The complete practitioner: Still a work in progress.

When one is reflecting on a career as a practitioner, a number of important influences, themes, and elements that contribute to being a successful practitioner are evident. The achievement of this success is not a solitary activity. Many role models and mentors serve as important influences and guides for developing as a professional over the course of one’s career. Ultimately, the goal is to aspire to become a complete practitioner. This includes being a passionate professional, clinically competent, a psychotherapist and clinician, an active consumer of research findings, ethical, a role model, a mentor, psychologically healthy, an advocate, a leader, a volunteer, an educator, a scholar, a colleague, a business person and entrepreneur, and an innovator and visionary; focusing on diversity and multicultural competence; and having a comprehensive vision of health. Because the goal of being a complete practitioner is aspirational, one never fully masters each of these roles and attributes but remains a work in progress. Yet, the process of endeavoring to become a complete practitioner is rewarding, gratifying, and meaningful. It is a journey well worth taking. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of TCDD on Ah receptor, ARNT, EGF, and TGF-alpha expression in embryonic mouse urinary tract

Lipoprotein(a) [Lp(a)] biogenesis was examined in primary cultures of hepatocytes isolated from mice transgenic for both human apolipoprotein(a) [apo(a)] and human apoB. Steady-state and pulse-chase labeling experiments demonstrated that newly synthesized human apo(a) had a prolonged residence time (approximately 60 min) in the endoplasmic reticulum (ER) before maturation and secretion. Apo(a) was inefficiently secreted by the hepatocytes and a large portion of the protein was retained and degraded intracellularly. Apo(a) exhibited a prolonged and complex folding pathway in the ER, which included incorporation of apo(a) into high molecular weight, disulfide-linked aggregates. These folding characteristics could account for long ER residence time and inefficient secretion of apo(a). Mature apo(a) bound via its kringle domains to the hepatocyte cell surface before appearing in the culture medium. Apo(a) could be released from the cell surface by apoB-containing lipoproteins. These studies are consistent with a model in which the efficiency of post-translational processing of apo(a) strongly influences human plasma Lp(a) levels, and suggest that cell surface assembly may be one pathway of human Lp(a) production in vivo. Transgenic mouse hepatocytes thus provide a valuable model system with which to study factors regulating human Lp(a) biogenesis.     

Concept-Based Method for Extracting Valid Subsets from an EXPRESS Schema

An EXPRESS schema is a data schema defined in EXPRESS, an international standard language for defining product data schemas. This technical paper proposes and formally defines a set of conditions for generating a minimum valid subset of an EXPRESS schema corresponding to a concept, where a concept is a general idea and a subset is a partial model of a data schema. We introduce a notion of “minimal set” to define the relationships between a subset and other subsets, and also between a subset and concepts. A minimal set is the smallest complete subset of a schema that corresponds to a concept. Using IFC, an international standard data model for the architecture, engineering, and construction industry, the proposed conditions have been implemented in a software application developed for extracting subsets from the IFC schema matching the concepts. A number of examples are demonstrated.     

Transition to Self-Similarity of Diffusion of Tracer in Turbulent Patch

A mixing of a passive tracer inside a turbulent patch generated by a localized short-time perturbation is studied numerically and analytically. Two kinds of an initial distribution of a tracer are considered: two-layer and continuous with constant gradient. For the turbulent patch shaped as a layer, it is shown that, regardless of details of initial distributions of a turbulent energy and dissipation, a tracer concentration evolves to self-similar regimes as time elapses. Analytical self-similar solutions to turbulent diffusion equations are found for three symmetric shapes of a turbulent patch: layer, cylinder, and sphere. Distributions of the concentration inside a patch are found to be substantially nonuniform, with a typical ratio of a concentration gradient in the middle of a patch to its initial value of about 0.5.     

Interactions between the structural domains of the RNA replication proteins of plant-infecting RNA viruses

Brome mosaic virus (BMV), a positive-strand RNA virus, encodes two replication proteins: the 2a protein, which contains polymerase-like sequences, and the 1a protein, with N-terminal putative capping and C-terminal helicase-like sequences. These two proteins are part of a multisubunit complex which is necessary for viral RNA replication. We have previously shown that the yeast two-hybrid assay consistently duplicated results obtained from in vivo RNA replication assays and biochemical assays of protein-protein interaction, thus permitting the identification of additional interacting domains. We now map an interaction found to take place between two 1a proteins. Using previously characterized 1a mutants, a perfect correlation was found between the in vivo phenotypes of these mutants and their abilities to interact with wild-type 1a (wt1a) and each other. Western blot analysis revealed that the stabilities of many of the noninteracting mutant proteins were similar to that of wt1a. Deletion analysis of 1a revealed that the N-terminal 515 residues of the 1a protein are required and sufficient for 1a-1a interaction. This intermolecular interaction between the putative capping domain and itself was detected in another tripartite RNA virus, cucumber mosaic virus (CMV), suggesting that the 1a-1a interaction is a feature necessary for the replication of tripartite RNA viruses. The boundaries for various activities are placed in the context of the predicted secondary structures of several 1a-like proteins of members of the alphavirus-like superfamily. Additionally, we found a novel interaction between the putative capping and helicase-like portions of the BMV and CMV 1a proteins. Our cumulative data suggest a working model for the assembly of the BMV RNA replicase.     

Environment-dependent tight-binding potential model

The yellow-pigmented bacterium isolated from a ditch was a gram negative rod with a G+C content of 63 mol%, and was classified in the genus Sphingomonas. Electron microscopy revealed that the bacterial cell surface was covered with many large plaits. When grown in a medium containing a polysaccharide as an essential nutrient, a pit of 0.02-0.1 micrometers in diameter was formed on the cell surface, and a thin section showed the rearrangement of the plaits and the presence of a region where the cell membrane sinks into the cytosol. The dependence of the pit formation on the presence of macromolecule may predict the existence of a direct uptake mechanism for macromolecules through a mouth-like pit, possibly in endocytosis fashion. The confirmation of the pit structure is the first such finding in the history of microbiology and may provide a new insight into the cell morphology and biochemistry of macromolecule transport in microbial cell system.     

Mathematical modeling of tornadoes and squall storms

Recent advances in modeling of tornadoes and twisters consist of significant achievements in mathematical calculation of occurrence and evolution of a violent F5-class tornado on the Fujita scale, and four-dimensional mathematical modeling of a tornado with the fourth coordinate time multiplied by its characteristic velocity. Such a tornado can arise in a thunderstorm supercell filled with turbulent whirlwinds. A theory of the squall storms is proposed. The squall storm is modeled by running perturbation of the temperature inversion on the lower boundary of cloudiness. This perturbation is induced by the action of strong, hurricane winds in the upper and middle troposphere, and looks like a running solitary wave (soliton); which is developed also in a field of pressure and velocity of a wind. If a soliton of a squall storm gets into the thunderstorm supercell then this soliton is captured by supercell. It leads to additional pressure fall of air inside a storm supercell and stimulate amplification of wind velocity here. As a result, a cyclostrophic balance inside a storm supercell generates a tornado. Comparison of the radial distribution of wind velocity inside a tornado calculated by using the new formulas and equations with radar observations of the wind velocity inside Texas Tornado Dummit in 1995 and inside the 3 May 1999 Oklahoma City Tornado shows good correspondence.     

C3a is a chemotaxin for human eosinophils but not for neutrophils. I. C3a stimulation of neutrophils is secondary to eosinophil activation

Inflammatory action of the potent chemotaxin C5a has been well characterized on a variety of human cell types, including neutrophils, monocytes, basophils, and eosinophils. The cellular effects of C3a are less well defined. Contradictory reports have been published for C3a activation of neutrophils. Recent reports that C3a activates both basophils and eosinophils prompted us to reinvestigate the effects of C3a stimulation on eosinophils. We hypothesized that C3a activation of eosinophils, cells that are present in most neutrophil preparations, might lead to neutrophil activation. Using neutrophils of 98% purity, we observed no evidence of cellular activation after stimulation with either C3a, recombinant human C3a (rhC3a), or the synthetic C3a analogue C3a 57-77, Y57. Eosinophils purified to > 98% purity displayed concentration-dependent polarization, chemotaxis, and enzyme release by stimulation with C3a, rhC3a, and the synthetic C3a analogue. An inactive form of C3a, C3adesArg, failed to stimulate either eosinophils or neutrophils. Using neutrophil preparations containing 5-9% eosinophils, up to 20% of neutrophils became polarized after exposure to C3a. Likewise, we demonstrated that supernatant from C3a-stimulated eosinophils promotes neutrophil chemotaxis. Eosinophil polarization experiments were repeated in the presence of antibody to the C5a receptor (C5aR) to show that C3a and C5a interact with different receptors. C3a activates eosinophils in the presence of anti-C5aR antibody at concentrations that fully block C5a activation. We conclude that eosinophils are directly activated by either C3a or C5a, whereas C3a failed to activate neutrophils. C3a acts on eosinophils via a receptor that is distinct from C5aR. Since neutrophils are indirectly stimulated by C3a, eosinophils contaminating neutrophil preparations may explain earlier reports that C3a activates human neutrophils.     

Obituary: Molly R. Harrower (1906–1999).

Memorializes Molly R. Harrower who is remembered as a gifted clinician and a serious researcher, a fine university teacher and one of the first psychologists in full-time private practice, a Gestalt psychologist and devotee of psychoanalysis, a psychologist and poet. Harrower developed a group Rorschach and used in widely. She published a classic article concerning the psychology of Nazi war criminals as determined by the Rorschach. Harrower developed a scale, based on a set of projective techniques, that effectively predicted which patients would profit from psychoanalytic treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Amyloid beta-peptide spin trapping. II: Evidence for decomposition of the PBN spin adduct

We investigated the effect of lipoprotein(a) (Lp(a)) on proliferation of human arterial smooth muscle cells (SMCs) and its mechanisms of action. Low density lipoprotein (LDL), Lp(a) and apolipoprotein(a) (apo(a)) significantly stimulated the proliferation of SMCs. Lp(a) and apo(a) reduced the amount of active transforming growth factor-beta (TGF-beta) with the mink lung epithelial cell bioassay, however LDL had no effect. Lp(a), but not apo(a), significantly stimulated the proliferation of SMCs even in the presence of a neutralizing antibody for TGF-beta. Our results suggest that Lp(a) stimulates the proliferation of SMCs via apo(a)-induced inhibition of TGF-beta activation and stimulation of SMCs by the LDL-particle of Lp(a).     

Dynamic interaction between a coherent precipitate and an edge dislocation

Dynamic interaction between a coherent precipitate and an edge dislocation is analyzed by means of a discrete atom method, which is based on classical statistical mechanics and linear elasticity. Precipitates having a dilatational misfit strain and elastic constants different from those of the matrix phase are treated in anisotropic elastic systems under a plane strain condition. A coherent interface transforms into a semicoherent one by nucleating dipolar dislocations at a stress concentration in a coherent precipitate. One of the dipolar dislocations glides along the precipitate-matrix interface to become a misfit dislocation, and the other slips into the matrix phase to become a lattice dislocation. In accordance with continuum elasticity, a coherent particle with a positive misfit strain migrates to the tension side of an edge dislocation, whereas a particle with a negative misfit diffuses to the region of compression. Morphological change is, however, caused by the dislocation as the particle tries to capitalize on the dislocation stress field, and the particle shape depends on its stiffness and elastic anisotropy. Under an applied shear, a hard coherent particle with a positive misfit strain is sheared along the shear direction, but a soft particle responds in the opposite direction. Elastic interaction between a coherent particle and an edge dislocation can be so strong that the particle-dislocation complex remains coupled even at a high shear strain applied to the system. Some composite applied stresses can cause an edge dislocation to split into two partials. One of the partials, a glissile component, is found to engage actively in the morphological evolution of a particle during a diffusional relaxation. This article is based on a presentation made in the symposium “Kinetically Determined Particle Shapes and the Dynamics of Solid:Solid Interfaces,” presented at the October 1996 Fall meeting of TMS/ASM in Cincinnati, Ohio, under the auspices of the ASM Phase Transformations Committee.     

Majority and minority influence: Source-position imbalance as a determinant of message scrutiny.

Two experiments addressed the issue of whether endorsement of a position by a numerical majority or a minority leads to greater scrutiny of the information presented in a persuasive message. In Exp 1, a counterattitudinal position was endorsed by a majority or a minority and was supported by strong or weak arguments. Argument quality had a larger impact on attitudes with majority than with minority endorsement. In Exp 2, a proattitudinal or a counterattitudinal message was endorsed by a majority or a minority and was supported by strong or weak arguments. When the source and message position were unexpected (i.e., majority-counter and minority-pro messages), argument quality had a larger impact on attitudes than when the source and message position were expected (i.e., majority-pro and minority-counter messages). Thus, either majority or minority endorsement can enhance message scrutiny if the source-position pairing is surprising. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Pseudoexstrophy associated with congenital pouch colon

Pseudoexstrophy or covered exstrophy is a rare exstrophy variant. The authors report a case of covered exstrophy that presented as a newborn with widely separated pubic bones and rectus muscles, a low-set umbilicus, and a subcutaneous bladder. The anal opening was absent, and there was a complex malformation of the external genitalia consisting of a small, laterally displaced penis and a right-sided ectopic hemiscrotum. Micturition and urinary continence were normal. The child also had a high anorectal malformation with a coexistent type IV congenital pouch colon (CPC) malformation. Both kidneys were normal. Preliminary surgery consisted of a divided sigmoid colostomy proximal to the colonic pouch. The literature is reviewed and the embryogenesis of pseudoexstrophy and its associated malformations are discussed.     

C3a and C5a are chemotaxins for human mast cells and act through distinct receptors via a pertussis toxin-sensitive signal transduction pathway

Mast cells are known to accumulate at sites of inflammation, however, the chemotaxins involved are undefined. Since most natural leukocyte secretagogues also induce cell migration, and since the anaphylatoxins C3a and C5a are mast cell secretagogues, we hypothesized that both C3a and C5a are also mast cell chemotaxins. Here we report that C3a and C5a are, in fact, potent chemotaxins for the human mast cell line HMC-1. The optimal concentrations, half-maximal effective concentrations (a measure of agonist potency) and the efficacy (response at the optimal concentration) compared with medium control were, for C3a: 10 nM, 0.5 nM, and 256%, respectively; for C5a: 1 nM, 10 pM and 145%. Chemotaxis of HMC-1 cells to both C3a and C5a was blocked by pertussis toxin, suggesting that Gi-coupled receptors are involved in signal transduction. C3a and C5a also induced transient pertussis toxin-inhibitable increases in [Ca2+]i (ED50 = 1 nM for both) that could be homologously but not heterologously desensitized, suggesting that the receptors for C3a and C5a are distinct. These results make C3a the most effective mast cell chemotaxin identified to date. The chemotactic potency described here for C3a is also 100- to 1000-fold greater than for all of its previously described cellular actions. Direct chemoattraction of mast cells by C3a and C5a may help explain the rapid accumulation of mast cells at sites of inflammation.     

Apolipoprotein(a) binds via its C-terminal domain to the protein core of the proteoglycan decorin. Implications for the retention of lipoprotein(a) in atherosclerotic lesions

Although it is known that lipoprotein(a) (Lp(a)) binds to proteoglycans, the mechanism for this binding has not been fully elucidated. In order to shed light on this subject, we examined the interactions of decorin, a proteoglycan with a well defined protein core and a single glycosaminoglycan (GAG) chain, with Lp(a) and derivatives, namely Lp(a) deprived of apo(a), or Lp(a-), free apo(a), and the two main proteolytic fragments, F1 and F2. By circular dichroism criteria, the decorin preparations used had the same secondary structure as that previously reported for native decorin. Authentic low density lipoprotein from the same human donor was used as a control. In a solid phase system, Lp(a-)and low density lipoprotein bound to decorin in a comparable manner. This binding required Ca2+/Mg2+ ions, was lysine-mediated, and was markedly decreased in the presence of GAG-depleted decorin, suggesting the ionic nature of the interaction likely involving apoB100 and the GAG component of decorin. Free apo(a) also bound to decorin; however, the binding was neither cation-dependent nor lysine-mediated, unaffected by sialic acid depletion of apo(a), and markedly decreased when either reduced and alkylated apo(a) or reduced and alkylated decorin was used in the assay. Of note, the binding of apo(a) was unaffected when it was incubated with a spectrally native decorin that had been renatured from either 4 M guanidine hydrochloride by extensive dialysis or cooled from 65 to 25 degrees C. On the other hand, the binding significantly increased when decorin was depleted of GAGs, which by themselves had no affinity for apo(a). The binding of apo(a) to the decorin protein core was also elicited by the C-terminal domain of apo(a), and it was favored by high NaCl concentrations, 1 to 2 M. No binding was exhibited by the N-terminal domain accounting for the lack of effect of apo(a) size polymorphism on the binding. In the case of whole Lp(a), the binding to immobilized decorin was mostly GAG-dependent and ionic in nature. A minor contribution by apo(a) was detected when GAG-depleted decorin was used in the assay. Our results indicate that the binding of Lp(a) to decorin involves interactions both electrostatic (apoB100-GAG) and hydrophobic (apo(a)-decorin protein core), and that the binding of apo(a) requires decorin protein core to be in its native state.     

Variation in lipoprotein(a) concentrations among individuals with the same apolipoprotein (a) isoform is determined by the rate of lipoprotein(a) production

Lipoprotein(a) [Lp(a)] is an atherogenic lipoprotein which is similar in structure to, but metabolically distinct from, LDL. Factors regulating plasma concentrations of Lp(a) are poorly understood. Apo(a), the protein that distinguishes Lp(a) from LDL, is highly polymorphic, and apo(a) size is inversely correlated with plasma Lp(a) level. Even within the same apo(a) isoform class, however, plasma Lp(a) concentrations vary widely. A series of in vivo kinetic studies were performed using purified radiolabeled Lp(a) in individuals with the same apo(a) isoform but different Lp(a) levels. In a group of seven subjects with a single S4-apo(a) isoform and Lp(a) levels ranging from 1 to 13.2 mg/dl, the fractional catabolic rate (FCR) of 131I-labeled S2-Lp(a) (mean 0.328 day-1) was not correlated with the plasma Lp(a) level (r = -0.346, P = 0.45). In two S4-apo(a) subjects with a 10-fold difference in Lp(a) level, the FCR's of 125I-labeled S4-Lp(a) were very similar in both subjects and not substantially different from the FCRs of 131I-S2-Lp(a) in the same subjects. In four subjects with a single S2-apo(a) isoform and Lp(a) levels ranging from 9.4 to 91 mg/dl, Lp(a) concentration was highly correlated with Lp(a) production rate (r = 0.993, P = 0.007), but poorly correlated with Lp(a) FCR (mean 0.304 day-1). Analysis of Lp(a) kinetic parameters in all 11 subjects revealed no significant correlation of Lp(a) level with Lp(a) FCR (r = -0.53, P = 0.09) and a strong correlation with Lp(a) production rate (r = 0.99, P < 0.0001). We conclude that the substantial variation in Lp(a) levels among individuals with the same apo(a) phenotype is caused primarily by differences in Lp(a) production rate.     

Structural basis for the pathophysiology of lipoprotein(a) in the athero-thrombotic process

Lipoprotein Lp(a) is a major and independent genetic risk factor for atherosclerosis and cardiovascular disease. The essential difference between Lp(a) and low density lipoproteins (LDL) is apolipoprotein apo(a), a glycoprotein structurally similar to plasminogen, the precursor of plasmin, the fibrinolytic enzyme. This structural homology endows Lp(a) with the capacity to bind to fibrin and to membrane proteins of endothelial cells and monocytes, and thereby to inhibit plasminogen binding and plasmin generation. The inhibition of plasmin generation and the accumulation of Lp(a) on the surface of fibrin and cell membranes favor fibrin and cholesterol deposition at sites of vascular injury. Moreover, insufficient activation of TGF-beta due to low plasmin activity may result in migration and proliferation of smooth muscle cells into the vascular intima. These mechanisms may constitute the basis of the athero-thrombogenic mode of action of Lp(a). It is currently accepted that this effect of Lp(a) is linked to its concentration in plasma. An inverse relationship between Lp(a) concentration and apo(a) isoform size, which is under genetic control, has been documented. Recently, it has been shown that inhibition of plasminogen binding to fibrin by apo(a) is also inversely associated with isoform size. Specific point mutations may also affect the lysine-binding function of apo(a). These results support the existence of functional heterogeneity in apolipoprotein(a) isoforms and suggest that the predictive value of Lp(a) as a risk factor for vascular occlusive disease would depend on the relative concentration of the isoform with the highest affinity for fibrin.     

Development of a blood cardioplegia delivery system for children

We have developed a blood cardioplegia delivery system for children. Essential points of a delivery system in pediatric cardiac surgery are (1) a small amount of priming volume of a delivery system, and (2) slow, steady infusion of a cardioplegic solution. We changed a heat exchanger to a smaller one for reduction of priming volume, and changed a roller pump tube to a smaller one for slow, steady infusion. Thus, priming volume of a delivery system has reduced from 180 to 100 ml, and we can infuse a cardioplegic solution at a steady rate less than 10 ml/min. Our clinical experience with this system suggests that this blood cardioplegia delivery system is useful for pediatric cardiac surgery.