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Energy-based healing techniques have rarely been explored in current complementary therapies literature. This therapy is appropriate for cardiac nursing and can be implemented as part of nursing care. The authors investigated the acute effects of a standardised energy-based healing technique on cardiac autonomic regulation.Method:This study was conducted on 18 healthy students (15 female, three male), all non-smokers aged 18–35 years. Heart rate variability (HRV) was analysed 10 minutes before and 10 minutes after the energy-based healing technique was carried out. Geometric, time and frequency domain indices of HRV were examined. The subjects were blindfolded and sat at rest for 10 minutes, then received a standardised energy-based healing technique from an experienced male healer; they remained blindfolded and seated for a further 10 minutes.Results:Time and frequency domain indices of HRV were not significantly different before and after the energy-based healing technique. TINN (triangular interpolation histogram of RR intervals) (P=0.04) and RRTri (triangular index) (P=0.02) were increased after the therapy. A Poincaré plot indicated a slight increase in RR intervals dispersion after energy-based healing technique.Conclusion:A standardised energy-based healing technique marginally improved cardiac autonomic function in healthy subjects.

Several letters to the editor are presented in response to articles in previous issues including one related to transportation in the U.S. in the March 20, 1954 issue, one on taxpayers of the U.S. and one on railroads being used as warehouses in the February 6, 1954 issue.

A series of six new aromatic polyamides with side oxadiazole rings has been synthesized by polycondensation reaction of aromatic diamines containing pendent substituted oxadiazole groups with a silicon-containing diacid chloride [namely, bis(p-chlorocarbonyl-phenylene)diphenylsilane] or with a fluorine-containing diacid chloride [namely, hexafluoroisopropylidene-bis(p-benzoyl chloride)]. All polymers were easily soluble in amidic solvents, such as N-methylpyrrolidinone and dimethylformamide, and gave thin transparent films by casting such solutions. Very thin coatings were deposited onto silicon wafers and exhibited smooth, pinhole-free surfaces in atomic force microscopy investigations. The polymers showed high thermal stability, with decomposition temperature >400°C. Some of them did exhibit a glass transition, in the range 152–276°C, with a reasonable interval between glass transition and decomposition. Four of these polymers showed blue photoluminescence, in the range 460–480 nm, which makes them promising candidates for future use as high-performance materials in the construction of light-emitting devices. © 2002 Wiley Periodicals, Inc. J Appl Polym Sci 87: 714–721, 2003

The success of lower limb bypass surgery depends, in the major part, on the availability of autologous saphenous vein as the most satisfactory arterial substitute known to date. Although various prosthetic conduits, used in the absence of saphenous vein, have shown promising success on short term follow-up, more long-term comparative data are required for adequate assessment. This study analyses, by life table method, the results of 134 infra-inguinal bypass grafts using polytetrafluoroethylene (PTFE) over a 6 year period. The results reconfirm the superior long-term patency of vein bypasses compared with such prosthetic grafts. Analysis suggests that, while PTFE may give acceptable results in the immediate and shortterm follow-up period, 6 year patencies approach 20–30 per cent.

Two-hundred eighty-three boys with Duchenne dystrophy and 10 with Becker dystrophy have been followed for up to 10 years in a protocol that accurately measured their function, strength, contractures, and back curvature. Clinical heterogeneity is noted. Patients whose muscles were stronger were more likely to die from a cardiomyopathy. Weaker patients died from respiratory failure. A series of milestones is defined, which is of use in following the illness in an individual patient. This approach permits a scoring system that allows the severity of the disease to be defined in an individual boy. Evaluation of physical therapy and surgical intervention shows that night splints and scoliosis surgery are effective forms of treatment.

Two successive, 6-month, randomized, double-blind, controlled trials of prednisone showed that 0.75 ing/kg/d was the optimal dose to improve strength in boys with Duchenne muscular dystrophy (DMD). We attempted to maintain 93 boys on that dose for an additional 2 years. During the 3 years of observation, the decline in average muscle strength scores of all boys taking prednisone was 0.072 units/yr, as compared with an expected decline of 0.341 units/yr from natural history controls. The occurrence of side effects in some boys prevented maintenance of the full dose, which may have lessened the response. At the time of last visit, dosages ranged from 0.15 mg/kg to 0.75 mg/kg. In addition to maintaining their strength, several of the boys actually improved their performance in lifting kilogram weights and in some timed function tests. Treatment of DMD with prednisone significantly slows the progression of weakness and loss of function for at least 3 years.

Prednisone has been shown to improve strength in Duchenne dystrophy. Azathioprine often benefits corticosteroid-responsive diseases and can reduce the dose of prednisone needed. The present study reports a randomized, controlled trial of prednisone and azathioprine designed to assess the longer-term effects of prednisone and to determine whether azathioprine alone, or in combination with prednisone, improves strength. Ninety-nine boys (aged five to 15 years) with Duchenne dystrophy were randomized to one of three groups: (I) placebo; (II) prednisone 0.3 mg/kg/d; or (III) prednisone 0.75 mg/kg/d. After 6 months, azathioprine 2 to 2.5 mg/kg/d was added in groups I and II and placebo added in group III. The study showed that the beneficial effect of prednisone (0.75 mg/kg/d) is maintained for at least 18 months and is associated with a 36 increase in muscle mass. There was weight gain, growth retardation, and other side effects. Azathioprine did not have a beneficial effect. This study suggests that prednisone's beneficial effect is not due to immunosuppression.

ROBISON, J. I., M. A. ROGERS, J. J. CARLSON, B. E. MAVIS, T. STACHNIK, B. STOFFELMAYR, H. A. SPRAGUE, C. R. MCGREW, and W. D. VAN HUSS. Effects of a 6-month incentive-based exercise program on adherence and work capacity. Med. Sci. Sports Exerc., Vol. 24, No. 1, pp. 85–93, 1992. The purpose of the study was to evaluate the effect of behavioral management techniques on exercise adherence linked to improvements in work capacity and maximal oxygen consumption (O2max). One hundred thirty-seven participants in six different worksites on a university campus (five experimental and one comparison site) completed 6 months of a minimally supervised, incentive-based endurance exercise program. All participants in the experimental group contracted to engage in at least four bouts of 30 min of verified aerobic exercise within a prescribed target heart rate range each week for the duration of the program. Forty dollars deposited at the beginning of the program served as a response cost that could be lost as a result of failure to fulfill the weekly contracts. Individuals in the comparison group participated in a similar 6-month program but without the contracts and response cost strategies. Weekly adherence for both groups was strictly defined as verified fulfillment of all four bouts of exercise. Adherence for the experimental group was 97 by this definition, and adherence for the comparison group was 19 (P< 0.01). O2maxincreased 2.6 (P< 0.01), and treadmill test time increased 16 (P< 0.01) in the experimental group after the 6-month program, with no significant changes in the comparison group. Recovery heart rates at 2 and 4 min post-exercise were significantly lower at 6 months in the experimental group but not in the comparison group. These data provide evidence that adherence to a 6-month endurance exercise program can be improved significantly through the use of well conceived behavior management strategies. In addition, the increased adherence results in significant improvements in cardiovascular efficiency and work capacity.

• Bullous pemphigoid in children appears to be the same disease as its adult counterpart based on a case in a 3-year-old boy. Generalized tense bullae over the skin and oral mucosa, characteristic direct and indirect immunofluorescence, elevated IgE levels, blood eosinophilia, and therapeutic response to corticosteroids parallel the disease in adults. The long-term prognosis, however, is still unknown. A review of bullous pemphigoid in children is presented.(Arch Dermatol 114:899-902, 1978)

Therapeutic application of physical pressure to various parts of the body has been in use for many years. Pressure has been used to facilitate the healing of wounds, burns, fractures, and chronic ulceration of the skin and in skin grafting. Pressure has also been used to prevent hemorrhage, interstitial cavitation, edema, and accumulation and stagnation of excess interstitial fluid. Smith1 was the first to apply pressure in the maxillary sinus with a balloon. He inflated a balloon in the sinus to apply pressure to and prevent edema in a skin graft in the sinus. Later Shea2 inflated a balloon in the maxillary sinus to hold the walls of the sinus in position after reduction of a fracture.METHOD OF TREATMENTFor several years I have treated certain types of maxillary sinusitis in selected patients by applying local pressure to the mucosa of one or both maxillary sinuses. I

The purpose of this paper is to call attention to some of the more important physiologic and pathologic factors and principles underlying infection of brain tissue and to detail a method of treatment which in my hands has proved satisfactory. In an effort to do this I shall not go into the problems of etiology and symptomatology but shall confine my remarks to a brief summary of the operative and postoperative course in four cases chosen to illustrate three types of disease of the brain-traumatic disease, acute abscess and chronic abscess. I shall quote from textbooks excerpts which I think have a bearing on the method of drainage of abscess of the brain with which this treatise is concerned.Case 1.—W. F. S., a man about 35 years of age, was injured on May 4, 1925, by a piece of 1 by 1 inch (2.5 by 2.5 cm.) lumber driven

During the development of the embryo certain anlages tend to carry with them to maturity some of the more important collateral systems which are destined to provide the mature parts with some of their most important physiologic functions. This tendency is noted particularly in the nerve supply of the muscles derived from the branchial arches. The trigeminal nerve supplies the muscles derived from the first branchial arch, the facial nerve supplies the muscles derived from the second branchial arch, while the glossopharyngeal and the vagus nerves innervate those derived from the third and fourth branchial arches. A good example of this is the derivation of the tensor tympani muscle from the first branchial arch and its innervation by the trigeminal, while the nearby stapedius muscle is derived from the second arch and is innervated by the facial nerve.1The best example of this developmental principle found in the lymphatic system

• A 63-year old man developed a delayed cutaneous reaction at the sites of intramuscular injections of a phytonadione (vitamin K1) preparation. The patient was tested with the drug and its components by intradermal and epicutaneous application. Sensitivity to the pure phytonadione and not the other components of the preparation was documented by patch tests.(Arch Dermatol 114:1790-1792, 1978)

In spite of some recent publications, the value of the agglutination test as a check on the efficiency of meningococcus serum has not been given the proper clinical appreciation. Regarding this, our experience with some forty-five cases of epidemic meningitis may be of interest.When the Army of Occupation entered Coblenz, sporadic cases of meningitis appeared, never two in the same company or neighborhood. All patients, whether brought in late or early in the disease, were at once put on the usual treatment, which consisted of intraspinal and at times intravenous injections of serum. This product, that of an American commercial firm, was five months old and dated good for another month.At this time Captain Leon Unger of Chicago, who in France had had considerable experience with this disease, urged that in clinical value the American serum was vastly inferior to that of the Pasteur laboratories.In spite of

THIS APPLIANCE was devised by one of my patients, Mr. George Weaver. He had had three unsuccessful operations for closure of an oral antral-alveolar fistula before consulting me. I operated on him by joining palatal and buccal flaps, but the fistula failed to remain closed. Following a second similar operation, a pressure bandage was applied to his cheek in the region of the fistula. The bandage was cumbersome, difficult to hold in place and interfered with his work. He devised the appliance illustrated here and wore it constantly for three weeks; I am sure it was instrumental in aiding the closure of the fistula. Three months later he had three upper molar teeth extracted on the opposite side. A large fistula resulted, which closed after one operation and the use of this appliance. Apparently this device immobilizes the buccal area, aids in approximation of the flap used in closure and

This instrument is an adaptation of the principle of the nasopharyngoscope to bronchoscopy. This bronchoscope has a slot in the distal end which holds the endoscope in place but which is not deep enough to prevent it being passed beyond the end of the bronchoscope.Fig. 1.—The endoscope and the grasping forceps in place in the bronchoscope.Fig. 2.—The bronchoscope used as a spatula through which the endoscope is passed into regions too small for the bronchoscope to enter.The endoscope is longer than the bronchoscope, which allows the distal end to be passed into regions too small for the bronschoscope to enter. This excessive length also removes the eyepiece and battery connection from the proximal end, allowing the use of grasping forceps to better advantage.The endoscope employs the system of lenses used in the nasopharyngoscope, giving an erect, magnified image, except that the terminal lens is so set

It is our purpose in this paper to describe a technique of scleral shortening with incarceration of a hinged roll of sclera. This procedure was evolved to obtain the advantages of a reduced scleral arc and a large and long-lasting choroidal fold without introducing a foreign body such as a plastic tube.From 1954 to 1958 we have operated on 97 cases, using the following method.To obtain adequate scleral exposure a conjunctival incision is made 10 to 12 mm. from the limbus. If the area to be operated on is confined to one quadrant, an episcleral traction suture is used; if there is more than one quadrant requiring surgery or if the optimum area for operation straddles a muscle, this rectus muscle is detached and a traction suture is placed through its tendon stump on the sclera.The location and extent of the scleral incisions will of course be