Psychophysiological correlates of the spontaneous K-complex

A pilot study covering three nights and two studies were carried out to investigate the psychophysiological correlates of the spontaneous K-complex in relation to intense psychotherapy. The pilot study produced evidence that the K-complex was not consistent and stable within or across nights and that its variability might be sensitive to psycho-emotional influences. In the first major study 2 subjects were recorded non-consecutively over a 3-wk. period during experience of intensive therapy while in the second 6 subjects were studied before and after two therapeutic sessions. Results indicated that nights after therapy differed significantly from baseline nights and a significant interaction took place between subjects and therapy on one or more variables of the K-complex and several eye movement indices. Some relationship to length of time in therapy was also noted. These findings were interpreted to indicate a possible relationship between complete expression of feeling and the occurrence of phasic events in the sleeping EEG.

The diagnosis of personality disorders: a pilot study

A pilot study was carried out to see what levels of agreement on the diagnosis of the different types of personality disorder, described by Schneider, could be obtained by observers with different amounts of clinical experience. Audio-recordings of eight patients were examined by 10 raters, who represented three levels of experience. Two patients had the same diagnosis made by 80 percent of the raters and these cases seemed best described as "typical". In all the cases agreement was increased when a second choice diagnosis was permitted. Significantly greater agreement was recorded by clinical clerks than by psychiatrists or psychiatric residents, though this was probably due to their making use of fewer of the types. It seemed probable that some types were less likely than others to be used for a first choice diagnosis. It is recommended that the most typical patients be employed in research in the field of the personality disorders if high diagnostic reliability is required.

Early arterial lesions in maturity onset diabetes mellitus detected by an ultrasonic technique

Using an ultrasonic technique preclinical atheroma was studied in maturity onset diabetics. The elasticity of the leg arteries was measured as the elastic modulus in 32 patients and a normal range was established in 13 controls. The elastic modulus was higher (i.e. the arteries were stiffer) in diabetics than controls and this was associated with a higher mean blood pressure in the diabetics. Nine phenformin and 10 chlorpropamide treated diabetics had evidence of more severe arterial disease than 13 diet treated patients. This could not be accounted for by other factors known to influence arterial disease.

Early detection of cancer of oesophagus along Caspian Littoral. Report of a pilot project

A simple mass-screening procedure for the early detection by brush cytology of oesophageal cancer in 280 adults in high-incidence villages of the Caspian Littoral is described. The presence of atypical cells in 7%, and the discovery of frank carcinoma in 3 symptom-free people encourages continuation of the project.

Relationship of patient-nurse activity to intracranial pressure variations: a pilot study

Persons with increased intracranial pressure (ICP) from all causes are subject to periods of markedly increased pressure. Research since the initial clinical studies in the early 1960s has focused primarily on characteristics of ICP variations in specific pathologies and on mechanisms basic to increases in ICP rather than on the relationship between basic patient-care activities, such as moving the patient in bed, and variations in ICP. Therefore, nine patients with pressure-controlled ventriculostomy drainage systems were observed continuously for up to 24 hours to determine whate, if any, patient-nurse activities were associated with transient of sustained increased ICP. Frequencies of ventricular fluid drainage (VFD) during activity and nonactivity were compared to predicted frequencies. One patient had no VFD; eight patients had greater than predicted incidence of VFD associated with activity and less than predicted incidence associated with nonactivity. The difference between predicted and actual incidence of VFD was statistically significant (p less than .001) for all eight patients. Although each patient displayed individual patterns of specific activity associated with VFD, turning in bed and conversation about the patient's condition were consistent among the sample. Coughing, chewing use of bedpan, and restless movemenss were consistently associated with VFD in patients.

Cross-cultural differences in the short-term prognosis of schizophrenic psychoses

Results of the 2-year followup of the patients included in the International Pilot Study of Schizophrenia (World Health Organization 1973) indicate that patients diagnosed schizophrenic on the basis of standardized assessments and clearly specified criteria demonstrated very marked variations of course and outcome over a 2-year period. Schizophrenic patients in the centers in developing countries had, on the average, considerably better course and outcome than schizophrenic patients in the centers in developed countries. Part of the variation of course and outcome was related to sociodemographic (e.g., social isolation and marital status) and clinical (e.g., type of onset and precipitating factors) predictors, but another larger part remained statistically unexplained. This suggests that variables usually used to describe psychopathology, the environment, and history of psychiatric patients in European and North American cultures may not account for cross-cultural differences. Clinical diagnosis on initial evaluation appeared to be a good predictor of subsequent symptomatology, but not of the length of the episodes, the total time during which the patient would be psychotic, pattern of course, or the degree of social impairment. A 5-year followup of the IPSS patients has also been completed, and the collected data are being analyzed.

Feasibility of determining blood alcohol concentrations in social drinking settings

Fifty-one per cent of persons leaving a variety of public and private drinking settings agreed to provide breath samples for blood alcohol determination.

Intramuscular/oral lorazepam in acute alcohol withdrawal and incipient delirium tremens

An open study was carried out in 21 chronic alcoholics with severe withdrawal symptoms and incipient delirium tremens to evaluate the efficacy of adjuvant treatment with intramuscular lorazepam (5mg). All symptoms subsided within 2 hours after a single injection and remained under control with oral lorazepam (mean daily dose 7 mg). No adverse reactions attributable to lorazepam were observed.

Visualization of breast lesions with an advanced ultrasonic device: results of a pilot study

A pilot study is described in which a new design of a sensitive ultrasonic device was used to visualize breast lesions in nine patients. The results were in general accord with clinical, histologic, and x-ray examinations, although ultrasound was superior to x-ray mammography in the visualization of discrete cysts in breasts having a "dense" background. As the device provides an indication of the capabilities of ultrasonic equipment which will be generally available within the next two years, projections are made on the impact of this equipment on the earlier diagnosis and prognosis of cancer, together with a discussion of the negligible radiation bio-hazards posed by devices of this type, in the light of present knowledge.

Is there job satisfaction in community mental health?

After discussing the importance of job satisfaction, this paper presents data concerning current levels and sources of job satisfaction in community mental health centers. Data came from a survey completed by 164 staff members working in 22 different programs located in Michigan. The return rate was 94%. Results indicated that compared to workers in other occupations, the staff were about average in satisfaction with co-workers and supervision, but low in satisfaction with the work itself. The two major sources of job satisfaction reported by staff were the level of accomplishment experienced in the work and the degree of clarity in organizational goals and policies. The paper concludes by suggesting ways in which job satisfaction in community mental health could be increased.

Changes in regional cerebral blood flow following stereotactic psychosurgery

Serial measurements of regional cerebral blood flow by the 133Xe inhalation method were performed in a pilot study in 6 patients undergoing stereotactic psychosurgical procedures (anterior capsulotomy, cingulotomy, frontobasal tractotomy). Average hemispheric flow did not change significantly from pre- to post-operative, but changes were seen in the patterns of regional flow distribution. The most striking finding was frontal flow reduction following capsulotomy. In view of the coupling of blood flow and function in the brain, the results indicate that this method offers a new way for exploring the effects of functional neurosurgery on brain activity.

A clinical pilot study on preformed autologous ossicles. I

The study is part of a project aimed at obtaining an autologous, preformed transplant for reconstruction of a defect ossicular chain. In animal experiments we found that bone could be produced in a titanium mould placed in the tibia of the rabbit and dog. To find out whether this observation was applicable in man, 5 patients with ossicular defects were selected. A titanium mould containing two chambers was placed in the proximal tibial metaphysis for 6 months. When the moulds were extracted bone was found in 7 of the 10 chambers. In 2 of these the bone was stable and suitable for ossiculoplasty. On histological examination the same picture as in the animal experiments was found, an outer layer of cortical bone surrounding a system of spongy bone with marrow and haematopoietic cells. Microradiological examination verified the presence of mineralized bone tissue.

Distinctive features for short-term memory of consonants in noise

Wickelgren's (1966) short-term memory paradigm was used to investigate distinctive features of consonants in noise; 18 English consonants paired with the vowel /a/ were presented to 3 normal listeners in a CV context. Ss were tested in a quiet sound field at most comfortable listening level in experimental conditions of (1) quiet, (2) speech and noise at 0, (3) --5, and (4) --10 db S/N. Errors in auditory perception were eliminated from the data analysis and only errors in short-term memory recall were used as input to INDSCAL analysis. Results revealed that few errors were made in the quiet condition, but that all the noise conditions had deleterious effects on features.

Vestibular system abnormalities in otosclerotic subjects

A technique to quantify the tandem Romberg test (posturography) was used to study ten patients with otosclerosis before (series 1), 48 hours after (series 2), and between two to four months after (series 3) a stapedectomy. The results were analyzed by power spectrum analysis and then compared to findings from electronystagmographic testing performed with series 1 and 3. There was no significant change in the electronystagmography (ENG) test findings between series 1 and 3. Posturography, however, demonstrated an uncompensated vestibular pattern in the immediate postoperative period which, after two months, converted to a compensated vestibular pattern. Posturography serves as a useful quantitative test for the study of patients with balance disorders because the procedure supplements rather than complements the ENG. In addition, posturography detects vestibular reflex abnormalities in stapedectomized patients two months afterwards. Other testing modalities have not consistently demonstrated this postoperative vestibular system instability.

Open-mindedness, rigidity, and the tendency to change inferences among psychiatric nursing staff: a pilot study

To test the relationship between open- and closed-mindedness, between rigidity and nonrigidity, and the tendency of psychiatric nursing staff to alter inferences when given additional information about a patient, the Dogmatism Scale, Form E, And the Gough-Sanford Rigidity Scale were presented to 120 psychiatric nursing staff members, all employed and working directly with patients. Low-dogmatic subjects changed their inferences regarding patient behavior significantly more than high-dogmatic subjects. Although high-rigid subjects changed their inferences about patient behaviour more than low-rigid subjects, the relationship was not significant.

Construct validation of the health belief model

A multitrait-multimethod design was employed to assess the construct validity of the Health Belief Model. The data were obtained from a nonrepresentative sample of 85 graduate students at The University of Michigan's School of Public Health. The traits consisted of the respondents' perceptions of: health interest, locus of control, susceptibility to influenza, severity of influenza, benefits provided by a flu shot, and the barriers or costs associated with getting a flu shot. Each trait was measured by three methods: a seven-point Likert scale, a fixed-alternative multiple choice scale, and a vignette. The results indicate that the Health Belief Model variables can be measured with a substantial amount of convergent validity using Likert or multiple choice questionnaire items. With regard to discriminant validity, evidence suggests that subjects' perceptions of barriers and benefits are quite different from their perceptions of susceptibility and severity. Perceptions of susceptibility and severity are substantially but not entirely independent. Perceived benefits and barriers demonstrate a strong negative relationship which suggests the possibility that these two variables represent opposite ends of a single continuum and not separate health beliefs. These preliminary results provide the basis for developing brief health belief scales that may be administered to samples of consumers and providers to assess educational needs. Such needs assessment, in turn, could then be used to tailor messages and programs to meet the particular needs of a client group.

Continent ileostomy. A pilot study in dogs

Nipple valve ileostomies with and without a performed pouch as well as conventional ileostomies were compared in dogs. In both groups with a nipple valve, a 150-200 ml reservoir developed. It was about 30 cm long when not preformed by an operation. Equal dilatation of the proximal bowel was observed in both groups with a nipple valve and both these groups had a substantial loss of weight which seemed to correspond with mucosal changes indicating malabsorption. For continent ileostomy function in dogs, the performed pouch thus seems unnecessary.

Microbial process translation--laboratory to pilot plant at the Frederick Cancer Research Center

In summary, operations in the FCRC pilot plant have included training an operating staff, operability trials, equipment modification and repair, and supplementation of the original equipment to gain greater versatility. In addition to effort spent on proving and improving the capacity of the pilot plant, development studies and production operations involving translation of laboratory operations to pilot level or volume have included: 1. Development of a production process for interferon as described above. As a by-product of the interferon program, samples of cell culture have been studied in the Basic Research Division of FCRC for the production of lymphokines. 2. Production of starting materials (cell paste) for carboxypeptidase G1, using three different organisms, and production of refined material from the FCRC 252 organism as described herein. 3. Production of large quantities of crude phenylalanine ammonia lyase in the form of cell paste for Prof. Creed Abell at the University of Texas, Medical Branch, at Galveston,. 4. Production of a crude staphylococcal nuclease for the program of Dr. David Sachs, National Cancer Institute, Bethesda, Maryland. 5. Developmental studies and limited production of a crude cysteine desulfhydrase according to the protocols of Dr. J. Uren, Sidney Farber Cancer Center, Boston, Massachusetts. 6. Preliminary production studies on the agent produced by Culture FCRC 14, discovered in the CFL search program. 7. Developmental fermentation studies on the antitumor antibiotic, piperazinedione 593A [6], in preparation for production of quantities of this antibiotic to support clinical studies under the auspices of the National Cancer Institute.

Subjective magnitude of auditory impairment. A pilot study

A study of two samples (one in London, the other in Cairo) of patients who were suffering from an impairment of hearing showed that the subjective magnitude of auditory handicap was significantly correlated to the average hearing level at 2 000 Hz for the two ears. For both samples, the subjective magnitude of the auditory handicap was shown to be a power function of the hearing loss expressed in terms of the sound pressure corresponding to the threshold of hearing. The exponents in the power function applying to the two samples were similar. Age, sex and pain threshold did not influence the estimation of the subjective magnitude of auditory handicap in this study.

Vincristine (NSC-67574), cytosine arabinoside (NSC-63878), 6 thioguanine (NSC-752) and daunorubicin (NSC-82151) (VAT-D): a pilot study of combination chemotherapy for remission induction in acute myeloid leukemia in adults

Fifteen newly diagnosed unselected adult patients with acute nonlymphocytic leukemia were treated in a pilot study of the combination of vincristine, cytosine arabinoside, 6-thioguanine, and daunorubicin (VAT-D) for remission induction therapy. Eleven of fifteen (75%) achieved a remission bone marrow. Median duration of remission was seven months in all responders (11 patients). The 11 patients achieving initial remission reached a median survival of 14 months. Twelve of seventeen attempts at reinduction of remission with VAT-D were successful. The total amount of daunorubicin required for induction was less than that required in the majority of reported acute leukemia treatment regimens utilizing daunorubicin.

Ripening of the uterine cervix and induction of labour at term with prostaglandin E2 in viscous gel

In order to achieve ripening of the uterine cervix or induce labour in patients at term with an unfavourable cervical state, 1 mg of prostaglandin E2 (PGE2), suspended in a viscous gel, was instilled into the cervical canal. In a pilot study, 41 patients received the PGE2-gel. Twenty-three of these, (56%), went into labour, and delivery occurred without further stimulation within 15 hours. In the remaining 18 patients, there was a marked improvement of the cervical state, which changed from an average (modified) Bishop score of 2.5 to 6.1 within 24 hours. In a double-blind study comprising 20 nulliparae, 10 received gel containing PGE2 and 10 gel without prostaglandin. Cervical state did not change significantly (Bishop score 3.6 and 4.0) after 24 hours in patients receiving placebo gel. In those receiving PGE2 gel, 8 went into labour and were delivered without further induction within 13 hours. Two patients showed an increase in Bishop score from 3 to 6 and 7, respectively, after 24 hours. They were then induced by oxytocin and delivery occurred after 8 and 10 hours. The results suggest that administration of PGE2 intracervically can induce ripening of the cervix in patients at term with an unfavourable cervical state, and thus facilitate delivery.

The treatment of perceptual disturbances in schizophrenia with naloxone hydrochloride

The authors treated 12 schizophrenic patients who had overt hallucinatory symptoms with intravenously administered naloxone hydrochloride, a narcotic antagonist purported to have antihallucinatory properties. They found no evidence of the effectiveness of naloxone in preventing hallucinations over that of placebo when administered in a randomized, double-blind fashion.

Newborn infant hearing screening - a five year pilot project

The criteria for screening infants' hearing in the newborn nursery are reviewed. The problems encountered are discussed and a screening program outlined. Over 12,000 newborn infants were screened for hearing over a five year period and a total of eight were confirmed deaf - an incidence of one in 1,500 live births.