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Biobrane remains an excellent biosynthetic dressing for thermal injury coverage. The present report of a probable case of toxic shock syndrome associated with its use does not question its efficacy as temporary coverage for partial thickness thermal burns. Instead, attention is focused on raising the index of suspicion of toxic shock syndrome in burn patients treated with Biobrane, or other occlusive dressings, who develop early signs or symptoms which may be consistent with the diagnosis.

Loxapine was introduced to the British market two years ago although it has been used in North America for eight years. We report the first probable case of neuroleptic malignant syndrome (NMS) secondary to loxapine in Britain. Two previous cases have been reported in North America (manufacturer's data).

The reproductive biology of the Montpellier snake (Malpolon monspessulanus) under natural conditions is poorly known. It is commonly accepted that, as in other colubrids, it lays its eggs under dry leaves (Naulleau, 1984) or in crevices in the ground (Hailey, 1982). Burger & Zappalorti (1986), while noting that the reasons for nest site selection have not been studied in snakes, suggest predator avoidance and protection of eggs from inclement weather. Both factors may be extremely important for nest-site selection in our study area, the Donana National Park (37°7′, 36°48′ N; 6°12′, 6°30′ W) which is extremely dry, with hot summers and mild winters. Montpellier snakes lay their eggs in mid-July, well into the summer (mean rainfall = 4°7 mm; average temperature = 22°28 °C, for June, July and August period). Additionally, densities of potential predators are also very high (Valverde, 1967). Consequently, selection of protected nest sites is likely to be extremely advantageous for this snake since both predation and desiccation of eggs will be reduced. As the sandy ground lacks natural crevices and holes, the use of dens of animals such as bee-eater galleries (Alvarez, 1974) and rabbit warrens may be favoured.

In Reply. —The arguments formulated by Dr Domen are difficult to follow. In his previous letter 1 he mentions historical cases of rheumatoid arthritis, one found in an Egyptian mummy from the Fifth Dynasty (2750 to 2625 BC) and the probable case of Emperor Constantine IX (c 980 to 1055 AD). Now he supports the hypothesis that rheumatoid arthritis originated in the New World and entered the Old World after the 15th century. The case of rheumatoid arthritis seen in the painting that we described dates back to 1430 to 1440. It thus predates the arrival in America of Columbus in 1492. In addition, we reported another patient with rheumatoid arthritis of the robust type in a priest born in Holland 76 years after the discovery of the New World. 2 The present published reports do not support the possibility that rheumatoid arthritis in Europe originated in the New World.

症例は59才男性.主訴は口唇潰瘍,皮疹.昭和59年1月,顔面に丘疹,口唇,舌に潰瘍出現し,つづいて無痛性の亀頭部潰瘍が出現した.プレドニゾロン療法をうけ症状の軽快をみたが,投薬中止後,症状増悪し入院となつた.入院時顔面に丘疹,下口唇に潰瘍を認めた.白血球数は14300/μlで,好酸球は30%と増加し,血中ビタミンB12が14540pg/mlと異常高値を示し, hypereosinophilic syndrome (HES)と診断した,粘膜潰瘍がhydroxyureaに反応したこと, Behcet病やStevens-Johnson症候群の粘膜潰瘍とは病像が異なったこと,外国に粘膜潰瘍を初発としたHESの2症例の報告のあることがら粘膜潰瘍をHESの-症状と考えた. HESに粘膜潰瘍を伴うことはまれである.

SUMMARYAstyanax schubarti is characterized by a diploid number of 36 chromosomes. In the present paper we report on the occurrence of a specimen with 54 chromosomes, a probable case of natural triploidy as shown not only by the chromosome number but also by the good morphological correspondence between the chromosomes of the 3x and 2x individuals. The fertilization of an unreduced oocyte is postulated as the probable cause of this triploidy.

Summary: A probable case of superfetation is recorded. An attempt is made to establish the differential development of the 2 fetuses by a histological comparison. Evidence for a second and later ovulation and fertilization as the basis for superfetation is presented and discussed.

SUMMARY:A case is reported in Montreal of human cysticercosis in a 44-year-old man who emigrated from Italy in 1956. Numerous subcutaneous nodules were found throughout his body. X-ray of his thighs and chest sho wed oblong calcific densities measuring 1 x 0.5 cm in size. Examination of an excised nodule from the right biceps revealed a cysticercus larva morphologically similar to Cysticercus cellulosae although the scolex lacked hooks. On the basis of the intensity of infection, focal and generalized epileptic seizures, changes in the CSF, and well demarcated lucencies observed in brain scan, cerebral cysticercosis was considered the most likely diagnosis.

Collins, Henry B., Jr. '1937 Archeology of St. Lawrence Island, Alaska. Smithsonian Institution Miscellaneous Collections 96(1). Bandi, Hans-Georg 1967 Preliminary report on the "St. Lawrence Island Archaeological Field Project 1967" of the University of Berne/Switzerland and the University of Alaska. Birket-Smith, Kaj 1959 The Eskimos, second edition. Methuen, London. Geist, Otto W. 1928 Diary. University of Alaska Archives. Larsen, H., and F. Rainey 1948 Ipiutak and the Arctic whale hunting culture. American Museum of Natural History Anthropological Papers 4 2. Nelson, Edward Wm. 1899 Eskimo about the Bering Strait. 18th Annual Report of the Bureau of American Ethnology to the Smithsonian Institution 1896-97. Zimmerman, Michael R., and George S. Smith n.d. A probable case of accidental inhumation of 1600 years ago. New York Academy of Medicine, Bulletin. (In press, ms. 1974.) et-Smith, Kaj

Amongst skeletons recovered from an archeological survey at Roonka on the lower Murray River in South Australia was that of a pregnant woman. The position of the full term foetus and evidence of head trauma to the woman suggests that a mercy killing took place following failure of childbirth. The study of this burial provides an insight into Aboriginal society which would not be available from other sources.

During the excavation of isolated graves along the north shore of the Orange River in the Cape Province of South Africa, a skeleton was uncovered that showed two large calcareous deposits near the lumbar region of the vertebral column. The individual was an adult female of about 55 years of age at the time of death. The calcified residue did not in any way resemble the external or internal anatomical form of a kidney, but X-ray powder diffraction analysis and scanning electron microscopy identified the material as apatite (Ca10(PO4)6 · (OH)2), a common constituent of human urinary calculi. It is postulated that the bilateral calcification was the result of a chronic renal disorder. Although it is rarely possible to identify the cause of death from skeletal remains alone, the disorder as seen in this specimen would appear to have been very severe and may well have been the ultimate cause of death.

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1.1. Two illustrative proven cases and one probable case of embolic mycotic aneurysm complicating bacterial endocarditis are presented. 2.2. Fifty-nine additional cases reported since the last complete review in 1923 have been compiled and are analyzed. 3.3. The development of an embolic mycotic aneurysm is an unusual but serious complication of bacterial endocarditis. 4.4. Four characteristic clinical syndromes are described which allow for recognition or a high index of suspicion. These syndromes reflect the intracranial, abdominal, thoracic or peripheral extremity location of the mycotic aneurysm.

Summary Three proved and one probable case of brain abscess in infancy are presented. Two of the patients died. With use of the appropriate antibiotic in three cases, plus the intraventricular instillation of Varidase in two instances, the infections were brought under control. The problem of resulting hydrocephalus remains, however, and accounted for the death of one of our patients.

SUMMARY 1 A resume is given of the work of those investigators who have recorded the occurrence of diseased shoots arising from potato tubers infected by P. infestans. 2 An experiment is recorded in which of 25 naturally infected tubers planted early in April in pots in the greenhouse, 2 produced by May 16th short diseased shoots, which developed conidiophores and spores. These shoots, doubtless infected ab initio by mycelium growing from the tuber, were closely similar to those which have been described by de Bary and other investigators. 3 A probable case of secondary infection was observed on a leaf on one of the healthy shoots of a plant which produced a diseased shoot.

There is a persistent notion in the literature on caste in India that new castes tend to develop within the caste system. Heretofore largely unsubstantiated, this notion receives support from the data of the present paper, which argues that a new caste is in the process of formation in an area of north India. The inevitability, given certain conditions, of new caste formation within an established caste system is posited, and such formation is hypothesized as both a reflection and one of the chief causes of the great stability of the Indian caste system.

Lymphoreticular proliferative disorders are described in two lizards. The first case, in an East Indian water lizard, Hydrosaurus amboinensis, was classified as a diffuse type of malignant lymphoma of lymphoblastic cell type and is the first known example of a hematopoietic neoplasm in a lizard (class Reptilia; suborder Sauria). The second case, in a Malayan monitor, Varanus salvator, also presented features characteristic of a generalized lymphosarcomatosis, but granulomas associated with a disseminated bacterial infection complicated the picture and precluded an incontestable diagnosis.

A probable case of reciprocal beating of the atria in a patient with prolonged A-V conduction and 2:1 A-V heart block is reported. The difficulties in making this diagnosis are discussed.

There have been isolated reports in the last 10 years of patients, who had previously been in excellent health, who present with swelling and pain in a peripheral part which is followed by extensive skin loss. It has been presumed that these presentations relate to a creature that has bitten the patient but as yet no creature has been caught in the act of biting; indeed, many patients do not even feel a bite. In view of the rarity of this problem, invariably other diagnoses are considered. This paper describes such a case.

A 25-year-old white woman was evaluated for "spots" on the roof of her mouth of 2 days' duration. The initial history, physical examination, and laboratory data all failed to indicate any cause for the bleeding diathesis. Therefore, a more intensive history was initiated which disclosed a probable case for fellatio as the cause of the spots. The intraoral examination showed the spots to be petechial hemorrhages located on the soft palate in the area of the insertion of the tendons of the tensor veli palatini and levator veli palatini muscles. The mechanism of injury producing these petechiae was postulated to be the combined muscular actions initiated reflexively through tactile stimulation and the negative pressure created through irrumation, both acting simultaneously on the mucosa of the soft palate. This case is presented to illustrate an addition that should be made to the differential etiologic factors of intraoral petechiae.

A non-consanguineous union between two people with congenital aniridia is described which resulted in the stillbirth of a female fetus with complete absence of eyes, nose, and adrenal glands.

In a prior paper I have described, from central New York, an archaeological instance of probable bear ceremonialism in the Owasco culture. A recent find in western New York, although of somewhat dissimilar character, strengthens the probability of the existence prehistorically in New York of a special and reverential attitude toward the bear, this time apparently among an Iroquois people. Briefly, the nature and circumstances of the new discovery are as follows.

SummarySera from 539 persons above 15 years of age were selected by random sampling from the 10,000 inhabitants in a typical Finnish country town. Clinical examination revealed 19 definite and 31 probable cases of rheumatoid arthritis. The Waaler-Rose test used as serological criterium transferred one probable case to the »definite» group and made two possible cases »probable». The latex test gave much more »non-specifically» positive results than the bentonite or the Waaler-Rose tests, but at least the Singer-Plotz latex test gives considerably more positive results in the case of rheumatoid arthritis than the Waaler-Rose test.

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Chief Complaint.—Pain in the left hip region when stepping up or down. Family History.—Irrelevant. Past History.—Childhood uneventful. At 15 years of age the patient had an osteomyelitis of the left tibia, which was operated on and which healed promptly. She enjoyed good health until she was 22 years of age. At that time she fell downstairs, striking her right thigh, but was able to get up and walk. A few days later, while lying on the beach, she turned quickly and fractured her right femur at the junction of the middle and lower thirds. At that time a diagnosis, on the basis of an X-ray examination, was made of a pathologic fracture due to osteitis fibrosa cystica. The fracture was treated in the usual manner and bony healing resulted. During the following winter the patient received some X-ray treatment over the region of the fracture. She enjoyed good health until February, 1930, when she began to complain of pain in the left hip joint region when going up and down stairs or when she remained seated in...

This chapter discusses conditions in the uranium market in 1982. It discusses the revised Institute figures for nuclear generating capacity and presents its comparison with the estimates that were published in April 1981. The continued cancellations and deferrals of reactors, combined with few new orders, account for the reduced forecasts of nuclear generating capacity in the years to 1995. The chapter presents a breakdown of nuclear generating capacity by major world areas for the most probable case. In the period 1982–1984, capacity forecasts have been reduced by approximately 2%, reflecting the fact that while nuclear plant construction is reasonably well determined for the next three years, some delays have occurred. In the period 1985 to 1988, decreases in generating capacity are smaller because some reactors that had been delayed from earlier years are projected to come on stream during this period. The slight increase in some years is because of improved lead times in countries such as France and West Germany.

Excerpt To the editor: We read with interest the report by Farber and Laguarda (1) of their use of serologic diagnosis in a probable case of human pulmonary nodular disease due toDirofilaria immiti...

One factor in a disaster, such as a small bus accident with about 30 injured up to the scale of an airplane crash, is the geographical location or the region in which the catastrophe happens. Even with well prepared disaster plans, any emergency case in open country will naturally have a different course from that in highly populated areas. In every accident, emergency, or catastrophe, the first helpers always immediately call for a doctor. In the most probable case, the first doctor to arrive at the site of the emergency is a general practitioner.

A patient is described in whom Huntington's disease was diagnosed at the age of 34 years. No evidence of the disorder was found in either parent. Their parentage of the alleged mutant could not be excluded from a study of the inheritance of 25 genetic markers.

Rapid, and rising, urbanisation now characterises world development. But this is not a simple condition. While the overall pattern is plain and persistent, its specific features vary considerably.

This report concerns a probable case of metastatic malignant bone tumor in the skull of a prehistoric skeleton from Honshu Island in Japan. In gross observation, a fragmental skull of an adult showed many osteolytic lesions without any healing processes which could be also ascertained by roentgenological studies. Besides this case, four cases with a diagnosis of malignant bone tumor have so far been reported among archeological skeletal remains in Japan. This case from the prehistoric "Jomon" period is certainly the oldest case showing such malignant tumorous change in the skeleton. In this report, the osteolytic changes in the "Jomon" skull are described in detail and compared with two other cases showing the same osteolytic changes. The morphology and distribution of the lesions as well as the sex and age of the individual are discussed to make an adequate differential diagnosis for malignant osteolytic lesions in the skeleton.

Many bizarre urinary tract abnormalities have been reported in association with imperforate anus. 1–3 However, there has been no mention of uretero-vas deferens anastomoses. We have had one case proved by surgery and another probable case documented by cystourethrography in which right vesicoureteral reflux demonstrated the vas deferens as originating from that ureter.

The convincing clinical and experimental evidence 1 of the antifungal properties of 2-dimethylamino-6-(beta-diethylaminoethoxy)-benzothiazole dihydrochloride (asterol® dihydrochloride) has led to its widespread use in human mycotic infections. It appears to be especially popular in the treatment of children afflicted with tinea capitis. The medicament, marketed as 5% ointment, tincture, and powder, has not seemed to cause undesirable side-effects in any of these forms; however, the recent notation of Stritzler 2 indicated that he had encountered one probable case of neurotoxicity in a patient treated with excessive amounts of asterol® dihydrochloride in a series of 500 patients receiving this medicament. He also mentioned another case observed by Dr. Irving Fishman and a third "in North Carolina," this last being case 3 reported here. REPORT OF CASES Case 1.— 2½-year-old white boy was first seen by Dr. Conrad Stritzler on Oct. 22, 1951, with tinea capitis due to Microsporum audouini. Routine treatment with