16 research outputs found
Expression of c-FLIP(L) and resistance to CD95-mediated apoptosis of monocyte-derived dendritic cells: inhibition by bisindolylmaleimide.
To gain insight into the mechanisms controlling apoptosis of dendritic cells (DC), human monocyte-derived DC were analyzed for their expression of CD95 (Fas/Apo-1) and their response to CD95 ligation. Although DC expressed the CD95 molecule on their membrane, they did not undergo apoptosis on CD95 ligation unless sensitized by cycloheximide. In parallel, DC synthesized c-FLIP(L), an inhibitor of the CD95-mediated death-signaling cascade. We also demonstrated that bisindolylmaleimide down-regulates c-FLIP(L) expression in DC and, in parallel, allows CD95-mediated apoptosis in these cells. In contrast, Bcl-2, Bcl-x(L), and Bax levels were not affected by bisindolylmaleimide. We conclude that DC resist CD95- mediated apoptosis in association with c-FLIP(L) expression and that the immunosuppressive potential of bisindolylmaleimide previously observed at the T-cell level also involves facilitation of CD95-mediated DC apoptosis.Journal ArticleResearch Support, Non-U.S. Gov'tinfo:eu-repo/semantics/publishe
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The Bad-Mad Dilemma for Public Psychiatry
Last September at St. Patrick’s Cathedral in New York City, a chronic mentally ill man bludgeoned an usher to death and injured a policeman before being killed by the police. This tragic incident underscores the dilemma faced by public psychiatry in its efforts to help seriously mentally ill individuals who are prone to violence while protecting their rights and the safety of the public. Once again, the media and the public questioned the mental health system’s ability to protect society from dangerous mentally ill persons. The news media traced the odyssey of the deranged man through numerous incarcerations and hospitalizations following violent actions. Certainly, monitoring of high-risk mentally ill patients is seriously handicapped by their continuous migration between the criminal justice and mental health systems. In New York City, as in other parts of the nation, these systems do not communicate with each other and are overwhelmed by an unprecedented number of inmates and patients. Police officers are permitted great discretion in their handling of socially disruptive people. As a result of the overcrowding in th
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Treating Substance Abusers: Why Therapists Fail
Can mental health professionals treat the substance abuser? Sadly, the answer may be no. Addiction treatment is becoming an area of specialized expertise. Mainstream mental health clinicians have not yet addressed their responsibilities in this area, even though addictive illness is the most common psychiatric disorder. Relatively few therapists are experienced in offering proper care to addicted persons. Instead of setting abstinence as the goal, many engage the patient in exploratory therapy, hoping that a resolution of his internal conflict or social stress will end his substance abuse. Others may refuse to provide treatment, telling the patient to find alternative care and to return when the addiction problem has been resolved. Neither approach plays a meaningful role in securing the patient’s abstinence and subsequent rehabilitation. There are, however, a variety of techniques currently available to help substance abusers achieve abstinence. Clinicians can work closely and supportively with addicted patients while they become integrated into a self-help group such as Alcoholics Anonymous. They can engage the family and social network in conjoint therapy to initiate and maintain abstinence and even to monitor disulfiram administration. They can adopt active interventions as necessary to ensure the integrity of the treatment, just as they do in treating a psychotic illness, in which denial is also a prominent feature. Why do so many clinicians fail to apply these approaches? Few of them have had formal training in treating substance abusers, in contrast to their broad experience in the care of depressed, neurotic, or schizophrenic patients. The die is cast during their professional training, even though they generally have some exposure to such patients. Ironically this exposure actually detracts from training in the care of substance abusers. The emergency room serves as a training ground for rapid r
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Who Profits From Deinstitutionalization
Deinstitutionalization, a euphemism for the massive and unplanned emptying of state psychiatric hospitals nationwide, has resulted in a reduction in the daily patient census from about 560,000 in 1955 t