1,189 research outputs found

    A new liver perfusion and preservation system for transplantation Research in large animals

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    A kidney perfusion machine, model MOX-100 (Waters Instruments, Ltd, Rochester, MN) was modified to allow continuous perfusion of the portal vein and pulsatile perfusion of the hepatic artery of the liver. Additional apparatus consists of a cooling system, a membrane oxygenator, a filter for foreign bodies, and bubble traps. This system not only allows hypothermic perfusion preservation of the liver graft, but furthermore enables investigation of ex vivo simulation of various circulatory circumstances in which physiological perfusion of the liver is studied. We have used this system to evaluate the viability of liver allografts preserved by cold storage. The liver was placed on the perfusion system and perfused with blood with a hematocrit of approximately 20% and maintained at 37°C for 3 h. The flows of the hepatic artery and portal vein were adjusted to 0.33 mL and 0.67 mL/g of liver tissue, respectively. Parameters of viability consisted of hourly bile output, oxygen consumption, liver enzymes, electrolytes, vascular resistance, and liver histology. This method of liver assessment in large animals will allow the objective evaluation of organ viability for transplantation and thereby improve the outcome of organ transplantation. Furthermore, this pump enables investigation into the pathophysiology of liver ischemia and preservation. © 1990 Informa UK Ltd All rights reserved: reproduction in whole or part not permitted

    The deindustrialisation/tertiarisation hypothesis reconsidered: a subsystem application to the OECD7

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    The diffusion of outsourcing, both national and international, and vertical FDIs among manufacturing firms, along with the higher integra- tion of business services in manufacturing, has recently led to question the empirical evidence supporting the Deindustrialisation/Tertiarisation (DT) hypothesis. Rather than a \real" phenomenon, it has been argued, DT would be an \apparent" one, mainly due to the reorganization of production across national and sectoral boundaries. The empirical studies that have dealt with the topic so far have not been able to effectively rule out such possibility, because of two main limitations: the sectoral level of the analysis and/or the national focus. In order to overcome them, the paper carries out an appreciative investigation of the actual extent of the DT occurred in the OECD area over the '80s and the '90s by moving from a sector to a subsystem perspective, thus retaining both direct and indirect relations, and by referring to a \pseudo-World" of 7 OECD countries, thus taking into account the \global" dimension of the phenomenon. The results strongly support the DT hypothesis: although the weight of business sector services in the manufacturing subsystem increased, acting as a counterbalancing tendency to the manufacturing decline, subsystem shares significantly decreased, thus confirming DT as a more fundamental trend of modern economies

    Lessons from a one-year hospital-based surveillance of acute respiratory infections in Berlin- comparing case definitions to monitor influenza

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    <p>Abstract</p> <p>Background</p> <p>Surveillance of severe acute respiratory infections (SARI) in sentinel hospitals is recommended to estimate the burden of severe influenza-cases. Therefore, we monitored patients admitted with respiratory infections (RI) in 9 Berlin hospitals from 7.12.2009 to 12.12.2010 according to different case definitions (CD) and determined the proportion of cases with influenza A(H1N1)pdm09 (pH1N1). We compared the sensitivity and specificity of CD for capturing pandemic pH1N1 cases.</p> <p>Methods</p> <p>We established an RI-surveillance restricted to adults aged ≤ 65 years within the framework of a pH1N1 vaccine effectiveness study, which required active identification of RI-cases. The hospital information-system was screened daily for newly admitted RI-patients. Nasopharyngeal swabs from consenting patients were tested by PCR for influenza-virus subtypes. Four clinical CD were compared in terms of capturing pH1N1-positives among hospitalized RI-patients by applying sensitivity and specificity analyses. The broadest case definition (CD1) was used for inclusion of RI-cases; the narrowest case definition (CD4) was identical to the SARI case definition recommended by ECDC/WHO.</p> <p>Results</p> <p>Over the study period, we identified 1,025 RI-cases, of which 283 (28%) met the ECDC/WHO SARI case definition. The percentage of SARI-cases among internal medicine admissions decreased from 3.2% (calendar-week 50-2009) to 0.2% (week 25-2010). Of 354 patients tested by PCR, 20 (6%) were pH1N1-positive. Two case definitions narrower than CD1 but -in contrast to SARI- not requiring shortness of breath yielded the largest areas under the Receiver-Operator-Curve. Heterogeneity of proportions of patients admitted with RI between hospitals was significant.</p> <p>Conclusions</p> <p>Comprehensive surveillance of RI cases was feasible in a network of community hospitals. In most settings, several hospitals should be included to ensure representativeness. Although misclassification resulting from failure to obtain symptoms in the hospital information-system cannot be ruled out, a high proportion of hospitalized PCR-positive pH1N1-patients (45%) did not fulfil the SARI case-definition that included shortness of breath or difficulty breathing. Thus, to assess influenza-related disease burden in hospitals, broader, alternative case definitions should be considered.</p

    Lives on track? Long-term earnings returns to selective school placement in England and Denmark

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    We explore the influence of between-school ability placement at lower secondary education on earnings across the life course in England and Denmark. We go beyond the mid-career snapshot provided by previous studies by exploiting the availability of four decades worth of earnings data for individuals born in the mid-1950s. Members of this cohort who were judged to be among the most academically able attended grammar schools in England (19 percent) and advanced secondary schools (Realskole) in Denmark (51 percent) prior to the start of comprehensivisation. This key difference makes England and Denmark interesting cases for comparison, not least since pro-selection policies have re-emerged in England based on the claim that grammar schools lead to better educational and labour market outcomes. Our analysis of the influence of selective school placement on earnings finds little support for this contention. We find that those from socioeconomically disadvantaged backgrounds were strikingly under-represented in schools ear-marked for higher ability pupils in both countries, even after taking into account social class differences in measured ability. Our analysis for England finds only modest earnings returns to attending a grammar school, totalling just £39,000 across the life course, while in Denmark the lifetime earnings returns to attending Realskole are somewhat larger (£194,000). Because those from advantaged backgrounds were substantially over-represented at grammar schools and Realskoles, these returns accrue disproportionately to pupils from more advantaged backgrounds. Lower secondary school placement in Denmark accounts for forty percent of the intergenerational reproduction of socioeconomic advantage and disadvantage, more than half of which is due to selection into school types based on socioeconomic background rather than measured ability. Our findings question the wisdom of expanding grammar schools when they appear to do little to improve individuals’ earnings or increase social mobility

    Tandem application of C-C bond-forming reactions with reductive ozonolysis

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    Several variants of reductive ozonolysis, defined here as the in situ generation of aldehydes or ketones during ozonolytic cleavage of alkenes, are demonstrated to work effectively in tandem with a number of C-C bond-forming reactions. For reactions involving basic nucleophiles (1,2- addition of Grignard reagents, Wittig or Horner-Emmons olefinations, and directed Aldol reactions of lithium enolates) the one-pot process offers a rapid and high-yielding alternative to traditional two-step protocols
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