Linda Taylor

Diagnostic considerations in virilization: iodomethyl-norcholesterol scanning in the localization of androgen secreting tumors.

Accurate localization of the source of androgen hypersecretion is critical to the appropriate surgical or medical management of women with virilization. Seven patients with virilization and hyperandrogenism of various causes were evaluated with the use of sequential studies: (1) testosterone stimulation and suppression tests; (2) computerized tomography (CT); (3) selective venous catheterization; and (4) 131 I-iodomethyl-norcholesterol (NP-59) scintigraphy. Comparison of the diagnostic accuracies of these localization studies with the ultimate diagnoses in this group of virilized women showed that: (1) endocrinologic suppression/stimulation studies are of limited value in tumor localization and helpful only in patients with steroidogenic enzyme deficiencies; (2) both selective catheterization and CT scanning may provide spurious localization data; and (3) NP-59 scintigraphy, by depicting both the anatomic localization and functional androgen hypersecretion, may provide the most significant localization data in the evaluation of patients with virilizing syndromes.

The Problems of Definition and Differentiation and the Need for a Classification Schema

From both a theoretical and practical perspective, the majority of respondents to the future survey recognized the as yet unmet need to develop valid procedures for differential diagnosis and subtyping of learning disabilities. The foundation for developing such procedures was seen as requiring agreement about the definition of LD and appropriate ways to operationalize the definition. There was, however, a major split among the respondents regarding how LD should be defined. Some wanted to keep the definition tied to learning problems stemming from central nervous system dysfunctions; others wanted to ignore cause and broaden the field by defining as LD any learning problem that is not readily understood. These contrasting views about definition were then reflected in the controversy among respondents about operational criteria, e.g., the appropriateness and feasibility of identifying LD based on a severe discrepancy between aptitude and achievement. Another concern was raised in connection with the matter of identifying LD subtypes, i.e., some respondents viewed such efforts as confounded by the lack of satisfactory procedures for differentiating LD from learning problems caused by other factors. In general, then, the survey responses underscore the controversy and widespread frustration over definition and differentiation and suggest that the LD fields future integrity is very much dependent on successfully dealing with these problems. It is time, we think, for the field to take a step back from narrow debates over definition and deal with the fundamental problem of developing a comprehensive classification scheme, i.e., one in which LD is differentiated from other categories of learning problems and subtypes are conceived within each category. The following paper on definition and subtypes focuses briefly on the nature of the definition and differentiation problems, the importance of placing and keeping LD in perspective vis à vis other learning problems, and ideas related to future development of a LD classification schema. (We should note that, in the course of recent events, the preparation of this paper for the series fell to us.)

Psychological Variables and Ability to Pronounce a Second Language.

The following study tested the hypothesis that the ability to speak a second language authentically or like a native speaker was related to an individuals sensitivity to cues in interpersonal situations, his empathic capacity. A test of empathy consisted of silent film clips shown at various speeds; subjects were asked to indicate each change in facial expression they observed. A test group of 28 University students took this and additional control tests including the Thematic Apperception Test. These subjects learned basic conversations in Japanese in four one-hour sessions. Their pronunciation was rated by native speakers on general authenticity and on specific phonetic details for five spontaneous sentences and five sentences repeated after the instructor. Results indicated differences in speaking skills which were related to two clusters of variables representing independent personality characteristics: an empathy dimension defined by four variables (tolerance to anxiety, intelligence, involvement in emotional experiences, and perception of emotional expression) was related to correct pronunciation of specific details in spontaneous sentences, while an intuition dimension (tolerance to anxiety, intelligence, and psychological mindedness) was significantly related to general authenticity of pronunciation of repeated sentences.

The role of personality variables in second language behavior.

EACHERS OF SECOND LANGUAGES have frequently made the observation that the ability to speak a new language authentically, to assimilate or approximate native-like pronunciation, cannot be totally accounted for by the learner’s intelligence, motivation, or skill in other facets of language training. Authenticity of pronunciation can be noted early in language learning and seems not to be modified to any great extent by training or eff0rt.l To date there have been few research efforts specifically aimed at analyzing pronunciation skills and explaining interpersonal differences in the ability to speak authentically. Experience and observation have prompted the suggestion that certain personality variables may play a critical role in the ability to speak a second language with native-like authenticity. Guiora has proposed that, other things being equal, the ability to speak a new language authentically is significantly related to the empathic capacity of an individual, his sensitivity to the feelings of others.” This theory postulates that individuals who are more sensitive in their interactions with others, who are more receptive to subtle cues of behavior and feelings, would have an enhanced capacity to discern those cues and nuances which, when incorporated in speaking, produce authentic, native-like pronunciation, A review of the literature on empathy indicates that, while theories and definitions of empathy have been well explicated, there has been little research adequately operationalizing the concept. Most definitions share the basic theory that empathy is the ability to understand the feelings of another through subtle cues of behavior or speech. Some theorists see the process as a temporary identification with another,3x4 while others propose that one reflects on his own similar feelings and experiences in order to understand the feelings of the other. 536 The definition of empathy on which this study is based has been offered by Guiora as one of three comprehending modalities.7

A Helpline for Learning Problems

With the increasing interest and concern related to learning disabilities, there is expanded need for ready access to information and help. It is suggested that telephone helplines are a promising tool in this connection. A demonstration program and data on its initial impact are presented.

Diagnostic Considerations in Virilization: lodomethyl-Norcholesterol Scanning in the Localization of Androgen Secreting Tumors

Accurate localization of the source of androgen hypersecretion is critical to the appropriate surgical or medical management of women with virilization. Seven patients with virilization and hyperandrogenism of various causes were evaluated with the use of sequential studies: testosterone stimulation and suppression tests; computerized tomography (CT); selective venous catheterization; and 131I-iodomethyl-norcholesterol (NP-59) scintigraphy. Comparison of the diagnostic accuracies of these localization studies with the ultimate diagnoses in this group of virilized women showed that: endocrinologic suppression/stimulation studies are of limited value in tumor localization and helpful only in patients with steroidogenic enzyme deficiencies; both selective catheterization and CT scanning may provide spurious localization data; and NP-59 scintigraphy, by depicting both the anatomic localization and functional androgen hypersecretion, may provide the most significant localization data in the evaluation of patients with virilizing syndromes.