Room-temperature ultraviolet nanowire nanolasers.

Room-temperature ultraviolet lasing in semiconductor nanowire arrays has been demonstrated. The self-organized, <0001> oriented zinc oxide nanowires grown on sapphire substrates were synthesized with a simple vapor transport and condensation process. These wide band-gap semiconductor nanowires form natural laser cavities with diameters varying from 20 to 150 nanometers and lengths up to 10 micrometers. Under optical excitation, surface-emitting lasing action was observed at 385 nanometers, with an emission linewidth less than 0.3 nanometer. The chemical flexibility and the one-dimensionality of the nanowires make them ideal miniaturized laser light sources. These short-wavelength nanolasers could have myriad applications, including optical computing, information storage, and microanalysis.

Pseudohypoparathyroidism and idiopathic hypoparathyroidism: relationship between serum calcium and parathyroid hormone levels and urinary cyclic adenosine-3',5'-monophosphate response to parathyroid extract.

Forty patients with hypocalcemia and/or Albright's hereditary osteodystrophy were studied. Based on the estimation of serum calcium and parathyroid hormone (PTH) levels as well as the urinary cAMP response to infusions with parathyroid extract, it was possible to classify all of the patients studied as cases with idiopathic hypoparathyroidism (n = 6, low PTH, normal cAMP response), pseudohypoparathyroidism (PHP) type I (n = 18, high PTH, low cAMP response) and type II (n = 2, high PTH, normal cAMP response), as well as pseudopseudohypoparathyroidism (n = 14, normal PTH, normal cAMP response). In three cases studied at the age of 12, 17, and 23 yr, the signs of Albright's hereditary osteodystrophy were not observed. PTH levels were unusually high for a given serum calcium concentration in some patients with PHP, the increased PTH levels were, however, normalized during iv calcium infusions. In two young children with PHP, a gradual increase of serum PTH levels occurred despite persistent normocalcemia over a period of 3 yr. This suggests that factors other than hypocalcemia or frequent small unobservable falls of the serum calcium concentration, such as a deficient formation of 1,25-dihydroxyvitamin D3, secretion of an abnormal PTH, or an abnormal metabolism of the hormone, may contribute to the secondary hyperparathyroidism in PHP.

Keratitis with hypoparathyroidism.

Chronic kiratitis developed in two children with nonsurgical hypoparathyroidism, as part of an autosomal recessive syndrome that included adrenal insufficiency and moniliasis in what was postulated to be an autoimmune disease. The corneal changes may also have been caused by autoimmune mechanism. Activity of the keratitis diminished once the hypoparathyroidism had been brought under control. However, these patients were thought to be at risk for adrenal insufficiency: neither had moniliasis or adrenocortical insufficiency at present, but the features of the hypoparathyroidism adrenal insufficiency-moniliasis syndrome appeared at different ages and in differing sequences.

[Neurosis and accident insurance]. / Neurose und Unfallversicherung.

The federal law-court for social insurance in Switzerland has recently changed his way of judging insurance claims for neurotic sequels of accidents. A short history of the traumatic neurosis is given and the consequences of this new situation are discussed in view of the psychiatrist as legal expert.

[Malpractice in psychotherapy]. / Der Kunstfehler in der Psychotherapie

Two cases of malpractice in psychotherapy are described. In one case there was a psychiatrist involved, in the other a non-medical psychotherapist. The legal aspects of malpractice in the view of Swiss legislation are shortly discussed. A legal liability for damages caused by the psychotherapist might arise if the following conditions are fulfilled: A deviance from the generally accepted standards of care in psychotherapy, a damage to the patient as a consequence of this deviance and a negligence on the part of the psychotherapist. Furthermore, there has to be an adequate causal nexus between malpractice and damage done to the patient. By some case reports the author tries to exemplify what can be understood by the term of generally accepted standards of care in psychotherapy.

[Medical ethics problems in psychiatry]. / Medizinisch-ethische Probleme in der Psychiatrie.

A humanitarian attitude and ethical convictions have contributed much to the development of psychiatry. In the present time these convictions have been codified, for instance in the declaration of the World Federation of Psychiatry in Hawaii 1977. In more detail the author discusses 3 areas where ethical considerations have special significance: the scope of psychotherapy, psychosurgery, and the use of psychiatric means to suppress and discipline politically dissident persons.

[The endocrine psychosyndrome in the long term. II. A catamnestic reexamination after treatment of patients suffering from Cushing's syndrome (author's transl)]. / Das endokrine Psychosyndrom in Langzeitverlauf. II. Langfristige Katamnesen von Kranken mit Cushing-Syndrom nach Behandlung.

Twelve patients with Cushing's syndrome (11 females, 1 male) who were examined for psychopathologic alterations in the course of the endocrine disease during the years 1960-61, were reexamined in 1976 regarding psychiatric sequelae after treatment. Ten patients had been treated by adrenalectomy, one patient by radiotherapy of the hypophysis, and one patient had refused any treatment. The average lapse of time from operation to reexamination or death (five patients) was 15 2/3 years. In seven patients it had been possible to stop completely the excessive production of adrenal hormones. Corresponding the long-term result was favorable, with complete recovery of the ability to work. The previous symptoms of the endocrine psychosyndrome disappeared almost completely. There was no permanent alteration of personality and the vital dependence on hormonal substitution was well tolerated. In four of the five patients with an unfavorable course of the disease it had not been possible to stop the excessive production of adrenal hormones. These patients became increasingly invalid and had to be cared for. Symptoms of chronic organic brain syndrome developed. In contrast to the course of panhypopituitarism where nonspecific personality factors are of considerable importance, in Cushing's syndrome the long-term prognosis depends entirely on the successful stoppage of the overproduction of adrenal hormones. The artificial subsitution is not necessarily a disadvantage for the psychic functioning of the patient.

[The endocrine psychosyndrome in the long term. I. A cantamnestic reexamination of patients suffering from panhypopituitarism (author's transl)]. / Das endokrine Psychosyndrom im Langzeitverlauf I. Langfristige Katamnesen von Kranken mit Hypophysenvorderlappeninsuffizienz.

Twelve patients (8 females, 4 males) with panhypopituitarism who had been thoroughly examined psychiatrically in 1957 and 1958 were reexamined in 1974 for psychopathologic alterations in the course of their endocrine disease. Eleven patients had been receiving an adequate hormonal treatment during the intervening years or (four patients) until the time of their death. Seven patients showed a good or excellent result of hormonal therapy, in respect of the psychic symptoms: the endocrine psychosyndrome which had been observed prior to treatment had improved considerably. Signs of organic brain syndrome were judged to be caused by age and not by the endocrinopathy. The factors influencing prognosis of psychic symptoms are: alteration in mental activity, in the sense of apathy and lack of drive, and the extent of social distegration caused by these alterations; the age of the patient at the onset of symptoms and the lapse of time prior to the beginning of adequate therapy; finally the personality structure and the social situation of the patient.

[The endocrine psychosyndrome in the long term. III. A catamnestic reexamination of patients suffering from hypothalamo-hypopituitary dwarfism (author's transl)]. / Das endokrine Psychosyndrom im Langzeitverlauf. III. Langfristige Katamnesen von Kranken mit hypothalamo-hypophysärem Zwerg-oder Kleinwuchs.

Fifteen patients (4 females and 11 males) with hypothalamo-hypopituitary dwarfism underwent extensive psychiatric investigation in 1962-1965. A follow-up study of the personality development and social conditions was made in 1977. The age of the patients ranged from 31 to 56 years (the average being 40). As before, the main finding was an infantile personality with a defective psychosexual maturity. Only a few patients had reached a somehat adult, independent personality in spite of hormonal deficiencies. Several patients had continued to grow and attained a stature slightly below average. However, this subsequent growth scarcely influenced personality development. Depressive moods are now more frequent than before and among the more differentiated patients, the neurotic symptoms are mainly phobic fears. Almost all of the patients have discontinued treatment with hormonal substitutes (androgenes, cortison, thyrotropic hormone) inspite of persistent deficiency symptoms, because the outcome did not match their high expectations. The symptoms of the endocrine psychosyndrome seem of minor importance compared with the psychic infantilism and the reactions to the experience of dwarfism and missing puberty. One female has suffered several psychotic episodes which were understood as being partially of endocrine origin.

[Medical and psychological problems relating to emergency shelters in case of war]. / Medizinische und psychologische Probleme bei Schutzraumaufenthalt im Kriegsfall

Modern warfare requires protection of the entire civilian population, and a main feature of Swiss planning is the provision of adequate shelter space for every inhabitant. The medical and psychologic problems of prolonged shelter living are considered, with reference to the literature on experience in other countries. The study centers on description of a shelter occupancy experiment. 25 men with an average age of 37 years spent 7 days in a closed shelter during the hottest part of the year. Floor space was 1.2 m2 and room volume 2.5 m3 per person. The experiment revealed that in-shelter climatic conditions remained tolerable. Initially several members of the group suffered from insomnia and nausea, while sleep disturbances, headache and gastrointestinal symptoms also occurred in the course of the stay. Daily self-rating of condition with appropriate scales showed a positive correlation of "irritability" with air humidity and a negative correlation of "vitality" with room temperature. Good shelter management and a trained leader are essential prerequisites for prolonged shelter occupancy.

[Herpes simplex encephalitis in newborns. Treatment with 5-iodo-2'-deoxyuridin? (author's transl)]. / Herpes simplex-Encephalitis bei Neugeborenen. Behandlung mit 5-Jodo-2'deoxyuridin

Premature twins both affected with generalized herpes simplex infection including CNS involvement were treated with 5-Iodo-2'-deoxyuridin (IDU). Therapy was started 6 days and 5 days, respectively, after appearance of the first symptoms. Nevertheless both babies died, twin A at the age of 24 and twin B at the age of 28 days. Herpes virus was cultured from all organs in twin A. The literature shows a decrease in mortality in children treated with IDU for herpes simplex encephalitis. The percentage of survivors with ultimate severe CNS damage, however, is very high and remains in treated or untreated patients the same. The institution of IDU therapy in neonates with manifest HSV encephalitis is therefore not unequivocally justified.

Neonatal severe primary hyperparathyroidism and alkaptonuria in a boy born to related parents with familial hypocalciuric hypercalcemia.

We describe a study of a boy with neonatal severe primary hyperparathyroidism (NSPHP) and alkaptonuria born to related parents of Turkish origin. The clinical and chemical courses (e.g. of mineral metabolism, of urinary excretion of amino acids and collagen metabolites) in response to various therapeutic approaches including total parathyroidectomy (PTX) are reported. Urinary excretion of calcium was unusually low before and immediately after PTX, and later during an inadvertent vitamin D intoxication. It corresponded to values typical for patients with familial hypocalciuric hypercalcemia (FHH), an autosomal dominant disorder. Both parents and one sibling had episodes of hypercalcemia with inappropriately high parathormone levels; in the father there was also relative hypocalciuria consistent with FHH. On the basis of the genetic and pathophysiologic data reported here, we speculate that homozygosity for the 'FHH-gene' is the cause of the life-threatening manifestation of NSPHP, whereas heterozygosity for the same gene leads to FHH, by comparison a mild disorder. The association of the two very rare recessively transmitted disorders, alkaptonuria and NSPHP, is unique; close linkage of the two genes, one coding for homogentisic acid oxidase, the other for the unknown gene product defective in NSPHP, can be suspected.

Quantification of bone mineralization using computed tomography.

Computed tomography was used to find a sensitive parameter for bone mineralization. A precision scanning instrument was constructed for determination of the mineral distribution in sections of the forearm. The quality of the reconstructed images allows separate quantification of compact and spongy bone even when gamma rays are used. Computer simulation and measured of models and macerated human bones showed that under clinical conditions it is possible to quantify spongy bone density within an accuracy of +/-2%.