Biomedical subjects

W M Dinn

Publications and source records attributed to W M Dinn.

11 recordsLinked to original sources

PubMed2001

Obsessive-compulsive disorder and immunocompetence.

OBJECTIVE: A postinfectious, autoimmune response may be associated with the development of pediatric obsessive-compulsive disorder (OCD). According to this model, antistreptococcal antibodies cross-react with basal ganglia neurons following streptococcus infection. This autoimmune reaction disrupts a basal ganglia-thalamocortical circuit and generates obsessive-compulsive symptoms. One implication of this model is that prolonged immunologic stress may be a risk factor for OCD. That is, immunologic stress may compromise the blood-brain barrier and permit the influx of antistriatal antibodies into the central nervous system. This article explores one part of this putative relationship by investigating whether adult OCD patients, compared to members of other psychiatric groups, demonstrate a higher incidence of recurrent infections and other conditions suggestive of compromised immune function. METHOD: To test this hypothesis, we conducted a medical records review of 100 consecutive patients evaluated at a private psychiatric clinic specializing in the treatment of anxiety disorders. Sixty-five patients met diagnostic criteria for an Axis-I syndrome. Primary diagnoses included OCD, posttraumatic stress disorder, social anxiety disorder, generalized anxiety disorder, panic disorder with agoraphobia, and dysthymic disorder. Each medical record was reviewed for the presence of target syndromes or presenting symptoms suggestive of compromised immune function. RESULTS: Chart review revealed an increased rate of immune-related symptoms and syndromes among OCD patients in comparison to other anxiety and mood disorder groups. Groups did not differ significantly in the incidence of non-immune symptoms and syndromes. CONCLUSION: Adult OCD patients appear to have an increased rate of immune-related diseases above and beyond that seen in other psychiatric disorders.

Adult↗

PubMed2000

Neurocognitive function in antisocial personality disorder.

Recent neuroimaging studies and neuropsychological test findings support the contention that prefrontal dysfunction is associated with psychopathic personality traits and antisocial behavior. However, conflicting results have arisen regarding performance on measures of frontal executive function. We administered a neuropsychological test battery consisting of measures sensitive to frontal lobe dysfunction and a battery of personality questionnaires and clinical scales sensitive to antisocial personality disorder (APD) subjects presenting with prominent psychopathic personality features and matched control subjects. We also monitored the subjects' electrodermal activity during the presentation of emotionally charged stimuli. APD subjects showed greater neuropsychological deficits on measures sensitive to orbitofrontal dysfunction in comparison to control participants. Moreover, APD subjects were electrodermally hyporesponsive to aversive stimuli relative to control group members. APD subjects did not demonstrate performance deficits on classical tests of frontal executive function. Participants also underwent clinical assessment. As expected, APD subjects were less conscientious, self-reproaching, guilt-prone, and socially anxious than matched control subjects. Moreover, the scores indicated that APD subjects were more venturesome and uninhibited relative to control subjects. Contrary to expectations, APD subjects and community control subjects did not differ on a self-report measure of sensitivity to specific phobic situations.

Antisocial Personality Disorder↗

PubMed1999

Posttraumatic obsessive-compulsive disorder: a three-factor model.

This paper presents a three-factor causal model of obsessive-compulsive disorder (OCD), which posits that exposure to long-term traumatic stress generates an inordinate degree of anxiety during the psychological development of the premorbid OCD child. In response to these conditions the child evolves a distinct cognitive style characterized by exaggerated threat appraisal and magical beliefs, and experiences alterations in brain metabolism. An entire functional brain system (a basal ganglia-orbitofrontal circuit) enters into a state of enhanced responsiveness following exposure to protracted threat. Over time the threshold for stimulation is dramatically lowered, resulting in a hypersensitivity to cues that signify potential harm. Individuals adapt to this hypersensitivity through a variety of strategies, which constitute OCD.

Adaptation, Psychological↗

PubMed1978

Computed tomography in genitourinary pathology.

Computed tomography (CT) provides accurate localization of pathologic processes within the abdomen and also frequently contributes information regarding the nature of the process. A review of 50 patients with suspected genitourinary pathology studied with CT suggests that this new noninvasive diagnostic modality can provide increased diagnostic accuracy but that it will not replace conventional abdominal radiography and intravenous urography as the primary screening examination for such patients. Situations in which CT has proved valuable include: (1) evaluation of areas which are relatively "blind" on conventional radiography: anterior and posterior margins of kidneys, paravertebral and midline portions of retroperitoneum, and base of bladder; (2) evaluation of patients with severely compromised function of one or both kidneys, including assessment of amount of functioning renal parenchyma and possible demonstration of cause of obstructive hydronephrosis; (3) evaluation of patients in whom intravenous urography is contraindicated; (4) differentiation of solid from cystic masses of kidney; (5) evaluation of spread of tumor outside boundaries of kidney; and (6) staging of bladder tumors.

Abscess↗

PubMed1977

Computed tomographic scanning in children.

Computed tomographic scanning (CT) has been effectively utilized in evaluating the pediatric patient. Our experience with CT of the chest and abdomen in 19 patients has been described. The advantages offered by CT include: a unique anatomic display, the lack of morbidity, and an acceptable radiation dosage. Few technical disadvantages exist. Further application of this unique technique can be predicted.

Abdominal Neoplasms↗

PubMed1977

Correlation of computed tomography, gray scale ultrasonography, and radionuclide imaging of the liver in detecting space-occupying processes.

The abilities of computed tomography (CT; scanning time=2.7 min), gray scale ultrasonography, and radionuclide imaging to detect and characterize space-occupying processes in the liver were compared. A numerical rating scale which emphasized detection abilities resulted in ultrasonography scoring 3.5 CT 3.2, and radionuclide imaging 2.9. CT resulted in no false positives and 6 false negatives, caused mainly by motion artifacts. The simplest technique, radionuclide imaging, also had the smallest number (2) of false negatives; it is therefore recommended as the screening procedure of choice. Sonography or CT should be done for those patients with a prior suspicious finding.

Carcinoma, Hepatocellular↗

PubMed1977

Isodense masses on CT: differentiation by gray scale ultrasonography.

Alterations in echo patterns enable isodense structures and lesions to be clearly identifiable by gray scale ultrasonography when they are not distinguishable by computed tomography (CT). In certain clinical situations this capability is a distinct advantage of ultrasound over CT. Findings in three cases with abnormalities visualized by ultrasound, but not by CT, are presented. In addition, a cadaver was scanned with CT and ultrasound and then sectioned in corresponding transverse planes for anatomic correlation.

Dysgerminoma↗

PubMed1977

Radionuclide imaging, computed tomography, and gray-scale ultrasonography of the liver: a comparative study.

Transmission computed tomography (CT), gray-scale ultrasonography, and scinitillation-camera imaging were compared for detection of intrahepatic space-occupying processes. Fifty patients with suspected liver disease were studied by the three modalities. In the 35 cases with confirmed abnormalities, the madalities were rated on a scale of 0 to 5 in terms of their detection value; Each modality was found to have definite advantages and disadvantages. The mean score of ultrasound was highest (3.61), followed by nuclear medicine (3.11) and then CT (2.77). The combination of ultrasound and nuclear medicine identified all lesions, whereas CT alone or in combination with another technique occasionally failed to detect abnormal foci. In the future, the relative efficacy of these procedures may change with improved imaging technology and increased interpreter experience.

Carcinoma, Hepatocellular↗

PubMed1976

The radiology of the superior intercostal veins.

The superior intercostal veins define the pleural reflections of the caudad extent of the posterior junction line. They are paired structures which drain the first three intercostal spaces and join the azygous on the right and the accessory hemiazygous on the left. Because of their location posterior and lateral to the esophagus and trachea, their pleural reflections may be altered early in the course of a focal nodal disease of the posterior mediastinum.

Azygos Vein↗

PubMed1976

Intestinal perforation. An infrequent complication of ventriculo-peritoneal shunts.

Bowel perforation by ventriculo-peritoneal shunts occurred in two children with no abdominal symptoms. The diagnosis in each instance was confirmed by opacification of the colon in one child and the small bowel in the other via contrast medium injection of the distal shunt tubing. "Shuntograms" are recommended for all patients with no readily evident cause of dysfunctioning cerebrospinal fluid-peritoneal shunts.

Cerebrospinal Fluid Shunts↗

PubMedDate not supplied

Adult attention-deficit/hyperactivity disorder: neuropsychological correlates and clinical presentation.

We compared the neuropsychological test performance of adult ADHD patients to the neurocognitive profiles of control subjects recruited from the general population. We administered a neuropsychological test battery consisting of measures considered sensitive to either orbitofrontal or dorsolateral-prefrontal (DLPF) dysfunction. Orbitofrontal hypoarousal is associated with behavioral disinhibition and a relative indifference to punishment. The DLPF region may function as a central executive system. Indeed, DLPF dysfunction may underlie many of the cardinal symptoms associated with ADHD. We tested the following hypotheses: (1) adult subjects meeting DSM-IV criteria for ADHD, predominantly hyperactive-impulsive type, would display neuropsychological deficits on tasks sensitive to orbitofrontal dysfunction; (2) adult subjects meeting DSM-IV criteria for ADHD, predominantly inattentive type, would perform poorly on measures sensitive to DLPF dysfunction; and (3) adult subjects meeting DSM-IV criteria for ADHD, combined type, would exhibit performance deficits on orbitofrontal measures and on DLPF tasks. Results partially confirmed our hypotheses. Subtyping ADHD patients revealed important group differences. Distinct neurocognitive and clinical profiles were observed.

Adult↗