Optic neuropathy in uremia is rare. Although the consequences of optic neuropathy-blindness or substantial loss of vision-are devastating, only a few cases have been reported by way of single case reports and case series studies. The reported patients are heterogeneous with regard to the cause of neuropathy. We report the case of a patient with uremic optic neuropathy and summarize the other cases reported in the literature so far. Based on the data available from these reports, we propose a classification system, which includes nonischemic neurotoxic uremic optic neuropathy; ischemic optic neuropathy, more specifically anterior ischemic optic neuropathy; and optic neuropathy as a result of drug side effects, benign intracranial hypertension, and optic neuritis. The immediate institution of dialysis and corticosteroid therapy and correction of anemia and relative hypotension can optimize the chances of visual recovery for these patients. Close collaboration among nephrologists, ophthalmologists, and neurologists is important in this interdisciplinary emergency.

Theory: I expand and elaborate, in an effort to understand more fully the growth and development of partisanship, the insights of Converse (1969) and Inglehart and Hochstein (1972).Hypotheses: (i) Behavioral partisanship (i.e., the proportion of voters supporting the same parry at two successive elections) develops primarily as a function of rime; (ii) behavioral partisanship responds primarily to economic and other ''crises''.Methods: Thomsen's (1987) legit method of ecological regression and time-series regression are applied to matched pairs of returns from Australian and New Zealand elections between 1905 and 1990.Results: Even more than Inglehart and Hochstein recognized, ''crises'' have, at least as much as the elapse of time, driven the growth of behavioral partisanship and the resultant stability of electoral politics.

This article describes and tests a process which generates the 'pro-coalition gender gap' in electoral behaviour which has been observed in recent research. More detailed analysis, however, indicates that this gap is more apparent than real: for almost three-quarters of the electorate (those who are not members of trade unions) the electoral behaviour of men and women is virtually identical. Further, sex segregation in the workforce appears at least as much as women's participation in the workforce to underlie the 'pro-coalition' gap. These results imply that this (at least partially artifactual) gap is likely to persist into the foreseeable future.

Has the behaviour of Australian voters become more 'nationalised' over time? Kemp (1978) and to a lesser extent Aitkin (1968) conclude that it has. Using more precise and comprehensive measures of nationalisation, a more standard (variance-components) statistical method and longer and directly comparable series of data, I qualify this conclusion heavily and place it on a firmer theoretical footing. I find that voting behaviour has generally been more spatially uniform in Australia than in the US, and that a sustained homogenisation-but not a 'nationalisation'-has been underway since the realignment of the late 1930s to early 1940s. Exceptionally and continually high levels of party identification, together with class-based alignments (and realignments) of electoral forces, appear to underlie the relatively high spatial uniformity of voting behaviour in Australia.

[The recent changes in popular attitudes towards an Australian republic] provide an object lesson in the way in which a relatively dormant issue characterised by more or less stable opinions over a long period can quickly be transformed when opinion leaders suddenly raise its profile and put it high on the public agenda (Bean 1993, 194-5).

This article investigates and revises the conventional wisdom about aggregate-level electoral change at Commonwealth elections. Unlike previous Australian analyses, it distinguishes temporary from permanent change and uniform from heterogeneous change. It also formulates rival hypotheses about the extent, timing and source of such change, and it tests them with a new source of data. It shows, in sharp contrast to the conventional wisdom, that significant aggregate-level change occurred at virtually every election between 1910 and 1969. In so doing it directs attention to the infrequent but pivotal influence of voters upon the scope and direction of public policy in Australia.

Objectives: Magnetic resonance imaging was used to assess the effects of ventilation with positive end-expiratory pressure (PEEP) on cardiac volumes, especially on atrial volumes as well as to determine semiquantitative measurements of spatial interactions between heart, lungs and chest.Design: Prospective study with healthy volunteers undergoing mechanical ventilation with different levels of PEEP during magnetic resonance imaging.Setting: Magnetic resonance unit, Institute of Diagnostic Imaging, Rudolfinerhaus Hospital.Subjects: Twelve healthy volunteers.Interventions: Volunteers were imaged, using a multislice-multiphase technique during spontaneous breathing and with PEEP values of O, 7, and 15 cm H2O.Measurements and Main Results: Atrial as well as ventricular volumes, chest diameters, and midventricular contact between the heart and anterior chest wall were determined on transverse-oblique sections. Atrial volumes showed a progressive decline beginning at a PEEP of 7 cm H2O. Diastolic filling of both ventricles was reduced. A PEEP level of 15 cm H2O induced a significant increase in the sagittal-oblique but not in the transverse-oblique chest diameter. PEEP values of 7 and 15 cm H2O shortened the length of the midventricular contact between the heart and anterior chest wall.Conclusions: Left and right ventricular end-diastolic volumes and stroke volumes decreased significantly during ventilation with PEEP at 15 cm H2O, as did end-systolic atrial volumes. Volume changes in association with changes of chest and heart configuration suggest external cardiac compression by the expanding lungs. Furthermore, this study illustrates the feasibility of magnetic resonance imaging in mechanically ventilated patients.

This article tests hypotheses about the electoral support of Canada's first-and perhaps most significant-third party. It demonstrates that two micro-economic concepts, price elasticity of demand and efficiency of production, describe accurately the material base of progressive party support. It thereby subsumes the study of agrarian parties and voting behaviour within a more general (public choice) framework. It also clarified substantiates important elements of the conventional wisdom about Progressive support. and it suggests means which might also shed new light upon the Co-operative Commonwealth Federation and Social Credit.

This article analyses the influence of economic conditions upon the behaviour of voters in elections to Australian, Canadian and New Zealand legislatures between the First and Second World Wars. It shows that this influence need be neither uniform nor unconditional: rather, it is contingent upon both political and economic phenomena. The existence of the relationship as well as its form and strength differ systematically in different settings. It varies according to the stratum of the electorate, the point in time and the type of party analysed.

A patient presented with neck impalement after a traffic accident. Respiratory arrest demanded immediate tracheal intubation, which was impossible as a wooden splinter had partially obstructed the pharynx and prevented laryngoscopy. An oesophageal tracheal Combitube airway was inserted successfully and the patient's lungs were ventilated adequately until tracheotomy was performed.

We present the case of a patient who required immediate intubation because of increasing upper airway bleeding. Endotracheal intubation failed because the glottis could not be visualized. An airway control device designed for cases of difficult emergency intubations was used successfully. This device can be inserted without the use of a laryngoscope.

This article analyses the electoral support of the candidates of the Australian Country Party at Commonwealth (Senate) elections between the First and Second World Wars. It differs markedly, in terms of its premises, method and conclusions, from ‘orthodox’ analyses of the party's electoral support. Orthodox analyses state implicitly that rational (ie. goal‐directed, income‐maximising) considerations do not underlie the behaviour of the supporters of the Country Party; in contrast, I state explicitly that these considerations do underlie this behaviour. Further, orthodox analyses do not collect the evidence or data which they require in order to corroborate their claims; in contrast, I do so. Finally, unlike the Orthodox analyses, I specify as clearly as possible the techniques which I utilise in order to confront my data and hypotheses. I conclude that the behaviour of the supporters of the Country Party between the First and Second Wars is consistent with the postulate of rational behaviour, and that it is inconsistent with the arguments of orthodox studies.

In a retrospective study once-daily dosage of netilmicin was compared with the thrice-daily regimen in critically ill patients. Netilmicin given once daily for 5 days appeared to be as effective as the multiple dose regimen, with no increase in the incidence of nephrotoxicity.

The esophageal tracheal combitube (ETC) is designed for emergency intubation. The ETC is inserted blindly allowing ventilation after either esophageal or endotracheal placement. A special pharyngeal balloon serves to seal the upper airways. In 10 cardiac arrest patients, emergency intubation with the ETC was performed. Blood gas analyses showed adequate ventilation. Radiography proved correct placement of the proximal and distal balloons in accordance with design theory. Hyperinflation experiments documented expansion of the proximal balloon into the oral cavity rather than towards the epiglottis.

The esophageal tracheal Combitube (ETC) is a new airway especially designed for airway maintenance and ventilation in unconscious patients such as those requiring CPR. The ETC may be used as an esophageal obturator or an endotracheal airway. Previous studies yielded a significantly higher mean arterial oxygen tension (PaO2) during ventilation using an ETC in the esophageal position compared to a conventional endotracheal airway (ETA). To investigate this phenomenon, endotracheal and airway opening pressures were examined in 12 patients in randomized order during ventilation with an ETC in the esophageal position, with an ETA, and with a mask, respectively. In this study again the PaO2 was higher with ETC compared to ETA. The following differences in intratracheal pressure and flow could be found for ETC when compared to ETA: smaller rising pressure during inspiration, prolonged expiratory flow time, and formation of a small positive end expiratory pressure (PEEP). These factors may be responsible for the improved oxygen tension with ETC. Comparing mask to ETC ventilation, PaO2 did not differ; however, mean arterial carbon dioxide tension was higher during mask ventilation.

We examined the effect of spontaneous breathing with continuous positive airway pressure (CPAP) on the plasma concentrations of immunoreactive (ir) alpha-atrial natriuretic peptide (ANP). In three experiments, each of 11 healthy male volunteers performed CPAP at 20, 10 and 0 cm H2O for 2 h during continuous volume loading. Samples were drawn from a peripheral vein. Plasma concentrations of irANP were determined by a sensitive radioimmunoassay. Significantly lower concentrations of irANP were observed during 20 cm H2O CPAP than at 10 and 0 cm H2O. The concentrations of irANP did not differ significantly when individuals breathing with CPAP at 10 and at 0 cm H2O were compared. Our data suggest that CPAP at 20 cm H2O lowers the release of ANP in volume-expanded subjects. We hypothesize that this phenomenon may contribute to the fluid retention and renal dysfunction observed frequently during high CPAP levels. The decline in plasma concentrations of irANP may be the result of atrial compression by the distended lungs and of reduced venous return to the heart during CPAP.

Mechanical ventilation in critically ill patients is usually performed with the conventional endotracheal airway. The esophageal tracheal combitube (ETC) is a new device for cardiopulmonary resuscitation, conceived to bridge the gap between hospital and prehospital phases. The ETC may be used in esophageal and endotracheal positions. The authors report six patients who were ventilated with the ETC in the esophageal obturator position for 2-8 h after emergency ventilation. Blood gas data showed adequate ventilation with the ETC during the observation period. Data suggest that mechanical ventilation with the ETC is possible for several hours after cardiopulmonary resuscitation. This might be helpful during the initial post-arrest period, when replacement of the ETC by a conventional endotracheal airway might destabilize a vulnerable patient.