Impact of a gonorrhea control program, including selective mass treatment, in female sex workers.

A gonorrhea control program initiated in 1967 in registered female sex workers (FSWs) in the Philippines involved weekly endocervical cultures for Neisseria gonorrhoeae, with treatment of FSWs found infected or named as contacts by US Navy servicemen. Gonorrhea prevalence in FSWs in Olongapo city fell from 11.9% to 4.0% within 4 months, and gonorrhea incidence in servicemen at nearby Subic Bay fell by half. Selective mass treatment (SMT) with oral ampicillin-probenecid or tetracycline was then given to registered FSWs in an attempt to further reduce gonorrhea rates. N. gonorrhoeae was isolated from 105 (4.0%) of 2640 FSWs before SMT and from 43 (1.6%) 1 week later (P < .001). However, gonorrhea incidence among servicemen fell no lower, and gonorrhea prevalence in FSWs quickly returned to higher levels. Thus, after implementation of weekly screening and treatment of FSWs found infected or named as contacts, SMT of FSWs (without increasing condom use or treating regular partners) contributed nothing further to gonorrhea control.

The importance of similarity in the marital relationship.

Concepts such as "agreement," "consensus," "understanding," and "shared meaning" are very familiar to clinicians. It is argued in this article that similarity in perceptions between spouses is a crucial dimension of the family system underlying these concepts. Findings are presented that support the idea that families vary along a dimension of similarity of perceptions, with more functional families characterized by high similarity between spouses' perceptions of their marriage and their family. In addition, the structure of this similarity was stable over 2 years and little change occurred in the mean level of similarity. Of three sets of predictor variables--psychological stress, marital cohesion, and structural variables--marital cohesion was the most powerful predictor of marital similarity. The importance of similarity of perceptions between family members in clinical work is discussed.

Imaging with indium111-labeled anticarcinoembryonic antigen monoclonal antibody ZCE-025 of recurrent colorectal or carcinoembryonic antigen-producing cancer in patients with rising serum carcinoembryonic antigen levels and occult metastases.

We tested whether nuclear imaging with indium111 (111In)-labeled murine monoclonal (MoAb) anticarcinoembryonic antigen (anti-CEA) ZCE-025 antibody could detect recurrent disease in patients with a rising serum CEA level but negative findings for computed tomographic (CT) scans of the abdomen and pelvis, chest radiograph, and colonoscopy or barium enema. Twenty patients with a history of completely resected CEA-producing adenocarcinoma (18 with colon cancer, one with breast cancer, and one with Hodgkin's disease) and a rising serum CEA level were given an intravenous infusion of 2 mg of 111In-labeled ZCE-025 mixed with 38 mg of unlabeled ZCE-025. Planar and single-photon emission CT (SPECT) scans were acquired at 72 and 144 hours, and in 19 of the 20 patients these were positive. Of those 19, 13 underwent exploratory surgery, and cancer was found in 10, and two had a diagnostic biopsy, which confirmed cancer. Three patients who had negative laparotomies and all four patients who did not undergo surgery or biopsy were followed radiologically. In all seven, cancer was subsequently detected at the sites suggested by the ZCE-025 scan. Thus, tumor was confirmed in all 19 patients with positive scans. Five of 13 patients who were explored benefited from the study and the exploratory laparotomy, as disease was entirely resected in four or was subjected to definitive radiation therapy to the pelvis in the fifth. In two additional patients who were not explored, MoAb imaging resulted in definitive therapy to regionally confined recurrent disease. 111In-labeled anti-CEA MoAb ZCE-025 scanning in patients with rising CEA successfully imaged metastatic colorectal cancer that eluded detection by other methods and affected the care given to some. These results suggest an important role for 111In-labeled ZCE-025 scanning among patients with rising CEA and otherwise occult metastatic cancer.

Clinical experience with intra lymphatic administration of 111In-labelled monoclonal antibody PAY 276 for the detection of pelvic nodal metastases in prostatic carcinoma.

The ability of 111In-PAY 276 (anti prostatic acid phosphatase antibody) in detecting pelvic lymph node metastasis following bipedal intra lymphatic administration was studied in five patients with carcinoma of the prostate. The labeled antibody was injected directly into the lymphatics of each foot. Planar and tomographic images radioactivity content of lymph nodes resected during staging pelvic lymphadenectomy were compared to the histologic and immunoperoxidase findings. Radioactivity in pelvic lymph nodes was prominently seen within 20 min of injection and was present 16 days later. Persistent accumulation of tracer in the lymphatics of the lower extremities was also observed in all patients 16 days post injection. Radioactivity counts in tumor-free lymph nodes were higher than in tumored lymph nodes resected. Our results demonstrate that intra lymphatic administration of 111In-labeled PAY 276 monoclonal antibody has major technical limitations, and that further research directed at the causes of tracer accumulation in the lymphatics and tumor-free lymph nodes is required.

Parental agreement on child-rearing orientations: relations to parental, marital, family, and child characteristics.

Recent research on parental agreement on child-rearing values has found it to be positively related to effective parenting. The exact nature of the relation, however, is not clear. Are they different constructs, or is agreement simply one more variable that describes effective parenting? A sample of 136 families and their preschool children was studied by observation and an extensive self-report questionnaire package. Parental agreement was assessed using the Block Child-rearing Practices Report. Hierarchical multiple regression analyses revealed that the agreement score rarely added any information not already provided by the parental effectiveness scores. A Q-factor analysis revealed that the agreement score actually represented agreement to a standard of good parenting. The parents who were high agreers were good parents who agreed with other good parents, while the low agreers were ineffective parents who disagreed with other parents, good or bad. Implications of these results for future research on parental agreement are discussed.

The Georgia family Q-sort: an observational measure of family functioning.

The development of a new observational measure of family functioning using a Q-sort methodology is described. The Q-sort is one way of obtaining observer measures of family that complements both microcoding and global ratings of family processes. Evidence for construct validity is presented along with a discussion of the advantages and disadvantages of the Q-sort approach to family observation.

Contribution of SPECT to imaging of gastrointestinal adenocarcinoma with 111In-labeled anti-CEA monoclonal antibody.

Fourteen patients with suspected adenocarcinoma of the gastrointestinal tract received 1 mg of 111In-labeled anticarcinoembryonic antigen monoclonal antibody type ZCE025 combined with 40 mg unlabeled antibody of the same type. Planar and single-photon emission CT (SPECT) imaging studies were performed 3 days after infusion and, when possible, 7 days after infusion. Scan findings were correlated with the findings at surgery when possible. Tumor was detected by day-3 planar imaging in eight of 13 patients in whom tumor was documented histopathologically. Day-3 SPECT allowed demonstration of tumor in 11 of these 13 patients. In another patient whose scan was negative, no residual tumor was found at surgery. SPECT was particularly helpful in identifying small and midline tumors. In two cases, localization on SPECT helped identify the tumor mass on CT. Two primary tumors weighing less than 5 g could not be detected on either planar or SPECT scans. Histologically positive, normal-sized lymph nodes were not seen by planar imaging or SPECT. SPECT increased the detection rate over that achieved with planar imaging, helped to better localize scan abnormalities, and afforded more useful comparison between the monoclonal antibody study and CT.

Remembering your parents: reflections on the retrospective method.

In the present paper, I critique the use of the retrospective method when it is used as a proxy for actual longitudinal data on personality development. Studies on the constructive nature of memory cast strong doubts about the meaning of retrospective data. There are good reasons, both theoretical and empirical, to distrust the accuracy of such recall concerning parenting, whether recalled by parents, children, or siblings. Instead of using the method as a shortcut to developmental data, studies examining individual differences in accuracy and distortion and the factors that moderate them may inform us of the various meanings of retrospective data.

Double labeled-antigen method for demonstration of intracellular antigens in paraffin-embedded tissues.

A double "labeled-antigen" method has been developed for the simultaneous staining of both kappa and lambda light chains in fixed paraffin sections. The method is a two step procedure utilizing a mixture of antisera against kappa and lambda light chains in the first stage, followed by the addition of a mixture of kappa antigen labeled with horseradish peroxidase and lambda antigen labeled with alkaline phosphatase. The selection of substrates yielding reaction products of contrasting color enabled the observer to distinguish kappa-containing cells (brown) from lambda-containing cells (blue). Reactive plasma cells stained either pure brown (kappa) or clear blue (lambda) in a ratio of 1.5:1. Blood vessels containing serum immunoglobulins showed a mixed brown-blue reaction, as did the Reed-Sternberg cells of some cases of Hodgkin's disease. The advantages of this double labeled-antigen method over previously reported methods for achieving double staining are discussed.

Detection of terminal transferase in paraffin sections with the immunoperoxidase technique.

Terminal deoxynucleotidyl transferase (TdT) is an early T-cell differentiation marker in a number of species, including man. We have demonstrated TdT in the nuclei of cortical thymocytes in paraffin-embedded sections of calf, rat, and human thymus by indirect immunoperoxidase techniques. In addition, these techniques have been used to verify and extend enzyme assay results by detecting TdT in blast cells from 10 patients with convoluted T-cell lymphoma/leukemia, 1 patient with acute granulocytic leukemia, 1 patient with chronic granulocytic leukemia in blast crisis, and 1 patient with non-T non-B acute lymphocytic leukemia.

Membrane fusion induced by the membrane mobility agent, A2C. Differentiation between fusible and non-fusible cells. Transfer of fusibility.

Red cells of different species respond differently to the treatment with the membrane mobility agent, A2C, with respect to both the A2C interaction and the subsequent cell-cell interaction. Depending on whether both, one or neither of the processes are effective, some red cells (e.g., nucleated Leghorn hen red cells, rat red cells) fuse easily, some (human red cells) show morphological changes but do not fuse, and others (nucleated Rock hen red cells) show little or no response. Mixed fusion (i.e., between fusible cells of different species) is readily obtained, indicating that no species-specific recognition sites are required for A2C-induced fusion. the potential for fusion is a transferable characteristic. In the presence of fusible cells, A2C induces both heterologous and homologous fusion of otherwise 'non-fusible' cells. Electron micrographs of fusing cells after treatment with A2C reveal 'onion-ring' structures ('whorls'), free of intramembranous protein particles but different from the smooth appearance of A(2)C particles. Whorls are considered to arise from fusion-potent membrane areas. Fusion is apparent at multiple sites along the contact line between apposed membranes. The postulated appearance of vesicle-like structures along the fusion line (Kosower, E.M., Kosower, N.S. and Wegman, P. (1977) Biochim. Biophys. Acta 471, 311-329) is confirmed by micrographs. The mechanism of this fusion process is duscussed and compared to other types of fusion process.

Pathways between constitution and competence during the 1st 5 years of life.

A global measure of newborn constitutional adequacy was found to be positively related to competent functioning at the age of 5-6 years. In a sample of 15 boys and 5 girls, newborn constitutional adequacy was related to aspects of focused (versus unfocused) activity, outgoingness, cognitive and verbal ability, and motor skill at the early childhood follow-up. Additionally, some preschool data were available on most of the sample and continuity of competent functioning was traced across the 3 age periods. Also, hyperactive behaviors at the preschool period had negative implications for functioning in early childhood.

C5b-9 dimer: isolation from complement lysed cells and ultrastructural identification with complement-dependent membrane lesions.

The membrane attack complex (MAC) of complement was extracted from the membranes of cells lysed by human complement and its properties were compared with those of the fluid phase complex SC5b-9. Upon sodium dodecyl sulfate polyacrylamide gel electrophoresis and immunochemical analysis, the two isolated complexes had identical subunit compositions, except that the MAC lacked the S-protein. The sedimentation coefficient and molecular weight of the extracted and isolated MAC were, respectively, 33.5 S and 1.7 x 10(6) daltons, compared to 23 S and 1.0 x 10(6) dalton for SC5b-9. Because the molecular weight of the MAC is approximately two times greater than that of C5b-0 (800,000 daltons), the MAC is considered the dimer of C5b-9. Under specified conditions, the 33.5 S dimer could be converted to the 23 S monomer without dissociation of subunits. The MAC had the electron microscopic appearance and dimensions that are characteristic for the complement produced ultrastructural membrane lesions. SC5b-9 had a different ultrastructure that is dissimilar to the morphology of the lesions. The isolated MAC could be reincorporated into phospholipid bilayers and assumed on the surface of the resultant lipid vesicles the orientation and appearance of typical complement lesions.

Newborn minor physical anomalies predict short attention span, peer aggression, and impulsivity at age 3.

From a 5-to 10-minute newborn examination, behaviors of males at age 3 could be predicted. The number of minor physical anomalies, assessed soon after birth, was significantly related to a cluster of behaviors that are frequently labeled hyperactivity.