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, Rabin, B S, & Gwaltney, J M (1997) Social ties and susceptibility to the common cold Journal of the American Medical Association, 277, 1940 1944 Cohen, S, Frank, E, Doyle, W J, Skoner, D P, Rabin, B S, & Gwaltney, J M, Jr (1998) Types of stressors that increase susceptibility to the common cold in healthy adults Health Psychology, 17(3), 214 223 Cohen, S, Tyrrell, D A, & Smith, A P (1991) Psychological stress and susceptibility to the common cold New England Journal of Medicine, 325(9), 606 612 Cohen, S, Tyrrell, D A, & Smith, A P (1993) Negative life events, perceived stress, negative affect, and susceptibility to the common cold Journal of Personality and Social Psychology, 64, 131 140 Cole, S W, Kemeny, M E, Taylor, S E, Visscher, B R.

, & Fahey, J L (1996) Accelerated course of human immunode ciency virus infection in gay men who conceal their homosexual identity Psychosomatic Medicine, 58, 1 13 Cole, S W, Kemeny, M E, Weitzman, O B, Schoen, M, & Anton, P A (1999) Socially inhibited individuals show heightened DTH response during intense social engagement Brain, Behavior, and Immunity, 13(2), 187 200 Crary, B, Hauser, S L, Borysenko, M, Kutz, I, Hoban, C, Ault, K A, Weiner, H L, et al (1983) Epinephrineinduced changes in the distribution of lymphocyte subsets in peripheral blood of humans Journal of Immunology, 131(3), 1178 181 1 Dantzer, R, Bluthe, R M, Laye, S, Bret-Dibat, J L, Parnet, P, & Kelley, K W (1998) Cytokines and sickness behavior Annals of the New York Academy of Sciences, 840, 586 590.

Davidson, L M, & Baum, A (1986) Chronic stress and posttraumatic stress disorders Journal of Consulting and Clinical Psychology, 54(3), 303 308 Davidson, R J, Coe, C C, Dolski, I, & Donzella, B (1999) Individual differences in prefrontal activation asymmetry predict natural killer cell activity at rest and in response to challenge Brain, Behavior, and Immunity, 13(2), 93 108..

5 DISCUSSION 51 Tissue-Engineered Vascular Grafts In this chapter we have described a biodegradable scaffold-based method of tissue engineering blood vessels with mechanical and functional properties that approach the requisite properties for clinical application Our constructs, grown under pulsatile conditions, possess many of the physiological and mechanical characteristics of native arteries, including burst strengths of more than 2000 mmHg provided entirely by the medial layer As our technique also emphasizes the creation of a functional endothelium, we have been the rst to implant autologous tissueengineered arteries that have remained patent and functional for up to 4 weeks Despite these exciting and promising accomplishments, many hurdles remain on the road to creating a fully functional tissue-based vascular graft The design of a functional nerve and microvascular supply in vitro to support the vascular tissue remains elusive.

TABLE 20.6 Multinomial Logistic Regression Results for the Prediction of Intense Male Violence, Common Couple Violence, and Nonviolence Intense Male Violence vs. Nonviolence 3.723*** .010 1.104*** .058*** .940*** .274 .053 .064* .063 .007 .070*** .476*** .159* .012 .105 527.999*** 28 Common Couple Violence vs. Nonviolence 2.444*** .004 .885** .027*** .661*** .097 .248*** .008 .003 .003 .086*** .377*** .036 .176** .078 Intense Male Violence vs. Common Couple Violence 1.278*** .006 .218 .031** .279 .176 .301*** .057 .066 .009 .017 .099 .195* .164 .027

Although perhaps not an essential requirement for vascular conduits, achieving their production would mark a signi cant leap forward in the eld of tissue engineering 52 Genetic Manipulation in Tissue-Engineered Blood Vessels To create functional vascular grafts that mimic the native vasculature as closely as possible, the in vitro loss of optimal cell phenotype will need to be addressed Endothelial cells in culture, for example, are known to downregulate the expression of many anticoagulant and anti-in ammatory molecules that are expressed on the native, quiescent endothelium [Wu and Thiagarajan, 1996] Unfortunately, many procoagulant and proin ammatory molecules including tissue factor, vascular cell adhesion molecule-1 (VCAM-1), and intercellular adhesion molecule-1 (ICAM-1) are instead upregulated during culture [Carlos and Harlan, 1994; Lin et al, 1997; Allen et al, 1998].

Thus it appears likely that cultured endothelial cells seeded onto the lumen of tissue-engineered blood vessels exhibit a procoagulant rather than antithrombogenic phenotype, ultimately contributing to graft failure due to thrombosis Not unexpectedly, the critical limitation in the successful.

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