bluuebunny/crossref_metadata_2025 huggingface dataset:
Misunderstanding Psychopathology as Medical Semiology: An Epistemological Enquiry
Authors: Ramos Gorostiza Pablo , Adan Manes Jaime
Published: April 2011

In our everyday clinical experience we encounter significant problems directly related to the instability of psychopathological concepts. In order to trace the origin of this inconsistency, the nature of these concepts will be explored in their historical development. They will be compared to those pertaining to medical semiology, paying special attention to the specific nature of the ‘object’ each of them refers to. While concepts belonging to medical semiology refer to natural objects and retain their meaning independently of the patient’s context, psychopathological concepts refer to fragments of experience, which lose their significance if detached from their contextual horizon. The instability of psychopathological concepts is a consequence of the misunderstanding of psychopathology as medical semiology. As an alternative to this view, it will be argued that psychopathology represents an active and never-ending process aimed at the creation of intelligibility.
Predictive Factors of Successful Varicocelectomy in Infertile Patients
Authors: Chen Shiou-Sheng , Chen Li-Kuei
Published: April 2011

Aim: To examine the predictive factors of successful varicocelectomy in infertile patients. Methods: Thirty-five infertile male patients with varicocele and requiring varicocelectomy were recruited in this study. The patients were divided into 2 groups based on their recovery outcome after subinguinal microsurgical varicocelectomy. Patients who showed significant improvement on their sperm density, motility and morphology 6 months after varicocelectomy were designated as group 1, whereas those who showed no improvement 6 months after surgery were designated as group 2. The predictive factors that were examined included: age; preoperative semen quality (i.e. sperm density, motility and morphology); testicular volume; seminal volume; varicocele grade; the number of ligated veins; body mass index (BMI), and serum levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin, testosterone, alkaline phosphatase (Alk-p), lactic dehydrogenase (LDH), cholesterol and triglyceride. Results: Sperm density, motility and morphology improved significantly 6 months after varicocelectomy in group 1 patients (n = 35; 71.4%). Group 1 patients had significantly higher testicular volumes (mean ± SD: 29.6 ± 5.9 vs. 23.2 ± 6.1 ml), lower FSH (11.3 ± 2.9 vs. 16.1 ± 4.8 mIU/ml) and higher numbers of ligated veins (9.3 ± 0.8 vs. 7.9 ± 0.7) than group 2 patients. No significant association was observed between surgical outcome and age, preoperative sperm density, motility and morphology, seminal volume, varicocele grade, BMI and serum levels of LH, prolactin, testosterone, Alk-p, LDH, cholesterol and triglyceride. Conclusions: These findings suggest that the significant predictive factors of successful varicocelectomy in infertile patients were high testicular volume (>29.6 ml), low serum concentration of FSH (<11.3 mIU/ml) and high number of ligated veins (>9).
Is Radical Oncosurgery Justified for the Treatment of Primary Malignant Fibrous Histiocytoma of the Urinary Bladder? Report of Two Cases and Analyses of Disease-Specific Survival Rates Based on a Review of the Literature
Authors: Gunia Sven , May Matthias , Koch Stefan , Erbersdobler Andreas
Published: April 2011

Disease-specific survival (DSS) rates were evaluated in 20 patients with primary malignant fibrous histiocytoma (MFH) of the bladder. The most common pathologic finding was the pleomorphic subtype of MFH (55%) with a mean tumor size of 6.8 cm. 10 patients underwent surgery without and 6 patients with adjuvant therapy. Local and systemic rates of progression were 30 and 60% after surgery only compared with 16.7 and 50% after surgery with adjuvant therapy. Although none of the patients showed metastatic dissemination at the time of diagnosis, overall 1- and 2-year DSS rates of only 47.8 and 31.9% were observed. Hence, after the onset of clinical symptoms, the disease runs a very aggressive course regardless of the therapeutic options employed. Although distant dissemination seems to be rare at the time of diagnosis, the prognostic outcome is dismal. The rarity and inconsistency of the currently available case reports on MFH of the bladder hampers the development of therapeutic guidelines. Advanced studies enrolling a larger number of patients with appropriate clinical and pathological data are needed to compare the beneficial effects of various treatment options.
The Comparison of Two Experimental Rat Varicocele Models and Their Effect on Sperm Quality
Authors: Yu Jian-Jun , Xu Yue Min , Tao Yian
Published: April 2011

Objective: To develop a modified rat varicocele model. Methods: 300 male Sprague-Dawley rats were selected. In 82 rats (classic group, CG), this was achieved by dissecting the left renal vein and ligating it using a 0.8-mm metal clip and 3–0 silk suture proximal to the inferior vena cava, followed by removal of the bar. In 118 rats (modified group, MG), in addition to the partial ligation of the left renal vein, the communicating branch was fully ligated. In 100 rats (sham operation group, SG), the left renal vein and communicating branches were dissected, but not ligated. The seminal fluid was aspirated and the diameters of the left spermatic veins were analyzed. Three months later, the examination was performed again. Results: The diameters were 0.16 ± 0.1 mm and 1.88 ± 0.1 mm before and after operation, respectively, in the CG (p < 0.01), and 0.15 ± 0.05 mm and 2.0 ± 0.1 mm in the MG (p < 0.01). Postsurgical diameters in the CG and MG were 1.88 ± 0.1 mm and 2.0 ± 0.1 mm (p > 0.5), and 0.16 ± 0.1 mm and 0.16 ± 0.11 mm in the SG (p > 0.5). Semen parameters in the CG had significant differences before and after the operation (p < 0.01), were significantly lower in the MG (p < 0.01), and had no significant differences in the SG (p > 0.5). Conclusion: Simple partial ligation of the renal vein combined with ligation of the communicating branch leads to acceptable models for varicocele.
Immediate Effect on Overactive Bladder Symptoms following Administration of Imidafenacin
Authors: Kitagawa Yasuhide , Kuribayashi Masato , Narimoto Kazutaka , Kawaguchi Shohei , Yaegashi Hiroshi , Namiki Mikio
Published: April 2011

Introduction: One of the factors influencing the treatment compliance of patients with overactive bladder (OAB) symptoms is thought to be the time to reach clinical effectiveness after administering drugs. We investigated the immediate effect of imidafenacin on OAB symptoms. Patients and Methods: Imidafenacin (0.1 mg) was administered. OAB symptom scores (OABSS) were evaluated before administration, and at 2 and 4 weeks after administration. The subjective efficacy in patients was examined by recording daily changes for 2 weeks. Results: Twenty patients were evaluated for efficacy using OABSS and uroflowmetry with postvoid residual volume. Nineteen patients completely recorded daily changes in subjective efficacy. The mean total OABSS decreased gradually during 2 weeks after administration. Patients reported the drug’s efficacy to begin 3 days after the commencement of administration. Urinary flow and postvoid residual volume did not change after administration. Conclusion: The subjective efficacy of imidafenacin was observed from 3 days after the commencement of administration.
Caveolin-1 May Participate in the Pathogenesis of Bladder Pain Syndrome/ Interstitial Cystitis
Authors: Lin Xia-Cong , Zhang Qing-Hua , Zhou Peng , Zhou Zhan-Song , Lu Gen-Sheng
Published: April 2011

Objectives: To determine whether caveolin-1 expression is associated with bladder pain syndrome/interstitial cystitis (BPS/IC) and to better understand the pathogenesis of BPS/IC. Methods: The study population was composed of 19 women with BPS/IC and 7 healthy women as controls. Midstream urine specimens were collected before cystoscopy and cold cup bladder biopsies were obtained from the trigone of the bladder. Caveolin-1 protein expression was determined by indirect immunofluorescence and Western blot analysis in cases and controls, using a rabbit polyclonal antibody against caveolin-1. χ2 test and Student’s t test were used in the statistical analysis. Results: A statistical difference of caveolin-1 protein expression was observed between BPS/IC and healthy controls (p < 0.05, χ2 test). Western blot analysis showed that the mean relative integrated density value of caveolin-1 in (BPS/IC) patients was significantly higher than that in the control group (p < 0.001, Student’s t test). Conclusions: The results of our study demonstrate that there is a relationship between the raised levels of caveolin-1 expression and BPS/IC. This preliminary study may provide a basis for further investigation of the role of caveolin-1 in the pathogenesis of BPS/IC.
Molecular Mechanisms of Natural Killer Cell Activation
Authors: Bryceson Yenan T. , Chiang Samuel C.C. , Darmanin Stephanie , Fauriat Cyril , Schlums Heinrich , Theorell Jakob , Wood Stephanie M.
Published: April 2011

With an array of activating and inhibitory receptors, natural killer (NK) cells can specifically eradicate infected and transformed cells. Target cell killing is achieved through directed release of lytic granules. Recognition of target cells also induces production of chemokines and cytokines that can coordinate immune responses. Upon contact with susceptible cells, a multiplicity of activating receptors can induce signals for adhesion. Engagement of the integrin leukocyte functional antigen-1 mediates firm adhesion, provides signals for granule polarization and orchestrates the structure of an immunological synapse that facilitates efficient target cell killing. Other activating receptors apart from leukocyte functional antigen-1 signal for lytic granule exocytosis, a process that requires overcoming a threshold for activation of phospholipase C-γ, which in turn induces STIM1- and ORAI1-dependent store-operated Ca2+ entry as well as exocytosis mediated by the SNARE-containing protein syntaxin-11 and regulators thereof. Cytokine and chemokine release follows a different secretory pathway which also requires phospholipase C-γ activation and store-operated Ca2+ entry. Recent studies of human NK cells have provided insights into a hierarchy of effector functions that result in graded responses by NK cell populations. Responses display cellular heterogeneity and are influenced by environmental cues. This review highlights recent knowledge gained on the molecular pathways for and regulation of NK cell activation.
Lung Cancer in Pulmonary Fibrosis: Tales of Epithelial Cell Plasticity
Authors: Königshoff Melanie
Published: April 2011

Lung epithelial cells exhibit a high degree of plasticity. Alterations to lung epithelial cell function are critically involved in several chronic lung diseases such as pulmonary fibrosis. Pulmonary fibrosis is characterized by repetitive injury and subsequent impaired repair of epithelial cells, which leads to aberrant growth factor activation and fibroblast accumulation. Increased proliferation and hyper- and metaplasia of epithelial cells upon injury have also been observed in pulmonary fibrosis; this epithelial cell activation might represent the basis for lung cancer development. Indeed, several studies have provided histopathological evidence of an increased incidence of lung cancer in pulmonary fibrosis. The mechanisms involved in the development of cancer in pulmonary fibrosis, however, remain poorly understood. This review highlights recently uncovered molecular mechanisms shared between lung cancer and fibrosis, which extend the current evidence of a common trait of cancer and fibrosis, as provided by histopathological observations.
Natural Killer Cell Activation Secondary to Innate Pattern Sensing
Authors: Seya Tsukasa , Kasamatsu Jun , Azuma Masahiro , Shime Hiroaki , Matsumoto Misako
Published: April 2011

Recent progress in understanding the outcomes of pattern-recognition by myeloid dendritic cells (mDC) allows us to delineate the pathways driving natural killer (NK) cell activation. Mouse mDC mature in response to microbial patterns and are converted to an NK cell-activating phenotype. The MyD88 pathway, the Toll/IL-1 receptor homology domain-containing adaptor molecule (TICAM)-1 (TRIF) pathway, and the interferon (IFN)-β promoter stimulator 1 (IPS-1) pathway in mDC participate in driving NK activation, as shown by analyses in knockout mice. Studies using synthetic compounds for Toll-like receptors/RIG-I-like receptors have demonstrated that mDC-NK cell contact induces NK cell activation without the participation of cytokines in mice. In vivo bone marrow transplantation analysis revealed that the IPS-1 pathway in nonmyeloid cells and the TICAM-1 pathway in mDC are crucial for dsRNA-mediated in vivo NK activation. These results infer the presence of cytokine-dependent and cytokine-independent modes of NK activation in conjunction with innate immune activation. Here, we focus on the IFN-inducing pathways and mDC-NK contact-induced NK activation and discuss the reported various NK activation modes.
Effect of Intravenous Saccharated Ferric Oxide on Serum FGF23 and Mineral Metabolism in Hemodialysis Patients
Authors: Takeda Yoko , Komaba Hirotaka , Goto Shunsuke , Fujii Hideki , Umezu Michio , Hasegawa Hirohito , Fujimori Akira , Nishioka Masato , Nishi Shinichi , Fukagawa Masafumi
Published: April 2011

Background/Aims: Fibroblast growth factor-23 (FGF23) plays a central role in the development of hypophosphatemia and inappropriately low 1,25-dihydroxyvitamin D induced by iron therapy for iron-deficiency anemia. The aim of this study was to examine the effect of intravenous saccharated ferric oxide on serum FGF23 levels and mineral metabolism in hemodialysis patients. Methods: This prospective study enrolled 27 hemodialysis patients who had iron-deficiency anemia defined by a hemoglobin concentration <10.5 g/dl and serum ferritin <100 ng/ml. Intravenous saccharated ferric oxide at a dose of 40 mg was administered three times weekly over 3 weeks. The dose of active vitamin D and phosphate binders was kept unchanged. Serum FGF23, intact parathyroid hormone (PTH) and other parameters were prospectively monitored for 5 weeks. Results: Serum FGF23 levels were markedly elevated [3,453 (338–6,383) pg/ml] at baseline. After 3 weeks of intravenous saccharated ferric oxide treatment, serum FGF23 further increased to 4,701 (1,251–14,396) pg/ml, and returned to the baseline values after 2 weeks of observation. There was also a significant decrease in intact PTH but no changes in serum calcium and phosphorus. Conclusions: Intravenous saccharated ferric oxide induces further increase in elevated FGF23 levels in hemodialysis patients. This increase does not induce hypophosphatemia and inappropriately low 1,25-dihydroxyvitamin D in the absence of functioning kidney, but may result in transient PTH suppression – possibly by directly acting on the parathyroid.
A Custom-Made, Low-Cost Intraoperative Fluorescence Navigation System with Indocyanine Green for Sentinel Lymph Node Biopsy in Skin Cancer
Authors: Fujisawa Yasuhiro , Nakamura Yasuhiro , Kawachi Yasuhiro , Otsuka Fujio
Published: April 2011

Background: Recently, indocyanine green (ICG) fluorescence imaging has been reported as new method to detect sentinel lymph nodes (SLNs). However, high introduction costs limit its use. Objective: The purpose of this study was to test an ICG fluorescence detection system constructed with parts commonly available on the market and to compare the SLN detection rate with that of the conventional combined dye and RI methods. Methods: We constructed this system using a charge-coupled device camera and light-emitting diodes. Results: We could construct our system at a cost of less than USD 1,600. This system could trace lymphatic channels through the skin and detect SLNs in 16 patients with skin cancer. However, SLNs in the neck were difficult to detect through the skin. Conclusion: Our system could be assembled at a reasonable cost and allowed us to detect SLNs efficiently. It may be used as an alternative to radiotracer for detecting SLNs located in the groin and axillary regions.
Prevalence and Pathology of Dementia with Lewy Bodies in the Oldest Old: A Comparison with Other Dementing Disorders
Authors: Jellinger Kurt A. , Attems Johannes
Published: April 2011

Background: While the prevalence of Alzheimer disease (AD) increases with age, little is known about the frequency of dementia with Lewy bodies (DLB) in the oldest old. A retrospective hospital-based study compared the relative prevalence of DLB among very old individuals. Methods: 1,100 consecutive autopsy cases of demented patients aged over 70 years (mean age: 83.9 ± 5.4 years) were examined using standardized neuropathological methods and current diagnostic consensus criteria. Results: Evaluation of three age groups (8th–10th decade) showed a significant increase in the relative prevalence of AD with cerebrovascular lesions including mixed dementia, while AD with Lewy body (LB) pathology showed a mild but insignificant age-related increase. Both ‘pure’ AD and vascular dementia showed a mild but insignificant decline, while DLB (without severe AD pathology) decreased progressively. While the severity of Lewy pathology in DLB slightly decreased with age, concomitant Alzheimer-like pathology increased progressively. Conclusion: Whether DLB in the oldest old represents a distinct group is a matter of discussion, but the relative prevalence of AD with LB in our sample remained fairly stable.
Long-Term Prognosis of Patients With Kawasaki Disease Complicated by Giant Coronary Aneurysms
Authors: Suda Kenji , Iemura Motofumi , Nishiono Hiroshi , Teramachi Yozo , Koteda Yusuke , Kishimoto Shintaro , Kudo Yoshiyuki , Itoh Shinichi , Ishii Haruka , Ueno Takafumi , Tashiro Tadashi , Nobuyoshi Masakiyo , Kato Hirohisa , Matsuishi Toyojiro
Published: April 2011

Background—

Some patients with Kawasaki disease develop giant coronary aneurysms and coronary stenosis, leading to ischemic heart disease. The aim of this study was to determine the long-term prognosis of patients with Kawasaki disease with giant aneurysms.

Methods and Results—

From our institutional database, 76 patients (57 men and 19 women) who developed giant aneurysms after January 1, 1972, were identified. Information on patient demographics, catheter and surgical interventions, and most recent status was collected from medical charts and patients' contacts. From these data, we calculated the survival rate and cumulative coronary intervention rate. The average age at onset was 2.9±2.9 years, and the median observational period was 19 years. During this period, 7 patients died and 1 patient underwent a heart transplantation, resulting in 95%, 88%, and 88% survival rates at 10, 20, and 30 years after the onset of KD, respectively. On the other hand, catheter and surgical coronary interventions (median, 1 intervention; range, 1 to 7 interventions) were performed to alleviate coronary ischemia in 46 patients (61%) at 1 month to 21 years (mode at 1 month) after onset, resulting in 28%, 43%, and 59% cumulative coronary intervention rates at 5, 15, and 25 years after onset, respectively.

Conclusions—

The long-term survival of patients with Kawasaki disease complicated by giant coronary aneurysms is moderately good with multiple catheter and surgical interventions. Further research should focus on the prevention of coronary vascular remodeling and on the indications for and effectiveness of percutaneous and surgical coronary interventions.
Novel Antiplatelet Drug Revacept (Dimeric Glycoprotein VI-Fc) Specifically and Efficiently Inhibited Collagen-Induced Platelet Aggregation Without Affecting General Hemostasis in Humans
Authors: Ungerer Martin , Rosport Kai , Bültmann Andreas , Piechatzek Richard , Uhland Kerstin , Schlieper Peter , Gawaz Meinrad , Münch Götz
Published: April 2011

Background—

Blocking of glycoprotein VI–dependent pathways by interfering in vascular collagen sites is commonly seen as an attractive target for an antiplatelet therapy of acute atherosclerotic diseases such as myocardial infarction or stroke. Revacept (soluble dimeric glycoprotein VI-Fc fusion protein) has been shown to reduce platelet adhesion by blocking vascular collagen in plaques or erosion and to be safe in preclinical studies. A dose-escalating clinical phase I study was performed to assess the safety, tolerability, pharmacokinetics, and pharmacodynamics of Revacept in humans.

Methods and Results—

In a first-in-humans study, 30 healthy men received a single intravenous administration of 10, 20, 40, 80, or 160 mg Revacept. The serum concentration–time courses of each dosage of Revacept showed a narrow variation and a concentration and time dependence. Revacept did not significantly affect the bleeding time. Collagen-induced platelet aggregation was dose-dependently inhibited up to 48 hours at lower doses and for 7 days after higher dose levels. In contrast, ADP- or thrombin receptor activating peptide–dependent platelet aggregation remained unaltered. There were no relevant drug-related adverse events or drug-related changes in laboratory parameters (biochemistry, hematology, and coagulation parameters). There were no drug-related changes in blood pressure, pulse rate, or ECG parameters (including 24-hour Holter monitoring). No anti-Revacept antibodies were detected.

Conclusion—

This phase I study demonstrated that Revacept is a safe and well-tolerated new antiplatelet compound with a clear dose-dependent pharmacokinetic profile with specific, dose-related inhibition of platelet aggregation despite completely unaltered general hemostasis.

Clinical Trial Registration—

URL:
www.clinicaltrials.gov
. Unique identifier: NCT 01042964. URL: eudract.ema.europa.eu. Identifier: 2005–004656-12.
Transmural Heterogeneity and Remodeling of Ventricular Excitation-Contraction Coupling in Human Heart Failure
Authors: Lou Qing , Fedorov Vadim V. , Glukhov Alexey V. , Moazami Nader , Fast Vladimir G. , Efimov Igor R.
Published: April 2011

Background—

Excitation-contraction (EC) coupling is altered in end-stage heart failure. However, spatial heterogeneity of this remodeling has not been established at the tissue level in failing human heart. The objective of this article was to study functional remodeling of excitation-contraction coupling and calcium handling in failing and nonfailing human hearts.

Methods and Results—

We simultaneously optically mapped action potentials and calcium transients in coronary perfused left ventricular wedge preparations from nonfailing (n=6) and failing (n=5) human hearts. Our major findings are the following. First, calcium transient duration minus action potential duration was longer at subendocardium in failing compared with nonfailing hearts during bradycardia (40 bpm). Second, the transmural gradient of calcium transient duration was significantly smaller in failing hearts compared with nonfailing hearts at fast pacing rates (100 bpm). Third, calcium transient in failing hearts had a flattened plateau at the midmyocardium and exhibited a 2-component slow rise at the subendocardium in 3 failing hearts. Fourth, calcium transient relaxation was slower at the subendocardium than at the subepicardium in both groups. Protein expression of sarcoplasmic reticulum Ca
2+
-ATPase 2a was lower at the subendocardium than the subepicardium in both nonfailing and failing hearts. Sarcoplasmic reticulum Ca
2+
-ATPase 2a protein expression at subendocardium was lower in hearts with ischemic cardiomyopathy compared with those with nonischemic cardiomyopathy.

Conclusions—

For the first time, we present direct experimental evidence of transmural heterogeneity of excitation-contraction coupling and calcium handling in human hearts. End-stage heart failure is associated with the heterogeneous remodeling of excitation-contraction coupling and calcium handling.
Flow-Mediated Dilation of the Radial Artery Is Offset by Flow-Induced Reduction in Transmural Pressure
Authors: Jiang Benyu , Seddon Mike , Fok Henry , Donald Ann , Chowienczyk Phil
Published: April 2011

Flow-mediated dilation of the brachial or radial artery in response to transient hyperaemic flow, the most widely used test of endothelial function, is only manifest after flow decays back to baseline. We examined whether this dissociation of flow and diameter might be explained by a reduction in transmural pressure generated by high flow. Studies were performed in healthy subjects 20 to 55 years of age. Flow-mediated dilation was measured in the radial artery using a standard protocol and after flow interruption at peak hyperemia during brachial artery infusion of saline and the NO synthase inhibitor
N
G
-monomethyl-
l
-arginine (8 μmol/min). Flow interruption 20 seconds after cuff release (during high flow but no dilatation) produced an immediate increase in radial artery diameter of 5.36±2.12%, inhibited by
N
G
-monomethyl-
l
-arginine to 1.09±0.67% (n=8;
P
<0.001). Mean intra-arterial radial blood pressure and, hence, transmural pressure fell after cuff release by a mean of 26±1.8 mm Hg (n=6;
P
<0.0001) at the time of peak hyperemic flow. Modulation of transmural pressure within the brachial artery by cuff inflation around the artery demonstrated that this fall is sufficient to reduce arterial diameter by an amount similar to flow-mediated dilation. These results suggest that flow-dependent, NO-dependent dilation is offset by a flow-induced fall in local arterial pressure and, hence, in transmural pressure. Shear related NO release is likely to play a greater role in the short-term regulation of arterial tone than that suggested by flow-mediated dilation.
Frequency of Familial Hyperaldosteronism Type 1 in a Hypertensive Pediatric Population
Authors: Aglony Marlene , Martínez-Aguayo Alejandro , Carvajal Cristian A. , Campino Carmen , García Hernán , Bancalari Rodrigo , Bolte Lillian , Avalos Carolina , Loureiro Carolina , Trejo Pamela , Brinkmann Karin , Giadrosich Vinka , Mericq Verónica , Rocha Ana , Avila Alejandra , Perez Viviana , Inostroza Andrea , Fardella Carlos E.
Published: April 2011

Familial hyperaldosteronism type 1 is an autosomal dominant disorder attributed to a chimeric CYP11B1/CYP11B2 gene (CG). Its prevalence and manifestation in the pediatric population has not been established. We aimed to investigate the prevalence of familial hyperaldosteronism type 1 in Chilean hypertensive children and to describe their clinical and biochemical characteristics. We studied 130 untreated hypertensive children (4 to 16 years old). Blood samples for measuring plasma potassium, serum aldosterone, plasma renin activity, aldosterone/renin ratio, and DNA were collected. The detection of CG was performed using long-extension PCR. We found 4 (3.08%) of 130 children with CG who belonged to 4 unrelated families. The 4 patients with CG had very high aldosterone/renin ratio (49 to 242). In addition, we found 4 children and 5 adults who were affected among 21 first-degree relatives. Of the 8 affected children, 6 presented severe hypertension, 1 presented prehypertension, and 1 presented normotension. High serum aldosterone levels (>17.7 ng/dL) were detected in 6 of 8 subjects (range: 18.6 to 48.4 ng/dL) and suppressed plasma renin activity (≤0.5 ng/mL per hour) and high aldosterone/renin ratio (>10) in 8 of 8 children (range: 49 to 242). Hypokalemia was observed in only 1 of 8 children. We demonstrated that the prevalence of familial hyperaldosteronism type 1 in a pediatric hypertensive pediatric population was surprisingly high. We found a high variability in the clinical and biochemical characteristics of the affected patients, which suggests that familial hyperaldosteronism type 1 is a heterogeneous disease with a wide spectrum of presentations even within the same family group.
Prevalence of Resistant Hypertension in the United States, 2003–2008
Authors: Persell Stephen D.
Published: April 2011

The prevalence of resistant hypertension is unknown. Much previous knowledge comes from referral populations or clinical trial participants. Using data from the National Health and Nutrition Examination Survey from 2003 through 2008, nonpregnant adults with hypertension were classified as resistant if their blood pressure was ≥140/90 mm Hg and they reported using antihypertensive medications from 3 different drug classes or drugs from ≥4 antihypertensive drug classes regardless of blood pressure. Among US adults with hypertension, 8.9% (SE: 0.6%) met criteria for resistant hypertension. This represented 12.8% (SE: 0.9%) of the antihypertensive drug–treated population. Of all drug-treated adults whose hypertension was uncontrolled, 72.4% (SE: 1.6%) were taking drugs from <3 classes. Compared with those with controlled hypertension using 1 to 3 medication classes, adults with resistant hypertension were more likely to be older, to be non-Hispanic black, and to have higher body mass index (all
P
<0.001). They were more likely to have albuminuria, reduced renal function, and self-reported medical histories of coronary heart disease, heart failure, stroke, and diabetes mellitus (
P
<0.001). Most (85.6% [SE: 2.4%]) individuals with resistant hypertension used a diuretic. Of this group, 64.4% (SE: 3.2%) used the relatively weak thiazide diuretic hydrochlorothiazide. Although not rare, resistant hypertension is currently found in only a modest proportion of the hypertensive population. Among those classified here as resistant, inadequate diuretic therapy may be a modifiable therapeutic target. Cardiovascular diseases, diabetes mellitus, obesity, and renal dysfunction were all common in this population.
On the Growth and Decay of the Subtropical Dipole Mode in the South Atlantic
Authors: Morioka Yushi , Tozuka Tomoki , Yamagata Toshio
Published: April 2011

Using observational data and outputs from an ocean general circulation model, the growth and decay of the South Atlantic subtropical dipole (SASD) are studied. The SASD is the most dominant mode of interannual variability in the South Atlantic Ocean, and its sea surface temperature (SST) anomaly shows a dipole pattern that is oriented in the northeast–southwest direction. The positive (negative) pole develops because the warming of the mixed layer by the contribution from the climatological shortwave radiation is enhanced (suppressed) when the mixed layer is thinner (thicker) than normal. The mixed layer depth anomaly over the positive (negative) pole is due to the suppressed (enhanced) latent heat flux loss associated with the southward migration and strengthening of the subtropical high. During the decay phase, since the temperature difference between the mixed layer and the entrained water becomes anomalously large (small) as a result of the positive (negative) mixed layer temperature anomaly, the cooling of the mixed layer by the entrainment is enhanced (reduced). In addition, the cooling of the mixed layer by the contribution from the climatological latent heat flux is enhanced (suppressed) by the same thinner (thicker) mixed layer. This paper demonstrates the importance of taking into account the interannual variations of the mixed layer depth in discussing the growth and decay of SST anomalies associated with the SASD.
Variations in North American Summer Precipitation Driven by the Atlantic Multidecadal Oscillation
Authors: Hu Qi , Feng Song , Oglesby Robert J.
Published: April 2011

Understanding the development and variation of the atmospheric circulation regimes driven by the Atlantic multidecadal oscillation (AMO) is essential because these circulations interact with other forcings on decadal and interannual time scales. Collectively, they determine the summer (June, July, and August) precipitation variations for North America. In this study, a general circulation model (GCM) is used to obtain such understanding, with a focus on physical processes connecting the AMO and the summertime precipitation regime change in North America. Two experimental runs are conducted with sea surface temperature (SST) anomalies imposed in the North Atlantic Ocean that represent the warm and cold phases of the AMO. Climatological SSTs are used elsewhere in the oceans. Model results yield summertime precipitation anomalies in North America closely matching the observed anomaly patterns in North America, suggesting that the AMO provides a fundamental control on summertime precipitation in North America at decadal time scales. The impacts of the AMO are achieved by a chain of events arising from different circulation anomalies during warm and cold phases of the AMO. During the warm phase, the North Atlantic subtropical high pressure system (NASH) weakens, and the North American continent is much less influenced by it. A massive body of warm air develops over the heated land in North America from June–August, associated with high temperature and low pressure anomalies in the lower troposphere and high pressure anomalies in the upper troposphere. In contrast, during the cold phase of the AMO, the North American continent, particularly to the west, is much more influenced by an enhanced NASH. Cooler temperatures and high pressure anomalies prevail in the lower troposphere, and a frontal zone forms in the upper troposphere. These different circulation anomalies further induce a three-cell circulation anomaly pattern over North America in the warm and cold phases of the AMO. In particular, during the cold phase, the three-cell circulation anomaly pattern features a broad region of anomalous low-level southerly flow from the Gulf of Mexico into the U.S. Great Plains. Superimposed with an upper-troposphere front, more frequent summertime storms develop and excess precipitation occurs over most of North America. A nearly reversed condition occurs during the warm phase of the AMO, yielding drier conditions in North America. This new understanding provides a foundation for further study and better prediction of the variations of North American summer precipitation, especially when modulated by other multidecadal variations—for example, the Pacific decadal oscillation and interannual variations associated with the ENSO and the Arctic Oscillation.
River Network Routing on the NHDPlus Dataset
Authors: David Cédric H. , Maidment David R. , Niu Guo-Yue , Yang Zong-Liang , Habets Florence , Eijkhout Victor
Published: April 2011

The mapped rivers and streams of the contiguous United States are available in a geographic information system (GIS) dataset called National Hydrography Dataset Plus (NHDPlus). This hydrographic dataset has about 3 million river and water body reaches along with information on how they are connected into networks. The U.S. Geological Survey (USGS) National Water Information System (NWIS) provides streamflow observations at about 20 thousand gauges located on the NHDPlus river network. A river network model called Routing Application for Parallel Computation of Discharge (RAPID) is developed for the NHDPlus river network whose lateral inflow to the river network is calculated by a land surface model. A matrix-based version of the Muskingum method is developed herein, which RAPID uses to calculate flow and volume of water in all reaches of a river network with many thousands of reaches, including at ungauged locations. Gauges situated across river basins (not only at basin outlets) are used to automatically optimize the Muskingum parameters and to assess river flow computations, hence allowing the diagnosis of runoff computations provided by land surface models. RAPID is applied to the Guadalupe and San Antonio River basins in Texas, where flow wave celerities are estimated at multiple locations using 15-min data and can be reproduced reasonably with RAPID. This river model can be adapted for parallel computing and although the matrix method initially adds a large overhead, river flow results can be obtained faster than with the traditional Muskingum method when using a few processing cores, as demonstrated in a synthetic study using the upper Mississippi River basin.
An Analysis of Tropical Cyclone Formations in the South China Sea during the Late Season
Authors: Lin Yung-Lan , Lee Cheng-Shang
Published: April 2011

This study examines tropical cyclone (TC) formations in the South China Sea (SCS) associated with the strong northeasterly monsoon during the late season. Results show that the percentage of all vortices that develop to TC intensity is lower in the late season when compared to that associated with the mei-yu front in May and June. But the average formation time for the late-season cases is significantly shorter than that for the mei-yu frontal cases. Composite analyses show that the formation cases in the late season have larger low-level vorticity and upper-level divergence as well as higher 700-hPa relative humidity when compared to the nonformation cases. Another major difference between the formation and the nonformation cases is the low-level northeasterlies to the north (or upstream) of the incipient disturbance, which weakens right before the pre-TC disturbance reaching 25 kt (~13 m s−1). The weakening of the northeasterlies may be important to TC formation because it decreases the vertical wind shear and prevents the shift of the disturbance center from over the southern SCS to near the Borneo landmass. Furthermore, it reduces the stabilizing effect associated with the cold- and dry-air intrusion. Previous studies have shown that stronger equatorial westerlies during the active Madden–Julian oscillation (MJO) period may produce stronger cyclonic shear vorticity; thus, favorable for triggering more convection activities and more vortex formations. However, more vortices or cloud clusters are not necessarily more favorable for an individual vortex to organize into a TC. Nonetheless the initial setup of favorable synoptic environment appears to be important for the further development of the incipient vortex.
Institutions and Legacies: Electoral Volatility in the Postcommunist World
Authors: Epperly Brad
Published: April 2011

The postcommunist states of Eastern Europe and the former Soviet Union have witnessed levels of electoral volatility higher than both Western Europe and Latin America, levels that have deleterious effects on party consolidation and representative democracy in the region. This article presents a model of postcommunist legislative electoral volatility, testing explanations developed in Western Europe and Latin America and refining them for the different experi ence of the twin transition to both democracy and capitalism. Pooled cross-sectional time series regression analysis is conducted on 67 legislative elections in 19 countries, covering the 1991-2006 period. Results demonstrate that, contrary to previous studies in other regions and of the first decade of the postcommunist era, economic determinants of volatility are of minimal salience. Rather, the institutional arrangement of the electoral system is found to be critically important, as is the more thorough “Leninist” or “Soviet” legacy in the states of the former Soviet Union.
Provider Perspectives About Latino Patients: Determinants of Care and Implications for Treatment
Authors: Valdez Carmen R. , Dvorscek Michael J. , Budge Stephanie L. , Esmond Sarah
Published: April 2011

Primary care settings are the gateway through which the majority of Latinos access care for their physical and mental health concerns. This study explored the perspectives of primary care providers concerning their Latino patients, in particular issues affecting their patients’ access to and utilization of services. Interviews were conducted with eight primary care providers and analyzed using consensual qualitative research methods. In addition, observations were conducted of the primary care setting to contextualize providers’ perspectives. Providers indicated that care for Latinos was affected by several domains: (a) practical/instrumental factors that influence access to care; (b) cultural and personal factors that shape patients’ presentations and views about physical and mental health and treatment practices; (c) provider cultural competence; and (d) institutional factors that highlight the context of care. In addition to recommendations for research and practice, the need for interdisciplinary collaboration between psychology and medicine in reducing ethnic minority disparities was proposed.
Can Intensive Care Staff See Their Patients? An Improved Visibility Analysis Methodology
Authors: Lu Yi , Zimring Craig
Published: April 2011

This is a study of the spatial properties of environments to which habitual users are attuned. The particular properties under consideration are those that affect visual fields. The authors tested the proposition that the impact of spatial organization becomes clearer when people focus on a prespecified set of visual targets. Empirical observations were performed to understand how medical staff members occupy space in an intensive care unit. The close correspondence between targeted visibility pattern and aggregated behavior patterns indicates that medical staff members are attentive to the relative visual information of environments. With the refinement of the targeted visibility analysis, the authors can better explain people’s spatial choices and routine behaviors. Furthermore, this study gives an opportunity and related measures for health care facility designers to specify the visual structures of important behavioral effects.
Effects of CNT concentration level and water/cement ratio on the piezoresistivity of CNT/cement composites
Authors: Han Baoguo , Yu Xun , Kwon Eil , Ou Jinping
Published: April 2011

Carbon nanotube (CNT)/cement composites with different concentration levels of multi-walled CNT (MWNT) and water/cement ratios are fabricated. By comparing the responses of electrical resistance of these CNT/cement composites to compressive stress, the effects of MWNT concentration level and water/cement ratio on the piezoresistive sensitivity of composites are investigated. Experimental results indicate that the piezoresistive sensitivities of CNT/cement composites with 0.05, 0.1, and 1 wt% of MWNT first increase and then decrease with the increase of CNT concentration levels. Water/cement ratio is another factor that affects the composite properties, the electrical resistance of CNT/cement composite with 0.6 water/cement ratio is more sensitive to compressive stress than that of composite with 0.45 water/cement ratio. The piezoresistive sensitivity is heavily dependent on the conductive network in the composites, which in turn is influenced by the CNT concentration level and water/cement ratio.
Terrorism and the economics of trust
Authors: Blomberg S Brock , Hess Gregory D , Tan Daniel YJ
Published: April 2011

Previous research has shown that trust is an important component that encourages investment and capital formation which, in turn, enhances economic performance. This article investigates the effect of terrorism on income, including its indirect role through lowering trust. We consider terrorism as a factor that can increase the cost of investing in technology and capital formation due to its ability to diminish trust in an economy. We then develop a novel and rich dataset spanning 179 countries from 1968 to 2007 using associated community, social, cultural, political, and economic factors from the World Values Survey and international terrorism incidence data from ITERATE. Using empirical tests, we first show that terrorism has a negative and statistically significant impact on individual income. This impact is larger than what has previously been found, possibly due to aggregation effects and data selection. We then estimate the societal impact of terrorism on economic growth by examining the extent to which terrorism taxes trust and how this, in turn, hinders economic performance. Consequently, we develop a measure of the economic consequences of terrorism through sizing the magnitude of the ‘trust tax’ from terrorism. We find that the trust tax is relatively minor compared to the direct impact of terrorism on income.
Polynomial Modeling of Child and Adult Intonation in German Spontaneous Speech
Authors: de Ruiter Laura E.
Published: April 2011

In a data set of 291 spontaneous utterances from German 5-year-olds, 7-year-olds and adults, nuclear pitch contours were labeled manually using the GToBI annotation system. Ten different contour types were identified.The fundamental frequency (F0) of these contours was modeled using third-order orthogonal polynomials, following an approach similar to the one Grabe, Kochanski, and Coleman (2007) used for English. Statistical analyses showed that all but one contour pair differed significantly from each other in at least one of the four coefficients. This demonstrates that polynomial modeling can provide quantitative empirical support for phonological labels in unscripted speech, and for languages other than English. Furthermore, polynomial expressions can be used to derive the alignment of tonal targets relative to the syllable structure, making polynomial modeling more accessible to the phonological research community. Finally, within-contour comparisons of the three age groups showed that for children, the magnitude of the higher coefficients is lower, suggesting that they are not yet able to modulate their pitch as fast as adults.
Environmental website production: a structuration approach
Authors: Stein Laura
Published: April 2011

The World Wide Web has excited much speculation, and a growing body of scholarship, about its potential to advance the communicative power of social movement organizations. As a medium that enables online publishing, and selected features and functions, websites could be important in this regard. Yet, studies of social movement websites have documented these groups’ modest uses of the medium, and few scholars have studied the organizational factors shaping social movement website production. In this study, I examine US environmental group website production practices. Drawing on structuration theory, I consider how organizational priorities, processes and resources limit and constrain website production. I use structuration theory to analyse environmental group website production practices as gleaned from semi-structured interviews with 28 environmental group webmasters. I conclude that despite their awareness of the Web’s capabilities, webmasters experience production constraints related to organizational norms, knowledge, and resources. Ultimately, I aim to provide an explanation for studies that find limited uses of the Web among social movement groups, to better understand the processes and practices involved in cultural production online, and to elucidate on some of the challenges website production poses for social movement groups.
Political consumerism, young citizens and the Internet
Authors: Ward Janelle , de Vreese Claes
Published: April 2011

Evidence suggests that purchasing products for ethical or political reasons−also known as political consumerism−may be gaining in importance. With (young) people’s declining voting rates and a general disinterest in political institutions, scholars and political elites alike are speculating on the evolution of citizenship. Research shows that citizens in countries like the UK see issue and life-style-based politics as increasingly relevant. These developments point to an interest in understanding political consumerism and its relationship to citizenship. Through analysis of a survey conducted among 1215 respondents in the UK, this article presents evidence in particular for youth’s notable presence online and their affinity for a particular strain of political consumerism identified as socially conscious consumption. It explores the relationship between this consumption and online and offline political participation. It discusses the potential for political consumerism to play a larger role in traditional political realms and particularly through the utilization of technology.