Meningitis after acute Borrelia burgdorferi infection in HIV infection

HISTORY AND CLINICAL FINDINGS: A 39-year-old HIV positive patient developed myalgia, headache and cough 4 weeks after a tick bite. His temperature was 37.4 degrees C and a circular pale erythema was noted over the left lower leg. INVESTIGATIONS: C-reactive protein was raised to 120 mg/l, white blood cell count was 5860/microliter, CD4-lymphocyte count 250/microliter. The chest radiogram showed pneumonitic infiltration in the left lower lobe. There were IgM antibodies against Borrelia burgdorferi. TREATMENT AND COURSE: Left lower lobe pneumonia and chronic erythema migrans were diagnosed and he was given oral azithromycin (500 mg on the first day and 250 mg for 4 days). The pneumonia cleared up, but 2 weeks later he developed symptoms of meningitis (496 cells per microliter, 87% lymphocytes, positive Borrelia burgdorferi antibody titer), which quickly and lastingly responded to ceftriaxon (2 g daily by brief infusion for 14 days). CONCLUSION: This immune-compromised HIV-infected patient developed disseminated borreliosis with CNS involvement 2 weeks after the occurrence of chronic erythema migrans. The initial treatment of the latter with azithromycin was unable to prevent the meningitis. It is unlikely that there was a causal connection between the borreliosis and the pneumonia.     

Prednisolone therapy of idiopathic feline lower urinary tract disease: a double-blind clinical study

A double-blind clinical study was performed to evaluate prednisolone as treatment for idiopathic feline lower urinary tract disease. No differences in response were observed in prednisolone- and placebo-treated cats.     

On the application of the Neuron MOS transistor principle formodern VLSI design

In this paper, the speed performance, power consumption, and layout area of Neuron MOS transistor circuits are monitored considering the requirements of modern VLSI design. The Neuron MOS transistor is a recently discovered device principle which has a number of input gates that couple capacitively to a floating gate. The floating gate potential controls the current of a transistor channel. This device can be used in logic circuits. A threshold current through the Neuron MOS transistor can be defined that causes a switching of the output of the logic circuits as soon as the channel current surmounts or falls below the specified value. We designed two different multiplier cells, one based on a Neuron MOS inverter, and the other on a Neuron MOS n-MOSFET which is used as one input device of a comparator circuit. Functionality of both cells is proven for data rates up to 50 MHz which represents the first high-speed measurement of a circuit based on this new design principle. A perspective for the upper speed limit found at more than 500 MHz is given by simulation. The new design principle has a layout area reduced by more than a factor of two compared to usual multiplier cells. Moreover, it is shown, that depending on the design chosen, high speed operation leads to considerable power savings. In view of those advantages it is concluded that the principle of threshold logic qualifies for a major breakthrough for packing density improvement of CMOS-based applications     

Activation of the anti-cancer drug ifosphamide by rat liver microsomal P450 enzymes

The NADPH-dependent metabolism of ifosphamide catalyzed by rat liver microsomes was investigated in order to identify individual P450 enzymes that activate this anti-cancer drug and to ascertain their relationship to the P450 enzymes that activate the isomeric drug cyclophosphamide. Pretreatment of rats with phenobarbital or clofibrate increased by up to 8-fold the activation of both ifosphamide and cyclophosphamide catalyzed by isolated liver microsomes. Studies using P450 form-selective inhibitory antibodies demonstrated that constitutively expressed P450s belonging to subfamily 2C (forms 2C11/2C6) make significant contributions to the activation of both oxazaphosphorines in uninduced male rat liver microsomes, while the phenobarbital-inducible P450 2B1 was shown to be a major catalyst of these activations in phenobarbital-induced microsomes. Pretreatment of rats with dexamethasone increased liver microsomal activation of ifosphamide approximately 6-fold without a corresponding effect on cyclophosphamide activation rates. Ifosphamide activation catalyzed by dexamethasone-induced liver microsomes was minimally inhibited by anti-P450 2B or anti-P450 2C antibodies, but was selectively inhibited by anti-P450 3A antibodies. Selective inhibition of liver microsomal ifosphamide activation was also effected by the macrolide antibiotic triacetyloleandomycin, an inhibitor of several dexamethasone-inducible 3A P450s. These studies establish that a dexamethasone-inducible family 3A P450 can make an important contribution to rat liver microsomal ifosphamide activation, and suggest that dexamethasone pretreatment might provide a useful approach for modulation of ifosphamide metabolism in order to improve its therapeutic efficacy in cancer patients.     

The multi-class binomial failure rate model

The impact of common cause failure (CCF) on PSA results for NPPs is in sharp contrast with the limited quality which can be achieved in their assessment. This is due to the dearth of observations and cannot be remedied in the short run. Therefore, the methods employed for calculating failure rates should be devised such as to make the best use of the few available observations on CCF. The Multi-Class Binomial Failure Rate (MCBFR) Model presented here achieves this by assigning observed failures to different classes according to their technical characteristics and applying the BFR formalism to each of these. The results are determined by a superposition of BFR type expressions for each class, each of them with its own coupling factor. The model hence integrates additional technical information on CCFs and leads to a better quality of results whenever this information is available. This is demonstrated by evaluating CCFs observed for combined impulse pilot valves in German NPPs.     

Apparatus for steady-state kinetic measurements of the catalytic reduction of nitric oxide by ammonia on iron oxide

The reduction of nitric oxide with ammonia on an unsupported iron oxide catalyst has been studied in a continuous-flow recycle reactor using simulated flue gas. The responses of the employed reactor system to step and pulse inputs of tracer indicate that the system could be regarded as a continuous stirred tank reactor (CSTR). Preliminary tests were carried out to determine the effect of temperature and particle size on the measured reaction rates. Additional experiments were performed in order to study the influence of oxygen and water concentration on these rates. A gas chromatographic system has been developed to analyze the gas components NO, N₂O, NO₂, NH₃, H₂O, O₂, CO₂ and N₂. In addition, the concentrations of NO and NO₂ were measured with a nondisperse infrared (NDUV/NDIR) analyzer.