Clinical study of the relation of borderline personality disorder to Briquet's syndrome (hysteria), somatization disorder, antisocial personality disorder, and substance abuse disorders

OBJECTIVE: The criteria for borderline personality disorder seem to select patients with very high rates of Briquet's syndrome (hysteria), somatization disorder, antisocial personality disorder, and substance abuse disorders. This study was undertaken to determine whether systematic assessment of patients with borderline personality disorder would reveal characteristic features of that condition which would distinguish it from these other disorders. METHOD: Eighty-seven white female patients (75 in St. Louis and 12 in Milan, Italy) who had borderline personality disorder according to both the DSM-III-R criteria and the Revised Diagnostic Interview for Borderlines were further examined with the DSM-III-R Checklist and the Perley-Guze Hysteria Checklist to determine their patterns of psychiatric comorbidity. RESULTS: Every patient had at least one additional DSM diagnosis. Patients in St. Louis and Milan averaged five and four additional diagnoses, respectively. Eighty-four percent of the patients in St. Louis met criteria for either somatization disorder, Briquet's syndrome, antisocial personality disorder, or substance abuse disorders. Patterns of comorbidity for panic (51%), generalized anxiety disorder (55%), and major depression (87%) in St. Louis were consistent with those in other studies. CONCLUSIONS: The data indicate that the boundaries for the borderline condition are not specific and identify a high percentage of patients with these other disorders. Furthermore, the comorbidity profiles closely resemble the psychiatric profiles of patients with these disorders. If the borderline syndrome is meant to include all of these disorders, its usefulness as a diagnosis is limited. Until the fundamental features of borderline personality disorder that distinguish it from the others are identified, it is recommended that clinicians carefully assess patients for these other diagnoses. Efforts should be made to change the borderline personality disorder criteria by shifting away from overlap with the criteria for the other disorders.     

Free radicals in the origin and clinical manifestation of Down's syndrome

The high level of free radicals and antioxidant protection disbalancing cause the chromosome nondisjunction in meiosis, appearance of trisomy 21 and fetuses with Down's syndrome, age-dependent pathology, of parent's mosaic clone, clinical manifestations of the syndrome, diseases in relatives, recurrent cases of trisomy 21. The comparative analysis of clinical traits of Down's syndrome and pathological changes in families with after-effects of radiation exposure was carried out. The factors causing an increase in the level of free radicals were considered.     

EcoRV-T94V: a mutant restriction endonuclease with an altered substrate specificity towards modified oligodeoxynucleotides

Synthetic oligodeoxynucleotides with single methyl phosphonate (mp) substitutions were used for an analysis of the contribution of phosphate contacts to the recognition of the cleavage site by the restriction endonuclease EcoRV. Only in the last position within the recognition sequence, is the methyl phosphonate substitution tolerated by the enzyme. The wild-type enzyme cleaves the Sp diastereomer of the oligodeoxynucleotide GACGATATmpCGTC and the unmodified sequence with equal rates, whereas the Rp diastereomer is cleaved much more slowly. Inspection of the crystal structure of an EcoRV-DNA complex revealed that the non-bridging oxygen atoms of the phosphodiester bond between the T and C bases are in hydrogen bonding distance of the hydroxyl group of the amino acid Thr94. We therefore tried to engineer a variant of EcoRV that would prefer a methyl phosphonate linkage over a normal phosphodiester bond and produced mutants with amino acid exchanges at position 94. One of them, Thr94Val, shows a dramatically reduced activity towards the unmodified DNA and does not accept the Rp diastereomer, but cleaves the Sp diastereomer with the same rate as wild-type EcoRV. Its selectivity, i.e. the ratio of cleavage rates determined for the unmodified and modified substrates, differs by three orders of magnitude from that of the wild-type enzyme.     

IgE antibody response of smokers, nonsmokers, and "smoke-sensitive" persons to tobacco leaf and smoke antigens

Serum samples from cigarette smokers, nonsmokers, and persons reporting "smoke sensitivity" were tested for IgE antibodies to tobacco leaf and smoke extracts by the radioallergosorbent test. Results indicated that none of the serum samples tested contained detectable IgE antibodies to smoke extracts. Occasionally, serum specimens from smokers or nonsmokers demonstrated reactivity to leaf antigen. The most significant reaction to leaf antigens was detected in serum from one of the 7 smoke-sensitive subjects tested. These results demonstrate that smoking, nonsmoking, and clinical "smoke sensitivity" are not correlated with the presence of IgE antibodies to tobacco leaf or smoke antigen.     

Long-term ovarian and gonadotropin changes in mice exposed to 4-vinylcyclohexene

This study investigated the relationships between 4-vinylcyclohexene-induced follicular destruction, plasma FSH levels, and the development of ovarian preneoplastic changes. Female, 28-day-old, B6C3F1 mice were administered VCH (800 mg/kg/day, ip) or sesame seed oil, ip daily for 30 days. At 30, 60, 120, 240, and 360 days following the beginning of treatment, groups were killed, their ovaries were harvested, and plasma was collected for measurement of FSH. Ovarian weight was less and oocytes contained in preantral follicles were significantly fewer than controls at all time points. Plasma FSH concentrations in VCH-treated animals were increased significantly above controls at 240 d and 360 d. Histologically, there was oocyte loss at all times, whereas at 240 and 360 days, small to medium, irregularly shaped foci of hypertrophic cells were present. In addition, at 360 days 80% of the VCH-treated mice had a 1- to 2-mm, blood-filled cystic structure present in one or both ovaries. These studies indicate that VCH-induced oocyte destruction and follicle loss are associated with increases in plasma FSH, are associated with ovarian failure at 360 days, and are temporally related to ovarian cellular hypertrophy and the formation of blood-filled cystic ovarian structures. These events are possibly related to ovarian neoplasms produced by long-term exposure to VCH.     

Prevention of calcification of tissue valves

In this study an attempt was made to find an optimum method of chemical treatment to prevent the calcification of bioprosthetic heart valves. Bovine pericardium was washed in a 5% sodium chloride solution followed by trypsin (Tr) treatment and was kept in 0.1% glutaraldehyde (GA) with a gradual increase in concentration up to 0.25% GA and finally posttreated with a 4% chitosan (Ch) solution. Fresh, 0.2% GA, 0.625% GA, and sodium chloride-Tr-GA treated pericardial samples were taken for comparative study. Tensile testing showed comparable strength and elongation at the breaking point for all groups. The thermal shrinkage studies indicated merit of the proposed treatment (5% sodium chloride-trypsin-glutaraldehyde treated pericardia with chitosan and without chitosan posttreatment). Collagenase assay showed that all differently treated (GA) materials were equally resistant to collagenase. All samples were implanted subcutaneously in rats for 2, 4, 8, or 12 weeks for calcification study. Morphological and mineral analyses showed complete prevention of calcification in sodium chloride-trypsin-GA-chitosan treated pericardium (Ca was 1.1 +/- 0.27 mg/g, von Kossa 0) at the 12th week of implantation.     

Long-term follow-up in Crohn's disease. Mortality, morbidity, and functional status

BACKGROUND: The purpose of this study was to analyse long-term results of an active approach to surgical treatment of Crohn's disease. METHODS: One hundred and thirty-six patients were studied after first resection for primary Crohn's disease during 1968-77. RESULTS: Mean follow-up was 16.6 years; 18 patients had died (3 of Crohn's disease). Cumulative risk for a second resection was 0.40 (95% confidence interval, 0.29-0.51) at 10 years and 0.45 (0.32-0.58) at 15 years, similar in classical disease and colitis. Cumulative risk of a third and fourth resection was 0.5 at 10 years. Median resected bowel length at the first operation was 8%. After two and three resections the cumulative resection was 23% and 33%, respectively. Of the patients 73% claimed full working capacity and 7% had disability pension. CONCLUSIONS: An active surgical approach in Crohn's disease is associated with low operative mortality and morbidity and good functional results and offers good symptomatic relief.     

The natural killer activity and indices of the interferon status of patients with recurrent genital herpes being treated with ridostin

There are many advantages to the computerization of colour vision tests. However, previous computerized colour vision tests have involved equipment and methods not commonly used in clinical practice. We created computer emulations of the City University Colour Vision Test (CUT), Ishihara plates and American Optical Hardy-Rand-Rittler (AO-HRR) plates using a commonly available 24-bit colour Macintosh computer. Our colour monitor was calibrated to standard display white (D65), and colour plates were imaged with a colour scanner. The computerized colour images were compared with the standard test plates in a sample of 21 subjects with normal colour vision, 10 patients with congenital red-green defect and 1 patient with an acquired mixed colour defect. The computer images of the three tests correlated well with their conventional counterparts on kappa statistic analysis (p < 0.001), for both the colour normal and colour defective groups. We conclude that our computer emulations of the CUT, Ishihara and AO-HRR tests screen subjects with normal colour vision with high specificity and delineate congenital colour defects with a sensitivity comparable to that of their conventional counterparts.     

Dental care of the polymedication patient

With increasing frequency, ambulatory patients maintained on multiple medications are seeking dental care. Because new medications are approved for use each year and new interactions and side effects are regularly exposed for existing medications, it is important to keep current in this area. With the availability of regularly updated computer programs to help analyze accurate patient medication lists, the treatment of the polymedication patient has become much easier. The close, careful attention to patient medications should help prevent medical problems as well as reveal much about the patient's ability to withstand dental procedures.     

Determination of mean energies and impact parameters characteristic of charge-changing reactions

A guinea pig passage-adapted strain of the arena-virus Pichinde (adPIC) is highly virulent in inbred guinea pigs, whereas the related strain PIC3739 is attenuated. Both viruses were macrophage tropic and infected peritoneal, splenic, liver, and alveolar macrophages during experimental Pichinde virus infection. Infection with the virulent strain was associated with unlimited viral replication in the face of exaggerated delayed-type hypersensitivity response, manifested by the macrophage disappearance reaction. Histopathological lesions unique to adPIC-infected guinea pigs included intestinal villus blunting with mucosal infiltration by pyknotic debris-laden macrophages and apoptosis of crypt epithelial cells. Splenic red pulp necrosis was also significantly associated with adPIC infection but not PIC3739 infection. These findings may provide clues to the pathogenesis of a group of poorly understood human viral hemorrhagic fevers.