Flight psychology at Sheppard Air Force Base

Flight psychology is the application of psychological principles to the unique environment of the aviator in order to enhance training, flight safety, and mission accomplishment. At Sheppard Air Force Base, TX, flight psychology is a cooperative effort between a clinical psychologist and the aeromedical services, with the former acting as a consultant to the latter. The primary focus of the flight psychology program is stress management, including managing the stress response of airsickness, for students in the Euro-NATO Joint Jet Pilot Training (ENJJPT) program. Psychological assessments of flying personnel, air traffic controllers, and individuals being considered for special duties constitute a valuable contribution to aeromedical services. We present clinical vignettes to illustrate the interaction of the flight psychologist and aeromedical services, and the effect on flying training and flight safety.

Listeria monocytogenes cerebritis, bacteremia, and cutaneous lesions complicating hairy cell leukemia

Hairy cell leukemia is a lymphoreticular malignancy characterized by a chronic course and multiple defects in host defense mechanisms. Infections are the major cause of morbidity and mortality in this malignancy. Opportunistic infections due to pathogens normally controlled by cell-mediated immune mechanisms have been increasingly described but have not included listerial infections. This report describes a case of disseminated Listeria monocytogenes infection including the uncommon manifestations of cerebritis and cutaneous lesions in a patient with hairy cell leukemia.

Lung mechanics, radiography and 67Ga scintigraphy in experimental Pneumocystis carinii pneumonia

Respiratory system pressure-volume (P-V) studies, 67Ga-citrate scans, and chest radiographs were made in the corticosteroid-treated rat model of Pneumocystis carinii pneumonia. The steroid treatment used to provoke Pneumocystis infection in this model resulted in a reduction in body weight, lung weight and lung volumes compared to age-matched controls but no change in the normalized pressure-volume curve. P. carinii infection was associated with increased lung wet weight and flattening of the respiratory system P-V curve when compared to either age matched controls or steroid-treated animals on trimethoprim-sulfamethoxazole prophylaxis for P. carinii. Radiographs were interpreted as positive in only three of 11 animals with P. carinii, whereas 10 of 12 animals showed positive gallium-67 lung scans. We conclude that both gallium uptake and altered lung mechanics occur in the rat with Pneumocystis carinii and may reflect increased alveolar permeability and surfactant abnormalities noted in other studies.

Identification and treatment of masked depression in a general medical practice

The usefulness of the Zung Self-Rating Depression Scale as a screening instrument to uncover masked depression, and the benefits of early identification and treatment with alprazolam, were evaluated in a general medical practice population. There was a 95% scale acceptance by patients and a 12% overall prevalence of depression based on SDS results. Patients who scored in the depressed range on the SDS were, on a randomized basis, either identified immediately to their physicians and treated with alprazolam (N = 21) or identified after 4 weeks (natural history controls, N = 20). Treatment resulted in improvement in 66% of the identified group versus a 35% spontaneous improvement in the control group (p less than .05).

Actuarial status of the Hospital Insurance and Supplementary Medical Insurance Trust Funds

This article, adapted from a summary of the 1983 Annual Reports of the Medicare Boards of Trustees, presents the present and projected future actuarial status of the Hospital Insurance (HI) and Supplementary Medical Insurance (SMI) Trust Funds following the enactment of the Tax Equity and Fiscal Responsibility Act of 1982 and the Social Security Amendments of 1983. Although the Trustees characterize the outlook for the HI Trust Fund as slightly more optimistic than it was a year earlier, they report that the fund may be exhausted sometime between 1988 and 1996 unless benefits under the HI part of Medicare are reduced or financing is improved. The SMI Trust Fund, which is financed by premiums adjusted each year to reflect actual experience and by general revenue contributions, is characterized as actuarially sound. The Trustees note, however, the growing extent to which general revenue financing is becoming the major source of income for the SMI part of Medicare.

The histological appearance of carbon fibre implants and neo-ligament in man

The results of this study indicate that a fibrous ingrowth occurs in man after surgical replacement of a tendon or ligament with carbon fibre. This ingrowth resembles normal tendon or ligament very closely, with parallel orientation of collagen fibres and fibroblasts. A multinucleate foreign-body giant-cell response was seen, but it was not possible to ascertain whether the fragmented carbon lay within or on these cells and other macrophagic components. Numerous intact carbon fibres were still present 2 and 3 years after implantation.

The effect of experimental ligation of the external carotid artery and its major branches on haemorrhage from the maxillary artery

The effect of ligation of the external carotid artery and its major branches on blood flow from the maxillary artery was investigated in four Chacma baboons. The left common carotid artery and its branches were surgically exposed and the maxillary artery was isolated, sectioned and cannulated. Blood flow from the proximal segment of the maxillary artery was determined with and without occlusion of the common carotid artery, the external carotid artery above and below the origin of the linguo-facial trunk and the posterior auricular occipital trunk. Ligation of the external carotid artery below and above the origin of the lingual and facial arteries reduced maxillary artery blood flow by 40% and 73% respectively. Ligation of the external carotid artery above the origin of the lingual and facial vessels, together with ligation of the posterior auricular occipital trunk reduced maxillary artery blood flow by 99.2%. On the basis of these experimental findings, it is suggested that maxillary artery haemorrhage in man may be most effectively controlled by ligation of the external carotid artery in the retromandibular fossa, distal to the origin of the posterior auricular artery, combined with ligation of the superficial temporal artery at the root of the zygoma.

A comparison of prazepam, diazepam, lorazepam and placebo in anxious outpatients in non-psychiatric private practices

A double-blind, random design, parallel group, four-week study of prazepam, diazepam, lorazepam, and placebo was conducted in diverse private outpatient practices (surgeon, internist, and obstetrician-gynecologist) using a common protocol, in order to evaluate their comparative efficacy in these settings. In addition, the effects of these anxiolytics on depressive symptoms in patients with anxiety were studied. Results showed that the non-psychiatric practitioners used lower dosages than psychiatrists in previous reports, and perception of anxiety levels of their patients were lower than the psychiatric raters. When patients were divided into two groups (1. predominantly depressed with anxiety, and 2. predominantly anxious with depression), differences between the benzodiazepines were shown. In the high depression-low anxiety group, all four treatment methods were effective in alleviating both anxiety and depression. In the high anxiety-low depression group, only prazepam and placebo were effective in alleviating both anxiety and depression, while diazepam and lorazepam decreased anxiety levels, but not depression.

Acute gastric dilation and rupture in Macaca arctoides associated with Clostridium perfringens

A clinical case of gastric dilation and rupture is described in an adult male Macaca arctoides. Clostridium perfringens was isolated from the heart blood and liver. Data collected from our macaque colony for 13 years indicated a mortality rate of 3.5% due to acute dilation.

Results of extended resection of tumors involving the cervical part of the trachea

Extended resection of the trachea with construction of a mediastinal tracheostomy was performed upon 21 patients with primary or recurrent carcinoma involving the cervical part of the trachea. In 12 patients, major complications developed, and eight died of these complications. Necrosis of skin flaps and tracheal wall, leading to sepsis of the mediastinum and rupture of major vessels, were the two most common complications and causes of death. Three patients remained free of disease for 143, 77 and 48 months. A review of this experience suggests that this procedure should be limited to patients witha tumor localized to the cervical portion of the trachea and that well vascularized skin flaps--myocutaneous flaps--should be used to resurface the mediastinum and base of the neck as a means of preventing most of the complications reported in this investigation.

Isolation of Staphylococcus hyicus subsp hyicus from a pig with septic polyarthritis

Staphylococcus hyicus subsp hyicus (coagulase-positive) was isolated in pure culture from the left coxafemoral and right shoulder joints of a 4-week-old pig with septic polyarthritis. Present taxonomic criteria and DNA-DNA hybridization studies with reference strains were utilized to identify the isolate. There were no clinical signs or generalized skin lesions of porcine exudative epidermitis noticed in this pig.

Fabrication of a maxillary complete denture utilizing the neuromuscular or centric occlusion position

The patient was unable to wear a maxillary complete denture that had been made from a verifiable record in the centric jaw relation position or terminal hinge position. When she brought her teeth together, only a few touched. Clinical examination showed that this patient had a discrepancy of approximately 3 mm anteroposteriorly and a discrepancy of 1 mm mediolaterally between the terminal hinge position and the centric occlusion or neuromuscular position. A new denture was made for the patient. The neuromuscular position was used as the starting position and as the position of maximum intercuspation (centric occlusion), and the terminal hinge position was used as a mounted border position of reference for occlusal adjustment and equilibration.

The host/parasite relationships of Xenopsylla astia and X. cheopis on Bandicota bengalensis in Rangoon, Burma

In Rangoon, Burma, over half the commensal B. bengalensis taken in live traps were found to be infested with Xenopsylla species fleas. X. astia infestations were twice as common as those of the classic plague vector X. cheopis. In terms of absolute numbers X. astia outnumbered X. cheopis by 10 to 1. X. astia was more commonly found as a monospecific infestation, and X. cheopis was more commonly found mixed with X. astia. The flea indicies were high, with a specific index of 2.4 for X. cheopis and 10.2 for X. astia. The flea indicies and flea sex ratios remained stable across the host population and could not be correlated to changes in the head and body length of the host and were not different on male or female hosts. The evidence of this and other surveys is that X. cheopis is not as well adapted for parasitism on free ranging B. bengalensis as is X. astia.

Basal cell extensions in human oral mucosa

Basal cell extensions have frequently been observed in a variety of odontogenic lesions as well as in the fibrous epulis (fibrous hyperplasia of the gingiva). In order to determine the frequency of these extensions in normal human oral nucosa, a study using autopsy and surgical material was conducted. The results indicated that a specific type of rete ridge morphology exists for gingiva, including the presence of thin double stranded extensions which may be related to the functional role of the gingiva or to the fact that the odontogenic apparatus is derived from surface epithelium in this region in the developing embryo, or both. Similar extensions have not been found in other oral epithelia.

Aflatoxicosis in swine

In an episode of aflatoxicosis in feeder pigs, mortality was about 20%. Histopathologic findings characteristic of experimentally induced aflatoxicosis and the finding of aflatoxin B1 in the serum of pigs and in the cornbased feed confirmed the diagnosis. Aflatoxins B1 and B2 were found in the corn used to prepare the feed. Combine harvesting of the corn, which cracked a large percentage of the kernels, coupled with prolonged drying time of the corn probably contributed to the aflatoxin production. Although the corn was fed to adult swine without observable effect, 47 of the 250 feeder pigs developed typical signs of aflatoxicosis. Unseasonably cold weather apparently was a factor in initiating the onset of clinical signs and probably increased the severity of the disease.

Control and monitoring system for clinically employed pneumatic blood pumps

Instantaneous position of the flexing member in pneumatic blood pumps is monitored on-line by measuring the electrical capacitance across the gas space within the pump. Monitor output is utilized in closed-loop pump control and for automatic pump shutdown in response to operational abnormalities. Thus, safety and efficacy are enhanced through operational optimization, automatic safety features, and facilitated evaluation.

Mycobacterium tuberculosis infection in two East African oryxes

Tuberculous lesions were observed at necropsy of 2 East African oryxes (Oryx gazella beisa) at a municipal zoological park in Jackson, Ms. Microscopic examination revealed granulomas containing acid-fast bacilli in the lungs and liver of both animals, as well as in the uterus and mediastinal lymph nodes of 1 animal. Mycobacterium tuberculosis was isolated from the tissues of both oryxes and from fluid aspirated from the mammary gland of 1 oryx; the organism was pathogenic for guinea pigs but not for rabbits.