Transplantation of the small intestine: the pathologist's perspective.

Small-bowel transplantation is now ready for clinical trials. The surgical techniques and methods for immunosuppression and monitoring bowel status have been developed in animal models over the past 30 years. Several attempts at small-bowel transplantation in humans have already been reported. In the course of future trials, pathologists will be involved in the monitoring of the posttransplant course by mucosal biopsies and functional studies, including maltose and xylose absorption tests. The morphology of rejection has been studied in canine and rat models. Activated lymphocytes and plasma cells infiltrate the lamina propria and invade crypt epithelium, causing "cryptitis." Villous blunting ensues, resulting eventually in necrosis. Graft survival without immunosuppression is about 10 days. Under Cyclosporine immunosuppression, a lymphoplasmacytic infiltrate has been noted around nerves and vessels in the submucosa. The overlying mucosa may be relatively normal. End-stage bowel is characterized by a contracted, scarred mass. Due to the large amount of lymphoid tissue in the allograft, graft-versus-host disease is a significant problem in small-bowel transplantation

The use of FK-506 for small intestine llotransplantation: Inhibition of acute rejection and prevention of fatal graft-versus-host disease

Small intestine allotransplantation in humans is not yet feasible due to the failure of the current methods of immunosuppression. FK-506, a powerful new immunosuppressive agent that is synergistic with cyclosporine, allows long-term survival of recipients of cardiac, renal, and hepatic allografts. This study compares the effects of FK-506 and cyclosporine on host survival, graft rejection, and graft-versus-host-disease in a rat small intestine transplantation model. Transplants between strongly histoincompatible ACI and Lewis (LEW) strain rats, and their Fi progeny are performed so that graft rejection alone is genetically permitted (F1→LEW) or GVHD alone permitted (LEW→F1) or that both immunologic processes are allowed to occur simultaneously (ACI—»LEW). Specific doses of FK-506 result in prolonged graft and host survival in all genetic combinations tested. Furthermore, graft rejection is prevented (ACI→LEW model) or inhibited (rejection only model) and lethal acute GVHD is eliminated. Even at very high doses, cyclosporine did not prevent graft rejection or lethal GVHD, nor did it allow long-term survival of the intestinal graft or the host. Animals receiving low doses of cyclosporine have outcomes similar to the untreated control groups. No toxicity specific to FK-506 is noted, but earlier studies by other investigators suggest otherwise. © 1990 by Williams & Wilkin

Preliminary Results of Aerodynamic Heating Studies on the X-15 Airplane

Aerodynamic heating analysis of X-15 aircraft in fligh

Novel Mechanism of Nucleon Stopping in Heavy Ion Collisions

When a diquark does not fragment directly but breaks in such a way that only one of its quarks gets into the produced baryon, the latter is produced closer to mid rapidities. The relative size of this diquark breaking component increases quite fast with increasing energy. We show that at a given energy it also increases with the atomic mass number and with the centrality of the collision and that it allows to explain the rapidity distribution of the net baryon number ($p$-$\bar{p}$) in $SS$ central collisions. Predictions for $Pb$-$Pb$ collisions are presented.Comment: 10 pages, Latex file and 6 PostSript figures uuencoded in one fil

Primary Cardiac Allograft Dysfunction-Validation of a Clinical Definition

Background.Heart transplantation is an established treatment for advanced heart failure. Primary allograft dysfunction (PGD) is reported in up to 40 % of transplants and is associated with a poor outcome.Methods.As part of Heart Evaluation and Retrieval for Transplantation study, an investigation of the assessment of donor hearts for transplantation, we proposed a clinical definition ffecting one or both ventricles accompanied by hypotension, low 72 hours (in the absence of hyper acute rejection and technical mine the prospective application of this definition to 290 heart d non-PGD cases. Results. Ninety-four of 290 transplants the PGD group at 24, 48, and 72 hours after transplantation fo ra o c ty. have acceptable function before organ retrieval may be ex-OriginalClinicalScienceçGeneral30 years.6 This has been attributed to improvements in dono

The use of national datasets to baseline science education reform: exploring value-added approaches

This paper uses data from the National Pupil Database to investigate the differences in ‘performance’ across the range of science courses available following the 2006 Key Stage 4 (KS4) science reforms in England. This is a value-added exploration (from Key Stage 3 [KS3] to KS4) aimed not at the student or the school level, but rather at that of the course. Different methodological approaches to carrying out such an analysis, ranging from simple non-contextualized techniques, to more complex fully contextualized multilevel models, are investigated and their limitations and benefits are evaluated. Important differences between courses are found in terms of the typical ‘value’ they add to the students studying them with particular applied science courses producing higher mean KS4 outcomes for the same KS3 level compared with other courses. The implications of the emergence of such differences, in a context where schools are judged to a great extent on their value-added performance, are discussed. The relative importance of a variety of student characteristics in determining KS4 outcomes are also investigated. Substantive findings are that across all types of course, science prior attainment at KS3, rather than that of mathematics or English, is the most important predictor of KS4 performance in science, and that students of lower socio-economic status consistently make less progress over KS4 than might be expected, despite prior attainment being accounted for in the modelling