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Using a nonair-drying modification of a method for longitudinal sectioning of metaphase spreads on glass slides [Wen et al., 1997], we have studied 14 preidentified X chromosomes (10 from fragile X specimens and 4 controls) with transmission electron microscopy (TEM). Four of 10 X chromosomes from fragile X specimens exhibited lighter chromatin density in the area of and distal to the fragile site, most pronounced under dark-field TEM. A clear line of separation at the fragile site locus was also observed by TEM in an X chromosome with no visible fragile site after Q-banding. We hypothesize that these areas of lighter density, including lines of separation, precede the appearance of the fragile site that is commonly observed using light microscopy.

We report recent experience with a new device, the thoracic vent, in the management of simple pneumothorax. There were 16 patients aged 19 to 73 years who suffered pneumothorax due to spontaneous (4), traumatic (3), or iatrogenic (9) causes. Ease of insertion, patient tolerance, and the presence of a unique signal diaphragm all contributed to patient and physician acceptance of the device. Average time to pneumothorax resolution was 2.5 days, and time to thoracic vent removal averaged 3.2 days. There were no immediate recurrences or significant complications. We conclude that the thoracic vent is an effective device for initial and definitive therapy of simple pneumothorax.

Rapid method, employing capillary column gas-liquid chromatography and a flame ionization detector, has been developed for the analysis of volatile substances present at extremely low concentrations in such complex media as biological fluids and polluted air. The method employs a direct injection of up to 100 mm3 of dilute aqueous samples, removal of water in a condenser at 0°C and subsequent sample trapping and concentration on a small, cooled precolumn packed with Tenax GC. Total sample preparation time is less than four minutes and the reproducibility of the method for standard solutions is indicated by an average standard deviation in the results of 5–6%.

The cytoarchitecture of the prearcuate gyrus, including the region of the physiologically defined frontal eye fields (FEF), was studied in four macaque monkeys (Macaca fascicularis, M. mulatta) to determine if the FEF could be anatomically identified. Brain sections were stained with standard Nissl and, in some cases, myelin stains. Two nonstandard planes of section were used: one tangential to the prearcuate gyrus and the second normal to the most posterior bend of the prearcuate gyrus. The first plane of section was advantageous for studying the location of the FEF with reference to the entire medial-lateral extent of the gyrus and the second allowed good comparisons of the FEF to adjacent anterior and posterior cortical areas. Frontal plane sections through the prearcuate gyrus were also examined in 15 macaque monkeys for comparison with sections cut normal to the posterior bend of the gyrus and tangential to the gyrus. Intracortical microstimulation was performed in three monkeys. The FEF was defined as the area from which low-threshold (less than or equal to 50 microA) saccades could be evoked. The area extended about 10 mm along the anterior bank of the arcuate sulcus. Within the area, saccade amplitudes were represented in a mediolateral, large-to-small topography. No topography of saccade direction was noted within FEF but reversals of saccade direction for any given electrode pass were found. These results confirm the results from our earlier mapping study of FEF (Bruce et al.: J. Neurophysiol. 54:714-734, '85). Cell bodies of large pyramidal cells in layers III and V of the prearcuate gyri from three hemispheres were measured with the aid of an image-combining computer microscope. The distribution of cells of greater than 22 microns diameter or cross-sectional areas of greater than 500 microns 2 were plotted. In one monkey, marker lesions made at microstimulation sites within the FEF or in adjacent non-FEF areas were also plotted. The location of the FEF appeared to coincide with the concentration of large layer V pyramidal cells in the prearcuate gyrus rather than with any previously mapped cytoarchitectonic area. The numbers of large pyramids in layer V were noticeably reduced along the lip of the prearcuate gyrus and at dorsomedial and ventrolateral locations which were outside the physiologically defined FEF.

A documentary survey of a national sample of males aged 25-34 on their first admission to a mental hospital in England and Wales for schizophrenia showed the usual excess of patients in social class V. However, the social class distribution of the fathers at the time of the patients' birth was very similar to that of the population as a whole. A clinical study of a representative series of consecutive admissions of male schizophrenics aged 15-30 living in a socially mixed area in outer London confirms these findings. It shows decline in occupational status both from father to son and in the patients' own history. The main evidence of individual downward "drift" is the ability of schizophrenic patients to win places at grammar schools, though they end in semi- or unskilled jobs. The employment histories showed that in their adolescence many patients pursued varied careers, a considerable proportion aiming at professional or technical jobs; they still fitted broadly with the career expectations of their home environment. The discrepancies in social performance between father and son could be mainly attributed to the disease process. Patients whose illness had an insidious onset at adolescence did not attain any professional or technical skill; those whose illness started acutely before admission dropped in social class shortly before admission; while those who were mentally subnormal as well as schizophrenic did not achieve any level of skill at all. This social drift appears to affect the highest and lowest social classes most severely. Only one patient out of 13 grammar school boys attained social class I or II status, and over half of those in social class V had dropped out of the labour market by the end of the survey. On the other hand, two-thirds of the patients in social classes III and IV survived in jobs requiring a moderate degree of skill. These findings suggest that gross socio-economic deprivation is unlikely to be of major aetiological significance in schizophrenia. On the other hand, occupational factors, yet to be defined clearly, appear to exert some influence on the course of the disease.

A procedure is developed, based on Couchy’s residue theorem, for bounding the undamped natural frequency, damping ratio, and real part of the roots of the characteristic determinant associated with a multicoupled system with several inputs and outputs. The method can lead to a locus of the roots as one or more parameters are varied. The underlying theory is developed and a numerical illustrative example is included.

Following a consecutive series of male admissions under 30 from their admission to a district mental hospital for a mean period of 32 months, length of stay in the mental hospital was related to severity of illness, to work performance before and after hospital admission and to home circumstances before and after admission. Since this was a detailed clinical investigation, numbers have been too small for proper statistical treatment or for studying the effects of two or more factors in combination. Nevertheless, the findings are in general agreement with other work and point to the need for further studies of young schizophrenic patients. In Part I it was shown that: 1. Severity of illness was of importance in distinguishing the schizophrenic patients from patients suffering from other conditions. 2. Those who had been in regular work until shortly before admission spent a considerably shorter period in hospital than those who had worked very little or had long spells of unemployment. 3. There was no direct relationship in the schizophrenic group between the patients' work performance after discharge and the length of stay. Those who worked well had on average stayed almost as long in hospital as those who did practically no work at all. The explanation may be that those who worked well often had a long period of rehabilitation and work in hospital; while those who did no work at all had often discharged themselves prematurely against medical advice. 4. The more unfavourable the home, in terms of family relationships and presence of mental disturbance in other members of the family, the longer the stay in hospital. These findings suggest that ( a ) unfavourable home circumstances and ( b ) prolonged unemployment before admission may be predictive of a prolonged stay in hospital. On the other hand, a longish stay in hospital is not necessarily indicative of poor prognosis, since the ability to co-operate in hospital treatment and to establish regular work habits may well lead to a successful re-establishment in the outside world even if home circumstances are unfavourable. In Part II of the Study the patients' ability to work after discharge was considered in relation to various personal and social factors. It was shown that: 1. In both the schizophrenic and non-schizophrenic groups the majority of patients who worked for more than 75 per cent. of the time they were out of hospital had also had a good work record before their admission. 2. In both groups the majority of patients who appeared to be well at follow-up had a good work record after discharge. While in the not schizophrenic group a good work record was practically synonymous with recovery, this was not necessarily so in the schizophrenic group. 3. In both groups most patients who maintained a good work record started work with in one month of discharge. 4. Schizophrenic patients worked most steadily when they returned to their old jobs, or when their work was arranged while in hospital. This did not apply to the non-schizophrenic patients, who were more often capable of finding jobs for themselves. 5. The work performance of schizophrenic patients who returned to their parents was worse than that of those who went to other kin or into lodgings. This difference was not related to the severity or chronicity of the illness. The work performance of the non-schizophrenic group did not appear to be affected by the type of living group to which they returned. Disturbed family relationships and mental ill health among relatives were associated with poor work performance in the schizophrenic group. The non-schizophrenic patients appeared to be less affected by the disturbances in their home environment. These findings suggest that while both the stability of work habits before the onset of illness and the degree of recovery contribute to the schizophrenic patient's ability to work in the community, social supports after discharge are also of importance. Among these supports are the speed and smoothness of transition from rehabilitation to work, realistic expectations on the part of those with whom the patient lives, and an environment reasonably free from persistent unresolved emotional conflict. This last is thought to be a crucial factor and will be treated in greater detail in a subsequent paper. Several questions arise from these findings. Could the patients with long periods of unemployment before admission to hospital have been diagnosed and treated earlier? Could more skill and effort be devoted to the employment problems of schizophrenic patients both before and after discharge? Is it possible to modify the unfavourable home circumstances associated with poor functioning in schizophrenic patients? Any consistent attempt at this would involve considerable social work resources. Should more schizophrenic patients be encouraged to live away from their parental homes? This would entail more provision of hostel or lodging accommodation. Controlled experiments might demonstrate the effectiveness of these social measures in improving the functioning of young schizophrenic patients and in preventing frequent re-admissions to hospital.

Monoclonal antibodies (MoAbs) produced against determinants A and B of the human ABO blood group system and against the Lea and Leb determinants of the Lewis (Le) blood group system detected these determinants on molecules released by cultured cells of human colorectal, gastric and/or pancreatic carcinoma (Ca) but not by a variety of other cells maintained in culture. Circulating Le antigen could be demonstrated in sera of patients by inhibiting the binding of MoAbs to a target preparation. A double determinant radioimmunoassay (DDIA) was then developed to detect the association of blood group determinants with a previously defined gastrointestinal cancer antigen (GICA). The DDIA with the anti-blood group and anti-GICA antibody was in some cases more sensitive in detecting GICA in sera than using the anti-GICA MoAb alone. Of 55 sera from patients with primary and early recurrent colorectal carcinoma (CRC), 10 (18%) were scored positive in the DDIA using only anti-GICA MoAb. When MoAb binding to a determinant on Leb and on H, type I, was used as first antibody in DDIA followed by anti-GICA MoAb 11 additional sera were reactive, increasing the percentage of positive sera to 38. Using the same combinations of MoAbs, the sensitivity of detection of GICA was only slightly improved from 63 to 66% in sera of patients with advanced CRC. The number of false positive sera from patients with non-malignant gastrointestinal diseases or from healthy donors remained at low levels when anti-blood group determinant antibodies were used together with anti-GICA MoAb. The results indicate that DDIAs with MoAbs against different blood group determinants and tumour associated antigens can improve the detection of circulating antigens in patients with early stage cancer.

The issues raised by the Crown on appeal in Morgentaler v. The Queen from the acquittal of the accused were rendered moot when the Supreme Court of Canada declared the abortion statute (section 251 of the Criminal Code) to be unconstitutional. There was no need for the Court to discuss either the issue of the use of the "defence of necessity" or defence counsel's "bad law" argument. Nevertheless, Chief Justice Dickson found the "bad law" argument of defence counsel, Morris Manning, Q.C., "so troubling," he felt "compelled to comment" on it. Mr. Manning argued that, although the jury was to take its instructions in the law from the judge, it had a right not to apply the law in the case to the facts because the abortion statute was "bad law." In his decision, Chief Justice Dickson reiterated that it is the duty of the judge to instruct the jury in the law and the function of the jury to apply the facts to the law, and that Mr. Manning was wrong to tell the jury otherwise. Among other things, the Chief Justice used a "racist jury" example to demonstrate Mr. Manning's error. The author argues in this comment that the Chief Justice's example was ill-conceived and inapposite, and concludes that the jury and Mr. Manning should be commended for helping to rid Canada of an oppressive abortion law.

The purpose of this report is to describe the evolution of an embolectomy-thrombectomy catheter (ETC) injury over a six week period. Carotid arteries and jugular veins in six adult dogs were subjected to ETC withdrawals at a standard velocity and balloon size. Vascular segments were excised as early as one hour and as late as six weeks. The specimens were prepared for light, scanning electron and transmission electron microscopic examination. In early specimens, arteries and veins showed endothelial denudation followed by regeneration. In later specimens, the arteries showed progressive disruption of the internal elastic lamina and marked subendothelial proliferation (arteriosclerosis). By the sixth week the artery's intima was equal in thickness to the media. The veins showed only regenerating endothelium without alterations of the subendothelium. Exposure of canine vasculature to ETC procedures caused pronounced transmural damage in the arteries and only endothelial alterations in the veins.

r NHE World Health Organization defines health as " a state of complete physical, merltal and social well-being, and not merely the i ,absence of disease or inflrmity". If we accept this deflnition we should study the physical health of young males in terms not only of the presence or absence of pathology such as tuberculosis, but also in terms of their growth, nutrition and physiological adaptability. Their mental health must be studied not only to determine the prevalence of mental defect or neurosis, but also for more positive indications of mental well-being, for example the effectiveness with which the young men use their abilities, their capacity to maintaiIl co-operative human relationships, the degree of their emancipation from the home, their resilience in face of change, and the realism of their outlook. We need to study the social health of young men, not only as shown by absenteeism rates and labour turnover, for instance, or delinquency, or the problem of the " unclubbable " youth, but we should also inquire into the satisfactions which they find at work and whether they have begun to think of the social responsibilities of mamage, parenthood and citizenship in a democratic society. As we are concerned in this study with eighteer-yearolds who are in a phase of transition and active development, these more " positive " aspects of health are related to physical, intellectual and emotional maturation. In this investigation we have studied some aspects of the physical, mental and social health of young men. We were interested in the following questions: What is the health of these youths ? What stage have they reached in their growth, physical, mental and social ? How do environmental forces such as family background, educational and vocational opportunities, and " social class " combine to influence the young men ?