An epidemiologic, clinical, and therapeutic study of childhood Guillain-Barré syndrome in Kuwait: is it related to the oral polio vaccine?

We studied Guillain-Barré syndrome, affecting children 12 years old or less, throughout Kuwait, in the period between January 1, 1992, and March 31, 1997. Nineteen children had the diagnostic criteria of Guillain-Barré syndrome, with an overall annual incidence rate of 0.95/100,000 population at risk. Female patients outnumbered male patients with a sex ratio of 1.4:1. There was a clustering of cases in winter and spring and in the year 1996. The disease symptoms were relatively severe in our patients because only 16% (3 of 19) of them were able to walk at the height of their illness, whereas the rest were bed or chair bound or needed assisted ventilation. Two patients had the electrodiagnostic features of axonal neuropathy and both had residual deficits on follow-up, whereas the rest recovered fully. All the patients received intravenous immunoglobulin. The mean time to walk unaided was 23.5 days (range, 2-84 days) after intravenous immunoglobulin and excluding the two patients with axonal neuropathy, and full recovery was achieved in a mean time of 103 days (range, 30-300 days). Contrary to previous studies, we found no correlation between oral polio vaccine administration and Guillain-Barré syndrome in 2 successive years (1995 and 1996) during a nationwide campaign targeting children less than 5 years old.     

Prognostic factors of early sequelae and fatal outcome of Japanese encephalitis

A clinical case control study to identify prognostic factors present at hospital admission associated with early sequelae and fatal outcome of acute Japanese encephalitis (JE) was carried out in Gusi county, Henan Province, central China from June to September 1991. A total of 70 patients with laboratory-confirmed acute JE were studied, of whom 3 cases died and 33 cases had neurological or psychiatric sequelae at the end of three months follow-up. The results showed that acute JE at younger age, with higher body temperature, high white cell count in CSF, and deep coma present at hospital admission were markers for unfavorable outcomes (sequelae or fatal). A history of the vaccination was not correlated with the early sequelae and fatal outcome of the disease. The paper suggests that early diagnosis and treatment and universal JE vaccination for all susceptible populations are keys for decreasing incidence of sequelae and fatal outcome of acute JE.     

Efficacy and pharmacokinetics of gallopamil in patients with coronary artery disease

We prospectively studied 10 patients with stable exertional ischaemia, selected from a larger group of patients referred for suspected coronary artery disease or to detect residual ischaemia after myocardial infarction, to evaluate pharmacokinetic changes during chronic treatment with gallopamil and its correlation with clinical efficacy in patients with coronary artery disease. Our study consisted of a 1-week run-in single-blind placebo treatment and a 4-week single-blind gallopamil treatment. At the end of the run-in period patients underwent two different exercise tests, the first 2 hours and the second 7 hours after placebo administration. During active treatment all patients underwent two different exercise tests, the first 2 hours and the second 7 hours after gallopamil (50 mg) administration on the 1st and 28th days of gallopamil therapy. On the same days in eight of the patients we evaluated gallopamil pharmacokinetic changes. Our data revealed a rapid increase of unchanged gallopamil and its metabolite (norgallopamil) in the plasma, and a peak concentration of these substances about 2 hour after oral administration on both the 1st and 28th day of observation. Moreover, our results demonstrated an increase between the first and 28th day of treatment in peak concentration of unchanged gallopamil in the plasma, and of AUC 0-infinity and AUC o-c values during chronic treatment with gallopamil. Our clinical data showed an improvement in exercise results during gallopamil therapy related to increased concentration of the drug.     

A new mumps virus lineage found in the 1995 mumps outbreak in western Switzerland identified by nucleotide sequence analysis of the SH gene

We determined the nucleotide sequence of the SH gene its flanking regions over a range of 380 nucleotides for three distinct mumps virus (MUV) isolates. Two isolates from the 1992 mumps epidemic in Western Switzerland and one MUV isolated in 1995 in the same geographic area have been analyzed and compared to 16 recently published SH nucleotide sequences and their presumed amino acid sequences. The nucleotide sequences from the 1992 MUV isolates were identical and closely related to two MUV strains from Eastern Switzerland and strains from the U.K. The MUV isolated in 1995 is clearly different from all other strains.     

Laboratory millimeter wave measurements of atmospheric aerosols

Measurements made in an untuned resonator by Fourier Transform Spectroscopy of atmospheric aerosols are explained by a pumped phonon model due to Fröhlich.     

Multiple time-scale diffusion models of starfish and coral state changes over the whole great barrier reef

A model is developed to investigate starfish and coral dynamics at the macro-scale of the whole Great Barrier Reef. This stochastic near-equilibrium theory is consistent with all available data for the mean rates of change of reef-state relative to abundances of the starfishAcanthaster planci and the scleractinian corals upon which it preys. This result is in striking contrast to the stably cyclic behaviour which dominates the meso-scale of individual reefs as reported previously by the authors. For the first time, a number of important numerical estimates have been made and are reported here. Generally, the starfish dynamics is dominated by randomness, being indistinguishable from Brownian motion in the state-space. On the other hand, the coral process is embedded in a drift field which is always directed towards the low coral state. In fact, the high coral state is inaccessible on the Great Barrier Reef.     

Parallel, self-organizing, hierarchical neural networks. II

For pt.I see IEEE Trans. Neural Networks, vol.1, p.167-78 (1990). Parallel, self-organizing, hierarchical neural networks (PSHNNs) involve a number of stages with error detection at the end of each stage, i.e., rejection of error-causing vectors, which are then fed into the next stage after a nonlinear transformation. The stages operate in parallel during testing. Statistical properties and the mechanisms of vector rejection of the PSHNN are discussed in comparison to the maximum likelihood method and the backpropagation network. The PSHNN is highly fault tolerant and robust against errors in the weight values due to the adjustment of the error detection bounds to compensate errors in the weight values. These properties are exploited to develop architectures for programmable implementations in which the programmable parts are reduced to on-off or bipolar switching operations for bulk computations and attenuators for pointwise operations