Injury to the central or peripheral nervous system is often associated with persistent pain. After ischemic injury to the spinal cord, rats develop severe mechanical allodynia-like symptoms, expressed as a pain-like response to innocuous stimuli. In its short-lasting phase the allodynia can be relieved with the [gamma]-aminobutyric acid (GABA)-B receptor agonist baclofen, which also reverses the hyperexcitability of dorsal horn interneurons to mechanical stimuli. Furthermore, there is a reduction in GABA immunoreactivity in the dorsal horn of allodynic rats. Clinical neuropathic (...) pain of peripheral and central origin often cannot be relieved by opiates at doses that do not cause side effects. The loss of sensitivity to opiates may be associated with the up-regulation of endogenous antiopioid substances, such as the neuropeptide cholecystokinin (CCK). CCK and its receptor (CCK-R) protein is normally not detectable in rat dorsal root ganglion cells. After peripheral nerve section, both CCK and CCK-R are up-regulated in the dorsal root ganglia. Furthermore, CI 988, an antagonist of the CCK-B receptor, chronically coadministered with morphine, reduces autotomy, a behavior that may be a sign of neuropathic pain following peripheral nerve section. Thus, opiate insensitivity may be due to the release of CCK from injured primary afferents. Similarly, in the chronic phase of the spinal ischemic model of central pain, the allodynia-like symptom is not relieved by systemic morphine, but is significantly reversed by the CCK-B antagonist. Consequently, up-regulation of CCK and CCK-R in the CNS may also underlie opiate drug insensitivity following CNS injury. Thus, dysfunction of central inhibition involving GABA and endogenous opioids may be a factor underlying the development of sensory abnormalities and/or pain following injury to neural tissue. (shrink)

The theme of my target article was dysfunction of inhibition in the spinal cord as an important factor in the development of chronic pain states. Some commentaries focused on the role of more central mechanisms and the limited usefulness of animal models for understanding mechanisms of human pain. More specific comments concerned the roles of GABA and cholecystokinin in pain control.

Dysfunction or injury of pain-transmitting primary afferents' central pathways can result in pain. The organism as a whole responds to such injury and consequently many symptoms of neuropathic pain develop. The nervous system responds to painful events and injury with neuroplasticity. Both peripheral sensitization and central sensitization take place and are mediated by a number of biochemical factors, including genes and receptors. Correction of altered receptors activity is the logical way to intervene therapeutically. [berkley; blumberg et al.; coderre & katz; (...) dickenson; mcmahon; wiesenfeld-hallin et al.]. (shrink)

Plastic changes in spinal cord function like neuronal wind-up and increased receptive field are too short-lived to explain chronic pain without structural changes. It is possible that learning could be a mechanism for longlasting changes in nociceptive regulation. A learning process localized to the spinal cord has been shown to be important for the development of tolerance to the analgetic effect of ethanol, suggesting that nociceptive control systems may be changed by learning. Long term potentiation (LTP) is regarded as a (...) useful model of learning and memory. LTP-like changes have been observed in invitro preparations from the spinal cord and in spinal cord field potentials. Recently a long term increase in spinal A-[beta] and C-fibre evoked responses after painful stimulation has been observed. [coderre & katz, dickenson, wiesenfeld-hallin et al.]. (shrink)

Central sensitization and related neurochemical mechanisms are also induced in V nociceptive pathways after craniofacial injury or inflammation. Their characteristics raise additional possibilities that may explain some of the phenomena outlined by coderre & katz, dickenson, and wiesenfeld-hallin et al. They also underscore the need for therapeutic approaches to reduce nociceptive inputs to the CNS or their neuroplastic effects which can potentially enhance post-traumatic pain.

Numerous mediators are involved in both the control and the transmission of nociceptive messages, and several lines of research have been developed in the management of pain. Complete enkephalin- degrading enzyme inhibitors, which produce naloxone-reversible analgesia in all tests where morphine has been found to be active, remains the most promising way. CCK compounds, especially the CCKB antagonists also may be interesting drugs. Indeed, they are able to strongly potentiate the antinociceptive effects of the opioids. [dickenson, wiesenfeld-hallin et (...) al.]. (shrink)

Neuroplastic changes in the inhibitory systems contribute to pathological pains such as hyperalgesia. Activation or inhibition of the intrinsic inhibitory systems may depend on the pathophysiology which induces a sustained pain state. The mechanisms of hyperalgesia, opioid insensitivity following nerve injury, and opioid tolerance may be related to common neuroplastic changes. [wiesenfeld-hallin et al.].

The authors presume that activity in the dorsal horn or nociceptors is well correlated with pain sensations and behavior. This overlooks the myriad of interactions between cortex and our spinothalamic tract. It is better to think of our nociceptors, the dorsal horn, and the pain centers in our brain as all components in one larger and complex pain sensory system. [berkley; blumberg et al.; coderre & katz; dickenson; mcmahon; wiesenfeld-hallin et al.].

The central hyperexcitability observed in animal models supports a pathophysiological explanation for chronic human pain. Novel information on cholecystokinin (CCK) upregulation offers a rationale for reduced opioid response in neuropathic pain. However, the basic information provided by scientists should not lead clinicians to equate experimental models to chronic human conditions. Clinicians should provide careful reports and attempt to classify pathophysiologically clinical conditions that have so far been grouped generically. [blumberg et al.; coderre & katz; dickenson; wiesenfeld-hallin et al.].

The possible dysfunction of [gamma] aminobutyric acid (GABA) and opioid inhibitory mechanisms following central and peripheral nervous system injury is an important and potentially useful finding. However, effective clinical application must take into account the specific characteristics of the models used in the studies and the relationship of these models to specific clinical conditions. [dickenson; wiesenfeld-hallin et al.].

This commentary on coderre & katz, wiesenfeld-hallin et al., and dickenson focuses on: (a) the brain as an under-recognized contributor to pain facilitation at the spinal cord; (b) these brain-to-spinal pathways being activated by learning or by body infection/inflammation; and (c) the resultant spinal release of anti-analgesic neuropeptides, activators of the NMDA-NO cascade, and activators of glia.

Both the sensory and the motivational-affective component of pain must be taken into account in studies on sex differences as well as on neuropathic, postoperative, sympathetic, and visceral pain. In all these cases, therapeutic strategies should be aimed at controlling the peripheral, central, and psychological mechanisms underlying the global pain experience. Similarly, it should be recalled that some neuropeptides act on both sensory and affective pain mechanisms. [berkley; mcmahon; dickenson; coderre & katz; wiesenfeld-hallin et al.; blumberg et al.].

The persistence of both inflammatory and neuropathic pain can only be explained when learning processes are taken into account in addition to sensitizing mechanisms. Learning processes such as classical and operant conditioning create memories for pain that are based on altered synaptic connections in supraspinal structures and persist without peripheral input. [coderre & katz; dickenson; wiesenfeld-hallin et al.].

Originally published in 1971, this volume was created to commemorate the bicentenary of Hegel's birth in 1770. Thirteen essays are included from experts with diverse approaches, concentrating on the central issues of Hegel's political philosophy, and covering all of the major political works. These essays demonstrate the vitality of Hegel's philosophical perspective, engaging the reader and providing a way into the often difficult explication of his ideas. Whilst this is a commemorative edition, and the views put forward are broadly sympathetic, (...) a critical distance is maintained, allowing for numerous fresh insights. Accessible and highly informative, this book will be of value to anyone with an interest in Hegelian thought and its political implications. (shrink)

The paper deals with the fundamental problems of Juraj Cíger’s philosophical and ethical thinking. It’s focus is on Cíger’s understanding and explaining of the legacy of the founder of modern philosophy R. Descartes as an enigmatic philosopher. In this context it shows that Descartes was the clue philosopher for Cíger and that in a sense Cíger himself can be seen as an enigmatic philosopher. The author offers an analysis of Cíger’s interpretation of Descartes’ philosophical conception, which on his opinion was (...) not dualistic, but rather trialistic. The impact of Cíger’s thinking on the theoretical and practical ethics is shown as well. (shrink)

Good and evil; religious aspects; Islam.

The Lodz Film School has existed since 1948.... In the year of the school's jubilee, we decided to publish five selected MA theses written by Direction Department graduates. Three of th theses, written by Krzysztof Kieślowski, Marcel Łoziński and Wojciech Wiszniewski, concern documentary film, whereas the two remainingones written by Grzegorz Królikiewicz and Edward Żebrowski refer to fiction films.... Their authors, excellent Polish film-makers, presented their auteurs' concept they had at the beginning of their artistic careers which were carried out (...) and verified by them through their work on... subsequent film projects. We decided to combine those theses with five complementary essays in which film historians and theoreticians analyse these directors' films which followed in the course of their career in the context of the concepts described by the directors in their MA theses."--English section, page 6. (shrink)

Arab countries; intellectual life; congresses.

In The Borderline Culture: Intensity, Jouissance, and Death, Željka Matijašević examines contemporary culture through psychological borderline theory.

D Z Phillips; Not in Front of the Children: children and the heterogeneity of morals, Journal of Philosophy of Education, Volume 14, Issue 1, 30 May 2006, Pages.

In lieu of an abstract, here is a brief excerpt of the content:Introduction to the 30th Anniversary Issue of Philosophy, Psychiatry, & PsychologyJohn Z. Sadler (bio)This issue marks the 30th anniversary of Philosophy, Psychiatry, and Psychology (PPP). All of us at the journal are grateful to our authors, readers, editors, and publishers for enabling this landmark. To commemorate this event, I invited our Founding Editor and Chair of the Advisory Board, K.W.M. "Bill" Fulford to write a brief essay, along with (...) our panel of smart and industrious senior editors. Their instructions were simple: 500 words on PPP past, present, and/or future. These essays appear in the pages to follow. As Editor-in-Chief, I write about PPP's early commitments as a scholarly journal, situate these in the history of academic publishing, and muse over our current moment.Bill Fulford briefly discusses the early years of the journal in his essay. My perspective emerges from an editor's perspective. As co-editors in the early years, Bill and I were committed to an international authorship with comparable editorial oversight. We wanted to build a journal that would equally recognize clinical science and practice and philosophy, maintaining the rigor of each field. We saw philosophers and mental health practitioners as equal partners, collaborators, innovators, and educators. More important, PPP was intended to offer up the best criticism of the mental health and related fields.The scattershot history of scholarly editing has identified several functions of the editor over the centuries following Gutenberg's invention of the printing press in the mid-1440s. The earliest editors took liberties with the language of the Bible, trying to make it more accessible to the public; the printing press permitted fast and inexpensive reproduction. Not surprisingly, this popularizing of the Bible led to praise as well as outrage. The printing of other scholarly works followed quickly. In 1470, only about 25 years after the invention of the printing press, Niccolo Perroni called for Pope Paul II to censor Andrea Bussi's edition of Pliny the Elder's Natural History, an anthology of then-ancient writings about the natural world. This marked the first recorded instance of censorship of a more-or-less secular scholarly work (Monfasani, 1988). In the ensuing centuries, "editors" initially were the popularizers, and later the gatekeepers of texts worth (and not worth) reading. In the [End Page 1] ensuing centuries into the present, editors have been venerated both as defenders of good reading and reviled as censors or intellectual selfaggrandizers.The current moment, in my view, represents a crisis in the history of editing and editorship. Digital communications have liberated communications worldwide. However, this liberty has come at the cost of colossal amounts of material not worth reading and an explosion of divisive, destructive discourse. Even worse, internet "trolls" on social media have moved bullying out of the schoolyard and into international cyberspace. Determining what is worth reading has moved away from a cluster of (hopefully) responsible editors to anyone who wants to go to the small effort of silencing others through online harassment and even violent threats. Such cyberbullying does not eliminate elitism, but instead substitutes a toxic online "elite" without principle other than self-promotion and the alienation of others. Our contemporary online culture has yet to figure out how to shape what is, and is not, worth reading.My wish and intent for the future of PPP is to maintain and grow our place of rational, deliberative, and open discourse, even in the face of such disruptive cultural change.John Z. Sadler John Z. Sadler, MD, is the Editor-in-Chief of PPP. He is the Daniel W. Foster, MD, Professor of Medical Ethics at the University of Texas Southwestern Medical Center, as well as a Professor of Psychiatry there. He has been a PPP editor since its inception.ReferenceMonfasani, J. (1988). The first call for press censorship: Niccolo Perotti, Giovanni Andrea Bussi, Antonio Moreto, and the editing of Pliny's Natural History. Renaissance Quarterly, 41, 1–31. Google ScholarCopyright © 2023 Johns Hopkins University Press... (shrink)

Žižek as comedian: jokes in the service of philosophy.

The latest book by the Slovenian critic Slavoj Zizek takes the work of French philosopher Gilles Deleuze as the beginning of a dazzling inquiry into the realms of radical politics, philosophy, film (Hitchcock, Fight Club ), and psychoanalysis. Of Organs without Bodies Joan Copjec ( Imagine There's No Woman ) has written: "With all his ususal humor and invention, Zizek -- the acknowledged master of the 180 degree turn -- here takes a trip into "enemy" territory to deliver Deleuze of (...) a marvelously rebellious child, one that seriously challenges Deleuze's other progeny with a surprising but convincing bid for succession. Those who thought Deleuze's forward march into the future would follow a straight path are forced to rethink their stance. From now on all readings of Deleuze will have to take a detour through this important -- even necessary -- book." Eric Santner ( On the Psychopathology of Everyday Life ) describes Organs without Bodies as offering "an entirely new degree of conceptual clarity and political urgency. Through his deep engagement with the logic of Deleuze's project, Zizek opens up new possibilities of thought beyond the terms of the current political debates on globalization, democratization, war on terror. Once again, Zizek has produced an utterly timely and radically untimely meditation." Recently profiled in The New Yorker , and hailed by the Village Voice as "the giant of Ljubljana," Zizek is one of the most provocative and entertaining thinkers at work today. (shrink)