High dose intravenous immune globulins and plasma exchange in Guillain-Barré Syndrome

We report the effects of treatment with plasma-exchange (PE) and intravenous immune globulins (IVIg) in 36 out of 50 patients with Guillain-Barré syndrome (GBS) recruited by an incidence study in the Emilia-Romagna region of Italy. Comparison of the patients treated with PE and IVIg showed no significant differences in terms of effectiveness in improving the clinical course of GBS: at one month, respectively 11.1% and 25% had recovered, and 55.5% and 58.3% had improved by at least one grade. These results are in agreement with those of the Dutch GBS trial. No relapses were observed in either group. Moreover, our results showed no difference in clinical outcome at 1 and 3 months between the patients receiving only one therapy and those receiving two; a second cycle of therapy did not seem to improve the clinical course of the disease significantly. We conclude that PE and IVIg are both safe and effective therapies for GBS.     

Three-dimensional anatomical model-based segmentation of MR brainimages through principal axes registration

Model-based segmentation and analysis of brain images depends on anatomical knowledge which may be derived from conventional atlases. Classical anatomical atlases are based on the rigid spatial distribution provided by a single cadaver. Their use to segment internal anatomical brain structures in a high-resolution MR brain image does not provide any knowledge about the subject variability, and therefore they are not very efficient in analysis. The authors present a method to develop three-dimensional computerized composite models of brain structures to build a computerized anatomical atlas. The composite models are developed using the real MR brain images of human subjects which are registered through the principal axes transformation. The composite models provide probabilistic spatial distributions, which represent the variability of brain structures and can be easily updated for additional subjects. The authors demonstrate the use of such a composite model of ventricular structure to help segmentation of the ventricles and cerebrospinal fluid of MR brain images. Here, a composite model of ventricles using a set of 22 human subjects is developed and used in a model-based segmentation of ventricles, sulci, and white matter lesions. To illustrate the clinical usefulness, automatic volumetric measurements on ventricular size and cortical atrophy for an additional eight alcoholics and 10 normal subjects were made. The volumetric quantitative results indicated regional brain atrophy in chronic alcoholics     

Si/SiGe epitaxial-base transistors. I. Materials, physics, andcircuits

A detailed review of SiGe epitaxial base technology is presented, which chronicles the progression of research from materials deposition through device and integration demonstrations, culminating in the first SiGe integrated circuit application. In part I of this paper, the requirements and processes for high-quality SiGe film preparation are discussed, with emphasis on fundamental principles. A detailed overview of SiGe HBT device design and implications for circuit applications is then presented     

Foodborne diseases: a survey on working methods used by 6 Public Health Services in the Lombardy Region. 1. Outbreaks

Since foodborne diseases, especially those caused by bacteria, have become an increasingly important public health problem, the Authors conducted a survey in order to evaluate the organization of, and the intervention carried out by, six Public Health Services in the Lombardia region, after reports of foodborne diseases outbreaks. Lack of correct methodology was detected, not to mention the usual omission of epidemic curves and attack rates. Besides, too many microbiological tests were made and it took too much time to take care of and to report the outbreaks to Regional and National Health Authorities. Forty-one outbreaks were examined: 415 cases occurred (AR: 28.7%), most of which home-made food-related. In 25 outbreaks the suspected food vehicles were eggs or fish, but only 5 of them were confirmed by laboratory tests. Salmonella enterica, either serovar Eenteritidis or group D, appeared responsible for 26 of the outbreaks [corrected].     

Photonic access concentrator for ATM gigabit switching fabrics

In future broadband communication networks the interest for purely photonic switches is due to the bandwidth mismatch between optical transmission networks and electronic switching nodes. Photonic ATM switching fabrics mainly based on wavelength-switching stages are therefore being studied, to implement high capacity switches with also concentration, multiplexing and demultiplexing functions, using state-of-the-art photonic technology. The architecture of an ATM photonic access concentrator is described in this paper, illustrating the design and implementation of its basic subsystems, the traffic concentrator and the cell multiplexer. The design guidelines are outlined in detail referring to an example, where 128 user lines at 622 Mb/s are given access to 4 outlets at 2.488 Gb/s. The corresponding implementation, based on the systematic use of cell wavelength encoding, makes use either of well-known photonic components, such as Fabry-Perot filters, fiber delay lines, splitters and combiners, either of recently developed devices, like high-speed optical gates and tunable filters and lasers. Finally, the system feasibility is demonstrated presenting the results obtained on a reduced size and speed experimental setup of the cell multiplexer     

Average intake of anti-oxidant (pro)vitamins and subsequent cancer mortality in the 16 cohorts of the Seven Countries Study

This ecologic study aimed to investigate whether differences in population mortality from lung, stomach and colorectal cancer among the 16 cohorts of the Seven Countries Study could be explained by differences in the average intake of anti-oxidant (pro)vitamins. In the 1960s, detailed dietary information was collected in small sub-samples of the cohorts by the dietary record method. In 1987, food-equivalent composites representing the average food intake of each cohort at baseline were collected locally and analyzed in a central laboratory. The vital status of all participants was verified after 25 years of follow-up. The average intake of vitamin C was strongly inversely related to the 25-year stomach-cancer mortality (r = -0.66, p = 0.01), also after adjustment for smoking and intake of salt or nitrate. The average intake of alpha-carotene, beta-carotene, and alpha-tocopherol were not independently related to mortality from lung, stomach or colorectal cancer, nor was vitamin C related to lung and colorectal cancer.     

Immunological properties of Weil-Felix test negative sera from patients with Japanese spotted fever

Sera from 4 out of 19 patients with the Japanese spotted fever were negative to OX2 antigen of Weil-Felix (WF) test. These WF test negative sera were analyzed by ELISA and immunoblot used whole cells and lipopolysaccharides (LPS) of rickettsiae and Proteus strains as antigens. These acute-phase sera have already possessed the IgG antibodies against LPS of Proteus OX2 strain, whereas IgM antibodies in these acute- and convalescent-phase sera did not react with this LPS. On the other hand, the reactivity of IgM antibodies of the convalescent-phase sera in the 2 patients with LPS of Proteus OX19 strain increased as compared with that of the acute-phase sera by ELISA, and these IgM antibodies also showed the reactivity with bands of OX19-LPS in the immunoblot. On the basis of these results, it is interpreted that the WF test negative sera from patients with Japanese spotted fever are due to the presence of IgG antibodies against OX2-LPS in the sera.     

The OKT3 Antibody Response Study: a multicentre study of human anti-mouse antibody (HAMA) production following OKT3 use in solid organ transplantation

Human anti-murine antibody titres following patient exposure to the monoclonal antibody Orthoclone OKT3 (muromonab-CD3) are determined by laboratories using diverse analytical methods which are not standardized and whose concordance is not established. A multicentre study group therefore compared testing for IgG anti-OKT3 antibody among seven laboratories. A set of 270 sera was obtained from 30 heart, 30 kidney and 30 liver transplant recipients with no previous exposure to OKT3 who were receiving OKT3 for induction immunosuppression. Sera were collected from each patient prior to and at 24 +/- 2 days and 31 +/- 2 days following initial OKT3 exposure. Identical aliquots of all 270 sera were tested for IgG anti-OKT3 antibody by each laboratory. In addition, the limit of detection of each laboratory's method was estimated by titration of an affinity-purified IgG anti-OKT3 reference material of known concentration. Anti-OKT3 antibody formation differed greatly among the three organ groups. Cardiac patients demonstrated the least sensitization and almost exclusively lower titres, while kidney recipients had more frequent and higher titre antibody formation. Liver recipients yielded the highest sensitization rate and the most frequent high titre sera. Importantly, the seven laboratories differed widely in the number of pretreatment sera reported as positive (ranging from 0% to 41% among laboratories), the number of post-OKT3 sera reported as positive (17-63%), the number of post-OKT3 samples with titre > or = 1000 (2-31%), and the number of patients sensitized 19-69%). Concordance among laboratories was highly variable, with interlaboratory agreement ranging from 38% to 83% on the sample titres assigned to 180 post-OKT3 sera. Many of the discordant results were consistent with differences in the limit of detection of the analytical methods, which ranged from 0.19 microgram/ml to > or = 15 micrograms/ml, a nearly 100-fold difference among laboratories. This study demonstrated the presence of both good concordance and significant discordance among laboratories in determining human anti-mouse antibody titres, and demonstrated that common titre categories (100, 1000, 10,000) were not equivalent among laboratories. The level of concordance among methods should be considered when comparing anti-OKT3 antibody results from different centres and their correlation with clinical events. Universal comparative testing, patterned after proficiency testing programmes, is needed to assess differences among laboratories and to bring uniformity and a sound interpretative basis to this field of testing.