Diphtheria toxin binds to the epidermal growth factor (EGF)-like domain of human heparin-binding EGF-like growth factor/diphtheria toxin receptor and inhibits specifically its mitogenic activity

The membrane anchored form of human heparin-binding epidermal growth factor-like growth factor (HB-EGF) acts as the diphtheria toxin (DT) receptor. Transfection of human HB-EGF cDNA into mouse LC cells, L cells stably expressing DRAP27, conferred sensitivity to DT, but transfection of mouse HB-EGF cDNA did not. To define the essential regions of HB-EGF that serve as the functional DT receptor, we examined the sensitivity to DT and DT binding of cells expressing several human/mouse HB-EGF chimeras. It was found that DT binds to the EGF-like domain of the human HB-EGF. However, mouse HB-EGF does not serve as a functional DT receptor due to non-conserved amino acid substitutions in this domain. In addition, CRM197, a non-toxic mutant of DT, inhibited strongly the mitogenic activity of the secreted form of human HB-EGF, but not of mouse HB-EGF and other EGF receptor-binding growth factors. These results confirmed further that DT interacts with the EGF-like domain of HB-EGF and that this interaction is specific for human HB-EGF.     

Getting the picture: The use of imagery to clarify therapeutic impasses.

Contends that imagery can be used to disclose the nature of the client–therapist relationship and to resolve therapeutic impasses. The most common forms of impasses in the relationship are the result of therapist's misperceptions, the pacing of therapy dealing with acting-out behavior, difficulties induced by transference and countertransference, and difficulties in making alliances with severely disturbed patients. To uncover latent images in the therapist–client interaction, therapists imagine a metaphoric meeting place with a client, what they become to each other there or what other forms they take, the activity both might be engaged in, what a dance between the 2 might look like, what might be done differently, and what translations can be made from the imaginal to the actual therapeutic relationship. Case illustrations with 4 female and 2 male clients are given. It is suggested that images clarify the symbolic and affective elements of the internal world. (45 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Ethics in hospice care.

Discusses 4 ethical issues that arise in hospice care: (1) What are the ethical responsibilities to the patient, family, and authorities when hospice workers discover that a patient has been given incompetent and shoddy care at a previous institution? (2) Hospices that advertise themselves as offering complete care should be prepared to deal with psychological and legal issues as well as medical ones. (3) The idea of treating the entire person must include responding to the likelihood that the patient and family may raise profound philosophical and religious questions. (4) Hospice staff should periodically examine themselves on a spiritual or philosophical level. (3 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)