Thalamic control of spontaneous alpha-rhythm and evoked responses. EEG, depth recordings from the thalamus, visual-evoked potentials, and readiness motor potentials were analyzed with a computer in 40 patients with involuntary movements and intractable pain who underwent stereotactic thalamotomy. It was demonstrated that there were significant correlations in alpha-rhythms between the ventrolateral (VL) nucleus and the frontocentral cortex, and also between the centromedian nucleus and the centroparietal cortex, with the phase difference of the cortex lagging behind the thalamus. Relationships between the thalamic VL nucleus and the frontocentral cortex were significant not only in alpha-rhythms, but also in evoked responses following photic stimulations, voluntary movements, and electrical thalamic stimulation. Thalamotomy produced a bilaterally decreased synchronization of the cortical alpha-rhythms, which recovered within 6 months.


Motivational slow negative potential shift (CNV) related to thalamotomy. The alteration of cortical electrical activity induced by imperative stimulation following warning stimulation, contigent negative variation (CNV), and psychological changes following thalamotomy for relief of intractable pain (CM) and tremor (VL) are studied, since CNV has a close relationship with the degree of psychological activity. Ventrolateral thalamotomy does not have any effect on the amplitude of cortical CNV, but the ventromedioposterior part of the centre median has a generating action of CNV in itself and it has facilitatory effects upon cortical CNV. According to these results, the effective mechanism of centre median thalamotomy for relief of intractable pain is caused by suppression of attention and expectancy for exogenous stimuli following lesions of the centre median.


Inversion or pronation of the foot following thalamotomy for Parkinson's disease. The author has observed inward turning of the foot of 2 parkinsonian patients following thalamotomy on the contralateral side. In one instance, the surgery was unilateral and in the other bilateral. The anatomical position of the involved lesions was in the region of the complex of the ventrocaudal nuclei (ventralis posterolateralis). It appears that three elements are present whenever such pronation of the foot occurs, namely, paresis, hypertonicity, and impairment of sensory modalities such as localization, two-point discrimination and vibration.


Single neuron analysis of the human midbrain tegmentum. Rostral mecencephalic reticulotomy for pain relief. Rostral mesencephalic reticulotomy (RMR) has been performed since 1973 for relief of intractable pain. The target area is in the midbrain reticular formation (MRF) bordering the periaqueductal gray matter at the superior collicular level. The target of RMR is 13--16 mm posterior to the midpoint of the AC-PC line and 5--8 mm below the AC-PC line. The laterality of the target is measured from the center of the aqueduct, ranging 5 to 8 mm from the midline. The rationale for this procedure is based upon the previous findings that the brain stem reticular formation plays a more important role above the spinal cord level than the lateral spinothalamic tract in the central conduction of nociceptive impulse. In the present study, intraoperative single neuron recording was made with tungsten microelectrodes from the human midbrain tegmentum in response to peripheral pinprick stimulation. These nociceptive neurons were classified into three groups in regard to the unit latency from the peripheral pinprick stimulation.


Production and analysis of citrinin in corn. A convenient method for the production and analysis of citrinin in corn is described. Up to 2.964 g of citrinin can be produced by Penicillium citrinum per kg of corn by harvesting on day 21 or later. The analysis method has a lower detection limit of 0.25 ppm. Heating citrinin-contaminated corn destroys citrinin but may produce another toxin instead.


Detection of staphylococcal enterotoxins A, B, C, D, and E in foods by radioimnunoassay, using staphyloccal cells containing protein A as immunoadsorbent. A sensitive radioimmunoassay utilizing Staphylococcus aureus cells containing protein A as a coprecipitant was developed for the detection and quantitation of staphylococcal enterotoxins A, B, C, D, and E in a variety of foods. The enterotoxins were extracted from the foods by a simple and rapid procedure. The sensitivity of the assay is 1.0 ng or less of enterotoxin per g of food.


Endotoxins in commercial vaccines.

Endotoxins in commercial vaccines. Twenty samples of commercial vaccines intended for administration to humans were assayed for the presence of bacterial endotoxins by using the Limulus amebocyte lysate test. Sixteen of the vaccines contained more than 0.1 ng of endotoxin per ml (which corresponds to 103 bacterial cell wall equivalents per ml in the undiluted vaccines). These results suggest that at some stage of preparation, the vaccines have contained varying amounts of gram-negative bacteria and may indicate the presence of other bacterial products as well. It might be useful to list the level of endotoxins, phage, and other contaminants on each vaccine lot to facilitate studies on any side effects of these contaminants. Selection of vaccine lots with the least endotoxin might reduce some of the adverse effects of vaccinations.


Antibiotic resistance patterns of gram-negative bacteria isolated from environmental sources. A total of 2,445 gram-negative bacteria belonging to fecal coliform, Pseudomonas, Moraxella, Acinetobacter, and Flavobacterium-Cytophaga groups were isolated from the rivers and bay of Tillamook, Oregon, and their resistances to chloramphenicol (25 microgram/ml), streptomycin (10 microgram/ml), ampicillin (10 microgram/ml), tetracycline (25 microgram/ml), chlortetracycline (25 microgram/ml), oxytetracycline (25 microgram/ml), neomycin (50 microgram/ml), nitrofurazone (12.5 microgram/ml), nalidixic acid (25 microgram/ml), kanamycin (25 microgram/ml), and penicillin G (10 IU/ml) were determined. Among fecal coliforms the bay isolates showed greater resistance to antibiotics than those from tributaries or surface runoff. No such well-defined difference was found among other bacterial groups. The antibiotic resistance patterns of gram-negative bacteria from different sources correlated well, perhaps indicating their common origin. The antibiotic resistance patterns of gram-negative bacteria of different general also correlated well, perhaps indicating that bacteria which share a common environment also share a common mode for developing antibiotic resistance.


Effect of phosphate buffer concentration on the heat resistance of Bacillus stearothermophilus spores suspended in parenteral solutions. The effect of various quantities of Butterfield phosphate buffer added to four parenteral solutions on the survival of Bacillus stearothermophilus spores heated at 121 degrees C was determined. The effect of the addition of phosphate buffer on spore survival varied with the parenteral solution. Spore survival was increased or decreased, depending upon the composition of the parenteral solution and the buffer concentration. The results obtained in these experiments attest to the fact that environmental factors, including the type of ions present and ionic concentration, affect the heat destruction rate of B. stearothermophilus spores. Therefore, the sterilization requirements of a product such as a parenteral solution may be affected by small changes in formulation.


Heavy-metal and antibiotic resistance in the bacterial flora of sediments of New York Bight. The New York Bight extends seaward some 80 to 100 miles (ca. 129 to 161 km) from the Long Island and New Jersey shorelines to the edge of the continental shelf. Over 14 x 10(6) m(3) of sewage sludge, dredge spoils, acid wastes, and cellar dirt are discharged into this area each year. Large populations of Bacillus sp. resistant to 20 mug of mercury per ml were observed in Bight sediments contaminated by these wastes. Resistant Bacillus populations were much greater in sediments containing high concentrations of Hg and other heavy metals than in sediments from areas further offshore where dumping has never been practiced and where heavy-metal concentrations were found to be low. Ampicillin resistance due mainly to beta-lactamase production was significantly (P < 0.001) more frequent in Bacillus strains from sediments near the sewage sludge dump site than in similar Bacillus populations from control sediments. Bacillus strains with combined ampicillin and Hg resistances were almost six times as frequent at the sludge dump site as in control sediments. This observation suggests that genes for Hg resistance and beta-lactamase production are simultaneously selected for in Bacillus and that heavy-metal contamination of an ecosystem can result in a selection pressure for antibiotic resistance in bacteria in that system. Also, Hg resistance was frequently linked with other heavy-metal resistances and, in a substantial proportion of Bacillus strains, involved reduction to volatile metallic Hg (Hg degrees ).


Thermal resistance of naturally occurring airborne bacterial spores. Simulation of a heat process used in the terminal dry-heat decontamination of the Viking spacecraft is reported. Naturally occurring airborne bacterial spores were collected on Teflon ribbons in selected spacecraft assembly areas and subsequently subjected to dry heat. Thermal inactivation experiments were conducted at 105, 111.7, 120, 125, 130, and 135 degrees C with a moisture level of 1.2 mg of water per liter. Heat survivors were recovered at temperatures of 135 degrees C when a 30-h heating cycle was employed. Survivors were recovered from all cycles studied and randomly selected for identification. The naturally occurring spore population was reduced an average of 2.2 to 4.4 log cycles from 105 to 135 degrees C. Heating cycles of 5 and 15 h at temperature were compared with the standard 30-h cycle at 111.7, 120, and 125 degrees C. No significant differences in inactivation (alpha = 0.05) were observed between 111.7 and 120 degrees C. The 30-h cycle differs from the 5-and 15-h cycles at 125 degrees C. Thus, the heating cycle can be reduced if a small fraction (about 10-3 to 10-4) of very resistant spores can be tolerated.


Incidence of Vibrio parahaemolyticus bacteriophages and other Vibrio bacteriophages in marine samples. Vibrio bacteriophages were isolated by enrichment from 177 of 643 samples of marine molluscan shellfish, crustaceans, seawater, and sediments. The predominant bacteriophage types isolated were specific for some strains of Vibrio parahaemolyticus. A high frequency of phage isolations was also observed with strains of agar-digesting vibrios (21 of 56) and psychrophilic vibrios (14 of 72) that were originally isolated from non-shellfish growing areas. No bacteriophages were isolated against V. alginolyticus and only rarely for V. anguillarum even though these were the two most abundant species found in near-shore environments. No V. cholerae phages were isolated. It was also determined from quantitative studies on the Pacific oyster (Crassostrea gigas) obtained from two environments in Washington and Oregon that the titers of V. parahaemolyticus bacteriophages increased with increasing seasonal water temperatures and that this was proportional to the increase in numbers of mesophilic vibrios and not with the incidence of V. parahaemolyticus. Titers of V. parahaemolyticus bacteriophages occasionally exceeded 10(6) per g of oyster during the summer months. Specific V. parahaemolyticus bacteriophages were also isolated from market seafoods and other marine samples that originated in cold environments where no mesophilic vibrios are expected to be found. The possibility that V. parahaemolyticus bacteriophages originate from Vibrio spp. other than V. parahaemolyticus and the role of these bacteriophages in the ecology of marine vibrios are discussed.


Ecological relationship between Vibrio parahaemolyticus and agar-digesting vibrios as evidenced by bacteriophage susceptibility patterns. Twenty bacteriophages active against Vibrio parahaemolyticus and agar-digesting vibrios, isolated from oysters (Crassostrea gigas) and Dungeness crab (Cancer magister) and by induction of a lysogenic agar digester, were tested as to their host range. These phages were specific for V. parahaemolyticus and various agar-digesting vibrios, and interspecies lysis occurred only between these two groups. V. alginolyticus, V. anguillarum and related species, V. cholerae, and a group of marine psychrophilic and psychrotrophic vibrios were not affected. No correlation was observed between the O and K serotypes of V. parahaemolyticus strains and bacteriophage susceptibility patterns, and 7 of 28 strains of V. parahaemolyticus were not lysed by any of the phages. Only two of the phage isolates were capable of lysing all susceptible V. parahaemolyticus strains. No correlation was observed between the inter-and intraspecies genetic relatedness (DNA homologies) of V. parahaemolyticus and agar-digesting vibrios and susceptibility patterns to different bacteriophages. Some of the phages were capable of plaque formation on V. parahaemolyticus as well as on some strains of agar-digesting vibrios that were separated by 70 to 80% differences in their DNA homologies. The possible ecological significance of these vibrio bacteriophages, particularly those having a wide host range, is discussed.


Carotene-superproducing strains of Phycomyces. Production of beta-carotene by wild-type Phycomyces blakesleeanus can be stimulated by light, chemicals, regulatory mutations, and sexual interaction between mycelia of opposite sex. Through genetic manipulations, we have isolated strains which have simultaneously and constitutively incorporated several of these stimulatory effects. In the dark and in a simple medium, some of the strains produce up to 25 mg of beta-carotene per g (dry weight), or about 500 times the wild-type production under the same conditions. High lycopene-producing strains have also been isolated by using carR mutants, which are blocked in the conversion of lycopene to beta-carotene. These strains should be useful in both industrial production of these pigments and basic research related to carotenogenesis.


Phosphorus-containing pesticide breakdown products: quantitative utilization as phosphorus sources by bacteria. Bacteria were isolated that could utilize representatives of the following ionic phosphorus-containing breakdown products of organophosphorus pesticides as sole phosphorus sources: dialkyl phosphates, dialkyl phosphorothioates, dialkyl phosphorodithioates, alkyl arylphosphonates, alkyl arylphosphonothioates, and alkyl alkylphosphonates. Utilization of each organophosphorus compound, which was complete for 7 of 12 compounds studied, was confirmed by determination of protein yield from the amount of phosphorus source consumed. This is the first report of the utilization of an ionic dialkyl thiophosphate or dithiophosphate by microorganisms.


Use of platinum electrodes for the electrochemical detection of bacteria. Platinum electrodes with surface area ratios of four to one were used to detect and enumerate a variety of gram-positive and gram-negative organisms. Linear relationships were established between inoculum size and detection time. End points for platinum electrodes were similar to those obtained with a platinum-reference electrode combination. Shape of the overall response curves and length of detection times for gram-positive organisms were markedly different than those for the majority of gram-negative species. Platinum electrodes are better than the platinum-reference electrode combination because of cost, ease of handling, and clearer definition of the end point.


Dry-heat destruction of lipopolysaccharide: design and construction of dry-heat destruction apparatus. A dry-heat oven with automatic, multiple-sample introduction and withdrawal has been constructed to achieve instantaneous heating and cooling of samples. The oven temperature fluctuation at set points of 170 to 250 degrees C was +/- 0.1 degrees C, with temperature variation between the replicate samples of +/- 0.2 degrees C. Correction required for a sample come-up time was minimal, i.e., less than 0.25 min of the dry-heat destruction time.


Bioproduction of [14C]ochratoxin A in submerged culture. A number of Aspergillus and Penicillium species were tested for production of ochratoxin A (OA) in several media. After 8 days of static incubations of submerged cultures at 28 degrees C, toxin yields of 25 and 30 micrograms/ml were obtained with Aspergillus alliaceus NRRL 4181 in Ferreirás and 2% yeast extract-4% sucrose media, respectively. However, the largest production observed in the preliminary screening was 54 micrograms/ml; this highest level was produced by A. sulphureus NRRL 4077 in a modified Czapek solution. The medium contained the basal salts and sucrose of Czapek plus urea (3%) and corn steep liquor (0.5% solids). A time study of toxin production demonstrated maximum yield of 350 micrograms/ml by the A. sulphureus isolate in the modified Czapek medium after 11 days of static incubation at 28 degrees C. The optimal production conditions were employed in additional tests designed to measure the efficiency of 14C incorporation from sodium [1-14C]-acetate into OA. Samples (20 microCi) of sodium acetate were added to separate culture flasks at 24-h intervals during the initial 9 days of the fermentation. Addition of [14C]acetate on day 4 of incubation provided the maximum yield of labeled OA. The highest specific activity of labeled toxin obtained was 0.07 microCi/mg of OA and the maximum incorporation rate of labeled acetate was 5.3%.


Use of cetylpyridinium chloride in the decontamination of water for culture of mycobacteria. Selective decontamination of large-volume aqueous samples for mycobacterial culture can be achieved with overnight exposure to 0.04% cetylpyridinium chloride.


Use of an internal standard in monitoring the bacterial degradation of crude oil. Hexachloroethane is nonvolatile, insoluble in water, and apparently not toxic to or metabolized by bacteria. Its addition to cultures growing at the expense of crude oil thus provides an internal standard against which the rate of degradation of individual crude oil components can be conveniently and reproducibly measured.


Stress response and its relationship to cystic (pseudofollicular) change in the definitive cortex of the adrenal gland in stillborn infants. The adrenal glands of 41 fresh stillbirths were studied and a 'stress response' pattern could be seen in 28. In these glands the stress response was characterised by compact cell change, lipid depletion, excess pyroninophilia, and dilatation of the very prominent granular endoplasmic reticulum. Scattered areas of cytolysis of cells, especially of the definitive cortex, gave rise to the commonly seen cystic (pseudofollicular) change and it was obvious that cells undergoing lysis were severely 'stressed'. In 2 infants there was a 'clear cell reversal' pattern. Histological and ultrastructural changes of the stress response were not identified in 11. Infants of low birthweight score were somewhat more commonly represented in the group that did not show a stress response. Cytolytic changes accompanying a stress response were commoner in immature infants. It is argued that cystic (pseudofollicular) change in the adrenal cortex of the newborn signifies a previous stress reaction.


Calcium intake in the first five days of life in the low birthweight infant. Effects of calcium supplements. Sixteen low birthweight infants were allocated to two groups. Both groups 1 and 2 received a formula with Ca/PO4 ratio of 1.21. Group 2 infants received a supplement of 800 mg/kg per day of Ca and Mg lactate, and the daily Ca, Mg, and PO4 levels were measured. Calcium intakes (mg/kg per day) were, comparing groups 2 and 1: 82 v. 33 on the 1st day; 133 v 45 on 2nd; 170 v. 56 on 3rd; 224 v 72 on 4th; 263 v. 88 on 5th. Magnesium intake (mg/kg per day) was 4.9 v. 3.8 on the 1st day; 8.3 v. 5.3 on 2nd; 9.8 v. 6.5 on 3rd; 15.5 v. 8.3 on 4th; 16.0 v. 10.0 on 5th. Phosphate intake was similar in both groups. Mineral content of vomits and regurgitations showed more Ca than P, with a ratio of 1:68. Comparing the two groups, in the supplemented infants, serum Ca rose from the 3rd day by an amount which was related to Ca intake: serum Mg was lower from the 4th day and was negatively correlated with Ca intake.


Failure to thrive or failure to rear?

Failure to thrive or failure to rear? The study group comprised 40 unselected Caucasian children admitted to hospital whose ages were between 3 months and 3 years and whose weights were less than 3rd centile. A comparison group comprised 34 children from a similar background whose weights were between the 25th and 75th contiles. The mothers of all 74 children were interviewed and information was obtained on physical health of the child, social and family factors, bonding, feeding difficulties, and maternal childhood experience. In 23 of the 40 underweight children the organic disease was considered to be insufficient to explain the child being underweight and to be probably insufficient in a further 9 children. Three factors occurred more frequently in these 32 underweight children. The mother often perceived herself as having a disturbed mood and used the word "depression" to describe these feelings. She also tended to come from a lower social class than the mother in the comparison group, and her infant frequently had a low birthweight. Identification of these children is not difficult; clinical investigations need to be minimal, and therapy should be directed towards supporting the mother emotionally, improving her relationship with her child, and increasing her mothering skills.


Pyridoxol metabolism in vitamin B6-responsive convulsions of early infancy. As there is uncertainty about the nature of the metabolic defect in vitamin B6-responsive convulsion, certain aspects of pyridoxol metabolism were studied in 3 patients who were believed on clinical grounds to have the condition. The findings were compared with those in healthy children and adults, and in children with mental handicap. The magnitude of the initial rise and the subsequent fall in plasma pyridoxal phosphate (PALP) concentrations after a load of pyridoxol suggested that the vitamin B6-responsive patients were able to synthesise PALP normally but were unable to maintain the prolonged high levels normally found in plasma. The urinary excretion of 4-pyridoxic acid was within normal limits, but the excretion of pyridoxol after the load was raised. It is suggested that there may be an instability of the PALP-albumin complex in this condition. Some of the biochemical features were also observed in an infant presenting with convulsions soon after birth but without evidence of clinical B6-dependency.


X-linked icthyosis. A sulphatase deficiency. In 3 pregnant women oestrogen excretion in the urine was very low. The pregnancies were otherwise uncomplicated and the 3 infants, boys, were normal at birth, but later developed ichthyosis of the X-linked inherited type. Histochemically, the placenta in each case showed deficiency in arylsulphatase-type C activity. In all three children the skin showed the same enzyme deficiency. In the skin of 9 other unrelated (adult) patients with proved X-linked inherited ichthyosis vulgaris, arylsulphatase C activity was deficient. Skin from 5 normal adults and 5 normal children showed arylsulphatase C activity to be present. It is concluded that a sulphatase deficiency is a factor in the causation of ichthyosis of the X-linked inherited type.


Hazards to children in traffic. A paediatrician looks at road accidents. An overall view is presented of the hazards to children in traffic. The importance of the developmental aspects of childhood accidents is stressed, and a plea is made for doctors working with children to recognise the part they could play in reducing the number of road accidents to children by their understanding of child development and behaviour. It is an aspect of preventive paediatrics that is largely neglected at present.


Immunodeficiency associated with laevocardia, bronchiectasis, and paranasal sinus anomalies. In a case of laevocardia, bronchiectasis, and paranasal sinus abnormalities, assessment on 2 occasions showed the presence of moderate immunodeficiency. Serum concentrations of IgG and IgM were low, and serum and salivary IgA was not detected. T-lymphocytes were reduced in number and cell-mediated immunity in vivo and in vitro was impaired. Opsonisation, complement system, and neutrophil functions were normal.


Spontaneous maturation of stage IV--S neuroblastoma. A case of stage IV--S neuroblastoma is presented in which treatment has deliberately been kept to a minimum. Gradual maturation to ganglioneuroma has been documented and the patient's generally good progress has justified this approach.


Hypomagnesaemic hypocalcaemia with hypokalaemia caused by treatment with high dose gentamicin. A 12-year-old boy developed renal wasting of magnesium, calcium, and potassium, with secondary hypomagnesaemia, hypocalcaemia, and hypokalaaemia (without hyperaldosteronism) after treatment with 14 400 mg gentamicin over 4 months. Gentamicin should not be given for prolonged courses if less toxic antibiotics are suitable. If it used, plasma magnesium, calcium, and potassium levels should be monitored during and after treatment.


Infrared irradiance from phototherapy units and the effect on osmolality of serum and urine in term infants. The osmolality of urine increased in 10 term infants receiving phototherapy. Phototherapy units made locally were likely to emit more infrared radiation than a unit available commercially, but both types led to falsely increased incubator thermometer readings. Interposing a 6-mm acrylic sheet prevents these effects.


Thermometers and rectal perforations in the neonate. Three neonates with rectal perforations probably caused by the use of the rectal thermometer, are reported. The dangers of this condition and the difficulty of diagnosis even at laporatomy are emphasised. It is suggested that since the axillary temperature in the neonate is an adequate reflection of the core temperature the routine use of the rectal thermometer, except in exceptional circumstances, should cease.


Variations in the resting oxygen consumption of small babies. Over 200 measurements of the resting rate of oxygen consumption using an open-circuit method were made on 15 small babies nursed in their usual clinical setting during the first month of life. There were striking and persistent variations between babies that could not be explained by postnatal age, relationship to feed, sleep, or time of day. It was not possible from clinical examination to predict which babies had the higher or lower metabolic rates, except that babies who were light-for-dates generally had higher values. Because of these variations the appropriate thermal temperature for small babies cannot be predicted from average values adjusted for body weight and postnatal age alone.


Nonphysiological anaemia of prematurity. Clinical and haematological findings at the nadir of the refractory, early anaemia of prematurity were compared in a study of 95 preterm infants. 53% of 30 babies less than 32 weeks' gestational age at birth had abnormal clinical features resulting from anaemia at its nadir, with a combination of tachycardia, tachypnoea, dyspnoea and feeding difficulties, diminished activity, and pallor. The expression 'available oxygen', derived from the Hb concentration and Hb-O2 affinity, correlated more closely with clinical features of anaemia that did the Hb concentration alone. A formula is presented that predicts the 'available oxygen', provided the Hb concentration and post-conceptual age are known; this avoids the need for direct measurement of Hb-O2 affinity. Clinical anaemia is common in preterm infants with Hb concentrations of up to 10.5 g/dl, consequent on the high O2 affinity of fetal Hb. This is the first description of any common clinical consequence of high Hb-O2 affinity.


Immunological events in acute measles influencing outcome. 77% of 30 children with measles who had severe lymphopenia (less than 2000/mm3; less than 2.0 x 10(9)/1) within 2 days of appearance of rash (group A) subsequently died or progressed to chronic chest disease. This was significantly worse than the outcome in 30 children with measles who had lymphocyte counts more than 2000/mm3 (more than 2.0 x 10(9)/1) (group B) of whom 67% recovered. In group A children the persistence of severe lymphopenia (caused by a reduction in T- and B-cells) for at least 15 days after onset of rash, remained a good predictive index of morbidity and mortality. Reversal of immunoparesis in group A was slower and incomplete 42 days from appearance of the rash in those who subsequently died or developed chronic chest disease compared with those who recovered. All patients who died failed to produce adequate measles antibodies. The therapeutic implications and immunopathological significance of these findings for chronic complications after acute measles are discussed.


Hypochondroplasia.

Hypochondroplasia. Clinical, radiological, and genetic features are described in 3 patients with hypochondroplasia. Early recognition of this disorder is possible from the abnormal body proportions with short limbs and lumbar lordosis without facial stigmata of achondroplasia. Radiological confirmation is possible provided a full skeletal survey is made. Two of our patients had a large head.


Evaluation of methods of assisted ventilation in hyaline membrane disease. Two methods of providing assisted ventilation were compared in infants severely ill with hyaline membrane disease (HMD). 10 infants were assigned to each group. One group received ventilation with a volume-cycled respirator, and the other was ventilated using a pressure-limited ventilator and reversed I:E ratio. Both groups were well matched for severity of illness in terms of pH and blood gases. pH and PO2 were quickly corrected by both ventilators. However, the pressure-cycled ventilator group had higher survival and lower complication rates. PAO2 after one hour was substantially improved at the same FIO2 in the pressure-limited group and after 8 hours the FIO2 required to maintain a PaO2 of 50--70 mmHg (6.6--9.3 kPa) was significantly decreased compared with the volume-cycled group. No effects on blood pressure were detected in either group. The study shows that the pressure-limited method is significantly better.


Chest wall sarcoma of childhood with a good prognosis. Four cases of a locally invasive sarcoma of the chest wall are described in children aged between 8 and 14 years. Although its morphology resembles a  Ewing's sarcoma of bone there are light and electron microscopical features that are distinctive. The sarcoma is thought to represent an entity which has not previously been defined. Its clinical importance lies in the fact that the prognosis with appropriate treatment appears to be good. One child died after 2 1/2 years, but the others are alive 6, 8, and 16 years after presentation.


Significance of raised immunoglobulin M levels in cord blood of small-for-gestational-age infants. Cord IgM values were determined in small-for-gestational-age infants born at Hammersmith Hospital during a 5 1/2-year period. 121 (12.5%) infants had levels more than 0.2 g/l; in 92 these were between 0.21 and 0.3 g/l. In only 18 (14.8%) was a level of 0.4 g/l exceeded, and 5 proved cases of intrauterine infection--rubella (2), syphilis (2), and toxoplasmosis (1)--were in this group. The factor most often associated with cord IgM more than 0.4 g/l was prolonged rupture of the membranes. There was an increased incidence of blood group B among the mothers, probably reflecting the greater number of nonCaucasian women giving birth to small-for-gestational-age infants. Determination of cord IgM did not help significantly indiagnosis.


Aneurysmal bone cyst: a report of three cases. Three children presenting with aneurysmal bone cysts are described. The first patient was 10 months old with a cyst of the scapula. The second was more typical but his cyst was treated initially as a malignant tumour. In the third child the second cervical vertebra was affected which posed considerable problems of management; it was treated by radiotherapy. Despite the problems all 3 children have made a good recovery.


Relationship between clinical features of tricyclic antidepressant poisoning and plasma concentrations in children. Clinical features and drug plasma concentrations were studied in 13 children admitted to hospital with tricyclic antidepressant poisoning. Patients with plasma concentrations below 500 microgram/l had anticholinergic signs and increased reflexes but did not have convulsions or cardiac arrhythmias. Four patients with plasma concentrations above 1000 microgram/l suffered convulsions, cardiac arrhythmias, or prolonged coma. The diagnosis of poisoning in 2 of these cases was made only by toxicological analysis. Quantitative estimation of tricyclic antidepressants is useful in atypical or severe poisoning both to reach the diagnosis and to give an idea of the likely duration of symptoms.


Adenoidectomy: an evaluation of the indications. A group of 76 children who had been listed for adenoidectomy was investigated by scoring the symptoms and signs usually attributed to adenoidal hypertrophy, and removing the adenoids and weighing them. With the possible exception of snoring there was no correlation between the size of the adenoids and the symptoms usually attributed to hypertrophy of this organ. We wish to acknowledge our gratitude to those consultants who allowed us access to their patients, to Dr Ian McDicken, Department of Pathology, University of Liverpool who did the histological examination, and to Mrs P. O'Brien who did the typing.


A case of paragonimiasis.

A case of paragonimiasis. A 2 1/2-year-old girl recently arrived from eastern Nigeria presented with a soft tissue swelling of the infraclavicular region. Subsequent investigation revealed a cavity in the left lung associated with a small pleural effusion and leucocytosis with pronounced eosinophilia. Clinical and serological findings were compatible with the diagnosis of paragonimiasis. After a course of Bitin-S the chest x-ray returned to normal, the soft tissue changes disappeared, and the eosinophil count fell.


The excretory system of young chickens experiencing mercury toxicity--effects on kidney development, morphology, and function. Four trials were conducted to determine if toxic levels of mercury affect kidney development, morphology, and renal function. Mercury, administered via the drinking water as mercuric chloride caused a reduction in gross kidney weight, an increase in relative kidney weight and a slight but significant increase in the percentage water retained by left kidney of 6-week-old cockerels. Mercury had no effect on renal function of 6-week-old birds as indicated by the clearance of phenol red from circulation. Histological discontinuity of the kidney was extensive and evidenced by foamy cell degeneration and nuclear pyknosis. Although mercury caused gross alterations in the morphology of the kidney, normal excretory function was maintained.


The effect of an in situ-produced oil shale processing water on metabolism. The effects of in situ-produced oil shale retort water on the metabolism of various substrates was studied both in vivo and  in vitro. The induction observed in rats was classified as Type I due to an increase in metabolism of hexobarbital and ethylmorphine without subsequent increases in zoxazolamine metabolism. The maximal absorption of the cytochrome-P450-CO complex was observed to be 450 millimicron, also consistent with Type I inducers. Cytochrome P-450 levels were also significantly increased over controls.


Cadmium-induced tissue specific changes in drug biotransformation rates in rats. Cadmium was administered into male rats in drinking water as cadmium chloride at a concentration equivalent to 250 ppm of cadmium for 2 and 8 weeks. The cadmium concentration in the liver microsomes was 0.85 +/- 0.11 microgram/g (wet wt) and in the supernatant 29.6 +/- 1.1 microgram/g and in the renal microsomes 1.30 +/- 0.30 microgram/g (w.wt) and in the supernatant 24.4 +/- 3.2 microgram/g after 8 weeks. In the intestinal postmitochondrial supernatant fraction the cadmium concentration was 14.2 +/- 1.0 microgram/g (wet wt) after 8 weeks administration. There was a slight increase in the hepatic cytochrome P-450 level, no changes in the hepatic p-nitroanisole O-demethylase and NADPH cytochrome c reductase activities and a clearcut induction in the hepatic aryl hydrocarbon hydroxylase activity after 8 weeks cadmium exposure. Renal activities followed mainly those of the liver. No changes were found in the hepatic UDPglucuronosyltransferase activity and a slight activation was present in the renal activity. The intestinal activities were markedly depressed after cadmium exposure. The results suggest that cadmium administration changes the drug biotransformation rates differently in various tissues.


Chlorination of benzidine and other aromatic amines an aqueous environments. The fate of aniline, N,N-dimethylaniline and benzidine in chlorinated waters was investigated. Conditions were controlled to approximate the process chlorination of raw water supplies and wastewater secondary effluents. As the molar ratio, (Cl2)/(amine), was increased, amine depletions increased and leveled off at about (Cl2)/(amine) = 1. Depletions in distilled water with "free" chlorine were somewhat higher than those in activated sludge/secondary effluent with combined chlorine. For each amine the number and type of products appeared to be independent of the water matrix and the ratio, (Cl2)/(amine). For the monophenyl amines ring chlorination was a significant depletion pathway. Extended chlorination of aniline yielded a precipitated product, while the N-substituted amine, N,N-dimethylaniline did not yield a solid product. In contrast to the monophenyl amines, when benzidine (p,p'-diaminobiphenyl) was exposed to chlorinated waters, a solid product resulted immediately. Infra-red analysis of this product indicated a polymeric structure with no ring chlorination. GLC analysis of the chlorination supernatant showed no ring substituted isomers of benzidine.


A biomonitoring procedure utilizing negative phototaxis of first instar Aedes aegypti larvae. Negative phototaxis of newly hatched Aedes aegypti L. larvae was inhibited by exposure to three heavy metals and five organic insecticides. This response was quantified in an inexpensive multiunit apparatus consisting of four glass troughs perpendicular to a uniform light source. The criterion of toxic effect, established with cupric sulfate as a standard, was: inability of larvae to migrate 30 cm in 60 sec after 8 hr of pre-exposure, designated as 8-hr EC50. The photomigration procedure was more sensitive than our comparative 24-hr acute lethal toxicity tests on metals. The 8-hr EC 50 values for cadmium, chromium and copper were 0.6, 2.4, and 1.4 mg/L, respectively. Values for insecticides ranged from 0.003 mg/L for fenitrothion (organophosphate) to 0.39 mg/L for methomyl (carbamate).


Fate of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) in a model aquatic environment. The fate of TCDD (2,3,7,8-tetrachlorodibenzo-p-dioxin) was studied by using aquatic sediment and lake water under laboratory conditions. Most of the TCDD was found in the sediment from which it slowly disappeared. Evaporation may be a major mode of disappearance of TCDD in samples incubated 39 days or more, with metabolism playing only a minor role. Under the experimental conditions the half-life of TCDD was in the order of 600 days. The metabolic activities were enhanced under conditions which stimulated microbial growth in the presence of sediment, and the metabolites were found to be released from the sediment to the ambient water.


Calcium-45 uptake by shell gland, oviduct, plasma and eggshell of DDT-dosed ducks and chickens. Experiments were conducted with ducks and chickens to determine the effects of acute doses of DDT and DDE on calcium-45 balance and calcium-45 distribution among plasma, femur, tibia, oviduct, shell gland, and eggshell. Species differences in distribution of calcium-45 were evident between control ducks and control chickens. Ducks contained more radiocalcium in plasma, shell glands, tibias, and femurs than chickens and eliminated less radiocalcium in their droppings than chickens. The percentage of radiocalcium deposited in eggshells by control birds of either species was about equal. Ducks and chickens treated with DDT or DDE contained more radiocalcium in their shell glands than their respective controls. Treatment with DDT or DDE caused eggshell thinning in ducks but not in chickens; however, treatment with DDT or DDE did not alter significantly the percentage of radiocalcium that appeared in eggshells of either species.


Dieldrin-14C elimination from chickens.

Dieldrin-14C elimination from chickens. A series of experiments was conducted with chickens contaminated with dieldrin-14C to find ways of accelerating the elimination of dieldrin from their bodies. The results of these experiments indicated that charcoal, imbiber beads, and the anion exchanges resins, Dowex XFS-4022 and Dowex SBR-C1, would not be useful agents for increasing the amount of dieldrin eliminated via feces (droppings) of chickens. Further, imbiber beads coalesced in the gizzard of the chickens and reduced their appetites. The anion exchange resin, cholestyramine, might be useful as gastrointestinal absorbant for increasing dieldrin elimination in chickens because it increased carbon-14 elimination in droppings, but its effect on carbon-14 residues in carcasses was not clear. We elected not to investigate this compound further. Probucol, investigated because it might alter gastrointestinal absorption or blood physiology that would affect dieldrin elimination, did not increase dieldrin elimination. Severe starvation was the only method investigated that clearly was useful for increasing dieldrin elimination because it increased carbon-14 elimination in droppings and reduced carbon-14 residues in carcasses.


Temperature preference of the crayfish Orconectes obscurus. Acclimation temperature influenced the acute preferred temperature of the crayfish Orconectes obscurus. This species preferred a higher temperature than its acclimation temperature for those acclimation temperatures ranging from 6 degrees to 26 degrees C. When acclimated to 30 degrees and 33 degrees C, the crayfish preferred a lower temperature than its acclimation temperature. The final temperature preferendum is estimated to be approximately 30 degrees C.


[Right blocks in interauricular communication]. The purpose of this study is to establish some electro-vectorcardiographic criteria useful in the differential diagnosis of right fascicular and truncular blocks in 72 cases of atrial septal defect proven by hemodynamic and surgical data. In all cases, the conduction disorder was analyzed by conventional electrocardiograms; in many cases, additional right unipolar thoracic and intracavitary leads were utilized; and in 22 cases high fidelity records were obtained with a Simultrace Recorder V6R. Right block was studied in vectorcardiographic curves recorded in three planes following the method of Grishman's cube. This block was considered as proximal or truncular in 46 cases: of minor degree in 8 and of intermediate degree in 38. In these cases the difference in time of onset of the intrinsicoid deflection between the free right ventricular wall and the low anterior right septal mass was up to 30 msec. Distal or fascicular block was diagnosed in 26 cases: RASB in 10 and RPSB in 16. The difference in time of onset of the intrinsicoid deflection between the free right ventricular wall and the right anterior-inferior septal mass exceeded 30 msec. The highest values were observed in aVR and V1, in the cases with RASB; in aVF, V3R and V1, in the cases with RPSB. The SF loop was diphasic in the presence of proximal block, appearing above the 0 point in the cases with RASB and below this point in the cases with RPSB. SH loop was anterior when truncular block existed, lateral when there was RASB and plus or less diphasic in the cases with RPSB. Sometimes, Q-Tc interval was prolonged in V2 and V3, grossly related to telediastolic pressure in the right ventricle. The facts reported here permit the formulation of the following conclusions: 1. The morphologic aspects of the electrocardiographic and vectorcardiographic curves are very useful for recognizing RASB. In order to establish the differential diagnosis between RBBB of intermediate degree and RPSB, it is necessary to perform a thoracic electric mapping. 2. The clockwise rotation of the entire SH loop, observed in 27 of 38 cases of intermediate degree RBBB, is probably due to the more important manifestation of right parietal electromotive forces because of the ventricular enlargement. 3. The prolonged Q-Tc interval in some right unipolar leads reflects the diastolic overloading of the homolateral ventricle (increased telediastolic pressure).


[Changes of the P wave in ischemic cardiopathy. Electrocardiographic correlation]. 1. In the presence of normal coronaries, it is possible to find--or not CAI, in patients with arteriosclerose cardiopathy. 2. When coronary obstructions are present, we also could find a clear dominance of CAI. It is necessary to emphasize the fact that every patient of these series who suffered of trivascular coronary illness presented CAI. 3. When CAI shows in at rest ECG of a patient clearly showing ischemic cardiopathy, more often than not we also find important coronary obstructions, but when this sign is not present it doesn't necessarily mean that we should discard the possibility of a vascular disease, it only points to us the presence of a trivascular coronary pathology. 4. Frequently we find a CVP between normal levels when CAI is not present. 5. We found CAI in every patient showing dysinesia and also in most of the patients with dysinergia.


[Various epidemiological aspects of hyperuricemia and gout in Mexico: incidence and the cardiovascular risk factor]. We studied the prevalence and the risk factor among the patients of gout in Mexico. Research was conducted in the National Institute of Cardiology and in our private practice. Prevalence of hiperuricemia and gout in the Institute of Cardiology was of 1% (970 out of nearly 100,000 patients). We divided those cases of two subgroups: Reumatology patients (333) and Cardiovascular patients (529). In the first group primary gout was (96.3), and (50.32% in the second. Risk factor was quite different too: nephropathy 9.9%, lithiasis 9.3%, pyelonephritis 2.7%, cardioangiosclerosis 12.9%, aortosclerosis 6.6%, coronary insufficiency 6.3%, myocardial infarction 0.9%, arterial hypertension 24.6% obesity 56.1% and diabetes 9.9% in the Reumatology group; in the Cardiovascular one, nephropathy 14.3%, lithiasis 12.2%, pyelonephritis 7.1%, cardioangiosclerosis 62.7%, aortosclerosis 31.7%, coronary insufficiency 24.9%, myocardial infarction 29%, arterial hypertension 51%, obesity 54.8% and diabetes 20.4%. Among the private practice patients prevalence was of 10.1% (961). In an early age (39 years) in men and a later one for women (53 years). Other characteristics of epidemiology and risk factor are: primary gout 89%, atherosclerosis 5%, coronary disease 4.6%, lithiasis 4.7%, nephropathy 2%, pyelonephritis 1%, obesity 43%, and diabetes 4.6%. In an small group of patients of our private practice we made an exhaustive study of risk factor and the metabolic disorder of lipids. We found the following frequency: 9.3 of nephropathy, 31.2% of lithiasis, 18.7% of pyelonephritis, 68.9% of cardioangiosclerosis, 46.8% de coronary insufficiency, 9.3% of myocardial infarction, 68.7% of arterial hypertension, 68.7% of obesity and 18.7% of diabetes. In the lipid profile we found an increase in triglicerids and prebeta lipoprotein. We have amply discussed the relation between hiperuricemia and pathology considered as a risk factor from the genetic point of view as well as the metabolic and circumstancial aspect. From all that we concluded that risk is multifactorial.


[Results of a prolonged program of physical training in patients with ischemic cardiopathology]. Training with resistant exercises has been proved to be beneficial for patients of ischemic cardiopathy. This kind of training increases working capacity, provided the exercise is maintained in the necessary threshold to avoid starting a chest angina. Nevertheless, there is no clear evidence of an increase in the blood flooding of the myocardio, the left ventricle function or the heart electric stability as a consequence of the said training. It's our opinion that the principal reasons for this lack of evidence are: a) insufficient research, b) the existence of technical difficulties for developing certain phases of the necessary research, and maybe that, c) some exercise programs are not sufficiently long and intense and to induce myocardial adaptation. The purpose of this study is to determine if a long program of physical exercise training could produce a better blood irrigation and ventricular function as well as restore the electric stability. This approach to the problem is justified by the recent finding of adequate methods which really and definitely answer these questions with the results obtained through properly controlled physical exercise.


Endolymph flow-pressure patterns in models of semicircular canals. Effects of angular accelerations in one or two spatial planes. The effects of angular accelerations in one or two spatial planes over the pressure exerted on the cupule of the semicircular canals, was studied using hydraulic models of the canals. The models were accelerated using a torsion pendulum and the resulting flow was monitored. The relative position of the model modifies the direction and magnitude of the flow in each canal and in the equivalent of the utricle where the canals join each other. When simultaneous accelerations in two spatial planes were used, a coriolic effect was observed, which could be significant to explain some vestibular symptoms that occur under similar conditions. From the information obtained with the models, the excitation-inhibition patterns in each of the six semicircular canals can be predicted for accelerations in any given spatial plane or combination of planes.


[Silent mitral stenosis (report of 8 cases)]. We studied eight cases of mitral "mute" stenosis we had discovered through echocardiogram, and analysed its clinical behaviour, the various findings in exploration, and electrocardiographic, radiologic, phonomecanocardiographic and echocardiographic changes. We mention the most notable signs for the suspected diagnosis of this kind of stenosis and the importance they have in the alleviation of this illness--frequently a very severe one, through surgical treatment. When mitral stenosis is not recognized in time through a precise diagnosis, turns to be a potentially lethal illness a short time after being diagnosed as a pulmonary arterial hypertension. We highly recommend the use of echocardiography for the diagnosis of mitral "mute" stenosis, because it has proved to be a inocuous, easy to obtain and very sensible way of diagnosing.


Isolation of a hypotensive substance from seeds of Casimiroa edulis. The hypotensive activity of the alcoholic and aqueous extracts of C. edulis has been previously reported. The present paper describes the pharmacological studies of a substance isolated from the alcoholic extract. Preliminary chemical and pharmacological data allowed a histamine-like compound to be proposed as the hypotensive principle. Studies were performed by means of in vitro and in vivo animal experiments.


[Hospital mortality of acute myocardial infarct]. Hospital mortality was studied in 541 consecutive patients with acute myocardial infarction (AMI) admitted during a three year period to the Coronary Care Unit (CCU) of the Instituto Nacional de Cardiología de México. Total mortality was 15.3%. Two thirds of the deaths occurred in the CCU. In the remaining fatal cases, the patients had been transferred to regular hospital wards at the time of their death. The largest number of deaths (68.7%) were due to pump failure. A smaller number of patients (14.5%) died as a result of cardiac ruptures. Deaths due to primary arrhythmias have practically disappeared at the CCU's. Hospital mortality due to AMI correlates well with the degree of left ventricular dysfunction. In the cardiogenic shock group and in the acute pulmonary edema group mortality was 93.4 and 50.0% respectively. Patients with moderate degrees of heart failure had a lower mortality rate (18.4%) while in those who did not develop clinical or radiological evidence of left ventricle failure mortality was minimal. In patients with AMI there is a direct relationship between the mass of destroyed myocardium and the degree of left ventricular dysfunction. Thus, mortality is greater in patients with previous infarction, with important enzyme elevation, intraventricular conduction defects, larger cardiac size, etc. Four fifths of the cases studied at post-mortem had a left ventricular mass destruction of at least 40% and most of the cases had significant atheromatous lesions of two or of all three coronary vessels. Further reduction in mortality due to AMI would require an early and effective treatment of the syndromes of left ventricular dysfunction.


Localization of alpha-galactomannan and of wheat germ agglutinin receptors in Schizosaccharomyces pombe. The location of galactomannan on the surface of Schizosaccharomyces pombe cells was reexamined by scanning electron microscopy by an indirect but specific method using gold markers. The polysaccharide was found on the cell surface and at the end beginning to grow but not on the wall established by division. Galactomannan was also localized on S. pombe thin sections by transmission electron microscopy using the same method. The polysaccharide was found deposited in two layers in the cell wall, i.e. at the periphery of the wall and near the plasmalemma. The septum was also marked but mainly near the plasmalemma. These results indicated that the polysaccharide is elaborated onto the outside of the wall during extension but not during septum formation. When thin sections of S. pombe were marked with gold granules labeled with wheat germ agglutinin, marking was found in vacuoles but not in the cell wall. This confirmed that S. pombe cell wall is devoid of chitin.


[Mitral valve replacement, results in 160 patients]. The results of 163 mitral valve replacement from 160 patients since August 1972 til August 1977 are presented, this is the second communication in Mexico related to mechanical mitral prosthesis. 95 patients were females and 55 males. With ages from 8 to 57 years, average 34; the 13% were child or teenagers. In 67% there were a clear background of rheumatic fever; 50% cardiac insufficiency and 19% previous mitral surgery from 8 months to 12 years before. 94% were class III or IV (N.Y.H.A.) and only 6% in I or II. Surgery was indicated according symptoms and hemodynamic data, 98% were catheterized. 26 Starr-Edwards and 137 Bjork-Shiley prosthesis were implanted in mitral position; in 112 cases only the mitral valve was substituted, in 41 cases a tricuspid procedure was done and in another 10 cases the aortic valve was also changed. The postoperative complications were: arrhythmies 32%; low cardiac output in 21%; infections 9%. Operative mortality in the isolated mitral replacement was 12%; in those cases with mitral-aortic or mitro-tricuspic lesions have been 33% in the first three years and 25% in the last three years. The long-term follow-up in 130 survivors is 29 months; 81% of them are actually in class I, 16% in class II and 3% in class III. The literature is reviewed and the facts responsive for the improved results are analyzed; special importance is given to the temporal external cardiac pacing in the management of the postoperative arrhythmies. Mitral valve replacement is considered as a good palliative procedure to the functional and socio-economical long-term rehabilitation in the survivors.


The cryopreservation of Chlorella. 4. Accumulation of lipid as a protective factor. Following growth under sub-optimal concentrations of nutrients, cells of Chlorella emersonii accumulated lipid and became more resistant to the damage caused by freezing and thawing. These results suggest that the factor responsible for the cold hardening of some Chlorella spp is not the effect of low temperatures per se but simply that of the reduced metabolic rate. Evidence is given that the post-thaw injury observed following rapid rates of cooling is associated with the vacuole.


[Differentiation of structural viral proteins using pyrolysis gas chromatography]. Types 1, 2, and 5 of structural proteins of adenovirus as well as human albumin, pepsin, trypsin, and ribonuclease tend to exhibit characteristic substance patterns when exposed to pyrolysis-gas chromatography. Those patterns may be helpful in differentiating between those proteins. The presence of a distributional pattern is assumed to depend, in most cases, not only on the given amino acid composition, but also on the amino acid sequence of the protein proper. Samples of complex composition, such as complete viruses or allantois fluids, were much less suitable for differentiation by means of pyrolysis-gas chromatography.


[Demonstration of IgM antibodies in influenza virus infections]. Forty-Four sera of patients with confirmed influenza-A infection were titrated in parallel with and without 2-mercaptoethanic treatment against influenza-A by means of passive haemagglutination. Reduction of titre by at least two levels was detectable in 21 cases. Gradient centrifugation was additionally undertaken of 23 patient sera and three serum samples obtained from intact probands who had produced a titre against influenza-A in passive haemagglutination. Antibody against influenza-A was present in both the IgM and IgG fractions of the patients' serum samples. Yet, in the three control sera of intact probands antibody against influenza-A was recordable only from the IgG fraction. IgM antibody could not be detected by 2-mercaptoethanoic treatment alone unless the 7s-antibody portion in a given serum sample was smaller than the 19s-antibody portion.


[Comparison between quantitative determinations of blood protein fractions of clinically healthy cattle using cellulose acetate film and micro-agar gel electrophoresis]. Cellulose acetate sheet and agar electrophoresis was used to test the plasma of 106 clinically intact Frisians for total protein and "classical fractions". The average total protein recorded from plasma samples was 6.9 g/100 ml. Plasma albumin concentrations measured by cellulose acetate sheet electrophoresis were 11.39 per cent in excess of those obtained by agar electrophoresis, all at the expense of the alpha1, alpha2, and beta globulins. The results obtained from the two variants of electrophoresis differed from one another by 99 per cent of statistical security for albumin, as well as for alpha1, alpha2, and beta globulins. No such significant difference, however, was established for gamma globulins. It is thought that the low amount of albumin in response to agar electrophoresis was attributable to the fact that part of the albumin fraction had been absorbed to the agar. In pherogram evaluation it would then be calculated as being identical with the subsequent and more slowly travelling fractions of the alpha1, alpha2, and beta globulins. Immuno-electrophoretic experiments have shown the impossibility of real separation of alpha1 globulins from albumin on agar with antiserum absent. The amount of alpha1 globulin, therefore, was relatively high in agar electrophoresis. The electrophoretic approach, consequently, must be considered in any interpretation of proteinograms to avoid error.


[Pathomorphology of radiation sickness in sheep following whole body roentgen irradiation]. Whole-body X-ray treatment was experimentally applied (380 median-line dosage) to eight Merino mutton sheep aged approximately one year. Five of the test animals were lost between 16 and 25 days after irradiation. A great diversity of pathomorphological changes was recorded from organs and tissues, and the most important pathological processes which occurred concomitantly with acute to subacute radiation syndrome of sheep were defective haematopoiesis, septico-toxic processes, haemorrhagic diathesis, and partial epilation. Severe damage to the organs involved in haematopoiesis was one of the primary pathological processes and reflected mainly in lymphopenia, agranulocytosis, and thrombocytopenia, in other words, with lymphopoieses, granulopoiesis, and thrombocytopoiesis particularly involved. Insufficiency of cellular (and humoral) defence would obviously cause germ flooding of the organism, starting from the intestine, and eventually lead to septic intoxication. Haemorrhagic diathesis was found to occur only short of death and is thought to result from thrombocytopenia due to damage to thrombopoiesis as well as from septico-toxic effects upon the blood coagulation and partitioning vascular system. Loss of wool (epilation) was recordable only from neck and shoulder regions, and even there it was on the decline.


[Use of structure-activity analysis in toxicology]. An account is given of principles and methods of quantitative structure-action analysis which have promising applications in toxicology. Particular reference is made to the development of active principles with low toxicity for warm-blooded animals, early assessment of toxicity of recently synthetised or envisaged compounds of one substance class of which the toxicity of some agents has already become known, and appraisal of unspecific toxic effects.


[The effect of ethylenethiorea on microsomal liver enzymes in the rat]. The effect of ethylene thiourea on microsomal liver enzymes of rat has been studied by measuring hexobarbital sleeping time and determining aminopyrine-N-demethylase and aniline-hydroxilase activities. Single oral doses of 50, 100 and 200 mg/kg body mass caused significant prolongation of the sleeping time in males. The same effect was caused by 200 mg/kg in females. When ethylene thiourea was administered in the diet at a level of 200 ppm sleeping time in males increased with duration of administration. The duration of narcosis of females increased up to the third week and remained almost constand over the following feeding period. The aminopyrine-N-demethylase and aniline-hydroxylase activities in the liver of male rats were inhibited by single doses of 20 mg/kg or more. Inhibition and subsequent enzyme change depended on dosage.


[Uptake and distribution of Camposan in rye]. Experiments for uptaking and distribution of the culm stabiliser "camposan" with the agens ethephon are very important to tell something about the dwarf behaviour of the treated plants of rye. The radioactive labelled ethephon is infiltrated through the roots, leaves and cuttings of culms. Uptaking through the roots is more complete than those about the foliar dissepiment. Otherwise uptaking through the foliar dissepiment is higher than about the leaves only. After radioautographic experiments, culmcutting-experiments and experiments with intact rye in the 5--6 leaf-stage we have found that the agens is transported acropetal in the xylem of the plants after uptaking by the roots up to 3 days. The labelled ethephon is translocated in a higher concentration in the phloem after foliar dissepiment application. The concentration of the agens decreases in the investigated plants up to the 5th day enormously (40--50% and after then slightly following the degradation to gaseous compounds. During 4 days ethephon is metabolized to about 5--15% ethylene and additional to about 18--20% carbondioxide.


[Determination of chlorocholine chloride, diquat and paraquat]. Chlorocholine chloride, diquate, and paraquate may be precipitated in aqueous solution with sodium tetraphenylborate. The precipitates are soluble in nitromethane and diethylketone. Acid fluxing agents have to be used for thin-layer chromatography with silica gel G.


[Acute Hedolite poisoning in humans].

[Acute Hedolite poisoning in humans]. Severe intoxication was contracted by an agrochemist who had handled Dintro-O-kresol (DNOC) over several days. The symptoms are described in this paper. The half-life calculated from the blood level course amounte to 148 hours. The particular case of intoxication is evaluated, and reference is made to literature, before the reader's attention is drawn to certain major and crucial aspects that should be duly considered in any use of DNOC, such as limitation of exposure, blood level monitoring, and availability of adequate safety clothing.


[Mechanism of acute toxic effects of chlorocholine chloride and 2-chloroethyl phosphonic acid (Ethephon)]. An account is given of results obtained from animal experiments that had been conducted with the view of elucidating the mechanisms underlying acute toxic action of CCC and Etephon. CCC was found to have neuromuscular blocking actions and, consequently, to lead to respiratory arrest in a situation of acute intoxication. The neuromuscular block has by all characteristics of a block by depolarisation. Acute toxicity of CCC was found to differ by species as well, which was attributable primarily to differentiated sensitivity of various species to depolarising neuromuscular blockers. The parasympathicomimetic effects of CCC were of secondary importance to acute toxicity of the compound. The toxicity of CCC could be reduced by small doses of atropine, but higher atropine doses proved to be unfavourable by aggravating respiratory paralysis. Reduction in acute CCC toxicity with concomitant administration of choline chloride was attributable to inhibition of the absorption rate of CCC. Long-term inhibition of plasma cholinesterase was recorded from rats and mice in after to oral administration of Etephon, but cholinesterases were not inhibited the erythrocytes and brain. All the cholinesterases studied, including those obtained from plasma, erythrocytes, and brain from rat and mouse, were inhibited in vitro by approximately identical Etephon concentrations. Inhibition of plasma cholinesteras was of no importance to acute toxic effects. Acid-borne corrosion was an established cause of deaths among rats and mice with acute Etephon intoxication.


[Pathomorphology and pathogenesis of radiation sickness in calves and young cattle following whole body roentgen irradiation]. Here are the most important pathomorphological findings recorded from 14 calves or heads of young cattle following whole-body X-ray treatment (170 R and u50 R median-line dosage): 1. Damage was caused to the haematopoietic system, with the most severe effects on granulopoiesis, thrombocytopoiesis, and lymphopoiesis, but less conspicuous lesion of erythropoiesis. 2. Haemorrhagic diathesis developed together with pneumonia in 86 per cent of all cases, manifested in most of them as severe fibrinous pneumonia and pleuropneumonia (in 75 per cent of the cases) and progressing pericarditis. 3. Liver degeneration occurred to all animals, usually in the form of centrobular liver cell necrobiosis (86 per cent), with most of the cases accompanied by diffuse degenerative hepatoparenchymal damage (80 per cent) as well as by granular degeneration of the myocardium and acute fubulonephrosis, the latter two processes obviously developing only short time before death. 4. Catarrhal as well as fibrinous and circumscribed diphtheroid enteritis developed in 43 per cent of all animals, those which had received a median-line dosage of 170 R. 5. Deficiency in supply was recorded, too, with severe damage to the haematopoietic organs being in the focus of the pathological process. That damage actually was the cause of the haematologically established granulocytopenia or agranulocytosis, thrombocytopenia, and lymphopenia. That was the background against which radiation syndrome of calf could be accompanied by activation of latent or subclinical infection of respiratory organs and the development of severe pneumonia as well as by changes in the intestinal flora leading to the outbreak of enteritis. The collapse of cellular defence mechanisms obviously caused intestinal induction of resorption of bacterial toxins and decomposed tissue products, with the pneumonia-damaged lungs being involved. The results eventually were intoxication with haemodynamic disorders, increase in vascular permeability, and degenerative damage to the parenchyma. Haemorrhagic diathesis was the result of thrombocytopenia and, possibly, endotoxic or toxic damage to the coagulation and blood vessel system. Further pathogenetic aspects relating to the radiation syndrome in calf and young cattle are discussed.


State anxiety, physical activity, and urinary 3-methoxy-4-hydroxyphenethylene glycol excretion. Measurement of urinary 3-methoxy-4-hydroxyphenethylene glycol (MHPG) levels has been suggested as possibly being important in elucidating the role of central noradrenergic function in affective illnesses. The influence on urinary MHPG excretion of the state variables of physical activity and stress has not been clearly defined in previous studies. During a baseline medication-free period, 24 hospitalized depressed female patients underwent a five-day protocol including an eight-hour period of either enhanced or restricted activity. Throughout the protocol, independent measurements of telemetered mobility and stale anxiety were obtained. There were no significant effects of physical activity on urinary MHPG levels. Furthermore, baseline urinary MHPG levels and baseline state anxiety did not covary significantly. However, within-individual analyses yielded a highly significant relationship between changes in urinary MHPG levels and changes in state anxiety. The data suggested that those patients with lower baseline MHPG levels were those more prone to experience increased anxiety under environmentally "activating" circumstances.


Toward a biochemical classification of depressive disorders. I. Differences in urinary excretion of MHPG and other catecholamine metabolites in clinically defined subtypes of depressions. The urinary excretion of 3-methoxy-4-hydroxyphenylglycol (MHPG) and other catecholamine metabolites was measured in a series of 63 patients with various clinically defined subtypes of depressive disorders. MHPG excretion was significantly lower in patients with bipolar manic-depressive depressions and schizo-affective depressions than in patients with unipolar nonendogenous depressions. Patients with schizophrenia-related depressions also excreted reduced levels of MHPG when compared with patients with unipolar nonendogenous depressions. Moreover, levels of urinary epinephrine and metanephrine were significantly lower in patients with schizophrenia-related depressions. These data, coupled with our recent finding that patients with schizophrenia-related depressions had significantly higher levels of platelet monoamine oxidase activity than control subjects of patients with unipolar endogenous depressions, suggest that we can discriminate three biochemically discrete subgroups of depressive disorders corresponding to the following clinically defined subtypes: (1) the bipolar manic-depressive depressions plus the schizo-affective depressions; (2) the unipolar nonendogenous depressions; and (3) the schizophrenia-related depressions.


Toward a biochemical classification of depressive disorders. II. Application of multivariate discriminant function analysis to data on urinary catecholamines and metabolites. The previous article in this series reported on the differences in urinary excretion of 3-methoxy-4-hydroxyphenylglycol (MHPG) in patients with various clinically defined subtypes of depressive disorders. We now report that further biochemical discrimination among depressive subtypes is provided by the following equation, derived empirically by applying multivariate discriminant function analysis to data on urinary catecholamine metabolits: Depression-type (D-type) score = C1(MHPG) + C2(VMA) + C3(NE) +C4(NMN + MN)/VMA + C0. In the original derivation of this equation, low scores were related to bipolar manic-depressive depressions, and high scores were related to unipolar nonendogenous (chronic characterological) depressions. Findings from a series of depressed patients whose biochemical data had not been used to derive this equation confirmed these differences in D-type scores among subtypes of depressions. The findings presented in this report further suggest that we can discriminate three biochemically discrete subgroups of depressive disorders.


Platelet monoamine oxidase in affective disorders. Platelet monoamine oxidase (MAO) activity was determined with tryptamine as substrate for 61 drug-free patients who had a primary major depressive disorder and for 32 normal controls. Although there were no significant differences between the mean platelet MAO activity of 19 bipolar patients (4.94 nmoles/hr/mg of protein), 42 unipolar patients (4.97 nmoles), and the controls (4.78 nmoles), an analysis of variance indicated that the variance of the bipolar group was significantly greater than that of the other groups. This suggests that there may be subgroups of bipolar patients that differ in their platelet MAO activity but that appear to be distinct from the bipolar I vs bipolar II classification.


Results of a token economy.

Results of a token economy. A token economy for chronic psychiatric patients (average hospital stay of ten years) is reported. One hundred seventy-four patients were treated. Follow-up data were obtained on 173 patients who had been discharged from the hospital for an average of three years at the time of follow-up. One hundred twenty-five patients completed the program, which featured a graduated method for shaping behavior (functional levels). Ninety-one of the 125 patients who completed the program and were living in the community were employed. The program was most effective with patients who had been in the hospital for less than ten years and had an IQ above 80.


Reliability and validity in binary ratings: areas of common misunderstanding in diagnosis and symptom ratings. Confusion may exist between the reliability of a binary rating (for example, schizophrenia versus not-schizophrenia) and its implications for validity. High reliability does not guarantee validity, but paradoxically, low reliability does not imply poor validity in all contexts. Changes in the base rate or in experimental design may indicate high validity even when the reliability was thought to be low. Attempts to improve the psychiatric nomenclature by increasing only reliability run the risk of the "attenuation paradox" where further increases in reliability will make the ratings less valid. Finally, the assumption of random error in making diagnoses does not always hold, so that statistical analyses must be adjusted accordingly. New statistical methods are needed to index only false-positive or false-negative rates in order to quantify the error that will reduce some validity coefficients.


Reliability of the Group for Advancement of Psychiatry Diagnostic Categories in Child Psychiatry. A total of 403 multiple diagnoses were independently assigned to 41 patient protocols by 73 psychiatrists, psychologists, and social workers to determine the levels of interrater reliability of the Group for the Advancement of Psychiatry (GAP) diagnostic categories. With the exception of the psychotic disorders category, these diagnostic categories were found to have low levels of interdiagnostician reliability. Differences in the reliabilities across disciplines and levels of training were found. It is noted, however, that neither years of experience, kind of training, nor direct contact with the patient can be regarded as a substitute for improvements in the classification system itself. The importance of a reliable classification system for child psychiatry is emphasized and suggestions for improvements in the present GAP system are made.


Training psychiatrists in social research: problems and prospects. An integrated program of psychiatric residency training and doctoral studies in social welfare has been conducted by Brandeis University and two Worcester (Mass) clinical institutions over the last five years. Its goal has been to train psychiatrists to conduct psychiatric research using social science concepts and techniques. This article reviews the advantages of such a program, as well as its problems, in the context of current trends in psychiatric education and research. This program is also compared to others with similar goals that use different models of training.


Some genetic aspects of alcoholism and criminality. A population of adoptees. The state criminal records and official registers of alcoholics were used in a study of 2,000 adoptees and their biological and adoptive parents. The frequency of registration for the adoptees were approximately the same as for the population in general, but for the biological parents it was two to three times greater. Very few adoptive parents appeared in the records. It is conceivable that to a large extent adoption neutralized the "social heritage" from the biological parents. There was, however, a significant correlation in the records between alcoholism in biological parents and in their adopted-out sons. On the other hand, the criminal records showed no such correlation between biological parents and their children. These results support the hypothesis that there is a genetic explanation for the development of alcoholism, but not for the manifestation of criminality.


Undiagnosed psychiatric illness in adolescents. A prospective study and seven-year follow-up. Twenty-four psychiatrically ill adolescents, unclassifiable by diagnostic criteria, were followed up after seven years. Fifteen had been ill in the interval, and the conditions of 12 of these could, as adults, be diagnosed according to established syndromes because atypical adolescent psychiatric disorder became more typical in adulthood. Nine subjects remained well. Their original disorders had been characterized by depressed mood, reactivity, and conflicts with parents. Such a clinical picture in the absence of drug or alcohol abuse had good prognosis. Among many clinical and sociological features present at the time of the original study, only the presence of a "psychotic" symptom (hallucinations, delusions, formal thought disorder, or bizarre behavior) differentiated those who would be sick at follow-up from those who would be well. Poor outcome was predicted by such a symptom regardless of what the diagnosis later turned out to be.


A cooperative clinical study of methadyl acetate. I. Three-times-a-week regimen. This was an open clinical trial of methadyl acetate (LAAM) compared with methadone in the maintenance of 636 heroin addicts who had previously been stabilized on a maintenance regimen of methadone. The starting sample assembled by the 13 cooperating clinics were randomly assigned to continued maintenance on methadone (= 308) or crossed over to methadyl acetate (= 328) for a period of 40 weeks. The starting dose was identical to the previously established dose of methadone, but beginning with the second visit, dosage was flexible. Safety was evaluated by clinical and laboratory observations conducted at four-week intervals throughout the study. Relative efficacy was evaluated by illicit drug use, program retention and attendance, and global staff judgments. It is concluded that methadyl acetate is as safe as methadone and, when given three times a week, is an acceptable and effective maintenance drug for many heroin addicts.


Comparative validity of random-interval and fixed-interval urinalysis schedules. Accurate detection of unprescribed drug use by addicts in treatment may facilitate their rehabilitation. Many clinics collect urine samples at random, using fixed-interval collection schedules, which are not free from sampling error. Random-interval schedules minimize sampling error and consequently increase detectability of drug use by eliminating safe periods during which drug use cannot be detected. We compared these two methods by observing rates of detected opiate- and quinine-positive samples preceding and following implementation of random-interval schedules. Detected drug use doubled initially. As detection and clinical sanctions became more certain, drug use declined to well below its former level. Programs that use fixed-interval schedules may underdetect drug use by more than 50%. If patients can reliably predict safe periods, the possibility of using drugs without fear of detection may impede their rehabilitation.


Multiple predictors of dropout from alcoholism treatment. A common problem in treating alcoholics is the high dropout rate. Many studies have identified individual factors associated with dropout, eg, poor motivation and previous dropout. We believe the present study reports the first major effort to use multivariate analyses to predict dropout in a large (792), one-year follow-up study of alcoholics, and examines the possibility that medical and nonmedical treatments lead to differential dropout rates. A multiple classification analysis technique showed that treatment variables as opposed to client characteristics were the best predictors of dropout. Patients remaining in treatment were more likely to have a variety of medical interventions, eg, medication and medical assessment, than those who dropped out. Results were similar to studies using other techniques and have interesting implications for the treatment of alcoholics, raising questions about current trends toward nonmedical treatment of alcoholism.


'Loss of control' in alcoholics.

'Loss of control' in alcoholics. This study evaluates the ability of alcoholics to regulate their blood alcohol levels (BAL) within a designated range by relying primarily on interoceptive cues. Forty male alcoholics and 20 control subjects were exposed to an initial training session in which they received sufficient ethanol to maintain them within a designated BAL range over a 2 1/2-hour period. They were then exposed to two experimental sessions, one providing "overfeedback" and one "underfeedback." During each session, subjects had ten drinking decisions to make with respect to regulation of their BAL. The results indicated that alcoholics displayed greater "loss-of-control" than control subjects. This finding supported the hypothesis that alcoholics may possess a neurophysiologic feedback dysfunction that contributes to their relative inability to regulate ethanol intake.


Paranoid symptoms in patients on a general hospital psychiatric unit. Implications for diagnosis and treatment. Paranoid symptoms were found in 40% of patients admitted to a university general hospital psychiatric unit during a ten-month period. Fifty-eight percent of this group had frank paranoid delusions, while the rest had ideas of reference or generalized suspiciousness. Only one half of those who had paranoid delusions had paranoid schizophrenia. A significant number had affective disorders or organic brain disorder. Ideas of reference and suspiciousness were found in many patients who were not psychotic. The therapeutic implications of these findings are reported in three patients who were inadequately treated for affective disorders because the presence of paranoid symptomatology had led to an incorrect diagnosis of schizophrenia.


Morbidity suppressive effect of lithium carbonate in cycloid psychosis. The possible morbidity suppressive effect of lithium carbonate on cycloid psychosis has been investigated in 30 patients who had suffered from recurrent episodes. The patients were followed up from 1 to 8.5 years after starting lithium treatment. In the analysis, patients were divided into those who took lithium regularly and those who took it irregularly, the division being based on the lithium plasma levels at the periodic control examinations. The study, which is of the so-called mirror tye, supports the hypothesis that well-conducted lithium maintenance treatment has a favorable morbidity suppressive effect in patients suffering from cycloid psychosis.


Alcoholics in interactional group therapy: an outcome study. Three interactional therapy groups of alcoholic patients (N = 20) were formed, and treatment outcome after eight months and again after 12 months of therapy was compared with the outcome of 17 neurotic patients in comparable therapy. Outcome assessment was obtained from three sources: patient, therapist, and independent judge, using both nomothetic and ideographic measures. The results indicated that although more alcoholic than neurotic patients terminated therapy within the first six sessions, a higher percentage of alcoholic patients remained in therapy for 12 months. At the end of 12 months, both samples had improved along a wide variety of variables, and there were no significant differences between the alcoholic and neurotic population in degree of improvement.


Prenatal loss of father and psychiatric disorders. To test the role of maternal stress during pregnancy in psychiatric and behavior disorders, a retrospective epidemiological study was conducted, using the Finnish population register for persons born between 1925 and 1957. One hundred sixty-seven persons were detected whose fathers had died before their children's births; a control group comprised 168 persons whose fathers died during the first year of their children's lives. The number of diagnosed schizophrenics treated in psychiatric hospitals and the number of persons committing crimes were significantly higher in the index than in the control group. The incidence of alcoholism and personality disorders was relatively high in both groups. The index psychiatric cases had a low frequency of birth complications, whereas those of the control group were high. The results suggest that especially during months 3 to 5 and 9 to 10 of pregnancy, maternal stress may increase the risk of the child for psychiatric disorders, perhaps mediated through the inborn temperament of the child.


Feminists' heterosexual relationships: more on dominance and mating. The hypothesis that female dominance inhibits mating whereas male dominance facilitates it, and seemingly incongruous findings suggesting that dominant women take more initiative and are more interested than others in sex, are explored through comparison of feminist and control subjects, ie, women who were expected, a priori, to be located at widely separated points on a theoretical dominance continuum. Principal findings are the following: (1) sexual initiative and satisfaction appear to be greater among feminists than others, (2) there is no difference between groups in frequency of coitus in a present (or most recent) sexual relationship, but (3) there is a tendency for feminists to have had less stable first marriages than control subjects. These findings do permit more than one interpretation: the greater sexual satisfaction combined with marital instability among feminists may reflect their energy and willingness to change an unsatisfactory condition, or, in addition, the more general proposition that personal power is associated with positive sexual response in both men and women, so that there is minimal complementarity along this dimension. Both cultural and biologic factors appear to contribute to the relative instability of feminists' marriages.


Conjoint marital therapy: a cognitive behavioral model. This article presents an integrated cognitive-behavioral model for conjoint therapy of chronic marital discord. The model is based on eight empirically testable hypotheses that are clinically relevant and integrate contributions from general systems theory, behavioral marital therapy, and psychoanalysis. Disproof of cognitive schemas for the perception of the opposite sex (transference reactions) is hypothesized to be a common therapeutic mechanism in the dissimilar models of marital therapy.


Catecholamine metabolism in anorexia nervosa. Urinary catecholamine levels were measured in 25 anorexia nervosa patients at the time when they were acutely ill with secondary depressive symptoms and again after treatment and weight gain to see whether changes in weight, activity levels, and symptoms of depression occurring during treatment might be associated with changes in urinary 3-methoxy-4-hydroxyphenylglycol (MHPG) concentrations. The latter was significantly lower in the acutely ill anorectics than in the control group. An increase in urinary MHPG concentration after treatment was significantly correlated with a decrease in depressive symptomatology. The increase in urinary MHPG level during treatment did not correlate significantly with change in patient's activity level. There seems to be a relationship between MHPG and the symptom of depression in a group of patients who do not carry a primary diagnosis of depression.


Subjective response as a predictor of outcome in pharmacotherapy: the consumer has a point. Forty-two newly admitted patients with a schizophrenic illness were given a test dose of chlorpromazine, and their subjective response was graded on a euphoric-dysphoric continuum. Subjective response at 4, 24, and 48 hours after the test dose was significantly correlated with the subsequent outcome of a therapeutic course of treatment with chlorpromazine, as measured by the Brief Psychiatric Rating Scale, the Global Assessment Scale, and a write-in symptom scale. An early dysphoric response to chlorpromazine seemed to augur a poor prognosis for further treatment with the drug. These findings suggest that the subjective response to a test dose of chlorpromazine may be a useful predictor of short-term symptomatic outcome.


Psychosurgery and the Porteus Maze Tests: review and reanalysis of data. Because of current interest in assessing psychosurgery outcome, a reanalysis of Porteus maze test findings was done. The maze tests are generally considered to measure foresight and judgment. Review of the literature relating to the effects of practice on the test shows average gains of 1.25 years on the second application of the test and an additional gain of 0.70 years on the third application. Much of the early psychosurgery research did not take practice effects into account. Reanalysis of data shows that the magnitude of changes in maze performance depends on the site of surgery and length of time between surgery and testing. The more posterior the frontal lobe surgery, the shorter the postoperative interval, the greater the loss in maze test ability. Losses following relatively posterior frontal lobe surgery are probably permanent.


The process of change in psychoanalytic psychotherapy. The patient in psychoanalytic psychotherapy experiences a variety of psychological and emotional responses during the treatment process. These are described and conceptualized as related to the structure of the therapeutic situation, the therapeutic relationship, the mobilization of conflict, the experience of affects and drive derivatives, the phenomenon of reinforcement, and the working through of the termination phase. The distinction between "core" and "derivative" psychic functions is developed, permitting a conceptual understanding of how this form of psychotherapy can produce significant and lasting intrapsychic change. Some of the differences between psychoanalytic psychotherapy and psychoanalysis are described. The general concepts are illustrated by clinical vignettes from a case of successful psychotherapy.


The effectiveness of family therapy: a review of outcome research. Outcome research was reviewed on the conjoint treatment of families that involved at least two generations. Results from studies without comparison groups show that conjoint family therapy has an impact that is similar, but not superior, to nonconjoint methods. Studies with comparison groups provide some evidence that conjoint treatment is superior to no treatment and to treatment with nonconjoint methods. Studies that examine the effect of factors (ie, patient, therapist, and technique) affecting the outcome of conjoint treatment show that variations in these factors do have an impact on the result. Identifying the proper criteria of change is important.


The value of interviewing family and friends in assessing life stressors. A reliability study of a life events questionnaire administered to 117 pairs of respondents indicated that a "significant other" (family member or friend) added approximately 29% new information to that gathered from the patient alone. A validity check of this information with a "knowledgeable" third party confirmed approximately 80% of the events reported by the subjects and significant others. The findings suggest that studies designed to collect information about the occurrence of specific life stressors would obtain more reliable and no less valid data from separate interviews of patients and significant others, and the pooling of the positive responses obtained from these two sources.


A comparison of electroconvulsive therapy and combined phenelzine-amitriptyline in refractory depression. Combined monoamine oxidase (MAO) inhibitor-tricyclic antidepressant therapy and electroconvulsive therapy (ECT) were compared in a population of refractory depressive patients. Seventeen patients were randomly assigned to either of the treatment groups, and an independent observer was used to rate overall progress. Between four and ten ECTs or a combination of phenelzine and amitriptyline were administered. Assays for MAO activity and plasma levels of amitriptyline and nortriptyline were performed. In both psychotic and neurotic depression, ECT was superior. When depression was accompanied by character disorder, the response was generally poor. Adequate levels of MAO inhibition were obtained, but tricyclic antidepressant levels were low. Electroconvulsive therapy is still considered to be the treatment of choice for severe depression, whereas the combination of low doses of phenelzine and amitriptyline are ineffective. This treatment modality needs further investigation.


Schizophrenic and medical inpatients as informed drug consumers. Twenty-five schizophrenic inpatients receiving antipsychotic medications were evaluated as informed and/or consenting drug consumers by means of a structured interview, in comparison with a matched group of medical inpatients receiving nonpsychotropic drugs. Medical patients were better informed about positive aspects of medication, such as name, dose, and relationship of drug treatment to a specific diagnosis. Schizophrenic patients, however, were significantly better informed about both side effects and risks. Although both groups felt that their medication had helped them, 93% of the medical patients but only 56% of the schizophrenic patients said they would take the medication if they had the choice. The fact that schizophrenic inpatients readily shared their reluctance to take medication with an interviewer may offer an avenue for detection and intervention to improve prospects for outpatient compliance.


[The determination of the oncolytic effect of clostridia with the hamster amelanotic Melanoma no.3--a quantitative study utilizing defined criteria of evaluation (author's transl)]. With a view of satisfying the practical demands on a diagnostic tumour clostridium assay the development of a biological tumour test model is of prime importance. We are interested in a safe method for differentiating between oncolytic clostridia and clostridial strains exerting no oncolytic capacity. It was therefore attempted to develop a reproducible assay system using hamster A-Mel-3 as a reference tumour. This was finally attained by quantifying oncolysis taking into account the criterium of spontaneous onconecrosis of this tumour. The proposed oncolytic assay system was submitted to a mathematical regression analysis using different strains of clostridia as well as different batches of cultivated spores of one and the same strain. The results are critically compared with the current literature.


Some clinically relevant variables affecting the mechanical behaviour of bone cement. The effects of 12 clinically relevant variables upon the basic mechanical properties of acrylic cement are reported. Attention is drawn to the facts that these variables may at times coexist to lead to serious reductions in the strength of the cement, and that the operating surgeon may exercise a substantial influence on the effective mechanical properties of the cement he is using.


The shear strength of trabecular bone from the femur, and some factors affecting the shear strength of the cement-bone interface. The shear strength of trabecular bone from the femur has been studied. In general, the strongest trabecular bone is found close to the cortico-cancellous junction, though its shear strength depends also on the relationship of the trabeculae to the plane of shear. Some factors affecting the shear strength of the cement-bone interface have been investigated. In vitro, maximal cement-bone interface shear strength is obtained by exposing and thoroughly cleaning strong trabecular bone, and then forcing onto it under pressure low viscosity cement.


Loosening of the femoral component in surface replacement of the knee. The incidence of loosening of the femoral component of the ICLH knee has been found to be lower than that of the tibial component. This is thought to be due to the fact that the compressive strength of the distal femur has been found to be greater than that of the proximal tibia. It has further been shown that the strength of even the femur can be so reduced by the osteoporosis accompanying Rheumatoid Arthritis that it becomes insufficient for adequate prosthetic fixation.


[Carcinoma in scar tissue after frost inquiry to the foot (author's transl)]. Carcinomas of the extremities are relatively rare neoplasms when compared to Sarcomas. After a review of the literature about carcinomas in chronic fistulae and other bone lesions, two cases are reported in which a carcinoma originated in scar-tissue, 31 years after a frost-bite lesion of the foot. The problems of etiology, pathogenesis and therapy are pointed out.