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Yes . . . many times the D on a slide needs to be read on a slide box (heated, usually by a light bulb). At least the "old" high protein anti-D reagents required it. I do typings at a local school on slides and always tell the students that if it comes up negative that more testing needs to be done to verify that Rh status.

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I totally agree with David.

One of the reasons that the immediate spin technique being more sensitive than the slide technique is that it introduces centrifugation, which brings the red cells that much closer together, allowing the IgG anti-D antibodies to bridge between red cell surfaces more easily. In other words, the mere act of centrifugation acts as a potentiator, and drives the function of the Law of Mass Action further to the right.

For those of you who are less mature in years than me (or, to put it another way, for those of you who are not as ancient as me), it may be of interest to know that Fred Stratton, who coined the phrase Du (to describe red cells that were D positive, but which were not agglutinated by the then human-derived IgM reagents - the "u" standing for unagglutinated), used the Stratton sandwich to demonstrate Du red cells. This was a technique where IgM or IgG (can't remember which, and am too tired to look for the original paper at the moment - bad night duty!!!!) anti-D and red cells were mixed on a slide with a drop of bovine serum albumin, and then another slide was put over the top to form a "sandwich". This was then incubated at 37oC and read. If there was then agglutination, where none was found by simple tube technique, you had a Du!

It wasn't that sensitive, but it was about all that was available at the time.

:highfive::highfive::highfive::highfive::highfive:

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Malcolm that is very interesting - I've never heard that that was the reason for the term Du. I have heard many people say that it was short for 'undecided' - I shall correct them! If you find the article I would love to read it.

Well, it's amongst something like 300 to 400 photocopies of iknteresting/seminal papers that I have at home (Dee is NOT pleased about this), so when I have a couple of hours I will rake it out, photocopy it and send it to you, but don't hold your breath, as I doubt if it will be this week!

Hope you had a wonderful birthday, by the way.

:highfive::highfive::highfive::highfive::highfive:

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Malcolm that is very interesting - I've never heard that that was the reason for the term Du. I have heard many people say that it was short for 'undecided' - I shall correct them! If you find the article I would love to read it.

Malcolm, I would love to as well - would you be able to post it for all of us, in due time and if it escapes assisted immolation (my wife suggests darkly that some of my things might "take a walk")?

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Well, it's amongst something like 300 to 400 photocopies of iknteresting/seminal papers that I have at home

lol, i think that's a common "condition" amongst blood bankers, Malcolm. i'll introduce some very highly technical jargon from my "practice:"

  • The Heap: this is the term for my desk, you can't actually see it beneath the papers and post-it notes.
  • The Pile: this is the term for the collection of books needing to be read. There is a Queen Anne style chair under there.....somewhere.

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I do have a 2 year Statute of Limitations for my Heap: if no one has bugged you to take care of an item in your Heap, it may be safely discarded after two years, the exception being to-do lists for biannual inspections. This will aid in keeping the height of the Heap under that of the ceiling.

Sometimes my Heap and my Pile overlap but they are on good speaking terms.

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1 file cabinet and a large plastic bin at home. 2 piles and a file cabinet at work.

I say keep it all! Last time I "down-sized", less than 2 weeks later I needed something I threw away. Go figure. Glad everyone else does that (I feel much better!)

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That's what worries me - AND MY WIFE!!!!!!!!!!!

that's because she'd have to vacuum around you!

For practice at successful file removal I suggest Jenga practice...

http://www.mountainphotographer.com/wp-content/uploads/2008/06/drunken-jenga2.jpg

I like to think of it as a 'piling system', so long as you know it's in there that's all that matters:p

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What a delightful conversation!!!!!! and I thought I was alone!!!! Yes "its here somewhere in the pile or heap" oups an avalance, thank goodness no one saw it.

Me: No its not on my desk

Tech: but I put it here,

me: well since then, others have added to the pile including myself.

Hm, And they think I dont work!!

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Well, I've finished trawling through my collection of original and/or photocopied papers, and I can't find the one by Stratton that I am looking for at all. For those of you who read P.G.Wodehouse, you may recall a bit in one of his books about Blandings Castle and Lord Emsworth's prize pig, the Empress of Blandings, where the person looking after the pig is described as, "A son of toil buried under a ton of soil". With the dust involved in moving all these papers, that just about sums up my situation.

I have, however, gone back to my very rare copy of the 1st edition of Rob Race and Ruth Sanger's book, Blood Groups in Man", 1950, Blackwell, and they certainly talk about unagglutinated and agglutinated red cells when talking about Du.

This is echoed in my edition of the Medical Research Council Memorandum No.19, The Rh Blood Groups and their Clinical Effects, by Patrick Mollison, Arthur Mourant and Rob Race (His Majesty's Stationery Office, 1948).

So, I am sorry Fluffy Agglutinates and Dr. Pepper, but it seems that I will be unable to send you a photocopy of Stratton's original paper (unless I can call in a favour from a friend of mine who works in the University of Westminster, who may bebale to get access to it through their library - I will keep you posted)!

:cries::cries::cries::cries::cries:

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Ah yes, it is one thing to find the reference; it is quite another to actually obtain a copy of the paper to be able to read it!

Actually, for some years "Du" was thought to be another allelomorph, rather than part of, if you like, a "continuum of different strengths" of the D antigen, and it is only comparatively recently that we have come to undertsand and map the miriade and complex genetic and molecular background giving rise to these apparent "allelomorphs". In reality, we are still "blind" as to which ones should be treated as "D+" and which as "D-"; we can only do this by either the experience of others or by prediction from where the amino acid substitutions are likely to occur on the RhD protein - a bit like predicting the numbers of a state lottery!

Edited by Malcolm Needs
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