Giant cell myocarditis. Report of a case

The authors report a case of giant cell myocarditis leading to rapidly progressive cardiac failure despite immuno-suppressor treatment in a 20 year old woman. The cardiac failure was successfully managed by implantation of a left ventricular assist device and then cardiac transplantation. The problems encountered underline the importance of accurate diagnosis by endomyocardial biopsy before undertaking treatment and the difficulties in the choice of appropriate method of assistance in this indication. Giant cell myocarditis is a rare cause of cardiac failure and should be considered in the differential diagnosis in view of its clinical features and risk of progression. The literature and the therapeutic implications are discussed.     

Anaemia in malaria control: a practical approach

Mortality from malarial anaemia and malarial infection in those who are already anaemic yet have some degree of compensation is now beginning to receive the attention it deserves. It is of particular concern in Africa and especially in young children and pregnant women. The asymptomatic parasitaemia remaining after poor response to full antimalarial treatment may lead to life-threatening anaemia; as drug-resistant strains of the malarial parasite proliferate this is becoming increasingly important. It is now possible to estimate haemoglobin levels, simply, cheaply, easily and safely, using a haemoglobin colour scale which is being developed by the World Health Organization. The potential and practical value of this scale in malaria-control programmes was demonstrated in a small, preliminary trial in 1995. Estimation of anaemia should become an additional parameter in the traditional malariometric survey. Haemoglobin concentrations should also be taken into consideration in the management of malaria patients at the primary-care level, particularly in deciding whether a patient should be referred to an appropriate treatment centre. The accurate prediction of clinical outcome of malaria and anaemia, and indication of the appropriate action (determined by a case-based reasoning device) should be possible in the near future.     

Human erythrocytes bearing electroinserted CD4 neutralize infection in vitro by primary isolates of human immunodeficiency virus type 1

Human erythrocytes bearing electroinserted full-length CD4 (RBC-CD4) can bind and fuse with a laboratory strain of human immunodeficiency virus type 1 (HIV-1) or with T cells infected by HIV-1. Here we show that RBC-CD4 neutralize primary HIV-1 strains in an assay of cocultivation of peripheral blood mononuclear cells (PBMC) from HIV-1-infected persons with uninfected PBMC. RBC-CD4 inhibited viral p24 core antigen accumulation in these cocultures up to 10,000-fold compared with RBC alone. Viral p24 accumulation was inhibited equally well when measured in culture supernatants or in call extracts. The inhibition was dose-dependent and long-lived. Two types of recombinant CD4 tested in parallel were largely ineffective. The neutralization of primary HIV-1 by RBC-CD4 in vitro was demonstrated in PBMC cultures from 21 of a total of 23 patients tested at two independent sites. RBC-CD4 may offer a route to blocking HIV-1 infection in vivo.     

Design for concurrent error detection and testability instorage/logic arrays

Storage/Logic Arrays (SLA's) represent a structured logic array approach to the design of VLSI sequential logic. Design for concurrent error detection and testability is complicated in these arrays by the presence of embedded memory elements and multiple levels of logic. A means of designing SLA's for ease of testability and concurrent error detection (CED) is provided in this paper. Test sets for static and dynamic CMOS circuits are described. Fault and error coverage is presented and performance and area costs are analyzed for example circuits. In addition, a means of implementing dynamic CMOS SLA's is presented and shown superior to previous NMOS, static CMOS, and dynamic CMOS approaches based upon power consumption and simplicity of design     

Telecoms-can one company do it all?

The telecommunications equipment market is a rapidly changing place. Niche companies are becoming more and more important. Time to market matters more than ever and return on investment is essential. Partnerships are therefore essential. The article examines why this is happening now, and why not earlier.