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While in a state of quiet sleep, 15 full-term male, 15 full-term female, and 15 premature male infants were presented a single auditory stimulus. Heart rate was continuously monitored and scored for mean and standard deviation in the 10-sec prestimulus period, as well as for peak and trough magnitude of the response and the latencies to these points. The infants tended to show a diphasic response, acceleration followed by rebound deceleration below baseline. Prestimulus mean and variability were inversely related, and significantly predictive of the amount of acceleration. Premature infants showed a high resting heart rate, and a milder response to the stimulus. Also evident were larger accelerations and longer latencies to trough for full-term females.

Studies on the so-called functional albuminuria, also variously designated as cyclic, intermittent, physiologic, orthostatic, etc., first focused attention on posture as a factor in renal activity. Naturally, the criterion most often used in the earlier works on this subject was the appearance of albumin in the urine. The volume of urine excreted in different body postures had been recorded by some investigators only as subsidiary observations. Edel1 noted decreased urine volume during the standing posture coincident with the maximum albuminuria and, conversely, an increased volume on the assuming of a recumbent posture when albumin disappeared from the urine. Linnoisier and Lemoine2 studied the influence of posture on renal activity by making twelve hour observations on renal and albuminuric patients. Notwithstanding the lack of adequate control of diet and water intake, they could observe a definite decrease, not only of the urine, but of urea and chlorides, during standing, as compared

The parathyroid function was investigated in 25 peptic ulcer patients of both sexes, with and without treatment, and in 9 controls of both sexes, by means of laboratory examinations and radiographs of the kidneys and the skeleton. The laboratory examinations consisted of serum calcium, protein, phosphorus and creatinine, phosphorus and calcium clearances and renal tubular reabsorption of phosphorus. A statistical evaluation was made of all the groups and their data.The comparison between the means of the laboratory data found in 25 peptic ulcer patients of both sexes, with and without treatment, and the 9 controls, revealed a significant increase in phosphorus and calcium clearances and a significant decrease in renal tubular reabsorption of phosphorus in the ulcer patients. The radiological examination of the kidneys and the skeletons of 18 patients showed no anomalies.The comparison between the means of the laboratory data found in 14 peptic ulcer patients of both sexes, submitted to a milk-alkali treatment, and the 11 peptic ulcer patients of both sexes, without treatment, did not reveal any significant difference, except for a slight significant increase in serum calcium.The comparison between the means of the laboratory data found in 16 duodenal ulcer patients of both sexes, with and without treatment, and 8 gastric ulcer patients of both sexes, with and without treatment, revealed a significant increase in phosphorus and calcium clearances and a significant decrease in renal tubular reabsorption of phosphorus in the duodenal ulcer patients.The comparison between the means of the laboratory data found in 19 peptic ulcer patients (men), with and without treatment, and 6 peptic ulcer patients (women), with and without treatment, revealed no significant difference.The significance is discussed of the manifest increase in phosphorus and calcium clearances observed in the peptic ulcer patients and particularly in those with* Present address: José E. Uriburu 1053, Buenos Aires, Argentina.duodenal ulcer, and its possible connection with parathyroid hyperfunction is commented upon.

Determinations of serum immunoreactive insulin (IRI) were done in venous samples from 22 normal women in labor before and after receiving a 10minute intravenous infusion of glucose. Serial samples were also obtained from the scalps of their fetuses during the 90minute period of observations. An early and sustained serum insulin response to the infusion was observed in the mothers, but the fetal IRI response was not evident until 40minutes after the end of the infusion. The highest fetal IRI values were observed approximately one hour after the fetal blood glucose peak. A transplacental load of glucose to the human fetus seems to produce a delayed IRI response similar to that seen in normal newborn infants after intravenous glucose tolerance tests.

The removal of skeletally bound Sr89is accelerated by diets whose Ca/P ratios are 4 or greater. Also, supplemental magnesium increases the removal of isotope if the dietary Ca P ratio is 2 or less. Large dietary Ca P ratios and supplemental magnesium produce hypercalciuria which is essential for increased Sr89elimination. Increased intake of magnesium ions routinely decreases urinary phosphorus and fecal calcium causing their balance to become more positive.

The surface-active complex lining alveoli in normal lung lowers surface tension on expiration, thus preventing alveolar collapse. Surface activity follows a developmental timetable. Infants with idiopathic respiratory distress syndrome (RDS) almost exclusively are prematurely born, and their lungs lack adequate surface activity and are deficient in the principal surface-active component, lecithin. This deficiency implies that RDS is a “disease of development,” with fetal and neonatal timetables for lecithin synthesis. The biosynthesis of lung lecithin in the living human infant was studied by examining phospholipids in lung effluent (pharyngeal aspirates, mucus), which have identical phospholipids to those in lung lavage (alveolar wash). The fatty acid esters of isolated lecithin and phosphatidyl dimethylethanolamine (PDME) were examined. The β-carbonfatty acids are indicators of the primary pathways of synthesis of lecithin: (1) a preponderance of palmitic acid signifying cytidinediphosphate choline (CDP-choline) + D-α,β-diglyceride→ lecithin(choline incorporation pathway) and (2) a preponderance of myristic acid signifying phosphatidyl ethanolamine (PE) + 2 CH3→ PDME+ CH3→ lecithin(methylation pathway).

DESPITE the high incidence of American cutaneous leishmaniasis found in the northern part of Guatemala, the reasons for reporting this case are the following: (1) observation of the appearance of multiple skin lesions over different parts of the body (ear, arm, back and buttock) and the rectal mucosa and (2) the fact that in the available statistics on American leishmaniasis, 80 to 90 per cent of the reported cases had single or multiple skin lesions and 10 to 20 per cent of the cases presented the association of mucocutaneous lesions of the face and lesions of the nasopharyngeal mucosa but, so far as I know, there was not another report of a case with lesions of the rectum. Furthermore, the discovery of the mucous membrane lesions was significant, as treatment prevented the development of the serious sequelae which follow the appearance of such ulcers in the bowel.The incubation period

Se presenta la modalidad terapéutica de asociar el uso de la griseofulvina con la ablación quirúrgica de las uñas en eltratamiento de la onicomicosis. A su vez, se describe la nueva técnica quirúrgica creada por el autor, para la resección de las uñas, poniéndo énfasis en la sencillez y facilidad de su ejecuten, ya que cualquier uña enferma de los pies o manos, puede ser resecada con sólo el uso de una pequeña cucharilla de bordes romos. Es una operación de cirugía menor, fácil, sencilla, practica y accesible para cualquier medico y aún para el dermatólogo no familiarizado con la cirugía de piel. Con la combinación de ambos métodos, prácticamente se elimina la posibilidad de las reacciones colaterales, de intolerancia o intoxicación consecutivas al uso del antibiótico, ya que se reduce en más de un 40% la dosis total que se administra; se detiene el proceso invasivo de los hongos; además, estos se enlinan mecánicamente al resecar la una enferma y se previene su recurrencia, con la administración postoperatoria del antibiótico. El tiempo de tratamiento, se reduce en más de la mintad y lacuración se obtiene en el lapso de un mes. Se trataron 200 enfermos y se resecaron 217 uñas en total, tanto de los pies como de las manos; la infección que predominó fué consecutiva al Trichophyton rubrum; los resultados terapéuticos obtenidos fueron muy satisfactorios, ya que se observó un 95% de curación; las recaídas se deben más que todo al uso deficiente de la griseofulvina en el período post‐operatorio y a que el enfermo regresaba a su ocupación anterior. The author describes a therapeutic modality which combines the use of griseofulvin with surgical avulsion of the nail in onychomycosis. The surgery employed is a new technique developed by the author as a sensible, practical and easy method for the resection of both finger and toenails; it allows avulsion with the use of only a smallblunt‐edged curette. Thus, the procedure may be considered minor surgery which maybe performed by any physician or by the dermatologist not routinely engaged in skin surgery. The combined method virtually eliminates the occurrence of side effects which may otherwise be seen with griseofulvin, since it allows a 40% plus reduction of the required total dosage. In addition, it arrests the invasive process, since the fungi are mechanically removed with the resection of the infected nail and re‐invasion is prevented by administering griseofulvin during the post operative period. Finally, the duration of treatment is reduced by more than one‐half, with a cure generally being obtained within a month. A total of 200 patients were treated and 217 finger and toenails resected with this method. Trichophyton rubrum was the predominant pathogen. The results obtained with the combined method were highly satisfactory, with a cure rate of 95%; there lapses seen were due either to insufficient use of griseofulvin during the postoperative period or to the fact that the patient had to return to his occupation, which was of a type favoring re‐infection. L'auteur décrit une méthode thérapeutique qui combine l'administration de griseofulvine avec le traitement chirurgical de l'onychomycose. Ce nouveau procédé chirurgical a été développé par l'auteur et constitue une méthode pratique et facile pour la résection des ongles des doigts de la main et du pied; on se sert d'une seule curette de fil obtu. Cette méthode est facile á suivre et peut être employée par le médecin général ou le dermatologue qui ne fait pasnormalement la chirurgie de la peau. Ce procédé combiné élimine virtuellement les réactions de la griseofulvine puisqu'il premet la réduction du dosage de 40%. En plus, le procès invasif est arrêter, puisque l'ongle infecté a été enlevé par la chirurgie et la réinfection est évitée par l'administration de griseofulvine pendant la période postopérative. Finalement, la durée du traitement est réduite á la moitiée et l'affection est curée dans le courant d'un mois. Deux cent malades ont été traité par ce procédé et 217 ongles ont été resectés. Trichophyton rubrum était prédominant. Les résultats obtenus par cette méthode ont été très satisfaisants, ayant obtenu 95% deguérison. Les rechutes ont été du a un dosage insuffisant de griseofulvine pendant la période post‐opérative ou au fait que le malade devait reprendre son occupation qui favorisait la réinfection.

Graves' disease is generally associated with a typical ophthalmopathy. The occurrence and intensity of this ophthalmopathy are not related to the course of hyperthyroidism. Pituitary ophthalmotropic factors, other than thyrotropic hormone, are considered to be the cause of the exophthalmos.3Two principal clinical types of exophthalmopathy have been described, namely, the simple and the malignant exophthalmos; however, most of the patients show a mixed picture, presenting some characteristics of each one. In severe exophthalmos, underlying edema and cellular infiltration of the conjunctiva and structures about the eye are clinically obvious.There have been many hypotheses on the mechanism of the ophthalmopathy of Graves' disease. It is now generally accepted that the proptosis is due to an increased volume of the retrobulbar tissues of the eye.3,9 Several factors may play a part in the filling of the orbit: an increase in retrobulbar fat,5,9 an increase in the size

The metabolism of 88 men and 16 women was determined by the Benedict-Roth portable metabolism apparatus and found to be -7.8 and -9.3 per cent respectively lower than the Aub-DuBois standards.

In eight cases of linear porokeratosis, the skin lesions appeared most commonly over the extremities during childhood and were clinically mistaken for linear verrucous epidermal nevus or lichen striatus. In a review of the literature, only seven instances of linear porokeratosis were found. We believe that linear porokeratosis should be recognized as a distinctive clinical variant and that the condition should be taken into consideration in the differential diagnosis of linear keratotic cutaneous eruptions.

In order to understand the so-called minimal or subclinical nutritional deficiency reactions observed in the United States, it is well to consider the severe or extreme reactions which may be observed elsewhere and especially in tropical America. At the Hospital San Juan de Dios in San José, Costa Rica, special attention has been given in the past three years to the study of changes in the hair of infants and young children with severe avitaminosis. Hair disturbances have been noted especially in the severe forms of vitamin A deficiencies, pellagra, riboflavin deficiency (cheilosis), nutritional edemas, beriberi and in the mixed forms of these general types. Such extreme hair disturbances have not been seen in the nutritional disturbances in the United States according to Blankenhorn,1 Spies2 and Vilter.3 In the Medical Survey of Nutrition in Newfoundland,4 note was made of a form of change in the hair,

Intact rats, fed diets high in phosphate, develop nephrocalcinosis; but parathyroidectomized rats do not. Neither intact nor parathyroidectomized rats, fed diets high in calcium, have mineral deposits in their kidney. Intact rats, but not parathyroidectomized rats, fed diets high in calcium and phosphate, develop kidney calcification. The mineral deposits consist of at least calcium, magnesium, and phosphate.