Lung reduction surgery in chronic obstructive lung disease

In the 1960s the promise of the Brantigan lung reduction surgery was shattered when it was shown that the improvement in airway conductance drifted back towards the preoperative value over a period of 12 to 18 months. Since then there has been a marked improvement in our understanding of emphysema, its pathology, and techniques for obtaining images of the lung. In addition, reliable automated cardiopulmonary and physiologic testing, advances in critical care medicine, and new pharmacologic agents have improved patient care. Surgical techniques now allow better control of air leaks and access to anatomic regions not previously accessible. The combination of all of the above makes lung reduction surgery worth re-examining as a palliative procedure for severely symptomatic patients. Clearly, it is not a panacea but can in some cases produce dramatic improvements in symptomatology and quality of life. This article presents the available data describing potential mechanisms of improvement and clinical outcomes following lung reduction surgery. It also outlines areas that need further work, such as patient selection and surgical techniques.     

Analytical investigation of factors influencing power systemstabilizers performance

Results of simulations, designed to illustrate the influence of power system stabilizers (PSS) on inter-area and local oscillations in interconnected power systems, are reported. It is shown that the PSS location and the voltage characteristics of the system loads are significant factors in the ability of a PSS to increase the damping of interarea oscillations. It is also shown that an interaction between modes in two distinct parts of a power system is possible, due to resonance, and that this might cause distortions in mode shape and participation factors     

Design of electrically small ground planes for HF ground wave transmission

Electrically small spiral ground planes for a monopole and an electrically small antenna have been designed for HF ground wave transmission. Prototype ground planes have been built and tested. For the monopole, the transmission loss of the designed ground plane is 6 dB better than that of the same size ground radials. For the electrically small antenna, the transmission loss of the designed ground plane is 7 dB better than that of the same size solid ground plane at the antenna's operating frequency.     

Epidemiologic and demographic aspects of peritoneal dialysis in Mexico

The rationale for anti-tumour necrosis factor-alpha (anti-TNFalpha) therapy in rheumatoid arthritis (RA) is based on experiments on cultures of human rheumatoidjoint tissue, supported by experiments in animal models, all of which demonstrated that anti-TNFalpha antibody had profound effects on the disease activity. Clinical trials have substantiated this concept, and we have used the serum samples from the clinical trials, as well as biopsies to study the changes occurring during anti-TNFalpha therapy as clues to the pathogenesis of RA. The major effects of anti-TNFalpha therapy are in downregulating cytokine activity, and in reducing leucocyte trafficking to the joints.     

Physiological regulation of early and late stages of megakaryocytopoiesis by thrombopoietin

Thrombopoietin (TPO) has recently been cloned and shown to regulate megakaryocyte and platelet production by activating the cytokine receptor c-mpl. To determine whether TPO is the only ligand for c-mpl and the major regulator of megakaryocytopoiesis, TPO deficient mice were generated by gene targeting. TPO-/- mice have a >80% decrease in their platelets and megakaryocytes but have normal levels of all the other hematopoietic cell types. A gene dosage effect observed in heterozygous mice suggests that the TPO gene is constitutively expressed and that the circulating TPO level is directly regulated by the platelet mass. Bone marrow from TPO-/- mice have decreased numbers of megakaryocyte-committed progenitors as well as lower ploidy in the megakaryocytes that are present. These results demonstrate that TPO alone is the major physiological regulator of both proliferation and differentiation of hematopoietic progenitor cells into mature megakaryocytes but that TPO is not critical to the final step of platelet production.     

Nature-nurture in the classroom: entrance age, school readiness, and learning in children

The impact of entrance age on reading and mathematics achievement in 1st grade was examined. Methodological problems with past research were identified, including small size of achievement differences, failure to take background variables into account, and confusion of achievement levels with degree of learning. Using a pre-post design, growth of reading and mathematics was examined in younger 1st graders, older 1st graders, and older kindergarteners. Comparisons of background information on these groups with children who were either held out prior to or retained an extra year in kindergarten, produced minimal background differences. Results revealed that younger 1st graders made as much progress over the school year as did older 1st graders and made far more progress than older kindergarteners. Overall, findings demonstrated that, in itself, entrance age was not a good predictor of learning or academic risk.