Alcohol: a description and comparison of recent scientific vs. public knowledge.

Sought to survey alcohol research since the "rediscovery" of fetal alcohol syndrome (FAS) and to compare recent scientific knowledge with that of the general public. Research was found to concentrate on searching for explanations of alcohol use and/or abuse and on several areas of biological morphogenesis. Significant documentation exists for FAS and validates both physiological and developmental attributes. As an index of public knowledge, an alcohol questionnaire was administered to 190 high-school, college, and graduate students. True-false items represented statements relative to the nature, etiology, effects, variables, and consequences of alcohol use/abuse. The composite mean of less than 60% correct suggested significant misinformation and misconceptions about alcohol. A summary of the most dramatic informational deficits was presented. There was a positive, though minimal, relationship between alcohol knowledge and education, and both sex and race differences were noted.


Brief form of the Competency Screening Test for mental competence to stand trial.

Investigated a brief 5-item version of the Competency Screening Test (a sentence completion test of mental competence to stand trial) for its relationship to the complete 22-item test, and for its power to predict the mental competency findings of a comprehensive Clinical Psychiatric Evaluation conducted by a forensic psychiatrist. Ss were 21 female patients serially examined in a forensic psychiatric service for mental competence to stand trial. Tests were individually administered. The brief version of Competency Screening Test was highly correlated, with the full test Rho = .92. It classified 17 (of 21) patients in direct agreement with the results of the Clinical Psychiatric Evaluation. It showed a theoretical, but small relationship with verbal intelligence for this group. The 5-item form seems applicable for preliminary competency screening evaluation.


A psychometric and behavioral comparison of delinquents who were abused as children with their non-abused peers.

Investigated responses of abused and non-abused juvenile delinquents to Bell's Adjustment Inventory and Gough's California Psychological Inventory, and information with regard to several related behavioral measures. The Ss were 52 institutionalized adolescent males and females. Results indicated that the abused Ss scored significantly higher than the non-abused group on the Home Adjustment Scale (indicative of poorer adjustment) and significantly lower than the non-abused group on the Flexibility, Tolerance, and Socialization Scales. Subsequent analysis showed a significant interaction effect on the behavioral measure with regard to the number of runaway attempts; abused males made significantly more attempts than abused females and non-abused males and females.


Attitudes toward women and orientation to seeking professional psychological help.

Studied the relationship between attitudes toward the rights and proper roles of women in society and attitudes toward seeking professional help for emotional problems in a sample of 80 college students. Liberal attitudes toward women were associated with positive help-seeking attitudes in men and women, contrary to predictions based on prior research and on feminist criticisms of the mental health profession. No sex difference in attitudes toward help-seeking was found; however, the attitudes toward women variable appears to be at least as good a predictor of actual help-seeking as a person's attitude toward help-seeking, within the sample studied.


Patients' understanding of prescribed drugs.

Patients must understand their physicians' recommendations if they are to follow medical advice. This study assesses the degree to which patients and physicians share basic information about medications. Patients who regularly attended the medical clinics of a large, urban teaching hospital were asked to recall the identity, purpose, and dose schedule of medications that were prescribed for them. Patients' responses were compared to the medications actually prescribed by their physicians. Patients identified 90% of medications prescribed during the visits, knew the purpose 83%, and the correct dose schedule for 80%. Only 58% of patients knew the dosage schedule of all their medications correctly. Patients' knowledge of prescribed drugs was inversely related to the number of their medical problems and the number of medications prescribed. Lack of effective communication between physicians and patients about medications may be an important reason why patients do not follow medical advice.


Diagnosis of acute myocardial infarction in the emergency room: a prospective assessment of clinical decision making and the usefulness of immediate cardiac enzyme determination.

This study evaluates (a) the ability of house staff physicians to diagnose acute myocardial infarction (AMI) in patients with chest pain and (b) the usefulness of immediate ("stat") creatine kinase determinations in aiding the decision to hospitalize patients with chest pain. Of 80 emergency room patients with chest pain, 34 were admitted to an intensive care unit and 46 were either discharged or admitted to a general medical unit. Of the 34 patients admitted to intensive care, 11 fulfilled criteria for AMI. Of the 46 who were not admitted, two met criteria for AMI: one had abnormal initial enzyme values; the other had normal initial values but diagnostic 48-hour values. Both had abnormal electrocardiograms. On the other hand, 11 patients who were not admitted had elevated initial enzyme values but did not have myocardial infarctions and might have been admitted inappropriately on the basis of their initial enzyme values. Five patients who were admitted had normal initial values but did develop infarctions and might have been sent home inappropriately on the basis of initial enzymes values. We conclude that: (a) physicians discharged 2 of 13 patients with AMI drawn from a population of 80 with chest pain and (b) the availability of stat cardiac enzymes could have prevented the discharge of only 1 patient and may have caused the inappropriate admission of 11 and discharge of 5 patients.


Rural access to regular source of medical care.

Household survey data from an adult rural west Texas population were used to investigate the role of demographic, economic, attitudinal, and need-related factors in (a) explaining physician contact and volume of physician visits and (b) differentiating between those individuals who have and those who do not have a regular source of medical care. Fifty-two percent of the variance in visit volume were explained; compared with the findings reported in similar studies, alignment with a regular source of care was more closely associated with visit volume and physician contact. Although the variance explained in having a regular source was only about 18%, the findings suggest that factors determining alignment with a regular source may differ considerably from those determining other dimensions of utilization. Furthermore, patterns evident across several dimensions in rural populations may be quite different from those exhibited in other populations.


"Positive programming": the use of data in planning for the rural health initiative.

A data-driven approach to allocating federal resources for primary care systems in rural areas is presented. This approach was developed and implemented by the Public Health Service (PHS) when it undertook its Rural Health Initiative Program. Nationally available small-area data were used to identify "priority counties" and PHS regional office staffs were asked to take an active role in developing rural health system projects in these counties. This approach was adopted to avoid the problem of the many communities eligible for and in need of funds that do not get them because they lack the organization and knowledgeable personnel required to develop a project grant application. The paper defines and discusses the "positive programming" approach (believed to be the first attempt to allocate federal health service delivery resources actively on the basis of small-area data), discusses the present shortcomings of the approach (including data limitations), and presents the results of implementing the approach. In the first year, 23% of the priority counties and 13% of the nonpriority counties were served, while in the second year 39% of the priority counties and 17% of the nonpriority counties were served. The substantial increase in the percentage of priority counties served reflects the effectiveness of the positive programming effort.


Changes in patient perceptions toward a family practice: a case study.

This paper presents the results of an evaluation of a family practice that focuses on changes in patient perceptions over five years. The evaluation includes an analysis of patient attitudes as well as behavior. Patient attitudes are measured by means of a personal interview and behavior is analyzed by creation of a Family Utilization Index. Significant changes are noted in the areas of both reported and actual utilization, with fewer changes in the areas relating to patients' perceptions of health and illness or in attitudes toward either the model of family practice of the specific site of obtaining care. This is not a definitive model for evaluation of family practice, but it is one of the few empirical studies available and suggests the need for more documentation of the effectiveness of family practice as a model for delivering primary care services.


Development of neocortical circuitry: histochemical localization of acetylcholinesterase in relation to the cell layers of rat somatosensory cortex.

Acetylcholinesterase (AchE) was histochemically localized in neocortex cerebri of newborn to 1-week-old rats. At birth AchE-dependent staining is limited to scattered somata (Cajal-Retzius cells) in the marginal zone and a few fibers and somata in primordial layer VI. By the end of the first week, neuronal elements are relatively well stained in particular cell laminae, giving the appearance of three horizontal AchE-rich "bands" which alternate with AchE-poor laminae. The subpial band (layer I) is a narrow tangential zone of intensely staining fibers and scattered somata. The mid-cortical band contains an AchE-positive fiber plexus (primordial layer IV) and numerous stained somata (pyramids of primordial layer V). In layer IV of the SmI region, intermittent foci of staining are noted which overlap the barrels' distribution in the barrel field. The deep cortical band (bottom of primordial layer VI) consists of numerous stained somata (Martinotti cells). It is concluded that there is a laminar pattern of acetylcholinesterase-dependent staining in postnatal rat somatosensory cortex, and that the laminar pattern bears a consistent spatial relation both to the cell layers and to the depths of high synapse density in immature cortex.


Quantitative studies of retinal ganglion cells in a turtle, Pseudemys scripta elegans. I. Number and distribution of ganglion cells.

Multiple pathways for the transmission of visual information from retina to brain have been described in reptiles, but little is known about their functional organization. These parallel channels begin at the retina, and we have therefore begun to study the functional organization of retinal ganglion cells in the turtle, Pseudemys scripta elegans. This paper describes the numbers and distribution of cells in the ganglion cell layer. To develop criteria for the identification of ganglion cells, we labelled them retrogradely by applying horseradish peroxidase (HRP) to the optic nerve. Ganglion cells were found to vary substantially in size and cytology. In low density areas of the retina, ganglion cells typically have cytoplasm with well developed Nissl substance, a distinct, pale nucleus, and a large nucleolus. In high density areas of retina, ganglion cells are small, densely staining, and gliaform. The average minimum proportion of ganglion cells in the ganglion cell layer is 75--80% of total profiles. No more than five or six percent of profiles in the ganglion cell layer are neurons which do not send an axon into the optic nerve (displaced amacrine cells or intraretinal association cells). The ganglion cell layer of P. s. elegans can be divided into a number of regions on the basis of cell density. Isodensity maps constructed from Nissl-stained, wholemounted retinas indicate that there is an elongated region of high ganglion cell density, the visual streak, which extends from nasal to temporal retina and is oriented such that its long axis follows the horizontal axis of the eye. The streak is aligned with the externally visible iris line. Seen in cross-section, the ganglion cell layer in the streak is three to four cells thick; in nonstreak retina, ganglion cells form only a monolayer of somas. Ganglion cell density drops off more rapidly above the streak than below it. The temporal arm of the streak is both shorter and broader than the nasal arm. There is a peak in ganglion cell density at the midpoint of the streak, in the approximate center of the retina. Here, ganglion cell densities exceed 20,000 cells mm-2. The total number of ganglion cells in the retina is 350,000--390,000.


Efferent projections of the dorsal ventricular ridge and the striatum in the Tegu lizard. Tupinambis nigropunctatus.

A H3 proline-leucine mixture was injected into the dorsal ventricular ridge (DVR) and striatum of the Tegu lizard in order to determine their efferent projections. The brains were processed according to standard radioautographic technique, and counterstained with cresyl violet. DVR projections were generally restricted to the telencephalon, while striatal projections were limited to diencephalic and mesencephalic structures. Thus the anterior DVR projects ipsilaterally to nuclei sphericus and lateralis amygdalae, striatum (ipsilateral and contralateral) ventromedial nucleus of the hypothalamus, nucleus accumbens, anterior olfactory nucleus, nucleus of the lateral olfactory tract and lateral pallium. Posterior DVR projections enter ipsilateral anterior olfactory nucleus, lateral and interstitial amygdalar nuclei, olfactory tubercle and bulb, nucleus of the lateral olfactory tract and a zone surrounding the ventromedial hypothalamic nucleus. Labeled axons from striatal injections pass caudally in the lateral forebrain bundle to enter (via dorsal peduncle) nuclei dorsomedialis, medialis posterior, entopeduncularis anterior, and a zone surrounding nucleus rotundus. Others join the ventral peduncle of LFB and enter ventromedial nucleus (thalami), while the remaining fibers continue caudally in the ventral peduncle to the mesencephalic prerubral field, central gray, substantia nigra, nucleus intercollicularis, reticular formation and pretectal nucleus posterodorsalis. These results are discussed in relation to the changing notions regarding terminology, classification and functions of dorsl ventricular ridge and striatum.


Localization of vagal cardioinhibitory preganglionic neurons with rat brain stem.

In chloralose-urethane anesthetized spinal rats, electrical stimulation of systematically chosen points over the entire caudal brain stem area was carried out to explore the site(s) responsible for vagally mediated bradycardia. A dorsomedial locus including the nucleus dorsalis and the adjacent structures, the nucleus tractus solitarius, the nucleus commissuralis and the area postrema, and a ventrolateral locus around the nucleus ambiguus were found to elicit bradycardia with low threshold and high responsiveness. In another series of experiments, horseradish peroxidase (HRP) was iontophoretically administered through a glass capillary microelectrode into the identified cardiac branch of the vagus nerve of rats in order to localize more precisely the cells of origin of vagal cardioinhibitory fibers within the brain stem. Distribution of the HRP-labeled cells was not confined to one area, but these cells were found within the nucleus dorsalis, the reticular formation surrounding the nucleus ambiguus and an intermediary zone between the two nuclei. Such a pattern of distribution of vagal cardioinhibitory preganglionic cells is discussed in relation to phylogenetic and ontogenetic development of the vagal motor nuclei.


Neuronal populations of the human periaqueductal gray, nucleus lateralis.

The present communication is part of a study designed to explore the neuronal populations and the organization of the periaqueductal gray matter(PAG). The data presented here deals exclusively with the nucleus lateralis (PAGL) and is based upon Golgi studies of 14 human brainstems. In this investigation 400 cells were measured and classified. Axonal origin, axonal and dendritic ramifications, and spine population were studied. The data demonstrate that morphologically the PAGL is comprised of a heterogeneous population of small and medium sized neurons consisting of three major cell types: vertical cells, stellate cells, and horizontal cells. Observations of axonal pathways and dendritic ramifications describes an anatomical substrate for direct communication between the PAGL and the superior colliculus, which includes a system of axonal projections from the PAGL into the superior colliculus. The cells of origin of this pathway have been identified as being primarily vertical and stellate cells. It is anticipated that these data will provide the groundwork for further detailed study of PAGL neurons and for identifying specific neuronal populations with their functional roles.


Ruffed cell: a new type of neuron with a distinctive initial unmyelinated portion of the axon in the olfactory bulb of the goldfish (Carassius auratus) I. Golgi impregnation and serial thin sectioning studies.

A new type of neuron was recognized in the olfactory bulb of the goldfish (Carassius auratus) by means of light and high voltage electron microscopy of Golgi-impregnated material, combined Golgi-electron microscopy, and electron microscopy of serial thin sections. The neuron is located in the layer between the olfactory nerve layer and the anterior olfactory nucleus. It has a spherical cell body, about 10--20 microns in diameter, and several dendrites which form a spherical dendritic field, about 70--100 microns in diameter, in the vicinity of the cell body. The most remarkable structural feature of this neuron is that its initial unmyelinated portion of the axon (IP) has elaborate protrusions with many synapses. The IP can be divided into three parts, parts 1, 2 and 3, based on its structural features. Part 1 is the initial part of the IP, about 20--40 microns in length. Many elaborate protrusions arise from the shaft and intermingle with one another to constitute a spherical field, about 20--40 microns in diameter, around the shaft. Part 2 is the middle part of the IP, about 10--20 microns in length. There are several collateral-like protrusions, which are scattered along the shaft and extended laterally about 5--15 microns. Part 3 is the last part of the IP, and is cylindrical without protrusions. The length of part 3 varies from 20 to more than 100 microns. The axon acquires a myelin sheath at distance of 70--250 microns from its origin. Protrusions make synaptic contacts mainly with granule cell dendrites. Some of them are of the reciprocal type. Protrusion are presynaptic in asymmetrical synapses, and postsynaptic in symmetrical synapses with granule cell dendrites. The shaft of the IP also has synapses similar to those on protrusions. The neuron described is a new type of neuron in the vertebrate central nervous system. We propose for it the name "ruffed cell."


Cerebellar corticonuclear fibers of the dorsal culminate lobule (anterior lobe--lobule V) in a prosimian primate, Galago senegalensis.

The organization of corticonuclear fibers from lobule V of the anterior lobe of the lesser bushbaby, Galago senegalensis, was studied utilizing the Fink and Heimer ('67) method. Corticonuclear fibers of lobule V are ipsilateral, topographically arranged in their trajectory into the deep cerebellar nuclei and organized into six identifiable zones. No evidence is seen to support the contention that these fibers may project diffusely into the cerebellar nuclei, either in a rostro-caudal or medio-lateral sequence, or that they may project to any of the contralateral nuclei. Lesions in lateral lobule V cortex produce degeneration in rostroventral magnocellular NL. No debris is seen in pavicellular NL and no degenerated axons enter the NIA, NIP or NM. The terminal field in the NL is roughly pyramid shaped with the base being located at the periphery of the nucleus and the apex directed toward the hilus. Based on the totality of its efferent projections the intermediate cortex (IC) of lobule V is a relatively wide region which is divisible into three separate areas. Lateral portions of the IC project heavily into the lateral NIA and send a sparse number of fibers into the NIP. The middle area of the IC sends fibers almost exclusively to a bifid terminal field located in the NIP. From this area of cortex no degenerated fibers enter either the NL or NM and only extremely sparse amounts od debris are seen in rostrolateral NIA. Following damage to medial regions of IC degeneration is seen primarily in medial portions of the NIA and in the juxtarestiform body, if the lesion involves the lateral portions of the vermal cortex. These three regions of the IC, identified here based on the arrangement of their corticonuclear fibers represent the cortical correlates of compartments C1, C2 and C3 (of Voogd, '69). Lesions involving the lateral aspect of the vermal cortex produce degeneration in the vestibular complex, primarily its lateral nucleus, and in the NIP. These observations may represent a subdivision of this area, a fact previously reported in the cat (Oscarsson and Sjölund, '77a). The medial portions of the vermal cortex project primarily to rostrodorsal NM. The results of this study provide data concerning the arrangement of zones in anterior lobe cortex of a primate. Due to the fact that differential projections into magnocellular versus parvicellular NL were not seen, the lateral cortex is designated only as zone D. The IC contains, from lateral to medial, zones C3, C2 and C1. The lateral edge of the vermal cortex is designated zone B, although it is recognized that subdivisions of this area may exist (Oscarsson and Sjölund, '77a) while zone A is the more medial area of vermal cortex. These zone designations represent those portions of cortex which overlie previously identified compartments (Voogd, '69) in the subcortical white matter.


Somatostatin neurons and their projections in dog diencephalon.

Immunocytochemical localization of the tetradecapeptide somatostatin was performed in dog brain using the unlabeled antibody enzyme method. A large population of immunoreactive neurons was seen in the periventricular areas of the preoptic area and anterior hypothalamus. This field of neurons extended into the paraventricular nucleus, arcuate nucleus and tuberal areas surrounding the ventromedial nuclei. Fibers from the periventricular somatostatin cells projected into the median eminence, the third ventricle, the pars nervosa of the hypophysis, the organum vasculosum of the lamina terminalis, the medial preoptic area and the interstitial nucleus of the stria terminalis. The tuberal cells projected to the ventromedial nucleus and the cells of the arcuate nucleus terminated within the arcuate nucleus as well as within the contact zone of the median eminence. These findings suggest that somatostatin can exert hormonal effects via the vasculature or the cerebrospinal fluid, or transmitter and/or neuromodulatory effects via contacts with other neurons.


Primary afferent axons in the tract of Lissauer in the cat.

The present study is concerned with the numbers of primary afferent axons in the tract of Lissauer in the cat. The data show that approximately 27% of the axons in mid-thoracic and lumbosacral tracts are primary afferent fibers from the segment in question and another 20% of the axons are primary afferent fibers that come from nearby segments. In addition the data show that approximately 80% of the axons in the tract are unmyelinated and that there is a slightly higher proportion of unmyelinated as opposed to myelinated primary afferents. There is also a higher proportion of primary afferents in the medial as opposed to lateral parts of the tract, but there are significant numbers of primary afferents in lateral parts of the tract. Thus it seems clear that the tract contains more primary afferent fibers than was previously believed and if these data are confirmed, the conclusions will have a bearing on considerations of the primary afferent input into the dorsal horn.


The specificity of innervation of regenerating motor neurons in the cockroach.

The pattern of neuromuscular connections of cockroach motor neurons regenerating to an intact mesothoracic leg after crushing nerve 5 has been investigated. While a number of anatomically identified motor neurons reestablished functional connections with their correct target muscles, some of the same and other motor neurons were found to functionally innervate inappropriate muscles. Muscles, and in some cases individual fibres, were often simultaneously innervated by both correct and foreign motor neurons. The frequency of innervation errors decreased with increasing post-operative times, although some errors persisted to the latest stages examined (227 days).


An electronmicroscopic analysis of the optic nerve in the golden hamster.

The electronmicroscopic examination of sections taken from the hamster's optic nerve 5 mm behind the globe indicated that the nerve contains 110,165 +/- 4,177 (p less than 0.05) fibres of which 96.4% are myelinated. The fibre diameter distribution is unimodal with a peak at 1.2 micrometer and axon diameters ranging from 0.20 micrometer to 3.93 micrometer. Fibres of all sizes are distributed uniformly throughout the cross section of the nerve. The thickness of the myelin sheath surrounding a given axon is highly (0.80) correlated with axonal diameter and the degree of myelination for a fibre of a given size is nearly constant throughout the nerve's cross section. In nerve sections taken just posterior to the globe most (64%) of the fibres counted are unmyelinated and the percentage of unmyelinated axons is highest near the peripheral boundary of the nerve. The process of myelination is essentially complete in sections taken 3.5 mm behind the eye. These differences in the myelination of the proximal and distal nerve most probably account for the discrepancy between the results reported here and those provided by a previous study (Tiao and Blakemore, '76) concerned with the structure of the optic nerve in this species.


Escape performance after inescapable shock in selectively bred lines of mice: response maintenance and catecholamine activity.

The effects of inescapable shock on subsequent escape performance and shock-elicited activity were examined in six lines of mice selectively bred for differences in general locomotor activity. The line differences in locomotor activity were found to be unrelated to the differences observed on shock-elicited activity. However, escape performance following exposure to inescapable shock was predictable from the levels of shock-elicited activity. Those lines that displayed the greatest decline in motor activity during shock likewise displayed the most pronounced escape deficits. The line differences in escape performance induced by inescapable shock could be mimicked by treatment with a tyrosine hydroxylase inhibitor, alpha-methyl-p-tyrosine. As predicted, the lines that displayed the least interference after tyrosine hydroxylase inhibition exhibited the smallest reduction in levels of catecholamines. The effects on escape performance following inescapable shock are interpreted in terms of the role of response maintenance deficits produced by catecholamine depletion.


Alcohol intake in selected lines of mice: importance of sex and genotype.

Mice selected by McClearn and Kakihana for differences in ethanol-induced sleep time were used as subjects. In Experiment 1, mice from the long-sleep (LS) and short-sleep (SS) lines were offered a choice of water or solution GS consisting of 3% glucose and .16% sodium saccharin (w/v); or a choice of water or solution GS + E that contained GS solution plus 4% ethanol (w/v). In Experiment 2, mice from the first experiment were provided with a three-way choice among water, solution GS, and solution GS + E. In both experiments, SS mice (alcohol-insensitive) consumed more GS + E than LS mice (alcohol-sensitive). In addition, female mice drank considerably more GS + E solution than male mice. Thus, consumption of sweetened ethanol in both a two-way choice (water and GS + E) and a three-way choice (water, GS, and GS + E) is dependent on both genotype and sex. High genetic sensitivity to ethanol was associated with low consumption, and vice versa. Although females consumed more alcohol than males, famales of these lines have not been previously found to show lower sensitivity to acute alcohol administration.


Middle temporal cortical visual area and visuospatial function in Galago senegalensis.

Bushbabies with lesions restricted to the middle temporal (MT) area and animals with larger extrastriate lesions including area MT were compared with normal control animals on test of visuospatial localization and discrimination learning. Ablation of area MT was sufficient to produce impairments in directing behavior appropriately on the basis of visuospatial cues. Extension of the lesion into areas 18 and 19 produced more profound deficits. Retardation in learning a stripe discrimination problem was correlated with the extent of damage to the geniculostriate system. It is hypothesized that area MT is important in achieving and maintaining fixation on a target whereas cortical areas 18 and 19 are necessary for establishing the location of stimulation in visual space.


Evidence that a factor besides progesterone, prolactin, or plasma-estradiol-binding protein inhibits estrogen-induced sexual receptivity in pregnant rats.

Daily administration of estradiol benzoate stimulated significantly less lordotic behavior in rats during the second half of pregnancy than in ovariectomized females that received subcutaneous progesterone implants, pituitary grafts that raised plasma prolactin, or both treatments combined. Following an initial facilitation of receptivity, females with progesterone implants showed only moderate reductions in lordosis quotients over 3 test days. The capacity of plasma from pregnant rats to bind estradiol was found to increase significantly during the second half of pregnancy. However, daily administration to pregnant rats of a synthetic estrogen, R 2858, which is not bound by plasma protein, was no more effective than estradiol benzoate in stimulating receptive behavior. Administration of estradiol benzoate also stimulated significantly lower levels of sexual behavior in pregnant females than in females in which pseudopregnancy had been prolonged by previous hysterectomy or induction of uterine decidualization. These findings suggest that some endocrine factor other than progesterone, prolactin, or estradiol-binding protein is primarily responsible for the potent suppression of behavioral responsiveness to estrogen which occurs in pregnant rats. It is suggested that 5 alpha-reduced androgens may cause these behavioral effects.


Development of physiological response patterns concomitant with the learning of voluntary heart rate control.

Thirty-six male undergraduate students were instructed to raise or lower heart rate in a multiple-session biofeedback experiment. Systolic and diastolic blood pressure, frontalis electromyographic activity, and skin conductance level were simultaneously recorded throughout biofeedback training. Principal axes factor analyses showed that physiological response patterning concomitant with the development of heart rate control was different early in training (Training Session 1) than it was late in training (Training Session 4) for both speeding and slowing conditions. These results indicate that different heart rate control strategies were used by the subjects early and late in training. The factor patterns also indicated a tendency for greater heart rate response specificity as training progressed for both speeding and slowing. Heart rate speeding sessions were also found to be associated with a significant increase in perceived state anxiety as measured by the State-Trait Anxiety Inventory. No significant change in perceived anxiety state, however, was associated with heart rate slowing.


Modifications induced by neonatal steroids in reproductive organs and behavior of male rats.

Male rats injected on Day 3 neonatally with .01, .1, 1, 10, 100, or 1,000 micrograms of estradiol benzoate (EB), 10,000 microgram of testosterone propionate (TP), or sesame oil were subsequently examined for testicular, penile, and accessory organ development. Sexual behavior was evaluated during therapy with fluoxymesterone (FM) and then with TP. Estradiol benzoate in dosages greater than 1.0 micrograms delayed testicular descent, reduced the size and hormone responsiveness of reproductive organs, and decreased sexual behavior in a dose-dependent manner. The 10,000-microgram dosage of neonatal TP delayed testicular descent and reduced sexual behavior to levels near those of the 10--100 micrograms EB groups, but it produced no significant penile or accessory organ changes. Neither reduced peripheral organ development nor inhibited neonatal testicular secretions fully explain reductions in male behavior following large dosages of neonatal TP. Neonatal androgen may reduce the responsiveness of central nervous system neurons governing male sexual behavior after being converted to estrogen or by directly altering steroid receptor systems.


Modulation of behavioral inhibition in appetitive extinction following manipulation of adrenal steroids in rats: implications for involvement of the hippocampus.

Corticosterone, the principal glucocorticoid in the rat, binds selectively to the CA1 pyramidal neurons of the hippocampus where the hormone has been demonstrated to exert a moderate chronic suppression of spontaneous activity. In the first experiment of the current study, the functional behavioral significance of this hormone--brain interaction was investigated in the extinction of an appetitive runway response in normal rats and those with lesions of the hippocampus. During extinction, half of the animals in each group were given daily subcutaneous injections of corticosterone. Whie the classical retardation effect of hippocampal lesions on appetitive extinction was replicated, hormone treatment was without effect in normal or hippocampally damaged subjects. The absence of a hormone effect in normals was primarily attributed to a saturated limited-binding system operating in the normal animal. Experiment 2 tested this notion, repeating the first experiment, with adrenal-ectomized (ADX), ADX + corticosterone replacement, and normal groups of animals. Adrenalectomy produced a striking facilitation of extinction which was speculated to be the result of a hyperactive inhibitory neural organ free from an inhibitory endocrine feedback. Corticosterone treatment normalized the progress of extinction in ADX animals, providing support for the afore-mentioned speculation. In the normal animal, it appears that a stress-induced surge in hormone level interacts with a limited-capacity neural binding to produce a transient dynamic range of behavioral disinhibition, perhaps promoting persistence during initial stages of frustrative nonreward in moderate stress tasks.


Evidence that probing the vaginal cervix is analgesic in rats, using an operant paradigm.

Probing against the vaginal cervix (CP) suppresses responses to noxious stimulation in rats. The first experiment rules out the possibility that this effect is due to CP-induced immobilization. All rats first learned to press a panel, thus terminating noxious skin shock. Then they either received CP (experimentals) or did not (controls) when they pressed the panel during skin shock that was inescapable. The controls soon showed extinction of the panel-press response, whereas the experimentals continued pressing the panel and obtaining CP, for significantly more trials. The rats thus performed an operant response for CP at a time before CP could have blocked their movement. The second experiment argues against the possiblity that CP exerts its effect by "distracting" the rats from the skin shock. The rats received inescapable skin shock which continued for 7 sec after each panel-press response. During this shock one group received CP, and another received perineal probing ("distraction" control). The panel-press latency was significantly shorter in the CP group than in the perineal group. Latency in a control group, in which shock was terminated as soon as the rats pressed the panel, did not differ significantly from the CP group. Latency in another control group, in which the shock persisted for 7 sec after the rats pressed the panel with no probing being applied, was not significantly different from that of the perineal-probing group but was significantly longer than latency in the CP group. Thus the present studies suggest that CP is indeed analgesic and that this effect of CP is mediated by neither movement inhibition nor distraction.


Effects of lesions of the amygdala, preoptic area, and hypothalamus on estradiol-induced activity in the female rat.

Lesions of the anterior hypothalamic nucleus and the medial preoptic area sharply attenuated enhancement of wheel running by estradiol benzoate in ovariectomized female rats. Lesions of the corticomedial amygdala had no effect on this behavior. The hormonal effects on activity were largely independent of any changes in body weight. Results of this first experiment indicated that the anterior hypothalamic and medial preoptic areas are critically involved in the induction of activity by estradiol. However, this experiment provided no support for suggestions that the corticomedial amygdala inhibits those structures that mediate the estrogenic induction of activity. In the second experiment, food deprivation was used to stimulate activity. Results of this experiment suggested that the reduction in the ability of estradiol to induce activity following anterior hypothalamic and medial preoptic lesions does not reflect a general inability to become more active.


Development of high resolution computed tomography of the spinal cord.

Computed tomography of the spinal cord was a natural development of total body scanning. Much time and effort was spent in order to visualize the spinal cord and the various conditions affecting it. This was achieved by using an EMI CT5005 scanner and a series of step by step modifications and improvements to obtain a very high degree of resolution. The large variety of intraspinal lesions seen at the Montreal Neurological Hospital allowed us, by selecting appropriate cases, to determine the value of CT of the spinal cord.


Assessment of regional myocardial perfusion by positron emission tomography after intracoronary administration of Gallium-68 labeled albumin microspheres.

Positron emission computed tomography (ECT) of the normal and ischemic canine heart was undertaken in eight anesthetized dogs after the intracoronary administration of 68gallium labeled human serum albumin microspheres (SAM). Bolus doses of 200 muCi of 68Ga-SAM were injected into the left anterior descending (LAD) and left circumflex coronary arteries of four normal dogs and four dogs undergoing LAD ligation. Positron imaging of 68Ga-SAM distribution was performed with a multicrystal positron camera and computer reconstruction. In normal dogs, five to six axial transverse section images of the heart demonstrated the transmural distribution of 68Ga-SAM in an annular pattern around the left ventricular cavity. In dogs with LAD ligation, perfusion defects in the anterolateral wall and septum were observed in tomographic cuts through ischemic areas. In conclusion, these studies demonstrate the feasibility of positron ECT imaging of the heart after intracoronary administration of 68Ga-SAM.


Radiotherapeutic applications of pelvic computed tomography.

One hundred and four computed tomography (CT) examinations were performed on 72 consecutive radiotherapy patients with pelvic malignancies. Prostate, bladder, rectosigmoid, gynecologic, and lymphomatous primaries were studied. Computed tomography demonstrated tumor volumes larger than clinically expected in 40% and tumor extension into unsuspected tissues in 43%. Based on CT, staging was revised upward in 25%. Computed tomography aided initial treatment planning in 61%. In 27 patients having post-therapy scans, changes in tumor volume were demonstrated in 59%. Modifications in therapy were made for 30% of the follow-up group. Computed tomography is recommended as an important adjunct in the workup and management of radiotherapy patients with pelvic malignancies.


Computed tomography of the normal adrenal glands: correlative study with autopsy specimens.

Computed tomography (CT) visualization of both adrenal glands was possible in 99 of 100 cases using a fast (2 sec) scanner. Previously reported CT variants of normal adrenal glands correlated well with transverse sections of 20 autopsy specimens.


Intraureteral tumor demonstrated by computed tomography.

Two cases of papillary carcinoma of the bladder are presented in which the ureter could not be demonstrated by standard radiographic techniques. Computed tomography (CT) allowed identification of the tumor filled ureter. Intraureteral papillary tumor has a radiographic density (CT number) above that of water but less than that of the enveloping ureter.


Statistical detection of nonvisible isodense subdural fluid collections.

An analytic method for detecting isodense subdural fluid collections from computed tomography (CT) scan pixel attenuation data is presented. Analysis of 44 CT scan levels from 8 patients with isodense subdural hematomas (ISDH) and 50 CT scan levels from 15 patients without ISDH indicates 6% false positive and 3% false negative errors if the analysis is restricted to noncontrast CT scans that demonstrate subcalvarial bilateral cortical attenuation symmetry in the pictorial display.


Normal and high accuracy computed tomography of the brain: dose and imaging considerations.

The high accuracy scanning mode of the EMI CT1010 scanner generates scans with imaging characteristics superior to those produced in the normal accuracy mode. The comparative dosimetry of normal and high accuracy scans is presented, along with an analysis of the image quality of the two scanning modes. High accuracy scanning is an effective adjunct in patients with difficult lesions in the cerebral hemispheres.


Orbital computed tomography: calcific densities of the posterior globe.

Computed tomography's (CT) marked sensitivity to calcium increases its usefulness in the workup of certain ocular lesions. The CT findings in five calcific ocular lesions are described. The relatively limited differential diagnosis of such a finding is discussed.


The temperature dependence of computed tomography attenuation values.

Attention is drawn to the variation in the computed tomography (CT) attenuation value of water with temperature. A difference of 5 to 6 Hounsfield units (1,000 scale) between typical room and body temperatures can be predicted as a consequence of the change in the density of water and was confirmed experimentally. This difference may be of significance in the calibration of CT machines, in the determination of "absolute" CT attenuation values for body tissues and fluids, and in comparing tissue attenuation values obtained in vivo and in vitro.


Nonlinear polychromatic and noise artifacts in x-ray computed tomography images.

The variance of the image noise in computed X-ray transmission tomography (CT) due to quantum noise is in a first approximation a nonlinear function of X-ray attenuation. Beam hardening in CT is also a nonlinear function of attenuation. We present a theoretical study of both phenomena. Computer simulations and numerical results show that both nonlinear dependencies have quite similar effects on image quality. We also show how the two-dimensional distribution of the noise variance in a CT image is a weighted superposition of images obtained by backprojecting integer powers of the noiseless projection data corresponding to the scanned object. The streak-like pattern in the image noise due to the anisotropic nature of the noise cross-correlation function is discussed. We also discuss how these nonlinear phenomena affect noise filtering and tissue characterization using statistical parameters.


Mesial temporal sclerosis detected by computed tomography.

We report a case of an epileptic patient in whom unilateral mesial temperal sclerosis was detected by computed tomography in the form of an arcuate, nonenhancing calcification. Temporal lobectomy was followed by relief of the seizures.


Carcinoma of choroid plexus in a premature infant.

A histologically proven case of choroid plexus carcinoma in a 5-week-old infant is presented. Computed tomography showed invasion through the ventricular wall, suggesting its malignant nature.


Cerebral granulomatous angiitis simulating brain tumor.

A case of surgically verified cerebral granulomatous angiitis, which was mistaken for a brain tumor on computed tomography, is reported. The focal, enhancing lesion was due to multiple confluent infarction caused by the angiitic process.


Deep vascular congestion in dural venous thrombosis on computed tomography.

In a 64-year-old female patient with verified dural venous thrombosis, postcontrast computed tomography showed dilatation of the transcerebral medullary veins, a feature that is probably pathognomonic.


Cystic Hodgkin's lymphoma of the thymus: computed tomography appearance.

We report a case of cystic Hodgkin's disease of the thymus that was evaluated preoperatively by computed tomography (CT). Although this is an uncommon cause of an anterior mediastinal mass, it should be considered in the differential diagnosis along with cystic thymoma and cystic treatomas, since the treatment of the these lesions is dramatically different. The CT appearance and pathology of this lesion are discussed.


Increased attenuation value in a hydropic gallbladder.

A case is presented in which the presence of sludge in a hydropic gallbladder altered both the usual sonographic and computed tomographic appearance of the gallbladder.


Computed tomography in the evaluation of a pelvic tumor.

A case of a pelvic tumor evaluated preoperatively by computed tomography (CT) is reported. Conventional radiology suggested pelvic lipomatosis, but CT revealed a solid tumor without fat deposits.


A sledge device for the accurate movement of small animals in a computed tomography scanner.

A simple sledge device is described for millimeter accurate movements of small animals through an EMI CT5005 scanner.


Rumen epithelium cell proliferation accelerated by propionate and acetate.

Ruminal papillae were biopsied from fasted adult sheep given 18 m mole/kg body weight per day of sodium propionate or sodium acetate intraruminally via fistula. The mitotic index of the epithelial cells in the papillae was estimated for the mitogenic effect of the acids. Before the administrations, mitotic indices were lower than .53%. They increased after a few days' propionate-administration, then declined. The peak values appeared on 2 or 4 days of the administration and were 1.64%, 1.38%, 1.73%, and 1.54% in four trials. Mitotic indices also increased from acetate and declined. The peak values appeared on 3 or 4 days of the administration and were 2.04%, 2.49%, 1.70%, and 2.03% in four trials. Mitotic indices of the control sheep given the same amount of .9% saline were lower than .28%. The mitogenic effect of propionate and acetate on the rumen epithelial cells was apparent, but it seems to be weaker than that of butyrate judged from the relatively slow rise of the index in this study.


Effect of number of young born (litter size) on milk yield of goats: role for placental lactogen.

Relationships of number of fetuses, placental mass, and lactogenic activity of plasma to development of mammary gland during pregnancy and of litter size to milk yield were examined in British Saanen goats. In late pregnancy lactogenic activity, measured in plasma by radioreceptor assay, increased with number of fetuses. Total weight of placentomes increased with total fetal weight and, hence, fetal number. The weight of the lobulo-alveolar component of the udders was correlated positively with placental mass and fetal number. In hand -milked goats which bore triplets or twins, mean milk yield was 47% and 27%, respectively, higher than in mothers of single kids after correction for lactation number. Milk yield was correlated with the weekly mean of placental lactogen titers between wk 11 and term. This supports the view that placental lactogen has a significant role in the control of normal mammary development and function in goats.


Estrous cycle patterns in cattle monitored by electrical resistance and milk progesterone.

An electronic probe with parallel stainless steel electrodes was designed to measure changes in electrical resistance in the anterior vagina associated with increased cervical mucus secretion at estrus. Three groups of Holsteins were probed, and a sample of residual milk after milking was taken for progesterone assay every 2nd day for 28 to 40 days. Group I consisted of 29 cycling virgin heifers, Group II consisted of 24 lactating cows in the Cornell herd, and Group III consisted of 62 lactating cows in three commercial herds. Lactating cows were 26 or more days postpartum when sampling began. In Group I, 77% of the measurements at the ventral surface of the anterior vagina were lowest on the day of estrus and correlated well with days KaMaR Heatmount Detectors were triggered or chalk was erased. In Groups II and III, average electrical resistance also was minimal at estrus and was correlated .92 to .99 with average milk progesterone during the 4 days preceding and including estrus. The electronic probe appears to enable one to detect which cows are cycling normally and to aid in determining when to expect estrus.


Pregnancy rate in dairy cows inseminated on the basis of electronic probe measurements.

A new vaginal probe with two pairs of parallel electrodes 90 degrees apart was designed with a switching arrangement so that electrical resistance (ohms) of the dorsal and the ventral areas of the anterior vagina could be monitored separately during the estrous cycle. Three inseminators probed cows during February--April, 1977, in nine herds in stanchion barn housing. Cows not seen in estrus by 40 to 60 dyas after calving were probed every 3rd day. At each dairyman's option normal cows with a low porbe reading were inseminated. Controls consisted of cows seen in estrus by the dairyman and reported for insemination in the routine manner. The diagnosed pregnancy rate for 86 first service controls was 49% versus 52% for 58 cows not seen in estrus, but identified by low probe readings. Cows varied in electrical resistance at breeding, but the fact that pregnancy rates were equivalent in the two groups is interpreted to mean that the probe was as effective in identifying cows suitable for insemination as was visual observation of estrus by dairymen.


Use of total whey constituents for human food.

In recent years, utilization of whey has been felt to be an inexorable necessity in view of the current requirements for alleviating environmental pollution as well as using available nutrients for feeding the malnourished segments of human population. Presence of several nutritionally important constituents having excellent functional characteristics enhances opportunities for a wide-range application of whey and whey constituents in the food industry. Technology is being developed to utilize whey for the manufacture of a variety of new food products as well as for the replacement of comparatively costly food ingredients. Various aspects of utilization of whey for human nutrition are described.


Metabolism of ornithine in perfused goat udder.

Four lactating goat mammary glands were perfused for several hours in the presence of ornithine labeled with 1-carbon-14 and delta-nitrogen-15 or 5-hydrogen-3 and received adequate quantities of glucose, acetate, and amino acids. For the first label carbon and nitrogen were incorporated in casein of milk. After isolation of the casein amino acids the carbon-14 was incorporated into proline only while nitrogen-15 was localized in aspartic acid, glutamic acid, alanine, serine, glycine, and the branched-chain amino acids. In the experiments with hydrogen-3 labeled ornithine, no reversible transamination of ornithine could be measured during passage through the udder. After incubation in vitro of goat blood in the presence of the labeled ornithine, no nitrogen-15 could be detected in other free amino acids of plasma. Ornithine is transaminated by the udder itself. The delta-amino group of ornithine contributed nitrogen for the synthesis of several nonessential amino acids in the mammary gland.


Plasma retinol transport and clearance in hypervitaminosis A.

Effects of mild and severe hypervitaminosis A on retinol transport and clearance were studied in mature ewes. Excessive vitamin A intake was assoicated with high concentrations of vitamin A in plasma and liver, with elevated serum enzymes, with decreased feed consumption and packed cell volume, and with epithelial hyperplasia. Retinol transport in plasma increased 6- to 8-fold with excessive dietary vitamin A, was greater with mild hypervitaminosis A, and increased exponentially with vitamin A concentration in plasma. Clearance of retinol from plasma increased 2-fold with hypervitaminosis A, exhibited a greater response in the mild group, and increased linearly with vitamin A concentration in plasma. The relationship of clearance to vitamin A concentration in liver was described best by a power function. Retinol clearance represents a mechanism to maintain vitamin A concentration in plasma and may be most effective below vitamin A concentrations of 135 microgram/dl plasma. With severe hypervitaminosis A, massive vitamin A accumulates in liver leading to hepatic dysfunction and a resultant decrease in retinol clearance from plasma.


Response of lactating cows to 300 mg of supplemental vitamin E daily.

Ten Holstein cows in mid-lactation which had been fed only stored feeds for several years were paired on milk production. One cow from each pair was assigned to either the control or group treated with supplemental vitamin E for a 12-wk experiment. All cows were fed 3 kg alfalfa-brome hay, corn silage ad libitum, and concentrate at 1 kg/3 kg milk produced daily. This ration provided about 500 mg of vitamin E (total tocopherols) daily. Five cows were fed an additional 300 mg vitamin E daily as D-alpha-tocopherol acetate in their concentrate mix. Feeding the supplemental vitamin E increased the vitamin E content of milk fat 15 to 20% from 18 microgram/g fat to over 21 microgram/g fat. However, this change in vitamin E content of milk was not sufficient to improve the oxidative stability of the milk. Blood characteristics indicative of vitamin E status generally were unaffected by vitamin E supplementation although red cell hemolysis, glutamic oxaloacetic transaminase, and lactate dehydrogenase of serum were lower in blood of supplemented cows.


Relationship of the estrous cycle to milk composition.

The relationship of the estrous cycle to milk composition was examined in 15 Holstein cows in first lactation which were approximately 45 days postpartum. Composite milk samples were collected twice daily and analyzed for progesterone, fat, protein, total solids, sodium, potassium, magnesium, calcium, and somatic cells. Milk progesterone was minimal (less than ng/ml) from day -1 to day 2 (day 0 = estrus) of the estrous cycle and then increased at a relatively constant rate through day 15. Milk yield and sodium and magnesium concentrations of the milk varied with days of the estrous cycle. Mean milk yield was highest and sodium and magnesium concentrations were lowest on day 1. However, sodium concentration of the milk was the only component that varied significantly during the 3 days centered on estrus (days -1, 0, and 1). No other milk component changed significantly during the estrous cycle. Although milk yield and composition varied during the estrous cycle, none of these components appeared to be a practical indicator of estrus.


Estrogen in plasma of parturient paretic and normal cows.

The endocrine factors associated with parturient paresis have not been defined totally. Estrogens stimulate uptake of calcium by bone. Since secretion of estrogen increases dramatically as parturition approaches, estrogen may be involved in homeostatic mechanisms regulating calcium metabolism. Plasma was collected for 30 days (-30) prepartum to 5 days (+5) postpartum from six Holstein and nine Jersey cows approaching three or more lactations. Of all cows, six Jerseys contracted parturient paresis. Estradiol and estrone were analyzed by radioimmunoassay, total calcium and total magnesium by atomic absorption spectrophotometry, and total phosphorus by colorimetry. Data were grouped into periods respresenting days -30 to -21, -20 to -11, -10 to -6, -5 to -4, -3 to -2, -1, 0 (parturition), +1, +2 to +3, and +4 to +5. Calcium in plasma was lower in parturient paresis cows on days +1 and +2 to +3, and magnesium was higher during the same periods but lower on days -4 to -5. Total phosphorus, estrone, and estradiol of normal cows and those with parturient paresis were not different. During the entire sampling period, phosphorus and estradiol were similar in both groups while magnesium was higher and calcium lower in cows with parturient paresis. Estrone was lower in cows with parturient paresis. Lower estrone in cows with parturient paresis may be predisposing for parturient paresis.


Effects of dietary zinc upon tissue zinc and percent unsaturated plasma-zinc binding capacity.

Calves were fed 520 ppm zinc for 21 days, then placed on a low zinc diet (20 ppm zinc) for 35 days to determine the biological availability of zinc reserves of tissue. Concentrations of zinc in liver and kidney were elevated greatly by feeding high dietary zinc for 21 days and continued to increase with time. On the low zinc diet, the tissue burden of zinc decreased within 35 days to those comparable to calves initially fed low zinc. Likewise, both zinc in plasma and percent capacity of unsaturated plasma for binding zinc were near negative controls 21 days after removal of calves from high zinc diets. Tissue stores of zinc will not maintain adequate zinc in blood for extended periods, and hence, they probably will not sustain optimal feed intakes and growth rates of calves on low-intakes of zinc.


Sister chromatid exchange in chromosomes of cattle (Bos taurus).

Lymhocytes from clinically healthy Holstein animals (8 males and 23 females) were cultured in media containing 5-bromodeoxyuridine (10 microgram/ml) for two cycles of deoxyribonucleic acid replication (48 h). The exchange of sister chromatids per cell varied from 1 to 16 with a mean of 5.4 and a standard deviation of 2.1 in 603 differentially stained metaphase chromosome spreads. The major fraction of exchanges in the X chromosome were located in the region of the subcentromeric G negative bands q1 and q2. When the cells were pulse labeled with tritium labeled thymidine (1 muCi/ml) for the last 6 h of the cell cycle, the rate of exchange was higher in the late replicating X chromosome (facultative heterochromatin) in comparison to its homologue (active X). This study characterizes the yield of sister chromatid exchange in lymphocytes exposed to a given amount of 5-bromodeoxyuridine in a population of normal individuals so that it may be used as a standard for 1) a diagnostic tool in pathological conditions and 2) as an assay of chromosome stability in relation to environmental hazards.


Milk fat as related to vitamin B12 status.

Two experiments examined whether vitamin B12 status of liver affects milk fat percentage or yield. In Experiment 1 B12 concentration in liver, measured at approximately 8 and 15 wk postpartum in 35 cows, was not correlated significantly with milk fat percentage or yield. In Experiment 2 twenty-two cows were fed a ratio similar to one used to depress milk fat percentage. The B12 status of 12 of these cows was enhanced by intramuscular injection of vitamin B12 while the other 10 served as controls. During wk 2 to 8 of lactation, milk fat percentages were almost identical for the two groups. A difference in milk fat yield in favor of the B12-treated group resulted from a difference in milk yield. The data do not support a recent hypothesis of the metabolic cause of milk fat depression.


Vitamin B12 binding proteins in bovine serum.

Examination of bovine serum by the diethylaminoethyl cellulose small column method revealed three proteins binding vitamin B12. The elution pattern suggested that they are similar to the three transcobalamins recognized in human serum. Distribution of unbound binding capacity among serum binders was assessed in serum from normal, ketotic, and B12- and Factor B-supplemented cows in early lactation. No major differences were observed among groups; however, cow serum displayed a pattern different from human serum. Mean total binding capacity of bovine serum for B12 as well as mean unbound binding capacity were lower than the corresponding means for human serum.


Mammary gland development of dairy heifers during their first gestation.

Mammary gland development was determined by analysis of udders at thirteen stages of the first gestation of nine pairs of identical twin dairy heifers. Stained sagittal sections of udders showed that gland parenchyma spread into and displaced adipose tissue so that total udder weight does not reveal extent of gland development. Changes in composition of mammary gland during gestation reflected gross and histological changes. Percentages of fat and deoxyribonucleic acid decreased while percentages of nitrogen, water, dry fat-free tissue, and ribonucleic acid increased. Development of the portion of the udder which was mammary gland appeared to be a continuous exponential process through gestation, and increases in quantitative development followed the general formula for organ growth, Y = Aekt (In Y = In A + kt), in which k is the rate constant for growth by months (t). Analysis of variance showed in addition to stage of gestation that body weight and pairs, but not age, affected the regression. Adjusting for body weight only produced rate constants for growth similar to those from adjusting for pairs and weight. Rates of development were approximately 33% per month for nitrogen, dry fat-free tissue, and internal surface area of mammary glands, and approximately 25% for parenchyma weight and deoxyribonucleic acid. Average rate of increase in total udder weight was only about .5 that for mammary glands only.


Calcium-containing crystals in alfalfa: their fate in cattle.

The fate of crystals in the parenchymatous sheaths around vascular bundles in alfalfa leaves was followed through the bovine digestive tract by scanning electron microscopy. The bundle and sheath pass from the rumen largely intact. Most crystals are released from the bundle sheath postruminally. In feces, some crystals appear partially eroded and others are intact. By energy-dispersive x-ray analysis calcium is the primary crystal cation. Intact cyrstals isolated from alfalfa leaves by low-temperature ashing and from bovine feces by washing and differential specific gravity were subjected to Raman microprobe analysis. Most crystals were calcium oxalate, a few were potassium oxalate, and some contained both compounds. From 20 to 33% of calcium in alfalfa is in the form of oxalate and apparently unavailable to ruminants. Carbonate is probably in partially eroded crystals from feces. Data presented account for the poorer utilization by cattle of calcium from alfalfa than that from inorganic sources.


Effect of a low chloride diet on lactating Holstein cows.

Twenty primiparous lactating Holstein cows were fed diets supplemented with either .5% sodium chloride or .75% sodium bicarbonate. Those fed the latter diet conserved chloride by reducing the chloride concentration in urine, feces, and, to a small but nonsignificant amount, in milk. The low chloride diet did not affect consumption of feed dry matter and water or milk production and composition. There was no indication of pica or other aberrant taste behavior. One half of the cows in each diet group was given free choice salt block of trace elements. Those fed the low chloride diet consumed more salt (337 versus 149 g/cow per wk). When chloride requirements have been established and data on chloride composition become more widely available, it will be possible to include both sodium and chloride in diet formulations and omit salt. This will reduce the amount of salt needed as either a sodium or chloride supplement.


Feeding cholesterol and tallow to young calves.

Four groups of eight 4 wk-old Holstein bull calves were fed calf starter diets containing either no additive (control) or added ingredients: 1% cholesterol, 5% tallow, or 1% cholesterol plus 5% tallow. Body weight and size were reduced, and average daily gain was lowered by added 5% tallow. The added dietary tallow and cholesterol increased lipids and cholesterol of plasma by 35 to 40%. The increased intake of fat due to feeding tallow caused both increased fat metabolism and fat excretion as based on chromic oxide estimates of digestibility. Fat digestibility was lowest in animals receiving cholesterol with no added tallow. Organ weights and composition of meat at slaughter at 21 wk of age were not different.


Squamous-cell carcinoma arising in a basal-cell epithelioma treated with 5-fluorouracil.

Intralesional injection of 5-fluorouracil has recently been reported as a possible method of treatment for an assortment of benign and malignant cutaneous neoplasms. We report the development of squamous-cell carcinoma within a basal-cell epithelioma that was treated with intralesional injections of 5-FU.


An "ultimate solution" for a painful toe.

A patient insisted upon amputation of a painfully disabling toe. For good reasons, his insistence was satisfied.


Epilation by electrocoagulation: factors that result in regrowth of hair.

From our experience, the most important requirement for permanent epilation by electrocoagulation is not only to destroy hair bulbs, but also to destroy the isthmal regions of hair follicles and the sebaceous glands.


An improved method of closure of donor sites in hair transplantation.

A modification of a method previously reported is herein described as particularly good for closure of donor sites in hair transplantation. When properly performed it defies detection even by the most observant of barbers.


Fibrous hamartoma of infancy.

Fibrous hamartoma of infancy is a type of juvenile fibromatosis which is either present at birth or develops before two years of age. If one is not familiar with this histological pattern, it could be mistaken for a malignant mesenchymal neoplasm. We describe the characteristic clinical and microscopic features.


Reconstruction of a sideburn by a rotated flap.

A method for reconstruction of a sideburn is described in detail. Rotated flaps provide coverage with hair at once in a single surgical procedure.


Planning in hair transplantation.

The size of an area to receive hair transplants can be minimized by designing a conservative hairline and by surgical reduction of the area of alopecia. A pattern of dispersion of grafts for optimal aesthetic effect is presented together will suggestions about frequency of sessions and amount of transplantation done each time. Hair transplanting begun prior to complete alopecia has advantages that are explained.


Etidocaine, a new local anesthetic.

Different local anesthetics have different physicochemical properties that result in different biological effects. Etidocaine (Duranest) is said to be a long-acting anesthetic with a rapid onset of action, properties that are particularly useful in busy office practices in which lengthy operative procedures are performed. Clinical testing confirmed that this anesthetic does, indeed, work in this manner, which makes it a good addition to the varieties of local anesthetics available.


Unexpected giant "V" waves during pulmonary artery catheterization.

Two cases of catheterization of the pulmonary artery, in which the hemodynamic findings were very different from the initial clinical diagnosis, are presented. The importance of verifying the adequate position and motion of the pulomonary artery catheters with two consecutive chest x-rays is discussed. In particular, attention is brought to the possible misinterpretation that occurs in patients with very elevated pulmonary artery mean pressure.


Hyperkinetic shock in viral and pneumococcal pneumonias.

Ten patients, suffering from severe viral or bacterial pneumonia had circulatory shock, characterised haemodynamically by normal or high cardiac output (CI = 4.1 +/- 1.2 1/min/m2) and low systemic resistance (SVR = 14 +/- 3.7 mm Hg/1/min/m2). Existence of such a hyperkinetic state greatly complicates the management of patients. Plasma volume expansion, performed in five cases of initial hypovolaemia, and Dopamine infusion (five patients) increased markedly the intra-pulmonary shunting. High level PEEP ventilation was not tolerated, despite the improvement of blood gases it produced. Extra-corporeal membrane lung oxygenation (three cases), whilst giving an initial decrease of shunting and restoring SVR, produced no long term surviors. All ten patients died from intractable shock and severe hypoxaemia. Spontaneous ventilation with positive expiratory pressure (CPAP) is believed to be an attractive alternative, due to its absence of deleterious haemodynamic effects.


Antipyrine elimination in critically ill patients.

Antipyrine kinetics were studied in 12 critically ill patients. Antipyrine half life was found to be short (6.5 +/- 3.4 h), this did not alter over 4 days of acute illness, although there was a tendency for antipyrine clearance to decrease over that time period. The need for further pharmacological studies in critically ill patients is stressed.


Experimental infusion thrombophlebitis. A comparison between glucose and frutcose and 5% and 10% glucose solution.

On the basis of clinical experience it has been claimed that glucose results in a higher incidence of infusion thrombophlebitis than fructose, and that glucose solutions in concentrations higher than 5% are extremely irritant to the venous endothelium. The validity of these two assertions has been investigated by an experimental method based on a quantitative histological study of rabbit-ear veins into which infusions were given under standardized conditions. In two series of experiments, it was shown (1) that fructose solutions caused significantly more inflammatory changes in the veins than did glucose solutions, and (2) that glucose in 10% solutions caused significantly more injury to the veins than 5% solutions, although the difference in the average inflammatory changes was only slight.


Tracheostomy and indwelling central venous line: a hazaradous combination?

A prospective study of 390 indwelling central venous catheters placed via the subclavian route defined bacteremia and tracheostomy as the only significant variables associated with the colonization of the catheters by pathogenic microorganisms. Catheter related sepsis was likely in only 3 of 33 episodes of proven bacteremia. Detailed statistical analyses of other potential contaminating factors revealed no significance. Specific concern must be assigned to placement of central venous catheters by the subclavian approach, when a tracheostomy is already present,


What the patients say: A study of reactions to an intensive care unit.

One hundred consecutive patients were interviewed between the 3rd and 7th days, inclusive, of their discharge from an intensive care unit to a general ward. The patients' recall of events related to their admission to the ICU was generally poor, and 41% of them felt that they had been confused at some time during their stay though much of this seems to have passed unnoticed by the nursing staff. Lack of sleep was a problem to about a quarter of the patients and 75% of these thought that the inability to lie comfortably was a factor preventing sleep. Other factors included pain, anxiety and noise. The patients seemed satisfied whilst in the ICU, and less than half said they were pleased to return to a general ward.


Tension pneumoperitoneum complicating cardiac resuscitation.

A case of gastric rupture and tension pneumonperitoneum following cardiac resuscitation is presented. Respiratory embarrassment necessitated emergency decompression by needle puncture of the peritoneal cavity, followed by laparotomy and repair of the gastric tear. The post-operative course has been satisfactory. The aetiology of the gastric rupture is discussed and recommendations are made for the prevention and treatment of this unusual complication of combined mouth to mouth respiration and external cardiac massage.


Subjective loudness of simulated quarry blast waves, with implications for the transition from impulsive to continuous sound.

The tradeoff between amplitude and duration for equal loudness was explored for idealized quarry blast waves. An extended low-frequency response loudspeaker-driven simulation booth was employed with computer-generated imput test signals. In place of actual irregular blast waves, the simulated signatures were composed of sequences of identical shock-decay impulses of 25 ms duration and 0.2 ms rise time. Sequences of 1--16 impulses yielded overall durations of 25--400 ms. At the short durations the loudness was found to increase 2 dB for each doubling of duration; above 100 ms the increase was progressively lower, approaching as an asymptote the level for continuous sound. The results were compared with theoretical predictions: for this purpose the spectral method of Johnson and Robinson, well varified in our earlier studies of sonic boom impulses, was used. The shorter quarry blast judgments (T less than or equal to 100 ms) were found to be in very good agreement in terms of relative loudness levels. With an ad hoc--but physically plausible--modification (including adjustment of the critical integration time of the ear) the predictive method was extended to encompass the long duration signals as well. Thus the applicability of the method has been demonstrated for other types of transient sounds than the N wave; and the extension of the method tentatively appears to bridge the range between impulsive and continuous sounds of similar spectral content.


Hearing loss from simulated work-week exposure to impulse noise.

Six monaural chinchillas were exposed to a repetitive, reverberant, impulse noise for a total of five days, 8 h per day. The average peak overpressure within the holding cage was 113 dB. The reverberation time (pressure fluctuation envelope within 20 dB of peak) was 160 ms. Auditory thresholds were measured at 0.25, 0.5, 1, 2, 4, and 8 kHz before and after each day's exposure using either the average-evoked response technique or shock avoidance conditioning. After the last exposure, recovery was monitored for five successive days. Final thresholds were obtained starting at 30 days postexposure after which the animals were sacrificed for cochlear histology. The high frequencies (4, 8 kHz) showed a daily median shift of 40 dB and a 27 dB recovery before the following day's exposure. The low frequencies (0.25, 0.5 kHz) were shifted 35 dB after each day's exposure with a 15 dB recovery overnight. Final median audiograms showed little permanent threshold shift. The cochleagrams for two test animals were found to be normal while the remaining four displayed 10%--40% losses in hair cells at specific cochlear sites.


Temporary threshold shifts in humans exposed to octave bands of noise for 16 to 24 hours.

Groups of human subjects were exposed in a diffuse sound field for 16--24 h to an octave-band noise centered at 4, 2, 1, or 0.5 kHz. Sound-pressure levels were varied on different exposure occasions. At specified times during an exposure, the subject was removed from the noise, auditory sensitivity was measured, and the subject was returned to the noise. Temporary threshold shifts (TTS) increased for about 8 h and then reached a plateau or asymptote. The relation between TTS and exposure duration can be described by a simple exponential function with a time constant of 2.1 h. In the frequency region of greatest loss, threshold shifts at asymptote increased about 1.7 dB for every 1 dB increase in the level of the noise above a critical level. Critical levels were empirically estimated to be 74.0 dB SPL at 4 kHz. 78 dB at 2 kHz, and 82 dB at 1 and 0.5 kHz. Except for the noise centered at 4.0 kHz, threshold shifts were maximal about 1/2 octave above the center frequency of the noise. A smaller second maximum was observed also at 7.0 kHz for the noise centered at 2.0 kHz, at 6.0 kHz for the noise centered at 1.0 kHz, and at 5.5 kHz for the noise centered at 0.5 kHz. After termination of the exposure, recovery to within 5 dB of pre-exposure thresholds was achieved within 24 h or less. Recovery can be described by a simple exponential function with a time constant of 7.1 h. The frequency contour defined by critical levels matches almost exactly the frequency contour defined by the E-weighting network.


Selective adaptation to frequency-modulated tones: evidence for an information-processing channel selectively sensitive to frequency changes.

Exposure to an FM tone elevates FM threshold but not AM threshold. This holds for a wide range of frequency deviations (delta F = +/- 0.4 Hz- +/- 30 Hz at least) provided that modulation frequency is low (fm = 2 Hz), but if fm is somewhat higher (e.g., 8 Hz) the finding only holds for small frequency deviations. FM threshold can rise with time up to an adapting duration of at least 1200 s, through this buildup depends on frequency deviation. Exposure to an AM tone elevates AM threshold, but not FM threshold, over a wide range of modulation depths (at least m = 5%--50%). Quasi-FM (QFM) adapting tones resemble FM adapting tones in their effects upon FM and AM sensitivities, even though QFM and AM adapting tones have identical power spectra. Exposure to a pure tone produces no difference between FM and AM threshold elevations. These data can be explained if the human auditory pathway contains separate information-processing channels for AM and FM signals whose sensitivities do not overlap even with suprathreshold stimuli. We suppose that the FM channel (but not the AM channel) is sensitive to changing differences (or ratios) between signals from different sites along the basilar membrane.


Suppression effects in backward and forward masking.

The differences in the suppression effect observed in forward and backward masking are consistent with an interpretation that suppression in forward masking results from a reduction of the effective level of the masker in the aditory periphery, and that the suppression in backward masking is influenced by these peripheral processes, but is dominated by additional, central processes. This conclusion is supported by experiments that show differences in the effect of ipsilateral versus contralateral presentation of the suppressor, and differences in the amount of the suppression observed as a function of the level, duration, and frequency of the suppressor.


Anticipatory coarticulation: some implications from a study of lip rounding.

The anticipation of articulatory features, in particular lip rounding in anticipation of a rounded vowel, has been reported to occur as many as four segments before the segment for which the feature is specified. In the data presented here, we find that the moter commands for the rounding gesture for /u/ begin a fixed time before the onset of the vowel. This timing is unaffected by the number of consonant segments in the preceding string. Thus, the initiation of lip rounding appears to be linked to other features of the vowel articulation.


Reflex activation of laryngeal muscles by sudden induced subglottal pressure changes.

In measuring the effect of subglottal pressure changes on fundamental frequency (Fo) of phonation, the effects of changing laryngeal muscle activity must be eliminated. Several investigators have used a strategy in which pulsatile increases of subglottal pressure are induced by pushing on the chest or abdomen of a phonating subject. Fundamental frequency is then correlated with subglottal pressure changes during an interval before laryngeal response is assumed to occur. The present study was undertaken to repeat such an experiment while monitoring electromyographic (EMG) activity of some laryngeal muscles, to discover empirically the latency of the laryngeal response. The results showed a consistent response to each push, with a latency of about 30 ms. Despite this response, analyses of fundamental frequency versus subglottal pressure changes during the interval of constant EMG activity were in general agreement with previously published values. With respect to the nature of the electromyographic response itself, its timing was found to be within the range of latencies appropriate for peripheral feedback, and was also similar to that for an acoustically--or tactually--elicited startle reflex.


Rhythmic and segmental perception are not independent.

The 36 basic "sentences" in the experiment were six-syllable nonsense sequences of the form DAS a LAS a GAS a or a DAS a BAS a LAS. Either (a) one vowel in the sentence was lengthened or shortened by about 50, 90, or 130 ms by computer-editing routines, or (b) the sentence was left intact (as spoken). The resulting perceptual impression after the vowel change was a change of tempo within the sentence. Vowel changes occurred systematically throughout the sentences, in one of syllables one through five. Reaction time (RT) was recorded to assigned target segments /b, d, or g/ in one of syllables one through six, and RT was compared to targets in tempo-changed versus intact sentences (these were acoustically identical except for the distorted vowel). The listeners responded to over 2000 versions of the sentences. The results were: (a) Tempo changes generally increased segment target RT. (b) Tempo-change effects were ubiquitous; for instance, vowel changes in the first syllable increased RT to targets in later syllables, and the reach of effects spanned four syllables. Both vowel shortening and lengthening increased target RT. (c) Effects attributed to precessing time decreased, whereas effects attributed to stimulus expectancy increased, with time into the sentence. (d) Tempo-change effects persisted throughout the experiment despite practice and familiarity with stimuli. The conclusions were: (a) The effects of time distortion of the stimulus on target RT were produced mainly by changes in stimulus-induced expectancy, not changes in processing time. (b) The expected input to perception is the acoustically intact utterance in both its rhythmic and segmental aspects; these aspects are not perceived independently.


Acoustical and perceptual characteristics of speech produced with an electronic artificial larynx.

Five normal-speaking adult males were taught to produce speech using an electrolarynx. Speech phoneme intelligibility was measured in a closed-set word discrimination test and through phonetic transcriptions of the spoken materials. Mean percentages of correct identification for the five talkers were 90% and 57% for the word-identification test and phonetic transcription, respectively. An analysis of perceptual confusions revealed that errors were most frequently associated with the voicing feature and that few manner or place of articulation errors occurred. Over the range of variables observed, the intensity of both the speech and the noise radiating directly from the electrolarynx, the spectrum of the radiated noise and speaking rate were not found to be determinants of intelligibility.


Ultrasonic absorption in liver tissue.

Ultrasonic attenuation coefficients were measured in mammalian liver for frequencies ranging from 0.5 to 10 MHz and for a range of sample preparations. Certain preparative procedures were found to greatly increase the low-frequency attenuation coefficient due to the introduction of bubbles into the sample. The low-frequency attenuation was reduced by storage at low temperatures or by pressurization, each caused the bubbles to go into solution, resulting in an attenuation coefficient that was a simple power function of frequency. Absorption coefficients of in vitro and in vivo samples were found to be similar and to show much less dependence on sample preparation than the attenuation measurements. These studies suggest that properties of carefully prepared in vitro samples are indicative of the in vivo properties.


Complement and contrast material reactors.

Patients showing systemic reactions to intravascular contrast media and patients receiving contrast media without reaction have significantly different mean values (p is less than 0.05) for functionally determined serum C1-esterase inhibitor (C1 INH) and total hemolytic complement (CH50). The lower concentration of these components in reactors appears in baseline serum samples (as well as after injection), and suggests that many anaphylactoid reactions to contrast media are conditioned by earlier complement consumption, and result directly from contrast-induced activation of complement, and other activation system components in the presence of inhibitor depression.


Immunoglobulin E to cow's-milk protein in breast-fed atopic children.

Over a 3-yr period, 18 children , ages 10 mo to 5 yr, were discovered to have IgE to cow's-milk protein (CMP). They were compared with 18 age-matched patients for having been primarily breast fed during the first 6 mo of life. All were new allergy clinic asthmatic patients with a strong family history of atopy and evidence of IgE to multiple allergens. Analysis of the data on this allergic population revealed that both a history of breast feeding and of milk-induced immediate reaction in patients with CMP-specific IgE was significantly higher (p is less than 0.03) than in those patients without IgE to CMP. Inadvertent sensitization to food antigens can occur in some atopic breast-fed infants.


Immunoglobulin E response during viral infections.

One hundred and three patients (90 nonatopics and 13 atopics) with respiratory infections to various viral agents were studied retrospectively with respect to IgE immunoglobulin levels during acute (1 to 7 days) and convalescent (8 to 30 days) phases of infection. It was found that 59% of patients had a decrease of 20% or more in IgE level, 27% remained the same, and only 14% showed a rise 20% or more from the acute to the convalescent phases of infection. IgE levels decreased up to 3 to 4 wk after symptoms and the degree of decrease was more apparent for the nonatopics who had higher IgE levels in their acute phase of infection. Less dramatic decrease in IgE was observed for the 13 atopics studied. The changes in IgE levels during the viral infectious period are discussed in terms of possible cellular mechanisms that may control IgE immunoglobulin.


Nutrition in the Humphrey tradition.

This is only a partial overview of some of the activities within DHEW related to nutrition, with a particular focus on the Nutrition Coordinating Committee. Although the activities are already broad, they will expand as we identify additional problems and decide on appropriate solutions. Let me call on the members of The American Dietetic Association to assist us in our efforts to assign priorities to our activity. My discussion began with nutrition education, because this is a priority for both The American Dietetic Association and DHEW. We would welcome your help now and in the future as we attempt to make our programs in nutrition education and information more effective, more available, and more responsive to the needs of the American people. Nutrition in the Humphrey tradition is alive and well in DHEW.


Infant feeding practices and obesity.

Selected assumptions regarding associations between artificial feeding and infantile obesity are examined. Although some artificial baby foods (desserts, meats, egg yolks) have considerably greater caloric density than breast milk, a large class of baby foods and most milks and formulas are comparable to breast milk in caloric density. The intake of infant foods seems to be related more to caloric density than volume. Modern day artificial feeding in developed countries tends to produce larger weight gains than breast feeding, although no good data exist to evaluate the composition of these weight gains. Many more data from well planned studies are needed to fully elucidate possible mechanisms of infantile obesity.


Nutritional care in pregnancy: the patient's view. I. Amount, type, and sources of dietary advice and treatment.

Interviews were conducted with ninety-two pregnant women who attended an out-patient clinic of a major obstetrical teaching hospital. All were between thirty-four and thirty-eight weeks pregnant when interviewed. Information was obtained on the amount, type, and sources of professional dietary advice; current dietary treatments; and the patterns and nature of the patients' contacts with dietitian. The dietitian was the major source of prenatal dietary advice. Only one-third of subjects received additional advice from other professionals, usually the nurse. Physicians were rarely identified as a source of dietary advice. Approximately one-third of subjects reported receiving dietary instructions to restrict intakes of calories and/or sodium. Physicians instituted these restrictions more frequently than did nurses. Few patients were referred to the dietitian for advice on these diets. Multivitamin and iron supplements were prescribed routinely. Three-quarters of subjects made at least one visit to the nutrition service, generally early in their prenatal care. For most subjects, this was their first experience with a dietitian. Nurses made considerably more referrals to the dietitian than did physicians. There would appear to be a need to educate other health professionals, especially physicians, on the advantages of more liberal diets and weight gain in pregnancy and on the special skills of the dietitian in promoting sound nutritional habits.


Nutritional care in pregnancy: the patient's view. II. Perceptions, satisfaction, and response to dietary advice and treatment.

Ninety-two pregnant women attending the out-patient clinic of a major obstetrical teaching hospital were interviewed. Information on their perception of diet during pregnancy, response to dietary advice, and satisfaction with the type and amount of dietary information given was collected. Almost all subjects considered diet to be important during pregnancy. Prenatal dietary advice was perceived as somewhat restrictive, and for approximately a third of the subjects, compliance with dietary advice was a serious concern. Most subjects indicated making some dietary changes during pregnancy, usually as a result of the advice received. Poor compliance was reported with iron supplementation, and many of the women attributed adverse symptoms to this medication. Subjects appeared more satisfied with the amount than the type of dietary advice received, and negative or noncommittal attitudes toward nutrition services were expressed by half of the subjects. Feeling of guilt, attitudes of other professionals, and perceived difficulties of complying with dietary instructions were the major reasons given for these negative feelings. Rescheduling and better integration of nutrition services in the prenatal visit are suggested to improve patient satisfaction with dietary counseling.


Nutritional care in pregnancy: the patient's view. III. Perceived need for advice and effectiveness of advice received.

Interviews were conducted with ninety-two pregnant women who attended the out-patient clinic of a major obstetrical teaching hospital. Information was obtained on the patients' perception of their need for dietary advice during pregnancy and selected demographic, nutritional, and medical care characteristics, as well as their response to, and satisfaction with, the dietary advice and treatment they received. The patients' perceived need for dietary advice appears to be an important factor in the apparent effectiveness of prenatal dietary counseling. Patients who expressed a need for dietary advice were more likely to consider diet important during pregnancy, to have positive feelings toward nutrition services, to have visited the dietitian, and to report making changes in their diet because of the advice received. Little association was observed between demographic and medical care characteristics of patients or more objective measures of need for dietary advice and the patients' own perception of need. It is suggested that patients whose expressed need for counseling is at variance with objective measures are a group requiring special attention.


Mothers' compliance with physicians' recommendations on infant feeding.

One hundred thirty-one mothers who were patients of ten physicians were surveyed to determine their compliance with physician-recommended infant feeding practices. For a direct, self-reported measure, the rate of non-compliance was nearly 30 per cent. A second measure, a "compliance score," was computed by comparing mothers' responses to specific questions about the feeding of their babies with their physcians' recommendations for normal, healthy infants. The mean noncompliance rate on this measure was 44 per cent. Differing response patterns regarding specific feeding practices were found for breast-feeding and bottle feeding mothers. To determine selected psychologic factors associated with compliance, health-related attitude and belief scales were originated and validated. Attitudes that "nutrition is important" and a "concern for health" were significantly correlated with the compliance score for breast-feeding mothers.


Trace minerals in commercially prepared baby foods.

Five categories of strained baby foods were analyzed for iron, copper, zinc, magnesium, manganese, strontium, and cadmium. Meats, egg yolk, and cerals tended to have the highest concentrations of iron, copper, and zinc. Fruits and vegetables had lower contents of these minerals. Cereals and vegetables were the best sources of magnesium and manganese. Strontium and cadmium levels were consistently low.


Assessment of maternal nutrition.

A booklet, "Assessment of Maternal Nutrition," has been published by the American College of Obstetricians and Gynecologists in cooperation with The American Dietetic Association as a useful guide for physicians, nurses, dietitians, and nutritionists. Nutritional risks during pregnancy are clearly outlined. Clinical, dietary, and biochemical factors, as well as medical, obstetric, and social factors, are delineated as components of nutritional assessment. An A.D.A. Liaison Committee had major responsibility for the development of the "Eating Habits Questionnaire," a tool to screen dietary intake for major deficits and excesses, which is included in the booklet. It should be useful also as a starting point for nutrition education. Additional evaluation of the use and reliability of the screening tool is recommended.


A new geriatric application of electrocardiographic treadmill testing in an office setting.

An accepted method of measuring exercise tolerance was applied exclusively to geriatric practice for the purpose of exercise prescription. This stress testing was performed to minimize the risks of introducing exercise in an elderly population, and to restore or maintain elderly persons at their own optimal level of function, for life. As no geriatric testing protocol was available, two standardized protocols were chiefly used to start the trial program in March, 1978. A geriatric modification devised by the author is described. During the first month of the study, in a physician's office, ECG-monitored treadmill testing was conducted without mishap in 175 patients (age range, 60--89 years). All but 4 of the subjects (98 percent) led habitually sedentary lives, and documented coronary heart disease was present in about one-fourth of the series. The initial test data in this proposed continuing study are summarized. The methods for candidate selection, the safety precautions, and the test procedure are outlined. The distinction is made between testing by functional grades and testing to maximal levels. Information obtained from this stress test is an integral part of the individualized exercise prescription for each geriatric subject.


Bacterial pneumonia in the elderly: a reappraisal of conventional therapy, with a note on cefamandole.

Community-acquired bacterial pneumonia in the elderly has for years been attributed almost exclusively to Streptococcus pneumoniae. Recent technical advances have provided bacteriologic and epidemiologic data demonstrating that other pathogens are important causes of pulmonary infection in older patients. This report reviews these data and reappraises the conventional therapy of community-acquired bacterial pneumonia in geriatric patients. Some properties of a new antibiotic, cefamandole nafate, are described.