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SUMMARY Common warts (verrucae vulgares) are the most common complaint in routine dermatological practice. Warts can be painful on pressure and are often an aesthetic problem, but they are not a major threat to the person’s general health. Treatment options are symptomatic and do not eradicate the causative agent. Dermatological surgery procedures such as cryotherapy, electrocauterization and excochleation can be painful, with common recurrences. These are the most important reasons for revival of the treatment procedures and remedies based on traditional medicine. Traditional medicine is still commonly practiced as a form of self-healing. This paper presents the most commonly used wart remedies of plant, animal and mineral origin, along with various magic practices. We emphasize that this paper is written from the viewpoint of physicians, practitioners of dermatology, not as a study in the history or culture. The main objective of the study was to explore various substances and methods people use as home remedies for warts. We performed a case study survey among the general population by interviewing 147 adult participants using a simple preliminary questionnaire inquiring about preferred treatment and knowledge about common warts.

SUMMARY The world is struggling to deal with the corona pandemic. Effective therapies are still awaited due to the lack of understanding of the pathophysiological mechanism of the disease. Bearing recent research and clinical observations in mind, the authors propose a novel physiological mechanism of COVID-19 and explain development of COVID-19 related acute respiratory distress syndrome (ARDS) secondary to COVID-19 related hemoglobinopathy. It is a consistent observation that the radiological picture of COVID-19 related ARDS bears more resemblance to high altitude pulmonary edema (HAPE) than typical ARDS. There has been great controversy regarding this proposed similarity. The main argument from those objecting to this comparison is that the etiology is hypoxia in case of HAPE and inflammation in COVID-19 related ARDS. We propose that considering the recent bioinformatics prediction models, COVID-19 might first infect red blood cells via CD147 and cause hemoglobin damage. The resulting hypoxemia may cause pulmonary hypoxic vasoconstriction leading to HAPE-like lung lesions. The now introduced alveolar hypoxia further exaggerates hemoglobinopathy hypoxemia leading to a vicious cycle. In this review, the authors recommend laboratory experiments to prove these hypotheses. The proposed physiological mechanism has significant therapeutic implications. If proven, the authors suggest the use of exchange transfusion as adjunct therapy and development of anti-CD147 drugs.

Robot-assisted brain tumor biopsy is becoming one of the most important innovative technologies in neurosurgical practice. The idea behind its engagement is to advance the safety and efficacy of the biopsy procedure, which is much in demand when planning the management of endocranial tumor pathology. Herein, we provide our earliest institutional experiences in utilizing this mesmerizing technology. Cranial robotic device was employed for stereotactic robot-assisted brain glioma biopsy in three consecutive patients from our series: an anaplastic isocitrate dehydrogenase (IDH) negative astrocytoma (WHO grade III) located in the right trigone region of the periventricular white matter; a low grade diffuse astrocytoma (WHO grade II) of bilateral thalamic region spreading into the right mesencephalic area; and an IDH-wildtype glioblastoma (WHO grade IV) of the right frontal lobe producing a contralateral midline shifting. Robot-assisted tumor biopsy was successfully performed to get tissue samples for histopathologic and immunohistochemical analysis. The adjacent tissue iatrogenic damage of the eloquent cortical areas was minimal, while the immediate postoperative recovery was satisfactory in all patients. In conclusion, considering the preliminary results of our early experiences, robot-assisted tumor biopsy was proven to be a feasible and accurate procedure when surgery for brain glioma was not an option. It may increase safety and precision, without expanding surgical time, being similarly effective when compared to standard stereotactic and manual biopsy. Using this method to provide accurate sampling for histopathologic and immunohistochemical analysis is a safe and easy way to determine management strategies and outcome of different types of brain glioma., Robotom potpomognuta tumorska biopsija postaje jednom od najvažnijih inovativnih tehnologija u neurokirurškom radu. Razlog njezine uporabe nalazi se u daljnjem poboljšanju sigurnosti, učinkovitosti i preciznosti biopsijske metode koja je osobito značajna u planiranju opskrbe endokranijske tumorske patologije. Ovim radom donosimo prva institucijska iskustva u primjeni ove začudne tehnologije pri biopsiji gliomskih tumora mozga. Kranijski robotički uređaj korišten je pri stereotaksijskoj robotom potpomognutoj tumorskoj biopsiji u tri susljedna slučaja iz naše serije, koja je uspješno učinjena radi uzimanja uzorka tumorskoga tkiva za patohistološku i imunohistokemijsku dijagnostiku u bolesnice s anaplastičkim izocitrat dehidrogenaza (IDH) negativnim astrocitomom (SZO st. III.) smještenim u periventrukulskoj bijeloj tvari desnoga trigonuma, u bolesnika s difuznim astrocitomom niskoga stupnja malignosti (SZO st. II.) smještenim obostrano u talamičkom području sa širenjem u desni mezencefalon, kao i u bolesnika s IDH-wildtype glioblastomom (SZO st. IV.) desnog čeonog režnja s pomakom središnjih tvorba. Jatrogena lezija pripadajućeg elokventnog moždanog korteksa bila je minimalna, dok je neposredni poslijeoperacijski oporavak bio uspješan u svih bolesnika. Uzimajući u obzir preliminarne rezultate našega početnog iskustva, zaključujemo kako je robotom potpomognuta tumorska biopsija dokazano izvodljiva i primjerena metoda u kirurgiji gliomskih tumora mozga kojom se može poboljšati sigurnost i preciznost bez produljenja vremena operacije, a koja je podjednako učinkovita u usporedbi sa standardnom stereotaksijskom i manualnom biopsijom. Uporaba navedene metode omogućuje precizno uzorkovanje tumorskoga tkiva za patohistološku i imunohistokemijsku analizu na siguran i lak način, što doprinosi odabiru strategije liječenja i predviđanju ishoda različitih tipova gliomskih tumora mozga.

Objective: Halitosis, or oral malodour, is an unpleasant smell emanating from the oral cavity. It is a common complaint among patients with periodontitis, however, their relationship is not fully elucidated. This study aimed to evaluate the association between halitosis measures, clinical indicators of periodontitis and tongue coating, as well as a novel measure, periodontal inflamed surface area (PISA). Material and methods: Data of 10 patients with periodontitis and halitosis were included in this study. Halitosis was assessed by the organoleptic method and the portable sulphide monitor, measuring volatiles sulphur compounds. A comprehensive periodontal examination was conducted, and the parameters of probing depth, gingival recession, clinical attachment level, bleeding on probing, plaque and tongue coating were registered. The PISA was calculated using clinical attachment level, gingival recession and bleeding on probing. Results: A correlation between organoleptic score and tongue coating (r=0.554) and plaque (r=0.614) could be observed. No correlation between measures of halitosis and probing depth or the PISA could be detected. A significant correlation was found between organoleptic scores and volatiles sulphur compounds values (r=0.931). Conclusion: This pilot study has shown and further reiterated a complex interplay between different factors causative to halitosis in patients affected by periodontitis. The results suggest that tongue coating and oral hygiene may have an important role in halitosis in patients with periodontitis., Cilj istraživanja: Halitoza ili zadah neugodan je vonj koji se širi iz usne šupljine. Česta je pritužba među pacijentima s parodontitisom, no njihova povezanost nije u cijelosti razjašnjena. Cilj ovog istraživanja bio je procijeniti povezanost između parametara halitoze, kliničkih parametara parodontitisa i obloženosti jezika te novog parametra – površine parodonta zahvaćene upalom (engl. periodontal inflamed surface area – PISA). Materijali i metode: U ovo su istraživanje uključeni podatci 10 pacijenata s parodontitisom i halitozom. Halitoza je procijenjena organoleptičkom metodom i prijenosnim sulfidnim monitorom kojim se mjere hlapljive sumporne spojeve. Proveden je sveobuhvatni parodontni pregled i registrirani su parametri dubine sondiranja, recesija gingive, razine kliničkoga pričvrstka, krvarenja pri sondiranju, plaka i naslaga na jeziku. PISA je izračunata koristeći se razinom kliničkoga pričvrstka, recesije gingive i krvarenja pri sondiranju. Rezultati: Uočena je povezanost između organoleptičke ocjene halitoze i obloženosti jezika (r = 0,554) i plaka (r = 0,614). Nije zabilježena povezanost između parametara halitoze i dubine sondiranja ili PISA-e. Organoleptička ocjena halitoze i vrijednost hlapljivih sumpornih spojeva značajno su korelirali (r = 0,931). Zaključak: Ovo pilot-istraživanje pokazuje i ponovno potvrđuje složenu interakciju između različitih čimbenika koji uzrokuju halitozu kod pacijenata s dijagnozom parodontitisa. Rezultati sugeriraju da naslage na jeziku i oralna higijena mogu biti važni u slučaju halitoze kod pacijenata s parodontitisom.

The prevalence and importance of male infertility make it a serious worldwide medical and social problem. The aim of this study was to determine if there were any significant differences in zinc concentrations in seminal fluid in men diagnosed with infertility compared to control group, and if there were, to determine how it affected the number and percentage of sperm cells with normal motility and morphology. A case-control study was conducted in the Osijek-Baranja County from January 2014 to June of 2015. The study included 276 subjects referred to biochemistry laboratory of the Osijek University Hospital Centre, 100 (36.2%) of them with low sperm count confirmed by spermiogram after 3 months. Semen samples were processed according to the World Health Organization criteria, and zinc concentrations were determined using spectrophotometry and direct colorimetry without deproteinization on a chemistry analyzer (Olympus AU 680, Beckman Coulter, Tokyo, Japan). Study results showed the men with low sperm count to be significantly older (Mann Whitney U test: p=0.013) and to have lower zinc levels (χ2-test: p, Muška neplodnost s obzirom na njenu učestalost i važnost predstavlja ozbiljan globalni medicinski i socijalni problem. Cilj ovoga istraživanja bio je utvrditi postoje li značajne razlike koncentracije cinka u sjemenoj tekućini muškaraca s dijagnozom smanjene plodnosti u odnosu na kontrolnu skupinu te ako postoje, utvrditi kako razina cinka djeluje na broj, postotak pokretnih i broj morfološki normalnih spermija. Studija slučajeva i kontrola provedena je na području Osječko-baranjske županije u razdoblju od siječnja 2014. godine do lipnja 2015. godine. U studiju je bilo uključeno 276 ispitanika koji su bili upućeni u biokemijski laboratorij KBC-a Osijek, od kojih je kod 100 (36,2%) ispitanika potvrđena dijagnoza smanjene plodnosti ponovljenim spermogramom nakon 3 mjeseca. Uzorci sjemene tekućine obrađeni su u skladu s kriterijima Svjetske zdravstvene organizacije, a koncentracija cinka određena je spektrofotometrijskom, direktnom kolorimetrijskom metodom bez deproteinizacije na kemijskom analizatoru tipa Olympus AU 680 (Beckman Coulter, Tokyo, Japan). Istraživanje je pokazalo kako su muškarci s dijagnozom smanjene plodnosti značajno stariji (Mann Whitney U test: p=0,013) i imaju značajno niže vrijednosti cinka (χ2-test: p

The aim of this study was to determine plasma adropin concentration and parameters of insulin resistance in obese male type 2 diabetes mellitus (T2DM) patients before and after 3-month liraglutide treatment. In this interventional study, we enrolled 15 obese male T2DM patients with body mass index (BMI) >35 kg/m2, uncontrolled disease and HbA1c >7.5%, having previously taken taking two oral antidiabetic drugs. We modified their therapy to metformin and liraglutide for the next three months. After three months of liraglutide treatment, we observed significant decrease in body weight (from 111.5±18.7 kg to 109.2±17.5 kg, p=0.016) and BMI (from 40.9±7.3 to 40.1±7.0 kg/m2, p=0.021). Plasma adropin concentration increased significantly (p=0.003) compared with baseline. Fasting plasma insulin level decreased from 17.79±6.53 to 13.38±3.51 mU/L (p=0.002), fasting plasma glucose level decreased from 8.66±3.07 to 7.41±2.21 mmol/L (p=0.004) and HbA1c decreased from 7.98±0.70% to 7.26±0.36% (p=0.003). Insulin resistance presented as HOMA-IR decreased significantly from 7.30±5.19 to 4.52±2.61 (p=0.002). Systolic blood pressure, lipid status, liver and kidney function improved, but not reaching statistical significance. Treating obese male T2DM patients with liraglutide resulted in a significantly higher plasma adropin concentration, significant weight loss and improved parameters of insulin resistance, i.e. decreased fasting plasma insulin, plasma glucose levels and HOMA-IR., Cilj je bio usporediti plazmatske vrijednosti adropina i parametre inzulinske rezistencije kod pretilih muškaraca koji boluju od šećerne bolesti tip 2 (ŠBT2) prije i nakon 3 mjeseca primjene liraglutida. U ovoj intervencijskoj studiji sudjelovalo je 15 pretilih muškaraca koji boluju od ŠBT2 s indeksom tjelesne mase (ITM) >35 kg/m2, loše reguliranom bolešću i HbA1c >7,5%. Ispitanici su prethodno u terapiji imali dva peroralna antidijabetična lijeka. Nakon uključenja u studiju terapija im je modificirana na metformin i liraglutid tijekom tri mjeseca. Nakon primjene liraglutida kod ispitanika je zamijećeno smanjenje tjelesne mase (sa 111,5±18,7 na 109,2±17,5 kg, p=0,016) i ITM (s 40,9±7,3 na 40,1±7,0 kg/m2, p=0,021), dok su plazmatske vrijednosti adropina bile značajno povišene (p=0,003). Zamijećeno je sniženje vrijednosti inzulina natašte (sa 17,79±6,53 na 13,38±3,51 mU/L, p=0,002), glukoze natašte (s 8,66±3,07 na 7,41±2,21 mmol/L, p=0,004) te HbA1c (sa 7,98±0,70% na 7,26±0,36%, p=0,003). HOMA-IR se značajno smanjio (sa 7,30±5,19 na 4,52±2,61, p=0,002). Također su zabilježene niže vrijednosti sistoličkog arterijskog tlaka, bolji lipidni profil te poboljšanje jetrene i bubrežne funkcije, iako ne statistički značajno. Primjena liraglutida u pretilih muškaraca koji boluju od ŠBT2 rezultira statistički značajno višim razinama plazmatskog adropina, značajnim smanjenjem tjelesne težine i poboljšanjem svih parametara inzulinske rezistencije, tj. sniženjem plazmatskog inzulina i glukoze natašte te nižim HOMA-IR.

SUMMARY Bone drilling causes focal temperature rise due to metal-to-bone contact, which may result in thermal osteonecrosis. Newly constructed internally cooled medical drill of an open type decreases temperature rise at a point of metal-to-bone contact although standard sterilization of such a drill could be inadequate due to bacteria retention within the drill lumen. The aim of this pilot study was to examine the effectiveness of sterilization and to propose sterilization recommendations for internally cooled open type bone drills. Unused internally cooled medical steel bone drills were tested. Drills were contaminated with Pseudomonas aeruginosa, Bacillus sp., beta-hemolytic Streptococcus sp., Enterobacter sp. and methicillin-resistant Staphylococcus pseudintermedius and then incubated for 24 hours at 37 °C. Afterwards, drills were autoclaved for 15, 20 and 30 minutes at 132 °C and 2.6 bar. When 15-minute sterilization was used, one out of 16 drills was contaminated with Pseudomonas aeruginosa, while the other 15 drills were sterile. Extended cycle sterilization in autoclave lasting for 20 and 30 minutes resulted in 100% sterility of all drills tested. In conclusion, lumened drills should be exposed to extended sterilization times in autoclave. Minimal recommended time for sterilization of lumened drills is 20 minutes.

The most severe effects of rheumatoid arthritis (RA) are loss of physical function and chronic pain, which may have a major impact on different areas of the person’s existence. The aim of this study was to get an insight into the quality of life (QOL) in subjects with RA in connection with pain perception and functional ability. The following instruments were used: the World Health Organization Quality of Life Questionnaire (WHOQOL-BREF), Short Form Health Survey (SF-36), Health Assessment Questionnaire Disability Index (HAQ-DI) and Visual Analog Scale for Pain (VAS Pain). The results indicated that there was no statistical difference in the QOL between subjects with RA and healthy population according to SF-36 Croatian norms. Also, the results showed that stronger pain experience was significantly associated with poorer social functioning assessment (SF36SF, Spearman’s rho=-0.463, p, Neke od najozbiljnijih posljedica reumatoidnog artritisa (RA) su kronična bol i gubitak fizičkih funkcija, što može imati snažan utjecaj na različita područja osobne egzistencije u oboljelih. U tom smislu, cilj ovoga istraživanja odnosio se na dobivanje uvida u kvalitetu života osoba s RA u povezanosti s percepcijom boli i funkcionalnom sposobnošću. Korišteni su sljedeći instrumenti procjene: Upitnik kvaliteta života Svjetske zdravstvene organizacije (WHOQOL-BREF), Upitnik za samoprocjenu zdravstvenog stanja SF-36, Upitnik procjene zdravstvenog statusa i indeksa invalidnosti (HAQ-DI) i Vizualno analogna ljestvica samoprocjene boli (VAS). Prema dobivenim podacima nije utvrđena statistički značajna razlika u procjeni kvalitete života između osoba s RA i zdrave populacije prema standardiziranoj hrvatskoj verziji upitnika SF-36. Međutim, intenzivniji doživljaj boli bio je značajno povezan s lošijom procjenom socijalnog funkcioniranja (SF36SF, Spearmanov rho=-0,463, p

Uvod: Sindrom pekućih usta (SPU) kronični je poremećaj koji uglavnom zahvaća žene u postmenopauzi, a svojstven mu je osjećaj pečenja u usnoj šupljini unatoč potpuno zdravoj oralnoj sluznici. Rezultati dosadašnjih istraživanja sugeriraju moguću ulogu centralnih i/ili perifernih neuroloških poremećaja. Ispitanici i postupci: U skupini od 20 ispitanika sa SPU-om (64,7 ± 12,3 godina) i njih 20 u kontrolnoj skupini (61,5 ± 15 godina) s bolovima u lumbosakralnom dijelu leđa, transkranijalnom sonografijom evaluirani su moždani parenhim, crna tvar (substantia nigra), središnji niz stanica smješten u formatio reticularis lateralno od rapha medulla oblongata (nucleus raphe) i crvena jezgra (nucleus ruber). Statistička analiza obavljena je Studentovim t-testom sa značajnošću od p < 0,05. Rezultati: Rezultati ovog istraživanja pokazuju da se kod oboljelih od SPU-a (p < 0,05), u usporedbi s kontrolnom skupinom, pojavljuje hipoehogenost substantia nigra i nuclei raphe, a hiperehogen ostaje nucleus ruber. Zaključak: Možemo zaključiti da promijenjeni nalazi transkranijalne sonografije moždanoga parenhima, nucleus raphe i crvene jezgre (nucleus ruber) kod bolesnika sa SPU-om mogu odražavati centralne poremećaje u sklopu ovog sindroma., Objective: Burning mouth syndrome (BMS) is a chronic disorder which is affecting mostly postmenopausal women and is characterized by burning symptoms in the oral cavity on the clinically healthy oral mucosa. The results of previous studies suggested a possible role of peripheral and/or central neurological disturbances in these patients. The aim of this study was to analyze patients with burning mouth syndrome using transcranial sonography. Methods: By use of transcranial sonography of the brain parenchyma, substantia nigra, midbrain raphe and brain nucleus were evaluated in 20 patients with BMS (64.7±12.3 years) and 20 controls with chronic pain in the lumbosacral region (61.5±15). Statistical analysis was performed by use of Student t test with significance set at p

Acidic liquids such as verjuice, lemon juice and vinegar are frequently consumed in Iran. Different kinds of acidic liquids are packaged in polyethylene terephthalate (PET) and high-density polyethylene (HDPE) bottles. There is evidence indicating that phthalates can leach from PET and HDPE bottles into their contents. In this work the effect of storage time, temperature and bottle type on the migration of phthalates from packaging materials into acidic liquids is studied by analyzing the samples stored under different conditions, before storage and after 2, 4 and 6 months of storage. The determined mean phthalate concentrations in µg/L were

Rifampicin showed high activity against experimental leprosy, inhibiting the multiplication of dapsone-sensitive and dapsone-resistant strains of Mycobacterium leprae in mice fed 5 mg./kg. body weight. In a formal pilot-type trial on six previously untreated patients with active lepromatous leprosy, rifampicin (600 mg. daily by mouth) was as effective as standard treatment with dapsone. Myco. leprae, however, appeared to be killed more rapidly by rifampicin than by dapsone or other antileprosy drugs so far studied. This was confirmed on a further 10 patients, including two with dapsone resistance, and from the infectivity in mice of bacilli recovered from patients during treatment with rifampicin or dapsone. These results are consistent with the bactericidal activity of rifampicin against other micro-organisms, which could be important to the chemotherapy of leprosy, since all antileprosy drugs in current use are bacteriostatic.

The leucocyte migration test, an in-vitro measure of cellular immunity, has been used to follow the changes in cell-mediated hypersensitivity to kidney and histocompatibility antigens in three patients after renal transplantation. Inhibition of leucocyte migration, indicating strong sensitization to the antigens used, occurred in each patient, starting five to seven days after transplantation. Satisfactory renal function had not been established in any of the patients at this time. In one case inhibition of leucocyte migration persisted almost continuously until the 24th day and was associated with poor renal function proved histologically to be due to rejection. Treatment with increased dosage of prednisone was associated with a rapid reversion to normal of the migration index and improvement in renal function. Later, inhibition of migration occurred again, and shortly afterwards the graft ceased to function. In the other two cases the migration index became normal without alteration in immunosuppressive therapy and a satisfactory diuresis followed. It is suggested that this simple test should prove useful in the specific diagnosis of rejection and in control of immunosuppressive therapy.

In two patients with symptoms and signs characteristic of a mechanical lumbar spine disorder epidurography showed the presence of small disc prolapses. Treatment by manipulation relieved the symptoms of lumbago, and repeat epidurography showed that the prolapses were reduced in size. Reduction of disc prolapse by manipulation has not before been objectively demonstrated.

Two patients are described who were found to have a destructive lesion of the myenteric plexus. In one the upper small intestine was involved and the clinical picture was of recurrent pseudo-obstruction; in the other the lesion was in the distal colon and resulted in intractable constipation. The lesion cannot be demonstrated by conventional histological techniques, being seen only in silver preparations cut parallel to the bowel wall, and may have been overlooked in the past. The aetiology is unknown.

A reliable method of determining the presence of a pericardial effusion has been evolved. Ultrasonic waves reflected from the posterior part of the anterior chest wall and from the anterior surface of the anterior myocardium and pericardium produce echoes separated from each other by a bare area. This bare area varies in width and the variation has the same periodicity as the cardiac cycle.

Radioactive 125 I-labelled human fibrinogen was given to 11 recipients of cadaveric renal transplants and the radioactivity of the transplant was measured with a scintillation counter. In the six patients with no increase in radioactivity over the transplants there was no evidence of rejection. The five patients with an increased transplant radioactivity all had other evidence of rejection at that time. In one patient the test detected rejection in the absence of any other signs, and this result was afterwards confirmed by renal biopsy. The test in one patient was invalidated by haemorrhage occurring from the site of a renal biopsy, and other possible errors in the test may arise. It is suggested that the technique may have particular value in recipients with delayed function of their transplants, but may also be useful in patients with functioning transplants in helping to confirm the diagnosis of rejection suspected on other grounds.

Glucagon was administered to six patients with acute myocardial infarction. Three of them had cardiogenic shock syndrome. Glucagon produced a positive inotropic response in all cases, which resulted in a significant rise in blood pressure, with only slight chronotropic effect. No arrhythmias were induced, and all patients with cardiogenic shock improved temporarily. Further evaluation of glucagon in shock syndrome to determine the dose and method of administration is required.

In the management of the pregnancy complicated by rhesus sensitization the guidance given by amniotic-fluid pigmentation (Bevis, 1956 ; Walker, 1957 ; Mackay, 1961 ; Liley, 1961,1963) has greatly reduced the perinatal mortality from haemolytic disease. In the National Women’s Hospital, Auckland, with a policy of selective induction based on amniocentesis findings, this perinatal mortality has fallen steadily from 22% in 1957–8 to 9% in 1962. It was obvious that no further reduction could be expected from conventional treatment when of 7 perinatal deaths in 80 consecutive rhesus-sensitized pregnancies one baby had multiple congenital abnormalities and the other six were all hydropic before 34 weeks’ gestation. Transfusion in utero appeared the logical procedure for these very severely affected babies early in the third trimester, and intraperitoneal transfusion seemed the simplest technique.

In eight patients with folic acid malabsorption the malabsorption was reversed only when a combination of either 250 mg. of lyophilized human jejunal juice or 5 g. of lyophilized calf jejunum with 5 mg. of synthetic folic acid was fed; calf liver was ineffective. The factors in calf jejunum that re-established folic acid absorption were heat-stable and did not form polyglutamyl folates on previous incubation with folic acid.

Diazepam has been found to increase the duration of the neuromuscular block produced by gallamine and to reduce that produced by succinylcholine. Preliminary studies suggest that the action is at the presynaptic site.

Isolated hearts of dogs have been preserved in a viable condition for 72 hours with hypothermic perfusion (5 degrees C.) at normal atmospheric pressure. On removal and connexion to the femoral artery and vein of another dog these hearts beat strongly and without failing until removed after six hours. In mechanical function and histological appearance they were virtually identical with control hearts. The most useful criterion of viability of the quiescent myocardium during storage was the change in coronary resistance with time of perfusion.

The use of promethazine and chloroquine sulphate to reduce reaction to total dose infusion of iron dextran (Imferon) is described. The patients chosen for the investigation were anaemic pregnant African women living in the coastal region of East Africa where malaria due to Plasmodium falciparum is holoendemic. The results show that promethazine has little value in the reduction of reactions whereas chloroquine appears to be effective.

Renal ischaemia for one hour in two groups of Gunn rats, one with and the other without bile-duct ligation, produced comparable reversible renal tubular lesions in both groups. Since Gunn rats have an unconjugated hyperbilirubinaemia, which is unaffected by bile-duct ligation, it seems likely that the high levels of bilirubin glucuronide are responsible for sensitizing the renal tubules to ischaemia, possibly by depressing cell respiration.

Brain tumors were successfully located by probe couniting after an intra- arterial injection of 50 mu c P/sup 32/. The pattern of uptake of various tumors was the same by this method as after intravenous injection of the isotope. Adequate uptake for tumor location was obtained only within the field of supply of the injected artery. The use of a dose of 50 mu c by intra-arterial injection, one-tenth to one-twentieth of the dose suggested for intravenous use, avoided the necessity for isolation of the patient or special methods of urine disposal. It also greatly reduced the difficulty of handling the isotope in a neurosurgical unit where such material is used only occasionally. (H.H.D.)

Both cigar and cigarette tobacco produce an increase in the number of goblet cells in the rat trachea and intrapulmonary airways over a six-week period. The increase in goblet cells is similar for the two types of tobacco; in both it is proportional to increase in dose and greatest in the proximal intrapulmonary airways.

In a preliminary study rubidomycin was found capable of inducing remission in adults with acute leukaemia, the remission rate in acute myeloblastic leukaemia comparing favourably with that achieved with previous forms of therapy. Marrow aplasia and cardio-toxicity occurred in a number of patients. Supportive measures during the former and early recognition by frequent electrocardiography can do much to mitigate these toxic effects.

Four patients undergoing treatment with phenelzine developed low serum pseudocholinesterase levels. In one of the patients an apnoea of one hour followed modified electric convulsion therapy. In three cases investigations showed that the serum pseudocholinesterase levels returned to normal after withdrawal of phenelzine.

alpha-Adrenergic blockade with phentolamine significantly enhances the insulin response to arginine. In women phentolamine may inhibit the growth hormone response to arginine. It is suggested that adrenergic mechanisms may act as modulators in hormonal responses to infused amino-acid.

Nearly half the rats gavage-fed with aspirin and aspirin-containing mixtures developed papillary necrosis in 20 weeks. This incidence is similar to that found in rats on A.P.C. mixtures with high and low concentrations of p-chloracetanilide, an impurity of phenacetin. Aspirin alone produced necrosis in 7 out of 19 rats (36·8%) whereas phenacetin in the same dose had failed to cause any renal damage over six to nine months. If these results also apply to man they suggest that aspirin and not phenacetin may be the major factor in analgesic nephropathy in patients taking A.P.C. mixtures. An augmented clearance of aspirin appeared to afford some protection to the medulla, and it is suggested that this observation may have important clinical and epidemiological applications.

Antilymphocytic and antithymic sera (raised in rabbits) are highly potent in preventing or alleviating experimental allergic encephalomyelitis in guinea-pigs. Good results are obtained when treatment is begun as late as 10 days after challenge. No protracted disease was seen from the use of antilymphocytic serum. Attempts to use this serum therapeutically once the disease was clinically established gave equivocal results. Antilymphocytic serum appears to have a non-specific stressor effect as well as its specific action, and possibly this adrenocorticotrophic-hormone (antiphlogistic) effect may ameliorate a developing encephalitis. The presence of an antimacrophagic factor in antilymphocytic serum may be important in increasing local reaction to injection of the serum and perhaps also in diminishing the appearance of haematogenous elements in the nervous lesions.

With the measles platelet aggregation test, a new technique recently developed for measuring virus antibody, 153 serum specimens from patients with multiple sclerosis and 164 controls were tested. With one of the three measles antigens used in the test a significantly higher positive rate (P