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GLUCAGON AND BODY GROWTH IN DWARF MICE
521 These facts make it seem likely that the maturation process of the foetal liver proceeds, from a haematological point of view, in two distinct phases. During the first phase the liver is mainly concerned with the production of a special type of Hb that is particularly well suited for the intrauterine life of the foetus.2During the second phase there is depression of this activity, and through the formation of certain enzyme systems the liver is being prepared for its function of conjugating and excreting the degradation products of Hb. It would seem that cessation of liver hxmatopoiesis is a prerequisite for the proper develcpment of this organ’s bilirubin excretory capacity. This preliminary report indicates that a very high relative proportion of foetal Hb in the blood of the newborn, apparently signifying the persistence of intense hxmatopoiesis in the liver, is associated with excessive neonatal jaundice. This might imply that the determination of this Hb fraction at birth might be used as a measure of the degree of liver maturity in terms of this organ’s capacity to excrete bilirubin. The correlation between the relative proportion and concentration of foetal Hb and neonatal jaundice not caused by blood incompatibility, as well as other implications of this finding, will be published elsewhere. Department of Women’s Diseases,
Karolinska Sjukhuset, and King Gustav V Research Institute, Stockholm 60, Sweden. Sweden.
BRODY. BRODY SAM SAM BRODY.
GLUCAGON AND BODY GROWTH IN DWARF MICE
SIR,-In a previous paper on the relationship between the pancreatic islets and growth I concluded that pancreatic glucagon can stimulate body growth in pituitary dwarf mice.! Further data suppoit this conclusion. Hypopituitary dwarf mice of the Snell strain, 4 weeks old, were treated with glucagon or somatotrophin in standard conditions. In order to avoid the stress of repeated injections, the hormones were incorporated in cholesterol pellets and the pellets implanted under the dorsal skin once weekly.2 Somatotrophin (Armour) or crystalline glucagon (Lilly, lot no. 258-234 B-54-2) were compressed in a pellet-making apparatus with cholesterol in order to obtain small pellets containing 100 g. of either hormone; control cholesterol pellets were prepared without hormones. It was ascertained that a week after the implantation the pellet was completely absorbed. The results are summarised in the xompanying table. EFFECT OF SOMATOTROPHIN AND
GLUCAGON
ON
BODY-WEIGHT
OF
HYPOPITUITARY DWARF MICE
mean per
cent.
variation in parentheses.
From the ’.f..ble it appears that both somatotrophin and glucagon, at the given doses, stimulated the growth of pituitary dwarf mice to about the same extent. Moreover, in comparison with our previous results, it appears that glucagon and, especially, somatotrophin are more active when given in pellets than by injection; this could be due to the repeated stress of injections and/or slower and continuous absorption of the pellets. Institute of Pathological Anatomy, University of Pavia, Italy.
CESARE CAVALLERO. Italy..
1. 2.
Cavallero, C. Ciba Found. Coll. Endocrinl. 1956, 9, 266. Ugrob, J. M., Lyons, W. R., Jordan, C. W., Jr., Li, C. H. Endocrinology, 1957, 61, 477.
STAPHYLOCOCCI IN HOSPITALS SIR,-Dr. Avery Jones (Jan. 24, Feb. 14) has drawn attention to the dirty state of the walls in many hospitals. The problem is especially difficult in the East End of London, since many steam trains traverse the district. The conditions are yet worse after many foggy days,
and especially so when influenza maids and porters.
incapacitates the ward-
of the walls of the of the other offices costs El 500. Even if the money were available (which it is not) to repeat the washing down, the problem would not be solved since the walls so soon get dirty. Washing the walls as far as the maids can reach is no solution and only draws attention to the grime. In the past year we have tried a different method. A short-handled mop impregnated with an oily solution has been used for all the ordinary dusting of the ward furniture; this adsorbs the dust and does not spread it around. A similar mop fixed to a long bamboo cane is now being used to wipe down the walls once a week. It is light and easily wielded by the wardmaid, and the tops of the walls can be reached. By this method, a recently painted or washed wall can be kept clean, but it is not possible to remove the ingrained dirt from a wall which has not been painted for many years. The walls of the long corridor are also wiped down once a week by a porter, and the mop becomes so dirty that it has to be washed at once and reimpregnafed. At the present time the corridor walls are very dirty as a result of the fogs and illness among the porters, but most of the grime will be removed when the influenza epidemic is over. The walls of the ward in which this method was first used were painted in 1956 and washed down in 1957; they are still clean, and the wardmaid takes pride in her work. Great credit is due to the matron, the ward sisters, the domestic supervisor, and the hospital secretary in this attempt to keep clean the walls of a hospital situated in At Bethnal Green
eighteen wards and
a
very
Hospital washing
some
dirty area. GEORGE GRAHAM
London, E.2.
Chairman, Central Group Hospital Management Committee.
PHENACETIN NEPHROPATHY
SiR,—Iam surprised that Dr. J. C. Eaton (Jan. 24) should express himself so strongly on the relative frequency of methxmoglobin and sulphsemoglobin when contradicting the statement in your annotation of Jan. 10 that methasmoglobinasmia is often the first sign of phenacetin intoxication. I know, certain differences between his results and while I worked in the Department of Medicine at my Glasgow Royal Infirmary, although discussed, have never In contrast to Dr. Eaton’s been satisfactorily resolved. observations I found in a smaller series of cases that, following the ingestion of both phenacetin and dapsone, methxmoglobinaemia is much commoner than sulphaemoglobinasmia, and that sulphaemoglobmasmia is rare without concomitant methaemoglobinsemia. Thus, in 20 patients with cyanosis suspected of being due to phenacetin, I found methxmoglobinaemia in 16 and sulphasmoglobinasmia in 4: in no case did sulphaemoglobin occur alone. In 45 tests on 19 patients treated with dapsone 12I found methaemoglobin 36 times and sulphasmoglobin 5 times: in only 2 cases did sulphsemoglobin occur without methaemoglobin. Under the circumstances, and especially in view of Dr. Eaton’s observations on routine blood samples sent to his department, I feel that even the brief report he gave should be accompanied by some reference to the methods used. Equally important is some indication of the anticoagulant used, the conditions of storage, and the delay between withdrawal of the blood and its examination. The in-vitro reduction of methxmoglobin in secondary methxmoglobinaemia is well recognised.3 So far
as
own
1. Alexander, J. O’D. Lancet, 1955, i, 1201. 2.. Alexander, J. O’D. Scot. med. J. 1958, 3, 212. 3. Finch, C. A. New Engl. J. Med. 1948, 239, 470.
Karolinska Sjukhuset, and King Gustav V Research Institute, Stockholm 60, Sweden. Sweden.
BRODY. BRODY SAM SAM BRODY.
GLUCAGON AND BODY GROWTH IN DWARF MICE
SIR,-In a previous paper on the relationship between the pancreatic islets and growth I concluded that pancreatic glucagon can stimulate body growth in pituitary dwarf mice.! Further data suppoit this conclusion. Hypopituitary dwarf mice of the Snell strain, 4 weeks old, were treated with glucagon or somatotrophin in standard conditions. In order to avoid the stress of repeated injections, the hormones were incorporated in cholesterol pellets and the pellets implanted under the dorsal skin once weekly.2 Somatotrophin (Armour) or crystalline glucagon (Lilly, lot no. 258-234 B-54-2) were compressed in a pellet-making apparatus with cholesterol in order to obtain small pellets containing 100 g. of either hormone; control cholesterol pellets were prepared without hormones. It was ascertained that a week after the implantation the pellet was completely absorbed. The results are summarised in the xompanying table. EFFECT OF SOMATOTROPHIN AND
GLUCAGON
ON
BODY-WEIGHT
OF
HYPOPITUITARY DWARF MICE
mean per
cent.
variation in parentheses.
From the ’.f..ble it appears that both somatotrophin and glucagon, at the given doses, stimulated the growth of pituitary dwarf mice to about the same extent. Moreover, in comparison with our previous results, it appears that glucagon and, especially, somatotrophin are more active when given in pellets than by injection; this could be due to the repeated stress of injections and/or slower and continuous absorption of the pellets. Institute of Pathological Anatomy, University of Pavia, Italy.
CESARE CAVALLERO. Italy..
1. 2.
Cavallero, C. Ciba Found. Coll. Endocrinl. 1956, 9, 266. Ugrob, J. M., Lyons, W. R., Jordan, C. W., Jr., Li, C. H. Endocrinology, 1957, 61, 477.
STAPHYLOCOCCI IN HOSPITALS SIR,-Dr. Avery Jones (Jan. 24, Feb. 14) has drawn attention to the dirty state of the walls in many hospitals. The problem is especially difficult in the East End of London, since many steam trains traverse the district. The conditions are yet worse after many foggy days,
and especially so when influenza maids and porters.
incapacitates the ward-
of the walls of the of the other offices costs El 500. Even if the money were available (which it is not) to repeat the washing down, the problem would not be solved since the walls so soon get dirty. Washing the walls as far as the maids can reach is no solution and only draws attention to the grime. In the past year we have tried a different method. A short-handled mop impregnated with an oily solution has been used for all the ordinary dusting of the ward furniture; this adsorbs the dust and does not spread it around. A similar mop fixed to a long bamboo cane is now being used to wipe down the walls once a week. It is light and easily wielded by the wardmaid, and the tops of the walls can be reached. By this method, a recently painted or washed wall can be kept clean, but it is not possible to remove the ingrained dirt from a wall which has not been painted for many years. The walls of the long corridor are also wiped down once a week by a porter, and the mop becomes so dirty that it has to be washed at once and reimpregnafed. At the present time the corridor walls are very dirty as a result of the fogs and illness among the porters, but most of the grime will be removed when the influenza epidemic is over. The walls of the ward in which this method was first used were painted in 1956 and washed down in 1957; they are still clean, and the wardmaid takes pride in her work. Great credit is due to the matron, the ward sisters, the domestic supervisor, and the hospital secretary in this attempt to keep clean the walls of a hospital situated in At Bethnal Green
eighteen wards and
a
very
Hospital washing
some
dirty area. GEORGE GRAHAM
London, E.2.
Chairman, Central Group Hospital Management Committee.
PHENACETIN NEPHROPATHY
SiR,—Iam surprised that Dr. J. C. Eaton (Jan. 24) should express himself so strongly on the relative frequency of methxmoglobin and sulphsemoglobin when contradicting the statement in your annotation of Jan. 10 that methasmoglobinasmia is often the first sign of phenacetin intoxication. I know, certain differences between his results and while I worked in the Department of Medicine at my Glasgow Royal Infirmary, although discussed, have never In contrast to Dr. Eaton’s been satisfactorily resolved. observations I found in a smaller series of cases that, following the ingestion of both phenacetin and dapsone, methxmoglobinaemia is much commoner than sulphaemoglobinasmia, and that sulphaemoglobmasmia is rare without concomitant methaemoglobinsemia. Thus, in 20 patients with cyanosis suspected of being due to phenacetin, I found methxmoglobinaemia in 16 and sulphasmoglobinasmia in 4: in no case did sulphaemoglobin occur alone. In 45 tests on 19 patients treated with dapsone 12I found methaemoglobin 36 times and sulphasmoglobin 5 times: in only 2 cases did sulphsemoglobin occur without methaemoglobin. Under the circumstances, and especially in view of Dr. Eaton’s observations on routine blood samples sent to his department, I feel that even the brief report he gave should be accompanied by some reference to the methods used. Equally important is some indication of the anticoagulant used, the conditions of storage, and the delay between withdrawal of the blood and its examination. The in-vitro reduction of methxmoglobin in secondary methxmoglobinaemia is well recognised.3 So far
as
own
1. Alexander, J. O’D. Lancet, 1955, i, 1201. 2.. Alexander, J. O’D. Scot. med. J. 1958, 3, 212. 3. Finch, C. A. New Engl. J. Med. 1948, 239, 470.