foot* ; Hand* ; Hemorrhage* ; Humans ; Immunoglobulins ; Infant ; Intubation ; Lung ; Male ; Mouth ; Mouth Diseases* ; Plasma ; Radiography ; Radiography, Thoracic ; Retrospective Studies ; Seizures ; Thorax ; Vitamin K

Hand, foot, and mouth disease (HFMD) is an acute, mostly self-limiting infection. Patients usually recover without any sequelae. However, a few cases are life threatening, especially those caused by enterovirus 71 (EV71). A 12-month-old boy was admitted to a primary hospital with high fever and vesicular lesions of the mouth, hands, and feet. After 3 days, he experienced 3 seizure episodes and was referred to our hospital. On admission, he was conscious and his chest radiograph was normal. However, 6 hours later, he suddenly lost consciousness and had developed a massive pulmonary hemorrhage that continued until his death. He experienced several more intermittent seizures, and diffuse infiltration of both lung fields was observed on chest radiography. Intravenous immunoglobulin, dexamethasone, cefotaxime, leukocyte-depleted red blood cells, fresh frozen plasma, inotropics, vitamin K, and endotracheal epinephrine were administered. The patient died 9 hours after intubation, within 3 days from fever onset. EV71 subgenotype C4a was isolated retrospectively from serum and nasopharyngeal swab by real-time reverse transcription-polymerase chain reaction. Here, we report a fatal case of EV71-associated HFMD with sudden-onset massive pulmonary hemorrhage and suspected encephalitis.
Cefotaxime ; Consciousness ; Dexamethasone ; Encephalitis ; Enterovirus* ; Epinephrine ; Erythrocytes ; Fever ; Foot* ; Hand* ; Hemorrhage* ; Humans ; Immunoglobulins ; Infant ; Intubation ; Lung ; Male ; Mouth ; Mouth Diseases* ; Plasma ; Radiography ; Radiography, Thoracic ; Retrospective Studies ; Seizures ; Thorax ; Vitamin K

Massive pulmonary hemorrhage in neonates is defined as an acute onset of severe endotracheal bleeding with an acute drop in hematocrit and the development of multilobar infiltrates on chest radiograph. It results from a wide etiologic spectrum and is a potentially life-threatening disorder. We experienced a case of massive pulmonary hemorrhage in 1-day-old male who was small for gestational age and whose mother was complicated with severe pregnancy induced hypertension. He was hospitalized due to tachypnea and poor feeding 24 hours after birth, and bright bloody fluid was continually suctioned from the trachea 4 hours after admission. Packed red blood cell and fresh frozen plasma was transfused. Respiratory failure was refractory to conventional mechanical ventilation. He received surfactant replacement therapy 12 hours after pulmonary hemorrhage, and subsequently chest x-ray findings and oxygenation index improved. He was discharged on the 20th day of life without any problem.
Erythrocytes ; Female ; Gestational Age ; Hematocrit ; Hemorrhage ; Humans ; Hypertension, Pregnancy-Induced ; Infant, Newborn ; Male ; Mothers ; Oxygen ; Parturition ; Plasma ; Pregnancy ; Pulmonary Surfactants* ; Radiography, Thoracic ; Respiration, Artificial ; Respiratory Insufficiency ; Suction ; Tachypnea ; Thorax ; Trachea