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, , 643-653. The histopathology of the lungs from four human cases of paraquat poisoning is described. In two of them there was a dense mass of fibroblastic tissue which obliterated the lung architecture, and one of these showed an extensive deposit of collagen with honeycomb change. In a third case pulmonary fibrosis was less severe and could be demonstrated exclusively within the alveolar spaces. The fourth showed earlier lesions of capillary congestion, alveolar oedema, and hyaline membrane formation. We suggest that paraquat produces the same effect on the lung in man as in the rat, namely a diffuse, cellular, fibrosis. The intra-alveolar origin of this fibrosis is often obscured in the advanced stage of the disease and has been misinterpreted as fibrosing alveolitis. This fibrosis is associated with a pulmonary vascular disease. In assessing the histopathology of the lung in paraquat poisoning a history of oxygen therapy must be taken into account, for prolonged exposure to this gas may in itself induce pulmonary fibrosis. [ABSTRACT FROM PUBLISHER]

Serial complement determinations have been carried out in 75 patients suffering from various forms of renal disease. Very low serum complement levels were found during the early active stage of acute nephritis, but these low values returned to normal in most cases in parallel with clinical recovery. Moderately depressed complement levels were found in subacute nephritis. These values returned to normal whether clinical recovery occurred or whether the patient progressed to chronic nephritis with or without terminal renal failure. Cases of chronic nephritis, chronic pyelonephritis or of chronic renal damage from other causes gave normal complement values. Serum complement values were similar when cases with and without the nephrotic syndrome were matched, as far as possible, according to the underlying disease process. Cases of the nephrotic syndrome of undetermined aetiology were divisible into a group with subnormal values and a group with persistently normal values. It is suggested on the basis of the foregoing observations that these two groups may be aetiologically distinct. The values of serial complement determinations as aids to diagnosis, the control of therapy (especially corticosteroid therapy) and prognosis in renal disease is appraised. [ABSTRACT FROM AUTHOR]

, , 488-491. Experience of valve replacement with the Beall compressed Teflon disc valve in 59 patients confirms that the incidence of clinically significant late red cell destruction is high. An apparently previously unrecorded high incidence of early haemolysis, so severe in one patient as to be directly the cause of death, is reported. In 29 patients there was massive haemolysis in early convalescence, not recognized in urine from some hours after the end of bypass and never encountered with other designs of prosthetic valve or homograft valve. [ABSTRACT FROM PUBLISHER]

Peritoneal dialysis is no longer experimental; it has become a routine procedure which can be easily performed at home when desirable. It can be used in poisonings, acute renal failure, other metabolic derangements, and in the terminal uremic patient as a "holding action" while he waits for kidney homotranspiant. The simplicity, economy, and efficiency of the procedure, together with recent advances in instrumentation and in our understanding of fluid and electrolytes, are helping to broaden the clinical usefulness of peritoneal dialysis. This communication surveys current clinical applications of peritoneal dialysis, its technic cal aspects and hazards, and its promising potential for therapy and research. [ABSTRACT FROM AUTHOR]