Internal mammary vein to coronary artery anastomotic fistula

Two patients are presented where internal mammary artery grafting was performed for the relief of symptomatic coronary artery disease. At follow-up the internal mammary artery was occluded and a communication between the internal mammary vein and the native coronary artery was demonstrated. These patients were characterised by the early recurrence of angina or the appearance of a continuous murmur. Both patients were treated by re-operation with ligation of the arterio-venous fistula and saphenous vein grafting.     

Erythrocyte sodium lithium countertransport in normal and hypertensive pregnancy: relation to haemodynamic changes

OBJECTIVE: To establish the changes in erythrocyte sodium lithium countertransport (SLC) with advancing normal pregnancy and to determine if these changes were different in pregnancy induced hypertension (PIH). The changes in both groups were assessed in relation to haemodynamic changes. DESIGN: SLC, mean arterial pressure (MAP), cardiac output (CO) and total peripheral vascular resistance (TPVR) were determined serially during normal pregnancy and cross-sectionally in PIH. Women were studied again 20 weeks after delivery where possible. SETTING: Routine antenatal clinic and antenatal ward of a regional reference centre. SUBJECTS: Fifty-one normal primigravid women were studied serially and 41 primigravid women with PIH were studied at time of diagnosis. RESULTS: During normal pregnancy SLC (mmol Li/h/l cells) increased from a nonpregnant value of 0.24 +/- 0.02 (mean +/- SEM) to 0.32 +/- 0.02 at 14 weeks, and 0.37 +/- 0.02 at 20 weeks gestation. This was maintained until 38 weeks (0.40 +/- 0.02). The increase until 20 weeks occurred at the time of greatest change in CO (5.10 +/- 0.18 to 6.79 +/- 0.20 l/min) and TPVR (1327 +/- 58 to 969 +/- 33 dyn/s/cm-5). The decrease in TPVR with a rise in SLC is opposite to the relation reported in essential hypertension so that a functional relation is unlikely. However, the changes within pregnancy were positively correlated (r = 0.43, P < 0.01). In hypertensive pregnancies TPVR was elevated compared with normotensive pregnancies (1543 +/- 100 vs 1090 +/- 37) but the SLC was not different from that found in normotensive pregnancies (0.43 +/- 0.02 vs 0.40 +/- 0.02). CONCLUSIONS: The changes in SLC activity suggest dynamic effects on erythrocyte membrane function during pregnancy. However, no differences could be found between normal and hypertensive pregnancy and SLC is unlikely to be of value as a marker of hypertensive risk during pregnancy.     

The stability robustness determination of state space models with real unstructured perturbations

This paper considers the robust stability of a linear time-invariant state space model subject to real parameter perturbations. The problem is to find the distance of a given stable matrix from the set of unstable matrices. A new method, based on the properties of the Kronecker sum and two other composite matrices, is developed to study this problem; this new method makes it possible to distinguish real perturbations from complex ones. Although a procedure to find the exact value of the distance is still not available, some explicit lower bounds on the distance are obtained. The bounds are applicable only for the case of real plant perturbations, and are easy to compute numerically; if the matrix is large in size, an iterative procedure is given to compute the bounds. Various examples including a 46th-order spacecraft system are given to illustrate the results obtained. The examples show that the new bounds obtained can have an arbitrary degree of improvement over previously reported ones. This work has been supported by the Natural Sciences and Engineering Research Council of Canada under Grant No. A4396.     

Chronic hepatitis in children after liver transplantation: role of hepatitis C virus and hepatitis G virus infections

BACKGROUND/AIMS: Chronic graft hepatitis occurs in 20-30% adults after liver transplantation but the prevalence and causes in children are not known. In adults, hepatitis C virus infection is prevalent prior to transplantation and recurrent infection is a frequent cause of graft dysfunction. The significance of the recently described hepatitis G virus infection remains unproven. The aim of this study was to examine the role of hepatitis C virus and hepatitis G virus infection in chronic graft hepatitis after paediatric liver transplantation. METHODS: The prevalence of graft hepatitis and the role of hepatitis C virus and hepatitis G virus infections in 80 children after liver transplantation have been studied, with a median follow up of 4.4 years (range 0.4 to 10.7), and the persistence of hepatitis G infection in the presence of immunosuppression has been determined. RESULTS: Chronic graft hepatitis was diagnosed in 19/80 (24%) children and was most frequently seen in children transplanted for cryptogenic cirrhosis (71%). There was no significant difference in the prevalence of chronic hepatitis in those transplanted before or after donor anti-HCV screening. Hepatitis C infection occurred in three children transplanted prior to donor screening but in only one was associated with chronic hepatitis. Hepatitis G infection was found in 22/79 (28%) transplant recipients but was not associated with graft hepatitis. In 17/21 children hepatitis G infection persisted for a median of 5.2 years after transplantation. CONCLUSION: Chronic hepatitis occurred in 24% of children after liver transplantation, a similar prevalence to that in adults. Cryptogenic liver disease predisposed to graft hepatitis, but neither hepatitis C nor hepatitis G infection was associated. Hepatitis G virus caused a frequent and usually persistent infection after transplantation.     

An exploratory study of buyers’ participation intentions in reputation systems: The relationship quality perspective

Drawing upon a relationship quality framework, this study identifies how satisfaction, trust and different styles of handling conflict influence online buyers’ participation intentions in reputation systems associated with a C2C online shopping platform. Furthermore, we investigate how these effects are moderated by social conformity and the perceived value of knowledge. The results of a survey of 269 online buyers indicate that satisfaction, trust and an accommodating conflict handling style positively impact the intention to submit positive ratings, whereas an avoiding conflict handling style negatively affects the intention to submit positive ratings. Implications and suggestions for future research are provided.     

Understanding buyers' loyalty to a C2C platform: the roles of social capital,satisfaction and perceived effectiveness of e‐commerce institutional mechanisms

Drawing upon social capital theory, this study aims to investigate how different dimensions of social capital affect online buyers' satisfaction and ultimately boost their loyalty to a Consumer‐to‐Consumer (C2C) platform. Specifically, we propose that three dimensions of social capital (i.e., cognitive, structural and relational capital) contribute positively to the two types of online buyers' satisfaction (i.e., economic and social satisfaction). In addition, we posit that perceived effectiveness of e‐commerce institutional mechanisms (PEEIM) moderates the relationships between economic and social satisfaction and buyers' loyalty to the platform. Three hundred buyers on the Consumer‐to‐Consumer platform, TaoBao, were surveyed to test the proposed model. The results suggest that buyers' evaluation of social capital with the community of sellers can enhance their satisfaction with the sellers, which subsequently affect their loyalty to the platform. Furthermore, perceived effectiveness of e‐commerce institutional mechanisms negatively moderates the effect of economic satisfaction and positively moderates the effect of social satisfaction on buyers' loyalty to the platform. The theoretical contributions and practical implications are discussed.     

A Web caching primer

The article provides a primer on Web resource caching, one technology used to make the Web scalable. Web caching can reduce bandwidth usage, decrease user-perceived latencies, and reduce Web server loads transparently. As a result, caching has become a significant part of the Web's infrastructure. Caching has even spawned a new industry: content delivery networks, which are also growing at a fantastic rate. Readers familiar with relatively advanced Web caching topics such as the Internet Cache Protocol (ICP), invalidation, and interception proxies are not likely to learn much here. Instead, the article is designed for the general audience of Web users. Rather than a how-to guide to caching technology deployment, it is a high-level argument for the value of Web caching to content consumers and producers. The article defines caching, explains how it applies to the Web, and describes when and why it is useful     

When and how authoritarian leadership and leader renqing orientation influence tacit knowledge sharing intentions

In this study of tacit knowledge-sharing intentions in China, we examine the roles of authoritarian leadership and fairness with respect to the way managers make decisions and treat their subordinates. In particular, we examine the role of leader renqing orientation, i.e., the way leaders distribute favors and emotional concern to their subordinates, as a moderating factor. We draw on the research literature in the domains of knowledge management and cross-cultural Psychology to identify constructs that we then test with a survey of 309 Chinese employees. Our findings are counter-intuitive and are discussed in detail before we conclude with implications for research and practice.