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PubMed2005

Dimensional personality traits and the prediction of DSM-IV personality disorder symptom counts in a nonclinical sample.

The third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III; APA, 1980) set forth a categorical system of personality psychopathology that is composed of discrete personality disorders (PDs), each with a distinct set of diagnostic criteria. Although this system is widely accepted and highly influential, alternative dimensional approaches to capturing personality psychopathology have been proposed. Three dimensional models of personality have garnered particular attention-the Five-Factor Model (FFM; Costa & McCrae, 1992), the Seven-Factor Psychobiological Model of Temperament and Character (Seven-Factor Model; Cloninger, Svrakic, & Przybeck, 1993); and the 18-factor model of personality pathology (18-factor model; Livesley, 1986). Although the personality traits from each of these models has been examined in relation to the ten personality disorders in the DSM-IV, no study has examined the comparative and incremental validity of these models in predicting PD symptoms for these ten disorders. Using self-report instruments that measure these models and the ten DSM-IV PDs, correlation and linear regression analyses indicate that traits from all three models had statistically significant associations with PD symptom counts. Hierarchical regressions revealed that the 18-factor model had incremental predictive validity over the FFM and Seven-Fac-tor Model in predicting symptom counts for all ten DSM-IV PDs. The FFM had incremental predictive validity over the Seven-Factor Model model for all ten disorders and the Seven-Factor was able to add incremental predictive validity over the 18-factor model for five of the ten PDs and for eight of the ten disorders relative to the FFM.

Adolescent↗
PubMed1997

A psychometric evaluation of the DSM-IV personality disorder criteria.

In this study, we examined the psychometric quality of the recently revised DSM-IV Personality Disorders (PD). A nationally drawn sample of mental health professionals rated 280 patients known to them, using a symptom checklist containing all the DSM-IV PD criteria. From this symptom level data we determined internal consistency, convergent validity, and discriminant validity for each DSM-IV PD criteria. Overall, the findings were encouraging. The internal consistency--a measure of reliability--of the PD criteria sets appears to be substantially improved. The median coefficient alpha for the DSM-IV PDs was .73. Convergent validity was generally adequate for the DSM-IV PD criteria sets. However, discriminant validity, a measure of the specificity of a criterion's relationship to its parent scale, continues to be a problem of the PDs. The findings suggest that the DSM-IV PDs may have better reliability than did their DSM-III-R predecessors. However, the weak discriminant validity found for the DSM-IV PD criteria sets indicates that the Axis II system will continue to show high levels of comorbidity. The usefulness of psychometric procedures in the development and refinement of the DSM PDs is also highlighted.

Adult↗
PubMed1998

Long-term test-retest reliability of personality disorder diagnoses in opiate dependent patients.

This investigation reports the two year test-retest reliability of DSM-III-R personality disorder (PD) diagnoses in a sample of 219 patients with opiate dependence admitted to methadone treatment. Different MA/PhD interviewers at each assessment used a semistructured diagnostic interview for PD, the Structured Interview for DSM-III-R Personality Disorders (SIDP-R), to make their diagnoses. The reliability of any PD diagnosis versus no PD was fair (kappa = .51). The reliability for any specific PD (weighted kappa = .31) was poor. Antisocial (kappa = .45) and sadistic (kappa = .42), were the only specific PDs for which at least fair reliability was achieved. At the cluster level, only Cluster B had fair reliability (kappa = .47). The intraclass correlation coefficients between number of criteria for the specific PDs at the two evaluation points were consistently higher (range .22 to .62.) than were the corresponding kappas for categorical diagnoses. In that the base rates for most of the PDs were low and agreement for the specific PDs typically exceeded 90%. Increasing the base rate by lowering the diagnostic threshold, or examining more severe cases by raising the diagnostic threshold, did not consistently effect reliability. Reasons for the low kappa coefficients and the implications for PD research are discussed.

Adult↗
PubMed2000

Associations between four types of childhood neglect and personality disorder symptoms during adolescence and early adulthood: findings of a community-based longitudinal study.

Data from a community-based longitudinal study were used to investigate the association between childhood neglect and personality disorder (PD) symptom levels during adolescence and early adulthood. Psychosocial and psychiatric interviews were administered to a representative sample of 738 youths and their mothers from upstate New York in 1975, 1983, 1985-1986, and 1991-1993. Evidence of childhood cognitive, emotional, physical, and supervision neglect was obtained from the maternal interviews that were conducted in 1975, 1983, and 1985-1986, and from New York State records. PDs were assessed among the youths in 1985-1986, when they were adolescents, and in 1991-1993, when they were young adults. Findings indicated that childhood emotional, physical, and supervision neglect were associated with increased risk for PDs and with elevated PD symptom levels during adolescence and early adulthood, after age, sex, childhood physical or sexual abuse, other types of childhood neglect, and cooccurring PD symptoms were controlled statistically. Childhood emotional neglect was associated with increased risk for avoidant PD and with paranoid and Cluster A PD symptom levels during adolescence and early adulthood. Childhood physical neglect was associated with increased risk for schizotypal PD and with Cluster A PD symptom levels during adolescence and early adulthood. Childhood supervision neglect was associated with increased risk for passive-aggressive and Cluster B PDs and with borderline, paranoid, and passive-aggressive PD symptom levels during adolescence and early adulthood. The present findings suggest that childhood emotional, physical, and supervision neglect may play a role in the etiology of some PDs.

Adolescent↗
PubMed2005

Continuity of axes I and II: toward a unified model of personality, personality disorders, and clinical disorders.

In the current standard psychiatric nomenclature, the DSM-IV-TR (APA, 2000), mental disorders are divided into two groups: Clinical Disorders (CDs) and Personality Disorders (PDs), and CD and PD diagnoses are recorded on two separate axes (Axes I and II, respectively). This article considers evidence regarding putative bases for distinguishing between CDs and PDs, and finds that these constructs are more similar than distinct. Links between the domains may be better understood by focusing on how personality connects CDs and PDs. This perspective underlines the need to work toward a more unified model of personality, PDs, and CDs in research and in future editions of the DSM.

Adult↗
PubMed2001

Clinical and molecular analysis of three Mexican families with Pendred's syndrome.

BACKGROUND: The autosomal recessive Pendred's syndrome is defined by congenital sensorineural deafness, goiter, and impaired iodide organification. It is caused by mutations in the Pendred's syndrome (PDS) gene that encodes pendrin, a chloride/iodide transporter expressed in the thyroid, the inner ear, and the kidney. OBJECTIVE: To perform a detailed clinical and molecular analysis of patients with Pendred's syndrome from four patients from three unrelated Mexican families. METHODS: Thyroid function tests, perchlorate test, thyroid scintigraphy, audiometry, computer tomography and magnetic resonance imaging were performed in all affected individuals. Haplotype analyses were performed using microsatellite markers flanking the PDS locus, and the PDS gene was submitted to direct sequence analysis. RESULTS: All patients presented with sensorineural deafness, Mondini malformations of the cochlea, an enlarged vestibular aqueduct, goiter, and a positive perchlorate test. Two patients were hypothyroid, two individuals were euthyroid. Sequence analysis revealed a complex homozygous deletion/insertion mutation at the end of exon 4 in the index patient of family 1 resulting in a premature stop codon at position 138. In family 2, the affected individuals were compound heterozygous for a splice acceptor mutation (IVS2 -1G>A) and a 1231G>C transversion substituting alanine 411 by proline (A411P). In family 3, the index patient was found to be homozygous for a transversion 412G>T in exon 4 replacing valine 138 by phenylalanine (V138F). CONCLUSIONS: All patients included in this study presented with the classic Pendred syndrome triad and molecular analysis revealed pendrin mutations as the underlying cause. The identification of three novel mutations, one of them of complex structure, expands the spectrum of mutations in the PDS gene and emphasizes that they display marked allelic heterogeneity.

Adolescent↗
PubMed2001

Phenotypes associated with replacement of His by Arg in the Pendred syndrome gene.

BACKGROUND: Pendred syndrome is often associated with inner ear malformations, especially enlarged vestibular aqueduct (EVA). Recently, mutations in the Pendred syndrome gene (PDS) have been reported in patients with EVA, in addition to those with classical Pendred syndrome. OBJECTIVE: The aim of this study was to investigate the genotype-phenotype correlations of PDS. METHODS: Each of the 21 exons and flanking splice regions of PDS was analysed by direct DNA sequencing in nine patients with EVA; allele-specific amplification was performed to confirm the mutation. Genetic analyses were compared with thyroid function tests, perchlorate discharge tests, thyroid volume and pure-tone audiogram. Magnetic resonance imaging was used to determine the volume of the endolymphatic duct and sac of each patient. RESULTS: A missense mutation, H723R, was identified in the homozygous state in three patients and in the heterozygous state in another three. Although none of the patients had goitre, increased serum thyroglobulin and an abnormal degree of iodide release were correlated with the number of mutant alleles identified. However, there was no relationship between the degree of hearing loss and the number of mutant alleles. CONCLUSION: The present study reveals that the number of mutant alleles correlates with the degree of subclinical thyroid abnormality, but not with the degree of hearing loss in Japanese patients with the PDS missense mutation H723R.

Adolescent↗
PubMed2006

Multipotent adult progenitor cells from swine bone marrow.

We show that multipotent adult progenitor cells (MAPCs) can be derived from both postnatal and fetal swine bone marrow (BM). Although swine MAPC (swMAPC) cultures are initially mixed, cultures are phenotypically homogenous by 50 population doublings (PDs) and can be maintained as such for more than 100 PDs. swMAPCs are negative for CD44, CD45, and major histocompatibility complex (MHC) classes I and II; express octamer binding transcription factor 3a (Oct3a) mRNA and protein at levels close to those seen in human ESCs (hESCs); and have telomerase activity preventing telomere shortening even after 100 PDs. Using quantitative-reverse transcription-polymerase chain reaction (Q-RT-PCR), immunofluorescence, and functional assays, we demonstrate that swMAPCs differentiate into chondrocytes, adipocytes, osteoblasts, smooth muscle cells, endothelium, hepatocyte-like cells, and neuron-like cells. Consistent with what we have shown for human and rodent MAPCs, Q-RT-PCR demonstrated a significant upregulation of transcription factors and other lineage-specific transcripts in a time-dependent fashion similar to development. When swMAPCs were passaged for 3-6 passages at high density (2,000-8,000 cells per cm(2)), Oct3a mRNA levels were no longer detectable, cells acquired the phenotype of mesenchymal stem cells (CD44(+), MHC class I(+)), and could differentiate into typical mesenchymal lineages (adipocytes, osteoblasts, and chondroblasts), but not endothelium, hepatocyte-like cells, or neuron-like cells. Even if cultures were subsequently replated at low density (approximately 100-500 cells per cm(2)) for >20 PDs, Oct3a was not re-expressed, nor were cells capable of differentiating to cells other than mesenchymal-type cells. This suggests that the phenotype and functional characteristics of swMAPCs may not be an in vitro culture phenomenon.

Adult Stem Cells↗
PubMed2006

Periodontal assessment by right- and left-handed examiners: is there a difference?

BACKGROUND: Multiple factors that influence the precision of periodontal probing measurements have been identified. These factors can be categorized as being dependent upon host-related, probe-related, or examiner-related variables. However, the potential influence of examiner handedness (right or left) on the measurement of periodontal probing depths (PDs) has not been addressed. The purpose of this study was to determine whether the measurements of PDs in the right and left quadrants are influenced by the handedness of the examiner. METHODS: Eight systemically healthy adult subjects with varying degrees of attachment loss and a minimum of 20 teeth were examined by five right-handed and five left-handed clinicians. The 10 clinicians were trained and calibrated for reproducible probe placement and angulation. PDs were measured using a conventional periodontal probe at six sites per tooth. Mean PD measurements were compared between right- and left-handed examiners using analysis of variance (ANOVA) with a random patient effect to correlate participant data and a random effect for the examiner. RESULTS: There was no statistical difference in the measurement of PDs between right- and left-handed examiners at various locations in the mouth (P>0.17 in all cases). Only three individual sites showed a statistically significantly different mean PD between right- and left-handed examiners (unadjusted P<0.05; differences at or near 0.5 mm). Overall, right-handed examiners tended to record slightly higher PD measurements than left-handed examiners, but this difference did not reach statistical significance. CONCLUSIONS: The handedness of the periodontal examiner does not appear to influence the recorded measurement of probing depths. This finding is relevant to those conducting clinical research involving assessment of periodontal status.

Adult↗
PubMed1996

Defining the personality disorders: description of an Australian database.

OBJECTIVE: We seek to improve the definition and classification of the personality disorders (PDs) and derive a large database for addressing this objective. METHOD: The paper describes the rationale for the development of a large set of descriptors of the PDs (including all DSM-IV and ICD-10 descriptors, but enriched by an additional 109 items), the design of parallel self-report (SR) and corroborative witness (CW) measures, sample recruitment (of 863 patients with a priori evidence of personality disorder or disturbance) and preliminary descriptive data. RESULTS: Analyses (particularly those comparing ratings on molar PD descriptions with putative PD dimensions) argue for acceptable reliability of the data set, while both the size of the sample and the representation of all PD dimensions of interest argue for the adequacy of the database. CONCLUSIONS: We consider in some detail current limitations to the definition and classification of the PDs, and foreshadow the analytic techniques that will be used to address the key objectives of allowing the PDs to be modelled more clearly and, ideally, measured with greater precision and validity.

Adult↗
PubMed1985

Extracellular volume, renal clearance and whole body permeability-surface area product in man, measured after single injection of polyfructosan.

In 22 patients non-compartmental analysis was applied to plasma disappearance curves obtained after a single injection of polyfructosan to measure volume of distribution (Vd), renal clearance (Cl) and the whole body permeability-surface area product (PdS) of the indicator. It was found that introduction of the theoretical plasma concentration at time zero, calculated as the injected amount divided by the plasma water volume independently determined, to the curves was necessary to determine the initial slope of the curve and subsequently calculate the PdS. This 'initial phase' approximation had negligible effect on the calculations of Vd and Cl. The approximation, however, allowed extension of the non-compartmental analysis to include calculation of the whole body PdS. The whole body PdS for polyfructosan was found to be 0.68 ml/100g X min or 429 ml/min. Assuming a capillary surface area of the whole human body of 50 cm2g-1, the average whole body diffusional permeability coefficient, Pd, for polyfructosan was found to be: 0.23 X 10(-5) cm X sec-1.

Arteriosclerosis↗
PubMed1996

Changes in agalactosyl IgG levels correlate with radiological progression in early rheumatoid arthritis.

Immunoglobulin G-lacking galactose (Gal[0]) appears to be helpful in differential diagnosis of early synovitis, and correlates with disease activity in rheumatoid arthritis (RA). Its utility for RA monitoring and prognosis has been evaluated in the present study. Forty-eight patients with early RA were observed for 3 years. Hand radiographs were assessed according to Larsen and results were expressed as damage score (DS) and progression of damage score (PDS). Gal[0], DS, and PDS were evaluated at the onset of the study and after 1 and 3 years. The average values of Gal[0] in RA patients at the onset of the observation were significantly higher as compared to healthy controls (0.43 +/- 0.22 vs. -0.03 +/- 0.09, P < 0.05). The findings of Gal[0] after a 3-year follow-up were also higher as compared to healthy controls (0.37 +/- 0.21 vs. -0.03 +/- 0.09, P < 0.05). Radiological progression (PDS > 15) was observed in 16 patients. This group was characterized by a constantly high level of Gal[0]. The level of Gal[0] in patients without or with moderate radiological progression (PDS < 15) was significantly lower at the onset of the study and remained low during the observation. The relationship between Gal[0] and radiological progression was shown. The data thus far obtained suggest that Gal[0] may serve as an indicator for the disease course in patients with RA. Secondly, we cannot exclude the possibility that the constantly elevated level of Gal[0] causes erosions.

Adult↗
PubMed1986

Digestion and absorption of sugars and sugar substitutes in rat small intestine.

The bioavailability of newly developed sugar substitutes was observed by measuring the transmural potential difference (delta PD) evoked by Na+-dependent active transport of glucose, which is supposed to be produced by the hydrolysis of sugar substitutes. delta PD was measured using everted intestinal sac prepared from jejunum of adult rats and compared with the digestibility of sugar substitutes in the mucosal homogenate of everted sac. delta PDs evoked by glucose, maltose or maltosylfructose had almost the same levels, however, the delta PD evoked by sucrose was a little lower. delta PDs evoked by maltitol or palatinose were low, and delta PDs evoked by fructo-oligosaccharides were negligible. The hydrolyzing activities of these sugars and sugar substitutes by the mucosal homogenate were correlated with the delta PDs. A significant positive correlation was observed between delta PDmax of various sugars and sugar substitutes and the Vmax of their corresponding hydrolyzing activities. Also, a significant positive correlation was observed between Kt and Km values of these sugars. These results suggest that the absorption of sugar substitutes is dependent on digestibility by membrane digestive enzymes.

Animals↗
PubMed2003

General practitioners' perceptions of the pharmaceutical decision-support tools in their prescribing software.

OBJECTIVES: To explore how Australian general practitioners use pharmaceutical decision-support (PDS) systems; to determine GPs' perceptions of the deficiencies and strengths of these systems; and how they believe they can be improved. DESIGN AND SETTING: Qualitative analysis of discussion from three focus groups of GPs (from one rural and two urban Divisions of General Practice) between April and May 2002. PARTICIPANTS: 22 GPs selected to include users of the five most popular prescribing/clinical practice software products available in Australia. MAIN OUTCOME MEASURES: Advantages and disadvantages of using PDS software; ideas for improving PDS systems; attitudes to electronic evidence-based guidelines. RESULTS: GPs believed that important interactions may be missed because of desensitisation resulting from too many alerts (which also intrude on workflow); that interaction alerts need to be severity graded and only significant ones should appear; and that improved computer-user interface design could enhance the usefulness of PDS systems. CONCLUSIONS: Our results will provide useful feedback to government, software vendors and software developers on the needs and expectations of end users and on the development of agreed software standards.

Attitude of Health Personnel↗
PubMed2000

Relationship of telomeres and p53 in aging bovine corneal endothelial cell cultures.

PURPOSE: To demonstrate a relationship between telomere lengths and levels of p53 in cultured bovine corneal endothelial cells (CECs) during aging. METHODS: Bovine CECs were grown and aged as long-term cultures. Telomere lengths were determined directly on gels with 32P probes after treatment of isolated DNA with RsaI and HinfI. Protein p53 was determined using an enzyme-linked immunosorbent sandwich assay. Cellular aging and the development of replicative senescence were monitored by the appearance of senescent morphology and the beta-galactosidase assay. RESULTS: Bovine CEC telomeres lost 4 kb (from 12.8 to 8.8 kb) over 1 year (89 population doublings [PDs]). The p53 levels in bovine CECs were initially small (approximately 60 pg/million cells), but rose 3.5-fold by culture age of 260 days (64 PDs). On initiation, cultured bovine CECs did not stain for the senescent marker beta-galactosidase. However, these cells stained at 89 PDs and senescent morphology was observed in the cultures at 64 PDs. CONCLUSIONS: The data indicate an inverse relationship between telomere lengths (decreasing) and levels of p53 (increasing) in bovine CECs during aging. These properties may influence the ability of these cells to divide as they enter into replicative senescence.

Animals↗
PubMed2000

[Power Doppler and 3D vascular sonography of intraprostatic blood supply: assessment criteria and value for the diagnostic and clinical staging of prostatic cancer].

OBJECTIVES: To compare the value of Power Doppler Sonography (PDS) and B mode sonography in the diagnosis of prostate cancer and to assess the value of PDS to assess cell differentiation as a function of the degree of blood supply and to specify capsular effraction of the cancer. PATIENTS: 133 patients, divided into 2 groups, were investigated: one group consisted of 41 patients with no suspicion of cancer (15 control subjects and 26 patients with acute prostatitis) and a second group consisted of 92 patient with suspected cancer (PSA > 4 ng/ml). METHODS: Power Doppler sonography with 3D reconstruction was used to calculate a graduated blood supply index from 1 to 3 for nodules of the peripheral zone. Three types of blood supply (A: regular avascular capsule, B: irregular avascular capsule, C: vessels crossing the capsule) were described as a function of the presumed stage of cancer (A: intraprostatic, B: undetermined, C: extraprostatic). Comparison with histology was performed on randomized biopsies (92 cases) and radical prostatectomy specimens (21 cases). RESULTS: A cancer was diagnosed in 57 of the 92 patients (62%) with suspected cancer. The overall sensitivity of PDS in the initial diagnosis of prostatic cancer was 94.7%, and its specificity was 77.1% (versus 93% and 42.8% for sonography alone, respectively). For a prevalence between 0.4 and 0.9, the PPV ranged from 73.4% to 97.4% and the NPV ranged from 95.6% to 62% (p = 0.02). The correlation between tumour blood supply and Gleason score showed that 20/40 tumours (50%) with a Gleason score > or = 7 had a blood supply index of 3 versus 6/17 (35%) of tumours with a Gleason score < 7 (r = 0.283, p = 0.033). The 3 vascular types, A, B, C, were evaluated prospectively in the detection of capsular effraction. Capsular effraction was detected in one of the 8 cases of type A cancer and in 6 of the 8 cases (75%) of type C cancer. CONCLUSION: PDS improves the reliability of sonography in the diagnosis and staging of prostate cancer. There is a correlation between tumour blood supply and Gleason score.

Aged↗
PubMed2000

[Ion channels and epilepsy].

OBJECTIVE: We review the role of ligand-gated ion channels and voltage-gated ion channels as a substrate for the epileptogenesis and as targets in the development of new antiepileptic drugs. DEVELOPMENT: Voltage-gated calcium channels are involved in the release of neurotransmitters, in the sustained depolarization-phase of paroxysmal depolarisation shifts (PDS), and in the generation of absences; they are also the genetic substrate of generalized tonic-clonic convulsions and absence-like pattern seen in some mice. The voltage-gated potassium channel has been implicated in the hyperpolarization-phase of PDS, it is the genetic substrate of the long QT syndrome, benign neonatal epilepsy, and episodic ataxia/myokymia syndrome, and it is the target of some antiepileptic drugs which activate this channel. The voltage-gated sodium channel is the target of most of the classical and newer antiepileptic drugs; it is also the substrate for generalized epilepsy with febrile seizures plus. The sodium channel of the nicotinic acetylcholine receptor is the substrate for nocturnal frontal lobe epilepsy. The sodium channels of the AMPA and KA glutamate receptors have been proposed as substrate for juvenile absence epilepsy and are a target for new antiepileptic drugs which inhibit it. The calcium channel of the NMDA glutamate receptor has been implicated in the sustained depolarization-phase of PDS and in epileptogenesis after kindling and is a main target for new antiglutamate drugs. The chloride channel of the GABAA receptor is responsible for the rapid hyperpolarization of PDS, it has been involved in epileptogenesis after kindling, it may be the substrate of the Angelman syndrome, and it is activated by many classical and new antiepileptic drugs. CONCLUSION: The knowledge of the role of the ion channels in the epilepsies is allowing the design of new and more specific therapeutic strategies.

Angelman Syndrome↗
PubMed1975

Evaluation of a selective medium for hydrogen sulfide production by salmonella.

An evaluation was made of Padron-Dock-Stader sulfide (PDS) agar for the rapid detection of Salmonella and Arizona microorganisms in foods. Analysts from 9 Food and Drug Administration District laboratories determined the reaction of 638 Salmonella cultures, 30 Arizona cultures, and 1754 non-Salmonella and non-Arizona cultures isolated from 157 food samples in PDS agar. The degree of positive reactions of these cultures in this agar was scored on a scale of "-" to "+++". The highest percentage of Salmonella isolates (64.1%) was in the category of +++ reactions. Progressively lower percentages of Salmonella isolates occurred in the more negative reaction categories. The highest percentage of Arizona isolates (66.7%) occurred in the intermediate ++ category. The majority of non-Salmonella and non-Arizona isolates occurred in the minus (41.0%) and plus or minus (44.8%) categories. Advantages of using the PDS agar are that it is simple to use, requires no specialized training or equipment, and alerts analysts to those Salmonella cultures which produce atypical reactions in triple sugar iron agar particularly the lactosepositive Salmonella. However, in this study the occurrence of false-negative reactions ranged from 4.3 to 13.9% for Salmonella and from 0 to 6.7% for Arizona, according to the criteria used to interpret the reactions in PDS agar.

Cells, Cultured↗