Gel Tubes Research Articles

Review of the Preanalytical Errors That Impact Therapeutic Drug Monitoring.

Preanalytical errors comprise the majority of testing errors experienced by clinical laboratories and significantly impact the accuracy of therapeutic drug monitoring (TDM). Specific preanalytical factors in sample timing, collection, transport, processing, and storage that lead to errors in TDM were reviewed. We performed a literature search using several scientific databases including PubMed, ScienceDirect, Scopus, Web of Science, and ResearchGate for human studies published in the English language from January 1980 to February 2021, reporting on TDM and the preanalytical phase. Blood collection errors (ie, wrong anticoagulant/clot activator used, via an intravenous line, incorrect time after dosing) delay testing, cause inaccurate results, and adversely impact patient care. Blood collected in lithium heparin tubes instead of heparin sodium tubes produce supertoxic lithium concentrations, which can compromise care. Specimens collected in serum separator gel tubes cause falsely decreased concentrations due to passive absorption into the gel when samples are not processed and analyzed quickly. Dried blood spots are popular for TDM as they are minimally invasive, allowing for self-sampling and direct shipping to a clinical laboratory using regular mail. However, blood collection techniques, such as trauma to the collection site, filter paper fragility, and hematocrit (Hct) bias, can adversely affect the accuracy of the results. Volumetric absorptive microsampling is a potential alternative to dried blood spot that offers fast, volume-fixed sampling, low pain tolerance, and is not susceptible to Hct concentrations. The identification of preanalytical factors that may negatively impact TDM is critical. Developing workflows that can standardize TDM practices, align appropriate timing and blood collection techniques, and specimen processing will eliminate errors.

An Intracellular Tripeptide Arg-His-Trp of Serum Origin Detected in MCF-7 Cells is a Possible Agonist to β2 Adrenoceptor.

The need for agonists and antagonists of β2 adrenoceptor (β2AR) is warranted in various human disease conditions, including cancer, cardiovascular and other metabolic disorders. However, the sources of agonists of β2AR are diverse in nature. Interestingly, there is a complete gap in the exploration of agonists of β2AR from serum that is a well-known component of culture media that supports growth and proliferation of normal and cancer cells in vitro. In this paper, we employed a novel vertical tube gel electrophoresis (VTGE)-assisted purification of intracellular metabolites of MCF-7 cells grown in vitro in complete media with fetal bovine serum (FBS). Intracellular metabolites of MCF-7 cells were then analyzed by LC-HRMS. Identified intracellular tripeptides of FBS origin were evaluated for their molecular interactions with various extracellular and intracellular receptors, including β2AR (PDB ID: 2RH1) by employing molecular docking and molecular dynamics simulations (MDS). A known agonist of β2AR, isoproterenol was used as a positive control in molecular docking and MDS analyses. We report here the identification of a few novel intracellular tripeptides, namely Arg-His- Trp, (PubChem CID-145453842), Pro-Ile-Glu, (PubChem CID-145457492), Cys-Gln-Gln, (PubChem CID-71471965), Glu-Glu-Lys, (PubChem CID-11441068) and Gly-Cys-Leu (PubChem CID-145455600) of FBS origin in MCF-7 cells. Molecular docking and MDS analyses revealed that among these molecules, the tripeptide Arg-His-Trp shows a favorable binding affinity with β2AR (-9.8 Kcal/mol). The agonistic effect of Arg-His-Trp is significant and comparable with that of a known agonist of β2AR, isoproterenol. In conclusion, we identified a unique Arg-His-Trp tripeptide of FBS origin in MCF-7 cells by employing a novel approach. This unique tripeptide Arg-His-Trp is suggested to be a potential agonist of β2AR and it may have applications in the context of various human diseases like bronchial asthma and chronic obstructive pulmonary disease (COPD).

Serum Copper and Zinc Levels of Oral Submucous Fibrosis Patients Using Areca Nut Products Reported at Isra University Hospital Hyderabad

Objective: To determine the copper and zinc levels in serum among oral submucous fibrosis patients using various areca nut products by taking healthy individuals as control at Isra University Hospital Hyderabad. Methodology: This descriptive case-control study was conducted on patients of oral submucosal fibrosis (OSMF) attending the Outpatient Department, Oral Surgery Isra Dental College, Isra university during a period of one year from November 2016 to October 2017. A total of 30 patients above 16 years of age and who were diagnosed cases of OSMF and gave history of areca nut and its commercial products consumption for more than one year were included as group (B)and in equal number healthy individuals were enrolled as control as group(A). The 6ml blood sample was collected in gel tube and then we centrifuged at 3000 rpm gravity for 10min to separate the serum from blood. The 4 to 5ml serum collected in this way was analyzed by spectrophotometric method on Hitachi 902(Roche Germany). The levels of copper and zinc were estimated from serum of both groups. All the data was collected via study proforma and analysis of the data was done by using SPSS version 20. Results: Mean age of the patients was 23.33±4.97 years and mean age of healthy controls was 22.80±4.61 years. The males were most common in both groups. Manipuri was commonest consumed areca nut (50.0%) followed by sweet scented areca nut and Gutkha 33.3% and 36.6% respectively. Mean of serum Cu in patients was lower 86±4.20 µg/dl in contrast to controls 114.0±13.8 µg/dl (p-0.0001). Average of serum Zinc was higher among patients 94.20±15.11 µg/dl as compared to controls as 68.06±17.10 µg/dl (p-0.0001). Conclusion: The average of serum copper level was observed to be significantly less and average of serum zinc significantly higher among OSMF patients using areca nut as compared to healthy individuals. These serum trace element levels could be used as potential prognostic and diagnostic markers in the OSMF patients. Key words: OSMF, Zinc, Copper, Areca nut

Impact of copper doping on thermal, optical and electrical properties of strontium L(+) tartrate pentahydrate crystals

Single crystals of intrinsic strontium L(+) tartrate (IST) and Cu2+ doped strontium L(+) tartrate (CuDST) are synthesized using single test tube gel diffusion technique. At ambient temperature, specific gravities of 1.050 and 1.055 and gel pH of 4.0 and 4.2 (with 0.5 M inner and upper reactants) are found to ensure optimized growth and quality of IST and CuDST crystals, respectively. These crystals show maximum sizes of 4.2 × 1.7 × 1.3 mm3 (for IST) and 5.1 × 0.9 × 0.8 mm3 (CuDST). Doping is observed to change the morphology of IST crystal. The stoichiometric composition and cationic distribution of the grown crystals are determined using Energy Dispersive X-Ray Analysis (EDAX) technique. The functional groups present in the crystals are identified by Fourier Transform Infrared Spectroscopy (FTIR) and Raman spectral studies. Thermal studies confirm the presence of five water molecules in the IST and CuDST crystals.Optical studies reveal that the crystals are transparent to visible and near Infrared (IR) wavelengths. Doping is observed to cause an increase in the peak absorbance in Ultraviolet (UV) region. Both IST and CuDST crystals show low absorbance in the entire visible region, indicating their usefulness in Nonlinear Optical (NLO) applications. The optical transmittance of the IST crystal is seen to increase on doping. Both IST and CuDST crystals show bandgap energies suggestive of their insulating nature, indicating their usefulness in electronic applications. The Voltage-Current (V-I) characteristics of the crystals show that the electrical conductivity of CuDST crystals is larger than the conductivity of IST crystals.

COMPARISON OF ENDOTRACHEAL INTUBATION VERSUS SUPRAGLOTTIC AIRWAY DEVICE IN PATIENTS UNDERGOING CORNEAL TRANSPLANTATION UNDER GENERAL ANAESTHESIA

Objective: To compare endotracheal intubation versus Suraglottic airway device in patients undergoing penetrating keratoplasty under general anaesthesia.
 Study Design: Quasi-experimental study.
 Place and Duration of Study: Armed Forces Institute of Ophthalmology, Rawalpindi, from Jan 2018 to Mar 2020.
 Methodology: Total 28 patients enrolled with a mean age of 42.82 ± 7.86 years and age-range of 18-55 belonging to American Society of Anesthesiology I, II & III undergoing penetrating keratoplasty under general anaesthesia. The airway was secured with I–Gel and Endotracheal tube in group A (n=14) and group B (n=14) respectively. Pre anaesthesia assessment along with informed written consent performed. General Anesthesia is given and patients monitored as per standard protocols. Postextubation incidence of cough, sore throat, bronchospasm, stridor and blood on device recorded in addition to surgery and recovery duration.
 Results: Twenty-eight patients were enrolled in the study with a mean age of 42.82 ± 7.86 years. There were 9 (32.1%) females and 19 (67.9%) males in the study group. The recovery time was significantly lower for group A as compared to group B (72.64 ± 5.06 vs 80.43 ± 3.75, p<0.001). Similarly, a significantly lesser number of patients experienced post-extubation complications i.e. cough, among group A as compared to Group B [1 (7.1%) vs 8 (57.1%) p0.005].
 Conclusion: I-Gel provides smooth recovery with reduced mean recovery time and decreased potential of raised intraocular pressure, when compared with endotracheal intubation in patients undergoing penetrating keratoplasty under general anaesthesia.

Systematic RHD genotyping in Brazilians reveals a high frequency of partial D in transfused patients serologically typed as weak D

BackgroundThe discrimination between weak D types and partial D can be of clinical importance because carriers of partial D antigen may develop anti-D when transfused with D-positive red blood cell units. The aim of this study was to determine by molecular analysis the type of D variants among Brazilian patients requiring transfusions with serologic weak D phenotypes. Material and methodsSamples from 87 patients (53 with sickle cell disease, 10 with thalassemia and 24 with myelodysplastic syndrome), serologic typed as weak D by manual tube indirect antiglobulin test or gel test were first RHD genotyped by using the RHD BeadChip Kit (BioArray, Immucor). Sanger sequencing was performed when necessary. ResultsRHD molecular analysis revealed 32 (36.8 %) variant RHD alleles encoding weak D phenotypes and 55 (63.2 %) alleles encoding partial D antigens. RHD variant alleles were present in the homozygous state or as a single RHD allele, one variant RHD allele associated with the RHDΨ allele, or two different variant RHD alleles in compound heterozygosity with each other in 70 patients, 4 patients and 13 patients, respectively. Alloanti-D was found in 9 (16.4 %) cases with RHD alleles predicting a partial D. DiscussionThe frequency of partial D was higher than weak D types in Brazilian patients serologically typed as weak D, showing the importance to differentiate weak D types and partial D in transfused patients to establish a transfusion policy recommendation.

Reversible electroadhesion of hydrogels to animal tissues for suture-less repair of cuts or tears

Electroadhesion, i.e., adhesion induced by an electric field, occurs between non-sticky cationic and anionic hydrogels. Here, we demonstrate electroadhesion between cationic gels and animal (bovine) tissues. When gel and tissue are placed under an electric field (DC, 10 V) for 20 s, the pair strongly adhere, and the adhesion persists indefinitely thereafter. Applying the DC field with reversed polarity eliminates the adhesion. Electroadhesion works with the aorta, cornea, lung, and cartilage. We demonstrate the use of electroadhesion to seal cuts or tears in tissues or model anionic gels. Electroadhered gel-patches provide a robust seal over openings in bovine aorta, and a gel sleeve is able to rejoin pieces of a severed gel tube. These studies raise the possibility of using electroadhesion in surgery while obviating the need for sutures. Advantages include the ability to achieve adhesion on-command, and moreover the ability to reverse this adhesion in case of error.

CYP2E1 Polymorphisms and Colorectal Cancer

Background: The hepatic cytochrome P450 2E1 (CYP2E1) enzyme plays an important role in the metabolic activation of nitrosamines and other carcinogenic compounds. Aim of the study: To determine the effect of chemotherapy and radiation for colorectal cancer patients on some biochemical and molecular parameters. Patients and methods: The current study was conducted in the Department of Biology at the College of Science at the University of Al-Qadisiyah and in cooperation with the Cancer Center in the Najaf city and the Department of Medicine City in Baghdad, Iraq during the period from November 15, 2019, to May 6, 2020. The study group included a total of (90) samples were taken from males and females of ages ranged between (33 years to 80 years) and then it was divided into two groups. The first included (60) samples of people with colorectal cancer (CRC), and the second included (30) samples of people The healthy ones represented the control group. (5ml) of venous blood was withdrawn and the sample was divided into two groups, the first was placed in tubes containing an anti-clotting substance for molecular examination and kept at a temperature (-20) until use, and the other part was placed in Gel tube tubes and then placed in a centrifuge to separate Serum, for the purpose of biochemical examinations. With regard to the results of the values of oxidative stress indicators (SOD, GSH, MDA). Results: there was a significant difference in the level of (SOD, GSH) between the control and treatment groups, where the highest percentage was in the control group, followed by the radiotherapy group and then chemotherapy. The results showed a significant increase in the MDA value of the chemotherapy group compared with the radiotherapy and control group. The results of the molecular study to study the genotypes of the CYPIE2 gene showed that the C1/C1 type is the normal type for the CYPIE2 gene and that the ratio of this type did not show any significant difference between the groups, while the C2/C2 type showed no significant difference between the groups and the C2/C2 type. Conclusion: It can be concluded that the use of radiotherapy and chemotherapy to treat patients with CRC cancer has a clear effect on health and on many of the patient's physiological and biochemical indicators, and this, in turn, is reflected in the patient's ability to fight the disease.

Molecular and Serological Detection of Toxoplasma gondii in Random Sample of pregnant and aborted women of Nineveh

The present study is to identify the rate of parasitic disease of toxoplasmosis among among females from 120 pregnant and aborted women attending to the Department of Obstetrics and Gynecology of the AL-Kansaa, AL- Salaam Hospital and 2 private clinics during (September 2019-febrauary2020). Three methods of tests to search for toxoplasmosis latex test, combo IgG and IgM rapid cassette and finally by PCR. Questionnaire is applying by pregnant and aborted patients and according to the information the females was divided to groups involved age, career, gestational period, housing cat or not in living zone ,number of abortion ,blood group and according to residence. The results show big rate of toxoplasmosis by latex test the positive cases 62(62%).the result re-tested by another serological method combo IgG and IgM rapid cassette and give the result 44 (73.33%) and 6 (9.09%) for IgG and IgM respectively. The result was confirmed by third test using molecular test conventional PCR to show the result 32 (51.61%). We used EDTA tube for whole blood for PCR, gel tube for serological testes. Three methods of tests to search for toxoplasmosis latex test, combo IgG and IgM rapid cassette and finally by PCR.

COMPARISON OF INTRAOCULAR PRESSURE AND HAEMODYNAMIC RESPONSES TO INSERTION OF THE I - GEL AND ENDOTRACHEAL TUBE IN ELECTIVE OPHTHALMOLOGICAL SURGERIES

Objective: To compare I–Gel versus endotracheal tube effects on hemodynamic stability and intraocular pressure in patients undergoing elective ophthalmological surgeries.
 Study Design: Quasi-experimental study.
 Place and Duration of Study: Armed Forces Institute of Ophthalmology, Rawalpindi Pakistan, from Nov 2019 to Oct 2020.
 Methodology: A total of 108 patients undergoing elective ophthalmological surgeries under general anesthesia from both genders, age range between 18-45 years, American Society of Anesthesiologists status I or II were included. General anesthesia given following standard procedures and monitoring. Heart rate, Systolic & Diastolic blood pressure monitored and intraocular pressure measured in each eye with Reichert ton open at baseline, upon insertion of airway device and 5 minutes after insertion.
 Results: Total 108 patients enrolled in the study with a mean age of 37.74 ± 6.0 years and age-range of 18-45. Heart rate at Insertion in I-Gel group was 78.14 ± 3.41 beats per minute whereas in intubated group was 97.20 ± 2.84 beats per minute, mean systolic blood pressure at insertion in group A and B was 115.28 ± 5.3 and 130.44 ± 2.81mm of Hg respectively. Intraocular pressure at insertion right eye in group A and B was 12.04 ± 0.48 and 17.98 ± 0.42 mm of Hg respectively. Intraocular pressure at insertion left eye in group A was 12.12 ± 0.45 whereas in group B was 17.95 ± 0.38mm of Hg (p-value=0.001).
 Conclusion: I–Gel provides better hemodynamic profile and intraocular pressure stability when compared with endotracheal tube.

Ion chromatography for the determination of ethylamine in the workplace air

Objective: To establish a method for the determination of ethylamine in the air of the workplace by ion chromatography. Methods: In August 2020, ethylamine in the air of the workplace was adsorbed by a basic silica gel tube, and ultrasonically desorbed with a 1 mmol/L sulfuric acid solution, and then qualitatively and quantitatively determined by ion chromatography. Results: The linear range of the method was 0.014-50 μg/ml, and the linear equation of the standard curve was y=0.1243x+0.0429, the correlation coefficient was r=0.9997. The detection limit of the method was 4.29 μg/L, and the lower limit of quantification was 14.29 μg/L. The lowest quantitative concentration was 0.012 mg/m(3) (in term of sampling 6.0 L) . The average desorption efficiency of the method was 97.31%, the precision was 1.00%-1.68%, and the standard recovery rate was 96.33%-99.61%. Conclusion: This method is fast, sensitive and accurate, and can be used for the determination of ethylamine in the air of workplace.

Serum Level of CCL20 and CXCL 10 in Patients with Vitiligo and their Association with Disease Activity

Aim of Study: study the level of CCL20 and CXCL 10 in serum of patients with vitiligo ,to compare theirlevel in patients with active vitiligo and stable vitiligo and compare level of each cytokine with others Toknow their association with disease activity.Materials/Methods: Sixty-five patients who include (35 active and 30 stable) with vitiligo. All participantsincluded were adult patients with nonsegmental vitiligo.Blood sample were collected by venipuncture from 65 patients (five millimeter of venous were drawing bydisposable syringe under sterilization technique and putting in gel tube then, allowed to clot; after that serumwas separated by centrifugation 1500 rpm for 5 minute. The serum has been collected in plain tube thenstored at -20c to be used for ELISA test to determine concentration of CCL20 and CXCL 10. The resultswere analyzed using the IBM SPSS analytic software.Result: The : current study revealed thatCCL20 are significant (P<0.05), while CXCL10 was not significant(P>0.05) according to the disease activity. The sensitivity and specificity of each of the measured biomarkerswas evaluated using the (ROC). It was found that CCL20 to be of a high significance to measuring thedisease activity. While the CXCL10 was of no significance when compared to the disease activityConclusions: CCL20 could be candidate as a biomarker to evaluate activity of vitiligo

Determination of hydrazine in workplace air by gas chromatography with large bore capillary column

Objective: To determine hydrazine quantitatively in workplace air by gas chromatography with large bore capillary column. Methods: In October 2019, hydrazine in the air was adsorbed by acid silica gel tube sampling and desorped using sulfuric acid solution. After derivatization with furfural and extraction, the content of hydrazine was determined by DM-FFAP capillary column gas chromatography with flame ionization detector. Results: The linear regression equation was y=353.8x+21.2 (r=0.9998) between 0.1-2.0 μg/ml of target concentration. The detection limit was 0.030 μg/ml. The lower limit of quantification was 0.100 μg/ml. If 15 L air sample was collected, the minimum detection concentration was 0.004 mg/m(3) and the minimum quantitative concentration was 0.013 mg/m(3) respectively. The average desorption efficiency was 86.5%-89.4%. The recovery was 94.4%-97.1%. The relative standard deviation was 1.6%-4.9%. Hydrazine and furfural derivative was 2-furaldehyde hydrazine. Conclusion: The method has symmetrical peak shape of hydrazine derivatives chromatographic peaks, short analysis time, easy operation, and is suitable for the determination of the concentration of hydrazine in the air in the workplace.

Construction of a dual-core hollow waveguide for visible and mid-infrared light transmission based on PTFE tubing and UV gel

This work proposes a facile approach to fabricate a dual-core hollow waveguide based on two common and low-cost raw materials, namely polytetrafluoroethylene (PTFE) tube and ultraviolet (UV) gel. A silica glass tube is nested inside a heat-shrinkable PTFE tube. After heat treatment at 350 °C, the PTFE tube shrinks and then transforms into the low-index polymer on the outside of the silica tube. The PTFE-coated silica glass tubing is filled with UV gel followed by inserting a typical Ag/AgI mid-infrared (IR) hollow optical fiber. The UV gel is cured by UV radiation, forming a solid low-index layer between the PTFE-coated silica glass tubing and the Ag/AgI hollow optical fiber. A visible laser beam can be transmitted at a loss of 0.4 dB/m through the silica annulus between the low-index PTFE and UV gel layer. A 10.6-μm-wavelength CO2 laser beam is delivered through the Ag/AgI hollow optical fiber (core size 530 μm) and the transmission loss goes up from 1.63 to 3.22 dB/m as the bending angle increases from 0° to 90°.

Determination of chloroacetic acid in workplace air by silanization-gas chromatography

Objective: A method to determine acrylic acid in workplace air was developed by silanization-gas chromatography. Methods: In March 2020, chloroacetic acid in air were absorbed by silica gel tube, the samples were dried, then were desorbed and silanized by acetonitrile: N, O-bis (trimethylsilane) trifluoroacetamide (2∶1, V/V) at room temperature, allowed quantitative analysis of chloroacetic acid as its silanization product by gas chromatography. Results: Calibration curve of the method was linear within the range 0-162.8 μg/ml and showed good linearity with linear equation: y=0.011 8x, r=0.999 7. The determination limit of the method was 0.8 μg/ml, and the minimum detection concentration was 0.05 mg/m(3) (collect 15 L air) . The relative standard deviation (RSD) was 0.5%-1.3% (n=5) . Recoveries were between 98.6%-101.2%. Conclusion: The results prove silanization-gas chromatography is an accurate, simple and high sensitive method for determining chloroacetic acid in workplace air.

The Role of Serum Level of Indoleamine 2,3–dioxygenase 1 (IDO1) in Patients with Prostate Cancer

Prostate cancer or carcinoma of prostate is the development of cancer in the prostate a gland in the malereproductive system. This is a cross sectional, hospital based study. This study was carried out at theOncology Center in Kirkuk City- Iraq from the 1st of February 2020 to the end of June 2020. A verbalconsent was taken from each Men included in this study whether considered as a case or control. Sixty_ Seven men with prostatic cancer were screened to participate in the present study. Men with prostaticcancer attended to Oncology Center were enrolled in this study. The diagnosis of prostate cancer was madeby the patient’s file contain information about his state after take agreement from each Men included inthis study, that is mean that the diagnosis of prostate cancer was according to discussion of the oncologist. Men ages were between 52 to 89 years, and they were from the center and periphery of Kirkuk City.Forty-Seven Men with prostatic cancer were considered as a study group, three Men did not meeting theinclusion criteria and 17 Men refuse to participate in this study due to the personal reasons. Forty apparentlyhealthy Men without prostatic cancer and with negative family history. Each Men with benign tumor, benignprostatic hyperplasia or prostatitis diseases were excluded from this study. By using a sterile disposablesyringe, 5 ml of venous blood sample was drawn from the vein of each Men at morning and was kept intodisposable gel tube and allowed to clot for(2hour) at room temperature, then each sample was centrifugedat 6000 rpm for 10 minutes to obtain serum. The serum was aspirated by mechanical micropipette andtransferred into clean Eppendorf tubes which labeled with number, then put this Eppendorf tubes in urinecups for safety and addition more information like name, date, number and stored at - 20 0C until the timeof estimation. Serum of the patients and controls had assay for: Human IDO1 (Indoleamine 2,3-dioxygenase1) and Human acid phosphatase/prostate by ELISA. The study demonstrated that, the rate of prostate canceroccurrence was increased with age and majority of patients were belonged to the age group (70-79 years).The study also showed non-significant difference between patients and control regarding their BMI mean(27.36±5.16 vs. 27.24±3.34kg\m²) respectively. The study showed that, serum level of IDO1 enzyme waselevated significantly (P<0.01) in prostate cancer patients (11.74±0.28 pg/ml) as compared with healthycontrol group (4.78±0.15 pg/ml). The study showed that, the highest mean of PAP enzyme was recorded inprostate cancer patients (0.111±0.075 pg/ml) as compared with healthy control group (0.069±0.024 pg/ml).The difference was highly significant (P<0.01), Table 3. The study showed positive correlation between PAPenzyme and stage of prostate cancer (r: 0.34). The study showed positive correlation between IDO1 leveland stage of prostate cancer (r: 0.62). The study showed negative correlation between IDO1 level and PAPlevel in prostate cancer patients (r: -0.22).

Ultrastructure of extracorporeal secretions of four sessile species of Rotifera (Gnesiotrocha), with observations on the chemistry of the gelatinous tube

AbstractSecretion of an extracorporeal hydrogel is a common defensive strategy employed by many aquatic invertebrates including several species of sessile rotifers. Here, we provide a comparative study of the ultrastructure of the gelatinous secretions of four species of Superorder Gnesiotrocha (Monogononta): Conochilus unicornis, Collotheca ferox, Stephanoceros fimbriatus, and Stephanoceros millsii. Additionally, we use differential staining and enzyme degradation assays to explore the chemistry of the gelatinous tube of S. fimbriatus. At least three types of secretions are produced by these four species: an external gelatinous tube, a thick glycocalyx, and an adhesive peduncle. These three different secretions all have a fibrous appearance, but each has different electron densities, fiber thicknesses, and glandular origins. The gel tube, which is likely secreted by pedal glands, has a highly hydrated framework of mesh‐like fibers with thick internal and external laminae that differ slightly among species. Chemical staining suggests that the gel tube is composed of glycoproteins with a high content of sulfonic groups and limited or no obvious lipids or cationic proteins. This tube is resistant to chemical and enzymatic digestion. The proteinaceous glycocalyx is secreted by the syncytial integument and has various densities and thicknesses among species. The peduncle is an adhesive attachment that connects a rotifer's foot to a substratum, or, in some species, to conspecifics as part of a colony. The secretion is highly electron dense and contains membrane‐bound vesicles; it appears to be derived from a different set of pedal glands than the hydrogel tube. The different chemistries and anatomical origins of the three gelatinous secretions suggest an independent evolutionary history for each.

The impact of different flow rate on apically extruded debris and irrigants

Aim: Root canal instrumentation might lead to extrusion of debris and irrigants, leading to postoperative pain and compromised outcomes. Several factors might impact extrusion during root canal instrumentation, including the flow rate in which the irrigant solution is applied inside the root canal. The aim of this study was to assess the extrusion of irrigants and debris with different flow rates of 0.9% saline solution. Matherials and Methods: Thirty mandibular premolars presenting single roots and straight root canals were used in this study. The roots were standardized in 17 mm and inserted in Eppendorf tubes. A 1.5% agar gel was placed inside the tube that involved the roots, while the coronal part of the roots was kept visible. The combination of tube and agar gel was weighted. Then, the specimens were randomly distributed to 3 different groups (n=10) according to the flow rate of the irrigation: Control Group (CG) 5 mL/min, High Flow rate Group (HG) 10 mL/min, and Ultra-High flow rate (UG) 60 mL/min. The canals were instrumented with a Reciproc Blue instrument size 25.08 up to the length of the root, following the manufacturer guidelines. After the instrumentation, the roots were removed and the tube and agar were weighted again. The difference between the final weight and the initial weight represented the total amount extruded beyond the apex. For statistical analysis, the ANOVA test (post-hoc Bonferroni) was used at P>0.05. Results: The mean weight of the extruded debris and irrigants for CG, HG, and UG was respectively 0.0079 ± 0.0087, 0.0110 ± 0.0093, and 0.0083 ± 0.0091. There were no statistically significant differences among the groups. Conclusions: Within the limitations of this study, it can be concluded that the flow rate of irrigants does not impact the extrusion of debris and irrigants.

Ethical Issues and Management of Fetal Hemolytic Anemia Caused by Anti-Rh17 in a Multipara with Rare –D– Phenotype

Background: The development of allo-anti-Rh17 (anti-Hr0) in a –D– phenotype whose red blood cells (RBCs) lack CcEe antigens is most likely triggered by transfusion, transplantation, or pregnancy. Gene conversion is the predominating factor in generating RHD-CE-D and RHCE-D-CE hybrids like –D–. Methods: We report here immunohematological and obstetrical data from 2 of the 5 pregnancies of a 24-year-old woman presenting with the –D– phenotype with anti-Rh17. Blood group typing, antibody screening, antibody differentiation, direct antiglobulin test (DAT), and antibody titers were performed by routine gel technology and tube testing. Additionally, molecular genetic analysis was performed. Fetal surveillance was done by sonographic evaluation of the fetal middle cerebral artery peak systolic velocity (MCA-PSV). Results: Blood group typing showed O, C-c-D+E-e- and the DAT was negative. DNA sequencing revealed homozygosity for an RHCE-D(3–9)-CE null allele. Anti-Rh17 titers in the fourth pregnancy remained between 1:8 and 1:128, and no signs for a fetal anemia were observed. However, in the fifth pregnancy, the antibody titers increased up to 1:4,096. Signs of moderate fetal anemia were detected and cesarean section was performed at 34 + 6 weeks of gestation. The newborn presented with hemolytic anemia (cord blood hemoglobin [Hb] = 8.5 mg/dL). She received 2 compatible (small) packed RBC concentrates, phototherapy, and intravenous immunoglobulins. Conclusion: Our case shows that the risk for hemolytic complications increases with the number of pregnancies of sensitized women. Only people who also lack CcEe antigens are compatible as donors. The role of such rare donors as lifesavers, their freedom, and voluntariness conflict with the urgent need for compatible blood.

Is Prevention of Hemolysis Possible in Blood Samples Collected from IV catheters in the Emergency Department?

The effectiveness of aspiration and vacuum filling method with an adaptor in reducing hemolysis was investigated. The study was conducted in the yellow zone of the Emergency department. Two different apparatuses that draw blood with two different techniques from an IV catheter were compared with our routine procedure. The first system drew blood with aspiration technique into 4.9 mL serum gel tube (Sarstedt S-Monovette®). The second was vacuum filling with a specific adaptor attached to the same catheter drawing the blood into vacuumed serum separator tubes (BD Vacutainer® SST™II and Luer-Lok™ Access Device (LLAD). In our routine, we use plastic syringes and deliver it into the same serum separator vacuum tubes. We measured the hemolysis index, AST, CK, potassium, and LDH. Hemolysis rates of aspiration method vs. routine were 0.80% and 38.7% (p < 0.001) and of vacuum filling with adaptor vs. routine were 13.5% and 40.6%, respectively (p = 0.0001). The hemolysis rate of the aspiration method was lower than the vacuum filling adaptor method (p = 0.0004). Both techniques showed better performance when measured parameters were compared; aspiration technique being the superior (all p < 0.0001). Aspiration method was more successful then vacuum filling methods in reducing hemolysis.