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Transactions of the London and Middlesex Archaeological Society, 1.3, 171-184

In recent years, significant developments have continued to be made in the field of pediatric liver transplantation. As experience increases, so there is now a wealth of outcome data. With improved patient and graft survival, issues such as quality of life and adherence to immunosuppressive medication regimes increase in importance, and affect outcomes. Demand for donor organs continues to increase, so surgical techniques and organ allocation policies are evolving to help meet this demand. Researchers have also looked at ways in which we might predict outcomes for liver transplant recipients, and how we may achieve increased graft tolerance in the future. By way of an introduction to recent articles in these exciting areas we have summarized several significant contributions from the hundreds of scientific articles related to pediatric liver transplantation published between 2006 and 2007. Comments linking themes across manuscripts have been included. This review is not exhaustive and we would encourage the reader to refer to the actual manuscripts and explore more deeply.

Ten case study businesses were assessed in relation to sixteen criteria in order to test the application of an hypothesised life cycle. Analysis of stakeholder aspirations for each of these ten businesses was also undertaken. On the basis of the empirical evidence, it was demonstrated that stakeholder groups favour diverse goals, that the level of goal coherence between major stakeholder groups declines as a co-op progresses through the co-operative life cycle and that in the later stages of the life cycle, the aspirations of the managers, rather than those of the farmers, are realised. Furthermore, the managers' preferred goals are reflected in the organisational and financial structures and trading practices of individual late stage businesses, which are more akin to investor oriented firms than traditional co-operatives.

This paper describes the evolution of the JikesTM Research Virtual Machine project from an IBM internal research project, called Jalapeno, into an open-source project. After summarizing the original goals of the project, we discuss the motivation for releasing it as an open-source project and the activities performed to ensure the success of the project. Throughout, we highlight the unique challenges of developing and maintaining an open-source project designed specifically to support a research community.

Recent data suggest that exogenous retinoic acid (RA), the biologically active derivative of vitamin A, can induce alveolar regeneration in a rat model of experimental emphysema. Here, we describe a mouse model of disrupted alveolar development using dexamethasone administered postnatally. We show that the effects of dexamethasone are concentration dependent, dose dependent, long lasting and result in a severe loss of alveolar surface area. When RA is administered to these animals as adults, lung architecture and the surface area per unit of body weight are completely restored to normal. This remarkable effect may be because RA is required during normal alveolar development and administering RA re–awakens gene cascades used during development. We provide evidence that RA is required during alveologenesis in the mouse by showing that the levels of the retinoid binding proteins, the RA receptors and two RA synthesizing enzymes peak postnatally. Furthermore, an inhibitor of RA synthesis, disulphiram, disrupts alveologenesis. We also show that RA is required throughout life for the maintenance of lung alveoli because when rats are deprived of dietary retinol they lose alveoli and show the features of emphysema. Alveolar regeneration with RA may therefore be an important novel therapeutic approach to the treatment of respiratory diseases characterized by a reduced gas–exchanging surface area such as bronchopulmonary dysplasia and emphysema for which there are currently no treatments.

Alveoli are formed postnatally in the rat, mouse, and human. The molecular signals controlling the patterning of this developmental process are not well understood. Here we describe immunohistochemical studies that label proliferating alveolar wall cells which suggest two distinct patterns of alveologenesis: (1) a low grade, peripheral subpleural parenchymal process which occurs from P1 through to P15; and (2) a dramatic increase in central cell proliferation from P4 which is complete by P15, corresponding to the well described period of alveolar septation. We describe the temporal and spatial expression of the retinoid-synthesizing enzymes Aldh-1 and Raldh-2 in the postnatal mouse lung. Both enzymes are upregulated during the period of maximal alveolar wall cell proliferation. Aldh-1 is located in the bronchial epithelium and alveolar parenchyma, and Raldh-2 is restricted to the bronchial epithelium and pleural mesothelial cells. High-pressure liquid chromatography (HPLC) reveals that rapidly septating lungs have relatively simple chromatographic profiles; in contrast, the adult lungs have a complex profile that includes many novel retinoids. These data suggest two patterns of alveolar proliferation with temporal and spatial association of the enzymes Aldh-1 and Raldh-2 and a dynamic role for different retinoids in both the septating and adult mouse lung.

This paper examines the range of objectives open to cooperative businesses and assesses the change in organizational focus over time through the semantic analysis of historical annual reports of seven agricultural cooperative businesses. The findings indicated that, although there was a positive relationship between business age and increasing corporate, as opposed to member, orientation, this phenomenon is not inevitable for all organizations. The results also offered evidence that some of the change in business focus is generated by the internal dynamics of the business rather than from external factors such as competition and economic trends. Copyright 1997, Oxford University Press.

A double minimum has recently been observed in the time–voltage switching response for a smectic C* liquid crystal layer in the surface stabilized geometry (“Ferroelectric Liquid Crystal Device,” K. P. Lymer and J. C. Jones, U.K. Patent No. GB2338797, 17th June 1999). Liquid crystal continuum theory is used to demonstrate that this unusual switching behavior arises if the equilibrium orientation of the molecular director rotates around the smectic cone as a function of distance through one half of the layer only. The double minimum is shown to evolve for large differences between the ε2 and ε1 components of the smectic C biaxial permittivity tensor.

This paper sets out to determine whether agricultural cooperative companies in the UK are more likely to underperform when compared with non-cooperative companies in the same sector. The research indicates, that on the basis of profitability, capital gearing and liquidity, there were no significant differences between the two groups. For the business operational efficiency indicators of sales/working capital ratios, and creditor ratios, there were also no significant differences although, for the indicators of stock turnover and debtor ratios, cooperatives were seen to have significantly higher rates when compared with the non-cooperative companies. The findings of this research reveal that cooperatives do not perform differently to non-cooperatives, despite being required to balance member needs with the attainment of corporate goals.

Changes in proliferation and number of epithelial cells of the murine genital tract, during the oestrous cycle, have been studied. A total of 47 animals in the prooestrous, metoestrous and dioestrous phases of the cycle were staged retrospectively on the basis of the genital tract histology. The average duration of the oestrous cycle in these animals was 4 days, and half of this period was occupied by the prooestrous/oestrous phases. Significant cycles of growth were observed in the luminal uterine epithelium and in the basal epithelium of the cervix-vagina. Most of this growth occurred during the pro-oestrous phase, which lasted approximately 1 day. During this time the numbers of luminal epithelial cells in the uterus and suprabasal cells in the cervix-vagina increased 2-3 fold. This pattern of growth appeared partly synchronous and corresponded to the period when serum oestrogen levels are at their highest. A corresponding and rapid reduction in the numbers of uterine luminal epithelial cells and suprabasal cells in the cervix and vagina was noted during the early metoestrous phase; and this occured during the period when serum oestrogens are at their lowest levels. No significant periodicity in the proliferation and numbers of the uterine gland epithelial cells was noted during the cycle. The kinetic role and function of the gland cells is discussed in relation to these data.

Recent data suggests that exogenous retinoic acid (RA) can induce alveolar regeneration in a mouse and a rat model of experimental emphysema and disrupted alveolar development. This may be because RA is required during normal alveolar development and the subsequent provision of RA reawakens the gene cascades used during development. Here, additional evidence that RA is required during alveologenesis in the mouse is provided by showing that disulphiram disrupts this process. A further model of disrupted alveolar development using dexamethasone administered postnatally is then described, and it is further shown that RA administered to these adult mice restores the lung architecture to normal. Alveolar regeneration with retinoic acid may therefore be an important novel therapeutic approach to the treatment of respiratory diseases characterised by a reduced gas-exchanging surface area, such as bronchopulmonary dysplasia and emphysema.

Retinoic acid (RA) is the biologically active metabolite of vitamin A. It is a low molecular weight, lipophilic molecule that acts on the nucleus to induce gene transcription. In amphibians and mammals, it induces the regeneration of several tissues and organs and these examples are reviewed here. RA induces the "super-regeneration" of organs that can already regenerate such as the urodele amphibian limb by respecifying positional information in the limb. In organs that cannot normally regenerate such as the adult mammalian lung, RA induces the complete regeneration of alveoli that have been destroyed by various noxious treatments. In the mammalian central nervous system (CNS), which is another tissue that cannot regenerate, RA does not induce neurite outgrowth as it does in the embryonic CNS, because one of the retinoic acid receptors, RAR beta 2, is not up-regulated. When RAR beta 2 is transfected into the adult spinal cord in vitro, then neurite outgrowth is stimulated. In all these cases, RA is required for the development of the organ, in the first place suggesting that the same gene pathways are likely to be used for both development and regeneration. This suggestion, therefore, might serve as a strategy for identifying potential tissue or organ targets that have the capacity to be stimulated to regenerate.

Copper access transmission systems, which provide high-speed communications (e.g. 2 Mbit/s) in one or both directions over local loops, are a recent innovation. The operation and maintenance of such systems poses some problems and offers some opportunities, which were not present in the passive copper loop environment, or with low-speed digital systems. These are discussed and set in the context of the revolution in access networks that is happening as optical fibre and other technologies are introduced. The evolution of the management of high-speed copper systems towards a vision of a centrally managed access network is described. >

The paper describes experiences with the design and implementation of the NPIC program analysis system. We describe how the object oriented design of the intermediate representation (Dakota) provides front end and analysis independence using the abstract factory pattern, and illustrate how using multiple inheritance allows it to be extended to support program analysis. We also describe how the intermediate representation can be serialized to and from a file. The techniques described in the article provide useful insight into the construction of an object oriented program analysis system.

Endogenous retinoids have been implicated in alveologenesis in both the rat and the mouse, and exogenous retinoic acid (RA) can reverse or partially reverse experimental emphysema in adult rat and mouse models by an unknown mechanism. In this study, we examine the cellular and molecular biology of retinoid signaling during alveologenesis in the mouse. We describe the temporal and spatial expression of the retinoid binding proteins CRBP-I, CRBP-II, and CRABP-I using RT-PCR and immunohistochemistry. We identify the retinoic acid receptor isoforms RAR-alpha 1, RAR-beta 2, RAR-beta 4, and RAR-gamma 2 and describe their temporal and spatial expression using RT-PCR and in situ hybridization. We demonstrate that both retinoid binding proteins and RAR isoforms are temporally regulated and found within the alveolar septal regions during alveologenesis. These data support a role of dynamic endogenous RA signaling during alveolar formation.

The 1999/2000 winter demands on the NHS have once again highlighted deficits in UK critical care provision (Daily Telegraph, 2000; London Evening Standard, 2000) Recent years have seen the development of the role of health care support workers in the NHS; some critical care units now employ health care support workers This research examined the views of critical care unit staff on the introduction of health care support workers into the critical care unit It is concluded that the role is viable within the setting of this study A framework is outlined that could form the basis for a critical care health care support worker training programme

This article reports on the views of theatre nurses on the role of the nurse anaesthetist, which has received recent attention in the context of changing nursing and medical roles. 168 nurses working in 5 major operating departments were asked by way of questionnaire, for their views on nurse anaesthetists. 103 responses were received with 57 (55.3%) in favour of the development and 46 (44.7%) against. F and G grade nurses were found to be more favourable about nurse anaesthetists than their junior colleagues. In view of these findings, further investigation and discussion, notably with the medical profession and clinical managers, is recommended. The author believes that this proposed development must be given due thought and serious consideration before any attempts to introduce it are made.

Hasnija Granov, a senior nurse in Reconstructive and Plastic Surgery from Kosevo Hospital, Sarajevo, came to the NATN 1996 Congress, kindly sponsored by JohnsonJohnson and Swann Morton. During her visit she talked about her experiences when Sarajevo was under seige. This is her story.

Introduction Fibrosis is a constituent of various respiratory diseases including asthma, COPD, idiopathic pulmonary fibrosis (IPF) and pulmonary hypertension. Research shows that Wnt genes, critical for lung development, are reactivated post cellular injury and that the canonical Wnt/β-catenin pathway is mis-expressed in these diseases. The non-canonical Wnt/PCP pathway can inhibit canonical signalling and also cause co-ordinated, directional cell migration. Moreover components of this pathway are suppressed in many respiratory fibro-proliferative disorders. We investigated the role of non-canonical Wnts in a tractable model of lung repair, by comparing the rate of wound healing using either canonical Wnt4 or non-canonical Wnt5a ligands. We hypothesised that Wnt5a would exhibit a higher rate of wound healing than Wnt4, coupled with increased cytoskeleton dynamics, favouring co-ordinated and directional cell migration. Methods Confluent A549 cells were scratched with a 10µl pipette tip to induce a ‘wound’ and treated with either recombinant canonical Wnt4 or non-canonical Wnt5a, or cultured in control serum free medium. Wound area was measured at t=0, t-6 and t=24h post scratch to determine the rate of wound healing using time-lapse imaging. Phalloidin labelling and imaging was used to determine levels and distribution of F-actin at those times. Results The addition of Wnt5a healed 4 times the area either Wnt4 or Control did using concentrations that induce maximal activity at t=6 (5.49, 1.23 and 1.01×105µm2 respectively) and t=24 (8.62, 2.42 and 2.39×105µm2 respectively) hours post scratch (p Conclusion Wnt5a is more efficient at wound healing in A549 cells than Wnt4. Wnt5a associated increase in focal F-actin enrichment amplified wound healing is associated with increased cytoskeletal dynamics and directional movement. In the future, novel therapies based around Wnt5a have the potential to be used to enhance repair in fibrotic respiratory diseases.

L-arginine is the physiological precursor of nitric oxide, which is the major endothelium-derived relaxing factor, a potent vasodilator. This study examined the cardiovascular responses to application of incremental levels (-10, -20 and -40 mmHg) of lower body negative pressure (LBNP) in ten normal male subjects, after 1 and 7 days administration of placebo or L-arginine. It was hypothesized that L-arginine may attenuate the vasoconstrictor response elicited by application of LBNP. Placebo administration had no effect on any responses to LBNP. L-arginine administration had no significant effect on mean arterial blood pressure either after 1 day, or after 7 days. After both 1 and 7 days L-arginine ingestion, forearm blood flow (FBF) and forearm vascular conductance (FVC) were significantly lower than before L-arginine ingestion (p < 0.01), but were not significantly different from after placebo ingestion. The magnitude of the changes in FBF and FVC, induced by application of LBNP, were not different under any conditions. These findings suggest that L-arginine supplementation in healthy subjects, either acutely or chronically, has no significant effect on peripheral haemodynamics, or on reflex responses to LBNP.

Getting published can be a very rewarding experience. Seeing your work in print with the knowledge that many colleagues and other health care professionals are reading it can do your self-esteem no end of good. Having your work published also enables you to communicate information to an audience that you otherwise would not reach.

Summary In a double-blind study, the effects of positive intra-operative suggestions on the incidence and severity of postoperative nausea and vomiting were studied in 60 patients randomly selected to undergo routine major gynaecological surgery. Patients who received positive suggestions suffered significantly less nausea and vomiting in the 24 h after surgery.

Martin Hind proposes that the role of the operating theatre nurse is in need of a change to a more perioperative nature that emphasizes patient-centred nursing. He explores the reasons underpinning the need for this change in role will be.

Martin Hind reviews the proposals about professional profiles with special reference to their implications for theatre nurses. He asks a number of questions to which the UKCC will give answers and one or two others which may bear thought.

The transient capacitance has been measured for two commercial nematic liquid crystal materials, E7 and MDA01-2012, subjected to an amplitude modulated ac voltage wave form in the planar Freedericksz geometry. The wave form amplitude is modulated in a stepwise fashion between a value above the Freedericksz transition voltage VC [V. Freedericksz and V. Zolina, Trans. Faraday Soc. 29, 919 (1933)], causing switching, and a value below the threshold, where relaxation of the switched profile occurs. For both materials the time evolution of the dielectric permittivity during the switching and relaxation periods is accurately described by nematic continuum theory with a single viscosity provided that the switching voltage is a small multiple of VC.

From the authors: H. Fehrenbach is perfectly correct to point out that the assessment of our data is based only on the measurement of mean chord length (Lm) and lung volume estimations, whereas “a whole range of stereological tools is available for more detailed anaysis”. However, the results were so dramatic that we felt that there was no need for these further, rather esoteric analyses, which would …

Ten patients received ocular gentamicin therapy topically or subconjunctivally. Systemic absorption was not detected after topical use but was detected after subconjuctival administration. The relative safety of ocular gentamicin therapy is discussed and the literature is reviewed.