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ASCORBIC ACID FOR PRICKLY HEAT
173 in
cell
culture.
We
therefore
undertook
the
present
investigation. Material for this study consisted of 20 surgically removed human appendices. Of these, 6 were removed during hernia " operations, whereas 14 were clinically classified as so-called acute catarrhal appendicitis ", but all were normal both macroscopically and microscopically; 3 of them showed slight cedema. Methods.-Soon after removal, each appendix was placed in a petri dish, opened lengthwise, and carefully washed several times with isotonic saline solution. Each appendix was then placed in 5 ml. of culture-mediumN.C.T.C. 109 ’ (Microbiological Associates), cut in small pieces, and gently stirred. The culture-medium was removed with a pipette. In most instances, it contained sufficient appendiceal cells to prepare several cultures. All these procedures were carried out at room temperature. Peripheral-blood lymphocytes from each donor of the appendix were cultured at the same time and in the same manner. For each appendix, two culture flasks were prepared. To one was added 0-5 mg. P.H.A. (Wellcome) per 5 ml. final culture mixture; the other was used as a control. The culture flasks were incubated at 37°C for 3 days and smears were then prepared from the cultured cells. Morphological criteria for judging the lymphocytes which underwent blastic transformation have been considered as reliable as criteria based on incorporation of [H3]-thymidine.l Results (%) of blastic transformation of lymphocytes from the 20 normal human appendices and from the donors’ peripheral blood after 3 days’ culture with P.H.A. were as follows:
In the cultures incubated without P.H.A. only occasional blast-like cells were observed. In contrast, 59-59-2 of the appendiceal lymphoid-cell population cultured in the presence of P.H.A. were large pyroninophilic blast-like cells. This figure is not significantly less than that obtained in the corresponding cultures of the peripheral-blood lymphocytes from the same patients (66-0:12). Furthermore, the blasts obtained in the P.H.A.-cultures with peripheral-blood and appendiceal lymphocytes were morphologically the same. In both, some blasts were in mitosis. This high P.H.A.-responsiveness of the lymphocytes from the human appendix suggests that this organ contains a large proportion of lymphocytes of the peripheral lymphoid type.
acid given 26 hours before sweat collection was completed. The sparse evidence provided by this brief experiment, completed just before the Unit closed down, suggested that losses of ascorbic acid or thiamine were so small that it was not necessary to supplement either ascorbic-acid or thiamine intakes of European men, who were already acclimatised, working in warm environments in the tropics to offset such losses as occurred in the sweat, provided they were already receiving normal amounts of these vitamins in their daily diet. The success of Dr. Hindson’s therapeutic trial suggests a need for repeating the experiment, perhaps with or without rather larger supplements of ascorbic acid, in adults and children. Such experiments are not always easy to arrange with the precise control which is necessary. There seems, however, to be a good case for further therapeutic trials in adults under the conditions in which severe prickly heat is encountered, happily more rarely nowadays than in the latter years of the 1939-45 war, whatever the mechanism of the effect Dr. Hindson has observed. Royal Naval Medical School, F. P. ELLIS. Alverstoke, Gosport, Hants.
ICE-CREAM-VAN ACCIDENTS
SiR,łThe approaching school holidays have prompted me to reply to your correspondents who last year1 asked whether accidents involving children and ice-cream vans are widespread. Many have occurred in Birmingham, and action has already been taken to teach children in schools the correct way to and leave the van. Miniature demonstration vans I believe, by ice-cream manufacturers have been used. Ought not publicity to be directed to the motorist instead of the child ? The vans are brightly coloured to attract attention from a distance, and generally operate in quiet residential streets rather than on fast main roads. If on seeing such a van the motorist slowed down for about 50 yd. (46 m.) on each side of the vehicle he would be ready for any rapidly emerging body and most of these accidents would be avoided. Additionally he should sound his horn. The small amount of extra time involved in this procedure is negligible compared with that taken up in the coroner’s court. Department of Pathology, Dudley Road Hospital, K. J. HUGHES. Birmingham 18.
approach provided,
1.
Briggs, M., Potter, J.
M.
Lancet, 1967, ii, 41.
The Blood Research Foundation Centre of Tortona is supported by the Blood Research Foundation, Washington, D.C., U.S.A. Blood Research Foundation Centre Municipal Hospital of Tortona, Italy, and Institute of Pathology, University of Milan, Italy.
G. ASTALDI R. AIRÒ A. GALIMBERTI M. P. NERVI.
Public Health Suspected Poliomyelitis
ASCORBIC ACID FOR PRICKLY HEAT SIR,-Dr. Hindson’s article 16 again raises the possibility that significant amounts of ascorbic acid may be lost when a person sweats profusely. In 1953, towards the end of a 4-year period of continuous hot-room studies at the Medical Research Council’s Royal Naval Tropical Research Unit, Singapore, it
suggested to Prof. J. W. H. Lugg and me 17 by another member of the Medical Faculty of the University of Malaya that under conditions which induce profuse sweating there might be harmful losses of water-soluble vitamins in the sweat. At short notice we, therefore, measured the ascorbic acid, dehydroascorbic acid, and thiamine in the sweat of healthy European men between 20 and 40 years of age who had been living in warm, moist, tropical environments for periods ranging from 11/2 to 41/2 years while they carried out a step-climbing task of moderate severity in hot-wet and hot-dry climates, both before and after a dietary supplement of 500 mg. of ascorbic was
16. 17.
Hindson, T. C. Lancet, 1968, i, 1347. Lugg J. H., Ellis F. P. Br. J. Nutr. 1954, 8,
71.
in
Birmingham
Birmingham has had three suspected cases of poliomyelitis in children aged 5, 3, and 2 years. The 5-year-old was admitted to hospital on June 12, severely paralysed, and was originally thought to have polyneuritis; but poliovirus was eventually isolated from the faeces, and a review strongly pointed to a diagnosis of poliomyelitis. The 3-year-old had burns and was failing to make progress satisfactorily; poliomyelitis was considered in view of the proximity of this child’s home to that of the first patient. The 2-year-old had some paralysis of the left leg for ten days before admission to hospital. In these last two cases the diagnosis was still in doubt on Tuesday. On July 10 health visitors, armed with oral poliomyelitis vaccine, made house-to-house visits in an area, bounded by busy main roads, in the centre of which were the homes of the three affected children; and by working through the day and the evening they completed their task in two days. Clinics for immunisation were held at the three welfare centres serving the area and at the central offices. Parents of children at four local schools were informed by letter (in English and in two other languages), and were invited to accept vaccination or re-vaccina-
cell
culture.
We
therefore
undertook
the
present
investigation. Material for this study consisted of 20 surgically removed human appendices. Of these, 6 were removed during hernia " operations, whereas 14 were clinically classified as so-called acute catarrhal appendicitis ", but all were normal both macroscopically and microscopically; 3 of them showed slight cedema. Methods.-Soon after removal, each appendix was placed in a petri dish, opened lengthwise, and carefully washed several times with isotonic saline solution. Each appendix was then placed in 5 ml. of culture-mediumN.C.T.C. 109 ’ (Microbiological Associates), cut in small pieces, and gently stirred. The culture-medium was removed with a pipette. In most instances, it contained sufficient appendiceal cells to prepare several cultures. All these procedures were carried out at room temperature. Peripheral-blood lymphocytes from each donor of the appendix were cultured at the same time and in the same manner. For each appendix, two culture flasks were prepared. To one was added 0-5 mg. P.H.A. (Wellcome) per 5 ml. final culture mixture; the other was used as a control. The culture flasks were incubated at 37°C for 3 days and smears were then prepared from the cultured cells. Morphological criteria for judging the lymphocytes which underwent blastic transformation have been considered as reliable as criteria based on incorporation of [H3]-thymidine.l Results (%) of blastic transformation of lymphocytes from the 20 normal human appendices and from the donors’ peripheral blood after 3 days’ culture with P.H.A. were as follows:
In the cultures incubated without P.H.A. only occasional blast-like cells were observed. In contrast, 59-59-2 of the appendiceal lymphoid-cell population cultured in the presence of P.H.A. were large pyroninophilic blast-like cells. This figure is not significantly less than that obtained in the corresponding cultures of the peripheral-blood lymphocytes from the same patients (66-0:12). Furthermore, the blasts obtained in the P.H.A.-cultures with peripheral-blood and appendiceal lymphocytes were morphologically the same. In both, some blasts were in mitosis. This high P.H.A.-responsiveness of the lymphocytes from the human appendix suggests that this organ contains a large proportion of lymphocytes of the peripheral lymphoid type.
acid given 26 hours before sweat collection was completed. The sparse evidence provided by this brief experiment, completed just before the Unit closed down, suggested that losses of ascorbic acid or thiamine were so small that it was not necessary to supplement either ascorbic-acid or thiamine intakes of European men, who were already acclimatised, working in warm environments in the tropics to offset such losses as occurred in the sweat, provided they were already receiving normal amounts of these vitamins in their daily diet. The success of Dr. Hindson’s therapeutic trial suggests a need for repeating the experiment, perhaps with or without rather larger supplements of ascorbic acid, in adults and children. Such experiments are not always easy to arrange with the precise control which is necessary. There seems, however, to be a good case for further therapeutic trials in adults under the conditions in which severe prickly heat is encountered, happily more rarely nowadays than in the latter years of the 1939-45 war, whatever the mechanism of the effect Dr. Hindson has observed. Royal Naval Medical School, F. P. ELLIS. Alverstoke, Gosport, Hants.
ICE-CREAM-VAN ACCIDENTS
SiR,łThe approaching school holidays have prompted me to reply to your correspondents who last year1 asked whether accidents involving children and ice-cream vans are widespread. Many have occurred in Birmingham, and action has already been taken to teach children in schools the correct way to and leave the van. Miniature demonstration vans I believe, by ice-cream manufacturers have been used. Ought not publicity to be directed to the motorist instead of the child ? The vans are brightly coloured to attract attention from a distance, and generally operate in quiet residential streets rather than on fast main roads. If on seeing such a van the motorist slowed down for about 50 yd. (46 m.) on each side of the vehicle he would be ready for any rapidly emerging body and most of these accidents would be avoided. Additionally he should sound his horn. The small amount of extra time involved in this procedure is negligible compared with that taken up in the coroner’s court. Department of Pathology, Dudley Road Hospital, K. J. HUGHES. Birmingham 18.
approach provided,
1.
Briggs, M., Potter, J.
M.
Lancet, 1967, ii, 41.
The Blood Research Foundation Centre of Tortona is supported by the Blood Research Foundation, Washington, D.C., U.S.A. Blood Research Foundation Centre Municipal Hospital of Tortona, Italy, and Institute of Pathology, University of Milan, Italy.
G. ASTALDI R. AIRÒ A. GALIMBERTI M. P. NERVI.
Public Health Suspected Poliomyelitis
ASCORBIC ACID FOR PRICKLY HEAT SIR,-Dr. Hindson’s article 16 again raises the possibility that significant amounts of ascorbic acid may be lost when a person sweats profusely. In 1953, towards the end of a 4-year period of continuous hot-room studies at the Medical Research Council’s Royal Naval Tropical Research Unit, Singapore, it
suggested to Prof. J. W. H. Lugg and me 17 by another member of the Medical Faculty of the University of Malaya that under conditions which induce profuse sweating there might be harmful losses of water-soluble vitamins in the sweat. At short notice we, therefore, measured the ascorbic acid, dehydroascorbic acid, and thiamine in the sweat of healthy European men between 20 and 40 years of age who had been living in warm, moist, tropical environments for periods ranging from 11/2 to 41/2 years while they carried out a step-climbing task of moderate severity in hot-wet and hot-dry climates, both before and after a dietary supplement of 500 mg. of ascorbic was
16. 17.
Hindson, T. C. Lancet, 1968, i, 1347. Lugg J. H., Ellis F. P. Br. J. Nutr. 1954, 8,
71.
in
Birmingham
Birmingham has had three suspected cases of poliomyelitis in children aged 5, 3, and 2 years. The 5-year-old was admitted to hospital on June 12, severely paralysed, and was originally thought to have polyneuritis; but poliovirus was eventually isolated from the faeces, and a review strongly pointed to a diagnosis of poliomyelitis. The 3-year-old had burns and was failing to make progress satisfactorily; poliomyelitis was considered in view of the proximity of this child’s home to that of the first patient. The 2-year-old had some paralysis of the left leg for ten days before admission to hospital. In these last two cases the diagnosis was still in doubt on Tuesday. On July 10 health visitors, armed with oral poliomyelitis vaccine, made house-to-house visits in an area, bounded by busy main roads, in the centre of which were the homes of the three affected children; and by working through the day and the evening they completed their task in two days. Clinics for immunisation were held at the three welfare centres serving the area and at the central offices. Parents of children at four local schools were informed by letter (in English and in two other languages), and were invited to accept vaccination or re-vaccina-