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Biomedical subjects

J S Strauss

Publications and source records attributed to J S Strauss.

At least 19 recordsLinked to original sources

Sebaceous gland activity and serum dehydroepiandrosterone sulfate levels in boys and girls.

BACKGROUND AND DESIGN: Increases in sebaceous gland activity are often the earliest sign of the approach of puberty in children. These increases have been attributed to increases in the secretion of adrenal androgens, but the supporting data are sparse and are based on measurements of urinary, rather than serum, androgen concentrations. In this study, we examined sebum composition, serum levels of dehydroepiandrosterone sulfate, and pubertal stage in 111 boys and girls, aged 2 to 15 years. Sebum composition was evaluated by measuring the ratio of wax esters/(cholesterol + cholesterol esters), a ratio known to increase with increasing sebaceous gland activity. RESULTS: Both wax esters/(cholesterol + cholesterol esters) ratios and serum dehydroepiandrosterone sulfate levels began to increase in children 7 to 10 years old. These changes occurred in many children before the appearance of any physical signs of puberty. Wax esters/(cholesterol + cholesterol esters) ratios were correlated with dehydroepiandrosterone sulfate levels in both boys and girls. In prepubertal children, the regression lines passed through the origin. In subjects who were in early or late puberty, the y intercepts of the regression lines had positive values. CONCLUSION: Adrenal androgens appear to be the major determinants of sebaceous gland activity during the prepubertal period and to be additive to another hormone or hormones during puberty.

Adolescent

Prolonged remissions of cystic and conglobate acne with 13-cis-retinoic acid.

Fourteen patients with treatment-resistant cystic and conglobate acne were treated for four months with oral 13-cis-retinoic acid, a synthetic isomer of naturally occurring all-trans-retinoic acid. The average dose was 2.0 mg per kilogram per day. Thirteen patients experienced complete clearing of their disease; the other had 75 per cent improvement, as determined by the number of acne nodules and cysts present before and after therapy. Prolonged remissions, currently lasting as long as 20 months after discontinuation of therapy, have been observed in all 14 patients. Clinical toxicity was limited to the skin and mucous membranes in most patients and was dose dependent and rapidly reversible upon discontinuation of therapy. The mechanism of action of 13-cis-retinoic acid in the therapy of acne probably involves a direct inhibitory effect of the drug on the sebaceous gland.

Acne Vulgaris

Egocentrism in children of parents with a history of psychotic disorders.

It is known that children of schizophrenic parents have an increased risk for becoming schizophrenic, but it has been extremely difficult to determine what features may exist in such children before they become manifestly ill that might provide a key for identifying vulnerability to subsequent disorder. This study was carried out to determine whether certain types of egocentric perception exist in the children of psychotic parents that might represent a clue to vulnerability. Sixty parent-child pairs were investigated as part of the University of Rochester (NY) Child and Family Study, using standardized diagnostic assessment procedures in the parents and several methods for evaluating egocentric perception in their offspring. Results showed that severity of psychotic symptoms in a parent related significantly to the degree of persistent age-inappropriate spatial egocentrism in his or her child. All of several diagnostic approaches used for parent classification were about equally valid in this regard, except for hospital diagnosis of schizophrenia, which did not correlate significantly with offspring egocentricity.

Child

Overview: the heuristic need for subgroups of the schizophrenic syndrome.

This article is an editor's introduction to the theme of an issue of the Schizophrenia Bulletin devoted to subgroups of the schizophrenic syndrome. The issue includes articles on subtyping from various points of view: neurological, genetic, biochemical, and descriptive. It is hoped that the wide range of findings being applied in ongoing classificatory efforts will produce subgroups with etiologic, prognostic, and treatment validity.

Humans

Subtypes of schizophrenia: descriptive models.

Descriptive approaches to subtyping schizophrenia use symptoms, signs, and functioning characteristics as diagnostic criteria. Such approaches often appear superficially to be obvious, simple, and atheoretical; in reality, however, there are many ways in which descriptive data can be selected and organized to subtype patients. This report describes these various approaches. Selection of diagnostic criteria can focus primarily either on cross-sectional or longitudinal characteristics of patients. Alternative ways of organizing descriptive data include typological and dimensional approaches and two increasingly common complex models, multiaxial and hierarchical subtyping. Examples and implications of these alternative approaches are described, and methods for choosing among them are suggested.

Cross-Sectional Studies

Epilogue: subtypes of the schizophrenic syndrome--their current status.

The expectation that important subtypes exist in dementia praecox (schizophrenia) was built into the earliest conceptualizations of this disorder by Kraepelin and Bleuler. Although the traditional subtypes are still used, more recent biological, psychological, and descriptive-clinical data suggest that quite different approaches to subtyping and subtyping categories may be more valid. No definitive answers to the subtyping problem have yet been reached, but the solution may well involve a complex consideration of biologic, psychologic, and social variables.

Diagnosis, Differential

Do psychiatric patients fit their diagnoses? Patterns of symptomatology as described with the biplot.

Systems of psychiatric diagnosis have been regularly criticized for their low reliability and their inability to fit accurately the kinds of patients coming for treatment. To explore the reasons for these problems, this study utilizes a new method, the biplot, for defining groups of similar patients and the relationships of these groups to key symptom clusters. Using this technique to analyze data from a representative sample of first admissions for psychiatric disorder, results showed: a) symptom clusters representing the classical diagnostic categories, mania, schizophrenia, neurotic depression, and psychotic depression, were readily identified; b) however, only a few patients were clustered near these traditional syndromes. These findings suggest that although syndromes do exist that fit traditional diagnostic categories, the vast majority of patients fall between these syndromes, having characteristics from several of them. For most patients, forcing the diagnostician to choose among the categories requires an arbitrary decision that may contribute to dissatisfaction in the diagnostician who recognizes how misleading the diagnosis can be.

Adjustment Disorders

Age-related changes in sebaceous gland activity.

The sebaceous glands of man show age-related differences in their activity as determined by quantitative and qualitative examination of sebum. Sebaceous secretion is low in children and begins to increase in mid- to late childhood under the influence of androgens. This rise continues until the late teens, after which no further significant change takes place until late in life. In elderly men, sebum levels remain essentially unchanged from those of younger adults until the age of 80. In women, sebaceous secretion decreases gradually after menopause and shows no significant change after the 7th decade. The most likely explanation for the decrease in sebaceous gland secretion with age in both men and women is a concomitant decrease in the endogenous production of androgens. Although surface lipid levels fall with age, paradoxically the sebaceous glands become larger, rather than smaller, as a result of decreased cellular turnover. Nonetheless, as the higher surface lipid levels after administration of fluoxymesterone (a synthetic testosterone derivative) indicate, the glands have the capacity to respond to androgens.

Adolescent

Intensive psychiatric care for adolescents and young adults: a model for treatment and evaluation.

The authors' model for the hospital treatment of severely disordered adolescents and young adults calls for a categorization of the patient's major characteristics that are relevant to treatment along six axes: symptoms and signs, previous course of the disorder, social functioning, work or school functioning, family or other living situation, and sense of identity. They present a case study of a 19-year-old male patient to demonstrate how the model works.

Adolescent

Unusual subepidermal bullous diseases with immunologic features of bullous pemphigoid.

Sixty-seven patients with histologic and immunologic features of bullous pemphigold (BP) were evaluated. Eleven patients had a localized blistering disease that was predominantly confined to one area of the body, most commonly the lower extremities. Two patients displayed a dapsone-responsive blistering disease that was characterized by a flexural distribution of ten to 20 1-cm or less, intensely pruitic, subepidermal bullae and linear IgA basement membrane zone deposition. Two patients had a chronic recalcitrant generalized scarring, hyperkeratotic, subepidermal blistering eruption that demonstrated serologic and direct immunofluorescence (IF) findings of BP. One patient displayed grouped small vesicles surmounted on an erythematous base; the clinical diagnosis was dermatitis herpetiformis, but direct IF examination of the biopsy specimen showed features of BP. One patient with epidermolysis bullosa acquisita had serologic and direct IF features suggestive of BP.

Adult

The fatty acids of human sebaceous gland phosphatidylcholine.

The fatty acids of human sebaceous gland phosphatidylcholine were examined by gas chromatography and by analysis of the double bond positions in the C-16 and C-18 monoenes. Compared to phosphatidylcholine from other organs, sebaceous gland phosphatidylcholine was found to be deficient in essential fatty acids and poly-unsaturated fatty acids. The relatively large mono-unsaturated fatty acid fraction consisted predominantly of fatty acids with delta6- and delta8-unsaturation. Analysis indicates that the fatty acids of sebaceous gland phospholipids are predominantly of types synthesized in sebaceous glands.

Fatty Acids