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Biomedical subjects

A E Meyer

Publications and source records attributed to A E Meyer.

At least 19 recordsLinked to original sources

Polylactide inhibition of carcinoma cell growth in vitro.

Normal fibroblasts and epithelial tumor cells were challenged by exposure for 24 hours to extracts of a pure metal, a metal alloy, and a polymer used in facial reconstruction to assess cellular growth effects. While none of these materials significantly altered fibroblast growth rates, poly-L-lactide inhibited carcinoma cell growth at 5.0% extract concentration. No carcinoma cell growth effects were seen from exposure to stainless steel or commercially pure titanium extracts.

Antineoplastic Agents

[Results and problems of time series analysis of individual observations in client-centered and psychodynamic brief psychotherapy].

The longitudinal data of five psychotherapies, collected during the Hamburg Short Psychotherapy Comparison Experiment, were statistically reviewed by the method of time series analysis. The intention of the single case studies was to describe the therapist-patient-interactions in details for acquiring greater knowledge of the therapeutical process. The items to study were obtained by ratings. Although there were thirteen nonverbal characteristics of the therapist and the patient as well as one common feature of the relationship between them both. The results did not correspond with the theoretical expectations. There were only few changes in the behaviors of the therapists and the patients and there was little proof of mutual effects in their behaviors during the therapeutical process. Only one of the therapies showed a significant patient's reaction, but it was unexpectedly negativistic. This supports the idea, that the therapist's influence on the patient may not be very strong und may not necessarily be positive. However, there were some severe methodological data problems mainly concerning the applicability of the time series analysis. Nonequidistant measurements as well as the relative shortness of the time series made the validity of the results a topic to be discussed. In dealing with these problems, the necessity of conceptualizing the time structures of psychological processes became evident.

Defense Mechanisms

["The most ill go into psychoanalytic treatment"? Critical comments on an article in Report Psychologie].

Thomas and Schmitz claim that they "deliver a proof for the effectiveness of humanistic methods" (p. 25) with their study. However, they did not or were not able to verify their claim due to several reasons: The authors did not say if and if so to what extent the treatments carried out within the framework of the TK-regulation were treatments using humanistic methods. The validity of the only criterium used by the authors, the average duration of the inability to work, must be questioned. The inferential statistical treatment of the data is insufficient; a non-parametrical evaluation is necessary. Especially missing are personal details concerning the treatment groups (age, sex, occupation, method, duration and frequency of therapy), which are indispensable for a differentiated interpretation. In addition there are numerous formal faults (wrong quotations, mistakes in tables, unclear terms etc.). In view of this criticism we come to the conclusion that the results are to a large degree worthless, at least until several of our objections have been refuted by further information and adequate inferential statistical methods. This study is especially unsuitable to prove a however defined "effectiveness of out-patient psychotherapies", therefore also not suitable to prove the effectiveness of those treatments conducted within the framework of the TK-regulation and especially not suitable to prove the superiority of humanistic methods in comparison with psychoanalytic methods and behavioural therapy.

Ambulatory Care

[Reports and clarification of "critical incidents" as promoting factors in psychotherapy. A process-efficiency study between psychodynamic and client-centered treatment of patients].

Our investigation assays if (i) the patient's thematization of and (ii) the attained degree of psychological clarification of "critical incidents" (sensu Rice & Saperia) covariate with favourable outcomes of psychotherapies. The sample consisted of 16 short psychotherapies (maximum 30 sessions), half of which treated with client centered (= CC) and the other half with psychodynamic (= PT) psychotherapy. These had been classified in a previous investigation (on the basis of questionnaire scores in 5 points in time, covering 12 years) into 8 differing time courses. Significant results are: "Critical incidents" were more often found in PT than in CC, reciprocally "psychological clarification" was higher in CC. In sessions rated "good" and in the 10 "ameliorating" time courses "critical incidents" were more frequent than in their respective countergroup. A crass exception was furnished by the "deteriorating" subgroup's quite high frequencies.

Adaptation, Psychological

Reduced corrosion of CP Ti and Ti-6A1-4V alloy endosseous dental implants after glow-discharge treatment: a preliminary report.

Inductively coupled argon plasma spectroscopic analysis was used to quantify titanium, aluminum, and vanadium corrosion products released by superficial layers of identically shaped commercially pure titanium and Ti-6A1-4V alloy dental implants. Halves of each of two originally sterile groups were analyzed directly from the manufacturer's packaging and the other halves received glow-discharge treatment prior to their corrosion assay. The implants were incubated in pH 3 modified saline solution and were analyzed after 2- and 12-week corrosion periods. Implants treated with glow discharge showed statistically significant reduction in the amounts of corrosion products released, apparently as a result of glow-discharge-produced surface oxides of greater passivity than originally present.

Aluminum

Radiofrequency gas plasma (glow discharge) disinfection of dental operative instruments, including handpieces.

The radiofrequency-stimulated argon gas plasma (glow discharge) technique, already well-known for surface cleaning and activation of adhesion, was investigated for determination of its separate potential for rapid disinfection of dental operative instruments. Disinfection effectiveness was judged from diminished post-treatment recovery of viable organisms from the instruments agitated in saline. Streptococcus salivarius, Bacillus stearothermophilus, and Escherichia coli were used as primary contaminant organisms, dried from gelatin-thickened laboratory cultures onto the instruments and not subjected to any preliminary cleaning steps. Significant disinfection was obtained, with no sensible temperature increases, in under 10 minutes in laboratory apparatus consuming fewer than 5 Watts of power per cycle. Also, clinically used and deliberately-saliva-contaminated high-speed handpieces were gas-discharge-treated, with their resultant rapid disinfection noted by complete suppression of the viability of any transferred natural contaminant organisms within two minutes. With regard to preservation of instrument quality, it was also shown that this low-temperature gas-discharge method provides the noted substantial disinfection without deterioration of sharp edges. Work now in progress suggests that the method can provide cool, rapid, and complete sterilization when hydrogen peroxide vapors are present in the gas plasma used for treatment of instruments first given the normally recommended thorough pre-cleaning.

Argon

Multiple cranial nerve deficits after ethylene glycol poisoning.

We report the cases of two patients who developed cranial nerve palsies after drinking ethylene glycol. A 33-year-old man developed multiple cranial nerve deficits nine days after the ingestion of ethylene glycol in a suicide attempt. Clinical findings included profound bilateral cranial nerve VII palsies and severe dysfunction of cranial nerves IX and X. The neuropathy occurred despite treatment with hemodialysis. The dysphagia completely cleared within two weeks, but at six months a severe bilateral cranial nerve VII dysfunction persisted. A 22-year-old man undergoing hemodialysis for ethylene glycol-induced renal failure developed bilateral cranial nerve VII dysfunction 14 days after ingestion. At a three-month follow-up, the patient demonstrated only moderate functional recovery. The etiology of the cranial nerve deficits is unknown but may be related to oxalate crystal deposition of ethylene glycol-induced pyridoxine dysfunction.

Adult

[Therapy of patients with severe anorexia (summary of a report on a research project)].

From 1981 to 1983 a special project on anorexia nervosa was granted within "Sonderforschungsbereich 115" (Hamburg--West Germany). We want to give a review of those aspects of our studies which led us to a therapeutic concept for severely affected inpatients. Starting in the diagnostic field with problems of motivation and alexithymia we turn to psychodynamic subgroups, mention the studies of endocrinology, the Self-structure and the father-types, continue with epidemiologic studies as a device of interpreting pathologic phenomena. Concerning our therapeutic investigations--basing on a long-term follow-up--we report on therapeutic elements, results, follow-up and a hierarchy in prognostic factors of our in-patient treatment. In a critical survey of the results we finally discuss therapeutic recommendations.

Affective Symptoms

[Common factors in psychotherapy as an explanation for results that are approximately indistinguishable--one more myth in psychotherapy research?].

The fact that the gross outcomes of quite different forms of psychotherapy do not differ accordingly has been attributed to the existence of factors communal to any and every form of psychotherapy. For empirical study this thesis has to be dichotomized: (1) Are there really communal factors? (2) Do these engender communal effects in different therapies? Our empirical investigation of client-centered versus psycho-dynamic short psychotherapy shows that (1) is correct, however, the frequencies of these communal element often differ significantly between the two therapy samples. The results and (2) show that in spite of communality the correlation between a certain process category and an outcome variable regularly only attains significance in one but not the other therapy sample--sometimes they even show contrary signs. Hence the initially described explanation seems to be yet another myth in psychotherapy research. This myth assumes (i) interventions to be "monosubstances" (ii) the "doses" of which can be adequately measured in frequency per time unit and (iii) which shows a monotone relation to outcome.

Adaptation, Psychological

Structural studies of human saliva.

Samples of mixed saliva and of parotid and sublingual/submandibular saliva fractions from four donors were subjected to instantaneous solidification in liquid nitrogen followed by sectioning in a microtome/cryostat. The sections were stained with hematoxylin-eosin, periodic acid-Schiff, Alcian blue, Oil-red-O, or Sudan Black B and then examined at the light-microscopic level. In all the sectioned samples several previously never described features were observed, the most pronounced of which were a loose overall network structure and collections of lipoid droplets often in a loose arrangement. In the mixed saliva sample sections many of the microorganism-like structures were observed in large bunches associated with epithelial cells and densely staining saliva components. The present method was tested in a series of experiments for possible errors.

Adult

Long-term stability of anorexia nervosa treatments: follow-up study of 218 patients.

We are reporting about the stability of n = 218 female in-patient treatments of Anorexia nervosa carried out at the University Clinic at Hamburg-Eppendorf from 1965 to 1979 mainly by a special program: introductory interview (with the family present), in-patient medical treatment (bed-rest, phenothiazines, tube-feeding), strict regimen and addressing the patients' conflict situation. The average interval between the end of therapy and the follow-up examination was 9.8 years. We were able to collect data about 93 per cent (n = 202) of the former patients concerning their somatic, psychological and psychosocial status. Based on these data we could assess 30 patients (14 per cent of our basic sample) as free of symptoms while 84 patients (39 per cent) presented slight symptoms so that 53 per cent of the former patients could exercise their profession without being considerably handicapped and able to keep up a relationship with a partner. On the other hand, 39 patients (18 per cent) still showed marked symptoms at follow-up and with 19 patients (9 per cent) there were manifestations of severe or extreme symptoms. Thirty former patients (14 per cent) had died with the mortality rate distinctly increasing over the years. Possible interpretations of our results and consequences for therapy are presented.

Anorexia Nervosa

[Systems theory solution of the Bieri trilemma. Comments on the comments by E. G. Schmidt on my comments on the body-mind problem in psychosomatic medicine].

E. G. Schmidt criticizes my critique of the wholist-emergentist solution for the mind-body problem. Against my repudiation he proposes an emergentist system theory solution apparently solving the so-called Bieri trilemma. I contend that his solution falsely introduces "psychogenic" causality into the wholist-emergentistic theory.

Arousal

[Verbalization of the therapeutic relationship in focal-psychoanalytic and client-centered psychotherapy. A content analytic study from the Hamburg comparative brief psychotherapy experiment].

The present investigation emerged from the Hamburg Short Psychotherapy Comparison Experiment. Its aim was to compare psychodynamic, conflict-centred, time-limited psychotherapy (PT) to client-centred psychotherapy (CC) with regard to the direct and indirect verbalization of the therapeutic relationship--particularly of transference and resistance--for the purpose of investigating the congruity of theory and practice of the therapists involved. Transcriptions of 28 PT and 21 CC audio-recorded therapies were examined by means of a content analysis catalogue. The following (ascending) rank order in the frequency of verbalization of transference was found: CC-therapists, CC-patients, PT-patients, PT-therapists. The main differences are statistically significant. The contrary approach of the therapists probably conditions the differences found in the patients. Therapists in PT verbalised the occurrence of resistance in a much more frequent manner than their patients did. In CC resistance was verbalised only sporadically. These results confirm that the therapists involved acted in conformity with their respective theory.

Humans

Silicone rubber temporomandibular joint (TMJ) meniscal replacements: postimplant histopathologic and material evaluation.

Medical grade silicone rubber has long been considered a suitable meniscal replacement, but there has been increasing concern about migration of this material into adjacent tissues. The objectives of this study were to determine the definitive composition of tissue-incorporated material which is presumed by light microscopy to be silicone and to identify long term histopathologic sequelae of meniscal replacements. Adult female patients underwent meniscectomy and replacement with silicone rubber (Silastic) implants. After 12 to 18 months, recurrence of symptoms in 8% of these cases led to implant removal with excision of peri-implant fibrous pseudocapsules. Excised tissues, including one preauricular lymph node and implants were submitted for light microscopy, SEM, and energy dispersive x-ray microanalysis (EDX) for the identification of elemental composition, critical surface tension measurement, and internal reflection infrared spectroscopy. EDX revealed prominent peaks for silicon in both pseudocapsular and nodal tissues. Morphologic findings surrounding the long-term implants included foreign body reaction, synovitis, dystrophic calcification, fibrocartilaginous metaplasia, hyalinization, and scarring. Particulate silicone debris induced a pathologic response in the tissues and migrated to nodes. These findings suggest that periodic evaluation be performed over the life of such implants to rule out breakdown under function. These findings should intensify the search for improvements or replacements for silicone rubber as an interpositional material in the temporomandibular joint.

Calcinosis

12-year follow-up study of the Hamburg short psychotherapy experiment: an overview.

In 1971/72 eighty-seven psychoneurotic and psychosomatic patients of the Psychosomatic Outpatient Department at the University Clinic of Hamburg-Eppendorf attained an indication for short-term psychotherapy. Nineteen patients did not accept our offer despite a sufficient prognosis; they form the nontreated control group. The remaining 68 patients were assigned at random to a psychodynamic conflict-centered (n = 34) or to a client-centered therapy (n = 34), each with a maximum of 30 sessions. In spite of this long interval of 12 years we gained information about 82.5% of our patients. The follow-up program consisted of a multidimensional approach to describe the posttreatment development of our patients: psychological tests, self-rating by the patient and assessments by the follow-up interviewer and independent ratings of experts. The efficacy of short psychotherapy is seen in the test scale 'extraversion' for both treatment groups, for 'depression' only for the client-centered therapy; for the psychodynamic therapy there is a tendency for late changes. The clinical ratings show no significant differences between the treatment and the control groups. Sex combination in the therapeutic dyads (i.e. same sex vs. opposite sex) is important for patients' posttherapeutic development.

Conflict, Psychological