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Summary We report a case of multiple thrombo-emboli with embolic intrahepatic artery occlusion. Intrahepatic occlusion or stenosis is rarely reported but occurs commonly after cytoxic infusion after intrahepatic arterial catheterisation. Another interesting facet to this case is that his non-functioning kidney, secondary to renal artery occlusion, was first revealed during a brain scanning procedure. Most scanning isotopes are not organ-specific so pathology in other systems can be demonstrated by them. Multisystem disease is often vascular in origin and atherosclerosis is the commonest arterial pathology. However, atherosclerosis causing hepatic artery occlusion is very rare. Patients with multisystem disease causing cerebral symptoms often have a brain scan and it should be remembered that pathological processes in the urinary system can sometimes be demonstrated during the procedure. This is a case presentation in which the suspicion of renal artery occlusion was raised during the brain scanning procedure, and in the course of investigation of the multisystem disease, intrahepatic artery occlusion was noted.

We report two cases of rhinocerebral mucormycosis due toAbsidia corymbifera, an extremely uncommon causal agent. Both occurred in patients with haematological disorders and both had a fatal outcome, despite antemortem diagnosis and aggressive treatment. We discuss the factors which generally contribute to the poor prognosis in this group of patients and suggest another possible mechanism which may contribute to the high mortality.

An 18-month-old boy treated for congenital dislocation of the hip, developed osteochondritis dissecans of the femoral head. Serial roentgenograms demonstrated that the lesion had healed by the time he was 15 years of age. There have been no previous reports of healing of osteochondritis dissecans complicating congenital dislocation of the hip, or Legg-Calve-Perthes disease, although healing in idiopathic cases has been described.

Although osteoarthritis (OA) generally is considered a disorder of mechanical origin, the common occurrence of chronic mononuclear cell infiltrates in the synovium in conjunction with immunofluorescent evidence for immune-reactant products in cartilage of surgical case specimens (knees, hips, and peripheral joints) has suggested the local involvement of immune processes in the arthritis. Further, the findings of polyarthropathy in the majority of these cases have indicated the propensity for a systemic disorder. Wide variations were noted in both synovial and cartilage immune changes, quite different to those found in rheumatoid arthritis, along with the frequent asymptomatology of the many joints involved. These features, with and without other causative factors, suggest that immune reactions of local and/or systemic origin occur at times in a population at risk for joint degradation.

A comparison of the services provided for the elderly in Great Britain and the United States shows the impact that organized medical care has on day-to-day clinical activities. The British...

Sodium valproate (VP) inhibited oxidative phosphorylation in isolated rat liver mitochondria. State 3 rates of oxygen consumption with glutamate as substrate were 80% of control values at a low VP concentration (24 microM). At 240 microM, there was more than 50% inhibition of glutamate and alpha-ketoglutarate state 3 rates. Succinate state 3 rates were 80% of control values, and uncoupling was noted at 2400 microM VP. These VP effects were similar to those of propionate and isovalerate, suggesting a common mechanism of toxicity. Inhibition of mitochondrial oxidative phosphorylation may explain why VP intoxication causes a hepatocerebral disorder that resembles Reye syndrome.

An electronic system for automatically testing the human visual field is described in the context of mass screening for visual disorders, such as glaucoma. Present methods of field testing are briefly reviewed. The new system is patient operated and uses a television monitor as the means for presenting the test stimuli and displaying the results. A multilevel map of a patient's retinal sensitivity is produced in a form which is readily interpreted by an ophthalmologist. A data-transfer unit enables the local storage of results and allows direct access to a computer. Preliminary clinical trials show good agreement with conventional field-testing methods, and yield more detailed information than has hitherto been feasible on a routine basis.