Regurgitation and choke in rats.

Male and female F344 rats choked on fecal pellets and regurgitant during the course of two long-term experiments. Each study involved feeding standard and high bulk diets containing 10% wood cellulose or 10% chrysotile asbestos fiber. Choke deaths occurred at all stages of the experiments. A total of 36 of 774 (4.6%) rats in the two studies died of choke. Females died of choke more frequently (26/382 or 6.8%) than did males (10/392 or 2.6%). Rats on high bulk diets were affected more frequently (33/571 or 5.8%), especially those on 10% asbestos diet (26/311 or 8.4%, than rats consuming standard diet (3/190 or 1.6%). The reason for the difference between females and males was not determined. Although choke may be related to some characteristics of high nonnutritive bulk feed fed in pellet form, the higher risk for females even on standard diet (3/95 or 3.2%) than for males (0/95) indicated that more than one factor operated in the etiology of these events.


Long-term cranial mesenteric vein cannulation in the rat.

A polyethylene-tipped silicone rubber catheter was placed in the cranial mesenteric vein of rats. Injections were made and blood withdrawn an average of seven times for each animal. Seventeen of 20 (85%) catheters remained patent for 3 weeks.


Surgical technique for a permanent tracheostomy in Beagle dogs.

A surgical procedure to produce a permanent tracheostomy in dogs was developed. The procedure consisted of dissecting portions of the cartilaginous rings free from the underlying tracheal mucosa, cutting through the mucosa and suturing the mucosa to the skin. The procedure was performed in approximately 30 minutes and resulted in a permanent, maintenance-free, mucocutaneous stoma that also permitted breathing through the upper respiratory airways.


Rapid methods for jugular bleeding of dogs requiring one technician.

Two methods were used to collect blood from the jugular vein of dogs. In both techniques, only one technician was required. A rope with a slip knot was placed around the base of the neck to assist in restraint and act as a tourniquet for the vein. The technician used one hand to restrain the dog by the muzzle and position the head. The other hand was used for collecting the sample. One of the methods could be accomplished with the dog in its cage. The bleeding techniques were rapid, requiring approximately 1 minute per dog.


Treatment regimen for air sacculitis in the chimpanzee (Pan troglodytes).

Six champanzees (Pan troglodytes) developed air sacculitis. Except for air sac distension and malodorous breath, clinical signs were rare. A variety of organisms, mainly enteric, were isolated from the air sacs. Only one case was treated surgically. Other cases were treated by the conservative method of irrigation which worked well.


A system for restraint and anesthesia in calves.

A mobile calf enclosure was developed which incorporated a hydraulic hoist and sling for the care of calves. This apparatus permitted induction of and emergence from anesthesia in an erect posture, which decreased the risk of aspiration and postoperative pulmonary problems. Fifty-two surgical procedures requiring general anesthesia have been performed on 29 calves during the last 2 years with only one operative death, and calves have been maintained within the enclosure for periods up to 1 month.


Demyelination and remyelination in the rat central nervous system following ethidium bromide injection.

Intracisternal injection of ethidium bromide induced status spongiosus with prominent degenerative changes in oligodendroglia in the subpial regions of the central nervous system of the rat. Chronologic investigation of the lesions has revealed that status spongiosus resulted in myelin degeneration, and by the 6th day postinjection many axons were demyelinated. At this time, numerous debris-filled phagocytic cells were observed among the totally naked axons. Vesicular transformation of myelin was the common degenerative change. Features suggestive of separation of myelin lamellae by phagocytic cells were also observed. In the demyelinated areas, oligodendroglial cells disappeared completely. By the 12th day postinjection, remyelination was apparent and numerous active oligodendroglia appeared in association with thinly myelinated axons. Some central nervous system axons were myelinated by Schwann cells. These patterns of demyelination and remyelination observed in ethidium bromide-treated rats were compared with those observed in other demyelinating conditions of varied etiology such as experimental allergic encephalomyelitis, diphtheria toxin, or lysolecithin injection and cuprizone intoxication.


The effects of ethanol and acetaldehyde on the products of protein synthesis by liver mitochondria.

Ethanol and acetaldehyde, alone or in combination, at physiologic concentrations, significantly inhibit mitochondrial protein synthesis in vitro. Mitochondria from rats chronically fed ethanol also display a reduced rate of mitochondrial protein synthesis in vitro. This effect is further aggravated by addition of ethanol to the incubation medium. Sodium dodecyl sulfate-gel electrophoresis of mitochondria fractionated with acetic acid-lubrol, which were incubated in the presence of ethanol or acetaldehyde, revealed a modest over-all decrease in labeling. However, a polypeptide fraction in the molecular weight range of 36,000 to 40,000 was conspicuously decreased. This range includes subunits of cytochrome oxidase, cytochrome b, and ATPase. Liver mitochondria from rats fed ethanol chronically showed a comparable decrease in the 36,000- to 40,000-molecular weight peak after incubation with radioactive leucine in vitro and fractionation with acetic acid-lubrol. Similar results were obtained when mitochondrial protein synthesis was determined in vivo in chronically treated rats. The data suggest that chronic ethanol consumption interferes with mitochondrial membrane biogenesis and that several products are more sensitive to this effect than others.


Mesangial uptake and processing of macromolecules in rats with diabetes mellitus.

The uptake and processing of colloidal carbon by the glomerular mesangium was studied in an attempt to determine whether abnormal mesangial function occurs in rats with longstanding streptozotocin-induced diabetes mellitus. The chronically diabetic rats were considerably smaller than their normal littermates receiving a similar dose of colloidal carbon based upon body weight. Thus, further control groups, animals weight-matched with the diabetic rats (younger rats) and littermates of the diabetic rats given the mean quantity of colloidal carbon administered to the diabetic rats, were included. Quantitative evaluation of renal tissues indicated that younger rats have more avid mesangial uptake of colloidal carbon from the circulation and more rapid processing of these macromolecules through the mesangium than the other groups studied. These quantitative studies did not demonstrate any marked impairment in diabetic rats in the over-all capacity of their mesangium to take up and process colloidal carbon when compared with the two groups of littermate nondiabetic animals. However, in those areas of the mesangium thickened by the diabetic process large aggregated of carbon accumulated and persisted over the 6-week period of the study. It appears, therefore, that those areas of the mesangium in diabetic rats with pathologic changes consequent to the diabetic state have significant functional impairment.


Endothelial regeneration. II. Restitution of endothelial continuity.

With a modified balloon catheter the endothelium of rat thoracic aortae was completely removed to study the interaction between two important responses of the vessel wall to intimal injury: endothelial regeneration and formation of an intimal fibrocellular thickening. Endothelial cells deriving from the uninjured intercostal arteries regenerated by migration followed by proliferation and proceeded as a continuous sheet at a rate of approximately 0.07 mm. per day in the circumferential direction and approximately 6 times faster in the axial direction. Smooth muscle cells appeared in the intima only in areas which were not covered by regenerating endothelium 7 days after injury. The smooth muscle cells formed a multilayered fibrocellular intimal lesion which reached the maximal thickness after 3 weeks. The continuous sheet of regenerating endothelium covered the intimal smooth muscle cells at a slower rate; 6 weeks after injury large areas located most distant from the source of regenerating endothelium still showed modified smooth muscle cells lining the lumen. However, platelets did not adhere to these smooth muscle cells, and the total amount of intimal thickening did not increase between 3 and 6 weeks after injury. We conclude that, in response to intimal injury, endothelial regeneration precedes the accumulation of intimal smooth muscle cells, and that injured intimal areas, which are rapidly covered by continuous endothelium, are protected from the development of a fibrocellular intimal lesion.


Morphologic and chemical variation of the kidney lesions in amyloidosis secondary to rheumatoid arthritis.

The kidneys of 20 patients who died of secondary systemic amyloidosis due to rheumatoid arthritis were studied histologically, and four of these were shown to have an uncommon pattern of deposition with almost no glomerular involvement but heavy deposits in the outer zone of the medulla. In three of the four patients frozen tissue was available. Immunochemical characterization of amyloid fibrils from these three cases showed that the major subunit amyloid fibril protein was protein AA, typical of secondary amyloidosis. Gel chromatography of fibrils revealed an uncommon elution pattern with two retarded major protein peaks. Both these proteins showed immunologic identity with protein AA and had N-terminal amino acid sequences identical with that protein but differed in size obviously due to a shortening of the C-terminal in one of the proteins. The reason for the correlation between the pattern of deposition of amyloid and alterations in protein AA is unclear but might be due to variations in enzymes responsible for the cleavage of the amyloid fibril subunit precursor protein SAA.


Effects of ethanol on liver microtubules and Golgi apparatus. Possible role in altered hepatic secretion of plasma proteins.

A combined morphometric and biochemical approach was used to study the effects of alcohol on hepatic microtubules. Feeding of ethanol-containing diets to rats decreased the amount of polymerized tubulin and the number of visible microtubules, and it also produced morphologic alterations of this organelle. These microtubular alterations were reproduced in isolated hepatocytes after incubation with ethanol. Pyrazole, an inhibitor of alcohol dehydrogenase, prevented these effects. Two oxidation products of ethanol, acetaldehyde and acetate, in concentrations likely to occur "in vivo" also reproduced the effects of ethanol on microtubules. The alterations of microtubules, induced by either ethanol or its metabolites, were associated with significant increases in the volume and surface densities of the Golgi complex. Moreover, both the microtubular and the Golgi alterations were prevented by inhibiting the oxidation of ethanol with pyrazole, an inhibitor of alcohol dehydrogenase. These findings indicate that ethanol oxidation alters liver microtubules; as a likely result, delayed secretion of export proteins ensues with early retention in the Golgi vesicles. After chronic alcohol feeding, there was also a significant increase in the volume of the cytoplasm, which could reflect retention of soluble proteins and water.


Bone conduction calibration: current status.

Attempts to specify normal threshold sensitivity by bone conduction have been unsuccessful because of problems in obtaining reliable measurements from commercially available artificial mastoids. Recent design modifications incorporated in the Bruel and Kjaer 4930 artificial mastoids have resulted in greater uniformity among these units. However, the new design has resulted in impedances that are higher than those recommended in current standards. Bone-conduction thresholds referenced to measurements made on B & K 4930 artificial mastoids with the new design were performed on 60 normal listeners by three participating laboratories. The results are reported for consideration in the development of a reference threshold for hearing by bone conduction.


Hearing performance inventory.

The Hearing Performance Inventory (HPI) was developed to assess hearing performance in problem areas experienced in everyday listening. It consists of six sections: (1) Understanding Speech, (2) Intensity, (3) Response to Auditory Failure, (4) Social, (5) Personal, and (6) Occupational. A self-report response style is used. Sentences were written to describe a number of listening situations covering a variety of talker characteristics and communication processes. The development, current status, and clinical implications of the HPI are presented.


The acquisition of question formation in spoken English and American sign language by two hearing children of deaf parents.

This longitudinal study investigated the acquisition of question formation in spoken English and American Sign Language (ASL) by two young hearing children of deaf parents. The linguistic environment of the children included varying amounts of exposure and interaction with normal speech and with the nonstandard speech of their deaf parents. This atypical speech environment did not impede the children's acquisition of English question forms. The two children also acquired question forms in ASL that are similar to those produced by deaf children of deaf parents. The two languages, ASL and English, developed in parallel fashion in the two children, and the two systems did not interfere with each other. This dual language development is illustrated by utterances in which the children communicated a sentence in spoken English and ASL simultaneously, with normal English structure in the spoken version and sign language structure in the ASL version.


Interpreting ear differences in static compliance measurements.

The value of static compliance measurements is limited by marked variability and considerable overlap of results among normal and abnormal middle ears. However, a procedure that compares static compliance measurements between the right and left ear of each individual overcomes this problem in large part. The methods and data to support the applicability of this approach for evaluating unilateral middle ear disorders are discussed further.


Hyperkinetic dysarthria as an early indicator of impending tardive dyskinesia.

Tardive dyskinesia is a potentially irreversible disturbance of the central nervous system that is associated with the chronic ingestion of neuroleptic medications. Abnormal movements within the oral musculature are characteristic of tardive dyskinesia and are manifested in motor speech production as hyperkinetic dysarthria. Early detection of hyperkinetic dysarthria in patients who have chronically ingested neuroleptic agents may play a critical role in preventing an irreversible condition of tardive dyskinesia.


Analysis of tympanometry of a severe to profound hearing-impaired population of school-age children.

Impedance audiometry provides a reliable technique for identifying undetected middle ear pathologies in children with severe to profound sensorineural hearing loss. In this study, tympanograms were obtained on 104 children with sensorineural hearing losses of 60 dB or more. The tympanograms were classified according to type and were compared for bilateral similarity. A high percentage of the younger children had abnormal tympanograms, with almost half of these children having the same type of abnormal tympanogram bilaterally. The use of impedance audiometry as a screening technique for hearing-impaired school-age children is discussed.


Effects of high-frequency cue reduction on the comprehension of distorted speech.

Forty-five subjects with sharply sloping sensorineural high-frequency hearing losses were examined for comprehension with a tape containing sentences that had been time-compressed (250 words/min), interrupted, (50 msec on-50 msec off), and masked with speech-spectrum noise (+2 dB S/N) in that order. All subjects yielded normal speech reception thresholds, and generally normal scores on the Northwestern University Auditory Test No. 6. Distorted-speech testing was completed at 40 dB SL. Subjects with losses at 2 kHz and above were able to comprehend only 50, 65, and 68% of compressed, interrupted, and noise-masked sentences, respectively. In contrast, subjects with losses at 3 kHz and above performed poorer than normal controls by 11.3, 12.5, and 8% points respectively, while subjects within normal hearing sensitivity at 3 kHz performed as well as controls (maximum drop of 4.6 points with noise-masking). The multiplicative hypothesis was upheld in that the performance of subjects with severe high-frequency deficiencies was much poorer than one would predict on the basis of what is known about performance on these tests with either filtering alone or other distortions alone. These subjects, most especially those with severe frequency deficiencies, outperformed by up to 29 percentage points the mean scores of groups of normals given the same test items and distortion conditions, but listening through filtering that simulated the hearing loss of subjects in this study. It was suggested that hypacusics with high-frequency hearing losses can learn to use residual cues efficiently and that it is not altogether permissible to model sensorineural high-frequency losses with normal-hearing subjects using frequency filtering.


The perception of temporally segmented vowels and consonant-vowel syllables.

The minimum initial-portion durations required by listeners for the correct identification of spoken isolated vowels and consonant-vowel (CV) syllables were determined. Eight vowels [see text] and 64 CVs comprised of each of eight consonants [see text] in combination with each of the eight vowels were used. Segments consisted of the initial 10 to 150 milliseconds of each stimulus in 10-msec steps. The major findings were (1) clues for better than change correct identification of tongue advancement and tongue height values for isolated vowels occur within the first 10 msec of the stimuli whereas approximately 30 msec of the stimuli are needed for the tense-lax feature to reach threshold, (2) clues for better than chance correct identification of place of articulation for the stop consonants are found within the initial 10 msec of the CVs whereas approximately 22 msec are needed for the voicing threshold to reach threshold, and (3) the threshold of voicing increases from front to back place of articulation for the stop consonants. The implications of the findings are discussed.


Perception of vowel features in temporally-segmented noise portions of stop-consonant CV syllables.

The ability of listeners to identify vowel features, given only segments of the aperiodic portion of CVs, was investigated. Segments of the aperiodic portions of stop consonant CVs, increasing in duration in 10-msec steps from onset, were identified by 18 listeners. The responses were analyzed for the correct identification of vowel features. Coarticulatory effects of the vowel on the aperiodic portion were found to (1) occur early in the aperiodic portion, (2) vary with consonant and vowel, and (3) vary with vowel feature. In general, however, tongue advancement for the vowel was identified correctly most often, tongue height next most often, and the tense versus lax distinction least often. For some CVs, sufficient clues for above chance level of identification of a feature were present during the shortest segments of the aperiodic portion. The findings lend support to the point-of-view that listeners may be able to narrow the choice of the vowel in an unvoiced-stop-consonant CV to a small number of alternatives prior to the beginning of voicing.


Effects of five experimental treatments of stuttering.

Twenty adult stutterers were exposed to each of five experimental treatments: time-out, noise, delayed auditory feedback (DAF), "wrong" and metronome. In each session a subject spoke for 20 minutes without treatment (baserate) followed by 30 minutes in one of the five experimental conditions. Before the five treatment sessions, subjects accomplished three pre-experimental tasks: expectancy, changeability, and adaptation tasks. Percent stuttering decreased significantly in all conditions, and stuttering duration reduced significantly in all but the noise condition. The amount of reduction in percent stuttering from baserate to treatment (change score) in time-out was positively related to the change scores in DAF and metronome. Change scores in metronome were positively related to change scores in time-out and "wrong." Percent stuttering change scores in noise, DAF, and "wrong" were essentially unrelated. Stuttering duration change scores were related only for the time-out and DAF, and metronome and DAF conditions. In general, the pre-experimental expectancy, changeability, and adaptation scores were unrelated to change scores in any of the experimental conditions. Words spoken per minute did not change significantly from baserate to treatment for any experimental condition except time-out.


Tempo of spectrum change as a cue in speech-sound discrimination by infants.

Six- to seven-month-old infants were tested on their ability to discriminate among three speech sounds which differed on the basis of formant-transition duration, a major cue to distinctions among stop, semivowel and diphthong classes. The three speech sounds, [see text] were produced in two different ways. The stimuli for one experiment were two-formant synthetic tokens which differed in formant-transition duration. The stimuli for a second experiment was produced with a computer-modification technique which artificially shortened or lengthened the formant-transition portion of a naturally produced [see text], resulting in tokens of [see text]. The discrimination procedure involved visual reinforcement of a head-turn response following a change from a repeating background stimulus to a contrasting stimulus. Infants in both experiments discriminated [see text]; evidence for [see text] discrimination was obtained for the "computer modified" tokens only. These findings are discussed in terms of possible mechanisms underlying speech perception in infancy.


Tympanometry in normal neonates.

Acoustic conductance and susceptance tympanograms were obtained at 220 and 660 Hz in 34 neonates. The neonates were categorized into three age groups (8-24 hours, 24-60 hours, and 60-96 hours). Single-peaked, double-peaked, and monotonically increasing tympanograms were found. Static values for conductance, susceptance, admittance, resistance, reactance and impedance at the lateral surface of the tympanic membrane were computed from the tympanograms. There were no significant differences in mean static values among the three groups. At 220 Hz, the individual static reactance values were usually smaller than the static resistance values and often assumed a positive sign. At 660 Hz, the individual static reactance values always assumed a negative sign and were approximately equal to the static resistance values. The single- and double-peaked tympanograms apparently were the result of previously identified interactions between static resistance and reactance values. The data were compared to those of infants and adults. Tympanograms at 220 Hz were obtained for 13 of the original subjects at the age of three to four months. The data collected in this group were consistent with those reported in the literature for the same age group.


An eye-marking investigation of anticipated and observed stuttering.

The subjects of this experiment read a list of words and underlined those on which they expected speech difficulty. The matched and non-stutterers were subsequently called upon to read silently a connected passage in which half of these words were present. During this reading, the relation of eye movement to the words read was recorded on film. Frame by frame analysis of the eyes' exact momentary position revealed that the stutterers evidenced significantly more fixations than did the non-stutterers. They also showed significantly more progressive and regressive eye movements. It follows that the overall duration of their eye movements was somewhat shorter. In contrast, the average duration of the stutterers' fixations were significantly longer for those words on which fluency failure had been anticipated and on words on which it was later observed than on those words on which difficulty was not expected and those on which stuttering did not occur. These data suggest that stutterers search among the words to be spoken and sort out those on which they anticipate and on which they have difficulty.


Acoustic admittance and the aging ear.

Tympanograms were acquired from 60 subjects, 20 through 79 years of age, with normal hearing and no history of otic pathology. Acoustic conductance and acoustic susceptance at the tympanic membrane (GTM and BTM) were derived and acoustic admittance (YTM) was calculated. Statistical analysis of GTM, BTM and YTM showed no significant variation in values across age decades. Comparison of these data with previous reports suggests that the effect(s) of age on measures of static acoustic admittance, and presumably acoustic impedance, is complex.


The structural characteristics of monologues in the speech of normal children: syntactic nonconversational aspects.

The syntactic nonconversational features of monologue speech were investigated as a companion paper to Gallagher and Craig's (1978) study of the semantic and conversational aspects of monologues. The monologue-dialogue language samples collected by Gallagher and Craig from nine normal subjects, three at Brown's language stages I, II, and III, were analyzed syntactically. The original procedure consisted of the collection of a two-hour language sample from each child containing alternations of dialogue with the examiner and monologue produced during independent play. The results indicate that the syntactic categories that occurred in monologue speech were similar to those appearing in dialogue speech but the percentage frequencies differed. Monologue subsamples can be characterized syntactically as highly structured sequences of revision behavior reflecting a basic metalinguistic performative. The clinical implications of the naturally occurring analysis procedures observed are discussed.


Fundamental frequency perturbation observed in sustained phonation.

The middle segments of sustained phonations of /i/, produced by six male adults at fo's ranging from 98 to 298 Hz, were examined for cycle-to-cycle frequency perturbation. The voice samples were analyzed by a peak-picking fo analysis program (Horii, 1975). The results showed that, between 98 Hz and 210 Hz, mean jitter size decreased as the fo increased, whereas the corresponding jitter ratios remained relatively constant. Above about 210 Hz, mean jitter remained relatively constant and, consequently, the jitter ratio increased as fo increased. The problems of temporal resolution for vocal jitter studies, vowel-dependent jitter magnitude characteristics and various perturbation measures are discussed.


Reflex threshold shift in chinchillas following a prolonged exposure to noise.

The acoustic reflex is considered to reduce transmission across the middle ear and thereby protect the inner ear from intense sounds. The dynamic properties of this reflex seem to be a function of the duration of the eliciting stimulus. Assessment of the protective action afforded by middle-ear muscle contractions for long-term noise exposures requires the knowledge of how these dynamic properties change under such conditions. Round window electrodes were implanted in eight chinchillas. Changes in the threshold of the acoustic reflex were measured during an eight-hour exposure at 95 dB SPL to an octave-band noise centered at 0.5 kHz. The criterion measure of the acoustic reflex was a change in the amplitude of the cochlear microphonic generated by a 0.5 kHz eliciting tone. Thresholds of the acoustic reflex increased systematically throughout the noise exposure up to approximately 14 dB after 8 hours. The time course of the changes in the threshold of the acoustic reflex was nearly identical to the time course of behaviorally measured changes in the auditory sensitivity as reported by Carder and Miller (1972).


Cognitive loci of impairments in picture naming by aphasic subjects.

In order to identify the process or processes responsible for impaired naming by aphasic patients, ten aphasic adults and ten normal adults performed three independent tasks--picture naming, modified Sternberg picture recognition, and modified Sternberg random shape recognition (Sternberg, 1966). Response times and error percentages were the dependent variables. Independent variables in naming were stimulus codability measured in bits of uncertainty (two levels) and number of naming trials (three trials). Independent variables in the recognition tasks were uncertainty (two levels), number of stimuli to be remembered (two or four stimuli) and response type ("yes" or "no"). The results showed that uncertainty had significant effects on naming but not on recognition performance. The aphasic group produced significantly longer naming response times regardless of uncertainty level. The differences between groups were much greater for high-uncertainty pictures (1100 msec) than for low-uncertainty pictures (270 msec). A comparison of estimates of word retrieval times showed that the two subject groups differed significantly for high-uncertainty but not for low-uncertainty items. It was concluded that (1) use of the term "word retrieval problem" rather than "loss of memory problem" was justified to describe the major component in the aphasic naming impairment for high-uncertainty items, and (2) when naming low-uncertainty items these aphasic subjects did not demonstrate a word retrieval problem. The results indicate that treatment procedures designed to improve naming should be process rather than content oriented.


Toward objective analysis for electroencephalic audiometry.

Middle-component AERs (8-90 msec) to tone-pips from 10 normal-hearing adults were subjected to three objective methods of response identification. Threshold was then determined for each subject according to four different rules. The criterion score, which considers conjointly latency and amplitude values across the middle-component peaks, was developed as a single-value measure for response-identification and subsequent threshold-determination procedures. One of the response-identification methods was applied to 10 hearing-impaired subjects; the results of the threshold-determination procedures were encouraging. Further directions toward improving objective response analysis are discussed.


Effects of cognitive set upon laboratory induced verbal (Freudian) slips.

Subjects participated in either of three treatments of a task which elicits verbal slips. With equal chance probabilities of eliciting verbal slips related either to electricity or to sex, subjects receiving a situational cognitive set toward electric shocks made more electricity-type verbal slips than sex-type errors, while the opposite was true for a situational cognitive set toward sex, and no difference occurred for a neutral cognitive set. Results provide insight into psycholinguistic processing of both naturally occurring verbal slips and normal error-free speech.


Age and the decoding of coarticulatory cues.

Thirty-two subjects between the ages of 60 and 80 years listened to tape-recorded voiceless stop + vowel syllables and subsyllabic segments systematically isolated from the syllables by electronic gating. This procedure allowed examination of the ability of older adults to perceive the acoustic effects of coarticulation. Comparison of the performances of subjects in the older age groups with previous data concerning four year olds, 11 year olds, and young adults (Oarnell and Amerman, 1978) revealed a close resemblance between the performance of four year olds and older adults in the proportion of correct syllable identifications, consistency of responses and substitution preferences. On all of these measures, the responses of these two age groups differed significantly from those of the 11 year olds and young adults. The results suggest a reduction in decoding precision for these coarticulatory cues as a function of the aging process.


The effects of triamcinolone acetonide on the voice.

With the exception of the pioneering work by Damsté in the mid 1960s and early '70's, no long term quantitative research on voice changes subsequent to drug therapy has been reported. This study reports the effects of a specific cortico-steroid, triamcinolone acetonide, on selected aerodynamic and acoustic parameters reflecting the vocal performance of twenty-one chronic asthmatic steroid dependent individuals. Measurements of the subjects' vocal fundamental frequency, maximum phonation time, oral air volume velocity, and peak intra-oral air pressure during production of selected speech stimuli were made before the introduction of triamcinolone and following the first and second years of drug use. After two years of triamcinolone therapy, significant changes were noted in parameters reflecting laryngeal functioning. Respiratory performance remained unchanged for most subjects. The results are discussed in terms of the possible physiological changes that might have occurred and their implications for the speech-language pathologist and speech scientist in medical management.


Lexical semantics and memory for words in aphasia.

Aphasic and non-neurological patients were assessed on a word recognition memory task. On any one trial, some words were instances of the same superordinate category, thus presupposing a common abstract conceptual feature, and some words could be linked thematically in the sense of forming context-dependent relations. Observing the temporal order in which patients pointed to the words they recognized permitted an assessment of the extent to which they clustered their responses either in terms of superordinate categories or along thematic lines. The conceptual structures indicated by these clusters were compared with those observed in a previous task requiring judgments of word relatedness. The data suggest that verbal memory limitations in aphasia are only in part linked to constraints on the conceptual features structuring lexical knowledge; and relatedly they raise the possibility that aphasics may have a disturbance of mnemonic processing quite apart from any disruption to language.


Voicing duration and vocal SPL changes associated with stuttering reduction during singing.

This study was conducted to determine if stuttering reduction during singing is associated with increased voicing duration and increased vocal SPL. Eight moderate to severe stutterers comprised the experimental group. Eight normal speakers, matched pairwise with the stutterers for sex and age, served as controls. Pre-experimental testing indicated that all subjects knew from memory the melody of the well-known song "Home on the Range." Subsequently, subjects were asked to read aloud and sing altered lyrics of this song to the conventional melody. Results showed that from reading to singing, disfluency frequency decreased significantly among the stutterers. Both groups of subjects significantly increased voicing durations across the two conditions, but only the normal speakers increased vocal SPL during song. These results indicated that the reduction in stutterers' disfluency (stutterings included) during singing was attended by an altered pattern of vocalization that included an increase in voicing duration, but no significant change in vocal SPL. These findings are discussed with reference to vocal tract dynamics, especially those that might promote higher levels of fluency among stutterers.


Factors influencing the acoustic-immittance characteristics of the acoustic reflex.

Measurements of the aural acoustic-immittance (admittance and impedance) characteristics of the middle-ear transmission system in humans during the quiescent (static) and reflexive states were made (N = 36) utilizing a signal-averaging technique. Three pure tones (750, 1000, and 2000 Hz) and broadband noise stimuli elicited the acoustic reflex in 2-dB steps at sound-pressure levels from 84-116 dB (tones) and 66-116 dB (noise) during ascending- and descending-intensity level runs. The contralateral middle-ear activity was monitored with a 220-Hz probe by digitizing the conductance and susceptance outputs of an admittance meter. A computer corrected for the ear-canal volume utilizing measurements made at ear-canal pressures of 0 and --350 daPa and then converted the conductance and susceptance values into admittance and impedance units. The results were reported in absolute and relative immittance units, including components, as a function of both stimulus sound-pressure level and intensity level above the acoustic-reflex threshold. The static immittance of the middle ear changed nonlinearly over time to lower admittance or higher impedance values. The influence of this static-immittance shift on the reflex magnitude was discussed. The largest mean reflex magnitude and the slowest rate of growth were observed with broadband noise, although eight of the 36 subjects demonstrated the largest reflex magnitude in response to one or more of the tonal stimuli. Although static-immittance values and acoustic-reflex thresholds were poorly correlated, the reflex magnitudes were proportional to static immittance. The variability of the reflex measures was similar to the variability of the static-immittance values. Finally, bi-directional changes in resistance during the reflexive state were observed and discussed.


Children's judgments of utterance appropriateness.

Judgments of utterance appropriateness were examined in 3-, 4-, 5-, and 6-year olds to examine the bases for these judgments in a variety of social contexts. The results indicated that the 4- and 5-year olds based their judgments in part on factors such as the available nonlinguistic evidence supporting the utterance and the types of evaluative terms used in the utterance. The judgments of the 6-year olds more closely resembled those of a group of adults, but their judgments were not yet free of some of the factors operative for the younger children. The findings are discussed in terms of the illocutionary and conversational characteristics of the stimulus utterances.


Phrase-level timing patterns in English: effects of emphatic stress location and speaking rate.

Phrase-level timing patterns in the utterance Bob hit the big dog were studied as a function of emphatic-stress location at two speaking rates. Five emphatic-stress conditions were defined: emphasis on each of the four content words, and one condition with no emphatic stress (neutral emphasis). Three subjects produced twenty repetitions of each condition at both rates. Results showed (1) the effect of emphatic stress on segment duration was not confined to the emphasized segments, but was manifest in nonemphasized segments as well; (2) when emphatic stress occurred near the beginning of the utterance, segment durations toward the end of the utterance were shortened relative to the duration of these segments in the neutral-emphasis utterance; however, for emphatic stress late in the utterance, beginning segments were not so modified; (3) the duration correlate of emphasis varied with position-in-utterance; and (4) increased speaking rate reduced or eliminated timing contrasts observed at the conversational rate, and affected the utterance-final segment differently from segments in other utterance positions.


Pragmatic and semantic development in young children with impaired hearing.

The purpose of the study was to characterize the early pragmatic-semantic communicative development of young hearing-impaired children learning spoken English as a first language. Twelve children with impaired hearing, ranging in age from 22 months to 60 months, were videotaped. Approximately 13 hours of videotaped data from four different communicative settings were analyzed. The pragmatic and semantic categories used by these children varied across age groups. Results are discussed with regard to age, expressive modality, mean length of utterance (MLU), and hearing loss. There was much variation among these parameters in communicative development across children.


Women who stutter: personality and speech characteristics.

This investigation was undertaken to determine whether adult female stutterers, when compared to adult male stutterers, would (1) present a different pattern of speech fluency or (2) evidence reduced self-esteem or both. Spontaneous speech samples were obtained from 10 adult female stutterers, 10 adult male stutterers, and 10 adult female nonstutterers. All were administered the California Test of Personality and semantic differential forms designed to assess self-concept. The female stutterers produced significantly fewer instances of revision-incomplete phrase than either of the other two groups and were more heterogeneous with respect to total frequency of disfluency. The female stutterers evidenced a significantly higher level of self-esteem than the male stutterers. Moreover, unlike the male stutterers, the female stutterers did not consider themselves handicapped. This investigation indicates that there may be significant differences in the stuttering symptomatology of adults that are related to gender.


Changes in the probability of stuttering following a stutter: a test of some recent models.

To test the models of stuttering proposed by Still and Sherrard (1976), six stutterers (two adults and four children between 12 and 14 years old) read 33 or more passages of prose of approximately 200 words, in sessions of 16 or 17 passages. Predictions tested concerned changes in stuttering probability as words elapse following the last stutter. Such changes may be confounded with sequential dependencies among word classes, together with correlations between word classes and stuttering. To allow for this, a multiple regression was carried out on six independent variables--initial phoneme, grammatical class, length of word, position in sentence, session, and familiarity of passage. From this analysis, predicted changes in stuttering probability were generated, and compared with observed probabilities. There was a significant decrease in the difference between observed and expected probabilities over the first 30 words following a stutter. Also, two subjects (the adults) showed an initial increase in rate of stuttering. These results support a combination of the anxiety and feedback models of Still and Sherrard.


An analysis of individual differences in words stuttered.

Six stutterers (two adults and four children between 12 and 14 years old) read 33 or more passages of prose of approximately 200 words, in sessions of 16 or 17 passages. Words were classified by initial phoneme, grammatical class, length, and position in sentence, and proportions of stutters were examined as a function of these variables. The extensive data allowed a detailed analysis of individual differences, with the following results. Five subjects showed the usual higher rate of stuttering on consonants, though there were differences in which consonants were stuttered most, and one subject showed more stuttering on vowels. A markedly higher rate was found on initial words of sentences in two subjects, and these two subjects were also exceptional in stuttering more on content than function words, and in showing a type of stutter characterized by blocks rather than repetitions. Possible explanations for this pattern are discussed. Contrary to Taylor (1966) there were significant correlations between stuttering and grammatical class even when initial phoneme and word in sentence were held constant. There were no significant changes within sessions. Two subjects showed a significant decrease between sessions, one showed an increase; these changes were due to familiarity with the experimental situation, rather than with passages per se.


The influence of deviant maternal input on the development of language during the preschool years.

Language development of five two-year-old hearing children of deaf parents was studied longitudinally. These results were compared with the normal language developmental literature, and analyzed in relation to the form of the mothers' oral input. Three of the deaf mothers were less than 15% intelligible and their MLU was less than 2.0. The children spent less than 20 hours weekly with normal speakers. Frequency and proportion measurements were used to compare these children's utterances with those of children from normal-hearing households studied by Lois Bloom and Roger Brown. The observed children's utterances contained similar categories of semantic-syntactic relations and as many syntactic utterance types as children from hearing households. Furthermore, the children were appropriately acquiring grammatical morphemes in relation to their MLU. The overwhelming majority of the children's utterances adhered to a subject-verb-object order of constituents, and discourse interaction (the ability to add information to another's utterance) was developing. The results indicate that children, when cognitively ready, need little exposure to the normal model language to learn to speak during the early stages of development.


The first three words.

The regularly reported influence on stuttering of early sentence position, particularly the first three words, evidently is confounded with the influence of grammatical class, another variable consistently found to correlate with stuttering frequency. Representative samples of English prose are found to contain, in early sentence positions, words of grammatical classes known to be associated with high stuttering frequency. Use of a specially constructed passage, which markedly altered the grammatical class composition of the first three words of sentences, resulted in significant changes in the typical patterns of stuttering frequency associated with word position and grammatical class. The findings lead to an analysis which identifies linguistics stress as the essential feature responsible for the effect on stuttering of both grammatical class and sentence position.


Spectral noise levels and roughness severity ratings for vowels produced by male children.

This study investigated the relationship between spectral noise level (SNL) and perceived roughness in sustained vowels phonated by children. Twenty male children, ten presenting normal vocal quality and ten presenting vocal roughness associated with benign vocal cord lesions, served as subjects. The children individually sustained each of the vowels (Formula: see text) at one intensity and at two pitch levels (comfortable and high). Each vowel recording was analyzed to produce a 3-Hz bandwidth, amplitude-by-frequency acoustic spectrum. The levels of inharmonic (noise) components were measured for the range 100 to 2600 Hz within each vowel spectrum and the mean of those measures provided an index of vowel spectral noise level. Each recorded sample was also rated for degree of roughness, by 11 trained judges, using a five-point, equal-appearing intervals scale. The fundamental vocal frequency (fo) of each production also was measured. The results indicated that four subjects with vocal pathology phonated their vowel productions with a relatively extreme fo when compared to subjects with normal voice quality. It was also found that vowel roughness and SNL differed predictably for individual vowels and that, especially for normal-speaking subjects, roughness and SNL decreased with an increase in fo. Further, for both subject groups, SNL measures were correlated positively and moderately highly with perceived roughness.


Acoustic characteristics of dysarthria associated with cerebellar disease.

The speech of five individuals with cerebellar disease and ataxic dysarthria was studied with acoustic analyses of CVC words, words of varying syllabic structure (stem, stem plus suffix, stem plus two suffixes), simple sentences, the Rainbow Passage, and conversation. The most consistent and marked abnormalities observed in spectrograms were alterations of the normal timing pattern, with prolongation of a variety of segments and a tendency toward equalized syllable durations. Vowel formant structure in the CVC words was judged to be essentially normal except for transitional segments. The greater the severity of the dysarthria, the greater the number of segments lengthened and the degree of lengthening of individual segments. The ataxic subjects were inconsistent in durational adjustments of the stem syllable as the number of syllables in a word was varied and generally made smaller reductions than normal subjects as suffixes were added. Disturbances of syllable timing frequently were accompanied by abnormal contours of fundamental frequency, particularly monotone and syllable-falling patterns. These dysprosodic aspects of ataxic dysarthria are discussed in relation to cerebellar function in motor control.


Voice onset time, frication, and aspiration during stutterers' fluent speech.

The purpose of this study was to investigate voice onset time (VOT) and durations of frication and aspiration in stutterers' fluent speech. Broadband wound spectrograms were used to measure five adult stutterers' and five adult normally fluent controls' VOT, frication and aspiration durations during fluent productions of 18 word-initial sounds or sound clusters. Results indicate that stutterers' mean VOT for six of the 18 sounds/sound clusters (/p b br pr tw bl/) was significantly different from that of normally fluent speakers. VOT values for four of these 18 sounds/sound clusters (/b bl p tw/) could, to a moderate degree, be predicted from knowledge of whether a subject is a stutterer or a normally fluent speaker. With one exception, aspiration duration for /tw/, stutterers were not significantly different from normally fluent speakers in terms of frication and aspiration durations. These results suggest that stutterers' VOT during fluency is within normal limits and as such is of small assitance in distinguishing between stutterers and normally fluent speakers.


Management of multiple lung metastases.

During the past seven years, 78 patients with multiple lung metastases under went lung resection. Most of the patients with bilateral lung metastases had lung resection through a median sternotomy rather than by bilateral thoracotomies. "Local excision" of the lung lesions was the most frequently used technique in order to preserve as much lung tissue as possible. Sixty-three of the 78 patients received adjuvant therapies following lung resection. Operative mortality was 3.8%. The over-all median survival was 18.3 months. Analysis of the data showed shorter tumor doubling time to be an indicator of poor prognosis, whereas other factors such as disease-free intervals and unilateral vs bilateral metastases did not affect the postoperative survival.


Epidermoid carcinoma of the breast.

Two patients with squamous cell carcinoma of the breast are described. In one patient the lesion represented a primary breast tumor; in the second, a metastases from primary bonchogenic carcinoma. Neither lesion possessed estrogen receptor protein. This report emphasizes the rarity of epidermoid lesions of the breast and the importance of identifying an extramammary primary source of metastases to the breast.


Immunotherapy of a murine sarcoma using specific antitumor immune RNA.

The effect of IRNA therapy in a polyoma-induced fibrosarcoma of C3H mice has been studied. Although a protocol that transferred in vitro cytotoxicity was used, no reduction in incidence of tumors, tumor size, or survival was demonstrated. In one experiment, enhancement of tumor growth occurred. It is concluded that cytotoxicity does not reflect in vivo changes and that therapeutic trials of IRNA are premature.


Reticuloendothelial system (RES) hyperfunction and erythropoietin (Ep) production in the regenerating liver.

Hepatic cells in rats were evaluated after subtotal hepatectomy using scintillation scanning with technetium sulfur colloid (TSC), autoradiography, and microstereology techniques. The ability of the liver to accumulate TSC increased during the course of the regeneration as did the labeling of Kupffer and parenchymal cells with tritiated thymidine (3H-tdR). Kupffer to parenchymal cell number ratios and Kupffer cell relative areas were also elevated, attaining peak values at 72 hours post-hepatectomy. This period corresponds to the time of peak erythropoietin (Ep) production in rats with regenerating livers after nephrectomy and exposure to hypoxia. These findings suggest that the Kupffer cell may function as a cellular site of Ep formation.


Single versus double preoperative intralesional BCG in 13762 mammary adenocarcinoma.

Ninety Fischer 344 female rats were injected subcutaneously with a syngeneic 13762 mammary adenocarcinoma. In order to study if repeated doses of preoperative intralesional (IL) BCG were more effective than single doses of IL BCG, and whether the amount of tumor burden influenced the effectiveness of single and/or double doses of BCG, 40 rats had single tumor implants and 50 had double tumor implants. If tumor was allowed to grow for 22 days before resection, all animals eventually died from spontaneous disseminated metastasis (survival for rats with single tumor = 72.8 +/- 12.1 days; for those with double tumors = 63.3 +/- 14.0 days). For rats with single tumors, one dose of IL BCG given 11 days before resection of tumor results in 25% longterm cures. But repeated doses of IL BCG gave much better survival results (43% cures). For rats with two subcutaneous tumors, single doses of preoperative BCG was not effective. Double injections of BCG significantly improved survival results and achieved occasional long-term cures (25%) if the combined tumor volumes were relatively small.


Effect of immunochemotherapy on lymphocyte response of patients with gastrointestinal cancer.

Patients with gastrointestinal cancer were treated with 5-fluorouracil (5-FU) in combination with a streptococcal preparation, OK-432, or without OK-432 before operation, and lymphocyte response to PHA was examined. Oral administration of 5-FU with or without intramuscular injection of OK-432 did not affect the response. However, treatment with cytostatic drugs in combination with OK-432 markedly augmented the lymphocyte response to PHA, but the cytotoxic activity of lymphocytes was not elevated.


Surgical treatment of postintubation tracheal injuries.

Two hundred-eight patients underwent tracheal resection and reconstruction for postintubation injuries from 1965 to early 1979. All but seven had received ventilatory assistance. Thirty-three had undergone prior attempts at surgical reconstruction. Twenty-three had had endotracheal tubes only. the patients had 112 cuff lesions, 78 stomal, 13 at both levels, and four lesions of uncertain origin. One hundred ninety-four had stenosis with or without accompanying malacic change, four showed "pure" malacia, nine had tracheoesophageal fistulas, and one had a tracheoinnominate fistula. There were many laryngeal injuries: 25 of these were major injuries to the low subglottic larynx, necessitating partial or complete removal of the anterior cricoid cartilage. Two hundred sixteen reconstructions were dond, eight for restenosis after initial resection. Cervical approach was used in 126, cervicomediastinal in 83, transthoracic in sic, and cutaneous reconstruction in one. The length of resection extended to 7 cm. Techniques for obtaining tension-free anastomosis included cervical flexion in all, laryngeal release in 20, hilar release in two, and use of partial external splinting in four. Fifty-seven required laryngotracheal anastomosis and nine partial laryngoplasty. Concurrent tracheostomy was rare except in the last group. One hundred-two open stomas were variously managed. There were five deaths (2%)-only one in a truly elective patient. Nine failures (5%) occurred. Ninety-three percent (189 patients) showed good (168) or satisfactory (21) results. Granulations at the suture line, necessitating bronchoscopy, were the most common complication, now seemingly avoided by use of absorbable sutures. Only one patient had postoperative innominate arterial hemorrhage.


Cold-blood potassium cardioplegia: evaluation of glutathione and postischemic cardioplegia.

Potassium (34 mEq/L) cardioplegia was induced with cold blood (CBK) in three groups of six dogs undergoing 60 minutes of myocardial ischemia at a systemic temperature of 27 degrees +/- 2 degrees and a myocardial temperature of 7 degrees +/- 2 degrees C (crushed ice). Group 1 (CBK) animals were reperfused initially with 400 ml cold blood over 8 to 10 minutes at increasing pressures of up to 75 mm Hg. Group II (CBK-K) dogs were reperfused in the same manner as Group I with the addition of potassium chloride, 30 mEq/L. In Group III (CBKG-KG) glutathione, 30 mg/100 ml, was added to both the pre- and postischemic perfusions with CBK. After 30 minutes of reperfusion control studies were repeated. Heart rate, peak systolic pressure, rate of rise of left ventricular pressure, maximum velocity of contractile element, pressure-volume curves, coronary flow distribution, muscle stiffness, and heart water were not significantly different from control values. Total coronary flow and myocardial uptake of oxygen, lactate, and pyruvate did not serve to separate the three groups; the same was true for right ventricular creatine phosphate, adenosine triphosphate, and adenosine diphosphate during ischemia and recovery. Ultrastructural myofibrillar lesions were noted in all groups. thus, postischemic cardioplegia and use of a physiological reducing agent do not enhance CBK cardioplegia with topical and systemic hypothermia.


The effect of diphenylhydantoin upon enzyme release in relation to collagen degradation in cat palatal mucosa during organ culture.

The effect of diphenylhydantoin (DPH) on degradation of collagen was studied during 10 days in organ culture of cat palatal mucosa by measuring the release of hydroxyproline to the culture medium. In parallel, the activities of beta-glucuronidaase and lactate dehydrogenase (LDH) as markers for lysosomal and cytosokic enzymes, respectively, were registered in the tissues and in the culture medium and the glucose consumption was also measured. DPH caused a 36% inhibition of the cumulative release of hydroxyproline to the medium. The activities in the media of beta-glucuronidase and LDH showed a 23% and 30% reduction, respectively. The glucose consumption was unaltered by the drug. The results show that one way by which DPH may interfere with collagen degradation is by blocking enzyme release from the cells.


The effect of diphenylhydantoin upon degradation of sulphated macromolecules in cat palatal mucosa in vitro.

The effect of diphenylhydantioin (DPH) upon the degradation of in vivo [35S]-sulphate-labelled proteoglycans was studied in cat palatal mucosa during organ culture. 8-week-old cats were injected intraperitoneally with [35S]-sulphate and 24 hours later the palatal mucosa was taken to organ culture. The release of radioactivity into the culture medium was taken as a measure of degradation of sulphated macromolecules, presumably proteoglycans, and the release of hydroxyproline as an indicator for collagen degradation. A parallel decrease in the release of radioactivity and in the release of hydroxyproline was observed when the culture was done in the presence of DPH (20 mg/l). Chromatography of the culture medium upon Sephadex G-25 revealed that the reduced release of radioactivity was due to a reduction of macromolecular degradation products leaving the amounts of free sulphate in the medium unchanged. The results were interpreted using a two compartment theory for proteoglycan degradation, extracellular breakdown of the protein core resulting in the production of macromolecular degradation products and intracellular lysosomal degradation resulting in free sulphate as the identifiable product. The results indicate that DPH inhibited the extracellular enzymatic degradation of proteoglycans without influencing their intracellular degradation.


Lidocaine inhibition of rosette formation.

Lidocaine effects a dose-related block of "early" and "late" E rosette and EA rosette, but not EAC rosette, formation of human lymphocytes. The block may be reversed by the removal of the drug from the rosetting milieu.


Alternative designs to study outcomes: the tonsillectomy case.

This article explores the impact of the tonsillectomy operation using a large data base and several different approaches. The likely range of effects of the surgery and various threats to validity are studied from a quasi-experimental perspective. Information on possible patient self-selection for tonsil surgery is provided. Selection is dealt with from another viewpoint by comparing the outcomes of patients under the care of physicians having a "high propensity to operate" with those going to physicians who tend to operate less. Finally, a computer simulation studies the extent to which the measured results of tonsil surgery might be explained by particular selection mechanisms working in conjunction with random processes of episode generation. The "savings" in respiratory episodes estimated by the various approaches ranges from 0.1 episodes to approximately 0.8 episode for the year following surgery.


Bioethical decision making: an approach to improve the process.

Current problems with the decision-making process for bioethical dilemmas are described, with emphasis on the social roles taken in this process by medical experts and laypersons. An approach is presented to improve bioethical decision making. Two consecutive steps are required. First, branching logic is used to separate the bioethical dilemmas into a series of independent, sequential decision points along a decision-making tree. This allows complex dilemmas to be dealt with more easily by resolving the individual component issues in a logical, stepwise fashion. Secondly, explicit criteria are used to decide whether each individual component is ethical or technical in nature. Using these two steps increases the likelihood that the professional and the layperson will assume their appropriate social roles and improve the overall decision-making process. How this approach can be applied to policy-making decisions, in addition to case-by-case deciding, is discussed, as are some of the settings in which the approach might be particularly helpful.


Consumer impact of a Cold Self-Care Center in a prepaid ambulatory care setting.

A Cold Self-Care Center was developed to be an alternative to professional care and to encourage more active involvement of consumers in their own care. A sample of the self-selected user population (n = 74) was studied by comparison with a random sample of plan members (n = 104), and the program was evaluated for cost, consumer satisfaction, and impact on behavior, knowledge and attitudes. Users demonstrated higher levels of knowledge about cold care than non-users, indicated more dependency on professional resources, and differed in health-related attitudes and cold-care behavior. The Cold Self-Care Center appears to have had little impact on self-medication behavior. However, it did affect care-seeking behavior. Knowledge of criteria for seeking professional care was greater than in non-users; 20 per cent sought professional care, and 6 per cent anticipated seeking professional care for future colds. General satisfaction with the program was quite high. Speed and ease of use were cited most often as reasons for satisfaction. The Center also was demonstrated to have a favorable impact on clinic costs. A flexible system which is convenient to use and which retains access to professional care when appropriate both can relieve clinic overload and meet the needs of a large percentage of cold patients.


Eosinophilic granuloma in the temporal bone.

Eosinophilic granuloma is an uncommon granulomatous disease which can affect the temporal bone. Although initially silent, the disease may erode the mastoid cortex, destroy the tegmen and extend into the cranial vault, as well as erode the semicircular canals or cochlea. These lesions almost always become infected and can be confused with chronic otomastoiditis. Equally important, temporal bone involvement may represent only one manifestation of a multifocal disease. Between 1940 and 1978, 19 cases of eosinophilic granuloma involving the temporal bone have been recorded in the Armed Forces Institute of Pathology Registry. Most recently, a 24-year-old white boatswain's mate was sent to the National Naval Medical Center for treatment of unifocal disease which originated in his right mastoid bone. He subsequently underwent modified radical mastoidectomy and received 2500 R cobalt therapy to the temporal bone following surgery. His case history is detailed and the problem of eosinophilic granuloma in the temporal bone is reviewed in depth.


Avoidance of early complications following radical neck dissection.

Multiple factors are associated with the increased risk of postoperative complications following radical neck dissection. Most significant of these are preoperative radiation and entry into the pharynx. The most common of these complications are discussed, and following is a description of preoperative, intraoperative, and postoperative methods to reduce them. Changes in operative methods and antibiotic coverage were associated with a decrease in wound infection and fistula formation. It is suggested that patients in high risk categories be covered with preoperative, prophylactic gram positive antibiotic coverage, along with Tobramycin.


Plastic surgical education for the otolaryngologist.

Otolaryngology shares responsibility for provision of plastic surgical services involving facial and cervical structures, but many training programs have been weak in this part of the specialty. Some still are. Beginning in 1963 when a national organization was formed, leading facial plastic surgeons and the senior author analyzed the weaknesses and embarked on a program to correct these educational deficits. There was widespread lack of surgical background, woefully inadequate knowledge of soft tissue techniques, and poor understanding of dynamics involved in cosmetic procedures. Annual meetings, international symposia, numerous courses, and extensive videotape and microfiche production, as well as political and academic recognition, have all helped plastic surgical teaching endeavors at both residency and postgraduate levels. However, much remains to be done. Program directors are the "key" people here. Suggestions for future action are presented.


Current management of nasopharyngeal stenosis: indications for Z-plasty.

Nasopharyngeal stenosis is not commonly seen at present. Formerly most often due to various severe infections of the upper respiratory tract, the most common current etiology is involvement of posterior pillars at the time of tonsillo-adenoidectomy. A brief review of the historical evolution of treating this problem is summarized. Various degrees of stenosis may occur with varying handicaps requiring surgical correction, utilizing plastic and reconstructive surgical techniques. Three such individuals treated by individually designed flaps with successful outcome are reviewed. Caveats regarding the primary surgical procedure and recommendations appropriate to the secondary surgical correction are outlined.


Surgical treatment of hypopharyngeal stenosis in children.

Five cases are presented of severe scarring, in the hypopharynx in children, which did not respond to conservative measures. These patients were treated by excision of the scar tissue and reconstitution of the area by Z-plasty, local mucosal flaps, regional chest flaps and colon transfer depending upon the severity of the problem. All had rehabilitation undertaken of the structural integrity of deglutive, respiratory, and vocal mechanisms. It is recommended that in this type of problem early rehabilitation is warranted rather than subjecting the child to prolonged gastrostomy and tracheotomy into puberty. When extended, the morbidity has a physical and psychological affect on these children.


Lip transposition in patients with facial paralysis.

Since facial reanimation is not always possible in patients with facial paralysis, one must have alternate methods of reconstruction available. Satisfactory static reconstruction of the face may be accomplished with the use of a brow lift, tarsorrhaphy, and correction of the paralyzed mouth. Transposition of the corner of the mouth utilizing the Z-plasty technique has proven to be an effective method to correct the drooling and garbled speech associated with facial paralysis. When combined with a brow lift and tarsorrhaphy, symmetry of the facial appearance while at rest has also been obtained.


Modified Asai procedure.

To develop a method of establishing speech in the patient who could not develop esophageal speech after laryngectomy, a modification of the Asai procedure with a specially designed Silastic prosthesis was used in three female patients. All three patients had immediate return of voice and were pleased initially. Eventually, however, because of complicating factors, all three operations were revised back to the original state and the new method considered as a failure. The reason for this presentation is to stimulate other surgeons to consider the problem further and perhaps to glean from this technique some useful considerations.


Nasal surgery and airway resistance.

This study investigates the effects of surgery and bronchodilation on nasal and pulmonary resistance. The plethysmograph is evaluated as a clinical tool for nasal flow studies. The method of adapting the plethysmograph to measure nasal resistance is presented. Discriminant Function Analysis considers the effects of surgery and bronchodilatation on 15 variables. The statistical analysis of 38 cases demonstrates the benefits of improved nasal airway for pulmonary airway resistance. A review of the literature points out many of the difficulties in measuring nasal airflow. The plethysmograph emerges as an available easily adapted clinical tool that overcomes many of the short-comings in earlier techniques and in rhinomanometry. The rhinologist is offered further insight into the nasopulmonary relationship and the use of the plethysmograph to document the effects of nasal surgery.


Retropharyngeal abscesses in children revisited.

Retropharyngeal abscess appears in infancy and early childhood. Because of the advances in antibiotic therapy, the frequency of this disease has decreased considerably. If overlooked, however, the sequelae of retropharyngeal abscess can be disastrous. Of the typical signs and symptoms listed in presentation, the swelling of the posterior pharyngeal wall is referred to as an important diagnostic sign. This presentation will discuss the fallibility of this important sign in the evaluation of a retropharyngeal abscess in children. The size of the pediatric oral cavity and the presence of pooling secretions in the pharynx, due to retropharyngeal tissue swelling, make assessment of swelling of the posterior pharyngeal wall extremely difficult. Radiological assessment of retropharyngeal abscesses cannot differentiate between cellulitis and abscess formation. The presentation will discuss the radiological appearance of a retropharyngeal swelling and discuss the differentiation of abscess formation from cellulitis. The rationale for a therapeutic regime will be developed to validate the concept that with suggestive clinical signs, suggestive radiological diagnosis, and in spite of negative evidence of retropharyngeal swelling by oral examination, justification exists for an examination under anesthesia and incision and/or aspiration of the retropharyngeal abscess.


Surgical management of brain tissue herniation into the middle ear and mastoid.

In the well pneumatized temporal bone, the temporal lobe of the brain is separated from the middle ear and mastoid process by a thin layer of bone known as the tegmen. Congenital defects, infection, and trauma can alter this structure in such a way that cerebral tissue herniates into the ear. This unusual condition may precipitate numerous otologic problems such as hearing loss, trapped squamous epithelium, and the potential for meningitis or encephalitis. The purpose of this paper is to define the problem as well as discuss the diagnosis and surgical management. The authors feel this should be a team effort, in many cases employing the assistance of a neurosurgeon, as the repair must often be intradural. Case histories and an extensive review of the literature are to be included.


Extramastoid cholesteatoma in chronic ear disease: a report of two cases.

Two patients who had undergone radical mastoid surgery developed an isolated focus of cholesteatoma embedded in the sternomastoid muscle just below the mastoid tip. In one instance the etiology was felt to be iatrogenic implantation of squamous epithelium. In the second, unrecognized extension from the mastoid tip probably occurred. The purpose of this paper is to describe and discuss in detail the clinical and pathological features of these two cases.


Tonsillectomy and adenoidectomy in the one and two-year-old child.

In an effort to substantiate the efficacy of adenotonsillectomy in very young children, 108 procedures in one and two-year-old children were reviewed. After rigid preoperative criteria are met, a meticulous, conservative adenotonsillectomy is performed. A review of all hospital and office records shows the procedure can be safely and simply performed without significant complications. Seventy-nine parents were questioned regarding postoperative problems and results. Of the parents, 96% were satisfied and would have the procedure done again if they had the chance. Eighty-four referring physicians were polled and 87% thought the procedure solved the children's problem altogether or mostly. In conclusion, the results of this study show that, in carefully selected young children using expert anesthesia and atraumatic surgical technique, adenotonsillectomy under the age of three is a safe and gratifying procedure.


Heterotopic salivary tissue in the neck.

Six cases of heterotopic salivary gland tissue in the anterolateral neck are presented with a review of their clinical and histopathologic characteristics. Neoplastic transformation, fistulization, and isolated rests represent a spectrum of these uncommon lesions. The embryologic derivation of salivary tissue and close association with the branchial apparatus are discussed. The significance of salivary carcinoma presenting in the neck is reinterpreted in light of the embryogenesis of these heterotopias.


Endoscopic lateralization of the vocal cord in abductor paralysis of the larynx.

Endoscopic surgical operations of the larynx have many desirable features, including the conservative nature of these procedures, plus the ability to produce surgical changes predictable from the onset. For several years the direct lateralization of the vocal ligament after the removal of a preassessed amount of thyroarytenoid muscle appeared to be the simplest and most accurate surgical procedure. The resection of this wedge of muscle was easily performed with laryngeal microcautery. Posterior cicatricial webs can be easily removed with this instrument. Simple suturing techniques are also described, including the practicability of using padded buttons plus lead fishing sinkers to adjust the tension and secure these sutures on the surface of the neck. So far 16 patients have been rehabilitated using this technique, including 6 patients with posterior commissure webs. These anatomical techniques should be considered because of their obvious simplicity.


Human laryngeal reinnervation: the Northwestern experience.

Recent publications have reported impressive success with laryngeal reinnervation utilizing a nerve-muscle pedicle. This innovative surgical procedure is claimed to be useful for unilateral and bilateral vocal cord paralysis. Although the surgical results reported by Tucker have been good, they have lacked corroboration from other centers. We have performed six laryngeal reinnervation procedures at Northwestern University Medical School. Four patients presented with bilateral vocal cord paralysis and two patients  with unilateral paralysis. All six operations were successful in restoring vocal cord function. The technique, problems, and results are discussed. Our experience supports the initial reports of success with this new operation.


Pharyngoceles of the hypopharynx.

The differential diagnosis of the complaint of dysphagia is extensive; however, a search of the literature gives the impression that pharyngocele as a cause of dysphagia is relatively infrequent, since only 18 well-documented cases have been reported. On the other hand, the author's experience reveals that pharyngocele occurs more commonly than indicated in the literature as, over the past 2 years, 24 patients with pharyngocele have been personally observed. This thesis is divided primarily into three sections: 1. a review of the physiology and anatomy involved in the swollowing mechanism; 2. a review of the English literature regarding pharyngocele, and 3. an evaluation of the author's 24 cases, allowing for discussion and conclusions. It is noted that laryngocele is frequently mistaken for pharyngocele; however, it is pointed out that a correctly performed barium swallow roentgenogram differentiates one from the other. Symptoms of laryngocele, Zenker's diverticulum and pharyngocele can be quite similar. Frequently, pharyngocele can be demonstrated by the Valsalva maneuver. Surgical repair is indicated when the symptoms are severe. Standard pharyngeal mucous membrane closure similar to the procedure utilized in the repair of Zenker's diverticulum should result in resolution of the problem.


Toward the total rehabilitation of the alaryngeal patient.

Rehabilitative efforts directed toward the total laryngectomee are receiving increasing interest. Fifteen to 50% of laryngectomees fail to develop speech, and 50% do not return to full employment. Many make poor psychological adjustment. A study was designed wherein laryngectomees and their families were individually interviewed. These people suggested that their rehabilitation could have been facilitated had they been better informed preoperatively. Many expressed a desire for exposure to a speech pathologist and a successfully rehabilitated laryngectomee preoperatively. A total of 1,276 otolaryngologists were surveyed regarding the substance and amount of information they believed patients should receive prior to laryngectomy. Otolaryngologists, in the main, feel that they do fully and adequately inform their patients. Speech pathologists and rehabilitated laryngectomy patients are often called to see patients preoperatively. Nevertheless, we deduce that improvements need to be made to insure that the preoperative patient patient does in fact receive the information and counselling intended.


Bone conduction changes following successful tympanoplasty type I.

Pre and one year postoperative bone conduction (b.c.) thresholds were compared for 50 ears of 48 patients, ranging in age from 14 to 42 years, in whom successful tympanic grafts resulted in at least an average improvement of 10 db for 500 to 4000 Hz. While pre and postoperative data are included for all ears and test frequencies, significant BC improvement is seen only at those frequencies, in each case, where the pre-op BC thresholds were worse than 10 db. Normal pre-op BC thresholds cannot show substantial improvement because of audiometric limitations. The amount of BC shift at each frequency for those with pre-op BC thresholds that were subnormal averaged 6 db at 500 Hz, 13.3 db at 1000 Hz, 13.8 db at 2000 Hz and 9 db at 4000 Hz, all highly significant statistically. There were no significant postoperative BC shifts related either to duration of the disease process, length of postoperative period before final test (all were more than one year) or whether the surgical procedure was tympanoplasty type I or myringoplasty.


Immediate facial rehabilitation in poor prognosis tumor patients.

Effective rehabilitation of facial paralysis in the poor prognosis tumor patient is best accomplished by the judicious and individualized use of that combination of static or static and dynamic procedures which will correct the major deformities present immediately and with minimal morbidity. This approach may be taken at the time of tumor ablation or later when the effects of paralysis become distressingly evident. In the rare patient whose disease is controlled, additonal dynamic rehabilitative efforts may be considered subsequently.


The effect of irradiation upon the bacterial flora in patients with head and neck cancer.

Twenty-two consecutive patients with cancer of the head and neck, who were to receive a full tumoricidal dose of irradiation to a field that included the oral cavity and pharynx, were studied to determine the effect of the irradiation on their local bacterial flora. Aerobic cultures were taken prior to, at the completion of, and one month after the completion of their irradiation. The percentage of patients with potentially pathogenic organisms increased dramatically as the effect of the irradiation increased. This change in the local flora has obvious implications concerning the increased incidence of postoperative wound infections in patients who have received prior irradiation.


Tonsil carcinoma--treatment results.

Epidermoid carcinoma of the tonsil region is one of the most common malignancies of the upper aerodigestive tract, equal in frequency to laryngeal carcinoma at the University of Cincinnati Medical Center. This paper reviews the author's experience in treating these lesions with a combination of 5000 rads preoperatively followed by composite resection. The overall two-year crude survival is 58%. A 60% two-year survival for T3 lesions compares favorably with other series for treatment of T3 lesions.


Mechanisms of synkinesis.

When the facial nerve is injured, changes occur in muscle, proximal nerve, distal nerve, and the cell body in the nucleus. All of these changes contribute to the quality of regeneration and repair. This paper describes the usual processes of neuronal regeneration with the objective of a better understanding of why some injuries inevitably result in poor return of motion and synkinesis, while others recover completely. The possible mechanisms of synkinesis include: imperfect regeneration due to axonal misdirection, demyelination, microglial scarring in the facial nucleus, neuron depopulation, multiple axon sprouting, and misdirection of regenerating axons via vertical anastomotic filaments.


Fatty acid composition of heart cells exposed to thermally oxidized fats.

Corn oil and olive oil were thermally oxidized, and the free fatty acids from the fresh fats, and from the distillable non-urea-adductable (DNUA) fractions of the thermally oxidized fats were prepared. These were added as emulsions to the medium of primary cultures of heart endothelial and muscle cells from neonatal rats. After exposure for 24 hr, the fatty acid composition of the triacylglycerol (TC) and phospholipid (PL) fractions of the cells was determined. Reflecting the nature of the fat used, the corn oil treatment produced relatively higher concentrations of linoleic acid in the TG and PL fractions compared to the olive oil treatment, in which case the oleic acid level was influenced. Treatment of the cultured cells with components derived from oxidized corn oil or oxidized olive oil resulted in lower concentrations of linoleic an arachidonic acids in the PL moieties compared to the fresh fat controls. However, there were marked increases in arachidonic acid in the TG fractions of both the endothelial and muscle cells. These changes due to the DNUA from thermally oxidized fats indicate a distinct metabolic response to the derivatives formed during thermal oxidation of the fats.


Correlation between skeletal muscle free fatty acid extraction and vascular decompensation during hemorrhagic hypotension.

The objective of this study was to determine whether or not a relationship exists between free fatty acid (FFA) extraction by skeletal muscle and onset of irreversible shock. Hind limb skeletal muscle vasculature of anesthetized dogs was surgically isolated from cutaneous tissue and subjected to a modified Wigger's hemorrhage shock protocol which was divided into five stages (I-V). Since the first signs of irreversibility began in stage II, this stage of hypovolemic hypotension was subdivided into IIa, IIb and IIc. Arterial and venous blood samples were taken during each stage for subsequent blood gas and FFA analysis. The data indicated that the onset of severe tissue ischemia and metabolic acidosis occurs concurrently with increased uptake of FFA and skeletal muscle vasodilation (decompensation). A possible physiological explanation for these observations could be related to an increased synthesis and release of PGE1. This agent has been shown by others to inhibit adrenergic neurotransmitter release causing loss of vascular tone.


A simplified procedure for the determination of betaine in liver.

A convenient procedure for the determination of hepatic betaine levels is described. The method takes advantage of ethanol precipitation to rid acidified tissue extracts of interfering substances. Betaine is reacted with potassium triiodide to form betaine periodide, which is selectively precipitated via pH adjustment. The precipitate of betaine periodide is dissolved in ethylene dichloride and measured spectrophotometrically. The method is specific, accurate, and simple and showed recoveries of from 97 to 103% at two different levels of added betaine. The applicability of the method was shown when it was demonstrated that diets containing different amounts of choline influenced levels of hepatic betaine.


Membrane lipids in bromodeoxyuridine-differentiated astroglial cells in culture.

Embryonic hamster astroblasts (NN strain) grown in continuous line were cultivated in the presence of bromodeoxyuridine (BrdU). A decrease in the growth rate of the cells and striking changes in their morphology were observed, the morphology of the cells resembling that of mature astrocytes. Membrane lipids of BrdU-differentiated and standard cells were compared. No modification of the lipid/protein ratio was observed. Phospholipids and cholesterol were increased in the same proportions in the cells, and no modification of the phospholipid distribution was observed. Ganglioside sialic acid remained at the same level, but the ganglioside distribution was highly modified. Complex gangliosides appeared (GM1 and GD1a), while the proportion of simple gangliosides (GM3 and GD3) decreased. However, neither GT1 nor GQ1 were detected in differentiated cells. The distribution of phosphoglyceride acyl groups was highly modified, the proportion of arachidonic and docosapentaenoic acids being 2 to 3 times higher in BrdU-treated cells than in proliferating ones. These results were compared to those obtained with another clonal line of glial cells (C6) which exhibited no morphological differentiation in the presence of BrdU; the lipids of these cells were not modified by such a treatment.


Inhibition of hepatic lipogenesis by 2-tetradecylglycidic acid.

2-Tetradecylglycidic acid (TDGA), a hypoglycemic agent, has been found to be a very effective inhibitor of de novo fatty acid synthesis by isolated hepatocytes. A comparison was made between the effectiveness of TDGA and 5-(tetradecyloxy)-2-furoic acid (TOFA), a hypolipidemic agent, on the metabolic processes of isolated hepatocytes. These compounds are structurally related and both inhibit fatty acid synthesis; however, they have opposite effects from each other on the oxidation and esterification of fatty acids. TDGA inhibits whereas TOFA stimulates fatty acid oxidation. TDGA stimulates whereas TOFA inhibits fatty acid esterification.


[Correlation between changes in lungs and the composition of amino acids in blood plasma caused by industrial dust. II. Studies on workers occupationally exposed to industrial dust].

Results of determination of free aminoacids in blood plasma of workers exposed to ceramic and grinding dusts as well as welding fumes are presented. In the blood plasma of those employed in ceramic factory or welders a significant decrease of free aminoacids in comparison with the control group was found except for hydroxyproline, whose content increased during the 25 year-employment. In experiments on animals a significant increase of total aminoacids content in lungs with simultaneous decrease of free aminoacids amount in blood plasma was observed. Similar changes in workers' blood plasma make us conclude that aminoacids content in human lungs may also increase, which is indicative of fibrinogenic processes.


[Respiratory tract in workers chronically exposed to cement dust].

175 men working at productive divisions of a cement plant (average age 39,5 years +/- 8.3, average duration of employment 9.3 years +/- 4.8) and 50 controls (average age 38.7 +/- 11.9 and average duration of employment 10.7 +/- 10.0) were examined. The survey involved: a complex evaluation of respiratory tract, including internal, radiological, spirographic, gasometric and capnographic examinations. The results demonstrated chronic bronchitis in 17% of cement plant workers and in 10% of controls. Qualitatively, chronic bronchitis was more advanced in cement plant workers. Chronic bronchitis prevalence increased with duration of work in exposure to cement dust. Chest radiograms gave no cause for diagnosing pneumoconiosis in any case. Mean values of dynamic spirographic indices were lower than in controls, the differences were, however, statistically insignificant. Instead, the mean values of partial pressures of carbon dioxide and oxygen were statistically significantly lower, than those in controls, though they did not differ much from normal values.


[Chemical hazards connected with electrochemical machining. I. Toxicity of nitric oxides and chlorine lesions in rats' parenchymatous organs].

In rats exposed for 12 weeks to the mixture of nitric oxides (0.34--2.81 mg/m3) and chlorine (0.61--1.50 mg/m3) the following changes were found: increased methemoglobin concentration (MetHb), increased partial pressure, increased total carbon dioxide concentration (pCO2 TCO2), increased current dicarbonate concentration (AB), and increased buffer bases (BB). In addition, asparagine transferase activity (aspAT), alanine aminotransferase (A1AT), alkaline phosphatase (AP) and hepatic isoenzyme of lactic dehydrogenase (LDH5) in serum were found to be increased. Histopathological examination revealed: inflammatory lesions and edema of pulmonary parenchyma, alveolar emphysema and edema of connective tissue of palpetra derm with mastocytes. Chronic exposure to low concentrations of nitric oxides and chlorine induces, apart from local lesions in conjunctivae, pulmonary lesions leading to respiratory acidosis compensated by metabolic alkalosis, or liberation of indicatory enzymes through impaired cells.


[Histopathological changes in the kidney of experimental animals caused by lethal doses of thallium].

The experiment was carried out on 65 white male Wistar rats and 65 white male Swiss mice poisoned with thallium sulfate in doses 30-40 mg/kg body weight. The animals were sacrificed in the 4, 8, 24, 48th hours of experiment and their kidneys were submitted to light and an electron microscopic examination. Protein level in urine and urea level in blood serum of the rats were determined. With the light microscope necrosis of epithelium of Henle loops, hydropic degeneration, swelling and focal necrosis of epithelium of proximal convoluted tubules, and stromal oedema were seen. An electron microscopic study pointed out swelling and degenerative changes in the mitochondria, loss of microvilli in many cells, dilatation of endoplasmic reticulum and decrease of electron density of basement membranes. Urea level in blood serum and protein level in urine increased.


[Sociological profile of Medical Academy graduates undertaking jobs in Industrial Health Services].

In 1977 nation-wide studies were carried out among Medical Academies graduates, considering their preparation to work as physicians, their plans and professional aspirations. This group included young physicians who had undertaken a job in industrial health service. All those graduates were analysed in terms of: sex, social origin, territorial origin, legal status, family status, place of graduation, and their opinions on their professional preparation. Based on the subjects' answers, a place of specialization in industrial medicine was determined in professional plans of young physicians working within industrial health service. In addition, based on analysed variables, the population of young physicians starting their work in industry immediately after graduation, was comprehensively outlined.


[Health and social effects of faciocranial traumas sustained during work in light industry workshops].

In the years 1967-76 at the laryngological clinic 35 patients with faciocranial traumas sustained during work at a light industry plant were treated. Considerable amounts of serious faciocranial injuries (10 cases), and frequent accompanying injuries (mostly lesions of eyes and central nervous system) were found. Direct social cost of those accidents in terms of hospitalization was 482 days and in terms of disability for work--738 days.


[Necessity for stomatologic treatment of workers at the woodworks factory at Sokółka].

Clinical examination of dentition, paradontium and mouth hygiene was carried out in 730 workers of the Woodwork Factory in Sokółka and on this basis the demand for stomatologic treatment was estimated. Analysis of the material was carried out, basing on general indices accepted in mass examinations: caries, type of treatment, PMA and OH.


[Air concentration of asbestos fibers at work sites].

The paper presents a method for measuring the concentration of asbestos fibres at workplaces. This method consists in sampling the dusted air onto membrane filters, making the filters transparent and counting asbestos fibres under an optical microscope with a positive phase contrast. Errors in counting asbestos fibres, sampling and precision of the method were discussed (total error of the method). Measurements of the concentration of asbestos fibres in the air at workplaces were made at plants producing asbestos textile products, seal plates, packings and frictional goods. 0.1 fibre/cm3 was the lowest concentration (sensitiveness of the method).


Physiological, psychological and situational stresses in depression during the climacteric.

The present study examined the characteristics and circumstances which distinguished between groups of depressed and non-depressed menopausal women: 20 women were studied overall. The Beck Depression Inventory (BDI) was used to assess depression levels, while the administration and content analysis of a semistructured interview provided information regarding the presence or absence of stress across a number of variables. While the depressed group were not found to differ significantly from the non-depressed group in terms of stress due to physical symptomatology, they did differ on a number of the psychological and social stress variables, and showed a significantly greater combination of stresses compared with the non-depressed group. Some recommendations concerning management are made.


Is the menopausal age rapidly changing?

A population study of women in Goteborg, Sweden was carried out in 1968--1969. Altogether 1462 women participated (participation rate 90.1%). Five age strata were studied: 38, 46, 50, 54 and 60 (women born in 1930, 1922, 1918, 1914 and 1908, respectively). The same women were re-studied in 1974--1975. Information about menopausal state and, in postmenopausal women, about menopausal age was obtained on both occasions. The information given by the women in 1974--1975 agreed well with the information given in 1968--1969. Very few women started to menstruate again, if the interval since the last menstruation had been 6 mth or longer. The vast majority of the women had a spontaneous menopause. The medians of menopausal age were found to be between 49 yr 7 mth (in women born in 1908) and 50 yr 5 mth (in women born in 1918). There was a tendency towards a continuously increased menopausal age with time as judged from women born in 1908, 1914 and 1918, respectively, but women born in 1922 were found to have a median menopausal age which was more similar to that of the women born in 1908 than that of the women born in 1918. Our sstudy has, thus, not supported the view that the menopausal age in rapidly changing.


Menopausal effects on risk factors for ischaemic heart disease.

Women of almost identical age but with a different menopausal state were compared in a population study of women, which was carried out in Goteborg, Sweden. The group of women aged 50 comprised about the same number of still menstruating and postmenopausal women and was, therefore, especially suitable for such a comparison. Serum cholesterol and serum triglycerides were higher in postmenopausal than in premenopausal 50-yr-old women and seemed to increase with postmenopausal time. The differences between premenopausal and postmenopausal women were hightly significant. Systolic blood pressure was slightly but significantly different (lower in postmenopausal women), while no difference was found for diastolic blood pressure. It seems that differences in risk factors for ischaemic heart disease could explain part of but not all the association between early menopause and ischaemic heart disease.