Hormonal factors related to the incidence of testicular tumors in male pseudohermaphrodite rats.

Pieces of testicular tumor from male pseudohermaphrodite (tfm) rats were transplanted between the skin and body wall musculature of 4-day-old female, male, and tfm hosts and to the anterior chambers of the eyes of gonadectomized and intact adult tfm, female, and male hosts. These transplants grew in all hosts except normal males. To determine whether these tumors were hormone-dependent, the levels of circulating gonadotropins were measured in all host types to ascertain which were low in the males and high in all of the others. Prolactin, luteinizing hormone (LH), and follicle-stimulating hormone (FSH) levels were measured in intact and castrated normal and tfm rats. Normal males had low levels of prolactin, estrogen, LH, and FSH; however, transplants grew well in other hosts with low titers of these hormones. Except for normal males, all hosts had high serum levels of LH. Thus, testicular tumors in tfm rats appear to be LH-dependent.

Asymptomatic carriage of Klebsiella pneumoniae producing extended-spectrum beta-lactamase by patients in a neurological early rehabilitation unit: management of an outbreak.

During 11 months 58 extended-spectrum beta-lactamase-producing Klebsiella pneumoniae (ESBL-Kp) isolates were grown from 10 patients on a neurological early rehabilitation unit. The patients had no signs of infection but were colonized in the nose and trachea, and unusually only one had colonization in the gut. A single clone of ESBL-Kp was identified by pulse field gel electrophoresis. Strong hygienic precautions similar to those for Methicillin-resistant Staphylococcus aureus patients prevented spread of the bacteria to other wards. However, rehabilitation for patients with severe neurological failures made it very difficult to follow hygienic requirements. Disinfection of mucous membranes was difficult. Eventually the application of a nasal spray containing povidone-iodine proved to be successful.

Corporate characteristics and worksite health promotion programs: survey findings from Fortune 500 companies.

A study was carried out to assess the nature and extent of worksite health promotion programs in Fortune 500 companies. Growth and interest in worksite health promotion continues at a remarkable rate. Fortune 500 firms are a good barometer of the state of the art of programs in work settings because these companies have large numbers of employees, an interest in cost savings, and expertise to invest in innovative efforts. Data collection consisted of questionnaires sent to the medical officer or Chief Executive Officer of all companies appearing on the 1984 Fortune 500 list. The following issues were addressed: whether companies offered worksite programs; what health promotion activities were provided in their programs; whether organizations had plans to start up or expand programs; what organizational support existed for programs (i.e. who pays, on whose time employees participate, when activities are offered, and what types of personnel are hired to staff programs); and whether these companies applied needs assessments, evaluation and cost analysis in their programs. Differences in these characteristics were examined in relation to the organizational variables of size (number of employees), Fortune 500 rank and type of industry (low-technology versus high-technology). The response rate for the survey was 49.4% (n = 247). Results of the study indicate a high level of health promotion activity in Fortune 500 firms. Out of the total group of respondents, two-thirds (n = 164) report having worksite programs and two-thirds of organizations with programs have plans to expand their health promotion offerings. One-third of responding organizations without programs planned to initiate them. The health promotion activities provided are numerous and varied, and within units that have programs rates of employee eligibility are reported to be high. However, the participation rates reported are appreciably lower. It is of special interest that, in general, the higher ranked, larger and high-technology companies are more likely to have programs; offer more activities in programs; have plans for program expansion; use a model of sharing costs of, and time to participate in program activities; make greater use of health professionals; and utilize more often needs assessment, evaluation and cost analysis techniques. The results of this study underscore the importance of examining a broad constellation of factors surrounding worksite programs. Given the organizational literature reviewed, it is likely that the characteristics of Fortune 500 programs documented here will serve as models for programs in midsize and smaller companies.

The 3-hour therapy criterion: a challenge for rehabilitation facilities.

Rehabilitation hospitals and units must meet certain requirements to be reimbursed by Medicare. Section 211 of the Medicare Hospital Manual specifies that at least 3 hours a day of physical and/or occupational therapy must be provided to each patient in addition to other required therapies and services. This article discusses the political and professional context surrounding the implementation of these guidelines and some of the practical issues that managers must address in the process. A case report is used to illustrate the management strategies and specific methods that have been implemented in the Occupational Therapy Department at the Rehabilitation Institute of Chicago in response to the 3-hour criterion. Data are presented to indicate how these efforts have contributed to raising our level of compliance with the criterion during the 1985-1986 fiscal year. The compliance data are discussed in relation to variation in both the number of patients and staff productivity over the course of the year.

[Quantification of the gnostic sensitivity via measurement of the vibration threshold and of finger tip sensation]. / Kwantificeren van gnostische sensibiliteit door het meten van de vibratiedrempel en van de vingertopsensatie.

OBJECTIVE: Quantification of vibration perception and fingertip sensation in routine neurological examination. SETTING: Neurological Clinic, University Hospital, Groningen, the Netherlands. DESIGN: Prospective, controlled investigation. METHODS: Vibration perception and fingertip sensation were quantified in a large group of normal control persons of various ages and in neurological patients and compared with the usual sensory tests at routine neurological examination. The vibration perception limit was measured with a biothesiometer without accelerometer, the fingertip sensation with a device for two-point discrimination slightly modified according to Renfrew ('Renfrew meter'). Concordance of the tests was studied by calculating kappa values. RESULTS: The normal values of both sensory qualities had a log-normal distribution and increased with age. The values obtained with the Renfrew meter correlated well with those of the two-point discrimination and stereognosis but were systematically higher than those indicated by Renfrew. CONCLUSION: Both methods appear useful at routine neurological examination if certain measuring precautions are taken.

[The Influence of the Permeability of the Cell Membrane on TMPD Oxydase Activity (author's transl)]. / Der Einfluss der Membranpermeabilität auf die TMPD-Oxydase-Aktivität bei Bakterien

26 bacterial strains representing a variety of both Gram-negative and Gram-postive groups were investigated for their N,N,N',N'-Tetramethyl-1, 4-phenylendiamin (TMPD) oxidase activities and cytochrome contents. The oxidase activites of colonies were examined by dropping the reagent on agar surface colonies. Intact and sonicated cells were tested by recording the oxidation of the TMPD reagent at 546 nm after addition to the cell suspensions. Cytochromes were determined by recording the difference spectra (KBH4-reduced minus H2O2-oxidized) between 400nm and 630 nm. After sonication of intact cells of the "oxidase negative" Enterobacteriaceae except the Proteus strains, the Flavobacterium strains, Streptococcus faecalis, Xanthomonas phaseoli, and the Acinetobacter strains investigated oxidase activities were observed and the oxidase activities of the "oxidase positive" Bacillus and Micrococcus strains and Haemophilus influenzae were increases. These observations show that negative oxidase reactions exhibited by bacterial colonies may not only be due to the lack of the oxidizing enzyme system itself but also to impermeability of the cell membrane for the TMPD reagent. The TMPD oxidase activity could not be correlated to the cytochrome contents of the cells.

[Epidemiology of Campylobacter jejuni/coli--enteritis in children]. / Infektketten bei Campylobacter jejuni/coli Infektionen des Kindes.

The infections of children caused by C. jejuni/coli are mainly transferred via three infection chains: (1) direct contact with C.jejuni coli-contaminated feces; (2) consumption of contaminated meat which was cooked insufficiently; (3) consumption of food which was contaminated by e.g. the mother during preparation of the childrens meat. The common characteristics of these chains are insufficient hygienic precautions.

[Rotavirus infection in the older child and adult]. / Die Rotavirusinfektion des älteren Kindes und des Erwachsenen.

Rotaviruses were detected in 1.3% of more than 10,000 stool samples from children--older than 6 years--and adults. Beside rotaviruses the main enteropathogenic agents found were salmonellae (6.3%) and Campylobacter jejuni/coli (1.7%). Similar as the rotavirus infection of infants, in adults symptoms and signs were nearly the same except that the disease was not so severe. A correlation of the rotavirus infection with certain behaviour or eating habits was not found.

[Serologic demonstration of antibodies against Campylobacter jejuni/coli in man]. / Serologischer Nachweis von Antikörpern gegen Campylobacter jejuni/coli beim Menschen.

Antibody response to Campylobacter jejuni/coli infections in man was studied by microagglutination assay against homologues organisms isolated from patients and by complement fixation test against a commercially available group-specific antigen of C. jejuni/coli. Titers of agglutinating antibodies raise within 1-2 weeks post infectionem (p.i.) to an extent of about 320 (reciprocal titer) and persist about 3-4 months. CF-antibody titers raise only to about 40 but they persist for a long time. Because of the low titers in the CF-test and because of a missing seroconversion the CF-test is not suitable for the diagnosis of an acute infection. On the other hand the persisting CF-antibodies allow the diagnosis of reactive arthritis caused by C. jejuni/coli, particularly if the causative bacteria could not be cultivated.

[In vitro activity of 23 chemotherapeutic agents against Campylobacter jejuni/coli strains isolated from feces]. / Die Aktivität von 23 Chemotherapeutika in vitro gegen aus Stuhlproben isolierte Campylobacter jejuni/coli-Stämme.

In vitro susceptibility of 256 C. jejuni/coli-isolates to 23 antimicrobial agents were tested by an agar-diffusion technique and by determination of the minimal inhibition concentrations. The isolates tested were highly susceptible to tetracycline, the aminoglycosides, chloramphenicol, nitrofurantoin, and pipemic acid. They were resistant to cephalosporins (except Cefotaxime) and penicillin and its derivatives. About 6% of the isolates were resistant to erythromycin (MIC 4 micrograms/ml) and about 15% to nalidixic acid (MIC 40 micrograms/ml). The significance of the resistance patterns of C. jejuni/coli strains for therapy and taxonomic problems was discussed.

[Campylobacter-enteritis in children (author's transl)]. / Campylobacter-Enteritis bei Kindern.

During 1980 out of 3,680 stool specimens of children aged up to 6 years with diarrhea routinely screened for enteropathogenic bacteria, 72 cases of Campylobacter fetus ssp. jejuni infection were found. They were more common during the summer months, in children aged less than 4 years, and in boys rather than in girls (2, 9:1). The most common symptoms were watery, mucus, and haemorrhagic diarrhea, fever, vomiting and abdominal pain. All strains exhibited nearly identical sensitivity patterns for the chemotherapeutics tested.

[Biochemical characterization of haemophilus-strains by using the API 20 E- and API 50e-testsystem (author's transl)]. / Die biochemische Charakterisierung von Haemophilus-Stämmen mit Hilfe der API 20E- und API 50E-Testsysteme.

The commercially available test systems API 20E and API 50E were used to characterize 74 reference strains and clinical isolates of Haemophilus influenzae, H. aegyptius, H. parainfluenza, H. paraphrophilus and H. paraphrohaemolyticus The strains were grown on chocolate agar followed by suspending some colonies colonies in proteose pepton medium, pH 7.6, supplemented with the X- and V-factors. The alkaline suspension was used to inoculate the cups of the test kits. The alkali of the medium did not influence the biochemical reactions of the bacteria and enabled elimination of false positive reactions, particularly with the indicator phenol red. The API-systems proved efficacious for the diagnosis and characterization of the strains as compared with conventional biochemical tests.

Moral treatment and the therapeutic community.

History can serve as a useful tool for better understanding contemporary mental health programs. At present, much interest is directed at apparent parallels between 19th century moral treatment and modern milieu therapies, especially the therapeutic community. A common emphasis on a humane living environment is typically cited as the major parallel between the treatments. However, on closer examination, it appears that moral treatment and the therapeutic community exemplify different conceptions of what constitutes a humane living environment. Moreover, the two overall treatment philosophies differ significantly. These differences are tied to the historical contexts and responses to cultural stress in the mid-19th and mid-20th centuries, and consequent conceptions of mental well-being. A heretofore overlooked, but suggestive parallel between the treatments, which may help explain their efficacy, is the importance of peer self-help as a therapeutic tool. However, whereas the therapeutic community actively encourages peer self-help, 19th century asylum superintendents were unaware of its value.

[The aerobic bacterial intestinal flora of various wintering geese species]. / Die aerobe bakterielle Darmflora verschiedener überwinternder Gänsearten.

The aerobic fecal flora of wintering Brent Goos (Branta bernicla), Barnacle Goose (Branta leucopsis), Greylag Goose (Anser anser), White-fronted Goose (Anser albifrons), Pink-footed Goose (Anser brachyrhynchus), and Bean Goose (Anser fabalis) was studied. There were no specific differences between the various geese. Bacterial counts were in the range of 10(5)-10(7) CPU per gram of feces. Neither pathogenic bacteria nor rotavirus could be detected in the fecal samples of the wintering geese, so that a contamination of the environment with those pathogenic organisms could be excluded. The majority of the isolated bacteria belonged to the genera Bacillus and Pseudomonas; enterobacteria and streptococci were less common. The observations are discussed regarding their epidemiological and ecological significance.

Energy metabolism of some representatives of the Haemophilus group.

The purpose of this investigation was to characterize the carbohydrate catabolism and the constellation of the respiratory chain components of Haemophilus influenzae RAMC 18 Bensted, H. parainfluenzae 1 Fleming, H. parainfluenzae 429 Pittman and H. aegyptius 180a Pittman. These strains represent several physiological types with respect to respiratory quinones and glucose catabolism. On addition of glucose or lactate to the complex growth medium a remarkable increase in cell mass was observed. Depending on the growth rate, carbohydrate degradation varied with the strains examined so that at the end of the exponential growth phase only small amounts of the supplements could be demonstrated. All strains were found to possess functional enzymes of Embden-Meyerhof-Parnas-, Entner-Doudoroff-pathways, hexosemonophosphate shunt, tricarboxylic acid cycle and gluconeogenesis with an extremely high activity of malate dehydrogenase. The concentration of cytochromes varied according to culture conditions. The cytochromes a1, d, o and b + c were found to occur under aerobic conditions. In cells grown anaerobically in the presence of fumarate cytochromes a1 and d could not be demonstrated. Under aerobic conditions preparations of H. parainfluenzae 1 Fleming exhibited an alpha-maximum at 558 nm, whereas under anaerobic culture conditions with fumarate as terminal electron acceptor an alpha-maximum at 552 nm occurred, suggesting different roles of b and c type cytochromes in aerobic and anaerobic electron transport to fumarate, respectively.

Martin Buber's relevance to institutional mental health care.

A Buberian perspective on problems related to the establishment of therapeutic environments on mental hospital wards is offered. Depersonalization and over-reliance on a medical treatment orientation in human relationships are identified as central problem areas in mental hospitals. The therapeutic community is identified as a major alternative model to respond to these problem areas. Difficulties in applying the therapeutic community model are identified. Buber's social philosophy, especially his interpretations of spiritual crisis, cultural crisis, structural renewal, and genuine dialogue, are identified as useful tools to clarify and resolve those difficulties.

Euthanasia and mental retardation: suggesting the unthinkable.

Current opinions on euthanasia of persons with mental retardation were discussed within the framework of the development of social policy towards this population. Historians of mental retardation have emphasized that incarceration and sterilization were the only two policy options available in the late 19th and early 20th centuries, but a third option, euthanasia, was also suggested. The significance of the euthanasia option as the nation struggled to find a solution to the question of how to deal with what was thought to be a sharp rise in the number of people with mental retardation in the United States in the late 19th and early 20th centuries was examined. The responses of service providers to suggestions that euthanasia be implemented were reviewed. The rejection of proposals for euthanasia on moral and religious grounds and on the basis that custodial institutions, based on eugenics principles, were able to achieve the same end through a scientifically justifiable means was explored.