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.     

Prevalence and severity of the dementia syndrome in homes for the aged and nursing homes. A study in elderly from a rural area near Zwolle

In the Netherlands both nursing homes and homes for the aged serve as a residence for demented elderly. Although these institutions differ considerably regarding financing and care facilities, specific functions of each institute concerning demented elderly have not been clearly defined. In order to know to what extent residential facilities serve demented elderly, the prevalence and severity of dementia among residents aged 65 and over was studied as part of a prevalence study among elderly people in a rural area of the Netherlands. The target population existed of all persons aged 65 and over who were registered in eight general practices. Patients who had to leave the practice on account of ill-health and were admitted to nursing homes were included in the study. In a two stage study the MMSE was applied as a screening instrument. Based on MMSE-score a non-proportional stratified random sample was drawn for the second, diagnostic stage, which existed of the CAMDEX. Prevalence estimates for DSM-III-R-dementia were 21% among residents of homes for the aged, 48% among residents of somatic wards of nursing homes and 100% among those admitted to psychogeriatric wards of nursing homes. Severity of dementia was highest among residents of psychogeriatric wards of nursing homes and lowest among those living in homes for the aged. Prevalence of dementia among residents of homes for the aged can be fully attributed to the age-distribution. The high frequency of dementia among residents of somatic nursing home wards can be explained in several ways: First, admission can be necessary due to a combination of dementia and somatic illness.(ABSTRACT TRUNCATED AT 250 WORDS)     

Multilevel barrel shifter for CORDIC design

The coordinate rotation digital computer (CORDIC) algorithm is used in numerous special purpose systems for real-time signal processing applications. It uses barrel shifters to complete shift operations. However, the barrel shifter occupies most of the area of the CORDIC chip. A new structure of multilevel barrel shifters is presented. With this structure the shifter size is reduced by 68%. The novel structure can also slightly reduce the latency time of shift operations     

InSb,GaSb, and GaInSb grown using trisdimethylaminoantimony

GalnSb alloys as well as the constituent binaries InSb and GaSb have been grown by organometallic vapor phase epitaxy using the new antimony precursor trisdimethylaminoantimony (TDMASb) combined with conventional group III precursors trimethylindium (TMIn) and trimethylgallium (TMGa). InSb layers were grown at temperatures between 275 and 425°C. The low values of V/III ratio required to obtain good morphologies at the lowest temperatures indicate that the pyrolysis temperature is low for TDMASb. In fact, at the lowest temperatures, the InSb growth efficiency is higher than for other antimony precursors, indicating the TDMASb pyrolysis products assist with TMIn pyrolysis. A similar, but less pronounced trend is observed for GaSb growth at temperatures of less than 500°C. No excess carbon contamination is observed for either the InSb or GaSb layers. Ga_1-xIn_xSb layers with excellent morphologies with values of x between 0 and 0.5 were grown on GaSb substrates without the use of graded layers. The growth temperature was 525°C and the values of V/III ratio, optimized for each value of x, ranged between 1.25 and 1.38. Strong photoluminescence (PL) was observed for values of x of less than 0.3, with values of halfwidth ranging from 13 to 16 meV, somewhat smaller than previous reports for layers grown using conventional precursors without the use of graded layers at the interface. The PL intensity was observed to decrease significantly for higher values of x. The PL peak energies were found to track the band gap energy; thus, the luminescence is due to band edge processes. The layers were all p-type with carrier concentrations of approximately 10¹⁷ cm³. Transmission electron diffraction studies indicate that the Ga_0.5In_0.5 Sb layers are ordered. Two variants of the Cu-Pt structure are observed with nearly the same diffracted intensities. This is the first report of ordering in GalnSb alloys.     

Phase-insensitive all-optical transistors based on second-ordernonlinearities

We demonstrate and compare two phase-insensitive all-optical transistors (AOT's) based on frequency-degenerate quadratic three-wave interactions. In particular, we demonstrate gain using KTP in a type II geometry. Both AOT's exploit the phase insensitivity inherent to three-wave parametric processes when only two fields are input, providing amplification of a small signal at the operating frequency via the interaction with a second-harmonic wave. The first scheme is based on successive up- and down-conversion (i.e., cascading) while the second relies on parametric down-conversion. We obtain gains of 5 and 160 in the two configurations, respectively, with a significant background and output coherent to the pump in the first case, no background and coherence between output and signal in the second     

Location of Aluminum in Substituted Calcium Silicate Hydrate (C-S-H) Gels as Determined by 29Si and 27Al NMR and EELS

Solid-state ²⁷Al and ²⁹Si magic angle spinning NMR spectroscopy has been combined with electron energy loss spectroscopy carried out in the transmission electron microscope to determine the location of Al substituting in a semicrystalline C-S-H gel present in a hydrated synthetic slag glass. The gel is found to contain mainly pentameric silicate chains in which the central silicon is substituted by aluminum.