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PubMedDate not supplied

Patterns of comorbidity among DSM-III-R personality disorders.

The aim of this study was to examine patterns of comorbidity among personality disorders (PDs) in a sample of 156 psychiatric inpatients. PDs were assessed with Semistructured Clinical Interview for DSM-III-R Personality Disorders. To determine significant co-occurrence among axis II diagnoses, odds ratio and the percent of co-occurrence of pairs of disorders were calculated. Both statistical methods revealed high rates of comorbidity: significance association was found for 36 pairs of disorders using the percent of co-occurrence, and for 22 pairs of disorders using the odds ratio. These results support the concept of 'apparent comorbidity' for most PDs, deriving from conceptual and definitional artifacts or from a 'state-biasing effect'. In light of these observations, a categorical approach to PDs, resulting in a list of diagnoses, appears useless in psychiatric practice. A dimensional classification is probably better suited for PDs, improving the understanding of personality psychopathology and its clinical implications.

Adolescent↗
PubMed1998

Electro-oculography in pigment dispersion syndrome.

Clinical data and the common embryological origin of the pigment epithelium of the iris and retinal pigment epithelium suggest that the latter may be involved in the pigment dispersion syndrome (PDS). In our study functional changes of the retinal pigment epithelium were evaluated by electro-oculography in 10 PDS patients, 10 patients with chronic open-angle glaucoma (COAG) and 10 normal subjects. The mean dark-trough latency and Arden ratio for the PDS group were significantly lower than those of the COAG and control groups. Analysis of the Arden ratios based on the Kruskall-Wallis test revealed that 30% of the PDS values were subnormal with respect to the control group mean -1 SD. These results indicate primary involvement of the retinal pigment epithelium in PDS.

Adult↗
PubMed2007

Saxatilin, a snake venom disintegrin, regulates platelet activation associated with human vascular endothelial cell migration and invasion.

BACKGROUND: Platelet activation results in platelet aggregation and the secretion of granules, which contain a variety of constituents including nonprotein molecules, adhesive proteins and hydrolases. The platelet-derived supernatant (PDS), which contains these granules, is known to trigger the activation of endothelium and chemotaxis of monocytes. METHODS AND RESULTS: PDS derived from collagen-activated platelets stimulated human umbilical vein endothelial cell (HUVEC) migration and invasion, as measured through the use of a Boyden chamber. This collagen-induced PDS also triggered integrin alpha(v)beta(3) upregulation in HUVECs. The inclusion of a neutralizing antibody to platelet-derived growth factor (PDGF)-B abolished HUVEC migration/invasion and integrin alpha(v)beta(3) upregulation, showing that PDGF-AB mediates the proangiogenic effects of collagen-activated PDS. Saxatilin, a snake venom disintegrin known to interrupt platelet aggregation by antagonizing integrin alpha(IIb)beta(3), inhibited the collagen-induced platelet activation and abolished the angiogenic properties of PDS. Saxatilin also inhibited the collagen-induced phosphorylation of Syk, a key mediator of inside-out signaling in platelet activation. CONCLUSION: Saxatilin inhibits platelet activation, platelet PDGF-AB release as well as subsequent endothelial cell migration and invasion.

Blood Platelets↗
PubMed2005

Impact of cluster C personality disorders on outcomes of acute and maintenance treatment in late-life depression.

OBJECTIVE: Personality disorders (PDs) have been associated with poor treatment outcomes in acute treatments for late-life depression and with persistent functional impairment after recovery from an episode of depression. METHODS: Using survival analysis and mixed-effects models, the authors examined the impact of Cluster C PDs on time-to-response and several aspects of functioning in acute and maintenance treatment of major depression in later life. RESULTS: Cluster C PDs were associated with longer time-to-response during acute treatment and non-response in continuation or maintenance treatment. Although not statistically significant, there was evidence of a cumulative negative impact of Cluster C PDs and residual depressive symptoms on instrumental activities of daily living (IADLs) during maintenance treatment. CONCLUSIONS: These findings suggest that screening for PD may be important for clinicians treating late-life depression and that the combination of Cluster C PDs and residual depressive symptoms may predict functional declines even after recovery from the index episode of depression.

Activities of Daily Living↗
PubMed1992

Assessment of DSM-III-R personality disorders by self-report questionnaire: the role of informants and a screening test for co-morbid personality disorders (STCPD)

A modified version of the revised Personality Diagnostic Questionnaire (PDQ-R), based on DSM-III-R personality disorders (PDs), was completed by 60 psychiatric patients. An informant's version was also completed by 60 relatives or friends nominated by each subject. Discrete DSM-III-R PDs were rare; the mean number of PDs per subject was 4.5. Cluster analysis showed that only antisocial PD was a basis for classification of patients, while most patients formed two groups which were mainly distinguished by quantitative differences related to the total scores of positive PD criteria. A shorter version of the questionnaire can be used as a screening test for co-morbid PDs (STCPD) which can predict the number of co-morbid DSM-III-R PDs. The total scores of positive PD criteria from the STCPD were usually (and significantly) higher than the corresponding scores from informants' questionnaires, but when an informant's total score exceeded that of the patient, this indicated a subject's under-reporting.

Adult↗
PubMed2000

Expression of Na+/I- symporter and Pendred syndrome genes in trophoblast cells.

Placental iodide transport is critical for the fetal thyroid function, but the molecular mechanisms of this transport are not understood. The expression of two recently identified iodide transporters, namely the sodium/iodide symporter (NIS) and pendrin, the product of the gene responsible for the Pendred syndrome (PDS), was studied using real-time kinetic quantitative PCR and immunohistochemistry 1) in placental tissues collected at different gestational ages and 2) in primary cultures of villous cytotrophoblast cells (VCT) that differentiate and fuse over 2-3 days in vitro to form villous syncytiotrophoblast (VSCT) cells. Both NIS and PDS genes are expressed in placenta, albeit at low levels compared with those in thyroid tissue. NIS gene expression in placental samples from first trimester and term pregnancies was similar. In contrast, the expression of PDS gene was higher in term than in first trimester pregnancy samples. In vitro, NIS gene was expressed at a high level in VCT obtained from first trimester pregnancy, and its expression decreased by 3- to 4-fold during the differentiation of VCT in VSCT. Expression of NIS was lower (up to 30-fold) in VCT obtained in placental samples from third trimester than from first trimester pregnancy. In contrast, the expression of PDS gene was low in VCT and increased by 5- to 10-fold during VSCT formation; this was observed in cells isolated from placental samples of both first trimester and term pregnancies. Immunohistochemical analysis showed that NIS protein was present on the entire membrane of VCT, whereas pendrin was mainly located at the brush border membrane of VSCT, facing the mother. In conclusion, 1) NIS and PDS genes are differently expressed in the placenta during gestation; and 2) whereas pendrin is expressed at the brush border membrane of syncytiotrophoblast cells, NIS protein is mainly located in the cytotrophoblast layer.

Carrier Proteins↗
PubMed2002

Measuring the core features of personality disorders in substance abusers using the Temperament and Character Inventory (TCI).

Personality disorders (PDs) are still classified through categorical taxonomies that are at odds with current research findings. Dimensional models provide a suitable alternative for measuring individual differences. However, as they have traditionally lacked a clear definition of the "disorder" construct, the clinical utility of these models has been limited. This study tests whether Cloninger's dimensional model is able to capture two domains: the features that differentiate PD subtypes from each other and the common core features underlying all PDs. Seventy-four drug dependent patients were independently assessed using the SCID-II and Cloninger's TCI. There was a slight relationship between TCI temperament dimensions and the DSM personality disorder subtypes, but the association was not specific enough to allow differential diagnosis. The character dimension Self-Directedness was strongly associated with the presence and severity of all PDs, irrespective of subtype, correctly classifying 77% of subjects. Character dimensions are a reliable, valid and low-cost tool for detecting PDs in drug abusers and may help to provide an operational definition of the common core features underlying all PDs.

Adult↗
PubMed2003

Personality disorders and personality dimensions in anorexia nervosa.

Information on the relationship between anorexia nervosa (AN) and personality disorders (PDs) and dimensions of temperament and character (measured by the Temperament and Character Inventory [TCI; Cloninger, Przybeck Svrakic, & Wetzel, 1994]) is limited. This study examines the predictive validity of the TCI for PD diagnoses assessed by the International Personality Disorder Examination-ICD-10 (IPDE-ICD-10; Loranger, Janca, & Sartorius, 1997) interviews of 46 women with DSM-IV-defined AN. Patients with a PD reported higher levels of harm-avoidance and lower levels of self-directedness than those without a PD. Scores on the TCI were predictive of the number of PD features present, particularly for those PDs in the anankastic, anxious, and dependent groups accounting for 40% to 51% of the variance. Cluster analysis based on scores on the TCI identified a subgroup of patients characterized by low levels of novelty seeking, self-directedness, and cooperativeness and high levels of harm avoidance. This cluster included the majority of those with avoidant, anxious, or dependent PDs. Assessment of particular personality dimensions was able to predict PDs in an anorexic sample. Since normal personality dimensions have greater validity than the categorical PDs, a consideration of normal temperament and character may assist in clinical decisionmaking and considerations concerning treatment.

Adult↗
PubMed2004

Depressive personality disorder: rates of comorbidity with personality disorders and relations to the five-factor model of personality.

Depressive personality disorder (DPD) is listed in the DSM-IV as one of the "Disorders for Further Study." In this investigation we examined (1) the rates of comorbidity of DPD with the 10 personality disorders (PDs) in the main text of DSM-IV, and (2) the convergent and discriminant validity of DPD in its relation to the 30 facet traits of the Five-Factor Model of personality (FFM). One hundred and sixty-nine participants with psychiatric diagnoses were interviewed with the Structured Clinical Interview for DSM-IV Personality Disorders Questionnaire (SCID-II) and completed the Revised NEO Personality Inventory (NEO PI-R). A total of 26 (15%) of the participants met diagnostic criteria for at least one of the 10 main text PDs, and 15 (9%) met criteria for DPD. Of those who met criteria for DPD, 10 (59%) of the participants also met criteria for one or more of the 10 main text PDs. Regression analyses indicated a four-facet trait set derived from the NEO PI-R thought to be uniquely associated with DPD accounted for a significant amount of variance in DPD SCID-II PD scores and was significantly larger for DPD than it was for the 9 of the 10 main text PDs; the sole exception was for avoidant PD. Diagnostically, DPD overlaps significantly with other PDs but is distinguishable in its unique relation with traits from the FFM.

Adult↗
PubMed2005

The structure of axis II disorders in adolescents: a cluster- and factor-analytic investigation of DSM-IV categories and criteria.

The aim of this study was to ascertain whether the structure of personality disorder (PD) symptoms in adolescents assessed using DSM-IV diagnoses and diagnostic criteria resembles the structure intended for the diagnosis of PDs in adults. A national sample of clinicians rated DSM-IV Axis II criteria on 294 adolescent patients in treatment for enduring maladaptive personality patterns. Cluster analysis replicating procedures used in an adult sample by Morey (1988) identified considerable similarity between adult and adolescent PDs, as did exploratory factor analysis of ratings of diagnostic criteria, which yielded ten empirically derived factors that resembled the ten DSM-IV PDs. Cluster analysis and confirmatory factor analysis with indicators of Axis II symptoms produced mixed results in replicating the DSM-IV hierarchical structure of PDs (Clusters A, B, and C), although hierarchical models generally fared better than models specifying only first-order factors or clusters. The structure of personality pathology as assessed by Axis II criteria in adolescents resembles that outlined in DSM-IV Axis II for adults, suggesting that PDs can be assessed in adolescents as in adults. Whether this is an optimal way of diagnosing personality pathology in adolescence, however, requires further investigation.

Adolescent↗
PubMed2006

Relative impact of young adult personality disorders on subsequent quality of life: findings of a community-based longitudinal study.

Little is known about long-term prognostic implications of personality disorder (PD) for quality of life (QOL) in the young adult population not selected for psychiatric treatment. The purpose of this study was to determine the association of PDs with QOL assessed after an 11-year interval. PDs were assessed in 1991-1994 at mean age 22, and indicators of QOL were assessed in 2001-2004 at mean age 33 based on a community sample of 588 young adults. Findings indicated that any PD, or a cluster A, B, or C PD each were independently associated with elevated impairment in overall QOL after adjusting for demographic variables, co-occurring Axis I disorder, and physical illness, and PDs in other clusters. Cluster B PD had a greatest adverse impact on QOL. Symptoms of antisocial, borderline, and schizotypal PD symptoms were independently associated with significant reductions in QOL; avoidant, paranoid, and dependent PD symptoms were associated with smaller reductions, not reaching statistical significance. Symptoms of other individual PDs were not associated with reduced QOL. PDs in young adults in the community have an enduring and adverse impact on subsequent QOL that cannot be attributed to physical illness or Axis I psychiatric disorder.

Adult↗
PubMed1999

Substance dependence and personality disorders: comorbidity and treatment outcome in an inpatient treatment population.

OBJECTIVE: Personality disorders (PDs) are common among patients with substance dependence, and antisocial PD in particular has been found to have a significant impact on treatment outcomes. Relatively little is known about other comorbid PDs, however. This study was designed to clarify the distribution of PDs among substance dependent patients and assess their role in treatment outcome. METHOD: PDs and substance use disorders were diagnosed for 252 (181 male) consecutively admitted substance dependent inpatients using structured clinical interviews. A subsample of these (n = 104) were also followed for 1 year to monitor treatment outcome and relapse. RESULTS: Fifty percent of the patients were diagnosed with one or more personality disorders, but no consistent relationships between drug of choice and PDs were found. The likelihood of relapse, however, increased significantly with the diagnosis of a PD. Only 6% of the patients who received more than one PD diagnosis were maintaining sobriety at the end of 1 year compared with 44% of those with no PD diagnoses. A preference for cocaine was also a significant predictor of relapse. CONCLUSIONS: The low participation rate for the treatment outcome study and other methodological limitations render the study results tentative. Nevertheless, the findings suggest that more attention should be given to Axis II disorders in substance dependence research and treatment.

Adult↗
PubMed2004

Mutations in Su(var)205 and Su(var)3-7 suppress P-element-dependent silencing in Drosophila melanogaster.

In Drosophila melanogaster, the w(+) transgene in P[lacW]ci(Dplac) is uniformly expressed throughout the adult eye. However, when other P elements are present, this w(+) transgene is randomly silenced and this produces a variegated eye phenotype. This P-element-dependent silencing (PDS) is limited to w(+) transgenes inserted in a specific region on chromosome 4. In a screen for genetic modifiers of PDS, we isolated mutations in Su(var)205, Su(var)3-7, and two unidentified genes that suppress this variegated phenotype. Therefore, only a few of the genes encoding heterochromatic modifiers act dose dependently in PDS. In addition, we recovered two spontaneous mutations of P[lacW]ci(Dplac) that variegate in the absence of P elements. These P[lacW]i(Dplac) derivatives have a gypsy element inserted proximally to the P[lacW]ci(Dplac) insert. The same mutations that suppress PDS also suppress w(+) silencing from these P[lacW]ci(Dplac) derivative alleles. This indicates that both cis-acting changes in sequence and trans-acting P elements cause a similar change in chromatin structure that silences w(+) expression in P[lacW]ci(Dplac). Together, these results confirm that PDS occurs at P[lacW]ci(Dplac) because of the chromatin structure at this chromosomal position. Studying w(+) variegation from P[lacW]ci(Dplac) provides a model for the interactions that can enhance heterochromatic silencing at single P-element inserts.

Animals↗
PubMed2005

Disparity in osmolarity-induced vascular reactivity.

Conventional peritoneal dialysis solutions (PDS) are vasoactive. This study was conducted to identify vasoactive components of PDS and to describe quantitatively such vasoactivity. Anesthetized nonheparinized rats were monitored continuously for hemodynamics while the microvasculature of the jejunum was studied with in vivo intravital microscopy. In separate experiments, vascular reactivity of rat endothelium-intact and -denuded aortic rings (2 mm) was studied ex vivo in a standard tissue bath. In both studies, suffusion of the vessels was performed with filter-sterilized isotonic and hypertonic solutions that contained glucose or mannitol as osmotic agents. PDS served as a control (Delflex 2.25%). Hypertonic glucose and mannitol solutions produced a significant vascular reactivity in aortic rings and instantaneous and sustained vascular relaxation at all levels of the intestinal microvasculature. Similarly, lactate that was dissolved in a low-pH isotonic physiologic salt solution produced significant force generation in aortic rings. Whereas isotonic glucose and mannitol solutions had no vasoactivity in aortic rings, isotonic glucose produced a selective, insidious, and time-dependent vasodilation in the intestinal premucosal arterioles (18 +/- 0.2% of baseline), which was not observed in the larger inflow arterioles (100 mum). This isotonic glucose-mediated vascular relaxation can be attenuated by approximately 50% with combined adenosine A(2a) and A(2b) receptor antagonists and completely abolished by adenosine A(1) receptor inhibition. By using two different experimental techniques, this study demonstrates that hyperosmolality and lactate are the major vasoactive components of clinical peritoneal dialysis solutions. The pattern and the magnitude of such reactivity are dependent on vessel size and on the solutes' metabolic activity. Low pH of conventional PDS is not a vasoactive component by itself but renders lactate vasoactive. Energy-dependent transport of glucose into cells mediates vasodilation of small visceral arterioles by an adenosine receptor-mediated mechanism and constitutes a significant fraction of PDS-mediated vascular reactivity in the visceral microvasculature.

Animals↗
PubMed1998

L-type calcium channel blockade mechanisms of panaxadiol saponins against anoxic damage of cerebral cortical neurons isolated from rats.

AIM: To identify the changes of L-type Ca2+ channel on cerebral cortical neurons of rats during anoxia and the protective mechanisms of panaxadiol saponins (PDS) against anoxic injury. METHODS: Patch-clamp technique of cell-attached configuration and in vitro cerebral anoxic modle built with actuely isolated cortical cells of Wistar rats. RESULTS: The open time of L-type Ca2+ channel of cortical neurons increased significantly from (2.85 +/- 0.21) ms to (9.1 +/- 1.0) ms (P < 0.01) under anoxia. The particular change was a long-lasting open, which was more than 20 ms in some cases. At the same time, the close time decreased from (38 +/- 8) ms to (10 +/- 3) ms (P < 0.01) and the open-state probability raised from (0.047 +/- 0.008) to (0.165 +/- 0.025) (P < 0.01). PDS (1.5 g.L-1) inhibited the activity of L-type Ca2+ channel both in normal and anoxic condition [open time from (2.23 +/- 0.47) ms and (9.1 +/- 1.0) ms to (1.03 +/- 0.25) ms and (2.1 +/- 0.4) ms; close time from (38 +/- 10) ms and (10 +/- 3) ms to (74 +/- 16) ms and (46 +/- 10 ms); open-state probability from (0.043 +/- 0.006) and (0.165 +/- 0.025) to (0.012 +/- 0.004) and (0.021 +/- 0.009), respectively, P all < 0.01]. The results of PDS were similar to those of verapamil, but were weaker compared with verapamil. CONCLUSION: The L-type Ca2+ channels of rat cerebral cortical neurons were obviously opened during anoxia. The channels in normal and anoxic condition were effectively blocked by PDS. It was one of the important mechanisms by which PDS protected brain from the anoxic injury.

Animals↗
PubMed2000

Axis II psychopathology in individuals with traumatic brain injury.

PRIMARY OBJECTIVES: To determine the frequency and nature of post-TBI personality disorders (PDs) in a community-based sample of individuals with TBI. RESEARCH DESIGN: One hundred individuals with TBI were administered a structural clinical interview to determine Axis II psychopathology. METHODS OF PROCEDURES: The Structured Clinical Interview for DSM-IV Personality Disorders, Clinician Version (SCID II) was used to determine 12 Axis II personality disorders. SCID II questions were modified so that symptom onset could be rated as occurring pre-injury vs. post-TBI. Data were analysed using student T-tests, chi-square analysis and one way analyses of variance. OUTCOMES AND RESULTS: Pre-TBI PDs were diagnosed in 24% of the sample; antisocial PD and obsessive-compulsive PD were the most common diagnoses. Post-TBI, 66% of the sample met criteria for at least one PD, with PDs independent of TBI severity, age at injury, and time since injury. The most common post-TBI PDs were: borderline, avoidant, paranoid, obsessive-compulsive and narcissistic. Men were more likely to be diagnosed with antisocial PD and narcissistic PD. Individuals with pre-TBI PDs were at greater risk of acquiring additional psychopathology post-TBI. Personality traits endorsed by more than 30% of the sample post-TBI reflected loss of self-confidence, attempts to cope with cognitive and interpersonal failures and negative affect. CONCLUSION: These findings argue against a specific TBI personality syndrome, but rather a diversity of personality disorders reflective of the persistent challenges and compensatory coping strategies developed by individuals post-TBI. Prospective need for clinical assessment, pro-active education and focused treatment approaches are discussed.

Adaptation, Psychological↗
PubMedDate not supplied

The effect of advanced glycation end-products and aminoguanidine on TNFalpha production by rat peritoneal macrophages.

OBJECTIVE: To evaluate the effect of advanced glycation end-products (AGEs) and the inhibitor of their formation, aminoguanidine, on tumor necrosis factor-alpha (TNFalpha) production (as a functional marker) by rat peritoneal macrophages (PMphi). DESIGN: Charles River rats underwent a daily intraperitoneal injection of peritoneal dialysis solution [(PDS), 4.25 g/dL dextrose; Dialine, Travenol, Ashdod, Israel] for a 2-month period (group E). Another group of rats was subjected to the same protocol with the addition of 25 mg/kg aminoguanidine (group A). Three control groups were utilized: (1) rats that were injected daily with aminoguanidine only (group AO), (2) rats that were injected with Dulbecco's phosphate-buffered saline (group D), and (3) rats in which no intervention was carried out (group C). After 2 months, PMphi were isolated from rat peritoneal effluent and their TNFalpha production measured by ELISA in cell-free culture supernatants, in both the basal state and after 24-hour stimulation with lipopolysaccharide (LPS). The concentrations of AGEs in peritoneal effluent were assayed and correlated to TNFalpha levels. PMphi obtained from normal rats were then incubated for 24 hours with (1) the peritoneal effluent of each of the above respective groups, with or without LPS; (2) increasing concentrations of AGEs (0-250 microg/mL); and (3) increasing concentrations of aminoguanidine (0-7.5 mg/mL), and TNFalpha secretion again determined. RESULTS: After 2 months of daily intraperitoneal injection of PDS, in the basal state, TNFalpha production was significantly higher in PMphi isolated from the peritoneal effluent groups (groups E, A, and AO) compared to controls (group C). Following LPS stimulation, a further increase in TNFalpha secretion was seen, with a significantly greater response in group AO versus groups E, A, and D. Effluent AGEs were markedly elevated only in group E. No correlation was found between TNFalpha secretion by these PMphi and the concentration of AGEs. On incubation with the respective peritoneal effluents (groups E, A, and AO), in both the basal and stimulated state, TNFalpha production by PMphi from normal rats was significantly enhanced compared to group C. Incubation with increasing concentrations of AGEs or aminoguanidine resulted in an increase of TNFalpha secretion by these PMphi. CONCLUSIONS: Following intermittent intraperitoneal administration of glucose-based PDS, rat PMphi are chronically activated, as evidenced by increased basal TNFalpha secretion. The peritoneal effluent of such treated animals is capable of stimulating TNFalpha production by normal rat PMphi. These data suggest that glucose-based PDS acts as a primer of PMphi, which retain their ability to further stimulation by LPS. Although, in vitro, AGEs promote TNFalpha secretion by normal rat PMphi, in vivo, their influence is probably modulated by other factors. Aminoguanidine has a specific inducing effect on rat PMphi, independent of glucose-based PDS.

Animals↗
PubMed2001

Combined use of power Doppler and gray-scale sonography: a new technique for the assessment of inflammatory myopathy.

OBJECTIVE: Ultrasonography (US) is a utilitarian approach to the assessment of inflammatory myopathy (IM). Power Doppler sonography (PDS), a newer technique, enables detection of muscle vascularity and inflammation. We describe the combined use of PDS and gray-scale US in patients with IM. METHODS: We studied 37 IM subjects and 6 control subjects. Clinical scores of muscle strength and function were obtained. The maximum score, 31, represented normal function and strength. Ultrasonographic gray-scale and vascularity results were scored 0-4. Nine subjects had serial assessments. RESULTS: Subjects ranged from 16 to 83 years of age and were predominantly female. IM subjects had significantly abnormal lower clinical scores than controls, 23.0 +/- 5.8 vs 29.8 +/- 2.0 (p < 0.001). Mean peak gray-scale score was 2.1 +/- 0.96 compared to 0.5 +/- 0.84 for controls (p = 0.001), indicating atrophy in the IM group. Similar results were found for average gray-scale scores. Peak vascularity scores were higher in IM, 2.7 +/- 0.8 vs 2.2 +/- 0.3 (p = 0.007). Disease of longer duration was significantly associated with more abnormal gray-scale scores and lower creatine phosphokinase (CPK) levels. PDS scores were more abnormal in disease of shorter duration. There was a negative association between functional scores and inflammatory scores on serial assessment. CONCLUSION: Sonography is a valuable tool in the assessment of IM. Gray-scale and PDS findings were significantly different between IM and control subjects. Abnormal gray-scale US scores were associated with disease of longer duration and lower CPK levels. In contrast, increased vascularity on PDS detected disease of shorter duration and varied with the clinical course more than did gray-scale findings.

Adolescent↗