bluuebunny/crossref_metadata_2025 huggingface dataset:
“Becoming”: A Method for Expanding Systemic Thinking and Deepening Empathic Accuracy
Authors: SNYDER MARYHELEN
Published: July 2004

The method of “becoming,” as an approach to increasing empathic ability, promoting exploratory dialogue, and heightening consciousness, is described. The method is seen as applicable across theoretical orientations. It is a way to operationalize Martin Buber's concept of “inclusion,” which he defined as a “bold swinging” into the consciousness of another person. Details are given about the method's application to resistance, confusion, defensiveness, criticalness, and other barriers to awareness, relationship, and the co‐creation of shared meanings. Case examples are provided to illustrate the use of the method in a variety of contexts.
Timing Disclosure Sessions: Adding a Narrative Perspective to Clinical Work with Adult Survivors of Childhood Sexual Abuse
Authors: WEINGARTEN KATHY , COBB SARA
Published: July 2004

Though the literature on the diagnosis and treatment of survivors of childhood sexual abuse has burgeoned in the last 20 years, relatively little guidance is available in the popular or professional literature to assist clients or therapists about issues of disclosure of this abuse to family members. When authors explicitly focus on disclosure, the timing of such disclosure is usually framed within a psychological and/or interpersonal perspective. In this article, we suggest that attention to characteristics of the sexual abuse narrative itself offers an important additional resource to guide decision making with respect to disclosure. We also describe ways that a narrative approach to disclosure can produce empowering conversational practices. A detailed case example provides the clinical material to illustrate this narrative approach to disclosure.
Forming a Consortium: A Design for Interagency Collaboration in the Delivery of Service Following the Disclosure of Incest
Authors: PECK JUDITH STERN , SHEINBERG MARCIA , AKAMATSU N. NORMA
Published: July 2004

A central issue in the treatment of intrafamilial sexual abuse is the “secondary trauma” experienced by both the victimized child and her family when the wider system of regulatory and treatment agencies present redundant, incongruent, or conflicting perspectives and demands. This article describes an attempt to effect second‐order change through formation of a consortium of regulatory and treatment agencies to develop a consistent and coordinated response to the disclosure of sexual abuse. Feminist, social constructionist, and organizational development ideas are used to develop principles of intersubjectivity, collaboration and a “both‐and” stance, which have guided both the clinical and wider systems work.
Who's Got the Power? Gender Differences in Partners’ Perceptions of Influence During Marital Problem‐Solving Discussions
Authors: BALL F.L. JESSICA , COWAN PHILIP , COWAN CAROLYN PAPE
Published: July 2004

Previous research on marital communication indicates that women have more influence in marital problem solving because they raise the issues and shape the discussion. Other studies suggest that men have the power in marital problem solving. This study re‐examines power and influence from the partners’ point of view. Twenty‐seven couples — 18 with a first child under 2, and 9 undecided about having children — were videotaped while working on a self‐selected problem concerning their division of family labor. Data sources included: (a) transcribed audiotaped accounts given by each partner while viewing a videotape of their problem‐solving discussion; (b) self‐report questionnaires; and (c) ratings by a research team of the concordance between spouses’ accounts. Husbands and wives were perceived as having a primary influence on different aspects of the discussion. Women tended to raise the issues and draw men out in the early phase of the discussion, while men controlled the content and emotional depth of the later discussion phases, and largely determined the outcome. The women's accounts emphasized that their influence in the early phase was often illusory: their behavior was shaped primarily by the effort to choose strategies that would avoid upsetting their husbands. In terms of overall satisfaction with marriage, wives had greater tolerance than their husbands for conflict in the area of division of domestic labor, but less tolerance for their husbands’ domination of the discussion process. Women's marital satisfaction was higher when there was concordance between spouses in their accounts of their problem‐solving discussion. This research highlights the importance of eliciting spouses’ own perceptions and definitions in understanding the impact of gender‐linked power differences in marital communication.
The Value of Curiosity and Naiveté for the Cross‐Cultural Psychotherapist
Authors: DYCHE LARRY , ZAYAS LUIS H.
Published: July 2004

Therapists today face a dramatic increase in the cultural diversity of their client populations. Cultural literacy, long the dominant model for preparing to do cross‐cultural therapy, advocates study of the prospective client's history and culture. This model, however, poses logistical problems, emphasizes scholarship over the experiential and phenomenological, and risks seeing clients as their culture and not as themselves. In this essay, we argue that teaching culture alone can obscure therapists’ view of human diversity. To balance the cognitive model of preparation, a process‐oriented approach is considered, whereby the therapists’ attitudes of cultural naiveté and respectful curiosity are given equal importance to knowledge and skill. We begin from a concern with clients’ vulnerability in the power distribution that inevitably exists in therapy, especially with immigrant and marginalized populations. The use of acculturation narratives, which the therapist explores with naiveté and curiosity, helps clients to find their voices.
The Excitation‐Adaptation Model of Pediatric Chronic Illness
Authors: MEIJER ANNE MARIE , OPPENHEIMER LOUIS
Published: July 2004

This article examines the value of the psychosomatic family model for the study of chronically ill children. Four conceptual problems arise in the discussion of this model: the unidirectional causality of the model; the function of the sick child for the family system; the pathology of the family characteristics; and the disease type. In the present study, we propose (a) that a distinction be made between uncontrolled and controlled forms of disease, and (b) that the family characteristics of “cohesion” and “adaptation” be examined in relation to the parental capacity for problem solving and the acceptance or rejection of the child by the parents. This is shown by means of empirical research. In this empirical study, 20 families with a child suffering from controlled asthma are compared with 20 families with a child suffering from uncontrolled asthma. Contrary to the assumptions derived from the psychosomatic family model, the results show significantly more cohesion and structure in the group with a child suffering from controlled asthma. The findings from this study are integrated in a new model for the study of chronic childhood illness —“the excitation‐adaptation model.” In this model, two circular processes are emphasized involving (a) the progress of the illness and the way in which parents and child deal with medication and medical advice (therapy compliance), and (b) the factors influencing the therapy compliance on the part of the parents, the family, and the child. By studying these factors in connection with the management of the illness, it should become clear whether family characteristics are adaptive or pathological.
Evaluating Therapists' Practices in a Postmodern World: A Discussion and a Scheme
Authors: Flemons Douglas G. , Green Shelley K. , Rambo Anne H.
Published: July 2004

The social constructionist ideas currently reshaping the practice of family therapy are also relevant for supervision. However, if, as postmodernists assert, there is no privileged, expert position, how can supervisors evaluate their trainees? This question — a most pertinent one for university‐based supervision, where evaluation is necessary and constant — is addressed both theoretically and pragmatically in this article. Ethical issues are explored, and an evaluation form, developed by the authors for use in a family therapy doctoral program, is presented and discussed.
Global Assessment of Relational Functioning Scale (GARF): II. Reliability and Validity in a Sample of Families of Bipolar Patients
Authors: DAUSCH BARBARA M. , MIKLOWITZ DAVID J. , RICHARDS JEFFREY A.
Published: July 2004

The companion article by the Group for the Advancement of Psychiatry (GAP) Committee on the Family (see p. 155, this issue) describes the development of the Global Assessment of Relational Functioning (GARF) scale. The present study evaluated the reliability and concurrent validity of a manualized version of the GARF in recently episodic bipolar patients (N = 73) participating with family members in laboratory interaction tasks. The GARF was applied with high reliability by raters with little clinical experience. GARF ratings discriminated between families rated high and low in expressed emotion, with families rated as high in emotional overinvolvement showing the lowest relational functioning scores. GARF scores also correlated with affective negativity scores derived from the interactional task‐based affective style and coping style coding systems. However, relational ratings were independent of levels of concurrent symptoms or illness chronicity among individual patients. GARF ratings may inform the treatment plans for patients with psychiatric disorders, but the optimal methods of data collection and rater training must be determined.
The Concept of Family Resilience: Crisis and Challenge
Authors: WALSH FROMA
Published: July 2004

The concept of resilience, the ability to withstand and rebound from crisis and adversity, has valuable potential for research, intervention, and prevention approaches aiming to strengthen couples and families. Resilience has been viewed as residing within the individual, with the family often dismissed as dysfunctional. This article advances a systemic view of resilience in ecological and developmental contexts and presents the concept of family resilience, attending to interactional processes over time that strengthen both individual and family hardiness. Extending our understanding of normal family functioning, the concept of family resilience offers a useful framework to identify and fortify key processes that enable families to surmount crises and persistent stresses. There are many pathways in relational resilience, varying to fit diverse family forms, psychosocial challenges, resources, and constraints. Shared beliefs and narratives that foster a sense of coherence, collaboration, competence, and confidence are vital in coping and mastery. Interventions to strengthen family resilience have timely relevance for weathering the rapid social changes and uncertainties facing families today.
Toward a Definition of Family Resilience: Integrating Life‐Span and Family Perspectives
Authors: Hawley Dale R. , DeHaan Laura
Published: July 2004

Family resilience is a relatively new construct that describes how families adapt to stress and bounce back from adversity. Literature pertaining to resilience as a family‐level variable is reviewed. An overview of the developmental psychopathology literature dealing with individual resilience is also presented. Implications for extending the study of family resilience drawn from research on individual resilience are discussed and a definition of family resilience is proposed.
A Psychoeducational Group Intervention for Family Members of Persons with HIV/AIDS
Authors: POMEROY ELIZABETH C. , RUBIN ALLEN , WALKER REBECCA J.
Published: July 2004

We describe a psychoeducational group intervention for family members of persons living with AIDS. The 33 family members were compared with 13 waiting‐list controls in order to evaluate the effectiveness of the intervention. We focus on the practice aspects of the intervention, its development and implementation, and our belief that it is an apparently effective approach for helping family members work through the social and emotional aspects of the devastating impact of HIV/AIDS.
Marital Conflict and Differential Treatment of Siblings
Authors: DEAL JAMES E.
Published: July 2004

Sibling differential experience of the family environment has recently come to the forefront of both the family and the developmental literatures. One hypothesized determinant of such treatment is marital conflict. The present report used structural family therapy as a theoretical framework to examine the relation between marital conflict and differential treatment of siblings in a sample of married couples with preschool and elementary‐school children. The results did find a significant, though modest, relation between marital conflict and differential treatment, suggesting that positive marital communication in an environment of mutual respect serves to lower the rate of differential treatment of siblings within the family.
Working with Lesbians, Gays, and Bisexuals: Addressing Heterosexism in Supervision
Authors: LONG JANIE K.
Published: July 2004

Heterosexism is a form of multicultural bias that has the potential to harm both clients and supervisees. Supervisors are encouraged to examine their own heterosexist lens as a first step in providing a safe environment in which supervisees can challenge their own heterosexism. The issue of heterosexism is first discussed from an ethical vantage point. The second section of the article examines four facets of heterosexism (discrimination, lack of knowledge, stereotyping, and insensitivity) and how they might be exhibited by the supervisor in the supervision arena. Special topics discussed in this section include: the possible consequences of “coming out” in the supervisory context; the presence of heterosexism in the foundational family systems theory; the need for recognition of the special family characteristics of lesbians, gays, and bisexuals; the value of personal and professional relationships with persons who are gay, lesbian, and bisexual; common heterosexist stereotypes and research that refutes them; and the use of language. The final section of the article offers suggestions for working with supervisees around these issues.
Platelet hyperactivity in clinical depression and the beneficial effect of antidepressant drug treatment: how strong is the evidence?
Authors: Von Känel R.
Published: July 2004

Objective: Platelet hyperactivity is thought to contribute to the increased coronary artery disease (CAD) risk in depression. This study reviewed the evidence for hyperactive platelets and for effects of antidepressant drug treatment on platelet ‘stickiness’ in clinical depression.

Method: By means of PubMed electronic library search, 34 studies in English were identified (1983–2003) and critically reviewed.

Results: In depression, flow cytometry studies allowing detection of subtle platelet activation states consistently found at least one platelet activation marker to be increased, while the bulk of platelet aggregation studies did not suggest increased platelet aggregability. Platelets seem to be more activated in depressed patients with CAD than in depressed individuals without CAD. The selective serotonin reuptake inhibitors normalized platelet hyperactivity in four studies.

Conclusion: Data on platelet activity in depression are inconclusive. To resolve this issue and its clinical implications, studies in larger sample sizes controlling for confounders of platelet functioning and prospectively designed are needed.
Smoking and depressive symptoms in Chinese elderly in Hong Kong
Authors: Lam T. H. , Li Z. B. , Ho S. Y. , Chan W. M. , Ho K. S. , Li M. P. , Leung G. M.
Published: July 2004

Objective:  To examine the association between smoking and depressive symptoms among Chinese elderly in Hong Kong.

Method: Cross‐sectional data on smoking and depressive symptoms from 56 167 Chinese elderly aged 65 or over in Hong Kong were analysed using logistic regression.

Results:  Current smokers and former smokers were more likely to have depressive symptoms than never smokers. The adjusted odds ratios (OR) and 95% confidence interval (CI) in males and females respectively were 1.62 (1.34–1.96) and 1.43 (1.20–1.70) for current smokers, and were 1.18 (0.99–1.40) and 1.29 (1.12–1.47) for former smokers. Former smokers were less likely to have depressive symptoms than current smokers (OR = 0.80, 95% CI: 0.70–0.92).

Conclusion:  Smoking is positively associated with depressive symptoms in Chinese elderly. Health care workers should be vigilant about the detection of depressive symptoms in elderly smokers.
Retroviral Spread by Induction of Virological Synapses
Authors: Jolly Clare , Sattentau Quentin J.
Published: August 2004

Cells of the immune system communicate via the formation of receptor‐containing adhesive junctions termed immunological synapses. Recently, retroviruses have been shown to subvert this process in order to pass directly from infected to uninfected immune cells. Such cell–cell viral dissemination appears to function by triggering existing cellular pathways involved in antigen presentation and T‐cell communication. This mode of viral spread has important consequences for both the virus and the host cells in terms of viral pathogenesis and viral resistance to immune and therapeutic intervention. This review summarises the current knowledge concerning virological synapses induced by retroviruses.
Masking of the CD3γ di‐Leucine‐based Motif by ζ is Required for Efficient T‐Cell Receptor Expression
Authors: Lauritsen Jens Peter H. , Bonefeld Charlotte Menné , von Essen Marina , Nielsen Martin Weiss , Rasmussen Anette Bødker , Ødum Niels , Dietrich Jes , Geisler Carsten
Published: August 2004

The T‐cell receptor (TCR) is a multimeric receptor composed of the Tiαβ heterodimer and the noncovalently associated CD3γδε and ζ2 chains. All of the TCR chains are required for efficient cell surface expression of the TCR. Previous studies on chimeric molecules containing the di‐leucine‐based endocytosis motif of the TCR subunit CD3γ have indicated that the ζ chain can mask this motif. In this study, we show that successive truncations of the cytoplasmic tail of ζ led to reduced surface expression levels of completely assembled TCR complexes. The reduced TCR expression levels were caused by an increase in the TCR endocytic rate constant in combination with an unaffected exocytic rate constant. Furthermore, the TCR degradation rate constant was increased in cells with truncated ζ. Introduction of a CD3γ chain with a disrupted di‐leucine‐based endocytosis motif partially restored TCR expression in cells with truncated ζ chains, indicating that the ζ chain masks the endocytosis motif in CD3γ and thereby stabilizes TCR cell surface expression.
Control of Immune Responses by Trafficking Cell Surface Proteins, Vesicles and Lipid Rafts to and from the Immunological Synapse
Authors: Taner Sabrina B. , Önfelt Björn , Pirinen Niina J. , McCann Fiona E. , Magee Anthony I. , Davis Daniel M.
Published: August 2004

Supramolecular clusters at the immunological synapse provide a mechanism for structuring complex communication networks between cells of the immune system. Regulating intra‐ and intercellular trafficking of proteins and lipids to and from the immunological synapse provides an additional level of complexity in determining the functional outcome of immune cell interactions. An emergent principle is that molecules requiring tightly regulated cell surface expression, e.g. negative regulators of cell activation or molecules promoting cytotoxicity, are trafficked to the immunological synapse from intracellular secretory as required lysosomes. Many molecules required for the early stages of the intercellular communication are already present at the cell surface, sometimes in lipid rafts, and are rapidly translocated laterally to the intercellular contact. Our understanding of these events critically depends on utilizing appropriate technologies for probing supramolecular recognition in live cells. Thus, we also present here a critical discussion of the technologies used to study lipid rafts and, more broadly, a map of the spatial and temporal dimensions covered by current live cell physical techniques, highlighting where advances are needed to exceed current spatial and temporal boundaries.
Scintigraphic Appearance of the Dorsal Cortex of the Third Metacarpus and Third Metatarsus in the Horse
Authors: Schallberger Sandra P. , Doherr Marcus G. , Ueltschi Gottlieb
Published: August 2004

The lack of “standard uptake pattern” to refer to when interpreting scintigraphic images poses a problem to anyone working with skeletal scintigraphy. An article written by Koblik et al. stated that in the normal scintigraphic image of older horses, the dorsal cortex of the metacarpus and metatarsus is not identifiable, whereas it can be identified in younger horses. In this retrospective study we evaluated the association between the age of a horse and visibility of the dorsal cortex of the metacarpus and metatarsus. We found that dorsal cortical uptake can be seen in the normal adult horse. The population in the study consisted of 139 horses scanned under general anesthesia in lateral recumbency. Scintigraphic images of 202 limbs were examined visually and by using a profile image tool. In almost all limbs the dorsal cortex was identifiable (82%); only 7% of the dorsal cortices were not identifiable; and 11% of the scintigraphic images were not interpretable.
Nuclear Scintigraphic Evaluation of the Distal Tarsal Region in Normal Horses
Authors: Murray Rachel C. , Dyson Sue J. , Weekes Jo S. , Branch Marion V. , Hladick Sarah
Published: August 2004

Bone‐phase scintigraphy is sensitive to the dynamic process of bone modeling and remodeling, which may be adaptive or pathologic. Our knowledge of normal patterns of radiopharmaceutical uptake (RU) is limited, making interpretation of images problematic. It is therefore important to characterize normal patterns of RU at specific sites and relate these to age and exercise, to ensure valid interpretation of images in clinical cases with subtle lesions. This study aimed to characterize patterns of uptake of radiopharmaceutical in the distal tarsal region in clinically normal horses, and to investigate the effects of age and work discipline. Retrospective evaluation of nuclear scintigraphic images of the distal tarsal region of 30 clinically sound, high‐level showjumpers and lower‐level riding horses was performed. All images were acquired dynamically as a series of 35 two‐second frames, which were then motion corrected and summated. The images were assessed using vertical and horizontal profile analysis across the distal tarsal region, and regions of interest comparisons between the distal tarsal region and tibia within each horse. There was a repeatable pattern of RU across the distal tarsal region in both horizontal and vertical directions. There was significantly greater RU on the dorsal compared with plantar aspect, and lateral compared with medial aspect of the distal tarsal region. RU in the right distal tarsal region was significantly greater than in the left. Elite showjumpers had significantly higher RU ratio compared with the lower‐level riding horses, but no significant alterations in the pattern of RU were detected.
Malignant Tumor Formation in Dogs Previously Irradiated for Acanthomatous Epulis
Authors: McEntee Margaret C. , Page Rodney L. , Théon Alain , Erb Hollis N. , Thrall Donald E.
Published: August 2004

In this retrospective study of 57 dogs irradiated for oral acanthomatous epulis, 2 (3.5%) dogs developed a second tumor (sarcoma, osteosarcoma) in the radiation treatment field at 5.2 and 8.7 years after the end of radiation therapy. As opposed to previous reports, no second epithelial tumors developed in the radiation treatment field. There is a risk of radiation‐induced carcinogenesis, but it appears that it is a relatively low risk and an event that occurs years after radiation therapy. Radiation‐induced tumors are of more concern in younger dogs that undergo radiation therapy for tumors that are radioresponsive, such as acanthomatous epulis, where long‐term survival is expected. The only statistically significant variable in the survival analysis was age, with dogs less than 8.3 years old having a significantly longer median overall survival (2322 days) than dogs older than 8.3 years (1106 days;P<0.0001).
Cobalt Radiation with or without Low‐Dose Cisplatin for Treatment of Canine Naso‐Sinus Carcinomas
Authors: Nadeau Marie‐Eve , Kitchell Barbara E. , Rooks Robert L. , LaRue Susan M.
Published: August 2004

The objective of this study was to determine if low‐dose cisplatin could be added safely to radiation therapy for the treatment of naso‐sinus carcinomas in dogs. Thirty‐one dogs were evaluated; 18 of these dogs received cobalt radiation in combination with low‐dose cisplatin while 13 dogs received radiation alone. No difference was observed for acute or late radiation effects. Cisplatin was administered at a dosage of 7.5 mg/m220 min prior to every other radiation treatment. An initial dose of 10 mg/m2was intended but toxicity (primarily azotemia) was unacceptable. Cisplatin was administered as prescribed in 12 of 18 dogs. Cisplatin was discontinued in 2 dogs because of azotemia. In the other 4 dogs cisplatin was not administered as prescribed because the dogs were withdrawn from treatment due to disease progression or radiation effects. There was no long‐term renal disease in patients who developed azotemia. The overall median survival was 433 days with 4 (12.9%) dogs still alive at the completion of the study.
Presidential Rhetoric and the Power of Definition
Authors: ZAREFSKY DAVID
Published: July 2004

This feature addresses three questions: (1) How do we understand the nature of presidential rhetoric and its effects? (2) What does presidential rhetoric do? (3) How do we know? From the perspective of the humanities, rhetoric is a complex transaction among speakers or writers, texts or performance, audiences, and critics. Effects are better understood as invitations to respond. A key function of presidential rhetoric is to define social reality. Eight case studies explore how presidents from George Washington to George W. Bush have relied on rhetorical definition.
THE FAILURE OF ORGANIZING, THE NEW UNITY PARTNERSHIP, AND THE FUTURE OF THE LABOR MOVEMENT
Authors: Hurd Richard
Published: August 2004

Organizing has been at the heart of union strategy discussions for twenty years; it became labor's top priority with the election of John Sweeney as president of the American Federation of Labor‐Congress of Industrial Organizations (AFL‐CIO) in 1995. However, recent data on membership confirm that union fortunes continue to decline. In response to the deepening crisis, five major unions formed the New Unity Partnership (NUP) in 2003. These unions argue that there is a fundamental weakness in the movement's structure that must be addressed. They call for consolidation through mergers, and for open debate on the role for the AFL‐CIO. There is open resistance to the restructuring proposals, and there are practical barriers to implementation. The NUP unions themselves have not been able to achieve increased density on a national scale. In spite of skepticism and resistance, the dramatic nature of the NUP framework at least broaches the notion that organizational transformation is required.
Revised Definitions of Women's Sexual Dysfunction
Authors: Basson Rosemary , Leiblum Sandra , Brotto Lori , Derogatis Leonard , Fourcroy Jean , Fugl-Meyer Kerstin , Graziottin Alessandra , Heiman Julia R. , Laan Ellen , Meston Cindy , Schover Leslie , Van Lankveld Jacques , Schultz Willibrord Weijmar
Published: August 2004

Introduction

Existing definitions of women's sexual disorders are based mainly on genitally focused events in a linear sequence model (desire, arousal and orgasm).

Aim

To revise definitions based on an alternative model reflecting women's reasons/incentives for sexual activity beyond any initial awareness of sexual desire.

Methods

An International Definitions Committee of 13 experts from seven countries repeatedly communicated, proposed new definitions and presented at the 2nd International Consultation on Sexual Medicine in Paris July 2003.

Main Outcome Measure

Expert opinions/recommendations are based on a process that involved review of evidence-based medical literature, extensive internal committee discussion, informal testing and re-testing of drafted definitions in various clinical settings, public presentation and deliberation.

Results

Women have many reasons/incentives for sexual activity. Desire may be experienced once sexual stimuli have triggered arousal. Arousal and desire co-occur and reinforce each other. Women's subjective arousal may be minimally influenced by genital congestion. An absence of desire any time during the sexual experience designates disorder. Arousal disorder subtypes are proposed that separate an absence of subjective arousal from all types of sexual stimulation, from an absence of subjective arousal when the only stimulus is genital. A new arousal disorder has provisionally been suggested, namely that of persistent genital arousal. Orgasm disorder is limited to absence of orgasm despite high subjective arousal. Dyspareunia includes partial painful vaginal entry attempts as well as pain with intercourse. Variable reflex muscle tightening around the vagina and an absence of abnormal physical findings are noted in the definition of vaginismus. Women's sexuality is highly contextual and descriptors are recommended re past psychosexual development, current context, as well as medical status. Diagnosing sexual disorders need not imply intrinsic dysfunction of the woman's own sex response system.

Conclusions

The International Definitions Committee has recommended a number of fundamental changes to the existing definitions of women's sexual disorders.
Disorders of Orgasm in Women
Authors: Meston Cindy M. , Hull Elaine , Levin Roy J. , Sipski Marca
Published: August 2004

Introduction

Orgasm is a sensation of intense pleasure creating an altered consciousness state accompanied by pelvic striated circumvaginal musculature and uterine/anal contractions and myotonia that resolves sexually-induced vasocongestion and induces well-being/contentment. In 1,749 randomly-sampled U.S. women, 24% reported an orgasmic dysfunction.

Aim

To provide recommendations/guidelines concerning state-of-the-art knowledge for management of orgasmic disorders in women.

Methods

An International Consultation in collaboration with the major urology and sexual medicine associations assembled over 200 multidisciplinary experts from 60 countries into 17 committees. Committee members established specific objectives and scopes for various male and female sexual medicine topics. The recommendations concerning state-of-the-art knowledge in the respective sexual medicine topic represent the opinion of experts from five continents developed in a process over a 2-year period. Concerning the Disorders of Orgasm in Women Committee, there were four experts from two countries.

Main Outcome Measure

Expert opinion was based on grading of evidence-based medical literature, widespread internal committee discussion, public presentation and debate.

Results

Female Orgasmic Disorder, the second most frequently reported women's sexual problem is considered to be the persistent or recurrent delay in, or absence of, orgasm following a normal sexual excitement phase that causes marked distress or interpersonal difficulty (DSM-IV). Empirical treatment outcome research is available for cognitive behavioral and pharmacological approaches. Cognitive-behavioral therapy for anorgasmia promotes attitude and sexually-relevant thought changes and anxiety reduction using behavioral exercises such as directed masturbation, sensate focus, and systematic desensitization treatments as well as sex education, communication skills training, and Kegel exercises. To date there are no pharmacological agents trials (i.e., bupropion, granisetron, and sildenafil) proven to be beneficial beyond placebo in enhancing orgasmic function in women diagnosed with Female Orgasmic Disorder.

Conclusions

More research is needed in understanding management of women with orgasmic dysfunction.
Priapism
Authors: Pryor John , Akkus Emre , Alter Gary , Jordan Gerald , Lebret Thierry , Levine Laurence , Mulhall John , Perovic Sava , Ralph David , Stackl Walter
Published: August 2004

Introduction

There are three different types of priapism: low-flow, ischemic, anoxic or veno-occlusive priapism; high-flow, arterial or nonischemic priapism; and recurrent or stuttering priapism.

Aim

To provide recommendations/guidelines concerning state-of-the-art knowledge for the diagnosis and treatment of priapism.

Methods

An International Consultation in collaboration with the major urology and sexual medicine associations assembled over 200 multidisciplinary experts from 60 countries into 17 committees. Committee members established specific objectives and scopes for various male and female sexual medicine topics. The recommendations concerning state-of-the-art knowledge in the respective sexual medicine topic represent the opinion of experts from five continents developed in a process over a 2-year period. Concerning the Priapism Committee, there were 10 experts from six countries.

Main Outcome Measure

Expert opinion was based on grading of evidence-based medical literature, widespread internal committee discussion, public presentation and debate.

Results

Concerning ischemic priapism, persistent cavernous smooth muscle relaxation and failure of contraction is a compartment syndrome with increasing intracavernosal anoxia, rising pCO2 and acidosis. Urgent medical attention should be sought for an erection lasting >4 hours; 90% with priapism >24 hours develop complete erectile dysfunction. After diagnosis and counselling, intracavernosal aspiration and alpha-blockers should precede surgical shunting. Concerning high-flow priapism (congenital, traumatic or iatrogenic), intervention is not urgent and often unnecessary. Definitive management is by selective embolization with autologous blood clot. Concerning recurrent/stuttering priapism, the pathophysiology may be central or local (sickle cell disease). Management needs to be individualized; androgen deprivation has proved useful but has adverse effects.

Conclusions

There is need for prospective, clinical trials to define safe and effective management strategies for patients with low-flow, high-flow or recurrent priapism.
Sample Size, Library Composition, and Genotypic Diversity among Natural Populations of
Escherichia coli
from Different Animals Influence Accuracy of Determining Sources of Fecal Pollution
Authors: Johnson LeeAnn K. , Brown Mary B. , Carruthers Ethan A. , Ferguson John A. , Dombek Priscilla E. , Sadowsky Michael J.
Published: August 2004

A horizontal, fluorophore-enhanced, repetitive extragenic palindromic-PCR (rep-PCR) DNA fingerprinting technique (HFERP) was developed and evaluated as a means to differentiate human from animal sources of
Escherichia coli
. Box A1R primers and PCR were used to generate 2,466 rep-PCR and 1,531 HFERP DNA fingerprints from
E. coli
strains isolated from fecal material from known human and 12 animal sources: dogs, cats, horses, deer, geese, ducks, chickens, turkeys, cows, pigs, goats, and sheep. HFERP DNA fingerprinting reduced within-gel grouping of DNA fingerprints and improved alignment of DNA fingerprints between gels, relative to that achieved using rep-PCR DNA fingerprinting. Jackknife analysis of the complete rep-PCR DNA fingerprint library, done using Pearson's product-moment correlation coefficient, indicated that animal and human isolates were assigned to the correct source groups with an 82.2% average rate of correct classification. However, when only unique isolates were examined, isolates from a single animal having a unique DNA fingerprint, Jackknife analysis showed that isolates were assigned to the correct source groups with a 60.5% average rate of correct classification. The percentages of correctly classified isolates were about 15 and 17% greater for rep-PCR and HFERP, respectively, when analyses were done using the curve-based Pearson's product-moment correlation coefficient, rather than the band-based Jaccard algorithm. Rarefaction analysis indicated that, despite the relatively large size of the known-source database, genetic diversity in
E. coli
was very great and is most likely accounting for our inability to correctly classify many environmental
E. coli
isolates. Our data indicate that removal of duplicate genotypes within DNA fingerprint libraries, increased database size, proper methods of statistical analysis, and correct alignment of band data within and between gels improve the accuracy of microbial source tracking methods.
Differential Protein Expression during Growth of
Acidithiobacillus ferrooxidans
on Ferrous Iron, Sulfur Compounds, or Metal Sulfides
Authors: Ramírez Pablo , Guiliani Nicolas , Valenzuela Lissette , Beard Simon , Jerez Carlos A.
Published: August 2004

A set of proteins that changed their levels of synthesis during growth of
Acidithiobacillus ferrooxidans
ATCC 19859 on metal sulfides, thiosulfate, elemental sulfur, and ferrous iron was characterized by using two-dimensional polyacrylamide gel electrophoresis. N-terminal amino acid sequencing and mass spectrometry analysis of these proteins allowed their identification and the localization of the corresponding genes in the available genomic sequence of
A. ferrooxidans
ATCC 23270. The genomic context around several of these genes suggests their involvement in the energetic metabolism of
A. ferrooxidans
. Two groups of proteins could be distinguished. The first consisted of proteins highly upregulated by growth on sulfur compounds (and downregulated by growth on ferrous iron): a 44-kDa outer membrane protein, an exported 21-kDa putative thiosulfate sulfur transferase protein, a 33-kDa putative thiosulfate/sulfate binding protein, a 45-kDa putative capsule polysaccharide export protein, and a putative 16-kDa protein of unknown function. The second group of proteins comprised those downregulated by growth on sulfur (and upregulated by growth on ferrous iron): rusticyanin, a cytochrome
c
552
, a putative phosphate binding protein (PstS), the small and large subunits of ribulose biphosphate carboxylase, and a 30-kDa putative CbbQ protein, among others. The results suggest in general a separation of the iron and sulfur utilization pathways. Rusticyanin, in addition to being highly expressed on ferrous iron, was also newly synthesized, as determined by metabolic labeling, although at lower levels, during growth on sulfur compounds and iron-free metal sulfides. During growth on metal sulfides containing iron, such as pyrite and chalcopyrite, both proteins upregulated on ferrous iron and those upregulated on sulfur compounds were synthesized, indicating that the two energy-generating pathways are induced simultaneously depending on the kind and concentration of oxidizable substrates available.
Purification and Characterization of Chitosanase from
Bacillus
sp. Strain KCTC 0377BP and Its Application for the Production of Chitosan Oligosaccharides
Authors: Choi Yeon Jin , Kim Eun Jung , Piao Zhe , Yun Young Chul , Shin Yong Chul
Published: August 2004

For the enzymatic production of chitosan oligosaccharides from chitosan, a chitosanase-producing bacterium,
Bacillus
sp. strain KCTC 0377BP, was isolated from soil. The bacterium constitutively produced chitosanase in a culture medium without chitosan as an inducer. The production of chitosanase was increased from 1.2 U/ml in a minimal chitosan medium to 100 U/ml by optimizing the culture conditions. The chitosanase was purified from a culture supernatant by using CM-Toyopearl column chromatography and a Superose 12HR column for fast-performance liquid chromatography and was characterized according to its enzyme properties. The molecular mass of the enzyme was estimated to be 45 kDa by means of sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The enzyme demonstrated bifunctional chitosanase-glucanase activities, although it showed very low glucanase activity, with less than 3% of the chitosanase activity. Activity of the enzyme increased with an increase of the degrees of deacetylation (DDA) of the chitosan substrate. However, the enzyme still retained 72% of its relative activity toward the 39% DDA of chitosan, compared with the activity of the 94% DDA of chitosan. The enzyme produced chitosan oligosaccharides from chitosan, ranging mainly from chitotriose to chitooctaose. By controlling the reaction time and by monitoring the reaction products with gel filtration high-performance liquid chromatography, chitosan oligosaccharides with a desired oligosaccharide content and composition were obtained. In addition, the enzyme was efficiently used for the production of low-molecular-weight chitosan and highly acetylated chitosan oligosaccharides. A gene (
csn
45) encoding chitosanase was cloned, sequenced, and compared with other functionally related genes. The deduced amino acid sequence of
csn
45 was dissimilar to those of the classical chitosanase belonging to glycoside hydrolase family 46 but was similar to glucanases classified with glycoside hydrolase family 8.
Purification, Cloning, and Sequencing of a 3,5-Dichlorophenol Reductive Dehalogenase from
Desulfitobacterium frappieri
PCP-1
Authors: Thibodeau Jacinthe , Gauthier Annie , Duguay Marie , Villemur Richard , Lépine François , Juteau Pierre , Beaudet Réjean
Published: August 2004

A membrane-associated 3,5-dichlorophenol reductive dehalogenase was isolated from
Desulfitobacterium frappieri
PCP-1. The highest dehalogenase activity was observed with the biomass cultured at 22°C, compared to 30 and 37°C, where the cell suspensions were 2.2 and 9.6 times less active, respectively. The reductive dehalogenase was purified 12.7-fold to apparent homogeneity. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis revealed a single band with an apparent molecular mass of 57 kDa. Its dechlorinating activity was not inhibited by sulfate and nitrate but was completely inhibited by 2.5 mM sulfite and 10 mM KCN. A mixture of iodopropane and titanium citrate caused a light-reversible inhibition of the dechlorinating activities, suggesting the involvement of a corrinoid cofactor. Several polychlorophenols were dechlorinated at the
meta
and
para
positions. The apparent

K
m

for 3,5-dicholorophenol was 49.3 ± 3.1 μM at a methyl viologen concentration of 2 mM. Six internal tryptic peptides were sequenced by mass spectrometry. One open reading frame (ORF) was found in the
Desulfitobacterium hafniense
genome containing these peptide sequences. This ORF corresponds to a gene coding for a CprA-type reductive dehalogenase. The corresponding ORF (named
cprA5
) in
D. frappieri
PCP-1 was cloned and sequenced. The
cprA5
gene codes for a 548-amino-acid protein that contains a twin-arginine-type signal for secretion. The gene product has a cobalamin binding site motif and two iron-sulfur binding motifs and shows 66% identity (76 to 77% similarity) with some tetrachloroethene reductive dehalogenases. This is the first CprA-type reductive dehalogenase that can dechlorinate chlorophenols at the
meta
and
para
positions.
Effects of Phosphate and Light on Growth of and Bioactive Peptide Production by the Cyanobacterium
Anabaena
Strain 90 and Its Anabaenopeptilide Mutant
Authors: Repka Sari , Koivula Minna , Harjunpä Vesa , Rouhiainen Leo , Sivonen Kaarina
Published: August 2004

Cyanobacteria synthesize several types of bioactive secondary metabolites.
Anabaena
strain 90 produces three types of bioactive peptides, microcystins (inhibitors of protein phosphatases 1 and 2A), anabaenopeptilides, and anabaenopeptins (serine protease inhibitors). To investigate the role of the anabaenopeptilides in
Anabaena
, wild-type strain 90 (WT) and its anabaenopeptilide deficient mutant (MU) were cultured with various light and phosphate levels to evaluate the effects and coeffects of these growth factors on the concentrations of the three classes of peptides and the growth characteristics. WT and MU grew in comparable ways under the different growth conditions. The total peptide concentration in WT was significantly higher than that in MU (2.5 and 1.4 μg/mg [dry weight], respectively). Interestingly, the average concentration of anabaenopeptins was significantly higher in MU than in WT (0.59 and 0.24 μg/mg [dry weight], respectively). The concentration of microcystins was slightly but not statistically significantly higher in MU than in WT (1.0 and 0.86 μg/mg [dry weight], respectively). In WT, the highest peptide concentrations were usually found after 13 days in cultures grown at medium light intensities (23 μmol m
−2
s
−1
) and with the highest phosphate concentrations (2,600 μg liter
−1
). In MU, the highest peptide concentrations were found in 13-day-old cultures grown at medium light intensities (23 μmol m
−2
s
−1
) and with phosphate concentrations greater than 100 μg liter
−1
. The higher concentrations of anabaenopeptins in MU may compensate for the absence of anabaenopeptilides. These findings clearly indicate that these compounds may have some linked function in the producer organism, the nature of which remains to be discovered.
Treatment ofSalmonella entericaSerovar Enteritidis with a Sublethal Concentration of Trisodium Phosphate or Alkaline pH Induces Thermotolerance
Authors: Sampathkumar Balamurugan , Khachatourians George G. , Korber Darren R.
Published: August 2004

The responses ofSalmonella entericaserovar Enteritidis to a sublethal dose of trisodium phosphate (TSP) and its equivalent alkaline pH made with NaOH were examined. Pretreatment ofS. entericaserovar Enteritidis cells with 1.5% TSP or pH 10.0 solutions resulted in a significant increase in thermotolerance, resistance to 2.5% TSP, resistance to high pH, and sensitivity to acid and H2O2. Protein inhibition studies with chloramphenicol revealed that thermotolerance, unlike resistance to high pH, was dependent on de novo protein synthesis. Two-dimensional polyacrylamide gel electrophoresis (PAGE) of total cellular proteins from untreated control cells resolved as many as 232 proteins, of which 22 and 15% were absent in TSP- or alkaline pH-pretreated cells, respectively. More than 50% of the proteins that were either up- or down-regulated by TSP pretreatment were also up- or down-regulated by alkaline pH pretreatment. Sodium dodecyl sulfate-PAGE analysis of detergent-insoluble outer membrane proteins revealed the up-regulation of at least four proteins. Mass spectrometric analysis showed the up-regulated proteins to include those involved in the transport of small hydrophilic molecules across the cytoplasmic membrane and those that act as chaperones and aid in the export of newly synthesized proteins by keeping them in open conformation. Other up-regulated proteins included common housekeeping proteins like those involved in amino acid biosynthesis, nucleotide metabolism, and aminoacyl-tRNA biosynthesis. In addition to the differential expression of proteins following TSP or alkaline pH treatment, changes in membrane fatty acid composition were also observed. Alkaline pH- or TSP-pretreated cells showed a higher saturated and cyclic to unsaturated fatty acid ratio than did the untreated control cells. These results suggest that the cytoplasmic membrane could play a significant role in the induction of thermotolerance and resistance to other stresses following TSP or alkaline pH treatment.