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ELECTROCARDIOGRAPHIC CHANGES IN HEALTHY YOUNG MEN AFTER EXERCISE
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disposable and comes back with the bottles from the hospitals, is E12 10s. per 1000. The top of the bottle is then covered with a transparentViscap’ (see accompanying figure). If blood is required for cross-matching, some of the pilot-tubing is pulled out of the holder, after the viscap has been removed, and a piece just in front of the next ring is cut off with a pair of scissors. Since the other end is still occluded by the other ring, the blood does not flow out of either the piece cut off or theremaining tube on the bottle. By gently stroking it, the blood in the segment is emptied into a test tube. Alternatively it will flow out if the other ring is cut off.
ELECTROCARDIOGRAPHIC CHANGES IN HEALTHY YOUNG MEN AFTER EXERCISE
SIR,-Electrocardiograms were taken after exercise in 81 young men whose ages ranged between 18 and 25 years, and who were being kept in custody and were eager to participate in daily physical exercise. A 3-minute Master single-step test was used to determine the effect of exercise. None of the young men had any illness ELECTROCARDIOGRAPHIC FINDINGS IN YOUNG HEALTHY MEN AFTER EXERCISE
The advantages of this arrangement are that the blood inside the pilot tubing does not become infected, and that, when a piece of the pilot tubing is cut off, the blood does not drip out. This arrangement has been in use for some time, and we have not received from our colleagues any criticism condemning the new contraption. Compared with the old pilot tubing, it has the advantage that it cannot be detached without deliberately trying; and the space occupied by the bottle is, of course, the same with or without pilot tubing. W. WEINER Regional Blood Transfusion Service, 15, Ampton Road, DAMIANA M. WROBEL. Birmingham, 15.
a. One with left-axis deviation, the other with a flat T wave in aVF. b’ One with a flat T wave in aVF. c. One also had high-amplitude waves and sinus tachycardia. * Coding according to the method of Blackburn et al.1
PHRENOLOGY IN MEDICINE
Sir,-
interested to read your account (Dec. 5) of Dr. Macdonald Critchley’s Schorstein lecture. There is no doubt that Gall’s contribution to the anatomy of the nervous system was of the greatest significance, but I should like to comment upon the priorities which are claimed for him. was
In the first place, he did not discover the cervical and lumbar enlargements of the spinal cord: Vicq d’Azyr described them in 1781.1 He was by no means the first to call attention to the differences in structure and function of the grey and white matter; Malpighi2 and many others thereafter pointed out the differences in microscopic structure, and Willis’s3 discussion of cortical and white matter function appeared in 1672. Vicq d’Azyr4 also described what Gall later called converging and diverging white-matter fibres, and Galen made several references to the corpus callosum.55 Finally, Reil described his island of convolutions in 1809 6-that is, before Gall. Nevertheless, Gall and his student Spurzheim must be remembered for the general stimulus they gave to anatomical and physiological studies of the nervous system. Their work was assessed by a commission in Paris which included Portal, Pinel, and Cuvier, and one of its statements is as follows: "... that they do not pretend to have discovered many new facts; but that the chief merit which they claim consists in the connection which they have been the first to establish between the known facts and in the general conclusions which they have deduced from them ".7
felt unable to do physical exercise, nor was anything imporfound on physical examination. The deviations found are shown in the accompanying table; 4 of the young men, in addition, showed sinus tachycardia. Apart from some real anomalies, the high frequency of ischaemia on exertion in these young men maizes us wonder whether this is associated in some way with the increasing prevalence of definite coronary heart-disease in men well below the age of 40. Sudden death in military recruits during strenuous training courses could be related to the apparently high frequency of deviations in young men. or
tant
The Netherlands Institute of Nutrition,
Wageningen. Ministry of Justice Medical Department, The Hague, Netherlands.
’
We should be grateful to Dr. Critchley, however, for pointing out the important role that phrenology has played not only in the history of neurology but also outside medicine. I am at the moment conducting a wide survey of the subject in all its aspects; and, if any of your readers have any personal knowledge of phrenology or phrenologists, I should be most grateful to receive it. Wellcome Historical Medical Museum and Library, Euston Road, 1.
London, N.W.1. Vicq d’Azyr, F. Histoire
5. 6. 7.
N. DE VOOGD R. SIEMELINK.
LEUCOCYTE ENZYMES IN DOWN’S SYNDROME
SIR,-We read with great interest the recent report by Dr. Mellman and his associates (Sept. 26) demonstrating increased activity of leucocyte acid phosphatase, glucose-6phosphate dehydrogenase, and galactose-1-phosphate uridyl transferase in patients with Down’s syndrome. These results are at variance with those of Hsia and coworkerswho report increased levels of the leucocytetransferase enzyme but normal activity of glucose-6phosphate dehydrogenase in both leucocytes and erythocytes of patients with Down’s syndrome. In
attempt to resolve the controversy as to whether raised enzyme levels in the leucocytes of patients with Down’s syndrome represent evidence that the gene loci for these enzymes reside on chromosome 213 or whether, as Mellman " et al. suggest, this is simply part of a generalised disturbance of leucocyte enzyme activity ", we are currently investigating the following enzymes in a blinded " group of patients with Down’s syndrome due to translocation and trisomy: an
"
EDWIN CLARKE.
de l’Académie Royale des Sciences de l’Institut de France; p. 600. Paris, 1784. 2. Malpighi, M. De viscerum structura exercitatio anatomica; p. 50. 3. 4.
L. M. DALDERUP A. B. PAPPIE.
Bologna, 1666. Willis, T. De anima brutorum; p. 76. Oxford, 1672. Vicq d’Azyr, F. Histoire de l’Academie Royale des Sciences de l’Institut de France; p. 535. Paris, 1784. Singer, C. Galen on Anatomical Procedures; pp. 231, 234. London, 1956. Reil, J. C. Arch. Physiol., Halle, 1809, 9, 144. Edin. med. Surg. J. 1809, 5, 45.
Leucocyte-5-nucleotidase, erythrocyte galactose-1-phosphate uridyl galactose-1-phosphate uridyl transferase, leucocyte alkaline phosphatase, leucocyte acid phosphatase, leucocyte
transferase, leucocyte
Blackburn, H., Keys, A., Rautaharju, P., Punsar, S. Circulation, 1960, 21, 1160. 2. Hsia, D. Y., Inouye, T., Wong, P., South, A. New Engl. J. Med. 1964, 270, 1085. 3. Alter, A. A., Lee, S. L., Pourfar, M., Dobkin, G. Blood, 1963, 22, 165. 1.
disposable and comes back with the bottles from the hospitals, is E12 10s. per 1000. The top of the bottle is then covered with a transparentViscap’ (see accompanying figure). If blood is required for cross-matching, some of the pilot-tubing is pulled out of the holder, after the viscap has been removed, and a piece just in front of the next ring is cut off with a pair of scissors. Since the other end is still occluded by the other ring, the blood does not flow out of either the piece cut off or theremaining tube on the bottle. By gently stroking it, the blood in the segment is emptied into a test tube. Alternatively it will flow out if the other ring is cut off.
ELECTROCARDIOGRAPHIC CHANGES IN HEALTHY YOUNG MEN AFTER EXERCISE
SIR,-Electrocardiograms were taken after exercise in 81 young men whose ages ranged between 18 and 25 years, and who were being kept in custody and were eager to participate in daily physical exercise. A 3-minute Master single-step test was used to determine the effect of exercise. None of the young men had any illness ELECTROCARDIOGRAPHIC FINDINGS IN YOUNG HEALTHY MEN AFTER EXERCISE
The advantages of this arrangement are that the blood inside the pilot tubing does not become infected, and that, when a piece of the pilot tubing is cut off, the blood does not drip out. This arrangement has been in use for some time, and we have not received from our colleagues any criticism condemning the new contraption. Compared with the old pilot tubing, it has the advantage that it cannot be detached without deliberately trying; and the space occupied by the bottle is, of course, the same with or without pilot tubing. W. WEINER Regional Blood Transfusion Service, 15, Ampton Road, DAMIANA M. WROBEL. Birmingham, 15.
a. One with left-axis deviation, the other with a flat T wave in aVF. b’ One with a flat T wave in aVF. c. One also had high-amplitude waves and sinus tachycardia. * Coding according to the method of Blackburn et al.1
PHRENOLOGY IN MEDICINE
Sir,-
interested to read your account (Dec. 5) of Dr. Macdonald Critchley’s Schorstein lecture. There is no doubt that Gall’s contribution to the anatomy of the nervous system was of the greatest significance, but I should like to comment upon the priorities which are claimed for him. was
In the first place, he did not discover the cervical and lumbar enlargements of the spinal cord: Vicq d’Azyr described them in 1781.1 He was by no means the first to call attention to the differences in structure and function of the grey and white matter; Malpighi2 and many others thereafter pointed out the differences in microscopic structure, and Willis’s3 discussion of cortical and white matter function appeared in 1672. Vicq d’Azyr4 also described what Gall later called converging and diverging white-matter fibres, and Galen made several references to the corpus callosum.55 Finally, Reil described his island of convolutions in 1809 6-that is, before Gall. Nevertheless, Gall and his student Spurzheim must be remembered for the general stimulus they gave to anatomical and physiological studies of the nervous system. Their work was assessed by a commission in Paris which included Portal, Pinel, and Cuvier, and one of its statements is as follows: "... that they do not pretend to have discovered many new facts; but that the chief merit which they claim consists in the connection which they have been the first to establish between the known facts and in the general conclusions which they have deduced from them ".7
felt unable to do physical exercise, nor was anything imporfound on physical examination. The deviations found are shown in the accompanying table; 4 of the young men, in addition, showed sinus tachycardia. Apart from some real anomalies, the high frequency of ischaemia on exertion in these young men maizes us wonder whether this is associated in some way with the increasing prevalence of definite coronary heart-disease in men well below the age of 40. Sudden death in military recruits during strenuous training courses could be related to the apparently high frequency of deviations in young men. or
tant
The Netherlands Institute of Nutrition,
Wageningen. Ministry of Justice Medical Department, The Hague, Netherlands.
’
We should be grateful to Dr. Critchley, however, for pointing out the important role that phrenology has played not only in the history of neurology but also outside medicine. I am at the moment conducting a wide survey of the subject in all its aspects; and, if any of your readers have any personal knowledge of phrenology or phrenologists, I should be most grateful to receive it. Wellcome Historical Medical Museum and Library, Euston Road, 1.
London, N.W.1. Vicq d’Azyr, F. Histoire
5. 6. 7.
N. DE VOOGD R. SIEMELINK.
LEUCOCYTE ENZYMES IN DOWN’S SYNDROME
SIR,-We read with great interest the recent report by Dr. Mellman and his associates (Sept. 26) demonstrating increased activity of leucocyte acid phosphatase, glucose-6phosphate dehydrogenase, and galactose-1-phosphate uridyl transferase in patients with Down’s syndrome. These results are at variance with those of Hsia and coworkerswho report increased levels of the leucocytetransferase enzyme but normal activity of glucose-6phosphate dehydrogenase in both leucocytes and erythocytes of patients with Down’s syndrome. In
attempt to resolve the controversy as to whether raised enzyme levels in the leucocytes of patients with Down’s syndrome represent evidence that the gene loci for these enzymes reside on chromosome 213 or whether, as Mellman " et al. suggest, this is simply part of a generalised disturbance of leucocyte enzyme activity ", we are currently investigating the following enzymes in a blinded " group of patients with Down’s syndrome due to translocation and trisomy: an
"
EDWIN CLARKE.
de l’Académie Royale des Sciences de l’Institut de France; p. 600. Paris, 1784. 2. Malpighi, M. De viscerum structura exercitatio anatomica; p. 50. 3. 4.
L. M. DALDERUP A. B. PAPPIE.
Bologna, 1666. Willis, T. De anima brutorum; p. 76. Oxford, 1672. Vicq d’Azyr, F. Histoire de l’Academie Royale des Sciences de l’Institut de France; p. 535. Paris, 1784. Singer, C. Galen on Anatomical Procedures; pp. 231, 234. London, 1956. Reil, J. C. Arch. Physiol., Halle, 1809, 9, 144. Edin. med. Surg. J. 1809, 5, 45.
Leucocyte-5-nucleotidase, erythrocyte galactose-1-phosphate uridyl galactose-1-phosphate uridyl transferase, leucocyte alkaline phosphatase, leucocyte acid phosphatase, leucocyte
transferase, leucocyte
Blackburn, H., Keys, A., Rautaharju, P., Punsar, S. Circulation, 1960, 21, 1160. 2. Hsia, D. Y., Inouye, T., Wong, P., South, A. New Engl. J. Med. 1964, 270, 1085. 3. Alter, A. A., Lee, S. L., Pourfar, M., Dobkin, G. Blood, 1963, 22, 165. 1.