The limits and power of psychotherapy: a critical reading

The psychotherapy has been founded as "scientific" discipline since the separation from philosophy and mainly religion. During the last two decades, the increasing frequency of groups that hide sectarian and religious aims behind the psychotherapy denomination, forces two tasks. On one hand we must propose the foundations of the psychotherapeutic process and the methods to evaluate its effects. On the other hand we must highlight that in these groups some procedures and behaviours are the opposit of the psychotherapy principles. In such cases we can talk of "denied psychotherapy".     

Keratin 15 expression in stratified epithelia: downregulation in activated keratinocytes

Keratin 15 (K15) is a type I keratin without a defined type II partner whose expression in epidermal diseases has not been investigated. In this study we have used LHK15, a monoclonal antibody raised against the last 17 amino acids of the K15 polypeptide, to show that K15 is expressed primarily in the basal keratinocytes of stratified tissues, including the fetal epidermis and fetal nail. Although K15 in normal hair follicles was virtually absent from hair bulbs, it was expressed by a subset of keratinocytes in the outer root sheath. By comparison, K14 expression was found throughout the outer root sheath of hair follicles; however, when both K14 alleles were naturally ablated, the expression of K15 was also observed throughout the outer root sheath of the follicles. Expression of K15 mRNA was assessed by in situ hybridization and corroborated the data from immunostaining. An increase in K15 mRNA and protein expression in hair follicles from the K14 ablated epidermis suggested an upregulation of the K15 gene in the absence of the K14 protein. In organotypical cultures where differentiating keratinocytes expressed markers of activated phenotype, i.e., K6 and K16, expression of K15 was undetectable. The expression of K15 mRNA and protein was also downregulated in two hyperproliferating situations, psoriasis and hypertrophic scars. Because keratinocytes in psoriasis and hypertrophic scars are activated, we conclude that K15 expression is not compatible with keratinocyte activation and the K15 gene is downregulated to maintain the activated phenotype.     

Neurologic aspects of microcephalic osteodysplastic primordial dwarfism type II

Microcephalic osteodysplastic primordial dwarfism type II is a specific disorder characterized by severe intrauterine and postnatal growth retardation, acquired microcephaly, cerebrovascular abnormalities, progressive bone dysplasia, and a characteristic face. Whereas the diagnostic features of this syndrome are well-recognized, the neurologic aspects have not been clearly defined. We report on a detailed neurodevelopmental follow-up study of a new case of microcephalic osteodysplastic primordial dwarfism type II, followed from the first years of life to adolescence, and we discuss the neurocognitive features of our patient. We also review the neurologic aspects of this disorder compared with syndromes with overlapping phenotypes, such as microcephalic osteodysplastic primordial dwarfism types I and III and Seckel syndrome.     

Ultrastructural localization of nicotinamide adenine dinucleotide phosphatase (NADPase), thiamine pyrophosphatase (TPPase), and cytidine monophosphatase (CMPase) in the Golgi apparatus of early spermatids of the rat

At the early steps 3-7 of spermiogenesis the hemispherical Golgi apparatus elaborates and is closely associated to the acrosomic system which grows at the surface of the spermatid's nucleus. It shows two distinct zones, a cortex made up of flattened saccules and related membranous tubules, and a medulla containing various types of vesicular profiles. The various components of the cortex of the Golgi apparatus were tested for their reactivity to three phosphatases. Nicotinamide adenine dinucleotide phosphatase activity (NADPase, Smith, 1980) was observed in the middle two to six saccules in the stack with a midsaccule being more reactive than the saccules above and below. A weak and spotty reaction was also noted in the remaining saccules on the trans-face of the stack and in the thick elements making up the GERL on the trans aspect of the stacks of saccules. Thiamine pyrophosphatase activity (TPPase, Novikoff and Goldfisher, 1961) was found in one or two saccules on the trans-face of the stacks but was absent from the other Golgi components. Cytidine monophosphatase activity (CMPase, Novikoff, 1967) was observed in the GERL, in vesicles of the medulla and in the developing acrosomic system. In the intersaccular regions of the cortex the branching membranous tubules showed the same reactivity for the phosphatases to that of the saccules to which they are connected. ER cisternae associated with the Golgi apparatus, anastomotic membranous tubules seen in the peripheral Golgi region, small vesicles, as well as the first saccule on the cis-face of the stacks were all negative for the three enzymes studied. These data indicated that in the cortex of the Golgi apparatus there were several distinct compartments that could be distinguished on the basis of structural and cytochemical features.     

Suppression of KATP currents by gene transfer of a dominant negative Kir6.2 construct

 Cardiac ATP-sensitive K⁺ (K_ATP) channels (SUR2A plus Kir6.2) couple the metabolic state of the myocyte to its electrical activity via a mechanism that is not well understood. Recent pharmacological evidence suggests that K_ATP channels may mediate ischemic preconditioning. However, there is no potent pharmaceutical agent that specifically blocks the sarcolemmal K_ATP channel without significant effects on other cellular proteins. As a molecular tool, the GFG sequence in the H5 loop of the murine Kir6.2 channel was mutated to AFA. This mutated channel subunit (6.2AFA) suppressed wild-type Kir6.2 (6.2WT) channel current in a dominant-negative manner: when co-expressed with SUR2A and 6.2WT, whole-cell K_ATP current recorded from HEK cells was greatly attenuated. The 6.2AFA subunit also co-assembled with endogenous subunits in both smooth-muscle-derived A10 cells and rat neonatal ventricular myocytes, resulting in a significant reduction of current compared with that recorded from non-transfected or mock-transfected cells (<15% of control for both cell types). This study shows that mutation of GFG→AFA in the putative pore-forming region of Kir6.2 acts in a dominant-negative manner to suppress current in heterologous systems and in native cells. Received: 22 June 1998 / Received after revision: 16 July 1998 / Accepted: 17 July 1998     

Serum amyloid A protein concentration in bone marrow transplantation for beta thalassaemia.

AIMS: To investigate whether serum amyloid A protein (SAA) and C-reactive protein (CRP) concentrations could be used in the management of beta thalassaemic patients undergoing bone marrow transplantation (BMT). METHODS: Serum SAA and CRP concentrations were determined in paired samples from 66 patients with beta thalassaemia before and after BMT. Serum SAA concentrations were determined by an enzyme linked immunoassay (EIA); serum CRP concentrations were determined by a nephelometric assay. RESULTS: Serum SAA concentrations before transplantation were significantly higher in the group that subsequently rejected the transplant than the group without complications. SAA concentrations increased after BMT in acute graft versus host disease (GvHD) and rejection. No significant increase in SAA or CRP was found in chronic GvHD. Increases in serum in SAA and CRP concentrations were not related to concomitant infection episodes. CONCLUSIONS: The different acute phase response in acute GvHD and rejection compared with chronic GvHD suggests that different immunopathogenic mechanisms are responsible.     

A cytochemical study of the Golgi apparatus of the spermatid during spermiogenesis in the rat

The reactivity of the various components of the Golgi apparatus of rat spermatids for three phosphatase activities (nicotinamide adenine dinucleotide phosphatase, NADPase; thiamine pyrophosphatase, TPPase; cytidine monophosphatase, CMPase) and the incorporation of ³H-fucose by the spermatids was analyzed at the 19 steps of spermiogenesis, i.e., during and after this organelle elaborated the glycoprotein-rich acrosomic system. During steps 1–3, the Golgi apparatus produced, in addition to the proacrosomic granules, multivesicular bodies that became associated with the chromatoid body. NADPase was located within the four or five intermediate saccules of Golgi stacks, and TPPase was found in the last one or two saccules on the trans aspect of the stacks from steps 1 to 17 of spermiogenesis. CMPase was located within the thick saccular GERL elements found in the trans region of the Golgi apparatus from steps 1 to 7 of spermiogenesis, but the CMPase-positive GERL disappeared from the Golgi apparatus after its detachment from the acrosomic system at step 8. The acrosomic system itself was reactive for CMPase and TPPase but was negative for NADPase, while the multivesicular bodies were CMPase and NADPase positive but unreactive for TPPase. Tritiated-fucose was readily incorporated within the Golgi apparatus of steps 1–17 spermatids; in steps 1–7 it was subsequently incorporated within the acrosomic system and multivesicular bodies. These various data indicated (1) that the Golgi apparatus of spermatids, although it loses its CMPase-positive GERL element in step 8, retains evidence of functional capacity until it degenerates in step 17; (2) that in early spermatids the various saccular components of the Golgi are specialized with respect to enzymatic activities; and (3) that each Golgi region may contribute in a coordinated fashion to the formation of the acrosomic system and multivesicular bodies.