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.

Deposition of rate of metallic Ag on ivory and enamel

The influence of various process parameters on the chemical deposition of Ag on ivory and enamel was investigated. Both AgN03 and AgF were used with various chemical reducing agents at temperatures from 7°C to 37°C. The authors evaluated the amount of adherent silver as a function of these variables.

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.

Determination of urinary mandelic and phenylglyoxylic acids in styrene exposed workers and a control population

Styrene is rapidly metabolized in humans to mandelic () and phenylglyoxylic acids (P) which are excreted in urine. The present study investigates a gas chromatographic technique for measuring urinary concentrations of MA and PGA of workers exposed to styrene, compares the urinary concentrations of metabolites with time-weighted average air exposures to styrene and determines the levels of these metabolites in a population of workers not exposed to styrene. Post-shift urine specimens were obtained from a group of workers exposed to styrene in the reinforced plastic industry and from a control group. High positive correlation was found between post-shift urinary concentrations of metabolites and 8-hour TWA styrene exposure. Both MA and total metabolites (MA + PGA) gave correlation coefficient values of 0.96, p less than 0.0001. The mean MA excretion for the control groups was 6 mg/L. Determination of the concentration of these metabolites in a post-shift urine provides an effective means of estimating and monitoring human exposure to styrene.

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.

The long-term effectiveness of interpersonal skills training in medical schools

To determine the effectiveness of teaching interpersonal skills (IPS) in medical school, the authors evaluated interview behaviors of 46 general internal medicine interns and residents from 24 schools. Measures of interview skills included three independent videotape ratings of actual patient interviews. Telephone and mail interview forms assessed the quality of interpersonal skills training provided by each medical school. House officers receiving IPS training did not perform significantly better than nontrained colleagues on any of 12 parameters. However, when IPS training was divided into high and low categories based on comprehensiveness of training, house officers receiving the more comprehensive courses demonstrated greater use of openended questions and emotion-related responses. Implications of these findings are discussed.

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.