Outbreak of paralytic poliomyelitis in a highly immunized population in Jordan

Between November 1991 and March 1992, 37 cases of paralytic poliomyelitis occurred in Jordan, where none had been reported since 1988. Of these, 17 (50%) of 34 patients had received at least three doses of oral poliovirus vaccine (OPV3). The first and 2 subsequent case-patients were children of Pakistani migrant workers, and the first 8 and a total of 27 (75%) case-patients resided in or near the Jordan Valley. A seroepidemiologic study of 987 children in all regions of Jordan was performed to assess OPV3 coverage and immune response to OPV. Although OPV3 coverage by 12 months of age was high (96%) in the general population, coverage was lower among Pakistani (21%), Bedouin (63%), and Gypsy (9%) children (P < .001). Seroprevalences for poliovirus type 3 were 71% in the Jordan Valley versus 81% in other regions after 3 doses of OPV (P < .06) and 77% in the Jordan Valley versus 98% in other regions after 5 doses of OPV (P < .001). This outbreak demonstrates the importance of achieving high seroimmunity to infection in all geographic areas to prevent the reintroduction and spread of imported strains of wild poliovirus.

Histone hyperacetylating agents stimulate promoter activity of human choline acetyltransferase gene in transfection experiment

Butyrate (5 mM), Trichostatin A (1 microM) or Trapoxin A (30 nM) increased choline acetyltransferase (ChAT) activity in cultured rat sympathetic neurons 3- to 8-fold in 2 days. On the contrary, the three drugs decreased ChAT activity in human CHP126 cells. Butyrate had little effect on ChAT mRNA level in these cells, suggesting post-transcriptional mechanisms for the decrease in ChAT activity. However, transient transfection experiments using CHP126 cells revealed that the M promoter, but not the R promoter, of human ChAT gene was activated 20- to 130-fold by the three hyperacetylating agents. A butyrate-responsive element was localized in the 1 kbp region upstream of exon M. Constructs containing in addition the genomic segment between exons M and 1 displayed maximal basal activity and inducibility by butyrate, suggesting the presence of butyrate-activated promoter/enhancer elements in this region. The stimulatory effects of butyrate and Trichostatin A were also observed in stably transfected CHP126 clones, suggesting that the chromatin environment was not preventing the induction of the endogenous ChAT gene by butyrate. Rather, the data suggest different chromatin organizations for the stable transgene and the endogenous ChAT gene.

Working with the family: the role of values

In this paper, we have examined that ethical aspect of working with families which stresses the relevance of values. Given that values are at the heart of both the family's and the therapists's view of the world, we see it as crucial for them to be addressed in the course of assessment and treatment. A variety of approaches have been adopted by clinicians ranging from those who regard ethics as a cornerstone of therapy to more compartmentalized positions, whereby specific sociopolitical themes like racism, poverty, and sexism are highlighted. Whatever model is preferred, the essential task is to accept that values are a necessary feature of therapeutic work and require negotiation. Failure to do so may have adverse repercussions on the therapist-family relationship, even to the point of jeopardizing therapy. Guidelines can be articulated to forestall such unfortunate consequences. We have attempted to identify these in the hope of clarifying for therapists the necessary steps they need to take to safeguard the family's interests and achieve an optimal ethical (and clinical) outcome.

A controlled trial of a counselling intervention for caregivers of relatives with schizophrenia

The effectiveness of short-term interventions to reduce caregiver 'burden' has not been clearly demonstrated. This study assessed the value of six weekly sessions of counselling for key relatives of patients with schizophrenia. The counselling had educational and problem-solving components and was conducted in the family home in the absence of the patient. A randomised controlled design was used. The subjects were the principal caregivers of patients consecutively admitted to acute psychiatric care. Assessments were made pre-treatment and at 3 and 6 months. Of 63 relatives recruited, 47 completed all phases of the study. Relatives in the intervention group reported that they were better able to understand the patient and had a more positive relationship. There were no differences between the intervention and control groups on negative aspects of caregiving or in coping style. Relatives who received the counselling reported slightly greater psychological morbidity at follow-up. However, they all said they would recommend it to others. We concluded that a brief, intensive counselling intervention was of modest benefit to caregivers. Some modifications are suggested.

Caring for relatives with serious mental illness: the development of the Experience of Caregiving Inventory

The aim of this study was to develop a practical, comprehensive, and valid self-report measure of the experience of caring for a relative with a serious mental illness. The notion of caregiver "burden' was rejected; instead caregiving was conceptualised within a 'stress-appraisal-coping' framework. A 66-item version of the Experience of Caregiving Inventory (ECI) was derived from analyses of responses from 626 caregivers, and then tested on an independent sample of 63 relatives of patients with schizophrenia recently in acute care. The extent to which the ECI complied with the stress-coping model was tested, especially the degree to which it, in association with coping, predicted psychological morbidity in carers. Ten sub-scales with good internal consistency resulted from our analyses, eight negative (difficult behaviours; negative symptoms; stigma; problems with services; effects on the family; the need to provide backup; dependency; loss) and two positive (rewarding personal experiences; good aspects of the relationship with the patient). The ECI, in conjunction with coping style, predicted a large proportion of the variance in the General Health Questionnaire (GHQ). We concluded that the ECI taps salient dimensions of caregiving distinct from, although linked with, coping and psychological morbidity. It has potential as a useful outcome measure for interventions aimed at promoting caregiver well-being.

The Melbourne Family Grief Study, II: Psychosocial morbidity and grief in bereaved families

OBJECTIVE

The aim of this study was to describe the intensity of grief, the psychosocial morbidity, and the coping patterns in members of families classified according to a typology of family functioning comprising supportive, conflict-resolving, intermediate, sullen, and hostile classes.

METHOD

One hundred fifteen families were assessed longitudinally 6 weeks (time 1), 6 months (time 2), and 13 months (time 3) after the death of a parent (constituting 670 individual responses) on measures of grief intensity, psychological state, social adjustment, and family coping. A previously described typology of perceptions of family functioning was applied. Repeated measures multivariate analysis of variance based on both individuals and families and post hoc comparisons of significant results were undertaken.

RESULTS

Sullen families displayed the most intense grief and the most severe psychosocial morbidity. Well-functioning families (supportive and conflict-resolving) resolved their grief and adjusted more adaptively than their dysfunctional counterparts (intermediate, sullen, and hostile families). There were no cluster-by-time interactions. The clusters accounted for 15.7% of the variance in depression (Beck Depression Inventory) and 27.9% of the variance in social functioning (Social Adjustment Scale). Well-functioning families used more family coping strategies (Family Crisis Oriented Personal Evaluation Scales).

CONCLUSIONS

More intense grief and greater psychosocial morbidity are found in sullen, hostile, and intermediate bereaved families than in the more adaptive supportive and conflict-resolving types. At-risk families are identifiable and could be treated preventively to reduce morbidity.

The Melbourne Family Grief Study, I: Perceptions of family functioning in bereavement

OBJECTIVE

The aim of this study was to identify patterns of family functioning in adult families after the death of a parent.

METHOD

One hundred fifteen families completed measures of family functioning, grief, psychological state, and social adjustment 6 weeks (time 1), 6 months (time 2), and 13 months (time 3) after the death of a parent (a total of 670 individual responses). Cluster analytic methods were applied to develop a typology of perceptions of family functioning during bereavement.

RESULTS

Five types of families emerged from dimensions of cohesiveness, conflict, and expressiveness on the Family Environment Scale. Thirty-six percent of the families were considered supportive because of their high cohesiveness, and another 23% resolved conflict effectively. Two types were dysfunctional: hostile families, distinguished by high conflict, low cohesiveness, and poor expressiveness, and sullen families, who had more moderate limitations in these three areas; they declined in frequency from 30% at time 1 to 15% at time 3. The remaining type (26%), termed intermediate, exhibited midrange cohesiveness, low control, and low achievement orientation. The typology at time 1 predicted typologies at time 2 and time 3. There were no age or gender differences among the family types, but offspring, as compared with spouses, were overrepresented in the hostile families.

CONCLUSIONS

Family types can be identified, allowing at-risk families to be helped to prevent complications of grief. Screening with the family relationship index of the Family Environment Scale would facilitate such a family-centered approach.

Counseling caregivers of relatives with schizophrenia: themes, interventions, and caveats

As part of a controlled study of the effectiveness of a counseling program for family caregivers of patients with schizophrenia, we conducted a comprehensive examination of the process. The particular foci were on themes that arose during sessions, principal therapeutic interventions offered, and caveats for counselors working in the field. The most striking finding was the diverse range of themes, covering personal, coping, family, and social aspects of the caregiving experience. This required a correspondingly broad array of interventions. The implications are clear: confining counseling for caregivers to such traditional dimensions as education or attempts to reduce emotional expressiveness denies them the opportunity to deal with other equally relevant concerns.

Can patients safely read their psychiatric records? Implications of freedom of information legislation

OBJECTIVE

To assess how suitable psychiatric medical records are for access by patients.

DESIGN

We examined a random selection of psychiatric records to identify features which we thought might be confusing or injurious to a patient reading his or her own record.

RESULTS

Potentially offensive, alarming or upsetting entries were found in most records.

CONCLUSION

Clinicians need to take care in recording information in medical records lest patients be adversely affected by the experience of reading their notes. Access should always be arranged in conjunction with a medical supervisor.

Developing a code of ethics for psychiatry: the Australasian experience

The first ever code of ethics of the Royal Australian and New Zealand College of Psychiatrists was promulgated in 1992. In this paper two of the four members of the College's Ethics Committee (which prepared the document) describe the code's provenance and the procedure used to determine its form and content. The code, a milestone in the College's history, reflects its maturity in confronting the many ethical issues with which psychiatrists have to wrestle in contemporary clinical (and research) practice. We hope that our account will assist them to deal effectively with this pivotal aspect of their professional work.

Family grief

As grief is both an individual and shared experience, adopting a systemic perspective is most appropriate for health-care professionals seeking to assist the bereaved. Within this framework, the family virtually always constitutes the most significant social group in which grief is experienced. In this paper we review the literature on family grief, covering clinical case reports, the observations of family therapists, systematic family bereavement research and family intervention studies. An understanding of patterns of family grief and vulnerability factors for morbid grief is pivotal to both preventive intervention and treatment of an established disorder.

Drug and alcohol abuse by doctors

OBJECTIVE

To determine whether doctors who abuse substances differ from controls in terms of their physical and psychological well-being, and their marital and occupational functioning.

DESIGN AND PARTICIPANTS

The 44 doctors concerned in all cases of substance abuse which came before the Medical Board of Victoria between 1984 and 1990 were invited to complete a demographic questionnaire, psychological tests and a semi-structured interview. A control group of 42 doctors, obtained from the Medical Register, was also invited, and the groups were compared.

SETTING

The study was carried out at St Vincent's Hospital, Melbourne, under the auspices of the Medical Board of Victoria.

RESULTS

Questionnaires were returned by 70% of the drug-dependent doctors and 83% of the controls. However, interviews were given by only 20% of the drug-dependent doctors. The groups differed significantly in terms of marital status (P < 0.002), overall health (P < 0.003), general wellbeing (P < 0.0009), and having experienced physical illness (P < 0.02) and psychiatric illness (P < 0.006) since graduation. No differences were found on the standardised questionnaires; this may reflect successful treatment.

CONCLUSION

Substance abuse in medical practitioners is a major problem and is associated with considerable morbidity. Prevention and early intervention are crucial.

Joint uptake and body distribution of a technetium-99m-labeled anti-rat-CD4 monoclonal antibody in rat adjuvant arthritis

Joint uptake and body distribution of a 99mTc-labeled monoclonal antibody (Mab) to the rat CD4 molecule (W3/25; IgG1) were investigated after intravenous injection in normal rats and in animals with experimentally induced adjuvant arthritis. An isotype-matched Mab with irrelevant specificity (anti-human carcino-embryonic-antigen) was used as control. A 4 hr sequential gamma-camera imaging revealed that both anti-CD4 and control Mab accumulated to a higher degree in arthritic than in normal ankle joints; the accumulation was comparable for the two Mabs. In contrast to the inflamed joints, a specific accumulation of the anti-CD4 Mab was found in organs rich in CD4-positive cells, i.e. spleen, bone marrow and lymph nodes, as assessed by direct well counter measurements 16 hr after injection. The control Mab displayed no preferential organ accumulation in either normal or diseased animals. These results indicate that a specific accumulation of anti-CD4 Mabs occurs in CD4-positive-cell-rich tissues in both normal and diseased animals and that immunoglobulins accumulate preferentially in inflamed joints regardless of their antibody specificity.

A systems approach to loss

Following the death of a family member, the mourners' experiences of grief are inevitably influenced by and, in turn, influence the experiences of their relatives. Therapy should apply a model which takes this interactive process into account. A systems approach can fulfil this requirement in certain cases. Three case histories are provided to illustrate the potential effectiveness of a systems-oriented intervention. The questions still remain as to when the model is optimally applied, and whether it has a role in preventive psychiatry.

Systemic family therapy in adult psychiatry. A review of 50 families

The place of family therapy in adult clinical psychiatry remains unclear, despite considerable theoretical developments in the subject. In order to delineate the potential role of a family therapeutic approach, a study was conducted of the first 50 families treated in a newly established family-therapy clinical located in an adult psychiatric hospital.

Specific respiratory patterns distinguish among human basic emotions

Prototypical respiratory-facial-postural actions ('emotional effector patterns') related to six basic emotions had been extracted from an ensemble of physiological reactions present in subjects reliving intense emotional situations (Bloch & Santibañez, 1972). Subjects reproducing these actions could evoke the corresponding subjective experience, which suggested their use as an experimental model for generating controlled emotional states. The aim of the present study was to quantify the respiratory parameters which characterize the emotions of joy-laughter, sadness-crying, fear-anxiety, anger, erotic love and tenderness. Respiratory movements and facial/postural expressions were recorded from 36 young actors who had learned in previous workshops to express these emotions by reproducing the corresponding prototypical actions. A qualitative analysis of the recordings showed that as the emotional reproduction went along, both breathing and expression evolved from an initial 'robot-like' phase to a more natural stage in which spontaneous vocalizations and gestures appeared. This suggested a partial activation of the emotional network. The quantitative analysis of the respiratory movements for the fundamental cycles showed that for anger, erotic love and tenderness significant changes in amplitude, rate and duration of the 'expiratory pause' were the major elements of differentiation, while for sadness, joy and fear inspiratory over expiratory time ratios were the elements of differentiation. These last three emotions were further characterized by small amplitude/high rate saccadic respiratory movements superposed to different phases of the fundamental cycles. It is concluded that quantitatively well differentiated sets of respiratory changes characterize each of six basic emotions. The bottom-up experimental model for generating such emotions based on the joint activation of the respiratory-facial-postural systems and its relation to corresponding 'real-life' emotions is discussed.

Interocular transfer of depth discrimination in intact and in DSO-sectioned pigeons

Interocular transfer (IOT) of a depth discrimination task was studied in intact pigeons and with a section of the supraoptic decussation (DSO). Animals were trained to respond to the nearer of two small light emitting diodes placed at different depths in the left and right compartments of a black tunnel. The near stimulus (at 10.5 cm from the eyes) and the far one (at 21 cm) could only be seen one at a time. Though the task was difficult to learn monocularly, intact as well as lesioned animals had good transfer scores with the untrained eye. Success in transfer may be related to the presentation of the discriminanda which assured that their images impinged upon the retinal 'red field'. DSO-transection did not affect IOT possibly because differential oculomotor adjustments needed for focusing near or far targets provide central bilateral and/or binocular information which is not conveyed by the DSO.

Color mixing in the pigeon. A psychophysical determination in the longwave spectral range

Pigeons were trained to discriminate between spectral lights and additive mixtures in the 580-640 nm range. Two behavioral procedures were used: (I) a simultaneous instrumental discrimination and (II) successive "autoshaping" discrimination. Pigeons were able to make color mixture matches within this spectral range with satisfactory precision. Matchings determined by the animal correspond well to those predicted on the basis of the spectral sensitivities of two (or even three) pigment-droplet combinations present in the pigeon retina.

Purification and characterization of Aeromonas hydrophila beta-hemolysin

Aeromonas hydrophila hemolysin was excreted in our culture conditions during the stationary growth phase. The toxin was purified to homogeneity by a three-step method: ultrafiltration, acid precipitation in the presence of RNA and anion exchange chromatography with FPLC apparatus. Beta-hemolysin is a protein not associated with lipids, carbohydrates or nucleic acids whose subunit mol. wt is 51,000. The mol. wt determined by polyacrylamide gel electrophoresis suggests that the molecule is in a trimeric form. The toxin is thermolabile and inactivated by proteolytic enzymes such as trypsin, chymotrypsin, pronase, subtilisin and proteinase K. Antibodies raised against the beta-hemolysin neutralize both hemolytic and cytotoxic activities. When injected at high dose, this purified hemolytic protein causes a positive rabbit ileal loop test, thus indicating that beta-hemolysin could be the main virulence factor involved in intestinal symptoms.

Depth resolution in the pigeon

Pigeons possess a binocular visual field and a retinal region of higher cellular density pointing to the center of this overlap. These features and the precision of pecking behavior suggest that in this lateral-eyed bird cues other than monocular ones might participate in depth judgements. Pigeons were trained with an operant procedure to discriminate between luminous points differing in depth which appeared to the observer as floating in the dark. The accuracy of depth judgements was found to be a function of the ratio between the interstimulus distance and the mean eyes-to-stimulus distance. In a first test (experiment I) no external binocular disparity cues were available, the animal only seeing one luminous point at a time (near or far). In a second test (experiment II) where binocular disparity cues were available, the animal having this time to discriminate a pair of points placed at equal depth from a pair placed at unequal depths, only one pair being visible at a time, depth resolution did not improve. This suggests that, at least within the range of distances explored, the pigeon has no stereoscopic vision. Notwithstanding this, binocular cues do play a role, since when tests were done comparing binocular with monocular viewing (experiment III), monocular depth resolution was significantly worse.

Subacute osteoporotic compression fracture: misleading magnetic resonance appearance

Three patients with benign subacute osteoporotic vertebral compression fractures are presented. T1 weighted magnetic resonance (MR) images (SE 500/30) showed decreased vertebral signal. Because the results of the MR examination were thought to indicate malignant disease, extensive medical workups, including one biopsy, were pursued in all three patients. Routine (SE 500/30) spin-echo pulse sequences cannot definitively distinguish between benign and malignant vertebral compression fractures.

Psychotherapy and dysmorphophobia: a case report

The treatment of patients with dysmorphophobia remains a confused matter, probably because of clinical heterogeneity. Our experience with the case reported in this paper suggests that psychodynamic psychotherapy is indicated for certain carefully selected patients.

Family life and diabetic control

Seventy two children with diabetes and their parents were studied to examine the relationship between family functioning and diabetic control. Children in families characterised by cohesion, emotional expressiveness, lack of conflict and a mother satisfied with her marriage, had better diabetic control than children living in families with opposing characteristics. Children living with both biological parents or with a single parent had significantly better diabetic control than those living with a step-parent or adoptive parents. There was no relationship between social class, family income, employment status or educational attainment of either parent, and diabetic control.

Chick brain glutamine synthetase and Mn2+-Mg2+ interactions

Glutamine synthetase (GS) from the chick brain was purified to apparent homogeneity by ammonium sulfate fractionation followed by affinity chromatography, electrofocusing and Sephadex G-150 chromatography. The purified enzyme showed a single band on sodium dodecyl sulfate analysis in polyacrylamide gel. By sedimentation equilibrium analysis and gel electrophoresis analysis, it was shown that the enzyme has a subunit molecular weight of 45,000 and a native molecular weight of 364,000, which is consistent with an octameric structure. Sedimentation analysis in the presence of Mg2+ revealed three different forms of macromolecules corresponding respectively to a monomer, a tetramer and an octamer. Among eight cations tested (Ca2+, Co2+, Fe2+, Li+, Mg2+, Mn2+, Ni2+, Zn2+) only Co2+, Mg2+ and Mn2+ supported GS activity; the order of activatory ability was Mg2+ greater than Co2+ greater than Mn2+. The maximum activating effect of Mn2+ occurs only within a very narrow range of concentration: with an excess of cation causing strong inhibition of GS activity. For each cation, maximal GS activity occurs at a defined cation/ATP ratio. A regulatory system in which Mn2+, modulates the Mg2+ dependent GS activity, is proposed; such cation interactions may be of significance in the intracellular control of glutamine synthesis.

Informed consent and the psychiatric patient

Informed consent is reviewed as it applies to psychiatric patients. Although new legislation, such as the Mental Health Act 1983, provides a useful safeguard for the protection of the civil rights of patients, it could actually reduce their humane care unless applied with sensitivity for the nature of their unique difficulties. In order to guard against this possibility, we suggest that legal requirements should be considered in light of the ethical principles which underlie them. Three principles are considered: those of autonomy (freedom); beneficence (paternalism); and the fiduciary principle (partnership). Psychotherapy is offered as a model for informed consent, which might be generalised to other clinical situations.

Goals of treatment in diabetes: a comparison of doctors and parents of children with diabetes

Treatment failure is usually understood as a problem of patient compliance. This paper suggests another approach: to see this problem as resulting from a difference in the goals of the two parties involved, the doctor and the patient. Comparison was made between the goals of doctors and those of parents in treating children with diabetes. Significant differences emerged between the goals. Parents' goals of treatment were governed more by avoidance of the short-term threat of diabetes (hypoglycemia); doctors' goals more by the long-term threat of diabetes (diabetic complications). The outcome of treatment (diabetic control) was more closely related to parents' than doctors' goals of control. These results indicate that doctors and patients do not always share the same goals in treatment. It is suggested that a more effective clinical alliance would result if the goals of the clinical team were at least made explicit, even if they were not always shared.

Glutamine synthetase and energy metabolism enzymes in cultivated chick neurons and astrocytes: modulation by serum and hydrocortisone

Primary cultures of astroglial cells and of neurons obtained from chick embryos were grown in culture medium with and without serum added. The expression of glutamine synthetase (GS) in the cultured nerve cells was investigated immunocytochemically and biochemically. The cellular localization of GS in cerebellar tissue sections and in cerebral cortex of chick embryos was investigated by immunohistochemical staining. In tissue sections the enzyme is only present in astrocytes and their processes; neurons and their structures do not express the enzyme. In contrast, in pure neuronal primary cultures, a high level of GS was detected by biochemical and immunochemical methods. Thus, our results clearly indicate the presence of GS in pure neuronal cell cultures and its absence in this type of cells in vivo. Removal of serum from the culture medium enhanced GS levels in primary astrocyte cultures, but was without effect on GS activity in neurons. Addition of calf serum to the culture medium induces a two-fold increase of cellular lactate dehydrogenase (LDH) activity in neurons by increasing specifically the M subunit containing isoenzymes. The sensitivity of chick astroglial cells and neurons toward the GS inducing effect of hydrocortisone and modulation of its effect by serum was also investigated. Differences in the sensitivity of the two types of nerve cells in culture toward the GS inducing effect of hydrocortisone, and the effect of serum could be demonstrated.

A qualitative analysis of emotional effector patterns and their feedback

This paper is devoted to the study of the relationship between the subjective component (feelings) and the behavioral aspect of emotions. The following emotions were studied: fear-anxiety, anger-aggression, joy-laughter, love-eroticism, love-tenderness, and sadness-tears. The observations were performed with three different groups of people: patients with anxiety neurosis, students under hypnosis, and drama students. Each emotion was characterized by a specific set of reactions in the respiratory pattern, heart activity, muscular activity, and facial expression. The feelings were correlated with the behavioral patterns and each time the behavioral patterns were interfered with a concomitant modification of the subjectivity component was observed. The direct performance of the behavioral emotional patterns in the absence of the emotogenic stimulus produced the feeling corresponding to the mimicked emotion. If the subjects were stimulated with an emotogenic stimulus during the direct performance of the behavioral patterns of another emotion, they confessed to have the feeling corresponding to the mimicked emotion, and not to the emotion belonging to the emotogenic stimulus. The role played by the feedback from the effector organs in the determination of the subjective emotional states is discussed.

Glutamine synthetase and energy metabolism enzymes in cultured chick glial cells: modulation by dibutyryl cyclic AMP, hydrocortisone, and trypsinization

Modifications induced by dibutyryl cyclic AMP (diBcAMP) and hydrocortisone in the energy metabolism of chick astroblasts in culture have been investigated. DiBcAMP does not modify the levels of enolase, malate dehydrogenase (MDH), total lactate dehydrogenase (LDH) and glutamine synthetase (GS) activities in these cultured glial cells. However, these cells can be sensitized to the nucleotide analog by trypsinization before seeding. The phenomenon affects specifically GS activity and the synthesis, with an inhibitory effect, of the H subunit of LDH. Addition of hydrocortisone to the culture medium stimulates MDH and GS activities of the cells; trypsinization accentuates the stimulatory effect on GS. This hormone also modifies the synthesis of H and M subunits of LDH in a positive and negative way respectively. The phenomenon is increased by trypsin treatment. The present studies indicate clearly that hydrocortisone generates in cultured chick glial cells metabolic modifications qualitatively different from those obtained by diBcAMP. It is suggested that trypsin treatment, by altering some protein constituents of the cell surface, modifies the adhesiveness of different cell types present in the cell suspension after dissociation of the brain and thus leads to select, in culture, a specific astroglial subpopulation.

What price psychotherapy? A rejoinder

In 1952 Eysenck threw down the gauntlet, when he claimed that psychoanalytical forms of psychotherapy were no more effective than spontaneous remission. As we trudge through the fourth decade of this debate, its quality remains as divisive and acrimonious as ever. Professor Michael Shepherd (1979, 1980) has latterly taken on Eysenck's mantle, averring that psychotherapy is not only ineffective but may actually harm patients. In an editorial in the British Medical Journal (1984), he launched yet a further attack, arguing on this occasion that the psychotherapist is little more than a ‘placebologist’ exerting his effects through nonspecific means. Why bother with highly trained therapists when an inert pill will produce the same result?

Comparing frontal and lateral viewing in the pigeon. III. Different patterns of eye movements for binocular and monocular fixation

The presence in the pigeon's retina of two areas of higher cellular density which we have shown mediate different visual functions, suggests the existence of two modes of fixation: a lateral monocular and a frontal binocular one. The participation of eye movements in these modes of fixation remained unexplored. We analyzed oculomotor behaviour in awake head-restrained pigeons by means of EOG and video film. Orienting saccades attaining up to 17 degrees from the resting positions could be elicited by presenting stimuli in different parts of the visual field. Two typical ocular patterns were consistently observed to the sudden presentation of large and novel stimuli: coordinated vergence of both eyes (even with one eye occluded) to stimulation within the frontal binocular field, and uncoordinated ipsilateral saccades to stimuli moving in one lateral field. Results point towards two different and reciprocally exclusive mechanisms of oculomotor control in the pigeon. The relevance of a trident mode of vision correlated to retinal organization and living praxis of some lateral-eyed vertebrates is discussed.

Pigeon's eyes converge during feeding: evidence for frontal binocular fixation in a lateral-eyed bird

Pigeons' head-in-space and eye-in-head positions were simultaneously recorded (EOG) in video during feeding. A linear correlation was found between the experimentally measured eye convergence (sum of both EOGs ) and grain parallax (calculated from interocular and eye-to-grain distances). This graded convergence of the eyes on approaching a target is considered evidence of frontal binocular fixation. Since such convergence prevails when the animal is forced to rely on frontal monocular or on lateral vision, a central mechanism controlling frontal fixation in the pigeon must be presupposed .

Interhemispheric differences in regional density of the normal brain

In a study of regional variations in cerebral X-ray attenuation as measured by computed tomography, a relationship between bone-related beam hardening and lateralized hemispheric density differences was sought. The CT scans of 22 normal right-handed individuals were evaluated by calculating regional mean attenuation values and regional left-right differences in attenuation, comparing these to regional measurements of skull thickness. A statistically insignificant number of significant correlations was found. This is interpreted to mean that observed left-right hemispheric density differences are not due to beam-hardening through bone. It was also found that left-right differences in density persisted over the entirety of the evaluated slices, suggesting that this finding is due to inherent hemispheric structural differences.

Trypsinization of chick glial cells before seeding: effects on energy metabolism enzymes and glutamine synthetase

In order to test the possible involvement of surface proteins on some metabolical aspects of chick glial cell differentiation in culture, perturbations were induced on the glial cell surface membrane by limited trypsinization before seeding. The developmental changes of enzymes involved in the energy metabolism of the cell: malate dehydrogenase (MDH), glutamate dehydrogenase (GDH), hexokinase (HK), lactate dehydrogenase (LDH), enolase as well as glutamine synthetase (GS) were determined in trypsin treated cells and controls. The total protein and DNA content per dish was higher in treated cells than in controls, however the protein ratio towards DNA remained unchanged. The levels of GS, GDH, LDH, and enolase activities were significantly enhanced after trypsin treatment of the cells compared to controls. The enhanced value of total LDH activity is essentially the result of the increase of M subunit containing isoenzymes. Considering that a higher level of GS activity characterizes some maturation of the glial cells (as observed during the maturation of the chick brain) it is apparent that modifications of cell surface located factors, by trypsin treatment, induce differentiation phenomena at the functional state of the glial cells in culture. This may indicate that interactions located at the cell surface are involved in the modulation of key enzymes of the energy metabolism pathway.

Cerebellopontine angle lipoma: a review

Lipomas located in the cerebellopontine angle (CPA) have rarely been reported. With the advent of computed tomographic scanning and more sophisticated physiological diagnostic techniques, CPA lipomas are being reported more frequently. This paper reviews the world's literature on this lesion and summarizes the symptoms and signs, diagnostic studies, pathology, and surgical results. Recommendations regarding the therapy of this lesion are presented.

Comparing frontal and lateral viewing in the pigeon. II. Velocity thresholds for movement discrimination

Pigeons have been described as poor movement detectors when tested in the frontal binocular field. Retinal organization and behaviour suggest that motion sensitivity may be better in the lateral field. Pigeons were trained to discriminate the direction of moving square gratings (0.3 cyc/deg) appearing briefly (250 msec) contingent upon pecking a key (behavioural fixation). Stimuli were presented at isoacuity distance (40 cm) 25 degrees below the beak for frontal and 80 degrees back from the beak for lateral viewing. The animal had to discriminate the direction of movement for decreasing angular velocities. Results show that lateral motion sensitivity in the pigeon is 3 times better than frontal motion sensitivity. The fovea centralis, looking laterally, seems to be adapted for motion detection and may play a special role in the recognition of moving predators.

Humour in group psychotherapy

The role of humour in group psychotherapy has received scant attention from both clinician and researcher. We have identified, and attempted to classify, several uses to which humour can be put in a group. We also point out the destructive potential of humour, and categorize its misapplications. We hope our scheme will serve as a framework within which systematic research can be conducted.

A preparatory interview for the neophyte group therapist

On the premiss that an important aim of the initial phase of supervision of the neophyte group psychotherapist is to convert a new and threatening situation into an old and familiar one, the function of a preparatory interview--whose focus was the therapist's set of expectations about his impending experience of leading a group--was examined. The findings of a series of 26 interviews point to the need for a systematic controlled study to test the effects of a preparatory interview of the trainee therapist on group process and leadership behaviour.

Comparing frontal and lateral viewing in the pigeon. I. Tachistoscopic visual acuity as a function of distance

Pigeon's visual acuity has mainly been tested in free viewing conditions so that the direction of gaze could not be controlled. In order to be able to compare the resolving power of the two retinal areas of higher cellular density--the area dorsalis in the red field with frontal binocular projection and the fovea centralis with lateral monocular projection--a method of behavioural fixation was used. This method consists in a forced pecking schedule and a tachistocopic presentation of the stimulus. The pigeon has to discriminate the orientation (vertical, positive; horizontal, negative) of square gratings of increasing spatial frequency. Tests were done with the stimuli appearing 25 degrees below the beak for frontal and 80 degrees back from the beak for lateral viewing, at distances of 10, 20, 40 and 80 cm for each direction. Results show that while frontal acuity decreases with distance, lateral acuity increases with distance. These psychophysical data confirm previous dioptric measurements done on frozen eyes, showing that the pigeon is myopic in the frontal field and hyperopic in the lateral field. Pigeons seem to be well adapted for visually guided frontal tasks at near distances (feeding, landing) and for visually guided lateral tasks at far distances (warning).