Accounting history and governmental inquiries: An experiment in adversarial roleplay

Governmental inquiries where accounting is a central focus are a rich resource for injecting much needed historical content into accounting courses in higher education. An adversarial roleplay recreated a Wage Stabilization Board hearing in Washington, D.C. which, in 1952, led to President Truman\u27s seizure of the American steel industry and ultimately to a constitutional crisis. The roleplay centered on the accounting issues debated by that Board in response to a highly provocative submission by W. A. Paton on behalf of the steel industry. The roleplay revealed strong support for recourse to such historical materials in providing an enjoyable, stimulating and effective way of learning accounting theory. Ancillary benefits were that students gained a better understanding of some important economic, political and constitutional issues in American history

Aberrations in hemostasis and coagulation in untreated discordant hepatic xenotransplantation: Studies in the dog-to-pig model

Discordant liver xenotransplantation is a poorly explored entity. Data from the few large animal studies of hepatic xenotransplantation suggest that severe hemorrhage is encountered. The purpose of the studies described here is to characterize the nature of the hemorrhage that accompanies liver xenotransplantation. Canine livers were transplanted into porcine recipients, and lethal hemorrhage was encountered. Analysis of recipient blood showed that factors V, IX, and X were present in adequate levels until after the hemorrhage appeared, suggesting that coagulation factor loss was the result and not the cause of hemorrhage. Platelet counts decreased dramatically in recipients within minutes of graft reperfusion. There also was no evidence of clotting activity in the blood of recipients of liver xenografts within minutes of graft reperfusion. This loss of clotting activity was specific to liver xenografts, was not seen in renal xenografts with or without venovenous bypass, and also was absent in pig-to-pig liver allografts. In brief, the hemorrhage that accompanies liver xenotransplantation occurs because of a decrease in the number and function of circulating platelets in the recipient. (Liver Transpl 2002;8:153-159.

Experimental discordant hepatic xenotransplantation in the recipient with liver failure: implications for clinical bridging trials

Background: Clinical xenotransplantation might start with bridge-to-bridge trials. Situations where hyperacute rejection is avoided would provide opportunities for the initiation of bridging trials. Patients with liver failure have a diminished capacity to initiate antibody and complement-induced injury of xenogeneic endothelium. Hyperacute rejection of a liver xenograft manifests as a coagulopathy. We examined the ability of a recipient with liver failure to hyperacutely reject a liver xenograft in the dog-to-pig model in the immediate postoperative period. Study Design: Liver failure in pigs was induced with galactosamine. Canine livers were transplanted into pigs with liver failure and into healthy pigs. The postoperative course was monitored for 1 hour for histologic changes in the xenograft, changes in platelet counts, and whole blood clotting with Sonoclot analysis. In vitro assays with pig serum and canine hepatic sinusoidal endothelial cells were used to assess the effect of liver failure on serum cytotoxicity and xenoreactive antibody levels. Results: All untreated pig recipients of liver xenografts died from a coagulopathy. Recipients with liver failure manifested no signs of coagulopathy, and had minimal change in platelet counts or Sonoclot (Sienco Inc., Morrison, CO) tracings. Liver xenograft biopsies from recipients with liver failure showed no evidence of the tissue injury that characterized the biopsies of control recipients. Serum from pigs was less cytotoxic to the canine hepatic sinusoidal endothelium after induction of liver failure. The xenoreactive antibody levels and repertoire were similar in the pig serum before and after liver failure was induced. CH 50 (total complement) levels were diminished in pigs after the induction of liver failure. Conclusions: Liver xenotransplantation used in bridging trials in recipients with liver failure might not face the barrier of hyperacute rejection. (J Am Coll Surg 2000;191:54-64. © 2000 by the American College of Surgeons