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[Psychosomatics of myasthenia].

The therapeutic experience with myasthenic patients is difficult. It is suggested to interprete myasthenia gravis as psychosomatic illness because of lower conflicttolerance, onset by emotional situations, abnormous patterns of behaviour and personality, and suspected neuro-psychological disturbances. In our pilot-study with 13 patients we found disturbances in early childhood, sexual behaviour and dreaming. The intelligence (I.Q.) had a high average. 11 patients showed abnormous personality, 9 patients a pathological Benton-Test, perhaps an information of higher cerebral disorder. Supportive psychotherapy of myasthenic patients in close cooperation with neurologists is proposed.

Dreams↗

Prefrontal volumes in habitually violent subjects with antisocial personality disorder and type 2 alcoholism.

Pathology of the prefrontal cortices has been suggested to be a part of neural networks underlying deviant behavioral patterns. Recently, reduced overall prefrontal cortical volumes have been proposed in subjects with antisocial personality disorder (ASP). It is not known whether there are specific patterns of volume loss within the prefrontal regions. Nor is it known if there are correlations between the prefrontal volumes and degree of psychopathology. In this study, total prefrontal, prefrontal white, and cortical (dorsolateral, orbitofrontal, medial frontal) prefrontal volumes were measured from magnetic resonance images in 24 non-psychotic, violent male subjects who had a diagnosis of ASP in combination with type 2 alcoholism, and 33 age-matched control males. The degree of psychopathy in the ASP subjects was assessed using the Psychopathy Checklist-Revised (PCL-R). Compared with the controls, the ASP subjects had significantly smaller volumes of all three cortical regions on the left, but this significance disappeared after controlling for differences in education and duration of alcoholism. For the dorsolateral and orbitofrontal cortices, only duration of alcoholism was significantly associated with the observed volume deficit, and for the medial frontal cortex it was the difference in education. Thus, the observed volume deficits in this sample were related more to alcoholism or differences in education rather than to the diagnosis of ASP. Moreover, no significant correlations between any of the volumes and the degree of psychopathy were found.

Adult↗

[Endothelial dysfunction and risk factors of its development in subjects with family history of atherosclerosis].

Brachial artery blood flow reactions to hyperemia and hyperventilation (endothelium dependent vasodilation and vasoconstriction) were studied by doppler sonography in 60 persons aged 19-39 years with family history of atherosclerosis and risk factors of this disease. Reactivity of peripheral artery and risk factors of atherosclerosis development were found to be interrelated. The results allowed to suggest participation of atherogenic fractions of lipoproteins, triglycerides, proinflammatory cytokines, and monocyte derived NO in formation of pathological vascular reactions in persons with family history of atherosclerosis.

Adult↗

The relationship among binge severity, personality psychopathology, and body mass index.

OBJECTIVE: To determine the relationship among binge severity, personality psychopathology, and body mass index (BMI) among individuals with binge eating disorder (BED). METHOD: Participants were 50 individuals from the community who responded to advertisements for a medication treatment study of compulsive overeating and met BED criteria. Participants completed the Eating Disorder Examination and the Structured Clinical Interview for DSM-IV Personality Disorders. RESULTS: Binge eating severity was significantly and positively correlated with BMI and personality disorder symptomatology. The frequency of binge eating episodes, but not binge size, was associated with greater levels of personality psychopathology. BMI and personality psychopathology were unrelated. Twelve percent of the participants met full criteria for avoidant personality disorder (APD) and 10% met full criteria for obsessive-compulsive personality disorder (OCPD). DISCUSSION: Findings suggest that eating pathology, rather than weight, is related to personality psychopathology. APD and OCPD traits may be of particular relevance when considering treatment interventions for individuals with BED.

Adult↗

Fine-needle aspiration cytology of tumors: diagnostic accuracy and potential pitfalls.

FNA biopsy is a quick, safe, and inexpensive method for obtaining material for pathological diagnosis. It is most useful in the diagnosis of a malignant tumor. In experienced hands it is highly accurate, and many of the pitfalls in cytological interpretation can be avoided with increased practice. Special training is required to become proficient in both obtaining and interpreting aspirated material. It is not sufficient for pathologists to apply personal experience from tissue pathology to the diagnosis of cytological specimens. Current indications are the FNA biopsy will be used with increasing frequency for reasons involving both clinical practice and cost containment.

Abdominal Neoplasms↗

The Rorschach and the DSM-III-R antisocial personality: a tribute to Robert Lindner.

This study utilized the Rorschach as a psychometric measure for understanding Antisocial Personality Disorder (American Psychiatric Association, 1987). Comprehensive System (Exner, 1986) Rorschach data for a sample of 60 ADP subjects and Rorschach object relations and defensive operations for 22 psychopathic APD (P-APD) and 21 nonpsychopathic APD (NP-APD) subjects are presented and discussed. The data support the absence of anxiety and attachment and the presence of pathological narcissism and borderline personality organization in P-APDs. The Rorschach's ability to differentiate antisocial groups based on level of psychopathy (Hare, 1980, 1985) strongly supports the need to use psychopathy as an independent measure when one is studying APD.

Adolescent↗

[Mental disorders in basaloma].

There were observed 70 patients (21 men, 49 women) with basaliomas (cancer of the skin). Mental disorders were observed in form of affective disorders (depression, hypothymic colour of the surrounding), syndrome of dismorphophobia-dismorphomania, relatively short cancerophobic feelings, somatogenic asthenia and a development of personality disorders. A forming of the mental disorders were conditioned at basaliomas by a complex influence of both somatogenic and psychogenic factors. An influence of the psychogenic factors was relatively transitory and psychologically comprehending (dysmorphophobia, cancerophobia, depression). An influence of the somatogenic factors predetermined a stability, a duration and a small reversibility of mental disorders (asthenia, irritative weakness, pathological development of the personality).

Basal Cell Carcinoma↗

Relationship between serum alpha 1-antichymotrypsin and Alzheimer's disease.

We obtained serum samples and measured alpha 1-antichymotrypsin (ACT) levels in 36 pairs of consecutive probable Alzheimer's disease (AD) patients and age- and sex-matched, cognitively intact control subjects. Serum ACT was measured by radial immunodiffusion. Unique to this study, we found that ACT levels rose significantly with age within controls (but not within AD cases), thus ACT may be related to the aging process. Consistent with other reports, we found that AD cases had greater serum ACT in 27 of 36 pairs [mean difference = 135.5 (SE = 50.8) mg/l (p < 0.05)]. Severity and duration of AD were not significantly associated with the observed difference. The ACT increase observed in AD is not sufficient to recommend ACT's use as a diagnostic marker for AD. Because adult Down's syndrome (DS) persons are known to have pathologic features of AD, we also measured serum ACT levels in 11 adult, noninstitutionalized, DS persons paired with 11 age- and sex-matched, volunteer control subjects; we found no statistically significant difference. The unexpected age-associated increase in ACT among normal controls could be an indicator of early amyloid plaque formation. Future studies comparing ACT levels in both serum and cerebrospinal fluid should help to clarify the origin of ACT found in amyloid plaques and its value as a diagnostic marker for AD.

Adult↗

[Emotional experience, expression and communication in musical improvization. A qualitative-quantitative single case study].

In this study the theory-conducted empirical procedure for analyzing active improvisatory music therapy of a single case will be described. The operationalization and tests for validation will be described. According to the aim of the study, the results show that the used method is appropriate to describe different and repetitive (emotional) patterns of improvisatory playing, which reflect the personal (emotional) and interpersonal pathology and healthy parts of the examined patient. With the aid of several tests the results of validating the macro-process will be discussed.

Expressed Emotion↗

Pica in institutionalized mentally retarded persons.

Pica, an eating disorder, is commonly observed in infants, young children and in developmentally delayed persons. The behaviour is regarded as pathological if it persists beyond the age of about 18 months. The present study was designed to study the prevalence of pathological pica in a state residential institution for mentally retarded persons. Of the total sample of 607 residents, 56 or 9.2% were identified and observed to engage in pica. The occurrence of pica was related to the degree of retardation and age of the residents. Observational data showed that the occurrence of pica varied in frequency across four different settings, both within and between subjects. A wide variety of objects were used for pica including clothing, dirt, dust and fluff off the floor, toys, paper, and grass. Medical case notes showed that only a small number of the residents engaging in pica suffered from the commonly known problems associated with pica.

Adolescent↗

[Therapeutic negotiation in psoriasis].

The patient based medicine joins together all the medical techniques making possible to adapt to a particular individual the scientific knowledge obtained through the study of broad populations. It rests on four successive phases: questions, explanations, negotiation and prescription. The purpose of these successive phases in the relation doctor-patient is to identify and take into account in the therapeutic decision, all the facets of the personality of the patient, the pathologies and treatments associated, the therapeutic experiments already carried out by this patient and his personal evaluation of his quality of life and of the impact of the treatments and the disease on this quality of life. These techniques are essential to efficiently treat chronic diseases. Their progressive development represents a therapeutic revolution resounding on the teaching of medicine, the development of new drugs and on the rights of the patients.

Decision Making↗

[Comparative study of 2 groups of paranoid syndromes appearing at different ages].

Clinical study of two groups of females beyond age of 65, institutionalized for delusional manifestations of schizophrenic nature and presenting also, at the time of examination, a pronounced paranoid state. In the first group: the manifestations had arisen before the age of 45. In the second group, after the age of 65. This study has demonstrated certain psychopathological characteristics suggesting the presence of personality problems definitely more profound in patients of the first group: autistic state, asthenia, thought disorder, incoherence and vagueness of delusional subjects, ordinarily much more unreal are characteristics of the first group in comparison to the second. This seems to bring evidence that these two paranoid states (paranoid schizophrenia in adult age and paranoid state in senility) are, at first sight, pathological entities based on personality problems of very different intensity.

Adult↗

Psychiatric comorbidity and gender differences of persons incarcerated for methamphetamine abuse in Taiwan.

Methamphetamine (MAP) abuse has been common in Taiwan for the past decade. The purpose of the present study was to investigate MAP abuse in Taiwan, with specific attention to psychiatric comorbidity and gender differences. A total of 325 MAP abuse subjects (180 male, 145 female) from a detention center in Taipei were assessed with the Diagnostic Interview for Genetic Studies. The following were studied: drug use behavior, treatment-seeking behavior, lifetime prevalence of mood disorders, MAP psychosis, alcohol use disorders, pathological gambling and antisocial personality. The MAP-abuse subjects in Taiwan had high psychiatric morbidity and low access to mental health services. There also exist certain differences in the prevalence of psychiatric illnesses and treatment-seeking behavior between male and female subjects. Compared with their male counterparts, more female subjects reported experience of mental disturbance and experience of psychiatric treatment. The female subjects more commonly reported suicidal behaviors than the male subjects.

Adolescent↗

[Pathology of adaptation according to Sami-Ali and index of conformity to the Rorschach test in ulcerative rectocolitis].

According to Sami-Ali's theoretical model the psychosomatic personality is characterised by an adaptation pathology whose main elements are the repression of imaginative thought and conformity to socio-cultural standards. This study examines adaptation pathology using the Rorschach test. The Authors have formulated a conformity index by relating kinestheses (M) and banal perceptions (BAN). The study was carried out on a sample of 41 patients suffering from ulcerous rectocolitis comprising 24 males and 17 women with a mean age of 32 years. As expected in the hypothesis 97.6% of the sample showed M values below the norm, and 68.3% had Ban values higher than normal, whereas the conformity index was positive and tendentially positive in 65.9% of cases. These findings confirm Sami-Ali's theory. Subjects with ulcerous rectocolitis form part of the adaptation pathology which characterised the psychosomatic personality, with an inverse proportionality between imaginative activity (kinesthesia below normal) and conformism (banal perceptions above the norm).

Adaptation, Psychological↗

[Histological investigations of the myocardium in unnaturally deceased persons (author's transl)].

Histo-pathological investigations carried out in the Institute of Forensic Medicine of the Martin-Luther-University of Halle on 6 differently localized myocardial portions (1,080 preparations) from the autopsy material of a total of 90 persons who had died in the course of 1973, revealed massive inflammatory cellular infiltrates (focal interstitial roundcelled myocarditis) in 18.9 percent and insignificant concentrations of round cells or individual mononuclear inflammation cells in 60 percent of cases. an evaluation of the autopsy data (age and sex ratio, classification of causes of death and attempted proof of pre-existing infectious and heart diseases or their symptoms) is followed by a discussion of under and overvaluating the occurrence of interstitial myocardial cells in the cases under investigation and, with regard to the cause of death, in the cases of an unexpected and sudden, presumably natural, death.

Accidents, Traffic↗

Immunologic cross-reactivity in the pathogenesis of ocular onchocerciasis.

PURPOSE: Onchocerca volvulus, a filarial worm, is a major cause of infectious blindness and inflammatory eye disease. An autoimmune cause for ocular onchocerciasis has been suggested since the identification of a recombinant antigen of O. volvulus that shows immunologic cross-reactivity with a host ocular component of 44,000 M(r). The aim of this study was to establish the distribution of the cross-reactive antigens in both host tissues and the parasite, and to determine if significant autoantibody responses to the host antigen could be detected in infected persons. METHODS: The tissue and organ distribution of the 44,000 M(r) antigen was determined by immunocytochemistry and Western blot analysis. Human autoantibody responses to the ocular antigen were demonstrated by Western blot analysis using sera collected from persons with onchocerciasis, with and without posterior segment pathology, Bancroftian filariasis, and Europeans with no filarial infection. RESULTS: The tissue distribution of the 44,000 M(r) antigen correlates with the sites of pathology in onchocerciasis and antibody reactivity against this antigen could be detected in all persons with onchocerciasis and posterior segment pathology. The antigen is also recognized by sera from persons with Bancroftian filariasis, but not from normal persons. CONCLUSIONS: A role is proposed for immunologic cross-reactivity in the pathogenesis of onchocerciasis and it is suggested that intraocular presentation of the cross-reactive parasite antigen by microfilariae is essential for the development of disease.

Adult↗

[Refining the definition of dissimulation].

Different approaches to the understanding of the term dissimulation are discussed. It is marked, that dissimulation may be encountered in all forms of pathology beyond the nosological boundaries, but depending upon the socio-personality significance of the disease. The authors propose to consider dissimulation from the clinico-social standpoint and understand it as a limited and changed by pathology personality-modulated behaviour of patients, directed towards preservation (rehabilitation) of a status of a normal individual. Such behaviour may be related both with a psychologically understood motivation (for instance, a more successful social adaptation) and pathological (for instance, delusional) purposes.

Delusions↗

Neuropathologic correlates of leuko-araiosis.

We describe the pathologic findings in 17 persons with dementia, 12 of whom exhibited leuko-araiosis on computed tomographic scan. The presence of white matter pallor was confirmed on autopsy in 11 of these 12 cases, 9 with Alzheimer's disease and 2 with multi-infarct dementia. Two further patients, 1 with Alzheimer's disease and 1 with multi-infarct dementia, proved to have white matter changes on pathologic examination. White matter pallor coexisted with cerebral amyloid angiopathy in the brains of the patients with Alzheimer's disease. The presence of severe white matter pallor in patients with Alzheimer's disease correlated with early death, while the presence of cortical scars was associated with prolonged survival. Because early death in patients with Alzheimer's disease has been linked with severe pathologic and chemical changes, the presence of white matter pallor may be further evidence of a particularly severe process in patients with early onset of Alzheimer's disease.

Aged↗