45 results on '"Hoeltge GA"'
Search Results
2. Allergic transfusion reactions: an evaluation of 273 consecutive reactions.
- Author
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Domen RE and Hoeltge GA
- Published
- 2003
- Full Text
- View/download PDF
3. Duration of red-cell storage and complications after cardiac surgery.
- Author
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Koch CG, Li L, Sessler DI, Figueroa P, Hoeltge GA, Mihaljevic T, and Blackstone EH
- Published
- 2008
4. Roles of the C-terminal domains of topoisomerase IIα and topoisomerase IIβ in regulation of the decatenation checkpoint.
- Author
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Kozuki T, Chikamori K, Surleac MD, Micluta MA, Petrescu AJ, Norris EJ, Elson P, Hoeltge GA, Grabowski DR, Porter ACG, Ganapathi RN, and Ganapathi MK
- Subjects
- Amino Acid Sequence, Animals, Antigens, Neoplasm drug effects, Antigens, Neoplasm genetics, Antigens, Neoplasm physiology, Cell Line, DNA Damage, DNA Topoisomerases, Type II drug effects, DNA Topoisomerases, Type II genetics, DNA Topoisomerases, Type II physiology, DNA, Complementary genetics, DNA-Binding Proteins drug effects, DNA-Binding Proteins genetics, DNA-Binding Proteins physiology, Drug Resistance, Neoplasm, Fibroblasts, HL-60 Cells, Humans, Mice, Mutagenesis, Site-Directed, Protein Domains, Recombinant Proteins metabolism, Sequence Alignment, Sequence Homology, Amino Acid, Structure-Activity Relationship, Topoisomerase II Inhibitors pharmacology, Antigens, Neoplasm chemistry, Cell Cycle Checkpoints physiology, Chromosomal Instability physiology, DNA Topoisomerases, Type II chemistry, DNA-Binding Proteins chemistry
- Abstract
Topoisomerase (topo) IIα and IIβ maintain genome stability and are targets for anti-tumor drugs. In this study, we demonstrate that the decatenation checkpoint is regulated, not only by topo IIα, as previously reported, but also by topo IIβ. The decatenation checkpoint is most efficient when both isoforms are present. Regulation of this checkpoint and sensitivity to topo II-targeted drugs is influenced by the C-terminal domain (CTD) of the topo II isoforms and by a conserved non-catalytic tyrosine, Y640 in topo IIα and Y656 in topo IIβ. Deletion of most of the CTD of topo IIα, while preserving the nuclear localization signal (NLS), enhances the decatenation checkpoint and sensitivity to topo II-targeted drugs. In contrast, deletion of most of the CTD of topo IIβ, while preserving the NLS, and mutation of Y640 in topo IIα and Y656 in topo IIβ inhibits these activities. Structural studies suggest that the differential impact of the CTD on topo IIα and topo IIβ function may be due to differences in CTD charge distribution and differential alignment of the CTD with reference to transport DNA. Together these results suggest that topo IIα and topo IIβ cooperate to maintain genome stability, which may be distinctly modulated by their CTDs., (© The Author(s) 2017. Published by Oxford University Press on behalf of Nucleic Acids Research.)
- Published
- 2017
- Full Text
- View/download PDF
5. Accreditation of Individualized Quality Control Plans by the College of American Pathologists.
- Author
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Hoeltge GA
- Subjects
- Humans, Program Development, Risk Management standards, Societies, Medical, United States, Accreditation, Laboratories standards, Pathology, Clinical standards, Quality Control
- Abstract
The Laboratory Accreditation Program of the College of American Pathologists (CAP) began in 2015 to allow accredited laboratories to devise their own strategies for quality control of laboratory testing. Participants now have the option to implement individualized quality control plans (IQCPs). Only nonwaived testing that features an internal control (built-in, electronic, or procedural) is eligible for IQCP accreditation. The accreditation checklists that detail the requirements have been peer-reviewed by content experts on CAP's scientific resource committees and by a panel of accreditation participants. Training and communication have been key to the successful introduction of the new IQCP requirements., (Copyright © 2016 Elsevier Inc. All rights reserved.)
- Published
- 2017
- Full Text
- View/download PDF
6. College of American Pathologists' laboratory standards for next-generation sequencing clinical tests.
- Author
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Aziz N, Zhao Q, Bry L, Driscoll DK, Funke B, Gibson JS, Grody WW, Hegde MR, Hoeltge GA, Leonard DG, Merker JD, Nagarajan R, Palicki LA, Robetorye RS, Schrijver I, Weck KE, and Voelkerding KV
- Subjects
- Clinical Laboratory Techniques standards, Computational Biology methods, Genetic Testing standards, Guidelines as Topic standards, Humans, Reference Standards, Reproducibility of Results, Societies, Medical, United States, Clinical Laboratory Techniques methods, Genetic Testing methods, High-Throughput Nucleotide Sequencing methods, Pathology, Clinical methods
- Abstract
Context: The higher throughput and lower per-base cost of next-generation sequencing (NGS) as compared to Sanger sequencing has led to its rapid adoption in clinical testing. The number of laboratories offering NGS-based tests has also grown considerably in the past few years, despite the fact that specific Clinical Laboratory Improvement Amendments of 1988/College of American Pathologists (CAP) laboratory standards had not yet been developed to regulate this technology., Objective: To develop a checklist for clinical testing using NGS technology that sets standards for the analytic wet bench process and for bioinformatics or "dry bench" analyses. As NGS-based clinical tests are new to diagnostic testing and are of much greater complexity than traditional Sanger sequencing-based tests, there is an urgent need to develop new regulatory standards for laboratories offering these tests., Design: To develop the necessary regulatory framework for NGS and to facilitate appropriate adoption of this technology for clinical testing, CAP formed a committee in 2011, the NGS Work Group, to deliberate upon the contents to be included in the checklist. Results . -A total of 18 laboratory accreditation checklist requirements for the analytic wet bench process and bioinformatics analysis processes have been included within CAP's molecular pathology checklist (MOL)., Conclusions: This report describes the important issues considered by the CAP committee during the development of the new checklist requirements, which address documentation, validation, quality assurance, confirmatory testing, exception logs, monitoring of upgrades, variant interpretation and reporting, incidental findings, data storage, version traceability, and data transfer confidentiality.
- Published
- 2015
- Full Text
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7. Blood storage duration and biochemical recurrence of cancer after radical prostatectomy.
- Author
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Cata JP, Klein EA, Hoeltge GA, Dalton JE, Mascha E, O'Hara J, Russell A, Kurz A, Ben-Elihayhu S, and Sessler DI
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- Blood Transfusion, Autologous, Disease-Free Survival, Humans, Male, Middle Aged, Multivariate Analysis, Neoplasm Recurrence, Local epidemiology, Neoplasm Recurrence, Local mortality, Proportional Hazards Models, Prostate-Specific Antigen blood, Survival Rate, Time Factors, United States epidemiology, Blood Preservation, Neoplasm Recurrence, Local etiology, Prostatectomy, Prostatic Neoplasms surgery, Transfusion Reaction
- Abstract
Objective: To test the hypothesis that perioperative transfusion of allogeneic and autologous red blood cells (RBCs) stored for a prolonged period speeds biochemical recurrence of prostate cancer after prostatectomy., Patients and Methods: We evaluated biochemical prostate cancer recurrence in men who had undergone radical prostatectomy and perioperative blood transfusions from July 6, 1998, through December 27, 2007. Those who received allogeneic blood transfusions were assigned to nonoverlapping "younger," "middle," and "older" RBC storage duration groups. Those who received autologous RBC transfusions were analyzed using the maximum storage duration as the primary exposure. We evaluated the association between RBC storage duration and biochemical recurrence using multivariable Cox proportional hazards regression., Results: A total of 405 patients received allogeneic transfusions. At 5 years, the biochemical recurrence-free survival rate was 74%, 71%, and 76% for patients who received younger, middle, and older RBCs, respectively; our Cox model indicated no significant differences in biochemical recurrence rates between the groups (P=.82; Wald test). Among patients who received autologous transfusions (n=350), maximum RBC age was not significantly associated with biochemical cancer recurrence (P=.95). At 5 years, the biochemical recurrence-free survival rate was 85% and 81% for patients who received younger and older than 21-day-old RBCs, respectively., Conclusion: In patients undergoing radical prostatectomy who require RBC transfusion, recurrence risk does not appear to be independently associated with blood storage duration.
- Published
- 2011
- Full Text
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8. Laboratory standardization from the patient's point of view.
- Author
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Hoeltge GA
- Subjects
- Diagnostic Errors, Humans, Practice Guidelines as Topic, Risk Management, Clinical Laboratory Techniques standards, Patient Care
- Abstract
Optimal patient care is best defined in terms of outcome. Reliable laboratory test results are important to patient safety. The laboratory must use the tools available to it to minimize the uncertainty of measurement. Three sources of error contribute to uncertainty: Intermethod bias, which is minimized and trueness of measure maximized when laboratories use calibrators and methods traceable to higher order, reference standards; imprecision inherent in the analysis, which is seen as small differences between replicate tests; interference from factors external to the test itself, which are seen as erroneous values markedly deviant from trueness. Although improbable, such contributions to total analytical error may be the most misleading. Risk is best managed by identifying the sources of error and controlling for those sources most likely to contribute to total analytical error. Comprehensive control of error requires the laboratory scientist and physicians caring for patients to work together to ensure interpretability of results. Practice guidelines are available from the Clinical and Laboratory Standards Institute to address each of these factors.
- Published
- 2009
9. The cost of patient safety.
- Author
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Hoeltge GA
- Subjects
- Humans, Medical Errors prevention & control, Safety Management organization & administration, United States, Cost-Benefit Analysis, Laboratories organization & administration, Medical Errors economics, Safety Management economics
- Abstract
To ensure patient safety, it costs an organization time, money, and commitment. The clinical laboratory may promote patient safety or may contribute to medical error. Laboratory errors put a patient at risk at any point along the path of workflow. The cost of an initiative in patient safety may be considered from four perspectives: compliance, feasibility, present risk, and financial. Three examples are offered to illustrate the use of these approaches. Most patient-safety strategies in laboratory medicine are not expensive. They are affordable with a structured outlay of existing resources and a willingness to follow defined work practices without exception. More extensive projects, especially those that cross jurisdictional lines within an organization, do require comprehensive project management. Management ofboth kinds of initiatives is addressed by NCCLS' documents on quality practice.
- Published
- 2004
10. The common SCN5A mutation R1193Q causes LQTS-type electrophysiological alterations of the cardiac sodium channel.
- Author
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Wang Q, Chen S, Chen Q, Wan X, Shen J, Hoeltge GA, Timur AA, Keating MT, and Kirsch GE
- Subjects
- Animals, Cell Line, Cells, Cultured, Electric Conductivity, Gene Frequency, Humans, Long QT Syndrome diagnosis, Long QT Syndrome physiopathology, NAV1.5 Voltage-Gated Sodium Channel, Patch-Clamp Techniques, Polymorphism, Single-Stranded Conformational, Sodium Channels metabolism, Long QT Syndrome genetics, Mutation, Missense, Sodium Channels genetics
- Published
- 2004
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11. A case of fatal West Nile virus meningoencephalitis associated with receipt of blood transfusions after open heart surgery.
- Author
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Armstrong WS, Bashour CA, Smedira NG, Heupler FA, Hoeltge GA, Mawhorter SD, Sudheendra V, and Gordon SM
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- Aged, Coronary Artery Bypass methods, Coronary Disease surgery, Fatal Outcome, Female, Humans, Meningoencephalitis etiology, Risk Assessment, Coronary Artery Bypass adverse effects, Erythrocyte Transfusion adverse effects, Meningoencephalitis virology, West Nile virus isolation & purification
- Abstract
First identified in the United States in 1999, West Nile virus caused approximately 3,500 infections in the late summer and fall of 2002. The virus is predominantly transmitted by mosquitoes, and the risk of infection through blood product transfusion is believed to be low. We present a case of West Nile virus encephalitis transmitted by red blood cell transfusion at the time of coronary artery bypass grafting that resulted in the patient's death. Individuals undergoing procedures with high blood product transfusion requirements, such as cardiac surgery or organ transplantation, may be at higher risk of this nosocomial infection during epidemics.
- Published
- 2003
- Full Text
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12. A pulmonary syndrome in patients with acute myelomonocytic leukemia and inversion of chromosome 16.
- Author
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Perez-Zincer F, Juturi JV, Hsi ED, Hoeltge GA, Rybicki LA, and Kalaycio ME
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- Adult, Aged, Case-Control Studies, Cryptogenic Organizing Pneumonia diagnosis, Cryptogenic Organizing Pneumonia drug therapy, Cryptogenic Organizing Pneumonia etiology, Female, Humans, Incidence, Leukemia, Myelomonocytic, Acute genetics, Lung Diseases diagnosis, Lung Diseases epidemiology, Male, Middle Aged, Retrospective Studies, Chromosome Inversion, Chromosomes, Human, Pair 16, Leukemia, Myelomonocytic, Acute complications, Lung Diseases etiology
- Abstract
Different subtypes of acute myelogenous leukemia have distinct clinical presentations and courses. The specific clinical and molecular aspects of these leukemias have helped modify and create specific strategies for their management. We observed an increased incidence of pulmonary complications in patients with acute myelomonocytic leukemias (AMML) with inversion of chromosome 16 [inv(16)] irrespective of the presence of hyperleukocytosis. We reviewed patient records available over a period of 12 years at The Cleveland Clinic Foundation of patients with AMML with inv(16) and compared the incidence of pulmonary complications to a matched control group of patients with AMML but without inv(16). We found an increased incidence of pulmonary complications in the AMML with inv(16)group when compared to the control group. Two of these patients demonstrated brochiolitis obliterans with organizing pneumonia (BOOP) on lung biopsy. No specific etiology for the pulmonary complications was identified. These findings represent the first observation of an association between WHO-AMML with inv(16) [FAB-AML M4 with inv(16)] with a pulmonary syndrome at presentation. BOOP should be suspected in these cases. A larger prospective study to evaluate this association is warranted.
- Published
- 2003
- Full Text
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13. A multicenter investigation with D-FISH BCR/ABL1 probes.
- Author
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Dewald G, Stallard R, Alsaadi A, Arnold S, Blough R, Ceperich TM, Rafael Elejalde B, Fink J, Higgins JV, Higgins RR, Hoeltge GA, Hsu WT, Johnson EB, Kronberger D, McCorquodale DJ, Meisner LF, Micale MA, Oseth L, Payne JS, Schwartz S, Sheldon S, Sophian A, Storto P, Van Tuinen P, Wenger GD, Wiktor A, Willis LA, Yung JF, and Zenger-Hain J
- Subjects
- Bone Marrow pathology, Fluorescent Dyes, Humans, Leukemia, Myelogenous, Chronic, BCR-ABL Positive genetics, Leukemia, Myelogenous, Chronic, BCR-ABL Positive pathology, Quality Control, Sensitivity and Specificity, Workload, Clinical Laboratory Techniques standards, Fusion Proteins, bcr-abl genetics, In Situ Hybridization, Fluorescence instrumentation, In Situ Hybridization, Fluorescence methods, In Situ Hybridization, Fluorescence standards, Leukemia, Myelogenous, Chronic, BCR-ABL Positive diagnosis
- Abstract
Twenty-eight laboratories evaluated a new fluorescence in situ hybridization (FISH) strategy for chronic myeloid leukemia. In a three-part study, bcr/abl1 D-FISH probes were used to study bone marrow specimens. First, laboratories familiarized themselves with the strategy by applying it to known normal and abnormal specimens. Then, collectively the laboratories studied 20 normal and 20 abnormal specimens blindly and measured workload. Finally, each laboratory and two experts studied six serial dilutions with 98-0% abnormal nuclei. Using the reported normal cutoff of < 1% abnormal nuclei, participants reported no false-negative cases and 15 false-positive cases (1-6.6% abnormal nuclei). Results provided by participants for serial dilutions approximated the expected percentages of abnormal nuclei, but those from the experts exhibited greater precision. The clinical sensitivity, precision, nomenclature, workload, recommendations for training, and quality assurance in methods using D-FISH in clinical practice are discussed.
- Published
- 2000
- Full Text
- View/download PDF
14. An optimized strategy for choosing the number of platelet concentrates to pool.
- Author
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Hoeltge GA, Shah A, and Miller JP
- Subjects
- Humans, Plateletpheresis statistics & numerical data, Reference Values, Platelet Count methods, Platelet Transfusion, Plateletpheresis standards
- Abstract
Context: The number of platelet concentrates (PCs) pooled per dose varies widely. The number should be based on quality control statistics., Objective: To determine the optimal number of PCs per pool that will achieve a target dose., Design: The population statistics of PC cell counts were obtained from routine quality control records. A target value of 3.00x10(11) cells was chosen. A theoretical model to predict the probability of achieving this target cell count was developed., Main Outcome Measures: The calculated probability was tested in a Monte Carlo simulation., Results: The mean of a sequential series of 100 PC counts (obtained from routine quality control records) was 9.08x10(10), and the standard deviation was 2.70x10(10). Platelet loss during pooling was measured at 8.3%, so that the pooling of 3.27x10(11) cells is required to deliver a dose of 3.00x10(11) cells. The pooling of 4 PCs from this data set predicts an average pool cell count of 3.63+/-2.30x10(11). Using standard tables for normal distribution, the probability of achieving a minimal pool dose of 3.00x10(11) cells is estimated to be greater than 0.76. Similarly, the probability of achieving the target value by pooling 5 PCs is greater than 0.99. In a Monte Carlo simulation selecting 4 PCs, 76.5% of the trials were successful, and for 5 PCs, 99.5% were successful (estimated P values of .77 and .99, respectively)., Conclusion: Five PCs per pool are necessary and sufficient to achieve the chosen target value given the cell count characteristics of our PC supply.
- Published
- 1999
- Full Text
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15. A multicenter investigation with interphase fluorescence in situ hybridization using X- and Y-chromosome probes.
- Author
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Dewald G, Stallard R, Al Saadi A, Arnold S, Bader PI, Blough R, Chen K, Elejalde BR, Harris CJ, Higgins RR, Hoeltge GA, Hsu WT, Kubic V, McCorquodale DJ, Micale MA, Moore JW, Phillips RM, Scheib-Wixted S, Schwartz S, Siembieda S, Strole K, VanTuinen P, Vance GH, Wiktor A, and Zinsmeister A
- Subjects
- Cytogenetics standards, Female, Humans, In Situ Hybridization, Fluorescence instrumentation, Laboratories standards, Lymphocyte Activation, Lymphocytes cytology, Male, Metaphase, Phytohemagglutinins, Quality Control, Reproducibility of Results, Sensitivity and Specificity, Workload, DNA Probes, In Situ Hybridization, Fluorescence methods, Interphase, X Chromosome, Y Chromosome
- Abstract
Twenty-six laboratories used X and Y chromosome probes and the same procedures to process and examine 15,600 metaphases and 49,400 interphases from Phaseolus vulgaris-leucoagglutinin (PHA)-stimulated lymphocytes. In Part I, each laboratory scored 50 metaphases and 200 interphases from a normal male and a normal female from its own practice. In Part II, each laboratory scored 50 metaphases and 200 interphases on slides prepared by a central laboratory from a normal male and a normal female and three mixtures of cells from the male and female. In Part III, each laboratory scored 50 metaphases (in samples of 5, 10, 15, and 20) and 100 interphases (in samples of 5, 10, 15, 20, and 50) on new, coded slides of the same specimens used in Part II. Metaphases from male specimens were scored as 98-99% XY with no XX cells, and 97-98% of interphases were scored as XY with 0.04% XX cells. Metaphases from female specimens were scored as 96-97% XX with 0.03% XY cells, and 94-96% of interphases were scored as XX with 0.05% XY cells. Considering the data as a model for any probe used with fluorescence in situ hybridization (FISH), a statistical approach assessing the impact of analytical sensitivity on the numbers of observations required to assay for potential mosaicisms and chimerisms is discussed. The workload associated with processing slides and scoring 50 metaphases and 200 interphases using FISH averaged 27.1 and 28.6 minutes, respectively. This study indicates that multiple laboratories can test/develop guidelines for the rapid, efficacious, and cost-effective integration of FISH into clinical service.
- Published
- 1998
16. An evaluation of the need for shared blood donor deferral registries.
- Author
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Domen RE, Grewal ID, Hirschler NV, and Hoeltge GA
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- Health Services Needs and Demand, Humans, Ohio, Regional Medical Programs, Blood Banks organization & administration, Blood Donors statistics & numerical data, Infection Control methods, Interinstitutional Relations, Registries
- Abstract
Objective: This study examined the frequency with which allogeneic, volunteer blood donors who had been deferred from donation at one blood collection facility donated, or attempted to donate, at a second blood collection facility., Methods: The blood donor computer files of two local blood collection facilities were-combined and matched donors on the donor deferral registry of each blood collection facility were identified., Results: Of 26,300 donors in the hospital-based blood bank file, 6732 (25.6%) were matched to the community blood center donor file (active donor base approximately 275,000). Matched donors on the donor deferral registry at each blood collection facility numbered 427 (6.3% of total matched donors). A total of 103 evaluable donors (1.5% of total, or 24.1% of deferred, matched donors) had been deferred at one blood collection facility and then later donated, or attempted donation, at the other blood collection facility. Of these 103, 51 were allogeneic donors who had been notified of their deferral status and should not have subsequently attempted blood donation. Thirty-two donors on the donor deferral registry of one blood collection facility made donations at the second blood collection facility which entered the general blood inventory., Conclusion: Shared donor deferral registries may be valuable at the local or regional level to prevent deferred blood donors from donating at other blood collection facilities. Whether or not a national donor deferral registry would be efficacious remains to be proven and deserves further study.
- Published
- 1997
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17. Platelet transfusion therapy for medical and surgical patients.
- Author
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Hussein MA and Hoeltge GA
- Subjects
- Contraindications, Humans, Patient Selection, Platelet Count, Risk Factors, Thrombocytopenia blood, Thrombocytopenia etiology, Platelet Transfusion adverse effects, Platelet Transfusion standards, Thrombocytopenia therapy
- Abstract
Platelet transfusions have become more common as more patients undergo bone marrow transplantation and aggressive chemotherapy for malignant diseases. This paper reviews the indications for platelet transfusions and the factors that can decrease their effectiveness.
- Published
- 1996
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18. Managing the infectious waste of the surgery unit and laboratory.
- Author
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Hoeltge GA
- Subjects
- General Surgery, Infection Control, Laboratories, Medical Waste classification
- Published
- 1995
- Full Text
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19. Expression of blood group antigen A by stage I non-small cell lung carcinomas.
- Author
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Rice TW, Tubbs RR, Hoeltge GA, Kirby TJ, Meeker DP, Medendorp SV, and Bukowski RM
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- Adenocarcinoma blood, Adenocarcinoma mortality, Adenocarcinoma pathology, Adenocarcinoma surgery, Aged, Antigens, Neoplasm metabolism, Carcinoma, Adenosquamous blood, Carcinoma, Adenosquamous mortality, Carcinoma, Adenosquamous pathology, Carcinoma, Adenosquamous surgery, Carcinoma, Non-Small-Cell Lung mortality, Carcinoma, Non-Small-Cell Lung pathology, Carcinoma, Non-Small-Cell Lung surgery, Carcinoma, Squamous Cell blood, Carcinoma, Squamous Cell mortality, Carcinoma, Squamous Cell pathology, Carcinoma, Squamous Cell surgery, Cell Transformation, Neoplastic pathology, Female, Follow-Up Studies, Humans, Lung Neoplasms mortality, Lung Neoplasms pathology, Lung Neoplasms surgery, Male, Middle Aged, Neoplasm Recurrence, Local epidemiology, Neoplasm Recurrence, Local pathology, Neoplasm Staging, Prognosis, Survival Rate, ABO Blood-Group System, Antigens, Neoplasm biosynthesis, Carcinoma, Non-Small-Cell Lung blood, Cell Transformation, Neoplastic metabolism, Lung Neoplasms blood
- Abstract
To clarify the significance of blood group antigen A (BAA) expression by neoplastic cells, we studied patients who had curative resections of stage I non-small cell lung carcinomas. Immunohistochemical staining using monoclonal antibodies was used to detect BAA expression by paraffin-embedded carcinoma cells. One hundred three patients were studied; mean age was 62.6 years, and 70 (68%) were male. Histologic types were as follows: adenocarcinoma, 52 (50.5%); squamous cell, 25 (24.3%); large cell, 24 (23.3%); and adenosquamous, 2 (1.9%). Histologic grades were as follows: I, 13 (12.6%); II, 26 (25.3%); and III, 64 (62.1%). All patients had American Joint Committee on Cancer stage I tumors: 65 patients (63.1%) had T1 tumors, and 38 (36.9%) had T2 tumors. Recurrences developed in 25 (24.3%) and metachronous malignancies in 4 (3.9%). Survival was 75% +/- 4.8% at 3 years and 66.6% +/- 7.5% at 5 years. Eighty-nine patients (86.4%) were blood group A and 14 (13.6%) were AB. Ninety-five (92.2%) were secretors of BAA and 8 (7.8%) were not. The expression of BAA by neoplastic cells was not detectable in 34 (33%), trace (1% to 5% of neoplastic cells) in 10 (9.7%), 1+ (6% to 25%) in 8 (7.8%), 2+ (26% to 50%) in 12 (11.7%), 3+ (51% to 75%) in 12 (11.7%), and 4+ (76% to 100%) in 27 (26.2%). The pattern of neoplastic cell staining was homogeneous in 14 patients (20.3%) and heterogeneous in 55 (79.7%). Carcinoma recurrence, overall survival, and event-free survival were not related to secretor status, BAA expression, or pattern of staining.(ABSTRACT TRUNCATED AT 250 WORDS)
- Published
- 1995
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20. An analysis of autologous blood donor motivational factors.
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Domen RE, Ribicki LA, and Hoeltge GA
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- Attitude to Health, Blood Donors psychology, Fear, Humans, Physician-Patient Relations, Physicians psychology, Surveys and Questionnaires, Virus Diseases prevention & control, Blood Transfusion, Autologous psychology, Motivation
- Abstract
Little is known about the patient's reasons for participating in an autologous blood (AUB) collection program. We surveyed 110 AUB donors in our hospital-based collection program. Although fear of infection from an allogeneic blood transfusion was cited by 20% of AUB donors, 68.2% indicated that their physician's recommendation was a motivating factor. For 18.2% self-initiated motivation was a factor in pursuing AUB. The overwhelming majority (97.1%) stated they would donate AUB even if the risk of getting AIDS from a blood transfusion was zero. Fear of infection does not appear to be the primary reason for patients to donate AUB. Recommendation by their personal physician is an important component in the patients' decision-making process to set aside their own blood for upcoming surgery.
- Published
- 1995
- Full Text
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21. Multiple red cell transfusions and alloimmunization. Experience with 6996 antibodies detected in a total of 159,262 patients from 1985 to 1993.
- Author
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Hoeltge GA, Domen RE, Rybicki LA, and Schaffer PA
- Subjects
- Adult, Aged, Female, Humans, Isoantibodies blood, Male, Middle Aged, Retrospective Studies, Sex Characteristics, Autoantibodies blood, Erythrocyte Transfusion adverse effects, Erythrocytes immunology
- Abstract
This retrospective study of red cell antibodies covered the period from 1985 to 1993. A three-cell antibody screen, 22% albumin enhancement, and a polyspecific antiglobulin reagent assay were performed. From a total of 159,262 patients in the data set, 6996 antibodies were detected among the sera of 4700 patients (2.9%). Four thousand two hundred thirty-five (60.5%) alloantibodies of potential clinical significance were found. These included anti-K1 (23.0%), -E (17.6%), -D (12.4%), -Le(a) (7.3%), -C (6.3%), -Fya (5.7%), and -c (4.4%). Cold agglutinins were found in 1119 positive antibody screens, 261 had warm autoantibodies, and 554 had high-titered, low-avidity antibodies. Three hundred seven were clinically insignificant (eg, Sda and Bga). Five hundred seventeen were too weak to identify. Most patients' sera demonstrated only one antibody (69.3%), but there was a strong linear correlation between the total number of recorded red cell transfusions and the number of antibodies found (r = .976; P < .0001). There was a higher percentage of females with antibodies than the percentage of females in the total study population (59.2% versus 43.8%, P < .0001). Two hundred nine of 554 (37.7%) high-titered, low-avidity antibodies and 349 (31.2%) of 1119 of the cold agglutinins accompanied or obscured clinically significant antibodies.
- Published
- 1995
22. Autologous blood transfusion and intraoperative cell salvage in a patient with homozygous sickle cell disease.
- Author
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Fox JS, Amaranath L, Hoeltge GA, and Andrish JT
- Subjects
- Adolescent, Female, Humans, Hypotension, Controlled, Intraoperative Period, Scoliosis complications, Anemia, Sickle Cell complications, Blood Preservation methods, Blood Transfusion, Autologous, Scoliosis surgery
- Abstract
Background: Autologous transfusion can eliminate the need for homologous transfusions. In addition, hypotensive anesthesia and devices that salvage red blood cells for return to the patient can reduce operative blood loss. However, blood from patients with sickle cell disease is difficult to store., Summary: A 16-year-old black girl with homozygous sickle cell disease needed surgery for progressive scoliosis. Her family's religious convictions precluded homologous transfusions. During surgery, 400 mL of autologous blood that had been successfully stored was transfused, as was 800 mL of blood salvaged using a cell-saving device, and 3800 mL of nonblood plasma expanders. Intravenous agents were used to maintain hypotension. However, following a rise in the patient's prothrombin and thromboplastin times, four units of homologous packed red cells were transfused with the permission of the patient's parents., Conclusions: Patients with sickle cell disease can be given hypotensive anesthesia and autologous transfusions of blood donated before surgery and blood salvaged during surgery using a cell-saving device.
- Published
- 1994
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23. Accidental fires in clinical laboratories.
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Hoeltge GA, Miller A, Klein BR, and Hamlin WB
- Subjects
- Safety, United States, Fires statistics & numerical data, Laboratories statistics & numerical data, Pathology, Clinical statistics & numerical data
- Abstract
The National Fire Protection Association, Quincy, Mass, estimates that 169 fires have occurred annually in health care, medical, and chemical laboratories. On the average, there are 13 civilian injuries and $1.5 million per year in direct property damage. Most fires in which the cause or ignition source can be identified originate in malfunctioning electrical equipment (41.6%) or in the facility's electrical distribution system (14.7%). The prevalence of fire safety deficiencies was measured in the College of American Pathologists Laboratory Accreditation Program. Of the 1732 inspected laboratories, 5.5% lacked records of electrical receptacle polarity and ground checks in the preceding year. Of these inspected laboratories, 4.7% had no or incomplete documentation of electrical safety checks on laboratory instruments. There was no evidence of quarterly fire exit drills in 9% of the laboratories. Deficiencies were also found in precautionary labeling (6.8%), in periodic review of safe work practices (4.2%), in the use of safety cans (3.7%), and in venting of flammable liquid storage areas (2.8%). Fire preparedness would be improved if all clinical laboratories had smoke detectors and automatic fire-extinguishing systems. In-service training courses in fire safety should be targeted to the needs of specific service areas.
- Published
- 1993
24. Proficiency testing in clinical cytogenetics. A 6-year experience with photographs, fixed cells, and fresh blood.
- Author
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Hoeltge GA, Dewald G, Palmer CG, David-Nelson MA, Saikevych I, Patil S, Schwartz S, Schneider NR, and Herrmann M
- Subjects
- Chromosome Aberrations diagnosis, Chromosome Disorders, Humans, Karyotyping, Clinical Competence, Cytogenetics, Pathology, Clinical standards
- Abstract
The College of American Pathologists and the American Society of Human Genetics offer a proficiency testing program in clinical cytogenetics. Two hundred twenty-five laboratories now provide data for this survey, which was begun in 1986. Challenges have consisted of photographed metaphases, fixed lymphoblastoid cell suspensions, fresh peripheral blood, and disarranged karyotypes. The "correct" response was based on 80% or greater consensus among either the referees or the participants. Referee laboratories performed better than participants. More laboratories were able to report accurate recognition of abnormalities by using a coded list than could write the interpretation in standardized nomenclature. Deletions, unbalanced translocations, and inversions were more difficult challenges than balanced translocations or trisomies. Prenatal and lymphocyte challenges were more likely to result in consensus than were bone marrow challenges. Participants performed best on whole-blood challenges. Fixed cell suspensions were less satisfactory. Excellent quality case material is essential for a successful challenge. A grading system has been devised to separate artifacts of the survey process from proficiency variables.
- Published
- 1993
25. Is your staff wise in waste management?
- Author
-
Hoeltge GA
- Subjects
- Inservice Training organization & administration, United States, Facility Regulation and Control, Hazardous Waste, Laboratories standards, Refuse Disposal standards, Safety
- Abstract
All laboratorians must learn their labs' protocols for hazardous waste disposal, including emergency plans and comprehensive procedures for storage, packing, and hauling.
- Published
- 1991
26. Explaining the risks of blood transfusion to patients.
- Author
-
Hoeltge GA and Sharp DE
- Subjects
- HIV Seropositivity transmission, Hepatitis B etiology, Hepatitis, Viral, Human etiology, Humans, Physician-Patient Relations, Risk Factors, Patient Education as Topic, Transfusion Reaction
- Abstract
Many patients express concern about the risk of an infection from blood transfusion. Blood transfusion is one of the safest therapies available, but its risks should never be trivialized when talking with patients. The most common infectious complication is hepatitis C, which occurs in 2% to 4% of transfused patients. Hepatitis B occurs in fewer than 1% of such patients. The risk of HIV infection from a blood transfusion is less than 1 in 100,000 in the United States. Explanation of risks is most effective when comparisons are meaningful and phrased from the patient's point of view.
- Published
- 1990
- Full Text
- View/download PDF
27. Alternate chromogens as substitutes for benzidine for myeloperoxidase cytochemistry.
- Author
-
Sheibani K, Lucas FV, Tubbs RR, Savage RA, and Hoeltge GA
- Subjects
- Histocytochemistry, Humans, Leukemia enzymology, Methods, Benzidines pharmacology, Chromogenic Compounds, Peroxidase metabolism, Peroxidases metabolism
- Abstract
Myeloperoxidase staining methods for classification of leukemias have traditionally employed benzidine dihydrochloride as the chromogen. Recent Occupational Safety and Health Administration regulations have classified benzidine as a carcinogen, which severely restricts its use in the clinical laboratory. Twenty-two specimens from normal control subjects and leukemia patients, previously classified by FAB criteria, were stained with benzidine and two alternate chromogens, diaminobenzidine and Hanker-Yates reagent (p-phenylenediamine and pyrocatechol). In a random, blind fashion, three experienced observers scored the stains from each case according to quality of smear, degree of peroxidase positivity, tinctorial distinction between nucleus and cytoplasm, and overall acceptability of the stain. All three observers rated the substitute chromogens as adequate for routine myeloperoxidase cytochemical staining. It is concluded that either of the methods studied would have clinical utility and can substitute for benzidine as a myeloperoxidase chromogen.
- Published
- 1981
- Full Text
- View/download PDF
28. Documentation of safe work practices in the clinical laboratory.
- Author
-
Hoeltge GA
- Subjects
- Accident Prevention, Documentation, Laboratories standards
- Abstract
The safety manual supplemented by explicit safety statements in the laboratory procedure manual should specify the hazards and containment methods for personnel. Control of fire hazards, biohazards, and chemical hazards are specifically addressed along with waste management and radionuclide consideration. Suggestions for incorporation of safety training into the laboratory's continuing education program are provided.
- Published
- 1986
29. A quality-control system for the general urinalysis laboratory.
- Author
-
Hoeltge GA and Ersts A
- Subjects
- Freezing, Preservation, Biological, Quality Control, Clinical Laboratory Techniques standards, Urine analysis
- Abstract
Sixteen quality-control products were prepared for general urinalysis testing. Empirically derived formulations simulating the variety found in clinical material monitored the routine analyses for pH, specific gravity, protein, glucose, ketone, and hemoglobin. Formalin-fixed erythrocytes, leukocytes, casts, crystals, and other particulates were added for qualitative identification of the formed sediment. Analytic results outside of the acceptable range were often due to errors in technic or subjective interpretation; re-education of individual personnel was followed by a decrease in the error rate over the first five months of the program.
- Published
- 1980
- Full Text
- View/download PDF
30. Plasmapheresis therapy of immunologic disease. Report of nine cases and review of the literature.
- Author
-
Calabrese LH, Clough JD, Krakauer RS, and Hoeltge GA
- Subjects
- Adult, Aged, Antigen-Antibody Reactions, Female, Humans, Male, Middle Aged, Immune Complex Diseases therapy, Plasmapheresis
- Published
- 1980
- Full Text
- View/download PDF
31. Abnormally banded chromosomal regions in doxorubicin-resistant B16-BL6 murine melanoma cells.
- Author
-
Slovak ML, Hoeltge GA, and Ganapathi R
- Subjects
- Animals, Cells, Cultured, Drug Resistance, Gene Amplification, Glycoproteins analysis, Mice, Molecular Weight, Phenotype, Sister Chromatid Exchange, Chromosome Aberrations, Chromosome Banding, Doxorubicin pharmacology, Melanoma genetics
- Abstract
B16-BL6 murine melanoma cells were selected for cytogenetic evaluation during the stepwise development of increasing resistance in vitro to the antitumor antibiotic, doxorubicin (DOX). Karyotypic studies demonstrated extensive heteroploidy with both numerical and structural abnormalities which were not present in the parental DOX-sensitive B16-BL6 cells. Trypsin-Giemsa banding revealed the presence of several marker chromosomes containing abnormally banding regions (ABRs) in the 44-fold B16-BL6 DOX-resistant subline. These ABRs appeared to be more homogeneously staining at the higher DOX concentrations. Length measurements (ABR index) in seven banded metaphases indicated a direct correlation with increasing DOX concentration. When the DOX-resistant cells were grown in drug-free medium for 1 yr, the drug-resistant phenotype gradually declined in parallel with the level of resistance and the ABR index. DOX-induced cytogenetic damage examined by sister chromatid exchange methodology in parental B16-BL6 cells indicated a linear sister chromatid exchange:DOX dose-response relationship. However, after continuous treatment of parental B16-BL6 cells with DOX (0.01 microgram/ml) for 30 days, sister chromatid exchange scores were found to return to base-line values. The B16-BL6 resistant cells demonstrated a cross-resistant phenotype with N-trifluoroacetyladriamycin-14-valerate, actinomycin D, and the Vinca alkaloids but not with 1-beta-D-arabinofuranosylcytosine. The results suggest that ABR-containing chromosomes in DOX-resistant sublines may represent cytogenetic alterations of specific amplified genes involved in the expression of DOX resistance. Further studies are required to identify and define the possible gene products and to correlate their relationship to the cytotoxic action of doxorubicin.
- Published
- 1986
32. Acute lymphocytic leukemia with microblastosis and near haploidy (26 chromosomes): a case report.
- Author
-
Hoeltge GA, Dyment PG, and Slovak ML
- Subjects
- Adolescent, Bone Marrow ultrastructure, Child, Child, Preschool, Chromosomes, Human, 16-18, Chromosomes, Human, 21-22 and Y, Diploidy, Female, Humans, Karyotyping, Leukemia, Lymphoid ultrastructure, Male, Metaphase, Middle Aged, Bone Marrow immunology, Haploidy, Leukemia, Lymphoid immunology, Lymphocytes ultrastructure
- Abstract
A three-year-old acute lymphocytic leukemia (ALL) patient had a modal chromosome count of 26 in her bone marrow metaphases. The leukemia was "common" ALL by cytochemical and immunologic studies. Five other cases had been reported previously, and all have had a near haploidy varying from 26 to 32 chromosomes. Disomy of chromosomes 18 and 21 is a consistent feature of this disease. Severe hypodiploidy correlates with microblastosis requiring morphologic separation from non-neoplastic small lymphocytes.
- Published
- 1982
- Full Text
- View/download PDF
33. Computer-assisted audits of blood component transfusion.
- Author
-
Hoeltge GA, Brown JC, Herzig RH, Johannisson MR, Millward BL, O'Hara PJ, Orlowski JP, Sharp DE, and Zurick AM
- Subjects
- Blood Preservation, Erythrocyte Transfusion, Freezing, Humans, Ohio, Plasma, Platelet Transfusion, Plateletpheresis, Quality Control, Blood Transfusion standards, Computers, Medical Audit
- Abstract
Comprehensive review of clinical blood transfusion practice at a tertiary-care medical center is complicated by the extraordinary number of patients that receive such therapy. Computer-assisted review of the key objective data used in making the decisions about transfusion is necessary to evaluate the process. Use of 15,873 units of red blood cells, 3,641 units of plasma, 2,619 pools of platelets or pheresis units, and 259 pools of cryoprecipitate was screened by comparing pre-transfusion and post-transfusion blood counts with the medical staff's evaluation criteria. On this basis, 81.4% of transfusion episodes (TEs) were considered fully justified. Medical records were selected for audit from the cases in which the transfusion decisions could not be justified by on-line information. Abstracted data subsequently justified 82 of 139 audited cases; 68.4% of the comments pertaining to the remaining 57 cases adequately explained the transfusion decision. Thus, nearly 96% of the TEs were justifiable as determined by peer review.
- Published
- 1989
- Full Text
- View/download PDF
34. The differential cytology of cerebrospinal fluids prepared by cytocentrifugation.
- Author
-
Hoeltge GA, Furlan A, and Hoffman GC
- Subjects
- Adolescent, Adult, Aged, Centrifugation, Child, Child, Preschool, Cytodiagnosis, Cytological Techniques instrumentation, Female, Humans, Infant, Male, Middle Aged, Cerebrospinal Fluid cytology
- Published
- 1976
- Full Text
- View/download PDF
35. Managing hazardous waste in the clinical laboratory.
- Author
-
Hoeltge GA
- Subjects
- Humans, Hazardous Waste, Laboratories, Medical Waste, Refuse Disposal, Sewage, Waste Disposal, Fluid, Waste Products
- Abstract
Clinical laboratories generate wastes that present chemical and biologic hazards. Ignitable, corrosive, reactive, toxic, and infectious potentials must be contained and minimized. A summary of these problems and an overview of the applicable regulations are presented. A checklist of activities to facilitate the annual review of the hazardous waste program is provided.
- Published
- 1989
36. Safety in the medical laboratory.
- Author
-
Hawk WA and Hoeltge GA
- Subjects
- Carcinogens, Electric Injuries prevention & control, Fires prevention & control, Medical Waste, Radioactive Waste, Radioisotopes, Refuse Disposal, United States, Accident Prevention, Facility Regulation and Control, Laboratories organization & administration, Safety
- Abstract
The clinical laboratory has achieved an enviable record for safety even though the opportunities for accident and misfortune are ever present. This article provides an overview of what constitutes an adequate safety program for a laboratory, as well as a list of sources from which more detailed information can be obtained.
- Published
- 1983
37. Proficiency testing in clinical cytogenetics. The 1986 experience of the College of American Pathologists.
- Author
-
Hoeltge GA, Dewald G, Miles J, and Palmer C
- Subjects
- Chromosome Aberrations, Chromosome Disorders, Humans, Karyotyping, Cytogenetics
- Abstract
In 1986, the College of American Pathologists introduced a proficiency testing program in cytogenetics entitled "survey CY." Approximately 140 laboratories actively participated. The survey consisted of 20 cytogenetic cases sent to the participants in quarterly shipments of five challenges each. Photographic negatives of metaphases were the primary medium studied. The results reported by the participants were highly concordant for the determination of modal chromosome count and sex chromosome designation. More than 90% of the participants correctly identified the following abnormalities: trisomies 8, 13, 18, 21, and X; monosomy X; t(9;22); t(8;21); der(2) t(2;?); and 5p-. Abnormalities A fra(X)(q27), t(5;11), inv(16), and t(15;17) were correctly identified by more than 80%, 70%, 70%, and 60% of the participants, respectively. The participants had the most difficulty with diagnoses that involved photographs of high-resolution chromosome banding. The 1986 survey was not graded, but the 1987 cytogenetics survey will be scored on those challenges where there is at least 80% consensus among the participants.
- Published
- 1988
38. The historical development of automated hemapheresis.
- Author
-
Millward BL and Hoeltge GA
- Subjects
- Blood Component Removal history, Equipment Design, History, 20th Century, Humans, Leukapheresis history, Leukapheresis instrumentation, Neutropenia therapy, Plasmapheresis history, Plasmapheresis instrumentation, United States, Blood Component Removal instrumentation
- Abstract
Many studies in the early twentieth century involved attempts to separate white blood cells from whole blood for further examination and experimentation as well as for the treatment of neutropenic patients. In the 1950s, the need to use blood and its derivatives efficiently produced the first apparatus to separate blood continuously in a closed system. The prototypes of present-day continuous flow blood cell separators were developed in the 1960s.
- Published
- 1982
- Full Text
- View/download PDF
39. Cytogenetic alterations associated with the acquisition of doxorubicin resistance: possible significance of chromosome 7 alterations.
- Author
-
Slovak ML, Hoeltge GA, and Trent JM
- Subjects
- Adenocarcinoma drug therapy, Adenocarcinoma genetics, Chromosome Aberrations, Chromosome Banding, Colonic Neoplasms drug therapy, Colonic Neoplasms genetics, Drug Resistance genetics, Fibrosarcoma drug therapy, Fibrosarcoma genetics, Gene Amplification, Humans, Karyotyping, Tumor Cells, Cultured drug effects, Chromosomes, Human, Pair 7, Doxorubicin therapeutic use
- Abstract
Cytogenetic abnormalities associated with the acquisition of doxorubicin (DOX) resistance (DOXR) were examined in two cell lines (HT1080 fibrosarcoma and LoVo colon adenocarcinoma) which were selected in the presence of increasing concentrations of DOX over a 2-year period. Karyotypes of both tumor lines were initially near-diploid although they differed significantly in their intrinsic sensitivities to DOX (DOX 50% inhibiting concentrations: LoVo, 0.10 micrograms/ml; HT1080, 0.006 microgram/ml). Chromosome banding analysis of DOXR sublines of the LoVo and HT1080 cell lines demonstrated a strikingly different response to DOX selection with regard to both numeric and structural chromosome alterations. DOXR LoVo cells maintained the parental modal chromosomal number of 49 despite a 285-fold increase in the level of resistance, with minimal structural chromosome changes observed. In contrast, the development of DOXR in HT1080 cells was accompanied by marked aneuploidy, including a significant increase in the complexity of the tumor karyotype with increasing levels of DOXR. Cytogenetic evidence suggestive of gene amplification (double minutes and homogeneously staining regions) was also observed in the DOXR HT1080 cell line. Examination of chromosome alterations common to both resistant lines revealed alterations of chromosomes 1, 5, 7, and 11, with chromosome 7q the most frequent site of chromosome change. Reversion of DOXR in both the HT1080 and LoVo cell lines (by continuous in vitro passage once off drug) resulted in an accompanying loss in structurally altered No. 7 chromosomes. Our data suggest that alterations of chromosome 7 are a common and perhaps significant feature of DOXR tumor cells.
- Published
- 1987
40. Cytogenetics of acute leukemia in 90 children and young adults. Prognostic value of karyotypic status at diagnosis.
- Author
-
Hoeltge GA, Slovak ML, Leatherman JR, and Norris DG
- Subjects
- Adolescent, Adult, Child, Child, Preschool, Female, Genetic Markers, Humans, Infant, Infant, Newborn, Male, Prognosis, Karyotyping, Leukemia, Lymphoid genetics
- Published
- 1983
- Full Text
- View/download PDF
41. Comprehensive Blood Bank Survey.
- Author
-
Walker RH, Cooper ES, Hoeltge GA, de Jongh D, and Kuban DJ
- Subjects
- ABO Blood-Group System, Blood Grouping and Crossmatching, Hospital Bed Capacity, Humans, MNSs Blood-Group System, Rh-Hr Blood-Group System, Blood Banks standards
- Abstract
Approximately 2,400 laboratories participated in the 1982 Comprehensive Blood Bank Survey of the College of American Pathologists. Fourteen Referee Laboratories were utilized to validate the results of participants and to assure lack of deterioration of the specimens during shipment. Results of the participants in ABO grouping, Rh D typing, special antigen typing, and antibody detection and identification are reported and discussed. Special ungraded studies, which provided additional challenges, and supplementary questions with the responses of participants are also included.
- Published
- 1985
42. Pharmacological and biological evidence for differing mechanisms of doxorubicin resistance in two human tumor cell lines.
- Author
-
Slovak ML, Hoeltge GA, Dalton WS, and Trent JM
- Subjects
- ATP Binding Cassette Transporter, Subfamily B, Member 1, Cytarabine pharmacology, Doxorubicin pharmacokinetics, Drug Resistance drug effects, Humans, Membrane Glycoproteins analysis, Verapamil pharmacology, Doxorubicin pharmacology, Tumor Cells, Cultured drug effects
- Abstract
The cellular pharmacology of doxorubicin resistance (DOXR) has most commonly been associated with decreased drug uptake, enhanced drug efflux, cross-resistance to multiple anticancer agents, and the overproduction of a Mr 170,000 cell surface glycoprotein (termed P-glycoprotein). In this study, the pharmacological and genetic characteristics of two newly derived human DOXR sublines were examined. These DOXR sublines were established following continuously increasing DOX exposure until a 222-fold resistant fibrosarcoma subline (HT1080/DR4) and a 285-fold resistant colon adenocarcinoma subline (LoVo/DR5) were developed. However, three major lines of evidence suggest that despite the similar selection strategy, the mechanism of DOXR differs significantly between these two cell lines. First, Western blotting using the C219 antibody specific to P-glycoprotein revealed the overexpression of the Mr 170,000 cell surface glycoprotein in LoVo DOXR cells but not in HT1080 DOXR cells. Second, LoVo DOXR cells are cross-resistant to vincristine, actinomycin D, colchicine, etoposide, and gramicidin D, but not to 1-beta-D-arabinofuranosylcytosine. In contrast, HT1080 DOXR cells display cross-resistance to vincristine, actinomycin D, vinblastine, and etoposide; however, they are not cross-resistant to gramicidin D, and show an increased (approximately 18-fold) cross-resistance to 1-beta-D-arabinofuranosylcytosine. Third, intracellular DOX accumulation (as measured by [14C]DOX at 1-h and high-performance liquid chromatography analysis) was decreased approximately 2.7-fold in LoVo DOXR cells and approximately 2.0-fold in HT1080/DR4 cells. However, while net accumulation studies in the presence of 5 micrograms/ml verapamil reversed DOXR to parental values in LoVo colon adenocarcinoma cells, it only minimally decreased DOX resistance (12.6%) in HT1080/DR4 cells. Efflux patterns of [14C]DOX were similar for the DOXR sublines with an approximately 50% decrease in DOX retention after 1 h when compared to their respective parental cell lines. Our results suggest that DOXR in LoVo/DR5 cells may result from overexpression of P-glycoprotein. In contrast, DOXR in HT1080/DR4 appears to be non-P-glycoprotein mediated and may be related to an alternative mechanism capable of altering drug efflux or differential drug binding.
- Published
- 1988
43. Erythropheresis in treating retinal detachments secondary to sickle-cell retinopathy.
- Author
-
Wilhelm JL, Zakov ZN, and Hoeltge GA
- Subjects
- Humans, Retinal Detachment etiology, Anemia, Sickle Cell complications, Blood Transfusion, Erythrocyte Transfusion, Retinal Detachment therapy
- Published
- 1981
- Full Text
- View/download PDF
44. Review of proficiency testing performance of laboratories accredited by the College of American Pathologists.
- Author
-
Hoeltge GA and Duckworth JK
- Subjects
- Clinical Competence standards, Evaluation Studies as Topic, Indiana, Kentucky, Michigan, Ohio, Ontario, Societies, Medical, United States, Accreditation standards, Laboratories standards, Pathology, Clinical standards
- Abstract
The Commission on Laboratory Accreditation of the College of American Pathologists (CAP), Skokie, III, monitors the proficiency testing of accredited laboratories by regular review of the Cumulative Survey Management Report. Analytes are targeted for review on the basis of repeated "unacceptable" results in the CAP Survey Program. Approximately 1% of proficiency testing results are repeatedly graded unfavorably. Directors of 271 Great Lakes Region laboratories reported the causes of and the corrective actions taken for 583 targeted results over a two-year period. Targetting of results in 31% was attributed to methodologic or instrumentation problems, 19% to technical performance factors, and 27% to clerical errors. Only 3% were ascribed to the Survey materials or to the criteria used for grading, and 20% of the problems remained unexplained after investigation. There was improvement in 496 (88%) of 583 targeted. During the study period, results from 96% of laboratories showed improved performance for all or a majority of the targeted analytes.
- Published
- 1987
45. Donor blood-count changes during and after plateletpheresis. Comparison of two cell-separator techniques.
- Author
-
Bator SM and Hoeltge GA
- Subjects
- Adult, Erythrocyte Count, Female, Humans, Leukocyte Count, Male, Middle Aged, Platelet Count, Blood Cell Count, Blood Component Removal instrumentation, Blood Donors, Plateletpheresis instrumentation
- Published
- 1987
- Full Text
- View/download PDF
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