The Neurobehavioral Cognitive Status Examination: accuracy of the "screen-metric" approach in a clinical sample.

This study assessed the accuracy of the "screen" versus "metric" portions of eight subtests of the Neurobehavioral Cognitive Status Examination (NCSE). As part of a routine hospital assessment, 95 male patients were administered both portions of the instrument regardless of outcome on the screen. Results indicate that the screen items of some of the NCSE subtests produced a relatively high false negative rate, where the screen was passed, but the metric was failed. It is recommended that all items of the subtests be administered to more fully assess each domain and, therefore, reduce the probability of overlooking significant deficits.

Expanded norms for the Controlled Oral Word Association Test.

The Controlled Oral Word Association Test (COWAT) is a measure of a person's ability to make verbal associations to specified letters (i.e., C, F, and L). This measure is a useful component of a neuropsychological battery as it is able to detect changes in word association fluency often found with various disorders. In order to generate current norms for the elderly and aid in interpreting their performance, the COWAT was administered to a group of community-dwelling elderly persons. Information regarding total numbers of words produced as well as frequency of perseverations, breaking set, using the same word stem, and using a proper noun is provided.

Selection criteria for APA-accredited internships stratified by type of site and competitiveness.

As the internship marketplace becomes more competitive, doctoral students and faculty of professional psychology programs must become more knowledgeable of the selection criteria used by APA-accredited internship sites. Clinical experience was identified as one of the most important criteria used for selection by all respondents. However, criteria used by medical schools, university counseling centers, and Veterans Affairs Medical Centers, the three largest suppliers of internships, and by sites reporting low, medium, or high competitiveness appeared to vary as a function of the unique characteristics of the sites.

Vertical integration in medical settings: A brief introduction to its potential effects on professional psychology.

Vertical integration in medical settings typically involves the merging of independent physicians, physician groups, and hospitals to render an organized health care network. Such systems are considered to be vertical, as they may allow for a seamless continuation of services throughout the range of needs a patient may require. Mergers often result in the redefining of professional services offered in the acquired facility or across the network. As such, mergers have the potential of adversely impacting psychological practices. Professional psychology needs to take a proactive stance in this changing health care landscape. Research regarding empirically validated treatments and effects of psychological interventions on overall health-care costs needs to be properly disseminated to health care administrators to assure their knowledge of the utility of psychological services in the medical setting. Training psychologists to assume leadership positions in health-care institutions, gaining representation on hospital staff boards, and linking psychologists and physicians through collaborative training, to provide improved care, may allow for psychology to influence health care delivery.

The effect of endotoxin on preirradiated mice.

Adult male mice were given a whole body irradiation with non-lethal doses of 2.5 or 5 Gy. Unirradiated animals served as controls. The animals (including controls) received a single injection of endotoxin (LPS from Salmonella abortus equi) with doses of 100, 200 or 400 micrograms one day up to one year after irradiation. Twelve, 24 or 48 hours after lipopolysaccharide (LPS) application the animals were killed and dissected. Animals which died spontaneously were also examined. Liver, lung, kidney, small intestine, and stomach were histologically investigated. The histological findings showed, that differences exist between irradiated and unirradiated mice and that the cause of death is also different for animals dying spontaneously. The investigations have shown that after irradiation phases of different degrees of sensitivity with regard to the endotoxin response exist. This behaviour can be observed by different lethality rates or in the light of the histological results. Moreover, the histological findings have shown, that distinct regenerative changes occur first of all in the liver, in the mucosa of small intestine, and the gastric mucosa, in which the number of differentiated cells compared with the mitotic active cells is reduced. It can be ascertained, that a whole body irradiation with 2.5 to 5 Gy enhances an additional injury by endotoxin weeks to months later. Contrary to this a preirradiation a few days before endotoxin application leads to a "protection" against the efficacy of endotoxin. These findings can be explained by modes of action described in literature, according to which endotoxins induce the formation of highly active mediators especially the tumor necrosis factor.

[Coincidence of Gaucher disease with primary hepatocellular carcinoma]. / Koinzidenz eines Morbus Gaucher mit primärem hepatozellulärem Karzinom.

Case report on a 48-year-old man with Gaucher's disease and a HBsAg-positive cirrhosis simultaneously. Postmortem examination revealed a hepatocellular carcinoma suggested by antecedent ultrasound examination. The coexistence of Gaucher's disease and hepatocellular carcinoma has not been described before. A possible relationship between Gaucher's disease and hepatocellular carcinoma is supposed due to Gaucher's disease and association to the hepatitis B infection.

An evaluation of gastric dysplasia in the years 1986 and 1987.

Since the fate and significance of gastric mucosal dysplasia is still largely unknown we have started a follow-up study for patients with dysplasia in the years 1986 and 1987. In this paper the short term results are reported. Dysplasia grade II was found in 2% of all patients and dysplasia grade III in 0.5%. The following results suggest a close-possibly sequential relationship of dysplasia and gastric cancer: dysplasia and gastric cancer are preferentially located in distal parts of the stomach; sex distribution of dysplasia and gastric cancer (especially intestinal type) are similar; considering the mean age of patients with dysplasia or gastric cancer we have observed that patients with dysplasia II were younger than patients with dysplasia III and both were younger than patients with gastric cancer of the intestinal type; during the short term follow-up (12-24 months) 4-8% of patients with dysplasia II and 18-20% of patients with dysplasia III showed a progression; of 26 carcinomas detected by follow-up of patients with dysplasia III 10 were early gastric cancer, 11 resectable with curative intent, 2 were metastatic and 3 without sufficient information for staging. We conclude therefore that gastric dysplasia is probably a true precancerous lesion that helps to identify high risk patients and thus contributes to the objective of an early diagnosis of gastric cancer.

Prevalence of Campylobacter pylori as demonstrated by histology or CLO-test in different types of gastritis. A study in 5 clinically predefined groups of patients.

The prevalence of Campylobacter pylori infection as detected by histology was studied in 5 predefined groups of patients. The associated histologic and endoscopic findings were registered. Validity of CLO-test was tested against the histologic detection. The following groups of patients were studied: A) Non-ulcer dyspepsia (defined by one or all of three symptoms: heartburn, nausea/inappetence, halitosis/belching) B) control group (no specific symptoms, no ulcer, no history of gastric surgery) C) Duodenal ulcer D) Gastric ulcer E) Billroth I or II resection of the stomach. 200 patients were recruited for group A-C, in group D 134 patients and in group E 113 patients were studied. A mean prevalence of 60% was observed. Prevalence was highest in patients with duodenal ulcer (86%). In group D a prevalence of 65%, in A and E a prevalence of 54%, and in B of 40% were seen. The overall test sensitivity of the CLO-test compared against the histologic detection rate was 75%, the specificity 81%. Sensitivity was reduced in group A (69%) and E (53%) and in patients with inactive chronic gastritis (67%). In all groups patients with active forms of gastritis showed the highest prevalence of C. pylori infection. The specificity of the CLO-test was reduced in patients with duodenal ulcer (46%) and gastric ulcer (48%). Decreased specificity observed after therapy with histamin receptor (H2) blockers may explain this finding. The relationship of C. pylori infection with active types of gastritis or gastro-duodenal ulcer hints at a causal relation but is no definite proof of its etiologic role. The validity of the CLO-test seems questionable in patients with gastroduodenal ulcer or operated stomach.

The Giemsa banding pattern of the canine karyotype.

The canine metaphase karyotype consists of 78 chromosomes. All autosomes exhibit telocentric or acrocentric configurations gradually diminishing in size. These features make identification of homologous pairs by conventional analysis difficult. Chromosome preparations were derived from short-term cultures of peripheral blood lymphocytes obtained from clinically normal dogs representing at least four breeds. Most components of the canine karyotype can be distinguished readily. No significant G-banding pattern variations were detected in the individuals screened. An idiogrammatic interpretation of the banding pattern is presented. Apart from bands, other characteristic morphologic features were found which aid in identification. The G-banding pattern of the canine metacentric X is quite similar to that of the banded human X. The canine Y is a minute metacentric having two positive bands.