Process studies in language conditioning—I: Counterconditioning of anxiety by “calm” words

In this study of the mechanisms underlying language conditioning the subjects were volunteers who had indicated anxiety concerning a variety of small animals. The CS was the verbal representation of the phobic object and was repeatedly paired with UCS words having one of four different connotative meanings: calm words, positive words, words sharing both qualities, and words neutral on both dimensions. The results of a variety of written and behavioral measures indicated that little or no change occured in the latter group or in a fifth group in which the CS word was unrelated to the phobia. In addition, there was some evidence to suggest that the calm words were superior to the other words, indicating a possible counterconditioning effect on the anxiety as a function of the UCS words' emotional relevance.     

Variation in training and use of the focused assessment with sonography in trauma (FAST)

Background

Training in ultrasound is variable among residents and practicing traumatologists. Focused Assessment with Sonography in Trauma (FAST) may be underused in non-urbanized areas, possibly due to lack of training.

Defining the anatomic perfusion bed of an occluded coronary artery and the region at risk to infarction: A comparative study in the baboon, pig and dog

To assess selectively the effectiveness of therapeutic interventions to reduce infarct size, it is important to assess both ultimate infarct size as well as the size of the region of myocardium at risk to infarction. The anatomically defined perfusion bed of an occluded artery has generally been assumed to be synonymous with the region at risk of infarction. This assumption was tested by delineating the anatomic perfusion bed of an occluded artery with microvascular dyes and by examining the relation of the anatomic perfusion bed to the region of acute ischemic injury. In 8 baboons, 12 pigs and 15 dogs a major branch of the left anterior descending or left circumflex coronary artery was occluded. At 2 and 30 minutes after occlusion the eplcardial area of ischemic injury was determined by epicardial S-T segment mapping. The boundary of epicardial S-T segment elevation was resolved to within 1 mm and marked directly on the ventricular surface. The heart was then excised and the perfusion bed of the occluded artery was delineated by either (1) injecting different colored silicone rubber microvascular dyes into the previously occluded artery as well as the adjacent perfusion beds (direct method), or (2) injecting dye only into the adjacent perfusion beds (defect method).

Serial cross-sections of the left ventricle from the direct and defect dye-perfused hearts in all three species showed the perfusion bed of the occluded artery to be readily demarcated. Microscopic examination demonstrated no evidence of capillary anastomoses and minimal inter-digitation of capillaries at the perfusion bed boundaries. In dye-perfused hearts, the baboon and the pig showed no evidence of precapillary anastomoses between perfusion beds; however, the dog demonstrated numerous epicardial collateral channels. The epicardial area of the anatomic perfusion bed correlated closely with the epicardial area of S-T segment elevation at 2 minutes after occlusion in the baboon (r = 0.97), pig (r = 0.99) and dog (r = 0.96). The epicardial area of S-T segment elevation did not change through the 30 minute period of occlusion in the baboon and the pig, but in the dog it showed a progressive and variable reduction reflecting the gradual recruitment of existing collateral channels from adjacent perfusion beds.

It is concluded that the techniques of direct and defect dye delineation accurately define the anatomic perfusion bed of an occluded coronary artery. This anatomic perfusion bed corresponds to the region of myocardium undergoing acute ischemic injury and hence the region at risk to infarction immediately after coronary occlusion in the three species studied.     

Left axis deviation and left anterior hemiblock among 8,000 Japanese-American men

Electrocardiographic patterns of left axis deviation and left anterior hemiblock, defined by a frontal plane QRS axis of −30 ° to −44 ° and −45 ° to −90 °, respectively, with normal QRS duration, were found to be fairly common (2.6 and 1.5 percent, respectively) in a community population of 8,000 Japanese-American men aged 45 to 69 years. More than 60 percent of men with these electrocardiographic patterns had no other cardiovascular abnormalities, and the incidence of fatal or nonfatal coronary heart disease and stroke in this group during observation periods of 3 to 6 years was not significantly different from that of control normal men.

A significant association was found between these electrocardiographic patterns and the prevalence of hypertension, myocardial infarction and stroke. However, the association of myocardial infarction with left anterior hemiblock appeared to be coincidental and was attributed largely to the similarity of the electrocardiographic manifestations of left anterior hemiblock and inferior wall myocardial infarction. Men with left axis deviation were fatter and had higher blood pressure than the control population. No such difference could be demonstrated for men with left anterior hemiblock although this group was significantly older than control subjects and men with left axis deviation.

The results of our study suggest that there are qualitative differences between the causative mechanisms and clinical features of left axis deviation and those of left anterior hemiblock.     

Thoracic air gun injuries in children

Four cases of thoracic air gun injuries in children are presented. Potentially lethal injuries with penetration of the heart and lung occurred. All of the children were treated with surgical removal of the pellet, two from the ventricular myocardium, one from the right atrial appendage, and one from the right middle lobe of the lung. All of the patients survived and had an uneventful recovery. The need for regulating the use of air guns by children has been alluded to, in addition to the need for public education regarding the potential danger of air gun injuries.     

Muscle reorientation following superior repositioning of the maxilla

In facial reconstructive surgery the importance of the orofacial muscles on form, function, and esthetics must be recognized. Once this fact is acknowledged, these muscles may be manipulated to advantage by the surgeon; thus, undesirable effects in the perioral area following superior repositioning of the maxilla can be avoided. A V-Y advancement-closure of the horizontal maxillary vestibular incision is advocated. This successfully repositions the lip muscles in a predictable manner and maintains normal lip form pout, and amount of exposed vermilion. Alar width and unesthetic widening of the alar bases may also be controlled by the proper repositioning of the transverse nasalis muscles. The validity of these surgical procedures is supported by a statistical analysis of the lip and nasal structures in patients whose dentofacial deformities were corrected by superior repositioning of the maxilla and concomitant facial muscle reorientation.