Search

Problems encountered by a young, unmarried woman who, as a result of a spinal injury in an automobile accident, loses use of all four limbs and requires complex home health care services delivered by a network of health and social service agencies in a rural area of Kentucky. Economic, psychosocial, ethical, preventive, and medical aspects of health care are discussed.

Eighty patients with severe back or leg pain were assessed by a battery of psychological tests. Functional factors (that is, psychological and behavioral characteristics) though to be contributing to the patient's pain experience were analyzed, and the patient's response to surgery was predicted. Patients were selected for the study on the availability of good follow-up data at 6 months or longer after surgery. The results reveal that the presence of functional factors was not of substantial consideration in the decision for surgical treatment. However, when both the clinical predictions and the subject's response to surgical treatment were rated on the same 0 to 5 scale, it was found that response to surgery could be predicted with 84% accuracy based upon functional data. Few single scores significantly discriminated between success or failure of surgery, and the basis for discrimination was made upon clinical judgment of an array of findings obtained by the functional pain assessment. The results are discussed with regard to a pain model which assumes the presence of an organic-functional pain continuum.

A mutation in the genetic code would place new amino acids in certain loci and entirely eliminate amino acids from other loci of practically all proteins in an organism. It is reasonable to postulate that mutations of this kind cannot supplant the original code. The genetic code, once established, would therefore remain invariant.

After a shift in temperature, the population kinetics of HeLa cells does not immediately reach a steady state characteristic of the new temperature. During the transition period the duration of each period of the life cycle (period before DNA synthesis, of DNA synthesis, after DNA synthesis, and the period of mitosis) increases toward its steady-state value. Of the four periods, the period before DNA synthesis reaches its steady-state value fastest. Exponential growth can be maintained only from 33 degrees C through 40 degrees C. The period of mitosis is the most temperature-sensitive period of the life cycle of the cell. At subnormal temperatures (26 degrees C through 31 degrees C) there is an accumulation of cells in mitosis, and mitotic indices as high as 0.44 can be obtained. The duration of mitosis is a function both of the temperature and of the time which the cell has spent at this temperature.