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PubMed1999

Oral ecology and person-to-person transmission of Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis.

The ecological characteristics of the oral cavity are dissimilar for A. actinomycetemcomitans and for P. gingivalis, as judged by differences in their colonization preferences and patterns, associations with periodontal disease parameters, relationships with the subgingival microbiota and the type of periodontitis and their clonal persistence in the oral cavity. These features also suggest that as a periodontal pathogen, A. actinomycetemcomitans is different from P. gingivalis. Probably in most infected individuals, low levels of A. actinomycetemcomitans can persist for years in equilibrium with the host and the resident oral microbiota. However, it is well established that A. actinomycetemcomitans can cause disease in some individuals or in some circumstances when the regulatory mechanisms are unable to maintain homeostasis in the ecosystem. Elevated A. actinomycetemcomitans proportions of the biota can be regarded as a sign of ecological imbalance, leading to increased risk of periodontal destruction. There is also evidence showing elevated pathogenic potential of certain A. actinomycetemcomitans clones. Although A. actinomycetemcomitans seems to be relatively rarely transmitted between cohabiting adults, transmission can occur to periodontally healthy children of A. actinomycetemcomitans-positive parents. Parents and children may share factors that promote successful oral colonization of A. actinomycetemcomitans, or the window of opportunity is in childhood. Therefore, to prevent parent-child transmission of A. actinomycetemcomitans, bacterium-positive parents of young children are optimal targets for enhanced information and treatment. In selected populations, screening for specific clones of A. actinomycetemcomitans has been employed in prevention of peridontitis. Future research aiming at finding the reasons which cause the changes in the oral homeostasis to allow the growth of A. actinomycetemcomitans may give insight into novel prevention strategies for A. actinomycetemcomitans-associated periodontitis. Compared with A. actinomycetemcomitans, P. gingivalis shows a different pattern of coexistence with the host. In periodontal health or in children, P. gingivalis is absent or only rarely detected. When present, P. gingivalis is commonly recovered in high numbers from dentitions exhibiting inflamed periodontitis and poor oral hygiene. Contrary to A. actinomycetemcomitans, the data on the vertical transmission of P. gingivalis are limited. The major infection route of P. gingivalis seems to be between adults, indicating that P. gingivalis commonly colonizes in an established oral microbiota. These characteristics suggest that the degree of tolerance between P. gingivalis and the host is inferior to that between A. actinomycetemcomitans and the host. It appears that the association of P. gingivalis with disease is a rule rather than an accidental incident. On these grounds, it seems that the host-P. gingivalis relationship approaches antibiosis. Since P. gingivalis infection is related to a typical periodontal eco-pathology, the susceptibility to person-to-person transmission of this pathogen may be controlled by periodontal treatment and emphasizing the significance of high standard oral hygiene.

Actinobacillus Infections↗
PubMed1988

Description of laryngeal pathologies by age, sex, and occupation in a treatment-seeking sample.

The purpose of the present investigation was to describe the occurrence of laryngeal pathologies and their distribution across age, sex, and occupation in a group of persons seeking physician treatment. Data were collected on 1,262 patients seen by eight otolaryngologists from three different residential areas. The five most frequent pathologies reported were nodules, edema, polyps, laryngeal cancer, and vocal fold paralysis. For the total sample, pathologies occurred more frequently in females than in males; however, certain pathologies were more common to one sex than the other. The voice-disordered population appears to be getting older. The top five occupations associated with laryngeal pathologies were retired persons, homemakers, factory workers, unemployed, and executive/managers. Comparisons with similar investigations were made.

Adolescent↗
PubMed1997

[Progress in psychoanalytic treatment].

The author considers psychoanalytic treatment to be most effective when based upon an interactive, intersubjective conception of normal and pathological psychic development. By internalizing pathological and pathogenic relationships during childhood, the person builds up a troubled internal relational pattern; it determines his her choices and ensuing relationships and thus perpetuates his her pathology. When it appears in the psychoanalytic relationship this pathological relational style can be analysed and resolved, while a new relationship, promoted by the psychoanalyst, is begun. It aims at fostering the person's development and mental health. This new, healthier relationship is progressively integrated into the patient's everyday life. Consequently the internal relationship pattern itself, through the person's new experiences, changes. Psychoanalysis comes to an end when the new internal relational pattern is consolidated. Therefore the psychoanalytic cure is seen as a process of transformation; and the psychoanalyst is its agent. Therein, the author maintains that counter transference precedes transference and is the driving force of the curing process. The author states that: precedence and priority should be given to counter-transference.

Countertransference↗
PubMed1996

Anorexia in older persons: epidemiology and optimal treatment.

Anorexia and weight loss are common findings in older persons. Over a life-time, normal persons decrease their food intake to counterbalance the decrease in physical activity and resting metabolic rate that occurs with aging. This physiological anorexia of aging increases the propensity to develop pathological anorexia and weight loss when an older person develops either a medical or psychological illness. The physiological anorexia of aging is due to a decreased opioid (dynorphin) feeding drive and an increase in the satiating effect of the gastrointestinal hormone, cholecystokinin. Nitric oxide deficiency may play a role in the early satiation commonly seen in older persons. A variety of social, psychological and medical conditions can lead to pathological anorexia. Depression is the most common cause of weight loss and anorexia in older persons. A number of conditions such as cancer and rheumatoid arthritis produce their anorectic and wasting effects by releasing cytokines. An idiopathic pathological senile anorexia has been characterised which also appears to be a cytokine-dependent syndrome. Early screening for malnutrition is a cornerstone of the management of anorexia; the Mini Nutritional Assessment is a well validated screening tool available for this purpose. Aggressive use of caloric supplements, enteral tube feeding and peripheral parenteral nutrition all have a role in the early management of anorexia. Numerous drugs (growth hormone, megestrol, cyproheptadine, tetrahydrocannabinol, anabolic steroids, prokinetic agents and antidepressants) have been utilised to treat the anorexia of aging with varying success.

Aged↗
PubMed1976

Serum creatine phosphokinase activity in psychiatrically hospitalized children.

Serum creatine phosphokinase (CPK) activity was determined in a series of 101 sequential admissions to the Pritzker Children's Hospital, an inpatient psychiatric facility. Black children had significantly higher serum CPK levels than whites, and males had significantly higher levels than females, as is the case with adults. There was a higher incidence of CPK elevations in children with organic brain pathology than in children with personality disorders or schizoprenia. Children with chronic symptoms of a psychotic nature did not have increased serum CPK activity, which is similar to the findings in adults. There were no children in the sample with acute psychotic symptoms, so it was not possible to determine whether acute psychosis in children is accompanied by increased serum CPK activity, as it frequently is in psychotics over the age of 17.

Adolescent↗
PubMed1977

Familial cancer in the general population.

In the course of collecting samples of human milk for the National Cancer Institute, family histories have been assembled since 1971. Ages, causes of death, reproductive histories, and the history and age of occurrence of cancer were obtained for all first degree relatives of the proband's parents. Two thousand and ninety cancers were identified in 31,945 persons. Cancers were confirmed by pathology reports, hospitals' and doctors' records, or death certificates. Of the family lineages, 65.9% had no cancers and 8.0% had two or more. For all cancers taken together, clustering was not significant but there was significantly more observed than expected cancers in lineages with cancer of breast, ovary, skin, corpus uteri, stomach, rectum, lung and bronchus, or colon. Little or no excess was observed in lineages with leukemia, lymphoma, and cancer of the cervix or prostate. The relative risk of breast cancer was increased 1.5 times for daughters and 3.8 times for sisters of women with the disease.

Breast Neoplasms↗
PubMed1983

The HTP as a measure of change in dialyzed schizophrenic patients.

Used the House-Tree-Person as a measure of pathology in 10 schizophrenic patients of both sexes between the ages of 19 and 30 before and after experimental hemodialysis treatment. Results obtained through the quantitative HTP scoring method, and reflected in HTP IQs, indicate that significant improvement as a function of treatment is seen in pre- to post-dialysis drawings. Data analysis, using the Two Factor Repeated Measures Analysis of Variance (ANOVA), indicates that drawings done after dialysis improve at the .005 and .001 levels. The HTP evaluations support the continued use of hemodialysis as an effective treatment for schizophrenia.

Adult↗
PubMed1985

Autosomal recessive distal muscular dystrophy: a comparative study with distal myopathy with rimmed vacuole formation.

To clarify the clinical and morphological characteristics of distal muscular dystrophy, clinical and pathological material from 4 affected persons was compared with similar studies in 4 patients with distal myopathy with rimmed vacuole formation. Although these two forms of autosomal recessive distal myopathy with onset in young adulthood were highly similar in their clinical symptoms, histochemical and electron microscopic findings of muscles subjected to biopsy were quite different. The muscle abnormalities in distal muscular dystrophy were almost the same as those in Duchenne muscular dystrophy, showing massive fiber necrosis followed by active fiber regeneration. In contrast, distal myopathy with rimmed vacuole formation showed a progressive muscle fiber atrophy and loss, rimmed vacuoles in the sarcoplasm, and no apparent fiber necrosis or regeneration.

Adolescent↗
PubMed1994

Factors related to tumor size of breast cancer at treatment in Taiwan.

METHODS. Personal information and clinical and pathological records were collected for 178 of 310 new cases of breast cancer in 1991 Cancer Registry of Taiwan. RESULTS. Among the subjects studied, 89.3% of the breast cancers were found incidentally. Delayed treatment, doctor shopping, and taking traditional medicine were common. Only 19.7% of the tumors were not more than 2 cm in diameter when the patients received treatment. The most important factors related to tumor size at treatment were occupation, family economic status, and action after detection. Those who were employed, had higher family economic status, and saw a doctor immediately after the tumor was detected were likely to have smaller (< or = 2 cm) tumors at treatment. The application of screening methods, however, did not show any significant relationship. The authors suggested implementing a breast self-examination health education program, evaluating cost-benefits of different screening methods, and setting up a breast cancer screening model that can meet the needs of Taiwanese women.

Adult↗
PubMed1996

Cultures in psychiatric nosology: the CCMD-2-R and international classification of mental disorders.

This essay reviews the Chinese Classification of Mental Disorders, Second Edition, Revised (CCMD-2-R, 1995), by assuming the theoretical stance that symptom recognition, disease construction, and taxonomic strategy in psychiatry reflect, and are constrained by, the cultural norms and values as well as the political and economic organizations of the society in which they are embedded. The CCMD-2-R is an ethnomedical classification grounded in both symptomatology and etiology, in which Chinese psychiatrists seek to conform with international classifications on the one hand, and to sustain a nosology with Chinese cultural characteristics on the other. Although broad similarities between the ICD-10 and CCMD-2-R are evident, their blending is legitimately incomplete. Thus, the particular additions (e.g., travelling psychosis, qigong induced mental disorders), deletions (e.g., somatoform disorders, pathological gambling, a number of personality and sexual disorders), retentions (e.g., unipolar mania, neurosis, hysteria, homosexuality), and variations (e.g., depressive neurosis, neurasthenia) reveal not only the changing notions of illness but also the shifting social realities in contemporary China. The CCMD-2-R will be widely used by Chinese psychiatrists and should standardize diagnostic practice and facilitate research, but its impact on everyday clinical work and psychiatric training remains to be evaluated. For Western researchers, it is one avenue for achieving an understanding of the Chinese social world, and should usefully be contrasted with the ICD-10 and DSM-IV as the move towards an international nosology continues.

China↗
PubMed1994

Abnormal classical eye-blink conditioning in autism.

Cerebellar and limbic system pathologies have been reported in persons with autism. Because these brain areas are involved centrally in the acquisition and performance in classical eye-blink conditioning, this study evaluated conditioning in 11 persons with autism. Compared to matched controls, persons with autism learned the task faster but performed short-latency, high-amplitude conditioned responses. In addition, differences in learning the extinction rates systematically varied with age thus suggesting a developmental conditioning abnormality in autism. The observed pattern of eye-blink conditioning may indicate that persons with autism have the ability to rapidly associate paired stimuli but, depending on processing of certain contextual information, have impairments in modulating the timing and topography of the learned responses. This abnormality may relate to deviant cerebellar-hippocampal interactions. The classical eye-blink conditioning paradigm may provide a useful model for understanding the biological and behavioral bases of autism.

Adolescent↗
PubMed1982

Multiple calcified aneurysms of splenic artery, hypersplenism and concomitant cholelithiasis.

Multiple calcified aneurysms of splenic artery with hypersplenism and concomitant cholelithiasis were found in a 73-year-old Japanese woman. The symptoms and radiological findings were referable to the aneurysms. The predisposing factors are reviewed. Proximal ligation of the splenic artery and splenectomy gave a good postoperative result. Histopathological examination revealed an atherosclerotic origin, nevertheless, specimens from an elderly person may obscure the actual pathology.

Aged↗
PubMed2003

Mathematical models and their application in body composition research.

Mathematical models are a means of formalizing the knowledge on living systems obtained in clinical physiology and theoretical biophysics. They allow the actual processes in living systems to be described and the mechanisms of these systems to be evaluated. The study of body composition strives to quantitatively evaluate intrinsic body compartments and to obtain important information on the nutritional and energy requirements of healthy persons and those with various pathologies. Although there has been great progress in the development of sophisticated instruments for body composition research, it is not always possible to directly measure certain body compartments (e. g. intracellular water and fat mass) because of either technical difficulties or for ethical reasons. Therefore, mathematical models, which can potentially estimate these compartments indirectly, may be a viable alternative. In this paper, we describe the various advances in the use of mathematical models for body composition research.

Body Composition↗
PubMedDate not supplied

[Cognitions in eating disorders and their assessment].

UNLABELLED: Cognitions are of crucial importance in the -aetiology and the maintenance of eating disorders. Dysfunctional cognitions in eating disorders are related to body image, self-esteem and feeding. The aim of this paper is to review the actual knowledge in this area. First, we will display -cognitive models in eating disorders. Cognitive factors in -eating disorders are logical errors, cognitive slippage and conceptual complexity. Eating disorder patients seem to have a deficient cognitive development. Some cognitive models stipulate that eating disorder patients may develop organised cognitive structures schemas concerning the issues of weight and its implications for the self. These schemas can account for the persistence and for the understanding the "choice of the eating disorder symptomatology. Cognitive pheno-mena of interest are self-schema, weight-related schema and weight-related self-schema. The maintenance model of ano-rexia nervosa argued that, initially there is an extreme need to control eating which is supported by low self-esteem. The maintenance of the disorder is reinforced by three mechanisms: dietary restriction enhances the sense of being in control; aspects of starvation encourage further dietary restriction; concerns about shape and weight encourage restriction. The development and maintenance of bulimic symptomatology are explained by placing a high value on attaining an idealised weight and body shape accompanied by inaccurate beliefs. The cognitive model of specific family of origin experiences puts forward the development of -maladaptative expectancies for eating and thinness. Second, we discuss distortions in information processing. a) In feeding laboratories, bulimics show a wide range of caloric intake and a disruption of circadian feeding patterns. In overeating bulimics, large meals occurred mainly during afternoon and evening with high fat and carbohydrate intake, but the majority of meals were of normal size and frequency. Responsivity to food cues indicates that bulimics were more responsive to sight, smell and taste of their favourite binge food, and a greater responsivity was associated with increasing -cue salience. Eating disorder patients appear to have internalised a mediated social rule concerning "good food" and make drastic selections thus removing the possibility of choice of foodstuffs. b) Experimental processes: temporal factors in the processing of threat seem to be of importance in patients with high levels of eating psychopathology. There is no evidence for preattentive processing biases among anorectics. Changes in information processing speed after treatment were not linked to treatment condition or treatment response. c) Judgement and emotions: in eating disorder patients, distortions of depressogenic nature are found that influence the cognitive style; thoughts about eating, weight and shape are characterised by negative affective tone; negative emotions could account for bulimic behaviour; anxiety and distress are correlated to thought control strategies. Information treating seems to be impaired in a non-homogeneous way. d) Cognitive schemas are seriously maladaptive and not well investigated. In eating disorder patients, core beliefs are absolute, unconditional and dichotomous cognitions about oneself and the world. There are only few studies in this field moreover showing controversial results. Core beliefs can explain links between personality disorders and eating psychopathology. Pathological core beliefs have to be taken in to account because they influence the outcome and the efficacy of cognitive behavioural therapy. Third, the last part of this paper summarises actually available rating scales eva-luating distorted cognitions in eating disorders. There are different methods for evaluation: specific and non-specific self-report questionnaires, thought-sampling procedures, -methods derived from cognitive psychology. The Mizes Anorectic Cognition questionnaire (MAC) is a well-known self-rating scale with good psychometric properties. The revised form of the MAC appears to be an improvement in the area of internal consistency, sensitivity, and reliability. It is obvious that there is no particular rating scale referring to specific cognitions on food. IN CONCLUSION: the main result of this literature review reflects that the cognitive treatment in eating disorders is altered in a specific way on an emotional basis and on self-representation.

Attitude to Health↗
PubMed2006

Disordered emotional processing in schizophrenia and one-sided brain damage.

The work concentrates on the problem of human emotions in healthy and pathologically changed brains, mainly in persons afflicted with schizophrenia or with organic impairments localized in one of the cerebral hemispheres. This chapter presents the state of current knowledge concerning the hemispheric lateralization of emotions among healthy people, psychiatric patients, and patients with one-sided brain lesion, on the basis of clinical observations, the results of experimental work, and the newest neuroimaging techniques. The numerous experiments and scientific methods used to assess the hemispheric lateralization of emotions and the discrepancies in their results point toward a lack of consistent theory in the field of hemispheric specialization in the regulation of emotional processes. Particular scientific interest was taken in the emotions of persons afflicted with schizophrenia, either in its early or late stages. This was inspired by the emotional behavior of schizophrenic patients on a psychiatric ward and their ability to perceive and express emotions during various stages of the schizophrenic process. In order to examine the cerebral manifestations of emotional deficits and the specialization of cerebral hemispheres for emotional processes, the author has described the emotional behavior of patients with unilateral cerebral stroke, i.e., patients with damage to the right or left cerebral hemisphere. Overall, the inferior performance of emotional tasks by right-hemisphere-damaged patients compared to other groups might support right-hemisphere superiority for affect perception despite variations in the stimuli used.

Cerebral Cortex↗
PubMed2001

From diversity to unity. The classification of mental disorders in 21st-century China.

Psychiatric disease constructs represent social constructs and genuine states of distress that have biopsychosocial sources. As such, they have social uses peculiar to the social groups in which they are created and legitimized. This is as true in the United States as in the rest of the world. The DSM schema, for instance, is so organized that every possible mental condition is listed as a disease to legitimate remuneration to practitioners from private medical insurance and government programs. This particular social use may be irrelevant to other societies where health care is financed differently. The CCMD-3 system represents an attempt at global unification and preservation of features that are salient for local application. Compared with its previous editions, noticeable changes have been made to render it in tune with international usage. This remarkable speed of adaptation speaks to the global flows of information technology and China's openness under rapid economic reform. It also demonstrates that the middle-aged cohort of more pragmatic Chinese psychiatric leaders who headed the CCMD-3 task force are now less vulnerable to the domination of the most senior generation of Chinese psychiatrists. Having been trained in the Russian system of psychiatry and gone through the various periods of national shame that traumatized China, they used to be very cautious about adopting foreign technology in general. This is why much less harmonization with the ICD-10 occurred with the CCMD-2-R, when the responsible task force was, for better or worse, dominated by these senior psychiatrists. Nonetheless, as Stengel and Sartorius remarked, an international classification must not aim to oust or replace regional classifications that serve valuable functions in the local contexts. No single classificatory system, Kirmayer submits, will suffice for all purposes--the correct diagnostic scheme is the one that accomplishes its explicit pragmatic aim by addressing the relevant level of description. The particular additions (e.g., travelling psychosis, culture-related mental disorders), deletions (e.g., depressive neurosis, pathologic gambling, avoidant and borderline personality disorders), retentions (e.g., unipolar mania, neurosis, hysteria, homosexuality), and epistemologic variations (e.g., somatoform disorder, neurasthenia) of diagnostic categories reflect exactly this simultaneous need to globalize and to take account of the changing reality of illness in contemporary China. Stengel advised that "no psychiatric classification can help being partly etiological and partly symptomatological, because these are the criteria by which psychiatrists distinguish mental disorders from each other." To an extent, the CCMD-3 is a critique of certain nosologic assumptions of Western psychiatry, such as the feasibility of a neo-Kraepelinian taxonomy grounded exclusively in symptomatology across all diagnostic categories, and the validity of syndromic architectures based on a firm adherence to the mind-body dichotomy. From this angle of vision, local systems of classification such as the CCMD-3 may offer an opportunity for needed reflections by North American psychiatrists who have simply taken the DSM-IV schema for granted. Sartorius reckoned that a classification is a way of seeing the world at a point in time. A deep study of the CCMD-3 is thus an avenue for achieving an understanding of the contemporary Chinese mind and the social realities in China. The remarkable diversity of China at present, namely, a Communist Party dominated state socialist political structure but the most rapidly growing capitalist economy in the world, guarantees that Chinese people's social and moral experience of illness will continue to change. The study of such culture-specific categories as travelling psychosis, neurasthenia, qigong-induced mental disorder, and dysfunctional homosexuality sheds light on the larger sociomoral processes and destabilizing changes in subjectivity that are occurring in this most populous country in the world.

China↗