bluuebunny/crossref_metadata_2025 huggingface dataset:
Release of proinflammatory mediators and expression of proinflammatory adhesion molecules by endothelial progenitor cells
Authors: Zhang Yanmin , Ingram David A. , Murphy Michael P. , Saadatzadeh M. Reza , Mead Laura E. , Prater Daniel N. , Rehman Jalees
Published: February 2009

Cell therapy with endothelial progenitor cells (EPCs) is an emerging therapeutic option to promote angiogenesis or endothelial repair. Although the release of angiogenic paracrine factors is known to contribute to their therapeutic effect, little is known about their release of proinflammatory factors and expression of proinflammatory adhesion molecules. “Early” EPCs and “late” EPCs were isolated from human peripheral blood and their release of chemokines and thromboinflammatory mediators as well as their expression of the proinflammatory adhesion molecules was assessed at baseline and with stimulation. The effect of simvastatin on monocyte chemoattractant protein-1 (MCP-1) secretion by late EPCs from patients with vascular disease was also evaluated. All groups of EPCs released chemokines and thromboinflammatory mediators. Early EPCs primarily released thromboinflammatory mediators such as tissue factor (0.5 ± 0.1 ng/million cells, P < 0.05), whereas adult late EPCs primarily released chemokines such as MCP-1 (287 ± 98 ng/million cells, P < 0.05). Stimulation with tumor necrosis factor (TNF)-α augmented the expression of proinflammatory adhesion molecules and paracrine factors by all EPC subtypes. The release of MCP-1 by late EPCs was markedly reduced by simvastatin treatment of the cells. All EPC subtypes expressed proinflammatory paracrine factors and adhesion molecules involved in atherosclerosis. Future clinical studies should therefore not only assess the efficacy of EPCs but also monitor inflammatory activation following EPC transplantation in patients. Pharmacological modulation of EPCs before and after transplantation may represent a novel approach to improve their safety.
Sarcomere length dependence of power output is increased after PKA treatment in rat cardiac myocytes
Authors: Hanft Laurin M. , McDonald Kerry S.
Published: February 2009

The Frank-Starling relationship of the heart yields increased stroke volume with greater end-diastolic volume, and this relationship is steeper after β-adrenergic stimulation. The underlying basis for the Frank-Starling mechanism involves length-dependent changes in both Ca2+ sensitivity of myofibrillar force and power output. In this study, we tested the hypothesis that PKA-induced phosphorylation of myofibrillar proteins would increase the length dependence of myofibrillar power output, which would provide a myofibrillar basis to, in part, explain the steeper Frank-Starling relations after β-adrenergic stimulation. For these experiments, adult rat left ventricles were mechanically disrupted, permeabilized cardiac myocyte preparations were attached between a force transducer and position motor, and the length dependence of loaded shortening and power output were measured before and after treatment with PKA. PKA increased the phosphorylation of myosin binding protein C and cardiac troponin I, as assessed by autoradiography. In terms of myocyte mechanics, PKA decreased the Ca2+ sensitivity of force and increased loaded shortening and power output at all relative loads when the myocyte preparations were at long sarcomere length (∼2.30 μm). PKA had less of an effect on loaded shortening and power output at short sarcomere length (∼2.0 μm). These changes resulted in a greater length dependence of myocyte power output after PKA treatment; peak normalized power output increased ∼20% with length before PKA and ∼40% after PKA. These results suggest that PKA-induced phosphorylation of myofibrillar proteins explains, in part, the steeper ventricular function curves (i.e., Frank-Starling relationship) after β-adrenergic stimulation of the left ventricle.
Time-frequency analysis of heart rate variability reveals cardiolocomotor coupling during dynamic cycling exercise in humans
Authors: Blain Grégory , Meste Olivier , Blain Alexandre , Bermon Stéphane
Published: February 2009

To test the hypothesis that cycling exercise modulates heart rate variability (HRV), we applied a short-time Fourier transform on the electrocardiogram of subjects performing a maximal graded cycling test. A pedaling frequency component (PFC) in HRV was continuously observed over the time course of the exercise test and extracted from R-R interval series obtained from 15 healthy subjects with a heterogeneous physical fitness, exercising at three different pedaling frequency ( n = 5): 70, 80, and 90 rpm. From 30 to 50% of the maximal power output (Pmax), in the 90 rpm group, spectral aliasing caused PFC to overlap with the respiratory sinus arrhythmia (RSA) band, significantly overestimating the PFC amplitude ( APFC). In the meantime, APFC did not increase significantly from its minimal values in the 70 rpm (∼1.26 ms) and 80 rpm (∼1.20 ms) groups. Then, from 60 to 100% maximal power output (Pmax), workload increase caused a significant ∼2.8-, ∼3.3-, and ∼3.4-fold increase in APFC in the 70, 80, and 90 rpm groups, respectively, with no significant difference between groups. At peak exercise, APFC accounted for ∼43, ∼39, and ∼49% of the total HRV in the 70, 80, and 90 rpm groups, respectively. Our findings indicate that cycling continuously modulates the cardiac chronotropic response to exercise, inducing a new component in HRV, and that workload increase during intense exercise further accentuates this cardiolocomotor coupling. Moreover, because PFC and RSA overlapped at low workloads, methodological care should be taken in future studies aiming to quantify RSA as an index of parasympathetic activity.
Modulation of actin isoform expression before the transition from experimental compensated pressure-overload cardiac hypertrophy to decompensation
Authors: Berni Roberta , Savi Monia , Bocchi Leonardo , Delucchi Francesca , Musso Ezio , Chaponnier Christine , Gabbiani Giulio , Clement Sophie , Stilli Donatella
Published: February 2009

In a rat model of long-lasting pressure-overload hypertrophy, we investigated whether changes in the relative expression of myocardial actin isoforms are among the early signs of ventricular mechanical dysfunction before the transition toward decompensation. Forty-four rats with infrarenal aortic banding (AC rats) were studied. Hemodynamic parameters were measured 1 mo (AC1 group; n = 20) or 2 mo (AC2; n = 24) after aortic ligature. Then subgroups of AC1 and AC2 left ventricles (LV) were used to evaluate 1) LV anatomy and fibrosis (morphometry), 2) expression levels (immunoblotting) and spatial distribution (immunohistochemistry) of alpha-skeletal actin (α-SKA), alpha-cardiac actin (α-CA), and alpha-smooth muscle actin (α-SMA), and 3) cell mechanics and calcium transients in enzimatically isolated myocytes. Although the two AC groups exhibited a comparable degree of hypertrophy (+30% in LV mass; +20% in myocyte surface) and a similar increase in the amount of fibrosis compared with control animals (C group; n = 22), a worsening of LV mechanical performance was observed only in AC2 rats at both organ and cellular levels. Conversely, AC1 rats exhibited enhanced LV contractility and preserved cellular contractile behavior associated with increased calcium transients. Alpha-SKA expression was upregulated (+60%) in AC1. In AC2 ventricles, prolonged hypertension also induced a significant increase in α-SMA expression, mainly at the level of arterial vessels. No significant differences among groups were observed in α-CA expression. Our findings suggest that α-SKA expression regulation and wall remodeling of coronary arterioles participate in the development of impaired kinetics of contraction and relaxation in prolonged hypertension before the occurrence of marked histopathologic changes.
Nitric oxide attenuates the expression of natriuretic peptide receptor C and associated adenylyl cyclase signaling in aortic vascular smooth muscle cells: role of MAPK
Authors: Arejian Maria , Li Yuan , Anand-Srivastava Madhu B.
Published: February 2009

We have earlier shown that the treatment of A10 vascular smooth muscle cells with S-nitroso- N-acetyl-penicillamine (SNAP); nitric oxide donor (NO) for 24 h decreased the expression of natriuretic peptide receptor C (NPR-C) and adenylyl cyclase signaling. The present study was undertaken to examine the implication of different signaling mechanisms in a NO-induced response. The treatment of A10 vascular smooth muscle cells with SNAP decreased the expression of NPR-C and Giα proteins in a time-dependent manner. The expression of Giα proteins was decreased at 6 h, whereas the expression of NPR-C was attenuated at 2 h. The NPR-C-mediated inhibition of adenylyl cyclase was attenuated (∼50%) after 2 h of treatment and was completely abolished after 6 h of treatment. The decreased expression of NPR-C and NPR-C-mediated attenuation of adenylyl cyclase after 2 h of treatment was reversed to control levels by PD-98059, a MEK inhibitor. SNAP also modulated the ERK1/2 phosphorylation in a time-dependent manner; an increase was observed up to 2 h, and, thereafter, the ERK1/2 phosphorylation was decreased. On the other hand, 1H-[1,2,4]oxadiazolo[4,3-a]quinoxalin-1-one and KT-5823 inhibitor of soluble guanylyl cyclase and protein kinase G, respectively, and Mn(III)tetrakis(4-benzoic acid)porphyrin, a scavenger of peroxynitrite, were unable to restore the SNAP-induced decreased expression of NPR-C protein and increased ERK1/2 phosphorylation to control levels. However, the decreased levels of phosphorylated ERK1/2 and Giα proteins were restored to control levels by 8-bromo-cAMP. These results indicate that a temporal relationship follows between a NO-induced decreased expression of NPR-C and Giα proteins. The decreased expression of NPR-C is mediated through cGMP-independent but MAPK-dependent pathway, whereas NO-induced decreased levels of cAMP may contribute to the decreased activation of MAPK and thereby decreased the expression of Giα proteins.
Kinetics of the translocation and phosphorylation of αB-crystallin in mouse heart mitochondria during ex vivo ischemia
Authors: Whittaker R. , Glassy M. S. , Gude N. , Sussman M. A. , Gottlieb R. A. , Glembotski C. C.
Published: February 2009

αB-crystallin (αBC) is a small heat shock protein expressed at high levels in the myocardium where it protects from ischemia-reperfusion damage. Ischemia-reperfusion activates p38 MAP kinase, leading to the phosphorylation of αBC on serine 59 (P-αBC-S59), enhancing its ability to protect myocardial cells from damage. In the heart, ischemia-reperfusion also causes the translocation of αBC from the cytosol to other cellular locations, one of which was recently shown to be mitochondria. However, it is not known whether αBC translocates to mitochondria during ischemia-reperfusion, nor is it known whether αBC phosphorylation takes place before or after translocation. In the present study, analyses of mitochondrial fractions isolated from mouse hearts subjected to various times of ex vivo ischemia-reperfusion showed that αBC translocation to mitochondria was maximal after 20 min of ischemia and then declined steadily during reperfusion. Phosphorylation of mitochondrial αBC was maximal after 30 min of ischemia, suggesting that at least in part it occurred after αBC association with mitochondria. Consistent with this was the finding that translocation of activated p38 to mitochondria was maximal after only 10 min of ischemia. The overexpression of αBC-AAE, which mimics αBC phosphorylated on serine 59, has been shown to stabilize mitochondrial membrane potential and to inhibit apoptosis. In the present study, infection of neonatal rat cardiac myocytes with adenovirus-encoded αBC-AAE decreased peroxide-induced mitochondrial cytochrome c release. These results suggest that during ischemia αBC translocates to mitochondria, where it is phosphorylated and contributes to modulating mitochondrial damage upon reperfusion.
Th2 cytokine-induced upregulation of 11β-hydroxysteroid dehydrogenase-1 facilitates glucocorticoid suppression of proasthmatic airway smooth muscle function
Authors: Hu Aihua , Fatma Sumbul , Cao Jing , Grunstein Judith S. , Nino Gustavo , Grumbach Yael , Grunstein Michael M.
Published: February 2009

The anti-inflammatory actions of endogenous glucocorticoids (GCs) are regulated by the activities of the GC-activating and -inactivating enzymes, 11β-hydroxysteroid dehydrogenase (11β-HSD)-1 and 11β-HSD2, respectively, that catalyze the interconversion of the inert GC, cortisone, and its bioactive derivative, cortisol. Proinflammatory cytokines regulate 11β-HSD1 expression in various cell types and thereby modulate the bioavailability of cortisol to the glucocorticoid receptor (GR). Since endogenous GCs reportedly attenuate the airway asthmatic response to allergen exposure, we investigated whether airway smooth muscle (ASM) exhibits cytokine-induced changes in 11β-HSD1 expression that enable the ASM to regulate its own bioavailability of GC and, accordingly, the protective effect of GR signaling on airway function under proasthmatic conditions. Human ASM cells exposed to the primary proasthmatic T helper type 2 (Th2) cytokine, IL-13, exhibited upregulated expression of 11β-HSD1, an effect that was attributed to activation of the transcription factor, AP-1, coupled to MAPK signaling via the ERK1/2 and JNK pathways. The induction of 11β-HSD1 expression and its oxoreductase activity by IL-13 (also IL-4) served to amplify the conversion of cortisone to cortisol by the cytokine-exposed ASM and, hence, heighten GR-mediated transcriptional activation. Extended studies demonstrated that this amplified 11β-HSD1-dependent GC activation enabled physiologically relevant concentrations of cortisone to exert enhanced protection of ASM tissues from the proasthmatic effects of IL-13 on ASM constrictor and relaxation responsiveness. Collectively, these novel findings identify a Th2 cytokine-driven homeostatic feedback mechanism in ASM that enhances its responsiveness to endogenous GCs by upregulating 11β-HSD1 activity, thereby curtailing the adverse effects of the proasthmatic cytokine on airway function.
IL-17F-induced IL-11 release in bronchial epithelial cells via MSK1-CREB pathway
Authors: Kawaguchi Mio , Fujita Junichi , Kokubu Fumio , Huang Shau-Ku , Homma Tetsuya , Matsukura Satoshi , Adachi Mitsuru , Hizawa Nobuyuki
Published: February 2009

IL-17F is involved in asthma, but its biological function and signaling pathway have not been fully elucidated. IL-11 is clearly expressed in the airway of patients with allergic airway diseases such as asthma and plays an important role in airway remodeling and inflammation. Therefore, we investigated the expression of IL-11 by IL-17F in bronchial epithelial cells. Bronchial epithelial cells were cultured in the presence or absence of IL-17F and/or Th2 cytokines (IL-4 and IL-13) or various kinase inhibitors to analyze the expression of IL-11. Next, activation of mitogen- and stress-activated protein kinase (MSK) 1 by IL-17F was investigated. Moreover, the effect of short interfering RNAs (siRNAs) targeting MSK1 and cAMP response element binding protein (CREB) on IL-17F-induced IL-11 expression was investigated. IL-17F induced IL-11 expression, whereas the costimulation with IL-4 and IL-13 augmented this effect even further. MEK inhibitors PD-98059, U0126, and Raf1 kinase inhibitor I, significantly inhibited IL-11 production, whereas overexpression of a Raf1 dominant-negative mutant inhibited its expression. IL-17F clearly phosphorylated MSK1, whereas PD-98059 inhibited the phosphorylation of IL-17F-induced MSK1. Both MSK1 inhibitors Ro-31-8220 and H89 significantly blocked IL-11 expression. Moreover, transfection of the cells with siRNAs targeting MSK1 inhibited activation of CREB, and the siRNAs targeting MSK1 and CREB blocked expression of IL-11. These data suggest that IL-17F may be involved in airway inflammation and remodeling via the induction of IL-11, and RafI-MEK1/2-ERK1/2-MSK1-CREB is identified as a novel signaling pathway participating in this process. Therefore, the IL-17F/IL-11 axis may be a valuable therapeutic target for asthma.
Odor Perception and Olfactory Bulb Plasticity in Adult Mammals
Authors: Mandairon Nathalie , Linster Christiane
Published: March 2009

The adult mammalian olfactory bulb (OB) is unique in that olfactory sensory neurons project directly, without prior thalamic relay, to the OB. This review discusses evidence for the direct involvement of the OB in odor perception and its modulation by olfactory experience. We first discuss recent data showing that the OB exhibits a high level of plasticity in response to olfactory experience including exposure, enrichment, and learning. We next review evidence showing that, in return, experimental manipulation of the OB neural network changes how odorants are processed and perceived. We finally review in more detail a few experiments showing a tight correlation between the modulation of OB neural processing and odor perception. We argue that the OB has evolved to be an adapting network, allowing animals to adjust olfactory computations to changing environments.
NKT Cell Subsets Mediate Differential Proatherogenic Effects in ApoE
−/−
Mice
Authors: To Kelly , Agrotis Alex , Besra Gurdyal , Bobik Alex , Toh Ban-Hock
Published: February 2009

Objective—

NKT cells promote atherogenesis, but the subtypes responsible have not been identified. We investigated 2 major NKT cell subtypes (CD4
+
and DN NKT) in ApoE
−/−
mice rendered NKT cell–deficient by day-3 neonatal thymectomy (3dTx).

Methods and Results—

Atherosclerosis development was studied in thymectomized ApoE
−/−
mice fed a high-fat diet with/without adoptively transferred NKT cells. We demonstrate NKT cell deficiency in thymectomized mice and markedly smaller atherosclerotic lesions. The reduction in lesion size was reversed by adoptive transfer of liver-derived NKT cells. Adoptive transfer of CD4
+
, but not DN NKT cells, into 3dTx ApoE
−/−
mice increased lesion size 2.5-fold. The differential effects were not attributable to differences in homing to developing atherosclerotic lesions. DN NKT cells expressed at least 3-fold higher levels of inhibitory Ly49 receptors (Ly49A, Ly49C/I, and Ly49G2) than CD4
+
NKT cells, and lesions expressed large amounts of their MHC class I ligand. In vitro these inhibitory receptors initiated greater effects in DN NKT cells. Culture of each NKT cell subset with TAP-deficient (MHC class I-deficient) dendritic cells and α-GalCer led to secretion of similar amounts of proatherogenic cytokines IL-2, IFN-γ, and TNF but, when cultured with MHC class I–positive dendritic cells, CD4
+
NKT cells secreted more of these cytokines.

Conclusions—

CD4
+
NKT cells are responsible for the proatherogenic activity of NKT cells. Expression of inhibitory Ly49 receptors by the subtypes appears responsible for regulating their secretion of proatherogenic cytokines and their differential proatherogenic effects.
HIF-1α Overexpression and Experimental Murine Atherosclerosis
Authors: Ben-Shoshan Jeremy , Afek Arnon , Maysel-Auslender Sofia , Barzelay Aya , Rubinstein Ardon , Keren Gad , George Jacob
Published: February 2009

Background—

Lymphocytes play an important role in the progression of atherosclerosis. Recently, hypoxia inducible factor-1 (HIF-1) was found to attenuate inflammation by regulating T cell activation and cytokine production. We studied the effects of overexpression of HIF-1α in ApoE knockout murine lymphocytes, on experimental atherosclerosis.

Methods and Results—

ApoE
−/−
mice were submitted to intravenous hydrodynamic injection of empty plasmid or HIF-1αP564A (HIF-1α mutated stabilized construct). Robust expression of HIF-1α was evident in spleen cells of recipient animals. Increased expression of IL-10 as well as decreased expression of IFN-γ was measured in splenocytes of HIF-1α–treated mice by RT-PCR. One week postinjection, antibody array analysis revealed a pattern consistent with a T helper 1 to T helper 2 shift. On sacrifice, assessment of aortic sinus lesions revealed a significant reduction in plaque size in HIF-1α injected mice. A reduced expression of IFN-γ was evident in CD4+ spleen-derived lymphocytes and aortas of HIF-1α–injected mice.

Conclusions—

HIF-1α expression in mouse lymphocytes is associated with a reduced IFN-γ expression and attenuation of experimental atherosclerosis.
Severity Assessment of Obstructive Sleep Apnea Syndrome (OSAS) in Pediatric Patients
Authors: Goroza Edmund , Sagy Mayer , Sagy Noa , Bock Kevin
Published: February 2009

Objective. To assess obstructive sleep apnea syndrome (OSAS) severity among pediatric patients. Design. A retrospective review of charts and polysomnography (PSG) results. Measurements and main results. Apnea—hypopnea index (AHI) and the cumulative duration of sleep while O2SAT was <91% were determined in 389 patients with OSAS. Patients with AHI ranging <5, 5 to 15, 16 to 30, and >30, had mean lowest observed O2SAT values of 88% ± 8%, 85% ± 9%, 78% ± 12%, and 69% ± 13%, respectively. The patients spent a mean of 3.5% ± 9.2 % of their sleep time with O2SAT < 91%. AHI values showed a poor linear correlation with the lowest measured O2SAT values. Body mass index percentiles showed no significant linear correlation with AHI values or with the lowest measured values of O2SAT. Conclusion. Values of AHI cannot accurately predict severity of oxyhemoglobin desaturation in pediatric OSAS and vice versa. No significant correlation between body mass index percentiles and severity of OSAS was established.
Management and Outcomes for Children with Acute Appendicitis Differ by Hospital Type: Areas for Improvement at Public Hospitals
Authors: Zilbert Nathan R. , Stamell Emily F. , Ezon Isaac , Schlager Avi , Ginsburg Howard B. , Nadler Evan P.
Published: February 2009

Background. Access to health care is a well-recognized issue in health policy, but use once patients have entered the health care system is uncommonly addressed. Methods. We performed a retrospective review of children between 2 and 17 years of age with pathologically confirmed appendicitis at our public city hospital and private university hospital and compared management and outcomes. Results. Among patients with acute appendicitis, the median length of stay was a day longer in the public hospital (2 days vs 1 day, P = <.001) despite a similar complication rate (12% vs 11%). More computed tomography (CT) scans were performed at the public hospital (36% vs 21%, P = .02) with a trend toward less use of ultrasound (US) (54% vs 65%, P = .13). Conclusions. Children at the public city hospital have a longer length of stay and undergo more expensive imaging. These findings may provide areas for improvement to optimize the care of children with appendicitis at government-funded institutions.
Parents' Reports Predict Abnormal Investigations in Global Developmental Delay
Authors: Tervo Raymond C. , Asis Martin
Published: February 2009

Aims. To identify symptoms reported by parents that predict abnormal laboratory investigations in preschoolers with global developmental delay (GDD). Methods. A cross-sectional descriptive study of 81 boys and 38 girls, with a mean age of 43.5 months (SD = 13.4), with global developmental delay. All parents/guardians completed the following: (1) a semistructured interview about their child and family; (2) the Child Development Inventory (CDI); (3) the Possible Problems Checklist (PPC); and (4) the Child Behavior Checklist 1½-5 (CBCL). Results. There were 61 abnormal results: MRI 37 (31%); high-resolution chromosomes 8 (7%); fragile X molecular testing 4 (3%); and microarray comparative genomic hybridization 12 (10%). A total of 47 children had abnormal tests (40%): none, 72 (60%); one, 36 (30%); two, 8 (7%); three, (3%). Younger children with more developmental delays are more likely to have abnormal tests. They are clumsy, more passive, and less disobedience. They had lower total, externalizing, and internalizing problems scores. The odds of finding an abnormal investigation are increasingly greater as parent's report of language comprehension and social development ratios increase, and decrease in likelihood for every increase in the expressive language and fine motor ratios. Interpretation. Parent's reports predict abnormal tests and indicate quantifiable differences requiring investigation.
Ideological Consistency and Attitudinal Conf lict
Authors: Wetstein Matthew E. , Ostberg C.L. , Songer Donald R. , Johnson Susan W.
Published: February 2009

According to attitudinal theorists, justices on the U.S. Supreme Court decide cases largely on political preferences that fall within one dimension of ideology. The focus of this study is to test whether a unidimensional ideological model explains the voting behavior of Canadian Supreme Court justices (1992—1997). The factor-analytic results in three areas of law, two of which have never been examined in this way in Canada, provide substantial evidence of ideological voting. Yet unlike the U.S. justices of the Rehnquist court, Canadian justices exhibit a much higher degree of ideological complexity. These findings call into question the widely held assumption of unidimensional decision making that is in vogue in the U.S. literature today, and they suggest that attitudinal theorists and comparative scholars must be cognizant that multiple dimensions of attitudinal voting might occur in high courts that are not as ideologically polarized as the U.S. Supreme Court.
Patronage and Political Stability in Africa
Authors: Arriola Leonardo R.
Published: February 2009

Political conflict across Africa is often linked to the pervasive use of patronage in retaining control of the state. However, few sources of data have been available to systematically examine the relationship between a leader’s patronage strategies and the likelihood of an extraconstitutional change in power. This article employs ministerial appointments to the cabinet as a proxy for changes in the size of a leader’s patronage coalition. With time-series cross-section data on 40 African countries, this study shows that the size of cabinets varies systematically according to regime type, resource constraints, ethnic fractionalization, and total population. It then shows that African leaders extend their tenure in office by expanding their patronage coalition through cabinet appointments. A proportional hazards model of regime duration indicates that cabinet expansion lowers the probability of a leader’s being deposed through a coup. The appointment of one additional minister to the cabinet lowers a leader’s coup risk by a greater extent than does a 1-percentage-point increase in economic growth.
Exploring the Theoretical Framework of Emotional Solidarity between Residents and Tourists
Authors: Woosnam Kyle M. , Norman William C. , Ying Tianyu
Published: February 2009

Residents and tourists within destinations are often portrayed as being separate from each other, possessing little in common. Such an approach can undermine the potential for a dynamic, intimate relationship to exist between residents and tourists. This research offers the theory of emotional solidarity, put forth by Emile Durkheim, as a theoretical framework to examine the relationship between residents and tourists. In addition, a series of focus groups with residents of a coastal South Carolina county was conducted to ascertain residents’ feelings about tourists and commonalities with tourists (i.e., shared beliefs, shared behavior, and interaction). Themes corresponding to constructs from Durkheim’s model were generated from the qualitative data analysis. Findings are discussed, along with practical implications and future research options.
Racism
Authors: Valls Andrew
Published: February 2009

Luc Faucher and Edouard Machery’s recent article in this journal uses evidence from psychological studies to criticize Jorge Garcia’s view of racism. This brief response argues that their critique fails because they misinterpret Garcia’s view and engage in some conceptual equivocation. It also argues that their focus on affect and human psychology is in fact compatible with Garcia’s view of racism as rooted in the human heart. Hence the evidence that they cite should be seen as empirical enrichment of Garcia’s basic view, rather than as evidence against that view.
Effects of Chronic Exposure to Air Pollution from Sao Paulo City on Coronary of Swiss Mice, from Birth to Adulthood
Authors: Akinaga Lícia Mioko Yoshizaki , Lichtenfels Ana Julia , Carvalho-Oliveira Regiani , Caldini Elia Garcia , Dolhnikoff Marisa , Silva Luiz Fernando Ferraz , De Siqueira Bueno Heloisa Maria , Pereira Luiz Alberto Amador , Saldiva Paulo Hilário Nascimento , Garcia Maria Lúcia Bueno
Published: February 2009

To explore the hypothesis that air pollution promotes cardiovascular changes, Swiss mice were continuously exposed, since birth, in two open-top chambers (filtered and nonfiltered for airborne particles ≤ 0.3 μm) placed 20 m from a street with heavy traffic in downtown Sao Paulo, twenty-four hours per day for four months. Fine particle (PM2.5) concentration was determined gravimetrically; hearts were analyzed by morphometry. There was a reduction of the PM2.5 inside the filtered chamber (filtered = 8.61±0.79 μg/m3, nonfiltered = 18.05±1.25 μg/m3, p < .001). Coronary arteries showed no evidence of luminal narrowing in the exposed group but presented higher collagen content in the adventitia of LV large-sized and RV midsized vessels ( p = .001) and elastic fibers in both tunicae adventitia and intima-media of almost all sized arterioles from both ventricles ( p = .03 and p = .001, respectively). We concluded that chronic exposure to urban air since birth induces mild but significant vascular structural alterations in normal individuals, presented as coronary arteriolar fibrosis and elastosis. These results might contribute to altered vascular response and ischemic events in the adulthood.
Information disclosure to terminally ill patients and their relatives: self-reported practice of Belgian clinical specialists and general practitioners
Authors: Michiels E , Deschepper R , Bilsen J , Mortier F , Deliens L
Published: February 2009

Objective of this study is to examine physicians’ practices regarding information disclosure to terminally ill patients and to their relatives, without informing the patient. A questionnaire had been sent to a random sample of 3014 Belgian physicians from different specialties frequently involved in end-of-life care. Responses were analysed using weighted percentages, Chi-square, Mann–Whitney U-tests and a multivariate ordinal logistic regression. Response rate was 58%. Both clinical specialists and general practitioners (GPs) discuss most topics related to terminal illness with their patients except end-of-life hastening options, spirituality, life expectancy and options to withhold/withdraw life-sustaining treatment. The topics which most physicians always discuss with relatives without informing the patient are the aim of treatment, palliative care and incurability. There is a significant difference between clinical specialists and GPs. Clinical specialists and GPs discuss most end-of-life topics with the patient but omit important issues such as end-of-life hastening options and life-expectancy.
Researching breathlessness in palliative care: consensus statement of the National Cancer Research Institute Palliative Care Breathlessness Subgroup
Authors: Dorman S , Jolley C , Abernethy A , Currow D , Johnson M , Farquhar M , Griffiths G , Peel T , Moosavi S , Byrne A , Wilcock A , Alloway L , Bausewein C , Higginson I , Booth S
Published: February 2009

Breathlessness is common in advanced disease and can have a devastating impact on patients and carers. Research on the management of breathlessness is challenging. There are relatively few studies, and many studies are limited by inadequate power or design. This paper represents a consensus statement of the National Cancer Research Institute Palliative Care Breathlessness Subgroup. The aims of this paper are to facilitate the design of adequately powered multi-centre interventional studies in breathlessness, to suggest a standardised, rational approach to breathlessness research and to aid future ‘between study’ comparisons. Discussion of the physiology of breathlessness is included.
Paediatricians’ perceptions on referrals to paediatric palliative care
Authors: Knapp C , Thompson L , Madden V , Shenkman E
Published: February 2009

Children have traditionally been referred to palliative care when curative treatments were exhausted. Recently, experts have suggested that children could benefit from palliative care early in their courses of illness. Using survey data from 303 paediatricians in Florida and California, this study assesses if paediatricians would refer children to palliative care early in their course of illness. Results showed that more years in practice were associated with decreased odds of referring children to palliative care. Academic practice setting and more Medicaid patients were associated with greater odds of referral prior to the end of life. Hispanic paediatricians, those with more experience and those who practice in a hospital setting were associated with decreased odds of referral prior to the end of life. Results suggest that health planners who wish to implement or refine integrated paediatric palliative care programs should consider outreach strategies targeted at paediatricians with specific characteristics.
Informal carer bereavement outcome: relation to quality of end of life support and achievement of preferred place of death
Authors: Grande GE , Ewing G ,   On behalf of the National Forum for Hospice at Home
Published: February 2009

This study investigated (a) whether carer bereavement outcome is affected by the achievement of the patient’s and/or carers’ preferred place of death and (b) the relationship between carer satisfaction with end of life care and bereavement outcome. Participants were 216 carers of patients referred to hospice at home (H@H). Prospective recording of preferred and actual place of death were obtained from H@H records. Carers’ level of grief and mental health and assessment of end of life care were obtained through postal survey three to four months post-bereavement. Fulfilment of carer preference for place of death only related to post-bereavement mental health at P < 0.1. Adequacy of psychological support showed the clearest relationship with bereavement outcome both in univariate and multivariate analyses. The level of support, particularly psychological, may be more important for carers’ bereavement outcome than achievement of the preferred place of death for the patient.
Treatment of palliative care emergencies by prehospital emergency physicians in Germany: an interview based investigation
Authors: Wiese CHR , Bartels UE , Ruppert D , Marung H , Luiz T , Graf BM , Hanekop GG
Published: February 2009

Palliative care medical emergencies as a consequence of advanced cancer account for approximately 3% of all prehospital emergency cases. Therefore, prehospital emergency physicians (EP) are confronted with ‘end of life decisions’. No educational content exists concerning palliative medicine in emergency medicine curricula. Over the course of 6 months, we interviewed 150 EPs about their experiences in ‘end of life decisions’ using a specific questionnaire. The total response rate was 69% ( n = 104). Most of the interviewed EPs (89%, n = 93) had been confronted with palliative care medical emergencies and expressed uncertainties in dealing with these difficult situations, especially in the area of psychosocial care of the patients (50%). The emergency treatment of palliative care patients can become a particular challenge for any EP. A large percentage of interviewed EPs felt uncertain about aspects of social care and in the assessment of decisions at the end of life. Further information and training are necessary to amenable EPs to provide adequate patient-oriented care to palliative care patients and their relatives in emergency situations.
Escitalopram prolonged fear induced by simulated public speaking and released hypothalamic-pituitary-adrenal axis activation
Authors: Garcia-Leal C. , Del-Ben CM , Leal FM , Graeff FG , Guimarães FS
Published: February 2009

Simulated public speaking (SPS) test is sensitive to drugs that interfere with serotonin-mediated neurotransmission and is supposed to recruit neural systems involved in panic disorder. The study was aimed at evaluating the effects of escitalopram, the most selective serotonin-selective reuptake inhibitor available, in SPS. Healthy males received, in a double-blind, randomized design, placebo (n = 12), 10 (n = 17) or 20 (n = 14) mg of escitalopram 2 hours before the test. Behavioural, autonomic and neuroendocrine measures were assessed. Both doses of escitalopram did not produce any effect before or during the speech but prolonged the fear induced by SPS. The test itself did not significantly change cortisol and prolactin levels but under the higher dose of escitalopram, cortisol and prolactin increased immediately after SPS. This fear-enhancing effect of escitalopram agrees with previously reported results with less selective serotonin reuptake inhibitors and the receptor antagonist ritanserin, indicating that serotonin inhibits the fear of speaking in public.
Radiographic Identification of the Primary Posterolateral Knee Structures
Authors: Pietrini Sean D. , LaPrade Robert F. , Griffith Chad J. , Wijdicks Coen A. , Ziegler Connor G.
Published: February 2009

Background

It is often difficult to identify the attachment sites of the fibular collateral ligament, popliteus tendon, and popliteofibular ligament for chronic posterolateral knee injuries or during revision surgeries. Descriptions of radiographic landmarks for these attachment sites would assist in the intraoperative identification of their locations and also allow for postoperative assessment of the placement of reconstruction tunnels.

Hypothesis

Identification of qualitative and quantitative radiographic landmarks for the attachments of the main posterolateral knee structures are reproducible among observers of various experience levels and allow for improved intraoperative and postoperative identification of these attachment sites.

Study Design

Descriptive laboratory study.

Methods

Dissections were performed on 11 cadaveric knee specimens. The attachments and locations of the investigated structures were labeled with radiopaque markers. The positions of the attachments relative to other attachment sites, labeled bony landmarks, and superimposed reference lines were quantified on anteroposterior and lateral radiographs. Measurements were performed by 3 independent examiners. Intraobserver and interobserver reliability was determined using intraclass correlation coefficients.

Results

Overall intraclass correlation coefficients for intraobserver reproducibility and interobserver reliability were calculated to be 0.981 and 0.983, respectively. On the anteroposterior view, the perpendicular distances from a line intersecting the femoral condyles to the popliteus tendon, proximal fibular collateral ligament, and lateral gastrocnemius tendon were 14.5, 27.1, and 34.5 mm, respectively. On the lateral view, the femoral attachments of the fibular collateral ligament, popliteus tendon, and lateral gastrocnemius tendon were 4.3, 12.2, and 13.1 mm, respectively, from the lateral epicondyle. In addition, the fibular collateral ligament and popliteus tendon were located within 1 mm of a reference line projected along the posterior femoral cortex distally, and also were located within the posteroinferior quadrant bound by the posterior femoral cortex extension reference line and another reference line perpendicular to it at the posterior margin of Blumensaat's line.

Conclusion

Comprehensive qualitative and quantitative guidelines for assessing posterolateral knee structures on both anteroposterior and lateral knee radiographs were described.

Clinical Significance

This radiographic information regarding the attachment sites of posterolateral structures can serve as a valuable reference for preoperative, intraoperative, and postoperative assessments of surgical reconstructions.
Arthroscopic Fixation of Anterior Tibial Spine Fractures with Bioabsorbable Nails in Skeletally Immature Patients
Authors: Liljeros Kristin , Werner Suzanne , Janarv Per-Mats
Published: February 2009

Background

A number of arthroscopic techniques have been introduced in the treatment of displaced anterior tibial spine fractures. Several of the procedures are technically demanding or include a second removal operation of metallic implants.

Purpose

The purpose of this study is to describe and evaluate an arthroscopic technique using bioabsorbable nails in displaced anterior tibial spine fractures.

Study Design

Case series; Level of evidence, 4.

Methods

Sixteen consecutive patients, aged 7 to 15 years, with anterior tibial spine fractures type II and III according to Meyers and McKeever, were treated with arthroscopic fixation of the fragment using bioabsorbable nails. After 2 to 5 years, 13 of the patients were evaluated with regard to anterior knee laxity, range of motion, hop tests, Lysholm knee scoring scale, and activity level. Postoperative surgical complications were registered in the whole group of patients.

Results

One of the 13 patients had an increased anterior knee laxity of 3 mm. Extension deficits of 5° were seen in 4 patients and flexion deficits of 5° to 10° in 3 patients. One patient had an outcome of <90% of the uninjured side in the hop tests. Eleven patients were excellent, 1 was good, and 1 was poor according to the Lysholm knee scoring scale. There was no influence on activity level. There were no inflammatory reactions and all fractures healed without complications. In 1 case, the arthroscopy was converted into an open procedure because of technical problems, still using the bioabsorbable nails.

Conclusion

The outcome is comparable with other procedures. A second operation for removal of metallic implants is avoided.
Timing of Anterior Cruciate Ligament Reconstructive Surgery and Risk of Cartilage Lesions and Meniscal Tears
Authors: Granan Lars-Petter , Bahr Roald , Lie Stein Atle , Engebretsen Lars
Published: February 2009

Background

There is inadequate evidence to determine when to perform surgery on anterior cruciate ligament—deficient knees.

Purpose

To study the association between timing of anterior cruciate ligament reconstruction and the risk of having meniscal tears and cartilage lesions.

Study Design

Cohort study (prognosis); Level of evidence, 2.

Methods

All patients registered in the Norwegian National Knee Ligament Registry who had undergone primary anterior cruciate ligament reconstruction from 2004 and throughout 2006 were reviewed. Logistic regression analyses were used to estimate the relationship between time from injury until anterior cruciate ligament surgery and the risk of meniscal tears or cartilage lesions.

Results

Of a total of 3475 patients, there were 909 patients (26%) with cartilage lesions, 1638 patients (47%) with meniscal tears, and 527 patients (15%) with both cartilage and meniscal lesions. The odds of a cartilage lesion in the adult knee (>16 years) increased by 1.006 (95% confidence interval, 1.003-1.010) for each month that elapsed from injury to surgery. The cartilage in young adults (17-40 years) deteriorated further with an increase in odds of 1.03 (95% confidence interval, 1.02-1.05) related to the aging in years of the patient. The odds for meniscal tears in young adults increased by 1.004 (95% confidence interval, 1.002-1.006) for each month that elapsed since injury. The presence of 1 degenerative lesion increased the odds of having the other degenerative lesion by between 1.6 and 2.0 in all patient groups.

Conclusion

The odds of a cartilage lesion in the adult knee increased by nearly 1% for each month that elapsed from the injury date until the surgery date and that of cartilage lesions were nearly twice as frequent if there was a meniscal tear, and vice versa.
Sports and Recreation Activity of Patients with Femoroacetabular Impingement before and after Arthroscopic Osteoplasty
Authors: Brunner Alexander , Horisberger Monika , Herzog Richard F.
Published: February 2009

Background

Hip arthroscopy represents a new and minimally invasive method of treating patients with femoroacetabular impingement (FAI). However, participation in popular sports after this procedure has not yet been analyzed.

Hypotheses

Arthroscopic treatment of FAI increases the level of popular sports activities, and this level of activity correlates with the clinical outcome in terms of pain and function.

Study Design

Case series; Level of evidence, 4.

Methods

Fifty-three patients (41 male, 12 female) were evaluated preoperatively and after a mean follow-up of 2.4 years (range, 2-3.2 years) after arthroscopic osteoplasty for cam and mixed FAI. Evaluation included the type and level of sports activities (sports frequency score [SFS]) as well as clinical outcome in terms of pain (VAS) and function (nonarthritic hip score [NAHS]).

Results

Forty-five of the 53 patients had regularly participated in popular sports until the first occurrence of FAI symptoms. Preoperatively, only 4 of these 45 patients had maintained their accustomed level of activity. At the final follow-up, 31 patients had returned to their full accustomed level of activity. None of the patients who had not been active in sports before the first occurrence of symptoms of FAI (n = 8) had begun participation in sports after arthroscopic osteoplasty. The SFS significantly increased from 0.78 to 1.84 (P < .001), and the mean VAS pain score significantly improved from 5.7 (range, 1-9) to 1.5 (range, 0-6) points (P < .001). The NAHS improved from 54.4 (range, 28.75-92.5) to 85.7 (range, 47.5-100) (P < .001). There was no significant correlation between SFS and NAHS (r = .051, P = .35), as well as between SFS and VAS pain score (r = .159, P = .140) preoperatively, but a significant correlation was seen at the time of the last postoperative follow-up (SFS/NAHS: r = .392, P = .003; SFS/VAS: r = .242, P = .049). The 3 most frequent sports activities postoperatively were biking, hiking, and fitness.

Conclusion

Arthroscopic osteoplasty can significantly improve the rate and level of popular sports activities in patients with FAI. The level of postoperative sports activity directly correlates with the clinical outcome in terms of pain and function.