Biomedical subjects
Publications and source records attributed to J Romano.
Numbers of neurons and glia were counted in the cerebral cortex of one well-documented case of autism and two age- and sex-matched controls. Areas in which cell counts were made were primary auditory cortex, Broca's speech area, and auditory association cortex. No consistent differences in cell density were found between the brains of the autistic patient and the control patients.
The minimum significant (p = 0.05 level) detectable change noted on measuring anterior chamber depth by a photographic method was found to be 7% either way from the mean. The minimum significant change for a peripheral chamber depth 5 mm from the optic axis was found to be 25% either way.
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Moxalactam, a potent new beta-lactam antibiotic with a relatively wide spectrum of activity against facultative and anaerobic gram-negative bacilli, was evaluated in vitro and in 28 patients with a variety of severe infections with moxalactam-susceptible organisms (minimum inhibitory concentration less than or equal to 31 microgram/ml). Although therapy was successful in most of these patients, caution is suggested because of the development of resistance on therapy in one patient, persistence of Bacteroides fragilis endocarditis in another, and for certain organisms, a significant inoculum effect on the minimum inhibitory concentration and minimum bactericidal concentration of moxalactam.
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Attention is drawn to the principal determinants of change since World War II in the teaching of psychiatry to medical students in the United States. From the outset the goals of the educational programs were addressed to all medical students, not only those who had made a career choice in psychiatry. Although there have been minor changes, the goals have stood the test of time. For several practical reasons, current examination of our existing educational programs is timely. Comments and criticisms of generations of medical students have informed us of our successes and our failures. The ambiance of the medical school as a whole as well as that of the Department of Psychiatry have contributed to a state of dysphoria academia. Several factors are cited as possible determinants of the decline in the number of medical students who choose psychiatric careers, as well as influencing the careers of physicians other than psychiatrists. The principal recommendation is to correct the deficiencies in our teaching programs.
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A trial of a mixture of guanethidine 5% and adrenaline 0.5% (Ganda 5.05) and of guanethidine 3% and adrenaline 0.5% (Ganda 3.05) was conducted on 90 eyes in 53 patients with open-angle glaucoma or ocular hypertension. The cases fell into 5 groups: untreated cases, cases on pilocarpine 1%, on pilocarpine 2%, on pilocarpine 2 to 4% and adrenaline 1%, and on separate guanethidine 5% and adrenaline 1%. Baseline pressures and average pressures on the previous treatment were established. Substitution with Ganda 3.05 or 5.05 was started, and the patients attended 2 weeks, 1 month, 3 months, and 6 months from the start of the trial. Applanation tonometry was carried out at the same time of day. The pupil was measured, ptosis and superficial punctate corneal staining were looked for and evaluated, and the patients were questioned for symptoms of side effects and acceptability. All the eyes that had previously been treated with pilocarpine 1% or 2% presented significantly lower intraocular pressures on Ganda 3.05. The patients on pilocarpine 4% and adrenaline 1% also had lower intraocular pressures on Ganda 5.05, but the significance was less, and the patients on separate guanethidine and adrenaline had a small but not statistically significant drop in pressure. Ptosis and discomfort were evaluated on a subjective scale. Patient acceptability was good. The trial was interrupted in 5 cases for various reasons. Tachyphylaxis and tolerance to the mixtures were not observed in this series.
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The exact mechanism involved in the pathogenesis of pyoderma gangrenosum (PG) still remains unclear, yet there is an increasing number of reports associating PG with immunologic abnormalities. A correlation between PG and myeloproliferative disorders has also been described. We describe a patient with chronic myelocytic leukemia in whom PG developed during the course of illness. We present an immunologic analysis of this case, speculation on the pathogenesis of PG, and a review of the literature. We report the futility of current therapeutic modalities in the treatment of PG.
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The research methodology for a current study of the assessment of family factors as they relate to the development of psychopathology in high-risk children is described. Factor analysis of preliminary data from 83 families led to the construction of 6 rating scales on the emotional health of the patient, spouse, and child; the family; and the marriage; these should prove valuable in predicting the outcome of the index child and his family.
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Nine cases of idiopathic bone cavities, also described as traumatic bone cysts, were discovered within a 15-month period. These lesions are obviously more prevalent than indicated by a perusal of the literature.
A survey was conducted in Rochester, NY, of the attitudes and practices of psychiatrists (both in private practice and fulltime academic settings), psychiatric residents, internists, and fourth-year medical students concerning physical examinations of psychiatric patients. Thirteen percent of the psychiatrists frequently perform an initial physical examination on their inpatients and 8% frequently do an initial physical examination on their outpatients. These percentages are much larger for the resident groups. A very high percentage of all respondents report that they feel a physical examination of psychiatric patients is important especially when the patient is receiving medication. The largest number of psychiatrists report that they omit the physical examination because the patient has been referred to them after a physical examination by another physician or they refer the patient for such an examination. A notable percentage of psychiatrists in this sample report that they do not feel competent performing a physical examination.
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