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- 저자 : Yazer, Mark Harris (검색결과 10 건)
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The how’s and why’s of evidence based plasma therapy
Mark H. Yazer 대한혈액학회 2010 Blood Research Vol.45 No.3
Although traditionally fresh frozen plasma (FFP) has been the product of choice for reversing a significant coagulopathy, the modern blood bank will have several different plasma preparations which should all be equally efficacious in reversing a significant coagulopathy or arresting coagulopathic bleeding. Emerging evidence suggests that for a stable patient, transfusing plasma for an INR≤1.5 does not confer a hemostatic benefit while unnecessarily exposing the patient to the risks associated with plasma transfusion. This review will discuss the various plasma products that are available and present some of the current literature on the clinical uses of plasma.
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The M142T Mutation Causes B3 Phenotype: Three Cases and an in vitro Expression Study
조덕,신동준,Mark Harris Yazer,임춘화,허영문,기승정,김수현,신명근,신종희,서순팔,양동욱 대한진단검사의학회 2010 Annals of Laboratory Medicine Vol.30 No.1
The B3 phenotype is the most common B subtype in Korea. The B305 allele (425 T>C, M142T) was first reported in 2 Chinese individuals; however, it has not yet been reported in the Koreans, and the impact of the M142T mutation on the expression of the B3 phenotype has also not been studied. To resolve an ABO discrepancy between a group O neonate and her group O father and A1B3 mother, blood samples from these individuals and other family members were referred to our laboratory for ABO gene analysis. The B305 allele was discovered in the neonate (B305/O01), her mother (A102/B305), and her maternal aunt (B305/O02), while her father was typed as O01/O02. Transient transfection experiments were performed in HeLa cells using the B305 allele synthesized by site-directed mutagenesis; flow cytometric analysis revealed that this transfect expressed 35.5% of the total B antigen produced by the B101 allele transfect. For comparison, Bx01 allele transfects were also created, and they expressed 11.4% of the total B antigen expressed on the surface of B101 transfects. These experiments demonstrate that the M142T (425 T>C) mutation is responsible for the B subtype phenotype produced by the B305 allele. (Korean J Lab Med 2010;30:65-9)
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Changes in hematologic indices in caucasian and non-caucasian pregnant women in the United States
Sarah K. Harm,Mark H. Yazer,Jonathan H. Waters 대한혈액학회 2012 Blood Research Vol.47 No.2
Background The objective of this study was to determine if there are differences in common red blood cell (RBC) indices and platelet concentrations during pregnancy and to establish if any observed differences in these parameters were based on the patient’s ethnicity. Methods From an electronic perinatal database which stores laboratory and clinical information on a large number of births at a regional hospital specializing in obstetrical care, RBC index and platelet concentration data were retrospectively analyzed at various time points throughout pregnancy. RBC index data was collected from 8,277 pregnant women (5,802 Caucasian pregnant women and 2,475 non-Caucasian pregnant women). Platelet concentration data was available from 8252 pregnant women (5,784 Caucasian pregnant women and 2,468 non-Caucasian pregnant women). Results Hemoglobin (HGB) levels were significantly higher amongst Caucasian women compared to non-Caucasian women (P at least <0.01) starting at 27 weeks gestation and proceeding until term. There was no significant difference in the mean PLT counts between Caucasian and non-Caucasian pregnant women at any point during gestation. Conclusion There are ethnic differences in HGB levels, but not the platelet concentrations, during pregnancy. Based on this finding it would be reasonable to conduct formal prospective studies to determine the clinical significance of this difference and to establish the threshold for diagnosing gestational anemia, especially in pregnant non-Caucasian women.
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A novel a subtype allele that demonstrates allelic competition.
Kim, Da-Woon,Cho, Duck,Yazer, Mark Harris,Lee, Ho-Jin,Kim, Kyeong-Hee,Shin, Myung-Geun,Suh, Soon-Pal,Shin, Jong-Hee,Ryang, Dong-Wook Institute for Clinical Science] 2011 Annals of clinical and laboratory science Vol.41 No.3
<P>A 68-year-old man with an ABO discrepancy discovered during a routine check up and 3 members of his family were referred for ABO analysis. A novel allele (A(w)14; 699 C>A, H233Q) was found by sequence analysis of exons 6&7 and in those with the A(w)14 allele, complete ABO analysis was performed. The propositus and his son had an A(w) phenotype with the A(w)14/O01 genotype. His daughter had an A(w)14/B101 genotype with a normal B phenotype. Three-dimensional molecular modelling was used to predict the effect of the H233Q amino acid change on the resulting A glycosyltransferase. The A(w)14 produced a weak A phenotype, and its ability to produce A antigens was further reduced when it was co-inherited with a B101 enzyme.</P>
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장민중,조덕,박경운,Mark Harris Yazer,신명근,신종희,서순팔,양동욱 대한진단검사의학회 2013 Annals of Laboratory Medicine Vol.33 No.5
Background: The aim of this study was to investigate the frequency of autoantibodies with mimicking specificity by using the dilution technique, to assess the usefulness of the combination of the dilution technique and red blood cell (RBC) phenotyping, and to establish a pre-transfusion testing algorithm in patients with warm autoantibodies. Methods: Serum samples from 71 patients with warm autoantibodies were tested using the dilution technique. Among them, 25 samples were adsorbed with allogeneic ZZAP (a combination of dithiothreitol and enzyme) or polyethylene glycol (PEG) and their RBC phenotypes were determined. Thirty-nine patients were transfused with our pre-transfusion testing algorithm using a combination of dilution technique and RBC phenotyping. Results: Autoantibodies with mimicking specificity were detected by the dilution technique in 26.8% (19/71) of the patients and most of them were directed against Rh system antigens. The agreement of the results obtained with the dilution technique in combination with RBC phenotyping and those from ZZAP or PEG adsorption was 100% (18/18) in patients who have autoantibodies with mimicking specificity and/or alloantibodies. No clinical symptoms indicating severe acute or delayed hemolytic transfusion reactions were reported in the 39 patients transfused with our pre-transfusion testing algorithm. Conclusions: Autoantibodies with mimicking specificity detected by the dilution technique in patients with warm autoantibodies are relatively frequent, can be discriminated from alloantibodies by employing a combination of dilution technique and RBC phenotyping, and might not appear to cause severe acute or delayed hemolytic transfusion reactions.
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A Dispermic Chimera with Mixed Field Blood Group B and Mosaic 46,XY/47,XYY Karyotype
Cho, Duck,Lee, Sang Ku,Yazer, Mark Harris,Shin, Myung Geun,Shin, Jong Hee,Suh, Soon Pal,Song, Jeong Won,Jeon, Mee Jeong,Kim, Ji Young,Park, Jong Tae,Ryang, Dong Wook KOREAN ACADEMY OF MEDICAL SCIENCE 2007 JOURNAL OF KOREAN MEDICAL SCIENCE Vol.22 No.3
<P>Chimerism in humans is a rare phenomenon often initially identified in the resolution of an ABO blood type discrepancy. We report a dispermic chimera who presented with mixed field in his B antigen typing that might have been mistaken for the B<SUB>3</SUB> subtype. The propositus is a healthy Korean male blood donor. Neither his clinical history nor initial molecular investigation of his <I>ABO</I> gene explained his mixed field agglutination with murine anti-B. Chimerism was suspected, and 9 short tandem repeat (STR) loci were analyzed on DNA extracted from blood, buccal swabs, and hair from this donor and on DNA isolated from peripheral blood lymphocytes from his parents. The propositus' red blood cells demonstrated mixed field agglutination with anti-B. Exon 6 and 7 and flanking intronic regions of his <I>ABO</I> gene were sequenced and revealed an <I>O01/O02</I> genotype. <I>B</I> allele haplotype-specific PCR, along with exon 6 and 7 cloning and sequencing demonstrated a third <I>ABO</I> allele, <I>B101</I>. Four STR loci demonstrated a pattern consistent with a double paternal chromosome contribution in the propositus, thus confirming chimerism. His karyotype revealed a mosaic pattern: 32/50 metaphases were 46,XY and 18/50 metaphases demonstrated 47,XYY.</P>
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The impact of suctioning RBCs from a simulated operative site on mechanical fragility and hemolysis
Jay S. Raval,Jonathan H. Waters,Mark H. Yazer 대한혈액학회 2011 Blood Research Vol.46 No.1
Background :Intraoperative cell salvage exerts shear stress upon RBCs, particularly as they are suctioned from the surgical field. Shear stress can result in overt hemolysis or it can cause sublethal injury to the suctioned RBCs. The mechanical fragility (MF) test uses shear stress to measure the extent of RBC sublethal injury. RBCs that have sustained sublethal injury are more susceptible to shear stress induced hemolysis. In this study we suctioned whole blood samples from an artificial surgical field to determine if pre-menopausal female RBCs would demonstrate greater resistance to hemolysis and less sublethal injury compared to that of males and post-menopausal females. Methods :Ten CPD-preserved whole blood units from these 3 donor groups were obtained and samples suctioned at -150 mmHg from a simulated surgical field. The MF test was then performed and the % hemolysis calculated. In addition the MF test was serially performed on these whole blood units during the 21 days of storage. Results :There were no differences in the extent of hemolysis or RBC shear stress resistance after suctioning between the 3 donor groups. During storage the pre-menopausal female RBCs demonstrated higher shear stress tolerance compared to the males or post-menopausal females at all of the time points. Conclusion :Although during static storage pre-menopausal female RBCs in CPD-preserved whole blood demonstrated higher shear stress tolerance, this enhanced resistance was not observed after suctioning from a simulated surgical field.
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Complications following an unnecessary peri-operative plasma transfusion and literature review
Jay S. Raval,Jonathan H. Waters,Darrell J. Triulzi,Mark H. Yazer 대한혈액학회 2012 Blood Research Vol.47 No.4
Plasma is used to correct coagulopathies, but not all coagulation abnormalities are clinically significant enough to require correction before an invasive procedure. We report an 82 year old female who, in response to a mildly prolonged INR of unknown etiology, was unnecessarily transfused with plasma in advance of elective surgery. The patient suffered a moderately severe transfusion reaction, including hives and voice hoarseness, which caused a 4-week delay in her surgery. This delay and adverse reaction could have been avoided had the principles of evidence based plasma therapy, which we herein review, been followed and if the etiology of the mildly elevated INR been investigated before the day of her surgery.
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