A radiochromatographic method for biliary contrast agent metabolites.


The application of Steinbuch's "Lernmatrix" as a new mathematical approach in the assessment of air pollution effects.


Teletransmission of physiological data.

Teletransmission of physiological data. The routine procedure of EEG recording is recalled to show the advantages of telemetric assessment of this parameter. The procedure for EEG telemetry is shown under different circumstances, e.g., by transmission with the aid of the 'Community Antenna System' of a hospital. Finally, a 16-channel telemetry system, using pulse width modulation is described.


A 4-channel telemetry system for hospital patient monitoring. A 4-channel radio telemetry system has been designed and implemented for use in the operating room on patients undergoing surgery. 30 such systems are in daily use throughout the Duke University Medical Cener. Relative simplicity, long battery life and a DC-response capability are the important features of these systems. The four physiological channels used are; electroencephalogram, electrocardiogram, peripheral pulse, and arterial blood pressure.


Violence in families: an overview.

Violence in families: an overview.


Calibration and measurement in 3-dimensional monitoring of human motion by optoelectronic means. II. Experimental results and discussion.


Neurological factors in violent behavior (the dyscontrol syndrome).


Family violence and criminal behavior.

Family violence and criminal behavior.


Psychodynamic aspects of violence.

Psychodynamic aspects of violence.


Violence toward children: medicolegal aspects.


Symposium on violence in families: questions and answers.


Regression as a way of coping with a life-threatening disease.


Juvenile court system. The devil's advocate.


Pastoral care of the physician.

Pastoral care of the physician.


Folie à deux in the parents of psychosocial dwarfs: two cases.


Inside the God squad: a panel on the value of staff diversity.


Ministry in the emergency room.

Ministry in the emergency room.


An oncology self help group.

An oncology self help group.


The integrity of religious professionals and their style in health care.


Ministry to the extended care facility: utilization of seminarian, clergy and laity.


The role of significant others in the pathology and treatment of older adults.


Assisting student nurses understand and relate to patients with various religious and spiritual needs.


"Continuing education and self-improvement".


Body talk: teaching non-verbal awareness to staff and students in a general hospital.


Pastoral performance in peer review: a model for evaluation and education.


Spiritual healing phenomena: implications for pastoral care and counseling.


Establishing a grief center.

Establishing a grief center.


Local clergy as hospital chaplains--a model for community building.


"It's not all in their heads".

"It's not all in their heads".


"Recruitment, training and use of volunteer clergy for crisis ministry in the hospital.".


The laity: to visit or not to visit.

The laity: to visit or not to visit.


Moral and ethical implications of positive and negative euthanasia.


The role of the chaplain in the emergency medical system (paramedics) or What's missing in T.V.'s "Emergency!".


A multi-faceted program of pastoral care to terminally ill children.


Religious faith and pastoral care in the crisis of hospitalization.


The missing link in health services: communicating with the public.


ACP's Latin influence.

ACP's Latin influence.


A profile of internists: the National Ambulatory Medical Care Survey.


Training more primary care internists. The Federated Council for Internal Medicine: a policy statement.


Internal medicine - will its identity be lost or reinforced?


Viewpoint: the President's page. New specialty boards.


Viewpoint: The President's page. Increasing costs of medical care.


The FDA and the internist.

The FDA and the internist.


ACP self-learning series distribution begins.


Viewpoint. The President's page. Training position in internal medicine.


Executive Vice President's rounds. Internal medicine residencies.


Introducing ACP's MKSAP IV--a prestigious CME program.


Communicating with the public: a physician's responsibility.


Investing in the future of internal medicine.


Definition of surgical microbiologic clean air.


Effects of withholding elective operations on surgical utilization rates.


The itinerant resident.

The itinerant resident.


Will the Equal Employment Opportunity Commission control specialty boards?


Three reports to the Fellows--presented during the Annual Meeting of Fellows, October 14, 1976, Chicago. Report from the Director of the American College of Surgeons.


Three reports to the Fellows--presented during the Annual Meeting of Fellows, October 14, 1976, Chicago. Report from the Chairman of the Board of Governors.


1976 reports from nine American surgical specialty boards to the Board of Regents of the American College of Surgeons. Presented at the meeting of the Board of Regents, October 10, 1976, in Chicago, Illinois. Report of the American Board of Neurological Surgery.


The reports to the Fellows--presented during the Annual Meeting of Fellows, October 14, 1976, Chicago. Report from the Chairman of the Board of Regents.


1976 reports from nine American surgical specialty boards to the Board of Regents of the American College of Surgeons. Presented at the meeting of the Board of Regents, October 10, 1976, in Chicago, Illinois. Report of the American Board of Plastic Surgery.


1976 reports from nine American surgical specialty boards to the Board of Regents of the American College of Surgeons. Presented at the meeting of the Board of Regents, October 10, 1976, in Chicago, Illinois. Report of the American Board of Colon and Rectal Surgery.


1976 reports from nine American surgical specialty boards to the Board of Regents of the American College of Surgeons. Presented at the meeting of the Board of Regents, October 10, 1976, in Chicago, Illinois. Report of the American Board of Surgery.


1976 reports from nine American surgical specialty boards to the Board of Regents of the American College of Surgeons. Presented at the meeting of the Board of Regents, October 10, 1976, in Chicago, Illinois. Report of the American Board of Thoracic Surgery.


1976 reports from nine American surgical specialty boards to the Board of Regents of the American College of Surgeons. Presented at the meeting of the Board of Regents, October 10, 1976, in Chicago, Illinois. Report of the American Board of Gynecology and Obstetrics.


1976 reports from nine American surgical specialty boards to the Board of Regents of the American College of Surgeons. Presented at the meeting of the Board of Regents, October 10, 1976, in Chicago, Illinois. Report of the American Board of Urology.


1976 reports from nine American surgical specialty boards to the Board of Regents of the American College of Surgeons. Presented at the meeting of the Board of Regents, October 10, 1976, in Chicago, Illinois. Report of the American Board of Otolaryngology.


1976 reports from nine American surgical specialty boards to the Board of Regents of the American College of Surgeons. Presented at the meeting of the Board of Regents, October 10, 1976, in Chicago, Illinois. Report of the American Board of Orthopaedic Surgery.


Public policy and the paradoxes of plenty.


Professional liability--closed claims study.


The influence of the manpower study of SOSSUS on graduate education in surgery. The Symposium on Graduate Education from the 1975 Clinical Congress: residency review committee report.


The influence of the manpower study of SOSSUS on graduate education in surgery. The Symposium on Graduate Education from the 1975 Clinical Congress: current and proposed changes for the foreign medical graduates' entry into the programs (the CCME report).


The influence of the manpower study of SOSSUS on graduate education in surgery. The Symposium on Graduate Education from the 1975 Clinical Congress: overview: in what direction does all surgery need to go?


Surgery--necessary?

Surgery--necessary?


A letter to my sons.

A letter to my sons.


The foreign medical graduate in American surgery.


Surgery in Australia.

Surgery in Australia.


The influence of recent changes in graduate medical education on undergraduate surgical education: influence of career choices on undergraduate surgical education.


The influence of recent changes in graduate medical education on undergraduate surgical education: effect on recruitment to surgery.


The influence of recent changes in graduate medical education on undergraduate surgical education: career selection.


March 1976 Meeting of Young Surgeons. Workshop II. Continuing education for young surgeons.


The influence of recent changes in graduate medical education on undergraduate surgical education: effects on recruitment to surgical specialties.


The federal government and the surgical profession.


March 1976 Meeting of Young Surgeons. Workshop I. Manpower and allied health services.


March 1976 Meeting of Young Surgeons. Workshop IV. Professional liability.


March 1976 Meeting of Young Surgeons. Workshop III. County, state, and specialty society disciplinary processes for surgeons.


March 1976 Meeting of Young Surgeons. Workshop V. Emergency medical services in the United States.


Director's memo. Continuing education.

Director's memo. Continuing education.


Use of items from SESAP No. 1 as a teaching aid in postgraduate medical education.


Optimal hospital resources for care of the seriously injured.


Primary care--the surgeon's role.

Primary care--the surgeon's role.


Misconceptions on surgical residency positions.


The distribution of load through the knee joint and its possible significance to the observed patterns of articular cartilage breakdown.


An introduction to the biomechanics and biomaterials of bone, joints, and implants. Biomechanics and biomaterials of bone, joints, and implants has been presented in an overview manner with the use of selected examples. The musculoskeletal system is a living, dynamic entity that is constructed so that changes in mechanics, if the body does not have time to compensate, can lead to major problems over a period of time. The mechanics of the tissues ensure a smoothly operating system.


Differential bone scanning.

Differential bone scanning. This is a preliminary report of eleven patients with painful total joint arthroplasties. In their evaluation the difficulty in the differential diagnosis between the loose and the infected total joint becomes apparent. We have found the use of differential bone scans an accurate method to identify the infected total joint. Further study along these lines is indicated with a larger series and generalization to other types of implants.


Naviculectomy for congenital vertical talus.


Cryptogenic infraclavicular brachial plexus neuritis: (preliminary report).


Hemangioma of the extensor pollicis longus: a case history.


Irreduceable metacarpophalangeal dislocations.


An evaluation of the effectiveness of parent involvement in a day care program.


Learning disability as a predisposing cause of criminality.


The abusive parent: a different perspective.


Sixty thousand children: the process of establishing a mental health program in a school community.


Project Toddler: "10,000 miles to go".

Project Toddler: "10,000 miles to go".


Assessing standards in children's mental health: a progress report.


Shared engineering.

Shared engineering.


Rehabilitation engineering at Rancho Los Amigos Hospital.


Role of the Electrical Safety Committee.


Hospital technical services and electrical safety.


Circuits for testing the external demand pacemaker.


Giant aneurysms of the posterior fossa presenting as space occupying lesions. In relation to the case history of a patient, who was observed at the Ursula Clinic, Wassenaar, Holland, a survey from the literature is given of 47 cases of giant aneurysms of the posterior fossa, which primarily presented as space occupying lesions.


Carotid ligation for carotid aneurysms.

Carotid ligation for carotid aneurysms. Thirty patients with subarachnoid haemorrhage due to rupture of a carotid aneurysm were treated by ligation of the common carotid artery. Two patients died as a result of the procedure, two patients developed persisting hemisphere deficit. Eight of the ten patients who developed cerebral ischemia after the operation were operated within ten days after the bleeding. At present out aim is to guide the patient safely through the first ten days after his haemorrhage and perform ligation at the end of the second week. After a follow up period of 1-8 years recurrent haemorrhage did not occur. Common carotid ligation, preferably with control of carotid artery end pressure, cerebral blood-flow and EEG is considered to be a valuable method to treat ruptured intracranial carotid aneurysm.


Bilateral acute spontaneous subdural hematoma. A case report. A patient is described, with a history of sudden headache and vomiting, without major neurological deficit. There was no history of trauma. The cause turned out to be an acute spontaneous bilateral subdural hematoma. Comparable cases in literature and the etiological possibilities are discussed.


Complications of the chronic subdural hematoma. Eighty three chronic subdural hematomas, obtained by surgery or by necropsy, were examinated. The patient age distribution curve of the non-complicated operative cases showed the highest incidence in the first year of life and also a moderate increase in the elderly group. Recurrent hemorrhage in the walls and in the cavity, was observed in twenty of the seventy three non-complicated cases of chronic subdural hematoma. In five cases the membranes and the subdural sac were invaded by leucemic cells and in the five remaining ones the hematoma was transformed in a subdural empyema. All these complicated subdural hematomas showed evidence of recurrent bleeding, suggesting that the leucemic cells or the infectious agent had spread to the subdural space by this way.


Intracranial tuberculomas.

Intracranial tuberculomas. In this paper the clinical findings, operation results and histological diagnosis of eight patients with intracranial tuberculomas are described, which were admitted to the Neurosurgical Clinic of Ankara University, Faculty of Medicine, during the years 1967-1975, among the 1,015 histologically verified intracranial tumours. Our impression by reviewing previous papers on this matter is, that although tuberculomas are not so frequently seen as before, they still count as a certain percentage in Turkey.


Cerebral bacterial aneurysms in subacute bacterial endocarditis. Bacterial aneurysms are aneurysms which develop on a vascular wall weakened as a result of a bacterial infection. They can develop anywhere. This paper describes a female patient with subacute bacterial endocarditis and multiple cerebral aneurysms. Conservative treatment followed.


Isofiltration capillary pressure and compartmental vascular resistances following elevation of venous pressure in subcutaneous tissue. Isofiltration technique was used to measure the functional capillary pressure in 10 canine hindpaw (mainly subcutaneous tissue) preparations. With simultaneous determinations of arterial pressure, blood flow and venous pressure, the changes in total, precapillary and postcapillary resistances were assessed at different levels of venous pressure. When the tibial arterial pressure was 100 mm Hg. at an initial venous pressure of 5 mm Hg, the isofiltration capillary pressure averaged 12.8 mm Hg, the ratio of pre-to post-capillary resistance 9.9. The precapillary resistance accounted for 90.8% of the total vascular resistance. The isofiltration capillary pressures were 24.9 and 38.0 mm Hg, respectively when venous pressure was elevated to 20 and 35 mm Hg. Capillary pressure (Pc) was approximately related to venous pressure (Pv) by: Pc=0.82Pvm8. Upon elevation of venous pressure, the total and precapillary resistances were not significantly altered. The paw resistance vessels possess neither myogenic nor metabolic autoregulation. With increasing venous pressure, presumably due to passive distension of venules, the postcapillary resistance fell and the ratio of pre-to post-capillary resistance increased.


Estrogen therapy: the dangerous road to Shangri-La. The use of estrogens almost tripled during the 1965-75 period, with usage concentrated as a cure-all for aging, for the degenerative diseases associated with aging, and for the emotional difficulties of middle age.  3 separate studies published in the last year have shown a high level of association between estrogen use and the development of endometrial cancer.  Results of these studies coupled with the significant recent increase in the incidence of cancer in women over 50 who are in the high socioeconomic groups--the groups most likely to use estrogen therapy--emphasize the association.  The U.S. FDA has proposed a modification in the labeling for estrogens, and a package insert for patients which would warn of possible hazards of estrogen therapy.  It is recommended that estrogen be used only for vasomotor symptoms and vaginal atrophy.  The lowest possible effective dosage should be used and for the shortest possible amount of time.  Earlier studies had suggested that estrogen replacement therapy might protect against breast cancer; most recent studies suggest the opposite.  In addition, estrogen may trigger high blood pressure and increase some blood clotting.  Women with high blood pressure or a family history of early heart attacks are contraindicated from using estrogen therapy.  Even for the treatment of osteoporosis, there may be safer alternative therapies.  Women are cautioned as to their own responsibilities when taking estrogens.


A scintiphotographic study of pulmonary edema and hemorrhage induced by cerebral compression and norepinephrine. Pulmonary edema and hemorrhage (PEH) was induced in rats by cerebral compression and intraveneous norepinephrine. We used scintiphotographic method to demonstrate the blood volume change in the lung subsequent to the hemodynamic events that cause PEH. A specific isotope, Indium-113m, was chosen for this purpose. The isotope forms large molecular, complex with plasma transferrin (molecular weight of roughly 90,000). It is evenly distributed inside the intravascular space. Normally, the lung showed little radioactivity. After cerebral compression or intravenous norepinephrine, a marked increase in radioactivity of the lung was evident. This indicates an accumulation of blood volume in that area. All the animals developed severe PEH which was proved postmortemly. Findings of the present as well as the previous studies agree with each other and indicate that either cerebral compression or norephinephrine elicits generalized systemic vasoconstriction, causing a shift of large amount of blood into the lung. The hemodynamic changes finally result in pulmonary hypertension and subsequent PEH. The scintiphostographic method may be employed as diagnostic tool when a hypervolemic lung change is suspected. Further quantitative analysis is to be accomplished for a prospective clinical application.


Organ donations by incompetents and the substituted judgment doctrine.


Liability for failure of birth control methods.


Rural ambulance service in West Virginia.


The EMT as first therapist of the sexual assault victim.


Legal barriers to EMS systemization: federal.


First forum debate: It is necessary for physicians to teach basic EMT courses.


Paramedics.

Paramedics.


Videotaped guide to staging a basic level EMT practical examination.


Equipment: Federal Specification, Ambulance KKK-A-1822.


Spinal cord injury: emergency management.


Learning styles of EMT's.

Learning styles of EMT's.


Monitoring equipment.

Monitoring equipment.


Communication.

Communication.


Nursing.

Nursing.


State organizations for human services.

State organizations for human services.


The Mega-Proposal.

The Mega-Proposal.


Inside DOPE The custom research databank in the analysis and transfer of information.


Is services integration dangerous to your mental health?


A system approach to human services integration.


Two views on services integration: Bertram S. Brown and Reubin Askew, by Susan Salasin.


Rural community mental health center uses decision-making model.


Women's utilization of mental health services studied.


Income patterns tied to mental health treatment.


Goal consistency: a prerequisite to evaluation of halfway houses.


Anti-suicide program conducts controlled study.


Evaluating children's mental health services.


The mental health consultant role in program research.


HEW capacity-building (federal, state, and local)--policy statement issued march 20, 1975--.


Establishing a model data system.

Establishing a model data system.


Training evaluators at the masters level: an experimental program.


Services integration and the Department of Health, Education, and Welfare.


Organizing human services in Florida. Response to a public policy process.


"Deinstitutionalization," a public policy fashion.


Organizing human services in Florida. Teaching public policy.


Student views of human services delivery in Florida.


Student views of human services delivery to Florida.


Evaluation in a Community Mental Health Center: Hillsborough CMHC, Tampa, Florida.


Developing optimum drug regimens.

Developing optimum drug regimens. In clinical pharmacological trials the determination of the optimum regimen for a drug using the technique of response surface analysis is proposed as being more advantageous than traditional analyses of dose response relationships. Major considerations in favour of this technique are that the optimum regimem can be identified with a minimum of human experimentation, and unacceptable regimens are eliminated from the study early, at a substantial saving of time and money.


Three years of bacteriological monitoring in the Department of Paediatric Surgery. The results of three years of bacteriological monitoring in the Department of Paediatric Surgery at the Ospedale Maggiore Ca'Granda in Milan are reported. The tests carried out involved the patients (faeces, urine, and pus cultures), the environment (operating theatre, incubators), and healthy carriers (upper respiratory tract of nursing and paramedical staff). The aetiopathogenesis of the post-operative infectious complications that occurred in 1974-1975 was investigated with the aid of surveys of the causative pathogens, the type of the surgical interventions, the atmospheric pollution in the operating theatre (mean indicative values), the number of operations per month, and the frequency of positive findings among the carriers. As a parallel investigation, between 1971 and the time of writing of this report the authors monitored the resistance to gentamicin of bacteria belonging to the family Pseudomonadaceae isolated from patients, in view of the constant threat posed by the vicinity of the burns department.


Polyacrylic bone cement containing erythromycin and colistin. I. In vitro bacteriological activity and diffusion properties of erythromycin, colistin and erythromycin/colistin comibination. Erythromycin and colistin demonstrate a non-antagonistic ability to inhibit the growth of a wide variety of aerobic and anaerobic bacterial isolates. When incorporated in Surgical Simplex P Radiopaque Bone Cement, fabricated cement pellets were effective in inhibiting 98% of all anaerobic and aerobic test isolates. Separate experiments indicate that each antibiotic can diffuse from polymerized cement, and that the concentration of each antibiotic is consistently above the minimum inhibitory concentration of 96% of the isolates. We conclude that erythromycin/colistin Surgical Simplex P radiopaque Bone Cement is a worthy candidate for clinical investigation.


Short-term and long-term clinical evaluation of a non-amphetaminic anorexiant (mazindol) in the treatment of obesity. The effectiveness and tolerance of a non-amphetaminic anorexiant drug has been evaluated in a short-term and in a long-term clinical trial in simple obesity and in refractory obesity. In the short-term 'crossover' trial, a more evident effectiveness and tolerance result when the anorexiant is given in a late phase of treatment. The association of an anorexiant drug with the hypocaloric diet was seen to be effective in the treatment of so-called refractory obesity. In the evaluation of the long-term treatment it is seen that weight loss is greater and remains so farr longer periods in patients receiving anorexiant, as compared to controls. This is related to a better maintenance of a restricted calorie regimen. Mazindol did not affect the improvement of glucose tolerance and insulin secretion which follows the weight reduction.


An evaluation of a once daily dosage régime of dothiepin hydrochloride (prothiaden). This paper reports on the use of a single daily dose of dothiepin hydrochloride (Prothiaden). The results from a metabolism study using [14C] dothiepin were used to calculate the daily variations in blood levels after once daily and thrice daily dose regimes. A clinical study on the use of a single daily dose of 75 mg of dothiepin showed this type of regime to be well tolerated and efficacious in the treatment of 105 depressed patients in general practice. Compared to a thrice daily regime the once daily dose appeared to be more beneficial on symptomatic insomnia during the early treatment period.


A study of once daily tenormin (atenolol) in hypertension: some implications in patient compliance. A clinical study is described in which hypertensive patients on no drug therapy were given atenolol in increasing doses from 50 mg twice daily to 200 mg twice daily until the diastolic blood pressure was 90 mm Hg or below. At this stage the drug was withdrawn until blood pressure readings had risen to pre-treatment levels. The same dose of atenolol was then re-introduced but now given once-a-day (in the morning) and was continued for four weeks. Of the elevel patients entering the study, one withdrew as his blood pressure was not controlled on a dose of 200 mg of atenolol twice daily, and another because on withdrawal of atenolol his blood pressure did not rise to pre-treatment levels. The remaining nine patients completed the study. There was a statistically significant fall in blood pressure on both atenolol regimes and there was no significant difference between the blood pressure control achieved on twice-a-day and once-a-day administration. Only one patient developed side-effects; this being an asthmatic who developed mild dyspnoea on atenolol which did not necessitate withdrawal of the drug. It is concluded that once-a-day administration of a given dose of atenolol is therapeutically equivalent to twice-a-day administration. The implications of this in terms of better patient compliance, and thus better prognosis, are discussed.


Effects of cloprednol and other corticosteroids on hypothalamic-pituitary-adrenal axis function. The effects of cloprednol and other corticosteroids on hypothalamic-pituitary-adrenal (HPA) function were studied in healthy subjects after administration of a single oral dose of corticosteroid at 6 a.m. or 6 p.m., and after daily 6 a.m. administration of corticosteroids at various doses for seven days. The degree of HPA suppression was assessed by metyrapone tests (METP), insulin hypoglycaemia tests (IHT) and 6 a.m. fasting plasma cortisol concentrations. Regardless of the corticosteroid tested, 6 p.m. dosing was at least four-fold more suppressive of METP response than 6 a.m. administration. At therapeutically equivalent doses, single doses of triamcinolone and dexamethasone were more suppressive of HPA-axis function than cloprednol, hydrocortisone or prednisolone, After 6 a.m. administration for seven days, 12-5 mg of cloprednol did not impair the cortisol response to IHT or interfere with the METP response. The clinically equivalent dose of prednisolone (25 mg) resulted in slightly greater HPA-axis suppression. All doses of dexamethasone (0-5, 3-75 and 6-0 mg) and of betamethasome (2-0, 4-0 and 6-5 mg) were more suppressive of HPA-axis function than either cloprednol or prednisolone. These results suggest that at equipotent anti-inflammatory doses, cloprednol is slightly less suppressive of HPA-axis function than prednisolone, and both cloprednol and prednisolone are much less suppressive than dexamethasone or betamethasone.


Bioavailability of digoxin and beta-methyl-digoxin. In a randomized crossover study the bioavailability of a single dose of digoxin and of beta-methyl-digoxin tablets was tested in four normal volunteers. No difference was found between the two products in the rate and extent of drug absorption using 6 day cumulative urinary excretion and serial serum concentration measurements.


Sulphonylurea and hypothyroidism in Nigerian diabetic subjects. Thyroid function has been assessed using the T3-Uptake test in 98 nigerian diabetic and 50 non-diabetic control subjects. Whilst abnormal tests suggestive of thyroidal hypofunctional state were commoner in the group on chlorpropamide alone, and in combination with metformin, these were unrelated to the duration of treatment. In addition, none had clinical hypothyroidism.


Physiopathologic relevance of alternative pathway of complement activation.


Prostaglandins as modulators of the inflammatory response in the rat. E-type PGs, injected in rat skin at a low dose concentration (1-5 ng ml-) proved not to release vasoactive amines from local mast cell, enhance increase in vascular permeability evoked by hypersensitivity endogenous inflammatory reactions (passive cutaneous anaphylaxis and reversed passive Arthus) or by intradermal injection of histamine and bradykinin. The possible role of PGE1 and PGE2 as modulators of the inflammatory response is discussed.


The effect of pre-treatment of syngeneic mice with tumour cells cultured in vitro on the induction of a transplantable tumour. The pre-treatment with in vitro cultured mammary adenocarcinoma (ADK-1t) cells strongly protects syngeneic Balb/c mice against the challenge with the same non-cultured tumour cells. If the cultured cells were detached with sodium versenate, 50-60% protection was given, whereas if trypsin was used only 20-30% protection was achieved. That in vitro culture considerably reduces the oncogenic potential of ADK-1t cells was shown by the fact that very many more cultured than non-cultured cells were required to induce tumours.


Disseminated intravascular coagulation.

Disseminated intravascular coagulation.


How patient educators view their role...and yours.


Executive session [or: how our board avoids boredom].


Effect of potato protease inhibitor on the clotting system and fibrinolysis in the dog. The potato inhibitor of proteolytic enzymes was found to inhibit the plasma clotting and fibrinolytic systems in the dog. The anticoagulative action of potato inhibitor consists in a prolongation of clotting time, inhibition of thromboplastin generation, reduction of prothrombin consumption and of the retractility of the blood clot. The potato inhibitor prolongs the euglobulin fibrinolysis time and causes a rise in the plasma antiplasmin level.


Postsplenectomy thrombocytosis in the mouse: changes in the size of thrombocytes.


Education directors: moving into a class by themselves.


Comparative studies on platelet membrane preparations. For the isolation of platelet plasma and cytoplasmatic membranes, the following methods were applied. 1. Glycerol-osmotic lysis technique, combined with sonication. 2. Glycerol-osmotic lysis technique carried out on fresh or frozen platelets. 3. Detergent treatment followed by separation of the protein fractions insoluble at low ionic strength. The detergents used were Triton X-100, Nonidet P-40, Na-deoxycholate and digitonin. The protein fractions were compared by SDS-PAG electrophoresis.


How hospital relationships shape the growth and stability of groups.


Haptoglobin level in haemophiliacs after administration of pooled cold precipitated antihaemophilic globulin. Preliminary report. Unlike compatible haemophiliacs, incompatible haemophiliacs developed a decrease in haptoglobin level after administration of pooled cryoprecipitate. The effect is attributed to haemolysis following intravascular agglutination and intravascular coagulation elicited by the cryoprecipitate in incompatible patients.


The effect of colloidal gold on blood coagulation. Coagulation tests were carried out in rabbits after the intravenous administration of 2 mg/kg colloidal gold. Among the clotting factors, platelet Factor 3 and Factor XIII were found to be inhibited by the gold preparation. Gold at 2 mg/ml concentration induced an overall antithrombotic state in spite of an increased tendency to platelet aggregation. These experiments suggest a new possibility for the inhibition of Factor XIII and platelet Factor 3.


Lanthanum Trichloride induced blood coagulation defect and liver injury. The rare earth metals have anticoagulant and hepatotoxic effects, among others. In view of the connection between liver and blood coagulation, the character of the coagulation defect developing in rabbits treated with lanthanum trichloride (La) was studied and in connection with it, the role of the liver injury described earlier. The results showed the effect to depend primarily on the dose of the drug administered; acute and prolonged treatments produce coagulation defects different in type. The effect of a single large dose is characterized by a severe disturbance of thrombin formation: Prothrombin activity is decreased, PTT is prolonged, native blood does not coagulate but may be coagulated with thrombin, and its fibrinogen content is high. The effect cannot be regarded as a result of the liver injury. On giving La in repeated smaller doses, a disturbance of intrinsic thromboplastin (or thrombin) formation develops, as indicated by a decrease in prothrombin consumption. This might be due to an alteration of some serum factor or of the thrombocyte lipid factor (factor 3) and is probably connected with the liver injury.


The health manpower act.

The health manpower act.


Polyagglutinability associated with the cad antigen. Various anti-Cad and anti-Sda reagents were tested against a panel of Cad red cells in order to determine whether Cad and Sda antigens were identical. According to the results, although strong Sda reactivity was always found in Cad red cells, the two antigen specificities are not identical. The polyagglutinability of Cad red cells seems to be related to an anti-Cad present in all human sera but Cad, and not with anti-Sda antibody.


Jk(a-b-) phenotype in a French family. Quantitative evidence for the inheritance of a silent allele (Jk). A Caucasian French family was investigated including two Jk(a-b-) sibs who had developed anti-JkaJkb. The parents were first cousins. Quantitative study of Kidd antigens using titration scoring and HD50 assay clearly showed the parents and a maternal aunt, phenotypically Jk(a+b-), to have a weak expression of Jka documenting thereby the transmission of the postulated silent gene Jk. Absorption, elution and coagglutination assays revealed the cross reactivity of the antibody developed by the two sibs. Leucocytes and platelets from these two individuals were not shown to absorb anti-JkaJkb.


Kinetics of mononuclear phagocytes after thymectomy. Some kinetic parameters of mononuclear phagocytes have been studied. Wistar rats were injected with 3H-thymidine. Samples of peripheral blood and peritoneal macrophages were obtained at 12, 14, 24, 36, 48, 60, and 84 hours respectively after injection. The labelling index and the mean grain count were determined. The turnover of monocytes was slowed down in the thymectomized animals. It is assumed that thymectomy had changed some biological qualities of mononuclear phagocytes and/or the humoral relations connected with the function and the regulation of mononuclear phagocytes.


Acute effect of endogenous inhibitors and exogenous cytostatics on the ultrastructure of bone marrow cells. I. Single dose of 1,2 : 5,6-dianhydrogalactitol (DAD). The ultrastructural effects of the endogenous inhibitor, granuloid crude extract (GCE), known to control the proliferation of myeloid cells, and of the current hexitol derivative, 1,2 : 5,6-dianhydrogalactitol (DAD) were compared on the rat bone marrow. A single intraperitoneally injected LD50 dose of DAD induces the following changes in the fine structure: The mitochondria become swollen, the matrix less electron-dense, the cristae fragmentate, the ribosomes aggregate, anomalies appear in the perinuclear the cell membranes, and myelin figures and intranuclear bodies develop. Autophagy,  degeneration and the phagocytotic activity of the reticulum cells is appreciable in 4 hours after treatment and increase by the 24th hour. The toxic effect of DAD is cell aspecific but in the ultrastructure its myelotropic effect manifests earlier than in erythropoiesis. In contrast, the arrest caused by a single dose of the endogenous granuloid inhibitor [2] is cell-specific and non-toxic.


Acute effect of endogenous inhibitors and exogenous cytostatics on the ultrastructure of bone marrow cells. II. Single dose of granulocyte crude extract (GCE). The particle-free crude extract of granulocytes (GCE) contains at least three inhibitors of proliferation (M.w. greater than or equal to 70,000, approximately 11,500 and less than or equal to 4000, [5,5]). Intraperitoneal administration of a single effective mitodepressive dose (EDM = 59.4 mg/kg b.w. protein) does not damage the majority of rat bone marrow cells. The observed slight ultrastructural alterations are as follows. The cristate pattern of the mitochondria is occasionally deficient, their matrix may contain membrane shreds or myelin figures, the package of individual granules may be injured. Cytoplasmic vacuolization, autophagy are infrequent and nuclear bleb formation occurred in a single case only. The incidence of such injuries is practically the same in untreated bone marrow cells. Although GCE effectively inhibits cell proliferation, its single dose does not induce such toxic, irreversible and degenerative ultrastructural alterations as have been observed in the same system after the administration of the cytostatic dianhydrogalactitol.


The Tarasoff decisions: suing psychotherapists to safeguard society.


Future drugs that will be lifesavers for the industry too.


Perfect accountability.

Perfect accountability.


Let's get started on improvement.

Let's get started on improvement.


Satisfaction guaranteed.

Satisfaction guaranteed.


Motivation: key to good results.

Motivation: key to good results.


Spotlight on the staff. Housekeeping.

Spotlight on the staff. Housekeeping.


When the problem is productivity.

When the problem is productivity.


Make instructions mistake-proof.

Make instructions mistake-proof.


A case study of performance improvement, part 1: The program.


Spotlight on the staff. Physical therapy.


Management of nursing care. A problem-solving approach to discipline.


More mileage from days off.

More mileage from days off.


Healthcare at home.

Healthcare at home.


Contracting for mental health.

Contracting for mental health.


A case study of performance improvement, part 2: the payoffs.


Spotlight on the staff. Volunteer services.


Management of nursing care: build leadership through communication.


Patient education via TV.

Patient education via TV.


Management by objectives in a healthcare setting.


Management of nursing care: when the patient is dying.


How to turn down job applicants without incurring charges of bias.


Spotlight on the staff. Admitting.

Spotlight on the staff. Admitting.


Care of the aged: inside and outside the nursing home.


Spotlight on the staff. Medical records.


Management of nursing care. Structure: from hierarchy to matrix.


The power of suggestion.

The power of suggestion.


Group dynamics: working for you or against you?


When two health facilities merge: a case study.


Spotlight on the staff. Social service.

Spotlight on the staff. Social service.


Charting the way to better patient care.


The woman supervisor: problems and challenges.


Management of nursing care: the ingredients of good supervision.


Art for the patient's sake.

Art for the patient's sake.


MBO: who's using it? who isn't?

MBO: who's using it? who isn't?


Admissions after the fact.

Admissions after the fact.


MBO for nurses.

MBO for nurses.


Anger: threat to managerial control.

Anger: threat to managerial control.


Performance appraisal: an upbeat approach.


Spotlight on the staff. Central service.


Delegation is not abdication.

Delegation is not abdication.


Labor relations and the supervisor.

Labor relations and the supervisor.


Healthcare on wheels.

Healthcare on wheels.


Spotlight on the staff. Pharmacy.

Spotlight on the staff. Pharmacy.


Management of nursing care: quality care in a small facility.


Self-appraisal: tool for managerial development.


Correlation between plasma growth hormone and insulin and blood glucose concentrations in premature infants. Plasma growth hormone, insulin and blood glucose levels were measured longitudinally during the first 60 days of life in 21 premature infants (8 males and 13 females) born between the 6th and 8th month of gestation. When these variables were related to age it was found that insulin and glucose, which are lower than in the prepubertal children and adults, rise simultaneously. Whereas growth hormone, which is higher than in older prepubertal children, decreases during the first 2 weeks of life. The decrease in growth hormone continues during the first 2 months of life, in contrast to the increases in insulin and glucose which do not persist in as long a period.


Growth hormone in blood sampled continuously during pentobarbitone-induced sleep in children. Growth hormone has been estimated in blood sampled continuously in periods each lasting 30 min during the first 3-4 h of pentobarbitone-induced sleep in 69 children. With only two half-hour samples, almost the same information was obtained as with the estimation of growth hormone in all samples. In this way 95% of normally growing children showed growth hormone levels of 5 muU/ml of more. Children with growth retardation of unknown cause and overweight children showed on the average lower growth hormone levels, not rarely even below 5 muU/ml. Pituitary dwarfs all had maximum growth hormone levels of 3 muU/ml or less. Growth hormone levels during sleep may be normal in children who show negative results on provocation, while subnormal growth hormone levels during sleep have been encountered in some children with retarded growth who had a normal response upon provocation.


The role of calcium in glucagon release. Interactions between arginine and calcium. The interrelationship between arginine and calcium in glucagon release was studied using the in vitro perfused rat pancreas. In the presence of a normal 2 mM calcium concentration, 10 mM arginine provoked biphasic glucagon release, the amplitude of such a response being inversely related to the glucose concentration of the perfusate. At the lowest 3.3 mM glucose concentration, and after prolonged (40 min) as well as short (10 min) periods of calcium deprivation, arginine-induced glucagon release was inhibited. These results clearly indicate that calcium is necessary for either the recognition or effectiveness of arginine as a stimulus to the alpha-cell. Taking into account this, as well as other data presently available in the literature, it is suggested that calcium plays a versatile role - permissive, inhibitory and stimulatory - in glucagon secretion. The intimate mechanisms by which calcium exerts such versatile actions in the alpha-cell remain to be elucidated.


Binding of methyltrienolone to various androgen-dependent and androgen-responsive tissues in four animal species. Comparative sucrose gradient studies of the in vitro binding of dihydrotestosterone (DHT) and of a synthetic androgen, methyltrienolone (R 1881), have been done with the cytosols of various tissues of the rat, mouse, cock and man. With rat prostate cytosol, the amount of R 1881 and DHT binding in the 8-9S region of the gradient was found to be comparable. Specific 8-9S peaks of R 1881 were also found in rat levator ani/bulbocavernosus and skeletal muscles and in the mouse kidney. Only 4-5S peaks could be demonstrated in the cock's comb while DHT under the same conditions showed both 8-9S and 4-5S binding. Binding of R 1881 to the cytosol of the hyperplastic prostate was polydispersed, and showed evidence of the presence of aggregates. Evidence was also found that R 1881 could bind to the progesterone receptor in rat uterus. Our study supports the theory that in a given species the androgen receptors are similar if not identical in all the tissues. The synthetic androgen R 1881 appears to be a useful tool for androgen receptor studies in various animal species provided that the tissue under study contains no progesterone receptor.


Statistics sans mystique.

Statistics sans mystique.


Physiotherapy at ground level.

Physiotherapy at ground level.


Rotary filing record for St Thomas's Hospital.


Hospital cheeses.

Hospital cheeses.


Kitchen hygiene. All that glitters is not clean.


Dietetics and menu planning.

Dietetics and menu planning.


Feasibility of freeze production catering.


Initiatives in equipment for the elderly.


Minicomputer installation.

Minicomputer installation.


Fuelling the kitchen electricity.

Fuelling the kitchen electricity.


Designer's Prize.

Designer's Prize.


Research grants.

Research grants.


A new concept in intubation.

A new concept in intubation.


Catering systems--the nurse's view.

Catering systems--the nurse's view.


Pepping-up hospital meals.

Pepping-up hospital meals.


Efficiency in the hospital pharmacy.

Efficiency in the hospital pharmacy.


Stake theory as an explanatory device in Navajo alcoholism treatment response.


Becoming a street addict.

Becoming a street addict.


Sociocultural factors in the intergroup perception of health problems: a case of grower attitudes toward their migrant labor.


Infant feeding and its effect on growth and development of children.


A long day's journey to health care.

A long day's journey to health care.


Serum vitamin A level of secondary school children.


Congenital hypertrophic pyloric stenosis.


Aplastic anaemia in children. A report of three cases.


The patient's right to refuse treatment.


Duplication cysts of the gastroinestinal tract. Report of two cases.


How to start a CME study group for staff physicians.


Changing relationships between hospitals and health professionals.


The rights of physicians and hospitals in due process.


Do physicians over 50 belong in active hospital practice?


Bylaws by law: a look at the St. John's decision.


Views from the chairman. On going full time.


Confidentiality, peer review, and the law.


AHA delegates applaud strong leadership role for hospitals.


Medical staff wins in bylaws dispute, but the problem lingers on.


Critical care: a classification system for ICU patients.


The legal aspects of a patient care classification system.


The JCAH: an assessment of strengths, needs, intentions.


Physicians as diagnosticians--a critical variable in hospital costs.


AMA does an about-face on collective bargaining.


Can malpractice insurance be a condition of staff membership?


The challenge of recertification.

The challenge of recertification.


The 'disorganized' medical staff.

The 'disorganized' medical staff.


Malpractice: funding emerges as a critical issue.


A legislative solution to the problem of physician discipline.


Identifying unfit physicians--the hospital's responsibility.


Florida's answer to the problem of professional incompetence.


Two states strengthen laws aimed at identifying disabled physicians.


Washington memo: quality assurance programs.


JCAH: 'saint' or 'sinner'?

JCAH: 'saint' or 'sinner'?


AMA congress confronts issues of credentials, continuing education.


Physician rehabilitation: a better alternative to punishment.


Primary care for the patient who needs it.


Hospital-physician relations: the climate is improving.


Research with human subjects: the medical staff's responsibility.


The triclofos mutiny.

The triclofos mutiny.


Receipt of prescription is an implied contract.


Pharmacy technician training program at a Veterans Administration hospital.


A questionnaire for manufacturers provides useful data on new drugs.


The 'privileges' problem.

The 'privileges' problem.


Continuing pharmaceutical education: I. A way to better patient care.


Losing control of a computerized formulary.


The National Drug Code system: its purpose and potential.


Justification of unit-dose: legal protection plus patient benefits.


Continuing pharmaceutical education: II. Protection against malpractice suits.


A Christmas fable.

A Christmas fable.


A plan for pharmacist-conducted patient discharge interviews.


Automatic stop orders: an essential part of hospital policy.


Quality assurance for medical products: unified program for all federal agencies.


A stillness in the Senate hearing room.

A stillness in the Senate hearing room.


FDA problems with medications in the marketplace: III. 'Therapeutic orphans'.


The challenge and promise of pharmacy in the future.


Need for an international standardized system of lot or batch numbers.


The enormous task of total formulary review.


Drug-caused potassium loss in nursing home patients.


A very tight formulary can work if it has a built-in escape valve.


What P&T Committee members need to know.


One hospital's guide for the provisional selection of antibiotics.


"Primum non nocere"--First do no harm.

"Primum non nocere"--First do no harm.


Financing comprehensive pharmaceutical services: how to swim with sharks.


IV infusion pumps: the pharmacist's role.


The pharmacist's role in team treatment of patients receiving injectable long-acting fluphenazine.


Questions to the consultant pharmacist on standards, accreditation and survey inspection.


Designing a modern hospital pharmacy.

Designing a modern hospital pharmacy.


Contemporary pharmacy services in the small hospital.


Can the pharmacist solve drug problems in hospitals and still stay afloat.


A survey of hospital drug purchases and inventories.


Report of the Task Force on Fees for Accreditation.


Radioactive vitamin B12 absorption studies in various gastrointestinal disorders.


Stool weights and transit time in North Indians.


Peritoneal dialysis in children.

Peritoneal dialysis in children.


Some metabolic facets of magnesium in diabetes mellitus.


Changes in blood sugar and osmolality during dialysis with glucose free dialysis solution.


Observations on serum immunoglobulin and complement fractions in rheumatoid arthritis.


Methyldopa liver injury.

Methyldopa liver injury.


C.S.F. in diabetic neuropathy--revisited.


Use of glucose free dialysate for haemodialysis.


Dialysing uremic children.

Dialysing uremic children.


Gas cysts of intestine.

Gas cysts of intestine.


Ascites of undetermined origin in patients with pneumatosis cystoides intestinalis.


Arsenic encephalopathy (a report of two cases).


Propositions and pilgrimage.

Propositions and pilgrimage.


Journey of a pastoral counselor.

Journey of a pastoral counselor.


AAPC constitution revision: a challenge to integrate function and form.


The healing of memories: psychotherapeutic ritual among Catholic pentecostals.


Pastoral counselors licensing bill in New Hampshire: realities and issues.


Nurturing the souls of black folk.

Nurturing the souls of black folk.


Pastoral counseling and the black perspective.


Toward a therapy of being.

Toward a therapy of being.


In vitro vs in situ development of Purkinje cells. Analysis of in vitro vs in situ development of Purkinje cells was undertaken in order to compare the transitory morphology of Purkinje cells grown in situ with their differentiation in vitro. Purkinje cells in rotary cultures developed their basic morphological pattern only when the cultures were prepared from 16-day chick embryos, indicating the existence of a critical period during their normal differentiation, which lasted approximately 24 hr between days 14 and 15 embryonic development.


Are dead-front (hospital grade) plugs as safe as the molded type?


Responses of single units in the cat cochlear nucleus to sinusoidal amplitude modulation of tones and noise: linearity and relation to speech perception. Responses to the sinusoidal modulation envelopes of amplitude-modulated tonend noise carriers were recorded from  single units in the cochlear nucleus of the cat. The unit discharges were synchronized to the peaks of the modulation envelope. Population-averaged firing rate were independent of the modulation index of the stimulus. Temporal firing patterns, as represented by the shapes and magnitudes of modulation-cycle histograms, were strongly dependent on stimulus intesity and modulation index. Nonlinear nonsinusoidal responses to sinusoidal modulation envelopes were observed, but only at high values of sound intensity. These and other results are discussed in the context of psychological studies concerning the perception of speech information.


The biomedical equipment technician.

The biomedical equipment technician.


The cost of a clinical engineering department.


Professional engineering registration and clinical engineering.


Structure of neuronal assemblies in cerebral cortex. Interrelations in the apical dendrite bundles of a single neuronal column were revealed by means of light and electron microscopy in the cat motor cortex. Such column presents an integrated structural module. There were also found wider joinings of several columns, among which complex coordination may exist.


Changes of CTP synthetase activity during postnatal rat brain development. The activity of CTP synthetase (UTP: ammonia ligase (ADP, EC. 6.3.4.2.) was determined in rat cerebral hemispheres and cerebellum during postnatal development. It was found that enzyme activity, when expressed per unit of protein or wet tissue weight, in both parts of the brain decreased with age, the diminution proceeding more rapidly in the cerebellum than in the hemispheres. When CTP synthetase was expressed on the basis of DNA an activity peak in the hemispheres with a maximum on the 5th day after birth was observed. The enzyme content per cell was several times lower in the cerebellum than in the hemispheres at each age studied, with the exception of 1-day-old animals, in which both tissues displayed similar activity. The results obtained were compared with literature data for the intensity of RNA synthesis in the developing brain. The conclusion was reached that the changes of CTP synthetase activity were closely related to the RNA metabolism. Therefore the enzyme under study may be one of the factors involved in cell control of RNA synthesis.


Failure to demonstrate alterations in gluconeogenesis in growth-retarded weanling rats with dorsomedial hypothalamic lesions. Bilateral electrolytic lesions were placed in the dorsomedial hypothalamic nuclei (DMN) of weanling male Sprague-Dawley rats. Sham-operated rats served as controls. After 22 days on lab chow and tap water ad libitum, the animals were injected with U-14 C-alanine 0.167 muC/mu moles intraperitoneally (5 muC and 30 mu moles/100 gm body weight) and sacrificed 2 hr later. There was no significant difference, in the incorporation of the label into total lipid, free fatty acids, glycogen, or tissue protein of both liver and diaphragm, between the DMN-lesioned and the sham-operated rats. Similarly, there was no significant difference in the incorporation into plasma glucose or protein. It is concluded that in spite of profound alterations in both ponderal and linear growth and food intake, there is no disruption of normal gluconeogenesis in the weanling rat with DMN lesions.


Effect of acetylcholine on the activity of dopamine beta-hydroxylase in rat brain.


Effects of local illumination of the hypothalamus on spontaneous and flash-induced multiunit activity recorded from the gonadotropic hypothalamic areas in quail. Multiple unit activity (MUA) was obtained from gonadotropic areas of the hypothalamus in quail. Pellets of radioluminous paint (RLP) were implanted unilaterally either in the nucleus tuberis or in the n. posterior medialis hypothalami. Control data were obtained from birds receiving nonluminous material (RP). Spontaneous MUA was decreased by 25% in gonadotropic arease in RLP-treated quail. Direct permanent photostimulation of hypothalamic neuronal population was not as effective in decreasing MUA as environmental photostimulation (50%). Activation in firing rates, which was constant in nonphotostimulated intact birds in response to repetitive flash-light stimulations, was completely suppressed after implantation of RLP.


The relationship of afterhyperpolarizations of extraocular motoneurons to membrane potential. The effect of membrane potential displacements caused by external current injection on the amplitudes of two antidromically evoked afterhyperpolarizations (AHP1 and AHP2) was measured in extraocular motoneurons. AHP1 had a reversal potential of-70mV and an average compensation for displacements from the reversal potential ("compensation gain") of -0.36. AHP2 had a reversal potential of-80mV and a compensation gain of -0.08. Measurements of input resistance of these motoneurons demonstrate a 30-50% decrease at depolarized membrane potentials. This rectification could account for the apparent lack of summation of AHP2. The functional role of AHP1 and AHP2 in the regulation of discharge frequencies of extraocular motoneurons during nromal eye movements is discussed.


Brain colchicine-binding protein (tubulin) during postnatal development in the rat. A time-decay colchicine-binding assay was used under optimal conditions for measuring tubulin concentration in the cerebral cortex and cerebellum during postnatal development. In both brain areas soluble tubulin concentration (pmoles colchicine bound/mg tissue) declined by about 35% between 4 and 12 days of age after which the decrease was more gradual up to adulthood. Colchicine-binding protein concentration of particulate fractions, on the other hand, increased between 4 and 12 days of age followed by relatively little change. The concentration of tubulin in the soluble and particulate fractions of the cerebral cortex was 45% and 75% greater, respectively, than corresponding fractions of the cerebellum. The expression of tubulin on the basis of DNA, revealed marked regional differences which can be considered a reflection of differences in the relative extent of morphological differentiation in these areas during the postnatal period. Tubulin in both soluble and particulate fractions exhibited a marked increase in lability for colchicine binding from approximately 12 days of age. The half-life for loss of colchicine-binding activity was 2,5-fold greater in particulate compared to soluble fractions. An analysis of the characteristics of the particulate colchicine-binding reaction provides additional support for the hypothesis that it represents a functionally significant association of tubulin with the membranous components.


Plugs and receptacles in the hospital: a compendium for the clinical engineer.


Response of a brain protein fraction 24 hours after training in rats. The aim of the study was to follow the amount and incorporation of 14C-valine into separate, soluble protein fractions of the hippocampus, thalamus, and visual cortex of rats from 0 to 72 hr after training. The behavioral test consisted of reversal of handedness with training twice daily for 25 min for 2 days, followed by a 5-day intermission without training, and a final session of 24 min. The animals were injected intraperitoneally with 14C-valine 30 min before sacrifice and taken 0, 24, 48, and 72 hr after last training. After 24 hr, and only at that time, double incorporation values and increased amounts were observed in a protein fraction, No. 6 from the front, in all three brain areas of the trained rats compared to active controls. At 48 hr this protein fraction was at control level.


Preventive maintenance program at Lutheran Hospital of Maryland.


The study of platelet microtubule assembly.


Directory of local & regional biomedical organizations.


Studies on cryosurgical treatment of chronic cervicitis.


A case report: a giant prostatic leiomyoma.


The hospital instrumentation department: delivering clinical engineering services to the hospital community.


Biological effects of exposure to lead in ambient air among Tokyo inhabitants.


A specialist/generalist peer group certification system.


Lexical derivation and the form class of word associations.


A comparison of oral and written code elaboration.


The role of syntax in sentence recall.

The role of syntax in sentence recall.


The effect of level of education on judgments of grammatical acceptability.


The design and use of a veterinary medical record.


How to work less and accomplish more.

How to work less and accomplish more.


Unitization of records in a small hospital.


Exploring curriculum relevance & local market conditions for MRTs.


One hospital's approach to word processing.


The meaning of frequency words in different contexts.


Elicited imitation of language: some ESNS population characteristics.


A reason for visit classification system for ambulatory care.


A helping hand in Afghanistan.

A helping hand in Afghanistan.


Elicited imitation and assessment of abilities.


The world turned upside down.

The world turned upside down.


President's message.

President's message.


The value of a disease index in a nursing facility.


An introduction to organization development for the hospital department head.


Attribution processes and interpersonal accommodation in a bilingual setting.


Confidentiality of alcohol and drug abuse patient records, part II.


Ethical norms of suicide prevention and crisis intervention. Life is not a so called highest value in itself--it is highest value as life subdued to the spirit, to the transcendence, as life 'in relation to'. Human existence is existence within history which means that it is vocational. If life is vocational it has an inborn eschatology. To commit suicide is to stop out of one's own history and eschatology, an act devoid of freedom. To help suicidals means: to give the suicidal person 'assistance to freedom', helping him to find his freedom which is also a freedom to suffer, to live, to believe, to gain confidence and to die when death overcomes us.


Theological reflections on suicide.

Theological reflections on suicide.


Suicide and Islamic law.

Suicide and Islamic law.


Some data on suicide and attempted suicide of the Jewish population in Israel.


Problems associated with culture contact in the psychotherapeutic setting: disparity of expectations between the western-trained therapist and the non-western patient. Observations made in this paper are based on work with a group of lower-class French-speaking North Africans receiving treatment at a Community Mental Health Centre in Jaffo. Experience with this group revealed a fundamental disparity between patients' and therapists' expectations from therapy. Patients generally expect tangible, quick relief and regard themselves as passive recipients of a procedure: therapists hope for some form of participation on the patients' part and view treatment as a slow process. Patients' expectations appeared to derive from basic features of their personalities. It is hypothesized that members of this group are 'psychologically undifferentiated': thus, among other things, they have poorly-developed identities, lack self-direction and stereotype themselves as subordinate beings, acted upon by authority figures. The present approach differs from the usual attitude adopted towards patients of this kind since it argues that it is possible to foster independence amongst them. It is proposed that this can be done only if the patient is regarded as an active participant in the therapeutic experience and if one uses the clinical situation as a fundamental learning experience. On a more general level, it is speculated that the observations and analysis presented here are not specific to the ethnic group dealt with, but are applicable to any disadvantaged lower-class group.


Social sychiatric implications of population control in Thailand. Several knowledge, attitude, and practice surveys in Thailand have shown that a majority of married women do not want more children because of the economic and physical difficulty of raising the children already born;  the ideal number of children was about 3.8.  However, population growth in Thailand is about 3.4% annually, one of the highest rates in Asia.  The findings that women, particularly younger women, are in favor of family planning is offset by lack of knowledge and fears of side effects.  The psychological approach to the prediction of contraceptive behavior, as studied at the Carolina Population Center, shows that, regardless of the method of measurement, intention always emerged with the highest coefficient in discriminating  contraceptive users from nonusers.  Emotional barriers have been considered 1 of the significant factors in contraceptive use, especially excessive dependency needs and passive-aggressive character.  Unwanted pregnancy can also contribute to poor mental health.  Since unregulated fertility, poverty, overpopulation, premarital pregnancy, and illegitimacy seriously impair mental health, contraceptive services should be considered a legitimate part of psychiatry and mental health personnel should  consider referrals for patients in need.


On suicide.

On suicide.


Present status and evaluation of suicide prevention and crisis intervention services in Europe. The present West-European suicide prevention and crisis intervention services are reviewed in the article, which also considers suicide prevention in the light of the literature, contains some critical remarks and puts forward certain suggestions for further development of the services concerned. It is concluded in the article that the present situation is not yet satisfactory as far as suicide prevention is concerned, nor is it likely today to be satisfactory in many countries in respect of crisis intervention.


Social psychiatric implications of population control in Indonesia.


Residential schools as powerful environments. This article attempts to make a preliminary classification of some of the theoretical material published in the last two decades which led to the emergence of a new area in educational research, that of residential education. This has come in response to the increasing frequency of placement in residential settings as a means of educating adolescents.


Student theatre as a means of promoting communication, self-development and creativity. In the process of producing plays in a student drama and theatre workshop at the Hebrew University of Jerusale, certain educational principles and techniques have been utilized. These principles appear to promote inter-group communication, as well as self-development and creativity and to provide a vital educational technique in the teaching of literature.


Socio-cultural modalities in population control. Overpopulation with its identifiable and noxious results, is probably the most ominous and potentially destructive condition existing in current world society. The etiology of this problem includes the failure of mankind to develop compatible interrelationships between members of his own family, clan, society, and world population. The author predicts that all efforts to achieve world population control will be essentially ineffective unless the insights of the holistically oriented science of social psychiatry are refined into principles and rules which direct population control endeavors. This paper reviews the extent and severity of the problem and stresses the need for the operational implementation of the value systems and methodologies of social psychiatry. The author believes that effective population control is possible if the actions of world leaders are directed toward efforts to achieve satisfaction of the basic (Ur) needs of all individuals and groups for physical survival, socialization, and transcendence. In all societies it has been easier for richer than poorer people to implement population control measures whether these measures be abortion, foundling home placement, or more modern methods of contraception.  Population among the poor has been limited primarily by malnutrition, illness, and death.  This surplus of population among poor nations and poor people within a nation is a basic problem which must be considered by social psychiatry.  This phenomena is believed the result of lack of satisfaction of basic "Ur" needs - deep-seated needs for health and longevity, an equally deep desire for human friendships and alliances, and a search for significance.  If the society does not provide means for friendship and significance other than one's family, then large numbers of children will be born.  Until governments and concerned social scientists develop other forms for expression of these deep needs, overpopulation will be a problem.


Bad tidings and the hospitalized patient. The physician in hospital practice may be faced with a situation in which a patient under his care suffers a bereavement or some other unexpected tragedy but is unaware of the fact. Three such cases encountered in the context of our psychiatric sonsultation service are presented. Factors influencing the decision as to whether, when and how the patient should be informed are considered. The complex psychodynamic situation which arises and involves the patient, his family  and the medical staff is described. Stress is laid on the role played by archaic fears of being the bearer of evil tidings. The situation is seen as being ideally handled by the direct treating physician in conjunction with the family, the extent of psychiatric intervention being dictated by the needs of each of the parties concerned. Ideally the patient should be told as soon as his physical and mental condition are seen as conducive and preferably before he leave hospital.


Self-destruction and religion.

Self-destruction and religion. In this paper a brief analysis of the development of the Western world after the second world war is attempted. It is stated that since the start of the sixties, anomie can be perceived in many of the components of its socio-cultural complex, especially in some major areas like the economy and religion, deeply influencing the others. To test the assumption that Durkheim's anomie theory is still valid and offers an adequate frame of reference for research of the underlying phenomena, the outcome of a research on 9.189 completed suicides in the Netherlands during the period 1961--1970 is presented, giving force to the validity and usefulness of this theory.


Theatre and community: 'the Tent of Joseph'. The rationale of community theatre is discussed and its mental health and social goals set forth; these are the mobilisation of creativity through the construction of an original community drama and, impelled by this and its performance, activity for community organisation. An original project in Israel and its first stages of implementation are reported and analysed.


Growth and ultrastructure of Streptomyces venezuelae during chloramphenicol production. Streptomyces venezuelae (3022a) was grown in flask cultures and fermentors, using three media having differential effects on chloramphenicol production. Micromorphology, ultrastructure and chloramphenicol concentrations were studied during the growth cycle in each medium. Chloramphenicol production was greatest in the glycerol-serine-lactate (GSL) medium, less in the glycerol-nutrient broth-yeast extract (GNY) medium and very low in glucose-mineral salts (GA) medium. In GSL and GA, much growth was in the form of microcolonies, especially in flask cultures, while short hyphal fragments predominated in GNY. The major ultrastructural features were the high frequency of mesosomes in fragmenting hyphae in GNY, and electron-transparent zones which appeared during chloramphenicol synthesis in GSL. None of the structural abnormalities induced by chloramphenicol in sensitive organisms were observed in S. venezuelae despite high levels of the antibiotic in GSL medium.


Fatty acid profiles of Streptococcus mutans NCTC 10832 grown on synthetic mediun with sucrose, fructose or sorbitol. Streptococcus mutans NCTC 10832 was grown on synthetic medium in a chemostat, using various major carbon sources, viz, sorbitol, fructose and sucrose. Freeze-dried cells were methylated and the methyl esters analysed by GLC. The fatty acid profiles obtained showed small quantitative change with different sugars, sucrose concentrations and types of growth.


Centrally mediated idiopathic orthostatic hypotension. A case of Shy-Drager syndrome.


Electroencephalographic study of sleep in organic brain damage.


The ventricular system in hydrocephalic chick brains induced by cyclophosphamide.


Intradural spinal lipoma.

Intradural spinal lipoma.


Ischemic myelopathy in aortic occlusive disease.


Choroid plexus carcinoma--a case report.


Early changes in the ultrastructure of the pars intermedia of the pituitary of Xenopus laevis after change of background color. Stereological analysis of the secretory cells of the pars intermedia of Xenopus laevis over a period of 3 days following the transfer of animals from a white to a black background has revealed that significant alterations in the ultrastructural appearance of these cells can be detected 8 h after the transfer. In particular, changes in the secretory granules and the rough endoplasmic reticulum were found to correlate well with previous reports concerning the melanocyte-stimulating hormone (MSH) content and the capacity for protein synthesis of the pars intermedia.


Comparison between hypothalamic, hippocampal and septal multiple unit activity and basal corticotropic function in unrestrained, unanesthetized resting pigeons. Multiple unit activity (MUA) was obtained from various forebrain regions in unanesthetized, unrestrained resting pigeons throughout the whole photoperiod and compared with plasma corticosterone levels. The pattern of electrical activity recorded from the adrenocorticotropic area of the hypothalamus showed diurnal variations which paralleled the plasma corticosterone fluctuations during the 24 h photoperiod. Both parameters were low in the late afternoon and the evening and high in the early morning. Hypothalamic activation slightly preceded the peak o corticosteronemia. Conversely, in hippocampal (H) and septal (S) regions, the peak of MUA occurred in phase opposition with respect to the hypothalamic peak, and there was a marked decrease of firing rates at the moment when adrenocorticotropic activation was initiated.


Autoradiographic localization of estradiol-concentrating cells in the female hamster brain. Autoradiographic methods were used to study the location of estrogen-concentrating cells in the brain of the female hamster. In the hypothalamus, well-labelled cells were reliably found in the posterior medial preoptic area (MPOA), the anterior hypothalamus (AHA), and the ventromedial (VM), arcuate (ARC) and ventral premammillary nuclei (VPM). In the limbic system, well-labelled cells were found in the ventro-lateral septum, bed nucleus of the stria terminalis, and the medial and cortical nuclei of the amygdala. Labelled cells, in small numbers, were also detected in the mesencephalic central gray (CG), lateral hypothalamus, subiculum and entorhinal cortex. The neuroanatomical pattern of estrogen-concentrating cells in the hamster supports the concept of a generalized vertebrate pattern. Furthermore, a comparison of hamster and rat patterns of cellular 3H-estradiol (3H-E2) concentration appears to suggest that species differences in their responsiveness to estrogen may be paralleled by differences in estrogen binding.


Metyrapone inhibition of 3H-hydrocortisone uptake and binding in various brain regions of the pig. Metyrapone (MET) inhibition of hydrocortisone (3H-HC) uptake binding in the cytosol and nucleus of various brain regions of the pig was demonstrated in vivo. The hippocampus, hypothalamus and septum were the regions most sensitive to the inhibition by MET. The hippocampus exhibited the greatest reduction in 3H-HC concentration in whole homogenate, bound in cytosol and in nuclei. The anterior pituitary and cerebral cortex were the least sensitive to MET. In vitro incubation of hypothalami with 3H-HC and MET substantiated the results obtained in vivo with regard to the inhibitory action of MET on 3H-HC uptake and binding. These results were interpreted to indicate the MET may act directly in certain brain regions and that this inhibitory aciton has important implications for both experimental and clinical uses of this drug.


Production of weanling rat ventromedial and dorsomedial hypothalamic syndromes by electrolytic lesions with platinum-iridium electrodes. Weanling Sprague-Dawley rats received bilateral anodic electrolytic lesions with platinum-iridium (PtIr) electrodes in the ventromedial (VMN) and dorsomedial (DMN) hypothalamic areas. Sham-operated rats served as controls. The rats were maintained for 48 days (experiment 1) and 33 days (experiment 2) and food intake, body weight (b.w.), nose-tail length and obesity index were recorded. The data of both experiments indicate that all parameters change in the same direction, as they do when lesions are produced with anodic stainless steel electrodes: in the VMN-P-lesioned animals, b.w. gains and overall mean food intake were normal, carcass fat increased and linear growth was reduced. In experiment 2, however, there was a temporary hyperphagia during the 1st 2 weeks of the study. In the DMN-lesioned rats, both ponderal and linear growth and food intake were decreased but body composition was normal. Plasma obtained at sacrifice in experiment 2 showed slight but significant hyperinsulinemia in the VMN rats (p less than 0.02 vs control and p less than 0.05 vs DMN rats). Prolactin (PRL) levels, on the other hand, were higher in the DMN-lesioned rats (p less than 0.05 vs control and p less than 0.02 vs VMN rats). The data indicate that the changes characteristic of the weanling rat VMN and DMN syndrmes are due to 'true' tissue destruction rather than to artifactitious side effects of the lesions. They also suggest, therefore, than an 'irritative focus' hypothesis is not required to account for the observed alterations. They further suggest that the DMN may play role in the control of PRL release.


Effect of ventromedial and dorsomedial hypothalamic lesions on circadian corticosterone rhythms. Weanling rats received bilateral electrolytic lesions in the dorsomedial (DMH) or ventromedial (VMH) hypothalamic areas destroying primarily the dorsomedial (DMN) or ventromedial (VMN) hypothalamic nuclei. Sham-operated rats served as controls. Lesions in the VMN and DMN, both of which have previously been shown to disrupt normal diurnal feeding rhythms, were also observed to disrupt normal plasma corticosterone rhythms in the present study. The a.m. values of plasma corticosterone in the DMN-lesioned rats were higher than the sham-operated controls. In the p.m., the values of both VMN- and DMN-lesioned rats were lower than those of the controls but unchanged in comparison to their own a.m. concentrations. This disruption of the normal diurnal plasma corticosterone rhythm persisted for at least 9 post-operative weeks.


Ovarian control of gonadotropin secretion during induced precocious sexual maturation in the rat. In sexually immature female rats 'primed' with a unilateral basal hypothalamic lesion on day 23 of life, a gonadotropin surge was triggered by progesterone (P) on day 26. The influence of sequential ovariectomy (OVX) on this response was studied in an attempt to elucidate the mode of action of brain lesions inducing precocious sexual maturation in this species. OVX, carried out on days 23-26, abolished or greatly reduced the LH surge, but had little effect on basal LH concentrations. In contrast, basal FSH concentrations rose rapidly after OVX. In lesioned rats, the post-castration rise of FSH could be prevented by leaving the ovaries in place during the 1st 24 or 48 h. It is concluded that the lesion-induced maturation of the positive feedback mechanism underlying the pubertal preovulatory gonadotropin surge is mediated by the ovaries. In prepubertal rats at this age, tonic FSH release, but not tonic LH release, is under tight negative feedback control.


Effects of continuous light and darkness, and of pinealectomy, adrenalectomy and gonadectomy on uptake of 3H-serotonin by the suprachiasmatic nuclear region of male rats. Rats exposed to continuous light show no significant differences in serotonin (5-HT) uptake by the suprachiasmatic nuclear region (SNR) at 10.00 and 22.00 L, while in continuous darkness, the uptake at 10.00 D is significantly higher than uptake at 22.00 D. In consideration of the role of the suprachiasmatic nucleus in light-mediated control of neuroendocrine activity, this suggests endogenous generation or control of this uptake rhythm. An effect of sham-pinealectomy in decreasing 5-HT uptake was found, but cannot be fully interpreted at this time. The lack of effect of castration or adrenalectomy suggests that these endocrines have little if any direct effect on 5-HT mechanisms in the SNR.


Selective actions of prolactin on catecholamine turnover in the hypothalamus and on serum LH and FSH. The effects of prolactin (PRL) administration on catecholamine turnover in various brain regions of ovariectomized rats were determined by observing the decline of dopamine and norepinephrine concentrations after alpha-methyltyrosine (alphaMT) administration. PRL had no effect on the steady state concentration of dopamine in the median eminence, anterior hypothalamus and corpus striatum or on the norepinephrine concentration in the anterior hypothalamus. However, PRL selectively enhanced dopamine turnover in the median eminence and anterior hypothalamus after a latent period of 10-26 h. In addition, PRL administration significantly decreased serum concentrations of LH and FSH. These results suggest that the PRL-induced increase in activity of dopaminergic neurons in the median eminence or anterior hypothalamus may be responsible for the reduction of the post-castration rise in serum concentrations of LH and FSH.


Increase in 3H-estradiol binding in brain and pituitary with time after gonadectomy in adult male and female rats.


Influence of dopaminergic agonists and antagonists on serum prolactin concentrations in the rat. Inhibitors of dopaminergic neurotransmission, such as reserpine (RES), given alone or combined with alpha-methyl-p-tyrosine (alpha-MpT)or Ro 4-4602, as well as haloperidol (HAL) and sulpiride (SUL), induced highly elevated serum prolactin (Prl) concentrations in intact rats. In contrast, the dopaminergic agonists apomorphine (APO), lisuride hydrogen meleate (LHM), D-amphetamine (AMPH), piribedil and L-dopa greatly lowered the high serum Prl concentrations in female rats induced by i.p. pretreatment with 2 mg/kg RES. Additional inhibition of catecholamine synthesis in RES-treated animals by alpha-MpT abolished the effect of AMPH, which indicates that the effect of this compound is mediated through newly synthesized dopamine (DA), while the effect of APO and LHM remained unchanged. Inhibition of dopa decarboxylation by Ro 4-4602 within the whole body abolished the effect of L-dopa, while lower dosages of Ro 4-4602, which do not penetrate the blood-brain barrier, had less effect. The noradrenergic receptor-stimulating agent clonidine (CLON) had no Prl-lowering effect in RES-treated female rats. In hypophysectomized rats bearing 4 pituitaries transplanted under the kidney capsule, APO and LSM still lowered serum Prl concentrations, while AMPH had no effect; SUL produced a strong increase. These results support the hypothesis that DA has a dominant role as an inhibitor of Prl secretion by acting itself as the Prl inhibiting factor (PIF) on dopaminergic receptors located within the pituitary.


Further studies on the effects of adrenergic, serotonergic and cholinergic drugs on the afternoon surge of plasma prolactin in ovariectomized, estrogen-treated rats. The involvement of adrenergic, serotonergic and cholinergic mechanisms in the diurnal surge of plasma prolactin (Prl) secretion has been examined using ovariectomized, polyestradiol phosphate-treated (PEP) rats bearing aortic catheters. An afternoon surge in plasma Prl was observed to peak at 15.00 h and 17.00 h followed by declining levels at 19.00 and 21.00 h. This pattern was observed between 5 and 21 days after PEP administration. The alpha-adrenergic blocker, phenoxybenzamine (Phenox), completely prevented the Prl surge. The beta-blocker, propranolol (Propra), appeared to delay the onset and intensity of the diurnal Prl surge so that maximum levels were observed at 19.00 and 21.00 h. The serotonergic blocker, methysergide (MES), delayed the maximum diurnal Prl level until 21.00 h, while cyproheptadine (Cypro), another serotonergic blocker, significantly inhibited the surge. The muscarinic cholinergic agonist, arecoline (Arec), when administered at 12.00 h, delayed the surge, while the repeated administration of Arec completely blocked the surge. Atropine (Atro) (10 m/kg at 12.00 h and 5 mg/kg every 2 h thereafter) did not have any effect on the Prl surge, but when administered simultaneously with Arec, prevented the inhibitory effect of Arec on Prl release. The data suggested that the adrenergic and serotonergic systems have a positive input in the occurrence and magnitude of the surge and that the cholinergic system does not appear to have a physiologic role in tonically inhibiting Prl release, but may function under certain special conditions.


Conference of Deans and Principals of Medical Colleges in India, held on April 23-24, 1976 at New Delhi: Post-concluding session: medical research in medical colleges.


Conference of Deans and Principals of Medical Colleges in India, held on April 23-24, 1976 at New Delhi: Summary report of the proceedings.


Health services of Sri Lanka.

Health services of Sri Lanka.


Conference of Deans and Principals of Medical Colleges in India, held on April 23-24, 1976 at New Delhi: Introduction.


National population policy.

National population policy. Dr. Singh emphasized that the Indian government realized radical measures were necessary to control the country's staggering population explosion.  With only 2.4% of the world's area, it has 15% of the world's population, increasing at a rate of over 1 million/month.  Suggested measures include raising the age of marriage, freezing state representation until 2001 to increase the states' interest in population problems, increasing female literacy, increasing monetary compensation for voluntary sterilization, providing group incentives, using voluntary organizations, and generally changing the urban elitist approach of the past into more imaginative rural-oriented attitudes.  States with adequate facilities could institute compulsory sterilization after 3 children, uniformly applicable to state citizens.


A study of managerial style of the district family planning administrators. In 1973-74, NIHAE, an organization established primarily to improve the general administration of health services by imparting inservice training in modern management concepts and techniques to senior health administrators in India, conducted a study to determine the training needs of district level family planning administrators, according to their actual managerial roles and functions and the problems and difficulties they face.  331 district family planning officials were mailed a Blake and Mouton grid questionnaire.  5 major styles located in the 4 corners and the mix point of the grid have been used as the representative managerial styles of 5 major sets of underlying assumptions.  The distribution of district family planning administrators in 1973 is based upon a pooled estimate of around 286 of the 331 district family planning officers.  Their managerial styles are as follows: 44.2% of the respondents revealed a managerial style that shows a high potential for team management and the ability to generate a climate of mutual interdependence, trust and confidence by integrating organizational purpose with the creation of sound and healthy human relationships;  2) 29.6% showed a style that focuses on the needs of people in an attempt to maintain interpersonal relationships leading to a friendly organizational climate and work tempo;  3) 10.7% represented the task management approach, showing primary concern for performance;  4) 12.2% strove to strike a balance between concern for performance and the human element;  and 5) 5.4% of the managers showed a lack of concern for either task performance or human relationships.  Although around 50% of the district family planning officers revealed managerial potential, the study findings indicate that individual respondents were dispersed in all the 5 typical styles, irrespective of age.  However, the organizational pressures in existing State Health Administrations were by and large tending to make the officers resort to levels of managerial style which failed to reflect their true potentials.


Job characteristic relationships: individual and structural moderators.


Review of NMEP in India.

Review of NMEP in India.


The American Dental Association stance toward expanded duty dental auxiliaries.


A health policy, anyone? or What this country needs is a market health risk equity plan!


Serial nerve conduction studies in patients with maturity onset diabetes mellitus. Serial study of peripheral nerve conduction in 18 patients with recently diagnosed maturity onset diabetes mellitus during a period of treatment of hyperglycaemia for 21/2 years showed improvement in motor conduction progressive increase in mixed nerve conduction velocity, but at the same time progressive fall of amplitude of sensory nerve action potentials. It is argued that two independent metabolic processes may underlie peripheral nerve dysfunction in these patients, only one of which is benefically affected by control of hyperglycaemia.


Electrophysiological and pathological studies in spinocerebellar degenerations. Electrophysiological and pathological studies have been performed on the peripheral nerves of patients with spinocerebellar degenerations. In Friedreich's ataxia there is impairment of sensory conduction and mild slowing of motor conduction which may be correlated with loss of large diameter fibres in the sural nerve. The abnormalities in Friedreich's ataxia are present early, in the first decade. In hereditary spastic paraparesis the nerve conduction studies and sural nerve biopsy are normal. In the other spinocerebellar degeneration and a mild loss of myelinated fibres in the sural nerve. However the abnormalities differ from those seen in Friedreich's ataxia.


Performance changes during recovery from closed head unjury.


The use of clonazepam in the treatment of tic douloureux (a preliminary report). Results are reported of a preliminary trial with clonazepam in 19 patients with trigeminal neuralgia refractory to carbamazepine treatment. In this series of patients, 13 (68.4%) showed excellent or good improvement. No serious side-effects were seen. The pharmacology and mechanism of action of clonazepam are discussed. It is suggested that patients with trigeminal neuralgia, who do not respond to carbamazepine, should be given clonazepam before surgery is considered.


Progressive facial hemiatrophy (Parry-Romberg syndrome). Three cases of progressive facial hemiatrophy are presented. In all three cases there is evidence of localised scleroderma or morphea in association with the facial hemiatrophy. This would seem to support the contention that the two disorders are closely related. In two cases, ocular complications are prominent and in one Raynaud's phenomena provide clear asymmetrical dilatation of the lateral ventricle suggest that there may be a central rather than a peripheral cause for the sympathetic overactivity.


Computerized axial tomography for intracranial diagnosis.


Evoked potential studies in neurological disorders. Techniques for recording and analysing visual and somatosensory evoked reponses using an on-line PDP 11/40 computer have been developed and applied to a group of subjects with established or suspected multiple sclerosis as well as to patients with a variety of other lesions of the visual pathways, myoclonic epilepsy and functional neurological deficits. The most consistent responses were obtained using the pattern reversal visual evoked response and the spinal somatosensory evoked response, abnormal responses being found with both techniques in a significant number of patients with suspected demyelinating disease even in the absence of symptoms or signs referable to the visual or somatosensory pathways. The complementary role of these techniques in the detection of sub-clinical abnormalities of conduction in sensory pathways in patients with suspected MS is emphasized.


The continual administration of neostigmine and the neuromuscular junction. The effect of continual administration of neostigmine on the neuromuscular junction of the rat diaphragm was examined by determining the number of quanta of acetylcholine released by each nerve impulse, the effect of differing repetition rats on quantal release and the amplitude and frequency of miniature end-plate potentials. The number of quanta of acetylcholine released at a nerve impulse repetition rate of 1/sec was reduced to 51% of normal in treated animals. The reduction was greater at faster repetition rates. The amplitude of miniature end-plate potentials was reduced to 75% of normal. This reduction appears to be due to blocking of receptor sites rather than the reduction in the amount of acetylcholine in each quantum. The frequency of spontaneous miniature end-plate potentials was reduced in treated animals.


Hereditary hypertrophic neuropathy in the Trembler mouse: electrophysiological studies.


Three cases of post traumatic vascular headache treated by surgery. Three cases are reported of vascular headache following trauma and which failed to respond adequately to standard therapy for migraine. In each case the effect of ligation of the arteries involved has been dramatic, with complete and lasting relief in two cases.


Computerized axial tomography findings in a group of patients with migrainous headaches. Computerized axial tomography of the cranium has been carried out in 46 patients referred because recurring migrainous headaches. Increasing frequency or severity of headaches or a change in headache pattern were the usual reasons for referral. Abnormalities were found in 37 cases and fell into 4 categories. The most frequent (21 cases) consisted of a mild degree of oedema in the white matter of one or both cerebral hemispheres. This was usually bi-frontal (15 patients) but was more extensive in 2 patients. Varying degrees of cerebral atrophy, as determined by widening of the Sylvian, brain-stem and interhemispheric cisterns, and/or widening of the third and lateral ventricles as compared to a group of normal scans, was found in 8 cases. Areas of occipital infarction were found in 4 patients with permanent visual field defects. Unexpected small areas of infarction were found in the temporal lobe in 2 other cases. Cerebral tumours were found in 2 cases. The significance of these findings is discussed, as well as the possible role of migrainous vaso-spasm with consequent changes in cerebral blood flow in the pathogenesis of oedema and atrophy in migraine subjects.


Epilepsy and driving.

Epilepsy and driving. 205 actual and potential drivers suffering from epilepsy were examined over a period of nine years in Tasmania under a State scheme whereby all such persons are referred to one neurologist. In Tasmania 0.3% of all road traffic accidents were due to epilepsy. 16% of the total who had had an accident had failed to disclose their disability and another 10% who were non-accident cases had similarly concealed their epilepsy. Only about 28% of the expected number (per year) of new cases of epilepsy in drivers disclose their complaint. Alcohol was a significant association with epilepsy in just over 8%. Medication should continue for at least three consecutive fit-free years and preferable five years. Only two out of 170 drivers approved to drive had a subsequent accident due to epilepsy.


A unique case of derangement of vitamin B12 metabolism. The case is described of a child, age 6 1/2 years, with retarded mental development, mild neurological signs and abnormal metabolism of sulphur-containing amino acids and methylmalonate, due to an inborn error in the formation of vitamin B12 coenzymes. The patient was treated for almost three years with hydroxycobalamin, folic acid, pyridoxine and choline. Though physical growth was normal, she continued to demonstrate a moderate degree of mental retardation. A brother of the patient died at the age of 5 years, probably of a similar, but undiagnosed, disorder. As far as we are aware there are only four other reported cases similar to the case described here. Two of these patients died and in other other two the defect was so mild that no treatment was necessary and who, in fact, showed appreciable improvement during the follow-up period, which to date amounts to 3 years and 3 months. For reasons detailed in the discussion, it is suggested that the diagnosis of homocystinuria is not complete until studies of folate and vitamin B12 metabolism are undertaken at the same time, so as to identify the metabolic defect(s) responsible for the condition.