The prediction of maximal oxygen uptake before and after physical training in children. Maximal oxygen consumption (V O2 max) expressed in ml/kg/min and predicted V O2 max were determined before and after 8 weeks of training in 24 boys 10-12 years. Training involved 13 of them while 11 were controls. Predicted V O2 max was based on submaximal cycling heart rate according to the Astrand-Rhyming procedure. Pre-training, V O2 max was underpredicted by 12 per cent. This resulted mainly from an apparently low cycling efficiency in these subjects compared to that implicit in the prediction equation. Although adjustments in the prediction equation could equalize the means for V O2 max and predicted V O2 max, the rather low correlation (r = .55) between these measures precluded the accurate prediction of individual scores. V O2 max remained unchanged with training while submaximal heart rate during bicycle and treadmill exercise showed a significant decrease, resulting in predicted increases in V O2 max in children. Since V O2 max was actually unchanged, the prediction falsely indicated an improvement. Furthermore, despite a significantly lower heart rate in the trained group, there was no difference in predicted V O2 max between the groups post-training. These findings indicate that if V O2 max is the parameter of interest, it would seem to be more satisfactory to measure it directly until more reliable methods of prediction are developed.


Medical surveillance for occupational respiratory diseases. Three simple procedures should be used to monitor industrial populations for the development of respiratory disease: (1) History, (2) chest x-ray, and (3) spirometry. The history should be complete and include occupational as well as medical information. Only a P-A x-ray examination of the chest is necessary. Accurate performance of spirometry with reliable equipment can provide useful evidence of physiologic impairment. Serial test results from each employee should be carefully compared to best assess the early development of occupational respiratory disease.


Pulmonary evaluation of sandblasters.

Pulmonary evaluation of sandblasters. A group of 32 sandblasters, all with over 25 years' experience, were compared with a control group of non-sandblasters. The evaluation consisted of chest x-rays and pulmonary functions. The chest x-rays were graded in random sequence by a consultant radiologist according to the 1971 International Classification of Radiographs of the Pneumonconioses. Pulmonary functions analyzed were forced expiratory volumes (FEV 1) and forced vital capacities (FVC). Any chest x-ray changes noted were equivalent between the sandblasters and the control group. The FEV 1/FVC ratios revealed no significant differences between the two groups; however, when the FEV 1 and FVC were compared with predicted values, the sandblasters appear significantly reduced compared to the controls. The two groups were not comparable in two respects, ethnic background and smoking habits. Other groups have reported ethnic differences in FEV 1 and FVC. A second study, comparing Negro and Caucasian males, demonstrated a significant difference in pulmonary functions, confirming the previous reports. A third evaluation of pulmonary function and smoking habits demonstrated a significant reduction in pulmonary function tests in smokers. After  corrections were made in the original study for differences in ethnic background and for smoking habits, no significant differences in pulmonary functions existed in the sandblasters compared to the control group.


[Noradrenaline and adrenaline content in different areas of the heart in patients dying of myocardial infarct]. Noradrenaline and adrenalin levels in different sections of the heart of persons deceased of myocardial infarction were measured, this being paralleled by determining the content of the said amines in the adrenal glands. It is shown that the noradrenaline level in the myocardium was down by comparison with controls during all periods of myocardial infarction studied. The most marked fall of the noradrenaline level in the heart muscle was noted to have occurred in persons who died in consequence of a progressive circulatory insufficiency. The authors believe that depletion of the noradrenaline reserves in the myocardium can be one of the causative factors in the development of cardiac insufficiency. An elevated concentration of adrenalin was found in the perinfarction region of the myocardium during acute period of infarction, especially 1-2 days following the onset of the latter. The highest rise in the adrenalin level was detected in individuals with repeated myocardial infarction evolving in a recurrent manner and complicated by well-marked arrhythmias. It cannot be ruled out that the amassment of adrenalin in the perinfraction zone may be causative of arrhythmias and recurrent lesions of the myocardium. In cases of myocardial infarction the catecholamines level in the adrenal glands is down, especially 1 more month following the development of infarction.


[Effect of inosine on the course of experimental myocardial infarct]. On a model of experimental myocardial infarction produced through ligation of the anterior descending branch of the coronary artery it is shown that inosine is capable of raising the activity of a number of respiratory enzymes, chiefly in the extra-infarction sectors of the myocardium, as well as in the perinecrotic areas and in intact muscular elements within the necrotic zone. It also helps accelerate the formation of the post-infarction scar. Under the effect of inosine the integrity and functional activity of the mitochondria are improved, the noradrenaline concentration in the myocardium is normalized more rapidly, the processes of the myocardial hypertrophy develop successfully and the contractility of the heart muscle increases. Investigations were conducted on 108 rabbits and they included histological, histochemical, electron-microscopic, biochemical methods, as well as electrocardiography and determination of intracardiac hemodynamics.


[Contractile activity of the myocardium in chronic coronary insufficiency]. Cardio- and hemodynamics was investigated in 69 patients with chronic coronary insufficiency without manifestations of cardiac decompensation and with symptoms of congestive incompetence of the heart by using radiocardiography and analyzing systolic phases of the left ventricle. Furthermore, fractional composition of myocardial proteins and the ATP-ase myosin activity were studied in 31 persons, who during their life-time suffered from ischemic heart disease. In patients presenting no symptoms of cardiac insufficiency significant changes in cardio- and hemodynamics along with a reduced content of the actomyosin complex proteins and their disturbed ATP-ase activity were uncovered. These changes proved more intensive in the face of manifestations indicating cardiac decompensation. Thus, a complex investigation of cardio- and hemodynamics enabled it to disclose initial disorders in the contractile activity of the myocardium in patients with chronic coronary insufficiency, when such disturbances are associated both with deranged utilization and with defective accumulation of energy in the myocardium.


[Trace element content in the blood and organs in arteriosclerosis]. The content of 10 trace elements was studied by employing the neutron-activation method and the lead level determined through the spectral analysis in the whole blood, aorta, the heart muscle, liver, intesties (small and large), in the pancreas, adrenal glands, the spleen, lungs of accident victims, among whom 87 were practically healthy and 91 had atherosclerosis. The latter demonstrated in a number of organs (especially in the aorta and liver) a reduction in the content, which increased with age and intensity of atherosclerotic changes, of nickel, manganese, zinc, cobalt, vanadium and iron and rise in the lead, gallium, copper, bismuth and bromine level. The disclosed data bear witness to a definite part played by a number of trace elements in the atherogenesis.


[Functional morphology of the myocardium in cardiac insufficiency]. Changes in the functional morphology of the myocardium in patients on different stages of cardiac insufficiency were studied. Edema of sarcoplasm and destruction of ultrastructural organelles were observed in the muscle cells in progressing cardiac insufficiency. Significant shifts in the activity of some redox enzymes and changes in the fluorescence spectrum of the muscle fibres were demonstrated. Different correlations were observed in the morphological structure and tissue metabolism of the myocardium in the development of the compensatory adaptional reactions.


[Diagnostic value of bloodless graphic methods of studying the heart and vessels in the early detection of circulatory insufficiency]. Based on the experience gained in examining over 3000 patients with various cardiovascular diseases (hypertensive, ischemic heart disease, myocarditis, heart failures of different etiology, etc) and upon literature sources a clinical grouping of bloodless methods of exploring the heart and vessels is given. At the root of the grouping is laid an investigation into the parameters of the cardio-vascular activity. Attention is called to widely employed and well-approved methods, such as electrocardiography, echocardiography and to the ones holding good promise (magnitocardiography, contactless investigations of the arterio-venous pulsation, etc). The authors believe the most informative bloodless methods of examination to be the ones that reflect the parameters of the cardio-vascular activity in a direct way, whereas methods reposing on the study of secondary manifestations produced by the work of the heart and vascular system (ballisto-, dynamo-, cardiovectorography and others) appear to them less promising with their significance for the clinical practice being of minor importance. The "bloody" and bloodless graphic methods of examining the heart and vessels do not compete with each other, but are mutually complementary. The diagnostic merit of the methods in recognizing circulatory insufficiency increases by using functional load and pharmacological tests.


[Use of cardiac glycosides in chronic circulatory insufficiency]. Features specific for the action produced by the most widely employed cardiac glycosides (strophanthin, corglycon, proscillardin A, methyl- and acetyldigoxine, isolanide, digoxine and digitoxin) on the hemodynamics, peripheral resistance, electrolyte composition, acid-base equilibrium, the blood adenyl system, etc were studied in 375 patients with different stages of chronic circulatory insufficiency. The data thus made available allowed some suggestions to be made as to the choice of cardiac glycosides, the duration of their application, possible combinations thereof, and also to propose a number of measures aimed at preventing the development of poisoning with cardiac glycosides.


[Use of glucagon in cardiac insufficiency]. Data derived from a study into the efficacy of glucagon in 50 patients with acute and chronic cardiac insufficiency are offered. In all of these cases there existed a grave cardiac insufficiency refractory to therapy with cardiac glycosides, mostly attended by deranged rhythm and conduction. Clinical and instrumental investigations (basic hemodynamic indices established through the dye-dilution method and integral rheography, polycardiography) proved glucagon to be a truly cardiotonic agent in dealing with patients of this category. A greater effect was achieved in cases involving acute cardiac insufficiency associated with myocardial infarction than it could be obtained in instances of a long-standing chronic decompensation. The use of glucagon is particularly indicated in cases when cardiac glycosides produce complications, or cannot be employed due to the already existent derangements of the rhythm and conduction.


[Treatment of resistant forms of cardiac insufficiency with a combination of diuretics]. The possibility of treating resistant forms of cardiac insufficiency by a combination of furosemide and brinaldix was studied. The efficacy of the diuretics was appraised with reference to diurnal diuresis, sodium-potassium- and chloruresis on the days of taking the diuretics. In making investigations the method of dispersion analysis (permutation trial test) was used. The final results show that the proposed combination (80 mg of furosemide and 40 mg of brinaldix) is effective and warranted in dealing with patients resistant to many diuretics including furosemide. The action of this combination continues for a long time in the presence of signs of cardiac incompetence and is not accompanied by the development of a marked hypokalemia.


[Early diagnosis of cardiac insufficiency with the spiroergometric method]. Standard and submaximal physical load tests were contrasted in studying the functional state of the cardio-respiratory system in healthy individuals and in patients with coronary atherosclerosis, post-infarction cardiosclerosis, mitral lesions and cardiac-pulmonary insufficiency. The application of physical load tests of different types is shown to be instrumental in obtaining a mutually complementary information about the function of the cardiac-respiratory system and the degree of pulmonary and cardiac decompensation. The authors attach great importance to determining the ratio of an actual oxygen uptake to its proper values and suggest using this indicator, called by them performance capacity index, in quantitative appraisal of physical capacity to perform work. In recognizing early stages of circulatory insufficiency of considerable interest is determining the ratio of the venous blood concentration of lactate, pyruvate and some other biochemical factors to the amount of work done.


[Renal factor in the early stages of hypertension]. The paper deals with a study into the state of renal-pressor humoral factors and morphological changes in the kidneys at early stages of inception and formation of hypertensive disease. By applying the radioimmunological method of determining renin in patients with the IIA and IIB stages of the disease--two groups among them, with normal or an elevated renin activity and with its low level were recognized. In analyzing morphological features of renal tissue obtained through biopsy it was found that in 2/3 of patients with the IB and IIA stages of hypertensive disease no changes in the kidneys were demonstrable. In 1/3 of the patients there were in evidence organic alterations in the form of arteriolohyalinosis, proliferation and fibrosis of the intima, myoelastosis, myoelastofibrosis involving the media of intrarenal arteries of diverse calibre, dystrophic changes in the tubular system, partial glomerular hyalinosis, hypertrophy and hyperplasia of the juxtaglomerular apparatus.


[Vasorenal hypertension in children and adolescents]. From among child-patients examined by the authors 41 were found to suffer from hypertension of vaso-renal genesis (58.5%). Major diagnostic tests were: functional intravenous urography, radioisotope renography, scintigraphy, angiography of the kidneys and also determination of the renin activity in the venous renal blood. The sole effective method of treating patients with vaso-renal hypertension is surgery.


[Disorder of erythrocyte membrane permeability in spontaneous genetic hypertension in rats]. The efflux of 22Na from erythrocytes of spontaneously hypertensive rats (SHR) and the ones of Wistar and Spra glue-Dawley aged 8 weeks was studied. The efflux rate of the isotope from erythrocytes with ouabaine blocked active transfer of ions was much higher in the SHR in the prehypertensive and early hypertensive stages than in Wistar and Sprague-Dawley rats. These data suggest that, by comparisons with the Wistar and Sprague-Dawley the SHR have an elevated passive permeability of the erythrocytes membrane to sodium. The authors consider this fact as a possible indication of the presence in spontaneous hypertension of a more extensive defect of the membranous permeability which can prove to be a major cause responsible for activation of servomechanisms that keep up the arterial pressure at a high level.


[Tubular functions in the regulation of osmotic and acid-base homeostasis in chronic hypertensive compensated glomerulonephritis]. In 45 patients with chronic compensated hypertensive glomerulonephritis and in 184 others suffering from different clinical variants of the same disease the state of tubular functions controlling the osmotic and acid-base homeostasis was investigated. The objective was to assess in this connection the scope of renal processes in this connection the scope of renal processes peculiar to the hypertensive from that keep up these function, to reveal (by studying the materials of renal biopsies) the morphological substrate of the dysfunctional under consideration and also to determine its ossible importance in maintaining hypertension. As a criterion for the mass of active nephrons the magnitude of glomerular filtration (from clearance of endogenous creatinine with a minute-long diuresis of 1.5-2.5 ml/min) was used. It was established that, as distinct from the latent forms, in cases of benign hypertensive form of chronic glomerulonephritis, as well as in those of nephritic one, the ammonium excretion is halved and so is also the maximum osmotic concentration. Common to the hypertonic syndrome proved to be a particularly steep, by 70%, fall of CH2O. The disclosed disturbances, except for reduced excretion of "osmotically free" water, may be attributed to the nature of morphological changes inherent in this form of the disease, i.e. in the atrophy of the tubular epithelium and of the tubulo-interstitial component. The major fall of CH2O is largely determined by an increased proximal transport of sodium and inhibition of this process in the distal part of the nephron. A derangement of the studied tubular functions may, though in part, be considered as a factor keeping up the arterial pressure.


Children in educational programs for the hearing impaired whose impairment was caused by mumps. Mumps was reported to be a cause of hearing loss in 259 persons from a sample of 43,946 students enrolled in special educational programs for the hearing impaired. Males and young children appear to be more prone to deafening by mumps, and there may be a relationship between age of onset and degree of hearing loss. Overall, those deafened by mumps appear to have characteristics quite different from those of children deafened by other causes.


Articulation development in children aged two to four years. The articulation skills of 147 children aged 24 to 48 months were tested and the results compared with earlier classical studies and distinctive feature development. The results of the present study indicate consistently earlier age levels for the correct sound and feature usage than the previous studies, though the general sequences of development are strikingly similar in all studies.


Central auditory deficits and temporal-lobe lesions. The capacity of auditory pathways from the weak ear (ear with the suppressed score in a dichotic listening test) to transmit speech information to the cortical processing areas was examined on 10 patients with unilateral temporal-lobe lesions. Three lines of evidence were developed to suggest that auditory pathways from the weak ear and speech information presented to the weak ear are not completely suppressed during dichotic stimulation. Speech in the weak ear frequently interacts with competing speech information in the strong ear causing contrasting articulatory features from the two ears to be blended into a single response. Two models of unilateral central auditory deficits are discussed: ipsilateral-suppression and transmission-line.


Some suggestions on how to evaluate a transposer hearing aid. The research presented here indicates that transposer hearing aids, which are now available commerically, might be helpful to some people. Specifically, it might help some people to detect the /s/, /integral/, /t/, /tintegral/, and possibly /k/ phonemes in speech. Any person considering the purchase of a transposer should be properly tested with one to determine whether the information provided by frequency transposition is helpful. It appears this evaluation cannot be done properly using procedures developed to evaluate a conventional hearing aid for a person with a mild or moderate communication impairment. Rather than outline a specific procedure, this report makes suggestions that a clinician might find useful when asked to evaluate the possible benefits of a transposer hearing aid for a client.


Incidence of chronic hoarseness among school-age children. A speech and voice screening of a kindergarten through eight grade Hebrew day school indicated that: (1) 38 (23.4%) of the 162 children in the school exhibited chronic hoarseness, (2) the incidence was higher in the primary grades, and (3) more boys than girls exhibited the disorder. Vocal nodules were diagnosed in 77.7& of the children examined by otolaryngologists. The findings of this and other recent studies indicate that a large number of school-age children, particularly those in the primary grades, exhibit chronic hoarseness. Futhermore, many such children may be expected to have vocal nodules.


The establishment of fluency with time-out procedures: three case studies. A successful application of time-out procedures is illustrated by three case studies with high school and college-age male stutterers. The method of administering the time-out procedure is described in detail, and typical results are illustrated by data collected from clinical sessions. Modifications of the basic procedure are tested and their results discussed.


Panendoscopic feedback in the study of voluntary velopharyngeal movements. A videopanendoscope system was used to record velopharyngeal movements and to display those movements to subjects who produced them. Three normal adults were studied as they attempted to produce nonspeech velopharyngeal closure by use of two maneuvers: (1) laryngeal fixation and (2) modification of an elicited gag reflex. A rating system was devised to extract data from the videotapes. The findings indicated that subjects were able to utilize the videopanendoscopic feedback to guide voluntary velopharyngeal movements. The velopharyngeal movements were accompanied by larynx displacement and other neck muscle contraction. The uvula was observed to contract during some motor acts.


Speech and language findings in a chronic hemodialysis patient: a case report. The speech and language findings in one patient who underwent chronic hemodialysis therapy are presented. The patient's degenerating physical status was first signaled by stutteringlike repetitions. The speech diagnosis is mixed dysarthria, apraxia of speech, and aphasia. Clinical implications are discussed.


Selected speech and fundamental frequency characteristics of patients with acromegaly. Selected speech characteristics of patients with acromegaly, a relatively uncommon endocrine disorder resulting from excessive secretion of growth hormone, are described. In patients with acromegaly, increased quantities of circulating growth hormone may cause hypertrophy of multiple bodily structures, including components of the phonatory and articulatory apparatus. Speech recordings of 11 patients with acromegaly (six women and five men) were subjected to fundamental frequency and articulation analysis. Despite clinically apparent lingual hypertrophy in each of the patients studied, no speech articulation errors were found. In contrast, acromegaly appeared to produce a lowering of voice fundamental frequency (fo) characteristics in some, but not all, patients. Women exhibited more striking changes in fo than did men.


An abbreviated impedance bridge technique for school screening. The hearing of 539 children were screened by conventional audiometric techniques and an abbreviated form of impedance audiometry. Otoscopic examination and estimates of the cost to accurately detect hearing loss were used as critieria for comparing the two methods. The impedance technique detected 94% of hearing disorders, the audiometric, 24%. Projections of cost included a factor for number screened. These demonstrated that the impedance technique was less expensive and approached one-sixth the cost of the audiometric technique at a rate of 10,000 children per year. A routine application of the impedance technique in an ongoing hearing conservation program (N = 2712) supported the initial conclusion that it was more effective and more easily employable than audiometric screening. One child who passed impedance screening was shown to have a 50-dB sensorineural loss. It was concluded that an abbreviated form of impedance audiometry that includes a single high-frequency screening tone is the technique of choice for school screening.


A biofeedback treatment for stuttering.

A biofeedback treatment for stuttering. Auditory feedback of laryngeal muscle tension was found to reduce stuttering dramatically in an exploratory study of a single patient. Amplitude of EMG signals was similarly reduced. Apparently, the therapeutic effect of biofeedback cannot be attributed to masking, distraction, or suggestion.


The communication game: dump and play.

The communication game: dump and play. Communication entails much more than formulating a linguistic code to map underlying intents. It entails the utilization of a role-taking attitude in reconciling communicative obstacles that arise from significant speaker-listener discrepancies in form or code, reference or representation, and license or acceptability. Young children communicate in a "talk to" fashion that essentially is issuing or dumping messages. As role-taking attitudes become acquired, communicative efforts change from merely dumping messages to active resolution of communicative obstacles in an effort to achieve the message of best fit for a particular situation.


The applied communication game: a comment on Muma's "communication game: dump and play". We now have technology available to teach speech and language skills to children. We cannot always expect children to carry over or generalize this training and spontaneously use this "trained language" in communication situations, so we now must develop technology for teaching interpersonal communication skills. This report commented on a model presented by Muma (1975). Illustrations were presented that should help clinicians train more effective interpersonal communication. The applied communication game provides an objective procedure that utilizes the natural consequences in communication situations to improve communication skill in handicapped children.


Anticipatory middle-ear reflex activity from noisy toys. Middle-ear reflex activity was measured in 14 listeners in response to visual and acoustic exposure to each of seven noisy toys (such as a cap gun, party horn, cow bell, and so forth). Anticipatory middle-ear reflex (AMER) activity was a common occurrence. Normal middle-ear reflex generally occurred after the sound exposure. AMERs generally occurred in the two seconds prior to sound exposure but as early as 10 seconds before sound exposure. Loudness ratings and exposure SPLs were obtained. The presence of acoustically evoked middle-ear (ME) reflex activity and AMERs to the toys was generally unrelated to SPL or reflex threshold. Many reflex responses occurred in response to exposure SPLs below reflex threshold and with low anticipated loudness rating.


Articulatory-defective children's discrimination of their production errors. Discrimination and production performance of seven severely misarticulating children was analyzed in terms of errors in distinctive features and phonemes. Their performance on the McDonald Deep Test of Articulation and a minimal pairs discrimination test was also compared to the performance of children without articulation errors on the same measures. The normal children performed equally well in production and discrimination. However, the articulatory-error children performed poorly on the production test but performed almost as well as the normal children on the discrimination test. A discrepancy in articulatory-error children's production and discrimination of their error phonemes was obtained. They discriminated features and phonemes they did not produce. Clinical relevance of these findings are discussed.


Imitation and language development: issues and clinical implications. The relationship between imitation and language learning is of both theoretical and clinical interest. While current psycholinguistic accounts give imitation only a limited role in language learning, learning theorists and others continue to refer to imitation as a major factor in the child's acquisition of language. Clinicians deal with imitation in modeling procedures as well as in counseling parents about how to promote children's language development. A review of theory and research on the nature and development of imitation reveals wide variation in terminology, definitions, and explanations. The clinical use of imitation procedures have greater significance for the acquisition of communication skills than for the development of linguistic structure.


Warble tone as an audiometric stimulus.

Warble tone as an audiometric stimulus. Pure-tone and warble-tone thresholds were compared for 198 normal-hearing inexperienced adult listeners at six frequencies at octave intervals from 250 through 8000 Hz. Results of the analysis of variance procedures showed statistically significant differences (p less than 0.01) for the test frequencies 500, 2000, 4000, and 8000 Hz. Although significant differences were found at four of the six test frequencies, mean differences were quite small, the largest being 2.3 dB at 8000 Hz. This finding is thought to support the notion that the audiologist may use warble tone with stimulus parameters up to and including frequency deviations of +/- 5% with modulation rates of five per second to measure thresholds, which are directly comparable to pure-tone thresholds for patients with normal hearing and those with relatively flat hearing loss.


Auditory responses of infants.

Auditory responses of infants. Forty infants, aged three through 12 months, participated in a study designed to differentiate the auditory response characteristics of normally developing infants in the age ranges three to five months, six to eight months, and nine to 12 months. Their selection was based on a determination of normal development upon pediatric examination and from the results of the Denver Developmental Screening Test. The results confirmed that a predictable developmental pattern as a function of age in the first year of life is observable despite the wide variability that may occur in a given child. Increased knowledge of these developmental milestones in normal-hearing infants should add to more effective programs of early identification and management of hearing-impaired children.


Diagnostic report writing.

Diagnostic report writing. This article reviews purposes and types of diagnostic reports and provides guidelines for report writing. Report writing varies greatly depending upon the examination itself and the clinician's style of reporting. Such variation is acceptable as long as professional standards are maintained. The basic guidelines of report writing are: (1) the organization should provide for easy retrieval of specific information; (2) the terms and categories should be free of ambiguity; and (3) only terms in common use by professional should be used. Lack of uniformity, bad writing, inappropriate terminology, and overstatements are the basic problems of report writing that may be overcome through practice, study of sample reports, and courses in report writing.


Transfer of /r/ across contexts.

Transfer of /r/ across contexts. This study was designed to determine if training on any one specific /r/ allophone would result in transfer to other /r/ allophones without specific training. Twelve grade school children who were unable to imitate correctly the /r/, /sigma/, and /gamma/ allophones in 40 stimulus items during baseline served as subjects. A multiple baseline was used: six subjects served as controls while six were trained, after which the first six were trained. Each subject received training on a randomly assigned syllable representing a specific allophone of /r/. After training, generalization to the untrained /r/s was assessed. Since most subjects increased the number of correct responses to items in several allophonic categories regardless of the specific allophone taught, the different allophones of /r/ may be members of the same response class rather than independent of one another.


A spondee list for determining speech reception threshold without prior familiarization. The purpose of this investigation was to select a list of spondees from the CID W-1 spondee word list that eliminates the need for familiarization but produces spondee thresholds equivalent to those obtained with familiarization. Forty-eight subjects with normal hearing responded to familiarized and unfamiliarized spondee words at their familiarized spondee threshold levels. Spondee words that were correctly identified most often without prior familiarization or whose correct response rates were least altered by familiarization were selected for the final list. Seventeen words were selected from the criteria of the present study; two of these words were excluded from the final list since they did not fall within the recommended 4-dB range. The 15 remaining spondee words without familiarization produced spondee thresholds equivalent to the entire CID W-1 list with familiarization in a direct comparison of the two lists in 20 subjects with normal hearing.


Hearing assessment with young children.

Hearing assessment with young children. This study evaluates the efficacy and reliability of auditory stimulus-response control training and assessment procedures with young children (nine to 25 months). The problems encountered in training stimulus-response control are discussed. Results indicate that reliable interest data can be obtained from young children using stimulus-response control procedures.


Recovery of auditory function following meningitic deafness. Two cases are presented that document improvement in hearing following Hemophilus influenzae meningitis. In both cases vestibular function was permanently lost. The possible anatomical and physiological sites of involvement are discussed. The two cases stress the importance of regularly scheduled audiometric reevaluations in cases of postmeningitic deafness.


Acupuncture and sensorineural hearing loss: a review. Recent reports concerning the use of acupuncture as a possible treatment for sensorineural hearing impairment were reviewed and evaluated. It was concluded that acupuncture has no effect upon the hearing ability of individuals with sensorineural losses. Further, it was suggested that subjective feelings of improvement represent a placebo effect resulting from the application of a treatment that patients believe might work and not from acupuncture itself.


Prediction of most comfortable loudness levels in hearing aid evaluation. Most comfortable loudness levels (MCLs) are used to determine the gain required in hearing aids. The relationship between MCL and the midpoint between pure-tone threshold and threshold of discomfort was evaluated to see if the MCL could be predicted from the midpoint values. The range of differences between midpoint and MCL precluded making such predictions.


Cultural influences in the development and treatment of stuttering: a preliminary report on the black stutterer. A behavioral analysis of a group of stutterers revealed speech behavioral differences that appeared to be culturally determined. Two general types of stuttering behavioral patterns were differentiated. The stuttering behaviors characteristic of the first pattern were overt repetitions and prolongations with a moderate number of secondary characteristics that were also overt and of the same relative degree of severity as the prolongations and repetitions. The second pattern was characterized by prolongations and repetitions that were more covert and by a larger number of secondary characteristics that were considerably more severe than the repetitions and prolongations. While 85% of the first pattern, Group I, were white stutterers, 79% of the second pattern, Group II, were black stutterers.  These results are explained by important black cultural elements such as (1) the importance of oral skills, (2) the importance of manifesting emotional "coolness," and (3) the cultural rejection of disfluent speech patterns. The authors believe that, generally, the forces within the black culture tend to be in opposition to currently practiced stuttering treatment procedures.


Cineradiographic assessment of articulatory mobility in the dysarthrias. This paper describes cineradiographic techniques for the assessment of articulatory mobility in dysarthric subjects. Sample data for the mobility ranges of articulatory points on the tongue, lower lip, and jaw are presented for four normal speakers and four dysarthric speakers. In addition, fleshpoint displacements during the articulatory movements of the dysarthric subjects are used to illustrate abnormalities in the range, rate, and direction of speech movements. Discussion of the point-parameterized cineradiographic data emphasizes possibilities for the clinical evaluation of dysarthric impairments.


Auditory-visual perception of speech.

Auditory-visual perception of speech. Hearing-impaired persons usually perceive speech by watching the face of the talker while listening through a hearing aid. Normal-hearing persons also tend to rely on visual cues, especially when they communicate in noisy or reverberant environments. Numerous clinical and laboratory studies on the auditory-visual performance of normal-hearing and hearing-impaired children and adults demonstrate that combined auditory-visual perception is superior to perception through either audition or vision alone. This paper reviews these studies and provides a rationale for routine evaluation of auditory-visual speech perception in audiology clinics.


Use of a high-risk register in newborn hearing screening. High-risk newborns were routinely screened for hearing loss by observing their behavioral responses to a 3000-Hz warbled tone at 90 or 100 dB SPL. Infants were identified as high risk if they presented any of the conditions listed by the Joint Committee on Infant Hearing Screening or if they were placed in the special care or intensive care sections of the newborn nursery. During the program's first 12 months, 17% of the total newborn population were included in the screening, and 7% of those screened failed to respond. Approximately half of the infants who failed the screening returned for follow-up testing. No hearing loss has been identified among these infants. Special steps have been required to improve the screening's effectiveness.


A case against teflon injection to lower vocal pitch. A patient with severe hoarseness was seen three months after Teflon injection of both vocal folds had been performed elsewhere to lower an abnormally high pitch. Pitch analysis utilizing voice spectrography revealed no significant drop in fundamental frequency. The hoarseness is presumed to have resulted from disparate glycerin absorption, inflammatory changes of the folds, and asynchronous vibration of the folds. Vocal fold injection to increase fold thickness and lower pitch is not a simple technique and is not advised until all parameters have been thoroughly studied.


The use of visual feedback in establishing normal vocal intensity in two mildly retarded adults. A voice-activated relay was used to provide visual feedback of vocal amplitude for two subjects who habitually used very soft voices. The relay system caused a light to go on when vocal intensity was 65 dB SPL or greater. Both subjects demonstrated significant increases in their use of normal vocal intensity. One subject was able to transfer this progress to spontaneous conversational settings. Though some difficulties in generalization and automatization were evident, this system is recommended for use with persons exhibiting functional intensity deficiences.


The effects of sophistication on Type V Bekesy patterns in simulated hearing loss. Forty-five normal hearing subjects were divided into three groups according to sophistication regarding Bekesy audiometry in simulated hearing loss. Both standard pulsed (200 msec on/200 msec off) and lengthened off-time (200 msec on/800 msec off) were compared with a continuous tone tracing at 1000 Hz. Data revealed a general decrease in the number of Type V patterns observed as sophistication increased.


Language therapy for children: some thoughts on context and content. A presentation of ideas on the ideal context for language therapy for children, this paper explores in detail the importance of teaching child language, centering language therapy in the present, teaching words with empirical significance to the child, attempting to provide a language context which is generative to unassisted later language learning, and finally, teaching communication, not merely to language skills. In addition a sample core lexicon is presented which was designed to relate the above contextual aspects of therapy to psycholinguistic strategies of language therapy.


Analysis of a father's speech to his language-learning child. This study analyzed the speech of a father to his language-learning child. Father-to-child speech was taped daily over a two-week period when the child was three years old. Results indicated that declarative (35%) and interrogative (34%) sentences occurred most often. Smaller percentages of exclamatory (9%) and imperative (6%) sentences were found. The father rarely repeated his own utterances and almost never expanded his daughter's utterances. The child rarely immediately imitated her father's utterances. Comparisons are made of aspects of father-to-child speech with mother-to-child speech as reported in previous investigations.


Patient-controlled delivery of monosyllabic words in a test of auditory discrimination. Normal- and sensorineural-hearing subjects repeated monosyllabic words under a conventional and subject-controlled method of presentation at 0, 8, 16, and 44 dB SL. Results of the study revealed little difference between discrimination scores obtained with the two methods of presentation. Discussion of clinical relevance was concerned with (1) saving of time, (2) standardization of test, and (3) favorable subjective reports of the new procedure.


Long-acting narcotic antagonist complexes. We evaluated the ability of close to 100 organic acids to form water-soluble salts with methadone, cyclazocine, naloxone, naltrexone and, more recently, diprenorphine. About half the acids yielded insoluble salts. Polybasic acids affording insoluble salts were evaluated for their ability to form drug:acid:metal complexes with the polyvalent metal ions, Zn++, Al+++, Mg++ and Ca++. Optimum conditions for forming complexes have been developed and the consistency of their composition has been established. Salts were analyzed spectrophotometrically for drug content, and complexes were analyzed for drug and metal content. The in vitro degree of dissociation at equilibrium was measured for the preparations suspended in a simulated physiological buffer, pH 7.3. Preparations of the narcotic antagonist drugs showing relatively low degrees of dissociation in vitro, since it early appeared that a high degree of dissociation contraindicated a prolonged duration of pharmacological action, were evaluated in mice after intramuscular administration at several dose levels by the mouse tail-flick test for the potency and duration of their morphine antagonist activity. Our most promising preparations to date, showing the most prolonged durations of action without evidence of gross toxicity, are naltrexone zinc tannate and naltrexone aluminum tannate. These are undergoing detailed evaluation as potential clinical candidates. Thus far, the most useful of several dosage forms studied is s suspension in an aluminum monostearate gel.


Sustained release of naltrexone from glyceride implants. Solid dispersions of naltrexone in natural glycerides were used to form injectable implants which continously release narcotic antagonists in vivo. The dispersions were formed and tested either as small cylindrical pellets, e.g. 1x3.0 mm in size, or as particles with diameters in size ranges between 125-250 mu, that are suspended in an aqueous methyl cellulose solution. Both types of implants delivered naltrexone to mice at rates that were effective in blocking the antiociceptive action of morphine for at least one month. The rate of naltrexone release was controlled by altering its concentration in the dispersion and by varying the glyceride composition. Degradation and absorption of the implants were found to depend on their composition, dimensions and location in the body. No appreciable tissue incompatibility was seen in mice, rats, rabbits, monkeys and swine, even when long-lasting preparations were removed a year after treatment.


Use of synthetic polypeptides in the preparation of biodegradable delivery vehicles for narcotic antagonists. Synthetic polypeptides consisting of copolymers of glutamic acid and leucine have been shown to be useful materials for the fabrication of practical, biodegradable delivery vehicles for narcotic antagonists. Model delivery vehicles in film form were prepared from copolymers containing 10 mole percent to 40 mole percent glutamic acid, and loaded with 10% to 40% naltrexone by weight. The naltrexone was found to be released by diffusion, exhibiting diffusion coefficients that varied as a function of the glutamic acid content and the initial naltrexone loading. A wide range in diffusion coefficients were achieved (0.31 x 10(-7) cm2/hr to 120 x 10(-7) cm2/hr), leading to release rates within practical ranges of interest for meeting the program goals. We have demonstrated that the polypeptides can be fabricated into dosage forms that are amenable to administration by trochar. For example, rods 0.4 mm to 0.8 mm in diameter containing as much as 40% naltrexone by weight were extruded using a simple compression mold and die arrangement. An in vitro evaluation of the rods showed that antagonist is released by diffusion at a continuously decreasing rate, a behavior similar to that observed with the film devices that were, nonetheless, capable of blocking an AD80 challenge of morphine sulfate in mice for more than 30 days. One of the most promising delivery vehicles that we have developed to date consists of a polypeptide tube filled with a naltrexone/polypeptide core. Preliminary experiments have shown that these devices may be capable of administering high, constant rates of release for prolonged periods of time. Additional work, however, is required to develop techniques for the preparation of reproducible delivery vehicles.


[Current concept of the role of the hygienic-epidemiologic service under special conditions and of the protection of human environment]. The contemporary role and tasks of hygienic-epidemiological service are the outcome of the significant social, demographic, economic and health changes as a result of general social development. Natural phenomena such as elemental catastrophies, pollution of human environment, permanent threat of breaking out war at different places, all these set special tasks and determine the role of hygienic-epidemiological service. The contemporary role of the hygienic-epidemiological service is to provide scientific approach to the efficient solving of topical hygienic-epidemiological problems originated in newly-made ecological conditions, disturbed balance in nature, and also in changes of social structure of population. The tasks of the hygienic-epidemiological service are classified according to the role and purpose of each institution and according to the territory where the institution is situated, all these depending on situation (regular or special). In regular situation they have the tasks which are concerned with protection of the living environment and they include prevention of the mass deseases, contagious and other. In special situation they are concerned with catastrophies such as floods, earthquakes, breaking out of grow epidemics, occurence of quarantine diseases and other, and their aim is to prevent or at least to lessen the consequences caused by these catastrophies.


[Absenteeism and pathological conditions during pregnancy. Experiences at the Pregnancy Consultation Health Center "Boris Kdrić"]. Looking at numbers we come to the conclusion that out of 1656 pregnant women the majority of 1003 or 60.56% was followed by different pathological conditions, where imminent miscarriage was present in 752 cases or 74.9%. With employed women the percentage of illnesses is 69.58% whereas with the unemployed it is only the half 35.1%. The number of pregnant women who were absent from work was 654 or 76.85% with a total of 66.739 days sick leave, averaging 102 days of sick leave per pregnant woman. At the same time, there were 241 or 24.02% of hospitalised patients with a total of 5.200 hospital days, the average being 26,6 hospital days per hospitalised pregnant woman. The absence from work of pregnant woman is not only of medical nature but is a much complex problem, says the author.


[Axial computerized tomography with high resolution matrix (160 x160)]. The evaluation 1250 patients investigated with computerized tomography reveals a very high detection rate with brain tumours and other intracranial space-occupying lesions. From 246 brain tumours 238 = 96,7 per cent could be diagnosed in the plain scan. After contrast enhancement only one false negative case, a tumour of the corpus callosum, remained. With emergency cases and neuropediatric diseases computerized tomography is the most informative investigation at all. The high definition matrix 160 x 160 in connection with the patient's movements correction has led to further improvement of resolution and visibility of details of intracranial anatomy and pathology in CT-scans.


[Significance and margin of error of echoventriculography in children up to 3 years of age]. Comparative ventricular measurements were made on 43 small children and infants between the ages of 0 and 3 years, the methods used being those of pneumoencephalography and enchoventriculography. The number of cases that could be analyzed was 31. Good agreement of the results for the third ventricle was obtained in 64.5 per cent and for the lateral ventricular index, in 80.6 per cent of the cases. More or less satisfactory agreement of the two methods provides against making a clear decision in favor of one or the other method. Good agreement was observed between the results of repeated echoventriculographic examinations on 31 normal children. From these results as well as from th results of echographic examination on hydrocephalic children it can be concluded that echoventriculography is a reliable method of diagnosis even in those cases in which it is routinely applied to both inpatients and outpatients.


[Brain scintigraphic check-ups during inflammatory CNS diseases to prove absence or presence of brain abscesses and subdural empyemas]. Methods of instrumental diagnosis, which are used to provide evidence for the absence of complications associated with inflammatory processes of the central nervous system and which often give unsatisfactory results in addition to being accompanied by major risks, are compared with long-time scintigraphic reexaminactions which involve no danger to the patient examined by this method. This comparison has been made from the point of view of workers at a department of neuroradiology of a clinic of neurosurgery. Process-like developments into abscesses or empyemata as well as mixed conditions may be readily diagnosed by cerebral scintigraphy so that it is sufficient to make only one single angiographic examination which, if necessary, may be directly followed by neurosurgical intervention.


[Typhoid encefalopathy followed by permanent memory defects (author's transl)]. An 18-years-old girl suddenly became comatose and afterwards presented stlpor, complex hyperkinesias and aphonia lasting 15-20 days. The clinical picture was that of an acute encephalopathy which was found to be due to typhoid fever. Follow-up showed severe permanent memory impairment and some degree of mental deterioration, but no longer evidence of basal ganglia signs.


Cerebral actinomycotic granuloma.

Cerebral actinomycotic granuloma. A rare case of primary cerebral actinomycosis is presented. Pathologically the most important finding is represented by two types of lesions occurring in the same granulomatous mass without abscess formation. The possibility of an associated infection by actinomyces israelii and actinobacillus actinomycetemcomitans or lignieresi is discussed.


[Traumatic intracranial aneurysm].

[Traumatic intracranial aneurysm]. The case of a traumatic aneurysm in the region of the terminal branch of the middle cerebral artery, which was due to parietooccipital fracture of the skull, is reported. The criteria of the traumatic origin of this aneurysm are discussed.


[A case of autoerotic fetishism: psychodynamic evaluation (author's transl)]. This paper presents a psychodynamic evaluation of a case of fetishism, whose main features are the homosexual or autoerotic choice of the fetish (hair), social and occupational maladjustment and occurrence of epysodes of psychotic depression. After a survey of the literature, with particular emphasis on psychoanalitic and psychodynamic approach, the authors discuss the diagnostic problems presented by this case and decide for a diagnosis works as a largely unsuccessful attempt to escape psychotic regression. In contrast with the situation which prevails in most cases of fetishism, there is no satisfactory adjustment to social and occupational life; the mecanism of ego-splitting is found to be impaired. The authors stress the importance of Kohut's recent contributions to the study of the early phases of narcissism for a better understanding of the differential diagnosis between psychosis, character disorders and perversions, Kohut's narcissistic personality disorders and "borderline syndrome".


[Infantile neuro-axonal dystrophy: anatomo clinical study of one case (author's transl)]. A case of Seitelberger's infantile neuroaxonal dystrophy (a rare familial neurologic disease of childhood) is described. The clinical picture is characterized by a progressive deterioration of psychomotor functions leading to flaccid paraplegia with hypotonia of axial muscles, complete involution of language, and total loss of communication with the external world; death due to recurrent unassociated disease occurred at the age of 4 years. Histology showed numerous axonal spheroids mainly in the gray matter of the C.N.S. and plurisystemic degenerations of the motor and sensory systems, of the cerebellum, of the basal ganglia, and of specific sensory system such as the optic and (reported here for the first time) of the olfactory and acoustic systems. In particular, the main histopathological findings included: 1) a characteristic distribution of axonal swellings prevailing in the posterior horn of the spinal cord and in the dorsolateral portions of the medulla oblongata, mainly at the level of the sensory nuclei; 2) demyelinization of the pyramidal tracts and of the ascendings pathways of the sensory system with fibrillar gliosis and myelin breakdown products in some areas (internal capsule, pes pedunculi, VPL thalamic nuclei); 3) severe cerebellar atrophy with almost complete loss of granule and Purkinje cells and marked fibrillary gliosis; 4) presence of enormous amount of sudanophilic lipids in the striatum and pallidum; 5) optic, acoustic and olfactory system degeneration with demyelinization and gliosis at all levels examined and, in particular, sudanophilic lipid deposition in the optic radiations, trigone, and olfactory striae. The discussion emphasized the dying-back type of evolution of the degenerative process insofar as a) the spheroids represent a peculiar alteration of presynaptic endings (as demonstrated by electron microscopy) prevailing at the first sensory neuron, and b) in all systems involved, the degeneration is most marked at distal levels. The striato-pallidal lipophanerosis suggests that the sudanophilic lipids are, here as in other systems, parenchymal degeneration products. On the other hand, there are still many unresolved problems in this rare and complex disease, such as a) the predilection of the lesions for the sensory systems which in our case involved all three special senses; b) the extreme cerebellar atrophy; and c) the etiopathogenetic substrate of the process. All biochemical and histochemical studies have not yielded any results up to the present.


[Effect of alloxan diabetes on the biosynthesis of unsaturated fatty acids from linoleic and arachidonic acids in rat liver and testis (author's transl)]. The effect of alloxan diabetes on the desaturating, elongating, and elongating-desaturating activity of the microsomes of rat liver and testis was studied. Linoleic and arachidonic acids were tested. It was found that in both liver and testis linoleic acid was desaturated to gamma-linolenic acid (18:3) when the conditions were exclusively desaturating. Diabetes deceased the 6-desaturase activity of both tissues. In elongating and desaturating conditions linoleic acid was converted to 18:3, 20:2, 20:3, 20:4, 22:2, 22:5 and 24:2 in both tissues. Alloxan diabetes decreased the activity of the reactions controlled by the 6-desaturase reducing the conversion to 18:3 in both tissues and to 20:4 only in liver. The elongating reactions were not significantly modified. When only elongating conditions were tested, either liver or testis synthetized only 20:2, 22:2 and 24:2 from linoleic acid and 22:4 from arachidonic acid. The elongating activity for both fatty acids was not decreased by diabetes. Therefore, it was proved that alloxan diabetes interferes with the metabolism of linoleic acid in both tissues, decreasing only the desaturation reaction, whereas the elongation of the fatty acid is not reduced.


Role of the autonomic nervous system in the inotropic variations induced by the infusion of angiotensin II. Inotropic effects of angiotensin II were studied in 26 anesthetized dogs with different conditions of autonomic activity. The values of maximal velocity of contraction (Vmax TP) were compared before and 10 minutes after the arterial pressure was elevated by the infusion of the drug. In eight dogs, previously treated with atropine and reserpine, the administration of angiotensin had no effect on mean values of Vmax TP. Nine animals submitted to ganglionic blockade by hexamethonium presented an improvement of myocardial contractility when angiotensin was infused. In nine dogs studied with intact nervous system, infusion of the drug was accompanied by decrease of mean values of the index. It was concluded that the polypeptide exerts no important physiological effects upon myocardial contractility without the mediation of the autonomic nervous system. It was considered that the positive inotropic effect verified in dogs under ganglionic blockade was due to adrenergic hyperactivity induced by angiotensin. The depression of the contractile state observed in intact animals was supposed to be mediated by variations of autonomic nervous system activiity consequent to baroreceptor reflex.


Effect of nonelectrolytes and tonicity on hydrosmotic properties of toad bladder. Water flow was measured gravimetrically in toad bladder sacs incubated in solutions of different ionic content. Substitution of Ringer's solution by isotonic and hypertonic nonelectrolyte solution increases water permeability markedly and depresses the effect of ADH on this structure. This effect is not reversible returning to Ringer after a preincubation for 3 hours in these solutions. It is also found, to a lesser extent, in Ringer made hypertonic with NaCl. Such effects are prominent when nonelectrolyte solutions are applied to the serosal medium; when applied to the mucosal side only, isotonic nonelectrolyte solutions do not induce alterations in water permeability, while the effect of hypertonic solutions is delayed. In nonelectrolyte solutions, the addition of calcium tends to normalize water permeability, but not ADH action. The addition of potassium has no effect on either function. On the other hand, a normal water permeability can be maintained when up to 50% of Ringer's solution is substituted by 400 mM mannitol. These findings indicate that an adequate ionic content of its bathing fluids is necessary for the preservation of the hydrosmotic function of the toad bladder, and that this epithelium appears to be more sensitive to electrolyte depletion via its serosal cell membrane than across the mucosal border.


Influence of testosterone on blood sugar, serum insulin and free fatty acid responses to glucose in normal male dog. The influence of testosterone propionate chronic treatment on blood sugar, serum immunoreactive insulin and free fatty acid levels of male, normal, fasted, unanesthetized dogs, basally and during an intravenous glucose tolerance test has been studied. Control experiments using uninjected or vehicle-injected dogs were also performed. Blood sugar and serum immunoreactive insulin basal levels were not affected by testosterone propionate and/or its vehicle, but serum free fatty acids basal values were increased. The blood sugar curve during the test observed in the dogs in the three conditions differed little; neither glucose space nor glucose "k" value were affected by treatments. Testosterone administration reduced by 50% the serum immunoreactive insulin peak following glucose load, as compared to vehicle-injected controls. Hyperglycemia and hyperinsulinaemia induced a fall in serum free fatty acid levels in control groups, followed by a recovery period at the end of the test. Either the fall or the recovery were more intense in testosterone-treated dogs than in vehicle-injected controls. Results are discussed, emphasizing that testosterone exerts a moderate "diabetogenic" action in male dog, inasmuch as although it intensely promotes lipid mobilization and moderately reduces the insulin response to glucose, fails to induce any glucose intolerance.


Carcinogenicity of 4-hydroxybutyl-butylnitrosamine in Syrian hamsters. 4-Hydroxybutyl-butylnitrosamine (HBBN), a urinary metabolite of dibutylnitrosamine (DBN) was shown to induce respiratory and bile duct tumors as well as carcinomas of the urinary bladder in Syrian golden hamsters. This contrasts with results previously obtained in rats and demonstrates that HBBN is not a specific bladder carcinogen. Bronchogenic tumors, seen in DBN-treated hamsters, were not observed after injection of HBBN.


A chronic study of artificial sweeteners in Syrian golden hamsters. Chronic administration of saccharin and sodium or calcium cyclamates in drinking water to Syrian golden hamsters, up the maximum tolerated dose level, failed to induce an excess of tumors compared to controls; nor were any urinary bladder tumors found.


The carcinogenic effect of dimethylnitrosamine on the Chinese hamster (Cricetulus griseus). Three groups of Chinese hamsters (20 males, 20 females/group) received weekly subcutaneous injections for life of dimethylnitrosamine (DMN) at dose levels 0.20, 0.10 and 0.05 of the LD50. Eighty-two to 100% of the animals developed tumors of vascular origin. The neoplasms were primarily hepatic hemangioendotheliomas and their incidence was unrelated to dose or sex. Although animals in the low dose group received a total dose which was one-third that of the highest dose group, their survival times were only slightly longer.


The macrophage content of some human tumours. The number of macrophages present in 44 surgically removed breast tumours and melanomas was determined by making a cell suspension and measuring the proportion of cells which bound a heterologous anti-macrophage serum and spread rapidly in culture. The macrophage content of the different tumours ranged from 0% to 30%. The malignant tumours which were known to have metastasized, as well as metastatic lesions, all contained less than 10% of macrophages whereas cancers for which there was no evidence of spread at operation had widely varying numbers of macrophages.


Induction of pancreatic neoplasms by 2,2'-dioxopropyl-N-propylnitrosamine. A high incidence of pancreatic duct adenomas and carcinomas were induced in Syrian golden hamsters as early as 13 weeks after chronic administration of 2,2'-dioxopropyl-n-propylnitrosamine (DOPN) at a 10 mg/kg dose. In contrast to another pancreatic carcinogen, 2,2'-dihydroxy-propyl-n-propyl-nitrosamine, DOPN induced no tumors of the upper respiratory tract or kidneys, and only a few neoplasms of the lungs and liver.


Biotransformation of 1-(4-chlorophenyl)-3,3-dimethyltriazene into 3-chloro-4-hydroxyaniline: intramolecular hydroxylation-induced chlorine migration during a catabolic degradation of a chemical carcinogen. Five modified anilines were identified in ethyl acetate extract from hydrolysed urine of rats which had been injected with the carcinogenic 1-(4-chlorophenyl)-3,3-dimethyltriazene. 4-Chloro-2-hydroxyaniline (15.1%) and 4-chloroaniline (5.2%) were the most abundant metabolites arising by in vivo fission of the diazoamino group. The structures and distribution of 4-hydroxyaniline (less than 0.1%), 4-chloro-3-hydroxyaniline (0.7%) and of 3-chloro-4-hydroxyaniline (8.2%) suggest that these metabolites are derived from a common 3,4-epoxy intermediate and arise either by elimination of chlorine, by opening of the epoxide ring or by an intramolecular hydroxylation-induced chlorine migration, respectively.


Ciliary alterations in hamster respiratory tract epithelium after exposure to carcinogens and cigarette smoke. Alterations in the ultrastructure of cilia were found to be one of the initial stages in the development of benzo(a)pyrene induced cancers in the trachea and bronchi of Syrian golden hamsters, as well as in the bronchi from which pulmonary adenocarcinomata originated after European hamsters were treated with N-dibutylnitrosamine. Similar abnormalities of cilia occurred in the respiratory epithelia of Syrian golden hamsters after one year of daily exposure to cigarette smoke.


Radiotherapy in malignant teratomas.

Radiotherapy in malignant teratomas. Twenty-seven patients with malignant teratoma, 19 of which received radiation, are presented and the radiation response analyzed. Radiotherapy seems most effective in the palliation of undifferentiated (embryonal) teratoma of the gonads and sacrococcygeal region in early childhood. It is less effective, yet useful, in undifferentiated gonadal and sacrococcygeal teratomas of older children and adults, but seems of little value in carcinomatous ovarian dermoids and in malignant mediastinal teratomas.


Concentration of biologically active 5-fluorouracil in general circulation during continuous portal infusion in man: a preliminary report. 5-Fluorouracil (5-FU) was administered to 8 patients with malignant liver tumours either by regional portal or general intravenous infusion. During continuous portal infusion of 15 mg 5-FU/kg/24 h, systemic serum-concentrations were generally below 100 ng/ml and no side-effects were seen. Intravenous infusion of the same dose was accompanied by serum-concentrations above 100 ng/ml and bone-marrow depression. This preliminary study indicates that there are better prerequisites for high anti-toumour effect and low frequency of side-effects during portal infusion of 5-FU than during general intravenous administration to patients with liver tumours.


Carcinogenic effects of niridazole.

Carcinogenic effects of niridazole. Swiss mice received chronic treatment with the schistosomacide, niridazole, at 3 dose levels. Tumors were found in several organs, including stomach, lung, manary gland, ovary and bladder. Niridazole is, without doubt, carcinogenic to mice.


Profile analysis of polycyclic aromatic hydrocarbons and metal content in sediment layers of a lake. The question is investigated whether polycyclic aromatic hydrocarbons (PAH) in the annual sediment layers of a lake mainly result from air dust pollution. Sample layers taken from drilling cores going back to 1915 show no significant differences at the forest shore (no buildings) during this period. In contrast, samples taken from a built-up area of the shore (with a highway and a main railway line) show today 5 times the amount of PAH compared with 1915. The same trend is observed in the content of Zn, whereas Pb, Fe, Cr, Ni, Cu and Mn levels are constant. Identification or characterization of PAH was accomplished by comparison of the retention times and mass spectrometry of authentic compounds. Sixty-four PAH are described. The results indicate that the burden of carcinogenic PAH air pollutants has increased 5-fold from 1915-1970.


The binding of dimethylnitrosamine to nucleic acids catalyzed by liver enzymic fractions. The in vitro binding of a metabolite of dimethylnitrosamine (DMNA) to calf thymus DNA catalyzed by a microsomal system from rat liver is reported. The amount ob binding is unaffected by using microsomes induced by 3-methylcholanthrene and/or normal or induced pH 5 enzymes. The microsomal system is also effective in catalyzing covalent binding of the nitroso compound with synthetic polyribonucleotides.


Careers advice to youths with atopic dermatitis. Adolescents who have suffered from atopic dermatitis frequently start training or apprenticeship for unsuitable jobs. The School Medical Serivce and the Youth Employment Service have now been linked with the Employment Medical Advisory Service to afford help to such young people. It is suggested that family doctors and parents be reminded of this with Guidance Notes.


Cross-sensitization patterns in acrylate allergies. Five subjects developed allergic contact dermatitis to one or more acrylate components used in a commercial adhesive tape. Patch testing to acrylic monomers was performed to examine their cross-reaction patterns. Two subjects with broad cross-reactions to acrylates did not react to methyl methacrylate or the alkyl methacrylate that corresponded to the acrylate which induced the sensitization. Methyl methacrylate may not be adequate as a screen for many acrylates used commercially.


Photodermatitis--study of the condition in Kuantan, Malaysia. The high incidence of photodermatitis among dermatological patients prompted the study of the condition. In the 18 months from October 1972 to March 1974, 199 patients presented with light sensitive dermatitis, forming 9% of all new cases seen in the Dermatology Clinic at Kuantan. A detailed history, including that of the use of drugs, proprietary and commercial products, was taken in each patient to determine the aetiology. Where there was suspicion of contact sensitisation, photo-patch tests were done with the suspected agents using natural sunlight as a source of ultra-violet light. The aetiology of photodermatitis in these patients is discussed. The systemic and topical use of medicaments accounts for the largest number of cases. It is inferred that the ready availability to the public of medicaments containing known photosensitisers and the unawareness of light sensitive dermatitis are factors responsible for the large number of patients developing this condition in this tropical climate where there is an abundance of ultra-violet light and where people wear light clothing.


Preventive dermatology: a point of view and a challenge. The implications of "subliminal toxicology a term which has been coined by Dr. L. Goldberg, the editor of Food and Cosmetics Toxicology, are discussed and related to the practice of dermatology. It is argued that only legislation proposed by dermatologists and instituted by Government Authorities can fully protect the public against unnecessary exposure to medicinal and industrial chemicals.


Chlorocresol sensitivity.

Chlorocresol sensitivity. Contact allergic sensitivity may follow the use of chlorocresol incorporated as a preservative into both betamethasone cream and aqueous cream, which are commonly prescribed as a mixture in South Australia. In several cases, although the clinical courses indicated sensitivity to chlorocresol, patch test reactions to this chemical were negative. In these cases positive patch test reactions to chloroxylenol, a chemical closely related to chlorocresol, confirmed the diagnoses.


Aroma chemicals: Reference sources for perfume and flavour ingredients with special reference to cinnamic aldehyde. Bibliographic sources for the complex subject of aroma chemicals are reviewed. The references are not comprehensive but are those which we found to be of value in finding out some of the opportunities for contact with a sensitizing chemical compound, cinnamic aldehyde.


Chamber test versus patch test for epicutaneous testing. A new modification of the chamber test for epicutaneous testing, and improved auxiliary equipment are presented. Compared with the customary patch test, the chamber test in its present form has several remarkable advantages, which are described in detail.


Contact dermatitis from ethanol.

Contact dermatitis from ethanol. A case history of a female patient with allergic contact eczema to ethanol is described. By means of allergological examination, allergies were found to some lower aliphatic alcohols, acetone and some alcoholic drinks.


Nickel allergy and hand eczema.

Nickel allergy and hand eczema. A clinical study was performed in 66 female patients with hand eczema and contact allergy to nickel. They were drawn from a basic material of 165 patients with nickel allergy in which hand eczema occurred in 86 cases (52%). The hand eczema started at an average age of 32 years and it had been preceded by a metal hypersensitivity for an average of 6 years. The eczema was found to be chronic with a mean duration up to the time of examination of 8 years. It was associated with secondary eruptions in half of the cases. The hand eczema showed a low degree of relevance with regard to dependance of occupation or vacation, as well as to exacerbation of the dermatitis after a direct contact with nickel-coated objects. The clinical examination disclosed in 77% a pompholyx, i.e. a symmetric vesicular eruption mainly located on the palms and volar aspects of fingers, and sides of fingers. The eczema often showed a periodic activity, with about 15 annual eruptions in the pompholyx cases. It is concluded that simple external contact with the metal can hardly explain the most common clinical pattern of the hand eczema in nickel allergy.


Cosmetic dermatitis due to a perfume.

Cosmetic dermatitis due to a perfume. A patient with perfume dermatitis was patch-tested to 94 constituents of perfume and was found to have positive reactions to 12 components. An approach with regard to reducing the prevalence of perfume dermatitis is suggested.


Hypersensitivity to hydrogenated lanolin. The number of patients with dermatitis from applied betamethasone-17-valerate ointment, which incorporated hydrogenated lanolin, rapidly increased in Japan after 1971. On patch testing, the incidence of hypersensitivity to hydrogenated lanolin is significantly higher than to anhydrous lanolin at the 1% level, that is 5.20% (26/502) with the former and 1.99% (10/502) with the latter, although sensitivity to both materials is significantly related at the 0.5% level. The possible explanations considered are that  hydrogenated lanolin contains three main allergens: the first is a group of lanolin alcohols which are the common eczematogens in anhydrous lanolin; the second refers to the products of hydrogenation, composed of saturated, easily oxidized, organic substances of low molecular weight; and the third refers to traces of nickel, copper and chromium, as a result of contamination in the hydrogenation process.


Patch testing with perfume ingredients.

Patch testing with perfume ingredients. From the large number of substances used in perfumes it is difficult and tedious to identify the allergen in a specific case of dermatitis. Many substances are both irritants and sensitizers. Based on personal experience, a list has been prepared of potential sensitizers, their concentrations and diluents suitable for patch testing.


New resin allergens in shoe contact dermatitis. Changes in the shoe industry have replaced some of the former allergens and introduced some new ones. In 45 cases of shoe contact dermatitis, the lack of response to known allergens inspired the authors to review present-day industrial shoe manufacture. Two new resin allergens for shoe dermatitis have been found: dodecyl mercapthane and polyurethanes. The first is used in the plastics industry to arrest the polymerization process. We suggest the possibility that a certain number of Neoprene sensitizations could be sensitizations to dodecyl mercapthane contained in it. The recommended solution for patch testing is: 0.1% in toluol.


A patch test closet.

A patch test closet. A way of adapting a treatment room for patch test purposes is described.


2,4-dinitrochlorobenzene sensitization of psoratic patients. Our experiments have shown that cell mediated immunity of psoriatic patients is reduced especially when psoriasis began at an early age and/or when it is "intermittent".


Proteinuria and distribution of fibrinogen split products in various forms of glomerulonephritis. The microelectrophoresis on gradient gels allows differentiation between the different types of proteinuria in 1 h in a one-step procedure. Due to their different molecular weights and forms, fibrinogen split products are separated by this method. The determination of fibrinogen split products not only offers a possibility for dicrimination between the various forms of glomerulonephritis but also offers a possibility for following the course of the disease.


Clinical value of the renal protein clearance determination. The clinical applicability of the determiniation of selectivity in proteinuria in the traditional way is limited. The methodological apparatus has to be relatively completed to get predicative results. Simplified procedures, e.g. determination according to two proteins only, have not proven to be useful in our hands. Screening tests such as disc electrophoresis have to precede the determinations. In special clinical problems, e.g. the question of steroid sensitiveness in morphological forms of glomerulonephritis, which supposedly do not respond to steroids according to the results of prospective studies, or as a parameter in observing the follow up of a disease, protein clearances may be a valuable diagnostic help.


Discelectrophoretic molecualr weight analysis of urinary proteins. A contribution to the clinical diagnostic differentiation and the pathophysiology of proteinuria. The SDS polyacrylamide gelelectrophoresis (SDS-PAA) as used in this study has proven to be an excellent tool to differentiate urinary proteins qualitatively and quantitatively, since the proteins are differentiated exclusively according to their molecular radius. Selectivity was estimated by the ratio transferrin:IgG. Some of the proteins were identified by specific antisera. For clinical use SDS-PAA may distinguish: chronic glomerulonephritis from chronic pyelonephritis; the different diabetic nephropathies; some cases of minimal change nephritis from proliferative and degenerative glomerular diseases; the uncomplicated posttransplantation course from (interstitial) rejection crises and from glomerular diseases (recurrent GN, glomerular rejection disease), and the persisting small glomerular proteinuria after acute glomerulonephritis from proteinurias becoming physiological.


Low molecular weight proteinuria.

Low molecular weight proteinuria. Low molecular weight (LMW) proteinurias vary widely in their microprotein composition. In general, there is little correlation between a given microprotein composition and a defined clinical disease (with the exception of the predominant beta-2-microglobulin in Wilson's disease). Free immunoglobulin light chains are a practically invariable component of, and may be the only detectable LMW protein in, 'tubular' proteinuria. The origins and significance of some frequently occurring urinary LMW proteins are discussed.


Effect of angiotensin on glomerular filtration of albumin. Angiotensin-induced proteinuria was examined at the glomerular-tubular level in rats. Ultra-micro-disc electrophoresis was employed to determine albumin concentration of rat proximal tubular fluid samples under control conditions and during the infusion of 0.15 mug/min X 100 g body weight angiotensin II using micropuncture techniques. Under control conditions proximal tubular albumin concentration was 1.32 +/- 0.79 (SD) mg/100 ml (n = 71). There was no correlation between albumin concentration and (TF/P)-inulin ratio indicating an albumin reabsorption in the proximal tubule parallel to fluid reabsorption under control conditions. During angiotensin infusion using re-collection techniques, there is an average increase of 26 times in tubular albumin concentration, indicating an increase in albumin filtered. There was no change in GFR, SNGFR, transit time, (TF/P)-inulin ratio, an increase in urine flow rate, sodium excretion, protein excretion, mean arterial blood pressure during angiotensin infusion. Since effective glomerular filtration pressure was not increased during angiotensin it is concluded that angiotensin-induced proteinuria is due to an increase in filtered protien mediated by a change in glomerular permeability to proteins.


Proteinuria in pigs with experimentally induced renal damage. Proteinuria was studied experimentally in pigs with renal damage induced by maleic acid, potassium dichromate and by 5/6 nephrectomy. The methods used were: analysis of total protein, immunochemical quantitation of a porcine low molecular weight (alpha-PLMW) protein, agarose gel electrophoresis, and gel chromatography of concentrated urine samples. The urinary clearance of the alpha-PLMW protein in normal pigs was considerably higher than LMW protein clearance in normal man. No increase was seen after surgery. The induction of proximal tubular damage resulted in an increased excretion of, above all, high molecular weight proteins (greater than or equal to albumin) but also of low molecular weight proteins. The highest increase in alpha-PLMW clearance was seen immediately after 5/6 nephrectomy, and the increased alpha-PLMW excretion in pigs with proximal tubular dysfunction was better correlated to creatinine clearance than to the degree of phosphaturia or glucosuria. The results suggest different renal handling of plasma proteins in pigs and humans.


Functional and morphological study on the onset of proteinuria in experimental diabetes mellitus. In latent hereditary diabetes mellitus increased protein excretion has been found in male diabetic mice compared to controls. This proteinuria is partly due to an increased excretion of higher molecular weight proteins, which could be identified as deriving from plasma. The suggested glomerular proteinuria has been verified by an increase in the renal excretion of high molecular weight PVP. No changes in GFR occurred in this early stage of diabetic glomerulopathy. No changes in morphology could be detected, suggesting some changes in the biochemical membrane structure that cause the findings of increased permeability of the diabetic basement membrane for plasma proteins.


The fine structure of the glomeruli as revealed by freeze-fracturing. Isolated glomeruli of the rat kidney were investigated using the freeze-fracture method. The observations were consistent with those made on thin sections. Only exceptionally components of zonulae occludentes were seen between the capillary endothelial cells. The split membrane of mesangial cells revealed aspects of gap junctions.


The ultrastructural basis of permeability to proteins in normal and nephrotic glomeruli. Electron microscopic and micropuncture studies using ferritin as a tracer. Following microinjection of ferritin into urinary space of the rat renal glomerulus in vivo, permeability of the visceral epithelial wall was examined with electron microscope. Results indicated that in normal glomeruli ferritin molecules can be retained by the slit diaphragmata of the eithelial cells; this suggests a barrier function of the slit diaphragmata. The nephrotic glomeruli, observations suggested a channel-like pathway to proteins penetrating the epithelial layer. The channel is formed by only one single cell and therefore, the term 'percellular channel' is proposed for that formation.


The role of membrane parameters and of filtration pressure in the determination of the shape of the polyvinylpyrrolidone sieving curve. An in vitro and in vivo study. The theoretical equations describing the transport of a solute across a porous membrane predict that the shape of the sieving curve (ratio of solute concentrations in filtrate and filtrand versus molecular size) depends not only on the porosity of the membrane but also on the filtration pressure. This has been verified experimentally on an artificial membrane (Amicon XM-50). This model has been used to interpret the effects of angiotensin II on the shape of the glomerular 125I PVP sieving curve. The mean effective filtration pressure is increased by the intrarenal perfusion of angiotensin II.


Early lesions of the nephron in paraproteinemia. Electron microscopy of renal biopsies in eight patients with paraproteinemia (six multiple myeloma, one Waldenström's disease, one idiopathic paraproteinemia) and without impairment of renal function demonstrates an increase of mesangial matrix and thickening of the lamina rara interna of the basement membrane in the glomerulus by fibrillar material without periodicity. These lesions are thought to exhibit precursors of amyloid deposits. The proximal tubules show signs of increased cellular activity probably because of handling an increased protein load. In the basement membranes there are proteins with a fibrillar structure and definite periodicity. These are suggested to be consistent with large aggregates of immunoglobulin fragments.


Interstitial nephritis with concomitant uveitis. Report of two cases. In two female pediatric cases of uveitis with proteinuria and glycosuria, kidney biopsy demonstrated the presence of interstitial nephritis. Peripheral leukocytes responded positively in vitro in the leukocyte migration inhibition test with renal tubular antigen, thus suggesting the possibility that the patients' lymphocytes infiltrating into the renal parenchyma might be sensitized against the renal tubular antigen. Urinary beta2-microglobulin was also demonstrable and its levels correlated fairly well with the clinical course of uveitis in both cases.


Antibody avidity for native DNA in lupus nephritis. To study the participation of the antibody avidity in the pathogenesis of lupus nephritis, we measured the antibody avidity to native DNA by the method of Minden and Farr (14) in patients with SLE. The avidity to native DNA was almost less than 40%. The avidity and the histological activity of lupus nephritis were well correlated; the antibody avidity of the active-group sera was higher than that of the inactive-group sera and the group without nephritis. In the group with antibodies of relatively high avidity, the complexes were deposited mainly in the subendothelial side of GBM and in the mesangium. On the other hand, in the group with low-avidity antibodies, the complexes were localized in the subepithelial side of GBM. On investigating the quality of the complexes, we noted that the complexes composed of high-avidity antibodies prepared in vitro were larger than those of low avidity and the former were larger than 19S. If the native-DNA-anti-native DNA system is the mechanism basic to lupus nephritis, the differences in immune response of the host, namely the degree of antibody avidity may greatly affect complex formation and influence the histological activity and nephritogenicity of lupus nephritis.


Program versus time: length of stay patterns in alcoholism. Various studies suggest that, in predicting length of stay (LOS), hospital policy, demographic or pathognomonic factors may be more important than type of treatment given. This investigation compared cumulative discharge curves for 6 sub-groups of male alcoholics (N = 627): Voluntary versus Committed; Married versus Unmarried; and Age 45 and Under versus Over 45. Actual LOS curves were contrasted with a theoretical curve, representing discharge as a simple function of elapsed time. Sample LOS statistics were also compared with data from an NIMH, nationwide survey. Results showed no significant cumulative LOS differences among the alcoholic sub-groups. During the first week of the program, release rates for all sub-groups greatly exceeded theoretical, then paralleled the theoretical curve until the 10th week of treatment. After the first week of treatment, patients were discharged at a rate similar to that expected if leaving were a simple effect of time elapsed -- no program effect on LOS was evident. Comparing the state hospital with the nationwide sample, significantly more state hospital patients left treatment during the first week; but local and national cumulative percentages for 30 days, 60 days and over 60 days were identical.


Life change, disease, perception and heroin addiction. This is a pilot study of heroin addicts using recently developed tests which measure life change, perception of life change and perception of disease. The data indicate that heroin addicts maintain very high levels of life change while having normal or augmented perception of the impact of life change and of the seriousness of their disease. It is postulated that treatment techniques aimed at increasing understanding and insight may be countertherapeutic for these patients in that it gives them additional methods of manipulating others and tends to perpetuate the addiction life reducing life change in a setting of tight behavioral control where behavioral substitutes to heroin use are offered.


Psychosocial effects of longterm cannabis use in India. A study of fifty heavy users and controls. Fifty cases of heavy cannabis users in India (25 smokers of charas and 25 drinkers of bhang) were studied for their physical and mental health and compared with 25 non-user controls. The average duration of cannabis use was more than 10 years with an estimated average consumption of about 150 mg of THC daily. Physical health and nutrition were relatively poor in users and there were more respiratory complaints. No case of definite psychosis related to the use of cannabis was found in the series, though minor neurotic complaints were present in all groups. In the social sphere cannabis users gave more often a history of poor work record, family maladjustment and episodes of violent behaviour.


Conditioning of narcotic abstinence symptoms in human subjects. Clinical evidence suggests the possibility of conditioning of narcotic abstinence symptoms. Addicts report subjective and objective signs of withdrawal/craving when exposed to certain stimuli. This may partially explain the high rate of relapse to drug seeking behavior when treated addicts return to their home environment. Conditioning of narcotic abstinence symptoms was produced experimentally in five of eight volunteer subjects. Brief naloxone precipitated abstinence was the unconditioned response. The conditioned stimulus was a tone and odor. After an average of seven training trials, the tone and odor produced a conditioned abstinence response. The conditioned response consisted of subjective components (feelings of sickness, nausea, cramps, craving) and objective components (yawning, tearing, rhinorrhea, irregular respiration and transiently increased blood pressure). These laboratory findings support the anecdotal evidence regarding the existence of conditioned abstinence phenomena.


Chronic cannabis takers: some temperamental characteristics. Two standardized interviewing schedules have been administered to 850 chronic cannabis takers and 839 nontakers, all males, ranging in age between 15 and about 50 years. The present paper is concentrated on presenting data pertaining to temperamental characteristics prevailing among takers. Some characteristics were found not to differentiate between takers and control. This was true regarding two basic personality traits, acquiescence and 'emotional lability'; three situational characteristics, aggressiveness, sense of responsibility in matters of money expenditure and the degree on attaches to one's promises in work situations; one point concerning family background, viz, death of either parent; and lastly two aspects of the complex role fathers play in the lives of their children, which is 'absence--presence' and 'showing interest in the children's future'. The two groups differed on another collection of attributes. Compared with controls, cannabis takers were low on submissiveness, impulsiveness and negativism, but at the same time showed callousness or indifference towards the presence of others. Taker were, also, low on quarrelsomeness and high on selflessness but at the same time expressed more inclination towards dishonesty. Instability in the orientation family prevailed among takers who related more incidents of separation and/or divorce between parents, and of the existence of step-parents. Takers had, moreover, spoiling fathers.


Dimensions of marihuana experience.

Dimensions of marihuana experience. A questionnaire concerned with expected effects of marihuana was completed by 182 persons with histories of social use of the drug. The majority of subjects were relatively infrequent users. Reported experiences from use were greater among the most frequent users, and included some unpleasant effects. Five factors of marihuana expectations were derived pertaining to: functional interference, euphoria, psychological distress, perceptual alteration and psychotomimetic effects. These results clearly suggest that the marihuana effect is multidimensional and that the profile of response differs from one individual to another. Studies of marihuana effects under various experimental conditions should take the nature of the effects as well as their magnitudes into consideration. The results also suggest that the marihuana questionnaire can be used to determine in advance the expectations of individual experimental subjects and thus to control for effects of set on responses in experimental studies of marihuana. One should thus be able to settle the question of the extent to which different expectations about marihuana produce variability in responses of subjects in experimental studies of effects of the drug.


Oral drug dependence: intellectual characteristics of patients receiving  treatment at a London drug dependence unit. Patients dependent upon orally abused drugs have received less research attention than have other drug dependent groups. This paper reports a study of the intellectual characteristics of such individuals. Fifty-eight subjects completed the Mill Hill and Progressive Matrices IQ tests, and the Wechsler Tests (WAIS or WISC) were also administered to 36 of these. The results which were analysed separately for males and females show scores which are within the normal range. One unusual finding, that female oral drug dependents have a deficient performance IQ score, is discussed, but no satisfactory explanation for this available and further research of this issue is suggested. The implications of the results for clinical psychological assessment and rehabilitation of drug abusers are discussed.


Liaison psychiatry on a coronary care unit. This paper presents several of the author's experiences as a liaison psychiatrist on coronary care units. Technological and pharmacological advancements over the past decade have made major contributions toward reducing the psychological stress of patients admitted to these units. The psychiatrist's main liaison role is in assisting with patient education and rehabilitation efforts. Examples are given of a patient education program and reasons for systematic evaluations for such programs. The psychiatrist also can aid in patient rehabilitation efforts carried out in the outpatient clinic. Results are given from an experimental program of group therapy as an adjunct to the treatment of post-myocardial infarction patients. Finally, two case histories are briefly presented which exemplify subjects' serum uric acid and serum cholesterol variability associated with psychological stresses encountered during their hospitalization following a myocardial infarction.


Plasma cortisol and growth hormone responses to intravenous characterization. Plasma cortisol and growth hormone (HGH) responses to venous catheterization were studied in 29 volunteer subjects. Repeat characterizations were performed in 18 individuals. Mean plasma cortisol levels were significantly elevated during the first hour of the initial catheterization experience. Morning and afternoon levels of cortisol were not distinguishable during the first catheterization, but PM levels were significantly lower than AM levels during the second catheterization experience. Growth hormone responses were much more variable than cortisol and were distributed logarithmically. Growth hormone responses tended to parallel cortisol responses during the first catheterization experience. Individuals who listed more symptoms in response to venipuncture and catheterization after finishing their first catheterization had significantly higher cortisol and growth hormone levels during this experience. These data suggest a definite endocrine adaptation to catheterization by the second or third hour of the experience.