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Current studies of neurocognitive function in alcoholics are generally restricted to a relatively small subsample of persons seeking treatment. Subjects are typically excluded from study if reporting signs or symptoms of possibly confounding disorders such as comorbid psychiatric disorders, medical, or neurologic disorders. Thus, the question arises as to whether those individuals who actually participate in these reported studies are representative of the larger population of unselected persons. Studies of women are particularly subject to this concern due to higher rates of comorbid medical and psychiatric disorders in women. The current study was directed to contrasting treatment-seeking women who either were or were not selected for a laboratory study of neurocognitive function. Specifically, we compared subgroups of women identified on the basis of the presence of an alcohol use disorder and/or being selected for study. A total of 638 women were available for comparison. Contrary to anticipated concerns, analysis of basic demographic, alcohol and drug use, and affective/cognitive measures revealed considerable similarities among the groups. Consistent with other literature, the large majority of these women reported a family history of alcohol use disorders. They also reported a preference for stimulants as opposed to other illicit substances as evidenced in self-report of their most frequently used drug in the six months prior to treatment (excluding alcohol). These findings suggest that current selection procedures, although necessarily biasing samples in response to specific questions, do not result in samples that are significantly different from the majority of treatment-seeking women, at least on the basis of demographic and affective variables. Furthermore, as described herein, these findings have specific indications for primary care assessment and treatment referral.

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After highlighting historical perspectives of posttraumatic stress symptoms, the authors describe PTSD's diagnostic features, frequent co-occurring symptoms and psychiatric disorders, and risk factors for developing this often chronic and disabling illness. In addition, they summarize research findings on the neurobiology of PTSD, including changes in neurotransmitters, hyperactivity of the hypothalamic-pituitary-adrenal axis, autonomic reactivity, and differences in brain structure and function. Finally, they present psychopharmacological and psychotherapeutic treatments, concluding that current clinical practice favors a combination of these two types of treatment, tailored to the patient's needs.

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The aesthetic surgeon may occasionally be consulted by a patient who wishes to discuss what can be done for the scars of self-inflicted wounds on the forearms. These scars are popularly referred to as "hesitation marks" or "suicide gestures." Unlike patients suffering from factitial ulcers or Münchhausen syndrome, these patients will admit to the physician that the scars are the result of self-inflicted wounds. These scars often consist of multiple, parallel, white lines extending up and down the forearms (usually volar surface), with more on the nondominant side. Although the pattern of these scars is apparently what drives these patients to the aesthetic surgeon for relief (because even lay people identify these scars as self-inflicted suicide marks), the authors propose a new and deeper motivation for surgery. Recent experiences with three of these patients resulted in an epiphany that prompted this report. Once the symbolic meaning of these scars was broached, a torrent of thoughts and theories followed. This article will recount these three cases and present a central thesis for this type of self-inflicted injury. A proposal for the proper surgical treatment of this condition will be offered. Uniquely, two of the patients will relate their own stories and propose guidelines and warnings for the aesthetic surgeon.

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This article describes the role of the speech and language clinician on a psychoeducational multidisciplinary team. The effects of language disorders on children's behavior and treatment are discussed along with specific ways in which the speech and language clinician can intervene.

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Rodents (n = 358) were trapped from 6 locations in Arizona, including 2 dairies, 2 swine raising operations, and 2 areas where domestic animal access was limited. Isolates of Leptospira interrogans serovar ballum were obtained from 3 house mice (Mus musculus) trapped in dairies. Leptospira were seen in silver-stained kidney sections of 10.4% of the rodents. The usefulness of serologic data in detecting leptospiral infection in these rodents was uncertain because so few animals yielded isolates that valid comparisons of culture positives to serologic positives were not possible. Titers greater than or equal to 1:160 were obtained to serovars autumnalis, ballum, bratislava, canicola, grippotyphosa, hardjo, icterohaemorrhagiae, and pomona. Nearly 60% of the rodents had microscopic lesions in kidneys, including 20 of 34 (59%) of those in which leptospira were seen.

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An adaptation of a previously reported patient-care unit (PCU) system of workload measurement is described. A PCU is any distributive or clinical pharmacy activity related to patient care, and the PCU system of workload measurement relates the activity frequency and the usual time required to complete each activity. The key to the system is the weighting factor (usual time) for each PCU. The PCU system was modified by breaking each PCU into its various elements and determining the time required to complete each element. Several time units were available from references; other units specific for hospital pharmacy were measured. The modified PCU definitions, counting mechanisms, and weighting factors used at the study hospital are included in an appendix. The number of service hours, which is the product of the frequency of each activity and its weighting factor, is an indicator of personnel time devoted to each pharmacy activity. The cost per service hour can be computed and used to set fees for each pharmacy activity. Other practical applications of the PCU system include evaluation of staffing patterns, trend analysis, and documentation of clinical services. The modified PCU system provides a more precise measurement of weighting factors than previously described methods, and it can be adapted by other institutions.

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The sedimentation coefficient of the infective unit of African swine fever in tissue culture harvest fluids was measured in a preparative ultracentrifuge. The boundary locator method used also permitted making an estimate of heterogeneity. The sedimentation coefficient ranged from 3,000 to 8,000 Svedberg units, representing many classes of infective particles. Electron microscopy on culture fluids from infected cells showed many kinds of virus-containing units. Sucrose-CsCl gradient centrifugation was used to concentrate and to purify (partly) African swine fever virus for analytical ultracentrifugation. The optical patterns of the physical particles revealed a range of coefficients from 1,800 to 3,200 Svedberg units in tris-buffered saline solution at 20 C and buoyant densities from 1.19 to 1.24 g/ml in CsCl. The disparity of these values from those obtained by preparative ultracentrifugation indicates a change in the virus structure or a selection of viral populations on purification (or both).

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The time interval between administering the serum and the virus was found to influence the results of the in vivo mouse protection test for foot-and-mouth disease antibodies. In particular, for both IgG and IgM antibodies to strain A12 virus, the mouse protection index increased from zero to a maximum at about 6 h and remained high for at least five days. Variations in the antiserum concentration, on a log scale, had a proportional effect on the mouse protection index, if between 1 and 3. The constant of proportionality was unity for IgM and 2 for IgG antibody. Comparison with in vitro neutralization tests revealed essentially parallel neutralization curves. The lower serum titre in the protection test, if computed for less than 10(3) LD50/dose, was accounted for by the simple dilution of the inoculated serum into the volume of the mouse. Consequently, in the low titre range, the same virus-antibody reaction and its effect are operable in each of the two tests. Analysis of literature data in which both the in vivo protection test and the in vitro neutralization test results were available on the same sera showed consistency with the above conclusions for both cattle and swine sera. The protection test had a highly atypical survival pattern occurring at antibody concentrations expected to neutralize more than 10(3) LD50/dose. The resulting in vivo dampening effect on virus titre is postulated to be caused by the excess antibody of the passive immunity test interfering with the spread of infection. The effect is analogous to an anomaly caused by not removing the inoculum in quantal tissue culture assays and it prevents quantification of antibody levels in strong sera.

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Classic neutralization studies by Fazekas de St. Groth and Webster (8) on mixtures of influenza viruses and mixtures of rabbit antisera are reinterpreted in terms of a percentage contaminant in the stock used for the dilution series. A very small amount of a different virus changes the shape of quantal assay curves considerably, but even a large amount of a different antiserum has negligible effect on the shape and merely shifts the curve along the serum dilution axis. These conclusions are the reverse of the authors, who only considered an absolute amount of another component in all dilution tubes. An artificial mixture of 2.7 percent O8 in O1 foot-and-mouth disease virus strains was tested against anti-O1 serum assaying in suckling mice. The small amount of O8 virus greatly altered the shape of the neutralization curve in the direction expected from the reanalysis of the influenza literature data. Results from artificial mixtures are used to explain what were hitherto anomalously broad neutralization curves for some other foot-and-mouth disease strains given by Booth et al. (1) Many of the virus stocks studied can now be postulated as a natural mixture of related virus strains. In fact, the O1 and O8 stocks used might also be of themselves mixtures. These virus strains also exhibit still a further test complication in that the virus-antibody reaction appeared to shift away from complexes on dilution immediately prior to assay.

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Block neutralization data since 1949 for the foot-and-mouth disease virus system have been analyzed in terms of a unified mass-action theory for computing the amounts of infectious complexes. Proof that infectious complexes contribute considerably to the assays was obtained by demonstrating a reduction in titer after an additional reaction with anti-Ig antibody before the assay. In the suckling-mice assay with intraperitoneal inoculation, both the data of others and our own on several types indicate that for IgG probably three of the unknown total number of critical sites on the virion must be available for infectivity and death. For IgM, just one of an unknown different total number of critical sites on the virion must be available. In tissue culture infectivity assays the minimum number is two or three, whereas in the bovine tongue assay it could be one or two, but probably two. The difficulties in establishing the at present unknown total numbers of neutralization sites to both IgG and IgM are considerable. However, by the simplest interpretation of the data, the number is estimated to be between 5 and 10 for IgG and perhaps just 1 for IgM. A speculation, consistent with the known virion architecture, is that just 1 of the 12 vertices is uniquely involved in infectivity and death, at least in the suckling-mice assay.

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All ideas implicit in the papers since 1953 involved in applying mass-action thermodynamics to antibody-antigen reactions are unified by the use of: (a) the intermediary concept of extent of reaction; (b) the concept of intrinsic association constant; (c) a statistical analysis for probable complexes; and (d) identification of the complex or complexes that contribute to the bioassay. Several general theoretical examples are given that show the limitations of linear interpretations of equilibrium data. Two practical examples from the literature illustrate foot-and-mouth disease virus and influenza virus neutralization.

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Suitably diluted cell culture adapted African swine fever virus preparations were inoculated on VERO cell monolayers and grown on coverslips. Gum tragacanth was used as an overlay. After three days incubation at 37 degrees C the infected cultures were fixed with acetone and stained with fluorescent antibody conjugate. Fluorescing plaques consisted of 20-30 infected cells. THREE STATISTICAL CRITERIA FOR A QUANTITATIVELY RELIABLE ASSAY WERE MET: the Poisson distribution for plaque counts, linearity of the relationship between the concentration of virus and the plaque count and reproducibility of replicate titrations. The method is suitable for counts up to at least 70 plaques per 5 cm(2) coverslip and computed titers are reproducible within 0.16 log units with a total of 300 plaques enumerated.

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