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The components of a court-mandated outpatient treatment program in Florida for adult sex offenders are discussed. Selection and treatment factors are presented, in addition to the success rate, in terms of recidivism for program participants (N = 202) over a 5-year time span. This study is an extension of the 1989 work of Bingham and Piotrowski.

An outbreak of Q fever in a university department where sheep placentas were being used for research is described. Of six persons exposed to the sheep, four had positive titers with only one person developing an acute febrile illness and liver disease. This report illustrates the value of the family physician obtaining an occupational history and conducting an outbreak investigation.

Free energies of oxygen-linked subunit assembly and cooperative interaction have been determined for 34 molecular species of human hemoglobin, which differ by amino acid alterations as a result of mutation or chemical modification at specific sites. These studies required the development of extensions to our earlier methodology. In combination with previous results they comprise a data base of 60 hemoglobin species, characterized under the same conditions. The data base was analyzed in terms of the five following issues. (1) Range and sensitivity to site modifications. Deoxy tetramers showed greater average energetic response to structural modifications than the oxy species, but the ranges are similar for the two ligation forms. (2) Structural localization of cooperative free energy. Difference free energies of dimer-tetramer assembly (oxy minus deoxy) yielded delta Gc for each hemoglobin, i.e., the free energy used for modulation of oxygen affinity over all four binding steps. A structure-energy map constructed from these results shows that the alpha 1 beta 2 interface is a unique structural location of the noncovalent bonding interactions that are energetically coupled to cooperativity. (3) Relationship of cooperativity to intrinsic binding. Oxygen binding energetics for dissociated dimers of mutants strongly indicates that cooperativity and intrinsic binding are completely decoupled by tetramer to dimer dissociation. (4) Additivity, site-site coupling and adventitious perturbations. All these are exhibited by individual-site modifications of this study. Large nonadditivity may be correlated with global (quaternary) structure change. (5) Residue position vs. chemical nature. Functional response is solely dictated by structural location for a subset of the sites, but varies with side-chain type at other sites. The current data base provides a unique framework for further analyses and modeling of fundamental issues in the structural chemistry of proteins and allosteric mechanisms.

Six (18%) of 34 healthy, asymptomatic young adults had mucosal thickening or fluid in the paranasal sinuses on screening magnetic resonance imaging (MRI) examination. When 19 of these subjects were challenged with rhinovirus, 18 became infected. Twelve of the 18 infected subjects had technically satisfactory serial MRI examinations, and four (33%) of these developed MRI abnormalities of the ethmoid or antral sinuses that were temporally associated with the acute infection. The mean total nasal secretion weights were 22 gm/5 days in the four subjects whose MRI abnormalities were associated with the acute infection compared with 5.5 gm/5 days in the eight subjects who had normal MRI examinations during the acute infection (p = 0.06). Abnormalities of the paranasal sinuses, which were associated with increased volumes of nasal secretion, were detected by MRI examination during rhinovirus infection. These abnormalities may have a role in the pathogenesis of acute sinusitis associated with colds.

Three hundred and forty-two patients with fractures of the clavicle attended the Fractrure Clinic at Bridgend General Hospital between 1957 and 1972. The history of injury was recorded in the notes at the first visit but in only 215 cases was the exact mechanism of the injury clearly stated. Of these, 91 per cent were caused by a fall or a blow on the point of the shoulder. All patients were treated symptomatically. A triangular sling was applied to support the weight of the arm and early use of the limb was encouraged. One hundred unselected patients were followed up, the longest period being 15 years and the shortest, 1 year. None had any loss of function of muscle power at the shoulder. Only 15 per cent were left with any noteworthy deformity at the site of fracture.