Psychology and psychiatry in the People's Republic of China: An annotated bibliography.

Summarizes 54 studies, published since 1970 and available in most university libraries, that represent a thorough analysis of what is currently known about Chinese psychology and psychiatry. The bibliography was selected from a computerized literature search yielding 826 citations, much of which was inaccesible, not in English, totally irrelevant, or outdated. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Benefits and risks of scheduled autologous transfusion

Blood transfusion, like any other medical activity, requires an analysis of the risk/benefit ratio for each patient. Autologous blood transfusion does not escape this golden rule. The benefits expected of scheduled autologous transfusion consist of the reduction of the risks inherent in homologous transfusion. Those benefits are indisputable in erythrocyte alloimmunisation and viral or parasitic disease transmission. But the risks attached to such protocols have often been underestimated. The risks for the patient are still linked to the transfusion of autologous labile blood products (haemolysis, bacterial infections) or to consequences of whole blood donations (cardiovascular intolerance, increased use of transfusion, increased operative bleeding). There are also risks for the patient community insofar as autologous blood products which do not all meet the same criteria of clinical and biological validation as homologous blood products are circulated in care institutions.     

Intraoperative and postoperative autologous transfusion in orthopedic surgery

Information was collected retrospectively on three comparable groups, 25 patients in each, who had been operated on for thoracic scoliosis. Group 1 received homologous transfusions only. Group 2 and group 3 were transfused postoperatively with drained whole blood (Solcotrans orthopaedics). Group 3 received in addition peroperatively washed packed red blood cells (Haemolite 2 Cell Saver) recirculated. The need for homologous transfusions was reduced from 119 units to 23 patients in group 1, to 36 units to 14 patients in group 2 and 34 units to 13 patients in group 3. Three of the first 15 patients in group 2 experienced chills and fever reactions in connection with the autologous transfusion. No reactions were seen after infusion when we scrapped the last 50 to 100 ml of drained blood.     

History of autologous blood transfusion in neurosurgical operations]

Two Caucasian patients are described who had destructive postpartum thyroiditis (PPT) before the subsequent onset of Graves' hyperthyroidism (GH). HLA class II DQ typing in these two subjects identified putative susceptibility alleles previously detected in GH and PPT. Although PPT destructive thyroiditis preceding the development of GH is relatively uncommon, the occurrence of both these syndromes in the same patient suggests the possibility of an etiological role for thyroid antigen release and genetic susceptibility as pathogenic factors in the development of Graves' disease.     

Safe levels of hemoglobin concentration in autologous blood transfusion

It has been generally accepted that an adequate oxygen-carrying capacity can be achieved with a hemoglobin concentration of 7 g/dl, as far as the patient's intravascular volume is sufficient to allow tissue perfusion. To guarantee patient's safety in the operating theater, patient's oxygenation, ventilation, circulation and temperature, which enable oxygen utilization in tissues, should be monitored vigilantly and ensured strictly. This is also true when taking care of anemic patients outside the operating theater, because failure of these functions in anemic patients leads directly to tissue hypoxia. Besides the standard monitoring, measuring oxygen carrying capacity/consumption parameters and gastric/sigmoidal intramucosal pH have been shown to be helpful to estimate tissue oxygenation. Therefore, safe levels of hemoglobin concentration should be determined according to the ability of doctors and nursing staffs to evaluate and to maintain patient's systemic and tissue oxygenation as well as to the patient's pathophysiological conditions.     

Postoperative inflammatory response after autologous and allogeneic blood transfusion

BACKGROUND: Allogeneic blood transfusions cause immunosuppression. The aim of this study was to determine whether complement anaphylatoxins, cytokines, or both are released in the recipient, after blood transfusions in general, and after autologous blood transfusions in particular. METHODS: Thirty-one patients having total hip joint replacement surgery were randomized to receive either allogeneic red blood cells (n = 15) or predeposited autologous whole blood transfusion (n = 16). Plasma concentrations of the anaphylatoxins C3a and C5a, the terminal C5b-9 complement complex, and cytokines IL-6 and IL-8 in the recipients were repeatedly analyzed before, during, and after surgery. RESULTS: Significantly increased concentrations of IL-6 and IL-8 appeared in both groups, with a significantly greater increase in the autologous blood group. Patients in both groups developed a moderate but significant increase of C3a without a significant difference between them. C5a and terminal C5b-9 complement complex were not greatly changed. CONCLUSIONS: The study showed a greater increase in cytokine concentration after autologous blood transfusion than after allogeneic blood transfusion. The lower response in the latter may result from transfusion-induced suppression of cellular immunity.     

History of autologous blood transfusion in the 19th century]

Autologous blood transfusion in animal experiments was performed already in the first half of the 19th century. These experiments, however, were not conducted to explore the feasibility of autologous blood transfusion in man, but provided only the experimental design for physiological investigations on the defibrination of blood. Blood withdrawn from the animals by phlebotomy in these experiments was retransfused either with or without defibrination. The idea of retransfusing the patient's own blood was mentioned for the first time by Eulenburg and Landois, when in 1866 they proposed to treat gas poisonings with a type of exchange transfusion (transfusion with simultaneous depletory bleeding). They suggested that the blood that would be withdrawn could be retransfused after the poisonous gases had been eliminated. The first who demonstrably considered the possibility of autologous blood transfusion in operative medicine was the Halle surgeon Richard von Volkmann in 1868. The first originally sourced autologous blood transfusion, however, was performed by the Kiel surgeon Friedrich von Esmarch who, in a case of exarticulation of the thigh at the hip joint, collected the blood that had been shed during the operation in a washbowl, defibrinated it, and reinjected it into the severed femoral vein. However, despite some further cases of autologous blood transfusion performed for various indications and in different countries, the method was unable to gain a foothold in the treatment of acute blood loss, and fell into oblivion until the Leipzig gynaecologist Johannes Thies revived interest in it in 1914. The authors surmise that the advantages of autologous blood transfusion had not been recognised in the 19th century.     

Adverse reactions associated with autologous blood transfusion: evaluation and incidence at a large academic hospital

Malignant fibrous histiocytoma (MFH) in the stomach is very rare, and only four cases have been reported. As a result, there is still little understanding of its clinical and pathological features. We recently experienced two cases of gastric MFH. The first case was a 78-year-old man with epigastralgia and a loss of body weight. Endoscopy revealed an ulcerated submucosal tumor. A gastrectomy was performed and the diagnosis of MFH was made histopathologically. The second case was a 77-year-old man with pulmonary symptoms. An image diagnosis indicated a strong suspicion of lung cancer, and a right middle and lower lobectomy was thus performed. One month after the operation, a bleeding gastric tumor was found and therefore a gastrectomy was performed. Both tumors were diagnosed as MFH. From the analysis of six reported cases including ours, a preoperative correct diagnosis is found to be difficult although the lesion has grown to a considerable size at the time of operation. Since a metastatic lung lesion was first detected in two out of six cases, it is thus recommended that the stomach should be examined when lung MFH is found. Considering the high mortality and the short survival in the six cases, the prognosis for gastric MFH seems to be poorer than that in the extremities. However, lymph node metastasis is uncommon, and a curative resection is possible in some cases such as in our second case.     

The effects of perioperative blood salvage and autologous blood donation on transfusion requirements in scoliosis surgery

Fifty consecutive cases of surgical instrumentation and fusion for adolescent idiopathic scoliosis were prospectively studied to test the hypothesis that the use of predonated autologous blood combined with judicious perioperative blood salvage could decrease the amount of homologous blood needed. All cases had posterior instrumentation and fusion. Nineteen patients had their rib prominence resected with an average of 4.8 ribs per patient. Our protocol called for perioperative blood salvage with the cell saver and reinfusion of postoperative drained blood if more than 300 ml were drained in 4 hours. Two units of predonated autologous blood was made available. Hypotensive anesthesia and meticulous hemostasis kept the blood loss to a minimum. The average total blood loss was 1,055 ml. Blood loss per segment was 91 ml with an average of 11 segments fused per patient. Patients with rib resection had a blood loss of 1,105 ml, while those without had a blood loss of 955 ml. The cell saver blood returned per case was 391 ml with the hematocrit of the product averaging 46%. Twelve patients were reinfused an average of 300 ml of the postoperative drained blood. The predonated autologous blood was used as part of the intraoperative fluid management. In no patient was homologous blood needed. The average starting hematocrit was 35.6%, with the hematocrit at discharge (seventh day) being 32.4%. There were no complications or blood transfusion reactions. Our results suggest that judicious perioperative blood management may decrease the need for homologous blood transfusion in selected posterior idiopathic scoliosis surgery.     

Review of autologous and allogeneic blood transfusion practices in patients undergoing radical hysterectomy

We investigated the short-term recuperation of bone mass during skeletal reloading after a period of unloading in young rats. One hind limb of 4-week-old rats was either unloaded irreversibly by sciatic neurectomy, or unloaded reversibly by external fixation. Other animals were sham-operated. After 9 days, the fixation-unloaded limbs were reloaded for 1-3 weeks and were compared with the hind limbs of age-matched unloaded (neurectomized) and sham-operated controls. Cortical and cancellous bone mass was measured using ashing and histomorphometry. Cortical bone mass (expressed as femoral dry and ash weight and tibial cortical bone area) was reduced in both unloaded groups and was accompanied by production of hypomineralized bone, as shown by a reduction in the percent ash of the dry weight. Cancellous bone mass (expressed as bone area and surface at the tibial metaphysis) was also reduced in both unloaded groups. Cortical bone mass deficit was greater in the fixation group than in the neurectomy group. Thereafter it increased in the neurectomy group despite a normal longitudinal growth rate, but returned to age-matched values in the reloaded group by 3 weeks. The changes in tibial cancellous bone mass were more pronounced but followed a similar pattern and normalized by 2 weeks. These data demonstrate that total unloading produced by external fixation causes a greater degree of bone mass deficit than partial unloading (produced by neurectomy); the rate of bone loss during unloading in the rat hind limb is more rapid than its recovery during reloading; and cancellous bone recuperates during the reloading phase faster than does cortical bone.     

Review of A textbook of social psychology, second edition.

Reviews the book, A textbook of social psychology, second edition by J. E. Alcock, D. W. Carment, and S. W. Sadava (1991). The volume under review is quite typical in its coverage of various topics. Its introduction and sixteen chapters deal with methods; social perception and cognition; attitudes and values; attitude change; social influence; prejudice, discrimination and sexism; inter-personal attraction and inter-personal relationships; aggression and violence; pro-social behaviour; communication; social categorization, groups, and leadership; conflict and its resolution; collective behaviour; social psychology of justice and the law; social psychology and the physical environment; health and illness. The current second edition is quite similar in coverage to the first. But it is substantially brought up-to-date and expanded, so that the book grew from 678 pages in the first edition to 824 pages in this second edition. In terms of its contents, then, this text does a very good job in covering what are now considered the major topics in social psychology. Instructors who select this volume as a text for a first course in social psychology arc well served. Not only do they get a treatment of social psychology that is comprehensive and up-to-date, but also has the additional benefits of being interesting, well-written, and relevant to the Canadian context. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Immune responsiveness in orthopedic surgery patients after transfusion of autologous or allogeneic blood

BACKGROUND: The proposed immunosuppressive effect of blood transfusion is not yet understood, and the clinical relevance is a controversial topic of discussion. STUDY DESIGN AND METHODS: The effect of blood transfusions on the capacity of the host's immunocompetent cells to react to mitogenic stimulation was evaluated. Patients undergoing hip replacement surgery received either allogeneic (n = 13) or autologous (n = 14) buffy coat-depleted red cells or plasma. Patients' blood samples taken before and on Days 1 and 5 after surgery were stimulated in a whole-blood assay. The release of interleukin 2, soluble interleukin 2 receptor, interleukin 6, tumor necrosis factor alpha, interferon alpha 2, and interferon gamma was assessed by enzyme-linked immunosorbent assay. In addition, the white cell counts and frequencies of the lymphocyte subsets CD4+, CD8+, and natural killer cells were analyzed. RESULTS: For both groups, decreased levels of interleukin 2 and interferon-gamma were detected postoperatively, whereas the values for soluble interleukin 2 receptor and tumor necrosis factor alpha showed no significant change. Interferon alpha 2 was decreased on Day 1, but returned to normal by Day 5. Interleukin 6 increased during the time of observation. There were no significant differences between the two groups in cytokine production and lymphocyte-subset analysis that could be attributed to the transfusion of allogeneic blood. CONCLUSION: The transfusion of buffy coat-depleted red cells showed no immediate suppressive effect on the immune function of the host's peripheral blood cells.     

Review of Process and practice in family therapy (second edition).

Reviews the book, Process and practice in family therapy (second edition) by Gerald H. Zuk (1986). This book is an elaboration on the views on family therapy Zuk presented in the first edition, published in 1975. The book consists of three parts. Part I provides most of the theoretical and philosophical considerations underlying the author's conceptualization of family therapy. Parts II and III offer more specific illustrations of these considerations. Zuk wrote this book for the mental health clinician who works primarily with couples and families. He expects that all mental health professionals will find interesting material in it. In this reviewer's opinion the book is of special value for the more experienced family therapist who is able to incorporate various theoretical views into a consistent treatment plan. For beginning family therapists and for mental health professionals without experience in marital or family therapy the material offered may be too specific and the translation gap between theory and practice too large. (PsycINFO Database Record (c) 2010 APA, all rights reserved)