Intranasal corticosteroid injection: indications, technique, and complications.

The intranasal injection of corticosteroids for symptomatic relief of nasal obstruction in selected cases has been described by several authors and widely used for over 25 years. Recently, circulated reports of blindness following such injections caused a number of otolaryngologists to discontinue using the procedure. All reported cases of visual complications following intranasal corticosteroid injection are reviewed, together with the reported experiences of the author and others who have successfully used the technique in thousands of cases. Preliminary topical cocainization of nasal mucosa and slow submucosal injection of a micronized corticosteroid suspension to minimize the risk of vasospasm and embolization involving the ophthalmic circulation are stressed. Indications for the procedure, the most common side effects, and the proper technique of injection are described.


Anatomy of the subglottic larynx.

There is little concensus concerning the boundaries of the subglottic space. To better define the subglottis, 50 head and neck surgeons were asked to define its anatomic limits. In addition, the larynx of each of 25 male and 25 female adult cadavers was removed, and four measurements in the anterior subglottis were taken. The results revealed significantly smaller subglottic dimensions for the women than for the men.


Benign chondroblastoma of the temporal bone.

Benign chondroblastoma is a rare tumor in the temporal bone. It occurs preponderantly in middle-aged men as a mass in the postero-superior region of the ear canal and is accompanied by hearing loss. On pathologic examination, giant cells and focal regions of chondroid differentiation are noted. After the extent of the tumor has been determined, the treatment is surgical removal. Preoperative irradiation may be helpful. Long-term follow-up is essential.


Preschool otologic and audiologic screening.

A study of otologic and audiologic screening of preschool children including tympanometry, acoustic reflexes, and pure-tone screening was carried out at school sites. Subsequent pure-tone threshold tests and otolaryngologic examinations were carried out in a hospital setting. Complete data are available on 1,335 subjects, ages 3 through 5 years. Results are reported in comparison with those of an earlier Pittsburgh screening study. The results of the earlier study showed that loss of hearing sensitivity could not be predicted by the otologic findings, and conversely, the otologic findings could not be predicted by the air conduction thresholds. The results of the present study showed a contribution by tympanometry and acoustic reflexes. The results are evaluated in terms of screening effectiveness in these age groups. One of the recommendations combines an interpretation of certain large negative tympanometric peak pressures (TPP) along with the absence of acoustic reflexes to certain stimuli. The method is more efficient than other aspects of middle ear measurement or of pure-tone screeniing. The efficiency of each procedure is documented. Summary matrices are used to show the effectiveness of each test compared to all other tests in the identification of subjects with hearing or middle ear dysfunction. A protocol for screening evaluation and otologic referral is suggested to effect a balance between over-referral and correct identification.


Suggestions for monitoring patients during treatment with aminoglycoside antibiotics.

Guidelines are suggested for the surveillance and prevention of ototoxicity in adults, based on experience and a compilation of opinions from otolaryngologists and infectious disease specialists. The influence of dosage and renal function on serum levels and their relevance to ototoxicity are discussed. Indications for testing of inner ear function are considered.


Stapedius muscle function tests in the diagnosis of neuromuscular disorders.

Muscle weakness and different patterns of fatigability are frequently seen in neuromuscular disorders. The value of a battery of stapedial muscle function tests in the diagnosis and management of these disorders has been evaluated. Each test of stapedial muscle function is described, and case examples of these tests in various neuromuscular disorders including myasthenia gravis and idiopathic facial nerve paralysis are reported.


The CT scan: pitfalls and posterior fossa cisternography.

A case of an inadequately enhanced 4-cm acoustic tumor missed by initial CT scan and diagnosed six months later on a second, different CT scanner is reported. The most common pitfall in acoustic tumor diagnosis by CT scan is the inability to resolve tumors less than 1.5 cm. This necessitates a posterior fossa cisternogram. A method of tumor size classification based on CT scan and cisternography is proposed.


Evaluation of the speech perception in noise (SPIN) test.

Several investigations were perfomed with normal hearing subjects to determine the effects of presentation level and signal-to-babble ratio on the speech perception in noise (SPIN) test. The SPIN test contains sentences that simulate a range of contextual situations encountered in everyday speech communication. Findings from several representative patients with sensorineural hearing loss demonstrate the possible clinical utility of the test to measure the effects of context on speech discrimination.


Hypercoagulability as a cause of sudden neurosensory hearing loss.

Fourteen patients with a documented sudden neurosensory hearing loss and four patients with other diseases causing neurosensory hearing loss were studied. The standardized coagulation workup included hematocrit, activated partial thromboplastin generation time, thrombin generation, prothrombin time, phase platelet count, platelet adhesivity, protamine sulfate, serum antithrombin III activity, fibrinogen, and Factor VIII values. Ony those patients having documented evidence of a neurosensory hearing loss occurring within hours or days were included in this study. Eight of the 14 paitents with a documented sudden neurosensory hearing loss satisfied our laboratory criteria for a diagnosis of in vitro hypercoagulability. Three of these patients had abnormal thrombin generation values, 4 had abnormal serum antithrombin III values, and 1 had an elevated platelet count. Four other patients with other diseases causing neurosensory hearing loss did not show evidence of in vitro hypercoagulability. It would appear from this data that coagulation abnormalities play a role in the pathogenesis of sudden neurosensory hearing loss.


Sterile preparation of the external auditory canal with povidone-iodine.

Sterile preparation of the external auditory canal is usually not undertaken, although the external auditory canal provides surgical access for several procedures involving the tympanic membrane, middle ear, and vesibule. This is due to the rarity of postoperative wound infections, as well as difficulty in sterilizing the external auditory canal. Four antiseptic solutions commonly used for operative preparation were tested to determine thrir potential for sterilizing the external auditory canal. Povidone-iodine solution was effective in sterilizing 90% of the external auditory canals of children and adults. This simple technique may find clinical use in surgical procedures involving the external auditory canal.


Cutaneous basosquamous carcinoma of the head and neck: a comparative analysis.

Considerable debate has taken place concerning cutaneous basosquamous carcinomas. Some authors believe they are merely a variant of basal cell carcinoma, based on the apparent rare occurrence of metastases. This comparative study of 33 cases of basosquamous, 1,796 cases of basal cell, and 736 cases of squamous carcinomas arising in the head and neck demonstrates that the basosquamous lesion has the potential to recur and to metastasize, which is similar to squamous cell lesions. An aggressive primary treatment program is recommended.


Predicting postoperative voice characteristics of spastic dysphonia patients.

Current treatment of spastic dysphonia may involve unilateral RLN section preceded by a temporary chemical paralysis of one RLN as a diagnostic test. This study compared the immediate postchemical paralysis and postsurgical paralysis voice and speech qualities of 33 spastic dysphonic patients using perceptual, acoustic, and temporal measurements and found that following section of the RLN, there was a decrease in overpressure and aperiodicity, an increase in vocal range, and a reduction of breathiness. Vocal tremor and speech rate were variably affected. It appears that chemical paralysis of the RLN is a fairly accurate means of previewing the postsurgical voice.


Muscular anatomy of the tonsil and tonsillar bed: a reexamination.

A study was designed to investigate the muscular relations to the tonsil and tonsillar bed in man. Twenty-one histologically prepared human fetal specimens were examined. Muscle bundles from the palatopharyngeus and stylopharyngeus muscles and the amygdaloglossus muscle were found to relate to the tonsillar capsule in such a way as to suggest that during swallow, the tonsils may be moved laterally to permit a wide and unobstructed pharyngeal port.


Transposition of infrahyoid muscles to replace intrinsic laryngeal muscles: technique and long-time observations on return of function.

Insertion of the separate motor branches of the caudal laryngeal nerve of the dog separately and atraumatically into a denervated infrahyoid muscle resulted in reinnervation of that muscle, as indicated by the appearance of electromyographic potentials two months postoperatively. When the nerve branches were used to reinnervate a sufficiently large mass of muscle, which was transposed to replace surgically removed intrinsic laryngeal muscles, nearly normal adduction and abduction of the vocal cord was obtained on the experimental side in some dog if ample time were allowed for maturation of nerve fibers and motor end plates. The minimum time for return of effective function under these circumstances was slightly more than 12 months, and function may improve for up to 36 months. A simplified procedure is described for reconstructing the intrinsic laryngeal muscles following submucosal resection. Electromyography is useful in monitoring the progress of reinnervation of muscle, but it is not a reliable indicator of mechanical function.


Unilateral complete aplasia of the inner ear with associated tracheoesophageal fistula: report of a case.

A case of unilateral complete aplasia of the petrous apex and inner ear associated with H-type tracheoesophageal fistula is reported. polytomography, computerized axial tomography, and plain film radiography confirmed the presence of this rare variant of inner ear aplasia. This patient, who has normal facial nerve function, is, to our knowledge, the first reported case of a nonthalidomide, Michel-type aplasia since the original report of Michel more than a century ago. Unilateral complete inner ear aplasia associated with tracheoesophageal fistula has not been previously reported.


Implications of Ewald's second law for diagnosis of unilateral labyrinthine paralysis.

The feasibility of replacement of the caloric test with sinusoidal rotatory stimulations of differing frequencies was investigated in ten normal subjects and seven patients with unilateral labyrinthine paralysis. Testing was performed at frequencies ranging from 0.0125 to 0.2 Hz at 60 degrees/sec and at 0.05 Hz at peak velocities of 30 degrees/sec to 180 degrees/sec. Gain, phase, and asymmetry of the nystagmic responses were measured in these groups. Results indicated that the rotatory test was not reliable enough to be used as the sole measure for identifying patients with unilateral labyrinthine lesions.


Thermal hazards in mastoid surgery: an evaluation of instruments and irrigation techniques.

Study of the mechanical properties of three commonly used mastoid drills disclosed major differences in their power and potential for heat production. Based on available information regarding heat tolerance of neural tissue, all drills were found capable of producing hazardous temperature elevations. After testing several irrigation techniques, continuous and copious suction irrigation was found to be most effective in preventing bone heating.


Further study of the surface morphology of the embryonic mouse cochlear sensory epithelia.

Histologic development of the mammalian cochlea has been studied by many investigators. In 1978, Li reported on a preliminary scanning electron microscopic study of hair cell development in the embryonic mouse cochlea. The present study further examines the surface morphology of the embryonic cochlea.


Sensorineural hearing level in unilateral otosclerosis.

Preoperative bone conduction threshold measurements were made in the otosclerotic and opposite ears of 25 patients with unilateral otosclerosis to tabulate the sensorineural hearing impairment in this disease. Middle ear otosclerosis was confirmed at surgery in all cases. The bone conduction thresholds at all frequencies measured were similar in the otosclerotic and opposite ears. Adequate masking was applied to the nontest ear to measure an accurate bone conduction threshold in the test ear without producing overmasking.


Olivocochlear bundle activity recorded in awake cats.

Multi-unit activity was recorded in awake cats from the crossed olivocochlear bundle (COCB). Miniature stainless stell concentric electrodes were chronically implanted onto the floor of the fourth ventricle of six animals. There was no activity at the electrode tip in anesthetized animals, while in awake cats a great deal of unit activity could be seen. A correlation between COCB activity and ongoing behavioral activity such as scratching, grooming, yawning, or orientation could not be established. It was found, however, that the multi-unit responses in the COCB statistically increased their firing rate during acoustic stimulation, and a 500-Hz tone was found to be most effective. The electrode locations were histologically confirmed. The present results are similar to other data that describe unit activity in the olivocochlear bundle of decerebrate cats. The capacity to record from this fiber tract in awake animals, however, provides a new tool for studying the peripheral efferent pathway of the auditory system.


Some tips on face-lifting.

The face-lift operation is not difficult for the well-trained otolaryngologist. However, as in every surgical procedure, there are certain techniques that facilite its performance and improve results. This paper discusses some of these techniques that have been developed during the past 20 years.


The tenacity of the frontal sinus mucosa.

A number of persons in other surgical disciplines express a blatant disregard for the potential dangers of frontal sinus mucosal entrapment. Although bone removal is universally recommended by the otolaryngologic proponents of ablative procedures in the frontal sinus, no comprehensive explanation has been proffered to justify this dictum. To this end, 27 cats had simple excision of the frontal sinus mucosa to see if it is necessary to bur away the inner table of bone to completely eliminate all vestiges of mucosa. Mucosal regrowth was seen in 72%, and suppurative infection, in 17% of the sinuses. Burring away of the frontal sinus inner table must then be considered as an essential part of any ablative procedure of the frontal sinus.


A conceptual approach to local flaps.

Few procedures offer the surgeon a greater opportunity to exercise his surgical and aesthetic judgement than the design and implementation of local flaps about the head and neck. Considerations include skin color and texture match; adequacy of flap blood supply; size, location, and characteristics of the donor site defect; functional capability of the proposed flap; nature of skin tension lines created; and number of surgical procedures required. A systematic approach to local flap design and implementation is presented, and illustrations of the geometric principles involved are included.


Moire topography in facial plastic surgery.

Moire topography, a form of biostereometrics, is a technique that provides one-step contour maps. Facial measurements so obtained may be useful in reconstructive surgery.


Introductory remarks regarding facial plastic and reconstructive surgery.

Some of the components of the author's training program at UCLA and in his actual practice in San Diego are compared, the type of surgical cases completed in training and in practice are examined, and the community acceptance of the author's definition of an otolaryngologist is commented on. Some of the conclusions regarding residency programs may be different from those of other specialists. The author's perspective is as a clinical assistant professor one year out of residency with an acute interest in the preparation for actual practice.


Otolaryngologic aspects of scuba diving.

Among the most common injuries encountered by the 700,000 active sport scuba divers in the United States are sinus and otitic barotrauma. The management of these injuries and the identification of high-risk patients during their required pretraining physical examination are discussed.


Augmentation of facial defects using Mersilene mesh implants.

The use of Mersilene mesh in both office and hospital practice was surveyed. Seventy patients received a total of 83 implants, 66 (80%) of which were Mersilene mesh. Of these 83 implants, 76 (91%) were used in chin augmentation, preponderantly by the intraoral route. An infection rate of 9% (8) was encountered; 4 (5%) of these required removal. The ideal implant material has not yet been discovered, but hopefully, with continued research and with the sharing of ideas, a more suitable implant will be found.


Radiation-induced carcinoma in a hemangioma.

A case of squamous cell carcinoma arising in repeatedly irradiated buccal hemangioma is reported, and the surgical techniques used in reconstructing the cheek and lips are described.


Juvenile spindle cell carcinoma.

Spindle cell carcinoma is an uncommon variant of squamous cell carcinoma that is rarely seen in children. The spindle cell pattern is frequently confused with sarcomas. A case of spindle carcinoma in a 14-year-old boy is presented. He is the youngest patient, to the authors' knowledge, with spindle cell carcinoma of the maxilla. Electron microscopic examination is helpful to define the epithelial nature of the spindle cells and can be performed on formalin-fixed tissue. Electron microscopic examination is essential to formulate an optimal treatment plan.


Mesenchymoma of larynx and neck.

A case of mesenchymoma of the larynx and neck with respiratory obstruction is presented. Mesenchymoma is a rare lesion in the head and neck area in which fibrous tissue is accompanied by two other mesenchymal components, often with an infiltrating margin in benign forms. The majority appear in patients under 25 years of age, most commonly in the subcutaneous scalp, cheek, or tongue. There is a 20% recurrence rate. A malignant type also occurs. Wide surgical excision is the treatment of choice.


Malignant schwannoma of the trigeminal nerve.

Malignant schwannomas are rare in the head and neck, even though benign schwannomas of this area are common. A case of a malignant schwannoma of the fifth cranial nerve with symptoms of otalgia and serous otitis media is described. About 20 such cases have been reported in the literature.


Posterior cranial fossa and temporal bone meningioma in a child, appearing as a neck mass.

Meningiomas are usually benign lesions that rarely involve the temporal bone and rarely occur in children or adolescents. A case of a posterior cranial fossa and temporal bone meningioma in a 9-year-old girl is presented; no similar case was found in the world literature.


Ganglioneuroma of the C4, C5 interspace.

Neurogenic tumors in the neck region are relatively infrequent with the exception of those involving the cranial nerves. A case of a ganglioneuroma or neurofibroma involving the nerve root of C4, C5 interspace is reported. The tumor appeared as a mass within the neck with a slight amount of pain in the shoulder and upper arm upon palpation. Surgical exploration revealed a mass superficial to the foramen and erosion of the foramen. Roentgenograms taken in the region demonstrated an extradural mass that was subsequently removed by laminectomy. Postoperatively, the patient did quite well. Surgical excision is the treatment of choice. Preservation of the nerve should be accomplished if at all possible.


Chondrosarcoma of the nasal septum extending into the maxillary sinus.

A case of chondrosarcoma of the nasal septum extending into the maxillary sinus is presented. These cartilaginous tumors are rare in the head and neck, with only 21 reported in the maxilla and four in the nasal septum. Careful histologic analysis is required for correct diagnosis. The present case was treated with an en bloc ethmoidectomy and medial maxillectomy, followed by fast neutron radiation therapy. The therapeutic program is analyzed for opportunity to provide an excellent chance of cure.


Teratoma of the nasopharynx in the newborn.

Teratomas of the newborn are rare true neoplasms occasionally arising from the nasopharynx and causing respiratory obstruction. A case requiring immediate tracheostomy is presented along with its subsequent management and eventual extubation. A brief discussion of teratomatous tumors is given. This case represents the youngest patient to receive a tracheostomy.


Radiation-induced carcinoma of the temporal bone.

A case of a patient in whom carcinoma of the right temporal bone developed 39 years after a series of injections of radium chloride is presented. Carcinomas of the temporal bone and paranasal sinuses are a complication of radium administered therapeutically or ingested accidentally by watch dial painters.


[Experiences with miconazole in the prevention and therapy of candidiasis].

1. The treatment of 26 children suffering from haemoblastoses and tumors by the antimycotic Miconazol is reported on. 2. The application took place prophylactically as well as therapeutically by an oral or intravenous administration. Mycological examinations (stools, urine, throat swab, blood) have been carried through before, during and after the treatment in weekly intervals. 3. The result of treatment is altogether to be called good, invasive mycoses have been prevented and proved Blastomyces infections successfully treated. 4. Side effects like nausea and vomiting were observed only in one case, damages of the haematopoietic system, the liver and kidneys could not have been demonstrated.


[Tetralogy of Fallot in a father and son].

A family is reported on, in which the tetralogy of Fallot is present in the father and the eldest son. In both the patients a total correction took place. The mother and the second son are healthy.


Basal cell carcinoma of the temporal bone.

A case of a 57-year-old man with a 25-year history of untreated basal cell carcinoma of the ear is presented. The lesion resulted in auricular destruction and temporal bone invasion. This case emphasizes the potential destructive ability of basal cell carcinoma. Extensive resection and reconstruction were required for control.


Element content of intracochlear fluids, outer hair cells, and stria vascularis as determined by energy-dispersive roentgen ray analysis.

Roentgen ray spectrometry was used to obtain element spectra from isolated samples of perilymph, endolymph, outer hair cells, and stria vascularis obtained by microdissection from the freeze-dried inner ears of chinchillas. The spectra of perilymph and endolymph residues indicated that no cross-contamination of the two cochlear fluids occurs during freeze-drying or sampling. The spectra of outer hair cells suggested that the extracellular fluid in the organ of Corti spaces is similar to perilymph in its ionic content. The spectra of stria vascularis samples indicated low sodium and high phosphorus contents. Energy-dispersive roentgen ray analysis of freeze-dried inner ears appears to be a promising method for low-contamination measurement of ion distribution in the cochlea.


Malignant parapharyngeal schwannoma (neurilemmoma).

A malignant parapharyngeal neurilemmoma developed in a 45-year-old woman who had had a benign solitary neurilemmoma removed from the same area nine years previously. Incomplete excision was achieved through a mandibulotomy approach. Malignant schwannoma usually is associated with neurofibromatosis and has a poor prognosis, spreading along the nerve of origin or by blood stream. Small localized tumors should be treated aggressively by surgery. The possibility that a previously benign schwannoma underwent malignant transformation must be considered.


Multiple simultaneous paragangliomas of the head and neck in association with multiple retroperitoneal pheochromocytomas.

A patient in whom multiple, familial, catecholamine-secreting head and neck paragangliomas and retroperitoneal pheochromocytomas were identified is reported. There were at least nine primary and possibly five recurrent neoplasms, the most reported in a single patient. In patients with family history of pheochromocytoma or paraganglioma or with multiple tumors, careful laboratory and angiographic studies are indicated to discover additional lesions.


The morphologic effects of histamine on the lateral cochlear wall.

The chinchilla lateral cochlear wall (stria vascularis, spiral ligament, and spiral prominence) was examined by morphologic and histochemical techniques following various doses of intravenous histamine. The three main findings were as follows: (1) the basic ultrastructure was not altered by histamine; (2) there is a time- and dose-dependent change in the rate of stria vascularis vessel permeability to a small protein tracer (horseradish peroxidase), but the mode of transport (large pore system) is unchanged; and (3) glycogen depletion in stria marginal cells occurs with its apparent mobilization into stria intercellular spaces.


A longitudinal study of cellular changes in experimental otitis media.

A longitudinal sequential study of otitis media in an experimental animal (cat) using eustachian tube obstruction was done. Fifty animals were used. The continuum of mucoperiosteal changes from one day to six months after obstruction revealed gradual changes that were similar for each animal. Stages were defined, and by using different staining techniques, including immunocytochemistry, an overall middle ear defense system was postulated and documented. Nonspecific as well as specific defense systems, including localized immunity, were described. Effusions were studied in a continuum, and their pathogenesis was discussed.


Corneal pain evoked by thermal stimulation.

The thermal sensitivity of the eyelid and cornea was compared using an automated apparatus to produce stimulus pulses of known magnitude and duration over the range 33--45 degrees C. Subjects reported only temperature sensation when the skin of the upper eyelid was tested; however, corneal stimulation in the same subjects was always perceived as nociceptive. The possibility that other ocular tissues may be involved in the pain responses was shown to be unlikely by direct experimentation or by calculation of heat flow in those tissues. Cornea and eyelid thresholds were compared in relationship to the structural and physical properties of these tissues. It was found that the nerve endings of the corneal epithelium are less sensitive to temperature change when compared to the thermal receptors of the eyelid. It is concluded that the cornea is useful for the experimental study of pain.


Nociceptive flexion reflexes elicited by noxious laser radiant heat in man.

This study, carried out in humans, is an attempt to elicit nociceptive flexion reflexes and to investigate the sensation reported by the subjects, using thermal stimulation achieved with laser radiant heat. It was found that noxious termal stimulation elicited long latency nociceptive reflexes very well correlated with a pricking pain. Since thermal stimulus is more specific and natural than an electrical one, it seems that this method should be of interest for pain research in man.


Ratio scaling of pain perception with the submaximum effort tourniquet technique.

The submaximum effort tourniquet technique (SETT) is becoming more widely used as part of the clinical assessment of chronic pain patients despite little information about the scaling of this technique. Ratio scaling procedures resulted in a linear function, presumed to underlie clinical application of the SETT, for only 11% of the subjects. Therefore, current clinical use of the tourniquet ratio score should be questioned. Normals also obtained significantly more negatively accelerated power functions than pain patients with no difference in tolerances. Differences in these growth curves are discussed with reference to the concept of pain endurance. Continued needs for standardized pain evaluation techniques suggest that this type of psychophysical scaling procedure may improve the precision of some clinical pain assessments.


Tooth pulp-driven neurons in somatosensory cortex of primates: role in pain mechanisms including a review of the literature.

The tooth pulp of primates was stimulated electrically while searching for evoked unit potentials in the cerebral cortex. Control procedures were employed to assure that the electrical stimuli reached only tooth pulp fibers but no extrapulpal sensory fibers. In addition, an electrode was inserted in soft tissue surrounding the tooth for separate excitation of extrapulpal axons. A tooth pulp projection area was identified in the "face area" of primary somatosensory cortex. Two major neuron groups were encountered, one excited only by the extrapulpal soft tissue stimulus, the other by tooth pulp stimuli. Within the pulp-projection area, soft tissue-driven neurons were most numerous in superficial cortex of the postcentral gyrus, pulp-driven neurons dominated in deep cortex in the base of the central sulcus. The pulp-driven population divided into several functional subsets: those excited from one pulp only (conceivably capable of localizing pulpal stimuli), those excited from more than one pulp and those excited from both pulp and extrapulpal soft tissue. Within each of these 3 pulp-driven subsets, some units responded to single shock, others only to a train of shocks. Mean discharge latency was shortest for the population excited only from soft tissue, intermediate for pulp-driven units excited by single shock and longest for pulp-driven units excited only by trains of shocks. Both soft tissue and pulp stimuli evoked extensive inhibitory effects. In the Discussion, the possible role of pulp-driven neurons in pain is considered. The functional properties of some neurons are consistent with a role in stimulus localization but those of the remaining neurons suggest other roles in pain. An examination of the literature on cortex and pain suggests that normally somatosensory cortex is important for localizing painful stimuli and that it contributes to other pain mechanisms as well. After certain lesions, somatosensory cortex has the capacity for generating "central" pain just like other structures in the nociceptive pathway.


Periventricular system lesions and stimulation-produced analgesia.

Three areas within the periventricular system were studied: caudal periaqueductal gray (PAG), rostral PAG, and caudal midline thalamus. Rats were chronically prepared with a bipolar stimulating electrode in one of these areas and two lesion electrodes in another. Current thresholds for stimulation-produced analgesia in the tail-flick test were assessed. Then, lesions were made and thresholds for analgesia re-assessed. Destruction of the caudal PAG consistently produced large increases in thresholds for analgesia at rostral stimulation sites; however, destruction of the rostral areas did not affect thresholds at caudal PAG sites. Lesions in all 3 areas yielded significant reductions in baseline (pre-brain stimulation) tail-flick latencies. Both sham lesioned control animals and animals with small lesions maintained stable baseline latencies and analgesia thresholds. The data support the view that all 3 brain areas studied contribute to the same pain-inhibitory system. They further suggest that stimulation at rostral sites activates elements which connect to or pass through the caudal PAG.


Bone and soft tissue changes in paraplegic patients.

The loss of bone mineral in 66 paraplegic patients has been measured in the lower femoral shaft by scanning the leg with a beam of mono-energetic radiation from 241Am. The profile of the transmitted radiation was used to determine a parameter which was related to bone mass. The bone mass of paraplegic patients was significantly lower than normal. Persistent paralysis does not lead to a continued fall in bone mass, but once it has fallen, bone mass remains constant. Soft tissues also showed a muscle/fat ratio was lower than normal.


Fatal intra-peritoneal bladder rupture due to blocked catheter in a paraplegic.

A female paraplegic developed intraperitoneal rupture of urinary bladder seven weeks after institution of indwelling urethral catheter drainage. Blockage of the catheter precipitated this fatal event. Oliguria after an initial encouraging urinary output despite adequate fluid replacement led us to suspect bladder rupture which was confirmed by urgent cystography. Although emergency laparotomy to repair the rent in the bladder was performed, she succumbed to gram-negative septicemia. Other hazards of indwelling urethral catheter drainage even for short periods are highlighted (though the above complication itself is admittedly rare) with an oft re-emphasised plea to consider earlier the alternative modality of intermittent catheterisation or pharmacotherapy in female patients.


Brain abscess following the insertion of skull tongs.

Brain abscess is an uncommon complication of the insertion of skull tongs. The two cases reported demonstrate the difficulty that may occur in diagnosis and the high mortality associated with this complication.


Fatal basilar artery occlusion following cervical spine injury.

A patient rendered acutely quadriplegic in an automobile accident was shown by angiography to have occlusion of the left vertebral artery. One month later, he abruptly became unconscious, apneic and died. Autopsy showed an organised thrombus in the left vertebral artery and a fresh thrombus occluding the entire basilar artery. This case differs from previously reported cases of traumatic vertebral artery thrombosis wherein symptoms of brain stem infarction were more immediately evident.


Spinal cord lesions after diagnostic and therapeutic procedures.

This paper is dealing with spinal cord lesions following diagnostic and therapeutic procedures according to the literature and some personal observations. It becomes quite clear what prices have to be payed using modern methods. There are not only surgical procedures involved. Spinal cord lesions following medical activities cannot be judged as malpractice in any case. Some of these accidents can be avoided by strong indications and sophisticated performance of any procedure.


Paraplegia following cardiovascular surgery.

A study of recent cases of spinal cord damage following aortic surgery confirmed previous reports that damage was confined to the anterior horn cells of the lumbar and sacral segments of the cord, with preservation of posterior column function and satisfactory bladder control.


Surgical injury of the cord and its roots.

Fifty-two patients sustained spinal cord, nerve root or combined injury following treatment conducted primarily by neurological and orthopaedic surgeons. Most patients did not receive the benefit of appropriate conservative treatment. Correct diagnosis was usually not arrived at even though diagnostic studies were performed sufficiently well to permit such diagnosis. Surgical treatment fell below standard in 86% of the cases in which the issue of adequacy was relevant. Post-operative care was also generally inadequate. The surgeons often failed to detect, diagnose, or reoperate promptly and properly for post-operative paralysis. These adverse results were not related to isolated surgical mishaps, to natural course of the disease, or to the inevitable result of treatment. They stem from a general failure of the surgeon to meet his responsibilities as a practitioner. There are both medical and social implications of this finding.


Recovery mechanisms from acute hypoglycaemia in complete tetraplegia.

Acute hypoglycaemia has been achieved in tetraplegic subjects and in healthy controls using insulin. The recovery from hypoglycaemia has been followed by measuring appropriate substrate levels in blood. Abnormal responses of lactate and free fatty acid concentrations were observed; blood glucose recovery proceeded at a normal rate.


Physiological responses to insulin hypoglycaemia in spinal man.

The physiologically responses to hypoglycaemia induced by fish insulin were studied in nine tetraplegic subjects with physiological complete cervical spinal cord transection between C4 and C8. During hypoglycaemia there was a reduction in both systolic and diastolic blood pressure unlike in normal subjects. This was accompanied by a rise in heart rate. The normal rise in plasma adrenaline levels did not occur. Plasma human insulin levels were suppressed. The usual neuroglycopenic symptoms accompanying hypoglycaemia did not occur in the tetraplegics.


Acute spinal epidural abscess.

A case of acute spinal epidural abscess is reported demonstrating many of the important features in the natural history of the disorder. The pathological changes in the cord at the level of the lesion are described. A series of 12 patients is reviewed. The average interval between the initial consultation and the onset of complete paralysis is 5 days and it is essential that the diagnosis is made during this period. Two indicators of prognosis are discussed--the duration of complete paralysis and the extent of sensory disturbance.


Spinal cord involvement in systemic lupus erythematosus.

A review is made of the literature on central nervous system involvement in systemic lupus erythematosus (CNS-SLE). Particular attention is focused on lupus myelopathy. Referring to two well-documented personal cases, the authors describe the characteristic multisystem involvement, protean clinical pattern, serum and cerebrospinal fluid changes, histoimmunologic findings, response to corticosteroids and immunosuppressive agents and some prognostic features.


Spinal cord angioma--non-progressive disease?

In an analysis of 214 patients admitted to the Midland Spinal Injuries Unit with non-traumatic cord damage 18 patients had arteriovenous malformations (AVM of the cord. This paper describes the experience gained by this unit in the rehabilitation of these patients. A brief review of literature is included, essentially to highlight the relentless progress of the disease. The overall rehabilitation potential of these patients was poor. Fifty per cent of patients had further neurological loss during the follow-up period after the onset of paraplegia.


An evaluation of discrepancy in capacity and contour of the neurogenic bladder as shown on cystography and pyelography.

A significant difference in the filling of the bladder with contrast medium on intravenous pyelography as compared to cystography has been noted in patients with spinal cord injury. Bladder capacity and contour of the bladder wall have been assessed in 50 patients with impaired bladder innervation consequent upon spinal cord injury. In 32% of the patients the bladder capacity was significantly greater when measured on pyelography than that found in cystography. The causes for this discrepancy in bladder filling on the two examinations are discussed. The possibility of erroneous assessment of the capacity and contour of the neurogenic bladder on cystography is pointed out.


Traumatic atlanto-axial fracture disclocation in a child.

An 18-month-old child was rendered tetraplegic below C6 in a road traffic accident. There was an associated fracture-dislocation of the atlanto-axial joint. Early management, and the probable role of autonomic dysreflexia in increasing the neurological deficit are considered.


Dilatation of the resting posterior urethra in spinal cord injury patients.

In 26 patients with detrusor-sphincter dyssynergia after a spinal cord injury the resting posterior urethra at cystography was found either closed as in normal subjects or open to a varying degree. Highest intravesical pressure measured at cystometry during uninhibited detrusor contraction was statistically significantly related to the degree of dilatation of the resting posterior urethra. An even higher correlation coefficient was found between the dilatation of the resting posterior urethra and an arbitrary score calculated on the basis of highest cystometric pressure and duration of disease since spinal cord injury. The possible importance of this finding in relation to incontinence after urethral sphincterotomy is discussed.


Dialysis bone disease in childhood: treatment with 25-hydroxycholecalciferol.

The effect of 8 months of administration of moderate doses of 25-hydroxycholecalciferol (25 OH D3) on radiologic, biologic, and bone histologic changes was assessed in five children on chronic hemodialysis. Osteomalacia, defined by an increase in the thickness index of the osteoid seams and decrease of the calcification rate, was present on the initial bone biopsy of only one patient and improved with the treatment. Secondary hyperparathyroidism and its prints on bone tissue, noted in all five children, did not improve in the absence of adequate serum phosphorus control. Furthermore, cancellous bone volume diminished in two patients with the administration of 25 OH D3. This activity of the drug could be related to its inhibitory effect of osteoblastic apposition as demonstrated by the decrease in the calcification rates, while the thickness index of the osteoid seams remains normal. Despite the small number of patients studied, these results suggest the importance of limiting the prescription of 25 OH D3 to children suffering from renal osteodystrophy only after having assessed unequivocally an osteomalacic component by histodynamical criteria. Secondary hyperparathyroidism appears not to be improved with moderate doses of 25 OH D3 in the absence of adequate serum phosphorus control.


Sickle cell syndromes. III. Silent-carrier alpha-thalassemia in combination with hemoglobin S and hemoglobin C.

Silent carrier alpha-thalassemia was identified in two individuals, one with sickle-cell trait and the other hemoglobin (Hb) C trait. Both are parents of a child with characteristic hematologic features of the Hb SC-alpha thalassemia syndrome, including microcytosis and an unbalanced pattern of globin synthesis. In contrast to the typical findings that accompany heterozygous Hb S or Hb C with concomitant alpha-thalassemia trait, neither of the parents had microcytosis nor a percent of the abnormal hemoglobin in their erythrocytes that was below the normal range. In both, however, globin synthesis of peripheral blood reticulocytes was unbalanced, consistent with mild alpha-thalassemia. These findings suggest that the alpha-thalassemia silent carrier may be hematologically indistinguishable from the nonthalassemic individual, even when hemoglobin S or C are present.


Reduction of cholesterol synthesis by methylxanthines in cultured glial cells.

Methylxanthines are shown in this study to decrease cholesterol synthesis in cultured C-6 glial cells. Aminophylline (10(-3) M) produced a rapid decline in cholesterol synthesis so that by 6 hr, synthesis in treated cells was less than 20% of that in untreated cells, and by 24 hr, less than 10%. Aminophylline induced parallel changes in 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase activity, the rate-limiting enzyme in cholesterol synthesis. Theophylline and caffeine produced similar effects. Thus, methyxanthines caused a specific, enzyme-mediated reduction in cholesterol synthesis in C-6 glial cells to the developing nervous system, cholesterol synthesis was studied in the presence of 10(-4)M aminophylline. This represents a theophylline concentration in the culture medium that is of the same order of magnitude as that produced in whole brain of animals administered therapeutic doses of aminophylline. Under these conditions, cholesterol synthesis was reduced to approximately 60% of control after 48 and 72 hr.


Compensatory renal hypertrophy in fetal lambs.

Compensatory renal hypertrophy was studied in fetal lambs during midgestation. Functional adaptation was correlated with anatomica and biochemical changes by measuring glomerular filtration and clearance of para-amino hippurate (PAH). Normal intrauterine body growth and kidney growth by changes in RNA and DNA over a 72-hr period were studied in twin fetuses. Seventy-two hr after left uninephrectomy in single fetuses, there was a significant increase in weight of the renoprival right kidney as well as a significant increase in renal cortical content of RNA and DNA. The rate of increase in RNA was greater than the increase in DNA. Preliminary studies suggest that an increase in renal function parallels renal hypertrophy in fetal lambs.


Evidence against a specific effect of serum from patients with cystic fibrosis on sodium-dependent glucose transport in the rat jejunum.

Sera from patients with cystic fibrosis of the pancreas (CF) and normal human sera were assayed for the ability to inhibit sodium-dependent glucose transport in rat brush-border membrane vesicles. Fresh CF and age- and sex-matched control sera were both inhibitory when compared to physiologic saline. The inhibition by CF serum was 44 +/- 13% (mean +/- SD) at a final serum concentration of 6.7%, 67 +/- 34% at 10% serum, and 68 +/- 28% at 20% serum. The ratio of the inhibition of CF sera compared to that of control sera was 1.00, 0.78, and 0.93 at 6.7, 10, and 20% serum concentrations, respectively. Although a slightly greater inhibition by CF serum was observed at a concentration of 10%, this is probably not significant because no difference could be detected at a concentration of 20% serum. Glucose transport in the presence of serum was sensitive to phlorizin indicating that the residual glucose transport was proceeding by the sodium-dependent glucose transport system. These findings suggest that CF serum does not specifically inhibit the sodium-dependent glucose transport system. The intravesicular space accessible to glucose was reduced in the presence of CF or control serum. Fresh CF serum was 1.4 times more effective than fresh control serum (P less than 0.01). The presence of substantial vesicle-shrinking activity in control serum indicates that this activity cannot be considered specific for CF.


Lysine intolerance in a variant form of citrullinemia.

An oral loading of lysine (100 mg of lysine-HCL/kg was performed in two patients, 18-and 23-yr-old, with a variant form of citrullinemia. Serum citrulline levels were approximately 10 times higher than control level and lysine levels were within the normal range, in contrast to the classical form of the disease in which serum citrulline is approximately 100 times normal levels and hyperlysinemia is usually present. After lysine loading, lysine levels rose sharply and clearance was decreased. Blood ammonia rose approximately 2.5 times. Lysine, citrulline, and arginine were markedly elevated in urine, collected 90--210 min after the lysine loading. Baseline homocitrulline and homoarginine excretion was elevated and increased further after the load.


Altered polyamine metabolism in cystic fibrosis.

Children with cystic fibrosis excreted elevated urinary levels of all three polyamines--putrescine, spermidine, and spermine. Heterozygote parents excreted intermediate concentrations of the polyamines, but not levels significantly different from levels in normal controls. Patients with cystic fibrosis who were administered a tracer amount of [14C]spermidine excreted 11--13% of the radiolabel within 72 hr whereas normal controls excreted 60--76% of the radiolabel within 72 hr. Spermine excretion was positively correlated with increased pathology as assessed by the National Institutes of Health (NIH) clinical score, whereas urinary putrescine and spermidine levels were negatively correlated with increased pathology.


Protein-bound homocyst(e)ine in normal subjects and in patients with homocystinuria.

A method was developed to quantitate protein-bound homocyst(e)ine using 2-mercaptoethanol. Protein-bound homocyst(e)ine was discovered in the plasma from normal individuals, ranging from 0.5--2.2 nmole/ml. In two obligatory heterozygotes for classical homocystinuria, plasma protein-bound homocyt(e)ine was 3.5 and 4.8 nmole/ml, respectively. Untreated homozygotes showed approximately a 40-fold increase of plasma protein-bound homocyst(e)ine. Furthermore, using conventional methods, no free homocystine was detectable in the supernatant of plasma precipitate from two classical homocystinuric patients treated with pyridoxine, but plasma protein-bound homocyst(e)ine showed a 10-fold increase. Protein-bound homocyst(e)ine was also demonstrated in the liver, kidney, and brain tissues from a patient with methylenetetrahydrofolate reductase deficiency.


Laryngeal chemoreflex in newborn lambs: respiratory and swallowing response to salts, acids, and sugars.

The laryngeal chemoreflex was tested in a standardized manner in eighteen 1- to 6-day-old lambs. The respiratory and swallowing components of the reflex response to chemical solutions introduced to the larynx were quantified to characterize the function of the receptors and to elucidate what kind of receptors most likely are involved. A relationship between the strength of the stimulus and the respiratory response was found. The response was suppressed with the addition of small amounts of CaCl2, NaCl, and LiCl. NaCl, 0.3--0.6 M, 0.15 M NaCl titrated to a pH of 3--5 with hydrochloric or acetic acid, and 0.25--1.0 M glucose in 0.15 M NaCl elicited the reflex response. A quantitative separation was seen in the respiratory response to equimolar concentrations of the salt solutions as well as to the acid solutions in normal saline with equal pH. The response to glucose was significantly reduced after application of potassium gymnemate (P less than 0.001). A direct relationship between the amount of swallowing and the respiratory response was found (r = 0.83). The laryngeal chemoreflex responses to the stimuli used have certain functional characteristics that are similar to taste receptor responses. This would suggest that the taste bud-like structures present in the laryngeal area are likely receptors for mediation of the reflex.


Malignant hyperphenylalaninemia--clinical features, biochemical findings, and experience with administration of biopterins.

Four cases of malignant hyperphenylalaninemia (MHPA) are described. Pretreatment serum phenylalanine levels were 1.5, 3.0, 2.4, and 0.9 mmoles/l. Dihydropteridine reductase (DHPR) deficiency was proven in one patient by assays on cultured fibroblastic cells and was presumed in her sibling and in another deceased patient whose parents' fibroblastic cells show approximately 50% of normal enzyme activity. DHPR and phenylalanine hydroxylase deficiency were excluded by assays on liver obtained at autopsy in the 4th patient. Parenteral administration of tetrahydrobiopterin (BH4) corrected the hyperphenylalaninemia and increased the levels of catecholamines and 5-hydroxy-indoles in the one patient studied in life, but BH4 did not reach the cerebrospinal fluid. A 3-wk course of BH4 therapy had no clinical effect. Oral biopterin was absorbed and excreted in the urine, but did not alter the serum phenylalanine level. The frequency of MHPA in Australia was estimated as 7 in 258 patients with phenylketonuria.


Chronically reserpinized rat as a model for cystic fibrosis: Na+ transport inhibitory effect in submaxillary saliva.

The retrograde perfusion assay in the rat parotid gland was used to investigate the effects of salivary secretions from control and reserpine-treated rats on Na+ reabsorption. Results demonstrated that submaxillary saliva from the treated animals caused a 69% inhibition of Na+ reabsorption, accompanied by a 28% reduction in the volume of saliva secreted, and a 22% reduction in flow rate. By contrast, submaxillary saliva from control rats caused a 6% inhibition of Na+ reabsorption, a 6% reduction in volume, and a 5% reduction in flow rate. Parotid saliva from reserpine-treated rats also inhibited Na+ reabsorption to the extent of 39% and caused a 38% reduction in volume and a 33% reduction in flow. Parotid saliva from control rats only inhibited Na+ reabsorption to the extent of 2.7% and caused a 4--6% reduction in salivary volumes and flow rates. The inhibition of Na+ reabsorption and the reduction in salivary volume and flow rates caused by submaxillary saliva of reserpine-treated rats were either abolished or significantly reduced when the saliva was previously heated to 100 degrees C, frozen, and then thawed or kept in glass tubes at 4 degrees C for 24 hr. These results indicate that saliva from reserpine-treated rats have comparable effects in this assay system to those of saliva from cystic fibrosis (CF) patients and further support its use as an animal model for this disease.


Serum ciliotoxic activity in mutant mice with some hereditary alterations resembling cystic fibrosis.

Serum ciliotoxic activity (SCA), which had been described in cystic fibrosis (CF), was studied in mutant mice with some hereditary alterations resembling this inherited disease. A test was developed to detect SCA in biologic fluids by means of a natural vibratile system; it consisted in the incubation of mouse sperm with different CF serum dilutions under controlled conditions, in order to determine the sperm translation cessation time (STCT) and the sperm activity cessation time (SACT). As the findings of this study were similar to those obtained by other authors who have been employing alternative systems, it was decided to apply this method on mice serum. Sera were obtained from male and female 3- to 4-wk-old mice of DBA/2J-cri, C57BL/6J-bgJ, and BALB/c inbred strains; SCA was investigated in affected homozygotes and their +/? siblings were used as controls. Male 8- to 16-wk-old BALB/c mice were employed as sperm donors. Significant differences were found between cri/cri and +/? mice of the DBA/2J-cri strain in both STCT and SACT determinations at 1/10 serum dilution. It is concluded that mouse sperm is a system sensitive enough to detect SCA in biologic fluids from human beings. Likewise, the test of the mouse sperm allowed us to detect SCA in cri/cri mice, turning this mutation into a possible animal model for CF.


Changes in CDP-diglyceride:inositol transferase activity during rabbit lung development.

During fetal and neonatal development the specific activity of the enzyme, CDP-diglyceride:inositol transferase in rabbit lung tissue increased 8- to 9-fold from day 17 of gestation to adulthood. This developmental increase in enzyme activity was not specific for lung tissue since a similar increase was also observed in liver tissue. The properties of CDP-diglyceride:inositol transferase in microsomes prepared from either fetal or adult rabbit lung tissue appeared to be the same. The increase in CDP-diglyceride:inositol transferase activity in rabbit lung tissue during development appeared to be reflective of synthesis of new enzyme rather than activation of pre-existing enzyme.


A study of inheritance in progressive intrahepatic cholestasis: hepatic excretory function in unaffected family members.

In an attempt to identify the heterozygotes state for progressive intrahepatic cholestasis (PIC), hepatic excretory function (131I rose bengal half-life (t1/2) and bromosulpthalein-transport maximum (BSP-Tm) was studied in controls and in eight members of a family, two of whom are affected with PIC. Values for 131I rose bengal t1/2 varied over a wide range in normal controls and were normal in patients with the syndrome of cholestasis and peripheral pulmonic stenosis in whom BSP-Tm and 45 min % retention were abnormal. 131I rose bengal t1/2 was abnormal in seven of eight family members. Despite this, BSP studies, including Tm, percent retention at 45 min, clearance were normal in all unaffected family members with the exception of the mother who has a reduced BSP-Tm. Fasting serum bile acid studies were normal in all unaffected family members. These studies do not clearly define the inheritance in this syndrome and suggest that any of the following three possibilities exist: 1) that the methods employed were not sensitive enough to detect heterozygotes, 2) that the inheritance in this syndrome is heterogenous; for instance, compound heterozygotes or autosomal dominant, or 3) that the family studies here represents a syndrome different from PIC.


Comparative hemodynamic effects of isoproterenol, dopamine, and dobutamine in the newborn dog.

To compare the hemodynamic effects of isoproterenol, dopamine, and dobutamine in the immature animal, each drug was infused into anesthetized open chest puppies and cardiac output was measured, as were systemic arterial blood pressure, heart rate, and renal artery blood flow. Cardiac output was increased by dopamine and dobutamine. Isoproterenol caused a significantly greater increment of heart rate than either of the other agents to achieve a similar change of cardiac output. Systemic arterial mean blood pressure was increased by dopamine and dobutamine, but decreased by isoproterenol. Dopamine produced a significant increase of renal artery blood flow while renal artery blood flow was unchanged by dobutamine and decreased by isoproterenol.


Iron deficiency in the rat: effects on phenylalanine metabolism.

Concentrations of phenylalanine in the plasma were markedly elevated in iron-deficient rats and appeared to vary directly with the degree of iron deficiency. Plasma concentrations of phenylalanine returned to control levels within one week after treatment of the iron-deficient rats with iron dextran. The elevated levels of plasma phenylalanine were probably not produced by a deficiency in liver phenylalanine hydroxylase because levels of activity of the enzyme were found to be normal in the livers of the iron-deficient animals.


Validity of endogenous creatinine clearance in low birthweight infants.

Despite methodologic problems, endogenous creatinine clearance is commonly used as an estimation of glomerular filtration rate (GFR). Inulin clearance was compared to endogenous creatinine clearance in a group of low birthweight infants to establish the validity of the latter. Thirty-three low birthweight infants (birthweight mean = 1600 g, gestational age mean = 33 wk) were studied between 10 hr and 10 days of age to simultaneously measure GFR by inulin and endogenous creatinine clearances. Inulin and creatinine clearances correlated directly (r = 0.738, P greater than 0.001). The slope of the regression line suggested an overestimation of GFR (inulin clearance) by creatinine clearance at the low GFR range and an underestimation at the high GFR range. The data were divided into two groups by the median inulin clearance (12.5 ml/min/1.73m2). The ratio of creatinine to inulin clearance was significantly higher in the low GFR group (1.28 +/- 0.16 vs. 0.89 +/- 0.04 SEM, n = 19, P less than 0.05). There was no difference between the two groups in plasma creatinine, birthweight, gestational age, incidence of respiratory distress, or oxygen requirements at the time of the studies. Endogenous creatinine clearance represents a good estimation of GFR (inulin clearance) in low birthweight infants. However, at the low GFR range, it represents an overestimation and at the high GFR range, an underestimation.


Sales of nonprescription cold remedies: a unique method of influenza surveillance.

In 1976, the National Institute of Allergy and Infectious Disease sponsored a nationwide network for influenza surveillance. In this paper, in addition to reporting the surveillance findings in Los Angeles, sales of nonprescription cold remedies in a large supermarket chain were evaluated as an indicator of influenza activity in the community. Twenty-seven isolates of influenza B occurred between February 17 and April 26, 1977. Peak influenza B activity occurred from mid-March to early April, 1977. A 5-10% increase in percent of respiratory and febrile respiratory illness seen in outpatient clinics was observed in late December and January. No variation in these statistics occurred during the peak of influenza activity. In contrast, sales of nonprescription cold remedies were apparently influenced by influenza B activity. Peak sales (345% increase) occurred 4 wk after the first influenza B isolate and 1 wk before peak influenza activity was documented by peak rates of isolation.


Digestion and absorption of carbohydrates by the fetal lamb in utero.

Intestinal digestive function was studied in 12 chronically catheterized third trimester fetal lambs by instilling glucose, fructose, lactose, maltose, and sucrose into their duodenums. Glucose was absorbed rapidly with the peak circulating glucose concentration reached within 1 hr. Fructose was absorbed well, but in contrast to glucose, blood fructose concentration did not peak; it continued to climb for 4 hr. Intraduodenal lactose administration resulted in a rapid rise in blood glucose with the maximum value reached in 1 hr. After receiving either glucose or lactose fetuses older than 130 days showed a faster rise in blood glucose, a greater total increase in glucose and a more rapid return to control levels than the younger fetuses. No change in blood glucose occurred with either maltose or sucrose administration. An increase in lactate concentration and a rise in fetal [H+] were noted after glucose and lactose administration, the only studies in which an increase in blood glucose concentration occurred.


Lung fluid balance in awake newborn lambs with pulmonary edema from rapid intravenous infusion of isotonic saline.

To study pulmonary transvascular filtration of fluid and the normal adaptive response of newborn animals to excessive water in the lungs, we measured lung lymph flow, pulmonary vascular pressures, and the concentration of protein in lymph and plasma of nine unanesthetized 1- to 3-wk-old lambs, before, during, and after a rapid iv infusion of isotonic saline, 130-250 ml/kg.hr for 3-4 hr. During infusions, lung vascular pressures increased, the transvascular gradient of protein osmotic pressure decreased, and there was a 2- to 5-fold increase of lung lymph flow. When infusions stopped, lymph flow decreased, as the concentration of protein in plasma increased and pulmonary vascular pressures decreased to new steady-state levels. The concentration of protein in lymph did not change for several hours after the infusions. Body weight increased by 28% and extravascular lung water content was 19% above normal after saline; these changes were associated with mild tachypnea, hypercarbia, and hypoxemia. Sections of lung from these lambs had prominent cuffs of fluid surrounding large blood vessels.


Serum complement levels in infancy: age related changes.

Levels of eight complement components and two control proteins, were determined on cord serum from normal full term neonates and serum from healthy infants aged 1 and 6 months. For all proteins, the levels were below the adult normal at birth and rose toward the adult range by age 6 months. In a second group of 271 patients, ages 1-36 months, serum Clq and properdin levels were measured. For both proteins, the mean values in early infancy were more than two SD below the adult range and did not reach the adult range until 18-21 months of age. The Clq concentration was more variable than that for any other component studied. In infants from 11 months-3 yr of age, Clq levels correlated with serum IgG levels, but properdin levels did not.


Developmental factors contributing to the susceptibility to bradycardia in isolated, cultured fetal mouse hearts.

A propensity for bradycardia in preterm human infants suggested that the heart rate response to cholinergic stimulation may vary during development. Isolated, intact fetal mouse hearts (FMH) in organ culture were used as a model to explore developmental differences in chronotropic response to cholinergic stimulation. FMH's of gestational ages (GA) from 13-22 days, maintained for 36 hr in culture, were exposed to acetylcholine (AcH) with and without prior addition of physostigmine. Heart rate decreased markedly with 10(-4) and 10(-6) M AcH (84 +/- 3 and 48 +/- 4%) in 13-14 day hearts, but the decrease was progressively blunted with increasing age and was only 7 +/- 3 and 3 +/- 2% at 21-22 days GA. Physostigmine markedly enhanced the cholinergic response in older hearts with 54 +/- 4 and 32 +/- 5% decreases in heart rate with the two doses of AcH at 21-22 days. However, it did not alter the response in younger hearts. The data suggest that the chronotropic response to AcH progressively diminishes with advancing GA and the extent of intrinsic cholinesterase activity at different GA's is, in part, responsible for the decrease.


The zinc, copper, manganese, vanadium, and iodine content of hair from 38 Canadian neonates.

Instrumental neutron activation analysis was used to establish "normal values" for the zinc, copper, manganese, vanadium, and iodine concentrations in washed hair samples from Canadian neonates. Sixteen males and 22 females (mean gestation of 40 wk; mean birthweight 3590 g) were included in the study. Their respective mean concentrations +/- SE (parts per million) were 224.0 +/- 6.29; 12.6 +/- 0.61; 0.24 +/- 0.04; 0.05 +/- 0.01; 24.3 +/- 4.76. All the trace elements were normally distributed. No correlations of hair copper, zinc, and manganese with the variables sex, parity, and maternal socioeconomic status were found. A positive correlation for zinc with manganese (0.32; P = 0.024) was apparent, suggesting that the concentrations of these two elements at birth were interrelated. It is concluded that neonatal hair concentrations of copper, manganese, and vanadium were lower than most reported values for older children and adults. In contrast, the hair zinc concentration of the neonates in this study was higher than that of Denver neonates, and may reflect higher body zinc concentrations, perhaps due to regional differences in the trace metal content of the ground water.


Effect of hydrocortisone on the metabolism of phosphatidylcholine in maternal and fetal rabbit lungs and livers.

Administration of hydrocortisone to pregnant rabbits caused a decrease in weights of fetal body and lung and an increase in the incorporation of choline into fetal lung PC. The authors found no induction of the enzymes related to the incorporation of choline into PC in fetal lung. Also, there was no stimulation of any enzymatic activity of CDP-choline pathway or PC-lysoPC cycle pathway in maternal lung and liver or fetal liver. In addition to the acceleration of choline incorporation into fetal lung PC by the cortisol, hydrocortisone also significantly stimulated the secretion of lung PC affected by glucocorticoids may also be related to apparent fetal lung maturation.


Monocyte subsets in neonates and children.

Volumetrically distinct subpopulations of peripheral blood monocytes, termed M1, M2, and M3, were identified in healthy normal adults and children. Because normal neonates have abnormal monocyte chemotaxis, it was determined whether monocyte subpopulations have different chemotactic capabilities and, if so, whether chemotactically active subpopulations were quantitatively deficient in neonates. Chemotaxis tests with zymosan-activated normal human serum as the chemoattractant and purified monocyte subpopulations revealed that large M3 monocytes were capable of significantly more directed migration than were small M1 and M2 monocytes. Volumetric analysis of monocytes from normal newborns rather than demonstrating an absence of M3 cells revealed that these cells were the predominant monocyte subpopulation. Therefore, we conclude that the impaired chemotactic ability of newborn monocytes is due to a functional rather than quantitative deficiency of M3 cells.


The mononuclear phagocyte system: role in expression of immunocompetence in neonatal and adult life.

The cells of the mononuclear phagocyte system are critical elements in host defense. They are essential to many specific immune processes in addition to their well-recognized role in nonspecific resistance. In this report we describe studies of the influence of the maturation of this system of cells on the capacity of the neonatal rat to generate specific immune responses. In addition, studies of human cord blood monocyte function are presented along with data demonstrating a previously unrecognized synergistic action between monocytes and a heat labile, nonantibody, serum factor which may play an important role in host defense. Finally, data are presented demonstrating that one of the recognition processes used by monocytes for cellular interaction is dependent upon a system of natural lectin-like receptors on the monocyte cell surface which recognize membrane-bound oligosaccharides on other cells.


Electromyographic tension levels in stutterers and normal speakers.

Electromyographic (EMG) recordings of masseter muscle tension during conversational speech by six adult stutterers were compared to EMG levels of 6 normal speakers. Stutterers' and normal speakers' tension levels were significantly different; however, there was no correlation found between level of tension and severity of stuttering.


Effect of a group perceptual-motor training program on kindergarten children.

For 21 boys and 24 girls in a middle-class kindergarten no differences in Identification of Body Parts, Copy Forms, or Motor Skills Test of the Rosner-Richman Perceptual Survey were noted. Scores increased from September to May testing on copying and motor skills, e.g., walking a rail, balancing, handling balls, as expected.


Prediction of later cognitive behavior from early school perceptual-motor, perceptual, and cognitive performances.

Multiple regression equations were generated to predict cognitive achievement for 189 young children (ages 57 to 92 mo.) 1 yr. after original administration of a battery of perceptual-motor, perceptual, and cognitive tests. Regression equations generated from maximum R2 improvement techniques indicated that a battery of perceptual and perceptual-motor performances at pre-kindergarten is useful for prediction of cognitive performance 1 yr. later at kindergarten level. This battery included one fine and two gross perceptual-motor tasks, and one visual and two auditory perceptual tasks. Inclusion of original cognitive performances did not improve the optimal prediction equation for this age group. In contrast, cognitive achievement at first grade and, particularly, at second grade levels was best predicted from knowledge of earlier cognitive performances.


Color preference for black and white by infants and young children.

The purpose of this study was to determine whether a preference for the color white was present in infants and young children. A color preference test was administered to 160 subjects who ranged in age from 6 mo. to 4.5 yr. Data were obtained from a 120-item test in which 12 different pairs of toys were presented to each subject. The toys in each pair were identical except that one was black and the other was white. The toy the subject selected was considered the subject's preference and the color of that toy was recorded. Statistical analysis did not support existing literature, refuting the published idea that white preference is a general quality in all human beings.


Prediction of maximum speed of human movement by two selected muscular coordination mechanisms and by maximum static strength.

This study was undertaken to test the predictive value of two selected muscular coordination mechanisms, the sequential order of muscle activation and a specific acceleration-deceleration point of inflection, and of the maximum static strength of agonist and antagonist muscles for maximum speed of human movement. For 22 male subjects 77% of the variance associated with maximum speed of human movement was accounted for by the two mechanisms of muscular coordination investigated and by maximum isometric strength. The results suggest that separate neuromotor systems control human speed and strength and that the interplay between agonist and antagonist muscles is important for maximum speed of human movement.


Acquisition and generalization of instruction following behavior in profoundly retarded individuals.

Four profoundly retarded male residents of a state institution learned to comply with the instructions "come here," "stay," and "sit." Acquisition occurred in a special therapy room and instructions were presented in a fixed sequence. All subjects learned to comply with the instructions in the training environment. Testing occurred in the subject's ward dayroom where instructions were presented in a random sequence. Despite dramatic changes in the stimulus conditions associated with the transfer to the testing situation the subjects performed close to their asymptotic level. Three experimentally naive subjects participated in a second experiment which was similar to the first, except that the number of acquisition sessions and the number of trials per session were reduced. The reduction in number of acquisition trials did not appear to affect performance in the testing environment. The possibility of terminating off-task behavior of institutionalized individuals by eliciting previously acquired instruction following behavior was discussed.


Behavioral contrast during the acquisition of speechreading.

Two hearing-impaired children were taught to speechread the names of 18 objects divided into three sets. A multiple baseline across sets of objects was obtained for each subject. Tokens presented contingent upon correct responses to certain sets of names increased the frequencies of those correct responses. Both subjects exhibited positive behavioral contrast during the acquisition of speechreading; correct responses to one set increased above the previously established level when the contingencies for a second set changed from token reinforcement to extinction. The obtained contrast effect was conductive to learning and the procedure was effective in teaching the children to speechread the training words.


Visual-field asymmetries in letter recognition: evidence for asymmetry in early visual registration.

Two experiments on visual-field differences in tachistoscopic letter recognition are described. In the first, a bright pre-exposure field with a black fixation point was used, and the conventionally expected dominance of the right visual field was found. However, a large number of "blank" trials were observed, in which subjects completely failed to detect the presence of the flashed target. These "blanks" were themselves significantly asymmetric between visual fields, suggesting that asymmetry in early stimulus registration may play an unsuspected role in typical measures of cerebral asymmetry in recognition accuracy. This was confirmed in a second experiment in which use of dark pre-exposure fields eliminated "blanks" and led to higher over-all accuracy, with no visual-field differences. Implications for interpretation of laterality data with normal subjects are discussed.


Communication and reasoning skills of deaf and hearing signers.

Six tests of intellectual performance were administered to 25 deaf and 21 hearing adult signers. The two groups were not significantly different on tests of Lip Reading and Reception of Signed English but the hearing subjects were superior on tests of non-verbal reasoning and perceptual speed. The hearing were greatly superior on a test of verbal reasoning.


Field independence, lateralization and defensive style.

This study investigated the relationship between field independence and defense clustering as measured by the Defense Mechanisms Inventory and lateral eye movements. Subjects had previously been classified either as hysterical or obsessive style by the Rorschach and WAIS Comprehension subtest. Previous findings indicate that these subjects have a preferred direction of lateral eye movement in a questioning format (hysterical style = left; obsessive style = right). This study found no relationship between field independence and defense clustering and lateral eye movements. To the extent that eye gaze indexes hemispheric activation, we conclude that neither field independence nor defense clustering was related to hemispheric lateralization.


Reported sleep: needed minus obtained sleep, family resemblance, and age.

For a normal population from 13 to 89 yr. of age there was a correlation of .02 between age and sleep obtained, -.07 between age and sleep needed, and -.33 (p less than .01) between age and sleep needed minus sleep obtained. Also, significant family resemblance was found for all three of the above sleep variables.


Reliability of electromyographic measurements after surface electrode removal and replacement.

The purpose of this study was to determine the reliability of electromyographic measurements after surface electrode removal and replacement. Eight male subjects performed an isometric exercise with the left triceps brachii at loads equivalent to 50, 40, and 30% of their maximum voluntary contractile strength (MVC). Surface electrodes were utilized and the integrated action potentials recorded electromyographically as the muscle contracted. The muscle was tested first in a rested condition and then again after a sustained 30% maximum voluntary contraction. Each one of the subjects was tested three different times with a range of from 2 to 16 days between testing sessions. The electrodes were removed after each testing session. The data were means in centimeters of integrated action potentials over specified time periods. The test-retest correlations for the three testing periods resulted in coefficients ranging from .87 to .99. This was true under all loads and with the muscle either rested or fatigued.


Effects of personality, perceptual difficulty and pacing of a task on productivity, job satisfaction, and physiological stress.

The relative psychological, physiological, and performance advantages and disadvantages of utilizing machine-paced and self-paced work were examined by having 12 subjects perform a marking-stapling task at 2 levels of perceptual difficulty and under 2 pacing conditions for 30 min. each. (a) 3 subjects who on the personality tests were identified as introverted, reserved, and trusting preferred to work in the machine-paced condition, while 9 subjects who were identified as extroverted, outgoing and suspicious preferred the self-paced condition, (b) the performance errors in machine-paced operation were 372% higher than for self-paced work, and (c) there were no differences between machine-paced and self-paced work on physiological variables, except for sinus arrhythmia for the task with high perceptual load, and quantity of production.


Children's autokinetic movement as a function of inferred movement of target shape.

Four target shapes, a control stimulus (circle) and one each representing geometrical (arrow), representational (car), and symbolic (cross) implied movement were presented to 10 children in each of five age groups of boys and girls (4, 6, 8, 10, 12 yr.) in an autokinetic movement task. While there were no differences in direction of perceived movement with regard to the control stimulus (circle), all other target shapes showed a decrease in the effects of implied movement with increases in age. The minor sex differences were not reported.


Association of weight and overactivity in institutionalized mentally retarded adults.

An analysis was conducted on the association between weight and overactivity in a sample of 148 mentally retarded adults. The results indicate an inverse relationship between weight and degree of overactivity.


Specificity and differences in three methods of assessing trainable mental retardates' reaction time.

The purposes of this study were to determine the specificity and differences in reaction time that exist among three manual methods of measurement. This dependent variable was measured from onset of a light stimulus until activation of a microswitch by one of the following methods: depressing or releasing a panel-mounted button or depressing a hand-held button. A rotational order of testing was implemented with 35 trainable mentally retarded subjects. Data indicated marked specificity among the three methods; reaction times were significantly faster with the depressed and hand-held methods than with the released method.


Pupil dilation, sex of stimulus, and age and sex of observer.

10-yr.-old, 16-yr.-old, and 20-yr.-old male and female observers (ns = 10; N = 60) rated a number of male and female faces for how 'good-looking' they were. Some of these faces were identical save that in one version the pupils were larger. Pupil dilation in the photographs of males produced no significant effects, whereas pupil dilation in the female photographs caused such faces to be rated as more good-looking by the two oldest groups of male observers. The 10-yr.-old boys and the 16- and 20-yr.-old women rated the female faces with enlarged pupils as significantly less 'good-looking' than the same faces with smaller pupils.


Time estimation and hyperactivity, replication.

Three groups of boys included 135 of normal IQ, showing normal activity; 6 were hyperactive and of normal IQ, and 6 showed normal activity but low IQ. Their ability to estimate a 30-sec. interval showed only the 6 normally active boys of low IQ had significantly different elapsed and estimated times. Time estimation is not clinically useful for identifying hyperactive boys.


Cardiac deceleration and accuracy of performance: recalculation of standard score transform.

In two previous studies the standard score transform used was based on a standard deviation derived from the mean standard deviations of the raw data in the six classifications employed in the studies rather than on one based on the entire set of raw scores as is the more common practice. The data were reanalyzed using the latter basis and major findings were confirmed. Some of the minor findings, however, were changed. These changes are pointed out and discussed where they occurred.


Use of operational criteria in an office practice for diagnosis of children referred for evaluation of learning or behavior disorders.

100 consecutively referred school-age children were evaluated for learning or behavior disorders. 45 children had one of three classical neurological syndromes of epilepsy, sensorineural deafness, or childhood migraine. The 26 children with epilepsy required medication adjustment to improve behavior or learning. Operational criteria for childhood depression, specific learning disability, developmental hyperactivity, and Gilles de la Tourette syndrome were used to establish the correct diagnosis in 55 children. 32 children had a single diagnosis, while 23 children fulfilled the criteria of two diagnostic categories. The diagnostic categorization permitted specific counseling of the child and family, development of a proper school program, and correct pharmacotherapy (when indicated).


Relation between flicker fusion threshold and retinal positions.

The critical flicker frequencies (CFF) were determined for various locations on the retina. Under the conditions in which pupil size varies little with target luminance and size for a retinal location, two findings were obtained. First, the relation between the CFF value and the retinal location depends basically upon the density distribution of the receptor cells (cones and rods) on the retina. Second, when a large test field is employed, the peripheral area shows a maximal CFF value. These characteristics are explicable in terms of the retinal structure and by assuming some functions for it.


Bender visual-motor abilities of slow learners.

The Bender-Gestalt protocols of 134 rural and 140 urban slow learners (IQ 70 to 84) are compared. Rural slow learners performed significantly below their mental ages more frequently than urban slow learners. Rural and urban slow learners performed developmentally below chronological ages, but as expected for mental ages until CA 10 (MA 8). At this point urban slow learners appeared to perform as expected from MAs, but a significant number of rural slow learners performed below expectations. After CA 14 (MA 11-0) the differences between the urban and rural groups, however, were not significant.


Oculomotor programming disturbances in the dementia syndrome.

Three types of oculomotor programming disturbances are described in patients with the dementia syndrome. This report describes two of these abnormalities, poorly regulated gaze patterns and a programming type of gaze perseveration. All patients showed poorly regulated gaze patterns in contrast to the normal controls, whereas on the whole only the moderately affected patients showed the programming type of gaze perseveration. The third type of oculomotor programming disturbance is efferent perseveration of gaze (a hypokinetic, "staring" type of gaze pattern) and can be seen with severe dementia. The possible significance of these findings is discussed.


Effects of sequence and variety of irrelevant items on visual search.

An experiment was done to determine how the sequence and variety of irrelevant items affects the speed of visual search. Three subjects searched for a target letter in sequences of predominantly alternating or repeating letters. Search through repeating sequences was faster than search through alternating sequences. Increasing the variety of irrelevant letters slowed search through alternating but not repeating sequences. Implications regarding eye fixations during visual search are discussed.


Human sound frequency preferences.

205 subjects each chose a "most pleasant" sound delivered through an earphone by turning the control knob on a continuously variable audio oscillator. Most subjects chose a frequency in a relatively narrow (approximately 350 Hz) band centered on 399 Hz. The preferences did not appear to be influenced by sex or age.


A length aftereffect from grating adaptation: now you see it ... now you don't.

Adaptation to a grating of short bars has the effect of increasing the apparent length of a subsequently viewed test bar, and adaptation to a grating of long bars has the effect of decreasing the apparent length of a subsequently viewed test bar. However, decreasing the interspace between the long adaptation bars has the effect of (1) negating the length aftereffect and (2) reducing the apparent width of the test bar viewed by the retina previously adapted to the grating of long bars.


Effects of background music on musical task performance and subsequent music preference.

The present study examined the effects of background music on performance of a musical task and on subsequent preference for that music. 60 music and 60 non-music majors heard background music in music-only or music-plus-task conditions, and a third group heard no music in a task-only condition. A preference test of four musical excerpts, including the background [corrected] music excerpt, was administered subsequently to all three groups of subjects. Although music majors scored higher than non-majors, background music did not differentially affect task scores. Music students exhibited a differential preference following both musical conditions, while non-music subjects demonstrated differential preference only following the music-only condition.


Labeling, attention and perception, a developmental study.

96 7- and 9-yr.-olds were under four experimental conditions. A "distinctive label" group (n = 24) associated four different gender-cued labels with four infants' faces. An "equivalent label" group (m = 24) associated only two of these labels. There were also two no-label groups (ns = 24), "differential perception" and "perception." In the former, perceptual cues were provided; no cues were provided in the latter. The main measure was a test of perception. 9-yr.-olds were not affected by the labels, 7-yr.-olds were but more significantly so during initial trials. It is proposed that perception is affected by labels, learning, and selective attention. These effects are determined developmentally. As age increases the effects of verbal cues diminish and of perceptual cues increase. The findings are related to cross-cultural data, indicating that Israeli toddlers classify according to gender earlier than do American children. This is probably because Hebrew more than English contains distinctive linguistic cues related to sex.


Relation of personality characteristics and color preferences.

150 students responded to the Edwards Personal Preference Schedule and ranked color plates from the Luscher Color Test. Regression analysis yielded no relationship of predictive significance between the two sets of variables. An ancillary analysis using sets of random numbers in place of the color preference data yielded results basically similar to those produced in the earlier analysis. Males and females rank ordered the colors identically except for yellow, which was significantly more preferred by males than females.


Effect of response class on self-monitoring accuracy.

The effect of response class on self-monitoring accuracy was investigated in a clinical population. 16 in-patients of a VA hospital self-monitored verbal and nonverbal behaviors in a couterbalanced design. The results supported suggestions of superior self-recording accuracy with nonverbal target behaviors. The implications for clinical use of self-monitoring in assessment are discussed.


Picture-naming interference with good and poor readers.

22 third grade children of high and low reading ability (ns = 11) were tested for their ability to name pictures while trying to ignore words or nonword strings of letters printed inside the pictures. Nonoverlapping sets of pictures and words were used as stimuli to avoid the possibility of sensitizing subjects to the particular words used in the experiment (Neisser, 1976). Both groups experienced more interference from intra-category than extra-category words, indicating that they processed the words automatically. Only the good readers experienced more interference from pseudowords than consonant strings, suggesting that poor readers are less sensitive than good readers to orthographic regularity.


Effects of familiarity of music on vigilant performance.

35 subjects, randomly assigned to five groups in a 2 x 2 + 1 between-subjects design, performed a vigilance task under familiar rock, familiar easy-listening, unfamiliar rock, unfamiliar easy-listening, and no music conditions. Familiar music significantly increased heart rate and percent detections and also mitigated the classical vigilance decrement. Type of music had no significant effect. It was concluded that the psychological chaaracteristics of noise are at least as important as its physical characteristics in determining level of vigilance performance.


Strategies for attention allocation in multiple input, multiple response tasks.

9 tasks involving multiple inputs and multiple responses were administered. The tasks involved monitoring, shadowing, and ignoring, in all combinations, monaural and dichotic meassages. Miss rates were compared to determine the effect of adding additional demands to different tasks. Results suggested that, when a demand was added to a task, attention was allocated away primarily from those demands already receiving the greatest amounts of attention, to accommodate the new demand. When the new demand drew attention toward a channel, those demands already receiving the least amounts of attention gained the largest amounts. There were several exceptions to these trends, suggesting that the total amount of effort available for allocation was apparently an important variable. The implication of the results for research in attention was discussed.


Field dependence and short-term memory.

This study examined the relationship between field dependence and short-term memory. It was predicted that relatively field-independent individuals would perform better on short-term memory tests in which a large amount of interference is assumed to be present than would individuals who are more field-dependent. Subjects' appraisals of their own attentional facility, as well as their thoughts and feelings about the experimental tasks, were also elicited, and were looked at in terms of their relationship to field dependence and short-term memory.


Border locking and the Café Wall illusion.

The Café Wall illusion (seen on the tiles of a local café) is a Münsterberg chequerboard figure, but with horizontal parallel lines which may have any luminance separating the rows of displaced squares. These (the 'mortar' lines) display marked wedge distortion which is especially affected by: contrast of the squares ('tiles'); width of the 'mortar' lines, and their luminance which must not be significantly higher than that of the light squares or lower than that of the dark squares for distortion to occur. An experiment is described from which quantitative data have been obtained by varying these parameters. It is suggested that contiguous regions of different luminance (and contiguous colour regions) are normally held in spatial register by locking from common luminance boundaries. The Café Wall illusion is attributed to this border locking producing inappropriate contour shifts from neighbouring regions of contrasting luminance when separated by narrow gaps of neutral luminance. Further implications on the border-locking notion are discussed.


Three-dimensional perception of planar line segments.

Two-dimensional line drawings can be perceived as three-dimensional images if they are viewed through a grating of parallel lines placed a short distance above the drawing. The position in space of the images is a function of the angle between the lines in the drawing and those in the viewer grating.


Assessment of depth perception in cats.

A behavioural method is described for the assessment of depth perception of kittens. Measurement is made of the smallest separation in depth that can be discriminated between two adjacent stimuli under both monocular and binocular viewing conditions. Normal animals can discriminate much smaller separations in depth when using two eyes than with monocular viewing, implying the presence of a cue to depth that is uniquely available with binocular viewing. The test provides a quick and reliable way of screening animals for stereopsis.


Visual-geometric illusions: unisex phenomena.

The possibility of sex differences in responses to visual-geometric illusions was investigated with the use of forty-five illusion variants and a sample of 221 observers. No difference in illusion magnitude as a function of sex was found. A second experiment measured illusion decrement and transfer of decrement to other illusion configurations. Again there were no significant differences between male and female observers.


Figure-ground formation by movement: influences and effects.

A twelve-letter array was segmented into figure and ground by moving some of its letters. Moved letters were shifted one letter-width left of right, independently of each other, in apparent movement. Since the figure of a display attracts attention, identification of letters of the figure segment should show an advantage over letters of the background segment. Three results are of interest. First, moved letters were identified more accurately and faster than stationary letters when only one or two letters moved. Stationary letters showed the advantage when eight of the twelve letters moved. This result suggests that the segment seen as figure is determined by both rapidly encodable letter movement and by the number of moved letters within the display. Second, segmentation of the visual display acids identification of moved letters in less than 90 ms, or well before the eye can move to the selected letter position. Third, letters in the figure segment which are closer to fixation are more likely to be identified than more eccentric letters.


Identification of familiar and unfamiliar faces from internal and external features: some implications for theories of face recognition.

Three experiments are reported in which recognition of faces from whole faces or internal or external features was compared. In the first experiment, where the faces were of famous people, an advantage was found for identification from internal features. In the second experiment involving unfamiliar faces, however, no difference was found in recognition rates when subjects were given the internal or the external features. In a third experiment famous faces were presented and mixed with other famous faces for a recognition test. As in experiment 1, better recognition occurred from internals as compared with external features. It is argued that the internal representation for familiar faces may be qualitatively different from that for face seen just once. In particular some advantage in feature saliency may accrue to the internal or 'expressive' features of familiar faces. The implications of these results are considered in relation to general theories of face perception and recognition.


Salt taste adaptation: the psychophysical effects of adapting solutions and residual stimuli from prior tastings on the taste of sodium chloride.

The paper reviews how adaptation to sodium chloride, changing in concentration as a result of various experimental procedures, affects measurements of the sensitivity, intensity, and quality of the salt taste. The development of and evidence for the current model that the salt taste depends on an adaptation level (taste zero) determined by the sodium cation concentration is examined and found to be generally supported, despite great methodological complications. It would seem that lower adaptation levels elicit lower thresholds, higher intensity estimates, and altered quality descriptions with predictable effects on psychophysical measures.