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PubMed1979

The off--centered TORP.

Refinement of the techniques of ossicular reconstruction has provided satisfactory hearing results for a majority of patients with chronic ear disease. As documented in 1976, 16% of patients, those requiring a columneller type of ossiculoplasty because of absence of the malleus, did not realize the same degree of hearing improvement as with other types of reconstruction. These procedures, short and long "L-shaped" assemblies, used for patients without a malleus, resulted in a mean 27 dB bone-air gap postoperatively. The conclusion reached after comparison with the results obtained with other types of reconstruction was "... the L-shaped conductive system is less efficient than normal by the amount observed (27 dB). If these results are to be improved, a change in the method of reconstruction resulting in a more normal system may be required." Following duplication of the aforecited report a change in the method of reconstruction used for patients with the malleus absent was instituted, but perversely creating a less normal conductive system. This paper will present the one year results of those patients in which a Plastipore prosthesis has been used as a replacement of the previously described method and will compare these results with those of the past technique.

Cartilage↗
PubMedDate not supplied

[Characteristics of the effect of drug combinations on the development of immediate hypersensitivity].

As compared to the action of the drugs given alone, the combinations of antiallergic drugs and cardiac glycosides had different effects on the nature and intensity of the processes inherent in allergy. These differences correlated to a certain degree with the mechanism of a reaction which experienced the action of the drug combination. Within the frames of synergoantagonism interplay, the drug combination produced on some of the reactions an effect which was similar to that exerted by one of the components. Meanwhile the magnitude of the effect produced by the same drug combination on the other reactions was half as that manifested by the components administered alone. Sometimes in the combinations of the drugs, the effects of the constituent parts were perversed in the course of action on some of the processes. In individual cases the combined drugs had remarkable effects on a reaction, while the individual components did not change it. Strophanthine given in the combinations tested, almost never displayed its specific action on the reactions inherent in sensitization. Combined diphenhydramine affected, as a rule, the sensitization and altered the effect of other substances.

Animals↗
PubMed1984

[Interaction of kynurenine and diazepam].

Intracerebroventricular injection of 1-kynurenine sulfate (10 micrograms) eliminated anticaffeine effect of diazepam (5, 10 and 20 mg/kg) in mice. Antipentylenetetrazole (0.5-2.5 mg/kg) and anticonflict (1-2.5 mg/kg) effects of diazepam were not altered by kynurenine (0.1-10 micrograms). The sedative effect of diazepam (1 and 4 mg/kg) was potentiated by kynurenine (1 microgram). Stimulation of locomotion induced by kynurenine (0.5 and 2.5 micrograms) was prevented or perversed by pretreatment with diazepam (1 mg/kg). In a conflict situation test, diazepam and kynurenine had an opposite action, respectively increasing and decreasing the number of transitions between light and dark compartments. The central effects of kynurenine can be related and not related to benzodiazepine receptors.

Animals↗
PubMedDate not supplied

The transferable penis and the self representation.

A group of female patients is described whose self representation includes significant male as well as female aspects, but who are not perverse or borderline. The unconscious fantasy of a transferable penis found in these patients is linked to specific etiologic factors including only intermittently available, unempathic early mothering and a prolonged incestuous post-oedipal father-daughter sexual relationship. Use is made of the concept of differing and conflicting aspects of the self-representation to elucidate the particular nature of these patients' bisexual fantasies, which allowed appropriate sexual gender and role to develop, and yet which, at times, also permitted drive gratification associated with the fantasy of being male and possessing a penis.

Adult↗
PubMed1984

Some considerations arising from the treatment of a patient with necrophilic fantasies in late adolescence and young adulthood.

Some psychoanalytic theories relating to necrophilia are reviewed, supplemented by other relevant theoretical abstracts. A psychoanalytic case of a young man with necrophilic fantasies is described, emphasizing separation anxiety, sadism and anal masturbation, all compellingly manifest in the transference and rooted in infantile trauma. The material is compared with that of other analysts working with similar pathology, then discussed in relation to perversions generally. Finally, it is argued that if the prognosis depends on whether core fantasies are amenable to analysis in the transference, then there may be therapeutic justification for keeping adolescence open by blocking the developmental move forward, on the grounds that these fantasies would quickly be rendered inaccessible under the normal repressive processes of young adulthood.

Adolescent↗
PubMed1983

[Alterity in psychopathologic languages. 3: the sex of words].

This study of alterity in psychopathological language includes three parts: 1) The double without dialogue; 2) The ego(s) in the soliloguy; and here: 3) The sex of words. Two clinical cases (an asexuation delusion, an agressive misogyny) show the systemic interrelations in one of their sides only. The relations between neurosis, perversion, psychosis are operating into the sexuation and into the insatured dialogical structure of language. Enclosed alterity in language is the specific fact of psychopathology.

Adult↗
PubMed1984

[Granulation tissue: inflammation and regeneration].

Healing of the external defects by the primary tension, under the scab, or by the secondary tension through the suppuration as well as the formation of granulation tissue (GT) in other organs, represent an adequate homeostatic response to the injury with stereotype kinetics of the inflammation and regeneration. The altered general and local responsiveness trophic disorders, burn and radiation trauma result in collapse of the autoregulatory mechanisms, pronounced disturbance of phagocytosis, microcirculation, mediator and contact cell interaction. This provokes the inhibition of fibroblast proliferation, depression and perversion of fibrillogenesis and the granulation tissue maturation, the formation of abnormal granulation tissue with repeated wakes of sclerosis, necrosis and inflammation, formation of persisting wounds, ulcers, hypergranulations or chronic inflammatory processes. Homeostatic protective response transforms into the pathologic response due to dissociation between the inflammation and regeneration and formation of "vicious circle".

Granulation Tissue↗
PubMed1984

The dark continent and its enigmas.

The author quotes at length from Freud's lecture on femininity of 1933 as a starting point to his paper. The female, in his opinion, is not precisely the 'victim' of the imaginary encounter of the man with his wife or sister, but, on the contrary, she functions as the promoting 'lure'. This lure alludes to desire, and the desire to the object petit a of Lacan. The object petit a is present in the normal fetishes of human sexuality, and becomes a perversion only when it fixates on a particular fetish. The function of 'lure' defines the female, in addition to a double identification characteristic of each sex. The lack for the female must be recognized to be the otherness of the primitive love object. Both the masculine and the feminine models of the reaction to the discovery of this loss constitute the key subject of this paper--the sexualization process.

Female↗
PubMedDate not supplied

Psychotherapy of the family as a measure for preventing relapses and improving the prognosis in schizophrenic patients.

The increasing interest in the relationship among psychoanalysis, linguistics and higher nervous activity (neurodynamic) is recalled. As most of the works on the therapy of the family have been based upon psychodynamic interpretations, the authors shall try to speculate on how much room this field should be given in the phenomena related to higher nervous activity. The study of Pavlov, Gantt and others on biological and social factors influencing human behaviour have been discussed in relation to the system represented by the family nucleus. Some aspects have been taken in consideration like the double bind, the perverse triangle and the formation of a scapegoat. Double bind theory and praxis is representing a paradoxical situation similar to unavoidable conditioned patterns. The behaviour of the "designed patient" may be interpreted as a tentative escape to express his disagreement to the fixed situation. What happens is a kind of abnormal conditioning which is realized through a progressive stratification of discordant learning. The final result is the disorganisation of cognitive processes. In the meantime, we observe a discordance of the activity of the first and the second signaling system because, very often, an apparent external calm is accompanied by intense cardiovascular or visceral turmoil. Every kind of communication should take care of both processes, the congnitive and the neurodynamic. The analysis of the verbal, as well as the non-verbal communication in the family setting, may be fruitfully based upon the study of the progressive significance of the cognitive-emotional dissyntony, as well as the dissyntony between the 1st and the 2nd S.S., and the transactional dissyntony implicit in the double bind. A group of 25 families of schizophrenics followed by one up to five years has been examined following the concepts above mentioned.

Double Bind Interaction↗
PubMed1981

Treatment of chronic pain: the Center for Pain Studies, Rehabilitation Institute of Chicago.

The Center for Pain Studies of the Rehabilitation Institute of Chicago (formerly known as the Low Back and Pain Clinic) has developed a multidisciplinary program for the management of chronic pain. Typically patients present a variety of chronic pain syndromes, most frequently low back pain, which have not responded to previous treatment including surgery, physical therapy, medication, vogue therapies, and other pain management programs. Patient capability to engage in normal daily activities such as standing, walking, sitting, lifting, etc. is often limited; most are unable to work or carry on pre-injury activities. Psychological ramifications of chronic pain appear frequently as a retreat from responsibility by the patient for his own welfare, manifested by distinct behaviour patterns (measurable on the MMPI); however, the ability of the patient to cope with chronic pain is largely a function of his ability to cope with other stresses prior to onset of pain. The patient's physical and psychological status alters his relationships with spouse and children, straining family well-being. Economic factors often occasion additional alteration in personal and family relations. Frequently a spouse not employed outside the home goes to work. Compensation programs and aid from public agencies may provide insufficient support or, conversely, compensation practices may establish perverse incentives toward recovery by providing the patient with net income equal to or greater than normally received.

Ambulatory Care Facilities↗
PubMed1983

[Effect of lithium hydroxybutyrate on the serotonin content of the brain in intact rabbits and during hyperactivity of the central serotoninergic systems].

Chronic administration of lithium hydroxybutyrate (10 mg/kg) to rats reduces the content of serotonin in the caudate nucleus, suppresses the growth of its level in all the subcortical brain structures. After 5-hydroxytryptophan administration it perverses the serotonin-positive action of dorsal raphe nucleus electric stimulation.

Animals↗
PubMedDate not supplied

Sclerous atrophic cellulitis.

The author deals only with the sclerous subcutaneous inflammation caused by venous stasis. There is no clear distinction between inflammation, and tissular sclerosis, the final stage of its development. There may be a certain lesional reversibility. The term "scleroinflammatory cellulitis" is therefore quite apt. Physiopathology. Pathology venous reflex results in a flood of proteins in the interstitial tissue, and this shows in signs of tissular pain, especially at the level of the hypoderm and dermis (anatomical reasons). Clinical. This is most often in the case of women with varicose affections or with post-phlebitic syndromes causing a painful, inflamed plaque, on the surface of the inside leg, at the junction of the middle and lower thirds. As well as the inflammation of this area, adhesion to the subjacent layers and induration are also confirmed. Venous dilations may be detected at the centre of this scleroinflammatory plaque. To begin with, the skin is red and taut, but later becomes dry and atrophic. It is prone to eczema and sometimes to ulceration. The development of subcutaneous inflammation is marked by sudden manifestation of inflammation which may be extensive and results in circular suffing, in extreme cases. Varicose sclerosis can provoke sudden manifestations of inflammation and especially if the technique is faulty (excessive dosage, lack of compression, insufficient compression). Treatment. 1. Local. Bandaging and walking are imperative. The bandage must be compressive, immovable, durable, and should be reinforced as necessary at the site of the induration, by latex rubber pads. Once the object of these slightly or non-elastic pads has been achieved they can be replaced by elastic contention. 2. General. Corticoids and phenylbutazone in short courses of treatment. Other products constitute auxiliary remedies. Thermal cures are always indicated in difficult cases. Medical treatment is often enough. In certain perverse cases a surgical treatment may be required, such as hypodermal resection and ligation of the perforants. Grafts (Vigoni). Certain severe cases remain unresponsive to all treatment and in such cases it is regrettable that suitable treatment was not administered at an earlier stage.

Atrophy↗
PubMed1978

The supply of surgeons and the demand for operations.

This paper presents a multiequation, multivariate analysis of differences in the supply of surgeons and the demand for operations across geographical areas of the United States in 1963 and 1970. The results provide considerable support for the hypothesis that surgeons shift the demand for operations. Other things equal, a 10 percent increase in the surgeon/population ratio results in about a 3 percent increase in per capita utilization. Moreover, differences in supply seem to have a perverse effect on fees, raising them when the surgeon/population ratio increases. Surgeon supply is in part determined by factors unrelated to demand, especially by the attractiveness of the area as a place to live.

Educational Status↗
PubMed1978

[Problem of sexual pathology in alcoholic delusions of jealousy].

The data on sex pathology in alcoholic delusions of jealousy with sado-masochist behaviour are reported. Such behaviour was seen when the patients tried to force their wives to "acknowledge" infidelity. A total amount of 196 patients were studied. Abnormal behaviour was characterized by moral and physical torture of their wives and selftorture. They were mostly expressed at late night hours and were connected with a peculiar satisfaction of the "tormenting voluptuosness" (Lemke-Rennert). There was also a sexual excitation with a dissociation between high necessities and a dropped possibilities in the sexual sphere against the background of lowered potency and other sexual disorders. Moreover, there was a high level of general excitation with a narrowing of consciousness, vegeto-vascular changes, which are described during ciotus and a satisfaction of sexual necessities by perversions. A visualization of images related to jealousy was observed, which lead to an increase of the affective shading in delusions.

Aggression↗
PubMedDate not supplied

Carbamazepine in the treatment of psychotic and behavioral disorders. A pilot study.

Symptoms of (mostly psychotic) agitation and symptoms of disrupted behavior, loss of impulse control (such as aggressiveness, impulsivity, perversity, suicidal attempts, orality, pseudomania which means mania subjectively experienced as unpleasant mania, mania not responding to lithium treatment) and EPS (very pronounced in group A, less in the other subgroups) in patients with a premorbid active-ambivalent personality pattern, in the absence of clinical and EEG signs of epilepsy, constitute an indication for the use of carbamazepine. This drugs allows a reduction, sometimes marked, of high doses of neuroleptics, as well as of many doubtful indications for lithium, characterised by our selection criteria.

Adult↗
PubMed1980

Schizophrenia and sexuality: a review and a report of twelve unusual cases--part I.

This review brings together the considerable, scattered literature on the sexuality of the schizophrenic. It encompasses the reports pertaining not only to the overt sexual behavior of schizophrenics but also their subjective experience including various delusions and hallucinations related to sexuality. Also reviewed are the sexual side effects of antipsychotic medication and sexual crimes and perversions occurring among individuals suffering from schizophrenia. The effectiveness of various treatment modalitites, including sex therapy, in controlling the bizarre sexual behavior that often accompanies schizophrenia, is also considered. Twelve unusual cases are also briefly reported. A greater awareness of these "sexual" symptoms of schizophrenia may be utilized to sharpen diagnostic sensitivity to the incipient forms of the disorder, to estimate prognosis in a given case, and to better understand some sexual crimes. In certain cases, such knowledge may alter the choice of antipsychotic medication.

Adolescent↗
PubMed1980

On masochistic enthralment a contribution to the study of moral masochism.

Freud rested his final understanding of moral masochism (the masochistic character) upon the concept of the death-instinct. Those analysts who have been unable to accept this concept have continued to define and enrich the understanding of the masochistic character. Out of their work has emerged the picture of a character structured in three discernible layers: an upper one of "nobility in adversity": a middle one of hate toward the mother; and the deepest one of primary union with the mother to which a later return is made. An abbreviated account of an analysis is given to exemplify this structure. An understanding of the relation between the deepest layers is essential to a comprehension of the total structure. Out of a primary maternal union accompanied by experiences of omnipotence and grandiosity emerges an ambivalent relationship to the omnipotent mother characterized primarily by hate. The relationship to the mother is one of masochistic enthralment. The lost omnipotence is then recaptured by a union mystica (primary identification) with the hating and hated mother now internalized as an aggressive self-ideal in which phallic characteristics become prominent. The unio mystica may be momentary and orgasmic as in the masochistic perversion or more or less enduring and characterological as in the masochistic character to which it contributes traits of haughtiness and disdain.

Character↗