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Biomedical subjects

F Busch

Publications and source records attributed to F Busch.

At least 19 recordsLinked to original sources

A pilot open trial of brief psychodynamic psychotherapy for panic disorder.

This is a complete report of an open trial of manualized psychodynamic psychotherapy for treatment of panic disorder, Panic-Focused Psychodynamic Psychotherapy (PFPP). Twenty-one patients with PD were entered into a trial of twice-weekly, 24-session treatment. Sixteen of 21 experienced remission of panic and agoraphobia. Treatment completers with depression also experienced remission of depression. Improvements in symptoms and in quality of life were substantial and consistent across all measured areas. Symptomatic gains were maintained over 6 months. This report was prepared specifically to describe 6-month follow-up on these patients. Psychodynamic psychotherapy appears to be a promising nonpharmacological treatment for panic disorder.

Adult↗

Open trial of psychodynamic psychotherapy for panic disorder: a pilot study.

OBJECTIVE: This report contains preliminary data from an open trial of brief psychodynamic psychotherapy for panic disorder. METHOD: Fourteen patients with primary DSM-IV panic disorder completed a 24-session, twice-weekly course of psychodynamic psychotherapy. Other psychiatric treatment was not permitted throughout the 12-week treatment period and the 6-month follow-up. Symptoms were assessed at baseline, treatment termination, and 6-month posttermination follow-up (40 weeks). RESULTS: Statistically significant, clinically meaningful improvements appeared in panic, depression, anxiety, and functional impairment both at treatment termination and at 6-month follow-up. CONCLUSIONS: Psychodynamic monotherapy can be used successfully to retain and treat patients with panic disorder. Psychodynamic interventions warrant further study for patients with panic disorder.

Adult↗

What is a deep interpretation?

Important differences are emerging regarding the place where analysts believe the most meaningful analytic work takes place. One area that highlights these distinct ways of working is the analyst's view of deep interpretations. Models underlying the differing perspectives on this issue are presented, along with an extended clinical example that illustrates the importance of considering, in formulating analytic interventions, the concept of a structured mind. A view of the analytic process that accords the patient's perspective greater privilege is introduced.

Adult↗

Preclinical and clinical studies of a collagen membrane (Bio-Gide).

Membranes are used to guide the repopulation of defects by preferred cells and to achieve a specific healing effect. The collagen membrane studied, Bio-Gide, was developed particularly for periodontal, peri-implant applications or to improve the ossification of bone defects of any origin. Bio-Gide is a bilayer membrane; one compact and smooth layer is covered by a particularly dense film, designed to prevent the invasion of soft tissue in a membrane-protected bone defect. The other, rough side of Bio-Gide must be placed towards the bone defect in order to make bone ingrowth possible. As a prerequisite for its therapeutic use in humans, the collagen matrix must be devoid of major immunogenicity. The immunological response to the membrane material was analysed in rabbits. Later, a clinical prospective study provided information about the bone regeneration effect under the Bio-Gide membrane inserted in six patients selected at random. The immune response to the collagen membrane Bio-Gide and the bone healing was tested in these patients when undergoing oral surgery.

Animals↗

Understanding the patient's use of the method of free association: an ego psychological approach.

While most of our methods of listening have been geared toward unearthing unconscious fantasies, those directed toward the ego's all-inclusive role in effecting the associative process have lagged far behind. It is the thesis of this paper that listening from the perspective of the ego allows the analyst to work more closely with what the patient is ready to understand. Clinical technique, using an ego psychological view, is elaborated, demonstrated, and compared to technique dependent on the reading of signs and symbols of the unconscious.

Adult↗

Long-term outcome of panic disorder treatment. A review of the literature.

This review was designed to provide a detailed analysis of long-term outcome data from treatment studies for panic disorder, with the goal of ascertaining differential efficacy of the available treatments. Studies were included if they were published after 1980 and if follow-up took place at least 6 months after treatment termination. Thirty-one studies were located. A variety of methodological problems were found in these studies, including lack of clarity of diagnosis, lack of clarity in the treatment administered, and inadequately tracked nonstudy treatments during the study and follow-up periods, which limited the information that could be obtained about long-term outcome. Long-term outcome studies that closely track the additional treatments that patients receive are necessary to draw more definitive conclusions about differential treatment efficacy for panic disorder. Available data suggest that there is limited evidence for long-term maintenance of short-term treatment gains in panic disorder patients in the absence of continued treatment.

Agoraphobia↗

The ego and its significance in analytic interventions.

Freud's view of the ego as Januslike, the one component of the psychic system turned toward the external world yet partly unconscious, should have insured its centrality in clinical interventions. However, history and experience do not bear this out. It is argued that a core part of the change process in analysis lies in the modifications that occur in ego functioning, making it necessary to carefully consider the role of the ego in clinical technique. Numerous clinical examples are presented to show the manner and significance of such an approach.

Adult↗

Selective downregulation of rat cardiac beta 1-adrenoceptors by cyclosporine A: prevention by diltiazem or angiotensin-converting enzyme inhibitors.

OBJECTIVES: This study attempted to determine whether long-term treatment with cyclosporine A in rats affects cardiac beta 1-adrenoceptors and whether this can be prevented by angiotensin-converting enzyme inhibitors or calcium-entry blocking agents. BACKGROUND: In the transplanted human heart the density of beta 1-adrenoceptors decreases with time after transplantation, whereas that of beta 2-adrenoceptors does not. Because heart transplant recipients are treated with cyclosporine A, we studied whether administration of cyclosporine A in rats might cause this beta 1-adrenoceptor downregulation. METHODS: We performed two studies. First, we treated groups of 10 male normotensive Wistar rats orally with 30 mg/kg body weight per day of cyclosporine A, 10 mg/kg per day of enalapril and 60 mg/kg per day of diltiazem, alone or in combination, for 6 weeks each. Second, we treated groups of 15 male normotensive Wistar rats orally with 15 mg/kg per day of cyclosporine A and 10 mg/kg per day of lisinopril, alone or in combination, for 6 weeks each. At the end of each treatment regimen, cardiac beta-adrenoceptor density and subtype distribution were assessed by (-)-[125I]iodocyanopindolol binding. RESULTS: Both doses of cyclosporine A caused a significant decrease in cardiac beta 1-adrenoceptor density without affecting beta 2-adrenoceptor density. Although diltiazem and the angiotensin-converting enzyme inhibitors alone did not affect cardiac beta-adrenoceptors, they prevented the cyclosporine A-induced downregulation of beta 1-adrenoceptors. CONCLUSIONS: In normotensive Wistar rats, cyclosporine A causes a significant decrease in cardiac beta 1-adrenoceptors without affecting beta 2-adrenoceptors. This can be prevented by diltiazem or angiotensin-converting enzyme inhibitors. In heart transplant recipients, who undergo long-term treatment with cyclosporine A, there is a very similar beta 1-adrenoceptor down-regulation with time after transplantation. Thus, administration of cyclosporine A may cause these beta-adrenoceptor subtype alterations.

Animals↗

[New possibilities for structural analysis of bone biopsies using microcomputer tomography (muCT)].

The combined histological and microcomputed analysis of human iliac crest biopsies leads to major advances in our understanding of three-dimensional bone architecture. Microcomputed tomography avoids the time-consuming reconstruction and artifacts of serial sections. Furthermore, its high resolution allows the recording of structural differences as low as 10 microns. Thus, three-dimensional analysis in combination with histological evaluation of cellular dynamics facilitates earlier and easier recording of changes of cancellous bone.

Biopsy↗

Do actions speak louder than words? A query into an enigma in analytic theory and technique.

While action is increasingly viewed as ubiquitous throughout psychoanalytic treatment, our understanding of why it occurs is limited by rudimentary views of verbalization and action. Dynamic and genetic interpretations of action, usually given at a time of resistance impasse, give only a partial explanation of the phenomenon. The question is explored of why the behavior may appear in the form of action, as well as its implication for interpretive strategies. A major premise is that the role of the ego has been overlooked, especially modes of thinking associated with earlier developmental levels.

Communication↗

Beginning a psychoanalytic treatment: establishing an analytic frame.

The opening phase of analysis has received scant attention. Freud initially included, as essential, the establishment of an analytic process via the method of free association in the opening phase. However, his stance in relation to this process we can now characterize as authoritarian, and as influenced by suggestion and manipulation. Recent literature, while contributing to the understanding of the range of dynamics possible when beginning an analysis, continues to ignore the manner in which the method of free association may be used by both participants in establishing an analytic frame. Two clinical examples of how this latter process may be inaugurated are given, and reasons for the drift away from it are suggested.

Adult↗

3D computed X-ray tomography of human cancellous bone at 8 microns spatial and 10(-4) energy resolution.

Human cancellous bone was imaged and its absorptive density accurately measured in three dimensions (3D), nondestructively and at high spatial resolution by means of computerized microtomography (microCT). Essential for achieving the resolution and accuracy was the use of monoenergetic synchrotron radiation (SR) which avoided beam hardening effects, secured excellent contrast conditions including the option of energy-modulated contrast, and yet provided high intensity. To verify the resolution, we selected objects of approximately 8 micron size that could be observed on tomograms and correlated them in a unique manner to their counter images seen in histological sections prepared from the same specimen volume. Thus we have shown that the resolution expected from the voxel size of 8 microns used in the microCT process is in effect also attained in our results. In achieving the present results no X-ray-optical magnification was used. From microCT studies of composites (Bonse et al., X-ray tomographic microscopy (XTM) applied to carbon-fibre composites. In: Materlik G, ed. HASYLAB Jahresbericht 1990. Hamburg: DESY, 1990; 567-568) we know that by including X-ray magnification a resolution below 2 microns is obtained. Therefore, with foreseeable development of our microCT method, the 3D and nondestructive investigation of structures in mineralized bone on the 2 micron level is feasible. For example, it should be possible to study tomographically the 3D distribution and amount of osteoclastic resorption in the surrounding bone structure.

Aged↗

Some ambiguities in the method of free association and their implications for technique.

The method of free association, rooted in the topographic model, has not been clearly defined in structural terms. Little changed since Freud; the method is geared toward overcoming rather than investigating resistances. Furthermore, it is designed to discourage rather than encourage self-analysis. This seems to be another example of a "developmental lag" in adapting the psychology of the ego to clinical technique.

Defense Mechanisms↗

[Inguinal hernia repair with local anesthesia--a comparative analysis].

Since February 1992 local anaesthesia has been routinely used for repair of inguinal hernias at the Surgical Department of the RWTU Aachen. All 607 patients undergoing Shouldice repair of primary inguinal hernia between January 1990 and March 1993 were retrospectively analysed with reference to need for analgesics, length of stay in hospital, and rate of complications. In addition, 50 patients treated with local anaesthesia and 50 patients treated under general anaesthesia underwent prospective pain analysis using a visual analogue scale and spirometric tests. Following local anaesthesia we found fewer need of analgesics, shorter stays in hospital, and less complications. The pain level was lower and ventilatory function was better. Repair of inguinal hernia with local anaesthesia is a safe method of lowering the risks involved in the operation and improving patient comfort without increasing complications.

Adolescent↗

"In the neighborhood": aspects of a good interpretation and a "developmental lag" in ego psychology.

The significance of the conscious ego in the interpretive process has increasingly come under scrutiny. It is becoming clearer that the analyst's view of the conscious ego orients his interpretive approach, and subtly sets the goals of the analysis. At various times Freud championed the analytic importance of the conscious ego, and alternately rejected its significance. Hartmann's view of the ego stimulated research into a developmental line of the ego, while investigations of the ego in clinical psychoanalysis lagged far behind. The importance of the conscious ego in understanding resistances and levels of communication are explored.

Defense Mechanisms↗

Recurring thoughts on unconscious ego resistances.

Analysis of the unconscious ego resistances is one of those clinical concepts more honored in the breach than in the observance. This same point has been made periodically over the past fifty years. It has not been sufficiently realized that a true psychoanalytic understanding of resistance analysis could only begin with Freud's second theory of anxiety. Freud himself never fully embraced this theory, and clinical contributions since then have varied in their ability to use the techniques inherent in the second theory of anxiety. Recent contributions to the literature have not eliminated the espousal of theories of resistance based on earlier views of anxiety. Reasons cited for this include: the ambiguities in Freud's writing, the direction of the early ego theorists, and proclivities toward deeper interpretations.

Adaptation, Psychological↗