"Naturally Occurring" Anti-Kell (Kl): Two Examples

"Naturally occurring" anti-Kell(Kl) is reported for the first time and was found in the sera obtained from two male adults. The two examples of this antibody were detected as a result of routine screening of donors' blood for atypical antibodies. Both strongly agglutinated type K:l cells in saline solution at room temperature. The mechanism of formation of the anti-Kl was not known in either case.     

Characterization of reactions after exclusive transfusion of white cell- reduced cellular blood components

BACKGROUND: Potential adverse effects of white cells (WBCs) within transfused cellular blood components include febrile nonhemolytic transfusion reactions (FNHTRs), alloimmunization, transmission of infectious diseases, transfusion-related acute lung injury, and immunomodulation. Although exclusive use of WBC-reduced components to prevent alloimmunization and cytomegalovirus transmission has been studied, the use of these components to avert FNHTR has not been examined. STUDY DESIGN AND METHODS: Transfusion reactions (FNHTRs, allergic reactions, and others) were characterized in recipients of 12,277 WBC-reduced single-donor apheresis platelets (SDAPs) and/or red cells (RBCs). Medical and laboratory evaluations for possible infectious and immunologic (alloimmunization) causes of each reaction were undertaken, and the benefit of further modification of components for the prevention of subsequent reactions was also evaluated. RESULTS: Transfusion reactions occurred after 481 (3.92%) of 12,277 transfusions. Allergic reactions occurred more commonly after transfusion of SDAPs (3.69%) than of RBCs (0.51%). Conversely, FNHTRs occurred more commonly after transfusion of RBCs (2.15%) than of SDAPs (1.58%). HLA antibodies were present in a posttransfusion sample from 27 (10.6%) of 255 patients; bacterial contamination was a possible cause of only 2 (0.42%) of 481 reactions. In patients with recurrent FNHTRs, further WBC reduction in components did not wholly prevent further FNHTRs. CONCLUSION: The incidence of FNHTRs and alloimmunization after exclusive transfusion of WBC-reduced RBCs and SDAPs was low. Further WBC reduction in components transfused to patients with a history of recurrent FNHTRs does not completely prevent subsequent reactions.     

供体鼠龄对急性心肌梗死骨髓间充质干细胞移植后血管发生的影响

目的:干细胞移植后可以通过改善梗死区域血管新生而发挥改善心功能的作用。实验观察不同鼠龄骨髓间充质干细胞移植后的效果,拟验证其对急性心肌梗死动物血管发生的影响。方法:实验于2006-02/2007-05在福建省高血压研究所完成。①实验材料:清洁级SD大鼠由上海实验动物公司提供。选用2周龄雄性SD大鼠作为幼年鼠骨髓间充质干细胞来源,选用1年龄雄性SD大鼠作为老年鼠骨髓间充质干细胞来源。实验过程中对动物处置符合动物伦理学标准。②实验方法:密度梯度离心法和贴壁筛选法获得SD大鼠骨髓间充质干细胞,观察老年与幼年大鼠骨髓间充质干细胞的凋亡情况。体外模拟梗死心肌缺血、缺氧条件,制备大鼠心肌梗死模型。将造模后大鼠随机分为3组:对照组(n=8)不进行干细胞移植,只在梗死心肌周围注入等量的生理盐水。老年鼠移植组(n=8)梗死心肌周围分4点注入同种异体老年鼠骨髓间充质干细胞,幼年鼠移植组(n=8)梗死心肌周围分4点注入同种异体幼年鼠骨髓间充质干细胞。③实验评估:干细胞移植4周后,采用Ⅷ因子免疫组织化学观察各组间血管密度的差别。结果:24只大鼠均进入结果分析。在缺血、缺氧条件下,幼年鼠骨髓间充质干细胞的抗凋亡能力强于老年鼠(P<0.05)。Ⅷ因子免疫组织化学检测显示,两移植组梗死区域均有新生血管生成,幼鼠移植组血管密度高于老年鼠移植组(P<0.05),老年鼠移植组高于对照组(P<0.05)。结论:供体年龄在一定程度上影响急性心肌梗死骨髓间充质干细胞移植后血管的发生。     

Peripheral and central sites of action for the non-selective cannabinoid agonist WIN 55,212-2 in a rat model of post-operative pain

Background and purpose:

Activation of cannabinoid (CB) receptors decreases nociceptive transmission in inflammatory or neuropathic pain states. However, the effects of CB receptor agonists in post-operative pain remain to be investigated. Here, we characterized the anti-allodynic effects of WIN 55,212-2 (WIN) in a rat model of post-operative pain.

Experimental approach:

WIN 55,212-2 was characterized in radioligand binding and in vitro functional assays at rat and human CB₁ and CB₂ receptors. Analgesic activity and site(s) of action of WIN were assessed in the skin incision-induced post-operative pain model in rats; receptor specificity was investigated using selective CB₁ and CB₂ receptor antagonists.

Key results:

WIN 55,212-2 exhibited non-selective affinity and agonist efficacy at human and rat CB₁ versus CB₂ receptors. Systemic administration of WIN decreased injury-induced mechanical allodynia and these effects were reversed by pretreatment with a CB₁ receptor antagonist, but not with a CB₂ receptor antagonist, given by systemic, intrathecal and supraspinal routes. In addition, peripheral administration of both CB₁ and CB₂ antagonists blocked systemic WIN-induced analgesic activity.

Conclusions and implications:

Both CB₁ and CB₂ receptors were involved in the peripheral anti-allodynic effect of systemic WIN in a pre-clinical model of post-operative pain. In contrast, the centrally mediated anti-allodynic activity of systemic WIN is mostly due to the activation of CB₁ but not CB₂ receptors at both the spinal cord and brain levels. However, the increased potency of WIN following i.c.v. administration suggests that its main site of action is at CB₁ receptors in the brain.British Journal of Pharmacology (2009) 157, 645–655; doi:10.1111/j.1476-5381.2009.00184.x; published online 3 April 2009     

Molecular analysis of CYP21A2 can optimize the follow‐up of positive results in newborn screening for congenital adrenal hyperplasia

Neonatal screening for congenital adrenal hyperplasia (CAH) is useful in diagnosing salt wasting form (SW). However, there are difficulties in interpreting positive results in asymptomatic newborns. The main objective is to analyze genotyping as a confirmatory test in children with neonatal positive results. Patients comprised 23 CAH children and 19 asymptomatic infants with persistently elevated 17‐hydroxyprogesterone (17OHP) levels. CYP21A2 gene was sequenced and genotypes were grouped according to the enzymatic activity of the less severe allele: A1 null, A2 < 2%, B 3–7%, C > 20%. Twenty‐one children with neonatal symptoms and/or 17OHP levels > 80 ng/ml carried A genotypes, except two virilized girls (17OHP < 50 ng/ml) without CAH genotypes. Patients carrying SW genotypes (A1, A2) and low serum sodium levels presented with neonatal 17OHP > 200 ng/ml. Three asymptomatic boys carried simple virilizing genotypes (A2 and B): in two, the symptoms began at 18 months; another two asymptomatic boys had nonclassical genotypes (C). The remaining 14 patients did not present CAH genotypes, and their 17OHP levels were normalized by 14 months of age. Molecular analysis is useful as a confirmatory test of CAH, mainly in boys. It can predict clinical course, identify false‐positives and help distinguish between clinical forms of CAH.     

Kappa-晒化卡拉胶对实验动物的抗心律失常作用

Kappa-硒化卡拉胶是一含硒有机化合物。ip 9 mg·kg^-1·d^-1×5d或单次ig 35,70,140mg·kg^-1能显著提高乌头碱致大鼠HA的阈剂量,此作用可与Na₂SeO₃ 1 mg·kg^-1·d^-1×5d ip比拟.随着Kappa-硒化卡拉胶ig剂量增加,尚可提高乌头碱所致VE,VT和VF的阈剂量。ip 9mg·kg^-1·d^-1×5 d或ig 70mg·kg^-1能提高BaCl₂致大鼠或哇巴因致豚鼠HA的阈剂量。对BaCl₂致大鼠VF或哇巴因致豚鼠VE的阈剂量,分别在ig70mg·kg^-1与140mg·kg^-1时有提高,而ipNa₂SeO₃ 1 mg·kg^-1·d^-1×5d无此明显影响。     

Living with Marfan syndrome II. Medication adherence and physical activity modification

We investigated the perceptions of and adherence to medication and physical activity guidelines in 174 adults with Marfan syndrome. Over 80% of those prescribed beta- and Ca2+-channel blockade reportedly adhere well to their medication regimen. The presence of cardiovascular symptoms and fatigue were positively correlated with the medication use. Medication-takers reported that they are psychologically receptive to the use of medication for prophylactic treatment of their cardiovascular problems. However, all do not view their medication as essential for their health. Duration of the medication regimen, type of medication, and perception of controllability of the condition were each independently associated with respondents' perceptions of the necessity of taking beta- or Ca2+-channel blockers. Over 80% of the respondents reported that they choose their physical activities with their diagnosis in mind. Modifying exercise activities was significantly correlated with an increased perception of Marfan syndrome as having negative consequences on the respondents' lives. Genetic counseling should address beliefs about medication use and physical activity restrictions, as perceptions of these health behaviors may have significant impact on how adults with Marfan syndrome adhere to these recommendations and cope with their condition.     

Impact of preoperative sarcopenia on postoperative outcomes following pancreatic resection: A systematic review and meta-analysis

Background

Morphometric analysis of sarcopenia has garnered interest due to its putative role in predicting outcomes following surgery for a variety of pathologies, including resection for pancreatic disease. However, there are no standard recommendations on whether sarcopenia is a clinically relevant predictor of outcomes in this setting. The aim of this study was to review the prognostic impact of preoperatively diagnosed sarcopenia on postoperative outcomes following pancreatic resection.