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Objective-To study maternal and fetal outcome in women with past or present histologically proven systemic lupus erythematosus (SLE) nephritis. Method-Retrospective study of 32 pregnancies in 22 women with past or present histologically proven SLE nephritis in a single French centre. Results-Pregnancy (25 planned and 7 not planned) occurred in a mean (SD) of 8 (5) years after SLE diagnosis and 6 (4) years after renal disease onset. Seven occurred in women with antiphospholipid syndrome. At pregnancy onset, all but one woman had creatininaemia below 100 µmol/l, five had proteinuria >0.5 g/day, none had hypertension. Twelve pregnancies occurred in women previously treated with immunosuppressant drugs. Treatment comprised prednisone (n=31), hydroxychloroquine (n=11), aspirin (n=22), heparin (n=12), and azathioprine in one patient with steroid resistant nephrotic syndrome disclosing SLE. No therapeutic abortion was done. During pregnancy or the postpartum period, or both, proteinuria >0.5 g/day occurred in 10 women (five related to pre-eclampsia, four to renal flare, one to stable nephrotic syndrome). One flare consisted of mild arthralgias. Pregnancy outcome comprised one fetomaternal death in SLE disclosed by pregnancy, five embryonic losses, two fetal deaths, and 18 premature (one neonatal death) and six full term births. No criterion appeared to influence fetal survival significantly. At long term, one patient died during an SLE flare, three women had renal relapses. At the last visit, all had creatininaemia below 100 µmol/l except one woman with creatinine level 115 µmol/l, nine had proteinuria >0.5 g/day, and one was treated for hypertension. Conclusion-Pregnancy need not be discouraged in women with a history of SLE nephritis with normal or mildly impaired renal function. Deterioration of renal function rarely occurs. However, these pregnancies are at high risk of preeclampsia and prematurity. (Ann Rheum Dis 2001;60:599-604) Systemic lupus erythematosus (SLE) aVects, particularly, women of childbearing age. Global SLE survival improvement due to better therapeutic management would lead to authorisation of pregnancy in an increased number of women. However, most studies analysing the relations between SLE and pregnancy found high fetal and maternal risksnotably, when pregnancy occurs in active SLE. 1In our 1987-91 French prospective study, SLE exacerbation was seen in 60% of the pregnancies and resulted in maternal death in 1.9% of the cases. Sixty three per cent of the newborn infants were premature, 29% growth retarded, and 5% died.2 Between 1982 and 1995 we prospectively "planned" 62 pregnancies in 38 women with SLE followed up in our department. Flares occurred in 27% of the cases. No child or mother died. After exclusion of early spontaneous and induced abortions, the live birth rate was 96%, which is close to that of the general French population. 3Nephritis is known to be one of the most serious complications of SLE and a strong predictor of poor outcome. However, its influence on mortality h...

Five percent of 145 HIV-1 infected men enrolled in an assisted reproductive technology (ART) program harbored detectable HIV-1 RNA in semen, although they had no other sexually transmitted disease and their blood viral load was undetectable for at least 6 months under antiretroviral treatment. This result justifies measuring HIV-1 RNA in semen before the ART process and suggests that a residual risk of transmission has to be mentioned to the patients who would like to have unprotected sexual intercourse.

Polymerization of 1,3‐cyclohexadiene was carried out in the presence of initiator systems such as titanium tetrachloride, organoalkali compounds, and Ziegler‐type catalysts. The best results as regards conversion rate and molecular weight, were those obtained with the use of organolithium compounds as initiators. When polymerization is performed in noncomplexing medium, all polycyclohexadienes are comparable, no matter what the initiator system used. They are composed mainly of 1,4‐substituted cyclohexene units and the double bond configuration is cis and trans. The cis–trans isomerization of the double bond seems to be independent of the polymerization mechanism. Complexing or highly polar reaction media favor the 1,2‐linking between cycles. The microstructure of the polymers was determined by infrared spectrometry and nuclear magnetic resonance analysis. Aromatization or partial dehydrogenation of polycyclohexadiene was achieved either by reaction with tetrachloro‐p‐benzoquinone or by bromination followed by dehydrobromination. An increase of the bromination temperature results in the direct formation of an aromatized polymer through the evolution of hydrogen bromide as soon as the bromine is fixed to the polymer. Infrared spectral analysis of the aromatized polymers give a further confirmation of two different types of substitution in polycyclohexadiene.

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It seems cautious individually to maintain the recommendations of safe sex and the recourse to ART, or at least to inform the couple of the residual potential risk, in serodiscordant couples desiring a child.

As part of an effort to develop a suspension-culture perfusion-based process with high flow rate without the fouling and antibody retention inherent to filter-based cell-separation devices, we have evaluated and contributed to the development of the Centritech Lab centrifuge for the perfusion culture of hybridoma cells in protein-free medium. Culture start-ups showed that cell growth and monoclonal-antibody (MAb) production rates were similar in both a spinner flask and continuous centrifugation coupled to a bioreactor. The centrifuge efficiently separated viable cells from dead ones. Viable-cell recoveries were never below 98%, whereas dead-cell recoveries were usually around 80%. The cell content of the centrifuge supernatant and concentrate was strongly determined by the total amount of cells, viable and dead, in the culture broth, but an influence of the centrifugation parameters (feed rate, times of separation and discharge, and rotor speed) was observed. This understanding of the separation process inside the centrifuge is important and may apply to other similar devices. Monoclonal antibodies were not retained in the bioreactor during centrifugation perfusion. However, whereas similar growth rates were obtained in perfusion cultures using either continuous centrifugation or filtration, MAb concentrations were 35% lower in the former case. Utilization of the centrifuge in an intermittent fashion decreased the daily cell residence time outside the bioreactor, the daily pelleted-cell residence time in the centrifuge, and the frequency of cell passage to the centrifuge. This led to higher viable-cell numbers in the bioreactor and an accompanying increase in MAb concentrations, 225-250 mg of IgM L-1, equal to the performance of filter-based perfusion systems with the same cell line. It was hypothesized that having cells periodically packed at the bottom of the centrifuge insert (up to 800 x 10(6) cells mL-1) is deleterious to the culture by exposing the pelleted cells to prolonged nutrient limitations.

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