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Peripheral neuropathy can be the first and only manifestation of necrotising primary immune-mediated vasculitis which, carries a high mortality. A clear idea of how to both recognise and treat peripheral nervous system vasculitis is important. We provide a practical approach to immediate and longer term treatment protocols.

We compared the cost-effectiveness of general anaesthetic agents in adult and paediatric day surgery populations. We randomly assigned 1063 adult and 322 paediatric elective patients to one of four (adult) or two (paediatric) anaesthesia groups. Total costs were calculated from individual patient resource use to 7 days post discharge. Incremental cost-effectiveness ratios were expressed as cost per episode of postoperative nausea and vomiting (PONV) avoided. In adults, variable secondary care costs were higher for propofol induction and propofol maintenance (propofol/propofol; p0.01) than other groups and lower in propofol induction and isoflurane maintenance (propofol/isoflurane; p0.01). In both studies, predischarge PONV was higher if sevoflurane/sevoflurane (p0.01) was used compared with use of propofol for induction. In both studies, there was no difference in postdischarge outcomes at Day 7. Sevoflurane/sevoflurane was more costly with higher PONV rates in both studies. In adults, the cost per extra episode of PONV avoided was pound 296 (propofol/propofol vs. propofol/ sevoflurane) and pound 333 (propofol/sevoflurane vs. propofol/isoflurane).

A technique that exposes fingerprint residue to a gaseous electrical discharge in nitrogen followed by treatment with ammonium hydrogen carbonate vapors to produce fluorescence is investigated. Particular attention is made to fluorescence observed via laser illumination at 514 nm. Insight into the nature of the fluorescent components is achieved through the use of thin-layer chromatography (TLC) of fingerprint residue. Results reported indicate the fluorescence observed is from previously non-fluorescent fractions of the fingerprint residue, and TLC results point towards lipid derivatives as a possible source of the fluorescence.

The use of lasers for the detection of fingermarks is widespread in the forensic field. Despite this, and the fact that many studies have been conducted into the composition of fingermark residue, the components responsible for the inherent visible fluorescence remain unidentified. Traditionally compositional studies have been performed on sweat, sebum, or skin surface washes, none of which are truly representative of the situation when a fingerprint is deposited on a surface. In this paper thin-layer chromatography (TLC) has been performed on sebum-rich fingermarks laid directly onto TLC plates and an argon ion laser used to visualize the separated components. It has been found to be a robust and reproducible method for studying the fluorescent components in fingermark residue and is considered to be more realistic than other methods of sample preparation as it eliminates the chances of extraneous matter being extracted from the skin surface. Investigations into the nature of the separated compounds have also been made and the results are reported.

Authoratative government pandemic preparedness requires an evidence-based approach. The scientific advisory process that has informed the current UK pandemic preparedness plans is described. The final endorsed scientific papers are now publicly available.

The total direct cost of treating schizophrenia in the UK is 397 million pounds, or 1.6% of the total health care budget. Hospital-based and community-based residential care accounts for nearly three-quarters of these costs, while drugs account for only 5%. A conservative estimate of the indirect annual costs of lost production is in the region of 1.7 billion pounds. The heterogeneity of the disease and its outcome means that average treatment costs per person with schizophrenia should be treated with caution; 97% of direct costs are incurred by less than half the patients. Therefore, treatments which reduce the dependence and disability of those most severely affected by schizophrenia are likely to have a large effect on the total cost of the disease to society and may therefore be cost-effective, even though they appear expensive initially.

The Second Report of the Marshall Study Group, entitled “An Assessment of the Integrity of PWR Pressure Vessels,” was published recently by the United Kingdom Atomic Energy Authority. The Report considers the integrity of a 4-loop PWR pressure vessel as now made, from the best available materials and using the most modern fabrication practices.

The entrapment of gas atoms at damage sites created during their injection as energetic ions into a solid, is treated theoretically. A general treatment is indicated and a special theory, based on the assumption that the spatial distribution of traps is uniform, is developed. The special theory leads to analytical solutions, which are dependent on the initial spatial distribution of free thermal gas, (i.e. the ‘range profile’). Three cases are considered (plane, xe−x and e−x distributions). It is shown that the assumed model provides that the amount of gas trapped in the solid is initially proportional to the ⅜-power of the ion fluence.

A silicon (111) surface was bombarded in U.H.V. with low energy (≤1 keV) He+ and Kr+ ions. The ions retained within the solid were subsequently desorbed into a closed volume, by raising the target temperature linearly, with respect to time, at a rate of 30°KS−1. The differentiated signal in a mass spectrometer provided desorption spectra. Two main release stages were noted, at ∼400°K and ∼1000°K. It is suggested that the former is related to divacancy motion, modified by the presence of gas and the latter to the annealing of bombardment-induced amorphousness. Helium was injected into a target which had been amorphized by prebombardment with krypton ions. The helium was largely released in the ∼400 °K stage and it was deduced that helium diffused through an amorphous layer at temperatures well below those required to anneal the amorphousness.

The author summarises recent reports regarding the appearance in Mesozoic rocks of Blanckenhorn's genus Dictyoconus, long supposed to have originated in the Middle Eocene. He figures and describes the best known of these Mesozoic forms, in order to place its age and generic attribution beyond question, and discusses the problem of its relationship to allied genera as affected by its early appearance. He then describes d'Orbigny's contemporary (Cretaceous) genus Orbitolina, with which Dictyoconus has often been confused, in order to show its radical difference in structure and the characteristics of forms which can be more justly regarded as related to it. He also discusses the genotype of Orbitolina, since the species lately quoted as such is unsuitable.

A polycrystalline rhenium target was bombarded in UHV at room temperature with low-energy A+ and He+ ions. The ions retained in the solid were desorbed into a closed volume by raising the target temperature linearly, with respect to time. The differential signal in a mass spectrometer provided desorption spectra and trapping coefficients were estimated. The behaviour was found to be similar to that observed in other metals. In the case of He+ ion bombardment, the damage state of the target prior to injection was varied by pre-bombarding with A+ ions. It was found that this damage considerably increased the amount of helium trapped: the trapping was predominantly at defects caused by the pre-bombardment. Helium was released at temperatures characteristic of the release of the argon, which caused the damage. The helium thus traced the damage present in the target prior to bombardment.

The author recalls the various opinions which have been expressed as to the relationships of Blanckenhorn's genus Dictyoconus to other foraminiferal types. He shows how Dictyoconus has been affiliated to the genera Lituola, Lituonella, and Coskinolina by such authorities as Messrs Schlumberger, Douvillé, and Schubert in the past; but has since been dissociated from them by Professor Cushman in his recent monograph on the Foraminifera. The author then discusses the grounds for this dissociation, which seem to him to be inadequate; and he describes his discovery, in certain Lower Eocene beds of Northern Baluchistan, India, of numerous specimens of Didyoconus, Coskinolina, and Lituonella, mixed indiscriminately together within the same narrow limestone bands, and deceptively similar in external appearance. He describes the differences between these genera—differences which are confined to the peripheral portion of the test—and shows how sections of the three Indian forms reveal the closest agreement in their internal characters as a whole; their generic characters alone affording the means of distinguishing between them. He therefore regards these Indian forms as affording clear evidence of the close affiliation of these three genera. These Indian forms, which are the first representatives of their respective genera to be found so far east, are very similar to such western forms as Dictyoconus egyptiensis (Chapman), Coskinolina liburnica Stache, and Lituonella roberti Schlumberger and Douvillé; but they have individual peculiarities of their own, and so are described by the author as three new species.

The author emphasizes the distinction of the marine Paleocene fauna of India from that of Europe, and its resemblance to that of the West Indies (Antilles). He suggests a marine connection between West and East Indies across North Africa, south of the Mediterranean region, in basal Tertiary times, before the Americas had drifted far from Europe and Africa.

The author recalls the facts regarding the rediscovery, in recent years, of Carter's genus Conulites ( = Dictyoconoides Nuttall). He shows how, of seven species which have been referred to this genus, three always have numerous intercalary whorls in their spires, and four never have any such whorls. The association of these two groups together within a single genus has, so far as he himself is concerned, been due to the uncertainty hitherto existing regarding the type species cooki, whose spire was stated by Carter sometimes to show an intercalary whorl, but generally to be “single throughout.” Carter's original specimens, which had long been mislaid, have recently been found, however, and they all prove to belong to now familiar types, which invariably contain numerous intercalary whorls in their spires. The author therefore separates the four species which do not possess such whorls into a new genus, Lockhartia.The author next discusses the supposed identity of Dictyoconoides with Rotalia, and shows that the Rotalia must be judged by their type species R. trochidiformis. He shows that this species, among other characteristic features, invariably displays the structures called “astral lobes” by Carpenter and Brady, and is distinguished by the same from both Dictyoconoides and Lockhartia; while it is further distinguished from Dictyoconoides by the absence of intercalary whorls in its spire.The author then compares the development of Rotalid forms, like the above, with that of piano-spiral ones like Nummulites and Assilines; and he finally shows the fundamental difference in structure between all these spirally wound types and those with an “end-on” development, like the Dictyoconus group of forms, with which some of them have been confused in the past.

In a recent paper (1940) I discussed the origins of the Indus, Jhelum, and Sutlej rivers. I suggested that the upper Jhelum resulted from the final severing of marine communications with Tibet by the rise of the north-west Himalayan axis at the close of Laki (Lower Eocene) times. The upper Indus probably originated rather later, from the overflow of Tibetan drainage ponded by the rise of this axis. The upper Sutlej I held to be much younger, and due to a geologically recent collapse of the main Himalayan axis along the line of an old (Gondwana) fault-trough.

In this lecture we will discuss two areas associated with fast breeder reactors. The first is safety and the second is the fuel cycle.

We now turn to the most difficult lecture of this series concerning fast breeder reactors because we are now going to discuss questions which are not scientific, not technical nor even economic; we are going to discuss a range of issues which, in recent years, have alarmed some members of the general public about the use of fast reactors. In short, we shall consider the emotional question of the “plutonium economy”. Opponents to fast reactors do not always make their points clear but so far as we are able to understand them, the “social” objections to the fast reactor fall into one or all of six areas.

The subject of these lectures will be the Fast Breeder Reactor. At the outset let us make some statements which will serve to illustrate the importance of this subject.

There is currently interest in the effectiveness and cost of the intraocular lens as compared with other methods of correcting aphakia following cataract extraction. We have undertaken a retrospective review of patients undergoing cataract surgery by the extracapsular method at Moorfields Eye Hospital during the period January 1982 to July 1983. From the total population we selected at random two groups of patients, having their aphakia corrected either by means of a contact lens or an intraocular implant. Patients under the age of 60 years and those with complicating illnesses were excluded from the study. Using case notes, we followed the sample patients from the time of referral until one year after the operation, and recorded a number of clinical and economic variables such as waiting time for operation, length of inpatient stay, incidence of per- and post-operative complications, number of follow-up visits, final visual acuity and (for the contact lens patients) waiting time for lens issue and average daily wearing time. We found that the visual acuities obtained, and the total costs to society, were similar for the two groups.

While various possibilities for the design of the fast breeder reactor exist, you will remember that the main development of the technology has been along the line of mixed oxide fuel, steel cladding and liquid metal coolants. We will restrict ourselves to the consideration of the design of this sort of reactor in this lecture, where we will describe some of the features in some detail. The performance of the fast breeder reactor can be varied with respect to the size of its specific plutonium inventory (the amount of fissile material required for the cycle of operation) and also the breeding gain (i.e. its excess plutonium production) and hence its doubling time, by altering some of the basic core parameters.

So far in these lectures we have looked at some fundamental points concerning fast reactors, we have reviewed the technological problems in developing them and we have examined the fuel cycle which is required to maintain them. We shall now turn to the more difficult task of discussing the economics of fast reactors.

Summary: Drug induced interstitial nephritis, hepatitis and exfoliative dermatitis. Robyn A. McMenamin, L M. Davies and P. W. Craswell, Aust. N.Z. J. Med., 1976, 6, pp. 583–587. Acute interstitial nephritis associated with hepatitis, exfoliative dermatitis, fever and eosinophilia is uncommon. The syndrome has been described previously in association with phenindione administration, leptospir-osis and heavy metal poisoning. Four cases are described, two of which were due to phenindione sensitivity. The other two patients had been exposed to a number of toxins inclucling allopurinol, frusemide, chlorothiazide and methyldopa so that the exact aetiological agent is unclear. Interstitial nephritis should be considered as a cause of acute renal failure in patients with other features of drug hypersensitivity.

WITH regard to recent letters on this subject1, I would recall in addition that Mr. R. V. Anderson reported finding Quercus in the Punjab Saline Series2; while Foraminifera said to be from the same were referred by me to Ranikot species. Commenting on my report, Sir Lewis Fermor remarked that: "The discovery of these fossils indicates a Ranikot or post-Ranikot age for the Salt Marl Series, and appears to set at rest the long controversy about the age of the Salt Marl. We appear now to know that the age of this series is Tertiary and not Cambrian"3.

WITH reference to Sir Cyril Fox's interesting article under the above heading1, I wish to make certain comments. I think that nobody maintains that the Kohat-Potwar Saline Series is of post-Eocene age. As Prof. Sahni says2, his "fossil evidence is consistent with any geological age from the Lower Tertiary to the recent. But since on stratigraphical grounds the Saline Series cannot be younger than early Tertiary, the conclusion is that it is of Eocene age". I have shown3 that the latest marine beds of that region are of Upper Khirthar (Auversian) age; so there were apparently no marine waters to desiccate, in that region, after the Eocene.

THE members of certain pairs of foraminiferal genera (Nummulites and Operculinoides, Assilina and Operculina, etc.) with flat spiral tests are distinguished from each other only by the rates (or angles) of opening of their spires. It therefore seems anomalous that no ruling exists as a guide in separating forms after this manner; for although the right allocation is often obvious, there are intermediate forms which might, at present, be as legitimately referred to one genus as to the other, in each of these pairs.