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For prevention of pulmonary embolism, transvenous interruption of the inferior vena cava by the umbrella filter was performed in 100 patients between July, 1968, and June, 1970. Filter dislodgment and migration did not occur, and there were no late complications. The recurrent embolism rate was 2 per cent, with a single recurrent fatal embolism. The 30-day hospital mortality was 16 per cent, with an additional late-death rate of 19 per cent. No deaths were directly related to the procedure. The mortality figures reflect the seriousness of the underlying pathologic process. Of 10 patients in whom phlebitis developed after filter insertion, seven had had phlebitis previously. Transvenous caval interruption by the umbrella filter thus seems a safe and effective procedure for prevention of pulmonary embolism.

The clinical, hemodynamic, and hematologic findings are described in 5 patients in whom severe intravascular destruction of erythrocytes resulted from incompetent prosthetic aortic valves. In each, an enzymatic or immunologic basis for anemia was excluded, and grossly attenuated survival of Cr 51 -labeled red cells was demonstrated. Destruction of erythrocytes was attributed to turbulent flow and shearing forces rather than to direct mechanical impact. In 1 patient, the half-life of tagged cells increased from 9.5 to 21 days after an incompetent Teflon valve was replaced with a prosthesis of the caged-ball type. The magnitude of regurgitant blood flow is an important determinant of the frequency with which a cell is subjected to trauma, and the derivation and application of a formula relating these variables is presented.

THE INJECTION of various dyes has long been used as an adjunct to excision of lesions such as pilonidal sinuses and thyroglossal duct cysts. The usefulness has been somewhat variable, particularly where spillage of the dye stains adjacent tissues and sometimes confuses rather than assists the operation. Forrest and Robinson 1,2 described the use of methylene blue injected into the parotid duct as a technical adjunct to operations for removal of tumors of the parotid gland. They reported that the dye stained the normal gland but not the tumor and that spillage did not occur. The present report concerns a further trial of this method. Method At the time of operation, after endotracheal intubation, the duct is visualized, dilated, and cannulated with a polyethylene tube (PE 90). The catheter is threaded in 1.5 cm and anchored to the buccal mucosa with a silk suture. The end of the catheter with

The authors present a small series of patients with good results in all but two patients. Side effects are much less than with antimetabolites.

Commercial γ-globulin given shortly before open-heart surgery and then one month later was ineffective in reducing the incidence of posttransfusion icteric hepatitis. There were 11 cases in 84 treated patients, 6 in 83 control patients. Half of the cases of hepatitis had an incubation period of less than 50 days and neither this nor the severity of disease was affected by the γ-globulin treatment.

IT HAS recently been demonstrated that partial obstruction of the suprahepatic segment of the abdominal inferior vena cava may accompany abdominal ascites in patients with cirrhosis or severe congestive heart failure. 1 Doppman and others reproduced this unusual form of vena caval obstruction in experimental animals and demonstrated that the narrowing resulted from increased intra-abdominal pressure and was the result of physical forces acting on the collapsible venous segment at its site of exit from the abdomen. 2 The precise hemodynamic consequences of this functional form of vena caval obstruction have not, however, been previously determined. In the present experiments, the effects of graded increases in intra-abdominal pressure on pressure and flow in the inferior vena cava were studied in the dog. Methods Twelve mongrel dogs, ranging in weight from 14 to 20 kg, were anesthetized with sodium pentobarbital administered intravenously (35 mg/kg) and ventilated with a volume-controlled respirator supplying