Search

IN 1931, observations on 11 cases of chronic glaucoma showing the effect of reduced illumination on the field of vision were reported.1The present review has to do with 50 additional cases studied by the same method. The possibility that examination of the fields of vision with reduced illumination might reveal earlier changes is not a new idea. In his bibliography Duke-Elder2cited a paper by Haffmans,3published in 1861. Stargardt4had used this procedure in 1906. Ferree and Rand,5in 1922, suggested the advantages of taking fields at more than one intensity of illumination. In 1925 Edmund and Moeller6published the fields in a case of glaucoma, showing the effect of a graded series of photometric dark glasses. Traquair,7although he stated the belief that the use of small visual angles gives as much information, expressed the opinion that reduction of the

An electronic double flash unit has been constructed to measure photographically average linear velocity of blood flow in the bulbar conjunctival vessels of the human eye. Two exposures on the same photograph separated by a predetermined time delay (adjustable from 2 to 200 msec) permit computation of velocity from the displacement of red cells per delay time. The equipment is small and mobile, the procedure innocuous.

The case histories of six patients with severe salicylate intoxication are presented. The features of this disorder are discussed in the light of these case histories. The initial effect of salicylates on acid-base balance is the production of respiratory alkalosis. The basis for the respiratory alkalosis is a direct central effect which requires the anterior hypothalamus for its mediation. One of the important results of this respiratory alkalosis is hypokalemia. The hypokalemia is manifested by low serum potassium concentrations, electrocardiographic and neuromuscular changes. The persistence of hypokalemia when alkalosis is no longer present indicates that potassium depletion is likewise present. The manifestations of hypokalemia and potassium depletion may be reversed by adequate potassium therapy. Other consequences of the respiratory alkalosis may include tetany and interference with tissue oxygenation. Therapy for this phase of the disease include fluid replacement, potassium replacement, and oxygen. The use of alkali and of respiratory center depressants is contraindicated. Some patients with severe salicylate intoxication may develop metabolic acidosis following the stage of respiratory alkalosis. The manifestations of the respiratory alkalosis and metabolic acidosis are so similar that frequent blood pH measurements are necessary to guide therapy. This is particularly true because the disease may progress from one stage to the other without obvious change in the patient's status. The most important therapeutic agent for metabolic acidosis is the administration of sodium bicarbonate or lactate. Other important effects of salicylate intoxication include: fever, hypoprothrombinemia, hemorrhagic gastritis, hypermetabolism, hypouricemia, renal failure, delirium, coma, and ultimately central nervous system depression. The prognosis of the adequately treated patient would appear to be good.

THE practice of giving multiple transfusions of blood, not only for the emergency treatment of severe hemorrhage but also to meet the requirements of elective surgery involving extensive blood loss, and for priming the pump oxygenator in open-heart surgery, is increasing rapidly. Although bank blood is satisfactory in most emergencies, fresh blood is preferred in exchange transfusions and in operations involving cardiac shunt. The collection of large quantities of heparinized blood in a twenty-four-hour period imposes a burden on the blood bank, and, if not used, the blood cannot be returned to the bank for routine use and is therefore . . .

Bragg peak proton beam irradiation of the pituitary gland for proliferative diabetic retinopathy was carried out in 56 patients. Most of them had been considered unsuitable for surgical hy...