Transjugular intrahepatic portosystemic shunts (TIPS) in children

The transjugular intrahepatic portosystemic shunt procedure is an accepted treatment for adults with complications of portal hypertension. We performed a retrospective review of all pediatric TIPS placements performed at the University of California, San Francisco between 1990 and 1996. Twelve procedures were attempted in nine children, with a mean age (+/- SD) of 9.4 +/- 3.9 years (range, 5 to 15 years) and a mean weight of 31 +/- 18 kg (range, 16 to 70 kg). The indications for TIPS placement were portal hypertension complicated by chronic variceal hemorrhage not controlled with sclerotherapy (n = 7) and hypersplenism with thrombocytopenia (n = 2). TIPS placement was successfully completed initially in seven of nine (78%) patients. Unfavorable vascular anatomy was the cause of failure in two cases. The seven patients who underwent successful TIPS placement were followed up for an average of 136 days (range, 1 to 800 days); two still have patent shunts, three underwent liver transplantation, one had a splenorenal shunt after stenosis, and one died of underlying liver disease. Variceal bleeding was controlled in four of five patients who successfully underwent TIPS placement. Shunt occlusion occurred in four patients; patency was restored by transjugular shunt revision in three, and a splenorenal shunt was performed in one.     

Viral dynamics of primary viremia and antiretroviral therapy in simian immunodeficiency virus infection

Mathematical modeling of viral replication dynamics, based on sequential measurements of levels of virion-associated RNA in plasma during antiretroviral treatment, has led to fundamental new insights into human immunodeficiency virus type 1 pathogenesis. We took advantage of the simian immunodeficiency virus (SIV)-infected macaque model to perform detailed measurements and mathematical modeling during primary infection and during treatment of established infection with the antiretroviral drug (R)-9-(2-phosphonylmethoxypropyl)adenine (PMPA). The calculated clearance half-life for productively infected cells during resolution of the peak viremia of primary infection was on the order of 1 day, with slightly shorter clearance half-lives calculated during PMPA treatment. Viral reproduction rates upon discontinuation of PMPA treatment after 2 weeks were approximately twofold greater than those obtained just prior to initiation of treatment in the same animals, likely reflecting accumulation of susceptible target cells during treatment. The basic reproductive ratio (R0) for the spread of SIV infection in vivo, which represents the number of productively infected cells derived from each productively infected cell at the beginning of infection, was also estimated. This parameter quantifies the extent to which antiviral therapy or vaccination must limit the initial spread of virus to prevent establishment of chronic disseminated infection. The results thus provide an important guide for efforts to develop vaccines against SIV and, by extension, human immunodeficiency virus.     

Temperament and substance abuse in schizophrenia: is there a relationship?

Dyspnea may be easily appreciated during exercise with dyspneic scales, but methodological standardisation still needs to be specified. Authors review the basic physiological mechanism relating dyspnea to indices obtained during a stress test. They propose to use the dyspnea/VE relationship. With the concept of dyspneic threshold (close to the ventilatory threshold) and the ramp that both could be modified (for instance by rehabilitation programmes including exercise training). Interpretation of dyspnea during an exercise test obviously needs to be integrated with other parameters studied during exercise.     

A method for functional magnetic resonance imaging of olfaction

A method for generating olfactory stimuli for humans within a functional magnetic resonance imaging (fMRI) experimental design is described. The system incorporates a nasal-mask in which the change from odorant to no-odorant conditions occurs in less than 500 ms and is not accompanied by visual, auditory, tactile, or thermal cues. The mask provides an ordorant-free environment following prolonged ordorant presence. Specific imaging parameters that are conducive to the study of the human olfactory system are described. In a pilot study performed using these methods, the specific patterns of activation observed converged with published experimental and clinical findings.     

Dexamethasone induces an increase in intracellular and membrane-associated lipocortin-1 (annexin-1) in rat astrocyte primary cultures

1. The antiinflammatory actions of glucocorticoid steroids are thought to occur through induction of the protein lipocortin-1 (LC-1; annexin-1). The purpose of the current study was to investigate whether astrocytic LC-1 content was increased in the presence of a synthetic glucocorticoid, dexamethasone. 2. Steroid-induced changes in cellular levels of LC-1 in astrocytes were determined by electrotransfer and immunoblotting techniques. Separate cell fractions were investigated to study the influence of dexamethasone on astroglial LC-1 content. The effect of culture state on LC-1 expression was also examined. 3. Intracellular LC-1 content was found to decrease after initiation of culture, with a substantial rise in both cell proliferation and LC-1 expression occurring after the replenishment of medium containing steroid-free serum. A further increase in intracellular LC-1 occurred upon incubation with dexamethasone. The glucocorticoid-induced change in intracellular LC-1 was a time-dependent event and coincided with an increase in membrane-associated LC-1. 4. The findings in this study indicate that astrocytic LC-1 content is influenced by cell culture conditions and, in the presence of glucocorticoid steroids, the cellular localization of LC-1 is altered. This may indicate that LC-1 has functions at more than one cellular locality.     

When danger lurks in the background: Attentional capture by animal fear-relevant distractors is specific and selectively enhanced by animal fear.

Across 2 experiments, a new experimental procedure was used to investigate attentional capture by animal fear-relevant stimuli. In Experiment 1 (N = 34), unselected participants were slower to detect a neutral target animal in the presence of a spider than a cockroach distractor and in the presence of a snake than a large lizard distractor. This result confirms that phylogenetically fear-relevant animals capture attention specifically and to a larger extent than do non-fear-relevant animals. In Experiment 2 (N = 86), detection of a neutral target animal was slowed more in the presence of a feared fear-relevant distractor (e.g., a snake for snake-fearful participants) than in presence of a not-feared fear-relevant distractor (e.g., a spider for snake-fearful participants). These results indicate preferential attentional capture that is specific to phylogenetically fear-relevant stimuli and is selectively enhanced in individuals who fear these animals. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effect of solidification time and heat treatment on the fatigue properties of a cast 319 aluminum alloy

Solidification time and heat treatment are known to have a large effect on the microstructure of cast aluminum alloys. This study was conducted to quantify how the fatigue properties of a 319-type aluminum alloy are affected by solidification time and heat treatment. Both porosity-containing (non-hot isostatically pressed (HIP)) and porosity-free (HIP) samples in the T6 (“peak aged”) or T7 (“overaged”) heattreated conditions were tested. As the solidification time increased, the average initiating pore diameter increased and stress-controlled fatigue life decreased. Heat treatment was observed to have a large effect on fatigue properties of the HIP samples. However, in the non-HIP fatigue samples, heat treatment did not significantly change the fatigue life or fatigue strength of the cast 319-type alloy. The absence of an influence of heat treatment on fatigue response is attributed to the predominance of the microporosity in fatigue crack initiation in cast aluminum.     

Learning Organizations in Construction

The transformation of organizations from production-oriented entities to proactive learning entities that continuously leverage the knowledge of the workforce is a primary objective of management researchers. This focus has significant relevance to the construction industry where production-related research has predominantly overshadowed organizational development research. As one effort to change this emphasis, the writers present a research effort designed to study current organization learning techniques and technologies fielded by organizations both inside and outside of the construction industry. Through a series of exploratory case studies, the writers developed a maturity model together with the Construction Industry Institute that provides construction organizations with a framework for developing a learning organization culture. The maturity model focuses on learning organization characteristics of leadership, processes and infrastructure, communication/collaboration, education, and culture at the organization, community, and individual levels. This paper introduces the results of that effort including a presentation of the learning organization maturity model, framework application, and the overall characteristics of a learning organization.