Conservative open anterior acromioplasty

The records of 29 consecutive patients treated by a pure, open, anterior acromioplasty were reviewed retrospectively. Excluded from consideration were patients with the following pathologic diagnoses or histories: (1) previously attempted acromioplasty on the same shoulder; (2) intraoperatively confirmed rotator cuff tear; (3) any surgically treatable biceps tendon or acromioclavicular abnormality; (4) lost to follow-up study. Three different techniques were employed to perform the acromioplasties. The first technique required partial deltoid origin detachment with an osteotome. The second technique spared the deltoid origin, while again using an osteotome to perform the acromioplasty. The third technique also spared the deltoid origin but used a high-speed burr to perform the acromioplasty. Evaluated in terms of patient satisfaction, residual pain, length of convalescence, suboptimal results, and complications, the first technique proved to be the least effective. The second technique produced early, excellent results. The third technique, in which a burr was employed through an intact deltoid origin, was most effective; technically, the method was also relatively simple and reliable.     

Thermoregulation in mice following acute administration of lead acetate

Several reports in the literature suggest a relationship between lead intoxication and thermoregulatory capacity. To investigate the effects of lead on the control of body temperature, mice of the BALB/c strain were injected intraperitoneally with lead acetate (0 to 100 mg/kg) while colonic temperature was measured 30, 60, and 90 min post-injection at ambient temperatures (Ta) of 20 and 30 degrees C. Lead acetate caused a transient hypothermia, an effect which was augmented at cooler Ta's. In a second experiment, mice were injected with 100 mg/kg lead acetate and placed in a longitudinal temperature gradient to measure their preferred Ta. Lead acetate significantly reduced the preferred Ta during the first 30 min post-injection which augmented the lead-induced hypothermia. In a third experiment it was found that lead acetate-induced lethality was potentiated with increasing Ta. Hence, the hypothermic response to acute lead acetate treatment may be beneficial to survival.     

The Alaska mental health lands

The Alaska mental health program is endowed with a 1-million-acre trust fund. A coalition of groups that make up the mental health constituency of the state united in a lawsuit to establish the trust. The history of this legacy, the struggle to realize its benefits, its current status, and some of its psychopolitical significance are discussed.     

Comparative toxicity of total lymphoid irradiation and immunosuppressive drug treated patients with intractable rheumatoid arthritis

Outcomes were compared between consecutive patients who had received either total lymphoid irradiation (TLI) or immunosuppressant treatment for intractable rheumatoid arthritis (RA). There were 33 TLI and 32 immunosuppressive recipients; all patients had failed standard therapy. Average followup from the start of therapy was 2.7 years for TLI and 5.9 years for immunosuppressive recipients. Final disability levels were the same in both groups; mortality was equal in both groups as well. There were more hospitalizations for infections in the TLI group and the infecting organisms tended to be staphylococcus or gram negative organisms. Apart from infections, there were more adverse effects reported in the immunosuppressive therapy group.     

Human factors in chemical containment laboratory design

A human factors engineering analysis of a chemical containment laboratory was performed to develop appropriate standards for future laboratory design. In order to perform this evaluation, a state-of-the-art facility was studied in depth. Measurements and observations were made of key operating areas. In addition, technicians were observed and interviewed as they performed various tasks. Compiled data were compared to existing ergonomic standards. The occupational implications of instituting ergonomically developed laboratory design standards are as follows: increased worker health, safety and productivity, improved work quality and reduced stress.     

The relationship between communication and marital satisfaction: a review

This paper provides a comprehensive methodological review of the literature assessing the relationship between marital satisfaction and communication. The investigations vary greatly in the adequacy of their assessment measures and soundness of their research design. Although it is generally concluded that both content and process communication are related to marital satisfaction, replication of the better designs is necessary. Specific findings and their practical implications for both future research and marital therapy are discussed.