Blood transfusion per se may not be a risk factor for poor prognosis after colorectal cancer surgery. However, the combination of perioperative blood transfusion and subsequent development of postoperative infectious complications may be associated with a poor prognosis.

Transfusion of buffy-coat-depleted red cells suspended in saline, adenine, glucose, and mannitol blood stored for < 21 days may be an independent risk factor for development of recurrence after elective colorectal cancer surgery.

The sVEGF (isotype 165) appears to be present in various blood transfusion components, depending on storage time.

Recipient cytokine release induced by blood transfusion seems to be dependent on storage time. This may have implications in transfusion-induced immune modulation.

SummaryTwelve patients had their arterial oxygen saturation measured pre-operatively and on days 1 , 4 and 7 after laparotomy.Measurements were performed in the supine, sitting and standing positions on each day. Arterial oxygen saturation was significantly higher during sitting and standing on days 1 and 4 after operation compared with the supine position dp < 0.05).These results give further evidence for the benefits of patient mobilisation after major surgery. Key wordsComplications; postoperative, hypoxia. Position.It is well established that pulmonary function deteriorates after major surgery with a maximum decrease in functional residual capacity (FRC) at approximately 16 h after operation and a gradual recovery towards pre-operative levels during the first postoperative week [l]. Similarly, the effect of posture on pulmonary mechanics is known to decrease FRC in the supine compared to the sitting position [2]. As hypoxaemia may be a pathogenic factor in postoperative organ dysfunction [3-91 and since many postoperative patients stay in the supine or semirecumbent position after major operations, we decided to study the effect of posture on oxygenation in the late postoperative period. MethodsTwelve patients gave their informed consent to be included in the study which had received local ethics committee approval. All patients were scheduled for major intraabdominal surgery. None of the patients was receiving any regular medication before operation and patients with thoracic deformities or symptoms of neurological, cardiac or respiratory disease were not studied. If patients subsequently required supplemental oxygen therapy later than 6 h after operation they were withdrawn from the study. All patients received a standard general anaesthetic regimen (thiopentone, midazolam, low-dose fentanyl, suxamethonium, pancuronium and nitrous oxide in oxygen), and postoperative analgesia was provided with morphine or ketomebidone 5-1 0 mg given intramuscularly on demand. Regional anaesthesia was not used during the per-and postoperative period.Arterial oxygen saturation (Spoz) was monitored with a pulse oximeter (Nellcor N-200, Nellcor Inc., Pleasanton, CA, USA) using an adhesive finger probe for three periods of 10 min, on each day of monitoring. The mean Spo, for each 10-min period was used in the data analysis. The monitoring periods were conducted with the patient in the supine position, sitting in bed (70") and standing. Before any measurements were made the patient had rested for 30 min in bed. Measurements were performed pre-operatively and 1, 4 and 7 days after operation and were always performed in the afternoon. At the same time, pulmonary function was assessed by measurement of peak expiratory flow (PEF), forced vital capacity (FVC) and forced expiratory volume in the first second (FEV,) using a mini Wright's respirometer and a Vitalograph. For the pulmonary function tests the patient was always in the sitting position. On every day of the study pain scores (verbal rating, 0 = no pain, 1 =discomfort, 2 = sl...

CgA concentrations in plasma have a high diagnostic accuracy in monitoring patients with ileo-cecal neuroendocrine tumors. In particular, an increase in plasma CgA concentration was useful to indicate tumor progression.

Objectives: TNF-α and IL-2 are important cytokines in macrophage and T-lymphocyte activity against infection and dissemination of malignant cells. We studied the influence of supernatants from stored whole blood and buffy-coat-depleted SAGM (saline, adenine, glucose and mannitol) blood in stimulating TNF-α and IL-2 release in an ex vivo assay. Methods: Supernatants of 10 units of whole blood and 10 units of SAGM blood were collected after 1, 21 and 35 days of standard blood bank storage. Heparinized blood from 20 healthy volunteers (as ‘recipients’), corresponding in ABO and Rh type to the stored blood, were used in a culture system with LPS and PHA as stimulators of TNF-α and IL-2 release. The effect of added supernatants, from either stored whole blood or SAGM blood, on cytokine release was evaluated compared to saline as control. TNF-α concentration was analyzed by ELISA after culture for 24 h and IL-2 after 72 h, respectively. Results: Supernatants from both stored whole blood and SAGM blood showed a significant decrease in both LPS- and PHA-stimulated TNF-α release that was dependent on storage time. IL-2 was not detected in response to LPS stimulation. PHA-stimulated IL-2 release was significantly reduced and related to storage time of both whole blood and SAGM blood. Conclusions: Recipient cytokine release induced by blood transfusion seems to be dependent on storage time. This may have implications in transfusion-induced immune modulation.

Summary.We studied extracellular accumulation in buffycoat-derived platelet pools suspended in platelet additive solutions (PAS). 20 platelet pools were prepared from buffy coats of 60 donors and stored in either PAS I (n ¼ 10) or PAS II (n ¼ 10). Samples were drawn from the donors to determine the normal range of histamine, plasminogen activator inhibitor 1 (PAI-1), myeloperoxidase (MPO) and interleukin (IL)-6. After preparation samples were collected on days 0, 5 and 7 from the 20 platelet pools respectively, to determine extracellular accumulation of the same substances. Extracellular histamine, PAI-1 and MPO were detected in significant levels (P < 0·0001) immediately after preparation of the platelet pools. Only the extracellular level of PAI-1 increased significantly during storage from day 0 to day 7 (P < 0·01). After preparation and storage to day 7 IL-6 was found in only three of the 20 platelet pools.Even though platelets were prepared by the buffy-coat method, to produce a low leucocyte count and thereby low cytokine (IL-6) content, there was still significant contamination by other bioactive substances.