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Biomedical subjects

A Springer

Publications and source records attributed to A Springer.

At least 19 recordsLinked to original sources

Female perversion: scenes and strategies in analysis and culture.

The author presents some ideas derived from observation in analysis about differing positions of Freud and Jung on perversion and about probable differences in perverse structural elements of women in contrast to men. In general perversion is understood as a defence of the self; in particular with women it is seen as a defensive way of achieving a false wholeness, a pseudo-androgyny. A case study describes the unfolding of a perverted transference. The importance of reaching the analyst and being understood by the analyst through projective identification is stressed. Quite often a sexually abusing mother seems to play an important role in generating female perversion; the implications in analysis are discussed as well as some ideas about culture and gender.

Adult

The affective memory and its implications for pathodynamics.

In this paper the author presents a review of the literature concerning the connections between affective states and memory processes together with the reflections on the implications of these connections for psychopathology and symptom/syndrome formation. Especially the issue of hypermnestic states in the context of dissociative phenomena is extensively discussed. The importance of these phenomena and processes for psychotherapy is discussed too. It might well be that they are involved in symptom formation as a transference reaction as part of the process of psychotherapy.

Affect

Exercise radionuclide ventriculography in evaluating successful transluminal coronary angioplasty.

To evaluate the ability of transluminal coronary angioplasty (TCA) to relieve myocardial ischemia, 44 patients with single vessel disease underwent exercise gated radionuclide ventriculography (GRNV) before and 2.8 +/- 1.3 days following angiographically successful TCA. Pre-TCA GRNV was abnormal in 11 of 14 patients with right coronary artery (RCA) stenosis and 24 of 30 with left anterior descending (LAD) stenosis. Following TCA there was an increase in exercise duration from 500 +/- 288 sec to 625 +/- 273 sec (P less than 0.001), and in maximum double product from (209 +/- 69) x 10(2) to (263 +/- 70) x 10(2) (P less than 0.001). The number of patients with stress-induced ST-T abnormalities decreased from 13 to 4 (P less than 0.05), and the number with chest pain during exercise decreased from 18 to one (P less than 0.001). Whereas resting ejection fraction was unchanged (0.58 +/- 0.10 vs 0.59 +/- 0.11) following TCA, the ejection fraction at peak exercise increased from 0.61 +/- 0.13 to 0.66 +/- 0.12 (P less than 0.001). Of 24 patients with resting abnormalities, regional wall motion improved in 13. In 22 of 31 patients with stress-induced asynergy, the wall motion response to exercise improved (P less than 0.001). Of 19 patients restudied angiographically and with exercise GRNV at 6-12 months, restenosis of greater than or equal to 50% had occurred in six, four of whom had abnormal studies. In six of whom the degree of stenosis of the dilated artery had remained less than or equal to 20% the exercise GRNV study remained normal. It is concluded that GRNV is helpful in documenting the improvement in resting left ventricular function and functional reserve in patients with angiographically successful TCA. In the limited number of patients with late follow-up studies, data suggest that GRNV may be a valuable test to detect restenosis.

Adult

Transluminal coronary angioplasty of the right coronary artery brachial cutdown approach.

Transluminal coronary angioplasty (TCA) of the right coronary artery (RCA) was performed by brachial cut-down approach in 33 patients during a period of 16 months. Flexible-tip guiding catheters were used in all cases. TCA was successful in 27 of 33 patients (81%). The stenosis was reduced in successful cases from a mean of 89% predilatation to 26% postdilatation (P less than 0.001). The systolic pressure gradient across the lesion was reduced from a mean of 49 mm Hg to 4 mm Hg (P less than 0.001). Following successful TCA, patients experienced marked improvement in clinical status, functional capacity, and relief of angina. The complication rate in this study was low. There was no early or late mortality. The most common complication was dissection of the coronary artery occurring in four cases (12%). One patient sustained an acute inferior myocardial infarction. Only one patient required emergency coronary artery bypass surgery. The late follow-up (mean 6 months) angiography was obtained in 17 patients. The stenosis recurred in late follow-up in three cases (18%). Our initial experience revealed that the use of softer guiding catheters by brachial technique offers more selective approach for TCA of RCA lesions and provides better results than percutaneous femoral approach with fixed-tip catheters. Our success rate of 81% for dilatation of RCA is significantly higher than previously reported.

Adult

Early experience of transluminal coronary angioplasty (TCA) by the brachial artery (the Sones technique in transluminal angioplasty).

Sixteen transluminal coronary angioplasty procedures (TCA), eight right coronary artery (RCA) and eight left anterior descending coronary artery (LAD), by the brachial artery cut-down approach, were attempted with 9/16 (56%) immediate successes and 2/16(12%) early recurrences. The procedure success rate for RCA obstructive lesions, 6/8 (75%) was greater than for LCA obstructions, 3/8 (38%). In six unsuccessful procedures the balloon catheter could not be advanced into the lesion, and in one unsuccessful procedure dissection of the coronary artery proximal to the lesion occurred. The brachial (Sones) technique for transluminal coronary angioplasty permits the use of softer guiding catheters for selective probing and approach to the coronary lesion but may be more likely to induce coronary spasm. Complete and high-resolution pre TCA angiograms with multiple views to disclose the exact anatomy of the coronary artery and its lesion is essential to ensure successful dilatation.

Adult

T-lymphocyte subpopulations in the peripheral blood of patients with Crohn's disease.

Samples of peripheral blood from 26 patients with Crohn's disease (CD) and 26 healthy age- and sex-matched controls were tested simultaneously for B and T lymphocytes and T-lymphocyte subpopulations with receptors for IgM (TM) and IgG (TG). Patients with CD had reduced proportions of T lymphocytes, and this reduction showed a significant correlation to the CD activity index (r = -0.65, p less than 0.01). There was slight reduction of TM only (p less than 0.05) inpatients with highly active disease but not in the total population of patients studied. Proportions of B and TG cells were similar in patients and controls. Patients with no clinical or radiological but histological signs of active disease had T lymphocytes and subpopulations like patients with inactive disease. This suggests that the reduction of T cells and T-cell subpopulations in CD are secondary effects. With regard to T-lymphocyte subpopulations, our results are in contrast to a recently published report and do not suggest that analysis of T cells according to the expression of Fc receptors helps in the understanding of functional changes in the T-cell system in patients with CD.

Adolescent

Effects of physicians' early parental counseling on rearing of Down syndrome children.

A survey of the feelings of 37 couples with a school-age Down syndrome child born since 1970 suggested a diminished influence of physicians' early counseling on parental decisions, attitudes, and rearing practices respecting their affected child. In contrast, undefined "personal feelings," own research, and input from community parent groups (such as the Pennsylvania Association for Retarded Citizens) were major influences. Parental decisions on further reproduction after the birth of a Down syndrome child was based less on perception of genetic risks than on concern for the care needs of their affected child.

Attitude to Health