Biomedical subjects
Publications and source records attributed to C W Schmidt.
It is reported on a female patient with skeletal fluorosis stage II. The osteosclerosis seen on X-rays of the skeleton has decisively diminished within 12 years after termination of fluoride exposure. The fluoride content of the bone ash correlates to the roentgenological picture. Consequences concerning a therapy of osteoporosis with sodium fluoride are discussed.
Seventy-six women who presented with a principal complaint of anorgasmia were partitioned into four distinct subtypes on the basis of psychosexual and psychological symptoms using hierarchical cluster analysis, a mathematical taxonomic method. The classification was accomplished with data from the Derogatis Sexual Functioning Inventory (DSFI) and the Brief Symptom Inventory (BSI). Comparisons involving age, race, marital status, and social class demonstrated no significant differences between the four subtypes; however, statistical analyses of psychosexual, psychological symptom, and chart-review variables (including psychiatric diagnosis) revealed very significant distinctions between the four groups. From the resulting typology, anorgasmic subtypes were presumptively identified as "low desire" (n = 21), "histrionic/marital conflict" (n = 20) "psychiatric disorder" (n = 12) and "constitutional" (n = 16). Implications of the typology for etiologic and optimal treatment decisions concerning anorgasmia are discussed.
Human immunodeficiency virus (HIV) was readily isolated by co-cultivation of patients' cells with phytohaemagglutinin-stimulated mononuclear cells from umbilical cord blood in 2 ml cultures in 24-well plates. Fluids from cultures of the MLA 144 cell line acted as an excellent source of interleukin-2, and promoted early replication of HIV in the primary cultures. Reverse transcriptase activity was commonly present at significant levels by 4-7 days. In contrast, recombinant IL-2 (recIL-2) did not promote early replication under these conditions. Adequate washing of the phytohaemagglutinin blasts was critical in this system, although others have reported it to be less important under other culture conditions. Cell concentrations and HIV: target cell ratios appeared not to play a major role in early outgrowth of virus. The particular sheep anti-alpha interferon tested resulted in a two-fold reduction in RT activity. Virus was readily transmitted in this simplified cheaper culture system.
The authors screened for alcoholism 145 consecutive patients who presented with sexual dysfunction or disorders. Using the Michigan Alcoholic Screening Test (MAST), 29% of the patients scored in the probable alcoholic range. Probable alcoholics were more likely to present without a partner and claimed higher sex drive than nonalcoholic patients. Probable alcoholic males reported less joy and vigor than probable alcoholic females, while the reverse held for the nonalcoholic groups. Blind to the MAST results, the staff made six alcohol-related diagnoses and referred one patient for alcohol treatment. The authors discussed the importance of training faculty and resident staff in the relationship of alcohol abuse associated with psychosexual dysfunctions.
Transvestic fetishism is characterized by eroticized cross-dressing in a heterosexual male. Twenty-one transvestites who were seeking psychiatric consultation were evaluated using the Derogatis Sexual Functioning Inventory (DSFI) and the Brief Symptom Inventory (BSI). They were compared with 45 heterosexual married males. The transvestic group was significantly more distressed on most dimensions of the BSI. The transvestic group displayed a more negative body image, a more feminine gender role perception, and less experience than the comparison group on the DSFI. Those transvestites who had no homosexual experience were less frequently gender dysphoric but more frequently had a concurrent axis I disorder. The transvestite with recent homosexual experience reported an earlier age when cross-dressing began. These findings are discussed in the context of previous research on transvestism.
The metabolism of fluorides in impaired renal function is described. The use of fluoridized drinking-water in the production of dialysis fluid is discussed controversial. In patients treated by chronic hemodialysis the plasma fluoride level rises at a content of 1 mg fluoride per liter dialysis fluid. A relevant effect on the state of health is not certain established today. Therefore, it will be advised to the use of fluoride-free dialysis water. Its production should be made by use of a reverse-osmosis unit.
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Report on 3 female patients who, after treatment of an osteoporosis with sodium fluoride, have developed a skeletal fluorosis. The proof was performed radiologically, histologically and by means of fluoride analysis in the bone ash. The diagnosis was made accidentally. Complaints relating to this are not mentioned. Osteosclerosis after fluoride therapy is no iatrogenically damage for the patient, but the aim of the therapy for the prevention of osteopenic fractures.
Couples requesting in vitro fertilization (IVF) may be sexually dysfunctional either as an etiologic factor in their infertility or because they experience decreased sexual satisfaction as a reaction to previous infertility treatment. The present study assessed the sexual functioning and psychologic status of 45 married couples who had requested IVF. The couples were given complete psychosexual evaluation by senior staff members of the Sexual Behaviors Consultation Unit and each participant completed the Derogatis Sexual Functioning Inventory (DSFI). Seven couples (15.5%) were experiencing a sexual dysfunction and 13 individuals (14.4%) were given Diagnostic and Statistical Manual of Mental Disorders III diagnoses. In total, 19 individuals (21%) of the sample were found to have either a sexual dysfunction or psychologic disorder. Couples with a sexual dysfunction were more likely (P = 0.05) to have unexplained infertility. Norms for psychologic evaluation as part of IVF are suggested and the role of such evaluation discussed.
Seventy-six women who presented with a principal complaint of anorgasmia were compared with a matched cohort of sexually functional controls on the domains of the Derogatis Sexual Functioning Inventory (DSFI). Patients were case matched with controls on age, race, marital status, and social class. Initial comparisons revealed significant differences between patient and control groups on a number of psychosexual characteristics, consistent with prior research. Based on evidence of heterogeneity within the patient sample and earlier research by our group, the anorgasmic cohort was partitioned by a "marker variable" approach into two anorgasmic subtypes. The marker variable used to create the subtypes was the presence of homosexual fantasies. Subsequent contrasts, both between the two anorgasmic subgroups, and with functional controls, revealed highly significant differences, and provided strong evidence for at least two psychologically distinct subtypes of anorgasmia.
The focus of this paper is on the adult who has adequately mastered the oedipal stage of psychosexual development and who presents with a sexual dysfunction. Drawing on the developmental sequence of Erik Erikson, the authors suggest that failure to address adequately an adult psychosocial crisis may result in sexual dysfunction. There may be both adult developmental deficits and regression to adolescent and adult stages previously negotiated. Both may be symptomatically represented by sexual dysfunction. The authors urge that the sexual and marital problems be evaluated within an adult developmental framework and that the therapy address the psychosocial issues which are appropriate to the developmental stage of the patient.
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Report on a 76-year-old man with untreated terminal renal insufficiency and fluoride load lasting for decades. We found the typical constellation of low fluoride values in the urine, very high serum values and considerable storage of fluoride in the skeleton. With regard to the fluoridation of drinking water fluorides are a remarkable factor in the care of patients with chronic renal diseases.
Report on an 86-year-old man with massive skeletal fluorosis. The disease arose during chronic exposure to fluorides from renal insufficiency caused by arteriosclerosis. The importance of knowing the renal functional parameters in cases of therapeutic use of fluorides is accentuated.