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Background: The feasibility and safety of a new mechanical atherectomy device, the Transluminal Rotary Atherectomy System (TRAC), for coronary application was examined in vivo in eight dogs. The system operates over a standard balloon coronary guide wire and excises and removes the atherosclerotic material in a single application., Methods: The TRAC was introduced percutaneously using routine cardiac catheterization technique in four open-chest dogs (acute experiments) and in four closed-chest dogs (chronic experiments)., Results: Coronary angiography at the end of the procedure and 1-3 days later demonstrated normal coronary arteries without evidence of dissection, perforation, spasm, or thrombus formation. Macroscopic examination revealed perivascular bleeding along the treated coronary arteries in two out of eight dogs. Microscopic examination of these arteries demonstrated minimal endothelial peeling. Histology of the other coronary arteries demonstrated normal intact blood vessels without evidence for thrombus formation., Conclusions: These results demonstrate that it is feasible and relatively safe to introduce and operate the new TRAC mechanical atherectomy system in the normal coronary arteries of a beating dog heart.

Earlier research demonstrated that complete section of the corpus callosum in the rat reduced the number of trials required to acquire a left-right response differentiation (LRRD). This study was designed to investigate whether the facilitatory effect on LRRD could be produced by section of an anatomical subdivision of the callosum. Rats with sections of the anterior or posterior corpus callosum mastered the LRRD task faster than sham subjects, but more slowly than rats with total callosal section; section of the middle portion of the callosum had no such effect. The partial facilitatory effects of anterior and posterior callosotomy appear to be independent, and suggest that the callosal intermixing of lateral information, which contributes to left-right confusion, occurs at both the sensory and motor levels of processing.

Split-brained rats learned a left-right response differentiation in a water maze significantly faster than rats with sham surgery. It is unlikely that this superiority resulted from improvement in performance variables since callosotomized rats did not differ significantly from sham operates in speed of acquisition of a brightness discrimination in the same apparatus. Additionally, callosotomy likewise had no effect on the acquisition of a water-maze task requiring consistent unilateral responses. The superiority of the callosotomized animals in forming the left-right response differentiation supports a hypothesis implicating the forebrain commissures in left-right confusion.

Eosinophilic cystitis is an uncommon inflammatory disorder of the urinary bladder which causes irritative voiding symptoms and may mimic rhabdomyosarcoma radiographically. In children, eosinophilic cystitis has been previously reported to be self-limiting and requires no specific therapy. Reported herein is a case of a nine-year-old girl in whom eosinophilic cystitis recurred following antireflux surgery, raising the question of an association of eosinophilic cystitis with local trauma such as bladder surgery. Consideration should be given to pretreatment with steroids and antihistamines prior to surgery in these patients.

The uroflow curves of 45 men with either bladder outlet obstruction or impaired detrusor contractility were retrospectively reviewed. The definitive diagnoses were attained by clinical and video-urodynamic studies with simultaneous detrusor pressure and uroflow measurements. Eight parameters were analyzed to determine if uroflow can differentiate obstruction from impaired contractility. There were no differences between the 2 groups in any of the parameters. This finding suggests that uroflowmetry as a single examination cannot distinguish between bladder outlet obstruction and impaired detrusor contractility.

For schizophrenic patients, denial of illness and resistance to treatment are pervasive during the subacute phase of the illness. The authors conceptualize these phenomena from a developmental perspective, with particular emphasis on self-reintegration. Theoretical concepts are discussed and guidelines for developing a treatment alliance are described. Clinical examples drawn from experience with schizophrenic patients in a day hospital setting are provided.

Rats (and humans) appear to be able to distinguish between left and right by referring to an intrinsic asymmetry as a navigational aid; this suggests that experimentally induced asymmetries might also facilitate such a distinction. We assessed the effects of asymmetries produced by unilateral shaving, unilateral vibrissotomy, and asymmetrical cortical lesions on acquisition of a left-right response differentiation. None of the treatments improved performance relative to appropriate control treatments; the rats were evidently unable to use these induced asymmetries to form the lateral differentiation. The results are related to evidence provided in an earlier report (Noonan & Axelrod, 1989) that even some reliable intrinsic asymmetries cannot function as navigational aids.

We studied the hypothalamo-pituitary-adrenal (HPA) system in Vietnam veterans with post-traumatic stress disorder (PTSD) who also met Research Diagnostic Criteria for endogenous depression (MDD-ED). Over half also abused alcohol, and many complained of pain-confounding factors usually associated with increased HPA activity. Nonetheless, not even one patient had elevated basal plasma cortisol concentrations or an abnormal dexamethasone suppression test (DST); the subjects' post-dexamethasone cortisol values and plasma cortisol per ng plasma dexamethasone were in the low-normal range. These results highlight the biological heterogeneity of endogenous depression and its possible influence by past psychological trauma, and they raise questions about the use of current typological criteria for research purposes.

A total of 373 normal young adult subjects were distributed among 5 experiments measuring earedness. Handedness, eyedness and familial L-handedness were also indexed. Special care was taken to remove environmental asymmetries when determining ear preference when listening to sound from a suspended earphone, and from a stopwatch on a table, and for using a telephone symmetrically constructed and displayed. Ear preference was strongly influenced by seemingly minor environmental asymmetries and did not influence telephone habits, and must be considered a very weak lateral preference. Earedness was as concordant with handedness as eyedness was found to be; earedness was concordant with handedness in 74% of dextrals and 65% of sinistrals, but earedness was not related to eyedness. Earedness did not vary with putatively hemisphere-specific stimulus types (music, speech). Laterality of telephone use was jointly determined by handedness and the expectation of writing, not by earedness.

A paste brushing method (Complete) and soaking in either of two denture cleanser tablet solutions (Efferdent or Polident) were compared for denture cleansing effectiveness as measured by plaque level. The 12-week product use period with weekly evaluations allowed an assessment of plaque reaccumulation on the denture surface as well as the effect of a single cleansing event and the contribution of bleaching to the total plaque-cleansing activity. The paste/brushing method was consistently the more effective procedure for removal of denture plaque. However, the bleaching effects of the effervescent tablets could be useful in an overall denture hygiene program.

A common approach to dealing with the serious misbehaviors of handicapped individuals is to use punishment procedures. Although punishment techniques are often effective, many claim that their use is restrictive. Emerging approaches for dealing with inappropriate behavior are to conduct a functional or structural analysis of behavior. These approaches allow practitioners to isolate and manipulate the factors responsible for aberrant behaviors. Such analyses may reveal that a maladaptive behavior results in adult attention, is associated with demand situations, or provides reinforcing sensory feedback. In each case corrective procedures relevant to the function of the inappropriate behavior or its associated stimuli, can be applied. In some cases the analysis will reveal alternative approaches to the use of punishment procedures. In other cases it may not. Presently, there have been relatively few examples of the functional and structural analysis approaches; results thus far, however, have been encouraging.

Changes in psychiatric treatment have rendered the "therapeutic community" concept inapplicable to the present day inpatient milieu. In this paper, the quality of staff interactional processes is used as the basis for reconceptualizing the milieu of the short-term psychiatric unit. Patient psychopathology and rapid patient turnover are among the sources of anxiety for the inpatient staff. However, under optimal circumstances staff interaction generates a matrix of relatedness, communication, and stability which becomes a "positive group introject" for staff members. The "positive group introject" enhances the integrative functioning of the unit staff, thereby facilitating patient reintegration and the development of a therapeutic alliance. Failure to establish a "positive group introject" as a countervailing structure to staff anxiety and fragmentation leads to the dominance of pathological forms of staff interaction. These come to characterize a particular ward as a collective entity. Three forms of pathological staff interaction are described; of special interest, because of its seemingly high prevalence on short-term receiving units, is the milieu characterized by the suppression of staff relatedness, affective expression, and communication. The structure of a psychiatric unit can be seen as a function of staff interactional processes, thus the quality of interpersonal relationships, and emotional experience of staff and patients, rather than the specifics of the ward program itself, holds the key to understanding the milieu's efficacy.

Twenty right-handed undergraduate men were taught in free vision to categorize distortions of prototypic random forms and were then tested in a Go/No Go task with lateralized tachistoscopic presentations of previously sorted (old) distortions, new distortions, the prototypes, and unrelated forms. Accuracy of performance on positive items increased in the order New less than Old less than Prototype. More false alarms occurred to unrelated items in the right than in the left visual field, suggesting that the trace systems generated during training had different characteristics in the two hemispheres.

Each of six different tests of lateral postural-motor asymmetries was repeatedly administered to 126 rats. Directional reliability was found for rotatory swimming, open-field exploration, and stepping down from a beam. Neonatal posture, turn in an unbaited T maze, and orientation to tail pinch proved not to be reliable across days. The behavioral asymmetries in the open-field and step-down tests were directionally consonant with each other, but neither was related to the asymmetry exhibited in rotatory swimming, implying the existence of at least two independent asymmetrical neural substrates underlying the behaviors. Neither sample-wide directional biases nor major sex differences in bias were found. The sexes were, however, differentially influenced in direction on some tests by the number of males in their natal litters, implying a role for intrauterine exposure to androgens in predisposing rats toward some left- or right-biased behaviors.

We were concerned about the precision (i.e., consensus as to meaning) of adjectives and adverbs used to express frequency in the medical literature. We asked 103 physicians and 106 nonphysicians to assign to each of 22 such modifiers a percentage representing their understanding of the term. As indexed by the standard deviations, the degree of imprecision for 17 terms was so great for both physicians and for laymen as to make their use unacceptable. Consensus was significantly less among laymen than among physicians for 10 of the terms. Greater consensus was shown by native English-speaking physicians than by those with other native languages. Our data suggest further that American graduates of American medical schools show more consensus than American graduates of foreign medical schools. Board-certified physicians did not show greater consensus than physicians who were not board-certified. Verbal expressions of frequency should be eliminated from medical communications; failing that, the author should specify numerically the frequency he intends when he uses any such expression.

Controlled stimuli were used to evaluate a commercially available dentifrice containing 10% strontium chloride hexahydrate for efficacy in alleviating the symptoms of uncomplicated dentinal hypersensitivity. Sixty-one subjects with hypersensitivity were included in the 12-week, double-blind, parallel, comparative (placebo) study. Levels of hypersensitivity in affected teeth were assessed by three methods: thermally controlled cold air stimulus, tactile stimulus with an electronic pressure sensitive probe, and subjective response. The results from all three methods of assessment indicated that the strontium chloride dentifrice, in comparison with a placebo, reduced dentinal hypersensitivity to a significantly greater degree. This therapeutic response to the active agent was apparent within 2 weeks and increased continuously thereafter for the length of the study. One can conclude that the regular at-home use of a dentifrice containing 10% strontium chloride hexahydrate is an effective means for reducing the discomfort and pain engendered by thermal and tactile stimuli in patients with dentinal hypersensitivity.

The rate of compliance with aftercare following hospitalization is disturbingly low despite its proven efficacy in preventing relapse and rehospitalization. This study of 134 emergency admissions to a New York City municipal hospital examined the impact of patient characteristics, clinical variables, and attitudes toward treatment on compliance with aftercare in the six months following discharge. Excluding 31 patients who required rehospitalization, 70 percent of patients attended their first aftercare appointment, and 40 percent completed six months of aftercare. Factors associated with better compliance with aftercare were continuity of care, as reflected in less time between discharge and the first aftercare appointment; increased number of prior hospitalizations; increased length of hospital stay; less denial of need for treatment; and greater perceived need for medications. Recommendations for improving compliance with after care are presented.

To examine the proposition that lateral asymmetry facilitates left-right response differentiation in rats, we examined the relationships between the strengths of several behavioral biases and the scores on a learning task requiring left-right response differentiation. No support was found for a simple model positing a monotonic relationship between any behavioral bias and the learning scores. However, performance showed a U-shaped relationship to one behavioral bias. This finding conforms to a curvilinear model in which rats at either extreme of asymmetry are disadvantaged, at low degrees of asymmetry by a lack of navigational reference, and at high degrees by resultant strong position habits; moderately asymmetrical rats have neither disadvantage and are best able to use the asymmetry as a reference in processing left-right information.

Information regarding age, sex, birth stress, and handedness was obtained form 762 university faculty members and 1869 undergraduate and medical students, who also provided age, sex, and handedness information for their first-degree relatives. In addition, students reported the occupations and educational levels of their parents. Analyses of the effects of birth order, reported birth stress, and maternal, paternal, and joint parental age showed that an increased incidence of sinistrality was only rarely associated with high birth risk; in all cases, the effects were confined to male subjects, most frequently male faculty members. Sinistrality was not associated with low socioeconomic status; on the contrary, there were significantly more sinistrals among parents of high than of low educational and occupational levels. The pathogenic hypothesis has other implications which fail to find support in the current literature, thus casting further doubt on the proposition that all sinistrality is pathological in origin.

We propose that individuals who are recipients or potential recipients of treatment designed to change their behavior have the right to a therapeutic environment, services whose overriding goal is personal welfare, treatment by a competent behavior analyst, programs that teach functional skills, behavioral assessment and ongoing evaluation, and the most effective treatment procedures available.

Many experimenters and practitioners regard eye contact between instructor and learner as a facilitator, if not a prerequisite, to the effective instruction of sighted people. Without scientifically supporting the practice of demanding eye contact, experimenters, nonetheless, advocate its use and offer a variety of procedures to promote its acquisition. To justify the widespread use of demanded eye contact and to explain its role functionally, one experiment and data from six replications with nine subjects are presented. The primary experiment provides an empirical base for the training of eye contact prior to instruction. In a multiple-baseline design across two students demanded eye contact resulted in levels of compliance that were double and triple those of baseline. A tentative functional analysis of demanded eye contact is presented, followed by a discussion of the relationship of eye contact to attending.

Bladder neck obstruction in women is rare. The symptoms are confounding and nonspecific. The diagnosis depends on demonstrating poor uroflow, a detrusor contraction of adequate magnitude and duration, and radiographic evidence of obstruction at the vesical neck. We treated successfully 3 women with vesical neck obstruction by transurethral vesical neck incision.

The in utero leakage of meconium from the gastrointestinal tract into the peritoneal cavity results in the clinical entity known as meconium peritonitis. A patent processus vaginalis in the male fetus may lead to the migration of meconium into the scrotum, and these infants can present with soft meconium-filled hydroceles at birth. Local tissue reaction during the first several weeks of life results in calcification of these hydroceles into hard tumor-like lesions that may mimic testicular neoplasia. We report an atypical case of meconium hydrocele in a newborn.

Four parents enrolled in a Responsive Teaching class carried out experiments using procedures they had devised for alleviating their children's problem behaviors. The techniques used involved different types of reinforcement, extinction, and punishment. One parent increased the frequency of the wearing of an orthodontic device during five daily time checks by making an immediate monetary payoff contingent on wearing the device. A second parent increased the number of points earned for doing daily household tasks by providing back-ups for which the points could be exchanged. The parents of a 4-yr-old boy decreased the frequency of whines, cries, and complaints by removing social attention when such behavior occurred. A mother decreased the duration of time it took for her 5-yr-old daughter to get dressed by making permission to watch television contingent on dressing within 30 min of the time she got up in the morning. Brief reversals of contingencies were used to show causal relationships between the procedures used and the changes in behavior. Checks on the reliability of measurement were made by persons present in the home.