Between 1975 and 1985, 29 patients with the diagnosis of carcinoma of the petrous temporal bone were seen at the Princess Margaret Hospital. Twenty-seven carcinomas were graded: 13 were well-differentiated; the remaining 14 were either moderately or poorly differentiated tumors. Fifteen patients were managed with a combination of surgery and radiotherapy, 13 were treated with radiotherapy only, and one patient was treated by surgery alone. Median follow-up time was 6.1 years, and the 5-year actuarial local control and cause-specific survival rates for the entire group were 40% and 50%, respectively. Age greater than 60 years, poor grade of tumor, and involvement of the facial nerve were three significant variables associated with poor outcome. A superior 5-year actuarial local control was achieved with surgery plus postoperative radiotherapy (54%) compared to other treatment approaches. Based on the results from this review, we would continue to recommend a combined modality approach of surgery followed by postoperative radiotherapy in the management of this rare, but life-threatening disease.

Adenocarcinoma↗

PubMedDate not supplied

Symptoms of interpersonal sensitivity in depression.

Six self-rated items of interpersonal sensitivity (IPS) were examined in 174 depressed outpatients. These items were "feeling critical of others," "your feelings being easily hurt," "feeling others do not understand you or are unsympathetic," "feeling others are unfriendly," "feeling inferior to others," "feeling shy or uneasy with the opposite sex." The population was grouped into tertiles based on their pretreatment IPS score. High levels of IPS were associated with earlier onset and greater chronicity of depression, higher Hamilton Rating Scale for Depression (HRSD) score, more severe depressed mood, guilt, suicidality, impaired work and interest, retardation, depersonalization, paranoia, and cognitive symptoms of depression. More frequent atypical features were found, e.g., overeating/weight gain, self-pity, phobic avoidance, and panic attacks. Response to a monoamine oxidase (MAO) inhibitor drug increased at higher levels of IPS, while the response to a placebo decreased.

Clinical Trials as Topic↗

PubMedDate not supplied

Familial psychiatric illness in chronic posttraumatic stress disorder.

One hundred and eight veterans with posttraumatic stress disorder (PTSD) were compared with 60 age-matched controls with regard to family history of psychiatric illness. Depressed controls had a higher morbidity risk (MR) for depression and generalized anxiety in siblings/parents and children, respectively. Patients with PTSD did not differ from alcoholics or nonpsychiatric controls on the basis of family history. PTSD was associated with greater familial anxiety when compared with controls who had experienced combat. When World War II and Vietnam veterans with PTSD were compared, a higher MR for alcohol and drug abuse was found in siblings/parents of Vietnam veterans, and a higher MR was found for other chronic psychiatric disorders in the children of Vietnam veterans.

Adolescent↗

PubMedDate not supplied

Neuroticism and personality disorder in depression.

Neuroticism and DSM-III personality disorder were studied in 39 depressed inpatients. Interrelationships between these variables and their relationship to depressive typology were compared. The relationship of neuroticism, DSM-III personality type and adequacy of personality to MAOI treatment are also examined. Neuroticism scores were unaffected by short-term treatment, and no differences in neuroticism were observed between melancholics and nonmelancholics, or between endogenous and nonendogenous depressives. Higher neuroticism scores were associated with DSM-III personality disorder. Personality disorder occurred significantly more often in nonmelancholia; borderline, antisocial and histrionic personality disorders occurred exclusively in nonmelancholia, while passive-aggressive, dependent and avoidant disorders occurred in both kinds of depression. Response to MAO inhibitor treatment was similar in patients with high and low neuroticism, adequate and inadequate personality, DSM-III personality disorder and no DSM-III personality disorder. Ambiguities of Eysenck's neuroticism scale are discussed in relationship to depression.

Antisocial Personality Disorder↗

PubMedDate not supplied

The Newcastle Anxiety Depression Diagnostic Index in relationship to the effects of monoamine oxidase inhibitors and tricyclic antidepressants.

The Newcastle Anxiety Depression Diagnostic Index (NADDI) was applied to 151 patients who received a monoamine oxidase inhibitor (MAOI) or a tricyclic antidepressant (TCA) drug. The pretreatment presence of a physical stressor and absence of agoraphobia were associated with superior MAOI effects. In women nine of the 13 NADDI items were associated with superior response to the MAOI drugs: these items comprised the absence of childhood anxiety, agoraphobia, compulsive symptoms, early awaking, and retardation, and the presence of dependent traits, neuroticism, physical stress, and panic attacks. In men the absence of suicidal tendencies and retardation, and the presence of dependent traits and panic attacks were associated with superior TCA effects. A within-treatment analysis indicated that depressed men responded better to MAOI than did anxious men.

Adult↗

PubMedDate not supplied

Emphysematous cystitis presenting as painless gross hematuria.

A case of emphysematous cystitis in an immunocompetent male is described. The diagnosis is generally rare, but may be made in the Emergency Department. A history of pneumaturia is highly suggestive of the entity, but is rarely offered by the patient. The evaluation and management of emphysematous cystitis are discussed.

Cystitis↗

PubMedDate not supplied

Insight and treatment outcome in obsessive-compulsive disorder.

To determine whether (1) insight in obsessive-compulsive disorder (OCD) improves when OCD symptoms improve, and whether (2) degree of insight in OCD predicts response to sertraline, data were obtained from five sites participating in a larger multisite study of relapse in OCD. During the first 16 weeks of the study, 71 patients received open-label treatment with sertraline and were assessed using the Yale-Brown Obsessive-Compulsive Rating Scale (Y-BOCS) and a rating scale to evaluate insight, the Brown Assessment of Beliefs Scale (BABS), at study baseline and termination. Baseline total BABS score was not significantly correlated with change in Y-BOCS score. Change in BABS total score and change in Y-BOCS total score were significantly correlated. There was no significant difference in mean endpoint Y-BOCS scores for patients with poor insight (n = 14) compared to patients with good insight at baseline (n = 57). Thus, insight improved with decrease in OCD symptom severity. Degree of insight at baseline did not predict response to sertraline, i.e., patients with poor insight were just as likely to respond to sertraline as patients with good insight.

Adult↗

PubMedDate not supplied

Evaluation of activated carbon filters for removal of ozone at the PPB level.

Performance of filters for the removal of ozone at ambient concentration is characterized. The removal efficiency and pressure drop of 10 commercial filters--including 8 made of granule or powdered activated carbon, 1 activated carbon fiber filter, and 1 packed bed made of an ozone catalyst--were measured for an influent ozone concentration of 120 ppb at 50% relative humidity and 2.54 m/sec face velocity. Activated carbon filters can be very effective at ozone removal, although not indefinitely because chemical reactions of ozone and carbon change the carbon. Initial efficiencies of the 1.27-cm thick flat samples varied from 4.6 to 98.3%. Analysis of the structure and composition of the filters with scanning electron microscopy and X-ray photoemission spectrometry showed chemical reactions permanently changed the composition of the carbon and decreased the surface area. Consequently, removal efficiency decreased with use. Moreover, it was not feasible to regenerate the filters by simply removing them from ozone-laden air. Changes in relative humidity, from 20 to 80%, had no measurable effect on the performance of a granule activated carbon filter. However, because the rate of adsorption of water is faster and the pores are smaller in activated carbon fiber, efficiency of the fiber filter decreased when relative humidity was raised from 20 to 50%. A quality factor, equal to the ratio of a threshold breakthrough time and pressure drop, is used to compare filters. In general, those with higher carbon surface area per unit volume had higher efficiencies and greater pressure drops. Future work should address the removal of ozone in the presence of other gases.

Adsorption↗