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PubMed1997

Minimal surface: a useful paradigm to describe the deeper part of the corpus callosum?

The aim of this magnetic resonance imaging study was to find a geometrical characterization of the deeper part of the corpus callosum. Its shape was studied in 12 middle-aged persons free of white matter pathology. Profiles of curvatures were measured showing that this surface was close to a minimal one, especially at the genu and near the splenium. To assess the effect of a white matter pathology on these geometrical features, the same measurements were performed in an extra group of nine patients with definite multiple sclerosis. The hypothesis of curvatures profiles parallelism for the two groups could be rejected at the 0.05 confidence level for the mean curvatures but not for the Gaussian ones. Curvatures profiles may give indications on balance between the cortex and the fiber bundles growth rates during the development and on large scale modifications co-occurring with multilocular white matter pathologies.

Adult↗
PubMed1998

Computerization in breast imaging and diagnosis.

Computerization in breast imaging is very important for activity management and for the qualitative and quantitative control of the diagnoses. The connection through a personal computer network is necessary for the simultaneous input of more data. The activity in our center is completely managed by a specific software which controls and facilitates the input of all personal, administrative, history, instrumental and pathological data. The encoded case history permits quick and accurate data input and the relative information is easy to understand. Database information can be used to make periodical administrative and diagnostic reports and queries, to elaborate useful data for scientific reports and to manage didactic material. The growing use of computers will permit the exchange of data among breast imaging centers and also create important data banks for breast cancer studies.

Ambulatory Care Information Systems↗
PubMed1995

Fictitious epilepsy in Munchausen syndrome by proxy: family psychodynamics.

This paper presents experience of Munchausen Syndrome by Proxy in four families where symptoms and signs of seizures in children were deliberately fabricated or induced by their own parent. At the time when the condition was suspected, the children (5, 7, 13 and 14 years old) had already been exposed to numerous investigations and antiepileptic drug intake-in one case resulting in drug intoxication. The important data, giving clues about how to uncover the condition, are peculiar to each family. After the condition was confirmed, a multidisciplinary team organized an approach aimed at protecting the abused child and changing the pathological parent-child relationship. Personality disorders were recognized in all illness perpetrators (the father in one and the mother in three families) and various psychopathological manifestations were present in all of the abused children. Psychodynamic factors causing the Manchausen Syndrome by Proxy are described and discussed.

Adolescent↗
PubMed2000

Elbow joint, crutches and locomotion: special reference to persons with haemophilia.

A 52-year-old, trans-femoral amputee with haemophilia was hospitalized because of ambulatory problems arising from the osteo-arthropathic involvement of other major articulations. Reduced function in the upper limbs, caused by the effects of recurrent haemarthroses, resulted in additional problems concerning the usage of auxiliary ambulatory aids. The advantages and disadvantages of traditional and experimental crutches highlight the functional problems of ambulation in persons with concomitant upper limb pathologies.

Amputees↗
PubMed1987

[Determination of normal values in the assessment of measurements and side differences in the ultrasonic study of the shoulder joint].

Sonography of the rotator cuff with measurement of relevant soft tissue structures was performed in 120 persons without evidence of shoulder pathology. Although the extension of all structures varied markedly, no significant differences were found on comparing both sides. However, with regard to the variability of side differences, a limited side difference must be accepted as a normal finding. Sex, age and other body-related variables did not correlate well and were not useful in the assessment of the dimension of rotator cuff structures.

Adult↗
PubMed1984

[Changes in serum carboxypeptidase N in patients with lung sarcoidosis].

Serum carboxypeptidases N (E.C.3.4.17.3) were determined spectrophotometrically in 39 patients with untreated pulmonary sarcoidosis (radiographic stages I-II). Carboxypeptidases N were, due to variable substrate affinity, subdivided into N1 (CN1) and N2 (CN2). The control group consisted of 52 healthy persons. In addition, haemodynamics, chemical pathology, and lung function tests were evaluated. Among controls both CN1 and CN2 were slightly increased in females when compared to males. Patients with pulmonary sarcoidosis had significantly higher CN1 and CN2 activities (P less than 0.005) than the control group. Neither among healthy probands nor among patients with sarcoidosis were there positive correlations between haemodynamics, chemical pathology and lung function data on the one hand and CN1 and CN2 on the other. However, a linear correlation between CN1 and CN2 could be established in both groups (P less than 0.001).

Adult↗
PubMed2001

Occult laryngeal pathology in a community-based cohort.

BACKGROUND: Little information is available regarding the prevalence of laryngeal pathology in adults. PURPOSE: To estimate the prevalence of occult laryngeal pathology in a community-based cohort of adults over 40 years of age. METHODS: One hundred consecutive volunteers over age 40 with no history of voice disorders were enrolled. All completed a self-administered laryngeal symptom questionnaire and underwent a comprehensive head and neck examination including transnasal fiberoptic laryngoscopy. RESULTS: The mean age of the cohort was 61 years. Vocal fold bowing (presbylaryngis) was present in 72% of the patients, and findings of laryngopharyngeal reflux were present in 64% of the cohort. In addition, other laryngeal pathology were identified in 21%. Only 12% had a completely normal laryngeal examination. CONCLUSIONS: Occult laryngeal pathology is very common in persons over 40. Findings suggestive of laryngopharyngeal reflux are present in 64%, and vocal fold bowing is present in 72% of persons over 40.

Adult↗
PubMed2006

Quantitative analysis of Kaposi sarcoma-associated herpesvirus (KSHV) in KSHV-associated diseases.

BACKGROUND: Accurate numbers of copies of Kaposi sarcoma-associated herpesvirus (KSHV) and numbers of virus-infected cells in lesions caused by KSHV-associated diseases are unknown. METHODS: Quantitative polymerase chain reaction (PCR) and computerized imaging of immunohistochemical analysis were performed on pathologic sections of samples from persons with KSHV-associated diseases. RESULTS: Real-time PCR and semiquantitative PCR-Southern blotting demonstrated that DNA extracted from biopsy samples of KS lesions contained approximately 1-2 viral copies/cell. KSHV-associated lymphoma contained 10-50 viral copies/cell. Computerized-image analysis demonstrated that approximately 49% of cells expressed KSHV-encoded latency-associated nuclear antigen in KS biopsy samples. On the basis of results of real-time PCR and computerized-image analysis, the predicted number of viral copies was 3.2 viral copies/cell in KS lesions. Computerized-image analysis also revealed that the expression of open-reading frame (ORF)-50 protein, an immediate early protein of KSHV, was very rare in KS lesions, which implies that they were mainly composed of proliferating cells latently infected with KSHV. In multicentric Castleman disease lesions, 25% of virus-infected cells expressed ORF50 protein, which suggests the frequent lytic replication of KSHV. CONCLUSIONS: Numbers of viral copies and of virus-positive cells vary among KSHV-associated diseases, which suggests different mechanisms of viral pathogenesis. The combination of real-time PCR and computerized-image analysis provides a useful tool for the assessment of the number of viral copies in KSHV-associated diseases.

Herpesviridae Infections↗
PubMed1993

Psychological distress, problem behaviors, and family functioning of sexually abused adolescent inpatients.

OBJECTIVE: By studying children and adolescents who have been sexually abused, improvements in identifying and treating emerging pathology can be gleaned before personality structures become more rigidly defined and less amenable to therapeutic interventions. It is through studying and comparing subgroups of victims and controls that clinical researchers can additionally elucidate abuse-related manifestations that contribute to the development of psychopathology. METHOD: A group of sexually abused adolescent psychiatric inpatients was compared with a control group of inpatient counterparts on measures of social competence, self-esteem, depression, substance abuse, and perceptions of family characteristics and functioning. Consecutive admissions to an adolescent inpatient psychiatric unit (N = 423) were carefully screened for a history of sexual abuse, then divided into two groups, each with 87 subjects, after matching on key variables including age, race, gender, socioeconomic status, and psychiatric diagnosis. RESULTS: Sexually abused and control group inpatient adolescents were similar on standardized measures of psychological distress and family functioning. Statistically significant differences were found between groups on substance abuse measures. CONCLUSION: The phenomenology of the relationship between sexual abuse and substance abuse and the implications for inpatient treatment are summarized.

Adolescent↗
PubMed2002

Treatment of compulsive sexual behaviour with naltrexone and serotonin reuptake inhibitors: two case studies.

Although there is no universally accepted definition of compulsive sexual behaviour (CSB), the term is generally used to indicate excessive sexual behaviour or sexual cognitions that lead to subjective distress, social or occupational impairment, or legal and financial consequences. Similar to impulse control disorders, CSB is characterized by a failure to resist the impulse for sex. Opioid antagonists have been effective in treating urge-driven disorders, such as pathological gambling disorder, alcoholism, borderline personality disorder with self-injurious behaviour, cocaine abuse, mental retardation with self-injurious behaviour and eating disorders. Based upon the efficacy of opioid antagonists in treating disorders associated with urges, we hypothesized that naltrexone would reduce both the urges associated with CSB and therefore reduce the sexual behaviour. We present two case reports of individuals with CSB treated successfully with naltrexone, a novel treatment for CSB. In both cases, symptoms dramatically decreased and psychosocial functioning improved with the use of naltrexone. Although more research is needed to determine the mechanism that leads to the excessive sexual behaviour in individuals with CSB, the present case reports suggest that naltrexone may be effective in treating some cases of CSB.

Adult↗
PubMed1990

Detection of a human intracisternal A-type retroviral particle antigenically related to HIV.

Sjögren's syndrome is an autoimmune disease that is characterized by dryness of the mouth and eyes. The loss of salivary and lacrimal gland function is accompanied by lymphocytic infiltration. Because similar symptoms and glandular pathology are observed in certain persons infected with human immunodeficiency virus (HIV), a search was initiated for a possible retroviral etiology in this syndrome. A human intracisternal A-type retroviral particle that is antigenically related to HIV was detected in lymphoblastoid cells exposed to homogenates of salivary tissue from patients with Sjögren's syndrome. Comparison of this retroviral particle to HIV indicates that they are distinguishable by several ultrastructural, physical, and enzymatic criteria.

Centrifugation, Density Gradient↗
PubMed1994

The circumscribed focus in intensive brief dynamic psychotherapy.

The clinical proposition that an ideal focus for intensive brief dynamic psychotherapy is an intra-psychic conflict rooted in oedipal pathology with circumscribed effects on personality functioning has been widely accepted a priori, without empirical validation. In this study 4 clinical raters assessed the 'degree of circumscribed conflict' and 'hypothesized psychosexual development level' from a dynamic evaluation interview. The variables were only marginally associated with DSM-III diagnoses. Within a subsample of 22 patients treated with intensive psychoanalytic technique, patients with whom a highly circumscribed conflict could be identified had the most favourable dynamic change 4 years after therapy.

Adult↗
PubMed1996

Psychiatry's culture.

Culture remains an ambiguous concept for psychiatry: deprecated by the assumption that it is secondary to biomedical reality, yet at the same time some notion of 'culture' has served to represent the modern against the primitive. Contemporary clinical understandings of culture derive from imperial medicine which had applied the accepted distinction between the biological form and the cultural content of psychopathology to local illnesses which could not easily be fitted into the European nosology. The later concept of culture-bound pathology, like the psychoanalysts' 'modal personality', only imperfectly escaped from evaluative assumptions of 'development', but it is difficult to argue that psychiatry provided British colonial administrations with any significant ideological justification.

Biological Psychiatry↗
PubMed2004

Reduced brain size and gyrification in the brains of dyslexic patients.

Dyslexia is a specific learning disability that affects the way in which a person acquires reading skills. The pathologic substrate of the condition has been debated in the literature. Conclusions from postmortem studies remain controversial because series have been based on few and often ill-characterized cases. The present article expands on one of the reported neuropathologic findings in dyslexia, that is, wider minicolumns. Measurements were made of magnetic resonance images in a series of 16 dyslexic and 14 age- and sex-matched controls. Dyslexic patients had significantly smaller total cerebral volume (P = .014) and reduced gyrification index (P = .021). No changes were noted in cortical thickness, the ratio of gray to white matter, or the cross-sectional areas of the corpus callosum and medulla oblongata. The findings, although not conclusive, are in keeping with a minicolumnar defect in dyslexia. The decreased gyrification and preserved cortical thickness can alter the information processing capacity of the brain by providing a greater degree of cortical integration at the expense of a slower response time. The article also emphasizes the contrast between findings in dyslexia and in autism.

Adolescent↗
PubMed1992

Parental idealization and the absence of Rorschach oral imagery.

Although the attitudes, behaviors, and pathologies associated with the oral personality have been examined extensively and are well-described (Masling, 1986), the absence of Rorschach oral imagery has not been studied. Based on previous research, we hypothesized that undergraduate subjects who do not provide any oral responses idealize at least one of their parents. This hypothesis was tested by asking subjects to describe their parents (Blatt, Wein, Chevron, & Quilan, 1979). Indeed, subjects who do not report perceiving any Rorschach oral imagery are more likely than subjects who do report oral imagery to engage in parental idealization. The results are discussed in the context of previous research on dependency and attachment.

Journal Article↗
PubMed1990

MMPI subtle-obvious scales and malingering: clinical versus simulated scores.

Subtle-obvious scale discrepancies on the Minnesota Multiphasic Personality Inventory were compared for pathology simulators and clinical groups to test the hypothesis that subtle-obvious scores help differentiate simulators. Total obvious minus subtle T score discrepancy greater than 100 discriminated the student malingerers and produced few false positives among clinical populations such as psychiatric inpatients and outpatients. The hypothesis that these clinical patients score high on these indices of malingering as a baserate or as a cry for help was rejected. These data suggest that there are differences between simulators and clinical patients, which are detectable by use of subtle-obvious scores, and that this procedure bears further exploration.

Adult↗
PubMed2002

Comorbid mental disorders among the patients with alcohol abuse and dependence in Korea.

This study investigated the patterns of alcohol disorder comorbidity with other psychiatric disorders, using Korean nationwide epidemiological data. By two-stage cluster sampling, 5,176 adult household residents of Korea were interviewed using the Korean version of the Diagnostic Interview Schedule. Psychiatric disorders strongly associated with alcohol disorders were, other drug abuse or dependence, major depression, simple phobia, antisocial personality disorder, tobacco dependence, and pathological gambling. Male alcoholics had a tendency to begin with tobacco dependence, and some male pathological gamblers first had alcohol disorders. The presence of comorbid psychiatric disorders was associated with a more severe form and the later onset of alcohol disorders, and associated with help-seeking for alcohol abuse/dependence.

Adolescent↗
PubMed1999

New on-line parameters for analysis of dynamic foot pressures in neuropathic feet of Hansen's disease subjects.

Pressures on the foot during walking are affected by the weight of the person and the walking velocity. It is also found that both the magnitude and duration of the dynamic foot pressures are important in ulcer formation in the neuropathic feet of persons with Hansen's disease (HD). Therefore, new parameters, Normalized Peak Pressure (NPP) and Pressure Contact Ratio (PCR), are calculated from dynamic foot pressure data in 10 defined areas of the feet of 52 nonimpaired controls and 108 persons with HD with different pathologies, using a long barograph that could accommodate at least two foot prints in one walking cycle. Statistical study of these new parameters, for various classes of HD subjects, shows significantly different mean values in the foot areas and hence could aid the clinician in better diagnosis and therapy planning. The second part of the article deals with on-line calculations and gray scale display of these parameter transforms for all the points on the plantar surfaces of both feet in a way that could help the clinician in quick analysis and better management and care of neuropathic feet.

Body Weight↗