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Biomedical subjects

A Parkin

Publications and source records attributed to A Parkin.

At least 73 records · Page 4Linked to original sources
PubMed1987

The two classes of objects and the two classes of transference.

The problem of reconciling within a single comprehensive theory and model the various phenomena of object love and narcissistic love is reviewed. This problem has given rise to such unintegrated theories as those of object-relations on the one hand and of drive-discharge and conflict on the other. Following an early suggestion of Freud a distinction is made between two different classes of objects: the discharge object and the reflexive object. Their distinctive lines and stages of development are described, each one being comprehended within the systems (structural) model of psychic organization. The development of the discharge object follows the differentiation of the ego out of the ego-id matrix while that of the reflexive object follows the development of the ego ideal-superego complex through processes of introjection. Accordingly, two classes of transference are then distinguished, the discharge transference and the reflexive transference. Their essential developmental and clinical differences are discussed.

Arousal↗
PubMed1986

Monoclonal immunoscintigraphy for the detection of primary colorectal cancers: a prospective study.

A prospective study to investigate the value of monoclonal antibody (McAb) immunoscintigraphy for the detection of primary tumours of the colon and rectum has been undertaken. Twelve patients received 1 mg 131I-labelled McAb YPC 2/12.1, an antibody raised to a human colonic carcinoma membrane preparation. Imaging of the blood pool was achieved using 99mTc-labelled red cells. After surgery specimens were scanned and samples of normal and malignant tissue excised to obtain antibody binding ratios. In only one patient was the primary tumour visualized pre-operatively. Images of the resected specimens revealed the primary tumour in ten cases but this appeared to be a function of increased blood pool within the tumour rather than specific antibody localization. The mean tumour/normal tissue count ratio was 1.27:1 (range 0.63:1-1.93:1). It is concluded that the McAb YPC 2/12.1 is unlikely to be of use clinically. Furthermore when selecting McAbs for the purposes of immunoscintigraphy the results of in vitro binding to malignant cell lines, immunohistological studies and xenograft experiments may be misleading and careful clinical evaluation is necessary.

Antibodies, Monoclonal↗
PubMed1986

The measurement of limb blood flow using technetium-labelled red blood cells.

A method for measuring blood flow below the knee during reactive hyperaemia induced by 3 min of arterial occlusion has been developed. Subjects are positioned with lower limbs within the field of view of a gamma camera and pneumatic cuffs are placed below the knees to isolate the blood and induce a hyperaemic response. The remaining blood pool is labelled with 99Tcm-labelled red cells. Blood flows have been derived from the initial gradients of time-activity curves and from equilibrium blood sampling. The technique has been validated using a tissue-equivalent leg phantom and peristaltic pump. The method has been applied to a small group of patients with peripheral vascular disease and to normal controls. The mean value (+/- SD) of limb perfusion for normal controls was found to be 16.4 +/- 3.0 ml/100 ml/min and for patients with intermittent claudication was 5.1 +/- 2.6 ml/100 ml/min. Flow measurements are found to correlate with clinical findings and with symptoms. Reproducibility (established by repeated measurements) is high. The method is well tolerated even by patients suffering from rest pain.

Arterial Occlusive Diseases↗
PubMed1985

Deranged liver blood flow patterns in the detection of liver metastases.

Hepatic flow scintigraphy has been used to evaluate 150 patients with gastrointestinal carcinoma. A normal range has been obtained on a group of 23 healthy volunteers. The flow scintigraphic findings have been correlated with the presence of metastases at the time of primary surgical therapy. The group of patients with livers ostensibly clear of metastases have been followed up over a one-year period. At one year the specificity of the investigation is 72 per cent with a sensitivity of 96 per cent. We conclude that flow scintigraphy is capable of not only detecting established hepatic metastases, but will also identify patients harbouring occult metastatic disease.

Gastrointestinal Neoplasms↗
PubMed1985

Narcissism: its structures, systems and affects.

The growth of object relationships may be studied along either the developmental line of the discharge-object or that of the reflexive-object. The former is the well-known line of development from the need-satisfying object to the constant object and is a study of id-ego relationships. The developmental line of the reflexive-object, on the other hand, follows the history of the introjects and is a study of either ego-superego or ego-ego ideal relationships. It is the latter which constitutes the study of narcissism. The development of the ideal ego out of the ego nuclei leads eventually to the child's struggle to maintain a sense of omnipotence and to the narcissistic crisis. Out of this struggle the introjection of the idealized mother occurs which, as the ego ideal, continues the systemic line of development of narcissism. Various narcissistic states and affects such as shame, humiliation, depression, grandiosity, pomposity, arrogance, adoration and enthralment are the result of either hypercathexis of the introjects of the ego ideal (or of persisting remnants of the ideal ego) and the resulting conflict with the ego, or hypocathexis of the introjects and resulting dormancy of the system ego ideal.

Child Development↗
PubMed1983

Primary lymphoma of the heart. A case report.

The necropsy findings of a large cell lymphoma involving only the pericardium and myocardium in a 62-year-old woman are reported. The initial presenting symptoms were heart failure followed by rapidly progressive heart block. The diagnosis of cardiac lymphoma was suggested by gallium and blood pool isotope studies, and was subsequently confirmed by operative myocardial biopsy. The clinical course was abrupt, and the patient died before therapy was instituted. While primary cardiac lymphoma is an extremely rare condition, experience in this case suggests that noninvasive isotope studies, particularly gallium and blood pool, are helpful in the diagnosis of atypical cardiomyopathy.

Diphosphates↗
PubMed1983

On structure formation and the processes of alteration.

What have traditionally been called the mechanisms of defence are processes which also have the function of contributing to the development of psychic structure. Some of these processes of ego alteration are re-examined with regard to their origin and manner of functioning. Primal repression is inextricably tied up with the development of the secondary processes, while the processes of introjection and identification contribute to the building up of the structure of the ego-ideal-superego complex and the ego respectively. Projection and reaction formation function as defences through the hypercathexis of existing ego processes or structures as probably does disavowal as well. Undoing is better regarded not as a defence mechanism or process of alteration but as the manifestation of an ego split following the failure of reaction formation. The concept of hypercathexis involves problems in the nature of psychic energy, a concept which in some form or other is probably indispensable to psychoanalytic theory.

Cathexis↗
PubMed1982

Archaic introjects and the cosmology of H.G. Wells.

The roles of the archaic loving and hating introjects are traced in the early scientific romances and the life work of H.G. Wells. The preambivalent polarization of the early loving introjects of an archaic ego ideal (giving rise to utopian fantasies and, later, to promulgations of a new world state) and the early hostile introjects of an archaic superego (giving rise to fears of death and, later, to fears of cosmic dissolution) is represented in eschatological preoccupations with death, the Last Judgment, heaven and hell. These religious preoccupations are derivatives of wishes for maternal union and bliss on the one hand, and of castration anxiety and fears of personal annihilation on the other. Further transformations of the archaic introjects are traced through an indentification with the role of redeemer, and later, through his scientific studies, to an espousal of T.H. Huxley's teachings of organic evolution and to the development of cosmological themes in his work.

Anxiety, Castration↗
PubMed1982

Regional lung ventilation in ankylosing spondylitis.

Patients with ankylosing spondylitis (AS) sometimes develop apical lung fibrosis and cavitation. It has been suggested that one causative factor is reduced apical ventilation due to rigidity of the thoracic cage. We measured regional ventilation in 27 patients with AS and 18 normal volunteers. Twelve patients (Group A) had chest expansion greater than 2 cm, twelve (Group B) had chest expansion of 2 cm or less and three (Group C) had apical lung lesions on chest radiographs; patients in Groups A and B had no radiographic lung lesions. Ventilation per unit volume (VE/VA min-1) was calculated from 81Krm washout curves. The ratio of upper zone to lower zone ventilation (VR) was calculated. VR in Group A (0.74 +/- 0.11) and group B (0.75 +/- 0.12) was not significantly different from VR in controls (0.76 +/- 0.08). There was no significant correlation between VR and FVC, FEV1 or maximal chest expansion. In patients with apical fibrosis only the radiographically abnormal areas had reduced ventilation. Patients with AS do not underventilate the upper zones of the lungs except in the presence of radiographically visible fibrosis.

Adult↗
PubMed1981

Preliminary evaluation of a single-day tubeless test of pancreatic function.

The test for pancreatic exocrine function using N-benzoyl-L-tyrosyl-p-aminobenzoic acid (BTP test) does not require duodenal intubation, but misleadingly abnormal results often occur in patients with liver or bowel disease because the p-aminobenzoic acid (PABA) released by chymotrypsin hydrolysis of the peptide either is not conjugated or is malabsorbed. This study evaluated a modified BTP test, using a tracer dose of 14C-PABA to eliminate misleading results, to assess exocrine function from a single six-hour collection of urine. The test clearly distinguished all patients with pancreatic steatorrhoea from normal subjects and identified patients with less severe pancreatitis as often as did the Lundh test. Furthermore, in patients with bowel or liver disease the misleadingly abnormal results of the unmodified BTP test were eliminated by the modified test in all but one case. These findings suggest that the modified BTP test provides a practical alternative to conventional tests of pancreatic function that entail duodenal intubation.

4-Aminobenzoic Acid↗
PubMed1981

5-Fluoro- and 5-chlorocyclophosphamide: synthesis, metabolism, and antitumor activity of the cis and trans isomers.

In seeking analogues of cyclophosphamide (1) having improved antitumor activity by virtue of accelerated formation of the cytotoxic metabolite phosphoramide mustard, cis and trans isomers of 5-fluoro- and 5-chlorocyclophosphamide (9, 10, 11 and 12, respectively) were synthesized by condensation of the appropriate 3-amino-2-halopropan-1-ol (13 or 26) with N,N-bis(2-chloroethyl)phosphoramidic dichloride (14). The metabolism of the halocyclophosphamides by rat liver microsomes was stereoselective; the cis isomers (9 and 11) were poorly metabolized, whereas the trans isomers (10 and 12) were metabolized with efficiency comparable to that of cyclophosphamide. However, there was no evidence that the yield of phosphoramide mustard produced by the trans analogues were significantly greater than that from cyclophosphamide following microsomal 4-hydroxylation. Hence, the halogen substituents did not accelerate beta-elimination of acrolein from the acyclic aldehydo tautomers. As expected, the poorly metabolized cis-5-fluoride (9) had little activity against the ADJ/PC6 tumor in mice. However, the cis-5-chloride (11) was as active as the trans isomer (12) and each had approximately half the therapeutic index of 1. The trans-5-fluoride (10) was much less active, having an ED90 value some 16-fold that of 1.

Animals↗
PubMed1980

On masochistic enthralment a contribution to the study of moral masochism.

Freud rested his final understanding of moral masochism (the masochistic character) upon the concept of the death-instinct. Those analysts who have been unable to accept this concept have continued to define and enrich the understanding of the masochistic character. Out of their work has emerged the picture of a character structured in three discernible layers: an upper one of "nobility in adversity": a middle one of hate toward the mother; and the deepest one of primary union with the mother to which a later return is made. An abbreviated account of an analysis is given to exemplify this structure. An understanding of the relation between the deepest layers is essential to a comprehension of the total structure. Out of a primary maternal union accompanied by experiences of omnipotence and grandiosity emerges an ambivalent relationship to the omnipotent mother characterized primarily by hate. The relationship to the mother is one of masochistic enthralment. The lost omnipotence is then recaptured by a union mystica (primary identification) with the hating and hated mother now internalized as an aggressive self-ideal in which phallic characteristics become prominent. The unio mystica may be momentary and orgasmic as in the masochistic perversion or more or less enduring and characterological as in the masochistic character to which it contributes traits of haughtiness and disdain.

Character↗