Learning to Observe Relationships and Coping

Milieu relationships provide the critical background presence to staff's attempts to motivate, regulate, and teach patients how to cope with stress. Forging a connection with hospitalized children and adolescents demands attention to how they respond to adults and engage with staff around milieu expectations. Assessment guides that deal with these issues are presented. Important aspects of children's relatedness are presented in the context of their working models of adults and the influence of these representations on their response to staff. Coping skills are explained with particular emphasis on behavioral coping strategies. Tied to the assessment process are interventions that emphasize staff's role in helping patients manage strong affects and avoid the use of nonproductive behavior regulation strategies.     

Follistatin and activin A production by the male reproductive tract

Follistatin is a binding protein for the activin and inhibin family of hormones, regulating their biological activity. In the male reproductive tract, the interaction of these factors is likely to be involved in the regulation of the proliferation of several cell types. We have investigated the presence of follistatin and activin A in seminal plasma using specific immunoassays and have localized follistatin and activin/inhibin subunits in the adult human testis, prostate and seminal vesicle to establish their likely sources. High concentrations of immunoreactive follistatin were present in seminal plasma in normal men (mean 97.9 ng/ml; 1.43 ng/ml in peripheral plasma) and were similar in men with oligo/azoospermia and following vasectomy. Follistatin immunoreactivity was localized to both Leydig and Sertoli cells of the testis, and to epithelial cells of the prostate gland and seminal vesicle, which are likely to be the predominant sources of the hormone in seminal plasma. Activin A was also present in seminal plasma in normal men but was undetectable following vasectomy, thus deriving from the testis. Consistent with this finding, the betaA-subunit was immunolocalized in Sertoli and Leydig cells but was not present in seminal vesicle or prostate gland. The functional significance of the high concentrations of follistatin secreted into seminal plasma by the prostate gland and/or seminal vesicle is uncertain, but they may regulate the biological activity of testis-derived activin A and inhibin B.      

Endothelins: potent releasers of prostacyclin and EDRF

The isopeptides endothelin-1 (ET-1) and endothelin-3 (ET-3) are potent vasoconstrictor substances in pithed or chemically-denervated rats. However, when injected into anesthetized rats with a high resting blood pressure, these peptides have vasodepressor actions. In addition, the pressor effects were potentiated by indomethacin indicating that release of endogenous eicosanoids modulated the pressor responses. Endothelin-1 released eicosanoids from a number of perfused isolated organ preparations. Prostacyclin and thromboxane A2 were released from perfused guinea-pig lungs, prostaglandin E2, prostacyclin and thromboxane A2 from rabbit spleen and prostacyclin and thromboxane A2 from rabbit kidneys. The eicosanoids were identified both by bioassay and by radioimmunoassay. Injection of ET-1 or ET-3 into the mesenteric artery of the rat isolated perfused mesentery preparation caused dose-related reductions in perfusion pressure. These depressor effects could be abolished by removing the endothelium with deoxycholate or by perfusing with oxyhaemoglobin, indicating that they were caused by release of EDRF. Endothelin-1 also released EDRF, identified by bioassay, from the endothelium of a perfused rabbit aorta. Endothelin-1 and ET-3 injected into anesthetized rabbits inhibited ex vivo platelet aggregation by increasing cyclic AMP, presumably through the release of prostacyclin into the circulation. Thus, endothelins release prostacyclin and EDRF both in vitro and in vivo.