ACKNOWLEDGEMENTS

 I wish to acknowledge the assistance of my doctoral

committee, Dr. Hannelore L. Wass, Dr. Walter A. Busby,

Dr. Stephen Olejnik, and Dr. Gordon F. Streib, in the

preparation of the dissertation, and in particular, am

grateful for the guidance and encouragement offered by Dr.

Wass, chairperson of the committee.

 My indebtedness to the patients who participated in

this study and to their physicians, Dr. Terry Bloom, M.D.,

Dr. Walter Durkin, M.D., Dr. Gregory Favis, M.D., Dr.

Herbert Kerman, M.D., Dr. Tariq Siddiqui, M.D., and Dr.

Alvin Smith, M.D., is acknowledged. I am also appreciative

of the assistance of Dr. Kerman and Mrs. Rebecca McDonald,

R.N., in arranging for the research to be conducted at

Halifax Hospital Medical Center.

 The assistance provided by Mrs. Margaret Elaine Free in

the preparation of the manuscript is gratefully acknowledged

and to my family and friends who encouraged me in this

endeavor, I extend my special thanks.