A Study of a ‘Transactional’ Psychotherapy

This study investigated the extent of posttraumatic stress disorder (PTSD) and psychiatric comorbidity among the 2010 flood victims in Pakistan and its relationship with disaster exposure characteristics, cognitive distortions, and emotional suppression. One hundred and thirty-one (F = 89, M = 42) flood victims were assessed using the Posttraumatic Diagnostic Scale, the General Health Questionnaire-28, the Cognitive Distortion Scales, and the Courtauld Emotional Control Scale. The results showed that all victims met the diagnostic criteria for PTSD and scored above the cut-off for psychiatric caseness. Partial least squares modelling showed that disaster exposure characteristics were significantly correlated with PTSD and psychiatric comorbidity. Disaster exposure characteristics were also significantly associated with cognitive distortions which in turn were also significantly associated with PTSD and psychiatric comorbidity. Cognitive distortions were also correlated with emotional suppression which, however, was not associated with PTSD or psychiatric comorbidity. To conclude, the flood victims reported PTSD and psychiatric comorbid symptoms which were related to their subjective exposure to the flood. Such exposure led to the development of dysfunctional thinking patterns which in turn influenced distress symptoms.     

THE THEORY OF THE BASIC ASSUMPTION OF INCOHESION: AGGREGATION/MASSIFICATION OR (BA) I:A/M

Presented in honour of Dr Estela Welldon as a friend and colleague, and in acknowledgement of her contributions to forensic psychotherapy and group analysis for people who suffer from extreme anxieties associated with confused sex and gender identifications and choices, sado-masochism and criminality, this article integrates Bionian and Foulkesian perspectives in group analysis by conceptualizing a fourth basic assumption in the unconscious life of social systems. The basic assumption of Incohesion: Aggregation/Massification or (ba) I:A/M is derived from a relational rather than an instinctual metapsychology, and assumes that helplessness and the fear of annihilation precede the emergence of envy, thus emphasizing the importance of traumatogenic processes. Traumatized people with crustacean and amoeboid defences/protections against the fear of annihilation are likely to personify aggregation and massification processes, respectively. This theory can be applied in the group treatments of our most disturbed patients, and in understanding the dynamics of traumatized social systems, ranging from families to organizations and even societies.     

Etoposide protein binding in cancer patients

The protein binding of etoposide was studied in vivo in 36 cancer patients receiving etoposide therapy. Free etoposide was separated from plasma using an ultrafiltration method and the etoposide concentrations (free and total) were measured by high-performance liquid chromatography (HPLC). Considerable interpatient variation in the protein binding of etoposide was observed. The protein binding of etoposide varied from 80% to 97% (mean, 93%). Univariate analysis showed a significant inverse correlation between the free fraction of etoposide and serum albumin (r=–0.74), daily dose (r=–0.37) and age (r=–0.34). Multivariate analysis demonstrated that serum albumin and age were independent predictors of the etoposide free fraction. Serum bilirubin showed no correlation with etoposide protein binding. There is wide variation in etoposide protein binding in cancer patients, which is mostly dependent on serum albumin concentration.     

The expression of major histocompatibility complex antigens by trophoblast in ectopic tubal pregnancy

The reactivity of the various trophoblast populations found in ectopic fallopian tube pregnancy with established trophoblast-reactive markers and monoclonal antibodies to MHC antigens has been studied. In ectopic tubal pregnancy fetal trophoblast shows an identical reaction pattern with these antibodies to that seen in intrauterine pregnancy, suggesting that ectopic implantation is not related to an inherent immunological abnormality of fetal trophoblast. However, from this and other studies, it appears that extravillous trophoblast displays an unusual class I MHC antigenic structure. This observation may explain the ability of class I MHC--bearing fetal trophoblast--to survive both in the uterus and at an abnormal implantation site.     

Immunohistochemical characterisation of trophoblast antigens and secretory products in ectopic tubal pregnancy

Fetal trophoblast populations in ectopic fallopian tube pregnancy have been characterised using immunohistochemical techniques. The distribution of trophoblast membrane antigens, low molecular weight epithelial cytokeratins, epithelial membrane antigen, human chorionic gonadotrophin, human placental lactogen, and pregnancy-specific beta 1-glycoprotein in ectopic tubal pregnancy appears similar to that reported in normal early intrauterine pregnancy. These findings emphasise the potential importance of ectopic pregnancy in the study of human gestation.     

Diagnosis of intrapericardial tumor in an infant by two-dimensional echocardiography

Summary Two-dimensional echocardiography is a useful noninvasive tool for diagnosing intrapericardial tumors as a cause of respiratory distress or abnormal cardiomediastinal shadow on chest x-ray. Early recognition of these tumors within the pericardium is important since surgical removal is often curative. Cardiac cineangiography is unnecessary to delineate further the tumor and should be reserved for those in which associated intracardiac defects are suspected.     

Conventional versus epineural sleeve neurorrhaphy technique: functional and histomorphometric analysis

Three methods of nerve repair involving the epineural sleeve technique were compared with conventional nerve repair using the rat sciatic nerve transection model in four groups. In group 1, the sciatic nerve was repaired using the conventional epineural technique by placing four sutures. In groups 2, 3, and 4, the epineural sleeve technique was combined with two sutures, fibrin glue, and two sutures with fibrin glue, respectively. Functional recovery was evaluated using walking track analysis, limb circumference, and the severity of toe contracture. Diameter of the sciatic nerve fibers, total number of myelinated fibers, diameter of the myelin sheath, and the axon-to-fiber diameter ratio were measured at 12 weeks. The results showed better functional recovery as well as a higher number of myelinated fibers in groups using the epineural sleeve technique compared with conventional technique ( < 0.05). The addition of fibrin glue, however, did not make any significant difference. The epineural sleeve technique was found to be superior when compared with conventional nerve repair, providing faster functional recovery and improved nerve regeneration.