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PubMed2004

Endozepine stupor: disease or deception? A critical review.

Presentation of patients with recurrent stupor associated with apparently elevated levels of an endogenous benzodiazepine-like agent, endozepine-4, has been reported from several centers, and a new syndrome, endozepine stupor has been proposed. We recently reported a case with typical features of this syndrome, which proved to be an example of surreptitious administration of exogenous benzodiazepine. This and other examples of clandestine drug use, together with uncertainties about the validity of tests used to distinguish exogenous and endogenous benzodiazepines, prompted us to undertake a reappraisal of this clinical syndrome.

Benzodiazepines↗
PubMed2003

Immune testing in fertility practice: truth or deception?

PURPOSE OF REVIEW: Much attention has been paid to the role of immunology in reproductive success or failure. Every step in the establishment of normal pregnancy has been implicated as a possible site of immune-mediated reproductive failure. The widespread testing of antiphospholipid, antinuclear, antithyroid, and antisperm antibodies, as well as generalized immune testing, have thus been employed to diagnose patients with otherwise unexplained infertility or recurrent pregnancy loss. Controversial data surrounding the widespread and variable use of immune testing in current fertility practice is reviewed to determine which tests are warranted based on sound scientific evidence. Because it is postulated that early miscarriage, when occult, could represent a failure of embryo implantation indistinguishable from unexplained infertility, this analysis of immune testing includes a discussion of patients with recurrent pregnancy loss. RECENT FINDINGS: Despite the increased prevalence of abnormal immune testing associated with early reproductive failure, the most rigorous studies have not proven a cause and effect between these phenomena. There is wide variation and inconsistency regarding this association, depending upon which test(s) are employed, the study methodology used, and the patient population under study. The significance of selected immunological test abnormalities associated with early reproductive failure is uncertain. SUMMARY: Great variability exists in identifying candidates for immune testing, determining which tests to order, interpreting the test results, and offering immunologic treatments. This review argues that the use of widespread immune testing in clinical practice can not be supported by existing data. The resulting therapies are similarly of unconfirmed benefit and may cause harm.

Antibodies, Antiphospholipid↗
PubMed1994

Disease, disorder, or deception? Latah as habit in a Malay extended family.

Thirty-seven cases of latah are examined within the author's Malay extended family (N = 115). Based on ethnographic data collected and a literature review, cases are readily divisible into two broad categories: habitual (N = 33) and performance (N = 4). The first form represents an infrequent, culturally conditioned habit that is occasionally used as a learned coping strategy in the form of a cathartic stress response to sudden startle with limited secondary benefits (i.e., exhibiting brief verbal obscenity with impunity). In this sense, it is identical to Western swearing. Performers are engaged in conscious, ritualized social gain through the purported exploitation of a neurophysiological potential. The latter process is essentially irrelevant, akin to sneezing or yawning. It is concluded that latah is a social construction of Western-trained universalist scientists. The concept of malingering and fraud in anthropology is critically discussed.

Adaptation, Psychological↗
PubMed1992

Deceptive liver histology delays diagnosis of cardiac ascites.

Cardiac ascites is a rare condition. Diagnosis is aided by liver histology, which characteristically shows diffuse hepatic congestion affecting the centrilobular region. In our case of refractory ascites due to constrictive pericarditis, diagnosis was delayed because centribular hepatic congestion was absent histologically. Contrary to numerous published reports, diffuse hepatic congestion is not uniformly present in cardiac ascites. Constrictive pericarditis is curable and should be considered in all cases of unexplained ascites, regardless of atypical hepatic histology.

Adult↗
PubMed2005

The capillary lobule: a deceptively benign feature of post-radiation angiosarcoma of the skin: report of three cases.

Three cases are presented of a proliferative vascular lesion of the skin developing in the chest wall of women who had received radiation therapy for breast carcinoma. All 3 lesions were characterized microscopically by the presence of the so-called capillary lobule, a formation generally regarded as a sign of benignancy but that in this setting proved to be a forerunner or indicator of angiosarcoma (malignant hemangioendothelioma). Therefore, the detection of capillary lobules in irradiated skin ought to be regarded with great suspicion, and other morphologic signs suggestive of angiosarcoma should be sought in the specimen.

Aged↗
PubMed2004

A controlled genetic programming approach for the deceptive domain.

Traditional genetic programming (GP) randomly combines subtrees by applying crossover. There is a growing interest in methods that can control such recombination operations in order to achieve faster convergence. In this paper, a new approach is presented for guiding the recombination process for genetic programming. The method is based on extracting the global information of the promising solutions that appear during the genetic search. The aim is to use this information to control the crossover operation afterwards. A separate control module is used to process the collected information. This module guides the search process by sending feedback to the genetic engine about the consequences of possible recombination alternatives.

Algorithms↗
PubMed2000

Evolution of reproductive strategies in the sexually deceptive orchid Ophrys sphegodes: how does flower-specific variation of odor signals influence reproductive success?

The orchid Ophrys sphegodes Miller is pollinated by sexually excited males of the solitary bee Andrena nigroaenea, which are lured to the flowers by visual cues and volatile semiochemicals. In O. sphegodes, visits by pollinators are rare. Because of this low frequency of pollination, one would expect the evolution of strategies that increase the chance that males will visit more than one flower on the same plant; this would increase the number of pollination events on a plant and therefore the number of seeds produced. Using gas chromatography-mass spectrometry (GC-MS) analyses, we identified more than 100 compounds in the odor bouquets of labellum extracts from O. sphegodes; 24 compounds were found to be biologically active in male olfactory receptors based on gas chromatography with electroantennographic detection (GC-EAD). Gas chromatography (GC) analyses of odors from individual flowers showed less intraspecific variation in the odor bouquets of the biologically active compounds as compared to nonactive compounds. This can be explained by a higher selective pressure on the pollinator-attracting communication signal. Furthermore, we found a characteristic variation in the GC-EAD active esters and aldehydes among flowers of different stem positions within an inflorescence and in the n-alkanes and n-alkenes among plants from different populations. In our behavioral field tests, we showed that male bees learn the odor bouquets of individual flowers during mating attempts and recognize them in later encounters. Bees thereby avoid trying to mate with flowers they have visited previously, but do not avoid other flowers either of a different or the same plant. By varying the relative proportions of saturated esters and aldehydes between flowers of different stem positions, we demonstrated that a plant may take advantage of the learning abilities of the pollinators and influence flower visitation behavior. Sixty-seven percent of the males that visited one flower in an inflorescence returned to visit a second flower of the same inflorescence. However, geitonogamy is prevented and the likelihood of cross-fertilization is enhanced by the time required for the pollinium deposited on the pollinator to complete its bending movement, which is necessary for pollination to occur. Cross-fertilization is furthermore enhanced by the high degree of odor variation between plants. This variation minimizes learned avoidance of the flowers and increases the likelihood that a given pollinator would visit several to many different plants within a population.

Animals↗
PubMed1992

Hepatic angiomyolipomas with a deceptive trabecular pattern and HMB-45 reactivity.

We report two cases of giant hepatic angiomyolipoma with a prominent component of epithelioid smooth muscle cells exhibiting a distinctive trabecular arrangement. These cells possessed peripherally vacuolated and centrally condensed hyaline cytoplasm. The nuclei were eccentrically placed in the cytoplasm. Immunohistochemically, they expressed HMB-45 intensely in the central condensed cytoplasm and actin in a perimembranous fashion. Staining for desmin, myoglobin and vimentin was negative. HMB-45 may prove to be a sensitive marker for angiomyolipoma with epithelioid cells. Hepatocellular carcinoma and other hepatic tumours with polygonal clear cells can be readily distinguished by these means.

Adult↗