RESUMEN
BACKGROUND: Alloimmune-mediated refractoriness to platelet transfusion is most commonly due to antibody to HLA antigens in multiply transfused or multiparous patients. Published reports of poor transfusion response due to antibodies to platelet-specific antigens are rare and often confounded by the presence of coexistent antibodies against HLA antigens. CASE REPORT: A case is presented of a multiparous woman with acute myelogenous leukemia whose sole cause of transfusion refractoriness was antibody to platelet antigen HPA-1a. She responded dramatically to HPA-1a-negative platelet transfusion. CONCLUSION: This case provides strong serologic and clinical evidence that platelet transfusion refractoriness may result from antibodies to platelet-specific antigens.
Asunto(s)
Antígenos de Plaqueta Humana/inmunología , Antígenos HLA/inmunología , Isoanticuerpos/efectos adversos , Transfusión de Plaquetas/métodos , Femenino , Humanos , Integrina beta3 , Isoanticuerpos/sangre , Leucemia Mieloide Aguda/sangre , Leucemia Mieloide Aguda/terapia , Persona de Mediana Edad , Recuento de Plaquetas , Transfusión de Plaquetas/normas , Insuficiencia del TratamientoRESUMEN
Advances in biotechnology and bioinformatics are offering promise for new breakthroughs in gene discovery and elucidation of gene function. At present, many candidate genes related to cancer pathogenesis have been identified in several types of human cancer, yet frequently their function remains elusive. This is particularly true as it relates to the progression of human cancer. This landscape could change dramatically, however, as technological innovations and improvements continue to revolutionize these fields. High-throughput molecular approaches are emerging, which may become accurate, automated, and cost-effective. For example, DNA arrays on microchips are under development with numerous applications, including the ability to screen genes rapidly for mutations and to study patterns of gene expression on a large scale. Automated systems for microdissection and sequencing are also in their implementation stages. Commensurate with their integration and evolution, these information and technological tools have the potential to offer a more comprehensive understanding of multiple genetic and cellular alterations occurring during cancer initiation, development, and progression. Ultimately, this fundamental knowledge can provide strategies for intervention, prevention, and early diagnosis. This is a US government work. There are no restrictions on its use.
Asunto(s)
Disección , Microquímica/instrumentación , Microcirugia , Metástasis de la Neoplasia/genética , Neoplasias/genética , Secuencia de Bases , Biotecnología , ADN de Neoplasias/análisis , ADN de Neoplasias/genética , Progresión de la Enfermedad , Regulación Neoplásica de la Expresión Génica/genética , Humanos , Aplicaciones de la Informática Médica , Biología Molecular , Mutación/genética , Neoplasias/diagnóstico , Neoplasias/prevención & control , Neoplasias/terapia , Oncogenes/genéticaRESUMEN
We present clinicopathologic findings in a patient treated with intraarterial thrombolysis and angioplasty for vertebrobasilar thrombosis. Autopsy revealed a marked inflammatory infiltrate within the vertebral artery at the site of catheter manipulation. This finding may have important implications for the use of interventional angiography in cerebrovascular disease.
Asunto(s)
Angioplastia de Balón/instrumentación , Endotelio Vascular/patología , Embolia y Trombosis Intracraneal/terapia , Terapia Trombolítica/instrumentación , Activador de Plasminógeno de Tipo Uroquinasa/administración & dosificación , Arteria Vertebral/patología , Insuficiencia Vertebrobasilar/terapia , Terapia Combinada , Endotelio Vascular/efectos de los fármacos , Endotelio Vascular/lesiones , Resultado Fatal , Humanos , Embolia y Trombosis Intracraneal/patología , Masculino , Persona de Mediana Edad , Activador de Plasminógeno de Tipo Uroquinasa/efectos adversos , Arteria Vertebral/efectos de los fármacos , Arteria Vertebral/lesiones , Insuficiencia Vertebrobasilar/patologíaRESUMEN
The role of the spatial relationship between target responses and reinforcers in the discrimination learning of mentally retarded subjects was evaluated. On each training trial, subjects were instructed to move a hand-operated manipulandum to a positive stimulus located at the left or right end of a track. Correct responses were immediately followed by onset of a light and presentation of an edible reinforcer. In the control condition the light and edible reinforcers were presented in a single location equidistant from the ends of the manipulandum track; in the experimental condition, they were presented directly adjacent to the terminus of the response at the end of the manipulandum track corresponding to the location of the correct stimulus. Results showed that discrimination performance was more efficient in the experimental condition than in the control condition.