Psychotherapy: patient-therapist matching reconsidered

The personality of the therapist does influence the psychotherapeutic process. Given that therapists are human, they do, in fact, bring into the encounter their moral and cultural, and sometimes even racial, attitudes in spite of efforts to maintain objectivity and neutrality. Ignoring the impact of the therapist-client, organismic variables may lead to spurious research findings and impractical interventions. Research and practical intervention, therefore, should be concerned with matching clients with the most appropriate therapist.

Beta-Amylases from Alfalfa (Medicago sativa L.) Roots

Amylase was found in high activity (193 international units per milligram protein) in the tap root of alfalfa (Medicago sativa L. cv. Sonora). The activity was separated by gel filtration chromatography into two fractions with molecular weights of 65,700 (heavy amylase) and 41,700 (light amylase). Activity staining of electrophoretic gels indicated the presence of one isozyme in the heavy amylase fraction and two in the light amylase fraction. Three amylase isozymes with electrophoretic mobilities identical to those in the heavy and the light amylase fractions were the only amylases identified in crude root preparations. Both heavy and light amylases hydrolyzed amylopectin, soluble starch, and amylose but did not hydrolyze pullulan or beta-limit dextrin. The ratio of viscosity change to reducing power production during starch hydrolysis was identical for both alfalfa amylase fractions and sweet potato beta-amylase, while that of bacterial alpha-amylase was considerably higher. The identification of maltose and beta-limit dextrin as hydrolytic end-products confirmed that these alfalfa root amylases are all beta-amylases.The pH optimum for both beta-amylase fractions was 6.0. Both light and heavy beta-amylases showed normal Michaelis-Menten kinetics, with soluble starch as substrate, and had respectively K(m) values of 5.9 and 6.8 milligrams starch per milliliter and V(max) of 640 and 130 international units per milligram protein. Arrhenius plots indicated that the energy of activation for the heavy beta-amylase remained relatively unchanged (12.7 to 13.0 kilocalories per mole) from 0 to 30 degrees C, whereas the energy of activation for the light amylase increased from 12.0 to about 28.0 kilocalories per mole at 8.7 degrees C as temperature was lowered. The light amylase was shown to be inhibited by maltose.

Sexual health care clinician in an acute spinal cord injury unit

This article introduces the role of the sexual health care clinician, a nonphysician specialist trained to diagnose and treat sexual dysfunctions of disabled persons. Under medical supervision, the clinician is part of the treatment team in an acute spinal cord injury unit, a general rehabilitation center and an extended care unit. The clinician's role includes direct patient care; education for professionals, students and community agencies; liaison with other rehabilitation groups; and research. The process of sexual rehabilitation is conceptualized and experience with the specialty in an acute setting is described. Experience indicates that sexual assessment, diagnosis and management is a technical specialty which requires in-depth training. The major contributions of the service are an early legitimization of sex-related concerns; the crystallization of physiologic emotional and social capabilities and needs; and the specific instructions for experimentation with various sexual alternatives.

Identification of mitochondrial proteins and some of their precursors in two-dimensional electrophoretic maps of human cells

A set of at least 30 proteins disappears from the two-dimensional electrophoretic pattern of human lymphoid cells treated with various antimitochondrial agents. This set is similar to the set of proteins found in isolated mitochondria (except for the presence of action in the latter group), indicating that the inhibitor effect stops production of a majority of mature mitochondrial proteins. Several proteins having the characteristics of precursors to the major cytoplasmically synthesized mitochondrial proteins can be observed in cells during fast-pulse experiments and in a reticulocyte lysate system fed with total lymphoid cell RNA. In the three major instances of mitochondrial precursor--product processing, the removed peptide is quite basic in each case, suggesting that a lysine- or arginine-rich terminal sequence may be necessary for initial recognition by the mitochondrial protein uptake apparatus. The inhibitor effect allows easy identification of a large set of mitochondrial proteins in two-dimensional maps of various cells, thereby specifying a particularly tractable and functionally distinctive subset of the cellular proteins. The nature and wide scope of the effect support the concept of energy-dependent "vectorial processing" [Schatz, G. (1979) FEBS Lett. 103, 203--211] and indicate that such a mechanism is generally applicable to the major class of cytoplasmically synthesized mitochondrial proteins in mammalian cells.

Sensory preference and overselective responding in autistic children

Five autistic and five normal children were allowed to register a sensory modality preference by bar pressing to select either a visual (slides) or an auditory (music) stimulus. The children were then taught a discrimination between the presence or absence of a compound auditory-visual stimulus (white noise and light). Testing for stimulus overselectivity revealed that the autistic children attended to only one aspect of the compound stimulus. In all cases this was the sensory modality that was selected during the preference test. Significant correlations were obtained between Gesell developmental scores and degree of overselectivity. Normal children registered an equal preference for music and slides and displayed no overselectivity.

The effects of protective equipment on styrene exposure in workers in the reinforced plastics industry

This study was designed to determine whether styrene absorption through the skin results in measurable changes in biologic indicators of styrene exposure using a group of workers engaged in hand lay-up operations during which extensive styrene skin contact occurs. Serial measurements of expired breath and blood styrene and urinary excretion of mandelic and phenylglyoxylic acid were made in eight female workers during 4 consecutive days using different experimental conditions including either (1) gloves/protective clothing alone, (2) respirator alone, (3) both gloves/protective clothing and respirator, or (4) neither respirator nor gloves/protective clothing. A two-by-two factorial design imbedded in a Latin square design allowed estimation of the effects of the two types of protection (i.e., gloves/clothing and respiratory) and any interaction. Levels of styrene in venous blood and expired breath and urine mandelic and phenylglyoxylic acid excretion were no different when gloves/clothes were used as protection compared to no protection at all. Significant reduction in all biologic indices occurred when respiratory protection was used. The results of the study suggest that percutaneous absorption of styrene is not a significant exposure source and does not significantly contribute to the body burden of styrene of workers in the reinforced plastic industry engaged in hand lay-up operations. Respiratory protective devices were the most effective means for reducing styrene absorption. Even though skin absorption of styrene is limited, skin protection is necessary because of the risk of dermatitis.

Ultrastructure of the pyramidal basket cells in the dentate gyrus of the rat

Light and electron microscopic preparations were used to examine the somata and dendrites of the large pyramidal basket cells in the dentate gyrus. Results from previous Golgi studies have shown that the somata of these neurons are located beneath the granule cell layer and that their axons are distributed around the granule cell somata, where they form basket endings. The results of the present study indicate that the morphology of the pyramidal basket cell differs in many ways from that of the granule cell, aside from the obvious difference of their greater size. The pyramidal baseket cells display unfolded nuclei and intranuclear rods and sheets, and these characteristics are not found in granule cells. The pyramidal basket cells also show a greater abundance of cisternae of granular endoplasmic reticulum and other perikaryal organelles. Furthermore, the somata and the smooth dendrites of these neurons form both symmetric and asymmetric synaptic junctions. The results of this study indicate that the pyramidal basket cells have distinct ultrastructural characteristics that are shared by other GABAergic neurons in the cerebral cortex. It is suggested that some of these characteristics may underlie the role played by these cells in providing GABA-mediated, tonic inhibition of other neurons.

Guidelines to birth control counselling of the physically handicapped

Birth control counselling of well motivated physically handicapped men and women is discussed in a series of suggested steps: (1) preappointment arrangements are made to ensure physical access to the office, and the partner or a helper may be invited to the visit; (2) the patient is encouraged to name the desired birth control method; (3) the patient's fertility is established from the history and the results of physical examination and laboratory tests; (4) methods of birth control are matched to the patient's physical and mental capabilities; (5) potential side effects of the proposed methods are considered in the light of the handicap; (6) a method is finally recommended that may be a trade-off, with ease of use balanced against efficacy, and living with side effects balanced against the risks of pregnancy; and (7) rechecks are necessary to ensure that the patient is using the method with skill and satisfaction.

Risk factor assessment in 101 total hip arthroplasties: a medical perspective

Our experience with 101 consecutive T.H.A.'s in 91 patients was examined in an attempt to identify preoperative risk factors for postoperative medical complications, especially pulmonary embolism and thrombophlebitis. Six per cent of patients developed postoperative clinical thrombophlebitis, and 8% a pulmonary embolism. Advancing age and previous venous thrombosis served as predictors for pulmonary embolism and thrombophlebitis, respectively (p less than 0.01), but obesity, venous varicosities, diabetes mellitus, cigarette smoking, previous pulmonary embolism, and length of surgery did not, for either. Fifty per cent of the patients with preoperative abnormal kidney function developed some form of medical complication postoperatively, a significant increase in risk (p less than 0.05) over patients with normal kidney function. We were unable to identify an increase in postoperative atelectasis or pneumonia associated with smoking or obesity in these patients. No consistent decrease in post-operative medical morbidity could be assigned to preoperative medical consultations, suggesting that we have not yet identified all significant risk factors. A thorough preoperative preparation and improvement in intra- and postoperative techniques and management may account for differences found in this study from traditionally held risk factors.

Comparison of three treatments for fractures of the diaphysis of the femur

Sixty-eight patients with fractured femurs were studied who, in terms of personal characteristics, associated injuries and type of fracture, could have been treated by intramedullary nailing or traction followed by the application of either a spica cast or fracture brace. Twenty-eight patients actually underwent intramedullary nailing, while 18 were treated with a spica cast and 22 with a fracture brace. Multiple outcome factors were studied and, based upon every comparison, intramedullary nailing was found superior. Among those patients treated by non-operative techniques, fracture bracing permitted earlier independent ambulation and increased the probability of normal knee motion at the conclusion of treatment.

High resolution two-dimensional electrophoresis of human plasma proteins

The two-dimensional electrophoretic technique of O'Farrell has been adapted to the analysis of human plasma proteins, and 30 polypeptides have been identified in the pattern produced. Genetic variants involving charge (isoelectric point) or size (molecular weight in the presence of sodium dodecyl sulfate) changes should be routinely detectable in at least 20 proteins at once, facilitating studies of human mutation rates.

Ebstein's anomaly: a report of 3 cases in the dog

Three young unrelated dogs were diagnosed as having the canine counterpart of Ebstein's anomaly, an eponymic term for a cardiac malformation in man. All of the dogs had systolic murmurs in the tricuspid area, and all had radiographic evidence of cardiac enlargement, particularly of the right atrium. Electrocardiography indicated atrial disease or right atrial enlargement and right ventricular conduction defects. The defect was confirmed by means of cardiac catheterization in all 3 dogs. Open heart surgery was performed on 2 of the dogs--plastic reconstruction of the tricuspid annulus and placement of a prosthetic valve in 1 and closure of an atrial septal defect in the other; both of these dogs died (1 day and 1 month after surgery).

The isomerization of 2,5- and 9,12-octadecadienoic acids by an extract of Butyrivibrio fibrisolvens

A cell-free particulate preparation from Butyrivibrio fibrisolvens was used to study the relative rates of isomerization of all cis,cis-methylene-interrupted isomers of octadecadienoic acid. Only two isomers were found to be substrates, the 9,12-isomer was isomerized at 41 +/- 4 mumol/min per mg protein, and the 2,5-isomer at 11 +/- 1 mumol/min per mg. The product of the isomerization of the 2,5-isomer had an ultraviolet absorption maximum at 233 nm indicating that it was the 3,5-isomer. The isomerization of the 2,5-isomer was studied in detail. Its rate of isomerization was linear with protein concentration up to 0.047 mg/ml, and was linear with substrate concentration up to 48 muM. The pH optimum was 6.8. Below pH 6, the substrate was also subject to spontaneous isomerization. The inhibition of isomerization of the 9,12-isomer by the other isomers was studied. Those isomers in which the double bonds are close to the carboxyl group were the most effective inhibitors. The preparation was also found capable of hydrogenating the conjugated diene product from the 2,5-isomer to a monoene after prolonged incubation.

Selectively blocked derivatives of muco-inositol and their conversion into derivatives of epi- and cis-inositol

Benzylation, and then hydrolysis, of 1, 2:4, 5-di-O-isopropylidene-muco-inositol (1) gave 3, 6-di-O-benzyl-muco-inositol (3). This was converted into a series of derivatives, including the 1, 5-di-O-benzoyl-3, 6-di-O-benzyl-2, 4-di-p-toluenesulfonate 7. The resistance to displacement of the sulfonate groups in 7 prevented conversion of 7 into an intermediate for the synthesis of aminoglycoside antibiotics. Monobenzylation of 1, followed by an oxidation-reduction cycle, yielded 6-O-benzyl-1, 2:4, 5-di-O-isopropylidene-epi-inositol (10). From this was synthesized a series of epi-inositol derivatives, analogous to the muco series but less complete. For derivatives of 1, 2:5, 6-di-O-isopropylidene-epi- and muco-inositol, the p. m. r. data indicate modified skew conformations. The reaction of the 3, 6-di-p-bromobenzenesulfonate (17) of 1 with anhydrous hydrazine proceeded in part by S-O cleavage to regenerate 1, and in part by displacement of both sulfonate groups by the same nitrogen atom. The resulting, novel 1, 4-epimino-cis-inositol was converted into further derivatives.