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Biomedical subjects

J M Lewis

Publications and source records attributed to J M Lewis.

At least 145 records · Page 8Linked to original sources
PubMed1983

Periodic alternating nystagmus associated with periodic alternating skew deviation.

A 34-year-old man had both periodic alternating nystagmus and periodic alternating skew deviation. Neurologic examination and cranial computed tomography supported the diagnosis of cerebellar degeneration. Pathophysiologic mechanisms of these motility disturbances are discussed briefly. To our knowledge these two unusual eye movement abnormalities have not been reported previously in the same patient.

Adult↗
PubMed1983

Competent adolescents from different socioeconomic and ethnic contexts.

In this report two groups of adolescents have been compared and contrasted--black adolescents from working-class families and white adolescents from middle- and upper-middle-class families. The comparisons were based on detailed content analyses of intensive interviews. Although from very different neighborhoods, levels of family income, and life opportunities, the adolescents in these two groups shared an important asset. They were from families determined by rigorous research methodology to be functioning at the more competent end of the continuum of family competence. A preliminary hypothesis that ethnic and socioeconomic forces would cause these two groups of adolescents to be very dissimilar was incorrect. The similarities were, in fact, striking. This important research finding underscores the power of the family as the crucible of human development.

Achievement↗
PubMed1982

Family interaction and the course of adolescent psychopathology: an analysis of adolescent and parent effects.

This study focused on evaluating the utility of three family measures for predicting outcome in a sample of disturbed but nonpsychotic adolescents: (a) the affective quality of the adolescents' voice tone when communicating with his/her parents; (b) the predominant affective quality of the parents' voice tones when communicating with the adolescent, and (c) the affective quality of the content of the parents' verbalizations to the adolescent. These measures were derived from 5-minute face-to-face discussions between parents and their disturbed adolescent. Results indicated that adolescents using positive or neutral voice tones during emotionally laden discussions with their parents tended to show relatively adequate levels of psychosocial adjustment as young adults, while adolescents using exclusively negative voice tones tended to show sufficient adjustment difficulties in early adulthood to warrant diagnoses within the extended schizophrenia spectrum. Although adolescent voice tone was associated with outcome, considering both adolescent and parent affective response led to improved prediction, with consideration of adolescent and parent variables leading to accurate prediction of outcome for 30 of the 33 sample cases.

Adolescent↗
PubMed1982

Dying with friends: implications for the psychotherapist.

The processes that augment the continued development of psychotherapeutic competence are little understood. One readily available source of learning is the life experiences of the therapist, particularly those situations which invoke intense affects and may increase empathic capacity. Some life experiences, however, lead to defenses against affect. In particular, situations in which the therapist feels helpless and those which confront the therapist with his or her own death may precipitate intense defenses. Several periods of such defensiveness resulting from discussions with four dying friends are explored and their implications for psychotherapeutic competence are analyzed.

Adult↗
PubMed1982

Resistances to psychotherapy with the elderly.

This exploration of the contribution of psychiatrists to the underutilization of psychiatric services by the elderly focuses on the therapists' resistances to psychotherapeutic work with older patients. These resistances can be understood as reflecting two very different types of processes. One involves cognitive misunderstandings of both the phenomenology of normal aging and the nature of age-specific adaptive coping mechanisms. The net result of such cognitive misunderstandings is that the psychiatrist interprets as psychopathology that which is part of normative aging. The second type of resistance involves empathic failure. Psychotherapists fail to respond to the affective component of the elderly patient's dilemma because to do so involves the risk of arousing unresolved feelings regarding their own aging and death or that of their parents. These resistances contribute to the myth that elderly patients are unavailable for appropriate psychotherapeutic exploration.

Adaptation, Psychological↗
PubMed1982

Technique of venous impedance plethysmography for quantification of venous reflux.

A study was conducted applying a technique of venous impedance plethysmography for the quantitation of venous reflux to a group of 20 normal persons and five patients with postphlebitic limbs. Results demonstrate a significantly higher reflux refilling rate for those patients with postphlebitic limbs compared with the refilling rate for those in the normal group. It is believed that this technique is a valuable diagnostic tool for detecting venous reflux caused by valve incompetence and that it provides an indication of progression of venous insufficiency in the patient.

Humans↗
PubMed1981

Response of circulating immunoreactive somatostatin to nutritional stimuli in normal subjects.

We have previously reported that in normal subjects plasma immunoreactive somatostatin levels rise after a mixed meal. The contribution of individual nutrients to this rise, and the molecular nature of the somatostatin immunoreactivity measured, have now been studied. Six normal healthy subjects received, on separate occasions, isocaloric (520 calories) and isovolumetric (260 ml) quantities of carbohydrate, protein, and fat. The mean fasting plasma somatostatin level was 29 +/- 5 pg/ml. After carbohydrate a peak of 48 +/- 7 pg/ml was reached at 30 min, and after protein and fat there were more sustained rises with peak levels of 74 +/- 8 pg/ml and 80 +/- 9 pg/ml, respectively. Sephadex G50 chromatography of extracts of fasting peripheral plasma showed two main peaks of somatostatin immunoreactivity, one coeluting with cyclic somatostatin and a larger peak of approximately 3500 molecular weight (mol wt). Levels of both 1600 and 35000 mol wt somatostatin were increased 60 min after a mixed meal. Approximately 80% of the 3500 mol wt form of somatostatin could be converted to the 1600 mol wt form by treatment with dithiothreitol (an agent which reduces disulphide bonds). It is concluded that: (a) in normal subjects fat and protein are potent stimuli for somatostatin release; (b) somatostatin in normal peripheral plasma exists in multiple forms, and that both 1600 and 35000 mol w forms of somatostatin immunoreactivity are stimulated by feeding; (c) the 3500 mol wt form could represent a dimer of somatostatin or a somatostatin molecule linked to a second peptide chain by disulphide bonds.

Adult↗
PubMed1981

Skin blood flow in seated geriatric patients.

A hard seat was equipped with devices sensing arteriolar pulsatile blood flow volume rate, externally developed pressure, and shear, all taken in lateral proximity to the ischial tuberosities of sitting subjects. Tests of 14 geriatric hospitalized patients and 9 healthy young men indicated the following: (1) No young healthy man demonstrated blood flow occlusion at pressure values less than 120mmHg. Of the geriatric hospitalized subjects, 2 occluded at less than 20mmHg. (2) Average shear values developed by the geriatric hospitalized group were 3 times that of the young healthy group. (3) Average pressure values demonstrated by the geriatric hospitalized subjects were roughly equal to those of the younger subjects (roughly 70mmHg). (4) Tipping the seat backwards through 20 degrees produced major benefits to the hospitalized geriatric group in terms of increased blood flow, lessened pressure, and lower shear. The young, healthy group experienced some increase in blood flow with no significant change in sitting reactions when tested in a tipped attitude.

Adult↗
PubMed1980

Follow-up of adolescents treated in a psychiatric hospital: measurement of outcome.

Treatment planning that is highly individualized and systematically improved must be based on careful assessments of the effectiveness of current technics. This report describes the long-term (three to eight years) outcome of psychiatric hospitalization for 120 severely disturbed adolescent patients as it is measured on three dimensions: peer and social functioning, relationship with parents, and educational and occupational functioning. The measurement scales and the follow-up procedures are practical and easily used.

Adolescent↗
PubMed1978

Distribution of clozapine in the rat: localization in lung.

To determine the distribution of the antipsychotic agent, clozapin (CLZ), a fluorometric procedure for its estimation was devised, and the drug was measured in various tissues of rats after i.p. injection (20 mg/kg). In a 24-hour urine collection, less than 1% injected drug was found. After 1 hour, CLZ concentrations were greatest in lung, spleen, liver and brain (16-64 microgram/g). After 6 hours, CLZ levels in lung remained at 52 microgram/g, whereas concentrations in all other tissues declined to less than 7 microgram/g. When rat lung slices were incubated (O2, 37 degrees C) in CLZ solution (20 microgram/ml), the drug was taken up by the tissue against a concentration gradient, attaining a maximum tissue/medium ratio of 97 after 4 hours. When the concentration of CLZ was raised from 2 to 200 microgram/ml the 1-hour tissue/medium ratio declined from 89 to 21. Chlordiazepoxide, amphetamine and morphine depressed the 1-hour tissue/medium ratio of CLZ by 34 to 50%. CLZ uptake was also decreased 19% by anaerobic conditions and 25% by the presence of 2,4-dinitrophenol. The results suggest that the lung is a site of (active) transport and accumulation for CLZ and perhaps certain other basic drugs.

Animals↗