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Two-year stability of personality disorder in older adolescent outpatients.

The 2-year stability of categorical and dimensional personality disorder (PD) in an older adolescent psychiatric outpatient sample was examined. One hundred and one 15-18-year-old participants were assessed using the Structured Clinical Interview for DSM Axis II Disorders (SCID-II) at baseline and 97 were re-interviewed, face-to-face, at 2 years. Of those with a categorical PD diagnosis at baseline, 74% still met criteria for a PD at follow-up, with marked gender differences (83% of females and 56% of males). Kappa for specific PDs was low for all except antisocial. Rank order and mean level dimensional stability ranged from high (antisocial, schizoid) to moderate (borderline, histrionic, schizotypal) to low (other PDs), with no decline in PD scores over the 2 years. There was no substantial influence upon stability of dimensional PD from the presence of Axis I disorder at baseline or from outpatient or inpatient treatment. However, categorical PD endured in 100% of those receiving inpatient care. The study supports that, in late teenage outpatients, the 2-year stability of the global category of PD is high and the stability of dimensionally rated PD appears to be similar to that found in young adults in a variety of settings, especially for some cluster A and B PDs. Diagnosis and early intervention appears to be justified in this age group.

Adolescent↗

Toward an empirical/theoretical grouping of the DSM-III-R personality disorders.

Despite some recent favorable findings, there has not been strong empirical support for the validity of DSM-III-R--and now DSM-IV--personality disorder (PD) clusters. In this study, Axis II symptom ratings on 320 personality disordered patients were used to obtain dimensional scores for the 11 DSM-III-R PDs. The dimensional scores for the DSM PDs were subjected to a principal component analysis with orthoginal rotation. Three factors emerged having eigenvalues > or = than 1. The pattern of factor loadings for the individual PDs were not consistent with the DSM Cluster. Rather, the factor loadings were quite consistent with Millon's theory of personality. These results are discussed in light of the clinical benefits provided by employing empirically determined and theoretically anchored model for organizing the Axis II disorders.

Adult↗

Treatment utilization and satisfaction: examining the contributions of Axis II psychopathology and the Five-Factor Model of personality.

Numerous studies have demonstrated a link between personality disorders (PDs) and increased treatment utilization and decreased satisfaction. However, few studies have examined the link between general personality models, such as the Five-Factor Model (FFM), and these treatment variables. The current study examines the role of depression, anxiety, and functioning, PDs, and the FFM in accounting for psychiatric treatment utilization and satisfaction with care in two distinct clinical samples (n = 99 and 544, respectively). The results suggest that both maladaptive personality symptoms and general personality traits are predictive of these outcome variables. Importantly, the findings regarding treatment utilization replicate across samples and level of personality assessment (i.e., FFM and PDs). It is argued that both types of personality information should be included in the initial treatment planning and implementation stages.

Adult↗

The longitudinal study of personality disorders: history, design considerations, and initial findings.

The Longitudinal Study of Personality Disorders (LSPD) began in 1990 and it is the first NIMH-funded prospective multiwave longitudinal study of all DSM-defined personality disorders (PDs). The LSPD, now in its 16th year, has focused on several major issues including: (a) the epidemiology of the PDs; (b) the stability of individual differences and mean levels of PD features over time; (c); patterns of individual growth in PD features over time; (d) the development of a neurobehavioral model that links personality and personality disorder; (e) specification of those neurobehavioral systems predicting change in borderline personality disorder; and (f) illumination of simultaneous growth processes in neurobehavioral systems and PD. The LSPD possesses a number of methodological enhancements designed to increase the validity of the longitudinal findings such as a prospective multiwave design, use of a validated structured interview and well-known self-report instrument for Axis II assessments, double measurement of all major constructs under study, use of blinded interviewers for all interview Axis II assessments, and use of a community sample. The history and context in which the LSPD was developed is reviewed, methodological issues related to the study of PDs are discussed, primary LSPD findings to date are summarized, and future directions of the LSPD are introduced.

Humans↗

Na(+)/I(-) symporter and Pendred syndrome gene and protein expressions in human extra-thyroidal tissues.

OBJECTIVE: 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 in a series of various extra-thyroidal human tissues, and especially in those known to concentrate iodide. METHODS: To this end, we used real-time kinetic quantitative PCR to detect NIS and PDS transcripts and immunohistochemistry for the analysis of their protein products. RESULTS: NIS gene and protein expression was detected in most tissues known to concentrate iodine, and particularly in salivary glands and stomach. In contrast, PDS gene expression was restricted to a few tissues, such as kidney and Sertoli cells. Interestingly, in kidney, pendrin immunostaining was detected at the apical pole of epithelial cells of the thick ascending limb of the Henle's loop and of the distal convoluted tubule. CONCLUSION: This study provides new insights on the localization and expression of two genes involved in iodide transport and emphasizes the interest of combining real-time quantitative PCR and immunohistochemistry for the comparison of gene and protein expression in tissues.

Biological Transport↗

Pacemaker potentials are the physiologic basis of epileptiform activity in the buccal ganglia of Helix pomatia.

Mechanisms of epileptic activity in nervous systems were studied using the identified neurons B1 through B4 in the buccal ganglia of the snail Helix pomatia as a model system. Activities were recorded with intracellular microelectrodes. Epileptiform activity was induced by bath application of an epileptogenic drug (pentylenetetrazol: 1 mM to 40 mM, or etomidate: 0.1 mM to 1.0 mM). Epileptiform potentials recorded from the somata of neurons consisted of paroxysmal depolarization shifts (PDSs). With increasing concentration of an epileptogenic drug, pacemaker potentials in neuron B3 developed into PDS. Simultaneously several types of chemical post-synaptic potentials were suppressed in amplitude. Since on the one hand epileptic seizures only appear when PDS are synchronized in many neurons and since on the other hand synaptic potentials were found to be suppressed during epileptic conditions, mechanisms underlying neuronal synchronization were studied. Evidence was found that, under epileptogenic conditions only, neurons were synchronized by an non-synaptic release of substances. Strong depolarizations accompanied by an increase in intracellular calcium concentration are known to induce an unspecific exocytosis. Thus, an unspecific exocytosis from the dendrites of PDS-generating neurons probably appears under epileptic conditions and synchronizes neighbouring neurons.

Action Potentials↗

Uptake and antiproliferative effect of molecular iodine in the MCF-7 breast cancer cell line.

This study analyzes the uptake and antiproliferative effect of two different chemical forms of iodine, iodide (I-) and molecular iodine (I2), in MCF-7 cells, which are inducible for the Na+/I- symporter (NIS) and positive for pendrin (PDS). The mouse fibroblast cell line NIH3T3 was used as control. Our results show that in MCF-7 cells, I- uptake is sustained and dependent on NIS, whereas I2 uptake is transient with a maximal peak at 10 min and a final retention of 10% of total uptake. In contrast, no I- was taken up by NIH3T3 cells, and although I2 was captured with the same time pattern as in MCF-7 cells, its uptake was significantly lower, and it was not retained within the cell. The uptake of I2 is independent of NIS, PDS, Na+, and energy, but it is saturable and dependent on protein synthesis, suggesting a facilitated diffusion system. Radioiodine was incorporated into protein and lipid fractions only with I2 treatment. The administration of non-radiolabeled I2 and 6-iodo-5-hydroxy-8,11,14-eicosatrienoic acid (6-iodolactone, an iodinated arachidonic acid), but not KI, significantly inhibited proliferation of MCF-7 cells. Proliferation of NIH3T3 cells was not inhibited by 20 microM I2. In conclusion, these results demonstrate that I2 uptake does not depend on NIS or PDS; they suggest that in mammary cancer cells, I2 is taken up by a facilitated diffusion system and then covalently bound to lipids or proteins that, in turn, inhibit proliferation.

Animals↗

Differential regulation of apical and basal iodide transporters in the thyroid by thyroglobulin.

We have shown that thyroglobulin (Tg) is a potent autocrine regulator of thyroid-specific gene expression, and proposed that the accumulated follicular Tg within the colloid is a major factor in determining follicular function. In the present report, we examined the effect of Tg on the action of TSH/cAMP and iodine with special focus on the regulation of basolateral and apical iodide transporters; the sodium/iodide symporter (NIS) and the pendred syndrome gene (PDS) by Tg. We show that expression of NIS and PDS are differentially regulated by Tg concentration and exposure time. In addition, we found that PDS gene was induced by TSH/cAMP and iodide in the presence of Tg. Based on these results, we propose a model for the physiological turnover of follicular function that is dynamically regulated by Tg.

Animals↗

Power Doppler sonography: use in measuring alterations in muscle blood volume after exercise.

OBJECTIVE: The purpose of this study was to show the ability of power Doppler sonography (PDS) to evaluate exercise-induced changes in muscle blood volume. SUBJECTS AND METHODS: We evaluated 20 biceps muscles with PDS in 10 healthy volunteers before and after they underwent a standardized exercise protocol. Intramuscular blood volume was qualitatively analyzed using a subjective scoring system to evaluate vascular conspicuity, comparing sonograms obtained before and after exercise. We also collected preliminary data on the quantification of estimated fractional moving blood volume (EFMBV) measured on sonograms obtained in eight biceps muscles of five volunteers. Assessment of significance was calculated using a Wilcoxon signed-rank correlation of significance. The stability of relative changes in EFMBV was also assessed with measurements performed at three different times in five healthy volunteers. RESULTS: With exercise, all 20 biceps muscles showed a significant subjective increase in apparent vascularity (p < .0005). Likewise, preliminary data on EFMBV showed significant increases (p < .01) between baseline and peak exercise values (mean, 470%; range, 180-900%). CONCLUSION: PDS revealed marked increases in intramuscular vascular conspicuity after exercise. EFMBV provided a potentially useful parameter to document such increases quantitatively.

Adult↗

Faculty perceptions of university students with psychiatric disabilities.

Information sources such as professional training, the media, personal relationships, and one's own experience may impact perceptions about people with psychiatric disabilities (PDs). The purpose of this study was to assess the relationship between information sources and university faculty members' perceptions of working with university students who have PDs. Specific types of personal experience were then analyzed: having a family member, friend, and student with a PD, and having a PD oneself. Faculty who had a friend or a student with a PD had more positive perceptions of university students with PDs than faculty who had neither of these experiences.

Adult↗

Tissue reaction to bone-anchored percutaneous implants in rabbits.

It has been demonstrated that direct attachment to bony skeletal tissues favors the longevity of percutaneous devices (PDs). This study is focused on improvement of the success rates by using a two-stage implantation technique. For this purpose, cylindrical-shaped PDs were inserted into the tibia of rabbits. The enossal part of the implants was made of Ti6Al4V and was coated with a layer hydroxyapatite (HA). The percutaneous part was made of dense HA. In a first surgical session, the enossal part of the implants was inserted. In a second implantation session, about 3 months later, the percutaneous part was fixed into the enossal part. The implants were left in situ for 5 months after the second session. Clinical and histological investigations were performed. The results confirmed the previous finding--that bone anchoring is effective in the maintenance of a permanent percutaneous passage. On the other hand, it could not be proven that a two-stage implantation procedure improves the success rate of one-stage bone-anchored PDs.

Animals↗

Control of human vascular smooth muscle cell proliferation by sera derived from 'experimentally stressed' individuals.

Recently we reported that individuals with high scores in standardized hostility evaluation tests, when placed in a environment, may have an association with increases in a blood-borne mitogenic substance(s) for arterial smooth muscle cells. To further investigate the molecular basis for such an association, PDS [plasma derived serum with platelet derived growth factor (PDGF) removed] from individuals showing the greatest differential pre/post-stress mitogenic activity, were tested for ability to modulate changes in the steady state of the c-myc mRNA in cultured VSMC (vascular smooth muscle cells) by Northern blot analysis. Post-stress PDS resulted in a significant increase in c-myc mRNA, when compared with pre-stress PDS of the same individual. These results give further experimental support for the notion that stress (even in the form of transient, episodic psychological challenges) may affect the cardiovascular system via rapid elicited rises in serum mitogenic activity for VSMC.

Cell Division↗

[Clinical study of eliminating dampness and removing blood stasis in treating coronary heart disease--the summary about serial study of blood stasis due to dampness].

OBJECTIVE: To elucidate the relationship between Dampness and blood stasis in patients with coronary heart disease (CHD). METHODS: One hundred and twenty-eight CHD patients with Phlegm-Dampness Syndrome (PDS) and 69 with blood stasis syndrome (BSS) were chosen and treated by eliminating Dampness and removing blood stasis. RESULTS: (1) CHD-PDS and -BSS possessed the similar changes on hemorheology, oxygen free radical, blood lipids and vascular active substance. (2) Both of these two methods could alleviate angina (effective rate was 88.3%, 89.9%), improve ischemic S-T segment changes in ECG obviously and reduce consumption of nitroglycerin significantly (P < 0.01), improve abnormal hemorheology obviously (P < 0.001), raise PGI2, SOD obviously (P < 0.01) and lowered TXA2, MDA, ANP, ET and blood lipids significantly (P < 0.001). (3) The two methods could regulate imbalanced state of PGI2/TXA2,SOD/MDA. CONCLUSIONS: CHD-PDS and -BSS had similar pathologic basis or pathologic changes, could eliminate the Dampness also had possessed similar pharmacologic or pharmacodynamic action of removing blood stasis. According to this, the viewpoint of "blood stasis due to Dampness" might be proved from clinical aspect.

Adult↗

[Use of polydimethylsiloxane in the endoscopic treatment of urinary incontinence of neurologic origin in children].

AIM: We report the use of polydimethylsiloxane (PDS-Macroplastique) in endoscopic treatment of urinary incontinence in children with neurogenic bladder and try to determine optimal criteria for patient selection. METHODS: Forty four children (19 males, 25 females) have been treated since 1995. Aetiology was mainly spina bifida (n = 36). Previous surgery had been performed in 26 patients, including bladder neck reconstruction in 21 cases and bladder augmentation in 15 cases. Mean age at injection was 13 years (7 to 17). Only one injection was performed in 27 patients, two injections in 4 cases, and three and more injections in 3 cases. Mean volume at each injection was 3.6 cc. Mean interval between two injections was 6 months (3-15 m). All injections were performed transurethrally. RESULTS: Follow-up ranged from 6 to 41 months (median: 23). Fifteen patients (34%) are dry (continence > 4 hours, no urinary pad during the day) and 11 (25%) are improved (continence from 2 to 3 hours, minimal pad). Eighteen patients obtained poor results. In the entire series previous bladder neck surgery or preoperative detrusor hyperactivity did not interfere with the results. The only difference concerns the sex-ratio: the good results were mainly seen in females: 44% of girls are cured versus 21% of boys. CONCLUSION: Injection of PDS in the bladder neck achieve the goal of continence in 34% of the cases in neurogenic bladder. Better results are seen in girls. Injection does not compromise other surgical procedures. The use of PDS seems more suitable than bovine collagen in view of the potential problems of prions.

Adolescent↗

Factors differentiating personality-disordered individuals with and without a history of unipolar mood disorder.

The relationship between mood disorders and personality disorders has been of longstanding interest to clinicians. Despite theoretical reasons to do so, virtually no studies have examined factors that discriminate personality-disordered subjects with a history of mood disorder (PD/HMD) from personality-disordered subjects without a history of mood disorder (PD). This study examined demographic variables, patterns of comorbidity, measures of life functioning, personality traits, and early life experiences differentiating PD/HMD (n = 83) from PD (n = 214). Diagnoses were assigned using structured clinical interviews and a best-estimate procedure. The results suggest that subjects with borderline personality disorder are more likely to have a life history of mood disorder than are subjects with other personality disorders. In addition, PD/HMDs are more likely to receive a diagnosis of anxiety disorder or alcoholism, to have lower Global Assessment of Functioning (GAF) scores, and to have sought treatment than PDs. On self-report measures of personality, PD/HMDs endorse higher levels of trait anxiety and affective lability (e.g., Harm Avoidance, Neuroticism) than do PDs. PD/HMDs are also more likely to report childhood physical and emotional abuse than are PDs, and to describe their parents as using affectionless control. No differences were found between Axis II clusters as a function of mood disorder history. The discussion suggests a potential model in which early environmental stress interacts with constitutional vulnerabilities to put individuals at an increased risk for both mood and anxiety disorders as well as personality disorders.

Adolescent↗

Origin of synchronized oscillations induced by neocortical disinhibition in vivo.

During disinhibition, the neocortex generates synchronous activities. Block of GABA(A) receptors in neocortex transforms cortical slow-wave oscillations into large-amplitude approximately 1 Hz discharges consisting of a negative spike or multiple negative spikes riding on a positive wave. Further block of GABA(B) receptors in neocortex slows the discharges to approximately 0.5 Hz and increments the number of negative spikes forming rhythmic approximately 10 Hz neocortical oscillations. Although the thalamus responds robustly to these neocortical discharges, these are unaffected by thalamic inactivation using tetrodotoxin. Thus, an important problem relates to the origin of these activities within the neocortex. Current source density analysis and intracellular recordings revealed that the first negative spike in a discharge corresponded to a current sink that reflected a paroxysmal depolarizing shift (PDS) and could originate in the lower layers or in the upper layers. Regardless of the origin (upper or lower layer), the initial current sink always spreads to the same site in upper layer V-IV. In contrast, the approximately 10 Hz oscillation that follows the initial negative spike corresponds to current sinks that always originate in the lower layers but do not spread to upper layer V-IV, jumping directly to the upper layers. Each current sink in the approximately 10 Hz oscillation reflects a small PDS and is followed by a current source that reflects the repolarization after each PDS.

Action Potentials↗

Repair of flexor tendon defects of rabbit with tissue engineering method.

OBJECTIVE: To repair rabbit tendon defects with tissue engineering method. METHODS: The third passage of fetal skin fibroblast cells was labeled with 5-bromo-2' deoxyuridine (Brdu) and then seeded on human amnion extracellular matrix (HA-ECM). Using 1 cm-long-Achilles tendon defects as repairing models in the experimental group, tendon defects were core bridged with polydioxanone (PDS) and then capsulated with the complex of fibroblasts-HA-ECM. In the control group I, defective tendons were sutured with PDS following the former procedure and capsulated with HA-ECM (without fibroblasts). In the control group II, only PDS was applied to connect the defective tendons. Gross examination, light microscopy, scanning electronmicroscopy and biomechanical measurement of the repaired tendons were respectively performed at postoperative 1, 2, 3 month as well as immunohistochemical examination. RESULTS: The optimal cell concentration for seeding fibroblasts was 3.5 x 10(6) cells/ml. Cells grew well and radiated or paralleled on HA-ECM. Immunohistochemistry showed that the labeled seed fibroblasts played an important role in tendonization. The results of light microscopy, electron microscopy, and biomechanical assessment suggested that the rate and quality of tendonization in the experimental group was superior to those of the control group I and II. The tensile strength in the experimental group was the greatest, the next was in the control group I, and the worst in the control group II (P<0.05). CONCLUSIONS: HA-ECM is the excellent carrier for fibroblasts. Fibroblasts-HA-ECM complex has the capability to repair tendon defect and to tendonize with rapid rate and good performance three months after operation. Its tensile strength is 81.8% of that of normal tendon.

Amnion↗

Medical devices: reclassification and codification of the absorbable polydioxanone surgical suture. Final rule.

The Food and Drug Administration (FDA) is announcing that it has issued an order in the form of a letter to Ethicon, Inc., reclassifying the absorbable polydioxanone surgical (PDS) suture intended for use in soft tissue approximation, including use in pediatric cardiovascular tissue where growth is expected to occur and ophthalmic surgery, from class III (premarket approval) to class II (special controls). Elsewhere in this issue of the Federal Register, FDA is announcing the availability of the guidance document entitled "Class II Special Controls Guidance Document: Surgical Sutures; Guidance for Industry and FDA," which is immediately in effect as the special control for the PDS suture, but remains subject to public comment and possible future revision under the agency's good guidance practices. The agency is reclassifying this device into class II because new information supplied by the petitioner indicates that special controls, in addition to general controls, will provide reasonable assurance of the safety and effectiveness of the device, and there is sufficient information to establish special controls. Accordingly, the order is being codified in the Code of Federal Regulations. Any firm submitting a premarket notification (510(k)) for a new PDS suture will need to address the issues covered in the special control guidance. However, the firm need only show that its device meets the recommendations of the guidance or in some other way provides equivalent assurances of safety and effectiveness.

Device Approval↗