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Live attenuated virus might induce in the susceptible host an autoimmune response by deregulation of the immune response, by nonspecific activation of the T cells directed against myelin proteins, or by autoimmunity triggered by sequence similarities of proteins in the vaccine to host proteins such as those of myelin. The latter mechanism might evoke a response to a self-antigen, so-called molecular mimicry Fujinami and Oldstone, 1989 ; . IOM 1994 Report at 48. The special masters frequently rely on the IOM's conclusions as a sound source for answering the first and second prongs outlined above; the court considers their determinations authoritative and subject to great deference. See supra n. 5, at 3-4 and n. 92, at 53. For this discussion, the IOM uses "biologic plausibility" in assessing causality in a manner different than proposed here. But, some of the committees' language is useful for explaining what this court will be looking for in prong one. For instance, in its 1994 report, the IOM reported that biologic plausibility meant the following: The vaccine-adverse event association [is] plausible and coherent with current knowledge about the biology of the vaccine and the adverse event. Such information includes experience with the naturally occurring infection against which the vaccine is given, particularly if the vaccine is a live attenuated virus. Animal experiments and in vitro studies can also provide biologic plausibility, either by demonstrating adverse events in other animals that are similar to the ones in humans or by indicating pathophysiologic mechanisms by which the adverse event might be caused by receipt of the vaccine. IOM 1994 Report at 22; see also Christopher P. Howson et al., Institute of Medicine, Adverse Effects of Pertussis and Rubella Vaccines 4, 59 1991 ; hereinafter "IOM 1991 Report" ; reviewing biologic plausibility evidence that included "background knowledge concerning the pathophysiology of an adverse event, attributes of a particular vaccine, or other biologic information derived from research in such areas as immunology and physiology" ; . In the words of the IOM, what is important is that petitioner demonstrate "a possible causal association [which] fits existing biologic or medical knowledge." IOM 1991 Report at 54; see also supra IOM 1994 Report at 22. See, e.g., Rogers, 2000 WL 1337185, at * 14 stating that although the IOM's 1994 report does not find it probable "by the high confidence level required by laboratorian standards" that the 37 and inderal. Access to essential medicines. Affordability of essential medicines.

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TABLE 3: EVIDENCE RATING SCHEMES AND REFERENCES FMSD 2004 ; Levels of Evidence A: Strong research-based evidence. Multiple relevant, high-quality scientific studies with homogeneous results. B: Moderate research-based evidence. At least one relevant, highquality study or multiple adequate studies. C: Limited research-based evidence. At least one adequate scientific study. D: No research-based evidence. Expert panel evaluation of other information. References Antibiotics for sore throat. The Cochrane Database of systematic reviews. CD000023. In: Cochrane Library [database online]. Issue 2. Oxford: Update Software; 2002 Deeter RG, Kalman DL, Rogan MP, Chow SC. Therapy for pharyngitis 10 of 15 and itraconazole, for instance, drug information.

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A total of 32 patients with regular check-ups at the Department of Rheumatology at the Karolinska Hospital were included in the present investigation and they all fulfilled the diagnosis of and DM based on the Bohan and Peter classification.25, 26 As control samples we included muscle biopsies from 11 healthy individuals and from 10 patients with muscle dystrophies or neuropathies. Muscle biopsies were taken from vastus lateralis or tibialis anterior muscle under local anesthesia by a semiopen technique using a conchotome.27 In cases when a repeated muscle biopsy was conducted it was performed on the contralateral side. Muscle pathology was assessed by routine examination by a neuropathologist IN ; at the Division of Pathology, Huddinge Hospital. For immunohistochemical analyses and immunofluorescence studies the biopsies were frozen and stored at 70C until the staining procedure was performed. Biop.
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