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When blood clots normally such a small amount of prothrombin and small quantity of accelerators remain in the hour-old serum that the prothrombin consumption test is prolonged. When blood from a severe coagulation abnormality clots, prothrombin and fibrinogen are both found in serum. When the blood from milder coagulation abnormalities or from transfused severe coagulation abnormalities clots no prothrombin remains in the serum but quantities of the prothrombin-like derivative appear. It is suggested that this component may be a derivative of prothrombin, and a comparison with prothrombin has been undertaken. Studies carried out using disulfide-linkage inhibitors, known to inhibit prothrombin activation, also inhibit the coagulation system supported by this new component. The prothrombin-like derivative is not stable at –25 C for more than a few days whereas prothrombin stored under similar conditions is stable indefinitely.

SummaryDNA measurements in normal human anterior pituitary glands reveal a constant concentration per unit weight and increased DNA in larger glands. This suggests that new cell formation (hyperplasia) is responsible for increased gland size.

To the Editor:— A case of false aneurysm of the carotid artery secondary to dehiscence of silk sutures holding a Dacron patch is presented. Symptoms of cerebral dysfunction secondary to probable embolization from the false aneurysm have focused our attention on this diagnosis as a possible cause of recurrent symptoms in patients who have previously had carotid artery surgery. False aneurysms have been reported after vascular reconstruction to the lower extremities. 1 To the best of our knowledge, false aneurysms after carotid artery reconstruction have not been previously described. This presentation reports a symptomatic false aneurysm of the carotid artery which occurred six years after carotid endarterectomy. Report of a Case:— A 56-year-old man was admitted to the San Francisco Veterans Administration Hospital on April 10, 1968, with acute hemiparesis on the right side and dysarthria. Several months prior to admission the patient had had an episode of transient right

As the incidence of civilian penetrating trauma increases, so do the number of injuries to major vascular structures. These may account for only a small proportion of the total number of cases of penetrating abdominal trauma, but are frequently fatal. With improved methods of transportation and resuscitation of the critically injured patient, more and more patients with vascular injuries will survive until they can be operated upon. Improved surgical salvage will then depend upon immediate recognition that major vascular injury exists and prompt control of the damaged vessel. We have developed a method which permits rapid exposure of injuries of the aorta, the vena cava, and their major branches. Clinical Material In the past five years, 46 patients with intra-abdominal vascular injuries involving the aorta, the vena cava, or their major visceral branches were admitted to San Francisco General Hospital (Table 1). The average age of the patients was 34

The tubeless detection of gastric acidity, as developed by Segal and associates, 1 makes it possible to ascertain the state of gastric acidity in specific cases or in mass screening examinations without the use of complicated or cumbersome chemical procedures. The rationale of tubeless analysis depends on the use of a dye, azure A, which is released from a cation exchange resin by free hydrochloric acid in the stomach. In the presence of free acid, the free dye is absorbed and consequently excreted in the urine and the blue color of the urine may then be visually compared with a solution of azure A of known concentration. It has been reported by other workers 2 that in about 50% of the tests the azure A is excreted in a reduced, colorless form that requires oxidation with acid and heat to bring out the color. In our experience, about 75% of

The endocrine glands react to demands for increased hormone production by an increase in their functional size and their weight. Thus, the thyroid, the adrenal, and the parathyroid glands are known to enlarge demonstrably in the syndromes associated with their increased hormone production. The pituitary, too, is generally considered to react in this manner, and increased pituitary size has been reported, for example, in primary myxedema and following adrenalectomy for Cushing's syndrome: in both instances there is presumably a compensatory increase in tropic hormone output by the pituitary—thyroid stimulating hormone in the first, adrenocorticotrophic hormone in the second. Evidence of a correlation between decreasing size and reduced hormone output can be seen in steroid-treated patients where a diminution in pituitary size—associated with decreased tropic hormone release—may well be the rule. These examples of reactive changes in pituitary size and weight in the human could be challenged; pituitary size increase in