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PubMed1987

Tattoos, body experience, and body image boundary among violent male offenders.

The author compared a measure of body image boundary and medically significant bodily experiences between 21 tattooed and 24 nontattooed men incarcerated for violent crimes. Although the tattooed and nontattooed subjects had no significant differences in their body boundary concepts or most other bodily experiences, the tattooed men were found to have a different distribution of scars on their bodies. Upon more detailed examination, it seemed that these different distributions could be explained by the observation that the tattooed subjects were the only ones with self-inflicted cuts. This finding further supports the notion that tattoos, despite their ostensibly decorative quality, may be a form of self-mutilation.

Adult↗
PubMed1986

Behavioral research in self-injury and self-stimulation.

This article reviews the behavioral literature on self-injury and self-stimulation. Studies investigating the causes of such pathologic behavior and methods of treatment are critiqued. New, promising treatment procedures, such as "sensory extinction," are described and discussed.

Autistic Disorder↗
PubMed1987

Peripheral nerve injury associated with fracture or fracture-dislocation of the pelvis in dogs and cats: 34 cases (1978-1982).

Peripheral nerve injury was associated with fracture or fracture-dislocation of the pelvis in 23 dogs and 11 cats. In most cases, peripheral nerve injury resulted from ilial fracture with craniomedial displacement of bone fragments, or from sacroiliac fracture-dislocation with cranial displacement of the ilium. Sciatic nerve injury was associated with fracture of the acetabulum in 2 dogs. A combination of sensory, voluntary motor, and reflex abnormalities were observed in the ipsilateral extremity of affected animals. Signs of severe pain were noticed in 4 of the dogs and in 1 cat. Eight of the animals died or were euthanatized for reasons not directly related to the severity of peripheral nerve injury. Of the remaining 26 animals, 21 (81%) had good or excellent limb function 16 weeks after peripheral nerve injury was sustained. Limb function was lost or self-mutilation occurred in 4 (15%) of the animals.

Animals↗
PubMed1987

[Cranial computerized tomography in incomplete Lesch-Nyhan syndrome].

The CT brain scan of a 17-year-old patient with primary hyperuricaemia and mental retardation is presented. The examination demonstrates subcortical and cortical atrophy of the brain. The HGPRTase level was below normal. Clinical evidence of self-mutilation or tophi was not found. This patient's condition was interpreted as an incomplete Lesch-Nyhan syndrome.

Adolescent↗
PubMed1969

Current concepts of hyperuricemia and gout.

Recent studies have confirmed that gout is an inborn error of metabolism. It has now become evident that the hyperuricemia associated with gout might occur either due to overproduction of uric acid, underexcretion of uric acid or a combination of these processes. Furthermore, patients with excessive purine synthesis may have a specific enzyme defect resulting in altered feedback inhibition of purine synthesis. A neurological disease manifest by mental retardation, choreo-athetosis, aggressive behavior, lip-biting and self-mutilation and associated with decidedly increased purine biosynthesis serves as a prototype of this kind of disorder. Other defects in regulation of purine biosynthesis have been postulated but their existence not yet confirmed. It has been demonstrated that urate crystals which are deposited from hyperuricemic body fluids set up an acute inflammatory reaction by means of a variety of chemical mediators. Thus, acute gouty arthritis is now recognized as an example of "crystal induced" synovitis. The treatment of gout consists of (1) the control of acute gouty attacks, and (2) the maintenance of normal serum uric acid concentrations. This latter may be achieved either with uricosuric drugs or with xanthine oxidase inhibition. With these principles in mind, it is now possible to avoid many of the severe crippling effects of gout and to restore the vast majority of gouty patients to useful and productive lives.

Chemical Phenomena↗
PubMed1981

Congenital insensitivity to pain with anhidrosis in a 2-month-old boy.

In a 2-month-old boy with congenital insensitivity to pain and anhidrosis, the initial symptom was recurrent fever of unknown origin. After eruption of the first teeth, self-mutilation of the tongue was limited by extraction of the teeth. Unmyelinated fibers were essentially lacking, and the number of small myelinated fibers was decreased in sural nerve. This case is the youngest to be diagnosed and the first one in which nerve biopsy clearly showed the characteristic findings.

Humans↗
PubMed1984

Implications of sensory stimulation in self-destructive behavior.

The self-stimulatory and social theories of self-destructive behavior of autistic, schizophrenic, and mentally retarded individuals were examined. The self-stimulatory theory states that self-destructive individuals obtain a form of sensory stimulation or reinforcement from the behavior itself. An extension of this theory, which is also presented in this paper, explains specifically how these individuals acquire sensory stimulation from such deviant behavior. By damaging the nerve structure of the skin, the tactile sensory threshold for physical input is lowered. This increase in the skin's sensitivity enables individuals to obtain sensory stimulation by repeatedly depressing the damaged area. In addition, I have proposed that the behavior may initially be a form of self-stimulation but subsequently may be operantly reinforced by the caretaker's concern for the individual.

Arousal↗
PubMed1984

Local anesthetics in dental practice.

Local anesthetics are the most widely used drugs in dentistry today. Knowledge of the pharmacology and toxicology of these agents will result in their intelligent and judicious use. The choice of local anesthetic should be individualized for each patient. The duration of the dental procedure should be weighed against the duration of action of the local anesthetic; a decision should be made as to whether a vasoconstrictor is needed to prolong its action. However, if the duration of numbness is too long, the possibility of self-mutilation must be considered in certain patients (for example, children and the mentally retarded). In other patients with whom postoperative pain is expected, it may be beneficial to administer a long-acting local anesthetic such as bupivacaine for control of postoperative pain. The total dose of local anesthetic and vasoconstrictor must be determined for each patient based upon body weight; the maximal dosages for each agent should be known. Small children or frail individuals will require below average dosages. The use of a vasoconstrictor may constitute the limiting factor to the total number of local anesthetic cartridges that can be administered safely over a given period of time. Certain medical problems, such as cardiovascular system impairments or hyperthyroidism, may influence the choice of anesthetic and the quantity of vasoconstrictor. An understanding of the physicochemical properties of local anesthetics is also important to a rational process of selection. There are several causes for failure to achieve profound regional anesthesia. These include inflammation and/or infection, anatomic variation, intravascular injection, accessory innervation, and deflection of the needle. Inflammation and infection reduce the efficacy of a local anesthetic by reducing its bioavailability. Local anesthetics with low pKa values (for instance, mepivacaine) are the most effective in this clinical situation. Other causes of inadequate regional anesthesia are primarily related to technique of administration and can be circumvented by the use of the periodontal ligament injection. A comprehensive review of this technique and its application has been presented by the Council on Dental Materials and Equipment of the American Dental Association. Occasionally, a clinician may be unsuccessful at achieving regional anesthesia despite these additional measures. Highly anxious dental patients or patients with a genuine tolerance to local anesthetics normally pose the most problems. Transitional block or threshold block phenomena should also be suspected in these situations.(ABSTRACT TRUNCATED AT 400 WORDS)

Anesthesia, Dental↗
PubMed1978

[Spectacles for dogs and cats (author's transl)].

Indications for using spectacles in dogs and cats are reviewed. These indications are classified into the following categories: (1) correction of visual acuity, (2) protection against external irritants such as ultraviolet rays and wind, (3) prevention of self-mutilation and (4) psychological reasons. The only justifiable indications for the use of spectacles or sun-glasses in dogs or cats consist in the treatment or prevention of some ophthalmic disorders.

Animals↗
PubMed1981

Current trends in the treatment of self-injurious behavior.

This chapter attempted to outline current trends and recent advances in the treatment of SIB. The major focus has been on the behavioral techniques, since it was obvious that at this stage other approaches have little to offer either diagnostically or therapeutically. It was pointed out, however, that these approaches and drug therapy in particular need further investigation before their role in the treatment of SIB can be adequately assessed. This chapter critically evaluated the current behavioral approaches in some depth and advanced several recommendations for future work. The general impression gained from current research is that significant advances have been made in the last decade in our understanding of the problem and that a small number of well-controlled studies have shown that SIB in certain children can be controlled for up to three years. Yet a concerted research effort is required to overcome the methodological problems that appeared with disconcerting regularity in most of this research. It is sobering to note that no current prevalence studies of SIB report a major decline in the prevalence of SIB in pediatric populations despite our current ability to provide some form of meaningful treatment.

5-Hydroxytryptophan↗
PubMed1982

[Psychosomatic diseases of the eye--a review].

After remarks on the uncritical use of the term "hysteria" in some investigations on psychosomatic phenomena in ophthalmology some recent reviews are presented, followed by the results of psychosomatic research on specific ophthalmological diseases. Dealing with glaucoma controlled studies are emphasized which attempt to determine the structure of neuroses and the importance of environmental situations. Using the MMPI high values on the scales 'depression', 'hypochondria' and 'hysteria' were observed. In previous attempts to influence glaucoma psychotherapeutically mainly autosuggestive and hypnotizing methods have been applied. The number of reported cases of psychogenic blindness has decreased considerably. We discuss, that it may not only be caused by the mechanism of hysterical conversion but also by a tendency to regression in schizoid neurotic structure. Concerning asthenopia and amblyopia the dependence of vision and visual acuity of the level of vegetative innervation is being accentuated; there appear to be correlations between certain errors of refraction and certain personality patterns. Psychiatric diseases may also influence vision: observations in paranoid and affective psychoses of later life and in schizophrenic children confirm it. This leads to the question, if schizoid neurotic structure can also be characterized by a specific disturbance in affective relations to sensations. Examples are given for investigations on other diseases (ablantio retinae, retinopathia centrales serosa), on the problem of self mutilation (auto-enuclation) and on neurophysiological question (psychogenic influences on pupil size).

Amblyopia↗
PubMed1981

Abnormal behavior patterns in rhesus monkeys: symptoms of mental disease.

This paper describes the morphology of abnormal behavior of rhesus monkeys which had experienced a certain degree of social isolation. Analysis of the morphology of the behavior starts from the hypothesis that abnormal activities should preferably be interpreted as distortions of normal behavior. The results indicate that all abnormal activities seemed to be symptoms of one social deprivation syndrome, because all activities could tentatively be interpreted as more or less idiosyncratically distorted, often self-directed forms of normally social behavior. The results also illustrate that abnormal behavior patterns can be considered at different levels of integration which should be clearly distinguished in comparative studies. Similarities to the behavior of human mental patients suggest that social deprivation is a prominent factor in a wide variety of mental diseases.

Animals↗
PubMed1981

Lesch-Nyhan syndrome in an Arab family. Detection and biochemical manifestation of heterozygosity.

A large Arab family affected with the rare X-linked Lesch-Nyhan syndrome is reported on. Two hemizygous boys, two and nine years of age, had the classical biochemical and clinical-neurological syndrome. The activity of erythrocyte hypoxanthine-guanine phosphoribosyltransferase (HGPRT) was below the detectable limit (greater than 0.1% of normal). They were mentally and physically retarded and exhibited spasticity and choreoathetosis; the older of the two also exhibited self-mutilation. The mother and three of her seven daughters, all clinically asymptomatic, were proven to be heterozygous for HGPRT deficiency, by demonstration of an increased rate of de novo purine synthesis in cultured skin fibroblasts. Erythrocyte HGPRT activity was normal in the three heterozygous daughters, but was significantly reduced in the mother. However, in all four heterozygotes, erythrocyte HGPRT/adenine phosphoribosyltransferase ratio was lower than in all other family members. All heterozygotes had blood uric acid levels within the normal range, although higher than in the normal women in the family. The ratio uric acid/creatinine concentration in the urine was significantly elevated in one of the heterozygotes, and in the upper normal limit in two others, indicating excessive purine production.

Adolescent↗
PubMed1978

Ataxia and disorders of purine metabolism: defects in hypoxanthine guanine phosphoribosyl transferase and clinical ataxia.

A relationship between disordered metabolism of purines and the central nervous system has been established by the Lesch-Nyhan syndrome. In this disorder a virtually complete defect in the activity of HGPRT is associated with a syndrome of severe mental retardation, choreoathetoid cerebral palsy, and bizarre, self-mutilative behavior. In patients with partial defects in HGPRT, two have had symptoms that have been labeled spinocerebellar. Neither were appreciably ataxic, and the relationship between the symptoms and the enzyme defect remains to be established. Analysis of HGPRT in members of a large kindred with spinocerebellar degeneration revealed normal levels of the enzyme. These observations suggest that a relationship between the activity of HGPRT and clinical ataxia is remote.

Ataxia↗
PubMed1980

Lumbosacral stenosis in dogs.

Fifteen dogs with stenosis of the lumbosacral portion of the spinal canal were treated by laminectomy, bilateral facetectomy, and foraminotomy. Concomitant disk extrusion, spondylosis, fracture, infection, neoplasia, hemivertebrae, and spinal bifida were not associated with the stenosis and attendant cauda equina compression. The predominant neurologic signs were intermittent hindlimb lameness and motor weakness; hindlimb muscle atrophy; presumed paresthesia with resultant dermatologic manifestations from self mutilation of the hindlimbs, tail, perineum, anal area, and genitalia; urinaryu or fecal incontinence, or both; and consistently elicitable pain on manipulation of the lumbosacral spine. Surgical decompression of the stenotic canal alleviated the clinical signs in all cases.

Animals↗
PubMedDate not supplied

Lesch-Nyhan Syndrome: report on two brothers.

Lesch-Nyhan syndrome is a rare X-linked disease characterized by over-production of uric acid and a central nervous system (CNS) disorder consisting of mental retardation, spasticity, choreoathetosis, and a compulsive form of self-mutilation. A deficiency in hypoxanthine-guanine phosphoribosyl transferase (HPRT) provides the underlying metabolic basis for this disease. A 12 month-old male baby who had orange crystals over the diapers since he was 3 months old was brought to our hospital due to developmental delay. Mental retardation and athetosis were also noted. Chemical analysis revealed hyperuricemia (uric acid 8.6 mg/dl). Urine routine showed microscopic hematuria and uric acid crystals. The activity of HPRT in erythrocyte lysates of parents were both within normal limits, but that of the patient was very low (0.0547 nm/min/mg protein, < 0.05% of control). His younger brother was born 2 months after this disorder diagnosed in this patient. The younger brother was noted to have uric acid crystals over the diapers when he was 40 days old and hyperuricemia (10.6 mg/dl) showed up later. He was also a case of Lesch-Nyhan syndrome since the activity of HPRT in erythrocyte lysates was also low (0.0327 nmol/min/mg protein, < 0.05% of control). Further studies, including carrier detection and deoxyribonucleic acid (DNA) analysis, could be helpful for genetic counseling. This syndrome is rare among Chinese, and this may be due to underdiagnosis.

Family Health↗