1H-magnetic resonance spectroscopy markers of cognitive and language ability in clinical subtypes of autism spectrum disorders

This study assessed metabolic functioning of regional brain areas to address whether there is a neurometabolic profile reflecting the underlying neuropathology in individuals with autism spectrum disorders, and if varied profiles correlate with the clinical subtypes. Thirteen children (7-16 years) with autism spectrum disorders and 8 typically developing children were compared on (1)H-magnetic resonance spectroscopy data collected from hippocampus-amygdala and cerebellar regions. The autism spectrum disorder group had significantly lower N-acetyl-aspartate/creatine ratios bilaterally in the hippocampus-amygdala but not cerebellum, whereas myo-inositol/creatine was significantly increased in all measured regions. Choline/creatine was also significantly elevated in the left hippocampus-amygdala and cerebellar regions of children with autism spectrum disorder. Comparisons within the autism spectrum disorder group when clinically subdivided by history of speech delay revealed significant metabolic ratio differences. Magnetic resonance spectroscopy can provide important information regarding abnormal brain metabolism and clinical classification in autism spectrum disorders.

Direct measurement of the coherence length of edge states in the integer quantum Hall regime

We have determined the finite temperature coherence length of edge states in the integer quantum Hall effect regime. This was realized by measuring the visibility of electronic Mach-Zehnder interferometers of different sizes, at filling factor 2. The visibility shows an exponential decay with the temperature. The characteristic temperature scale is found inversely proportional to the length of the interferometer arm, allowing one to define a coherence length l_(phi). The variations of l_(phi) with magnetic field are the same for all samples, with a maximum located at the upper end of the quantum Hall plateau. Our results provide the first accurate determination of l_(phi) in the quantum Hall regime.

Successful treatment of invasive Aspergillus sinusitis with caspofungin and voriconazole

Chronic invasive Aspergillus sinusitis is a rare and potentially devastating infection. Management typically requires extensive surgical debridement followed by long-term antifungal therapy, primarily with intravenous amphotericin B. We describe the case of an elderly woman who had been diagnosed with extensive Aspergillus sinusitis that had invaded critical structures. The extensiveness of the infection and the patients frailty and unwillingness to undergo a disfiguring procedure precluded surgery, and her medical condition was too fragile to withstandamphotericin B therapy Therefore, we decided to treat her with a combination ofcaspofungin and voriconazole, two relatively nontoxic antifungal agents that have different mechanisms of action. After administration of this novel regimen, the infection resolved rapidly.

Successful Treatment of Invasive Aspergillus Sinusitis with Caspofungin and Voriconazole

Chronic invasive Aspergillus sinusitis is a rare and potentially devastating infection. Management typically requires extensive surgical debridement followed by long-term antifungal therapy, primarily with intravenous amphotericin B. We describe the case of an elderly woman who had been diagnosed with extensive Aspergillus sinusitis that had invaded critical structures. The extensiveness of the infection and the patient's frailty and unwillingness to undergo a disfiguring procedure precluded surgery, and her medical condition was too fragile to withstand amphotericin B therapy. Therefore, we decided to treat her with a combination of caspofungin and voriconazole, two relatively nontoxic antifungal agents that have different mechanisms of action. After administration of this novel regimen, the infection resolved rapidly.

Experimental test of the high-frequency quantum shot noise theory in a quantum point contact

We report on direct measurements of the electronic shot noise of a quantum point contact at frequencies nu in the range 4-8 GHz. The very small energy scale used ensures energy independent transmissions of the few transmitted electronic modes and their accurate knowledge. Both the thermal energy and the quantum point contact drain-source voltage V_{ds} are comparable to the photon energy hnu leading to observation of the shot noise suppression when V_{ds}<hnu/e. Our measurements provide the first complete test of the finite frequency shot noise scattering theory without adjustable parameters.

A novel luminescent lifetime-based optrode for the detection of gaseous and dissolved oxygen utilising a mixed ormosil matrix containing ruthenium (4,7-diphenyl-1,10-phenanthroline)3Cl2 (Ru.dpp)

A novel luminescent lifetime optrode is presented for the detection of gaseous and dissolved oxygen. The optrode utilises ruthenium (4,7-diphenyl-1,10-phenanthroline)(3)Cl(2) as the sensing fluorophore immobilised in a hydrophobic ormosil matrix. The ormosil matrix is synthesised at room temperature from octyltriethoxysilane and methyltriethoxysilane precursors. Investigations of different ormosils were conducted and the most effective one was selected for optrode production. Optrodes were tested for responses to gaseous and dissolved oxygen. Their responses were modelled using traditional two-site or two-exponential methods and feed-forward artificial neural networks. Comparison of the two modelling methodologies is presented and further improvements in modelling and ormosil design are suggested.

Intra-carotid chemo (ICC) followed by radiation (RT) with concomitant temozolamide (TMZ) and subsequent maintenance TMZ therapy in patients (pts) with glioblastoma multiforme (GBM)

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Background: Glioblastoma multiforme is one of the most resistant malignant tumors. Surgery provides only temporary, palliative relief. Radiation therapy affords additional, though short, benefit. Systemic, intravenous and/or oral chemotherapy with nitrosoureas and TMZ, increases survival only slightly. Median survival (MS) after all these modalities incorporated remains unimpressive, less than 14 months. Intracarotid chemotherapy with cisplatin and VP-16, a standard treatment at Stony Brook University Hospital since 1999, prior to RT, results in MS of 20 months. A year later we added TMZ as a part of standard treatment with or without ICC in patients with GBM. Provided here is a retrospective analysis of the treatment consisting of surgery, ICC, RT with concomitant TMZ followed by 2 years of TMZ maintenance. Methods: Fifteen patients with pathologically confirmed, newly diagnosed GBM were treated from year 2000 to 2005; 11 men; median age 53 (range 25-68); 80% with PS over 70. They underwent a surgical procedure (5 near total) followed by ICC with cisplatin 60 mg/m2 and VP-16 40 mg/m2 every 3 weeks for total of 3 cycles. Subsequently they received TMZ 75 mg/m2/day orally, concomitantly with RT 6120–6300 cGY, followed a month later by maintenance therapy with TMZ 200 mg/m2/ daily for 5 days out of each month for 2 years or until progression. Results: Fourteen pts.are being evaluated (one too early), all have survived at least 12 months.One-year PFS is 79%. Median time to progression is 19.5 months; MS is 25 months with a range of 12-48 months. Toxicity is limited to nausea and vomiting mainly grade 1-2; only 1 patient experienced grade 3 vomiting with subsequent TMZ maintenance dose reduction by about 10%. Conclusions: Surgery followed by ICC, then combination of RT + TMZ followed by maintenance TMZ therapy seems to be more effective in improving patient survival than surgery, ICC and RT as reported previously by us in pts with GBM (Cancer 2000; 10:2350–6). This treatment has been well tolerated.

No significant financial relationships to disclose.

Spectroscopie par résonance magnétique des tumeurs cérébrales

MR spectroscopy (MRS) can complement MRI in the evaluation of intracranial tumors. Before treatment, MRS can contribute to the differential diagnosis between tumor and non tumoral lesion (especially intracranial abscesses), to assess the aggressiveness of a glial tumor or to determine its extension to better delineate the surgical removal or the target volume of radiotherapy. During treatment follow-up, MRS helps differentiate recurrent tumor from radionecrosis or physiological post-surgical contrast enhancement. The current studies are trying to determine if the indications of MRS, alone or in association with other MR sequences can further be extended in the study of brain tumors, in particular the follow-up of lesions undergoing chemo or radiotherapy.

The Importance of Histology in the Evaluation of Pulmonary Transplantation: Carcinomatous Lymphangitis

Pulmonary carcinomatous lymphangitis is a form of neoplastic metastatic spread to the lungs, which represents a poor prognosis for the patient. The physician may be confronted by a differential diagnosis with diffuse pulmonary interstitial affections requiring specific treatment, including lung transplantation. We present the case of a patient, diagnosed with pulmonary interstitial disease with rapidly progressive worsening of lung function, who was considered for lung transplantation. Videothoracoscopic lung biopsy demonstrated the existence of carcinomatous lymphangitis, which completely changed the therapeutic direction.

Fano factor reduction on the 0.7 conductance structure of a ballistic one-dimensional wire

We have measured the nonequilibrium current noise in a ballistic one-dimensional wire which exhibits an additional conductance plateau at 0.7x2e(2)/h. The Fano factor shows a clear reduction on the 0.7 structure, and eventually vanishes upon applying a strong parallel magnetic field. These results provide experimental evidence that the 0.7 structure is associated with two conduction channels that have different transmission probabilities.

Hanbury Brown-Twiss correlations to probe the population statistics of GHz photons emitted by conductors

We present the first study of the statistics of GHz photons in quantum circuits, using Hanbury Brown and Twiss correlations. The super-Poissonian and Poissonian photon statistics of thermal and coherent sources, respectively, made of a resistor and a radio frequency generator, are measured down to the quantum regime at milli-Kelvin temperatures. As photon correlations are linked to the second and fourth moments of current fluctuations, this experiment, which is based on current cryogenic electronics, may become a standard for probing electron/photon statistics in quantum conductors.

Does participation in a pain course based on the International Association for the Study of Pain's curricula guidelines change student knowledge about pain?

BACKGROUND

The People in Pain course was set up as a joint initiative of the Departments of Occupational Therapy and Physiotherapy within the School of Health and Rehabilitation Sciences at The University of Queensland. It was instigated in response to the publication of Pain Curricula for Occupational Therapy and Physiotherapy by the International Association for the Study of Pain (IASP) in 1994 (1). The first year it was offered, the "People in Pain" course comprised 14 h of lecture content. It was then expanded to encompass 28 h of lectures and seminar involvement.

OBJECTIVES

To evaluate the impact of participation in a university pain course that meets the IASP pain curricula guidelines to increase health professional students' knowledge about pain.

METHODS

Students who participated in the People in Pain course over the first three years were invited to complete the Revised Pain Knowledge and Attitudes Questionnaire (R-PKAQ) pre- and postcourse. Data obtained from 22 students in the short course formed a pilot project, and data from 22 students in the longer version of the course were used in the present study.

RESULTS

Examination of the correlation matrix indicated substantial correlations between all R-PKAQ subscales except physiological basis of pain and pharmacological management of pain. In both the pilot project during the first year of the course and the expanded course in the following two years, significant improvement was found in the students' knowledge on five of the six subscales of the R-PKAQ: physiological basis of pain, psychological factors of pain perception, assessment and measurement of pain, cognitive-behavioural methods of pain relief, and pharmacological management of pain. Improvements in the developmental aspects of pain perception subscale failed to reach significance.

CONCLUSIONS

An integrated pain course developed according to the pain curriculum guidelines developed by the IASP resulted in increased student knowledge regardless of the length of the program attended.

Impaired Nitric Oxide Function in the Basilar Artery of the Obese Zucker Rat

The effect of insulin-resistance syndrome on vascular function has been examined in isolated basilar arteries using the obese Zucker rat (OZR) and age-matched lean littermate controls (lean Zucker rat; LZR) at 36 weeks of age. The OZR showed significantly reduced oral glucose tolerance and increased body weight, blood pressure, proteinuria, plasma levels of triglycerides, cholesterol, and insulin compared with the LZR. The contractile response to serotonin was significantly increased in the OZR. Furthermore, contractions to serotonin in LZR but not OZR were enhanced in the presence of the nitric oxide synthase inhibitor Nomega-nitro-L-arginine methyl ester (NAME). Relaxations to acetylcholine (ACh), histamine, and A23187 were significantly reduced in precontracted arteries from the OZR. In the presence of NAME, histamine responses were significantly reduced whereas ACh and A23187 responses were almost abolished. Relaxations to free-radical nitric oxide (NO) and papaverine were not different in arteries from the OZR, even though responses to sodium nitroprusside were reduced in the OZR. Western blot and immunofluorescent quantitative analyses of eNOS content in cerebral microvessel fractions and basilar artery preparations, respectively, were not significantly different between OZR and LZR. The results suggest impairment in endothelial function resulting in reduced NO function in the basilar artery from the OZR.

Cognitive performance and MR markers of cerebral injury in cognitively impaired MS patients

OBJECTIVE

To relate neuropsychological performance to measures of cerebral injury in persons with MS selected for cognitive impairment.

METHODS

Participants were 37 individuals with relapsing-remitting (59.5%) and secondary progressive (40.5%) MS. They were tested at baseline as part of a clinical trial to enhance cognition with an acetylcholinesterase inhibitor. Eligibility criteria included at least mild cognitive impairment on a verbal learning and memory task. A modified Brief Repeatable Battery of Neuropsychological Tests formed the core of the behavioral protocol. Neuroimaging measures were central (ventricular) cerebral atrophy, lesion volume, and ratios of N-acetyl aspartate (NAA) to both creatine and choline.

RESULTS

A clear, consistent relation was found between cognitive and MR measures. Among neuroimaging measures, central atrophy displayed the highest correlations with cognition, accounting for approximately half the variance in overall cognitive performance. NAA ratios in right hemisphere sites displayed larger correlations than those on the left. Multiple regression models combining the MR measures accounted for well over half the variance in overall cognitive performance. The Symbol Digit Modalities Test was the neuropsychological task most strongly associated with the neuroimaging variables.

CONCLUSIONS

If a strong and stable association can be firmly established between cognitive and MR variables in appropriate subsets of MS patients, it might aid in the investigation of interventions to enhance cognition and modify the course of the disease.

Quantum partition noise of photon-created electron-hole pairs

We show experimentally that even when no bias voltage is applied to a quantum conductor, the electronic quantum partition noise can be investigated with GHz radio frequency excitation. Using a quantum point contact configuration as the ballistic conductor we are able to make an accurate determination of the partition noise Fano factor resulting from the photon-assisted shot noise. Applying both voltage bias and rf irradiation we are able to make a definitive quantitative test of the scattering theory of photon-assisted shot noise.

Adoptive T cell therapy using antigen-specific CD8+ T cell clones for the treatment of patients with metastatic melanoma: in vivo persistence, migration, and antitumor effect of transferred T cells

Adoptive T cell therapy, involving the ex vivo selection and expansion of antigen-specific T cell clones, provides a means of augmenting antigen-specific immunity without the in vivo constraints that can accompany vaccine-based strategies. A phase I study was performed to evaluate the safety, in vivo persistence, and efficacy of adoptively transferred CD8+ T cell clones targeting the tumor-associated antigens, MART1MelanA and gp100 for the treatment of patients with metastatic melanoma. Four infusions of autologous T cell clones were administered, the first without IL-2 and subsequent infusions with low-dose IL-2 (at 0.25, 0.50, and 1.0 x 10(6) unitsm(2) twice daily for the second, third, and fourth infusions, respectively). Forty-three infusions of MART1MelanA-specific or gp100-specific CD8+ T cell clones were administered to 10 patients. No serious toxicity was observed. We demonstrate that the adoptively transferred T cell clones persist in vivo in response to low-dose IL-2, preferentially localize to tumor sites and mediate an antigen-specific immune response characterized by the elimination of antigen-positive tumor cells, regression of individual metastases, and minor, mixed or stable responses in 8 of 10 patients with refractory, metastatic disease for up to 21 mo.

[MRI: an essential examen for the management of sacrococcygeal chondromas]

Chordomas are rare tumors, involving mainly the sacrococcygeal area and the clivus. Although a significant radiological semiology exists (osteolytic, lobulated, calcified tumor), the definite diagnosis is histological. Five cases of sacral and/or coccygeal chordomas were studied by CT scan and MRI. Clinical, radiological (tumoral topography and extension) and histological data were noted in all cases. At CT scan, the tumor was median, osteolytic, often calcified, of intermediate density, sparing iliac bones. MRI showed, in all the cases, a tumoral lobulation making easier the diagnosis of chordoma. Futhermore, as compared to CT scan MRI brought new information for the study of the tumoral extension, revealing a frequent involvement of adjacent muscles and spinal canal. It also showed that the tumor most often spared the rectal wall. These data are fundamental in the management of patients: the therapeutical aim must be, if possible, a complete removal of the tumor. Thus, besides its interest in the diagnosis, MRI appears to be essential in the pre-therapeutical assessment of sacro-coccygeal chordomas.

Australia's notifiable diseases status, 1999: annual report of the National Notifiable Diseases Surveillance System

In 1999 there were 88,229 [corrected] notifications of communicable diseases in Australia reported to the National Notifiable Diseases Surveillance System (NNDSS). The number of notifications in 1999 was an increase of 3 per cent on notifications in 1998 (85,227) and the second largest reporting year since the NNDSS commenced in 1991. Notifications in 1999 consisted of 29,977 bloodborne infections (34% of total), 22,255 gastrointestinal infections (25%), 21,704 sexually transmitted infections (25%), 5,986 vector borne infections (7%),5,228 vaccine preventable infections (6%), 1,967 (2%) other bacterial infections (legionella, meningococcal, leprosy and tuberculosis), 1,012 zoonotic infections (1%) and 3 quarantinable infections (0.003%). Notifications of bloodborne viral diseases particularly hepatitis B and hepatitis C and some sexually transmitted infections such as gonorrhoea and chlamydia continue to increase in Australia. Steep declines in vaccine preventable diseases such as Haemophilus influenzae type b, measles, mumps and rubella continued in 1999. This report also summarises data on communicable diseases from other surveillance systems including the Laboratory Virology and Serology Surveillance Scheme (LabVISE) and sentinel general practitioner schemes. In addition this report comments on other important developments in communicable disease control in Australia in 1999.

Tuberculosis notifications in Australia, 1999

Australia has one of the lowest incidence of tuberculosis in the world. The crude annual notification rate for tuberculosis (TB) has remained stable at between 5 and 6 per 100,000 population since 1991. In 1999, there were a total of 1,159 TB notifications in Australia of which 1,117 were new TB cases, and 42 were relapsed cases. The corresponding annual notification rate for new and relapsed TB was 5.9 and 0.2 per 100,000 population respectively. People born overseas accounted for 83 per cent of the notified cases. TB notification rates remain highest among overseas-born residents from high prevalence countries, and indigenous Australians. The lowest rates of disease are in the non-indigenous, Australian born population and data from the last 7 years indicate that the rate of tuberculosis in this population is continuing to fall.