Systematic functional analysis of Leishmania protein kinases identifies regulators of differentiation or survival

Differentiation between distinct stages is fundamental for the life cycle of intracellular protozoan parasites and for transmission between hosts, requiring stringent spatial and temporal regulation. Here, we apply kinome-wide gene deletion and gene tagging in Leishmania mexicana promastigotes to define protein kinases with life cycle transition roles. Whilst 162 are dispensable, 44 protein kinase genes are refractory to deletion in promastigotes and are likely core genes required for parasite replication. Phenotyping of pooled gene deletion mutants using bar-seq and projection pursuit clustering reveal functional phenotypic groups of protein kinases involved in differentiation from metacyclic promastigote to amastigote, growth and survival in macrophages and mice, colonisation of the sand fly and motility. This unbiased interrogation of protein kinase function in Leishmania allows targeted investigation of organelle-associated signalling pathways required for successful intracellular parasitism.

Investigating the Swimming of Microbial Pathogens Using Digital Holography

To understand much of the behaviour of microbial pathogens, it is necessary to image living cells, their interactions with each other and with host cells. Species such as Escherichia coli are difficult subjects to image: they are typically microscopic, colourless and transparent. Traditional cell visualisation techniques such as fluorescent tagging or phase-contrast microscopy give excellent information on cell behaviour in two dimensions, but no information about cells moving in three dimensions. We review the use of digital holographic microscopy for three-dimensional imaging at high speeds, and demonstrate its use for capturing the shape and swimming behaviour of three important model pathogens: E. coli, Plasmodium spp. and Leishmania spp.

Fast, high-throughput measurement of collective behaviour in a bacterial population

Swimming bacteria explore their environment by performing a random walk, which is biased in response to, for example, chemical stimuli, resulting in a collective drift of bacterial populations towards 'a better life'. This phenomenon, called chemotaxis, is one of the best known forms of collective behaviour in bacteria, crucial for bacterial survival and virulence. Both single-cell and macroscopic assays have investigated bacterial behaviours. However, theories that relate the two scales have previously been difficult to test directly. We present an image analysis method, inspired by light scattering, which measures the average collective motion of thousands of bacteria simultaneously. Using this method, a time-varying collective drift as small as 50 nm s(-1) can be measured. The method, validated using simulations, was applied to chemotactic Escherichia coli bacteria in linear gradients of the attractant α-methylaspartate. This enabled us to test a coarse-grained minimal model of chemotaxis. Our results clearly map the onset of receptor methylation, and the transition from linear to logarithmic sensing in the bacterial response to an external chemoeffector. Our method is broadly applicable to problems involving the measurement of collective drift with high time resolution, such as cell migration and fluid flows measurements, and enables fast screening of tactic behaviours.

Degraded auditory processing in a rat model of autism limits the speech representation in non-primary auditory cortex

Although individuals with autism are known to have significant communication problems, the cellular mechanisms responsible for impaired communication are poorly understood. Valproic acid (VPA) is an anticonvulsant that is a known risk factor for autism in prenatally exposed children. Prenatal VPA exposure in rats causes numerous neural and behavioral abnormalities that mimic autism. We predicted that VPA exposure may lead to auditory processing impairments which may contribute to the deficits in communication observed in individuals with autism. In this study, we document auditory cortex responses in rats prenatally exposed to VPA. We recorded local field potentials and multiunit responses to speech sounds in primary auditory cortex, anterior auditory field, ventral auditory field. and posterior auditory field in VPA exposed and control rats. Prenatal VPA exposure severely degrades the precise spatiotemporal patterns evoked by speech sounds in secondary, but not primary auditory cortex. This result parallels findings in humans and suggests that secondary auditory fields may be more sensitive to environmental disturbances and may provide insight into possible mechanisms related to auditory deficits in individuals with autism.

Differential dynamic microscopy of bacterial motility

We demonstrate a method for the fast, high-throughput characterization of the dynamics of active particles. Specifically, we measure the swimming speed distribution and motile cell fraction in Escherichia coli suspensions. By averaging over ∼10(4) cells, our method is highly accurate compared to conventional tracking, yielding a routine tool for motility characterization. We find that the diffusivity of nonmotile cells is enhanced in proportion to the concentration of motile cells.

A Survey Of Pulmonary Thromboembolic Disease

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Post-traumatic stress symptoms and distress 1 year after burn injury

The occurrence and predictors of post-traumatic stress symptoms 1 year after a burn injury were assessed in a large prospective sample (N = 172). Participants completed a self-report post-traumatic stress symptom checklist at 3 time points: within 24 hours of admission to a burn center, 1 month after the injury, and 1 year after the injury. A notable number of participants had a range of post-traumatic stress symptoms both at 1 month and at 1 year after the burn injury. More than half of the sample reported recurrent intrusive recollections of the burn injury at 1 month and at 1 year. Other commonly endorsed symptoms were sleep disturbance, avoidance of thoughts or feelings associated with the burn, and distress at reminders of the burn. The number of post-traumatic stress symptoms endorsed at 1 month was the only significant predictor of post-traumatic stress symptoms at 1 year. These results suggest that it is common for patients to have some post-traumatic symptoms 1 year after a burn injury and that early experiences of post-traumatic stress symptoms may be associated with the development or maintenance of post-traumatic stress disorder. We recommend that burn care professionals identify and intervene with patients who have clinically significant distress as a result of their burn injuries.

Post-traumatic stress symptoms and distress following acute burn injury

The occurrence and predictors of acute post-traumatic stress symptoms were assessed in a large, prospective sample of persons with new burn injuries (N = 172). Participants completed a self-report post-traumatic stress symptom checklist, pain ratings, and a premorbid mental health inventory within 24 h of admission to a burn center (Day 1). Over half of the sample reported sleep disturbance and recurrent, intrusive recollections of the burn injury on Day 1. Other commonly endorsed symptoms were difficulties concentrating, avoidance of thoughts/feelings associated with the burn, flashbacks, and exaggerated startle response. Persons with less favorable premorbid mental health and larger burns reported a greater number of stress symptoms on Day 1. These results suggest that experiencing some post-traumatic stress symptoms immediately following a burn trauma is normal. It is recommended that burn care professionals identify and intervene with patients who are suffering clinically significant distress early in the hospitalization.

Human rights of psychiatrically disturbed persons in the tropical Pacific

The management of acutely disturbed patients in smaller Pacific island communities presents many clinical challenges as well as ethical and human rights questions. The aggressive, excited, sexually inappropriate, and possibly violent disturbed person frequently will need physical restraint and possible seclusion in a secure environment. In practical terms, on many Pacific islands the only physically secure room is a jail cell. This environment will protect others and possibly protect the out-of-control person from themselves. After protection, the next requirements are adequate information about the person and clinically informed individuals who can make a diagnosis and commence treatment in the jail environment. Adequately trained people who can diagnose and suggest initial treatment are few and widely dispersed in Pacific island communities. Two representative case vignettes from the author's experience as a World Health Organization short-term consultant in Tonga and the Commonwealth of the Northern Mariana islands illustrate the tension between a disturbed person's right to adequate treatment and the right of a citizen/patient to be free of coercion.

A profile of medically serious suicide attempts

BACKGROUND

This study identified factors associated with medically serious suicide attempts (requiring medical hospitalization).

METHOD

Demographic information, current psychiatric mental state, suicide attempt and psychiatric history characteristics, and DSM-IV diagnoses were compared between 65 patients hospitalized for a medically serious suicide attempt (MSSA) and 32 patients seen in the emergency room for suicide attempt but not medically hospitalized (NMSSA).

RESULTS

Those with MSSAs had a higher rate of substance-induced mood disorder (but not substance abuse or dependence), while those with NMSSA had more attempts, more years since first attempt, and a higher rate of sexual and physical abuse, traumatic life events, borderline personality disorder, and bipolar disorder.

CONCLUSION

Substance-induced mood disorder is an important diagnosis in the evaluation of suicidal patients. The vulnerability of mood effects caused by substance abuse may lead to a more serious suicide attempt despite less extensive psychiatric problems. The most important early psychiatric intervention may be the immediate recognition and aggressive treatment of an individual's affective and substance use disorders.

The crime of saving lives. The FDA, John Najarian, and Minnesota ALG

The indictment of John Najarian, MD, and Richard Condie at Minneapolis, Minn, on April 10, 1995, was a defining episode in the prolonged agony that has ensued since August 1992, when the federal Food and Drug Administration (FDA) placed Minnesota Anti-Lymphocyte Globulin (MALG) on clinical hold, bringing to an end its use as an immunosuppressive agent for patients undergoing transplantation. The principal charge in the indictment is that from about 1968 until 1992--the whole period of the development and use of MALG--Dr Najarian and Mr Condie conspired to defraud the United States by impeding the FDA in its oversight of biological drugs and that they did so for the purpose of financial gain. If the charges can be considered seriously, they mean that Dr Najarian's purpose in the development and manufacture of MALG was to make money, presumably for himself, and that the possible benefit of MALG to the patients was of secondary concern to him. Several difficulties arise immediately. In 1968, MALG offered a promising new approach to immunosuppression. In a relatively crude form, it had been used at the University of Colorado with striking improvement in the survival of patients undergoing transplantation and transplanted organs, but it was painful to administer by intramuscular injections and, in addition to other side effects, produced muscular spasms. Dr Najarian and his colleagues succeeded in purifying MALG so that the pure globulin could be injected into a central vein. The process of purification was complicated and expensive, so it was hardly practical for each transplant center to produce MALG for itself. Thus, in 1969, when Dr Najarian submitted an investigational new drug application (IND) to the FDA, he stated that his purpose was to manufacture MALG not only for patients at the University of Minnesota Hospital but also for patients at other transplant centers, which were not in a position to make it for themselves. He asked the FDA to approve recovery of the cost of providing MALG to other institutions. The FDA approved Dr Najarian's IND application early in 1970 but did not respond to his request for cost recovery--then, or for the next 15 years. Dr Najarian was free to manufacture MALG and to distribute it to other transplant centers for investigational use, but as for paying for it, that was his problem. The FDA offered no suggestion.

Dawn simulation treatment of winter depression: a controlled study

OBJECTIVE

This study sought to determine whether dawn simulation was superior to a shorter dimmer "placebo" dawn signal in treating winter depression.

METHOD

In a randomized, parallel design, 22 patients with winter depression were treated with either 1 week of a 2-hour dawn simulation peaking at 250 lux or 1 week of a 30-minute dawn simulation peaking at 0.2 lux. The subjects were told that they would receive either a "gradual" dawn or a "rapid" dawn reaching an intensity that would be dimmer than standard bright light treatment. At the end of both the baseline week and the treatment week, subjects were assessed in a blind manner with the Hamilton Rating Scale for Depression. Analysis of covariance was used to compare the two dawn treatments.

RESULTS

The 2-hour, 250-lux dawn simulation resulted in Hamilton depression scale scores that were significantly lower than scores after the 30-minute, 0.2-lux dawn simulation.

CONCLUSIONS

This study indicates that dawn simulation is an effective treatment for winter depression.

Diagnosis of severely ill inpatients in China. A collaborative project using the structured clinical interview for DSM-III (SCID)

The purpose of this project was to investigate any differences in diagnostic practice between Chinese psychiatry and Western psychiatry with regard to severe psychiatric illness among Chinese inpatients. Specifically, the project aimed to look at differences between the Chinese diagnostic system and DSM-III. This study stemmed partly from a desire to investigate the supposed "overdiagnosis" of schizophrenia in China relative to the West. A second objective was to use a structured interview format to obtain clinical data for DSM-III and to decide whether a translated version of such an interview offered promise for future transcultural psychiatric research. Forty-two inpatients on a psychiatric ward in China were interviewed by an American psychiatrist assisted by a Chinese faculty translator and a diagnosis was made using the Structured Clinical Interview for DSM-III. A Chinese professor of psychiatry who was blind to the structured interview results interviewed each patient independently and assigned a diagnosis within the current Chinese system. Follow-up data was obtained on 69% of the patients after 16 months to check for stability of diagnosis. Results of the study pointed to less diagnostic disagreement than previous work had predicted. On cases where there was disagreement, DSM-III diagnoses tended toward affective disorders or atypical forms of psychosis while the Chinese diagnosis tended towards schizophrenia.(ABSTRACT TRUNCATED AT 250 WORDS)

Mania with cryptococcal meningitis in two AIDS patients

Two AIDS patients with mania were found to have cryptococcal meningitis. In patients with AIDS or AIDS-related complex, physicians must thoroughly investigate the possibility of an organically based psychiatric syndrome.

Comparative efficacy of propranolol, chlordiazepoxide, and placebo in the treatment of anxiety: a double-blind trial

The efficacy and safety of propranolol in the treatment of anxiety was compared with those of chlordiazepoxide and placebo in a 3-week, double-blind study of 212 patients. After a 1-week, single-blind placebo-washout period, patients were randomized to receive either propranolol (80, 160, or 320 mg/day), chlordiazepoxide (30, 45, or 75 mg/day), or placebo. Patients were evaluated by three physician-rated scales--Hamilton Rating Scale for Anxiety (HAM-A), Covi Anxiety Scale (CAS), and Clinical Global Impressions scale--and two patient-rated scales--Symptoms Checklist 90 and Profile of Mood States. Patients in all groups demonstrated significant improvement in their level of anxiety at all time points compared with their baseline level. At Week 1 propranolol and chlordiazepoxide patients were significantly better than placebo patients, as measured by the HAM-A and CAS. At Week 2 only propranolol was superior to placebo, based on HAM-A and CAS scores. Fifteen patients prematurely terminated because of adverse reactions (4 taking propranolol, 4 taking placebo, and 7 taking chlordiazepoxide). The incidence of side effects was similar for the two active drugs; fatigue, drowsiness, and change in libido were significantly more frequent with chlordiazepoxide and drowsiness and indigestion were more frequent with propranolol compared with placebo.

Effect of alprazolam and diazepam on anxiety and panic attacks in panic disorder: a controlled study

Forty-eight patients currently experiencing panic attacks were randomly assigned to double-blind treatment with alprazolam, diazepam, or placebo. Efficacy was assessed using the Hamilton Rating Scale for Anxiety and a panic attack frequency rating scale. Results indicate that the two active treatments appeared equally effective in reducing both the frequency of panic attacks and the severity of generalized anxiety when compared with placebo. Overall, these data support the use of benzodiazepines in the treatment of panic disorder.

The DST in psychiatric outpatients with generalized anxiety disorder, panic disorder, or primary affective disorder

The authors administered the dexamethasone suppression test (DST) to outpatients, who were free from psychoactive drugs for at least 10 days before the test, with primary affective disorder (N = 60), generalized anxiety disorder (N = 26), panic disorder (N = 22), and agoraphobia with panic attacks (N = 13). With a cortisol value of 5 micrograms/dl considered nonsuppression, there were no significant differences in dexamethasone nonsuppression rates among the diagnostic groups. Scores on the Hamilton Rating Scale for Depression and a melancholia subscale were significantly higher in the depressed group than in the anxiety disorder group. The findings raise questions concerning the specificity of the DST for primary affective disorder in relationship to anxiety disorders.

Resistance to injury by sulfur dioxide : correlation with its reduction to, and emission of, hydrogen sulfide in Cucurbitaceae

In Cucurbitaceae young leaves are resistant to injury from acute exposure to SO(2), whereas mature leaves are sensitive. After exposure of cucumber (Cucumis sativus L.) plants to SO(2) at injurious concentrations, illuminated leaves emit volatile sulfur, which is solely H(2)S. Young leaves emit H(2)S many times more rapidly than do mature leaves. Young leaves convert approximately 10% of absorbed [(35)S]SO(2) to emitted [(35)S]H(2)S, but mature leaves convert less than 2%. These results suggest that a high capability for the reduction of SO(2) to H(2)S and emission of the H(2)S is a part of the biochemical basis of the resistance of young leaves to SO(2).

Emission of Hydrogen Sulfide by Leaf Tissue in Response to l-Cysteine

Leaf discs and detached leaves exposed to l-cysteine emitted a volatile sulfur compound which was proven by gas chromatography to be H(2)S. This phenomenon was demonstrated in all nine species tested (Cucumis sativus, Cucurbita pepo, Nicotiana tabacum, Coleus blumei, Beta vulgaris, Phaseolus vulgaris, Medicago sativa, Hordeum vulgare, and Gossypium hirsutum). The emission of volatile sulfur by cucumber leaves occurred in the dark at a similar rate to that in the light. The emission of leaf discs reached the maximal rate, more than 40 picomoles per minute per square centimeter, 2 to 4 hours after starting exposure to l-cysteine; then it decreased. In the case of detached leaves, the maximum occurred 5 to 10 h after starting exposure. The average emission rate of H(2)S during the first 4 hours from leaf discs of cucurbits in response to 10 millimolar l-cysteine, was usually more than 40 picomoles per minute per square centimeter, i.e. 0.24 micromoles per hour per square decimeter. Leaf discs exposed to 1 millimolar l-cysteine emitted only 2% as much as did the discs exposed to 10 millimolar l-cysteine. The emission from leaf discs and from detached leaves lasted for at least 5 and 15 hours, respectively. However, several hours after the maximal emission, injury of the leaves, manifested as chlorosis, was evident. H(2)S emission was a specific consequence of exposure to l-cysteine; neither d-cysteine nor l-cystine elicited H(2)S emission. Aminooxyacetic acid, an inhibitor of pyridoxal phosphate dependent enzymes, inhibited the emission. In a cell free system from cucumber leaves, H(2)S formation and its release occurred in response to l-cysteine. Feeding experiments with [(35)S]l-cysteine showed that most of the sulfur in H(2)S was derived from sulfur in the l-cysteine supplied and that the H(2)S emitted for 9 hours accounted for 7 to 10% of l-cysteine taken up. (35)S-labeled SO(3) (2-) and SO(4) (2-) were found in the tissue extract in addition to internal soluble S(2-). These findings suggest the existence of a sulfur cycle which converts l-cysteine to SO(4) (2-) through cysteine desulfhydration.

Evidence for an intracellular sulfur cycle in cucumber leaves

H2S emission from cucumber (Cucumis sativus L.) leaf discs supplied with L-cysteine in the dark is inhibited 80-90% by aminooxyacetic acid (AOA), an inhibitor of pyridoxal-phosphate dependent enzymes. Exposure to L-cysteine in the light enhanced the emission of H2S in response to this sulfur source. Turning off the light reduced the emission of H2S to the rate observed in continuous dark; turning on the light enhanced the emission of H2S to the rate observed in continuous light. Therefore, in the light H2S emission in response to L-cysteine becomes a partially light-dependent process. Treatment with cyanazine, an inhibitor of photosynthetic electron transport, reduced H2S emission in the light to the rate observed in continuous dark, but did not affect H2S emission in the dark. In leaf discs pre-exposed to L-cysteine in the light, treatment with cyanazine+ AOA inhibited the emission of H2S in response to L-cysteine completely. Therefore, only part of the H2S emitted in response to this sulfur source is derived from a light-independent, but pyridoxal-phosphate-dependent process; the balance of the H2S emitted is derived from a light-dependent process that can be inhibited by cyanazine. When cucumber leaf discs were supplied with a pulse of L-[(35S)]cysteine, radioactively labeled H2S was emitted in two waves, one during the first hour of exposure to L-cysteine, and a second after 3-4 h; unlabeled H2S, however, was emitted continuously. The second wave of emission of labeled H2S was not observed in pulse-chase experiments in which sulfate or cyanazine were added to the treatment solution after 3 h of exposure to L-cysteine, or when the lights was turned off. The labeling pattern of sulfur compounds inside cucumber cells supplied with a pulse of L-[(35)S]cysteine showed that the labeled H2S released from L-cysteine partially enters first the sulfite, then the sulfate pool of the cells. The radioactively labeled sulfate, however, is not incorporated into L-cysteine, but enters the H2S pool of the cells again. These observations are consistent with the idea of an intracellular sulfur cycle in plant cells. The L-cysteine taken up by the leaf discs seems to be desulfhydrated in a light-independent, but pyridoxal-phosphate-dependent process. The H2S synthesized this way may be partially released into the atmosphere; the other part of the H2S produced in response to L-cysteine may be oxidized to sulfite, then to sulfate, which is subsequently reduced via the light-depent sulfate assimilation pathway. In the presence of excess L-cysteine, synthesis of additional cysteine may be inhibited, and the sulfide moiety may be split off carrier bound sulfide to enter the H2S pool of the cells again. It is suggested that the function of this sulfur cycle may be regulation of the free cysteine pool.

The phenomenology of bipolar I manic-depressive illness

There have been several advances in the knowledge of the phenomenology of Bipolar Manic-Depressive Illness in the past decade. Studies of groups of carefully diagnosed bipolar patients have characterized features of the course of illness, the presence and prognostic influence of psychotic features, the influence of stressful life events, features of social adjustment and aspects of personality and long-term functioning. Similar studies of bipolar illness in non-western cultures would be of interest.

Pimozide versus chlorpromazine in chronic schizophrenia: a 52 week double-blind study of maintenance therapy

This study compared the effectiveness and safety of pimozide and chlorpromazine in the maintenance therapy of chronic schizophrenic outpatients. Forty-three patients were assigned in double-blind fashion to one of the drugs for the 52 week study. Both medication groups showed a general pattern of improvement over the course of the study, but there was no significant difference between the two groups. The results demonstrated the effectiveness and safety of pimozide in once daily administration. Previous research results showing the special utility of pimozide for the improvement of emotional withdrawal and social competence in schizophrenia were not replicated.

Command Hallucinations and self-amputation of the penis and hand during a first psychotic break

An unusual case is presented of a psychotic young man who experienced command auditory hallucinations which directed him to amputate his right hand and distal penis to atone for a "terrible sexual transgression." The existing literature on genital self-mutilation is reviewed as well as some recent work on factors that might be used to predict an episode of self-mutilation. In patients who are felt to be at extremely high risk, careful monitoring and rapid medication schedules might be effective in preventing such an incident.

Utilizing dispersed mental health para-professionals for scattered Pacific islands: a micronesian experience

A mental health program developed for the huge tropical Pacific area of Micronesia is described. Training of para-professionals as mental health coordinators for the six main island districts of Micronesia was undertaken to respond to the most pressing mental health needs of these scattered islands. Adequate follow-up care of the chronically mentally ill was the first priority with less urgent needs addressed secondarily. Frequent on-island visits by the supervising psychiatrist to teach patient-related evaluation and treatment procedures was of importance. A program with dispersed para-professional coverage and centralized supervision may have relevance for other large areas with a scattered and low population.

Transcultural psychiatry on an American psychiatric ward

Transcultural psychiatry is generally thought to be an appropriate concern only in distant or unusual environments. But because many immigrant groups in the U.S. maintain their original customs and traditions, a transcultural approach may be necessary in many clinical situations, as illustrated by the case histories of three immigrant patients on a university hospital's psychiatric service. All had manifestations of severe psychiatric disturbance, but their clinical evaluation and management were complicated by difficulties in communication and by culturally linked behavior patterns and family responses at variance with American norms. Careful attention to transcultural factors is necessary for the optimal management of such cases.

Emission of ethylene and ethane by leaf tissue exposed to injurious concentrations of sulfur dioxide or bisulfite ion

Leaf tissues injured with SO(2) gas or bisulfite ion in solution emit ethylene and ethane. The amounts of these gases produced by the tissues depend on the degree of exposure to SO(2) or bisulfite. The amount of ethylene produced in response to SO(2) fumigation correlates positively with SO(2) exposure (0 to 5.5 microliters per liter for 16 hours), SO(2) absorbed, and the amount of visible injury sustained by the leaf tissues. Ethane production is correlated positively with the injury resulting from treatment with bisulfite ion. The rate of emission of ethane from leaf discs of cucurbit cultivars as a result of exposure to bisulfite solutions is in agreement with the order and the degree of their resistance to injury by SO(2). Thus, exposure to bisulfite and the subsequent release of ethane can be used to determine the relative resistance of different species and cultivars to SO(2) gas.A rapid, simple, objective assay for SO(2) resistance based on ethane emission is described. This assay should preferentially detect SO(2) resistance which does not depend on stomatal behavior. The screening of several other cucurbits with this assay showed a 24-fold difference between the most and the least sensitive plants tested.

Cross-cultural differences in indicators of improvement from psychosis: the case of betel nut chewing

This paper uses a case from the Micronesian Island of Yap to illustrate that indicators of improvement from an episode of schizophrenic psychosis can vary tremendously from culture to culture. At times, the clinician must search diligently for such indicators since the patient will not verbalize any perception of improvement. A 39-year-old Yapese woman was evaluated by a psychiatrist and was found to have been psychotic for several years, suffering from gross delusions, and auditory hallucinations, flattened affect, and social isolation. In addition, she had discontinued chewing betel nut that was used daily by virtually all of her fellow islanders on Yap. Two months after beginning treatment with twice monthly injectable antipsychotic medication she was still delusional, with flat affect, and heard the same voices. She was slightly less socially withdrawn and she had interestingly resumed chewing betel nut. It seemed that she had given up betel nut chewing during the socially withdrawn phase of her illness and had resumed it as she improved and became less autistically preoccupied. In her culture, betel chewing was a main avenue of social intercourse and an intrinsic part of almost all social activities. In her particular case, the resumption of betel chewing was a primary indicator of her improvement from psychosis and reintegration into her social group.

The use of a stroke group treatment program on an extended care unit

The purpose of this paper is to present the concept of combining group process and rehabilitation modalities in treating stroke patients' function in activities of daily living, mobility, perception and communication. The group structure, administration and content are discussed. Reasons for the program's value and success are explored.

Mechanisms of resistance to sulfur dioxide in the Cucurbitaceae

The relative resistance of four cultivars of the Cucurbitaceae (Cucumis sativus L. cv. National Pickling, and inbred line SC 25; Cucurbita pepo L. cv. Prolific Straightneck Squash, and cv. Small Sugar Pumpkin) to SO(2) was determined. According to plots of the degree of exposure to SO(2) (which depends on the SO(2) concentration and the duration of the exposure), there is an 8-fold difference in resistance to this toxic gas among these cultivars. However, if the degree of injury is plotted as a function of the amount of SO(2) absorbed, all four cultivars appear similarly sensitive to the gas. We conclude that the principal reason for special and varietal differences in resistance among these cultivars is the relative rate of absorption of the gas. The densities of stomata on the upper and lower surfaces of leaves did not differ sufficiently between cultivars to account for the differences in absorption rates. It remains to be determined whether the differences in rate of SO(2) absorption reflect differences in stomatal activity.Resistance of individual leaves changes with position on the plant axis (age of the leaf). There exists a gradient of decreasing resistance from the apex downward. This resistance gradient cannot be accounted for by differences in rates of SO(2) absorption. We infer the existence of a biochemically based, developmentally controlled resistance mechanism which functions after SO(2) has entered the leaf. Biochemical comparisons of old and young leaves with such differences in resistance should be helpful in determining the biochemistry of SO(2) toxicity.

Light-dependent Emission of Hydrogen Sulfide from Plants

With the aid of a sulfur-specific flame photometric detector, an emission of volatile sulfur was detected from leaves of cucumber (Cucumis sativus L.), squash and pumpkin (Cucurbita pepo L.), cantaloupe (Cucumis melo L.), corn (Zea mays L.), soybean (Glycine max [L.] Merr.) and cotton (Gossypium hirsutum L.). The emission was studied in detail in squash and pumpkin. It occurred following treatment of the roots of plants with sulfate and was markedly higher from either detached leaves treated via the cut petiole, or whole plants treated via mechanically injured roots. Bisulfite elicited higher rates of emission than sulfate. The emission was completely light-dependent and increased with light intensity. The rate of emission rose to a maximum and then declined steadily toward zero in the course of a few hours. However, emission resumed after reinjury of roots, an increase in light intensity, an increase in sulfur anion concentration, or a dark period of several hours.The emission was identified as H(2)S by the following criteria: it had the odor of H(2)S; it was not trapped by distilled H(2)O, but was trapped by acidic CdCl(2) resulting in the formation of a yellow precipitate, CdS; it was also trapped by base and the contents of the trap formed methylene blue when reacted with N,N-dimethyl-p-phenylenediamine and Fe(3+).H(2)S emission is not the cause of leaf injury by SO(2), since bisulfite produced SO(2) injury symptoms in dim light when H(2)S emission was low, while sulfate did not produce injury symptoms in bright light when H(2)S emission was high.The maximum rates of emission observed, about 8 nmol min(-1) g fresh weight(-1), are about the activity that would be expected for the sulfur assimilation pathway of a normal leaf. H(2)S emission may be a means by which the plant can rid itself of excess inorganic sulfur when HS(-) acceptors are not available in sufficient quantity.

The couvade syndrome

This is a psychophysiologic reaction to a woman's pregnancy on the part of her spouse. Nausea, vomiting, cramps or appetite disturbance occur in the husband early in pregnancy or near term. Anthropologists have found that ritual couvades dates back to ancient rituals regulating the behavior of the husband of a woman in labor. The modern syndrome is usually a self-limited condition but may indicate fears and anxieties that can be relieved by the understanding approach of the family physician.

The formation of exchangeable sulphite from adenosine 3'-phosphate 5'-sulphatophosphate in yeast

A new low-molecular-weight bound sulphite was found in yeast enzyme reaction systems which convert the sulphur of 35S-labelled adenosine 3'-phosphate 5'-sulphatophosphate into exchangeable radioactive sulphite. This bound sulphite was separated from other components by paper electrophoresis and Sephadex G-25 chromatography, and shown to be a peptide with multiple thiol groups and an estimated mol.wt. of 1400. The labelled sulphur in this peptide is highly exchangeable with unlabelled sulphite, but exchangeability decreases with time and freeze-drying. The low-molecular-weight acceptor is tightly bound to enzyme B of the yeast system and, apparently, accepts the sulpho group of adenosine 3'-phosphate 5'-sulphatophosphate and is released as bound sulphite only in the presence of enzymically or chemically reduced fraction C. It is proposed that the low-molecular-weight acceptor is a carrier peptide which, after release of the reduced sulphur, becomes re-oxidized and returns to enzyme B. Fraction C appears to function as an obligatory reductant of the oxidized acceptor before it can accept another-SO-3-moiety from adenosine 3'-phosphate 5'-sulphatophosphate. These findings are consistent with mechanisms proposed for sulphate reduction in spinach and Chlorella, and suggest that fraction C is the natural thiol required in these systems. An improved column technique for the preparation of adenosine 3'-phosphate 5'-sulphatophosphate is described.

Post-detoxification drug treatment of anxiety and depression in alcohol addicts

A study was undertaken to assess the effectiveness of treating alcoholics after detoxification for the very commonly observed syndrome of anxiety, depression, and somatic complaints. Previous studies had indicated that these patients generally respond quite well to drug treatment with the phenothiazine class of drugs. However, a double blind placebo-controlled study of adequate size had not been undertaken. Forty-five comparably addicted male alcoholics with anxiety or mixed anxiety-depression from an inpatient alcohol treatment ward comprised the treatment group. Twenty-three patients received thioridazine treatment and 22 received placebo treatment in a double blind fashion after acute withdrawal from alcohol. Progress over a 4-week period was measured with standard rating instruments--the Hamilton Rating Scale for Depression (by physician) and the Zung and Lipman Self-Rating Scales. Both placebo and active medication groups improved symptomatically during the 4-week program. The thioridazine group had significantly better improvement in sleep disturbance (early, middle, and late insomnia) than the placebo group. There was also significantly better improvement in anxiety with thioridazine as compared with placebo. Interestingly, the placebo group had significantly better work and activity (as appraised by the ward physician) than the thioridazine group. The authors note that active drug effect might actually hamper some patients in their rehabilitative effort, especially if phenothiazines of the more sedating variety are used. Since alcohol rehabilitation generally utilizes a wide range of activities (such as didactic sessions, occupation therapy, group therapy), alertness and performance ability appear to be important factors in the rehabilitation program. Although thioridazine treatment for some patients with anxiety and insomnia would appear to be quite helpful, its blanket use for the post-detoxification anxiety-depression of the alcoholic might be detrimental for others and cannot be recommended as a routine treatment strategy in an alcohol rehabilitation program.