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Personality disorders in the elderly compared to four younger age groups: a cross-sectional study of community residents and mental health patients.

The notion is expressed in the DSM-IV that some personality disorders (PDs) tend to remit with age whereas other types do not. This notion is supported by the literature and the study reported here. Studies published between 1951 and 2000 show that (1) in old age, PDs are prevalent both in normal subjects and to a greater extent in the mentally ill; (2) the evidence for general age-relatedness of PDs is scarce and contradictory; (3) there is evidence for specific age-relatedness of PDs in old age. This empirical study focused on the prevalence of PDs in five different age groups ranging from adolescence to old age. It included both community residents (N = 623, aged 17-87), and mental health patients (N = 315, aged 18-86). Dimensional scores for PDs were assessed by means of the DSM-III-R- and ICD-10- based self-report Questionnaire of Personality Traits (VKP) (Duijsens, Eurelings-Bontekoe & Diekstra, 1996). There was consistent evidence for a specific effect of aging: community residents in the oldest age group reported more schizoid and more obsessive-compulsive characteristics compared to one or more of the younger age groups. Older mental health patients showed more schizoid disorder characteristics and fewer high-energy disorder characteristics compared to one or more of the younger patient groups.

Adolescent↗

Difficulties in interpersonal relationships associated with personality disorders and axis I disorders: a community-based longitudinal investigation.

A longitudinal study was conducted to investigate the association between Axis I and Axis II psychiatric disorders, interpersonal relationships, and global functioning among men in the community. Structured clinical interviews assessing Axis I and Axis II psychiatric disorders, global assessments of functioning, and questionnaires assessing social support, social conflict, and loneliness were administered to a community sample of 95 HIV+ and 45 HIV- men. The questionnaires were readministered 1 year later. Results indicated that (a) Personality disorders (PDs) and unipolar depressive disorders were associated with loneliness, social conflict, and low levels of social support after HIV status was controlled statistically; (b) PDs were associated with interpersonal and global impairment after HIV status and co-occurring Axis I disorders were controlled statistically; (c) Axis I disorders were associated with global impairment, but were not associated with interpersonal difficulties after HIV status and PDs were controlled statistically; (d) PDs, but not Axis I disorders, predicted increases in social conflict and global impairment after HIV status was controlled statistically; (e) PDs continued to predict increases in global impairment after both Axis I disorders and HIV status were controlled statistically; and (f) HIV+ men reported more loneliness, less social support, and had a higher prevalence of substance use disorders than HIV- men. The present findings are of particular interest because they suggest that PDs are associated with loneliness, social conflict, and a lack of social support among men in the community, whether or not Axis I disorders are present.

Adult↗

The Collaborative Longitudinal Personality Disorders Study (CLPS): overview and implications.

The Collaborative Longitudinal Personality Disorders Study (CLPS; Gunderson et al., 2000) was developed to fill gaps in our understanding of the nature, course, and impact of personality disorders (PDs). Here, we review published findings to date, discuss their implications for current conceptualizations of PDs, and raise questions that warrant future consideration. We have found that PDs are more stable than major depressive disorder, but that meaningful improvements are possible and not uncommon. We have confirmed also that PDs constitute a significant public health problem, with respect to associated functional impairment, extensive treatment utilization, negative prognostic impact on major depressive disorder, and suicide risk. At the same time, we have demonstrated that dimensional models of PDs have clinical validity that categories do not, especially greater temporal stability. Furthermore, dimensional personality traits appear to be the foundation of behaviors described by many PD criteria. Taken together, our results lead us to hypothesize that PDs may be reconceptualized as hybrids of stable personality traits and intermittently expressed symptomatic behaviors.

Anxiety Disorders↗

Power Doppler sonography of hepatocellular carcinoma treated by transcatheter arterial chemoembolization. Assessment of the therapeutic effect.

PURPOSE: To evaluate the usefulness of power Doppler sonography (PDS) in assessing the therapeutic effect of transcatheter arterial chemoembolization (TACE) in hepatocellular carcinoma (HCC). MATERIAL AND METHODS: TACE was performed in 43 patients (48 lesions) with HCC. All patients were examined with both PDS and color Doppler sonography (CDS) to assess the therapeutic results 1 week after TACE. Follow-up hepatic angiography was performed in 39 patients 3-4 months after TACE and then CT after iodized oil reinjection was also performed 3-4 weeks after a repeat TACE; in the remaining 4 patients, hepatectomy was performed within one month after chemoembolization and histologic study was undertaken to confirm the Doppler findings. RESULTS: Determination of therapeutic results with PDS and CDS were in agreement with those of follow-up findings in 37 and 29 of the 48 lesions, respectively. There was a significant difference in overall accuracy (p=0.038) between PDS and CDS results. CONCLUSION: PDS is more effective than CDS for evaluating changes in tumor vascularity after TACE. PDS may also replace angiography in assessing the therapeutic effects of TACE for HCCs, except in deep-seated areas.

Aged↗

Changes of sugar-evoked transmural potential differences in intestine of rats with streptozotocin-induced diabetes.

The changes of the transmural electrical potential difference (delta PD) evoked by infusion of glucose, maltose and sucrose and the disaccharidase activities in the everted intestine were studied in diabetic rats. After the induction of diabetes by streptozotocin, delta PDs evoked by sugars and the enzyme activities were observed in the jejunum and ileum. delta PDs evoked by glucose, maltose and sucrose markedly increased both in the jejunum and ileum of diabetic rats. The Kt values for these sugars in diabetic rats were the same as those of control rats. The Vmax values were significantly increased in the ileum of diabetic rats. Maltase and sucrase activities in the ileum increased in diabetic rats. Highly significant linear correlations were found between the delta PDs evoked by glucose and the delta PDs evoked by maltose or sucrose both in the jejunum and ileum of control and diabetic rats. However, delta PDs evoked by maltose and sucrose did not correlate with maltase and sucrase activities in the jejunum. In the ileum, delta PDs evoked by sucrose correlated with the sucrase activity which was very low. These results suggest that the increase of transport of glucose derived from disaccharides in the diabetes induced by streptozotocin is mainly due to the increased activity of the glucose transport system, but not due to the increase of disaccharidase activities.

Animals↗

Humoral factors trophic for vascular smooth muscle during the development of hypertension in rats.

There is evidence that a humoral factor or factors in rats with one-kidney, one-clip (1K1C) hypertension increase growth of cultured vascular smooth muscle cells. Such humoral trophic factors may contribute to the abnormal growth of arterial muscle in hypertension. To further study the longitudinal expression of this trophic factor or factors, we prepared rats with 1K1C hypertension of different durations. To determine if the factor or factors are also expressed in other forms of experimental hypertension, we additionally prepared rats with two-kidney, one-clip (2K1C) hypertension and paired two-kidney (2K) normotensive controls; we also studied Spontaneously Hypertensive Rats (SHR) plus appropriate controls. In the presence of growth stimulated by background levels (1%) of fetal calf serum, 20% platelet-poor, plasma-derived serum (PDS) from 1K1C rats 8-14 days (n = 10) and 28 days (n = 12) after clipping increased [3H]-thymidine incorporation of growth-arrested cultured rat aortic smooth muscle cells more than the paired 1K PDS, by up to +67% and +40%, respectively (P < 0.01). However, with PDS from 1K1C rats 4 days (n = 11) and 38 days (n = 6) after clipping there was no evidence for a differential effect (P > 0.5 and P > 0.1, respectively). PDS from seven 2K1C rats (at 9 days) also increased [3H]-thymidine incorporation of the assay cells more than PDS from the paired 2K rats, by up to +19% (P < 0.05). However, there was no evidence that PDS from SHR differentially increased cellular thymidine incorporation. Thus, evidence from this study suggests that the humoral factor or factors trophic for vascular smooth muscle are expressed in both low- and high-renin forms of experimental renovascular hypertension, but not in the very early or in the late complicated stages of the hypertension, or in genetic hypertension in rats.

Animals↗

Relationship between perceptual differences of parenting and adolescent antisocial behavior and depressive symptoms.

The relation between adolescent negative adjustment and differences in parent-child ratings of parents' warmth and negativity was examined with a national sample of 720 families. It was predicted that perceptual differences (PDs) would be linked to more negative adjustment. Adjustment was regressed on PDs, which were calculated as absolute differences between parent and child ratings of parenting. Results showed that PDs were significantly associated with adjustment independent of the level of parenting behavior. Associations differed by gender for PDs over maternal verbal aggression. Some of the most important results were curvilinear effects indicating that both high and low, but not medium, levels of PDs are linked with maladjustment. Finally, differences between younger and older adolescents were found: The linear relationship between PDs over parental negativity and maladjustment disappeared for older adolescents.

Adolescent↗

['Leiden Impotence Screening Test'(LIST) in men with erectile dysfunction as a pre-selective method prior to psychophysiological diagnostic tests].

OBJECTIVE: To compare, in men with erectile dysfunction, the diagnosis obtained with the 'Leiden impotence questionnaire' (LIQ)--which differentiates between psychogenic and organic erectile dysfunction--with the clinical diagnosis based on psychophysiological diagnostic screening (PDS). DESIGN: Exploratory, comparative, and prospective. METHOD: The LIQ-questionnaire was administered to 320 consecutive patients with erectile dysfunction who underwent PDS (i.e. visual sexual stimulation and penile vibration) in the Department of Endocrinology and Reproduction, Erasmus University Medical Centre, Rotterdam, the Netherlands. The clinical diagnosis was based on PDS and later, retrospectively, compared to the LIQ-based diagnosis (only the first six of the 11 LIQ-questions were answered by all patients). RESULTS: The clinical diagnosis, psychogenic or somatic, corresponded well with the LIQ-diagnosis. Following PDS an organic aetiology was assumed in 30% of the patients; compared to 33% according to the LIQ. For a psychogenic aetiology the figures were 70% and 67% respectively. Overall there was a 74% correspondence between PDS-diagnosis and the LIQ-diagnosis. Age was a significant factor: younger men (< 40 years) had the highest LIQ-score (compared to men aged 40-60 and > 60 years) and the strongest penile responses. This is indicative of a more frequent psychogenic aetiology of the erectile dysfunction in younger men. CONCLUSION: Elaborate psychophysiological diagnostic screening is not necessarily the first diagnostic choice in men with erectile dysfunction; one may start by applying the LIQ. A high LIQ-score (5-7) virtually excludes a somatic aetiology. A low LIQ-score (0-2) necessitates further psychosomatic diagnostic screening, preferably with PDS.

Adult↗

Intravenous human interleukin-1alpha impairs memory processing in mice: dependence on blood-brain barrier transport into posterior division of the septum.

Peripherally administered cytokines profoundly affect the central nervous system (CNS). One mechanism by which they could affect the CNS is by crossing the blood-brain barrier (BBB) to interact directly with brain receptors. Human and murine IL-1alpha (hIL-1alpha; mIL-1alpha) are transported across the murine BBB with a high rate of transport into the posterior division of the septum (PDS), but it is unknown whether BBB transport is relevant to their actions. Here, we injected species-specific blocking antibodies into the PDS to determine whether transport across the BBB is required for blood-borne hIL-1alpha to affect memory. Retention was impaired in a dose-dependent manner when hIL-1alpha was injected either by tail vein (i.v.) or into the PDS, with the PDS route being 1000 times more potent. About 70% of the memory impairment induced by i.v. hIL-1alpha was reversed by injecting a blocking antibody (Ab) specific for hIL-1alpha into the PDS. This shows that much of the memory impairment induced by hIL-1alpha depends on its ability to cross the BBB. Ab specific for mIL-1alpha was also effective in reversing memory impairment, showing that hIL-1alpha releases mIL-1alpha from endogenous stores. Whether the mIL-1alpha was released from peripheral stores, which would require it to cross the BBB, or from brain stores is unknown. In conclusion, these results show that exogenous, blood-borne hIL-1alpha affects memory by releasing mIL-1alpha from endogenous stores and by crossing the BBB to act at sites within the PDS.

Algorithms↗

Influence of pH-neutral peritoneal dialysis solution.

We evaluated the influence of a neutral peritoneal dialysis solution (PDS) on the peritoneum. The subjects were 10 stable PD patients using conventional PDS. We substituted pH-neutral PDS (PD Solita A: Shimizu Medical, Tokyo, Japan) for conventional PDS (Gambrosol A: Shimizu Medical). Effluent from 4-hour dwells was collected, and the appearance rate of cancer antigen 125 (CA125-AR) was calculated using the method of Pannekeet et al and corrected to body surface area. The dialysate-to-plasma creatinine (D/P Cr) was obtained, and personal dialysis capacity (PDC) was evaluated at 3-month intervals. Mean daily ultrafiltration volumes did not significantly change when pH-neutral PDS was used. The mean CA125-AR obtained 1 month after substitution was twice as high as that before substitution (139.2 +/- 47.3 U/min/1.73 m2 before substitution vs. 286 +/- 126.2 U/min/1.73 m2 1 month later). However, mean values of CA125-AR were maintained at higher levels and did not significantly vary for 7 months after PD fluid substitution. When the change in CA125-AR (delta CA125-AR) was calculated as the ratio of the CA125-AR value before substitution to that after substitution at the respective measurement points, delta CA125-AR negatively correlated with D/P Cr. However, none of % area, % absorption, or % plasma loss significantly correlated with the delta CA125-AR obtained 6 months later. Although mesothelial cell viability may increase with the use of pH-neutral PDS, the level of the increase may differ depending on the severity of peritoneal damage. In addition, the use of a neutral PD fluid did not improve the endothelial cell system. In the future, development of a novel osmotic pressure-regulating substance substituting for glucose is essential to the development of PD fluids with higher biocompatibility.

Adult↗

Primary direct stenting versus endoscopic atraumatic coronary artery bypass surgery in patients with proximal stenosis of the left anterior descending coronary artery--a prospective, randomised study.

BACKGROUND: The dynamic development of interventional cardiology resulted in an increasing proportion of patients treated with various forms of coronary angioplasty instead of surgery. On the other hand, it has been well established that the results of coronary artery by-pass surgery of the left anterior descending (LAD) coronary artery with the use of the internal mammary artery are excellent. AIM: To compare the results of primary direct stenting (PDS) and endoscopic atraumatic coronary artery bypass (EACAB) surgery in patients with an isolated proximal LAD type A or B1 lesion. METHODS: This prospective and randomised study included 100 patients with an isolated critical (> or =70%) LAD stenosis who underwent PDS (n=50) or EACAB (n=50). RESULTS: After a six-month follow-up period, 32 (64%) PDS patients and 47 (94%) EACAB patients were angina-free. The rate of major cardiac adverse events (MACE) was significantly higher in the PDS group than in surgically treated patients (p<0.05). After one year of follow-up, 40 (80%) PDS-treated patients and all 50 EACAB patients had no recurrences of angina. After two-year follow-period, the survival rate without MACE was significantly higher in the EACAB group than in the PDS-treated patients (94% vs 76%, p<0.05). CONCLUSIONS: Minimally invasive cardiac surgery is an alternative method to direct stenting in the treatment of patients with proximal LAD stenosis.

Adult↗

Enhancement of virus-induced gene silencing in tomato by low temperature and low humidity.

Virus-induced gene silencing (VIGS) is an attractive reverse-genetics tool for studying gene function in plants. We showed that silencing of a phytoene desaturase (PDS) gene is maintained throughout TRV-PDS-inoculated tomato plants as well as in their flowers and fruit and is enhanced by low temperature (15 degrees C) and low humidity (30%). RT-PCR analysis of the PDS gene revealed a dramatic reduction in the level of PDS mRNA in leaves, flowers and fruits. Silencing of PDS results in the accumulation of phytoene, the desaturase substrate. In addition, the content of chlorophyll a, chlorophyll b and total chlorophyll in the leaves of PDS-silenced plants was reduced by more than 90%. We also silenced the LeEIN2 gene by infecting seedlings, and this suppressed fruit ripenning. We conclude that this VIGS approach should facilitate large-scale functional analysis of genes involved in the development and ripening of tomato.

Carotenoids↗

Clinical outcomes of neoadjuvant chemotherapy and primary debulking surgery in advanced ovarian carcinoma.

BACKGROUND: Primary debulking surgery (PDS) and paclitaxel-platinum chemotherapy remains the mainstay of treatment for advanced ovarian cancer. However, there is considerable morbidity and even mortality associated with this approach. The concept of primary chemotherapy followed by interval debulking surgery (IDS) has emerged for advanced stage disease with the aim of improving sensitivity to chemotherapy and improving survival. The purpose of our study was to examine the impact of IDS on clinical outcomes of patients considered unsuitable for PDS and compare them with outcomes of women that had conventional PDS followed by chemotherapy. PATIENTS AND METHODS: A non-randomised prospective cohort study of 35 patients who underwent IDS and 29 patients treated with PDS were included. All patients had Stage IIIC or IV disease. The IDS patients were considered unresectable based on an initial laparoscopy or preoperative computed tomography findings. All patients were treated by the same lead surgeons and received the same regimen of chemotherapy. RESULTS: The median intraoperative blood loss, the incidence of pelvic lymphadenectomies, the median hospital stay and the possibility of admission to the Intensive Care Unit were significantly less in the IDS group. Optimal cytoreduction was higher in the IDS compared to the PDS group, but did not reach statistical significance. CONCLUSIONS: IDS for advanced ovarian cancer may be associated with less morbidity compared to PDS and appears to require less use of hospital resources. If the ongoing randomised studies confirm that IDS does not adversely affect the long-term survival of these patients, morbidity related to ovarian cancer surgery may evolve as a crucial factor for choosing treatment options.

Adult↗

[Effects of peritoneal dialysis solution on proliferation and apoptosis of rat peritoneal mesothelial cells].

OBJECTIVE: To investigate the effects of peritoneal dialysis solution (PDS) on proliferation and apoptosis of rat peritoneal mesothelial cells (RPMCs). METHODS: The proliferation of RPMCs treated with PDS containing glucose of different concentrations for different times in vitro were examined by MTT colorimeric assay. The cell cycles and cell apoptosis rate were determined by flow cytometry. RESULTS: After PDS treatment for 1 h, the cell proliferation inhibition rate, percentage of cells at G(0)/G(1) stage and early cell apoptosis rate increased, and such increment was more manifest with higher glucose concentration in PDS and longer treatment time of the cells. After treatment with PDS containing 4.25% glucose for 3 h, the proliferation inhibition rate of the RPMCs reached 44.12%, the percentage of cells at the G(0)/G(1) stage amounted to 71.95% and the early apoptosis rate reached 23.59%, which was several times higher than that of the negative control and 1.5% glucose/PDS groups, and also higher than that of 4.25% mannitol/PDS groups. CONCLUSION: PDS containing high-concentration glucose can induce significant apoptosis and inhibit the proliferation of RPMCs in vitro.

Animals↗

Does ethane 1,2-dimethanesulphonate (EDS) have a direct cytotoxic effect on the seminiferous epithelium of the rat testis?

The authors examined the possibility that ethane 1,2-dimethanesulphonate (EDS) has a cytotoxic effect on spermatogenesis that is not secondary to androgen withdrawal resulting from the well known cytotoxic effect of EDS on Leydig cells. Adult male rats were implanted with polydimethylsiloxane (PDS) capsules containing testosterone (T) and estradiol (E), and were simultaneously injected with EDS. The PDS-TE implants, by inhibiting luteinizing hormone (LH) production, prevented Leydig cells from repopulating the testis and clamped testosterone within the seminiferous tubules at increasing concentrations relative to implant size. In rats that received EDS alone, the number of advanced spermatids per testis was significantly reduced by 2 weeks, but within 8 weeks returned to the numbers maintained in vehicle-injected control rats or in vehicle-injected rats that received testosterone- and estradiol-filled capsules of 24 cm and 0.1 cm, respectively (PDS-24TE). Surprisingly, in rats that received an EDS injection plus PDS-24TE implants, the number of advanced spermatids per testis was significantly reduced at 8 weeks and severe seminiferous tubule atrophy occurred despite the fact that the testosterone concentration was sufficient to quantitatively maintain spermatogenesis in vehicle-injected rats. In rats injected with EDS and implanted with 24 cm testosterone but not estradiol-filled capsules (PDS-24T), the advanced spermatid number per testis was significantly higher than that in the EDS plus PDS-24TE rats, but significantly lower than that in control rats. These results suggest that EDS may have a cytotoxic effect on the seminiferous epithelium that is independent of the elimination of Leydig cells, and the EDS and estradiol act synergistically to exert a profound toxic effect on spermatogenesis.

Animals↗

Quantitative measurements of the changes in protein thiols in cervical intraepithelial neoplasia and in carcinoma of the human uterine cervix provide evidence for the existence of a biochemical field effect.

Quantitative micromethods have been used for measuring reactive protein thiols (PSHr), total reactive protein sulfur (TRPS), total protein thiols (PSHt), and protein disulfides (PDS) in fixed frozen sections of human uterine cervix. PSHr and TRPS were stained using 2,2'-dihydroxy-6,6'-dinaphthyl disulfide; PSHt and PDS were stained using mercurochrome methods. Microspectrophotometric measurements were made on the stained sections using a microdensitometer with associated data processing; the results obtained for areas of epithelium and stroma were converted to absorbance values per micron 2. Samples of uterine cervix that were diagnosed as containing cervical intraepithelial neoplasia (CIN) I-III or carcinoma were examined and compared with samples of normal uterine cervix. Measurements were made not only on identified lesions but also on apparently normal tissue obtained from the same cervix. Epithelial/stroma ratios (E/S) were calculated for PSHr, TRPS, PSHt and PSHt + PDS; in addition, the double ratios of PSHr/TRPS and PSHt/PSHt + PDS were also calculated for E/S. The mean E/S values for PSHr and PSHt were significantly different for all types of lesion compared with control samples. The E/S ratios for apparently normal tissue obtained from cervices with CIN or carcinoma were also significantly different compared with corresponding control values, indicating a field effect. There was a considerable degree of overlap between individual values in the control groups versus those obtained with each type of lesion. The corresponding mean E/S values for TRPS and for PSHt + PDS in the samples containing lesions were not significantly different from control means except for the group containing CaCx. However, the mean values for the double ratios (PSHr/TRPS and PSHt/PSHt + PDS) were significantly different in the groups containing lesions compared with the controls. Moreover, apparently normal tissue obtained from cervices containing CIN or carcinoma had different mean values compared with the controls, confirming the existence of a field effect. The degree of overlap of individual values in the lesion groups compared with the control values was much less with double ratio values than previously noted for single ratio values. In consequence, the double ratio measurements clearly discriminated CIN I + II and CIN-III from controls. Our data show that CIN is associated with marked changes in tissue protein thiols and disulfides and that these differences extend to neighboring apparently normal tissue indicative of a field effect.

Adult↗

Polydioxanone suture in the gastrointestinal tract.

A randomized prospective trial was undertaken of polydioxanone suture (PDS) versus conventional suture material in 98 patients undergoing anastomoses in the gastrointestinal tract. Nine patients died within 6 months of surgery, one of these being related to an anastomotic leak. All other patients were followed up for between one and three and a half years. In 57 colonic anastomoses, 30 were randomized to a single layer of 2/0 (BPC) interrupted PDS and 27 to a single of 2/0 (BPC) interrupted silk. Follow up sigmoidoscopy and barium enemas were used to confirm the clinical suspicion of 6 benign anastomotic strictures, 5 of which occurred in the PDS group. At this stage, the colonic arm of the trial was discontinued because the 19% stricture rate with PDS was deemed unacceptable. In a second limb of the study, patients were randomized to two layers of 2/0 (BPC) continuous PDS or 2/0 (BPC) continuous chromic catgut. There were no significant differences in 32 gastric or small bowel anastomoses and in particular, no anastomotic strictures were apparent. The reasons for the high rate of stricture formation when using PDS for large bowel anastomoses are unclear. However, it would seem to be a suitable alternative to chromic catgut when confined to the stomach and small intestine.

Adult↗

Maintenance of physiologic concentrations of plasma testosterone in the castrated male dog, using testosterone-filled polydimethylsiloxane capsules.

Effects of various numbers of polydimethylsiloxane (PDS) capsules filled with testosterone (PDS-T) on plasma testosterone (PT) in castrated male dogs were studied. Dogs were implanted with 1 empty PDS capsule or 1, 3, or 5 PDS-T capsules. Blood samples were collected prior to and after implantation, after castration with capsules in situ, and after capsule removal. The PT was determined in these samples by radioimmunoassay. One empty capsule had no effect on PT concentration; after castration, PT values fell to nondetectable amounts. One PDS-T capsule maintained PT at concentrations above nondetectable amounts after castration, but these concentrations were significantly (P less than 0.05) lower than were preimplantation values. Three or five PDS-T capsules were capable of maintaining PT concentrations in the castrated male dog similar to those concentrations seen in the intact dog.

Animals↗