bluuebunny/crossref_metadata_2025 huggingface dataset:
Advantages of the Femoral Approach
Authors: HOFMANN MANFRED
Published: June 2007

The safety, simplicity, and low complication rate of diagnostic and therapeutic coronary interventions depend on the coronary anatomy, the vascular access site, and the route to the heart. Therefore, the femoral approach competes with the brachial and, recently, with radial access to the arterial vasculature. There are some niche conditions where only one of the methods is possible (e.g., complete arterial occlusion). Usually, both routes are available for the majority of patients. We recommend the femoral approach as the standard because of its ease of use, minimal x‐ray exposure, and low consumption of contrast medium. Repetitive punctures and access to all branching arteries of the aortic arch are possible. Closure devices reduce the in‐hospital stay compared with the brachial or radial approach. Furthermore, in our experience, it is possible and less expensive to perform the majority of diagnostic procedures with 4Fr catheters and therapeutic interventions, including stent implantations with 5Fr guiding devices leading to a short in‐hospital stay.
Interventional Versus Surgical Closure of Atrial and Ventricular Septal Defects: Advantages and Limitations of the Catheter‐Based Approach
Authors: MORITZ ANTON , DOSS MIRKO , DOGAN SELAMI , AYBEK TAYFUN , WIMMER‐GREINECKER GERHARD
Published: June 2007

The surgical closure of ASDs and VSDs is a safe and effective procedure with low morbidity and mortality. Surgical correction of these defects has been performed for over 40 years. Percutaneous transcatheter techniques for the closure of ASDs and VSDs are also effective for certain forms of these defects. Frequently, young female patients or children require ASD closure. This has stimulated efforts to create cosmetically more appealing surgical incisions, and most recently, to use minimally invasive surgical techniques. These techniques allow skin incisions to be limited to 4‐6 cm in the submammary crease. For the latest robotically assisted technique only four stab wound incisions have to be performed on the chest. All surgical procedures described require cardiopulmonary bypass. This is associated with well‐known specific problems that can be reduced by recent modifications. Improved cosmesis, lower cost, shorter procedural time, and the ability to correct even more complex malformations with minimally invasive surgical techniques currently compete with the still complex percutaneous defect closures.
Experimental Preseeding of the STARFlex Atrial Septal Occluder Device with Autologous Cells
Authors: JUX CHRISTIAN , BERTRAM HARALD , WOHLSEIN PETER , BRUEGMANN MICHAEL , FINK CHRISTOPH , WUEBOLDT PETRA , PAUL THOMAS , HAUSDORF GERD
Published: June 2007

Devices used in interventional cardiology are permanent implants. However, most of the devices fulfill only a temporary function. For example, atrial septal defect (ASD) occluders serve as mechanical shields until complete in‐ and overgrowth of the occluding device by endogenous tissue from the defect edges has occurred. Thereafter, the foreign body material of the devices is no longer needed and bears potential long‐term adverse effects. The concept of “biodegradable” occluder devices that act as transient mechanical shields to close the defects and as scaffolds for overgrowth with autologous tissue is, therefore, tempting. Since rapid and complete ingrowth as well as coverage by firm tissue is a prerequisite for any such “biological” occluder devices, the feasibility and short‐term in vivo response to STARFlex devices preseeded with autologous cells was studied in an experimental sheep model. The experiments demonstrated that autologous cell preseeding of cardiovascular implants is technically feasible. Cells survived the mechanical stress of device implantation. A precoating of conventional STARFlex occluders led to an increased cellular density after cell seeding of the device, an increased resistance of the precultured cytolayer against mechanical stress, and a significantly higher poststress viability of “implanted” cells. Experimental closure of ASD using autologous‐cell preseeded STARFlex devices was uncomplicated. In the sheep model this led to rapid, complete, and firm ingrowth of the device into the adjacent atrial tissue. A thicker layer of young fibrous granulation tissue in organization was found on the preseeded devices compared with the unseeded control group after 4 weeks in vivo. Currently, an increased thrombogenicity limits in vivo application.
Substantial Reduction of Platelet Adhesion by Heparin‐Coated Stents
Authors: BICKEL CHRISTOPH , RUPPRECHT HANS J. , DARIUS HARALD , BINZ CHRISTIANE , HAURÖDER BÄRBEL , KRUMMENAUER FRANK , MEYER JÜRGEN
Published: June 2007

Although optimized antiplatelet medication has improved the clinical outcome after coronary stenting, vessel occlusion and restenosis still remain a relevant clinical problem. Platelets play a key role in this process. Therefore, the authors compared the platelet adhesion on different stent surface modifications (electropolished without coating or coated with carbon, carbon and additional heparin, silicon carbide, or heparin alone) to investigate their role in reducing platelet adhesion. All stem and additional stainless steel plates were incubated in heparinized whole blood with radiolabeled platelets. Afrer washing the stents and plates four times, radioactivity caused by the adhesion of radiolabeled platelets was measured. The adhesion of radiolabeled platelets, compared to uncoated, electropolished stents, was reduced through silicon carbide coating to 58.6%, by carbon coating with additional heparin to 32.9%, and heparin coating alone to 7.7%. Stent coating with heparin is the most effective among the examined coatings in reducing platelet adhesion in vitro.
Role of Prolonged Intravenous Heparin in Unstable Angina Patients Prior to Coronary Angioplasty
Authors: GANGASANI SREENIVASULU R. , O'NEILL WILLIAM W. , GRINES CINDY L.
Published: June 2007

Background: The optimal timing of coronary angioplasty in unstable angina patients is controversial. Early reports suggested using 3–5 days of intravenous heparin and aspirin for plaque stabilization before angioplasty. There is no clearcut data in this regard from the published literature. The purpose of this study was to evaluate whether delaying the angioplasty in order to stabilize the plaque affected the outcome. Methods: We reviewed the hospital course of patients who were admitted with unstable angina through the emergency room and ruled out for myocardial infarction, and who required angioplasty during the index hospitalization. To diminish the influence of coronary stenting and glycoprotein IIb/IIIa receptor blockade, we reviewed all patients admitted during 1994. Results: Of the 305 patients, 166 patients received ≤48 hours and 139 patients received > 48 hours of intravenous heparin infusion before angioplasty. Both groups were well‐matched. The procedural success was similar in both the groups (98% vs 97%, P = 0.72). The complication rate was similar in both groups, including abrupt closure, emergency bypass surgery, myocardial infarction and death. Length of hospital stay was significantly prolonged in the group with > 48 hours of heparin infusion (4.4 ± 3.0 vs 7.4 ± 3.6 days; P < 0.001). Conclusion: In patients with unstable angina undergoing angioplasty, prolonged duration of heparin infusion influenced the procedural outcome or postprocedural complications, but prolonged the hospital stay. These data suggest that early angioplasty of unstable angina patients is safe and may be cost‐effective, even in the absence of stenting and potent antiplatelet agents. However, prospective, randomized trials are needed to clarify the need for and duration of heparin infusion prior to angioplasty in unstable angina patients.
The Clinical Significance of QTc Dispersion Measurement for Risk of Syncope in Patients with Aortic Stenosis.
Authors: KOŞAR FERIDUN , TANDOǦAN İZZET , HİSAR İSMET , AYTAN YILMAZ , İLERİ MEHMET
Published: June 2007

Objectives: (1) To evaluate the clinical usefulness of QTc dispersion determination in aortic stenosis and (2) to compare the effects of QTc dispersion on the occurrence risk of syncope in aortic stenosis. Background: QT interval dispersion has long been known to be a marker of dispersion of ventricular repolarization and, hence, electrical instability. Additionally, it has been shown that these patients have a propensity to ventricular tachyarrhythmic syncope. Methods: The study included 86 patients with aortic stenosis who underwent left‐heart catheterization and coronary angiography during investigation of syncope, as well as 30 control subjects. The patients were characterized with regards to the presence or absence of a history of syncope and the severity of aortic stenosis (the degree of peak transvalvular gradient). In addition, QT dispersion measurements were corrected for heart rate according to Bazett's formula and both were measured. Results: QTc dispersion was greater in patients with aortic stenosis than in the control subjects (60 ± 13 msec vs 38 ± 12 msec, P < 0.001). Similarly, QTc dispersion was greater in the patients with a history of syncope than in the patients with no history of syncope (68 ± 12 msec vs 53 ± 10 msec, P < 0.001). In addition, QTc dispersion values were greater in the patients with a high transvalvular gradient than in the patients with a low transvalvular gradient (65 ± 12 msec vs 50 ± 9 msec, P < 0.001). Multivariate logistic regression analysis showed that only an increased QTc dispersion had significant value for the risk of syncope in aortic stenosis. Conclusions: An increased QTc dispersion increases the occurrence risk for syncope in aortic stenosis. These results suggest that high values of QTc dispersion are a sensitive noninvasive marker for determining the risk for syncope in aortic stenosis.
Measurement of Fractional Flow Reserve to Assess Moderately Severe Coronary Lesions: Correlation with Dobutamine Stress Echocardiography
Authors: JIMÉNEZ‐NAVARRO MANUEL , ALONSO‐BRIALES JUAN H. , HERNÁNDEZ GARCÍA JOSÉ MARÍA , BAILÓN ISABEL RODRÍGUEZ , GÓMEZ‐DOBLAS JUAN JOSÉ , DE TERESA GALVÁN EDUARDO
Published: June 2007

Background: New techniques to evaluate coronary artery disease, such as calculation of myocardial fractional flow reserve (FFR) with a guidewire and pressure transducer, provide a functional assessment of coronary lesions. The present study was designed to determine the correlation between FFR and dobutamine stress echocardiography in patients with moderately severe coronary stenosis in order to judge the usefulness of FFR for commonly encountered clinical problems. Methods and Results: We studied 21 patients with 23 moderately severe coronary artery stenoses on angiography. The FFR was calculated and dobutamine stress echocardiography was performed to detect ischemia. Of the 16 stenoses with a negative FFR (≤ 0.75), dobutamine echocardiography also was negative. In the seven stenoses with a positive FFR (< 0.75), dobutamine echocardiography was positive in three. The efficacy of FFR in detecting ischemia that was confirmed with stress echocardiography was sensitivity 100%, specificity 80%, positive and negative predictive value 42.8%, and 100%. respectively, with a global predictive value 82.6%. A moderate degree of correlation was found between the two diagnostic tests (kappa [k] = 0.51). Conclusions: FFR correlates moderately well with dobutamine stress echocardiography in the assessment of moderately severe lesions in patients for whom coronary arteriography is usually indicated. However, its high negative predictive value makes FFR a useful aid in reaching clinical decisions promptly in the hemodynamics laboratory.
Therapeutic Angiogenesis in Critical Limb and Myocardial Ischemia
Authors: VALE PETER R. , ISNER JEFFREY M. , ROSENFIELD KENNETH
Published: June 2007

Research in animal models of ischemia has shown that administration of angiogenic growth factors, either as a recombinant protein or by gene transfer, can augment nutrient perfusion through neovascularization to promote the development of supplemental collateral blood vessels that will constitute endogenous bypass conduits around occluded native arteries; a strategy termed “therapeutic angiogenesis.” In animal models and clinicul trials, the best studied cytokines with angiogenic activity are vascular endothelial growth factor (VEGF) and fibroblast growth factor (FGF). Clinical trials of therapeutic angiogenesis in patients with critical limb ischemia demonstrated resolution of rest pain and/or improved limb integrity, increased pain‐free walking time and ankle‐brachial index, newly visible collateral vessels by digital subtraction angiography, and qualitative evidence of improved distal flow by magnetic resonance imaging. Initial clinical trials in patients with end‐stage coronary artery disease using direct myocardial injection via thoracotomy resulted in large increases in exercise time and marked reductions in anginal symptoms, as well as objective evidence of improved perfusion and leji ventricular function. Larger scale placebo‐controlled trials have been limited to intracoronary and intravenous administration of recombinant protein, and have not shown significant improvement in exercise time or angina compared to placebo. Larger scale placebocontrolled studies of gene transfer using catheter‐based endocardial delivery are in progress. Future clinical studies are required to determine the optimal dose, formulation, route of administration, and combinations of growth factors, as well as the requirement for endothelial progenitor cell or stem cell supplementation, to provide effective and safe therapeutic angiogenesis for patients with critical limb ischemia and chronic myocardial ischemia who are not candidates for conventional revascularization procedures.
Percutaneous Arterial Aortoiliac Intervention
Authors: ST. GOAR FREDERICK G. , JOYE JAMES D. , LAIRD JOHN R.
Published: June 2007

Historically reconstructive vascular surgery, has been a cornerstone of treatment for symptomatic obliterative uortoiliac disease. Surgical results include a reported aortobifemoral bypass 5‐year patency rate from 85% to 90% and a 10‐year patency rate of 70% to 75%.1 Operative mortality for aortoiliac reconstruction ranges from 1.6% to 3.3%, with an aggregated systemic morbidity of 8.3%.2 Clinical indications for surgical intervention are well‐established and are limited primarily to severe claudication and limb‐threatening ischemia. Broader application of surgical intervention is not recommended because of significant morbidity and mortality associated with the procedure, As balloon angioplasty and endovascular stenting technologies evolve, they are proving to be an effective modality for the treatment of aortoiliac disease. These lower risk procedures have allowed expansion of traditional indications for intervention. Treatment is recommended presently for patients with clinical symptoms that impact lifestyle and professional requirements. Less conventional indications include allowing access for coronary intervention or for placement of an intra‐aortic balloon pump, or improving inflow prior to a distal surgical bypass procedure. Results of aortoiliac percutaneous interventions are difficult to compare with surgical data sinse methods and technology continue to improve and evolve, and randomized studies are limited. It is clear that as long as outcomes of percutaneous interventions are predictable and secondary patency rates acceptable, the low complication rates of a percutaneous intervention are clearly preferable to a riskier surgical alternative.
Chronic Total Occlusions: Experience with Fiber‐Optic Guidance Technology — Optical Coherence Reflectometry
Authors: MORALES PHILIP A. , HEUSER RICHARD R.
Published: June 2007

Chronic total occlusions are difficult to treat and continue to challenge the interventional cardiologist. The primary difficulty is safely crossing the total occlusion with a guidewire before any revascularization can begin. One of the main reasons conventional and newer guidewires have not proven effective is simply the lack of visualization to safely steer the guidewire across the occlusion. This limitation can be overcome with new technology using a “forward‐looking” fiber‐optic guidance. The Safe‐Steer TO (Total Occlusion) Crossing System is a new guidance system that uses optical coherence reflectometry to steer a guidewire through total occlusions. Optical coherence reflectometry uses algorithms to determine tissue types (plaque vs arterial wall) by measuring the intensity of the reflection of near‐infrared light. The authors’clinical experience with the Safe‐Steer System has met considerable success. With their initial 28 patients (7 women, 21 men) with known chronic total occlusions and confirmed ischemia, the primary success rate for the crossing the occlusion was 86% (24/28 cases). The average occluded lesion length was 41.1 ± 30.8 mm. Our initial clinical experience demonstrates that the optical guidewire is a viable technology in the treatment of chronic total occlusions.
Peripheral Vascular Disease: Perspectives on Aortoiliac, Renal, and Femoral Treatments Using Catheter‐Based Techniques
Authors: MORALES PHILIP A. , HEUSER RICHARD R.
Published: June 2007

The percutaneous treatment of peripheral vascular disease has advanced over the past two decades and is fast becoming the preferred treatment of choice. Stents have positively altered the clinical outcomes in peripheral revascularizations. Anatomic variability is an important factor in determining if the patient is an ideal percutaneous interventional candidate. Future technological developments in percutaneous interventions will help include new patients with peripheral vascular disease previously considered nonideal percutaneous candidates.
Transcatheter Closure of Atrial Septal Defects in Children & Adults Using the Amplatzer Septal Occluder
Authors: OMEISH ABDALLAH , HIJAZI ZIYAD M.
Published: June 2007

We are reporting the worldwide experience in closing atrial septal defects (ASDs) in children and adults using the Amplatzer Septal Occluder (ASO) as of July 2000. The outcome measures were safety and efficacy with special emphasis on: (1) immediate success of the ASD closure as measured by transesophageal echocardiography (TEE), (2) short‐ and medium‐ten follow‐up at 24 hours and 1 and 3 months and long‐term follow‐up at 1, 2, and 3 years as assessed by transthoracic echocardiography (TTE); and (3) the incidence of complications. In all, 3580 procedures were performed in 3535 patients. In 75 patients, the device was not implanted for variety of reasons: 3460 patients received a single ASO device and 45 received two devices for multiple ASDs. The median age of the patients was 12.1 year, (range, 10 days‐88 years, the median weight was 41.0 kg (range, 2.4–137 kg) and the median Qp/Qs ratio was 2 (range, 0.3–10). The median size of ASD by TEE was 14 mm (range, 1–38 mm) and the median stretched diameter was 18 mm (range, 4–44 mm). The median size of device implanted was 18 mm (range, 4–40 mm). The median fluoroscopy time was 17.1 minutes (range, 0.0–194.0 minutes). The immediate success rate including those patients with complete closure, trivial residual shunt, or with small residual shunt was 97.4%. This increased to 99.2% and 100% at 3 months and 3 years, respectively. Minor complications were encountered in 2.8% of procedures, while serious complications occurred in less than 0.3% of the cases. There were no device related deaths. We conclude that the ASO is a safe and effective device for catheter closure of small to large ASDs up to a stretched diameter of 40 mm in children and adults with very high short‐, medium, and long‐term success rates. (J Interven Cardiol 2001;14:37–44)
Simultaneous Double or Triple Coil Technique for Closure of Moderate Sized (± 3.0 mm) Patent Ductus Arteriosus
Authors: AKAGI TEIJI , IEMURA MOTOFUMI , TANANARI YOSHIFUMI , ISHII MASAHIRO , YOSHIZAWA SHIHO , KATO HIROHISA
Published: June 2007

One important complication of coil occlusion of patent ductus arteriosus using the conventional Gianturco coil is migration of coils into peripheral vessels. Especially in patients having relatively larger size ductus, the risk for such complication could be increased. In this regard, a detachable coil may have some technical benefits in performing coil occlusion and reducing the incidence of complications such as migration of coil. Based on our clinical experiences, we describe the clinical efficacy of a simultaneous double or triple coil occlusion technique using the Cook detachable coil system to close the ductus arteriosus, especially in patients whose ductus diameter more than 3.0 mm. (J Interven Cardial 2001;14:91–96)
Percutaneous Closure of Patent Foramen Ovale in Symptomatic Patients
Authors: WAHL ANDREAS , WINDECKER STEPHAN , EBERLI FRANZ R. , SEILER CHRISTIAN , MEIER BERNHARD
Published: June 2007

Background: Patent foramen ovale (PFO) and atrial septal aneurysm (ASA) have been associated with stroke in young adults. Patients with PFO suffering from paradoxical embolism are at increased risk for recurrent events. Percutaneous PFO closure is a new treatment modality aimed at secondary prevention. Methods and Results: Since April 1994, 132 consecutive patients, aged 51 ± 12 years with PFO and with at least one paradoxical embolic event, underwent percutaneous PFO closure using six different device types. The embolic index event was an ischemic stroke in 62% of patients, a transient ischemic attack (TIA) in 33% of patients, and a peripheral embolism in 5% of patients. Thirty‐six (27%) patients had PFO associated with ASA, whereas 96 (73%) patients had PFO only. The implantation procedure was successful in 130 (98%) patients. During and up to 6 years of follow‐up (mean 1.8 ± 1.6 years, 231 patient years), a total of eight recurrent embolic events were observed, with six TIAs, two peripheral emboli, and no ischemic stroke. The actuarial freedom from recurrence of the combined end point of TIA, ischemic stroke, and peripheral embolism was 95.3% (95% confidence interval [CI], 91.0%–96.4%) at 1 year and 90.5% (95% CI, 83.6%–97.2%) at 6 years. Conclusions: Percutaneous PFO closure can be performed with a high success rate. The procedure appears a promising therapeutic modality for secondary prevention of recurrent embolism in patients with PFO. Randomized trials must define its therapeutic value. (J Interven Cardiol 2001;14:203–210)
The expression of CD23 in cutaneous non‐lymphoid neoplasms
Authors: Carvalho Jason , Fullen Douglas , Lowe Lori , Su Lyndon , Ma Linglei
Published: June 2007

Background:  Cluster designation 23 (CD23) is generally used as a lymphoid marker. Its utility in cutaneous epithelial tumors has never been studied. In our routine practice, we observed that CD23 reacted strongly with eccrine and apocrine secretory coils.

Methods:  Immunohistochemical staining of CD23 was performed in a total of 131 cases of apocrine, eccrine, follicular and other cutaneous non‐lymphoid tumors.

Results:  CD23 expression was detected in all benign apocrine tumors and in half of benign eccrine tumors, particularly those derived from secretory coils. CD23 staining was seen in 42% (8/19) of microcystic adnexal carcinoma (MAC), while no staining was observed in tumor cells of desmoplastic trichoepithelioma, morpheaform basal cell carcinoma and syringoma. All mammary and extramammary Paget’s disease were labeled with CD23. In comparison, pagetoid Bowen’s disease, melanoma in situ and sebaceous carcinoma exhibited negative staining. In addition, CD23 reacted diffusely with cutaneous mucinous eccrine carcinoma in a manner similar to breast or colonic adenocarcinoma.

Conclusion:  CD23 appears to be a reliable immunohistochemical marker of the eccrine/apocrine secretory coil and helpful in identifying sweat gland tumors of such origin. It is of ancillary value in differentiating MAC from its mimicker. CD23 is a useful addition to the diagnostic immunohistochemical panels for Paget’s disease.
Phase II trial of anti‐idiotypic p53 peptides (Pentrys) plus granulocyte‐macrophage colony‐stimulating factor in patients with hormone‐refractory prostate cancer
Authors: DAVIS Ian D , TONER Guy , BROAD Adam , CAMPANO Louise M , ROSENTHAL Mark
Published: June 2007

Background:  p53 overexpression occurs commonly in hormone‐refractory prostate cancer (HRPC). T‐cell responses against p53 could potentially mediate an antitumor effect. We investigated a novel system of vaccination using three peptides derived from a mouse‐antihuman p53 antibody (Pentrys) in men with HRPC.

Patients and methods:  A phase II, single‐arm, open‐label study of Pentrys peptides admixed with granulocyte‐macrophage colony‐stimulating factor (GM‐CSF) was injected intradermally in men with HRPC, rising prostate‐specific antigen (PSA) and minimal symptoms. The primary objective was to determine clinical responses as measured by PSA. Secondary objectives were to determine duration of PSA response, progression‐free survival (PFS), anti‐p53 antibody response, and safety. Patients received study drug on weeks 1, 3, 5, 9, 13 and 17. Patients suitable for ongoing treatment received two more doses at weeks 21 and 25. Tumor status was assessed at baseline, week 17 and 3 months after the final injection.

Results:  Forty patients entered the study and were evaluable for safety; 39 were evaluable for efficacy. Thirty patients completed at least 16 weeks of treatment. One PSA response was observed that lasted 85 days. Median PFS was 56 days. Treatment was generally well tolerated. Only one dose‐limiting toxicity was observed (allergic rhinitis and urticaria). Five patients had anti‐p53 antibodies at screening. Two patients developed anti‐p53 antibodies during the study, including the patient with the PSA response.

Conclusions:  Pentrys administered with GM‐CSF by intradermal injection is well tolerated. Only one PSA response was seen and anti‐p53 seroconversion was observed in two patients. Pentrys has minimal clinical activity in this patient population.
Microsatellites reveal the genetic structure of thelytokous strains of the migratory locust
Authors: TENG ZHAO‐QIAN , KANG LE
Published: June 2007

Abstract
This study reports on two parthenogenetic strains of the migratory locust Locusta migratoria. The offspring of thelytokou females had a single fragment per microsatellite loci. All offspring of the parthenogenetic F1 females were genetically identical. These results further confirmed that restitution of the sister products of early cleavage mitoses and cell fusion might be the most likely diploidization mechanisms in the thelytokous locusts. Polymerase chain reaction amplification results demonstrated that thelytoky in the locust was not induced by Wolbachia bacteria. Apart from the low fitness gained in thelytokous females, large populations with migration and losing heterozygosity may be other reasons why regular parthenogenesis has not evolved in the locust.
HRM‐based reforms in public organisations: problems and perspectives
Authors: Pichault François
Published: June 2007

Many attempts at modernisation have been launched in public organisations during the last decade, focused on a renewal of HR policies and devices. Via an in‐depth exploration of three case studies in Belgium, this paper develops an analytical framework likely to explain their contrasting performances. Our main hypothesis is that a lack of coherence (a) within the content itself of HRM‐based reforms, (b) between this content and the context in which it is introduced, or (c) the process by which it is implemented, could explain a large part of the problems encountered. The paper also suggests some key recommendations for the management of HRM‐based reforms in the public sphere.
Marital Violence: Dimensions of the Problem and Modes of Intervention*
Authors: Saunders Daniel G.
Published: June 2007

This paper reviews data on the incidence of marital violence and recommends methods of intervention on a family and social level. Myths which may block awareness of this widespread problem are briefly described. Particular attention is given to the inadequacy of the catharsis hypothesis in explaining and treating marital violence. Interventions for couple counseling aimed at enhancing the couple's problem‐solving abilities and eliminating abusive behavior are described and illustrated with case examples. Several suggestions are made for social interventions including police training, legal reform, and the formation of shelter homes for the victims of abuse.
Intimacy Is Sharing Hurt Feelings: A Reply to David Mace
Authors: L'Abate Luciano
Published: June 2007

Mace's arguments concerning the love‐anger cycle in marriage are criticized on philosophical (theoretical) and technical (clinical) grounds. Underneath the smoke‐screen of anger there is the fire of hurt feelings. Dealingwith these feelings decreases the expression of anger and helps the couple reach “real” intimacy: the sharing of hurt feelings. Victories we can sharewith anybody. Anybody is willing to share victories with us. Hurt feelings, on the other hand, belong within the marriage.
Lawyer and Counselor as an Interdisciplinary Team: Preparing the Father for Custody*
Authors: Bernstein Barton E.
Published: June 2007

Traditionally, the mother received custody of the children unless she was clearly proven to be “unfit.“ The “unfit mother” concept has been superseded by a doctrine which would indicate that either parent has an equal right to custody, and the proper measure is what is in the “best interest of the children.” A father who seeks custody faces unique problems which the mother does not face because of her personal familiarity with the children, their needs and activities. Educating the father to fulfill these needs and to develop proper parenting skills is the role of the marriage and family counselor. Proving to the judge or jury who should be custodian is the duty of the lawyer with the guidance of the counselor. This article suggests areas which should be familiar to every father who is preparing for trial and provides a checklist for objective testimony.
Abstracts
Authors: Taggart Morris
Published: June 2007

Bennett, D., Fox, C, Jowell, T., & Skynner, A. C. R. Toward a family approach in a psychiatric day hospital.

Blechman, E. A., Olson, D. H. L., & Hellman, I. D. Stimulus control over family problem‐solving behavior: The family contract game.

Butler, J. F. The toilet training success of parents after reading “Toilet Training in Less Than a Day.”

Dell, P. F., & Appelbaum, A. S. Trigenerational enmeshment: Unresolved ties of single‐parents to family of origin.

Kalter, N. Children of divorce in an outpatient psychiatric population.

Kelly, J. B., & Wallerstein, J. S. Divorce counseling: A community service for families in the midst of divorce.

Kelly, J. B., & Wallerstein, J. S. Brief interventions with children in divorcing families.

Klein, M. H. Feminist concepts of therapy outcome.

Krell, R., & Miles, J. E. Marital therapy of couples in which the husband is a physician.

Leiber, L., Plumb, M. M., Gerstenzang, M. L., & Holland, J. The communication of affection between cancer patients and their spouses.

Rubenstein, R. Briefing on inner space.

Strean, H. S. The extramarital affair: A psychoanalytic view.

Turkel, A. R. The impact of feminism on the practice of a woman analyst.

Wincze, J. P., Caird, W. K. The effects of systematic desensitization and video desensitization in the treatment of essential sexual dysfunction.

Wyatt, G. E., Strayer, R. G., & Lobitz, W. C. The treatment of sexually dysfunctioning couples of Afro‐American descent.
Hedonism and the Family: Conflict in Values?*
Authors: Glasser Lois N. , Glasser Paul H.
Published: June 2007

In American society (and maybe all of the “Western world), there seems to be an increasing emphasis on instant gratification and avoidance of pain for its individual members. These two trends—one towards hedonism and the other involving the centrality of the rights of the individual—are closely connected. Both implicate basic values. Both have important effects upon the family. The purpose of this paper is to highlight issues related to these values, discuss their past and potentially future effects on the family, and reflect upon the role of the educator and helping professional in encouraging or discouraging certain biases among their students and clients and in the more general community.
Couple Therapy as a Method for Treating Male Exhibitionism: “Flashing”
Authors: Johnson Thomas F.
Published: June 2007

The exhibiting of the genitals by males has previously been defined as symptomatic of narcissism and infantile sexuality. Viewed as a developmental anomaly of emotional life, treatment has been focused upon stimulating personal development by working out the problems which have inhibited maturation. Results have been discouraging. As an alternative, defining the problem as symptomatic of disturbances in basic relationships and treating the current central relationships as the focus offers a strong opportunity for inducing satisfactory changes.
New Life at the Graveyard: A Method of Therapy for Individuation from a Dead Former Parent
Authors: Williamson Donald S.
Published: June 2007

First, the usual form of family‐of‐origin work with living parents toward the individuation of adult children is briefly illustrated. This is done in order then to compare and contrast this procedure with a method of therapy, presented here, for structuring family‐of‐origin work towards individuation from a dead parent. Several case illustrations follow. The paper concludes that under certain conditions, it is possible successfully to engage in and to complete individuation work with a parent who is already dead.
Family Therapy: A Client‐Centered Perspective
Authors: Levant Ronald F.
Published: June 2007

>This article first critiques therapist‐directed approaches to family therapy in the light of research findings on therapist variables (empathy, warmth, genuineness) associated with positive outcomes in psychotherapy. Second, two polar opposite positions in family therapy — psychodynamic and family systems — are examined and found to have much in common. The two approaches are based on a pessimistic view of the family, which is seen as an intractable unit, resistant to its own growth. Third, an alternative, phenomenological view of the family is developed, which more optimistically assumes the family to be motivated for enhancement and growth. Finally, a client‐centered approach to family therapy is described.
ABSTRACTS
Authors: Taggart Morris
Published: June 2007

Marriage and Family Consultation Center Houston, Texas

Andreasen, N. C, Endicott, J., Spitzer, R. L. & Winokur, G. The family history method using diagnostic criteria. Archives of General Psychiatry, 1977, 34, 1229–1235.

Derdyn, A. P. A case for permanent foster placement of dependent, neglected, and abused children. American Journal of Orthopsychiatry, 1977, 47, 604–614.

Ferguson, J. M., Marquis, J. N. & Taylor, C. B. A script for deep muscle relaxation. Diseases of the Nervous System, 1977, 38, 703–708.

Gansheroff, N., Boszormenyi‐Nagy, I. & Matrullo, J. Clinical and legal issues in the family therapy record. Hospital and Community Psychiatry, 1977, 28, 911–913.

Jenkins, R. L. Maxims in child custody cases. Family Coordinator, 1977,26, 385–389.

Leeming, J. T. & Duke, A. Multidisciplinary meetings with relatives of elderly hospital patients in continuing‐care wards. Age and Aging, 1977, 6, 1–5.

Nadelson, T. & Eisenberg, L. The successful professional woman: on being married to one. American Journal of Psychiatry, 1977, 134, 1071–1076.

Sorosky, A. D. The psychological effects of divorce on adolescents. Adolescence, 1977, 12, 123–136.

Tew, N. J., Laurence, K. M., Payne, H. & Rawnsley, K. Marital instability following the birth of a child with spina bifida. British Journal of Psychiatry, 1977, 131, 79–82.

York, J. L. & Calsyn, R. J. Family involvement in nursing homes. The Gerontologist, 1977, 17, 500–505.
Family Therapy Training and Supervision Literature: A Comparative Review*
Authors: Liddle Howard Arthur , Halpin Richard J.
Published: June 2007

The family therapy field is more sophisticated developmentally in its therapeutic methodologies than in the areas of training and supervision. Publications and research efforts on these latter topics have not kept pace with the progress of the clinical aspects of the field. Family therapy training and supervision literature were reviewed and found to be fragmented and disorganized. There is a need for a comprehensive source which would synthesize this literature and compare the existing viewpoints. This paper works toward this end by reviewing, contrasting, and categorizing the available publications according to a series of content areas frequently appearing in the literature. These topic areas are: (1) Goals of Training and Supervision and Skills of the Supervisor; (2) Training and Supervision Techniques; (3) Supervisor‐Supervisee Relationship; (4) Personal Therapy for Trainees; (5) Politics of Family Therapy Training; and (6) Evaluation of Training. A comprehensive table is provided to quickly access references in the content area. Recommendations are offered for future efforts in this area.
Disrespect, Tension, and Togetherness‐Apartness in Marriage*
Authors: Rosenblatt Paul C. , Titus Sandra L. , Cunningham Michael R.
Published: June 2007

For a study of marital togetherness and apartness, the partners in 136 couples completed questionnaires. The role of disrespect, a factor that might serve as an abrasive in marriage, was investigated. Couples above average on disrespect spent more time apart on days when there had been a big fight, considerable annoyance, or anger; couples below average on disrespect spent more time together on days when there had been a big fight, considerable annoyance, or anger. This finding suggests that therapy for couples with a presenting problem of insufficient contact may first have to deal with abrasive factors.
An Empirical Assessment of the Goals of Family Therapy*
Authors: Sprenkle Douglas H. , Fisher Barbara L.
Published: June 2007

This study is an empirical assessment of the goals of family therapists. A list of goals was developed based on a theoretical clustering of the family therapy literature into the dimensions of communication, cohesion, and adaptability. Three hundred ten clinical members of the American Association for Marriage and Family Therapy (AAMFT) responded to a questionnaire about their use of these goals in family therapy. The findings indicate that the goals employed by this sample seem to reflect ideas from the literature which are not the property of any one “school” of family therapy. The goals that were rated and ranked highest included encouraging family members to relate caringly, responsibly, and creatively in negotiating their differences. Goals that were rated and ranked lowest included the more advanced or technical communication skills and some cohesion goals that may be interpreted as related to institutional aspects of family life.
The Post‐Hospital Mental Patient and Family Therapy: Prospects and Populations*
Authors: Goldman Howard H.
Published: June 2007

Changes in the pattern of delivery of mental health services have led to dramatic increases in the number of patients discharged from mental hospitals. These post‐hospital mental patients represent a new challenge to the field of family therapy. Of the approximately 1 million patient admissions to state and county mental hospitals, general hospitals, and private psychiatric hospitals, over 380,000 are married, and more than half of the remaining patients are estimated to be living with family. Almost 135,000 admissions receive family therapy during their hospitalization, and an estimated 650,000 mental patients will return to their families upon discharge.
Brief Family Therapy: A Metaphorical Task
Authors: de Shazer Steve
Published: June 2007

This article presents a therapeutic procedure designed to prescribe, in metaphorical form, the family's troublesome behavior pattern. Particular attention is paid to using a compliment to precede delivering a task assignment as a method of increasing the likelihood that the family will perform the task, and thus change will be promoted. A case example is used to illustrate the use of this procedure to help make change less painful.
The E‐R‐A Model: The Role of Feelings in Family Therapy Reconsidered: Implications for a Classification of Theories of Family Therapy
Authors: L'Abate Luciano , III Joseph Frey
Published: June 2007

The importance of considering a continuum of Emotionality (E) separately from Rationality (R) or Activity (A) is emphasized. A model showing equally all three aspects is presented that allows a clearer classification of family therapy theorists than has been possible heretofore. Diagnostic, therapeutic, and research implications are hinted at, but will be part of future work.
Non‐Equilibrium, Chance and Change in Family Therapy
Authors: Elkaïm Mony
Published: June 2007

The model of the systemic approach that we commonly use in family therapy is mainly an homeostatic model insisting essentially on negative feedback and allowing little room for amplification phenomena and for abrupt changes that may occur. Our approach, called “systemic,” is related principally to models applying in cases of processes occurring at thermodynamic equilibrium or at stationary states close to equilibrium. In those instances, stability is maintained no matter what external or internal perturbations are exerted on the system.

But our practice shows that a modification limited to one part of the family system extends quickly to the whole system. How are those changes brought about? How is an open system, such as the family in which feedback loops exist, pulled away from a stationary state? It was partly to answer such questions that we started to give attention to organizational forms likely to appear away from thermodynamic equilibrium and particularly to the work done in this field by the team ofllya Prigogine. Starting with a few examples of “dissipative structures” some concepts will be introduced which seem likely to be fruitful in our field.
Family Therapy and the Alienation Syndrome*
Authors: Zwerling Israel
Published: June 2007

This paper reviews the increasing separation of the contemporary family from the community in terms of the sociological concept of alienation. It proposes that there is compelling evidence that the isolation of the nuclear family exerts a pathological influence on the mental health of families and of individual family members; that family therapists have paid minimal attention to the isolation in their zeal to develop effective techniques for altering intra‐familial processes; and that the family therapy movement has the potential for exerting a significant corrective impact on the social forces which further the isolation of contemporary families.
An Integrated Structural/Strategic Approach To Family Therapy
Authors: Stanton M. Duncan
Published: June 2007

While the structural and strategic family approaches have many similarities, their espoused differences have sometimes left therapists in a position of having to choose between them. However, they may be more compatible than has commonly been believed. This paper reviews their basic concepts and operations and presents a model for integrating both approaches in a concurrent and contrapuntal fashion, drawing on the best and most appropriate features of each. Case examples are used to clarify points. Special attention is given to the technique of “strategic disengagement.” A set of rules is provided for decision‐making as to when one approach or the other might be applied.
The Family Therapy Congress in Belgium
Authors: Elkaim Mony
Published: June 2007

Maps, Territories and Singularities Introduction to the international symposium on “Family Therapies and Network practices”. Brussels, March 26 to 28, 1981
Abstracts
Authors: Olson David H.
Published: June 2007

Fritz, G. S., Stoll, K. and Wagner, N. N. A comparison of males and females who were sexually molested as children. Journal of Sex and Marital Therapy, 1981, 7, 54–59.

Baisden, Major J., Jr. and Baisden, Joanna. A profile of women who seek counseling for sexual dysfunction. American Journal of Family Therapy, 1979, 7, 1, 68–76.

Murphy, G. J., Hudson, W. W. and Cheung, P. Marital and sexual discord among older couples. Social Work Research Abstracts, 1980, 16, 11, 11–16.

Chesney, A. P., Blakeney, P. E., Chan, F. A., and Cole, C. M. The impact of sex therapy on sexual behaviors and marital communication. Journal of Sex and Marital Therapy, 1981, 7, 1, 70–79.

Price, S., Heinrich, A. G., and Golden, J. S. Structured group treatment of couples experiencing sexual dysfunctions. Journal of Sex and Marital Therapy, 1981, 6, 4, 247–257.

Zilbergeld, B. and Rinkleib‐Ellison, C. Social skills training as an adjunct sex therapy. Journal of Sex and Marital Therapy, 1979, 5, 4, 340–350.
THE LAWYER‐THERAPIST CONSULTATION TEAM*
Authors: Korelitz Ann , Schulder Diane
Published: June 2007

This paper discusses a six‐month pilot study done at The Ackerman Institute for Family Therapy. Joint consultations with a Family Therapist and a Matrimonial Attorney were offered to ten couples and one woman contemplating divorce. Sessions were videotaped. A project addendum was done with telephone interviews. The authors were interested in determining whether joint consultations would be useful to help couples understand the psychological and legal implications of conflicts expressed during the separation process.
DEVELOPMENTAL ASPECTS OF THE COTHERAPY RELATIONSHIP*
Authors: Brent David A. , Marine Esther
Published: June 2007

Cotherapy has become an accepted albeit sometimes controversial approach to group and family therapy. Though many differing views of cotherapy have been expressed, most authors have emphasized the need for a cooperative, open and flexible relationship between cotherapists as being essential to facilitating growth for clients. In this paper, a model for the understanding of the development of the cotherapy relationship is proposed. Both developmental fixations and modes for enhancement of this relationship are discussed with particular reference to family therapy.
THINKING LIKE A FAMILY THERAPIST: A MODEL FOR INTEGRATING THE THEORIES AND METHODS OF FAMILY THERAPY*
Authors: Grunebaum Henry , Chasin Richard
Published: June 2007

We present a classification system which presumes that information about families can be seen from three different perspectives (historical, interactional, and existential) and that treatment proceeds from three approaches (understanding, transformation, and identification). Using this scheme, we discuss how theories from different schools of thought are substantially overlapping, show that families may respond according to principles other than those the therapist had in mind, indicate how traditional links between certain evaluation perspectives and approaches are unnecessarily limiting, and define two current poles or modes in family therapy (the “ingenious” and the “involved”), suggesting indications for the use of each mode. Various teaching benefits of the scheme are outlined.
A FAMILY THERAPIST RATING SCALE*
Authors: Piercy Fred P. , Laird Roger A. , Mohammed Zain
Published: June 2007

This article reports the development of a scale for evaluating family therapist skills. The scale includes ten items within each of five skill categories. All items were found to discriminate significantly between videotaped segments of effective and ineffective family therapist skills. Also all skill categories discriminated significantly between experienced and inexperienced family therapists. The interrater reliability and internal consistency of the categories were also judged to be acceptable. Suggestions are presented for uses of the scale in therapist training research.