Depression during interferon therapy in chronic hepatitis C patients--a prospective study

The number of patients treated with interferon (IFN) has increased markedly in Japan since 1992, when the Health and Welfare Ministry approved the use of IFN for treating chronic active hepatitis C. It is important to identify and treat depression, which is one of the psychiatric complications of IFN therapy and often leads to discontinuation of the therapy, in patients with chronic hepatitis C. In this study we prospectively investigated the incidence of depression during IFN therapy in patients with chronic active hepatitis C. The psychiatric status of 85 patients (53 men, 32 women; mean age 49.1 years) with chronic active hepatitis C who began receiving IFN at Showa University Hospital was assessed before and 2, 4, 12 and 24 weeks after the start of IFN therapy, using the major depressive episode diagnostic criteria listed in the DSM-III-R and the Hamilton Depression Scale HDS). All of the patients provided informed consent prior to participation in this study. IFN therapy was discontinued in 5 cases (5.9%) because of physical side effects and in 4 cases (4.7%) because of depression. Two, 11, 14, 25 and 16 patients were diagnosed as having major depressive episodes before and 2, 4, 12 and 24 weeks after the start of IFN therapy, respectively. The number of patients who were asymptomatic before the start of IFN therapy but were diagnosed as having a major depressive episode at least once during IFN therapy was 31 (31/83 = 37.3%). The mean HDS scores at 2, 4, 12 and 24 weeks (5.4, 6.0, 8.8 and 6.6) were significantly higher than that before the start of IFN therapy (3.0). The patients whose first diagnosed major depressive episodes occurred more than 4 weeks after the start of IFN therapy tended to be more severely depressed than those in whom it occurred less than 4 weeks after the start of IFN therapy. Compared to the 47 patients who completed 24 weeks of IFN therapy without experiencing depression, the 31 patients who were diagnosed as experiencing major depressive episodes during IFN therapy had significantly higher neuroticism scores determined using the Eysenck Personality Questionnaire, showed a more severely depressed mood and experienced more severe sleep disturbances before the start of IFN therapy. The latter group of patients also tended to have comorbid chronic physical disorders such as hypertension or diabetes mellitus and the histories of mental disorders before the IFN therapy; however these differences were not statistically significant. There were no differences between the two groups in patient age or sex, the severity of hepatitis before the IFN therapy, the type of IFN used in the therapy or the efficacy of IFN in the treatment of the hepatitis C. Our results indicate that the decision as to whether to treat chronic active hepatitis C with IFN should be made carefully and that early intervention and careful monitoring of depression are required during IFN therapy in the treatment of chronic active hepatitis C.     

A 39-to-45-Gbit/s multi-data-rate clock and data recovery circuit with a robust lock detector

We describe a 40-Gbit/s-class clock and data recovery (CDR) circuit with an extremely wide pull-in range. A Darlington-type voltage-controlled oscillator (VCO) is newly designed to cover the STM-256/OC-768 full-rate-clock frequencies with a wide frequency margin. We also describe a new lock detector using an exclusive-NOR gate. The CDR IC was fabricated using InP/InGaAs HBTs. Error-free operation and wide eye opening were confirmed for 40-, 43-, and 45-Gbit/s PRBS with a word length of 2/sup 31/ - 1. We attached a frequency search and phase control (FSPC) circuit to the chip as a new frequency acquisition aid, and this allows the CDR circuit to pull in throughout a 39-45-Gbit/s range. The peak-to-peak and rms jitter of the recovered clock were 3.6 and 0.48 ps, respectively.     

Successful engraftment of unrelated cord blood stem cells for familial erythrophagocytic lymphohistiocytosis. Kinki Cord Blood Bank

PURPOSE: To describe a case of Felty syndrome (FS) in a child with (JRA) and review the previous literature on this rare entity. METHODS: Review of clinical data including results of serial blood counts, bone marrow aspirate, human leukocyte antigen (HLA)-typing, and abdominal sonography. RESULTS: Serial blood counts over 2 years revealed persistent leukopenia and thrombocytopenia. Bone marrow aspirate showed normal trilineage hematopoiesis, abdominal sonography demonstrated an enlarged spleen, but normal liver and portal circulation. HLA-typing was most significant for positivity of the DR 1 allele. CONCLUSION: This is only the third child, and the first preadolescent, to be reported with FS complicating juvenile rheumatoid arthritis. This condition needs to be considered in the differential diagnosis when leukopenia, thrombocytopenia, or both develop in patients with JRA.     

Vertical two-phase flow identification using advanced instrumentation and neural networks

Most two-phase flow measurements, including void fraction measurements, depend on correct flow regime identification. There are two steps taken towards the successful identification of flow regimes: first, develop a non-intrusive instrument to demonstrate area-averaged void fluctuations and second, develop a non-linear mapping approach to perform objective identification of flow regimes. In this paper, an advanced non-intrusive impedance void-meter provides input signals to neural networks which are used to identify flow regimes. After training, both supervised and self-organizing neural network learning paradigms performed flow regime identification successfully. The methodology presented holds considerable promise for multiphase flow diagnostic and measurement applications.     

Rain Attenuation at Millimeter Wavelength of 1.33 mm

Specific rain attenuation values calculated by using the four empirical raindrop-size distributions, that is, the Marshall and Palmer, the Joss, Thams and Walgvogel, the Ihara, Furuhama and Manabe, and the Weibull raindrop-size distributions. The millimeter wave measurement at 225 GHz (1.33mm) was compared with our calculations. It has been shown that the Weibull distribution has the best agreement with the measurements.     

T cell response to Borrelia garinii, Borrelia afzelii, and Borrelia japonica in various congenic mouse strains

The infectivity and T cell response to Borrelia garinii SIKA2, Borrelia afzelii BFOX, and Borrelia japonica 0612, the organisms that cause Lyme disease in Japan, were examined in various inbred and congenic strains of mice. Infectivity differed among the species: B. garinii SIKA2 and B. afzelii BFOX were each able to infect 90% to 100% of C3H/He mice; B. japonica 0612 was able to infect only 20% of C3H/He mice. The pattern of infectivity to various inbred and congenic strains of mice may influence the pathogenicity of the organism and the clinical signs of Lyme disease. Cross-reactivity between Borrelia antigens was observed, but there was no cross-reactivity between Borrelia antigens and Leptospira antigens. We evaluated the genetic control of the delayed-type hypersensitivity (DTH) reaction in the form of footpad swelling produced by Borrelia antigens using viable or sonicated bacteria as sensitization. Differences in strains of mice infected by viable antigen were observed. However, all strains of mice showed a strong DTH reaction using sonicated antigens without genetic background. A DTH reaction in the form of footpad swelling did not appear to be associated with genetic background. The footpad reaction was mediated by CD4+8- and Ia- T cells, as revealed by in vitro monoclonal antibody treatment. However, CD8+ T cells did not suppress footpad swelling. These results indicate that many antigenic epitopes of the Borrelia spirochete can stimulate the DTH reaction.