Four years' experience of an interim secure unit

An interim secure unit of 14 beds (Rainford Ward) at Rainhill Hospital has been functioning for four years. During that period 78 patients were referred and 39 were admitted from various sources. Of those admitted, 40% were women, all had committed dangerous acts, and the most common diagnosis was schizophrenia. Only seven patients have stayed for one year or more, and only one seems set to stay indefinitely. Patients discharged are followed up in roughly equal numbers by their catchment area psychiatric teams and by the regional forensic psychiatric service. The number of patients in the ward has settled to about 12 for a population of one million. The unit now functions unobtrusively in a large psychiatric hospital, has a high morale, has had few recruiting problems, and has suffered extremely few disturbing incidents.

Genetic screening for mental retardation in Michigan

The Michigan Department of Mental Health established a genetic screening laboratory in 1977 to provide diagnostic information on retarded patients. Of 727 patients screened during a 2-year period, a genetic diagnosis was established for 121 moderately to severely retarded patients. Genetic counseling was provided for 40 percent of their parents. A wide variety of chromosomal abnormalities, inborn errors of metabolism, and dysmorphic syndromes was discovered, including 16 instances of previously unknown familial conditions. This program has demonstrated a cost-effective method for determining genetic etiology in mental retardation and, in some instances, has led to prevention of mental retardation.

Chronic active hepatitis. Who meets treatment criteria?

In order to ascertain the proportion of patients with biopsy-proven chronic active hepatitis who meet currently accepted criteria for immunosuppressive treatment, an analysis of 86 patients seen between 1973 and 1978 carrying this diagnosis was undertaken. Only 66 could be confirmed to have this lesion on blind histologic review. Nine of these 66 were on concomitant immunosuppressive therapy, four had inadequate documentation of chronicity, five consumed more than two ounces of alcohol daily, five had concurrent malignancy, two were prepubertal, and one had oxyphenisatin-induced disease. None of the remaining 40 patients met the biochemical criteria for disease activity. The disease was predominantly seen in asymptomatic middle-aged males and was of viral etiology. A small subgroup of elderly female patients was also identified whose disease was apparently nonviral. In conclusion, the vast majority of chronic active hepatitis seen at a large university center occurs in individuals for whom treatment guidelines have not been established.

Oxpentifylline in Parkinson's disease

The effects of oxpentifylline were assessed in a double-blind trial in 11 patients with Parkinson's disease already under treatment. No significant improvement was noted. Eight patients developed involuntary movements or a worsening of movements if already present. The significance of this unexpected finding is discussed.

"Pseudosarcoma" of the larynx

Polypoid epidermoid carcinoma of the larynx with a cellular, often atypical stroma has also been classified as pseudosarcoma, carcinosarcoma, pleomorphic carcinoma, or spindle cell sarcoma. The nature of the spindle-shaped stromal cells has clinical significance, but pathologists do not agree about the origin and potential of these cells. This paper describes two laryngeal tumors, one with an abundant osseous component in which light-microscopic, ultrastructural, and clinical features suggest the origin of these fusiform cells from reactive pluripotential mesenchyme. In a second case, atypical fusiform cells within the stroma show ultrastructural epithelial characteristics. These findings suggest a varied histogenesis for pseudosarcoma of the larynx and may explain divergent theories expressed in the literature.

Role of regional and distant lymph nodes in rejection of feline sarcoma virus-induced tumors in sheep

The immune response of regional and distant lymph nodes was compared relative to rejection of feline sarcoma virus (FeSV)-induced tumors in sheep. Following injection of FeSV-transformed allogeneic or autochthonous fibroblasts into the lower leg, small tumors developed at the site of inoculation and subsequently regressed. Efferent lymph from the regional popliteal nodes and distant nodes in the same host was collected for periods up to 40 days after tumor cell inoculation. The cell response in the efferent lymph of the stimulated node was the same regardless of whether inoculum consisted of autochthonous or allogeneic FeSV-transformed sheep cells. There was a rapid rise in total lymphocytes leaving the regional node, beginning at 3 days and peaking at 6--8 days post inoculation. On days 6--8 post inoculation, lymphoblasts appeared in regional lymph ranging from 25 to 40% of the total cell output. The cell population in lymph from distant (nonstimulated) nodes, however, remained morphologically normal throughout the response. Lymphocytes cytotoxic to the injected FeSV-transformed cells appeared in efferent lymph from the regional node within 5 days post inoculation and in lymph from distant nonstimulated nodes several days later. Cytotoxic lymphocytic cells had no "killing" effect against the corresponding nontransformed cells if the inoculum was autochthonous in origin; however, they did have such an effect when corresponding nontransformed cells were allogeneic. The cytotoxicity of lymph cells varied according to the type of cells in the lymph. With the use of the growth inhibition assay, it was possible to demonstrate that lymph cell populations high in lymphoblasts "killed" all target cells in 24 hours, whereas populations of lymph cells comprised mainly of small lymphocytes took up to 2--3 days to "kill" the target cells. Complement-dependent antibody first appeared in lymph from the stimulated popliteal node at 8 days post inoculation and at 12 days post inoculation in blood sera and lymph from distant nodes.

The demonstration of antibody specificity by a new technique. The gel electrophoresis-derived enzyme-linked immunosorbent assay (GEDELISA) and its application to antibodies specific for feline leukemia virus

By combining the high resolution of sodium dodecylsulfate polyacrylamide gel electrophoresis with the sensitivity of enzyme-linked immunosorbent assay (ELISA) antibodies specific for different feline leukemia virus components are characterized. Based on the same principle, Concanavalin A binding sites of FeLV components are also detected.

The intravenous furosemide test: a simple way to evaluate renin responsiveness

To identify patients with low-renin hypertension, we measured plasma renin activity after the administration of 40 mg of furosemide intravenously and 30 minutes of upright posture in 127 normotensive subjects and 363 patients with essential hypertension. Plasma renin activity 30 minutes after intravenous furosemide was found to be closely correlated to the level found after either 2 or 4 h of standing or 3 days of a low-salt diet plus 2 h of upright posture. Renin responsiveness was significantly lower in hypertensive patients, blacks, and women, compared with normotensive subjects, whites, and men respectively. The level of plasma renin activity in most normal white subjects was greater than 1.0 ng/ml - h and in most normal blacks was greater than 0.5 ng/ml - h. It was below those levels in 23% of white hypertensive and 25.2% of black hypertensive patients respectively. The mean level of plasma renin activity fell with increasing age of hypertensive patients. This procedure is recommended as a safe, easy, and reliable test for assessing renin responsiveness and identifying the low-renin state.

A note on the relationship between the comfortable interpersonal distance scale and the sociometric status of emotionally disturbed children

The purpose of this study was to investigate the relationship between two measures of social attraction or status: namely, the recently developed Comfortable Interpersonal Distance (CID) Scale and a traditional measure of sociometric status. Both measures were recorded for a sample of emotionally disturbed, preadolescent boys who were in residential treatment. The results indicated that the two measures were very highly correlated. This finding means that the more a boy was liked by his cottage peers, the closer these peers indicated that they would like to sit next to the boy in a room. In other words, physical interpersonal distance seems to be nonverbal way of communicating liking for a person.

Attitudes underlying reluctance to donate blood

Attitudes underlying reluctance to donate blood were examined in two samples, college and general public, by means of direct and indirect questionnaires. Results were highly consistent across samples and sexes, and indicated that personal and emotional concerns, such as fear of the needle, fear of the sight of blood, fear of dizziness, inconvenience, and possibly ill effects on health, contribute more heavily to reluctance than people can (or will) recognize. Forthright handling of these fears and concerns by blood collection agencies is advocated.

Inconsistent socialization

Evidence bearing on the hypothesis that inconsistent socialization leads to various forms of maladjustment and is more detrimental than consistently negative socialization was reviewed. Studies relying upon clinical observation, case histories, interviews, inventory and rating techniques, direct observation of parental behavior, and experimental manipulation received treatment. While the evidence for the deleterious effects of inconsistent socialization is highly suggestive, demonstration is not definitive.