The contribution of epidemiology to psychosomatic medicine

The G1 glycoprotein of California encephalitis (CE) virus plays a critical role in the infection of mosquito and mammalian cells. We found that CE virus enters baby hamster kidney (BHK-21) and Aedes albopictus (C6/36) cells by the endocytic pathway. Ammonium chloride, a lysosomotropic amine that prevents release of virus from endosomes, inhibited infection of both cell types when added within 10 min after viral adsorption. In addition, infected cells formed polykaryons when the extracellular pH was lowered to 6.3; optimal fusion occurred at pH 5.8 and 6.0 (C6/36 and BHK-21 cells, respectively). Two neutralizing G1 MAba, 6D5.5 and 7D4.5, inhibited low pH-induced syncytia formation without affecting viral attachment, suggesting a role for G1 in viral entry. Since viral fusion proteins have been demonstrated to undergo conformational changes at low pH, acid-induced changes in G1 and G2 were assessed. While both G1 and G2 demonstrated low pH-induced alterations in detergent binding, only G1 displayed an altered protease cleavage pattern at the fusion pH. These results indicate that the G1 protein of CE virus undergoes conformational changes necessary for low pH-mediated entry into both mosquito and mammalian cells.     

The mind-body connection

People who took part in the Chernobyl accident cleanup have been registered upon their return to Kyrgyzstan since 1991, and their children since 1992. Later, citizens affected by the Semipalatinsk and Chelyabinsk contamination incidents were included for registration and health care purposes. The effects of the nuclear waste depositories in the Mailuu-Suu region were examined with the assistance of the Kansas University Medical Center (United States of America). All these investigations of affected people indicate apparent increases in a number of symptoms and illnesses when compared to the rest of the population. Sample sizes ranged from several hundred to several thousand. Above-normal radiation levels and/or the stress and fear of living in contaminated area can lead to significant increases in nervous disorders, cardiovascular diseases and other problems. The most significant increase was in the suicide rate.     

Psychological aspects of mind-body medicine: promises and pitfalls from research with cancer patients

Research in psychosocial oncology has grown considerably. In this article, psychological interventions for cancer patients are reviewed. The following four areas are examined: (1) adjustment and quality of life, (2) symptom control, (3) immune function, and (4) disease progression. In each area, psychosocial dimensions of risk and resilience, the efficacy of current interventions, and the trajectory of future developments are considered.     

"Sociosomatics": the contributions of anthropology to psychosomatic medicine

We report an unusual case of T 0 N 2 M 0 small cell lung cancer in a patient with Lambert-Eaton myasthenic syndrome (LEMS). A 52-year-old man began to notice muscle weakness in a left limb in January 1996, which was followed by muscle weakness in his left arm and fingers, appetite loss, and general fatigue. An electromyogram (EMG) showed the waxing phenomenon in response to high-frequency repetitive stimulation. Lambest-Eaton myasthenic syndrome was diagnosed, based on his symptoms and EMG findings. Chest computed tomography (CT) was done, and left paratracheal, tracheobronchial, subaortic, and hilar lymphadenopathy were found. No mass was seen in either lung field. Cytologic examination of the sputum and bronchial lavage fluid were done, but no malignant cells were found Small cell lung cancer was diagnosed after thoracoscopic resection of the subaortic lymph nodes. No metastases were detected by bone scintigraphy, abdominal CT, or magnetic resonance imaging of the brain. Complete response and resolution of symptoms were obtained by chemotherapy and irradiation.     

Planning and implementation of research projects in psychosomatic medicine

Based on experiences of the author in planning and realization of scientific studies the different phases and steps of research process are discussed. Especially in the phases of reflecting and planning of a study, a lot of essential preliminary tasks are quite often missed. Failures in these initial phases of a scientific study lead to difficulties in collecting and evaluating of data. Important steps in the different phases of a project are reported in an overview. Finally some typical failures and faults in psychosomatic research made by physicians and social scientists are mentioned.     

The foundations of allergy

This article discusses the immune system in relation to allergy. The importance of the role of the nurse in identifying and referring patients who have the most common allergic diseases is also emphasised.     

Artificial neural network and medicine

The introduction of human brain functions such as perception and cognition into the computer has been made possible by the use of Artificial Neural Network (ANN). ANN are computer models inspired by the structure and behavior of neurons. Like the brain, ANN can recognize patterns, manage data and most significantly, learn. This learning ability, not seen in other computer models simulating human intelligence, constantly improves its functional accuracy as it keeps on performing. Experience is as important for an ANN as it is for man. It is being increasingly used to supplement and even (may be) replace experts, in medicine. However, there is still scope for improvement in some areas. Its ability to classify and interpret various forms of medical data comes as a helping hand to clinical decision making in both diagnosis and treatment. Treatment planning in medicine, radiotherapy, rehabilitation, etc. is being done using ANN. Morbidity and mortality prediction by ANN in different medical situations can be very helpful for hospital management. ANN has a promising future in fundamental research, medical education and surgical robotics.     

The psychophysiology of confession: Linking inhibitory and psychosomatic processes.

We investigated the short-term autonomic correlates of disclosing personal and traumatic experiences among two samples of healthy undergraduates. In Experiment 1, subjects talked into a tape recorder about extremely stressful events that had occurred in their lives, as well as what they planned to do following the experiment. Skin conductance, blood pressure, and heart rate were continuously measured. Based on judges' ratings of subjects' depth of disclosure, subjects were classified as high or low disclosers. Talking about traumatic events was associated with decreased behavioral inhibition, as measured by lower skin conductance levels among high disclosers. Disclosing traumatic material was also associated with increased cardiovascular activity. In Experiment 2, subjects both talked aloud and thought about a traumatic event and about plans for the day. Half of the subjects were alone in an experimental cubicle and talked into a tape recorder; the remaining subjects talked to a silent "confessor" who sat behind a curtain. Among high disclosers, both talking and thinking about traumatic events produced lower skin conductance levels than did thinking or talking about plans for the day. The presence of a confessor inhibited subjects' talking. Implications for understanding the nature of confession and the development of an inhibitory model for psychosomatic processes are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Organic unity theory: an integrative mind-body theory for psychiatry

The potential of psychiatry as an integrative science has been impeded by an internal schism that derives from the duality of mental and physical. Organic unity theory is proposed as a conceptual framework that brings together the terms of the mind-body duality in one coherent perspective. Organic unity theory is braided of three strands: identity, which describes the relationship between mentally described events and corresponding physically described events; continuity, which describes the linguistic-conceptual system that contains both mental and physical terms; and dialectic, which describes the relationship between the empirical way of knowing that is associated with the physical domain of the linguistic-conceptual system and the hermeneutic way of knowing that is associated with the mental domain. Each strand represents an integrative formulation that resolves an aspect of mental-physical dualism into an underlying unity. After the theory is presented, its implications for psychiatry are briefly considered.     

The foundations of literacy: learning the sounds of letters

Learning the sounds of letters is an important part of learning to read and spell. To explore the factors that make some letter-sound correspondences easier for children to learn than others, we first analyzed knowledge of letters' sounds (and names) by 660 children between 3 1/2 and 7 1/2 years old. A second study examined pre-schoolers' (M age 4 years, 11 months) ability to learn various sound-letter mappings. Together, the results show that an important determinant of letter-sound knowledge is whether the sound occurs in the name of the letter and, if so, whether it is at the beginning or the end. The properties of the sound itself (consonant versus vowel, sonorant versus obstruent, stop versus continuant) appear to have little or no influence on children's learning of basic letter-sound correspondences. The findings show that children use their knowledge of letters' names when learning the letters' sounds rather than memorizing letter-sound correspondences as arbitrary pairings.     

The foundations of professional psychology.

Three problems that constitute significant impediments to the growth and development of professional psychology are outlined: the lack of (1) a single definition of the profession and its scope, (2) a uniform general education process for new professionals, and (3) a single, unambiguous professional credential. Possible solutions are proposed for each of these problems. (17 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Philosophical foundations of psychological theories: The issue of synthesis.

Examines 3 prototypical psychological perspectives represented by psychoanalysis, humanistic psychology, and behaviorism in light of their parallel philosophical world views (idealism, interactionism, and empiricism). It is suggested that both strengths and limitations are inherent in these philosophical bases. At present, incompatibility in these methodological commitments prevents true synthesis in either philosophy or psychology. The strength of psychological pluralism is stressed: Endorsing pluralism permits retention of all major content areas commonly viewed as part of psychology and appears to be the most intellectually responsible course. Four essential characteristics of pluralistic psychology are outlined. (38 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Common whiplash: psychosomatic or somatopsychic?

We have previously demonstrated that gamma/delta T lymphocytes may participate in the host immune response against lung adenocarcinomas. Here we show that, in about one-fourth of human lung cancers, gamma/delta T cells represented a significant proportion of freshly isolated tumor-infiltrating lymphocytes. Moreover, these cells selectively expand in vitro upon culture in the presence of IL-2, thus suggesting a prior activation in vivo. Finally, when we evaluated the expression of heat shock proteins and of a panel of tumor-associated antigens in lung cancers infiltrated by gamma/delta vs. alpha/beta T cells, we found that the former displayed a distinct antigenic pattern, characterized by over-expression of HSP72 and of the 67-kDa high-affinity laminin receptor, which might account for gamma/delta T-cell recognition.     

The analytic environment in times of bodily dysfunction: The effect of psychoanalytic psychosomatic theories.

This article examines the analytic environment in which psychoanalytic work occurs when patients struggle with complex somatic experiences, such as disease or physiological dysfunction. Patients express fantasies and beliefs about the etiology of their somatic experiences; they elaborate theories about why infertility, irritable bowel disease, or some other disease, syndrome, or crisis is happening to them. I consider these to be patients’ multiply determined, fantasy-saturated psychosomatic theories, and suggest that the analyst’s understanding of patients’ ideas about their somatic experiences is organized by the analyst’s both articulated and not articulated psychosomatic theories. Using brief clinical vignettes, I highlight the potentially constricting effect of clinicians’ theories on their analyses of patients’ psychosomatic theories. I examine psychoanalytic theories of psychosomatics, suggesting that adherence to the theories we have, which often posit linear psychogenesis of somatic phenomena, can result in collusion with, rather than analysis of, the psychic stances reflected by patients’ theories. To address the problematic adherence to our theories, and characterize a less constricting clinical and theoretical stance, I critique aspects of the theories and suggest directions for replenishing them. (PsycINFO Database Record (c) 2010 APA, all rights reserved)