bluuebunny/crossref_metadata_2025 huggingface dataset:
Transmural pressure and axial loading interactively regulate arterial remodeling ex vivo
Authors: Lawrence Amanda R. , Gooch Keith J.
Published: May 2009

Physiological axial strains range between 40 and 60% in arteries, resulting in stresses comparable to those due to normal blood pressure or flow. To investigate the contribution of axial strain to arterial remodeling and function, porcine carotid arteries were cultured for 9 days at physiological and reduced axial stretch ratios in the presence of normotensive and hypertensive transmural pressures by ex vivo perfusion techniques. Consistent with previous in vivo studies, vessels cultured with physiological levels of axial strain and exposed to hypertensive pressure had greater mass, wall area, and outer diameter relative to those cultured at the same axial stretch ratio and normotensive pressure. Reducing the amount of axial strain resulted in mass loss and decreased cell proliferation. Culture in a hypertensive pressure environment at reduced axial strain produced arteries with greater contractility in response to norepinephrine. Arteries cultured at reduced axial strain with the matrix metalloproteinase inhibitor GM6001 maintained their masses over culture, indicating a possible mechanism for this model of axial stretch-dependent remodeling. Although not historically considered one of the primary stimuli for remodeling, multiple linear regression analysis revealed that axial strain had an impact similar to or greater than transmural pressure on various remodeling indexes (i.e., outer diameter, wall area, and wet mass), suggesting that axial strain is a primary mediator of vascular remodeling.
Lactosylceramide promotes cell migration and proliferation through activation of ERK1/2 in human aortic smooth muscle cells
Authors: Mu Hong , Wang Xinwen , Wang Hao , Lin Peter , Yao Qizhi , Chen Changyi
Published: May 2009

Increased plasma levels of lactosylceramide (LacCer) have been associated with cardiovascular disease. However, it is largely unknown whether LacCer directly contributes to dysfunction of smooth muscle cells (SMCs), a key event in vascular lesion formation. In the present study, we determined the effects and potential mechanisms of LacCer on cell migration and proliferation in human aortic SMCs (AoSMCs). Cell migration and proliferation were determined by a modified Boyden chamber assay and nonradioactive colorimetric (MTS) assay, respectively. We found that LacCer significantly induced AoSMC migration and proliferation in a concentration- and time-dependent manner. In addition, LacCer significantly upregulated the expression of PDGFR-B, integrins (αvand β3), and matrix metalloproteinases (matrix metalloproteinase-1 and -2) at both mRNA and protein levels, as determined by real-time PCR and Western blot analyses, respectively. Furthermore, LacCer increased superoxide anion production and the transient phosphorylation of ERK1/2 in AoSMCs, as determined by dihydroethidium staining and immunoassay, respectively. Accordingly, LacCer-induced cell migration and proliferation were effectively blocked by antioxidants (seleno-l-methionine and Mn tetrakis porphyrin) and by a specific ERK1/2 inhibitor. Thus, LacCer promotes cell migration and proliferation through oxidative stress and activation of ERK1/2 in AoSMCs. These findings demonstrate the functional role of LacCer in the vascular disease pathogenesis.
Influence of the menstrual cycle on nonlinear properties of heart rate variability in young women
Authors: Bai Xiaopeng , Li Jingxiu , Zhou Lingqi , Li Xueqi
Published: May 2009

This study was designed to assess the changes in nonlinear properties of heart rate (HR) variability (HRV) during the menstrual cycle by means of complexity measures, including sample entropy (SampEn) and correlation dimension (CD), and explore probable physiological interpretations for them. In 16 healthy women (mean age: 23.8 ± 2.7 yr), complexity measures along with the spectral components of HRV (sympathovagal markers) were analyzed over 1,500 R-R intervals recorded during both the follicular phase ( day 11.9 ± 1.4) and the luteal phase ( day 22.0 ± 1.4) of each woman's menstrual cycle. Simultaneously, serum ovarian hormone (estradiol-17 and progesterone) and thyroid-related hormone [free triiodothyronine, free thyroxine (T4), and thyroid-stimulating hormone] concentrations were measured. With regard to HRV measures, SampEn, CD, and high-frequency (HF) components decreased from the follicular phase to the luteal phase, whereas normalized low-frequency (LF) components and the LF-to-HF ratio as well as resting HR increased. In regard to hormone levels, whereas progesterone was increased, the other hormone concentrations were unchanged. Furthermore, across the menstrual cycle, both SampEn and CD were well correlated with the spectral indexes and free T4 concentrations, and SampEn also showed significant correlations with the ratio of estradiol-17 to progesterone concentrations. These results suggest that the nonlinear properties in HRV are altered during the regular menstrual cycle and that the autonomic nervous system, ovarian hormone balance, and free T4 may be involved in nonlinear HR control in healthy women. All of these factors may enrich the physiological meanings of complexity measures.
Cinaciguat, a soluble guanylate cyclase activator, causes potent and sustained pulmonary vasodilation in the ovine fetus
Authors: Chester Marc , Tourneux Pierre , Seedorf Greg , Grover Theresa R. , Gien Jason , Abman Steven H.
Published: May 2009

Impaired nitric oxide-cGMP signaling contributes to severe pulmonary hypertension after birth, which may in part be due to decreased soluble guanylate cyclase (sGC) activity. Cinaciguat (BAY 58-2667) is a novel sGC activator that causes vasodilation, even in the presence of oxidized heme or heme-free sGC, but its hemodynamic effects have not been studied in the perinatal lung. We performed surgery on eight fetal (126 ± 2 days gestation) lambs (full term = 147 days) and placed catheters in the main pulmonary artery, aorta, and left atrium to measure pressures. An ultrasonic flow transducer was placed on the left pulmonary artery to measure blood flow, and a catheter was placed in the left pulmonary artery for drug infusion. Cinaciguat (0.1–100 μg over 10 min) caused dose-related increases in pulmonary blood flow greater than fourfold above baseline and reduced pulmonary vascular resistance by 80%. Treatment with 1H-[1,2,4]oxadiazolo[4,3-a]quinoxalin-1-one (ODQ), an sGC-oxidizing inhibitor, enhanced cinaciguat-induced pulmonary vasodilation by >120%. The pulmonary vasodilator effect of cinaciguat was prolonged, decreasing pulmonary vascular resistance for >1.5 h after brief infusion. In vitro stimulation of ovine fetal pulmonary artery smooth muscle cells with cinaciguat after ODQ treatment resulted in a 14-fold increase in cGMP compared with non-ODQ-treated cells. We conclude that cinaciguat causes potent and sustained fetal pulmonary vasodilation that is augmented in the presence of oxidized sGC and speculate that cinaciguat may have therapeutic potential for severe neonatal pulmonary hypertension.
C/EBPα is required for pulmonary cytoprotection during hyperoxia
Authors: Xu Yan , Saegusa Chika , Schehr Angelica , Grant Shawn , Whitsett Jeffrey A. , Ikegami Machiko
Published: May 2009

A number of transcriptional pathways regulating fetal lung development are active during repair of the injured lung. We hypothesized that C/EBPα, a transcription factor critical for lung maturation, plays a role in protection of the alveolar epithelium following hyperoxic injury of the mature lung. Transgenic CebpαΔ/Δmice, in which Cebpα was conditionally deleted from Clara cells and type II cells after birth, were developed. While no pulmonary abnormalities were observed in the CebpαΔ/Δmice (7–8 wk old) under normal conditions, the mice were highly susceptible to hyperoxia. CebpαΔ/Δmice died within 4 days of exposure to 95% oxygen in association with severe lung inflammation, altered maturation of surfactant protein B and C, decreased surfactant lipid secretion, and abnormal lung mechanics at a time when all control mice survived. mRNA microarray analysis of isolated type II cells at 0, 2, and 24 h of hyperoxia demonstrated the reduced expression of number of genes regulating surfactant lipid and protein homeostasis, including Srebf, Scap, Lpcat1, Abca3, Sftpb, and Napsa. Genes influencing cell signaling or immune responses were induced in the lungs of CebpαΔ/Δmice. C/EBPα was required for the regulation of genes associated with surfactant lipid homeostasis, surfactant protein biosynthesis, processing and transport, defense response to stress, and cell redox homeostasis during exposure to hyperoxia. While C/EBPα did not play a critical role in postnatal pulmonary function under normal conditions, C/EBPα mediated protection of the lung during acute lung injury induced by hyperoxia.
Retinoic acid prevents virus-induced airway hyperreactivity and M2 receptor dysfunction via anti-inflammatory and antiviral effects
Authors: Moreno-Vinasco Liliana , Verbout Norah G. , Fryer Allison D. , Jacoby David B.
Published: May 2009

Inhibitory M2 muscarinic receptors on airway parasympathetic nerves normally limit acetylcholine release. Viral infections decrease M2 receptor function, increasing vagally mediated bronchoconstriction. Since retinoic acid deficiency causes M2 receptor dysfunction, we tested whether retinoic acid would prevent virus-induced airway hyperreactivity and prevent M2 receptor dysfunction. Guinea pigs infected with parainfluenza virus were hyperreactive to electrical stimulation of the vagus nerves, but not to intravenous acetylcholine, indicating that hyperreactivity was due to increased release of acetylcholine from parasympathetic nerves. The muscarinic agonist pilocarpine, which inhibits vagally mediated bronchoconstriction in control animals, no longer inhibited vagally induced bronchoconstriction, demonstrating M2 receptor dysfunction. Treatment with all-trans retinoic acid (1 mg/kg) prevented virus-induced hyperreactivity and M2 receptor dysfunction. However, retinoic acid also significantly reduced viral titers in the lungs and attenuated virus-induced lung inflammation. In vitro, retinoic acid decreased M2 receptor mRNA expression in both human neuroblastoma cells and primary cultures of airway parasympathetic neurons. Thus, the protective effects of retinoic acid on airway function during viral infection appear to be due to anti-inflammatory and antiviral mechanisms, rather than to direct effects on M2 receptor gene expression.
The contribution of inositol 1,4,5-trisphosphate and ryanodine receptors to agonist-induced Ca2+signaling of airway smooth muscle cells
Authors: Bai Yan , Edelmann Martin , Sanderson Michael J.
Published: May 2009

The relative contribution of inositol 1,4,5-trisphosphate (IP3) receptors (IP3Rs) and ryanodine receptors (RyRs) to agonist-induced Ca2+signaling in mouse airway smooth muscle cells (SMCs) was investigated in lung slices with phase-contrast or laser scanning microscopy. At room temperature (RT), methacholine (MCh) or 5-hydroxytryptamine (5-HT) induced Ca2+oscillations and an associated contraction in small airway SMCs. The subsequent exposure to an IP3R antagonist, 2-aminoethoxydiphenyl borate (2-APB), inhibited the Ca2+oscillations and induced airway relaxation in a concentration-dependent manner. 2-APB also inhibited Ca2+waves generated by the photolytic release of IP3. However, the RyR antagonist ryanodine had no significant effect, at any concentration, on airway contraction or agonist- or IP3-induced Ca2+oscillations or Ca2+wave propagation. By contrast, a second RyR antagonist, tetracaine, relaxed agonist-contracted airways and inhibited agonist-induced Ca2+oscillations in a concentration-dependent manner. However, tetracaine did not affect IP3-induced Ca2+release or wave propagation nor the Ca2+content of SMC Ca2+stores as evaluated by Ca2+-release induced by caffeine. Conversely, both ryanodine and tetracaine completely blocked agonist-independent slow Ca2+oscillations induced by KCl. The inhibitory effects of 2-APB and absence of an effect of ryanodine on MCh-induced airway contraction or Ca2+oscillations of SMCs were also observed at 37°C. In Ca2+-permeable SMCs, tetracaine inhibited agonist-induced contraction without affecting intracellular Ca2+levels indicating that relaxation also resulted from a reduction in Ca2+sensitivity. These results indicate that agonist-induced Ca2+oscillations in mouse small airway SMCs are primary mediated via IP3Rs and that tetracaine induces relaxation by both decreasing Ca2+sensitivity and inhibiting agonist-induced Ca2+oscillations via an IP3-dependent mechanism.
Immunotargeting and cloning of two CD34 variants exhibiting restricted expression in adult rat endothelia in vivo
Authors: Testa Jacqueline E. , Chrastina Adrian , Oh Phil , Li Yan , Witkiewicz Halina , Czarny Malgorzata , Buss Tim , Schnitzer Jan E.
Published: May 2009

Mapping protein expression of endothelial cells (EC) in vivo is fundamental to understanding cellular function and may yield new tissue-selective targets. We have developed a monoclonal antibody, MAb J120, to a protein expressed primarily in rat lung and heart endothelium. The antigen was identified as CD34, a marker of hematopoietic stem cells and global marker of endothelial cells in human and mouse tissues. PCR-based cloning identified two CD34 variant proteins, full length and truncated, both of which are expressed on luminal endothelial cell plasma membranes (P) isolated from lung. Truncated CD34 predominated in heart P, and neither variant was detected in P from kidney or liver. CD34 in lung was readily accessible to125I-J120 inoculated intravenously, and immunohistochemistry showed strong CD34 expression in lung EC. Few microvessels stained in heart and kidney, and no CD34 was detected in vessels of other organs or in lymphatics. We present herein the first complete sequence of a rat CD34 variant and show for the first time that the encoded truncated variant is endogenously expressed on EC in vivo. We also demonstrate that CD34 expression in rat EC, unlike mouse and human, is restricted in its distribution enabling quite specific lung targeting in vivo.
Simultaneous Biventricular Noncontact Mapping and Ablation of Septal Ventricular Tachycardia in a Chronic Ovine Infarct Model
Authors: Sivagangabalan Gopal , Pouliopoulos Jim , Huang Kaimin , Barry Michael A. , Lu Juntang , Thomas Stuart P. , Ross David L. , Thiagalingam Aravinda , Kovoor Pramesh
Published: May 2009

Background—

We assessed a novel simultaneous biventricular mapping and ablation approach for septal ventricular tachycardia (VT) in a chronic ovine infarct model.

Methods and Results—

In 8 sheep with inducible VT, mapping and ablation were performed 9�3 months after percutaneously induced myocardial infarction, with left ventricular ejection fraction 23�8%. Scar was identified by EnSite Dynamic Substrate Mapping plus CARTO voltage mapping. Thirty VT episodes (cycle length, 235�42 ms) were mapped with simultaneous analyses using EnSite arrays deployed in both the left ventricle and the right ventricle. Short ablation lines were created perpendicular to the breakout pathway along the scar border in the ventricle with earliest activity. If septal VT was still inducible, this line was extended before ablation in the second chamber. The end point of noninducibility of VT was achieved in all animals. The mean difference in delay in noncontact breakout timing between the ventricles was shorter for VT with (n=18) than without (n=12) septal breakout (32�7.8 ms,
P
<0.001). In 5 of 6 animals, after ablation in one ventricle, septal VT was still inducible with a common breakout site in the second ventricle. After septal ablation in the second ventricle, VT was no longer inducible. In the 6 animals in which septal VT had been ablated, transmural septal ablation was identified at the scar border, with overlapping left ventricular and right ventricular ablation lesions present in 5 of 6 (septal thickness 8 to 17 mm) and left ventricular endocardial ablation being transmural in 1 of 6 (6 mm).

Conclusions—

Biventricular scar and VT activation mapping correctly localizes septal VT pathways, directing ablation from one or both septal endocardial aspects. Creation of a transmural septal lesion at the scar border interrupting VT exit points is highly effective at ablating septal VT.
Feasibility of Cardiovascular Magnetic Resonance to Assess the Orifice Area of Aortic Bioprostheses
Authors: von Knobelsdorff-Brenkenhoff Florian , Rudolph André , Wassmuth Ralf , Bohl Steffen , Buschmann Eva Elina , Abdel-Aty Hassan , Dietz Rainer , Schulz-Menger Jeanette
Published: May 2009

Background—

Prosthetic orifice area, usually calculated by transthoracic echocardiography (TTE) or transesophageal echocardiography (TEE), provides important information regarding the hemodynamic performance of aortic bioprostheses. However, both TTE and TEE have limitations; therefore accurate and reproducible determination of the orifice area often remains a challenge. The present study aimed to investigate the feasibility of cardiovascular magnetic resonance (CMR) to assess the orifice areas of aortic bioprostheses.

Methods and Results—

CMR planimetry of the orifice area was performed in 65 patients (43/22 stented/stentless prostheses; mean time since implantation, 3.1�2.8 years; mean orifice area [TTE], 1.70�0.43 cm
2
; 62 normally functioning prostheses, 2 severe stenoses, and 1 severe regurgitation) in an imaging plane perpendicular to the transprosthetic flow using steady-state free-precession cine imaging under breath-hold conditions on a 1.5-T MR system. CMR results were compared with TTE (continuity equation, n=65) and TEE (planimetry, n=31). CMR planimetry was readily feasible in 80.0%; feasible with limitation in 15.4% because of stent, flow, and sternal wire artifacts; and impossible in 4.6% because of flow artifacts. Correlations of the orifice areas by CMR with TTE (
r
=0.82) and CMR with TEE (
r
=0.92) were significant. The average difference between the methods was −0.02�0.24 cm
2
(TTE) and 0.05�0.15 cm
2
(TEE). Agreement was present for stented and stentless devices and independent of orifice size. Intraobserver and interobserver variabilities of CMR planimetry were 6.7�5.4% and 11.5�7.8%.

Conclusions—

The assessment of aortic bioprostheses with normal orifice areas by CMR is technically feasible and provides orifice areas with a close correlation to echocardiography and low observer dependency.
The Abiding Nature of Empathic Connections: A 10-Year Follow-up Study
Authors: Myers Sharon A. , White Catherine M.
Published: May 2009

This qualitative study explores the enduring impact of the therapeutic encounter. Participants, who had engaged in therapeutic relationships 10 years previously and endorsed empathy as a catalyst for personal growth, were invited to reflect on their experiences and to articulate ways in which the relationships have continued to shape their ongoing development. Two predominant themes emerged: therapeutic relationship as a foundation for change, and affirmation/enhancement of personal agency, which was characterized by inter- and intrapersonal self-efficacy and by emotional regulation. This study confirms the abiding nature of personal growth well beyond the therapeutic encounter. Ten years later, participants continue to credit the therapeutic relationship as the basis for their personal growth.
Early Retirement in the Three Types of Welfare States
Authors: Kim Jeungkun
Published: May 2009

The main purpose of this study was to examine the labor force participation rate of 55- to 64-year-olds across countries and by gender on the basis of Esping-Andersen's typology of welfare states. The author investigated the influence of a country's socioeconomic characteristics on work participation using data from nine Organisation for Economic Co-operation and Development countries from 1984 to 2001. The results show that classifying countries according to Esping-Andersen's typology provides insight into how a set of country-level socioeconomic conditions and policies may influence individual work decisions. The results also show that men and women respond differently to economic and demographic changes at the country level. Conclusions imply that policy interventions to reverse patterns of early retirement need to consider country-level economic and demographic characteristics and their interaction, along with policies that would change financial incentives facing individuals.
The Impact of Late-Life Parental Death on Adult Sibling Relationships
Authors: Khodyakov Dmitry , Carr Deborah
Published: May 2009

The authors examined whether the effect of parental death on adults siblings' relationship quality varies on the basis of the presence and perceived effectiveness of a deceased parent's formal preparations for end-of-life care. The authors used data from the Wisconsin Longitudinal Study and focused on the relationship quality of a bereaved adult child and his or her randomly selected sibling. Parental death was associated with a decrease in sibling closeness. The parent's use of advance directives (living will and durable power of attorney for health care) did not have uniformly positive effects on adult siblings' relationship quality. Sibling relationships suffered when the living will was believed to “cause problems,” but relationships improved when the deceased parent named someone other than his or her spouse or a child as durable power of attorney for health care. The authors discuss the implications for developing effective end-of-life preparations that benefit both the decedent and surviving kin.
Challenges and Strategies to Maintaining Emotional Health
Authors: Ornelas India J. , Perreira Krista M. , Beeber Linda , Maxwell Lauren
Published: May 2009

Mexican immigrant mothers face many challenges that put them at increased risk for poor mental health. To understand the factors that lead to the development of depressive symptoms among Mexican immigrant mothers, we analyzed data from 20 qualitative, semistructured interviews. Participants included low-income, Mexican-born mothers of young children living in North Carolina. Most of the mothers in our study reported experiencing depressive symptoms after becoming parents. They expressed their symptoms as feelings of sadness, depression, loneliness, shame, and anxiety. Economic stressors contributing to their emotional health included financial obligations, work, and child care. Social stressors included family separation, social isolation, and discrimination. To cope with these stressors, mothers relied heavily on social networks and community resources. Our results suggest that a combination of both risk and resiliency factors shape the emotional health of Mexican immigrant mothers.
Public Perceptions and Expectations of the Forensic Use of DNA
Authors: Curtis Cate
Published: May 2009

The forensic use of Deoxyribonucleic Acid (DNA) is demonstrating significant success as a crime-solving tool. However, numerous concerns have been raised regarding the potential for DNA use to contravene cultural, ethical, and legal codes. In this article the expectations and level of knowledge of the New Zealand public of the DNA data-bank and the surrounding processes are discussed. A questionnaire was developed in consultation with key stakeholders, comprising a combination of open and closed questions. The ensuing survey comprised a sample of 100 participants. Although participants initially appeared in favor of the forensic use of DNA, particularly in regard to the collection of DNA from sex offenders, perceptions and attitudes were based on limited knowledge of processes, policies, and implications. Upon further discussion and reflection a number of concerns were raised, such as ownership of DNA samples and the potential for misuse.
Participatory Paradoxes
Authors: Powell Maria C. , Colin Mathilde
Published: May 2009

Mechanisms to engage lay citizens in science and technology are currently in vogue worldwide. While some engagement exercises aim to influence policy making, research suggests that they have had little discernable impacts in this regard. We explore the potentials and challenges of facilitating citizen engagement in nanotechnology from the “topdown,” addressing the following questions: Can academics and others within institutions initiate meaningful engagement with unorganized lay citizens from the top-down? Can they facilitate effective engagement among citizens, scientists, and policy makers while building citizen engagement capacities? Is it possible to create independent bottom-up citizen engagement in scientific and technological issues from the top-down, and what are the challenges in doing so? Our experiences show that although academics can build citizens' individual, collective, and political capacities to engage with each other, scientists, and policy makers, this work is enormously time and energy intensive, and institutional support is needed to sustain it.
Stand by Me
Authors: Campbell David A.
Published: May 2009

Over 250 new nonprofit organizations were founded in the immediate aftermath of the 9/11 attacks. This study explores the characteristics of those organizations, the role they played and founders' motivations. The creation of new organizations is compared to the Disaster Resource Center's typology of organized responses to disaster. The study finds that classification of the organized response to recovery efforts following 9/11 requires a different typology and identifies two elements: derivative and unaffiliated organizations. Most of the new 9/11 organizations were temporary and defined long-term recovery as one to two years; those that endured five years had close institutional or experiential ties to victims’ families. New organizations created in response to disaster have a shorter lifespan than other populations of new organizations. The study indicates that the setting of a disaster and how its victims are defined affect the kinds of organizations people create, their role and endurance.
Offender Rehabilitation as a Value-Laden Process
Authors: Day Andrew , Ward Tony
Published: May 2009

This article investigates some of the primary assumptions and values that underpin correctional practice in the area of offender rehabilitation. It is suggested that values are reflected in offenders’ and clinicians’ fundamental beliefs about the rehabilitative process and as such underlie their various actions. This article identifies three areas in which values may be important (organisational values about crime and punishment, professional values, and personal values) and discusses each in relation to its relevance for rehabilitative practice. It is concluded that despite the apparent role of values in the correctional domain, very little is known about the values of those who deliver rehabilitative programs and how these might influence rehabilitative outcomes.
Patellofemoral Full-Thickness Chondral Defects Treated With Second-Generation Autologous Chondrocyte Implantation
Authors: Gobbi Alberto , Kon Elizaveta , Berruto Massimo , Filardo Giuseppe , Delcogliano Marco , Boldrini Lorenzo , Bathan Lyndon , Marcacci Maurilio
Published: May 2009

Background

Patellofemoral lesions represent a very troublesome condition to treat for orthopaedic surgeons; however, second-generation autologous chondrocyte implantation (ACI) seems to offer an interesting treatment option with satisfactory results at short-term follow-up.

Hypothesis

Hyaluronan-based scaffold seeded with autologous chondrocytes is a viable treatment for the damaged articular surface of the patellofemoral joint.

Study Design

Case series; Level of evidence, 4.

Methods

Among a group of 38 patients treated for full-thickness patellofemoral chondral lesions with second-generation ACI, we investigated 34 who were available for final follow-up at 5 years. These 34 had chondral lesions with a mean size of 4.45 cm2. Twenty-one lesions were located on the patella, 9 on the trochlea, and 4 patients had multiple lesions: 3 had patellar and trochlear lesions, and 1 had patellar and lateral femoral condyle lesions. Twenty-six lesions (76.47%) were classified as International Cartilage Repair Society (ICRS) grade IV A or B, 5 lesions (14.70%) were grade IIIC, and 3 (8.82%) were lesions secondary to osteochondritis dissecans (OCD). Results were evaluated using the International Knee Documentation Committee (IKDC) 2000 subjective and objective scores, EuroQol (EQ) visual analog scale (VAS), and Tegner scores at 2 and 5 years. Eight patients had second-look arthroscopy and biopsies.

Results

All the scores used demonstrated a statistically significant improvement ( P < .0005) at 2 and 5 years’ follow-up. Objective preoperative data improved from 8 of 34 (23.52%) normal or nearly normal knees to 32 of 34 (94.12%) at 2 years and 31 of 34 (91.17%) at 5 years after transplantation. Mean subjective scores improved from 46.09 points preoperatively to 77.06 points 2 years after implantation and 70.39 at 5 years. The Tegner score improved from 2.56 to 4.94 and 4.68, and the EQ VAS improved from 56.76 to 81.47 and 78.23 at 2 and 5 years’ follow-up, respectively. A significant decline of IKDC subjective and Tegner scores was found in patients with multiple and patellar lesions from 2 to 5 years’ follow-up. Second-look arthroscopies in 8 cases revealed the repaired surface to be nearly normal with biopsy samples characterized as hyaline-like in appearance.

Conclusion

Hyaluronan-based scaffold seeded with autologous chondrocytes can be a viable treatment for patellofemoral chondral lesions.
Success of Meniscal Repair at Anterior Cruciate Ligament Reconstruction
Authors: Toman Charles V. , Dunn Warren R. , Spindler Kurt P. , Amendola Annunziata , Andrish Jack T. , Bergfeld John A. , Flanigan David , Jones Morgan H. , Kaeding Christopher C. , Marx Robert G. , Matava Matthew J. , McCarty Eric C. , Parker Richard D. , Wolcott Michelle , Vidal Armando , Wolf Brian R. , Huston Laura J. , Harrell Frank E. , Wright Rick W.
Published: May 2009

Background

Meniscal repair is performed in an attempt to prevent posttraumatic arthritis resulting from meniscal dysfunction after meniscal tears. The socioeconomic implications of premature arthritis are significant in the young patient population. Investigations and techniques focusing on meniscus preservation and healing are now at the forefront of orthopaedic sports medicine.

Hypothesis

Concomitant meniscal repair with anterior cruciate ligament reconstruction is a durable and successful procedure at 2-year follow-up.

Study Design

Case series; Level of evidence, 4.

Methods

All unilateral primary anterior cruciate ligament reconstructions entered in 2002 in a cohort who had meniscal repair at the time of anterior cruciate ligament reconstruction were evaluated. Validated patient-oriented outcome instruments were completed preoperatively and then again at the 2-year postoperative time point. Reoperation after the index procedure was also documented and confirmed by operative reports.

Results

A total of 437 unilateral primary anterior cruciate ligament reconstructions were performed with 82 concomitant meniscal repairs (54 medial, 28 lateral) in 80 patients during the study period. Patient follow-up was obtained on 94% (77 of 82) of the meniscal repairs, allowing confirmation of meniscal repair success (defined as no repeat arthroscopic procedure) or failure. The overall success rate for meniscal repairs was 96% (74 of 77 patients) at 2-year follow-up.

Conclusion

Meniscal repair is a successful procedure in conjunction with anterior cruciate ligament reconstruction. When confronted with a “repairable” meniscal tear at the time of anterior cruciate ligament reconstruction, orthopaedic surgeons can expect an estimated >90% clinical success rate at 2-year follow-up using a variety of methods as shown in our study.
Relational Challenges and Recovery Processes in Male Survivors of Childhood Sexual Abuse
Authors: Kia-Keating Maryam , Sorsoli Lynn , Grossman Frances K.
Published: May 2009

Male survivors of childhood sexual abuse face challenges resolving sexual victimization experiences with the ideals of masculinity, often experiencing intimacy problems, emotional discomfort, alienation, and anger. Little attention has been paid to how male survivors learn to develop long-term connections, disclose emotions in relationship contexts, and negotiate intimacy. The current qualitative study of 16 adult male survivors of childhood sexual abuse, examined the relational challenges and the processes by which these survivors improved their capacity for seeking and participating in supportive relationships over time. Several mechanisms associated with positive adaptation were identified in their narratives, including engaging in safe relationships; gaining a sense of belonging by locating a community of others with shared experiences; learning healthy ways to manage relationships through setting boundaries, controlling anger, building trust, and developing intimacy; and achieving acceptance. Clinical implications and future directions for research and intervention are presented.
Skill-Based Development of Entrepreneurs and the Role of Personal and Peer Group Coaching in Enterprise Development
Authors: Kutzhanova Nailya , Lyons Thomas S. , Lichtenstein Gregg A.
Published: May 2009

This article argues that skill building lies at the heart of entrepreneurs' success, and it seeks to begin the process of understanding how skills can best be developed. The authors begin with a discussion of skill building and why it must be the focus of productive enterprise development efforts. They then examine a unique enterprise development program in central Appalachia that uses a system of blended personal and peer group coaching to develop the skills of its client entrepreneurs. By triangulating the results of in-depth interviews with entrepreneurs, coaches, and the managers of the program, the research reported here creates a set of comparative case studies that sheds light on how coaching can affect the way entrepreneurs learn. The findings have implications for how entrepreneurs can be more effectively assisted.
Housing Choice Vouchers, the Low-Income Housing Tax Credit, and the Federal Poverty Deconcentration Goal
Authors: Williamson Anne R. , Smith Marc T. , Strambi-Kramer Marta
Published: May 2009

Poverty deconcentration has gained prominence as a federal housing policy goal during the past decade. The authors address the issue of whether the interaction between the two dominant programs aimed at housing for low-income persons in the United States—the Housing Choice Voucher and the Low-Income Housing Tax Credit (LIHTC)—tends to support this goal by examining three questions: How extensively are vouchers used in LIHTC developments? Does the pattern of usage vary across counties and metropolitan areas? Does the use of vouchers in LIHTC units result in concentrations of voucher holders in poverty areas, contrary to poverty deconcentration goals? The authors find that LIHTC units are important sources of housing opportunity for voucher holders in some areas. However, they also find evidence that LIHTC location patterns in economically distressed areas known as Qualified Census Tracts may reinforce existing poverty concentrations.
Cultural Proficiency
Authors: Waite Roberta , Russell Ramsay J.
Published: May 2009

Background: Guidelines for assessment, diagnosis, and treatment of ADHD have been drawn from research focused primarily on Caucasian males generating, in part, the need to redress health disparities. Diagnostic criteria may therefore be limited, especially regarding gender differences and other associated cultural, familial, socio-environmental, and individual influences. Objective: To examine how one woman with ADHD managed social, academic, interpersonal, and familial roles and to discuss the need for culturally proficient practice and treatment frameworks that are gender-sensitive to diagnosis and treatment. Method: A case example of a 29-year-old Hispanic woman. Findings: There is a gap in early diagnosis and treatment for some woman and individuals from ethnic minority and diverse groups. Conclusion: Cultural competence in practice and research are critical to mitigate the disparities in accurate and timely diagnosis and treatment of adult ADHD among the American population. (J. of Att. Dis. 2010; 13(4) 424-432)
Predictors of Nonmedical ADHD Medication Use by College Students
Authors: Rabiner David L. , Anastopoulos Arthur D. , Costello E. Jane , Hoyle Rick H. , Swartzwelder H. Scott
Published: May 2009

Objective: To identify the predictors of nonmedical ADHD medication use by college students. Participants: A total of 843 undergraduates attending one public or one private university in southeastern United States. Method: Students completed a Web-based survey inquiring about ADHD medication use during the first semester freshman of their year and a second time during the second semester of their sophomore year. Results: A total of 45 participants (5.3%) reported the onset of nonmedical ADHD use between the two survey administrations. The majority of these students were high substance users as freshman. Attention difficulties also predicted the onset of nonmedical use, especially in the absence of excessive substance use. Compared with other nonmedical users of ADHD medication, those reporting attention difficulties had lower GPAs, greater academic concerns, and higher levels of depressive symptoms. Conclusion: Attention difficulties contribute to the onset of nonmedical ADHD medication use in a significant minority of nonmedical users. These students may begin using ADHD medication to address attention problems they experience as undermining their academic success. (J. of Att. Dis. 2010; 13(6) 640-648)
MRI measures show significant cerebellar gray matter volume loss in multiple sclerosis and are associated with cerebellar dysfunction
Authors: Anderson VM , Fisniku LK , Altmann DR , Thompson AJ , Miller DH
Published: May 2009

Background

Regional atrophy measures may offer useful information about the causes of specific clinical deficits in multiple sclerosis (MS).

Objective

To determine the magnitude of cerebellar gray and white matter (GM and WM) atrophy in patients with clinically isolated syndromes (CIS) and MS, and their role in clinical manifestations of cerebellar damage.

Methods

T1-weighted volumetric magnetic resonance imaging (MRI) of 73 patients [29 CIS, 33 relapsing–remitting MS (RRMS), 11 secondary progressive MS (SPMS)] was compared with 25 controls. GM and WM regions were generated using SPM5 and cerebellar regions delineated. Linear regression was used to investigate differences in tissue-specific cerebellar volumes between groups and the association with clinical measures.

Results

Mean cerebellar GM volume (CGMV) was 100.1 cm3 in controls, 96.4 cm3 in CIS patients, 91.8 cm3 in RRMS patients, and 88.8 cm3 in SPMS patients. Mean cerebellar WM volumes (CWMV) were 21.3 cm3, 20.4 cm3, 19.9 cm3, and 18.8 cm3, respectively. CGMV was reduced by 4.8 cm3 ( P = 0.054) in RRMS patients, and 8.5 cm3 ( P = 0.012) in SPMS patients, relative to controls. Only patients with SPMS showed a borderline significant reduction in CWMV compared with controls (mean 2.1 cm3, P = 0.053). CGMV was significantly smaller in patients assessed as having cerebellar dysfunction compared with patients who had normal cerebellar function. Significant associations of CGMV and CWMV with performance on the nine-hole peg test were also observed.

Conclusion

Clinically relevant GM atrophy occurs in the cerebellum of MS patients and is more prominent than WM atrophy. As such, it may provide complementary data to other regional atrophy and intrinsic tissue measures.
Retinal nerve fiber thickness in inflammatory demyelinating diseases of childhood onset
Authors: Yeh EA , Weinstock-Guttman B , Lincoff N , Reynolds J , Weinstock A , Madurai N , Agarwal N , Buch P , Karpinski M , Ramanathan M
Published: May 2009

Purpose

To evaluate retinal nerve fiber layer thickness (RNFLT) using optical coherence tomography (OCT) in children with acquired demyelinating diseases.

Methods

This is a cross-sectional study of patients seen between 2006–2008 at the Pediatric MS Center of the Jacobs Neurological Institute. Consensus definitions for pediatric demyelinating disease were followed. All children received OCT testing and assessment of visual acuity (VA) using Snellen and low contrast letter acuity (LCLA) charts.

Results

Thirty-eight children diagnosed with acquired demyelinating disease, 15 healthy controls, and five children with other neurological disorders (OND) were included. Average RNFLT in healthy controls was 107 ± 12 μm( n = 30) versus 108 ± 5 μm ( n = 10) in OND controls. In children with multiple sclerosis, average RNFLT ± SD was 99 ± 14 μm in unaffected ( n = 24) versus 83 ± 12 μmin eyes affected by optic neuritis (“affected eyes”) ( n = 10). Average RNFLT in children with acute disseminated encephalomyelitis and transverse myelitis was 102 ± 15 μm in unaffected ( n = 18) versus 67 ± 17 μm in affected eyes ( n = 6). In children with optic neuritis (ON), average RNFLT ± SD was 97 ± 13 μm in unaffected ( n = 5) versus 89 ± 12 μm in affected eyes ( n = 9). Differences between children with demyelinating disease and controls and between ON and nonON eyes were statistically significant ( P < 0.001). Bivariate correlations of RNFLT with LCLA ( P = 0.002) and VA ( P < 0.001) were significant.

Conclusions

OCT may be a valuable tool for the assessment and monitoring of anterior optic pathway dysfunction in children with demyelinating diseases.
Pulmonary arterial hypertension associated with interferon beta treatment for multiple sclerosis: a case report
Authors: Ledinek AH , Jazbec SŠ , Drinovec I , Rot U
Published: May 2009

A 23-year-old woman with multiple sclerosis developed respiratory symptoms 3 years after introduction of interferon beta-1b. The diagnosis of pulmonary arterial hypertension (PAH) was established. The patient partially responded to sildenafil and bosetan treatment. This is the first report of PAH, associated with interferon beta therapy. As shown in experimental models, interferon treatment can induce PAH by stimulation of thromboxane cascade and secretion of various inflammatory mediators.
Evaluating potential therapies for bladder dysfunction in a mouse model of multiple sclerosis with high-resolution ultrasonography
Authors: Al-Izki S , Pryce G , Giovannoni G , Baker D
Published: May 2009

Background

In multiple sclerosis (MS), demyelinating and neurodegenerative lesions develop throughout the central nervous system, which result in a loss of neurotransmission. As a result, people with MS exhibit a wide range of symptoms including dysfunction of the bladder, which can lead to urinary incontinence or retention. Such signs can develop in animal models of MS. Current assessments of bladder properties in animal models are generally invasive, electrophysiological techniques.

Objective

The use of a non-invasive, ultrasound system for measuring bladder volume in a mouse model of MS.

Methods

Chronic relapsing experimental autoimmune encephalomyelitis was induced in mice. The bladder volume was assessed using ultrasonography, during the disease course and following therapy with bethanechol chloride.

Results

It was demonstrated that volumes obtained ultrasonically positively-correlated (r = 0.960) with the urine volumes obtained by manual expression. It was also shown for the first time that bladder size increased significantly in mice with residual neurological deficit. Indeed, this increase in bladder size showed a strong, positive-correlation (r = 0.951) with the hind limb spasticity. Following treatment with bethanechol chloride, bladder volume significantly decreased in mice with chronic experimental autoimmune encephalomyelitis.

Conclusion

This study demonstrates a novel outcome measure in experimental MS that allows; repeated, non-invasive, high resolution ultrasonic monitoring of bladder function.
Aquaporin-4 autoimmune syndrome and anti-aquaporin-4 antibody-negative opticospinal multiple sclerosis in Japanese
Authors: Matsushita T , Isobe N , Matsuoka T , Shi N , Kawano Y , Wu XM , Yoshiura T , Nakao Y , Ishizu T , Kira JI
Published: May 2009

Background

Antibodies to aquaporin-4 (AQP4) are found in a fraction of Japanese opticospinal multiple sclerosis (OSMS) patients. However, it remains unknown whether anti-AQP4 antibody-positive and negative OSMS patients possess an identical disease.

Objective

The objective of the current study was to clarify immunological differences between the two groups of patients.

Methods

We studied the serum antibody titers against AQP4 in 191 patients with idiopathic central nervous system demyelinating diseases and clarified their relationships with immunological parameters.

Results

Anti-AQP4 antibody positivity rate was higher in patients with OSMS (21/58, 36.2%), idiopathic recurrent myelitis (4/17, 23.5%), and recurrent optic neuritis (7/26, 26.9%), than in conventional MS (CMS) patients (6/90, 6.7%) and patients with other diseases (0/87). Anti-AQP4 antibody titer was significantly higher in patients with SS-A/B antibodies than in those without them. Anti-AQP4 antibody-negative OSMS patients showed significantly higher CD4+IFN-γ+IL-4−T cell percentages and intracellular IFN-γ/IL-4 ratios than anti-AQP4 antibody-positive patients, anti-AQP4 antibody-negative CMS patients, and healthy controls, and CD4+IFN-γ+IL-4−T cell percentages were negatively correlated with anti-AQP4 antibody titers.

Conclusion

Anti-AQP4 antibody-positive patients are immunologically distinct from anti-AQP4 antibody-negative OSMS patients owing to a Th2 shift in the former group in comparison to a Th1 shift in the latter.
Randomized study of interferon beta-1a, low-dose azathioprine, and low-dose corticosteroids in multiple sclerosis
Authors: Havrdova E , Zivadinov R , Krasensky J , Dwyer MG , Novakova I , Dolezal O , Ticha V , Dusek L , Houzvickova E , Cox JL , Bergsland N , Hussein S , Svobodnik A , Seidl Z , Vaneckova M , Horakova D
Published: May 2009

Background

Studies evaluating interferon beta (IFNβ) for multiple sclerosis (MS) showed only partial efficacy. In many patients, IFNβ does not halt relapses or disability progression. One strategy to potentially enhance efficacy is to combine IFNβ with classical immunosuppressive agents, such as azathioprine (AZA) or corticosteroids, commonly used for other autoimmune disorders.

Objective

The Avonex–Steroids–Azathioprine study was placebo-controlled trial and evaluated efficacy of IFNβ-1a alone and combined with low-dose AZA alone or low-dose AZA and low-dose corticosteroids as initial therapy.

Methods

A total of 181 patients with relapsing–remitting MS (RRMS) were randomized to receive IFNβ-1a 30 μg intramuscularly (IM) once weekly, IFNβ-1a 30 μg IM once weekly plus AZA 50 mg orally once daily, or IFNβ-1a 30 μg IM once weekly plus AZA 50 mg orally once daily plus prednisone 10 mg orally every other day. The primary end point was annualized relapse rate (ARR) at 2 years. Patients were eligible for enrollment in a 3-year extension.

Results

At 2 years, adjusted ARR was 1.05 for IFNβ-1a, 0.91 for IFNβ-1a plus AZA, and 0.73 for combination. The cumulative probability of sustained disability progression was 16.8% for IFNβ-1a, 20.7% for IFNβ-1a plus AZA, and 17.5% for combination. There were no statistically significant differences among groups for either measure at 2 and 5 years. Percent T2 lesion volume change at 2 years was significantly lower for combination (+14.5%) versus IFNβ-1a alone (+30.3%, P < 0.05). Groups had similar safety profiles.

Conclusion

In IFNβ-naïve patients with early active RRMS, combination treatment did not show superiority over IFNβ-1a monotherapy.