Interpretation of HRCT Scans in the Diagnosis of IPF: Improving Communication Between Pulmonologists and Radiologists.

Idiopathic pulmonary fibrosis (IPF) is a progressive fibrosing interstitial lung disease (ILD). In this review, we describe the central role of high-resolution computed tomography (HRCT) in the diagnosis of IPF and discuss how communication between pulmonologists and radiologists might be improved to make the interpretation of HRCT scans more effective. Clinical information is important in the interpretation of HRCT scans, as the likelihood that specific radiologic features reflect IPF is not absolute, but dependent on the clinical context. In cases where the clinical context or HRCT pattern are inconclusive, multidisciplinary discussion (MDD) between a pulmonologist and radiologist (and, where relevant, a pathologist and rheumatologist) experienced in the differential diagnosis of ILD is necessary to establish a diagnosis. While it can be challenging to convene a face-to-face meeting, MDD can be conducted virtually or by telephone to enable each specialty group to contribute. To make the MDD most effective, it is important that relevant clinical information (for example, on the patient's clinical history, exposures and the results of serological tests) is shared with all parties in advance. A common lexicon to describe HRCT features observed in ILD can also help improve the effectiveness of MDD. A working diagnosis may be made in patients who do not fulfill all the diagnostic criteria for any specific type of ILD, but this diagnosis should be reviewed at regular intervals, with repeat of clinical, radiological, and laboratory assessments as appropriate, as new information pertinent to the patient's diagnosis may become available

Self-Similar Random Processes and Infinite-Dimensional Configuration Spaces

We discuss various infinite-dimensional configuration spaces that carry measures quasiinvariant under compactly-supported diffeomorphisms of a manifold M corresponding to a physical space. Such measures allow the construction of unitary representations of the diffeomorphism group, which are important to nonrelativistic quantum statistical physics and to the quantum theory of extended objects in d-dimensional Euclidean space. Special attention is given to measurable structure and topology underlying measures on generalized configuration spaces obtained from self-similar random processes (both for d = 1 and d > 1), which describe infinite point configurations having accumulation points

Some Variations on Maxwell's Equations

In the first sections of this article, we discuss two variations on Maxwell's equations that have been introduced in earlier work--a class of nonlinear Maxwell theories with well-defined Galilean limits (and correspondingly generalized Yang-Mills equations), and a linear modification motivated by the coupling of the electromagnetic potential with a certain nonlinear Schroedinger equation. In the final section, revisiting an old idea of Lorentz, we write Maxwell's equations for a theory in which the electrostatic force of repulsion between like charges differs fundamentally in magnitude from the electrostatic force of attraction between unlike charges. We elaborate on Lorentz' description by means of electric and magnetic field strengths, whose governing equations separate into two fully relativistic Maxwell systems--one describing ordinary electromagnetism, and the other describing a universally attractive or repulsive long-range force. If such a force cannot be ruled out {\it a priori} by known physical principles, its magnitude should be determined or bounded experimentally. Were it to exist, interesting possibilities go beyond Lorentz' early conjecture of a relation to (Newtonian) gravity.Comment: 26 pages, submitted to a volume in preparation to honor Gerard Emch v. 2: discussion revised, factors of 4\pi corrected in some equation

Gauge Transformations in Quantum Mechanics and the Unification of Nonlinear Schr\"odinger Equations

Beginning with ordinary quantum mechanics for spinless particles, together with the hypothesis that all experimental measurements consist of positional measurements at different times, we characterize directly a class of nonlinear quantum theories physically equivalent to linear quantum mechanics through nonlinear gauge transformations. We show that under two physically-motivated assumptions, these transformations are uniquely determined: they are exactly the group of time-dependent, nonlinear gauge transformations introduced previously for a family of nonlinear Schr\"odinger equations. The general equation in this family, including terms considered by Kostin, by Bialynicki-Birula and Mycielski, and by Doebner and Goldin, with time-dependent coefficients, can be obtained from the linear Schr\"odinger equation through gauge transformation and a subsequent process we call gauge generalization. We thus unify, on fundamental grounds, a rather diverse set of nonlinear time-evolutions in quantum mechanics.Comment: RevTeX, 20 pages, no figures. also available on http://www.pt.tu-clausthal.de/preprints/asi-tpa/021-96.htm

Mast cell clones: a model for the analysis of cellular maturation.

Cloned mouse mast cells resemble, by ultrastructure, immature mast cells observed in vivo. These mast cell clones can be grown in the absence of any other cells, facilitating direct investigations of their biochemistry and function. We find that cloned mast cells express plasma membrane receptors (Fc epsilon R) that bind mouse IgE with an equilibrium constant (KA) similar to that of normal mouse peritoneal mast cells. In addition, cloned mast cells do not display detectable la antigens and cannot enhance lg secretion when added to lymphocyte cultures or mediate natural killer lysis. In the presence of 1 mM sodium butyrate, cloned mast cells stop dividing and acquire abundant electron-dense cytoplasmic granules similar to those of mature mast cells. Their histamine content increases concomitant with cytoplasmic granule maturation and may exceed that of untreated mast cells by 50-fold. Unlike peritoneal mast cells, cloned mast cells incorporate 35SO4 into chondroitin sulfates rather than heparin. These findings demonstrate that, unlike fully differentiated mouse peritoneal mast cells, cloned immature mouse mast cells contain no heparin and low levels of histamine. In addition, they establish that high-affinity Fc epsilon R are expressed early in mast cell maturation, well before completion of cytoplasmic granule synthesis and mediator storage

Cloned mouse cells with natural killer function and cloned suppressor T cells express ultrastructural and biochemical features not shared by cloned inducer T cells.

We have examined the morphology, cytochemistry, and biochemistry of mouse leukocyte subsets by analyzing cloned leukocyte populations specialized to perform different immunologic functions. Cloned cells expressing high-affinity plasma membrane receptors for IgE and mediating natural killer (NK) lysis and cloned antigen-specific suppressor T cells contained prominent osmiophilic cytoplasmic granules similar by ultrastructure to those of mouse basophils. Both clones also incorporated 35SO4 into granule-associated sulfated glycosaminoglycans, expressed a characteristic ultrastructural pattern of nonspecific esterase activity, incorporated exogenous [3H]5-hydroxytryptamine, and contained cytoplasmic deposits of particulate glycogen. By contrast, cloned inducer T cells lacked cytoplasmic granules and glycogen, incorporated neither 35SO4 nor [3H]5-hydroxytryptamine, and differed from the other clones in pattern of nonspecific esterase activity. These findings establish that certain cloned cells with NK activity and cloned suppressor T cells express morphologic and biochemical characteristics heretofore associated with basophilic granulocytes. However, these clones differ in surface glycoprotein expression and immunologic function, and the full extent of the similarities and differences among these populations and basophils remains to be determined

Antinuclear antibodies (ANA) in chronic hepatitis C virus infection: correlates of positivity and clinical relevance.

We examined correlates of antinuclear antibody (ANA) positivity (ANA+) in individuals with chronic hepatitis C virus (HCV) infection and the effect of positivity on clinical outcome of HCV. Pretreatment sera from 645 patients from three centres in Sweden (n = 225), the UK (n = 207) and Italy (n = 213) were evaluated by indirect immunofluorescence on Hep-2 cells for ANA pattern and titre by a single laboratory. Liver biopsies were all scored by one pathologist. A total of 258 patients were subsequently treated with interferon monotherapy. There was a significant difference in the prevalence of ANA (1:40) by geographic location: Lund 4.4%, London 8.7%, Padova 10.3% [odds ratio (OR) = 0.66; 95% CI: 0.46-0.94; P = 0.023]. Duration of HCV infection, age at infection, current age, route of infection, viral genotype, alcohol consumption, fibrosis stage and inflammatory score were not correlated with ANA+ or ANA pattern. Female gender was correlated with ANA+ and this association persisted in multivariable analyses (OR = 3.0; P = 0.002). Increased plasma cells were observed in the liver biopsies of ANA-positive individuals compared with ANA-negative individuals, while a trend towards decreased lymphoid aggregates was observed [hazard ratio (HR) = 9.0, P = 0.037; HR = 0.291, P = 0.118, respectively]. No correlations were observed between ANA positivity and nonresponse to therapy (OR = 1.4; P = 0.513), although ANA+ was correlated with faster rates of liver fibrosis, this was not statistically significant (OR = 1.8; P = 0.1452). Low titre ANA+ should not be a contraindication for interferon treatment. Our observation of increased plasma cells in ANA+ biopsies might suggest B-cell polyclonal activity with a secondary clinical manifestation of increased serum immunoglobulins

On the virial coefficients of nonabelian anyons

We study a system of nonabelian anyons in the lowest Landau level of a strong magnetic field. Using diagrammatic techniques, we prove that the virial coefficients do not depend on the statistics parameter. This is true for all representations of all nonabelian groups for the statistics of the particles and relies solely on the fact that the effective statistical interaction is a traceless operator.Comment: 9 pages, 3 eps figure

Intensity-Modulated Radiation Therapy, Proton Therapy, or Conformal Radiation Therapy and Morbidity and Disease Control in Localized Prostate Cancer

There has been rapid adoption of newer radiation treatments such as intensitymodulated radiation therapy (IMRT) and proton therapy despite greater cost and limited demonstrated benefit compared with previous technologies