Rationale, practice and problems of holistic medicine.
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Biomedical subjects
Publications and source records attributed to J H Carter.
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Having survived to reach their senior years is testimony to the individual emotional and physical ruggedness of aged black men and women. Surprisingly, of the 24 million elderly Americans alive today, 8 percent are black. The coping styles that led to their survival have antecedents in youth. Consequently, the measure of strength of aged blacks can be judged only within the framework of their whole lives. Anxiety, depression, and despair are frequent findings that demand greater diagnostic acumen and selective treatment.
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Accurately diagnosing psychiatric disorders in black patients has been a controversial subject. Criticism has been made that blacks are more likely to receive a diagnosis of psychosis, eg, paranoid schizophrenia. With proper use of the Diagnostic and Statistical Manual of Mental Disorders (DSM III), the author anticipates greater diagnostic accuracy with blacks. The multiaxial perspectives of DSM III, particularly axis IV, help resolve some critical aspects of diagnostic difficulties. This case illustrates the diagnostic errors frequently made when variables of culture, ethnicity, and psychosocial factors are minimized.
Vibration of hamster small intestinal segments in hypotonic media containing PVP is a rapid method for obtaining quantitative yields of viable intestinal epithelial cells. This preparation of epithelial cells offers a unique system for the study of epithelial cell function in vitro. The method for cell separation combines hypoosmotic swelling of cells, which separates them at the desmosomes, with mechanical agitation which releases the cells from the lamina propria. No chemical agents known to affect cell proteins and cell surfaces are employed in this procedure. Only a short time is elapsed between in vivo and in vitro conditions, i.e., a preparation time of approximately 75 minutes. Although the technique yields a pure population of epithelial cells, the cells are of different morphologies, are removed from different areas of the crypts and villi, and therefore presumably have different functions. Examination of the intestinal tissue remaining after several vibration intervals by light and scanning electron microscopy indicates that the sequence of release of cells is removal of: (1) cells from the villus bases, (2) cells from the lower one-half to two-thirds of the villi, (3) cells from the villus tips (and some crypts), and (4) cells from the crypts. When pools of a+b cells are compared to pools of c+d cells, it is found that villus cells can be characterized by: (1) processes, such as monosaccharide absorption, associated with the brush border, and (2) synthesis of components (e.g., glycoproteins) of the brush border. Surprisingly, disaccharide hydrolytic activity is found in cells which transport monosaccharides poorly. The subpopulations of cells synthesize proteins equally.
Isolated hamster intestinal epithelial cells can be separated by velocity sedimentationion on 2-10% Ficoll gradients into three subpopulations of cells which differ in morphology, biochemistry, physiology, and membrane components. These subpopulations are not pure but are enriched in a single cell type to the extent that differences in cell function can be observed. The proliferative crypt cells are separated from the digestive-absorptive villus cells. A third subpopulation with a distinctive morphology is also obtained. Quantitation of DNA recoveries from the gradients indicates that this population constitutes approximately one-third of the epithelial cell population. These carrot-shaped cells are found adjacent to the digestive-absorptive columnar epithelial cells on the villus. The two types of villus cells differ in glycolipid or glycoprotein components of the brush border as shown by lectin binding experiments with the isolated cells. The gradient data also suggest that only one-third of the intestinal epithelial cell population is responsible for most monosaccharide absorption in hamster small intestine.
Some of the problems associated with providing quality mental health care for aged blacks are discussed. It is postulated that treatment should be used selectively, not in terms of simplistic formulas or part-truths about aged blacks, but on the bases of clinical indications in differential diagnosis. The essence of improved mental health for blacks, regardless of sex or age, entails an unrelenting struggle by mental health professionals toward the removal of all vestiges of racism.
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The authors examine the historical, sociological, and behavioral literature about black family life. Prevailing myths surrounding black families are contrasted with their seldom acknowledged strengths and adaptive behavioral patterns. This diverse scientific literature leads to specific implications for family therapy.
Some loss of visual efficiency with age is universal. Such visual impairment probably is more disabling than most young eye practitioners tend to realize because the visual loss that attends uncomplicated aging impacts only slightly the common clinical tests of vision. Nevertheless, visual impairment associated with aging can interfere significantly with one's ability to perform certain types of visual tasks efficiently. This becomes a problems particularly when these tasks must be carried out under less than optimal viewing conditions.
The personality of the therapist does influence the psychotherapeutic process. Given that therapists are human, they do, in fact, bring into the encounter their moral and cultural, and sometimes even racial, attitudes in spite of efforts to maintain objectivity and neutrality. Ignoring the impact of the therapist-client, organismic variables may lead to spurious research findings and impractical interventions. Research and practical intervention, therefore, should be concerned with matching clients with the most appropriate therapist.
A definitive diagnosis of a posttraumatic stress disorder in black Vietnam veterans can be made when recognition is given, not only to the stressors of war but to racism. An aftermath of the war for black veterans has been an alarming increase in alcoholism, believed to be an attempt to reduce feeling of inadequacy, pessimism, and uncontrollable rage.Two cases are described that are illustrative of the posttraumatic stress disorder and alcoholism in black Vietnam veterans. A brief discussion of salient issues that are crucial to diagnosis and treatment is presented.
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Daily gain, daily feed intake, feed per unit of gain, serum Ca, serum P, serum Mg, structural soundness scores, foot pad scores, metacarpal breaking force and metacarpal ash values from five Ca P trials with barrows, gilts or boars were subjected by sex in each trial to multivariate analysis of variance. Correlation coefficients were obtained from the residual sums of squares and sum of products; thus, coefficients were corrected for treatment effects. Individual values were used for all comparisons except those involving daily feed and feed/gain, for which pen means were used. High positive correlations were observed between daily gain and daily feed; there was no relationship between daily gain and feed/gain, but daily feed was positively correlated with feed/gain. Serum Ca levels were not highly correlated with daily gain, daily feed or feed/gain. Although all coefficients were less than .5, serum P was positively (P less than .01 or less than .05) related to daily gain. Serum Ca and serum Mg concentrations were unrelated to serum P concentrations, but serum Ca was positively correlated with serum Mg. There was no relationship between daily gain and soundness or pad scores. Although there were some inconsistencies, a positive relationship was observed between daily gain and metacarpal dried weight, and between daily gain and breaking strength. There appeared to be little, if any, relationship between daily feed and feed/gain and bone parameters. Ca, P and Mg were not consistently related to metacarpal dried weight, breaking strength or ash. Dried weight was positively correlated to breaking strength in four trials and to ash in two trials. Breaking strength was correlated to ash in only one trial. These results offer no support for the belief that stronger, denser bones produce more structurally sound animals, because soundness and pad scores were not related to bone parameters.
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