NUCLEAR PROJECTIONS IN EOSINOPHILS

924 TETRACYCLINE BLOOD-LEVELS

(IN g.

PER

ml. I.S.E.M.)

IN

mg.

8

HEALTHY

q.i.d.

AND

drawn, while the other 4 ate breakfast. Serum-tetracycline activity was determined by the agar-diffusion method with Bacillus cereus var. mycoides (ATCC 9634), using tetracycline was

U.S.P. as the standard. As shown in the accompanying table, adequate levels are obtained with 300 mg. of lymecycline b.d.; in addition there is the advantage of higher peaks of serum-antibiotic activity, after each administration, which are not greatly affected by meals. L. VITARTALI Ospedale Civile di Merate, A. PISANI-CERETTI. Como, Italy.

SUBJECTS AFTER 300 mg. b.d.

mone

from

ORAL ADMINISTRATION OF

(L.H.) was measured by laboratory.2

a

method

LYMECYCLINE, 150

previously reported

our

F.S.H. and L.H. were measured on daily samples in six women, who were admitted to hospital for the study, in control cycles and cycles during which they received norethynodrel 2-5 mg. and mestranol 01mg. daily for 17-25 days beginning on the 2nd day of flow. In a typical normal menstrual cycle plasmaF.S.H. was significantly raised in the first half of the follicular phase, followed by a sharp midcycle peak of lesser magnitude than the L.H. peak; F.S.H. luteal-phase levels were significantly less than follicular levels (fig. 1). Similar results were seen in 21 normal menstrual cycles in the women. F.S.H. values in the control cycle of a second woman and in response to the oral

ORAL CONTRACEPTIVES AND FOLLICLE STIMULATING HORMONE our knowledge, the effects of oral contraceptives plasma-follicle-stimulating-hormone (F.S.H.) levels in women have not been reported, though Stevens et a1.l reported

SiR,ņTo

on

decreased F.S.H. excretion in the urine after ethynodiol diacetate and mestranol. We report here the effects of an oral contraceptive on plasma-levels of F.s.H. measured by a double-antibody method of radioimmunoassay, using ’Reichert 780 ’ pituitary F.S.H. labelled with 131J and rabbit antihuman F.S.H. serum, with the International Reference Preparation, no. 2, of human menopausal gonadotrophin as reference standard. Luteinising hor1. Stevens, V. 14, 327.

C., Vorys, N., Besch, P. K., Barry, R. D. Metabolism, 1965,

Fig. 2-Plasma-F.S.H. in a second woman during a control cycle (on left), and in response to norethynodrel 25 mg. and mestranol 01 mg. daily, beginning on 2nd day of flow (on right).

contraceptive are shown in fig. 2. The early follicular rise and the midcycle peak were obliterated, and all values were comparable to the luteal-phase levels of the control cycle. The same response was seen in all six women receiving the contraceptive. The suppression of plasma-F.s.H. by norethynodrel and mestranol was similar to the previously reported suppression of plasma L.H.3 in the

same women.

Endocrinology Branch, National Cancer Institute, Bethesda, Maryland 20014.

C. M. CARGILLE G. T. Ross.

PROJECTIONS IN EOSINOPHILS SIR,-Nuclear projections (nuclear pockets or blebs) similar NUCLEAR

those described by Epstein and Achong4 have been found in several types of normal and abnormal cells of the blood, lymph-nodes, bone-marrow, and thymus, and in lymphoid, neutrophilic, and monocytic leucocytes-e.g., in thymocytes and Reed-Sternberg cells. It has been suggested that these nuclear features are a physiological structure in all forms of leucocytes,5and they have been described in immature bonemarrow granulocytes from patients on fluorouracil 6 or cytarabine hydrochlorideand from those with untreated pernicious anaemia,6 in peripheral-blood myeloblasts of treated

to

2. Odell, W. D., Ross, G. T., Rayford, P. L. ibid. 1966, 15, 287. 3. Ross, G. T., Odell, W. D., Rayford, P. L. Lancet, 1966, ii, 1255. 4. Epstein, M. A., Achong, B. G. J. natn. Cancer Inst. 1965, 34, 241. 5. Huhn, D. Nature, Lond. 1967, 216, 1240. 6. Stalzer, R. C., Kiely, J. M., Pease, C. L., Brown, A. L., Jr. Cancer,

Fig. 1—F.S.H. (solid line) and L.H. (interrupted line) in plasmasamples taken daily during a normal menstrual cycle in a representative woman.

7.

N.Y., 1965, 18, 1071. Ahearn, M. J., Lewis, C. W., Campbell, L. A. Nature, Lond. 1967, 215, 196.

925

doctors, who be, and who ment

are are

unit free

to

capable and experienced as few others can offering a ready-made research and treatthe Ministry, should be refused. Still more

mystifying is it when one hears that one of the doctors has been accepted for the treatment of addicts in a large teaching hospital in central London. He is a capable person then in one place, but unsuitable in another 3 or 4 miles off. I have seen the Chelsea Centre, and its suitability is simply not in question. The Ministry does not gain respect from anyone, lay or medical, engaged in combating this pest by such inexplicably contradictory behaviour. A. J. HAWES. *** Dr. Chapple and Dr. Gray describe their experience at the centre in an article on p. 908. They add: " The Chelsea Addiction and Research Centre has been financed partly personally and partly through the Salvation Army. No payment is or will be accepted from patients, all of whom are treated under the National Health Service, either as patients on our N.H.S. list or as temporary residents. We have been constituted as a Trust, recognised by the recently Charity Commission, and have two trustees, Sir William Arbuthnot Lane and Mrs. Phyllis Marks, and a qualified accountant who has agreed to be our treasurer. We are very keen to preserve our independence, and individual membership of the Trust is available. Local authortities and private organisations are also encouraged to subscribe. Our research work requires extensive further facilities to be developed. To this end we are planning the setting up of an institute in our area to replace our present accommodation, which is due for redevelopment. The money for this will need to come from private individuals as well as the Ministry of Health and other bodies."-ED. L. ADDICTION NEW STYLE

(p. 852) you discuss the dilemma facing the doctors employed in the new special clinics for addicts. Only two courses, apparently, are open to them; either to take the patient’s word that he is on such and such a dose of heroin (thus giving him the chance to sell his surplus on the black market), or to admit him to hospital. But surely there is a third possibility-namely, that the doctor (or the nurse assisting him) should administer the drug. In what other field of ethical medical practice is the patient expected to give his own intravenous injections ? Even a diabetic, having subcutaneous injections, gets daily visits from the district nurse until she is sure his technique is satisfactory. We know that among the causes of high mortality among heroin addicts are such conditions as bacterial endocarditis, lung abscess, hepatitis, and embolism. Is it ethical to prescribe treatment without provision for preventing such occurrences ? We are asked to regard drug addicts simply as patients with an illness. I entirely agree, but let us, in that case, give them as much care as we would give other patients. In this way we would lift this field of work into the same ethical plane as our other activities, and at the same time obviate the two difficulties vou discuss in vour annotation. W. NORMAN-TAYLOR SIR,-In

Fig. 2-Nuclear projection philic series (x15,600).

in

a

granular leucocyte of the eosino-

and untreated

patients with myelocytic leukaemia,8 in peripheral-blood neutrophils of healthy subjects,59 and in a lymph-node neutrophil from a patient with untreated Hodgkin’s disease.10 Nevertheless,

we do not know of reports of similar in eosinophils. We have found nuclear projections in peripheral-blood cells of the eosinophilic series in a 50-year-old woman with untreated acute 1_eukania. These nuclear features were observed, with the electron microscope, in many poorly differentiated cells, and also in several granular leucocytes (fig. 1). Some of the latter could be classified as eosinophilic because of the fine structure of their cytoplasmic granules (fig. 2). The finding of nuclear projections in eosinophils is another example of the wide diffusion of these structures, and supports the hypothesis of the non-specific nature of these nuclear features, which are possibly due to dynamic changes related to an increase of nucleo-cytoplasmic interactions. Istituto di Anatomia e Istologia Patologica, F. MOLLO Centro di Microscopia Elettronica, Istituto di Patologia Speciale Medica V. PRATO. e Metodologia Clinica, Turin University, Italy.

findings

THE CHELSEA ADDICTION AND RESEARCH CENTRE see in the SIR,-I daily Press that the Ministry of Health has refused to allow Dr. Geoffrey Gray and Dr. P. A. L. Chapple to continue to run the above centre, which all their colleagues engaged in the treatments of addicts know has done such valiant work. It passes the wit of man to understand why these two 8. 9. 10.

Anderson, D. R. J. ultrastruct. Res. 1966, suppl. 9. Smith, G. F., O’Hara, P. T. Nature, Lond. 1967, 215, 773. Mollo, F., Stramignoni, A. Br. J. Cancer, 1967, 21, 519.

your annotation last week

DISULFIRAM IMPLANTATION FOR ALCOHOLISM SiR,ňThis treatment has been used for some years on the Continent, but the reports are somewhat inaccessible, and we believe that

we

are

the first

to

have used it in the United

Kingdom. Unfortunately it gained premature publicity in the lay press, giving rise to excessive claims which we wish to correct.

The treatment consists of the subcutaneous implantation of 8-10 100 mg. tablets of sterile compressed disulfiram, usually under local anxsthesia. The tablets, 8 mm. in diameter x 2 mm. in thickness, are placed 4-5 cm. from the incision. Side-effects are the same as with oral disulfiram but more prolonged; in