Accuracy of early estimation of maturity.
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Biomedical subjects
Publications and source records attributed to W Reid.
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Using a clinical case, I have attempted to demonstrate how an analytic "listening attitude" may permit a patient request which would at a manifest level, not usually require insight but, if such were given, would then influence the whole course of treatment. Thus, the fundamental concept of psychoanalysis dealing with unconscious mental mechanisms becomes operational if it is not limited simply to a technical frame of reference. The developing situation then approaches that of psychoanalysis. This process may occur if flexibility is maintained in the basic technique of psychotherapy. The views of Jean Bergeret on borderline states are briefly presented as tools of psychodynamic understanding of clinical situations.
Of the 8 pregnancies studied, 2 were of small gestational sacs with blighted ova and were associated with devices in which the copper wire had very high detectable X-ray emissions for copper (greater than 90%). In 2 other pregnancies intrauterine deaths had occurred by the time of termination at 13 and 17 weeks and copper levels in the products of conception were variable. There was no abnormality of the fetus in the term pregnancy but it seems possible that copper can affect the early growth and development of the embryo. On only 1 of the 8 devices was any great amount of calcium deposited and it is therefore considered unlikely that calcium deposition increases the risk of pregnancy by preventing the release of copper.
Fetal malnutrition has emerged as a significant health problem over the past decade. Present evidence suggests that maternal environment plays the major etiologic role in fetal malnutrition. The association of fetal malnutrition in mothers with chronic hypertension is well known, but fetal malnutrition is associated with maternal hypertension in less than 25 per cent of cases. Among a group of 182 pregnant women studied at midpregnancy for blood levels of vitamins, trace metals, proteins, amino acids, and parameters of maternal leukocyte energy metabolism, it was found that the concentration of 10 amino acids, alpha-1-globulin, zinc, and total carotenes had a statistically significant relationship to fetal growth. Similarly significant correlations were found for maternal leukocyte adenosine disphosphate, phosphofructokinase activity, ribonucleic acid (RNA) synthesis, and cell size. Maternal cigarette smoking was correlated with reduced fetal growth. Analysis showed that there was a significant reduction in leukocyte RNA synthesis and phosphokinase activity and in the plasma levels of 14 amino acids, and carotene in smoking mothers. This information lends support to the hypothesis that factors which affect the growth of fetal cells also will affect maternal leukocytes in a definable way.
Frey's syndrome occurs after parotid gland surgery or injury to the parotid gland and is characterized by gustatory sweating and erythema of the face upon mastication. The syndrome occurs in 50 to 60 per cent of all patients undergoing parotid surgery but the symptoms are only distressing to about 10 per cent of patients undergoing parotidectomy. A case of Frey's syndrome is reported The patient obtained good relief of symptoms with scopolamine cream and atropine cream. Other methods of therapy are discussed along with their limitations. Noninvasive therapy with topical anticholinergic creams is effective and seems appropriate in the control of gustatory sweating.
The results of reconstructive arterial surgery in 113 critically ischaemic limbs during 1958 to 1972 are presented. There were 61 aorto-iliac reconstructions with 4 operative deaths (6.5%), resulting in a limb salvage rate of 75.4 per cent and 49 femoro-popliteal operations with 3 deaths (6.1%) and a limb salvage rate of 73.5 per cent.
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The results of a survey of 302 operations in 277 patients during 1959-70 are presented, and an additional 69 operations during 1971 are included in the mortality figures. Operative mortality (1968-71) was 0.9% in 113 aortoiliac operations and nil in 96 femoropopliteal operations.Immediate patency rates on dismissal from hospital exceeded 95%, and the five-year patency rate for aortoiliac operations was just over 70% and for femoropopliteal operations 60%.
A preclinical method for the evaluation of antibacterial agents for use against dental plaques associated with caries and periodontal disease is proposed. The method is applicable to screening agents and to defining, in vitro, the minimal conditions required for maximal antiplaque effect. As a model of antiplaque agents, chlorhexidine was assessed in vitro against preformed plaques of microorganisms conducive to dental caries and periodontal disease. The agent was bactericidal to plaques of nine strains of Streptococcus mutans and one strain of Actinomyces viscosus when used in a single treatment for 20 min at 2 x 10(-1)%, in two 2-min treatments on the same day, or in daily 2-min treatments at this same concentration. Using the last of these experimental conditions, we then tested chlorhexidine in vivo by topical application to the maxillary teeth of infected hamsters and found it to be effective in controlling plaques of S. mutans and A. viscosus.
The distribution of polysaccharide-forming activity from sucrose was investigated in cultures of three strains of Streptococcus mutans by using an assay which conveniently determines total polysaccharide. The enzymatic activity for polysaccharide formation from sucrose is almost exclusively extracellular. The ratio of the fructan to glucan in the polysaccharide differs among the three strains investigated. The enzymatic activity for the formation of polysaccharide from sucrose has been shown to be bound to the cell-free polymer itself.
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