[The use of therapeutic apheresis in neurological diseases and comparison between plasma exchange and immunoadsorption]

The use of plasmapheresis in neurological diseases with immune-mediated pathogenesis is widely certified. In recent years, the technological evolution of the dialysis membranes allowed to accompany the classical plasma exchange (PEX) treatment of apheresis by means of selective adsorption (IA). It has proved to be of equal therapeutic efficacy and, at the same time, devoid of most of the PEX side effects. The recent guidelines of the American Society for Apheresis (ASFA) and, later, the American Academy of Neurology, outlined directions and diagrams for the application of the method that has found wide use in many neurological diseases on the basis of auto-antibodies; in particular in Myasthenia Gravis, Guillain-Barre Syndrome, Multiple Sclerosis and Chronic Demyelinating Polyradiculoneuropathy. We add our experience in the treatment of 13 patients suffering from Myasthenia Gravis, treated over a four years period with filters containing tryptophan immunoadsorption in polyvinyl alcohol gel. The results confirm the achievement of a rapid regression of clinical symptoms, together with the rapid fall in the levels of antibody against acetylcholine-receptor. Therefore, the method of AI is to be considered of equal therapeutic efficacy of PEX, providing greater security in its use.

Predictive control of thermally induced wavefront aberrations

In this paper we experimentally demonstrate the proof of concept for predictive control of thermally induced wavefront aberrations in optical systems. On the basis of the model of thermally induced wavefront aberrations and using only past wavefront measurements, the proposed adaptive optics controller is able to predict and to compensate the future aberrations. Furthermore, the proposed controller is able to correct wavefront aberrations even when some parameters of the prediction model are unknown. The proposed control strategy can be used in high power optical systems, such as optical lithography machines, where the predictive correction of thermally induced wavefront aberrations is a crucial issue.

A new non-degenerate primer pair for the specific detection of the nitrite reductase gene nrfA in the genus Desulfovibrio

Dissimilatory nitrate reduction to ammonia (DNRA) is the process in which nitrate is reduced, via nitrite, to ammonia. Bacteria known to carry out DNRA mainly originate from wastewater treatment plants, where DNRA is a relevant process. The ability to carry out DNRA is phylogenetically widespread, and the gene nrfA, encoding for the key enzyme of the second step of the pathway, could be used as a marker for this process. In this study we developed a new primer pair specific for nrfA in the genus Desulfovibrio. The specificity of the primer pair was tested on DNA from thirteen species of Desulfovibrio and DNA from two wastewater samples. PCR amplifications yielded products of the expected size (850 bp), and sequences obtained from Desulfovibrio strains and environmental sample clone libraries matched the Desulfovibrio nrfA gene. Nevertheless, we found nrfA gene sequences in the environmental samples that are not present in the databases. The new primer set can be used to obtain more sequences of the nrfA gene and improve our knowledge of the DNRA pathway in this genus, e.g. with the aim to improve the wastewater treatment process.

An innovative and efficient method to control the shape of push-pull membrane deformable mirror

We carry out performance characterisation of a commercial push and pull deformable mirror with 48 actuators (Adaptica Srl). We present a detailed description of the system as well as a statistical approach on the identification of the mirror influence function. A new efficient control algorithm to induce the desired wavefront shape is also developed and comparison with other control algorithms present in literature has been made to prove the efficiency of the new approach.

First successful double-factor PGD for Lynch syndrome: monogenic analysis and comprehensive aneuploidy screening

Preimplantation genetic diagnosis (PGD) has been applied worldwide for a great variety of single-gene disorders over the last 20 years. The aim of this work was to perform a double-factor preimplantation genetic diagnosis (DF-PGD) protocol in a family at risk for Lynch syndrome. The family underwent a DF-PGD approach in which two blastomeres from each cleavage-stage embryo were biopsied and used for monogenic and comprehensive cytogenetic analysis, respectively. Fourteen embryos were biopsied for the monogenic disease and after multiple displacement amplification (MDA), 12 embryos were diagnosed; 5 being non-affected and 7 affected by the disease. Thirteen were biopsied to perform the aneuploidy screening by short-comparative genomic hybridization (CGH). The improved DF-PGD approach permitted the selection of not only healthy but also euploid embryos for transfer. This has been the first time a double analysis of embryos has been performed in a family affected by Lynch syndrome, resulting in the birth of two healthy children. The protocol described in this work offers a reliable alternative for single-gene disorder assessment together with a comprehensive aneuploidy screening of the embryos that may increase the chances of pregnancy and birth of transferred embryos.

Terahertz wavefronts measured using the Hartmann sensor principle

We demonstrate for the first time that the Hartmann wavefront sensor (HWS) principle can be applied for characterizing the wavefronts of terahertz (THz) electromagnetic radiation. The THz Hartmann wavefront sensor consists of a metallic plate with an array of holes and a two-dimensional scanable pyro-electric detector. The THz radiation with different wavefronts was generated by a far-infrared gas laser operated at 2.5 THz in combination with a number of objects that result in known wavefronts. To measure the wavefront, a beam passing through an array of holes generates intensity spots, for which the positions of the individual spot centroids are measured and compared with reference positions. The reconstructed wavefronts are in good agreement with the model expectations.

Determination of wavefront structure for a Hartmann wavefront sensor using a phase-retrieval method

We apply a phase retrieval algorithm to the intensity pattern of a Hartmann wavefront sensor to measure with enhanced accuracy the phase structure of a Hartmann hole array. It is shown that the rms wavefront error achieved by phase reconstruction is one order of magnitude smaller than the one obtained from a typical centroid algorithm. Experimental results are consistent with a phase measurement performed independently using a Shack-Hartmann wavefront sensor.

Usefulness of bladder-prostate ultrasound in the diagnosis of obstruction/hyperactivity in males with BPH

OBJECTIVE

To determine the utility of prostate ultrasound in the diagnosis of infravesical obstruction (IVO) and detrusor hyperactivity(DH).

METHODS

Prospective study with 39 patients consulting for LUTS. Clinical history was compiled, IPSS was determined, a digital rectal exam was performed, abdominal ultrasound was used to calculate detrusor thickness/weight, prostate volume, and middle lobe length (MLL). Urodynamic study (UD) was performed with determination of the Abrams-Griffiths number and ICS nomogram. Mean values were compared with Mann-Whitney U-test, and ROC curves were plotted determining the cutoff points for optimum sensitivity/specificity.

RESULTS

Mean age was 63.1 years (SD: 7.8), with a mean IPSS score of 14 (SD: 6). 53.8% of the patients presented IVO at UD evaluation, and 43.6% DH. The differences between free flowmetry Qmax(p=0.015) and MLL (p=0.003) between patients with and without IVO proved significant. The ROC curves yielded an AUC for middle lobe length of 0.772, with a maximum sensitivity and specificity cutoff point at 10.5 mm (sensitivity 90%, specificity 73%, PPV 76%, NPV 85%). There were no significant differences in any parameter between patients with and without DH.

CONCLUSION

Ultrasound MLL measurement in patients with LUTS offers high sensitivity/specificity in diagnosing IVO, with a cutoff point of 10.5 mm. In our study it wasn't effective in the noninvasive diagnosis of DH.