Search

Two Chinese brothers who underwent sex-change surgery to female status are described. Early life experiences of the two siblings differed from those of their non-transsexual brothers and sisters. The pre-transsexual males were raised primarily by the maternal grandmother, whereas the others were reared by their parents. Feminine role orientation began during childhood and continued through adolescence. Sex-change surgery was performed during adulthood in two stages, and both patients are currently living as women. With the exception of another article in this journal issue, there are no other reports of transsexualism in male siblings.

A syndrome of supravalvular pulmonary stenosis and an abnormal facial appearance is described in 15 children. The auscultatory findings suggest stenosis of the pulmonary valve. The presence of an abnormal facial appearance consisting of hypertelorism, a flat nasal bridge, a prominent upper lip, and low-set ears should suggest the correct diagnosis. Angiocardiography shows a constant, thin, “diaphragm-like” radiolucency in the main pulmonary artery. Physical retardation and left-axis deviation on the electrocardiogram are frequently present. Additional cardiac defects were also noted in one third of this group of children. No etiologic factor could be determined.

SUMMARY The developing hard tissues of the teeth of Echinus esculentus are described and figured, and it is noted that calcification occurs in two forms. Attention is drawn to a structural analogy which appears to exist between these two calcified tissues and the primary tissues of vertebrate teeth, despite certain differences in the chemical analysis. This is considered noteworthy in view of the fact that true teeth are generally associated only with the vertebrates.

A modified double lumen perfusion method has been used to study dibasic amino acid absorption in human jejunum. Results using this method have been compared with those from oral load studies. Using the perfusion method, kinetic constants (Kt and Vmax) for lysine were: Kt 4.9 mM; V max 51.3 μmoles min-1 30 cm and for arginine were: Kt 3.8 mM, V max 46.3 μmoles min-1 30 cm Lysine absorption was compared in normal and cystinuric subjects. A significant difference was seen between these groups when studied by perfusion but not using the oral load method. Furthermore, oral load studies using mixtures of lysine, ornithine, and arginine showed a difference between the groups for arginine but no difference for lysine and ornithine. All three dibasic amino acids appeared to be well absorbed in the cystinuric patients. Possible explanations for these differences and the failure of oral tolerance tests to demonstrate the known transport defect in cystinuria are discussed.

In discussing comparative abortion incidence care must be taken in defining abortion and expression and interpreting statistical data. prevalent in urban than rural areas. gal and illegal abortions and between use of abortion and contraception are very complex and not easily analyzed. Japan Hungary and Britain show that a decline in birthrate is due to pre- and post-conceptive control of fertility. computer analysis of a model population using reversible contraception has shown that at least 25% of couples will have one unplanned pregnancy. ion. sterilized after attaining desired family size. es of legal abortion increases with the duration of pregnancy. Morality rates of illegal or clandestine abortion are difficult to establish. le that the death rate for illegal abortion is approaching 1% whereas in developed countries the rate may be 1 in 1000 or less.

Pulmonary capillary blood flow(Qpc) was measured in 24 term infants (5 hours to 14 days of age) using the infant plethysmograph and nitrous oxide (N2O). The method is a modification of the Lee and DuBois technique, the deep inspiration being replaced by a brief period of rebreathing 60% N2O and 40% O2 from a 100 ml bag. The rate of uptake of N2O is divided by the mean alveolar N2O concentration and the solubility in cord blood to give Qpc. There was a significant increase in Qpc with increasing age from 173 ml/kg/min at 24 hours to 230 ml at 14 days (p < 0.0l). As the method does not measure any shunted blood this change could represent decreasing fetal shunts, but as there was a significant increase in heart rate (125/min at 24 hours to 168/min at 14 days) this seems unlikely. It is suggested that this increase in Qpc follows the known increase in metabolic rate in the newly born infant. In two anesthetized dogs tile mean difference between Qpc measured with this method and pulmonary arterial flow measured directly from a chronically implanted electromagnetic flowmeter was -2.6% S.E.±3.6%.

Effective pulmonary blood flow was measured in 32 normal infants by an indicator gas technique. To check the accuracy of this technique in the absence of shunts, we obtained 39 pairs of measurements of pulmonary blood flow in anesthetized rabbits by the gas technique and dye dilution. The results showed a high degree of correlation between the two methods of measurement (r = 0.986). Effective pulmonary blood flow was 1.1% less than total pulmonary flow (p < 0.005); this difference was attributed to venoarterial shunting through non- ventilated parts of the lung. Measurements of effective pulmonary blood flow in normal newborn infants increased with age. Before 24 hours of age, mean effective pulmonary flow averaged 138 ml/min/kg or less and gradually rose to a mean value of 166 ml/min/kg (±25.6 SE) at a mean age of 81 hours. It is possible that our measurements of effective pulmonary blood flow before 24 hours of age were falsely low because of the presence of clinically undetectable left-to-right shunts.

Acupuncture is of no use, or for the optimist of perhaps marginal use, in sensorineural hearing loss, contrary to what is popularly described in China. 5% or less of patients with tinnitus are helped. It is of moderate help in certain types of vertigo, acute labyrinthitis and some aspects of Meniere's disease, whilst it is of great benefit in motion sickness.The treatment is of moderate benefit in ‘nasal catarrh’, sinusitis and recurrent tonsillitis. It is the treatment of first choice in most forms of headache.May I take this opportunity to endorse the critical commentary of Dr. Beagley and his colleagues of the Rawson Report as expressed in your Journal and Hearing and also in the B.M.J, I will add a few of my own comments concerning what are, in my opinion, yet further deficiencies of this otherwise informative and well written report.

Oil pollution has been causing damage to bird populations for half-a-century. Owing to increasing precautions that are being taken, it is not clear that despite a vast increase in traffic the position is any worse now than it was before World War II. Information on the full scale and character of the damage is still inadequate, however, and the first need is for many more data. Meanwhile it seems very doubtful whether any bird species in northern Europe is threatened with reduction in numbers on more than a local scale, although locally the damage may be severe. It is argued that the most effective way of combating such reduction is by the further control of pollution and by conservation of the breeding stock to enable it to repair the damage—rather than by the rehabilitation of oiled birds, as it seems doubtful whether this can ever be carried out on a sufficient scale to influence the outcome markedly. The main argument for rehabilitation appears to be a humanitarian one, for the relief of suffering and to avoid the unnecessary slaughter of birds that could be saved. It is suggested that if birds are rehabilitated it is unsatisfactory to release them immediately, when they have become tame and accustomed to be fed, and that the best method of disposal for them may be not to attempt to return them directly to the wild state but to try to establish breeding populations of tame semi-captive birds in protected situations, where they might provide useful objects for study and an ornament to the countryside.

The sera of 20 random human heart transplant recipients, drawn before the administration of immunosuppressive medications, were screened for the presence of factors that might inhibit the mixed lymphocyte reaction. The donors for the lymphocyte cultures were unrelated both to one another and to the heart donor and recipient. Inhibition was defined as a reduction of the number of transformed cells produced in vitro to less than one-third of that produced in autologous serum. It appears that patients who have had previous heart surgery on bypass fare better with heart transplants than those who have not had surgery. This may indicate some change in the overall physiology of the former class of patients resulting in better acceptance of the transplant. In turn, this could be due to the development of a serum factor or an impairment in the patients' cellular immune systems. In the series of recipients studied, the majority possessed serum inhibitory factors possibly non-specific by-products of their heart failure. The precise nature of these factors has yet to be determined. Future research is planned to determine whether bypass surgery is responsible for the stimulation of new immuno-depressive factors or if in some way it boosts the titer of pre-existing factors.

The concentration of chromium in the hair of thirty-three normal children and nineteen children with juvenileonset diabetes mellitus was measured by atomic absorption 8pectropholometry. The geometric mean for the group of normal children was 0.85 μg./gm.; range (mean ± 2 SD) 0.36 — 1.87 μg./gm., and for the diabetic children, 0.56 μg./gm. (range, 0.26 — 1.19 μg./gm.). Comparison of these results revealed a highly significant difference (p < 0.001) between the two groups.

Summary We report a case of multiple thrombo-emboli with embolic intrahepatic artery occlusion. Intrahepatic occlusion or stenosis is rarely reported but occurs commonly after cytoxic infusion after intrahepatic arterial catheterisation. Another interesting facet to this case is that his non-functioning kidney, secondary to renal artery occlusion, was first revealed during a brain scanning procedure. Most scanning isotopes are not organ-specific so pathology in other systems can be demonstrated by them. Multisystem disease is often vascular in origin and atherosclerosis is the commonest arterial pathology. However, atherosclerosis causing hepatic artery occlusion is very rare. Patients with multisystem disease causing cerebral symptoms often have a brain scan and it should be remembered that pathological processes in the urinary system can sometimes be demonstrated during the procedure. This is a case presentation in which the suspicion of renal artery occlusion was raised during the brain scanning procedure, and in the course of investigation of the multisystem disease, intrahepatic artery occlusion was noted.

A comparison of the services provided for the elderly in Great Britain and the United States shows the impact that organized medical care has on day-to-day clinical activities. The British...

An electronic system for automatically testing the human visual field is described in the context of mass screening for visual disorders, such as glaucoma. Present methods of field testing are briefly reviewed. The new system is patient operated and uses a television monitor as the means for presenting the test stimuli and displaying the results. A multilevel map of a patient's retinal sensitivity is produced in a form which is readily interpreted by an ophthalmologist. A data-transfer unit enables the local storage of results and allows direct access to a computer. Preliminary clinical trials show good agreement with conventional field-testing methods, and yield more detailed information than has hitherto been feasible on a routine basis.