Small bowel transplantation: current progress and clinical application

Total parenteral nutrition (TPN) is used routinely to maintain patients with the Short Bowel Syndrome (SBS). Until recently, TPN has been the only available therapeutic modality for patients with SBS. Currently, it is the treatment of choice for such individuals and occasionally, when the loss of bowel is extensive, it may be the only way of maintaining life. Unfortunately, TPN is expensive and markedly restrains an individual's lifestyle. Despite the overall success of TPN, the numerous risks associated with its use and the many complications of having an intravenous indwelling for years have served as the stimulus for alternative treatments such as small bowel transplantation (SBT). The first attempts at small bowel transplantation in clinical medicine were by Detterling almost 25 years ago. Patient death or graft loss in these early attempts was caused by the failure to control graft rejection and/or the inability to prevent Graft Versus Host Disease (GVHD). A stimulus for renewed clinical interest in SBT was provided by Starzl et al in 1988 with a report of prolonged graft survival without graft rejection or GVHD in a patient who was the recipient of a multivisceral graft consisting of the entire small bowel and other abdominal organs. Since 1964, 78 Small Bowel transplants have been performed in humans. Several variations of the multivisceral procedure in which the liver and the small bowel constitute the major components of the graft were adopted. The longest survival has been in a child who is still alive with a working graft for more than two years, as reported by Goulet from Paris in 1989. The introduction in SBT of the new immunosuppressive agent FK 506 had provided results which are superior to those achieved with Cyclosporine A (CsA). This latter observation prompted the Pittsburgh group to initiate a large series of isolated and composite intestinal grafts. The remarkable results have demonstrated the clinical utility of intestinal transplantation. This paper will try to summarize the history of the small bowel transplantation until the end of the year 1992, with the current progress in use today.     

Is Relevance Relevant? Market,Science, and War: Discourses of Search Engine Quality

In the face of rising controversy about search engine results—that they are too restrictive, too comprehensive, lacking in certain areas, over-represented in others—this article presents the results of in-depth interviews with search engine producers, examining their conceptions of search engine quality and the implications of those conceptions. Structuration theory suggests that the cultural schemas that frame these discourses of quality will be central in mobilizing resources for technological development. The evidence presented here suggests that resources in search engine development are overwhelmingly allocated on the basis of market factors or scientific/technological concerns. Fairness and representativeness, core elements of the journalists' definition of quality media content, are not key determiners of search engine quality in the minds of search engine producers. Rather, alternative standards of quality, such as customer satisfaction and relevance, mean that tactics to silence or promote certain websites or site owners (such as blacklisting, whitelisting, and index "cleaning") are seen as unproblematic.     

From dust till drawn

We present a system for drawing pastel media in real-time as an effective alternative to most existing digital solutions that basically allow for drawing arbitrary strokes in a particular style. Our approach is focused on the simulation of the natural material itself and on its interaction with the drawing surface and the drawing tool. Upon free-form drawing, a bidirectional transfer of pigment takes place. In one direction, the paper surface is dusted with new pigment particles broken off the tip (i.e., the end of the drawing tool). A large part of these particles will be deposited or blended together with previously deposited ones whereas the remainder does not contribute to the drawing and is blown off. On the other hand, a certain amount of previously deposited pigment is scraped off and picked up again soiling the tip. This is noticeable in the next strokes to be drawn. Furthermore, both the tip and the paper surface are subject to weathering depending on the exerted pressure and friction of the drawing tool, and the bumpiness of the paper. As a result, the paper surface becomes slightly damaged, limiting the deposition of new pigment. The tip, on the other hand, becomes blunt making new strokes wider. From a stylistic point of view, similarly to traditional drawings our results convey the artists’ characteristics (e.g., the way of wielding the brush, skillfulness, feeling for the medium). Therefore, we believe that our system allows an artist to create realistically looking pastel images without losing his/her personal touch.     

Six Synthesis Methods for Reversible Logic

The (2 ^w )! reversible transformations on w wires, i.e. reversible logic circuits with w inputs and w outputs, together with the action of cascading, form a group, isomorphic to the symmetric group S ₂ ^w . Therefore, we investigate the group S _n as well as one of its subgroups isomorphic to S _n/2 × S _n/2. We then consider the left cosets, the right cosets, and the double cosets generated by the subgroup. Each element of a coset can function as the representative of the coset. The coset can then be considered as the set of all group elements that differ from the representative by merely multiplying (either to the left or to the right or to both sides) by an arbitrary element of the subgroup. Different choices of the coset space and different choices of the coset representatives lead to six different syntheses for implementing an arbitrary reversible logic operation into hardware. Evaluation of all six methods, by means of three different cost functions (gate cost, switch cost, and quantum cost), leads to a best choice.     

Impact of Preferential P-Diffusion Along the Grain Boundaries on Fine-Grained Polysilicon Solar Cells

Thin-film polysilicon solar cells are a promising low-cost alternative for bulk silicon solar cells due to their reduced material thickness. Recently, we showed that the use of an amorphous silicon/polycrystalline silicon heterojunction emitter instead of a diffused homojunction emitter led to a boost in the open-circuit voltage by 90 mV. Now, we present a full evidence that shows that this improvement is related to the absence of dopant smearing along the grain boundaries. By using scanning spreading resistance microscopy, we found an enlargement of the junction area by a factor of five in case of a homojunction. The tips of the dopant spikes represent lowly doped areas with an enhanced recombination.     

Interference effects from grammatically unavailable constituents during sentence processing.

Evidence from 3 experiments reveals interference effects from structural relationships that are inconsistent with any grammatical parse of the perceived input. Processing disruption was observed when items occurring between a head and a dependent overlapped with either (or both) syntactic or semantic features of the dependent. Effects of syntactic interference occur in the earliest online measures in the region where the retrieval of a long-distance dependent occurs. Semantic interference effects occur in later online measures at the end of the sentence. Both effects endure in offline comprehension measures, suggesting that interfering items participate in incorrect interpretations that resist reanalysis. The data are discussed in terms of a cue-based retrieval account of parsing, which reconciles the fact that the parser must violate the grammar in order for these interference effects to occur. Broader implications of this research indicate a need for a precise specification of the interface between the parsing mechanism and the memory system that supports language comprehension. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Extension Factors for Trimester Yields of Milk and Fat

Evidence of problems with sire proofs of extended incomplete records suggests the desirability of another method of evaluating dairy bulls for milk that minimizes the need for extending records by instead considering yields of three parts of a lactation (days 1 to 90, 91 to 180, and 181 to 270) as distinct and separate traits. Records of less than 90 days (or 180 or 270 days) require extension to 90-day (or 180- or 270-day) equivalents. Last sample day production of 17,826, 15,282, and 12,115 first-lactation records of Holstein cows was used to calculate extension factors to predict remaining yields to days 90, 180, and 270 for months of freshening and days in milk. Cumulative remaining yield was computed as the product of days remaining to day 90, 180, or 270, yield on last sample day, and the appropriate extension factor. There were no differences in factors due to age, but factors were different for months of freshening and number of days in milk.     

Immunological mimicry between retinal S-antigen and group A streptococcal M proteins

Immunological mimicry between host and microbial proteins has been suggested as a potential mechanism in the development of uveitis in humans. In this study immunological crossreactivity between anti-streptococcal monoclonal antibodies (MAbs) and the human eye was investigated. In indirect immunofluorescence, we demonstrated novel immunological crossreactivity of two anti-streptococcal MAbs (27 and 112) with the rod outer (and inner) segments of the retina of the human eye. In further studies, retinal S-Ag, a uveitogenic protein in the rod outer (and inner) segments, was found to react with the anti-streptococcal MAbs. In addition, several uveitogenic peptides of S-Ag were recognized by the anti-streptococcal MAbs. In the ELISA and Western immunoblot, anti-S-Ag MAbs crossreacted with group A streptococci and the streptococcal M protein further demonstrating sites of antigenic similarity. Homology between the retinal S-Ag and streptococcal M protein was observed in amino acid sequences repeated in the B repeat region of the streptococcal M5 protein. These data show that retinal S-antigen has immunological similarities with streptococcal M protein, a major virulence determinant and strong bacterial cell surface antigen.