Development of non‐ABO RBC alloantibodies in patients undergoing allogeneic HPC transplantation. Is ABO incompatibility a predisposing factor?

BACKGROUND: Data from the appearance of RBC antibodies other than ABO in patients undergoing HPC transplantation are limited. STUDY DESIGN AND METHODS: The incidence and specificity of non-ABO RBC alloantibodies are described in a series of 217 patients undergoing allogeneic HPC transplantation because of various hematologic malignancies. RESULTS: Eight patients (3.7%) developed 10 antibodies after transplant. None of these patients had previously been immunized. Seven patients had one RBC antibody and one patient had three RBC antibodies. Antibody specificity were anti-Jk(b) (2 patients), -Kell (2), -M (2), -Le(b) (1), and -D (1). Finally, two patients had a panagglutinin. The mean time between transplant and antibody detection was 23 days (range, 16-672). The source of the HPCs, the conditioning regimen administered, and the type of GVHD prophylaxis administered did not influence the rate of antibody formation. On multivariate analysis, ABO blood group incompatibility (p = 0.005) and patient's age (p = 0.02) were the only two variables significantly associated with the development of RBC alloantibodies. CONCLUSION: Patients undergoing allogeneic HPC transplantation are at risk of developing RBC-specific antibodies despite the immunosuppressive therapy administered. Antibody formation was more frequently observed in ABO-mismatched cases, which suggests a potential role of this incompatibility in facilitating antibody production.     

Functional magnetic resonance: new applications in epilepsy

Functional magnetic resonance imaging technique is a non-invasive tool that is capable to detect the subtle hemodynamic changes produced during regional brain activation. Functional MRI applications in epilepsy patients are language lateralization and mapping, memory function assessment and localization of ictal and interictal changes. Functional MRI for language lateralization is currently used in clinical practice and provides comparable results to the intracarotid amobarbital test. In functional MRI studies for memory function assessment, results show changes in epileptic patients, but further studies are required to validate this technique for individual cases. A new application is ictal or interictal functional MRI with EEG recording that provides more detailed information about simultaneous electrographic and hemodynamic changes during interictal discharges or EEG seizures. This technique seems to have encouraging results to localize the epileptogenic area and to study propagation patterns.     

Ceftizoxime-induced hemolysis secondary to combined drug adsorption and immune-complex mechanisms

BACKGROUND: Immune hemolytic anemia has been associated with the administration of various antibiotics, including cephalosporins. Presented here is a patient who developed severe acute hemolysis while receiving ceftizoxime (Ceftizox, Fujisawa USA), a third-generation cephalosporin. This is the fourth reported case of hemolysis in association with ceftizoxime. In the previous cases, ceftizoxime was shown to induce hemolysis by the immune-complex mechanism. However, in one of those reports, the concentration of drug used to treat the target RBCs in vitro may not have been optimal. CASE REPORT: The patient's antemortem blood samples were analyzed retrospectively for drug-dependent antibodies by the drug-adsorption and immune-complex methods. Antibody class and titer were evaluated. RESULTS: The patient's sample agglutinated RBCs coated with ceftizoxime as well as uncoated RBCs in the presence of ceftizoxime. The antibodies to ceftizoxime were IgM and IgG. CONCLUSION: This is the first report on both the immune-complex and drug-adsorption mechanisms of ceftizoxime-induced hemolysis. The differential diagnosis of a falling Hct in a patient receiving antibiotics should include drug-related hemolysis; once this diagnosis is considered, management includes the appropriate serologic workup, immediate cessation of the implicated drugs, and possible transfusion support.     

肝细胞生长因子在非小细胞肺癌中的表达及其意义

目的研究肝细胞生长因子（简称HGF／SF）表达与肺癌微血管密度及肺癌预后的相关性。方法应用免疫组化方法和图像分析仪分析对49例手术切除非小细胞肺癌（NScLc）标本进行检测分析。结果HGF阳性表达率63．3％，HGF阳性表达主要出现肺癌组织中癌细胞胞浆内，HGF表达与肺癌的微血管生成及肺癌的进展有关，其中Ⅲ期肺癌组HGF阳性率为85．7％高于Ⅰ、Ⅱ期组（P＜0．005）；有淋巴结转移N1N2组HGF阳性率分别为91．7％和90．9％，高于无淋巴结转移N0组（46．2％）（P＜0．005）；2年生存率HGF表达阳性组（51．6％）明显低于HGF表达阴性组（83．3％）（P＜0．05）；HGF表达阳性肺癌组织中微血管密度明显高于HGF表达阴性组（P＜0．05）。结论HGF是促进肺癌组织血管生成的重要因素，可作为判断肺癌患者预后的重要指标。     

First two cases of immune hemolytic anemia associated with ceftizoxime

BACKGROUND: Second- and third-generation cephalosporins have been associated with immune-mediated hemolytic reactions. This report discusses two patients who developed clinically significant extravascular hemolysis while receiving the third-generation cephalosporin ceftizoxime (Ceftizox). This is believed to be the first time hemolysis has been described in patients receiving this drug. STUDY DESIGN AND METHODS: Immunologic workup of drug-dependent antibodies was performed on blood samples using drug-coated and immune complex methodologies. Antibody classes and titers were analyzed. RESULTS: Both the patients' sera contained anti-ceftizoxime that reacted with red cells only when ceftizoxime was added to the sera ("immune complex" method). The patients recovered without complications following discontinuation of the drug. Each patient had IgM and IgG drug-dependent antibodies.The drug-induced antibodies from each patient cross-reacted with cefotaxime, which is structurally similar to ceftizoxime, but cross-reacted either weakly or not at all with ceftriaxone, which has a more complex side chain. CONCLUSION: This report describes the first cases of immune hemolytic anemia associated with ceftizoxime. In drug-induced hemolytic reactions, prompt recognition and discontinuation of the drug may be important factors in reducing the chance of serious sequelae.     

RBC autoantibodies in autoimmune lymphoproliferative syndrome

BACKGROUND: Patients with autoimmune lymphoproliferative syndrome (ALPS) have an autosomal dominant genetic defect that affects lymphocyte apoptosis and is associated with chronic nonmalignant lymphadenopathy, splenomegaly, and autoimmunity, particularly affecting RBCs, WBCs, and platelets. STUDY DESIGN AND METHODS: DATs were performed on 34 consecutive patients with ALPS and 37 of their clinically unaffected relatives. The effects of age, sex, race, and immunoglobulin levels on the incidence of autoantibodies and clinical hemolysis were assessed. RESULTS: The DAT was positive in 21 (62%) of ALPS patients but in only 1 (3%) of their relatives (p = 0.001). The DAT reacted because of IgG alone in 43 percent, complement alone in 5 percent, and IgG plus complement in 19 percent; 33 percent of the patients' cells had a positive reaction with polyspecific reagent only. All 10 ALPS patients with a history of hemolytic anemia had a positive DAT. Sixty percent of them had only IgG on their cells, 30 percent had IgG and complement, and 10 percent reacted only with polyspecific reagent. Of the 11 patients with a positive DAT and no history of hemolytic anemia, IgG alone was present in 27 percent, complement alone in 9%, and IgG plus complement in 9 percent; 55 percent had positive DATs only with polyspecific reagent. Among ALPS patients, those with a positive DAT had greater quantities of cells with increased alpha and ss T-cell receptors that phenotyped as CD4-CD8- and higher IgG levels. CONCLUSIONS: The DAT results in ALPS patients are most similar to those found in warm autoimmune hemolytic anemia. The DAT is useful to distinguish affected and unaffected persons within an ALPS family.     

Neural correlates of the implicit association test: evidence for semantic and emotional processing

The implicit association test (IAT) has been widely used in social cognitive research over the past decade. Controversies have arisen over what cognitive processes are being tapped into using this task. While most models use behavioral (RT) results to support their claims, little research has examined neurocognitive correlates of these behavioral measures. The present study measured event-related brain potentials (ERPs) of participants while completing a gay-straight IAT in order to further understand the processes involved in a typical group bias IAT. Results indicated significantly smaller N400 amplitudes and significantly larger LPP amplitudes for compatible trials than for incompatible trials, suggesting that both the semantic and emotional congruence of stimuli paired together in an IAT trial contribute to the typical RT differences found, while no differences were present for earlier ERP components including the N2. These findings are discussed with respect to early and late processing in group bias IATs.     

IAT与MAT化疗方案治疗难治和复发性急性髓系白血病的疗效观察

为了研究联合化疗提高难治复发急性髓系白血病(AML)患者治疗有效率,回顾分析99例难治和复发AML,其中难治性AML 56例,复发性AML 43例,分别给予伊达比星联合阿糖胞苷、替尼泊苷(IAT)方案28例和米托蒽醌联合阿糖胞苷、替尼泊苷(MAT)方案71例。结果表明:两组患者的总体有效率(OR)为65.7%,完全缓解(CR)率49.5%,部分缓解(PR)率16.2%。IAT组总有效率64.3%,CR率46.4%;MAT组总有效率66.2%,CR率50.7%,两组差异无统计学意义(P>0.05)。IAT组患者2年总生存率25%,MAT组患者2年总生存率15.5%。两组化疗患者中出现严重感染的分别为25%和9.9%。结论:IAT/MAT方案是难治和复发AML的有效治疗方案,两组CR率、总体有效率、无病生存率和总生存率无明显差异,两方案毒副作用患者可以耐受,本研究为患者争取移植机会和疾病长期存活奠定基础。     

Combining the P300-complex trial-based concealed information test and the reaction time-based autobiographical implicit association test in concealed memory detection

Despite the P300-concealed information test's validity in detecting concealed memory when it is conducted immediately after the mock crime, whether the P300-CIT's detection efficiency is moderated by time delay remains unknown. Here, we conducted a mock crime study in which guilty participants were tested immediately after the mock crime or 1 month later. An innocent group was also tested. Assuming that the autobiographical Implicit Association Test (aIAT) and the P300-CIT rely on nonoverlapping mechanisms for memory detection, participants were tested using both the P300-CIT and the reaction time (RT)-based aIAT. Results suggested that the sensitivity of both tests remains even after the 1-month delay. The indicators from the RT-aIAT and P300-CIT were uncorrelated, thus combining P300-CIT and aIAT data further increased the efficiency of memory detection.     

Crossmodal correspondences in product packaging. Assessing color-flavor correspondences for potato chips (crisps)

We report a study designed to investigate consumers’ crossmodal associations between the color of packaging and flavor varieties in crisps (potato chips). This product category was chosen because of the long-established but conflicting color-flavor conventions that exist for the salt and vinegar and cheese and onion flavor varieties in the UK. The use of both implicit and explicit measures of this crossmodal association revealed that consumers responded more slowly, and made more errors, when they had to pair the color and flavor that they implicitly thought of as being “incongruent” with the same response key. Furthermore, clustering consumers by the brand that they normally purchased revealed that the main reason why this pattern of results was observed could be their differing acquaintance with one brand versus another. In addition, when participants tried the two types of crisps from “congruently” and “incongruently” colored packets, some were unable to guess the flavor correctly in the latter case. These strong crossmodal associations did not have a significant effect on participants’ hedonic appraisal of the crisps, but did arouse confusion. These results are relevant in terms of R&D, since ascertaining the appropriate color of the packaging across flavor varieties ought normally to help achieve immediate product recognition and consumer satisfaction.