Long-term follow-up with Granulocyte and Monocyte Apheresis re-treatment in patients with chronically active inflammatory bowel disease

<p>Abstract</p> <p>Background</p> <p>Patients with IBD and chronic inflammation refractory to conventional therapy often demonstrate higher risk of serious complications. Combinations of immunosuppression and biological treatment as well as surgical intervention are often used in this patient group. Hence, there is need for additional treatment options. In this observational study, focused on re-treatment and long-term results, Granulocyte/Monocyte Adsorption (GMA, Adacolumn^®) treatment has been investigated to study efficacy, safety and quality of life in IBD-patients with chronic activity.</p> <p>Methods</p> <p>Fifteen patients with ulcerative colitis and 25 patients with Crohn's disease, both groups with chronically active inflammation refractory to conventional medication were included in this observational study. The patients received 5-10 GMA sessions, and the clinical activity was assessed at baseline, after each completed course, and at week 10 and 20 by disease activity index, endoscopy and quality of life evaluation. Relapsed patients were re-treated by GMA in this follow-up study up to 58 months.</p> <p>Results</p> <p>Clinical response was seen in 85% and complete remission in 65% of the patients. Ten patients in the UC-group (66%) and 16 patients in the CD-group (64%) maintained clinical and endoscopic remission for an average of 14 months. Fourteen patients who relapsed after showing initial remission were re-treated with GMA and 13 (93%) went into a second remission. Following further relapses, all of seven patients were successfully re-treated for the third time, all of three patients for the fourth time and one for a fifth time.</p> <p>Conclusions</p> <p>IBD-patients with chronic inflammation despite conventional therapy seem to benefit from GMA. Re-treatment of relapsing remission patients seems to be effective.</p

Taclets: a new paradigm for writing theorem provers

Frameworks for interactive theorem proving give the user explicit control over the construction of proofs based on meta languages that contain dedicated control structures for describing proof construction. Such languages are not easy to master and thus contribute to the already long list of skills required by prospective users of interactive theorem provers. Most users, however, only need a convenient formalism that allows to introduce new rules with minimal overhead. On the the other hand, rules of calculi have not only purely logical content, but contain restrictions on the expected context of rule applications and heuristic information. We suggest a new and minimalist concept for implementing interactive theorem provers called taclet. Their usage can be mastered in a matter of hours, and they are efficiently compiled into the GUI of a prover. We implemented the KeY system, an interactive theorem prover for the full JavaCard language based on taclets

The KEY Approach: Integrating Object Oriented Design and Formal Verification

This paper reports on the ongoing KeY project aimed at bridging the gap between (a) object-oriented software engineering methods and tools and (b) deductive verification. A distinctive feature of our approach is the use of a commercial CASE tool enhanced with functionality for formal specifiation and deductive verification

The KeY system: Integrating object-oriented design and formal methods

Abstract. This paper gives a brief description of the KeY system, a tool written as part of the ongoing KeY project 1, which is aimed at bridging the gap between (a) OO software engineering methods and tools and (b) deductive verification. The KeY system consists of a commercial CASE tool enhanced with functionality for formal specification and deductive verification.