Immunization to Rho(D) Observed in Pregnancy of a Woman with Type rhG(G)

A Negro woman was tested during her third pregnancy and found to have type rh^G(G). When the patient was re-tested during the sixth month of her fourth pregnancy, she was found to have a weak antibody of questionable identity. During the last two months of the pregnancy, the titer of the antibody rose sharply and it was established to be specific for Rh_o(D). The infant, delivered by cesarean section shortly before term, had evidence of mild hemolytic disease; it recovered without transfusion therapy. Since this indicates that isoimmunization to Rh_o can occur in a person of type rh^G, such persons should receive only Rh_o-negative blood for transfusion. They should be regarded as Rh-negative for prenatal purposes, but it might be considered preferable not to use them as blood donors for Rh-negative recipients.     

Thermoresponsive release from poly(Glu(OMe))-block-poly(Sar) microcapsules with surface-grafting of poly(N-isopropylacrylamide)

Thermoresponsive microcapsules were prepared by grafting poly(N-isopropylacrylamide) (PNIPAAm) on the surface of polypeptide (poly(Glu(OMe))-block-poly(Sar)) microcapsules. Naked poly(Glu(OMe))-block-poly(Sar) microcapsules were partly hydrolysed with NaOH to remove methyl groups and newly formed carboxyl groups were used to anchor polyallylamine having 4,4′-azobis(4-cyanovaleric acid) groups. Graft polymerization of N-isopropylacrylamide at the microcapsule surface was initiated by photo-cleavage of the azo groups. Microscopic examination showed that a homogeneous dense skin layer of PNIPAAm was formed on the surface of microcapsule at 40°C, while the skin layer became loose when the temperature was lowered to 25°C. Dextran release from the microcapsule was faster below the lower critical solution temperature (LCST) of PNIPAAm than that above it. When the temperature changed across the LCST, a reversible, thermoresponsive release from the microcapsule was observed. Notably, the transition of the release rate by changing the temperature occurs quickly in a narrow temperature range.     

Further analysis of Del (D-elute) using polymerase chain reaction (PCR) with RHD gene-specific primers

D_el (D-elute) in the Rh blood group system is a variant with very weak D antigen and no agglutination is found by the indirect antiglobulin test. This variant is characterized by the presence of anti-D eluate obtained after an adsorption-elution test using anti-D antibodies. We studied here the molecular genetic status of D_el by using polymerase chain reaction with sequence-specific primers (PCR-SSP).
We screened 306 serologically apparent D-negative Japanese donors comprising 102 D_el types for exons 7, 4 and 10 of the RHD gene. No PCR product was found in all 204 non-D_el samples from the D-seronegative donors. However, PCR products were found in all 102 D_el samples and all 70 D-seropositive samples tested by the three PCR methods for exons 7, 4 and 10 analysis.
D_el was found with CCee, CcEe and Ccee, but not with CCEe, CcEE, ccEE, ccEe or ccee phenotype. The incidences of D_el in the samples with the serological phenotypes CCee, CcEe and Ccee were 80.0% (4/5), 68.2% (45/66) and 61.6% (53/86), respectively.
The results provide evidence that D_el samples have exons 4, 7 and 10 of an RHD gene present in some form. This is consistent with the evidence that D antigen is present on the cells although only detected by antibody adsorption and elution. The PCR-SSP method in the present study is useful to confirm D_el among serologically apparent D-negative samples.     

Kaletra (lopinavir/ritonavir)

OBJECTIVE: To review the pharmacology, virology, pharmacokinetics, efficacy, safety, and clinical use of lopinavir/ritonavir (Kaletra, Abbott Laboratories). DATA SOURCES: English-language MEDLINE and AIDSline searches were performed (1966-July 2001) using lopinavir, ABT-378, and Kaletra as key words. Abstracts from infectious diseases and HIV scientific meetings were identified. Abbott Laboratories provided additional published and unpublished information. DATA EXTRACTION: All publications, meeting abstracts, and unpublished information were reviewed and relevant items included. In vitro and preclinical studies were included as well as Phase II and III clinical trials. DATA SYNTHESIS: Lopinavir/ritonavir is a fixed-dose protease inhibitor (PI) combination used for the treatment of HIV-1 infection. Lopinavir, the active component of this combination, is extensively metabolized by CYP3A4 and produces low systemic concentrations when used alone. Ritonavir potently inhibits CYP3A4 and is used to enhance the systemic exposure of lopinavir. This combination results in lopinavir concentrations that greatly exceed those necessary in vitro to inhibit both wild-type and PI-resistant HIV isolates. In clinical trials with antiretroviral na?ve and experienced patients, lopinavir/ritonavir was effective at suppressing HIV-RNA and increasing CD4+ T cell counts. Compared with other PIs, lopinavir/ritonavir may have advantages in the areas of pharmacokinetics, efficacy, and resistance. Toxicity, drug interactions, and medication adherence are important considerations surrounding its clinical use. CONCLUSIONS: Lopinavir/ritonavir is an effective option for the treatment of HIV-1-infected individuals when used in combination with other antiretroviral agents. It may be used as a component of initial therapy or salvage therapy; future studies will better define its place in therapy.     

Norovirus (infants/children)

Human norovirus (NoV) is an important cause of the epidemic acute gastroenteritis in children and adults. This review mentions on the required knowledge to understand morphology, genetics, transmission, pathogenesis, and control. The development of molecular diagnostic techniques is clarified the epidemiological impact that is now recognized not only as the major cause of foodborne gastroenteritis outbreaks but also as a cause of sporadic gastroenteritis. It was recognized that the combination pattern to an intestinal epithelium of NoV was prescribed in organization, blood type antigen (histoblood group antigen: HBGA). In children, NoV has various complications especially benign convulsions associated with mild gastroenteritis and associated-encephalopathy. NoV virus-like particle (VLP) vaccine is developing as the protection against acute viral gastroenteritis with a homologous virus.     

Losec (omeprazole/MSD)

The treatment of patients with Zollinger-Ellison syndrome has represented a challenge in the past. Losec Delayed-Release Capsules may provide these patients with a well-tolerated alternative, allowing them a more natural lifestyle. In addition, Losec may also offer benefits to the patient suffering from severe gastroesophageal reflux disease in whom traditional therapy is not providing adequate results. Knowledge of this newer medication and its advantages and disadvantages will allow the nurse to take an active role in patient instruction regarding this therapy.     

Movement-related desynchronization-synchronization (ERD/ERS) in patients with Unverricht-Lundborg disease

We studied changes in event-related desynchronization/synchronization (ERD/ERS) patterns in patients with Unverricht-Lundborg disease (ULD), presenting with prominent action myoclonus. We analyzed the movement-related ERD/ERS in alpha and beta frequency bands in 15 patients using self-paced finger extension as a motor paradigm and we compared the results with those obtained in 12 healthy volunteers. In all ULD patients, alpha- and beta-ERD regularly occurred with onset and location similar to that found in healthy controls, but the desynchronization of alpha activity was significantly greater than in controls (C3: -64.4+/-9.8% vs. -49.7+/-14.8%; p=0.004). Moreover, in the patients, both alpha- and beta-ERD spread toward frontal electrodes. In controls, the post-movement beta-ERS regularly occurred; it was absent in eight patients with severe action myoclonus, while, in seven patients with mild or moderate myoclonus, the beta-peak was significantly smaller with respect to that measured in controls (55.6+/-15.1% vs. 153.9+/-99.8%, p=0.006). The failure of beta-ERS well-correlated with motor impairment resulting from action myoclonus, whereas SSEPs and long-loop reflexes performed to detect signs of cortical hyperexcitability showed inconsistent changes. In ULD patients, ERD/ERS changes indicate an increased activation of motor cortex during movement planning and a great reduction of post-excitatory inhibition of motor cortex. The changes involving beta-ERS had a significant relationship with the functional disability in individual patients and might play a pathogenic role in the motor dysfunction.