Developmental expression of catenins and associated proteins during submucosal gland morphogenesis in the airway.

Although lymphoid enhancer binding factor-1 (Lef-1) plays an obligatory role in airway submucosal gland (SMG) development, its expression alone is not an adequate signal for initiating gland morphogenesis. Because Lef-1 forms a bipartite transcription factor with beta-catenin to mediate wnt pathway signaling, we investigated the expression of beta-catenin and associated proteins during SMG development with both in situ hybridization and immunocytochemistry. Unexpectedly, high levels of E-cadherin mRNA were expressed by cells in developing gland buds from the earliest stages through subsequent differentiation into mature glands. In contrast, a decreased level of E-cadherin immunoreactivity in stage I gland bud cells suggested that post-translational modulation of E-cadherin protein levels may play a critical role in early stages of gland morphogenesis. Adenomatous polyposis coli (APC) mRNA was expressed relatively weakly in the developing ferret trachea, but higher levels of protein staining were observed throughout the cytoplasm of gland buds and surface epithelial cells. B-Catenin mRNA was abundantly expressed throughout the tracheal epithelium and at the highest levels in primordial gland buds. B-Catenin protein localized to the basolateral membranes of all airway epithelial cell types. However, no detectable increases in nuclear or cytoplasmic staining were associated with gland buds, as would be expected if beta-catenin served as a transcriptional cofactor for Lef-1 in gland morphogenesis. Additional studies demonstrated the gamma-catenin distribution to be remarkably similar to that of beta-catenin, whereas alpha-catenin staining was more diffuse in the cytoplasm of airway epithelial and gland bud cells. These descriptive results do not rule out a role for wnt signaling in SMG development , but provide no evidence that beta-catenin, or gamma-catenin, is a cofactor in Lef-1 regulation of SMG development.

Denial of pregnancy and childbirth.

Pregnancy is seen as a period of psychological maturation during which old conflicts related to sexuality, aggression, dependency, autonomy and motherhood are rekindled and old solutions reworked. Anxiety associated with these conflicts may threaten to overwhelm the pregnant woman's ability to cope in an adaptive fashion and may result in the denial of pregnancy as a defense. Denial and rationalization of symptoms and denial of pregnancy may result in inadequate behavioural responses at the time of childbirth, and may result in the death of the newborn. The denial may also extend to the patient's social network and may continue through the post-partum period. The strength of the denial may be so great as to thwart attempts at psychotherapeutic intervention.