Primary adenocarcinoma of the upper oesophagus. Adenocarcinoma of the upper one-third of the oesophagus is an uncommon entity. A review of the literature reveals 20 reported cases. This paper reports an additional case. The lesion may arise from oesophageal glands, foci of ectopic gastric mucosa, or a Barrett's oesophagus. In contrast with squamous cell carcinomas submucosal spread is not prominent; however, transverse penetration through the oesophageal wall is common. The prognosis is grave. Treatment modalities that have been employed include supportive care, surgery alone, pre-operative radiation therapy and surgery and radiation therapy alone. Survival statistics produced by these various regimens are similar. There is little documented evidence for the radioresponsiveness of primary adenocarcinoma of the oesophagus. The case described demonstrates marked tumour regression following a course of external radiotherapy as shown by serial oesophagrams. Optimum treatment for adenocarcinoma of the upper oesophagus remains to be determined. It is felt that the role of radiation therapy should be further evaluated.


Correlations between duodenal loop size and external body measurements. Measurements of the area, height and width of duodenal loops in male and female controls were correlated with their body height, weight, surface area, lean body mass and adjusted body surface area in order to assess the possibility of predicting loop size from body habitus. In male subjects the most marked correlations were between bodyweight and loop area (r = 0.58) and between true body surface area and loop area (r = 0.57). No relationship was observed between the size of the duodenal loop and body size in females.


Transient small bowel intussusception in adult coeliac disease. Considerable disagreement exists in the literature concerning the occurrence and incidence of transient non-obstructive intussusception in adult coeliac disease. Only a few case reports have been published and several standard texts do not mention the association at all. We report six adult patients, all with coeliac disease, who demonstrated transient non-obstructive intussusception on small bowel meal examination. The technique of the small bowel meal and the radiological signs of malabsorption are briefly described. The literature is reviewed and reasons for the disagreement herein are discussed. We conclude that the incidence of finding intussusception in adult coeliac disease is related to the intensity of searching and in our series this association was seen in at least 20% of cases. It is considered to be an additional radiological sign of coeliac disease although in no case did it occur in the absence of other prominent radiological evidence of malabsorption.


Calcified meconium in the newborn.

Calcified meconium in the newborn. Six neonates are described in whom plain films of the abdomen demonstrated scattered flecks of calcification. Three of the patients had rectal atresia with recto-urethral fistula, one rectal atresia without fistula, one jejunal atresia and one a severe stenosis of the distal small bowel associated with log segment aganglionosis. At operation the calcification was found to be in meconium within the bowel lumen and not as expected to represent serosal plaques following meconium peritonitis due to an intrauterine bowel perforation. Previous case reports are reviewed and possible mechanism discussed.


Radiology of the gastrointestinal abnormalities seen in patients with adult hepatorenal polycystic disease. A review of 97 patients with adult hepatorenal polycystic disease (AHRPD) revealed a significant number of patients with gastrointestinal symptoms as the initial or primary manifestation of their disease. The typical appearance of the gastrointestinal barium examinations is presented.


The hysterographic diagnosis of stromal endometriosis. The hysterographic appearances in three histologically verified cases of stromal endometrosis are presented. Interpretation of the unusual radiographic findings on the basis of uterine pathology is attempted. Little is known about the preoperative diagnosis of the disease. A triad of uterine enlargement, endometrial stromal hyperplasia with few or no glands in the curettings and unusual hysterographic findings strongly suggests a diagnosis of stromal endometriosis.


The role of computerised tomography in the diagnosis and management of intracranial abscess. A retrospective study has been undertaken of patients with intracerebral abscess and subdural empyema. Computerised tomography (CT) offers a rapid, non-invasive mode of diagnosis with accurate localisation and assessment of multiplicity of lesions. We propose that early diagnosis and correctly timed surgical intervention has lessened the mortality rate. CT allows for easy follow-up of patients and has allowed us in one case, to treat an inaccessible abscess conservatively.


The phlebographic demonstration of venous thrombosis occurring during the treatment of scoliosis. The application of plaster casts to the trunk plays an important part in the management of severe scoliosis. The edge of these casts may impair venous drainage from the limbs and predispose to thrombosis, as in the three illustrative cases. A further case shows the possibility of a pelvic halo ring device causing similar venous compression. Steps should be taken to prevent this venous impingement from occurring, both at the time of case application and afterwards.


Soft tissue changes in early rheumatoid arthritis as seen on xeroradiography and non-screen radiographs. Forty-seven patients with early or newly established rheumatoid arthritis were studied with non-screen radiography and xerography. Estimations of soft tissue swelling, bone erosion and cysts were made by two observers and the results compared between observers and the two types of imaging. The results indicate no significant advantage or disadvantage in xerographic imaging compared with non-screen radiographs in the identification of superficial soft tissue swelling and bone erosions. More cysts were, however, identified on the radiographs. In a previous anatomical study of the dissected hand, xerography showed definite advantages in the detection of certain features.


Excretion of urea by the foetal guinea pig. 1. The placental transfer of urea was studied by perfusing the guinea-pig foetal placenta in situ with dextran solutions containing various amounts of urea, and radioactively labelled urea. 2. Transfer of urea was linearly related to the difference in concentration between the maternal and the foetal sides of the placenta, but transfer in both directions across the placenta was equal when the concentration of urea in the perfusing fluid was 2.5--3.5 mmol/l less than the maternal arterial value. This suggested that urea may be transferred against a concentration gradient. 3. Foetal plasma urea concentrations were found to be 0.5 mmol/l less than the maternal, suggesting that active transfer from the foetal circulation to the maternal can occur. However, because of the close relationship between foetal and maternal plasma urea (r = 0.96), it is concluded that the major control of foetal urea concentrations is by diffusion of urea between maternal and foetal extracellular fluids.


Effect of prolactin on glomerular filtration rate. 1. The effect of infusion of ovine prolactin was studied in anaesthetized dogs pretreated with bromocryptine to reduce the release of endogenous prolactin. 2. Prolactin, injected intravenously and also directly into one kidney, resulted in a 12--18% increase in glomerular filtration rate (GFR) by both kidneys. 3. This increased GFR was not associated with any demonstrable changes in whole-kidney blood flow, distribution of intrarenal blood flow, fractional excretion of sodium or osmolar or free-water clearance. 4. We conclude that ovine prolactin produced an increase in GFR not dependent on an increase in whole-kidney plasma flow.


Effect of acute ethanol administration on liver oxidative capacity in rats. 1. The administration of a single oral dose of 2, 3, 4 or 5 g of ethanol/kg (43.5, 65.2, 87.0 or 108.7 mmol/kg respectively) to rats increases the rate of oxygen consumption by liver slices from animals killed 24--48 h later. 2. The increase in the rate of hepatic respiration can be blocked by incubation in a medium containing ouabain, an inhibitor of the sodium pump, or in a calcium-free medium. 3. The enhancement of oxygen uptake caused by a single dose of ethanol can be abolished by adrenalectomy or by prior administration of the alpha-adrenergic blocking agent phentolamine, and is markedly less in thyroidectomized animals. 4. It is suggested that the effect which is elicited by acute ethanol administration on respiration by liver slices is mediated by adrenaline and by throid hormones, both of which appear to exert a calorigenic effect by activation of the sodium pump. The results are discussed in relation to the changes in liver oxidative capacity induced by chronic alcohol ingestion.


Effect of a surgically created side-to-side arteriovenous fistula on heat elimination from the human hand and forearm: evidence for a critical role of venous resistance in determining fistular flow. 1. In eight patients with a unilateral fistula between the radial artery and a nearby superficial vein, heat elimination from both hand and forearm, as measured by calorimetry, was always substantially greater on the side of the fistula (a mean excess from hand-plus-forearm 889 J/min). 2. Fistular blood flow measured by hand-plus-forearm plethysmography in these patients averaged 431ml/min. Correlation between fistular blood flow and heat elimination was poor (r = 0.70, P less than 0.06), probably because heat elimination due to the fistula takes place mainly from veins, whose pattern varies from patient to patient. 3. Approximately half of the total increased heat elimination due to the fistula is from the hand. Occlusion of the circulation to the hand caused fistular flow rate to be reduced by about half. This suggests that the  main resistance to fistular is venous, proximal veins offering a similar resistance to distal veins. 4. The obligatory heat loss due to fistula is unlikely to embarrass temperature regulation, except in severe cold stress.


Hepatic elimination of renin in man.

Hepatic elimination of renin in man. 1. Hepatic elimination of renin was measured in 10 well-compensated cardiac patients with normal liver function during a control period and during a period of reduced hepatic plasma flow, induced by physical exercise (seven patients) or intravenous infusion of lysine vasopressin (three patients). 2. Hepatic renin elimination rate (hepatic plasma flow x arterial-hepatic vein difference of plasma renin activity) was found to be linearly correlated with arterial plasma renin activity (r = 0.986, P less than 0.001). 3. When hepatic plasma flow fell by 45% the hepatic extraction ratio of renin (arterial-hepatic vein plasma renin activity difference/arterial plasma renin activity) increased by 75%. Hepatic renin clearance (hepatic plasma flow x extraction ratio) remained constant. 4. The results indicate that changes in the hepatic elimination rate of renin do not contribute to changes in plasma renin activity during these events.


Effects of chronic renal insufficiency and metabolic acidosis on glutamine metabolism in man. 1. Arterial concentration and arterial-venous differences of glutamine across the kidney, forearm, hepato-splanchnic bed and brain were measured in patients with chronic renal insufficiency and in patients with normally functioning kidneys before and during chronic ammonium chloride acidosis. 2. In chronic renal insufficiency and in chronic metabolic acidosis there is a rise in glutamine release from the muscles and a suppression of glutamine uptake by the hepato-splanchnic bed and the brain. 3. In chronic renal insufficiency arterial glutamine concentrations is significantly increased in comparison with subjects with normal renal function and either normal acid-base balance or chronic metabolic acidosis. 4. In patients with chronic renal insufficiency the kidney extracts negligible amounts of glutamine, which cannot account for the renal ammonia production measured in the same patients.


Tracing the fate of oxygen consumed during phagocytosis by human neutrophils with 15O2. 1. The metabolism of oxygen by phagocytosing neutrophils was traced by using 15O2. 2. The isotope did not exchange with the incubation medium or cells to an appreciable extent and unmetabolized oxygen was readily eluted by gassing the cell suspension. 3. The polarographic measurements of oxygen consumption closely paralleled the recovery of metabolized 15O2. 4. Almost all the metabolized 15O2 was converted into water, both in the presence and absence of KCN, supporting the concept that the oxygen consumed by neutrophils is converted into H2O2. It is unlikely that an appreciable proportion of this oxygen is incorporated into the organic composition of the cell or of the ingested micro-organism.


Child abuse training: a community-based interdisciplinary program. In the area of child abuse, a scarce resource is trained personnel. This paper describes a training program focusing on the need for individuals representing diverse disciplines to work together. Subjects discussed are the rationale and the organization process for a multidisciplinary, community-based training program; the formulation of the educational experience and the curriculum; evaluation measures; and the implementation of the program in a typical site. Various activities related to child abuse have been initiated in communities where training has occurred. Plans are to provide more intensive training in the treatment area for those professionals trained so far.


Peer review in community mental health.

Peer review in community mental health. The paper discusses the medical origins of the peer review legislation and its adaptation to community mental health. Three models of peer eview are presented which could be used in community mental health centers. They are the problem model, the sequential model, and the Psychiatric Utilization Review and Evaluation Project (PURE) model. All three require a review of records by a committee of respected clinical staff, regardless of profession.


Multimodal outpatient group treatment for the psychiatrically disabled. Outpatient clinics gradually accumulate patients with longstanding disabilities. The traditional treatment approach is to see such patients in brief, intermittent, individual visits. Staff generally dislikes treating such patients and patients may, in part, maintain their symptoms in order to maintain ties with a nurturing institution. The experience with an alternative approach, weekly group meetings using a number of helping modalities, is described. Although no panacea, the approach appears to provide a reasonably effective, efficient, and enjoyable way of helping chronically disabled patients.


Design considerations for community mental health management information systems. Many community mental health centers are presently faced with the necessity of implementing a management information system. This article offers guidelines for centers dealing with this situation. Whether a center chooses to adapt an existing system or develop one of its own, careful planning prior to the implementation of the system can help ensure that it will meet the needs of the center and operate successfully. The guidelines are organized into the categories of data considerations, people considerations, and system considerations. The first two categories are of general interest, whereas the last category is more technical in nature.


The acces system: a procedure for evaluating children's services at community mental health centers. This paper describes the efforts made by one community mental health center to develop a system of program evaluation for children's treatment services. The approach described has the capability of objectively assessing (1) patterns of utilization of children's services; (2) satisfaction with services as well as the availability, accessibility, and acceptability of services; and (3) the quality of children's mental health services as measured by the attainment of individualized treatment goals. A rationale for the development of this system as well as a description of the modifications and automatization of the procedure are included. By way of illustration, initial results are presented which pertain to 500 goals written for 208 child clients receiving treatment within any one of three of the center's child direct-service programs.


Referral preferences among the mental health professions. A questionnaire presenting two clinical cases with questions about a diagnosis, type of treatment, and whether the respondent would treat or refer the person was administered to pastoral counselors, psychologists, social workers, and psychiatrists. Psychiatrists tend to see the most and social workers the least pathology in the cases. Psychiatrists see the least need for a psychometric evaluation, but no difference was found concerning need for a neurological examination. The majority prefer to treat the "neurotic" case, whereas there was an almost equal tendency to refer the "phychotic" case. Social workers most prefer to treat and pastoral counselors to refer the "psychotic" case. Overall, social workers refer the most, pastoral counselors the least. Credibility as referral source is ranked as follows: psychiatry, psychology, social work, counselors (both pastoral and marriage, family and child), with laymen ranking lowest. Rankings of credibility and effectiveness as referral sources are highly correlated. Furthermore, the more effective and credible a professional group, the supply of such persons is seen as ample.


How evaluation findings can be integrated into program decision making. The paper describes difficulties in integrating the findings of research and evaluation studies back into the ongoing process of decision making. The paper suggests how to present information in such a way as to improve its intellectual understandability and to decrease affective resistances to the acceptance of new information. The paper also describes common blocks that are met in the attempt to implement recommendations and describes methods to overcome them.


A client satisfaction survey as one element in evaluation. Surveys and interviews were conducted with clients and former clients of units of a large mental health and mental retardation authority as part of an evaluation of the agency. Both clients and former clients reported overall satisfaction with services. Highest percent of dissatisfaction was reported toward operating hours of the agency. Results of the survey were compared with those from similar investigations and conclusions drawn as to why clients are inclined to give favorable ratings to services.


Together with the farmers: social and rural medicine in Japan. Japan emerged from feudalism a century ago. Farmers comprise 20 percent of the population of 110 million. The agricultural cooperative movement sponsors 118 hospitals in rural areas. Of these, the Saku Central Hospital is the largest, and provides leadership to a vigorous rural health movement. Its unique outreach program and its contributions to rural health are described, together with remarks about Japan's health situation generally. There may be lessons here for America.


Transcultural aspects of psychiatric patients in Qatar. The illness behaviour of Qatari psychiatric patients is defined by the nature of their symptomatology. The importance of somatic symptoms in determining the patient role and patient-doctor relationship is discussed in the light of cultural characteristics of the Qatari community. Delusory cultural beliefs related to possession, sorcery and envy provide a conceptual framework for explanation of many disorders. Inter-generational conflict is an important factor in neurotic disorders. Failure to report symptoms in an abstract fashion is characteristic of qatari patients. The cultural and religious heritage absorbs many behaviours which would otherwise be considered symptomatic of psychiatric disorder.


The 14-MeV neutron activation analysis of Chinese medicines for protein, phosphorus, potassium and magnesium contents. Elementary form of nitrogen (protein), phosphorus, potassium and magnesium contained in sixty-six different kinds of Chinese medicines were analyzed by means of 14-MeV neutron activation technique. The % contents of these elements in Chinese medicines range from 4.1 to 38.6% (average: 12.7%) for protein, 0.1 to 10.5% (average: 1.3%) for phosphorus, 1.6 to 13.8% (average 4.5%) for potassium and 0.1 to 2.5% (average: 0.5%) for magnesium. The procedure proves to be quite precise and potentially quite accurate, while only requiring about 20 minutes per sample. The methods of determining the elements are described.


Endorphin release: a possible mechanism of acupuncture analgesia. The action of acupuncture stimulation on analgesia has been investigated. The brain and serum extracts of acupunctured rabbits injected into rabbits produced a marked analgesic effect on the recipient, as shown by a great increase of their pain threshold. This effect is counteracted by a specific opiate anatagonist, naloxone. The data suggest that the release of the endogenous substances with morphine-like biological properties, endorphins, is increased by acupuncture stimulation, thus inhibiting pain perception.


Physiological effects of stimulation at acupuncture loci: a review. Recent studies reporting significant physiological effects associated with electrical and manual stimulation at several traditional Chinese acupuncture loci are reviewed. Other reports on the anatomy and electrical properties (DC resistance and potential, AC impedance) of these sites indicate that many are significant local skin resistance minima and may also be points of locally more positive DC potential. Further investigation of the basic properties of the acupuncture system and its mode of action is fully warranted by these preliminary findings.


Technical aspects of CT scanning.

Technical aspects of CT scanning. The advent of computed tomography (CT) has initiated a technological revolution which continues to the present time. A brief review of basic principles of CT scanning is presented, and the evolution of modern CT scanner systems is traced. Some early indications of future trends are also presented.


Anatomic and pathologic correlations with computerized tomography. Material familiar to the pathologist is reviewed from the view point of confirming and extending the diagnostic utility of computerized tomography. Pathological examples of variations in ventricular shape, acute hydrocephalus and obstruction of arachnoid villi are cited. Calcification in basal ganglia and periventricular leukomalacia are illustrated. Acute traumatic hemorrhage and hemorrhagic necrosis of the visual cortex are shown.


Radionuclide brain imaging--its role and relation to CT scanning. Separate CNS disease entities are discussed with either the complementary or exclusive indications for radionuclide brain imaging and computerized cranial tomography. Either modality alone has a potential overall precision somewhat in excess of 90% in the localization of cerebral lesions with the effectiveness of each modality differing according to the histology and anatomic location of the lesion. Most investigators agree that the combined application of the two procedures is far superior to their separate use. Routine dynamic isotope studies are essential and in addition, new radiopharmaceuticals and technological advances may improve the radionuclide evaluation of CNS disease. Areas discussed include: primary and secondary CNS neoplasms; acute cerebrovascular accidents; arteriovenous malformations; traumatic cerebrovascular disease; hydrocephalus and dementia; and intracranial inflammatory processes.


CT diagnosis of cerebrovascular disorders--a review. During the past few years CT has emerged as an unsurpassed diagnostic modality in cerebrovascular disease. CT is of limited value in TIA, but reveals a wide variety of findings in completed infarcts. Ischemic, petechial, and hemorrhagic infarcts can be distinguished. Contrast enhancement, varying with the age of the infarct, is frequent. Also the general density of the infarct varies with time. Differential diagnosis, primarily infarct vs tumor, is made by angiography or by followup CT scans. Saccular aneurysms are directly demonstrable by CT if larger than 0.5 cm in diameter. Sequelae of ruptured aneurysm--hematoma, hydrocephalus, ischemia--are consistently visible. This generally also applies to arteriovenous malformations. Angiography is necessary to clarify anatomical details of aneurysms and vascular malformations, and is often indispensable for differential diagnosis.


CT scanning in traumatic and emergency patients. In emergency cases and traumatic head cases, CT scanning has completely changed the diagnostic method and angiography can in most cases be avoided. Not only can a proper diagnosis be set concerning intracranial bleedings or hematomas of different kinds but also additional information which earlier with help of angiography were not available can now be diagnosed. The article discusses the principles for using CT scanning as a diagnostic method in traumatic and emergency patients and discusses also the limitations and benefits with this method compared with angiography.


The blood-brain barrier: its role in contrast studies. The concept of a blood-brain barrier includes overlapping control mechanisms which work together to produce a constant microenvironment. Most important is the barrier to macromolecule passage located in cerebral capillary endothelium. Many drugs bound to proteins cannot pass this obstruction. Also important are membrane properties shared by all living cells. Lipid soluble molecules pass cell membranes easily; water soluble and ionized molecules do not. Other components include selective ion regulation, facilitated sugar transport, and resorption by the choroid plexus. The bulk flow of cerebrospinal fluid washes all solutes, and even particulate debris, from the system.


Craniocerebral computed tomography in the neonate. Craniocerebral computed tomography (CT) is an extremely important component of the armanentarium for diagnosis of neurological disorders in the neonate. The indications, techniques, normal anatomy, and pathologic abnormalities of CT scans in newborn infants are presented. Hydrocephalus and intracranial hemorrhage are discussed in depth.


CT diagnosis of intracranial cystic abnormalities in children. The introduction of computed axial tomography has been of tremendous importance in the evaluation of intracranial pathology in children. The broad spectrum of cystic intracranial lesions of congenital, infectious, traumatic, vascular and neoplastic origin are discussed. Their CT findings, pathology and pathogenesis are emphasized.


Computed tomography in the evaluation of sella and parasella lesions: the value of sagittal and coronal reconstructions. A method is described whereby contiguous, thin-section (3 mm) axial CT scans are obtained followed by computer manipulation of the data to reconstruct good quality images in sagittal and coronal planes. The application of this technique in the evaluation of sella and parasella abnormalities is discussed. In our experience, this has resulted in an increased sensitivity of CT scanning for the detection of abnormalities around the sella. In addition, it has been possible to more accurately define the true extrasella extension of pituitary tumors.


Midline angio-tomography of the posterior fossa. Interpretation of the angiographic findings in posterior fossa angiography can be improved by a simple angiotomographic device which gives a midline tomography of the posterior fossa. Especially the vessels around the brain stem and close to the midline can be well seen and this is especially helpful with lesions in the brain stem and the anterior part of the posterior fossa. A few examples are given of midline angiotomography which demonstrates the advantages of this technique.


Contact dermatitis in Salvador, Brazil.

Contact dermatitis in Salvador, Brazil. In Salvador, Brazil, 536 patients were patch tested with 24 contact allergens. The most common sensitizers included potassium dichromate, thimerosal, hydroquinone, nitrofurazone ointment and nickel sulfate. The results of this South American study are compared with those published by North American and European dermatologists. Low frequencies of positive reactions were encountered in Salvador to some substances, including mercury bichloride and p-phenylenediamine. The influences of climate and life style in determining patterns of contact sensitivity are discussed.


Contact allergy to toothpaste flavors.

Contact allergy to toothpaste flavors. Toothpaste flavors are fragrance mixtures. Oil of peppermint and spearmint, carvone and anethole are ingredients with a low sensitizing potential, but they are used in almost every brand of toothpaste and caused seven cases of contact allergy in a 6-year period at Gentofte Hospital. Toothpaste reactions are rare due to several reasons; local factors in the mouth, the low sensitizing potential of the flavors generally used, and the lack of recognition. It is emphasized that the toothpaste battery for patch testing has to be relevant and changed according to the consumers' and manufacturers' taste and fashion.


Immunological activity of parthenin and its diasteriomer in persons sensitized by Parthenium hysterophorus L. Persons suffering from allergic dermatitis caused by direct contact with Parthenium hysterophorus (Compositae) showed delayed immunologic reaction to the sesquiterpene lactone parthenin but not to its diasteriomer, hymenin.


Sensitizing capacity of naturally occurring quinones. V. 2.6-dimethoxy-p-benzoquinone: occurrence and significance as a contact allergen. 2.6-dimethoxy-1,4-benzoquinone has already been discovered in more than 25 different plants and woods. Several authors have shown its strong bacteriostatic activity against micro-organisms. In 1972 a positive skin reaction to 2.6-dimethoxybenzoquinone was obtained in a patient allergic to Sucupira wood (Bowdichia nitida Benth.). This compound could be isolated from the wood. During the chemical investigations of other commercial woods which have been described as the cause of allergic contact dermatitis, 2.6-dimethoxybenzoquinone could be isolated from an additional 21 different species. In the case of Australian blackwood Acacia melanoxylan R.BR., its structure was elucidated by x-ray analysis. Sensitization of guinea pigs revealed that 2.6-dimethoxybenzoquinone is a relatively good sensitizer. In some of the woods investigated, quinones have never been discovered before, for example in Makoré, Australian blackwood, Wengé, White wood, Afrormosia and Afzelia. In 10 of them only this quinone was detectable. Besides its allergenic properties, 2.6-dimethoxybenzoquinone may be responsible for the high termite resistance of these woods. In all cases of contact dermatitis from these wood species in which quinoid allergens other than 2,6-dimethoxybenzoquinone could be detected, this quinone should be used for patch tests.


Allergic contact dermatitis from chromate in military textiles. Two cases with allergic contact dermatitis from chromate in green military uniform sweater and pants are described. Chemical analysis showed that water-soluble chromate was released from a uniform even after repeated washings.


Purpuric allergic contact dermatitis to paraphenylenediamine. A 59-year-old saleswoman of black hats presented with a severe purpuric eruption of the exposed areas of the face, neck and arms. Patch testing to paraphenylenediamine produced a purpuric test reaction. Similar eruptions have been reported due to N-isopropyl-N-phenylparaphenylenediamine (IPPD), a rubber antioxidant. The patient had previous dermatitis underneath the elastic portions of her undergarments. It was determined that IPPD is added to elastic material used in some elastic trim on undergarments in the United States. This relationship is discussed.


Kinetics of PTH metabolism and PTH fragments in chronic renal failure. Distribution and metabolic degradation of bPTH was studied in man after infusion of 400 U bPTH and blood sampling up to 2h. Disappearance rates of intact 1-84 bPTH, carboxyl- and amino-regional peptides were calculated for healthy subjects (n = 12); patients suffering from moderate (GFR 15--30 ml/min, n = 4) and advanced (GFR less than or equal to 10 ml/min, n = 36) chronic renal failure; and bilateral nephrectomized patients (n = 3). Two components with a rapid and a slow disappearance rate can be separated ("distribution", "metabolism"). Half-lives are found to be in the range known from animal experiments with marked differences between intact 1-84 PTH and peptide fragments. Influence of impaired renal function on metabolic turnover rates of PTH is given.


Humoral control by the kidney of intestinal transport to sodium. The impairment of water and sodium absorption by the jejunum following an acute saline load depends on the dietary balance of sodium, the mucosa-to-serosa unidirectional flux of this ion being modulated by a direct effect of the changes in blood concentration and by a humoral material of renal origin which itself is released as a consequence of either chronic or acute sodium loading. A possible interference of mineralocorticosteroids, angiotensin or antidiuretic hormone seems to be excluded. A positive correlation exists between mucosa-to-serosa sodium flux and glucose absorption. The kidney controls the exchanges of sodium and water in the jejunum as well as in the kidney itself by the way of an endocrine function.


Dopamine-sodium relationship: is dopamine a part of the endogenous natriuretic system? A possible role of DA as an endogenous natriuretic hormone was reviewed under three aspects: (1) its excretion in response to saline vs. albumin-induced volume expansion, (2) the origin of urinary free DA and (3) urinary free DA excretion in an unexplained salt-retaining condition, idiopathic edema. We have shown (1) that the urinary free DA excretion increase in response to saline is specifically related to salt and does not occur when the same degree of volume expansion is induced by albumin, (2) that this increase in free DA originates in the kidney and (3) that idiopathic edema patients excrete less free DA than control subjects. It is proposed that free DA originating in the kidney is a rather sal than volume-dependent endogenous natriuretic factor. Its deficiency may contribute to excessive sodium retention in idiopathic edema. However, DA is probably not the single natriuretic hormone but a part of a natriuretic system, components of which are other renal vasodilating and natriuretic substances such as prostaglandins and kallikrein-bradykinin.


Natriuretic factor, a lasting enigma.

Natriuretic factor, a lasting enigma. A gel filtration fraction of urine from patients with chronic uremia (natriuretic factor) decreases potential difference, net sodium flux and lumen to peritubular flux of sodium across the isolated rabbit cortical collecting tubule. These effects are consistent with the possibility that natriuretic factor represents a modulator of sodium excretion in the mammalian nephron. Natriuretic factor induces a dose-dependent inhibition of short-circuit current in the isolated toad bladder. By comparing the effects of natriuretic factor to those of a standard unit of reference, it may be possible to develop a quantitative assay for natriuretic factor. The acidic nature of natriuretic factor was confirmed by cation exchange column in a high pressure liquid chromatography system.


Role of erythropoietin in the anemia of renal insufficiency in man and in an experimental uremic rabbit model. ESF deficiency is probably not a major contributing factor in the early stages of the anemia of renal insufficiency. Serum ESF titers are lower in advanced renal failure when compared to that of nonuremic anemic subjects suffering from equivalent anemia. With increasing renal insufficiency a relative ESF deficiency gains increasing importance as a pathogenic factor in reduced erythropoiesis. Kidneys without excretory function may still be erythropoietically effective, since a further increase in the anemia occurs after bilateral nephrectomy. However, a basal erythropoiesis is still maintained by extrarenal ESF production, which is also enhanced by hypoxia. ESF deficiency is compensated after successful renal transplantation. A decreased response of the bone marrow to ESF may be another factor contributing to the hypoproliferative state of erythropoiesis in uremia. As demonstrated in a chronic uremic rabbit model there may be a blockade of further differentiation of the erythroid precursors. The relationship of this blockade in differentiation to the inhibitor of heme synthesis is not clear.


Regulation of the vitamin D endocrine system located in the kidney. During the past decade, it has been clearly established that the kidney is an endocrine organ which converts 25-hydroxyvitamin D to the active hormone 1,25-dihydroxyvitamin D. The kidney and intestine are the sites of an alternative hydroxylation which places an 24 hydroxyl in the R position on either 25-hydroxyvitamin D or 1,25-dihydroxyvitamin D. The production of 1,25-dihydroxyvitamin D is stimulated by hypocalcemia through the parathyroid gland, hypophosphatemia, the sex hormones and the peptide hormones insulin and prolactin. This vitamin D based endocrine system is of central importance in regulating calcium and phosphorus metabolism and its disturbances result in a variety of pathological conditions.


Reference values for clinical chemistry using the Coulter Chemistry System. Reference (normal) ranges were established for clinical chemistry results obtained from the Coulter Chemistry instrument on specimens from dogs, cats, horses, and cattle. These results, in general, are very similar to those reported in the current veterinary literature. The specimens obtained from horses and cows were subdivided according to age and lactation status, respectively. Significant differences were noted between the subgroups in the results of certain tests.


Visual agnosia in an artist.

Visual agnosia in an artist. This report describes a 73 year old left-handed male artist who presented with agnosic symptoms following an occipital cerebral vascular accident. Against a background of a memory disturbance, but otherwise essentially intact linguistic and cognitive capacities, the patient was generally unable to identify single objects on visual presentation, and displayed marked difficulty in interpreting complex objects, depicted scenes, and partially occluded figures. The patient's preserved ability to recognize geometric forms, to perceive optical illusions, and to copy designs, and objects with considerable accuracy suggested the clinical picture of visual agnosia. An examination was undertaken of the effects of this recognition disorder on the artist's capacity to draw. Despite an inability to recognize an object or scene, the patient retained various techniques (perspective, shadowing, designation of texture) which allowed him to copy the display in a veridical fashion. When displays were recognized, or when the patient was given only the name of the object and asked to draw it, he adopted a less slavish approach, characteristic of his pre-morbid artwork. While his post-morbid drawings bore a strong similarity to his earlier works, such features as insufficient differentiation of figure from ground, over-elaboration of detail, and areas of neglect revealed the debilitating effects of the recognition disorder. Moreover, an examination of the patient's strategies revealed numerous compensatory verbal and motor procedures which guided his drawing. Acknowledgments. We wish to acknowledge Dr. Prather Palmer, J.R.'s neurologist, for his cooperation and for making available his very thorough examination notes. Thanks also to Dr. Kent Stevens for providing the stereograms, and to Dr. Frank Benson and Dr. Edgar Zurif for their helpful comments on the manuscript.


Alliteration and assonance in neologistic jargon aphasia. This paper discusses certain aspects of the speech patterns of neologistic jargon aphasic patients, whose syndrome is one form of a more general classification referred to as Wernicke's or cortical sensory aphasia. The classical lesion site is in the posterior superior temporal convolution of the dominant hemisphere. Patients with such lesions typically have difficulties in the comprehension of auditory linguistic stimuli and their speech is often marked with neologistic jargon. A neologism is a phonological form produced by the patient for which one cannot recover with any reasonable degree of certainty some single item in the patient's vocabulary as it presumably existed before the onset of the disease. Specific analysis is focused on those stretches of speech which exhibit perseveration to the point where there is an excessive amount of alliteration and assonance. The data is described in terms of segments, syllables and sequences of syllables and related to both a mechanism underlying the production of this sort of speech and to the more general problems of neologisms in jargon aphasia.


Responses to dichotic listening tasks in temporal epileptics with or without clinically evident lesions. Dichotic listening was studied in two groups of temporal epileptics with monolateral circumscribed EEG focus: the first presenting with signs of brain damage and the second free from these signs. The lesional group tended to prefer the ear ipsilateral to the side of lesion, while subjects with non-lesional focus tended to prefer the ear contralateral to the side of focus. The results are discussed and compared with other observations in this field.


"Semantic" and "acoustic" errors of aphasic and schizophrenic patients in a sound-picture matching task. Broca's aphasics, Wernicke's aphasics, brain-damaged patients without aphasia, and chronic schizophrenics were tested on a task to match meaningful sounds to one of four pictures. One of the depicted objects was the natural source of the sound, one was an object belonging to the same semantic category as the correct object, one was an object producing acoustically similar sounds as the correct object, and one was an object not related either semantically or acoustically to the correct object. In one item set the "semantic" distractors produced a sound completely different from the presented one; in another item set the "semantic" distractors made practically no specific sounds at all. Broca's and Wernicke's aphasics were shown to have significantly higher total error scores than brain-damaged patients without aphasia and to make significantly more "semantic" errors only on the first item set and "acoustic" errors on both item sets than the brain-damaged patients without aphasia. However, after correcting for guessing the differences  between groups with respect to "semantic" and "acoustic" errors vanished. The aphasics' difficulties in coping with the sound-picture matching task might be difficulties in processing the acoustic dimensions of the items. It is, however, suggested that the impairment is not perceptual but of the cognitive kind repeatedly demonstrated in tasks which require the analytic extraction of features of the stimulus or of the concept represented by the stimulus.


Analytic and global strategies in copying designs by unilaterally brain-damaged patients. Different strategies in copying designs were investigated in unilaterally brain-damaged patients. Site of lesions (right or left) and presence or absence of aphasia, seen as a planning disorder, were taken in consideration. Aphasic patients proved to be more inclined to use an analytic strategy rather than a global one, differing from both other brain-damaged patients and normals. A comparison between patients with right and left brain lesion failed to yield a significant difference.


Upright and inverted faces: the right hemisphere knows the difference. The existence of a right hemisphere capacity, specific to upright faces was investigated. Upright and inverted faces, equally complex as patterns, were presented under lateralized tachistoscopic conditions to two groups of normal adult subjects. A significant orientation by visual field advantage was found. While there was a highly significant left visual field advantage for upright faces, the visual field difference for inverted faces failed to reach significane. This pattern of results supports the hypothesis that the right hemisphere is specialized for the perception of faces in particular, in addition to its specialization for the perception of visuospatial patterns in general.


The effect of unilateral brain damage on the appearance of question-induced CLEM reactions. Three groups of subjects--34 non brain damaged, 15 left hemisphere damaged patients, and 15 right hemisphere damaged patients--were administered 40 questions facing the questioner while eye-movement following each question was recorded. 20 of the questions required subjects to indicate how many letters were in a given word. 20 questions tested their visuospatial capacity. The control group revealed a marked tendency to look to the left visual field regardless of the content of the question. The tendency to left-look or right-look, however, was not found to be related to education, age, length of hospitalization, the score on the "letters in a word" test, or the score on the visuospatial test. The left hemisphere damaged group performed remarkably like the control in that they too looked more to the left visual field than to the right. The right hemisphere damaged group, however, did not show a significant difference between left looking and right looking in response to both questionnaires. The findings were discussed in relation to the previous work of Kinsbourne (1972), and Gur, Gur and Harris (1975).


Recognition reading in paralexia.

Recognition reading in paralexia. Reading aloud and recognition reading were examined in a paralexic patient. Certainty ratings made by the patient during oral reading indicated that he was usually unaware of paralexic errors which he made. In an auditory recognition reading task for words previously misread, the patient still performed poorly, often chosing his paralexic response as the correct alternative. Possible mechanisms underlying paralexia are discussed in the light of these findings.


The effect of auditory rhythmic stimulation on articulatory accuracy in apraxia of speech. In order to study the effects of different rates of rhythmic auditory stimulation on the phonemic accuracy of speakers who have apraxia of speech, eight apraxic subjects read four equated monosyllabic passages under one control and three experimental conditions. In the experimental conditions, rhythmic auditory stimulation provided by a metronome was imposed at each subject's oral reading rate as well as 75% and 125% of this established rate. In the control condition, the subjects read without any accompanying rhythmic stimulation. It was found that the stimulus supplied by an auditory metronome did not significantly improve the phonemic accuracy of these subjects. Articulatory accuracy tended to deteriorate under imposed rhythmic stimulation.


Indigenous and expatriate addicts in Laos: a comparison. Opium addiction has been reported among virtually all large ethnic groups in Asia. Conspicuous by its absence has been any mention of addiction among the Lao, a people surrounded by poppy-growing tribal groups. A sample of Lao patient-addicts are here compared to expatriate Asian addicts in Laos. Lao and expatriate addicts show marked similarity in their sociodemographic profiles and patterns of narcotic use. Some differences in their recent use of narcotic drugs appear related to the greater cash income of the expatriate Asians and their greater access to heroin. No specifically 'cultural' factors for explaining ethnic differences in addiction have yet been identified.


Scars of experience: the art of moxibustion in Japanese medicine and society. Beliefs and practices surrounding moxibustion, a cautery technique used in Japan, are analyzed to demonstrate that the concept of holism is culture-bound and that the practice of East Asian medicine is often reductionistic. Pluralistic traditional medical belief systems of historical and contemporary Japan are discussed with reference to moxibustion. Moxa is used in popular family medicine, for ritual purification, as a technique to cure disease or as part of a holistic approach to healing; its symbolic meaning changes according to its usage and it serves to unite disparate medical beliefs. Socialization practices concerning attitudes towards illness reflect pluralistic values derived from traditional medical systems. One dominant set of values encourages patient and family responsibility during the healing process, adaptation to psychosocial relationships regarded as causal in disease occurrence and avoidance of verbal analysis of problems. These concepts, fundamental to East Asian medicine, cannot be readily adapted in the West as part of a holistic approach to health care.


Traditional medical practices and medicinal plant usage on a Bahamian island. The traditional medical system of a small Bahamian island is explored through a health survey of 83% of the population and an analysis of the activities and materials of the two main native health 'professionals'--the healing specialist and the 'herbalist'. The present findings suggest that the Bimini medical system has historically been efficacious in the treatment and management of many health problems on the island. Part of the success may be attributed to the resourceful utilization of indigenous medicinal plant species, several of which contain chemical substances that may be curatively effective against a number of diseases as claimed. In recent years the island has experienced a relatively smooth process of medical modernization including the increased availability of 'westernized' health care and the gradual supplementation of the herbal remedies by imported patent and prescription medications.


Latah: the symbolism of a putative mental disorder. This paper examines the symbolic properties and cultural relevance of latah, a behavioral state noted in Malay and Indonesia since the 19th Century. Most interpretations of latah have been psychological, latah being perceived as a 'mental disorder.' In the following, it is concluded that latah is intimately related to other aspects of Malayo-Indonesian culture and that it is a well-known cultural pattern and not a mental disorder as such, though it may occur among persons, largely women, in a socially and psychologically marginal situation. Latah is a symbolic representation of marginality, and it is as appropriate to certain mythological and religious figures to the socially marginal.


The atypical psychoses.

The atypical psychoses. The psychiatric literature contains numerous accounts of psychoses found worldwide that do not fit classic definitions of schizophrenia, manic-depression, or organic brain syndrome. These vaguely defined 'atypical psychoses' are under scrutiny because of growing knowledge and more rigorous methodology in descriptive and cross-cultural psychiatry. The authors trace the history of atypical psychosis concepts from the contributions of Kraepelin, Jaspers, and Freud to contemporary European and Anglo-American viewpoints. Studies of the atypical psychoses are reviewed in the light of current validation methods in psychiatry. Several methodologic problems plague this area: inadequate definitions, etiologic prejudice, poor premorbid and follow-up assessment, as well as certain naive notions about psychopathology in different cultures. Consequently, knowledge of atypical psychosis is limited and largely impractical. The authors suggest several possibilities for interpreting present and future evidence about these disorders and certain strategies for future studies.


Ethno-behaviorism and the culture-bound syndromes: the case of Amok. The phenomenon of amok is reviewed in order to demonstrate the heuristic value of an ethno-behavioral model of culture-bound syndromes. The notion that culture-bound syndromes share underlying common disease forms is rejected. Instead, the ethno-behavioral model postulates that culture-bound syndromes consist of culturally specific behavioral repertoires legitimated by culturally sanctioned norms and concepts, but with both behavior and norms acquired in accordance with basic principles of human learning universal to all cultures. Consistent with this model, amok is shown to be a common behavioral pathway for multiple precipitants (which may or may not include disease pathology), but with a distinct form and conceptualization which can be traced to the social learning practices and beliefs of the Malay.


The effect of pentoxifylline on the flow properties of human blood. Recent investigations have revealed that erythrocytes from patients with chronic arterial occlusive disease are significantly less deformable than red blood cells from healthy subjects. The influence of pentoxifylline on red blood cell fluidity was measured by a standard filtration technique using 8 micron membrane filters. Impaired deformability of erythrocytes was significantly improved in patients suffering from peripheral vascular disorders following intravenous injection of 200 mg pentoxifylline. Studies on reduced red cell deformability induced by hyperosmolarity in vitro showed that pentoxifylline (4 and 20 microgram/ml) produced a dose-dependent improvement both in blood from healthy subjects and from patients with peripheral arterial occlusive disease. The results suggest that the positive therapeutic effect of pentoxifylline in peripheral arterial occlusive disease is mediated by improving red cell fluidity in the microcirculation.


Labetalol in the difficult hypertensive patient in general practice. An open study was carried out in general practice to assess the effectiveness and tolerance of labetalol in the treatment of 53 difficult hypertensive patients, most of whom had failed to respond to previous hypotensive therapy. The results showed that in the 49 patients receiving treatment for more than 3 months good blood pressure control was readily achieved, and with labetalol alone in all but 6 of them. The majority were controlled on doses ranging from 300 to 600 mg per day. Treatment was discontinued in 3 patients because of severe side-effects. Mild, tolerable side-effects, similar to those found with beta-adrenergic blocking agents, were reported by 35 patients.


Carbenoxolone and incorporation of (3H) glucosamine into gastric mucosa. The effect of carbenoxolone on incorporation of the labelled sugar, (3H) glucosamine, into rat gastric mucosa was examined. Rats were treated with either 25 mg/kg, or 50 mg/kg or 75 mg/kg carbenoxolone for 10 days. The rats were then killed and the uptake of (3H) glucosamine by gastric mucosal scrapings measured. There was no statistically significant difference in uptake between treated and untreated scrapings. The results do not confirm earlier findings of other investigators which suggested that carbenoxolone promoted gastric ulcer healing by stimulating specific glycosyl transferases to produce a modified mucus.


Clinical experience with a low dose oral contraceptive containing norethisterone and ethinyl oestradiol. The results are presented of a clinical investigation of an oral contraceptive containing 0.5 mg norethisterone and 0.035 mg ethinyl oestradiol. The medication was administered orally as a 21-day cyclic regimen in 1,168 women. Duration of use was from 1 to 53 cycles with an overall total of 16,345 cycles. When the preparation was taken as directed, no pregnancies occurred. Three women conceived during the course of this study; however, these subjects missed 3, 2, and 1 prescribed tablets, respectively, and their pregnancies are thus judged due to patient failure. The overall pregnancy rate was 0.22 per 100 women years of use calculated as a Pearl Index. Intermenstrual bleeding (spotting and/or breakthrough bleeding) was noted primarily in the early cycles, soon tapering off to a lower and stable level. The overall cumulative cyclic incidence of amenorrhoea was 1.0%.


Children discharged from foster care in New York City: where to--when--at what age? The Child Welfare Information Service (CWIS) a computerized information system in New York City, provides data shedding new light on the movement of children out of the foster care system.


Alaska's children's code.

Alaska's children's code. Enactment of alaska's new Children's Code was achieved only after years of struggle involving many professional and public forces. The code is considered a breakthrough in legislation for children.


Acoustic features and auditory perceptions of the cries of newborns with prenatal and perinatal complications. This article describes 2 experiments which examine the relation between neonatal cry features and obstetric histories. Experiment 1 shows that 24 clinically healthy, normal newborns who may be at risk due to a high number of prenatal and perinatal complications can be distinguished from 24 low-complications infants by harmonic and durational features of the cry. High-complications infants required more stimulation to elicit the cry, had a longer latency to cry onset, a shorter first cry expiration, a higher cry pitch, and cried less in total time than low-complications infants. In experiment 2, naive adults rated the high-complications infant cries as more aversive, grating sick, urgent, distressing, piercing, discomforting, and arousing than low-complications infant crues. Factor analyses showed that although the low-complications infant cries were described along one dimension of discomfort, a second factor emerged conveying the "sick" nature of the sound of the cry of the high-complications infants. It was suggested that certain cry features may reflect the risk status of the infant.


Third-party purchase of voluntary agency services. The problem of setting rates for third-party purchase of voluntary agency services is a complex one. The approach taken affects agency efficiency as well as the flow of private donations.


The effects of height on infants' social responses to unfamiliar persons. The effects of absolute height of an approaching unfamiliar person and height of the person relative to the infants' viewing height on infants' social responsiveness were investigated. 48 infants, 9--12 months old, were observed as 2 tall (6 feet, 2 inches) and 2 short (5 feet, 6 inches) male strangers approached them. Infants were divided into 3 viewing height groups: low (35 inches from the floor), medium (53 inches), and high (72 inches). Facial expresion, gase aversion, fretting/fussing, and directional movement were measured as the strangers touched the infants. Infants did not respond more negatively to tall versus short strangers. However, they did respond more negatively as a function of viewing-height condition. Infants who were in the low and medium conditions showed more movement away, more gaze aversion, and less concentration than infants in the highest viewing condition. These observations are explained ethologically in terms of an inborn predisposition to respond negatively to towering stimuli in unfamiliar settings. The importance of a multideterminant model of infants' social responses to unfamiliar persons is emphasized.


Youth helping youth in cases of maltreatment of adolescents. The active involvement of youth themselves in meeting the problem of maltreatment of adolescents is the central feature of this innovative project.


Defining the comminity context for parent-child relations: the correlates of child maltreatment. This report presents the results of studies designed to illustrate the use of child maltreatment report data as social indicators of the quality of life for families. It addresses the feedback function of family-support systems and links maltreatment to the overall balance of stresses and supports in the neighborhood context of families. This study focuses on the reported incidence of child abuse and neglect at 2 levels of neighborhood analysis within a single metropolitan county-20 neighborhood areas and 93 census tracts. Multiple-regression analysis is used to develop predictive equations using socioeconomic, demographic, and some attudinal data as the independent variables. For the 20 subareas, 81% of the variance and for the 93 census tract, 52% of the variance is accounted for. Data on the source of reports tend to discount the widely held position that biased reporting accounts for the negative correlation between socioeconomic status and chold maltreatment. The results are related to an emerging ecological perspective on human development.


The role of spatial cues in the probe-type serial memory task. 2 experiments were carried out with the aim of clarifying the role of spatial cues in the probe-type serial memory task devised by Atkinson, Hansen, and Bernbach. In experiment 1, preventing the formation of specific items-location associations drastically reduced performance at the early to intermediate serial positions for a group of second graders; yet these children still exhibited a primancy effect (position 1 greater than position2). In experiment 2, the stimulus items were spaced farther apart than usual in an attempt to reduce the contextual uniqueness of the first (far left) item. Children aged 4 and 5 years who were administered this task produced a serial-position function that was essentially flat. It was concluded that (a) spatial cues serve as functional stimuli in the standard probe-type task, and (b) the contextual uniqueness of the first item is probably responsible for the occurrence of primacy in young children. Implications of this research for interpreting age-related differences in the shape of the serial-position curve were also discussed.


The development of time concepts in young children: the relations between duration and succession. 108 children from nursery school, first grade, and third grade were given 5 problems measuring the concept of time, in which they were required to judge and explain which of 2 partially overlapping events started first, which ended first, and which lasted for a longer time. 2 types of problems were used which presented time with and without the interference of movement: "still time" (the duration of 2 lights) and "linear time" (the traveling time of 2 toy cars). In both types of problems, judging the succession of both beginnings and endings was equally difficult and was easier than judging duration. Duration judgments were explaned predominantly by succession, whereas succession judgments were explained tautologically or by mere "seeing." Overall, performance increased with age and decreased with interference. A recent model of the development of time concepts is further elaborated and compared with Piaget's framework.


The role of perceptual salience in the development of analysis and synthesis processes. The ability of 6- and 11-year-old children to solve problems requiring the analysis or the synthesis of salience-assessed stimulus relations was investigated. The relative salience of the relations of form, color, and position was assessed and a salience hierachy determined for each child. Following salience assessment, children were given a recall problem in which the salience of the relations and the type of evaluation required for solution were varied. In analysis problems, the relative salience of the irrelevant relation was either higher or lower than that of the relevant relation. In synthesis problems, the two relations to be evaluated were either more or less salient. Both younger and older children were able to solve problems requiring the analysis or the synthesis of relations, but the rate of solution varied as a function of the salience of the relations involved. There was no evidence that either analysis or synthesis preceded the other in the course of development.


Family outreach: a program for the prevention of child neglect and abuse. A Texas volunteer program designed to prevent child neglect and abuse also stresses promotion of the public's awareness of its responsibility to report suspected cases.


Linking the group home and the community school. A group home lacking an on-grounds school set up a system of progress reports from teachers in a community school, and then integrated the reports into the home program. The benefits were considerable.


The effect of change in stimuli on the transfer of dimensional pretraining to the discrimination learning of kindergarten children. Kindergarten children were given verbal pretaining prior to a simultaneous discrimination learning task under 1 or 2 stimulus conditions. For half the children, the stimuli were changed from the pretaining task to the criterion task; for the other half, the stimuli were identical in the 2 tasks. During pretaining, the children learned to label the values of the dimension that would be either relevant, constant, or irrelevant in discrimination learning. When the stimuli were identical in 2 tasks, pretaining produced significant facilitation and interference effects in discrimination performance. The pretaining effects in the changed-stimulus condition were greatly attenuated and nonsignificant. The relation of these results to earlier findings and to studies of dimensional attention in general is discussed.


Memory for location and picture cues at ages two and three. 3 delayed-relayed-response experiments are reported, testing 2-and 3-year-old children's memory for location of a hiddeen object under several combinations of spatial and pictorial cue availability and emphasis. In the first study, both age groups responded well on the basis of location cues alone. However, when picture cues were available, the 2-year-olds primarily relied on location while the 3-year-olds depended more pictures. The next studies asked if changes designed to de-emphasize location cues or emphasize pictures could encourage the younger children to make more use of pictorial information. Although these manipulations were only partially successful, the combined results of these studies suggest (1y, that information about both location and picture cues can be represented by both age groups and (2), that there is a real shift from reliance on place cues at age 2 to increased utilization of pictorial cues by age 3.


The perception of solid form in early infancy. Day and McKenzie determined the rate of habituation of fixation of young infants to repeated visual presentations of a cube. They found the habituation rate to be the same when the stimulus orientation changed between presentations as when it was fixed, and they interpreted this as evidence of shape constancy. However, a failure to discriminate between cubes in different orientations is only evidence of shape constancy if the infant can at the same time discriminate the cube from other cubelike forms. The experiment described here contrasted the rate of habituation of fixation of 12-week-old infants to a homogenous stimulus series (a cube presented in different orientations) with the rates of habituation to various heterogeneous series, in each of which a cube was alternated with some other solid. It was found that, while the infant could distinguish a cube from a photograph of a cube and a concave solid (an L-form), there was no evidence of discrimination between the cube and either a wedge or a truncated pyramid. The results imply limits to the young infants capacity to resolve solid form.


Effects of similarity grouping on attentional processes in children. First and fifth graders sorted cards into 2 piles based on the orientation of a T figure. Cards did or did not contain irrelevant information: irrelevant information did or did not contrast in line slope with the target. The position of targets varied within arrays from 1 card to the next. Children at both grade levels sorted more slowly in the presence of contrasting irrelevant information relative to no irrelevant information, but younger children were slowed more that older ones when sorting in the presence of similar irrelevant information relative to contrasting irrelevant information. A second card-sorting experiment examined similar effects in a filtering task in which target position was constant from card to card. Effects were minimal for fifth graders, wheras first graders were slower in the presence of contrasting irrelevant information relative to no irrelevant information, and slower in the presence of similar as compared with contrasting irrelevant information. Processing differences underlying these results are discussed.


The relationship of hand dominance to the motor corrdination, mental ability, and right-left awareness of young normal children. Normal children who had established hand dominance, as measured by the McCarthy Scales, were compared on mental and motor variables with youngsters who did not give evidence of dominance. Using the McCarthy normative sample (N = 1,032) as the data source, significant differences in cognitive and motor ability were found for 2(1/2)--4(1/2)-year-olds but not for 5--8(1/2)-year-olds. However, a significant relationship between handedness and right versus left awareness was obtained for the older group.


[Anatomical directions for the placement of central venous catheters]. Based on approximately 70 dissection studies, the topographical situation of the central veins forming the superior vena cava is described. Actual problems and complications following punctures of central veins are commented upon, from the morphological point of view.


[Synovial cysts of the hip joint].

[Synovial cysts of the hip joint]. Four cases of a ganglion of the hip joint are reported. Besides the symptomatology and the clinical findings, special attention is payed to the anatomical relationship. The weak part of the joint capsula medially to the longitudinal traction of the ligamentum iliofemorale and laterally to the ligamentum pubofemorale was found to be the source of these ganglions. The most helpful diagnostic measure is arthrography through a lateral access. Therapy consists of resection of the cystic tumor, and careful closure of the hip joint capsula will prevent recurrence.


[The significance of the duodenal papilla within the framework of diseases of gallbladder and bile ducts]. On the basis of 3185 biliary tract operations performed at the city hospitals of Braunschweig and Lüneburg, 12% of which included papillotomies, the frequency and pathogenesis of Vater's papilla stenosis is discussed. About 5% of all stenoses of Vater's papilla do not appear in connection with lithiasis in the biliary tract; these are defined as primary stenoses. 95% of Vater's papilla stenoses occur with lithiasis and inflammatory diseases of biliary tract. Stenosis of Vater's papilla is most often seen in connection with severe cholecystitis and pericholecystitis. There exists in most cases a purely inflammatory swelling of papillas mucosa which decreases following sanitation of the biliary tract. Intraoperative findings show good dilatation through catheterization and Vater's papilla should therefore not be discised. In opposite the concommitant stenoses of Vater's papilla caused by choledocholithiasis, chiefly in case of calculus near the papilla, are signed by severe deforming alterations even concerning deeper layers of papilla wall. The high grade destruction of muscle tissue leads to a not retrogressive stenosis, even after sanitation of biliary tract, which principally should be discised. 211 biopsies of papilla were taken and histologically analyzed. A specific pathologic-anatomic substrate of stenosis of Vater's papilla could not be found.


[Experiences with transumbilical cannulation of the portal vein. Review of 180 consecutive cases]. The canulation of the umbilical vein in the adult is reported on 180 consecutive cases. The small operation hardly stressing the patient and not having led to serious complications, may be allowed without any objection if the necessary precautions are observed.


Nucleolar size in parallel with ribosomal RNA synthesis at diapause termination in the eggs of Bombyx mori. The eggs of Bombyx mori, both in diapause and nondiapause, were subjected to cytological examination of nucleoli and measurement of RNA precursor incorporation (2 hours) into ribosomal RNA. In diapause eggs, the nucleoli were very small and the rate of ribosomal RNA synthesis was the lowest of the samples tested. Most cells in diapause possessed nuclei with one nucleolus. In contrast, the eggs activated from diapause by long chilling attained the largest size of nucleoli and the highest rate of ribosomal RNA synthesis. A significant proportion of the cell nuclei still had only one nucleolus at this stage. Three days after activation, the eggs exhibited intermediate levels in both the size of nucleoli and the rate of ribosomal RNA sythesis. At this stage, about half of the egg cell nuclei had two nucleoli.


Identification of the small nuclear RNAs associated with the mitotic chromosomes of Amoeba proteus. Amebas contain 7 electrophoretically distinct species of small nuclear RNAs (snRNAs), some of which are known to associate in a striking manner with mitotic chromosomes. These RNAs can be divided into 2 classes, one consisting of 4 snRNA species that shuttle in a non-random way between nucleus and cytoplasm during interphase and one consisting of 3 snRNA species that do not leave the nucleus at all during interphase. In the work reported here we sought to determine which class is associated with mitotic chromosomes. Through a series of micromanipulative procedures we arranged for the shuttling snRNAs to be the only radioactive molecules in the cell. Such cells were allowed to enter mitosis, whereupon they were fixed and subjected to autoradiography. In those cells no radioactive snRNAs were found associated with mitotic chromosomes. It is concluded, therefore, that those snRNAs that do associate with mitotic chromosomes must be one or more of the non-shuttling species.--In the Discussion, how the non-shuttling snRNAs may function in cell activities is considered.


Septic shock associated with operations for colorectal disease. The hospital records of 24 patients with septic shock associated with the need for surgical treatment of diseases of the colon and rectum were reviewed. In this group of patients shock was caused by gram-negative or anaerobic microorganisms. The sources or infection were the abdomen, chest, and urinary tract. Nineteen (79 per cent) patients survived the acute shock episode, but only four (16 per cent) were permanent survivors. The 15 patients who died following resuscitation from shock succumbed to continuing infection and/or multiple organ failure. Although the timing of treatment did not affect immediate survival, long-term survival occurred only among those patients treated early in the course of shock. Accordingly, the pathophysiology of early septic shock is presented, and the need to recognize and treat the condition at this stage is emphasized. In addition, the author's current treatment protocol, with which they have been able to achieve 85 per cent acute and 60 per cent long-term survival, is discussed.


Prophylactic administration of low-dose heparin in colorectal surgery. A retrospective study of 192 patients operated on by three members of the Edward Wilson Colon and Rectum Unit, Sydney Hospital, was carried out. All operations performed involved dissection within the pelvis. Prophylactic administration of low-dose heparin was used for 71 of these patients. The incidences of clinical thromboembolic disease were 7 per cent in both the group receiving heparin and the other group. In slightly more than half of the patients, pulmonary emboli occurred in the absence of peripheral deep venous thrombosis. It is suggested that the source of these emboli was thrombosis arising in the pelvic veins.


Juvenile colonic polyposis associated with congenital heart disease. Four members of a family with juvenile colonic polyposis in two generations were examined by the authors. The disease showed a very marked dominant mode of inheritance, not sex-linked, in this family. At the same time, the same members of the family had congenital heart disease, including atrial septal defects and pulmonary stenosis. This disease also resulted from a dominant, highly penetrating gene, not sex-linked. The occurrence of both these hereditary diseases at the same time suggests a close relationship or link between the responsible genes. This combination may represent the emergence of a new syndrome.


Benign lymphoid hyperplasia manifesting as a cecal mass: report of a case. We have presented an unusual case of benign lymphoid hyperplasia, which manifested as a cecal deformity in a 15-year-old boy. The clinical manifestation may have been related to partial occlusion of the appendiceal orifice. In future cases of benign lymphoid hyperplasia, colonoscopy may be diagnostic, and if it is used for continuing observation, may avert unnecessary surgical procedures in children and young adults.


Pseudomembranous colitis associated with ampicillin and erythromycin therapy: report of a case. Pseudomembranous colitis has been observed increasingly often after therapy with several antibiotics. This report describes the case of a patient in whom pseudomembranous colitis developed in association with ampicillin, an extremely rare complication of this drug, and erythromycin, a drug that has not been previously reported to cause the disease. Clinical and pathologic features, pathogenesis, and management are discussed. Early diagnosis and treatment are extremely important to reduce the significant morbidity and mortality associated with this disorder.


A comparison of treatment effectiveness of nonaddict and exaddict professionals in an adolescent treatment program. This paper examines the relative effectiveness of the nonaddict professional and the exaddict professional in an adolescent drug abuse treatment program. Based upon statistical and clinical considerations, the authors' conclusion is that exaddict professionals untrained in psychology or a related health field should perhaps not work with adolescents who present with drug and mental health problems. Strengths and weaknesses of each group are discussed, as is clinical effectiveness with respect to client retention and discharge rates. Age, race and sex were explored relative to length of employment. It was found that exaddict professionals left work significantly more often than nonaddict professionals as a result of negative or unethical behavior.


Seeking truth in heroin indicators: the case of New York City. An epidemiological investigation of New York City's indirect indicators of heroin activity from 1970 through 1976 yielded insights about New York City heroin trends. Indirect indicators were gathered from official data sources, such as law enforcement, health, and treatment agencies. Since each indicator had significant limitations inhibiting interpretation, a factor analysis of the indicators was performed, resulting in the reduction of a large number of variables to a small number of factors. The factor analysis demonstrated the way in which New York City indicators cluster or move together--a "street" component, including arrests, hepatitis, price and purity of retail heroin; a "new admissions to methadone treatment" component; and a "readmissions to methadone treatment" component. Furthermore, the analysis revealed the time-lag relationships between components--"new admissions to methadone treatment" lag 1--2 years behind the "street" component; "readmissions to methadone treatment" lag 1--3 years behind the "new admissions" component. Finally, the 1970--1976 factor scores were related to 1970--1974 estimates of narcotic addicts in New York City in regression analysis, and were also projected through 1978, yielding estimates of New York City's heroin addict population from 1975 through 1978.


Drug dependence, crime and personality among female addicts. Female drug addicts and female criminals have received relatively little research attention. This study investigates the personality correlates of female addicts attending a London drug clinic convicted for drug-related, violent and other offences. More than half of the sample had at least one conviction, and fourteen out of thirty-seven had convictions for non-drug-related offences. Convicted subjects were more extraverted than non-convicted subjects. This result may reflect some relationship between impulsivity and criminal behaviour, though other personality factors may interact with extraversion.


Social skills training and cognitive restructuring with alcoholics. Social skills training (SST) has been shown to produce significant increases in skills immediately after training. However, persistence of skills has not been demonstrated during the follow-up period. The present study investigated this issue using SST and cognitive restructuring (CR) methods. Twenty-four hospitalized "alcoholics" were allocated to one of the following three group: (i) SST, (ii) CR, and (iii) traditional supportive therapy (TST). Twelve 2-hour sessions were conducted with each group. Before, following, and three months after treatment (i) behaviour ratings through structured interview, (ii) nurses' ratings, (iii) self-reported ratings of social skills and (iv) alcohol intake were recorded. Analysis of variance indicated SST to be significantly superior on all measures compared to CR, which was superior to TST immediately after training. However, 3 months after treatment, the subjects in the CR group indicated greater skill increments than the SST group subjects who, in turn, showed greater improvement than subjects in the TST group. These results led to the conclusion that CR was more effective than SST and TST in producing long-term skill increments. The significance of these findings in providing support for the social learning model of alcohol dependence and cognitive restructuring theory of social skills modification is discussed.


[Reversible myocardial ischaemia or irreversible myocardial fibrosis? Differentiation by biphasic 201thallium scintigraphy (author's transl)]. The results of biphasic 201thallium (201Tl) scanning were compared with those of coronary arteriography, left ventricular angiogarphy and stress ECG in 56 patients with coronary artery disease and six with no evidence of heart disease. There were 104 201Tl defects, 50 of them reversible. The defects were always located in the area supplied by a critically stenotic coronary artery. Correlation of regional wall motion with 201Tl activity demonstrated that in all forms of abnormal wall motion there was either ischaemia or fibrosis. The resting LV angiogram thus does not make it possible to distinguish between myocardial ischaemia and fibrosis. Taking the LV angiogram as a standard, the rate of false-positive 201Tl scintigrams was 5%, that of false-negative ones 23%. The biphasic 201Tl scintigram was more sensitive than the stress ECG in detecting myocardial ischaemia. It furthermore made it possible to localize the ischaemic (or fibrotic) region within the LV and to estimate its size.


[Peptic ulcer in children: diagnosis and treatment (author's transl)]. Within a period of 14 years 23 children were treated for peptic ulcer (0.039% of all inpatients). Acute ulcers were seen in neonates or after major surgery, and were diagnosed only after perforation or bleeding. Chronic ulcers predominantly occurred after the sixth year. In addition to abdominal pain and colic, perforation and haemorrhage were also seen, the latter occasionally without previous symptoms. Three children were operated on for perforation, two for gastroduodenal haemorrhage. One of them, a neonate, died of septicaemia with subarachnoid haemorrhage. The bleedings were stopped by purse-string suture, the perforations by oversewing in two, local excision in one. Follow-up examination was undertaken in 14 of the 22 surviving children six months to 12 years after the initial manifestation. None had a recurrence. It is concluded that peptic ulcer is more frequent in children than is generally supposed. Treatment is mainly conservative. In case of perforation or haemorrhage the least possible surgical intervention should be practised.


[On the aetiology of malignant pericardial mesothelioma (author's transl)]. Two cases of malignant pericardial mesothelioma are described. Morphologically they corresponded to the epithelial or fibrous type, respectively. In one patient, an old-metal dealer, an increased number of asbestos bodies were found in the lung parenchyma and phase-microscopy demonstrated increased asbestos needles in the lung parenchyma. Since, beyond a certain fibre size, asbestos can induce bronchial carcinoma as well as pleural or peritoneal mesothelioma, it is likely that the pericardial mesothelioma had a similar aetiology.


[The hypertensive heart. VII. Effect of atenolol on the function, coronary haemodynamics and oxygen uptake of the left ventricle (author's transl)]. After acute beta-adrenergic blockade (5 mg atenolol intravenously) in 11 patients with essential hypertension but no heart failure arterial blood pressure and inotropic state fell slightly (-5.4% and -7.5%, respectively), but there was a definite decrease in heart rate (-13.8%), cardiac index (-11.5%) and cardiac work (-14.3%). There was a marked decrease in coronary blood flow (-14.5%) and myocardial oxygen uptake (-13.6%), while the coronary arterio-venous oxygen difference remained normal. Coronary vascular resistance increased significantly (+12.7%). Atenolol increased the coronary reserve of the left ventricle by about 21% in the five patients in whom it was measured. The results indicate that during acute beta-adrenergic blockade in essential hypertension there is an effective lowering of the left ventricular systolic load, with an equivalent decrease in myocardial energy requirement. The change in coronary vascular resistance and increase in coronary reserve of the left ventricle during this blockade is apparently the result of metabolic changes.


[The diagnostic value of determining serum-mercaptans in liver disease (author's transl)]. Aliphatic mercaptans (aethanthiol, methanthiol, dimethylsulphide) can be measured in serum with a simple and rapid gaschromatographic method. The test takes 30 minutes. Aethantiol was found to be increased ten-fold (P less than 0.0001) in patients with acute hepatic failure (endogenous coma), while in exogenous hepatic coma it was always normal or decreased. Mild increase in aethanthiol concentration (two or threefold) was also found in chronic aggressive hepatitis, cirrhosis and obstructive jaundice. Methanthiol concentration was elevated in patients with endogenous and exogenous hepatic coma. Values for methanthiol are, however, of only limited use, because methionine is converted in small amounts to methanthiol during the test procedures. Dimethylsulphide is found in only very severe cases of endogenous or exogenous hepatic coma and can be considered to be a prognostically unfavourable sign. Determination of mercaptans makes it possible to differentiate exactly between endogenous and exogenous hepatic coma. Its value also lies in the recognition of the severity of endogenous intoxication and it is suitable for serial and control determination of the effectiveness of therapeutic measures.


[A trial of combined chemotherapy and radiotherapy for stage IV Hodgkin's disease with initial lung involvement (author's transl)]. Between 1972 and 1975 a total of 20 patients were treated for stage IV Hodgkin's disease with initial lung involvement. All had pathological findings in the mediastinum, and 17 had a nodular-sclerosing type histologically. Four patients were in full remission after six months of multiple chemotherapy. Further chemotherapy or combined chemotherapy and radiotherapy achieved full remission in a total of eight patients, i.e. a six-year  survival rate of 40%. The prognosis was poor if lung involvement was still evident after six-month chemotherapy. But if the lung involvement disappears radiologically the authors recommend further treatment, analogous to that in stages II and III, i.e. exploratory laparotomy with splenectomy, plus upper and - if necessary - lower section radiotherapy.


[Epidemiology, clinical data and immune response of an epidemic of hepatitis A (author's transl)]. Almost all members of an affected family (46 persons) were followed up for a year after contracting hepatitis A during an epidemic in a rural area. Sixteen children, one juvenile and a 42-year-old woman had been infected. A mild subclinical course was present in about a third. All but one person in the studied population who were over 25 years had antibody titres from an earlier hepatitis A infection. As result, those who fell ill were almost exclusively children and juveniles with an average age of 15 years. Contagion rate within the family was 56.7% for those not immunised. Antibodies against hepatitis A virus of the IgG class rose in the majority of patients between the sixth and twelfth month of the infection. There was a significant correlation between the titre after one year and maximal GPT and bilirubin levels in the acute phase of the illness.


[A simple and quick method for measuring low blood-glucose concentrations (author's transl)]. A new method of measuring glucose concentrations (Reflotest-Hypoglycemie) was tested on 141 serum samples and 119 capillary blood samples and compared with the hexokinase-glucose-6-phosphate dehydrogenase method. The Reflotest (reflectance meter) compared well with the reference test. Comparison of results with three sera measured by the method in six different laboratories indicated the accuracy of the test. Endogenous bilirubin, uric acid, and haematocrit values did not influence the result. The test is therefore suitable for quantitative measurements.


[Suicide with beta-methyldigoxin (author's transl)]. A 50-year-old woman committed suicide by taking an overdose of beta-methyldigoxin. The interval between swallowing the tablets and death was about 60 minutes. Plasma and tissue samples, taken 163 hours after death, were analysed for glycosides by radioimmunoassay. The plasma-glycoside level was 75.1 ng/ml, in the left ventricular myocardium it was 143.2 ng/g wet-weight. and in the right ventricular myocardium 159.7 ng/g wet-weight. The tissue-plasma ratio for the various parts of the heart varied from 0.8 to 2.1. Death occurred in the early distribution stage.


[Pancreatic glucagon and the pathogenesis of diabetes mellitus (author's transl)]. Eleven patients who had had total pancreatic resection had hyperglycaemia (16.8 +/- 7.7 mmol/1 corresponding to 3.02 +/- 1.38 g/l) after fasting for 14 or 36 hours. After arginine stimulation there was no evidence for pancreatic glucagon. These findings indicate that (1) in man there are no sites of pancreatic glucagon production outside of the (resected) pancreas; (2) marked hyperglycaemia may occur without glucagon.


[Heparin in the prevention of thromboembolism after elective hip-joint operations (author's transl)]. Using the 125I-fibrinogen test, the antithrombotic effect of three different heparin schedules was examined in 113 patients untergoing elective hip surgery. Low-dose heparin (3 X 5000 IU/24 h) reduced the incidence of postoperative thrombosis from 60% in the control subjects (not receiving any heparin) to 33%. Combined low-dose heparin and acetylsalicyl-lysine, given intravenously, further reduced the incidence slightly to 27%. Increasing the heparin dosage postoperatively to 3 X 7500 IU/24 h effectively prevented the incidence of thrombosis by reducing it to 11% in these high-risk patients.


[Dopamine and dobutamine in the treatment of severe cardiac failure (author's transl)]. Ten patients in severe cardiac failure were treated with dopamine (4 microgram/kg . min) and dobutamine (7.5 microgram/kg.min). Both drugs brought about a similar increase in stroke volume and cardiac output of about 50% and 60%, respectively, accompanied by a fall in peripheral vascular resistance of about 33%. On dopamine the heart rate increased by 12%, but remained unaltered on dobutamine. There was a significant fall in the preload of both ventricles with dobutamine, while ventricular filling pressure during dopamine infusion was only slightly decreased, unchanged or even increased. The pulmonary (wedge) pressure during dopamine infusion averaged 9 mm Hg higher than during dobutamine (P less than 0.001). There is thus the potential danger with dopamine of aggravating pulmonary congestion. Furthermore, the improvement in cardiac function due to dopamine is at the expense of a higher oxygen demand than with dobutamine. Dobutamine is, therfore, preferable to dopamine in the treatment of advanced myocardial failure.


[Activator treatment of acute venous thrombosis (author's transl)]. Plasminogen activator contains equimolar proportions of streptokinase and human plasminogen, and as proactivator-streptokinase complex it has activator properties. In nine patients with recent venous thromboses of the upper or lower limbs plasminogen activator treatment achieved complete recanalisation in 14 of 27 veins occluded by thrombosis and partially in six. Clotting tests indicated that activator treatment can be better controlled than streptokinase treatment.


[Cortical localizations seen by the dynamic gamma-camera : a new approach in neuropsychology]. We present here the results obtained in the study of normal brain functions, in normal awake man performing normal voluntary tasks, by mean of new approach developed in our laboratory. Its principle lies on the fact that focal changes in cortical blood flow during brain function are due to the coupling between local function aand metabolism, which has been demonstrated in man during hand movement by Olesen (1971) and by Raichle and associates (1976). So far as the changes are focal (uni- or multifocal) they can be assessed by external measurement of focal cerebral blood flow (rCBF) with the 133Xenon clearance technique, provided that the detection apparatus used yields a proper spatial and temporal resolution. A temporal resolution of 45 sec. is made possible by the initial slope calculation of Olesen and coll. (1971), using intracarotid injection of isotope. The spatial resolution has been improved by the design of a special system using 254 scintillation detectors with individual collimation, each 8 mm ø, connected to individual ratemeters (Sveinsdottir et al., 1975). This allows the simultaneous processing of the 254 clearance curves by a small on-line Varian computer. The results are displayed as functional colour pictures of the brain on a T.B. screen, less than 3 min. after isotope injection. The studies have been performed to date in more than 200 patients, usually in connection with carotid angiography. 84 subjects could be classified as "normals+ because of lack of detectable brain lesion and of permanent symptoms, and they constitute the reference material for exploring normal brain functions. In each case one or two "rest" studies have been made for comparison with the test situations. The following observations were made: Resting pattern: with the patients lying in a quiet dark room with minimal sensory input the normal pattern is much the same in both hemispheres and it is characterized by higher flows in the anterior upper parts of the frontal lobes (fig. 1 a). The percent variation in a given area during two different rest studies is about 5 percent (fig. 1 b). Primary sensory inputs. Auditory and visual inputs activate the corresponding parts of temporal and occipital regions (fig. 2 and 3). Simple cutaneous stimulation such as touch or vibrations do not change the rest pattern. Moderate pain gives a global increase of CBF, pre-dominantly in the frontal regions (Ingvar, 1976). Vestibular stimulation with cold or warm water in the ear gives an increase of rCBF in the parietal regions. Simple movements. Movements of mouth, eyes, hand or foot clearly activate the corresponding parts of the central region, with an increase of rCBF up to 50--100% (Sveinsdottir et al., 1975). When the movement is repetitive there is in all cases an additional clearcut increase in the upper premotor region, probably including the supplementary motor area. This last region is activated alone when the subject tries to imagine a movement without actually moving (fig. 5 a, b, c). Sensory discrimination...


Time distortion in acute phencyclidine (PCP) psychosis. A correlation between 30 seconds estimation and urine drugs levels. In fifteen patients hospitalized with phencyclidine (PCP) psychosis, several measures of psychopathology, including those of time distorsion, were examined in relationship to urine PCP levels and duration of hsopitalization. Impaired ability to estimate thirty seconds duration was found to correlate significantly with a higher urine PCP level and a longer hospitalization, the test for ability to estimate thirty seconds may be useful in clinical management of patients with PCP psychosis particularly when there is no urine PCP level available.


Plasma mineralocorticoids, plasma renin, and urinary kallikrein in salt-sensitive and salt-resistant rats. Plasma aldosterone, deoxycorticosterone (DOC), 18-hydroxy-deoxycorticosterone (18OH-DOC), and corticosterone were measured in Dahl salt-sensitive (S) and salt-resistant (R) rats. Plasma corticosterone and DOC were not different between strains but plasma aldosterone was decreased and plasma 18OH-DOC increased in S compared to R. Plasma renin activity and urinary kallikrein excretion were both lower in S than R. Urinary kallikrein is known to vary directly with mineralocorticoid activity and 18OH-DOC is a weak mineralocorticoid. The lower urinary kallikrein in the presence of elevated 18OH-DOC could mean that urinary kallikrein differences between S and R are under independent genetic control from 18OH-DOC.