- Email: [email protected]
EXPANSION OF CANCER RESEARCH
874
tion; Thal et al. found segmental blockage in only 2 of their patients, and consequently they believe that endarterectomy is unlikely to succeed. Divergent opinions such as these are difficult to reconcile; but from coronary arteriography, if it proves as trouble-free and informative in other hands, more can be learnt about the lesions in ischaemic heartIf observations elsewhere in the body are a guide, it seems likely that both localised and diffuse disease will be found in individual patients, and call for different operative approaches. While these questions are being settled the Beck operation continues to give good results at Cleveland.99 In 1954-58, 347 patients were operated on with a mortality of 6% overall, and of 2% in the last 200 cases. 295 patients are still alive, and the result is described as excellent or good in no less than 94%-a striking figure. But the follow-up period in many is still short, and the longest is only four years, so the ultimate results in terms of increased survival are still unknown. If, as Blalock 10 has suggested, the results are very similar after different operative procedures, perhaps the production of intercoronary anastomoses is the factor common to each; and in this case there is much in favour of undertaking the simplest and safest operation. The further outlook in the surgery of ischxmic heart-disease is clearly unsettled.
probably disease.
SUCCESSFUL KIDNEY HOMOGRAFT
THE Peter Bent Brigham Hospital, Boston, Mass., has announced what appears to be the first successful kidney homograft in non-identical twins. A man, aged 23, had chronic glomerulonephritis with severe uraemia and hypertension ; his life expectancy was thought to be a matter of days. He was given whole-body irradiation in two doses250r followed eight days later by 200r. No corticoids were given and no bone-marrow graft was attempted. A kidney from his twin brother was transplanted on Jan. 24, and both diseased kidneys were later removed. For a month after the irradiation he was kept in a room sterilised by detergent, with positive-inflow ventilation and an ultraviolet-ray barrier. The patient is now in good health, and.the kidney seems to be functioning well; the bloodpressure is normal, and the blood and urine show no evidence of uraemia or bone-marrow damage. Survival for three months does not prove complete success, for in the past kidney homografts from unrelated persons have functioned for as long as five months before rejection; but none functioned as rapidly or efficiently as in the present case. The donor is thought to be close genetically to the patient (his blood-groups are identical); but he is not an identical twin because his appearance differs, and a skin-graft from the patient to him was rejected. Three factors are thought to have contributed to the success: the genetic closeness (though not identity) of the brothers; the severe uraemia, which depressed immune mechanisms; and the divided doses of radiation, which were enough to depress immune reactions without completely destroying the bone-marrow. Successful kidney transplants in identical twins have previously been reported from the Peter Bent Brigham Hospital 11; but this case, of a successful homograft to a patient not genetically identical with the donor, is
apparently unique. 9.
10. 11.
,
Beck, C. S., Leighninger, D. S., Brofman, B. L., Bond, J. F. J. Amer. med. Ass. 1958, 168, 2110. Blalock, A. Lancet, 1958, i, 1013. Murray, J. E., Merrill, J. P., Harrison, J. H. Ann. Surg. 1958, 148, 343; see Lancet, Jan. 3, 1959, p. 31.
EXPANSION OF CANCER RESEARCH
IN about two years, when its new building in Lincoln’s Inn Fields is ready, the Imperial Cancer Research Fund will be able to expand its work greatly. Prof. G. F. Marrian, F.R.S., who is to take up his full duties as director of research next October, is already making plans for this expansion, in which the laboratories are to be organised in divisions-though in practice, of course, most research problems will need an interdivisional approach. The division of experimental biology and virology has already been established in the Fund’s laboratory at Mill Hill, headed for the past six months by Mr. R. J. C. Harris, PH.D., who was formerly in charge of the Pollard’s Wood division of the Institute of Cancer Research. The division of pathology will be temporarily housed at 48, Lincoln’s Inn Fields, where Dr. A. R. Currie, of Glasgow, will take up his appointment in October. The nucleus of a division of physiology and endocrinology already exists at Mill Hill, and so far as space allows it will be encouraged to enlarge, under the leadership of Mr. P. C. Williams. The division of biochemistry and chemistry, to be established in October under the leadership of Professor Marrian, has a nucleus at the Royal College of Surgeons and will have further accommodation at 48, Lincoln’s Inn Fields until it can move into the new building. Dr. C. C. Spicer, of the Public Health Laboratories at Colindale, is to head a small division of statistics. Dr. James Craigie, F.R.s., having given up his administrative work as director of the Mill Hill laboratories, remains on the research staff of the Fund.
The 56th annual report,! presented on Wednesday, contains a brief account of the work of the clinicopathological research unit at Lincoln’s Inn Fields, written by Prof. Geoffrey Hadfield, its director, in terms readily intelligible to the general reader. This report, illustrated by photographs, is again designed to attract and maintain the interest of the Fund’s lay supporters. At E260,000 the income in the year ended last November, from all sources except legacies of El 000 or more, was nearly E40,000 higher than in the previous year; and about 138,000 was from subscriptions and donations, including charity performances. Legacies, at nearly E280,000, increased by some
E50,000. CARDIAC SURGERY TEAM TO VISIT MOSCOW Mr. W. P. Cleland, Dr. D. G. Melrose, Mr. H. H. Bentall, and four other members of the Postgraduate Medical School of London’s cardiac surgery team have left for Moscow where they are to demonstrate the clinical use of the Melrose heart/lung machine, the technique of elective cessation of the heart-beat, and British methods of open intracardiac surgery. The operations are being undertaken at the invitation of Professor Bakulev, president of the Academy of Medical Sciences of the U.S.S.R., in the Institute of Thoracic Surgery. During their stay in Moscow the British team will be the guests of the Soviet Government. Transport expenses are being met by grants from the British Council, the Nuffield Foundation, the Postgraduate Medical School, and the boards of governors of Hammersmith, King’s College, and the Brompton Hospitals. A Melrose machine has been purchased by the Russian Government for use in Moscow, and will be used during the demonstrations. Anaesthetic equipment and drugs and surgical instruments have been supplied for the demonstrations by British firms. The team expects to spend two or three weeks in Moscow, and some 8 or 10 operations have been planned. Dr. A. C. ALPORT, formerly professor of medicine in the University of Cairo, died in London on April 17 at the age
of 79. 1. From the office of the Fund at the Royal College of Surgeons, Lincoln’s Inn Fields, London, W.C.2.
tion; Thal et al. found segmental blockage in only 2 of their patients, and consequently they believe that endarterectomy is unlikely to succeed. Divergent opinions such as these are difficult to reconcile; but from coronary arteriography, if it proves as trouble-free and informative in other hands, more can be learnt about the lesions in ischaemic heartIf observations elsewhere in the body are a guide, it seems likely that both localised and diffuse disease will be found in individual patients, and call for different operative approaches. While these questions are being settled the Beck operation continues to give good results at Cleveland.99 In 1954-58, 347 patients were operated on with a mortality of 6% overall, and of 2% in the last 200 cases. 295 patients are still alive, and the result is described as excellent or good in no less than 94%-a striking figure. But the follow-up period in many is still short, and the longest is only four years, so the ultimate results in terms of increased survival are still unknown. If, as Blalock 10 has suggested, the results are very similar after different operative procedures, perhaps the production of intercoronary anastomoses is the factor common to each; and in this case there is much in favour of undertaking the simplest and safest operation. The further outlook in the surgery of ischxmic heart-disease is clearly unsettled.
probably disease.
SUCCESSFUL KIDNEY HOMOGRAFT
THE Peter Bent Brigham Hospital, Boston, Mass., has announced what appears to be the first successful kidney homograft in non-identical twins. A man, aged 23, had chronic glomerulonephritis with severe uraemia and hypertension ; his life expectancy was thought to be a matter of days. He was given whole-body irradiation in two doses250r followed eight days later by 200r. No corticoids were given and no bone-marrow graft was attempted. A kidney from his twin brother was transplanted on Jan. 24, and both diseased kidneys were later removed. For a month after the irradiation he was kept in a room sterilised by detergent, with positive-inflow ventilation and an ultraviolet-ray barrier. The patient is now in good health, and.the kidney seems to be functioning well; the bloodpressure is normal, and the blood and urine show no evidence of uraemia or bone-marrow damage. Survival for three months does not prove complete success, for in the past kidney homografts from unrelated persons have functioned for as long as five months before rejection; but none functioned as rapidly or efficiently as in the present case. The donor is thought to be close genetically to the patient (his blood-groups are identical); but he is not an identical twin because his appearance differs, and a skin-graft from the patient to him was rejected. Three factors are thought to have contributed to the success: the genetic closeness (though not identity) of the brothers; the severe uraemia, which depressed immune mechanisms; and the divided doses of radiation, which were enough to depress immune reactions without completely destroying the bone-marrow. Successful kidney transplants in identical twins have previously been reported from the Peter Bent Brigham Hospital 11; but this case, of a successful homograft to a patient not genetically identical with the donor, is
apparently unique. 9.
10. 11.
,
Beck, C. S., Leighninger, D. S., Brofman, B. L., Bond, J. F. J. Amer. med. Ass. 1958, 168, 2110. Blalock, A. Lancet, 1958, i, 1013. Murray, J. E., Merrill, J. P., Harrison, J. H. Ann. Surg. 1958, 148, 343; see Lancet, Jan. 3, 1959, p. 31.
EXPANSION OF CANCER RESEARCH
IN about two years, when its new building in Lincoln’s Inn Fields is ready, the Imperial Cancer Research Fund will be able to expand its work greatly. Prof. G. F. Marrian, F.R.S., who is to take up his full duties as director of research next October, is already making plans for this expansion, in which the laboratories are to be organised in divisions-though in practice, of course, most research problems will need an interdivisional approach. The division of experimental biology and virology has already been established in the Fund’s laboratory at Mill Hill, headed for the past six months by Mr. R. J. C. Harris, PH.D., who was formerly in charge of the Pollard’s Wood division of the Institute of Cancer Research. The division of pathology will be temporarily housed at 48, Lincoln’s Inn Fields, where Dr. A. R. Currie, of Glasgow, will take up his appointment in October. The nucleus of a division of physiology and endocrinology already exists at Mill Hill, and so far as space allows it will be encouraged to enlarge, under the leadership of Mr. P. C. Williams. The division of biochemistry and chemistry, to be established in October under the leadership of Professor Marrian, has a nucleus at the Royal College of Surgeons and will have further accommodation at 48, Lincoln’s Inn Fields until it can move into the new building. Dr. C. C. Spicer, of the Public Health Laboratories at Colindale, is to head a small division of statistics. Dr. James Craigie, F.R.s., having given up his administrative work as director of the Mill Hill laboratories, remains on the research staff of the Fund.
The 56th annual report,! presented on Wednesday, contains a brief account of the work of the clinicopathological research unit at Lincoln’s Inn Fields, written by Prof. Geoffrey Hadfield, its director, in terms readily intelligible to the general reader. This report, illustrated by photographs, is again designed to attract and maintain the interest of the Fund’s lay supporters. At E260,000 the income in the year ended last November, from all sources except legacies of El 000 or more, was nearly E40,000 higher than in the previous year; and about 138,000 was from subscriptions and donations, including charity performances. Legacies, at nearly E280,000, increased by some
E50,000. CARDIAC SURGERY TEAM TO VISIT MOSCOW Mr. W. P. Cleland, Dr. D. G. Melrose, Mr. H. H. Bentall, and four other members of the Postgraduate Medical School of London’s cardiac surgery team have left for Moscow where they are to demonstrate the clinical use of the Melrose heart/lung machine, the technique of elective cessation of the heart-beat, and British methods of open intracardiac surgery. The operations are being undertaken at the invitation of Professor Bakulev, president of the Academy of Medical Sciences of the U.S.S.R., in the Institute of Thoracic Surgery. During their stay in Moscow the British team will be the guests of the Soviet Government. Transport expenses are being met by grants from the British Council, the Nuffield Foundation, the Postgraduate Medical School, and the boards of governors of Hammersmith, King’s College, and the Brompton Hospitals. A Melrose machine has been purchased by the Russian Government for use in Moscow, and will be used during the demonstrations. Anaesthetic equipment and drugs and surgical instruments have been supplied for the demonstrations by British firms. The team expects to spend two or three weeks in Moscow, and some 8 or 10 operations have been planned. Dr. A. C. ALPORT, formerly professor of medicine in the University of Cairo, died in London on April 17 at the age
of 79. 1. From the office of the Fund at the Royal College of Surgeons, Lincoln’s Inn Fields, London, W.C.2.