Influence of visual cueing on conditioned response inhibition in retarded individuals. A consistent finding with respect to retarded individuals is that they exhibit prolonged responding during the extinction phase of a classical eyelid-conditioning procedure relative to nonretarded individuals. The present investigation was carried out to determine whether the failure of retarded individuals to cease conditioned responding is due to a motor inhibitory deficit or to the inability to form a cognitive inhibitory set. The results indicated that, with prompting, the retarded subjects were able to inhibit the conditioned response, thereby eliminating the motor inhibitory deficit explanation for the continued conditioned responding. The data further suggested that the failure to form a cognitive inhibitory set may be related to the inability of retarded individuals to produce effective mediators.


Optimizing test performance of moderately and severely mentally retarded adolescents and adults. This study provided further evidence for the validity of a learning potential assessment procedure with institutionalized moderately and severely retarded adolescents and adults. Significant positive correlations were obtained between psychometric and learning scores, attendants' and teachers' ratings of ability, and the posttraining scores on the modified Kohs Extended Learning Potential procedure. In addition, performance on this test-train-test procedure was compared with a train-within-test format for two different tasks: training embedded within the administration of the Leiter International Performance Scale and a formboard version of Raven's Coloured Progressive Matrices. The students responded equally to the two formats. Stanford-Binet IQs were least predictive of performance on the three learning potential measures and were unrelated to teachers' and attendants' ratings of ability. The implications of these data were discussed with particular attention to the potential advantages of the train-within-test model.


Blocking of stimuli and the free recall and subjective organization of EMR adolescents. Number of unrelated stimulus items presented consistently and spatially grouped (1, 3, or 5) was studied in a multitrial free recall experiment with EMR adolescents. This blocking was effective in (a) improving recall from recently presented items, (b) increasing subjective organization, and (c) leading to the formation of stable clusterable output groups. Some evidence suggested that overall recall also increased as a result of the consistent and simultaneous presentation. Discussion of the results emphasized that for a retarded population the relationship between organization and recall may not be strong unless intensive strategy training is employed.


Verbalization in EMR children's observational learning. The effect of descriptive verbalization during observation of a model on mentally retarded boys' retention for what they had observed was examined. Forty 9- to 12-year-old boys in public-school EMR classes were grouped on the basis of relatively high or low IQ scores. One-half of each group observed a videotaped model perform a series of novel acts, while in addition to viewing the tape, the other half described the model's actions. Observational learning was immediately tested through a set of prompts for imitation, with prizes offered commensurate with level of performance. Regardless of IQ group, the boys who were required to verbalize the model's behavior were able to imitate it significantly better than boys who merely watched the model; high and low IQ groups did not significantly differ in observational learning. Further directions for research on mentally retarded children's observational learning were suggested.


Systematic observation of classroom behavior of retarded and autistic preschool children. Two groups of 6 children, previously diagnosed as autistic and mentally retarded, were observed for seven 20-minute sessions. The following environmental parameters were manipulated: teacher-to-child ratio, presence of food reinforcement, and skill area being presented. Behavior under observation fell into 3 classes: (a) adaptive performance (percentage response and percentage correct), (b) attention, and (c) maladaptive behavior. Results suggested that (a) food reinforcement and the 1:1 teacher-to-child ratio may not generally enhance adaptive performance but may have an effect upon attention and tantrum behavior; (b) attention to task is more predictive of adaptive behavior than attention to teacher; and (c) interactions were generally lacking between the above parameters and diagnostic group, while level of functioning did show such interactions. The present results support the practice of individual behavioral assessment of autistic and retarded children. The present procedure, coupled with statistical analysis for individual subjects, may provide educational prescriptions for individual children.


Effects of stimulus-response variables on the choice reaction time of mildly retarded adults. Nonretarded and mildly retarded adults were compared in two experiments on an 8-choice reaction time (RT) task. Stimulus lights were either distant or close. Both groups responded more slowly when stimuli were distant, this effect being more marked for retarded subjects. Patterns of latencies suggested that, compared with nonretarded subjects, retarded subjects inspected information input for longer periods of time and made more inspections before responding. Faster RTs to stimuli nearest the ends and midline of the display and to stimulus repetitions indicated that retarded subjects were more reliant upon more discriminable cues in the stimulus display.


Efficiency of self-generated elaborations by EMR and nonretarded children. Paired-associates learning tasks were given to 24 EMR and 24 nonretarded children. Subjects in each group received instructions to elaborate the noun pairs by embedding them in a sentence, and a qualitative analysis of the elaborations generated by the subjects was conducted by comparing levels of recall associated with the different types of elaboration. Elaborations that were conjunctive in nature, especially those which expressed thematic or functional relationships, were most effective overall. EMR children generated more inefficient elaborations than did nonretarded children.


Communication in retarded adolescents: utilization of known language skills. Six retarded adolescents were pretested for comprehension and production of items on a sentence comprehension test and then given a referential communication task using these items as stimulus material. Each child acted as speaker and listener with each of the other five children. The presentation of items was arranged so that the target sentence differed from others of the set equally often in subject, verb, or object. Results showed that the critical feature was less likely to be communicated successfully when it was the verb. Some adolescents were less successful than others in this task but improved with further trials.


Differential ovarian and adrenal vein catheterization. Twenty-two hirsute women underwent percutaneous adrenal and ovarian vein catheterization to differentiate and localize excessive hormonal output. All studies were done under fluoroscopic control; catheter placement was verified by venography, and blood samples were withdrawn for hormonal analysis. The right ovarian vein was successfully sampled in 42 per cent of attempts; the left ovarian vein, in 75 per cent; the right adrenal vein, in 56 per cent; and the left adrenal vein, in 100 per cent. Bilateral catheterization did not prove clinically useful. First, anatomic variations in venous size and drainage made catheterization and bilateral sampling difficult. Second, adrenal secretion is both episodic and parallel, necessitating both simultaneous catheterization and serial sampling for adequate diagnosis. The stress of the procedure may provoke increased adrenal output. Third, since ovarian secretion is not parallel, and since increased hormone output has been documented in that ovary containing developing follicles or a corpus luteum, distinguishing ovarian dysfunction proved difficult. Finally, for a time-consuming procedure, patient discomfort cannot be disregarded. This technique has not proved to be a reliable means of determining the site of androgen hypersecretion and thus cannot be recommended in the routine evaluation of female hirsutism.


Gestational and pregestational diabetes: an approach to therapy. The objective of management in the pregnant diabetic patient is to achieve physiologic glucose homeostasis through the use of diet and insulin. As outlined, the numerous ancillary tests developed during the past 15 years to assist the clinician in determining impending fetal death have left much to be desired, especially where metabolic homeostasis has not been achieved prior to the thirty-sixth week of gestation. The statistics from this institution indicate that the maintenance of the plasma glucose concentration below 100 mg. per cent throughout gestation, regardless of the severity of the diabetes, all but removes the risk of maternal-fetal complications due to diabetes. The management is uniform for all patients exhibiting an abnormality of carbohydrate metabolism, and, although it is rather difficult to accept, there have been minimal neonatal complications when the protocol outlined in this presentation has been followed.


Oral prostaglandin E2 for labor induction in high-risk pregnancy. Oral prostaglandin E2 (PGE2) was used alone or synergistically with intravenous oxytocin to induce labor in 84 women whose pregnancies were at high risk. A control group of 84 similar high-risk pregnancies where labor was induced with intravenous oxytocin alone was studied to compare the safety and efficacy of the two regimens. Oral PGE2 administration, combined with the synergistic effect of intravenous oxytocin, is safe for induction of labor in gravid women whose fetuses are at risk. Uterine polysystole, which is potentially dangerous, especially to the high-risk fetus, was not commonly encountered and only once was associated with transient fetal bradycardia. Uterine hypertonus was not encountered with PGE2; however, it did occur with oxytocin stimulation. Nausea and vomiting occurred in one third of the women treated with PGE2 but were well tolerated and required discontinuation of the drug in only one instance. There was no apparent advantage of using the combination PGE2 regimen in patients whose cervices were more favorable for induction of labor (Bishop score, 5 to 9). However, oral PGE2, used either alone or synergistically with oxytocin, appears twice as effective in inducing labor than was oxytocin alone in women in whom labor was considered to be "difficult to induce" (Bishop score, 0 to 4).


An analysis of the utility of plasma immunoreactive estrogen measurements in determining delivery time of gravidas with a fetus considered at high risk. Although maternal estrogen excretion and plasma estrogen levels are widely used to assess fetal health, the utility of these tests in lowering perinatal mortality rates has not been established. In order to ascertain if, with the help of plasma immunoreactive estrogen measurements, a reduction in perinatal deaths could be achieved, a population of women with a fetus at high risk were randomly divided into two groups and studied prospectively: in 315 gravidas, the estrogen results were reported (Group A); in 307, they were not reported (Group B). Nine perinatal deaths occurred in Group A, 10 in Group B. Ten Group B women whose infant ultimately did well would have been delivered 28 days or more prematurely if management had been based solely on the basis of abnormal immunoreactive estrogen levels. Measurement of estrogen levels is of little value in management of women with a fetus at risk; it may even lead to erroneous premature delivery.


Classical and "true" gestational postmaturity. In a study of a sample of 317 conceptional basal body temperature (BBT) curves obtained from normal women, the authors have applied new definitions of prematurity and postmaturity which take into account the time of ovulation. They were thus able to estimate (1) the error rates associated with the classical definitions-incorrect classification as pre- or postmature and nondetection; in particular, for this series, the percentage of incorrectly classified postmatures is high (70 per cent) and is even more so when considering only the unwanted births (80 per cent); (2) the order of magnitude in terms of days of the error made in assessing postmaturity by the classical method. This was found to be quite substantial for the misclassified cases.


Venous distensibility during pregnancy determined by graded venous congestion. The increase in volume of the human calf and forearm during pregnancy resulting from graded venous congestion has been measured plethysmographically in the raised leg and forearm of 10 recumbent subjects during and after pregnancy. Normal pressure volume curves were determined and the alterations in this curve over the various stages of gestation were presumed to indicate an alteration in the distensibility of the capacity blood vessels. This distensibility was found to increase with the progression of pregnancy in both the forearm and the calf particularly after the thirtieth week of pregnancy. The distensibility, however, appeared to return to below the 10 week gestation level at the eighth postpartum week. The increase in distensibility was greater in the calf than in the forearm although both were significantly increased.


The evaluation of Regionalized Perinatal Health Care Programs. A survey, conducted in the summer of 1974, to determine the extent of regionalized perinatal care in the United States revealed 28 states to have programs in operation. Evaluation was a common concern of these programs. A model for the evaluation of Regionalized Perinatal Care Programs is presented here with the North Carolina program used as an example. Evaluation was mandated as an integral component of the program in North Carolina, and this model has been developed in response to that mandate.


Regionalization of a birth defects prevention clinic. Screening programs to detect the carrier state of Tay-Sachs disease have been established in many large urban areas. A regionalized program has been established in the middle-Tennessee area to permit smaller communities to benefit from such programs. The numerical and psychosocial results of this program are discussed. The general concept of regionalization of health care delivery as related to birth defects screening programs is presented. Through such regionalized programs, obstetricians may be provided with new information concerning diagnostic and screening tests for genetic diseases.


Fetal alcohol syndrome: seven new cases. In one year, the "fetal alcohol syndrome" (FAS) was recognized in seven newborn and older infants, bringing the total in the current literature to 26 cases. This recently rediscovered disorder consists of severe prenatal and postnatal growth failure, mental deficiency, and characteristic hypoplasia of the middle face and orbits with minor malformations of the heart and joints. The mothers have chronic alcoholism. By identifying and counseling such women, obstetricians and gynecologists may prevent the occurrence of the syndrome or diagnose it in the neonate.


Placental lesions in experimental toxemia in the rabbit. Unlike the normal human placenta, the normal rabbit placenta, near term, is essentially free of such stigmas of aging as infarcts and syncytial knots. When experimental toxemia is produced in the pregnant rabbit by ligating the terminal aorta to a specific degree of stricture, placental lesions resembling those found in human toxemia are observed; namely, diffuse congestion, old and recent infarcts, and syncytial knots. All the treated animals who exhibited anatomical and clinical signs of toxemia presented, in association, obvious placental lesions; there were, however, some animals which showed infarct but no other signs of toxemia.


Thyroid function in human pregnancy. IX. Development or retardation of 7-year-old progeny of hypothyroxinemic women. Progeny of women, whose thyroid function was studied gestationally, had psychological and/or neurologic examinations at 8 months, 4 years and 7 years of age. In more than 100 pregnancies (at least 3 per cent of total pregnancies) hypothyroxinemia occurred and was treated adequately or inadequately. Children were delivered after uncomplicated pregnancies (except hypothyroxinemia), had birth weights of at least 2,500 grams, and were excluded when postnatal insults intervened. At 8 months and 4 years progeny of inadequately treated hypothyroxinemic women had the lowest psychological scores. Now 246 7-year-old children have been examined psychologically and neurologically (earlier data on only 101). Definite trends and a few statistically lower psychological scores of progeny of inadequately treated hypothyroxinemic pregnant women are compared with better psychological scores of 7-year-old children born to euthyroid and adequately treated hypothyroxinemic women. In six sibling sets outcome was better when hypothyroxinemic women were treated with adequate thyroid replacement therapy. If a woman has a poor reproductive history, early in a subsequent gestation, thyroid status should be examined and adequate thyroid medication considered seriously.


Estimation of fetal weighty by ultrasonic abdominometry. The fetal abdomen was measured with an ultrasonic contact scanner in order to correlate abdomenal circumference and birth weight. A sample of 134 measurements was used to calculate a standard graph, which was then tested against a subsequent 280 measurements, giving a mean estimation error of 105 Gm. Head-to-abdomen circumference ratio measurements were used to assess the type of growth retardation.


Estrogen potencies of three new low-dose oral contraceptives. The estrogen potencies of three new oral contraceptive formulations--Brevicon, Modicon, and Lo/Ovral--were determined. Brevicon and Modicon were found to have estrogen potency equal to mestranol 50 mug and equal to or greater than Norinyl 1 + 50 and Ortho-Novuum 1 + 50. Lo/Ovral, which is identical to Ovral in the type and ratio of progestin but 40 per cent lower in drug content, could be estimated to have an estrogen potency of 0.73 relative to mestranol 50 mug and therefore, by inference, to Brevicon and Modicon.


Measured intelligence in offspring of oral and nonoral contraceptive users. A study has been made of measures of intelligence of 210 children (5 to 8 years of age) born to mothers who used oral and nonoral contraceptives pregestationally. Ninety-six of these children were born to mothers who used oral contraceptives, and one hundred and fourteen were born to mothers who used vaginal contraceptive methods. The intelligence of the children was measured in the form of the full-scale I.Q. score by the Wechsler Intelligence Scale for Children (WISC) adapted and normalized for Puerto Rico by the Puerto Rico Department of Education. A three-factor analysis of variance was performed on the data collected for comparison of the two groups. It was observed that there was no significant difference between the average I.Q. scores of children born to mothers using oral contraceptives and those born to the mothers using nonoral contraceptives. The average I.Q. in children of the oral contraceptive group was 85.04 and that in children of the nonoral contraceptive group was 85.54. Distributions for both groups were also found to be similar. No significant differences between means were observed for sex, age, and interacitons with the exception of the age and sex interaction, where, again, no specific, meaningful trend could be established. The average I.Q. in the sample fell very close to the center of the "normal" range of the WISC, Puerto Rican adaptation. The results of the study do not offer any evidence as to the effect of the use of oral contraceptives on the intelligence measure (by the WISC) of the offspring born to mothers using them pregestationally. The children under study, on an average, are of "normal" intelligence as measured by the Puerto Rican intelligence standards.


The effects of norgestrel on carbohydrate and lipid metabolism over one year. Carbohydrate and lipid metabolism were studied with the use of a three-hour oral glucose tolerance test in 71 women before and after one year of daily oral norgestrel, 0.075 mg., treatment. There was no significant change in weight or fasting plasma triglyceride and cholesterol levels. There was a significant elevation of both the blood glucose and plasma insulin levels after one year of treatment. This was true for both the fasting and the glucose-stimulated values. Whereas all of the individual glucose tolerance curves at the pretreatment control test were normal by selection, 15.5 per cent of the curves were borderline abnormal to abnormal at the one-year test. The significance of these metabolic alterations is discussed.


Mucinous tumors of the ovary. II. Ultrastructural features of mucinous cystadenocarcinomas. On the basis of light microscopic and scanning and transmission ultrastructural observations, ovarian mucinous tumors of borderline malignancy contain two types of mucinous epithelium--an endocervical type and an intestinal type. The fully malignant tumors were composed solely of intestinal-type epithelium. These findings may have prognostic and therapeutic significance.


Psychomotor objectives in occupational therapy education. This article describes the role of educational objective taxonomies in facilitating the specification of intended learning outcomes and the apparent neglect of objectives directed toward psychomotor learning. A review of the literature indicates extensive material is available on motor learning and on the classification of psychomotor levels of behavior according to a systematic framework. Although many of the categories are functional for special areas, no one system has universal applicability. It is suggested that each discipline may need to draw on the literature to formulate its own taxonomic system, and a model taxonomy is offered for occupational therapy education in which levels of psychomotor performance are differentiated by the degree of individuation, the unique quality of performance introduced by the learner. Examples are given at each level and illustrative objectives combine expected behaviors with selected curriculum areas.


Humanistic psychology and rehabilitation programs in mental hospitals. A humanistic growth-oriented theory, specifically Maslow's need-satisfaction theory, was used as a basis for examining the contributions work and employment make toward rehabilitation of the state mental hospital patient. Research literature reviewed indicated that if the rehabilitation program is to be viable and optimally effective, satisfying the belongingness and esteem needs of the patient is important. Research that stresses the therapeutic benefit of work, as well as research that raises the issue of workshops inhibiting independence and fostering dependence are presented. Modifications of rehabilitation programs that resulted in reports of increased program effectiveness are discussed. Fundamental features of these alternative or ancillary programs were: 1. a definite structure that allows various levels of advancement; 2. group participation; 3. patient initiative; 4. an orientation that reflects the competitive nature of employment; and 5. early community involvement. The importance of evaluating each client's needs and planning for growth before his/her job placement is considered vital to the program and to the individual.


Three-dimensional construction tests for children aged five and six years. The constructional praxis ability of 69 normal 5 and 6 year olds was studied to validate established norms, to gain normative data for the Gesell Block Test and the Benton and Fogel Test of Constructional Praxis, and to identify a developmental continuum. No significant difference was found between scores obtained by the two age groups; however, a difference significant at the less than .05 level was found between scores of five-year-old boys and girls. The results suggest that these tests measure a continuum of development and that with revisions they may be useful to provide additional information about development of constructional praxis ability in a larger sample of normal and brain-damaged children.


Electronic training devices for hand rehabilitation. Several new electronic hand rehabilitation devices are shown. These devices, which can be assembled locally with minimal funds, are excellent information feedback devices that can be used effectively in hand rehabilitation. Electrogoniometers may be used for hand and wrist range-of-motion feedback. In addition, various pressure sensitive devices are illustrated and the way in which these devices may be used in hand rehabilitation are portrayed.


Modified finger exercise board.

Modified finger exercise board. This article describes constructional and material changes made to a finger exercise board (1), a device that provides the occupational therapist with versatile equipment for resistive exercises for most muscles of the hand. It is particularly effective in the treatment of disabilities that involve multiple muscles of the hand such as is commonly the case in rheumatoid arthritis. The modifications of the board have substantially eased grading resistive tension, and construction has been simplified and its stability increased. Brief additional information is supplied below for use of the exercise board in the treatment of arthritic deformities.


Effect of perceptual motor training on gross-motor skill and self-concept of young children. Preschool teachers from four different day care centers assessed four-and five-year-old children for deficits in gross-motor skill and self-concept. Forty subjects were randomly assigned to experimental and control groups. The experimental group participated in a 30 minute per day, 5 day per week perceptual-motor training program for 10 weeks, while the control group received no specialized intervention other than their regular classroom activities. Two posttests were administered: Cratty's Six-Category Gross-Motor Test and Goodenough's House, Tree, Person Projective Test. The experimental group performed better on the gross-motor test, but the results were not statistically significant. Analysis of the projective test supported the hypothesis that a perceptual-motor program may improve the self-concept of young children. Specialized intervention with perceptual-motor activities improved self-concept and these results were discussed in relation to recognizing the need for early screening and remediation of perceptual-motor dificits exhibited by preschool children.


Measurement in occupational therapy.

Measurement in occupational therapy. Occupational therapists use many forms of measurement tools to assess the existing and potential functions of their clients. Too often the principles of measurement theory have not been applied in the development of such instruments and the resulting assessments have no established validity or reliability. This article presents basic measurement theory and appropriate procedures for estimating validity and reliability within an occupational therapy framework. Special considerations with regard to measurement of motor behavior are emphasized. An understanding of these assesment principles can enable a therapist to construct measurement scales that are valid, reliable, and yield data of scientific value.


A home-treatment program for the cerebral-palsied child. The process and results of a two-month intensive home-treatment program for a two-year-old athetoid cerebral-palsied boy are described in this article. The exploratory program was designed to develop methods and procedures for the mother to use to promote the child's normal postural tone and movement during daily handling and care. The foundation for the intervention program was based on a collation of the child's history, a one-day assessment of the child's activities and time schedule in the home, and a physical evaluation. Postevaluation identified changes in the child's feeding, playing, and sleep patterns that suggested more normal movement and muscle tone. Also, the mother established new physical handling patterns and the therapist gained skill and a new awareness in home intervention programs.


Toward program development.

Toward program development. An era of disciplined thinking may result not only in acknowledging but also in addressing those questions that may lead to a consistent examination of existing programs within a profession. This paper is one attemp at encouraging the professional membership to continue to address: 1. the nature and focus of the content and practice environments of the field of Occupational Therapy; 2. two approaches to investigating the distinctive character of the field of Occupational Therapy-the Separate Domain Approach and the Retroductive Approach; 3. and the basic documents developed and/or sponsored by the professional organization-in this case-The Ohio State Study (1), the NIH Study (2), and the Curriculum Guide (3).


Dynamic strain gage measurements on ophthalmic lenses impacted by low energy missiles. Strain distributions on impacted ophthalmic lenses were measured with strain gages. The strain distributions, which resulted from impacts produced with a special apparatus, were shown to be comparable to those which arise in the FDA drop-ball test. The measured strain drops off very rapidly away from the impact point, implying that only a small part of the lens is really being tested. The results are in good agreement with the quasi-static predictions. The effect of differences in lens power, of input kinetic energy, and of inserting the lens in a polyethylene bag are also investigated.


The visual evoked response to word stimuli in the visual fields. The visual evoked response (VER) has been considered an objective indicator of visual and perceptual processing, although as yet there is no clear evidence of a relationship between visual recognition and electrophysiological activity. The present study was performed to determine whether VER's can provide indications of differences in responses to word stimuli presented in different parts of the visual field. Additionally, evidence was sought as to whether the left and right hemispheres process visual information symmetrically. In 20 adult subjects with normal binocular vision, VER's were recorded simultaneously from left and right hemispheres in response to the repeated presentation of a three-letter word in each of 7 visual field locations. VER's of any subject in response to one stimulus site were consistent and repeatable; intersubject variation was large. For subject comparison, amplitude of VER was the measured response. No significant or consistent amplitude characteristics were identified that related to recognition of the stimulus. From comparison of responses to the different field locations, central stimulation (at 0 degrees) evoked the largest peak-to-trough amplitude (X=8.21 uV+/- 2.56). Amplitudes tended to be larger at 4 degrees than at 2 degrees from center; left field stimulation tended to give larger amplitudes than right field; however, these trends were larger than from the left, this difference was not valid since 11 subjects had larger right hemisphere responses, whereas 9 had larger amplitudes from the left hemisphere. Thus, the study suggests that the VER reflects some net electrical activity from the recording sites that may be traced to an external sensory stimulus and shows that this activity is symmetrical for each hemisphere.


Calculating magnification differences in monocular aphakia. The calculation of magnification differences is treated well in a number of texts, 1, 3, 4, 5, 7 but the formulas are not always presented in their most convenient form. Because of this, many complex schemes have been illustrated 2 and many different versions have been published. 3, 4, 5. The purpose of this paper is to present the pertinent equations in a simplified manner and to illustrate them by a specific example, namely, the case of monocular aphakia.


Simple formulas for computation of prism vergence and accommodation stimulation in a Brewster stereoscope. Two formulas are presented which permit rapid determination of accommodative and convergence demands in a Brewster stereoscope. The formulas are easily applied and are valid for any circumstances. The formula for convergence is unique in that it is independent of the patient's interpupillary setting for all instrument settings and yields results directly comparable to standard clinical measurements. The formula for accommodation is: see article. The formula for convergence is: see article. These formulas hold where A is accommodation in diopters, C is convergence in prism diopters, TD is distance of stereogram from stereoscope lenses in meters, P is power of stereoscope lenses in diopters, LS is separation of optical centers of stereoscope lenses in centimeters, and TS is the separation of corresponding points of the stereogram half-views in centimeters.


Fields of view as they relate to the magnification of a telescope: a clarification. The manufacturers of telescopic instruments typically describe their products in terms of the magnification produced. Most include some reference to the "object field" or the "acceptance angle," i.e., the angle subtended by the entrance port at the center of the entrance pupil. This paper considers varied factors utilized for calculating magnification and object field and proposes expressing the object field in terms of prism diopters rather than degrees.


Contact lens surface damage related to cases and case removal techniques. Surface damage incurred as a result of removing polymethyl methacrylate (PMMA) contact lenses form various contact lens carrying cases was monitored by photographic techniques. As compared to the controls, the experimental lenses showed consistent increases in surface damage, particularly if they were removed by a sliding (dragging) motion along the contours of the case.


The measurement and recording of vision at near test distances. Confusion and misconception characterize the designation of near visual acuities because of the numerous systems in use. Most of these systems do not lend themselves to accurate or easy usage or to comparison with other test distances. Use of the M system, with the actual test distances recorded in meters, is suggested as a simplified system for standardization.


Pathologic changes in the liver and kidney produced by immunization with intestinal antigens. Rabbits were immunized with intestinal antigens derived from rabbits, guinea pigs, and germfree rats. Inflammatory changes throughout the portal tracts of the liver were found in 55% (16 of 29) of the immunized rabbits. Interstitial nephritis was present in 7 of 23 rabbits evaluated. These changes did not occur when nonintestinal antigens were used for immunization. Antigen shared by liver, kidney, duodenum, ileum, and colon were found in each of the species used for immunization. An immune response to the antigen shared by the various tissues may be a factor in the pathogenesis of disease in this experimental system. In man, chronic active hepatitis and interstitial nephritis are found in association with inflammatory bowel disease. A similar mechanism of pathogenesis may be a factor in these extraintestinal manifestations of inflammatory bowel disease in man.


Age-related accumulation of ceroid-like pigment in mice with Chediak-Higashi syndrome. The Chediak-Higashi Syndrome (CHS) is a rare inherited disorder occurring in man and several animal homologs including the beige mouse; it is characterized by pigmentary dilution, susceptibility to pyogenic infections, and the presence of enlarged lysosomes in many cell types. Beige mice 6 months of age and older were found to have darkened livers, kidneys, and spleens, accompanied by splenomegaly. A fluorescence microscopic survey of tissues from beige mice revealed marked accumulations of a microscopic survey of tissues from beige mice revealed marked accumulations of a yellow autofluorescent pigment inhepatocytes, renal proximal tubule cells, and splenic macrophages. Additionally, large amounts of hemosiderin were present in the spleen. In beige mice, the pigment was noted in animals as young as 1 to 2 weeks of age and gradually increased in amount as the animals aged. A histochemical investigation of the pigment showed that it was ceroid-like in nature and contained in lysosomes. Ultrastructurally, the pigment was composed of lipid-like droplets embedded in a dense matrix and surrounded by a limiting membrane. The accumulation of ceroid-like material in beige mice may be a reflection of the metabolic disturbance which underlies CHS.


The effect of leukocyte and platelet transfusion on the activation of intravascular coagulation by endotoxin in granulocytopenic and thrombocytopenic rabbits. The effect of transfusion of peritoneal leukocytes, platelets, or cell suspension medium on the activation of intravascular coagulation and on the generation of capillary microclots was studied in 51 granulocytopenic and thrombocytopenic rabbits. Granulocytopenia and thrombocytopenia induced by feeding the cytoxic drug busulfan prevented the activation of intravascular coagulation and the occurrence of renal glomerular microclots after two injections of endotoxin. The transfusion of platelets into busulfan-pretreated rabbits increased the mean platelet count from 2,400 to 205,000 cells/mul, but platelet-transfused rabbits did not exhibit activation of intravascular coagulation after endotoxin injection. If however, granulocytopenic and thrombocytopenic rabbits were transfused with peritoneal leukocytes (1.0 X 10(9) cells/kg) before the second injection of endotoxin, activation of intravascular coagulation occurred, and microclot formation in renal glomerular capillaries was observed in a high percentage of animals. Positive reactions to endotoxin were obtained in leukocyte-transfused rabbits even with platelet counts of 1,000 cells/mul before the second injection of endotoxin. Thus platelets do not seem to be essentially involved in the activation of intravascular coagulation by endotoxin, whereas the presence of leukocytes is required for triggering endotoxin-induced generalized intravascular coagulation.


The repopulation of lymph nodes of dogs after 1200 R whole-body x-irradiation and intravenous administration of mononuclear blood leukocytes. Fresh and cryopreserved autologous or allogeneic mononuclear blood cells (MBCs) intravenously injected in 1200 R total-body x-irradiated dogs repopulated lymph nodes within 10 days after tranfusion. Several parameters of the lymphopoietic regeneration were correlated with the number of cells transfused and with the number of colony-forming units contained in the cell suspension when they were cultured in agar (CFUc). Values within the normal or close to normal range were reached in the mesenteric nodes of most of the animals transfused with 10 X 10(9) MBC or more. These values were obtained when 5 X 10(5) CFUc or more were transfused. Axillary nodes showed lower values than mesenteric nodes. They were mostly under the normal range but well over those of the irradiated controls. Frozen and thawed MBCs seem to be as effective as fresh cells for lymphopoietic restoration. The mesenteric nodes of dogs transfused with allogeneic MBCs showed higher cellularity and larger cortical-paracortical areas than those of dogs tranfused with approximately the same number of autologous cells. The repopulation of lymph nodes parallels that of the marrow.


Chicken dystrophy. The geometry of the transverse tubules. The pectoral muscle of chickens afflicted with muscular dystrophy, when examined with the electron microscope, contains a) numerous, often quite large vesicles with and without caveolar evaginations, b) tubules with caveolar evaginations, and c) tubular networks. We have demonstrated that all these structures are derivatives of the transverse tubles as revealed by tracer studies and freeze-fracture complementary replicas. The membranes of transverse tubular origin show a small number of intramembranous particles on both P and E faces with no complementary geometry. The membranes of the free sacrcoplasmic reticulum (SR) and the junctional SR of normal and dystrophic muscle appear identical in complementary freeze-fracture replicas. Vesicles that carry only a small number of particles on both E and P faces exposed by freeze-fracturing in isolated SR preparations can be taken as presumptive evidence and serve as a morphologic marker for transverse tubular origin of such vesicles when mitochondrial and lysosomal contamination has been excluded.


The morphologic relationship of light and dark cells of the collecting tubule in potassium-depleted rats. The luminal surface of collecting tubule cells in the inner stripe of the renal medulla in normal and potassium-depleted rats was studied by scanning electron microscopy. In normal rats the luminal surfaces were of two types. One cell type was sparsely covered with small bulbous microvilli and had either a single or double cilium. This type corresponds to the light cell seen in transmission electron microscopy. The second cell type was covered by prominent microplicae and represents the dark cell observed in transmission electron microscopy. In potassium-depleted animals, numerous cells with a morphologic appearance of intermediate forms were identified. By scanning electron microscopy, the luminal surface of these cells was covered by a mixed population of villi and microplicae in different stages of development and often showed cilia, which were previously considered to exist only on light cells. On the basis of these morphologic findings, we conclude that the dark and light cells are not different cell types but rather represent different forms of a single type of cell.


Oxygen-induced enzyme release after irreversible myocardial injury. Effects of cyanide in perfused rat hearts. The effects of 5 mM potassium cyanide (KCN) on creatine phosphokinase (CPK) release and cellular morphology were studied. Rat hearts were perfused with substrate-deficient media gassed with O2 or N2 (O2 medium, N2 medium) at 37 C, and effluent was collected for creatine phosphokinase analysis. Tissue fixation was with glutaraldehyde for light and electron microscopy. Experiments included the following: a) continuous perfusion with O2- or N2-medium in the presence of KCN; b) 45 or 60 minutes of perfusion with N2-medium followed by O2-medium for 15 or 180 minutes, respectively; c) 45 minutes of perfusion with N2-medium with KCN added 15 minutes before reoxygenation with O2-medium plus KCN; (4) 60 minutes of N2-medium plus KCN followed by O2-medium plus KCN for 180 minutes; d) as a control for irreversible injury, 21 minutes of perfusion with calcium-free O2-medium followed by 2.5 mM calcium-O2-medium ("calcium paradox"). The following results were seen: a) Initial CPK release occurred about 30 minutes later from hearts perfused with O2-medium plus KCN than from hearts perfused with N2-medium plus KCN. b) Upon reoxygenation after either 45 or 60 minutes of anoxia, hearts had a sudden peak of oxygen-induced CPK release. Most irreversibly injured cells were massively swollen and had sarcolemmal defects and contraction bands. Reversibly injured cells in the same hearts resembled normal myocardium. A previously unrecognized third population of cells is described. These cells were characterized by contraction bands but were not swollen, had intact sarcolemma, and contained both normal and damaged mitochondria with intramatrical calcium accumulation granules. It could not be determined if these cells were reversibly injured or in an early stage of irreversible injury. c) KCN added 15 minutes before reoxygenation of hearts after 45 minutes of anoxia inhibited the sudden peak of oxygen-induced CPK release but not a slow sustained release. Small to moderate numbers of cells in these hearts contained contraction bands. d) After 60 minutes, KCN completely inhibited both oxygen-induced CPK release and contraction band formation. e) Addition of calcium to calcium-free hearts caused both massive CPK release and contraction band formation. It is concluded that: the beginning of CPK release from oxygenated KCN-inhibited hearts requires about 30 minutes longer than from anoxic hearts; KCN can inhibit both oxygen-induced CPK release and contraction bands in irreversibly injured rat myocardial cells; sudden contracture of myocardial cells as occurs in the calcium paradox can result in massive CPK release; contraction bands occur in nonswollen cells, hence contraction bands can occur independently of massive cell swelling or membrane rupture. It is postulated that there may be two stages of irreversible myocardial injury; a) loss of control of contraction and b) progressive loss of mitochondrial and membrane integrity.


Lymphoreticular and myeloid pathogenesis of Venezuelan equine encephalitis in hamsters. Ultrastructural, histopathologic, and virologic studies of adult hamsters infected with virulent Venezuelan equine encelphalomyelitis (VEE) virus (Subtype I-B) demonstrated precise chronologic and topographic progression of lesions and viral replication in extraneural sites. Thymus contained the earliest lesions and the highest initial and subsequent viral titers. No particular cytotropism was observed as highly efficient viral replication and severe cytonecrosis proceded. Early cortical necrosis of splenic periarteriolar lymphocytic sheath was followed by lymphoblastoid repopulation of the peripheral zone. Massive bone marrow necrosis was accompained by ultrastructural evidence of VEE viral particle production in reticulum cells, rubricytes, myeloid cells, lymphoblastoid cells, and megakaryocytes. Speed, efficiency, destructiveness, and relative sensitivity of virtually all lymphoreticular and hematopoetic cells were hallmarks of virulent VEE infection in the hamster.


Individuation and discrimination in the classroom. A negative tone pervades much of the literature on teacher discrimination in the classroom, and conjures up images of inequality, oppression, and racism. This paper differentiates between the negative forms of discrimination (responding prejudicially to children) and individuation (discerning differences among children and responding to individual needs). Focus is on the positive face of discrimination, as exemplified by three teachers who are highly "individuating" in their attitudes and behaviors towards children.


A hospital play program: helping children with serious illness. Children hospitalized with a life-threatening disease are experiencing a severely stressful situation that is often confusing, frightening, and anxiety-provoking. This paper describes a play-therapy program designed to facilitate the expression of these feelings, enhance the sense of mastery, foster adaptive behavior, and increase cooperation with medical treatment.


Residential treatment today: the paradox of new premises. The once-isolated world of the residential treatment center has been altered by the broad social and cultural changes of recent years. New values, especially as introduced by younger staff whose attitudes are often closer to their clients than to their administrators, have created new problems. This paper points to the need for a sensitive professional response, and the ability to embrace change and put it to new therapeutic uses.


Television in the hospital: programming patients' delusions. Systematic collection of art products from 55 schizophrenic patients provided unexpected documentation of the impact of television on delusion-formation. Patients' drawings and descriptions demonstrate the ease with which they incorporate TV program material in their psychotic experience. It is suggested that clinicians consider television viewing a relevant variable in the design of treatment programs.


Focus on maternal behavior in infant intervention. A six-stage maternal behavior progression is outlined, and its use as a schema for the assessment of parental behavior in parent-infant interaction is described. This approach focuses on parent-infant interaction, rather than the teaching of infant skills, as a basis for enhancing cognitive and affective development of the child. Use of the schema is illustrated in two cases from an intervention program for high-risk infants.


Concomitants of social acceptance: exploratory research and implications for treatment. A population of 98 fourth and fifth grade students responded to instruments that yielded data on social acceptance, liking for others, need for approval, and interpersonal relationship orientation. Results suggest that social acceptance is related to interpersonal relationship orientation, but unrelated to liking for others and need for approval. Implications for treatment are discussed.


Methodological issues in psychopharmacological research: chlorpromazine--a case in point. Past research on the relative efficacy of powerful psychotropic agents has generally relied on group designs, which may mask critical individual differences in drug response. This and other methodological inadequacies raise questions about much of the vast literature in support of the clinical efficacy of chlorpromazine and similar drugs. A research strategy employing within-subJect designs, using a single subject as his own control, is suggested as advantageous in assessing individual drug effects at specific dosage levels.


Family television viewing habits and the spontaneous play of preschool children. In the course of an experimental study of effects of television on imagination and emotion in nursery school children, interviews and questionnaire responses concerning viewing habits were obtained from 70 parents. Group consultations were initiated to help parents understand television's impact on children and to develop methods for controlling family viewing patterns.


The myth of the multi-problem family.

The myth of the multi-problem family. It is suggested that the concept "multi-problem family" is a myth when viewed in the context of our current service delivery system. That system, itself fragmented, may do more to promote than relieve family distintegration, conflict, and personal anxiety. Continued professional training and tendencies that lead to viewing problems presented by individuals only as individual problems may result in overlooking opportunities for total family approaches to treatment and prevention.


Disposition decisions in a walk-in clinic: social and psychiatric variables. The success of a walk-in clinic in providing care without regard to social and diagnostic factors is measured in a study of 391 patients. Results indicate that acceptance or nonacceptance into the clinic system were unrelated to social class or diagnosis, although these factors did influence referrals to specific clinic resources.


An instrument for differentiating programs in prevention--primary, secondary and tertiary. Prevention programs in mental health have been developed slowly, in part due to an inadequate understanding of primary, secondary, and tertiary prevention. This paper describes an instrument developed to identify critical dimensions to consider in differentiating among prevention programs, and to help clarify the complex issues underlying the design of such programs.


Overview: psychiatric sequelae to multiple trauma. The authors discuss the setting, patients, and staff, and the role of psychiatric consultants in intensive care units and trauma centers. They point out the similarities and differences between patients with multiple trauma and those who have had open-heart surgery and head or spinal cord injuries. They also deal with the question of an element of self-destructive behavior in accidents and offer suggestions for the psychiatric management of severely traumatized patients. The authors conclude that the role and obligation of the psychiatrist of the the future will lie in crisis intervention within the medical-biological model.


Effects of peer review on outpatient psychotherapy: therapist and patient follow-up survey. Interviews with 80 therapists and 50 patients at a community mental health center revealed that peer review effectively monitored the appropriateness of treatment and allocated limited treatment funds without unduly interfering with established treatment patterns, relationships, or outcomes. Most therapists reported receiving helpful consultation from the peer review committee, and the process encouraged them to focus more clearly on treatment goals. On the other hand, patients were concerned about the committee's role in making decisions about their treatment. Therapists noted as a problem the lack of certainty in establishing a treatment contract prior to peer review since the contract with the patient must remain fluid during the evaluation period. The therapists and patients demonstrated remarkable agreement in their assessment of treatment progress and whether further therapy was needed.


Behavior therapy and sex therapy.

Behavior therapy and sex therapy. Behavior therapy is characterized by the way in which clinical data are collected, analyzed, and used in the treatment program-specifically, the application of the methods of experimental and social psychology. A case history of the behavioral treatment of a sexual problem is presented to illustrate this process. Many people have assumed that the "new sex therapy" is behavior therapy because of its focus on the here and now and similarities in particular treatment maneuvers. However, the author notes that sex therapy is behavior therapy only to the extent that it deals comprehensively with environmental, interpersonal, and organismic factors that operate to maintain the sexual problem.


The effects of the sealed record in adoption. The authors found that 40 of 50 adult adoptees who had reunions with their birth parents found the experience satisfying. Only 10% of the birth parents reacted adversely, although negative response were somewhat more common among the adoptive parents. These findings confirm the author's belief that adoption practices, which in all but 4 states include permanent sealing of birth records, should be changed to recognize the life-long nature of adoption. Their recommendations include opening the records for adult adoptees, creation of agencies to be available to provide assistance and counseling for all involved (adoptees, their adoptive parents, and birth parents), and consideration of new adoption methods that would not require biological parents to forever relinquish their child and all knowledge of him/her at adoption.


The course of development of mania in patients with recurrent depression. The authors attempted to assess the extent to which bipolar patients are misdiagnosed as unipolar by evaluating the development of mania in patients who had recognized bipolar illness and by means of follow-up data on patients who had recurrent depressions. Mania occurred early in the course of bipolar illness: almost 80% of the bipolar patients were initially hospitalized for mania. Follow-up data and theoretically based calculations suggest that the chance of a patient with recurrent depressions becoming bipolar is about 5%. Based on these findings, the authors make suggestions for the classification of unipolar patients.


Linguistic performance in vulnerable and autistic children and their mothers. The authors studied the language patterns of schizophrenic mothers and their 4-year-old children, and compared them with the speech of normal mothers and children and normal mothers with autistic children. They found that children of schizophrenic mothers showed lags in language development and language distortions less severe than but in some ways similar to those seen in autistic children. Schizophrenic mothers were more likely to produce more deficient and/or distorted language in interactions with their children. Mothers of autistic children produced language that was equal to or above that of mothers of normal children on most parameters and adjusted their language to the chronological rather than the linguistic age of the child.


A five-year study of brief hospitalization. The authors compare their experience with 4 years on a brief hospitalization unit based on crisis theory with a fifth year on the same unit based on a traditional psychiatric approach. In terms of demographic and diagnostic variables and rehospitalization rates, they found that the change in approach had no significant effect on the type of patient admitted or the treatment outcome. The fact that certain tasks necessary for rapid discharge were effectively performed accounted for the success of the unit.


Alcohol and drug abuse consultation in the general hospital: a systems approach. The authors describe a program that is directed at assuring effective treatment and referral for alcoholic and addicted patients in a general hospital; the program was developed to assure maximal utlization of available addiction treatment facilities without adding to the hospital staff. Drawing on systems theory, the authors review both a pragmatic and a conceptual basis for psychiatric intervention with paraprofessional support to provide consultation to the general medical staff who treat alcoholic and addicted patients. They stress the feasibility of altering the nature of the hospital system to achieve more effective treatment for these patients.


Competency-based psychiatric education.

Competency-based psychiatric education. The focus of training in a competency-based residency program is on ensuring that all residents attain prespecified levels of competence for particular objectives in each training activity. The authors examine the components of a competency-based program and describe the phases of development that their department went through in creating such a program. They conclude that the competency-based training model directly faces the issue of certifying competence by holding itself accountable in a demonstrable way for ensuring that its residents have mastered specific areas of knowledge, skills, and attitudes.


The concept of drug automatism.

The concept of drug automatism. The drug-automatism hypothesis implies a medication-induced absence of intentionality for self-poisoning and a relative amnesia for serial or single overdosage. Controversy stems from problems encountered in the formulation and verfication of the hypothesis. The author reviews the literature, presents a case associated with a proprietary sleeping preparation, and discusses psychopharmacological and psychophysiological elements in the mechanism of drug automatism and its differential diagnosis.


Red blood cell catechol O-methyl transferase and response to imipramine in unipolar depressive women. When baseline red blood cell catechol O-methyltransferase (COMT) was measured in 15 unipolar depressive women, the authors found a linear correlation between COMT and response to imipramine (best outcome occurring at low COMT). The results of this study were not related to such variables as intensity of depression, family history, or psychiatric history. The authors suggest that this assay may be useful either as a predictor of response to the drug or as a guide in choosing the optimum dose.


Therapeutic effects of methadone and 1-alpha-acetylmethadol. Many heroin addicts prefer methadone maintenance treatment to 1-alpha-acetylmethadol(LAAM) because of the "rush-like" effect of methadone. Although there have been no observable differences in the safety and effectiveness of the two drugs, LAAM appears to lead to a more stable, consistent physiological state. The authors report on two patients who had ego defects characterized by severe mood swings. Both patients preferred LAAM to methadone because of its stabilizing effect and smoother action.


Adolescent parricide: a comparison with other adolescent murder. The authors examined the available data for 10 adolescents who had been charged with parricide and compared these with data for matched groups of 10 adolescents charged with murdering another relative or a close acquaintance and 10 charged with murdering a stranger. They found significant differences between parricidal adolescents and other homicidal adolescents on personality, family, social, and follow-up adjustment variables.


Subtle neuropsychiatric sequelae of carbon monoxide intoxication: two case reports. Carbon monoxide intoxication may result in subtle neuropsychiatric abnormalities that can be overlooked, misdiagnosed, or not fully appreciated. The author describes two patients who developed subtle but troublesome emotional cognitive problems following carbon monoxide poisoning and stresses the value of sequential neuropsychological testing and judicious psychiatric counseling in such cases.


The psychiatrist in primary medical care training: a solution to the mind-body dichotomy? The author calls attention to developing changes in medical training that may provide an appropriate setting for overcoming the dichotomous view of mind and body, of psychological medicine and "scientific medicine." Primary care training programs that include liaison psychiatry may be the vehicle for solving this persistent problem.


Student mental health services and departments of psychiatry. The authors suggest that the potential usefulness of a college mental health service as a site for teaching, training, and research has been understimated by departments of psychiatry. College health services can provide an opportunity for both trainees and investigators to deal with concepts of psychotherapeutic intervention, a developmental perspective, and a community mental health orientation.


Early sex education in relationship to later coital and reproductive behavior: evidence from Jamaican women. In a group of 150 working-class Jamaican women, lack of information from their mothers about sex coupled with chronic resentment was associated with having had more sexual partners, impregnators, and children. In contrast to age at first coitus, age at first pregnancy did not seem related to the early availability of information about sex, and it was less significantly correlated with overall education.


Assessment of sociolegal judgment of offenders. While working with young male offenders the authors developed a scale to assess sociolegal judgment, i.e., the ability to evaluate the possible social and legal consequences of various choices of action in a given situation. They found that some inmates had committed crimes because of poor sociolegal judgment, whereas others understood the consequences of their actions but chose to act illegally despite this knowledge.


Recovery after intravenous sedation. A comparison of clinical and paper and pencil tests used in assessing late effects of diazepam. Twelve healthy subjects received intravenously 0-15 mg/kg of diazepam twice, with a two-week interval between doses. They were tested in a cross-over manner before and after the injection either with a clinical test battery plus paper and pencil tests, or with a carefully selected psychomotor test battery having a correlation to real traffic behavior. Neither the clinical tests nor the paper and pencil tests demonstrated impairment of performance 1/2 and 2 1/2 hours after the injection, whereas the psychomotor tests revealed considerable impairment of reactive and co-ordinative skills 2 1/2 hours after the injection. The results stress the importance of the presence of an escort when patients are discharged from hospital after outpatient anaesthesia or sedation.


Paroxysmal hyperadrenergic state. A case during surgery for intracranial aneurysm. A case is reported of a patient with a cerebral aneurysm in whom it was difficult to induce hypotension. The hyperadrenergic state mimicked, in some respects, that seen in patients with neural crest lesions. Possible mechanisms are discussed and the anaesthetic management described.


Immediate care of cardiac emergencies.

Immediate care of cardiac emergencies. The emergency treatment of serious disorders of cardiac rhythm, left heart failure, cardiogenic shock, and cyanotic attacks is discussed. The article is intended for medical practitioners without special cardiological experience.


Efficacy of a nerve stimulator in regional analgesia; experience in a resident training programme. Forty interscalene brachial plexus regional blocks and twenty sciatic-femoral lower limb blocks were performed by 1st and 2nd year anaesthesia residents. Nerve trunk location was equally but randomly divided between use of a peripheral nerve stimulator and reliance on paraesthesiae. The stimulator group were sedated prior to nerve block while the non-stimulator group were similarly sedated after nerve block. There was no significant difference either in the number of needle insertions required for nerve location, or in the success rate, between stimulator and non-stimulator techniques. It is concluded that the stimulator is not a useful adjunct for nerve location, except in those patients who are unable to co-operate in eliciting paraesthesia. In such patients the stimulator permits a comparable success rate.


Ketamine for pediatric cardiac anesthesia. Eighty-five patients ranging from 12 h to 7 years of age were included in this study. In the first group 35 cases received ketamine, gallamine and oxygen for surgery on the great vessels. Ketamine provided satisfactory analgesia and amnesia. Heart rate did not change significantly. Gallamine gave additional safety in the prevention of bradycardia. One hundred per cent oxygen increased oxygen saturation and made more oxygen available for the tissues. The combination secured favorable conditions even in cases of sevre right to left shunt. Seven patients developed some degree of bradycardia, requiring treatment. All but one responded to epinephrime infusion. The one who did not improve died on the table. There were 6 additional deaths during the first 48 postoperative hours. Fifty infants and children received pentobarbital and morphine premedication and ketamine, pancuronium, nitrous-oxide oxygen anesthesia for open heart surgery. Cardiovascular stability with good operating conditions characterized the course of anesthesia. The increase in systolic and diastolic blood pressures and heart rate was small after induction. Further changes in these parameters during anesthesia were statistically insignificant. Perfusion pressure during cardio-pulmonary bypass was well maintained. The addition of 50 per cent nitrous oxide to inhaled oxygen significantly potentiated the duration of hypnosis and analgesia proved by ketamine. Mechanical ventilation was facilitated in both groups by the analgesia extending well into the postoperative period. There were 6 deaths in the first 48 postoperative hours in this group. The state of consciousness at the end of anesthesia and postoperative conditions of all 85 patients were comparable with that found with other agents. The techniques described provided suitable alternatives to the anesthetic management pediatric cardiac surgery.


[Influence of dopamine on the pulmonary pressure and shunt volume after cardiac surgery (author's transl)]. After the administration of Dopamine to 20 patients after cardiac surgery pulmonary shunt volume was determined with regard to the cardiac output and pulmonary pressure. It was shown that the infusion of Dopamine leads to decrease of the arterio-venous oxygen difference (AVDO2) as well as to the decrease of the PO2 in the arterial blood. On the contrary, in venous bood, PO2, Oxygen saturation, content and pulmonary pressure increased. The increase of the pulmonary right-to-left shunt observed (Qs Qt form 14.9 to 19.2%) is in proportion with the increase in cardiac output. Hence we do not suppose a specific shunting effect of Dopamine. Our findings suggest, that in the case of an already reduced blood oxygen level a further fall of the arterial oxygen saturation caused by a shunt must be avoided by additional enrichment of oxygen content of the inspired air.


[Treatment in perforation of the dura by catheter during peridural anesthesia in obstetrics (author's transl)]. A rare complication following a dural tap in labour is reported: cerebrospinal fluid was aspirated although a catheter was properly re-inserted into the peridural space. The most successful therapy is proposed.


[Ulstrasonic monitoring for early diagnosis of air embolism during neurosurgical procedures (author's transl)]. The sitting position of the patient offers many advantages to the neurosurgeon for operations at the posterior fossa, the upper cervical region, the Gasserian ganglion and the retroganglionic trigeminal root. Air embolism is however one of the greatest dangers during operations in this position. Air emboli occur more frequently than it is generally recognized. Most monitoring systems indicate the entrance of air at a late stage only. But early diagnosis and immediate therapy are of utmost importance. The use of an ultrasonic monitoring device for early diagnosis and the preoperative insertion of a right artrial catheter for immediate aspiration of the air are recommended.


[The anaesthesia-machine-care center, a prerequisite of the methodical service of apparatus for anaesthesia and intensive care medicine (author's transl)]. The technical equipment necessary for modern anaesthesia and intensive care medicine needs special and organized outfit control of the apparatus used and of their operation and proper function. Setting up of a centre for maintenance work on anaesthetic equipment is a possibility. Studies have shown that the necessary technical and hygienic maintenance work may be subdivided into 12 working phases each need special working sites and technical equipment corresonding to the requirements. The above systematic study is recommended to decrease risks assoicated which technique and hygiene.


On the etiology of "primary" hyperparathyroidism. A study of 92 patients operated on for primary hyperparathyroidism revealed that the condition was secondary to renal disease, thyrotoxicosis or malignancy in 35. Review of the literature revealed no reports of experimental studies on the relationship between hyperparathyroidism and thyrotoxicosis or malignancy. In renal disease, however, the author's own investigations show that the traditional concept of hypocalcemia as the most important factor in the development of parathyroid hyperfunction should be rejected. The parathyroid glands probably can be stimulated by various factors in "primary" hyperparathyroidism. Recent studies on the etiology of primary hyperparathyroidism are discussed and it is concluded that the term "primary" should be avoided as the disease is so often secondary.


Use of hypertonic-barium mixtures in the diagnosis of the dumping syndrome. A hypertonic glucose-barium test meal is a useful study in making the diagnosis of dumping syndrome. A distorted small bowel pattern is seen in the positive response as a result of the rapid entrance of hypertonic glucose into the small bowel with edema of the bowel wall and excessive fluid outpouring into the bowel lumen. The findings in the glucose-barium meal test should be correlated with clinical and laboratory findings to confirm the diagnosis. A negative response to the hypertonic glucose-barium test meal practically precludes the diagnosis of the dumping syndrome. A positive test is highly suggestive of the syndrome but not diagnostic in itself.


Pyloric stenosis: a 13-year experience in operative management. Infantile hypertrophic pyloric stenosis is best treated surgically, after an appropriate period of rehydration and resuscitation. Our experience with this entity has resulted in the performance of fewer contrast studies to establish the diagnosis as well as the use of an operative technique which can be safely applied to the teaching environment.


Acute mesenteric infarction.

Acute mesenteric infarction. Twenty-three cases of mesenteric infarction were reviewed retrospectively. Of note are high surgical mortality and frequent misdiagnosis. Patients are generally older than 60, and have severe, poorly localized pain and nonspecific physical findings. Laboratory studies of value include evidence of hemoconcentration and leukocytosis. Roentgenographic findings are equally nonspecific unless late in the course. Recommended operative procedures depend on the etiology of the infarction. Hyperalimentation may be of benefit early in the postoperative course to provide both nutrition and a chance for adaptation.


Perforated jejunal diverticulitis.

Perforated jejunal diverticulitis. The 25th case of perforated jejunal diverticulitis is reported and all previous cases are reviewed. The mortality in this group of patients is 32%. Resection of the perforated segment with end-to-end anastomosis seems to offer the best chance of cure.


Bilateral subclavian and axillary artery anomaly. A case is reported of bilateral absence of the third portion of the subclavian and axillary arteries in an asymptomatic woman.


Intraperitoneal rupture of pancreatic pseudocyst: report of a case and review of the literature. A case is presented of pancreatic pseudocyst which ruptured as a result of an automobile accident. Sixty-three cases from the literature of ruptured pseudocyst of the pancrease due to a variety of causes are reviewed. Special reference is made of the site of perforation and treatment. It is concluded that each case should be individualized, tailoring the operative procedure to the operative findings. While external drainage may be life saving in some cases and sometimes the only procedure possible, internal drainage is superior and should be considered when it can be done without endangering the patient's life.


Renal vein leiomyosarcoma.

Renal vein leiomyosarcoma. The third reported case of renal vein leiomyosarcoma is presented. Diagnosis was not made until exploratory celiotomy revealed a tumor originating from the left renal vein. The tumor was resected with margins of normal vein, and the patient was alive without recurrence 12 months after operation. Review of 65 cases of leiomyosarcoma originating in other retroperitoneal structures revealed a two-year survival rate of 20%. Therefore, we recommend consideration of postoperative adjunctive chemotherapy for renal vein leiomyosarcomas.


Giant lipoma of the mesentery: report of an unusual case and review of the literature. A patient with a huge mesenteric lipoma is discussed. A review of the literature reveals that there are less than 30 reported cases and consequently this diagnosis is rarely made preoperatively. An upper gastrointestinal series with a small bowel follow-through and a mesenteric arteriogram may suggest this condition. Surgical excision is the treatment of choice, since these large tumors may undergo malignant degeneration.


Lower-limb amputation for occlusive vascular disease. A small series of 58 patients who required amputation because of gangrene of the lower limb with nonreconstructable arteries at New York University Medical Center illustrates the manner in which application of some of these principles achieved primary healing of 78% in below-knee amputation and rehabilitation rate of as high as 90% using simple nonrigid dressings.


Enteroenteric fistula secondary to pancreatic carcinoma: a case report. Duodenocolic fistula has been reported as the result of a variety of benign and malignant processes, but rarely from a pancreatic carcinoma. Such a case in a young adult is presented. The literature is reviewed; a single duodenocolic and two gastrocolic fistulas secondary to adenocarcinoma of the pancreas have previously been reported.


Amyloidosis of the stomach: report of an unusual case and review of the literature. Amyloidosis confined to the stomach is a rare occurrence; the second reported case is presented. Involvement of the stomach with widespread "primary" and "secondary" amyloidosis, the amyloidosis of multiple myeloma, and the familial forms is a common pathologic finding; the involvement is seen clinically less often. The incidence, clinical presentation, diagnosis, pathological findings and treatment are reviewed. The diagnosis should be kept in mind in all patients who have signs or symptoms compatible with peptic ulcer disease or gastric carcinoma. This is especially important for those with multiple myeloma, chronic debilitating diseases or a family history that predisposes them to the development of amyloidosis.


[Subacute sclerosing panencephalitis. Report of 31 cases (author's transl)]. We present 31 cases of subacute sclerosing panecephalitis from the epidemiologic, clinical, electroencephalographic, laboratory and anatomopatological point of view. Psychical disorders (51,59%) and generalized convulsive fits (19,45%) stand out as a first cause of consultation. A high visual hallucinatory incidence (35,48%) was observed. Repeated complexes were of great value for the early diagnosis as well as the high titers of measles-virus antibody in the serum and cerebrospinal fluid for the diagnosis corroboration.


[Fallot's tetralogy with severe symptomatology during the first year of life (author's transl)]. Seventeen cases of Fallot's Tetralogy with severe symptomatology during the first year of life are reviewed. In all of them, a cardiac catheterization and angiocardiography were performed. In 2 cases the pulmonary outflow tract was atretic. In general, the clinical, radiologic, electrocardiographic and hemodynamic findings were similar to those previously reported, although in 3 patients of the present series atypical electrocardiographic findings were found. Pronounced narrowing and horizontal orientation of the infundibular chamber, and accentuated hypoplasia of the pulmonary artery branches and of the left heart cavities and were all unfavourable findings for total correction frequently found in the present material. Minimal or non-existent aortic dextroposition was observed in association with cases of Fallot's Tetralogy with extreme severity. Surgery was indicated as an emergency measure in the majority of the cases. Palliatives procedures were performed in 10 patients, and corrective surgery in one. Surgical results agree with the extreme severity that this lesion has, when it gives rise to important symptomatology so early in the life.


[A case of Burkitt lymphoma (author's transl)]. A case of sporadic Burkitt lymphoma, localized in the face, in a four year old male, is presented. The marked involvement of the hemolymphatic system and the prognostic value of the metastatic cellular type that may be found in bone marrow is pointed out. Due to the lack of other concluding etiopathogenic criteria, the diagnosis can be established in view of the pathologic and histochemical characteristics of the tumor.


[Social development and family composition (author's transl)]. Starting from the theory regarding the social behaviour of the child and, on the other hand, from the concept of the family as a cultural and psychological and, in addition, sociological unit, an index of social development for children of 6 to 14 years of age is presented, and which is obtained by adding the process of school adaptation plus the process of learning plus personal attitudes. Having this hypothesis as a working basis, a study has been carried out on a total of 240 pupils (120 males and 120 girls) included in the chronological age of from 6 to 14 and belonging to National Schools in Zaragoza (Spain) and within the on going program of growth and development. Social development has been studied through inquiries of personal application at family level and through the application of psychograms of our own tabulation. The number of children in the family has been related to the aforementioned parameters, five family units having been established: one child, two children, three children, four children, five or more children. The overall result indicates that the index of social development proposed by us is higher in the case of unique children; that it is practically the same for those children whose family unit is of two, three or four children, and is sensibly lesser in children included in the family unit of five or more children.


[Effect of tolbutamide on plasmatic insulin and glucose in children treated with diphenylhydantoin (author's transl)]. The response of the serum glucose and insulin to tolbutamide in six epileptic children before and after one month treatment with DH are studied. A significant increase of the glycemia after treatment with DH is observed having insulin values no statistically significant modification.


[Congenital heart block and pacemaker implantation (author's transl)]. A six years old boy was sent to our service due to a loss of conscience spell. He had no preceding history E.K.G. showed a complete A-V block. Laboratory findings were within normal limits. Cardiac catheterism was performed and it ruled out any antomic abnormality, making evident a good contraction ability. To decide pacemaker implantation we evaluted: 1. That cardiac frequency was not increased by exercise neither by action of pharmacologyc agents (atropine, insoproterenol).-2. The existence of wide and bizarre QRS ocmplex.-3. And dizziness spels. The patient has been controlled during the past two years. Parasistolia has appeared, not showing modification till today.


Thrombocytopenia occurring during the administration of heparin. A prospective study in 52 patients. In a group of 52 patients receiving continuous intravenous heparin, 16 developed thrombocytopenia (platelets less than 100 000/mm3). Ten of the 16 patients who had thrombocytopenia had elevated titers of fibrinogen-fibrin degradation products, and five of these 10 patients also had a reduction in plasma fibrinogen. The abnormalities disappeared after the heparin preparation was discontinued. These occurrences could not be attributed to drugs other than heparin, to the dose of heparin administered, or to prior exposure to heparin. The mechanism by which the heparin preparation may induce these changes is not known.


Gentamicin serum concentrations: pharmacokinetic predictions. Recent studies that emphasize the unpredictability of gentamicin serum concentrations have cast doubt on the accuracy of commonly used dosing nomograms. We therefore developed a digital computer program to evaluate gentamicin pharmacokinetics and have tested its ability to predict correctly gentamicin serum levels under clinical conditions. A significant relation (P less than .001) was found between 130 measured (bioassayed) and computer predicted levels from 40 patients. Serum levels were reliably estimated in patients with unstable renal function and were statistically, but not clinically, affected by changes in hematocrit. The calculation of volume of distribution on the basis of the patient's lean body weight rather than total body weight was an important factor that contributed to the accuracy of the predicted level. A new dosing chart is presented that incorporates the important variables affecting gentamicin pharmacokinetics into an easily used, convenient form.


Familial disease of the renal medulla. A study of progeny in a family with medullary cystic disease. Cystic disease of the renal medulla is rarely diagnosed before end-stage renal failure appears. To discover early signs of disease in an affected family, we studied renal function and intravenous pyelography in 12 asymptomatic children of three sisters with this disorder. Defects in urine concentrating ability and X-ray abnormalities indistinguishable from medullary sponge kidney were found. While these changes probably represent early manifestations of medullary cystic disease, a clear separation between medullary cystic disease and medullary sponge kidney cannot be made in our patients. We propose that the designation "familial disease of the renal medulla" be used for such patients, with further classification determined by evidence of progressive disease.


[Hospital discharge summary (author's transl)]. A form to fill up, hospital discharge summary is presented. Main characteristics are: special framework, shortness and conciseness. It can be filled up since patient is admitted to hospital on the base of problem oriented medical record. Quantity and quality of information has been favourably evaluated either by our own medical staff or general pediatrician who watches out for baby after hospital discharge. In 84% of patients it was given at the same moment of discharge and before two weeks for the rest. It's time and work saving and from the point of view of education has been considered very useful for both author and reader.


[Intoxication by diphenoxylate (author's transl)]. Two cases of intoxication by diphenoxylate, inespecific antidiarrheal, depressor of the intestinal motility, are presented. Diphenoxylate is chemically related with meperidine. One case was caused by hipersensitivity and the other one by overdose. Both had a favourable outcome. Existent bibliography was reviewed and clinical signs of this intoxication pointed-out. It is suggested that diphenoxylate should not be prescribed to children under thirty months.


Pituitary enlargement, pituitary failure, and primary hypothyroidism. Enlargement of the pituitary gland associated with primary hypothyroidism was observed in two patients. Serum thyroid-stimulating hormone (TSH) concentration and the TSH response to thyrotropin-releasing hormone were increased in both. Other pituitary function tests were subnormal in both patients, suggesting that a thyrotroph pituitary tumor was present that compromised the other pituicytes. The presence of a pituitary tumor secondary to primary hypothyroidism and resulting pituitary failure should be considered in all patients with long-standing primary hypothyroidism.


The use of khat (Catha edulis) in Yemen. Social and medical observations. Catha edulis, or khat, a plant indigenous to Yemen, Ethiopia, and East Africa, has sympathomimetic and euphoriant effects. Its role in the economic, social, and political lives of people in North and South Yemen and certain clinical and psychiatric aspects are discussed.


[Clinical and social fate of craniocerebral injuries in young adults]. After looking 15 years back, the authors based two detailed observations of young adult cranio-cerebral injured taken amongst a group of 30 others who had been the subject of a medical doctorate thesis. From then on, the authors drew notions of semeiology, concerning the subjects becoming aware of their body before being injured, when waking up from coma and during the phasis of after effects. They mean to suggest to consider the notions of "normal person" and of pre-traumatic mind, of "present person" and of traumatic mind, and of "future person" and of post-traumatic mind. They attempted to write a comparative essay with the cerebral and physical disable of early youth. By way of conclusion, they briefly studied the attitudes of the clinical, familial and social relations and of the medical and legal consequences of these attitudes.


[Thematic study of the narration of dreams of normal, and of schizophrenic and other psychotic subjects]. A thematic study according to Hall's and Van de Castle's method on the narrations of dreams by schizophrens and non schizophrens delirious patients attended to in a psychiatric hospital, compared with a group of control, all females. A report of the method and of the satistically significant results. A study of the sexual, benevolent and aggressive social interactions, of the authors of the acts, of the type of issues, of the intervention of chance and of the quality of emotions, as well, as of the diversity of the intervening people. Its is possible to distinguish the narrations of the normal people's dreams and of those of the patients. These tell less numerous dreams, which are shorter, less rich, heavier with aggressive events and painful sexuality and less provided with benevolence. Death is more frequent in them. Outside hostility is embodied by the father, unknown people or fate.


[Psychopathology of expression in the German language, countries. Attempt at a summary]. The foundations of the modern psychopathology of pictorial expression were laid more than a half-century ago by a Frenchman, Marcel Réja (1907), à Swiss, Morgenthaler (1921), and a German, Prinzhorn (1922). In the early days, this was a matter of marginal interest for a handful of psychiatrists and it attracted little official attention. Since the last war however, and especially since the establishment of the S.I.P.E., this special branch of psychopathology has won the recognition to which it is entitled. In French-speaking and other Latin language countries, Volmat's book (1956) provided a powerful stimulus to research. Numerous studies were also undertaken in German-speaking countries. A Swiss psychiatrist, living in a polyglot country, surrounded by some of the world's major linguistic zones, is especially well situated to follow the evolution of ideas. He soon comes to realize that these language areas are sharply separated by very real barriers. In the past few years, the lack of communication between French and German-speaking investigators has become increasingly apparent. Within the limits of a single report, it is impossible to cover all of the work that has been published in German since the time of Prinzhorn. The author has restricted himself to a selection of studies which he personally regards as important. He has sought to retrace and bring into view a line of thought which has proved to be productive and which has not received the attention it deserves in the French-language literature.


Mathematics and the surgeon.

Mathematics and the surgeon. The surgeon uses elementary mathematics just as much as any other educated layman. In his professional life, however, much of the knowledge and skill on which he relies has had a mathematical strand in its development, possibly woven into the supporting disciplines such as physics, chemistry, biology, and bioengineering. The valves and limitations of mathematical models are examined briefly in the general medical field and particularly in relation to the surgeon. Arithmetic and statistics are usually regarded as the most immediately useful parts of mathematics. Examples are cited, however, of medical postgraduate work which uses other highly advanced mathematical techniques. The place of mathematics in postgraduate and postexperience teaching courses is touched on. The role of a mathematical consultant in the medical team is discussed.


Magnesium metabolism: a brief review.

Magnesium metabolism: a brief review. The important role played by the magnesium ion in the body is not generally recognized. The action of numerous enzyme systems critical to cellular metabolism is regulated by it and it contributes importantly to macromolecular structure. Magnesium defiency occurs more often than is generally suspected; magnesium excess, though uncommon, is of special interest to the anaesthetist because it produces a curare-like effect on neuromuscular transmission. It is hoped that this brief review of magnesium metabolism will draw attention to its importance and relevance in everyday practice.


The Mobin-Uddin umbrella filter in the management of proven and threatened pulmonary embolism. An umbrella filter was inserted into the inferior vena cava in 8 patients with proven or threatened pulmonary embolism. The technique was found to be simple and without major complication in this small series. Two patients died of their primary disease and a further 2 died of lung complications secondary to their initial embolism. The remaining 4 patients have been followed up for periods ranging from 2 to 11 months.


Safe handling of tissue containing radioactive substances. Patients recently treated with radioactive isotopes may present problems or even hazards during physical examination, operation or autopsy, especially following the use of iodine isotopes and 198Au. 32P is rarely a significant hazard. Contamination of victims of radiation accidents may be a problem initially, but they are usually promptly decontaminated. Guidance of the hospital's radiation safety officer is helpful, particularly with regard to handling of contaminated persons or materials. Long-lived isotopes, such as radium or thorotrast, are usually present in too low concentration to be dangerous. Projected use of artificial hearts powered by plutonium should not be hazardous because of adequate shielding of the source.


Measurement of free erythrocyte protoporphyrin in blood collected on filter paper as a screening test to detect lead poisoning in children. A procedure for the measurement of free erythrocyte protoporphyrin (FEP) in a drop of blood collected on filter paper is described. The method is useful as a screening test for lead poisoning in children. Based on the FEP finding and blood lead tests, asymptomatic children are classified into four major categories. A course of action is suggested for each category.


Repetitive tissue biopsy by venipuncture: enzyme activities in isolated leukocyte populations. Despite the rapidly expanding clinical use of leukocyte biochemistry, there is a limited amount of data available on normal human leukocytes. Some of the problems associated with the clinical use of leukocytes are discussed briefly. Enzyme activities of alkaline and acid phosphatase, lysozyme, and beta-galactosidase are presented. Results are reproducible between normals when expressed per mg of leukocyte deoxyribonucleic acid (DNA). Much higher lymphocyte activties of lysozyme and alkaline phosphatase are noted than previously reported with cytochemical or intact cell systems. It has been demonstrated that leukocytes cannot be considered chemically homogenous but should be separated and considered as individual cell types.


The laboratory management of a medicolegal specimen. The medicolegal specimen refers to any material, biologic or nonbiologic, that is analyzed by the laboratory as part of an investigative procedure, the results of which may be presented as evidence in a court of law. The medicolegal specimen is an example of physical evidence and has an intrinsic credibility based on the reliability of the person handling it, the reliability of methods of laboratory analysis and the reliability of testimony with relationship to the interpretations of the findings. Aspects of specimen integrity, re: chain of custody, sample collection, specifications for samples and utilization of samples, are outlined. The responsibilities for the management of the specimen are defined and discussed with suggested guidelines recommended.


Berylliosis as an auto-immune disorder.

Berylliosis as an auto-immune disorder. Exposure to compounds of beryllium can cause dermatitis, acute pneumonitis and chronic pulmonary granulomatosis ("berylliosis") in humans. These syndromes seem to have an allergic-immunologic component in common. Hypersensitivity to beryllium is of the delayed (cell-mediated) type and can be measured as skin reactivity to patch test; lymphocyte blast transformation; and macrophage migration inhibition. There is good correlation between the results of these tests in exposed populations, but the degree of hypersensitivity is not necessarily a measure of either extent of exposure or severity of berylliosis. In animal experiment, inhalation exposure has suppressed a previously established cutaneous hypersensitivity, and degree of hypersensitivity and degree of berylliosis were in significant inverse correlation.


[Actinomyces pneumonicus var. altamicus var. nov., a producer of new altamycin antibiotics]. Actinomycete LIA-0788 was isolated from a soil sample. By its morphological and cultural features the actinomycete was close to Actinomyces pneumonicus and differed from it in the antibiotic properties. This provided classification of actinomycete LIA-0788 as Act. pneumonicus var. altamicus var nov. The culture produced altamycins A and B, new antibiotics. Their physico-chemical characteristics is presented.


Drug interference in laboratory testing. Characteristic problems in the interpretation data when a drug or its metabolite interferes with a laboratory procedure are reviewed. Various mechanisms of interference (physical, chemical, pharmacological and drug-drug interaction) are discussed. The role of a computerized drug-test interference file in assisting in the predication as well as interpretation of apparent test results is described.


[Isolation and physicochemical characteristics of antibiotics from the LIA-0773 and LIA-0780 s trains]. Individual components of the antibiotics from strains LIA-0773 and LIA-0708 were isolated with the method of counter-current distribution. Physico-chemical and biological properties of these substances were studied. It was shown that the substances differed from each other and chondamycin, and antifungal antibiotic by the values of their chromatographic mobility, physico-chemical and biological properties.


Diagnostic problems in drug-induced diseases. The evaluation of adverse drug reactions (ADR's) in clinical patients is usually a complex and multifactorial problem. A methodology for this evaluation has been derived from the experience with over 3,000 cases. Illustrative cases are presented to demonstrate in detail a variety of means of linking a drug with an ADR. Emphasis is placed on the frequent diagnostic utility of accurate time-related information, in addition to the use of historical, clinical-laboratory and morphologic findings.


[Conditions for the self-organization of submicroscopic structures from mycelial extracts of the "fructose" variant of Actinomyces roseflavus var. roseofungini]. Self-organization of various submicroscopic formations, such as "tubes", "ribbons", etc. differing in ultrastructure and containing a polyenic antibiotic was observed in acetone extracts of the mycelium of the "fructose" variant of Actinomyces roseoflavus var. roseofungini. Conditions for separate isolation of the above structures are described. Concentration of the extract and the ratio of the volumes of water added to the extract are determinant for the process of self-organization. A possibility of reorganization of the tubular structures into the ribbon-like ones and vice versa is shown.