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The article presents a study regarding several types of staphylococcal skin infection, including secondary infection and sycosis barbae. The results of the administration of penicillin to the infections are discussed, as well as the increasing drug resistance of the infections as indicated by antibiograms.

The article discusses the practical ointment bases. Topics discussed include anionic emulgents, non-ionic bases, and polyethylene glycols. Particular focus is given to certain dermatologic conditions, such as allergic reactions to wool fat. In addition, a classification of ointment bases is presented, according to its physical properties , incompatibilities, and PH range.

The article discusses the disease of chromoblastomycosis, a superficial mycotic infection of the skin, characterized by the formation of verrucous or papillomatous lesions. Topics discussed include lymphatic blockage with elephantiasis and deformity, together with enlarged limbs. The treatment includes the administration of potassium iodide combined with X-ray therapy.

The article focuses on warts and their treatment. It discusses the different types of warts or verrucae in which it mentions that common warts are characterized by horny layer hypertrophy and filiform warts occur as a normal skin around several parts of human body in middle-aged people such as neck, nostrils, and eyelids. It explores several warts treatments including psychotherapy, oral, parenteral and local chemotherapy, and immunization therapy.

The article focuses on the relationship between ecological medicine and social responsibility. The interests of ecologists lies fundamentally in four types of relationships. The relationships of animals and their life cycles to one another, the relationship of plants and of their life cycles to one another, etc., are part of those interests. Each of these complex sets of milieus or relationships can be regarded as a system. In this sense an ecology is a system and subject to a systems analysis in precisely the sense in which the engineer or general systems theorist analyzes a system. Like all systems, however, an ecological system has components, boundary constraints, functional relationships among its components, negative and positive feedback processes, etc. The human body and its physiology also constitutes a set of systems in the sense just defined. The author of this article also mentions some medicines for regulating physiological functioning. It is also discussed that various types of drugs have been found to produce teratoma and congenital malformations in children.

Copyright of International Journal of Dermatology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of International Journal of Dermatology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The literature concerning changes in mast cell populations in human gingiva associated with inflammation is contradictory. No reports of the effects of therapy on these populations have been published. This study was designed to determine whether gingival mast cell populations are altered by inflammation and whether these populations change following routine therapy. Twenty systemically healthy patients, age 20 to 40, ten with normal gingiva and ten with periodontitis of similar severity bilaterally, were selected for study. Biopsies of interdental papillae from premolar regions were utilized. In the periodontitis group, one papilla was obtained prior to therapy, the second from the ipsilateral quadrant two weeks after root planing and curettage. Mast cell populations were determined from frozen sections stained with EACNAS-GBC Hematoxlin (Hall, 1966). Granule estimates were obtained from photographic negatives of frozen sections stained with EACNAS-GBC alone, using a photoelectric assaying device. Mast cell counts and granule estimates were made separately for beneath col and beneath keratinized tissue. Results show a larger mast cell population and a greater granule estimate under keratinized tissue than beneath the col. Mast cell counts and granule estimates show a decrease during periodontitis and a return to "normal" limits following routine therapy. These results support the concept that mast cell numbers are decreased in the presence of chronic inflammation but return to "normal" levels following resolution of the inflammatory process. [ABSTRACT FROM AUTHOR]

This article discusses the relation among illness, therapy and the modern urban American family. The analogy of physician, and parents in part is simple and obvious. These are the stronger and more adequate persons on whom the child and the sick person, respectively, are made to rely; they are the ones to whom he must turn to have those of his needs fulfilled which he is incapable of meeting through his own resources. As people shall maintain, these analogies must not be pressed too far. But they do constitute a convenient jumping off place for the analysis. The primary psychodynamically relevant reasons researchers find in the special character of the American urban family, which is extremely vulnerable to certain types of strain. Mechanisms have developed which relieve the family of the additional stresses which would be imposed upon it by making the care of the sick one of its principal functions. At the same time, most cases of illness with psychological components are probably more effectively cared for in the special circumstances of the society by professionalized agencies than they would be in families.

Rather than viewing psychotherapy with teen-agers as essentially a holding operation and waiting until adult years when self-defeating patterns have become rigidified, the period may be considered as offering a unique opportunity for facilitating change and focusing on new directions in the life of the client. One workable psychotherapeutic procedure, a team approach involving Diagnosis and Planning, Bargain-Setting, Psychotherapy Proper, and Termination, is briefly described. Involving the parents is seen as being of major importance. Other special concerns briefly examined and illustrated are interpreting closeness, establishing controls, and exercising flexibility. [ABSTRACT FROM AUTHOR]

Psychotherapy with individual patients is central to the objective of resolving children's psychological problems. Clarification is needed of the term "psychotherapy" and of the field it encompasses. The relationship between psychotherapy and the patient's environment is considered, and the importance of transference in the patient-therapist relationship is illustrated by the case history of a child receiving therapy. [ABSTRACT FROM AUTHOR]

The article cites a study which discusses the effect of growth substances on attached and detached root tips of Pisutn Sativuin L. It may be valid if the limitations of such detached systems are clearly defined and understood. Only then can information obtained from using detached organs be properly interpreted. These considerations may account for the apparent inconsistencies of observations on root length cell elongation and cell division. The present study attempts to clarify these limits by determining if different effects on growth occur when completely detached roots and roots that are attached to the rest of the shoot are subjected to treatment with growth substances.

Although many studies have been done in the framework of Rogerian theory, few have included the constructs of openness to experience and organismic valuing. Yet these occupy a central place in the structure of researcher C.R. Rogers theories of therapy, personality, and psychological adjustment, and as such deserve extensive study. The purpose of the present study was to test the Rogerian proposition that openness to experience and organismic valuing are positively related in a normal population. Because of the breadth of the definitions of these constructs, a strategy of conceptual-operational coordination advocated by researcher D.W. Fiske was followed. Each of the two large constructs was analyzed into several constituent, but smaller, subconstructs, which would presumably be more congruent with measurement operations. Openness to experience, according to Rogers refers to the complete availability of all stimulation to awareness, and to a perceptual-symbolic process whose function is to keep experience and symbolization congruent.

The article focuses on operant motor behavior (OMB) in acute schizophrenics. OMB seems best classified as a peripheral variable in terms of psychopathology. It is peripheral in the sense that functional psychopathology is generally viewed as fundamentally representing disturbances in interpersonal relationships. According to this frame of reference, a central variable in psychopathology would have to refer in some way to interpersonal processes. The following exploratory hypotheses were formulated for the investigation of operant motor behavior in 30 acute schizophrenics undergoing insulin coma therapy (a) severity of neuropsychiatric illness will be inversely related to rate of operant response, and (b) clinical improvement will be positively related to an increased operant rate. A personality organization-disorganization rating scale was constructed to measure severity of illness. The operant motor task involved pulling a plunger for rewards of candy and cigarettes. Further analysis of the data revealed a curvilinear relationship between severity of illness and operant rate. This relationship showed some promise in terms of offering a framework for predicting changes in operant rate when there was clinical improvement.

This article will begin with a few general comments on theory. Then some of the main points in the commentary will be illustrated by an example of the development and testing of a theory of approach avoidance conflict behavior. Finally, the discussion will include a brief resume of recent extensions of the theory to displacement, psychotherapy, and psychological effects of certain drugs. References will also be made to new experimental evidence relevant to these extensions. A theoretical model can be created as an intellectual game without any reference to specific phenomena in the real world. In order for a theory to be useful, the scientist must have some relatively unambiguous way of relating the terms in the theory to the phenomena that interest him. Some of the greatest difficulties of applying theory to phenomena of practical importance arise at the point of linking the antecedent conditions in the practical situation with those specified in the theoretical model. It may be difficult to measure the conditions in the practical situation, they may vary in unknown ways or be too complex for the theory to handle.

Group psychotherapy is a term with many different meanings. It is used in referring to a lecture by a therapist to a group of patients, it may mean a group of patients discussing their difficulties under the guidance of a therapist and finally, it may refer to the use of expanding interpersonal relationships within an integrated group as a medium of therapy. It is group psychotherapy only when the patients' participation in a group is the primary medium of therapy. The basic orientation was to translate the need for therapy into the need to develop a minimally comfortable community life. The patients were charged with the responsibility of treating themselves. The therapy staff was available but served only as interpreters, and then only when such help was requested. The patients were faced with the necessity of administering their community life, and handling all of the problems of living together as a group twenty-four hours a day. Apart from adhering to a few military rules and a skeleton schedule, the patients were free to meet this responsibility in any way they saw fit. Social controls, leadership, therapy activity, and social organization were to come from within the group. Provision was made for any materials the patients requested.

The biochemical, physiological and psychological features of metabolic and endocrie disorders prevalent in alcoholics, in conjunction with reactions to carbohydrate, amino acid anti nicotinic acid tolerance tests, suggest a means of distinguishing true alcoholism from hearty drinking. Case and family histories, considered in relation to genetic factors, dermatoglyphics and diet preferences, provide additional data which are of value in diagnosis, assessment of predisposition to addiction, aria choice of treatment. [ABSTRACT FROM AUTHOR]

Copyright of British Journal of Addiction (to Alcohol & Other Drugs) is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Suppression of the primary immune response by treatment of mice with carbon 1 day before initial immunization markedly interfered with development of immunological `memory', since such mice responded to a subsequent Challenge injection of RBCs by formation of mainly IgM PFCs and serum antibody. Appearance of IgG PFCs and 2-ME resistant antibody was delayed several days in these carbon treated animals, indicating failure of a typical secondary response. The immune response of these animals was similar to that of a primary response of control animals to a single injection of red cells. Reticulo-endothelial cell blockade with colloidal carbon suspensions interfered with development of a normal secondary type immune response to sheep red blood cells,, as assayed on both the cellular and humoral levels. Fewer antibody PFCs, mainly 19S IgM but also 7S IgG, appeared in spleens of antigen primed mice treated with carbon 1-3 days prior to a challenge injection of red cells, as compared to control primed mice injected with erythrocytes alone. However, the peak day of antibody response was the same for both control and carbon treated animals. Mice treated with carbon 1-3 days before secondary immunization had much lower peak serum litres, mostly susceptible to 2-ME inactivation. The time of inoculation of carbon in relation to immunization was important since carbon treatment 1-3 days before secondary RBC Immunization resulted in maximum suppression. Injection of carbon 5-7 days before resulted in only a slight effect, whereas Injection 30 days before had no detectable effect. Injection of carbon simultaneously or after RBC injection had little effect The dose of carbon used for immunosuppression, as well as the concentration of sheep erythrocytes used for immunization affected the number of antibody PFCs and the serum titres in control as well as carbon treated animals. [ABSTRACT FROM AUTHOR]

Studies the psychological treatment of Roman Catholics. Elements of paranoia with regard to analysis in general and non-Catholic analysts in particular; True, living faith that may underlie superstitious beliefs; Need for the tendencies to be understood and uncovered by analyst and patient alike for the analysis of the parent archetype to be effective and for treatment to proceed satisfactorily.

Offers insights into training analysis. Effect of training analysis in approximating to an ordinary therapeutic analysis; Assumption that training analysis must be conducted by one analyst only if the earliest pre-oedipal conflict-patterns are to be adequately worked through; Question of whether analysis of childhood gives sufficient attention to the shadow, the animus and the anima.

Focuses on the importance of group analysis on analytical psychology. Important aspect of group transference; Discussion of the group psychodynamics, the group archetype and the group transference; Establishment of the therapeutic modality of the resolution of the group transference through a group analysis.

The article attempts to add the understanding of therapy with respect to the dimension of psychological climate. Specifically the study is concerned with the therapist's behavior under two conditions of threat, and undertook to examine physiological and verbal response to threat. The study concerned the effect of two threat levels upon the physiological and verbal behavior of therapists. Sixteen therapists showed greater physiological activation as measured under the evaluative condition. It was concluded that an evaluative climate produced some decrement in verbal effectiveness but that quantitatively the amount of decrement was minimal.

The article cites two studies that examined the effects of contingent shock and verbal command on body rocking of retarded persons. Researchers observed subjects in a controlled environment under baseline and treatment conditions. Results of the study revealed that a few contingent shocks brought high rates of body rocking in all subjects to near-zero levels. Although this effect appeared to persist over a long period of time, it was also evidently highly situation-specific. The verbal command also produced a rapid cessation of rocking.

The article presents a study which attempts a more molecular examination of individual behavior by examining data from two stages in group development by factor analyzing responses of group therapy members on verbal process items. A factor analysis of group process variables on group therapy patients at two stages of group development revealed distinct and identifiable response communalities. For early group sessions, six factors were identified and labeled. In the second stage, another six factors quite distinct from the previous stage emerged. Obtained changes suggested increased meaningful interaction and depth of participation.

The article highlights the effects of the therapeutic conditions of accurate empathy, non-possessive warmth, and genuineness on hospitalized mental patients during therapy. The findings tend to support the original hypothesis indicating a positive relationship between level of conditions offered during group psychotherapy and degree of therapeutic outcome. Since the hospitalized patients themselves were primarily diagnosed as schizophrenic, the significant change on the subjects subscales is of particular relevance. Also, as can be seen, patients who received relatively low levels of conditions, as a group, showed negative or deteriorative change on the subjects scale, whereas patients receiving high levels of conditions showed positive change on the subjects scale.

The article highlights the degree of negative transference occurring in group psychotherapy and client outcome in juvenile delinquents. The results suggest that the occurrence of negative transference in group psychotherapy with juvenile delinquents is associated with positive therapeutic benefit. Further, the degree of occurrence of negative transference in juvenile delinquents had no differential effects whether the therapist was high or low in empathy, warmth, or genuineness. Moreover, it is to at least some degree the therapist who is more open, non-defensive, real or genuine who facilitates the expression of negative transference. Juvenile delinquents typically have difficulty in relating to authority figures.

The article focuses on a behavioral approach to the group treatment of depressed persons or patients with mental depression. In this study preliminary results of a behaviorally oriented approach to the group treatment of depressed individuals are presented. The approach emphasizes lack of "social skill" as an important antecedent condition for occurrence of depressive behaviors and makes use of the group and of the behavior of the patients in the group to produce behavioral changes in the direction of increased social skill.

The article reports on the behavior therapy and target symptoms of the patients. This study describes three cases treated by behavior therapy, where treatment aimed at the target symptom also brought about other changes, which had seemed unrelated to the presenting symptom. The remarkable aspect of the whole treatment procedure is that the patient has lost all interest in homosexual and transvestite activities, although no specific treatment was directed towards his sexual deviations. The patient himself was even more grateful for the disappearance of his sexual perversions than for his recovery from the traffic phobia.

The article investigates the feelings of therapists in the therapeutic process. This study was concerned with what therapists typically feel in psychotherapy sessions, what the structure of these feelings was, and how these feeling clusters were related to the patient's experience. In general, salient therapist feelings were role-syntonic. There were nine dimensions of therapist affective experience and some of these were related to patient experiences. The value of these relationships as practical cues and for a greater understanding of psychotherapy process are discussed.

This article focuses on relationships between visual and auditory cues of therapeutic effectiveness. The importance of nonverbal cues in judging interpersonal interactions has recently been emphasized. Studies have shown that judges who are allowed only visual monitoring of Ss can make reliable, psychologically meaningful statements about the expressors' current emotional state. The relationship between verbal and nonverbal behavior has been in the fore front of some investigators' interests. Research in psychotherapy has suggested that randomly chosen audio-tape segments of individual and group psychotherapy can be reliably rated for degree of therapist genuineness, empathy and warmth and that such ratings can predict improvement or deterioration in the patient as a result of the therapy.

The article presents a study which reports the results of a comparison of female and male alcoholics. It is the purpose of this study to determine whether the differences in the ratio of identified male and female alcoholics, and the clinical hypotheses derived from these difference, first are reflected in measurable personality and intellectual variables, and secondly, to examine any implications they may have for therapy with alcoholics in general. The variance differences on the Rorschach indices for male and female alcoholic patients yielded no positive results.

The article cites a study that evaluates the nature of therapeutic change by using correlation and factor analysis of several measures of change which reflected different levels and areas of personality functioning. This study used the method to examine the nature of change in successfully treated adolescent delinquent boys. The success of the psychotherapeutic program for adolescent delinquent boys was shown by significant changes in all three areas investigated--overt behavior, personality attitudes, and achievement test performance. In evaluating personality attitudes, three areas in which the boys were believed to have special problems were sampled--attitude toward authority, control of aggression, and self image.

The article presents a study on an ideal therapeutic relation between therapists and patients. The study was conducted on 208 patients of the University of Texas, Austin, Texas's Testing and Counseling Center who were seen separately by one of the eight counselor-interns during the period of September 1958 to June 1961.

This article describes, and attempts a preliminary assessment of, a new approach to the treatment of underachieving adolescent boys who resist needed psychotherapy. It would appear most economical to briefly describe the remedial clinic setting in which this investigation took place, and then to proceed to a consideration of method and results. The Clinic School, established in 1921, on the campus of the University of California, Los Angeles, is a remedial center providing facilities for: the diagnostic psychological assessment of children with severe learning disorders, the treatment of a limited number of such children, either in the full-day remedial school program or in the part-time tutoring program, and training and research.

The article reports that the utilization of psychologists as administrators of psychiatric wards or as members of ward treatment teams has led to the need to scrutinize and to reformulate the role of the psychologist. Whether the psychologist partly assumes the role of a ward psychiatrist, or whether he becomes a member of a ward team, changes in functions, attitudes and perceptions, and role-definition are inevitable. The traditional functions of psychodiagnostic testing, research, and psychotherapy developed by the psychologist are inexorably modified by the demands of the ward and team setting. The ward psychologist has no precedents to follow.

The article presents a study that investigates the relationships over time among blood pressure, personality dynamics discussed during therapy, and overt behaviors for a single hypertensive patient. The patient was a 38 year old white male hypertensive who was still in the fluctuating stage of hypertension. His blood pressures ranged between 120/70 and 140/200 during the nine months period in which he was followed. The patient's blood pressure was measured daily by the medical staff over the period of this study, but the psychotherapist avoided any knowledge of this variable in order to prevent any methodological contamination between this variable and the variables measured in the therapy sessions.

The article cites a case of outpatient treatment of a seriously disturbed child in a child guidance center. An attempt to evolve a suitable treatment plan for a child like the one studied in the article raises questions that cannot be answered with certainty. Despite current theories about the preference for residential treatment for the severely disturbed child, the diagnostic team at the Center proposed a plan for out patient therapy. This was done with full knowledge that such a plan would require more treatment hours over a longer period of time than is accorded the average treatment case.

The article informs that maladjustment has been explained as "repetition compulsion" or as the imposition of past perceptions upon present experience. Repetition of the past involves not only inaccurate perceptual content, but more especially a structure-bound manner of experiencing. There is experiencing of structures and patterns instead of the richly detailed immediacy of present events. It follows that immediacy of experiencing is a mark of adjustment. Increased immediacy of experiencing has also been viewed as inherent in the process of therapy.

The article evaluates the relationship of therapists' ratings of patients to duration of stay in therapy, and appraises the effect of clinical experience on these relationships. Fifteen rated variables were utilized and compared with duration of stay in outpatient psychotherapy. The most striking finding of this study is the moderate to high reliability of ratings of experienced judges on therapeutic assets of therapy candidates and the failure of these judgments to relate to actual duration of stay in psychotherapy.

The article attempts to set up models of therapeutic situations in which analogues to several different therapeutic approaches might be examined. For example, if the patient and therapist concentrate on the environment, the nature of the environment, the forces at work in the environment, and other general environmental factors, it can be seen that particular therapeutic approach is quite similar to the approach classically practiced by the social or guidance worker. The study suggests that the categories of response concern primarily with the environment, the subject, and the examiner can be rated reliably and offer a potential tool for further research in the area of psychotherapy.

This article reports on a homosexual who was treated with rational psychotherapy. The client was a thirty-five year old male, living in Brooklyn with his parents, and operating his disabled father's toy factory. He had been raised as a Catholic, but no longer considered himself a believer. He was the only son of what he described as a "very religious and very neurotic" mother and an "exceptionally weak, dome mated father" who had been disabled by a serious stroke two years before the client came for treatment. He had always been quite close to his mother, and usually did her bidding, even though he bitterly resented her persistent attempts to control himself and his father.

The article discusses the performance of psychiatrists and psychologists in a therapeutic interview. This investigation was undertaken for the purpose of obtaining empirical evidence on therapists' performance in an initial interview and to explore the effects of relevant therapist variables upon clinical judgments, including diagnostic and prognostic evaluations, formulations of treatment plans and goals, communications addressed to the patient. Psychotherapists were asked to participate as vicarious interviewers while being exposed to a sound film of an unrehearsed initial interview. Subsequently, they were asked to record their clinical impressions. Data were collected from 235 therapists representing a wide range of experience and training.

This article discusses some normative data on new Minnesota Multiple Personality Inventory (MMPI). The normal male and female standardization samples used for the new scales were drawn from the general Minnesota normal sample described in the MMPI Manual but are not quite identical with any previously used normative samples. The new samples were developed for use in standardizing all new scales. To make up these samples the old norms were in proved by re-examination of every one of the records to discard incomplete ones or any others that looked defective; other records from among the originals were substituted for defective ones and some attempt was made to select cases so as to improve representativeness of the sampling.

This article discusses rhythmical responses of low grade and middle grade mental defective to music therapy. Observations were made during experimentation with a large scale music therapy program in ten Colony cottages devoted to care, treatment and training of a low grade and middle grade defective male population. The music was provided by two musicians playing saxophone and guitar. The melody was played on the saxophone and the rhythmical beat of the amplified guitar accompaniment was accentuated in an effort to elicit active participation on the part of the patients.

This article discusses outcome of employing three techniques of psychotherapy. Since it has been the writer's custom, for the last several years, to keep summary records on all clients seen, including information relating to diagnosis, number of sessions, and therapeutic outcome, 78 closed cases were taken from the therapist's files, consisting of individuals who had been treated for at least ten sessions with rational analysis. These were matched with 78 cases of individuals who had been treated for at least ten sessions with psychoanalytically oriented psychotherapy.

This article discusses Minnesota Multiphasic Personality Inventory (MMPI) and electroshock therapy (EST). The present concern is with one method of treatment, electroshock therapy, and one method of evaluating behavior change as a result of this treatment, the Minnesota Multiphasic Personality Inventory. This represents a prototype study, part of a larger evaluation of hospital treatment, and illustrates a design which could be employed with other treatments and other methods of evaluating treatment.

The article examines the role and status structure in psychotherapy groups. Psychotherapy groups exemplify the rule that prolonged interaction results in some measure of role differentiation and status structuring. For the purpose of this study interaction process data were used for individual profiles. These were derived by summating a group member's entries under a category heading over eight successive meetings. Therapy groups begin with the least possible structuring. The members are discouraged from meeting outside the therapeutic situation, and were in no instance known to do so as a complete group. Examining the content of therapeutic interaction, the most interesting finding is the way in which attempts to use the group as a source of reassurance and sympathy are appraised, in contrast with a willingness to supply such support to others.

This article focuses on social class and the acceptance of psychotherapy. The patient source was the Out-patient Department of the Henry Phipps Psychiatric Clinic, Johns Hopkins Hospital, a training institution and community clinic offering various types of psychotherapy. A total of 57 patients who met the qualifications specified below were included in the study. All patients were between the age of 18 and 55 years and their diagnoses were either psychoneurosis or some form of personality disorder. Specifically excluded were patients with a diagnosis of organic brain disease, anti-social character disorder, alcoholism, overt psychosis, or mental deficiency.

The article discusses a methodology for measuring personality changes in psychotherapy. Psychotherapy has existed and flourished during the past five decades in spite of the fact that it remains almost completely unvalidated by scientific standards. Psychotherapy is, in some respects, an implausible procedure offering to the individual the opportunity to learn those things about himself which by definition he does not wish to know. The methodology for measuring changes before and after psychotherapy is based on the Interpersonal System. This system involving a complex combination of formal and empirical operations has been described elsewhere.