bluuebunny/crossref_metadata_2025 huggingface dataset:
Extraction of Diethylhexylphthalate by Home Total Parenteral Nutrition From Polyvinyl Chloride Infusion Lines Commonly Used in the Home
Authors: Loff Steffan , Hannmann Torsten , Subotic Ulrike , Reinecke Franziska‐Maria , Wischmann Hartmut , Brade Joachim
Published: March 2009

Objectives:

Recently, our group detected that polyvinyl chloride (PVC) perfusion lines leach large amounts of the toxic plasticizer diethylhexylphthalate (DEHP) under conditions typical of intensive care units. In the present study, we investigated the extraction of DEHP from PVC connecting tubes that are commonly used for total parenteral nutrition (TPN) solutions. The aim of the study was to estimate the amount of DEHP to which children receiving home TPN are exposed for months and years.

Materials and Methods:

1000 mL of TPN, identical in constitution and amount to the home TPN of 1 of our patients, were perfused through 5 different connecting tube systems and collected in hexane‐rinsed glass bottles. The concentration of DEHP in the TPN was analyzed before and after perfusion.

Results:

Before perfusion of the lines, the solution had a DEHP concentration of 0.05 to 0.69 μg/mL (baseline value). After perfusion of the lines, the load of DEHP in the solution varied between 1.41 and 2.07 μg/mL. This TPN was established for children weighing 20 kg. The daily dosage is between 71 and 104 μg · kg−1· day−1. TPN is administered at home for many months and years. The monthly charge of DEHP is between 42.3 and 62.1 mg. Children weighing 20 kg therefore receive a dosage between 2.1 and 3.1 mg · kg−1· month−1.

Conclusions:

Diethylhexylphthalate and its metabolite monoethylhexylphthalate have been demonstrated to be carcinogenic, embryotoxic, hepatotoxic, pneumotoxic, and cardiotoxic and are known to disrupt endocrine pathways and liver detoxifying capacity in animals. They are suspected of having multiple effects in humans as well. The doses presented above should therefore be avoided in children receiving home TPN by the use of tubing systems that are completely free of DEHP. Such systems are available.
Anti‐NSP4 Antibody Can Block Rotavirus‐induced Diarrhea in Mice
Authors: Hou Zongliu , Huang Yongkun , Huan Youming , Pang Wei , Meng Mingyao , Wang Ping , Yang Meifen , Jiang Lihong , Cao Xinan , Wu Kenneth K
Published: March 2009

Background:

Rotavirus infection is the most common cause of infectious diarrhea and gastroenteritis among children worldwide. The viral proteins (VP), especially VP4‐ and VP7‐induced neutralizing antibodies, were considered to be critical in protective immunity to rotavirus disease. However, whether the antibody to rotavirus nonstructural protein 4 (NSP4) protects against rotavirus‐induced diarrhea directly is not completely clear, especially for the protective time course.

Materials and Methods:

To obtain direct evidence, 12‐day‐old ICR mice were treated with NSP4 and entire rotavirus to induce diarrhea.

Results:

Both NSP4 and rotavirus‐treated mice developed diarrhea, which was accompanied by histological changes in the small intestine compared to age‐matched control mice. Anti‐NSP4 antibody demonstrated protection against both entire rotavirus‐induced diarrhea and NSP4‐induced diarrhea. The histological changes in the small intestinal were reversible. These data show that early intervention with anti‐NSP4 antibody can prevent rotavirus‐induced diarrhea in mice; late intervention with anti‐NSP4 antibody could halt diarrhea progression in mice.

Conclusions:

Our findings demonstrate for the first time that administration of anti‐NSP4 antibody is effective both prior to and during the time course of rotavirus infection. These observations extend our knowledge of rotavirus infection and its therapeutic options.
Impact of Upper Gastrointestinal Endoscopic Ultrasound in Children
Authors: Bjerring OS , Durup J , Qvist N , Mortensen MB
Published: March 2009

The impact and feasibility of upper gastrointestinal endoscopic ultrasound (EUS) in younger children are unknown. We retrospectively reviewed the EUS procedures we had performed in children younger than 16 years with regard to feasibility, safety, and impact on further treatment. In all, 18 patients (12 boys, 6 girls; median age 12 years, range 0.5–15) underwent EUS. The indications were as follows: tumor (9), epigastric pain (3), recurrent pancreatitis (2), unexplained jaundice (2), hypoglycemia (1), and von Hippel‐Lindau disease (1). We concluded that EUS had a significant impact in 78% of the cases. EUS seems to be a safe, feasible, and valuable diagnostic tool.
Fatty Acids and Neurodevelopment
Authors: Belkind‐Gerson J , Carreón‐Rodríguez A , Contreras‐Ochoa CO , Estrada‐Mondaca S , Parra‐Cabrera MS
Published: March 2009

Knowledge of the importance of docosahexaenoic acid (DHA), arachidonic acid (AA), and long‐chain polyunsaturated fatty acids (LCPUFAs) in neurodevelopment was originally obtained from animal studies. These fatty acids are rapidly accreted in brain during the first postnatal year in animal and human infants, and they are found in high concentrations in breast milk. Reports of enhanced intellectual development in breast‐fed children, and reports linking LCPUFA deficiency with neurodevelopmental disorders have stressed the physiological importance of DHA in visual and neural systems. In addition to high concentrations of fatty acids in breast milk, they are also present in fish and algae oil and have recently been added to infant formulas. Esterified poplyunsaturated fatty acids act in cellular membranes, in signal transduction, in neurotransmission, and in the formation of lipid rafts. Nonesterified polyunsaturated fatty acids can modulate gene expression and ion channel activities, thus becoming neuroprotective agents. The conversion of linoleic acid and α‐linolenic acid into ARA and DHA have led to randomized clinical trials that have studied whether infant formulas supplemented with DHA or both DHA and ARA would enhance visual and cognitive development. This review gives an overview of fatty acids and neurodevelopment, focusing on the findings from these studies.
Acute Malnutrition in Latin America: The Challenge of Ending Avoidable Deaths
Authors: Weisstaub Gerardo , Araya Magdalena
Published: March 2009

In Latin America and the Caribbean, malnutrition still represents a health concern expressed mainly as stunting and micronutrient deficiencies, lessening the attention given to acute malnutrition (moderate and severe); however, the latter has a high fatality rate. Ending these avoidable deaths represents a major health and ethical challenge in the region. Acute malnutrition plus infections (mainly diarrhea and pneumonia) determine an important fraction of the fatality rate due to malnutrition in most regions, especially those with higher poverty and social instability. Application of the World Health Organization guidelines for the treatment of children with acute severe malnutrition reduces the fatality rate significantly. Among the many possibilities for treatment, systems based on day care centers and at home should be promoted. Training in the application of the World Health Organization guidelines should be incorporated into the curricula of health‐related professions in countries where malnutrition is prevalent.
MERIT40 controls BRCA1–Rap80 complex integrity and recruitment to DNA double-strand breaks
Authors: Shao Genze , Patterson-Fortin Jeffrey , Messick Troy E. , Feng Dan , Shanbhag Niraj , Wang Yingqun , Greenberg Roger A.
Published: March 2009

Rap80 targets the breast cancer suppressor protein BRCA1 along with Abraxas and the BRCC36 deubiquitinating enzyme (DUB) to polyubiquitin structures at DNA double-strand breaks (DSBs). These DSB targeting events are essential for BRCA1-dependent DNA damage response-induced checkpoint and repair functions. Here, we identify MERIT40 (Mediator of Rap80 Interactions and Targeting 40 kD)/(C19orf62) as a Rap80-associated protein that is essential for BRCA1–Rap80 complex protein interactions, stability, and DSB targeting. Moreover, MERIT40 is required for Rap80-associated lysine63–ubiquitin DUB activity, a critical component of BRCA1–Rap80 G2 checkpoint and viability responses to ionizing radiation. Thus, MERIT40 represents a novel factor that links BRCA1–Rap80 complex integrity, DSB recognition, and ubiquitin chain hydrolytic activities to the DNA damage response. These findings provide new molecular insights into how BRCA1 associates with independently assembled core protein complexes to maintain genome integrity.
Scalp dermoscopy of androgenetic alopecia in Asian people
Authors: INUI Shigeki , NAKAJIMA Takeshi , ITAMI Satoshi
Published: March 2009

Although dermoscopy is used mainly for diagnosing pigmented skin lesions, this device has been reported to be useful in observing alopecia areata and frontal fibrosing alopecia. Herein, we investigated the dermoscopic features and their incidence of androgenetic alopecia (AGA; n = 50 men) and female AGA (FAGA; n = 10 women) in Asian people. More than 20% hair diameter diversity (HDD), which reportedly is an early sign of AGA and corresponds to hair follicle miniaturization, was observed in the affected area of all AGA and FAGA cases, suggesting that HDD is an essential feature to diagnose AGA and FAGA. Peripilar signs, corresponding to perifollicular pigmentation, were seen in 66% (33/50) of AGA and 20% (2/10) of FAGA women. This incidence in the present study was lower than previously reported in white subjects possibly because the Asian skin color conceals slight peripilar pigmentation. Yellow dots were observed in 26% (13/50) of AGA and 10% (1/10) of FAGA cases and the number of yellow dots in AGA and FAGA was limited to 10 on the overall hair loss area. Yellow dots possibly indicate the coincidence of AGA and enlargement of the sebaceous glands caused by common end‐organ hypersensitivity to androgen. In conclusion, dermoscopy is useful to diagnose AGA and FAGA and provides insights into the pathogenesis of AGA.
Case of herpes zoster duplex bilateralis
Authors: SHIN Bong Seok , SEO Hyun Deok , NA Chan Ho , CHOI Kyu Chul
Published: March 2009

Non‐contiguously simultaneous development of herpes zoster is very rare. It is named either herpes zoster duplex unilateralis or bilaterarlis, depending on whether one or both sides of the body are involved. Herein, we report a 21‐year‐old man, who had been treated for ulcerative colitis with prednisolone, and presented with painful grouped vesicles of the lower abdomen and back in a relatively symmetrical distribution. A Tzanck smear and punch biopsy were performed on the vesicles of the back. We report a rare case of symmetrical herpes zoster duplex bilateralis.
STrengthening the REporting of Genetic Association studies (STREGA) – an extension of the STROBE statement
Authors: Little Julian , Higgins Julian P.T. , Ioannidis John P.A. , Moher David , Gagnon France , Von Elm Erik , Khoury Muin J. , Cohen Barbara , Davey‐Smith George , Grimshaw Jeremy , Scheet Paul , Gwinn Marta , Williamson Robin E. , Zou Guang Yong , Hutchings Kim , Johnson Candice Y. , Tait Valerie , Wiens Miriam , Golding Jean , Van Duijn Cornelia , McLaughlin John , Paterson Andrew , Wells George , Fortier Isabel , Freedman Matthew , Zecevic Maja , King Richard , Infante‐Rivard Claire , Stewart Alex , Birkett Nick
Published: March 2009

Making sense of rapidly evolving evidence on genetic associations is crucial to making genuine advances in human genomics and the eventual integration of this information in the practice of medicine and public health. Assessment of the strengths and weaknesses of this evidence, and hence the ability to synthesize it, has been limited by inadequate reporting of results. The STrengthening the REporting of Genetic Association studies (STREGA) initiative builds on the STrengthening the Reporting of OBservational Studies in Epidemiology (STROBE) Statement and provides additions to 12 of the 22 items on the STROBE checklist. The additions concern population stratification, genotyping errors, modelling haplotype variation, Hardy–Weinberg equilibrium, replication, selection of participants, rationale for choice of genes and variants, treatment effects in studying quantitative traits, statistical methods, relatedness, reporting of descriptive and outcome data and the volume of data issues that are important to consider in genetic association studies. The STREGA recommendations do not prescribe or dictate how a genetic association study should be designed, but seek to enhance the transparency of its reporting, regardless of choices made during design, conduct or analysis.
Development of an instrument to measure the quality of documented nursing diagnoses, interventions and outcomes: the Q‐DIO
Authors: Müller‐Staub Maria , Lunney Margaret , Odenbreit Matthias , Needham Ian , Lavin Mary Ann , Van Achterberg Theo
Published: March 2009

Aims and objectives.  This paper aims to report the development stages of an audit instrument to assess standardised nursing language. Because research‐based instruments were not available, the instrument Quality of documentation of nursing Diagnoses, Interventions and Outcomes (Q‐DIO) was developed.

Background.  Standardised nursing language such as nursing diagnoses, interventions and outcomes are being implemented worldwide and will be crucial for the electronic health record. The literature showed a lack of audit instruments to assess the quality of standardised nursing language in nursing documentation.

Design.  A qualitative design was used for instrument development.

Methods.  Criteria were first derived from a theoretical framework and literature reviews. Second, the criteria were operationalised into items and eight experts assessed face and content validity of the Q‐DIO.

Results.  Criteria were developed and operationalised into 29 items. For each item, a three or five point scale was applied. The experts supported content validity and showed 88·25% agreement for the scores assigned to the 29 items of the Q‐DIO.

Conclusions.  The Q‐DIO provides a literature‐based audit instrument for nursing documentation. The strength of Q‐DIO is its ability to measure the quality of nursing diagnoses and related interventions and nursing‐sensitive patient outcomes. Further testing of Q‐DIO is recommended.

Relevance to clinical practice.  Based on the results of this study, the Q‐DIO provides an audit instrument to be used in clinical practice. Its criteria can set the stage for the electronic nursing documentation in electronic health records.
Effects of a preceptorship programme on turnover rate, cost, quality and professional development
Authors: Lee Tso‐Ying , Tzeng Wen‐Chii , Lin Chia‐Huei , Yeh Mei‐Ling
Published: March 2009

Aim and objectives.  The purpose of the present study was to design a preceptorship programme and to evaluate its effects on turnover rate, turnover cost, quality of care and professional development.

Background.  A high turnover rate of nurses is a common global problem. How to improve nurses’ willingness to stay in their jobs and reduce the high turnover rate has become a focus. Well‐designed preceptorship programmes could possibly decrease turnover rates and improve professional development.

Design.  A quasi‐experimental research design was used.

Methods.  First, a preceptorship programme was designed to establish the role and responsibilities of preceptors in instructing new nurses. Second, a quasi‐experimental design was used to evaluate the preceptorship programme. Data on new nurses’ turnover rate, turnover cost, quality of nursing care, satisfaction of preceptor’s teaching and preceptor’s perception were measured.

Results.  After conducting the preceptorship programme, the turnover rate was 46·5% less than the previous year. The turnover cost was decreased by US$186,102. Additionally, medication error rates made by new nurses dropped from 50–0% and incident rates of adverse events and falls decreased. All new nurses were satisfied with preceptor guidance.

Conclusions.  The preceptorship programme effectively lowered the turnover rate of new nurses, reduced turnover costs and enhanced the quality of nursing care, especially by reducing medication error incidents. Positive feedback about the programme was received from new nurses.

Relevance to clinical practice.  Study findings may offer healthcare administrators another option for retaining new nurses, controlling costs, improving quality and fostering professional development. In addition, incentives and effective support from the organisation must be considered when preceptors perform preceptorship responsibilities.
A literature review of the application of the Geriatric Depression Scale, Depression Anxiety Stress Scales and Post‐traumatic Stress Disorder Checklist to community nursing cohorts
Authors: Allen Jacqui , Annells Merilyn
Published: March 2009

Aims and objectives.  To explore through literature review the appropriateness of three common tools for use by community nurses to screen war veteran and war widow(er) clients for depression, anxiety and post‐traumatic stress disorder.

Background.  War veterans and, to a lesser extent, war widow(er)s, are prone to mental health challenges, especially depression, anxiety and post‐traumatic stress disorder. Community nurses do not accurately identify such people with depression and related disorders although they are well positioned to do so. The use of valid and reliable self‐report tools is one method of improving nurses’ identification of people with actual or potential mental health difficulties for referral to a general practitioner or mental health practitioner for diagnostic assessment and treatment. The Geriatric Depression Scale, Depression Anxiety Stress Scales and Post‐traumatic Stress Disorder Checklist are frequently recommended for mental health screening but the appropriateness of using the tools for screening war veteran and war widow(er) community nursing clients who are often aged and have functional impairment, is unknown.

Design.  Systematic review.

Conclusions.  Current literature informs that the Geriatric Depression Scale accurately predicts a diagnosis of depression in community nursing cohorts. The three Depression Anxiety Stress Scales subscales of depression, anxiety and stress are valid; however, no studies were identified that compared the performance of the Depression Anxiety Stress Scales in predicting diagnoses of depression or anxiety. The Post‐traumatic Stress Disorder Checklist predicts post‐traumatic stress disorder in community cohorts although no studies meeting the selection criteria included male participants.

Relevance to clinical practice.  This review provides recommendations for the use of the Geriatric Depression Scale, Depression Anxiety Stress Scales and The Post‐traumatic Stress Disorder Checklist based on examination of the published evidence for the application of these screening tools in samples approximated to community nursing cohorts. Findings and recommendations would guide community nurses, managers and health planners in the selection of mental health screening tools to promote holistic community nursing care.
Sequential processing of hepatitis C virus core protein by host cell signal peptidase and signal peptide peptidase: a reassessment
Authors: Pène V. , Hernandez C. , Vauloup‐Fellous C. , Garaud‐Aunis J. , Rosenberg A. R.
Published: March 2009

Summary.  Hepatitis C virus (HCV) core protein is believed to play critical roles in the virus morphogenesis and pathogenesis. In HCV polyprotein, core protein terminates with a signal peptide followed by E1 envelope protein. It has remained unclear whether cleavage by host cell signal peptidase (SP) at the core‐E1 junction to generate the complete form of core protein, which is anchored in the endoplasmic reticulum membrane, is absolutely required for cleavage within the signal peptide by host cell signal peptide peptidase (SPP) to liberate the mature form of core protein, which is then free for trafficking to lipid droplets. In this study, the possible sources of disagreement in published reports have been examined, and we conclude that a product generated upon inhibition of SP‐catalysed cleavage at the core‐E1 junction in heterologous expression systems was incorrectly identified as mature core protein. Moreover, inhibition of this cleavage in the most relevant model of human hepatoma cells replicating a full‐length HCV genome was shown to abolish interaction of core protein with lipid droplets and production of infectious progeny virus. These results firmly establish that SPP‐catalysed liberation of mature core protein is absolutely dependent on prior cleavage by SP at the correct core‐E1 site to generate the complete form of core protein, consistent with this obligatory order of processing playing a role in HCV infectious cycle.
Preparation and Properties of a Heat‐Treated Human Plasma Protein Fraction
Authors: HINK JOHN H. , HIDALGO JOHN , SEEBERG VICTOR P. , JOHNSON FREDERICK F.
Published: March 2009

By precipitating a particular mixture of albumins and globulins from an Effluent IV‐1 prepared by a modified fractionation procedure, a safe and osmotically active fraction was obtained from human plasma in high yield. The HTPF thus obtained is devoid of cat depressor activity. Both fibrinogen and gamma globulin can be recovered from plasma by the method described.

Technical details concerning the preparation of HTPF are given. Results of physico‐chemical measurements show that during heating at 60°C. for over 10 hours little change occurs to the proteins present in HTPF. Pharmacological data show HTPF to be an effective plasma volume expander.

Par précipitation d'un mélange particulier d'albumines et de globulines provenant d'un Effluent IV‐1 préparé par un procédé de fractionnement modifié, les auteurs ont pu obtenir à grand rendement une fraction de plasma humain ne présentant pas de danger de transmission de l'hépatite et d'une activité osmotique satisfaisante. Cette HTPF (heat‐treated plasma fraction) est dépourvue d'effet dépresseur chez le chat. La méthode employée pour l'obtenir permet aussi de récupérer la fibrinogène et la gammaglobuline. Les détails technique de la méthode sont décrits. L'analyse physio‐chimique a montré qu'après 10 heures de chauffage à 60° les protéines présentes dans l'HTPF ont été à peine modifiées. Des études pharmacologiques il ressort que l'HTPF est un expanseur plasmatique efficace.

Durch Ausfällen einer Albumin‐Globulin‐Mischung aus einem nach einer modifizierten Fraktionierungsmethode gewonnenen Eluat IV‐1 gelingt es, aus menschlichem Mischplasma eine pasteurisierbare und daher hepatitissichere Fraktion mit hoher osmotischer Aktivität in guter Ausbeute zu gewinnen. Diese als HTPF bezeichnete Lösung zeigt an der Katze keine Depressoraktivität. Als Nebenprodukte können bei diesem Verfahren aus dem Plasma Fibrinogen und Gamma‐globulin gewonnen werden. Die technische Herstellung von HTPF wird eingehend beschrieben. Physikochemische Untersuchungen zeigten, daß die im HTPF enthaltenen Proteine durch die Pasteurisation nur unbedeutende Veränderungen erleiden. Pharmakologische Untersuchungen zeigten, daß HTPF ein wirksames Präparat zur Kreislauffüllung darstellt.
Studies on the Nature of the Immune Adherence Receptor
Authors: Nelson D. S. , Uhlenbruck G.
Published: March 2009

Studies were made on the inhibitory effects of various substances on haemagglutination due to immune adherence of sheep erythrocyte‐antibody‐complement complexes (EAC′) to human erythrocytes. Two methods of measuring inhibition were tested. The more satisfactory of these was semi‐quantitative and involved determination of the number of EAC′ complexes, formed with a fixed amount of complement, required to produce immune adherence haemagglutination in the presence and in the absence of inhibitor. Ghosts prepared by lysis of normal human erythrocytes in distilled water or by freezing and thawing inhibited immune adherence haemagglutination. Ghosts from non‐reactive animal or human erythrocytes or from papain‐treated human erythrocytes did not inhibit immune adherence haemagglutination. Ageing of erythrocytes in vitro was accompanied by loss of inhibitory power of ghosts prepared from them. Some mucoids extracted from human erythrocytes and most samples of mucopeptides extracted from human erythrocytes were inhibitory. Comparison of the inhibitory power of ghosts and mucopeptides indicated that considerable loss of activity occurred during extraction. It is suggested that the immune adherence receptor was partially degraded during extraction and that the mucopeptides acted as ‘incomplete analogues' of the receptor. It is considered more likely that the immune adherence receptor lies in the peptide part of such material than in the carbohydrate part. Neuraminic acid had no inhibitory activity. Active inhibitors were also extracted from bovine erythrocytes and human platelets, which do not react in immune adherence. The possibility is suggested that the immune adherence receptor may be present but masked or present in incomplete form on some non‐reactive cells.
24‐Hour Survival of ACD‐ and CPD‐Stored Red Cells
Authors: Valeri C. R. , Szymanski I. O. , Zaroulis C. G.
Published: March 2009

Abstract. Using an automated differential agglutination procedure, 218 red cell survival studies were performed in patients requiring therapeutic transfusion. Blood was collected in acid‐citrate‐dextrose (ACD) or citrate‐phosphate‐dextrose (CPD). Some of the blood was stored as such and some as concentrated red cells. Adverse effects of storage on both washed and nonwashed whole blood and concentrated red cells were determined by 24‐hour posttransfusion survival measurements. There were no significant differences in the storage limitations of non‐washed ACD‐ and CPD‐collected whole blood, and concentrated red cells. Washing stored red cells with either buffered or nonbuffered 0.9% sodium chloride solution with or without glucose did not significantly affect 24‐hour survival. However, there was a significant decrease in survival when stored red cells were washed with CPD solution or with a buffered 0.9% sodium chloride solution supplemented with calcium and magnesium.
Possible Relationship between Concanavalin A Reactivity and the Bovine A Blood Group System
Authors: Hines H. C. , Uhlenbruck G. , Schmid D. O.
Published: March 2009

Abstract. Intraspeciflc variation was observed in the agglutinability of trypsin‐treated bovine erythrocytes by Concanavalin A. There was a significant relationship between Concanavalin A agglutinability and the presence of bovine blood group factor A.
BS II Lectin: A Second Hemagglutinin Isolated from Bandeiraea Simplicifolia Seeds with Affinity for type III Polyagglutinable Red Cells
Authors: Judd W. J. , Beck M. L. , Hicklin B. L. , Iyer P. N. Shankar , Goldstein I. J.
Published: March 2009

Abstract. BS II lectin, a second hemagglutinin isolated from Bandeiraea Simplicifolia seeds, agglutinated the red cells from 11 patients manifesting the ‘acquired B’ antigen phenomenon. The results of serological studies indicate that this lectin has specificity for the type III polyagglutinable receptors rather than for the ‘B‐like’ antigens present on ‘acquired B’ red cells.

Two other blood samples which did not possess ‘acquired B’ antigens were also found to react with BS II lectin. Both of these samples were shown to have properties similar to those reported for Tk red cells. The serological characteristics of red cells modified in vitro by a culture broth of Bacteroides fraglis suggest that type III polyagglutinable receptors are identical to those associated with Tk red cells.
Serological Characteristics of the Third Anti‐Aua
Authors: Drachmann Ole , Thyme Steen , Tippett Patricia
Published: March 2009

The third example of anti‐Aua is reported. The antibody, probably immune in origin, was detected 37 years after a single pregnancy. The serological and immunological features of anti‐Aua are discussed.
Zeta Potentials, van der Waals Forces and Hemagglutination
Authors: van Oss C.J. , Absolom D.R.
Published: March 2009

Abstract. It has recently become possible to determine the van der Waals (Hamaker) coefficient of erythrocytes, whilst their ζ‐potential has been known for some time. With these two data the net potential energy of interaction versus distance diagrams could be elaborated for unsensitized human erythrocytes suspensed in saline water, as well as for erythrocytes monogamously sensitized with anti‐D (Rh0) antibodies of the IgG class. Unsensitized erythrocytes can approach each other, to within ≅ 79 Å of their sialoglycoprotein surfaces, leaving a distance between their actual cell membranes of ≅ 180 Å, which is considerably more than the maximum distance between the two valencies of an IgG molecule (≅ 120 Å). This explains why unaided anti‐D (Rh0) antibodies of the IgG class cannot cross‐link two D (Rh0)‐positive erythrocytes, although cross‐linking can easily be achieved with IgM class antibodies. D (Rh0)‐positive erythrocytes, monogamously sensitized with antibodies of the IgG class, can approach each other to within ≅ 60 Å (between the Fc ends of the protruding antibodies), which makes cross‐linking by means of anti‐IgG antibodies of the IgG class feasible.
Immune Response to Chronic Red Blood Cell Transfusion
Authors: Blumberg Neil , Peck Kathy , Ross Karen , Avila Eduardo
Published: March 2009

Abstract. Patients receiving chronic transfusion for aplastic anemia or hemoglobinopathy are believed to be at high risk for developing red blood cell alloantibodies, while those undergoing chemotherapy for leukemia are believed to be at low risk. To test this hypothesis, we studied the acquisition of new alloantibodies in 703 transfused patients. While none of 99 patients with lymphocytic leukemia made new antibodies, patients with myelogenous leukemia (16%), hemoglobinopathy (29%), aplastic anemia (11%), gastrointestinal bleeding (11%) or renal failure (14%) made antibodies at statistically similar rates. Lymphocytic leukemia or its treatment is characterized by a lack of immunologic response to transfusion. Patients with hemoglobinopathy or aplastic anemia do not appear at statistically significant greater risk of alloimmunization than many other patients requiring chronic transfusion. Neither intensive chemotherapy for myelogenous leukemia nor the uremia of renal failure significantly suppress the formation of blood group antibodies.
Cross‐Reactions in the HLA System Revealed by Red Blood Cells Expressing HLA Determinants, with Particular Reference to Cross‐Reaction between HLA‐A2 and B17
Authors: Nordhagen R.
Published: March 2009

Abstract. Sera with cytotoxic and haemagglutinating activity towards HLA‐A2/28 were also shown to react with red blood cells (RBC) expressing the HLA‐B17 antigen determinant. Absorption procedures with white blood cells (WBC) indicated that this was due to an HLA‐A2/B17 cross‐reaction. Absorption experiments with some other sera which previously had shown cytotoxic and haemagglutinating activity towards different HLA specificities, revealed broad cross‐reactions related to HLA‐B locus antigens.
Plasma Exchange in Autoimmune Thrombocytopenic Purpura
Authors: Cotter F.E. , Newland A.C. , Turnbull A.L.
Published: March 2009

Abstract. We present data on 5 cases with autoimmune thrombocytopenic purpura treated with plasma exchange in whom conventional drug therapy had been ineffective. In 3, preparation for splenectomy allowed the operation to be performed without bleeding problems. 1 patient who was unfit for splenectomy underwent successful coronary artery vein grafting following preparation with plasma exchange. 2 patients were maintained for variable periods with intermittent exchanges, 1 prior to splenectomy and 1 post‐splenecto‐my.

In summary we had no prolonged response to plasma exchange but found it a useful technique as preparation for or adjunctive to more conventional therapy. It was also helpful in patients unresponsive to other forms of therapy who required a brief increase in platelet count to cover surgery or spontaneous haemorrhage.
Reticuloendothelial Cell Function in a‐Methyldopa‐Induced Hemolytic Anemia
Authors: Branch Donald R. , Gallagher Michael T. , Shulman Ira A. , Mison Angeles P. , Hian Anita L. Sy Siok , Petz Lawrence D.
Published: March 2009

Abstract. 2 patients having α‐methyldopa‐induced hemolytic anemia were followed sequentially using an in vitro assay of autologous monocyte‐macrophage activity to determine if their reticuloendothelial system (RES) function was abnormal and thus could be related to the mechanism of lysis. RES function was evaluated while the patients were actively hemolyzing and during remission, following discontinuance of the drug. The results indicated that RES activity is normal in patients having hemolytic anemia due to a‐methyldopa administration. Also, following cessation of drug therapy, the patients' IgG‐coated red cells interacted significantly for a prolonged period (4–5 months) with autologous or normal allogeneic monocyte‐macrophages. This was associated with a concurrent reti‐culocytosis and indicates a persistent low‐level hemolytic phase throughout this period, even though hemoglobin and hematocrit values remained within the normal ranges. Although levels of IgG sensitizing the patients' red cells were essentially constant during the hemolytic phase and when the patients were in complete remission, significant monocyte‐macrophage activity was only evident during the hemolytic period. In an attempt to explain this phenomenon, it is postulated that hemolysis in patients receiving α‐methyldopa is related to the interaction of drug with red cell membrane proteins which results in a variably expressed ‘altered’ antigen which is recognized by ‘autoantibody’. The proper expression of the Fc portion of the immunoglobin molecule to result in specific recognition by receptors on monocyte‐macrophages depends upon the extent of the antigen alteration by α‐methyldopa. If the drug does not result in appropriate antigen alteration, then, although ‘autoantibody’ may still bind to the red blood cell, its Fc region is not readily recognized by monocyte‐macrophages and little or no erythrophagocytosis occurs.
A New Low‐Frequency Antigen, Hga (Hughes)1
Authors: Rowe G. P. , Hammond W.
Published: March 2009

Abstract. This paper describes a ‘new’ low‐frequency antigen, Hga which came to light during routine antibody identification tests. 3 families were investigated, 2 found during the screening of 5,434 random group 0 donors, giving a frequency of 1:2717. The families showed the antigen to be inherited as a Mendelian autosomal dominant character segregating independently of: Rh, MNS and is not linked to X or Y. No pure examples of the corresponding antibody have been discovered in testing 6,580 sera from normal donors in South Wales.
Study of a Family with a Variant M Antigen
Authors: Lawe John E. , LaRoche Linda L.
Published: March 2009

Abstract. Anti‐M antibody was found in the serum of a 64‐year‐old woman during a routine pre‐operative screen. Her red cell type was MN but the antibody was shown not to be an autoantibody. Blood tests were run on other members of her family, and it was found that her sister's red cells, also type MN, were not agglutinated by the patient's IgM antibody. Chemical studies are reported on the red cell surface glycoproteins of the patient and 2 family members. This red cell variant is compared with previous reports of Ma and is believed to be a further example of this blood type.
Rhnull Red Cells and Pregnancy
Authors: Gibbs B.J. , Moores Phyllis
Published: March 2009

Abstract. The haemoglobin, haematocrit and osmotic fragility red cell values in a South African white woman with Rhnull cells and the corresponding haematological syndrome were shown to vary only minimally during her third pregnancy. This occurred in spite of the precautionary donation by her of two units of her blood at 20 and at 27 weeks of pregnancy for storage in liquid nitrogen. Although there was fear to the contrary, the woman's infant was found at birth to be suffering only mildly from haemolytic disease of the newborn due to the anti‐Rh29 antibodies present in her plasma.
Beta‐Propiolactone for the Inactivation of Non‐A/Non‐B Type 1 Hepatitis Virus Capable of Inducing Cytoplasmic Tubular Ultrastructures in Chimpanzees
Authors: Yoshizawa H. , Itoh Y. , Iwakiri S. , Kitajima K. , Noguchi Y. , Tachibana K. , Nakamura T. , Miyakawa Y. , Mayumi Dr.M.
Published: March 2009

Non‐A/Non‐B type 1 hepatitis virus may be recognized because it induces characteristic tubular ultrastructures in the hepatocyte cytoplasm of chimpanzees. 3 chimps received 0.1 ml of a chimp serum containing more than 100 chimp infecting units of non‐A/non‐B type 1 hepatitis virus after it had been treated with β‐propiolactone with or without combined ultraviolet irradiation. All of the chimps escaped infection throughout the observation period of 23 weeks. The treatment of the serum with β‐propiolactone at the mildest condition employed (0.05%, 4°C, 20 min) was still effective in inactivating the virus. The susceptibility of the chimps was ascertained by the subsequent challenge with 0.1 ml of the untreated serum which invariably induced non‐A/non‐B type 1 hepatitis in them. On the basis of these results, β‐propiolactone was extremely efficacious for the cold sterilization of non‐A/non‐B type 1 hepatitis virus.
Plasma Discolouration Due to Sun‐Tanning Aids
Authors: Bareford D. , Cumberbatch M. , Tovey L. Derrick
Published: March 2009

The ingestion of the new sun‐tan capsules ‘Orobronze’ containing the carotenoid derivative canthaxanthin discolours plasma orange. This is noticeable in the plasma of blood donations received 4 days after starting the capsules and continues for a further 4 weeks after finishing the course. This cause of plasma discolouration should be recognised as it was found to mask haemolysis within a plasma sample.
An International Reference Typing for Ch and Rg Determinants on Rare Human C4 Allotypes1
Authors: Rittner Ch. , Tippett P. , Giles C.M. , Mollenhauer E. , Berger R. , Nordhagen R. , Buskjœr L. , Bruun‐Petersen G. , Lamm L. , Roos M.H.
Published: March 2009

Red cells, serum and plasma samples of 20 individuals, selected for their C4 allotypes, were distributed from Bonn to five laboratories, for investigation of their Chido (Ch) and Rodgers (Rg) determinants. One anti‐Ch (M.H.) and one anti‐Rg(Prest.) were distributed, but the individual laboratories also used their own reagents and their own typing methods. There was general agreement in interpretation of the majority of samples. Partial inhibition for Ch and Rg was detected. Two samples gave anomalous results; one sample with C4 A1,3 BQO, QO had Ch determinants on the red cells and in plasma (partial inhibition), and another sample with C4 A3,4 B5, QO apparently lacked Ch determinants on the red cells and in plasma. Heterogeneity of anti‐Ch and anti‐Rg was suggested in testing red cells, perhaps, reflecting a quantitative effect. This heterogeneity was confirmed by inhibition studies. The capacity of some reagents to detect partial inhibition probably reflects qualitative as well as quantitative differences.
Quantitative Evaluation of Elution Methods for Red Cell Antibodies
Authors: Panzer S. , Salama A. , Bödeker R.H. , Mueller‐Eckhardt C.
Published: March 2009

Two recent techniques using xylene and chloroform for antibody elution from red blood cells (RBC) were compared with the most widely used ether and heat elution by means of a quantitative 125I‐antiglobulin test. Free serum alloantibodies and cell‐bound alloantibodies from in vivo sensitization of delayed hemolytic transfusion reactions and of hemolytic disease of the newborn as well as autoantibodies in autoimmune hemolytic disease were studied. With alloantibodies, xylene proved more efficient than chloroform (p<0.025), while both methods were superior to heat or ether elution (p<0.005). Autoantibody elution was equally effective with xylene and chloroform (p>0.1) but again better than heat or ether elution (p<0.02). However, no single method produced the strongest eluate with all antibodies studied. We conclude that xylene and/or chloroform elution are valuable implementations in RBC serology, but, in selected instances, the classical elution methods will retain their importance.
Improvement of Enzyme‐Linked Antiglobulin Test by Using an Antiglobulin Linked to Glucose Oxidase: Description of the Technique
Authors: Rigal D. , Monestier M. , Lafont S. , Raffin T. , Got A. , Meyer F. , Jouvenceaux A.
Published: March 2009

The classic enzyme‐linked antiglobulin test (ELAT) used to detect and quantify the amount of IgG antibodies on red blood cells (RBC) is sensitive to hemolysis and erythrocyte enzymatic activities. We describe a new ELAT by using glucose oxidase (GO) linked to antihuman IgG. The optical density baseline of GO‐ELAT, alkaline phosphatase‐ELAT and peroxidase‐ELAT were, respectively, 0.180, 0.350 and 0.550. This very low baseline of GO‐ELAT was due to the absence of hemolysis (the pH of the GO substrate is 6.5). This technique is ten times more sensitive than the indirect antiglobulin test and detects up to 1 ng/ml of anti‐D alloantibodies. Additional advantages of the technique are (1) there is no intrinsic GO enzyme in RBC, and (2) it is not necessary to fix the RBC.
Use of Preserved Autologous Red Blood Cells to Absorb Warm Autoantibodies from the Serum of Patients Receiving Blood Transfusion Therapy
Authors: Reid Marion E. , Toy Pearl T.C.Y.
Published: March 2009

This paper describes two practical methods for the preservation of pretransfusion patient red blood cells for antigen typing and autoabsorption during a course of transfusion therapy. Blood samples from patients who had serum warm autoantibodies and a positive direct antiglobulin test were collected, the serum frozen, and the red cell aliquots separately preserved by PVP‐methanol or formaldehyde fixation. After storage and recovery, the IgG antibodies were dissociated and the cells used for absorption of the warm autoantibodies. The preserved red cells removed the warm autoantibodies as effectively as fresh red blood cells from the same patient. Preservation of autologous red cells prior to the onset of transfusion therapy provides an extension of the autoabsorption procedure and a simple alternative to differential absorption.
Cold Lymphocytotoxic Antibodies in Systemic Lupus erythematosus
Authors: Derksen R.H.W.M. , Schuurman H.J. , Heijnen Cobi J. , Meekes Anne‐Marie J. , Broekhuizen R. , Kater L.
Published: March 2009

Optimum conditions were established for the assay of cold lymphocytotoxic antibodies (cLCTA) in serum from patients with systemic lupus erythematosus (SLE). The optimum temperature of the incubation step with complement was 15°C. For target cells incubated with dextran a significantly higher percentage of damaged cells (p<0.005), a faster rate of cell damage (p<0.001) and a requirement for less complement was observed than for target cells not incubated with dextran. Under optimum conditions in the cytotoxicity assay, 62% of SLE sera damaged more than 60% of the target cells, whereas 73% of the sera from control donors damaged less than 20% of the target cells. In multiple serum samples obtained during follow‐up of 30 patients with SLE, the serum cytotoxic activity or titer of cLCTA fluctuated and did not relate to clinical symptoms of disease activity. In sera obtained during active disease the cytotoxic activity was related to the anti‐dsDNA antibody level and with levels of circulating immune complexes measured by the Raji cell assay and the indirect granulocyte phagocytosis test. We found no restricted reactivity of cLCTA against phenotypically distinct T‐lymphocyte subpopulations with different immunoregulatory functions. The reactivity pattern of cLCTA towards the various T‐lymphocyte subpopulations was not related to disease activity. We conclude that cLCTA in patients with SLE represent an epiphenomenon, being the result of a hyperreactive B‐cell system rather than the cause of the disease.
Simultaneous Occurrence of Anti‐Fl and Anti‐I Cold Agglutinins in a Patient's Serum
Authors: Roelcke D. , Weber Maria Theresia
Published: March 2009

Abstract. The second example of anti‐Fl cold agglutinins recognizing a developmentally regulated antigen like I is described. The antibody occurred transiently and simultaneously together with an anti‐I cold agglutinin. Although anti‐Fl and anti‐I specificities are entirely different, the data on the biochemistry of Fl and I antigenic determinants provide an explanation for the simultaneous occurrence of anti‐Fl and anti‐I cold agglutinins in connection with a poly‐ or oligoclonal autoimmune response.
Carbohydrate‐Specific Antibodies in Normal Human Sera
Authors: Lalezari Parviz , Jiang An Fu , Kumar Mahendra , Lalezari Iraj
Published: March 2009

Abstract.A glucose‐dependent hemagglutinin, present in the serum of an apparently healthy donor, is shown to be a polyclonal IgM immunoglobulin with specificity for β‐D‐glucopyranose configuration. The antibody did not agglutinate erythrocytes coated with hexoses differing from glucose at C2, C3, or C4 positions or lacking the primary alcohol group at C6 position. The hemagglutination reaction, quantitated in a continuous flow system, was inhibited by the addition of 6‐deoxyglucose, 5‐thioglucose, 2‐deoxyglucose, 2‐aminoglucose or 3–0 methylglucose.D‐glucose, in β‐ but not in α‐configuration, attached by a glycosidic bond to another glucose or to an aglycone, was also inhibitory. A cross‐reactivity was demonstrated between glucose and 6‐deoxyglucose by antibody absorption and elution techniques. The donor's serum contained independent antibodies that reacted with erythrocytes coated with melibiose, gentiobiose, cellobiose, or N‐acetylmannosamine. Further investigation revealed that antibodies are present in sera of all normal adults against erythrocytes coated with melibiose and N‐acetylmannosamine and with high frequency against erythrocytes coated with gentiobiose,L‐rhamnose, cellobiose,D‐mannose, lactose, orD‐galactose.
Response to Immunization with A and B Human Glycoproteins for the Procurement of Blood Grouping Reagents
Authors: Contreras Marcela , Armitage Susan E. , Hewitt Patricia E.
Published: March 2009

Abstract. 37 subjects have been immunized with A or B human blood group substances. All subjects showed at least a threefold increase in potency of their ABO antibodies. Use of the resulting plasma has considerably improved the quality of our ABO grouping reagents. The IgG component of these antibodies increased in all subjects and an IgA component was seen in the majority of post‐immunization samples. All group O subjects developed cross‐reacting anti‐A,B antibodies.
Platelet Storage in Glow Discharge‐Treated Polyvinylchloride Bags: Effects of a Plasticizer on Platelet Hypotonic Shock Response
Authors: Ishikawa Yoshihide , Sasakawa Shigeru
Published: March 2009

Abstract. The effect of a plasticizer (DEHP) of PVC blood bags on platelet response to hypotonic shock was examined. The response of the platelet concentrate (PC), stored in the bag in which DEHP elution was prevented by glow‐discharge treatment, did not change until 72 h of storage. On the other hand, during PC storage in control bags or in plasma containing DEHP, the response decreased approximately linearly. The time course of DEHP incorporation into platelet agreed well with that of the decrease of the response to hypotonic shock.