Biomedical subjects
Publications and source records attributed to M F Schwartz.
Partial monosomy of 6q resulting from an interstitial deletion of bands q16----q22 was found in a 12-year-old boy manifesting mental retardation, seizure disorder, and dysmorphic features. The correlation of phenotypic expression and specific long arm deletions of chromosome No. 6 is discussed.
Certain individuals who want to change their homosexual preference can be helped by a short-term intensive intervention adapted from the Masters and Johnson model for treating heterosexual disorders. Pretreatment counseling aims at improving the patient's dating, sexual, and intimacy skills; creative problem solving; and stress management. Then for 2 weeks the patient and an opposite-sex partner, living in social isolation, meet daily with a therapy team to address fears and anxieties about intimacy as they arise. The directive psychotherapy format alternates between confrontation of maladaptive belief systems and patterns of relating and support for finding new ways of coping that foster a positive self-image.
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The purpose of this paper is to discuss conceptual components of treating paraphilia. Detailed description of the treatment interventions will be published subsequently. The format of the psychotherapy has components similar to the programs for sexual dysfunction and homosexual dissatisfaction therapy. Intensive short-term directive conjoint therapy remains essential. The therapeutic model focuses on the paraphilia as an interpersonal relationship disorder which is manifested as an unproductive and sometimes addictive means of coping with stress, particularly engendered by discomfort with intimacy in adult erotic relationships. The basic model of psychotherapy includes specific intervention directed at potential social skill deficits, changing erotic imagery, attitude and cognitive restructuring, self-esteem difficulties, dating anxiety, sexual dysfunction, intimacy issues and addictive behavior, all of which encourage mastery, self-assertion, self-responsibility and communication skills within the context of a relationship.
A case of primary amyloidosis with vitreous involvement was diagnosed by study of a specimen obtained by pars plana vitrectomy. Vitreous opacities had been interpreted clinically as a vitreous hemorrhage. Medical evaluation after study of the vitreous specimen failed to demonstrate evidence of amyloidosis, although postmortem examination 19 months later established the systemic diagnosis of nonfamilial systemic primary amyloidosis. Both eyes were obtained postmortem. Amyloid involvement of the vitreous, retina, and choroid was found. There was also amyloid deposition in the trabecular meshwork, although the intraocular pressure was normal. Amyloid was deposited along the anterior, pupillary, and posterior surfaces of the iris. The histochemistry, ultrastructure, and treatment of this condition are discussed.
One hundred and thirty-six men, who presented at Masters & Johnson Institute for treatment of impotence, ejaculatory incompetence, and inhibited sexual desire, underwent endocrine screening. Eleven men (8.1%) were found to be hyperprolactinemic: three had a mild degree of hyperprolactinemia while eight had markedly elevated serum prolactin levels in conjunction with subnormal serum testosterone levels. The markedly hyperprolactinemic men, all of whom were subsequently found to have prolactin-secreting pituitary adenomas, presented with diverse histories of sexual disorders which were similar to those of men with psychogenic sexual dysfunctions. All eight experienced some degree of improvement of sexual function following a 2-week course of intensive psychotherapy, although full restoration of libido was contingent on reduction of circulating prolactin to normal or near-normal levels. Measurement of prolactin levels should be routinely performed in all men presenting with the above sexual disorders and depressed testosterone levels.
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The absence of an interdisciplinary science of sexology has resulted in sexuality being narrowly defined by the particular ideology of the various scientific disciplines. This review presents a theoretical model to integrate the interdisciplinary data related to the development of the three phases of eroticism. A biosocial integration of the multiple aspects of eroticism will hopefully generate research and psychotherapeutic innovations not plagued by mind-body dichotomization. The emphasis of this paper is on the solicitation, attraction and pair-bonding phase of eroticism, since this has been more neglected by sexologists than the copulatory and conceptive phases.
Plasma testosterone levels in a group of 341 men with sexual dysfunction were compared to those in 199 men with normal sexual function. All subjects were participants in a 2-week intensive conjoint sex therapy program at the Masters & Johnson Institute. Testosterone determinations were made using radioimmunoassay methods after column chromatography; all blood samples were obtained on the second day of therapy between 8:00 and 9:00 a.m. after an overnight fast. Circulating levels of testosterone in men with normal sexual function (mean 635 ng/dl) were not significantly different from testosterone values in sexually dysfunctional men (mean 629 ng/dl). However, men with primary impotence (N = 13) had significantly higher testosterone levels than men with secondary impotence (N = 180), with mean levels of 710 and 574 ng/dl, respectively (p < 0.001). The mean testosterone level for men with ejaculatory imcompetence was 660 ng/dl (N = 15), while for men with premature ejaculation the mean was 622 ng/dl (N = 91). Plasma testosterone concentrations were not related to therapy outcome but were correlated negatively with age of patients.
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Hypomelanosis of Ito (incontinentia pigment achromians, systematized achromic nevus) is a cutaneous abnormality consisting of bizarre, patterned, macular hypopigmentation over variable portions of the body surface. Multiple associated defects in other systems occur in a significant precentage of affected individuals. Most commonly, the central nervous system, eye, and musculoskeletal structures are involved. It is suggested that the cutaneous abnormality, which is often detectable at birth or during infancy, may forewarn pediatricians of the possible emergence of defects in other organ systems.
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The skeptic over the existence of this important clinical entity, are now very few. Anatomo-clinical studies and the analysis of altered cognitive procedures suggest, however, that we are dealing with a heterogeneous group. Two models of conduction apahasias are presented, in which the mechanism of the altered repetition, as well as the probable localization of the lesion, differ considerably. One has a lesion in the posterior parietal region of the left hemisphere and it exemplifies an acoustic verbal memory deficit (short term memory). The other points at a functional disconnection between the decodification and verbal processes and those of expression. In this case, we are dealing with a left temporal lesion in a left-handed individual. The analysis of our material and of the clinical literature upholds the idea of a plurality of the altered mechanisms in the verbal repetition and suggest that the conduction aphasia is a syndrome.