No description available.

Thesis (M.S.)--University of California, San Francisco, 2009. / Source: Masters Abstracts International, Volume: 47-06, page: 3490. Adviser: Janice Lee.

Thesis (M.A.)--University of California, San Francisco, 2009. / Source: Masters Abstracts International, Volume: 47-06, page: 3510. Adviser: Elizabeth S. Watkins.

<p> My research is focused on the experiences of musicians confronted with the loss of Absolute Pitch. Having studied the genetic, somatic, and emotional components likely encountered in one's sixties, there is currently next to nothing to read on the subject of AP loss. However, being aware of the complex connections between the brain, the ear, and the unique properties of the brain in promoting musicality sheds considerable light. For each person the story is different, as are the attempts to recapture one's AP. Regardless of the timing and extent of losing one's musical center, the strange limbo one feels needs to be better understood and discussed. My research, which includes listening to personal stories, is a start in understanding the void many talented musicians and music lovers feel, having benefited from Absolute Pitch all of their life. To be educated about, aware of, and accepting of this unexpected change is what I hope to provide.</p>

Neutrophils have been implicated in exacerbating ischemia/reperfusion injury in hearts. This study was undertaken to compare the adhesion of isolated rabbit neutrophils to rabbit coronary endothelial cells grown in culture under static and flow conditions. Also, the effects of a platelet activating factor (PAF) antagonist (SDZ 64-412) were evaluated in both systems along with monoclonal antibodies (mab) against specific adhesion proteins in the static system. Comparable concentration response curves for SDZ 64-412 were obtained in both systems with a greater decrease in adhesion seen in the flow system versus the static system. Both systems showed a significant inhibition of adhesion with increased concentration. The mabs against CD11a, CD11b, CD18, and ICAM reduced adhesion to 94.8%, 76.5%, 72.6%, and 26.7%, respectively. In conclusion, neutrophil/coronary endothelial cell adhesion can be quantified in both static and flow systems. Also, SDZ 64-412 effectively inhibits the adhesion of these two cell types to an even greater extent than certain adhesion protein mabs.

Restoration of blood flow to the ischemic myocardium is the most effective approach to limit necrosis. However, it appears that the act of reperfusion causes additional tissue damage, and this condition is known as myocardial reperfusion injury. It is well established that leukocytes contribute to additional myocyte and vascular injury during reperfusion, and that this injury occurs within the first minutes of flow restoration. A great deal is known about the leukocyte contribution to myocardial reperfusion injury. However, the mechanisms under which leukocytes accumulate in the coronary microcirculation during early reperfusion are unclear. The purpose of these studies was to identify the mechanisms of leukocyte accumulation in the coronary microcirculation during early reperfusion following ischemia. Using direct visualization techniques, it was observed that leukocyte accumulation in coronary capillaries and venules during the first minutes of reperfusion differs with respect to the magnitude and persistence of accumulation. During reperfusion, significant leukostasis in coronary capillaries occurs in the absence of blood activation, and is significantly enhanced when the blood is activated and when the reperfusion blood flow is moderately reduced. Also, the results indicate that postischemic capillary leukostasis can be attenuated by increasing leukocyte deformability and by inhibition of P- and L-selectin adhesion molecules. In contrast, leukocyte adhesion to the coronary venules during reperfusion is not significantly increased when the blood is not activated and returned at full flow. However, leukocyte adhesion to the venules is enhanced when the blood is activated or when reperfusion blood flow is severely reduced. In addition, under conditions of low reperfusion blood flow, leukocyte adhesion to the venules is attenuated by P- and L-selectin adhesion molecule inhibition. In these experiments, leukocytes remained in the capillaries longer than they remained in the venules during reperfusion. These results indicate that the degree to which leukocyte accumulation occurs in postischemic capillaries and venules is dependent upon the conditions of reperfusion. The results of this study also suggest that attempts to limit early myocardial leukocyte-mediated reperfusion injury should consider leukocyte deformability, the state of activation of the leukocyte, reperfusion blood flow, and selectin-mediated adhesion events.

Children with Juvenile Rheumatoid Arthritis (JRA) often describe themselves as lonely. This grounded theory investigation documented ways that friends aid children with JRA. In depth, open ended interviews with three children with JRA, their best friends, and mothers of each were done. Observations at Arthritis Camp supplemented the interview data. In this document only the data from the children with JRA were reported. A substantive range nursing theory was generated to specify the process by which friendships influence the child with JRA's well-being. The basic social psychological process of Keeping Up, the child with JRA's ability to maintain acceptable play interactions, was identified as the core category in the grounded theory Keeping Up With Friends. Three stages of friendships were identified: Making Friends, Being Friends, and Losing Friends. The process of Keeping Up took place in the stage of Being Friends. Categories that positively related to the child with JRA's sense of well-being were: Keeping Up, Maintaining Acceptable Play Interactions, Companionship, Help from Friends, and Strategies to Manage Denigrating Social Responses. Categories that decreased the child's well-being included Problems with Having JRA and Missing Out. Well-being was defined by the children with JRA as feeling good, happy, strong, and as normal as possible. Being Visibly Different from friends and Barriers to Friendships were found to negatively affect the child with JRA's ability to Keep Up. Among several implications for nursing practice and research was the importance of the children learning to pace themselves as they participated in social activities as well as their sensitivity to unwanted attention in social situations. Clinically this model could be used "as is" when working with girls with JRA who are lonely, being teased or left out of social activities.

Traumatic brain injury (TBI) is a leading cause of mortality and morbidity in young adults. With TBI, a cascade of events is initiated that leads to the degradation of the lipid bilayer of the cell membrane. The purpose of this study was to investigate central nervous system membrane damage following traumatic brain injury through biological (phospholipid and creatine kinase isoenzyme) and behavioral (Glasgow Coma Scale score and Survival Status) measures. The purpose was also to determine the relationship between the biological measures of injury and the behavioral assessment of neurological status. Ten patients participated in the study. The cerebrospinal fluid (CSF) samples from the ventricular catheter system and Glasgow Coma Scale (GCS) scores were obtained 2-3 times each day over 2 to 3 days. The phospholipids were extracted from the CSF samples with a 2 step procedure using Chloroform:Methanol. The phospholipid classes were separated using normal phase High Performance Liquid Chromatography with a Hexane:Isopropanol:Water gradient and quantified from calibration curves for each of the phospholipid classes: phosphatidylethanolamine, phosphatidylserine, phosphatidylcholine, sphingomyelin, and lysophosphatidylcholine. The creatine kinase isoenzyme (CK-BB) concentration was determined by electrophoresis. Data were analyzed using descriptive statistics, Spearman rank order correlation coefficient, and point biserial correlation. The concentration of phospholipids and CK-BB changed over time with the peak mean concentration for phosphatidylethanolamine, phosphatidylcholine, and sphingomyelin on day 4 after injury; for phosphatidylserine on day 2 after injury, and for lysophosphatidylcholine and CK- BB on day 1 after injury. There was a significant positive relationship between phospholipids and the GCS score on day 2 after injury and a significant negative relationship between phospholipids and the GCS score on day 6 after injury. There was a significant relationship between Survival Status and phospholipids on day 1 and day 4 after injury. There was a significant relationship between Survival Status and CK-BB on day 1 and day 2 after injury. Future studies are needed to test the relationship between acute measures of membrane damage and long term physical, cognitive, emotional and behavioral outcomes.

The majority of AIDS cases in children occur as a result of perinatal transmission of HIV-1 at an estimated rate of 30%. However, the molecular mechanisms and viral determinants associated with perinatal transmission are not known, thus making it difficult to develop strategies for prevention and treatment of HIV-1 infection. In this study, we have investigated the role of HIV-1 accessory genes vif, vpr and vpu in maternal-fetal transmission and the kinetics of HIV-1 replication in neonatal blood mononuclear cells. While there was a high degree of conservation of vif, vpr and vpu open reading frames in mother-infant pairs' isolates, the non-transmitting mothers' showed a high frequency of defective vif and vpr open reading frames. The functional domains required for Vif, Vpr and Vpu activity were highly conserved in sequences from transmitting mothers and their infants, but were found to exhibit defects, length polymorphism and substitutions in the conserved motifs of non-transmitting mothers' isolates. There was a low degree of heterogeneity in vif and vpr sequences from transmitting mothers and their infants and non-transmitting mothers. However the non-transmitting mother sequences were less heterogeneous than transmitting mother sequences. The vpu sequences from transmitting mothers and their infants were more heterogeneous than vif and vpr sequences. Phylogenetic analysis of vif, vpr and vpu sequences revealed distinct clusters for each mother-infant pair and non-transmitting mother, indicating that the sequences from same individual or linked individuals were more closer than unrelated individuals. Furthermore, we observed that HIV-1 replicates more efficiently in immature blood lymphocytes and monocytes/macrophages cells compared to mature blood cells, suggesting that increased susceptibility of neonatal cells to productive infection could result in rapid progression to AIDS in children. In addition, there was a difference in the susceptibility of neonatal and adult blood monocytes/macrophages to primary HIV-1 isolates. Taken together, these findings suggest that accessory genes vif, vpr and vpu may play an essential role in HIV-1 transmission from mother to infants and susceptibility of neonatal monocytes/macrophages may be critical for establishing productive infection. These findings may be helpful in the developing better strategies for prevention and treatment of HIV-1 infection in children.

Congestive heart failure (CHF) represents the end-stage of all heart disease. The current incidence of CHF in the US is 550,000 cases per year and is expected to increase in the future. Therapy with β-blockers, ACE inhibitors, and digoxin has been associated with a decreased risk of all-cause hospitalization and CHF-related hospitalization in randomized clinical trials. The purpose of this study was to evaluate the effect of beta-blocker, ACE inhibitor, and digoxin therapy on these outcomes and total direct medical costs among patients with CHF enrolled in a managed care plan. Neither therapies were associated with a statistically significant reduction in CHF-related hospitalizations. ACE inhibitor therapy (180 days) was associated with a significant decrease (34.7 percent, p < 0.0001) in the risk of all-cause hospitalization and lower total direct medical costs ($2135, p < 0.001) over a one year period. The results suggest increased use of ACE inhibitors is warranted.