Pleasingness vs interestingness of visual stimuli with controlled complexity: their relationship to looking time as a function of exposure time. Ss take more time to perceive interesting/displeasing stimuli than uninteresting/pleasing ones. This is consistent with the results of former experiments. However we used a different operationalization of looking time, based on binocular rivalry. Each of six stimulus pairs was presented in a stereoscope. One member of each pair was interesting but displeasing in comparison to the other member. Stimulus complexity was under control. Due to binocular rivalry Ss perceived only one pattern a time. 20 Ss were asked to indicate which pattern they actually saw by pushing two buttons. For each stimulus pair was registered how long each button was pushed during each of six successive minutes. Unlike other operationalizations this one is less dependent on S's determination of what stimulus will be looked at or for how long. It has the advantage that it is bound up more exclusively with relations of similarity and dissimilarity between stimulus elements. It allows manipulation of exposure time in a systematic and continous way. There is no significant interaction between looking and exposure time.


Haptic-visual form identification in children aged 4 through 13. Children 4 through 13 yr. of age performed on a haptic-to-visual form-identification task. The obtained curves showed that for both sexes, rate of improvement slowed down at approximately 9 yr. of age.


Children's constructions of their self-images. In order to trace the normal development of the self-qua-body image during elementary school age, 250 public school children in that age range were tested. The test devised involved assembling self-replicas from a standard array of 37 jigsaw-like, prefashioned segments representing various body parts. A highly reliable and flexible quantitative scoring scheme was applied to the resulting protocols. Mean performance improved with age until age 10 yr., except for judgments of body proportions. Recurrent error patterns involved omission of arms, hands and feet, underestimation of body size relative to head size, and mislocation of upper and lower extremities. On the basis of the results, it was hypothesized that the arms and hands often are not as integral to the body image as are the head, trunk and legs. In most respects, qualitive performance was not affected by sex or IQ. Performance on the self-image construction test was compared with children's self-drawings and the implications of some commonalities as well as disparities in the two methods were discussed.


Successive processing of color and form from brief visual displays. Visual processing of multidimensional stimuli was explored with a task designed to determine the number of separable perceptual stages operating and the nature of their relationship. Displays containing 2 rows of 5 randomly selected letters were presented briefly. In half the displays, 1 of the 10 letters was red and the other 9 black; in the remaining displays, all 10 letters were black. Ss made two responses to each display; color detection, in which the presence or absence of a red letter was judged, and letter naming, in which Ss reported as many letters as they could. The findings suggested that the two tasks were performed by separate perceptual mechanisms and the selection of letters to be named could be influenced by the information acquired by the color-detection mechanism.


Personality, emotional state, and perception of nonverbal communications. The study investigated whether emotionally provoking disagreements between 36 marriage partners influenced their ability to identify each other's feelings from tone of voice cues. The results suggested that among the males the ability of stable introverts to identify increased after disagreements, while that of neurotic introverts decreased (p smaller than 0.01).


Measurement of subvocal speech: correlations between two muscle leads and between two recording methods. Electromyographical (EMG) activity was recorded from both the lip and the chin speech muscles of 46 preschool children while they silently memorized names of pictures in a memory task. Correlations between responses from the lip and chin muscle channels, performed for each trial, were high. A more sensitive measurement procedure of squaring and integrating voltages was used to quantify EMG activity. Correlations per each trial of squared, integrated voltages with amplitude of the single highest pen deflections (a commonly used measurement in studies of subvocal speech) were somewhat lower than desirable; correlations with amplitude of the five highest pen deflections were noticabley higher.


Relationship of objective score, perceptual trace, and practice method in learning to balance. The relationship of the perceptual trace to the objective score (raw score) under three practice conditions was the main concern of this study. Three groups of 14 Ss performed 35 trials on a stabilometer balancing task. Ss were asked to estimate how well they did after each trial. The difference between S's actual score and his guess was used as a measure of the perceptual trace. While performance and time estimations improved with practice, they correlated very low. The results were discussed in the context of Adams' closed-loop theory and gave mixed support for the theory.


Toward a modification of the indices of neonatal prematurity. In a study of 233 infants, traditional indices of neonatal prematurity were excessively high for predicting developmental lag at 1 yr., and alternative cut-off scores were suggested. Prematurity indices were especially important for infants with below-average development.


Duration of stimulus presentation and screening for perceptual disabilities. This study examined the effects of increasing the stimulus-presentation time of a motion picture test for identifying perceptual disabilities in the performance of Ss in regular first and fourth grade classrooms and on a sample of Ss in special education classes who had been identified as having varying degrees of perceptual deficiencies. The length of stimulus presentation increased the total performance of Ss on the motion picture test but did not add to the value of the instrument as a screening device.


Integrational deficits in children with visual-perceptual-motor disabilities. To assess the psycholinguistic and perceptual aspects of their differential performance, 12 normal and 12 learning disabled children in elementary school were tested on a visual-motor task, both with and without an added verbal component. No differences were found for motor performance in any condition, but significant differences were found for linguistic performance during the combined task. The power of linguistic performance during the combined task to serve as a means of diagnosis for learning disabilities was explained as an indication of delayed development of the ability to superimpose process upon process.


Is construction reserved for the target during visual search? This study was designed to examine the possibility, that where there is high similarity between irrelevant and target letters, the irrelevant letter will be constructed to sudents each attended a 1-hr. experimental session in which they searched 25 lists, followed by a recognition test. The lists were made up from the upper case letters of the alphabet, and during the recognition test each S was required to indicate how many times each of the irrelevant letters had appeared on the final list searched. Analysis of variance showed a significant recognition frequency effect. The results indicated Neisser's (1967) view, that during visual search construction is reserved for the target, may require modification.


Relationship of acoustic parameters and perceptual ratings of esophageal speech. For 10 male and 10 female esophageal speakers selected acoustic and perceptual dimensions of esophageal speech were investigated to determine the intercorrelations of the following measures: intelligibility, articulation, rate, fundamental frequency, mean relative intensity, and effectiveness. Results indicate that only articulation and effectiveness were significantly correlated with intelligibility, whereas measures of intelligibility, articulation, rate, fundamental frequency, and mean relative intensity were all significantly correlated with effectiveness ratings.


A video-tape study on the relationship between wearing spectacles and judgments of intelligence. Video-tapes were made of men and women students with and without spectacles. Judges rated 7 of the 8 Ss as being more intelligent when wearing spectacles.


Simultaneous disappearances of both images during binocular rivalry of contours and effect on eye-blink rate. Simultaneous disappearances of both rivalry images were reported by 28 women who reported on the rivalry 3.2 degree diagonal rivalry contours for 10 min. of continuous viewing. The data support the notion that suppression of images during binocular rivalry is independent in both eyes. In a second study, 48 women reported simultaneous disappearances during the rivalry of 3.2 degree vertical and horizontal contours for 10 min. of continuous viewing under one of two blink-rate instruction conditions. Fewer simultaneous disappearances were reported by Ss instructed to blink every 5 sec. than by Ss instructed to blink every 15 sec. Blinking may reduce the probability of simultaneous disappearances in rivalry. In both studies, the fusion squares surrounding the rivalry stimuli were continuously perceived.


On the psychophysical law: an information theory interpretation. For more than a century Fechner's psychophysical law has been the subject of dispute and debate. Fechner based his law on Weber's indisputable observations and measurements. Yet, using these observations as a starting point, but measuring information instead of sensation, one may arrive at numerical laws quite different from Fechner's psychophysical law.


Clinical and "actuarial" evaluation of organic brain damage by psychologists and non-psychologists using the Memory-for-Designs. This study examined the effects of type of training and level of education on clinical judgment, as demonstrated in "clinical" and "actuarial" evaluation of the Graham-Kendall Memory-for-Designs (1960). Protocols of 6 organic and 6 non-organic patients matched for age and IQ were evaluated by 18 judges. Nine of the judges were psychologists and nine had degrees in some field other than psychology. In each group 3 judges had PhDs, 3 had Master's degrees and 3 had Bachelor's degrees. There was no significant difference (p greater than .01) between the 2 groups in clinical or actuarial diagnoses of brain damage regardless of level of education, and inter-rater reliability was all but identical. Results were consistent with other research on clinical judgment.


Pediatric aspects of nuclear medicine.

Pediatric aspects of nuclear medicine. During the last few years, the number, variety, and complexity of nuclear medical examinations that can be performed in children have increased impressively, due partly to recent accomplishments in radiopharmaceutical development and the availability of gamma scintillation cameras and computer systems for acquisition, storage, and analysis of data. The reduction in radiation exposure with the new radiopharmaceuticals has helped to expand the scope of nuclear medical examinations in children to include not only the study or evaluation of suspected malignant disease but also the evaluation of nonmalignant disease and organ function in a number of body systems. Specific applications of nuclear medical techniques in children are discussed, with relation to the brain and cerebrospinal fluid, thyroid, lungs, heart and great vessels, liver and spleen, kidneys and bladder, and bone.


Urinary tract infections in the adult. The Postgraduate Medicine Lecture. Diagnosis of urinary tract infection should be made only on the basis of complete evidence. Examination and culture of the urine are necessary steps in correct diagnosis and treatment. Urinary obstruction is almost always present in recurrent infections. Contributory factors include sex practices conducive to entry of bacteria, poor perineal hygiene, occupations that require long periods of driving or riding, chronic constipation, and use of oral contraceptives, tampons, and douches. Many antibacterial drugs are effective in eliminating infection. Contributing factors should be modified or eliminated to prevent recurrence.


Resuscitation of the newborn.

Resuscitation of the newborn. Resuscitation of the newborn is not different from resuscitation of any other patient, but in newborns, resuscitation requires special skills and considerations because of the size of the patient. If properly done, it can save many lives. If done incorrectly, however, it can save many lives. If done incorrectly, however, it can result in death or permanent neurologic damage to the infant. Because it is difficult to predict the status of the infant before birth, any delivery room must have experienced personnel and adequate equipment necessary for the resuscitation of the newborn.


[The essentials of a modern campaign against tuberculosis with special emphasis on the general B.C.G. vaccination (author's transl)]. 1. In the proposals for the reorganisation of the campaign against T.B., published in 1973, the german Central Committee focused its attention on the search for sources of infection and their elimination. Closely connected with this is the use of the tuberculin test as a means of verifying cases, and in the estimation of the epidemiological situation by determining the risk of infection. 2. Only the elucidation of epidemiological conditions can vouchsafe the definite use of the effective measures possible today. The indefinite vaccination of the new-born hinders this attempt considerably. In the main the immunal prophylaxis of those exposed to the disease can be continued. However, in certain cases chemical prophylaxis should be applied. Mass X-ray examinations must be increasingly assessed in the light of general precautional methods. 3. Criterion for the danger of tuberculosis is the risk of infection. This risk can be determined by representative tuberculin tests which can be carried out singly in each federal state in order to do justice to local peculiarities. A risk of infection of less than 1%o makes indefinite measures for the most part superfluous. Furthermore, in the long run, the further trend of tuberculosis can be kept under observation by continued determination of the risk of infection with random samples. 4. The main task of the Public Health Service in the campaign against T.B. is the search for the sources of infection. The more a measure helps to achieve this aim, the more important it is. The ensuing hierarchy of measures taken should form the basis of all planning and organization.


[The essentials of a modern campaign against tuberculosis with special emphasis on the general B.C.G. vaccination]. 1. In the proposals for the reorganisation of the campaign against T.B., published in 1973, the german Central Committee focused its attention on the search for sources of infection and their eleimination. Closely connected with this is the use of the tuberculin test as a means of verifying cases, and in the estimation of the epidemiological situation by determining the risk of infection. 2. Only the elucidation of epidemiological conditions can vouchsafe the definite use of the effective measures possible today. The indefinite vaccination of the new-born hinders this attempt considerably. In the main the immunal prophylaxis of those exposed to the disease can be continued. However, in certain cases chemical prophylaxis should be applied. Mass X-ray examinations must be increasingly assessed in the light of general precautional methods. 3. Criterion for the danger of tuberculosis is the risk of infection. This risk can be determined by representative tuberculin tests which can be carried out singly in each federal state in order to do justice to local peculiarities. A risk of infection of less than 1%o makes indefinite measures for the most part superfluous. Furthermore, in the long run, the further trend of tuberculosis can be kept under observation by continued determination of the risk of infection with random samples. 4. The main task of the Public Health Service in the campaign against T.B. is the search for the sources of infection. The more a measure helps to achieve this aim, the more important it is. The enxuing hierarchy of measures taken shozld form the basis of all planning and organisation.


[The epidemiology of lung cancer in the German Federal Republic, with special reference to regional differences (author's transl)]. 11 per cent more men and 23 per cent more women died of lung cancer in the German Federal Republic during 1960-1971 than would have been the case if the age structure had remained unchanged. This increase involves exclusively (men) or predominantly (women) the over-65 years age group. It is still showing an upward trend in men and is most pronounced in the 45-74 age group. Mortality from lung cancer differs significantly between the Länder of the Federal Republic. It is highest for both men and women in the City States and is lowest in the less industrialized areas, particularly South Germany. This difference is presumably not entirely population: the particularly marked increase (especially in men) in the Saarland and North-Rhine-Westphalia-Länder with a predominance of heavy industry-suggests that occupational noxae may play a part.


Correlation between gait speed and spasticity at the knee. An automated system designed and developed at this laboratory was used to measure spasticity in the thigh musculature of fifteen patients with hemiplegia. In addition, each subject was timed during a gait trial over a measured distance at maximum speed. Analysis of the data revealed no statistically significant correlation between spasticity in the thigh musculature and the gait speed of the subjects studied. Factors which may have contributed to the findings are mentioned.


Reading "physical therapy" from an ethics perspective. Physical therapists have an increasing need to incorporate an ethics perspective into their professional outlook. One way a physical therapist can become more proficient in recognizing morally significant data is to identify such data in articles written by physical therapists and other health professionals. An article should be evaluated according to the facts included or omitted, the loyalties expressed by the author, the life-view implied by the author, and the norms of good and right directing the author's thinking.


Placement of recording electrode in median and peroneal nerve conduction studies. Motor nerve conduction examinations were performed on the median and peroneal nerves of thirteen normal women (mean age equals 20.4 years). The purpose in this study was to determine the difference and variation of latencies and amplitudes when measured from various recording sites over the abductor pollicis brevis and extensor digitorum brevis. Optimal areas of four square centimeters over the center of the abductor pollicis brevis and over the proximal portion of the extensor digitorum brevis were found to be the most favorable for recording maximum action potential amplitude and shortest latency. The muscle action potentials were found to be diphasic with a sharp onset in a negative direction from the oscilloscope base line when recorded within the optimal area of each muscle. The results of this study indicate that there is a margin for error in recording electrode placement (3 to 4 cm2) before the action potential amplitude or latency measurements are significantly affected.


Comparison of opinions, attitudes, and interests of physical therapy students with other students at the University of Michigan. Scores on the Opinion, Attitude, and Interest Survey made by freshmen who later successfully completed work in the Physical Therapy Curriculum at the University of Michigan were compared with scores of eighteen other freshmen groups at the university. Physical therapy students ranked highest on the Biological Science Interest, Social Adjustment, and Emotional Adjustment scales, and lowest on the Infrequent Response, Social Undesirability, and Creative Personality scales. The conclusion was that freshmen who later completed work in the Physical Therapy Curriculum exhibited different opinions, attitudes, and interests than did other freshmen at the university.


Abdominoplasty by the W technique.

Abdominoplasty by the W technique. The W abdominoplasty is an excellent esthetic operation (Figs. 7-12), based on several important principles. 1. The drawing of the W with its 3 angles gives 3 good landmarks for a symmetrical result. The mid-angle may be cut off by one to two cm at the time of closure, if it seems too sharp. 2. By making the incision inside the hairline, there is no increase in the height of the pubic hair. 3. By removing more tissues laterally than in the midline the traction on the flap is equalized, thus giving a nice draping on the hips. 4. The operation equalizes the wound edges and avoids producing skin folds. 5. Complete removal of the skin and fat between the umbilicus and the pubis is always possible if the operating table is put in a proper position for closure. No vertical scar has ever been necessary in our series. 6. The direction of the final scar, although different from the primary incision due to the traction, remains low-just above the inguinal fold and approximately in the same direction, in the area concealed by small bathing suits. 7. The maximum stretching of the abdominal skin favors a lasting result.


Report on a series of 50 craniofacial operations. We present a retrospective study of 50 patients who have undergone craniofacial surgery. The indications, types of osteotomies, complications, and other aspects are reported.


Intralesional BCG, intravenous immune lymphocytes, and immunization with neuraminidase-treated tumor cells to manage melanoma; A clinical assessment. An attempt was made to produce tumor immunity in 193 patients who had melanoma, 160 of whom had metastases and 33 of whom did not. Four stages of treatment are outlined. The patients whose disease was confined to the skin, subcutaneous tissues, and lymph nodes seemed to benefit most. The treatment was of no benefit to patients whose disease had progressed to the visceral, skeletal, or central nervous systems.


First branchial cleft cysts and sinuses. A brief review of the embryology and anatomy of first branchial cleft cysts and sinuses, with a resume of our experience, is presented. An illustrative case of each general type of this anomaly is given. The surgical treatment of these lesions, with special reference to technique and the precautions to be applied to minimize complications and recurrence, is discussed.


Surgical treatment of Moebius syndrome by platsma and temporalis muscle transfers. The essential features of Moebius syndrome are described. The etiology of the condition remains in doubt. The role of heredity and the possible familial incidence are noted. We present two cases of Moebius syndrome in which  the facial paralysis was surgically corrected by means of dynamic muscle transfers. The use of an innervated platysma muscle flap in the first patient is believed to be the first surgical description of such a procedure.


Reconstruction of ear, eyebrow, and sideburn in the burned patient. Some new variations are described for partial and total ear reconstructions, eyebrow reconstructions, and sideburn reconstructions in burned patients.


Further experiences with the arytenoid-epiglottic flap for chronic aspiration pneumonia. We present our experiences with 7 patients in whom we did arytenoid-epiglottic flaps for the treatment of  chronic aspiration pneumonia. The indications for the operation are outlined, and some technical suggestions are made.


A new technique for reduction mammaplasty. We present a new technique of reduction mammaplasty which we have employed in 20 cases. We believe it has specific advantages, as outlined.


Tropical ulcers.

Tropical ulcers. We review 230 cases of tropical ulcers, includied reports of 7 cases with squamous cell carcinoma. We think the etiology may be a combination of the hot, humid environment, trauma, local infection, and malnutrition. Agressive treatment of these ulcers is advocated, to heal the wounds and to prevent malignant transformation.


Surgical correction of lesions of the temporomandibular joints. The previous report of 140 cases of TM joint disorders from the University of Michigan experience has been updated by the addition of 25 recent cases of surgical management of TM joint pathology. The surgical correction pathology of the articular disc, the condyle head, the articular eminence of the glenoid fossa, ankylosis, and chronic dislocation is discussed. Our experiences in these 25 cases are summarized.


Benign teratoid tumor of the parotid; Case report. We present a patient who had a benign teratoid tumor of the parotid gland. We believe this is the first such case reported.


Stress fracture of the clavicle after a radical neck dissection; Case report. We report a case of a stress fracture occurring in the medial end of the clavicle, 15 months after a radical neck dissection.


A modification in the face-lift incision to facilitate suturing around the earlobe. We present a modification of the face-lift incision which avoids some of the problems we had in suturing around and behind the earlobe.


Dynamic correction of unilateral paralysis of the lower lip. We present a simple operation, performed under local anesthesia, to restore essential movement to the side of a lower lip paralyzed by injury to the mandibular branch of the facial nerve. The operation consists of a limited lateral resection of the paralyzed lower lip, plus transposition of the segment of orbicularis muscle from the paralyzed lower lip to the normal upper lip, through a subcutaneous tunnel.


Tattoo removal by superficial dermabrasion. Five-year experience. A 5-year clinical experience using superficial dermabrasion to remove tattoos is presented. This procedure can be done quickly in the office with low patient risk. Good pigment removal is obtained with little or no scar formation.  Cases are presented which are typical of the 250 tattoos removed in the last 5 years.


The constricted (cup and lop) ear.

The constricted (cup and lop) ear. The author classifies ear deformities into 3 major groups and two sub-groups. The surgical procedures used to correct the deformity in each group are described.


Revisional surgery after reduction mammaplasty. The occasional unsatisfactory results after reduction mammaplasty are classified and analyzed. Methods of revision in 4 illustrative cases are presented and discussed.


W-epicanthoplasty.

W-epicanthoplasty. A modified W-plasty technique is described for the correction of epicanthal folds.


A new folded pharyngeal flap. Preliminary report. In an attempt to minimize postoperative scar contracture and shrinkage after a pharyngeal flap operation, a folded flap operation was devised. This operation was performed on 14 patients with velopharyngeal inadequacy. A superiorly-based flap was elevated from the posterior pharyngeal wall and was folded with the mucosa outside. The flap-velum connection was made through raw surfaces produced on each lateral ridge of the flap and the two penetrating incisions on the sides of the soft palate. In none of the cases did detachment of the flap or any other complications occur. This rather simple technique which aims to prevent scar contracture of the flap will permit further elaboration of the flap design-depending on the extent of velopharyngeal incompetence.


Fiberoptic endoscopy in the head and neck region. The potential use of fiberoptic endoscopy in the head and neck region was evaluated by the comparison with the findings we obtained from indirect, mirror endoscopy. Fiberoptic endoscopy confirmed our clinical staging and diagnosis in 39 percent, changed our diagnosis in 41 percent, and changed our clinical staging in 20 percent of this series of patients. These findings indicate that fiberoptic endoscopy is a valuable aid for clinical staging; in some instances it may be used in preference to indirect, mirror examination; frequently, it may enable one to avoid a direct laryngoscopy. The procedure is safe, well tolerated, and may be performed on an outpatient basis. With this instrument, routine examination of the head and neck in suitable patients may lead to improved clinical evaluations.


Cancellous bone grafts from the distal radius for use in hand surgery. A method of obtaining small autogenous cancellous grafts for hand surgery from the volar side of the distal radius is presented.


Growth of homotransplanted ear cartilage in baby rabbits. Our study verifies that homografted ear cartilage in baby rabbits does, indeed, grow in size. It showed an average increase of 75 percent in length and 211 percent in area.


Proboscis lateralis. Case report.

Proboscis lateralis. Case report. We present a case of proboscis lateralis, an uncommon malformation which gives the nose a snout shape. The surgical treatment is outlined.


The diagnosis of 'hysteria'.

The diagnosis of 'hysteria'. A study of 120 inpatients diagnosed as suffering from hysteria is presented and the validity of the diagnosis questioned. Clinical study showed that 13% showed only hysterical symptoms, 33% showed hysterical symptoms occuring with affective symptoms, 28% showed affective symptomatology only, and the remainder were either of other or uncertain diagnostic grouping. It is concluded that the 13% are suffering from a condition that can only be diagnosed as hysteria.


Multiple personality. A single case study with a 15 year follow-up. A review of the literature relating to multiple personality is presented together with a study of a single case of hysterical aetiology that demonstrates the development of multiple personality from a fugue amnesic state. A re-examination of this case after 15 years without significant psychotherapeutic intervention demonstrates a tendency towards remission. The view that multiple personality is a form of fugue, not necessarily hysterical, in which an alternative personality is adopted and that this behaviour is reinforced by the attention that it receives, is discussed.


Hysteria and parental psychiatric illness. A two-generation study of 46 families of convicted women felons showed that the daughters of sociopathic fathers had a significantly higher prevalence of hysteria than did the daughters of other fathers. The differences were significant both for daughters with hysteria plus sociopathy and for daughters with hysteria without sociopathy. The association was independent of assortative mating between sociopathic men and women with hysteria or sociopathy.


Incidence of referred mental illness in Chichester and Salisbury. The annual rates of referral to two differently organized comprehensive psychiatric services in separate but demographically similar areas are presented for various demographic social and clinical categories. In Part 1 the rates are examined for similarities both between the two areas and with findings from other studies in order to obtain pointers to factors affecting the inception of psychiatric disorders. In Part 2 an attempt is made to evaluate an aspect of the community service. Differences between the rates in the two areas are discussed with a view to identifying those variables that selectively affect referral to a community service.


Depression followed by suicide: a comparison of depressed suicides with living depressives. The characteristics of 64 suicides with a retrospective diagnosis of depression and 128 depressives referred for psychiatric treatment were compared. The following items differentiated the suicide group: male sex, older age in females, single status, living alone, the symptoms of insomnia, impaired memory and self neglect, and a history of suicide attempts. The value of these items in assessing suicide risk in depressive illness is discussed.


Severity of symptoms of psychiatric outpatients: use of the General Health Questionnaire in hospital ang general practice patients. A sample of 91 new referrals to a community based psychiatric outpatient service was compared with a cross-matched control sample of 107 patients attending the general practitioner's surgery. The subjects in both groups completed the General Health Questionnaire and there was a very marked difference between the scores of the two groups. Seventy-five of the psychiatric group had a high score on the questionnaire, and a large number of these were extremely high, while 74 of the general practice group had a low score. The 'false' positives and negatives are discussed. It is considered that the validity of this questionnaire as a screening device for demonstrating psychiatric morbidity and severity in general practice is further established in this study by showing that in matched samples the expected psychiatric morbidity in general practice can be compared with the much greater morbidity in psychiatric outpatient referrals. For the psychiatric sample more patients showed high scores and these tended to be much higher.


Factor analysis of subjectively reported sleep habits, and the nature of insomnia. Factor analysis was performed on variables used to describe subjectively the sleep habits of three groups of subjects--male patients, female patients, and medical students. Similarities in the six factors from each analysis indicate the existence of dimensions of variation which are common to normal sleep habits and insomnia.


Influence of psychiatric training, medical qualification, and paramedical training on the rating of abnormal behaviour. The psychiatric ratings, using the In-Patient Multi-dimensional Psychiatric Scale, of (1) a group of over 200 psychiatrists from the British Isles, (2) third year psychology students, (3) trainee sister tutors, (4) general practitioners attending a postgraduate course in psychiatry, and (5) a group of new registrars at the Maudsley Hospital, were compared. The first hypothesis, that, whereas the non-psychiatrists would rate similar levels of symptoms, the psychiatrists would tend to rate lower than other professional groups, was upheld. The second, that the pattern or profile of symptoms as shown by the IMPS syndromes would differ little between the groups, was also upheld. The third hypothesis, that because of their special training in the recognition of synptoms, psychiatrists would tend to show greater intra-group agreement on the levels of symptoms that the other groups, was not upheld. Some possible reasons for the findings are discussed. The importance for a screening schedule, designed to be used by non-psychiatrists for the detection of psychiatric illness, of the finding that non-psychiatrists rate higher levels of symptoms than psychiatrists, is also discussed.


Social versus clinical prediction in minor psychiatric disorders. Fifty new psychiatric outpatients, suffering from minor disorders, were assessed using standardized social and clinical interview schedules. Forty-six were successfully followed-up six months later and their condition was assessed using a specially constructed rating scale. Social dysfunction in the area of the patient's material circumstances was the single most important predictive variable. Clinical predictions of outcome were shown to be closely related to the proportion of time the patient had been ill over the five years before inception.


Intravenous cholangiography: optimum dosage and methodology. Cholangiography was performed in 442 patients using four dosage regimens of Cholografin: (a) a single-dose, full-strength injection in 10 minutes (150 examinations), (b) two dilute (76 examinations) or very dilute single doses (71 examinations) infused in 30 minutes, and (c) one dilute double dose infused in 30 minutes (145 examinations). Results showed that the double-dose infusion gave maximum visualization, followed by the single-dose injection and the two single-dose infusions. With the double-dose method, both the reaction rate and the incidence of SGOT elevation were twice that seen with any single-dose method, making the single-dose injection the procedure of choice despite slightly lower opacification.


Intravenous cholangiography in normal and subsequently liver-damaged dogs. When a 30-minute infusion is chosen for intravenous cholangiography, the optimal dose in subjects with normal and decreased hepatic function seems to be 0.6 ml/kg iodipamide. Delayed visualization of the ducts and gallbladder occurs in hepatic dysfunction, therefore, radiographs should be taken up to eight hours after the start of the examination if the cholangiogram is not diagnostic sooner. Prolonged infusion time, increased dosage, or both did not improve the radiographic results significantly when this method was not diagnostic. Contary to what is seen in obstructive jaundice, a markedly reduced gallbladder size, compared to its own baseline, was found in hepatic dysfunction.


The value of the fatty meal in oral cholecystography. A fatty meal was given to 231 patients who had a well-visualized gallbladder with no stones. The radiological diagnoses on fluoroscopic spot films made before and after the fatty meal were compared. Only one case was diagnosed differently after the fatty meal. In 4 patients the post-fat film was useful in confirming a suspected diagnosis. Indications for administration of a fatty meal include (a) overlying gas shadows, (b) differentiation of a stone from a polyp, (c) adenomyomatosis, (d) a distended gallbladder, and (e) suspected common bile duct obstruction. In the absence of these indications, the time, effort, and cost involved in making the post-fat film are not justified by the additional diagnostic information obtained.


Planning the new x-ray department.

Planning the new x-ray department. Planning a radiology facility requires consideration of many aspects of the x-ray operation. Not only is the available space an important consideration, but concepts on how the radiology facility is used, such as teaching, research, diagnosis, type and frequency of examinations, viewing and filing, film handling, and processing, must also be considered.


Technique charts: the key to radiographic quality. The radiologic technologist has three professional obligations: to provide consistent quality radiographs, to use minimum exposures necessary for these radiographs, and to reduce unnecessary costs by maintaining good techniques.  Through the development and routine use of standardized techniques, he can assure that the radiologist has radiographs of consistent quality to interpret, the patient receives minimum radiation exposure, and the administration maintains a non-wasteful budget in the radiology department.  The technique chart is the key to maintaining radiographic quality from which the rest flow.


Technique management.

Technique management. Good technique management is an imperative in modern, efficient departmental routine and patient care.  The control of processor efficiency and generator output, along with the production of comprehensive technique charts are factors that contribute to this effective management.  They fall well within the responsibility area of the radiologic technologist and require minimal time in department routine.


The fat embolism syndrome.

The fat embolism syndrome. The "shock lung syndrome," whenever associated with trauma, is probably in part the consequence of fat emboli, though aspiration, disseminated intravascular coagulation, microatelectasis, pulmonary edema, and hemorrhage due to other lung insults may be important in the etiology of many cases. When lung injury is due to fat emboli, there is an interval between the time of trauma and the onset of clinical symptoms and chest radiographic findings. The radiographic picture is that of a diffuse alveolar and interstitial lung density. In severe cases marked respiratory embarrassment requires the use of both oxygen therapy and mechanical respirators for survival.


Intralobar pulmonary sequestration; with special emphasis on bronchial communication. The radiologic and pathologic features of eight cases of intralobar pulmonary sequestration are reported. Special attention was given the communication between the cystic areas and the normal bronchial tree. In three of five surgical specimens, probing revealed such communications. Microscopically, the transition from the normal bronchus to the cysts revealed no inflammation to suggest fistulous communication secondary to infection. The possibility of preexisting congenital bronchocystic communications within the pulmonary sequestrations was therefore suggested.


Selective bronchial arteriography in patients with cystic fibrosis and massive hemoptysis. Massive hemoptysis is a potentially fatal complication of long-standing cystic fibrosis. Lobectomy may prevent a hemorrhagic death if the hemorrhage source can be identified and if involvement of the remaining lung tissue is mild. Selective bronchial arteriography was performed in six patients with cystic fibrosis to localize a lobar source of bleeding. Arteriographic findings correlated with bronchoscopic observations. Bronchial arteriography may be helpful when bronchoscopy cannot be done because of continuous hemorrhage or because the severity of the lung disease precludes general anesthesia, but it is not an adequate substitute for bronchoscopy in most patients.


Clearing patterns of pulmonary infarction and slowly resolving pneumonia. Previous authors have suggested that the radiographic clearing pattern of pulmonary infarction is specific and permits differentiation from pneumonitis. Pulmonary infarcts are said to "shrink" or "melt" and pneumonitis consolidations to clear diffusely. Chest radiographs of 4 patients with angiographically confirmed pulmonary infarction and 5 with slowly resolving pneumonitis were examined, in random case order, by three independent radiologists unaware of the diagnosis. All observers found the shrinking pattern in 3 of the 4 cases of pulmonary infarction and in 1 case of pneumonitis. The shrinking pattern is not specific for pulmonary infarction; it may be related to fibrotic organization of pulmonary consolidation.


Likelihood ratios as a measure of the diagnostic usefulness of excretory urogram information. The log likelihood ratio (LLR) method of assessing physicians' diagnostic judgments can be used to measure the diagnostic usefulness of radiologic information (urography in this study). The method requires collection of referring pbysicians' diagnosis prior to and after urography and their certainty in relation to receipt of the radiologic information. Physicians in daily practice are able to provide diagnoses and assign a percentage number to their certainty. The LLR method permits measurement of the diagnostic usefulness of both normal and abnormal urogram results. Retrospective chart review does not provide the same LLR results as those obtained from the prospective study.


Vesiculographic findings in cysts of the seminal vesicle. Vasoseminal vesiculography showed medial displacement and stretching of the ampulla of the vas deferens in 3 patients with cysts of the seminal vesicle. In 2 a nonopacified mass separated the ampulla from the ipsilateral seminal vesicle. All 3 patients were managed without surgical intervention. If such a vesiculographic pattern is seen in a patient with a paraprostatic mass, the contents of the mass should be aspirated and contrast material injected to document its cystic nature.


Ureteral ectopia associated with seminal vesicle cyst and ipsilateral renal agenesis. A case of an ectopic ureter entering a seminal vesicle cyst and associated with ipsilateral renal agenesis is presented. The differential diagnosis and the embryological explanation of the anomaly are considered.


Holster accidents: self-inflicted gunshot injuries of the knee and leg. A man accidentally shot himself in the knee while holstering his own revolver. Although the pain was minimal, the wound "clean", and the joint flexible, angiography revealed a false aneurysm of the popliteal artery, a short segment of minimal tears below it, and a popliteal arteriovenus fistula slightly distal to the false aneurysm. Any penetrating wound of the popliteal fossa whose trajectory points to the vascular structures should be investigated angiographically.


Pyarthrosis complicating rheumatoid arthritis. Roentgenographic evaluation of 5 patients and review of the literature. Five patients with pyarthrosis complicating rheumatoid arthritis are described. Only minimal clinical signs may be seen in such patients, making accurate diagnosis of this occasional complication difficult. Roentgenographic abnormalities include a rapidly enlarging joint effusion and progressive cartilage and bone destruction. Fistulas may develop. The principal differential diagnoses include exacerbtion of rheumatoid arthritis and alterations in the rheumatoid joint following trauma.


Arthrography of the ankle joint: problems in diagnosis of acute lateral ligament injuries. Arthrography of the ankle joint is a reasonably accurate and helpful method of delineating the extent of injuries to the lateral ligament. Forty-six arthrograms were obtained following acute injuries, with 26 patients having operative evaluation. Eight false negative results were encountered, all in combination with fairly massive capsular tears. Although ankle arthrography in acute injuries is useful, it is not infallible. An explanation for the large number of false negative results is offered and additional suggestions are made about the technique of examination.


Mesentsery and colon injuries secondary to blunt trauma. Three cases of colon lesions following blunt trauma are presented to illustrate their varied manifestations. Although these injuries are not as common as those to the small bowel and solid viscera, the radiologist's awareness of them and of their various presentations may be helpful in suggesting the correct diagnosis. The major types of colon injury include mesenteric laceration with blood loss, vascular injury with or without bowel ischemia, intramural hematoma, bowel wall laceration, and delayed cicatricial stenosis.


Gas in the portal and inferior mesenteric veins caused by diverticulitis of the sigmoid colon. Report of a case with survival. Colonic diverticulitis can produce gas in the portal and inferior mesenteric veins. Such an occurrence is usually associated with massive bowel necrosis and carries a grave prognosis. The authors report a case in which the patient survived.


The colitis of Behcet's disease: a clinical-radiographic correlation. The radiographic, colonoscopic, and pathologic findings in this case of Behcet's colitis differ completely from ulcerative or granulomatous colitis as well as from other, less commonly seen inflammatory colitides. Discrete, peptic-type ulcers, with normal intervening mucosa and normal overall configuration of the colon, are seen on radiography and endoscopy. The angiographic features are not diagnostic but differ considerably from findings in other inflammatory colitides. No tortuous arterioles, mucosal hyperemia or early venous filling was encountered.


Angiography vs. pancreatography in diagnosis of carcinoma of the pancreas. Relative efficacy of angiography and pancreatography in the diagnosis of pancreatic carcinoma was assessed in 13 patients. Pancreatography provided a correct preoperative diagnosis in 10 patients. In 3 patients the duct could not be cannulated. Twelve patients underwent angiography and a correct diagnosis was made in 10. Preoperative diagnosis was not made by either technique in 1 patient. Pancreatography did not detect carcinoma of the pancreas at an earlier stage than did angiography. These procedures should be considered complementary to each other. Angiography defines the size, extension and resectability of the tumor. Pancreatography outlines the internal architecture of the gland and duct system.


Postmortem radiology of head neck injuries in fatal traffic accidents. A series of 146 victims of fatal traffic accidents were subjected to postmortem radiographic examination prior to medicolegal autopsy. A total of 42% were found to have radiographically demonstrable head injuries ranging from relatively simple linear skull fractures to massive skull damage. Free intracranial or intravascular air was demonstrated in more than 60%. A total of 21% had demonstrable neck injuries, most of which were localized to a single level at the craniocervical junction or the upper two cervical vertebrae. Flexion and extension studies of this area are of major importance in demonstrating the injury and locating potentially occult lesions for the forensic pathologist.


Angiographic features of hypervascular neurinomas of the head and neck. Neurinomas of the head and neck are often hypervascular. The angiograms of 32 patients with neurinomas of the head or neck were reviewed. Twenty-two (68%) of these tumors displayed abnormal tumor vascularity. Complete selective angiography with direct magnification, subtraction technique, and special projections aided in the recognition of tumor vascularity. Although the angioarchitecture in some cases is indistinguishable from that of meningiomas, neurinomas can exhibit distinctive vascular patterns, such as intermixed areas of increased and decreased vascularity or tortuors, irregular tumor vessels.


Ocular complications of orbital venography. Three ocular complications directly related to orbital venography are described, one resulting in permanent loss of vision,. The patient had lymphangioma of the orbit which evidently had bled secondary to increased venous pressure and injection of contrast bolus. Both of the 2 patients with transient visual disturbances had diabetic retinopathy. The common factor is felt to be an imparied vascular bed which cannot meet the stress of increased venous pressure and contrast medium injection. Conditions which predispose to ocular-orbital stasis and/or hemorrhage are discussed.


Vascularity of the femoral head: 18fluorine scintigraphy validated with tetracycline labeling. Blood flow to the femoral head was assessed by 18F positron scintigraphy and tetracycline fluorescent labeling in 17 patients undergoing replacement of the femoral head with an endoprosthesis. Radioactivity was absent in the femoral head of 10 patients, normal in 5, and increased in 2. Normal or increased radioactivity indicated presence of blood flow to the femoral head; decreased or absent radioactivity indicated absence of blood flow. Results of 18F scintigraphy correlated with those of tetracycline labeling.


Abnormal brain scans in adrenal leukodystrophy. A study of three cases. Brain scintiphotography in three patients with the clinical characteristics of adrenal leukodystrophy demonstrated focal areas of increased uptake of the radionuclide. Histological examination of cerebral tissue corresponding to the abnormal foci on the scan revealed sudanophilic leukodystrophy. These findings suggest that areas of active demyelination, such as occur in adrenal leukodystrophy, accumulate radionuclide. Thus, brain scintiphotography may be useful in the evaluation of patients in whom the diagnosis of adrenal leukodystrophy is being considered.


Neonatal septic "dislocation" of the hip: true dislocation or pathological epiphyseal separation? The clinical and roentgenologic appearance of septic dislocation of the hip may be caused by either a true dislocation or a pathological epiphyseal separation due to osteomyelitis. Arthrography of the hip permits differentiation in the neonate. The significance of these two anatomical possibilites is discussed in terms of follow-up and results of neonatal infections about the hip, and a case of pathological epiphyseal separation at the hip diagnosed in the neonatal period by aspiration and arthrography and followed up for 3 years is presented.


The cervical aortic arches.

The cervical aortic arches. Four cases of cervical aortic arch are described and correlated with the 21 previously reproted cases. Five distinct forms of cervical aortic arch were found and classified according to configuration of the aorta, sequence of brachiocephalic branching, and embryogenesis. In brief, Type A has separate external and internal carotid artery branches from the aortic arch. Tye B is similar but has dual common carotid arteries. Type C is a left cervical arch with a right-sided descending aorta and bicarotid trunk. Type D is a left cervical arch with a normal branching pattern, redundant transverse aorta and left-sided (often hypoplastic) descending aorta. Type E is a right cervical aortic arch with a right descending aorta and an aberrant left subclavian artery.


Retention of small foreign objects in the stomach and duodenum. A sign of partial obstruction caused by duodenal anomalies. Small round, oval, or cuboidal foreign objects nearly always pass through the gastrointestinal tract promptly, and stasis of such objects in the stomach or duodenum is extremely uncommon. The authors describe 3 cases of prolonged retention in children with no clinical or plain-film evidence of duodenal obstruction. In each case, a barium meal demonstrated a congenital anomaly of the duodenum producing partial obstruction: duodenal stenosis, prolapse of the duodenal diaphragm ("windsock duodenum"), and an annular pancreas.


Acoustical holography: physical parameters and potential clinical applications. Acoustical holography achieves real-time imaging of bodily structures through ultrasound. The fundamentals of acoustical holography and a description of a prototype unit undergoing trials at the authors' institution are presented. Physical parameters and means of calibrating the acoustic beam are discussed, and results of preliminary experimental and clinical studies reviewed. Acoustical holography has the potential for providing complementary diagnostic information which, after further technical developments, may furnish clinically useful information.


Ultrasonic diagnosis of seminal vesicle cyst. Seminal vesicle cysts are uncommon, particularly when associated with ipsilateral agenesis of the kidney, ureter, and/or trigone. This entity should be considered when a cystic pelvic mass is seen in a young male. B-scan ultrasound can be of considerable aid in making the diagnosis.


Radiation therapy of cardiac and pericardial metastases. Cardiac metastasis should be strongly suspected in the cancer patient with sudden onset of unexplained tachycardia, arrhythmia, or congestive heart failure. Conduction defects and low voltage on electrocardiographic examination and an enlarged heart shadow on the chest film are virtually confirmatory. Thirty-eight such patients were treated through anterior and posterior opposing portals and received 2,500-3,500 rads in 3-4 weeks, except for 6 lymphoma and leukemia patients who were controlled with lower doses (1,500-2,000 rads in 11/2-2 weeks). Primary sites and duration of improvement were as follows: breast (11/16 patients): 2-36 months; lung (2/7 patients): 1-9 months; lymphoma and leukemia (6/7 patients): 2-4 months; others (4/8 patients): 1-4 months. Overall, the clinical improvement rate was 60%, with durations of 12 to 36 months.


Tumor and normal tissue response to irradiation in vivo: variation with decreasing dose rates. Continuous irradiation in vivo at dose rates ranging form 0.54 to 274 rads per minute was performed in mice using the EMT6 tumor, the gut clone system, and the bone-marrow CFU system. A progressive increase in D0 and decrease in ñ were seen with decreasing dose rates in the EMT6 tumor and the gut clone system. The D0 showed little change in the bone-marrow CFU system. These findings are related to the D2-D1 values obtained from split-dose experiments at conventional dose rates. The results do not fit the various mathematical models proposed for correlating the effects of continuous low-dose-rate irradiation and acute exposure.


The total biological dose.

The total biological dose. The nominal standard dose concept is used to define the total biological dose or cumulative radiation effect at a point for treatment regimens employing two or more radiation modalities. Various clinical applications are illustrated. A convenient nomographic method for determining the total biological dose is presented.


The adjuvant effect of lucanthone (miracil D) in clinical radiation therapy. Clinical trials were undertaken to determine whether lucanthone (miracil D) affects radiation-induced regression in measurable pulmonary metastases and advanced squamous-cell oral and pharyngeal tumors. The time required for 50% tumor regression was decreased by approximately 50% in those patients who received lucanthone in addition to irradiation. These results indicate that lucanthone has a definite adjuvant effect when used together with irradiation.


Preshaped catheters for percutaneous transaxillary selective coronary arteriography. Percutaneous transaxillary selective coronary arteriography using preshaped catheters is useful in patients who have had aorto-iliac surgery or have clinical evidence of occlusive arterial disease of the lower extremities. For safety and ease of performance it compares favorably with the percutaneous transfemoral method and can be readily mastered by those experienced in the transfemoral approach.


A drop-in treatment shell support.

A drop-in treatment shell support. An easily made, inexpensive drop-in support for the use with treatment shells fabricated by the direct (plaster of paris bandage) method is used to immobilize the patient and reproduce the treatment position. Its quick and easy method of attachment and removal requires a minimum of patient cooperation.


Rapid treatment field light adjustment for linear accelerators. A technique for rapid, accurate alignment of the light field to the radiation field is presented. When these two fields are coincident, a permanent template results which minimizes machine down time when this procedure is required during the treatment day.


Device for lower extremity phlebography. A simple device is described for lower extremity phlebography. With the patient standing or recumbent, simultaneous injection of contrast material can easily be achieved by one person.


A simplified injection technique for shoulder arthrography. An easy and reliable technique to inject the shoulder joint for arthrography is described. The technique utilizes a straight anteroposterior position of the patient and a directly vertical placement of the needle with the aid of fluoroscopy.


A block and wedge holder for the Picker Series 8 cobalt-60 teletherapy machines. A rigid, easily demountable, and versatile device combines the function of three separate accessories for the Picker Series 8 cobalt-60 teletherapy machine. Wedges and lead blocks are held simultaneously, and firmly so that the blocked field may be directed at any angle.


The challenge of continuing medical education. Continuing education is an important responsibility in the practice of radiology. The response to the growing demand for additional and new educational opportunities includes specialty societies and their programs of scientific paper presentations and refresher courses, audiovisual aids and seminars. Lacking, however, is organization of efforts leading toward programmed instruction, permitting renewal and expansion of knowledge on an organized and continuing basis. The Intersociety Educational Committee is attempting to coordinate educational efforts. A unified and effective educational process would eliminate much duplication of effort and increase efficiency.


Some possible consequences of recertification. In the absence of documented conclusions concerning the problems of recertification, the author suggests carrying out a few experiments prior to embarking on an elaborate program. Perhaps one or two specialities could conduct programs to investigate the consequences of training and the giving of examinations to various age groups, comparing the work of those with and those without recertification. After analysis of the results, it might be appropriate to embark in a step-wise fashion on rigorous and clearly defined methods of recertification.


Will radiology participate?

Will radiology participate? Because of the ever increasing need for radiological services in disadvantaged and remote areas of the United States, it is proposed that there be more emphasis and encouragement of family practice radiology. Since most diagnostic work consists of "bread and butter" radiology rather than highly specialized procedures, and because much of radiation therapy is palliative and can be done outside major therapy centers, the author believes that competency in these areas can be obtained in a resonable training time.


Hypotonic examination of the colon with glucagon. The authors report their experience with glucagon in the barium enema examination. Two milligrams of glucagon given intramuscularly was found to be safe and effective in overcoming functional spasm, permitting more detailed evaluation of organic narrowing. The relatively infrequent side effects and few contraindications seen with glucagon make it the drug of choice when reduction in intestinal tone is indicated.


Appraisal of the angiographic circulation time as an index of cerebral blood flow. The relationship of the brain angiographic mode circulation time (AVCT) to the mean transit time of the vascular indicator C15O-labeled hemoglobin (tc15o) and the regional cerebral blood flow (rCBF) as measured by the clearance of the diffusible tracer H2-15O was examined in 38 patients with selected cerebral diseases. The results demonstrate a predictable relationship does exist between the rCBF and tc15o. This relationship is linear when plotted as tc15o vs. 1/CBF. Further, tc150 can be estimated with sufficient accuracy from the AVCT to permit at least a qualitative assessment of rCBF from the cerebral angiogram.


Rhinocerebral mucormycosis.

Rhinocerebral mucormycosis. Nine cases of rhinocerebral mucormycosis are reviewed. Eight patients had diabetes and 7 had symptoms related to the orbit. Roentgen analysis of focal bone destruction and uniform mucosal thickening will frequently suggest the diagnosis. Mucormycosis should be suspected in the diabetic patient with destruction of the walls of the bony sinuses, especially when multiple sinus involvement suggests an etiology other than neoplasm.


The manifestations of diaphragmatic and juxtadiaphragmatic diseases in the liver-spleen scintigraph. Diaphragmatic and juxtadiaphragmatic abnormalities can be recognized on liver-spleen scintigraphs by alteration of the normal disparity in height between the liver and the spleen and by flattening of the superior margins of the liver and spleen. A unilateral abnormality is manifested by exaggeration or reversal of the normal disparity in height between the superior margins of the liver and spleen by cephalad or caudad displacement of one of these organs. Bilateral peridiaphragmatic abnormalities are manifested by flattening of the superior margins of the liver and spleen by caudad displacement of both organs.


Determination of cerebral death by radionuclide angiography. A unique appearance was seen in 18 of more than 4,000 radionuclide cerebral angiographic studies performed over a period of 5 years in patients who had cerebral death. Absence of cerebral perfusion was indicated by a lack of intracerebral activity and nondelineation of the sagittal sinus during the first minutes after the appearance of scalp activity. This technique provides a sensitive, unambiguous means of identifying a lack of cerebral perfusion.


Diagnosis of midgut malrotation with 99mTc-pertechnetate abdominal imaging. In a six-year-old girl with recurrent abdominal pain, abdominal imaging with technetium-99m pertechnetate was performed to detect ectopic gastric mucosa in a Meckel's diverticulum but was negative in this respect. The pattern of radioactivity, moving from the stomach to the proximal small bowel, showed abnormal localization and high concentration of the radionuclide to the right of the midline, indicating midgut malrotation and obstruction. This was subsequently confirmed at exploratory laparotomy.


Pulmonary lymphangiectasia demonstrated by lymphangiography in 2 patients with Noonan's syndrome. Two cases of pulmonary lymphangiectasia associated with Noonan's syndrome are described. Chest films showed diffuse pulmonary intersitial infiltrates from infancy. Lymphangiograms demonstrated obstructive changes and collateral formation in the retroperitoneal, mediastinal, pulmonary, and cervical lymphatics and extensive opacification of the pulmonary and visceral pleural lymphatics. Possible mechanisms and causes of the lymphatic malformation are discussed.


Delayed radiographic presentation of congenital right diaphragmatic hernia. The diagnosis of right-sided Bochdalek hernias is diffucult. Problems encountered in diagnosis include delayed radiographic manifestations and stimulation of inflammatory disease. The case is presented of a neonate in whom a right-sided diaphragmatic hernia masqueraded as inflammatory disease of the chest.


The modulus of elasticity of human cortical bone: an in vivo measurement and its clinical implications. The modulus of elasticity was derived by combining the velocity of ultrasound measurements and photon absorption (Norland-Cameron method) in human cortical bone (proximal radius) in vivo. The results compare favorably with published values of the elasticity modulus obtained in vitro. Values obtained for a heterogeneous group of patients with bone and joint complaints differed from those of normal volunteers.


Ultrasonic localization for renal biopsy. B-scan ultrasound was used in 30 patients to localize the kidney prior to renal biopsy. The lower pole of the kidney was outlined in the longitudinal and transverase planes and the depth of the kidney was easily obtained from the ultrasonic tracings. The puncture site was marked on the skin and the angle of the needle pathway determined. Renal biopsy was performed successfully in 28 patients, which compares favorably with the results of other localization methods.


Analytical approach for depth dose calculations (60Co beams with fixed source-target distance). A method is described to calculate depth dose distribution to a principal plane using analytical formulas for 60Co teletherapy units and constant source-to-target distance. The formulas were derived from experimental measurements taking into consideration the obliquity of the beam. For the purposes of dose calculation the beam was divided into primary and scattered components. A computer program incorporating the formulas was developed for an IBM 360/67 computer. Dose distributions computed and obtained from experimental measurements were in good agreement. The computer program is now in use for treatment planning, including rotational techniques.


A data acquisition system for three-dimensional treatment planning. The authors describe a coordinate measuring device developed to simplify manual acquisition of the digital information required for computerized three-dimensional treatment planning. This system has been used for two years and shown to be both fast and accurate. The time needed to digitize contour data is reduced to approximately one-tenth of that required for manual methods in most cases.


Residual radiation damage in mouse skin 5 to 8 months after irradiation. Residual injury from large doses of x-rays or neutrons given 5-8 months earlier was assessed by the response of the skin to further doses of 250 kV x-rays. The "dose remembered" was assessed by single test doses. Two doses separated by 24 hours or 7 days were given to assess the capacity for repair of sublethal injury and recovery by proliferation. About 10% of the pretreatment dose was "remembered" 5-8 months later. The capacity for repair of sublethal injury and proliferation was similar in controls and animals receiving 1000-3000 rads as pretreatment. These results apply to basal layer epidermal cells and may differ from those of more slowly dividing populations.


Human CNS perfusion scanning with 123I-iodoantipyrine. Regional perfusion scanning of the central nervous system requires lipophilic radionuclides that rapidly penetrate the intact blood brain barrier. The first compound of this type to be developed for human use is 123I-iodoantipyrine. 123I-iodoantipyrine rapidly crosses the blood brain barrier and is flow-limited in its delivery to the brain. This makes possible the CNS perfusion scanning of the human brain, thereby showing regional distribution of microcirculatory blood flow.


Cholescintigraphy with 99mTc-penicillamine. D-pencillamine labeled with 99mTc (Tc-Pen) was used for cholescintigraphy in dogs and man. Satisfactory images of the gallbladder were obtained using a scintillation camera fitted with a pinhole collimator. The results of cholescintigraphy and contrast cholecystography compared favorably. The authors suggest that Tc-Pen is taken up by the hepatocytes and excreted into the bile canaliculi which enter the gallbladder. Tc-Pen may prove to be an ideal agent for evaluation of hepatocellular function.


Peroneal tenography in previous calcaneal fractures. The evaluation of persistent hindfoot pain in patients with previous calcaneal fractures should include contrast examination of the peroneal tendon sheaths. The identification of extrinsic compression or displacement of the peroneal tendons may indicate that source of pain, the diagnosis being substantiated by temporary relief of discomfort following Xylocaine injection.


Instrumentation for salivary duct cannulation. The use of lacrimal probes to locate and dilate the ducts of major salivary glands is described. This technique greatly facilitates cannulation for sialography.


Visualization of the posterolateral elements of the upper cervical vertebrae in the anteroposterior projection. A radiographic view in the anteroposterior projection through the open mouth for visualization of the laminae and articular processes of the upper cervical vertebrae is described. This view is adaptable to acutely injured patients.


A simple device for measuring angles without marking the radiographic film. Measurements of angles in radiology can be made without marking the radiographs when a simple modification of a standard goniometer is used.


A pneumatically operated femoral artery compressor. A readily assembled, inexpensive pneumatically operated femoral artery compressor for use in transfemoral arteriography is described. This device is effective in controlling post-procedure bleeding and oozing around the catheter during the procedure.


An evaluation of an automated radiographic table. Results of an official field trial of an automated radiographic film-handling system for horizontal Bucky radiography without cassettes, complete with vacuum exposure magazine are reported. An integral tube stand may limit usefulness of the equipment; a fast film/screen combination and delayed film transport protects the x-ray tube. No film transport problems were found.


Light fog on radiographic films: how to measure it properly. A single step wedge imaging technique is described for the proper evaluation of light fog in radiographic darkrooms. Tests indicate that this technique is a more sensitive indicator of light fog than the conventional technique utilizing unexposed film. It is recommended that fog tests be carried out in radiographic darkrooms annually to maintain optimum radiographic image contrast.


Abdominal aorta catheterization via the left axillary artery. A simple technique is described for catheterization of the abdominal aorta via the left axillary artery. A commercially available pigtail catheter is used to direct the guide wire toward the descending aorta, and the contrast material may be injected through this catheter. This method works well, even in elderly patients with elongated, tortuous aortas.


Coronary angiographic nomenclature. Current status and a plea for standardization. Currently, there is no universal agreement on coronary angiographic anatomic nomenclature. A standardized version is proposed with regional anatomy as the unifying concept. The suggested nomenclature adds no new names to the long list currently in use but rather utilizes those arterial branch names which denote regional perfusion. The goals are to simplify the learning process and to provide more meaningful clinical communication.


Errors in applying the NSD concept.

Errors in applying the NSD concept. An analysis of selected papers in which the Nominal Standard Dose (NSD) concept is used reveals that about 50% of them contain errors. These mistakes are both conceptual and mathematical in nature and average plus or minus 7%. Typical errors and methods to eliminate them are discussed. A table is provided for interconversion of NSDs, partial tolerances, and time, dose and fractionation (TDF) factors.


The localization of abnormal mediastinal parathyroid glands. The venous drainage of parathyroid glands ectopically located in the mediastinum is generally caraniad into the inferior thyroid veins. Parathyroid glands in the neck can cause elevated concentrations of parathyroid hormone in mediastinal veins because of thyroidalthymic anastomoses. Therefore venous sampling alone cannot distinguish cervical from mediastinal adenomas. Arteriography can localize mediastinal parathyroids and should be perfomred before any repeat exploration.


Treatment of hyperparathyroidism by percutaneous embolization of a mediastinal adenoma. Percutaneous embolization of parathyroid adenomas was attempted in three hypercalcemic patients with previously unsuccessful neck explorations. Two adenomas were in the mediastinum and the third was within the thyroid lobe. Autologous clot, Gelfoam, and silicone rubber were used to obstruct feeding arteries. The intrathyroidal adenoma failed to respond but both mediastinal adenomas were infarcted. Hyperparathyroidism recurred after 7 months in one patient but the other remains normocalcemic 8 months postembolization.


The wandering gallbladder.

The wandering gallbladder. An unusual case of a hypermobile gallbladder and liver is presented. The liver and gallbladder, supported only by a long midline falciform ligament, rotated freely from the right to the left upper quadrant. Because of a long gastrohepatic ligament and mesocolon, intermittent volvulus of the stomach and colon were associated findings.


Radiographic diagnosis and accuracy in knee joint effusions. Anteroposterior and lateral knee radiographs were obtained prior to arthrography in 200 patients. Presence and quantity of joint effusion were recorded, and radiologic criteria for the presence or absence of knee effusion were evaluated. Only the lateral projection was of value in assessing joint fluid. The fat pad separation sign was the most accurate indicator of fluid and effusions as small as 1-2 ml were recognized. There were accuracies of 88% in the diagnosis and 90% in the exclusion of knee effusions. Satisfactory lateral knee radiographs required radiologic demonstration of the entire suprapatellar area. Minimal knee flexion and a 5degrees cephalad angulation of the x-ray tube help in adequately visualizing this area.


Effects of inguinal hernias upon the bladder and ureters. The presence of inguinal hernia may be associated with extrinsic defects upon the bladder and ureter in the absence of actual herniation of the urinary structures. The findings are characteristic unless associated with irregularity of the bladder wall or elevation of the bladder floor by prostatic enlargement. In some cases, the possibility of intrinsic bladder pathology is raised, requiring retrograde study for clarification. Ureteral displacements may be either ipsilateral or contralateral, depending upon the segment of bowel involved and the side of the hernia. The bladder findings are best demonstrated when the patient is prone or upright.


Effects of metrizamide, a new nonionic contrast medium, on cardiac function during coronary angiography in the dog. Metrizamide is a new non-ionic radiopaque agent with low osmolarity and low intravenous toxicity. Hyperosmolarity is one of the factors involved in the decrease of myocardial contracility, alterations of aortic pressure, and disturbances in the cardiac rhythm which contrast media induce during coronary angiography. Metrizamide has been compared to other commonly used contrast media and was shown to produce fewer changes on the cardiac functions recorded.


Xeroradiography of axillary lymph node disease. Xeroradiographic evaluation of the axillary lymph nodes permits differentiation of characteristic patterns, including normal nodes and those enlarged as the result of fatty infiltration, inflammation, metastases from a breast primary, or primary nodal disease such as lymphoma or hyperplasia. The author describes his experience with this technique in selected patients.


Thermal evaluation of breast disease using local cooling. A simple, inexpensive local cooling system for thermal evaluation of breast disease is described. Skin temperature measured during a 10-minute cooling process averaged 1.2degrees C higher over 31 proved cancers and 0.6degrees C lower over 18 benign masses. Forty-nine masses averaged 1.7 cm in diameter and were 1.5 cm deep; 23 of 31 malignancies (74%), 16 of 18 benign growths (88%), and 46 of 52 "normals" (88%) would have been correctly diagnosed, while results for 10 of 22 women (45%) with asymmetrical diffuse non-malignant disease would have been falsely classified positive.


Hysterographic evidence of polypoid filling defects in the uterine cavity. According to earlier studies, radiographic evidence of polypoid filling defects in the uterine cavity has a physiological background if hysterography is carried out during the secretory phase of the menstrual cycle, but if performed during the proliferative phase, the defects indicate endometrial hyperplasia. This view was not confirmed in the present investigation. Of 8,000 hysterograms reviewed, 200 (2.5%) showed filling defects. Of these, 162 hysterograms were from cases in which the coexisting histological appearance of the endometrium was available; 78% of the histological examinations showed no abnormalities. There was no difference between the secretory and proliferative phases in this respect, and no correlation between radiographic evidence of polypoid filling defects and abnormal uterine bleeding.


Positive lymphangiography in gaucher's disease. Report of a case. The author reports a case of Gaucher's disease in which lymphangiography was performed to evaluate cervical lymphadenopathy, later shown to be Hodgkin's disease. The 24-hour lymphangiogram showed fragmentation of the normal nodal architecture and foamy-appearing lymph nodes in the aortic bifurcation. Microscopic study of these nodes revealed abnormalities characteristic of Gaucher's disease.


Calcification in pelvic lymph nodes containing Hodgkin's disease following radiotherapy. The appearance of roentgenographically demonstrable calcification in intrathoracic lymph nodes containing Hodgkin's disease following radiotherapy is an unusual but recognized occurrence. This report describes two patients with Hodgkin's disease in whom similar lymph node calcifications developed in involved pelvic nodes following radiotherapy. Such calcification appears to be secondary to tumor degeneration which may result from a variety of postulated causes, including radiotherapy.


Lumbar radiculography with metrizamide. A nonionic water-soluble contrast medium. Six hundred lumbar radiculographies were performed with metrizamide in 581 patients. Excellent radiographs were obtained in almost all cases. The adverse effects were minor and no serious complications occurred. The authors consider metrizamide superior to other water-soluble contrast media in present use from both toxicological and radiological points of view.


The pattern of infection with gastro-intestinal nematodes in young fattening lambs at pasture. The pattern of infection with gastrointestinal nematodes in young fattening lambs was determined during the period 1965-69 in 10 counties of the UK. On 25 farms with a history Nematodirus disease, 193 lambs were killed, mostly in pairs, at intervals of three weeks from the end of April to mid-July. In three of the seasons similar studies were extended to mid-September on 33 farms which had a history of parasitic gastroenteritis. Worms were counted 361 parasitic gastroenteritis. Worms were counted in 361 lambs killed at intervals of four weeks. The degree of infection and incidence of different genera covering the same period were identical in both series. The division into Nematodirus and parasitic gastroenteritis farms proved artificial and the results were combined to obtain an overall picture based on average worm burdens during weekly periods from the last week in April to the second week in September. An average total of 2500 worms was present in four-week-old lambs at the end of April and this rose steadily to a peak of 10, 000 during the first week in June. A gradual fall to 5500 in mid-July was followed by a rapid rise which had reached 22, 000 at the end of observations in mid-September. The first wave of infection up to mid-July consisted almost entirely of Nematodirus and Ostertagia in the approximate proportions 3;1, 2:1 and 1-5:1 midway through the months of May, June and July respectively. The second rise from mid-July onwards consisted principally of Ostertagia and Trichostrongylus. Nematodirus worm numbers remained at a lower level while a few Cooperia and Haemonchus had appeared. Unidentified third and fourth stage larvae in the abomasum and small intestine reflected the prevalence of Ostertagia and Nematodirus respectively. The significance of this infection pattern, which was common to all geopgraphical areas, in relation to the epidemiology of parasitic infections in lambs is discussed.


The involvement of dietary fat and vitamins, stress, litter and starvation on the incidence of the fatty liver and kidney syndrome in chicks. Dietary and environmental factors involved in the fatty liver and kidney syndrome (FLKS) were studied. Addition of maize oil, tallow or olive oil isoenergetically at the expense of starch to the standard highmortality diet reduced mortality from 19 to 7 per cent. Supplementation of the standard diet with a mixture of vitamins reduced mortality to 1 per cent whereas supplementation with thiamin alone reduced it to 11 per cent. Mortality was 53 per cent higher among females than males. At 25 days of age mortality was 94 per cent higher among birds that had been subjected to repeated stressing. Withdrawal of food on day 36 resulted in a marked increase in mortality.


The erythrokinetics of Zebu cattle chronically infected with Trypanosoma congolense. The erythrokinetics of Ethiopian Zebu cattle infected with T congolense were studied at 12-16 weeks after infection using 59Fe and 51Cr-labelled red cells. The severe anaemia which developed as a result of the infectionw as found to be due principally to a massive loss of red cells from the circulation.


The effect of bithionol sulphoxide on Echinococcus granulosus and Taenia hydatigena infections in dogs. Trials with bithionol sulphoxide involving 130 dogs, infected with either Echinococcus granulosus or Taenia hydatigena, indicated that a single treatment at a dose rate of 400 mg/kg or two treatments at 50 mg/kg eliminated the former, but a single treatment at 50 mg/kg was sufficient to eliminate the latter. Dose rates 200 mg/kg or more were lethal to some dogs. With two doses of 50 mg/kg, there was only minor discomfort from vomiting or diarrhoea in some dogs.


Functional recovery from spinal cord trauma following delayed incision of spinal meninges in dogs. The spinal cords of 16 normal dogs were exposed via dorsal laminectomies and damaged with a known force. In eight dogs the spinal cord meninges were incised longitudinally after a delay of 2 h. The other eight dogs were kept as controls and their meninges were not incised. The spinal cord function of all dogs was monitored for up to 32 days. The results show that delayed incision of the spinal meninges is of little benefit to dogs following experimental trauma to the spinal cord.


Epidemiology of equine streptococci.

Epidemiology of equine streptococci. Equine tonsillar tissue and the draining regional lymph nodes, as well as deep nasal swabs were examined bacteriologically. Group C streptococci, predominantly Streptococcus zooepidemicus, were shown to be present in all tissues. The most frequent site for isolation was the tonsil. Streptococcus equi was not located in any of the tissues sampled.


The virulence of vaccine strains of Mycoplasma mycoides var. mycoides recovered from inoculated cattle. The T1 and KH3J attenuated strains of M mycoides, well-known in Africa for immunisation against contagious bovine pleuropneumonia, were recovered from the lymph nodes of cattle at intervals up to three months after vaccination. Virulence titrations in mice indicated that the organisms recovered from cattle were of no greater virulence than the strains used for inoculation. There was, therefore, no suggestion that the use of attenuated vaccines in the field might be associated with reversion to virulence after inoculation.


Tissue lipid composition in fatty liver and kidney syndrome in chicks. The lipid composition of the liver, kidneys, heart and adipose tissue of chicks affected by the fatty liver and kidney syndrome were analysed. Livers and kidneys showed 400 to 500 per cent increases in heart lipid levels. Liver and kidney triglycerides contained increased proportions of mono-unsaturated fatty acids, mainly palmitoleic acid, at the expense of the saturated fatty acids, mainly stearic acid. Phospholipid and adipose tissue fatty acid composition were not markedly altered. The abnormalities were regressing in birds recovering from the syndrome.


Prophylaxis and treatment of experimental anaphylaxis in cattle by sodium meclofenamate. Sodium meclofenamate was compared to saline for efficacy in preventing and treating experimentally induced, acute, systemic anaphylaxis in cattle. Respiratroy changes were shown to be reduced to the greatest extent. Lacrimation and collapse were not affected. The timing and routes of administration giving maximum efficacy were those which gave maximum plasma levels of the drug closest to the time of exposure of the animal to the specific antigen.


Haemagglutination and haemagglutination inhibition with Mycoplasma synoviae. A haemagglutinating antigen prepared from cultures of M synoviae WVU 1853 successfully detected homologous haemagglutination inhibition (HI) in sera of fowls and turkeys inoculated with M synoviae. Nonspecific HI was encountered with normal fowl sera but this was removed by treatment with receptor destroying enzyme. It is suggested that M synoviae. HA antigen will be a useful reagent for the diagnosis of M synoviae infection.


Intestinal intubation in the unanaesthetised miniature pig: technique for sampling and measurement of gut length per fistulam. Techniques have been developed and are described for the surgical preparation of long-term jejunal and ileal fistulas in miniature swine and for the management and restraint of the fistulated swine for laboratory investigation. An apparatus and procedure is described for per fistulam intubation which allows sampling of intestinal contents at any site in the jejuno-ileum of the unanaesthetised pig. A comparison between in vivo intestinal length, measured by intubation between jejunal and ileal fistulas, and post mortem intestinal length demonstrates that, as in the human, the intestine becomes remarkably elongated after death.


Carbohydrate digestion and absorption studies in the horse. The ability of the horse to digest and absorb soluble carbohydrates was assessed using a series of oral disaccharide tolerance tests followed in the same animals by tolerance tests with the constituent monosaccharides. In horses older than three years, lactose did not produce an increase in the plasma glucose levels but induced the passing of soft faeces, indicating that adult horses are lactose intolerant. Horses of all ages could absorb the glucose: galactose mixture without any change in the faeces. The tolerance is due to a failure to hydrolyse lactose and does not involve the monosaccharide transport systems. These findings correspond to the known development pattern of brush border lactase activity in the equine small intestine. Both sucrose and maltose were rapidly hydrolysed, the resulting tolerance curves closely approximating to those for the constituent monosaccharides. Galactose was absorbed at a similar rate to glucose, although a dose of 1g/kg was necessary to produce galactosaemia. An oral lactose tolerance test (1 g/kg as a 20 per cent solution) could be of clinical value to determine small intestinal mucosal damage in diarrhoeic foals when the continued ingestion of lactose might be detrimental.


The effect of dietary fat and protein levels, form and cereal type on fatty liver and kidney syndrome in chicks. A total of 4200 day-old Ross I broiler chicks were subjected to an ambient temperature 2 to 3C degrees higher than normal and were fed various diets to determine the effects of dietary factors and sex on mortality from fatty liver and kidney syndrome (FLKS). In a first experiment mortality was not significantly influenced by cereal type (barley or wheat) but was influenced significantly by fat content of the diet. In a second experiment mortality was increased significantly with a low protein diet and with a pelleted one compared with a mash diet. In both experiments mortality was signigicantly higher in females than in males. High levels of protein and fat in the diet had a protective influence on mortality but the results, especially with pelleted diets, suggested that some other nutrient(s) might be involved in the syndrome.


The pathogenesis of single experimental infections with Strongylus vulgaris in foals. The clinical signs, pathology and clinical pathology associated with single experimental infections of Strongylus vulgaris in worm-free pony foals are described. The major clinical signs which became apparent in the infected foals during the first three weeks were pyrexia, anorexia, dullness and abdominal pain. Within the first two weeks of infection lesions were confined to the intestine and terminal branches of the intestinal arteries and consisted of mucosal, submucosal and serosal haemorrhage together with arteritis of submucosal and serosal arteries and also a marked inflammatory reaction. The main lesion seen three weeks after infection was gross thrombosis of the anterior mesenteric artery or one of its major branches. On section these affected arteries showed marked intimal thickening with infiltration of plasma cells, lymphocytes, macrophages and neutrophils. Between one and four months after infection the gross lesions were predominantly in the arteries and consisted of fibrous thickening of the arterial wall and thrombosis associated with the presence of developing fourth stage larvae. Four months after infection the arterial lesions were still prominent and microscopically there was fibrosis of the wall of the affected artery with wide-spread disruption of the intima. In the adventitia organised thrombi were apparent in the vasa vasorum and resulted in the obliteration of their lumina. The typical lesion associated with the return of fifth stage larvae to the intestine was nodule formation in close proximity to thrombosed terminal intestinal arteries and sections of parasites were seen in the intestinal wall surrounded by neutrophils and necrotic debris. By nine months after infection the arterial lesion had healed, but histologically there was fibrosis of the intima and macrophages containing haemosiderin were seen in the arterial wall. The most significant haematological findings during the experimental period were a marked polymorphonuclear leucocytosis and an increase in the number of circulating eosinophils in the infected animals. Also marked was an increase in the serum globulin levels of the infected foals.


Analysis of factors determining the resistance to diffusion in patients with liver cirrhosis. In 5 patients with liver cirrhosis the measured pulmonary diffusing capacity for oxygen (DLo2) was related to the diffusing capacity of the pulmonary membrane (DM) and to the volume of blood in the pulmonary capillary bed (Vc) as estimated from the measured pulmonary blood flow (Qc) and the value of the presumptive transit time. DL and DM were found to be diminished in 4 of the 5 cases, DM being only once 1,7 times greater than DL. The relationship between the resistance of the red blood cells to diffusion and the resistance of the pulmonary membrane to diffusion (see journal for formula) ranged between 5 and 35% indicating that the resistance of the pulmonary membrane to the uptake of O2 was of greater importance than the resistance of the red cells. A correlation was found to exist between D/Q and DM/ThetaVc (diffusing capacity/blood flow and membrane diffusing capacity/diffusing capacity of the red cells in the pulmonary capillary bed). The possible site and nature of the diffusion defect is discussed.


Indications for lung scintigraphy.

Indications for lung scintigraphy. Perfusion and ventilation lung scintigraphy are indicated: (1) for evaluating regional perfusion and ventilation, (2) for establishing a ratio between ventilation and perfusion in different areas of the lung, (3) when chest surgery is planned (especially for mapping out the extent of resection), (4) when surgery of the upper abdomen is to be performed, and (5) when global function studies are compromised. Regional ventilation and perfusion studies are invaluable in the diagnosis of pulmonary thromboembolism in which a perfusion defect is accompanied by well-preserved ventilation in the underperfused area. Regional function tests are indicated for evaluating the distribution of ventilation and pulmonary circulation in practically any chronic pulmonary disease, especially when global function studies, such as spirometry, show significant decreases.


[The effect of metered aerosols on bronchospasm induced by acetylcholine inhalation comparison of ipratropiumbromide (Sch 1000) and fenoterol (Berotec) (author's transl)]. Twenty patients with bronchoconstriction induced by inhaled acetylcholine were treated with Sch 1000 and Berotec comparatively. From the mean value diagrams a faster, stronger and more constant decrease of bronchial resistance due to Berotec inhalation can be recognized. The effect, however, is called in question by contrasting diagrams of single cases.


Transcendental meditation and asthma.

Transcendental meditation and asthma. A 6-month study with crossover at 3 months was designed to evaluate the possible beneficial effects of transcendental meditation upon bronchial asthma. 21 patients kept daily diaries of symptoms and medications and answered questionnaires at the end of the study and 6 months later. Other measurements included physician evaluation, pulmonary function testing, and galvanic skin resistance. The results indicated that transcendental meditation is a useful adjunct in treating asthma.


Silo-Filler's disease.

Silo-Filler's disease. The effects of oxides of nitrogen inhalation are reported in a 21-year-old gardener exposed to silage gas. Initial nausea, cough and fever remitted, but respiratory failure developed 3 weeks later. Roentgenograms and lung function studies revealed pulmonary edema, volume restriction, and severely impaired gas exchange. Needle biopsy showed a nonspecific interstitial pneumonia. With steroid therapy all functional parameters except diffusing capacity returned to normal. Failure to inquire about non-occupational activities led to delayed diagnosis. A brief review of toxic effects of nitrogen oxides is presented.


Respiratory function in esophageal hiatus hernia. II. Regional lung function. 64 subjects with hiatus hernia (34 sliding, 22 mixed, and 8 of paraesophageal variety) were divided into 3 groups according to the transverse diameter of the thoracic loculus and examined by 133Xe-radio-spirometry in the supine position. 48 subjects (22 sliding, 18 mixed, and 8 or paraesophageal variety) showed a significant reduction in the regional ventilation, perfusion or lung volume. Significant correlations were found between the diameter of the thoracic loculus and the reduction in these vairables of the affected lung.


Evolution of spirographic patterns in pulmonary bilaterally denervated dogs. One stage total bilateral pulmonary denervation produced in a group of 23 dogs an increase breathing frequency, an increase in the amplitude of respiration and a characteristic morphology of the spirographic pattern. Later in the evolution, these alterations returned to normal with the exeption of the amplitude of respiration which remained increased. This normalization was not accompanied by the reappearance of the Hering-Breuer reflux. Administration of an aerosol of acetylcholine after normalization of the spirographic pattern produced a temporary reappearance of the immediate postdenervation spirographic pattern. We postulate that in denervated lung a nervous plexus localized in the bronchi not related to the vagus might assume an important role in the regulation of respiration. One cannot exclude, however, the possibility that the reappearance of postdenervation pattern is due to stimulation of airways vagal receptors located in areas proximal to the level of the nervous section.


Comparative measurements of airway resistance. Three different ways to calculate airway resistance with the whole body plethysmograph during spontaneous breathing and the MBC maneuver were tested on normal subjects and patients with obstructive airway disease. The 'effective resistance values' calculated by applying periodic electric current theory correlate well with a linear interpolation of the various alveolar pressure-flow loops. These apparent linear airway resistance values are as good as the procedure described by Jaeger and Otis, based on the main assumption of sinusoidal flow, to calculate airway resistance. The difficulties in assessing the ventilated lung volume, e.g. in patients with obstructive airway disease, justifies use of the 'apparent resistance values' which are easy to calculate for clinical testing.