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The purpose of this retrospective study was to evaluate the utility of routine measurement of amniotic fluid alpha-fetoprotein levels at the time of second trimester genetic amniocentesis (mean gestational age, 17.3 weeks +/- 2.5 weeks standard deviation; median, 16.8 weeks; range, 15 to 22 weeks). During the study period 7174 patients underwent second trimester genetic amniocentesis. Outcome data were available in all cases. In 79 (1.1%) cases the amniotic fluid alpha-fetoprotein level was > or = 2.0 multiples of the median. Thirty-three of the 79 (42%) patients had normal ultrasonograms, and in 31 of 33 (94%) the amniotic fluid alpha-fetoprotein level was between 2.0 and 3.0 multiples of the median. Forty-six of the 79 (58%) patients had abnormal ultrasonographic findings, and of these, 82% were neural tube defects, abdominal wall defects, or cystic hygromas. Acetylcholinesterase was positive in 37 cases, all of which had abnormal ultrasonographic findings. None of the fetuses with negative findings on sonographic screening had detectable abnormalities at birth. In this study, with over 7000 patients, amniotic fluid alpha-fetoprotein and acetylcholinesterase levels did not increase the detection of fetal abnormalities. On the basis of these results, routine measurement of amniotic fluid alpha-fetoprotein level at the time of routine genetic amniocentesis (15 to 22 weeks) does not appear justified.

We reviewed the ultrasonographic studies and the clinical course of 22 fetuses with supraventricular tachycardia to determine whether the heart rate alone could serve as a basis for conservative management. Hydrops was not encountered with heart rates under 230 beats per minute. The conditions of all 22 fetuses stabilized without invasive administration of medications. Eighteen were delivered vaginally and only four by cesarean section. No fetal or neonatal losses occurred. Regardless of the type of supraventricular tachycardia, reducing heart rate in these fetuses to levels preventing or resolving hydrops allowed term vaginal delivery, thereby reducing the substantial problems of ventilating an immature or hydropic neonate.

The purpose of this study was to evaluate the risk of fetal aneuploidy in the presence of isolated choroid plexus cysts and to evaluate the results obtained from our institution and those reported previously in the English literature. All patients with fetal choroid plexus cysts on prenatal ultrasonography were offered genetic counseling and amniocentesis for fetal karyotyping. Seven of 274 fetuses, 2.6% (95% confidence interval = 1.0 to 5.2%), with isolated choroid plexus cysts were aneuploid. Literature analysis located 23 other reports of 1537 fetuses with isolated choroid plexus cysts; 26 were karyotypically abnormal, 1.7% (95% confidence interval = 1.0 to 2.4%). When evaluating only those patients whose indication for amniocentesis was choroid plexus cysts (i.e., eliminating those patients with advanced maternal age or abnormal serum screening) the risk of having a fetus with trisomy 18 changed little, 1.9% (95% confidence interval = 0.4 to 5.5%). Our data, combined with those of the literature, suggest that the risk of finding an abnormal fetal karyotype in the presence of isolated choroid plexus cysts is at least 1% and may be as high as 2.4%. On the basis of these results, genetic counseling and prenatal diagnosis should be offered to these patients.

In this study we examined the effect of a nurse-managed cholesterol screening program on the preventive health behaviours (e.g., diet changes, weight loss, medical surveillance) of 534 Hutterites. Hutterites are the largest single rural ethnic group in Canada and they have been found to be at high risk for heart disease. Eighty-one percent of the participants engaged in at least one preventive behaviour. Ongoing cholesterol surveillance was reported by 34.5% of the participants. Weight loss and dietary fat reduction were reported by 31% and 62% of the respondents, respectively. Seven percent of the respondents began lipid-lowering pharmacologic therapy. Screening cholesterol levels and age were significantly related to all of the outcomes except weight loss. This study provides evidence that community-based screening accompanied by counselling and referral by nurses can positively affect preventive behaviours.

Objective: We previously reported that the ovine fetus does not significantly increase its red blood cell production rate after a 40% loss of blood in spite of a transient elevation in plasma erythropoietin concentration. In this study we hypothesized that, in response to a more severe loss of blood, the ovine fetus would undergo a sustained rise in plasma erythropoietin concentration and an augmentation in its red blood cell mass expansion rate., Study Design: Twelve chronically catheterized fetal sheep (six control and six hemorrhaged) were studied beginning at 126 +/- 1 (SE) days' gestation. Fetal blood volume, plasma volume, red blood cell mass, reticulocyte count, plasma erythropoietin level, and plasma iron level were measured for 10 consecutive days. On days 1, 2, and 3 the hemorrhaged fetuses had an average of 102 +/- 4 ml per day of blood removed at a rate of 1 ml/min for a total of 305 +/- 10 ml of blood removed. Statistical analysis was by one- and three-factor analysis of variance., Results: Control animals had a progressive increase in blood volume, plasma volume, and red blood cell mass throughout the 10-day protocol. Reticulocyte counts and plasma iron and erythropoietin levels did not change. In fetuses at 24 hours after the third hemorrhage blood volume averaged 9.3% below (p = 0.03) and plasma volume averaged 16.4% above (p = 0.04) that in the control animals. Thereafter blood and plasma volumes expanded at rates similar to controls. Erythropoietin increased (p < 0.001) but returned to prehemorrhage values by day 7. Posthemorrhage expansion of the red blood cell mass in the hemorrhaged animals was 1.9 times controls (6.8% +/- 0.9%/day vs 3.5% +/- 0.5%/day, p = 0.003). Fetal reticulocyte counts remained elevated throughout the posthemorrhage observation period (p < 0.001). The fetal plasma iron concentration decreased (p < 0.0001) and remained depressed. The recovery of red blood cell mass and the 10-day mean plasma iron concentration were highly correlated (p = 0.01, r = 0.91)., Conclusion: The ovine fetus significantly increases its release of red blood cells in response to a severe hemorrhage. Further, the ability of the fetus to restore its red blood cell mass appears to be dependent on the plasma iron concentration.

Objective: Some Aboriginal children have poor growth while others grow according to international standards. This study was designed to find whether these differences were related to families., Methodology: Data were obtained on 13 families at Cherbourg Aboriginal Community in Queensland. There were data on the growth and hospital admissions of children in these families for at least two generations. Data were taken from records of the Infant Health Clinic and Hospital on the Community. A total of 606 children were considered., Results: The growth of a child during infancy is correlated with the growth of his/her mother in infancy, but not with the growth of the father. We have therefore defined families in the matrilineal line. There were marked and highly significant differences between the growth of children in the 13 families. The families with good growth in one generation were likely to have good growth of children in the next generation., Conclusions: In spite of the overall improvements in the growth of infants and children at Cherbourg, families tended to maintain their rankings from one generation to the next. It would be cost-efficient to target health advice to those families who have, in the past, had poor growth among their children.

Objective: Our purpose was to create xenogeneic lymphohematopoietic chimerism by in utero transplantation of human fetal liver cells in the midgestation fetal baboon., Study Design: Human fetal liver cell suspensions obtained from preimmune human fetuses (< 80 days' gestation) were injected into the peritoneal cavity of three fetal baboons (85, 95, and 104 days' gestation). A total of 9 x 10(6) cells, in a volume of 1 ml, were injected percutaneously into the fetal abdominal cavity under ultrasonographic guidance. The success of the injection was assessed by observing ascites and free loops of fetal bowel after injection. Fetal umbilical cord blood (35 days posttransplantation) and neonatal blood and bone marrow were obtained to be assayed for the presence of donor hematopoietic cells. Chimerism was detected by fluorescence in situ hybridization with a human Y-chromosome specific probe., Results: All the animals survived the in utero procedures. Thirty-five days after transplantation engraftment was noted in one animal. Postnatally the same animal showed engraftment in both the peripheral blood and bone marrow. The rate of chimerism was 1.5% (1.5% of the cells were human) in both the peripheral blood and bone marrow., Conclusions: This study demonstrates that creation of xenogeneic lymphohematopoietic chimerism is possible in the midgestation fetal baboon. However, the level of chimerism was too low to study the biologic activity of the transplanted cells or to potentially ameliorate lymphohematopoietic disorders. Future studies using allogeneic tissue, evaluating cells obtained from both fetal and adult donors, and comparisons between purified stem cells and fetal liver cells are needed.

Objective: We hypothesized that amnioinfusion with normal saline would increase fetal plasma sodium and chloride concentrations, resulting in a hyperchloremic acidosis, and that these alterations would not occur after amnioinfusion with lactated Ringer's solution., Methods: Chronically catheterized fetal sheep (137 +/- 1 days' gestation; mean +/- SE) were divided into three groups: control (n = 8), infused with normal saline (n = 10), and infused with lactated Ringer's solution (n = 10). The protocol consisted of a 30-minute pre-infusion period, a 1-hour amnioinfusion, and a 1-hour recovery period. During amnioinfusion, warmed solution was infused at a rate of 100 mL/minute for 1 hour. Fetal plasma and amniotic fluid electrolyte concentrations and osmolalities were measured every 20 minutes. Statistical analysis was by analysis of variance and linear regression., Results: Amniotic fluid electrolyte concentrations changed significantly (P < .001) in both amnioinfusion groups, resulting in amniotic fluid compositions that were essentially the same as the infused fluid 20 minutes after starting the amnioinfusion. Significant increases in fetal plasma Na+ and CI- concentrations (2-3 mEq/L) occurred in the normal-saline infusion group relative to both the control and lactated Ringer's groups (P < .001). The lactated Ringer's group demonstrated only a modest increase in plasma Na+ (P = .04) and no change in plasma Cl- concentration. Fetal arterial pH decreased (-0.015 U) in the normal-saline group, and the change in fetal pH was linearly related to the change in plasma Cl- concentration (r = -0.532, P = .004)., Conclusions: Normal-saline amnioinfusion can significantly alter fetal plasma electrolyte concentrations and blood pH, whereas amnioinfusion with lactated Ringer's solution results in minimal changes in fetal electrolytes and acid-base balance. The fetal plasma changes that occur during saline infusion are in the physiologic but not the pathologic range.

Objective: Aqueductal stenosis is a common cause of fetal hydrocephalus. Published studies of neonates with aqueductal stenosis have noted variable outcomes, with normal development seen in 24-86% of cases. In an attempt to better assess long-term outcomes in cases diagnosed in utero and to determine what prenatal sonographic findings might be used to predict prognosis, a retrospective analysis of patients with aqueductal stenosis was done., Materials and Methods: Fifty-three consecutive cases of aqueductal stenosis discovered in utero at two high-risk obstetrical centers in Seattle between 1980 and 1993 were studied. Parents elected to continue pregnancy in 39 of these cases. Two months to 10 years of long-term follow-up was available in 30 patients, who form our study group. Prenatal sonograms, postnatal cranial ultrasound, and head CT and MR were evaluated. Prenatal sonographic data collected included the biparietal diameter, size of the lateral and third ventricles, the ratio of the two, and thickness of the frontoparietal cortical mantle. Medical records provided an assessment of development based on physical examination, meeting of major milestones, and neuropsychological testing. The in utero diagnosis of aqueductal stenosis was confirmed by postnatal CT, MR imaging, sonography, or autopsy., Results: Within the study group of 30 patients, eight died in the postnatal period and four died subsequently. Of the 22 patients with adequate postnatal follow-up, moderate or severe developmental delay was present in 16 (73%). Normal developmental milestones were met in only three (10%) of all 30 patients and in 14% of those surviving the neonatal period. Although size of the lateral and third ventricles was not a useful predictor of long-term prognosis, the ratio of the two, as well as thickness of the frontoparietal cortical mantle, was weakly associated with long-term prognosis. No correlation was found between biparietal diameter and outcome., Conclusion: As compared with previous reports, prenatal diagnosis of aqueductal stenosis carries a grave prognosis. Twelve of the 30 patients died, for an overall mortality of 40%. Normal development was seen in only 10%, significantly less than in prior studies.

Objective: This investigation tested the hypothesis that elevations in fetal vascular pressures during nonlabor uterine contractions would be eliminated during polyhydramnios and augmented during oligohydramnios., Study Design: Twenty-two chronically catheterized fetal sheep were divided into three groups: (1) control with normal amniotic fluid volume, (2) polyhydramnios produced by amnioinfusion, and (3) oligohydramnios produced by fluid drainage. Fetal arterial pressure, venous pressure, and amniotic fluid pressure were continuously recorded with on-line computer techniques. Amniotic fluid pressure was continuously subtracted from fetal arterial pressure and fetal venous pressure to correct to the fetal zero pressure reference. One minute averages were collected for 30 minutes centered around the nonlabor uterine contraction., Results: Amniotic fluid pressure increased significantly during nonlabor uterine contractions in the control group. During polyhydramnios the amplitude and duration of the amniotic fluid pressure elevation were similar to those of controls (not significant). During oligohydramnios the duration of the uterine contractions was similar to that of both controls and polyhydramnios groups; however, the amplitude was less (p < 0.001). Fetal vascular pressures increased significantly during nonlabor uterine contractions in the control group (p < 0.001) but did not change significantly during nonlabor contractions in the polyhydramnios group. The contraction-induced elevations in fetal arterial pressure and fetal venous pressure in the oligohydramnios group were significantly greater than those in the control group (p < 0.001)., Conclusion: This study shows that the fetal vascular pressure responses to nonlabor uterine contractions were modified significantly by increases or decreases in amniotic fluid volume. The fact that the fetal arterial pressure and fetal venous pressure responses were augmented during oligohydramnios and eliminated during polyhydramnios suggests that direct compression or a conformational change of the fetus may be the cause of the vascular pressure changes during nonlabor contractions.

The solid-state characterization of gliclazide, for which no analytical standard was previously available, has been completed by extensive structural and physical analytical examination. The crystal and molecular structure for gliclazide was determined by single-crystal X-ray diffraction. Gliclazide crystallizes in the monoclinic space group P2(1)/n, with the unit cell dimensions a = 10.828(2) A, b = 14.342(19) A, c = 11.005(6) A, and with beta = 106.97(2) degrees, V = 1635(12) A3, and Z = 4. The gliclazide molecule is articulated in an open extended conformation about the sulphonylurea nucleus. Two gliclazide molecules form a complex with one calcium atom to facilitate the transport of calcium ions across the pancreatic beta cells necessary for the stimulation of insulin secretion. The only conformation that allows for the close apposition of the tolyl groups, and therefore the formation of the gliclazide:calcium complex, is the extended conformer.

We have used data from existing health records to study the birthweights and percentage weights for age (%W/A) of children in five Aboriginal communities in Queensland. The data are from cohorts of children born in the 1950s-80s at Cherbourg, the 1960s-80s at Yarrabah and the 1970s-80s in Woorabinda, Palm Island and Doomadgee. Birthweights have not changed significantly in any of the communities and generally remain below the international level. The weights for 1 and 5 year old children have improved significantly at Cherbourg and Palm Island, but have dropped significantly at Doomadgee. The overall pattern is for children on remote communities to have a lower %W/A and less improvement in %W/A than those closer to population centres. Other workers have found the same pattern elsewhere. These patterns of growth are probably not directly related to the level of general health services, but rather to other facilities available and attitudes of mothers to child care. The results also show that Aboriginal children can reach international levels of %W/A, so the poor growth in many communities is potentially preventable.

Objective: We hypothesized that the fetus, in response to a moderately severe hemorrhage, would restore its plasma volume and red blood cells so that plasma volume would be returned to normal within 24 hours and red blood cell mass would be restored in 5 to 7 days., Study Design: Time-dated pregnant sheep (five control and six hemorrhage, gestational age 124 +/- 1 [SE] days) were subjected to a 10-day protocol. Fetal blood volume, plasma volume, red blood cell mass, and plasma protein mass were measured on protocol days 1, 3, 4, 6, 8, and 10. Fetal plasma erythropoietin and plasma iron concentrations were measured daily. On protocol day 3 the hemorrhage animals underwent a 120 ml fetal hemorrhage over 2 hours. Statistical analysis was by three-factor analysis of variance., Results: Control animals had a progressive increase in blood volume, plasma volume, plasma protein mass, and red blood cell mass throughout the 10-day protocol. The 2-hour hemorrhage removed 39.8% +/- 1.2% of the prehemorrhage blood volume. During the 7-day posthemorrhage recovery period fetal blood volume and red blood cell mass in the animals that were hemorrhaged expanded in parallel to, but remained below, that of the control animals. There was no difference in the expansion of fetal plasma volume or plasma protein mass between the two groups. After hemorrhage there was a nonsignificant increase in the fetal reticulocyte index in the animals undergoing hemorrhage. In response to the hemorrhage, erythropoietin levels increased and remained marginally elevated, whereas plasma iron levels decreased in the hemorrhaged animals relative to controls during the 7-day recovery period., Conclusions: The normal expansion of plasma volume and plasma protein mass that occurs with fetal growth was not altered by a large fetal blood loss. However, in spite of a transient increase in plasma erythropoietin levels the fetuses undergoing hemorrhage did not restore their red blood cell mass or blood volume. These observations suggest that the ovine fetus is able to withstand a significant loss of red blood cells, but fetal transfusion may be needed to restore fetal red blood cell mass after a moderate-to-severe fetal hemorrhage.

This study compared the use of fetal growth curves with the Rossavik mathematical model in predicting third trimester fetal growth in 27 Hispanic patients. The parameters tested were BPD, HC, AC, and FL. The growth curve method of predicting third trimester fetal growth was significantly more accurate than the mathematical model for three of the four fetal parameters tested: BPD, HC, and FL. We conclude that the mathematical model method offered no advantage over the more commonly used growth curve method for predicting third trimester fetal growth. In addition, growth curves do not require complex calculations and are conceptually simpler and easier to use.

The potassium (K), sodium (NA), calcium (CA), and magnesium (MG) salts of p-aminosalicylic acid were obtained, and their thermal behavior was characterized by means of differential scanning calorimetry (DSC) and thermogravimetric analysis (TG). Their crystal and molecular structures were determined by single-crystal X-ray diffraction after powder patterns had shown them to be nonisomorphous. Different degrees of hydration were observed for the solid salts, and an assessment of hydrate stability to dehydration was made from thermogravimetric studies. The onset temperature of dehydration (Tt) of each salt varied within the series and exhibited correlation with X-ray determined structure. The observed onset of dehydration of MG and CA was higher than that of NA and is consistent with stronger ion-dipole interactions for the divalent salts. Crystallographic determination of the bond lengths between the metal ion and the water oxygens were 2.4 and 2.9 A for NA, between 2.0 and 2.1 A for MG, and 2.4 A for CA. The open nature and presence of a channel feature in the structure of the sodium salt may have facilitated escape of water molecules from the crystal. Particle presentation (e.g., size, crystallinity) was also shown to affect dehydration behavior.

The role of environmental radiation in the etiology of birth defects, stillbirths, and other adverse outcomes of pregnancy was evaluated for 13,329 Navajos born at the Public Health Service/Indian Health Service Hospital in the Shiprock, NM, uranium mining area (1964-1981). More than 320 kinds of defective congenital conditions were abstracted from hospital records. Using a nested case-control design, families of 266 pairs of index and control births were interviewed. The only statistically significant association between uranium operations and unfavorable birth outcome was identified with the mother living near tailings or mine dumps. Among the fathers who worked in the mines, those of the index cases had histories of more years of work exposure but not necessarily greater gonadal dosage of radiation. Also, birth defects increased significantly when either parent worked in the Shiprock electronics assembly plant. Overall, the associations between adverse pregnancy outcome and exposure to radiation were weak and must be interpreted with caution with respect to implying a biogenetic basis.

The infant mortality rate (IMR) at Cherbourg Aboriginal Community in south-eastern Queensland remained high from 1906 to about 1955-60, but since then has dropped from over 200/1000 live births in 1956-60 to 16/1000 live births in 1986-90, compared with the 1987 rate for Queensland (9.2/1000) and Australia (8.6/1000). The rapid improvement in the IMR was associated with the installation of a piped and chlorinated water supply, sewerage and an intensive campaign to eradicate intestinal worms. There has also been a change in community attitudes towards routine health practices and it is likely that this has been a major factor in the changes.

Chromosomal analysis was performed on products of conception from 18 patients having early pregnancy loss after assisted reproduction. Sonographic findings prior to obtaining tissue varied from gestational sacs consistent with a blighted ovum to fetal poles with cardiac activity. The mean age of the patients was 36.3 years. There were nine (50%) normal karyotypes, five (28%) autosomal trisomies, two cases of tetraploidy, one case of monosomy, and a case with two pericentric inversions. The results of this study suggest that patients undergoing assisted reproduction are not at an increased risk for chromosomal abnormalities.

Subclinical infection may play a role in the failure of magnesium sulfate tocolysis. Using a double-blind randomized study design, we administered a combination of ampicillin-sulbactam and indomethacin or corresponding placebos to patients in preterm labor who were receiving intravenous magnesium sulfate tocolysis. The mean gestational age at enrollment was 30.1 weeks, and mean cervical dilatation was 2.15 cm. No differences were noted between placebo (n = 43) and study patients (n = 43) in gestational age at delivery, term deliveries, days gained, or neonatal outcome. Preterm delivery (less than 36 weeks) occurred in 61% of the total population. The likelihood of a beta error was 0.07 to 0.23 on the basis of outcome analysis. In our population adjunctive ampicillin-sulbactam with indomethacin did not improve the success of magnesium sulfate tocolysis.

An experiment is reported that addresses the impact of lexical constraint on the production characteristics (mean duration and peak amplitude) of a given target word within a sentence production task. Subjects produced aloud sentences from memory that contained a target word (e.g., cat) that was either a repetition of an earlier word in the sentence (e.g., cat), associatively related to an earlier word in the sentence (e.g., dog), or unrelated to an earlier word in the sentence (e.g., son). The position within the sentence and phonetic environment of the target were equated across conditions. The results indicated that the mean durations for the target word were shorter in the repetition condition, compared to the associatively related condition, which in turn produced shorter production durations compared to the unrelated condition. In addition, the peak amplitude measurements indicated that the repeated condition produced relatively lower peak amplitudes for the target word, compared to the remaining two conditions which did not differ.

A multicenter clinical trial was conducted to evaluate the effects on compliance of a group counseling program for cardiac patients and spouses. The sample comprised 58 couples in which one of the partners had documented atherosclerotic heart disease and was enrolled in an outpatient cardiac rehabilitation program. The experimental intervention involved a ten-week series of group sessions based on symbolic interactionist role theory. The research used a quasi-experimental, three-group, time-series design: Experimental group 1 consisted of 17 patients and their spouses who participated in group counseling; experimental group 2 consisted of 22 patients and their spouses, but only the patients participated in the group series; the control group consisted of 19 patients and their spouses who did not participate in the experimental program. Data were collected at baseline, ten weeks, and six months on four cardiac risk factors: weight loss, blood pressure, exercise, and smoking. Repeated measures analysis of variance showed a significant difference (P less than 0.01) in mean body fat among treatment groups, with experimental group 2 having the greatest decrease over time. Patients in both experimental groups demonstrated lowered blood pressure, with a significant decrease (P less than 0.05) in systolic blood pressure. Again, the largest decrease was in experimental group 2. Changes in weekly exercise level were not significantly different among groups, although the highest compliance was reported by experimental group 1 patients. Results support the efficacy of group counseling based on an interactionist role theory framework to increase compliance. The anticipated effect of spouse participation was not confirmed.

One hundred six consecutive women who came to our clinic complaining of urinary incontinence underwent complete urodynamic evaluation. Urologic questions, pelvic examination findings, and the Q-tip cotton swab test results were examined to determine their ability to predict genuine stress incontinence (N = 59) versus other urologic disorders (N = 47). The symptom of stress incontinence, moderate to severe cystocele, and Q-tip cotton swab test result greater than or equal to 30 degrees were more common in women with genuine stress incontinence. Of the other urologic symptoms, only sensory urgency and enuresis were significantly associated with overactive detrusor function and voiding disorders. The combined findings of stress incontinence, cystocele, and no sensory urgency correctly identified 22% of women with genuine stress incontinence and eliminated 96% of women with other urologic disorders. Stress incontinence, moderate to severe cystocele, and no sensory urgency had a positive predictive value of 100%, but a sensitivity of only 10%. When used in series, the Q-tip cotton swab test contributed no additional information to that found by history taking and physical examination.

Granulocytes have been isolated by counterflow centrifugation-elutriation (CCE) from canine leukocyte-rich blood obtained by continuous-flow centrifugation leukapheresis (CFCL). We have attempted to define both the maximal granulocyte recovery and the efficiency of granulocyte purification for the Beckman JE6 elutriation rotor when large volumes of leukocyte rich blood are utilized. The efficiency of granulocyte purification by CCE is 81% (1.31 +/- 0.1 x 10(9) PMNL) if the number of granulocytes entered into the Beckman JE-6 rotor as leukocyte rich blood is limited to 1.60 +/- 0.13 x 10(9) PMNL. Approximately 96 +/- 2% of the leukocytes in the purified fraction were of the granulocytic series with mononuclear leukocytes comprising the residual 4% of the cell population. In vitro analysis of the isolated granulocytes indicated that the cells did not lose their morphological integrity or physiological function as a result of the dual CFCL/CCE procedure relative to granulocytes isolated by CCE from freshly drawn peripheral blood.

Changes in the distensibility of dorsal hand veins during the menstrual cycle were measured in 19 healthy young women using a new optical method relying upon a pressure-diameter principle. Significantly greater venous distensibility was found during the first half compared with the second half of the menstrual cycle. The possible causes for this finding, particularly the role of oestrogen, are discussed.

This paper reports the results of a survey of acute care hospitals which was undertaken to: (1) identify and establish the organizational positioning of key hospital marketing personnel; (2) measure the role of these personnel in influencing the traditional marketing mix decisions; and, (3) identify tactical marketing activities most frequently undertaken.

Work values and key influencers of a sample of black male and female adolescents were examined. Results indicated that boys and girls valued both the intrinsic and extrinsic rewards of work; however, girls reported slighter stronger extrinsic values than did boys. In addition, the sexes reported differences in the importance of specific work values such as "making lots of money," and "doing important things." When naming a key influencer, respondents tended to cite a same-sex and race individual. Sex of one's key influencer was related to certain work values, with subjects reporting a male key influencer valuing "trying out one's own ideas" and "having a secure future" more than those reporting a female key influencer. The interaction of sex of subject and sex of key influencer was significant on one of the work value outcomes. Implications of these findings are considered.

Detonation of fission-type nuclear devices results in an inner circle of complete denudation of desert shrub vegetation, often about 0.5 mi in radius, surrounded by a zone of partial and selective destruction which is variable in width. The gross injury to vegetation appears to be attributable to mechanical and thermal effects. Successional change in the composition of the vegetation, due to invasion by plants of pioneer character, is taking place in all disturbed areas.