Fred H. Allen

Linkage of HL-A and GBG.

Abstract. The HL‐A histocompatibility locus is closely linked to that for the glycinerich β‐glycoprotein polymorphism. No recombinants were seen among 44 children from 12 informative families.

Chronic Granulomatous Disease and the Kell Blood Groups

Summary. Fifteen antigenic determinants are known to be related to the Kell blood group. Some boys with X‐linked chronic granulomatous disease have the very rare McLeod or K0 phenotype on their red cells. Serological studies of the McLeod type suggest that the weak Kell antigens that are present differ qualitatively and quantitatively from those on red cells of common Kell type. A new antigen, Kx, has been characterized and shown to be present on red cells and neutrophil leucocytes. Lack of red‐cell Kx is associated with the McLeod phenotype, lack of leucocyte Kx is associated with chronic granulomatous disease.

Inhibition of anti-I sera by human milk.

Summary. Human milk has been found to contain a high concentration of water‐soluble I blood‐group substance. Tests with 24 different anti‐I sera showed that to a variable extent all of them could be inhibited by milk and some could be inhibited by strong I secretor saliva. The susceptibility of I antibodies to inhibition was not related to titer, and the results suggest that qualitative differences in the antibody‐antigen reaction are responsible.

Serum bilirubin levels in the newborn infant

Summary 1. Cord bilirubin levels of full-term“compatible”, full-term “incompatible”, and premature infants are essentially the same. The average cord bilirubin level of infants with erythroblastosis is more than double that of infants without erythroblastosis and a level above 5 mg. per cent is strongly suggestive of this disease. 2. Normal infants usually show a rise of bilirubin during the first day of life, but infants with erythroblastosis show a marked elevation during this period. 3. Normal full-term infants reachtheir peak elevation of bilirubin at about two days of life, whereas the peak bilirubin of premature infants is attained on the fourth day of life, on the average. The peak elevation of bilirubin of premature infants not only occurs later than that of full-term infants, but reaches higher levels, confirming the clinical impression that physiological jaundice is more severe and more prolonged in the premature infant than in the full-term infant. 4. In this series, infants with erythroblastosis,treated by exchange transfusion, have their bilirubin peak during the second day of life, on the average. Exchange transfusion greatly modifies the bilirubinemia in these infants. A level of serum bilirubin above 10 mg. per cent during the first twenty-four hours of life, or the appearance of skin icterus during this period, must be considered due to erythroblastosis until proved otherwise. 5. Determinations of the level ofserum bilirubin during the first two days of life are of great diagnostic value with respect to erythroblastosis, particularly in cases caused by ABO incompatibility. They are of even greater value as a therapeutic guide in the use of replacement transfusion.

MN Blood-Group Locus: Data Concerning the Possible Chromosomal Location

Combined data derived from clinical, cytogenetic, and blood-grouping studies of one family suggest that the MN locus is on the long arm of either the No. 2 or the No. 4 chromosome.

Droplet-Frozen Sensitized Red Cells for Gm Typing

Summary

Analysis for possible linkage between the loci for the Waardenburg syndrome and various blood groups and serological traits.

SummaryLinkage was sought between the Waardenburg syndrome locus and the loci for various genetic markers segregating in a single family. Close linkage was shown to be unlikely with the loci for Rh, MN, Ag, ADA, HL-A, and Gm. Evidence obtained is consistent with the possibility of linkage with the locus for the AB0 blood group, but study of additional families will be required to provide a definite answer.ZusammenfassungIn einer Familie wurde nach Genkopplung zwischen dem locus für das Waardenburg-Syndrom und verschiedenen genetischen Markern gefahndet. Für die loci für Rh, MN, Ag, ADA, HL-A und Gm wurde enge Kopplung als unwahrscheinlich erwiesen. Dagegen lassen die Daten die Annahme einer Kopplung mit dem AB0-locus zu. Für eine endgültige Entscheidung müßten zusätzliche Familien untersucht werden.

Nine Blood-group Antibodies in a Single Serum after Multiple Transfusions

giving repeated doses of dimethyl ether of D-tubocurarine iodide by the same route. We have based the dosage of the dimethyl ether of D-tubocurarine iodide on body weight; it has initially been of the order of 1 mg. per stone (6.35 kg.). We feel that it is safer to dose a patient adequately than to underdose him with any curarizing agent, to lessen the tendency to bronchospasm. Incremental doses of the dimethyl ether of D-tubocurarine iodide are of the order of 3 mg., and their administration is guided by the degree of diaphragmatic activity. We were impressed by one striking improvement in our results on changing to the new compound-namely, the extreme ease with which a lung or lobe which had been allowed to collapse could be reinflated. Using D-tubocurarine chloride we had always been able to reinflate a lung or lobe, but quite firm pressure on the bag was often required, more particularly in the later stages of the operation. Using dimethyl ether of D-tubocurarine iodide, however, we found that the pressure required to reinflate the lung was much less and remained so throughout the operation. What is the explanation ? Is it that when using D-tubocurarine chloride an excess of circulating histamine, with its tendency to increase bronchial muscle tone, is released as the operation proceeds and trauma increases, and that with the use of dimethyl ether of D-tubocurarine iodide there is less histamine release and consequently less stimulation of the tone of the bronchial tree ? There was also a definite change in the blood pressure picture. The fall in systolic blood pressure with an accompanying rise in diastolic pressure previously noticed did not seem to occur to the same extent, or, if it did, was manifest only at a much later stage than with D-tubocurarine chloride.

Biochemical genetics of MN.

Abstract. Quantitative hemagglutination studies of the MN‐hemizygous (M/‐) patient and his family reported by German et al. are given together with data on the electrophoretic mobility of their red cells. These results, and those obtained on the cells of a donor of the MU pheno‐type (MU = M+N−S−s−U+; Mu = M+N−S−s−U−), demonstrate a series of shortcomings in the current ‘precursor transferase’ theory of the biochemical genetics of MN antigens. Another theory is proposed, according to which the effects of the MN genes take place exclusively in the protein part of the glycopeptide. The MN proteins would carry acceptor sites for the antigenic oligosaccharides which are put together by enzymes genetically independent of MN. In M glycoproteins, the acceptor sites are close to each other, in doublets, while in N they are all separate. This model is shown to apply successfully to several difficult problems in MN.

Anti-IP: an antibody defining another product of interaction between the genes of the I and P blood group systems.

Abstract. We have tested a serum that reacts strongly with I, P1 red cells, weakly with I, P2 cells, more weakly with i adult, P1 cells, and not at all with I, p cells. Two iso‐antibodies were detected, one being anti‐IP1, which could be isolated in pure form by absorption of the serum with ordinary P2 cells. The second antibody, from its reactions with various P1‐negative cells, was presumably anti‐IP, indicating still another interaction product of the I and P genes.