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Emotionally handicapped youth in transition: issues and principles for program development.

Seriously emotionally handicapped adolescents face significant transition issues as they move through our system of care and attempt to assume adult role responsibilities in the community. Service delivery efforts must be sensitive to these issues and begin to realistically address the transition needs of this population. Nine integrative principles are discussed which appear essential when developing transition services.

Adolescent

The calcium-phosphorus metabolism expert system module: a program developed in the ALEX Smalltalk/V shell.

The object-oriented computing model of Smalltalk/V proved to be very well suited for the creation of a medical expert system on the diagnosis of calcium-phosphorus metabolism abnormalities. A major reason for this was that a disease could be viewed as a self-contained, active, entity. The expert system is implemented in ALEX, an expert system shell that is written in Smalltalk/V. The shell consists of classes and methods that can be modified, as needed, by the developer. The expert system is, at present, 140,000 bytes in size, and includes 43 diseases, arranged in 7 contexts. Sixty case reports were used to test the expert system. In 30 cases, there was complete agreement between clinician and expert system; in 12 cases, the expert system responded appropriately when presented with diseases that were not known to the system; and in 18 cases, the system gave plausible results.

Calcium

An assessment of a toxicological incident in a drug development program and its implications.

In an exceptionally thorough program of preclinical toxicity testing in laboratory animals of the anti-allergy drug FPL 52757 (6,8-diethyl-5-hydroxy-4-oxo-4H-1-benzopyran-2-carboxylic acid), no significant hepatotoxic potential was detected. Despite this evidence of safety in a wide range of laboratory animals, the drug produced mild reversible hepatotoxicity in some patients in some clinical trials. Extensive toxicity and investigational studies are described, and the importance of the correct choice of species for toxicology evaluations based on sound pharmacokinetic principles is highlighted. This paper reviews this incident and the lessons to be learned from it in light of current regulatory requirements.

Animals

Characterization of Lyt-2-, L3T4- class I-specific cytolytic clones in C3H-gld/gld mice. Implications for functions of accessory molecules and programmed development.

We report the first demonstration of Thy-1+, Lyt-2-, L3T4- MHC-specific CTL clones derived from the Lyt-2-, L3T4- subset of lymph node cells of C3H-gld/gld mice. These clones express alpha/beta heterodimeric TCRs on the cell surface and specifically recognize class I molecules on target cells. Lyt-2 and L3T4 molecules are therefore not essential for the induction, recognition, and killing of antigen-specific CTL. In addition, these studies suggest that antigen specificity development for class I structures may occur before Lyt-2 gene activation in the differentiation of T cells.

Animals