Ten commercial transport swabs were evaluated for their ability to preserve bacteria for 24 and 48 hours. Microorganisms included ATCC strains of Gram-positive and Gram-negative aerobes and anaerobes. There was a wide variation in performance. Swabs using Amies plus charcoal medium or Stuart's medium had better recovery rates than those using Amies medium alone. The nature of the tips of the swabs had little influence. Performance was not correlated with cost of the swabs. These data will assist institutions to make cost-effective decisions when purchasing bacteriological transport systems.

Over the last few years various studies have reported the advantage of low molecular weight heparin (LMWH) over standard unfractionated heparin (UFH). The advantages are stated to be ease of administration (once daily injection), the suggested non-requirement of monitoring for prophylaxis, fewer bleeding episodes and a greatly rôduced risk of venous thrombotic episodes when used in orthopaedic surgery. LMWH has greater bioavailability and greater duration of activity when Injected subcutaneously, with a longer biological half-life than UFH. the anti-thrombotic effects being due to the Inhibition of factor Xa. The commercial chromogenic assay tor measuring Anti-Xa activity (BERICHROM-HEPARIN) has been used as an Indicator of Fragmin activity. The method utilizes the principle that Factor Xa is inactivated by ATIII which Is catalysed by heparin. A pilot study of twenty patients undergoing either hip or knee surgery was undertaken to assess the standard dose recommended by the manufacturer (5000 IU/day lor high-risk' patients). In our study S.C. Fragmin 2500 U was given pre-operatively, with the premedication, followed by 2500 IU immediately post opetatively. The day following surgery and daily, for a total of 7 days Fragmin 50CO IU was administered at 6.00 a.m. and Anti-Xa assays collected 4 hours latee batched, and tested retrospectively. Other laboratory investigations included FBE and baseline APTT and INR. On day seven, photographs and ultrasound examination of the operated leg were undertaken. In the study 60% of patients had Anti-XA levels > 0.4 U/ml and all patients had levels > 0.2 U/mi. The mean Anti Xa level was 0.46 U/ml. These results were higher than expected. Patients with levels >0.4 U/ml being above the prophylactic range may have a higher risk of bleeding. Associated with these levels was significant blood loss. For knee surgery, the average blood loss was 1170 mis, with an average of 3.4 units transfused; for hip surgery the average toss was 1255 mis, with an average of 3.2 units transfused. In three patients unusual Wound blistering' was noted, and In 50% significant bruising was present at the operative site, with distal extension, uncharacteristic for the procedure. No clinical venous thrombosis was detected. In all patients, ultrasound was negative for thrombosis. In one patient only a DVT subsequently occurred three weeks post-operatively. In this study subjectively significant bleeding occurred with the recommended daily dose of 5000 IU SC. which may be substantiated by the higher than expected Anti-Xa levels. In order to avoid monitoring FRAGMIN for prophylaxis and m view of the above findings it is recommended that a dose réduction to 2S00 IU day be considered for knee surgery, and possibly for hip surgery. For the latter, this must be balanced against the thrombotic risks, and can only be elucidated by further studies. Over the last few years various studies have reported the advantage of low molecular weight heparin (LMWH) over standard unfractionated heparin (UFH). The advantages are stated to be ease of administration (once daily injection), the suggested non-requirement of monitoring for prophylaxis, fewer bleeding episodes and a greatly rôduced risk of venous thrombotic episodes when used in orthopaedic surgery. LMWH has greater bioavailability and greater duration of activity when Injected subcutaneously, with a longer biological half-life than UFH. the anti-thrombotic effects being due to the Inhibition of factor Xa. The commercial chromogenic assay tor measuring Anti-Xa activity (BERICHROM-HEPARIN) has been used as an Indicator of Fragmin activity. The method utilizes the principle that Factor Xa is inactivated by ATIII which Is catalysed by heparin. A pilot study of twenty patients undergoing either hip or knee surgery was undertaken to assess the standard dose recommended by the manufacturer (5000 IU/day lor high-risk' patients). In our study S.C. Fragmin 2500 U was given pre-operatively, with the premedication, followed by 2500 IU immediately post opetatively. The day following surgery and daily, for a total of 7 days Fragmin 50CO IU was administered at 6.00 a.m. and Anti-Xa assays collected 4 hours latee batched, and tested retrospectively. Other laboratory investigations included FBE and baseline APTT and INR. On day seven, photographs and ultrasound examination of the operated leg were undertaken. In the study 60% of patients had Anti-XA levels > 0.4 U/ml and all patients had levels > 0.2 U/mi. The mean Anti Xa level was 0.46 U/ml. These results were higher than expected. Patients with levels >0.4 U/ml being above the prophylactic range may have a higher risk of bleeding. Associated with these levels was significant blood loss. For knee surgery, the average blood loss was 1170 mis, with an average of 3.4 units transfused; for hip surgery the average toss was 1255 mis, with an average of 3.2 units transfused. In three patients unusual Wound blistering' was noted, and In 50% significant bruising was present at the operative site, with distal extension, uncharacteristic for the procedure. No clinical venous thrombosis was detected. In all patients, ultrasound was negative for thrombosis. In one patient only a DVT subsequently occurred three weeks post-operatively. In this study subjectively significant bleeding occurred with the recommended daily dose of 5000 IU SC. which may be substantiated by the higher than expected Anti-Xa levels. In order to avoid monitoring FRAGMIN for prophylaxis and m view of the above findings it is recommended that a dose réduction to 2S00 IU day be considered for knee surgery, and possibly for hip surgery. For the latter, this must be balanced against the thrombotic risks, and can only be elucidated by further studies.

This case reports the first description of Fitzgerald factor (high molecular weight kininogen) deficiency in Australia. Since this homozygous abnormality was found in an Aborigine it is suggested that the defective gene may be prevalent in some tribes and that abnormal results of clotting tests in Aborigines should be investigated carefully.

Hemoglobin Woodville was detected in a Vietnamese woman during antenatal and cord blood screening programs for families of South East Asian origin. The variant constitutes 9% of total hemoglobin and structural analysis demonstrated the substitution alpha 6 Asp----Tyr. Hematological data on the proposita were normal. No apparent clinical or pathological findings were associated with this abnormal hemoglobin.

Hemoglobin Woodville was detected in a Vietnamese woman during antenatal and cord blood screening programs for families of South East Asian origin. The variant constitutes 9% of total hemoglobin and structural analysis demonstrated the substitution α6 Asp → Tyr. Hematological data on the proposita were normal. No apparent clinical or pathological findings were associated with this abnormal hemoglobin.

Familial antithrombin III (AT III) deficiency, with mesenteric venous thrombosis, is reported in an Australian family. Antithrombin III was assayed chromogenically, fluorometrically, and immunologically. The deficiency was further analysed using crossed-immunoelectrophoresis. It is suggested that when AT III deficiency is suspected, both a functional and an immunological assay should be performed.

Platelets were harvested by a Hemonetics Model-30 discontinuous cell separator from 20 normal volunteers and were cryopreserved in the presence of 5% DMSO at a controlled rate of freezing of −1 °C/min and stored in liquid nitrogen for up to 3 months.

Summary A familial hypodysfibrinogenaemia occurring in four females with occasional haemorrhagic problems in an Adelaide family was investigated. Affected family members had slightly prolonged thrombin time, prothrombin time and Reptilase time tests, and apparently elevated levels of fibrin degradation products (FDPs). Fibrinogen assessed by reactivity with thrombin (Clauss method) was significantly less than fibrinogen determined by various other methods, though even by immunoquantitation fibrinogen levels were only slightly above half normal in affected family members. Isoelectric focussing (IEF) of the reduced patient's fibrinogen in urea/polyacrylamide gel revealed minor components with higher isoelectric points (pI) than present in normal fibrinogen or fibrin. These were shown to have a molecular weight similar to the alpha chain of fibrin by subsequent sodium dodecyl sulphate‐polyacrylamide gel electrophoresis (SDS‐PAGE). The abnormal species tended to remain in plasma after clotting with Reptilase or thrombin although polymerization of the clotted fibrin was normal. The magnitude of the pI shift relative to normal fibrin alpha chain indicated an increased positive charge on the abnormal species.

A lupus anticoagulant was detected in plasma from two pairs of siblings using the kaolin clotting time mixing test. Strong evidence for this inhibitor in one further sibling pair is presented. Although coagulation abnormalities are usually classified as either acquired or of genetic origin it is apparent that the lupus anticoagulant might often be an acquired coagulation defect requiring genetic predisposition.