Simultaneous passenger lymphocyte syndrome and multiple alloimmunization against donor's blood group antigens after liver transplantation.

BACKGROUND: If 'passenger lymphocyte syndrome' (PLS) is a well-recognized complication in ABO-mismatched solid organ transplantation, the coexistence of this reaction with recipient's alloimmunization against multiple antigens expressed on the residual red blood cells in the graft is less common and unpredictable. METHODS: The receiver of an ABO minor-mismatch liver graft from a cadaveric donor developed haemolytic anaemia within 2 weeks after transplantation. The organ donor was of blood group O D+C+c+E+e+ K+k+ Le(a+b-) and the recipient, A1 D-C-c+E-e+ K-k+ Le(a-b-). The donor and recipient were both tested for irregular antibodies. Elution was performed on the recipient's red blood cells (RBCs). RESULTS: None of the recipient and donor had irregular alloantibodies at the time of transplantation. On day 10, anti-A antibodies were detected in the recipient's serum and eluted from his RBCs. At the same time, the patient developed multiple alloantibodies: anti-D, anti-C, anti-E, anti-K and anti-Le(a) against the donor's erythrocyte antigens. CONCLUSION: Although serological analysis and haemolytic parameters confirmed the diagnosis of PLS which required transfusion support, no sign of graft damage due to recipient's immune reaction was detected. This case illustrates the required follow-up of the recipient after transplantation.

High production of poly(3-hydroxybutyrate) from a wild Bacillus megaterium Bolivian strain.

AIM: Taking into account that a novel strain of Bacillus megaterium was isolated from Uyuni salt lake (Bolivia) in a previous work, the objectives of this new study were to determine the maximal Poly-3-hydroxybutyrate production potential of B. megaterium strain uyuni S29 in an industrial conventional media, the possibility that the strain accumulates different types of polyhydroxyalkanoates, the cellular morphology during the biosynthesis process and the characterization of the produced biopolymers. METHODS AND RESULTS: The micro-organism was first tested in a 3-L bioreactor obtaining a high specific growth rate of 1·64 h(-1). A second fed-batch experiment was carried out in shaking flasks, reaching up to 70% PHB of cell dry mass. The biosynthesized polymers were extracted by two different extraction procedures and characterized. The results showed that all of them were PHB with thermal properties different to the conventional PHB. The micrographs taken by TEM show the different cell morphology during the fermentation process. CONCLUSIONS: In this previous study, the strain not only grew properly in the industrial conditions proposed without spore formation, but also produced and accumulated a large content of PHB, never reached before for its genus. Therefore, if the culture conditions can be optimized, the biopolymer production could be increased. SIGNIFICANCE AND IMPACT OF THE STUDY: The impact of the study has related to the area of the biomaterials and their production. The study provides new data related to the high production of PHB from the wild novel strain B. megaterium uyuni S29, the highest polymer accumulation for the genus Bacillus without spores formation.

[Clinical case of the month. Mild hemolytic disease of the newborn due to an anti-Wr(a) antibody]. / Maladie hémolytique néonatale modérê due à un anticorps anti-Wr(a).

A Caucasian woman, with a A+ CCD.ee K neg erythrocyte phenotype and no history of blood transfusion, delivered a first child who developed mild anemia. The direct antiglobulin test performed on the newborn red blood cells belonging to the A+ CCD.ee K neg group, was strongly positive for IgG. During the pregnancy and after the delivery, the woman had a negative irregular antibody screening test, using standard red blood cells. However, at birth, using a collection of thawed red blood cells with rare phenotypes (private antigens), the lab showed an antibody anti-Wr(a) in the maternal serum. The activity of the maternal antibody, with a titer of 16, was completely inhibited by dithiothreitol, indicating the nature IgM of the circulating antibody. The presence of the antigen Wr(a) on the surface of the newborn and its biological father red blood cells was confirmed. The concentration of IgG anti-Wr(a) on baby erythrocytes was demonstrated by the presence of the antibody anti-Wr(a) in the eluate. This case illustrates the difficulties to detect antibodies against private antigens on baby erythrocytes, responsible of hemolytic diseases of newborn. Indeed, standard red blood cell panels used for irregular antibodies screening test do not express generally those private antigens.

[Plasma calcium in haemodialysis patients: total calcium or ionized calcium? Should we systematically provide a value of total corrected calcium on our protocols?]. / Calcium chez les patients hémodialysés : calcémie totale ou calcium ionisé ? Le laboratoire doit-il systématiquement fournir au clinicien une valeur de calcémie totale corrigée obtenue par calcul ?

Ionized calcium is the only physiologically active form of calcium. Because of the variation of albumin, pH and haemoconcentration observed during haemodialysis session in patients with chronic renal failure, measure of total calcium does not reflect the real variation of ionized calcium. However, many formulae to correct total calcium by albumin have been proposed but none of them has been validated in dialysis patients. At present time, computing progress permit laboratory to systematically provide a value of corrected total calcium on protocols but is it really indicated? Our results showed that any of those formulae allows obtaining a value of total calcium that possesses a significant critical difference in relation to total calcium. Thus, correction formulae must be abandoned in aid of ionized calcium in haemodialysis patients.

New insight into the ternary complexes of uranyl carbonate in seawater.

Uranium is naturally present in seawater at trace levels and may in some cases be present at higher concentrations, due to anthropogenic nuclear activities. Understanding uranium speciation in seawater is thus essential for predicting and controlling its behavior in this specific environmental compartment and consequently, its possible impact on living organisms. The carbonato calcic complex Ca2UO2(CO3)3 was previously identified as the main uranium species in natural seawater, together with CaUO2(CO3)32-. In this work, we further investigate the role of the alkaline earth cation in the structure of the ternary uranyl-carbonate complexes. For this purpose, artificial seawater, free of Mg2+ and Ca2+, using Sr2+ as a spectroscopic probe was prepared. Combining TRLIF and EXAFS spectroscopy, together with DFT and theoretical thermodynamic calculations, evidence for the presence of Sr alkaline earth counter ion in the complex structure can be asserted. Furthermore, data suggest that when Ca2+ is replaced by Sr2+, SrUO2(CO3)32- is the main complex in solution and it occurs with the presence of at least one monodentate carbonate in the uranyl coordination sphere.

[Ghosal haematodiaphyseal dysplasia: a new case]. / Un nouveau cas de dysplasie hématodiaphysaire de Ghosal.

Ghosal-type hematodiaphyseal dysplasia has been first described in 1986, as a steroid-dependent anemia with endosteal broadening of the long bone's diaphyses and metaphaphyses, which makes a distinction with the periosteal reaction in Camuratti-Engelmann's disease and with Caffey's disease. Extreme pallor is first noticed and leads to search for palpable thick long bones that are not always clinically obvious. The transmission of this rare entity seems to be autosomal recessive, with a common racial background from the Middle East and the Indian subcontinent. Anemia is considerably improved by steroids, which allow to avoid blood cells transfusions, but a minimum maintenance dose is necessary to keep the hemoglobin at a normal level probably during the whole life, involving iatrogen complications. The mechanism of anemia and the genetic cause of the disease are yet unknown.

Importance of searching for associated mitochondrial DNA alterations in patients with multiple deletions.

Multiple mitochondrial DNA (mtDNA) deletions have been reported in patients with autosomal dominant and recessive disorders. We studied several affected and one non-affected individuals belonging to a pedigree in which the inheritance of the pathological trait was compatible with an autosomique dominant transmission. Affected members had late-onset multisystem disorders with multiple mtDNA deletions in skeletal muscle. But this family presented a striking difference from previously described cases, because none of the patients had progressive external ophthalmoplegia (PEO). We also studied one young boy with a no contributary family history. He had a cerebellar ataxia with PEO and multiple mtDNA deletions in muscle. Molecular analysis revealed that in the first family, repeated sequences were present at the breakpoint junctions, whereas such motifs were not found in the young patient's case. In the first family, we evidenced mtDNA point mutations in clones containing breakpoint junctions and a 9-bp motif triplication in the intergenic COII/tRNA(Lys) region, whereas this sequence is repeated twice in the wild type mtDNA. Our results suggest that multiple deletions observed in the two pedigrees result from different molecular mechanisms and point out the role of repeated sequences in the first pedigree. No mtDNA repair system has been described in mammals so far, but the molecular abnormalities found in the first family suggest that a defect in an mtDNA repair system, homologous to the E. coli MutHLS pathway, could be responsible for such a phenotype.

Micellar liquid chromatography for prediction of drug transport.

The vast majority of well absorbed drugs are transported passively across the cell membranes. Physicochemical descriptors of drug molecules that are believed to influence transcellular transport are routinely used to predict drug absorption by means of complex mathematical models. In this paper, a new in vitro method, based on the retention data in micellar liquid chromatography (MLC), is validated for the prediction of passive drug absorption. The retention of a heterogeneous drugs set in MLC using Brij 35 as surfactant in the mobile phase is compared with the retention data reported in literature obtained in red cell membrane lipid liposomes, human red cell membranes vesicles (vesicles), native membranes of adsorbed red cells (ghosts) and egg phospholipids liposomes [Beigi et al., Int. J. Pharm., 164 (1998) 129-137]. Finally, the correlation between the logarithm of retention factors in MLC and reported oral drug absorption values for barbiturates and beta-blockers is studied. Predictive regression models for estimating oral drug absorption using the logarithm of the retention values as independent variable are proposed.

Potential of biopartitioning micellar chromatography as an in vitro technique for predicting drug penetration across the blood-brain barrier.

The blood-brain barrier (BBB) is considered to be the main barrier to drug transport into the central nervous system (CNS). The BBB restricts the passive diffusion of many drugs from blood to brain. The ease with which any particular drug diffuses across the BBB is determined largely by the molecular features of drugs, and it is therefore possible to predict the BBB permeability of a drug from its molecular structure. Biopartitioning micellar chromatography (BMC), a mode of micellar liquid chromatography that uses micellar mobile phases of Brij35 in adequate experimental conditions, can be useful in mimicking the drug partitioning process into biological systems. Retention in BMC depends on the hydrophobicity, electronic and steric properties of drugs. In this paper, the usefulness of BMC for predicting the BBB penetration ability of drugs expressed as the brain/blood distribution coefficient (BB) is demonstrated. A multiple linear regression (MLR) model that relates the BB distribution coefficients data with BMC retention data and total molar charge is proposed. The model is obtained using 44 heterogeneous drugs including, neutral, anionic, and cationic compounds. A comparison with other reported methodologies to predict the BBB permeability is also presented.

Response of the flexion-relaxation phenomenon relative to the lumbar motion to load and speed.

STUDY DESIGN: Nonrandomized control trial. OBJECTIVE: To determine if the variations of speed and loading conditions during trunk flexion-extension could influence the times of occurrence and disappearance of the electrical silence of the erector spinae muscles, the degrees of lumbar flexion at those instants, and the relative lumbar motion time. SUMMARY OF BACKGROUND DATA: It has been suggested that varying either the speed of movement or the load on the trunk during trunk flexion-extension movements may influence the flexion-relaxation phenomenon or the kinesiologic data. However, no study dealt with the simultaneous effect of the speed of movement on the spine rhythm and on the occurrence of the electrical silence of the erector spinae. METHODS: A total of 22 pain-free volunteers performed a series of trunk flexion-extension movements varying the speed and load. The motion of the lumbar spine ( degrees ) and the integrated electromyography (microV) of erector spinae muscles were simultaneously recorded. Two measures were calculated: the percentage of the maximum lumbar spine flexion at the instants when changes of electrical activity represented the beginning and end of the electrical silence and the relative lumbar spine motion time during trunk flexion and extension movements. RESULTS: The increase in speed of movement significantly increased the relative lumbar flexion time and significantly reduced the relative lumbar extension time (t = 2.49 and t = 2.25, P < 0.05); furthermore, it significantly delayed the appearance of the electrical silence in the range of flexion (t = 3.52, P < 0.01). There was no significant effect from a change in load. CONCLUSIONS: The relative spine motion time differed depending on the direction of movement, being longer during trunk flexion and shorter during extension. The increase in speed of movement produced greater differences in the relative time between trunk flexion and extension; furthermore, it delayed the appearance of the electrical silence of the erector spinae muscles in the range of flexion.

Rapid in vitro test to predict ocular tissue permeability based on biopartitioning micellar chromatography.

The drug permeability prediction across the ocular tissues is important in the development of new drugs and drug delivery strategies. Physicochemical characteristics of drugs, mainly acid-base character, hydrophobicity and the molecular size determine both their transport across the eye tissue barriers and their retention in biopartitioning micellar chromatography (BMC). An in vitro model able to describe and predict the whole cornea drug permeability is proposed. The model uses the retention of drugs in BMC and molecular weight (MW) as predictive variables. The relationships between drug retention data in BMC and their bibliographic permeability values in stroma, epithelium-plus-stroma and endothelium-plus-stroma are also studied. The results show that BMC can be a useful tool to select drug candidates according to their whole cornea permeability at the early stage of the drug discovery process.

A software tool to acquire, synchronise and playback multimedia data: an application in kinesiology.

Assessing the physical condition of the human body frequently requires evaluating different tests performed by different devices. This information has to be analysed simultaneously to derive conclusions, and so a temporal relationship must be established between the data sources. In this paper, synchronisation of the sources of information is achieved by synchronising the clocks of computers connected in a Local Area Network. A clock synchronisation protocol is used and a global time is stamped in each information data flow. During analysis, the time-stamp is used to playback the data in a synchronised way. The proposed system is valid for any medical application in which data synchronisation is needed. However, it has initially been used in a distributed medical environment for analysing electrical muscular activity and lumbar movement. The dual aim is to detect injuries and plan training sessions for athletes. It was specifically used to analyse data generated by: electromyographs; lumbar equipment; and images generated by video cameras. The simple operation of the application and the precision of the synchronisation protocol enabled several interesting medical conclusions to be made.

[Negativity of the exercise thallium test despite tight stenosis of the common trunk of the left coronary artery]. / Négativité du thallium d'effort malgré une sténose serrée du tronc commun de l'artère coronaire gauche.

The authors report a case of severe angina linked to subocclusive ostial stenosis of the common trunk of the left coronary, characterised by the contrast between a very positive stress test on the basis of clinical and electrocardiographic parameters and a negative Thallium stress test. The occasion is taken to review the sensitivity of Thallium stress testing in lesions of the common trunk.

[Intervention in children with pragmatic language and communication disorders]. / Intervencion en niños con trastornos pragmaticos del lenguaje y la comunicacion.

AIMS: In this paper we analyse the educational and therapeutic needs of children who present pragmatic disorders in language and communication. DEVELOPMENT: Pragmatic disorders in language and communication stand apart from the other disorders affecting the remaining aspects of language development. Their less specific nature goes beyond the purely linguistic domain and involves wide areas of the patient's affective and social development. CONCLUSIONS: Not only is it necessary to adapt the general model of speech therapy intervention, but also to include it within a set of pedagogical (based on the framework of school itself) and psychological measures (in early care and family guidance services).

Information-processing differences and laterality of students from different colleges and disciplines.

1023 college students were assessed for hemispheric brain dominance using the paper-and-pencil test, the Human Information Processing Survey. Analysis of scores of students majoring in Advertising, Interior Design, Music, Journalism, Art, Oral Communication, and Architecture suggested a preference for right-brain hemispheric processing, while scores of students majoring in Accounting, Management, Finance, Computer Science, Mathematics, Nursing, Funeral Service, Criminal Justice, and Elementary Education suggested a preference for left-hemispheric strategies for processing information. The differential effects of hemispheric processing in an educational system emphasizing the left-hemispheric activities of structured logic and sequential processing suggests repression of the intellectual development of those students who may be genetically favorable to right-hemispheric processing.

A Metamagnetic Two-Dimensional Molecular Material with Nickel(II) and Azide.

Bridging azido ligands transmit both ferro- and antiferromagnetic interactions. The sheetlike structured complex [Ni(µ-N(3))(2)(N,N-Et(2)-N'-Me-en)](n) (see picture) exhibits a range of magnetic behaviors at low temperature. Short-range ferromagnetic and three-dimensional antiferromagnetic ordering compete, giving metamagnetic behaviors. N,N-Et(2)-N'-Me-en=N,N-diethyl-N'-methylethylenediamine.

[Hemoptysis in a young man smoking cannabis]. / Inhalation de cannabis frelaté, responsable d'une hémoptysie.

The respiratory toxicity of cannabis is well known today. Along with the classic cannabis 'joint', there are other ways of consuming it, which should be known. Smoking cannabis that has been cut with micro-particles of silicon dioxide may cause hemoptysis. We will describe here the case of a young 16-year-old man who was in the hospital because of hemoptic expectoration. The etiologic investigation was negative, in particular a thoracic scan and a bronchial fiberscope. Questioning the patient afterwards allowed us to discover the inhalation of cannabis 2 h before the hemoptysis, cannabis mixed with micro-particles of silicon dioxide. Stopping inhalation stopped the symptoms. Pediatricians should be familiarized with such practices. Silicon dioxide particles cause ENT problems or bronchial ones (coughing, spitting, hemoptysis, wheezing). Over the long term, the risk of silicosis cannot be excluded, although a longer and more complete exposure is necessary.