Dilute polyelectrolyte solutions: recent progress and open questions

Polyelectrolytes are a class of polymers possessing ionic groups on their repeating units. Since counterions can dissociate from the polymer backbone, polyelectrolyte chains are strongly influenced by electrostatic interactions. As a result, the physical properties of polyelectrolyte solutions are significantly different from those of electrically neutral polymers. The aim of this article is to highlight key results and some outstanding questions in the polyelectrolyte research from recent literature. We focus on the influence of electrostatics on conformational and hydrodynamic properties of polyelectrolyte chains. A compilation of experimental results from the literature reveals significant disparities with theoretical predictions. We also discuss a new class of polyelectrolytes called poly(ionic liquid)s that exhibit unique physical properties in comparison to ordinary polyelectrolytes. We conclude this review by listing some key research challenges in order to fully understand the conformation and dynamics of polyelectrolytes in solutions.

Controlled mechanical properties of poly(ionic liquid)-based hydrophobic ion gels by the introduction of alumina nanoparticles with different shapes

Ionic-liquid gels, also known as ion gels, have gained considerable attention due to their high ionic conductivity and CO2 absorption capacity. However, their low mechanical strength has hindered their practical applications. A potential solution to this challenge is the incorporation of particles, such as silica nanoparticles, TiO2 nanoparticles, and metal-organic frameworks (MOFs) into ion gels. Comparative studies on the effect of particles with different shapes are still in progress. This study investigated the effect of the shape of particles introduced into ion gels on their mechanical properties. Consequently, alumina/poly(ionic liquid) (PIL) double-network (DN) ion gels consisting of clustered alumina nanoparticles with various shapes (either spherical or rod-shaped) and a chemically crosslinked poly[1-ethyl-3-vinylimidazolium bis(trifluoromethanesulfonyl)imide] (PC2im-TFSI, PIL) network were prepared. The results revealed that the mechanical strengths of the alumina/PIL DN ion gels were superior to those of PIL single-network ion gels without particles. Notably, the fracture energies of the rod-shaped alumina/PIL DN ion gels were approximately 2.6 times higher than those of the spherical alumina/PIL DN ion gels. Cyclic tensile tests were performed, and the results indicate that the loading energy on the ion gel was dissipated through the fracture of the alumina network. TEM observation suggests that the variation in the mechanical strength depending on the shape can be attributed to differences in the aggregation structure of the alumina particles, thus indicating the possibility of tuning the mechanical strength of ion gels by altering not only particle kinds but its shape.

Superchaotropic Nano-ion Binding as a Gelation Motif in Cellulose Ether Solutions

Nanometer-sized anions (nano-ions) like polyoxometalates and boron clusters exhibit so-called superchaotropic behavior, which describes their strong binding to hydrated non-ionic matter in water. We show here that nano-ions, at millimolar concentrations, dramatically enhance the viscosity and induce gelation of aqueous solutions of non-ionic cellulose ethers (CEs), a class of widely utilized polymers known for their thickening and gel-forming ability. These phenomena arise from an interplay of attractive forces and repulsive electrostatic forces between CE-chains upon nano-ion binding. The attractive forces manifest themselves as aggregation of CE-chains into a physically crosslinked polymer network (gel). In turn, the electrostatic repulsions hamper the viscosity increase and gelation. Superchaotropic nano-ion binding emerges as a novel and general physical crosslinking motif for CE-solutions and exceeds by far the conventional thickening effects of classical salts and ionic surfactants.

Photo- and thermo-responsive microgels with supramolecular crosslinks for wavelength tunability of the volume phase transition temperature

Functional microgels have powerful applications, especially due to their quick responsiveness to different external stimuli such as temperature, pH, ionic strength, solvent composition and light. Here, we describe the synthesis of novel dual-responsive poly(N-isopropylacrylamide) (PNIPAM) microgels and demonstrate that, in addition to temperature, light changes their properties. The crosslinks inside the microgels were achieved by the host-guest interactions between the trans azobenzene (transAzo) and β-cyclodextrin (βCD) units. transAzo can be photoisomerized to cisAzo which exhibits significant lower binding affinity to βCD. As a consequence, the crosslink density, and thus several microgel properties, can be controlled by light irradiation. Surprisingly, this irradiation with light can significantly change the volume phase transition temperature (VPTT) by several degrees centigrade, presumably due to the fact that the polar βCD shields the transAzo bound to it, whereas the unbound cisAzo is rather apolar. As a result, continuous irradiation with specific wavelengths until reaching the respective photostationary state allows for a full control over the VPTT within the physiologically relevant range between 32 °C and 38 °C.

How Softness Matters in Soft Nanogels and Nanogel Assemblies

Softness plays a key role in determining the macroscopic properties of colloidal systems, from synthetic nanogels to biological macromolecules, from viruses to star polymers. However, we are missing a way to quantify what the term "softness" means in nanoscience. Having quantitative parameters is fundamental to compare different systems and understand what the consequences of softness on the macroscopic properties are. Here, we propose different quantities that can be measured using scattering methods and microscopy experiments. On the basis of these quantities, we review the recent literature on micro- and nanogels, i.e. cross-linked polymer networks swollen in water, a widely used model system for soft colloids. Applying our criteria, we address the question what makes a nanomaterial soft? We discuss and introduce general criteria to quantify the different definitions of softness for an individual compressible colloid. This is done in terms of the energetic cost associated with the deformation and the capability of the colloid to isotropically deswell. Then, concentrated solutions of soft colloids are considered. New definitions of softness and new parameters, which depend on the particle-to-particle interactions, are introduced in terms of faceting and interpenetration. The influence of the different synthetic routes on the softness of nanogels is discussed. Concentrated solutions of nanogels are considered and we review the recent results in the literature concerning the phase behavior and flow properties of nanogels both in three and two dimensions, in the light of the different parameters we defined. The aim of this review is to look at the results on micro- and nanogels in a more quantitative way that allow us to explain the reported properties in terms of differences in colloidal softness. Furthermore, this review can give researchers dealing with soft colloids quantitative methods to define unambiguously which softness matters in their compound.

Oscillatory rheology of carboxymethyl cellulose gels: Influence of concentration and pH

The flow properties of ionic polysaccharides are determined by the interplay of electrostatic and hydrophobic interactions, which depend on the ionic strength and pH of the solvent. We explore the LVE and LAOS rheology of carboxymethyl cellulose (CMC) in aqueous media, focusing on its gelling behaviour. We find that addition of HCl promotes gel formation and addition of NaOH suppresses it. The former effect is interpreted as being caused by a decrease of the charge density of the polymer, which facilitates interchain associations and the later effect can be assigned to solubilisation of cellulose backbone by NaOH. Our results along with a review of the literature allow us to establish the concentration regimes and associated properties of physical gels of carboxymethyl cellulose. At neutral pH, the storage modulus of NaCMC gels of varying molecular weight and DS at a given concentration does not vary by more than a factor 5.

Ionotropic Gelation Fronts in Sodium Carboxymethyl Cellulose for Hydrogel Particle Formation

Hydrogel microparticles (HMPs) find numerous practical applications, ranging from drug delivery to tissue engineering. Designing HMPs from the molecular to macroscopic scales is required to exploit their full potential as functional materials. Here, we explore the gelation of sodium carboxymethyl cellulose (NaCMC), a model anionic polyelectrolyte, with Fe3+ cations in water. Gelation front kinetics are first established using 1D microfluidic experiments, and effective diffusive coefficients are found to increase with Fe3+ concentration and decrease with NaCMC concentrations. We use Fourier Transform Infrared Spectroscopy (FTIR) to elucidate the Fe3+-NaCMC gelation mechanism and small angle neutron scattering (SANS) to spatio-temporally resolve the solution-to-network structure during front propagation. We find that the polyelectrolyte chain cross-section remains largely unperturbed by gelation and identify three hierarchical structural features at larger length scales. Equipped with the understanding of gelation mechanism and kinetics, using microfluidics, we illustrate the fabrication of range of HMP particles with prescribed morphologies.

Screening lengths and osmotic compressibility of flexible polyelectrolytes in excess salt solutions

We report results of small angle neutron scattering measurements made on sodium polystyrene sulfonate in aqueous salt solutions. The correlation length (ξ) and osmotic compressibility are measured as a function of polymer (c) and added salt (cS) concentrations, and the results are compared with scaling predictions and the random-phase approximation (RPA). In Dobrynin et al.'s scaling model the osmotic pressure consists of a counter-ion contribution and a polymer contribution. The polymer contribution is found to be two orders of magnitude smaller than expected from the scaling model, in agreement with earlier observations made on neutral polymers in good solvent condition. RPA allows the determination of single-chain dimensions in semidilute solutions at high polymer and added salt concentrations, but fails for cS≤ 2 M. The χ parameter can be modelled as the sum of an intrinsic contribution (χ0) and an electrostatic term: χ∼χ0 + K'/√cS, where χ0 > 0.5 is consistent with the hydrophobic nature of the backbone of NaPSS. The dependence of χelec∼ 1/√cS disagrees with the random-phase approximation (χelec∼ 1/cs), but agrees with the light scattering results in dilute solution and Dobrynin et al.'s scaling treatment of electrostatic excluded volume.

Flow properties reveal the particle-to-polymer transition of ultra-low crosslinked microgels

Exploiting soft, adaptive microgels as building blocks for soft materials with controlled and predictable viscoelastic properties is of great interest for both industry and fundamental research. Here the flow properties of different poly(N-isopropylacrylamide) (pNIPAM) microgels are compared: regularly crosslinked versus ultra-low crosslinked (ULC) microgels. The latter are the softest microgels that can be produced via precipitation polymerization. The viscosity of ULC microgel suspensions at low concentrations can be described with models typically used for hard spheres and regularly crosslinked microgels. In contrast, at higher concentrations, ULC microgels show a much softer behavior compared to regularly crosslinked microgels. The increase of the storage modulus with concentration discloses that while for regularly crosslinked microgels the flow properties are mainly determined by the more crosslinked core, for ULC microgels the brush-like interaction is dominant at high packing fractions. Both the flow curves and the increase of the storage modulus with concentration indicates that ULC microgels can form glass and even reach an apparent jammed state despite their extreme softness. In contrast, the analysis of oscillatory frequency sweep measurements show that when approaching the glass transition the ultra-low crosslinked microgels behave as the regularly crosslinked microgels. This is consistent with a recent study showing that in this concentration range the equilibrium phase behavior of these ULC microgels is the one expected for regularly crosslinked microgels.

Entanglement Properties of Polyelectrolytes in Salt-Free and Excess-Salt Solutions

We study the entanglement properties of polyelectrolytes in salt-free and excess-salt solutions, corresponding to rod-like and expanded coil conformations, respectively. While the solvent's ionic strength has a large impact on the conformation of polyelectrolytes, it does not affect its entanglement density and entanglement crossover. This contradicts current models of polymer entanglement and suggests that the density of binary contacts in solution is not affected by the solvent quality. Based on this observation, we work out the reptation dynamics of polyelectrolytes in salt-free solution, which differ appreciably from earlier models.

Viscosity of Semidilute and Concentrated Nonentangled Flexible Polyelectrolytes in Salt-Free Solution

We report viscosity data of nonentangled sodium polystyrene sulfonate (NaPSS) in salt-free aqueous solution as a function of polymer concentration ( c) and degree of polymerization ( N). Different empirical equations are examined and found not to describe the semidilute solution viscosity over a wide concentration range and/or to yield values of [η] that do not match dilute solution measurements. Deviations from the scaling prediction of η_sp ∝ c^1/2 (Fuoss' law) are observed at high concentrations. Specifically, we find η_sp ≈ N^1.26 c^1/2 e^{1.4 c} in the semidilute regime, which agrees with the scaling prediction only for c ≲ 0.02 M. The viscosity data presented in this study and in earlier reports show a high degree of consistency. A comparison with diffusion measurements for NaPSS in salt-free solution by Oostwal and co-workers suggests that the disagreement between the scaling theory and experiments does not arise solely from the concentration dependence of the monomeric friction coefficient.

Effect of ionic strength on the structure and elongational kinetics of vimentin filaments

Intermediate filaments are a major structural element in the cytoskeleton of animal cells that mechanically integrate other cytoskeletal components and absorb externally applied stress. Their role is likely to be linked to their complex molecular architecture which is the product of a multi-step assembly pathway. Intermediate filaments form tetrameric subunits which assemble in the presence of monovalent salts to form unit length filaments that subsequently elongate by end-to-end annealing. The present work characterizes this complex assembly process using reconstituted vimentin intermediate filaments with monovalent salts as an assembly trigger. A multi-scale approach is used, comprising static light scattering, dynamic light scattering and quantitative scanning transmission electron microscopy (STEM) mass measurements. Light scattering reveals the radius of gyration (Rg), molecular weight (Mw) and diffusion coefficient (D) of the assembling filaments as a function of time and salt concentration (cS) for the given protein concentration of 0.07 g L-1. At low cS (10 mM KCl) no lateral or elongational growth is observed, whereas at cS = 50-200 mM, the hydrodynamic cross-sectional radius and the elongation rate increases with cS. Rgversus Mw plots suggest that the mass per unit length increases with increasing salt content, which is confirmed by STEM mass measurements. A kinetic model based on rate equations for a two step process is able to accurately describe the variation of mass, length and diffusion coefficient of the filaments with time and provides a consistent description of the elongation accelerated by increasing cS.

Enzyme-Compatible Dynamic Nanoreactors from Electrostatically Bridged Like-Charged Surfactants and Polyelectrolytes

Reported is an unanticipated mechanism of attractive electrostatic interactions of fully neutralized polyacrylic acid (PAA) with like-charged surfactants. Amphiphilic polymer-surfactant complexes with high interfacial activity and a solubilization capacity exceeding that of conventional micelles are formed by bridging with Ca²⁺ ions. Incorporation of a protease into such dynamic nanoreactors results in a synergistically enhanced cleaning performance because of the improved solubilization of poorly water-soluble immobilized proteins. Competitive interfacial and intermolecular interactions on different time- and length-scales have been resolved using colorimetric analysis, dynamic tensiometry, light scattering, and molecular dynamic simulations. The discovered bridging association mechanism suggests reengineering of surfactant/polymer/enzyme formulations of modern detergents and opens new opportunities in advancing labile delivery systems.

Microfluidic devices for small-angle neutron scattering

A comparative examination is presented of materials and approaches for the fabrication of microfluidic devices for small-angle neutron scattering (SANS). Representative inorganic glasses, metals, and polymer materials and devices are evaluated under typical SANS configurations. Performance criteria include neutron absorption, scattering background and activation, as well as spatial resolution, chemical compatibility and pressure resistance, and also cost, durability and manufacturability. Closed-face polymer photolithography between boron-free glass (or quartz) plates emerges as an attractive approach for rapidly prototyped microfluidic SANS devices, with transmissions up to ∼98% and background similar to a standard liquid cell (I ≃ 10-3 cm-1). For applications requiring higher durability and/or chemical, thermal and pressure resistance, sintered or etched boron-free glass and silicon devices offer superior performance, at the expense of various fabrication requirements, and are increasingly available commercially.

Droplet microfluidic SANS

The coupling of droplet microfluidics and Small Angle Neutron Scattering (SANS) is demonstrated with a range of model systems: isotopic solvent (H₂O/D₂O) mixtures, surfactant (sodium dodecyl sulfate, SDS) solutions and colloidal (silica) suspensions. Several droplet carrier phases are evaluated and fluorinated oil emerges as a suitable fluid with minimal neutron background scattering (commensurate with air), and excellent interfacial properties. The combined effects of flow dispersion and compositional averaging caused by the neutron beam footprint are evaluated in both continuous and droplet flows and an operational window is established. Systematic droplet-SANS dilution measurements of colloidal silica suspensions enable unprecedented quantification of form and structure factors, osmotic compressibility, enhanced by constrained global data fits. Contrast variation measurements with over 100 data points are readily carried out in 10-20 min timescales, and validated for colloidal silica of two sizes, in both continuous and droplet flows. While droplet microfluidics is established as an attractive platform for SANS, the compositional averaging imposed by large (∼1 cm) beam footprints can, under certain circumstances, make single phase, continuous flow a preferable option for low scattering systems. We propose simple guidelines to assess the suitability of either approach based on well-defined system parameters.

Does Flory-Rehner theory quantitatively describe the swelling of thermoresponsive microgels?

The swelling of thermoresponsive microgels is widely modelled through Flory-Rehner theory, which combines Flory-Huggins solution thermodynamics with the affine network model of elasticity. While it has been shown that FR theory closely follows experimental results for a range of systems, the large number of free parameters required to fit size vs. temperature data make a proper evaluation of the theory difficult. In order to test the applicability of FR theory to microgel particles, we analyse viscosity and light scattering data for PNIPAM microgels as a function of temperature, cross-linking degree (f) and molar mass. In the collapsed state, the polymer volume fraction is estimated to be ϕ_C ≃ 0.44, independent of cross linking degree and molar mass. Fixing ϕ_C, f and the θ temperature to independent estimates, the FR model appears to describe microgel swelling well, particularly for high cross-linking densities. Estimates for the various fit parameters differ from earlier reports by an order of magnitude. A comparison of the χ parameter obtained from FR theory with values for the linear polymer reveals that the agreement between experiment and theory is somewhat fortuitous. Although the FR model can accurately describe experimental data, the accuracy of the obtained fit parameters is significantly poorer.

Rapid contrast matching by microfluidic SANS

We report a microfluidic approach to perform small angle neutron scattering (SANS) measurements of contrast variation and matching, extensively employed in soft and biological matter research. We integrate a low scattering background microfluidic mixer and serpentine channel in a SANS beamline to yield a single phase, continuous flow, reconfigurable liquid cell. By contrast with conventional, sequential measurements of discrete (typically 4-6) solutions of varying isotopic solvent composition, our approach continually varies solution composition during SANS acquisition. We experimentally and computationally determine the effects of flow dispersion and neutron beam overillumination of microchannels in terms of the composition resolution and precision. The approach is demonstrated with model systems: H₂O/D₂O mixtures, a surfactant (sodium dodecyl sulfate, SDS), a triblock copolymer (pluronic F127), and silica nanoparticles (Ludox) in isotopic aqueous mixtures. The system is able to zoom into a composition window to refine contrast matching conditions, and robustly resolve solute structure and form factors by simultaneous fitting of scattering data with continuously varying contrast. We conclude by benchmarking our microflow-SANS with the discrete approach, in terms of volume required, composition resolution and (preparation and measurement) time required, proposing a leap forward in equilibrium, liquid solution phase mapping and contrast variation by SANS.

Microfluidic-SANS: flow processing of complex fluids

Understanding and engineering the flow-response of complex and non-Newtonian fluids at a molecular level is a key challenge for their practical utilisation. Here we demonstrate the coupling of microfluidics with small angle neutron scattering (SANS). Microdevices with high neutron transmission (up to 98%), low scattering background (≲10⁻² cm⁻¹), broad solvent compatibility and high pressure tolerance (≈3-15 bar) are rapidly prototyped via frontal photo polymerisation. Scattering from single microchannels of widths down to 60 μm, with beam footprint of 500 μm diameter, was successfully obtained in the scattering vector range 0.01-0.3 Å(-1), corresponding to real space dimensions of ≃10-600 Å. We demonstrate our approach by investigating the molecular re-orientation and alignment underpinning the flow response of two model complex fluids, namely cetyl trimethylammonium chloride/pentanol/D₂O and sodium lauryl sulfate/octanol/brine lamellar systems. Finally, we assess the applicability and outlook of microfluidic-SANS for high-throughput and flow processing studies, with emphasis of soft matter.

Structure of Sodium Carboxymethyl Cellulose Aqueous Solutions: A SANS and Rheology Study

We report a small angle neutron scattering (SANS) and rheology study of cellulose derivative polyelectrolyte sodium carboxymethyl cellulose with a degree of substitution of 1.2. Using SANS, we establish that this polymer is molecularly dissolved in water with a locally stiff conformation with a stretching parameter. We determine the cross sectional radius of the chain ( 3.4 Å) and the scaling of the correlation length with concentration (ξ = 296 c^−1/2Å for c in g/L) is found to remain unchanged from the semidilute to concentrated crossover as identified by rheology. Viscosity measurements are found to be in qualitative agreement with scaling theory predictions for flexible polyelectrolytes exhibiting semidilute unentangled and entangled regimes, followed by what appears to be a crossover to neutral polymer concentration dependence of viscosity at high concentrations. Yet those higher concentrations, in the concentrated regime defined by rheology, still exhibit a peak in the scattering function that indicates a correlation length that continues to scale as. © 2014 The Authors. Journal of Polymer Science Part B: Polymer Physics Published by Wiley Periodicals, Inc. J. Polym. Sci., Part B: Polym. Phys. 2015, 53, 492–501

Microfluidic approach to the formation of internally porous polymer particles by solvent extraction

We report the controlled formation of internally porous polyelectrolyte particles with diameters ranging from tens to hundreds of micrometers through selective solvent extraction using microfluidics. Solvent-resistant microdevices, fabricated by frontal photopolymerization, encapsulate binary polymer (P)/solvent (S1) mixtures by a carrier solvent phase (C) to form plugs with well-defined radii and low polydispersity; the suspension is then brought into contact with a selective extraction solvent (S2) that is miscible with C and S1 but not P, leading to the extraction of S1 from the droplets. The ensuing phase inversion yields polymer capsules with a smooth surface but highly porous internal structure. Depending on the liquid extraction time scale, this stage can be carried out in situ, within the chip, or ex situ, in an external S2 bath. Bimodal polymer plugs are achieved using asymmetrically inverted T junctions. For this demonstration, we form sodium poly(styrenesulfonate) (P) particles using water (S1), hexadecane (C), and methyl ethyl ketone (S2). We measure droplet extraction rates as a function of drop size and polymer concentration and propose a simple scaling model to guide particle formation. We find that the extraction time required to form particles from liquid droplets does not depend on the initial polymer concentration but is rather proportional to the initial droplet size. The resulting particle size follows a linear relationship with the initial droplet size for all polymer concentrations, allowing for the precise control of particle size. The internal particle porous structure exhibits a polymer density gradient ranging from a dense surface skin toward an essentially hollow core. Average particle porosities between 10 and 50% are achieved by varying the initial droplet compositions up to 15 wt % polymer. Such particles have potential applications in functional, optical, and coating materials.

Risk factors for acute stress disorder in children with burns

The purpose of this study was to (1) estimate the prevalence of acute stress disorder (ASD) in a sample of burned children, and (2) determine risk factors for ASD in these children. Seventy-two children were assessed for acute stress disorder approximately 10 days after being hospitalized for a burn. Variables hypothesized to predict ASD symptoms (i.e., size of the burn, prior behavioral symptoms, body image, parents' symptoms, heart rate) were also assessed. Based on a diagnosis derived from the ASD module of the Diagnostic Interview for Children and Adolescents (DICA), 31% of children met criteria for ASD. Path analyses revealed that the variables of heart rate, body image, and parents' acute stress symptoms were directly related to the development of ASD symptoms and accounted for 41% of its variance. These variables also mediated the relationship between the size of the burn and ASD symptoms. ASD is found in almost one third of children hospitalized for a burn. A high resting heart rate, lowered body image, and parent's acute stress symptoms were found to be significant risk factors for ASD symptoms.

Implementation of an event reporting system in a transfusion medicine unit: a local experience

Event reporting can provide data to study the failure points of an organization's work process. As part of the ongoing efforts to improve transfusion safety, a Medical Event Reporting System Transfusion Medicine, (MERS - TM) as designed by Kaplan et al was implemented in the Transfusion Medicine Unit of the University Malaya Medical Centre to provide a standardized means of organized data collection and analysis of transfusion errors, adverse events and near misses. An event reporting form was designed to detect, identify, classify and study the frequency and pattern of events occurring in the unit. Events detected were classified according to Eihdhoven Classification model (ECM) adopted for MERS - TM. Since our system reported all events, we called it Event Reporting System - Transfusion Medicine (ERS-TM). Data was collected and analyzed from the reporting forms for a period of five months from January 15th to June 15th 2002. The initial half of the period was a process of evaluation during which 118 events were reported, coded, analyzed and corrective measures adopted to prevent the recurrence of the same event. The latter half saw the reporting of 122 events following the adoption of corrective measures. There was a reduction in the occurrence of some events and an increase in others, which were mainly beyond the organization's control. A longer period of evaluation is necessary to identify the underlying contributory causes that can be useful to develop plans for corrective and preventive action and thereby reduce the rate of recurrence of errors through proper training and adoption of just culture.

Genetic polymorphism of CYP2D6 in Chinese subjects in Malaysia

BACKGROUND

Although Malaysian Chinese share an origin with the mainland Chinese, their evolution has been influenced by intermarriages. With a gene such as CYP2D6, which is highly polymorphic, it is expected that the Malaysian Chinese would exhibit a polymorphism profile different from those of the Chinese populations in other geographical locations.

OBJECTIVE

To study the genotype distribution of CYP2D6 among the Chinese people in Malaysia.

METHOD

We obtained DNA from 236 Chinese individuals in Malaysia and used PCR-based methods to identify any common CYP2D6 alleles.

RESULTS

A total of 236 subjects were enrolled and were successfully genotyped. Malaysian Chinese were relatively heterogeneous in terms of their CYP2D6 genotypes with nine genotypes recorded. CYP2D6*4, *5, *9, *10 and *17 were detected with the most common genotype being *1/*10. No subject had genotypes that predicted poor metabolic activity. However, 40% showed genotypes (e.g. CYP2D6*10/*10, *17, *4 and *9 and *9/*9) that predicted an intermediate metabolizer phenotype. Another subject carried the defective CYP2D6*17 allele and six carried the defective CYP2D6*9 allele. Both these alleles have not been reported in other earlier Chinese studies.

CONCLUSION

This study revealed that, in terms of CYP2D6 polymorphism, Malaysian Chinese were a heterogeneous group of people. Although sharing some similarities with other Orientals, they also seemed to have some notable differences. The alleles CYP2D6*4, *5, *9, *10 and *17 were all detected. CYP2D6*3 was however absent.

The prevalence of GP Mur and anti-"Mia" in a tertiary hospital in Peninsula Malaysia

The Mi III phenotype of the Miltenberger subsystem (or GP Mur) is relatively common in Southeast Asia especially along the south-east coast lines of China and Taiwan. The term anti-"Mia" describes antibodies that react with the Mi III phenotype. Since the Peninsula Malaysian population is a multiethnic one with a significant proportion of Chinese, a study was conducted into the prevalence of anti-"Mia" in patients from its 3 major ethnic groups--Chinese, Malays and Indians, as well as the GP Mur phenotype in blood donors (healthy individuals). Blood samples from 33,716 patients (general and antenatal) were screened for anti-"Mia" from January 1999 to December 2000. The investigation for the GP Mur phenotype representing the corresponding sensitizing antigen complex was carried out in 655 blood donors. Serum anti-"Mia" antibody was found to be the third most commonly occurring antibody detected in our patients and was found in all the ethnic groups. The antibody was detected in 0.2% of 33,716 antenatal and general patients with a prevalence in Chinese of 0.3%, Malay 0.2% and Indian 0.2%. The detection of these antibodies in the ethnic groups other than the Chinese is a noteworthy finding as such information is not well documented. The GP Mur red cell phenotype was detected in 15/306 (4.9%) of Chinese blood donors, a lower prevalence than in Chinese populations in other countries in the region. More significant was its detection in the Malays (2.8%) and the Indians (3.0%). Because of the many reports of clinical problems associated with the "Mia" antibody including the causation of fetal hydrops and haemolytic transfusion reactions, it is warranted that the GP Mur red cells be included in screening panels for group and screen procedures in countries with a significant Asian population.

Differential accumulation of a 24-kd dehydrin protein in wheat seedlings correlates with drought stress tolerance at grain filling

The Pacific Northwest (PNW), an important region for wheat production in the USA, is often subject to water deficits during sowing and grain filling. These deficits reduce the quality and yield of the crop. As a consequence, an important objective of breeding programs in the region is improving the genetic adaptation of wheat cultivars to drought stress. One response to dehydrative stresses is the accumulation of proteins called dehydrins, which are believed to protect membranes and macromolecules against denaturation. We characterized dehydrin accumulation in seedlings during drought stress and its correlation with stress tolerance during grain filling in seven wheat cultivars, 'Connie', 'Gene', 'TAM105', 'Rod', 'Hiller', 'Rhode', and 'Stephens'. A 24-kd dehydrin accumulated in seedlings under stress, but not in irrigated control plants. Connie, TAM105, and Gene started to accumulate dehydrins at the fourth day of stress, while the other cultivars showed dehydrins after twelve days of stress. This differential accumulation in seedlings was associated with stress tolerance at grain filling, characterized by a lower reduction in yield and in the rate of decrease in leaf water potential per day of stress. Connie, TAM105, Gene and Rod where the most tolerant cultivars. The results indicate that expression of this 24-kd dehydrin might serve as a rapid and non-destructive screening technique at the seedling stage. Even though the results are promising, selection experiments using a population segregating for stress tolerance are needed to test more conclusively whether this dehydrin can serve as a genetic marker for cultivars with tolerance to drought stress.

An analysis of blood utilization for elective surgery in a tertiary medical centre in Malaysia

BACKGROUND

The purpose of this study is to determine the efficiency of blood utilization for elective surgery at the University of Malaya Medical Centre (UMMC). A similar study conducted six years earlier in the same unit resulted in the introduction and implementation in December 1997 of the local Maximum Surgical Blood Order Schedule (MSBOS) and the Group Screen and Hold (GSH) procedure instead of a full crossmatch. This paper compares the findings of the current study with that conducted earlier.

MATERIALS AND METHODS

A prospective survey of the blood ordering practice for elective surgery over a 3-month period, from February to April 2001 was conducted in the Transfusion Medicine Unit (TMU) of the UMMC. Outcome measures used in this study were (a) decision on whether to perform a full cross match or a GSH procedure using the MSBOS guidelines, (b) the crossmatch transfusion ratio (CT), (c) the transfusion index (TI) and (d) the degree of over transfusion calculated from the pre and postoperative hemoglobin levels. The CT ratio and the TI were calculated for each type of elective surgery performed during the study period.

RESULTS

In the present study 31.2% of cases had blood crossmatched as against 40.6% in the earlier one The overall CT ratio was 5.0 and many procedures were found to have a high CT ratio and a low transfusion index. It was observed that 47.7% of patients were over transfused as compared to 45.5% in the earlier study.

CONCLUSION

The introduction of MSBOS and GSH has led to a significant decrease in the percentage (p= < 0.05) of cases for which a full crossmatch is done. The conservation policies have led to a decreased crossmatch workload and reduced blood outdating. Although the CT ratio has improved for many individual procedures, the overall CT ratio in fact increased from 4.4 to 5.0. There remains therefore, a continuous opportunity to improve transfusion practices by reviewing the local MSBOS. The transfusion index (TI) calculated for each procedure in this study can be utilized to recommend a GSH for those procedures with low TI.

An audit of fresh frozen plasma usage in a tertiary referral centre in a developing country

This paper evaluates the practice of fresh frozen plasma (FFP) transfusion at the University Hospital, Kuala Lumpur, and analyses its usage by the various clinical departments. The aim of this study is to identify where it is inappropriately used and the clinical indications in which such misuse is common. A retrospective analysis of the blood bank request forms and work sheets during a 6-month period between January 1998 and June 1998 formed the basis of this study. Overall, 40% of 2665 units transfused were considered appropriate. However, out of the 931 episodes of FFP transfusions only 31% were for appropriate indications. The average FFP requirement when used for appropriate indication was about 4 units per episode, whereas for inappropriate indication it was 2.5 units per episode. Inappropriate use in terms of the number of units was highest by the surgical services (68%) and Orthopaedics (64%), while the Department of Paediatrics had the lowest incidence of inappropriate use (40%). When Paediatrics was used as the benchmark, the incidence of inappropriate use by other departments was significantly higher (p < 0.01). As for FFP usage in common clinical indications, there was a high incidence of inappropriate use in burns (82%), perioperative period (73%), cardiac surgery (68%), massive bleeding (62%) and trauma (60%). The findings in this study, specifically the use of FFP for volume support in trauma, massive bleeding and burns, routine requests without identified indication in cardiac bypass surgery, and prophylactic use in the perioperative period can be the basis for recommendations to minimize the inappropriate use of FFP in the future.

Efficiency of blood usage for elective surgery in the University Hospital Kuala Lumpur

Provision of quality care, service and blood products to patients while containing costs and the amount of blood used should be the aim of every blood bank. Therefore a prospective audit was carried out over three months to determine how efficiently blood was being used in elective surgery in the University Hospital, Kuala Lumpur. Every case with blood crossmatched was monitored to determine the amount transfused and the posttransfusion haemoglobin level. Overcrossmatching of varying degrees was noted in almost all surgical procedures and overtransfusion in 45.5% of patients transfused. The rate of case postponement was 18.1%. These indicate inefficient utilization of blood and other resources. The transfusion index (TI) and range of units transfused were calculated for each procedure. They can be used as indicators of blood requirement and potential severity of hemorrhage. Suggestions to improve efficiency of blood utilization include the introduction and ongoing monitoring of guidelines on crossmatching and transfusion based on the data obtained here, by the hospital blood transfusion committee; the "group, screen and hold" practice for surgical procedures with high crossmatch transfusion ratios, low transfusion indices and a small range of units transfused could also be adopted.

Prevalence of hepatitis delta virus infection in Malaysia

The prevalence of coinfection, superinfection and chronic infection with the hepatitis delta virus (HDV) was studied in 324 hepatitis B surface antigen (HBsAg)-positive Malaysians. Of these, 10.0% (5/50) had coinfection, 5.7% (11/194) had superinfection, but none of the 80 patients with chronic liver disease (CLD) or primary hepatocellular carcinoma (PHC) had chronic infection with HDV. The overall HDV infection was 4.9% (16/324). One of the coinfection cases acquired the HDV infection as early as 1982. HDV superinfection was detected mainly among IV drug abusers (20% or 7/35) and promiscuous males and females (13.6% or 3/22). They were all asymptomatic. Only 0.8% (1/125) apparently healthy blood donors was infected with HDV. None of the 12 multi-transfused patients examined were positive. Malaysia is the only Southeast Asian country examined so far in which HDV infection was detected. The reason could be that the IV drug abusers and the sexually promiscuous groups missed being examined in the other countries. Comparing the HDV infection rates in 4 categories of infected Malaysians (viz. acute hepatitis B patients, IV drug abusers, blood donors and CLD patients) with those of other countries, it was noted that the Malaysian rates were similar to the lowest in the range of prevalence rates of each category in the latter group. The rate of coinfection in a preliminary study in 1982-84 (9.0% or 1/11) was not very different from that obtained to date (10.0% or 5/50).(ABSTRACT TRUNCATED AT 250 WORDS)