A group of hypertensive patients (N = 19) and a control group of normotensive patients (N = 15) were shown two movies depicting two types of doctor-patient interaction. In the first movie, the doctor was rude and disinterested in the patient (the bad doctor). In the second movie, the doctor was relaxed and warm (the good doctor). After viewing the two movies, all patients were interviewed as to their impressions of the two scenes. During the viewing, blood pressure and pulse rate responses in the hypertensive group were small but significantly greater than those in the normotensive group; during the interview, the significantly greater response in the hypertensives was physiologically meaningful. The urinary catecholamine and cortisol excretion rates were no different between the 2 groups. Most striking was the finding that the hypertensive group tended to deny seeing any differences between the doctors depicted in the two movies, while the normotensive group could clearly identify differences in the behavior of the good doctor versus that of the bad doctor.In a second experiment, the same movies were shown to a hypertensive group and to 3 normotensive groups. The patients were asked to fill out a questionnaire derived from auditing the tape recordings in the first experiment. This questionnaire made it possible to differentiate significantly between the hypertensive and normotensive groups. These data are compatible with the hypothesis that the hypertensive patient may perceptually screen out potentially noxious stimuli as a behavioral response to his hyperreactive pressor system.Psychophysiologic factors in hyperten-pressure to emotional as well as to other sion have dealt primarily with two aspects types of noxious stimuli has been demonof the problem: (a) hyperreactivity of blood strated repeatedly; and (b) the personality of the patient with hypertension often has From the University of Pittsburgh School of been the subject of investigation; the hyMedicine, Department of Medicine, Psychosomatic pertensive patient has been described as an and Clinical Pharmacology Sections Pittsburgh, Pa. i n d i v i d u a l w h o h o s t i J i s u n a b l e

Over the past 30 years ethylene glycol, the p r i m a r y component of commercial antifreeze, h a s become recognized as a n extremely toxic material. To date, the majority of the reports in the medical literature have dealt with the d i r e and often fatal consequences s e e n when i t is ingested by adults as a substitute for alcohol. However, little emphasis h a s been given to the wide clinical spectrum that can be seen following exposure to this agent. This report deals with the variety of clinical presentations that were observed in a group of patients following the ingestion of ethylene glycol and a n attempt to analyze our series in the light of previously reported experiences.

Supportive drug use in hospitals (narcotics, analgesics, sedatives, and tranquilizers) varies with a number of factors, among which are pain and anxiety. Two hundred-fifty consecutive postoperative patients were categorized in their recovery room behavior according to the amount of pain expressed. This grouping proved to be a good indicator for the use of all supportive drugs during the first postoperative week. Surgical procedures associated with the highest drug use were the same in our study as among others. This population was then compared with 150 consecutive patients with detached retina on whom photocoagulation was performed. Though this procedure is considered relatively painless, its anxiety component is high. More of the categories of supportive drugs were used on all postoperative days than among the general surgical patients. Supportive drug use after operation reflects both pain and anxiety but is not a good differentiator between the two.

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Sampling tube and fingertip contamination were found to present potential problems in the collection of samples for micro blood lead analyses. Large differences between micro screening and macro confirming lead levels were frequently observed when the time between collection of the two samples was 1-2 weeks. The magnitude of these differences decreased as macro blood lead concentration increased and were apparently a result of episodic lead ingestion in the population.