High-level language ability in healthy individuals and its relationship with verbal working memory.

The aims of the study were to investigate healthy subjects' performance on a clinical test of high-level language (HLL) and how it is related to demographic characteristics and verbal working memory (VWM). One hundred healthy subjects (20-79 years old) were assessed with the Swedish BeSS test (Laakso, Brunnegård, Hartelius, & Ahlsén, 2000) and two digit span tasks. Relationships between the demographic variables, VWM and BeSS were investigated both with bivariate correlations and multiple regression analysis. The results present the norms for BeSS. The correlations and multiple regression analysis show that demographic variables had limited influence on test performance. Measures of VWM were moderately related to total BeSS score and weakly to moderately correlated with five of the seven subtests. To conclude, education has an influence on the test as a whole but measures of VWM stood out as the most robust predictor of HLL.

Single-shot photofragment imaging by structured illumination.

A laser method to suppress background interferences in pump-probe measurements is presented and demonstrated. The method is based on structured illumination, where the intensity profile of the pump beam is spatially modulated to make its induced photofragment signal distinguishable from that created solely by the probe beam. A spatial lock-in algorithm is then applied on the acquired data, extracting only those image components that are characterized by the encoded structure. The concept is demonstrated for imaging of OH photofragments in a laminar methane/air flame, where the signal from the OH photofragments produced by the pump beam is spatially overlapping with that from the naturally present OH radicals. The purpose was to perform for the first time, to the best of our knowledge, single-shot imaging of HO(2) in a flame. These results show an increase in signal-to-interference ratio of about 20 for single-shot data.

Reduced-toxicity conditioning with treosulfan and fludarabine in allogeneic hematopoietic stem cell transplantation for myelodysplastic syndromes: final results of an international prospective phase II trial.

BACKGROUND: An alternative reduced-toxicity conditioning regimen for allogeneic transplantation, based on treosulfan and fludarabine, has recently been identified. The rationale for this study was to investigate the efficacy and safety of this regimen prospectively in patients with a primary myelodysplastic syndrome. DESIGN AND METHODS: A total of 45 patients with primary myelodysplastic syndromes were conditioned with 3×14 g/m(2) treosulfan and 5×30 mg/m(2) fludarabine followed by allogeneic hematopoietic stem cell transplantation. Subtypes of myelodysplastic syndromes were refractory anemia with excess blasts-2 (44%), refractory cytopenia with multilineage dysplasia (27%), refractory anemia (9%), refractory anemia with ringed sideroblasts (4%), refractory cytopenia with multilineage dysplasia and ringed sideroblasts (4%), refractory anemia with excess blasts-1 (2%), and myelodysplastic syndrome with isolated del (5q) (2%). The myelodysplastic syndrome was unclassified in 7% of the patients. Forty-seven percent of the patients had a favorable karyotype, 29% an unfavorable one, and 18% an intermediate karyotype. Patients were evaluated for engraftment, adverse events, graft-versus-host disease, non-relapse mortality, relapse incidence, overall survival and disease-free survival. RESULTS: All but one patient showed primary engraftment of neutrophils after a median of 17 days. Non-hematologic adverse events of grade III-IV in severity included mainly infections and gastrointestinal symptoms (80% and 22% of the patients, respectively). Acute graft-versus-host disease grade II-IV developed in 24%, and extensive chronic graft-versus-host disease in 28% of the patients. After a median follow-up of 780 days, the 2-year overall and disease-free survival estimates were 71% and 67%, respectively. The 2-year cumulative incidences of non-relapse mortality and relapse were 17% and 16%, respectively. CONCLUSIONS: Our safety and efficacy data suggest that treosulfan-based conditioning therapy is a promising treatment option for patients with myelodysplastic syndromes. clinicaltrials.gov identifier: NCT01062490.

Simultaneous Visualization of Hydrogen Peroxide and Water Concentrations Using Photofragmentation Laser-Induced Fluorescence.

A concept based on photofragmentation laser-induced fluorescence (PFLIF) is for the first time demonstrated for simultaneous detection of hydrogen peroxide (H2O2) and water (H2O) vapor in various mixtures containing the two constituents in a bath of argon gas. A photolysis laser pulse at 248 nm dissociates H2O2 into OH fragments, whereupon a probe pulse, delayed 100 ns and tuned to an absorption line in the A2Σ+ (v = 1) ← X2Π(v = 0) band of OH near 282 nm, induces fluorescence. The total OH fluorescence reflects the H2O2 concentration, while its spectral shape is utilized to determine the H2O concentration via a model predicting the ratio between the fluorescence intensities of the A2Σ+ (v = 1) → X2Π(v = 1) and the A2Σ+ (v = 0) → X2Π(v = 0) bands. The H2O detection scheme requires that the bath gas has a collisional cross-section with OH(A) that is significantly lower than that of H2O, which is the case for argon. Spectrally dispersed OH fluorescence spectra were recorded for five different H2O2/H2O/Ar mixtures; the H2O2 concentration in the range of 30-500 ppm and the H2O concentration in the range of 0-3%. Fluorescence intensity ratios predicted by the model for these mixtures agree very well with corresponding experimental data, which thus validates the model. The concept was also demonstrated for two-dimensional imaging, using two intensified charge-coupled device (CCD) cameras for signal detection. Water content was here sensed through the different temporal characteristics of the two fluorescence bands by triggering the two cameras so that one captures the total OH fluorescence while the other one captures only the early part, which mainly stems from A2Σ+ (v = 1) → X2Π(v = 1) fluorescence. Hence, the H2O2 concentration is reflected by the image of the camera recording the total OH fluorescence, whereas H2O concentration is extracted from the ratio between the two camera images. Quantification of the concentrations was carried out based on calibration measurements performed in known mixtures of H2O2 (30-500 ppm) and H2O (0-3%) in bulk argon. The detection limits for single-shot imaging are estimated to be 20 ppm for H2O2 and 0.05% for H2O. The authors believe that the concept provides a valuable asset in, for example, pharmaceutical or aseptic food packaging applications, where H2O2/H2O vapor is routinely used for sterilization.

Quantitative Imaging of Ozone Vapor Using Photofragmentation Laser-Induced Fluorescence (LIF).

In the present work, the spectral properties of gaseous ozone (O3) have been investigated aiming to perform quantitative concentration imaging of ozone by using a single laser pulse at 248 nm from a KrF excimer laser. The O3 molecule is first photodissociated by the laser pulse into two fragments, O and O2. Then the same laser pulse electronically excites the O2 fragment, which is vibrationally hot, whereupon fluorescence is emitted. The fluorescence intensity is found to be proportional to the concentration of ozone. Both emission and absorption characteristics have been investigated, as well as how the laser fluence affects the fluorescence signal. Quantitative ozone imaging data have been achieved based on calibration measurements in known mixtures of O3. In addition, a simultaneous study of the emission intensity captured by an intensified charge-coupled device (ICCD) camera and a spectrograph has been performed. The results show that any signal contribution not stemming from ozone is negligible compared to the strong fluorescence induced by the O2 fragment, thus proving interference-free ozone imaging. The single-shot detection limit has been estimated to ∼400 ppm. The authors believe that the presented technique offers a valuable tool applicable in various research fields, such as plasma sterilization, water and soil remediation, and plasma-assisted combustion.

Risk factors for the development of cytomegalovirus disease after allogeneic stem cell transplantation.

BACKGROUND AND OBJECTIVES: Cytomegalovirus (CMV) disease remains an important complication of allogeneic stem cell transplantation (SCT). We studied viral load kinetics and correlated the viral load and other transplant factors with the development of CMV disease. DESIGN AND METHODS: We studied 162 consecutive patients who were CMV seropositive or had CMV seropositive donors. Quantification of CMV DNA was performed by real-time polymerase chain reaction. RESULTS: CMV DNA detected was detected in 105 of the 162 patients. The mean peak viral loads were similar at first and subsequent reactivations. The serologic status of the donors and recipients prior to SCT significantly influenced the viral load. The cumulative incidence of CMV disease was 1.8% at 100 days and 6.3% at 365 days after SCT. The peak viral load were higher in patients who developed CMV disease than in patients without CMV disease (log10 3.5; SE +/- 0.26/200,000 cells vs. log10 2.7; SE +/- 0.09/200,000 cells; p=0.02). However, in multivariate analysis, only acute graft-versus-host disease (GVHD) grade II-IV and a graft from a CMV-negative donor to a CMV-positive patient were significant risk factors for CMV disease. In patients who required more than one course of pre-emptive therapy, acute GVHD and the rate of decrease in viral load during first pre-emptive therapy were significant risk factors for subsequent development of CMV disease. INTERPRETATION AND CONCLUSIONS: A decrease in viral load during pre-emptive therapy is an important factor for later development of CMV disease.

Reduced risk for extensive chronic graft-versus-host disease in patients receiving transplants with human leukocyte antigen-identical sibling donors given polymerase chain reaction-based preemptive therapy against cytomegalovirus.

BACKGROUND: The aim of this study was to investigate the relationship between cytomegalovirus (CMV) and extensive chronic graft-versus-host disease (GvHD) after allogeneic stem-cell transplantation (SCT). METHODS: Two hundred sixty-two consecutive patients undergoing conventional SCT with human leukocyte antigen-identical sibling donors, given cyclosporine A and methotrexate as GvHD prophylaxis and surviving more than 3 months after SCT, were retrospectively analyzed. Most patients received transplants because of a hematologic malignancy (n=226), but 36 patients with nonmalignant disorders were included in the analysis. Ninety-nine patients were monitored for CMV infection with rapid virus isolation and 163 patients by either a pp65 antigenemia test (n=5) or a qualitative polymerase chain reaction (PCR) assay for CMV-DNA (n=158). RESULTS: One hundred thirty (50%) of the patients developed chronic GvHD, of whom 17 (6.5%) developed extensive chronic GvHD. Risk factors for development of extensive chronic GvHD were determined by multivariate logistic regression. The strategy of PCR-based monitoring for CMV-DNA, giving preemptive antiviral therapy on demand, significantly decreased the risk for developing extensive chronic GvHD (odds ratio=0.32, P =0.03). No other factors tested, including recipient and donor age and sex, source of graft, cell dose, and acute GvHD, had any significant effect on the development of extensive chronic GvHD. CONCLUSIONS: We conclude that the risk for extensive chronic GvHD in this homogenous group of patients was reduced by the use of PCR-based preemptive therapy.

Simultaneous visualization of water and hydrogen peroxide vapor using two-photon laser-induced fluorescence and photofragmentation laser-induced fluorescence.

A concept based on a combination of photofragmentation laser-induced fluorescence (PF-LIF) and two-photon laser-induced fluorescence (LIF) is for the first time demonstrated for simultaneous detection of hydrogen peroxide (H2O2) and water (H2O) vapor. Water detection is based on two-photon excitation by an injection-locked krypton fluoride (KrF) excimer laser (248.28 nm), which induces broadband fluorescence (400-500 nm) from water. The same laser simultaneously photodissociates H2O2, whereupon the generated OH fragments are probed by LIF after a time delay of typically 50 ns, by a frequency-doubled dye laser (281.91 nm). Experiments in six different H2O2/H2O mixtures of known compositions show that both signals are linearly dependent on respective species concentration. For the H2O2 detection there is a minor interfering signal contribution from OH fragments created by two-photon photodissociation of H2O. Since the PF-LIF signal yield from H2O2 is found to be at least ∼24,000 times higher than the PF-LIF signal yield from H2O at room temperature, this interference is negligible for most H2O/H2O2 mixtures of practical interest. Simultaneous single-shot imaging of both species was demonstrated in a slightly turbulent flow. For single-shot imaging the minimum detectable H2O2 and H2O concentration is 10 ppm and 0.5%, respectively. The proposed measurement concept could be a valuable asset in several areas, for example, in atmospheric and combustion science and research on vapor-phase H2O2 sterilization in the pharmaceutical and aseptic food-packaging industries.

CMV retinitis after allogeneic bone marrow transplantation: a report of five cases.

Four cases of cytomegalovirus (CMV) retinitis (CMVR) after allogeneic blood stem cell transplant (SCT) were documented in Huddinge University Hospital between 1994 and 1999. Prior to 1994, only one case was documented. All five patients were transplanted due to malignant disease, two with sibling donors and three with matched unrelated donors. Despite adequate antiviral treatment against CMV retinitis, the result has been almost total unilateral blindness in three patients. However rare, the complication seems to have become more common since we began doing more matched unrelated donor transplants, which leads to a more pronounced T-cell defect and to a delayed immune reconstitution compared to sibling transplants. We conclude that CMV retinitis is a rare but important complication to allogeneic blood stem cell transplantation.

Leukocyte depleted, unscreened blood products give a low risk for CMV infection and disease in CMV seronegative allogeneic stem cell transplant recipients with seronegative stem cell donors.

Leukocyte depletion (LD) by blood product filtration has been shown to be similarly effective to the use of screened, CMV seronegative blood products to prevent CMV disease in CMV seronegative allogeneic stem cell transplant (SCT) patients with CMV seronegative donors. The aim of this retrospective study was to determine the risk for development of CMV infection requiring preemptive therapy and for CMV disease if unscreened products treated by prestorage LD is used. Forty-nine consecutive patients transplanted after June 1995 were included. As a control group, 33 patients transplanted from January 1992 to June 1995 in whom a combination of CMV seronegative and LD blood products were given. All patients were monitored weekly by a leukocyte-based PCR for CMV DNA detection. Preemptive therapy was initiated after two consecutively positive tests. No patient developed CMV disease in either group. CMV DNA was detected in 6/49 (p = NS) in the study group and in 3/33 patients in the historical control group. Two patients in the study group were given preemptive therapy compared to one patient in the control group. This study suggests that the risk for CMV disease and the need for preemptive therapy against CMV is low in CMV seronegative allogeneic SCT patients receiving grafts from CMV seronegative stem cell donors receiving LD blood products. Thus, this strategy can be safely used together with PCR monitoring and preemptive therapy.