Families of autistic and dysphasic children. II. Mothers' speech to the children

This paper tests various hypotheses about deviance in the communication of mothers to their autistic children. The language of mothers of 13 autistic boys is compared to the language of mothers of 13 boys with developmental receptive dysphasia. The two groups of boys are of similar age, nonverbal intelligence, and language level. The language samples come from hour-long taped interactions between the mothers and their children in their homes. Aspects of maternal communication that are examined include: the amount of language used, the frequency usage of different types of utterances, the syntactic complexity of utterances, the grammaticality of utterances, the clarity of communication, and the tones of voice used. No differences were found between the two groups of mothers in level of language usage, pattern of functional interaction, or in overall clarity of communication. In conclusion, the findings of this study provide no support for the suggestion that autism is due wholly or in part to deviant patterns of mother-child communication.

Psychiatric disorder in children with speech and language retardation. A critical review

This article critically reviews the literature concerning psychiatric disorder in children with speech and language retardation. The data indicate that speech- and language-disordered children are at risk for psychiatric disorder, that there is some correlation between the presence of psychiatric disorder and the type of speech and language disturbance, and that there is a likely correlation between certain types of speech and language problems and the type of psychiatric difficulty. Firm conclusions in this area are hampered by many methodological difficulties. Finally, a review of the nature of the association between psychiatric disorder and speech and language retardation reveals that except in rare instances psychiatric disorder does not cause speech and language retardation, and that in most cases psychiatric disorder is indirectly caused by speech and language retardation.

Phase I trial of ftorafur combined with mitomycin C or methyl-CCNU in gastrointestinal cancers

Twenty-five patients with disseminated gastrointestinal malignancies were treated in a phase I study with a combination of ftorafur and mitomycin C or florafur and methyl-CCNU. Most patients had been heavily treated previously. Gastrointestinal, central nervous system, and marrow toxicity were manageable. Tumor regression was noted in five of 25 patients. A large-scale phase II study in untreated patients with gastrointestinal malignancies appears indicated with a combination of these agents.

Phase II study of 5-azacytidine in solid tumors

A phase II study utilizing 5-azacytidine in the treatment of patients with solid tumors was carried out by the Southwest Oncology Group (SWOG-7208). Of 214 patients entered in the study 191 were eligible and 167 were evaluable. While initially they received 225 mg/m2 iv on Days 1--5 every 3 weeks because of toxicity the dose was subsequently reduced to 175mg/m2 and later to 150 mg/m2. Five partial regressions, 2.6% of the eligible patients and 3% of the evaluable patients, lasting from 28 to 77 days were observed. Sixteen patients 8.4% of the eligible patients and 9.6% of the evaluable patients, had no significant change in their disease for 39--255 days. The major toxicities were myelosuppressive and gastrointestinal with 13 deaths attributable to drug toxicity: 11 due to sepsis and two due to cerebral hemorrhage. 5-Azacytidine induced few favorable responses; those that did occur usually were of poor quality and short duration and were associated with significant toxicity.

Nephropathy caused by methicillin therapy for staphylococcal septicemia

Nephropathy, eosinophilia and fever were observed in an 18-year-old man being treated for staphylococcal septicemia. Parenteral challenge with suspected sensitizing agents confirmed methicillin as the likely offender. Review of the literature relating to methicillin-induced nephropathy suggests a hypersensitivity origin for this disorder, but immunologic and ultrastructural investigation to date has failed to elucidate pathogenesis.

Hyperinsulinism in infancy: diagnosis by demonstration of abnormal response to fasting hypoglycemia

The metabolic adaptation to fasting in infants with hyperinsulinism was examined to see whether a characteristic abnormality could be found that would aid in the diagnosis of this disorder. Seven infants under 1 year of age with hyperinsulinism were studied; 7 control infants of similar age and 12 children with ketotic hypoglycemia served as contrast groups. At the time of hypoglycemia, four of the seven infants with hyperinsulinism did not have elevated levels of insulin. However, levels of beta-hydroxybutyrate were significantly lower in the infants with hyperinsulinism than in the control and ketotic hypoglycemic groups. Levels of free fatty acids were also lower in the infants with hyperinsulinism. Expected levels and normal limits for beta-hydroxybutyrate, insulin, and free fatty acids when plasma glucose is below 40 mg/100 ml were estimated by combining the control and ketotic hypoglycemic groups. Using these values as standards, the diagnosis of hyperinsulinism can be made by evaluation of the response to fasting hypoglycemia. The application of this approach is illustrated by three case examples.

Sex differences in binding of human growth hormone to isolated rat hepatocytes

Since liver is a target for growth hormone action, binding of 125I-labeled human growth hormone to enzymatically isolated rat hepatocytes was studied. Specific binding was shown with hepatocytes from both male and female animals. There was a single class of receptors for human growth hormone on cells from males (affinity constant, Ka = 1.16 x 10(9) liters/mole; sites per cell, q = 6200). In males, bovine growth hormone was almost as potent as human growth hormone in displacing bound 125I-labeled human growth hormone, while ovine prolactin was about 1000 times less potent. Cells from female rats bound more 125I-labeled human growth hormone than cells from males. The cells from females contained at least two classes of receptors for human growth hormone. The receptor of highest affinity had the same affinity for human growth hormone as the single receptor found in males (Ka = 0.96 x 10(9) liters/mole). However, there were three to four times as many of these receptors per cell in females (q = 21,000). In females, bovine growth hormone and ovine prolactin were both about 20 times less potent than human growth hormone. Treatment of male rats with estrone produced cells that show the same binding characteristics as females. These results indicate that human growth hormone binds to a somatogenic receptor in hepatocytes from male rats. In females and estrogen-treated males, the receptors that bind human growth hormone recognize lactogenic as well as somatogenic properties. This suggests that the lactogenic and growth-promoting effects of human growth hormone in the rat are mediated by different receptors.

Pleural effusion in cancer patients. A prospective randomized study of pleural drainage with the addition of radioactive phsophorous to the pleural space vs. pleural drainage alone

Sixty-seven patients with disseminated cancer were randomly allocated to treatment with continuous closed chest drainage removing all fluid for 72 hours (PD) or pleural drainage for 72 hours with the instillation into the pleural space of radioactive colloidal chromic phosphate (PD + 32P). Forty-nine patients had breast carcinoma, and the remaining 18 patients had other cancers. Four of 49 patients with breast cancer and 13 of 18 with other cancer were dead in 8 weeks from the onset of effusion. In the group of patients with breast cancer PD + 32P controlled the effusion in 12 of 22 (54%) and PD alone in 15 of 30 episodes (50%). In the nonbreast group of patients PD + 32P controlled the effusion in five of six evaluable episodes (83%), and PD alone was successful in two of nine (22%). In 33% of breast cancer patients and 25% of the nonbreast-cancer patients, systemic chemotherapy produced objective remissions. Pleural effusion did not recur in any of these patients.

[Computerised axial tomography of the head (E.M.I. scan). Clinical experience with a new diagnostic method for examining the brain (author's transl)]

Computerised tomography of the head is a unique radiological method with an exceptional ability in demonstrating intracranial lesions. Increasing experience will ensure this method very wide scope in the diagnosis of neurological and neurosurgical diseases; it will make conventional methods, such as angiography, pneumo-encephalography and brain scanning largely superfluous. The frequency of incorrect diagnoses is acceptable and will be further reduced with increasing experience of the method.

A conceptual model of psychosomatic illness in children. Family organization and family therapy

Linear and open systems (multiple feedback) models of psychosomatic illness in children are contrasted in terms of their implications for cause and treatment. An open systems family model is presented that describes three necessary (but not independently sufficient) conditions for the development and maintenance of severe psychosomatic problems in children: (1) a certain type of family organization that encourages somatization; (2) involvement of the child in parental conflict; and (3) physiological vulnerability. Predisposition for psychosomatic illness, symptom choice, and maintenance are discussed within this conceptual framework. We report on family therapy strategies based on this model and the results of family treatment with 48 cases of "brittle" diabetes, psychosomatic asthma, and anorexia nervosa.

Massive empyema due to Citrobacter diversus

Citrobacter diversus is a gram-negative rod member of the Enterobacteriacease family. A patient is described from whom this organism was isolated twice in pure culture from empyema fluid. Our isolates of Citrobacter diversus were resistant to ampicillin and carbenicillin and sensitive to cephalothin. Citrobacter diversus should be distinguished from Citrobacter freundii, Enterobacter cloacae and Klebsiella pneumoniae. This organism joins Streptococcus pyogenes, bacteroids species, anaerobic streptococci and Escherichia coli as a cause of slight pneumonia with extensive empyema.

Low serum triiodothyronine in patients with anorexia nervosa

Patients with anorexia nervosa can demonstrate clinical and/or laboratory findings suggestive of reduced thyroid hormone secretion. In this study, the thyroxine (T4) and triiodothyronine (T3) serum concentrations, and thyrotropin (TSH) response to intravenous administration of thyrotropin releasing hormone (TRH) were determined in 6 patients (aged 9 to 15 yr) with anorexia nervosa and the results compared to those found in a group of 15 normal subjects. The mean basal TSH concentration and mean maximum increase in TSH after TRH were comparable to those in the normal subjects. The mean T4 concentration (7.2 mug/100 ml) in the anorexia nerovsa group was slightly but significantly lower than in the normal group (9.5 mug/100 ml). Five of the 6 patients had serum T3 concentrations below the lower limits of normal and the mean T3 concentrations (49.7 ng/100 ml) was significantly lower than in the normal group (106 ng/100 ml). The extremely low serum levels of T3 in these patients with anorexia nervosa suggest that peripheral conversion of T4 to T3 is impaired during chronic starvation.

The Imaging Photopolarimeter Experiment on Pioneer 10

A 2.5-centimeter telescope aboard Pioneer 10 is capable of making two-dimensional spin-scan maps of intensity and polarization in red and blue light at high spatial resolution. During the recent flyby of Jupiter, a large quantity of imaging and polarimetric data was obtained on Jupiter and the Galilean satellites over a wide range of phase angles.