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AN AID TO SUTURE OF THE LEFT MAIN BRONCHUS
596 Sera from
apparently normal persons (54 students and factory workers) were titrated by this technique. 20% of the students and 76% of the factory workers showed complement-fixation antibodies at a titre of 1/4 to 1/64. Titrations were also made on paired sera from 254 military and civilian patients with acute respiratory disease of many clinical types. Antibody levels in the acute-phase sera were comparable with those in the above-
New Inventions
65
mentioned groups.
Greater than fourfold rises in antiviruses believed to indicate infection were found in 17 soldiers and 1 civilian with acute respiratory-tract infections of the type previously described in this country as " febrile catarrh."9 Similar rises also took place in the serum titres of 3 elderly patients with acute relapses of chronic bronchitis. Some of these rises were confirmed by specific neutralising antibody titrations. A fuller analysis of the correlation between the clinical and the laboratory findings will be published later. By complement-fixation tests on the same sera it was possible to recognise two cases of influenza-A infection, 28 of influenza-B infection, and 6 of influenza-C infection. All these serological responses were specific except 1 rise in titre against both A and B
body against
AN AID TO SUTURE OF THE LEFT MAIN
BRONCHUS
pneumonectomy is performed, with the patient prone, the surgeon, in closing the bronchus, is often hampered by the aorta, which, at the optimum site of bronchial division, may overlap by an inch or more. This difficulty is particularly noticeable if the openbronchus method of closure is used-i.e., no proximal WHEN
a
left
A.P.C.
EXAMPLES OF SEROLOGICAL RESPONSES FOUND IN SERVICEMEN WITH ACUTE RESPIRATORY ILLNESS
bronchus clamp is employed. It is usually technically easier to insert the needle from the anterior aspect than from the posterior, but it is then often hard to identify the needle-point as it emerges through the posterior wall of the bronchus. The instrument illustrated above was made to my specifications by the Genito-Urinary Instrument Company, Ltd. Not only does it provide adequate access to the bronchus stump with the least possible retraction, but it enables one to recognise the needlepoint as it emerges. I would like to thank Mr. Christopher Parish for his help and Dr. G. T. Ey and Mr. E. W. Groves for the photograph. CHRISTOPHER CUMMINS Thoracic Surgical Unit.
Papworth, Cambridge
"
*, soluble " or S antigen. t, amniotic-fluid antigen. titre of serum obtained at onset of illness; second first figure titre of serum obtained about 14 days after onset. figure =
=
influenza viruses. Examples of are iÙustrated in the table.
our
serological findings
been
isolated
from
adenoids
F.R.C.S.E.
Senior surgical registrar
A SENSITIVE PULSE-INDICATOR THE indicator was originally designed to simplify the estimation of the systolic blood-pressure in severely burnt patients. It is now also being used as an aid in hypotensive anaesthesia. A small microphone, connected as shown in the diagram, is strapped to the pulp of the patient’s thumb or big toe, and a sphygmomanometer cuff is applied at some suitable place proximal to it, if necessary over bandages. The cuff is inflated until the arterial supply is
the A.P.C. viruses found in many members of the several population groups tested, and rises in antibody titre, indicating specific infection, were found in paired sera from 20 persons with acute respiratory illnesses.
Complement-fixing antibody against
was
We wish to thank Lieut.-Colonel T. P. H. McKelvey, Captain A. R. Pate, and Captain K. J. Dennis (all of the R.A.M.C.), and Dr. F. J. Flint for supplying sera and clinical data from their patients ; Dr. J. M. Whitehead for the results of antibody titrations against influenza viruses on some of the sera ; and Mr. J. D. Gray for supplying adenoids. Expenses of this investigation were defrayed by the Medical Research Council. The work was done in consultation with, and under the direction of, Prof. C. H. Stuart-Harris and Prof. C. P. Beattie.
ELISABETH ZAIMAN
M.A., B.M. Oxfd Scientific Assistant, Department of Medicine
D. BALDUCCI M.D. Rome Research Assistant, Department of Bacteriology D. A. J. TYRRELL M.D. Sheff., M.R.C.P. Virus Research Laboratory of the University of Sheffield,
Lodgemoor Hospital, Sheffield
Member of the External Scientific Staff of the Medical Research Council
9. Stuart-Harris, C. H., Andrewes, C. H., Smith, W., Chalmers, D. K. M., Cowen, E. G. H., Hughes, D. L. Spec. Rep. Ser. med. Res. Coun., Lond. no. 228. 1938.
M, U.S. Army T-30-V throat microphone with brass cover removed. C, 100 mfd 50-V. wkg electrolytic condenser. R, 270 ohms. .a, 50 or 100 icA FSD micro-ammeter or ex-W.D. visual indicator No. I. VR, sensitivity control. 5000 ohms variable resistance with switch S. S, on-off switch on VR. B, 12-18-V. battery. VR must be connected so that slider is at point " a " when S operates.
occluded and the microphone no longer picks up pulsations. The air is slowly released, and the pressure in the cuff at which the meter pointer again starts to oscillate is taken as the systolic blood-pressure. By this method it has been found possible to determine systolic pressures of 25 mm. Hg in an adult and of 45 mm. Hg in a child aged 5 years. D. C. SIMPSON B.SC., PH.D.Edin. Member of external staff, Department of Surgery, University of Edinburgh 1.
Medical Research Council
Keating, V. J. Brit. med. J. 1952, i, 1188.
apparently normal persons (54 students and factory workers) were titrated by this technique. 20% of the students and 76% of the factory workers showed complement-fixation antibodies at a titre of 1/4 to 1/64. Titrations were also made on paired sera from 254 military and civilian patients with acute respiratory disease of many clinical types. Antibody levels in the acute-phase sera were comparable with those in the above-
New Inventions
65
mentioned groups.
Greater than fourfold rises in antiviruses believed to indicate infection were found in 17 soldiers and 1 civilian with acute respiratory-tract infections of the type previously described in this country as " febrile catarrh."9 Similar rises also took place in the serum titres of 3 elderly patients with acute relapses of chronic bronchitis. Some of these rises were confirmed by specific neutralising antibody titrations. A fuller analysis of the correlation between the clinical and the laboratory findings will be published later. By complement-fixation tests on the same sera it was possible to recognise two cases of influenza-A infection, 28 of influenza-B infection, and 6 of influenza-C infection. All these serological responses were specific except 1 rise in titre against both A and B
body against
AN AID TO SUTURE OF THE LEFT MAIN
BRONCHUS
pneumonectomy is performed, with the patient prone, the surgeon, in closing the bronchus, is often hampered by the aorta, which, at the optimum site of bronchial division, may overlap by an inch or more. This difficulty is particularly noticeable if the openbronchus method of closure is used-i.e., no proximal WHEN
a
left
A.P.C.
EXAMPLES OF SEROLOGICAL RESPONSES FOUND IN SERVICEMEN WITH ACUTE RESPIRATORY ILLNESS
bronchus clamp is employed. It is usually technically easier to insert the needle from the anterior aspect than from the posterior, but it is then often hard to identify the needle-point as it emerges through the posterior wall of the bronchus. The instrument illustrated above was made to my specifications by the Genito-Urinary Instrument Company, Ltd. Not only does it provide adequate access to the bronchus stump with the least possible retraction, but it enables one to recognise the needlepoint as it emerges. I would like to thank Mr. Christopher Parish for his help and Dr. G. T. Ey and Mr. E. W. Groves for the photograph. CHRISTOPHER CUMMINS Thoracic Surgical Unit.
Papworth, Cambridge
"
*, soluble " or S antigen. t, amniotic-fluid antigen. titre of serum obtained at onset of illness; second first figure titre of serum obtained about 14 days after onset. figure =
=
influenza viruses. Examples of are iÙustrated in the table.
our
serological findings
been
isolated
from
adenoids
F.R.C.S.E.
Senior surgical registrar
A SENSITIVE PULSE-INDICATOR THE indicator was originally designed to simplify the estimation of the systolic blood-pressure in severely burnt patients. It is now also being used as an aid in hypotensive anaesthesia. A small microphone, connected as shown in the diagram, is strapped to the pulp of the patient’s thumb or big toe, and a sphygmomanometer cuff is applied at some suitable place proximal to it, if necessary over bandages. The cuff is inflated until the arterial supply is
the A.P.C. viruses found in many members of the several population groups tested, and rises in antibody titre, indicating specific infection, were found in paired sera from 20 persons with acute respiratory illnesses.
Complement-fixing antibody against
was
We wish to thank Lieut.-Colonel T. P. H. McKelvey, Captain A. R. Pate, and Captain K. J. Dennis (all of the R.A.M.C.), and Dr. F. J. Flint for supplying sera and clinical data from their patients ; Dr. J. M. Whitehead for the results of antibody titrations against influenza viruses on some of the sera ; and Mr. J. D. Gray for supplying adenoids. Expenses of this investigation were defrayed by the Medical Research Council. The work was done in consultation with, and under the direction of, Prof. C. H. Stuart-Harris and Prof. C. P. Beattie.
ELISABETH ZAIMAN
M.A., B.M. Oxfd Scientific Assistant, Department of Medicine
D. BALDUCCI M.D. Rome Research Assistant, Department of Bacteriology D. A. J. TYRRELL M.D. Sheff., M.R.C.P. Virus Research Laboratory of the University of Sheffield,
Lodgemoor Hospital, Sheffield
Member of the External Scientific Staff of the Medical Research Council
9. Stuart-Harris, C. H., Andrewes, C. H., Smith, W., Chalmers, D. K. M., Cowen, E. G. H., Hughes, D. L. Spec. Rep. Ser. med. Res. Coun., Lond. no. 228. 1938.
M, U.S. Army T-30-V throat microphone with brass cover removed. C, 100 mfd 50-V. wkg electrolytic condenser. R, 270 ohms. .a, 50 or 100 icA FSD micro-ammeter or ex-W.D. visual indicator No. I. VR, sensitivity control. 5000 ohms variable resistance with switch S. S, on-off switch on VR. B, 12-18-V. battery. VR must be connected so that slider is at point " a " when S operates.
occluded and the microphone no longer picks up pulsations. The air is slowly released, and the pressure in the cuff at which the meter pointer again starts to oscillate is taken as the systolic blood-pressure. By this method it has been found possible to determine systolic pressures of 25 mm. Hg in an adult and of 45 mm. Hg in a child aged 5 years. D. C. SIMPSON B.SC., PH.D.Edin. Member of external staff, Department of Surgery, University of Edinburgh 1.
Medical Research Council
Keating, V. J. Brit. med. J. 1952, i, 1188.