RESUMO
In addition to being a risk factor for the course of chronic pain, the personality characteristics of the individual attachment style are also predictors for the success of medical and psychosocial interventions and aspects of the physician-patient relationship. Insecurely attached patients seem to be less able to sustain the positive effects of pain therapy. These results are especially relevant as insecure attachment patterns are overrepresented among chronic pain patients. As a result the attachment style can be seen as a psychosocial vulnerability factor for the chronification of acute pain.
Assuntos
Dor Crônica/psicologia , Transtorno Reativo de Vinculação na Infância/psicologia , Transtornos Somatoformes/psicologia , Catastrofização/psicologia , Catastrofização/terapia , Dor Crônica/terapia , Transtorno Depressivo/psicologia , Transtorno Depressivo/terapia , Humanos , Manejo da Dor/psicologia , Relações Médico-Paciente , Transtorno Reativo de Vinculação na Infância/terapia , Transtornos Somatoformes/terapia , Resultado do TratamentoRESUMO
Nucleolin functions in ribosome biogenesis and contains an acidic N terminus that binds nuclear localization sequences. In previous work we showed that human nucleolin associates with the N-terminal region of human topoisomerase I (Top1). We have now mapped the topoisomerase I interaction domain of nucleolin to the N-terminal 225 amino acids. We also show that the Saccharomyces cerevisiae nucleolin ortholog, Nsr1p, physically interacts with yeast topoisomerase I, yTop1p. Studies of isogenic NSR1(+) and Deltansr1 strains indicate that NSR1 is important in determining the cellular localization of yTop1p. Moreover, deletion of NSR1 reduces sensitivity to camptothecin, an antineoplastic topoisomerase I inhibitor. By contrast, Deltansr1 cells are hypersensitive to the topoisomerase II-targeting drug amsacrine. These findings indicate that nucleolin/Nsr1 is involved in the cellular localization of Top1 and that this localization may be important in determining sensitivity to drugs that target topoisomerases.
Assuntos
DNA Topoisomerases Tipo I/metabolismo , Proteínas Fúngicas/metabolismo , Proteínas Nucleares , Proteínas de Ligação a RNA , Proteínas de Saccharomyces cerevisiae , Saccharomyces cerevisiae/enzimologia , Saccharomyces cerevisiae/metabolismo , Amsacrina/farmacologia , Antineoplásicos/farmacologia , Camptotecina/farmacologia , Divisão Celular/genética , DNA Topoisomerases Tipo II/metabolismo , Resistência Microbiana a Medicamentos/genética , Proteínas Fúngicas/química , Proteínas Fúngicas/genética , Humanos , Testes de Sensibilidade Microbiana , Microscopia de Fluorescência , Mutação , Ligação Proteica , Estrutura Terciária de Proteína , Transporte Proteico , Proteínas Recombinantes de Fusão/metabolismo , Saccharomyces cerevisiae/genética , Frações Subcelulares/química , Inibidores da Topoisomerase I , Inibidores da Topoisomerase II , Transformação GenéticaRESUMO
HISTORY AND CLINICAL FINDINGS: A 35-year-old man, for 6 years known to have non-Hodgkin lymphoma (NHL) was admitted because of deteriorating general condition, drowsiness and 11 days of flu-like symptoms. A generalized rash had been noted 5 days after onset of symptoms. His 2-year-old son had fallen ill with measles a few days earlier. The patient had reportedly had measles as a child. On admission a generalized rash was found, he had a fever of 40.5 degrees C, tachypnoea, conjunctivitis and possible meningismus. INVESTIGATIONS: Lactate dehydrogenase activity was raised to 458 U/ml, and C-reactive protein to 240 mg/ml. Cerebrospinal fluid contained 8/3 cells and protein of 269 mg/l. The chest radiogram revealed opacification in the left upper lobe. Computed tomography of the skull demonstrated a pansinusitis. DIAGNOSIS, TREATMENT AND COURSE: As measles encephalitis seemed unlikely he was treated for the measles superinfection of bacterial pneumonitis (measles RNA in the bronchoalveolar lavage) and the sinusitis with broad-spectrum antibiotics. After initial improvement artificial ventilation had to be be gun on day 3 because of an acute respiratory distress syndrome, diagnosed both clinically and radiologically. Despite additional antiviral and intensive medical treatment he died on day 11. CONCLUSION: Patients with impaired immunocompetence due to NHL may lose their immunological "memory" for a previous measles infection. Prevention of exposure may therefore be necessary, in addition to early hyperimmunoglobulin administration.
Assuntos
Hospedeiro Imunocomprometido , Leucemia Linfocítica Crônica de Células B/complicações , Sarampo/complicações , Adulto , Conjuntivite/etiologia , Encefalite Viral/etiologia , Evolução Fatal , Humanos , Memória Imunológica/imunologia , Leucemia Linfocítica Crônica de Células B/imunologia , Masculino , Sarampo/imunologia , Pneumonia Bacteriana/etiologia , Síndrome do Desconforto Respiratório/etiologia , Sinusite/etiologia , Superinfecção/etiologiaRESUMO
71 surgically removed pituitary adenomas with amyloid deposits were studied by light microscopical and immunohistological means. In none of the adenomas was there a predominance of amyloid deposits. There were no correlations between the extent or pattern of the deposits with either age, immunohistological hormone content or localization. Our results do not support either of the theories about the origin of amyloid--whether mesenchymal or produced by adenoma cells--in pituitary adenomas.
