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PubMedDate not supplied

Adenosine sestamibi SPECT post-infarction evaluation (INSPIRE) trial: A randomized, prospective multicenter trial evaluating the role of adenosine Tc-99m sestamibi SPECT for assessing risk and therapeutic outcomes in survivors of acute myocardial infarction.

BACKGROUND: Preliminary studies indicate that adenosine myocardial perfusion single photon tomography (SPECT) can safely and accurately stratify patients into low and high risk groups early after acute myocardial infarction (AMI). METHODS AND RESULTS: INSPIRE is a prospective, randomized multicenter trial which enrolled 728 clinically stable survivors of AMI. Following baseline adenosine sestamibi gated SPECT, patients were classified as low, intermediate or high risk based on the quantified total and ischemic left ventricular (LV) perfusion defect size (PDS). A subset of high risk patients with a LV ejection fraction > or =35% were randomized to a strategy of either intensive medical therapy or coronary revascularization. Adenosine SPECT was repeated at 6-8 weeks to determine the relative effects of anti-ischemic therapies on total and ischemic PDS (primary endpoint). All patients were followed for one year. The baseline demographic, clinical and scintigraphic characteristics of the study population are presented. Adenosine SPECT was performed within 1 day of admission in 12% of patients and in 64% by Day 4. CONCLUSION: The unique study design features of INSPIRE will further clarify the role of adenosine sestamibi SPECT in defining initial patient risk after AMI and in monitoring the benefits of intensive anti-ischemic therapies.

Adenosine↗
PubMed2005

Personality traits in schizophrenia and related personality disorders.

We investigated whether schizophrenia spectrum disorders share common personality characteristics or traits. Participants with a diagnosis of schizophrenia or schizoaffective disorder (SZ) or with a schizophrenia spectrum personality disorder (schizophrenia spectrum PD: schizoid, paranoid, and schizotypal personality disorder) were compared with non-psychiatric control subjects on the five-factor model of personality and the psychosis-proneness scales. On the five-factor personality scales, SZ subjects showed higher levels of neuroticism, and lower levels of openness, agreeableness, extraversion, and conscientiousness than control subjects. Higher scores on openness and lower scores on neuroticism distinguished schizophrenia spectrum PD from SZ. On the psychosis-proneness scales, both PD and SZ participants scored high relative to non-psychiatric control participants on magical ideation and perceptual aberration, while PD participants scored intermediate between non-psychiatric control participants and SZ on social anhedonia. Discriminant analysis indicated that schizophrenia spectrum patients could be distinguished from PDs by more severe social withdrawal and maladjustment, while subjects with PDs could be best distinguished from control subjects on the basis of odd or novel ideation and decreased conscientiousness.

Adult↗
PubMed2004

Full-thickness diaphragmatic resection with simple and secure closure to accomplish complete cytoreductive surgery for patients with ovarian cancer.

OBJECTIVE: The diaphragm is a common site of metastasis in patients with primary ovarian cancer. While most diaphragmatic implants are superficial, invasive disease can occur. This report evaluates the use of full-thickness diaphragmatic resection in completely cytoreduced ovarian cancer. METHODS: A prospective record of all patients with ovarian cancer treated between May 1, 2002, and September 30, 2003, was kept. Seven of the 37 patients required full-thickness diaphragmatic resection to achieve complete cytoreduction. The surgical technique and outcome as well as the clinical course and disease status were monitored. RESULTS: Full-thickness diaphragmatic metastases were resected and diaphragmatic defects were closed with #1 loop-PDS suture in a mass closure technique. In addition to diaphragm resections, a variety of other procedures were performed to achieve complete cytoreduction. Intraoperative blood loss ranged from 800 to 2500 ml. Operating room time ranged from 3.5 to 7 h. No chest tube placements were required. The length of hospitalization ranged from 10 to 24 days. Paclitaxel and carboplatin was administered to each patient without the need for dose reductions or treatment delays. Complete clinical response was achieved in six of seven patients. One patient died with disease 4 months after surgery. Follow-up ranged from 4 to 21 months. CONCLUSIONS: Diaphragmatic resection is feasible and has minimal morbidity. The use of a loop-PDS suture to close the diaphragmatic defect adds ease and security to the procedure. If complete cytoreduction can be accomplished with the use of this procedure, it is conceivable that benefits in clinical outcomes may be offered to patients with aggressive, advanced ovarian cancer.

Aged↗
PubMed1997

The impact of personality disorders on behavioral treatment outcome for social phobia.

The impact of personality disorders (PDs) on exposure in vivo treatment for social phobia was investigated in three groups of social phobics: social phobia without any PD (n = 30), social phobia with a single diagnosis of avoidant PD (n = 18) and social phobia with multiple PDs (n = 13). We hypothesized parallel change for social phobia with and without an avoidant PD with the latter group being more impaired before and after treatment. In order to test this hypothesis, confidence intervals for change were computed. In line with our hypothesis, social phobics in all three groups improved significantly during treatment and no interaction effects were found on the repeated MANOVAs. By using a confidence interval, parallel change was found on most measures. The impact of additional anxiety and mood disorders on treatment outcome was investigated separately. The analyses showed that an additional anxiety or mood disorder also did not predict outcome of exposure treatment.

Adult↗
PubMed1999

Behavioral assessment of personality disorders.

This article examines the definition of personality disorders (PDs) from a functional analytical framework and discusses the potential utility of such a framework to account for behavioral tendencies associated with PD pathology. Also reviewed are specific behavioral assessment methods that can be employed in the assessment of PDs, and how information derived from these assessments may be linked to specific intervention strategies.

Adaptation, Psychological↗
PubMed1999

Synthesis and intermembrane transfer of pyrene-labelled liponucleotides: ceramide phosphothymidines.

Phospholipid conjugates of 3'-azido-3'-deoxythymidine (AZT) show activity against human immunodeficiency virus (HIV) in vitro. Here we report on the synthesis and characterization of two pyrene containing conjugates: 2-N-(4-(pyren-1-yl)butanoyl)ceramide 5'-phosphothymidine (Pbs-Cer-P-T) (XII) and 2-N-(10-(pyren-1-yl)decanoyl)ceramide 5'-phosphothymidine (Pds-Cer-P-T) (XIII). These fluorescent labelled conjugates served as model compounds to study incorporation of sphingoliponucleotides into membranes. The complex compounds were prepared by condensation of 3'-acetylthymidine and labelled ceramides using the phosphite triester coupling procedure. UV absorption, fluorimetry as well as 1H-, 31P-, 13C-NMR analyses were used for structure confirmation of the synthesized substances. When incorporated into small unilamellar 1-palmitoyl-2-oleoyl-glycerophosphatidyl-choline (POPC) vesicles and incubated with unlabelled acceptor POPC vesicles, the compounds (XII) and (XIII) exhibited spontaneous transfer. Kinetic data suggest that transfer from donor to acceptor vesicles occurred via the intervening aqueous phase. The non-specific lipid transfer protein from bovine liver stimulated the transfer of Pds-Cer-P-T between phospholipid vesicles in a concentration dependent manner.

Animals↗
PubMedDate not supplied

Associations of self-reported past "psychotic" phenomena with features of personality disorders.

Patients with borderline personality disorder (BPD) may present with "psychotic" phenomena, which can be defined as a range of specified "altered experiences of reality." This study investigated the associations between self-reported past psychotic phenomena and features of DSM-III-R personality disorders (PDs) in 57 inpatients without a previous diagnosis of the main disorders that involve delusions and hallucinations. The present findings include associations between past psychotic phenomena and features of BPD, between repeated self-harm and a report that "thoughts seemed put into head," and between psychotic phenomena and features of other PDs, particularly schizotypal PD. There was a high prevalence of BPD in the present sample. Dissociation, in the context of the features of BPD, may be a causal factor for the development of some of the psychotic phenomena presented by patients with PD.

Adolescent↗
PubMedDate not supplied

Gender differences in borderline personality disorder: findings from the Collaborative Longitudinal Personality Disorders Study.

A majority of the literature on borderline personality disorder (BPD) focuses on its occurrence in women or does not specifically assess for gender differences in clinical presentations. Some studies report that men with BPD may be more likely to be diagnosed with substance use disorders, as well as paranoid, passive-aggressive, narcissistic, sadistic, and antisocial personality disorders (PDs). Additionally, women with BPD appear to be more likely to report histories of adult physical and sexual abuse and to meet diagnostic criteria for post-traumatic stress disorder (PTSD) and eating disorders. The purpose of the present study was to further examine gender differences in BPD. Using baseline data from the Collaborative Longitudinal Personality Disorders Study (CLPS), men and women who met criteria for BPD were compared on current axis I and II disorders, BPD diagnostic criteria, childhood trauma histories, psychosocial functioning, temperament, and personality traits. Men with BPD were more likely to present with substance use disorders, and with schizotypal, narcissistic, and antisocial PDs, while women with BPD were more likely to present with PTSD, eating disorders, and the BPD criterion of identity disturbance. Generally speaking, women and men with BPD displayed more similarities than differences in clinical presentations. The differences that did emerge are consistent with those found in epidemiological studies of psychopathology and therefore do not appear unique to BPD. Additionally, many gender differences traditionally found in epidemiological samples did not emerge in BPD subjects. For example, no difference was found in rates of major depressive disorder, a condition that is more prevalent in females. Thus, BPD pathology may be a prevailing characterization that can attenuate usual gender-based distinctions.

Adolescent↗
PubMedDate not supplied

Comorbidity of axis I and axis II diagnoses in a sample of Egyptian patients with neurotic disorders.

Neurosis and personality disorder (PD) are two of the most used but least clarified and understood terms in psychiatry. The separation of PD by the American Psychiatric Association in DSM-III and -IV as a discrete axis of classification has been a major advance in psychiatric nosology. Also with the advent of DSM-III and its multiaxial system, it was recognized that both PD and clinical syndromes can coexist, and in some cases this coexistence may have implications on treatment response and prognosis. This study was performed on 200 neurotic patients in an attempt to investigate possible correlations between various neurotic subcategories and personality types. Our results confirm that PD and personality abnormality are significantly higher in neurotic patients than in controls and need to be considered in diagnostic assessment. Some comorbidity was shown between borderline PD and somatoform disorder; compulsive PD and obsessive-compulsive disorder (OCD), and generalized anxiety disorder (GAD); and avoidant PD and phobia. However, our data failed to show a correlation between the presence of an additional PD and particular neurotic symptomatology. It seems that the association between neurotic disorders and PD should not be taken to indicate a direct causative relationship. It is likely that personality is just one of the predisposing factors that influence the individual response to psychological trauma and determine the form of neurosis. The most prevalent PD was found to be PD NOS, followed by borderline, compulsive, avoidant, and finally histrionic PDs. The term, multiple PD, should be given substance to characterize the diagnosis as a disorder, rather than leaving it at its current status of what seems to be a nondistinct clinical picture. Extensive research has to be undertaken in an attempt to decide which specific PDs most deserve to be included in the official nomenclature.

Adult↗
PubMedDate not supplied

Identifying the unique and common characteristics among the DSM-IV antisocial, borderline, and narcissistic personality disorders.

A clinical chart-review study of the Cluster B personality disorders (PDs) was conducted to evaluate the specificity of DSM-IV criteria for the Antisocial Personality Disorder (ANPD), Borderline Personality Disorder (BPD), and Narcissistic Personality Disorder (NPD). Eight-six outpatients meeting DSM-IV criteria for a PD were identified through a retrospective chart-review procedure. Records of these 86 patients were independently rated on all of the ANPD, BPD, and NPD symptom criterion for the DSM-IV. High interrater reliabilities were obtained for the presence or absence of a PD and symptom criteria for ANPD, BPD, and NPD (all kappa > or = .80). The sample consisted of ANPD (n = 20), BPD (n = 25), NPD (n = 15), and other personality disorders (OPD; Cluster A and C; n = 26). Five ANPD criteria reliably differentiated ANPD patients from BPD and NPD patients (1, 2, 3, 6, 7), and two criteria did not differentiate this group from either intracluster category (4, 5). BPD criteria also differentiated BPD patients from ANPD and NPD patients; however, the specific criteria that effectively differentiated categories were dependent on the group comparisons. BPD criteria (1, 2, 3, 6, 7) differentiated BPD and ANPD patients. BPD and NPD patients could be discriminated on other BPD criteria (2, 3, 5, 6, 7, 8). NPD criteria showed a similar ability to differentiate patients. NPD criteria differentiated NPD and BPD patients on DSM-IV criteria of 1, 3, 4, 5, 7, and 9. NPD and ANPD patients could be differentiated on other NPD criteria (1, 2, 3, 4, 5, 9). The results of this study provide general support for the use of specific criteria for these three disorders in the differential comparison of related and unrelated PDs. The utility of items that describe essential features are discussed.

Antisocial Personality Disorder↗
PubMedDate not supplied

Effect of comorbid anxiety, depressive, and personality disorders on treatment outcome of somatoform disorders.

Comorbid mental disorders of DSM-IV axis I and axis II have repeatedly been found to be a negative predictor for the treatment of axis I disorders, although recent contrary findings exist. Little is known about the effect of comorbidity on the therapy outcome of somatoform disorders. We compared three types of comorbidity, (1) personality disorders (PDs), (2) major depression (MDD) and anxiety (ANX) disorders, and (3) PDS and MDD and ANX, with regard to their relevance for the treatment outcome of somatoform disorders. One hundred twenty-six inpatients were assessed at least 4 weeks before admission to treatment, upon admission, and again at discharge. Somatoform, hypochondriacal, and depressive symptomatology, dysfunctional cognitions about body and health, dysfunctional social relationships, and other clinical characteristics were measured. Diagnostic assessments were based on the DSM-IV. Our findings suggest that none of the three types of comorbidity influence the therapy outcome of somatoform disorders or have a modifying effect on the level of psychopathology.

Analysis of Variance↗
PubMed2001

Identification of rod- and cone-specific phosducins in teleost retinas.

Phosducin (PD) is a regulatory protein of vertebrate phototransduction cascades. In mammalian retina, it has been thought that only one kind of PD commonly exists in both rods and cones. However, we have found two kinds of PD (OIPD-R and OIPD-C) in the retina of a teleost, medaka (Oryzias latipes). In situ hybridization and immunohistochemical analysis demonstrated that OIPD-R and -C are selectively expressed in rods and cones, respectively. The antiserum against medaka PDs recognized two kinds of proteins in bluegill (Lepomis macrochirus) retina. These results suggest that rod- and cone-specific PDs exist in teleost retinas, probably creating differences in light adaptation between rods and cones.

Amino Acid Sequence↗
PubMed1987

Sperm from some infertile men may consist of several populations.

In the hamster ovum penetration (HOP) test, when ova have equal penetrability and sperm have equal penetrating ability, the distribution of zona-free hamster ova classified by number of penetrating human sperm is expected to follow the Poisson distribution (PD). This study reports tests for PD in HOP tests on 9 infertile patients and 11 normal controls. The data, presented in detail, show the expected PD in the control group. In contrast, 3 patients had HOP tests with definite non-PDs, whereas 5 patients have clearcut PDs. The cause of non-PD is unknown, but could result from differences among motile sperm in penetrating ability.

Adult↗
PubMed1990

Hadamard transform photothermal deflection densitometry of electrophoretically blotted proteins.

Hadamard transform spatial multiplexing techniques are applied to laser densitometry in order to prevent the photo-induced degradation of sensitive materials. Photochemical and thermal degradations can often occur in point focused scanning laser densitometry. In spatial multiplexing, the excitation source is defocused and efficiently distributed throughout the sample, reducing local power density. In this paper, we describe the application of Hadamard transform spatial multiplexing to transverse photothermal deflection spectroscopy (PDS). Proteins western blotted on nitrocellulose membrane are line imaged using the Hadamard transform PDS densitometer. For comparison, the blots are imaged with a high-dynamic-range video densitometer.

Alkaline Phosphatase↗
PubMed2000

Effects of valproate derivatives II. Antiepileptic efficacy in relation to chemical structures of valproate sugar esters.

The structure effect relationships of derivatives of the antiepileptically active ester of valproate (VPA) 3,4:5,6-Di-O-isopropylidene-1-O-(2-propylpentanoyl)-D-mannitol (1) have been studied using intracellular recording to record the membrane potential of single neurons (buccal ganglia, Helix pomatia). Epileptiform activity was induced by the epileptogenic drug pentylenetetrazol. The effects of several derivatives on epileptiform activity were compared with those of the relay compound 1. Most of the synthesized agents decreased the duration of paroxysmal depolarization shifts (PDS) and increased their repetition rate. It was considered that a decreased the duration of PDS is antiepileptic and an increased repetition rate is pro-epileptic. Compared with the effects of compound 1, the following relationships were found: (1) Derivatives containing glucitol or galactitol were of similar antiepileptic potency. (2) Introduction of pyranoses or furanoses rendered the substances inactive or even pro-epileptic. (3) VPA in position 1 and 6 at the sugar acted as an antiepileptic whereas in position 3 and 4 it proved to be ineffective. (4) Replacement of VPA by ethylhexanoyl reduced the antiepileptic potency slightly and pivaloyl strongly. (5) Replacement of isopropylidene bridges by penta-O-acetyl or cyclohexylidene residues led to largely inactive substances. (6) Compounds having isopropylidene bridges in position 2,4;3,5 proved to be antiepileptic whereas bridges especially in positions 2,3:4,5 slightly enhanced epileptic activities.

Animals↗
PubMed2002

Abnormal gaze strategies during problem solving in Parkinson's disease.

We have taken a novel approach to the study of problem solving involving the detailed analysis of natural scanning eye movements during the 'one touch' Tower of London task. Control subjects and patients with idiopathic Parkinson's disease (PDs) viewed a series of pictures depicting two arrangements of coloured balls in pockets within the upper and lower halves of a computer display. The task was to plan (but not execute) the shortest movement sequence required to rearrange the balls in one half of the display (the Workspace) to match the arrangement in the opposite half (the Goalspace) and indicate the number of moves required for problem solution. As problem complexity increased, control subjects spent proportionally more time fixating the Workspace region. This pattern was found regardless of whether subjects were instructed to solve problems by rearranging balls in the lower or upper visual fields. The distribution of gaze within the Workspace was also found to be problem dependent, with gaze being selectively directed towards the problem critical balls. In contrast, PDs were found to make more errors in the task and failed to show any dissociation in the amount of time fixating the two halves of the display. This pattern suggests that the patients had difficulty in encoding and/or maintaining current goals during problem solving, consistent with a role for fronto-striatal circuits in mechanisms of working memory and attention.

Aged↗
PubMed1999

Examination of the safety and efficacy of an absorbable dura mater substitute (Dura Patch) in normal applications in neurosurgery.

BACKGROUND: The possibility of the transmission of Creutzfeldt-Jakob disease and slow virus infection (HIV) by cadaveric dura implants makes it necessary to find synthetic, absorbable substitute materials for plastic reconstruction of the dura mater. Dura-Patch is a bilayered composite of a dyed polydioxanone (PDS) foil and an undyed fleece of Polyglactin 910 (Vicryl) and PDS threads, known to be completely resorbable. METHODS: The Dura-Patch was tested prospectively in 101 patients undergoing 75 supratentorial, 20 infratentorial, and 6 spinal operations in seven different neurosurgical departments. Fixation of the substitute was either by suturing, gluing, or both. The specific tissue properties were investigated considering biocompatibility, form, size, adaptability, fixation, scarring, and resistance to CSF tearing with the aid of hematologic and neurological parameters, CCT, and/or MRI scanning up to 6 months postoperatively. RESULTS: A total of 76 of 101 patients completed the study (75%). The biocompatibility of the Dura-Patch with timely absorption of the implant material was excellent without exception. There was no notable local scarring and no infections. Transient CSF cushioning in 12.9% of the patients was in keeping with the normal range. The elasticity and flexibility of the Dura-Patch was rated as "good" in 90% and was still better when the size of the implant increased, with an overall rating of handling as "good" or "excellent" in 97% of all operations. CONCLUSIONS: The new absorbable Dura-Patch showed itself to be suitable for both plastic dura reconstruction and plastic extension of the subdural space with primary, watertight, germproof closure in routine intracranial and spinal tumor removal.

Brain Diseases↗
PubMed1997

Comparison of effects of suture materials on wound healing in a rabbit pyeloplasty model.

OBJECTIVES: To compare the effects of chromic catgut, polyglactic acid, polydioxanone (PDS), and polytrimethylene carbonate suture on urothelial healing in a rabbit model simulating pyeloplasty. METHODS: Pyeloureterotomies were performed on 8-week-old rabbits [12 rabbits (24 renal units) and 3 control rabbits] and closed with interrupted 7-0 sutures. At 10 days, 5 weeks, and 12 weeks postoperatively, we assessed the upper tracts by examining microscopic sections of the renal pelvis and upper ureter. Acute and chronic inflammation, foreign body reaction, and fibrosis/scar formation were assessed blindly and scored from 0 to 4. RESULTS: Histologic evidence of acute and chronic inflammation and foreign body reaction was most severe at 10 days and 5 weeks in pyeloureterotomies closed with chromic catgut. There was mild inflammation in those closed with polyglactic acid at 10 days, but it was minimal in those closed with polyglactic acid, PDS, and polytrimethylene carbonate at 5 and 12 weeks. Reabsorption of polyglactic acid was complete by 5 weeks, but was incomplete with the other three sutures at that time. By 12 weeks, there was persistent suture in 50% of the renal units closed with polydioxanone and in 100% of those closed with polytrimethylene carbonate. No animal developed a renal calculus. CONCLUSIONS: Because of the mild inflammatory response and rapid tissue reabsorption of polyglactic acid in this animal model, this suture appears to be the best suture for pyeloplasty.

Animals↗