A distinction between dogmatic and rigid thinking.

"The purpose of this study was to investigate certain cognitive aspects of the phenomenon of dogmatism, to distinguish such aspects from rigidity, and to demonstrate the operation of personality organization upon cognitive behavior." The findings are in accord with the hypotheses posed and lend support to the validity of the formulation of the construct of dogmatism and its differentiation from rigidity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Volume recruitment and oxygenation in pulmonary edema: a comparison between HFOV and CMV

Although the transplanted human liver is susceptible to rejection with a similar incidence of rejection as seen with renal allografts, the liver enjoys many immunological benefits relative to other transplanted organs. These include relative resistance to antibody-mediated injury, low frequency of chronic rejection, relatively easy reversibility of acute rejection, and even reversibility of chronic rejection. The reasons for the liver's favored status from an immunological perspective are unclear but are perhaps multifactorial. Currently used clinical protocols of immunosuppression for liver transplantation rely principally on the calcineurin inhibitors, cyclosporine and FK-506. Steroid withdrawal at variable periods after liver transplantation is becoming increasingly common. Compared with other organ transplants, relatively few human liver transplants are lost because of rejection. The transplanted liver may be an appropriate target for tolerance studies.     

The correlation of the radiologic extent of lung transplantation edema with pulmonary oxygenation

OBJECTIVE: The study set out to evaluate the relationship between the efficiency of pulmonary oxygenation and the extent of the reimplantation response as revealed on chest radiography after bilateral lung transplantation. MATERIALS AND METHODS: Postoperative chest radiographs of 31 patients who had undergone bilateral lung transplantation were evaluated for the extent of the reimplantation response. For each patient, the contemporaneous oxygenation indexes (partial pressure of oxygen in arterial blood divided by fraction of inspired oxygen) were calculated and correlated with a radiographic score produced from the evaluation of chest radiographs. RESULTS: The method of evaluating chest radiographs for the extent of the reimplantation response was shown to be reproducible. Although mean oxygenation indexes were found to decrease with increasing radiographic scores, this trend was not statistically significant. CONCLUSION: Although the extent of the reimplantation response on the early postoperative chest radiography inversely correlated with the oxygenation efficiency of the transplanted lungs, this finding was not statistically significant.     

PEEP and low tidal volume ventilation reduce lung water in porcine pulmonary edema

Gonococci producing a distinct opacity protein (OpaA in strain MS11) adhere to and are efficiently internalized by cultured epithelial cells such as the Chang conjunctiva cell line. Both adherence and uptake require interactions between OpaA and heparan sulfate proteoglycans on the mammalian cell surface. Chinese hamster ovary (CHO) cells also support adherence of gonococci through interactions of OpaA with cell surface heparan sulfate proteoglycans. However, despite this similarity in the requirements for adherence, CHO cells are not capable of internalizing gonococci. In this report, we characterized this apparent deficiency and identified a factor in fetal calf serum (FCS) which is capable of mediating uptake of gonococci by CHO cells. In the absence of FCS, OpaA+ gonococci adhered to but were not internalized by CHO cells, whereas in the presence of up to 15% FCS, the bacteria were efficiently internalized by the cells. Preincubation of bacteria, but not cells, with FCS also stimulated internalization, suggesting that a factor present in FCS was binding to the surface of gonococci and subsequently stimulating entry. Using a combination of chromatographic purification procedures, we identified the adhesive glycoprotein vitronectin as the serum factor which mediates the internalization of gonococci by CHO cells. Vitronectin-depleted serum did not support gonococcal entry, and this deficiency was restored by the addition of purified vitronectin. Further experiments using a set of gonococcal recombinants, each expressing a single member of the family of Opa outer membrane proteins, demonstrated that vitronectin bound to the surface of OpaA-producing gonococci only and that the vitronectin-mediated uptake by the CHO cells was limited to this bacterial phenotype. To our knowledge, our data are the first example that vitronectin can serve as a molecule that drives bacterial entry into epithelial cells.     

Effect of eicosanoid inhibition on the development of pulmonary edema after acute lung injury

In experimental models of acute lung injury, cyclooxygenase inhibition improves oxygenation, presumably by causing a redistribution of blood flow away from edematous lung regions. This effect on perfusion pattern could also reduce alveolar edema formation. On the other hand, pulmonary pressures usually increase after cyclooxygenase inhibition, an effect that could exacerbate edema accumulation. Therefore we tested the following hypothesis: the total accumulation of pulmonary edema in dogs during a 24- to 28-h period of observation after acute lung injury caused by oleic acid will be less in a group of animals treated with meclofenamate (n = 6) or with the thromboxane-receptor blocker ONO-3708 (n = 5) than in a group of animals treated with oleic acid alone (placebo, n = 6). Lung water concentrations (LWC), the regional pattern of pulmonary perfusion, and protein permeability were measured with the nuclear medicine imaging technique of positron emission tomography. After 24-28 h, LWC was significantly less (P < 0.05) in the ONO-3708 group than in the meclofenamate group (a similar trend was seen compared with the placebo group, P = 0.12). After 24-28 h, pulmonary arterial pressures were highest in the meclofenamate group. Regardless of group, the only significant correlation with the change in LWC was with the integral of pulmonary pressures over the 24- to 28-h period. The data suggest that thromboxane inhibition will reduce edema accumulation in acute lung injury but that this effect depends on reducing as much as possible the simultaneous development of pulmonary hypertension from other causes.     

Relationship between haemodynamics and morphology in pulmonary hypertension. A quantitative intravascular ultrasound study

BACKGROUND: Intravascular ultrasound imaging of the pulmonary arteries has been demonstrated to be a reliable method of quantifying vessel diameter, luminal area and pulsatility. Simultaneous measurement of flow velocity and its response to vasodilators allows the relationship between morphology and functional compromise to be studied, especially endothelial dysfunction. METHODS: In 51 patients (mean age = 49.8 +/- 12.6 years, 17 female) we performed right heart catheterization and simultaneous intravascular ultrasound of pulmonary artery branches. The patients were divided in two groups: group 1 with normal pulmonary artery pressure and pulmonary vascular resistance, and group 2 with pulmonary hypertension (peak pulmonary artery pressure > 30 mmHg and/or mean pulmonary artery pressure > 20 mmHg). Vessel wall and lumen were studied using a 2.9 F intravascular ultrasound catheter with a 30 MHz phased array transducer. Measurement of blood flow velocity was accomplished by a Doppler flow wire (0.018 inch). The maximal flow change during acetylcholine infusion (adjusted to 10(-6); 10(-5), and 10(-4) M concentration in the blood vessel) was measured. RESULTS: There were no significant differences between groups 1 and 2 with respect to age (48.5 +/- 14.3 years vs 50.3 +/- 12.3 years; P = ns), gender (4 female/8 male vs 13 female/26 male; P = ns), luminal area of the vessel segment in which the intravascular ultrasound measurements were obtained (11.8 +/- 6.1 mm2 vs 16.7 +/- 14.3 mm2; P = ns), internal diameter (3.9 +/- 1.2 mm vs 4.2 +/- 1.7 mm; P = ns), and external diameter (6.1 +/- 1.3 mm vs 6.9 +/- 2.1 mm; P = ns). Cross-sectional images of the pulmonary artery wall demonstrated a single ring with high echodensity with a thin inner layer regarded as intima in group 1. In contrast, the majority of patients (n = 35/39) in group 2 demonstrated a thickening of the intimal layer and/or a disturbance of layering of the echogenic arterial wall. The relative wall thickness was higher in group 2 than in group 1 (22.5 +/- 10.4% vs 15.3 +/- 6.5%; P < 0.05). There were no significant correlations between pulmonary artery pressure and wall thickness pulmonary artery pressure and area change in the cardiac cycle, acetylcholine-dependent increase in pulmonary flow and morphological changes in the vessel wall. CONCLUSION: We conclude that intravascular ultrasound is capable of detecting morphological changes in the pulmonary vessel wall in pulmonary hypertension and that vessel wall hypertrophy of small pulmonary segment arteries, as detected by intravascular ultrasound, is not predictive of functional vasodilatory response of resistance vessels of the same vessel area.     

On the distinction between artifacts and information.

G. Sperling et al. (see record 1990-06589-001) argued that all previous research on the kinetic depth effect has been contaminated by stimulus artifacts, and they developed a new task that they believe can successfully overcome this problem. The present discussion offers a counter-argument that artifacts are not as pervasive in previous research as Sperling et al. imply and that their proposed method is subject to precisely the same limitations as earlier studies. Also discussed are some general guidelines of experimental design in this type of research to minimize the possibility that subjects will adopt an inappropriate response strategy that does not truly reflect their visual perceptions of three-dimensional form. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cardiopulmonary baroreflexes: effects of pulmonary congestion and edema

Systemic vasodepressor reflexes were initiated in pump-oxygenator perfused dogs by separately pressurizing the pulmonary vessels and the left cardiac chambers. Pulmonary vascular pressurization caused transient systemic vasodilation of a magnitude proportional to stimulus pressure over the range 0-65 cmH2O. The sensitivity of this reflex was sigificantly less than that of the left heart baroreflex. Mild pulmonary edema produced by a period of sustained congestion, and moderate edema, caused by sustained congestion in the presence of alloxan, had no discernible effect on systemic vasomotor tone or on subsequent pulmonary vascular baroreflexes. By comparison of these results with earlier studies in similar preparations I concluded that pulmonary arterial baroreflexes could alone produce the response obtained by pressurizing the entire pulmonary vascular bed. Although it was anticipated that type-J, irritant, and stretch receptors would be affected by congestion, no systemic vascular effects attributable to them were seen.     

A comparison between an outpatient hospital-based pulmonary rehabilitation program and a home-care pulmonary rehabilitation program in patients with COPD. A follow-up of 18 months

AIM: In this study, the effects of a 12-week hospital-based outpatient pulmonary rehabilitation program (HRP) are compared with those of a 12-week home-care rehabilitation program (HCRP) in COPD patients. A control group received no rehabilitation therapy. METHODS: After randomization and stratification, effects on lung function, exercise performance (4-min walking test and cycle ergometer test), dyspnea, and leg effort during exercise, and well-being were assessed in 45 COPD patients with moderate to severe airflow limitation (mean [SD] FEV1 percent predicted, 42.8 [8.4]). RESULTS: After HRP and HCRP, at 3 to 6 months after the start of the study, equal improvements were detected in exercise capacity and in Borg dyspnea and leg effort scores at similar work levels during the cycle test. However, whereas after HRP at longer term values tended to return to baseline outcome, after HCRP a further ongoing significant improvement in exercise capacity was observed, while Borg dyspnea scores remained significantly improved over 18 months. Improvements in cycle workload and dyspnea score were significantly better maintained after HCRP as compared with HRP. Lung function, arterial oxygen saturation, and heart frequency during exercise did not change. A significant improvement in well-being was maintained over 18 months in both rehabilitation groups. CONCLUSION: Beneficial effects are achieved both after a HRP and a HCRP in COPD patients with moderate to severe airflow limitation. Yet we recommend to initiate HCRPs as improvements are maintained longer and are even further strengthened in this setting.     

On the arbitrary distinction between states and traits.

Posits that the distinction between state and trait is an arbitrary one and presents a delineation and analysis of factors that have contributed to the propagation of the distinction. Observational, philosophical, and empirical sources of evidence are cited. Three beliefs are examined: (a) that a label can refer to both a state and a trait; (b) that whether an instrument measures state or trait depends on the accompanying instructions; and (c) that state and trait are so inextricably tied that a measure of state is used to derive an index of trait. Overlap among terms used in the Profile of Mood States, the Multiple Affect Adjective Check List, the Adjective Check List, Cattell's (1943) list of personality labels, and the Allport-Odbert (1936) categories is presented. Empirical illustrations are cited in support of the contention that the state–trait distinction can be used to explain almost any personality research finding post hoc. (61 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A new view of pulmonary edema and acute respiratory distress syndrome

The old division of lung edema into two categories--cardiogenic (hydrostatic) and noncardiogenic (increased permeability)--is no longer adequate. For instance, it fails to distinguish between the capillary leak caused by acute respiratory distress syndrome from that caused by interleukin-2 treatment. Further, it fails to account for the capillary leak ('stress-failure') that may accompany edema. A modern view of edema must recognize the natural barriers to the formation and spread of edema. These barriers are the capillary endothelium and the alveolar epithelium. Varying degrees of damage to them can account for the varying radiographic and clinical manifestations of lung edema. Thus, interleukin-2 administration causes increased endothelial permeability without causing alveolar epithelial damage. The result is lung edema that is largely confined to the interstitium, causing little hypoxia and clearing rapidly. However, acute respiratory distress syndrome, which is characterized by extensive alveolar damage, causes air-space consolidation, severe hypoxia, and slow resolution. Thus, a reasonable classification of lung edema requires at least four categories: 1) hydrostatic edema; 2) acute respiratory distress syndrome (permeability edema caused by diffuse alveolar damage); 3) permeability edema without alveolar damage; and (4) mixed hydrostatic and permeability edema. The authors emphasize the importance of the barriers provided by the capillary endothelium and the alveolar epithelium in determining the clinical and radiographic manifestations of edema. In general, when the alveolar epithelium is intact, the radiographic manifestations are those of interstitial (not air-space) edema; this radiographic pattern predicts a mild clinical course and prompt resolution.     

Husserl revisited: The forgotten distinction between psychology and phenomenology.

Argues that as phenomenology attracts growing attention in current psychology, it is increasingly important for psychologists to understand that phenomenology encompasses much more than a mere appreciation for subjective self-report data. The ideas of E. Husserl, the so-called founder of phenomenology, are reexamined to enlighten psychologists about phenomenology's contrasting approach to the study of consciousness. Whereas psychology studies actual subjective responses to actual environmental events (empirical data), phenomenology studies the essential character of consciousness in meaning-conferring acts (essential knowledge). Husserl proposed phenomenology as a positive alternative to the experimental methods of the new scientific psychology. Husserl believed phenomenology was needed to clarify the essential, but unanalyzed, pre-understandings of mental phenomena that guide psychology's experimental investigations. (36 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

More on the distinction between episodic and semantic memories.

Responds to E. Tulving's (see record 1986-19162-001) reply to the critique of the present authors and a colleague (see record 1986-19143-001) regarding episodic/semantic distinction of memory by asserting that the classification methods proposed by Tulving may be detrimental to the advancement of theory and that whole domains of inquiry should not be excluded from the usual criteria of experimental psychology. (18 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Noninvasive differential diagnosis between chronic pulmonary thromboembolism and primary pulmonary hypertension by means of Doppler ultrasound measurement

We examined the development of tolerance to the antiallodynic effect of chronic intrathecal (IT) administration of the adenosine analog R-phenylisopropyladenosine (R-PIA) in a rat model of central pain after ischemic spinal cord injury. After 10 days of IT R-PIA treatment, the effect of IT morphine was also assessed to examine whether cross-tolerance between R-PIA and morphine was present. IT R-PIA completely alleviated allodynia-like behaviors to mechanical and cold stimuli in spinally injured rats. The anti-allodynic effect of R-PIA was maintained for 6-7 days with twice-daily administration and was reduced thereafter, particularly with respect to cold allodynia. IT morphine alleviated mechanical and cold allodynia in rats rendered tolerant to R-PIA to a degree comparable to that in R-PIA-naive (control) rats, which indicates that the anti-allodynic property of R-PIA is independent of the mechanisms by which morphine acts. The possibility of using agonists of adenosine receptors in treating refractory pain in patients with spinal cord injury is discussed. IMPLICATIONS: There is often no satisfactory treatment for chronic pain after spinal cord injury. Our study suggests such pain can be treated with a spinal injection of R-phenylisopropyladenosine in rats. Reduced effect to R-phenylisopropyladenosine was noted with repeated administrations. However, there was no cross-tolerance to morphine.     

"Ventricularization" of the pulmonary artery pressure curve: a hemodynamic sign of proximal pulmonary embolism

OBJECTIVE: To determine the relative expression of cyclo-oxygenase (COX)-1 and COX-2 in the chorion-decidual part of human fetal membranes following delivery at term and to identify any changes in expression associated with labour. METHODS: Fetal membranes were collected from 12 term pregnancies before labour following elective caesarean section and from 12 spontaneous vaginal deliveries. Expression of COX-1 and COX-2 mRNA was measured using a previously validated quantitative RT-PCR assay. RESULTS: COX-2 expression exceeded that of COX-1 by approximately eight-fold. COX-1 expression did not change but COX-2 expression was found to increase four-fold with labour. CONCLUSIONS: Chorion-decidua has the capacity to contribute to the increase in prostaglandin synthesis within the uterus associated with labour. As in the amnion, it is COX-2 and not COX-1 which is upregulated with labour. COX-2 selective anti-prostaglandins should therefore be as effective as nonselective drugs in inhibition of fetal membrane prostaglandin synthesis.     

The elusive relationship between perceived employment opportunity and turnover behavior: A methodological or conceptual artifact?

Recent conceptual work focused attention on the gap between psychological turnover theory and the empirical literature regarding the prominence of perceived employment alternatives in shaping turnover decisions (e.g., C. L. Hulin et al; see record 1985-21605-001). Meta-analysis confirmed that measures of perceived alternatives and turnover are weakly related (Mr?=?.13). The current review supplements earlier work by focusing on 3 methodological problems that may contribute to the lack of support for the predictive utility of perceived alternatives in the contemporary literature: (1) interoccupational vs intraoccupational variance or the dependence of turnover researchers on occupationally homogeneous samples, (2) attenuating effects of the turnover base rate, and (3) inadequate instrumentation. Potential solutions to these problems are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A case of acute pulmonary edema and bulbar paralysis after local epinephrine infiltration

A cataract developed in a 23-year-old man 4 months after a vitrectomy to repair a traumatic retinal detachment. An uneventful phacoemulsification was performed, using antibiotic-fortified infusion solution. Afterward, a large area of atrophic retina, consistent with gentamicin toxicity, was observed in the macula. The patient remains stable with 20/200 best-corrected acuity. The authors suggest that because the vitreous had been removed, gentamicin was able to settle over the macula during the entire cataract procedure. Therefore, gentamicin should be used intracamerally with caution, especially in eyes in which vitrectomy has been performed.     

Postpneumonectomy pulmonary edema. A retrospective analysis of incidence and possible risk factors

OBJECTIVE: To analyze the incidence of postpneumonectomy pulmonary edema (PPE) and to determine potential risk factors for PPE. MATERIAL AND METHODS: A group of 197 patients was studied retrospectively, and the incidence of PPE was recorded over a 5-year period. Preoperative, perioperative, and postoperative clinical data were collected, and preoperative and postoperative chest radiographs were reviewed. A scoring system was used to distinguish between premanifest and manifest PPE. Postpneumonectomy patients with pulmonary edema, with no clinically evident cause, were considered to have PPE. RESULTS: The incidence of premanifest PPE was 12.2% (n = 24), and that of manifest PPE was 2.5% (n = 5). Mortality in the group of patients who developed manifest PPE was 100%. Two significant perioperative associations were found in the PPE group. One was the administration of fresh frozen plasma (FFP) transfusions (relative risk, 4.3; 95% confidence interval, 1.3 to 14.4 corrected for age and sex), while the other was higher mechanical ventilation pressures during surgery (relative risk, 3.0; 95% confidence interval, 1.2 to 7.3). CONCLUSION: Our data suggest that FFP transfusions form an important risk factor for PPE. The mechanism may be an increased permeability of the pulmonary vessels due to an immunologic reaction after multiple FFP transfusions. The significantly higher mechanical ventilation pressures we found in the PPE group may be explained as an early sign of the development of PPE.     

On the distinction between clinical process and clinical content theories.

Draws a distinction between clinical process theory, which refers to the method of investigation, and clinical content theory, which refers to the findings of an investigation. It is suggested that psychoanalysts attend to the process and attempt to specify and microanalyze it in its naturalistic context. The problem of clinical evidence is perhaps the most neglected topic in psychoanalytic therapy. The significance of broad-based mental models of human experience in understanding the therapeutic process is discussed. It is suggested that psychoanalytic therapy should be viewed as an early craft that is not yet a science. (PsycINFO Database Record (c) 2010 APA, all rights reserved)