Showing papers by "University of Colorado Colorado Springs published in 1999"

A dual-process model of defense against conscious and unconscious death-related thoughts: an extension of terror management theory

Abstract: Distinct defensive processes are activated by conscious and nonconscious but accessible thoughts of death. Proximal defenses, which entail suppressing death-related thoughts or pushing the problem of death into the distant future by denying one's vulnerability, are rational, threat-focused, and activated when thoughts of death are in current focal attention. Distal terror management defenses, which entail maintaining self-esteem and faith in one's cultural worldview, function to control the potential for anxiety that results from knowing that death is inevitable. These defenses are experiential, are not related to the problem of death in any semantic or logical way, and are increasingly activated as the accessibility of death-related thoughts increases, up to the point at which such thoughts enter consciousness and proximal threat-focused defenses are initiated. Experimental evidence for this analysis is presented.

Ten-year disease free survival after transperineal sonography-guided iodine-125 brachytherapy with or without 45-Gray external beam irradiation in the treatment of patients with clinically localized, low to high Gleason grade prostate carcinoma.

Abstract: BACKGROUND The authors report observed 10-year brachytherapy results in the treatment of 152 consecutive patients with clinically organ-confined prostate carcinoma. METHODS One hundred and fifty-two consecutive patients with T1-T3, low to high Gleason grade, prostate carcinoma were treated between January 1987 and June 1988 at Northwest Hospital in Seattle, Washington. Their median age was 70 years (range, 53-92 years). Of these 152 patients, 98 (64%) received an iodine-125 implant alone (Group 1), and the remaining 54 patients (36%), who were judged to have a higher risk of extraprostatic extension, also were treated with 45 gray (Gy) of external beam irradiation to the pelvis (Group 2). No patient underwent lymph node sampling, and none received androgen ablation therapy. Multivariate regression and the Mann-Whitney rank sum test were used for statistical analysis. Preoperative patient data with associated success or failure outcomes at 10 years after treatment were used for training and validating a back-propagation neural network prediction program. RESULTS The average preoperative prostate specific antigen (PSA) value, clinical stage, and Gleason grade were 11.0 ng/mL, T2, and 5, respectively. The median posttreatment follow-up was 119 months (range, 3-134 months). Overall survival 10 years after treatment was 65%. At last follow-up only 3 of the 152 patients (2%) had died of prostate carcinoma. Ninety-seven patients (64%) remained clinically and biochemically free of disease at 10 years of follow-up and had an average PSA value of 0.18 ng/mL (range, 0.01-0.5 ng/mL). In these patients a period of 42 months was required to reach the average PSA (0.5 ng/mL). The median to last PSA follow-up was 95 months (range, 3-134 months). Postoperative needle biopsies were negative in 56% of patients, positive in 15% of patients, and not available in 29% of patients. Only 6% of patients developed bone metastasis. At 10 years there was no statistically significant difference in treatment outcome between patients who received iodine-125 alone, and those who received iodine-125 with 45-Gy external beam irradiation (P = 0.08). Nevertheless, in these two groups preoperative PSA, stage, and Gleason grade were significantly different (P < 0.01). In the artificial neural network analysis, pretreatment serum PSA was the most accurate predictor of disease-free survival. CONCLUSIONS Percutaneous prostate brachytherapy is a valid and efficient option for treating patients with clinically organ-confined, low to high Gleason grade, prostate carcinoma. Observed 10-year follow-up documents serum PSA levels superior to those reported in several published external beam irradiation series, and comparable to those published in a number of published radical prostatectomy series. Cancer 1998;83:989-1001. © 1998 American Cancer Society.

Stereotypes and terror management: evidence that mortality salience enhances stereotypic thinking and preferences.

Abstract: If stereotypes function to protect people against death-related concerns, then mortality salience should increase stereotypic thinking and preferences for stereotype-confirming individuals. Study 1 demonstrated that mortality salience increased stereotyping of Germans. In Study 2, it increased participants' tendency to generate more explanations for stereotype-inconsistent than stereotype-consistent gender role behavior. In Study 3, mortality salience increased participants' liking for a stereotype-consistent African American and decreased their liking for a stereotype-inconsistent African American; control participants exhibited the opposite preference. Study 4 replicated this pattern with evaluations of stereotype-confirming or stereotype-disconfirming men and women. Study 5 showed that, among participants high in need for closure, mortality salience led to decreased liking for a stereotype-inconsistent gay man.

Spirit and community at Southwest Airlines:: An investigation of a spiritual values‐based model

Abstract: One important issue is whether spirituality in the workplace can be used only to benefit employees or can it be developed also to the advantage of organizations? The purpose of this article is to articulate a model of how spiritual values can be integrated into organizations and then assess how this model predicts organizational behavior in one company, Southwest Airlines (SWA). The application of this model provides insights into how and under what specific conditions spiritual values can positively impact both profitability and employee attitudes in organizations. Implications for both research and practice are discussed.

Leadership and Organizational Justice: Similarities and Differences across Cultures

Abstract: International management scholars and practitioners agree that managers cannot simply assume that leadership behaviors effective in one culture can be readily transferred to other cultures. This study examines the relationship of transformational leadership and leader member exchange to organizational justice and job satisfaction in five separate cultures. Results indicate that while there is consistent support for some of the proposed linkages, there are also some interesting differences across cultures. Implications for theory and future research on international business are discussed.

Conservation of resources and coping self-efficacy predicting distress following a natural disaster: A causal model analysis where the environment meets the mind

Abstract: Disaster research has increasingly examined how personal characteristics mediate emotional recovery following disaster exposure. We investigated the importance of lost resources, coping self-efficacy, and coping behavior as important variables in acute disaster reaction and medium range disaster recovery following Hurricane Andrew. One hundred and eighty participants living in southern Dade county completed the initial phase of the study (1–4 months post-hurricane), with 135 individuals completing the second wave (8–12 months post-hurricane). Results confirmed that lost resources, coping self-efficacy, and coping behavior are important in understanding psychological reactivity following a natural disaster. These variables together provided the best fitted causal model for describing psychological reactions to the hurricane over time. Results are discussed in relation to how coping self-efficacy may serve as an important intra-personal factor that mediates how lost resources are managed and how ef...

Coping Self‐Efficacy as a Mediator of Distress Following a Natural Disaster

Abstract: Social-cognitive theory and conservation-of-resources theory were utilized to understand individual differences in psychological response to natural disaster. Coping self-efficacy, lost resources, social support, and optimism were assessed along with demographic variables in predicting distress following Hurricane Opal. Participants included 67 residents of Okaloosa County, Florida. Multiple regression analyses indicated that coping self-efficacy was the strongest predictor of general distress and trauma-related distress. Loss of resources and gender were also important predictors of general distress. Path analyses demonstrated that lost resources directly influenced general distress, social support, optimism, and coping self-efficacy. These analyses also indicated that coping self-efficacy perceptions mediated the relationships between loss of resources and trauma-related distress, social support and both trauma and general distress, and optimism and both types of distress. Theoretical implications are discussed.

Chlamydia Transmission: Concurrency, Reproduction Number, and the Epidemic Trajectory

Abstract: To identify factors that influence individual and group transmission of Chlamydia, the authors conducted community-wide contact tracing of chlamydia cases in Colorado Springs, Colorado, from mid-1996 to mid-1997. Case patients identified persons with whom they had had contact during the 6 months preceding diagnosis; contacts were actively sought and offered DNA amplification testing. Sexual contact networks were used to identify "source cases" and "spread cases," permitting estimation of the basic reproduction number (R0) for individuals and groups. Network and epidemiologic factors influencing R0 were assessed using univariate and multivariate procedures. Of 1,309 case patients, 1,131 (86%) were interviewed, and 2,409 contacts were identified. The 1,131 interviewed cases yielded 623.9 computed spread cases, for an overall R0 of 0.55. Few subgroups analyzed yielded a mean R0 exceeding unity-an observation in keeping with routine surveillance information which suggests that chlamydia incidence is declining in Colorado Springs. Concurrency, a network measure of simultaneous partnerships, was the most powerful predictor of transmission. Direct estimation of basic reproduction numbers for chlamydia using contact tracing techniques is feasible and can produce useful data with which to prioritize control efforts, evaluate interventions, and gauge the place of chlamydia on the epidemic continuum.

Death, sex, love, and neuroticism: why is sex such a problem?

Abstract: Terror management theory posits that sex is a ubiquitous human problem because the creaturely aspects of sex make apparent our animal nature, which reminds us of our vulnerability and mortality. People minimize this threat by investing in the symbolic meaning offered by the cultural worldview. Because people high in neuroticism have difficulty finding or sustaining meaning, sex is a particular problem for them. In Study 1, mortality salience caused high-neuroticism participants to find the physical aspects of sex less appealing. Study 2 revealed that for such individuals thoughts of physical sex increase the accessibility of death-related thoughts. This finding was replicated in Study 3, which also showed that providing meaning by associating sex with love reduces the accessibility of death-related thoughts in response to thoughts of physical sex. These findings provide insight into why people high in neuroticism have conflicting thoughts about sexuality and why sexuality is so often regulated and romanticized.

Open versus arthroscopic ankle arthrodesis: a comparative study.

Abstract: A retrospective review was undertaken for 36 patients who underwent ankle arthrodesis. Nineteen patients underwent an arthroscopic ankle arthrodesis, and 17 patients underwent an open arthrodesis. Only patients with limited angular deformities were suitable candidates for an arthroscopic arthrodesis. The open arthrodesis group inclusion criteria were defined by the maximum coronal and sagittal plane deformity in the arthroscopic group. Perioperative parameters were compared and analyzed.Arthroscopic ankle arthrodesis yielded comparable fusion rates to open ankle arthrodesis, with significantly less morbidity, shorter operative times, shorter tourniquet times, less blood loss, and shorter hospital stays. Arthroscopic ankle arthrodesis is a valid alternative to traditional open arthrodesis of the ankle for selected patients with ankle arthritis.

Communication system with fast control traffic

Abstract: A method and system for conducting rapid control traffic in a time division multiple access (TDMA) communication system comprises a base station communicating with a plurality of user stations in assigned time slots of a time frame. For bearer traffic, time slots are assigned to particular user stations for an extended duration. In unassigned time slots, the base station transmits a general polling message indicating availability of the time slot. A user station desiring to hand off communication from one base station to another uses multiple available time slots at the target base station for exchanging control traffic messages with the target base station. The next available time slot is indicated by a slot pointer in the header of each general polling message to facilitate rapid exchange of control traffic messages. During handover, the user station may establish a new link with the target base station before relinquishing the existing communication link with the old base station.

Mutations of c-kit JM domain are found in a minority of human gastrointestinal stromal tumors.

Abstract: The c-kit gene encodes a transmembrane receptor kinase (KIT) which is expressed in the majority of human gastrointestinal stromal tumors (GISTs), a subtype of gastrointestinal mesenchymal neoplasms. A previous study identified mutations in the juxtamembrane (JM) domain of c-kit in five of six GISTs (Science 279: 577, 1998). To better define the frequency and spectrum of c-kit gene mutations in mesenchymal neoplasms of the GI tract that had been characterized for KIT protein expression, we examined archived tissue samples for mutations in the JM domain by PCR amplification and DNA sequencing. c-kit JM domain mutations were found in nine of 56 mesenchymal tumors (46 GISTs, eight leiomyomas, two leiomyosarcomas) and occurred exclusively in GISTs (21%). Seven of the nine mutations consisted of intragenic deletions of one to 19 codons. There was one insertion mutation that added 12 codons and one missense mutation (Val560Asp). None of the mutations disrupted the downstream reading frame of the gene. The single missense mutation (Val560Asp) is very similar to the only other missense mutation reported in GISTs (Val599Asp). Of the 46 GISTs, 43 were strongly positive for KIT protein expression and negative for diffuse expression of desmin. Neither KIT expression nor gene mutations were found in gastrointestinal leiomyomas or leiomyosarcomas. We conclude that mutation of the c-kit JM domain does not occur in gastrointestinal mesenchymal neoplasms with well developed-smooth muscle differentiation, and is restricted to GISTs. However, since these mutations are only found in a minority of GISTs, further investigation into the mechanisms of c-kit gene activation in this group of neoplasms is warranted.

If Looks Could Sell: Moderation and Mediation of the Attractiveness Effect on Salesperson Performance

Abstract: This study empirically investigates the effect of perceived salesperson attractiveness on actual salesperson performance, focusing first on the moderating effect of length of the buyer - salesperson relationship and then on the mediating effects of perceived communication ability, likeability, expertise, and trustworthiness on the attractiveness effect A sample of 339 physicians was surveyed to obtain their evaluations of pharmaceutical company sales representatives’ attractiveness as well as their perceptions of the mediators Actual brand-by-brand market share data of the subject physicians’ prescriptions was collected as the dependent variable The results showed that perceived salesperson attractiveness had a significant positive effect on salesperson performance, but the effect was found to diminish as the length of the salesperson-customer relationship increased Three of the four proposed mediators were found to partially mediate the effect of attractiveness on sales performance

Network structural dynamics and infectious disease propagation.

Abstract: We aimed to relate dynamic changes in risk-network (sex and/or injecting drug) structure to observe STD/HIV transmission. We analysed macro- and micro-structural elements in 2 heterosexual networks, augmented by ethnographic observations. In a Colorado cohort of injecting drug users (n = 595), measures of subgroup formation and of density of activity show decrease of network cohesion over time; only one HIV transmission was observed in 3 years. In a group of adolescent heterosexuals in Georgia (n = 99), the reverse process (increase in structural cohesion) was associated with efficient syphilis transmission: 10 cases were observed. Changes in personal risk behaviours over time were modest. STD/HIV transmission patterns were associated with intensification or diminution of network cohesion. Network and ethnographic data suggest that enhanced connectivity facilitates transmission while segmentation impedes it, suggesting opportunities for interventions. These data also emphasize the need to re-evaluate purely behavioural explanations of STD/HIV transmission.

Creativity and terror management: Evidence that creative activity increases guilt and social projection following mortality salience

Abstract: The present research, based on the ideas of O. Rank (1932/1989) and E. Becker (1973), was designed to test the hypotheses that engaging in creative expression after personal mortality has been made salient will lead to both increased feelings of guilt and a desire to enhance social connectedness. In Study 1, the authors used a 2 (mortality salience vs. control) X 2 (creative pretask vs. noncreative pretask) between-subjects factorial design and measured self-report guilt. Results indicated that participants who were reminded of their death and completed the creative pretask expressed more guilt than all other participants. In Study 2 this effect was replicated with a modification of the creativity treatment. In Study 3, the same conditions leading to increased guilt also led mortality-salient creative-task participants to express higher levels of social projection, an index of perceived social connectedness. Implications of these results for creativity, the interpersonal nature of guilt, and terror management theory are briefly discussed.

Inverse eigenvalue problems on directed graphs

Abstract: The differential operators iD and −D2 − p are constructed on certain finite directed weighted graphs. Two types of inverse spectral problems are considered. First, information about the graph weights and boundary conditions is extracted from the spectrum of −D2. Second, the compactness of isospectral sets for −D2 − p is established by computation of the residues of the zeta function.

Once-daily fexofenadine HCl improves quality of life and reduces work and activity impairment in patients with seasonal allergic rhinitis.

Abstract: Background Fexofenadine HCl (Allegra, Telfast) is approved in the US for twice-daily dosing for treatment of seasonal allergic rhinitis. Objective To determine the effect of once-daily fexofenadine HCl on patient-reported quality of life and impairment at work, in the classroom, and in daily activities due to seasonal allergic rhinitis symptoms. Methods This placebo-controlled, double-blind, randomized study included patients aged 12 to 65 years with moderate-to-severe seasonal allergic rhinitis symptoms. Outcomes were assessed using self-administered questionnaires at baseline, week 1, and week 2. Outcome measures included change from baseline in: overall Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) score; individual RQLQ domain scores; work, classroom, and daily activity impairment measured using the Work Productivity and Activity Impairment (WPAI) instrument; and ratings in 3 generic health domains from the SF-36 Health Survey. Results Intent to treat efficacy analyses included 845 patients from 40 sites. Patients receiving either 120 or 180 mg QD fexofenadine HCl reported significantly greater improvement ( P ≥ .006) in overall RQLQ score than patients receiving placebo. Similarly, both fexofenadine treatment groups reported significantly greater reductions in overall work impairment and daily activity impairment compared with the placebo group ( P ≥ .004). There was a trend for improvement in classroom impairment with fexofenadine treatment, although differences from placebo were not statistically significant. Generic health measures demonstrated fexofenadine HCl treatment had a positive effect on general health. Conclusion Once-daily fexofenadine HCl, 120 or 180 mg, significantly improved patient-reported quality of life and reduced performance impairment in work and daily activities due to seasonal allergic rhinitis symptoms compared with placebo.

Delta-sigma oversampled ultrasound beamformer with dynamic delays

Abstract: The principles of oversampling are exploited in a simple beamforming architecture using a single bit delta-sigma (/spl Delta/C) analog to digital converter (A/D) on every channel. The high sampling rate required for the single bit A/D provides adequate delay accuracy for high quality beamforming using elementary sample manipulations. Images produced with this beamformer exhibit significant artifacts directly related to dynamic focusing. However, a simple digital recording technique following delays permits dynamically focused beamforming without degrading image quality. The simplicity of this beamformer compared to conventional methods may facilitate very large channel count or low power beamformers suitable for 1.5-D arrays or portable scanners.

Racing cyclist power requirements in the 4000-m individual and team pursuits.

Abstract: BROKER, J. P., C. R. KYLE, and E. R. BURKE. Racing cyclist power requirements in the 4000-m individual and team pursuits. Med. Sci. Sports Exerc., Vol. 31, No. 11, pp. 1677–1685, 1999.Purpose:The purpose of this paper is: 1) to present field test data describing the power requirements of internation

Pioneering Experiences in Distance Learning: Lessons Learned

Abstract: This article describes the lessons learned from teaching human resource management via Web-based instruction. Three areas of recommendation are addressed: (a) communication logistics, (b) knowledge sharing, and (c) the benefits of conducting a pilot program. Although the specific content for this course was human resource management, the same principles for creating a valuable learning experience are applicable to any content taught via the Internet.

Stress-buffering factors related to adolescent coping: a path analysis.

Abstract: To uncover those factors that buffer the impact of stressful negative experiences on adolescent adjustment, a theoretical model of adolescent stress and coping, with social support and social problem solving proposed as moderators, was investigated using path analysis. The study was conducted with 122 ninth-and tenth-grade nonreferred high school students. Using the LISREL statistical package (Joreskog & Sorbom, 1986), it was found that a recursive loop leading from stress outcomes back to negative stressors did not allow for a successful solution to the model. However, the effects of stressful events on adjustment were mediated by coping resources, which included a combination of problem-solving abilities and social support. Overall, the findings replicated previous investigations that have demonstrated direct relationships among stressful life events, social support, problem solving, and adolescent adjustment. While a successful fit to the theoretical model was not attained, it was concluded that a refined model may provide a more acceptable solution.

Caller identification delivery in a wireless local loop or other systems

Abstract: A method of communicating FSK-modulated Caller ID signals through a network incompatible to the transmission of these signals is presented. A first network component couples between the incompatible network and a Central Office, and a second network component couples between the incompatible network and the telephone. In one embodiment, the call flow proceeds until the second network component would ring the line of the called party. The second network component seizes the line but does not apply a ringing signal. The second network component continues with the call flow as though the second network component had entered the silent interval after the first ring cycle at the called party. Subsequently, the CO transmits the FSK Caller ID information to the first network component which detects the FSK transmission and converts it into an out-of-band message and transmits the out-of-band message over the incompatible network to the second network component. Upon receipt of this out-of-band message from the first network component, the second network component converts it back into an in-band FSK Caller ID message, and delivers the FSK message during the first silent interval. In another embodiment, the first network component, without sending signals to the second network component, initiates a call flow to the CO as though the second network component were entering the silent interval. Subsequently, the CO transmits the FSK Caller ID information to the first network component which detects the FSK transmission and converts it into an out-of-band message for transmission to the second network.

Psychometric properties of a Hurricane Coping Self-Efficacy measure

Abstract: This brief report describes the psychometric properties of an instrument designed to measure Hurricane Coping Self-Efficacy (HCSE). Survivors of Hurricane Andrew (n = 165) and Hurricane Opal (n = 63) completed the HCSE and assessments of optimism, social support, distress, and resource loss. Principal components factor analyses revealed a unidimensional structure for the HCSE. Internal consistency of the HCSE was strong. In both samples, HCSE was positively associated with optimism and social support, but negatively associated with general psychological distress, trauma related distress, and resource loss. Finally, hierarchical regression analyses demonstrated that the HCSE explained a significant amount of experimental variance for intrusive thoughts and avoidance after controlling for social support, lost resources, and optimism.

Through the eyes of a child: EMDR with children.

Abstract: Eye movement desensitization and reprocessing (EMDR) has helped thousands of adults haunted by traumatic events. But what about children? Millions of children witness violence in the home and in the streets. Many others are traumatized by accidents, natural disasters, abuse, and neglect. This book shows that EMDR can be successfully applied to children, which can ensure their mental health, growth, and development. Through the Eyes of a Child demystifies the application of EMDR for children, from the first session with the parents to later sessions with children at all developmental stages. The adult protocol is modified so that it can be applied to children as young as two years old (and possibly younger). A system of classification of childhood trauma that allows therapists to predict a child's response to EMDR is presented. Myriad cases illustrate the use of EMDR with various traumas. Many examples of simple traumas are presented, including automobile accidents, lightning strikes, bereavement, and specific phobias such as a fear of animals. In addition, cases illustrate success with complex traumas, where aspects of the trauma are ongoing and EMDR becomes part of several possible therapeutic interventions. EMDR is also discussed as an intervention for children who have problems that are not caused by trauma. Case illustrations show how EMDR can be used with children with ADHD, anxiety, depressive, or reactive attachment disorders, as well as learning difficulties and somatoform disorders. With its compelling, frank style, Through the Eyes of a Child will appeal to all who are interested in applying this revolutionary new therapy with children.

A Comparison of Computerized and Standard Versions of the Wisconsin Card Sorting Test

Abstract: The manual version of the Wisconsin Card Sorting Test (WCST) is the most frequently used neuropsychological instrument for differentiating normal from populations with frontal-lobe impairments. A number of computerized versions have become available, and their ability to accurately detect frontal-lobe dysfunction is based on the assumption of equivalence with the standard manual version. Accordingly, comparisons of the distribution properties of central tendency, variability, and shape between the manual version with four computerized versions of the WCST were performed (n = 22 per condition). None of the computerized versions were found to be equivalent to the manual version on all assessment measures. Given the discrepancies between the manual and computerized versions, it is concluded that the norms provided for the standard manual presentation method should not be used for the computerized versions, and for continued use of the computerized versions, new norms for computer versions need to be establis...

Efficient error control for wireless packet transmissions

Abstract: Methods and mechanisms for error control in a communication system where a group of more than one message is transmitted by one entity of the communication system, i.e., a transmitting entity, to a second entity in the communication system, i.e., a receiving entity. A transmitting entity transmits a group of more than one message to a receiving entity. The receiving entity thereafter generates a responsive message (400) to transmit in response to the transmission of the group of messages. The responsive message indicates each message in the group of messages that was successfully transmitted to the receiving entity. The responsive message is also indicative of each message in the group of messages that was not successfully transmitted. After generating the responsive message, the receiving entity transmits it to the transmitting entity. The transmitting entity, upon receiving the responsive message, determines what messages in the group of messages, if any, were successfully transmitted. The transmitting entity does not retransmit any of these successfully transmitted messages to the receiving entity.

Simultaneous anterior and posterior hemivertebra excision.

Abstract: The operative treatment of congenital scoliosis secondary to hemivertebra may involve in situ spinal epiphysiodesis, in situ fusion, or hemivertebra excision. The technique described in this paper, simultaneous anterior and posterior resection of the hemivertebra and correction of deformity with posterior instrumentation, has evolved from many different surgical methods used by the senior author in the past. This series of 11 patients describes the resection technique, degree of deformity correction, and complications encountered with this approach to a very difficult clinical problem. The preoperative mean age of the patients at the time of surgery was 18 months (range, 1 month-30 months), and preoperative curves averaged 47 degrees (range, 30 degrees-80 degrees). Immediate postoperative curves averaged 13 degrees (range, 1 degree-40 degrees), and at a mean of 28 months followup the curves averaged 14 degrees (range, 1 degree-47 degrees). One patient experienced transient left leg weakness. There were no long term neurologic injuries and no other surgical complications.

Ultrasound-Guided Central Venous Access

Abstract: Hypothesis Real-time ultrasound guidance should increase the success rate and lower the complication rate of central venous access in patients with relative contraindications to having the procedure performed. Design Prospective case series. Setting A community-based tertiary care hospital. Patients Fifty-two patients were studied. Relative risks to central venous catheter insertion included (1) thrombosis or stenosis of central veins, (2) inherent or acquired anticoagulation abnormalities, (3) inability to assume a supine position, (4) hypovolemia, (5) obesity or altered anatomy, and (6) severe respiratory compromise. Interventions Real-time ultrasound evaluation of the proposed vein to be cannulated, followed by real-time percutaneous central vein access. Main Outcome Measures Successful cannulation of a central vein. Results All attempts at central vein cannulation were successful. No bleeding complications occurred. One pneumothorax occurred in an obese patient. Conclusions Ultrasound-guided central venous access is a helpful technique to gain venous access in difficult cases. Surgeons who perform central venous access procedures should become acquainted with the techniques involved. The techniques should be incorporated into currently developing ultrasound instruction courses for surgeons.