Toward the ideal state mental hospital: the human equation

This paper gives the historical sketch necessary for an understanding of the current state of American psychiatry. It reviews some of the reasons why the rendering of good hospital care must be reconsidered, and describes some of the main features of the future public institution.     

A double blind comparison of diclofenac and indomethacin in the treatment of ankylosing spondylitis

During almost 12 years of development and clinical trials, diclofenac sodium has been shown to be both effective and safe as a new nonsteroidal antiinflammatory drug (NSAID) for the treatment of rheumatic diseases including ankylosing spondylitis (AS). We compared the safety and efficacy of 75, 100, or 125 mg/day of diclofenac with the same doses of indomethacin in a multicenter, randomized, parallel group trial in patients with AS. A single blind placebo washout period of 2 days to 2 weeks preceded the 13-week double blind treatment period. Both diclofenac and indomethacin produced significant (p less than 0.001) improvement from baseline for all 14 efficacy variables analyzed. There were no significant between treatment differences. Differences favored diclofenac in the frequency and the severity of adverse experiences reported and in the frequency of complaints affecting the central nervous system.     

Computed tomographic investigation of serosal and intramural gastrointestinal pathology

Various cases are presented demonstrating the role of computed tomography (CT) in the assessment of serosal and bowel wall pathology. Reference is made to the morphology of the lesions. Illustrative examples of tumors, secondary malignant dissemination, irradiation injury to the gut, and intramural gas associated with ulcerative colitis, are all illustrated.     

Relation between temperature and processes of spontaneous quantum and non-quantum mediator release from motor nerve endings of the mouse

The spontaneous quantal and nonquantal acetylcholine release was investigated at the temperature range from 10 to 35 degrees C in white mouse semidiaphragm. The quantal release was evaluated by calculation of miniature end-plate potentials frequency, while the nonquantal one--from the H-effect value. The spontaneous quantal release increased exponentially with the temperature growth. The temperature dependence of the nonquantal release showed two relative maxima: at 20 degrees and 35 degrees C. At 10 degrees C the nonquantal release was absent. The value of calculated effective energy of activation of the quantal release was 57.0 kJ/mol in the investigated temperature range. The effective energy of activation for the nonquantal release process in intervals 15-20 degrees C and 25-35 degrees C was 45.5 and 38.2 kJ/mol, relatively. It is suggested that the nonquantal release is rather due to active transport processes than to simple diffusion of acetylcholine molecules.     

Effect of thiamine on auditory evoked potentials of the guinea pig

Application of thiamine (1 X 10(-11)-1 X 10(-3) mol/l) on the membrane of cochlear round window increased the amplitude and decreased the latency of the auditory nerve action potential, waves I and II of brainstem auditory-evoked electrical potentials in response to acoustic clicks of different intensity. The mechanism of thiamine action on auditory-evoked electric potentials is discussed.     

Factors relating to the sensory acuity of limbs with peripheral vascular insufficiency

We examined several possible causes for the high incidence of poor sensory acuity in the limbs of 176 patients with moderate to severe peripheral vascular insufficiency. We investigated the relationships of diabetes, alcoholism, and smoking, as well as the severity of peripheral vascular disease, to the integrity of basic sensory modalities such as two-point discrimination and perception of light touch. The presence or absence of diabetes exerted the strongest effect on peripheral sensation. In patients who did not have diabetes, sensation in the limbs was most strongly affected by whether the patient was an alcoholic. Smoking did not have a significant effect on limb sensation. Among nondiabetic, nonalcoholic patients, there was a weak residual effect related to the severity of the peripheral vascular insufficiency. Even among these patients, however, systemic factors predominated in determining the loss of sensation. We also examined the extent to which loss of sensation might be related to the development of ulcers. Among patients who were not diabetic, there was a highly significant relationship between loss of sensation and the presence of limb ulceration. Surprisingly, however, there was no discernable relationship between the presence of ulcers in diabetic patients and the degree of loss of peripheral sensation. This result suggests that a large percentage of ulcers seen in diabetic patients are not of neurogenic origin.