Optic neuropathy resembling normal-pressure glaucoma in a teenager with congenital macrodiscs

We report a unique case of a renal transplant patient with a long-term nonprogressive human immunodeficiency virus type-1 (HIV-1) infection and who is asymptomatic despite sustained immunosuppression. Renal function is normal, and HIV infection was probably acquired through blood transfusion before the transplant. Nonprogression may be due either to an effective immune control of HIV replication or to particular genetic aspects of the virus. Several virological investigations were carried out to verify if she is infected with an attenuated virus strain. Results show an unusual combination of high and stable CD4 count, ongoing viral replication and elevated viral loads. Attempts to isolate the virus from plasma were unsuccessful, but isolation was possible from peripheral blood mononuclear cells, and the virus was shown to be non-syncytium-inducing. Sequence analysis of the nef gene revealed no mutation. This exceptional lack of progression of HIV infection under immunosuppressive therapy requires further investigation.     

Differential expression and distribution of focal adhesion and cell adhesion molecules in rat hepatocyte differentiation

The present study has examined the distribution of axons of differing sizes in the optic pathway of the ground squirrel. Axon diameters were measured from electron micrographs at various locations across sections of the optic nerve and tract, and total distributions and numbers were estimated. In both the nerve and tract, roughly 1.2 million optic axons were present. The population of optic axons had a unimodal size distribution, peaking at 0.9 microm in diameter and having an extended tail toward larger diameters. Local axon diameter distributions in the optic tract indicated distinct (though partially overlapping) axon diameter classes, including one of fine sizes peaking at 0.8-0.9 microm, a second of medium sizes peaking around 1.7-1.8 microm, and a third composed of the larger fibers with diameters up to 4.8 microm. The fine-caliber axons were found at all locations in the tract, and were the only axons present immediately adjacent to the pia, while the medium- and coarse-caliber axons were found at deeper locations. Curiously, the larger axons were found primarily in the medial parts of the tract, where axons from the dorsal retina normally course. A similarly restricted distribution of the larger axons was observed in the dorsotemporal parts of the optic nerve, suggesting that this difference in the tract may relate to an asymmetric distribution of ganglion cells on the retina giving rise to these axons. Measurements of axonal size taken within the optic fiber layer in dorsal and ventral parts of the retina confirmed this asymmetry, consistent with previous demonstrations of soma size differences in the dorsal versus ventral retina. The partial segregation of axons by size in the optic tract of the ground squirrel then reflects both the asymmetric distribution of retinal ganglion cell classes and the chronotopic reordering of optic axons that occurs within the chiasmatic region.     

Premedication with oral midazolam in children--an assessment of psychomotor function, anxiolysis, sedation and pharmacokinetics

We studied 30 children, aged 4 to 12 years, undergoing elective circumcision, premedicated with midazolam 0.5 mg.kg-1 and atropine 0.02 mg.kg-1 by mouth. A modified postbox test and the coding component of the Wechsler intelligence scale (WISC-R) was used to assess the preoperative effect of premedication on psychomotor function. Mood and sedation were also scored and related to serum midazolam concentrations. The children showed a significant decline in psychomotor performance 30 and 60 minutes after premedication when compared with their best unmedicated performance recorded the previous evening. This decline in psychomotor performance was only weakly associated with serum midazolam concentrations (r = 0.1). The postbox toy ratio is a suitable measurement of psychomotor performance in children because of its simplicity and ease of use in the clinical environment, although it may suffer the "test-retest" limitations of similar types of assessment. The sedative and anxiolytic effects of midazolam provide a quiet environment for a smooth induction of anaesthesia.     

The effect of DNA probe distribution on the reliability of label-free biosensors

As the design of label-free DNA biosensors matures, and their sizes reduced to enhance their sensitivity, not much has been researched about the variations in the received signal with the positioning of the probes on the sensitive surface. We approach this issue computationally in this paper. By adopting the finite-element model on a three-dimensional biological field-effect transistor (BioFET) slice, and running Monte-Carlo simulations on the positions of the DNA molecules, we extract the expected variations in the signal. Then, we show that signal-to-noise (SNR) ratio can be low enough to hinder the functionality of the device, placing a limitation on how low the sensitivity of a sensor of a certain size can be.     

Treatment of acute lymphoblastic leukemia. 30 years' experience at St. Jude Children's Research Hospital

BACKGROUND: Therapy for childhood lymphoblastic leukemia has evolved during the past three decades, but key questions about what are the least toxic, most effective forms of treatment remain unanswered because of the lack of comprehensive follow-up information. METHODS: To assess long-term outcome in the series of clinical trials conducted at St. Jude Hospital, we compared the results of treatment typical of four eras: exploratory combination chemotherapy (era 1, 1962 to 1966; 91 patients), regimens for the control of meningeal leukemia (era 2, 1967 to 1979; 825 patients), limited intensification of therapy (era 3, 1979 to 1983; 428 patients), and extended intensification of therapy (era 4, 1984 to 1988; 358 patients). ("Intensification" refers to strategies of systemic chemotherapy that are more aggressive than conventional ones.) The major end points were survival and event-free survival; we also calculated the relative risk of treatment failure and the rate of relapse or death after treatment ended (post-treatment failure rate). RESULTS: The probability of event-free survival improved significantly in each successive era (P < 0.001 by the log-rank test), reaching 71 percent in era 4. There was a decrease of approximately 50 percent in the risk of treatment failure from one era to the next in each subgroup of patients defined according to different combinations of the leukocyte count, race, age, and sex. Leukemia appeared to be eradicated in patients who remained in complete remission for three years or more after treatment in era 4. The incidence of death due to nonleukemic causes remained 4 to 6 percent despite the trend toward more intensive treatment. An estimated 765 patients (45 percent) are long-term survivors; most of them (80 percent) have no health problems related to leukemia or its treatment. CONCLUSIONS: The development and successful application of preventive therapy for meningeal leukemia, followed by the intensification of systemic chemotherapy, has progressively improved the rate of cure of childhood lymphoblastic leukemia, with relatively few adverse sequelae.     

Bronchoalveolar lavage. Quantitation of intraalveolar fluid?

A precise calculation of the amount of intraalveolar fluid is the basis of a quantitative analysis of intraalveolar compounds. Different approaches have been made to cover this important problem. Here, we report a comparative study with five markers: 99mTc-DTPA, 51Cr-EDTA, inulin, urea, and methylene blue in animal experiments as well as in human experiments. The marker substances were added to the lavage fluid, and the "dilution" of the markers, i.e., the alveolar fluid, was calculated. The results showed that in animals with healthy lungs the tracer methods are able to calculate amounts of intraalveolar fluid that are comparable to morphologic findings. In animals as well as in humans, methylene blue and inulin were shown to be useless in determining alveolar fluid volume compared with the tracer methods. In humans, the calculations with the urea method and with Tc-DTPA were in the same magnitude, but there was no individual correlation. We conclude that, at present, the methods to quantitate alveolar fluid volume lack precision and add nothing to a deeper understanding of alveolar biology.     

A utility maximization approach for information-communication tradeoff in Wireless Body Area Networks

Healthcare systems have made a dramatic shift towards ubiquitous monitoring in the recent past. The reasons for such a change have been ease of timely diagnosis, convenience and comfort of clinical treatments. Wireless Body Area Networks (WBANs) are mainly characterized by deployment of biomedical sensors around human body which transmit vital signs measurements about the health status of the patient. Unfortunately, the huge traffic load of clinical data and limited resources of biomedical sensors make the efficiency of long-term operations almost impossible. Therefore, it is necessary to make significant advances in sensor’s energy saving. Our idea is to reduce the activities of some sensors depending on the relevance between the data they measure and the diseases to detect. This paper shows how to extend the lifetime of medical WBANs by appropriately taking benefit of correlation between the knowledge about the disease and sensing data to drive the best scheduling of the medical sensors. For that, the theoretical framework of an economic approach, i.e., network utility maximization, is developed for sensor scheduling under operations cost constraint. It is shown that the compact subset of sensors can be found to provide necessary information for timely and correct diagnoses. Based on the theoretical framework, an algorithm combining sensor selection and information gain is then proposed. Simulation results show that the algorithm achieves high performance in terms of energy saving vs latency in disease detection.     

On the accuracy of Landweber and Tikhonov reconstruction techniques in gas‐solid fluidized bed applications

As electrical capacitance tomography technique needs a sophisticated reconstruction, the accuracy of two of the most widely used reconstruction techniques (Landweber and Tikhonov) for gas‐fluidized bed applications were assessed. For this purpose, the results of two‐fluid model simulations were used as an input of reconstruction. After finding the optimum reconstruction parameters for the studied system, it is found that both techniques were able to obtain the radial profile and overall value of average volume fraction very well. Conversely, both methods were incapable to determine bubble sizes accurately especially small bubble sizes, unless the Landweber technique with inverted Maxwell concentration model is applied. The probability distribution of the reconstructed results was also smoother in transition between the emulsion and bubble phases compared to the reality. Finally, no significant differences in noise immunity of these two techniques were observed. © 2015 American Institute of Chemical Engineers AIChE J, 61: 4102–4113, 2015