The management of metastatic squamous cell carcinoma can be challenging in patients with low-grade non-Hodgkin lymphoma. 18F-fluorodeoxyglucose positron emission tomography can be useful in the diagnosis of metastatic squamous cell carcinoma in patients with low-grade non-Hodgkin lymphoma.

Autologous collections are strongly advocated by the New South Wales Red Cross Blood Transfusion Service (BTS) and have increased more than sevenfold since 1988. Directed donations, although not promoted, have also increased during this time. The prevalence of infectious disease markers (HIV, hepatitis C, hepatitis B and syphilis) in donations collected by the BTS from different donor groups including overall volunteer homologous, first-time volunteer homologous, autologous and directed were evaluated over a 42-month period. Donations from first-time volunteer homologous donors had the highest prevalence of hepatitis B and C. Autologous donations had a significantly higher prevalence of hepatitis B, hepatitis C and syphilis compared with overall volunteer homologous donations. The percentage of directed donations testing positive for either hepatitis B or C was higher than overall volunteer homologous donations, but not statistically significant. This study demonstrates that donations from first-time donors are the least safe, that the crossover of autologous blood into the volunteer homologous pool decreases the safety of that pool and suggests that directed donations may not be as safe as volunteer homologous donations and cannot be generally advocated at this time.

Monitoring the outdating of donated units is one way of assessing the efficiency of blood usage. Inventory management in public hospital blood banks in Sydney was reviewed with the aim of determining factors which lead to the outdating of donor blood. Factors which correlated significantly with increased outdating in hospitals included absence of an effective hospital transfusion committee; high ratio of average inventory: units transfused; fewer than three routine deliveries from the BTS per day; increased time taken for delivery of urgent products; CT values greater than 2:1, premature performance of the crossmatch and prolonged crossmatching holding time. Hospitals were informed of the initial audit results and were alerted to the factors contributing to excessive outdating. They received monthly feedback of individual outdating results compared with overall outdating. After 6 months there was a significant reduction in overall outdating from 5.0 to 0.9% (P < 0.05), which has been maintained for a further 12 months. Changes in inventory management associated with an improvement in overall outdating included: changes in crossmatching practice which increase the effective shelf-life of blood, knowledge of when blood was due to outdate and effective stock rotation.

The aim of the present study was to characterize hepatitis C virus (HCV) genotypes using the INNO-LiPA HCV line probe assay and direct sequencing from three different HCV-RNA-positive (serum) groups: (i) blood donors (n = 59); (ii) haemophiliacs (n = 43); and (iii) patients undergoing liver transplantation (n = 26). Of 128 HCV-RNA-positive samples, 74 (58%) were genotype 1. Of these, 41 were genotype 1a, 32 were genotype 1b and one was genotype 1 indeterminate. Of the remaining 54 samples, seven (5%) were genotype 2a, two (2%) were genotype 2b, 26 (20%) were genotype 3a, three (2%) were genotype 4a, while 16 (12.5%) were of a mixed genotype. There was no significant difference between the three groups with regard to the prevalence of any specific genotype. However, in blood donors and haemophiliac patients there was a statistically significant difference in the occurrence of genotype 3a in patients with elevated alanine aminotransferase (ALT) levels (30.3%) compared with those patients with persistently normal ALT levels (5.6%; P = 0.004; chi 2). Genotype 3a was also uncommon in liver transplant patients (one of 14) with "sporadic' HCV infection. Genotype 4a was detected only in liver transplant patients. These patients had originated from Egypt (n = 1), Italy (n = 1) and Romania (n = 1).

With the aim of reducing the damage to platelets while effectively removing class I HLA antigens from their surfaces, we developed a new method using acidified chloroquine diphosphate. Platelets were treated with a 0.2 M solution of chloroquine diphosphate (pH 4.0). More than 90% of the platelets remained viable after treatment. While a marked reduction in reactions of acidified chloroquine-treated platelets with multispecific HLA antisera was noted in comparison with phosphate-buffered-saline-(PBS)-treated platelets, reactions with platelet-specific antibodies were preserved. This was demonstrated by immunofluorescence tests and solid-phase and monoclonal antibody immobilization of platelet antigen assays. Aggregation responses, though reduced in comparison with PBS-treated platelets, were still preserved after acidified chloroquine treatment. Ultrastructural analysis did not show any significant difference from PBS-treated platelets. We conclude that treatment of platelets with acidified chloroquine diphosphate is a simple and effective method for removing class I HLA antigens from their surfaces with minimal damage to their structure and function.