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General practitioner Derry, Northern Ire land, 1949-96 (b 1926; q Queen's University, Belfast 1948; FRCGP), died from melanoma on 25 April 1999. Peter retired most reluctandy at the age of 70, having embraced the challenges of general practice with enthusiasm and style. His response to the social deprivation of his native city was the subtext of his life as he believed in social jus tice and fair play. He was instrumental in founding child welfare societies on both sides of the Irish border and initiated vocational training schemes in Derry and Donegal. His was the first teaching and training practice in the area, he was provost of the Northern Ireland faculty of the Royal College of General Practitioners in 1985, and served for many years on the Council for Postgraduate Medical Education. Peter had a hospital appointment in ophthalmol ogy and vast experience in obstetrics. At a recent gathering of five GPs, four had been delivered by him. He was a keen sailor, pho tographer, and an acclaimed after dinner speaker with an impish sense of humour. He was aJP and a member of the Northern Ire land Community Relations Commission. His crowded funeral mass was attended by five bishops from both communities. He leaves a wife, Joan; two sons; and two daugh ters. [P McEvoy, V Cavanagh]

A case of apparently primary sideroblastic anemia, in an elderly woman, refractory to hematinic therapy and requiring many blood transfusions, was treated with azathioprine. Over a period of 6 mo, the hemoglobin level gradually rose to normal, no further transfusions have been required in the 30 mo since then, and the marrow picture shows a considerable decrease in the degree of mitochondrial iron overload. There was a simultaneous fall in the titer of HL-A cytotoxic antibodies. The possible role of immunologic factors in this sequence of events is discussed.

Summary Three cases of intramural pseudodiverticulosis of the oesophagus are described together with a review of the relevant literature. This unusual condition, diagnosed by characteristic features on the barium swallow, is associated with a high incidence of benign oesophageal stricture which responds readily to endoscopic dilatation.

This study of risk factors for diabetic nephropathy in juvenile Type 1 (insulin-dependent) diabetes mellitus compares two carefully characterised groups of patients, one with proteinuria (n = 23), the other a control group (n = 24) with no evidence of nephropathy despite more than 25 years of diabetic life. No significant difference was observed between the groups in any HLA-A, -B or -DR antigen of Bf allotype. DR3 was present in 87% of patients with proteinuria and 75% of the diabetic control group; DR4 was present in 48% of patients with proteinuria and 63% of diabetic controls; BfFl was present in 17% of patients with nephropathy and 9% of the diabetic control group. Compared with the control group, patients with proteinuria had significantly higher mean diabetic-clinic blood glucose concentrations before the diagnosis of microvascular disease, a significantly earlier age at diagnosis of diabetes, and had more often been treated with once-daily as opposed to twice-daily insulin regimens. Susceptibility to nephropathy in Type 1 diabetes appears to be determined by the quality of metabolic control and age of onset of diabetes; although the number of subjects studied was relatively small no evidence was found of any influence of HLA or Bf phenotype.

Pancreozymin in man as in animals appears to act as a specific enzyme stimulant. The preparations of pancreozymin used in these experiments also contain cholecystokinin, which causes the gall bladder to contract, and a smooth muscle stimulant, possibly substance P. The duodenal contents obtained in response to a standard dose of secretin and pancreozymin have been collected quantitatively in man and the volume and amount of bicarbonate, amylase, trypsin, and lipase measured in order to study pancreatic function. The results of 105 tests undertaken on a normal group, in pancreatic and biliary disease, and in non-pancreatic steatorrhoea have been analysed. In localized pancreatic lesions and after recovery from acute pancreatitis, normal function is often retained. Mild functional impairment may be demonstrated only by a poor enzyme output in the post-pancreozymin fractions, while at a later stage bicarbonate output is affected and finally the volume of the duodenal contents is reduced. The secretin-pancreozymin test is most valuable, therefore, in the more chronic and advanced forms of pancreatic disease in which it gives a good assessment of residual pancreatic function. In diagnosis care must be taken in interpreting a functional test in terms of anatomical pathology. The test has proved useful not only in diagnosis but also as a guide to treatment and an index of prognosis.