A randomized, double-blind, comparative trial comparing high- and standard-dose oral acyclovir for first-episode genital herpes infections

Orally administered acyclovir ameliorates the clinical course and decreases the duration of viral shedding in patients with first-episode genital herpes infections. We investigated in a randomized, double-blind, comparative trial whether a higher (4 g) than standard (1 g) daily dose of oral acyclovir results in greater clinical benefit and influences the time to first recurrence. A total of 139 patients with first-episode genital herpes were randomized to receive orally 4 or 1 g of acyclovir daily. A total of 52 subjects were excluded from the efficacy analysis because most had recurrent disease. Of 87 eligible subjects, 28 (32%) had primary herpes simplex virus type 1 (HSV-1) infections, 48 (55%) had primary HSV-2 infections, and 11 (13%) had nonprimary HSV-2 infections. We did not find any statistically significant differences in the duration of symptoms or viral shedding between the two dose groups, nor did the median time to first recurrence differ between the two groups. Initiation of therapy with either dose within the first 3 days of the appearance of symptoms shortened the duration of the first episode. Adverse gastrointestinal effects developed in 8% of subjects receiving the higher dose, whereas no adverse reactions were observed among those receiving the standard dose (P = 0.10). We conclude that, in comparison with standard therapy, higher-dose oral acyclovir does not result in additional clinical benefit or modify the time to first recurrence. The present study may have implications for the development and efficacy of congeners of acyclovir which provide higher levels in blood than the standard dose of acyclovir.

Single-dose and three-day regimens of ofloxacin versus trimethoprim-sulfamethoxazole for acute cystitis in women

We compared the safety and efficacy of a single 400-mg dose of ofloxacin, ofloxacin (200 mg) once daily for 3 days, and trimethoprim-sulfamethoxazole (160:800 mg) twice daily for 7 days for the treatment of acute uncomplicated cystitis (urinary tract infection [UTI]) in women. At 5 weeks posttreatment, 35 (81%) of 43 patients treated with single-dose ofloxacin, 40 (89%) of 45 treated with 3 days of ofloxacin, and 41 (98%) of 42 treated with trimethoprim-sulfamethoxazole were cured (P = 0.03, single-dose ofloxacin group versus trimethoprim-sulfamethoxazole group). Retreatment for symptomatic recurrent UTI was given to 7 (16%) of 43 patients initially treated with single-dose ofloxacin, 3 (7%) of 45 patients treated with 3 days of ofloxacin, and 0 of 42 patients treated with trimethoprim-sulfamethoxazole (P = 0.01, single-dose ofloxacin group versus trimethoprim-sulfamethoxazole group). There was a trend in each of the three treatment groups toward an association between persistent or recurrent episodes of significant bacteriuria and a history of UTI in the past year and with diaphragm use. Ofloxacin was more effective than trimethoprim-sulfamethoxazole in eradicating Escherichia coli from rectal cultures during or soon after therapy, but there were no differences at later follow-up visits. Adverse effects were equally common among the three treatment groups. We conclude that single-dose ofloxacin was less effective than 7 days of trimethoprim-sulfamethoxazole for treatment of uncomplicated cystitis in women, while the 3-day ofloxacin regimen and the trimethoprim-sulfamethoxazole regimen were not significantly different in efficacy.

[A comparison of conventional tomography and computed tomography in cases of diseases of the sacroiliac joint]

16 patients with diseases of the sacroiliac joints were examined both with computer tomography and with conventional tomography. Both techniques were characterized by a high sensitivity. Computer tomography was superior in exactly delineating the extent of the pathologic changes. In conventional tomography the joint surface was more blurred, erosions were larger, and signs of ankylosis were more expanded, so that the joints seemed to be more altered in 8 cases than demonstrated by computer tomography. Very accurate changes like subchondral cysts were recognized only in the computer tomograms. In all cases in which anteroposterior radiographs revealed no clear result, the authors recommend to additionally employ computer tomography.

Wheelchair-mounted robot manipulators. Long term use by patients with Duchenne muscular dystrophy

This report relays practical clinical information about the modification and use of commercially available training robot manipulators. Such manipulators were used to increase independence in the activities of daily living of patients with advanced Duchenne muscular dystrophy. The control panels of five industrial robot manipulator training devices were modified for use by advanced Duchenne muscular dystrophy patients. Six patients with only residual finger movement, three of whom were dependent on respiratory support, mastered the use of these devices. The four patients with long-term access employed their manipulators for facilitation of activities of daily living an average of 8 h a day for 3 +/- 1.8 yr. There was approximately 3 h of estimated attendant care time saved per patient per day.

Heterogenic mRNAs with an identical protein-coding region of the human embryonic myosin alkali light chain in skeletal muscle cells

The formation of human myotubes in culture is accompanied by the induction of developmentally regulated, muscle-specific genes. We have studied the expression of human myosin light chain proteins and mRNAs during myogenesis in culture, in particular the skeletal embryonic myosin light chain 1 (MC1emb), which is indistinguishable from MLC1 of adult atrial cardiac muscle (MLC1A) as has been shown for rodent and bovine MLC1emb. We have identified distinct MLC1emb/MLC1A mRNAs in cultured human skeletal muscle cells that differ in their 5' and 3' untranslated regions but contain identical protein-coding regions. The alternative 3' untranslated region is detectable also in RNA of human atria. The different MLC1emb RNAs are likely to be encoded by one gene. It appears that the two MLC1emb 5' untranslated regions of the human gene are specific for man. In the mouse, only one 5' untranslated region of the MLC1emb gene has been detected.

Surgical treatment of iliofemoral vein thrombosis technical aspects. Possible secondary interventions

From October 1982 to February 1989 148 patients underwent venous thrombectomy. Priority for surgery was given especially in patients under 40 years with posttraumatic, postoperative and postpartum thrombosis where lysis was not possible. Our standardized operative technique includes atraumatic exposure of the vessels, clot extraction by balloon catheter and ring stripper, endoscopic control of the lumen and establishment of a temporary arteriovenous fistula. Postoperative angiography revealed that more than 10% of the patients needed secondary dilatation of iliac vein stenosis which can be carried out easily at the time of closing the fistula. Functional and anatomical parameters as well as the clinical outcome after 12 months show good to excellent results which confirm venous thrombectomy as a useful treatment modality at an acceptable risk level.

Development of clinically recognizable genital lesions among women previously identified as having "asymptomatic" herpes simplex virus type 2 infection

STUDY OBJECTIVE

To determine if patients initially identified by history, clinical examination, and serologic status as having asymptomatic herpes simplex virus type 2 infection report clinically recognizable genital lesions after having a detailed instructional session on the clinical signs and symptoms of genital herpes.

DESIGN

Prospective follow-up of two groups of women.

SETTING

Outpatient clinic of an urban city-county hospital.

PATIENTS

Two populations of women were recruited. One group was referred because they had documented asymptomatic genital herpes or were suspected of asymptomatically transmitting genital herpes to a sex partner. The other group was recruited from the hospital's general gynecologic clinic and consisted of women with herpes simplex virus type 2 antibodies who denied a history of genital herpes.

INTERVENTION

Patients had a one-on-one interview describing the clinical symptoms of genital herpes.

MEASUREMENTS AND MAIN RESULTS

Twelve of nineteen women with herpes simplex virus type 2 antibodies who had documented asymptomatic genital herpes or were suspected of asymptomatically transmitting infection to a sex partner, and 18 of 43 women with herpes simplex virus type 2 antibodies who were recruited from the gynecologic clinic developed clinically recognizable genital lesions during a 5-month follow-up. Symptomatic genital herpes was the most frequent gynecologic complaint identified during follow-up.

CONCLUSIONS

Approximately 50% of women with herpes simplex virus type 2 antibodies who do not initially report a history of genital lesions do indeed have clinically symptomatic genital herpes. These women can be accurately counseled and taught to distinguish genital herpes from other genitourinary infections. Identification of symptomatic recurrences and counseling to avoid sexual activity during these episodes may help reduce transmission of genital herpes.

Double-blind, placebo-controlled trial comparing long-term suppressive with short-term oral acyclovir therapy for management of recurrent genital herpes

A total of 156 patients with frequently recurring genital herpes were enrolled in a randomized, double-blind, one-year trial comparing long-term suppressive and intermittent oral acyclovir therapy with placebo in the management of recurrent genital herpes. Subjects received either suppressive treatment with acyclovir, 400 mg twice daily for one year, and 200 mg five times per day for five days, for short-term treatment of recurrences; intermittent treatment with placebo, twice daily for one year, and oral acyclovir, 200 mg five times per day for five days, for short-term treatment of recurrences; or treatment with placebo, twice daily for one year, and five times per day for five days for short-term treatment of recurrences. Median time to first recurrence was 250 days for the suppressive group, 28 days for the intermittent group, and 23 days for the placebo group (p = 0.001). The median number of days per month with active disease was 0.32 for the suppressive group, 4.18 for the intermittent group, and 4.72 for the placebo group (p less than 0.001), with a median recurrence rate per 30-day treatment period of 0.08 recurrences/patient in the suppressive group, 0.70 in the intermittent group, and 0.74 in the placebo group (p less than 0.001). Median duration of recurrence was 5.0 days in the suppressive group compared with 6.0 days in the combined intermittent acyclovir plus placebo group (p = 0.001), and was reduced from 7.0 to 6.0 days when intermittent acyclovir treatment was compared with placebo treatment (p = 0.05). Daily administration of oral acyclovir for one year is superior to intermittent or placebo treatment in the management of patients with frequently recurring genital herpes.

Transmission of genital herpes in couples with one symptomatic and one asymptomatic partner: a prospective study

To determine the risk of transmission of genital herpes simplex virus (HSV) infection, we prospectively studied, for a median of six months, 38 couples who had been together for a median of 10 mo. In each couple, one partner had a history of symptomatic genital herpes and one did not. At entry, of the 38 asymptomatic, exposed partners, 21 were seronegative, and results of western blot analysis showed that seven had antibody to HSV type 1 (HSV-1), four to HSV type 2 (HSV-2), and six to both HSV-1 and HSV-2. One of the 28 exposed partners without antibody to HSV-2 at enrollment asymptomatically acquired HSV-2 infection, but four of 10 with antibody to HSV-2 at enrollment developed culture-proven HSV-2 infection during follow-up. Restriction endonuclease analysis of DNA from paired isolates revealed identical strains in three couples and different strains in one. In this group of asymptomatic sex partners of persons with genital herpes, asymptomatic and unrecognized acquisition of HSV-2 infection was common, but more than half of the exposed partners remained free of HSV-2 infection after a median of 16 mo of sexual contact.

Detection of herpes simplex virus DNA from genital lesions by in situ hybridization

Lesion specimens from 118 episodes of recurrent genital herpes were used to compare herpes simplex virus (HSV) isolation with a direct specimen test for in situ DNA hybridization utilizing a biotinylated probe. The frequency of detection of HSV was similar with both tests; HSV was isolated from 81% of vesicular lesions, 76% of pustules, and 67% of ulcers, while HSV DNA was detected in 77, 76, and 55% of lesions in these stages, respectively. Utilizing both methods, HSV was identified in 91, 94, and 79%, respectively. The sensitivity and specificity of the DNA probe in comparison to standard viral isolation in tissue culture were 92 and 63%, respectively. Seven DNA-positive, viral isolation-negative specimens were obtained from patients who had positive culture confirmation at some time subsequent or prior to enrollment, suggesting that these were true positive results. The sensitivity of the DNA probe was dependent on cellular content of the specimen, and 36 (28%) of the 127 submitted specimens had fewer than 20 nonsuperficial cells. The DNA probe was rapid and convenient; its major disadvantage was the lack of type-specific information. The performance of the probe in lower-prevalence populations and in asymptomatic shedding of HSV remains to be evaluated.

Vitamin D and retinoblastoma. The presence of receptors and inhibition of growth in vitro

The vitamin D receptor has been found in several human organs not involved in calcium metabolism and in several malignant neoplasms found in humans. The role of the receptor in these tissues is unclear. There is, however, a relationship between the presence and quantity of the vitamin D receptor in a malignant cell line and the antineoplastic effect of vitamin D on that cell line. We found that Y-79 retinoblastoma cells have receptors specific for calcitriol (1,25-dihydroxycholecalciferol). Scatchard analysis of the receptor data shows a quantity of 56,000 receptors per retinoblastoma cell. These receptors have a dissociation constant of 1.18 nmol/L. Retinoblastoma cells treated with 10(-9) mol/L of calcitriol for nine days had 15% less cell growth than the control cells. Further studies of the effect of vitamin D on retinoblastoma may warrant its inclusion in chemotherapeutic protocols for the treatment of this childhood affliction.

Comparison between manual and computer measurement of ST-segment amplitude during exercise

Several studies have shown that the maximal ST/HR slope may be used as a reliable index of myocardial ischemia as assessed by coronary angiography, but this involves laborious training and derivation, particularly with respect to the measurement of ST segment amplitude, which is obtained by averaging values measured in at least 10 cardiac cycles in the steady state. The authors compared manual measurement of ST-segment amplitude with computer-processed beat using cardiac cycles in six consecutive patients with standard 12-lead records obtained over 5 seconds and a beat processed by the recorder to represent each lead (modal beat, over 10 seconds). All recordings were made in the steady state. Two patients had myocardial ischemia, as assessed by means including the maximal ST/HR slope and the occurrence of ST-segment depression at the end of exercise. Comparisons were made between measurements in 324 pairs of ST-segment amplitude obtained, respectively, from manually averaged recorded beats (average beat) and the modal beat during each step of the exercise test. The level of the ST-segment, (80 msec after the end of QRS complex) was independently obtained from the two records in a blinded fashion. The group data showed that the modal beat gave significantly lower values of ST-segment amplitude than the average beat. Similar results were obtained when 286 pairs of positive amplitudes were compared in the range of 0-7.25 mm. In the remaining 38 pairs in which ST-segment depression was found, the amplitude in the modal beats was not significantly different from the average beats.(ABSTRACT TRUNCATED AT 250 WORDS)

Diagnosis of herpes simplex virus by direct immunofluorescence and viral isolation from samples of external genital lesions in a high-prevalence population

One hundred thirty specimens from 108 consecutive patients with a history of recurrent genital ulcerations were used in a study comparing herpes simplex virus (HSV) isolation with a direct fluorescent-antibody (DFA) technique using mouse monoclonal antibodies. HSV was isolated from 70% of vesicular lesions, 67% of pustular lesions, 32% of ulcerative lesions, and 17% of crusted lesions, whereas the DFA technique detected HSV antigen in 87, 67, 30, and 10% of lesions in similar stages, respectively. When both methods were used, HSV was identified in 97, 79, 45, and 17% of vesicles, pustules, ulcers, and crusted lesions, respectively. The overall sensitivity and specificity of the DFA technique in comparison with virus isolation (VI) were 74 and 85%, respectively. Of the 17 patients from whom DFA-positive, VI-negative samples were obtained, HSV was subsequently isolated from a genital lesion in 14, suggesting that they were not DFA false-positives. Similarly, of the 46 patients whose initial lesion samples were DFA and VI negative, 37 (80%) had HSV identified from subsequent genital lesions during follow-up. Thus, a single sample for VI or DFA testing from a recurrent genital lesion had a sensitivity of only 53 and 51%, respectively. Combining the DFA technique and VI increased the sensitivity of laboratory diagnosis of a single recurrent episode of genital HSV; however, repetitive laboratory testing was often required to confirm the diagnosis of recurrent genital HSV infection.

Antigenic variation in the hemagglutinin-neuraminidase protein of human parainfluenza type 3 virus

Sixteen monoclonal antibodies directed to the hemagglutinin-neuraminidase (HN) protein of a 1957 isolate of parainfluenza type 3 virus (PIV3) were produced and used to examine antigenic variation in clinical strains. Analysis of hemagglutination-inhibition reactivity patterns of antigenic variants selected in vitro in the presence of monoclonal antibodies indicated that there were a minimum of six distinct epitopes detectable on the HN molecule. Competitive-binding assays indicated that these epitopes were located in two topologically nonoverlapping antigenic sites. An additional four epitopes were detected when 37 PIV3 clinical strains isolated over a period of 26 years in three geographic regions were tested for reactivity with the antibodies. Of the 10 unique epitopes defined by our monoclonal antibodies, 5 did not undergo detectable antigenic variation in any of the 37 strains examined. These results were expected since PIV3 viruses have been characterized as being antigenically monotypic. In contrast, antigenic variation was detected in the remaining five epitopes. This variation was not characterized by the accumulation of antigenic alterations with time (as for influenza A viruses), but appeared to represent genetic heterogeneity within the PIV3 population.

A double-blind study of oral acyclovir for suppression of recurrences of genital herpes simplex virus infection

Patients with frequently recurring genital herpes were enrolled in a double-blind placebo-controlled trial comparing 200-mg acyclovir capsules, given five or two times daily, with placebo. Of 47 placebo recipients, 44 (94 per cent) had recurrences during the 120-day treatment period, compared with 13 (29 per cent) of 45 patients treated with acyclovir five times daily and 18 of 51 (35 per cent) treated with acyclovir twice daily (P less than 0.001 for each regimen compared with placebo). The median time to the first clinical recurrence was 18 days in placebo recipients, compared with over 120 days in both acyclovir-treated groups (P less than 0.001 for both groups compared with placebo). The mean monthly recurrence rate during the medication period was 0.86 in placebo recipients, compared with 0.13 in patients treated with acyclovir five times daily and 0.14 in patients treated with acyclovir twice daily (P less than 0.001 for both groups compared with placebo). While receiving therapy, 86 of 96 acyclovir-treated patients had over a 50 per cent reduction in their pretreatment recurrence rate. Breakthrough recurrences in acyclovir recipients were of shorter duration and associated with a lower frequency of viral shedding than recurrences in placebo recipients. After medication was discontinued, the subsequent recurrence rate returned to pretreatment frequencies. Daily oral acyclovir was well tolerated. We conclude that oral acyclovir given for four months markedly reduces but does not completely prevent recurrences of genital herpes and does not influence the long-term natural history of the disease.

The effects of long-term physical training in patients with coronary heart disease

A previous trial was completed in 24 patients with coronary heart disease, randomly assigned to a group who undertook a 6-month exercise training programme (5BX/XBX) and a control (no training) group. It was shown that the patients in the training group were able to achieve during exercise a higher heart rate at ST segment depression of 0.1 mV (HR/ST threshold) and that the patients in the control group showed a reduction in the threshold as well as symptomatic deterioration; the results indicated that the training programme had resulted in a reduction in the severity of myocardial ischaemia. In the present trial 9 patients of the previous training group were followed up to examine the effect of long-term maintenance training (up to 4.5 years). The same methods were used to examine the effect of maintenance training in a further group of 8 patients with coronary heart disease, 6 of whom were on beta-blocker therapy. By the end of the study, the heart rate achieved during exercise in the 17 patients was still significantly greater (P less than 0.0004) by 12.1 +/- 2.85 beats/min (mean +/- SEM) than that at the beginning of the trial; similar results were obtained in the 6 patients on beta-blocker therapy. Therefore a maintenance exercise training programme in patients with coronary heart disease can result in a sustained improvement in the form of a reduction in the severity of myocardial ischaemia, and this can occur in patients on beta-blocker therapy.

[First case of rhinoentomophthoromycosis observed in the People's Republic of the Congo (Congo Brazzaville)]

The first case of rhinoentomophthoromycosis to be recognised in the People's Republic of the Congo (Congo Brazzaville) is reported. The patients was a 55 years old congolese male. The early symptoms consist of a progressive nasal obstruction with a massa inside of the nostril, initially diagnosed as a rhinoscleroma. One year later the patient had a prominent distorsion of the face and the histological lesions were characteristic of an entomophthoromycose. Cultures were positive for Conidiobolus coronatus.

Secretory IgA antibody in cervicovaginal secretions from women with genital infection due to herpes simplex virus

Sequential samples of cervicovaginal secretions from women with untreated first and recurrent episodes of genital infection due to herpes simplex virus type 2 (HSV-2) were assayed for IgA antibodies to HSV-2 by using fluorescent antibodies to human secretory piece (sIgA) and human IgA. Among women with first-episode genital herpes, sIgA antibody to HSV-2 was detected in 20 of 31 women from whom HSV was isolated from the cervix, compared with four of 13 women from whom it was not (P less than .05). Among women with first-episode genital herpes, the mean titer of sIgA antibody to HSV-2 peaked between days 9 and 16 of disease, whereas among women with recurrent genital HSV, the peak occurred at days 3-8 of disease. HSV-2 was not isolated from the cervix from any of 130 samples taken when titers of sIgA antibody to HSV-2 were greater than or equal to 1:2, compared with 98 of 259 samples taken when titers were less than or equal to 1:2 (P less than or equal to .01).

Treatment of primary first-episode genital herpes simplex virus infections with acyclovir: results of topical, intravenous and oral therapy

Three double-blind, placebo-controlled evaluations of acyclovir were performed in first-episode genital herpes infections. In one trial intravenous acyclovir or saline was administered in hospital over 5 days. In the other two trials, 10-day courses of oral, or 7-day courses of topical acyclovir and respective placebos were followed up in the outpatient department. Regular assessments included staging examinations, culture of lesions and blood and serum analyses. No patient discontinued medication because of an adverse reaction, although one quarter of topically treated patients complained of local irritation on application. The placebo-controlled evaluations indicate that, if given within the first 7 days after the onset of lesions, topical, intravenous and oral acyclovir are useful in shortening the course of first-episode primary genital herpes. The clinical and virological effects of intravenous and oral acyclovir were more marked than those of topical treatment in the reduction of viral shedding; the time to complete healing of lesions; and in the reduction of new lesion formation. Systemic preparations of acyclovir also decreased the symptoms of herpes simplex virus urethritis and intravenous acyclovir those of herpes simplex virus cervicitis. Neither systemic treatment, however, was effective in delaying or reducing the frequency of subsequent recurrences, which may be related to the development of early ganglionic infection. Despite this, acyclovir treatment is a significant advance in the management of primary genital herpes.

Skin tumors induced by painting nitrosoalkylureas on mouse skin

The carcinogenic action of nitrosamides has been investigated by applying a 0.04 M solution in acetone of 17 nitrosoalkylureas and one nitrosoalkylcarbamate to the shaved interscapular skin of female Swiss mice. Each of a group of 20 mice received 25 microliter of solution twice a week for 40 or 50 weeks, after which the animals were observed until death or 100 weeks. The appearance and progression of skin tumors within the painted area was charted for each animal. Nitroso-2-fluoroethylurea was toxic to the skin and was retested using a 0.01 M solution in acetone. No tumors was seen with nitrosoallylurea, nitroso-iso-butylurea, nitrosobenzylurea, and nitroso-2-phenylethylurea. The most potent compounds were nitrosomethylurea, nitrosoethylurea, and nitroso-2-fluoroethylurea. Nitroso-n-amylurea and nitroso-n-hexylurea were somewhat less potent, each inducing tumors in 11 of 20 mice. Nitrosocarbaryl gave rise to skin tumors in eight mice. The remaining compounds, nitroso-n-propylurea, nitroso-iso-propylurea, nitroso-n-butylurea, nictroso-sec-butylurea, nitroso-n-undecylurea, nitroso-n-tridecylurea, nitrosophenylurea, and nitrosocyclohexylurea were much less effective skin carcinogens, yielding tumors in from one to five mice. No good correlation was apparent between the relative stability of the compounds, their mutagenicity to Salmonella and their carcinogenicity to mouse skin.

Comparison of viral isolation, direct immunofluorescence, and indirect immunoperoxidase techniques for detection of genital herpes simplex virus infection

Seventy-six consecutive patients presenting to a genital herpes simplex virus (HSV) clinic were enrolled in a study comparing viral isolation (VI), indirect immunoperoxidase (indirect IP), and direct immunofluorescence (direct FA) techniques for the detection of HSV antigen. Of the 76 patients, 61 (80%) demonstrated HSV by VI, compared with 66% by indirect IP and 55% by direct FA (P less than 0.05). Genital lesions from nine patients demonstrated HSV antigen by direct FA or indirect IP but were VI negative; eight of nine patients had subsequent episodes of genital HSV confirmed by VI. During the vesicular-pustular stage of the disease, VI was positive in 90%, indirect IP was positive in 76%, and direct FA was positive in 71% of the lesions, whereas with ulcerative lesions, VI was positive in 72%, indirect IP was positive in 55%, and direct FA was positive in 38%. These commercially available rapid viral diagnostic techniques are specific and useful, if adequate specimens are obtained from early genital lesions.

Husband involvement in the behavioral treatment of overweight women: initial effects and long-term follow-up

This study investigated whether husband participation would augment the effectieness of the Sturart & Davis (1972) weight-reduction program for 37 obese women. Following a five-week baseline period, participants were taught behavioral weight-control techniques in eight 90-minute sessions over a 16-week period. Random assignment was made to conditions that required husbands to participate in all treatment sessions, the first four sessions, or not at all. Results indicated that although women in all three conditions lost significant amounts of weight and developed more adaptive eating habits, husband involvement fostered reliably greater weight loss, which was maintained through a six-week post-treatment assessment. Participant husbands became more accurate observers of changes in their wives' eating habits and were viewed as being more helpful than were noninvolved husbands. A three-year follow-up indicated that the wives had maintained their initial weight losses and reported changes in eating habits, while the effects engendered by husband involvement had dissipated.

The abdominal muscle receptor organ in Astacus leptodactylus (Crustacea)

The structure of both the slow- and the fast-adapting abdominal muscle receptor organ of Astacus leptodactylus is described with particular reference to differences between the two systems. The receptors are composed of a thin muscle that extends from the front edge of one segment to the front edge of the following and a sensory cell connected with this muscle. In the zone where the sensory cells enter their respective muscle, muscle fibers are reduced (zone of relative muscle exclusion = ZRME) and partly replaced by connective tissue. The occurrence of dendritic processes of both the slow and the fast neurons is confined to this zone. The following differences between the two receptor types are established: (1) The fast receptor muscle reveals a smaller sarcomere length than the slow receptor muscle and a higher myosin/actin filament ratio. (2) Muscle fibers that pass the ZRME are always found at its periphery in the fast system, separated from dendritic processes by layers of connective tissue, while in the slow system muscle fibers frequently are intermingled with the sensory elements. (3) The ZRME of the slow receptor is 20-30% longer than that of the fast receptor. (4) The dendritic varicosities of the slow neuron, on an average, contain many more mitochondria than those of the fast neuron. (5) Dendritic processes (fine twigs as well as varicosities) are juxtaposed to the sarcolemma of the muscle fibers only in the slow system; in the fast system dendrites and muscle are spatially separated by connective tissue. It is assumed that these differences between the two receptor types are at least in part responsible for the different thresholds observed in physiological experiments.