Observations of the Number of Available c, D, and E Antigen Sites on Red Cells

Abstract. The number of available antigen sites within the Rh system were estimated using trace-labelled antibodies. The results were as follows, given as the number of sites per red cell: c-antigen: on cc cells, 70,000–85,000: on Cc, 37,000–53,000; D sites on cells of phenotype -D-: 110,000–202,000; E-antigen sites showed considerable heterogeneity depending on phenotype as well as source of anti-E, and estimates varied between 450 and 25,600; e-antigen: on eE cells, 13,400 and 14,500: on ee cells, 18,200 and 24,400.
The average equilibrium constants of the antibodies were: anti-E, 4 × 10⁸ 1/mol; anti-e, 2.5 × 10⁸ 1/mol; anti-c, 3.2 × 10⁷ and 5.6 × 10⁷ 1/mol.     

Lupus anticoagulant: a clinical and laboratory study of 100 cases

Summary The clinical and laboratory features of 100 patients with lupus anticoagulant (LA) are reviewed. Subjects were divided into three groups according to their age (1–5, 15–35, 45–89 years). Female prevalence was observed in each group and overall F/M ratio was 3/1. An underlying autoimmune disease (principally lupus erythematosus) was found in 47 cases (10% of the children, 80% of the 15–35-year-old patients and 37% of the elderly patients). Biological criteria for the LA diagnosis were prolonged activated partial thromboplastin time and diluted thromboplastin time (1.3 × control), not corrected after addition of control to patient's plasma. Thromboplastin time was normal in 77 patients. Other types of coagulation inhibitors were eliminated by specific factor assays (with a 10-fold increase of cephalin concentration when necessary). Twenty-three thrombotic episodes were observed. No significant difference was found in the incidence of thrombosis between the autoimmune and non-autoimmune disease group, but the age when first thrombosis occurred was clearly lower in the former. Fourteen obstetrical accidents were noted in eight women but 13 pregnancies terminated without accident. Four patients experienced haemorrhagic complications; they all presented with a severe thrombocytopenia associated with the LA. In our experience, LA is a frequent coagulation abnormality, associated in about half of the cases with a clearly defined autoimmune disease. Clinical presentation appears as notably different according to the patient's age; it is particularly noteworthy that in nine out of 10 children, LA disappeared spontaneously within 6 months.     

Lymphoproliferative responses to Borrelia burgdorferi in circumscribed scleroderma

Summary Humoral immune responses to Borrelia hurgdorferi (Bb) have been reported to occur in certain patients with circumscribed scleroderma (CS) (morphoea). Together with the isolation of spiro-chaetes from CS skin biopsies, this finding was taken to suggest Bb as the aetiological agent of CS. Since there is cellular immunoreactivity to Bb in patients with chronic Lyme borreliosis (LB). Bb-specific lymphocytic responses were tested in patients with CS. For this purpose, peripheral blood mononuclear cells from CS patients and. as controls, from patients with various manifestations of LB, and from healthy volunteers without any evidence of Bb infection, were exposed to Bb organisms for 5 days and then assayed for DNA synthesis. Stimulation indices (SI)> 10 were scored positive. By performing lymphocyte proliferation tests we found: (i) that not only patients with various manifestations of LB but also a considerable percentage of seropositive (five of 13 = 38%) and seronegative (six of 26 = 23%) CS patients exhibit an elevated Bb-induced lymphocyte proliferation; (ii) that the magnitude of the cellular response seen in CS patients is comparable to that encountered in patients with established Bb manifestations; and (iii) that, within a given patient, antibiotic therapy can result in a significant reduction of this response. These results support a causative role of Bb in at least some CS patients. Bb-induced lymphocyte responses were also seen in both seropositive and seronegative erythema chronicum migrans patients. These findings show that the pattern of Bb-specific immune responses is more complex than previously thought, and underscore the importance of lymphocyte function assays in evaluating the diagnosis of potential Bb infection in seronegative patients.     

Patient Satisfaction and Reported Long-Term Therapeutic Efficacy Associated with 1,320 nm Nd:YAG Laser Treatment of Acne Scarring and Photoaging

BACKGROUND AND OBJECTIVE: Nonablative laser treatments have become increasingly used for the treatment of acne scarring and photoaging. While nonablative laser treatments are more convenient and relatively safer than ablative laser resurfacing, efficacy and patient satisfaction with the level of improvement of textural abnormalities in acne scarring and rhytids associated with photoaging needs further study. DESIGN/MATERIALS AND METHODS: Structured interviews were performed with 34 patients from a referral-based academic practice who each previously received a series of 6 monthly treatments with a 1,320 nm neodymium:yttrium-aluminum-garnet (Nd:YAG) laser for treatment of acne scarring or photoaging. Topical anesthesia was applied 1 hour before each treatment. Patients were interviewed at least 3 months after cessation of treatment (range 3-12 months). RESULTS: Patients tolerated the treatments well. Combined results for acne scarring and photoaging patients were as follows: (a) patient satisfaction with treatment was rated at 62%, and (b) textural improvement was reported at 31% at the end of the six treatments, and 30% at the date of interview. When results were stratified by diagnosis, patient satisfaction was slightly higher for treatment of acne scarring than for photoaging. Overall degree of improvement on a 1-10 scale was 5.4 for acne scarring and 3.8 for wrinkling. CONCLUSION: Nonablative treatment with the 1,320 nm Nd:YAG laser induced significant patient-reported improvement in both acne scarring and photoaging. The majority of patients reported satisfaction with the degree of improvement.     

SUXAMETHONIUM-INDUCED HYPERKALAEMIA IN PATIENTS WITH SEVERE INTRA-ABDOMINAL INFECTIONS

In nine patients, undergoing repeat operations because of severeintra-abdominal infection developing after major abdominal surgery,serum potassium concentrations were monitored during inductionof anaesthesia. Four patients showed an increase of serum potassiumranging from 2.5 to 3.1 mmol/ litre above baseline values within3–6 min after suxamethonium 100 mg i.v. In five patientsthere was no change. The four patients demonstrating an increasehad suffered from pyrexia and leucocyt-osis for at least 2 weeks.The other five had signs of infection for no more than 9 days.It is concluded that patients with signs of severe intra-abdominalinfection lasting longer than 1 week represent an additionalcategory susceptible to suxamethonium-induced hyperkalaemia.They should receive only non-depolarizing muscle relaxants.When the use of suxamethonium is unavoidable, the injectionof a non-depolarizing muscle relaxant before the administrationof suxamethonium is recommended.     

Valve movement response of the mussel Dreissena polymorpha -- the influence of pH and turbidity on the acute toxicity of pentachlorophenol under laboratory and field conditions

The Dreissena-Monitor is a biological early warning system for the continuous monitoring of water quality, based on the computer assessment of valve movements in two groups of 42 zebra mussels (Dreissena polymorpha). In the laboratory, two series of toxicity tests were conducted with PCP. (1) At neutral pH conditions only the concentration of PCP was altered. The dose--response relationship revealed 15 g l–1 PCP for the number of valve movements and 20 g l–1 PCP for the percentage of open mussels. (2) At 50 g l–1 PCP the pH value was altered from 6.5 to 8.4, demonstrating an inverse relationship between the toxicity of PCP and the pH. The detection limits evaluated from a series of toxicity tests under the field conditions of the River Rhine at Koblenz were nearly ten times higher than those from the laboratory. During a second series of toxicity tests under the field conditions of the River Rhine at Bad Honnef, the toxicity of PCP seemed to be reduced in relation to the increasing turbidity. The differences between the results obtained under laboratory and field conditions are discussed with respect to the influence of the pH and turbidity at the toxicity of PCP on D. polymorpha