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PubMed1984

What are the psychosocial factors involved in motivating individuals to retain their teeth? Dreams and facts.

The mother-child relationship, the family milieu and the scholastic environment all play a part in determining the ability of an individual to accept oral care. The acceptance of such care needs to be prompted by arguments based on the principal functions of the teeth: chewing and digestion; elocution and communication; and aesthetics--especially the smile displaying harmonious teeth which is synonymous with beauty, youth and happiness. Avoidance or rejection of dental care are direct consequences of fear; fear of pain and primordial fears linked to infant anxieties and the castration complex. Refusal or neglect to practise oral hygiene may represent aggression and rebellion against the established order. Harmful eating habits, notably the symbolic seductiveness of sugar, and parafunctional behaviour, which contains auto-aggressive or masochistic components, all contribute to the irrational relationships people have with their teeth. Attitudes totally opposed to the aims of prevention readily develop in response to some media messages. If prevention is forced guilt feelings are reinforced and conflict ensues. To overcome this, dentists should establish methods of prevention which do not depend only upon individual participation.

Adult↗
PubMed2005

Evolutionary approaches to understanding sleep.

A major controversy over REM sleep's role in memory processing may owe to inadequate allowances for the highly conservative nature of evolutionary adaptations. The controversy hinges on whether NREM sleep, alone, retains primitive memory processing capabilities. The selective pressure for primitive sleep, is thought to have been the need to obviate conflicts between enormous neural processing requirements of complex visual analysis and split-second control of movements, on the one hand, and memory processing, on the other. The most efficient memory processing during mammalian and avian sleep appears to be a two-step process: synapses in individual component circuits of events are reinforced primarily by slow brain waves during NREM sleep, with the reinforced components temporally bound by fast waves, and manifested as dreams, during REM sleep. This dual action could account for partitioning of sleep periods into multiple NREM-REM cycles. It is proposed that in the absence of REM sleep, all needed memory processing can be accomplished by NREM sleep, alone, though less efficiently. Many symptoms of fatal familial insomnia are attributed to subnormal nightly reinforcement of brain circuitry because of almost total loss of sleep, and compensatory responses thereto during waking. During this disorder, sensory circuitry seemingly is spared by virtue of its supernormal reinforcement during almost continuous waking. Contrariwise, sparing of an adult's 'higher faculties' in encephalitis lethargica appears to owe to supernormal circuit reinforcement during almost continuous sleep.

Awareness↗
PubMed1997

Induction of visual imagery during NREM sleep.

In an attempt to induce eye movements (EMs) in non-rapid eye movement sleep, light and sound stimuli were presented to human subjects (at below-waking threshold) during stage 2 sleep. EMs were used as an indicator of ponto-geniculo-occipital (PGO) wave activity. When at least one concurrent EM in response to the stimuli was observed, the subjects were awakened and mentation reports collected. Compared to equivalent control periods with no stimulation, awakenings from the stage 2 stimulation condition showed a higher frequency of visual imagery reports, electroencephalogram alpha activity, and k-complexes. Additional control and stimulation conditions elicited from rapid eye movement sleep awakenings showed no significant differences in the frequency of visual imagery reports. When the amount of alpha activity before stage 2 awakenings from which imagery was reported was compared to that from which imagery was not reported, imagery awakenings showed significantly more alpha. Results can be interpreted as evidence for a link between PGO activity and dreaming in humans or in terms of an arousal-window hypothesis of visual hallucinations.

Adolescent↗
PubMed2002

Imaging and manipulation of biological structures with the AFM.

Many biologists have dreamt of physically touching and manipulating the biomolecules they were investigating. With the invention of the atomic force microscope (AFM), this dream has come true. Here, recent applications of the AFM to image and to manipulate biological systems at the nanometer scale are reviewed. Macromolecular biological assemblies as well as individual biomolecules can be subjected to controlled nanomanipulation. Examples of AFM application in imaging and nanomanipulation include the extraction of chromosomal DNA for genetic analysis, the disruption of antibody--antigen bonds, the dissection of biological membranes, the nanodissection of protein complexes, and the controlled modulation of protein conformations. Also reviewed is the novel combination of single molecule imaging and force spectroscopy which allows biomolecules to be imaged, and inter- and intramolecular forces to be measured. Future application of these nanotechniques will reveal new information on the structure, function and assembly of biomolecules.

Antigen-Antibody Complex↗
PubMed2004

Nightmares, insomnia, and sleep-disordered breathing in fire evacuees seeking treatment for posttraumatic sleep disturbance.

Eight months after the Cerro Grande Fire, 78 evacuees seeking treatment for posttraumatic sleep disturbances were assessed for chronic nightmares, psychophysiological insomnia, and sleep-disordered breathing symptoms. Within this sample, 50% of participants were tested objectively for sleep-disordered breathing; 95% of those tested screened positive for sleep-disordered breathing. Multiple regression analyses demonstrated that these three sleep disorders accounted for 37% of the variance in posttraumatic stress symptoms, and each sleep disorder was significantly and independently associated with posttraumatic stress symptoms severity. The only systematic variable associated with posttraumatic stress symptoms of avoidance was sleep-disordered breathing. The findings suggest that three common sleep disorders relate to posttraumatic stress symptoms in a more complex manner than explained by the prevailing psychiatric paradigm, which conceptualizes sleep disturbances in PTSD merely as secondary symptoms of psychiatric distress.

Adult↗
PubMed1992

Hierarchies, boundaries, and representation in a Freudian model of mental organization.

Freud used a spatial model of mental organization, derived from his explanation of aphasia, as an organizing framework for psychoanalytic theory. He introduced the ideas of representation and overdetermination to describe relations of the contents of systems that were joined to form, first, a hierarchical nervous system, then, mental systems. Freud used his basic model to organize aspects of mental function and phenomena, of interpersonal and social phenomena, and some kinds of biological phenomena. His accounts of metapsychology and clinical psychoanalysis are similar to his description of the basic aphasia/nervous system model. Across the boundaries of mental systems, translation of the contents of one system led to their being represented in another. Repeated editing and translation account for many properties of the systems. The mind pictured is a hierarchical structure of agencies, functions, and fantasy organizations. Complexity results from the combination of relatively simple relations and repetition of the same operations. The mind described by Freud's psychoanalysis is the self-reflecting mind and the mental activity of an analyst and of a patient in analysis.

Aphasia↗
PubMed2005

The dream of a vaccine against tuberculosis; new vaccines improving or replacing BCG?

In the last 10 yrs, work with experimental laboratory models has developed many new vaccine candidates against tuberculosis (TB). They include subunit vaccines, modified bacilli Calmette-Guérin (BCG) and attenuated Mycobacterium tuberculosis. Phase I clinical trials of new TB vaccine candidates have begun for the first time after 80 yrs of use of BCG. Many of these new trials involve recombinant BCG or improve BCG immunity by boosting with vaccines consisting of subunits or attenuated vaccinia virus expressing TB antigens. However, effective vaccination against TB presents diverse and complex challenges. For example, TB infection can become reactivated years later and infection does not guarantee resistance to a subsequent second infection. A truly effective TB vaccine may, therefore, have to elicit an immune response that is greater than that induced by natural infection. In addition, various different populations have to be protected including those vaccinated with BCG and those infected with M. tuberculosis or HIV. The goal is a new generation of vaccines effective against respiratory forms of tuberculosis. As a first step, good candidate vaccines able to boost bacille Calmette-Guérin and thereby improve protection could be a reality in the near future. Tuberculosis vaccine candidates, able to replace the currently used bacille Calmette-Guérin and/or make the eradication of tuberculosis feasible, can only be expected in the long-term, and safe live vaccines could be promising candidates.

BCG Vaccine↗
PubMed1999

Deconstructing DID.

The author contends that a psychoanalytically informed approach to the patient with dissociative identity disorder (DID) can be very useful. However, there are difficulties in conceptualizing this condition without extending existing theory or applying in new ways what is already known. It is also difficult to put DID in a proper context relative to all the other disorders known to occur in the human mind. Depending on one's clinical experience, level of skepticism, and appreciation of history, DID may be seen as either: a) the psychological "missing link" that realizes Freud's goal of uniting the psychology of dreams with psychopathology, or b) a fraudulent condition that is wittingly or unwittingly manufactured in the therapist's office or c) a population of disturbed and disturbing patients, once the subject of great scientific interest, which, exiled like a "Lost Tribe," is now back in the fold of legitimacy. The author has had extensive clinical experience with psychic trauma, and bases his own views of DID on three assumptions: 1. that dissociation may be seen as a complex defense; 2. that DID may be thought of as a "lower level dissociative character"; and 3. that there is a unique psychic structure, the "dissociative self" whose function is to create "alter personalities" out of disowned affects, memories, fantasies, and drives. This "dissociative self" must be dissolved in order for integration of "alter personalities" to occur. A clinical vignette is offered to illustrate how he addresses some of the challenges of developing a therapeutic alliance at this end of the dissociative-character-pathology continuum, and how he grapples with the difficulty of integrating clinical phenomena, such as the appearance of "alters," with the psychoanalytic model of the mind.

Adult↗
PubMed2003

Parasomnia pseudo-suicide.

Complex behaviors arising from the sleep period may result in violent or injurious consequences, even death. Those resulting in death may be erroneously deemed suicides. A series of case examples and review of the pertinent literature are provided to increase awareness of the possibility that some apparent "suicides" are the unfortunate, but unintentional, consequence of sleep-related complex behaviors and therefore are without premeditation, conscious awareness, or personal responsibility. The correct cause-of-death determination in such cases may have profound social, religious, and insurance implications for surviving friends and family members.

Adult↗
PubMed2004

The clinical spectrum of narcolepsy with cataplexy: a reappraisal.

In the absence of a golden standard for the diagnosis of narcolepsy, the clinical spectrum of disorder remains controversial. The aims of this study were (1) to determine frequency and characteristics of sleep-wake symptoms in patients with narcolepsy with cataplexy, (2) to compare clinical characteristics with results of ancillary tests, and (3) to identify factors that discriminate narcolepsy from other conditions with excessive daytime sleepiness (EDS). We prospectively studied 57 narcoleptics with cataplexy, 56 patients with non-narcoleptic hypersomnia (H), and 40 normal controls (No). Based on suggested and published criteria, we differentiated between narcoleptics with definite cataplexy (N) and narcoleptics without definite cataplexy (possible cataplexy, NpC). Assessment consisted of questionnaires [all patients and controls, including the Ullanlinna Narcolepsy Score (UNS)], polysomnography (all patients), multiple sleep latency test (MSLT) and human leukocyte antigen typing (in most narcoleptics). A new narcolepsy score based on five questions was developed. Data were compared with those of 12 hypocretin-deficient narcoleptics (N-hd). There were significant differences between N and NpC (including mean sleep latency on MSLT), but none between N and N-hd. A score of sleep propensity during active situations (SPAS) and the frequency of sleep paralysis/hallucinations at sleep onset, dreams of flying, and history of sleep shouting discriminated N from H and No (P < 0.001). Cataplexy-like symptoms in H (18%) and No (8%) could be discriminated from 'true' cataplexy in N on the basis of topography of motor effects, triggering emotions and triggering situations (P < 0.001). Our narcolepsy score had a similar sensitivity (96% versus 98%) but a higher specificity (98% versus 56%) than the UNS. Analysis of co-occurring symptoms in narcolepsy revealed two symptom complexes: EDS, cataplexy, automatic behaviors; and sleep paralysis, hallucinations, parasomnias. Low/undetectable cerebrospinal fluid hypocretin-1 levels and a history of definite cataplexy identify similar subgroups of narcoleptics. Specific questions on severity of EDS (SPAS score) and characteristics of cataplexy allow the recognition of subgroups of narcoleptics and their differentiation from non-narcoleptic EDS patients, including those reporting cataplexy-like episodes. The existence of co-occurring symptoms supports the hypothesis of a distinct pathophysiology of single narcoleptic symptoms.

Adult↗
PubMed1989

[Polygraphic sleep data in AIDS patients].

Somnopolygraphic recordings were registered from 29 patients with AIDS, their age ranged from 20 to 55 years (mean: 40.9; median: 44). The patients represent the full range of cerebral disintegration representing the picture of a progressing destruction of physiological sleep organization. Some disturbances begin quite early and progress successively, such as the reduction of REM- and delta-sleep as well as the reduction of sleep spindle- and K-complex-densities. Other changes are not manifest until intellectual capabilities break down; they occur massively such as the shortening of real sleep time and the reduction of sleep stage 2 with a simultaneous increase in waking time. It is remarkable that despite the enormous REM reduction there is no suppression of REM periods corresponding to "REM sine REM". REM periods become very short at an early stage; this is not only because the patients awake more frequently and earlier from their dream periods.

Acquired Immunodeficiency Syndrome↗
PubMed2006

Trauma, reverie, and the field.

The author uses a clinical vignette to demonstrate complex concepts at work--concepts such as those derived from a productive grafting of Bion's thinking onto the concept of the psychoanalytic field. The underlying theory is narrated by the use of images, which the author finds to be the most appropriate way to demonstrate this theory at work--a theory of the mind based on the concept of digestibility of emotions, as well as the progressive introjection of instruments to render such an operation possible. Key points include the waking dream thought, the analyst's reverie, unsaturated interpretations, continual re-dreaming on the content of the session as permitted by the field, and the development of the ability to metabolize emotional contents.

Countertransference↗
PubMed2004

Activity-dependent hepatocyte growth factor expression and its role in organogenesis and cancer growth suppression.

Studies by Murphy et al. have shown that neuronal stimulation can activate immediate early genes that code for transcription factors. Recent data suggest that Ca(2+) elevation in both neuronal cytoplasmic and nuclear compartments is responsible for the coupling of synaptic excitation to gene expression. Deisseroth et al. suggest that Ca(2+) influx through L-type voltage-sensitive Ca(2+) channels (VSCCs) activates cytoplasmic Ca(2+) targets such as calmodulin (CaM). The Ca(2+)-CaM complex then translocates to the nucleus leading to Ca(2+) and cAMP response element-binding protein (CREB) phosphorylation and gene expression. Reports have shown that L-type VSCCs are found on the vagus nerve. Other studies have suggested that activation of L-type VSCCs leads to a Ca(2+) store-dependent elevation of nuclear [Ca(2+)] that triggers gene expression by more direct activation of nuclear Ca(2+)/CaM-dependent protein kinase (CaMK). Moreover, nuclear transcription factors such as DREAM are themselves Ca(2+)-dependent, further supporting the importance of both nuclear and cytoplasmic Ca(2+) elevation in regulating gene expression. Our simulation studies suggest that intense synaptic stimulation in combination with amplification by release from intracellular Ca(2+) stores can produce elevations in nuclear Ca(2+) concentration and CaMK phosphorylation leading to CREB phosphorylation and gene expression. One of the downstream events would be the production of hepatocyte growth factor (HGF). HGF has trophic, repair, therapeutic or mitotic effect on kidney, pancreas, spleen, liver, lung, heart and spinal cord. These organs and systems' regeneration can be achieved by either upregulation of HGF release from the vagus nerve or upregulation of HGF production within the system (spinal cord). Conversely, inhibition of HGF release from the vagus nerve can inhibit cancer growth. Vagus nerve seems to be the nerve that nature intends to regulate organ growth and regeneration, it is very possible that other than HGF and injurin, other growth factors could be found in the vagus nerve. Electrical depolarization and hyperpolarization of the vagus nerve would be the most natural and effective way to induce organ regeneration and suppress cancer growth, respectively. A similar pathway seems to exist for different organs as HGF has trophic, repair, therapeutic or mitotic effect on different vagally innervated organs.

Animals↗
PubMed1999

Unconscious influences on a choice of a career: implications for organizational consultation.

The choice of a career is a highly significant and highly complex process that includes all the spheres of a person's life and continues throughout life. Psychodynamic theory makes a significant contribution to current models of career counseling and organizational consultation by adding the dimension of unconscious career choice. The unconscious determinants of vocational choice are internalized "objects" and "object relations" that reflect the individual's personal and familial history. People choose an occupation that enables them to replicate significant childhood experiences, fulfill needs that were unfulfilled in their childhood or actualize occupational dreams, professional patterns and expectations passed on to them by the familial heritage. The addition of the component of unconscious selection is critical to the full understanding of career choices and the prediction of success and satisfaction in that career. An example that demonstrates this point is presented.

Career Choice↗
PubMed1985

Rorschach content interpretation in post-traumatic stress disorders: a reply to Carr.

In traumatized patients, Rorschach responses draw from a variety of sources, including the traumatic event itself, past and current experiences, and internal fantasy. As complex and highly condensed mental constructions, these responses often serve to reveal the meaning of the trauma in terms of the patient's prevailing personality conflicts. In many cases, this meaning may be hidden in the response's distortion of or elaboration on images drawn from the actual event.

Accidents, Traffic↗
PubMed2000

Desert wanderings: pathways for whole, broken and shattered psyches.

This paper challenges an implicit assumption of analytical psychology that centred, mandalic images express psychical wholeness in an optimal fashion across cultures and eras. I suggest that liminal, bardo-like eras, such as our 'post-modern' one, constellate complex, antithetical and ec-centric images, which are process-oriented and which encompass wholeness and fragmentation, conjunction and disjunction, thus holding and expressing actual individual and collective experience. In our era, we inhabit unfolding states of wholeness, brokenness and fragmentation. Images of wholeness, emerging spontaneously from the unconscious, may reflect part or all of these contradictory realities. Examples of such antithetical Self-images are developed from the ancient midrashic traditions of the rabbis; from Jung's contemporary exposition of Pauli's 'world-clock' dream; from Kepler's discovery, at the dawn of modernity, that the planets circled the sun in ellipses rather than circles; and from a clinical illustration.

Bible↗
PubMed1977

A repeated dose comparison of three benzodiazepine derivative (nitrazepam, flurazepam and flunitrazepam) on subjective appraisals of sleep and measures of psychomotor performance the morning following night-time medication.

Repeated doses of 5 mg nitrazepam, 15 mg flurazepam, and 1 mg flunitrazepam improved subjective assessments of the ease of getting to sleep and the perceived quality of induced sleep in a population of 30 healthy volunteers. The subjective reports of improved sleep inducement were related to a perceived difficulty in awakening from sleep the morning following medication. This subjectively reported "hangover" is also shown in the impairment of mental arithmetic abilities as measured on the serial subtraction of sevens technique. However, complex psychomotor performance is unaffected by repeated administration of these three benzodiazepine derivatives, although these later results are somewhat equivocal. Evidence of a "rebound phenomenon" following 4 nights' withdrawal of active medication is shown in both subjective and objective measures of sleep and early morning behaviour.

Adult↗
PubMed2003

RNA interference in biology and medicine.

First discovered in plants the nematode Caenorhabditis elegans, the production of small interfering RNAs (siRNAs) that bind to and induce the degradation of specific endogenous mRNAs is now recognized as a mechanism that is widely employed by eukaryotic cells to inhibit protein production at a post-transcriptional level. The endogenous siRNAs are typically 19- to 23-base double-stranded RNA oligonucleotides, produced from much larger RNAs that upon binding to target mRNAs recruit RNases to a protein complex that degrades the targeted mRNA. Methods for expressing siRNAs in cells in culture and in vivo using viral vectors, and for transfecting cells with synthetic siRNAs, have been developed and are being used to establish the functions of specific proteins in various cell types and organisms. RNA interference methods provide several major advantages over prior methods (antisense DNA or antibody-based techniques) for suppressing gene expression. Recent preclinical studies suggest that RNA interference technology holds promise for the treatment of various diseases. Pharmacologists have long dreamed of the ability to selectively antagonize or eliminate the function of individual proteins--RNAi technology may eventually make that dream a reality.

Animals↗