Assessment of a comparison of colorimetric methods used for oxytocinase determination.

The correlation of three colorimetric oxytocinase determination methods used in clinics was compared and assessed. It was found that the new methods, the method of Kleiner and Brounet-Yager, and that of Usategui-Gomez et al., show a high correlation with respect to the Tuppy and Nesvadba method (modified by Klimek) the usefulness of which has already been proved. The method of Usategui-Gomez et al., using L-cystine-bis-p-nitroanilide as substrate, is more sensitive and has more advantages.


Molecular weight-dependent distribution of acidic glycosaminoglycans in human plasma.

Acidic glycosaminolglycans (AGAG) in human plasma were studied by enzymatic and electrophoretic procedures after fractionation by gel filtration on Sephadex G-100. Galactosaminoglycans were the predominant acidic glycosaminoglycans in the small molecular weight fraction, but glucosaminoglycans were predominant in the macromolecular weight fraction. The major constituents of plasma AGAG were estimated as udersulfated chondroitin sulfate isomers followed by a lesser amount of hyaluronic acid characterized by susceptibility to specific chondroitinases and streptomyces hyaluronidase. In addition, the presence of small amounts of heparan sulfate and oversulfated chondroitin sulfate in human plasma was indicated.


Evaluation of fluorimetrically estimated serum bile acid in liver disease.

Fasting serum bile acid (SBA) was measured by the enzymic fluorimetric method coupled with the NAD-resazurin system in 23 controls, 35 asymptomatic carriers of HIs antigen including 4 e antigen carriers and 91 patients with various liver diseases. All GHBs and e antigen carriers showed SBA within the normal range. SBA was most significantly correlated with serum bilirubin (gamma=0.74) and was a more sensitive index for impaired liver function than bilirubin or alkaline phosphatase in 164 radomly chosen samples from the liver disease group. In serial determinations of SBA with reference to GOT, GPT, changing patterns of these two parameters were classified into the parallel type and the discrepant type. Thirty two out of 40 cases with chronic liver disease belonged to the parallel type. SBA remained abnormal even after the normalization of transaminase in 12 out of 20 resolving episodes in cases of the parallel type, regardless of diagnosis. Since SBA changes according to the stage of the disease activity, serial and simultaneous estimation of SBA and GOT, GPT was found to be helpful in the observation of liver diseases. Maximum values of SBA elevation in an endogenous bile acid tolerance test after eating two egg yolks were higher than controls in 4 out of 7 cases with liver disease, who were associated with normal fasting SBA.


Determination of ethanol in serum by an enzymatic PMS-INT colorimetric method.

A simple, rapid and accurate colorimetric method for the determination of ethanol in serum was studied. Ethanol is converted to acetaldehyde by alcohol dehydrogenase, and the NADH formed transfers its hydrogen through the phenazine methosulphate-p-iodonitrotetrazolium violet (PMS-INT) system to produce the red formazan which is stable and absorbs at 505 nm. The method correlates very well with an enzymatic-UV method, r=0.98 (p less than 0.001). The precision (95% limits) of the method for samples ranging from 11 to 145 mg/dl was +/-6.6%, and the recovery averaged 99%.


A contribution to the study of fluoride excretion.

Three population groups (two of them consisting of school-going children) with a low content of fluoride in the drinking water have been used to investigate parameters influencing fluoride excretion. For the population living in an area contaminated by F-air pollution, there was no significant effect of age or sex from 3 to 17 years. For the population living in a non-contaminated area, there is an increase with age. The data are distributed according to log normal. To determine these excretion levels, first-morning samples were used and it is concluded that for population research (not necessarily for individuals) this is more practical than 24-h samples and yield reliable results. To correct for urine concentration, correlation with Ca2+, Cl- and creatinine were investigated. Low or insignificant correlations were obtained.


Cholesterol determinations. A comparative study of methods with special reference to enzymatic procedures.

Two enzymatic methods for the determination of cholesterol in serum have been modified for automatic use. These methods utilize the colour reactions according to Kageyama or Trinder to measure the hydrogen peroxide resulting from the enzymatic reaction. The procedures have been compared with the classical methods according to Abell and to Huang. Details regarding the procedures are given. Comparisons made during routine analysis of a large number of different sera have been expressed in the form of regression equations. The standard errors of the methods are given along with the standard deviations for differences between methods. Some conversions of values from one method into another are also given. It appears that the automated Kageyama method can be used for large scale practice. The manual Kageyama method is not very satisfactory because of its large experimental error. A disadvantage of the Kageyama methods is the necessity of having blank corrections for haemolytic sera. The Trinder method avoids the problem and has some additional advantages.


Influence of fatty acids on the binding of calcium to human serum albumin.

Fatty acids have been shown to influence the binding of calcium to human serum albumin. The calcium binding to albumin was enhanced when long-chain fatty acids were added to albumin prepared by two different methods and decreased when fatty acids were removed from albumin. Palmitic, stearic and oleic acids all exhibited this phenomenon. The effects of long-chain fatty acids on the binding of calcium to albumin in vitro appears to be of sufficient magnitude to have in vivo implications in calcium homeostasis and in determining the ratio of free to total calcium. Preliminary in vivo experiments have confirmed the calcium binding of fatty acids in serum and suggest a physiological role for this phenomena.


Steroid receptors in the human prostate. Detection of tissue-specific androgen binding in prostate cancer.

We have searched for tissue-specific binding of 5alpha-androstan-17beta-ol-3-one (5alpha-dihydrotestosterone; 5alpha-DHT) in cytosols prepared from 25 surgically obtained benign prostatic hypertrophy (BPH) samples and in 3 tissue specimens containing prostate cancer cells. The distinction between steroid-receptor complexes and ligand binding to serum sex hormone-binding globulin (SHBG) was facilitated by combination experiments involving both sucrose gradient ultracentrifugation and agar gel electrophoresis. Gradient analysis of a cytosol prepared from a cervical lymph node (CLN) containing metastatic prostate tissue, revealed both 8-S and 4-S forms of high affinity (charcoal stable) 5alpha-[3H]DHT binding. When electrophoresis was performed on gradient fractions from these zones, anodally migrating steroid-receptor complexes were found only in the 8-S peak, the 4-S region containing radioligand bound to cathodally directed SHBG. In similar experiments with two BPH samples heavily invaded with prostate cancer cells only a single 4-S peak of radioligand binding was detected. Its multicomponent nature was uncovered electrophoretically when, in addition to SHBG, saturable, androgen binding molecules appeared anodally. Their incomplete resolution from SHBG on a gradient might have prevented their identification had this been the only method used. In contrast to the cancer-containing tissues, no saturable 5alpha-[3H]-DHT binding, other than that to SHBG, was detected in any of the BPH samples analysed. It is considered that, of the methods currently available, agar gel electrophoresis may be particularly useful for further investigations into the possible multicomponent nature of androgen binding of tissue origin in the human prostate.


The effect of 2,3-diphosphoglycerate on oxygen consumption burst in thrombin-stimulated platelets.

2,3-Diphosphoglycerate (2,3-DPG) modifies platelet function; it diminishes aggregation and the release reaction. The hypothesis that this occurs through a modification of the intracellular level of cyclic AMP or through an alteration in the synthesis of prostaglandins has been proposed. Since the release reaction occurs simultaneously with a burst in the consumption of oxygen, the authors have studied the effect of 2,3-DPG on oxygen consumption after the addition of thrombin with or without the addition of substances which modify platelet metabolism (aspirin, theophylline, glucagon, etc.). It was observed that 2,3-DPG diminishes oxygen consumption induced by thrombin. This mechanism alters the platelet membrane function.


Metabolism of nicotinic acid in children with burns and scalds.

The excretions of two metabolites of nicotinic acid, N1-methylnicotinamide and N1-methyl-2-pyridone-5-carboxamide have been measured at varying times after injury in a group of 27 burned or scalded children. Compared with control patients the excretions of both of these metabolites were significantly raised after injury, which suggests that the utilisation of nicotinic acid is increased.


Short-term fluctuations in plasma cortisol in Cushing's syndrome.

Short-term fluctuations in plasma cortisol were determined overnight in twelve patients with Cushing's syndrome: eight patients with bilateral adrenal hyperplasia of hypothalamic-pituitary orgin, three patients with a cortisol producing adenoma and one patient with a carcinoma of the adrenal cortex. While either secretory episodes in plasma cortisol or a fixed pattern of cortisol secretion were observed both in patients with pituitary dependent and in those with pituitary independent hypercorticism, a typical night-day variation in plasma cortisol was only found in one of the eight patients with Cushing's syndrome of hypothalamic-pituitary origin. The patient with a cortisol producing carcinoma showed only minor fluctuations in plasma cortisol throughout the test period. The results indicate that no discrimination can be made between patients with pituitary dependent or independent Cushing's syndrome by demonstrating an episodic or a fixed secretion of cortisol. It seems, however, that the finding of a typical night-day variation in hormone secretion points to hypercorticism of hypothalamic-pituitary orgin.


The hypoglycaemic action of somatostatin in the anaesthetized dog.

The hypoglycaemic action of somatostatin was investigated in fasted anaesthetized dogs. An isotopic turnover technique with radioactive D-[2-3H] glucose tracer was used to measure the rates of hepatic production and peripheral utilization of glucose before, during, and after a 60min infusion of 150 mug somatostatin. Plasma concentrations of insulin, glucagon, growth hormone, cortisol and free fatty acids were also measured. Somatostatin infusion caused a fall of plasma glucose demonstrable within 10 min. After 60 min plasma glucose had fallen to 75% of the pre-infusion concentration. Simultaneoulsy the specific activity of the D-[2-3H] glucose increased and calculation of the rates of production and utilization of glucose over 10 min intervals indicated that the mean hepatic production rate of glucose fell to 59% of the pre-infusion rate while the rate of peripheral utilization of glucose fell to 83% of the pre-infusion rate. These results show that the hypoglycaemic action of intravenous somatostatin depends exclusively upon the inhibition of hepatic glucose production. This effect may have been partly due to a fall of plasma glucagon concentration and occurred despite a fall of plasma insulin to less than 1 mu 1(-1).


Familial goitre with partial iodine organification defect, lack of thyroglobulin, and high levels of thyroid peroxidase.

From a sibship of three sisters having congenital goitre and normal hearing, two had impairment of organification of iodine. S1 (4 years old) had goitre since birth, euthyroidism, and a negative perchlorate test. S2 (15 years old) and S3 (13 years old) were hypothyroid, and had radioiodide discharge after potassium perchlorate administration of 19.8% and 26.1%, respectively. Thyroid tissue was obtained at thyroidectomy. Peroxidase activity, in the thyroidal subcellular particles, was found to be qualitatively normal, but quantitatively increased. In the triiodide assay, the activity was: S1 6912 u, S2 2590 u, and S3 3844 u (normal values 900-1700 u). In the tyrosine-iodinase assay, the activities, expressed as nmoles of iodide incorporation per gram of tissue, were S1 1046, S2 471 (normal values 220-410). The activity of the thyroidal NADPH-cytochrome c reductase, an enzyme possibly involved in hydrogen peroxide generation, was: S1 0.084, S2 0.047, and S3 0.005 (normal values 0.018 muEq/min/mg). No thyroglobulin was detected by analytical ultracentrifugation, polyacrylamide gel electrophoresis, or double immunodiffusion in agar of the supernatant fractions. In patient S2, whose gland was labelled in vivo with 125I, 60% of the total radioactivity of the gland (pooled nodular and paranodular specimens) was in a particulate iodoprotein that was solublilized by trypsin, deoxycholate or digitonin. In the soluble fraction there were two iodoproteins: iodalbumin, and a second iodoprotein similar to the solubilized particulate iodoprotein. It is postulated that absence of the normal thyroidal receptor protein might be in some cases a cause of iodine organification defect.


A long-term follow up of patients with autoimmune thyroid disease.

A survey in a general practice in the North-East of England in 1963 detected thyroglobulin antibodies in 16.2% of women and 4.3% of men. High titres of antibodies were found in 4.6% of women and 1.6% of men. Forty six subjects with thyroglobulin antibodies (from an original total of fifty-two) were studied in 1972 and forty of these were studied further in 1975. These subjects were compared with a group of  age- and sex-matched controls from the original survey. Three of the subjects had developed overt hypothyroidism by 1975 and a raised serum thyroid-stimulating hormone (TSH) concentration was found more frequently in euthyroid subjects peviously found to be antibody positive. There was a striking difference in the antibody studies in that only 26% of the previously antibody positive subjects had thyroglobulin antibodies in 1972 and 30% in 1975. A raised serum TSH concentration was found to correlate with cytoplasmic a-tibodies and particularly with the combination of cytoplasmic and thyroglobulin antibodies.


Plasma and pituitary thyrotrophin (TSH) in severe and prolonged hypothyroidism, as studied in the rat.

Thyroidectomized rats, kept on a low iodine diet, were killed at 60, 80 and 270 days after thyroidectomy and plasma and pituitary TSH levels measured. Pituitary TSH content was lowere in the thyroidectomized rats than in the controls at 60 and 80 days, starting to increase between 60 and 80 days, and reaching higher values than those of the controls by 270 days. Plasma TSH was higher in the thyroidectomized rats than in the controls at all the times studied, but declined markedly between 60 days (17.53 +/-1.98 mug/ml) and 270 days (3.63 +/-0.49 mug/ml. This decrease in plasma TSH levels was accompanied by a decrease in plasma PBI: from 0.69+/-0.08 mug/dl at 60 days to 0.06+/-0.01 mug/dl at 270 days. The daily injection of 1.75 mug T4/100 g body weight for 12 days in either thyroidectomized rats or normal intact rats resulted in a decline of plasma TSH levels in both groups. Pituitary TSH content increased in the thyroidectomized rats and decreased in the controls after T4 treatment. Present results agree with previous observations indicating  that severe and chronic thyroid hormone deficiency is not accompanied by a progressive increase in circulating TSH levels, though an elevation is always fou nd even in mild or subclinical forms or primary hypothyroidism. They show that in the rat this connot be accounted for by an impairment of TSH synthesis, as previosly suggested: an impairment of TSH secretion appears more probable.


High level of a nerve growth factor in the serum of a patient with medullary carcinoma of the thyroid gland.

The serum of a patient with a familial medullary thyroid carcinoma showed levels of a factor, active in the nerve growth factor (NGF) bioassay and cross-reacting immunologically with mouse NGF, 20-1000 times higher than sera from normal controls or from patients with unrelated tumours. Variations of the level of this factor in the serum closely correlated with the progression of the disease. One of the patient's sons, apparently clinically normal, also showed high levels of this factor in the serum, raising the possibility that abnormality in the production of this factor could be present at an early stage of the disease.


Effect of cortisol treatment on hormonal relationships in congenital adrenal hyperplasia.

The temporal relationship between administration of cortisol and serum 17alpha-hydroxyprogesterone was investigated in five patients aged 9-19 years with congenital adrenal hyperplasia due to 21-hydroxylase deficiency. There was marked variability in the 17alpha-hydroxyprogesterone response (determined hourly for 24 h) of individual patients to administration of cortisol. Mean concentration was less than 0.030 micronmol/l in one patient but 0.519 micronmol/l in another. Levels were higher in all patients while off treatment, and were greatest in those with salt-losing adrenal hyperplasia. Growth hormone secretion was not suppressed by treatment with cortisol. Withdrawal of cortisol for 3 days resulted in a significant decrease in the mean serum FSH/LH ratio and a rise in serum testosterone in all subjects. Episodic release of gonadotrophins persisted in the adolescent patients.


Effects of a feminizing testicular Leydig cell tumour on nontumorous testicular tissue: an ultrastructual study.

The ultrastructural effects of a Leydig cell tumour of the testis on nontumorous testicular tissue have not yet been reported. Described here are the electron microscopic findings in the nonneoplastic testicular tissue of a patient with a feminizing testicular Leydig cell neoplasm. Serial studies were carried out over a period of 31/2 years prior to removal of the tumour. The overall general picture was characterized by progressive degeneration of Leydig cells, cells of the germinal series and Sertoli cells. Concomitantly, there was increasing thickening and fibrosis of the tubular walls. Cytoplasmic focal accumulations of glycogen, increasing with the duration of the disease, were conspicuous in many spermatogonia. All of these alterations are nonspecific and are attributable to adverse endocrine effects introduced by the oestrogen-secreting tumour. They were present bilaterally and were more prominent on the tumour-bearing side. Attention is drawn to the role of artifacts, fixation technique and degenerative processes in the production and appearance of certain ultrastructural findings, such as 'light' and 'dark' cells, myelin figures, membranous whorls and focal glycogen accumulations.


The cardiovascular and lipid status of pernicious anaemia patients with and without thyroid antibodies.

A study has been undertaken of the cardiovascular and lipid status of patients with pernicious anaemia (PA). There was no evidence of elevated cholesterol, triglyceride and lipoprotein concentrations nor of an increased prevalence of ischaemic heart disease and peripheral vascular disease in those patients who had positive thyroid antibodies compared with those who had not. There were also no significant differences in cardiovascular or lipid status in the antibody positive patients between those who had an exaggerated thyroid stimulating hormone (TSH) response to thyrotrophin releasing hormone (TRH) and those who had a normal or impaired response. It is suggested that an exaggerated response to TRH in these PA patients usually indicates 'compensated euthyroidism' and not 'subclinical hypothyroidism' or 'premyxoedema' and that they are no more at risk for cardiovascular disease than are PA patients with no evidence of thyroid abnormality.


Radioimmunoassay of free thyroid hormone concentrations in the investigation of thyroid disease.

Direct radioimmunoassay of free triiodothyronine (fT3) and free thyroxine (fT4) in serum dialysate has been performed in fifty-two normals, twenty-one hyperthyroid, and twenty-one hypothyroid patients. In health, there is an almost equimolar concentration of fT3 and fT4. In hyperthyroidism, the free thyroid hormone concentrations were clearly discriminated from the normals. In a proportion of the symptomatic hypothyroids studied, the free hormone values fell within the normal range, challenging the concept that free thyroid hormone concentrations are the sole determinants of thyroid status. In the population studied, there were statistically significant correlations between fT3 and fT4, as well as the free hormones with their respective total hormone levels. It is concluded that fT3 and fT4 estimated are unlikely to play a major role in the routine investigation of thyroid disease.


C-peptide and insulin during blockade of the hyperglycaemic response to surgery by epidural analgesia.

Insulin secretion, as expressed by peripheral plasma insulin and C-peptide levels, was studied during and after abdominal hysterectomy in six patients having general anaesthesia and in six patients having epidural analgesia. The hyperglycaemic response to surgery was abolished during epidural analgesia. Insulin as well as C-peptide levels in plasma were low and unchanged during general anaesthesia and low and slightly decreasing during epidural analgesia. (1) Insulin secretion to the hyperglycaemic stimulus is blocked during surgery: (2) abolition of the hyperglycaemic response to surgery by epidural analegesia is not caused by an increased insulin secretion.


The effect of endogenous oestrogen on plasma and urinary calcium and phosphate in oophorectomized women.

Using a specific radioimmunoassay, significant levels of plasma oestradiol can be detected in the blood of oophorectomized women. In these women the plasma concentration of oestradiol correlates positively with body fat content. Low circulating concentrations of oestradiol are associated with increased values for serum phosphate and alkaline phosphatase, but no significant change in serum calcium. The fasting urinary calcium creatinine ratio is inversely related to circulating plasma oestradiol concentration which also correlates, in a more complex way, with the renal threshold for phosphate (TmPO4/GFR). It is suggested that oestrogen production may be an important factor in determining bone loss in postmenopausal women.


The response of heart rate to isoproterenol in hemodialyzed patients before and after parathyroidectomy.

The response of the heart rate to intravenous isoproterenol was studied in seven chronic hemodialysis patients with severe hyperparathyroidism, before and after subtotal parathyroidectomy (PTX). Before PTX, significantly higher doses of isoproterenol were needed to achieve a standardized increase in heart rate when compared with the doses needed following PTX. A similar difference was observed before and after removal of a parathyroid adenoma in an additional nonuremic patient with primary hyperparathyroidism. This decreased cardiac responsiveness to a beta-adrenergic stimulus seemed to be related to the hyperparathyroid state.


Intradialytic measurement of cardiac output by thermodilution and impedance cardiography.

Impedance cardiography was compared with thermodilution cardiography in the measurement of cardiac output serially during maintenance hemodialyses in ten chronic uremic patients. Measurements were carried out pre-dialysis and post-dialysis as well as hourly during dialysis. The results demonstrated statistical identity between impedance and thermodilution cardiography at all times of measurement. The study confirms the validity of the non-invasive technique in measuring cardiac output in the uremic patient.


Membranoproliferative glomerulonephritis with disruption of the glomerular basement membrane.

Seven patients with a form of membranoproliferative glomerulonephritis distinct in its glomerular ultrastructure from other forms are described. The use of silver impregnated electron micrographs revealed contiguous subepithelial and subendothelial deposits associated with basement membrane disruption, replication and layering of lamina densalike material. By light and fluorescence microscopy the appearance was distinctive but not diagnostic. Immunohistology consistently showed abundant C3 and properdin in a granular pattern while immunoglobulins and Clq were variably present. Low serum C3 concentrations were observed at some time in each patient, often accompanied by low levels of properdin, whereas the concentrations of Clq and C4 were normal. The patients were indistinguishable in their clinical course from those with other types of MPGN.


Use of hemodialysis in meprobamate overdosage.

A case of meprobamate overdosage successfully treated with hemodialysis is described. The patient was admitted 4 hours after an overdosage of meprobamate (30-40 g) deeply unconscious, hypotensive, in respiratory failure and with a serum meprobamate level of 50 mg/100 ml. Hemodialysis was instituted using a Gambro parallel flow dialyzer and a portable re-circulating dialyzate delivery system (Redy, CCi Life Systems). Meprobamate removal with hemodialysis was 672+/-167 mg/hr with a corresponding clearance of 61.97+/-9.9 ml/min. Drug removal with forced diuresis was 177+/-23.4 mg/hr. Metabolic degradation of the drug was approximately 482 mg/hr with a plasma disappearance rate of 5.2%/hr. No drug could be detected in the dialyzate fluid after its passage through the Redy re-circulating dialyzate system. Because of the rapidity of metabolic degradation of meprobamate, we feel that hemodialysis should be reserved for severe clinical intoxication and either compromised normal excretory routes or progressive clinical deterioration.


Antimicrobial dosage in renal failure: a unifying nomogram.

A concise method is presented for calculating the dosage of commonly used anti-microbial agents in patients with impaired renal function.


Recent improvement in outcome for the small premature infant. Follow-up of infants with a birth weight of less than 1,500 grams.

1. Developmental and neurologic outcome was determined for 176 premature infants of birth weight less than 1,500 gm, born during 1965-1970. 2. No significant difference in outcome was found when infants of birth weight 1,000 to 1,500 gm were compared with those weighing less than 1,000 gm. 3. The overall outcome is generally favorable, with 67% of the entire group noew deemed developmentally and neurologically normal. 4. Improvement in outcome in the small premature infant seems related to aggressive perinatal care, particularly monitoring of biophysical, biochemical and metabolic factors in the fetus and neonate;


Adrenal hemorrhage in the newborn. The phenomenon of "enclosed" hemorrhage as a cause of neonatal jaundice and later adrenal calcifications.

In an infant with unexplained hyperbilirubinemia, abdominal mass and a fall in hematocrit, an IVP with total body opacification should be considered so that the diagnosis of adrenal hemorrhage, which is almost always a benign conditions, may be made. Follow-up abdominal films at 3 months of age may further substantiate the etiology by revealing calcifications in the involved areas.


The clinical profile of the newborn with persistent pulmonary hypertension. Observations in 19 affected neonates.

In 19 neonates with severe cyanosis, normal chest x-rays, anatomically normal hearts, and a high incidence of perinatal complications, the clinical course was characterized by variable sustained cyanosis. Cardiac catheterization data showed high systemic or suprasystemic pulmonary artery pressure with right to left intracardiac shunting via the foramen ovale and ductus arteriosus. Arterial oxygen tension at an inspired oxygen concentration above 65% was helpful in distinguishing these patients from those with congenital heart disease, and for predicting prognosis.


Lack of dependence of urine PCO2 upon reduction of glomerular filtration rate in alkalotic dogs.

1. The PCO2 gradient between alkaline urine and arterial blood (U-B PCO2) is thought to depend primarily on distal hydrogen ion secretion. However, other variables affecting the U-B PCO2 include the urine flow rate, the urinary bicarbonate and phosphate excretion rates and the glomerular filtration rate. 2. In order to evaluate the effects of acute changes in these factors on the U-B PCO2, bicarbonate-loaded dogs with maximal U-B PCO2 values were subjected to either acute unilateral elevations of ureteral pressure or hypotension caused by nitroprusside infusion. The results demonstrate that acute reduction in the glomerular filtration rate does not cause a decrease in the U-B PCO2 as long as the urinary concentrations of phosphate and bicarbonate do not decline. 3. Urinary concentrations of phosphate and bicarbonate appeared more important than their excretion rates in the maintenance of elevated U-B PCO2 values.


Effect of pentobarbitone sodium on serum creatine kinase of normal and dystrophic hamsters.

1. The dose of pentobarbitone required for anaesthesia was significantly greater for dystrophic hamsters than for normal animals. 2. Serum creatine kinase activity was significantly higher in dystrophic than in normal hamsters. 3. Brain, heart and tibialis anterior muscle from dystrophic animals contained significantly less creatine kinase than the normal tissues. 4. Creatine kinase in normal and dystrophic sera, as in skeletal muscles, consisted of MM isoenzyme. Heart creatine kinase consisted of both MM and MB types and brain contained only the BB isoenzyme. 5. Pentobarbitone raised serum creatine kinase activity of normal and dystrophic hamsters to the same extent, elevation of enzyme activity being dependent on the amount of pentobarbitone injected. 6. The sera of pentobarbitone-treated normal and dystrophic hamsters contained only the MM isoenzyme.


Epitaxial relationships in urolithiasis: the brushite-whewellite system.

1. Whewellite (calcium oxalate monohydrate) crystals were found to induce epitaxially the heterogeneous nucleation of brushite (calcium monohydrogen phosphate dihydrate) from its metastable supersaturated solution in approximately one-quarter of the time required for spontaneous precipitation in the absence of added nucleating agents. Scanning electron-microscope observation of the crystalline phase showed brushite crystals originating from the whewellite seed crystals. 2. Crystal growth, upon nucleation, proceeded rapidly, and the metastable solutions quickly approached saturation. 3. Brushite crystals also induced the precipitation of calcium oxalate crystals in about one-quarter of the time required for spontaneous precipitation; however, the rate of crystal growth was considerably slower. In support of the chemical data, scanning electron micrographs showed few crystals of calcium oxalate nucleated on the surface of the brushite seed. 4. The results provide some insight into the cause of stones containing calcium oxalate or calcium phosphate (or both), which form in the normally acid environment of human urine.


Inhibition of frusemide-induced natriuresis by indomethacin in patients with the nephrotic syndrome.

1. In four patients with nephrotic syndrome indomethacin not only reduced proteinuria but also inhibited the natriuretic effect of high doses of frusemide. 2. The inhibition of natriuresis by indomethacin could not be antagonized by albumin infusions. 3. Only the combined use of spironolactone and frusemide induced a natriuresis during indomethacin treatment. Spironolactone alone was ineffective. 4. It is suggested that inhibition of prostaglandin synthesis by indomethacin, in the presence of a stimulated renin-angiotensin system and hyperaldosteronism, may cause this strong tendency to sodium retention.


The course of arterial pressure and the effect of Sar1-Thr8-angiotensin II in a new model of two-kidney hypertension in conscious dogs.

1. We describe a new method of producing two-kidney hypertension in dogs by a two-step procedure with complete occlusion of a renal artery 2 weeks after it was partially constricted. 2. Control mean arterial pressure (96 +/- 3 mmHg) of nine conscious, trained dogs rose to 107 +/- 3 mmHg 2 weeks after partial constriction of a renal artery, and it stabilized at a sustained hypertensive plateau (124 +/- 7 mmHg) 3 weeks after complete occlusion. 3. Intravenous infusion of an angiotensin II antagonist (Sar1-Thr8-angiotensin II) caused arterial pressure to fall during the acute but not the chronic phase of renal hypertension. In this latter phase plasma renin activity had returned to control values. 4. We conclude that the renin-angiotensin system appears not to be directly involved in the chronic phase of two-kidney hypertension in the dog.


Comparison of the effect of two groups of diuretics on renin secretion in the anaesthetized dog.

1. The effects of two groups of diuretics on renin secretion have been compared in dogs anaesthetized with pentobarbital. 2. Frusemide, ethacrynic acid and bumetanide cause an immediate rise in renin secretion which is not inhibited either by DL-propranolol or by a bilateral ureterovenous anastomosis which prevents salt and water loss. 3. Clopamide, metolazone and indapamide do not cause an immediate rise in renin secretion. Renin hypersecretion is induced only 1 h after intravenous injection of these diuretics. 4. Renin secretion was studied for 6 h after frusemide injection: the immediate rise was followed by a later increase in renin secretion. This later rise was inhibited by propranolol and by ureterovenous anastomosis. 5. These results allow us to distinguish between a direct renal mechanism responsible for early renin hypersecretion, which appears to be connected with the action of the diuretic on the ascending limb of Henle's loop, and an indirect mechanism responsible for late renin hypersecretion, which appears to be connected with salt and water loss.


The development of a radioimmunoassay procedure for the estimation of Tamm-Horsfall glycoprotein in human serum.

1. A quantitative radioimmunoassay was developed for the measurement of nanogram amounts of Tamm-Horsfall (TH) glycoprotein in the presence of serum proteins at concentrations above 30 mg/ml. 2. Specific anti-(TH-glycoprotein) antibodies were labelled with 125I and these were usable for a period of 8 weeks. 3. Agarose beads (Sepharose 4B), to which TH-glycoprotein had been coupled via cyanogen bromide activation of the Sepharose, were used as the solid phase in the assay. This proved stable upon storage at 4 degrees C for periods in excess of 4 months. 4. The dissociation of the glycoprotein in the presence of serum proteins that was necessary for quantification was achieved by subjecting the sample to ultrasonication. 5. Assays conducted on a small sample of normal serum produced evidence that normal serum contained amounts (50-180 ng/ml) of a substance that reacted similarly to TH-glycoprotein in the assay procedure and in a series of experiments conducted to confirm the presence of this substance in human serum.


Effect of nephrectomy and enterectomy on plasma clearance of intravenously administered dipeptides in rats.

1. Sham-operated and bilaterally nephrectomized rats were injected intravenously with glycyl-L-leucine, glycylglycine and glycylsarcosine, and the concentrations of these dipeptides in plasma and muscle, liver, renal cortex (in the sham-operated rats) and intestinal mucosa at various intervals were determined. 2. Initially the plasma concentrations of glycyl-leucine and glycylglycine were higher in nephrectomized than in control rats but later the concentrations were similar in both groups of rats. The disappearance of these two dipeptides from plasma was almost complete within 20 min, and their plasma half-lives were not changed remarkably by nephrectomy. In contrast, nephrectomy markedly impaired disappearance of glycylsarcosine from plasma and prolonged its half-life from 7-6 min to 52-0 min. 3. Glycyl-leucine and glycylglycine were not detected in tissues of control rats injected with these dipeptides, but glycylsarcosine was recovered from all four tissues examined. Nephrectomy resulted in greater accumulations of glycylsarcosine in tissues and the appearance of glycylglycine in the remaining three tissues and glycyl-leucine in muscle. 4. Enterectomy did not have a remarkable effect on plasma half-life of glycylglycine but it allowed recovery of this dipeptide from renal cortex, liver and muscle. 5. It is concluded that kidneys amd small intestine are involved in the disposition of circulating dipeptides, but in their absence other tissues may assume a greater role in this regard. However, renal clearance appears to be an important route for the disposition of dipeptides which are poorly hydrolysed by body tissues.


The forms of vitamin B12 on the transcobalamins.

1. The transcobalamins from normal serum were obtained in two fractions. One contained transcobalamin I and transcobalamin III: the other contained transcobalamin II. The forms of vitamin B12 in the two fractions were then examined. 2. Methylcobalamin and adenosylcobalamin were found in both fractions. Hydroxocobalamin was found in the fraction containing transcobalamin I and transcobalamin III. Cyanocobalamin was found in both fractions in two cases, in the transcobalamin III fraction only in one case and was absent in one case.


Accentuation of ethanol-induced fatty liver by phenobarbitone.

1. Four groups of rats received a liquid formula diet, given alone (control), or supplemented with either ethanol or phenobarbitone, or both together. 2. The ethanol-treated group showed a fall in plasma triglyceride and a rise in liver triglyceride, as compared with the control rats. 3. The phenobarbitone-treated group showed a marked rise in plasma triglyceride but not in liver triglyceride. 4. The group receiving both ethanol and phenobarbitone also showed a rise in plasma triglyceride, but this was accompanied by a striking increase in liver triglyceride. 5. These results suggest that ethanol and phenobarbitone each stimulate triglyceride synthesis but that in addition ethanol has an inhibitory effect on hepatic triglyceride secretion.


The relative transfer rates for sodium and xenon from gut lumen to plasma in man.

1. A whole-gut perfusion technique has been used to compare the rates of intestinal absorption of sodium and xenon. 2. The calculated transit-time spectra for sodium and xenon across the gut mucosa do not differ significantly either in mean transit time or, for the first 15 min, in shape. 3. These results support the hypothesis that the rate of transfer of sodium from the small intestinal lumen to plasma is limited by blood flow. 4. It is suggested that some features of cholera can be explained by the hypothesis.


Concentrations of prostaglandin A-, E- and F-like substances in gastric mucosa of normal subjects and of patients with various gastric diseases.

1. Prostaglandin A-, prostaglandin E- and prostaglandin F-like substances were determined radioimmunologically in antral biopsy material obtained by endoscopy. 2. In patients with gastritis, the concentrations of prostaglandin (E+A)-like substances were six times as high and of prostaglandin F-like substances twice as high as in normal subjects. In chronic atrophic gastritis, the concentrations of prostaglandin (E+A)-like material was four times as high as in normal subjects whereas prostaglandin-F like material remained unchanged. In acute gastric ulcer, prostaglandin (E+A)-like material reached concentrations four times times higher than in normal subjects, accompanied by a fivefold increase of prostglandin F-like substances. After healing of the gastric ulcer, prostaglandins returned to normal values. 3. There was no correlation between gastrin and prostaglandins in all biopsy specimens.


Amino acid concentrations in portal venous plasma during absorption from the small intestine of the guinea pig of an amino acid mixture simulating casein and a partial enzymic hydrolysate of casein.

1. The characteristics of absorption of individual amino acids from amino acid mixtures simulating casein and from enzymic hydrolysates of casein containing oligopeptides as well as free amino acids are known to be different. The differences, which are attributable to mucosal uptake of small peptides, involve more rapid absorption from the enzymic hydrolysates of certain amino acids which are relatively slowly absorbed from the amino acid mixtures. This could lead to more effective utilization of amino acids from the enzymic hydrolysates than from the amino acid mixtures. 2. To obtain further information bearing on this hypothesis, we have used a recently developed technique for portal cannulation in the guinea pig to make a preliminary investigation of amino acid concentrations in the portal venous plasma at intervals after the infusion into the duodenum of equivalent amounts of (a) an amino acid mixture simulating casein and (b) a partial enzymic (papain followed by kidney peptidases) hydrolysate of casein, the two preparations being infused in separate experiments. 3. For some amino acids, such as leucine, isoleucine, valine, phenylalanine and lysine, the curves after the enzymic hydrolysate were fairly similar to the corresponding curves after the amino acid mixture, though usually slightly lower. With other amino acids, the curves after the enzymic hydrolysate were very much lower than the corresponding curves after the amino acid mixture. With serine, glutamine, proline and glycine this discrepancy was particularly great. 4. The results cannot yet be fully explained, but their main features are explicable by the hypothesis that the lower amino acid concentrations in portal plasma after the enzymic hydrolysate are the result of entry of amino acids into the portal blood in peptide form, in which they would not be detectable by the analytical technique employed, and possibly also of more rapid clearance of amino acids from the blood during absorption of this preparation.


Interaction of mental factors with hypercapnic ventilatory drive in man.

1. The effect of mental arithmetic tasks on ventilation, breathing pattern, oxygen intake and carbon dioxide output was studied during air breathing and carbon dioxide rebreathing in healthy subjects. 2. Ventilation and breathing frequency increased significantly on performance of the task during 4 min air breathing and 4 min rebreathing; tidal volume was unchanged. The slopes of the ventilatory, frequency and tidal volume responses to carbon dioxide changed little during task performance. 3. During 15 min air breathing, oxygen intake was unchanged with task performance. Carbon dioxide output increased significantly with task performance, as a result of wash-out of carbon dioxide from body stores by the increased ventilation. 4. Mental arithmetic had no effect on the coefficients of variation of the slope and position variables of the ventilatory, frequency and tidal volume responses to carbon dioxide. It is concluded that task performance does not improve the reproducibility of these responses.


Oxygen affinity in vivo and in vitro in chronic ventilatory failure.

1. The oxygen affinity in vitro, haematological indices, erythrocyte 2,3-diphosphoglycerate and plasma inorganic phosphate were determined in 20 patients with chronic ventilatory failure and in 20 healthy non-smokers of similar age. 2. No significant difference was observed between the mean oxygen affinity or phosphate concentrations of the patients and healthy subjects but the mean haemoglobin and packed cell volume were significantly higher in the patients. 3. There was a positive correlation between plasma and intraerythrocytic pH which was similar in both patients and healthy subjects. 4. The arteriovenous difference in oxygen saturation in vivo (directly measured at cardiac catheterization) correlated closely with that calculated from the individual patient's oxygen affinity determined in vitro and arterial and mixed venous oxygen and carbon dioxide tensions, suggesting that oxygen affinity in vitro accurately reflects the curve in vivo.


Human skeletal muscle function: description of tests and normal values.

1. The force produced by isometric contractions of the quadriceps muscle have been studied during maximal voluntary contractions and when a substantial part of the muscle was electrically stimulated via surface electrodes. 2. In normal children and adults, the force of a maximal voluntary contraction of the quadriceps was proportional to body weight. 3. The function of the quadriceps has been described in terms of the force/frequency curve, speed of relaxation and the rate of loss of force during 18 s stimulation at 30 Hz and 100 Hz. 4. The functional characteristics of adductor pollicis when stimulated via the ulnar nerve were essentially similar to those of the quadriceps. 5. Studies of the function of these two muscles are complementary since quadriceps femoris is amenable to needle biopsy investigations of its structure and chemistry whereas adductor pollicis is more suitable for electrophysiological studies.


A study of the contractility, biochemistry and morphology of an isolated preparation of human skeletal muscle.

1. A new method of studying isolated human skeletal muscle has been evaluated. This involves the incubation and electrical stimulation of strips of muscle, obtained at surgical biopsy, that are tied at the cut ends of the fibre bundles. 2. Morphological examination showed that the fibres were sealed off at the cut ends. Damage appeared to be restricted to the areas immediately adjacent to the ties. 3. Contractile properties were well maintained for several hours and measurements of tissue metabolites showed that muscle contents of the high-energy phosphate compounds were well preserved. 4. The isolated preparations were found to have the same contractile properties as human quadriceps femoris studied in vivo by the methods described in the preceeding paper. 5. Correlation was found between the relaxation speed of the isolated preparations and their fibre-type composition histochemically determined. 6. It is concluded that this technique is a valid addition to the present methods of studying the physiology and pharmacology of human skeletal muscle.


Blood pressure response of nephrectomized hypertensive rats to converting enzyme inhibition: evidence for persistent vascular renin activity.

1. Blood pressure and plasma renin activity were studied after bilateral nephrectomy in groups of rats with hypertension caused by unilateral renal ischaemia with the opposite kidney left intact. 2. Although blood pressure showed only a small fall in the first hour after bilateral nephrectomy, plasma renin activity fell rapidly with a half-life of 10 min. 3. Infusion of converting enzyme inhibitor (SQ20881) produced a 26-1% fall in blood pressure 1 h after nephrectomy, 24-% at 2 h and 4-6% at 6 h. 4. An angiotensin antagonist (Sar1-Ala8-angiotensin II) was infused into hypertensive rats 1 h after nephrectomy; this blocked the vasodepressor action of the converting enzyme inhibitor, indicating that the fall in blood pressure produced by the inhibitor was due to its action upon the renin-angiotensin system. 5. The renin-angiotensin system maintains blood pressure in this model even after plasma renin has fallen to insignificant levels. This supports the view that vascular renin activity has a longer half-life than circulating renin and is important in the control of blood pressure.


Plasma calcitonin in Paget's disease of bone.

1. Plasma levels of immunoreactive calcitonin were measured in 22 patients with untreated Paget's disease of bone and in 22 control subjects matched for age and sex. 2. No significant differences in plasma calcitonin were found between patients and control subjects, and hormone levels did not correlate significantly with activity of plasma alkaline phosphatase. 3. These results suggest that Paget's disease of bone is not due to deficient of endogenous calcitonin.


Blunt trauma to the eye.

1. Blunt trauma to the orbital region may result in a blowout fracture, characteristically found in the orbital floor, which may contain herniated orbital contents including both inferior muscles of the eye. Persistent diplopia continues as a problem in a significant number of patients following the surgical management of a blowout fracture of the orbit. 2. Prompt recognition and treatment of blowout fractures exhibiting diplopia is usually successful. Inferior rectus and inferior oblique muscles incarcerated in a blowout fracture site for periods varying from two months to nine years may fail to function properly even following successful release of the entrapped muscles. There is some presumptive evidence to suggest a myogenic or neurogenic cause for such dysfunction. 3. Vertical diplopia that persists beyond three months following release of entrapped muscle tissue requires surgical correction, depending on the degree of vertical dissociation. 4. Motility surgery was required in 18 of 20 cases of persistent diplopia. Multiple muscle combinations are frequently required to achieve success. The criterion for a successful result was elimination of vertical diplopia in the primary and reading positions.


Post-traumatic pain syndromes.

A number of post-traumatic pain syndromes may be grouped as causalgia or mimocausalgia. These are important entities and should be well known to most disciples of medicine. Our concern is the early recognition of patients whose complaints have an organic basis but whose physical signs are not of sufficient degree to make this fact readily apparent. These patients are often misunderstood and discredited. They are all too often mismanaged or neglected for so long that the underlying pathologic physiology secures supremacy over normal function. Recognized and treated properly by means of sympathetic ablation, either medical or surgical, the vast majority of symptoms can be relieved. The extremities then can be rehabilitated by appropriate measures.


Paraplegia from traumatic spinal injury.

Acute spinal injury with paresis or paralysis is an increasing problem in modern communities. The corrdinated efforts of many are necessary for its management. The expertise developed by various disciplines through work with nonparaplegic patients should be coupled with the specific expertise of those responsible for total care. Generally, operative techniques have only a limited application, whereas basic medical and nursing techniques give good results.


Preparation of mental health personnel for the delivery of mental retardation services.

The developmental experience of an urban community mental health-mental retardation center is presented as a guiding model for other community mental health centers interested in "tooling up" their mental retardation services. Surveying personnel needs, establishing educational objectives tailored to personnel, presenting specific knowledge about mental retardation, clarifying mandates for community mental health-mental retardation service, and two conceptual frameworks for service delivery are elaborated.


Physical environment and job satisfaction in a community mental health center.

Relocation of professional staff in a community mental health center provided a setting in which to evaluate the effects of physical environment on job satisfaction. Two mental health teams moved from an old, drab central clinic building to new satellite clinics while a third team remained in the old building. Relocated staff reported significant increase in satisfaction with physical surroundings as compared to staff that did not move. Furthermore, satisfaction with physical surroundings had some impact on overall satisfaction ratings. Physical surroundings in a community mental health center may be a mediating variable for staff morale and effectiveness.


The use of volunteers in a community mental health center emergency and reception service: a comparative study of professional and lay telephone counseling.

A model of volunteer participation in a community mental health center emergency and reception service is presented and tested by comparing the telephone counseling effectiveness of volunteers and community mental health professionals. Experienced and inexperienced volunteers, professionals, and control subjects responded to simulated telephone crisis calls that were tape-recorded and replayed for ratings along seven scales which assessed various dimensions of counseling effectiveness. The results suggested that carefully selected and trained volunteers can function as effectively as professional staff in providing supportive and emergency telephone services for distressed callers and community mental health center clients.


An economical rural mental health consumer satisfaction evaluation.

An economical direct and indirect consumer satisfaction evaluation was conducted in a rural community mental health center. The inquiry consisted of determining whether clients felt better after a therapy session than prior to it and if they were satisfied with the clinic services. Adjective Generation Technique (AGT) scores indicated that consumers felt significantly better after a psychotherapy session than the comparison group. Results from a postcard survey seem to support this finding, suggesting that approximately 80% of the consumers were satisfied with their clinic experience. The financial costs were less than $125 and staff time amounted to no more than 18 hours.


Correlates of consumer satisfaction with outpatient therapy assessed by postcards.

This paper presents research findings on the effect of numerous psychotherapy variables on clients' satisfaction with psychotherapy in an outpatient unit of a community mental health center. The surprising result is that so few variables had any significant impact. Those that did have an impact raise some questions about the value of certain kinds of therapy.


Interpersonal skill practive as a component in effective parent training.

This study emphasized the importance of including parental practice of skills in an effective, interpersonal-skill parent-training program. In particular, it is stressed as being most effective to include parental practice with the child as a component within the actual training session. Using a training approach developed by R.R. Carkhuff and emphasizing this parent-child practice component, parents were trained in interpersonal skills. At the conclusion of 15 hours of training, the parents were significantly better able to attend to and respond to their children than before the training. Additionally, the parents saw themselves as much improved in these areas.


The effect of newspaper publicity on a mental health center's community visibility.

A community mental health center conducted a street survey to determine the community visibility of its facility and service. Following newspaper publicity about the center, another sample was taken which indicated the publicity had significantly increased the community's awareness of the center. Six weeks later the community was again surveyed and results indicated that the publicity effect on visibility was generally quite stable. It is concluded that centers with low visibility in the community can drastically increase that visibility through use of the media.


Possible programmatic consequences of community mental health center funding arrangements: illustrations based on inpatient utilization data.

Funding arrangements have a direct and substantial influential effect on the delivery of mental health services. Despite the original intent of the community mental health center philosophy, centers have not been freed from programmatic limitations imposed by the fiscal systems. The focus of this article is the inpatient unit that has the key role as relates to a center's ability to raise revenue. Using data from a study of community mental health center inpatient utilization patterns, the authors demonstrate that centers face the problem of becoming revolving doors (for a recidivist population). Existing fiscal arrangements, it is suggested, reinforce this pattern and tend to downplay innovative alternatives to traditional inpatient care.


Comprehensive community mental health center- business community relationship: a reexamination.

In this paper the belief that nonprofit service organizations and profit-motivated organizations should function separately from each other is questioned. Several of the advantages inherent from a cooperative relationship between comprehensive community mental health centers and the business community for the worker, mental health professional, comprehensive community mental health center, and business are discussed. Possible negative emotional responses against this new alliance are presented and dispelled. A joint effort between comprehensive community mental health centers and the business community is anticipated to develop with the common goal being the promotion of mental health.


The use of a mid-Manhattan hotel as a support system.

The mass media have focused recently on the failure of psychiatric institutions to provide adequate follow-up for its patients released into the inner city. Many expatients deteriorate and become part of the "revolving door": single-room occupancy--city hospitals--state hospital. This paper attempts to demonstrate the feasibility of utilizing existing community resources (for example, a large midtown Manhattan hotel and local service agencies) to cope with this problem. A description of the multiagency organized hotel programs as well as objective and subjective data is provided in order to substantiate our contention that this approach offers a viable alternative to long-term hospitalization.


Clergy consultation as a community mental health program.

The authors describe the planning, development, implementation, and results of a consultation program to the clergy as part of an agency's community mental health service. The paper focuses on the four main program goals of (1) revitalizing a local association for the clergy, (2) developing the clergy's pastoral skills, (3) increasing community supports for mental health, and (4) developing a counseling service sponsored by the local clergy for community residents.


The bartender as a mental health service gatekeeper: a role analysis.

Efforts to expand mental health manpower have taken three major directions: (1) increased use of consultation, (2) creating entirely new roles, and (3) offering training to persons engaged in roles or occupations presumably at strategic points of contact between the public and the mental health system. Among such roles are clergy, police, hairdressers, and bartenders. Little effort has been made to analyze systematically this third approach to assess its true utility for mental health service. In this paper the role of the bartender is analyzed along four dimensions: personality component, functional centrality, role distance, and nonperson status. Functional centrality appears as a clear asset. Role distance and nonperson status have mixed value depending on the activity envisioned. These role attributed will be generally incompatible with relationships requiring sustained intimacy but could facilitate initial opening up and revelation of sensitive personal information. The lack of protracted professional socialization poses some risk with respect to obtrussion of personal idiosyncracies.


Mechanism of cinnamaldehyde sensitization.

The skin sensitization of cinnamaldehyde is probably initiated by the reaction of cinnamaldehyde with epsilon-amino groups on protein side chains. Alpha-Substituted cinnamaldehydes, which are known not to be skin sensitizers, react very slowly or not at all with amines in comparison with cinnamaldehyde.


Delayed hypersensitivity in females. The development of allergic contact dermatitis in females during the comparison of two predictive patch tests.

Ten chemically different compounds were applied to the skin of the backs of male and female volunteers to induce delayed hypersensitivity responses. The 10 compounds had a low, moderate, high or unknown allergenic potential and were divided among five test panels (modified Draize) consisting of 150 subjects each. In each panel, 75 subjects (mean age 31 years) were always male prisoners (50% Caucasians) and the remaining 75 subjects (greater than 90% Caucasians) were divided, age-matched free males and females (mean age 24 years). Three compounds, each on different panels, had a significantly higher sensitization rate in females than in free males or total males. The remaining compounds produced sensitization, usually in lower numbers, but females dominated in sensitization rates. Viewed as absolute rates of sensitization for the 10 compounds, females were higher on eight test compounds and tied on two when compared to all males. These studies show that females develop significantly more cell-mediated immune responses to some chemical haptenes than men and the data also points to an overall higher rate of haptene recognition. Seven of these 10 compounds were simultaneously tested for their sensitization potential by the modified Maximization method (all males) in order to compare the two tests' ability to disclose potential sensitizers. Female sensitizations on the modified Draize accounted for this test's superiority.


Effects of concurrent verbal and musical tasks on a unimanual skill.

Subjects balanced a dowel rod on the right or left index finger while speaking, while remaining silent, and while humming a melody. In males balancing times for the right hand decreased with concurrent verbalization. Verbalization had no effect on left hand performance in males, nor on either hand in females. Concurrent humming had no effect on performance of males or females. Poorer right hand performance by males when verbalizing is attributed to interference with right-sided motor control by the left hemisphere due to verbal activity programmed by the same hemisphere. Unimpaired right hand performance in verbalizing females suggests that the language function is less clearly lateralized in females than in males. The possibility that music may be shared by both hemispheres is discussed.


Linguistic and articulatory aspects of single word production in apraxia of speech.

The errors of ten apraxic speakers on a single word task were analyzed to determine the effects of articulatory and linguistic variables on speech production. Results suggested that phoneme difficulty but not phoneme position or grammatical class significantly affected the errors of the subjects. A significant low positive correlation between mean word abstraction and the errors of the apraxic speakers was observed although correlations for the grammatical classes decreased with increases in abstraction. These findings were interpreted to suggest that impaired motor speech programming may be affected by linguistic and articulatory variables.


Base rates and the decision making model in clinical neuropsychology.

Issues involving base rates and decision weighting techniques in neuropsychology are discussed. In both clinical and research work of neuropsychologists, the effect of asymmetrical base rate or unequal group size in research may have significant influence on the accuracy with which certain classifications are made. The general rule, given approximately unbiased error rates, is that the classification of greater incidence will be predicted more accurately than the low frequency classification. This disparity in predictive validity increases as asymmetry of base rate increases. Rather than despair about the decrease in overall predictive validity, the differential diagnostic accuracy can be utilized to estimate the probability of correctness of the obtained clinical decision.


Handedness in relation to direction and degree of cerebral dominance for language.

In so far as ear asymmetries on dichotic listening reflect cerebral dominance for language, the present evidence indicates a progressively decreasing incidence of left hemisphere dominance in right handed, mixed handed and left handed individuals. In the absence of a family history of sinistrality there are no indications that the degree of dominance is reduced in left handers or mixed handers when compared to right handers, nor that right hemisphere dominance is less securely established than left hemisphere dominance. Among strong left handers with a family history of sinistrality, however, ear difference scores are significantly smaller, indicating reduced lateralization or bilateral representation of language in such individudals. This applies equally in left dominant and right dominant left handers.


Wh-questions: responses by aphasic patients.

The syntactic relationship between wh-questions and their answers was investigated in the speech of aphasic subjects. The subjects were twenty-two aphasic patients whose mean age was 39.7 years and whose mean severity rating on the Boston Diagnostic Aphasia Examination was 2.63. The data revealed significant differences in the frequency of correct response among types of wh-questions and a limited set of response strategies for incorrect answers. The results are discussed in terms of language theory with implications for language assessment and remediation.


Short term memory for a nonverbal tactual task after cerebral commissurotomy.

Using a tactual modification of the Memory for Designs Test, it was found that the right hemispheres of subjects having complete cerebral commissurotomy were markedly superior to their left hemispheres. This result is further explicit for independent hemispheric memories as well as for a right hemispheric superiority in the recollection of spatial configurations. Subjects with partial commissurotomy (sparing the splenium) performed in the normal range with each hand, confirming previous conclusions as to the ability of a small callosal remnant to effect interhemispheric transfer.


Differences in tachistoscopic recognition between abstract and concrete words as a function of visual half-field and frequency.

This experiment demonstrated that the greater right visual half-field (VHF) superiority for abstract words than for concrete words reported in two previous studies generalized to an independent, larger sample of abstract and concrete nouns. In addition, degree of concreteness was found to be positively related to overall recognition, with high concrete words averaging 38% correct, moderate concrete words averaging 30% correct, and abstract words averaging 20% correct. Analyses of ratio scores indicated that high frequency abstract words showed a significantly larger right VHF asymmetry than high frequency moderately concrete words or high frequency high concrete words. Groups of abstract, moderately concrete and high concrete words were also matched on right VHF recognition, to evaluate whether differences in VHF asymmetry were secondary to the differences in overall recognition. A significant interaction between VHF and word class was found, again indicating larger right VHF superiority for the abstract words. The data are consistent with previous suggestions that some left VHF concrete words are recongized by the right hemisphere.


Pragmatic-semantic and syntactic factors influencing ear differences in dichotic listening.

In a three-factorial experiment sequences of 3 words were presented dichotically. The sequences consisted of two uninflected nouns denoting a person or a group of persons and 1 verb denoting an interaction. The three factors were Ear, Syntactic Structuredness vs. Unstructuredness and Semantic-Pragmatic Structuredness vs. Unstructuredness. The sequences in the syntactic unstructuredness condition are spoken in staccato form without sentence intonation and the order of the 2 nouns and the verb was at random; in the syntactic structuredness condition the sequences were spoken fluently and with sentence intonation and the order was always N-V-N. Semantic-pragmatic structuredness of the sequences means that one of the two potential actor-object-relations between the two nouns of a sequence was more probable than the other. The results show that it is only the left hemisphere that is responsive to syntactic structuredness, while the two hemispheres seems to be equally responsive to semantic-pragmatic structuredness. But it is possible that the two hemispheres differ in the manner in which they make use of semantic structures: the left hemisphere in a selective manner, appropriate for the solution of a specific task, and the right hemisphere in a more diffuse and global manner.


Phonemic identification defect in aphasia.

Eight-four right-handed patients with unilateral hemispheric damage (50 aphasics, 12 non-aphasic left brain-damaged and 22 right brain-damaged patients) and 53 control patients without cerebral lesions were given a test of phoneme identification which examined the S's ability to identify the acoustic boundary between the two phonemes, /d/ and /t/, expressed in terms of voice-onset time (VOT). Phonemic identification defect (PID), defined with reference to the performance of the control group, was found to be virtually limited aphasics; in over 70 per cent of them, the identification of the boundary zone between voiced and voiceless consonants along the VOT continuum was either impossible or abnormal, While neither the fluency - nonfluency dimension of speech nor the level of comprehension seemed to be crucially associated with PID, some evidence pointed to disordered phonemic output as to one dimension of aphasia that is specifically related to it.


Decision in ambiguity: hemispheric dominance or interaction?

Fifty-eight subjects were shown tachistoscopically grey rectangles, at the centre of the field of vision. The rectangles extended equally to the left and right of the visual fixation point, and were presented under four background conditions: all white, all black, white in the left half of the field and black in the right half, black in the left and white in the right half. "Chimerical" backgrounds were assumed to create an interhemispheric ambiguity in the perception of the greyness of the stimuli as a consequence of opposed brightness contrasts. The reported birghtness was therefore expected to reflect a hemispheric dominance or an interhemispheric averaging of information. The results of the experiment supported the second hypothesis.


Rapid bedside computation of cardiorespiratory variables with a programmable calculator.

The value prompt assessment of hemodynamic cardiorespiratory function in critically ill medical and surgical patients is widely appreciated. We have presented a system for rapidly computing these variables on real time in the ICU, for a capital outlay of less than $250. In so doing, we hope to extend the benefits of this type of assessment to the smaller community hospital ICU and individual clinicians.


Hemodynamic monitoring in the community hospital ICU.

Cardiac output and intravascular pressures were monitored in a series of 20 critically ill patients in a community hospital during a 1-year period. Hemodynamic monitoring was very useful in the evaluation of clinical problems; data indicating hypovolemia and cardiac problems were found in 8 and 5 patients, respectively. More importantly, the frequently repeated measurements before and during therapy were extremely helpful in titrating therapy. Reliance of CVP measurements would not have provided the essential information.


A hazard of the Intraflo continuous flush system.

Patency of pressure sensing systems can be provided by the Intraflow Continuous Flush System (Sorenson Research Company, Salt Lake City, UT 84115). This device allows continuous flow of flush solution through a regulatory valve while preventing transmission of the high pressure of the flush solution. The case presented describes the recognition of a false elevation of a monitored pressure secondary to the malfunction of the Intraflo regulatory valve. Elimination of the flush solution high pressure during monitoring prevents inappropriate data collection.


Continuous electrocardiogram monitoring in a surgical intensive care unit.

We tested a computer system for routine arrhythmia monitoring in 181 postoperative patients in order to evaluate its practical value. There was no significant difference in the incidence of arrhythmias between patients clinically classified in poor condition and those classified in good condition. Conventional vital signs appeared to have more value than a PVC count or an index of arrhythmias. We found no evidence that continuous electrocardiogram monitoring might provide an early warning signal in these patients monitored.


A simple method for diagnosing pneumonia in intubated or tracheostomized patients.

A safe, simple, reliable technique for sampling uncontaminated peripheral bronchial secretions in patients with endotracheal tubes has been developed. It is easily performed and requires no special training or equipment. This report summarizes the techniques's usefulness in providing diagnostic samples of peripheral airway secretions from 20 patients with pneumonic infiltrates. In eight of the patients, a single organism was recovered from the peripheral airway despite polymicrobial colonization of the upper airways. An additional patient had two anaerobes. The recovered organism's role as a pathogen was verified by an appropriate response to specific antibiotic therapy in two patients, isolation from blood or empyema fluid in five, confirmation by bronchoscopy in one, and transtracheal aspiration after extubation in one. Peripheral bronchial secretions were sterile in the remaining 11 patients, even though multiple organsims were isolated from usual tracheal suctionings.


Diuretic action of Bay g 2821 in oedema-free volunteers.

The sulphonamide-free diuretic Bay g 2821 was tested under standardized conditions 43 oedema-free volunteers. The threshold dose was 10 mg (0.14 mg/kg). The doseresponse curve was practically linear for doses up to 80 mg. The excretion of sodium and chloride was very high, and that of potassium, magnesium and calcium markedly lower. Itarenal haemodynamic investigations showed that the inulin clearance was unchanged, and the PAH clearance increased slightly. The tubular reabsorption of sodium and chloride was inhibited. Side-effects after a single oral dose did not occur.


Prediction of outcome and severity of illness by analysis of the frequency distributions of cardiorespiratory variables.

Despite the wide variety of illnesses and operations, we observed a common cardiorespiratory pattern of shock that was differenf for the survivors and nonsurvivors, although no one variable was capable of predicting outcome. Differences between the patterns of survivors and nonsurvivors were defined by range criteria and by cut-points operationally obtained from the frequency distributions of cardiorespiratory variables. The values of each of the 33 variables obtained, at times remote from therapy during each successive stage in the postoperative course, were used to predict survival and death in a series of 113 patients by the range and cut-point methods. An average of 13.5% of all the available variables gave a correct prediction by the range cirteria and 35% by the cut-point method. The mean percentage of Right--Wrong classifications throughout all stages for range and cut-point methods was 80 and 85%, respectively. Using the last available stage, the outcome was correctly predicted by the range criteria in 80% and by the cut point method in 88% of the patients. The high percentage of correct predictions suggests that these methods may provide a measure of the severity of acute illness as well as early warning of impending death.


The mechanism of action of Bay g 2821: a new diuretic.

Acute water diuresis and hydropenic studies were carried out in 7 healthy volunteers to investigate the site of action of a new non-sulphonamide diuretic, Bay g 2821. The effects of the drug on the concentrating and diluting mechanism, and on the renal handling of sodium, potassium, calcium, phosphorus and uric acid were studied. The results suggest sites of actions of Bay g 2821 at the proximal tubule and the medullary portion of the ascending limb of the loop of Henle.


Anti-arrhythmic properties of acebutolol (Bay c 7705), a new cardioselective beta-adrenergic blocking agent: a preliminary report.

A study was carried out in 20 ambulatory patients with various heart diseases and different forms of cardiac arrhythmias to evaluate the anti-arrhythmic effect of acebutolol when given orally(400 mg/day). Long-term(4 hour) ECGs were monitored before and after 3 days of treatment. The results showed that after acebutolol treatment 60% of all the arrhythmias were prevented or abolised, 16% were improved, and only 24% persisted unchanged.


Profound spontaneous hypoglycaemia in congestive heart failure.

Eleven cases of spontaneous hypoglycaemia in congestive heart failure in adults are reported. There were 5 males and 6 females, aged from 15 to 65 years (mean, 44 years). Blood sugar ranged from 2 to 42 mg/100 ml (mean 21 mg/100 ml). Six patients were in coma on admittance, 1 was confused, and 4 were conscious. The underlying condition was rheumatic valvular heart disease (3), chronic obstructive lung disease (4), cornonary heart disease (3) and cardiomyopathy (1). Five of the 11 patients died. The mechanism of hypoglycaemia is discussed and thought to be a combination of factors such as liver dysfunction, low calorie intake, malabsorption, and increased glusose utilization by ischaemic tissues, including the heart. It is recommended that in patients with congestive heart failure presenting with coma or confusion, blood sugar should be checked for possible hypoglycaemia.


Measurement of cerebral blood flow following intravenous administration of pentoxifyline ('Trentral').

Using 99mTc cerebral scintigraphy and a gamma camera/computer system, the pattern of cerebral blood flow in 5 brain areas was monitored in 30 geriatric patients with cerebrovascular insufficiency. Readings were compared on a within-patient basis for the following treatments: initial control (I), intravenous administration of 10 ml physiological saline solution (II), and intravenous administration of 10 ml (200 mg) pentoxifylline (III). By comparsion with treatment I and II, pentoxifylline produced significant increases in cerebral blood flow. It is suggested that this increase in perfusion is possibly due to an improvement in the flow properties of blood.


Nodular angioblastic hyperplasia with eosinophilia and lymphofolliculosis.

Two cases of nodular angioblastic hyperplasia with eosinophilia and lymphofolliculosis are presented. The position of such lesions in a histopathologic classification is discussed. The possible relationship to Kimura's disease and low-grade angiosarcoma is considered.


Accidental inoculation blastomycosis.

The pathogenesis of blastomycosis as a primary pulmonary infection has been well established and widely accepted. The rate cases of primary cutaneous inoculation are in all documented instances related to "laboratory" accidents. A case of inoculation with a culture suspension of Blastomyces Dermatitidis is herein reported. A slow healing chancre remained active for about eight months.


Nodular grouped milia.

A young girl had a distinctive nodule with white spherules. Histologically, the lesion was composed of multiple small keratotic cysts.


Preoperative radiotherapy in the management of posterior fossa choroid plexus papillomas.

Although primary radical removal is the procedure of choice in the treatment of choroid plexus papillomas, the age of the child, the size and/or location of the tumor and an above average surgical risk can make advisable the use of a first stage shunt operation, with section of the tentorium if there are signs of upwards tentorial herniation. The present two observations clearly demonstrate that radiotherapy shrinks the vascular stroma of these tumors, thus reducing its size and vascularity making possible the postponement of radical surgery and greatly simplifying the final radical removal of the lesion. Preoperative radiotherapy as well as shunt operations and tentorial section can be considered as first stage procedures for the surgical management of choroid plexus neoplasms in certain cases.


Hypothalamic symptomatology and its relationship to diencephalic tumor in childhood.

Autonomic dysfunction in a child may present confusing clinical phenomena which mimic other diseases. Various clinical manifestations were seen during the 6-year course of a child with an astrocytoma of the hypothalamus. These ranged from the initial features of the diencephalic syndrome of infancy to autonomic seizures with striking paroxysms of hypertension, tachycardia, and sweating. Disturbances in hormonal regulation and gastrointestinal abnormalities were possibly related to the autonomic disturbance. The mechanisms for these findings were poorly understood. We conclude that a diencephalic lesion should be suspected in any child exhibiting such findings.


Central neurogenic pulmonary edema: with a review of its pathogenesis and treatment.

One of the unusual signs of sudden increase in intracranial pressure is central neurogenic pulmonary edema. This pulmonary edema produces a capillary-aveolar block resulting in hypoxia complicating the underlying neurologic condition. Good success in treating this problem has been obtained with controlled ventilation and positive end expiratory pressure respiration.


Angiographic characteristics of certain subdural collections of fluid.

The presence of abnormal amounts of fluid in the subdural space has been referred to as subdural hematoma, subdural effusion and subdural hygroma. These are supposed to be differentiated by the appearance of the fluid and the presence of membranes in the dubdural space. Although both hygroma and chronic subdural hematoma are liquid, space-occupying lesions which cause pressure in the underlying brain, we have found that there are definite angiographic, clinical and prognostic differences between them. These differences are described.


Stimulus variables which affect the concordance of visual and manipulative exploration in six-month-old infants.

In Experiment I, 26-week-old infants were repeatedly exposed to 1 object and then shown a second object that was different in color or that was different in shape and texture. During repeated exposures, infants looked at an manipulated the object less, but response latencies did not change. Looking and manipulation increased upon introduction of the novel object in the shape and texture change condition. The novel object in the color change condition elicited an increase in looking but not in manipulation. The purpose of Experiment II was to determine if the coordination of visual and manipulative exploration in the shape and texture change condition was primarily due to the new tactile information or because of the introduction of more than 1 physical change. In this experiment, the novel object differed either in shape or in texture, For both conditions, there was a decline in looking and manipulation times during familiarization and recovery of novel objects for both looking and manipulation. It was concluded that either shape or texture information is sufficient to coordinate visual and manipulative differential responding.


The effect of visual feedback of the hand on the reaching and retrieval behavior of young infants.

Reaching and retrieving, with and without visual feedback of the hand, were observed in 50 infants ranging in age from 2 1/2 to 6 1/2 months. Failure, to see the hand did not completely inhibit reaching and retrieving, although reaching and retrieving were reduced in this situation for infants 5 1/2 months and older. It was hypothesized that infants of this age expected to see their hands within their visual fields. When this expectation was not met, the infant's ongoing behavior was disrupted.


Cross-modal transfer in human infants.

This study investigated cross-modal transfer in infants by their proclivity to respond differentially to novel and familiar stimuli after familiarization in a different sensory modality. Across a variety of stimulus shapes, 1-year-old infants significantly and reliably looked more at and reached more for the novel than the familiar stimulus subsequent to information input from tactual stimulation. Furthermore, for the first time, it is demonstrated that not only do infants gain information about the shape of objects from their oral experience with them but this information can be made available to the visual modality.


Infants' perception of similarity between live people and their photographs.

5-month-old infants who had been habituated to a live face showed no change in fixation time when presented with an immediately following photographic slide of that same face, while they showed an increase in fixation time (dishabituation) to a photographic slide of a novel face of different sex, hair color, and hair style. The similarity in responses to the live person and his photograph indictaes that some identification of people in photographs is possible even in the absence of extended prior developmental experience with pictures. A second experiment found that 5-month-old Ss exhibited the same amount of looking when a live face was followed either by its own photograph or by a photograph of a novel person of like sex, hair color, and hair style. Apparently, these Ss used only rather gross physiognomic features to perceive a similarity between a live person and that person's photograph.


The visual-preference technique in infancy: effect of number of stimuli presented upon experimental outcome.

To examine the effects of the number of stimuli presented when the visual-preference technique is used to measure attention in infancy, 2- and 4-month-old infants were randomly assigned to 1 of 3 experimental conditions. In the first condition, infants were shown 3 different checkerboards using the single-stimulus visual-preference methodology; in the second condition, 4 checkerboards; and in the third condition, 5 checkerboards. Infants in both the 3- and 4-pattern conditions were able to order the patterns as predicted by scaling theory. However, there was a significant decrease in the number of infants in the 5-pattern condition who could do so. The results are discussed in terms of both their methodological and theoretical implications.


Auditory-visual coordination in neonates.

Neonatal oculomotor behavior was observed under various conditions of visual and auditory stimulation. In 1 experiment babies were observed tracking a moving visual target with their eyes. Such tracking was uninfluenced by the addition of sound to the visual target, nor was it disrupted by the presence of a stationary auditory stimulus. The presentation of a moving auditory stimulus alone was not sufficient to elicit reliable tracking responses. In a second experiment, neonates failed to show ocular orientation toward a laterally presented sound. These findings are interpreted as illustrating the relative independence of auditory and visual perception during the neonatal period.


Caregiving behaviors and early cognitive development as related to ordinal position in preterm infants.

Naturalistic home observations of 54 preterm infants and their caregivers were made when the infants were 1, 3 and 8 months of age. Differences were found in the kinds of everyday transactions which occur with preterm infants raised with and without siblings. At 1 month of age the care of firstborn and later-born infants was similar in most ways. At 3 months and 8 months firstborn infants clearly received more responsive care and more stimulation from their mothers than later-born infants. Furthermore, the firstborn infant received more social transactions from anybody. Firstborn preterm infants obtained higher Gesell developmental scores than later-born infants, replicating results reported with infant test performance of full-term infants.


Mental development of preterm infants during the first year.

Developmental rates and standard scores are examined for 56 infants in 4 gestational age groups by repeated measurements on the mental scale of the Bayley Scales of Infant Development. Rates across the first year of life can be predicted largely by a biological model that assumes equality of development for infants of the same conceptual age. However, standard scores based on biological age are elevated during the early months for the most premature groups, indicating a transient advantage of increased extrauterine life. Scores from 3 to 12 months' biological age are slightly higher for the most premature groups but are consistent within groups, with no special acceleration of the premature.


Test anxiety and off-task behavior in evaluative situations.

The relationship between performance and off-task behavior was examined as a function of childrens anxiety level in a clearly evaluative situation. 48 fourth-and fifth-grade boys and girls (assigned to low, middle, and high anxiety groups by their scores on the Test Anxiety Scale for Children) performed anagram tasks in the presence of an experimenter also working on anagrams. Frequency and direction of off-task glancing were used as measures of off-task behavior. As expected, both performance and off-task glancing were related to anxiety: high-anxious children hag than low- and middle-anxious children. It was proposed that anxious children's history of failure makes them more sensitive to and highly reliant on external feedback and evaluation and less likely to solve problems on their own. It was suggested that the performance of these children, who typically have greater ability than they show in evaluative situations, may be improved by increasing their on-task orientation through task-inherent and task-related feedback.


The nature of verbal interactions among handicapped and nonhandicapped preschool children.

The nature of verbal interactions among handicapped and nonhandicapped preschool children was examined in instructional and free-play settings. A wide variety of linguistic parameters designed to reflect verbal productivity and grammatical complexity was selected for analysis. The speech of designated nonhandicapped children wddressed. Listeners were classified as manifesting mild, moderate, severe, or no developmental delays. The results indicated that the speech of the designated children tended to be more complex, more frequent, and more diverse when addressed to developmentally more advanced children in both settings. These results were discussed in terms of their significance for facilitating the development of the language-delayed child.


Visual habituation, sensorimotor development, and tempo of play in one-year-old infants.

The pattern of relationships between rate of visual habituation, sensorimotor development, play tempo, and motor activity was examined in 168 1-year-old infants. Subjects were exposed to 3 consecutive series of a repeated visual stimulus and the rate of habituation determined for each series. The measures of sensorimotor development included both standard psychometric and Piagetian scales. Measures of play tempo and motor activity were obtained from observations of free play. Longer fixation time to the initial stimulus presentation and faster habituation on the original series were associated with advanced sensorimotor development for girls. Longer initial fixation time in boys was associated with a slower tempo of play. The magnitude of these relationships, however, was found to be dependent on whether the subject completed the entire experimental session or was terminated early due to irritability or drowsiness. The results suggest that both the sex and state of the infant are important moderators of the relationship between measure of visual attention and other individual difference variables.


Relationships among the Brazelton Neonatal Scale, Bayley Infant Scales, and early temperament.

The present study investigated whether the Brazelton Neonatal Assessment Scale predicts 10-week performance on the Bayley Scales of Infant Development and examined whether early temperament relates to performance on both scales. 18 normal, term infants were studied. Conceptual, a priori scoring dimensions were applied to neonatal assessments at a mean of 8.6 days. Infant temperament data were available for 12 of the subjects at a mean of 13.3 days, and mental and motor development were assessed for all subjects at a mean of 68.8 days. The results indicate that the total of a priori Brazelton scoring dimensions and neonatal state control were predictive of Bayley mental quotients at 10 weeks. Caretakers' judgments of temperamental intensity and distractability at 2 weeks correlated with the Bayley scales and the Brazelton dimensions. Furthermore, dividing the infants into worrisome and optimal groups on the basis of the total produced significant differences in Bayley mental scores.


Validation of a laboratory play measure of child aggression.

The validity of laboratory play measures of aggression has been called into question. Critics have charged that laboratory findings on childhood aggression cannot be generalized to everyday aggression. In the present study, the validity of striking a Bobo clown as a measure of aggression was assessed by correlating the rate of this behavior with peer ratings, teaching ratings, and self-ratings of aggressiveness in a preschool. Laboratory aggression correlated significantly with both peer ratings, r = .76, p less than .01, and teacher ratings, r = .57, p less than .05, but not with self-ratings, r = .36. Laboratory aggression correlated more highly with aggression ratings for males (N = 9) than for females (N = 9), but not significantly so. The findings support the use of laboratory play as a valid measure of aggression in children.


Nonverbal visual short-term memory as a function of age and dimensionality in learning-disabled children.

A serial recognition task was used to compare performance of 2 learning disability age groups with 2- and 3-dimensional representations of nonlabeled 8-point random shapes. Age-related increases in short-term memory (STM) performance for both dimensions were found. No significant differences were found between 2- or 3-dimensional stimuli. Contrary to reports of STM performance with normal children, learning-disabled children showed no primacy effect for the 2-dimensional treatment, and second choices were not consistently correct when the first choice was incorrect, These findings were interpreted according to Flavell's notions of mediational inefficiencies.


Verbal rehearsal and short-term memory in reading-disabled children.

The present study investigated the hypothesis that frequently found short-term memory deficits in poor readers may reflect a lack of ability or inclination to use efficient task strategies on some memory tasks. The performance of second-grade good and poor readers was compared on a task which allowed direct observation of the use of verbal rehearsal as a mnemonic strategy. Children in the 2 reading groups differed significantly in both total recall score and amount of verbalization (rehearsal) observed, with the poor readers obtaining lower scores on both measures. On a variation of the task which had been previously demonstrated to facilitate the use of rehearsal, the poor readers improved significantly in both amount of verbalization and total recall scores. On this latter task, the memory and verbalization scores of good and poor readers were not significantly different from one another.


Cerebral dominance in disabled readers, good readers, and gifted children: search for a valid model.

A group of 10 reading-disabled children with average intelligence were compared with 11 good readers of average intelligence and 12 academically accelerated, gifted children on their recognition of words presented tachistoscopically under simultaneous, bilateral viewing conditions. The poor readers were inferior in right-field performance compared with the gifted children and good readers. With IQ as a covariate, the poor readers produced a higher left-field score and a lower visual-field difference score in comparison with the gifted children. It is argued that the skills needed to become literate are not isomorphic biologically with general linguistic competence. The results suggest (1) that reading acquisition involves enhanced left-hemisphere decoding of written language and (2) that reading disability is related to the prevalence of a right-hemisphere-based perceptual coding strategy.


Infant recognition memory: studies in forgetting.

In a series of studies on delayed recognition and forgetting, the failure of 22-week-old infants to recognize which of 2 face photos (e.g., man or woman) had been previously exposed was shown to be influenced by what the infant saw during a retention interval. Highly similar intervening targets (other face photos) consistently produced failure of recognition. Targets intermediate in similarity (rotated photos) or of low similarity (line drawings) had little effect. Forgetting due to interference with high-similarity targets was shown to be temporary in nature, however, with recovery of recognition occurring after longer retention intervals and forgetting easily offset by further, brief exposure to the familiar stimulus.


The interfering effect of distracting stimuli on the infant's memory.

Infants 3 1/2 months of age were assessed for the possible role of the dissimilarity of the distracting stimulus to the originally learned standard in a modified familiarization-distraction-test paradigm. When data for all subjects were analyzed, there was no evidence that the distraction had any interfering effect at all on the memory for the original standard. However, specialized analyses suggested that interference varied with the likelihood that subjects actually encoded the distracting stimuli might govern the probability or extent that an infant encodes the distracting stimulus rather than affecting the interference process directly.