ABSTRACT
We present a patient with dissociative identity disorder (DID) who after 15 years of diagnosed cortical blindness gradually regained sight during psychotherapeutic treatment. At first only a few personality states regained vision, whereas others remained blind. This was confirmed by electrophysiological measurement, in which visual evoked potentials (VEP) were absent in the blind personality states but normal and stable in the seeing states. The switch between these states could happen momentarily. As a neural basis of such psychogenic blindness, we assume a top-down modulation of activity in the primary visual pathway, possibly at the level of the thalamus or the primary visual cortex. Therefore VEPs do not allow distinction of psychogenic blindness from organic disruption of the visual pathway. In summary, psychogenic blindness seems to suppress visual information at an early neural stage.
Subject(s)
Blindness/physiopathology , Blindness/psychology , Dissociative Identity Disorder/physiopathology , Dissociative Identity Disorder/psychology , Psychophysiologic Disorders/physiopathology , Psychophysiologic Disorders/psychology , Visual Perception , Adult , Blindness/diagnosis , Dissociative Identity Disorder/diagnosis , Female , Humans , Psychophysiologic Disorders/diagnosisABSTRACT
Pericentral and periportal hepatocytes differ in their capacity to eliminate and velocity of eliminating bile acids and other organic anions. We wonder whether differences in the distribution of anion transporters (ntcp [M77479], besp [NM_031760], mrp2 [NM_012833], oatp1 [NM_017111], oatp2 [NM_131906]) cause the differences in bile acid excretion. Therefore, we analyzed the distribution of these anion transporters in periportal and pericentral cells by immunohistology, their mRNA by quantitative PCR, and regulating nuclear factors (NF-kappaB, HNF1, HNF3, HNF4, FXR, PXR) by gel shift assay. We did not find any differences in nuclear factors or regarding the proteins that could explain the zonal differences in anion transport.
Subject(s)
Bile Acids and Salts/metabolism , Hepatocyte Nuclear Factors/metabolism , Hepatocytes/metabolism , Organic Anion Transporters/metabolism , Animals , Bile Acids and Salts/analysis , Biological Transport/physiology , Cells, Cultured/cytology , Female , Glutathione Synthase/metabolism , Hepatocyte Nuclear Factors/analysis , Immunohistochemistry , Male , Models, Animal , Organic Anion Transporters/analysis , Polymerase Chain Reaction/methods , RNA, Messenger/analysis , Rats , Rats, Sprague-Dawley , Sensitivity and SpecificityABSTRACT
With this comes the question: Are there typical relationship patterns and affects, that appear in physicians experience of their relationships to patients with different illnesses? We asked 33 physicians about impressive experiences with one AIDS-, one cancer- and one metabolic disorder patient each. The narratives we received were evaluated with two contentanalytic methods. The relationship patterns were assessed by the Core Conflictual Relationship Theme (CCRT), developed by Luborsky. The affects were assessed by the Gottschalk-Gleser Content Analysis Scales. We found some significant differences between the relationship experience with AIDS- and cancer patients on the one hand, and metabolic disorder patients on the other hand. In relationships with critical ill AIDS- and cancer patients the physicians verbalize more death anxiety and more diffuse or nonspecific anxiety. Furthermore they show more covert hostility against the AIDS- and cancer patient, whereas they verbalize more overt hostility against the metabolic disorder patients. We found also some fine distinction between the relationship experiences with AIDS-patients on the one hand and cancer patients on the other hand. The physicians get more involved with the relationships to AIDS-patients and the closeness-distance-regulation seems to be one central issue in this relationships.
Subject(s)
Acquired Immunodeficiency Syndrome/psychology , Affect , Attitude of Health Personnel , Metabolic Diseases/psychology , Neoplasms/psychology , Physician-Patient Relations , Adult , Female , Hostility , Humans , Male , Middle Aged , Patient Compliance/psychology , Patient Participation/psychology , Personality Assessment , Sick RoleABSTRACT
In the state-run health office in Ulm a survey of the frequency of anonymous HIV-antibody tests was taken between 1985 to 1991, of the age and gender representation from 1988 to 1991, of the test motives from 1.1.1990 to 1.3.1991. The result was a regressive trend following the test boom of 1987 and 1988, which is becoming more and more stable. The relation of men and women has been amounting to 6:4 in the last four years; the proportion of women receding slightly but constantly. The main motive of being tested was finding out about a high-risk or potentially high-risk sexual contact, mostly at the beginning of a new partnership. The motive ranking second in frequency was the investigation of the consequences of blood exposure, mostly relating to medical work. The third place was taken by irrational anxieties as a test motive. The article discusses the fact that test at the beginning of a new partnership frequently have the meaning of a sacrifice and a symbol of bondage in combination with a vow to be faithful. In case of irrational anxieties about AIDS the test-counsellor gets a chance to diagnose a possibly neurotic development at a very early stage, so that painful and expensive chronification and generalisation could be stopped or eased.
Subject(s)
AIDS Serodiagnosis/statistics & numerical data , HIV Infections/epidemiology , Sick Role , Adult , Age Factors , Cross-Sectional Studies , Female , Germany/epidemiology , HIV Infections/psychology , HIV Infections/transmission , Health Knowledge, Attitudes, Practice , Humans , Incidence , Male , Sex FactorsABSTRACT
Caring for people with AIDS physicians and nurses are confronted with special problems. Compared to other severe illnesses there are specific problems in the relationship between doctors and nurses with their patients due to the similarity in age, the risk of infection and that most of the patients belong to stigmatized, marginal groups, that represent despised and threatening impulses (homosexu-ality, promiscuity, addiction). The results of our survey of 85 physicians and 111 nurses suggest, that physicians and nurses react with a typically professional attitude concerning the identification with AIDS-patients. The "concordant identification", that is induced by the same age of many AIDS-patients, is followed by a "complementary identification" with the professional role that serves as a defence and helps in coping with threatening internal conflicts. Wherein physicians have a mainly neutral attitude and delegate their feelings to the nurses, nurses show an unlimited commitment for AIDS-patients delegating their aggressive reactions to the physicians.
Subject(s)
Acquired Immunodeficiency Syndrome/psychology , Attitude of Health Personnel , Nurse-Patient Relations , Physician-Patient Relations , Sick Role , Acquired Immunodeficiency Syndrome/transmission , Adult , Female , Humans , Life Style , Male , Middle Aged , Risk FactorsABSTRACT
Qualitative salmonella investigations and E. coli titre determinations were carried out in about 4,000 water samples taken from the coastal region of Kiel Bight (Western Baltic) in 1972 and 1973, and evaluated in connection with epidemiological data. Further, about 100 samples were determined quantitatively by the MPN method and set in relation to the E. coli titre. The significance to be attributed to positive salmonella findings particularly in relation to the assessment of risk of infection and as impurity indicators was investigated with reference to this material. A comparison of salmonella findings and E. coli titre showed that with increasing E. coli contamination the proportion of positive salmonella findings also increased (paraboloid curve). Salmonella frequencies and the frequency with which the limiting values of the E. coli titre is exceeded run approximately parallel; the frequency of exceeding a limiting value of E. coli titre of 1.0 and the frequency of salmonella (determination in 100 ml) in sewage laden areas largely coincide. The quantitative salmonella investigations (MPN method) also showed that up to an E. coli titre of 1.0 extremely low salmonella counts only are to be expected (on the average, less than 2/100 ml). With an E. coli titre of 0.1, a marked increase can be seen. A limiting value of 1.0 is proposed for the E. coli titre in coastal waters. Epidemiological data have also shown that an increased risk of infection could not be deduced from positive salmonella findings. According to the present investigations, the value of the information obtained from salmonella findings is small compared with the E. coli titre. Considering the great expense of laboratory investigations, tests for salmonella should be dispensed with in routine examination of water.
