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SummaryThe anxiolytic effect of lorazepam was assessed in 48 patients admitted with a mixture of acute and chronic mental diseases. Patients with anxiety and depressive neuroses were selected for the trial. Two case histories are submitted. The doses ranged from 3 to 7.5 mg. daily. The effect was considered excellent or good in 37% of the patients, moderate in 21 %, while no effect was obtained in 42%. Side-effects consisted mainly of mild fatigue and dizziness which often could be avoided by starting treatment with a low and gradually increased dose. It is not advisable to use the drug for patients with intellectual impairment or brain damage.

111 consecutive sinoscopic biopsies from the mucosa of the maxillary sinus in patients suffering from sinusitis were studied with regard to a number of histological parameters and compared with the appearance of the mucosa during sinoscopy. No characteristic histological picture was found for either group of sinoscopic pictures, but a statistically significant association was found between, on the one hand, thickening of the basement membrane, eosinophilia, loss of epithelium and cilia, and increased number of goblet cells and, on the other, the allergically dominated polypous and fibrous types of sinusitis. The reproducibility of the semiquantitative histological grading and the representativity of the biopsies were studied. The individual biopsies were found not to be representative with regard to all of the histological parameters. It is concluded that the introduction of a flexible biopsy forceps with optic is necessary for further utilization of sinoscopic biopsy.ZUSAMMENFASSUNG111 konsekutive sinoskopische Biopsien der Kieferhöhlen-schleimhaut bei Sinuitis wurden blind untersucht, um eine Reihe von histologischen Parametern zu erzielen, und wurden mit dem Bild der Schleimhaut bei Sinoskopie verglichen.Es wurde kein charakteristisches histologisches Bild jeder Gruppe der sinoskopischen Bilder gefunden, dagegen aber ein statistisch signifikanter Zusammenhang zwischen einerseits Basalmembranenverdickung, Eosinophil, Epithel- und Zilienverlust sowie einer vermehrten Anzahl Becherzellen und andererseits den von allergischen Fällen dominierten polypösen und fibrösen Sinuitisgruppen.Die Reproduzierbarkeit der semiquantitativen, histologischen Gradierung und die Repräsentativität der Biopsien wurden untersucht. Die einzelne Biopsie war bei allen histologischen Parametern nicht repräsentativ.Schlussfolgerung: Das Benutzen einer beweglichen Biopsiezange mit Optik ist für ein weiteres Ausnutzen der sinoskopischen Biopsie erforderlich.

The results of various forms of primary treatment of cancer of the vulva during the decade 1958-1968 in the Radium Centre, Århus Municipal Hospital, University of Århus, are submitted. The series consists of 67 patients classified by the T-N-M system (U.I.C.C. 1967). Comparison of 29 patients treated by vulvectomy and node dissection with 26 patients treated by less extensive surgery without node dissection showed a 19% higher corrected 4 year survival and a 14% lower nodal recurrence rate in the former group although according to the T-N-M classification it must be presumed to have contained rather more advanced cancers. There was quite a marked difference between the clinical assessment of the regional lymph nodes and the histological findings at dissection. This applied to the histologically positive as well as negative lymph nodes. A review of the literature shows that the present results are in keeping with previous publications which have shown that the treatment of choice in cancer of the vulva is still total vulvectomy with routine dissection of the superficial and deep inguinal lymph nodes, supplemented by dissection of the iliac lymph nodes, if histological examination during the operation shows positive lymph nodes in the inguinal region.

A description is given of a modification of Foch’s method for precise measurement of the thickness and the refractive index of a lamina. White-light reflection fringes from the lamina are compared in a spectrometer with the fringes produced by a Michelson interferometer when one light path in the interferometer contains the lamina. Analysis and experiment show that the interferometer fringes may be brought into perfect register with the reflection fringes over the entire spectrum regardless of the dispersion of the lamina.

The sequence of fifty-seven nucleotides in the coat protein cistron of phage R17 RNA directly confirms the genetic code, shows that the code used by the phage is degenerate and suggests that highly ordered base-paired structures exist in this RNA. Such base-paired loops may be involved in regulation of cistron expression and packing of the RNA in the phage particle.

Following a dislocation of the lower edge of the nasal septal cartilage from the furrow in the pre-maxilla and vomer (Figs. 1, 2) the cartilaginous outer nose is often twisted and the support is poor (Figs. 4 a, b). In 7% of the cases no deviation is evident unless a compression-test is carried out (Fig. 4 b). This procedure is recommended in the routine examination of newborn infants. If twisting is found the infant should be examined by a specialist in ear, nose and throat diseases. 141 cases of dislocation of the nasal septal cartilage were found in a series of 9 707 living newborn infants (1.45%) (Fig. 5). However, in a series of 907 newborn infants all examined rhinologically 29 cases were found (3.19%) (Fig. 6). Two thirds of the cases are apparently caused by trauma during pregnancy and the early stages of labour. They are equally distributed between right and left. One third of the cases are caused by trauma solely during internal rotation, which in the L.O.A.-presentation causes a dislocation of the inferior edge to the right, in the R.O.A.-presentation to the left (Figs. 10, 11, 12). The condition occurred significantly more commonly in firstborn infants but the reason for this was not evident from the analyses of the data. It was also more common in multiparae if second-stage of labour was prolonged beyond 15 min (Table VIII). Therefore it is suggested that the second stage should not exceed 15 min in multiparae. The dislocation does not reduce spontaneously. The results obtained after reduction according to the method of Metzenbaum (Fig. 4 c) are good (Fig. 13), and the procedure can be carried out under local anaesthesia.

The resistivity of a series of aluminium strips with thicknesses between 0·017 and 0.95 mm has been measured from 1.6 to 45°k. The bulk resistivity has been obtained by extrapolation to infinite thickness. Appreciable deviation from Matthiessen's rule was found, and it is proposed that this should be explained by a large difference in the scattering cross section for phonon-electron collisions between electron states in the second and in the third Brillouin zone.

A method of ‘fingerprinting’ high-molecular-weight32P-labelled RNA species, using a two-dimensional thin-layer-chromatographic separation of ribonuclease T1 digestion products, has been applied to RNA from the Escherichia coli bacteriophage R17. The ‘fingerprinting’ technique, besides giving a unique pattern that can be used as a characterization of the RNA, has made it possible to isolate a number of the larger oligonucleotides and to determine their nucleotide sequences.

Measurements of the ordinary and extraordinary refractive indexes of synthetic sapphire are reported. Direct independent measurements of the birefringence are given. Temperature and piezo-optical coefficients of birefringence are given and combined with published data and calculations of W. L. Bragg to yield order of magnitude values for the thermal coefficient of expansion and Young’s modulus.

Endoscopic examination of the maxillary sinus was introduced in 1902 but only infrequently used in the next half century, partly because of the limited capacity of the optics and light source. The method has been reintroduced and the technique refined in the last 20 years. The development of cold light and Hopkins optics has improved the capability of the method and now makes it possible to make excellent colour photographs for further study, comparison and education. As the method gives information which is often superior to that obtained during clinical and roentgen-examination, it is essential to disseminate the knowledge of the method. The technique used and typical findings are demonstrated in colour photographs.

Antibiotics are commonly used systemically in the treatment of sinusitis. However, controlled investigations have shown that there is only slight or doubtful effect. We have, therefore, in connection with a clinical trial of a new antibiotic (pivampicillin, Pondocillin®), determined the tissue levels of ampicil-lin in the mucosa of the sinus. It has been shown that the concentration of ampicillin in nasal polyps following a single dose of pivampicillin 356 mg given orally (mean: 2.11 μg/g) is of the same magnitude as that found in nasal polyps (mean: 2.28 μg/g) and mucosa from the sinus (mean: 1.67 μg/g) after a chemically equivalent single dose of ampicillin sodium 250 mg given intramuscularly. It is therefore probable that the same tissue concentration can be obtained in the mucosa of the sinus following a similar dose of pivampicillin. Some effect of both ampicillin sodium and pivampicillin can thus be expected in the treatment of sinusitis.

The sequencing of the ribosome binding sites and parts of the coat protein cistron has enabled the order of the three R17 genes to be established by direct chemical means. Translation may be influenced by the conformation of the RNA.

Systemic antibiotics appear to have only a doubtful or slight effect on recovery from sinusitis. Since it has been demonstrated that a sufficient tissue level of ampicillin should be expected in the mucosa of the maxillary sinus following a new peroral ampicillin derivative, pivampicillin (Pondocillin®), some effect would be expected in the treatment of cases of maxillary sinusitis caused by sensitive bacteria. In a double blind study of cases with acute, subacute or chronic maxillary sinusitis without fever, 45 patients were treated with pivampicillin, 356 mg four times daily, nasal decongestant and daily lavage, and 55 patients with placebo, decongestant and daily lavage. The trial disclosed a difference in the average recovery time of 0.9 days. This difference is not significant. The treatment had to be discontinued in 3 patients in the pivampicillin treated group, as the patients developed urticaria, nausea or abdominal pain and diarrhoea. However, discontinuance was also necessary in one patient in the control group, due to the same side effects.

A comparison between the results obtained from X-ray examination and endoscopy (sinoscopy) of the maxillary sinus has not previously been published. In the present series 585 maxillary sinuses were examined by both methods. In 3% of the cases we were unable to accomplish sinoscopy, and in 9% we may have overlooked the changes seen on the X-ray pictures. Sinoscopy was superior to the X-ray examination in the remaining cases, giving more exact information for differential diagnosis of the type and degree of the changes found in the sinus. An exact diagnosis by X-ray was not obtained in 29% of the sinoscopical diagnoses, although this could reasonably have been expected. The presence of discharge was incorrectly diagnosed at X-ray examination in 38% of the cases. Sinoscopy can give valuable information in cases of malignancy of extension to the maxillary sinus prior to irradiation or surgery. Consequently, in many cases one must consider whether the standard X-ray examination of the sinus can be replaced by sinoscopy.

Bacteriophage R17 RNA was labelled with 32P and was subjected to partial digestion with ribonuclease T1. The products were fractionated by ionophoresis on polyacrylamide gel. Two fragments were purified and their nucleotide sequences determined by methods involving complete and further partial digestion with ribonucleases A and T1. Fragment 20 had a sequence that coded for the amino acids in positions 32–53 of the coat protein of the bacteriophage. Fragment 20X, on further purification in 7m-urea, gave rise to two smaller nucleotides whose sequences coded for the amino acids in positions 56–66 and 67–76 of the coat protein. The sequence of the two fragments was such that they could be written in the form of loops stabilized by base-pairing.

A filter in which the two high-reflection elements are dielectric multilayers of the type that show a rapid wavelength variation of the phase change on reflection yields several pass bands, some of which are very narrow. The grouping of these bands, and their various widths, depend in a characteristic way on the order in which the individual layers of the multilayers are arranged on the two sides of the spacer. Fair quantitative agreement is obtained between the theoretical and observed positions and widths of the bands. For an asymmetrical arrangement of the layers the filter shows, at one particular wavelength, no splitting of the pass band into polarized components at non-normal incidence.