Visual patterned reflex present during hypothalamically elicited attack.

A cat from which attack is elicited by electrical stimulation of the hypothalamus lunges more frequently toward a mouse presented to the eye contralateral to the stimulated site than it does to a mouse presented to the ipsilateral eye. This differential effect does not appear to be attributable to a temporary or permanent defect in the ipsilateral eye.

Control of sensory fields by stimulation of hypothalamus.

Stimulation of the cat's hypothalamus, which elicits attack, also establishes sensory fields for two reflexes related to biting. Touching a perioral region leads to head movement, bringing the stimulus to the mouth. Touching the lip-line leads to jaw opening. The size of the fields depends on the intensity of stimulation.

Neural pathways from thalamus associated with regulation of aggressive behavior.

Small electrolytic lesions were made through electrodes in the thalamus of cats at sites where electrical stimulation elicited attack on a rat. Staining by modified Nauta reduced silver methods revealed that significant degeneration passed caudally from the lesions and entered the midbrain dorsal central gray region. Electrical stimulation of this dorsal midbrain region elicited attack on a rat, and destruction of this region suppressed the attack elicited by thalamic stimulation.

Neural pathways associated with hypothalamically elicited attach behavior in cats.

Small electrolytic lesions were made in cats through electrodes, which, when stimulated, elicited either quiet biting attack or affective paw strike attack upon rats. The Nauta method for impregnating degenerating axoplasm was used to reveal that degeneration resulting from lesions at quiet attack sites followed largely along the course of the medial forebrain bundle, while the degeneration after lesions of affective attack sites was concentrated more heavily in the periventricular system.

Biting attack elicited by stimulation of the ventral midbrain tegmentum of cats.

An area in the ventral midbrain tegmentum has been discovered in which electrical stimulation elicits biting attack. The midbrain sites from which attack was elicited correspond well with the zone in the midbrain tegmentum where degeneration was previously observed after lesions were made in lateral hypothalamic attack sites.

Bat-associated histoplasmosis in Maryland bridge workers.

An epidemic of acute prolonged febrile respiratory disease affecting nine of 19 workers on a Maryland State bridge maintenance crew was diagnosed as histoplasmosis by serologic testing in all and by isolation of the organism in one. In our investigation, it was revealed that work on a particular bridge was associated with disease. Culture of bat guano from the site two months later revealed H. capsulatum. Four previously uninfected epidemiologic investigators also became ill with histoplasmosis following collection of soil and bat guano. This outbreak reveals that bats and bat guano are a source of histoplasmosis, suggests that only brief exposure is necessary for acute infection and reemphasizes that histoplasmosis is not confined to the midwestern states.

Afferent projections to quiet attack sites in cat hypothalamus.

Quiet biting attack by a cat on a rat was elicited by electrical stimulation of sites in the cat's lateral hypothalamus. Horseradish peroxidase was deposited at the attack sites. Cells containing reaction products were found in gyrus proreus, anterior and central medial amygdaloid nuclei, lateral and medial preoptic areas, substantia innominata, the bed nuclei of stria terminalis, and anterior commissure. The dorsomedial area of the hypothalamus, paraventricular nucleus, supramammillary region, and posterior hypothalamic area also contained reactive cells. In the midbrain the ventral tegmental area of Tsai, the dorsal and superior central nuclei of the raphe, central gray matter and interpeduncular nucleus were regions with reactive cells. In the pontine region, the locus coeruleus, parabrachial nuclei, nucleus of the lateral lemniscus, and the dorsal tegmental nucleus of Gudden all had reactive cells. There are many structures which send afferent projections to quiet attack sites located in the hypothalamus and the pontine tegmentum. The commonality of afferents to attack sites lends credence to the notion that a complex, distributed, interactive network underlies the neural basis of attack behavior.

Afferent projections to affective attack sites in cat hypothalamus.

Horseradish peroxidase was deposited at sites at which affective attack was elicited by electrical stimulation. Cells containing reaction products were found in the nucleus accumbens, subiculum and presubiculum, the medial nucleus of the amygdala, the lateral and to a lesser extent the medial septal nuclei. In the thalamus cells were found in the paraventricular nucleus and nucleus reuniens. The bed nucleus of the stria terminalis and anterior commissure contained a small number of reactive cells. The lateral and medial preoptic areas were well represented, as was the anterior hypothalamic area. There were numerous cells in a large number of the hypothalamic regions, namely, the lateral hypothalamus particularly the dorsal part, the periventricular area, the dorsal part of the paraventricular nucleus, ventromedial nucleus, the arcuate nucleus, the perifornical region, and even the supraoptic nucleus. The posterior hypothalamic and supramammillary regions also had reactive cells. In the midbrain such cells were found in the ventral, lateral and dorsal central gray matter and in the superior central nucleus of the raphe. In the pontine region, the locus coeruleus, the parabrachial nuclei and the dorsal tegmental nucleus of the Gudden had cells with reaction products. Several of these regions also contained cells after HRP injections at quiet attack sites.

Afferent projections related to attack sites in the pontine tegmentum.

Attack by a cat on a rat was elicited by electrical stimulation of the ventral parabrachial nucleus or the paralemniscal pontine reticular formation. The attack was quiet and it differed from similar behavior elicited at other sites in that the cat not only bit the rat but struck it with its paw. Horseradish peroxidase was deposited at the attack sites. Cells sending projections to the attack sites were located in gyrus proreus, anterior, central, and medial amygdala, the bed nucleus of the stria terminalis, lateral, dorsal and perifornical hypothalamus, as well as the central gray matter, superior colliculus, midbrain reticular formation, locus coeruleus, nucleus of the lateral lemniscus, and nucleus interpositus. Additional sites of cells of origin appeared with less regularity. This distribution of sites correlates well with the sites from which attack can be elicited or modulated.

Unit activities in the hypothalamus and midbrain during stimulation of hypothalamic attack sites.

Unit activity in the hypothalamus and midbrain of unanesthetized cats was studied during electrical stimulation of the hypothalamus at sites that induced attack and at other comparable sites from which attack was not induced. The changes in the firing of units at distances from 0.7 to 1.9 mm from the site of stimulation were similar to those of units at distances from 2.0 to 5.2 mm. Although stimulation in general affected a majority of units, resulting in increases rather than in decreases of firing rates, and produced similar patterns of unit activity, stimulation at sites that induced attack affected more units, produced a greater change in unit activity and markedly increased firing rates in the lateral hypothalamus and the dorsal part of the midbrain.

Afferent projections related to attack sites in the ventral midbrain tegmentum of the cat.

Quiet attack was elicited by electrical stimulation of the ventrolateral midbrain tegmentum of the cat. The paw was not used other than to position or hold the rat during the bite. Bites were directed toward the head and neck region and were not accompanied by autonomic responses other than pupillary dilation and sometimes slight piloerection on the back. Horseradish peroxidase was deposited at the attack sites. Cells labeled with the peroxidase reaction product were located in gyrus propreus, gyrus genualis, nucleus accumbens, bed nucleus of the stria terminalis, bed nucleus of the anterior commissure, nucleus of the diagonal band, substantia innominata, anterior amygdaloid area, ventromedial hypothalamic area, paraventricular nucleus, perifornical hypothalamic area, lateral hypothalamic area, dorsal hypothalamic area, field of Forel, midbrain reticular formation, superior colliculus, ventral central grey, lateral central gray, locus coeruleus, parabrachial nuclei, nucleus of the lateral lemniscus, oral pontine reticular nucleus, and the dorsal raphe. Other regions were less prominently labeled. Previous studies have shown most of these sites to have some involvement in attack.

Transfer of an escape response from tail shock to brain-stimulated attack behavior.

Nine cats, each with two hypothalamic electrodes in sites which when stimulated produced either quiet attack or attack accompanied by certain forms of vocalization, were trained to escape from tail shock by jumping onto a stool. They were then tested for transfer of the escape response to brain stimulation. Stimulation of the seven sites that yielded quiet biting attack did not elicit the learned response of jumping onto the stool. Stimulation of eight of the 11 sites that yielded attack accompanied by vocalization did elicit the learned response. It was concluded that attack behavior elicited by brain stimulation should not be considered a special case of the response to aversive stimulation, but that attack and response to aversive stimulation involve independent but overlapping systems.

War crimes during the Persian Gulf War.

Evidence of violations of the 1949 Geneva Conventions by Iraq's military personnel during Desert Shield and Desert Storm are described and adverse effects on the Kuwaiti health care delivery system are discussed. New diplomatic and military initiatives that include education and accountability are needed to ensure better compliance with international conventions designed to protect victims of war.

Peer review: a successful teaching strategy in baccalaureate education.

Faculty and students alike have been enthusiastic about the use of this teaching strategy to introduce the peer review process and provide practical application in clinical settings. The secondary benefits mentioned have increased our enthusiasm and insured that we will continue to use this strategy. Future plans call for the possible involvement of other health professionals in this process. We are also planning to devise a study that would indicate whether or not graduates exposed to this teaching-learning strategy have incorporated certain aspects of it into their practice. It is our hope that quality nursing care becomes the concern of all nurses.

The role of licensing in child placement and protection.

Regulation of child residential care facilities requires licensors who have professional experience in child welfare. Licensing requirements must be applied within a context of professional knowledge and experience, particularly in regard to child placement and child protective services. The licensing of facilities for out-of-home care of vulnerable children generally has not been viewed as a mainstream social service or child welfare function. Although licensing differs from placement services and protective services in that licensing is basically a nonservice approach to protection each of the three elements forms a triangle of comprehensive protection for vulnerable children. Recognition of both the similarities and the distinguishing characteristics of the three elements reduces individual and organizational role conflict and, furthermore, holds promise for mature and effective coalitions in achieving the common goal of protection for vulnerable children in out-of-home care. The strength of a statewide licensing program is founded in centralized organizational and supervisory structure. Licensing must fulfill its partnership role in coordination with child placement and child protective services to achieve genuine community protection for vulnerable children.