Straight-Chain Acyl-CoA Oxidase Knockout Mouse Accumulates Extremely Long Chain Fatty Acids from α-Linolenic Acid: Evidence for Runaway Carousel-Type Enzyme Kinetics in Peroxisomal β-Oxidation Diseases

Extremely long chain polyunsaturated fatty acids (ELCPs) with >24 carbons and four or more double bonds are normally found in excitatory tissues but have no known function, and are greatly increased in brain and other tissues of humans with peroxisomal disorders. Straight-chain acyl-CoA oxidase (...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Molecular genetics and metabolism 2002-02, Vol.75 (2), p.108-119
Hauptverfasser: Infante, Juan P., Tschanz, Carolyn L., Shaw, Natacha, Michaud, Anthony L., Lawrence, Peter, Brenna, J.Thomas
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page 119
container_issue 2
container_start_page 108
container_title Molecular genetics and metabolism
container_volume 75
creator Infante, Juan P.
Tschanz, Carolyn L.
Shaw, Natacha
Michaud, Anthony L.
Lawrence, Peter
Brenna, J.Thomas
description Extremely long chain polyunsaturated fatty acids (ELCPs) with >24 carbons and four or more double bonds are normally found in excitatory tissues but have no known function, and are greatly increased in brain and other tissues of humans with peroxisomal disorders. Straight-chain acyl-CoA oxidase (AOX) catalyzes the first, rate-limiting step of peroxisomal β-oxidation of very-long-chain saturated and unsaturated fatty acids. We have studied the polyunsaturated fatty acid metabolism of AOX knockout mice (AOX−/−) as a model of human AOX deficiency (pseudo-neonatal adrenoleukodystrophy), and as a genetic tool to test the putative peroxisomal β-oxidation involvement in polyunsaturated fatty acid synthesis. Liver lipids of 26-day-old weanling AOX−/− mice livers accumulate n-3 and n-6 ELCPs from C24 to C30 with 5 and 6 double bonds, have 356 ± 66 μg/g docosahexaenoic acid (22:6n-3), similar to congenic (AOX−/* = AOX+/+ and AOX+/−) controls (401 ± 96 μg/g), but increased 22:5n-6 (22.4 ± 3.7 vs 6.4 ± 1.5 μg/g). AOX+/* mice injected intraperitoneally at 23 days with [U-13C]-18:3n-3show strong labeling of 22:6n-3 after 72 h, whereas AOX−/− mice display less labeling of 22:6n-3but strong tracer incorporation into 24:6n-3, 26:6n-3, and 28:6n-3, after the same period. These data suggest that ELCPs are natural runaway elongation by-products of 22:6n-3 and 22:5n-6 synthesis, which are normally disposed of by peroxisomal β-oxidation. Under conditions with impaired peroxisomal β-oxidation, such as Zellweger syndrome and adrenoleukodystrophies, ELCPs accumulate due to increased synthesis and impaired disposal. Two mechanisms for the formation of these runaway elongation by-products and the involvement of secondary carnitine deficiency in this process are proposed: n-3 ELCPs are synthesized by a carnitine-dependent multifunctional mitochondrial docosahexaenoic acid synthase (mtDHAS) which normally synthesizes primarily 22:6n-3, while n-6 ELCPs are synthesized by independent elongation enzymes in the endoplasmic reticulum.
doi_str_mv 10.1006/mgme.2001.3279
format Article
fullrecord <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_71472440</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S1096719201932792</els_id><sourcerecordid>71472440</sourcerecordid><originalsourceid>FETCH-LOGICAL-c340t-b394ef583fd8a5dc8ad2f28a5240f04e19510a5ceda80e8095ebedfd5ffada3f3</originalsourceid><addsrcrecordid>eNp1kcmOEzEQhlsIxCxw5Yh84uZg95J0c4uaDCCCBsFwthy7nDF4CbZ7SM9bwWsgzTPhngRx4uRy6au_lr8onlEyo4TMX9qthVlJCJ1V5aJ7UJxS0s3xoiTzh39j2pUnxVmMXzNFm65-XJxQ2jZNV3anxe_PKXC9vU64v-baoaUYDe79El3uteQR0HvnxTc_JPTBD_m7FGKwg-EJIlrtUwALZkRr77boIHDBUxozpmVEKniL7n7itXbegNPiPv8KrW60BCcAKR_Qp8HxH3xEPQ9TB4Ovxh2glbsdbe6uHSQtIsrKHyH4vY7ecoPufuH7AZP2Dr3WEfKo8UnxSHET4enxPS--XKyu-rd4ffnmXb9cY1HVJOFN1dWgmrZSsuWNFC2XpSpzWNZEkRpo11DCGwGStwRa0jWwAalkoxSXvFLVefHioLsL_vsAMTGrowBjuIO8AlvQelHWNcng7ACK4GMMoNguaMvDyChhk31sso9N9rHJvlzw_Kg8bCzIf_jRrwy0BwDyfjcaAotCT6eUOoBITHr9P-0_6YOv3w</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>71472440</pqid></control><display><type>article</type><title>Straight-Chain Acyl-CoA Oxidase Knockout Mouse Accumulates Extremely Long Chain Fatty Acids from α-Linolenic Acid: Evidence for Runaway Carousel-Type Enzyme Kinetics in Peroxisomal β-Oxidation Diseases</title><source>Elsevier ScienceDirect Journals Complete - AutoHoldings</source><source>MEDLINE</source><creator>Infante, Juan P. ; Tschanz, Carolyn L. ; Shaw, Natacha ; Michaud, Anthony L. ; Lawrence, Peter ; Brenna, J.Thomas</creator><creatorcontrib>Infante, Juan P. ; Tschanz, Carolyn L. ; Shaw, Natacha ; Michaud, Anthony L. ; Lawrence, Peter ; Brenna, J.Thomas</creatorcontrib><description>Extremely long chain polyunsaturated fatty acids (ELCPs) with &gt;24 carbons and four or more double bonds are normally found in excitatory tissues but have no known function, and are greatly increased in brain and other tissues of humans with peroxisomal disorders. Straight-chain acyl-CoA oxidase (AOX) catalyzes the first, rate-limiting step of peroxisomal β-oxidation of very-long-chain saturated and unsaturated fatty acids. We have studied the polyunsaturated fatty acid metabolism of AOX knockout mice (AOX−/−) as a model of human AOX deficiency (pseudo-neonatal adrenoleukodystrophy), and as a genetic tool to test the putative peroxisomal β-oxidation involvement in polyunsaturated fatty acid synthesis. Liver lipids of 26-day-old weanling AOX−/− mice livers accumulate n-3 and n-6 ELCPs from C24 to C30 with 5 and 6 double bonds, have 356 ± 66 μg/g docosahexaenoic acid (22:6n-3), similar to congenic (AOX−/* = AOX+/+ and AOX+/−) controls (401 ± 96 μg/g), but increased 22:5n-6 (22.4 ± 3.7 vs 6.4 ± 1.5 μg/g). AOX+/* mice injected intraperitoneally at 23 days with [U-13C]-18:3n-3show strong labeling of 22:6n-3 after 72 h, whereas AOX−/− mice display less labeling of 22:6n-3but strong tracer incorporation into 24:6n-3, 26:6n-3, and 28:6n-3, after the same period. These data suggest that ELCPs are natural runaway elongation by-products of 22:6n-3 and 22:5n-6 synthesis, which are normally disposed of by peroxisomal β-oxidation. Under conditions with impaired peroxisomal β-oxidation, such as Zellweger syndrome and adrenoleukodystrophies, ELCPs accumulate due to increased synthesis and impaired disposal. Two mechanisms for the formation of these runaway elongation by-products and the involvement of secondary carnitine deficiency in this process are proposed: n-3 ELCPs are synthesized by a carnitine-dependent multifunctional mitochondrial docosahexaenoic acid synthase (mtDHAS) which normally synthesizes primarily 22:6n-3, while n-6 ELCPs are synthesized by independent elongation enzymes in the endoplasmic reticulum.</description><identifier>ISSN: 1096-7192</identifier><identifier>EISSN: 1096-7206</identifier><identifier>DOI: 10.1006/mgme.2001.3279</identifier><identifier>PMID: 11855929</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Acyl-CoA Oxidase ; Adrenoleukodystrophy - genetics ; Adrenoleukodystrophy - metabolism ; alpha-Linolenic Acid - metabolism ; Animals ; carnitine ; Crypthecodinium cohnii ; desaturase ; Disease Models, Animal ; Fatty Acids - metabolism ; Female ; Humans ; Kinetics ; Male ; Mice ; Mice, Knockout ; mitochondria ; mtDHAS ; multifunctional mitochondrial DHA synthase ; Oxidoreductases - genetics ; Oxidoreductases - metabolism ; Peroxisomal Disorders - genetics ; Peroxisomal Disorders - metabolism ; peroxisomes ; PPAR</subject><ispartof>Molecular genetics and metabolism, 2002-02, Vol.75 (2), p.108-119</ispartof><rights>2002 Elsevier Science (USA)</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c340t-b394ef583fd8a5dc8ad2f28a5240f04e19510a5ceda80e8095ebedfd5ffada3f3</citedby><cites>FETCH-LOGICAL-c340t-b394ef583fd8a5dc8ad2f28a5240f04e19510a5ceda80e8095ebedfd5ffada3f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1006/mgme.2001.3279$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,778,782,3539,27911,27912,45982</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11855929$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Infante, Juan P.</creatorcontrib><creatorcontrib>Tschanz, Carolyn L.</creatorcontrib><creatorcontrib>Shaw, Natacha</creatorcontrib><creatorcontrib>Michaud, Anthony L.</creatorcontrib><creatorcontrib>Lawrence, Peter</creatorcontrib><creatorcontrib>Brenna, J.Thomas</creatorcontrib><title>Straight-Chain Acyl-CoA Oxidase Knockout Mouse Accumulates Extremely Long Chain Fatty Acids from α-Linolenic Acid: Evidence for Runaway Carousel-Type Enzyme Kinetics in Peroxisomal β-Oxidation Diseases</title><title>Molecular genetics and metabolism</title><addtitle>Mol Genet Metab</addtitle><description>Extremely long chain polyunsaturated fatty acids (ELCPs) with &gt;24 carbons and four or more double bonds are normally found in excitatory tissues but have no known function, and are greatly increased in brain and other tissues of humans with peroxisomal disorders. Straight-chain acyl-CoA oxidase (AOX) catalyzes the first, rate-limiting step of peroxisomal β-oxidation of very-long-chain saturated and unsaturated fatty acids. We have studied the polyunsaturated fatty acid metabolism of AOX knockout mice (AOX−/−) as a model of human AOX deficiency (pseudo-neonatal adrenoleukodystrophy), and as a genetic tool to test the putative peroxisomal β-oxidation involvement in polyunsaturated fatty acid synthesis. Liver lipids of 26-day-old weanling AOX−/− mice livers accumulate n-3 and n-6 ELCPs from C24 to C30 with 5 and 6 double bonds, have 356 ± 66 μg/g docosahexaenoic acid (22:6n-3), similar to congenic (AOX−/* = AOX+/+ and AOX+/−) controls (401 ± 96 μg/g), but increased 22:5n-6 (22.4 ± 3.7 vs 6.4 ± 1.5 μg/g). AOX+/* mice injected intraperitoneally at 23 days with [U-13C]-18:3n-3show strong labeling of 22:6n-3 after 72 h, whereas AOX−/− mice display less labeling of 22:6n-3but strong tracer incorporation into 24:6n-3, 26:6n-3, and 28:6n-3, after the same period. These data suggest that ELCPs are natural runaway elongation by-products of 22:6n-3 and 22:5n-6 synthesis, which are normally disposed of by peroxisomal β-oxidation. Under conditions with impaired peroxisomal β-oxidation, such as Zellweger syndrome and adrenoleukodystrophies, ELCPs accumulate due to increased synthesis and impaired disposal. Two mechanisms for the formation of these runaway elongation by-products and the involvement of secondary carnitine deficiency in this process are proposed: n-3 ELCPs are synthesized by a carnitine-dependent multifunctional mitochondrial docosahexaenoic acid synthase (mtDHAS) which normally synthesizes primarily 22:6n-3, while n-6 ELCPs are synthesized by independent elongation enzymes in the endoplasmic reticulum.</description><subject>Acyl-CoA Oxidase</subject><subject>Adrenoleukodystrophy - genetics</subject><subject>Adrenoleukodystrophy - metabolism</subject><subject>alpha-Linolenic Acid - metabolism</subject><subject>Animals</subject><subject>carnitine</subject><subject>Crypthecodinium cohnii</subject><subject>desaturase</subject><subject>Disease Models, Animal</subject><subject>Fatty Acids - metabolism</subject><subject>Female</subject><subject>Humans</subject><subject>Kinetics</subject><subject>Male</subject><subject>Mice</subject><subject>Mice, Knockout</subject><subject>mitochondria</subject><subject>mtDHAS</subject><subject>multifunctional mitochondrial DHA synthase</subject><subject>Oxidoreductases - genetics</subject><subject>Oxidoreductases - metabolism</subject><subject>Peroxisomal Disorders - genetics</subject><subject>Peroxisomal Disorders - metabolism</subject><subject>peroxisomes</subject><subject>PPAR</subject><issn>1096-7192</issn><issn>1096-7206</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2002</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kcmOEzEQhlsIxCxw5Yh84uZg95J0c4uaDCCCBsFwthy7nDF4CbZ7SM9bwWsgzTPhngRx4uRy6au_lr8onlEyo4TMX9qthVlJCJ1V5aJ7UJxS0s3xoiTzh39j2pUnxVmMXzNFm65-XJxQ2jZNV3anxe_PKXC9vU64v-baoaUYDe79El3uteQR0HvnxTc_JPTBD_m7FGKwg-EJIlrtUwALZkRr77boIHDBUxozpmVEKniL7n7itXbegNPiPv8KrW60BCcAKR_Qp8HxH3xEPQ9TB4Ovxh2glbsdbe6uHSQtIsrKHyH4vY7ecoPufuH7AZP2Dr3WEfKo8UnxSHET4enxPS--XKyu-rd4ffnmXb9cY1HVJOFN1dWgmrZSsuWNFC2XpSpzWNZEkRpo11DCGwGStwRa0jWwAalkoxSXvFLVefHioLsL_vsAMTGrowBjuIO8AlvQelHWNcng7ACK4GMMoNguaMvDyChhk31sso9N9rHJvlzw_Kg8bCzIf_jRrwy0BwDyfjcaAotCT6eUOoBITHr9P-0_6YOv3w</recordid><startdate>20020201</startdate><enddate>20020201</enddate><creator>Infante, Juan P.</creator><creator>Tschanz, Carolyn L.</creator><creator>Shaw, Natacha</creator><creator>Michaud, Anthony L.</creator><creator>Lawrence, Peter</creator><creator>Brenna, J.Thomas</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20020201</creationdate><title>Straight-Chain Acyl-CoA Oxidase Knockout Mouse Accumulates Extremely Long Chain Fatty Acids from α-Linolenic Acid: Evidence for Runaway Carousel-Type Enzyme Kinetics in Peroxisomal β-Oxidation Diseases</title><author>Infante, Juan P. ; Tschanz, Carolyn L. ; Shaw, Natacha ; Michaud, Anthony L. ; Lawrence, Peter ; Brenna, J.Thomas</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c340t-b394ef583fd8a5dc8ad2f28a5240f04e19510a5ceda80e8095ebedfd5ffada3f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2002</creationdate><topic>Acyl-CoA Oxidase</topic><topic>Adrenoleukodystrophy - genetics</topic><topic>Adrenoleukodystrophy - metabolism</topic><topic>alpha-Linolenic Acid - metabolism</topic><topic>Animals</topic><topic>carnitine</topic><topic>Crypthecodinium cohnii</topic><topic>desaturase</topic><topic>Disease Models, Animal</topic><topic>Fatty Acids - metabolism</topic><topic>Female</topic><topic>Humans</topic><topic>Kinetics</topic><topic>Male</topic><topic>Mice</topic><topic>Mice, Knockout</topic><topic>mitochondria</topic><topic>mtDHAS</topic><topic>multifunctional mitochondrial DHA synthase</topic><topic>Oxidoreductases - genetics</topic><topic>Oxidoreductases - metabolism</topic><topic>Peroxisomal Disorders - genetics</topic><topic>Peroxisomal Disorders - metabolism</topic><topic>peroxisomes</topic><topic>PPAR</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Infante, Juan P.</creatorcontrib><creatorcontrib>Tschanz, Carolyn L.</creatorcontrib><creatorcontrib>Shaw, Natacha</creatorcontrib><creatorcontrib>Michaud, Anthony L.</creatorcontrib><creatorcontrib>Lawrence, Peter</creatorcontrib><creatorcontrib>Brenna, J.Thomas</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Molecular genetics and metabolism</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Infante, Juan P.</au><au>Tschanz, Carolyn L.</au><au>Shaw, Natacha</au><au>Michaud, Anthony L.</au><au>Lawrence, Peter</au><au>Brenna, J.Thomas</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Straight-Chain Acyl-CoA Oxidase Knockout Mouse Accumulates Extremely Long Chain Fatty Acids from α-Linolenic Acid: Evidence for Runaway Carousel-Type Enzyme Kinetics in Peroxisomal β-Oxidation Diseases</atitle><jtitle>Molecular genetics and metabolism</jtitle><addtitle>Mol Genet Metab</addtitle><date>2002-02-01</date><risdate>2002</risdate><volume>75</volume><issue>2</issue><spage>108</spage><epage>119</epage><pages>108-119</pages><issn>1096-7192</issn><eissn>1096-7206</eissn><abstract>Extremely long chain polyunsaturated fatty acids (ELCPs) with &gt;24 carbons and four or more double bonds are normally found in excitatory tissues but have no known function, and are greatly increased in brain and other tissues of humans with peroxisomal disorders. Straight-chain acyl-CoA oxidase (AOX) catalyzes the first, rate-limiting step of peroxisomal β-oxidation of very-long-chain saturated and unsaturated fatty acids. We have studied the polyunsaturated fatty acid metabolism of AOX knockout mice (AOX−/−) as a model of human AOX deficiency (pseudo-neonatal adrenoleukodystrophy), and as a genetic tool to test the putative peroxisomal β-oxidation involvement in polyunsaturated fatty acid synthesis. Liver lipids of 26-day-old weanling AOX−/− mice livers accumulate n-3 and n-6 ELCPs from C24 to C30 with 5 and 6 double bonds, have 356 ± 66 μg/g docosahexaenoic acid (22:6n-3), similar to congenic (AOX−/* = AOX+/+ and AOX+/−) controls (401 ± 96 μg/g), but increased 22:5n-6 (22.4 ± 3.7 vs 6.4 ± 1.5 μg/g). AOX+/* mice injected intraperitoneally at 23 days with [U-13C]-18:3n-3show strong labeling of 22:6n-3 after 72 h, whereas AOX−/− mice display less labeling of 22:6n-3but strong tracer incorporation into 24:6n-3, 26:6n-3, and 28:6n-3, after the same period. These data suggest that ELCPs are natural runaway elongation by-products of 22:6n-3 and 22:5n-6 synthesis, which are normally disposed of by peroxisomal β-oxidation. Under conditions with impaired peroxisomal β-oxidation, such as Zellweger syndrome and adrenoleukodystrophies, ELCPs accumulate due to increased synthesis and impaired disposal. Two mechanisms for the formation of these runaway elongation by-products and the involvement of secondary carnitine deficiency in this process are proposed: n-3 ELCPs are synthesized by a carnitine-dependent multifunctional mitochondrial docosahexaenoic acid synthase (mtDHAS) which normally synthesizes primarily 22:6n-3, while n-6 ELCPs are synthesized by independent elongation enzymes in the endoplasmic reticulum.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>11855929</pmid><doi>10.1006/mgme.2001.3279</doi><tpages>12</tpages></addata></record>
fulltext fulltext
identifier ISSN: 1096-7192
ispartof Molecular genetics and metabolism, 2002-02, Vol.75 (2), p.108-119
issn 1096-7192
1096-7206
language eng
recordid cdi_proquest_miscellaneous_71472440
source Elsevier ScienceDirect Journals Complete - AutoHoldings; MEDLINE
subjects Acyl-CoA Oxidase
Adrenoleukodystrophy - genetics
Adrenoleukodystrophy - metabolism
alpha-Linolenic Acid - metabolism
Animals
carnitine
Crypthecodinium cohnii
desaturase
Disease Models, Animal
Fatty Acids - metabolism
Female
Humans
Kinetics
Male
Mice
Mice, Knockout
mitochondria
mtDHAS
multifunctional mitochondrial DHA synthase
Oxidoreductases - genetics
Oxidoreductases - metabolism
Peroxisomal Disorders - genetics
Peroxisomal Disorders - metabolism
peroxisomes
PPAR
title Straight-Chain Acyl-CoA Oxidase Knockout Mouse Accumulates Extremely Long Chain Fatty Acids from α-Linolenic Acid: Evidence for Runaway Carousel-Type Enzyme Kinetics in Peroxisomal β-Oxidation Diseases
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-16T03%3A23%3A05IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Straight-Chain%20Acyl-CoA%20Oxidase%20Knockout%20Mouse%20Accumulates%20Extremely%20Long%20Chain%20Fatty%20Acids%20from%20%CE%B1-Linolenic%20Acid:%20Evidence%20for%20Runaway%20Carousel-Type%20Enzyme%20Kinetics%20in%20Peroxisomal%20%CE%B2-Oxidation%20Diseases&rft.jtitle=Molecular%20genetics%20and%20metabolism&rft.au=Infante,%20Juan%20P.&rft.date=2002-02-01&rft.volume=75&rft.issue=2&rft.spage=108&rft.epage=119&rft.pages=108-119&rft.issn=1096-7192&rft.eissn=1096-7206&rft_id=info:doi/10.1006/mgme.2001.3279&rft_dat=%3Cproquest_cross%3E71472440%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=71472440&rft_id=info:pmid/11855929&rft_els_id=S1096719201932792&rfr_iscdi=true