Viral dynamics of primary viremia and antiretroviral therapy in simian immunodeficiency virus infection

Mathematical modeling of viral replication dynamics, based on sequential measurements of levels of virion-associated RNA in plasma during antiretroviral treatment, has led to fundamental new insights into human immunodeficiency virus type 1 pathogenesis. We took advantage of the simian immunodeficiency virus (SIV)-infected macaque model to perform detailed measurements and mathematical modeling during primary infection and during treatment of established infection with the antiretroviral drug (R)-9-(2-phosphonylmethoxypropyl)adenine (PMPA). The calculated clearance half-life for productively infected cells during resolution of the peak viremia of primary infection was on the order of 1 day, with slightly shorter clearance half-lives calculated during PMPA treatment. Viral reproduction rates upon discontinuation of PMPA treatment after 2 weeks were approximately twofold greater than those obtained just prior to initiation of treatment in the same animals, likely reflecting accumulation of susceptible target cells during treatment. The basic reproductive ratio (R0) for the spread of SIV infection in vivo, which represents the number of productively infected cells derived from each productively infected cell at the beginning of infection, was also estimated. This parameter quantifies the extent to which antiviral therapy or vaccination must limit the initial spread of virus to prevent establishment of chronic disseminated infection. The results thus provide an important guide for efforts to develop vaccines against SIV and, by extension, human immunodeficiency virus.     

Primary (granulomatous) angiitis of the central nervous system with multiple aneurysms of spinal arteries. Case report

A 55-year-old woman with primary (granulomatous) angiitis of the central nervous system in association with non-Hodgkin's lymphoma (mucosa-associated lymphoid tissue type) presented with an acute spinal subdural hemorrhage secondary to rupture of one of several fusiform inflammatory aneurysms of the spinal cord radicular arteries. The literature on hemorrhagic complications, aneurysms, and spinal cord involvement in granulomatous angiitis is reviewed. Recognition of granulomatous angiitis is important, as the condition may be responsive to immunosuppressive therapy.     

Carcinoembryonic antigen in diagnosis and monitoring of colorectal cancer]

Female SJL mice are more susceptible than male mice to experimental autoimmune encephalomyelitis (EAE) induced by myelin basic protein (MBP)-specific T lymphocytes. In the present study, we examined mechanisms involved in this gender-related difference in disease susceptibility. MBP-specific T lymphocytes derived from spleens of males during the effector phase of adoptive EAE produced significantly higher levels of IL-10, an anti-inflammatory cytokine in EAE. A protective effect of testosterone was then shown. Females implanted with dihydrotestosterone pellets demonstrated a significantly less severe course of EAE as compared with females implanted with placebo pellets. Finally, MBP-specific T lymphocytes derived from dihydrotestosterone-implanted females produced significantly higher levels of IL-10 than those from placebo. Together these data indicate that testosterone exerts a protective effect in EAE that is mediated at least in part by enhanced production of IL-10 by autoantigen-specific T lymphocytes.     

Secobarbital in humans discriminating triazolam under two-response and novel-response procedures

The percentage of long-term survivors after intensive chemotherapy and the outcome of MDS patients who achieve partial remission (PR) with intensive chemotherapy (IC) are not known. Between 1981 and 1996 we treated 99 patients with de novo MDS who had high-risk MDS or progression to AML, with IC. 41 (41%) achieved CR, 16 (16%) achieved partial remission (PR), 26 (26%) had failure, and 16 (16%) died in aplasia. Eight of the patients who achieved CR were autografted, three were allografted and the remaining cases received moderate consolidation chemotherapy. After IC, the 16 PR patients fulfilled the criteria for RA in 15 cases and CMML in one case. Median PR duration was 17 months, and three PR were > 3 years (39, 50+, 82+ months). Median actuarial survival of patients who achieved PR and CR was 18 months and 20 months from the onset of IC, respectively (difference not significant). Of the 71 patients treated before 1993, with sufficient follow-up, 10 (14%) had survived > 4 years (long-term survivors). Four of them were alive in first CR after 49+ to 110+ months and probably cured, two were alive in PR after 50+ and 82+ months and four had died after 49-78 months. Long-term survivors were characterized by a significantly higher incidence of RAEB-T at diagnosis, and with normal or favourable cytogenetic findings. In patients with RAEB-T at diagnosis included before 1993, 8/23 (35%) cases who had no unfavourable karyotype had survived > 4 years. Our findings suggest that MDS patients who achieve PR with IC, and not only those who achieve CR, can benefit from this type of treatment. The percentage of long-term survivors remains low, however, and is almost restricted to patients with RAEB-T at diagnosis and no unfavourable karyotype.     

Scheduling DAG's for asynchronous multiprocessor execution

A new approach is given for scheduling a sequential instruction stream for execution “in parallel” on asynchronous multiprocessors. The key idea in our approach is to exploit the fine grained parallelism present in the instruction stream. In this context, schedules are constructed by a careful balancing of execution and communication costs at the level of individual instructions, and their data dependencies. Three methods are used to evaluate our approach. First, several existing methods are extended to the fine grained situation. Our approach is then compared to these methods using both static schedule length analyses, and simulated executions of the scheduled code. In each instance, our method is found to provide significantly shorter schedules. Second, by varying parameters such as the speed of the instruction set, and the speed/parallelism in the interconnection structure, simulation techniques are used to examine the effects of various architectural considerations on the executions of the schedules. These results show that our approach provides significant speedups in a wide-range of situations. Third, schedules produced by our approach are executed on a two-processor Data General shared memory multiprocessor system. These experiments show that there is a strong correlation between our simulation results, and these actual executions, and thereby serve to validate the simulation studies. Together, our results establish that fine grained parallelism can be exploited in a substantial manner when scheduling a sequential instruction stream for execution “in parallel” on asynchronous multiprocessors     

Prevalence of multiple cardiovascular disease risk factors among women in the United States, 1992 and 1995: the Behavioral Risk Factor Surveillance System

We sought to examine the prevalence of self-reported multiple cardiovascular disease (CVD) risk factors (hypertension, high blood cholesterol, diabetes, overweight, and current smoking) among women in 1992 and 1995 in the United States using data from the Behavioral Risk Factor Surveillance System. In 1992, 37.5%, 34.4%, and 28.1% of women had zero, one, and two or more of the five risk factors, respectively. In 1995, the respective estimates were 35.5%, 34.3%, and 30%. In both years, the prevalence of two or more risk factors increased with age, decreased with educational level, was higher among black women (lowest among Hispanic women and women of other ethnic groups), and higher among women reporting cost as a barrier to healthcare. The percentage of women with two or more risk factors was higher in 1995 than in 1992 for 35 of 48 states, being statistically significant for 7 states. The percentage of women with at least two risk factors was not significantly lower in 1995 than in 1992 for any state. A higher percentage of women reported having multiple CVD risk factors in 1995 compared with 1992. A multifactorial approach to primary prevention and risk factor reduction should be encouraged to help reduce the prevalence and burden of CVD among women.     

The effects of pressure on the isothermal fluid behavior of bituminous coals

An investigation into the effects of pressure (helium gas) on the isothermal fluid behavior includes: (1) the effect of pressure on the rate of melting and coking as evidenced by the rate constants k(melt) and k(coke); (2) the effect of pressure on the energies of activation of melting and coking; (3) the effects of pressure on the characteristic times; (4) the effects of pressure on the maximum isothermal fluidity. Results from the effects of pressure on k(melt) revealed that it was generally the high total sulfur, low nitrogen, low reactives/mineral matter ratio, medium rank coals which show the greatest increase in k(melt), whereas the highest rank coals show the least decrease in k(coke). The energies of activation of melting and coking were not significantly affected by pressure. The investigation also reveals increases or decreases in the respective times of softening, maximum fluidity, resolidification and total time of fluid behavior under isothermal pressurized conditions. There appears the possibility that these shifts may be rank dependent. Additionally, the lower rank coals show the largest relative increase in their fluidities when subjected to pressure. Empirical relationships were derived in order to quantitatively predict the maximum isothermal fluidity for most (fluid) coals at a given pressure.     

Analytical pyrolysis as a tool for the study of plastic coals

The technique of analytical pyrolysis has been used to characterize 40 similar mid-rank western Kentucky coals of widely differing ASTM Gieseler plasticity. Certain pyrolysis/g.c. variables were shown to correlate well with both ASTM Gieseler and isothermal plasticity. Highly plastic coals were shown to exhibit certain characteristic peaks in the 450 °C pyrogram which were absent in the pyrogram of the non-plastic coals. Two coals, representing the two extremes in plasticity, were selected for further study. After extraction with solvents such as DMF the characteristic peaks were absent in the 450 °C pyrogram of the extraction residue of the highly plastic coal. These peaks were also shown to decrease with increasing severity of air oxidation of the plastic coal. This technique appears to be a useful tool for the analysis of mid-rank plastic coals and supports the view that the substances contained in the bitumen fraction of these coals are involved in the development of the plastic state.     

Approach to the poisoned patient

Routine poison management involves the following: (1) stabilization, (2) toxidrome recognition, (3) decontamination, (4) antidote administration, (5) enhanced elimination of toxin, and (6) supportive care. Stabilization involves airway, ventilation, and circulation support. In the patient with altered mental status, oxygen, naloxone, glucose, and thiamine should be administered. Symptom complexes that relate to specific classifications of toxins are referred to as toxidromes. Emesis by means of syrup of ipecac is rarely used for in-hospital gastric decontamination. Activated charcoal is a useful adsorbent for gastric decontamination. Whole bowel irrigation is useful for iron, lead, and lithium poisoning and for the body packer phenomenon. Enhancement of elimination may involve multiple doses of activated charcoal, hemodialysis, or charcoal hemoperfusion.