Functional assessment of therapeutic anti-D immunoglobulin using Fc-mediated assays.

Therapeutic anti-D immunoglobulin preparations issued by the Scottish National Blood Transfusion Service, between 1980 and 1986, were evaluated using in-vitro Fc-mediated functional tests that reflect potential in-vivo mechanisms of specific red cell destruction and clearance. All batches tested were found to: (a) contain anti-D of mainly IgG1 subclass and lesser amounts of IgG3; (b) mediate lymphocyte and monocyte rosetting; and (c) produce lytic activity in both K cell and monocyte ADCC. The functional activity of the therapeutic immunoglobulin preparations over this period of production had not altered despite increased plasma contributions latterly to the pool from deliberately immunized male donors. This is the first in-vitro study of the Fc-mediated function of therapeutic polyclonal anti-D preparations. As these preparations were clinically effective in the prophylactic anti-D programme, such bioassays of FcRI/II and FcRIII activity are justified for the future evaluation of immune plasma before blending for fractionation and production of therapeutic anti-D immunoglobulin.

Portable ramps for wheelchair users--an appraisal.

This paper describes a study to establish values for gradients which could be achieved by wheelchair users whilst using two different lengths of otherwise identical portable ramps. Sixty subjects each tested gradients of between 1:14 and 1:6 on portable ramps of 1 metre and 1.8 metres length. The results demonstrated that the majority of attendant-propelled, self-propelling, and powered wheelchair users could negotiate gradients of 1:8 and 1:6 on the shorter ramp with varying degrees of effort. A gradient of 1:10 on a short ramp presented few difficulties for the majority of wheelchair users. Although this work relates specifically to portable ramps, there is little to suggest that the results could not be applied to permanent ramps, including those used in the home.