The working alliance inventory - short version: psychometric properties of the patient and therapist form in youth mental health and addiction care.

The therapeutic alliance is considered to play an important role in youth treatment. The commonly used versions of the Working Alliance Inventory (WAI) are based on Bordin's three-dimensional alliance model. However, previous psychometric studies of the WAI did not find this three-dimensional structure in youth psychotherapy. These earlier findings may indicate different perceptions of the alliance by adolescent versus adult patients, but may also be due to methodological shortcomings. The current study aims to address previous study limitations by evaluating the factor structure of the short version of the WAI (WAI-S) in youth treatment in multilevel analysis to address the hierarchical structure of the alliance data. We examined the psychometric properties of the patient (n = 203) and therapist (n = 62) versions of the WAI-S in youth mental health and addiction care and tested four multilevel models of alliance at start of treatment and 2-month follow-up. Our results suggests a two-factor model for youth and a three-dimensional model for their therapist at both time points. Since this is the first study that finds a best fit for a two-dimensional construct of alliance in youth, more research is needed to clarify whether the differences in alliance dimensions are due to measurement differences between the WAI-S for youth and therapists or whether youth and their therapists truly differ in their perceptions of the concept of alliance.

Determination of equine deep digital flexor muscle volume based on distances between anatomical landmarks.

In equine medicine the use of Botox® is experimental. Dosages are determined from human treatment-protocols and limited numbers of equine studies. Determination of target-muscle volume can be helpful to extrapolate human dosages. The aim of the study was to calculate a formula enabling the estimation of the deep digital flexor muscle (DDFM) volume based on distances between anatomical landmarks. Nineteen cadaveric limbs were collected and distance A (top of olecranon to Os carpi accessorium) and B (circumference of limb) were measured. Converting mathematical formulas, C was calculated: π × (((0.5B)/π)(2)) × A. DDFM volume was determined by water displacement. Linear Regression Analysis was used to analyse data. The line best fitting the observed points was: Ln(volume[ml]) = -1.89 + 0.98 × Ln(value C[cm(3)]). Correlation was highest when natural logarithm was applied to both variables and was 0.97. The calculated formula enables estimating DDFM volume of a living horse. This estimated volume can be useful to apply human Botox® treatment-protocols.

Abdominal injuries after high falls: high incidence and increased mortality.

BACKGROUND: Falls from height are a major cause of morbidity and mortality. Injuries to the extremities and head are common. However, little has been reported on abdominal injuries or their treatment. This study aims to assess the abdominal injuries, treatment, and mortality after falls from height. METHODS: We searched our hospital's Trauma registry from January 2004 through December 2007 and identified all patients who fell from five meters or higher. Additional data was extracted from medical records, radiology reports, and operation reports. RESULTS: One hundred and thirty-nine patients (median age 31 years) were included. There were 106 men and 33 women. Forty-one patients had abdominal injuries. Thirteen patients had a retroperitoneal hematoma, eleven had a liver laceration, nine had a kidney laceration, and eight had a spleen laceration. Eleven patients required emergency laparotomy and/or endovascular stenting or coiling to stop the bleeding. Patients with abdominal injuries had a tenfold higher mortality than those without abdominal injuries (19.5% versus 2.0%). CONCLUSION: Abdominal injuries were common and associated with a tenfold increase in mortality.

The stress axis, stanniocalcin, and ion balance in rainbow trout.

In teleosts, the stress hormone cortisol and the calcium regulatory hormone stanniocalcin (STC) are both involved in the regulation of ion balance. Under stressful conditions, ion balance is easily disturbed as stressors via the stress signals they evoke disturb easily and primarily gill function. The gills are key in fish gas exchange and ion regulation. The present work evaluates the effect of the pivotal stress signal cortisol, the eventual output of the stress axis on STC secretion in freshwater rainbow trout (Oncorhynchus mykiss). Plasma cortisol levels were manipulated by intraperitoneal injections of porcine ACTH(1-39) or dexamethasone (Dex), and plasma cortisol, STC and mineral status were assessed. A perifusion assay of trout Stannius corpuscles was validated and used to study the direct effects of stress-related signals on STC release. In perifusion, cortisol, adrenocorticotropic hormone (ACTH), and dexamethasone did not affect STC release. ACTH injections increase plasma cortisol (corresponding to an acute stress) and STC concentrations, but did not affect mineral status. Dexamethasone injections resulted either in a classical hypocortisolinemia or, unexpectedly, in hypercortisolinemia. However, independently of the resulting cortisol status Dex induced a chronic stress effect, as indicated by decreased plasma Na, Cl, and Ca levels, and increased plasma STC concentrations. The increased STC secretion cannot be explained by the classical elevation of plasma calcium concentration. Thus, plasma parameters other than calcium could be involved and we propose that STC secretion might be stimulated also by a decrease of NaCl concentrations, implying a broader function than the classical hypocalcemic action of STC.

Cloning and sequence analysis of two cDNAs encoding cyclin A and cyclin B in the zebra mussel Dreissena polymorpha.

Cyclins are key components in the progression of both mitotic and meiotic cell cycle control. Full-length cDNA clones encoding cyclin A and cyclin B were isolated from a zebra mussel testis cDNA library. The clones contained open reading frames of 419 and 434 amino acids, had similarity to cyclins A and B from other species, but also some unique features in their sequences. Cyclin A and B mRNA was expressed in testis, ovary, gill, mantle, muscle, and eggs, as shown by specific polymerase chain reaction.

Acid stress induces a D1-like dopamine receptor in pituitary MSH cells of Oreochromis mossambicus.

A 7-day exposure of tilapia (Oreochromis mossambicus) to water with a pH of 4.5 activates their pituitary melanophore-stimulating hormone (MSH) cells to preferentially release diacetyl alpha-MSH as an important corticotrope (13). We here focus on the control of alpha-MSH release by dopamine in tilapia exposed to water with low pH ("low-pH tilapia"). The MSH cells of low-pH tilapia showed a decreased sensitivity to inhibitory concentrations (10(-7)-10(-5) M) of dopamine compared with controls. Low concentrations (10(-14)-10(-8) M) of dopamine stimulated the release of alpha-MSH in low-pH tilapia but not in controls. Strong pharmacological evidence for a stimulatory dopamine receptor (D1-like) was obtained: the D1-agonists SKF-38393 and 6-chloro-7,8-dihydroxy-3-allyl-1-phenyl-2,3,4,5-tetrahydro-1H-3-benzazep ine hydrobromide (6-chloro APB) had a stimulatory effect on the release of alpha-MSH in low-pH tilapia MSH cells but not in controls. The selective D2-agonists quinpirole and 2-hydroxy apomorphin inhibited the release of alpha-MSH in controls as well as in low-pH tilapia, and there was no difference in the sensitivity of the cells to these agonists. We conclude that only MSH cells of low-pH exposed tilapia exhibit a D1-like receptor activity. A comparable D2-like receptor activity, as demonstrated by specific D2-receptor agonists, is present in both controls and low-pH-adapted fish. The apparent loss of sensitivity of the MSH cells to inhibitory concentrations of dopamine, therefore, must be caused by the activation of the D1-like receptors and not by changes in the activity of the D2-like receptor proper. Stimulatory concentrations of dopamine not only quantitatively but also qualitatively enhanced the corticotropic activity of the released alpha-MSH, as indicated by the elevated ratio of diacetyl and monoacetyl alpha-MSH. This effect was mimicked by the D1-like agonists SKF-38393 and 6-chloro APB, indicating that the D1-like receptor activity is responsible for the enhancement of the di/mono ratio.

Cloning and sequence analysis of a hypothalamic cDNA encoding a D1c dopamine receptor in tilapia.

Physiological and pharmacological studies have indicated that during acid stress a D1-like dopamine receptor becomes functional on intermediate pituitary melanocyte-stimulating hormone cells of tilapia (Oreochromis mossambicus). As a first step towards physiological expression studies we isolated a D1-like dopamine receptor from a tilapia hypothalamus cDNA library. Construction of a phylogenetic tree of most of the D1-like receptors known in human, rat, Xenopus, goldfish and Drosophila revealed that the here presented clone is most likely the tilapia equivalent of the Xenopus D1c dopamine receptor.

A specific role for TRH in release of diacetyl alpha-MSH in tilapia stressed by acid water.

After exposure of tilapia for 7 days to low-pH water, plasma thyrotropin-releasing hormone (TRH) levels were elevated, and the melanocyte-stimulating hormone (MSH) cells in the pituitary pars intermedia had increased in size and showed enhanced synthetic and secretory activity. The MSH cells became more sensitive to TRH but not to corticotropin-releasing hormone (CRH). Stimulation by TRH (but not by CRH) of the MSH cells of tilapia exposed to low pH specifically enhanced the release of diacetyl alpha-MSH, the most potent corticotropic form of alpha-MSH. Acute stress imposed by handling and confinement for 1 h elevated the plasma cortisol level but did not affect blood plasma alpha-MSH levels. We conclude that stimulation by TRH is pivotal for an enhanced release of diacetyl alpha-MSH during low-pH adaptation. These results are further evidence of a role for TRH and alpha-MSH in the activation of the hypothalamopituitary-interrenal axis during adaptation to low pH.

A role for di-acetyl alpha-melanocyte-stimulating hormone in the control of cortisol release in the teleost Oreochromis mossambicus.

In stressed tilapia, Oreochromis mossambicus, total alpha-melanocyte-stimulating hormone (alpha-MSH) levels and di-acetyl alpha-MSH/mono-acetyl alpha-MSH (di:mono) ratios are elevated. We therefore investigated the role of alpha-MSH in the regulation of the pituitary-interrenal axis. The corticotrophic activities of des-acetyl alpha-MSH, mono-acetyl alpha-MSH and di-acetyl alpha-MSH were compared. These forms of alpha-MSH were isolated from neurointermediate lobes and tested in a superfusion experiment with homologous interrenal tissue. The corticotrophic activity of di-acetyl alpha-MSH was the highest, followed by that of des-acetyl alpha-MSH and mono-acetyl alpha-MSH. Apparently, acetylation of alpha-MSH is of functional significance for corticotrophic action. Di-acetyl alpha-MSH proved to be about 100 times less potent than ACTH(1-39): the half-maximal stimulating concentrations for ACTH and di-acetyl alpha-MSH were 0.89 nmol/l and 110 nmol/l respectively. Surprisingly, a superfusate from neurointermediate lobes proved to be only about three times less active than a superfusate from the pituitary pars distalis, in which the corticotrophic activity is attributable to its ACTH content. When selectively stripped of all forms of alpha-MSH by passage through a Sepharose column coated with an antiserum against alpha-MSH, the neuro-intermediate lobe superfusate was devoid of corticotrophic activity. Thus alpha-MSH appears to be the corticotrophic factor in the superfusate of the neurointermediate lobe. After the same treatment, the corticotrophic activity of the pars distalis superfusate was not affected.(ABSTRACT TRUNCATED AT 250 WORDS)

Regulation of differential release of alpha-melanocyte-stimulating hormone forms from the pituitary of a teleost fish, Oreochromis mossambicus.

Using high-performance liquid chromatography (HPLC) in combination with radioimmunoassay, three forms of alpha-MSH (des-acetyl, mono-acetyl and di-acetyl alpha-MSH) were separated and identified in tilapia neurointermediate lobes and plasma, and in medium from lobes superfused in vitro. The presence of acetylated forms in lobe extracts indicated that the peptides are acetylated intracellularly. Di-acetyl alpha-MSH was, especially in comparison with monoacetyl alpha-MSH, relatively more abundant in lobe extracts than in plasma. This suggests that the three forms of alpha-MSH are not released according to their relative intracellular abundances. The possibility of regulation of this differential release by dopamine and TRH was investigated, using a microsuperfusion system. Dopamine was a potent inhibitor of alpha-MSH release, but did not modulate the relative abundance of the different forms of alpha-MSH released from the MSH cells. TRH was a potent stimulator of alpha-MSH release. It enhanced in vitro the release of di-acetyl alpha-MSH more than the release of mono-acetyl alpha-MSH. Thus tilapia may be able to modulate not only the quantitative but also the qualitative signal from the MSH cells. This might enhance the flexibility of the animals to respond to environmental challenges.

Changes in plasma renin activity and renal immunohistochemically demonstrated renin in carbadox treated pigs.

Carbadox is known to induce toxic effects on the adrenal cortex, resulting in hypoaldosteronism. To study the involvement of carbadox on the renin-angiotensin system, weaned piglets of five weeks old received feed supplemented with 0 (control group), 50, 100, 150 or 200 ppm carbadox. After four weeks the 100 and 150 ppm groups had significantly higher plasma renin activity levels than the control group and after nine weeks plasma renin activity levels of all treated groups were significantly higher than the control group. Five and 10 weeks after carbadox administration, three and two pigs, respectively, of all groups were necropsied and the kidneys were screened for immunohistochemically demonstrated renin. All dosed pigs demonstrated an increase of immunoreactive renin, which was dose- and time-related. From these results it is concluded that carbadox induces activation of the renin-angiotensin system, secondary to the suppressing effect on mineralocorticoid secretion and that these changes may be responsible for part of the clinical picture.

Immunoelectron microscopic localization of renin in the juxtaglomerular cells of the amphibian Bufo bufo.

The ultrastructural localization of renin in the juxtaglomerular apparatus of the kidney of the toad Bufo bufo has been examined using an immunogold staining method for electron microscopic immunocytochemistry and an antiserum to renin isolated from the submandibular gland of the mouse. Renin immunoreactivity was confined to lamellated granules in the cytoplasm of epitheloid or juxtaglomerular cells in the glomerular afferent arterioles and also in the media cells of larger arteries. Mouse kidney tissue, examined for purposes of comparison, showed immunolabeling limited to the granules of the juxtaglomerular cells. The presence of renin or a renin-like substance in the juxtaglomerular granules of the toad kidney is discussed in relation to the lysosomal nature of these granules. A model is presented linking the lysosomal function of the juxtaglomerular granules and the release of renin mediated by beta-adrenergic receptors present on the surface of the juxtaglomerular cells.

Histochemistry of the juxtaglomerular apparatus in the toad Bufo bufo. Acid phosphatase activity of the epitheloid cells in the glomerular afferent arterioles.

Histochemical techniques for acid phosphatase activity applied to kidney tissue of the toad Bufo bufo demonstrate that a high enzyme activity is present in the dense granules of the proximal tubule cells, but also in the media cells in the wall of the glomerular afferent arterioles. The acid phosphatase activity is confined to the characteristic granules in these juxtaglomerular cells, which therefore are lysosomal in nature.

Immunohistochemical demonstration of renin in the juxtaglomerular apparatus of three Bufo species.

The cellular localization of renin was examined in the kidneys of some amphibians of the genus Bufo by immunoperoxidase and immunofluorescence techniques with an antiserum to renin isolated from the submandibular gland of the mouse. Immunoreactivity could be demonstrated in the media cells of the afferent arterioles (juxtaglomerular cells) close to as well as at great distance from the glomeruli. Occasionally, media cells of larger arterial vessels were also stained. The immunohistochemical data seem to be in accordance with earlier results obtained with a modified silver impregnation technique (Movat's staining procedure) used for the visualization of juxtaglomerular cells in non-mammalian vertebrates. Mouse kidney tissue, studied for purposes of comparison, showed renin-immunoreactivity as described by earlier investigators, i.e., immunoreactive staining in the afferent arterioles near the glomeruli and in the proximal tubule cells.