bluuebunny/crossref_metadata_2025 huggingface dataset:
Intravitreal Ranibizumab and Bevacizumab in Combination with Full-Fluence Verteporfin Therapy and Dexamethasone for Exudative Age-Related Macular Degeneration
Authors: Forte Raimondo , Bonavolontà Paola , Benayoun Yohan , Adenis Jean Paul , Robert Pierre-Yves
Published: September 2010

Purpose: To evaluate the efficacy and safety of triple therapy with intravitreal anti-vascular-endothelial-growth-factor (VEGF) antibody, dexamethasone and verteporfin photodynamic therapy (PDT) for exudative age-related macular degeneration (AMD). Methods: Retrospective, comparative, interventional study. Records of treatment-naïve patients who received intravitreal bevacizumab or ranibizumab in monotherapy or in combination with dexamethasone and full-fluence verteporfin PDT in triple therapy were reviewed. logMAR visual acuity, foveal thickness (FT) on optical coherence tomography, intraocular pressure and endophthalmitis occurrence were recorded. Results: Sixty-one eyes were included in the triple-therapy group, 40 eyes were included in the monotherapy group. The mean follow-up was 14.1 ± 3.4 months in the triple-therapy group and 16.3 ± 4.1 months in the monotherapy group. The triple-therapy group enjoyed a lower total number of treatments (1.92 ± 0.44 vs. 3.12 ± 0.37, p < 0.001) and a longer time before first retreatment (5.4 ± 3.3 vs. 3.6 ± 2.5 months, p = 0.001). A significant improvement of visual acuity and FT was present in both groups during the 12 months following first treatment. No adverse effects were observed. Conclusion: The combination of intravitreal bevacizumab or ranibizumabwith dexamethasone and full-fluence PDT for exudative AMD provided visual and anatomic improvement and a good safety profile. Triple therapy may reduce the number of retreatments when compared to anti-VEGF alone.
Clinical Significance of Early-Onset Hyperuricemia in Renal Transplant Recipients
Authors: Chung Byung Ha , Kang Seok Hui , Hwang Hyeon Seok , Choi Bum Soon , Park Cheol Whee , Kim Yong-Soo , Kim Ji-Il , Moon In Sung , Yang Chul Woo
Published: September 2010

Background/Aims: It is undetermined whether the effect of uric acid (UA) on graft outcome is independent of graft dysfunction. This study was designed to explore whether early-onset hyperuricemia has clinical significance regardless of graft function. Methods: This study was conducted based on a retrospective chart review. We calculated time-averaged UA and estimated glomerular filtration rate from the values at 3, 6, and 9 months after transplantation. Cardiovascular complications during follow-up and long-term graft survival were assessed according to UA levels and graft function. Results: 351 patients were enrolled into this study. Hyperuricemia increased the risk of cardiovascular complications (HR = 2.8, 95% CI 1.1–7.1; p = 0.02), but reduced graft function did not. In the hyperuricemia group, 5- and 10-year graft survival was significantly lower than in the normouricemia group (89 and 81% vs. 96 and 92%, respectively; p = 0.02). In the reduced graft function group, these values were also lower than in the normal graft function group (89 and 81% vs. 96 and 93%, respectively; p = 0.02). In the multivariate analysis, both hyperuricemia and reduced graft function were independent risk factors for graft failure and the presence of both factors presented the highest risk. Conclusion: Early-onset hyperuricemia is a significant predictor of cardiovascular complications and graft survival independently of graft function.
Demographic and Clinical Characteristics of Patients with Autosomal Dominant Polycystic Kidney Disease: A Multicenter Experience
Authors: Kazancioglu Rumeyza , Ecder Tevfik , Altintepe Lutfullah , Altiparmak Mehmet Riza , Tuglular Serhan , Uyanik Abdullah , Cavdar Caner , Ecder Sabahat Alisir , Tokgoz Bulent , Duman Neval , Duzova Ali , Cetinkaya Ramazan ,   on behalf of the Turkish Society of Nephrology Polycystic Kidney Disease Working Group
Published: September 2010

Aim: Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary kidney disease. It accounts for 5–10% of patients with end-stage renal disease (ESRD). The aim of this multicenter study was to investigate the demographic and clinical characteristics of patients with ADPKD. Methods: 1,139 patients with ADPKD who were followed up at 12 different centers were recruited for this study. The investigated demographic and clinical characteristics were gender, age, smoking history, educational status, the existence of hypertension, hematuria, urinary tract infection, urinary tract stones and renal replacement therapy. Patients were considered as hypertensive if they were taking antihypertensive medications or if they had blood pressure (BP) of 140/90 mm Hg or greater. If the patients were currently on antihypertensive drugs, the classes of these agents were noted. Results: 548 male and 591 female patients were included and the mean age at initial diagnosis was 37.1 ± 16.3 years. 20.3% were current smokers whereas 15% were ex-smokers. The mean systolic and diastolic BPs were 136.1 ± 29.8 and 84.9 ± 17.8 mm Hg, respectively. 63.7% used antihypertensive drugs and 73.1% of those used renin-angiotensin system blockers. 11.8% had ESRD, of which 75.8% were treated with hemodialysis. Conclusion: This study showed that hypertension is the most common (72.6%) clinical finding in ADPKD patients in Turkey and renin-angiotensin system blockers are widely used.
Early Acute Kidney Injury Is a Risk Factor That Predicts Mortality in Patients Treated with Colistin
Authors: Ko Hee ja , Jeon Min hyok , Choo Eun ju , Lee Eun jung , Kim Tae hyong , Jun Jae-Bum , Gil Hyo-Wook
Published: September 2010

The nephrotoxicity of colistin has been reported in the literature. A previous report has shown that acute kidney injury (AKI) occurred after an average of 13.5 days, but we have experienced that AKI developed with colistin administration earlier. We investigated clinical features of patients who developed AKI according to the time of AKI development after colistin use. We retrospectively collected the data of the patients who were admitted to 4 hospitals between January 2007 and May 2009. This study included 119 patients who had received intravenous colistin for over 72 h. We compared the early AKI group (AKI developed within 7 days) with the late AKI group. The patients’ age was 64.1 ± 14.0 years. AKI occurred in 65 of the 119 patients (54.6%). The duration of colistin use was 7.7 ± 6.4 days. AKI occurred in 46 patients within 7 days after colistin treatment and in 19 patients after 7 days. The patients with early AKI had a higher mortality rate than those with late AKI (OR: 4.37, 95% CI: 1.34, 14.18). In conclusion, clinicians might be cautioned that the mortality rate is higher for the patients with early occurrence of AKI than that for the patients with late occurrence of AKI.
Association of the Vitamin D Metabolism Gene
CYP24A1
With Coronary Artery Calcification
Authors: Shen Haiqing , Bielak Lawrence F. , Ferguson Jane F. , Streeten Elizabeth A. , Yerges-Armstrong Laura M. , Liu Jie , Post Wendy , O'Connell Jeffery R. , Hixson James E. , Kardia Sharon L.R. , Sun Yan V. , Jhun Min A. , Wang Xuexia , Mehta Nehal N. , Li Mingyao , Koller Daniel L. , Hakonarson Hakan , Keating Brendan J. , Rader Daniel J. , Shuldiner Alan R. , Peyser Patricia A. , Reilly Muredach P. , Mitchell Braxton D.
Published: September 2010

Objective—

The vitamin D endocrine system is essential for calcium homeostasis, and low levels of vitamin D metabolites have been associated with cardiovascular disease risk. We hypothesized that DNA sequence variation in genes regulating vitamin D metabolism and signaling pathways might influence variation in coronary artery calcification (CAC).

Methods and Results—

We genotyped single-nucleotide polymorphisms (SNPs) in
GC
,
CYP27B1, CYP24A1
, and
VDR
and tested their association with CAC quantity, as measured by electron beam computed tomography. Initial association studies were carried out in a discovery sample comprising 697 Amish subjects, and SNPs nominally associated with CAC quantity (4 SNPs in
CYP24A1
,
P
=0.008 to 0.00003) were then tested for association with CAC quantity in 2 independent cohorts of subjects of white European ancestry (Genetic Epidemiology Network of Arteriopathy study [n=916] and the Penn Coronary Artery Calcification sample [n=2061]). One of the 4 SNPs, rs2762939, was associated with CAC quantity in both the Genetic Epidemiology Network of Arteriopathy (
P
=0.007) and Penn Coronary Artery Calcification (
P
=0.01) studies. In all 3 populations, the rs2762939 C allele was associated with lower CAC quantity. Metaanalysis for the association of this SNP with CAC quantity across all 3 studies yielded a
P
value of 2.9×10
−6
.

Conclusion—

A common SNP in the
CYP24A1
gene was associated with CAC quantity in 3 independent populations. This result suggests a role for vitamin D metabolism in the development of CAC quantity.
Endothelial Estrogen Receptor α Plays an Essential Role in the Coronary and Myocardial Protective Effects of Estradiol in Ischemia/Reperfusion
Authors: Favre Julie , Gao Ji , Henry Jean-Paul , Remy-Jouet Isabelle , Fourquaux Isabelle , Billon-Gales Audrey , Thuillez Christian , Arnal Jean-François , Lenfant Françoise , Richard Vincent
Published: September 2010

Objective—

To assess the coronary endothelial protective effects of 17β-estradiol (E2) and the role of estrogen receptor (ER) α in ischemia/reperfusion (I/R).

Methods and Results—

E2 exerts protective effects in cardiac I/R. However, the implication in vivo of the endothelium and the cellular targets of the anti-ischemic effects of E2 are unknown. Mice were subjected to I/R (30 minutes of I and 1 hour of R) in vivo, after which acetylcholine-induced relaxation of isolated coronary segments was assessed ex vivo. I/R induced a coronary endothelial dysfunction in untreated ovariectomized mice that was prevented by long-term treatment with E2 in wild-type, but not in ERα
−/−
, mice. Chimeric mice inactivated for ERα in the hematopoietic compartment remained protected by E2. Further inactivation of endothelial ERα abolished the protective action of E2 on coronary endothelial function in Tie2-Cre(+) ERα
f/f
mice. More importantly, E2 significantly limited infarct size in wild-type mice but not in mice deficient in endothelial ERα, even in the presence of hematopoietic ERα.

Conclusion—

Endothelial ERα plays a crucial role in the E2-induced prevention of endothelial dysfunction after I/R. To our knowledge, we demonstrate for the first time, by using unique genetically modified mice, that targeting endothelial protection per se can confer cardiomyocyte protection in I/R.
CXCR4-Mediated Bone Marrow Progenitor Cell Maintenance and Mobilization Are Modulated by c-kit Activity
Authors: Cheng Min , Zhou Junlan , Wu Min , Boriboun Chan , Thorne Tina , Liu Ting , Xiang Zhifu , Zeng Qiutang , Tanaka Toshikazu , Tang Yao Liang , Kishore Raj , Tomasson Michael H. , Miller Richard J. , Losordo Douglas W. , Qin Gangjian
Published: September 2010

Rationale:

The mobilization of bone marrow (BM) progenitor cells (PCs) is largely governed by interactions between stromal cell–derived factor (SDF)-1 and CXC chemokine receptor (CXCR)4. Ischemic injury disrupts the SDF-1–CXCR4 interaction and releases BM PCs into the peripheral circulation, where the mobilized cells are recruited to the injured tissue and contribute to vessel growth. BM PCs can also be mobilized by the pharmacological CXCR4 antagonist AMD3100, but the other components of the SDF-1–CXCR4 signaling pathway are largely unknown. c-kit, a membrane-bound tyrosine kinase and the receptor for stem cell factor, has also been shown to play a critical role in BM PC mobilization and ischemic tissue repair.

Objective:

To investigate the functional interaction between SDF-1–CXCR4 signaling and c-kit activity in BM PC mobilization.

Methods and Results:

AMD3100 administration failed to mobilize BM PCs in mice defective in c-kit kinase activity or in mice transplanted with BM cells that expressed a constitutively active c-kit mutant. Furthermore, BM levels of phosphorylated (phospho)–c-kit declined after AMD3100 administration and after CXCR4 deletion. In cells adhering to culture plates coated with vascular cell adhesion molecule 1, SDF-1 and stem cell factor increased phospho–c-kit levels, and AMD3100 treatment suppressed SDF-1–induced, but not SCF-induced, c-kit phosphorylation. SDF-1–induced c-kit phosphorylation also required the activation of Src nonreceptor tyrosine kinase: pretreatment of cells with a selective Src inhibitor blocked both c-kit phosphorylation and the interaction between c-kit and phospho-Src.

Conclusions:

These findings indicate that the regulation of BM PC trafficking by SDF-1 and CXCR4 is dependent on Src-mediated c-kit phosphorylation.
Myomasp/LRRC39, a Heart- and Muscle-Specific Protein, Is a Novel Component of the Sarcomeric M-Band and Is Involved in Stretch Sensing
Authors: Will Rainer D. , Eden Matthias , Just Steffen , Hansen Arne , Eder Alexandra , Frank Derk , Kuhn Christian , Seeger Thalia S. , Oehl Ulrike , Wiemann Stefan , Korn Bernhard , Koegl Manfred , Rottbauer Wolfgang , Eschenhagen Thomas , Katus Hugo A. , Frey Norbert
Published: September 2010

Rationale and Objective:

The M-band represents a transverse structure in the center of the sarcomeric A-band and provides an anchor for the myosin-containing thick filaments. In contrast to other sarcomeric structures, eg, the Z-disc, only few M-band–specific proteins have been identified to date, and its exact molecular composition remains unclear.

Methods and Results:

Using a bioinformatic approach to identify novel heart- and muscle-specific genes, we found a leucine rich protein, myomasp (
Myo
sin-interacting,
M
-band-
a
ssociated
s
tress-responsive
p
rotein)/LRRC39. RT-PCR and Northern and Western blot analyses confirmed a cardiac-enriched expression pattern, and immunolocalization of myomasp revealed a strong and specific signal at the sarcomeric M-band. Yeast 2-hybrid screens, as well as coimmunoprecipitation experiments, identified the C terminus of myosin heavy chain (MYH)7 as an interaction partner for myomasp. Knockdown of myomasp in neonatal rat ventricular myocytes (NRVCMs) led to a significant upregulation of the stretch-sensitive genes GDF-15 and BNP. Conversely, the expression of MYH7 and the M-band proteins myomesin-1 and -2 was found to be markedly reduced. Mechanistically, knockdown of myomasp in NRVCM led to a dose-dependent suppression of serum response factor–dependent gene expression, consistent with earlier observations linking the M-band to serum response factor–mediated signaling. Finally, downregulation of myomasp/LRRC39 in spontaneously beating engineered heart tissue constructs resulted in significantly lower force generation and reduced fractional shortening. Likewise, knockdown of the myomasp/LRRC39 ortholog in zebrafish resulted in severely impaired heart function and cardiomyopathy in vivo.

Conclusions:

These findings reveal myomasp as a previously unrecognized component of an M-band–associated signaling pathway that regulates cardiomyocyte gene expression in response to biomechanical stress.
The FGF-BMP Signaling Axis Regulates Outflow Tract Valve Primordium Formation by Promoting Cushion Neural Crest Cell Differentiation
Authors: Zhang Jue , Chang Julia Y.F. , Huang Yanqing , Lin Xiang , Luo Yongde , Schwartz Robert J. , Martin James F. , Wang Fen
Published: September 2010

Rationale:

Heart valves develop from precursor structures called cardiac cushions, an endothelial-lined cardiac jelly that resides in the inner side of the heart tube. The cushions are then invaded by cells from different sources, undergo a series of complicated and poorly understood remodeling processes, and give rise to valves. Disruption of the fibroblast growth factor (FGF) signaling axis impairs morphogenesis of the outflow tract (OFT). Yet, whether FGF signaling regulates OFT valve formation is unknown.

Objective:

To study how OFT valve formation is regulated and how aberrant cell signaling causes valve defects.

Methods and Results:

By using mouse genetic manipulation, cell lineage tracing, ex vivo heart culture, and molecular biology approaches, we demonstrated that FGF signaling in the OFT myocardium upregulated
Bmp4
expression, which then enhanced smooth muscle differentiation of neural crest cells (NCCs) in the cushion. FGF signaling also promoted OFT myocardial cell invasion to the cushion. Disrupting FGF signaling interrupted cushion remodeling with reduced NCCs differentiation into smooth muscle and less cardiomyocyte invasion and resulted in malformed OFT valves.

Conclusions:

The results demonstrate a novel mechanism by which the FGF-BMP signaling axis regulates formation of OFT valve primordia by controlling smooth muscle differentiation of cushion NCCs.
Effects of Metformin in Experimental Stroke
Authors: Li Jun , Benashski Sharon E. , Venna Venugopal Reddy , McCullough Louise D.
Published: September 2010

Background and Purpose—

Adenosine 5′-monophosphate-activated protein kinase (AMPK) is an important sensor of energy balance. Stroke-induced AMPK activation is deleterious because both pharmacological inhibition and genetic deletion of AMPK are neuroprotective. Metformin is a known AMPK activator but reduces stroke incidence in clinical populations. We investigated the effect of acute and chronic metformin treatment on infarct volume and AMPK activation in experimental stroke.

Methods—

Male mice were subjected to middle cerebral artery occlusion after acute (3 days) or chronic (3 weeks) administration of metformin. Infarct volumes, AMPK activation, lactate accumulation, and behavioral outcomes were assessed. The roles of neuronal nitric oxide synthase and AMPK were examined using mice with targeted deletion of AMPK or neuronal nitric oxide synthase.

Results—

Acute metformin exacerbated stroke damage, enhanced AMPK activation, and led to metabolic dysfunction. This effect was lost in AMPK and neuronal nitric oxide synthase knockout mice. In contrast, chronic metformin given prestroke was neuroprotective, improved stroke-induced lactate generation, and ameliorated stroke-induced activation of AMPK. Similarly, the neuroprotective effect of chronic prestroke metformin was lost in neuronal nitric oxide synthase knockout mice.

Conclusions—

AMPK is an important potential target for stroke treatment and prevention. These studies show that the timing, duration, and amount of AMPK activation are key factors in determining the ultimate downstream effects of AMPK on the ischemic brain.
Explaining Japanese Antimilitarism: Normative and Realist Constraints on Japan's Security Policy
Authors: Izumikawa Yasuhiro
Published: September 2010

Since the late 1990s, Japan has sent increasing numbers of its military forces overseas. It has also assumed a more active military role in the U.S.-Japan alliance. Neither conventional constructivist nor realist approaches in international relations theory can adequately explain these changes or, more generally, changes in Japan's security policy since the end of World War II. Instead, Japan's postwar security policy has been driven by the country's powerful antimilitarism, which reflects the following normative and realist factors: pacifism, antitraditionalism, and fear of entrapment. An understanding of the influence of these three factors makes it possible to explain both Japan's past reluctance to play a military role overseas and its increasing activism over the last decade. Four case studies—the revision of the U.S.-Japan Security Treaty in 1960, the anti–Vietnam War period, increases in U.S.-Japan military cooperation during détente, and actions taken during the administration of Junichiro Koizumi to enhance Japan's security profile—illustrate the role of antimilitarism in Japan's security policy. Only through a theoretical approach based on analytical eclecticism—a research strategy that considers factors from different paradigms—can scholars explain specific puzzles in international politics.
Distinct Neural Systems Involved in Agency and Animacy Detection
Authors: Gobbini Maria Ida , Gentili Claudio , Ricciardi Emiliano , Bellucci Claudia , Salvini Pericle , Laschi Cecilia , Guazzelli Mario , Pietrini Pietro
Published: September 2010

We designed an fMRI experiment comparing perception of human faces and robotic faces producing emotional expressions. The purpose of our experiment was to investigate engagement of different parts of the social brain by viewing these animate and inanimate agents. Both human and robotic face expressions evoked activity in face-responsive regions in the fusiform gyrus and STS and in the putative human mirror neuron system. These results suggest that these areas mediate perception of agency, independently of whether the agents are living or not. By contrast, the human faces evoked stronger activity than did robotic faces in the medial pFC and the anterior temporal cortex—areas associated with the representation of others' mental states (theory of mind), whereas robotic faces evoked stronger activity in areas associated with perception of objects and mechanical movements. Our data demonstrate that the representation of the distinction between animate and inanimate agents involves areas that participate in attribution of mental stance.
Rapid Modulation of Sensory Processing Induced by Stimulus Conflict
Authors: Appelbaum Lawrence G. , Smith David V. , Boehler Carsten N. , Chen Wen D. , Woldorff Marty G.
Published: September 2010

Humans are constantly confronted with environmental stimuli that conflict with task goals and can interfere with successful behavior. Prevailing theories propose the existence of cognitive control mechanisms that can suppress the processing of conflicting input and enhance that of the relevant input. However, the temporal cascade of brain processes invoked in response to conflicting stimuli remains poorly understood. By examining evoked electrical brain responses in a novel, hemifield-specific, visual-flanker task, we demonstrate that task-irrelevant conflicting stimulus input is quickly detected in higher level executive regions while simultaneously inducing rapid, recurrent modulation of sensory processing in the visual cortex. Importantly, however, both of these effects are larger for individuals with greater incongruency-related RT slowing. The combination of neural activation patterns and behavioral interference effects suggest that this initial sensory modulation induced by conflicting stimulus inputs reflects performance-degrading attentional distraction because of their incompatibility rather than any rapid task-enhancing cognitive control mechanisms. The present findings thus provide neural evidence for a model in which attentional distraction is the key initial trigger for the temporal cascade of processes by which the human brain responds to conflicting stimulus input in the environment.
The Relationship of Language and Emotion: N400 Support for an Embodied View of Language Comprehension
Authors: Chwilla Dorothee J. , Virgillito Daniele , Vissers Constance Th. W. M.
Published: September 2010

According to embodied theories, the symbols used by language are meaningful because they are grounded in perception, action, and emotion. In contrast, according to abstract symbol theories, meaning arises from the syntactic combination of abstract, amodal symbols. If language is grounded in internal bodily states, then one would predict that emotion affects language. Consistent with this, advocates of embodied theories propose a strong link between emotion and language [Havas, D., Glenberg, A. M., & Rinck, M. Emotion simulation during language comprehension. Psychonomic Bulletin & Review, 14, 436–441, 2007; Niedenthal, P. M. Embodying emotion. Science, 316, 1002–1005, 2007]. The goal of this study was to test abstract symbol vs. embodied views of language by investigating whether mood affects semantic processing. To this aim, we induced different emotional states (happy vs. sad) by presenting film clips that displayed fragments from a happy movie or a sad movie. The clips were presented before and during blocks of sentences in which the cloze probability of mid-sentence critical words varied (high vs. low). Participants read sentences while ERPs were recorded. The mood induction procedure was successful: Participants watching the happy film clips scored higher on a mood scale than those watching the sad clips. For N400, mood by cloze probability interactions were obtained. The N400 cloze effect was strongly reduced in the sad mood compared with the happy mood condition. Furthermore, a difference in late positivity was only present for the sad mood condition. The mood by semantic processing interaction observed for N400 supports embodied theories of meaning and challenges abstract symbol theories that assume that processing of word meaning reflects a modular process.
Protest and Parents
Authors: Førland Tor Egil , Korsvik Trine Rogg , Christophersen Knut-Andreas
Published: September 2010

In this study, we examine factors assumed to have disposed students to radicalism in the late 1960s and early 1970s. The data are from a recent retrospective survey of 1,246 former University of Oslo students born between 1940 and 1950. The unprecedented number of radical respondents allows for analyses that could not be done in earlier studies, especially of the extreme left. The results reflect the preponderant influence of parents’ political preferences. Variations in political orientation between different fields of study and between cohorts, with students born towards the end of the 1940s being more radical than students born earlier in the decade, suggest influence by peers, although this is hard to gauge. Urban upbringing is found to be significant, pointing to the possible importance of exposure to radical world-view carriers. Neither gender nor class has significant controlled predictive power. Since most students were men, and students were far more likely to protest than extramural youth, males dominated the protest movement. Students from the working class were more radical than middle-class students, but apparently this was due not to any independent effect of class but to differences in the world-view to which they were exposed at home, manifested in parents’ political preferences.
“You, I, we Created the Poet”: Anne Sexton’s Recorded Therapy, November 1963
Authors: Skorczewski Dawn
Published: September 2010

In 1991, when it was revealed that the psychiatrist Martin Orne had released tapes of his therapy sessions with Anne Sexton to her biographer, mental health professionals expressed concern and outrage. Those who actually listen to the controversial tapes would be curious to find a debate between Sexton and Orne about mental illness, creativity, and therapeutic process. To what extent did Sexton’s creative accomplishments point to aspects of her psychiatric progress that might otherwise have been overlooked? While Sexton asserted her achievements and sought affirmation from her psychiatrist, Orne persistently responded by stating that the poetry is not as important as the person. Their different ways of understanding the relationships between poetry and therapeutic process speak volumes about the power of the creative imagination to challenge existing structures of thought, even structures designed to define the psyche itself.
The Lure of the Symptom in Psychoanalytic Treatment
Authors: Ogden Thomas H. , Gabbard Glen O.
Published: September 2010

Psychoanalysis, which at its core is a search for truth, stands in a subversive position vis-à-vis the contemporary therapeutic culture that places a premium on symptomatic “cure.” Nevertheless, analysts are vulnerable to succumbing to the internal and external pressures for the achievement of symptomatic improvement. In this communication we trace the evolution of Freud’s thinking about the relationship between the aims of psychoanalysis and the alleviation of symptoms. We note that analysts today may recapitulate Freud’s early struggles in their pursuit of symptom removal. We present an account of a clinical consultation in which the analytic pair were ensnared in an impasse that involved the analyst’s preoccupation with the intransigence of one of the patient’s symptoms. We suggest alternative ways of working with these clinical issues and offer some thoughts on how our own work as analysts and consultants to colleagues has been influenced by our understanding of what frequently occurs when the analyst becomes symptom-focused.
Exploring the Influence of National Board Certified Teachers in Their Schools and Beyond
Authors: Cannata Marisa , McCrory Raven , Sykes Gary , Anagnostopoulos Dorothea , Frank Kenneth A.
Published: September 2010

Purpose: This article explores the relative influence over schoolwide policy and leadership activities of teachers certified by the National Board for Professional Teaching Standards. Interest centers on teacher leadership activities and perceived influence over schoolwide policy and decision making. In particular, the study asks whether National Board Certified Teachers (NBCTs) are engaged in leadership and influence that may be attributable to board certification. Method: Data come from a survey of the entire teaching faculties in 47 elementary schools in two states ( N = 1,282). Teacher perceived influence over schoolwide policy and participation in leadership activities were regressed on NBCT status, demographic and assignment characteristics, and inclination toward teacher leadership, controlling for schools with fixed effects. Findings: NBCTs engage in more leadership activities at both the school and district levels than their non-board certified peers. Yet, NBCTs do not report greater influence over schoolwide policy than their colleagues. Implications: The effect of NBCT status on opportunities for teacher leadership is complex, with NBCTs having the most effect on domains and activities closest to the classroom. The data also point to a potential paradox about the nature of teacher leadership as greater engagement in leadership activities does not lead to enhanced influence over schoolwide policy.
The Meaning(s) of Teacher Leadership in an Urban High School Reform
Authors: Scribner Samantha M. Paredes , Bradley-Levine Jill
Published: September 2010

Purpose: The purpose of this study is to examine the meaning of teacher leadership from teachers’ perspectives. The authors examine teachers’ practice of and talk about legitimate sources of power and influence in the context of an urban high school reform. Design: This is an interpretive study of teacher leadership situated in one small high school within a large urban high school (comprised of six small school communities) in a Midwestern city. The school was engaged in a technology-driven, project-based reform requiring team teaching and high levels of teacher involvement in curricular, pedagogical, and other organizational decision making. Researchers conducted monthly observations and two to three in depth-interviews with each participant and collected and analyzed relevant documents during the 2007-08 school year. Participants included all seven teachers in the focus school, the small school administrator, and a district-level administrator. Findings: Data revealed a cultural logic that afforded some teachers more authority than others. Three of the seven teachers were repeatedly identified as being the leaders (despite other teachers actively influencing organizational activities). Analysis of teachers’ talk about teacher leadership and related interactions revealed patterns falling into three categories: organizationally legitimized roles, institutionally legitimized content area expertise, and gendered leadership roles. Significance: Because leadership is a cultural construct itself, this study brings to the foreground the meaning(s) of teacher leadership from teachers’ perspectives and how these meanings reward or eclipse actual leadership practices. This is especially salient for researchers and leaders interested in the role of teacher leadership in nurturing democratic school communities.
School Leadership Stability, Principal Moves, and Departures: Evidence From Missouri
Authors: Baker Bruce D. , Punswick Eric , Belt Charles
Published: September 2010

Purpose: The objective of this study is to investigate and characterize principals’ backgrounds, individual and school level factors associated with leadership stability, and principal career paths and exit behaviors in Missouri. Method: In this study, the authors construct two data sets of practicing school principals in the state of Missouri: (a) one consisting of approximately 2,700 school principals across grade levels for each year from 1999 to 2006, and (b) one consisting of three cohorts of principals who were new to a given school in 1999, 2000, and 2001. With the first data set, the authors construct “stability” ratios identifying the amount of time a principal spent in any given school as a percentage of the total time that principal was in the data set. With the second data set, the authors create indicators of the time period at which a cohort member (a) left the principalship altogether (in Missouri), (b) made a first move to another school, or (c) made a second move to another school. Using the first data set, the authors estimate truncated regression models to identify the relationship between principal characteristics, school context, and principal stability. Using the second data set, they estimate Cox Proportional Hazard models to determine the relationship between principal characteristics, school context, and exit or move behavior. Findings: The authors find that a principal’s relative salary, compared to peers in the same labor market, exerts a consistent influence on stability— the higher the salary, the more likely a principal is stable and less likely he or she is to move to another school. Principals were able to leverage school-to-school moves for an average change in relative salary of about +5%. The authors also find that school racial composition—specifically percentage of students who are Black—may lead to instability and greater likelihood of a second move and that middle school principals are less stable.
Political Parties: When Do They Turn to Terror?
Authors: Danzell Orlandrew E.
Published: September 2010

The purpose of this article is to explain the creation of terrorist organizations by political parties. Extant literature argues that institutional structural constraints, such as electoral systems, are more likely to lead political parties to create terrorist organizations. However, this article hypothesizes that party ideology is also an important factor that explains the creation of terrorist organizations by political parties. Using a Poisson random effect model for panel data on twenty-eight countries between 1965 and 2003, this article shows that party ideology is positively correlated with the formation of terrorist organizations even after controlling for institutional structural constraints. The implication of these findings is important for policy makers eager to create stable polities.
“I Could Move Mountains”
Authors: Alexander Gina K. , Innes Kim E. , Brown Cynthia J. , Kulbok Pamela , Bourguignon Cheryl , Bovbjerg Viktor E. , Taylor Ann Gill
Published: September 2010

Purpose

The purpose of this study was to describe firsthand experiences with yoga as shared by adults with or at risk for type 2 diabetes and to examine their beliefs regarding maintenance of yoga practice over time.

Methods

In this qualitative study, 13 adults with or at risk for type 2 diabetes described their experiences with yoga and their beliefs regarding maintenance of yoga practice over time. Semistructured interviews occurred 16 to 20 months after completion of an 8-week yoga-based clinical trial.

Results

Themes of readiness for continuing yoga, environmental support for yoga, and integrating yoga emerged through data analysis.

Conclusions

Findings indicate that yoga is appealing to some individuals with diabetes, but maintaining yoga practice over time is a challenge. Diabetes educators may be able to support maintenance by discussing specific strategies with individuals who express interest in yoga practice.
Parenteral but Not Enteral Omega‐3 Fatty Acids (Omegaven) Modulate Intestinal Regrowth After Massive Small Bowel Resection in Rats
Authors: Sukhotnik Igor , Shany Annette , Bashenko Yulia , Hayari Lili , Chemodanov Elena , Mogilner Jorge , Coran Arnold G. , Shaoul Ron
Published: September 2010

Background: The purpose of the present study was to evaluate the effects of ω‐3 fatty acids (Omegaven) on early intestinal adaptation in rats with short bowel syndrome (SBS). Methods: Male Sprague‐Dawley rats were randomly assigned to 1 of 4 groups: sham rats underwent bowel transection; SBS rats underwent 75% bowel resection; SBS‐O ω‐3 rats underwent bowel resection and were treated with oral Omegaven given by gavage; and SBS‐I ω‐3 rats underwent bowel resection and were treated with Omegaven given intraperitoneally. Rats were killed on day 14. Parameters of intestinal adaptation (bowel and mucosal weight, mucosal DNA and protein, villus height and crypt depths, cell proliferation and apoptosis) were determined at time of death. Real‐time polymerase chain reaction was used to determine the level of Bax and Bcl‐2 messenger RNA (mRNA). Statistical analysis was performed using Kruskal‐Wallis test followed by post hoc test, with P < .05 considered statistically significant. Results: Oral ω‐3 supplementation did not significantly change intestinal regrowth. In contrast, parenteral ω‐3 in rats that underwent resection resulted in higher bowel and mucosal weights, mucosal DNA and protein in ileum, villus height in ileum, crypt depth in jejunum and ileum, and greater rates of cell proliferation in jejunum and ileum compared with SBS animals. The initial decreased levels of apoptosis corresponded with the early decrease in Bax and increase in Bcl‐2 mRNA levels. Conclusions: Parenteral but not enteral Omegaven augments and accelerates structural bowel adaptation in a rat model of SBS. Increased cell proliferation and decreased apoptosis reflect increased cell turnover in Omegaven‐treated animals.
The Impact of Glutamine Dipeptide–Supplemented Parenteral Nutrition on Outcomes of Surgical Patients
Authors: Wang Yan , Jiang Zhu‐Ming , Nolan Marie T. , Jiang Hua , Han Hae‐Ra , Yu Kang , Li Hai‐Long , Jie Bin , Liang Xiao‐Kun
Published: September 2010

Objective: To evaluate the impact of glutamine dipeptide–supplemented parenteral nutrition (GLN‐PN) on clinical outcomes in surgical patients. Methods: MEDLINE, EMBASE, Web of Science, and the Cochrane Controlled Clinical Trials Register were searched to retrieve the eligible studies. The studies were included if they were randomized controlled trials that evaluated the effect of GLN‐PN and standard PN on clinical outcomes of surgical patients. Clinical outcomes of interest were postoperative morbidity of infectious complication, mortality, length of hospital stay, and cost. Statistical analysis was conducted by RevMan 4.2 software from the Cochrane Collaboration. Results: Fourteen randomized controlled trials (RCTs) (N = 587) were included in this meta‐analysis. The results showed that glutamine dipeptide significantly reduced the length of hospital stay by around 4 days in the form of alanyl‐glutamine (weighted mean difference [WMD] = −3.84; 95% confidence interval [CI] −5.40, −2.28; z = 4.82; P < .001) and about 5 days in the form of glycyl‐glutamine (WMD = −5.40; 95% CI −8.46, −2.33; z = 3.45; P < .001). The overall effect indicated a significant decrease in the infectious complication rates of surgical patients receiving GLN‐PN (risk ratio = 0.69; 95% CI 0.50, 0.95; z = 2.26; P = .02). Conclusion: GLN‐PN was beneficial to postoperative patients by shortening the length of hospital stay and reducing the morbidity of postoperative infectious complications.
Effects of Enteral Immunonutrition on the Maintenance of Gut Barrier Function and Immune Function in Pigs With Severe Acute Pancreatitis
Authors: Zou Xiao‐Ping , Chen Min , Wei Wei , Cao Jun , Chen Lei , Tian Mi
Published: September 2010

Background: This study evaluated the effects of enteral immunonutrition (EIN) supplemented with glutamine, arginine, and probiotics on gut barrier function and immune function in pigs with severe acute pancreatitis (SAP). Methods: The model was induced by retrograde injection of 5% sodium taurocholate and trypsin via the pancreatic duct. After induction of SAP, 18 pigs were randomly divided into 3 groups, in which either parenteral nutrition (PN), control enteral nutrition (CEN), or EIN was applied for 8 days. Serum and pancreatic fluid amylase concentration was determined. Intestinal permeability (lactulose to mannitol ratio) was measured by high‐performance liquid chromatography, and plasma endotoxin was quantified by the chromogenic limulus amebocyte lysate technique. Samples of venous blood and organs were cultured using standard techniques. Pancreatitis severity and villi of ileum were scored according to histopathologic grading. Plasma T‐lymphocyte subsets were measured by flow cytometry, and immunoglobulins (Igs) were determined via enzyme‐linked immunosorbent assay. Results: There were no significant differences in serum and pancreatic fluid amylases concentrations or in pancreatitis severity between any 2 of the 3 groups. Compared with PN and CEN, EIN significantly decreased intestinal permeability, plasma endotoxin concentration, and the incidence and magnitudes of bacterial translocation, but increased ileal mucosal thickness, villous height, crypt depth, and percentage of normal intestinal villi. Significant differences were found in CD3+, CD4+ lymphocyte subsets, the ratio of CD4+: CD8+ lymphocyte subsets, and serum IgA and IgG, but not IgM, between any 2 of the 3 groups. Conclusions: EIN maintained gut barrier function and immune function in pigs with SAP.
Cisplatin Upregulates Glutamine Transport in Human Intestinal Epithelial Cells
Authors: Nose Satoko , Wasa Masafumi , Tazuke Yuko , Owari Mitsugu , Fukuzawa Masahiro
Published: September 2010

Background: Glutamine (GLN) prevents the intestinal mucosal injury induced by chemotherapy, although the mechanism of this protective action has not yet been elucidated. Amino acid transport across the plasma membrane is essential for supplying enterocytes with amino acids for cellular metabolism. It was hypothesized that chemotherapy stimulates GLN transport, which enables GLN to be used more efficiently as a metabolic fuel. Methods: A rat model was used to examine the effect of enteral GLN on intestinal mucosal injury induced by intraperitoneal injection of cisplatin (7.0 mg/kg of body weight). The effects of cisplatin on amino acid transport and the expression of messenger RNA and protein were evaluated by real‐time polymerase chain reaction and Western blot analysis, respectively, in the human intestinal epithelial cell line Caco‐2. The effects of cisplatin on glutaminase activity and intracellular glutathione were also studied. Results: GLN prevented mucosal atrophy induced by cisplatin in rats. In Caco‐2 cells, cisplatin significantly increased GLN transport and the expression of GLN transporter ASCT2 messenger RNA and protein. Leucine, but not glutamate, transport significantly increased in the cisplatin‐treated group due to the increase in LAT1 (leucine transporter) protein expression. Glutaminase activity and intracellular glutathione increased significantly in the cisplatin‐treated group. Conclusions: Bolus enteral GLN prevents intestinal mucosal injury induced by cisplatin in rats, as demonstrated by increased GLN transport and increased GLN transporter expression after cisplatin administration.
Metabolic vs Nutrition Support
Authors: Burke Peter A. , Young Lorraine S. , Bistrian Bruce R.
Published: September 2010

It is now generally accepted that early feeding post injury exerts a positive effect on outcome in the critically ill, despite the fact that many of these patients are well nourished or even overnourished on admission. One possible mechanism is that early feeding post injury may have a positive influence on the duration and intensity of the systemic inflammatory response, especially when coupled with intensive insulin therapy to maintain normoglycemia at <150 mg/dL. Current clinical nutrition guidelines recommend early enteral nutrition providing full nutrition requirements in the critically ill patient; however, in the first week post injury, exclusive enteral feeding is typically inadequate, particularly in protein. A potentially new and different therapeutic goal to modulate the systemic inflammatory response might be more effectively accomplished for the first week post injury by hypocaloric feedings (~9–18 kcal/kg or 50%–75% resting metabolic expenditure) principally as intravenous dextrose but with at least 1 g/kg protein as intravenous amino acids to provide early metabolic support. This proposed regime, along with intensive insulin therapy to maintain glucose homeostasis, should promote the protein synthetic component of the postinjury inflammatory response while reducing net protein catabolism. A formal trial of early metabolic support in the acutely injured should be safe, easy to execute, and potentially efficacious, with subsequent improvement in the inflammatory state and, it is hoped, clinical outcomes.
Parenteral Fish Oil as Monotherapy Improves Lipid Profiles in Children With Parenteral Nutrition–Associated Liver Disease
Authors: Le Hau D. , de Meijer Vincent E. , Zurakowski David , Meisel Jonathan A. , Gura Kathleen M. , Puder Mark
Published: September 2010

Background: Parenteral nutrition (PN) is a life‐saving therapy but has been associated with dyslipidemia. Because fish oil has been shown to have positive effects on lipid profiles, the authors hypothesize that a parenteral fish oil lipid emulsion will improve lipid profiles in children who are PN dependent. Methods: The authors examined the lipid profiles of a unique cohort of 10 children who were exclusively administered a fish oil–based lipid emulsion while on PN for a median duration of 14 weeks. Longitudinal data analysis with a generalized estimating equations approach was used to determine the sterol and bilirubin levels based on duration of the fish oil–based lipid emulsion. Results: After 14 weeks of fish oil monotherapy, children had a 24% increase in high‐density lipoprotein. Compared to baseline, serum low‐density lipoprotein, very low‐density lipoprotein, total cholesterol, and triglyceride levels all significantly decreased by 22%, 41%, 17%, and 46%, respectively. Eight children had their bilirubin improved with a decreased direct bilirubin from 6.9 mg/dL (range, 4.4‐10.7) at baseline to 2.3 mg/dL (range, 1.3‐4.0) after 14 weeks, and a decrease in total bilirubin from 8.7 mg/dL (range, 5.5‐13.7) to 3.8 mg/dL (range, 2.2‐6.5). Conclusion: A fish oil–based lipid emulsion used as monotherapy in children who exclusively depended on PN for survival was associated with significant improvement in all major lipid panels as well as improvement of hyperbilirubinemia. Parenteral fish oil may be the preferred lipid source in children with dyslipidemia.