The results of the ROADSTER trial demonstrate that the use of the ENROUTE Transcarotid NPS is safe and effective at preventing stroke during CAS. The overall stroke rate of 1.4% is the lowest reported to date for any prospective, multicenter clinical trial of CAS.

In situ retrograde laser fenestration is a feasible and effective option for revascularizing the LSA during emergent TEVAR. Longer follow-up is necessary to determine the durability of this technique.

CDU imaging has a high sensitivity in detecting endoleaks requiring intervention, is better at identifying the type of endoleak, and is an excellent test for graft surveillance after endovascular aneurysm repair. Compared with CT scan, CDU imaging in our experience is the preferred test on which to base an intervention for endoleak.

Ligamentum teres tears had a higher prevalence in this study than was published in the past, most probably attributable to a lower threshold used in defining a tear. The incidence is defined both using the Gray and Villar classification, as well as a new descriptive classification system that categorizes the LT according to amount of tearing.

This report reviews three categories of precursor cells present within adults. The first category of precursor cell, the epiblast-like stem cell, has the potential of forming cells from all three embryonic germ layer lineages, e.g., ectoderm, mesoderm, and endoderm. The second category of precursor cell, the germ layer lineage stem cell, consists of three separate cells. Each of the three cells is committed to form cells limited to a specific embryonic germ layer lineage. Thus the second category consists of germ layer lineage ectodermal stem cells, germ layer lineage mesodermal stem cells, and germ layer lineage endodermal stem cells. The third category of precursor cells, progenitor cells, contains a multitude of cells. These cells are committed to form specific cell and tissue types and are the immediate precursors to the differentiated cells and tissues of the adult. The three categories of precursor cells can be readily isolated from adult tissues. They can be distinguished from each other based on their size, growth in cell culture, expressed genes, cell surface markers, and potential for differentiation. This report also discusses new findings. These findings include the karyotypic analysis of germ layer lineage stem cells; the appearance of dopaminergic neurons after implantation of naive adult pluripotent stem cells into a 6-hydroxydopamine-lesioned Parkinson's model; and the use of adult stem cells as transport mechanisms for exogenous genetic material. We conclude by discussing the potential roles of adult-derived precursor cells as building blocks for tissue repair and as delivery vehicles for molecular medicine.

To support psychology's continued evolution as a profession, it is important to conceptualize roles that psychologists can play in the future and create pathways for developing and accessing them. This article considers a variety of roles that may become central to professional psychology in the future. Important opportunities appear to exist in the areas of psychological management of health and disease, serious mental illness, and public policy. Psychology faces both internal and external barriers to accessing these roles in larger numbers. Strategies related to public education, policy and advocacy, marketing, and training are recommended for overcoming them. RONALD F. LEVANT received his EdD in clinical psychology and public practice from Harvard University in 1973. He has been a clinician in independent practice, a clinical supervisor in hospital settings, a clinical and academic administrator, and an academic faculty member. He is currently dean and professor at the Center for Psychological Studies, Nova Southeastern University, and recording secretary of the American Psychological Association (APA). GEOFFREY M. REED received his PhD in clinical psychology from the University of California, Los Angeles, in 1989. He is currently assistant executive director for professional development in the APA Practice Directorate, where his work focuses on the development and implementation of programs related to expanding opportunities for professional psychology. STEPHEN A. RAGUSEA received his PsyD in clinical psychology from Baylor University in 1980. He has taught family psychology at Pennsylvania State University and Harvard Medical School. He currently works as a clinical psychologist at the Child, Adult and Family Psychological Center in State College, PA. MARIE DlCowDEN received her PhD in clinical psychology from George Washington University in 1981. She is past president of Division 22 (Rehabilitation Psychology) of APA.

This study demonstrates that SIA of iliac CTOs is feasible and can be performed safely and effectively, even in high-risk patients. Excellent patency and limb salvage rates can be achieved. In our experience, the safety and durability of SIA makes it an attractive first-line therapy for iliac artery occlusive disease.

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