Successful bone marrow transplantation in a patient with Schimke immuno-osseous dysplasia.

Early death in Schimke immuno-osseous dysplasia often results from renal failure and/or cell-mediated immunodeficiency. Kidney transplants have improved renal function, but effective therapy for the immunodeficiency has not yet been reported. We describe markedly improved marrow function 2 years after bone marrow transplantation in a boy with Schimke immunoosseous dysplasia.

Assessment of GPS carrier-phase stability for time-transfer applications.

We have conducted global positioning system (GPS) carrier-phase time-transfer experiments between the master clock (MC) at the U.S. Naval Observatory (USNO) in Washington, DC and the alternate master clock (AMC) at Schriever Air Force Base near Colorado Springs, Colorado. These clocks are also monitored on an hourly basis with two-way satellite time-transfer (TWSTT) measurements. We compared the performance of the GPS carrier phase and TWSTT systems over a 236-d period. Because of power problems and data outages during the carrier-phase experiment, the longest continuous time span is 96 d. The data from this period show agreement with TWSTT within +/-1 ns, apart from an overall constant time offset (caused by unknown delays in the GPS hardware at both ends). For averaging times of a day, the carrier-phase and TWSTT systems have a frequency uncertainty of 2.5 and 5.5 parts in 10(15), respectively.

Time synchronization over the Internet using an adaptive frequency-locked loop.

This paper describes the operation of an algorithm for synchronizing the time of computers using messages transmitted over packet-switched networks such as the Internet. The algorithm configures itself to realize any specified performance level at minimum cost (measured in computer cycles or network bandwidth). If the highest possible accuracy is requested, the performance will be limited by the larger of the instability of the local clock oscillator or the noise in the measurement process between the client and the server; uncertainties of about 8 ms RMS have been obtained using standard workstations and average network connections. Lower accuracy can be realized at substantially lower cost because the cost varies approximately as the inverse of the accuracy squared over a wide range of these parameters. The algorithm makes better use of scarce network bandwidth than previous methods. This improvement is realized by using a pure frequency-locked loop (rather than mixed frequency/phase locking algorithms currently proposed for the NTP) with unequal spacing between calibration cycles. The result is a cleaner separation between network noise and clock noise, which is especially important when the highest possible accuracy is desired. In addition, the algorithm is an improvement over the pure-FLL "Interlock" algorithm described previously because it is self configuring. In addition to supporting an explicit trade-off between cost and accuracy, the algorithm provides better performance than previous methods because it is better able to adapt itself to fluctuations in the asymmetry of the network delay.

Carrier-phase time transfer.

We have conducted several time-transfer experiments using the phase of the GPS carrier rather than the code, as is done in current GPS-based time-transfer systems. Atomic clocks were connected to geodetic GPS receivers; we then used the GPS carrier-phase observations to estimate relative clock behavior at 6-minute intervals. GPS carrier-phase time transfer is more than an order of magnitude more precise than GPS common view time transfer and agrees, within the experimental uncertainty, with two-way satellite time-transfer measurements for a 2400 km baseline. GPS carrier-phase time transfer has a stability of 100 ps, which translates into a frequency uncertainty of about two parts in 10(-15) for an average time of 1 day.

Time synchronization using the Internet.

This paper discusses a new algorithm for synchronizing the clocks of networked computers using messages transmitted over the network itself. The design is based on a statistical model of the clock and the network, and uses this model to define the parameters of a frequency-lock loop which is used to discipline the local oscillator. The design was tested by synchronizing a standard workstation to a time server located 1200 km away; the time offset between the clock synchronized in this way and UTC is 2 ms rms. This analysis also can be used to design algorithms that provide lower accuracy at lower cost.

Time transfer using the phase of the GPS carrier.

We report on tests of time transfer using the phase of the GPS carrier. The first set of experiments used two clocks connected to independent GPS receivers with closely-spaced antennas. The second set of experiments compared a clock at NIST in Boulder with one at the US Naval Observatory in Washington, DC.

Pancolonic disease in cystic fibrosis and high-dose pancreatic enzyme therapy.

We describe a child with cystic fibrosis who was treated with high-dose pancreatic enzyme replacement therapy and who had a prominent ascending colon stricture with submucosal fibrosis. Unlike prior reported cases, this patient's disease was more extensive, involving the entire colon, and was associated with chylous ascites.

Outbreak of central-nervous-system toxoplasmosis in western Europe and North America.

Acute encephalitis caused by Toxoplasma gondii was diagnosed in ten patients in Belgium, the U.S.A., and Canada. None had underlying conditions usually associated with toxoplasmosis. Three had evidence of extraneural infection at necropsy. Nine patients died. Only two of the patients had a history of homosexuality, and one was a heroin addict. Five were Haitian, and four of them had lived in North America for 2-5 years. Eight of the patients had pronounced lymphopenia. Diagnosis of toxoplasmosis was hampered by a lack of suspicion that Toxoplasma could be the agent causing necrotising encephalitis in the non-immunocompromised host, the protean manifestations of the encephalitis, and a lack of a specific antibody response. The large number of cases appearing in western Europe and North America emphasise the necessity of including toxoplasmosis in the differential diagnosis of encephalitis of unknown aetiology.