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Neuroanatomy and pathophysiology of pain related to spinal disorders.

Sensation is achieved through the integration of many neural elements: receptors, afferent and efferent neurons, the spinal cord with its subdivisions, and the higher brain centers. One of the many sensations perceived by the human body is that of pain or nociception. To understand the concept of "back pain" associated with various spinal pathologies, some basic knowledge of the anatomy and physiology of sensation, and more specifically nociception, is necessary. This knowledge is presented herein.

Back Pain↗

[A case of Hansen's disease seen in an Indonesian resident, and tracing of the patient after coming back to Indonesia].

A 26-year-old Indonesian male living in Japan consulted our hospital with complaint of fever, general malaise and infiltrative erythematous plaques associated with lymph node swelling. Physical examination revealed a sensation disorder in the distal portion of the extremities and hypertrophy of peripheral nerves. Histopathology of the skin lesion showed the multifocal granulomatous inflammation containing many acid-fast bacilli associated with infiltration of foam cells and neutrophils. Under the diagnosis of leprosy (LL type) accompanied by erythema nodosum leprosum, the combined chemotherapy (clofazimine, rifampicin, and diphenyl sulfone) was started. For the leprosy reaction, short-term administration of the systemic steroid was added. The general condition was carried out soon, and the sensation disorder has also been gradually improved. The patient came back to Indonesia after 6 months treatment because of the time limit of visa. We traced the patient's condition through personal networks, and knew that the patient could not have continual treatment for the disease, and that he is suffering from disability of hands and feet. In this case, several medical facilities were consulted before the final diagnosis of leprosy. The Japanese medical doctors should also remember this disease when they examine persons with infiltrative skin eruptions and sensation disorders.

Adult↗

[Termination of a scandal--solution of the oracle of Apollo at Delphi in psychiatry (corrigendum to papers previously published in this journal) (author's transl)].

Endogenous psychoses are pathological disorders of time sensation. Disorders generally classified as "mental insanity", "mental illness" or "psychoses" are disorders involving time. The mind can become derailed or go astray on the lines of time consciousness. Mental and biological life are inseparably interlinked on the basis of time, and will be apprehended by perception and experience as a uniform structure within the co-ordinates of space and time. In this manner, the "Body and Soul" problem loses the character of an insoluble riddle.

Biographies as Topic↗

Prevalence of tattooing and body piercing in Germany and perception of health, mental disorders, and sensation seeking among tattooed and body-pierced individuals.

OBJECTIVE: The objective of this study was to obtain data on the incidence and relationship of psychological factors to tattooing and body piercing from a large and representative sample of German citizens (N=2043). METHODOLOGY: Representative data (sample age range=14-93 years) were evaluated with respect to health-related quality of life (SF-36), mental health (General Health Questionnaire), mental disorders (Patient Health Questionnaire), and sensation seeking (Arnett Inventory of Sensation Seeking). RESULTS: The prevalence of tattooing and that of body piercing in the general German population are 8.5% and 6.5%, respectively. Individuals aged between 14 and 24 years display the highest rate of body piercings or tattoos (females, 41%; males, 27%). Within the group of individuals aged between 14 and 44 years, unemployment and nonaffiliation to a church are positively correlated, tattooing is significantly correlated with the perception of reduced mental health, and both tattooing and body piercing are correlated with significantly increased sensation-seeking behavior. CONCLUSIONS: Next to being motivated by fashion and the urge to fit in with one's peers, the major reasons for body modification practices in the German population appear to be negatively perceived conditions of life, reduced social integration, and increased sensation-seeking behavior.

Adolescent↗

[Characteristics and outcome perspectives of lumbar nerve root decompression in elderly patients].

A series of 14 334 cases with lumbar nerve root compression demonstrated between 1993 and 1998 a growing number of operations in elderly patients. In order to assess the treatment results in this patient group the authors evaluated the retrospective multicenter data and performed a prospective clinical study up to 24 months postoperatively in 44 patients of a single institution. The group of patients older than 60 yrs. have been compared to another group being 30-50 yrs. old. Elderly patients showed a complete remission of palsies in 67% and of sensation disorders in 54% compared to 100% and 88% respectively in younger patients. 60% of the elderly and 54% of the younger patients suffered from pain, but less intensively than pre treatment. The postoperative complication rate in older individuals was higher with 25%. In both groups 90% felt that the result of the treatment was "very good" or "good".

Adult↗

Validation of a system of classifying female substance abusers on the basis of personality and motivational risk factors for substance abuse.

This study explored the validity of classifying a community-recruited sample of substance-abusing women (N = 293) according to 4 personality risk factors for substance abuse (anxiety sensitivity, introversion-hopelessness, sensation seeking, and impulsivity). Cluster analyses reliably identified 5 subtypes of women who demonstrated differential lifetime risk for various addictive and nonaddictive disorders. An anxiety-sensitive subtype demonstrated greater lifetime risk for anxiolytic dependence, somatization disorder, and simple phobia, whereas an introverted-hopeless subtype evidenced a greater lifetime risk for opioid dependence, social phobia, and panic and depressive disorders. Sensation seeking was associated with exclusive alcohol dependence, and impulsivity was associated with higher rates of antisocial personality disorder and cocaine and alcohol dependence. Finally, a low personality risk subtype demonstrated lower lifetime rates of substance dependence and psychopathology.

Adult↗