Hyperferritinemia and hypergammaglobulinemia predict the treatment response to standard therapy in autoimmune hepatitis.

Autoimmune hepatitis (AIH) is a chronic hepatitis with an increasing incidence. The majority of patients require life-long immunosuppression and incomplete treatment response is associated with a disease progression. An abnormal iron homeostasis or hyperferritinemia is associated with worse outcome in other chronic liver diseases and after liver transplantation. We assessed the capacity of baseline parameters including the iron status to predict the treatment response upon standard therapy in 109 patients with untreated AIH type 1 (AIH-1) in a retrospective single center study. Thereby, a hyperferritinemia (> 2.09 times upper limit of normal; Odds ratio (OR) = 8.82; 95% confidence interval (CI): 2.25-34.52) and lower immunoglobulins (<1.89 times upper limit of normal; OR = 6.78; CI: 1.87-24.59) at baseline were independently associated with the achievement of complete biochemical remission upon standard therapy. The predictive value increased when both variables were combined to a single treatment response score, when the cohort was randomly split into a training (area under the curve (AUC) = 0.749; CI 0.635-0.863) and internal validation cohort (AUC = 0.741; CI 0.558-0.924). Patients with a low treatment response score (<1) had significantly higher cumulative remission rates in the training (p<0.001) and the validation cohort (p = 0.024). The baseline hyperferritinemia was accompanied by a high serum iron, elevated transferrin saturations and mild hepatic iron depositions in the majority of patients. However, the abnormal iron status was quickly reversible under therapy. Mechanistically, the iron parameters were not stringently related to a hepatocellular damage. Ferritin rather seems deregulated from the master regulator hepcidin, which was down regulated, potentially mediated by the elevated hepatocyte growth factor. In conclusion, baseline levels of serum ferritin and immunoglobulins, which are part of the diagnostic work-up of AIH, can be used to predict the treatment response upon standard therapy in AIH-1, although confirmation from larger multicenter studies is pending

Ultrasound attenuation in gap-anisotropic systems

Transverse ultrasound attenuation provides a weakly-coupled probe of momentum current correlations in electronic systems. We develop a simple theory for the interpretation of transverse ultrasound attenuation coefficients in systems with nodal gap anisotropy. Applying this theory we show how ultrasound can delineate between extended-s and d-wave scenarios for the cuprate superconductors.Comment: Uuencode file: 4 pages (Revtex), 3 figures. Some references adde

Magnetic correlations and quantum criticality in the insulating antiferromagnetic, insulating spin liquid, renormalized Fermi liquid, and metallic antiferromagnetic phases of the Mott system V_2O_3

Magnetic correlations in all four phases of pure and doped vanadium sesquioxide V_2O_3 have been examined by magnetic thermal neutron scattering. While the antiferromagnetic insulator can be accounted for by a Heisenberg localized spin model, the long range order in the antiferromagnetic metal is an incommensurate spin-density-wave, resulting from a Fermi surface nesting instability. Spin dynamics in the strongly correlated metal are dominated by spin fluctuations in the Stoner electron-hole continuum. Furthermore, our results in metallic V_2O_3 represent an unprecedentedly complete characterization of the spin fluctuations near a metallic quantum critical point, and provide quantitative support for the SCR theory for itinerant antiferromagnets in the small moment limit. Dynamic magnetic correlations for energy smaller than k_BT in the paramagnetic insulator carry substantial magnetic spectral weight. However, the correlation length extends only to the nearest neighbor distance. The phase transition to the antiferromagnetic insulator introduces a sudden switching of magnetic correlations to a different spatial periodicity which indicates a sudden change in the underlying spin Hamiltonian. To describe this phase transition and also the unusual short range order in the paramagnetic state, it seems necessary to take into account the orbital degrees of freedom associated with the degenerate d-orbitals at the Fermi level in V_2O_3.Comment: Postscript file, 24 pages, 26 figures, 2 tables, accepted by Phys. Rev.

Helical spin-density wave in doped V2O3

Recent neutron scattering and nuclear magnetic resonance experiments have revealed that the low temperature phase of doped V_{2-y}O_3 is an itinerant antiferromagnet with a helical spin structure. We use a band structure calculation as the point of departure to show that these experiments are in agreement with mean field results for an Overhauser spin-density wave state. The influences of a finite life-time and of dilute magnetic impurities are discussed.Comment: 6 pages RevTex incl. 7 postscript figures, to be published by PR

Regularity of a kind of marginal functions in Hilbert spaces

We study well-posedness of some mathematical programming problem depending on a parameter that generalizes in a certain sense the metric projection onto a closed nonconvex set. We are interested in regularity of the set of minimizers as well as of the value function, which can be seen, on one hand, as the viscosity solution to a Hamilton-Jacobi equation, while, on the other, as the minimal time in some related optimal time control problem. The regularity includes both the Fréchet differentiability of the value function and the Hölder continuity of its (Fréchet) gradient