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The recent studies of Zinsser1concerning the possible relationship of Brill's disease to a previous typhus fever infection suggests the importance of determining by a simple test a previous infection with typhus fever.Inasmuch as many such patients are of foreign birth, and in whom infection had probably occurred some years previous, the clinical history is not always readily obtained. Likewise, a Weil-Felix reaction usually becomes negative with, or soon after convalescence and therefore cannot be used for this purpose.The present work described the use of formalized Rickettsia suspension for this purpose. Fleck and Kurkowski2found that filtrates of Proteus X 19 were ineffective. Our tests were carried out with a formalized Rickettsia suspension made from tunica vaginalis scrapings kindly furnished us by Zinsser of Harvard University.Accordingly, a series of 12 males who had had typhus fever, the diagnosis having been established 6 months previously in one case, and in the remainder from one year to 8 years were given the test about to be described. These cases were obtained through the courtesy of Dr. J. Rosenbluth, of the Bureau of Communicable Diseases of the New York City Department of Health. In all these cases the diagnosis had been confirmed by a positive Weil-Felix reaction with the exception of one in which the Weil-Felix had not been carried out.For the control, 10 adults with no previous history of typhus fever infection were given a similar skin test. The test consisted of an intracutaneous injection of 0.1 to 0.2 cc. of formalized Rickettsia suspension. The patients were observed 24 to 48 hours after the injection. None of the controls gave any reaction, whereas all the 12 with the previous history of typhus infection showed an erythematous indurated area from 1 cm. to 4 cm. in diameter.

Any investigations which throw light on the causation or treatment of that greatest of obstetrical calamities, rupture of the uterus, are of importance to the obstetrician, the surgeon and the general practitioner. The most frequent causes of this condition are obstructions to the descent of the fetus, with neglect of the procedures necessary for delivery of the child, as in patients treated by midwives or by the laity. Such obstructions are often in the form of contracted pelves, or tumors of the pelvis encroaching on the parturient canal. A normal fetal head of large measurements or a hydrocephalic head may cause obstruction by failure to enter a normal pelvis. Malpositions of the fetus, as a transverse position with a shoulder presentation, lead invariably to obstruction unless properly cared for.Rupture of the uterus has been the direct result of manipulations, as attempted versions or the use of the hand or

A single mAb is an effective therapy in nonhuman primates infected with Marburg or Ravn virus.

In a previous report, one of us (Goodman) had outlined the evidence for the belief based upon epidemiological studies of others that thrombo-angiitis obliterans was a late manifestation of typhus fever. Since that time, Zinsser has pointed out in studies of Brill's disease that typhus infection may remain latent in the body for an indefinite length of time.In a previous communication we have pointed out that a formalized Rickettsia suspension seemed to give a positive skin reaction in individuals with a previous typhus infection. Therefore we attempted this skin test in a number of cases of thrombo-angiitis obliterans in order to determine whether or not they had had a previous infection of typhus fever.Accordingly, 14 males clinically diagnosed as thrombo-angiitis obliterans, some with and some without gangrene, were given intracutaneously 0.1 to 0.2 cc. of formalized Rickettsia suspension as used previously. At the same time for control, an injection of a similar amount of Proteus X19 filtrate was also likewise injected at a different site. A group of 12 controls included 2 with arteriosclerosis. The site of the injections was examined as in the previous study after 24 to 48 hours following the injection. The results are enumerated in Table I, where a negative reaction indicates no erythema or induration, and a + reaction a wheal or raised, reddened, indurated area 1/2 cm. to 1 cm. in diameter, and a ++ reaction from 1 cm. to 3 cm.The cases diagnosed clinically as thrombo-angiitis obliterans show a positive skin test with Rickettsia organisms which suggests the possibility of previous typhus fever infection. Moreover, a number of the cases diagnosed as thrombo-angiitis obliterans came from typhus infected areas.Of course the series is small and likewise further controls are required by skin-testing other vascular conditions as well as skin tests with further control suspension, such as tunica vaginalis and guinea pig testicle.

When Congress 'grandfathered' existing coal-fired power plants form its strictest regulatory standards in the 1977 Clean Air Act Amendments, it was on the expectation that the old plants would soon be closed. Nearly a quarter century later, federal and state agencies are suing eight power companies for allegedly making substaintial modifications to dozens of plants without undergoing the stringent New Source Review permitting procedure that brand-new plants must face. The result, say the agencies, is longer lives for the plants, and more pollution. The companies argue that the modifications don't cross the threshold that would make the plants subject to New Source Review. At the same time, the whole concept of New Source Review is under scrutiny -even attack- by a wide range of interests. New sources must install prescribed Best Available Control Technology in CAA attainment areas for a particular pollutant, while new sources in non-attainment areas must install even stricter Lowest Achievable Emissions Rate technology. Both methods are costly, offer industry little alternative in compliance, and discourage the entry of cleaner technologies, critics say.As a result of all this controversy, some members of Congress are considering banishing or significantly amending New Source Review to grant business more flexibility to innovate in meeting the act's pollution abatement and public health goals. The end of grandfathering has also been featured in congressional proposals. Meanwhile, EPA officials are talking about reforms of their own to rationalize the permitting process for all power plants, new and old. Is it time to end grandfathering, so that old coal-fired plants can be retired? And is it time to look at the New Source Review program to see if it shouldn't beretired -or rejuvenated- at the same time? [ABSTRACT FROM AUTHOR]

Presents a letter to the editor in response to the article 'Blood Relations,' by Bill Amos in the November 1995 issue.

In studies of the conditions incident to the cause of autolysis and the dissolution of the transplant, we devoted especial attention to the influence of hemolysis and agglutination on transplants. No question is more timely than that concerning the causes of their absorption.Most authors lay great stress on the importance of eliminating the two great dangers in blood transfusion — hemolysis and agglutination. We must consider blood transfusion not only as an infusion of a certain quantity of fluid, but also as a transplantation of a definite mass of tissue represented by the cellular elements of the blood.Accordingly, before transplanting the thyroid, we first made hemolysis and agglutination tests, and operated only when these reactions were absent.Owing to difficulties in obtaining and in handling the blood (which have since been obviated to some extent by a new method), we are thus far able to report results in