[Clinical application of ROM in psychosis]

AIM

The use of 'routine outcome monitoring' (ROM) in mental health care has increased widely during the past decade. However, little is known about the use of ROM outcome in daily clinical practice. We investigated to what extent ROM results were reflected in psychotic patients' treatment plans.

DESIGN

Cross-sectional study.

METHOD

The ROM-Phamous, a ROM-protocol for patients with psychotic disorders in which data is collected on the basis of interviews, questionnaires and physical examination was implemented in the northern Netherlands. A random sample of 100 patients was extracted from the 2010 ROM database (n = 1040), from which we determined the prevalence of a number of problem areas. We then investigated whether these problems were reflected in patients' treatment plans.

RESULTS

The sample consisted of 63 men and 37 women, with a mean age of 44 years and a mean duration of illness of 18 years. The prevalence of symptoms and psychosocial problems was 13-37%; the prevalence of cardiovascular risk factors was 11-86%. The majority of problems identified with ROM were not reflected in patients' treatment plans; the opposite also occurred: psychosocial problems, in particular, mentioned in the treatment plans were not always identified with ROM.

CONCLUSION

ROM and treatment should ideally be integrated in mental-health services, but currently appear to be separate processes. If improvement of integration of ROM and clinical practice succeeds it could lead to improvement of care for psychiatric patients. Further investigation is warranted. Conflict of interest and financial support: ICMJE forms provided by the authors are available online along with the full text of this article.

The environment influences whether high-fat foods are associated with palatable or with unhealthy

This study investigated whether relatively automatic evaluations of food differ between situations and between obese people and lean controls. These evaluations were assessed in the affective priming paradigm (APP) -- a response latency based measure for associations. In Experiment 1, we either focused participants (33 obese and 26 lean controls) on the palatability (restaurant condition) or on the healthiness (health condition) of food, prior to the APP. Independent of weight-status, relatively automatic evaluations of food were based on palatability in the restaurant condition, and on health in the health condition. So, the current focus of attention can shape the way foods are evaluated relatively automatically. In Experiment 2, craving was induced in participants (27 obese and 29 lean controls). Unexpectedly, the craving induction did not achieve its goal of focusing on the palatability of food in general, but just for low-fat foods, possibly because of the health-emphasizing environment -- a hospital. Interestingly, obese people showed a stronger palatability priming effect with increasing levels of initial craving. For normal weight controls the effect was in the same direction, but missed significance. In our environment, palatability of food may be too salient, and health may not be salient enough, influencing automatic food-evaluations.

Early associations with food in anorexia nervosa patients and obese people assessed in the affective priming paradigm

Two experiments are reported that used the affective priming paradigm (Fazio, R. H., Sanbonmatsu, D. M., Powell, M. C., & Kardess, F. R. (1986). On the automatic activation of attitudes. Journal of Personality and Social Psychology, 50, 229-238) to uncover associations with food at a relatively automatic level. Experiment 1 tested the hypothesis that anorexia nervosa (AN; n=22) patients would show less sensitivity to the palatability of foods than unrestrained lean controls (n=27). Results indeed suggested that AN patients did not display a liking of palatable foods over unpalatable foods, whereas unrestrained controls did. Experiment 2 tested the hypothesis that obese people (n=27) would show more sensitivity to the palatability of (high-fat) palatable foods than unrestrained lean controls (n=27) would. However, results suggested that the priming effect was based on health concerns, in that participants showed a preference for low-fat palatable foods over high-fat palatable foods. Average speed of responding and context are discussed as variables influencing the affective priming effect. Taken together, results suggest that food evaluations at a relatively automatic level are controlled by an interaction between participant characteristics, stimuli characteristics, and the specific context.

A cortical mechanism for binding in visual working memory

Luck and Vogel (1997) showed that the storage capacity of visual working memory is about four objects and that this capacity does not depend on the number of features making up the objects. Thus, visual working memory seems to process integrated objects rather than individual features, just as verbal working memory handles higher-order "chunks" instead of individual features or letters. In this article, we present a model based on synchronization and desynchronization of reverberatory neural assemblies, which can parsimoniously account for both the limited capacity of visual working memory, and for the temporary binding of multiple assemblies into a single pattern. A critical capacity of about three to four independent patterns showed up in our simulations, consistent with the results of Luck and Vogel. The same desynchronizing mechanism optimizing phase segregation between assemblies coding for separate features or multifeature objects poses a limit to the number of oscillatory reverberations. We show how retention of multiple features as visual chunks (feature conjunctions or objects) in terms of synchronized reverberatory assemblies may be achieved with and without long-term memory guidance.

Full versus divided attention and implicit memory performance

Effects of full and divided attention during study on explicit and implicit memory performance were investigated in two experiments. Study time was manipulated in a third experiment. Experiment 1 showed that both similar and dissociative effects can be found in the two kinds of memory test, depending on the difficulty of the concurrent tasks used in the divided-attention condition. In this experiment, however, standard implicit memory tests were used and contamination by explicit memory influences cannot be ruled out. Therefore, in Experiments 2 and 3 the process dissociation procedure was applied. Manipulations of attention during study and of study time clearly affected the controlled (explicit) memory component, but had no effect on the automatic (implicit) memory component. Theoretical implications of these findings are discussed.

Information processing during general anesthesia: evidence for unconscious memory

Memory for words presented during general anesthesia was studied in two experiments. In Experiment 1, surgical patients (n = 80) undergoing elective procedures under general anesthesia were presented shortly before and during surgery with words via headphones. At the earliest convenient time after surgery (within 5 h) and 24 h later, memory was tested by asking patients to complete auditorily presented word stems with the first word that came to mind and to leave out words they remembered having heard earlier (exclusion task). Moreover, patients were requested to perform a "yes/no" forced-choice recognition task to assess recognition memory for both the pre- and intraoperative words. Memory for the material presented during anesthesia was demonstrated immediately after surgery and 24 h later by means of both tasks. In a second similar experiment (n = 80), the results were replicated. These findings show that anesthetized patients can process information that was presented intraoperatively.

Implicit memory for stimuli presented during inhalation anesthesia in children

During general inhalation anesthesia, neutral phrases including either the color blue or yellow combined with one of two objects, ball or kite, were repeatedly presented to 36 children undergoing eye surgery. Postoperative testing with a coloring and two-choice task was performed to detect preferences for the colors and objects presented under anesthesia. No preference attributable to implicit memory could be demonstrated, and there was no explicit recollection of intraoperative events. Memory of intraoperative events occurring during inhalation anesthesia was not demonstrated with the present methodology in young children.

Expression and characterization of a structural and functional domain of the mannitol-specific transport protein involved in the coupling of mannitol transport and phosphorylation in the phosphoenolpyruvate-dependent phosphotransferase system of Escherichia coli

The mannitol-specific transport protein in Escherichia coli, EIImtl, consists of three structural and functional domains: a hydrophilic EIII-like domain (the A domain); a hydrophobic transmembrane domain (the C domain); and a second hydrophilic domain (the B domain) which connects the A and C domains together. The A domain contains the first phosphorylation site, His554, while the B domain contains the second phosphorylation site, Cys384. The phosphoryl group which is needed for the active transport of mannitol is sequentially transferred from P-enolpyruvate via the two phosphorylation sites to mannitol bound to the substrate binding site. In this paper, the expression, purification, and initial characterization of the B domain, IIBmtl, are described. Oligonucleotide-directed mutagenesis was used to produce an amber stop codon (TAG) and HindIII restriction site in a flexible loop between the B and A domains in the subcloned gene fragment coding for IIBAmtl (van Weeghel et al., 1991c). The gene fragment coding for IIBmtl was then subcloned behind strong promoters, located in two different expression/mutagenesis vectors, which directed the expression of the 15.3-kDa polypeptide in Escherichia coli. The domain was purified from E. coli crude cell extracts by using Q-Sepharose Fast Flow, S-Sepharose Fast Flow, and hydroxylapatite column steps. This purification procedure resulted in 1 mg of pure IIBmtl/g of cell, wet weight. The purified B domain was analyzed in vitro for its catalytic activity with membranes containing the phosphorylation site mutant form of EIImtl, C384S, and with the transmembrane domain, IICmtl. The B domain, together with purified IIA, was able to restore the P-enolpyruvate-dependent phosphorylation activity of the membrane-bound C domain. Steady-state mannitol phosphorylation kinetics at saturating EI, HPr, and IIAmtl yielded an apparent Km of P-IIBmtl for IICmtl of 200 microM and an apparent Vmax of 71 nmol of mtl-P min-1 mg of membrane protein)-1. This Vmax value is comparable to that of wild-type EIImtl measured under the same experimental conditions.

Implicit memory during balanced anaesthesia. Lack of evidence

The effect of the number of presentations on implicit memory for words was studied in anaesthetised patients. During standardised, balanced anaesthesia, 81 surgical patients were presented with less common specimens of familiar word categories. For each of three word categories the number of word presentations varied between the patients (0 (control), 5, or 30 presentations). Postoperatively, repetition priming was tested by asking patients to generate exemplars for each of the word categories. No implicit memory for the words presented during anaesthesia was found and consequently no effect of number of word presentations could be demonstrated. It is suggested that this finding, which contradicts previous results, may be caused by the relatively low familiarity of the words used.

Design of a polyurethane membrane for the encapsulation of islets of Langerhans

A semipermeable membrane for the encapsulation of the islets of Langerhans, consisting of a microporous polymer network, has been developed. The polyurethane network was formed by cross-linking a mixture of linoleic acid and a linear poly(etherurethane) with dicumyl peroxide. Cross-linking the polyurethane impedes the formation of hard domains. Miocroporosity was introduced by adding salt crystals of different sizes before cross-linking and leaching it out afterwards. To optimize the permeability and immunoprotectivity, membranes were prepared with three different porosities. Membranes of this material were filled with islets of Langerhans and implanted in the peritoneal cavity of rats. Short-term in vivo experiments in rats show that membranes with pores in the range 0.3-0.7 micron and a wall thickness of about 8 microns were permeable for insulin and glucose and protected the islets of Langerhans against the cells of the immunological system.

Mental arithmetic: effects of calculation procedure and problem difficulty on solution latency

In this chronometric study of mental arithmetic, problems with sums greater than 20 and less than 100 were presented to third-grade subjects (age 8-9). It is argued that such problems are calculated by using procedures in which the problem is broken down into subproblems for which solutions are retrieved from a declarative knowledge base. Important bottlenecks in this process are the processing capacity (since only one subproblem can be handled at a time) and the storage capacity of working memory (since the original problem and all outcomes of subproblems have to be retained). Therefore it can be hypothesized that arithmetic procedures and types of problems that necessitate more subproblems will lead to longer solution times. Both hypotheses were confirmed. Significant interactions between types of problems and arithmetic procedures show an increasing difference in solution time between the procedures with increasing problem difficulty. It can be concluded that for the type of problems studied, arithmetic procedures requiring a smaller number of subproblems lead to better performance.

Selenium, rubidium and zinc in human semen and semen fractions

The levels of selenium, rubidium and zinc were determined in samples of semen, seminal plasma and spermatozoa from men with suspected infertility, together with several parameters of semen quality. The proportion of whole semen selenium present in sperm increased with increasing sperm count from 0 to 40%. For rubidium 98 +/- 4% and for zinc 95 +/- 8% of the total amount in semen was contained in seminal plasma. In seminal plasma a positive correlation was found between the levels of zinc and selenium, and between the levels of zinc and rubidium, indicating that, like zinc, selenium and rubidium in seminal plasma also derive mainly from the prostate gland. Semen quality parameters, such as sperm motility, vitality, speed and morphology, were not correlated with the contents of the three elements in either whole semen or seminal plasma. As the seminal content of selenium is dependent on the proportion of prostatic secretion in seminal plasma and on the sperm count, and both factors can vary considerably, the selenium level of whole semen does not appear to be a suitable parameter for investigation of the relationship between selenium and semen quality. Provisional measurements suggest lower sperm selenium levels at abnormally low or high sperm counts.

An enzyme-immunoassay for antibodies against hepatitis B core antigen: characteristics and clinical validation

An enzyme-immunoassay (EIA) for antibodies to hepatitis B core antigen (anti-HBc) was developed. The new test uses undiluted samples, incubated directly into an HBcAg coated well. Three alternative test procedures are possible. The stability of reagents was studied and a preclinical evaluation was performed intramurally. An assay correlation study was organised. We report the results of the external evaluation performed at 4 centres. A mean analytical sensitivity of 1.1, 1.2 and 0.36 PEI units/ml anti-HBc was found for procedure I (1 h/1 h/30 min), procedure II (30 min/30 min/30 min) and procedure III (16-20 h/1 h/30 min), respectively. In total, 5288 determinations on serum or plasma from various patients and healthy individuals were performed: 10% with procedure I, 52% with procedure II and 38% with procedure III. The qualitative (positive or negative) results were compared with those found with tests used routinely at the centres--47% with Corzyme (Abbott) and 53% with Corab (Abbott)--in a first screening. A final evaluation was made taking into account the repeatability of the results. Based on all results together, the agreement between the new EIA for anti-HBc and the routine tests was 97.6% at the first screening and increased to 99.0% after further evaluation.

Enhancing single-term recognition accuracy by cueing spatial locations in vision

With single-item visual displays, facilitating effects of foreknowledge of position have been shown in detection tasks with latency and with accuracy as the dependent variables, as well as in recognition tasks with latency as the dependent variable. There is no evidence, however, of positive selective attention effects on recognition accuracy with single-item displays. One failure to find such an effect was reported by Grindley and Townsend (1968). It is argued that in the study of Grindley and Townsend sub-optimal conditions were used and that a more elaborate replication of their study is in order. In the experiment reported here, an exposure duration resulting in 75% correct recognitions of target letters was determined per subject. This exposure time was used in the subsequent experimental sessions. In the experimental trials, single letters were presented on one out of five positions on an imaginary circle around a fixation point. The position of the impending target item was either cued or not cued by presenting either one or five dots at corresponding positions on the circumference of a similar, but somewhat larger, imaginary circle. The results showed a small, but highly significant, improvement in recognition accuracy when the position of the target letter was cued. It is concluded that cueing enhances recognition accuracy in single-item displays. Such an effect can only be shown if optimal experimental conditions are used.

Improved ELISA for the detection of HBsAg

A sandwich ELISA for hepatitis B virus surface antigen (HBsAg) was developed using monoclonal anti-HBs for the solid phase and horse-radish peroxidase labelled sheep anti-HBs. The sensitivity was approx. 0.3 U/ml HBsAg, in the standard test procedure, comprising two incubation steps of 1 h at 37 degrees C, or in a shortened procedure comprising two incubation steps of 30 min at 50 degrees C. A slightly reduced sensitivity (approx. 0.5 U/ml) was obtained when the two incubations were combined in a one-step incubation for 1 h at 37 degrees C. All three procedures were completed by an incubation for 30 min at room temperature with peroxide and tetra-methylbenzidine. The number of false positives obtained when donor sera were screened was below 0.5%. False positive reactions occurred more frequently, but still to a limited extent, when previously selected sera containing rheumatoid factor or other possibly interfering factors were tested with the standard procedure. Most sera containing factors that interfere with a commercial ELISA for HBsAg using sheep anti-HBs coated plates, were negative. Rheumatoid factor positive sera seldom gave false positive results. The lower detection limit became approx. 0.1 U/ml when the cut-off was reduced, while the number of false positives in a donor population only increased to 1.5%. The results obtained with reagents from four different batches indicate a stability of up to 4 wk at 37 degrees C and for at least 26 wk at 4 degrees C.

Detection of hepatitis B virus DNA in serum and relation with the IgM class anti-HBc titers in hepatitis B virus infection

Sera from four groups of patients wtih different serologic markers of HBV infection were examined for HBV DNA using molecular hybridization technique and for IgM class anti-HBc using an ELISA based on the antibody capture principle. Results of HBV DNA assay were generally in good agreement with the presence of HBeAg. However, HBV DNA was found in 13% of anti-HBe+ sera and in one patient with anti-HBc as a sole marker. IgM anti-HBc was detected at high titers in acute hepatitis B patients and was also present during the "window-period." This marker was also found, though less frequently when other markers for HBV infectivity were absent, in chronic hepatitis B patients and healthy carriers. From these findings we conclude that the HBV DNA assay provides a reliable method of detecting the infectious agent, particularly in anti-HBe+ sera and sera with anti-HBc as a sole marker. The assay for IgM anti-HBc is useful for establishing the diagnosis of recent infection in patient with anti-HBc as a sole marker, and during acute hepatitis with very high aminotransferase values, a condition in which HBV DNA may be undetectable.

Cellular and humoral immune reactions in chronic active liver disease. II. Lymphocyte subsets and viral antigens in liver biopsies of patients with acute and chronic hepatitis B

The characteristics and distribution of the inflammatory infiltrate in liver biopsies of 25 patients with hepatitis B viral (HBV) infection were studied in relation to the distribution and expression of HBV antigens. Mononuclear subsets were characterized with monoclonal (OKT, OKM, Leu) antibodies to surface antigens. For the demonstration of viral antigens directly conjugated antibodies to surface (HBsAg), core (HBcAg) and 'e' (HBeAg) antigen were used. For the study of mutual relations all methods were performed on serial cut tissue sections. In chronic active hepatitis B (CAH-B, n = 12) OKT8+ lymphocytes of T cell origin were the only cell type present in areas with liver cell degeneration and T cell cytotoxicity appears to be the only immune mechanism. In chronic persistent hepatitis B (CPH-B, n = 7) the only conspicuous feature was the presence of many Leu 3+ lymphocytes of the helper/inducer population in the portal tracts. In acute hepatitis B (AHB, n = 6) OKT8+ cells of non-T origin (OKT1-,3-) and Leu 7+ cells of presumed natural killer (NK) potential predominated in the areas with liver cell necrosis, and non-T cell cytotoxicity appears to be the predominant immune mechanism. In none of these disease entities a positive spatial relation could be established between the cytotoxic cells and the demonstrable expression of HBV antigens in hepatocytes. It is concluded that differences in immunological reaction pattern may explain the different course in the three forms of HBV infection studied.

Improved Hepanostika, an enzyme-immunoassay for hepatitis B surface antigen

Two modifications of Hepanostika were studied in order to improve this enzyme-immunoassay with regard to duration of the test, sensitivity and reading of test results. Test conditions and composition of some components of the test system were modified. With the first modification the test could be performed within 3 h and was about 3X as sensitive as Hepanostika. However, this method was less specific than Hepanostika and it was not suitable for routine screening. A second modification was studied with two differently prepared conjugates. The duration of the test was less than 4 h and the sensitivity was at least twice that of Hepanostika. The test results could be measured directly with a suitable photometer. Preliminary results with more than 500 deep-frozen donor sera showed that the specificity was acceptable with a number of false positives being less than 2%.

Detection of human antibodies to hepatitis B surface antigen (HBsAg) by an enzyme-immunoassay for HBsAg

We studied the feasibility of detecting antibody to hepatitis B surface antigen (anti-HBs) by an inhibition assay using the reagents of an enzyme-immunoassay for HBsAg (Hepanostika). Several modifications of the basic assay were investigated. Sensitivity was greatest when the test sample was incubated with a predetermined amount of HBsAg before the usual procedure of HBsAg detection. The presence of anti-HBs in the test sample was shown by a reduction of the solid-phase bound enzyme label. Results were obtained with a dilution series of serum samples containing anti-HBs, the anti-HBs Reference Panel of the American Bureau of Biologics, sera of hepatitis B patients, and sera of two individuals passively immunised with anti-HBs. The enzyme-immunoassay method showed at least the same sensitivity as passive haemagglutination. It was less sensitive than a commercially available radioimmunoassay (Ausab). There are no indications that non-specific reactions occur frequently. This study also revealed that the antigenaemia of acute hepatitis-B patients can be interrupted by a transient seroconversion.

Results of a multicentre clinical trial of the solid-phase enzyme immunoassay for hepatitis B surface antigen

The results obtained in a multicentre clinical trial of an enzyme immunoassay (EIA) method for hepatitis B surface antigen (HBsAg) (65,451 sera tested) have demonstrated that this new test has a significantly higher sensitivity than a reversed haemagglutination test (rHA). In a part of the trial, EIA was also compared with radioimmunoassay (RIA). Only a small number of discrepant results was obtained with these two tests, indicating similar sensitivities. No definite conclusion about a difference in sensitivities could be drawn from these results. Although the specificity of the EIA screening test is lower than that of rHA and RIA, the mean percentage of false positives was 2.2% of the total number of donor samples screened. Presumptive positives in EIA were subjected to a confirmatory test based on neutralization with human antibodies to HBsAg. After elimination of false positives in EIA screening, there was excellent agreement between EIA and RIA results.

Enzyme-immunoassay in diagnosis of hepatitis with emphasis on the detection of "e" antigen (HBeAg)

A brief survey of the application of enzyme-immunoassay (EIA) for the detection of hepatitis B surface antigen (HBsAg), hepatitis A, and their corresponding antibodies is given. The preliminary results of a similar EIA for detection of hepatitis B-related "e" antigen (HBeAg) and its antibody (anti-HBe) are reported. This EIA is much more sensitive than immunodiffusion: at least 128 times for HBeAg and at least 512 times for anti-HBe. HBsAg and its antibody do not interfere with the test. Only a few sera strongly positive for rheumatoid factor gave rise to false-positive results, as was demonstrated by a confirmatory test.

Enzyme-linked immunosorbent assay for hepatitis B surface antigen

A solid-phase enzyme-linked immunosorbent assay (ELISA), based on the "sandwich" principle with use of microtiter plates, was developed for the detection of hepatitis B surface antigen (HBSAg). Results could be read within one day by the naked eye or by colorimeter. The detection level was less than or equal to 5-10 ng of HBSAg/ml. The sensitivities of ELISA and radioimmunoassay were about the same in dilution series and in a follow-up study of 19 patients with acute hepatitis B infection. In 11 European medical centers where greater than 50,000 samples were tested, ELISA detected significantly more HBSAg-positive samples than a reversed hemagglutinatiom test. No significant difference in sensitivity between ELISA and radioimmunoassay could be demonstrated. On the average, 2.2% of readings were false-positive reactions. Falsely positive samples were identified by a confirmatory test.

Solid-phase enzyme-immunoassay for detection of hepatitis B surface antigen

The preliminary results of a solid-phase enzyme-immunoassay (EIA) for the detection of hepatitis B surface antigen (HBsAg) are presented. This method has been compared with the solid-phase radioimmunoassay (RIA) for HBsAg in dilution series of four HBsAg positive sera four national reference panels (The Laboratory Panel of the Central Laboratory of the Blood Transfusion Service of the Netherlands Red Cross, USA BOB Reference Panels Nos 2 and 3, and the 1st Panel of the National Reference Centre for virus Hepatitis at the Institute of Hygiene of the University of Göttingen, West Germany). In addition, the two test methods were compared in a weekly (up to 16 weeks) follow-up of 14 patients with acute viral hepatitis B. It was seen that, both by reading EIA test results with the naked eye and by colorimetric reading, the sensitivity and specificity of this test method compared very favourably with those of the RIA. EIA may have a slightly lower sensitivity than RIA for the subtype ad, while its sensitivity for the subtype ay may be slightly higher than that of RIA. These minor sensitivity differences may be due to the specificity profiles of the antisera used.

[Complications following ambulatory abortion]

A survey was made of 394 abortions with ensuing complications during the years 1970-1974. Of these 17 were induced abortions, 3 of which showed serious complications. In two of these cases uterus extirpation by laparotomy was necessary.

Hepatitis B surface antigen and human serum proteins

The purification of HBs Ag is briefly discussed with emphasis on the immunochemical characterization of the resulting preparations. Results of experimental work in various laboratories aimed at establishing presence or absence of human serum proteins as integral parts of (highly purified) HBs Ag particles do not yet allow definite conclusions.

C3 Consumption in Immune Reactions

C3 consumption and site formation was studied with specific antisera against three antigenic determinants of the C3 globulin molecule, namely, [β1C] or B, the β1A and the α2D determinant.

Interaction between C3 in serum and optimal specific precipitates results in the rapid loss of the [β1C] or B determinant and concomitant appearance of C3i and free α2D in the fluid phase, the latter determinant being nearly unexposed in intact C3 globulin. Experimental data further suggest that the B determinant of the intact C3 molecule is lost by destruction or by intramolecular rearrangement in the C3 molecule after interaction with cell bound C. This is borne out by the following data. (a) Immune aggregates with bound complement are incapable of inducing anti-[β1C] antibodies in rabbits; (b) sensitized Lea-positive red cells with bound complement agglutinate with monospecific anti-α2D and anti-β1A, but fail to agglutinate with anti-[β1C]; (c) EAC1̄, cells prepared with limited C3 fail to agglutinate with anti-[β1C] but agglutinate strongly with anti-β1A and anti-α2D.

Autoimmune haemolytic anaemias. 3. Preparation and examination of specific antisera against complement components and products, and their use in serological studies

The preparation and examination of agglutinating antisera, specific for β1E, β1A, α2D and the /β1C/ determinant of the β1C molecule are described. With these reagents it could be established that anticomplement serum does not contain antibodies against the B determinant of the β1C molecule, while antiserum prepared with β1C globulin does. Further, the complement factors present on red cells, the complement coating of which was effected in various ways, were studied.

Whereas red cells incubated in vitro with haemolytic iso- or auto-antibodies are agglutinated by anti-β1E, anti-β1A and anti-α2D sera, the cells of patients with autoimmune haemolytic anaemia of any of the serologically defined groups of this disease, only reacted with anti-α2D. The possible significance of these findings is discussed.