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8040624
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[Management of the uterine endometrial cancer cases whose cytological and histologic specimens cannot be obtained from the uterine cavity--assessment by CA125 or vaginal ultrasonography].
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An examination for endometrial cancer has been done by cytology. However, cytology is sometimes not possible because of closed or narrow cervix of postmenopausal woman. We did a retrospective study regarding the usefulness of CA125 or transvaginal ultrasonography in postmenopausal cases. The mean +/- S.D. of CA125 in normal menopausal women was 10.3 +/- 3.0 U/ml. The value of mean +/- 2S.D., the finding of Relative Operating Characteristic curve and the purpose that false positive was 0%, so we set 17 U/ml as the cut off value for CA125. In 46 cases with postmenopausal endometrial carcinoma, 23 cases were screened; and in 30 cases with surgical stage I, 10 cases were screened with this cut off value. The echoic patterns for uterine cavities which were observed by transvaginal ultrasonography were divided into 4 patterns (type I: anechoic pattern, type II: linear pattern, type III: clear mass pattern, type IV: unclear mass pattern). In 20 cases with postmenopausal endometrial cancer, 19 cases had type III or IV. In 41 normal postmenopausal women, 26 cases showed an anechoic pattern and 14 cases showed a linear pattern. It was found that 97.5% of cases with anechoic or linear patterns were normal endometrium. The screening by transvaginal ultrasonography was more useful than CA125. However CA125 was more useful than transvaginal ultrasonography in detecting lymph node metastasis.
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8040623
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[The factors involved in invasive ability of endometrial carcinoma cells].
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The in vitro invasive ability, the expression of cell adhesion molecule E-cadherin, activity of matrix metalloproteinase (MMP) and K-ras point mutation were investigated in eight human endometrial carcinoma cell lines. 1) In vitro invasive abilities of endometrial carcinoma cell lines depend on the degree of cell differentiation and the origin of cell lines. A poorly-differentiated carcinoma cell line (NUE-1) and a cell line derived from metastatic lymph node (SNG-M) were more invasive than moderately-(HEC-1A, HEC-1BE) and well-differentiated (HEC-6, Ishikawa) cell lines. 2) Immunohistochemically, less or non-invasive cell lines expressed E-cadherin strongly, whereas a highly invasive cell line (NUE-1) expressed E-cadherin weakly. 3) When cultured on Matrigel-coated dishes, the tumor cells derived from moderately- and well-differentiated carcinoma aggregated with each other and did not invade Matrigel in the invasion assay. The aggregated cells expressed E-cadherin more strongly when cultured on Matrigel. 4) 72-kD gelatinase (MMP-2) was secreted in serum-free conditioned medium of all cell lines. In an invasive cell line (NUE-1,SNG-M), the activity of MMP-2 was stronger than in other cell lines. And the activity of 92-kDa gelatinase (MMP-9) was detected in most invasive cell line (NUE-1). 5) Point mutation of K-ras codon 12 was detected in four of eight (50%) cell lines by the PCR-RFLP method. The changes in the DNA sequence were identified, but K-ras point mutation was not correlated with in vitro invasiveness of the tumor cells.
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8040622
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[Maternal working status and low birthweight: findings from a cohort study].
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To explore possible associations of maternal working status with birthweight, a cohort study was conducted from July, 1989 to June, 1991 in 8 general hospitals in the Tokai district. Using a self-administered questionnaire, data on job employment were collected mostly in the first or second trimester. Information on delivery outcome was recorded by doctors, midwives or nurses after child birth. Included in this analysis were 1,360 pregnants who delivered a live singleton without major malformations at gestation of 37 weeks or more. The following major findings emerged. (1) No significant difference in mean birthweight was detected between working and non-working pregnants. (2) Working pregnants were at greater risk of delivering a low birthweight (< 2,500g) baby. (3) Delivery of a low birthweight baby was more frequent in multiparous than nulliparous mothers. (4) The risks of delivering a low birthweight baby significantly differed according to the maternal working status. (5) These results suggest that not only the maternal working factor itself but the working status should be deliberately taken into consideration in order to provide proper prenatal care.
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8040621
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[Recent status of group B streptococcal (GBS) infection of newborn in Japan].
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Group B streptococcal (GBS) infections in neonates have been a leading cause of bacterial infections. In many cases the infected neonates and young infants died or sequelae remained. The trend of cases, risk factors and prognosis of this disease have been the subjects of questionnaires for the past 5 years in Japan. The number of cases has increased year by year. Risk factors including amniotic turbidity, chorioamnionitis, premature rupture of membrane and fever during labor were recognized in 58% of early onset (less than 7 days of age) and in 28% of late onset (7 days and more of age) infant disease. Cases of death and remaining sequelae were 63(20.8%) of 303 early onset, 27(39.1%) of 69 late onset and 90(24.2%) out of a total of 372 cases. These results suggested that strategies for the prevention of GBS infections in the newborn are necessary.
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8040620
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[A role of cytokines produced by allostimulated lymphocytes on maintenance of pregnancy--enhancement of trophoblast proliferation and beta-hCG secretion by cytokines].
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The purpose of this study was to elucidate the enhancement of pregnancy maintenance by cytokines produced by allostimulated lymphocytes. Two-way mixed lymphocyte cultures between wife and husband were performed in 20 normal fertile couples and 21 unexplained recurrent aborting couples and the supernatants were harvested. Couples were defined as normally fertile if they had had two or more successful pregnancies. The effects of mixed wife-husband lymphocyte culture supernatant (MLCS) and wife's lymphocyte culture supernatant (LCS) on DNA synthesis and beta-hCG secretion of cultured human trophoblast cells were examined. 1. MLCS of normal fertile couples significantly enhanced DNA synthesis (238.2 +/- 19.9% of control, p < 0.0001) and beta-hCG secretion (190.5 +/- 8.9% of control, p < 0.001) from trophoblast cells. However, MLCS of recurrent aborting couples and LCS of both groups were observed to have no significant effect on trophoblast proliferation or beta-hCG secretion. 2. Concentrations of macrophage colony-stimulating factor (M-CSF), Interleukin (IL)-2 and IL-6 in MLCS and LCS were measured. The mean M-CSF level in MLCS of the normal fertile group was 182.0 +/- 26.1 IU/ml, in contrast, it was not detected in MLCS of recurrent aborting couples or LCS of either group. No significant difference was found between the groups in the IL-2 or IL-6 concentration. 3. Recombinant M-CSF (100 IU/ml, 250 IU/ml) significantly enhanced both DNA synthesis (191.7 +/- 15.7% of control, p < 0.05, 212.2 +/- 8.8% of control, p < 0.05) and beta-hCG secretion (144.8 +/- 13.9% of control, p < 0.02, 197.4 +/- 23.0% of control, p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
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8040619
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[Effects of estrogen and progestin on platelet-activating factor acetylhydrolase].
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Platelet-activating factor (PAF) is one of the potent proinflammatory agents and is associated with a number of human diseases, including asthma, endotoxin shock and cardiovascular diseases. Additionally, plasma PAF acetylhydrolase (PAF-AH) activity to inactivate PAF is regulated by hormones. In this study, we elucidated the effects of estrogen and progestin on plasma PAF-AH and also the effects of PAF on rat tissues to investigate the mechanisms involved in the thrombotic episode. Plasma PAF-AH activity in female adult rats treated with 17 alpha-ethynylestradiol (50 micrograms/kg, 5 days) was decreased by 50%. However, medroxyprogesterone (50 mg/kg, 5 days) increased the enzyme activity by 50%. When PAF (5 to 60 nmol/kg) was injected intravenously into non-treated female adult rats, 80% of the animals died at 20 nmol/kg of PAF. Macroscopic findings showed hemorrhage, hyperemia and congestion in the lungs and heart, and necrosis-like change in the gastrointestines. Microscopically, thrombus was observed in the lungs and heart. When PAF was administered to female adult rats pretreated with sex steroid hormones, the mortality of the rats with low plasma PAF-AH activity caused by estrogen was increased, but decreased in the animals with high enzyme activity caused by progestin. These findings suggest that the imbalance between PAF and plasma PAF-AH is one of the mechanisms involved in the thrombotic episode, and estrogen and progestin are related to the event by regulating the plasma PAF-AH activity.
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8040615
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Characterization of low-temperature (i.e., < 65 degrees C) lipid transitions in human stratum corneum.
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This study aims to characterize human stratum corneum (SC), focusing on those lipid transitions that occur at or below physiologically relevant temperatures. In the past, a lipid transition near 35 degrees C had been thought to be variable and a consequence of superficial sebaceous lipid contamination. However, analysis here indicates that it is widely present, and cannot be attributed to sebum production. We demonstrate that this transition represents a solid-to-fluid phase change for a discrete subset of SC lipids. The reversibility of this transition upon reheating, and its absence in extracted lipid samples imply that these lipids are not uniformly present throughout the SC, but would appear to be differentially distributed in response to terminal differentiation. Further, such an arrangement could involve a close association with other nonlipid (e.g., protein) components. Evidence for a new transition at approximately 55 degrees C is presented that suggests the loss of crystalline orthorhombic lattice structure. The existence of orthorhombic structure at physiologic temperature is reasoned to involve ceramides and/or free fatty acids. Localization of these lipids at the level of the corneocyte envelope supports a comprehensive picture of water transport across the SC, whereby diffusion occurs primarily via the intercellular lipids. This view, coupled with the hydration-induced changes in lipid disorder observed here provides additional insight into the mechanism by which skin occlusion increases permeability. Summarily, these results i) emphasize the inherent danger of over-interpreting experiments with isolated SC lipids, ii) emphasize the potential advantage(s) of employing several biophysical techniques to study SC structure, and iii) indicate that a full characterization of lipid phase behavior is requisite to our eventual understanding of SC structure and permeability function, particularly those phase transitions that occur near or at normal skin temperature.
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8040614
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TGF-beta 1 stimulates expression of keratinocyte integrins during re-epithelialization of cutaneous wounds.
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Epidermal keratinocytes migrate over a provisional matrix during the re-epithelialization of cutaneous wounds. We have investigated the expression of integrins and of transforming growth factor-beta 1 (TGF-beta 1) during re-epithelialization in a porcine model. Tissue specimens were collected at different times after injury and stained with antibodies against subunits of the fibronectin receptor, integrin alpha 5 beta 1, and the vitronectin receptor, integrin alpha v beta 5. Intense staining was observed in the migrating keratinocytes of 5-d wounds; basal and suprabasal cells were stained around the entire cell periphery. Staining returned toward normal levels in 14-d wounds. The appearance of the extracellular form of TGF-beta 1 seemed to be coordinated with the increased expression of integrin subunits: it was detected in migrating keratinocytes and in the adjacent epidermis of early wounds at 5 and 7 d. We also investigated the effect of TGF-beta 1 on cultured epidermal cells. Treating human keratinocytes with TGF-beta 1 increased the levels of mRNA for the integrin subunits alpha 5, alpha v, and beta 5, but had little effect on beta 1. The corresponding cell-surface expression of alpha 5 and alpha v was also increased after treatment. Thus, during wound repair, TGF-beta 1 may induce epidermal keratinocytes to express integrins that facilitate the migratory component of re-epithelialization.
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8040613
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Antigen-bearing Langerhans cells in skin draining lymph nodes: phenotype and kinetics of migration.
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Application of the fluorescent contact sensitizer Rhodamin B on mouse epidermis was used to study the migration kinetics of Langerhans cells into the draining lymph nodes. The expression of the dendritic cell markers NLDC-145 and MIDC-8 was followed over time to determine the correlation between these markers and Langerhans cell migration. In contrast with its high expression on intraepidermal Langerhans cells, the expression of NLDC-145 on dendritic cells in the draining lymph node was low at 24 h but increased at later times; in contrast, MIDC-8 expression on dendritic cells decreased. Ten days after Rhodamin B application, antigen-bearing Langerhans cells were still present in the epidermis; application of another unrelated contact sensitizer to the epidermis at this time did not lead to migration of these residual Langerhans cells. These results indicate that not all antigen-bearing Langerhans cells migrate from the skin after application of a contact sensitizer, indicating that signals in addition to simple antigen binding are necessary for migration. During this migration from epidermis to lymph nodes Langerhans cells undergo phenotypic changes. The decreased expression of the endosomal antigens MIDC-8 and MOMA-2 correlates with differentiation from predominantly antigen-processing cells to predominantly antigen-presenting cells. The reduced expression of NLDC-145 is discussed in light of a Langerhans cell-independent pathway of antigen transportation from skin to lymph node.
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8040612
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In vivo effects of interleukin-10 on contact hypersensitivity and delayed-type hypersensitivity reactions.
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Interleukin (IL) 10 is a recently discovered cytokine, originally isolated from T-helper 2 (Th2) cells, which inhibits cytokine production of T-helper 1 (Th1) cells. Because Th1 cells appear to be of importance during the contact hypersensitivity reaction (CHS) we hypothesized that IL-10 might modulate the outcome of CHS in vivo. Intraperitoneal injection of murine recombinant IL-10 (1000 ng) into naive mice 24, 72, or 120 h before sensitization by epicutaneous application of 2,4-dinitrofluorobenzene (DNFB) did not affect ear swelling when ears were challenged 5 d later. However, intraperitoneal injection of IL-10 into already sensitized mice 24 h before challenge resulted in a significant suppression of the ear swelling response, suggesting that under the conditions employed IL-10 is able to block the effector phase, but not the induction phase of CHS in vivo. The suppression could be reversed by the concurrent injection of an IL-10 antibody. Moreover, heat inactivation of native IL-10 resulted in loss of the inhibitory capacity. When mice were sensitized by subcutaneous injection of trinitrophenyl-coupled spleen cells (DTH) instead of epicutaneous application of the hapten (CHS), intraperitoneally-injected IL-10 suppressed the effector phase, but also the induction phase of DTH. IL-10 did not inhibit the toxic ear-swelling response induced by topical application of two irritants tested (croton oil or benzalkonium chloride). The capacity of IL-10 to suppress the effector phase of CHS and DTH supports an important role for this cytokine in the downregulation of type IV immune reactions in vivo. The finding that IL-10 suppresses the induction of DTH, but not of CHS, further suggests that CHS and DTH are related but distinct immune reactions.
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8040611
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Reappraisal of histologic features of the acute cutaneous graft-versus-host reaction based on an allogeneic rodent model.
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We employed a rat model of complete major histocompatibility complex-mismatched allogeneic bone marrow transplantation to better characterize the histologic expression of the acute cutaneous graft-versus-host reaction (GVHR), compared with changes due to the preparative regimen. Cyclosporin A abolished the development of this GVHR. Low levels of dyskeratotic cells were present in all groups (allogeneic and syngeneic transplants with and without cyclosporin A) and, alone, were insufficient to diagnose a cutaneous GVHR. A consistent histologic feature of the GVHR was significant lymphoid infiltration of the dermis. The pattern of cytotoxic folliculitis involved follicular epithelium above the entry of sebaceous glands. Immunostain for major histocompatibility complex class II, IA, and IE antigens revealed that dendritic cells within the follicle were limited to this upper region and that lower follicular epithelium did not upregulate expression with evolution of the GVHR. Based on this model, we conclude 1) that the diagnostic scheme for the acute cutaneous GVHR should include lymphoid infiltration of the dermis, 2) that the preparative regimen (including total body irradiation) induces persistent low levels of dyskeratotic cells (two to three cells/linear mm of epidermis), and 3) that the pattern of follicular involvement may relate to the distribution of dendritic cells and to an inability of lower follicular epithelium to upregulate major histocompatibility complex class II antigens.
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8040610
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Are atypical nevi a risk factor for uveal melanoma? A case-control study.
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Atypical nevi and other potential risk factors for uveal melanoma were studied in 109 uveal melanoma patients and 149 controls. Information concerning employment, medical history, drug use, family history of cancer, excess sun exposure, and blistering sunburn before and after the age of 15 was obtained. A total skin examination was performed and skin type, hair color, eye color, freckles, actinic damage, the total number of common acquired nevi, and the number of clinically atypical nevi were noted. More atypical nevi were found in uveal melanoma patients than in controls (age- and sex-adjusted odds ratio of 2.9 [95% confidence interval 1.2-6.3] for one or two atypical nevi versus none; odds ratio of 5.1 [95% CI 1.3-20.0] for three or more atypical nevi versus none). Light skin types and freckling also prevailed in uveal melanoma cases. In our study, atypical nevi are more common in uveal melanoma patients than in controls. Further studies will have to indicate whether risk factors comparable to those for cutaneous melanoma really exist for uveal melanoma.
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8040609
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High-molecular-weight forms of tyrosinase and the tyrosinase-related proteins: evidence for a melanogenic complex.
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Tyrosinase, tyrosinase-related protein-1 (TRP-1), and tyrosinase-related protein-2, (TRP-2, dopachrome tautomerase) were shown by immunoblotting and enzyme assays to copurify from extracts of Cloudman S91 melanoma cells. Antibodies to TRP-1 and TRP-2 immunoprecipitated tyrosinase activity, suggesting a stable interaction (complex) among these proteins. The tyrosine hydroxylase activity of tyrosinase was reduced in the complexed form; treatment with Triton X-100 dissociated the complex and activated the tyrosinase present within it. To further study this complex, we employed sucrose gradient density centrifugation of extracts from cultured murine melanocytes. Tyrosinase, TRP-1, and TRP-2 all existed in high molecular weight "multimers" of approximately 200 to > 700 kilodaltons. Extraction of cells with buffers containing the detergent CHAPS preserved the high molecular weight multimers; Triton X-100 caused their dissociation into monomers. Low pH, low ionic strength, and millimolar concentrations of calcium ions favored the maintenance of multimers. The results of this study demonstrate that the participation of tyrosinase, TRP-1, and TRP-2 in a multimeric complex could have important physiologic consequences, and raise the possibility that some of the well-known interactions between coat color genes may be explained by intermolecular interactions between the gene products.
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8040608
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Enhanced elastin and fibrillin gene expression in chronically photodamaged skin.
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Cutaneous aging consists of chronologic aging as well as actinic damage, referred to as photoaging. Most of the morphologic changes associated with an aged appearance result from actinic damage to the skin. The morphologic changes in sun-damaged skin are associated with accumulation of material having the staining characteristics of elastin, known as solar elastosis, in the superficial dermis. Previous studies have demonstrated the presence of elastin within areas of solar elastosis; however, little is known about the mechanisms leading to elastin accumulation in photoaged skin. In addition, fibrillin, the fibrillar component of elastic fibers, has been found in small amounts in solar elastosis. In this study we demonstrate increased elastin mRNA levels in photoaged skin, as well as increased elastin and fibrillin mRNAs in skin explant-derived fibroblasts using Northern hybridizations, compared with controls from sun-protected sites of the same individual. Increased elastin mRNA levels result from transcriptional upregulation of the gene, as demonstrated by transient transfections with a human elastin promoter/chloramphenicol acetyltransferase construct. Elevated mRNA levels were also correlated with increased elastin and fibrillin deposition in paired biopsy specimens from photodamaged and non-sun-exposed skin, as demonstrated by immunohistochemical staining. Thus, approaches to counteract transcriptional activation of elastin gene expression may be useful in preventing the changes associated with cutaneous photoaging.
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8040607
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Fine mapping of the locus for nevoid basal cell carcinoma syndrome on chromosome 9q.
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The nevoid basal cell carcinoma syndrome is an autosomal dominant disorder characterized primarily by multiple basal cell carcinomas, odontogenic keratocysts, and pits of the palms and soles. Tumor deletion studies and linkage analysis in Caucasians have revealed that the gene is on chromosome 9q. To further refine the location of the nevoid basal cell carcinoma syndrome locus, we tested linkage to this region in three families. Evaluation of recombinants suggested that the nevoid basal cell carcinoma syndrome locus lies in the interval defined distally by D9S127. Our data, together with existing published data defining D9S12 as a proximal flanking marker, refine the location of nevoid basal cell carcinoma syndrome to an 8.3-cM interval. Two of the families studied were African-American and show a notable variation in phenotypic expression in which affected individuals developed few skin cancers. However, despite clinical heterogeneity, our data are consistent with the hypothesis that the same locus is involved in these African-American families.
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8040606
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The extracellular aminoterminal domain of bovine desmoglein 1 (Dsg1) is recognized only by certain pemphigus foliaceus sera, whereas its intracellular domain is recognized by both pemphigus vulgaris and pemphigus foliaceus sera.
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The major antibody binding regions of desmoglein 1 (Dsg1) in pemphigus foliaceus and pemphigus vulgaris were examined using cDNA-encoded fusion proteins combining glutathione S-transferase with various domains of bovine Dsg1, namely, the extracellular regions EC1-2, EC3-5, EC1-5, and the entire intracellular region IC. In immunoblot analyses using these fusion proteins, EC1-2, as well as EC1-5, which comprises EC1-2, were recognized by 50% of the sporadic pemphigus foliaceus sera and 45% of Brazilian pemphigus foliaceus sera that reacted with Dsg1 in immunoblotting of bovine desmosome preparations. None of these fusion proteins reacted with any sera of pemphigus vulgaris. None of these sera showed reactivity with EC3-5. In contrast, the IC domain was recognized by 91% of pemphigus vulgaris sera reactive with Dsg1 in bovine desmosome preparations, and by certain pemphigus foliaceus and Brazilian pemphigus foliaceus sera. These results indicate that major epitopes of Dsg1 recognized by pemphigus foliaceus and Brazilian pemphigus foliaceus sera are located in the extracellular amino-terminal domain EC1-2, and that sera of the Dsg1-positive pemphigus vulgaris contain antibodies against the intracellular domain, which may not play a pathogenic role. Possible reasons for this selectivity of antigen binding site are discussed.
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8040605
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Pemphigus vulgaris antigen lacks biochemical properties characteristic of classical cadherins.
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Pemphigus vulgaris antigen (PVA) is a member of the desmoglein subfamily of the cadherin supergene family. PVA has homology to the classical cadherins (e.g., E-cadherin), both in its extracellular and cytoplasmic domains. Classical cadherins possess certain well-defined and characteristic biochemical properties of both domains. The cytoplasmic domain binds alpha-, beta-, and gamma-catenins. The extracellular domain is protected by calcium from degradation by trypsin. In this study we show that PVA does not share these characteristic biochemical features. Immunoprecipitation of E-cadherin and PVA from human keratinocytes shows that under the same conditions in which the catenins co-precipitate with E-cadherin, only plakoglobin (which co-migrates with gamma-catenin) co-precipitates with PVA. Treatment of keratinocytes with 0.01% trypsin in 1 mM calcium (T/C) does not degrade the extracellular region of E-cadherin, but does partially degrade that of PVA. This increased T/C susceptibility of PVA is not due to its cytoplasmic domain, as the same sensitivity of the extracellular domain of PVA to T/C was observed in L cell clones transfected with a chimeric cDNA that encoded for the extracellular domain of PVA and the cytoplasmic domain of E-cadherin. These data demonstrate that although the desmogleins and classical cadherins share striking amino acid homologies in both the cytoplasmic and extracellular domains, they do not exhibit identical biochemical properties and, by extension, may not subserve identical cell biologic functions.
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8040604
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Identification of neutrophil elastase as the proteinase in burn wound fluid responsible for degradation of fibronectin.
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To identify proteinases responsible for fibronectin degradation in the wound environment we studied wound fluid obtained from burn patients. Immunoblotting experiments showed that extensive degradation of fibronectin had occurred in some burn wound fluid samples, in which case intact fibronectin molecules were undetectable, and the largest fibronectin fragment was 116 kDa. The 116-kDa fragment as well as a smaller 90-kDa fragment contained the fibronectin cell binding domain. These burn-fluid samples degraded freshly added fibronectin. Activity of the fibronectin-degrading enzyme was blocked by a broad-spectrum serine proteinase inhibitor or by specific neutrophil elastase inhibitors but not by metalloproteinase inhibitors or inhibitors of trypsin-like or chymotrypsin-like serine proteinases. Enzyme activity also was neutralized by antibodies against human neutrophil elastase. Incubation of fibronectin with burn wound fluid or purified human neutrophil elastase generated similar fibronectin-degradation products. Finally, direct assay of burn-wound-fluid samples with a synthetic elastase substrate showed a correlation between fluid-phase elastase activity and fibronectin degradation. Based on these findings, we conclude that burn-wound-fluid elastase is responsible for extensive fibronectin degradation. Acute elevation of elastase did not appear to hinder normal wound repair.
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8040603
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Dietary fish-oil supplementation in humans reduces UVB-erythemal sensitivity but increases epidermal lipid peroxidation.
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Ultraviolet radiation (UVR)-induced erythema may be mediated in part by free radical-generated tissue damage, including lipid peroxidation. We have examined the effect of dietary fish oil rich in omega-3 fatty acids upon susceptibility to UVB-induced erythema and epidermal lipid peroxidation. Fifteen volunteers took 10 g fish oil, containing 18% eicosapentaenoic acid and 12% docosahexaenoic acid, daily for 3 or 6 months. Sensitivity to UVB was assessed at intervals on fish oil, and 2.5 months after stopping treatment. Paired skin shave biopsies were taken from six subjects, at baseline and 3 months, from both irradiated and control skin. Fatty acid composition was analyzed and thiobarbituric acid-reactive substances measured as an index of lipid peroxidation. With increasing time on fish oil the minimal erythema dose rose progressively, from 18.9 +/- 13.9 mJ/cm2 (mean +/- SD) at baseline to 41.1 +/- 16.6 mJ/cm2 at 6 months, p < 0.01. Ten weeks after stopping fish oil the minimal erythema dose fell to 23.1 +/- 4.9 mJ/cm2, p < 0.05. Epidermal total omega-3 fatty acids rose from 1.8 +/- 0.4% total fatty acids (mean +/- SEM) to 24.2 +/- 3.9% at 3 months, p < 0.01. This was accompanied by a rise in thiobarbituric acid-reactive substances in irradiated skin from 6 +/- 0.3 (mean +/- SEM) to 18.5 +/- 2.6 A532/g skin, p < 0.01. Hence dietary omega-3 fatty acids produce a pronounced reduction in UVB-erythemal sensitivity, although susceptibility of skin to lipid peroxidation is increased. Thus, omega-3 fatty acids may act as an oxidizable buffer, protecting more vital structures from free radical damage.
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8040602
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A murine model for inducing and manipulating hair follicle regression (catagen): effects of dexamethasone and cyclosporin A.
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Most cases of hair loss are based on premature induction of follicle regression (catagen). Deciphering the unknown regulation of catagen is therefore clinically important, but catagen is also an excellent model for organ involution by rapid terminal differentiation and for epithelial cell death (apoptosis). We here report an assay for the controlled pharmacologic induction and manipulation of catagen follicles. Dexamethasone-21-acetate (0.1%) was applied once daily to depilation-induced, growing follicles (anagen VI) on the backs of C57 B1-6 mice. Characteristic catagen-associated changes in skin color were photodocumented and assessed by morphometric histology. Topical dexamethasone induced catagen-like follicles significantly earlier, more homogeneously, and also more extensively than vehicle. This process was inhibited by high intraperitoneal doses of cyclosporin A. In addition to its clinical relevance as a screening assay for catagen-blocking drugs, this simple murine model is an attractive tool for dissecting the molecular, cellular, and developmental biology of catagen.
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8040601
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Isolated bladder rupture after minor trauma in a patient with alcohol intoxication.
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We report the case of an intoxicated male patient who presented with an isolated intraperitoneal urinary bladder rupture, with a history of minor trauma. A review of the literature reveals that isolated bladder rupture after minimal or no trauma in association with alcohol or drug ingestion is an infrequently reported, but recognized, injury. The diagnosis of bladder rupture should be considered in an intoxicated patient with lower abdominal pain, even without a history of trauma. A history of voiding or bladder dysfunction should increase the suspicion for this injury. If suspected, a retrograde cystogram should be obtained promptly. Failure to consider and recognize this injury may lead to significant morbidity.
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8040600
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Objectives to direct the training of emergency medicine residents of off-service rotations: toxicology.
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Toxicology is an integral component in the training of the emergency physician. This is the 27th article in a continuing series of goals and objectives. The article provides basic guidelines for the organization of the toxicology elective with specific goals and objectives and a list of the contents of the toxicology briefcase. This information should aid in providing a comprehensive experience in toxicology for emergency medicine residents.
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8040596
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The acquired immune deficiency syndrome: an overview for the emergency physician, Part 1.
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The acquired immune deficiency syndrome (AIDS) was recognized as a distinct entity in 1981. It began as a medical curiosity affecting only several dozen individuals in a restricted segment of the U.S. population. In the 12 years since its description, AIDS has become a pandemic affecting tens of millions with cases reported from all major countries. The illness is caused by a retrovirus, termed human immunodeficiency virus (HIV). It is a blood-borne disease with sexual, parenteral, and perinatal modes of transmission. Infection with the virus can be determined by a number of serologic techniques as well as viral culture. The pathophysiology of illness is incompletely understood, but is in large part related to destruction of helper, CD4 lymphocytes. This results in immune dysfunction and the development of a variety of opportunistic infections and malignancies. A great deal has been learned over the last decade, with important advances in treatment. Zidovudine (AZT) remains the most important agent in slowing progression of the disease and has resulted in prolonging survival. All organ systems can be affected by HIV, and many clinical manifestations are protein. Fever, weight loss, and diarrhea are often encountered general symptoms. The skin is frequently involved, with Kaposi's Sarcoma the most common malignancy and a variety of fungi and viruses the most frequent cause of infection. The lung is involved in the majority of patients, with Pneumocystis Carinii (PCP) and mycobacteria emerging as the most important pathogens. A variety of treatments have demonstrated efficacy for PCP. The risk of PCP is related to the decay in CD4 lymphocytes so that prophylactic treatment is recommended when CD4 counts fall below 200. Mycobacterial infection with multiresistant organisms has complicated the management of these infections and poses new risks to health care workers. Part 1 of this two-part series on AIDS discusses the pathophysiology and clinical expression, epidemiology, laboratory testing, and the general clinical manifestations of AIDS, as well as dermatologic, pulmonary, and cardiac symptoms. Part 2 will discuss the gastrointestinal, neurologic, and ocular symptoms, as well as the treatment and management of the AIDS patient.
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8040595
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Confirmation of traumatic interhemispheric subdural hematoma by magnetic resonance imaging.
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We report a case of interhemispheric subdural hematoma following closed head injury producing contralateral neurological findings and focal seizures. Non-contrast cranial computed tomography scan was initially reported to be normal, but magnetic resonance imaging of the brain demonstrated an interhemispheric subdural hematoma. Head injury, specifically occipital, is the leading cause of interhemispheric subdural hematoma in adults. Most patients develop a "falx syndrome." If adequately interpreted, magnetic resonance imaging of the brain showing the appearance of blood on T1- and T2-weighted images can detect interhemispheric subdural hematoma. However, computed tomography scan should always be done first to detect intercranial bleeding, and it should be performed with and without contrast in patients with prior head trauma and delayed bleeds.
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8040593
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Recognition and treatment of multifocal atrial tachycardia: a critical review.
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Multifocal atrial tachycardia (MAT) is an uncommon but clinically important tachydysrhythmia that is usually seen in the setting of severe cardiopulmonary illness. Diagnostic criteria include the presence of at least three different, nonsinus P waves in the same lead; an atrial rate greater than 100 beats per minute; and an isoelectric baseline between P waves. MAT is often difficult to differentiate from atrial fibrillation. The pathogenesis of MAT is unknown; however, it is probably incited by "triggered" electrical activity, a form of abnormal automaticity. This electrophysiologic model has led to several small, uncontrolled clinical trials using calcium channel and beta-adrenergic blocking agents, specifically verapamil and metropolol. None of these trials meets rigorous methodologic standards, and all exclude unstable patients who are at greatest risk for hemodynamic compromise from the tachycardia. Treatment of MAT should first be directed at potential predisposing factors, such as hypoxia, congestive heart failure, and theophylline toxicity. Pharmacologic treatment includes intravenous metoprolol or verapamil; in published reports both agents have been well tolerated and have controlled the heart rate in a majority of patients.
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8040594
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Public health measures following a nuclear accident in The Netherlands.
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The Dutch government has set up a project on public health measures to be followed in the event of a nuclear accident or disaster. The project includes curative and preventive measures, together known as direct measures. This article summarizes the curative measures to be used both on-site and in the action zone, during transportation, and in the hospital Accident and Emergency Department. Preventive measures including public information, sheltering, iodine prophylaxis, decontamination, evacuation, and the use of supportive nuclear teams are also discussed.
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8040592
|
Dapsone intoxication: two case reports.
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Two patients with dapsone intoxication, an adult and a 16-month-old child, are reported. Both developed symptomatic methemoglobin concentrations, of 35% and 37%, respectively, and improved with intravenous methylene blue. Methemoglobin levels subsequently rose in both cases to 25% at 24 and 37 hours, respectively. The recurrence of elevated methemoglobin levels resulted from either continued absorption of dapsone or its toxic metabolite from the gastrointestinal tract. Both patients were begun on serial oral activated charcoal and the child received a second methylene blue treatment. During the intoxication, serum hemoglobin concentrations dropped 2 gm with an increase in the reticulocyte count. Review of 20 cases of dapsone overdose from the literature showed that the major toxic manifestations are methemoglobinemia and hemolysis. Delayed sulfhemoglobinemia, reported in only one case, resolved spontaneously. The treatment of dapsone intoxication is intravenous methylene blue for symptomatic methemoglobinemia, gastric decontamination, and early administration of serial oral activated charcoal. Hemolysis is mild but transfusions may be required for patients with a glucose-6-phosphate dehydrogenase deficiency.
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8040591
|
Ectopic pregnancy in a blunt trauma patient.
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Trauma during pregnancy is a frequent occurrence, and early pregnancies are likely to be unrecognized in the routine evaluation of female trauma patients. We present the case of a 16-year-old woman injured in a motor vehicle crash who sustained a closed head injury and was found to have a right ectopic tubal pregnancy. Since several physiologic responses and pathologic conditions occur during pregnancy, which complicate the diagnosis and treatment of a pregnant patient, it is important to detect pregnancy early in the patient's evaluation. This case report demonstrates an unusual presentation of ectopic pregnancy and illustrates the merits of routine pregnancy testing of female trauma patients.
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8040590
|
Henoch-Schönlein purpura: four cases and a review.
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Henoch-Schönlein Purpura (HSP) is a common, usually self-limited, vasculitis affecting children and young adults. Manifested by a characteristic rash, the course of HSP is typically a benign one, but may be accompanied by varying degrees of abdominal pain, arthritis or arthralgia, gastrointestinal bleeding, and nephritis. The various manifestations of HSP may present at any stage during the illness and mimic other disease processes, some of which may be life threatening. Thus, the emergency physician must consider the diagnosis of HSP in order to detect complications and avoid needless intervention in what usually is an otherwise benign process. We present four cases and a brief review of the literature to highlight HSP in the differential diagnosis of patients who present with any of the typical clinical signs and symptoms.
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8040589
|
Model rocket engine burn injuries: the need for stricter regulation.
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During the 18-year period from 1975 to 1992, the Consumer Product Safety Commission's National Electronic Injury Surveillance System database received reports of 18 burn injuries caused by model rocketry sets and their engines. Children in the age range of 11 to 15 years, who frequently use the products inappropriately, are the pediatric population most at risk. Unfortunately, current regulations do not impose age restrictions on the purchase or use of these products; consequently, the industry sets its own age limits. The current regulations appear to be inadequate and need to be altered to cover the population at risk. Specific recommendations include imposing an adequate age limit and improving the labelling of these products. Two case reports are presented that exemplify the typical burn injuries sustained from model rocket engine accidents.
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8040588
|
Case report: sternal fracture from a seatbelt.
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We report a case of a sternal fracture in a patient restrained by a seatbelt on the passenger side of a car in a moderate-speed motor vehicle accident. This patient apparently did not have contact with any fixed part of the car. In reporting this case it is our intention to demonstrate that the increased use of seatbelts, although life-saving in many ways, may be associated with emergence of a new spectrum of less "life-threatening" injuries associated with their use. We, therefore, make a case for increased search for sternal injuries and potential complications (including cardiac) for restrained passengers without evidence of other direct chest trauma. We believe that although seatbelts are an essential part of passenger car safety, their use should not deter extensive investigation when evaluating the emergency patient for injuries usually associated with the unrestrained passenger.
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8040587
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Strangulation associated with a passive restraint shoulder harness seatbelt: case report.
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Diagonal shoulder harness restraint devices have been implicated as causes of neck trauma in motor vehicle accidents. This type of seatbelt is commonly used as an alternative to airbags in required passive restraint systems. A case of strangulation secondary to an automatically engaging diagonal shoulder harness used without the accompanying lap seatbelt is reported.
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8040586
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Dissection of the vertebral arteries: case report and discussion.
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Vertebral artery dissection is an unusual condition with potentially protean neurologic presentations. It may occur spontaneously or follow apparently minor neck trauma. Ischemic symptoms related to the posterior circulation ensue and may be due to obstruction or embolization. The ensuing stroke is ischemic, although subarachnoid hemorrhage may be a complication as well. A case of vertebral artery dissection in a young woman who developed symptoms approximately one week after mild neck injury is reported, and the topic is reviewed.
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8040585
|
Gastric volvulus: two cases and a review of the literature.
|
We report two cases of gastric volvulus. A discussion of the epidemiology, pathophysiology, clinical presentation, diagnosis, and treatment of this rare entity is presented.
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8040584
|
Primary sternal osteomyelitis.
|
Primary sternal osteomyelitis is a rare condition. Most of the recent cases have been reported in intravenous drug abusers. A case of primary sternal osteomyelitis with no apparent risk factors is reported. Diagnosing sternal osteomyelitis can be difficult, but failure to clinically recognize this type of infection in its early stages can lead to serious sequelae. The diagnosis should be suspected in a young patient presenting with acute inflammatory swelling over the sternum. It is further supported by leukocytosis, elevated sedimentation rate, lateral radiograph of the sternum, and positive Gram's stain. While bacteriological culture results are pending, antibiotic therapy with Staphylococcus aureus coverage should be initiated empirically. Diagnostic evaluation and management of the patients with this entity are briefly discussed.
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8040583
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The emergency department management of near-hanging victims.
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A 7-year retrospective review was performed to assess the complications of near-hangings injuries. Thirty-nine cases of near hanging were seen during this period. There were no hanging drops greater than 5 feet and no cervical spine fractures. One patient required intubation for soft tissue swelling. The adult respiratory distress syndrome (ARDS) occurred in three patients. All victims with field Glasgow Coma Scale levels >3, and three of eight with GCS = 3 survived to discharge with a normal mental status. We conclude that aggressive resuscitation and treatment of postanoxic brain injury is indicated even in patients without evident neurologic function in the field, as full recovery may still occur. Cervical spine fractures have not been reported in near-hanging victims and should only be considered if there is a possibility of a several foot drop or if a focal neurologic deficit is present. Injury to the anterior soft tissues of the neck may cause respiratory obstruction. Close attention to the development of pulmonary complications is required.
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8040579
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[Newborn resuscitation in the delivery room: evaluation of a regional training program conducted in 1990 in the Centre region].
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To evaluate the regional programme designed to train personnel for resuscitation of the neonate in the delivery room and organized in the district of Centre, France in 1990. Transversal study. SITE: The different maternities of the district. 31 maternities, 156 persons in charge of neonates in the delivery room including medical personnel (doctors, mid-wives) and paramedics, with or without any special training in 1990. A single evaluator visited each maternity and met the personnel involved. The modalities of the evaluation were not given in advance and included a census of the personnel who had participated in the training programme and changes in material. The success of the training programme was evaluated on a theoretical and practical basis for the personnel and on the number of severe meconium aspirations observed. The training programme had reached 53% of the personnel involved. It had a wide impact both in terms of changed material and in neonatal resuscitation rates compared with untrained personnel. The number of severe meconium aspirations fell from 3 in 1989 to 0 in 1990.
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8040578
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[Premature rupture of membranes. Prospective study of 218 cases].
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To verify the importance of a wait-and-see attitude after premature rupture of the membranes before 34 weeks of amenorrhoea when allowed by the initial physical examination and of an intervening attitude after 34 weeks. A prospective study included 218 cases of premature ruptures of the membranes divided into four groups according to the weeks of amenorrhoea: Group 1, before 32 weeks (n = 11); Group 2, between 32 and 34 weeks (n = 26); Group 3, between 34 and 37 weeks (n = 18); Group 4 after 37 weeks (n = 163). Before 34 weeks of amenorrhoea, the frequency of premature rupture of the membranes was 0.72%, of germ-positive infants 8% and of infected infants, 11%. Perinatal mortality was 80% and 17.4% of the infants were delivered by cesarian section. Labour was induced in 100 cases (46%), when there was evidence of infection, after a 24-hour waiting period or at 34 weeks of amenorrhoea. When the aspect of the cervix was unfavourable, cervical maturation was induced by intravenous injection of prostaglandins in 75 cases (34%). When the rupture occurred before 34 weeks of amenorrhoea and without signs of infection, tocolysis should be entertained. From 28 to 34 weeks and when a favourable outcome is expected, maturation by corticoids can be proposed. When chorio-amniotic infection is suspected and is not confirmed by the laboratory, antibiotic prophylaxy does not appear to improve fetal outcome. The beneficial effect of a conservative wait-and-see attitude before 34 weeks and of intervening thereafter can only be demonstrated with a large randomized study. Thus each case must be managed individually, making it difficult to establish a standard recommended attitude.
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8040577
|
[Kidney cancer: fortuitous discovery of a para-uterine mass at the beginning of pregnancy].
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The authors relate the case of an incidental detection of a renal cell carcinoma in pregnancy. The tumor appeared as an heterogeneous adnexial mass. Special consideration for the diagnostic evaluation was taken because of pregnancy and a minimal number of CAT scan was performed. A radical nephrectomy was performed at 13 weeks. The patient tolerance, the pregnancy and postdelivery courses were as well as possible. No recurrence of the carcinoma occurred. This cas is discussed in the light of the literature.
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8040576
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[Ethnic predisposition of the severity of HELLP syndrome. Retrospective study of 12 cases including 5 during post-partum].
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HELLP syndrome is characterized by association of haemolysis (H), elevated liver enzymes (EL), and low platelets (LP). From 1989 to 1991, we studied retrospectively 12 cases of HELLP syndrome cases that occurred during the third trimester for 7 cases and during post-partum for 5 cases. 83% of patients (10/12) were black people (African or Creole). The most frequent sign of HELLP syndrome during pre- and post-partum was epigastric or dorsal pain, present in 91% of the cases (11/12) and in all cases of preeclampsia. Aggressive treatment was always performed, leading to 12 births: 7 of the 12 children were hypotrophic for gestational age. There were no maternal or neonatal deaths. Post-partum HELLP syndrome occurred 28.8 hours (mean) after delivery. Whether HELLP syndrome occurred during pre- or post-partum, laboratory findings returned to normal levels after equivalent delays: platelets 57 hours, ASAT 68 hours and ALAT 65 hours.
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8040575
|
[Serum alkaline phosphatase levels in pregnancy].
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Serum levels of total alkaline phosphatase increase during pregnancy but the presently available methods are not very precise. We used the CHEM 1 Bayer Diagnostic test in all the consecutive patients admitted to our unit between June 1 and October 16, 1990. Exclusion criteria were twin pregnancies, pruritus, liver disease or parasitosis. A multifactorial analysis was used to discriminate between general, obstetric, pathologic and drug parameters. There were 373 serum samples, 91% were obtained during the last three months of pregnancy. The mean serum alkaline phosphatase level was 68.2 U/l and 75.9 U/l during the first two trimesters respectively and rose to 126.7, 178.8 and 234 U/l during the last three months respectively. The elevation was greater in cases of vomiting during the first trimester, alpha-methyldopa intake. It was less after hypodroxyapatite intake and was positively correlated with weight gain. Age, parity, pregestational weight, neonatal weight, other pathologies and other drug intake did not affect the results. Knowledge of these physiological levels will be useful for evaluating most liver diseases occurring during pregnancy. Assay of the enzyme fractions would be ordered secondarily.
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8040573
|
[Reflections on 10 years of medically induced abortions in Ille-et-Vilaine].
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The medical files of 532 patients who underwent medically induced abortion over a 10-year period (1982-1991) in the French department of Ille-et-Vilaine were studied in order to evaluate the indications and outcomes. Among the patients, 358 resided in the department (67%). Comparatively with the number of births during the 10-year period, there was a relative increase in the number of medically induced abortions from 3.5/1000 to 5.5/1000. This parameter was taken into consideration for the interpretation of a parallel decrease in the perinatal mortality during the same period, from 5.9/1000 to 5.1/1000. There was a maternal indication in 91 cases which correspond to the former category of therapeutic induced abortions. There was a clear increase in 1991 corresponding to abortions induced because of extremely premature rupture of the membranes which were formerly allowed to continue to dead births. Foetal indications were frequent: 441 cases (83%). Exogenous causes were lower (15.6%), particularly due to the disappearance of indications resulting from maternal irradiation. For indications related to infection, the vaccination against rubella and improved prenatal diagnosis resulted in the disappearance of rubella as an indication during the last three years of the study and a clear decrease in the number of toxoplasmosis indications. There were few indications due to maternal infection by human immunodeficiency virus (4 cases). Chromosomal abnormalities were the main cause of medically induced abortion among the foetal indications (27.7%).(ABSTRACT TRUNCATED AT 250 WORDS)
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8040574
|
[Bereavement evolution in mothers and families after perinatal death].
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Semi-structured interviews were conducted with 33 mothers one to 9 years after the death of a child in the perinatal period: 15/33 mothers (45.5%) are dissatisfied with care givers attitudes, 8/33 (24.2%) showed pathological grief reactions, 11/29 (37.9%) had established a pathological relationship with at least one of their living children, 5/29 (17.2%) were in disagreement with the child's father. Univariable analysis of interviews and obstetrical data showed that some factors where significantly correlated with pathological evolution. The relative risk (RR) of mothers' dissatisfaction was significantly decreased by positive attitudes: support by their obstetrician (RR 0.22, p < 0.01), by midwives and nurses (RR 0.24, p < 0.05), showing the dead baby (RR 0.39, p < 0.05), and increased by caregivers negative altitudes RR 13.18 p < 0.01) as well as by a concurrent bereavement (RR 2.29, p < 0.05). Pathological grief was more frequent amongst foreign culture mothers (RR 5.25, p < 0.01). Pathological mother-child relationships were increased by negative attitudes (RR 8.13, p < 0.05), by dissatisfaction (RR 4.82, p 0.01), by another bereavement (RR 2.86, p < 0.05) and decreased by seeing the dead baby (RR 0.35, p < 0.05) and understanding the cause of the death (RR 0.35, p < 0.05).
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8040572
|
[Ovarian steroid cell tumors: a bilateral form].
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The authors report a case of bilateral ovarian steroid cell tumour, not otherwise specified (as subclassified now by Scully). For two years a 46-year-old woman had androgenic manifestations. Only plasma testosterone level was increased. A hysterectomy with bilateral ovariectomy was performed. The first diagnosis was bilateral Leydig cell tumour, but no Reinke crystal was found. The final diagnosis was steroid cell tumour, not otherwise specified. No significant nuclear atypia or mitotic activity were found and two-year follow-up was favourable. The authors discuss the difficulty to class some ovarian tumours between Leydig cell tumour and steroid cell tumour, not otherwise specified as defined by Scully.
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8040571
|
[Value of cold-knife conization without hemostatic sutures].
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Retractile scarring often occurs after conisation of the cervix uteri, concealing the new squamocolumnar junction. It has been suggested that healing quality is improved if haemostatic sutures are not used. We report here on 118 cold-knife conisations carried out without haemostatic sutures. On histological examination there were 3% microinvasive carcinomas, 87% high-grade and 10% low-grade dysplasias. The endocervical margin was positive or doubtful in 6% of cases (n = 7). Six of these patients underwent secondary procedures which produced specimens free of transformation. A new colposcopic examination was performed six months after the cone biopsy: the squamocolumnar junction was visible in 90% confirming the usefulness of the technique.
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8040569
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[Primary amenorrhea and arterial hypertension in a case of 17 alpha-hydroxylase deficiency].
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A 28 year old patient presented with primary amenorrhoea, streak ovaries, mosaicism with 46,XX/47,XXX, hypertension resistant to a tri-therapy and osteoporosis. The presence of hypergonadotropic hypogonadism, increased levels of corticosterone and desoxycorticosterone, a decreased response of cortisol and aldosterone to i.v. ACTH were characteristic of a 17 alpha-hydroxylase deficiency. Administration of 0.5 mg of dexamethasone normalized the blood pressure. Genetic origin of this disease and the different aspects of the ovaries that have been observed are discussed.
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8040570
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[Study and significance of ferritin levels in 104 women using intrauterine devices].
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To study the ferritin level in women using an intrauterine device. 104 women were enrolled before and during use of the intrauterine device. The subjects were divided into four groups according to whether or not they had used oral contraception previously. There was a significant decrease in ferritin level, particularly in women who had not used contraception previously (Student's test). Ferritin assay is a better test for measuring the effect of an intrauterine device on iron depletion than blood cell count or haemoglobin level.
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8040568
|
[Gynecology and obstetrics in ancient Egypt].
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We analyzed scriptural and archeologic sources of information concerning gynaecology and obstetrics as practiced in ancient Egypt. Knowledge of anatomy was rudimentary but precocious diagnosis of pregnancy was practiced. An obstetrical chair had been used since the VIth dynasty. The Egyptians were the first to describe prolapsus of the genital organs. The pessary was a known treatment. Spermicidal mixtures were used for contraception.
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8040566
|
Heat conduction calorimeters: time constants, sensitivity and fast titration experiments.
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Seven heat conduction calorimeters have been evaluated in terms of sensitivity and thermal response time. The use of a dynamic method to correct for the thermal inertia of the calorimeter is shown to reduce by one order of magnitude the time required to conduct a stepwise titration experiment involving a fast reaction. The ability to determine association constants of strong 1:1 complexes has been evaluated in terms of the precision of determining thermal energy.
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8040565
|
Rapid purification of antiserum against Mycoplasma hyopneumoniae by an efficient absorption method.
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A simple and efficient method for the removal of unwanted cross-reactive antibodies has been developed. The antiserum purification method was based on treatment of the antiserum with both sonicated extracts and boiling extracts of the Escherichia coli host cells used in immunoscreening the lambda EMBL3 library. We have demonstrated unambiguously that through this simple treatment, the rabbit anti-Mycoplasma hyopneumoniae antiserum can be effectively purified so that the amount of antibodies cross-reacted with Escherichia coli lysate proteins is drastically reduced. Compared with the traditional absorption methods, which require the chemical coupling of an absorbing agent to an insoluble support, and affinity purification methods, which have harsh denaturing condition, this method should greatly facilitate a successful immunoscreening experiment.
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8040564
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Competitive protein-binding radioassay of thiamine in selected biological materials.
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A principle of competitive protein-binding radioassay is developed for thiamine determination in some biological samples. Thiamine in an assay sample competes with radiolabelled thiamine for Sepharose-immobilized buckwheat-seed thiamine-binding protein. A blank sample is prepared by destruction of thiamine in hot alkaline solution. Model studies show that the radioassay works in thiamine concentration range of 1-10 microM, in samples of moderate ionic strength (up to 0.25 M NaCl) and is specific for thiamine in the presence of up to 5-fold molar excess of thiamine phosphates. Thiamine phosphates can also be determined but after hydrolysis with a suitable phosphatase enzyme (Taka-Diastase). Using this method, thiamine contents are successfully determined: (i) in spinach juice, directly, (ii) in cow's milk, after deproteinization, and (iii) in human urine, after desalting. Both the precision (C.V. less than 15%) and the recovery of thiamine supplements (82-100%, depending on thiamine pre-extraction method) are reasonable. Results of thiamine radioassay show a good correlation with control determinations by the standard thiochrome method.
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8040563
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Interaction of methyl benzoate as a model odorant with a series of free-base amino acids and some amino-acid hydrochlorides.
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The interactions of methyl benzoate as a model odorant with a series of free-base amino acids: lysine, tryptophan, arginine, proline, histidine, cysteine, leucine, threonine and phenylalanine, were studied by gas-phase adsorption on solid amino-acid samples. DL-, D- and L-isomers were investigated for all of the amino acids with the exception of cysteine where only DL- and D- were studied. Langmuir adsorption isotherms show that the strongest interactions are with lysine. Correlation of the relative interaction strength with the chemical structures suggests that binding is strongest to the remote amino groups in the amino-acid side-chain and involves a nucleophilic attack of a lone pair of electrons on the epsilon-nitrogen of lysine to the carbon of the carbonyl group of the methyl benzoate. This suggestion is supported by studies on hydrochlorides of lysine where the side-chain amino groups are protonated and thus cannot participate in a lone-pair interaction. Arginine mono-hydrochloride was found to adsorb more methyl benzoate than even the lysine free-base, an observation which is not fully understood.
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8040562
|
Spectrophotometric determination of effective proteolytic activity in biodetergents.
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A new procedure for the determination of effective proteolytic activity in biodetergents has been developed. Effective enzyme activity is defined as the activity exhibited by the tested enzyme under real washing conditions, i.e., in the water suspensions of the biodetergent tested at the working temperature (usually 40 degrees C). Two insoluble chromolytic substrates, namely black gelatin (gelatin cross-linked with glutaraldehyde in the presence of black drawing ink) and the protease substrate based on the immobilization of dyed casein in the structure of polyacrylamide gel (blue casein-PAAG) were successfully used. It was found that there is a great difference in effective proteolytic activity among various biodetergents. The proposed procedure is suitable both for the manufacturers for a quick control of their products and for the quality control laboratories.
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8040561
|
Glycation of albumin: reaction with glucose, fructose, galactose, ribose or glyceraldehyde measured using four methods.
|
Albumin was glycated (nonenzymatically glycosylated) with glucose, fructose, galactose, ribose or glyceraldehyde for 5, 9, 15 and 19 days. The extent of glycation was determined (a) by the thiobarbituric acid method, (b) by fructosamine assay, (c) by method based on the reaction with hydrazine, and (d) by measurement of fluorescence. Results show that the three colorimetric methods used differ in the sensitivity and in addition with the use of each method not the same extent of glycation with various sugars was found.
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8040558
|
Oedipus and the sphinx: triumph and catastrophe.
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The downfall of Oedipus in Sophocles' most famous play, Oedipus Tyrannus, is the reversal of his triumphant entry into the city of Thebes 17 years earlier. The oracle at Delphi has told the Thebans that the plague will end only when the murderer of Laius is identified and punished. The unconscious collusion between Oedipus and the Thebans to ignore the unsolved murder breaks down. Told by Teiresias that he is the culprit, Oedipus begins a desperate effort to find evidence to refute this accusation. When other witnesses come forward, his cause is lost. The effect of Oedipus's collusive interaction with the Thebans is balanced in Sophocles' account by the story of the riddle of the Sphinx. The Sphinx is a goddess of discontinuity. She represents the unconscious forces at work both in Oedipus's personal fantasies and in the collective fantasies of the Thebans. The tragedy results from the interaction of these fantasies in the government of the polis. Sophocles' play thus exemplifies the intricate intertwining of the child's innate wishes and the reaction they evoke from the environment during the oedipal period. The neurotic patient's illusion of sexual triumph over his or her father or mother as a child can be best understood through the interaction of these factors.
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8040557
|
Observing the other: reflections on anthropological fieldwork.
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Aspects of anthropological fieldwork are examined from a psychoanalytic viewpoint using two sources: (1) Malinowski's A Diary in the Strict Sense of the Term, a fieldwork journal he kept in New Guinea and the Trobriand Islands "as a means of self-analysis"; (2) the analysis of an anthropologist both before and after she returned from the field. Malinowski's Diary, written in a virtually free-associative form, illustrates how fieldwork stimulates derivatives of significant early infantile conflicts. The patient's analysis revealed the unconscious meaning of, and motivation for, fieldwork for this particular individual. Based on these data, it is postulated that during fieldwork a new, emotionally charged object relationship, with its concomitant transference responses, may be unconsciously established by the anthropologist with the alien society being studied.
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8040556
|
Connectionism and psychoanalysis.
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A currently interesting set of models of perception, learning, and cognition--known as connectionist or neural net systems--have contributed to changes in the way cognitive scientists view brain function. A fruitful interaction between brain models and computer models leads us to think that the brain may be less dependent on a central processor, that there may be much brain work that is self-organizing, and that mind-brain dualism may be unnecessary. This article explores the implications for psychoanalytic theory that emerge from these new models.
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8040555
|
In the eye of the beholder: Helmholtzian perception and the origins of Freud's 1900 theory of transference.
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Freud's 1900 theory of transference was indebted to the convergence of philosophy and physiology found in nineteenth-century theories of visual perception. The author maps out the post-Kantian philosophical and German physiological currents that gave rise to Hermann von Helmholtz's influential work on perception, and proposes that Freud's 1900 theory of transference was a creative synthesis of novel notions like unconscious wishing and psychic defense with a Helmholtzian model of visual illusion.
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8040554
|
Maternal empathy, family chaos, and the etiology of borderline personality disorder.
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Psychoanalytic writers have traced the etiology of borderline personality disorder (BPD) to be a preoedipal disturbance in the mother-child relationship. Despite the prevalence of theories focusing on the role of mothering in the development of BPD, few empirical studies have tested the hypothesis that borderlines were the recipients of unempathic mothering. The current preliminary study compared 13 mothers of borderline adolescents with 13 mothers of normal adolescents. This study found that mothers of borderlines tended to conceive of their children egocentrically, as need-gratifying objects, rather than as individuals with distinct and evolving personalities. This study also found that the mothers of borderlines reported raising their daughters in extremely chaotic families struggling to cope with multiple hardships, including divorce and financial worries. The stressful environmental circumstances reported by the mothers likely affected the borderline daughters directly as well as the mothers' ability to parent effectively and empathically. The results of this study suggest that, as predicted by psychoanalytic theory, a problematic mother-child relationship may play a significant role in the genesis of borderline pathology; however, the life circumstances that contextualize the mother-child relationship also need to be considered when accounting for the etiology of BPD.
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8040553
|
Oedipal sibling triangles.
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Sibling triangles exist independent of parent-child triangles and undergo parallel development into constellations bearing significant formal and dynamic similarities to the standard parent-child oedipal relationships. They may exert definitive effects on the individual's identifications, adult object choices, and patterns of relating. Recognition of such constellations and their outcomes is often crucial to successful therapy. A developmental line is delineated with emphasis on the recapitulation throughout development of oedipal sibling issues. Speculations are offered about the possible factors responsible for pathological outcomes of oedipal sibling triangles, and about why, in many cases, oedipal sibling experience may be more influential in development than oedipal parental experience.
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8040552
|
The uses of the past and the actualization of a family romance.
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This paper elaborates an aspect of the therapeutic experience of analysis that pertains to the examination of the past as it influences a patient's view of his self-worth and relationship to the world. It is complementary to the usual view of psychoanalytic process that involves analysis of transference resistance, revelation of transference, and the discovery of its genetic roots. I propose an additional therapeutic aspect of the reexperience of the past in which the changed representation of patient as child is validated by a new object, the analyst, who is experienced as a benevolent witness to the past and as a benevolent presence in the past, thereby consolidating the change and influencing the patient's adult self-representation. This therapeutic effect is more likely to be of significance in patients who have experienced parental loss or significant deprivation in childhood. Segments of the analysis of a patient illustrate this point. The patient described "listening to himself with compassion for the child he had been" and being listened to by me in the same way. He became thereby "tolerant and empathetic with the child he had been." The more general implications of this as a vehicle for change in psychoanalysis are discussed. Of ancillary interest was the patient's research into his past and ultimately his actualization of a family romance fantasy with a particular ironic twist.
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8040551
|
Bedrock and beyond: an examination of the clinical utility of contemporary theories of female psychology.
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Libido theory and the idea of an innate matrix of bisexuality are an inadequate basis on which to understand female psychology. Rather, it is the mutual influence of sexuality, aggression, object relations, and a superego that inherits the object-related conflicts of early childhood, intertwined as these are with gender issues, that determine the way a woman experiences herself. A woman can have a basically confident, narcissistically valued sense of femaleness and at the same time be troubled by intense feelings of inadequacy and deprivation. Instead of arbitrarily attributing these feelings to penis envy and a sense of castration, based on the idea of bisexuality as bedrock, this paper suggests that we consider primary femininity as bedrock, but that the superego, as heir to unresolved preoedipal and oedipal object-related conflicts, functions to maintain these painful emotions. Clinical material illustrates the utility of these ideas.
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8040550
|
Psychoanalytic supportive psychotherapy.
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Psychoanalytic Supportive Psychotherapy (PSP) is described as a distinct psychotherapeutic method rooted in the psychoanalytic frame of reference. It is argued (a) that PSP is psychotherapy and indeed a therapeutic modality on its own, (b) that it is supportive, and (c) that it is psychoanalytic. PSP is characterized by a therapeutic relationship determined predominantly by its primary relationship aspect, a therapeutic technique consisting in the main of supportive interventions, a therapeutic process that consists essentially of growing by experience, and a therapeutic goal residing in the first place in structure building. Like psychoanalysis proper, but in a substantially different way, it aims at structural personality change and can provide lasting results. As far as therapy is concerned, psychoanalysis is no longer a unimodal discipline. The psychoanalytic therapies include at least three treatment modalities: psychoanalysis proper, interpretive psychotherapy, and psychoanalytic supportive psychotherapy. Enlarging the number of therapeutic methods based on psychoanalytic theory represents a new approach to the widening scope of indications for psychoanalysis.
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8040549
|
A motivational systems approach to the clinical experience.
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A conception of the self and five motivational systems is applied to clinical psychoanalysis. Each motivational system develops in infancy from innate and learned patterns in response to a basic need, and each involves particular affects. Each motivational system contributes patterns from which important transferences evolve. At any given moment, motives derived from one or another system dominate a person's experience, motives from the other system being subsidiary or dormant. We describe the manner in which these concepts contribute to an explanation of foreground-background relations during analysis, and how analysts and analysands construct model scenes to give meaning to information acquired by empathic listening. We conclude with a clinical vignette illustrating the application of these concepts to the patient's transference and the analyst's response in the intersubjective realm of an analytic enactment and verbal exchange.
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8040548
|
On love and lust in erotic transference.
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Intense erotic transference is one of the most powerful and challenging phenomena in clinical psychoanalysis. Powerful longings for love and for sexual gratification are likely to elicit enactments in the analytic setting that interfere with the analyst's ability to maintain a dual state of awareness in which he or she is both a participant in and an observer of the immediate experience with the patient. These enactments occur on a continuum from frank love affairs between patient and analyst to subtle forms of partial transference gratification. Moreover, the two primary elements in the manifest content of erotic transference--love and lust--may be dissociated from one another and may produce significantly different reactions in the analyst.
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8040547
|
Some ambiguities in the method of free association and their implications for technique.
|
The method of free association, rooted in the topographic model, has not been clearly defined in structural terms. Little changed since Freud; the method is geared toward overcoming rather than investigating resistances. Furthermore, it is designed to discourage rather than encourage self-analysis. This seems to be another example of a "developmental lag" in adapting the psychology of the ego to clinical technique.
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8040546
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On the homogenization of psychoanalysis and psychoanalytic psychotherapy: a review of some of the issues.
|
Concepts of the psychoanalytic process and of the various modes of therapeutic action are allied to the similarities and differences between psychoanalysis and psychoanalytic psychotherapy. Lack of clarity about these concepts calls for a concerted effort toward outcome studies that can provide a scientific basis for and elucidate the relation of process and mode of therapeutic action to efficacy. Clinical concepts such as the development and resolution of transference or of a transference neurosis can then be compared scientifically with others which emphasize the interactive models. The thesis is held that the development of a psychoanalytic process typically requires thorough immersion through frequent sessions which permits greater resolution of the transference or transference neurosis, with insight and greater opportunity for the achievement of autonomy. Other modes of therapeutic action also play into the process as in psychotherapy, but the interpretive mode with progressive insight distinguishes psychoanalysis proper.
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8040544
|
Research on women physicians with multiple roles: a feminist perspective.
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This paper describes a feminist empiricist approach to research and conceptual advances in the study of women professionals and applies it to research on women physicians with multiple roles. In past research, social values about appropriate roles for women led to an emphasis on negative outcomes, vagueness about which roles conflict, and the assumption that the work role is the most problematic for women. The effects of social context, including interpersonal relationships, has also been ignored. Research using new approaches has shown that there are benefits to combining roles, that role conflict is most common between work and parental roles, and that social support from the spouse is crucial. The importance of the work environment is also stressed.
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8040543
|
Evaluation of parallel pelvic/breast and male genital/rectal teaching programs.
|
Pelvic/breast (PB) and male genital/rectal (GR) programs were evaluated to learn if male and female students differed in their reactions to the programs and if observations of the programs confirmed students' reactions. In-depth interviews were conducted with male and female teaching associates to uncover the need for program improvements beyond those suggested by observation and student reactions. Participating in the PB program were 74 men and 85 women; 79 men and 90 women took part in the GR program. Sex differences were found in the GR program: Female students admitted to greater anxiety about examining male genitalia prior to the program (p = .009) and expressed more dissatisfaction with the timing (too late in the curriculum p = .006). Male students were less likely than females to improve their ability to communicate as a result of the GR program (p = .009). Observations and interviews indicated that the programs were successful in teaching technical skills but that they needed further work in integrating technical and communication training, especially during GR examination training.
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8040540
|
Magnetic resonance imaging: practical theory and clinical relevance.
|
Magnetic resonance imaging can be a valuable diagnostic tool. Some fundamental concepts behind MRI are discussed, using clinical cases to illustrate the potential of this imaging system.
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8040539
|
Evaluating intensity output of curing lights in private dental offices.
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Dentists in private offices were using inadequate curing lights, according to these study results. Many were unaware that the output of the lights was inadequate to completely cure composite resins.
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8040538
|
Smoke signals: an alert for oral disease.
|
Since the early 1600s, questions have been raised about the ill effects of smoking. Tobacco has long been linked to oral cancer and leukoplakia, but research in the last 20 years suggests an association with other oral diseases as well. Studies concerning the effects of smoking on the periodontal diseases--and the mechanisms involved--are reviewed.
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8040536
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Perspectives on the interaction of biological, psychological and social factors in TMD.
|
Temporomandibular disorders remain a poorly understood but related collection of clinical syndromes involving pain and function limitations. This article discusses TMD from the perspective of a chronic pain illness, which shares some features found in common chronic pain conditions, such as tension headache and benign back pain. From these perspectives, TMD may be viewed as a self-limiting chronic pain illness not associated with progressive physical deterioration.
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8040535
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Managing occupational risks in the dental office: HIV and the dental professional.
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Despite universal precautions, work behavior modifications and technological advances, health care workers continue to experience occupational exposures to HIV and other bloodborne pathogens. Although the risk for infection is low when compared with other bloodborne pathogens, 39 documented cases of HIV seroconversion have been recorded. Recent attention has focused on secondary prevention of HIV infection through post-exposure chemoprophylaxis.
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8040534
|
Back to the Little Bighorn.
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Fillings found in the skull of a 7th Cavalry trooper killed 118 years ago in the Battle of Little Bighorn show sophisticated, well-executed dentistry. Some fillings are examples of early preventive dentistry, using a variety of materials and techniques typical of 19th-century cavity preparation. Dental care most likely was delivered by a private dentist or performed in part at a dental school in the East or Midwest, in a large city or at West Point. The logical, deductive process suggests an identification: Cpl. George Lell. Without additional corroborative documentation, however, this is speculation. Whoever he was, the cavalryman was older and shorter and had better oral care and health than most of the comrades who died with him in 1876. He used tobacco, most likely by chewing it. His remains provide a glimpse into the reality of life and death, dental care and hygiene of the mid-19th century.
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8040533
|
Re-evaluating pulp protection: calcium hydroxide liners vs. cohesive hybridization.
|
Certain clinical and biological studies have reported that prepared dentin and the underlying pulp must be protected with a calcium hydroxide base and liners that supposedly impart biological and structural integrity to tissues. Since the mid-1950s, dentists have relied on a number of calcium hydroxide medicaments for this goal. But recent studies imply that clinicians need to re-evaluate the generous use of certain calcium hydroxide medicaments under restorations.
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8040524
|
Sexual harassment: identifying it in dentistry.
|
Sexual harassment can be a difficult problem to identify in the workplace. Scenarios are used to help define and identify harassment. Discussion also includes explanations of why sexual harassment is unethical and illegal.
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8040523
|
Treating nevoid basal cell carcinoma syndrome.
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More than 100 anomalies are associated with this syndrome. In this case, a cyst removed from a 15-year-old male was diagnosed as an odontogenic keratocyst. The long history of this syndrome with its associated problems is described.
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8040522
|
Chorda tympani nerve injury following inferior alveolar injection: a review of two cases.
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Permanent nerve injury following the injection of local anesthetic during dental procedures is rare. Two cases of chorda tympani nerve injury shown by ageusia are presented.
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8040517
|
Patient comfort using three methods of endodontic therapy: traditional, paraformaldehyde, and hybrid sealer techniques.
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This paper is not a study, but rather a clinical evaluation of three endodontic techniques based solely on subjective postoperative symptoms reported by patients. From 1968 to 1972 (four years), the author treated 452 teeth with a traditional endodontic technique. During 1973-1981 (eight years), he treated 625 additional teeth by instrumenting the root canals in the same manner as in the traditional method, but without the employment of sodium hypochlorite. In this procedure, the canals were obturated with a paraformaldehyde-steroid-zinc oxide and eugenol paste (PSZOE). A third "hybrid" endodontic technique was used in treating 522 other teeth during 1982-1991 (nine years). During the latter period, the teeth were instrumented in the same manner as in the first two modes of therapy, sodium hypochlorite was not used, and the root canals were filled with gutta percha cones covered with the PSZOE paste. Based on subjective reports of postoperative swelling and pain, there was a 10% incidence of swelling and a 20% incidence of pain in cases treated by the traditional technique and their root canals filled with gutta percha cones coated with Tubliseal by Kerr Dental Manufacturing Company of Detroit. Based on these same criteria, there was only a 1.6% prevalence of swelling and a 1.9% prevalence of pain when the root canals of 625 teeth were completely filled with a PSZOE paste. When the root canals of 522 other endodontically treated teeth were filled with gutta percha cones coated with PSZOE, postoperative swelling was reported in 1.5% of the cases and postoperative pain in 3.2% of the treated teeth.(ABSTRACT TRUNCATED AT 250 WORDS)
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8040513
|
Food restriction and binge eating: a study of former prisoners of war.
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Food restriction is correlated with binge eating, but evidence that restriction leads to binge eating is scanty. In this study we investigated postwar binge eating in 67 World War II combat veterans and 198 former prisoners of war. As predicted, binge eating was relatively rare in combat veterans but was significantly more prevalent in veterans who, as prisoners in German prisoner of war camps, lost significant amounts of weight during their captivity. Our data thus support the contention that starvation or dieting seems to precede binge eating.
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8040512
|
Specificity and generality of motivational components in depression: a personal projects analysis.
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Features of depression, as measured by the Beck Depression Inventory (BDI), were distinguished from anxiety, as assessed by the Beck Anxiety Inventory (BAI), and were explored from a goals perspective using the Personal Projects Analysis methodology (B.R. Little, 1983). Depression and anxiety were found to reflect a "negative" appraisal pattern characterized by goals rated high in stress and difficulty, and low in structure, control, perceived skill, and positive outcome expectancy. Depression also revealed distinctive features not found in anxiety (e.g., goals that are perceived as being less visible to important others). A goal-based approach to research and diagnosis is presented, and implications for future research are discussed.
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8040511
|
Handedness in first-episode psychotic patients and their first-degree biological relatives.
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We evaluated the handedness of 58 schizophrenia patients and 54 of their relatives, 23 patients with major depression with psychosis and 24 of their relatives, 36 patients with bipolar psychosis and 33 of their relatives, and 119 nonpsychiatric subjects and 42 of their relatives. Computerized tomography measures were also available for a subset of the psychotic patients. The schizophrenia patients were significantly more left-handed than any of the other groups, and increased sinistrality was also associated with larger lateral ventricle to brain area ratios. The relatives of the schizophrenia patients did not significantly differ on handedness from either the relatives of the affective psychosis patients or the nonpsychiatric subjects. Our findings do not support the notion that left-handedness in schizophrenia is genetically influenced. More research with larger family member data sets is warranted to further explore this possibility.
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8040510
|
Memory bias in panic disorder.
|
We investigated selective memory effects in patients with panic disorder. Thirty patients with panic disorder and 20 normal controls learned panic-related, strongly pleasant, and strongly unpleasant words. During the incidental learning task, Ss imagined scenes combining the referent of a presented word with themselves. After a distractor task, Ss took a free-recall test. Panic Ss showed enhanced memory for panic-related words but not for positive or negative words.
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8040509
|
Personality disorders and features in social phobia and panic disorder.
|
The hypothesis that there is a specific relationship between social phobia (SP) and avoidant personality disorder (APD) was investigated. Using the Structured Clinical Interview for DSM-III-R Personality Disorders, we screened 32 patients with SP and 85 patients with panic disorder (PD) for the presence of personality disorders. Avoidant features were found significantly more often in SP than in PD, although the diagnosis of APD could not be established significantly more often. On the item level, APD Criterion 6 (fears being embarrassed) discriminated the strongest. Social phobics appeared to be more disturbed on Axis II than PD patients.
|
8040508
|
Psychopathology in war-zone deployed and nondeployed Operation Desert Storm troops assigned graves registration duties.
|
Early psychopathology outcomes were compared in troops mobilized for Persian Gulf graves registration duty but differentiated by war-zone deployment. Constructs of interest were Axis I psychiatric disorders, particularly posttraumatic stress disorder (PTSD), negative affect states, and somatic complaints. Psychometric instruments, including the Structured Clinical Interview for DSM-III-R, were administered to troops attending drill exercises. Although similar in personal characteristics and reporting low rates of premorbid psychopathology, groups differed in the prevalence of PTSD diagnoses, anxiety and anger symptoms, and somatic complaints. Current and lifetime PTSD rates of 48% and 65%, respectively, suggest that the psychological aftermath of war-zone participation involving the gruesome task of handling human remains was profound.
|
8040507
|
Word completion in chronic pain: evidence for schematic representation of pain?
|
Schematic representation of pain information was investigated in chronic pain patients, health professionals, and nonpatient controls. Under the guise of an English-language experiment, Ss were presented with 12 word stems to be completed with the first 2 English words that came to mind. Four of the stems could be completed with sensory pain words, 4 with effective, and 4 with words associated with pain or illness. All could be completed with at least 3 other nonpain words of equal or greater frequency. Results indicate that chronic pain Ss produced significantly more pain-related completions than control Ss and that in all 3 groups the types of pain words produced were related to the extent of personal experience of pain. The theoretical implications of these findings are discussed in relation to the organization of schema, implicit memory, and the activation of mental representations of pain (schema).
|
8040506
|
Evaluation of social problem solving in schizophrenia.
|
We examined social problem solving in schizophrenia. Twenty-seven schizophrenic patients in an acute hospital, 19 patients with bipolar disease, and 17 demographically matched nonpatient controls were tested on an empirically developed problem-solving battery that assessed the ability to generate solutions to problems, the ability to evaluate the effectiveness of solutions, and the ability to implement solutions in a role-playing format. Schizophrenic Ss were impaired on all 3 problem-solving domains compared with the nonpatient controls, but bipolar Ss were equally impaired. Several alternative explanations for these findings were considered. The most compelling hypothesis is that the deficits resulted from different factors: cognitive impairment for schizophrenic Ss and acute illness for bipolar Ss. However, longitudinal studies are required to determine whether problem-solving deficits in schizophrenic patients persist during periods of remission. Implications for rehabilitation strategies are discussed.
|
8040505
|
Episodic memory functioning in a community-based sample of old adults with major depression: utilization of cognitive support.
|
Community-based samples of old adults with current major depression (n = 17; mean age = 83.29 years) and healthy old adults (n = 51; mean age = 83.29 years) were examined on a variety of episodic recall and recognition tasks. Results indicate depression-related deficits in recall that were reduced, but not eliminated, in recognition. Control Ss were able to utilize cognitive support in the form of more study time and item organizability in free recall, whereas depressed Ss were not. However, both groups showed equal gains from the provision of category cues and beneficial effects of prior knowledge and more study time in recognition. Results suggest that depression results in deficits in effortful, elaborate processes at encoding and retrieval and that old age depression is associated with a reduced ability to utilize cognitive support to improve episodic memory. Depressed older adults appear to require cognitive support at both encoding and retrieval to demonstrate memory facilitation.
|
8040504
|
Relationship between the five-factor model of personality and Axis I disorders in a nonclinical sample.
|
The relationship between the five-factor model (FFM) of personality and Axis I disorders was evaluated in a nonclinical sample of 468 young adults. In general, scores on the 5 personality dimensions of neuroticism, extraversion, openness to experience, agreeableness, and conscientiousness (assessed via the NEO Five-Factor Inventory) distinguished subjects with and without a variety of Axis I diagnoses from the revised third edition of the Diagnostic and Statistical Manual of Mental Disorders. In several instances, results indicate that scores on these dimensions were differentially sensitive to diagnosis. Furthermore, scores on these 5 personality dimensions accounted for unique variance in several Axis I diagnoses above and beyond that accounted for by a general measure of current psychopathological symptoms. These results support the utility of the FFM of personality in Axis I diagnostic assessment.
|
8040503
|
Frontal brain activation in repressors and nonrepressors.
|
We assessed whether resting anterior asymmetry would discriminate individual differences in repressive-defensive coping styles. In 2 sessions, resting electroencephalogram was recorded from female adults during 8 60-s baselines. Subjects were classified as repressors or nonrepressors on the basis of scores on the Marlowe-Crowne Social Desirability Scale (MC), the State-Trait Anxiety Inventory (STAI), and the Beck Depression Inventory (BDI). In midfrontal and lateral frontal sites, repressors demonstrated relative left hemisphere activation when compared with other groups. The MC, but not the STAI or the BDI, contributed unique variance to frontal asymmetry. Relative left frontal activation may be linked to a self-enhancing regulatory style that promotes lowered risk for psychopathology.
|
8040502
|
Personality traits are linked to crime among men and women: evidence from a birth cohort.
|
Is there a relationship between personality and criminal behavior? We addressed this question in a representative birth cohort of 862 male and female 18-year-olds. Personality was assessed with the Multidimensional Personality Questionnaire (MPQ). The MPQ measures 10 relatively independent personality traits and was not designed to identify offenders. Delinquency was assessed via 3 data sources: self-reports, informant reports, and official records. Variable-centered analyses revealed that MPQ scales indexing negative emotionality and behavioral constraint were consistent predictors of delinquency across the 3 data sources. Person-centered analyses revealed that youths abstaining from delinquency were uniquely characterized by low interpersonal potency. Youths involved in extensive delinquency were uniquely characterized by feelings of alienation, lack of social closeness, and risk taking. Advances in understanding criminal behavior can be made through research that places the personality-delinquency link in a developmental context.
|
8040501
|
Hypnosis and the dream hidden observer: primary process and demand characteristics.
|
In Study 1, virtuoso (n = 13; passed more than 10 suggestions on the Harvard Group Scale of Hypnotic Susceptibility, Form A [HGSHS:A] and Stanford Hypnotic Susceptibility Scale, Form C), high hypnotizable (n = 14; passed more than 8 suggestions on the HGSHS:A), and medium hypnotizable (n = 17; passed 4-8 suggestions on the HGSHS:A) Ss were administered a hypnotic dream suggestion followed by a "dream hidden observer" suggestion (i.e., access hidden part; have new thoughts and images pertinent to dream). The majority of Ss reported dreams (81.8%) and hidden observers (80%), with hidden reports being characterized by more personal content, less primary processes, and poorer recall than dream reports. Study 2 replicated major findings. Although hypnotized (n = 18) and low hypnotizable simulating Ss (n = 17) responded comparably on most measures, hypnotizable Ss' dreams contained more primary process than did simulating Ss, providing support for M. R. Nash's (1991) psychoanalytic model.
|
8040500
|
Adolescent psychopathology: II. Psychosocial risk factors for depression.
|
In a prospective study of adolescent depression, adolescents (N = 1,508) were assessed at Time 1 and after 1 year (Time 2) on psychosocial variables hypothesized to be associated with depression. Most psychosocial variables were associated with current (n = 45) depression. Formerly depressed adolescents (n = 217) continued to differ from never depressed controls on many of the psychosocial variables. Many of the depression-related measures also acted as risk factors for future depression (n = 112), especially past depression, current other mental disorders, past suicide attempt, internalizing behavior problems, and physical symptoms. Young women were more likely to be, to become, and to have been depressed. Controlling for the psychosocial variables eliminated the gender difference for current and future but not for past depression.
|
8040499
|
Risk for alcoholism and classical conditioning to signals for punishment: evidence for a weak behavioral inhibition system?
|
Nonalcoholic men with high-density family histories of alcohol dependence (high risk) were compared with men with negative family histories (low risk) on a differential classical conditioning protocol that examined the acquisition of conditioned skin conductance responses (SCRs) to a tone (CS+) signaling the occurrence of an electric shock. High-risk Ss had significantly smaller SCRs to the CS+ tone probes during the acquisition phase and poor response discrimination between CS+ probes and CS- tones that were not paired with shock. The low-risk Ss showed a consistent pattern of discrimination between the CS+ and CS- tones. Unresponsivity to the CS+ probes was significantly related to more alcohol-related problems. The results suggest a relationship between risk for alcohol abuse and poor conditioning to signals for punishment, possibly reflecting weak behavioral inhibition system processes (D. C. Fowles, 1987).
|
8040498
|
Recall of early experience and the repressive coping style.
|
We investigated recall of early experience and the repressive coping style by testing hypotheses concerning restricted access to negative childhood memories and eliciting accounts of quality of parenting received. Repressors free recalled fewer negative childhood memories than nonrepressors, and the age of first negative memory for repressors was older both in free recall and cued recall. Repressors' also took longer to retrieve negative childhood memories but not positive memories. Repressors' accounts of their childhoods were more likely to be characterized by paternal antipathy and indifference, and they were less likely to report an emotionally or physically close relationship with their fathers.
|
8040497
|
Saccadic system functioning among schizophrenia patients and their first-degree biological relatives.
|
In Study 1, 30 schizophrenia Ss and 27 nonpsychiatric comparison Ss were presented with a fixation task, a visually guided reflexive saccade (prosaccade) task, a predictive tracking task (0.4-Hz square wave), and an antisaccade task. The 2 groups did not differ on either the fixation or prosaccade tasks. Schizophrenia Ss had an increased number of errors on the antisaccade task and had decreased rightward visually guided saccade amplitudes during the predictive tracking task. In Study 2, 13 psychiatric comparison Ss and 32 first-degree biological relatives of the schizophrenia Ss were compared with the schizophrenia Ss and a larger and older sample of nonpsychiatric Ss (n = 33) on the predictive tracking and antisaccade tasks. The groups did not differ on predictive saccadic tracking. The schizophrenia Ss and their first-degree biological relatives made more errors on the antisaccade task than both the nonpsychiatric and psychiatric comparison groups (who did not significantly differ). Results are consistent with the notion that dysfunction of dorsolateral prefrontal cortex, caudate nucleus, or both is related to liability for schizophrenia.
|
8040496
|
Neuroendocrine reactivity, internalizing behavior problems, and control-related cognitions in clinic-referred children and adolescents.
|
Literature on neuroendocrine-behavior relations suggests that cortisol reactivity to social challenge may be associated with children's internalizing problem behavior. To explore this possibility, and the role of control-related beliefs, we studied 102 7-17-year-old clinic-referred children. Measures of problem behavior, depression and anxiety, and control-related beliefs were collected, and Ss' saliva was sampled before and after a parent-child conflict task. Neuroendocrine activation (i.e., cortisol increase) in response to the interaction task was associated with Ss' (a) social withdrawal, social anxiety, and social problems; (b) socially inhibited behavior during the task; and (c) low levels of perceived social contingency and high levels of external attributions for personal successes and failures. Our findings are among the first to link children's behavioral response to social challenge, neuroendocrine activation, cognitions, and psychopathology.
|
8040495
|
Latent structure of DSM-III-R Axis II psychopathology in a normal sample.
|
The Personality Disorder Examination was administered to 302 normal controls in the New York High-Risk Project in order to elicit Axis II diagnoses (revised 3rd edition of the Diagnostic and Statistical Manual of Mental Disorders; American Psychiatric Association, 1987) and quantitative dimensions of psychopathology. LISREL confirmatory factor analysis was used to evaluate the Axis II hypothesis of 3 orthogonal factors. There was considerable overlap among personality disorders. The best fitting LISREL model was of 3 oblique factors that were different for male and female subjects. Given that our choice of variables to constrain in order to mathematically identify our models was partially based on analysis of intercorrelations in our data set, our methods were not purely confirmatory. We present our results not to confirm specific hypotheses but to generate explicit hypotheses that can be tested in independent samples.
|
8040494
|
Differential relationships between stress and disease activity for immunologically distinct subgroups of people with rheumatoid arthritis.
|
Immunologically distinct subgroups of patients with rheumatoid arthritis (RA)--those with the autoantibody rheumatoid factor (seropositive RA) and those without (seronegative RA)--were compared on a variety of clinical and self-report measures in a consecutive series of women with disease of 7 years' or less duration. The groups were comparable on clinical, pain, functional, and psychosocial variables. However, the seronegative RA group reported elevated levels of preonset negative life event stress. Postonset life event stress and disease activity were significantly correlated for the seronegative RA group, but not for the seropositive RA group. Results suggest that stress factors may be more important in the etiology and maintenance of seronegative RA and that the seronegative RA group may possibly derive particular benefit from psychological techniques to enhance stress management skills.
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