Research perspectives on psychotherapy with borderline patients.

Outlines psychotherapeutic implications of previous research findings on the borderline diagnosis and subgroups of borderline patients. Developmental patterns of object relations in neurotic, borderline, and schizophrenic patients are examined. It is suggested that when Rorschach records for these psychiatric groups were scored for differentiation, articulation, integration, content, and accuracy, an ideal database for assessing an individual's representational world was developed. Findings of significant differences in the developmental level of the concept of the object, the quality of reality testing, and regressive potential that successfully distinguished hospitalized from nonhospitalized borderline patients suggest that the borderline diagnosis may be conceptualized along a continuum of severity. Case illustrations are included, involving a 17-yr-old female presenting with depression and suicidal ideation and a 36-yr-old female who felt she had been fated by her father's death. (49 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The stress in ion-plated HfN and TiN coatings

The X-ray diffraction sin²ψ method was used to determine the state of stress in HfN and TiN coatings made by ion plating onto various substrates. Some subsidiary measurements on chemically vapour-deposited coatings are also included. In many cases the results show deviations from the simple linear behaviour: examples of both curvature (stress gradients perpendicular to the surface) and ψ splitting (shear stress effects) are found. Both the chemically vapour-deposited samples show the latter effect together with compressive and tensile stresses in the HfN and TiN coatings respectively in the plane of the coating. The ion-plated coatings are all under compressive stress. On stainless steel the stress level is high owing to a change in the stress distribution in the steel during the ion plating process. The stress in the coatings on cemented carbide and high speed steel, which should be unaffected by the coating process, falls as the coating thickness increases; this appears to be related to a microstructural change in the coating.     

Nerve growth factor receptor-like immunoreactivity in the human spinal cord

Nerve growth factor (NGF) receptor-like immunoreactivity has been demonstrated in the normal human adult spinal cord using the monoclonal antibody ME20.4. Intense immunoreactivity was associated with fibres and terminals in the substantia gelatinosa. In lamina IX the neuropil demonstrated punctate staining, the motor neurons themselves being negative. At thoracic levels occasional neurons of the intermediolateral column cell group were NGF receptor positive. Fine axonal and punctate terminal reactivity was observed in the gracile fasciculus, corresponding to axons in transverse section. Similar, though slightly less dense immunoreactivity was observed in the cuneate fasciculus. The demonstration of NGF receptor immunoreactivity may provide a useful marker of sensory innervation in the human spinal cord.     

Expression of microfibrillar proteins by bovine bladder urothelium

OBJECTIVE: To compare hydrodynamic characteristics of a new bileaflet heart valve, the CarboMedics kinetic cardiac valve prosthesis, with those of a St. Jude Medical (SJM) heart valve. METHODS: Hydrodynamic characteristics were determined in the mitral and aortic positions of a Vivitro Systems pulse duplicator for size 23 Kinetic aortic values, size 23 SJM aortic valves, size 29 Kinetic mitral valves and size 29 SJM mitral valves. Test conditions were 72 beats per min with cardiac outputs of 2, 5 and 7 l/min. Values of forward flow pressure drop (delta P), regurgitant and energy loss were determined for each valve. The test results for the two valve designs were compared by valve size. RESULTS: The test results show that both the size 23 and size 29 Kinetic valves have 8-14% lower delta P values and 5-10% greater effective orifice area (EOA) values. The size 29 Kinetic mitral valve has a 1-2 ml lower regurgitant volume, while the size 23 Kinetic aortic valve has a 0.5 ml greater regurgitant volume than the corresponding SJM values. These factors combine to provide a 5-10% lower energy loss for size 23 Kinetic aortic valves and a 15-25% lower energy loss for size 29 Kinetic mitral valves over the cardiac cycle than for corresponding sizes of SJM valves. CONCLUSIONS: The Kinetic valve's fluid dynamics are superior to equivalent sizes of SJM valves. This is especially impressive considering that the tissue annulus diameters for Kinetic valves are approximately 0.5 mm less than equivalent size SJM valves. The primary reasons for the superior hydrodynamic performance of Kinetic valves are (1) the larger orifices which result in lower forward flow delta P values and (2) the opening angles, which have been customized for each valve size to minimize energy loss.     

Role of lipids in development of noninsulin-dependent diabetes mellitus: Lessons learned from pima indians

We studied the role of lipids in the pathogenesis of nonlinsulin-dependent diabetes mellitus (NIDDM) in Pima Indians. High plasma levels of nonesterified fatty acid (NEFA) predicted development of NIDDM, but this effect cannot entirely be explained by the glucose-fatty acid cycle. Dyslipidemia, although often associated with diabetes, did not seem to predict NIDDM, and might rather be associated with or the consequence of insulin resistance. In some individuals, a single amino acid substitution in the intestinal fatty acid binding protein could result, in increased rates of intestinal absorption of dietary NEFA and thereby contribute to increased lipid-oxidation rates and insulin resistance.     

Sumatriptan. An updated review of its use in migraine

Sumatriptan is a selective agonist at serotonin 5-HT1-like receptors, including 5-HT1B/1D subtypes. It is an effective treatment for acute migraine attacks and the injectable form has also shown efficacy in the treatment of cluster headaches. In placebo-controlled clinical trials, sumatriptan, administered subcutaneously, orally, intranasally or rectally was significantly more effective than placebo in relieving migraine headache and in producing resolution or reduction of other symptoms associated with migraine, including nausea, photophobia and phonophobia. Improvements in clinical disability were also significantly greater after sumatriptan than after placebo. Headache recurred in 21 to 57% of patients who received oral or subcutaneous sumatriptan, but most patients responded to a second dose of the drug. Results of comparative trials showed that subcutaneous sumatriptan 6 mg was significantly more effective than either patients' usual antimigraine treatments or intranasal dihydroergotamine mesylate 1 mg in relieving migraine headache. Subcutaneous sumatriptan 6 mg and subcutaneous dihydroergotamine mesylate 1 mg provided similarly effective migraine relief, but the headache recurrence rate was significantly higher after sumatriptan than after this formulation of dihydroergotamine mesylate. Response rates achieved after oral sumatriptan were similar to those reported after treatment with oral naratriptan, rizatriptan or lysine acetylsalicylate plus metoclopramide. Treatment of acute migraine attacks with oral or subcutaneous sumatriptan leads to less loss of workplace productivity than other antimigraine therapies. Several pharmacoeconomic analyses showed that gains in workplace productivity in sumatriptan recipients ranged from 12.1 to 89.8 hours per patient per year. Significant improvements from baseline in overall health-related quality-of-life scores were also experienced by sumatriptan recipients. Sumatriptan is generally well tolerated. Nausea, vomiting, malaise and fatigue are the most common adverse events with oral sumatriptan. Injection site reactions occur in 10 to 40% of patients receiving the drug subcutaneously. A bitter taste at the back of the mouth occurs frequently after intranasal administration. Serious adverse events occur in about 0.14% of patients with migraine treated with sumatriptan. As the drug is associated with the rare development of cardiovascular effects, it is contraindicated in patients with a history of cardiovascular disease. CONCLUSIONS: Despite its relatively high acquisition cost, reductions in lost workplace productivity experienced by patients treated with sumatriptan may result in savings in the overall cost of migraine to society. Thus, sumatriptan is a useful first- or second-line treatment option for patients with moderate or severe migraine.     

Organogenesis: Drosophila goes gonadal

In many animals, germ cells migrate to the gonad to assemble into a functional organ. Recent work in Drosophila has built a picture of the gene activities that specify the gonad and allow it to attract germ cells, and has led to the identification of a gene, columbus, that may encode the attractive factor.     

The subliminal psychodynamic activation method: A critical review.

Research on subliminal psychodynamic activation has generated considerable interest and controversy because of researchers' claims that psychoanalytic hypotheses have been successfully tested experimentally with the use of specially constructed subliminal stimuli. The present review of Silverman's studies in this field reveals internally inconsistent results and few attempts at exact replication; instead, Silverman expanded the applications of the method without carefully establishing the conditions under which results could be reliably obtained. These problems are discussed in the light of methodological weakness present in the entire research program and theoretical concerns regarding (a) the assumption that subliminal generic messages are consistent with psychoanalytic theory about the nature of unconscious conflict and (b) the assumption that subliminal stimuli can activate unconscious conflict. (PsycINFO Database Record (c) 2010 APA, all rights reserved)