Persistent GAD 65 antibodies in longstanding IDDM are not associated with residual beta-cell function, neuropathy or HLA-DR status

Persistent humoral autoimmunity to the enzyme glutamic acid decarboxylase (GAD) has been described in a substantial proportion of patients with insulin-dependent diabetes mellitus (IDDM) of long duration. The source of the stimulus for this autoimmune reactivity is still unknown. Because the GAD 65 isoform is mainly expressed in pancreatic beta-cells and in the nervous system we investigated in the present study of the largest number of well characterized patients with longstanding IDDM (n = 105; median duration: 21 years; range: 10-46 years) the presence of autoantibodies to GAD 65 and their relationship to a residual C-peptide response or peripheral and autonomic neuropathy. Additionally we studied the HLA-DR status relative to GAD 65 antibodies in 86 out of the 105 individuals. One hundred healthy control subjects and 100 recent onset IDDM patients were also studied for GAD 65 antibodies. GAD 65 antibodies were detected in a radioligand-binding-assay with recombinant human GAD 65 and were present in 32% of the long-term diabetic patients, 82% of the recent onset IDDM patients and in 3% of the healthy control subjects. A preserved C-peptide response to i.v. glucagon (Hendriksen criteria) was observed in 23% of the long-term IDDM patients. Autonomic neuropathy and peripheral neuropathy was identified using criteria based on both symptoms and formal testing giving a frequency of 67% vs 79%. The HLA specific DR 4/X was observed in 47% and HLA-DR 3/X in 22% of the long-term IDDM patients. Patients who were heterozygous for DR3/DR4 were found in 23% of the cases. GAD 65 antibodies were significantly less frequent in the long-term IDDM patients compared to recent onset IDDM (p < 0.001), and diabetes duration showed a significant negative correlation with GAD 65 antibody index levels (r = 0.22, p < 0.01). Interestingly, GAD 65 antibodies were not significantly correlated either with residual beta-cell function or neuropathy and no particular HLA-DR status was associated with persistent GAD 65 antibodies. In conclusion neither residual beta-cell function nor diabetic neuropathy or a certain HLA-DR specificity are exclusively associated with persistent autoimmunity directed to GAD 65 in longstanding IDDM. The stimulus for the persistent humoral immune response and its significance for the disease process and its complications remain to be established.     

Inductively coupled plasma etching of InGaP, AllnP, and AlGaP in Cl2 and BCl3 chemistries

Dry etching of InGaP, AlInP, and AlGaP in inductively coupled plasmas (ICP) is reported as a function of plasma chemistry (BCl₃ or Cl₂, with additives of Ar, N₂, or H₂), source power, radio frequency chuck power, and pressure. Smooth anisotropic pattern transfer at peak etch rates of 1000–2000Å·min^?1 is obtained at low DC self-biases (?100V dc) and pressures (2 mTorr). The etch mechanism is characterized by a trade-off between supplying sufficient active chloride species to the surface to produce a strong chemical enhancement of the etch rate, and the efficient removal of the chlorinated etch products before a thick selvedge layer is formed. Cl₂ produces smooth surfaces over a wider range of conditions than does BCl₃.     

Successive interference cancellation for multiuser asynchronousDS/CDMA detectors in multipath fading links

There has been an increasing interest in the use of code-division multiple access (CDMA) in cellular mobile and wireless personal communications. The choice of such multiaccess technique is attractive because of its potential capacity increases and other technical factors such as privacy and multipath rejection capabilities. However, it is well known that the performance of CDMA can be significantly degraded due to cochannel interference (CI) and the near-far effects. We consider the performance of direct-sequence (DS)-based CDMA over fading channels that are modeled as slowly varying Rayleigh-fading discrete multipath channels. Specifically, we propose and analyze an adaptive multistage interference cancellation strategy for the demodulation of asynchronous DS spread-spectrum multiple-access signals. Numerical results show that the proposed multistage detector, which alleviates the detrimental effects of the near-far problem, can significantly improve the system performance     

New results on selection diversity

The performances of selection diversity receiver structures in a slow flat Rayleigh-fading environment are assessed. A number of new and interesting results are obtained. Binary digital signaling using noncoherent frequency-shift keying (NCFSK), differential phase-shift keying (DPSK), coherent phase-shift keying (CPSK), and coherent frequency-shift keying (CFSK) is considered. The traditional analysis (the traditional selection diversity model) of a selection diversity system is based on choosing the branch with the largest signal-to-noise (SNR) power ratio while assuming that the noise power is constant across all branches. However, many practical selection systems choose the branch based on a largest signal-plus-noise (S+N selection) sample of a filter output. This paper comprises accurate analyses of such S+N selection systems. Results show that S+N selection systems perform better than predicted by the traditional selection diversity model. This is because the former includes the statistical nature of the noise, whereas the latter does not. The performance difference between the two models increases as the number of diversity branches increases. For each of DPSK and CPSK, the dual diversity equal gain (EG) combining and S+N selection systems perform identically. For each of NCFSK and CFSK, receiver structures which are equivalent when there is no diversity perform differently in a diversity environment. Certain dual diversity S+N selection systems give the same performances as EG combining or square law combining. The results are contingent upon perfect cophasing for the EG combining. In systems where estimates of the combining carrier phases contain noise, S+N selection outperforms EG combining for dual diversity     

Multi-emitter Si/GexSi1-x heterojunctionbipolar transistor with no base contact and enhanced logic functionality

We demonstrate multi-emitter Si/Ge_xSi_1-x n-p-n heterojunction bipolar transistors (HBT's) which require no base contact for transistor operation. The base current is supplied by the additional emitter contact under reverse bias due to the heavy doping of the emitter-base junction. Large-area HBT test structures exhibit good transistor characteristics, with current gain β≈400 regardless of whether the base current is supplied by a test base electrode or one of the emitter contacts. These devices have enhanced logic functionality because of emitter contact symmetry. Since device fabrication does not require base electrode formation, the number of processing steps can be reduced without significant penalty to HBT performance     

Vitamin A deficiency and nocturnal vision in teenagers with cystic fibrosis

The aim of this study was to document plasma retinol status and nocturnal vision in ten eutrophic adolescents with cystic fibrosis (CF) receiving daily retinol supplementation. Plasma retinol, alpha and beta carotenes and retinol binding protein were measured in ten clinically stable CF patients (mean age: 14.3 years; Shwachman score: 80-100). Nocturnal vision evaluation was performed with a Beyne optometer. Plasma retinol (mean 0.42 +/- 0.16 mg/l), alpha carotene and beta carotene levels were below the lower limit of normal in all but one patient. Five out of ten patients with normal standard opthalmological examination presented a poor (n = 3 patients) or a pathological (n = 2) dark adaptation test. These two patients showed a dramatic increase in nocturnal vision after 1 year of adapted retinol supplementation. CONCLUSION: Low vitamin A levels occur frequently in clinically stable, eutrophic and retinol supplemented CF adolescents. Since vitamin A deficiency is associated with poor nocturnal vision and since this pattern can be reversed by adapted retinol supplementation, we recommend monitoring plasma vitamin A levels in CF patients and evaluation of dark adaptation in retinol deficient patients.     

The effects of observational feedback on treatment integrity in school-based behavioral consultation.

Evaluated the effects of performance feedback on levels of treatment integrity in school-based behavioral consultation. Three teachers employed in a residential treatment community were responsible for treatment implementation. Treatment integrity was defined as the percentage of 2-min intervals during which contingent teacher reinforcement for student on-task behavior was directly observed. Teacher and child behavior were monitored across baseline, traditional consultation, and consultation with performance feedback conditions in a multiple baseline design. Following a Problem Identification Interview and Problem Analysis Interview (J. R. Bergan, 1977), mean levels of treatment integrity for the 3 teachers ranged from 9% to 37%. The addition of a performance feedback package increased treatment integrity for all 3 teachers to levels ranging from 60% to 83%. The findings contribute to a growing literature supporting the need for direct assessment of treatment integrity in school-based consultation research and practice. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Endosonographic features of esophageal granular cell tumors

BACKGROUND AND STUDY AIMS: Granular cell tumors of the esophagus are rare tumors. A definite diagnosis is achieved by endoscopic biopsies in only 50% of cases. Endoscopic ultrasonography (EUS) is the best procedure in the evaluation of upper gastrointestinal tract submucosal tumors. The aim of this study was to describe the endosonographic findings of esophageal granular cell tumors. METHODS: From January 1989 to March 1994, 15 patients with 21 granular cell tumors which had negative biopsies were examined by EUS (Olympus GF UM3 or GF UM20,7,5 and 12 MHz). In five cases, the tumor was also studied with a 20 MHz Olympus miniprobe. The final histological diagnoses were obtained by subsequent endoscopic snare resection in 20 cases and surgically in one case. RESULTS: The endosonographic features (with the GF UM3 or GF UM20) of esophageal granular cell tumors were: a) a tumor size of less than 2 cm in 95% of cases; b) an hypoechoic solid pattern in 100% of cases; c) a tumor arising in the inner layers in 95% (second echo-poor layer n=15; third echo-rich layer n=5). In one case, the endosonographic finding was transmural malignant infiltration of the esophageal wall (histologically confirmed). CONCLUSION: When a granular cell tumor of the esophagus is suspected, EUS can show the inner layer location of the tumor and thus contribute to planning the endoscopic resection or follow up. When the tumor also invades the outer layers, EUS can contribute to planning the surgical resection.     

Development of contrast sensitivity and temporal-frequency selectivity in primate lateral geniculate nucleus

We studied the development of spatial contrast-sensitivity and temporal-frequency selectivity for neurons in the monkey lateral geniculate nucleus. During postnatal week 1, the spatial properties of P-cells and M-cells are hardly distinguishable, with low contrast-sensitivity, sluggish responses, and poor spatial resolution. The acuity of P-cells improves progressively until at least 8 months, but there is no obvious increase in their maximum contrast-sensitivity with age. The contrast sensitivity of M-cells is already clearly higher than that of P-cells by 2 months, and at 8 months of age this characteristic difference between M- and P-cells approaches the adult pattern. There is a major increase in responsiveness during the first 2 postnatal months, especially for M-cells, the peak firing rate of which rises fivefold, on average, between birth and 2 months. Many P-cells in the neonatal and 2-month-old animals did not give statistically reliable responses to achromatic gratings, even at the highest contrasts: this unresponsiveness of P-cells might result from low gain and/or chromatic opponency. The upper limit of temporal resolution in the neonate is low--about one-third of that in the adult. Among M-cells, the improvement in temporal resolution, like that in contrast sensitivity, is rapid over the first 2 months, followed by a slower change approaching the adult value by 8 months of age. The development of contrast sensitivity, responsiveness and temporal tuning are little affected, if at all, by binocular deprivation of pattern vision from birth for even a prolonged period.     

Perturbation in the 240Pu/239Pu global fallout ratio in local sediments following the nuclear accidents at Thule (Greenland) and Palomares (Spain)

Diabetes complicates 2-3% of all pregnancies and is associated with an increase in both perinatal morbidity and mortality, though reasons for these adverse outcomes are unknown. Estrogen biosynthesis is a critical factor during pregnancy and is carried out in the placenta via aromatase (cytochrome P450 19A1), which catalyzes the conversion of C-19 androgens to C-18 estrogens. Previous studies have shown that hormones such as insulin-like growth factors and insulin regulate aromatase activity when studied in vitro. Interestingly, levels of these hormones are altered in patients with diabetes. Thus, we hypothesized that the presence of maternal diabetes may alter placental aromatase activity and thus estrogen biosynthesis, possibly serving as one factor in the adverse outcomes of babies born to mothers with diabetes. To this end, we measured the production of 19-hydroxyandrostenedione, 19-oxoadrostenedione and estrone in 30 placental tissues from diabetic patients, using [7-3H]androst-4-ene-3,17-dione as a model substrate for aromatase (P450 19A1). A statistical difference was detected in the percentage of 19-oxoandrostenedione formed between the overt and control groups (P < 0.05). Additionally, NADPH P450-reductase levels were measured in these same tissues to determine whether alterations in this enzyme necessary for aromatase activity could be affected by diabetes. No differences in reductase levels were detected among the patient groups. However, a statistical correlation was found between NADPH P450-reductase activity and the formation velocities of all three estrogen products (P < 0.05). Thus, it appears that the presence of diabetes does not affect placental aromatase activity.