In the Trenches,Cost Containment Ain't Always Easy: An Illustrative Case Report

A specific case report illustrates the interplay between human considerations and technological potency that makes cost containment difficult in the real world of medical practice.     

Acute Hemodynamic Effects of Angiotensin II: Preliminary Report

Angiotensin II was given to over 200 patients during heart catheterization studies. Left to right shunts through atrial and ventricular septal defects were increased. Shunts not detected under control conditions could then be recognized. In normal subjects left atrial pressure increased about 5-10 mm. Hg, producing a secondary rise in pulmonary artery pressure. The response of the pulmonary vessels to angiotensin was usually passive. Cardiac output declined in the normal subject after angiotensin administration. Right to left shunts decreased after angiotensin administration in some patients with cyanotic congenital heart disease, thus decreasing cyanosis. This finding has possible therapeutic applications. The pulmonary arterioles of patients with pulmonary hypertension may respond to angiotensin in a different manner from those with normal pulmonary arterioles.     

Indian Boarding Schools And Ethnic Identity: An Example From The Southern Plains Tribes Of Oklahoma

Abstract

In the late 1800s, boarding schools sponsored by the United States government were created for the education and socialization of American Indian youth. These institutions gradually and purposefully pursued a policy of total assimilation of American Indians into the mainstream of society. The boarding schools failed in their ultimate goal to assimilate Indians. Surprisingly, however, they did attain limited acceptance among many Oklahoma Indians. The segregationist policies of the boarding schools are interpreted as having inadvertently perpetuated the formation of an Indian identity. Frequent visiting by family, segregation of Indian from non-Indian students, and symbolic association of the boarding schools with federal government obligations are identified as factors which contributed to the maintenance of this identity.     

The Seminole Indians of Oklahoma: Morphology and serology

Two hundred and sixty-three Indians aged six and above were studied in Oklahoma for blood types, hemoglobin types, and physical traits; 53% were Seminoles and the remainder were admixed with Creek or other populations. The results indicate that they resemble the Florida Seminoles in most of their serologic traits. In physical traits they are comparable to the group studied by Krogman two decades ago. Compared with the Florida Seminoles, the Oklahoma sample are slightly taller and heavier, significantly lighter in skin color, and have a lower incidence of sickle cell gene. By both serology and morphology the Oklahoma group are most similar to Florida Seminoles, slightly less similar to other Indian groups, and still less to White and Negro populations. The Oklahoma sample of women showed a non-significantly greater fertility than those of Florida. Some indication of positive assortative mating for skin color was found in both groups.