Chemotherapy versus chemoimmunotherapy with levamisole or Corynebacterium parvum in advanced lung cancer

A total of 109 patients with advanced lung cancer, all cell types, were randomized between MACC chemotherapy only, consisting of methotrexate, doxorubicin (Adriamycin), cyclophosphamide, and lomustine (CCNU); MACC plus levamisole (LMS) orally; and MACC plus Corynebacterium parvum (CP) sc. Of these patients, 101 were evaluable, with no differences among the three treatment groups for overall response rate and survival time. Objective response rates and median survival times were 41% and 230 days for patients given MACC only, 39% and 257 days for those given MACC plus LMS, and 44% and 223 days for those given MACC plus CP, respectively. There was a significant increase in survival for patients with large cell anaplastic carcinoma receiving CP or LMS, particularly in the good-performance-status category. Pretreatment delayed cutaneous hypersensitivity to recall antigens in 50 patients had prognostic significance, but repeat tests after 2 months of treatment in 30 patients did not show different patterns of conversion among the three groups. There was no difference in hematologic toxicity among the three groups. With the possible exception of large cell anaplastic carcinoma, immunotherapy with LMS or CP as given in this trial does not appear to be therapeutically advantageous in advanced lung cancer.

Reduction of mortality in general medical in-patients by low-dose heparin prophylaxis

The effect of prophylactic low-dose heparin on mortality was tested in 1358 consecutive patients admitted to the medical wards of an acute care hospital. Eligibility for treatment or exclusion was ascertained on admission by predefined contraindications. Eligible patients with even-number hospital records were assigned to treatment (5000 U twice daily), those with odd-number records served as controls. Because determination of eligibility was open to bias, evaluation of treatment was based on comparison of the total even-number group (669 patients, of which 411 were treated with heparin), and the total odd-number group (689 patients, none treated with heparin). Mortality was significantly lower in the even-number group-7.8% (52 of 669 patients) versus 10.9% (75 of 689 patients) in the odd-number group; the difference increased consistently with length of hospitalization (p = 0.025). The estimated reduction in mortality attributable to heparin was 31.1%. We believe that low-dose heparin prophylaxis is appropriate in all immobilized medical patients who are not at risk of bleeding.

Predictive value of the CFU-C assay in acute nonlymphocytic leukemia

A double-layer agar culture assay for granulopoietic progenitor cell (CFU-C) was employed to study the in vitro growth pattern of bone marrow or peripheral blood cells from 37 patients at diagnosis of acute nonlymphocytic leukemia. The patients were classified as having type A growth if there were greater than 50 colonies (A1), or greater than one colony and greater than 50 clusters was observed after 14 days in culture (A2). Type B growth was defined as no growth (B1), less than 50 colonies and less than 50 clusters (B2) or cluster growth only (B3). Agar cultures containing marrow cells from 10 patients were stained in situ, and the colonies and clusters revealed abnormal cellular maturation. Treatment with cytosine arabinoside and an anthracycline resulted in a complete remission of leukemia in one of 15 patients with type A growth and 17 of 22 patients with type B growth. The subtype of growth pattern did not correlate with the mechanism (i.e., drug resistance versus kinetic resistance) for the failure to achieve a complete remission. The subtype of type B growth (B1, B2 or B#) did not correlate with the duration of complete remission. Nonetheless, the growth patterns observed in cultures of cells obtained from patients with acute nonlymphocytic leukemia appear to be excellent predictors of the success of achieving complete remission with induction therapy.

A comparison of nine systems to diagnose schizophrenia

The files of 283 hospitalized patients discharged with a diagnosis of schizophrenia, schizoaffective schizophrenia, or paranoid state were examined without knowledge of the patient's subsequent history. These patients, most of whom had originally been diagnosed by DSM-I criteria, were retrospectively diagnosed by New York Research Diagnostic Criteria (RDC), the New Have Schizophrenia Index (NHSI), the St. Louis criteria, Taylor-Abrams 1978 criteria, Schneider's first-rank symptoms (FRS), the Washington IPSS 12-Point Flexible System, Astrup's process/nonprocess distinction, and DSM-III. Kappa values measuring pairwise diagnostic agreement amont the nine systems were typically low except among RDC, DSM-III, and St. Louis criteria. Long-term followup status was not significantly predicted by the FRS, NHSI, or Taylor-Abrams criteria. Diagnosis by means of the other systems, especially the Astrup process/nonprocess distinction, was significantly correlated with followup. However, Astrup's "process" schizophrenia is not operationally defined and could not be expected to be used with the degree of interrater reliability desired by researchers. On the other hand, of the operationally defined systems, DSM-III schizophrenia has the highest correlation with followup and is thus suggested for use by researchers desiring a highly homogeneous, although narrowly defined, population. Investigators wishing to cast a wider net could use a less restrictive system such as the RDC, with or without schizoaffectives included.

Severity measurement in multiple trauma by use of ICDA conditions

We report here the results of a study of grading injury severity for patients with multiple traumatic injuries from ICDA codes listed on the face sheets of hospital medical records. We developed a method of scoring the severity of individual ICDA traumatic injuries with use of data from the NCHS Hospital Discharge Survey. When tested on a set of patients having multiple trauma conditions (also from the NCHS Hospital Discharge Survey), these scores had a strong relationship with fatality. The development of an injury severity index based on ICDA codes has considerable impact on the feasibility of conducting studies involving large numbers of patients hospitalized with traumatic injuries.

Fetal outcome in narcotic-dependent women: the importance of the type of maternal narcotic used

The records of 239 infants born to 228 women dependent on narcotic drugs were reviewed to determine if type of drug abused and adequacy of prenatal care would affect pregnancy and fetal outcome. Seventy-nine (33%) pregnancies occurred in women in supervised methadone maintenance, 78 (32%) in women on unsupervised methadone maintenance, 49 (21%) in women on street heroin, and 33 (14%) in women who were multiple drug users. Although the presence of withdrawal symptoms did not differ with respect to type of drug abused, the outcome was significantly better in those infants born to women on supervised methadone maintenance as compared to all other groups (p less than 0.001). There was no demonstrable relationship between the number of prenatal visits to the clinic and fetal outcome. A relationship could not be demonstrated between the maintenance dose during pregnancy and the presence of withdrawal symptoms in the infants born to women on supervised methadone maintenance. The findings of the study suggest that supervised methadone maintenance is compatible with an uneventful pregnancy and delivery. Neonatal complications, with the exception of withdrawal, do not appear to differ from that seen among infants born to nondrug dependent women.

The revised estimated survival probability index of trauma severity

The construction of a revised version of the Estimated Survival Probability Index (or ESP index) is described. The original index had been proposed as a tool that would be useful in grading from hospital medical records the severity of injuries sustained by patients hospitalized with trauma conditions. The revised index (RESP) is based on a data set of 61,419 records. Unlike the ESP, the RESP index is based upon parameters that are age specific and specific to decimal ICDA codes. The RESP is validated by correlating RESP scores with observed mortality by using an independent set of multiple-trauma patients. Overall, a strong monotonic relationship between the RESP index and increasing mortality was demonstrated. Also, the RESP index correlated with mortality in selected subsets of multiple trauma patients with extremely severe injuries. Some uses and limitations of this index are discussed.

Viewpoint. What the marine mollusc Aplysia can tell the neurologist about behavioral neurophysiology

Only recently has man begun to regard himself as mundane and not divine. This conceptual liberation has allowed him to ask frank questions concerning the physical and chemical mechanisms which determine or affect his behavior. Unfortunately the answers to these questions have been slow in coming. The reasons for this are two-fold: Basic ethical considerations preclude the experiments necessary to investigate the neural substrates of human behavior in man. Further, man’s behavior and nervous system are both so enormously complex and subtle, it is therefore unlikely that much real fundamental knowledge could be gained from such experiments if performed. It is more expedient to study simple behavior in simpler organisms than man to understand how nervous systems operate in general and, it is hoped, to eventually gain a better understanding of the human in particular. This tactic is known as the “model systems” approach. By discovering the strategies adopted by less complex nervous systems to deal with simple situations one can devise a realistic model of the neural mechanisms that control more complex behavior in more advanced animals.

Many animals have served as valuable sources of model systems. Among them the marine gastropod molluscAplysiahas received considerable attention. In comparison to the human nervous system with approximately 50 billion neurons, theAplysianervous system contains relatively few neurons — about 20,000. Furthermore the study of theAplysianervous system has several other advantageous characteristics. A number of forms of behavioral plasticity that are found in all higher metazoans including man are also found in theAplysia. These simple but non-trivial types of behavioral plasticity include habituation, sensitization and associative learning as well as easily defined qualities of neural function which we choose to call “behavioral states”. In addition the nervous system is composed of neurons which are large and, in many cases, easily identified by anatomical and physiological criteria so that the “same” cell can be studied in more than one animal under more than one set of experimental conditions. The cell bodies of the neurons inAplysia, from which electrical recordings can be fairly easily obtained, are electrically close to their dendrites so that changes in postsynaptic potentials occurring during modifications of behavior can be monitored.

Clinical evaluation of high copper amalgam restorations

A comprehensive clinical investigation of amalgam restorations was undertaken to evaluate the performance of "high copper' amalgams and the methods used to examine the marginal integrity of restorations. Six alloys, Aristaloy CR (A), Dispersalloy (D), Indiloy (I), an experimental "high copper' amalgam (E), Tytin (T), and New True Dentalloy (N) as a control, were randomly placed by four operators in 435 Class 1 and Class II restorations. Black and white 1 x photographs were taken at baseline, 6, 12 and 18 months and evaluated using the method described by Mahler & Marantz (1979). In addition, the U.S. Public Health Service system (Cvar & Ryge, 1971) was used at each recall. An analysis of variance based on photographic scoring indicated significant differences (P less than 0.05) among alloys at each recall. The use of Duncan's multiple range test resulted in two homogeneous subsets at 18 months: D, I, E and T, N, A. Six and 12 months recall data showed a close similarity in the rank order of the six alloys. The U.S.P.H.S. system showed no statistically significant differences between the alloys using the chi-square test, however, at each recall the rank order was comparable to that obtained with the photographic method.

The development of acute myelomonocytic leukemia in a patient with acute lymphocytic leukemia

A diagnosis of acute lymphocytic leukemia (ALL) was made from a peripheral blood and bone marrow specimen from a 59-year-old woman. Typical-appearing lymphoblasts were positive for periodic acid-Schiff (PAS) reaction, but negative for peroxidase, Sudan black B (SBB) and non-specific esterase (NSE) stains. Lymphoblasts failed to form non-immune rosettes and had no surface membrane immunoglobulins. However, lymphoblasts exhibited an "Ia-like" membrane antigen and markedly stimulated allogeneic lymphocytes in a mixed lymphocyte reaction (MLR). These cytochemical and immunologic studies were considered characteristic of null-cell subtype of ALL. Thirteen months later, the peripheral blood and bone marrow specimens contained numerous myelomonoblasts characterized by a weak or negative PAS stain and strongly positive peroxidase, SBB, and NSE reactions. Electron micrographs of the bone marrow suggested that the majority of leukemic cells were myelomonocytic and a minority of cells were lymphoblasts. In addition, myelomonoblasts in liquid cultures appeared to differentiate into mature macrophages. These data suggest the development of acute myelomonocyte leukemia in a previous case of ALL.

Plasmapheresis in refractory generalized myasthenia gravis

A group of 16 patients with severe generalized myasthenia gravis (MG) (five with thymoma) that was resistant to anticholinesterases, thymectomy, and corticosteroids were treated by plasmapheresis. Twelve patients showed an excellent clinical response. Plasmapheresis is an effective treatment modality for many patients with severe generalized MG resistant to other forms of therapy. Unfortunately, the beneficial results are only transient and periodic plasmapheresis treatments are necessary.

Factors affecting trauma center utilization in Illinois

The Illinois Trauma System has served as a prototype for many of the advanced emergency medical services systems developed during the past decade. The Illinois Trauma Study uses a cross-sectional research design to assess the trauma patient utilization patterns at hospitals in Illinois. Data were collected from 33 Trauma Centers and 43 nonsystem hospitals for the time interval July 1973-June 1974. Results indicated that 45.5 per cent of patients admitted with specified trauma conditions were hospitalized at Trauma Centers. When adjustment is made for differences in the size of hospitals, a 50 per cent excess in patient capture is found at Trauma Centers. This excess utilization found in Trauma Centers for this sample of trauma victims was not found among all patients admitted to these hospitals. Factors found to be associated with high Trauma Center use are race (high use among nonwhites), injury severity, evening admission to hospital and vehicular injury. Also, approximately two thirds of trauma patients that were admitted to intensive care units or transferred from other hospitals were hospitalized at Trauma Centers.

Cross-sectional clinical evaluation of recurrent enamel caries, restoration of marginal integrity, and oral hygiene status

Both marginal quality and oral hygiene status have strong effects on the risk of recurrent caries. Although there was no statistically significant interaction between these two parameters in this study, the influence of each variable was dependent on its severity. There is a difference between the behavior or the likelihood of recurrent caries on occlusal surfaces as compared with smooth surfaces. On the smooth surfaces, there is a continued increased risk with decreasing marginal quality; the occlusal surfaces, however, show no change in vulnerability beyond a modified marginal quality score of 3. Variation in oral hygiene had a more pronounced effect on the probability of recurrent caries of restorations with moderate margin scores than it did on restorations with either very poor or very good cavosurface margins. This work further emphasizes the importance of technically good restorative care at the operative visit, which, coupled with conscientious oral hygiene, should have a positive effect on increasing the longevity of restorations and decreasing the need for replacement.

A comparison of androgens for anemia in patients on hemodialysis

To compare the erythropoietic effects of nandrolone decanoate, testosterone enanthate, oxymetholone, and fluoxymesterone, we performed a randomized clinical trial in patients with anemia who were receiving maintenance hemodialysis (the women were not given testosterone enanthate). After a control period of at least two months, patients received one of the drugs for six months and then returned to control status; a second and third drug were administered in a similar fashion. Seventy-seven patients completed the first drug period, 56 the second, and 35 the third. The response to nandrolone and testosterone enanthate, the two drugs given by injection, was clearly superior to the response to oxymetholone or fluoxymesterone, given by mouth, in terms of the percentage of patients responding and the mean rise in hematocrit. Approximately half the patients had an increase of at least 5 percentage points in hematocrit after an injectable androgen was given; more than half the women responded. Patients who required transfusions regularly and those who had bilateral nephrectomies did not respond.

In-vitro differentiation of myeloblasts from a patient with acute myeloid leukemia

Although acute myeloid leukemia is characterized by defective granulocytic maturation in vivo, blasts from an occasional patient will differentiate in vitro. Leukemic myeloblasts from a 49-year-old woman who had acute myeloid leukemia were suspended in liquid culture containing McCoy's 5A medium with 15% fetal calf serum. Conditioned medium, prepared from normal human peripheral blood adherent cells incubated with 2-mercaptoethanol in McCoy's 5A medium with 15% fetal calf serum, was added to the cultures at a concentration of 40%. Within six days, cellular differentiation to polymorphonuclear granulocytes was observed. These cells were capable of phagocytosis. Attempts to induce differentiation of leukemic cells in liquid culture will, it is hoped, contribute to the understanding of defective cellular maturation in this disease.

Myeloid differentiation of human blood mononuclear cells in liquid culture

Human blood mononuclear cells were prepared from peripheral blood or single donor plateletpheresis residues by depletion of adherent cells and T lymphocytes. In double-layer soft agar culture, 5 x 10(5) such cells yielded from 33 to 165 colonies. For liquid culture, these cells were suspended in McCoy's 5A medium with 15% fetal bovine serum and 0%, 20%, or 40% conditioned medium (CM) and incubated for up to 14 days at 37 degrees C in a humidified 5% CO2-95% air atmosphere. The number of cells in cultures with CM decreased about 0%-10%, while cell counts from cultures without CM decreased about 45%-65%. In cultures with CM, 5%-20% of the cells were classified as blasts after 3-5 days. After 7-11 days, blasts and promyelocytes comprised up to 53% of all cells. After 9-11 days, cells with specific granules and maturing nuclei comprised up to 56% of all cells. At 11 days, up to 66% of the cells contained peroxidase-positive granules. Cultures without CM contained no more than 5% blasts and promyelocytes and less than 5% maturing granulocytic cells. 3H-thymidine and Na235SO4 incorporation reached a peak at 3-5 days and at 5-11 days, respectively, in cells from cultures containing CM.

Blood colony and cluster-forming activity during various stages of chronic granulocytic leukemia

The colony and cluster-forming capacity of peripheral blood cells obtained from 25 patients who had chronic granulocytic leukemia (CGL) was evaluated in a double-layer agar culture. Increased numbers of colonies (mean, 264) and clusters (mean, 908) were obtained from the blood cells of nine of ten patients when first examined. The blood cells from 19 patients whose diseases were in the control phase formed normal or nearly normal numbers of colonies and clusters. During the aggressive phase, elevated blood colonies and clusters were observed in the 12 patients studied. Two to four times as many clusters as colonies were observed during these phases of CGL. At the time of blastic crisis, at least eightfold more blood clusters than colonies were observed in the eight patients studied. These studies indicate that the evaluation of blood colony and cluster-forming cells may provide a useful characterization of various clinical phases of CGL in individual patients.

Types of colonies formed by normal human bone marrow, peripheral blood and umbilical cord blood CFUc

Four types of colonies can be formed by progenitor cells (CFUc) in double layer agar cultures: eosinophil, granulocyte, macrophage, and mixed granulocyte-macrophage. We have developed a method for in situ staining of intact agar plates with luxol fast blue and acetoorcein employed to differentiate the type of colonies. Cultures of 10(5) normal human bone marrow cells yielded 89.1 colonies, of which 72% were eosinophil. Cultures of 5 X 10(5) peripheral blood cells, enriched by isopycnic sedimentation, yielded 39.0 colonies, of which 48% were eosinophil. T-cell depleted peripheral blood mononuclear cells yielded 116.9 colonies/5 X 10(5) cells, of which 74% were eosinophil. Umbilical cord blood cells yielded 65.1 colonies/5 X 10(5) cells, of which 23% were eosinophil. Comparing similar numbers of total colonies, there appears to be fewer relative and absolute numbers of eosinophil colonies formed by CFUc recovered from cord blood as opposed to adult peripheral blood and bone marrow. Enumeration of colony numbers without regard to types of colonies is imprecise. The method employed in the present study is easy to perform, reproducible and provides permanent slides.

Association of monocytic leukemia in patients with extreme leukocytosis

Fifteen of 73 newly diagnosed patients with acute myeloid leukemia (AML), admitted to Mount Sinai Hospital between July 1977 and October 1979, presented with leukocyte counts greater than 100,000/microliter. Eleven of these 15 patients with hyperleukocytosis had myelomonocytic (AMML-M4) or monocytic (AMOL-M5) leukemia compared to 15 of 58 patients with lower white cell counts (p < 0.001). Identification of type of leukemia, using the FAB classification, was based on morphology and special stains, including myeloperoxidase, Sudan black B, periodic acid-Schiff and nonspecific esterase with and without inhibition by fluoride. The proportion of patients with splenomegaly is higher in those with hyperleukocytosis (73 percent) than in those with lower white blood cell counts (p < 0.001) regardless of cell type. Leukemic infiltration of the skin, gums and central nervous system was seen exclusively in patients with AMML and AMOL. The serum lysozyme levels were significantly higher for all patients with AMML and AMOL regardless of the white blood cell count. The mean serum lysozyme for M-4, M-5 patients was 59.7 microgram/ml compared to 18.9 microgram/ml in patients with other cell types (p < 0.0001). Patients with a white blood cell count less than or equal to 100,000/microliter had a complete remission rate of 69 percent compared to 47 percent for patients with higher white blood cell counts.

Purification of human peripheral blood colony forming cells (CFUC)

A 10-fold enrichment of colony forming cells (CFUC) from single donor platelet-apheresis residues and from 70-120 ml of peripheral blood of normal donors was achieved by sequential sedimentation on Ficoll-diatrizoate, depletion of cells adherent to plastic, and depletion of cells rosetting with sheep red blood cells (T lymphocytes). Culture of 5 x 10(5) unfractionated mononuclear cells yielded 9 +/- 3 colonies and mononuclear cells depleted of adherent cells and T lymphocytes yielded 53 +/- 6 colonies. The mononuclear cell fraction depleted of adherent cells and T lymphocytes was further enriched for CFUC by isopycnic sedimentation of Percoll gradients. Cells recovered in the 1.0063-1.065 g/cm3 density layer of the gradient formed 146 +/- 9 colonies in culture. The mononuclear cells depleted of adherent cells and T lymphocytes were also enriched for CFUC by depletion of Fc-receptor positive cells using an immune sheep red blood cell rosette sedimentation technique. Cultures of the Fc-receptor depleted fractions yielded 107 +/- 12 colonies, while the Fc-receptor enriched fraction yielded only 2 +/- 1 colonies. CFUC appear to lack surface membrane receptors for sheep erythrocytes and the Fc portion of immunoglobulin as well as the ability to adhere to plastic.

Rapid in situ cytochemical classification of CFU-C colonies in soft agar culture: permanent whole culture preparations

Soft agar culture CFU-C (colony-forming units in culture) are rapidly classified in situ as eosinophil, macrophage, and neutrophil-monocyte types by whole culture staining with luxol fast blue for eosinophil specific granules and acetoorcein for nuclei. Stained colonies may be picked and examined individually as wet mount cover slip preparations, or the agar culture may be air dried and mounted permanently. The whole culture stain has been variously modified for the enzyme markers alpha-naphthyl acetate esterase and peroxidase and for nuclear staining alone with acetoorcein.

Relation of Gothic arch apex to dentist-assisted centric relation

These data suggest that the widely held belief that thumb pressure can position the mandible consistently more posterior than the position indicated by the Gothic arch apex is unfounded. Furthermore, this study provides no evidence to support the contention that the dentist-assisted jaw relation is more reproducible than the relation indicated by the Gothic arch apex.

An evaluation of the Illinois trauma registry: the completeness of case reporting

The Illinois Trauma Registry (ITR) was developed as the principal evaluative tool for the comprehensive set of medical programs known as the Illinois Trauma System. In order to determine the completeness of case reporting to the ITR, a 10% sample of traumatic injuries was drawn at 33 hospitals designated as Trauma Centers. An attempt was then made to link the cases found at the Trauma Centers with those in the ITR; theoretically, all cases found in the Trauma Center should appear in the ITR. Analysis reveals that the ITR is drastically underreported; for all 33 Trauma Centers combined, only 36.9% of the cases appeared in the ITR. On an individual hospital basis, completeness ranged from 0.0% (eight hospitals) to 83.3%. Inclusion in the ITR is significantly associated with the categorization of hospital emergency capability, the method of patient transport to the hospital, the mechanism of injury and subsequent admittance to the intensive care unit. Of particular interest for evaluative studies is the marginally significant difference between the case fatality rate as reported in the ITR (5.0%) and that found in the hospital (2.8%). Guidelines are suggested to improve the development, management and data quality of future registries.

Central nervous system involvement at presentation in acute granulocytic leukemia. A prospective cytocentrifuge study

We have undertaken a perspective study of the prevelance of the central nervous disease in acute granulocytic leukemia (AGL). Thirty-nine newly diagnosed patients with AGL underwent cytocentrifuge examination of cerebral spinal fluid. Seven of the 39 patients had blast cells in their cerebral spinal fluid. All seven of these patients had acute myelomonocytic leukemia (AMML). No patients with other variants of AGL demonstrated blast cells in their cerebral spinal fluid. Other high risk factors associated with meningeal infiltration were elevated serum lysozyme levels, high peripheral white blood cell count, low age, splemomegaly and the presence of infiltration in other organs. The admission rates for patients with meningeal leukemia were lower and the survival time was shorter than in both the 32 noninvolved patients and the noninvolved patients with AMML. We believe that a lumbar puncture is indicated in all patients with newly diagnosed AMML.

The short-term memory ability of children with learning disabilities

Three groups of learning disabled children, defined on the basis of their Wechsler Intelligence Scale for Children profiles, and one control group of normal readers were asked to retain verbal material across distractor intervals ranging from zero to 18 seconds. None of the learning disabled groups (low verbal, high performance; high verbal, low performance; verbal equals performance) performed worse on this task than the normal controls. Furthermore, the older learning disabled children in the high-verbal, low-performance group actually retained somewhat more material than the normal control group. It was concluded that at least on this standard version of a short-term retention assessment task, learning disabled children are not at a significant disadvantage.

Spontaneous remission in acute myelogenous leukemia in the adult

A spontaneous complete remission of 17 months duration was observed in a patient with acute myelogenous leukemia. Resolution of all clinical and morphologic abnormalities occurred. The remission was apparently associated with an acute pulmonary infection. At relapse, remission induction was accomplished with cystosine arabinoside and daunorubicin therapy. In vitro granulocyte-macrophage agar culture studies (CFU-c) showed an abnormal growth pattern at presentation, which persisted during the period of spontaneous remission. Reports of spontaneous remissions of acute myelogenous leukemia in adults have become increasingly rare, and the remissions themselves are short-lived. Despite the association between spontaneous remissions and acute infections or febrile episodes, attempts at remission induction with infectious agents have been unsuccessful. Spontaneous remissions are an uncommon variant of the natural course of acute myelogenous leukemia in the adult.

Startle reflex habituation in children with cerebral palsy

Two groups of children (9 with cerebral palsy and 10 normals, matched for sex and age) participated in a study of the startle reflex. Each child was instructed to press a button as soon as possible after the onset of a visual stimulus on a box on the table at which they were seated. During some of the trials, a sudden and intense auditory stimulus (85 dB) was presented concomitantly with the onset of the visual stimulus, and effects on reaction time recorded. Mean reaction time of normal children was significantly faster than that of the group with cerebral palsy. The magnitude of disruption associated with the first startle stimulus presentation was signicantly greater for cerebral palsied children. The course between groups of habituation to the startle stimuli was not significantly different. Data support the hypothesis that startle reflexes of children with cerebral palsy are more marked than are those of normal children.

An evaluation of beta titanium alloys for use in orthodontic appliances

A beta titanium alloy was evaluated for use in orthodontic appliances. Standard mechanical tests and aspecially designed spring test were used. Two particular thermo-mechanical treatments resulted in titanium springs with 1.8 times the extension of comparable stainless steel springs, and a 2.2 fold reduction in force per unit displacement.